bluuebunny/crossref_metadata_2025 huggingface dataset:
The expression and clinical significance of miR-30b-3p and miR-125b-1-3p in patients with periodontitis
Authors: Zhu Jinjuan , Zhong Zhihong
Published: August 2022

Objective

Periodontitis is a chronic inflammatory infectious disease caused by the deposition of dental plaque on the tooth surface, leading to adverse systemic consequences. Accumulating evidence shows that dysregulated microRNAs (miRNAs) are associated with the disease severity of periodontitis. Herein, we report two novel miRNAs, miR-30b-3p and miR-125b-1-3p, in the context of periodontitis and their relationships with disease severity of periodontitis.

Methods

The miRNA profiles of gingival crevicular fluid (GCF) samples were used to screen differentially expressed miRNAs (DEmiRNAs) between periodontitis patients and periodontally healthy individuals. Clinical human GCF samples were collected from 80 patients diagnosed with periodontitis (PD +) for the first time and 100 periodontally healthy individuals (PD-). The severity of periodontitis was categorized into mild/moderate (MPD) and severe (SPD) groups. The expressions of miR-30b-3p and miR-125b-1-3p were determined by quantitative real-time PCR. The levels of IL-1β, IL-6, and TNF-α were determined by ELISA methods.

Results

We applied GEO2R bioinformatics tool to analyze the raw data of the GSE89081 dataset and identified miR-30b-3p (|logFC|= 1.987) and miR-125b-1-3p (|logFC|= 1.878) between periodontitis patients and periodontally healthy individuals. It was found that PPD, CAL, BOP, and the relative expression levels of miR-30b-3p and miR-125b-1-3p were all higher in the PD + group than the PD- group, in the SPD group than the MPD group (P < 0.05). The periodontitis patients with high-miR-30b-3p expression exhibited increased PPD, CAL, and BOP compared to those low-miR-30b-3p expression, while high-miR-125b-1-3p expression group showed significant differences on PPD and BOP from low-miR-125b-1-3p expression group (P < 0.05). Pearson correlation analysis demonstrated a significantly positive correlation between the levels of inflammatory cytokines, miR-30b-3p expression, and miR-125b-1-3p expression (P < 0.001). Results of ROC curves showed AUC of 0.878 and 0.927, sensitivity of 0.843 and 0.855, and specificity of 0.791 and 0.801, respectively, when miR-30b-3p and miR-125b-1-3p expression levels were used to diagnose periodontitis.

Conclusion

These data unveiled that miR-30b-3p and miR-125b-1-3p expressions may be associated with the pathogenesis of periodontitis.
Implementation and evaluation of a shock curriculum using simulation in Manila, Philippines: a prospective cohort study
Authors: Gardner Yelton Sarah E. , Ramos Lorelie Cañete , Reuland Carolyn J. , Evangelista Paula Pilar G. , Shilkofski Nicole A.
Published: August 2022

Background

Shock causes significant morbidity and mortality in children living in resource-limited settings. Simulation has been successfully used as an educational tool for medical professionals internationally. We sought to improve comfort and knowledge regarding shock recognition and fluid management by implementing a pediatric shock curriculum using simulation as an assessment for trainees in Manila, Philippines.

Methods

We assessed a shock curriculum focused on patients with malnutrition in a prospective cohort study, using a written test and a videotaped simulation-based objective standardized clinical examination. Implementation occurred in March 2020 with 24 Filipino pediatric residents at a single institution in Manila. Outcomes included time to initiation of fluid resuscitation, improvement in confidence, knowledge on a written assessment, and performance in simulation. Results were compared pre- and post-intervention using Wilcoxon signed-rank test.

Results

The time to initiation of fluids did not change between the baseline simulation (median [interquartile range] = 71.5 seconds [52–116.5]) and the final simulation (68 seconds [52.5–89]; P = 0.42). Confidence in identifying shock and malnutrition, managing hypovolemic shock, managing septic shock, and placing intraosseous access all increased (P < 0.01) post-intervention. Written test scores showed no improvement, but performance in simulation, measured using a checklist, improved from a total score of 10 [8.5–11] to 15 [13-16] (P < 0.01).

Conclusion

In our study of a simulation-based shock education program, we showed improvement in confidence and knowledge as measured by a resuscitation checklist. It is feasible to establish a successful simulation-based education program in a low-resource setting.
Healthcare resource utilization and costs in 23–25-year-old women with human papillomavirus (HPV) associated anogenital diseases in Germany – a retrospective analysis of statutory health insurance claims data
Authors: Reuschenbach Miriam , Mihm Sarah , Wölle Regine , Schneider Kim Maren , Jacob Christian , Greiner Wolfgang , Hampl Monika , Goodman Elizabeth
Published: August 2022

Background

Human papilloma virus (HPV) causes multiple anogenital diseases including cervical cancer and is the most common sexually transmitted infection. Healthcare resource utilization (HRU) associated with HPV-related anogenital diseases includes diagnostic and disease specific treatment regimens. A recent study showed disease burden of young women aged 23–25 years, who were the first populations eligible to receive HPV vaccination after its introduction in Germany. Cost for the German statutory health insurance (SHI) due to HPV‑related anogenital diseases in this population are unknown. This study aimed at assessing HRU and costs related to HPV-associated anogenital diseases for the Germany SHI.

