bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasound guided percutaneous catheterization of the brachiocephalic vein by small caliber catheter: An alternative to epicutaneo-caval catheter in newborn and premature infants
Authors: Merchaoui Zied , Laudouar Quitterie , Marais Clémence , Morin Luc , Ghali Narjess , Charbel Ramy , Seeman Nada , Mokhtari Mostafa , Tissières Pierre
Published: August 2021

Background:

Umbilical Venous Catheter (UVC) and Epicutaneo-Caval Catheters (ECC) are reference catheters in the neonatal period. However, many factors such as the corpulence of neonates, poor venous capital, and anatomical variants can complicate ECC insertion or make it impossible. In newborns with failed ECC insertion, we developed an hybrid technique that combines the insertion of a long-lasting silicone or polyurethane small caliber catheter, usually used as a ECC in newborns, with the ease and speed of ultrasound guided puncture of the brachiocephalic vein (BCV).

Methods:

Three years retrospective single center experience of ultrasound guided BCV insertion of silicon or polyurethane small caliber central catheter in a tertiary neonatal intensive care in case of insertion fail of ECC.

Results:

Twenty-one echo guided BCV-ECC insertions were performed in 20 newborns. Median age was 16 days (range: 0–110 days), median weight was 1700 g (range: 605–4960 g) at insertion. In most cases, insertion was on the left side (17/21). No failures were noted. Only one attempt was necessary in all cases. Insertion time, when noted, was always of <45 min. The median duration of use of these catheters was 11 days (range 3–35 days). No complication was noted during insertion or catheter use, including catheter-related infections and thrombosis.

Conclusion:

Echo guided percutaneous catheterization of the brachiocephalic vein with a long lasting silicone or polyurethane small caliber catheter is a safe alternative to the ECC if insertion has failed. However, it requires a mastery of ultrasound-guided insertion technique in term and premature neonates.
Adoption and fidelity of Sport Education in Spanish schools
Authors: Gutiérrez David , García-López Luis Miguel , Hastie Peter Andrew , Segovia Yessica
Published: August 2021

The main objectives of this study were to determine the percentage of teachers applying the Sport Education (SE) model in a central region of Spain and to identify the features these teachers perceived they were using when applying it. As a secondary objective, an attempt was made to respond to the differences in the application of the model depending on the educational stage and gender, and to determine any differences between the curriculum features of teachers applying SE and those who follow other methodologies. One hundred and ninety-nine physical education (PE) teachers participated in this study and a survey research design was used. The results reinforce the notion that PE teachers apply SE in a contextualised and pragmatic way. A significant percentage of teachers (64.8%) reported using SE in their curriculums, which demonstrates the success in expanding this instructional model in this region. Teachers also perceived that they applied a high percentage of the SE elements, although there was low fidelity to most of those elements that were considered to be central to the model such as extended units and permanent teams. Results are discussed based on literature about which goals are achieved and which ones are not based on the degree of fidelity to the central elements of the model. Implications for teacher training and future research are provided.
Benefits and Role of Carbon Dioxide Angiography in Case of Misalignment Between Fenestration and Target Vessel During Fenestrated Endovascular Aneurysm Repair
Authors: Chisci Emiliano , Michelagnoli Stefano , Masciello Fabrizio , Turini Filippo , Panci Simone , Troisi Nicola
Published: August 2021

Purpose:

To report the benefits and the role of carbon dioxide (CO2) angiography in case of misalignment between fenestration and target vessel during fenestrated endovascular aneurysm repair (F-EVAR).

Technique:

During F-EVAR, misalignment between fenestration and target vessel is a potentially catastrophic complication. In 2 patients, we experienced that one of the target vessels were not visible during standard angiography in different projections after positioning a fenestrated graft and even after cannulation of the corresponding fenestration. In both cases, the graft was sealed to the aortic wall but not in the predictable position. Consequently, acute occlusion of the target vessel was hypothesized. However, CO2 angiography was useful to evaluate patency of the target vessel clarifying the relative position of the fenestration versus the target vessel. Rescue maneuvers were feasible under the guidance of CO2 angiography in order to obtain the cannulation of both renal arteries. In both cases, the procedure was successfully accomplished.

Conclusion:

In case of misalignment of a fenestration during F-EVAR and non-visualization of the target vessel with standard angiography, CO2 angiography could have the unique and complementary role of clarifying the patency and position of the target vessel. In addition, CO2 could guide the rescue maneuvers.
Unusual Endovascular Treatment of Iliac Occlusive Disease With a Physician-Modified Endograft to Preserve a Transplant Renal Artery
Authors: Bonvini Stefano , Raunig Igor , Wassermann Valentina , Petralia Benedetto , Tasselli Sebastiano
Published: August 2021

Purpose:

We describe the feasibility and early results of iliac stenting using a physician-modified endograft (PMEG) to preserve a transplant renal artery in patient with iliac occlusive disease.

Case Report:

A 70-year-old male patient, with sub-occlusive left common iliac artery stenosis at the level of the transplanted kidney arterial anastomosis, presented with left critical limb ischemia (CLI) and pseudo-transplant renal artery stenosis (pseudo-TRAS) symptoms. He was treated with a physician-modified fenestrated covered stent introduced percutaneously via ipsilateral femoral artery after failure of simple angioplasty (percutaneous transluminal angioplasty, PTA). The modified graft was created by performing a square fenestration graftotomy on a Medtronic iliac limb stent graft (Medtronic Cardiovascular, Santa Rosa, CA, USA). The procedure was technically successful with no intraoperative complications. Procedural time was 110 minutes, including 35 minutes for device modification. On short-term follow-up, the patient had early improvement of renal function and resolution of CLI. The iliac and transplant renal artery remained patent with no sign of stent migration or kinking on 6 months surveillance computed tomography angiography and 1 year color Doppler ultrasonography.

