bluuebunny/crossref_metadata_2025 huggingface dataset:
Ladybird communities in rural woodlands: Does an invader dominate?
Authors: Farrow Rachel A. , Roy Helen E. , Brown Peter M. J.
Published: August 2022

The invasive alien speciesHarmonia axyridis(Coleoptera: Coccinellidae) was first observed in the UK in 2004. Previous studies have demonstrated the adverse effects on other species ofH. axyridisduring its early stages of establishment. However, habitat factors are important in determining distribution and population trends of ladybirds. Whilst the abundance ofH. axyridisis well known in the UK within urban and other managed habitats, much less is known about its abundance in the wider countryside. Here we present the results of surveys from rural woodland habitats to assess whether or notH. axyridisdominates coccinellid communities in these rural habitats. Additionally, we explored the relationship between coccinellid and aphid abundance within these habitats. All field sites were in Cambridgeshire or Suffolk, East Anglia, UK and were surveyed between May and October 2016 and 2017. Three deciduous sites and three coniferous sites were included in the study. Surveys were conducted using a standardised approach involving sweep-netting within grass margins and tree beating to sample ladybirds from trees. Three distinct vegetation structures or layers were surveyed within both the coniferous and deciduous sites; tree, shrub and herb layer. All captured coccinellids were identified to species-level. Seventeen species of coccinellid and over 1300 individuals were recorded during the study period from two distinct site types (deciduous, coniferous). Species richness was lower at deciduous sites (n = 12) in comparison to coniferous (n = 16) sites. The coccinellid community also did not appear to be dominated byH. axyridisat rural sites, in contrast to urban areas. Deciduous woodland appeared to be a lesser preferred habitat ofH. axyridisthan coniferous woodland. Additionally, there was a distinct difference in the coccinellid community in relation to vegetation structure (across the tree, shrub and herb layers) between coniferous and deciduous sites. Our results indicate that there appear to be distinct native coccinellid communities at deciduous and coniferous sites. We discuss the way in which rural woodlands could act as a refuge for some native coccinellids.
Outcomes of postoperative delirium in patients undergoing cardiac surgery: A systematic review and meta-analysis
Authors: Lin Lingyu , Zhang Xuecui , Xu Shurong , Peng Yanchun , Li Sailan , Huang Xizhen , Chen Liangwan , Lin Yanjuan
Published: August 2022

Background

Postoperative delirium (POD) is an acute brain dysfunction that is frequently observed in patients undergoing cardiac surgery. Increasing evidence indicates POD is related to higher mortality among cardiac surgical patients, but the results remain controversial. Moreover, a quantitative evaluation of the influence of POD on hospital days, intensive care unit (ICU) time, and mechanical ventilation (MV) time has not been performed.

Objective

This study aimed to evaluate the correlation between POD and outcomes in patients undergoing cardiac surgery by a systematic review and meta-analysis.

Materials and methods

A total of 7 electronic databases (Cochrane Library, PubMed, EMBASE, CINAHL Complete, MEDLINE, Wan-fang database, and China National Knowledge Infrastructure) were searched from January 1980 to July 20, 2021, with language restrictions to English and Chinese, to estimate the impact of the POD on outcome in patients who underwent cardiac surgery. The meta-analysis was registered with PROSPERO (Registration: CRD42021228767).

Results

Forty-two eligible studies with 19785 patients were identified. 3368 (17.0%) patients were in the delirium group and 16417 (83%) were in the non-delirium group. The meta-analysis showed that compared to patients without POD, patients with POD had 2.77-fold higher mortality (OR = 2.77, 95% CI 1.86–4.11, P < 0.001), 5.70-fold higher MV (>24h) rate (OR = 5.70, 95% CI 2.93–11.09, P < 0.001); and longer MV time (SMD = 0.83, 95% CI 0.57–1.09, P < 0.001), ICU time (SMD = 0.91, 95% CI 0.60–1.22, P < 0.001), hospital days (SMD = 0.62, 95% CI 0.48–0.76, P < 0.001).

Conclusion

The synthesized evidence suggests that POD is causally related to the increased risk of mortality, prolonged length of ICU and hospital stay, and a longer duration of MV time. Future research should focus on the interventions for POD, to reduce the incidence.

Systematic review registration

[www.crd.york.ac.uk/PROSPERO], identifier [CRD42021228767].
Serial assessment of early antibody binding to decellularized valved allografts
Authors: Oripov Firdavs , Ramm Robert , Falk Christine , Goecke Tobias , Ebken Johannes , Jashari Ramadan , Böthig Dietmar , Horke Alexander , Avsar Murat , Bobylev Dmitry , Haverich Axel , Hilfiker Andres , Sarikouch Samir
Published: August 2022

Objectives

Decellularized homograft valves (DHV) appear to elicit an immune response despite efficient donor cell removal.

Materials and methods

A semiquantitative Dot-Blot analysis for preformed and new recipient antibodies was carried out in 20 patients following DHV implantation on days 0, 1, 7, and 28 using secondary antihuman antibodies. Immune reactions were tested against the implanted DHV as well as against the stored samples of 5 non-implanted decellularized aortic (DAH) and 6 pulmonary homografts (DPH).

