bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of L-Carnitine Supplementation on MicroRNA-217 Expression Level in Non-alcoholic Steatohepatitis Suffering Patients with Obesity: A Randomized Controlled Trial
Authors: Iravani Farzaneh , Roudi Fatemeh , Amiri-Moghadam Shirin , Asle-Mohajeri Mahsa , Salehi Maryam , Azimi-Nezhad Mohsen , Mojarrad Majid , Nematy Mohsen
Published: January 2021

BackgroundNonalcoholic steatohepatitis (NASH) is a severe subtype of Nonalcoholic fatty liver disease (NAFLD) and a progressive chronic liver disease which is associated with oxidative stress, inflammation, fibrosis, lipotoxicity, and altered mitochondrial metabolism. Silent Information Regulator 1 (SIRT1) gene is considered as a potential therapeutic target in NAFLD, microRNA-217 (MiRNA-217) inhibits expression of SIRT1 and this inhibition may play role in the pathogenesis of NASH. On the other hand, L-carnitine may have beneficial effects on NASH. Therefore, we investigated the effect of L-carnitine on the MiRNA-217 expression levels in obese NASH suffering patients.MethodsThis double-blind randomized controlled trial (RCT) was carried out in the nutrition clinic of Mashhad University of Medical Sciences (March 2013-June 2014). Seventy-one obese NASH suffering patients were enrolled and randomly assigned to receive L-carnitine (2000 mg/day) /placebo for 12 weeks. Micro RNA (MiR)-217 expression levels were assessed at the study baseline and at the end of study. The MiRNA-217 expression level were assessed in compare with 36 age, sex, and BMI matched NAFLD/NASH negative obese subjects, as control population.ResultsMiRNA-217 expression level was higher in NASH suffering group compared to NASH negative obese patients (P < 0.001). There was a significant difference in the expression level of MiRNA-217 between L-carnitine and placebo receiving groups after the study intervention (P = 0.001); while the expression levels had no significant difference between the two groups at the initiation of the study. L-carnitine supplementation reduced MiRNA-217 expression levels in participants who were assigned to the supplementation group; while MiRNA-217 expression levels in the placebo received NASH, positive obese patients didn’t change during the study.ConclusionMiRNA-217 expression level can be considered as a noninvasive practical biomarker for diagnosis, and treatment follow-up of NASH suffering patients. However, further studies are required to find out the exact relationships between MiRNA-217 expression and different stages of NAFLD.Trial registrationThis trial was registered on Iranian Clinical Trials Registry Platform IRCT201212052602N8 (https://en.irct.ir/trial/2379) on February 4, 2013.
COVID-19 Viral Load Not Associated with Disease Severity: Findings from A Retrospective Cohort Study
Authors: Abdulrahman Abdulkarim , Mallah Saad , AlQahtani Manaf
Published: January 2021

Background: Being able to use COVID-19 RT-PCR Ct values as simple markers of disease outcome or prognosis would allow for the easy and proactive identification and triaging of high-risk cases. This study’s objective was thus to assess whether a correlation exists between COVID-19 viral loads, as indicated by RT-PCR Ct values, and disease severity, as indicated by respiratory indices Results: A multi-centre cross-sectional retrospective study was conducted, using data obtained from Bahrain’s National COVID-19 Task force’s centralised database. The study period was from May 2, 2020 to July 31, 2020. A multivariable logistic regression was used to assess for a correlation. The covariates adjusted for included sex, age, presentation, and comorbidities. In our cohort, Ct value showed no statistical significance for an association with requirement for oxygenation on admission (Odds ratio 1.046; 95%CI 0.999 to 1.096, p=0.054). Conclusion: Viral load, as indicated by Ct values, did not seem to be associated with requirement for oxygenation on admission in our cohort. We postulate however that time since onset of symptom may have acted as an unaccounted-for confounder.
Deep Learning-Based Four-Region Lung Segmentation in Chest Radiography for COVID-19 Diagnosis
Authors: Kim Young-Gon , Kim Kyungsang , Wu Dufan , Ren Hui , Tak Won Young , Park Soo Young , Lee Yu Rim , Kang Min Kyu , Park Jung Gil , Kim Byung Seok , Chung Woo Jin , Kalra Mannudeep , Li Quanzheng
Published: January 2021

Imaging plays an important role in assessing severity of COVID-19 pneumonia. The recent COVID-19 researches indicate that in many cases, disease progress propagates from the bottom of the lungs to the top. However, semantic interpretation of chest radiography (CXR) findings do not provide a quantitative description of radiographic opacities, and the existing AI-assisted CXR image analysis frameworks do not quantify the severity regionally. To address this issue, we propose a deep learning-based four-region lung segmentation method to assist accurate quantification of COVID-19 pneumonia. Specifically, a segmentation model to separate left and right lung is firstly applied, and then a carina and left hilum detection network is used to separate the upper and lower lungs. To improve the segmentation performance of COVID-19 images, ensemble strategy with five models is exploited. For each region, we evaluated the clinical relevance of the proposed method compared with the Radiographic Assessment of the Quality of Lung Edema (RALE). The proposed ensemble strategy showed dice score of 0.900, which outperforms the conventional methods. Mean intensities of segmented four regions indicate positive correlation to the extent and density scores of pulmonary opacities based on the RALE framework. Therefore, the proposed method can accurately segment four-regions of the lungs and quantify regional pulmonary opacities of COVID-19 pneumonia patients.
Risk Factors for Pediatric Surgical Site Infection Following Neurosurgical Procedures for Hydrocephalus: A Retrospective Single-Center Cohort Study
Authors: Shibamura-Fujiogi Miho , Ormsby Jennifer , Breibart Mark , Warf Benjamin , Sandora Thomas , Priebe Gregory , Soriano Sulpicio , Yuki Koichi
Published: January 2021

