bluuebunny/crossref_metadata_2025 huggingface dataset:
Healthcare Professional Experiences and Opinions on Depression and Suicide in People With Diabetes
Authors: Majidi Shideh , Cohen Lauren , Holt Richard I. G. , Clements Mark , O’Neill Simon , Renard Eric , Tynan Doug , Naranjo Diana , Messer Laurel H. , Klonoff David C. , Barnard-Kelly Katharine
Published: May 2023

Objective:

People with diabetes have an increased risk of depression, intentional self-injury and self-harm (ISI), and suicide compared with the general population. This study aimed to explore experiences and awareness of healthcare professionals (HCPs) regarding depression, ISI, and suicide, and understand resource use and needs among HCPs who care for persons with diabetes (PWD).

Methods:

Healthcare professionals who see children and/or adults with type 1 diabetes or type 2 diabetes anonymously completed an online survey about their experiences, opinions, barriers, and needs surrounding identification and care of PWD with depression, ISI, and suicide.

Results:

One hundred twenty-nine HCPs participated. The majority were medical doctors (MDs) or advanced practice providers (APPs). Only a quarter of MDs and APPs felt very comfortable asking about ISI or suicidal ideation (SI), whereas 20% felt they had received appropriate training to support those with ISI or SI. The primary needs reported include more training on how to ask, respond, and support those expressing ISI and SI. Healthcare professionals reported wanting better access to resources for PWD.

Discussion:

The HCPs tend to underestimate SI in the diabetes population and rates of training were low. Areas to address include providing education and training to HCPs to improve identification and management of ISI and suicide risk. These data can inform the development of mechanisms to improve discussions of depression and suicide and of resources to help HCPs support PWD.
Mobile Applications to Support Diabetes Self-Management Education: Patient Experiences and Provider Perspectives
Authors: Krall Jodi S. , Childs Belinda , Mehrotra Neha
Published: May 2023

Background:

Diabetes self-management education and support (DSMES) is a critical component of diabetes care, but time for it is often limited. Digital tools, such as mobile applications (apps), show promise in extending efforts and supporting self-management education, but have not been fully used. Objectives of this multi-phase study were to (1) evaluate an app designed to support patients with insulin therapy and (2) examine provider perspectives on DSMES apps.

Methods:

Phase 1: Thirty-two adult patients with type 2 diabetes new to or having difficulties with insulin therapy were introduced to the BDTM Diabetes Care App. Three-month app use and satisfaction and changes in hemoglobin A1c (HbA1c) and diabetes distress were assessed. Phase 2: Sixty diabetes providers completed a survey about their experiences with and perspectives on DSMES apps.

Results:

Phase 1: Patients reported satisfaction with the app, and significant improvements in HbA1c and diabetes distress were observed. Phase 2: Most providers viewed apps as adjuncts to diabetes education. Only 33% had previous app experience; however, 100% would consider recommending apps to their patients. Most would spend 5-15 minutes introducing apps to patients. All respondents agreed that the following DSMES app features—evidence-based educational content, data logging and tracking features, customizable user experience, digital coaching via goal setting or reminders, and ability to share data with providers—are key components to consider.

Conclusions:

Findings suggest DSMES apps can play a role in self-management support and provide guidance on factors to consider when introducing digital tools into clinical practice.

Trial Registration:

Clinicaltrials.gov, #NCT03999268
Fiber-reinforced polymer composite: Higher performance with renewable and eco-friendly plant-based fibers
Authors: Nurhania Nurhania , Syarifuddin Syarifuddin , Armynah Bidayatul , Tahir Dahlang
Published: May 2023

Considering sustainable environmental problems due to waste and the enormous potential of natural plant resources in producing natural fibers has encouraged researchers to make environmentally friendly composite materials reinforced with fibers. Several articles on using natural fibers as composite reinforcement have been collected and studied to produce this article. This article aims to comprehensively describe the physical properties, chemical composition, factors that affect fiber quality, and their relationship with mechanical properties. In the first section, we introduce the general classification of plant fibers and summarize the annual production and category of fiber origin used for fiber-reinforced composites. It then presents the parts of plants and plant species for fiber, including fruit, leaf, and seed fibers, and discuss their characteristics. Further describes the chemical compounds and physical and mechanical properties based on fiber sources. Based on our discussion, this review shows that plant fibers are very suitable as an alternative to polymer-based reinforcement materials due to low cost, renewable, and environmentally friendly composites. However, compatibility with synthetic polymers, dimensional stability and processability must be actively considered to replace synthetic fibers in various applications.
Outcomes of hyperbolic tapering of antidepressants
Authors: van Os Jim , Groot Peter C.
Published: May 2023

Background:

In patients attempting to discontinue their antidepressant medication, there have been no prospective studies on patterns of withdrawal as a function of the rate of antidepressant reduction during the tapering trajectory, and moderators thereof.

Objective:

To investigate withdrawal as a function of gradual dose reduction.

Design:

Prospective cohort study.

Methods:

The sampling frame consisted of 3956 individuals in the Netherlands who received an antidepressant tapering strip between 19 May 2019 and 22 March 2022 in routine clinical practice. Of these, 608 patients, majorly with previous unsuccessful attempts to stop, provided daily ratings of withdrawal in the context of reducing their antidepressant medications (mostly venlafaxine or paroxetine), using hyperbolic tapering strips offering daily tiny reductions in dose.

