bluuebunny/crossref_metadata_2025 huggingface dataset:
Healthcare providers’ readiness for electronic health record adoption: a cross-sectional study during pre-implementation phase
Authors: Ngusie Habtamu Setegn , Kassie Sisay Yitayih , Chereka Alex Ayenew , Enyew Ermias Bekele
Published: March 2022

Background

The adoption of an electronic health record (EHR) in the healthcare system has the potential to make healthcare service delivery effective and efficient by providing accurate, up-to-date, and complete information. Despite its great importance, the adoptions of EHR in low-income country settings, like Ethiopia, were lagging and increasingly failed. Assessing the readiness of stakeholders before the actual adoption of EHR is considered the prominent solution to tackle the problem. However, little is known about healthcare providers’ EHR readiness in this study setting. Accordingly, this research was conducted aiming at examining healthcare providers’ readiness for EHR adoption and associated factors in southwestern Ethiopia.

Methods

An institutional-based cross-sectional study was conducted from September 1 to October 30, 2021. A total of 423 healthcare providers working in public hospitals were selected using a simple random sampling technique. Multivariable logistic regression was fitted to identify determinant factors of overall healthcare providers’ readiness after the other covariates were controlled.

Result

In this study, the overall good readiness level of EHR adoption was 52.8% (n = 204) [95% CI of 47.9% to 56.6%]. Age, computer literacy, computer access at health facilities, attitude towards EHRs, awareness about EHRs, perceived benefit, and perceived technology self-efficacy were significantly associated with the overall health care providers’ readiness for the adoption of EHR using a cut point of P-value less than 0.05.

Conclusion

Around half of the respondents had a good level of overall healthcare providers’ readiness for the adoption of EHR which was considered inadequate. This finding implied that a huge effort is required to improve readiness before the actual implementation of EHRs. The finding implied that younger-aged groups were more ready for such technology which in turn implied; the older one needs more concern. Enhancing computer literacy, confidence building to raise self-efficacy of such technology, addressing the issue of computer availability at health facilities, building a positive attitude, awareness campaign of EHR, and recognizing the usefulness of such systems were the necessary measures to improve EHR readiness in this setting.

Additionally, further studies are recommended to encompass all types of EHR readiness such as organizational readiness, technology readiness, societal readiness, and so on. Additionally, exploring the healthcare provider opinion with qualitative study and extending the proposed study to other implementation settings are recommended to be addressed by future works.
Olsenella uli-induced pneumonia: a case report
Authors: Yan Yufen , Li Hong , Li Shuai , Liu Shuhui , Jia Nan , Liu Yanfei , Liu Qing , Li Jing , Han Chunhua
Published: March 2022

Background

Olsenella uli is anaerobic or microaerophilic bacteria, commonly found in oral cavity or gastrointestinal tract, which has not been reported to be associated with lower respiratory tract infection. Herein, we report the first case of Olsenella uli infection in the lung.

Case presentation

A 70-year-old male farmer with no history of other respiratory tract diseases developed a cough with bloody sputum three times a day without obvious causes or other concomitant symptoms. After a period of treatment with empirical antibiotic, his condition did not improve. The computed tomography (CT) and lung biopsy results indicated bilateral pneumonia, and Olsenella uli was identified by micromorphology, sequence analysis and mass spectrometry analysis recovered from sputum. Ceftazidime, a third generation cephalosporin was used for the treatment, and the patient recovered after 10 days.

Conclusions

Our report suggests a causative role of gingival bacteria in the pathogenesis of pneumonia, thus early diagnosis and prompt antibiotic therapy may play a role in the treatment of Olsenella uli induced pneumonia.
Characterization of distinct circular RNA signatures in solid tumors
Authors: Wang Chengdi , Liu Wen-Rong , Tan Shuangyan , Zhou Jian-Kang , Xu Xiaomin , Ming Yue , Cheng Jian , Li Jiao , Zeng Zhen , Zuo Yuanli , He Juan , Peng Yong , Li Weimin
Published: March 2022

Background

Circular RNAs (circRNAs) are differentially expressed between normal and cancerous tissues, contributing to tumor initiation and progression. However, comprehensive landscape of dysregulated circRNAs across cancer types remains unclear.

Methods

In this study, we conducted Ribo-Zero transcriptome sequencing on tumor tissues and their adjacent normal samples including glioblastoma, esophageal squamous cell carcinoma, lung adenocarcinoma, thyroid cancer, colorectal cancer, gastric cancer and hepatocellular carcinoma. CIRCexplorer2 was employed to identify circRNAs and dysregulated circRNAs and genes were determined by DESeq2 package. The expression of hsa_circ_0072309 (circLIFR) was measured by reverse transcription and quantitative real-time PCR, and its effect on cell migration was examined by Transwell and wound healing assays. The role of circLIFR in tumor metastasis was evaluated via mouse models of tail-vein injection and spleen injection for lung and liver metastasis, respectively.

Results

Distinct circRNA expression signatures were identified among seven types of solid tumors, and the dysregulated circRNAs exhibited cancer-specific expression or shared common expression signatures across cancers. Bioinformatics analyses indicated that aberrant expression of host genes and/or RNA-binding proteins contributed to circRNA dysregulation in cancer. Finally, circLIFR was experimentally validated to be downregulated in six solid tumors and to significantly inhibit cell migration in vitro and tumor metastasis in vivo.

