bluuebunny/crossref_metadata_2025 huggingface dataset:
A case study of local ecological knowledge of shellfishers about edible cockle (Cerastoderma edule) in the Ria de Aveiro lagoon, Western Iberia
Authors: Braga Heitor O. , Azeiteiro Ulisses M. , Magalhães Luísa
Published: March 2022

Background

The cockle is available to numerous fishing villages in Europe, especially Portugal. In the Ria de Aveiro, there is a lack of a fisheries management program and the need for new ecological studies on cockle biology, ecology, and conservation. We shared local ecological knowledge (LEK) highlights about the cockle—Cerastoderma edule (Linnaeus 1758) in the Ria de Aveiro in favor of adaptive management of this bioresource.

Methods

Semi-structured interviews with sixty shellfishers in this coastal lagoon were carried out during April and May 2021. LEK data on the biology and ecology of the cockle were analyzed using an ethical-emic approach and the model of integration of different individual skills. These informal data were compared with previously published data for the species, the Fish Base, and GBIF databases.

Results and discussion

The average minimum size of the cockle for capture was 23.4 mm, and the average capture per tide was 137.12 kg. The areas with the highest productivity and the most shellfish were RIAV1 and RIAV2. Cockles inhabit areas of sand and mud at an average depth of 2.71 cm. Feeds are mainly small particles, plankton, mud, and algae. The main predators were crabs, European plaice, and bird species. Cockles spawn primarily in late spring and summer. As of 2010, there was a slight decrease in cockle stocks in the Ria de Aveiro due to overfishing, increased rainfall, and changes in the sediment. Considering and analyzing this knowledge is essential for a better understanding of the environmental context the cockles thrive in the view of users of the natural resource.

Conclusion

Informal data shared by shellfishers in the Ria de Aveiro were typical of filter-feeding bivalves. LEK may assist in planning future management plans for cockles, and unrefuted data may serve as untestable hypotheses. Ethnobiological studies in the Ria de Aveiro lagoon with other species may improve the management of this system since multiple fisheries are carried out in this coastal area.
Breastfeeding, feeding practices and stunting in indigenous Ecuadorians under 2 years of age
Authors: Tello Betzabé , Rivadeneira María F. , Moncayo Ana L. , Buitrón Janett , Astudillo Fabricio , Estrella Andrea , Torres Ana L.
Published: March 2022

Background

The indigenous child population in Ecuador has a high prevalence of stunting. There is limited evidence of the association between breastfeeding, feeding practices, and stunting in indigenous children. This study aimed to analyze the prevalence of breastfeeding and complementary feeding practices and explore their association with stunting in Ecuadorian indigenous children under two years of age.

Methods

Cross-sectional study of secondary data analysis using the 2012 Ecuador National Health and Nutrition Study, in 625 children aged 0–23 months (48,069 expanded sample), representative for the indigenous population. Breastfeeding and complementary feeding indicators were analyzed by age groups. Timely initiation of breastfeeding (within one hour after birth), exclusive breastfeeding (infants under six months who received only breast milk for the previous day), and other indicators were measured. Chi-square test or Fisher's exact test and logistic regression for complex samples were used to explore association with demographic and socioeconomic factors and stunting.

Results

Twenty-six-point eight percent of the children were stunted. Stunting occurred mainly in children with rural residence, on poor households, and where there were four or more children. Most of the children had a timely initiation of breastfeeding (69.5% for 0–12 months and 75.5% for 13–23 months) and exclusive breastfeeding up to six months (78.2%). Among children between 6–12 months of age, 99.3% continued to be breastfed. In children from ages 6 to 12 months, 32.5% received food with adequate dietary diversity. Lower percentages of complementary feeding occurred in the poorest, adolescent mothers or those with less education. Children who did not receive the minimum frequency of meals for their age had higher odds of stunting (OR 3.28; 95% CI 1.3, 8.27). Children from age 19 to 23 months who consumed foods rich in iron showed lower probabilities of stunting (OR 0.04; 95% CI 0.00, 0.51).

Conclusions

Breastfeeding practices reached a prevalence of 70% or more, without being associated with stunting. Complementary feeding practices showed differences by socioeconomic condition. Not reaching the minimum meal frequency between 6 and 12 months of age was associated with stunting. Plans and strategies are necessary to promote adequate feeding and breastfeeding practices in the indigenous population.
Dosimetric effect of respiratory motion on planned dose in whole-breast volumetric modulated arc therapy using moderate and ultra-hypofractionation
Authors: Mankinen Mikko , Virén Tuomas , Seppälä Jan , Hakkarainen Heikki , Koivumäki Tuomas
Published: March 2022

Background and purpose

The interplay effect of respiratory motion on the planned dose in free-breathing right-sided whole-breast irradiation (WBI) were studied by simulating hypofractionated VMAT treatment courses.

Materials and methods

Ten patients with phase-triggered 4D-CT images were included in the study. VMAT plans targeting the right breast were created retrospectively with moderately hypofractionated (40.05 Gy in 15 fractions of 2.67 Gy) and ultra-hypofractionated (26 Gy 5 fractions of 5.2 Gy) schemes. 3D-CRT plans were generated as a reference. All plans were divided into respiratory phase-specific plans and calculated in the corresponding phase images. Fraction-specific dose was formed by deforming and summing the phase-specific doses in the planning image for each fraction. The fraction-specific dose distributions were deformed and superimposed onto the planning image, forming the course-specific respiratory motion perturbed dose distribution. Planned and respiratory motion perturbed doses were compared and changes due to respiratory motion and choice of fractionation were evaluated.

