bluuebunny/crossref_metadata_2025 huggingface dataset:
Automated diagnosis and prognosis of COVID-19 pneumonia from initial ER chest X-rays using deep learning
Authors: Chamberlin Jordan H. , Aquino Gilberto , Nance Sophia , Wortham Andrew , Leaphart Nathan , Paladugu Namrata , Brady Sean , Baird Henry , Fiegel Matthew , Fitzpatrick Logan , Kocher Madison , Ghesu Florin , Mansoor Awais , Hoelzer Philipp , Zimmermann Mathis , James W. Ennis , Dennis D. Jameson , Houston Brian A. , Kabakus Ismail M. , Baruah Dhiraj , Schoepf U. Joseph , Burt Jeremy R.
Published: July 2022

Background

Airspace disease as seen on chest X-rays is an important point in triage for patients initially presenting to the emergency department with suspected COVID-19 infection. The purpose of this study is to evaluate a previously trained interpretable deep learning algorithm for the diagnosis and prognosis of COVID-19 pneumonia from chest X-rays obtained in the ED.

Methods

This retrospective study included 2456 (50% RT-PCR positive for COVID-19) adult patients who received both a chest X-ray and SARS-CoV-2 RT-PCR test from January 2020 to March of 2021 in the emergency department at a single U.S. institution. A total of 2000 patients were included as an additional training cohort and 456 patients in the randomized internal holdout testing cohort for a previously trained Siemens AI-Radiology Companion deep learning convolutional neural network algorithm. Three cardiothoracic fellowship-trained radiologists systematically evaluated each chest X-ray and generated an airspace disease area-based severity score which was compared against the same score produced by artificial intelligence. The interobserver agreement, diagnostic accuracy, and predictive capability for inpatient outcomes were assessed. Principal statistical tests used in this study include both univariate and multivariate logistic regression.

Results

Overall ICC was 0.820 (95% CI 0.790–0.840). The diagnostic AUC for SARS-CoV-2 RT-PCR positivity was 0.890 (95% CI 0.861–0.920) for the neural network and 0.936 (95% CI 0.918–0.960) for radiologists. Airspace opacities score by AI alone predicted ICU admission (AUC = 0.870) and mortality (0.829) in all patients. Addition of age and BMI into a multivariate log model improved mortality prediction (AUC = 0.906).

Conclusion

The deep learning algorithm provides an accurate and interpretable assessment of the disease burden in COVID-19 pneumonia on chest radiographs. The reported severity scores correlate with expert assessment and accurately predicts important clinical outcomes. The algorithm contributes additional prognostic information not currently incorporated into patient management.
Maternal and neonatal safety outcomes after SAR-CoV-2 vaccination during pregnancy: a systematic review and meta-analysis
Authors: Hagrass Abdulrahman Ibrahim , Almadhoon Hossam Waleed , Al-kafarna Mohammed , Almaghary Bashar Khaled , Nourelden Anas Zakarya , Fathallah Ahmed Hashem , Hasan Mohammed Tarek , Mohammed Yasmine Adel , Al-Nabahin Aya Osama , Wafi Dalia Sami , Ismail Islam Osama , Hamam Yaser Aref , Sayad Reem , Hamouda Mohamed , Zaazouee Mohamed Sayed , Ragab Khaled Mohamed
Published: July 2022

Background and objective

More than five million individuals died because of problems connected to COVID-19. SARS-Cov-2 poses a particular challenge to expectant mothers, who comprise one of the most vulnerable segments of the population. Our aim is to demonstrate the maternal and neonatal safety of the COVID-19 vaccine during pregnancy.

Methods

We searched PubMed, Cochrane Library, Scopus, Web of Science (WOS), Embase, Ovid, MedRxiv, and BioRxiv databases from inception till December 2021 and then updated it in April 2022. Additionally, we searched ClinicalTrials.gov, Research Square and grey literature. Cohort, case–control studies, and randomized controlled trials detecting the safety of the Covid-19 vaccine during pregnancy were included. We used the Cochrane tool and Newcastle–Ottawa Scale to assess the risk of bias of the included studies and the GRADE scale to assess the quality of evidence. A meta-analysis was conducted using review manager 5.4.

Results

We included 13 studies with a total number of 56,428 patients. Our analysis showed no statistically significant difference in the following outcomes: miscarriage (1.56% vs 0.3%. RR 1.23; 95%CI 0.54 to 2.78); length of maternal hospitalization (MD 0.00; 95%CI -0.08 to 0.08); puerperal fever (1.71% vs 1.1%. RR 1.04; 95%CI 0.67 to 1.61); postpartum hemorrhage (4.27% vs 3.52%. RR 0.84; 95%CI 0.65 to 1.09); instrumental or vacuum-assisted delivery (4.16% vs 4.54%. RR 0.94; 95%CI 0.57 to 1.56); incidence of Apgar score ≤ 7 at 5 min (1.47% vs 1.48%. RR 0.86; 95%CI 0.54 to 1.37); and birthweight (MD -7.14; 95%CI -34.26 to 19.99).