Results:

Withdrawal in daily-step hyperbolic tapering trajectories was limited, and inverse to the rate of taper. Female sex, younger age, presence of one or more risk factors and faster rate of reduction over shorter tapering trajectories were associated with more withdrawal and differential course over time. Thus, sex and age differences were less marked early in the course of the trajectory, whereas differences associated with risk factors and shorter trajectories tended to peak early in the trajectory. There was evidence that tapering in weekly larger steps (mean per-week dose reduction: 33.4% of previous dose), in comparison with daily tiny steps (mean per-day dose reduction: 4.5% of previous dose or 25.3% per week), was associated with more withdrawal in trajectories of 1, 2 or 3 months, particularly for paroxetine and the group of other (non-paroxetine, non-venlafaxine) antidepressants.

Conclusion:

Antidepressant hyperbolic tapering is associated with limited, rate-dependent withdrawal that is inverse to the rate of taper. The demonstration of multiple demographic, risk and complex temporal moderators in time series of withdrawal data indicates that antidepressant tapering in clinical practice requires a personalised process of shared decision making over the entire course of the tapering period.
Cytotoxic lesions of the corpus callosum during the course of ketotic hyperglycemia revealing type I diabetes: A case report
Authors: Scoppettuolo Pasquale , Sinkunaite Laura , Topciu Mihaela-Felicia , Schulz Joachim
Published: May 2023

Cytotoxic lesions of the corpus callosum are lesions secondary to different medical conditions. Radiologically, lesions are identified on magnetic resonance imaging as a hyperintense signal on diffusion-weighted imaging and decreased apparent diffusion coefficient values of the splenium of corpus callosum. Signal changes are reversible in almost totality of the cases. Previous cases of cytotoxic lesions of the corpus callosums have been associated with several metabolic disturbances, but ketotic hyperglycemia has never been reported. We here discussed the case of 28-year-old patient with complex visual hallucinations presenting with cytotoxic lesions of the corpus callosums and type I diabetes. Treatment of hyperglycemia was followed by full clinical recovery and complete regression of the radiological abnormalities at 3-month follow-up. Elevated levels of circulating pro-inflammatory mediators associated with ketotic hyperglycemia in type I diabetes support an implication of cytokines in the pathophysiology of the cytotoxic lesions of the corpus callosums.
Towards a Psychology of Corporate Governance: Theoretical Insights on Non-Executive Director and CEO Performance
Authors: Oppong Seth , Safo Lartey Joshua King
Published: May 2023

Generally, corporate governance research has been considered the preserve of economics, accounting, and finance scholars. However, attempts are being made to apply behavioral science knowledge in this domain that has traditionally been considered economics and finance. The purpose of this article is to further the efforts in establishing a tradition of behavioral science research in corporate governance. To accomplish this objective, the article establishes the gaps in the extant literature on corporate governance. The article argues from theoretical insights emanating from organizational psychology in particular and behavioral sciences in general. As a result, this article attempts to apply some of the existing theories in social and organizational psychology to explain factors influencing the performance of non-executive directors on boards as well as executive performance and remuneration. Principally, we utilized theories of motivation (expectancy and equity theories) and social influence theory (conformity) to highlight the potential contributions that the psychology of corporate governance can make to advance knowledge and practice. Further, applications and practical ways of testing derived assumptions are also discussed.
Effects of Patient Assessment and Education by an Integrated Care Team on Postoperative Adherence and Failure Rates After Osteochondral Allograft and Meniscal Allograft Transplantation in the Knee
Authors: Rucinski Kylee , Stucky Renee , Crecelius Cory R. , Stannard James P. , Cook James L.
Published: May 2023

Background:

Patient nonadherence with prescribed rehabilitation protocols is associated with up to 16 times higher likelihood of treatment failure after osteochondral allograft transplantation (OCA) and meniscal allograft transplantation.

Hypothesis:

Patients who completed counseling with an orthopaedic health behavior psychologist as part of an evidence-based shift in practice at our institution would have significantly lower rates of nonadherence and surgical treatment failure versus patients who did not participate in counseling.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Patients in a prospective registry who underwent OCA and/or meniscal allograft transplantation between January 2016 and April 2021 were included for analysis when 1-year follow-up data were available. Of 292 potential patients, 213 were eligible for inclusion. Patients were categorized based on whether they participated in the preoperative counseling and postoperative patient management program: no health psych group (n = 172) versus health psych group (n = 41). Nonadherence was defined as documented evidence of a deviation from the prescribed postoperative rehabilitation protocol.

Results:

In this cohort of patients, 50 (23.5%) were documented to be nonadherent. Patients in the no health psych cohort were significantly more likely to be nonadherent ( P = .023; odds ratio [OR], 3.4). Tobacco use (OR, 7.9), higher preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference score, lower preoperative PROMIS Mental Health score, older age, and higher body mass index were also significantly associated with nonadherence ( P < .001 for all). Patients who were nonadherent with the prescribed postoperative rehabilitation protocol during the first year after transplantation were 3 times more likely ( P = .004) to experience surgical treatment failure than those who were adherent. Overall, 26.2% of patients in the no health psych group experienced surgical treatment failure versus 12.2% in the health psych cohort.