Conclusions

Our results provide a comprehensive landscape of differentially expressed circRNAs in solid tumors and highlight that circRNAs are extensively involved in cancer pathogenesis.
Early surgical and oncological outcomes during adoption of a single port VATS lung resection in a tertiary cancer center: a retrospective analysis
Authors: Abdel Jalil Riad , Abou Chaar Mohamad K. , Al-Qudah Obada , Al-Edwan Ahed , Almajali Omar , Ababneh Hazim , U’wais Ahmad , Al-Ghazawi Munir , Al-Najjar Hani , Abu-shanab Ahmad
Published: March 2022

Background

Video-assisted thoracoscopic surgery (VATS) is a safe and effective surgical approach for pulmonary resection. VATS can be accomplished with only a single incision, resulting in less postoperative pain and paresthesia, better cosmetic results, and greater patient satisfaction. Single-port VATS (spVATS) has become increasingly common for lung resection. We assess the early surgical and oncological outcomes after adopting this new technique at our tertiary cancer center as the first institution to do so in the country.

Method

Medical records for 257 patients in a tertiary cancer center, with a diagnosis of non-small cell lung cancer, pulmonary metastasis, or other chest-confined pathology, were accessed to obtain perioperative outcomes, pathologic results, post-operative follow-up data, and early surgical and oncological outcomes. All patients underwent spVATS for limited or major lung resection. Simple descriptive analysis was utilized.

Results

spVATS was either performed with curative intent (79.8%, N = 205), or as a diagnostic procedure (20.2%, N = 52). Resection types were subcategorized for curative intent group as limited (73.6%, N = 151), lobectomy (16.6%, N = 34), and complex (9.7%, N = 20). Resection with a negative margin (R0) rate was 100% for the primary lung cancer (PLC) patients and 97% for the pulmonary metastasectomy (PM) group. The complication rate was 5%. Three-year disease-free survival was 87% and 68.5% for PLC and PM group, respectively. The 3-year overall-survival was 91.3% for the PLC and 82.8% for PM. Operation duration showed a downtrend over the study period in each curative subcategory with a borderline difference in the limited resection (P value = 0.05).

Conclusion

All the spVATS procedures were successfully performed without perioperative severe complications or mortality, regardless of complexity. R0 resection was excellent. Middle- and long-term efficacies of spVATS for lung cancer require further follow-up. With proper training, appropriate indication and meticulous application, adopting spVATS is safe and feasible technique that does not compromise surgical and oncological outcomes.
A pilot randomized placebo-controlled study on modified MaZiRenWan: a formulated Chinese medicine to relieve constipation for palliative cancer patients
Authors: Cheng Chung-wah , Mok Hoi-fung , Yau Cora W. S. , Chan Jasmine T. M. , Kang Yu-chen , Lam Pui-yan , Zhong Linda L. D. , Zhao Chen , Ng Bacon F. L. , Kwok Annie O. L. , Tse Doris M. W. , Bian Zhao-xiang
Published: March 2022

Background

Constipation is a common problem among advanced cancer patients; however, many of them find limited effective from current therapies. Thus, we aimed to test the effect of a traditional Chinese herbal formula, modified MaZiRenWan (MZRW), by comparing with placebo among palliative cancer patients with constipation.

Methods

This is a randomized, double-blind, placebo-controlled trial. Participants aged over 18 were recruited and randomized to MZRW or placebo group in addition to current prescriptions (including ongoing laxatives treatment) for two weeks. Exclusion criteria included cognitive impairment, presence of a colostomy or gastrointestinal obstruction and estimated life expectancy of less than one month. Individualized modification of MZRW was allowed according to the traditional Chinese medicine (TCM) pattern of patient. The primary outcome was the global assessment of improvement, which reflected whether the constipation had improved, remained the same or worsened.

Results

Sixty patients, with mean age 75.2 years (range 47–95 years), were randomized to MZRW or placebo group. Among the MZRW group, 59.3% (16/27) had improvement in the global assessment score, as compared with 28.6% (8/28) of the placebo group (p-value = 0.022). Besides, the MZRW group had significant increase in stool frequency, and reduction in constipation severity and straining of defecation (p-value < 0.05). No serious adverse event was reported due to the research medication.

Conclusion

This pilot trial suggests modified MZRW is well-tolerated and effective for relief of constipation in patients with advance cancer. It could be considered as a potential treatment option for constipation in palliative care.

Trial registration: The trial had been registered in ClinicalTrials.gov with identifier number NCT02795390 [https://clinicaltrials.gov/ct2/show/NCT02795390] on June 10, 2016.
Expert opinion on the recognition, diagnosis and management of children and adults with Fabry disease: a multidisciplinary Turkey perspective
Authors: Ezgu Fatih , Alpsoy Erkan , Bicik Bahcebasi Zerrin , Kasapcopur Ozgur , Palamar Melis , Onay Huseyin , Ozdemir Binnaz Handan , Topcuoglu Mehmet Akif , Tufekcioglu Omac
Published: March 2022