Conclusion

In pregnancy, the current meta-analysis shows no effect of SAR-CoV-2 vaccination on the risk of miscarriage, length of stay in the hospital, puerperal fever, postpartum hemorrhage, birth weight, or the incidence of an Apgar score of ≤ 7 at 5 min.
Does medical disparity exist while treating severe mental illness patients with acute appendicitis in emergency departments? A real-world database study
Authors: Hung Shang-Kai , Kou Hao-Wei , Wu Kai-Hsiang , Chen Shou-Yen , Li Chih-Huang , Lee Chao-Wei , Hung Yu-Yung , Gao Shi-Ying , Wu Po-Han , Hsieh Chiao-Hsuan , Chaou Chung-Hsien
Published: July 2022

Background

Patients with severe mental illness (SMI) have a shorter life expectancy and have been considered by the World Health Organization (WHO) as a vulnerable group. As the causes for this mortality gap are complex, clarification regarding the contributing factors is crucial to improving the health care of SMI patients. Acute appendicitis is one of the most common indications for emergency surgery worldwide. A higher perforation rate has been found among psychiatric patients. This study aims to evaluate the differences in appendiceal perforation rate, emergency department (ED) management, in-hospital outcomes, and in-hospital expenditure among acute appendicitis patients with or without SMI via the use of a multi-centre database.

Methods

Relying on Chang Gung Research Database (CGRD) for data, we selectively used its data from January 1st, 2007 to December 31st, 2017. The diagnoses of acute appendicitis and SMI were confirmed by combining ICD codes with relevant medical records. A non-SMI patient group was matched at the ratio of 1:3 by using the Greedy algorithm. The outcomes were appendiceal perforation rate, ED treatment, in-hospital outcome, and in-hospital expenditure.

Results

A total of 25,766 patients from seven hospitals over a span of 11 years were recruited; among them, 11,513 were excluded by criteria, with 14,253 patients left for analysis. SMI group was older (50.5 vs. 44.4 years, p < 0.01) and had a higher percentage of females (56.5 vs. 44.4%, p = 0.01) and Charlson Comorbidity Index. An analysis of the matched group has revealed that the SMI group has a higher unscheduled 72-hour revisit to ED (17.9 vs. 10.4%, p = 0.01). There was no significant difference in appendiceal perforation rate, ED treatment, in-hospital outcome, and in-hospital expenditure.

Conclusions

Our study demonstrated no obvious differences in appendiceal perforation rate, ED management, in-hospital outcomes, and in-hospital expenditure among SMI and non-SMI patients with acute appendicitis. A higher unscheduled 72-hour ED revisit rate prior to the diagnosis of acute appendicitis in the SMI group was found. ED health providers need to be cautious when it comes to SMI patients with vague symptoms or unspecified abdominal complaints.
Physical activity behavior during Covid 19 pandemic among Iranian dwellers in Southern Iran based on planned behavior theory: a SEM analysis
Authors: Khani Jeihooni Ali , Jafari Fatemeh , Shiraly Ramin , Rakhshani Tayebeh , Asadollahi Abdolrahim , Karami Hamed
Published: July 2022

Background

The COVID-19 pandemic restrictions curtailed physical activity. The current study applied an integrated Theory of Planned Behavior to identify the determinants of physical activity behavior and the processes involved in the COVID-19 pandemic.

Methods

A cross-sectional study was conducted in Shiraz city, Southern Iran, among 2500 people who met the inclusion criteria were included in the study. Data were collected using the demographic information questions and questionnaire based on the Theory of Planned Behavior (TPB) constructs. The Questionnaire via WhatsApp, emails, and SMS was shared. Data analysis was performed using SPSS26 and Amos version 24. Mean and standard deviation was used to describe the data. Also, one-way ANOVA and structural equation analysis were used to analyze the data. The significance level in all the tests was considered to be 0.05.

Results

One thousand one hundred sixty-nine samples (46.8%) said they had been exercising less than 3 days a week, and 47.6% of them did not have any exercise or physical activities (n = 1191). The mean score of attitudes, SN, PBC, and intention were 9.38 ± 2.07, 9.27 ± 2.03, 9.32 ± 2.05, and 12.29 ± 2.35, respectively. The effect size values demonstrate the independent variables’ high coefficient of influence on explaining the theoretical model. According to the results, the factors play an important role in samples’ intention (η2 ≥ 0.2, p ≤ 0.05). The effect size of intention on doing physical activities and exercise during the SARS-CoV-2 pandemic is Eta square = 0.777, which means the measure was high. The obtained model was good based on the main goodness of fit indices (Chi2 = 108.6, df = 25, n = 2500, Chi2/df = 4.344, RMSEA = 0.036, AGFI = 0.92, CFI = 0.95, GFI = 0.90, Fornell-Larcker criterion = 0.87, HTMT = 0.89).

Conclusion

The TPB provides a useful framework to explore psychosocial determinants of physical activity behavior during the pandemic and identify key strategies for program planning aimed at improving exercise among people who were already influenced by quarantine and lockdown restrictions.
How to maintain and transport equine adipose tissue for isolating mesenchymal stem cells?
Authors: Rezaei Faezeh , Khasaf Samira , Ghasemi Samaneh , Parham Abbas , Mirshokraei Pezhman
Published: July 2022

Background

Adipose tissue (AT) is one of the most important mesenchymal stem cell (MSC) sources because of its high quantities, availability and ease of collection. After being collected samples, they should be transported to a laboratory for stem cell (SC) isolation, culture and expansion for future clinical application. Usually, laboratories are distant from animal husbandry centers; therefore, it is necessary to provide suitable conditions for adipose tissue transportation, such that adipose-derived MSCs are minimally affected. In the current study, the impact of tissue maintenance under different conditions on MSCs derived from these tissues was evaluated. We aimed at finding suitable and practical transportation methods in which ASCs go through the slightest changes.