Results

The respiratory motion perturbed PTV coverage (V95%) decreased by 1.7% and the homogeneity index increased by 0.02 for VMAT techniques, compared to the planned values. Highest decrease in CTV coverage was 0.7%. The largest dose differences were located in the areas of steep dose gradients parallel to respiratory motion. The largest difference in DVH parameters between fractionation schemes was 0.4% of the prescribed dose. Clinically relevant changes to the doses of organs at risk were not observed. One patient was excluded from the analysis due to large respiratory amplitude.

Conclusion

Respiratory motion of less than 5 mm in magnitude did not result in clinically significant changes in the planned free-breathing WBI dose. The 5 mm margins were sufficient to account for the respiratory motion in terms of CTV dose homogeneity and coverage for VMAT techniques. Steep dose gradients near the PTV edges might decrease the CTV coverage. No clinical significance was found due to the choice of fractionation.
Dosimetric parameters and absolute monocyte count can predict the prognosis of acute hematologic toxicity in cervical cancer patients undergoing concurrent chemotherapy and volumetric-modulated arc therapy
Authors: Xiang Xiaoyong , Ding Zhen , Zeng Qi , Feng Lingling , Qiu Chunyan , Chen Dongjie , Lu Jiawei , Li Ning
Published: March 2022

Purpose

To explore clinical and dosimetric predictors of acute hematologic toxicity (HT) in cervical cancer patients treated with concurrent chemotherapy and volumetric-modulated arc therapy (VMAT).

Methods and materials

We retrospectively reviewed the clinical data of 184 cervical cancer patients who had concurrent chemotherapy and VMAT. Hematological parameters were collected during the treatment period. The total pelvic bone (TPB) was delineated retrospectively for dose-volume calculations. To compare the differences between two groups, the normality test findings were used to run a paired-samples t-test or Wilcoxon signed-rank test. Pearson's correlation analysis or Spearman's correlation was used to testing the correlation between the two variables. Binary logistic regression analysis was used to analyze associations between HT and possible risk factors. The receiver operating characteristic curve(ROC) was used to evaluate the best cut-off point for dosimetric planning constraints.

Results

The nadir of absolute monocyte count (AMC) was found to be positively correlated with the nadir of absolute white blood cells (WBC) count (r = 0.5378, 95% CI 0.4227–0.6357, P < 0.0001) and the nadir of absolute neutrophil count(ANC) (r = 0.5000, 95% CI 0.3794–0.6039, P < 0.0001). The AMC decreased and increased before the ANC and WBC. In multivariate logistic regression analysis, the chemotherapy regimens and the TPB_V20 were independent risk factors for developing grade ≥ 3 HT. The optimal TPB_V20 cut-off value identified by ROC curves and the Youden test was 71% (AUC = 0.788; 95% CI 0.722–0.845; P value < 0.001).

Conclusions

The changing trend of AMC can be used as an effective predictor for the timing and severity of the ANC/WBC nadirs and prophylactic G-CSF administration. Maintain TPB_V20 < 71% and selecting single-agent cisplatin or carboplatin could significantly reduce grade ≥ 3 HT in cervical cancer patients undergoing concurrent chemoradiotherapy.
MiR-146a expression profiles in osteoarthritis in different tissue sources: a meta-analysis of observational studies
Authors: Liu Jia-Neng , Lu Song , Fu Chang-Ma
Published: March 2022

Background

MiR-146a has been widely studied in the pathogenesis of osteoarthritis (OA); however, the results are still controversial.

Objective

This meta-analysis analyzes the expression profile of miR-146a in various tissues of OA patients.

Methods

Public databases were searched for appropriate studies published up to September 1, 2021. A case–control study comparing the OA population and a non-OA healthy population was included.

Results

26 articles were included in analysis. The results showed that the expression level of miR-146a in peripheral blood mononuclear cells (PBMCs) was significantly higher in OA patients than in controls (SMD: 1.23; 95% CI 0.08–2.37;p = 0.035) but not in plasma (SMD: 1.09; 95% CI − 0.06, 2.24;p = 0.064). The expression level of miR-146a in cartilage was also significantly higher in OA patients than in controls (SMD: 6.39; 95% CI 0.36, 12.4;p = 0.038) but not in chondrocytes (SMD: − 0.71; 95% CI − 4.15, 2.73;p = 0.687). The miR-146a level was significantly lower in synoviocytes in the OA population than in control patients (SMD: − 0.97; 95% CI − 1.68, − 0.26;p = 0.008). In synovial tissue, synovial fluid, and regulatory T cells, there was no significant difference.

Conclusion

The expression level of miR-146a in cartilage tissue and PBMCs was significantly higher in OA patients than in non-OA healthy controls. Due to the limitations of this study, more research is needed to confirm these results in the future.

