bluuebunny/crossref_metadata_2025 huggingface dataset:
A Mental Workload Evaluation Model Based on Improved Multibranch LSTM Network with Attention Mechanism
Authors: Zhang Hongning
Published: May 2022

People’s study, life, and work pressures have increased dramatically in recent years, as the pace of life has accelerated. Long-term high mental stress causes physiological secretion dysfunction and decreased immunity, resulting in a variety of diseases and even the risk of karoshi. Mental workload is another important factor that contributes to mental illness. Accurate assessment of mental workload is a method of effectively coping with physical and mental illness. Traditional physiological indicator measurement is inaccurate because changes caused by physiological indicators may not be solely due to psychological factors. As a result, based on the long short-term memory network, this paper proposes a mental workload evaluation model of multibranch LSTM with attention mechanism (LSTM). This model introduces an attention mechanism based on the classic LSTM network, which can screen the features differently, not only improving the utilization of effective information but also reducing calculation parameters and simplifying the model. This study employs a multibranch LSTM to improve the network’s generalization performance and stability. The basic idea behind multibranch LSTM is to train the branch LSTM network model separately using a variety of data, resulting in a branch LSTM network with a specific structure for the input EEG data. Finally, a total prediction result is obtained by combining the prediction outputs of multiple branch LSTM networks, which is used as the final mental workload evaluation result. The experimental results show that the model used in this paper has higher accuracy and more stable evaluation results in assessing psychological load. This study has a certain amount of reference value.
Application Research in Computer Vision Signature Encryption System of Enterprise Contract Economic Management
Authors: Sun Feifei , Shi Guohong
Published: May 2022

This paper mainly proposes a nonrepudiation digital signature authentication scheme based on an enterprise contract computer vision system. Based on the RSA algorithm and MD5 message-digest algorithm, a digital signature scheme of enterprise economic contract based on IC card is proposed. The method realizes digital signature and ensures the confidentiality of the transmitted data. Finally, this paper proposes a concrete digital signature experiment system implemented in Java. The results of this study show that the computer vision signature encryption system helps to improve the reliability of the system.
Analysis of Pregnancy Outcomes after Laparoscopic Myomectomy: A Retrospective Cohort Study
Authors: Lu Bilu , Wang Qingming , Yan Lifeng , Yu Kewen , Cai Yan
Published: May 2022

Objective. This study aimed to investigate the factors related to pregnancy outcomes after laparoscopic myomectomy. Methods. A retrospective review was conducted on 156 patients aged 18 to 45 years who underwent laparoscopic myomectomy in Ningbo Women and Children’s Hospital from January 2010 to December 2016. Follow-up medical records and information were collected on demographic variables, clinical variables, and postoperative pregnancy rate. The logistic regression model was used to assess the association between related factors and postoperative pregnancy rate or pregnancy outcome. The outcome indicators included

abortion
=
0

,

premature
 
birth
=
1

, and

full
 
term
=
2

. The chi-squared test or Fisher’s exact test was used to compare the differences in pregnancy outcomes, postpartum hemorrhage, and placenta adhesion between the cohorts. Results. The size of fibroids correlated with the postoperative pregnancy rate. The larger the fibroids, the lower the postoperative pregnancy rate, and the difference was statistically significant. The number of fibroids and placental adhesions was positively associated with postoperative pregnancy; the higher the number of fibroids, the higher the incidence of placental adhesions. However, the postoperative interval of pregnancy, fibroid size, and number and type of fibroids are not correlated with the pregnancy outcomes of postoperative patients. Conclusions. The size of myoma may influence the pregnancy rate of patients after laparoscopic myomectomy. The number of fibroids can affect the incidence of placental adhesions during postoperative pregnancy.
An Integrated Framework for Mapping Nationwide Daily Temperature in China
Authors: Zhong Shaobo , Ye Xinlan , Wang Mingxing , Mei Xin , Song Dunjiang , Wang Wenhui
Published: May 2022

Air temperature (Ta) is an essential parameter for science research and engineering practice. While the traditional site-based approach is only able to obtain observations in limited and discrete locations, satellite remote sensing is promising to retrieve some environmental variables with spatially continuous coverage. Nowadays, land surface temperature (Ts) measurements can be obtained from some satellite sensors (e.g., MODIS), further enabling us to estimate Ta in view of the relationship between Ta and Ts. In this article, we proposed a two-phase integrated framework to estimate daily mean Ta nationwide. In the first phase, multivariate linear regression models were fitted between site-based observations of daily mean air temperature (Ta-mean) and MODIS land surface temperature products (including Terra day: TMOD-day, Terra night: TMOD-night, Aqua day: TMYD-day, and Aqua night: TMYD-night) conditional on some covariates of environmental factors. The fitted models were then used to predict Ta-mean from those covariates at unobserved locations. The predicted Ta-mean were looked on as stochastic variables, and their distributions were also obtained. In the second phase, Bayesian maximum entropy (BME) methods were used to produce spatially continuous maps of Ta-mean taking the meteorological station observations as hard data and the predicted Ta-mean in the first phase as soft data. It is shown that the proposed approach is promising to improve the interpolation accuracy significantly, comprehensively considering the prior knowledge and the context of space variability and correlation, which will enable it to compile spatially continuous air temperature products with higher accuracy.
Anxiety-like behavior and anxiolytic treatment in the Rett syndrome natural history study
Authors: Buchanan Caroline B. , Stallworth Jennifer L. , Joy Aubin E. , Dixon Rebekah E. , Scott Alexandra E. , Beisang Arthur A. , Benke Timothy A. , Glaze Daniel G. , Haas Richard H. , Heydemann Peter T. , Jones Mary D. , Lane Jane B. , Lieberman David N. , Marsh Eric D. , Neul Jeffrey L. , Peters Sarika U. , Ryther Robin C. , Skinner Steve A. , Standridge Shannon M. , Kaufmann Walter E. , Percy Alan K.
Published: May 2022