Results

In the current study, after being collected, equine AT was randomized into eight groups: four samples were maintained in stem cell culture media at 25 οC and 4 οC for 6 and 12 hrs. as transportation via SC media groups. Three samples were frozen at three different temperatures (− 20, − 75 and − 196 οC) as cryopreserved groups; these samples were defrosted 1 week after cryopreservation. Fresh and unfrozen AT was evaluated as a control group. The tissue samples were then initiated into enzymatic digestion, isolation and the culturing of SCs. Cells at passage three were used to evaluate the ability to form colonies, proliferation rate, plotting of the cell growth curve, and viability rate. All experiments were performed in triplicate. Stem cell isolation was successful in all groups, although purification of SCs from the first series of cryopreservation at − 196 οC and two series of − 20 οC was unsuccessful. There was no significant difference between the surface area of colonies in all groups except for − 20 οC. The growth rate of transportation via stem cell media at 25 οC for 6 hrs. was similar to that of the control group. MTT analysis revealed a significant difference between 25 οC 12 hrs. Group and other experimental groups except for control, 4 οC 12 hrs. and − 196 οC group.

Conclusion

Data have shown freezing at − 75 οC, transportation via stem cell media at 4 οC for 12 hrs. and 25 οC for 6 hrs. are acceptable tissue preservation and transportation methods due to minor effects on MSCs features.
Proteomic analysis of cardiometabolic biomarkers and predictive modeling of severe outcomes in patients hospitalized with COVID-19
Authors: Schroeder Philip H. , Brenner Laura N. , Kaur Varinderpal , Cromer Sara J. , Armstrong Katrina , LaRocque Regina C. , Ryan Edward T. , Meigs James B. , Florez Jose C. , Charles Richelle C. , Mercader Josep M. , Leong Aaron
Published: July 2022

Background

The high heterogeneity in the symptoms and severity of COVID-19 makes it challenging to identify high-risk patients early in the disease. Cardiometabolic comorbidities have shown strong associations with COVID-19 severity in epidemiologic studies. Cardiometabolic protein biomarkers, therefore, may provide predictive insight regarding which patients are most susceptible to severe illness from COVID-19.

Methods

In plasma samples collected from 343 patients hospitalized with COVID-19 during the first wave of the pandemic, we measured 92 circulating protein biomarkers previously implicated in cardiometabolic disease. We performed proteomic analysis and developed predictive models for severe outcomes. We then used these models to predict the outcomes of out-of-sample patients hospitalized with COVID-19 later in the surge (N = 194).

Results

We identified a set of seven protein biomarkers predictive of admission to the intensive care unit and/or death (ICU/death) within 28 days of presentation to care. Two of the biomarkers, ADAMTS13 and VEGFD, were associated with a lower risk of ICU/death. The remaining biomarkers, ACE2, IL-1RA, IL6, KIM1, and CTSL1, were associated with higher risk. When used to predict the outcomes of the future, out-of-sample patients, the predictive models built with these protein biomarkers outperformed all models built from standard clinical data, including known COVID-19 risk factors.

Conclusions

These findings suggest that proteomic profiling can inform the early clinical impression of a patient’s likelihood of developing severe COVID-19 outcomes and, ultimately, accelerate the recognition and treatment of high-risk patients.
The autophagy inducer trehalose stimulates macropinocytosis in NF1-deficient glioblastoma cells
Authors: Del Bello Barbara , Gamberucci Alessandra , Marcolongo Paola , Maellaro Emilia
Published: July 2022

Background

Glioblastoma is a highly aggressive brain tumor. A big effort is required to find novel molecules which can cross the blood–brain barrier and efficiently kill these tumor cells. In this perspective, trehalose (α-glucopyranosyl‐[1→1]‐α‐d‐glucopyranoside), found in various dietary sources and used as a safe nutrient supplement, attracted our attention for its pleiotropic effects against tumor cells.

Methods

Human glioblastoma cell lines U373-MG and T98G were exposed to trehalose and analyzed at different time points. Cell proliferation was evaluated at medium term, and clonogenic capacity and cell morphology were evaluated at long term. Western blot was used to evaluate biochemical markers of autophagy (also measured in cells co-treated with EIPA or chloroquine), and mTOR, AMPK and ERK 1/2 signalling. Macropinocytosis was evaluated morphologically by bright-field microscopy; in cells loaded with the fluorescein-conjugated fluid-phase tracer dextran, macropinocytic vacuoles were also visualized by fluorescence microscopy, and the extent of macropinocytosis was quantified by flow cytometry.

Results

The long-term effect of trehalose on U373-MG and T98G cell lines was impressive, as indicated by a dramatic reduction in clonogenic efficiency. Mechanistically, trehalose proved to be an efficient autophagy inducer in macropinocytosis-deficient T98G cells and an efficient inducer of macropinocytosis and eventual cell death by methuosis in U373-MG glioblastoma cells, proved to be poorly responsive to induction of autophagy. These two processes appeared to act in a mutually exclusive manner; indeed, co-treatment of U373-MG cells with the macropinocytosis inhibitor, EIPA, significantly increased the autophagic response. mTOR activation and AMPK inhibition occurred in a similar way in the two trehalose-treated cell lines. Interestingly, ERK 1/2 was activated only in macropinocytosis-proficient U373-MG cells harbouring loss-of-function mutations in the negative RAS regulator, NF1, suggesting a key role of RAS signalling.