Methods

We used a retrospective, matched cohort design to leverage the prior identified cohort of 23–25-year-old women born between 1989–1992 diagnosed with HPV-related anogenital disease from the Institute for Applied Health Research Berlin (InGef) Research Database. German SHI claims data from 2012–2017 were analyzed. The prior identified cases were matched (direct, without replacement) to women without anogenital diseases (1:10 ratio). HRU and costs for inpatient care, outpatient care, and pharmaceutical during a 3-year observation period were determined for both cases and controls and increments between the groups were assessed.

Results

2,972 women diagnosed with anogenital diseases (cases) who were matched to 29,720 women without anogenital diseases (controls). Cases had more outpatient visits (52.4 visits vs. 39.2 visits) and more cases (45.2% vs. 31.7%) were hospitalized at least once in the 3‑year observation period. Most common outpatient procedures performed in cases were conization of the cervix uteri (4.4% cases; n < 5 controls), followed by other excision and destruction of diseased tissue of the cervix uteri (3.1% in cases; 0.0% in controls). Median difference in total healthcare costs of €684 (mean difference: €1,089, 95%CI: €752–1,426) suggest that HPV-related anogenital diseases were responsible for approximately €3.2 Million more healthcare costs for the identified cases in the four birth cohorts within the 3‑year observation period in the InGef Research Database. Costs were mainly driven by outpatient care (41.6% of total costs).

Conclusion

In Germany, HPV-related anogenital diseases among young women are associated with considerable HRU and financial expenditures, mostly driven by outpatient care.
Glycated ACE2 reduces anti-remodeling effects of renin-angiotensin system inhibition in human diabetic hearts
Authors: Marfella Raffaele , D’Onofrio Nunzia , Mansueto Gelsomina , Grimaldi Vincenzo , Trotta Maria Consiglia , Sardu Celestino , Sasso Ferdinando Carlo , Scisciola Lucia , Amarelli Cristiano , Esposito Salvatore , D’Amico Michele , Golino Paolo , De Feo Marisa , Signoriello Giuseppe , Paolisso Pasquale , Gallinoro Emanuele , Vanderheyden Marc , Maiello Ciro , Balestrieri Maria Luisa , Barbato Emanuele , Napoli Claudio , Paolisso Giuseppe
Published: August 2022

Background

High glycated-hemoglobin (HbA1c) levels correlated with an elevated risk of adverse cardiovascular outcomes despite renin-angiotensin system (RAS) inhibition in type-2 diabetic (T2DM) patients with reduced ejection fraction. Using the routine biopsies of non-T2DM heart transplanted (HTX) in T2DM recipients, we evaluated whether the diabetic milieu modulates glycosylated ACE2 (GlycACE2) levels in cardiomyocytes, known to be affected by non-enzymatic glycosylation, and the relationship with glycemic control.

Objectives

We investigated the possible effects of GlycACE2 on the anti-remodeling pathways of the RAS inhibitors by evaluating the levels of Angiotensin (Ang) 1–9, Ang 1–7, and Mas receptor (MasR), Nuclear-factor of activated T-cells (NFAT), and fibrosis in human hearts.

Methods

We evaluated 197 first HTX recipients (107 non-T2DM, 90 T2DM). All patients were treated with angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB) at hospital discharge. Patients underwent clinical evaluation (metabolic status, echocardiography, coronary CT-angiography, and endomyocardial biopsies). Biopsies were used to evaluate ACE2, GlycACE2, Ang 1–9, Ang 1–7, MasR, NAFT, and fibrosis.

Results

GlycACE2 was higher in T2DM compared tonon-T2DM cardiomyocytes. Moreover, reduced expressions of Ang 1–9, Ang 1–7, and MasR were observed, suggesting impaired effects of RAS-inhibition in diabetic hearts. Accordingly, biopsies from T2DM recipients showed higher fibrosis than those from non-T2DM recipients. Notably, the expression of GlycACE2 in heart biopsies was strongly dependent on glycemic control, as reflected by the correlation between mean plasma HbA1c, evaluated quarterly during the 12-month follow-up, and GlycACE2 expression.

Conclusion

Poor glycemic control, favoring GlycACE2, may attenuate the cardioprotective effects of RAS-inhibition. However, the achievement of tight glycemic control normalizes the anti-remodeling effects of RAS-inhibition.

Trial registration: https://clinicaltrials.gov/ NCT03546062.
The pancreas-to-muscle signal intensity ratio on T1-weighted MRI as a predictive biomarker for postoperative pancreatic fistula after distal pancreatectomy: a single-center retrospective study
Authors: Fukada Masahiro , Murase Katsutoshi , Higashi Toshiya , Fujibayashi Seito , Kuno Masashi , Yasufuku Itaru , Sato Yuta , Kiyama Shigeru , Tanaka Yoshihiro , Okumura Naoki , Matsuhashi Nobuhisa , Takahashi Takao
Published: August 2022

Background

Postoperative pancreatic fistula (POPF) is one of the serious complications of pancreatic surgery. When POPF occurs and becomes severe, it causes secondary complications and a longer treatment period. We previously reported a correlation between pancreatic fibrosis and magnetic resonance imaging (MRI) findings, and MRI may have the potential to predict POPF. This study aimed to assess the predictive ability of the pancreas-to-muscle signal intensity ratio on T1-weighted MRI (SIR on T1-w MRI) for POPF after distal pancreatectomy (DP).

Methods

This single-institution retrospective study comprised 117 patients who underwent DP. It was conducted between 2010 and 2021 at the Gifu University Hospital. We statistically analyzed pre-, intra-, and postoperative factors to assess the correlation with POPF.