Results

In this study, 20 patients (3 female and 17 male patients) were prospectively included, with a median age of 18 years and an IQR of 12–30 years. Six patients received DPH and 14 received DAH. The amount of antibody binding, averaged for all patients, decreased on post-operative days 1 and 7 compared to pre-operative values; and on day 28, antibody binding reached close to pre-operative levels (16.8 ± 2.5 on day 0, 3.7 ± 1.9 on day 1, 2.3 ± 2.7 on day 7, and 13.2 ± 3.7 on day 28). In comparison with the results in healthy controls, there was a higher amount of antibody binding to DAH than to DPH. The mean number of arbitrary units was 18.4 ± 3.1 in aortic and 12.9 ± 4.5 in pulmonary DHV (p = 0.140). Male patients exhibited higher antibody binding to aortic DHV than female patients (19.5 ± 2.1 vs. 1.6 ± 6.7). The p-value calculation was limited, as only two female patients received DAH. There was no correlation between the amount of overall antibody binding to DHV with respect to donor age (Kruskal–Wallis test p = 0.550). DHV recipients with a sex mismatch to the donor showed significantly less antibody binding (6.5 ± 1.8 vs. 13.7 ± 1.8; p = 0.003). Our main finding was an increase in antibody binding in younger patients receiving decellularized aortic allografts. This increase was higher in patients with early degeneration signs but was not specific to the individual DHV implanted nor previous DHV implantation. Antibody binding toward explanted DHV was significantly increased in implicating antibody-mediated DHV degeneration.

Conclusion

Serial assessment of tissue-specific antibody binding revealed an increase in some patients within 4 weeks after surgery, who subsequently developed early signs of allograft degeneration. Further studies with larger sample sizes are needed to confirm the prognostic relevance of increased antibody activity in addition to targeted research efforts to identify the molecular agents triggering this type of antibody response.
β-sheets in serum protein are independent risk factors for coronary lesions besides LDL-C in coronary heart disease patients
Authors: Li Yu-lin , Xie Jia-ying , Lu Bin , Sun Xiao-di , Chen Fang-fang , Tong Zhou-jie , Sai Wen-wen , Zhang Wei , Wang Zhi-hao , Zhong Ming
Published: August 2022

Background

Coronary heart disease (CHD) patients with standard low-density lipoprotein cholesterol (LDL-C) remain at risk of cardiovascular events, making it critical to explore new targets to reduce the residual risk. The relationship between β-sheet conformation and CHD is gaining attention. This study was designed to compare the coronary lesions in CHD patients with varying LDL-C and evaluate whether serum β-sheets are associated with coronary damage.

Methods

Two hundred and one patients diagnosed with stable CHD were recruited and divided into four groups according to LDL-C. Baseline information, coronary lesion-related indicators, and peripheral blood samples were collected. Serum β-sheet content was determined by thioflavin T fluorescence.

Results

The baseline information was comparable in CHD patients with different LDL-C. No difference was found in indicators relevant to coronary lesions among groups. The content of β-sheet was negatively correlated with LDL-C. Multiple linear regression revealed that serum β-sheet was positively correlated with coronary lesion when risk factors such as age, smoking, and LDL-C were controlled.

Conclusions

This is the first study that reports the serum β-sheet levels of CHD patients being gradually increased with decreasing LDL-C when coronary lesions were comparable. Serum β-sheet might exacerbate the coronary lesions in CHD patients independent of known risk factors such as LDL-C.
Incremental value of preoperative right ventricular function in predicting moderate to severe acute kidney injury after heart transplantation
Authors: Zhu Shuangshuang , Zhang Yanting , Qiao Weihua , Wang Yixuan , Xie Yuji , Zhang Xin , Wu Chun , Wang Guohua , Li Yuman , Dong Nianguo , Xie Mingxing , Zhang Li
Published: August 2022

Background

Acute kidney injury (AKI) commonly occurs after heart transplantation (HTx), but its association with preoperative right ventricular (RV) function remains unknown. Consequently, we aimed to determine the predictive value of preoperative RV function for moderate to severe AKI after HTx.

Materials and methods

From 1 January 2016 to 31 December 2019, all the consecutive HTx recipients in our center were enrolled and analyzed for the occurrence of postoperative AKI staged by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Conventional RV function parameters, including RV fractional area change (RVFAC) and tricuspid annular plane systolic excursion (TAPSE), were obtained. The primary endpoint was moderate to severe AKI (the KDIGO stage 2 or 3). The secondary endpoints included the impact of AKI on intensive care unit (ICU) mortality, in-hospital mortality, and 1-year mortality.

Results

A total of 273 HTx recipients were included in the study. Postoperative AKI occurred in 209 (77%) patients, including 122 (45%) patients in stage 1 AKI, 49 (18%) patients in stage 2 AKI, and 38 (14%) patients in stage 3 AKI. Patients with higher AKI stage had lower baseline estimated glomerular filtration rate (eGFR), more frequent diabetes, higher right atrial pressure (RAP), longer cardiopulmonary bypass (CPB) duration, more perioperative red blood cell (RBC) transfusions, and worse preoperative RV function. A multivariate logistic regression model incorporating previous diabetes mellitus [odds ratio (OR): 2.21; 95% CI: 1.06–4.61; P = 0.035], baseline eGFR (OR: 0.99; 95% CI: 0.97–0.10; P = 0.037), RAP (OR: 1.05; 95% CI: 1.00–1.10; P = 0.041), perioperative RBC (OR: 1.18; 95% CI: 1.08–1.28; P < 0.001), and TAPSE (OR: 0.84; 95% CI: 0.79–0.91; P < 0.001) was established to diagnose moderate to severe AKI more accurately [the area under the curve (AUC) = 79.8%; Akaike information criterion: 274].