Conclusions

Our results indicate that trehalose is worthy of further study as a candidate molecule for glioblastoma therapy, due to its capacity to induce a sustained autophagic response, ultimately leading to loss of clonogenic potential, and more interestingly, to force macropinocytosis, eventually leading to cell death by methuosis, particularly in tumor cells with RAS hyperactivity. As a further anticancer strategy, stimulation of macropinocytosis may be exploited to increase intracellular delivery of anticancer drugs.
Functional interplay between long non-coding RNAs and Breast CSCs
Authors: Hussen Bashdar Mahmud , Kheder Ramiar Kamal , Abdullah Sara Tharwat , Hidayat Hazha Jamal , Rahman Heshu Sulaiman , Salihi Abbas , Taheri Mohammad , Ghafouri-Fard Soudeh
Published: July 2022

Breast cancer (BC) represents aggressive cancer affecting most women’s lives globally. Metastasis and recurrence are the two most common factors in a breast cancer patient's poor prognosis. Cancer stem cells (CSCs) are tumor cells that are able to self-renew and differentiate, which is a significant factor in metastasis and recurrence of cancer. Long non-coding RNAs (lncRNAs) describe a group of RNAs that are longer than 200 nucleotides and do not have the ability to code for proteins. Some of these lncRNAs can be mainly produced in various tissues and tumor forms. In the development and spread of malignancies, lncRNAs have a significant role in influencing multiple signaling pathways positively or negatively, making them promise useful diagnostic and prognostic markers in treating the disease and guiding clinical therapy. However, it is not well known how the interaction of lncRNAs with CSCs will affect cancer development and progression.

Here, in this review, we attempt to summarize recent findings that focus on lncRNAs affect cancer stem cell self-renewal and differentiation in breast cancer development and progression, as well as the strategies and challenges for overcoming lncRNA's therapeutic resistance.
Modified thromboelastometric tests provide improved sensitivity and specificity to direct oral anticoagulants compared to standard thromboelastometric tests in-vitro
Authors: Groene Philipp , Butte Jennifer , Thaler Sarah , Görlinger Klaus , Schäfer Simon T.
Published: July 2022

Background

The detection of direct oral anticoagulants (DOACs) is still challenging but important in emergency patients. We recently demonstrated that modified thromboelastometry can detect rivaroxaban and dabigatran. Data on the detection rates of modified compared to standard thromboelastometric tests of apixaban and edoxaban, are missing. The aim of this in-vitro dose-effect-study was to add data on these DOACs and to evaluate thromboelastometric tests in-vitro using data of both studies.

Methods

The study was approved by the Ludwig-Maximilians-University ethics committee (No 17-525-2). Written informed consent was obtained from all individuals. Blood samples of healthy volunteers and samples of 10 volunteers for each DOAC were used. Blood samples were spiked with six different concentrations of edoxaban and apixaban (0ng/ml; 31.25ng/ml; 62.5ng/ml; 125ng/ml; 250 ng/ml; 500ng/ml). Modified tests (low-tissue-factor test TFTEM and ecarin-based test ECATEM) as well as standard tests (e.g. FIBTEM) analyzing extrinsic pathway of coagulation were used. Receiver operating characteristics analyzes were performed as well as regression analyzes.

Results

TFTEM CT correlated well with anti-Xa levels of apixaban and edoxaban (apixaban: r2 = 0.8064 p < 0.0001; edoxaban: r2 = 0.8603; p < 0.0001). The detection of direct FXa inhibitors (> 30 ng/mL) was successful with FIBTEM CT with a sensitivity and specificity of 81% and 90%, respectively. As expected, ECATEM CT was not prolonged by direct FXa-inhibitors due to its specificity for direct thrombin inhibitors. Again, TFTEM CT provided the highest sensitivity and specificity for the detection of direct FXa inhibitors with 96% and 95%, respectively. ECATEM test showed 100% sensitivity and 100% specificity for the detection of dabigatran.

Conclusions

Our study presents modified thromboelastometric tests with improved detection of even low DOAC concentrations > 30 ng/mL, including apixaban in-vitro. The study thus complements the previously published data on dabigatran and rivaroxaban. Validation studies must confirm the results due to the explanatory design of this study.
Transplanted allogeneic cardiac progenitor cells secrete GDF-15 and stimulate an active immune remodeling process in the ischemic myocardium
Authors: Mishra Rachana , Saha Progyaparamita , Datla Srinivasa Raju , Mellacheruvu Pranav , Gunasekaran Muthukumar , Guru Sameer Ahmad , Fu Xuebin , Chen Ling , Bolli Roberto , Sharma Sudhish , Kaushal Sunjay
Published: July 2022

Background

Despite promising results in clinical studies, the mechanism for the beneficial effects of allogenic cell-based therapies remains unclear. Macrophages are not only critical mediators of inflammation but also critical players in cardiac remodeling. We hypothesized that transplanted allogenic rat cardiac progenitor cells (rCPCs) augment T-regulatory cells which ultimately promote proliferation of M2 like macrophages by an as-yet undefined mechanism.

Methods and results

To test this hypothesis, we used crossover rat strains for exploring the mechanism of myocardial repair by allogenic CPCs. Human CPCs (hCPCs) were isolated from adult patients undergoing coronary artery bypass grafting, and rat CPCs (rCPCs) were isolated from male Wistar-Kyoto (WKY) rat hearts. Allogenic rCPCs suppressed the proliferation of T-cells observed in mixed lymphocyte reactions in vitro. Transplanted syngeneic or allogeneic rCPCs significantly increased cardiac function in a rat myocardial infarct (MI) model, whereas xenogeneic CPCs did not. Allogeneic rCPCs stimulated immunomodulatory responses by specifically increasing T-regulatory cells and M2 polarization, while maintaining their cardiac recovery potential and safety profile.