Background Infection is a major complication following cerebral spinal fluid (CSF) diversion procedures for hydrocephalus. However, their pediatric risk factors for surgical site infection (SSI) are currently not well defined. Because SSI prevention bundle is increasingly introduced, the purpose of this study was to evaluate risk factors associated with SSIs following CSF diversion surgeries under SSI bundle at a single quaternary care pediatric hospital.Methods We performed a retrospective cohort study of patients undergoing CSF diversion procedures from 2017 to 2019. SSIs were identified prospectively through continuous surveillance. We performed univariate analyses to determine an association between SSIs and patient demographics, comorbidities and perioperative factors, with subsequent multivariate logistic regression analyses to identify independent risk factors for SSI.Results We identified a total of 561 CSF diversion procedures with an overall SSI rate of 3.6%. In univariate analyses, older age, number of previous shunt revisions and comorbid cardiac disease were significantly associated with SSI. In multivariate analyses, history of brain tumor (OR2.75, 95%CI 1.03-7.33, P=0.04) and cardiac comorbidities (OR9.47, 95%CI 2.15-41.73, P=0.003) were significantly associated with SSIs. When endoscopic third ventriculostomy was excluded, only cardiac disease was independently associated with SSI. Cardiac diseases associated with SSI included single ventricle disease with palliative repair and valvulopathy with underlying connective tissue diseases. Conclusion This study showed that comorbid conditions (cardiac disease, brain tumor) were more important than perioperative factors as risk factors for SSI in pediatric patients undergoing CSF diversion procedures. Further investigation is needed to define the mechanisms behind these associations.
Comparative Analysis of Cytokine mRNA Expressions in Human Tissues With Mycobacterium Tuberculosis Infection
Authors: Park Sung-Bae , Park Heechul , Choi Yoon-Sung , Park Ji Young , Lee Dongsup , Kim Jungho , Chang Hee-Kyung , Kim Sunghyun
Published: January 2021

Background: One of the widely used diagnostic methods for Mycobacterium tuberculosis (MTB) infection is the acid-fast bacilli staining of formalin-fixed paraffin-embedded (FFPE) tissues; however, this method cannot discriminate between MTB and nontuberculous mycobacteria (NTM) species. Moreover, confirming tuberculosis (TB) using FFPE tissue specimens may be difficult owing to their low bacterial load. In addition, interference in molecular diagnostic assays, including polymerase chain reaction (PCR), may occur owing to fragmentation and genomic DNA cross-linkage in FFPE tissues formed during formalin fixation or paraffin-embedding procedures. Therefore, we aimed to investigate whether an automated molecular diagnostic method based on PCR-reverse blot hybridization assay can discriminate between human MTB-positive and -negative FFPE tissues and to compare the relative mRNA expression levels of various host immune markers between MTB-infected and uninfected human tissues using quantitative reverse transcription (qRT) PCR. A total of 52 human FFPE tissue samples from various regions of the body, including the lungs, lymph nodes, tendons, colon, and appendix, were collected and used for the molecular identification of Mycobacterium species and analysis of cytokine mRNA expression. Results: IFN-γ, TNF-α, IP-10, CXCL9, CXCL11, and GM-CSF mRNA expression levels in MTB-infected tissues were significantly higher than those in uninfected samples. Additionally, the differences in the mRNA expression levels of IFN-γ, CXCL9, and GM-CSF between MTB-infected and uninfected tissues were statistically significant were statistically significant (p < 0.05). Correlation curve analysis indicated that the mRNA expression of IFN-γ was inversely proportional to that of IP-10 and that the mRNA expression levels of IFN-γ, TNF-α, CXCL9, CXCL11, GM-CSF, and TNFR were proportional and well-correlated. Furthermore, to establish marker profiles for detecting MTB infection, the statistically significant expression levels of three markers were combined. We confirmed that the combined profile of IFN-γ, CXCL9, and GM-CSF expression levels was statistically significant (P < 0.001). Conclusions: Although the mRNA expression patterns of host immune markers may vary according to MTB infection status, these patterns may be highly correlated and can be simultaneously used as an additional indicator for diagnosing TB in human tissue samples.
Multichannel optogenetics combined with laminar recordings for ultra-controlled neuronal interrogation
Authors: Eriksson David , Schneider Artur , Thirumalai Anupriya , Alyahyaey Mansour , Crompe Brice de la , Sharma Kirti , Ruther Patrick , Diester Ilka
Published: January 2021

Highlights: To combine large-scale recordings with optical perturbation we have developed a number of new techniques such as thin optical side-emitting fibers, a fiber matrix connector for thin fibers, an electro-optical commutator for multiple thin fibers, an active patch cord, a flexible fiber bundle ribbon cable, and a modular multi-optrode implantation holder.Summary: Simultaneous large-scale recordings and optogenetic interventions hold the promise to decipher the fast-paced and multifaceted dialogue between neurons that sustains brain function. Here we developed unprecedentedly thin, cell-sized Lambertian side-emitting optical fibers and combined them with silicon probes to achieve high quality recordings and ultrafast multichannel optogenetic inhibition in freely moving animals. Our new framework paves the way for large-scale photo tagging and controlled interrogation of rapid neuronal communication in any combination of brain areas.
CD8+ T Lymphocyte Co-expression Genes Correlates With Immune Microenvironment and Overall Survival in Breast Cancer
Authors: Jiang Jialing , Wang Yutao , Zhao Yi
Published: January 2021

