bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying key factors associated with subscapularis tendon tears and developing a risk prediction model to assist diagnosis
Authors: Xu Wennan , Wang Fei , Xue Qingyun
Published: April 2022

Background

There are still some challenges in diagnosing subscapularis (SSC) tendon tears as accurately as posterosuperior rotator cuff tears on MRI. The omission of SSC tendon tear can lead to muscle atrophy, fatty infiltration, and increased tearing accompanied by aggravated shoulder pain and loss of function. An effective non-invasive evaluation tool will be beneficial to early identification and intervention. The study aims to identify sensitive predictors associated with SSC tendon tears and develop a risk prediction model to assist in diagnosis.

Methods

Data on 660 patients who received shoulder arthroscopic surgery with preoperative shoulder MRI were collected retrospectively. Of these, patients with SSC tendon tears were defined as the SSC tear group, and patients with intact SSC tendon were enrolled in the non-SSC tear group. Logistic regression analysis was used to identify the key predictors of SSC tendon tears which were then incorporated into the nomogram.

Results

Among 22 candidate factors, five independent factors including coracohumeral distance (CHD, oblique sagittal plane) (OR, 0.75; 95%CI, [0.67–0.84]), fluid accumulation (Y-face) (OR, 2.29; 95%CI, [1.20–4.38]), long head of biceps tendon (LHB) dislocation/subluxation (OR, 3.62; 95%CI, [1.96–6.68]), number of posterosuperior (PS) rotator cuff tears (OR, 5.36; 95%CI, [3.12–9.22]), and MRI diagnosis (based on direct signs) (OR, 1.88; 95%CI, [1.06–3.32]) were identified as key predictors associated with SSC tendon tears. Incorporating these predictors, the nomogram achieved a good C index with a good agreement on the risk estimation of calibration plots. Higher total points of the nomogram were associated with a greater risk of SSC tendon tears.

Conclusion

When evaluating the severity of SSC tendon injury, the combination of reliable predictors can improve the sensitivity and diagnostic performance of MRI. This model provides an individualized probability of risk prediction, which is convenient for clinicians to identify patients at high risk for SSC tendon tears to avoid missed diagnosis.
Predictors for patient satisfaction of a single intra-articular injection of crosslinked hyaluronic acid combined with mannitol (HANOX-M-XL) in patients with temporomandibular joint osteoarthritis. Results of a prospective open-label pilot study (HAPPYMINI-ARTEMIS trial)
Authors: Baron Dominique , Baron Hugo , Baerer Catherine , Bodere Céline , Conrozier Thierry
Published: April 2022

Background

Chronic pain and functional impairment interfere with the quality of life of subjects suffering from temporomandibular joint (TMJ) disorders. Intra-articular (IA) hyaluronic acid (HA) injections have been shown to alleviate pain and improve mandibular mobility in patients with TMJ osteoarthritis (OA).

Objectives

The primary aim of the study was to identify the prognostic factors of patient satisfaction for a single IA injection of a mannitol-modified crosslinked HA (HANOX-M-XL) in patients with TMJ-OA. The second goal was to obtain clinical data on effectiveness, safety and mandibular mobility throughout a six-month follow-up period.

Patients and methods

This was an observational single-arm prospective trial with a six-month follow-up. Inclusion criteria: patients with TMJ-OA which is not relieved by analgesics and/or non-steroidal-anti-inflammatory drugs and/or orthotics, with radiological evidence of TMJ-OA. All patients received a single IA injection of 1 ml HANOX-M-XL in the target TMJ. The primary endpoint was patient satisfaction on day 180. The main secondary outcome measures were pain variation on a 11-point numeric scale (0–11) between the date of injection and month six, the variation over time of the Maximum Inter-Incisal Opening Distance (MIIOD) and the patient’s assessment of effectiveness. Predictive factors of success or failure were also studied. All adverse events were recorded.

Results

36 subjects (mean age 55.3 years, mean disease duration 98 months), covering a total of 52 injected TMJs, were included. Between baseline and endpoint, the average pain while chewing decreased dramatically from 6.9 ± 1.2 to 2.9 ± 1.3 (p < 0.0001) and the MIIOD increased from 29 ± 7 to 35 ± 5 mm (p < 0.01). On day 180, all patients were satisfied with the treatment, with 34 patients (94%) rating it as highly effective or effective. Tolerability was good in all but one patient. In the multivariate analysis, patient satisfaction on day 180 was highly correlated with the pain while chewing score, pain on palpation score and the decrease of pain over time (all p < 0.0001) but not with MIIOD, gender, age, bruxism, articular noise and symptom duration. Previous viscosupplementation was also related to higher satisfaction (p = 0.01).

Conclusion

Despite a long history of pain, most of the patients with symptomatic TMJ-OA benefited from a single injection of HANOX-M-XL, as shown by the sustained (up to 6 months) decrease in pain and improvement in mandibular mobility, with no safety concerns.
Risk of uterine leiomyoma based on BET1L rs2280543 single nucleotide polymorphism and vegetarian diet
Authors: Lee Shan Chih , Chou Ying-Hsiang , Tantoh Disline Manli , Hsu Shu-Yi , Nfor Oswald Ndi , Tyan Yeu Sheng , Liaw Yung-Po
Published: April 2022

Background

Bet1 Golgi vesicular membrane trafficking protein-like (BET1L) rs2280543 single nucleotide polymorphism (SNP) and diet have been independently associated with uterine leiomyoma (UL). However, whether the SNP and diet could jointly influence the risk of UL is yet to be assessed. Therefore, we investigated the independent and interactive effects of vegetarian diet and BET1L rs2280543 on uterine fibroids in Taiwanese women.