Conclusion:

Data from the present study suggest that preoperative counseling with a health behavior psychologist is associated with an improved rate of patient adherence and a lower proportion of surgical treatment failure after OCA and meniscal allograft transplantation. Patients who remained adherent to the postoperative protocol were 3 times more likely to have a successful short-term (≥1 year) outcome.
Ghostly murals: Tracing the politics of public art in Vancouver’s Hogan’s Alley
Authors: Landau-Donnelly Friederike
Published: May 2023

The article unpacks the multiple political implications of commissioned murals in contested urban space. It examines public artwork in Hogan’s Alley, a historically Black neighborhood in Vancouver, BC, situated on the unceded Indigenous territories of the Musqueam, Squamish, and Tsleil-Waututh Coast Salish Nations. Drawing from ethnographic field research and semi-structured interviews with local artists, policymakers and community activists, I read the mural Remember Hogan’s Alley (2019), covering the sidewall of a subsidized housing project, as a contested public space. In this conflictual space, multiple pasts appear, disappear and reappear, oscillating between the celebration of Black culture, food and entertainment and the systematic displacement of Black residents and businesses. By contrasting diverging rationales, expectations and dreams regarding murals’ contributions to memory-making and cultural reconciliation, I trace where and how conflicts about public art inscribe themselves into the urban cultural fabric. The article intervenes into the predominantly ‘positive’ discussion of sanctioned public art to develop a more conflict-attuned understanding of artworks placed in the public realm. It deploys a framework of hauntology to discuss the appearance of ghosts invited into the public realm via official art commissions. These ghosts, becoming visible on urban walls via acts of placemaking, conjure memories of spatial displacement and racial discrimination, as well as stories of community care and healing. In sum, the article argues that the analytic of ghosts assists to foster an understanding of public art as always-already conflictual, thus inviting to stay with conflicts of belonging and memory, rather than to suppress them or shy away. By reflecting on what public art does politically – unpacking diverse narratives of the past that continue to mark present racial inequalities – the article contributes to sketching a conflict-oriented understanding of public space that is needed in cities wounded by racism and displacement.
Nr4a1 promotes renal interstitial fibrosis by regulating the p38 MAPK phosphorylation
Authors: Tao Yilin , Tang Chengyuan , Wei Ju , Shan Yi , Fang Xi , Li Ying
Published: May 2023

Background

Renal interstitial fibrosis (RIF) is a common pathway to end-stage renal disease regardless of the initial etiology. Currently, the molecular mechanisms for RIF remains not fully elucidated. Nuclear receptor subfamily 4 group A member 1(Nr4a1), a member of the NR4A subfamily of nuclear receptors, is a ligand-activated transcription factor. The role of Nr4a1 in RIF remains largely unknown.

Methods

In this study, we determined the role and action mechanism of Nr4a1 in RIF. We used unilateral ureteral obstruction (UUO) mice and transforming growth factor (TGF)-β1-treated human renal proximal tubular epithelial cells (HK-2 cells) as in vivo and in vitro models of RIF. A specific Nr4a1 agonist Cytosporone B (Csn-B) was applied to activate Nr4a1 both in vivo and in vitro, and Nr4a1 small interfering RNA was applied in vitro. Renal pathological changes were evaluated by hematoxylin and eosin and Masson staining, and the expression of fibrotic proteins including fibronectin (Fn) and collagen-I (Col-I), and phosphorylated p38 MAPK was measure by immunohistochemical staining and western blot analysis.

Results

The results showed that Nr4a1 was upregulated in UUO mouse kidneys, and was positively correlated with the degree of interstitial kidney injury and the levels of fibrotic proteins. Csn-B treatment aggravated UUO-induced renal interstitial fibrosis, and induced p38 MAPK phosphorylation. In vitro, TGF-β induced Nr4a1 expression, and Nr4a1 downregulation prevented TGF-β1-induced expression of Fn and Col-I and the activation of p38 MAPK. Csn-B induced fibrotic proteins expression and p38 MAPK phosphorylation, and moreover Csn-B induced fibrotic proteins expression was abrogated by treatment with p38 MAPK inhibitor SB203580. We provided further evidence that Csn-B treatment promoted cytoplasmic accumulation of Nr4a1.

Conclusion

The findings in the present study indicate that Nr4a1 promotes renal fibrosis potentially through activating p38 MAPK kinase.
Genome characterization of two novel deep-sea sediment fungi, Penicillium pacificagyrus sp. nov. and Penicillium pacificasedimenti sp. nov., from South Pacific Gyre subseafloor sediments, highlights survivability
Authors: Sobol Morgan S. , Hoshino Tatsuhiko , Delgado Victor , Futagami Taiki , Kadooka Chihiro , Inagaki Fumio , Kiel Reese Brandi
Published: May 2023

Background

Marine deep subsurface sediments were once thought to be devoid of eukaryotic life, but advances in molecular technology have unlocked the presence and activity of well-known closely related terrestrial and marine fungi. Commonly detected fungi in deep marine sediment environments includes Penicillium, Aspergillus, Cladosporium, Fusarium, and Schizophyllum, which could have important implications in carbon and nitrogen cycling in this isolated environment. In order to determine the diversity and unknown metabolic capabilities of fungi in deep-sea sediments, their genomes need to be fully analyzed. In this study, two Penicillium species were isolated from South Pacific Gyre sediment enrichments during Integrated Ocean Drilling Program Expedition 329. The inner gyre has very limited productivity, organic carbon, and nutrients.