Conclusion:

Use of PMEG to preserve visceral branches in occlusive iliac disease is a feasible endovascular technique with encouraging technical success and satisfying early results.
Intracardiac Echocardiography for Point-of-Care Guided Left Ventricular Assist Device Implantation: Surgical Implications for COVID-19
Authors: Yastrebov Konstantin , Brunel Laurencie , Paterson Hugh S. , Williams Zoe A. , Wise Innes K. , Burrows Christopher S. , Bannon Paul G.
Published: August 2021

Data from animal models is now available to initiate assessment of human safety and feasibility of wide-angle three-dimensional intracardiac echocardiography (3D ICE) to guide point-of-care implantation of percutaneous left ventricular assist devices in critical care settings. Assessment of these combined new technologies could be best achieved within a surgical institution with pre-existing expertise in separate utilization of ICE and Impella.
Sexual Consent and Communication Among the Sexual Minoritized: The Role of Heteronormative Sex Education, Trauma, and Dual Identities
Authors: de Heer Brooke , Brown Meredith , Cheney Julianna
Published: August 2021

Prior research and the #MeToo movement have recognized the complexities of sexual consent and how it contributes to experiences of sexual violence. A heteronormative perspective often dominates discussions on sexual violence at the expense of lesbian, gay, bisexual, transgender, queer, and other sexual minoritized individuals’ (LGBTQ+) experiences. Utilizing focus groups with LGBTQ+ people to discuss sexual consent, themes relating to sex education, defining sex in queer relationships, trauma and victimization, and overlapping gender and sexual orientation identities emerged. Findings are presented in the context of feminist and queer theoretical perspectives with particular focus on power inequity.
Adaptive energy control strategy of PHEV based on the Pontryagin’s minimum principle algorithm
Authors: Shi Dapai , Liu Kangjie , Wang Yun , Liu Ruijun , Li Shicheng , Sun Yanzhao
Published: August 2021

The optimization of energy control strategy is one of the key technologies of plug-in hybrid vehicles (PHEVs) to improve the capabilities of energy saving and emission reduction. In order to improve fuel economy of PHEV, adaptive equivalent minimum fuel consumption strategy (A-ECMS) is proposed. Firstly, optimization methods of different energy control strategies are analyzed, and the Pontryagin’s Minimum Principle (PMP) and the equivalent fuel consumption theory are selected to optimize energy control strategy of the PHEV. Secondly, the configuration of PHEV and research objectives of the power control system are determined. Thirdly, the energy control problem is analyzed by the PMP theory, and the improvement measures for the energy control problem are put forward by the equivalent minimum fuel consumption strategy (ECMS). Fourthly, after analyzing the relationship between the equivalent factor and reference SOC, adaptive equivalent minimum fuel consumption strategy (A-ECMS) model is established by MATLAB/Simulink. Finally, combined with Cruise software, the PHEV simulation model is simulated, and the simulation results are analyzed. The results show that compared with the CD/CS energy control strategy, the A-ECMS energy control strategy reduced the 100 km fuel consumption of the vehicle by 7% under three times WLTC driving condition.
Basslines, brains, bits, bytes, and burgers: Working with, and within the limits to, Marxism
Authors: Fraser Alistair
Published: August 2021

This paper considers some of what it means to work with, and within the limits to, Marxism. I make reference to two sets of inquiries where Marxism matters but remains at the margins of things. My focus will be on human cognition and digital life. To balance things, I then highlight some issues where Marxism is much more to the fore, specifically what I loosely refer to as "foodscapes." Finally, I conclude the essay with some further personal comments on my engagement with Marxism. Throughout, I want to give some expression to the sensation of walking a fine line between remaining committed to the conclusion that capitalist social relations are an enormous problem for human society but finding also that Marxism does not provide enough of the analytical equipment to answer how we should move beyond it. At the same time, I try to offer reflections on critical intellectual thought and action as a tentative and iterative experience, rather than an engagement framed by the security that one can find enough of what’s needed in Marxism.
Unsupported and Stigmatized? The Association Between Relationship Status and Well-Being Is Mediated by Social Support and Social Discrimination
Authors: Girme Yuthika U. , Sibley Chris G. , Hadden Benjamin W. , Schmitt Michael T. , Hunger Jeffrey M.
Published: August 2021

Single adults, on average, experience worse well-being compared to coupled adults. But why? The current research bridged interpersonal and intergroup perspectives to examine the influence of social support and social discrimination on single versus coupled adults’ well-being. We drew on a nationally representative prospective study from New Zealand (Study 1, N = 4,024) and an integrative data analysis of three North American data sets examining peoples’ general (Study 2, N = 806) and day-to-day (Study 2, N = 889 and 9,228 observations) social experiences. The results demonstrated that single adults reported lower life satisfaction compared to coupled adults, and this may be partly due to single adults reporting lower perceptions of social support availability and greater experiences of negative treatment and discrimination compared to coupled adults. These novel findings move away from stereotypical assumptions about singlehood and highlight the important role of social relationships and interactions in determining single adults’ happiness and well-being.
How I Do It: Inferior Turbinectomy: Modified Techniques for Submucosal Resection
Authors: Omura Kazuhiro , Nomura Kazuhiro , Takeda Teppei , Yanagi Norihiro , Kuroyanagi Hiroki , Yanagihara Taichi , Tanaka Yasuhiro , Kojima Hiromi , Otori Nobuyoshi
Published: August 2021