Trial registration: retrospectively registered.
Differences in fixation to young and elderly quadrilateral surfaces with anatomic quadrilateral surface plate (AQSP) based on cortical thickness morphological results
Authors: Guo Jialiang , Dong Weichong , Zhou Yali , Hu Jinglue , Ye Pengyu , Chen Wei , Zhang Yingze , Hou Zhiyong
Published: March 2022

Aims

With relatively thinner cortical thickness, the management of acetabulum osteoporotic fractures in elderly patients is difficult. The aim of the research was to compare and present the morphological characteristics of the quadrilateral plate in young and elderly age groups, such as the area, and position distribution of the thin cortical thickness region, fracture lines maps, and propose a revised design plate for elderly patients based on these anatomic information.

Methods

As a retrospective research, acetabular fracture with one normal hemipelvises, including 110 men and 39 women, were collected to present the morphological characteristics of the quadrilateral region. The subjects were divided into three different age groups: Group I = 18–40 years (31.3 ± 6.6 years), Group II = 41–60 years (49.9 ± 5.3 years), and Group III ≥ 61 years (68.7 ± 6.8 years). The area of the quadrilateral surface, the area and position distribution of the thin cortical thickness region, the ratio and fracture lines maps were calculated and compared with Mimics in different groups.

Results

The thin cortical thickness/width region area (TCWRA) was significantly increased in Group III compared with Group I and Group II. The ratio of TCWRA accounted for in the quadrilateral region was also significantly increased in Group III (≥ 61 years) compared with Group I (P = 0.01) and Group II (P = 0.011). None of the subjects had a component involving the “A” zone, thirty-three thin cortical thickness regions were located in the “B” zone, and one hundred and sixteen involved both zones of the quadrilateral plate (“A + B” zone). Furthermore, there were a significant differences in the fracture line distributions in three age groups. More fracture lines of elderly patients were located at anterior part (B zone) compared with Group I and Group II.

Conclusions

It was identified the area of thin cortical thickness region increased as age grown, and fracture lines were inclined to be more distributed in “B” zone in elderly patients. To meet the demands of acetabular fixation in different age groups, cortical thickness changes in young and elderly individuals should be given special attention when the quadrilateral surface plate is designed.

Level of evidence Level IV, observational study.
α-Mangostin inhibits LPS-induced bone resorption by restricting osteoclastogenesis via NF-κB and MAPK signaling
Authors: Zhang Wenkan , Jiang Guangyao , Zhou Xiaozhong , Huang Leyi , Meng Jiahong , He Bin , Qi Yiying
Published: March 2022

Background

Excessive osteoclast activation is an important cause of imbalanced bone remodeling that leads to pathological bone destruction. This is a clear feature of many osteolytic diseases such as rheumatoid arthritis, osteoporosis, and osteolysis around prostheses. Because many natural compounds have therapeutic potential for treating these diseases by suppressing osteoclast formation and function, we hypothesized that α-mangostin, a natural compound isolated from mangosteen, might be a promising treatment as it exhibits anti‐inflammatory, anticancer, and cardioprotective effects.

Methods

We evaluated the therapeutic effect of α-mangostin on the processes of osteoclast formation and bone resorption. The receptor activator of nuclear factor-κB (NF-κB) ligand (RANKL) induces osteoclast formation in vitro, and potential pathways of α-mangostin to inhibit osteoclast differentiation and function were explored. A mouse model of lipopolysaccharide‐induced calvarial osteolysis was established. Subsequently, micro-computed tomography and histological assays were used to evaluate the effect of α-mangostin in preventing inflammatory osteolysis.

Results

We found that α-mangostin could inhibit RANKL-induced osteoclastogenesis and reduced osteoclast‐related gene expression in vitro. F-actin ring immunofluorescence and resorption pit assays indicated that α-mangostin also inhibited osteoclast functions. It achieved these effects by disrupting the activation of NF-κB/mitogen-activated protein kinase signaling pathways. Our in vivo data revealed that α-mangostin could protect mouse calvarial bone from osteolysis.

Conclusions

Our findings demonstrate that α-mangostin can inhibit osteoclastogenesis both in vitro and in vivo and may be a potential option for treating osteoclast-related diseases.
Physicians’ knowledge on specific rare diseases and its associated factors: a national cross-sectional study from China
Authors: Zhang Huanyu , Xiao Ying , Zhao Xinyue , Tian Zhuang , Zhang Shu-yang , Dong Dong
Published: March 2022

Background

Rare disease patients often experience diagnosis delays or misdiagnosis, which may be due to lack of knowledge on rare diseases among physicians.

Objective

To assess Chinese physicians’ knowledge on specific rare diseases and identify its associated factors.

Methods

Thirty-four patient organizations with a unique disease of interest were invited to develop 3 knowledge questions for each rare disease to assess physicians’ knowledge on the disease that they felt most experienced in. The total knowledge score for each participant ranged from a score of 0 to 3. A national cross-sectional study conducted in a cohort of 3197 physicians from 6 provinces across western, central and eastern China. The demographic information of the participants was collected including gender, age, birthplace, income, education, hospital class, working title, working years, and specialty. A multiple linear regression analysis was performed to assess the independent associations between the physician variables and the total knowledge score.

Results

Two thousand, one hundred and fifteen (66.16%) of the involved physicians obtained a total knowledge score of 2 or 3. The median knowledge scores of 10 (29.4%) rare diseases were a score of 1.5 or below. Physicians with female gender (β = 0.08, p < 0.05 for females vs. males), and a monthly income of 5000–10,000 RMB (β = 0.11, p < 0.01 for 5000–10,000 vs. < 5000) and 10,000–30,000 RMB (β = 0.14, p < 0.05) were associated with a higher score. Specialties of physicians who received a relatively higher score included internal medicine, obstetrics and gynecology, radiology, intensive care unit, and surgery.

