bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic Role of Myocardial Edema as Evidenced by Early Cardiac Magnetic Resonance in Survivors of Out‐of‐Hospital Cardiac Arrest: A Multicenter Study
Authors: Zorzi Alessandro , Mattesi Giulia , Baldi Enrico , Toniolo Mauro , Guerra Federico , Cauti Filippo Maria , Cipriani Alberto , De Lazzari Manuel , Muser Daniele , Stronati Giulia , Marcantoni Lina , Manfrin Massimiliano , Calò Leonardo , Lanzillo Chiara , Perazzolo Marra Martina , Savastano Simone , Corrado Domenico
Published: November 2021

Background

Sudden cardiac arrest (SCA) may be caused by an acute and reversible myocardial injury, a chronic and irreversible myocardial damage, or a primary ventricular arrhythmia. Cardiac magnetic resonance imaging may identify myocardial edema (ME), which denotes acute and reversible myocardial damage. We evaluated the arrhythmic outcome of SCA survivors during follow‐up and tested the prognostic role of ME.

Methods and Results

We included a consecutive series of 101 (71% men, median age 47 years) SCA survivors from 9 collaborative centers who underwent early (<1 month) cardiac magnetic resonance imaging and received an implantable cardioverter‐defibrillator (ICD). On T2‐weighted sequences, ME was found in 18 of 101 (18%) patients. According to cardiac magnetic resonance imaging findings, the arrhythmic SCA was ascribed to acute myocardial injury (either ischemic [n=10] or inflammatory [n=8]), to chronic structural heart diseases (ischemic heart disease [n=11], cardiomyopathy [n=20], or other [n=23]), or to primarily arrhythmic syndrome (n=29). During a follow‐up of 47 months (28 to 67 months), 24 of 101 (24%) patients received an appropriate ICD intervention. ME was associated with a significantly higher survival free from both any ICD interventions (log‐rank=0.04) and ICD shocks (log‐rank=0.03) and remained an independent predictor of better arrhythmic outcome after adjustment for left ventricular ejection fraction and late gadolinium enhancement. The risk of appropriate ICD intervention was unrelated to the type of underlying heart disease.

Conclusions

ME on early cardiac magnetic resonance imaging, which denotes an acute and transient arrhythmogenic substrate, predicted a favorable long‐term arrhythmic outcome of SCA survivors. These findings may have a substantial impact on future guidelines on the management of SCA survivors.
Manual Thrombus Aspiration and its Procedural Stroke Risk in Myocardial Infarction
Authors: Sotomi Yohei , Ueda Yasunori , Hikoso Shungo , Nakatani Daisaku , Suna Shinichiro , Dohi Tomoharu , Mizuno Hiroya , Okada Katsuki , Kida Hirota , Oeun Bolrathanak , Sunaga Akihiro , Sato Taiki , Kitamura Tetsuhisa , Sakata Yasuhiko , Sato Hiroshi , Hori Masatsugu , Komuro Issei , Sakata Yasushi ,   the Osaka Acute Coronary Insufficiency Study (OACIS) Group
Published: November 2021

Background

The previous large‐scale randomized controlled trial showed that routine thrombus aspiration (TA) during percutaneous coronary intervention (PCI) was associated with an increased risk of stroke. However, real‐world clinical evidence is still limited.

Methods and Results

We investigated the association between manual TA and stroke risk during primary PCI in the OACIS (Osaka Acute Coronary Insufficiency Study) database (N=12 093). The OACIS is a prospective, multicenter registry of myocardial infarction. The primary end point of the present study is stroke at 7 days. A total of 9147 patients who underwent primary PCI within 24 hours of hospitalization were finally analyzed (TA group, n=4448, versus non‐TA group, n=4699 patients). TA was independently associated with risk of stroke at 7 days (odds ratio [OR], 1.92 [95% CI, 1.19‒3.12];
P
=0.008) in the simple logistic regression model, while the multilevel random effects logistic regression model with hospital treated as a random effect showed that manual TA was not associated with incremental risk of stroke at 7 days (OR, 0.91 [95% CI, 0.71‒1.16];
P
=0.435). The 7‐day stroke risk of manual TA was significantly heterogeneous in different institutions (
P
for interaction
=0.007).

Conclusions

Manual TA during primary PCI for patients with acute myocardial infarction was independently associated with the overall increased risk of periprocedural stroke. However, this result was substantially skewed because of institution specific risk variation, suggesting that the periprocedural stroke may be preventable by prudent PCI procedure or appropriate periprocedural management.

Registration

URL:
https://upload.umin.ac.jp/cgi‐open‐bin/ctr_e/ctr_view.cgi?recptno=R000005464
. Unique identifier: UMIN000004575.
Diameter Reduction Determined Through Carotid Ultrasound Associated With Cardiovascular and All‐Cause Mortality: A Single‐Center Experience of 38 201 Consecutive Patients in Taiwan
Authors: Chen Pei‐Chun , Lin Fu‐Yu , Huang Han‐Chun , Chiang Hsiu‐Yin , Chang Shih‐Ni , Chen Pei‐Shan , Guo Yuh‐Cherng , Liao Pei‐Shan , Wei Yu‐Chyn , Kuo Chin‐Chi
Published: November 2021

Background

Few studies have evaluated the prognostic significance of diameter‐based carotid sonographic measurements for mortality. We investigated whether a reduction in diameter of different carotid anatomical segments is associated with cardiovascular and all‐cause mortality in a hospital‐based cohort with universal health care.

