bluuebunny/crossref_metadata_2025 huggingface dataset:
Next-Generation Sequencing for Pathogen Identification in Infected Foot Ulcers
Authors: Choi Yoonjung , Oda Eimi , Waldman Olivia , Sajda Thomas , Beck Christopher , Oh Irvin
Published: July 2021

Background:

Accurate identification of primary pathogens in foot infections remains challenging due to the diverse microbiome. Conventional culture may show false-positive or false-negative growth, leading to ineffective postoperative antibiotic treatment. Next-generation sequencing (NGS) has been explored as an alternative to standard culture in orthopedic infections. NGS is highly sensitive and can detect an entire bacterial genome along with genes conferring antibiotic resistance in a given sample. We investigated the potential use of NGS for accurate identification and quantification of microbes in infected diabetic foot ulcer (DFU). We hypothesize that NGS will aid identification of dominant pathogen and provide a more complete profile of microorganisms in infected DFUs compared to the standard culture method.

Methods:

Data were prospectively collected from 30 infected DFU patients who underwent operative treatment by a fellowship-trained orthopedic foot and ankle surgeon from October 2018 to September 2019. The average age of the patient was 60.4 years. Operative procedures performed were irrigation and debridement (12), toe or ray amputation (13), calcanectomies (4), and below-the-knee amputation (1). Infected bone specimens were obtained intraoperatively and processed for standard culture and NGS. Concordance between the standard culture and NGS was assessed.

Results:

In 29 of 30 patients, pathogens were identified by both NGS and culture, with a concordance rate of 70%. In standard culture, Staphylococcus aureus (58.6%) was the most common pathogen, followed by coagulase-negative Staphylococcus (24.1%), Corynebacterium striatum (17.2%), and Enterococcus faecalis (17.2%). In NGS, Finegoldia magna (44.8%) was the most common microorganism followed by S. aureus (41.4%), and Anaerococcus vaginalis (24.1%). On average, NGS revealed 5.1 (range, 1-11) pathogens in a given sample, whereas culture revealed 2.6 (range, 1-6) pathogens.

Conclusion:

NGS is an emerging molecular diagnostic method of microbial identification in orthopedic infection. It frequently provides different profiles of microorganisms along with antibiotic-resistant gene information compared to conventional culture in polymicrobial foot infection. Clinical use of NGS for management of foot and ankle infections warrants further investigation.

Level of Evidence:

Level II, diagnostic study.
Does pterygium morphology affect corneal astigmatism?
Authors: Doğan Emine , Çakır Burçin , Aksoy Nilgün , Köse Elif , Alagöz Gürsoy
Published: July 2021

Purpose:

The purpose of this study was to evaluate the correlation between corneal astigmatism and the morphology of pterygium with anterior segment optic coherence tomography (AS-OCT).

Material and Methods:

The size of pterygium (horizontal length, vertical width) was measured manually; pterygium area and percentage extension of the pterygium onto the cornea were calculated. Anterior and posterior corneal astigmatism, Sim K, K1, K2 were measured using a dual Scheimpflug analyzer. Morphological patterns of the pterygium analyzed with AS-OCT were determined according to the extension of the pterygium apex below the corneal epithelium. Two tomographic patterns were identified: continuous and nodular. Correlation between anterior corneal astigmatism and pterygium size, percentage extension of the pterygium, and morphological pattern of the pterygium was analyzed.

Results:

The mean ages of the 47 patients were 49.4 ± 16.6 (22–80) years. Mean horizontal pterygium length, vertical width, pterygium area, and percentage extension of the pterygium were 2.8 ± 1.2 mm, 4.8 ± 1.6 mm, 7.42 ± 5.6 mm2 and 24.5 ± 10.4%, respectively. Mean anterior corneal astigmatism was 2.3 ± 2.3 D and simulated keratometry was 43.4 ± 2.02 D. In terms of the morphological pattern of the pterygium, 24 eyes had continuous, 23 eyes had a nodular pattern and the median (interquartile range) anterior corneal astigmatism was 1.87 (1.01–3.80) and 1.22 D (0.58–2.35), respectively ( p = 0.102). Other topographic and pterygium size parameters were similar between groups. Analyzing the correlations in groups separately, a positive moderate statistically significant correlation was present between vertical width, percentage extension, pterygium area, and anterior corneal astigmatism in both continuous and nodular groups.

Conclusions:

Although not statistically significant, anterior corneal astigmatism was higher in continuous group. Using AS-OCT to standardize the morphology of pterygium could provide additional clinical information.
Do spatial differences in the personal car market reflect a centre-periphery structure? The case of Poland
Authors: Kołsut Bartłomiej , Stryjakiewicz Tadeusz
Published: July 2021

Aim of the study

A centre-periphery structure reflects spatial inequalities in the level of economic development of countries and regions. Most often, it provides a simplified picture of spatial distribution of income or spatial accessibility. In this study the authors try to identify the relationship between the level of centrality/peripherality of an area and selected features of the personal car market, using the case of Poland.

Method

In order to identify the relationship between the level of centrality/peripherality of an area and selected features of the peresonal car market, the correlation and regression analysis has been used. As a dependent variable the index of centrality/peripherality consisting of population and enterprise income has been calculated for all Polish communes (gminas). The features of the car market (independent variables) are: 1) car ownership (number of cars per 1000 inhabitants), 2) sales of new cars, 3) the import of second-hand cars, and 4) the average age of personal cars.