Purpose: To identify CD8+ T lymphocyte related co-expressed genes that increase CD8+ T lymphocyte proportions in breast cancer, and to elucidate the underling mechanisms among relevant genes in the tumor microenvironment.Method: We obtained breast cancer expression matrix data, patient phenotype following information from TCGA–BRCA FPKM. Tumor purity, immune score, stromal score, and estimate score were calculated using the ‘estimate’ package in R. The CD8+ T lymphocyte proportions in each breast carcinoma sample were estimated using the CIBERSORT algorithm. The samples with P < 0.05 were considered to be significant and were taken into the weighted gene co-expression network analysis. Based on the CD8+ T lymphocyte proportion and tumor purity, we generated CD8+ T lymphocyte co-expression networks and selected the most CD8+ T lymphocyte related module as our interested co-expression modules. We constructed a Cox regression risk model based on CD8+ T cell-related factors and explored their correlations with microenvironmental indicators. Results: A breast carcinoma CD8+ T lymphocyte proportion co-expression yellow module was determined. Four CD8+ T lymphocyte proportion co-expressed genes (CD74, HLA-DMA, HCST and GIMAP4) were determined to increase the CD8+ T lymphocyte proportion levels in breast cancer patients. The yellow module was significantly enriched in the antigen presentation process, cellular response to interferon−gamma, and leukocyte proliferation. Subsequently, we generated risk scores based on CD74, HLA-DMA, HCST, and GIMAP4. The AUC of the CD8+ T lymphocyte related risk score was 0.66. The risk score showed significant prognostic ability in various subgroups. Expression levels of proteins encoded by CD74, HLA-DMA, HCST and GIMAP4 were lower in the breast carcinoma samples than in normal tissue, suggesting that expression differences both at the mRNA and the protein levels. Conclusion: These four CD8+ T lymphocyte proportion co-expression genes increase CD8+ T lymphocyte in breast cancer by an antigen presentation process. The mechanism might suggest new pathways to improve outcomes in patients who do not benefit from immune therapy.
Novel Mumps Virus Epitopes Reveal Robust Cytotoxic T Cell Responses After Natural Infection but Not After Vaccination
Authors: Kaaijk Patricia , Emmelot Maarten , Meiring Hugo , Els Cecile van , Wit Jelle de
Published: January 2021

Mumps is nowadays re-emerging despite vaccination. The contribution of T cell immunity to protection against mumps has not been clearly defined. Previously, we described a set of 41 peptides that were eluted from human leukocyte antigen (HLA) class I molecules of mumps virus (MuV)-infected cells. Here, we confirmed immunogenicity of five novel HLA-B*07:02- and HLA-A*01:01-restricted MuV T cell epitopes from this set of peptides. High frequencies of T cells against these five MuV epitopes could be detected ex vivo in all tested mumps patients. Moreover, these epitope-specific T cells derived from mumps patients displayed strong cytotoxic activity. In contrast, only marginal T cell responses against these novel MuV epitopes could be detected in recently vaccinated persons, corroborating earlier findings. Identifying which MuV epitopes are dominantly targeted in the mumps-specific CD8+ T- response is an important step towards better understanding in the discrepancies between natural infection or vaccination-induced cell-mediated immune protection
Pressure Effect of the Mechanical, Electronics and Thermodynamic Properties of Mg-B Compounds: A First-Principles Investigation
Authors: Zhang GuoWei , Xu Chao , Wang MingJie , Xu Hong , Dong Ying , Sun FengEr , Ren Xiaoyan , Zhao Yuhong
Published: January 2021

First principle calculations were performed to investigate the structural, mechanical, electronic properties, and thermodynamic properties of three binary Mg-B compounds under pressure, by using the first principle method. The results implied that the structural parameters and the mechanical properties of the Mg-B compounds without pressure are well matched with the obtainable theoretically simulated values and experimental data. The obtained pressure–volume and energy–volume revealed that the three Mg-B compounds were mechanically stable, and the volume variation decreases with an increase in the boron content. The shear and volume deformation resistance indicated that the elastic constant C ij and bulk modulus B increased when the pressure increased up to 40 GPa, and that MgB 7 had the strongest capacity to resist shear and volume deformation at zero pressure, which indicated the highest hardness. Meanwhile, MgB 4 exhibited a ductility transformation behaviour at 30 GPa, and MgB 2 and MgB 7 displayed a brittle nature under all the considered pressure conditions. The anisotropy of the three Mg-B compounds under pressure were arranged as follows: MgB 4 > MgB 2 > MgB 7. Moreover, the total density of states (TDOS) varied slightly and decreased with an increase in the pressure. The Debye temperature Θ D of the Mg-B compounds gradually increased with an increase in the pressure and the boron content. The temperature and pressure dependence of the heat capacity and the linear thermal expansion coefficient α were both obtained on the basis of Debye model under increased pressure from 0GPa to 40 GPa and increased temperatures. This paper brings a convenient understanding of the magnesium-boron alloys.
Phospholipid Translocation Captured in a Bifunctional Membrane Protein MprF
Authors: Liu Zhenfeng , Song Danfeng , Jiao Haizhan
Published: January 2021