Methods and Results

We conducted a retrospective cohort study of 38 201 patients who underwent carotid duplex ultrasound at a medical center in Taiwan. Carotid sonographic parameters were the diameter reduction percentage in carotid bifurcation, the internal carotid artery, the common carotid artery, and the external carotid artery and the overall carotid atherosclerotic burden score, determined by summing the scores from all segments. The vital status was ascertained by linking data to National Death Registry until 2017. During a median follow‐up of 4.2 years, 5644 participants died, with 1719 deaths attributable to cardiovascular diseases. The multivariable‐adjusted hazard ratios (HRs; 95% CIs) for cardiovascular mortality were 1.33 (1.16‒1.53), 1.58 (1.361.84), and 1.89 (1.58, 2.26) for participants with 30% to <40%, 40% to <50%, and ≥50% reduction in carotid bifurcation diameter, respectively, compared with participants with <30% diameter reduction (
P
for trend <0.001). The corresponding HRs (95% CIs) for all‐cause mortality were 1.25 (1.16‒1.34), 1.42 (1.31‒1.54), and 1.60 (1.45‒1.77), respectively. Diameter reduction at other carotid sites and the carotid atherosclerotic burden score exhibited the same dose–response relationship.

Conclusions

This study suggests that reduction in carotid artery diameter, which can be determined through routinely available sonography, is an independent risk factor for all‐cause and cardiovascular mortality.
Relationship of Neighborhood Deprivation and Outcomes of a Comprehensive ST‐Segment–Elevation Myocardial Infarction Protocol
Authors: Huded Chetan P. , Dalton Jarrod E. , Kumar Anirudh , Krieger Nikolas I. , Kassis Nicholas , Phelan Michael , Kravitz Kathleen , Reed Grant W. , Krishnaswamy Amar , Kapadia Samir R. , Khot Umesh
Published: November 2021

Background

We evaluated whether a comprehensive ST‐segment–elevation myocardial infarction protocol (CSP) focusing on guideline‐directed medical therapy, transradial percutaneous coronary intervention, and rapid door‐to‐balloon time improves process and outcome metrics in patients with moderate or high socioeconomic deprivation.

Methods and Results

A total of 1761 patients with ST‐segment–elevation myocardial infarction treated with percutaneous coronary intervention at a single hospital before (January 1, 2011–July 14, 2014) and after (July 15, 2014– July 15, 2019) CSP implementation were included in an observational cohort study. Neighborhood deprivation was assessed by the Area Deprivation Index and was categorized as low (≤50th percentile; 29.0%), moderate (51st –90th percentile; 40.8%), and high (>90th percentile; 30.2%). The primary process outcome was door‐to‐balloon time. Achievement of guideline‐recommend door‐to‐balloon time goals improved in all deprivation groups after CSP implementation (low, 67.8% before CSP versus 88.5% after CSP; moderate, 50.7% before CSP versus 77.6% after CSP; high, 65.5% before CSP versus 85.6% after CSP; all
P
<0.001). Median door‐to‐balloon time among emergency department/in‐hospital patients was significantly noninferior in higher versus lower deprivation groups after CSP (noninferiority limit=5 minutes;
P
noninferiority
high versus moderate = 0.002, high versus low <0.001, moderate versus low = 0.02). In‐hospital mortality, the primary clinical outcome, was significantly lower after CSP in patients with moderate/high deprivation in unadjusted (before CSP 7.0% versus after CSP 3.1%; odds ratio [OR], 0.42 [95% CI, 0.25–0.72];
P
=0.002) and risk‐adjusted (OR, 0.42 [95% CI, 0.23–0.77];
P
=0.005) models.

Conclusions

A CSP was associated with improved ST‐segment–elevation myocardial infarction care across all deprivation groups and reduced mortality in those from moderate or high deprivation neighborhoods. Standardized initiatives to reduce care variability may mitigate social determinants of health in time‐sensitive conditions such as ST‐segment–elevation myocardial infarction.
The taxonomic status of Cryptobatrachus frogs (Anura: Hemiphractidae) from the Serranía del Perijá
Authors: MEZA-JOYA FABIO LEONARDO , RAMOS ELIANA , ROJAS-RUNJAIC FERNANDO J. M. , OVALLE-PACHECO ANDRÉS
Published: November 2021

The Neotropical frog genus Cryptobatrachus includes six currently recognized species distributed throughout the northern Andes in Colombia and Venezuela. Cryptobatrachus conditus, C. pedroruizi, and C. remotus were described from the Colombian and Venezuelan slopes of the Serranía del Perijá. Due to the great morphological similarity among these species, we re-assess their taxonomic status based on morphological and molecular data from types, topotypes, and specimens from localities referred to in the original descriptions of these species. Morphometric comparisons showed that all these species are virtually indistinguishable, although some subtle qualitative differences in morphological traits distinguish C. conditus from the other species. Phylogenetic analyses of DNA sequences found that C. remotus and C. pedroruizi are not reciprocally monophyletic and exhibit low genetic divergence (< 1 %). Therefore, C. remotus should be considered a junior synonym of C. pedroruizi. This work stresses the importance of comprehensive taxon sampling in poorly explored areas, especially between neighbouring countries.
A new species in the genus Chadisra Walker (Notodontidae: Periergosinae) from the Great Nicobar Island, India
Authors: SINGH NAVNEET , AHMAD JALIL , RAHA ANGSHUMAN
Published: November 2021