Results

According to the definition and grading of the International Study Group of Pancreatic Fistula (ISGPF), 29 (24.8%) of the 117 patients had POPF grades B and C. In the univariate analysis, POPF was significantly associated with the pancreas-to-muscle SIR on T1-w MRI, the drainage fluid amylase concentration (D-Amy) levels on postoperative day (POD) 1 and 3, white blood cell count on POD 1 and 3, C-reactive protein level on POD 3, and heart rate on POD 3. In multivariate analysis, only the pancreas-to-muscle SIR on T1-w MRI (>1.37; odds ratio [OR] 23.25; 95% confidence interval [CI] 3.93–454.03; p < 0.01) and D-Amy level on POD 3 (>737 U/l; OR 3.91; 95% CI 1.02–16.36; p = 0.046) were identified as independent predictive factors.

Conclusions

The pancreas-to-muscle SIR on T1-w MRI and postoperative D-Amy levels were able to predict the development of POPF after DP. The pancreas-to-muscle SIR on T1-w MRI may be a potential objective biomarker reflecting pancreatic status.
Exploring pandemic-related health literacy among adolescents in Germany: a focus group study
Authors: Loer Anne-Kathrin Mareike , Domanska Olga Maria , Stock Christiane , Jordan Susanne
Published: August 2022

Background

Health literacy enables people to cope efficiently with health threats, such as the COVID-19 pandemic. However, little is known about health literacy among adolescents in general and especially in the context of pandemics. This study aimed to explore pandemic-related health literacy among adolescents by addressing cognitive, behavioral, conative, and affective components of the multidimensional health literacy construct.

Methods

Four online focus groups with 24 adolescents aged 13-17 years from four German federal states were conducted during the COVID-19 pandemic in May and June 2021. Data were analyzed using qualitative content analysis.

Results

Regarding the cognitive and behavioral components of pandemic-related health literacy, adolescents reported to use a broad range of traditional and digital media and personal information sources. The adolescents considered pandemic-related information to be good and easy to understand, when the information is presented in a concise and structured manner. The participants stated difficulties in finding, understanding, and evaluating pandemic-related information regarding particular protective measures. The adolescents described themselves to be critical when evaluating pandemic-related information and reported a high level of adherence to protective measures. Regarding the conative and affective components of health literacy, the adolescents explained that their wish to protect their loved ones from getting infected was the predominant motive for adherence to protective measures. They were convinced that people of their age play a role in pandemic containment. The adolescents reported sometimes making exceptions from adhering to protective measures to cope with negative feelings they experienced during the pandemic.

Conclusions

This study provides insights on how measures to improve pandemic-related health literacy among adolescents may be tailored to their needs. Prompt, concise, structured, and comprehensible preparation and communication of pandemic-related information in addition to educational efforts to strengthen health-related cognitive skills and critical health literacy may be supportive to reduce barriers in finding, understanding, and evaluating pandemic-related content.
Impact of vancomycin use trend change due to the availability of alternative antibiotics on the prevalence of Staphylococcus aureus with reduced vancomycin susceptibility: a 14-year retrospective study
Authors: Kang Yu Ri , Kim Si-Ho , Chung Doo Ryeon , Ko Jae-Hoon , Huh Kyungmin , Cho Sun Young , Kang Cheol-In , Peck Kyong Ran
Published: August 2022

Background

We investigated the trend change in vancomycin-intermediate Staphylococcus aureus (VISA)/heterogeneous VISA (hVISA) prevalence among methicillin-resistant S. aureus (MRSA) bacteremia strains and antistaphylococcal antibiotic use together with mutation studies of vancomycin resistance-related gene loci to evaluate the impact of changes in antibiotic use after new antistaphylococcal antibiotics became available.

Methods

Among 850 healthcare-associated MRSA isolates from 2006 to 2019 at a tertiary hospital in South Korea, hVISA/VISA was determined by modified PAP/AUC analysis, and the identified hVISA/VISA strains were genotyped. Gene mutations at vraSR, graSR, walKR, and rpoB were studied by full-length sequencing. Antistaphylococcal antibiotic use in 2005–2018 was analyzed.

Results

Two VISA and 23 hVISA strains were identified. The prevalence rate ratio of hVISA/VISA carrying mutations at the two-component regulatory systems among MRSA was 0.668 (95% CI 0.531–0.841; P = 0.001), and the prevalence rate ratio of hVISA/VISA carrying rpoB gene mutations was 1.293 (95% CI 0.981–1.702; 174 P = 0.068). Annual vancomycin use density analyzed by days of therapy (DOT) per 1,000 patient-days did not decrease significantly, however the annual average length of time analyzed by the number of days vancomycin was administered for each case showed a significantly decreasing trend.