Methods

We linked participants’ electronic data in the Taiwan Biobank (TWB) database to their medical records in the National Health Insurance Research Database (NHIRD). The TWB had genotypic, lifestyle, and biochemical data between 2008 and 2015 and the NHIRD had data on disease diagnoses between 1998 and 2015. In this study, we included 1997 premenopausal women with complete data.

Results

Compared  to participants with the BET1L rs2280543 CC genotype (wildtype), those with CT/CC genotype had an odds ratio (OR) of 0.69 and a 95% confidence interval (CI) of 0.51–0.93. Vegetarian diet and UL were not significantly associated: OR = 1.09 and 95% CI = 0.77–1.55. However, the test for interaction between rs2280543 and vegetarian diet was significant (p = 0.046). Compared to individuals with the CC genotype, the risk of UL was lower among vegetarians with the CT/TT genotype: OR (95% CI) = 0.15 (0.05–0.47).

Conclusion

The BET1L rs2280543 CT/TT genotype was associated with a lower risk of UL especially among vegetarians.
Asking the right questions: towards a person-centered conception of shared decision-making regarding treatment of advanced chronic kidney disease in older patients
Authors: Verberne Wouter R. , Stiggelbout Anne M. , Bos Willem Jan W. , van Delden Johannes J. M.
Published: April 2022

An increasing number of older patients have to decide on a treatment plan for advanced chronic kidney disease (CKD), involving dialysis or conservative care. Shared decision-making (SDM) is recommended as the model for decision-making in such preference-sensitive decisions. The aim of SDM is to come to decisions that are consistent with the patient’s values and preferences and made by the patient and healthcare professional working together. In clinical practice, however, SDM appears to be not yet routine and needs further implementation. A shift from a biomedical to a person-centered conception might help to make the process more shared. Shared should, therefore, be interpreted as two persons bringing two perspectives to the table, that both need to be explored during the decision-making process. Starting from the patient’s perspective will enable to determine the mutual goals of care first and, subsequently, determine the best way for achieving those goals. To perform such SDM, the healthcare professional needs to become a skilled companion, being part of the patient’s relational context, and start asking the right questions about what matters to the patient as person. In this article, we describe the need for a person-centered conception of SDM for the setting of older patients with advanced CKD.
Economic impact of generic antiretrovirals in France for HIV patients’ care: a simulation between 2019 and 2023
Authors: Demeulemeester Romain , Savy Nicolas , Mounié Michaël , Molinier Laurent , Delpierre Cyrille , Dellamonica Pierre , Allavena Clotilde , Pugliesse Pascal , Cuzin Lise , Saint-Pierre Philippe , Costa Nadège
Published: April 2022

Background

In a context where the economic burden of HIV is increasing as HIV patients now have a close to normal lifespan, the availability of generic antiretrovirals commonly prescribed in 2017 and the imminence of patent expiration are expected to provide substantial savings in the coming years. This article aims to assess the economic impact of these generic antiretrovirals in France and specifically over a five-year period.

Methods

An agent-based model was developed to simulate patient trajectories and treatment use over a five-year period. By comparing the results of costs for trajectories simulated under different predefined scenarios, a budget impact model can be created and sensitivity analyses performed on several parameters of importance.

Results

The potential economic savings from 2019 to 2023 generated by generic antiretrovirals range from €309 million when the penetration rate of generics is set at 10% to €1.5 billion at 70%. These savings range from €984 million to €993 million as the delay between patent and generic marketing authorisation varies from 10 to 15 years, and from €965 million to €993 million as the Negotiated Price per Unit (NPU) of generics at market-entry varies from 40 to 50% of the NPU for patents.

Discussion

This economic savings simulation could help decision makers to anticipate resource allocations for further innovation in antiretrovirals therapies as well as prevention, especially by funding the Pre-Exposure Prophylaxis (PrEP) or HIV screening.
Deviations from temporal scaling support a stage-specific regulation for C. elegans postembryonic development
Authors: Mata-Cabana Alejandro , Romero-Expósito Francisco Javier , Geibel Mirjam , Piubeli Francine Amaral , Merrow Martha , Olmedo María
Published: April 2022

Background

After embryonic development, Caenorhabditis elegans progress through for larval stages, each of them finishing with molting. The repetitive nature of C. elegans postembryonic development is considered an oscillatory process, a concept that has gained traction from regulation by a circadian clock gene homologue. Nevertheless, each larval stage has a defined duration and entails specific events. Since the overall duration of development is controlled by numerous factors, we have asked whether different rate-limiting interventions impact all stages equally.

Results

We have measured the duration of each stage of development for over 2500 larvae, under varied environmental conditions known to alter overall developmental rate. We applied changes in temperature and in the quantity and quality of nutrition and analysed the effect of genetically reduced insulin signalling. Our results show that the distinct developmental stages respond differently to these perturbations. The changes in the duration of specific larval stages seem to depend on stage-specific events. Furthermore, our high-resolution measurement of the effect of temperature on the stage-specific duration of development has unveiled novel features of temperature dependence in C. elegans postembryonic development.