Conclusion

Preoperative RV function parameters provide additional predicting value over clinical and hemodynamic parameters, which are imperative for risk stratification in patients with HTx at higher risk of AKI.
Case report: Reducing the duration of positive-pressure ventilation for large mediastinal masses
Authors: Zhang Zaili , Jiang Meiru , Sun Xijia , Tan Wenfei
Published: August 2022

Large mediastinal masses (MMs) are rare and present some challenges in hemodynamic and airway management under general anesthesia. Multiple studies have reported cardiopulmonary collapse during general anesthesia. Maintenance of spontaneous ventilation, avoidance of muscle relaxants, and awake-intubation were usually recommended during general anesthesia for high-risk patients with large MMs. However, the recent notion challenged the classic teaching that maintaining spontaneous ventilation is superior to positive-pressure ventilation (PPV). In our case reports, we present two patients with large MMs during general anesthesia. In the first case, a 21-year-old male was administered a muscle relaxant during induction, followed by PPV, but his blood oxygen saturation decreased to 40% after 20 min. Finally, his oxygen saturation was restored by a sternotomy rather than by cardiopulmonary bypass (CPB) by femoral vascular intubation. In the second case, a 33-year-old male was also administered a muscle relaxant during induction followed by PPV, but for him, sternotomy was immediately performed, with stable blood oxygen saturation. Both patients recovered well and were discharged from hospital a week after surgery. Therefore, we present a recommendation that patients with large MMs could undergo PPV after the administration of a muscle relaxant during induction, but the cardiothoracic surgeon should immediately cleave the sternum.
Do fluoroquinolones increase aortic aneurysm or dissection incidence and mortality? A systematic review and meta-analysis
Authors: Chen Can , Patterson Benjamin , Simpson Ruan , Li Yanli , Chen Zhangzhang , Lv Qianzhou , Guo Daqiao , Li Xiaoyu , Fu Weiguo , Guo Baolei
Published: August 2022

Objective

The aim of this study was to determine the association between fluoroquinolones (FQs) use, the risk of de novo aortic aneurysm or dissection (AAD), and the prognosis of patients with pre-existing AAD.

Materials and methods

We searched PubMed, EMBASE, CENTRAL, Scopus, and Web of Science on 31 March 2022. Observational studies that evaluated the association of FQs with AAD risk in the general population or FQs with the prognosis of patients with preexisting AAD and presented adjusted effect estimates were included. Two reviewers assessed study eligibility, extracted data, and assessed the risk of bias and certainty of evidence using GRADE.

Results

Of the 13 included studies, 11 focused on the association of FQs with de novo AAD incidence, and only one study investigated the association of FQs with the patient with AAD prognosis. FQ use was associated with an increased risk of de novo AAD within 30 days (RR: 1.42; 95% CI: 1.11–1.81; very low certainty) and 60 days (RR: 1.44; 95% CI: 1.26–1.64; low certainty). Specifically, the association was significant when compared with amoxicillin, azithromycin, doxycycline, or no antibiotic use. Furthermore, patients with preexisting AAD exposure to FQ had an increased risk of all-cause mortality (RR: 1.61; 95% CI: 1.50–1.73; moderate certainty) and aortic-specific mortality (RR: 1.80; 95% CI: 1.50–2.15; moderate certainty), compared to the non-exposed FQ group within a 60-day risk period.

Conclusion

FQs were associated with an increased incidence of AAD in the general population and a higher risk of adverse outcomes in patients with preexisting AAD. Nevertheless, the results may be affected by unmeasured confounding factors. This should be considered by physicians contemplating using FQs in patients with aortic dilation and those at high risk of AAD.

Systematic Review Registration

[https://www.crd.york.ac.uk/prospero/], identifier [CRD42021230171].
First-in-human pilot trial of combined intracoronary and intravenous mesenchymal stem cell therapy in acute myocardial infarction
Authors: Hsiao Lien-Cheng , Lin Yen-Nien , Shyu Woei-Cherng , Ho Ming , Lu Chiung-Ray , Chang Shih-Sheng , Wang Yu-Chen , Chen Jan-Yow , Lu Shang-Yeh , Wu Mei-Yao , Li Keng-Yuan , Lin Yu-Kai , Tseng Wen-Yih I. , Su Mao-Yuan , Hsu Chin-Ting , Tsai Cheng-Kang , Chiu Lu-Ting , Chen Chien-Lin , Lin Cheng-Li , Hu Kai-Chieh , Cho Der-Yang , Tsai Chang-Hai , Chang Kuan-Cheng , Jeng Long-Bin
Published: August 2022

Background

Acute ST-elevation myocardial infarction (STEMI) elicits a robust cardiomyocyte death and inflammatory responses despite timely revascularization.

Objectives

This phase 1, open-label, single-arm, first-in-human study aimed to assess the safety and efficacy of combined intracoronary (IC) and intravenous (IV) transplantation of umbilical cord-derived mesenchymal stem cells (UMSC01) for heart repair in STEMI patients with impaired left ventricular ejection fraction (LVEF 30-49%) following successful reperfusion by percutaneous coronary intervention.

Methods

Consenting patients received the first dose of UMSC01 through IC injection 4-5 days after STEMI followed by the second dose of UMSC01 via IV infusion 2 days later. The primary endpoint was occurrence of any treatment-related adverse events and the secondary endpoint was changes of serum biomarkers and heart function by cardiac magnetic resonance imaging during a 12-month follow-up period.

Results

Eight patients gave informed consents, of whom six completed the study. None of the subjects experienced treatment-related serious adverse events or major adverse cardiovascular events during IC or IV infusion of UMSC01 and during the follow-up period. The NT-proBNP level decreased (1362 ± 1801 vs. 109 ± 115 pg/mL, p = 0.0313), the LVEF increased (52.67 ± 12.75% vs. 62.47 ± 17.35%, p = 0.0246), and the wall motion score decreased (26.33 ± 5.57 vs. 22.33 ± 5.85, p = 0.0180) at the 12-month follow-up compared to the baseline values. The serial changes of LVEF were 0.67 ± 3.98, 8.09 ± 6.18, 9.04 ± 10.91, and 9.80 ± 7.56 at 1, 3, 6, and 12 months, respectively as compared to the baseline.