Conclusions

During the 14-year period when the average length of vancomycin therapy decreased every year with the availability of alternative antibiotics, the prevalence of hVISA/VISA did not decrease significantly. This seems to be because the resistant strains carrying the rpoB mutations increased despite the decrease in the strains carrying the mutations at the two-component regulatory systems.
The role of policies in transforming regional fiscal structures: an exploratory analysis of spatial data from a policy of fiscal decentralization in Latin America
Authors: Fernández-Marín Juan Camilo , de Oliveira Nadja Simone Menezes Nery , Mourao Paulo
Published: August 2022

One of the goals of decentralized policies is to consider the differences between regions and municipalities, which can lead to greater economic growth as well as greater economic development in all areas. However, endogenous limitations should also be overcome. For these purposes, policies have been designed and must therefore be evaluated in terms of the consequences. One of the most ambitious policies in Latin America in recent years has been the implementation of the ‘General Regalías system’ in Colombia. This paper will assess whether this policy has led to significant changes in the fiscal performance of the municipalities in the Valle del Cauca region, in which the most important city is Cali. We found that this policy was not able to change the ‘neighborhood contagion’ observed before implementation. This is an important conclusion of the study, which includes the spatial dependence to explain the fiscal performance of the municipalities. Through an exploratory analysis of spatial data (AEDE), we verified that the referenced system failed to reach its most ambitious objectives, raising the need for another type of public policy instrument.
Consumer preferences for wild game meat: evidence from a hybrid choice model on wild boar meat in Italy
Authors: Fantechi Tommaso , Contini Caterina , Scozzafava Gabriele , Casini Leonardo
Published: August 2022

The increasing numbers of wild animals in Europe is leading, on the one hand, to growing problems stemming from their interaction with human activities. On the other, many European countries have still not developed national supply chains to market wild game. Instead, these supply chains could represent a win–win strategy in providing a sustainable alternative to production via intensive livestock farming and developing rural territories. Our aim was to understand consumer behaviour towards wild game meat. We conducted a choice experiment on wild boar meat on a sample of Italian consumers (625). The application of a hybrid model combining a structural equation model and a latent class analysis allowed us to identify the antecedents of attitude towards wild game meat and to analyse consumer choices by utilising attitude as an explanatory variable. The results provide useful suggestions to implement rural development policies and offer food for thought in the area of consumer behaviour.
Dominant changes in the breast muscle lipid profiles of broiler chickens with wooden breast syndrome revealed by lipidomics analyses
Authors: Liu Ranran , Kong Fuli , Xing Siyuan , He Zhengxiao , Bai Lu , Sun Jiahong , Tan Xiaodong , Zhao Di , Zhao Guiping , Wen Jie
Published: August 2022

Background

Chicken is the most consumed meat worldwide and the industry has been facing challenging myopathies. Wooden breast (WB), which is often accompanied by white striping (WS), is a serious myopathy adversely affecting meat quality of breast muscles. The underlying lipid metabolic mechanism of WB affected broilers is not fully understood.

Results

A total of 150 chickens of a white-feathered, fast-growing pure line were raised and used for the selection of WB, WB + WS and control chickens. The lipids of the breast muscle, liver, and serum from different chickens were extracted and measured using ultra performance liquid chromatography (UPLC) plus Q-Exactive Orbitrap tandem mass spectrometry. In the breast, 560 lipid molecules were identified. Compared to controls, 225/225 of 560 lipid molecules (40.2%) were identified with differential abundance (DA), including 92/100 significantly increased neutral lipids and 107/98 decreased phospholipids in the WB/WB + WS groups, respectively. The content of monounsaturated fatty acids (MUFA) was significantly higher, and the polyunsaturated fatty acids (PUFA) and saturated fatty acids (SFA) were significantly lower in the affected breasts. In the liver, 434 lipid molecules were identified, and 39/61 DA lipid molecules (6.7%/14.1%) were detected in the WB and WB + WS groups, respectively. In the serum, a total of 529 lipid molecules were identified and 4/44 DA lipid molecules (0.8%/8.3%) were detected in WB and WB + WS group, respectively. Compared to controls, the content of MUFAs in the serum and breast of the WB + WS group were both significantly increased, and the content of SFAs in two tissues were both significantly decreased. Only five lipid molecules were consistently increased in both liver and serum in WB + WS group.

Conclusions

We have found for the first time that the dominant lipid profile alterations occurred in the affected breast muscle. The relative abundance of 40.2% of lipid molecules were changed and is characteristic of increased neutral lipids and decreased phospholipids in the affected breasts. Minor changes of lipid profiles in the liver and serum of the affected groups were founded. Comprehensive analysis of body lipid metabolism indicated that the abnormal lipid profile of WB breast may be independent of the liver metabolism.
Critical aspiration pneumonia during induction of anesthesia in elective abdominal surgery: a case report
Authors: Mogami Midori , Yamazaki Yuki , Nemoto Chiaki , Muto Mariko , Tanaka Youichi , Inoue Satoki
Published: August 2022

Background

We experienced the critical aspiration pneumonia during induction of anesthesia in elective abdominal surgery which standard fasting period was complied with.

Case presentation

A 64-year-old male was scheduled for gastrojejunostomy because of gastrointestinal obstruction. He fasted from the night before surgery. General anesthesia was induced, and cricoid pressure was applied during intubation. However, he vomited huge amount of gastric contents. The scheduled surgery was performed without surgical complications, and postoperatively respiratory management, including mechanical ventilation with prone positioning, was performed in high care unit. He was extubated on postoperative day 2. He was discharged from the hospital on POD 25.

