bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence and Severity of Nasal Injuries in Preterm Infants Associated to Non-Invasive Ventilation Using Short Binasal Prong
Authors: Ribeiro Débora de Fátima Camillo , Barros Frieda Saicla , Fernandes Beatriz Luci , Nakato Adriane Muller , Nohama Percy
Published: April 2021

Short binasal prongs can cause skin and mucosal damage in the nostrils of preterm infants. The objective of this study was to investigate the incidence and severity of nasal injuries in preterm infants during the use of short binasal prongs as non-invasive ventilation (NIV) interfaces. A prospective observational study was carried out in the public hospital in a Southern Brazil. The incidence and severity of internal and external nasal injuries were evaluated in 28 preterm infants who required NIV using short binasal prongs for more than 24 hours. In order to identify possible causes of those nasal injuries, the expertise researcher physiotherapist has been carried empirical observations, analyzed the collected data, and correlated them to the literature data. A cause and effect diagram was prepared to present the main causes of the nasal injury occurred in the preterm infants assessed. The incidence of external nasal injuries was 67.86%, and internal ones 71.43%. The external nasal injuries were classified as Stage I (68.42%) and Stage II (31.58%). All the internal injuries had Stage II. The cause and effect diagram was organized into 5 categories containing 17 secondary causes of nasal injuries. There was a high incidence of Stage II-internal nasal injury and Stage I-external nasal injury in preterm infants submitted to NIV using prongs. The injuries genesis can be related to intrinsic characteristics of materials, health care, neonatal conditions, professional competence, and equipment issues.
A Case Report of College Students’ Rating of a Shared Decision-Making Tool for Taking Antidepression Medication
Authors: Reis Janet
Published: April 2021

Forty-nine students enrolled at a medium size public university volunteered to review an interactive decision-making tool constructed to present the pros and cons of taking antidepression medication. The tool is built according to guidelines for shared decision-making with 7 educational sections followed by 4 queries on expectations about antidepressants, 3 key knowledge questions, and determination of readiness to take action. The most frequently cited reason for the content being helpful was improved understanding (78%) followed by increased personal confidence (37%) and helped me take action (14%). The most frequently cited reason for the content not being more helpful was already known information (74%) followed by not enough information (12%). The range of personal preferences underscores the complexity of motivations in responding to depressive symptoms. The prevalence of depression in the college population with a range of treatment options, limitations on resources, and new challenges mounted with the pandemic for campus life recommends further study of such tools.
Engaging Women With Lived Experience: A Novel Cross-Canada Approach
Authors: Teed Moira , Ianiro Julia , Culhane Cynthia , Monaghan Jennifer , Takacs Judit , Arthur Gavin , Nash Amanda
Published: April 2021

Women with heart disease, stroke, and vascular cognitive impairment (VCI) experience gender inequities across the health care continuum. The Heart and Stroke Foundation of Canada conducted needs assessment to inform its approach in addressing health inequities experienced by women with heart disease, stroke, and VCI across the continuum of care. Although specific input is confidential, this article outlines the engagement methods used and the evaluation results. The 3-stage engagement process consisted of an internal content review, 18 in-person discussion groups via a cross-Canada tour, 14 expert interviews, and a collaboration session. In total, 204 and 57 participants were recruited for the cross-Canada tour and collaboration session, respectively. Using the Public and Patient Engagement Evaluation Tool, participants scored the engagement processes positively and found participation to be a valuable use of their time. This undertaking highlighted aspects to consider when engaging people with lived experience and how engagement can support the recovery journey. Insights presented throughout this article can help inform future research that seeks to engage stakeholders at a national level.
Gender Differences in Service Quality of Upazila Health Complex in Bangladesh
Authors: Rumi Maruf Hasan , Makhdum Niaz , Rashid Md. Harunur , Muyeed Abdul
Published: April 2021

The gender-based differences in satisfaction on the service quality of the Upazila Health Complex (UHC) in Bangladesh are assessed in this paper using the SERVQUAL model. Two Upazila, field administrative unit of Bangladesh, of Meherpur district of Bangladesh, were selected to conduct the study. The study used a quantitative approach, primarily using the survey method. The research found that the perception of male and female on service quality of UHC varies significantly. Though they have a similar perception of reliability dimension, females still have a comparatively more positive perception of accessibility, tangibles, empathy, and responsiveness dimensions to UHC than male service receivers. The regression result showed that responsiveness is the key factor to bring satisfaction in service, while empathy and accessibility moderately influence service receivers’ satisfaction. The findings will be useful for policymakers, public health stakeholders, earnest learners, practitioners, and academia.
Validation of a Patient Questionnaire Assessing Patient Satisfaction With Orthopedic Outpatient Clinic Consultation
Authors: Waters Stuart , Edmondston Stephen , Gucciardi Daniel F.
Published: April 2021

Previous qualitative research has identified a number of factors which influence patient satisfaction with orthopedic outpatient clinic visits. To further evaluate these factors, the authors initially generated a number of items or statements representing these factors. This cohort of items was then subjected to analysis by an expert group to assess which 3 items best represented each factor. These items formed the basis of a draft survey which was then administered to 323 orthopedic outpatients to assess these factors as characteristics of patient satisfaction. Items and factors were also assessed against 2 global measures of patient satisfaction. One hundred and one survey responses were returned and subjected to factorial analysis. Results indicated that factors of trust, empathy, and relatedness were not distinguishable and subsequently combined to represent a single factor, the therapeutic relationship. A final 5-factor model is proposed incorporating 3 interpersonal factors (communication, expectation, therapeutic relationship) and 2 environmental factors (clinic wait time, clinical contact time). The factors identified by this study should be considered in surveys evaluating patient satisfaction with orthopedic outpatient services.
The Pandemic Penalty: The Gendered Effects of COVID-19 on Scientific Productivity
Authors: King Molly M. , Frederickson Megan E.
Published: April 2021