A new species, Chadisra curvipenis N. Singh, Ahmad & Raha, sp. nov. is described from the Great Nicobar Island, India, and its detailed description along with habitus images, male genitalia illustrations and diagnoses with similar congeners are provided. A complete checklist of the genus with distributional records and a distribution map are given.
Monotypic no more: A new species of the unusual genus Mayagueza Wheeler, 1960 from the Neotropical region (Diptera: Drosophilidae: Steganinae)
Authors: COSTA SÁVIO CUNHA , PIRANI GABRIELA , OLIVEIRA SARAH SIQUEIRA
Published: November 2021

A new species belonging to the previously monotypic steganine genus Mayagueza Wheeler, 1960 (Diptera: Drosophilidae) is described. The new species, Mayagueza lopesi sp. nov., was collected in the Brazilian Cerrado. This is the first record of this genus for South America, and the description of the new species, based on male and female adult specimens, includes photographs and detailed illustrations of male and female terminalia.
Africa and Africans in the World Wars: The Prelude and Disposition for Leveraged Exploitation through Violence and Coercion
Authors: Ejiogu EC , Umego Nneka L.
Published: November 2021

This article argues that there is a set twin repertoires of coercion and violence that consistently characterized Europe’s involvement in Africa starting with its trans-Atlantic slave trade in which millions of able-bodied Africans were transported against their will to the New World where they were forced to labor as chattels in plantations, through the trade in produce commodities, conquest, and de facto occupation of the continent to the two World Wars when African commodity produce and manpower were impressed and utilized in the win the war efforts. Both repertoires remain handy all through the above-listed endeavors, and without them, it could have been extremely impossible for Europeans to successfully pull each one of them off. An analysis that factors both repertoires in reveals that the era of conquest and occupation of Africa flowed seamlessly into the era of World War I when the European powers that colonized Africa relied on them to impress Africans as manpower for its win the war efforts. For one to better understand each of the six endeavors, one needs to understand all six.
Of Passport and Politics: Faith and Politics Among the ‘Neo-Salafis’ of South India
Authors: Ilias M. H.
Published: November 2021

There is a major assumption regarding the politics of the neo-Salafis in South India (especially in Kerala) widely shared in the political, media and academic circles; their everyday life and religiosity do not provide a conscious address to things such as state and politics and they are confined to the social and religious sphere rather than the political one . The recurring question in this study is, therefore, how to make sense of the political expressions of a group, which apparently shows no direct inclination towards the ‘mainstream’ politics. This study also tries to address the ambiguity about the role of Salafi ideology in everyday conduct of politics among the neo-Salafis. What is the position of Salafism in the scheme of political thinking and how it relates to the political imagination of neo-Salafis, are examined taking cues from the experience of some of the neo- Salafist groups, which keep a strong open disbelief in the secular polity.
Machine Learning and Statistical Prediction of Pitching Arm Kinetics
Authors: Nicholson Kristen F. , Collins Gary S. , Waterman Brian R. , Bullock Garrett S.
Published: November 2021

Background:

Over the past decade, research has attempted to elucidate the cause of throwing-related injuries in the baseball athlete. However, when considering the entire kinetic chain, full body mechanics, and pitching cycle sequencing, there are hundreds of variables that could influence throwing arm health, and there is a lack of quality investigations evaluating the relationship and influence of multiple variables on arm stress.

Purpose:

To identify which variables have the most influence on elbow valgus torque and shoulder distraction force using a statistical model and a machine learning approach.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A retrospective review was performed on baseball pitchers who underwent biomechanical evaluation at the university biomechanics laboratory. Regression models and 4 machine learning models were created for both elbow valgus torque and shoulder distraction force. All models utilized the same predictor variables, which included pitch velocity and 17 pitching mechanics.

Results:

The analysis included a total of 168 high school and collegiate pitchers with a mean age of 16.7 years (SD, 3.2 years) and BMI of 24.4 (SD, 1.2). For both elbow valgus torque and shoulder distraction force, the gradient boosting machine models demonstrated the smallest root mean square errors and the most precise calibrations compared with all other models. The gradient boosting model for elbow valgus torque reported the highest influence for pitch velocity (relative influence, 28.4), with 5 mechanical variables also having significant influence. The gradient boosting model for shoulder distraction force reported the highest influence for pitch velocity (relative influence, 20.4), with 6 mechanical variables also having significant influence.

Conclusion:

The gradient boosting machine learning model demonstrated the best overall predictive performance for both elbow valgus torque and shoulder distraction force. Pitch velocity was the most influential variable in both models. However, both models also revealed that pitching mechanics, including maximum humeral rotation velocity, shoulder abduction at foot strike, and maximum shoulder external rotation, significantly influenced both elbow and shoulder stress.

Clinical Relevance:

The results of this study can be used to inform players, coaches, and clinicians on specific mechanical variables that may be optimized to mitigate elbow or shoulder stress that could lead to throwing-related injury.
Helping jurors to understand: Misconceptions about delay in making a complaint
Authors: Byrne Greg
Published: November 2021

In a sexual offence case, jurors may have misconceptions that inappropriately affect their evaluation of a complainant’s evidence, for example, where the complainant has not complained at the first reasonable opportunity to do so. In Victoria, a judge may assist jurors to understand why a complainant may not have complained earlier by providing examples that are not drawn from the evidence. The Victorian Court of Appeal has recently questioned the legislative authority to do this. This article answers the Court’s question. It also considers the Court’s obligations to address this misconception, having regard to a complainant’s interests, to ensure a fair trial.
How Do Leaders vs. Followers Construct Followership? A Field Study of implicit followership theories and Work-Related Affect Using Latent Profile Analysis
Authors: Coyle Patrick T. , Foti Roseanne
Published: November 2021