This consensus statement by a panel of Fabry experts aimed to identify areas of consensus on conceptual, clinical and therapeutic aspects of Fabry disease (FD) and to provide guidance to healthcare providers on best practice in the management of pediatric and adult patients with FD. This consensus statement indicated the clinical heterogeneity of FD as well as a large number of pathogenic variants in theGLAgene, emphasizing a need for an individualized approach to patient care. The experts reached consensus on the critical role of a high index of suspicion in symptomatic patients and screening of certain at-risk groups to reveal timely and accurate diagnosis of FD along with an increased awareness of the treating physician about the different kinds of pathogenic variants and their clinical implications. The experts emphasized the crucial role of timely recognition of FD with minimal delay from symptom onset to definite diagnosis in better management of FD patients, given the likelihood of changing the disease’s natural history, improving the patients’ quality of life and the prognosis after enzyme replacement therapy (ERT) administered through a coordinated, multidisciplinary care approach. In this regard, this consensus document is expected to increase awareness among physicians about unique characteristics of FD to assist clinicians in recognizing FD with a well-established clinical suspicion consistent with pathogenic variants and gender-based heterogeneous clinical manifestations of FD and in translating this information into their clinical practice for best practice in the management of patients with FD.
Neurological signs, symptoms and MRI abnormalities in patients with congenital melanocytic naevi and evaluation of routine MRI-screening: systematic review and meta-analysis
Authors: Fledderus Anne C. , Widdershoven Anna Linn , Lapid Oren , Breugem Corstiaan C. , Pasmans Suzanne G. M. A. , van der Horst Chantal M. A. M. , Engelen Marc M. , Spuls Phyllis I.
Published: March 2022

Background

A congenital melanocytic naevus (CMN) is a rare skin condition that can be associated with abnormalities of the central nervous system (CNS). These anomalies can sometimes cause severe complications, and rarely death. Adequate information about aetiology and management is therefore crucial. To identify how to monitor patients with CMN, we aimed to estimate the prevalence of neurological involvement in patients with CMN and to summarize what specific neurological signs and symptoms and MRI abnormalities are reported in the medical literature. In addition, we summarized and evaluated the recommendations regarding MRI-screening reported in the medical literature.

Methods

This review was registered in PROSPERO and reported according to the MOOSE checklist. A search was conducted in EMBASE (Ovid), PubMed, and the Cochrane Library. We included studies with 10 or more patients with CMN, reporting on neurological signs and symptoms or CNS MRI. Study selection, data extraction and methodological quality assessment were performed by two independent reviewers. A meta-analysis was used to assess the prevalence of neurological signs and symptoms.

Results

Out of 1287 studies, fourteen studies were eligible for inclusion of which eight were included in the meta-analysis. Neurological signs and symptoms prevalence was 7.04% (CI 95% 4.47–10.93%) in the meta-analysis group and 6.26% (95% CI 3.85–10%) in a subgroup of patients with a CMN > 6 cm, evaluated in seven studies. Neurodevelopmental delay and seizures were the most frequently reported signs and symptoms. CNS melanocytosis and hydrocephalus were the most frequently reported MRI abnormalities. It was not possible to estimate the increased risk of neurological involvement in patients with CMN due to low quality of evidence and clinical heterogeneity.

Conclusion

Standardization in CMN studies and a multi-centre prospective study are needed to evaluate neurological involvement. Based on current literature, it is not possible to make strong recommendations on routine MRI-screening. For now, every clinical centre should decide on its own policy and weigh the advantages and disadvantages of routine MRI.
Guidelines for bioinformatics of single-cell sequencing data analysis in Alzheimer’s disease: review, recommendation, implementation and application
Authors: Wang Minghui , Song Won-min , Ming Chen , Wang Qian , Zhou Xianxiao , Xu Peng , Krek Azra , Yoon Yonejung , Ho Lap , Orr Miranda E. , Yuan Guo-Cheng , Zhang Bin
Published: March 2022

Alzheimer’s disease (AD) is the most common form of dementia, characterized by progressive cognitive impairment and neurodegeneration. Extensive clinical and genomic studies have revealed biomarkers, risk factors, pathways, and targets of AD in the past decade. However, the exact molecular basis of AD development and progression remains elusive. The emerging single-cell sequencing technology can potentially provide cell-level insights into the disease. Here we systematically review the state-of-the-art bioinformatics approaches to analyze single-cell sequencing data and their applications to AD in 14 major directions, including 1) quality control and normalization, 2) dimension reduction and feature extraction, 3) cell clustering analysis, 4) cell type inference and annotation, 5) differential expression, 6) trajectory inference, 7) copy number variation analysis, 8) integration of single-cell multi-omics, 9) epigenomic analysis, 10) gene network inference, 11) prioritization of cell subpopulations, 12) integrative analysis of human and mouse sc-RNA-seq data, 13) spatial transcriptomics, and 14) comparison of single cell AD mouse model studies and single cell human AD studies. We also address challenges in using human postmortem and mouse tissues and outline future developments in single cell sequencing data analysis. Importantly, we have implemented our recommended workflow for each major analytic direction and applied them to a large single nucleus RNA-sequencing (snRNA-seq) dataset in AD. Key analytic results are reported while the scripts and the data are shared with the research community through  GitHub. In summary, this comprehensive review provides insights into various approaches to analyze single cell sequencing data and offers specific guidelines for study design and a variety of analytic directions. The review and the accompanied software tools will serve as a valuable resource for studying cellular and molecular mechanisms of AD, other diseases, or biological systems at the single cell level.
Seeking justice amidst chaos: methods to identify and document individuals implicated in crimes against the Rohingya in August 2017
Authors: Leigh Jennifer , Blum Alexander , Petty Agnes , Woods Andrea , Parmar Parveen , Beyrer Chris
Published: March 2022

Background

Documenting perpetrators of human rights violations enables effective prosecution and can help prevent future atrocities. Doing so calls for collecting reliable data using verifiable and transparent methodology. We present methods used to document crimes and identify alleged perpetrators implicated in the 2017 attacks against Rohingya civilians in Myanmar. The findings and lessons-learned have relevance to contemporary crises with widespread atrocities.