Academia serves as a valuable case for studying the effects of social forces on workplace productivity, using a concrete measure of output: scholarly papers. Many academics, especially women, have experienced unprecedented challenges to scholarly productivity during the coronavirus disease 2019 (COVID-19) pandemic. The authors analyze the gender composition of more than 450,000 authorships in the arXiv and bioRxiv scholarly preprint repositories from before and during the COVID-19 pandemic. This analysis reveals that the underrepresentation of women scientists in the last authorship position necessary for retention and promotion in the sciences is growing more inequitable. The authors find differences between the arXiv and bioRxiv repositories in how gender affects first, middle, and sole authorship submission rates before and during the pandemic. A review of existing research and theory outlines potential mechanisms underlying this widening gender gap in productivity during COVID-19. The authors aggregate recommendations for institutional change that could ameliorate challenges to women’s productivity during the pandemic and beyond.
Evaluation of Risk Factors of Cardiovascular Diseases in Shimoga Population
Authors: Parameshwara S. , Manjula B. , Bhaktha Geetha , Gurupadappa K. , Ranjith Kumar G.K.
Published: April 2021

Background:

The morbidity and mortality rate is increasing due to cardiovascular disease around the globe. This may be due to drastic changes in lifestyle, food habits, work, stress, genetic factors, and environmental conditions. The present study is undertaken to evaluate the risk factors of cardiovascular disease (CVD) in Shimoga region.

Objective:

Evaluation of risk factors of CVD in patients who admitted for treatment in McGann Teaching District Hospital, Shimoga.

Methods:

A retrospective study was conducted in Mc Gann's Teaching District Hospital, Shimoga from October 2017 to March 2018. Data about sociodemographic parameters such as age, sex, height, weight, smoking, the status of diabetes mellitus, type of occupation, and diet, tobacco, and alcohol consumption were retrieved from the medical record section and statistical analysis was done using Statistical Package for the Social Sciences (SPSS).

Results:

Out of 262 CVD cases, 60% were male and 40% were female. Based on the body mass index (BMI), 1.9% were underweight, 40.1% were normal, 34.4% were overweight, and 23.7% were obese. Sedentary (64.9%) lifestyle was significantly higher when compared to moderate (2.3%) and heavy (32.8%). Diabetes, smoking, tobacco, and alcohol consumption were seen to be significant while food custom was not significant among the study population ( P < .05).

Conclusion:

In our study, a higher percentage of CVD patients falls under normal BMI when compared to other studies. This may be due to lifestyle, socioeconomic status, ethnicity, and family heredity. Further extensive studies should be carried out to find the main cause of CVD in Shimoga population.
U-type mechanical clamping to anchor the CFRP composites in strengthening of RC beams subjected to bending
Authors: Letcham K , Vincent P
Published: April 2021

The present study investigates the performance of U-type clamp anchorage on external strengthening of reinforced concrete beams using carbon fibre-reinforced polymer composites. Unidirectional carbon fibre was used to strengthen the beam having a cross-section of 150 × 200 mm2 and the fabricated U-type clamp was used as a clamping device to enhance the fibre-reinforced polymer (FRP) bonding. To test the beam, four-point bending system was adopted and the experimental parameters were the number of FRP layers. The failure mode of strengthened beams with U-type clamp was very similar (rupture of FRP composites) to the beams without U-type clamp. However, the delamination of FRP was evaded by counteracting the peeling stress development at the edge of fibre. Since the beams strengthened with U-type clamp exhibited more linear behaviour than that of the beams strengthened without U-type clamp, there may be a higher possibility for abrupt/rapid/brittle mode of failure and the ductility index of the beam with U-type clamp confirmed the above behaviour. However, the introduction of U-type clamp enhanced the flexural stiffness and ultimate strength by counteracting the debonding, and the beam with U-type clamp exhibited a maximum of 58.33% and 20.37% enhancement in flexural stiffness and ultimate strength than that of the beam without U-type clamp, respectively. The theoretical strength value of all strengthened beams was evaluated using models proposed in the previous research and compared with experimental results. It is inferred that the use of U-type clamp in FRP strengthening provides economic and structural benefits compared to a beam without U-type clamp.
Endoscopic Repair of the Proximal Hamstring
Authors: DeFroda Steven F. , Kester Benjamin S. , Newhouse Alexander C. , Wichman Daniel M. , Suppaiksorn Sunikom , Nho Shane J.
Published: April 2021

Background:

Proximal hamstring injuries are increasingly common. While open repair with suture anchors placed in the ischial tuberosity has long been the gold standard technique for surgical management, endoscopic techniques can allow for smaller incisions, reduced wound complications, and an expedited recovery.

Indications:

Patients with full-thickness 3-tendon proximal hamstring tears, 2-tendon tears with retraction >2 cm, or partial tears that remain symptomatic despite conservative management are considered for surgery. High-demand patients are often treated acutely, and low-demand patients may be offered surgery after a conservative management period.