In this study, we integrate follower categorization theory with affective events theory (AET) to investigate the extent to which within-person patterns of implicit followership theories (IFTs) and work-related affect predict job satisfaction for leaders versus followers. Latent profile analysis (LPA) was used to identify and to describe distinct profiles of IFTs and work-related affect for leaders versus followers. For the sample of 242 leaders, two profiles with distinct patterns of IFTs and work-related affect ( Proactive and Alienated) were found. Leaders with Proactive views of followers showed above-average ratings of work-related affect, while leaders with Alienated views of followers showed lower ratings of work-related affect. In the sample of 240 followers, there were four profiles of followers with distinct patterns of IFTs and work-related affect ( Conforming, Alienated, Proactive, and Negative). Despite showing a similar pattern of IFTs, followers with Alienated views of their own role showed below-average ratings of work-related affect, while followers with Negative views of their own role showed the highest ratings of work-related affect. These findings suggest that IFTs and work-related affect show unique within-person interaction for followers. Furthermore, for followers, profile membership of IFTs and work-related affect significantly predicted mean levels of job satisfaction. Implications are discussed.
Sex Moderates Reward- and Loss-Related Neural Correlates of Triarchic-Model Traits and Antisocial Behavior
Authors: Brislin Sarah J. , Weigard Alexander S. , Hardee Jillian E. , Cope Lora M. , Martz Meghan E. , Zucker Robert A. , Heitzeg Mary M.
Published: November 2021

Abnormalities in responses to reward and loss are implicated in the etiology of antisocial behavior and psychopathic traits. Although there is evidence for sex differences in neural response to reward and loss, it remains unclear how sex differences may moderate links between these neural responses and the phenotypic expression of antisocial behavior and psychopathic traits. This study examined sex differences in associations of neural response to reward and loss with antisocial personality symptoms and psychopathic traits. Functional neuroimaging data were collected during a monetary incentive delay task from 158 participants. Among males, during loss anticipation, activation in the left nucleus accumbens was negatively associated with antisocial behavior. Among females, during loss feedback, activation in the left nucleus accumbens and left amygdala was negatively associated with antisocial behavior. These results suggest that phenotypic sex differences in psychopathic traits and antisocial behavior may in part be attributable to different etiological pathways.
Understand the difference between clinical measured ultrafiltrationand real ultrafiltration in peritoneal dialysis
Authors: Yu Zanzhe , Wang Zhuqing , Wang Qin , Zhang Minfang , Jin Haijiao , Ding Li , Yan Hao , Huang Jiaying , Jin Yan , Davies Simon , Fang Wei , Ni Zhaohui
Published: November 2021

Background

It has been noticed for years that ultrafiltration (UF) is important for survival in peritoneal dialysis. On the other hand, precise and convenient UF measurement suitable for patient daily practice is not as straight forward as it is to measure UF in the lab. Both overfill and flush before fill used to be source of measurement error for clinical practice. However, controversy finding around UF in peritoneal dialysis still exists in some situation. The current study was to understand the difference between clinical measured UF and real UF. The effect of evaporation and specific gravity in clinical UF measurement were tested in the study.

Methods

Four different brands of dialysate were purchased from the market. The freshest dialysate available in the market were intentionally picked. The bags were all 2 L, 2.5% dextrose and traditional lactate buffered PD solution. They were stored in four different conditions with controlled temperature and humidity. The bags were weighted at baseline, 6 months and 12 months of storage. Specific gravity was measured in mixed 24 h drainage dialysate from 261 CAPD patients when they come for their routine solute clearance test.

Results

There was significant difference in dialysate bag weight at baseline between brands. The weight declined significantly after 12 month’s storage. The weight loss was greater in higher temperature and lower humidity. The dialysate in non-PVC package lose less weight than PVC package. The specific gravity of dialysate drainage was significantly higher than pure water and it was related to dialysate protein concentration.

Conclusion

Storage condition and duration, as well as the type of dialysate package have significant impact in dialysate bag weight before use. Evaporation is likely to be the reason behind. The fact that specific gravity of dialysate drainage is higher than 1 g/ml overestimates UF in manual exchanges, which contributes to systemic measurement error of ultrafiltration in CAPD.

Trial registration

ClinicalTrials.gov ID: NCT03864120 (March 8, 2019) (Understand the Difference Between Clinical Measured Ultrafiltration and Real Ultrafiltration).
Changes of macular vessel density and thickness in gas and silicone oil tamponades after vitrectomy for macula-on rhegmatogenous retinal detachment
Authors: Liu Yang , Lei Boya , Jiang Rui , Huang Xin , Zhou Min , Xu Gezhi
Published: November 2021

Purpose

To investigate the macular vessel density and thickness in macular-on rhegmatogenous retinal detachment (RRD) after vitrectomy with gas and silicone oil (SO) tamponade.

Methods

Patients with macular-on RRD eyes, treated with a single successful vitrectomy with gas or SO tamponade and a minimum 30 months follow-up, were reviewed. Best-corrected visual acuity (BCVA), macular vessel density and retinal thickness by using optical coherence tomography angiography, were compared to the contralateral eyes.

Results

Sixteen eyes with gas tamponade and 17 eyes with SO tamponade were included in the study. LogMAR best-corrected visual acuity (BCVA) slightly improved from 0.25 ± 0.18 (Snellen 20/36) to 0.17 ± 0.23 (Snellen 20/30) in eyes with gas tamponade, and decreased from 0.30 ± 0.22 (Snellen 20/40) to 0.49 ± 0.28 (Snellen 20/62) in eyes with SO tamponade. The parafoveal vessel densities in superficial vascular complex (SVC) and the corresponding inner retinal thickness (IRT) were similar between the affected eyes and the contralateral eyes in gas tamponade group (P = 0.578, P = 0.943), while significantly reduced in the affected eyes, compared to the contralateral eyes in SO tamponade group (P < 0.001, P < 0.001).