Mechanistically, we confirmed the inactivation of NF-kB in Treg cells and increased M2 macrophages in the myocardium after MI by transplanted CPCs derived GDF15 and it’s uptake by CD48 receptor on immune cells.

Conclusion

Collectively, these findings strongly support the active immunomodulatory properties and robust therapeutic potential of allogenic CPCs in post-MI cardiac dysfunction.
Immunotherapy landscape analyses of necroptosis characteristics for breast cancer patients
Authors: Yu Honghao , Lv Wenchang , Tan Yufang , He Xiao , Wu Yiping , Wu Min , Zhang Qi
Published: July 2022

Necroptosis plays a major role in breast cancer (BC) progression and metastasis. Besides, necroptosis also regulates inflammatory response and tumor microenvironment. Here, we aim to explore the predictive signature based on necroptosis-related genes (NRGs) for predicting the prognosis and response to therapies. Using Lasso multivariate cox analysis, we firstly established the NRG signature based on TCGA database. A total of 6 NRGs (FASLG, IPMK, FLT3, SLC39A7, HSP90AA1, and LEF1), which were associated with the prognosis of BC patients, were selected to establish our signature. Next, CIBERSORT algorithm was utilized to evaluate immune cell infiltration levels. We compare the response to immunotherapy using IMvigor 210 database, and also compared immune indicators in two risk groups via multiple methods. The biological function of IPMK was explored via in vitro verification. Finally, our results indicated that the signature was an independent prognostic indicator for BC patients with better efficiency than other reported signatures. The immune cell infiltration levels were higher, and the response to immunotherapy and chemotherapy was better in the low-risk groups. Besides, other immunotherapy-related factors, including TMB, TIDE, and expression of immune checkpoints were also increased in the low-risk group. Clinical sample validation showed that CD206 and IPMK in clinical samples were both up-regulated in the high-risk group. In vitro assay showed that IPMK promoted BC cell proliferation and migration, and also enhanced macrophage infiltration and M2 polarization. In summary, we successfully established the NRG signature, which could be used to evaluate BC prognosis and identify patients who will benefit from immunotherapy.
Kagami–Ogata syndrome: a case report
Authors: Suriapperuma Tharindi , Randeny Shobhavi , Mettananda Sachith
Published: July 2022

Background

Kagami–Ogata syndrome is a rare genetic imprinting disorder involving the 14q32.2 genomic location of chromosome 14. The estimated incidence is less than 1 per 1 million. Here we report a male neonate with Kagami–Ogata syndrome presenting with severe respiratory distress requiring mechanical ventilation since birth.

Case presentation

A Sri Lankan male neonate born at term via caesarean section to a mother with type 1 diabetes mellitus and hypothyroidism developed respiratory distress immediately after birth. On examination, the baby had facial dysmorphism with a hirsute forehead, full cheeks, flat nasal bridge, elongated protruding philtrum, and micrognathia. His chest was small and bell shaped, and he had severe intercostal and subcostal recessions. His abdominal wall was lax and thin, with evidence of divarication of the recti. Bowel peristalsis was easily visible through the abdominal wall. The chest x-ray showed narrowing of the rib cage with crowding of the ribs in a “coat-hanger” appearance. The coat-hanger angle was 32°, and the mid-to-widest thoracic diameter was 68%. On the basis of facial dysmorphism, chest and anterior abdominal wall abnormalities, coat-hanger appearance of the rib cage, increased coat-hanger angle, and reduced mid-to-widest thoracic diameter, a clinical diagnosis of Kagami–Ogata syndrome was made. Owing to severe respiratory distress, the baby required intubation and ventilation immediately after birth. He was ventilator-dependent for 3 weeks; however, he was successfully weaned off the ventilator on day 22 after several failed extubation attempts. At 3-month follow-up, he had generalized hypotonia and mild global developmental delay. His developmental age corresponded to 2 months.

Conclusions

We report a patient with Kagami–Ogata syndrome presenting with respiratory distress immediately after birth. This case report highlights the importance of being aware of this rare condition, which could present as severe respiratory distress in term and preterm newborns. A positive diagnosis could avoid unnecessary treatment and aid in accurate prognostication.
The university students’ self-regulated effort, flexibility and satisfaction in distance education
Authors: Turan Zeynep , Kucuk Sevda , Cilligol Karabey Sinem
Published: July 2022

Distance education offers flexible learning opportunities in terms of time, place and learning speed to teachers and students through internet technologies. However, the learning opportunities provided in distance education environments require students to act more autonomously and take more responsibility for regulating their learning processes to achieve their learning goals. For this reason, it is crucial to reveal the relationships between flexibility, self-regulated effort and satisfaction factors to provide efficient and effective learning environments in distance education. Accordingly, within the scope of this study, it is aimed to investigate university students’ perceptions of flexibility, self-regulated effort and satisfaction with the distance education process, and their views on distance education. Survey research was used as the research method in the study. The study sample consisted of 1760 university students studying at 28 different universities. Data were analysed using t-test, ANOVA, and regression methods. As a result of the study, male students were more satisfied with distance education than female students, and education faculty students had the highest level of satisfaction. In addition, self-regulated effort and flexibility variables were significant factors affecting students’ satisfaction towards distance education. Furthermore, the advantages and problems of distance education and suggestions for future distance learning environments were presented in the light of students views. Finally, the study’s implications and various recommendations for practitioners and researchers were discussed in detail.
Polymorphism of the IL-10 gene in Azeri population of Iran
Authors: Asgharzadeh Mohammad , Taghinejad Zahra , Asgharzadeh Vahid , Mehramouz Bahareh , Rashedi Jalil , Mahdavipoor Behroz , Pourostadi Mahya , Vegari Ali , Vishkaei Ali Safarzad , Taghizadeh Sepehr , Kafil Hossein Samadi
Published: July 2022