Results

Here, we present high-quality genomes of two proposed novel Penicillium species using Illumina HiSeq and PacBio sequencing technologies. Single-copy homologues within the genomes were compared to other closely related genomes using OrthoMCL and maximum-likelihood estimation, which showed that these genomes were novel species within the genus Penicillium. We propose to name isolate SPG-F1 as Penicillium pacificasedimenti sp. nov. and SPG-F15 as Penicillium pacificagyrus sp. nov. The resulting genome sizes were 32.6 Mbp and 36.4 Mbp, respectively, and both genomes were greater than 98% complete as determined by the presence of complete single-copy orthologs. The transposable elements for each genome were 4.87% for P. pacificasedimenti and 10.68% for P. pacificagyrus. A total of 12,271 genes were predicted in the P. pacificasedimenti genome and 12,568 genes in P. pacificagyrus. Both isolates contained genes known to be involved in the degradation of recalcitrant carbon, amino acids, and lignin-derived carbon.

Conclusions

Our results provide the first constructed genomes of novel Penicillium isolates from deep marine sediments, which will be useful for future studies of marine subsurface fungal diversity and function. Furthermore, these genomes shed light on the potential impact fungi in marine sediments and the subseafloor could have on global carbon and nitrogen biogeochemical cycles and how they may be persisting in the most energy-limited sedimentary biosphere.
Microbial circadian clocks: host-microbe interplay in diel cycles
Authors: Wollmuth Emily M. , Angert Esther R.
Published: May 2023

Background

Circadian rhythms, observed across all domains of life, enable organisms to anticipate and prepare for diel changes in environmental conditions. In bacteria, a circadian clock mechanism has only been characterized in cyanobacteria to date. These clocks regulate cyclical patterns of gene expression and metabolism which contribute to the success of cyanobacteria in their natural environments. The potential impact of self-generated circadian rhythms in other bacterial and microbial populations has motivated extensive research to identify novel circadian clocks.

Main text

Daily oscillations in microbial community composition and function have been observed in ocean ecosystems and in symbioses. These oscillations are influenced by abiotic factors such as light and the availability of nutrients. In the ocean ecosystems and in some marine symbioses, oscillations are largely controlled by light-dark cycles. In gut systems, the influx of nutrients after host feeding drastically alters the composition and function of the gut microbiota. Conversely, the gut microbiota can influence the host circadian rhythm by a variety of mechanisms including through interacting with the host immune system. The intricate and complex relationship between the microbiota and their host makes it challenging to disentangle host behaviors from bacterial circadian rhythms and clock mechanisms that might govern the daily oscillations observed in these microbial populations.

Conclusions

While the ability to anticipate the cyclical behaviors of their host would likely be enhanced by a self-sustained circadian rhythm, more evidence and further studies are needed to confirm whether host-associated heterotrophic bacteria possess such systems. In addition, the mechanisms by which heterotrophic bacteria might respond to diel cycles in environmental conditions has yet to be uncovered.
Comparison of preoxygenation efficiency measured by the oxygen reserve index between high-flow nasal oxygenation and facemask ventilation: a randomised controlled trial
Authors: Park Sujung , Kim So Yeon , Kim Min-Soo , Park Wyun Kon , Byon Hyo-Jin , Kim Hyun Joo
Published: May 2023

Background

High-flow nasal oxygenation and the oxygen reserve index (ORI), which is a non-invasive and innovative modality that reflects the arterial oxygen content, are used in general anaesthesia. This study compares the preoxygenation efficiency (measured by the ORI) of high-flow nasal oxygenation and facemask ventilation during the induction process.

Methods

This single-centre, two-group, randomised controlled trial included 197 patients aged ≥ 20 years who underwent orotracheal intubation for general anaesthesia for elective surgery. The patients were randomly allocated to receive preoxygenation via facemask ventilation or high-flow nasal oxygenation. The ORI was measured and compared between both groups.

Results

The ORI increased during preoxygenation in all patients. At 1 min of preoxygenation, the ORI was significantly higher in the high-flow nasal oxygenation group (0.34 ± 0.33) than in the facemask ventilation group (0.21 ± 0.28; P = 0.003). The highest ORI was not significantly different between the two groups (0.68 ± 0.25 in the high-flow nasal oxygenation group vs. 0.70 ± 0.28 in the facemask ventilation group; P = 0.505).

Conclusions

High-flow nasal oxygenation results in an oxygenation status similar to that provided by facemask ventilation during the induction process of general anaesthesia; therefore, high-flow nasal oxygenation is a feasible preoxygenation method.