Result

The research confirmed a positive correlation between the index of centrality/peripherality (and hence the central character of the commune) and the sales of new automobiles, and a negative correlation with the average age of cars. There is no correlation between the level of centrality/peripherality of an area and the indicators of car ownership and the import of second-hand vehicles.
Predicting mortality among septic patients presenting to the emergency department–a cross sectional analysis using machine learning
Authors: Karlsson Adam , Stassen Willem , Loutfi Amy , Wallgren Ulrika , Larsson Eric , Kurland Lisa
Published: July 2021

Background

Sepsis is a life-threatening condition, causing almost one fifth of all deaths worldwide. The aim of the current study was to identify variables predictive of 7- and 30-day mortality among variables reflective of the presentation of septic patients arriving to the emergency department (ED) using machine learning.

Methods

Retrospective cross-sectional design, including all patients arriving to the ED at Södersjukhuset in Sweden during 2013 and discharged with an International Classification of Diseases (ICD)-10 code corresponding to sepsis. All predictions were made using a Balanced Random Forest Classifier and 91 variables reflecting ED presentation. An exhaustive search was used to remove unnecessary variables in the final model. A 10-fold cross validation was performed and the accuracy was described using the mean value of the following: AUC, sensitivity, specificity, PPV, NPV, positive LR and negative LR.

Results

The study population included 445 septic patients, randomised to a training (n = 356, 80%) and a validation set (n = 89, 20%). The six most important variables for predicting 7-day mortality were: “fever”, “abnormal verbal response”, “low saturation”, “arrival by emergency medical services (EMS)”, “abnormal behaviour or level of consciousness” and “chills”. The model including these variables had an AUC of 0.83 (95% CI: 0.80–0.86). The final model predicting 30-day mortality used similar six variables, however, including “breathing difficulties” instead of “abnormal behaviour or level of consciousness”. This model achieved an AUC = 0.80 (CI 95%, 0.78–0.82).

Conclusions

The results suggest that six specific variables were predictive of 7- and 30-day mortality with good accuracy which suggests that these symptoms, observations and mode of arrival may be important components to include along with vital signs in a future prediction tool of mortality among septic patients presenting to the ED. In addition, the Random Forests appears to be a suitable machine learning method on which to build future studies.
Normalisation of the psychometric encephalopathy score within the Cameroonian population
Authors: Pessidjo Djomatcho Larissa , Kowo Mathurin Pierre , Ndam Antonin Ndjitoyap , Njonnou Sylvain Raoul Simeni , Kenfack Gabin Ulrich , Andoulo Firmin Ankouane , Bagnaka Servais Fiacre Eloumou , Bekolo Winnie Tatiana , Malongue Agnès , Babagna Isabelle Dang , Sida Magloire Biwolé , Luma Henry , Njoya Oudou
Published: July 2021

Background

Minimal hepatic encephalopathy (MHE) is the presence of neuropsychological abnormalities detectable by psychometric tests. Psychometric Hepatic Encephalopathy Score (PHES) is a gold standard test for the early diagnosis of MHE in cirrhotic patients. The aim of this study was to standardize the PHES in a healthy Cameroonian population and to evaluate the prevalence of MHE among cirrhotic patients.

Methods

This was a prospective, multicentric study from 1 December 2018 to 31 July 2019 in two groups: healthy volunteers and cirrhotic patients without clinical signs of hepatic encephalopathy. The results of the number connection test-A, number connection test-B, serial dotting test, line tracing test were expressed in seconds and those of the digit symbol test in points.

Results

A total of 102 healthy volunteers (54 men, 48 women) and 50 cirrhotic patients (29 men, 31 women) were included. The mean age was 38.1 ± 12.55 years in healthy volunteers and 49.3 ± 15.6 years in cirrhotic patients. The mean years of education level was 11.63 ± 4.20 years in healthy volunteers and 9.62 ± 3.9 years in cirrhotic patients. The PHES of the healthy volunteer group was − 0.08 ± 1.28 and the cut-off between normal and pathological values was set at − 3 points. PHES of the cirrhotic patients was − 7.66 ± 5.62 points and significantly lower than that of volunteers (p < 0.001). Prevalence of MHE was 74% among cirrhotic patients. Age and education level were associated with MHE.

Conclusion

PHES cut-off value in Cameroonians is − 3, with MHE prevalence of 74% among cirrhotic patients.
The impact of physical exercises with elements of dance movement therapy on the upper limb grip strength and functional performance of elderly wheelchair users living in nursing homes – a randomized control trial
Authors: Wołoszyn Natalia , Wiśniowska-Szurlej Agnieszka , Grzegorczyk Joanna , Kwolek Andrzej
Published: July 2021

Introduction

Over the last few decades, the quality of care and the quality of life of nursing home (NH) residents have significantly improved, but insufficient physical activity and social involvement still represent substantial challenges in modern nursing facilities. The main aim of this research was to assess the influence of physical exercises with dance movement therapy (DMT) elements on strength and other fitness components of the upper limbs and the overall functional performance of NH residents in wheelchairs compared to standard exercise programmes and usual care.