Background

Interleukin (IL)-10 is one of the key interleukins in the immune system. It plays an anti-inflammatory role in body by inhibition of the synthesis of pro-inflammatory cytokines and reducing the expression of major histocompatibility complex II molecules. The single-nucleotide polymorphism in the gene of this interleukin affects its expression level. Thus, this study was conducted to investigate the IL-10 gene polymorphism at position -1082A/G in Azeri population of Iran.

Methods

Blood samples were taken from 254 healthy and non-relevant Iranian Azeri individuals. After DNA extraction, the frequency of IL-10 genotypes and alleles at -1082A/G position was determined by allele specific-PCR method. Then, q-square test was used to compare allele frequencies and IL-10 genotypes with other populations, and p value of < 0.05 was considered significant.

Results

In Iranian Azeri population, the frequency percentage of AA, AG and GG genotypes in IL-10 gene at the -1082A/G location was 37.4, 43.3 and 19.3%, respectively. The frequency percentage of A and G alleles also were 59.1 and 40.9%, respectively. Based on statistical analysis, frequency of IL-10 genotypes in the current study was very similar to the population of Saudi Arabia, but it had a significant difference with East Asia and Ireland populations.

Conclusion

Results of the present study indicate similar polymorphism of IL-10 genotype with neighbor ethnicities in Middle East country. Based on patients backgrounds mentioned in their questioners, this polymorphism was associated with the susceptibility to asthma and Alzheimer in this population which are common in the region.
The therapeutic role of repetitive transcranial magnetic stimulation in children with attention deficit/hyperactivity disorder in Egypt a randomized sham controlled clinical trial
Authors: Nagy Nahla Al Sayed , Amin Ghada Refaat , Khalil Sherine Ahmed , Mahmoud Dalia Abdel Moneim , Elkholy Hussien , Shohdy Mostafa
Published: July 2022

Background

Repetitive transcranial magnetic stimulation showed some evidence for improving symptoms of ADHD along with its relative safety, thus could serve as a treatment strategy or an alternative to stimulant medication. Accordingly, 60 children with ADHD were assessed, and 30 participants were allocated to the rTMS group and received 15 sessions of rTMS over the right dorsolateral prefrontal cortex combined with Atomoxetine 1.2 mg/kg/day. The other 30 participants were allocated to the Sham group and received 15 sessions of sham rTMS and atomoxetine 1.2 mg/kg/day. Clinical assessments of ADHD symptoms and severity were done and compared at 3 points, before treatment, after receiving 15 sessions of rTMS and follow-up 1 month after the last rTMS session, using Conner’s Parent Rating Scale-Revised-Long form, Children’s Global Assessment Scale, and Clinical Global Impression.

Results

The two groups show significant improvement in the T scores of all CPRS subscales, CGI and CGAS. However, the rTMS group had a significantly more improvement than the sham group in inattention, total ADHD severity, CGI, and CGAS after rTMS and continued to the follow-up after 1 month.

Conclusions

rTMS is an efficacious intervention for treating ADHD, and combined rTMS and atomoxetine is superior to atomoxetine alone in improving attention deficit symptoms and total ADHD symptoms severity.

Trial registration

PACTR, PACTR202110558451583. Registered 25 June 2021. Approved 29 October 2021- Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=15968.
High-risk Growth Trajectory Related to Childhood Overweight/Obesity and Its Predictive Model at Birth
Authors: Chen Yan , Cai Chen , Tan Jintong , Lei Xiaoping , Chen Qian , Zhang Jun , Zhang Yongjun
Published: July 2022

Context

Childhood obesity increases the risk of chronic disease in adulthood.

Objective

To construct an early predictive model for a growth trajectory that is highly related to childhood overweight/obesity.

Design

Prospective cohort study.

Settings

Shanghai Birth Cohort (SBC) and US Collaborative Perinatal Project (CPP).

Participants

A total of 848 mother-child pairs in the SBC (2013-2016) and 22 691 pairs in the CPP (1959-1965) with 2- and 7-year follow-up, respectively.

Main Outcome Measures

A high-risk postnatal growth trajectory intimately associated with childhood overweight/obesity and its predictive model.

Results

We demonstrated that the shifts of postnatal body mass index (BMI) percentile had been completed around 1 year of age and identified a high-risk growth trajectory that was closely related to overweight/obesity [odds ratio 6.5 (95% CI 5.9, 7.2)] at 7 years old. Children with this trajectory presented with a consistent BMI around the 85th percentile after the age of 1 year. It could be recognized early after birth using a predictive model with 4 metabolites (tyrosine, glycine, octenoylcarnitine, and stearoylcarnitine), combined with sex, birth weight, and maternal prepregnancy BMI. The model had an area under the receiver operating characteristic curve of 0.869 (95% CI 0.779, 0.932), a sensitivity of 83.3% (95% CI 51.6%, 97.9%), and a specificity of 81.1% (95% CI 70.3%, 89.3%) in the validation data set.