Although inferior turbinectomy with submucosal resection effectively reduces the volume of the inferior turbinate, there is room for improvement in surgical procedures. Techniques have been developed to reduce crusting and bleeding while efficiently achieving volume reduction. State-of-the-art procedures pertaining to the local injection site, incision line, exposure of the periosteum, submucosal outfracture of the turbinate bone, trimming of redundant mucosa, and incision line suturing are described. Pre and postoperative Nasal Obstruction Symptom Evaluation (NOSE) scores and postoperative inferior turbinate bleeding and crusting were evaluated. For the 18 consecutive patients analyzed, the pre and postoperative NOSE scores were 67.8 ± 14.8 and 16.1 ± 13.0, respectively ( P = .0002). Postoperatively, bleeding was absent, and only minor suture thread crusting was observed in 13 patients. In conclusion, our novel technique improves the effectiveness of surgery as well as the postoperative quality of the inferior turbinate.
Urban planners as boundary spanners: Steering perceptions of asylum seeker accommodations in Germany
Authors: Schiller Maria
Published: August 2021

Since its open-door policy for welcoming asylum seekers in 2015, Germany has experienced a resurgence of anti-immigrant sentiments and a backlash against the safeguarding of human rights. Such perceptions of asylum seekers and their accommodation are shaped in urban neighborhoods, where street-level bureaucrats try steering such perceptions. While much literature has discussed how immigrant affairs departments promote intercultural encounter or acceptance of diversity, we know relatively little so far if and when urban planners steer perceptions of migration-related diversity. Yet, urban planners work closely with residents in urban regeneration programs and were confronted with residents’ anxieties about the potential impact of the asylum seeker accommodation when large reception centers were opened in 2015. The article aims to fill a gap in the literature. Based on two in-depth case studies it shows how structural contexts inform whether urban planners span disciplinary boundaries and act as broker between residents and the state in order to steer perceptions of asylum seeker accommodations. The article is based on field research and qualitative interviews in two large German cities. The article contributes to literatures on perceptions of migration and diversity, urban planning and urban regeneration, street-level bureaucracy, boundary spanning and brokerage.
‘Utopia’ failed? Social enterprise, everyday practices and the closure of neoliberalism
Authors: Mazzei Micaela , Montgomery Tom , Dey Pascal
Published: August 2021

In the context of recurrent economic crises, ‘alternative’ models of economic organising such as social enterprise offer compelling examples of utopian imageries of a better future ‘to come’. Social enterprise qua utopia implies not only that alternative ways of being and co-existence are desirable, but that there is often a disjuncture between the desirable futures such utopian imaginaries project and the extent to which they are actualised or even actualisable in practice. The UK, which has long been considered the most conducive environment for social enterprise activity, offers a fertile ground to study this tension between utopian imagination and empirical actualization. Drawing from three large-scale research projects focusing on the social economy in Scotland and the North of England, this paper explores the link between social enterprise as a political program and as lived material practices unfolding under conditions of extreme resource scarcity caused by austerity measures. Our findings reveal that whatever utopian impulse social enterprise might contain, it is constituted, in the last instance, in the movement between ideas and everyday life, i.e. the aggregate of mundane practices, routines and experiences. Attentiveness to the precariousness instigated through austerity measures, such as social budget cuts, the key contribution this paper makes is to jettison approaches that treat social enterprise as a context-independent and totalizing ideal that divorces its utopian potential from the everyday practices through which this potential is being realized.
Proteome profiling of human placenta reveals developmental stage-dependent alterations in protein signature
Authors: Khorami Sarvestani Sara , Shojaeian Sorour , Vanaki Negar , Ghresi-Fard Behrouz , Amini Mehdi , Gilany Kambiz , Soltanghoraee Hale , Arefi Soheila , Jeddi-Tehrani Mahmood , Zarnani Amir-Hassan
Published: August 2021

Introduction

Placenta is a complex organ that plays a significant role in the maintenance of pregnancy health. It is a dynamic organ that undergoes dramatic changes in growth and development at different stages of gestation. In the first-trimester, the conceptus develops in a low oxygen environment that favors organogenesis in the embryo and cell proliferation and angiogenesis in the placenta; later in pregnancy, higher oxygen concentration is required to support the rapid growth of the fetus. This oxygen transition, which appears unique to the human placenta, must be finely tuned through successive rounds of protein signature alterations. This study compares placental proteome in normal first-trimester (FT) and term human placentas (TP).

Methods

Normal human first-trimester and term placental samples were collected and differentially expressed proteins were identified using two-dimensional liquid chromatography-tandem mass spectrometry.