Methods

A mixed-methods assessment conducted from May to July 2018 included: (1) cross-sectional quantitative surveys among leaders of affected hamlets in northern Rakhine State, (2) qualitative interviews to record hamlet-level accounts, and (3) clinical evaluations of survivors of violence. Survey respondents who reported violence and destruction in each hamlet were asked to identify perpetrators of those acts, including known role or affiliation. The reported names were reviewed for clarity and divergent spellings, repeated references were aggregated, and the names and roles were analyzed and classified by location and affiliation.

Results

143 individuals were implicated in atrocities committed across three Northern Rakhine townships. Each was independently identified by at least three separate survey respondents as directly committing violence or destruction in their hamlet of origin, or as witnessed while fleeing to Bangladesh. Two-thirds (69%) of identified perpetrators were reported by four or more participants and 47% by five or more. Some form of additional identifying information, was provided for 85% of names. The most common affiliations were: Myanmar army (n = 40), Border Guard Police (n = 32), Village Tract Administrators (n = 17), and extremists (n = 25).

Conclusions

The methodology presented here yielded a unique record of individuals purported to have directly committed acts of violence and destruction in Rakhine State in August 2017, forming the most extensive record of individuals implicated in ground-level perpetration of those crimes. This methodology can play a key role in accountability mechanisms for the Rohingya, and in other settings in which perpetrators are many and documentation of their crimes is difficult. The use of survey methods and standardized data collection amongst affected populations to comprehensively characterize crimes committed and to identify individuals implicated in those crimes can serve as a key tool in documentation and an important component of accountability.
The long and short non-coding RNAs modulating EZH2 signaling in cancer
Authors: Mirzaei Sepideh , Gholami Mohammad Hossein , Hushmandi Kiavash , Hashemi Farid , Zabolian Amirhossein , Canadas Israel , Zarrabi Ali , Nabavi Noushin , Aref Amir Reza , Crea Francesco , Wang Yuzhuo , Ashrafizadeh Milad , Kumar Alan Prem
Published: March 2022

Non-coding RNAs (ncRNAs) are a large family of RNA molecules with no capability in encoding proteins. However, they participate in developmental and biological processes and their abnormal expression affects cancer progression. These RNA molecules can function as upstream mediators of different signaling pathways and enhancer of zeste homolog 2 (EZH2) is among them. Briefly, EZH2 belongs to PRCs family and can exert functional roles in cells due to its methyltransferase activity. EZH2 affects gene expression via inducing H3K27me3. In the present review, our aim is to provide a mechanistic discussion of ncRNAs role in regulating EZH2 expression in different cancers. MiRNAs can dually induce/inhibit EZH2 in cancer cells to affect downstream targets such as Wnt, STAT3 and EMT. Furthermore, miRNAs can regulate therapy response of cancer cells via affecting EZH2 signaling. It is noteworthy that EZH2 can reduce miRNA expression by binding to promoter and exerting its methyltransferase activity. Small-interfering RNA (siRNA) and short-hairpin RNA (shRNA) are synthetic, short ncRNAs capable of reducing EZH2 expression and suppressing cancer progression. LncRNAs mainly regulate EZH2 expression via targeting miRNAs. Furthermore, lncRNAs induce EZH2 by modulating miRNA expression. Circular RNAs (CircRNAs), like lncRNAs, affect EZH2 expression via targeting miRNAs. These areas are discussed in the present review with a focus on molecular pathways leading to clinical translation.
Opinions about the most appropriate surgical management of diabetes‐related foot infection: a cross‐sectional survey
Authors: Seng Leonard , Drovandi Aaron , Fernando Malindu E , Golledge Jonathan
Published: March 2022

Background

There is a lack of high quality evidence to guide the optimal management of diabetes‐related foot infection, particularly in cases of severe diabetes‐related foot infection and diabetes‐related foot osteomyelitis. This study examined the opinions of surgeons about the preferred management of severe diabetes‐related foot infection.

Methods

Vascular and orthopaedic surgeons in Australia and New Zealand were invited to complete an online survey via email. The survey included multi‐choice and open‐ended questions on clinical management of diabetes‐related foot infection. Responses of vascular surgeons and orthopaedic surgeons were compared using non‐parametric statistical tests. Open‐text responses were examined using inductive content analysis.