Method

The study participants were persons aged 68–85 who lived in NH and used manual wheelchairs as a primary means of mobility. Individuals meeting the inclusion criteria were assigned to one of the three groups: Group 1, basic exercise/BE group (n = 55); group 2, physical exercises with elements of dance movement therapy/PED group (n = 55); and group 3, control group, usual care/CO group (n = 55). The intervention for both exercising groups consisted of a 30-min session, two times a week, for 12 weeks in total. Outcome assessments were performed at baseline, 12 weeks after baseline (immediately after the intervention) and 24 weeks after baseline (12 weeks after the intervention). The main outcome was observed for hand grip strength (HGS), while secondary outcomes for box and block test (BBT), arm curl test (ACT), back scratch test (BS), chair sit-and-reach (CSR), peak expiratory flow (PEF), Barthel Index (BI), Berg Balance Scale (BBS) and the range of motion of the shoulder.

Results

Prior to the start of the exercise programmes, all the tested groups were homogeneous. After 12 weeks the PED group presented higher statistically significant scores in HGSL, BBT, ACT, BS, CSR, BI, BBS: p < 0.001 and HGSR: p = 0.01, compared to the BE group. After 24 weeks from the beginning of the intervention the comparison between the PED group and the BE group showed statistically significant differences (p < 0.001) in favour of PED group in almost all areas: HGSR, HGSL, BBT: ACT, PEF, BS, CSR, BI. After 12 and 24 weeks both intervention groups performed better than the CO in all measures except for Katz ADL and shoulder extension.

Conclusion

Twelve weeks of physical exercises had beneficial effects on the strength and fitness of the upper limbs and overall functional performance in both exercise groups. This study demonstrated that group performing physical exercises with elements of DMT obtained statistically better scores in the majority of analysed domains than other groups.

Trial registration

The study was registered in the Sri Lanka Clinical Trials Registry (Registration Number - SLCTR/2018/014 - Date of Registration 16/05/2018. Accessed on https://slctr.lk/trials/1045).
Application of a novel hybrid algorithm of Bayesian network in the study of hyperlipidemia related factors: a cross-sectional study
Authors: Wang Xuchun , Pan Jinhua , Ren Zeping , Zhai Mengmeng , Zhang Zhuang , Ren Hao , Song Weimei , He Yuling , Li Chenglian , Yang Xiaojuan , Li Meichen , Quan Dichen , Chen Limin , Qiu Lixia
Published: July 2021

Background

This article aims to understand the prevalence of hyperlipidemia and its related factors in Shanxi Province. On the basis of multivariate Logistic regression analysis to find out the influencing factors closely related to hyperlipidemia, the complex network connection between various variables was presented through Bayesian networks(BNs).

Methods

Logistic regression was used to screen for hyperlipidemia-related variables, and then the complex network connection between various variables was presented through BNs. Since some drawbacks stand out in the Max-Min Hill-Climbing (MMHC) hybrid algorithm, extra hybrid algorithms are proposed to construct the BN structure: MMPC-Tabu, Fast.iamb-Tabu and Inter.iamb-Tabu. To assess their performance, we made a comparison between these three hybrid algorithms with the widely used MMHC hybrid algorithm on randomly generated datasets. Afterwards, the optimized BN was determined to explore to study related factors for hyperlipidemia. We also make a comparison between the BN model with logistic regression model.

Results

The BN constructed by Inter.iamb-Tabu hybrid algorithm had the best fitting degree to the benchmark networks, and was used to construct the BN model of hyperlipidemia. Multivariate logistic regression analysis suggested that gender, smoking, central obesity, daily average salt intake, daily average oil intake, diabetes mellitus, hypertension and physical activity were associated with hyperlipidemia. BNs model of hyperlipidemia further showed that gender, BMI, and physical activity were directly related to the occurrence of hyperlipidemia, hyperlipidemia was directly related to the occurrence of diabetes mellitus and hypertension; the average daily salt intake, daily average oil consumption, smoking, and central obesity were indirectly related to hyperlipidemia.

Conclusions

The BN of hyperlipidemia constructed by the Inter.iamb-Tabu hybrid algorithm is more reasonable, and allows for the overall linking effect between factors and diseases, revealing the direct and indirect factors associated with hyperlipidemia and correlation between related variables, which can provide a new approach to the study of chronic diseases and their associated factors.
Family planning use and correlates among female sex workers in a community empowerment HIV prevention intervention in Iringa, Tanzania: a case for tailored programming
Authors: Beckham S. Wilson , Stockton Melissa , Galai Noya , Davis Wendy , Mwambo Jessie , Likindikoki Samuel , Kerrigan Deanna
Published: July 2021

Background

Female sex workers in sub-Saharan Africa face high unmet need for family planning and higher risk for unintended pregnancy. Community empowerment HIV prevention approaches have the potential to increase family planning uptake and present an opportunity to integrate HIV, reproductive health, and contraception. This article describes family planning use and pregnancy among female sex workers in Iringa, Tanzania and evaluates whether engagement in a community empowerment HIV prevention program is associated with contraceptive use.

Methods

This study consists of secondary analysis from a two-community randomized controlled trial following a longitudinal cohort over 18 months. We implemented a year-long community empowerment intervention consisting of 1) a community-led drop-in-center; 2) venue-based peer education, condom distribution, and HIV testing; 3) peer service navigation; 4) sensitivity trainings for providers and police; and 5) text messages to promote engagement. Additionally, monthly seminars were held at the drop-in-center, one of which focused on family planning. Modified Poisson regression models were used to estimate the association between program exposure and family planning use in the intervention arm. (Trials Registration NCT02281578, Nov 2, 2014.)