Technique Description:

In the prone position, 2 arthroscopic portals are created in the gluteal fold. Fluoroscopy is used to verify safe portal placement, and the sciatic nerve is visualized along with the retracted tendon origin. The ischial tuberosity is identified, and the hamstring origin is debrided and decorticated. An accessory portal is created for suture anchor placement. Two double-loaded anchors are placed in the tuberosity, the sutures of which are used to repair the hamstring tendons using a horizontal mattress configuration. Patients undergo a stepwise postoperative physical therapy protocol.

Results:

An 85% return to sport rate can be expected following all hamstring repairs, with some studies reporting as high as 95% after endoscopic repair. Compared with nonoperative treatment, proximal hamstring repair overall results in higher patient satisfaction and return to sport. While large studies have yet to report on outcomes compared with the traditional open technique, the smaller incisions look to reduce wound complications and postoperative pain.

Discussion/Conclusion:

Recent advancements in endoscopic techniques have allowed for adequate visualization and robust repair of proximal hamstring avulsions. We present our endoscopic technique of the proximal hamstring, which, compared with the traditional open repair, can decrease perioperative complications and accelerate recovery.
Using Alternative Bibliometric Indices to Characterize High-Impact Articles Published in the Field of Facial Plastic Surgery
Authors: Miller Ryan J. , Costeloe Anya , Peleman John , Johnson Jared , Chung Michael T. , Rayess Hani , Zuliani Giancarlo F.
Published: April 2021

Background: Conventional measures of scholarly impact derived from citation count do not account for academic readership and do not measure impact on the nonacademic audience (ie, the general population that does not engage in scholarship). To more broadly characterize attention received by research articles, alternative measures have been developed, including Mendeley readership and Altmetric Attention scores. Together, these metrics reflect academic readership and the effects of research in mainstream media. Characterizing articles that score highly according to these alternative measures is of interest to facial plastic surgeons, especially those who aim to disseminate their work to broad audiences. Objectives: To identify characteristics of facial plastic surgery articles associated with increased attention from both academic and nonacademic audiences. Methods: The top 50 most-cited articles with a facial plastics focus published since 2009 were categorized according to various themes. Article attention was assessed using conventional and alternative bibliometric indices. Pearson correlation matrix assessed associations between indices. Rank order congruence between indices was also assessed. MANOVAs assessed the overall effect of article theme on scholarly impact. Multiple one-way ANOVAs assessed effect of theme on individual indices. Results: Citation count, Mendeley readership, and Altmetric mentions all showed significant positive correlation with citations per year ( P < .05, P < .01, P < .01, respectively). Citations/year was most congruent with total citations (50% congruence). Articles focused on “lower face” received significantly more Mendeley readership than those focused on “head and neck” ( P = .009). Articles focused on “cosmetics” had significantly more citations/year ( P = .018) and Altmetric mentions ( P = .015) than those focused on “reconstruction.” Conclusion: The facial plastic research articles that received the most attention from both academic and nonacademic audiences were those focused on cosmetics. Additionally, articles pertaining to the lower face received more academic attention than those pertaining to head and neck.
Fatigue Resistance and Failure Behavior of Penetration and Non-Penetration Laser Welded Lap Joints
Authors: Guo Xiangzhong , Liu Wei , Li Xiqing , Shi Haowen , Song Zhikun
Published: April 2021

Penetration and non-penetration lap laser welding is the joining method for assembling side facade panels of railway passenger cars, while their fatigue performances and the difference between them are not completely understood. In this study, the fatigue resistance and failure behavior of penetration 1.5+0.8-P and non-penetration 0.8+1.5-N laser welded lap joints prepared with 0.8 mm and 1.5 mm cold-rolled 301L plates were investigated. The weld beads showed a solidification microstructure of primary ferrite with good thermal cracking resistance, and their hardness was lower than that of the plates. The 1.5+0.8-P joint exhibited better fatigue resistance to low stress amplitudes, whereas the 0.8+1.5-N joint showed greater resistance to high stress amplitudes. The failure modes of 0.8+1.5-N and 1.5+0.8-P joints were 1.5 mm and 0.8 mm lower lap plate fracture, respectively, and the primary cracks were initiated at welding fusion lines on the lap surface. There were long plastic ribs on the penetration plate fracture, but not on the non-penetration plate fracture. The fatigue resistance stresses in the crack initiation area of the penetration and non-penetration plates calculated based on the mean fatigue limits are 408 MPa and 326 MPa, respectively, which can be used as reference stress for the fatigue design of the laser welded structures. The main reason for the difference in fatigue performance between the two laser welded joints was that the asymmetrical heating in the non-penetration plate thickness resulted in higher residual stress near the welding fusion line.
Association of cyclin-dependent kinase inhibitor 2B antisense RNA 1 gene expression and rs2383207 variant with breast cancer risk and survival
Authors: Kattan Shahad W. , Hobani Yahya H. , Shaheen Sameerah , Mokhtar Sara H. , Hussein Mohammad H. , Toraih Eman A. , Fawzy Manal S. , Abdalla Hussein Abdelaziz
Published: April 2021

Background

The expression signature of deregulated long non-coding RNAs (lncRNAs) and related genetic variants is implicated in every stage of tumorigenesis, progression, and recurrence. This study aimed to explore the association of lncRNA cyclin-dependent kinase inhibitor 2B antisense RNA 1 (CDKN2B-AS1) gene expression and the rs2383207A>G intronic variant with breast cancer (BC) risk and prognosis and to verify the molecular role and networks of this lncRNA in BC by bioinformatics gene analysis.