Results

29 vascular and 20 orthopaedic surgeons completed the survey. One‐third (28.6%) used best‐practice guidelines to assist in decisions about foot infection management. Areas for guideline improvement identified included more specific advice regarding the indications for available treatments, more recommendations about non‐surgical patient management and advice on how management can be varied in regions with limited health service resource. The probe‐to‐bone test and magnetic resonance imaging were the preferred methods of diagnosing osteomyelitis. Approximately half (51.2%) of respondents indicated piperacillin combined with tazobactam as the preferred antibiotic choice for empirical treatment of severe diabetes‐related foot infection. Negative pressure wound therapy was the most common way of managing a wound following debridement. All vascular surgeons (100%) made revascularisation decisions based on the severity of ischemia while most orthopaedic surgeons (66.7%) were likely to refer to vascular surgeons to make revascularisation decisions. Vascular surgeons preferred using wound swabs while orthopaedic surgeons favoured tissue or bone biopsies to determine the choice of antibiotic. Respondents perceived a moderate variation in management decisions between specialists and supported the need for randomised controlled trials to test different management pathways.

Conclusions

Most vascular and orthopaedic surgeons do not use best‐practice guidelines to assist in decisions about management of diabetes‐related foot infection. Vascular and orthopaedic surgeons appear to have different preferences for wound sampling to determine choice of antibiotic. There is a need for higher quality evidence to clarify best practice for managing diabetes‐related foot infection.
EVITA Dengue: a cluster-randomized controlled trial to EValuate the efficacy of Wolbachia-InfecTed Aedes aegypti mosquitoes in reducing the incidence of Arboviral infection in Brazil
Authors: Collins Matthew H. , Potter Gail E. , Hitchings Matt D. T. , Butler Ellie , Wiles Michelle , Kennedy Jessie K. , Pinto Sofia B. , Teixeira Adla B. M. , Casanovas-Massana Arnau , Rouphael Nadine G. , Deye Gregory A. , Simmons Cameron P. , Moreira Luciano A. , Nogueira Mauricio L. , Cummings Derek A. T. , Ko Albert I. , Teixeira Mauro M. , Edupuganti Srilatha
Published: March 2022

Background

Arboviruses transmitted by Aedes aegypti including dengue, Zika, and chikungunya are a major global health problem, with over 2.5 billion at risk for dengue alone. There are no licensed antivirals for these infections, and safe and effective vaccines are not yet widely available. Thus, prevention of arbovirus transmission by vector modification is a novel approach being pursued by multiple researchers. However, the field needs high-quality evidence derived from randomized, controlled trials upon which to base the implementation and maintenance of vector control programs. Here, we report the EVITA Dengue trial design (DMID 17-0111), which assesses the efficacy in decreasing arbovirus transmission of an innovative approach developed by the World Mosquito Program for vector modification of Aedes mosquitoes by Wolbachia pipientis.

Methods

DMID 17-0111 is a cluster-randomized trial in Belo Horizonte, Brazil, with clusters defined by primary school catchment areas. Clusters (n = 58) will be randomized 1:1 to intervention (release of Wolbachia-infected Aedes aegypti mosquitoes) vs. control (no release). Standard vector control activities (i.e., insecticides and education campaigns for reduction of mosquito breeding sites) will continue as per current practice in the municipality. Participants (n = 3480, 60 per cluster) are children aged 6–11 years enrolled in the cluster-defining school and living within the cluster boundaries who will undergo annual serologic surveillance for arboviral infection. The primary objective is to compare sero-incidence of arboviral infection between arms.

Discussion

DMID 17-0111 aims to determine the efficacy of Wolbachia-infected mosquito releases in reducing human infections by arboviruses transmitted by Aedes aegypti and will complement the mounting evidence for this method from large-scale field releases and ongoing trials. The trial also represents a critical step towards robustness and rigor for how vector control methods are assessed, including the simultaneous measurement and correlation of entomologic and epidemiologic outcomes. Data from this trial will inform further the development of novel vector control methods.

Trial registration

ClinicalTrials.govNCT04514107. Registered on 17 August 2020

Primary sponsor: National Institute of Health, National Institute of Allergy and Infectious Diseases
Longitudinal assessment of reactivity and affinity profile of anti-Jo1 autoantibodies to distinct HisRS domains and a splice variant in a cohort of patients with myositis and anti-synthetase syndrome
Authors: Notarnicola Antonella , Preger Charlotta , Lundström Susanna L. , Renard Nuria , Wigren Edvard , Van Gompel Eveline , Galindo-Feria Angeles S. , Persson Helena , Fathi Maryam , Grunewald Johan , Jakobsson Per-Johan , Gräslund Susanne , Lundberg Ingrid E. , Fernandes-Cerqueira Cátia
Published: March 2022

Background

To address the reactivity and affinity against histidyl-transfer RNA synthetase (HisRS) autoantigen of anti-Jo1 autoantibodies from serum and bronchoalveolar lavage fluid (BALF) in patients with idiopathic inflammatory myopathies/anti-synthetase syndrome (IIM/ASSD). To investigate the associations between the reactivity profile and clinical data over time.

Methods

Samples and clinical data were obtained from (i) 25 anti-Jo1+ patients (19 sera with 16 longitudinal samples and 6 BALF/matching sera at diagnosis), (ii) 29 anti-Jo1− patients (25 sera and 4 BALF/matching sera at diagnosis), and (iii) 27 age/gender-matched healthy controls (24 sera and 3 BALF/matching sera). Reactivity towards HisRS full-length (HisRS-FL), three HisRS domains (WHEP, antigen binding domain (ABD), and catalytic domain (CD)), and the HisRS splice variant (SV) was tested. Anti-Jo1 IgG reactivity was evaluated by ELISA and western blot using IgG purified from serum by affinity chromatography. In paired serum-BALF, anti-Jo1 IgG and IgA reactivity was analyzed by ELISA. Autoantibody affinity was measured by surface plasmon resonance using IgG purified from sera. Correlations between autoantibody reactivity and clinical data were evaluated at diagnosis and longitudinally.