As a large family of membrane proteins crucial for bacterial physiology and virulence, the Multiple Peptide Resistance Factors (MprFs) utilize two separate domains to synthesize and translocate aminoacyl phospholipids to the outer leaflets of bacterial membranes. The function of MprFs enables Staphylococcus aureus and other pathogenic bacteria to acquire resistance to daptomycin and cationic antimicrobial peptides. Here we present cryo-electron microscopy structures of MprF homodimer from Rhizobium tropici (RtMprF) at two different states in complex with lysyl-phosphatidylglycerol (LysPG). RtMprF contains a membrane-embedded lipid-flippase domain with two deep cavities opening toward the inner and outer leaflets of the membrane respectively. Intriguingly, a hook-shaped LysPG molecule is trapped inside the inner cavity with its head group bent toward the outer cavity which hosts a second phospholipid-binding site. Moreover, RtMprF exhibits multiple conformational states with the synthase domain adopting distinct positions relative to the flippase domain. Our results provide a detailed framework for understanding the mechanisms of MprF-mediated modification and translocation of phospholipids.
Retinal Sensitivity and Ganglion Cell-Related Retinal Layer Thickness in the Normal Aging Process 
Authors: Araie Makoto , Fujii Makoto , Ohno Yuko , Tanaka Yuki , Kikawa Tsutomu , Iwase Aiko
Published: January 2021

Aging-associated changes in visual field (VF) sensitivity were compared prospectively and longitudinally with the circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and macular ganglion cell-inner plexiform layer thickness (GCIPLT) changes in the corresponding retinal areas of the same eyes (72 eyes of 37 normal Japanese subjects; mean age, 51.3 years). The Humphrey Field Analyzer 24-2 test (HFA 24-2) and spectral-domain optical coherence tomography (SD-OCT) measurements of the cpRNFLT and GCIPLT in a 0.6-mm-diameter circle corresponding to the four central points of HFA 24-2 adjusted for retinal ganglion cell displacement (GCIPLT4TestPoints) were performed every 3 months for 3 years. The tiem changes of the mean sensitivity over the entire field (VFmean) and the four central points (VF4TestPoints), cpRNFLT, and GCIPLT4TestPoints were analyzed using a linear mixed model. The aging-associated decline rates of VFmean and VF4TestPoins were 0.12 and 0.19 decibels/year (p<0.001), which significantly accelerated with increased subjects’ age (0.009 and 0.010 decibels/year, p<0.001, respectively) without changes in the ocular media. Those of the CpRNFLT and GCIPLT4TestPoints were not significant in both (p>0.114), but significantly accelerated with increased subjects’ age (0.021 and 0.010 mm/year, p=0.001 and 0.004, respectively). These results have implications in studying physiological aging- or desease-related changes in these parameters.
Combining Symbolic Regression with the Cox Proportional Hazards Model Improves Prediction of Heart Failure Deaths
Authors: Wilstrup Casper , Cave Chris
Published: January 2021

Background: Heart failure is a clinical syndrome characterised by a reduced ability of the heart to pump blood. Patients with heart failure have a high mortality rate, and physicians need reliable prognostic predictions to make informed decisions about the appropriate application of devices, transplantation, medications, and palliative care. In this study, we demonstrate that combining symbolic regression with the Cox proportional hazards model improves the ability to predict death due to heart failure compared to using the Cox proportional hazards model alone. Methods: We used a newly invented symbolic regression method called the QLattice to analyse a data set of medical records for 299 Pakistani patients diagnosed with heart failure. The QLattice identified a minimal set of mathematical transformations of the available covariates, which we then used in a Cox model to predict survival.Results: An exponential function of age, the inverse of ejection fraction, and the inverse of serum creatinine were identified as the best risk factors for predicting heart failure deaths. A Cox model fitted on these transformed covariates had improved predictive performance compared with a Cox model on the same covariates without mathematical transformations. Conclusion: Symbolic regression is a way to find transformations of covariates from patients’ medical records which can improve the performance of survival regression models. At the same time, these simple functions are intuitive and easy to apply in clinical settings. The direct interpretability of the simple forms may help researchers gain new insights into the actual causal pathways leading to deaths.
Effects of Lower Limb and Pelvic Pin Positions on Leg Length and Offset Measurement Errors in Experimental Total Hip Arthroplasty
Authors: Kawamura Haruo , Watanabe Yasuhiko , Nishino Tomofumi , Mishima Hajime
Published: January 2021

BackgroundLeg length (LL) and offset (OS) are important factors in total hip arthroplasty (THA). Because most LL and OS callipers used in THA depend on fixed points on the pelvis and the femur, limb position could affect measurement error. This study was conducted on a THA simulator to clarify the effects of lower limb position and iliac pin position on LL and OS errors and to determine the permissible range of limb position for accurate LL and OS measurement. MethodsAn LL and OS measurement instrument was used. Two pin positions were tested: the iliac tubercle and the top of the iliac crest intersecting with the extension of the femoral axis. First, the limb was moved in one direction (flexion-extension, abduction-adduction, or internal-external rotation), and LL and OS were measured for each pin position. Next, the limb was moved in combinations of the three directions. Then, the permissible range of combined limb position, which resulted in LL and OS measurement error within ±2 mm, was determined for each pin position. ResultsOnly 4 degrees of abduction/adduction caused 5-7 mm error in LL and 2-4 mm error in OS, irrespective of pin position. The effects of flexion–extension and internal–external rotation on LL error were smaller for the top of the iliac crest than for the iliac tubercle, though OS error was similar for both pin positions. For LL, the permissible range of the combined limb position was wider for the top of the iliac crest than for the iliac tubercle. ConclusionTo minimize LL and OS measurement errors in THA, adduction–abduction must be maintained. The iliac pin position in the top of the iliac crest is preferred because it provides less LL measurement error and a wider permissible range of combined limb position for accurate LL measurement.
Patient-reported dyspnea and health predict waitlist mortality in patients waiting for lung transplantation in Japan
Authors: Ikeda Masaki , Oga Toru , Chen-Yoshikawa Toyofumi F , Tokuno Junko , Oto Takahiro , Okawa Tomoyo , Okada Yoshinori , Akiba Miki , Tanaka Satona , Yamada Yoshito , Yutaka Yojiro , Ohsumi Akihiro , Nakajima Daisuke , Hamaji Masatsugu , Isomi Maki , Chin Kazuo , Date Hiroshi
Published: January 2021