Results

Despite the overall similarities, 120 proteins were differently expressed in first and term placentas. Out of these, 72 were up-regulated and 48 were down-regulated in the first when compared with the full term placentas. Twenty out of 120 differently expressed proteins were sequenced, among them seven showed increased (GRP78, PDIA3, ENOA, ECH1, PRDX4, ERP29, ECHM), eleven decreased (TRFE, ALBU, K2C1, ACTG, CSH2, PRDX2, FABP5, HBG1, FABP4, K2C8, K1C9) expression in first-trimester compared to the full-term placentas and two proteins exclusively expressed in first-trimester placentas (MESD, MYDGF).

Conclusion

According to Reactome and PANTHER softwares, these proteins were mostly involved in response to chemical stimulus and stress, regulation of biological quality, programmed cell death, hemostatic and catabolic processes, protein folding, cellular oxidant detoxification, coagulation and retina homeostasis. Elucidation of alteration in protein signature during placental development would provide researchers with a better understanding of the critical biological processes of placentogenesis and delineate proteins involved in regulation of placental function during development.
Genomics and transcriptomics of epizoic Seisonidea (Rotifera, syn. Syndermata) reveal strain formation and gradual gene loss with growing ties to the host
Authors: Mauer Katharina M. , Schmidt Hanno , Dittrich Marco , Fröbius Andreas C. , Hellmann Sören Lukas , Zischler Hans , Hankeln Thomas , Herlyn Holger
Published: August 2021

Background

Seisonidea (also Seisonacea or Seisonidae) is a group of small animals living on marine crustaceans (Nebaliaspec.) with only four species described so far. Its monophyletic origin with mostly free-living wheel animals (Monogononta, Bdelloidea) and endoparasitic thorny-headed worms (Acanthocephala) is widely accepted. However, the phylogenetic relationships inside the Rotifera-Acanthocephala clade (Rotiferasensulatoor Syndermata) are subject to ongoing debate, with consequences for our understanding of how genomes and lifestyles might have evolved. To gain new insights, we analyzed first drafts of the genome and transcriptome of the key taxon Seisonidea.

Results

Analyses of gDNA-Seq and mRNA-Seq data uncovered two genetically distinct lineages inSeison nebaliaeGrube, 1861 off the French Channel coast. Their mitochondrial haplotypes shared only 82% sequence identity despite identical gene order. In the nuclear genome, distinct linages were reflected in different gene compactness, GC content and codon usage. The haploid nuclear genome spans ca. 46 Mb, of which 96% were reconstructed. According to ~ 23,000 SuperTranscripts, gene number inS. nebaliaeshould be within the range published for other members of Rotifera-Acanthocephala. Consistent with this, numbers of metazoan core orthologues and ANTP-type transcriptional regulatory genes in theS. nebaliaegenome assembly were between the corresponding numbers in the other assemblies analyzed. We additionally provide evidence that a basal branching of Seisonidea within Rotifera-Acanthocephala could reflect attraction to the outgroup. Accordingly, rooting via a reconstructed ancestral sequence led to monophyletic Pararotatoria (Seisonidea+Acanthocephala) within Hemirotifera (Bdelloidea+Pararotatoria).

Conclusion

Matching genome/transcriptome metrics with the above phylogenetic hypothesis suggests that a haploid nuclear genome of about 50 Mb represents the plesiomorphic state for Rotifera-Acanthocephala. Smaller genome size inS. nebaliaeprobably results from subsequent reduction. In contrast, genome size should have increased independently in monogononts as well as bdelloid and acanthocephalan stem lines. The present data additionally indicate a decrease in gene repertoire from free-living to epizoic and endoparasitic lifestyles. Potentially, this reflects corresponding steps from the root of Rotifera-Acanthocephala via the last common ancestors of Hemirotifera and Pararotatoria to the one of Acanthocephala. Lastly, rooting via a reconstructed ancestral sequence may prove useful in phylogenetic analyses of other deep splits.
Integrated miRNA and transcriptome profiling to explore the molecular determinism of convergent adaptation to corn in two lepidopteran pests of agriculture
Authors: Gimenez Sylvie , Seninet Imène , Orsucci Marion , Audiot Philippe , Nègre Nicolas , Nam Kiwoong , Streiff Réjane , d’Alençon Emmanuelle
Published: August 2021

Background

The degree to which adaptation to same environment is determined by similar molecular mechanisms, is a topic of broad interest in evolutionary biology, as an indicator of evolutionary predictability. We wished to address if adaptation to the same host plant in phytophagous insects involved related gene expression patterns. We compared sRNA-Seq and RNA-Seq data between two pairs of taxa of Ostrinia and Spodoptera frugiperda sharing maize as host-plant. For the latter, we had previously carried out a reciprocal transplant experiment by feeding of the larvae of the Corn strain (Sf-C) and the Rice strain (Sf-R) on corn versus rice and characterized the mRNA and miRNA responses.

Results

First, we predicted the genes encoding miRNA in Ostrinia nubilalis (On) and O. scapulalis (Os). Respectively 67 and 65 known miRNA genes, as well as 196 and 190 novel ones were predicted with Os genome using sncRNAs extracted from whole larvae feeding on corn or mugwort. In On, a read counts analysis showed that 37 (55.22%) known miRNAs and 19 (9.84%) novel miRNAs were differentially expressed (DE) on mugwort compared to corn (in Os, 25 known miRs (38.46%) and 8 novel ones (4.34%)). Between species on corn, 8 (12.5%) known miRNAs and 8 (6.83%) novel ones were DE while only one novel miRNA showed expression variation between species on mugwort. Gene target prediction led to the identification of 2953 unique target genes in On and 2719 in Os, among which 11.6% (344) were DE when comparing species on corn. 1.8% (54) of On miR targets showed expression variation upon a change of host-plant.