Methods

Serum CDKN2B-AS1 relative expression and rs2383207 genotypes were determined in 214 unrelated women (104 primary BC and 110 controls) using real-time PCR. Sixteen BC studies from The Cancer Genome Atlas (TCGA) including 8925 patients were also retrieved for validation of results.

Results

CDKN2B-AS1 serum levels were upregulated in the BC patients relative to controls. A/A genotype carriers were three times more likely to develop BC under homozygous (OR = 3.27, 95% CI 1.20–8.88, P = 0.044) and recessive (OR = 3.17, 95% CI 1.20–8.34, P = 0.013) models. G/G homozygous patients had a higher expression level [median and quartile values were 3.14 (1.52–4.25)] than A/G [1.42 (0.93–2.35)] and A/A [1.62 (1.33–2.51)] cohorts (P = 0.006). The Kaplan–Meier curve also revealed a higher mean survival duration of G/G cohorts (20.6 months) compared to their counterparts (A/A: 15.8 and A/G: 17.2 months) (P < 0.001). Consistently, BC data sets revealed better survival in cohorts with high expression levels (P = 0.003). Principal component analysis (PCA) showed a deviation of patients who had shorter survival towards A/A and A/G genotypes, multiple lesions, advanced stage, lymphovascular invasion, and HER2+ receptor staining. Ingenuity Pathway Analysis (IPA) showed key genes highly enriched in BC with CDKN2B-AS1.

Conclusions

The findings support the putative role of CDKN2B-AS1 as an epigenetic marker in BC and open a new avenue for its potential use as a therapeutic molecular target in this type of cancer.
Use of sodium bicarbonate in out-of-hospital cardiac arrest: a systematic review and meta-analysis
Authors: Alshahrani Mohammed S. , Aldandan Hassan W.
Published: April 2021

Background

Out-of-hospital cardiac arrest (OHCA) is a common cause of death worldwide (Neumar et al., Circulation 122:S729–S767, 2010), affecting about 300,000 persons in the USA on an annual basis; 92% of them die (Roger et al., Circulation 123:e18–e209, 2011). The existing evidence about the use of sodium bicarbonate (SB) for the treatment of cardiac arrest is controversial. We performed this study to summarize the evidence about the use of SB in patients with out-of-hospital cardiac arrest (OHCA).

Methods

We searched PubMed, Scopus, EBSCO, Web of Science, and Cochrane Library, until June 2019, for randomized controlled trials (RCTs) and observational studies that used SB in patients with OHCA. Outcomes of interest were the rate of survival to discharge, return of spontaneous circulation (ROSC), sustained ROSC, and good neurological outcomes at discharge. Odds ratio (OR) with their 95% confidence interval (CI) were pooled in a random or fixed meta-analysis model.

Results

A total of 14 studies (four RCTs and 10 observational studies) enrolling 28,412 patients were included; of them, eight studies were included in the meta-analysis. The overall pooled estimate did not favor SB or control in terms of survival rate at discharge (OR= 0.66, 95% CI [0.18, 2.44], p=0.53) and ROSC rate (OR= 1.54, 95% CI [0.38, 6.27], p=0.54), while the pooled estimate of two studies showed that SB was associated with less sustained ROSC (OR= 0.27, 95% CI [0.07, 0.98], p=0.045) and good neurological outcomes at discharge (OR= 0.12, 95% CI [0.09, 0.15], p<0.01).

Conclusion

The current evidence demonstrated that SB was not superior to the control group in terms of survival to discharge and return of spontaneous circulation. Further, SB was associated with lower rates of sustained ROSC and good neurological outcomes.
Identification and Pyramiding of QTLs for Rice Grain Size Based on Short-Wide Grain CSSL-Z563 and Fine-Mapping of qGL3–2
Authors: Liang Peixuan , Wang Hui , Zhang Qiuli , Zhou Kai , Li Miaomiao , Li Ruxiang , Xiang Siqian , Zhang Ting , Ling Yinghua , Yang Zhenglin , He Guanghua , Zhao Fangming
Published: April 2021

Background

Chromosome segment substitution lines (CSSLs) can be used to dissect complex traits, from which single-segment substitution lines (SSSLs) containing a target quantitative trait loci (QTL) can be developed, and they are thus important for functional analysis and molecular breeding.

Results

A rice line with short wide grains, CSSL-Z563, was isolated from advanced-generation backcross population (BC3F6) derived from ‘Xihui 18’ (the recipient parent) and ‘Huhan 3’ (the donor parent). Z563 carried seven segments from ‘Huhan 3’, distributed on chromosomes 3, 7, and 8, with average substitution length of 5.52 Mb. Eleven QTLs for grain size were identified using secondary F2 population of ‘Xihui 18’/Z563. The QTLs qGL3–1, qGL3–2, and qGL7 control grain length in Z563 and have additive effects to reduce grain length; qGW3–1 and qGW3–2 control grain width in Z563 and have additive effects to increase grain width. Four SSSLs, three double-segment substitution lines (D1–D3), and two triple-segment substitution lines (T1 and T2) were developed containing the target QTLs. The genetic stability of eight QTLs, including qGL3–2, qGL3–1, and qGL7, was verified by the SSSLs. D1 (containing qGL3–2 and qGL3–1), D2 (qGL3–1 and qGL7), and T1 (qGL3–2, qGL3–1, and qGL7) had positive epistatic effects on grain length, and their grain length was shorter than that of the corresponding SSSLs. The QTL qGL3–2 was fine-mapped to a 696 Kb region of chromosome 3 containing five candidate genes that differed between ‘Xihui 18’ and Z563. These results are important for functional research on qGL3–2 and molecular breeding of hybrid rice cultivars.