Background

Rett syndrome (RTT) is a neurodevelopmental disorder most often related to a pathogenic variant in the X-linked MECP2 gene. Internalizing behaviors appear to be common, but standard methods of diagnosing anxiety are not readily applied in this population which typically has cognitive impairment and limited expressive language. This study aims to describe the frequency of anxiety-like behavior and anxiolytic treatments along with associated clinical features in individuals with RTT.

Methods

Parental reports and medication logs provided data from 1380 females with RTT participating in two iterations of the multicenter U.S. RTT Natural History Study (RNHS) from 2006 to 2019.

Results

Most participants with RTT (77.5%) had at least occasional anxious or nervous behavior. Anxiety was reported to be the most troublesome concern for 2.6%, and within the top 3 concerns for 10.0%, of participants in the second iteration. Parents directly reported treatment for anxious or nervous behavior in 16.6% of participants in the second iteration with most reporting good control of the behavior (71.6%). In the medication logs of both RNHS iterations, the indication of anxiety was listed for a similar number of participants (15% and 14.5%, respectively). Increased use of anxiolytics and selective serotonin reuptake inhibitors (SSRIs) was related to more frequent anxiety-like behaviors (P < 0.001), older age (P < 0.001), and mild MECP2 variants (P = 0.002).

Conclusion

Anxiety-like behavior is frequent at all ages and is a significant parental concern in RTT. Older individuals and those with mild MECP2 variants are more likely to be treated with medications. Better diagnosis and treatment of anxiety in RTT should be a goal of both future studies and clinical care.

Trial registration

NCT00299312 and NCT02738281
Label-free LC–MS/MS proteomics analyses reveal proteomic changes in oxidative stress and the SOD antioxidant strategy in TM cells
Authors: Li Qian , Zhang Liyu , Xu Yuxin
Published: May 2022

Background

Treatment for glaucoma has traditionally been limited to reducing intraocular pressure (IOP). Inhibiting oxidative stress in the trabecular meshwork (TM) is regarded as a new treatment for glaucoma; however, the effects do not meet expectations. Exploring the mechanism by which oxidative stress and antioxidant stress occur in TM cells will offer clues to aid the development of new treatments.

Methods and results

In our study, we cultured TM cells and used H2O2 and SOD to induce and inhibit oxidative stress, respectively. Label-free LC–MS/MS quantitative proteomic analysis was conducted to analyze the differentially expressed proteins and relevant signaling pathways. A total of 24 upregulated proteins and 18 downregulated proteins were identified under oxidative stress. PTGS2, TGFβr2 and ICAM-1 are the key proteins. The PTGS2/NF-ĸb pathway, TGF-β/Smad signaling pathway and AGE-RAGE signaling pathway in diabetic complications may be the major signaling pathways under conditions of ROS-induced damage in TM cells. Seventy-eight proteins were upregulated and 73 proteins were downregulated under antioxidant stress in TM cells. The key protein was ICAM-1, which participates in the African trypanosomiasis pathway, one of the most important pathways under antioxidant stress. Combining the results of the Venn diagram with protein–protein interactions (PPIs), ICAM-1 was identified as the major protein. Cell Counting Kit-8 (CCK-8) and western blotting (WB) were used to reveal that suppressing the expression of ICAM-1 would improve the survival of TM cells.

Conclusions

Key proteins and signaling pathways play important roles in the mechanisms of oxidative stress and antioxidant strategies in TM cells. ICAM-1 knockdown can suppress the apoptosis of TM cells induced by H2O2, which may reveal new therapeutic targets and biomarkers for glaucoma.
Transcriptome profiling and proteomic validation reveals targets of the androgen receptor signaling in the BT-474 breast cancer cell line
Authors: Vasiliou Stella K. , Filippou Panagiota S. , Clotet-Freixas Sergi , Soosaipillai Antoninus , Batruch Ihor , Viktor Tsianos Foivos , Konvalinka Ana , Diamandis Eleftherios P.
Published: May 2022

Background

Accumulating evidence suggests that the androgen receptor (AR) and its endogenous ligands influence disease progression in breast cancer (BCa). However, AR-mediated changes in BCa differ among the various BCa subtypes according to their hormone receptor profile [i.e., presence/absence of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2, (HER2)]. Thus, we explored the androgen-regulated transcriptomic changes in the ER+PR+HER2+ BCa cell line, BT-474, and compared them with PR-mediated changes.

Methods

We performed RNA sequencing analysis in treated BT-474 cells with dihydrotestosterone (DHT) and progesterone. Validation of the top ten differentially androgen-regulated genes and a number of other genes found in enriched signaling pathways was performed by qRT-PCR in BT-474 and other BCa cell lines. In addition, a parallel reaction monitoring targeted proteomic approach was developed to verify selected transcripts at the protein level.