Conclusion

The standard fasting period can prevent aspiration pneumonia in most cases. However, even in elective cases without abdominal symptoms, we consider that massive-volume gastric residual contents, especially in susceptible cases. We suggest that point-of-care gastric ultrasonography be performed in suspicious cases before induction of anesthesia.
Typing expertise in a large student population
Authors: Pinet Svetlana , Zielinski Christelle , Alario F.-Xavier , Longcamp Marieke
Published: August 2022

Typing has become a pervasive mode of language production worldwide, with keyboards fully integrated in a large part of many daily activities. The bulk of the literature on typing expertise concerns highly trained professional touch-typists, but contemporary typing skills mostly result from unconstrained sustained practice. We measured the typing performance of a large cohort of 1301 university students through an online platform and followed a preregistered plan to analyse performance distributions, practice factors, and cognitive variables. The results suggest that the standard model with a sharp distinction between novice and expert typists may be inaccurate to account for the performance of the current generation of young typists. More generally, this study shows how the mere frequent use of a new tool can lead to the incidental development of high expertise.
A soft actor-critic deep reinforcement learning method for multi-timescale coordinated operation of microgrids
Authors: Hu Chunchao , Cai Zexiang , Zhang Yanxu , Yan Rudai , Cai Yu , Cen Bowei
Published: August 2022

This paper develops a multi-timescale coordinated operation method for microgrids based on modern deep reinforcement learning. Considering the complementary characteristics of different storage devices, the proposed approach achieves multi-timescale coordination of battery and supercapacitor by introducing a hierarchical two-stage dispatch model. The first stage makes an initial decision irrespective of the uncertainties using the hourly predicted data to minimize the operational cost. For the second stage, it aims to generate corrective actions for the first-stage decisions to compensate for real-time renewable generation fluctuations. The first stage is formulated as a non-convex deterministic optimization problem, while the second stage is modeled as a Markov decision process solved by an entropy-regularized deep reinforcement learning method, i.e., the Soft Actor-Critic. The Soft Actor-Critic method can efficiently address the exploration–exploitation dilemma and suppress variations. This improves the robustness of decisions. Simulation results demonstrate that different types of energy storage devices can be used at two stages to achieve the multi-timescale coordinated operation. This proves the effectiveness of the proposed method.
Cannabis consumption is associated with lower COVID-19 severity among hospitalized patients: a retrospective cohort analysis
Authors: Shover Carolyn M. , Yan Peter , Jackson Nicholas J. , Buhr Russell G. , Fulcher Jennifer A. , Tashkin Donald P. , Barjaktarevic Igor
Published: August 2022

Background

While cannabis is known to have immunomodulatory properties, the clinical consequences of its use on outcomes in COVID-19 have not been extensively evaluated. We aimed to assess whether cannabis users hospitalized for COVID-19 had improved outcomes compared to non-users.

Methods

We conducted a retrospective analysis of 1831 patients admitted to two medical centers in Southern California with a diagnosis of COVID-19. We evaluated outcomes including NIH COVID-19 Severity Score, need for supplemental oxygen, ICU (intensive care unit) admission, mechanical ventilation, length of hospitalization, and in-hospital death for cannabis users and non-users. Cannabis use was reported in the patient’s social history. Propensity matching was used to account for differences in age, body-mass index, sex, race, tobacco smoking history, and comorbidities known to be risk factors for COVID-19 mortality between cannabis users and non-users.

Results

Of 1831 patients admitted with COVID-19, 69 patients reported active cannabis use (4% of the cohort). Active users were younger (44 years vs. 62 years, p < 0.001), less often diabetic (23.2% vs 37.2%, p < 0.021), and more frequently active tobacco smokers (20.3% vs. 4.1%, p < 0.001) compared to non-users. Notably, active users had lower levels of inflammatory markers upon admission than non-users—CRP (C-reactive protein) (3.7 mg/L vs 7.6 mg/L, p < 0.001), ferritin (282 μg/L vs 622 μg/L, p < 0.001), D-dimer (468 ng/mL vs 1140 ng/mL, p = 0.017), and procalcitonin (0.10 ng/mL vs 0.15 ng/mL, p = 0.001). Based on univariate analysis, cannabis users had significantly better outcomes compared to non-users as reflected in lower NIH scores (5.1 vs 6.0, p < 0.001), shorter hospitalization (4 days vs 6 days, p < 0.001), lower ICU admission rates (12% vs 31%, p < 0.001), and less need for mechanical ventilation (6% vs 17%, p = 0.027). Using propensity matching, differences in overall survival were not statistically significant between cannabis users and non-users, nevertheless ICU admission was 12 percentage points lower (p = 0.018) and intubation rates were 6 percentage points lower (p = 0.017) in cannabis users.

Conclusions

This retrospective cohort study suggests that active cannabis users hospitalized with COVID-19 had better clinical outcomes compared with non-users, including decreased need for ICU admission or mechanical ventilation. However, our results need to be interpreted with caution given the limitations of a retrospective analysis. Prospective and observational studies will better elucidate the effects cannabis use in COVID-19 patients.
Gut microbiome reflect adaptation of earthworms to cave and surface environments
Authors: Gong Xin , Chen Ting-Wen , Zhang Lili , Pižl Václav , Tajovský Karel , Devetter Miloslav
Published: August 2022

Background

Caves are special natural laboratories for most biota and the cave communities are unique. Establishing population in cave is accompanied with modifications in adaptability for most animals. To date, little is known about the survival mechanisms of soil animals in cave environments, albeit they play vital roles in most terrestrial ecosystems. Here, we investigated whether and how gut microbes would contribute to the adaptation of earthworms by comparing the gut microbiome of two earthworm species from the surface and caves.