Conclusions

The short and wide grain of Z563 was mainly controlled by qGL3–1, qGL3–2, qGL7, qGW3–1 and qGW3–2. The major QTL qGL3–2 was fine-mapped to a 696 Kb region of chromosome 3 containing five candidate genes. Different QTLs pyramiding displayed various phenotypes. In essence, the performance after pyramiding of genes depended on the comparison between the algebraic sum of the additive and epistatic effects of QTLs in the pyramidal line and the additive effect value of the single QTL. The results lay good foundation in the functional analysis of qGL3–2 and molecular design breeding of novel hybrid rice cultivars.
An efficient ensemble method for missing value imputation in microarray gene expression data
Authors: Zhu Xinshan , Wang Jiayu , Sun Biao , Ren Chao , Yang Ting , Ding Jie
Published: April 2021

Background

The genomics data analysis has been widely used to study disease genes and drug targets. However, the existence of missing values in genomics datasets poses a significant problem, which severely hinders the use of genomics data. Current imputation methods based on a single learner often explores less known genomic data information for imputation and thus causes the imputation performance loss.

Results

In this study, multiple single imputation methods are combined into an imputation method by ensemble learning. In the ensemble method, the bootstrap sampling is applied for predictions of missing values by each component method, and these predictions are weighted and summed to produce the final prediction. The optimal weights are learned from known gene data in the sense of minimizing a cost function about the imputation error. And the expression of the optimal weights is derived in closed form. Additionally, the performance of the ensemble method is analytically investigated, in terms of the sum of squared regression errors. The proposed method is simulated on several typical genomic datasets and compared with the state-of-the-art imputation methods at different noise levels, sample sizes and data missing rates. Experimental results show that the proposed method achieves the improved imputation performance in terms of the imputation accuracy, robustness and generalization.

Conclusion

The ensemble method possesses the superior imputation performance since it can make use of known data information more efficiently for missing data imputation by integrating diverse imputation methods and learning the integration weights in a data-driven way.
Streamlining differential exon and 3′ UTR usage with diffUTR
Authors: Gerber Stefan , Schratt Gerhard , Germain Pierre-Luc
Published: April 2021

Background

Despite the importance of alternative poly-adenylation and 3′ UTR length for a variety of biological phenomena, there are limited means of detecting UTR changes from standard transcriptomic data.

Results

We present the diffUTR Bioconductor package which streamlines and improves upon differential exon usage (DEU) analyses, and leverages existing DEU tools and alternative poly-adenylation site databases to enable differential 3′ UTR usage analysis. We demonstrate the diffUTR features and show that it is more flexible and more accurate than state-of-the-art alternatives, both in simulations and in real data.

Conclusions

diffUTR enables differential 3′ UTR analysis and more generally facilitates DEU and the exploration of their results.
Phenology-mediated effects of phenotype on the probability of social polygyny and its fitness consequences in a migratory passerine
Authors: Canal David , Schlicht Lotte , Santoro Simone , Camacho Carlos , Martínez-Padilla Jesús , Potti Jaime
Published: April 2021

Why females engage in social polygyny remains an unresolved question in species where the resources provided by males maximize female fitness. In these systems, the ability of males to access several females, as well as the willingness of females to mate with an already mated male, and the benefits of this choice, may be constrained by the socio-ecological factors experienced at the local scale. Here, we used a 19-year dataset from an individual-monitored population of pied flycatchers (Ficedula hypoleuca) to establish local networks of breeding pairs. Then, we examined whether the probability of becoming socially polygynous and of mating with an already mated male (thus becoming a secondary female) is influenced by morphological and sexual traits as proxies of individual quality relative to the neighbours. We also evaluated whether social polygyny is adaptive for females by examining the effect of females’ mating status (polygamously-mated vs monogamously-mated) on direct (number of recruits in a given season) and indirect (lifetime number of fledglings produced by these recruits) fitness benefits. The phenotypic quality of individuals, by influencing their breeding asynchrony relative to their neighbours, mediated the probability of being involved in a polygynous event. Individuals in middle-age (2–3 years), with large wings and, in the case of males, with conspicuous sexual traits, started to breed earlier than their neighbours. By breeding locally early, males increased their chances of becoming polygynous, while females reduced their chances of mating with an already mated male. Our results suggest that secondary females may compensate the fitness costs, if any, of sharing a mate, since their number of descendants did not differ from monogamous females. We emphasize the need of accounting for local breeding settings (ecological, social, spatial, and temporal) and the phenotypic composition of neighbours to understand individual mating decisions.
Factors affecting the rapid changes of protein under short-term heat stress
Authors: Wu Bingjin , Qiao Jianwen , Wang Xiaoming , Liu Manshuang , Xu Shengbao , Sun Daojie
Published: April 2021

Background

Protein content determines the state of cells. The variation in protein abundance is crucial when organisms are in the early stages of heat stress, but the reasons affecting their changes are largely unknown.