Conclusions

Altogether, our results show that multiple factors fine tune developmental timing, impacting larval stages independently. Further understanding of the regulation of this process will allow modelling the mechanisms that control developmental timing.
Serum metabolomic profiles associated with subclinical and clinical cardiovascular phenotypes in people with type 2 diabetes
Authors: Huang Zhe , Klaric Lucija , Krasauskaite Justina , McLachlan Stela , Strachan Mark W. J. , Wilson James F. , Price Jackie F.
Published: April 2022

Background

Atherosclerotic cardiovascular diseases (CVD) is the leading cause of death in diabetes, but the full range of biomarkers reflecting atherosclerotic burden and CVD risk in people with diabetes is unknown. Metabolomics may help identify novel biomarkers potentially involved in development of atherosclerosis. We investigated the serum metabolomic profile of subclinical atherosclerosis, measured using ankle brachial index (ABI), in people with type 2 diabetes, compared with the profile for symptomatic CVD in the same population.

Methods

The Edinburgh Type 2 Diabetes Study is a cohort of 1,066 individuals with type 2 diabetes. ABI was measured at baseline, years 4 and 10, with cardiovascular events assessed at baseline and during 10 years of follow-up. A panel of 228 metabolites was measured at baseline using nuclear magnetic resonance spectrometry, and their association with both ABI and prevalent CVD was explored using univariate regression models and least absolute shrinkage and selection operator (LASSO). Metabolites associated with baseline ABI were further explored for association with follow-up ABI and incident CVD.

Results

Mean (standard deviation, SD) ABI at baseline was 0.97 (0.18,N = 1025), and prevalence of CVD was 35.0%. During 10-year follow-up, mean (SD) change in ABI was + 0.006 (0.178,n = 436), and 257 CVD events occurred. Lactate, glycerol, creatinine and glycoprotein acetyls levels were associated with baseline ABI in both univariate regression [βs (95% confidence interval, CI) ranged from − 0.025 (− 0.036, − 0.015) to − 0.023 (− 0.034, − 0.013), allp < 0.0002] and LASSO analysis. The associations remained nominally significant after adjustment for major vascular risk factors. In prospective analyses, lactate was nominally associated with ABI measured at years 4 and 10 after adjustment for baseline ABI. The four ABI-associated metabolites were all positively associated with prevalent CVD [odds ratios (ORs) ranged from 1.29 (1.13, 1.47) to 1.49 (1.29, 1.74), allp < 0.0002], and they were also positively associated with incident CVD [ORs (95% CI) ranged from 1.19 (1.02, 1.39) to 1.35 (1.17, 1.56), allp < 0.05].

Conclusions

Serum metabolites relating to glycolysis, fluid balance and inflammation were independently associated with both a marker of subclinical atherosclerosis and with symptomatic CVD in people with type 2 diabetes. Additional investigation is warranted to determine their roles as possible etiological and/or predictive biomarkers for atherosclerotic CVD.
Heterogeneous treatment effects of intensive glycemic control on major adverse cardiovascular events in the ACCORD and VADT trials: a machine-learning analysis
Authors: Edward Justin A. , Josey Kevin , Bahn Gideon , Caplan Liron , Reusch Jane E. B. , Reaven Peter , Ghosh Debashis , Raghavan Sridharan
Published: April 2022

Background

Evidence to guide type 2 diabetes treatment individualization is limited. We evaluated heterogeneous treatment effects (HTE) of intensive glycemic control in type 2 diabetes patients on major adverse cardiovascular events (MACE) in the Action to Control Cardiovascular Risk in Diabetes Study (ACCORD) and the Veterans Affairs Diabetes Trial (VADT).

Methods

Causal forests machine learning analysis was performed using pooled individual data from two randomized trials (n = 12,042) to identify HTE of intensive versus standard glycemic control on MACE in patients with type 2 diabetes. We used variable prioritization from causal forests to build a summary decision tree and examined the risk difference of MACE between treatment arms in the resulting subgroups.

Results

A summary decision tree used five variables (hemoglobin glycation index, estimated glomerular filtration rate, fasting glucose, age, and body mass index) to define eight subgroups in which risk differences of MACE ranged from − 5.1% (95% CI − 8.7, − 1.5) to 3.1% (95% CI 0.2, 6.0) (negative values represent lower MACE associated with intensive glycemic control). Intensive glycemic control was associated with lower MACE in pooled study data in subgroups with low (− 4.2% [95% CI − 8.1, − 1.0]), intermediate (− 5.1% [95% CI − 8.7, − 1.5]), and high (− 4.3% [95% CI − 7.7, − 1.0]) MACE rates with consistent directions of effect in ACCORD and VADT alone.

Conclusions

This data-driven analysis provides evidence supporting the diabetes treatment guideline recommendation of intensive glucose lowering in diabetes patients with low cardiovascular risk and additionally suggests potential benefits of intensive glycemic control in some individuals at higher cardiovascular risk.
Nine-fold higher risk of acute myocardial infarction in subjects with type 1 diabetes compared to controls in Norway 1973–2017
Authors: Saeed Maryam , Stene Lars C. , Ariansen Inger , Tell Grethe S. , Tapia German , Joner Geir , Skrivarhaug Torild
Published: April 2022

Background

We aimed to study the cumulative incidence and risk factors (sex, age, calendar year of diabetes onset, country of origin and educational level) of acute myocardial infarction (AMI) in subjects with type 1 diabetes and matched controls.