Results

In total 19,450 transcripts were detected, of which 224 were differentially regulated after DHT treatment. The increased expression of two well-known androgen-regulated genes, KLK2 (p < 0.05) and KLK3 (p < 0.001), confirmed the successful androgen stimulation in BT-474 cells. The transcription factor, ZBTB16, was the most highly upregulated gene, with ~ 1000-fold change (p < 0.001). Pathway enrichment analysis revealed downregulation of the DNA replication processes (p < 0.05) and upregulation of the androgen signaling and fatty acid metabolism pathways (p < 0.05). Changes related to progesterone treatment showed opposite effects in gene expression than DHT treatment. Similar expression profiles were observed among other BCa cell lines expressing high levels of AR (ZR75.1 and MBA-MB-453). The parallel reaction monitoring targeted proteomic analysis further confirmed that altered protein expression (KLK3, ALOX15B) in the supernatant and cell lysate of DHT-treated BT-474 cells, compared to control cells.

Discussion

Our findings suggest that AR modulates the metabolism of BT-474 cells by affecting the expression of a large number of genes and proteins. Based on further pathway analysis, we suggest that androgen receptor acts as a tumor suppressor in the BT-474 cells.
Optimized sample preparation and data analysis for TMT proteomic analysis of cerebrospinal fluid applied to the identification of Alzheimer’s disease biomarkers
Authors: Weiner Sophia , Sauer Mathias , Visser Pieter Jelle , Tijms Betty M. , Vorontsov Egor , Blennow Kaj , Zetterberg Henrik , Gobom Johan
Published: May 2022

Background

Cerebrospinal fluid (CSF) is an important biofluid for biomarkers of neurodegenerative diseases such as Alzheimer’s disease (AD). By employing tandem mass tag (TMT) proteomics, thousands of proteins can be quantified simultaneously in large cohorts, making it a powerful tool for biomarker discovery. However, TMT proteomics in CSF is associated with analytical challenges regarding sample preparation and data processing. In this study we address those challenges ranging from data normalization over sample preparation to sample analysis.

Method

Using liquid chromatography coupled to mass-spectrometry (LC–MS), we analyzed TMT multiplex samples consisting of either identical or individual CSF samples, evaluated quantification accuracy and tested the performance of different data normalization approaches. We examined MS2 and MS3 acquisition strategies regarding accuracy of quantification and performed a comparative evaluation of filter-assisted sample preparation (FASP) and an in-solution protocol. Finally, four normalization approaches (median, quantile, Total Peptide Amount, TAMPOR) were applied to the previously published European Medical Information Framework Alzheimer’s Disease Multimodal Biomarker Discovery (EMIF-AD MBD) dataset.

Results

The correlation of measured TMT reporter ratios with spiked-in standard peptide amounts was significantly lower for TMT multiplexes composed of individual CSF samples compared with those composed of aliquots of a single CSF pool, demonstrating that the heterogeneous CSF sample composition influences TMT quantitation. Comparison of TMT reporter normalization methods showed that the correlation could be improved by applying median- and quantile-based normalization. The slope was improved by acquiring data in MS3 mode, albeit at the expense of a 29% decrease in the number of identified proteins. FASP and in-solution sample preparation of CSF samples showed a 73% overlap in identified proteins. Finally, using optimized data normalization, we present a list of 64 biomarker candidates (clinical AD vs. controls, p < 0.01) identified in the EMIF-AD cohort.

Conclusion

We have evaluated several analytical aspects of TMT proteomics in CSF. The results of our study provide practical guidelines to improve the accuracy of quantification and aid in the design of sample preparation and analytical protocol. The AD biomarker list extracted from the EMIF-AD cohort can provide a valuable basis for future biomarker studies and help elucidate pathogenic mechanisms in AD.
Diabetes risk loci-associated pathways are shared across metabolic tissues
Authors: Bouland Gerard A. , Beulens Joline W. J. , Nap Joey , van der Slik Arno R. , Zaldumbide Arnaud , ’t Hart Leen M. , Slieker Roderick C.
Published: May 2022

Aims/hypothesis

Numerous genome-wide association studies have been performed to understand the influence of genetic variation on type 2 diabetes etiology. Many identified risk variants are located in non-coding and intergenic regions, which complicates understanding of how genes and their downstream pathways are influenced. An integrative data approach will help to understand the mechanism and consequences of identified risk variants.

Methods

In the current study we use our previously developed method CONQUER to overlap 403 type 2 diabetes risk variants with regulatory, expression and protein data to identify tissue-shared disease-relevant mechanisms.

Results

One SNP rs474513 was found to be an expression-, protein- and metabolite QTL. Rs474513 influenced LPA mRNA and protein levels in the pancreas and plasma, respectively. On the pathway level, in investigated tissues most SNPs linked to metabolism. However, in eleven of the twelve tissues investigated nine SNPs were linked to differential expression of the ribosome pathway. Furthermore, seven SNPs were linked to altered expression of genes linked to the immune system. Among them, rs601945 was found to influence multiple HLA genes, including HLA-DQA2, in all twelve tissues investigated.

Conclusion

Our results show that in addition to the classical metabolism pathways, other pathways may be important to type 2 diabetes that show a potential overlap with type 1 diabetes.
Seed inoculation with antagonistic bacteria limits occurrence of E. coli O157:H7gfp + on baby spinach leaves
Authors: Karlsson Maria E. , Uhlig Elisabeth , Håkansson Åsa , Alsanius Beatrix W.
Published: May 2022

Backround

During the last decades, outbreaks of foodborne illnesses have increasingly been linked to fresh and/or minimally processed fruit and vegetables. Enterohemorrhagic Escherichia coli was the causal agent for major outbreaks in Europe with leafy green vegetables and sprouts. To improve food safety, microbial antagonism has received attention during recent years and could be one of the solution to prevent contamination of food borne pathogens on fresh produce. Here we investigate the antagonistic effect of three bacterial strains (Pseudomonas orientalis, P. flavescens and Rhodococcus sp.) isolated from spinach leaves against E. coli O157:H7gfp + under laboratory and greenhouse conditions.