We found molecular changes matching convergent phenotype, i.e., a set of nine miRNAs that are regulated either according to the host-plant both in On and Sf-C or between them on the same plant, corn. Among DE miR target genes between taxa, 13.7% shared exactly the same annotation between the two pairs of taxa and had function related to insect host-plant interaction.

Conclusion

There is some similarity in underlying genetic mechanisms of convergent evolution of two distant Lepidopteran species having adopted corn in their host range, highlighting possible adaptation genes.
Factors associated with IgG levels in adults with IgG subclass deficiency
Authors: Barton James C. , Barton Jackson Clayborn , Bertoli Luigi F. , Acton Ronald T.
Published: August 2021

Background

Factors associated with IgG levels in adults with IgG subclass deficiency (IgGSD) are incompletely understood. We studied adults with IgGSD with subnormal IgG1 only, subnormal IgG1/IgG3, or subnormal IgG3 only without other subnormal IgG subclasses, IgA, or IgM. We compiled: age; sex; autoimmune condition(s) (AC); atopy; IgG, IgG subclasses, IgA, IgM; IgGsum (IgG1 + IgG2 + IgG3 + IgG4); and D (percentage difference between IgGsum and IgG). We compared attributes of patients with/without subnormal IgG (< 7.00 g/L; subnormal IgG1 subclass groups only) and analyzed IgGsum and IgG relationships. We performed backward stepwise regressions on IgG using independent variables IgG subclasses, age, and sex and on D using independent variables age and sex.

Results

There were 39 patients with subnormal IgG1 only (89.7% women), 53 with subnormal IgG1/IgG3 (88.7% women), and 115 with subnormal IgG3 only (91.3% women). Fifteen patients (38.5%) and 32 patients (60.4%) in the respective subnormal IgG1 subclass groups had subnormal IgG. Attributes of patients with/without IgG < 7.00 g/L were similar, except that AC prevalence was lower in patients with subnormal IgG1 only and IgG < 7.00 g/L than ≥ 7.00 g/L (p = 0.0484). Mean/median IgG1 and IgG2 were significantly lower in patients with IgG < 7.00 g/L in both subnormal IgG1 subclass groups (p < 0.0001, all comparisons). Regressions on IgG in three subclass groups revealed positive associations with IgG1 and IgG2 (p < 0.0001 each association). Regressions on D revealed no significant association. IgG1 percentages of IgGsum were lower and IgG2 percentages were higher in patients with subnormal IgG1 subclass levels than subnormal IgG3 only (p < 0.0001 all comparisons).

Conclusions

We conclude that both IgG1 and IgG2 are major determinants of IgG in patients with subnormal IgG1, combined subnormal IgG1/IgG3, or subnormal IgG3 and that in patients with subnormal IgG1 or combined subnormal IgG1/IgG3, median IgG2 levels are significantly lower in those with IgG < 7.00 g/L than those with IgG ≥ 7.00 g/L.
Association between eNOS rs1799983 polymorphism and hypertension: a meta-analysis involving 14,185 cases and 13,407 controls
Authors: Shi Jikang , Liu Siyu , Guo Yanbo , Liu Sainan , Xu Jiayi , Pan Lingfeng , Hu Yueyang , Liu Yawen , Cheng Yi
Published: August 2021

Background

Essential hypertension is a complex disease determined by the interaction of genetic and environmental factors, eNOS is considered to be one of the susceptible genes for hypertension. Our study aimed to evaluate the association between eNOS rs1799983 polymorphism and hypertension, and to provide evidence for the etiology of hypertension.

Methods

Case–control studies of eNOS rs1799983 polymorphism and hypertension were included by searching PubMed, Embase, Web of Science, Medline, Scopus, WanFang datebase, Vip datebase, and CNKI database according to PRISMA guideline. Eligible data were extracted and pooled, and were analyzed using R software based on five different genetic models.

Results

A total of 60 eligible articles involving 14,185 cases and 13,407 controls were finally selected. We found significant association between eNOS rs1799983 polymorphism and hypertension under any genetic model (T vs G: OR = 1.44, 95% CI 1.26–1.63; GT vs GG: OR 1.34, 95% CI 1.18–1.52; TT vs GG: OR 1.80, 95% CI 1.41–2.31; GT + TT vs GG: OR 1.42, 95% CI 1.25–1.63; TT vs GG + GT: OR 1.68, 95% CI 1.35–2.08; GT vs GG + TT: OR 1.24, 95% CI 1.11–1.40).

Conclusions

We found that eNOS rs1799983 polymorphism is associated with the increased risk of hypertension under any genetic model. Moreover, investigations of gene–gene and gene-environment interactions are needed to give more insight into the association between eNOS rs1799983 polymorphism and hypertension.
Circulating lymphocyte subsets as promising biomarkers to identify septic patients at higher risk of unfavorable outcome
Authors: Polilli Ennio , Esposito Jessica Elisabetta , Frattari Antonella , Trave Francesca , Sozio Federica , Ferrandu Giovanna , Di Iorio Giancarlo , Parruti Giustino
Published: August 2021

Background

Early recognition of patients hospitalized for sepsis at higher risk of poor clinical outcome is a mandatory task and many studies suggested that indicators of the immune status may be useful for this purpose. We performed a retrospective, monocentric cohort study to evaluate whether lymphocyte subsets may be useful in predicting in-hospital mortality of septic patients.