Results

We quantified 47,535 mRNAs and 3742 proteins in the filling grains of wheat in two different thermal environments. The impact of mRNA abundance and sequence features involved in protein translation and degradation on protein expression was evaluated by regression analysis. Transcription, codon usage and amino acid frequency were the main drivers of changes in protein expression under heat stress, and their combined contribution explains 58.2 and 66.4% of the protein variation at 30 and 40 °C (20 °C as control), respectively. Transcription contributes more to alterations in protein content at 40 °C (31%) than at 30 °C (6%). Furthermore, the usage of codon AAG may be closely related to the rapid alteration of proteins under heat stress. The contributions of AAG were 24 and 13% at 30 and 40 °C, respectively.

Conclusion

In this study, we analyzed the factors affecting the changes in protein expression in the early stage of heat stress and evaluated their influence.
mRNA-Seq reveals the quorum sensing system luxS gene contributes to the environmental fitness of Streptococcus suis type 2
Authors: Li Jinpeng , Wang Yuxin , Du Yanbin , Zhang Hui , Fan Qingying , Sun Liyun , Yi Li , Wang Shaohui , Wang Yang
Published: April 2021

Background

Streptococcus suis type2 (SS2) is an important zoonotic pathogen. We have previously reported the structure of LuxS protein and found that theluxSgene is closely related to biofilm, virulence gene expression and drug resistance of SS2. However, the mechanism ofluxSmediated SS2 stress response is unclear. Therefore, this experiment performed stress response toluxSmutant (ΔluxS) and complement strain (CΔluxS), overexpression strain (luxS+) and wild-type SS2 strain HA9801, and analyzed the differential phenotypes in combination with transcriptome data.

Results

The results indicate that theluxSgene deletion causes a wide range of phenotypic changes, including chain length. RNA sequencing identified 278 lx-regulated genes, of which 179 were up-regulated and 99 were down-regulated. Differential genes focus on bacterial growth, stress response, metabolic mechanisms and drug tolerance. Multiple mitotic genes were down-regulated; while the ABC transporter system genes, cobalamin /Fe3+-iron carrier ABC transporter ATPase and oxidative stress regulators were up-regulated. The inactivation of theluxSgene caused a significant reduction in the growth and survival in the acid (pH = 3.0, 4.0, 5.0) and iron (100 mM iron chelator 2,2′-dipyridyl) stress environments. However, the mutant strain ΔluxSshowed increased antioxidant activity to H2O2(58.8 mmol/L).

Conclusions

TheluxSgene in SS2 appears to play roles in iron metabolism and protective responses to acidic and oxidative environmental conditions.
Successful double-layer metal stents rotational ablation under 2-dimensional and 3-dimensional optical coherence tomography guidance: a case report
Authors: Yaliang Tong , Guohui Liu , Cheng Zhang , Beibei Du , Yanan Zhao , Yuquan He , Ping Yang
Published: April 2021

Background

Stent ablation with rotational atherectomy has been considered a bail-out strategy for the treatment of severe stent underexpansion. Only a few reports have yet shown rotational ablation for double-layer metal struts.

Case presentation

We present a case of 80-year-old female patient presented to our hospital because of worsening effort angina. Coronary angiography revealed severe in-stent restenosis in the proximal left anterior descending artery. Optical coherence tomography (OCT) examinations found that severe stenosis occurred at the overlap region with 2-layer underexpanded stents and circumferential calcification beneath them. Under the guidance of 2-dimensional (2D) and 3-dimensional (3D) OCT, we successfully performed percutaneous coronary intervention (PCI) of this lesion after adequate stent ablation, high-pressure balloon dilatation, and subsequent everolimus-eluting stent implantation. The patient recovered well uneventfully and discharged from hospital 7 days later. No restenosis occurred after 12 months.

Conclusions

We report a very rare case of in-stent restenosis due to double-layer underexpanded stents. The entire percutaneous coronary intervention procedure was performed step by step under the guidance of high-resolution OCT. Our findings highlight the specific value of 2D and 3D OCT guidance in double-layer stents rotational ablation.
A rare cause of sudden unexpected death syndrome (SUDS) in the first year of life: endomyocardial fibroelastosis (EFE) due to two compound heterozygous MYBPC3 mutations
Authors: Hartung Benno , Tank Anne , Dittmann Sven , Ritz-Timme Stefanie , Schulze-Bahr Eric
Published: April 2021

Background

Autopsies regularly aim to clarify the cause of death; however, relatives may directly benefit from autopsy results in the setting of heritable traits (“mortui vivos docent”).

Case presentation

A case of a sudden unexpected cardiac death of a 5.5-months-old child is presented. Autopsy and thorough postmortem cardiac examinations revealed a massively enlarged heart with endomyocardial fibroelastosis. Postmortem molecular testing (molecular autopsy) revealed an unusual combination of two biparental MYBPC3 gene mutations likely to underlie the cardiac abnormalities. Thus, the molecular autoptic findings also had consequences for the relatives of the deceased child and impact on further family planning.