Results

Our results shows that significantly less culturable E.coli O157:H7gfp + were retrieved from the spinach canopy subjected to antagonist seed treatment than canopy inoculation. Seeds inoculated with Rhodococcus sp. significantly reduced growth of E. coli O157:H7gfp + compared with the other antagonists. The result from the in vitro study shows a significant reduction of growth of E. coli O157:H7gfp+, but only after 44 h when E. coli O157:H7gfp + was propagated in a mixture of spent media from all three antagonists.

Conclusions

The antagonistic effect on phyllospheric E.coli O157:H7gfp + observed after seed inoculation with Rhodococcus sp. might be an indication of induced resistance mechanism in the crop. In addition, there was a small reduction of culturable E.coli O157:H7gfp + when propagated in spent media from all three antagonists. Nutritional conditions rather than metabolites formed by the three chosen organisms appear to be critical for controlling E. coli O157:H7gfp+.
Outcomes and risk factors for delayed-onset postoperative respiratory failure: a multi-center case-control study by the University of California Critical Care Research Collaborative (UC3RC)
Authors: Stocking Jacqueline C. , Drake Christiana , Aldrich J. Matthew , Ong Michael K. , Amin Alpesh , Marmor Rebecca A. , Godat Laura , Cannesson Maxime , Gropper Michael A. , Romano Patrick S. , Sandrock Christian , Bime Christian , Abraham Ivo , Utter Garth H.
Published: May 2022

Background

Few interventions are known to reduce the incidence of respiratory failure that occurs following elective surgery (postoperative respiratory failure; PRF). We previously reported risk factors associated with PRF that occurs within the first 5 days after elective surgery (early PRF; E-PRF); however, PRF that occurs six or more days after elective surgery (late PRF; L-PRF) likely represents a different entity. We hypothesized that L-PRF would be associated with worse outcomes and different risk factors than E-PRF.

Methods

This was a retrospective matched case-control study of 59,073 consecutive adult patients admitted for elective non-cardiac and non-pulmonary surgical procedures at one of five University of California academic medical centers between October 2012 and September 2015. We identified patients with L-PRF, confirmed by surgeon and intensivist subject matter expert review, and matched them 1:1 to patients who did not develop PRF (No-PRF) based on hospital, age, and surgical procedure. We then analyzed risk factors and outcomes associated with L-PRF compared to E-PRF and No-PRF.

Results

Among 95 patients with L-PRF, 50.5% were female, 71.6% white, 27.4% Hispanic, and 53.7% Medicare recipients; the median age was 63 years (IQR 56, 70). Compared to 95 matched patients with No-PRF and 319 patients who developed E-PRF, L-PRF was associated with higher morbidity and mortality, longer hospital and intensive care unit length of stay, and increased costs. Compared to No-PRF, factors associated with L-PRF included: preexisiting neurologic disease (OR 4.36, 95% CI 1.81–10.46), anesthesia duration per hour (OR 1.22, 95% CI 1.04–1.44), and maximum intraoperative peak inspiratory pressure per cm H20 (OR 1.14, 95% CI 1.06–1.22).

Conclusions

We identified that pre-existing neurologic disease, longer duration of anesthesia, and greater maximum intraoperative peak inspiratory pressures were associated with respiratory failure that developed six or more days after elective surgery in adult patients (L-PRF). Interventions targeting these factors may be worthy of future evaluation.
Effect of intratracheal dexmedetomidine combined with ropivacaine on postoperative sore throat: a prospective randomised double-blinded controlled trial
Authors: Niu Jingyi , Hu Rui , Yang Na , He Yan , Sun Hao , Ning Rende , Yu Junma
Published: May 2022

Background

The present study aimed to investigate whether intratracheal dexmedetomidine combined with ropivacaine reduces the severity and incidence of postoperative sore throat after tracheal intubation under general anaesthesia.

Methods

Two hundred patients with American Society of Anaesthesiologists physical status I-II who were subjected to general anaesthesia were randomly divided into four groups, namely, Group D, Group R, Group DR and Group S; these groups received intratracheal dexmedetomidine (1 µg/kg), 0.8% ropivacaine (40 mg), dexmedetomidine (1 µg/kg) combined with 0.8% ropivacaine (40 mg) and normal saline before endotracheal intubation, respectively. The primary outcomes were the incidence and grade of sore throat and hoarseness at 2 h and 24 h after surgery. Moreover, the modified Observer's Assessment of Alertness/Sedation Scale results were recorded at each time point. The secondary outcomes were intraoperative haemodynamic fluctuations, intraoperative anaesthetic drug requirements, and adverse reactions during and after surgery. The patients’ vital signs before induction, before superficial anaesthesia, after superficial anaesthesia, before intubation, after intubation, and 1 min after intubation were recorded. The use of anaesthetic drugs and occurrence of adverse effects were also recorded.

Results

The incidence and severity of sore throat were significantly lower in Group DR than in the other three groups 2 h after the operation, but they were only significantly lower in Group DR than in the control group 24 h after the operation. Moreover, compared with Group S and Group D, Group DR exhibited more stable haemodynamics during intubation. The doses of remifentanil and propofol were significantly lower in Group DR than in the other groups.