Background
Waitlist mortality due to donor shortage for lung transplantation is a serious problem worldwide. Currently, the selection of recipients is mainly based on registration order in Japan. However, scientific evidence for risk stratification for waitlist mortality is needed in future. We hypothesized that patient-reported dyspnea and health would predict mortality in patients waitlisted for lung transplantation.
Methods
Using data on 203 patients who were registered as candidates for lung transplantation from deceased donors, we analyzed factors related to waitlist mortality. Dyspnea was evaluated by the modified Medical Research Council (mMRC) dyspnea scale and health status was measured with the St. George’s Respiratory Questionnaire (SGRQ).
Results
Among 197 patients who met inclusion criteria, the main underlying disease was interstitial pneumonia (IP) in 99 patients. During the median follow-up period of 572 days, 72 patients on the waitlist died and 96 received lung transplantation (69 from deceased donor). Univariable competing risk analyses revealed that both mMRC dyspnea and SGRQ Total were significantly associated with waitlist mortality (p = 0.003 and p < 0.001). Multivariable competing risk analyses revealed that the mMRC and SGRQ were associated with waitlist mortality, among age, IP, arterial carbon dioxide pressure, and forced vital capacity, which were all significant factors in univariable analyses.
Conclusions
Both mMRC dyspnea and SGRQ were significantly associated with waitlist mortality regardless of patients’ background, underlying disease, and pulmonary function. Patient-reported dyspnea and health should be measured not only from the perspective of multi-dimensional analysis including subjective perceptions, but also as risk stratification for waitlist mortality.
Low use of Modern Family Planning Methods in women suffering from Physical and Psychological abuse by their partiners: Findings from Cross-Sectional Study
Authors: Baritwa Mrimi Simion , Joho Angelina Alphonce
Published: January 2021

Background: Married women who experience intimate partner violence are less likely to negotiate with their partners on modern family planning use. This study aimed to assess the influence of intimate partner violence on modern family planning use among married women in Mara region.Methods: A community based analytical cross-sectional study which included 366 married women in Mara from May to July 2019. Seven multistage sampling techniques were employed to select the sample size. A structured questionnaire was used to collect data which were analyzed using SPSS version 20. Binary logistic regression model was applied to determine the predictors of modern family planning use. P-value less than 0.05 was considered significant.Results: The overall prevalence of intimate partner violence (IPV) was 73% with 54.1% physical violence, 36.3% psychological violence and 25.4%, sexual violence. The prevalence of modern family planning (FP) use was 62%, the most common method practiced by married women was injection (depo Provera) (49.1%). Factors associated with FP use were physical violence (AOR = 0.32, p = 0.0056), psychological violence (AOR = 0.22, p = 0.0022), religious (AOR = 4.6, p = 0.0085) and availability of preferred FP methods (AOR = 9.27, p<0.0001).Conclusion: This study shows a positive association between FP use and IPV. Effective intervention is required to increase modern family plan use and reducing intimate partner violence.
Associations Between Sinus Tachycardia and Adverse Cardiovascular Outcomes and Mortality in Cancer Patients
Authors: Okwuosa Tochi , Hemu Mohamad , Chiang Caleb , Bhatt Parva , Ahmed Aamir , Hein Kyaw Zaw , Randall Megan , Palomo Andres , Kramer Jason , Fughhi Ibtihaj , Fogg Louis , Bonomi Philip , Mourad Talal
Published: January 2021

BackgroundSinus tachycardia in cancer reflects significant multi-system organ stressor and disease, with sparse literature describing its clinical significance. We assessed cardiovascular (CV) and mortality prognostic implications of sinus tachycardia in cancer patients.MethodsWe conducted a case-control study of 622 cancer patients at a U.S. urban medical center from 2008 to 2016. Cases had ECG-confirmed sinus tachycardia (heart rate [HR] ≥ 100 bpm) in ≥ 3 different clinic visits within 1 year of cancer diagnosis excluding history of pulmonary embolism, thyroid dysfunction, left ventricular ejection fraction < 50%, atrial fibrillation/flutter, HR > 180 bpm. Adverse CV outcomes (ACVO) were heart failure with preserved ejection fraction (HFpEF), HF with reduced EF (HFrEF), hospital admissions for HF exacerbation (AHFE), acute coronary syndrome (ACS). Regression analyses were conducted to examine the effect of sinus tachycardia on overall ACVO and survival.ResultsThere were 51 cases, age and sex-matched with 571 controls (mean age 70 ± 10, 60.5% women, 76.4% Caucasian). In multivariate analysis over a 10-year follow-up period, sinus tachycardia (HR ≥ 100 vs. < 100 bpm) was an independent predictor of overall ACVO (OR 2.8, 95% CI: 1.4 -5.5; p = 0.006). There was increased incidence of HFrEF (OR 3.3, 95% CI: 1.6- 6.5; P= 0.004) and AHFE (OR 6.3, 95% CI: 1.6-28; P = 0.023), but not HFpEF or ACS (p>0.05) compared with controls. Sinus tachycardia was a significant predictor of overall mortality after adjusting for significant covariates (HR 2.9, 95% CI 1.8-5; p<0.001).ConclusionIndependent of typical factors that affect cardiovascular disease, sinus tachycardia around the time of cancer treatment is associated with increased ACVO and mortality in cancer patients at 10 years of follow-up.
Tracheostomy Practice in Mechanically Ventilated Patients With SARS-CoV-2 Induced Acute Respiratory Distress Syndrome: a Single-center Retrospective Study With Focus on Tracheomalacia
Authors: Guarnieri Marcello , Andreoni Patrizia , Gay Hedwige , Giudici Riccardo , Bottiroli Maurizio , Mondino Michele , Casella Gianpaolo , Chiara Osvaldo , Morelli Oscar , Conforti Serena , Langer Thomas , Fumagalli Roberto
Published: January 2021