Methods

A nationwide cohort of subjects with type 1 diabetes diagnosed at age < 15 years in Norway during 1973–2000 was followed until the first AMI event, emigration, death or 31st of December 2017. The Norwegian Childhood Diabetes Registry was linked to five nationwide registries, and up to ten sex- and age-matched controls per case were included.

Results

Among 7086 subjects with type 1 diabetes, 170 (2.4%) were identified with incident AMI, compared to 193 (0.3%) of 69,356 controls. Mean age and diabetes duration at first AMI was 40.8 years and 30.6 years, respectively. The probability of AMI after 40 years of follow-up was 8.0% in subjects with type 1 diabetes and 1.1% in controls, aHR 9.05 (95% CI 7.18–11.41). In type 1 diabetes, male sex (aHR 1.45), higher age at onset of diabetes and lower education (higher compared to lower, aHR 0.38) were significantly associated with higher risk of AMI. There was no significant time trend in AMI by calendar year of diabetes onset.

Conclusions

We found nine-fold excess risk of AMI in subjects with type 1 diabetes, and three-fold higher risk in subjects with low versus high education. These results highlight a strengthened focus on prevention of cardiovascular disease, and diabetes education tailored to the subjects’ educational background.
Engineered probiotics
Authors: Ma Junheng , Lyu Yuhong , Liu Xin , Jia Xu , Cui Fangyun , Wu Xiaoheng , Deng Shanshan , Yue Changwu
Published: April 2022

Engineered probiotics are a kind of new microorganisms produced by modifying original probiotics through gene editing. With the continuous development of tools and technology progresses, engineering renovation of probiotics are becoming more diverse and more feasible. In the past few years there have been some advances in the development of engineered probiotics that will benefit humankind. This review briefly introduces the theoretical basis of gene editing technology and focuses on some recent engineered probiotics researches, including inflammatory bowel disease, bacterial infection, tumor and metabolic diseases. It is hoped that it can provide help for the further development of genetically modified microorganisms, stimulate the potential of engineered probiotics to treat intractable diseases, and provide new ideas for the diagnosis of some diseases or some industrial production.
A qualitative assessment of the health systems factors influencing the prevention of malaria in pregnancy using intermittent preventive treatment and insecticide-treated nets in Ghana
Authors: De-Gaulle Virtue Fiawokome , Kamgno Joseph , Orish Verner N. , Kotoh Agnes , Mbacham Wilfred , Tagbor Harry , Magnussen Pascal
Published: April 2022

Background

Ghana has adopted and implemented intermittent preventive treatment using sulfadoxine-pyrimethamine (IPTp-SP) and insecticide-treated nets (ITNs) in an antenatal care (ANC) context to prevent malaria among pregnant women. However, the increased ANC attendance and its frequency facilitated by a free maternal health care policy in Ghana does not correspond with the uptake of IPTp-SP and ITN use among pregnant women. This study sought to elucidate the contextual health system factors influencing the delivery of IPTp-SP and ITN from a related quantitative study conducted in Ghana.

Methods

This is the qualitative section of a mixed-methods study design, where audio recorded key informant interviews (KIIs) were conducted with health workers from across health facilities, districts, regional and national health directorates. The KIIs elicited information on health worker knowledge, perceptions, and rationale for the delivery practices of IPTp-SP and ITN revealed in the quantitative findings. The interviews were transcribed and imported into NVivo for analysis. Using the World Health Organization (WHO) Health Systems Framework as the theoretical basis, thematic analysis was conducted under broad themes of the building blocks. Findings are presented in narrative quotes, with a mindmap used to summarize the various health system factors and their interrelated relationship influencing the delivery of IPTp-SP and ITN.

Results

Health system factors identified included health staff untrained on malaria delivery directives due to an ineffective trainer of trainer (ToT) system. Additionally, health worker confusion on when to commence SP (at quickening or ≥ 16 weeks) was found to result in delayed start of SP. Stock-outs in facilities due to procurement delays at the national level resulted in missed opportunities to deliver SP to eligible pregnant women at the ANC. Similarly, ITN stock outs led to eligible pregnant women not receiving one at ANC clinics.

Conclusion

Poor health worker knowledge on policy directives, a consequence of ineffective training strategy led to delayed delivery of IPTp-SP to eligible pregnant women. Supply chain management challenges related to stock of SP and ITN resulted in missed opportunities to deliver the interventions to pregnant women attending ANC.
Validation and minimally important difference of the Child-OIDP in a socioeconomically diverse sample of Indian adolescents
Authors: Mathur Manu Raj , Nagrath Deepti , Yusuf Huda , Mishra Vijay Kumar , Tsakos Georgios
Published: April 2022

Introduction

While different measures have been validated and used to assess the oral health related quality of life (OHRQoL) of children and adolescents, no previous study has tested the psychometric performance of OHRQoL amongst the most marginalized adolescents, living in extremely deprived neighbourhoods like urban slums and resettlement areas in modern cities. Our study assessed the internal consistency reliability, construct validity and Minimally Important Difference (MID) of the Child-OIDP in a sample of adolescents aged 12–15 years reporting oral health problems that lived in three different types (including two extremely vulnerable) of neighbourhoods (urban slums, resettlement colonies, and middle and upper middle-class neighbourhoods) in the National Capital Territory of Delhi.