Results

Two dominant earthworm species inhabited caves, i.e., Allolobophora chlorotica and Aporrectodea rosea. Compared with the counterparts on the surface, A. rosea significantly decreased population in the cave, while A. chlorotica didn’t change. Microbial taxonomic and phylogenetic diversities between the earthworm gut and soil environment were asynchronic with functional diversity, with functional gene diversity been always higher in earthworm gut than in soil, but species richness and phylogenetic diversity lower. In addition, earthworm gut microbiome were characterized by higher rrn operon numbers and lower network complexity than soil microbiota.

Conclusions

Different fitness of the two earthworm species in cave is likely to coincide with gut microbiota, suggesting interactions between host and gut microbiome are essential for soil animals in adapting to new environments. The functional gene diversity provided by gut microbiome is more important than taxonomic or phylogenetic diversity in regulating host adaptability. A stable and high-efficient gut microbiome, including microbiota and metabolism genes, encoded potential functions required by the animal hosts during the processes of adapting to and establishing in the cave environments. Our study also demonstrates how the applications of microbial functional traits analysis may advance our understanding of animal-microbe interactions that may aid animals to survive in extreme ecosystems.
Revisiting imaging features of rectosigmoid vascular malformation with emphasis on multiparametric MRI: a case report
Authors: Erdemli S. , Alis D. , Çiçek B. , Göksel S. , Karahasanoğlu T. , Karaarslan E.
Published: August 2022

Background

Gastrointestinal vascular malformations are rare benign vascular neoplasms of the gastrointestinal tract, with the rectosigmoid region being the most frequently involved site. Patients often manifest with recurrent, intermittent rectal bleeding, which might occasionally be life-threatening.

Case presentation

A 39-year-old man with a history of hemorrhoid operations twice was presented to our gastroenterology department with blood in the stool and abdominal pain. After the colonoscopy, multiparametric MRI, and CT examinations, robotic low anterior resection was performed with the diagnosis of rectosigmoid venous malformation. The histopathological examination confirmed the diagnosis.

Conclusion

Colonoscopy is the preferred method in diagnosing rectosigmoid vascular malformation, but wrong and delayed diagnoses are common. Thus, imaging modalities might add to colonoscopy in equivocal cases.
Palliative care models for patients living with advanced cancer: a narrative review for the emergency department clinician
Authors: Grudzen Corita R. , Barker Paige C. , Bischof Jason J. , Cuthel Allison M. , Isaacs Eric D. , Southerland Lauren T. , Yamarik Rebecca L.
Published: August 2022

Eighty-one percent of persons living with cancer have an emergency department (ED) visit within the last 6 months of life. Many cancer patients in the ED are at an advanced stage with high symptom burden and complex needs, and over half is admitted to an inpatient setting. Innovative models of care have been developed to provide high quality, ambulatory, and home-based care to persons living with serious, life-limiting illness, such as advanced cancer. New care models can be divided into a number of categories based on either prognosis (e.g., greater than or less than 6 months), or level of care (e.g., lower versus higher intensity needs, such as intravenous pain/nausea medication or frequent monitoring), and goals of care (e.g., cancer-directed treatment versus symptom-focused care only). We performed a narrative review to (1) compare models of care for seriously ill cancer patients in the ED and (2) examine factors that may hasten or impede wider dissemination of these models.
Partial Breast Irradiation Versus Whole Breast Irradiation for Early Breast Cancer Patients in a Randomized Phase III Trial: The Danish Breast Cancer Group Partial Breast Irradiation Trial
Authors: Offersen Birgitte V. , Alsner Jan , Nielsen Hanne M. , Jakobsen Erik H. , Nielsen Mette H. , Stenbygaard Lars , Pedersen Anders N. , Thomsen Mette S. , Yates Esben , Berg Martin , Lorenzen Ebbe L. , Jensen Ingelise , Josipovic Mirjana , Jensen Maj-Britt , Overgaard Jens ,   on behalf of the Danish Breast Cancer Group Radiotherapy Committee
Published: August 2022

PURPOSE

On the basis of low risk of local recurrence in elderly patients with breast cancer after conservative surgery followed by whole breast irradiation (WBI), the Danish Breast Cancer Group initiated the noninferiority external-beam partial breast irradiation (PBI) trial (ClinicalTrials.gov identifier: NCT00892814 ). We hypothesized that PBI was noninferior to WBI regarding breast induration.

METHODS

Patients operated with breast conservation for relatively low-risk breast cancer were randomly assigned to WBI versus PBI, and all had 40 Gy/15 fractions. The primary end point was 3-year grade 2-3 breast induration.

RESULTS

In total, 865 evaluable patients (434 WBI and 431 PBI) were enrolled between 2009 and 2016. Median follow-up was 5.0 years (morbidity) and 7.6 years (locoregional recurrence). The 3-year rate of induration was 9.7% for WBI and 5.1% for PBI ( P = .014). Large breast size was significantly associated with induration with a 3-year incidence of 13% (WBI) and 6% (PBI) for large-breasted patients versus 6% (WBI) and 5% (PBI) for small-breasted patients. PBI showed no increased risk of dyspigmentation, telangiectasia, edema, or pain, and patient satisfaction was high. Letrozole and smoking did not increase the risk of radiation-associated morbidity. Sixteen patients had a locoregional recurrence (six WBI and 10 PBI; P = .28), 20 patients had a contralateral breast cancer, and eight patients had distant failure (five WBI and three PBI). A nonbreast second cancer was detected in 73 patients (8.4%), and there was no difference between groups.