Methods

Data of all consecutive patients with a diagnosis of sepsis at discharge and an available peripherical blood lymphocyte subset (CD4, CD8, CD16/CD56 and CD19) analysis at hospital entry were retrospectively collected between January 2015 and August 2018. Clinical characteristics of patients, past medical history and other laboratory parameters were also considered.

Results

Two-hundred-seventy-eight septic patients, 171 (61.5%) males, mean age 63.2 ± 19.6 years, were enrolled. Total counts of lymphocytes, CD4 T cells, CD8 T cells and B cells were found significantly lower in deceased than in surviving patients. At univariate analyses, CD4 T cells/µL (OR 0.99 for each incremental unit, 95%CI 0.99–1.10, p < 0.0001), age (OR 1.06, 95%CI 1.04–1.09, p < 0.0001), procalcitonin (OR 1.01, 95%CI 1.01–1.02, p < 0.0001) and female gender (OR 2.81, 95%CI 1.49–5.28, p = 0.001) were associated with in-hospital mortality. When a dichotomic threshold of < 400/µL for CD4 T cells as a dependent variable was considered in multivariate models, age (OR 1.04; 95%CI 1.01–1.09, p = 0.018); female gender (OR 3.18; 95%CI 1.40–7.20, p = 0.006), qSOFA (OR 4.00, 95%CI 1.84–8.67, p < 0.001) and CD4 T cells < 400/µL (OR 5.3; 95%CI 1.65–17.00, p = 0.005) were the independent predictors.

Conclusions

In adjunct to biomarkers routinely determined for the prediction of prognosis in sepsis, CD4 T lymphocytes, measured at hospital entry, may be useful in identifying patients at higher risk of in-hospital death.
A study to design minimum data set of COVID-19 registry system
Authors: Zarei Javad , Badavi Mohammad , Karandish Majid , Haddadzadeh Shoushtari Maryam , Dastoorpoor Maryam , Yousefi Farid , Raji Hanieh , Cheraghi Maria
Published: August 2021

Background

From the beginning of the COVID-19 pandemic, the development of infrastructures to record, collect and report COVID-19‏ ‏data has become a fundamental necessity in the world. The disease registry system can help build an infrastructure to collect data systematically. The study aimed to design a minimum data set for the COVID-19 registry system.

Methods

A qualitative study to design an MDS for the COVID-19 registry system was performed in five phases at Ahvaz University of Medical Sciences in Khuzestan Province in southwestern Iran, 2020–2021. In the first phase, assessing the information requirements was performed for the COVID-19 registry system. Data elements were identified in the second phase. In the third phase, the MDS was selected, and in the four phases, the COVID-19 registry system was implemented as a pilot study to test the MDS. Finally, based on the experiences gained from the COVID-19 registry system implementation, the MDS were evaluated, and corrections were made.

Results

MDS of the COVID-19 registry system contains eight top groups including administrative (34 data elements), disease exposure (61 data elements), medical history and physical examination (138 data elements), findings of clinical diagnostic tests (101 data elements), disease progress and outcome of treatment (55 data elements), medical diagnosis and cause of death (12 data elements), follow-up (14 data elements), and COVID-19 vaccination (19 data elements) data, respectively.

Conclusion

Creating a standard and comprehensive MDS can help to design any national data dictionary for COVID-19 and improve the quality of COVID-19 data.
Association between bacterial finding, antibiotic treatment and clinical course in patients with pharyngotonsillitis: a registry-based study in primary healthcare in Sweden
Authors: Pallon Jon , Sundqvist Martin , Rööst Mattias , Hedin Katarina
Published: August 2021

Background

The role of non-group A streptococci and Fusobacterium necrophorum in pharyngotonsillitis has been disputed and few prospective studies have evaluated the effect of antibiotic treatment. This study uses registry data to investigate the relation between antibiotic prescription for pharyngotonsillitis in primary healthcare and return visits for pharyngotonsillitis, complications, and tonsillectomy.

Methods

Retrospective data were extracted from the regional electronic medical record system in Kronoberg County, Sweden, for all patients diagnosed with pharyngotonsillitis between 2012 and 2016. From these data, two cohorts were formed: one based on rapid antigen detection tests (RADT) for group A streptococci (GAS) and one based on routine throat cultures for β-haemolytic streptococci and F. necrophorum. The 90 days following the inclusion visit were assessed for new visits for pharyngotonsillitis, complications, and tonsillectomy, and related to bacterial aetiology and antibiotic prescriptions given at inclusion.

Results

In the RADT cohort (n = 13,781), antibiotic prescription for patients with a positive RADT for GAS was associated with fewer return visits for pharyngotonsillitis within 30 days compared with no prescription (8.7% vs. 12%; p = 0.02), but not with the complication rate within 30 days (1.5% vs. 1.8%; p = 0.7) or with the tonsillectomy rate within 90 days (0.27% vs. 0.26%; p = 1). In contrast, antibiotic prescription for patients with a negative RADT was associated with more return visits for pharyngotonsillitis within 30 days (9.7% vs. 7.0%; p = 0.01). In the culture cohort (n = 1 370), antibiotic prescription for patients with Streptococcus dysgalactiae ssp. equisimilis was associated with fewer return visits for pharyngotonsillitis within 30 days compared with no prescription (15% vs. 29%; p = 0.03).