Conclusion

This pilot study shows that combined IC and IV transplantation of UMSC01 in STEMI patients with impaired LVEF appears to be safe, feasible, and potentially beneficial in improving heart function. Further phase 2 studies are required to explore the effectiveness of dual-route transplantation of UMSC01 in STEMI patients.
Sodium-glucose co-transporter-2 inhibitors reduce the risk of new-onset stroke in patients with type 2 diabetes: A population-based cohort study
Authors: Lin Tsung-Kun , Chen Yong-Hsin , Huang Jing-Yang , Liao Pei-Lun , Chen Mei-Chun , Pan Lung-Fa , Jong Gwo-Ping
Published: August 2022

Background

Epidemiological evidence suggests the association of diabetes with an increased risk of stroke. Clinical studies have investigated the effects of sodium-glucose co-transporter-2 (SGLT2) inhibitors on new-onset stroke (NOS), but the results are inconsistent.

Objectives

To determine the association between the use of SGLT2 inhibitors and NOS in patients with type 2 diabetes mellitus (DM).

Methods

We conducted a retrospective longitudinal cohort study based on the Taiwan Health Insurance Review and Assessment Service database (2016–2019). The primary outcome of the assessment was the risk of incident stroke by estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Multiple Cox regression was applied to estimate the adjusted HR of NOS. Subgroup analysis was also conducted.

Results

Among the 232,101 eligible patients with type 2 DM aged ≥ 20 years, SGLT2-inhibitor users were compared with non-SGLT2-inhibitor users based on age, sex, and the duration of type 2 DM matching at a ratio of 1:2. The event rate per 10 000 person-months was 9.20 (95% CI 8.95 to 9.45) for SGLT2-inhibitor users and 10.5(10.3–10.6) for non-SGLT2-inhibitor users. There was a decreased risk of NOS for SGLT2-inhibitor users (adjusted HR 0.85, 95% CI 0.82–0.88) compared with non-SGLT2-inhibitor users. Results for the propensity score-matched analyses showed similar results (adjusted HR 0.87, 95% CI 0.84–0.91 for both SGLT2-inhibitor users and non-SGLT2-inhibitor users).

Conclusion

The risk of developing NOS was lower in patients with SGLT2-inhibitor users than in non-SGLT2-inhibitor users. The decreased risk of NOS in patients with type 2 DM was greater among patients with concurrent use of statins, biguanides, thiazolidinediones, and glucagon-like peptide-1 receptor agonists. We, therefore, suggest that the long-term use of SGLT2 inhibitors may help reduce the incidence of NOS in patients with type 2 DM.
Batholith recorded mesozoic multistage tectonic evolution of the South china block: A case study of the guandimiao intrusions
Authors: Qin Jin-Hua , Huang Fan , Wang Deng-Hong
Published: August 2022

South China is a well-known grand felsic igneous rocks province. However, it is still controversial and not well understood whether the Mesozoic tectono-magmatic pattern is dominated by the subduction of the paleo-Pacific oceanic plate. In this study, we address this question by concentrating on the long-term evolutionary Guandimiao batholith, which has complex lithofacies with different formation ages and can be a superb record of the Mesozoic tectonic evolution in South China. Geochronologically, four stages of magmatism can be identified combined with previous reports: granodiorite (G1, 239 Ma), biotite monzogranite (G2-1) and two-mica monzogranite (G2-2) (230–203 Ma), granite porphyry (G3, 211–190 Ma), and lamprophyre (L4, 121 Ma). G1 and G2-1 have an affinity with I-type granite and were derived from metabasaltic to metatonalitic sources, whereas G2 and G3 show S-type granite characteristics and were derived from the para-metamorphic basement of the Cathaysia block. The L4 was derived from partial melting of garnet and spinel lherzolite and underwent mixing between Mesoproterozoic pelagic and/or terrigenous sediments and the subcontinental lithosphere mantle (SCLM) of South China. The granitoids of the Guandimiao batholith underwent intensely fractional crystallization of feldspar, Ti-bearing minerals, allanite and monazite. The zircon U–Pb dating of L4 in the Guandimiao batholith completely records the six stages of pre-Mesozoic tectonic events in the SCB. During the Mesozoic, the main body of the Guandimiao batholith (G1, G2-1 and G2-2) recorded the closure of the paleo-Tethys Ocean in the Triassic and the subsequent regional extension of the postcollision. G-3 and L4 of the Guandimiao batholith documented the transition of tectonic and dynamic regimes in the early Yanshanian and the rollback and steep subduction of the paleo-Pacific Ocean in the late Yanshanian.
The effects of tropical cyclones on characteristics of barrier layer thickness
Authors: Zhang Zheliang , Ma Zhanhong , Fei Jianfang , Zheng Yunxia , Huang Jiancheng
Published: August 2022