CONCLUSION

External-beam PBI for patients with low-risk breast cancer was noninferior to WBI in terms of breast induration. Large breast size was a risk factor for radiation-associated induration. Few recurrences were detected and unrelated to PBI.
Racial and Ethnic Health Disparities in Delay to Initiation of Intensity-Modulated Radiotherapy
Authors: Hutten Ryan J. , Weil Christopher R. , Gaffney David K. , Kokeny Kristine , Lloyd Shane , Rogers Charles R. , Suneja Gita
Published: August 2022

PURPOSE:

Delays in initiation of radiotherapy may contribute to inferior oncologic outcomes that are more commonly observed in minoritized populations in the United States. We aimed to examine inequities associated with delayed initiation of intensity-modulated radiotherapy (IMRT).

MATERIALS AND METHODS:

The National Cancer Database was queried to identify the 10 cancer sites most commonly treated with IMRT. Interval to initiation of treatment (IIT) was broken into quartiles for each disease site, with the 4thquartile classified as delayed. Multivariable logistic regression for delayed IIT was performed for each disease site using clinical and demographic covariates. Differences in magnitude of delay between subsets of patients stratified by race and insurance status were evaluated using two-sample t-tests.

RESULTS:

Among patients (n = 350,425) treated with IMRT between 2004 and 2017, non-Hispanic Black (NHB), Hispanic, and Asian patients were significantly more likely to have delayed IIT with IMRT for nearly all disease sites compared with non-Hispanic White (NHW) patients. NHB, Hispanic, and Asian patients had significantly longer median IIT than NHW patients (NHB 87 days, P < .01; Hispanic 76 days, P < .01; Asian 74 days, P < .01; and NHW 67 days). NHW, Hispanic, and Asian patients with private insurance had shorter median IIT than those with Medicare ( P < .01); however, NHB patients with private insurance had longer IIT than those with Medicare ( P < .01).

CONCLUSION:

Delays in initiation of IMRT in NHB, Hispanic, and Asian patients may contribute to the known differences in cancer outcomes and warrant further investigation, particularly to further clarify the role of different insurance policies in delays in advanced modality radiotherapy.
Effects of Wnt-β-Catenin Signaling and Sclerostin on the Phenotypes of Rat Pheochromocytoma PC12 Cells
Authors: Morimoto Eisaku , Inagaki Kenichi , Komatsubara Motoshi , Terasaka Tomohiro , Itoh Yoshihiko , Fujisawa Satoshi , Sasaki Erika , Nishiyama Yuki , Hara Takayuki , Wada Jun
Published: August 2022

Pheochromocytomas and paragangliomas (PPGLs) are classified into 3 major categories with distinct driver genes: pseudohypoxia, kinase signaling, and Wnt-altered subtypes. PPGLs in the Wnt-altered subtype are sporadic and tend to be aggressive with metastasis, where somatic gene fusions affecting mastermind-like 3 (MAML3) and somatic mutations in cold shock domain containing E1 (CSDE1) cause overactivation of Wnt-β-catenin signaling. However, the relation between Wnt-β-catenin signaling and the biological behavior of PPGLs remains unexplored. In rat pheochromocytoma PC12 cells, Wnt3a treatment enhanced cell proliferation and suppressed mRNA expression of tyrosine hydroxylase (TH), the rate-limiting enzyme of catecholamine biosynthesis, and dopamine secretion. We identified the expression of sclerostin in PC12 cells, which is known as an osteocyte-derived negative regulator for Wnt signaling-driven bone formation. Inhibition of endogenous Wnt pathway by XAV939 or sclerostin resulted in attenuated cell proliferation and increased TH expression. Furthermore, Wnt3a pretreatment suppressed bone morphogenetic protein (BMP)-induced Smad1/5/9 phosphorylation whereas BMPs enhanced sclerostin expression in PC12 cells. In the Wnt-altered subtype, the increased Wnt-β-catenin pathway may contribute the aggressive clinical behavior with reduced catecholamine production. Furthermore, upregulated expression of sclerostin by BMPs may explain the osteolytic metastatic lesions observed in metastatic PPGLs.
Orderly Obsolescence: The Decline of /hw/ in Ontario
Authors: Needle Jeremy M. , Tagliamonte Sali A.
Published: August 2022

The loss of /hw/ in English in words like where and wheat is virtually complete in contemporary North American English, though /hw/ has lingered in Ontario, Canada. For vernacular speech from Almonte and Parry Sound, the authors analyze the decline of /hw/ in apparent time among individuals born from the 1880s to the 1950s. They place these observations within the field of language obsolescence and suggest that Parry Sound and Almonte are examples of intermediate isolation, less profound than is typical in studies of dialect loss. Almonte has retained /hw/ much longer than Parry Sound; this pattern parallels the greater share of /hw/-ful Scots and Irish speakers in Almonte’s early immigration and accords with Parry Sound’s increased outside contact due to a rising tourism industry. Both communities uniformly exhibit more /hw/ in content words than in function words as the feature recedes to total absence for speakers born in the 1950s. This pattern is an example of linguistic order persisting during obsolescence.
Cars, Debt, and Carcerality
Authors: Livingston Julie , Ross Andrew
Published: August 2022