Methods

We conducted data analysis on a cross-sectional study, comprising of 840 adolescents. The Child-OIDP was used as a measure of OHRQoL. Internal consistency reliability was tested using the standardized Cronbach’s Alpha Coefficient. The Child-OIDP was also tested for content and construct validity (the latter through the median test), while a distribution-based approach was used to identify the MID.

Results

The Indian Child-OIDP showed good internal consistency, as the Cronbach’s alpha coefficient was 0.77. Inter-item correlation coefficients among the items ranged from 0.13 to 0.50, with the mean inter-item correlation being 0.30. The corrected item-total correlations ranged from 0.30 (social contact) to 0.54 (speaking). For construct validity, the Child-OIDP extent was significantly associated with three subjective oral and general health variables in the expected direction. The calculated effect sizes for these differences indicated that they were moderate (0.50–0.79). We also calculated the standard error of measurement (SEM) of Child-OIDP extent as 0.75.

Conclusion

This study demonstrated that the Indian Child-OIDP is a reliable and valid measure for the assessment of the oral health related quality of life among Indian adolescents especially from marginalised and socioeconomically vulnerable groups. This is an essential step towards assessing oral health and evaluating oral health promotion interventions in those populations and settings.
Sexual function and sexual quality of life in men with genital warts: a cross-sectional study
Authors: Nia Marzieh Hosseini , Rahmanian Fatemeh , Ghahartars Mehdi , Janghorban Roksana
Published: April 2022

Background

Human papillomavirus is the most common sexually transmitted infection, usually passing from one person to another after the first sexual activity. Infection with this virus and the occurrence of genital warts (GWs) could have several effects on patients’ health. This study was performed to evaluate the sexual function and sexual quality of life (SQOL) in men with GWs.

Methods

This cross-sectional study was conducted from September 2019 to March 2020 with a sample size of 105 men with GWs in the dermatology clinic of Shahid Faghihi Hospital in Shiraz University of Medical Sciences, Iran. Data were collected using a demographic questionnaire, the International Index of Erectile Function (IIEF), and the Sexual Quality of Life-Men (SQOL-M) questionnaires and analyzed by descriptive and inferential tests with SPSS software version 22.

Results

The mean score for overall sexual function in men was 48.50 ± 8.89. About 35.2% of men had overall sexual dysfunction (SD). The highest disorder rate was related to the erection domain (85.7%), and the lowest was related to the desire domain (5.7%). In the erection domain, most men (54.3%) experienced mild to moderate erectile dysfunction. The mean score for SQOL-M was 38.36 ± 14.47, and 56.2% of them had a good SQOL.

Conclusions

GWs affected men’s erection more than the other sexual function domains. SD in men with GWs has a significant impact on their SQOL and ED was associated with impaired SQOL. Therefore, it is recommended to pay more attention to SD screening alongside SQOL assessment of men with GW.
Pseudoaneurysm with a fistula to the right ventricle late after surgical repair of type A aortic dissection in a patient with systemic lupus erythematosus
Authors: Shimada Akie , Yamamoto Taira , Endo Daisuke , Nishida Kousuke , Matsushita Satoshi , Asai Tohru , Amano Atsushi
Published: April 2022

Background

Pseudoaneurysm with a shunt to the right ventricle after aortic repair for acute aortic dissection is an extremely rare and life-threatening condition. Surgical treatment is unavoidable, but surgery is complicated, and there are some pitfalls. This study describes the reoperation performed in a patient at a high surgical risk by clarifying the shunt site using multimodality imaging before surgery.

Case presentation

A 69-year-old woman with a history of systemic lupus erythematosus (SLE) and Sjogren’s syndrome presented with a pseudoaneurysm 1 year after emergency surgery for acute type A aortic dissection. Eight years after the first surgery, she experienced sudden chest pain and presented to the emergency department. Her dyspnea worsened; therefore, echocardiography and three-dimensional computed tomography (3DCT) were performed, and a pseudoaneurysm and shunt to the right ventricle were identified. The medical team attempted to close the shunt with a percutaneous catheter but was unsuccessful, and she was referred to our department for surgical treatment. The pseudoaneurysm originating from the proximal side of the aorta was large (diameter = 55 mm), and echocardiography-gated 3DCT identified the shunt from the pseudoaneurysm to the right ventricle. First, extracorporeal circulation was initiated, and resternotomy was performed. We could not insert the left ventricular venting tube from the right side because of the pseudoaneurysm size. Instead, the tube was inserted from the left atrial appendage. We found a half-circumferential disengaged anastomosis around the proximal anastomosis, which formed the large pseudoaneurysm leading to a fistula in the right ventricle. We closed the fistula and performed a Bentall operation. The patient had a good postoperative course and was discharged on postoperative day 21. She continued treatment for SLE and Sjogren’s syndrome, and her inflammatory reaction improved.