Conclusion

Eyes in SO tamponade group had worse BCVA, lower SVC vessel densities and thinner corresponding IRT after vitrectomy for macular-on RRD, than those in gas tamponade group.
Prevalence and factors associated with post-traumatic stress disorder in healthcare workers exposed to COVID-19 in Wuhan, China: a cross-sectional survey
Authors: Pan Lingling , Xu Qiancheng , Kuang Xia , Zhang Xiancui , Fang Fengxia , Gui Liling , Li Mei , Tefsen Boris , Zha Lei , Liu Huan
Published: November 2021

Background

The COVID-19 pandemic has posed significant threats to both the physical and psychological health of healthcare workers working in the front-line combating COVID-19. However, studies regarding the medium to long term impact of COVID-19 on mental health among healthcare workers are limited. Therefore, we conducted this cross-sectional survey to investigate the prevalence, factors and impact of post-traumatic stress disorder (PTSD) in healthcare workers exposed to COVID-19 8 months after the end of the outbreak in Wuhan, China.

Methods

A web-based questionnaire was delivered as a link via the communication application WeChat to those healthcare workers who worked at several COVID-19 units during the outbreak (from December 2019 to April 2020) in Wuhan, China. The questionnaire included questions on social-demographic data, the post-traumatic stress disorder checklist-5 (PCL-5), the family care index questionnaire (Adaptation, Partnership, Growth, Affection and Resolve, APGAR), and the quality-of-life scale (QOL). The prevalence, risk and protective factors, and impact of PTSD on healthcare workers were subsequently analyzed.

Results

Among the 659 participants, 90 healthcare workers were still suffering from PTSD 8 months after the end of the outbreak of COVID-19 in Wuhan, in which avoidance and negative impact were the most affected dimensions. Suffering from chronic disease, experiencing social isolation, and job dissatisfaction came up as independent risk factors for PTSD, while obtaining COVID-19 related information at an appropriate frequency, good family function, and working in well-prepared mobile cabin hospitals served as protective factors. The impact of PTSD on COVID-19 exposed healthcare workers was apparent by shortened sleeping time, feeling of loneliness, poorer quality of life and intention to resign.

Conclusions

Eight months after the end of the COVID-19 outbreak in Wuhan, the level of PTSD in healthcare workers exposed to COVID-19 was still high. Apart from the commonly recognized risk factors, comorbid chronic disease was identified as a new independent risk factor for developing PTSD. For countries where the pandemic is still ongoing or in case of future outbreaks of new communicable diseases, this study may contribute to preventing cases of PTSD in healthcare workers exposed to infectious diseases under such circumstances.
Correlation between immune-related adverse events and therapeutic effects of nivolumab in patients with malignant pleural mesothelioma
Authors: Yoneda Hiroto , Nokihara Hiroshi , Mitsuhashi Atsushi , Ozaki Ryohiko , Yabuki Yohei , Ogino Hirokazu , Otsuka Kenji , Nishioka Yasuhiko
Published: November 2021

Background

Nivolumab is used for the treatment of malignant pleural mesothelioma (MPM). However, immune-related adverse events (irAEs) occur in patients treated with nivolumab. Several studies have reported the correlation between irAEs and therapeutic effects of immune checkpoint inhibitor, but none have reported the correlation in MPM. Here we report a retrospective study which shows the correlation between irAEs and therapeutic effects of nivolumab in patients with MPM.

Methods

This study included patients treated with nivolumab at Tokushima University Hospital from February 2009 to September 2021. We retrospectively reviewed the medical records to evaluate the several clinical factors, such as the presence or absence of irAEs, their severities, progression-free survival (PFS), overall survival (OS) or objective response to the treatment.

Results

Eleven patients received treatment with nivolumab. Objective response rate was 18.2% and the disease control rate was 90.9%. Median PFS was 6.8 months (95% confidence interval, 1.3 to 11.9 months) and median OS was 15.2 months (95% confidence interval, 8.9 to 21.5 months). IrAEs occurred in eight patients (72.7%), and grade ≥ 2 irAEs occurred in six patients (54.5%). PFS and OS were significantly longer in the grade ≥ 2 irAEs group than in grade < 2 irAEs group (median PFS 13.6 vs. 3.8 months, p = 0.0093; median OS not reached vs. 8.6 months, p = 0.0108).

Conclusions

This is the first study to report the correlation between irAEs and therapeutic effects in patients with MPM. Because the presence of irAEs may be associated with a favorable clinical outcome, early detection and appropriate management of irAEs will increase the therapeutic benefits to patients.
Integrating diabetes, hypertension and HIV care in sub-Saharan Africa: a Delphi consensus study on international best practice
Authors: McCombe Geoff , Murtagh Sara , Lazarus Jeffrey V. , Van Hout Marie Claire , Bachmann Max , Jaffar Shabbar , Garrib Anupam , Ramaiya Kaushik , Sewankambo Nelson K. , Mfinanga Sayoki , Cullen Walter
Published: November 2021

Background

Although HIV continues to have a high prevalence among adults in sub-Saharan Africa (SSA), the burden of noncommunicable diseases (NCD) such as diabetes and hypertension is increasing rapidly. There is an urgent need to expand the capacity of healthcare systems in SSA to provide NCD services and scale up existing chronic care management pathways. The aim of this study was to identify key components, outcomes, and best practice in integrated service provision for the prevention, identification and treatment of HIV, hypertension and diabetes.