Conclusions

Almost two thirds of the participants had an average or good level of knowledge on the specific rare disease that they felt most experienced in. Physicians with female gender, a monthly income of 5000–10,000 RMB and 10,000–30000 RMB, and specialties of internal medicine, obstetrics and gynecology, radiology, intensive care unit, and surgery, were associated with a relatively higher knowledge score.
Utilizing the “teach-back” method to improve surgical informed consent and shared decision-making: a review
Authors: Seely Kevin D. , Higgs Jordan A. , Nigh Andrew
Published: March 2022

The teach-back method is a valuable communication tool that can be employed to improve patient safety and shared decision-making. Its utility in patient care has been studied extensively in many areas of clinical medicine. However, the literature on the use of teach-back in surgical patient education and informed consent is limited. Additionally, there is some ambiguity about the functional definition and performance of the teach-back method in the literature, consequently rendering this valuable tool an enigma. This review examines the current standards and ethics of preoperative informed consent and provides a concise, actionable definition of teach-back. The manner in which teach-back has been implemented in medicine and surgery is then examined in detail. Studies analyzing the use of teach-back in medicine have demonstrated its effectiveness and benefit to patient care. Further study on the use of teach-back to improve preoperative informed consent is supported by the few preliminary trials showing a positive effect after implementing the teach-back method in critical patient interactions.
Characterization of a rare mosaic unbalanced translocation of t(3;12) in a patient with neurodevelopmental disorders
Authors: Hu Xiaolin , Baker Elizabeth K. , Johnson Jodie , Balow Stephanie , Pena Loren D. M. , Conlin Laura K. , Guan Qiaoning , Smolarek Teresa A.
Published: March 2022

Background

Unbalanced translocations may be de novo or inherited from one parent carrying the balanced form and are usually present in all cells. Mosaic unbalanced translocations are extremely rare with a highly variable phenotype depending on the tissue distribution and level of mosaicism. Mosaicism for structural chromosomal abnormalities is clinically challenging for diagnosis and counseling due to the limitation of technical platforms and complex mechanisms, respectively. Here we report a case with a tremendously rare maternally-derived mosaic unbalanced translocation of t(3;12), and we illustrate the unreported complicated mechanism using single nucleotide polymorphism (SNP) array, fluorescence in situ hybridization (FISH), and chromosome analyses.

Case presentation

An 18-year-old female with a history of microcephaly, pervasive developmental disorder, intellectual disability, sensory integration disorder, gastroparesis, and hypotonia presented to our genetics clinic. She had negative karyotype by parental report but no other genetic testing performed previously. SNP microarray analysis revealed a complex genotype including 8.4 Mb terminal mosaic duplication on chromosome 3 (3p26.3->3p26.1) with the distal 5.7 Mb involving two parental haplotypes and the proximal 2.7 Mb involving three parental haplotypes, and a 6.1 Mb terminal mosaic deletion on chromosome 12 (12p13.33->12p13.31) with no evidence for a second haplotype. Adjacent to the mosaic deletion is an interstitial mosaic copy-neutral region of homozygosity (1.9 Mb, 12p13.31). The mother of this individual was confirmed by chromosome analysis and FISH that she carries a balanced translocation, t(3;12)(p26.1;p13.31).

Conclusion

Taken together, the proband, when at the stage of a zygote, likely carried the derivative chromosome 12 from this translocation, and a postzygotic mitotic recombination event occurred between the normal paternal chromosome 12 and maternal derivative chromosome 12 to “correct” the partial 3p trisomy and partial deletion of 12p. To the best of our knowledge, it is the first time to report the mechanism utilizing a combined cytogenetic and cytogenomic approach, and we believe it expands our knowledge of mosaic structural chromosomal disorders and provides new insight into clinical management and genetic counseling.
Growth retardation and congenital heart disease in a boy with a ring chromosome 6 of maternal origin
Authors: Dong Yanling , Li Jian , Zeng Ziye , Zhang Xue , Liang Mingxin , Yi Hong , Luo Jianyun , Li Junnan
Published: March 2022

Background

Rare chromosomal structural abnormalities, including ring chromosomes, often pose challenges to clinical genetic counselling.

Results

Here, we report a newborn with congenital heart disease and developmental delay who inherited ring chromosome 6 [46,XY,r(6)(p25q27)mat] from a phenotypically normal mother. Genotypes and phenotypes were analysed by molecular cytogenetic analysis, whole-exome sequencing and literature review.

Conclusions

Our study showed that the pathogenicity of the ring chromosome abnormality [r(6)(p25q27)] was mainly affected by chromosome imbalance, deletions of genes with haploinsufficiency, duplications of genes with triple sensitivity, parental inheritance of the imbalance and the imprinting status of the affected genes.
Preparedness for mass gatherings: rescue and emergency medical services’ workloads during mass gathering events
Authors: Koski Anssi , Pappinen Jukka , Kouvonen Anne , Nordquist Hilla
Published: March 2022

Background

Mass gathering (MG) events may cause delayed emergency responses via various mechanisms and strain the resources of local emergency services. Therefore, preparedness, including adequate pre-planning and sufficient resourcing during MG events, is vital. The aim of this retrospective register study was to investigate the impact of MG events on the workload of rescue and emergency medical service (EMS) personnel during events to enable more precise and sufficient deployment of these authorities’ operative resources.