Conclusion

The combined use of dexmedetomidine and ropivacaine for surface anaesthesia before intubation significantly reduced the incidence and severity of postoperative sore throat. This treatment also decreased anaesthetic drug requirements and intraoperative haemodynamic fluctuations and caused no adverse effects.

Trial registration

This clinical research was registered at the Chinese Clinical Trial Registry (ChiCTR1900022907, Registration date 30/04/2019).
Synergistic prognostic value of coronary distensibility index and fractional flow reserve based cCTA for major adverse cardiac events in patients with Coronary artery disease
Authors: Zhu Xiao-long , Pang Zhi-ying , Jiang Wei , Dong Ting-yu
Published: May 2022

Background

Coronary distensibility index (CDI), as an early predictor of cardiovascular diseases, has the potential to complement coronary computed tomography angiography (cCTA)-derived fractional flow reserve (CT-FFR) for predicting major adverse cardiac events (MACEs). Thus, the prognostic value of CT-FFR combined with CDI for MACEs is worth exploring.

Methods

Patients with a moderate or severe single left anterior descending coronary artery stenosis were included and underwent FFR and CDI analysis based on cCTA, followed up at least 1 year, and recorded MACEs. Multivariate logistic regression analysis was performed to determine independent predictors of MACEs. The area under of receiver operating characteristic (ROC) curve was used to evaluated evaluate the diagnostic performance of CT-FFR, CDI, and a combination of the two.

Results

All the vessel-specific data were from LAD. 150 patients were analysed. 55 (37%) patients experienced MACEs during follow-up. Patients with CT-FFR ≤ 0.8 had higher percentage of MACEs compared with CT-FFR > 0.8 (56.3% vs.7.3%, p < 0.05). Patients’ CDI was significantly decreased in MACEs group compared with non-MACEs group (p < 0.05). Multivariate analysis revealed that diabetes (p = 0.025), triglyceride (p = 0.015), CT-FFR ≤ 0.80 (p = 0.038), and CDI (p < 0.001) are independent predictors of MACEs. According to ROC curve analysis, CT-FFR combined CDI showed incremental diagnostic performance over CT-FFR alone for prediction of MACEs (AUC = 0.831 vs. 0.656, p = 0.0002).

Conclusion

Our study provides initial evidence that combining CDI with CT-FFR shows incremental discriminatory power for MACEs over CT-FFR alone, independent of clinical risk factors. Diabetes and triglyceride are also associated with MACEs.
Novel biomarkers of inflammation in heart failure with preserved ejection fraction: analysis from a large prospective cohort study
Authors: Carris Nicholas W. , Mhaskar Rahul , Coughlin Emily , Bracey Easton , Tipparaju Srinivas M. , Halade Ganesh V.
Published: May 2022

Background

Heart failure with preserved ejection fraction (HFpEF) is a syndrome with a heterogeneous cluster of causes, including non-resolving inflammation, endothelial dysfunction, and multi-organ defects. The present study’s objective was to identify novel predictors of HFpEF.

Methods

The study analyzed the Multi-Ethnic Study of Atherosclerosis (MESA) to assess the association of specific markers of inflammation with new onset of HFpEF (interleukin-2 [IL-2], matrix metalloproteinase 3 [MMP3], large low-density lipoprotein cholesterol [LDL-C], and medium high-density lipoprotein cholesterol [HDL-C]). The study included men and women 45 to 84 years of age without cardiovascular disease at baseline. The primary outcome was the multivariate association of the hypothesized markers of inflammation with new-onset of HFpEF versus participants without new-onset heart failure. Participants with missing data were excluded.

Results

The present analysis included 6814 participants, 53% female, with a mean age of 62 years. Among the entire cohort, HFpEF was diagnosed in 151 (2.2%) participants and heart failure with reduced ejection fraction (HFrEF) was diagnosed in 146 (2.1%) participants. Participants were followed for the outcome of heart failure for a median 13.9 years. Baseline IL-2 was available for 2861 participants. The multivariate analysis included 2792 participants. Of these, 2668 did not develop heart failure, 62 developed HFpEF, 47 developed HFrEF, and 15 developed unclassified heart failure. In the multivariate regression model, IL-2 was associated with new-onset HFpEF (OR, 1.00058; 95% confidence interval, 1.00014 to 1.00102, p = 0.009) but not new-onset HFrEF. In multivariate analysis, MMP3, large LDL-C, and medium HDL-C were not associated with HFpEF or HFrEF.

Conclusion

These findings portend IL-2 as an important component of suboptimal inflammation in the pathogenesis of HFpEF.
The pre-ablation triglyceride-glucose index predicts late recurrence of atrial fibrillation after radiofrequency ablation in non-diabetic adults
Authors: Tang Qinghui , Guo Xiao-Gang , Sun Qi , Ma Jian
Published: May 2022

Background

Current prognostic risk scoring systems and biomarkers are routinely used as non-invasive methods for assessing late recurrence of atrial fibrillation (AF) in patients who have undergone radiofrequency catheter ablation (RFCA). This study aimed to investigate the predictive value of the triglyceride-glucose (TyG) index for late AF recurrence after RFCA in non-diabetic patients.

Methods

In total, 275 patients with AF who underwent RFCA at the Fuwai hospital (Beijing, China) between January 2016 and December 2018 were enrolled in this study. During follow up, patients were divided into late and non-late AF recurrence groups, based on whether they had experienced late AF recurrence determined by electrocardiography (ECG) examine or 48 h Holter monitoring. The TyG index was calculated using the following equation: ln [fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2].