Conclusions

We performed a Bentall operation and fistula closure with resternotomy in a patient with type A aortic dissection with SLE and Sjogren’s syndrome. Multimodal imaging is essential in defining the pseudoaneurysm and the fistula surrounding the anatomy while ensuring their resolution and guiding the approach for operation.
Predictive value of ACEF score for clinical prognosis of patients with heavily calcified coronary lesions after percutaneous coronary intervention with rotational atherectomy
Authors: Chen Hongwu , Yu Xiaofan , Qiu Guangquan , Ma Likun
Published: April 2022

Background

To inquiry the predictive value of the age, creatinine, and ejection fraction (ACEF) score for cardiac mortality in patients diagnosed with heavily calcified coronary lesions at 1 year after percutaneous coronary intervention (PCI) with rotational atherectomy (RA).

Methods

275 patients with heavily calcified coronary lesions undergoing PCI with RA in the Department of Cardiology of Anhui Provincial Hospital from January 2017 to December 2019 were consecutively recruited. The primary endpoint event was cardiac death at postoperative 1 year. The ROC curve was used to assess ACEF scoring system and predict cardiac mortality.

Results

In term of ACEF score upon admission, 275 patients were divided into low-to-intermediate risk group (n = 130) with ACEF score < 1.23 and high-risk group (n = 145) with ACEF score ≥ 1.23. The age, gender proportion and left ventricular ejection fraction (LVEF) have a significant difference between the low-to-intermediate risk group and the high-risk group (all P < 0.05). The area under ROC curve for ACEF scoring system to predict cardiac mortality at 1 year after PCI with RA was 0.756 and 0.715, respectively.

Conclusions

ACEF value upon admission can predict the cardiac mortality at 1 year following PCI with RA in heavily calcified coronary lesions patients.
The role of ATP-binding cassette subfamily A in the etiology of Alzheimer’s disease
Authors: Bossaerts Liene , Cacace Rita , Van Broeckhoven Christine
Published: April 2022

Background

Alzheimer’s disease (AD) is the leading cause of dementia, clinically characterized by memory deficits and progressive cognitive decline. Despite decades of research effective therapies are lacking, and a large part of the genetic heritability remains unidentified.ABCA7andABCA1, members of the ATP-binding cassette subfamily A (ABCA), were identified as AD risk genes in genome-wide association studies. Nevertheless, genetic and/or functional studies propose a link between AD and two other members of the ABCA subclass, i.e., ABCA2 and ABCA5.

Main body

Changes in expression or dysfunction of these transporters were found to increase amyloid β levels. This might be related to the common role of ABCA transporters in cellular cholesterol homeostasis, for which a prominent role in AD development has been suggested. In this review, we provide a comprehensive overview and discussion on the contribution of the ABCA subfamily to the etiopathogenesis of AD.

Conclusions

A better understanding of the function and identification of disease-associated genetic variants in ABCA transporters can contribute to the development of novel therapeutic strategies for AD.
The boundaries between complex posttraumatic stress disorder symptom clusters and post-migration living difficulties in traumatised Afghan refugees: a network analysis
Authors: Schiess-Jokanovic Jennifer , Knefel Matthias , Kantor Viktoria , Weindl Dina , Schäfer Ingo , Lueger-Schuster Brigitte
Published: April 2022

Background

Psychological distress due to the ongoing war, violence, and persecution is particularly common among Afghan asylum seekers and refugees. In addition, individuals face a variety of post-migration living difficulties (PMLDs). Complex posttraumatic stress symptoms are among the most common mental health problems in this population, and were associated with the overall burden of PMLDs. The complex interplay of posttraumatic symptoms has been investigated from a network perspective in previous studies. However, individuals are embedded in and constantly react to the environment, which makes it important to include external factors in network models to better understand the etiology and maintaining factors of posttraumatic mental health problems. PMLDs are a major risk factor for posttraumatic distress and considering their impact in interventions might improve response rates. However, the interaction of these external factors with posttraumatic psychopathological distress is not yet fully understood. Thus, we aimed to illuminate the complex interaction between PMLDs and CPTSD symptom clusters.

Objective

The main objective is the exploration of the network structure and the complex interplay of ICD-11 CPTSD symptom clusters and distinct forms of PMLDs.

Method

The symptom clusters of CPTSD and PMLDs were collected within a randomised controlled trial among 93 treatment-seeking Afghan asylum seekers and refugees via a fully structured face-to-face and interpreter assisted interview. Using a network analytical approach, we explored the complex associations and network centrality of the CPTSD symptom clusters and the PMLD factors: discrimination & socio-economical living conditions, language acquisition & barriers, family concerns, and residence insecurity.

Results

The results suggest direct links within and between the constructs (CPTSD, PMLD). Almost all PMLD factors were interrelated and associated to CPTSD, family concerns was the only isolated variable. The CPTSD symptom cluster re-experiencing and the PMLD factor language acquisition & barriers connected the two constructs. Affective dysregulation had the highest and avoidance the lowest centrality.