Methods

The data from Finland covered of 25,124 EMS and rescue service missions during a three-year period (2015–2017), including data from nine MG events and reference material for the same weekdays two weeks before and after the event. The data were analysed through statistical and geospatial analyses.

Results

Our findings showed that missions increased in most events included in this study. Analysis of the missions’ reasons showed that the categories of violence, traffic accidents and other accidents and injuries increased during events, with violence-related missions showing the highest relative risk (RR 1.87, 95% CI 1.43–2.44). In the four-grade (A–D) urgency grading, the analysis showed an increase in category C missions and a decrease in non-urgent category D missions. The analysis indicated an increase in missions during the evening and night-time. The geospatial analysis revealed dense hotspots of missions in the vicinity of the event area.

Conclusion

The workload for EMS and rescue service personnel increases during MG events. Most of the increase is allocated to EMS staff, peaking in evening and night hours. The geospatial analysis showed hotspots of missions on the outskirts of the actual event area during events; thus, the workload can also increase for those authority resources that are not directly allocated to the event. Detailed information regarding workloads is valuable for the authorities that are responsible for resource planning and preparedness for MG events. Replicating the study internationally would improve the methodology for the future.
Cellular mechanisms underlying response and resistance to CDK4/6 inhibitors in the treatment of hormone receptor-positive breast cancer
Authors: Watt April C. , Goel Shom
Published: March 2022

Pharmacological inhibitors of cyclin-dependent kinases 4 and 6 (CDK4/6) are now an established standard of care for patients with advanced hormone receptor-positive breast cancer. The canonical mechanism underlying CDK4/6 inhibitor activity is the suppression of phosphorylation of the retinoblastoma tumor suppressor protein, which serves to prevent cancer cell proliferation. Recent data suggest that these agents induce other diverse effects within both tumor and stromal compartments, which serve to explain aspects of their clinical activity. Here, we review these phenomena and discuss how they might be leveraged in the development of novel CDK4/6 inhibitor-containing combination treatments. We also briefly review the various known mechanisms of acquired resistance in the clinical setting.
Hybrid high-definition microvessel imaging/shear wave elastography improves breast lesion characterization
Authors: Gu Juanjuan , Ternifi Redouane , Larson Nicholas B. , Carter Jodi M. , Boughey Judy C. , Stan Daniela L. , Fazzio Robert T. , Fatemi Mostafa , Alizad Azra
Published: March 2022

Background

Low specificity in current breast imaging modalities leads to increased unnecessary follow-ups and biopsies. The purpose of this study is to evaluate the efficacy of combining the quantitative parameters of high-definition microvasculature imaging (HDMI) and 2D shear wave elastography (SWE) with clinical factors (lesion depth and age) for improving breast lesion differentiation.

Methods

In this prospective study, from June 2016 through April 2021, patients with breast lesions identified on diagnostic ultrasound and recommended for core needle biopsy were recruited. HDMI and SWE were conducted prior to biopsies. Two new HDMI parameters, Murray’s deviation and bifurcation angle, and a new SWE parameter, mass characteristic frequency, were included for quantitative analysis. Lesion malignancy prediction models based on HDMI only, SWE only, the combination of HDMI and SWE, and the combination of HDMI, SWE and clinical factors were trained via elastic net logistic regression with 70% (360/514) randomly selected data and validated with the remaining 30% (154/514) data. Prediction performances in the validation test set were compared across models with respect to area under the ROC curve as well as sensitivity and specificity based on optimized threshold selection.

Results

A total of 508 participants (mean age, 54 years ± 15), including 507 female participants and 1 male participant, with 514 suspicious breast lesions (range, 4–72 mm, median size, 13 mm) were included. Of the lesions, 204 were malignant. The SWE-HDMI prediction model, combining quantitative parameters from SWE and HDMI, with AUC of 0.973 (95% CI 0.95–0.99), was significantly higher than the result predicted with the SWE model or HDMI model alone. With an optimal cutoff of 0.25 for the malignancy probability, the sensitivity and specificity were 95.5% and 89.7%, respectively. The specificity was further improved with the addition of clinical factors. The corresponding model defined as the SWE-HDMI-C prediction model had an AUC of 0.981 (95% CI 0.96–1.00).

Conclusions

The SWE-HDMI-C detection model, a combination of SWE estimates, HDMI quantitative biomarkers and clinical factors, greatly improved the accuracy in breast lesion characterization.
INHBA is a mediator of aggressive tumor behavior in HER2+ basal breast cancer
Authors: Liu Moqing , Smith Rebecca , Liby Tiera , Chiotti Kami , López Claudia S. , Korkola James E.
Published: March 2022

Background

Resistance to HER2-targeted therapeutics remains a significant clinical problem in HER2+ breast cancer patients with advanced disease. This may be particularly true for HER2+ patients with basal subtype disease, as recent evidence suggests they receive limited benefit from standard of care HER2-targeted therapies. Identification of drivers of resistance and aggressive disease that can be targeted clinically has the potential to impact patient outcomes.