Consumer lore in the United States celebrates the automobile as a “freedom machine,” consecrating the mobility of a free people. Yet, paradoxically, the car also functions at the crossroads of two great systems of unfreedom and immobility—the debt economy and the carceral state. Drawing on interviews with formerly incarcerated people, this article investigates this paradox in detail, tracing how the long arms of carcerality and debt operate in tandem in the daily life of car use and ownership. It describes the ways in which credit dovetails with capture—pretextual traffic stops, revenue policing from fines and fees, the overreach of automobile-related surveillance, the predatory auto loan and repossession businesses, and criminal justice debt—all shot through with profound racial bias. In the autocentric United States, transportation is a basic need, yet it has never been recognized or funded as a public good. As the “age of mobility” beckons, with autonomous driving as its technological centerpiece, the authors call for the social liberation of the automobile. From the outset, the automobile has traded on the romance of the open road, but it has too long served as a vehicle of inequality and injustice.
Herculean Unproductivity in Pasolini's La ricotta and Teorema
Authors: Velásquez Juan C.
Published: August 2022

This article examines the relationship between work, capitalist productivity, and the filmmaking practice of Pier Paolo Pasolini. This article examines how Pasolini's La ricotta and Teorema represent an interruption of labor and a contestation of the disciplining mechanisms that compel workers to work. Recuperating Jean-François Lyotard's concept of acinema, this inquiry suggests that Pasolini creates scenes that oppose the capitalist work ethic through formal techniques associated with immobility and contingency. It deploys Hannah Arendt's concept of action and Jacques Rancière's dissensus to describe workers’ political actions in these films as gestures where they shed their identity as workers to enjoy life as humans. The purpose of this intervention is to reframe academic debates of anticapitalism around workers’ desire not to work. Pasolini's films give viewers images that highlight workers’ unproductive potentials, thereby giving them examples of immobile, nonwork dissensual actions, or Herculean unproductivity.
Comic Socrates?
Authors: Diken Bülent , Laustsen Carsten Bagge
Published: August 2022

In the Clouds, Aristophanes apparently ridicules Socratic philosophy as a useless, essentially passive preoccupation, which, “twisted” in the wrong hands, can seriously harm the City. But such an instrumentalist reading of the Clouds (and of philosophy) misses a crucial point regarding the relation between philosophy and comedy. Insofar as philosophy, love of wisdom, is irreducible to wisdom—insofar as, in other words, philosophy is also a matter of taste (a concept which seeks to combine knowledge and pleasure)—the Clouds can be read as an ironic-comic defense of philosophy. To discuss this, the article reads the Clouds in the perspective of free use. This reading makes it possible to articulate two distinct but related senses of perverting philosophy, which are evidenced with material from within the play: the reduction of reason to instrumental reason and/or to state philosophy. To end with, the article discusses the relationship between comedy and philosophy in more general terms.
The development of a digital twin concept system
Authors: Duan Hyman , Gao Su , Yang Xu , Li Yuanlin
Published: August 2022

Background: Digital twins are gaining ever-increasing attention from academies and industries to standardization bodies all over the world owing to their great capabilities and fundamental values in the coming fourth industrial revolution. However, there is no consistent set of definitions or concept system for the digital twin domain yet.

Methods: This paper summarizes the methodology of developing a concept system with integrating ISO standards guidelines and system thinking methods, analyzes the polysemy phenomenon of the term "digital twin", and identifies the necessity to differentiate digital twin entity and digital twin system from the general term “digital twin”.

Results: After analyzing nineteen definitions of digital twin (entity) and summarizing ten superordinate concepts from these definitions, this paper proposes that a digital twin entity is a kind of digital asset rather than digital representation. Based on the new superordinate concept and definition of digital twin entity, a systematic digital twin concept system is developed which consists of four parts: top-level ontology and taxonomy of entity, digital twin entity related concepts, digital twin system related concepts, and taxonomy framework related concepts.

Conclusions: This work demonstrates the power and effectiveness of the combination of ISO terminology work standards, system thinking methods, and information modeling tools, lays a solid foundation for future concept systems development of other domains, and will provide useful input to the efforts of digital twin standardization.
Summary of 10 years of work of an outpatient therapeutic group conducted using the psychodrama method.
Authors: Borowiec Mateusz
Published: August 2022

Celem pracy jest przedstawienie użyteczności ambulatoryjnej psychoterapii grupowej metodą psychodramy. Opisano historyczny rozwój terapii grupowej, szczególnie metody psychodramy stworzonej 100 lat temu przez Jacoba L. Moreno. Omówiono założenia teoretyczne leżące u podłoża tej metody wywodzące się z filozofii egzystencjalnej — teorię spotkania Martina Bubera oraz teorię spontaniczności i kreatywności, a także wywiedzioną z tej filozofii specyficzną dla psychodramy metodę zamiany ról. Wyróżniono najważniejsze mechanizmy leczące w psychodramie: doświadczenie reparacyjne, wykorzystanie rzeczywistości poszerzonej, doświadczenie katharsis, przeżycie emocjonalnej wspólnoty z grupą, wypróbowywanie nowych ról, trening ról społecznych, transformację wewnętrznych ról, rozszerzenie świadomości i większy wgląd w siebie zawdzięczany feedbackowi. Praktykę psychodramy przybliżono przedstawiając model funkcjonowania ambulatoryjnej grupy terapeutycznej współprowadzonej przez autora od 10 lat. Omówiono poszczególne fazy sesji psychodramatycznej: puls, rozgrzewkę, grę na scenie, sharing i feedback z ról. Zjawiska i procesy zachodzące w psychodramie zilustrowano materiałem klinicznym — opisem przebiegu 4-godzinnej sesji psychodramy.