Conclusions

Antibiotic prescription was associated with fewer return visits for pharyngotonsillitis in patients with a positive RADT for GAS but with more return visits in patients with a negative RADT for GAS. There were no differences in purulent complications related to antibiotic prescription.
Bacteriology and mortality of necrotizing fasciitis in a tertiary coastal hospital with comparing risk indicators of methicillin-resistant Staphylococcus aureus and Vibrio vulnificus infections: a prospective study
Authors: Tsai Yao-Hung , Huang Tsung-Yu , Chen Jiun-Liang , Hsiao Cheng-Ting , Kuo Liang-Tseng , Huang Kuo-Chin
Published: August 2021

Background

Vibrio vulnificus has been reported as the leading causative pathogen of necrotizing fasciitis (NF) and related fatality in the coastal area. Necrotizing fasciitis caused by methicillin-resistant Staphylococcus aureus (MRSA) and V. vulnificus have high mortality rates. The purpose of this prospective study was to clarify the clinical characteristics between death and survival NF patients, to investigate bacteriologic profile and mortality of NF patients, and to compare risk indicators of MRSA and V. vulnificus NF patients.

Methods

This prospective study was conducted in 184 consecutive NF patients over a period of three years in a tertiary coastal hospital. Differences in mortality, laboratory findings, microbiology and clinical outcomes were compared between the death and survival groups, and the V. vulnificus and MRSA subgroups.

Results

Twenty patients died, resulting in a mortality rate of 10.9%, and there were 108 patients with a monomicrobial infection (58.7%). The death group had a significantly higher incidence of shock at emergency room and bacteremia than did the survival group. Vibrio species (40 cases) and S. aureus (31 cases) were the two major pathogens. Significant differences with respect to hepatic dysfunction, shock, the event with seawater or seafood contact, bacteremia, C-reactive protein, mean platelet counts, and the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score were observes between V. vulnificus and MRSA groups.

Conclusions

NF patients with both hepatic dysfunction and diabetes mellitus, bacteremia and shock have significantly higher mortality. We should be aware of the increasing incidence of monomicrobial NF and higher mortality rates of Gram-negative pathogens in the warm coastal area. LRINEC score is not a suitable diagnostic indicator for V. vulnificus NF, which is more rapidly progressive and fulminant than MRSA NF. NF needed team works by early suspicion, immediate surgical intervention and aggressive care, which can successfully decrease mortality.
Chronic kidney disease diagnosis using decision tree algorithms
Authors: Ilyas Hamida , Ali Sajid , Ponum Mahvish , Hasan Osman , Mahmood Muhammad Tahir , Iftikhar Mehwish , Malik Mubasher Hussain
Published: August 2021

Background

Chronic Kidney Disease (CKD), i.e., gradual decrease in the renal function spanning over a duration of several months to years without any major symptoms, is a life-threatening disease. It progresses in six stages according to the severity level. It is categorized into various stages based on the Glomerular Filtration Rate (GFR), which in turn utilizes several attributes, like age, sex, race and Serum Creatinine. Among multiple available models for estimating GFR value, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), which is a linear model, has been found to be quite efficient because it allows detecting all CKD stages.

Methods

Early detection and cure of CKD is extremely desirable as it can lead to the prevention of unwanted consequences. Machine learning methods are being extensively advocated for early detection of symptoms and diagnosis of several diseases recently. With the same motivation, the aim of this study is to predict the various stages of CKD using machine learning classification algorithms on the dataset obtained from the medical records of affected people. Specifically, we have used the Random Forest and J48 algorithms to obtain a sustainable and practicable model to detect various stages of CKD with comprehensive medical accuracy.

Results

Comparative analysis of the results revealed that J48 predicted CKD in all stages better than random forest with an accuracy of 85.5%. The study also showed that J48 shows improved performance over Random Forest.

Conclusions

The study concluded that it may be used to build an automated system for the detection of severity of CKD.
Real-time prediction of intradialytic relative blood volume: a proof-of-concept for integrated cloud computing infrastructure
Authors: Chaudhuri Sheetal , Han Hao , Monaghan Caitlin , Larkin John , Waguespack Peter , Shulman Brian , Kuang Zuwen , Bellamkonda Srikanth , Brzozowski Jane , Hymes Jeffrey , Black Mike , Kotanko Peter , Kooman Jeroen P. , Maddux Franklin W. , Usvyat Len
Published: August 2021

Background

Inadequate refilling from extravascular compartments during hemodialysis can lead to intradialytic symptoms, such as hypotension, nausea, vomiting, and cramping/myalgia. Relative blood volume (RBV) plays an important role in adapting the ultrafiltration rate which in turn has a positive effect on intradialytic symptoms. It has been clinically challenging to identify changes RBV in real time to proactively intervene and reduce potential negative consequences of volume depletion. Leveraging advanced technologies to process large volumes of dialysis and machine data in real time and developing prediction models using machine learning (ML) is critical in identifying these signals.

Method

We conducted a proof-of-concept analysis to retrospectively assess near real-time dialysis treatment data from in-center patients in six clinics using Optical Sensing Device (OSD), during December 2018 to August 2019. The goal of this analysis was to use real-time OSD data to predict if a patient’s relative blood volume (RBV) decreases at a rate of at least − 6.5 % per hour within the next 15 min during a dialysis treatment, based on 10-second windows of data in the previous 15 min. A dashboard application was constructed to demonstrate how reporting structures may be developed to alert clinicians in real time of at-risk cases. Data was derived from three sources: (1) OSDs, (2) hemodialysis machines, and (3) patient electronic health records.