Conclusions

The presented case highlights the need for clinical autopsies including cardiac examinations and postmortem molecular testing; it also paves the way for further cascade screening of family members for cardiac disease, if a distinct genetic disorder is suspected.
Relationship between body composition and the histology of non‐alcoholic fatty liver disease: a cross‐sectional study
Authors: Miyake Teruki , Miyazaki Masumi , Yoshida Osamu , Kanzaki Sayaka , Nakaguchi Hironobu , Nakamura Yoshiko , Watanabe Takao , Yamamoto Yasunori , Koizumi Yohei , Tokumoto Yoshio , Hirooka Masashi , Furukawa Shinya , Takeshita Eiji , Kumagi Teru , Ikeda Yoshio , Abe Masanori , Toshimitsu Kumiko , Matsuura Bunzo , Hiasa Yoichi
Published: April 2021

Background

Causes of non-alcoholic fatty liver disease and its progression include visceral fat accumulation and loss of muscle mass; however, which of the two phenomena is more critical is unclear. Therefore, we intended to examine the relationship between body composition and non-alcoholic fatty liver disease progression as indicated by fibrosis and the non-alcoholic fatty liver disease activity score.

Methods

This cross-sectional study comprised 149 patients (55 men; age, 20–76 years) treated for non-alcoholic fatty liver disease between December 2010 and January 2020. Body composition measurements, histological examinations of liver samples, and comprehensive blood chemistry tests were performed. The relationship between body composition and non-alcoholic fatty liver disease histology findings was analyzed using the logistic regression model.

Results

Fibrosis was significantly and inversely correlated with muscle mass and appendicular skeletal muscle mass and significantly and positively correlated with fat mass, fat mass/height squared, visceral fat area, and waist-hip ratio (P < 0.05). After adjustment for sex, blood chemistry measurements, and body composition indices, fibrosis remained associated with appendicular skeletal muscle mass, fat mass, fat mass/height squared, and visceral fat area (P < 0.05). Non-alcoholic fatty liver disease activity score ≥ 5 significantly correlated with fat mass and fat mass/height squared in a univariate but not multivariate analysis.

Conclusions

Fibrosis in non-alcoholic fatty liver disease, an indicator of unfavorable long-term outcomes, is associated with more indices of fat mass than of those of muscle mass. Hence, fat mass should be controlled to prevent non-alcoholic fatty liver disease progression.
Successful treatment of infantile oxysterol 7α-hydroxylase deficiency with oral chenodeoxycholic acid
Authors: Tang Yun-Ping , Gong Jing-Yu , Setchell Kenneth D. R. , Zhang Wujuan , Zhao Jing , Wang Jian-She
Published: April 2021

Background

Deficiency of oxysterol 7α-hydroxylase, encoded by CYP7B1, is associated with fatal infantile progressive intrahepatic cholestasis and hereditary spastic paraplegia type 5. Most reported patients with CYP7B1 mutations presenting with liver disease in infancy have died of liver failure. However, it was recently reported that two patients treated with chenodeoxycholic acid survived. Correlations between the phenotype and genotype of CYP7B1 deficiency have not been clearly established.

Case presentation

A 5-month-7-day-old Chinese baby from non-consanguineous parents was referred for progressive cholestasis and prolonged prothrombin time from one month of age. Genetic testing revealed compound heterozygous mutations c.187C > T(p.R63X)/c.334C > T(p.R112X) in CYP7B1, and fast atom bombardment mass spectrometry analysis of the urinary bile acid confirmed the presence of atypical hepatotoxic 3β-hydroxy-Δ5-bile acids. While awaiting liver transplantation she was orally administered chenodeoxycholic acid. Her liver function rapidly improved, urine atypical bile acids normalized, and she thrived well until the last follow-up at 23 months of age. Her 15-year-old brother, with no history of infantile cholestasis but harboring the same mutations in CYP7B1, had gait abnormality from 13 years of age. Neurological examination revealed hyper-reflexia and spasticity of the lower limbs. Brain MRI revealed enlarged perivascular space in the bilateral basal ganglia and white matter of frontal parietal.

Conclusions

In summary, these findings highlight that the phenotype of CYP7B1 deficiency varies widely, even in siblings and that early administration of chenodeoxycholic acid may improve prognosis.
Clinicopathological and prognostic evaluations of anorectal cancer after fecal diversion for patients with Crohn’s disease
Authors: Kuroki Hirosuke , Sugita Akira , Koganei Kazutaka , Tatsumi Kenji , Futatsuki Ryo , Nakao Eiichi , Obara Nao , Arai Katsuhiko
Published: April 2021

Purpose

Colorectum diversion with a proximal stoma is often the preferred surgical approach in patients with Crohn's disease-related anorectal lesions or refractory colitis. To date, few studies have assessed the incidence and prognosis of cancer in the diverted anorectal segments. This study aimed to evaluate the clinical characteristics and prognosis of anorectal cancer associated with Crohn's disease following fecal diversion.

Methods

This was a retrospective study based on medical records of patients diagnosed with Crohn’s disease between 1999 and 2020. It was conducted at Yokohama Municipal Citizen’s Hospital. Patients diagnosed with anorectal cancer following fecal diversion were identified, and their prognosis was the primary outcome measure.

Results

Among 1615 patients, 232 patients (14%) underwent colorectum diversion. Of those 232 patients, 11 were diagnosed with anorectal cancer following fecal diversion, ten were diagnosed with advanced cancer, 10 underwent abdominoperineal resection, and eight died. 1 could not undergo resection due to multiple lung metastasis and died. The overall five-year survival rate in patients diagnosed with anorectal cancer following fecal diversion was 20%.