The impact of tropical cyclones on the characteristics of barrier layer (BL) thickness is investigated in this study in combination with observations and numerical simulations. Statistical results based on Simple Ocean Data Assimilation reanalysis (SODA) data and Argo float measurements reveal a significant effect of TCs on the BL characteristics. The BL thickness increases remarkably with the TC approaching, reaches its maximum 1–5 days after the TC passage, and recovers to its pre-storm state within 30 days on average. The peak increase in BL thickness is slightly rightward biased relative to the TC track, reaching ∼1.31 m (26.93%) relative to the pre-storm state as revealed by SODA data. The changes in BL thickness show a strong correlation with TC characteristics in terms of intensity and translation speed, tending to be more significant with more intense or slower-moving TCs. The thickening of the isothermal layer on the right of TC tracks and shallowing of the mixed layer act together to determine the BL development. The three-dimensional Price–Weller–Pinkel (3DPWP) ocean model is applied to explore the influence of precipitation on BL thickness. The results show that the precipitation tends to decrease the mixed layer depth while the vertical mixing of TCs deepens the isothermal layer depth, both of which act together to increase the BL thickness.
Impact of dyslipidemia on the cumulative pregnancy outcomes after first ovarian stimulation
Authors: Jiang Xue , Lu Xinle , Cai Mingshu , Liu Yu , Guo Yihong
Published: August 2022

Objectives

To investigate the cumulative live birth rate (CLBR) according to lipid metabolism in patients with or without polycystic ovarian syndrome (PCOS) undergoing their first complete in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles.

Patients

A total of 1,470 patients with PCOS and 3,232 patients without PCOS who underwent their first complete IVF/ICSI cycles from January 2016 to June 2018 were included. During a minimum of 2 years of follow-up, they had achieved at least one live birth or used all available embryos. The cumulative pregnancy outcomes were compared based on the patients’ blood lipid parameters, including triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), in the two populations. Patients with an abnormal level of one or more of these four indicators were considered the dyslipidemia group. Patients whose four indicators were normal were considered the control group.

Results

Among 1,470 patients with PCOS, the cumulative pregnancy outcomes were similar in the dyslipidemia group and control group. Logistic regression analysis showed that the TC levels were significantly negatively associated with the cumulative live birth rate (CLBR) after adjustment for confounding factors such as age and BMI (aOR 0.81, 95% CI 0.66-0.98, P<0.05). Among the 3,232 patients without PCOS, there was no significant difference in the cumulative pregnancy outcomes between the dyslipidemia group and the control group. No significant correlations were found in other logistic regression analyses.

Conclusions

TC negatively impacts the CLBR after first ovarian stimulation in PCOS patients. PCOS patients with dyslipidemia caused by elevated TC may have a poor CLBR.
Association of famine exposure and the serum calcium level in healthy Chinese adults
Authors: Yang Yu-ying , Zhang Deng , Ma Ling-ying , Hou Yan-fang , Bi Yu-fang , Xu Yu , Xu Min , Zhao Hong-yan , Sun Li-hao , Tao Bei , Liu Jian-min
Published: August 2022

Objective

Famine exposure and higher serum calcium levels are related with increased risk of many disorders, including Alzheimer’s disease, atherosclerosis, diabetes, and osteoporosis. Whether famine exposure has any effect on serum calcium level is unclear. Besides, the normal reference range of serum calcium is variable among different populations. Our aims are 1) determining the reference interval of calcium in Chinese adults; 2) exploring its relationship with famine exposure.

Methods

Data in this study was from a cross-sectional study of the epidemiologic investigation carried out during March-August 2010 in Jiading district, Shanghai, China. Nine thousand and two hundred eleven participants with estimated glomerular filtration rate (eGFR) ≥60ml/min/1.73m2 were involved to calculate reference interval of total calcium from 10569 participants aged 40 years or older. The analysis of famine exposure was conducted in 9315 participants with complete serum biochemical data and birth year information.

Results

After rejecting outliers, the 95% reference interval of total serum calcium was 2.122~2.518 mmol/L. The equation of albumin-adjusted calcium was: Total calcium + 0.019* (49-Albumin), with a 95% reference interval of 2.151~2.500 mmol/L. Compared to the age-balanced control group, there was an increased risk of being at the upper quartile of total serum calcium (OR=1.350, 95%CI=1.199-1.521) and albumin-adjusted calcium (OR=1.381, 95%CI=1.234-1.544) in subjects experienced famine exposure in childhood. Females were more vulnerable to this impact (OR= 1.621, 95%CI= 1.396-1.883 for total serum calcium; OR=1.722, 95%CI= 1.497-1.980 for albumin-adjusted calcium).

Conclusions

Famine exposure is an important environmental factor associated with the changes in circulating calcium concentrations, the newly established serum calcium normal range and albumin-adjusted calcium equation, together with the history of childhood famine exposure, might be useful in identifying subjects with abnormal calcium homeostasis and related diseases, especially in females.
Polygenic Innate Immunity Score to Predict the Risk of Cytomegalovirus Infection in CMV D+/R- Transplant Recipients. A Prospective Multicenter Cohort Study
Authors: Bodro Marta , Cervera Carlos , Linares Laura , Suárez Belén , Llopis Jaume , Sanclemente Gemma , Casadó-Llombart Sergi , Fernández-Ruiz Mario , Fariñas María Carmen , Cantisan Sara , Montejo Miguel , Cordero Elisa , Oriol Isabel , Marcos María Angeles , Lozano Francisco , Moreno Asunción ,   GESITRA-IC/SEIMC/REIPI investigators
Published: August 2022