Results

Among the 339 participants with follow-up data on family planning, 60% reported current family planning use; 6% reported dual use of modern contraception and condoms; over 90% had living children; and 85% sought antenatal care at their most recent pregnancy. Among the 185 participants in the intervention arm, the adjusted relative risk (aRR) of family planning use among female sex workers who reported ever attending the Shikamana drop-in-center and among female sex workers who reported attending a family planning-related workshop was respectively 26% (aRR 1.26 [95% Confidence Interval (CI): 1.02–1.56]) and 36% (aRR 1.36 [95%CI: 1.13–1.64) higher than among those who had not attended.

Conclusion

There is a clear need for family planning among this population. General program exposure and exposure to a family planning workshop were associated with higher family planning use, which suggests that community empowerment models have potential to increase family planning uptake for this vulnerable group.
Cerebral arterial air embolism after endobronchial electrocautery: a case report and review of the literature
Authors: He Yu-Ping , Liu Yuan-Ling , Gao Xing-Lin , Wang Li-Hua
Published: July 2021

Background

Endobronchial electrocautery is a common and safe therapeutic endoscopic treatment for malignant airway obstruction. Cerebral arterial air embolism (CAAE) is a rare but potentially fatal complication of endobronchial electrocautery.

Case presentation

We present the first case of cerebral arterial air embolism after endobronchial electrocautery. A 56-year-old male with a pulmonary tumour in the right upper lobe received repeated endobronchial electrocautery. During the procedure, he experienced unresponsiveness, hypoxemia and bradycardia, and he developed tetraplegia. Brain computed tomography showed several cerebral arterial air emboli with low-density spots in the right frontal lobe. He received hyperbaric oxygen therapy with almost full recovery, except for residual left-sided weakness.

Conclusions

General physicians should realize that CAAE may be a possible complication of endobronchial electrocautery. Several measures, including avoiding positive pressure, lowering ventilatory pressures if possible, avoiding advancing the bronchoscope to occlude the bronchus and using the non-contact technique, should be used to prevent this devastating complication.
Single incision thenar muscle reconstruction using the free functional pronator quadratus flap
Authors: Aman Martin , Boecker Arne H. , Thielen Mirjam , Mueller Camillo T. , Bigdeli Amir K. , Kneser Ulrich , Harhaus Leila
Published: July 2021

Background

Injuries to the thenar muscle mass or the thenar branch of the median nerve and resulting loss of thumb opposition lead to a massive impairment of hand function. For decades, reconstructive approaches were based on tendon transfers. To broaden the reconstructive repertoire, we present the free functional pronator quadratus flap as a viable alternative for functional reconstruction and provide a specification for its indication. We demonstrate our surgical technique to a single incision reconstruction using the free functional pronator quadratus flap. Based on a series of three patients, which were analyzed for hand function using Kapandji’s score and the angle of Bourrel, grip strength and nerve conduction velocity in a two year follow up, we present an indication algorithm.

Results

After successful reinnervation of all flaps, we found an improvement of Kapandji’s score from 4.3 ± 0.94 preoperatively, to 8.7 ± 0.47 after two years. Accordingly, the angle of Bourrel decreased from 75.75 ± 3.45 degrees to 36.96 ± 3.68 degree. Grip strength also improved from 14 ± 2.2 kg to 26.2 ± 1.2 kg. No impairment of wrist pronation was observed.

Conclusion

We found excellent functional recovery of thumb opposition and strength, showing similar or even superior results compared to results from tendon transfers. With the benefit of a single incision surgery and therefore minimal donor site morbidity, this free functional muscle transfer is a viable alternative to classic tendon transfers.
Lifestyle changes among people with type 2 diabetes are associated with participation in online groups and time since diagnosis
Authors: Hansen Anne Helen , Wangberg Silje C. , Årsand Eirik
Published: July 2021

Background

For people with Type 2 diabetes (T2D), lifestyle changes may be the most effective intervention. Online groups for people with diabetes holds a great potential to support such changes. However, little is known about the association between participation in online groups and lifestyle changes based on internet information in people with T2D. The aim of this study was to investigate the association between self-reported lifestyle changes and participation in online groups in people with T2D.

Methods

We used e-mail survey data from 1,250 members of The Norwegian Diabetes Association, collected in 2018. Eligible for analyses were the 540 respondents who reported to have T2D. By logistic regressions we studied the association between self-reported lifestyle changes and participation in online groups. Analyses were adjusted for gender, age, education, and time since diagnosis.

Results

We found that 41.9 % of the participants reported lifestyle changes based on information from the internet. Only 6 % had participated in online groups during the previous year. Among those with a disease duration of less than 10 years, 56.0 % reported lifestyle changes, whereas 33.4 % with a disease duration of 10 years or more did so. The odds for lifestyle changes were more than doubled for those who participated in online groups. People who had been diagnosed with diabetes for less than 10 years were significantly more likely to change their lifestyle compared to those with a longer disease duration.

Conclusions

Lifestyle changes based on information from the internet among people with T2D are associated with participation in online groups. Lifestyle changes are also associated with time since diagnosis, making the first years after a T2D diagnosis particularly important for lifestyle interventions. People with T2D, web site developers, online group moderators, health care services, and patient organisations should be aware of this important window for lifestyle change, and encourage participation in online groups.
NCK1-AS1 promotes the progression of melanoma by accelerating cell proliferation and migration via targeting miR-526b-5p/ADAM15 axis
Authors: Lin Quan , Jia Yan , Zhang Duo , Jin Hongjuan
Published: July 2021

Background

Long non-coding RNAs (lncRNAs) are vital regulators of gene expression and cellular processes in multiple cancers, including melanoma. Nevertheless, the function of lncRNA NCK1-antisense 1 (NCK1-AS1) in melanoma remains unknown.