Background: The SARS-CoV-2 pandemic increased the number of patients needing invasive mechanical ventilation, either through an endotracheal tube or through a tracheostomy. Tracheomalacia is a rare, but potentially severe complication of mechanical ventilation, which can significantly complicate the weaning process. Aim of this study was to describe the strategies of airway management in mechanically ventilated patients with respiratory failure due to SARS-CoV-2, the incidence of severe tracheomalacia, and investigate the factors associated with its occurrence.Methods. Retrospective, single-center study performed in an Italian teaching hospital. All adult patients admitted to the Intensive Care Unit (ICU) between February 24 and June 30, 2020, treated with invasive mechanical ventilation for respiratory failure caused by SARS-CoV-2 were included. Clinical data were collected on the day of ICU admission, while information regarding airway management was collected daily.Results. A total of 151 patients were included in the study. On admission, ARDS severity was mild in 21%, moderate in 62%, and severe in 17% of the cases, with an overall mortality of 39.7%. A tracheostomy was performed in 73 (48.3%) patients: open surgical technique in 54 patients (74%) and percutaneous Ciaglia technique in 19 patients (26%). Patients in whom a tracheostomy was performed had, compared to the other patients, a longer duration of mechanical ventilation and longer ICU and hospital length of stay. Tracheomalacia was diagnosed in 8 (5%) patients. The factors associated with tracheomalacia were female sex, obesity, and tracheostomy.Conclusions. In our population, approximately 50% of patients with ARDS due to SARS-CoV-2 were tracheostomized. Tracheostomized patients had a longer ICU and hospital length of stay. Five percent of our population was diagnosed with tracheomalacia. This percentage is 10 times higher than what is reported in available literature and the underlying mechanisms are not fully understood.
Thrombomodulin is Associated with Increased Mortality and Organ Failure in Mechanically Ventilated Children with Acute Respiratory Failure: A Prospective Observational Study.
Authors: Monteiro Ana C , Flori Heidi , Dahmer Mary K , Sim Myung Shin , Quasney Michael W. , Curley Martha A.Q. , Matthay Michael A , Sapru Anil
Published: January 2021

BACKGROUNDAcute respiratory failure (ARF) can progress to acute respiratory distress syndrome (ARDS) and death. Biomarkers such as soluble thrombomodulin (sTM), implicated in pulmonary vascular injury, may allow for risk stratification and prognostic enrichment in ARF.METHODSThis was a prospective observational study of 432 patients aged 2 weeks - 17 years requiring invasive mechanical ventilation. It was ancillary to the multicenter clinical trial, Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE). After consent, patients had up to 3 plasma samples collected at 24-hour intervals within 5 days after intubation. sTM was assayed by ELISA. Hazard ratio (HR) for 90-day mortality was determined by cox regression. Mixed effect models (MEM) were used to test for association with extrapulmonary multiorgan failure (MOF) and oxygenation index (OI). Age, race, sex and PRISM-III scores were used as confounding variables for multivariable analyses.RESULTSsTM values ranged from 16.6 to 670.9 ng/ml within 5 days after intubation. Higher sTM was associated with increased 90-day mortality (n=432, adjusted HR= 1.003, p=0.02) and worse OI in the first 5 days after intubation (n=252, Estimate = 0.02, p<0.01). Both initial and slope of sTM were associated with increased extrapulmonary MOF in unadjusted and adjusted analyses (Intercept, Estimate=0.003, p<0.0001; and slope, Estimate=0.01, p=0.0009, n= 386). CONCLUSIONSPlasma sTM are associated with mortality, severity of ARDS extrapulmonary MOF in children with ARF. This suggests a role of vascular injury in pathogenesis of ARF and provide potential application for targeted therapies. TRIAL REGISTRATIONNCT00814099
A Cohort Study on Lung Cavitations in Severely Ill COVID-19 Patients – Evidence for a Thromboembolic Pathogenesis.
Authors: Kruse Jan M. , Zickler Daniel , Lüdemann Willie M , Piper Sophie K , Gotthardt Inka , Horst David , Kahl Andreas , Eckardt Kai Uwe , Elezkurtaj Sefer
Published: January 2021