Several genetic polymorphisms of the innate immune system have been described to increase the risk of cytomegalovirus (CMV) infection in transplant patients. The aim of this study was to assess the impact of a polygenic score to predict CMV infection and disease in high risk CMV transplant recipients (heart, liver, kidney or pancreas). On hundred and sixteen CMV-seronegative recipients of grafts from CMV-seropositive donors undergoing heart, liver, and kidney or pancreas transplantation from 7 centres were prospectively included for this purpose during a 2-year period. All recipients received 100-day prophylaxis with valganciclovir. CMV infection occurred in 61 patients (53%) at 163 median days from transplant, 33 asymptomatic replication (28%) and 28 CMV disease (24%). Eleven patients (9%) had recurrent CMV infection. Clinically and/or functionally relevant single nucleotide polymorphisms (SNPs) fromTLR2,TLR3,TLR4,TLR7,TLR9,AIM2,MBL2,IL28, IFI16,MYD88,IRAK2andIRAK4were assessed by real time polymerase chain reaction (RT-PCR) or sequence-based typing (PCR-SBT). A polygenic score including theTLR4(rs4986790/rs4986791),TLR9(rs3775291),TLR3(rs3775296),AIM2(rs855873),TLR7(rs179008),MBL(OO/OA/XAO),IFNL3/IL28B(rs12979860) andIFI16(rs6940) SNPs was built based on the risk of CMV infection and disease. The CMV score predicted the risk of CMV disease with an AUC of the model of 0.68, with sensitivity and specificity of 64.3 and 71.6%, respectively. Even though further studies are needed to validate this score, its use would represent an effective model to develop more robust scores predicting the risk of CMV disease in donor/recipient mismatch (D+/R-) transplant recipients.
A Fenton-like cation can improve arsenic trioxide treatment of sclerodermatous chronic Graft-versus-Host Disease in mice
Authors: Chêne Charlotte , Jeljeli Mohamed Maxime , Rongvaux-Gaïda Dominique , Thomas Marine , Rieger François , Batteux Frédéric , Nicco Carole
Published: August 2022

Graft-versus Host Disease (GvHD) is a major complication of hematopoietic stem cell transplant. GvHD is characterized by the chronic activation of immune cells leading to the development of systemic inflammation, autoimmunity, fibrosis and eventually death. Arsenic trioxide (ATO) is a therapeutic agent under clinical trial for the treatment of patients with systemic lupus erythematosus (SLE) and chronic GvHD (cGvHD). This therapy is admittedly rather safe although adverse effects can occur and may necessitate short interruptions of the treatment. The aim of this study was to combine ATO with a divalent cation, to generate a Fenton or Fenton-like reaction in order to potentiate the deletion of activated immune cells through the reactive oxygen species (ROS)-mediated effects of ATO in a mouse model, and thereby enabling the use of lower and safer ATO concentrations to treat patients with cGvHD. In vitro, among the various combinations of divalent cations tested, we observed that the combination of ATO and CuCl2 (copper chloride) induced a high level of oxidative stress in HL-60 and A20 cells. In addition, this co-treatment also decreased the proliferation of CD4+ T lymphocytes during a mixed lymphocyte reaction (MLR). In vivo, in a cGvHD mouse model, daily injections of ATO 2.5 µg/g + CuCl2 0.5 µg/g induce a decrease in lymphocyte activation and fibrosis that was equivalent to that induced by ATO 5 µg/g. Our results show that the addition of CuCl2 improved the effects of ATO and significantly limited the development of the disease. This co-treatment could be a real benefit in human patients to substantially decrease the known ATO side effects and optimize ATO treatment in pathologies characterized by activated cells sensitive to an increase in oxidative stress.
Spatial organization and early signaling of the B-cell receptor in CLL
Authors: Shorer Arbel Yamit , Bronstein Yotam , Dadosh Tali , Kamdjou Talia , Tsuriel Shlomo , Shapiro Mika , Katz Ben-Zion , Herishanu Yair
Published: August 2022

Most chronic lymphocytic leukemia (CLL) clones express B-cell receptors (BcR) of both IgM/IgD isotypes; however, 5%–10% of CLL cases express isotype-switched immunoglobulin G (IgG). The early signaling and spatial patterning of the various BcRs at steady state and after activation are still fully unresolved. Herein, we show higher expression of the BcR signalosome elements and a more robust constitutive cell-intrinsic proximal BcR signaling in CLL with unmutated IGHV expressing IgM isotype (IgM U-CLL), compared with IGHV-mutated CLL (M-CLL) expressing either IgM or IgG isotypes. IgM in U-CLL is frequently located in the membrane plane in polarized patches, occasionally in caps, and sometimes inside the cells. Among M-CLL, IgM is scattered laterally in the membrane plane in a similar pattern as seen in normal B cells, whereas IgG is dispersed around the cell membrane in smaller clusters than in IgM U-CLL. Upon BcR engagement, both IgG and IgM expressing M-CLL showed attenuated signaling and only slight spatial reorganization dynamics of BcR microclusters and internalization, compared with the extensive reorganization and internalization of the BcR in IgM expressing U-CLL. The global gene signature of IgG M-CLL was closely related to that of IgM M-CLL rather than IgM U-CLL. Overall, we report fundamental differences in the basal composition, biochemical status, and spatial organization of the BcR in the three examined immunogenetic CLL subtypes that correlate with their clinical behavior. On the basis of our findings, IgG class-switched M-CLL likely represents the same disease as IgM M-CLL rather than a different biological and/or clinical entity.
Estrogen mediates inflammatory role of mast cells in endometriosis pathophysiology
Authors: McCallion Alison , Nasirzadeh Yasmin , Lingegowda Harshavardhan , Miller Jessica E. , Khalaj Kasra , Ahn SooHyun , Monsanto Stephany P. , Bidarimath Mallikarjun , Sisnett Danielle J. , Craig Andrew W. , Young Steven L. , Lessey Bruce A. , Koti Madhuri , Tayade Chandrakant
Published: August 2022