Methods

We performed siRNA knockdown screens of genes differentially expressed between lapatinib-responsive and -resistant HER2+ breast cancer cells, which corresponded largely to luminal versus basal subtypes. We then validated hits in 2-d and 3-d cell culture systems.

Results

Knockdown of one of the genes, INHBA, significantly slowed growth and increased sensitivity to lapatinib in multiple basal HER2+ cell lines in both 2-d and 3-d cultures, but had no effect in luminal HER2+ cells. Loss of INHBA altered metabolism, eliciting a shift from glycolytic to oxidative phosphorylative metabolism, which was also associated with a decrease in tumor invasiveness. Analysis of breast cancer datasets showed that patients with HER2+ breast cancer and high levels of INHBA expression had worse outcomes than patients with low levels of INHBA expression.

Conclusions

Our data suggest that INHBA is associated with aggressiveness of the basal subtype of HER2+ tumors, resulting in poor response to HER2-targeted therapy and an invasive phenotype. We hypothesize that targeting this pathway could be an effective therapeutic strategy to reduce invasiveness of tumor cells and to improve therapeutic response.
The effect of tourniquet application on the morphology and function of quadriceps in patients undergoing total knee arthroplasty: study protocol for a single-blind randomized controlled trial
Authors: Dong Ziyang , Li Yang , Tao Liyuan , Tian Hua
Published: March 2022

Background

Tourniquet is currently widely used in total knee arthroplasty to reduce intraoperative blood loss. The academic view of tourniquet application in TKA is now in dispute. Some scholars argue that tourniquet may cause quadriceps injury and bring extra side effects, so they oppose the application of tourniquet. Others find that tourniquet application has no significant adverse impact on TKA patients. Regarding its advantages in reducing intraoperative blood loss, they advocate the regular application of tourniquet in TKA. Quadriceps injury is considered the main cause of tourniquet side effects. There are now many high-quality trials about tourniquet application in TKA but few of them concentrate on quadriceps morphology and function.

Methods

A prospective, single-blind, randomized controlled trial will be adopted. The target sample is 130. Patients who meet the eligibility criteria will be randomly allocated to the tourniquet group and non-tourniquet group. The primary outcome is quadriceps thickness evaluated by ultrasound test. Secondary outcomes include quadriceps stiffness, rehabilitation outcomes, operation time, intraoperative and postoperative blood loss, blood transfusion rate, thigh circumference, VAS score, opioid consumption, d-dimer and C-reactive protein level in the serum, knee function score, postoperative satisfaction score, and complications.

Discussion

This proposed study will contribute to improve evidence of tourniquet application in total knee arthroplasty. This will be a high-quality single-blind randomized controlled trial with a sufficient sample size and strict study design. It will investigate the effects of tourniquet application especially on the morphology and function of quadriceps in patients undergoing total knee arthroplasty and offer advice for tourniquet application in clinical practice.

Trial registration

Chinese Clinical Trial Registry ChiCTR2000035097. Registered on 31 July 2020
A randomized non-inferiority study of low-dose and standard-dose ticagrelor after intervention for acute coronary syndrome: study protocol for the TIGER STUDY
Authors: Pang Yanan , Ma Minglu , Xia Jiachun , Wang Dong , YanChen  , Ye Jianfei , Jia Zhongwei , Wu Sicheng , Yang Jian , Hou Lei
Published: March 2022

Background

Current guidelines recommend that patients with acute coronary syndrome (ACS) who have successfully undergone percutaneous coronary intervention (PCI) should continue to use dual antiplatelet therapy (DAPT) for 12 months. The long-term use of standard-dose dual antiplatelet therapy will increase the risk of bleeding. An optimized antiplatelet strategy that can prevent ischemic events and reduce the risk of bleeding remains to be explored.

Methods

The study is a prospective, multicenter, randomized, open-label, controlled study involving 2090 patients from six clinical centers in China. Through the interactive web response system (IWRS), ACS patients undergoing successful PCI will be randomly divided into the low-dose ticagrelor group or the normal-dose ticagrelor group, after taking 100 mg aspirin and 90 mg ticagrelor bid for 1 week. The primary endpoint is a composite of cardiovascular death, non-fatal myocardial infarction, stent thrombosis, repeat revascularization, and stroke. The secondary endpoints are bleeding events of grade 2 or higher according to Bleeding Academic Research Consortium [BARC] criteria, cardiovascular death, acute myocardium infarction, and coronary revascularization at 1 year.

Discussion

Recent studies have confirmed that 90 mg ticagrelor alone can safely and effectively reduce bleeding without increasing ischemic events of patients with ACS after PCI. Compared with standard-dose DAPT, whether low-dose ticagrelor combined with aspirin can ensure the anti-ischemic effect while reducing the bleeding risk remains unclear in Chinese patients.

The TIGER study will be the first large-scale, multicenter study to compare the efficacy and safety of low-dose and standard-dose ticagrelor combined with aspirin in ACS patients 1 week after successful PCI.