Conclusions

Re-experiencing and affective dysregulation have the strongest ties to PMLDs. Thus, these domains might explain the strong association of posttraumatic psychopathology with PLMDs and, consequently, prioritization of these domains in treatment approaches might both facilitate treatment response and reduce burden caused by PMLDs.
Stasis ulcer and hydronephrosis after severe genital prolapse: a case report
Authors: Leanza Vito , Di Stefano Alessandra , Paladino Erika Carlotta , Rivoli Luca , Distefano Rosario Emanuele Carlo , Palumbo Marco
Published: April 2022

Introduction and importance

The most common complication of pelvic organ prolapse is stress urinary incontinence, whereas hydronephrosis or stasis ulcers are quite rare and typical of severe stages. The best treatment for this unusual presentation is still controversial. Here we present our approach.

Case presentation

Here we present the case of a 70-year-old White/Caucasian woman who presented to our hospital with genital procidentia lasting for 10 years that was associated with both hydronephrosis and stasis ulcers.

Clinical findings and investigations

The Pelvic Organ Prolapse Quantitation system was used to assess the severity of the prolapse, being evaluated as stage IV with the apical compartment leading. A thorough search of the literature was conducted to find any similar cases and evaluate the best evidence treatment.

Interventions and outcomes

A no-mesh procedure comprising vaginal hysterectomy, axial apex suspension, and anterior and posterior repair with ulcerated skin removal resulted in complete resolution of both mechanical and functional symptoms. At 3- and 6-month follow-up visits, a satisfying vaginal profile without hydronephrosis was seen. The Pelvic Organ Prolapse Quantitation at 6 months follow-up was as follows: Aa -3, Ba -3, C -7; gh 2, pb 3, tvt 9; Ap -3, Bp -3.

Relevance and impact

Pelvic organ prolapse involves many organs and causes further complications, leading seldom to renal insufficiency and stasis ulcers. A temporary solution to the obstruction can be achieved by utilizing a pessary, but this device cannot be applied when a stasis ulcer has been previously established. The use of mesh for pelvic floor repair is controversial, but a previous vaginal ulcer may represent a contraindication. A complete evaluation and a challenging surgery may allow the recovery of complicated and severe pelvic organ prolapse. Native tissue pelvic repair gives no erosion postsurgical risk, which is the typical complication of the prosthesis.
Function of epithelial stem cell in the repair of alveolar injury
Authors: Chan Manwai , Liu Yuru
Published: April 2022

Alveoli are the functional units of blood-gas exchange in the lung and thus are constantly exposed to outside environments and frequently encounter pathogens, particles and other harmful substances. For example, the alveolar epithelium is one of the primary targets of the SARS-CoV-2 virus that causes COVID-19 lung disease. Therefore, it is essential to understand the cellular and molecular mechanisms by which the integrity of alveoli epithelial barrier is maintained. Alveolar epithelium comprises two cell types: alveolar type I cells (AT1) and alveolar type II cells (AT2). AT2s have been shown to function as tissue stem cells that repair the injured alveoli epithelium. Recent studies indicate that AT1s and subgroups of proximal airway epithelial cells can also participate alveolar repair process through their intrinsic plasticity. This review discussed the potential mechanisms that drive the reparative behaviors of AT2, AT1 and some proximal cells in responses to injury and how an abnormal repair contributes to some pathological conditions.
Whole cells of recombinant CYP153A6-E. coli as biocatalyst for regioselective hydroxylation of monoterpenes
Authors: Cannazza Pietro , Rabuffetti Marco , Donzella Silvia , De Vitis Valerio , Contente Martina L. , de Oliveira Maria da Conceição Ferreira , de Mattos Marcos C. , Barbosa Francisco G. , de Souza Oliveira Ricardo Pinheiro , Pinto Andrea , Molinari Francesco , Romano Diego
Published: April 2022

Optimized recombinant whole cells of E. coli bearing CYP153A6 were employed for catalyzing the hydroxylation of different monoterpene derivatives. In most cases, high selectivity was observed with exclusive hydroxylation of the allylic methyl group bound to the aliphatic ring. In the case of (R)- and (S)-carvone, hydroxylation occurred also on the other allylic methyl group, although to a lesser extent. Biotransformations carried out in fed-batch mode on (S)-limonene and α-terpineol showed that recombinant whole cells retained activity for at least 24 h, allowing for the recovery of 3.25 mg mL−1 of (S)-perillyl alcohol and 5.45 mg mL−1 of 7-hydroxy-α-terpineol, respectively.
Histone methyltransferase KMT2D cooperates with MEF2A to promote the stem-like properties of oral squamous cell carcinoma
Authors: Wang Xinmiao , Li Rui , Wu Luping , Chen Yang , Liu Shaopeng , Zhao Hui , Wang Yifan , Wang Lin , Shao Zhe
Published: April 2022

Background

Epigenetic reprogramming is involved in multiple steps of human cancer evolution and is mediated by a variety of chromatin-modifying enzymes. Specifically, the histone lysine methyltransferase KMT2D is among the most frequently mutated genes in oral squamous cell carcinoma (OSCC). However, the mechanisms by which KMT2D affects the development of OSCC remain unclear.

Results

In the present study, we found that the expression of KMT2D was elevated in OSCC compared to paracancerous specimens and was correlated with a more advanced tumor grade. More importantly, knockdown of KMT2D impaired their reconstitution in patient-derived organoids and decreased the expression of CD133 and β-catenin in OSCC cells. In in vitro and in vivo models, knockdown of KMT2D reduced the colony formation, migration and invasion abilities of OSCC cells and delayed tumor growth. Mechanistically, the dual-luciferase reporter and co-immunoprecipitation assays in two individual OSCC cell lines indicated that KMT2D may cooperate with MEF2A to promote the transcription activity of CTNNB1, thereby enhancing WNT signaling.