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) induces lung injury of varying severity, potentially causing severe acute respiratory distress syndrome (ARDS). Pulmonary injury patterns in COVID-19 patients differ from those in patients with other causes of ARDS. We aimed to explore the frequency and pathogenesis of cavitary lung lesions in critically ill patients with COVID-19.Methods: Retrospective study in 39 critically ill adult patients hospitalized with severe acute respiratory syndrome coronavirus 2 including lung injury of varying severity in a tertiary care referral center during March and May 2020, Berlin/Germany.Results: We observed lung cavitations in an unusually large proportion of 22/39 (56%) COVID-19 patients treated on intensive care units (ICU), including 3/5 patients without mechanical ventilation. Median interquartile range (IQR) time between onset of symptoms and ICU admission was 11 5 (6 25-17 75) days. In 15 patients, lung cavitations were already present on the first CT scan, performed after ICU admission; in seven patients they developed during a subsequent median (IQR) observation period of 48 (35-58) days. In seven patients we found at least one cavitation with a diameter > 2 cm (maximum 10 cm). Patients who developed cavitations were older and had a higher body mass index. Autopsy findings in three patients revealed that the cavitations reflected lung infarcts undergoing liquefaction, secondary to thrombotic pulmonary artery branch occlusions.Conclusion: Lung cavitations appear to be a frequent complication of severely ill COVID-19 patients, probably related to the prothrombotic state associated with COVID-19.
Performance Determinants of Unsupervised Clustering Methods for Microbiome Data
Authors: Shi Yushu , Zhang Liangliang , Peterson Christine , Do Kim-Anh , Jenq Robert
Published: January 2021

Background: In microbiome data analysis, unsupervised clustering is often used to identify naturally occurring clusters, which can then be assessed for associations with characteristics of interest. In this work, we systematically compared beta diversity and clustering methods commonly used in microbiome analyses. We applied these to four published datasets where highly distinct microbiome profiles could be seen between sample groups. Results: Although no single method outperformed the others consistently, we did identify key scenarios where certain methods can underperform. Specifically, the Bray Curtis metric resulted in poor clustering in a dataset where high-abundance OTUs were relatively rare. In contrast, the unweighted UniFrac metric clustered poorly when used on a dataset with a high prevalence of low-abundance OTUs. To test our proposition, we systematically modified properties of the poorly performing datasets and found that this approach resulted in improved Bray Curtis and unweighted UniFrac performance. Based on these observations, we rationally combined the Bray Curtis metric and the unweighted UniFrac metrics and found that this new beta diversity metric showed high performance across all datasets. We also evaluated our findings by examining a clinical dataset where clusters are less separated. Conclusions: Our systematic evaluation of clustering performance in these five datasets demonstrates that there is no existing clustering method that universally performs best across all datasets. We propose a combined metric of Bray Curtis and unweighted UniFrac that capitalizes on the complementary strengths of the two metrics.
Five Year Trend Analysis of Malaria Cases in Adama, Boset and Lume Districts of East Shawa, Oromia, Ethiopia
Authors: Hulluka Temesgen File , Chala Bayisa Chala
Published: January 2021

BackgroundMalaria is an infectious disease caused by Plasmodium parasites. Of the five human malaria parasites Plasmodium falciparum and Plasmodium vivax are the two co-endemic predominant and widely distributed species in Ethiopia greatly affecting public health and socio-economic development. Even though enormous effort have been made countrywide to reduce the disease burden little has been reported about trends of malaria transmission in the several localities of malarious areas like East Shawa Zone of Oromia Regional State, Ethiopia. Thus, the present study was aimed at assessing five- year (2016-2020) trends of malaria transmission at Adama, Boset and Lume districts of East Shawa Zone of Oromia Regional State, Ethiopia. MethodsRetrospective data were collected from the central surveillance of East Shawa Zone Health Office. The data collected was analyzed from September 2020 to December 2020 to examine trends of malaria epidemiology in three malarious districts in the Zone. The result shows, although a remarkable decrease in slide positivity rate (SPR) from (47.8 to 7.9%) and prevalence rate (6 to 1%) in the area, a recent slight increase of malaria SPR and prevalence was observed. Male individuals, particularly the productive section of the society (fifteen years and above age group) were more infected (60%), where falciparum, vivax and mixed malaria cases accounted for (53%), (41%), and (6%) respectively. Conclusion and Recommendations: Although reduction of malaria incidence was recorded in the study area, and higher malaria prevalence compared to the report of the national malaria indicator survey and inconsistency of the reduction rate noted in the study area demands due attention in the sector.
The Endometriotic Nodule Has Lower T-cadherin, E-cadherin, Progesterone Receptor and Oestrogen Receptor Than Endometrioma Tissue
Authors: Biyik Ismail , Kalkan Uzeyir , Simsek Sercan
Published: January 2021

Objective:To compare the T-cadherin, E-cadherin, PR and ER staining levels of endometriotic nodules, ovarian endometriomas and normal endometrial tissues.Methods:Endometriotic nodules of 24 cases, endometrioma of 30 cases and normal endometrial tissues of 30 cases were examined. T-cadherin, E-cadherin, ER-α and PR-α staining levels of endometriotic nodular tissues, endometrioma tissues and endometrial tissues were compared immunohistochemically. H-score was calculated to compare the expression of T-cadherin, E-cadherin, ER-α, PR-α in IHC staining based on the percentage of cells stained at each intensity level.Results:T-cadherin, E-cadherin, ER and PR H-score were found lowest in endometriotic nodule tissue and the highest in endometrial tissue (p <0.0001, <0.0001, <0.0001 and <0.0001, respectively). In correlation analysis, a positive correlation was found between T-cadherin, E-cadherin, PR and ER H-score (p <0.0001 for each). No correlation was found between age, BMI, VAS score, CA125, endometrioma size and the severity of dysmenorrhea, dyspareunia and dystonia (p> 0.05).Conclusions:T-cadherin, E-cadherin, ER and PR H-score were found lowest in endometriotic nodule tissue, the highest in endometrium tissue. The finding of lower expression of PR-α in endometriotic nodule in our study may be related to decrease in progesterone effect which could not inhibit the decrease in the expression of T-cadherin and E-cadherin, thus the invasiveness of endometriotic nodule. These findings suggest that endometriotic nodule and ovarian endometrioma tissues have a different biology.
Protein Suppresses Both Bitterness and Oleocanthal-elicited Pungency of Extra Virgin Olive Oil
Authors: Gachons Catherine Peyrot des , O’Keefe Abigail J. , Slade Louise , Beauchamp Gary K.
Published: January 2021