Methods

RT-qPCR was used to analyze the expression of NCK1-AS1, microRNA-526b-5p (miR-526b-5p) and ADAM metallopeptidase domain 15 (ADAM15). Cell proliferation was determined by CCK-8, colony formation and EdU assays. Cell migration was assessed by transwell migration and wound healing assays. Mechanism experiments including luciferase reporter, RIP and RNA pull down assays were conducted to demonstrate the interactions between RNAs. Xenograft model was established to verify the function of NCK1-AS1 and miR-526b-5p in melanoma in vivo.

Results

NCK1-AS1 was overexpressed in melanoma cell lines and NCK1-AS1 knockdown hampers the proliferation and migration of melanoma cells. Besides, miR-526b-5p binds to NCK1-AS1 in melanoma and ADAM15 was validated as its downstream target. Further, the inhibitory effects of NCK1-AS1 knockdown on cell proliferation and migration in melanoma were reversed by the depletion of miR-526b-5p and further counteracted by ADAM15 knockdown. The growth of melanoma tumors was hindered by the down-regulation of NCK1-AS1 or up-regulation of miR-526b-5p.

Conclusion

NCK1-AS1 facilitates cell proliferation and migration in melanoma via targeting miR-526b-5p/ADAM15 axis.
Identification of differential proteomics in Epstein-Barr virus-associated gastric cancer and related functional analysis
Authors: Wang Zeyang , Lv Zhi , Xu Qian , Sun Liping , Yuan Yuan
Published: July 2021

Background

Epstein-Barr virus-associated gastric cancer (EBVaGC) is the most common EBV-related malignancy. A comprehensive research for the protein expression patterns in EBVaGC established by high-throughput assay remains lacking. In the present study, the protein profile in EBVaGC tissue was explored and related functional analysis was performed.

Methods

Epstein-Barr virus-encoded RNA (EBER) in situ hybridization (ISH) was applied to EBV detection in GC cases. Data-independent acquisition (DIA) mass spectrometry (MS) was performed for proteomics assay of EBVaGC. Functional analysis of identified proteins was conducted with bioinformatics methods. Immunohistochemistry (IHC) staining was employed to detect protein expression in tissue.

Results

The proteomics study for EBVaGC was conducted with 7 pairs of GC cases. A total of 137 differentially expressed proteins in EBV-positive GC group were identified compared with EBV-negative GC group. A PPI network was constructed for all of them, and several proteins with relatively high interaction degrees could be the hub genes in EBVaGC. Gene enrichment analysis showed they might be involved in the biological pathways related to energy and biochemical metabolism. Combined with GEO datasets, a highly associated protein (GBP5) with EBVaGC was screened out and validated with IHC staining. Further analyses demonstrated that GBP5 protein might be associated with clinicopathological parameters and EBV infection in GC.

Conclusions

The newly identified proteins with significant differences and potential central roles could be applied as diagnostic markers of EBVaGC. Our study would provide research clues for EBVaGC pathogenesis as well as novel targets for the molecular-targeted therapy of EBVaGC.
Evaluation of a novel real-time PCR assay for the detection, identification and quantification of Plasmodium species causing malaria in humans
Authors: van Bergen Kim , Stuitje Toon , Akkers Robert , Vermeer Eric , Castel Rob , Mank Theo
Published: July 2021

Background

The entry of PCR-based techniques into malaria diagnostics has improved the sensitivity and specificity of the detection of Plasmodium infections. It has been shown that humans are regularly infected by at least six different Plasmodium species. The MC004 real-time PCR assay for malaria diagnosis is a novel single-tube assay that has been developed for the purpose of simultaneously detecting all Plasmodium species known to infect humans, and discrimination between Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale wallikeri, Plasmodium ovale curtisi, Plasmodium knowlesi (including differentiation of three strains) and Plasmodium cynomolgi (including differentiation of three strains). Detection and identification of Plasmodium species relies on molecular beacon probe-based melting curve analysis. In addition, this assay might be used to quantify the parasitaemia of at least P. falciparum by calculating the level of parasitaemia directly from the Cq-value.

Methods

The samples used in this study comprised reference samples, patient samples, and synthetic controls. The following analytical performance characteristics of the MC004 assay were determined: analytical specificity, limit of detection, the ability to detect mixed infections, and the potential to determine the level of parasitaemia of P. falciparum, including assessment of within-run and between-run precisions.

Results

No false positive or false negative results were observed. The limit of detection of P. falciparum was 1 × 10–3 IU/mL (WHO standard). Mixed infections with P. falciparum and non-falciparum species were correctly identified. A calibration curve could be established to quantify the parasitaemia of at least P. falciparum. The within-run and between-run precisions were less than 20% CV at the tested parasitaemia levels of 0.09%, 0.16%, 2.15% and 27.27%.

Conclusion

Based upon the analytical performance characteristics that were determined, the MC004 assay showed performance suitable for use in clinical settings, as well as epidemiological studies.
Later sleep timing predicts accelerated summer weight gain among elementary school children: a prospective observational study
Authors: Moreno Jennette P. , Razjouyan Javad , Lester Houston , Dadabhoy Hafza , Amirmazaheri Mona , Reesor-Oyer Layton , O’Connor Teresia M. , Hernandez Daphne C. , Najafi Bijan , Alfano Candice A. , Crowley Stephanie J. , Thompson Debbe , Baranowski Tom
Published: July 2021

Objectives and background

Social demands of the school-year and summer environment may affect children’s sleep patterns and circadian rhythms during these periods. The current study examined differences in children’s sleep and circadian-related behaviors during the school-year and summer and explored the association between sleep and circadian parameters and change in body mass index (BMI) during these time periods.