Results

Treatment data from 616 in-center dialysis patients in the six clinics was curated into a big data store and fed into a Machine Learning (ML) model developed and deployed within the cloud. The threshold for classifying observations as positive or negative was set at 0.08. Precision for the model at this threshold was 0.33 and recall was 0.94. The area under the receiver operating curve (AUROC) for the ML model was 0.89 using test data.

Conclusions

The findings from our proof-of concept analysis demonstrate the design of a cloud-based framework that can be used for making real-time predictions of events during dialysis treatments. Making real-time predictions has the potential to assist clinicians at the point of care during hemodialysis.
Using a machine learning approach to identify key prognostic molecules for esophageal squamous cell carcinoma
Authors: Li Meng-Xiang , Sun Xiao-Meng , Cheng Wei-Gang , Ruan Hao-Jie , Liu Ke , Chen Pan , Xu Hai-Jun , Gao She-Gan , Feng Xiao-Shan , Qi Yi-Jun
Published: August 2021

Background

A plethora of prognostic biomarkers for esophageal squamous cell carcinoma (ESCC) that have hitherto been reported are challenged with low reproducibility due to high molecular heterogeneity of ESCC. The purpose of this study was to identify the optimal biomarkers for ESCC using machine learning algorithms.

Methods

Biomarkers related to clinical survival, recurrence or therapeutic response of patients with ESCC were determined through literature database searching. Forty-eight biomarkers linked to recurrence or prognosis of ESCC were used to construct a molecular interaction network based on NetBox and then to identify the functional modules. Publicably available mRNA transcriptome data of ESCC downloaded from Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) datasets included GSE53625 and TCGA-ESCC. Five machine learning algorithms, including logical regression (LR), support vector machine (SVM), artificial neural network (ANN), random forest (RF) and XGBoost, were used to develop classifiers for prognostic classification for feature selection. The area under ROC curve (AUC) was used to evaluate the performance of the prognostic classifiers. The importances of identified molecules were ranked by their occurrence frequencies in the prognostic classifiers. Kaplan-Meier survival analysis and log-rank test were performed to determine the statistical significance of overall survival.

Results

A total of 48 clinically proven molecules associated with ESCC progression were used to construct a molecular interaction network with 3 functional modules comprising 17 component molecules. The 131,071 prognostic classifiers using these 17 molecules were built for each machine learning algorithm. Using the occurrence frequencies in the prognostic classifiers with AUCs greater than the mean value of all 131,071 AUCs to rank importances of these 17 molecules, stratifin encoded by SFN was identified as the optimal prognostic biomarker for ESCC, whose performance was further validated in another 2 independent cohorts.

Conclusion

The occurrence frequencies across various feature selection approaches reflect the degree of clinical importance and stratifin is an optimal prognostic biomarker for ESCC.
Diagnostic possibility of the combination of exhaled nitric oxide and blood eosinophil count for eosinophilic asthma
Authors: Li Jiang-Hua , Han Rui , Wang Yu-Bo , Cheng Min , Chen Heng-Yi , Lei Wen-Hui , Li Li , Gao Chen , Zhao Na-Na , Nie Nai-Fu , Li Zhong-Yan , Yin Guo-Qing , Huang Shuai , He Yong
Published: August 2021

Background

Tests to identify reversible airflow limitation are important in asthma diagnosis, but they are time-consuming and it may be difficult for patients to cooperate. We aimed to evaluate whether the combination of fractional exhaled nitric oxide (FeNO) and blood eosinophil (B-Eos) can be used to distinguish some asthma patients who could avoid objective tests.

Methods

We conducted a retrospective cohort study on 7463 suspected asthma cases between January 2014 and December 2019 in Chongqing, China, and identified 2349 patients with complete FeNO, B-Eos count, and spirometry data. Asthma was diagnosed by clinicians by the criteria of recurrent respiratory symptoms and a positive bronchial-provocation or bronchodilation test (BPT, BPD). We evaluated the diagnostic accuracy of FeNO or B-Eos alone or both in combination for asthma using receiver operating characteristic (ROC) curve analysis.

Results

In this study, 824 patients were diagnosed with asthma. When FeNO and B-Eos counts were used in combination, the area under the ROC curve (AUC) for diagnosing asthma increased slightly (0.768 vs. 0.745 [FeNO] or 0.728 [B-Eos]; both P < 0.001). The odds ratio for having asthma increased progressively with a gradual increase in FeNO or B-Eos count (both P < 0.001; assessed using the Cochran–Armitage trend test). Further analysis of in-series combinations of different threshold values for these biomarkers indicated that moderately elevated biomarker levels (FeNO > 40 ppb and B-Eos > 300 cells/μl) support a diagnosis of asthma because diagnostic specificity was > 95% and the positive likelihood ratio (PLR) was > 10. This conclusion was verified when selecting the 2017–2019 data as the internal validation dataset.

Conclusion

FeNO or B-Eos count alone is insufficient to accurately diagnose asthma. Patients with moderately elevated biomarkers (FeNO > 40 ppb and B-Eos > 300 cells/μl) could be diagnosed with asthma and avoid objective tests when such tests are not feasible.