Trial Registration

Clinicaltrials.gov (NCT04291339).
Comparing ultrasonographically assessed carotid and abdominal aorta plaques in cardiovascular disease risk estimation
Authors: Parkkila Karri , Kesäniemi Y. Antero , Ukkola Olavi
Published: May 2023

Background

Individual risk estimation is an essential part of cardiovascular (CV) disease prevention. Several imaging parameters have been studied for this purpose. Based on mounting evidence, international guidelines recommend the ultrasound assessment of carotid artery plaques to refine individual risk estimation. Previous studies have not compared carotid artery and abdominal aorta plaques in CV risk estimation. Our aim was to explore this matter in a prospective study setting.

Methods

Participants were part of the Oulu Project Elucidating Risk of Atherosclerosis (OPERA) project. All participants (n = 1007, 50% males, aged 51.3 ± 6.0 years) were clinically examined in the beginning of 1990’s and followed until the end 2014 for fatal and non-fatal CV events.

Results

During a median follow-up of 22.5 (17.5–23.2) years, 246 (24%) participants suffered a CV event and 79 (32%) of those CV events were fatal. When compared to those without plaques, both carotid (hazard ratio, HR 2.854 [95% confidence interval, CI, 2.188–3.721, p < 0.001) and abdominal aorta plaques (HR 2.534 [1.503–4.274], p < 0.001) were major risk factors for CV events as an aggregate endpoint. These associations remained even after adjusting the multivariable models with age, sex, systolic blood pressure, smoking, diabetes, LDL cholesterol, and with previous CV events (coronary artery disease and stroke/transient ischemic attack). However, only carotid plaques were significant risk factors for fatal CV events: multivariable adjusted HR 2.563 (1.452–4.524), p = 0.001. Furthermore, reclassification and discrimination parameters were improved only when carotid plaques were added to a baseline risk model. Adding abdominal aorta plaques to the baseline risk model improved C-statistic from 0.718 (0.684–0.751) to 0.721 (0.688–0.754) whereas carotid plaques improved it to 0.743 (0.710–0.776).

Conclusions

Both carotid and abdominal aorta plaques are significant risk factors for CV events, but only carotid plaques provide prognostic information beyond traditional CV risk factors on fatal CV events. If one ultrasound parameter for plaque detection and CV risk estimation had to be chosen, carotid plaques may be preferred over abdominal aorta.
Soluble CD163 is a predictor of fibrosis and hepatocellular carcinoma development in nonalcoholic steatohepatitis
Authors: Kawanaka Miwa , Nishino Ken , Kawada Mayuko , Ishii Katsunori , Tanikawa Tomohiro , Katsumata Ryo , Urata Noriyo , Nakamura Jun , Suehiro Mitsuhiko , Haruma Ken , Kawamoto Hirofumi
Published: May 2023

Background

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. The serum level of soluble CD163 (sCD163), a macrophage activation marker, is associated with liver tissue changes; however, its prognostic value is unknown. Here, we determined the utility of sCD163 as a marker for hepatocellular carcinoma (HCC) and prognostic marker for NAFLD.

Methods

This retrospective study obtained data regarding serum sCD163 levels, liver histology, and background factors associated with NAFLD in 287 patients (men/women, 140/147; average age, 53 ± 14 years) with NAFLD who underwent liver biopsy. Repeated liver biopsies of 287 patients with NAFLD (5.0 ± 2.7 years) were compared regarding serum sCD163 levels and liver tissue changes (stage, grade, steatosis, and NAFLD activity score).

Results

Serum sCD163 levels increased with the progression of liver fibrosis and inflammation (both P < 0.05) and were particularly helpful in distinguishing cases of Grade 4 fibrosis (P < 0.001). Levels of sCD163 significantly decreased in patients with NAFLD exhibiting alleviated fibrosis and inflammation (P < 0.05). We could also predict the development of HCC and associated mortality based on serum sCD163 levels at the time of NAFLD diagnosis. Serum sCD163 levels were higher in patients with HCC than in patients without HCC (1074 ± 379 ng/ml vs. 669 ± 261 ng/ml; P < 0.0001), and the same trend was observed for mortality.

Conclusions

The serum sCD163 level reflects the progression of fibrosis and inflammation in liver tissues, showing much promise as a noninvasive biomarker for nonalcoholic steatohepatitis and NAFLD as well as a possible predictor of HCC development and patient prognosis.
Pericarditis due to Campylobacter coli infection: a case report
Authors: Katsuno Shohei , Itamoto Chieko , Hase Isano
Published: May 2023

Campylobacter spp. is a gram-negative bacillus that causes infectious enteritis and consists of several species, including Campylobacter jejuni, Campylobacter coli, and Campylobacter fetus. Although C. jejuni and C. coli cause infectious enteritis primarily in immunocompetent hosts, C. fetus causes extraintestinal infections such as septicemia, meningitis, and perinatal infections in immunocompromised hosts, as well as myopericarditis in rare cases. Only a few cases of infectious myo(peri)carditis associated with C. coli in immunocompetent hosts have been reported. These studies concentrated on antecedent C. coli enterocolitis and never demonstrated a positive culture in the pericardial fluid.