Conclusion

Crohn's disease-associated anorectal cancer following fecal diversion was challenging to diagnose early, and patients had a poor prognosis even after curative resection. Early abdominoperineal resection may be considered for patients with Crohn's disease who cannot benefit from cancer screening and surveillance due to difficulty accessing the anorectal stricture via endoscopy.
Characterization of novel and large fragment deletions in exon 1 of the IL10RA gene in Chinese children with very early onset inflammatory bowel diseases
Authors: Tang Zifei , Zhang Ping , Ji Min , Yin Chunlan , Zhao Ruiqin , Huang Zhiheng , Huang Ying
Published: April 2021

Background

Defects in interleukin 10 (IL10) and its receptors are particularly involved in very early onset inflammatory bowel disease (VEOIBD). However, large fragment deletions of IL10 receptor A (IL10RA) are rare.

Methods

VEOIBD patients with confirmed mutations in the IL10RA gene were enrolled from January 1, 2019 to June 30, 2020. The clinical features and endoscopic-radiological findings of the patients with large fragment deletions of the IL10RA gene were determined and followed up.

Results

Thirty-five patients with IL10RA gene mutations, namely, 28 compound heterozygous mutations and 7 homozygote mutations, were enrolled in this study. Six patients carried the reported point mutation c.301C > T (p. R101RW) or c.537 G > A (p. T179T) in one locus and a large fragment deletion in exon 1 in another locus, which were novel mutations in this gene. A 333-bp deletion of exon 1 (117857034–11857366 del) was the main mutation in this locus in 85.7% of the patients with large fragment deletions. The time of disease onset ranged from birth to 4 years, and diarrhea was the main initial symptom. In total, 6/7 patients had perianal complications, including perianal abscess, fistula and skin tags. Six patients accepted thalidomide treatment, 5/7 accepted mesalamine, 3/7 accepted hematopoietic stem cell transplantation (HSCT), and 3/7 were waiting for HSCT.

Conclusions

We identified a novel large deletion of exon 1 involving the IL10RA gene for the first time and showed the characteristics of VEOIBD patients. This study expands the spectrum of Chinese VEOIBD patients with IL0RA gene mutations.
Perioperative risk factors for survival outcomes in elective colorectal cancer surgery: a retrospective cohort study
Authors: Liu Xing-Xing , Su Jun , Long Yuan-yuan , He Miao , Zhu Zhao-Qiong
Published: April 2021

Background

Surgical resection remains the best option for long-term survival in colorectal cancer (CRC); however, surgery can lead to tumor cell release into the circulation. Previous studies have also shown that surgery can affect cancer cell growth. The role of perioperative factors influencing long-term survival in patients presenting for CRC surgery remains to be investigated.

Methods

This retrospective single–center cohort study was conducted to collect the clinical data of patients who underwent elective laparoscopic resection for CRC from January 2014 to December 2015, namely clinical manifestations, pathological results, and perioperative characteristics. Survival was estimated using the Kaplan–Meier log-rank test. Univariable and multivariable Cox regression models were used to compare hazard ratios (HR) for death.

Results

A total of 234 patients were eligible for analysis. In the multivariable Cox model, tumor-node-metastasis (TNM) stage (stage IV: HR 30.63, 95% confidence interval (CI): 3.85–243.65; P = 0.001), lymphovascular invasion (yes: HR 2.07, 95% CI 1.09–3.92; P = 0.027), inhalational anesthesia with isoflurane (HR 1.96, 95% CI 1.19–3.21; P = 0.008), and Klintrup–Makinen (KM) inflammatory cell infiltration grade (low-grade inflammation: HR 2.03, 95% CI 1.20–3.43; P = 0.008) were independent risk factors affecting 5-year overall survival after laparoscopic resection for CRC.

Conclusions

TNM stage, lymphovascular invasion, isoflurane, and KM grade were independent risk factors affecting CRC prognosis. Sevoflurane and high-grade inflammation may be associated with improved survival in CRC patients undergoing resection.
Games of uncertainty: the participation of older patients with multimorbidity in care planning meetings – a qualitative study
Authors: Oksavik Jannike Dyb , Solbjør Marit , Kirchhoff Ralf , Sogstad Maren Kristine Raknes
Published: April 2021

Background

Active patients lie at the heart of integrated care. Although interventions to increase the participation of older patients in care planning are being implemented in several countries, there is a lack of knowledge about the interactions involved and how they are experienced by older patients with multimorbidity. We explore this issue in the context of care-planning meetings within Norwegian municipal health services.

Methods

This qualitative study drew on direct observations of ten care-planning meetings and an interview with each patient right after the meeting. Following a stepwise-deductive induction approach, the analysis began inductively and then considered the interactions through the lens of game theory.

Results

The care-planning interactions were influenced by uncertainty about the course of the disease and how to plan service delivery. In terms derived from game theory, the imaginary and unpredictable player ‘Nature’ generated uncertainty in the ‘game’ of care planning. The ‘players’ assessed this uncertainty differently, leading to three patterns of game. 1) In the ‘game of chance’, patients viewed future events as random and uncontrollable; they felt outmatched by the opponent Nature and became passive in their decision-making. 2) In the ‘competitive game’, participants positioned themselves on two opposing sides, one side perceiving Nature as a significant threat and the other assigning it little importance. The two sides negotiated about how to accommodate uncertainty, and the level of patient participation varied. 3) In the ‘coordination game’, all participants were aligned, either in viewing themselves as teammates against Nature or in ascribing little importance to it. The level of patient participation was high.

Conclusions

In care planning meetings, the level of patient participation may partly be associated with how the various actors appraise and respond to uncertainty. Dialogue on uncertainty in care-planning interventions could help to increase patient participation.