Conclusion

Children with postnatal high-risk growth trajectories were significantly associated with subsequent overweight/obesity at 7 years old. Metabolite profiles at birth combined with clinical measures were able to predict at-risk children before overweight/obesity occurrence.
Associations Between Maternal Lipid Blood Levels at the 13th Week of Pregnancy and Offspring’s Adiposity at Age 11-12 Years
Authors: Baas Rosa E , Hutten Barbara A , Henrichs Jens , Vrijkotte Tanja G M
Published: July 2022

Context

There is increasing evidence that intrauterine lipid metabolism influences the adiposity of the newborn and the first years thereafter. It remains unclear if these effects persist when these children grow older.

Objective

This study examined the associations between maternal lipid blood levels during the 13th week of pregnancy and an offspring’s adiposity, measured at age 11-12, and if these associations were moderated by the child’s sex.

Methods

Data were obtained from a community-based birth cohort, the Amsterdam Born Children and their Development (ABCD) study. At a median of 13 weeks’ gestation, nonfasting blood samples of triglycerides (TGs), total cholesterol (TC), free fatty acids (FFAs), and apolipoprotein B/apolipoprotein A1 ratio (ApoB/ApoA1) were measured. An offspring’s body mass index (BMI), subcutaneous fat (SCF), waist-to-height-ratio (WHtR), and fat percentage (fat%) were measured at age 11-12. Mothers with at-term born children were included (n = 1853). Multivariable linear regression analyses were performed to assess the associations between maternal lipids and each offspring’s adiposity outcome separately. Sex differences were additionally evaluated.

Results

TGs, TC, ApoB/ApoA1, and FFAs were significantly positively associated with BMI, WHtR, and fat% (adjusted for gestational age at blood sampling, child’s age, sex, and sexual maturation). After additional adjustments for potential confounders and covariates, only TGs remained significantly associated with WHtR (0.45, 95% CI –0.007; 0.91). There were no associations between maternal lipids and SCF and no clear sex-specific results were found.

Conclusion

Overall, our results do not strongly support that maternal lipid profile during the 13th week of pregnancy has programming effects on adiposity in preadolescence.
Sex-specific Regulation of Prolactin Secretion by Pituitary Bradykinin Receptors
Authors: Abeledo-Machado Alejandra , Peña-Zanoni Milagros , Bornancini Dana , Camilletti María Andrea , Faraoni Erika Yanil , Marcial Agustina , Rulli Susana , Alhenc-Gelas Francois , Díaz-Torga Graciela Susana
Published: July 2022

Sex differences in the control of prolactin secretion are well documented. Sex-related differences in intrapituitary factors regulating lactotroph function have recently attracted attention. Sex differences in prolactinoma development are well documented in clinic, prolactinomas being more frequent in women but more aggressive in men, for poorly understood reasons. Kallikrein, the enzyme releasing kinins has been found in the pituitary, but there is no information on pituitary kinin receptors and their function. In the present work, we characterized pituitary bradykinin receptors (BRs) at the messenger RNA and protein levels in 2 mouse models of prolactinoma, Drd2 receptor gene inactivation and hCGβ gene overexpression, in both males and females, wild type or genomically altered. BR B2 (B2R) accounted for 97% or more of total pituitary BRs in both models, regardless of genotype, and was present in lactotrophs, somatotrophs, and gonadotrophs. Male pituitaries displayed higher level of B2R than females, regardless of genotype. Pituitary B2R gene expression was downregulated by estrogen in both males and females but only in females by dopamine. Activation of B1R or B2R by selective pharmacological agonists induced prolactin release in male pituitaries but inhibited prolactin secretion in female pituitaries. Increased B2R content was observed in pituitaries of mutated animals developing prolactinomas, compared to their respective wild-type controls. The present study documents a novel sex-related difference in the control of prolactin secretion and suggests that kinins are involved, through B2R activation, in lactotroph function and prolactinoma development.
Features of the formation of the hospitality industry of the Vinnytsia region
Authors: Lopatiuk R.
Published: July 2022

In Ukraine, there are certain limiting problems in the field of tourism positive transformation of this type of activity. Hospitality establishments of the Vinnytsia region are analyzed in the article. It was revealed that with the help of a cluster form of enterprise organization, it is possible to improve the management mechanism, specialization, cooperation, rationally use territorial division and resources.

Examples of improving the standard of living of the population with the help of a cluster mechanism are given, which increases the competitiveness of businesses located in a certain territory, supports an effective business climate and ensures the transition to the integrated use of the potential of the entire state.
A modern view of the causes and mechanisms of the development of acute disseminated peritonitis
Authors: Benedyct V. , Prodan A. , Bahrii V. , Dzhyvak V.
Published: July 2022

Despite the fact that the diagnosis of acute peritonitis has improved in recent years, a wide range of antibiotics is available, and minimally invasive methods of surgical treatment have been implemented, the mortality rate for this disease is high and ranges from 12.5 % to 39.2 %.

The purpose of the work was to analyze data from literary sources regarding the classification of acute peritonitis, to summarize the causes and mechanisms of its development among the adult population.

Analytical and bibliosemantic research methods were used in the work.

It is known that according to the nature of penetration of microflora into the abdominal cavity, peritonitis is divided into primary, secondary and tertiary. According to the clinical course, peritonitis is divided into acute, subacute and chronic. According to the nature of the exudate in the abdominal cavity, serous, serous-purulent, fibrinous, fibrinous-purulent, purulent, hemorrhagic, fecal and purulent peritonitis are distinguished. To date, the existing classifications are constantly being improved and have both practical and academic significance.