A 72-year-old Japanese man presented with a 2-week fever, cough, and vomiting lasting. He was on hemodialysis for polycystic kidney disease, as well as medication for diabetes and hypertension. A chest computed tomography (CT) scan and a transthoracic echocardiogram revealed bilateral pleural fluid and large pericardial fluid at the time of admission. C. coli was identified from blood culture samples and blood-tinged pericardial fluid. He was successfully treated with antibacterial chemotherapy as well as pericardial fluid drainage and was discharged from the hospital with no complications.

In this case, the presence of C. coli in the pericardial fluid confirmed the diagnosis of C. coli pericarditis. C. coli may cause septic pericarditis in immunocompromised hosts, despite typically causing only enteritis.
Elevated interleukin (IL)-6 as a predictor of disease severity among Covid-19 patients: a prospective cohort study
Authors: Nikkhoo Bahram , Mohammadi Matin , Hasani Sabah , Sigari Naseh , Borhani Aryan , Ramezani Chia , Charajoo Arian , Badri Shaho , Rostami Farzin , Etemadi Mashala , Rahmani Khaled
Published: May 2023

Background

accompanied to the spreading of coronavirus disease 2019 (Covid-19) in the world, identifying factors related to the severity of the disease is one of the interests of physician and medical researchers. We hypothesized that interleukin 6 serum level is associated with severe outcome.

Methods

In this longitudinal prospective cohort study we enrolled 208 confirmed COVID-19 patients who were admitted to the Tohid Hospital (Sanandaj, Iran). Patients were classified into two groups based on IL-6 value in the first day of admission, elevated (n = 107) or not elevated/normal (n = 101), and followed until the occurrence of final outcome (death or discharge from the hospital). Data were analyzed using univariate methods, Chi-squared and independent two sample T test. The relationship between the independent variables and our interesting outcomes were investigated by multiple linear and penalized logistic regression modeling.

Results

A total of 208 patients, 51% female and mean age 53.6 ± 16.3 years, including 107 elevated and 101 non-elevated IL-6 patients, were followed. No significant difference was observed between the two groups in demographic and clinical characteristics. Although not significant, logistic regression results showed that the chance of death occurrence among patients with elevated IL-6 are 3.91 times higher. According to the multiple linear regression modeling, elevated IL-6 significantly increased the duration of hospital stay (P = 0.02). Frequency of ICU admission (P = 0.04) and mean of ICU stay (P = 0.8) are also higher in elevated IL-6 group.

Conclusion

This study revealed that elevated IL-6 is significantly related to prolongation of hospital stay in Covid-19 patients. Although not significant, the occurrence of death among patients who had increased IL-6 in the time of admission was higher than patients with normal or lower serum levels of IL-6.
Classification of chest X-ray images by incorporation of medical domain knowledge into operation branch networks
Authors: Tsuji Takumasa , Hirata Yukina , Kusunose Kenya , Sata Masataka , Kumagai Shinobu , Shiraishi Kenshiro , Kotoku Jun’ichi
Published: May 2023

Background

This study was conducted to alleviate a common difficulty in chest X-ray image diagnosis: The attention region in a convolutional neural network (CNN) does not often match the doctor’s point of focus. The method presented herein, which guides the area of attention in CNN to a medically plausible region, can thereby improve diagnostic capabilities.

Methods

The model is based on an attention branch network, which has excellent interpretability of the classification model. This model has an additional new operation branch that guides the attention region to the lung field and heart in chest X-ray images. We also used three chest X-ray image datasets (Teikyo, Tokushima, and ChestX-ray14) to evaluate the CNN attention area of interest in these fields. Additionally, after devising a quantitative method of evaluating improvement of a CNN’s region of interest, we applied it to evaluation of the proposed model.

Results

Operation branch networks maintain or improve the area under the curve to a greater degree than conventional CNNs do. Furthermore, the network better emphasizes reasonable anatomical parts in chest X-ray images.

Conclusions

The proposed network better emphasizes the reasonable anatomical parts in chest X-ray images. This method can enhance capabilities for image interpretation based on judgment.
Validated risk prediction models for outcomes of acute kidney injury: a systematic review
Authors: Haredasht Fateme Nateghi , Vanhoutte Laban , Vens Celine , Pottel Hans , Viaene Liesbeth , De Corte Wouter
Published: May 2023

Background

Acute Kidney Injury (AKI) is frequently seen in hospitalized and critically ill patients. Studies have shown that AKI is a risk factor for the development of acute kidney disease (AKD), chronic kidney disease (CKD), and mortality.

Methods

A systematic review is performed on validated risk prediction models for developing poor renal outcomes after AKI scenarios. Medline, EMBASE, Cochrane, and Web of Science were searched for articles that developed or validated a prediction model. Moreover, studies that report prediction models for recovery after AKI also have been included. This review was registered with PROSPERO (CRD42022303197).

Result

We screened 25,812 potentially relevant abstracts. Among the 149 remaining articles in the first selection, eight met the inclusion criteria. All of the included models developed more than one prediction model with different variables. The models included between 3 and 28 independent variables and c-statistics ranged from 0.55 to 1.