The Mediterranean diet, considered one of the healthiest in the world, is characterized in part by the major source of its fat, which is extra virgin olive oil (EVOO). Among the health benefits of consuming EVOOs is the presence of phenolic compounds, which have been shown to lower the incidence of coronary heart disease and are suspected of providing many other health benefits. These phenolic compounds also contribute to the flavor of EVOO, adding both pungent and bitter notes that are valued by connoisseurs but reported to be unpleasant by naïve consumers. Here, we demonstrate that some food-derived proteins, when added to pungent and bitter EVOOs, reduce or even eliminate both the pungency and bitterness. This sensory loss seems to be caused by the proteins binding the pungent phenolic compound, oleocanthal, as well as bitter tasting phenolics, leaving them unable to activate their respective sensory receptors (TRPA1 and TAS2Rs). Thus, when used in various foods recipes (e.g. mayonnaise), pungent and bitter EVOOs may lose their pungent and bitter characteristics thereby rendering them more palatable to many consumers. These data also raise the question of whether the bioactivities of EVOO phenolics remain unchanged when consumed with and without protein-containing foods.
Transcriptome sequencing and metabolome analysis of food habits domestication from live prey fish to artificial diets in mandarin fish (Siniperca chuatsi)
Authors: He Shan , You Jun-Jie , Liang Xu-Fang , Zhang Zhi-Lu , Zhang Yan-Peng
Published: January 2021

Background: As economical traits, food habits domestication can reduce production cost in aquaculture. However, the molecular mechanism underlying food habits domestication has remained elusive. Mandarin fish (Siniperca chuatsi) only feed on live prey fish and refuse artificial diets. In the present study, we domesticated mandarin fish to feed on artificial diets. The two groups were obtained, the fish did not eat artificial diets or ate artificial diets during all of the three domestication processes, named Group W or X, respectively. Results: Using transcriptome and metabolome analysis, we investigated the differentially expressed genes and metabolites between the two groups, and found three common pathways related to food habit domestication, including retinol metabolism, glycerolipid metabolism, and biosynthesis of unsaturated fatty acids pathways. Furthermore, the western blotting and bisulfite sequencing PCR analysis were performed. The gene expression of TFIIF and histone methyltransferase ezh1 were significantly increased and decreased in the fish of Group X, respectively. The total DNA methylation levels of TFIIF gene and tri-methylation of histone H3 at lysine 27 (H3K27me3) were significantly higher and lower in the fish of Group X, respectively. Conclusion: It was speculated that mandarin fish which could feed on artificial diets, might be attributed to the lower expression of ezh1, resulting in the decreased level of H3K27me3 and increased level of DNA methylation of TFIIF gene. The high expression of TFIIF gene might up-regulate the expression of genes in retinol metabolism, glycerolipid metabolism and glycerophosphoric metabolism pathways. Our study indicated the relationship between the methylation of DNA and histone and food habits domestication, which might be a novel molecular mechanism of food habits domestication in animals.
Aesthetic evaluation of the labiolingual position of maxillary lateral incisors by orthodontists and laypersons
Authors: Jiang Xue , Cao Zhiwei , Yao Yang , Zhao Zhihe , Liao Wen
Published: January 2021

Background: The maxillary anterior teeth play a crucial role in smile aesthetics. Previous studies regarding the importance of maxillary lateral incisors for smile aesthetics concentrated on their size, incisor edge level, and inclination, etc. However, the aesthetic effect of lateral incisor movement in the spatial position has not been studied yet. Therefore, the purpose of this study was to explore the influence of the labiolingual position of maxillary lateral incisors on the aesthetic perception of smiles by orthodontists and laypersons, as well as analyze differences in this perception between male and female raters.Methods: A three-dimensional (3D) dental model was generated from the photograph of a man’s smile using iOrtho7.0 software (Time Angel, Wuxi, China). Based on this model, seven images were generated with different labiolingual positions of the maxillary lateral incisors in 0.5 mm increments (+ indicating labial translation, and - indicating lingual translation). The images were evaluated by 86 orthodontists and 161 laypersons using a visual analog scale, with lower scores indicating less attractiveness. Data were analyzed using Student’s t test and one-way analysis of variance with post hoc test.Results: There was no significant difference in smile ratings by males and females. Orthodontists assigned lower scores to all images than laypersons. The smile at +1.5 mm was considered the least attractive by orthodontists, while smiles at +1.5 mm and -1.5 mm were regarded as the least attractive by laypersons. The smile at 0 mm was evaluated as the most attractive by all raters. Laypersons gave different scores to smiles at 0 or -0.5 mm, but orthodontists did not.Conclusions: The labiolingual position of maxillary lateral incisors does affect the perception of smile aesthetics. Orthodontists may rate smile aesthetics more critically than laypersons. Therefore, communication and discussion between orthodontists and patients is needed to achieve better therapeutic and aesthetic outcomes.