Methods

This was a prospective observational study with 119 children ages 5 to 8 years with three sequential BMI assessments: early school-year (fall), late school-year (spring), and beginning of the following school-year in Houston, Texas, USA. Sleep midpoint, sleep duration, variability of sleep midpoint, physical activity, and light exposure were estimated using wrist-worn accelerometry during the school-year (fall) and summer. To examine the effect of sleep parameters, physical activity level, and light exposure on change in BMI, growth curve modeling was conducted controlling for age, race, sex, and chronotype.

Results

Children’s sleep midpoint shifted later by an average of 1.5 h during summer compared to the school-year. After controlling for covariates, later sleep midpoints predicted larger increases in BMI during summer, (γ = .0004, p = .03), but not during the school-year. Sleep duration, sleep midpoint variability, physical activity levels, and sedentary behavior were not associated with change in BMI during the school-year or summer. Females tended to increase their BMI at a faster rate during summer compared to males, γ = .06, p = .049. Greater amounts of outdoor light exposure (γ = −.01, p = .02) predicted smaller increases in school-year BMI.

Conclusions

Obesity prevention interventions may need to target different behaviors depending on whether children are in or out of school. Promotion of outdoor time during the school-year and earlier sleep times during the summer may be effective obesity prevention strategies during these respective times.
Integrative analysis of key candidate genes and signaling pathways in ovarian cancer by bioinformatics
Authors: Dong Cuicui , Tian Xin , He Fucheng , Zhang Jiayi , Cui Xiaojian , He Qin , Si Ping , Shen Yongming
Published: July 2021

Background

Ovarian cancer is one of the most common gynecological tumors, and among gynecological tumors, its incidence and mortality rates are fairly high. However, the pathogenesis of ovarian cancer is not clear. The present study aimed to investigate the differentially expressed genes and signaling pathways associated with ovarian cancer by bioinformatics analysis.

Methods

The data from three mRNA expression profiling microarrays (GSE14407, GSE29450, and GSE54388) were obtained from the Gene Expression Omnibus (GEO) database. Differentially expressed genes between ovarian cancer tissues and normal tissues were identified using R software. The overlapping genes from the three GEO datasets were identified, and profound analysis was performed. The overlapping genes were used for pathway and Gene Ontology (GO) functional enrichment analysis using the Metascape online tool. Protein–protein interactions were analyzed with the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING). Subnetwork models were selected using the plugin molecular complex detection (MCODE) application in Cytoscape. Kaplan–Meier curves were used to analyze the univariate survival outcomes of the hub genes. The Human Protein Atlas (HPA) database and Gene Expression Profiling Interactive Analysis (GEPIA) were used to validate hub genes.

Results

In total, 708 overlapping genes were identified through analyses of the three microarray datasets (GSE14407, GSE29450, and GSE54388). These genes mainly participated in mitotic sister chromatid segregation, regulation of chromosome segregation and regulation of the cell cycle process. High CCNA2 expression was associated with poor overall survival (OS) and tumor stage. The expression of CDK1, CDC20, CCNB1, BUB1B, CCNA2, KIF11, CDCA8, KIF2C, NDC80 and TOP2A was increased in ovarian cancer tissues compared with normal tissues according to the Oncomine database. Higher expression levels of these seven candidate genes in ovarian cancer tissues compared with normal tissues were observed by GEPIA. The protein expression levels of CCNA2, CCNB1, CDC20, CDCA8, CDK1, KIF11 and TOP2A were high in ovarian cancer tissues, which was further confirmed via the HPA database.

Conclusion

Taken together, our study provided evidence concerning the altered expression of genes in ovarian cancer tissues compared with normal tissues. In vivo and in vitro experiments are required to verify the results of the present study.
Apatinib treatment efficiently delays biochemical-only recurrent ovarian cancer progression
Authors: Wang Zhongyu , Huang Yake , Long Ling , Zhou Li , Huang Yan , Gan Lei , Pu Aimin , Li Sufen , Xie Rongkai
Published: July 2021

Background

Biochemical recurrence is defined as only rising CA-125 but no radiographic evidence of disease; noteworthily, it generally precedes the onset of clinical evidence. Now treatment strategies of biochemical recurrence ovarian cancer (OC) remain controversial. Apatinib as monotherapy or in combination with other chemotherapeutic agents has shown its effect in the treatment of some advanced malignancies. In our study, we focused on the efficacy of apatinib in recurrent OC, especially its clinical activity in biochemical-only recurrent OC patients.

Methods

We retrospectively analyzed clinical material of 41 recurrent patients who had received apatinib monotherapy or apatinib plus chemotherapy between June 2016 and August 2018. Apatinib was administered at a 500mg daily dose. Response was determined according to measurable disease or serum carbohydrate antigen (CA)-125 levels. Progression-free survival (PFS) was estimated by Kaplan–Meier method.