Endometriosis is an estrogen dependent, chronic inflammatory disease characterized by the growth of endometrial lining outside of the uterus. Mast cells have emerged as key players in regulating not only allergic responses but also other mechanisms such as angiogenesis, fibrosis, and pain. The influence of estrogen on mast cell function has also been recognized as a potential factor driving disease pathophysiology in number of allergic and chronic inflammatory conditions. However, precise information is lacking on the cross talk between endocrine and immune factors within the endometriotic lesions and whether that contributes to the involvement of mast cells with disease pathophysiology. In this study, we observed a significant increase in mast cell numbers within endometriotic lesions compared to matched eutopic endometrium from the same patients. Compared to eutopic endometrium, endometriotic lesions had significantly higher levels of stem cell factor (SCF), a potent growth factor critical for mast cell expansion, differentiation, and survival for tissue resident mast cells. Targeted mRNA Q-PCR array revealed that the endometriotic lesions harbour microenvironment (upregulation of CPA3, VCAM1, CCL2, CMA1, CCR1, and KITLG) that is conducive to mast cells recruitment and subsequent differentiation. To examine cross-talk of mast cells within the endometriotic lesion microenvironment, endometriotic epithelial cells (12Z) and endometrial stromal cells (hESC) incubated with mast cell-conditioned media showed significantly increased production of pro-inflammatory and chemokinetic cytokines. To further understand the impact of estrogen on mast cells in endometriosis, we induced endometriosis in C57BL/6 mice. Mature mast cells were significantly higher in peritoneal fluid of estrogen-treated mice compared to untreated mice within the sham operated groups. Mouse endometriotic lesion tissue revealed several genes (qRT-PCR) relevant in mast cell biology significantly upregulated in the estrogen treated, endometriosis-induced group compared to control endometrium. The endometriotic lesions from estrogen treated mice also had significantly higher density of Alcian blue stained mast cells compared to untreated lesions or control endometrium. Collectively, these findings suggest that endometriotic lesions provide a microenvironment necessary for recruitment and differentiation of mast cells. In turn, mast cells potentially release pro-inflammatory mediators that contribute to chronic pelvic pain and endometriosis disease progression.
Fates of petroleum during the deepwater horizon oil spill: A chemistry perspective
Authors: Overton Edward B. , Adhikari Puspa L. , Radović Jagoš R. , Passow Uta
Published: August 2022

We describe the initial bulk and compound specific composition of the liquid oil spilled during the Deepwater Horizon (DwH) disaster. The emphasis is on the target hydrocarbon compounds typically found in highest concentrations and on those of concern from a toxicological perspective (i.e., the target normal alkanes and isoprenoids, and PAHs on U.S. Environmental Protection Agency’s (EPA) priority list with their alkyl homolog compounds), and/or those relevant for forensic fingerprinting of spill residues (i.e., sulfur containing PAHs and biomarker compounds). Weathering changed the oil’s composition in various environmental compartments. These compositional changes and potential environmental impacts of the remaining weathered residues are presented in this paper. Biodegradation occurred in both surface and subsurface environments while photooxidation primarily modified and removed hydrocarbons in floating oil slicks. The volatile, soluble and highly labile C1 to C10 hydrocarbons were rapidly degraded in the water column and/or emitted to the atmosphere (evaporation). The semi-volatile hydrocarbons (labile C10 to C25) that remained in the water column and floating oil on the water’s surface were lost from oil residues during weathering. The heavy nonvolatile and insoluble hydrocarbons (recalcitrant C25+) were least affected by initial weathering processes in 2010. The composition of the residual oil fraction in surface floating oil was further altered by the addition of oil soluble oxy hydrocarbons produced from photooxidation. During 2011 and 2012 the resulting highly insoluble recalcitrant C25+ oily residues remained on the shorelines, bottom sediments, or bound to suspended particulates in the water column, with detectable residues mostly returning to near pre-spill levels by 2015 to 2020. Some recalcitrant oil residues can still be found at various locations, including some coastal environments (e.g., marshes), or deep-water sediments, at very low levels, ten years after the spill.
Complete and rapid regeneration of fragments from the upside-down jellyfish Cassiopea
Authors: Ostendarp Malte , Plewka Julia , Flathmann Jenny , Tilstra Arjen , El-Khaled Yusuf C. , Wild Christian
Published: August 2022

The upside-down jellyfish Cassiopea increasingly occurs in many (sub-) tropical coastal habitats such as mangrove forests, seagrass meadows, and coral reefs. Its mixotrophic lifestyle and ecophysiological plasticity as well as a high regenerative capacity may be reasons for its success. While the regeneration of umbrella tissue and body structures (i.e. rhopalia and oral arms) was already demonstrated, it remains unclear whether a fully functioning medusa can regenerate from only umbrella tissue. In this study, we thus investigated the regeneration of umbrella fragments over time. We conducted a laboratory experiment for which we used 18 Cassiopea medusae of three different size classes that were cut into two pieces each, one fragment with oral arms and one without. Over a total observation period of 5 weeks, we regularly monitored survival, pulsation behavior, growth and the regeneration pattern of fragments. Findings revealed that 100% of the fragments with oral arms and 88% of the fragments without oral arms survived. Pulsation behavior occurred in all fragments and lasted until the end of the experiment in 94% of all fragments. The umbrella area of fragments without oral arms showed a significantly higher decrease in the first two weeks compared to fragments with oral arms. A complete regeneration of umbrella tissue was observed in all fragments, with and without oral arms alike, and 50% of all fragments even regenerated rhopalia or oral arms as body structures after 33 days. These results suggest an outstanding regenerative capacity of Cassiopea jellyfish after fragmentation. This may contribute to (i) explain the currently observed success of upside-down jellyfish and (ii) extend our knowledge about its regeneration process, which might even act as an asexual reproduction mode in Cassiopea.
Combined spinal-epidural analgesia and epidural analgesia induced maternal fever with a similar timing during labor-A randomized controlled clinical trial
Authors: Chu Qinjun , Sun Yan , Bai Lihui , Bai Yafan , Zhang Dongqing , Zheng Ping , Jin Xiaogao
Published: August 2022

Background

Both epidural and combined spinal-epidural (EA and CSEA) analgesia can induce intrapartum maternal fever. CSEA has a more rapid onset and wider nerve block than EA. Therefore, CSEA might have a different profile of intrapartum maternal fever, including higher temperatures or earlier occurrence. This randomized clinical trial was to determine whether CSEA could cause maternal fever earlier than EA.