Methods

An international, multi stakeholder e-Delphi consensus study was conducted over two successive rounds. In Round 1, 24 participants were asked to score 27 statements, under the headings ‘Service Provision’ and ‘Benefits of Integration’, by importance. In Round 2, the 16 participants who completed Round 1 were shown the distribution of scores from other participants along with the score that they attributed to an outcome and were asked to reflect on the score they gave, based on the scores of the other participants and then to rescore if they wished to. Nine participants completed Round 2.

Results

Based on the Round 1 ranking, 19 of the 27 outcomes met the 70% threshold for consensus. Four additional outcomes suggested by participants in Round 1 were added to Round 2, and upon review by participants, 22 of the 31 outcomes met the consensus threshold. The five items participants scored from 7 to 9 in both rounds as essential for effective integrated healthcare delivery of health services for chronic conditions were improved data collection and surveillance of NCDs among people living with HIV to inform integrated NCD/HIV programme management, strengthened drug procurement systems, availability of equipment and access to relevant blood tests, health education for all chronic conditions, and enhanced continuity of care for patients with multimorbidity.

Conclusions

This study highlights the outcomes which may form key components of future complex interventions to define a model of integrated healthcare delivery for diabetes, hypertension and HIV in sub-Saharan Africa.
Eight-year post-trial follow-up of morbidity and mortality of telephone health coaching
Authors: Mustonen Erja , Hörhammer Iiris , Patja Kristiina , Absetz Pilvikki , Lammintakanen Johanna , Talja Martti , Kuronen Risto , Linna Miika
Published: November 2021

Background

Health coaching is a patient-centred approach to supporting self-management for the chronic conditions. However, long-term evidence of effectiveness of health coaching remains scarce. The object of this study was to evaluate the long-term effect of telephone health coaching (THC) on mortality and morbidity among people with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF)..

Methods

1535 T2D, CAD and CHF patients with unmet treatment targets were randomly allocated into an intervention group (n = 1034) and control group (n = 501). Intervention group received monthly individual strength-based, autonomy supportive THC sessions (average 30 min) for behavior change with a specially trained nurse for 12 months additional to usual health care. Control group received usual health care services. The primary outcome was a composite of death from cardiovascular causes or non-fatal stroke or non-fatal myocardial infarction (AMI) or unstable angina pectoris (UAP) during a follow-up of 8 years Three other composite endpoints with distinct combinations of fatal and non-fatal cardiovascular events and death from any cause were used as secondary outcomes. Other outcomes followed were the most relevant components of the composite endpoints. Randomized controlled trial (RCT) data was linked to Finnish national health and social care registries and electronic health records (EHR). Post-trial eight-year evaluation was conducted using intention-to-treat (ITT) and per-protocol (PP) analysis.

Results

The composite primary outcome event rate per 100 person years was lower in the intervention group (3.45) than in control group (3.88) in ITT -analysis, but the difference was not statistically significant (hazard ratio in the intervention group 0.87; 95% CI, 0.71 to 1.07; P = 0.19). In the subgroup (T2D, CAD/CHF) analysis, there were no statistically significant effects. The secondary PP-analysis showed statistically significant benefits for those who participated in the study.

Conclusions

No statistically significant effect of health coaching on mortality and morbidity was found in intention to treat analysis. The per protocol results suggest, however, that the intervention may be effective among patients who are willing and able to participate in health coaching. More research is needed to identify patients most likely to benefit from low-intensity health coaching.

Trial registration

NCT00552903 (registration date: the 1st of November 2007, updated the 3rd of February 2009).
Association of glycated hemoglobin A1c levels with cardiovascular outcomes in the general population: results from the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium
Authors: Sinning Christoph , Makarova Nataliya , Völzke Henry , Schnabel Renate B. , Ojeda Francisco , Dörr Marcus , Felix Stephan B. , Koenig Wolfgang , Peters Annette , Rathmann Wolfgang , Schöttker Ben , Brenner Hermann , Veronesi Giovanni , Cesana Giancarlo , Brambilla Paolo , Palosaari Tarja , Kuulasmaa Kari , Njølstad Inger , Mathiesen Ellisiv Bøgeberg , Wilsgaard Tom , Blankenberg Stefan , Söderberg Stefan , Ferrario Marco M. , Thorand Barbara
Published: November 2021

Background

Biomarkers may contribute to improved cardiovascular risk estimation. Glycated hemoglobin A1c (HbA1c) is used to monitor the quality of diabetes treatment. Its strength of association with cardiovascular outcomes in the general population remains uncertain. This study aims to assess the association of HbA1c with cardiovascular outcomes in the general population.

Methods

Data from six prospective population-based cohort studies across Europe comprising 36,180 participants were analyzed. HbA1c was evaluated in conjunction with classical cardiovascular risk factors (CVRFs) for association with cardiovascular mortality, cardiovascular disease (CVD) incidence, and overall mortality in subjects without diabetes (N = 32,496) and with diabetes (N = 3684).