Conclusion

Few validated risk prediction models targeting the development of renal insufficiency after experiencing AKI have been developed, most of which are based on simple statistical or machine learning models. While some of these models have been externally validated, none of these models are available in a way that can be used or evaluated in a clinical setting.
Deep learning-based multi-model approach on electron microscopy image of renal biopsy classification
Authors: Zhang Jingyuan , Zhang Aihua
Published: May 2023

Background

Electron microscopy is important in the diagnosis of renal disease. For immune-mediated renal disease diagnosis, whether the electron-dense granule is present in the electron microscope image is of vital importance. Deep learning methods perform well at feature extraction and assessment of histologic images. However, few studies on deep learning methods for electron microscopy images of renal biopsy have been published. This study aimed to develop a deep learning-based multi-model to automatically detect whether the electron-dense granule is present in the TEM image of renal biopsy, and then help diagnose immune-mediated renal disease.

Methods

Three deep learning models are trained to classify whether the electron-dense granule is present using 910 electron microscopy images of renal biopsies. We proposed two novel methods to improve the model accuracy. One model uses the pre-trained ResNet convolutional layers for feature extraction with transfer learning which was firstly improved with skip architecture, then uses Support Vector Machine as the classifier. We developed a multi-model to combine the traditional ResNet model with the improved one to further improve the accuracy.

Results

Deep learning-based multi-model has the highest model accuracy, and the average accuracy is about 88%. The improved ReseNet + SVM model performance is much better than the traditional ResNet model. The average accuracy of the improved ResNet + SVM model is 83%, while the traditional ResNet model accuracy is only 58%.

Conclusions

This study presents the first models for electron microscopy image classification of Renal Biopsy. Identifying whether the electron-dense granule is present plays an important role in the diagnosis of immune complex nephropathy. This study made it possible for Artificial Intelligence models assist to analyze complex electron microscopy images for disease diagnosis.
Bleeding risk and mortality according to antithrombotic agents’ exposure in cancer-related stroke patients: nationwide population-based cohort study in South Korea
Authors: Choi Bo Kyu , Lee Ji Sung , Kim Hae Reong , Kim Han Sang , Jung Yo Han , Park Yu Rang
Published: May 2023

Background

Ischemic stroke with active cancer is thought to have a unique mechanism compared to conventional stroke etiologies. There is no gold standard guideline for secondary prevention in patients with cancer-related stroke, hence, adequate type of antithrombotic agent for treatment is controversial.

Methods

Subjects who were enrolled in National Health Insurance System Customized Research data during the period between 2010 and 2015 were observed until 2019. Subject diagnosed with ischemic stroke within six months before and 12 months after a cancer diagnosis was defined as cancer-related stroke patient. To solve immeasurable time bias, the drug exposure evaluation was divided into daily units, and each person-day was classified as four groups: antiplatelet, anticoagulant, both types, and unexposed to antithrombotic drugs. To investigate bleeding risk and mortality, Cox proportional hazards regression model with time-dependent covariates were used.

Results

Two thousand two hundred eighty-five subjects with cancer-related stroke were followed and analyzed. A group with anticoagulation showed high estimated hazard ratios (HRs) of all bleeding events compared to a group with antiplatelet (major bleeding HR, 1.35; 95% confidence interval [CI], 1.20–1.52;p < 0.001). And the result was also similar in the combination group (major bleeding HR, 1.54; 95% CI, 1.13–2.09;p = 0.006). The combination group also showed increased mortality HR compared to antiplatelet group (HR, 1.72; 95% CI, 1.47–2.00;p < 0.001).

Conclusions

Bleeding risk increased in the anticoagulant-exposed group compared to antiplatelet-exposed group in cancer-related stroke patients. Thus, this result should be considered when selecting a secondary prevention drug.
Adverse infant outcomes following low-risk pregnancies in England: a retrospective cohort study
Authors: Riley Megan , Lambrelli Dimitra , Graham Sophie , Henry Ouzama , Sutherland Andrea , Schmidt Alexander , Sawalhi-Leckenby Nicola , Donaldson Robert , Stoszek Sonia K.
Published: May 2023

Background

There are limited data describing adverse infant outcomes in infants born to women with a low risk of complications during pregnancy, such as those who may be enrolled in maternal immunization trials. This retrospective study estimated incidence proportions of infant outcomes in different cohorts of liveborn infants in England between 2005 and 2017.

Methods

The incidence proportions of 10 infant outcomes were calculated for liveborn infants from pregnancies represented in the Clinical Practice Research Datalink (CPRD) Mother-Baby Link (MBL) and linkage to Hospital Episode Statistics (HES). Three infant cohorts were designed: (1) the all pregnancies infants cohort (N = 185,119), (2) the all pregnancies with a gestational age (GA) ≥ 24 weeks infants cohort (N = 183,869), and (3) the low-risk pregnancies infants cohort (LR infants cohort, N = 121,871), which included pregnancies with a GA ≥ 24 weeks and no diagnosis of predefined high-risk medical conditions until 24 weeks GA.