Results

During a median follow-up of 26.1 months, late AF recurrence event rates significantly increased in the highest TyG index tertile group (tertile 3) compared to the lowest group (tertile 1) (54% versus 12%, respectively; p < 0.001). The mean TyG index was higher in the late AF recurrence group compared to the non- late AF recurrence group (9.42 ± 0.6 versus 8.68 ± 0.70, respectively; p < 0.001). On multivariate Cox regression analysis, the pre-ablation TyG index was an independent risk factor for late recurrence of AF after RFCA (hazard ratio [HR] 2.015 [95% confidence interval (CI): 1.408–4.117]; p = 0.009). Receiver operating characteristic (ROC) curve analysis revealed that TyG index was a significant predictor of late AF recurrence after RFCA, with an area under the ROC curve (AUC) of 0.737 (95% CI: 0.657–0.816; p < 0.001). In addition, the AUC of left atrial diameter (LAD) was 0.780 (95%CI: 0.703–0.857, p < 0.001). Finally, the TyG index positively correlated with LAD (r = 0.133, p = 0.027), high sensitivity C-reactive protein (r = 0.132, p = 0.028) and N-terminal pro B-type natriuretic peptide (r = 0.291, p < 0.001) levels.

Conclusions

An elevated pre-ablation TyG index was associated with an increased risk of late AF recurrence after RFCA in non-diabetic patients. The TyG index may be potentially useful as a novel biomarker for the risk stratification of late AF recurrence in non-diabetic patients.
The sham effect of invasive interventions in chronic coronary syndromes: a systematic review and meta-analysis
Authors: Palma Catarina , David Cláudio , Fernandes Ricardo M. , Pinto Fausto J. , Costa João , Ferreira Joaquim J. , Caldeira Daniel
Published: May 2022

Background

Some patients with chronic coronary syndromes undergo invasive procedures but the efficacy of such interventions remains to be robustly established by randomised sham-controlled trials (RCTs).

Purpose

To determine the sham effect in patients with chronic coronary syndromes enrolled in RCTs by performing a systematic review and meta-analysis.

Methods

In April 2022, we performed a literature search for published patient-blind RCTs (CENTRAL, MEDLINE®, PsycINFO, and reference lists) with sham procedures, reporting the pre-post effects in the invasive sham arm among patients with Canadian cardiovascular society (CCS) angina or angina equivalents.

Results

16 RCTs were included with 546 patients in the sham arm. Pooled results showed that sham interventions were associated with: improvement of 7% (95% CI 2–11%; I2 = 0%) in exercise time; decrease of 0.78 (95% CI − 1.10 to − 0.47; I2 = 75%) in CCS angina class; decrease of 53% (95% CI 24–71%; I2 = 96%) and 25% (95% CI 20–29%; I2 = 0%) in anginal episodes and nitroglycerine (NTG) use, respectively. Pooled results also showed an improvement in the physical functioning, angina frequency, treatment satisfaction, and disease perception domains of the Seattle Angina Questionnaire (SAQ).

Conclusion

Sham interventions in patients with chronic coronary syndromes were associated with a significant decrease in anginal episodes, NTG use, and CCS angina class and increased SAQ quality of life and exercise time. These results highlight the need for previous non sham-controlled trials to be interpreted with caution, and the importance of new invasive interventions to be evaluated versus a sham procedure.
Evaluation of cardiometabolic risk markers linked to reduced left ventricular ejection fraction (LVEF) in patients with ST-elevation myocardial infarction (STEMI)
Authors: Mahdavi-Roshan Marjan , Ghorbani Zeinab , Gholipour Mahboobeh , Salari Arsalan , Savar Rakhsh Amir , Kheirkhah Jalal
Published: May 2022

Background

It is well established that left ventricular systolic dysfunction (LVSD), as marked by reduced left ventricular ejection fraction (LVEF), notably worsens the prognosis of ST-elevation myocardial infarction (STEMI). However, the link between cardiometabolic risk markers and LVSD seems unclear. This study aimed to investigate the differences in variables affecting reduced LVEF in STEMI patients.

Methods

In the current retrospective study, 200 consecutive STEMI patients were enrolled between April 2016 to January 2017. Analysis of serum parameters, anthropometric evaluation, and echocardiography was performed after admission. The participants were categorized according to LVEF levels as follows: group1 (normal: 50–70%, n = 35), group2 (mildly reduced: 40–49%, n = 48); group3 (moderately reduced: 30–39%, n = 94) and group4 (severely reduced: < 30%, n = 23). Between-group comparisons were made using the Kruskal–Wallis test.

Results

Overall, of 200 STEMI patients with a mean age of 62 years, 27%(n = 54) were females. The median of BMI of patients in group4 (31.07 kg/m2) was significantly higher than group3 (26.35 kg/m2), group2 (25.91 kg/m2), and group1 (24.98 kg/m2; P value < 0.0001). Group4 patients showed significantly increased fasting blood sugar (FBS) than groups 1 (212.00, vs. 139.00 mg/dl; P value = 0.040). Patients in groups 1 and 2 exerted significantly elevated triglyceride levels than those in group4 (142.00, 142.50, and 95.00 mg/dl; P value = 0.001). WBC count, neutrophil%, and neutrophil to lymphocyte ratio among those in group1 (10,200/m3, 70.00%, and 2.92, respectively) were significantly lower than group4 (12,900/m3, 83.00%, and 5.47, respectively; P value < 0.05).