Results

Anti-Jo1 IgG from serum and BALF bound HisRS-FL, WHEP, and SV with high reactivity at the time of diagnosis and recognized both conformation-dependent and conformation-independent HisRS epitopes. Anti-HisRS-FL IgG displayed high affinity early in the disease. At the time of IIM/ASSD diagnosis, the highest autoantibody levels against HisRS-FL were found in patients ever developing interstitial lung disease (ILD) and arthritis, but with less skin involvement. Moreover, the reactivity of anti-WHEP IgG in BALF correlated with poor pulmonary function.

Levels of autoantibodies against HisRS-FL, HisRS domains, and HisRS splice variant generally decreased over time. With some exceptions, longitudinal anti-HisRS-FL antibody levels changed in line with ILD activity.

Conclusion

High levels and high-affinity anti-Jo1 autoantibodies towards HisRS-FL were found early in disease in sera and BALF. In combination with the correlation of anti-HisRS-FL antibody levels with ILD and ILD activity in longitudinal samples as well as of anti-WHEP IgG in BALF with poor pulmonary function, this supports the previously raised hypothesis that the lung might have a role in the immune reaction in anti-Jo1-positive patients.
Fossils and plant evolution: structural fingerprints and modularity in the evo-devo paradigm
Authors: Tomescu Alexandru M. F. , Rothwell Gar W.
Published: March 2022

Fossils constitute the principal repository of data that allow for independent tests of hypotheses of biological evolution derived from observations of the extant biota. Traditionally, transformational series of structure, consisting of sequences of fossils of the same lineage through time, have been employed to reconstruct and interpret morphological evolution. More recently, a move toward an updated paradigm was fueled by the deliberate integration of developmental thinking in the inclusion of fossils in reconstruction of morphological evolution. The vehicle for this is provided by structural fingerprints—recognizable morphological and anatomical structures generated by (and reflective of) the deployment of specific genes and regulatory pathways during development. Furthermore, because the regulation of plant development is both modular and hierarchical in nature, combining structural fingerprints recognized in the fossil record with our understanding of the developmental regulation of those structures produces a powerful tool for understanding plant evolution. This is particularly true when the systematic distribution of specific developmental regulatory mechanisms and modules is viewed within an evolutionary (paleo-evo-devo) framework. Here, we discuss several advances in understanding the processes and patterns of evolution, achieved by tracking structural fingerprints with their underlying regulatory modules across lineages, living and fossil: the role of polar auxin regulation in the cellular patterning of secondary xylem and the parallel evolution of arborescence in lycophytes and seed plants; the morphology and life history of early polysporangiophytes and tracheophytes; the role of modularity in the parallel evolution of leaves in euphyllophytes; leaf meristematic activity and the parallel evolution of venation patterns among euphyllophytes; mosaic deployment of regulatory modules and the diverse modes of secondary growth of euphyllophytes; modularity and hierarchy in developmental regulation and the evolution of equisetalean reproductive morphology. More generally, inclusion of plant fossils in the evo-devo paradigm has informed discussions on the evolution of growth patterns and growth responses, sporophyte body plans and their homology, sequences of character evolution, and the evolution of reproductive systems.
The current state of knowledge on imaging informatics: a survey among Spanish radiologists
Authors: Eiroa Daniel , Antolín Andreu , Fernández del Castillo Ascanio Mónica , Pantoja Ortiz Violeta , Escobar Manuel , Roson Nuria
Published: March 2022

Background

There is growing concern about the impact of artificial intelligence (AI) on radiology and the future of the profession. The aim of this study is to evaluate general knowledge and concerns about trends on imaging informatics among radiologists working in Spain (residents and attending physicians). For this purpose, an online survey among radiologists working in Spain was conducted with questions related to: knowledge about terminology and technologies, need for a regulated academic training on AI and concerns about the implications of the use of these technologies.

Results

A total of 223 radiologists answered the survey, of whom 76.7% were attending physicians and 23.3% residents. General terms such as AI and algorithm had been heard of or read in at least 75.8% and 57.4% of the cases, respectively, while more specific terms were scarcely known. All the respondents consider that they should pursue academic training in medical informatics and new technologies, and 92.9% of them reckon this preparation should be incorporated in the training program of the specialty. Patient safety was found to be the main concern for 54.2% of the respondents. Job loss was not seen as a peril by 45.7% of the participants.

Conclusions

Although there is a lack of knowledge about AI among Spanish radiologists, there is a will to explore such topics and a general belief that radiologists should be trained in these matters. Based on the results, a consensus is needed to change the current training curriculum to better prepare future radiologists.
Post-systolic shortening is superior to global longitudinal strain in predicting adverse events in patients with stable coronary artery disease and preserved systolic function
Authors: Lu Shirui , Hu Xin , Zhang Jun , Zhu Ying , Zhou Wei , Liu Yani , Deng Youbin
Published: March 2022

Background

Post-systolic shortening (PSS) is an important indicator for early identifying myocardial dysfunction. We aimed to investigate the predictive value of PSS assessed with speckle tracking automated functional imaging (AFI) on adverse events in patients with stable coronary artery disease (CAD) and preserved systolic function.