Results

The most common adverse infant outcome in the three infant cohorts was macrosomia (e.g., 1,085.9/10,000 live births in the LR infants cohort), followed by minor congenital anomalies (e.g., 800.6/10,000 in the LR infants cohort), very low/low birth weight (e.g., 400.6/10,000 in the LR infants cohort), and major congenital anomalies (e.g., 270.4/10,000 in the LR infants cohort). The incidence proportions for early-onset sepsis, very low/low birth weight, and minor and major congenital anomalies were lower in the LR infants than in the other cohorts (non-overlapping confidence intervals [CIs]). The incidence proportions of neonatal death, infant death, late-onset sepsis, macrosomia, small for GA, and large for GA were similar between cohorts (overlapping CIs).

Conclusions

This study generated background rates of adverse infant outcomes from liveborn infants of all and low-risk pregnancies represented in the CPRD Pregnancy Register MBL and linkage to HES. The results indicate lower incidence proportions of several adverse infant outcomes in infants from low-risk pregnancies compared to all pregnancies, illustrating the importance of considering maternal risk factors. These background rates may facilitate the interpretation of safety data from maternal immunization trials and of pharmacovigilance data from maternal vaccines. They may also be of interest for other interventions studied in pregnant women.
The optimal time of starting adjuvant chemotherapy after curative surgery in patients with colorectal cancer
Authors: Yang Yuchong , Lu Yao , Tan Hui , Bai Ming , Wang Xia , Ge Shaohua , Ning Tao , Zhang Le , Duan Jingjing , Sun Yansha , Liu Rui , Li Hongli , Ba Yi , Deng Ting
Published: May 2023

Background

Postoperative adjuvant chemotherapy (AC) is now well-accepted as standard for high-risk stage II and stage III colorectal cancer (CRC) patients, however the optimal time to initiate AC remains elusive.

Methods

A comprehensive literature search was performed using the PubMed and Embase databases. The Hazard ratio (HR) with the corresponding 95% confidence interval (CI) was used as an effect measure to evaluate primary endpoints. All analyses were conducted using Stata software version 12.0 with the Random-effects model.

Results

A total of 30 studies were included in our study. Upon comparison on overall survival (OS), we identified that delaying the initiation of AC for > 8 weeks after operation was significantly associated with poor OS (HR: 1.37; 95% CI: 1.27—1.48; P < 0.01). The poor prognostic value of AC delay for > 8 weeks was not undermined by subgroup analysis based on region, tumor site, sample size and study quality. No obvious differences were observed in survival between AC within 5–8 weeks and ≤ 4 weeks (HR: 1.03; 95% CI: 0.96 -1.10; P = 0.46). Moreover, two studies both highlighted that the survival benefit of AC was still statistically significant when AC was applied 5–6 months after surgery compared with the non-chemotherapy group.

Conclusions

Delaying the initiation of AC for > 8 weeks after surgery was significantly associated with poor OS. AC started within 8 weeks after surgery brought more benefits to CRC patients. There were no obvious differences in survival benefits between AC within 5–8 weeks and ≤ 4 weeks. Compared to patients not receiving AC after surgery, a delay of approximately 5–6 months was still useful to improve prognosis.
ZDHHC15 promotes glioma malignancy and acts as a novel prognostic biomarker for patients with glioma
Authors: Liu Zhen-Yuan , Lan Tian , Tang Feng , He Yong-Ze , Liu Jin-Sheng , Yang Jin-Zhou , Chen Xi , Wang Ze-Fen , Li Zhi-Qiang
Published: May 2023

Background

Glioma is the most common and aggressive tumor in the adult brain. Recent studies have indicated that Zinc finger DHHC-type palmitoyltransferases (ZDHHCs) play vital roles in regulating the progression of glioma. ZDHHC15, a member of the ZDHHCs family, participates in various physiological activities in the brain. However, the biological functions and related mechanisms of ZDHHC15 in glioma remain poorly understood.

Methods

Data from multiple glioma-associated datasets were used to investigate the expression profiles and potential biological functions of ZDHHC15 in glioma. Expression of ZDHHC15 and its association with clinicopathological characteristics in glioma were validated by quantitative reverse transcription PCR (RT-qPCR) and immunohistochemical experiments. GO enrichment analysis, KEGG analysis, GSEA analysis, CCK-8, EdU, transwell, and western blotting assays were performed to confirm the functions and mechanism of ZDHHC15 in glioma. Moreover, we performed Kaplan-Meier analysis and Cox progression analysis to explore the prognostic significance of ZDHHC15 in glioma patients.

Results

ZDHHC15 expression was significantly up-regulated in glioma and positively associated with malignant phenotypes. Results from the GO and KEGG enrichment analysis revealed that ZDHHC15 was involved in regulating cell cycle and migration. Knockdown of ZDHHC15 inhibited glioma cell proliferation and migration, while overexpression of ZDHHC15 presented opposite effects on glioma cells. Besides, results from GSEA analysis suggested that ZDHHC15 was enriched in STAT3 signaling pathway. Knockdown or overexpression of ZDHHC15 indeed affected the activation of STAT3 signaling pathway. Additionally, we identified ZDHHC15 as an independent prognostic biomarker in glioma, and higher expression of ZDHHC15 predicted a poorer prognosis in glioma patients.

Conclusion

Our findings suggest that ZDHHC15 promotes glioma malignancy and can serve as a novel prognostic biomarker for glioma patients. Targeting ZDHHC15 may be a promising therapeutic strategy for glioma.