Conclusion

These findings highlight higher BMI, FBS, and leucocyte count linked to LVSD, probably through increasing the inflammation and reducing LVEF levels. More extensive studies are needed to clarify the clinical relevance of these results.
Effect of CPB glucose levels on inflammatory response after pediatric cardiac surgery
Authors: Zeng Zhi-Hua , Yu Xin-Yi , Liu Xiao-Cheng , Liu Zhi-Gang
Published: May 2022

Background

Systemic inflammatory response syndrome (SIRS) is a common complication after cardiac surgery. There are no definite optimal glycemic threshold for pediatric patients receiving open-heart surgery with CPB. The study aimed to investigate the optimal cardiopulmonary bypass (CPB) glucose in patients undergoing cardiac surgery.

Methods

We enrolled children with congenital heart disease who underwent surgical repair between June 2012 and December 2020. We included only patients who underwent cardiac surgery with CPB. The primary outcome was severe SIRS. A two-piece-wise regression model was applied to examine threshold effect of CPB glucose on severe SIRS.

Results

A total of 7350 patients were enrolled in the present study, of whom 3895 (52.99%) are female. After potential confounders were adjusted, non-linear relationship was detected between CPB glucose and severe SIRS, whose turning point was 8.1. With CPB glucose < 8.1 mmol/L, the estimated dose–response curve was consistent with a horizontal line. However, the prevalence of severe SIRS increased with increasing glucose up to the turning point (Glucose > 8.1 mmol/L); the odds ratio (OR) of the Glucose was 1.35 (95% CI 1.21, 1.50).

Conclusions

The present study indicates the association of CPB glucose with inflammatory response after pediatric cardiac surgery. The patients might have the best outcomes with the optimal CPB glucose no more than 8.1 mmol/L.
ELaPro, a LOINC-mapped core dataset for top laboratory procedures of eligibility screening for clinical trials
Authors: Rafee Ahmed , Riepenhausen Sarah , Neuhaus Philipp , Meidt Alexandra , Dugas Martin , Varghese Julian
Published: May 2022

Background

Screening for eligible patients continues to pose a great challenge for many clinical trials. This has led to a rapidly growing interest in standardizing computable representations of eligibility criteria (EC) in order to develop tools that leverage data from electronic health record (EHR) systems. Although laboratory procedures (LP) represent a common entity of EC that is readily available and retrievable from EHR systems, there is a lack of interoperable data models for this entity of EC. A public, specialized data model that utilizes international, widely-adopted terminology for LP, e.g. Logical Observation Identifiers Names and Codes (LOINC®), is much needed to support automated screening tools.

Objective

The aim of this study is to establish a core dataset for LP most frequently requested to recruit patients for clinical trials using LOINC terminology. Employing such a core dataset could enhance the interface between study feasibility platforms and EHR systems and significantly improve automatic patient recruitment.

Methods

We used a semi-automated approach to analyze 10,516 screening forms from the Medical Data Models (MDM) portal’s data repository that are pre-annotated with Unified Medical Language System (UMLS). An automated semantic analysis based on concept frequency is followed by an extensive manual expert review performed by physicians to analyze complex recruitment-relevant concepts not amenable to automatic approach.

Results

Based on analysis of 138,225 EC from 10,516 screening forms, 55 laboratory procedures represented 77.87% of all UMLS laboratory concept occurrences identified in the selected EC forms. We identified 26,413 unique UMLS concepts from 118 UMLS semantic types and covered the vast majority of Medical Subject Headings (MeSH) disease domains.

Conclusions

Only a small set of common LP covers the majority of laboratory concepts in screening EC forms which supports the feasibility of establishing a focused core dataset for LP. We present ELaPro, a novel, LOINC-mapped, core dataset for the most frequent 55 LP requested in screening for clinical trials. ELaPro is available in multiple machine-readable data formats like CSV, ODM and HL7 FHIR. The extensive manual curation of this large number of free-text EC as well as the combining of UMLS and LOINC terminologies distinguishes this specialized dataset from previous relevant datasets in the literature.
Raking of data from a large Australian cohort study improves generalisability of estimates of prevalence of health and behaviour characteristics and cancer incidence
Authors: Yap Sarsha , Luo Qingwei , Wade Stephen , Weber Marianne , Banks Emily , Canfell Karen , O’Connell Dianne L. , Steinberg Julia
Published: May 2022

Background

Health surveys are commonly somewhat non-representative of their target population, potentially limiting the generalisability of prevalence estimates for health/behaviour characteristics and disease to the population. To reduce bias, weighting methods have been developed, though few studies have validated weighted survey estimates against generally accepted high-quality independent population benchmark estimates.

Methods

We applied post-stratification and raking methods to the Australian 45 and Up Study using Census data and compared the resulting prevalence of characteristics to accepted population benchmark estimates and separately, the incidence rates of lung, colorectal, breast and prostate cancer to whole-of-population estimates using Standardised Incidence Ratios (SIRs).

Results

The differences between 45 and Up Study and population benchmark estimates narrowed following sufficiently-informed raking, e.g. 13.6% unweighted prevalence of self-reported fair/poor overall health, compared to 17.0% after raking and 17.9% from a population benchmark estimate. Raking also improved generalisability of cancer incidence estimates. For example, unweighted 45 and Up Study versus whole-of-population SIRs were 0.700 (95%CI:0.574–0.848) for male lung cancer and 1.098 (95%CI:1.002–1.204) for prostate cancer, while estimated SIRs after sufficiently-informed raking were 0.828 (95%CI:0.684–0.998) and 1.019 (95%CI:0.926–1.121), respectively.