Results

All patients were evaluable, 19 (46.34%) had biochemical relapse and 22 (53.66%) had clinical relapse. The objective response rate (ORR) and disease control rate (DCR) in the overall population were 31.71% and 78.05%, respectively. The median PFS was 7 months (95% confidence interval 5.43–8.57). And in patients with biochemical-only relapse, the median PFS was 6 months, with ORR of 26.32% and DCR of 89.47%.

Conclusions

Apatinib is a well-tolerated and effective agent to delay clinical progression of patients with biochemical-only recurrent OC. More important, our study shows the promising prospect for treating OC patients with asymptomatic biochemical relapse.
Incidence and challenges of helicopter emergency medical service (HEMS) rescue missions with helicopter hoist operations: analysis of 11,228 daytime and nighttime missions in Switzerland
Authors: Pietsch Urs , Knapp Jürgen , Mann Michael , Meuli Lorenz , Lischke Volker , Tissi Mario , Sollid Stephen , Rauch Simon , Wenzel Volker , Becker Stefan , Albrecht Roland
Published: July 2021

Objective

We aimed to investigate the medical characteristics of helicopter hoist operations (HHO) in HEMS missions.

Methods

We designed a retrospective study evaluating all HHO and other human external cargo (HEC) missions performed by Swiss Air-Rescue (Rega) between January 1, 2010, and December 31, 2019.

Results

During the study period, 9,963 (88.7 %) HEMS missions with HHO and HEC were conducted during the day, and 1,265 (11.3 %) at night. Of the victims with time-critical injuries (NACA ≥ 4), 21.1 % (n = 400) reached the hospital within 60 min during the day, and 9.1 % (n = 18) at night. Nighttime missions, a trauma diagnosis, intubation on-site, and NACA Score ≥ 4 were independently and highly significantly associated with longer mission times (p < 0.001). The greatest proportion of patients who needed hoist or HEC operations in the course of the HEMS mission during the daytime sustained moderate injuries (NACA 3, n = 3,731, 37.5 %) while practicing recreational activities (n = 5,492, 55.1 %). In daytime HHO missions, the most common medical interventions performed were insertion of a peripheral intravenous access (n = 3,857, 38.7 %) and administration of analgesia (n = 3,121, 31.3 %).

Conclusions

Nearly 20 % of patients who needed to be evacuated by a hoist were severely injured, and complex and lifesaving medical interventions were necessary before the HHO procedure. Therefore, only adequately trained and experienced medical crew members should accompany HHO missions.
Intraoperative fluorescence imaging with aminolevulinic acid detects grossly occult breast cancer: a phase II randomized controlled trial
Authors: Ottolino-Perry Kathryn , Shahid Anam , DeLuca Stephanie , Son Viktor , Sukhram Mayleen , Meng Fannong , Liu Zhihui , Rapic Sara , Anantha Nayana Thalanki , Wang Shirley C. , Chamma Emilie , Gibson Christopher , Medeiros Philip J. , Majeed Safa , Chu Ashley , Wignall Olivia , Pizzolato Alessandra , Rosen Cheryl F. , Teene Liis Lindvere , Starr-Dunham Danielle , Kulbatski Iris , Panzarella Tony , Done Susan J. , Easson Alexandra M. , Leong Wey L. , DaCosta Ralph S.
Published: July 2021

Background

Re-excision due to positive margins following breast-conserving surgery (BCS) negatively affects patient outcomes and healthcare costs. The inability to visualize margin involvement is a significant challenge in BCS. 5-Aminolevulinic acid hydrochloride (5-ALA HCl), a non-fluorescent oral prodrug, causes intracellular accumulation of fluorescent porphyrins in cancer cells. This single-center Phase II randomized controlled trial evaluated the safety, feasibility, and diagnostic accuracy of a prototype handheld fluorescence imaging device plus 5-ALA for intraoperative visualization of invasive breast carcinomas during BCS.

Methods

Fifty-four patients were enrolled and randomized to receive no 5-ALA or oral 5-ALA HCl (15 or 30 mg/kg). Forty-five patients (n = 15/group) were included in the analysis. Fluorescence imaging of the excised surgical specimen was performed, and biopsies were collected from within and outside the clinically demarcated tumor border of the gross specimen for blinded histopathology.

Results

In the absence of 5-ALA, tissue autofluorescence imaging lacked tumor-specific fluorescent contrast. Both 5-ALA doses caused bright red tumor fluorescence, with improved visualization of tumor contrasted against normal tissue autofluorescence. In the 15 mg/kg 5-ALA group, the positive predictive value (PPV) for detecting breast cancer inside and outside the grossly demarcated tumor border was 100.0% and 55.6%, respectively. In the 30 mg/kg 5-ALA group, the PPV was 100.0% and 50.0% inside and outside the demarcated tumor border, respectively. No adverse events were observed, and clinical feasibility of this imaging device-5-ALA combination approach was confirmed.

Conclusions

This is the first known clinical report of visualization of 5-ALA-induced fluorescence in invasive breast carcinoma using a real-time handheld intraoperative fluorescence imaging device.

Trial registration

Clinicaltrials.gov identifier NCT01837225. Registered 23 April 2013.
DNA methylation under the major depression pathway predicts pediatric quality of life four-month post-pediatric mild traumatic brain injury
Authors: Duan Kuaikuai , Mayer Andrew R. , Shaff Nicholas A. , Chen Jiayu , Lin Dongdong , Calhoun Vince D. , Jensen Dawn M. , Liu Jingyu
Published: July 2021

Background

Major depression has been recognized as the most commonly diagnosed psychiatric complication of mild traumatic brain injury (mTBI). Moreover, major depression is associated with poor outcomes following mTBI; however, the underlying biological mechanisms of this are largely unknown. Recently, genomic and epigenetic factors have been increasingly implicated in the recovery following TBI.