Trial registration

Clinicaltrials.gov NCT04255602. Registered on 5 February 2020.
From tissue engineering to mosquitoes: biopolymers as tools for developing a novel biomimetic approach to pest management/vector control
Authors: Friuli Marco , Cafarchia Claudia , Lia Riccardo Paolo , Otranto Domenico , Pombi Marco , Demitri Christian
Published: March 2022

Background

Pest management has been facing the spread of invasive species, insecticide resistance phenomena, and concern for the impact of chemical pesticides on human health and the environment. It has tried to deal with them by developing technically efficient and economically sustainable solutions to complement/replace/improve traditional control methods. The renewal has been mainly directed towards less toxic pesticides or enhancing the precision of their delivery to reduce the volume employed and side effects through lure-and-kill approaches based on semiochemicals attractants. However, one of the main pest management problems is that efficacy depends on the effectiveness of the attractant system, limiting its successful employment to semiochemical stimuli-responsive insects. Biomaterial-based and bioinspired/biomimetic solutions that already guide other disciplines (e.g., medical sciences) in developing precision approaches could be a helpful tool to create attractive new strategies to liberate precision pest management from the need for semiochemical stimuli, simplify their integration with bioinsecticides, and foster the use of still underemployed solutions.

Approach proposed

We propose an innovative approach, called “biomimetic lure-and-kill”. It exploits biomimetic principles and biocompatible/biodegradable biopolymers (e.g., natural hydrogels) to develop new substrates that selectively attract insects by reproducing specific natural environmental conditions (biomimetic lure) and kill them by hosting and delivering a natural biopesticide or through mechanical action. Biomimetic lure-and-kill-designed substrates point to provide a new attractive system to develop/improve and make more cost-competitive new and conventional devices (e.g. traps). A first example application is proposed using the tiger mosquito Aedes albopictus as a model.

Conclusions

Biomaterials, particularly in the hydrogel form, can be a useful tool for developing the biomimetic lure-and-kill approach because they can satisfy multiple needs simultaneously (e.g., biomimetic lure, mechanical lethality, biocompatibility, and bioinsecticide growth). Such an approach might be cost-competitive, and with the potential for applicability to several pest species. Moreover, it is already technically feasible, since all the technologies necessary to design and configure materials with specific characteristics are already available on the market.

Graphical Abstract
Sustained efficacy of collars containing 10% w/w imidacloprid and 4.5% w/w flumethrin (Seresto®) in dogs against laboratory challenge with Haemaphysalis longicornis (Neumann, 1901) ticks
Authors: Meyer Leon , Lekouch Nouha , Altreuther Gertraut , Schunack Bettina , Pollmeier Matthias
Published: March 2022

Background

Haemaphysalis longicornis ticks are reported on dogs from an increasing geographic range. This study aimed to determine the sustained efficacy of Seresto® collars (imidacloprid/flumethrin) against experimental infestations of H. longicornis in dogs.

Methods

Twenty-four Beagle dogs previously assessed for their suitability to harbor ticks were included in the study and randomized into three groups of eight dogs each. Two of the groups were treated with collars at different time points: at the first tick infestation, dogs in group 1 had already worn collars for 92 days, while dogs in group 2 had received collars only on the previous day, thus allowing evaluation of two different treatment durations at the same point in time. Infestation of the treated groups was conducted at 1, 7, 28, and 56 days (group 2) and 92, 119, 147, 168, 196, 227, and 238 days (group 1) after collar placement. Group 3 served as untreated control and was infested whenever the dogs of the other two groups were infested. Infestations were conducted using 50 viable, adult, unfed female ticks of a US isolate of H. longicornis per dog. Ticks were removed and counted 48 h after each infestation. Health and body weight of the dogs were monitored throughout the study. The efficacy against ticks was calculated for groups 1 and 2 based on arithmetic mean values at each assessment day according to Abbott’s formula. The mean post-treatment H. longicornis tick counts were compared statistically between treatments, using an analysis of variance with a treatment effect untransformed tick count.

Results

Dogs in the control group were adequately infested at all tick counts. Efficacy was 88.2% on day 3, however well above 90% (i.e., 98.3 to 100%) at all other time points up to day 240. Statistical analysis confirmed significantly different live tick counts (P < 0.001) between the treated groups and the control group at all time points.

Conclusions

The 8-month sustained acaricidal efficacy demonstrated by the Seresto® collar (imidacloprid/flumethrin) provides a reliable strategy against H. longicornis infestations in dogs.

Graphical Abstract
Impact of diabetes mellitus on outcomes of patients with sepsis: an updated systematic review and meta-analysis
Authors: Jiang Li , Cheng Mengdi
Published: March 2022

Background

The effect of concurrent diabetes on the outcome of sepsis is not conclusively known. A meta-analysis published in 2017 indicated that diabetes did not influence the mortality of patients with sepsis but increased the risk of acute renal injury. In view of publication of several new studies in recent years, there is a need for updated evidence.

Methods

A systematic search was conducted using the PubMed, Scopus, Embase, and Google Scholar databases. Studies that were done in patients with sepsis, were observational in design- either cohort or case–control or analysed retrospective data were considered for inclusion. Statistical analysis was performed using STATA software.

Results

A total of 21 studies were included. The risk of in-hospital mortality (RR 0.98, 95% CI 0.93, 1.04) and mortality at latest follow up i.e., within 90 days of discharge (RR 0.94, 95% CI 0.86, 1.04) among diabetic and non-diabetic subjects was statistically similar. There was an increased risk of in-hospital mortality among those with high blood glucose level at admission (RR 1.45, 95% CI 1.01, 2.09). Among those who were diabetic, the risk of acute renal failure (RR 1.54, 95% CI 1.34, 1.78) was higher than non-diabetics. The risk of respiratory failure, adverse cardiac events, need for additional hospitalization post-discharge and length of hospital stay was similar among diabetics and non-diabetics.