It has long been known that the cause of unsatisfactory results of surgical treatment of patients with acute disseminated peritonitis can be the development of intra-abdominal hypertension with subsequent development of compartment syndrome and multiple organ failure. The development of multiple organ failure is the leading cause of death in patients with acute surgical pathology. Abdominal compartment syndrome plays a big role in this, the mortality in which reaches very significant figures – 42-68 % and without treatment approaches 100 %.

Therefore, the development of acute peritonitis is due to numerous reasons (in particular, acute destructive appendicitis, cholecystitis, perforated ulcer of the stomach or duodenum, intestinal obstruction, tumor processes, gynecological pathology, abdominal injuries, etc.), which in turn causes the absence of a generally recognized justified classification.
Multi-scale strategies in environmental education, that pursue appreciation of the natural and rural areas of the Mediterranean mountains, in southern Spain
Authors: Luque-Revuelto Ricardo Manuel , Molero-Baltanás Rafael
Published: July 2022

The meridional mountains of Europe are located in Andalusia, in the south of the Iberian Peninsula. In this region, orographic and climatic factors are the main circumstances that condition the landscape and cultural peculiarities. Nowadays, its ecosystems show a high vulnerability to climate change, its traditional ways of life are in crisis and its cultural heritage is endangered by abandonment and depopulation. This paper analyzes some of the main documents that include proposals of environmental education at European, national and regional levels from the point of view of its adaptation the territory of the Andalusian Mediterranean mountains. Some educational actions are also evaluated in order to detect the possible existence of dysfunctionalities or deficiencies among the different educational policies and projects. Finally, a series of actions are proposed to optimize environmental education programs.
Hogares de población anciana en el municipio de Málaga: caracterización, evolución numérica y distribución espacial
Authors: Juan José Natera-Rivas , Batista-Zamora Ana Ester , Larrubia-Vargas Remedios
Published: July 2022

En un contexto de envejecimiento de la población, la presente investigación tiene por objetivo caracterizar, cuantificar y dar cuenta de la distribución espacial intramunicipal de los hogares con población anciana en el municipio de Málaga, entendiendo por tal la que tiene 75 años o más. La fuente de información que hemos empleado es el Padrón Municipal de Habitantes, a escala de barrio, lo que nos ha permitido no solo identificar los hogares compuestos por dos ancianos y los unipersonales, sino también realizar una evolución temporal de su número, y su distribución en el espacio urbano, entre 2008 y 2020. El número de ambos tipos de hogar se ha incrementado notablemente en nuestro periodo de estudio, al tiempo que hemos podido identificar áreas de sobrerrepresentación de los mismos –empleando el Cociente de Localización–, que no coinciden exactamente con la distribución espacial del conjunto de población anciana.
Covid-19 and sustainable development in Europe: a temporal comparison
Authors: Bartiromo Marianna
Published: July 2022

Covid-19 has posed major challenges globally. One of these is undoubtedly the achievement of the Sustainable Development Goals (SDGs) of the 2030 Agenda.This study aims to analyze, in a time perspective, the effects of the pandemic on the levels of sustainable development achieved in Europe. To measure the impact of Covid-19, 3 different sustainability indices (SIs) will be constructed referring to 2015, 2018 and 2020. To construct these indices, 17 indicators (one per SDG) from Eurostat’s free database will be used. The Adjusted Mazziotta-Pareto Index (AMPI) method will be used to aggregate these indicators. This method relying on a Min-Max transformation allows for an absolute time comparison. In addition, this method allows for high replicability of results. Furthermore, in order to capture the differences between different European specificities, a hierarchical clustering will be performed according to the Ward method. The results confirm the negative effects of Covid-19. In fact, there is a general worsening of sustainable development levels between 2015 and 2020.
The study of the informal city using the sources available: the case of illegal urbanisations in Andalusia
Authors: López-Casado David
Published: July 2022

The phenomenon of illegal urbanisations continues to be one of the great environmental and territorial challenges to be overcome in Andalusia. In spite of this, the process of fully understanding this phenomenon is significantly hindered by the scarcity of easily accessible sources that allow the scientific community to study and analyse them. This article focuses on highlighting, firstly, the scarcity of existing sources for the study of illegal urbanisations on intermediate scales; and, secondly, when they exist, their limitations to allow a diachronic analysis of the process. In addition, the possibilities offered by other cartographic sources available in the region are explored. The results point to the need for the regional administration to update the inventories in order to know the current situation of the process, as well as the limitations and potential of the Spatial Reference Data for this purpose.
Gallbladder mucocele part 2: treatment and prognosis
Authors: Uusaed Liis , Aldridge Paul
Published: July 2022

As discussed in part 1 of this series, gallbladder mucocele is defined as a build-up of immobile mucus within the gallbladder that can result in extrahepatic biliary obstruction, pressure necrosis of the gallbladder wall and, ultimately, rupture. Although many gallbladder mucoceles are discovered during abdominal ultrasonography while screening for other diseases, patients with mature gallbladder mucoceles or gallbladder rupture can present as an emergency. Medical management with hepatoprotectants, choleretics, antibiotics and suitable diet can be attempted in certain cases, but cholecystectomy remains the gold standard treatment option. If an underlying cause is detected (such as an endocrinopathy), this should be treated accordingly. Mortality rates following gallbladder removal vary from 16–40%. A high mortality rate has been associated with septic bile peritonitis, hyperadrenocorticism and/or pancreatitis as a concurrent disease.