Results

Kaplan–Meier curves showed higher event rates with increasing HbA1c levels (log-rank-test: p < 0.001). Cox regression analysis revealed significant associations between HbA1c (in mmol/mol) in the total study population and the examined outcomes. Thus, a hazard ratio (HR) of 1.16 (95% confidence interval (CI) 1.02–1.31, p = 0.02) for cardiovascular mortality, 1.13 (95% CI 1.03–1.24, p = 0.01) for CVD incidence, and 1.09 (95% CI 1.02–1.17, p = 0.01) for overall mortality was observed per 10 mmol/mol increase in HbA1c. The association with CVD incidence and overall mortality was also observed in study participants without diabetes with increased HbA1c levels (HR 1.12; 95% CI 1.01–1.25, p = 0.04) and HR 1.10; 95% CI 1.01–1.20, p = 0.02) respectively. HbA1c cut-off values of 39.9 mmol/mol (5.8%), 36.6 mmol/mol (5.5%), and 38.8 mmol/mol (5.7%) for cardiovascular mortality, CVD incidence, and overall mortality, showed also an increased risk.

Conclusions

HbA1c is independently associated with cardiovascular mortality, overall mortality and cardiovascular disease in the general European population. A mostly monotonically increasing relationship was observed between HbA1c levels and outcomes. Elevated HbA1c levels were associated with cardiovascular disease incidence and overall mortality in participants without diabetes underlining the importance of HbA1c levels in the overall population.
Association of MIR17HG and MIR155HG gene variants with steroid-induced osteonecrosis of the femoral head in the population of northern China
Authors: Liu Tingting , Cao Yuju , Han Changxu , An Feimeng , Wang Tiantian , Sun Menghu , Ma Chao , Dong Qiumei , Wang Jianzhong
Published: November 2021

Introduction

Steroid-induced osteonecrosis of the femoral head (ONFH) is a disease of the bone. Metabolism and genetic factors are generally considered to play an important role. The purpose of this study was to investigate the relationship between single-nucleotide polymorphisms (SNPs) in MIR17HG and MIR155HG and the risk of steroid-induced ONFH in the population of northern China.

Methods

A total of 199 steroid-induced ONFH patients and 506 healthy controls were recruited for the study. Four SNPs of MIR17HG and seven SNPs of MIR155HG were genotyped by Sequenom MassARRAY. ORs and 95% CIs were used to evaluate the relationship between these SNPs and steroid-induced ONFH.

Results

In the codominant model, patients with the MIR17HG SNPs (rs7318578) AA genotype had an increased risk of steroid-induced ONFH (OR = 1.79, p = 0.039); in the recessive model, patients with the MIR17HG SNP (rs7318578) AA genotype had an increased risk of steroid-induced ONFH (OR = 1.78, p = 0.032). Stratified analysis showed that a MIR17HG SNP (rs7318578) and the MIR155HG SNPs (rs77218221, rs11911469, rs34904192 and rs4143370) were closely related to different unornamented phenotypes of steroid-induced ONFH. Analysis of the clinical indicators revealed significant differences in high-density lipoprotein (HDL-C) levels between the ONFH group and the control group (p = 0.005). In the MIR17HG SNP (rs75267932), patients with different genotypes had different levels of triglyceride (TG). The MIR155HG SNPs (rs77699734, rs1893650, and rs34904192) showed differences in triglyceride (TG), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) levels in patients with different genotypes.

Conclusion

Our results confirm that MIR17HG and MIR155HG gene mutations are associated with steroid-induced ONFH susceptibility in the population of northern China, providing new evidence for the early detection and prevention of ONFH.
Association between type of anesthesia and length of hospital stay in primary unilateral total knee arthroplasty patients: a single-center retrospective study
Authors: Wang Xiaoqing , Li He , Yuan Conghu , Zhao Hang
Published: November 2021

Objective

This study explored the risk factors influencing the length of hospital stay (LOS) and establish whether the type of anesthesia is independently associated with the LOS in patients after primary unilateral total knee arthroplasty (TKA).

Methods

In this retrospective cohort study, 2309 patients undergoing unilateral TKA were recruited between January 2013 and June 2014 in a tertiary academic medical center in Singapore. Univariate and multivariate linear regression analyses were used to identify the independent risk factors associated with LOS. Besides, subgroup and interaction analyses were performed to evaluate the relationship between the type of anesthesia and LOS.

Result

In total, 2309 patients were identified. Out of these, 791 patients underwent general anesthesia, whereas 1518 patients underwent regional anesthesia. Multivariate regression analyses revealed that prolonged LOS was significantly associated with age ≥ 65 years (β = 0.48; 95% CI, 0.09–0.87; P = 0.015), diabetes mellitus (DM) (β = 0.8; 95% CI, 0.33–1.27; P = 0.001), congestive cardiac failure (CCF) (β = 4.1; 95% CI, 2.02–6.17; P < 0.001), perioperative blood transfusion (β = 5.71; 95% CI, 4.86–6.56; P < 0.001), creatinine > 2 mg/dL (β = 4.54; 95% CI, 2.46–6.62; P < 0.001), ASA status (III) (β = 1.72; 95% CI, 0.72–2.71; P = 0.001), general anesthesia (β = 0.78; 95% CI, 0.41–1.66; P < 0.001). The LOS further decreased among participants receiving regional anesthesia at advanced age (age ≥ 65 years) (β = − 1.12; 95% CI, − 1.66 to − 0.58; P < 0.001), patients with BMI ≤ 25 kg/m2 (β = − 1.92; 95% CI, − 2.73 to − 1.11; P < 0.001) or ≥ 30 kg/m2 (β = − 0.58; 95% CI, − 1.1 to − 0.06; P = 0.029).