Methods

A randomized, double-blind, controlled clinical trial was performed on 233 nulliparous full-term pregnant women during vaginal delivery. The pregnant women were randomly allocated into the EA group (n = 113) and the CSEA group (n = 120). The fever latent period, from analgesia start to fever occurrence, was the primary endpoint in this study. The temperature was measured every 30 min using an eardrum thermometer during labor analgesia. The fever was defined as an eardrum temperature of ≥38 °C.

Results

No difference was found in the maternal fever rate between the EA and the CSEA groups (10/113 vs. 7/120, P = 0.356). There was no significant difference in the fever latent period between the two groups (4.75 ± 0.86 h vs. 3.79 ± 2.2 h, p = 0.305). The temperatures at all points had no differences between EA and CSEA.

Conclusion

CSEA had a similar latent fever period as EA. A further study is warranted to confirm the similar characteristic between CSEA and EA in the development of intrapartum maternal fever.

Clinical trial registration

www.chictr.org.cn, identifier ChiCTR2000038793.
Health sciences students' and instructors' perceptions of the emergency switch to virtual internship amid the COVID-19 pandemic: A case from Qatar
Authors: Bawadi Hiba , Abdul Rahim Hanan , Moawad Joyce , Shami Rula , Du Xiangyun , El-Awaisi Alla , Al-Moslih Ayad Moslih Ibrahim , Diab Mohammad , Al-Jayyousi Ghadir Fakhri
Published: August 2022

In efforts to contain the COVID-19 pandemic, health colleges at Qatar University shifted their clinical training to virtual internships (VI) and project-based learning (PBL). The shift was new to students and faculty alike, and a major change that posed many challenges. This study aimed to explore the experience of changing to VIs during the pandemic from both the clinical instructors' and health sciences students' perspectives. A qualitative study was conducted based on the framework of readiness to change. It involved focus group discussions with students from the departments of Public Health and Human Nutrition and in-depth interviews with clinical instructors using appropriate online platforms. A total of 4 focus groups with 20 students and 4 interviews with instructors were conducted. Transcripts were analyzed following the inductive-deductive approach. The major themes that emerged from the analysis described students' and clinical instructors' perceptions of the necessity and efficiency of the switch to VI; the design of the VI and the extent of the clinical/field experience and skills that it offered; confidence in the ability to succeed in this type of internship and confidence about reaching expected goals; academic and moral support from clinical faculty and coordinators and the communication process with faculty and preceptors; and finally, the benefits gained and how employers would view this type of internship. Health sciences students' readiness for VI was generally low. Several student and faculty needs have to be addressed, specifically regarding the design of the program and the level of preceptors' communication with students. The findings would direct health programs, clinical instructors, and preceptors to better understand students' needs and efficiently plan for virtual internships during not only emergencies but also whenever there is a need to deliver online experiential learning courses.
Investigation of Gynura segetum root extract (GSrE) induced hepatotoxicity based on metabolomic signatures and microbial community profiling in rats
Authors: Gu Xinyi , Li Shuwei , Lu Mengna , Li Ying , Wang Qixue , Chen Long , Jia Yiqun , Cao Shan , Zhang Ting , Zhou Mingmei , Gou Xiaojun
Published: August 2022

In recent years, many reports focus on the hepatotoxicity of Gynura segetum root extract (GSrE), but the interaction between GSrE and the gut microbiota is still unclear. This study investigated the mechanism of GSrE-induced hepatotoxicity of different doses and exposure durations by combining metabolomics and gut microbiota analysis. SD rats were divided into 3 groups: blank, low-dose (7.5 g/kg), and high-dose (15 g/kg) groups. Urine and feces samples were collected on day 0, day 10, and day 21. Metabolomics based on gas chromatography-mass spectrometry (GC-MS) was carried out to identify metabolites and metabolic pathways. 16S rDNA gene sequencing was applied to investigate the composition of gut microbiota before and after GSrE-induced hepatotoxicity. Finally, a correlation analysis of metabolites and gut microbiota was performed. Differential metabolites in urine and feces involved amino acids, carbohydrates, lipids, organic acids, and short chain fatty acids. Among them, L-valine, L-proline, DL-arabinose, pentanoic acid, D-allose, and D-glucose in urine and D-lactic acid and glycerol in fecal metabolites depended on the exposure of time and dose. In addition, 16S rDNA sequencing analysis revealed that GSrE-induced hepatotoxicity significantly altered the composition of gut microbiota, namely, f_Muribaculaceae_Unclassified, Lactobacillus, Bacteroides, Lachnospiraceae_NK4A136_group, f_Ruminococcaceae_Unclassified, Prevotellaceae_Ga6A1_group, and Escherichia-Shigella. The correlation analysis between gut microbiota and differential metabolites showed the crosstalk between the gut microbiota and metabolism in host involving energy, lipid, and amino acid metabolisms. In summary, our findings revealed that peripheral metabolism and gut microbiota disorders were time- and dose-related and the correlation between gut microbiota and metabolites in GSrE-induced hepatotoxicity.