Conclusion

Raking may be a useful tool for improving the generalisability of exposure prevalence and disease incidence from surveys to the population.
The molecular characteristics of gastric cancer patients living in Qinghai-Tibetan Plateau
Authors: Yuan Ling , Chen Shilong , Wang Yongcui , Ma Yingcai
Published: May 2022

Gastric cancer, or stomach cancer, that originates in the inner lining of the stomach, was the fifth most common cancer and the fourth mortality globally, with over one million new cases in 2020 and an estimated 769,000 deaths. The molecular characteristics of gastric cancer has been complicated by histological and intratumor heterogeneity. The incidence of gastric cancer shows wide geographical variation. As the largest and highest region in China, Qinghai-Tibetan Plateau is one of the important global biodiversity hotspots. Here, we collect tumour and paired normal bio-samples from 31 primary gastric cancer patients from Qinghai Provincial People’s Hospital, and discuss the molecular characteristics for gastric cancer patients living in plateau. They have more single nucleotide polymorphisms (SNP) located in chromosome 7 with C → T and G → A as the most common alteration types, barely share the cancer driver genes with western patients, and have no significant differences in various Chinese nation. These characteristics offers a great opportunity to further understanding the divergent mechanism of gastric cancer, increase the efficacy for diagnosis and prognosis, finally lead the optimal targeted therapeutics.
Prevalence and determinants of physical frailty among people living in residential aged care facilities: a large-scale retrospective audit
Authors: Milte Rachel , Petersen Jasmine , Boylan Jo , Henwood Tim , Hunter Sarah , Lange Belinda , Lawless Michael , Torode Stacey , Lewis Lucy K.
Published: May 2022

Background

Physical frailty is associated with increased risk of falls, hospitalisation and mortality. There is a dearth of information on physical frailty of older adults living in residential aged care. This study aimed to describe physical frailty in aged care residents and investigate possible determinants of frailty.

Method

A retrospective audit of resident records was undertaken across 14 residential aged care facilities. Data were extracted on all consenting residents who had completed measures relating to frailty (Short Physical Performance Battery SPPB; grip strength). All data of the first record of measures were extracted, resident characteristics, and the time from admission to assessment. Summary statistics were completed. Differences between sub-groups were explored (Mann-Whitney U, Kruskall-Wallis Ranked tests). Associations between variables were explored with Chi-squared and Pearson correlations. Determinants of physical frailty were determined with linear regression analyses. Alpha (2-sided) was 0.05.

Results

Data were extracted for 1241 residents (67% female), with a mean age of 86.0 (7.6) years. Males had a significantly lower time from admission to assessment of frailty (p ≤ 0.001). The average SPPB score was 4.1 (3.3), 75% of residents were frail and 19% pre-frail. Bivariate analyses indicated no significant relationships between grip strength and SPPB score, but significant differences for grip strength, where males were significantly stronger (males 20.2 ± 8.3 kg; females 12.4 ± 5.4 kg; p ≤ 0.001). There was a significant positive relationship between SPPB total score and grip strength, gender (p ≤ 0.001), and marital status (p = 0.049) and a negative relationship between time from admission to assessment and SPPB total score (p ≤ 0.001). There were significant negative relationships between gender (p ≤ 0.001) and age (p ≤ 0.001), and time from admission to assessment (p ≤ 0.001) with grip strength.

Conclusion

Older adults living in residential aged care have a high level of physical frailty which may lead to increased risk of adverse outcomes. Time in the residential aged care setting and age appear to predict physical frailty. There is a need for a consistent battery of measures to continually monitor frailty and programs to address the high levels of frailty in residential aged care.
Respiratory viruses among ethnic Nicobarese during COVID-19 pandemic
Authors: Muruganandam Nagarajan , Roy Avijit , Sivanandan Nimisha , Vins Alwin , Beniwal Nisha , Kaur Harpreet , Potdar Varsha , Parvez Rehnuma
Published: May 2022

Background

Acute respiratory infections (ARIs) and severe acute respiratory illness (SARI) are public health burdens globally. The percentage of non-SARS CoV-2 respiratory viruses among patients having ARI and SARI who visit Car Nicobar's hospital settings is undocumented. Changes in the epidemiology of other respiratory viruses during COVID19 pandemic is being reported worldwide.

Methods

Inpatient and outpatient settings at BJR hospital, Car Nicobar Island, India, were used to conduct prospective monitoring for ARI and SARI among Nicobarese tribal members. The patients with ARI and SARI were enlisted in BJR hospital from June 2019 to May 2021. At the ICMR-NIV in Pune, duplex RT-PCR assays were used to test the presence of respiratory viruses. The prevalence of non- SARS CoV-2 respiratory viruses was measured by comparing here between pandemic and pre-pandemic periods.

Results

During the COVID19 pandemic, Influenza A (H3N2) and rhinovirus were predominantly reported non-SARS CoV-2 respiratory viruses while Human metapneumovirusand influenza A (H1N1)pdm09were most commonly reported in the prepandemic period. This result indicates the altered circulation of non-SARS CoV-2 during pandemic.

Conclusions

A considerable proportion of respiratory infection was correlated with respiratory viruses. Prevalence of non-SARS CoV-2 respiratory viruses was high at the time of infection when compared with pre-pandemic period, at Car Nicobar Island. This study enlightened the change in circulation of other respiratory viruses among the indigenous Nicobarese tribes. Clinicians and allied medical staff should be more prudent of these respiratory infections.