Conclusions

Diabetes is not associated with poor survival outcomes in patients with sepsis but is associated with increased risk of acute renal failure. High blood glucose levels, irrespective of the diabetes status, are associated with increased risk of in-hospital mortality. Findings underscore the need for better evaluation of renal function in diabetic patients with concurrent sepsis.
The role of growth hormone and IGF-1 in retinopathy: a prospective study of retinopathy in patients with acromegaly and impaired fasting glucose
Authors: Wu Tzu-En , Chen Harn-Shen
Published: March 2022

Aims

To investigate the effects of the growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis on the incidence and progression of retinopathy.

Methods

We enrolled 91 patients with acromegaly and 123 subjects with impaired fasting glucose (IFG) between 2008 and 2016 to examine the incidence and prevalence of retinopathy. Patients attended follow-ups in our clinics and underwent examinations according to the national guidelines for diabetes management. Both cohorts attended follow-ups until June 2019.

Results

Both groups had similar HbA1c, cholesterol, and blood pressure levels. However, patients with acromegaly had higher GH (8.05 ± 16.18 vs. 0.78 ± 1.25 ng/mL) and IGF-1 (547.0 ± 342.1 vs. 146.7 ± 51.4 ng/mL) levels than in subjects with IFG. During the follow-up period, 8 patients (8.8%) with acromegaly and 12 patients (9.8%) with IFG developed some degree of retinopathy. Three patients with acromegaly and two with IFG progressed to proliferative retinopathy. Patients with acromegaly had the same incidence of non-proliferative retinopathy (odds ratio [OR] 0.830; 95% CI 0.318–2.164) and a non-statistically significantly higher incidence of proliferative retinopathy (OR 2.461; 95% CI 0.404–14.988).

Conclusion

The data reveals that GH and IGF-1 might play a crucial role in the development of proliferative retinopathy and influence its progression. Therefore, we suggest screening patients with acromegaly should be similar to diabetes patients.
Prevalence and prognosis of respiratory pendelluft phenomenon in mechanically ventilated ICU patients with acute respiratory failure: a retrospective cohort study
Authors: Chi Yi , Zhao Zhanqi , Frerichs Inéz , Long Yun , He Huaiwu
Published: March 2022

Background

Respiratory pendelluft phenomenon, defined as intrapulmonary gas redistribution caused by asynchronous alveolar ventilation, could be potentially harmful by inducing lung injury. The aim of the present study was to investigate its prevalence and prognosis in intensive care unit (ICU) patients with acute respiratory failure (ARF).

Methods

This was a retrospective observational study on 200 mechanically ventilated ARF patients treated in a tertiary ICU. The presence of pendelluft was determined using electrical impedance tomography (EIT) within 48 h after admission. Its amplitude was defined as the impedance difference between the sum of all regional tidal impedance variation and the global tidal impedance variation. A value above 2.5% (the 95th percentile from 30 healthy volunteers) was considered confirmative for its occurrence.

Results

Pendelluft was found in 61 patients (39 in 94 patients with spontaneous breathing, 22 in 106 receiving controlled ventilation), with an overall prevalence of 31%. Existence of spontaneous breathing and higher global inhomogeneity index were associated with pendelluft. Patients with pendelluft had a longer ICU length of stay [10 (6, 14) vs. 7 (4, 11) days; median (lower, upper quartile); p = 0.022] and shorter 14-day ventilator-free days [8 (1, 10) vs. 10 (6, 12) days; p = 0.015]. Subgroup survival analysis suggested the association between pendelluft and longer ventilation duration, which was significant only in patients with PaO2/FiO2 ratio below 200 mmHg (log-rank p = 0.042). ICU mortality did not differ between the patients with and without pendelluft.

Conclusions

Respiratory pendelluft occurred often in our study group and it was associated with longer ventilation duration. Early recognition of this phenomenon should trigger interventions aimed at alleviating pendelluft.
Empirical examination of relationship between venture capital financing and profitability of portfolio companies in Uganda
Authors: Kato Ahmed I. , Germinah Chiloane-Phetla E.
Published: March 2022

In recent times, venture capital (VC) financing has evolved as an alternative feasible funding model for young innovative companies. Existing studies focus on whether VC enhances profitability. While helpful, this body of work does not address a critical question: whether VC firms are more profitable than non-VC firms. The co-existence of both VC and non VC firms in Africa provides an opportunity to address this question. Accordingly, this paper sought to extend the understanding of the relationship between VC financing and the profitability of portfolio companies in Uganda, a rapidly growing VC market. We utilised a mixed methods approach, which involved quantitative data collected from 68 key VC stakeholders, and qualitative data collected from 16 semi-structured face-to-face interviews. The results confirm the superior performance of VC-financed enterprises when compared to non-VC-financed enterprises. The study makes a vital contribution by offering a diversified framework for enterprise success. The framework will assist VC firms in evaluating and customising funding programmes that can propel early-stage firms’ success in Uganda, and in similar emerging economies. Secondly, our results contribute to extant knowledge about recent developments in Uganda’s VC industry and how it influences the profitability trends of SMEs, also in similar emerging economies.