Results

This study leveraged DNA methylation within the major depression pathway, along with demographic and behavior measures (features used in the clinical model) to predict post-concussive symptom burden and quality of life four-month post-injury in a cohort of 110 pediatric mTBI patients and 87 age-matched healthy controls. The results demonstrated that including DNA methylation markers in the major depression pathway improved the prediction accuracy for quality of life but not persistent post-concussive symptom burden. Specifically, the prediction accuracy (i.e., the correlation between the predicted value and observed value) of quality of life was improved from 0.59 (p = 1.20 × 10–3) (clinical model) to 0.71 (p = 3.89 × 10–5); the identified cytosine-phosphate-guanine sites were mainly in the open sea regions and the mapped genes were related to TBI in several molecular studies. Moreover, depression symptoms were a strong predictor (with large weights) for both post-concussive symptom burden and pediatric quality of life.

Conclusion

This study emphasized that both molecular and behavioral manifestations of depression symptoms played a prominent role in predicting the recovery process following pediatric mTBI, suggesting the urgent need to further study TBI-caused depression symptoms for better recovery outcome.
Prokaryotic diversity and potentially pathogenic bacteria in vended foods and environmental samples
Authors: Muriuki Susan W. , Rengan Michael S. , Budambula Nancy L. M.
Published: July 2021

Purpose

Ready-to-eat fast food vending outlets provide a cheap and readily available food. Foodborne diseases have been previously reported in Embu, Kenya, but data on the prokaryotic metagenome in vended foods is scanty. This study aimed to determine the prokaryotic diversity in fruits, vegetable salad, African sausage, chips (potato fries), fried fish, roasted beef (meat), smokies, samosa, soil, and water collected from food vendors and the surrounding environment in Embu Town and Kangaru Market.

Methods

The study used 454 pyrosequencing, Illumina high-throughput sequencing of 16S rRNA gene in the analysis of total community DNA extracted from samples using the phenol-chloroform method. The 16S rRNA gene variable region (V4-V7) of the extracted DNA was amplified and library construction performed. Sequence analysis was done using QIIME2. Hierarchical clustering of samples, diversity indices, rarefaction curves, and Venn diagrams were generated using the R programming language in R software version 3.6.3.

Results

Bacterial operational taxonomic units (OUTs) were distributed in Proteobacteria (52.81%), Firmicutes (31.16%), and Lentisphaerae (0.001%). The OTUs among archaea were Candidatus Nitrososphaera (63.56%) and Nitrososphaera spp. (8.77%). Brucella spp. and Bacillus cereus associated with foodborne diseases were detected. Potential pathogens, Rickettsia spp. in risk group 2 and Brucella spp. in risk group 3, were detected. Uncultured Candidatus Koribacter and Candidatus Solibacter were also detected in the food samples. There was a significant difference in the microbial community structure among the sample types (P<0.1).

Conclusion

The results demonstrated the presence of some prokaryotes that are associated with food spoilage or foodborne diseases in vended foods and environmental samples. This study also detected uncultured prokaryotes. The presence of potential pathogens calls for stringent hygiene measures in food vending operations.
Clinical improvement of encapsulating peritoneal sclerosis after challenging course and 6 months of total parenteral nutrition in child with nephronophthisis: a case report
Authors: AlZabali Saeed Mohammed , AlAnazi Abdulkarim , Rahim Khawla A. , Faqeehi Hassan Y.
Published: July 2021

Background

Encapsulating peritoneal sclerosis is a rare but potentially lethal complication of long-term peritoneal dialysis that is associated with significant morbidity and mortality. The occurrence of encapsulating peritoneal sclerosis varies worldwide, but is increased in patients maintained on peritoneal dialysis for 5–8 years. The etiology of encapsulating peritoneal sclerosis remains unidentified, and a high index of clinical suspicion is required for diagnosis.

Case presentation

We report a 5-year-old Saudi female with end-stage renal disease secondary to nephronophthisis type 2. She underwent peritoneal dialysis for 30 months, with four episodes of peritonitis. She presented with clinical signs of peritonitis. Three days later, she developed septic shock, which required pediatric intensive care unit admission. The peritoneal dialysis catheter was removed because of refractory peritonitis. Her course was complicated by small bowel perforation, and severe adhesions were revealed on abdominal ultrasound and computed tomography, consistent with a diagnosis of EPS. This finding was later confirmed by diagnostic laparotomy performed twice and complicated by recurrent abdominal wall fistula. She received total parenteral nutrition for 6 months and several courses of antibiotics. The patient received supportive treatment including nutritional optimization and treatment for infection. No other treatments, such as immunosuppression, were administered to avoid risk of infection. Following a complicated hospital course, the patient restarted oral intake after 6 months of total parenteral nutrition dependency. Her abdominal fistula resolved completely, and she was maintained on hemodialysis for few years before she received a kidney transplant.

Conclusion

When treating patients using peritoneal dialysis, it is important to consider encapsulating peritoneal sclerosis with refractory peritonitis, which is not always easy to identify, particularly if the patient has been maintained on peritoneal dialysis for less than 3 years. Early identification of encapsulating peritoneal sclerosis and appropriate conservative treatment, including nutritional optimization and treatment of infections, are essential to achieve a better prognosis.