Methods

A total of 204 consecutive patients clinically diagnosed with stable CAD and left ventricular ejection fraction (LVEF) > 50% were included. Multiple parameters were analyzed with AFI technique. The composite endpoint included all-cause mortality, heart failure, myocardial infarction and stroke.

Results

During a median follow-up of 24 months (IQR 19–28 months), 30 patients (14.7%) reached the endpoint. Patients experiencing the endpoint had a lower absolute global longitudinal strain (GLS), a higher post-systolic index (PSI), and more left ventricle walls displaying PSS than patients without events. PSI (hazard ratio, 1.15; 95% CI, 1.04–1.27; p = 0.005) and per 1 increase in the number of left ventricle walls with PSS (hazard ratio 1.52, 95% CI 1.21–1.91, p < 0.000) were independent predictors of the endpoint, whereas GLS was not significantly associated with the endpoint after adjustment models. For patients with absolute value of GLS > 15.4%, a significant prognostic superiority was found in PSI compared with GLS (AUC = 0.73 [PSI] vs. 0.58 [GLS], p = 0.024).

Conclusions

PSS is an independent predictor for adverse events in stable CAD patients with preserved systolic function, and the prognostic value may be superior to GLS in patients with normal or mildly reduced GLS.
A Brucella melitensis H38ΔwbkF rough mutant protects against Brucella ovis in rams
Authors: Muñoz Pilar M. , Conde-Álvarez Raquel , Andrés-Barranco Sara , de Miguel María-Jesús , Zúñiga-Ripa Amaia , Aragón-Aranda Beatriz , Salvador-Bescós Miriam , Martínez-Gómez Estrella , Iriarte Maite , Barberán Montserrat , Vizcaíno Nieves , Moriyón Ignacio , Blasco José M.
Published: March 2022

Brucella melitensis and Brucella ovis are gram-negative pathogens of sheep that cause severe economic losses and, although B. ovis is non-zoonotic, B. melitensis is the main cause of human brucellosis. B. melitensis carries a smooth (S) lipopolysaccharide (LPS) with an N-formyl-perosamine O-polysaccharide (O-PS) that is absent in the rough LPS of B. ovis. Their control and eradication require vaccination, but B. melitensis Rev 1, the only vaccine available, triggers anti-O-PS antibodies that interfere in the S-brucellae serodiagnosis. Since eradication and serological surveillance of the zoonotic species are priorities, Rev 1 is banned once B. melitensis is eradicated or where it never existed, hampering B. ovis control and eradication. To develop a B. ovis specific vaccine, we investigated three Brucella live vaccine candidates lacking N-formyl-perosamine O-PS: Bov::CAΔwadB (CO2-independent B. ovis with truncated LPS core oligosaccharide); Rev1::wbdRΔwbkC (carrying N-acetylated O-PS); and H38ΔwbkF (B. melitensis rough mutant with intact LPS core). After confirming their attenuation and protection against B. ovis in mice, were tested in rams for efficacy. H38ΔwbkF yielded similar protection to Rev 1 against B. ovis but Bov::CAΔwadB and Rev1::wbdRΔwbkC conferred no or poor protection, respectively. All H38ΔwbkF vaccinated rams developed a protracted antibody response in ELISA and immunoprecipitation B. ovis diagnostic tests. In contrast, all remained negative in Rose Bengal and complement fixation tests used routinely for B. melitensis diagnosis, though some became positive in S-LPS ELISA owing to LPS core epitope reactivity. Thus, H38ΔwbkF is an interesting candidate for the immunoprophylaxis of B. ovis in B. melitensis-free areas.
Foraging on the wing for fish while migrating over changing landscapes: traveling behaviors vary with available aquatic habitat for Caspian terns
Authors: Rueda-Uribe C. , Lötberg U. , Åkesson S.
Published: March 2022

Background

Birds that forage while covering distance during migration should adjust traveling behaviors as the availability of foraging habitat changes. Particularly, the behavior of those species that depend on bodies of water to find food yet manage to migrate over changing landscapes may be limited by the substantial variation in feeding opportunities along the route.

Methods

Using GPS tracking data, we studied how traveling behaviors vary with available foraging habitat during the long-distance migration of Caspian terns (Hydroprogne caspia), a bird with a specialized diet based on fish that needs bodies of water to forage. We measured individual variation in five traveling behaviors related to foraging along the route and used linear mixed effects models to test the following variables as predictors of traveling behaviors: proportion of overlap with water bodies, weather conditions, days at previous stopover and days of migration. Also, we tested if during traveling days flight height and speed varied with time of day and if birds were in areas with greater proportion of water bodies compared to what would be expected by chance from the landscape.

Results

We found variation in migratory traveling behaviors that was mainly related to the proportion of overlap with water bodies and experienced tailwinds. Suggesting a mixed migratory strategy with fly-and-foraging, Caspian terns reduced travel speed, flew fewer hours of the day, had lower flight heights and increased diurnal over nocturnal migratory flight hours as the proportion of overlap with water bodies increased. Birds had lower flight speeds and higher flight heights during the day, were in foraging habitats with greater proportions of water than expected by chance but avoided foraging detours. Instead, route tortuosity was associated with lower wind support and cloudier skies.