Conclusion

The upregulation of KMT2D contributes to stem-like properties in OSCC cells by sustaining the MEF2A-mediated transcriptional activity of CTNNB1.
Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings
Authors: Hoey Seamus , O’Sullivan Jeremiah , Byrne Jennifer , Devine Sinead , Toomey William , McAllister Hester , Skelly Cliona
Published: April 2022

Background

Osteochondrosis is a common condition of young horses where there is a failure of endochondral ossification, usually at predisposed sites. The estimated prevalence of osteochondrosis is 33–44%, with radiographic screening of yearlings being used to identify lesions. Radiography has two major limitations: poor sensitivity in detecting cartilaginous lesions and secondly, the exposure of the horse and personnel to ionising radiation. Ultrasonography allows imaging of the articular cartilage and subchondral bone margins and has been shown to be more sensitive in identifying osteochondrosis lesions. However, the ultrasonographic technique for examining joints is operator dependant, resulting in highly variable examinations, thus affecting its reliability and reproducibility as a screening test.

Results

A prospective observational clinical population study was undertaken involving twenty-two clinically normal weanling thoroughbred horses on-farm, describing a detailed protocol of the ultrasonographic examination technique for on-farm screening of common sites of osteochondral disease in the young horse, namely the carpal, metacarpophalangeal, stifle, tarsal and metatarsophalangeal joints.

Conclusion

Two veterinary practitioners used the technique to illustrate the repeatability of the protocol. The step-by-step protocol provides a valuable, reliable, repeatable technique for veterinary professionals performing screening ultrasound in the field.
On the periodic boundary value problems for fractional nonautonomous differential equations with non-instantaneous impulses
Authors: Wang Xue , Zhu Bo
Published: April 2022

In this paper, we investigate periodic boundary value problems for Caputo type fractional semilinear nonautonomous differential equations with non-instantaneous impulses. By using semigroup theory combined with the measure of noncompactness and some fixed point theorems, the existence of PC-mild solutions for the equations is established. At the end, an example is presented to illustrate the application of our main results.
Numerical modeling of reinjection and tracer transport in a shallow aquifer, Nesjavellir Geothermal System, Iceland
Authors: Gómez-Díaz Esteban , Scott Samuel , Ratouis Thomas , Newson Juliet
Published: April 2022

Reinjection of excess water from the power production process in the Nesjavellir geothermal field has increased the temperature of shallow groundwaters, posing a risk to cold water wells used for the power plant as well as the ecosystem in Lake Thingvellir. Here, we present a numerical model of fluid flow and heat transport in the shallow reinjection zone to elucidate the flow path of reinjected liquid and the impact of reinjection on the temperature of groundwaters. The permeability structure of the model is based on a 3D geological model of the area. The numerical simulation is calibrated against underground water temperature data measured between 1998 and 2018 and data from a tracer test performed in 2018–2019. The model reproduces the overall temperature field and shows how a high-permeability lava flow together with rift-parallel normal faults act as permeable channels controlling fluid transport. If injection continues, the temperature along the lava flow increases considerably and spreads vertically to much deeper levels, generating a narrow warm zone along the main fault. If shallow injection ceases, temperature drops rapidly at the surface, but decreases slowly around the reinjection zone over 20 years. The numerical model in this study allowed a better characterization of the fracture–matrix interface and the porosity of post-glacial lava flows, contributing to sustainable management of the geothermal resource and the surrounding environment.
Relationship between morality, happiness, and social support among elderly people
Authors: Ahmed Hanem Ahmed Abd El Khalek , Mohamed Bothina Elsayed Said
Published: April 2022

Background

Various factors influence the lives of elders, such as social support, which is critical in preventing physical, psychological, and social difficulties. This study aimed to investigate the relationship between morality, happiness, and social support among elderly people. A descriptive correlational design was used in carrying out this study. This study was conducted at the Geriatric Social Club in El-Qawmia; Zagzig City, Alsharkia Governorate. A purposeful sample of 235 elders was recruited for this study. Four tools were used to collect data: A structured interview questionnaire, Philadelphia Geriatric Center Morale Scale (interview version), Multidimensional Scale of Perceived Social Support, and Oxford Happiness Questionnaire.

Results

Results denoted that less than half of studied elders had moderate score as regards morale scale and perceived social support. As well, less than three-fifths of them had moderate score regards total happiness. There were statistically significant relations between morality and both of age, income, chronic diseases, and taking medication. Perceived social support was positively statistically significantly related with elders’ gender, marital status, chronic diseases, medication, and income. There were statistical significant relations between elderly happiness level and working condition, income, and with whom they live. Elders’ perceived social support was highly positively statistically correlated with happiness and morality.

Conclusions

It was concluded that these variables were positively correlated with each one, where increasing perceived social support and feeling of happiness associated with enhancing feeling of morality among elders. The perceived social support and happiness were the key co-existences of elders’ morality. Therefore, it is recommended to implement caring and training programs focusing on enhancing social support in order to develop morale among elders. The country should provide various kinds of assistance to the elderly, such as counseling services.