Conclusion

Our findings demonstrated that age ≥ 65 years, DM, CCF, perioperative blood transfusion, creatinine > 2 mg/dL, ASA status (III), general anesthesia are associated with a prolonged LOS after primary TKA. Elderly patients (age ≥ 65 years) and patients with BMI ≤ 25 kg/m2 or ≥ 30 kg/m2 receiving regional anesthesia have a further reduced LOS. Therefore, when TKA is performed, priority for regional anesthesia is given to the elderly patients (age ≥ 65 years old) and those with BMI ≤ 25 kg/m2 or ≥ 30 kg/m2.
Germline 3p22.1 microdeletion encompassing RPSA gene is an ultra-rare cause of isolated asplenia
Authors: Oszer Aleksandra , Bąbol-Pokora Katarzyna , Kołtan Sylwia , Pastorczak Agata , Młynarski Wojciech
Published: November 2021

Background

Isolated Congenital Asplenia (ICA, OMIM #271400) is a rare, life-threatening abnormality causing immunodeficiency, which is characterized by the absence of a spleen. Diagnosis should be completed in early childhood and antibiotic prophylaxis applied with additional vaccinations.

Case presentation

We report the case of a six-month old girl with hematologic abnormalities and asplenia documented in imaging, with Howell-Jolly bodies in peripheral blood smear. Targeted Next Generation Sequencing screening did not reveal any pathogenic variant in genes associated with congenital asplenia. Since absence of the spleen was found by imaging, high-resolution copy number variations detection was also performed using genomic Single Nucleotide Polymorphism microarray: a heterozygous 337.2 kb deletion encompassing the RPSA gene was observed, together with SLC25A38, SNORA6, SNORA62 and MOBP genes. Despite haploinsufficiency of SLC25A38, SNORA6, SNORA62 and MOBP, no change in the clinical picture was observed. A search of available CNV databases found that a deletion of the RPSA locus seems to be unique and only duplications were found in this region with the frequency of less than 0.02%.

Conclusions

Copy number variations in RPSA gene locus are ultrarare cause of isolated asplenia. Furthermore, since the patient does not present any concomitant clinical features, it would appear that haploinsufficiency of SLC25A38, SNORA6, SNORA62 and MOBP genes does not affect the phenotype of patients. However, to confirm this thesis a longer follow-up of the patient’s development is needed.
CircRNA-DOPEY2 enhances the chemosensitivity of esophageal cancer cells by inhibiting CPEB4-mediated Mcl-1 translation
Authors: Liu Zhenchuan , Gu Shaorui , Wu Kaiqin , Li Lei , Dong Chenglai , Wang Wenli , Zhou Yongxin
Published: November 2021

Background

Cisplatin-based chemotherapy is a mainstay systematic therapy for advanced esophageal squamous cell carcinoma (ESCC), and cisplatin resistance, which is not uncommon, is the major barrier to improving patient outcomes. Circular RNAs (circRNAs) are novel noncoding RNAs that are implicated in cancer progression, but their involvement in modulating cisplatin responsiveness in ESCC remains unknown.

Methods

Bioinformatics analysis was used to profile and identify the circRNAs involved in cisplatin responsiveness in ESCC. The chemosensitive role of cDOPEY2 was confirmed both in vitro and in vivo. The molecular mechanism of cDOPEY2 was investigated by mass spectrometry, immunoprecipitation, and ubiquitination analyses.

Results

We report that a novel circRNA (cDOPYE2, hsa_circ_0008078) was markedly downregulated in cisplatin-resistant ESCC cells (ESCC-CR) compared with parental chemosensitive cells. Re-expression of cDOPEY2 substantially enhanced the cell-killing ability of cisplatin by augmenting the apoptotic process in ESCC-CR cells, which was achieved by decreasing the abundance of the antiapoptotic protein Mcl-1. Mechanistically, we showed that cDOPEY2 acted as a protein scaffold to enhance the interaction between the cytoplasmic polyadenylation element binding protein (CPEB4) and the E3 ligase TRIM25, which in turn facilitated the ubiquitination and degradation of CPEB4. The increased Mcl-1 expression in ESCC-CR cells was dependent on the binding of CPEB4 to its untranslated mRNA, and depletion of CPEB4 mediated by cDOPEY2 reversed this effect. Rescue experiments confirmed that the critical role of cDOPEY2 in maintaining cisplatin sensitivity was dependent on the depletion of CEPB4 and its downstream target Mcl-1. Clinical and in vivo data further corroborated the significant relevance of cDOPEY2 to cisplatin responsiveness in ESCC.

Conclusions

We provide evidence that cDOPEY2 inhibits CPEB4-mediated Mcl-1 translation by promoting the ubiquitination and degradation of CPEB4 to alleviate cisplatin resistance, indicating that cDOPEY2 may serve as a valuable biomarker and potential therapeutic target in ESCC.
Biosynthesis and regulation of terpenoids from basidiomycetes: exploration of new research
Authors: Wang Qi , Cao Rui , Zhang Yuna , Qi Pengyan , Wang Lizhi , Fang Shiming
Published: November 2021

Basidiomycetes, also known as club fungi, consist of a specific group of fungi. Basidiomycetes produce a large number of secondary metabolites, of which sesquiterpenoids, diterpenoids and triterpenoids are the primary components. However, these terpenoids tend to be present in low amounts, which makes it difficult to meet application requirements. Terpenoid biosynthesis improves the quantity of these secondary metabolites. However, current understanding of the biosynthetic mechanism of terpenoids in basidiomycetes is insufficient. Therefore, this article reviews the latest research on the biosynthesis of terpenoids in basidiomycetes and summarizes the CYP450 involved in the biosynthesis of terpenoids in basidiomycetes. We also propose opportunities and challenges for chassis microbial heterologous production of terpenoids in basidiomycetes and provide a reference basis for the better development of basidiomycete engineering.