Conclusions

Our findings show how birds may adjust individual behavior as foraging habitat availability changes during migration and contribute to the growing knowledge on mixed migratory strategies of stopover use and fly-and-forage.
The why of open pedagogy: a value-first conceptualization for enhancing instructor praxis
Authors: Werth Eric , Williams Katherine
Published: March 2022

Theoretical evolution within the field of Open Pedagogy has progressed rapidly in recent years. Practical application, however, has lagged this conceptual development. This article seeks to explore the gap between theory and practice by examining how the use of terms within the open education space may create barriers for instructors new to the concept. The authors of this article argue that the most effective approach to creating momentum toward practices associated with Open Pedagogy is to begin with an alignment of an instructor’s values with the attributes of an open educator. Subject matter experts were consulted in the association of open pedagogical values with specific practices. The result is a visual aid useful for an instructor’s self-assessment or in collaboration with curriculum designers to identify a logical start point for an instructor as they begin their movement from a more traditional to an open approach.
Recent development in functional nanomaterials for sustainable and smart agricultural chemical technologies
Authors: Shao Chen , Zhao Huawei , Wang Ping
Published: March 2022

New advances in nanotechnology are driving a wave of technology revolution impacting a broad range of areas in agricultural production. The current work reviews nanopesticides, nano-fabricated fertilizers, and nano activity-based growth promoters reported in the last several years, focusing on mechanisms revealed for preparation and functioning. It appears to us that with many fundamental concepts have been demonstrated over last two decades, new advances in this area continue to expand mainly in three directions, i.e., efficiency improvement, material sustainability and environment-specific stimulation functionalities. It is also evident that environmental and health concerns associated with nano agrochemicals are the primary motivation and focus for most recent work. Challenges and perspectives for future development of nano agrochemicals are also discussed.
Surgical resection of mixed neuroendocrine-non-neuroendocrine neoplasm in the biliary system: a report of two cases
Authors: Tamaki Ayano , Tani Yuma , Sato Hiroki , Yoshida Ryuichi , Yasui Kazuya , Horiguchi Shigeru , Kuise Takashi , Umeda Yuzo , Yoshida Kazuhiro , Fuji Tomokazu , Kumano Kenjiro , Takagi Kosei , Yagi Takahito , Fujiwara Toshiyoshi
Published: March 2022

Background

Mixed neuroendocrine-non-neuroendocrine neoplasm (MINEN) is a rare disease and there is scarce literature on its diagnosis, treatment, and prognosis. We encountered two unusual cases of MINEN in the biliary tract, one in the ampulla of Vater and the other in the distal bile duct. In this report, we describe the clinical course of these two cases in detail.

Case presentation

Case 1: A 69-year-old woman presented with a chief complaint of epigastric pain. When endoscopic sphincterotomy and retrograde biliary drainage were performed for gallstone pancreatitis, an ulcerated lesion was found in the ampulla of the Vater. Based on the biopsy results, the lesion was diagnosed as the ampulla of Vater carcinoma and subtotal stomach-preserving pancreatoduodenectomy (SSPPD) was performed. Postoperative histopathological examination revealed the coexistence of adenocarcinoma and neuroendocrine carcinoma components, consistent with the diagnosis of MINEN. In addition, lymph node metastasis was found on the dorsal side of the pancreas and the metastatic component was adenocarcinoma. Adjuvant chemotherapy with etoposide and cisplatin was administered for 6 months, and presently the patient is alive without recurrence 64 months after surgery. Case 2: A 79-year-old man presented with a chief complaint of anorexia. Cholangiography showed severe stenosis of the distal bile duct. A biopsy was conducted from the stenotic lesion and it revealed the lesion to be adenocarcinoma. A diagnosis of distal bile duct carcinoma was made, and SSPPD was performed. Histopathological examination revealed the coexistence of adenocarcinoma and neuroendocrine carcinoma components, and the tumor was confirmed as MINEN of the distal bile duct. No adjuvant chemotherapy was administered due to the poor performance status. 7 months later, the patient was found to have a liver metastasis.

Conclusion

We experienced two valuable cases of biliary MINEN. To identify better treatments, it is important to consider the diversity of individual cases and to continue sharing a variety of cases with different presentations.
Le Fort I maxillary osteotomy in a Jehovah’s Witness patient: strategies for minimizing blood loss and maximizing safety
Authors: O’Connor Michaela K. , Emanuelli Elisa , Garg Ravi K.
Published: March 2022

Background

The Watch Tower Society, the main governing organization of the Jehovah’s Witness (JW) faith, introduced the doctrine to refuse blood in 1945 and has been enforcing it since 1961. A member can be expelled for accepting prohibited blood components. Many reconstructive surgeries place patients at an increased risk for blood loss. There have been attempts at reducing the rate of transfusions in craniofacial surgery, even in patients not opposed to it.

Presentation

A 15-year-old female patient, who refused blood transfusion due to her faith, presented with a class III malocclusion, transverse maxillary constriction, and a lateral open bite. Surgery was deferred until the patient reached 18 years of age and had undergone preoperative orthodontics. A two-piece Le Fort I osteotomy was performed. Erythropoietin, oral iron, and tranexamic acid were used to minimize intraoperative blood loss.

Conclusion

Here we discuss preoperative and intraoperative management strategies to ensure a transfusion-free environment for patients with religious objections to blood transfusions undergoing operations with increased bleeding risk.