bluuebunny/crossref_metadata_2025 huggingface dataset:
Isolated intracranial hypertension following COVID-19 vaccination: A case report
Authors: Thunstedt Dennis C , Straube Andreas , Schöberl Florian
Published: September 2021

Increased intracranial pressure in cerebral venous sinus thrombosis or metabolic disease has been reported. We present a case of new-onset chronic headache and bilateral papilledema in the setting of elevated intracranial pressure in strong temporal association to vaccination against COVID-19 with AstraZeneca. After repeated drainage of cerebrospinal fluid and conservative drug therapy, pathological findings were regredient. Even in absence of typical risk factors, increased intracranial pressure should be considered in case of clinical suspicion after COVID-19 vaccination.
Arthroscopic Repair of Batter’s Shoulder
Authors: Cross Austin G. , Goldman Brian H. , Makhni Eric C.
Published: September 2021

Background:

Batter’s shoulder is a condition in which the posterior labrum is typically torn during the baseball swinging motion, producing a traumatic tear and posterior instability. The injury commonly occurs in the batter’s lead shoulder due to repetitive microtrauma, raising concern for switch-hitters due to the cumulative stress of throwing and swinging on the lead shoulder. Instability is commonly caused by a posterior humeral force and relative shoulder adduction, which is most prevalent during a swing attempt at a low and outside pitch.

Indications:

Damage to the labrum during the acute traumatic event can cause residual pain and recurrent instability of the shoulder. Indications include failed conservative management. The patient demonstrated a full-thickness longitudinal tear that was grossly unstable with gentle probing.

Technique Description:

After establishing presence of an unstable posterior labral tear during diagnostic arthroscopy, a 7-o’clock portal is established for the labral repair. A knotless suture anchor construct was utilized for its low-profile features. Care is taken to avoid both tangling of sutures and overtensioning of the repair.

Results:

Patients return to live batting practice at 6 months postoperatively and most patients return to the same level of play following surgical management.

Discussion/Conclusion:

Avoid overtightening of labral repair and subsequent loss of range of motion. Use of a low-profile knotless suture anchor is the senior author’s preferred method of surgical management. A majority of patients surgically managed for unstable posterior labral injuries return to the same level of play.
Dual RNA-seq transcriptome analysis of caecal tissue during primary Eimeria tenella infection in chickens
Authors: Sandholt Arnar K. S. , Wattrang Eva , Lilja Tobias , Ahola Harri , Lundén Anna , Troell Karin , Svärd Staffan G. , Söderlund Robert
Published: September 2021

Background

Coccidiosis is an infectious disease with large negative impact on the poultry industry worldwide. It is an enteric infection caused by unicellular Apicomplexan parasites of the genusEimeria. The present study aimed to gain more knowledge about interactions between parasites and the host immune system during the early asexual replication phase ofE. tenellain chicken caeca. For this purpose, chickens were experimentally infected withE. tenellaoocysts, sacrificed on days 1–4 and 10 after infection and mRNA from caecal tissues was extracted and sequenced.

Results

Dual RNA-seq analysis revealed time-dependent changes in both host and parasite gene expression during the course of the infection. Chicken immune activation was detected from day 3 and onwards with the highest number of differentially expressed immune genes recorded on day 10. Among early (days 3–4) responses up-regulation of genes for matrix metalloproteinases, several chemokines, interferon (IFN)-γ along with IFN-stimulated genesGBP, IRF1andRSAD2were noted. Increased expression of genes with immune suppressive/regulatory effects, e.g.IL10, SOCS1,SOCS3, was also observed among early responses. ForE. tenellaa general up-regulation of genes involved in protein expression and energy metabolism as well as a general down-regulation genes for DNA and RNA processing were observed during the infection. SpecificE. tenellagenes with altered expression during the experiment include those for proteins in rhoptry and microneme organelles.

Conclusions

The present study provides novel information on both the transcriptional activity ofE. tenelladuring schizogony in ceacal tissue and of the local host responses to parasite invasion during this phase of infection. Results indicate a role for IFN-γ and IFN-stimulated genes in the innate defence againstEimeriareplication.
Ceftriaxone therapy attenuates brain trauma in rats by affecting glutamate transporters and neuroinflammation and not by its antibacterial effects
Authors: Lim Sher-Wei , Su Hui-Chen , Nyam Tee-Tau Eric , Chio Chung-Ching , Kuo Jinn-Rung , Wang Che-Chuan
Published: September 2021

Background

Ceftriaxone is a β-lactam antibiotic used to treat central nervous system infections. Whether the neuroprotective effects of ceftriaxone after TBI are mediated by attenuating neuroinflammation but not its antibacterial actions is not well established.

Methods

Anesthetized male Sprague–Dawley rats were divided into sham-operated, TBI + vehicle, and TBI + ceftriaxone groups. Ceftriaxone was intraperitoneally injected at 0, 24, and 48 h with 50 or 250 mg/kg/day after TBI. During the first 120 min after TBI, we continuously measured heart rate, arterial pressure, intracranial pressure (ICP), and cerebral perfusion pressure. The infarct volume was measured by TTC staining. Motor function was measured using the inclined plane. Glutamate transporter 1 (GLT-1), neuronal apoptosis and TNF-α expression in the perilesioned cortex were investigated using an immunofluorescence assay. Bacterial evaluation was performed by Brown and Brenn’s Gram staining. These parameters above were measured at 72 h after TBI.

Results

Compared with the TBI + vehicle group, the TBI + ceftriaxone 250 mg/kg group showed significantly lower ICP, improved motor dysfunction, reduced body weight loss, decreased infarct volume and neuronal apoptosis, decreased TBI-induced microglial activation and TNF-α expression in microglia, and increased GLT-1 expression in neurons and microglia. However, the grades of histopathological changes of antibacterial effects are zero.

Conclusions

The intraperitoneal injection of ceftriaxone with 250 mg/kg/day for three days may attenuate TBI by increasing GLT-1 expression and reducing neuroinflammation and neuronal apoptosis, thereby resulting in an improvement in functional outcomes, and this neuroprotective effect is not related to its antibacterial effects.
Pneumonia-targeted lopinavir/ritonavir-based treatment for patients with COVID-19: an early-period retrospective single center observational study
Authors: Kim Jongkyu , Jung Jiwoong , Kim Tae Ho , Kang Naree , Choi Hanzo , Oh Dong Hyun , Ahn Mi Young , Kim Su hyun , Hahm Chorom , Lee Young Kyong , Park Keunhong , Hong Kiho , Choi Jae-phil
Published: September 2021

Background

Robust evidenced treatment strategy for Coronavirus disease 2019 (COVID-19) has not been established yet. Early, targeted, comprehensive management approach can be essential.

Methods

A lopinavir/ritonavir (LPV/r)-based antiviral treatment was administered to the patients with computed tomography (CT)-documented pneumonia. Medical records of patients with COVID-19, previously discharged or hospitalized for ≥ 21 days at the Seoul Medical Center from January 29 to April 15, 2020 were reviewed to analyze clinical and virological outcomes. Patients were divided into two groups (PCR-Negative conversion group vs. Non-negative conversion group and requiring oxygen group vs. Non-requiring oxygen group).

Results

In total, 136 patients with a mean age of 41.8 ± 18.2 years were included with median 3-day delay of hospitalization after illness. Thirteen (9.56%) were initially asymptomatic, and 5 (3.67%) were persistently asymptomatic. Eighty-five (62.5%) had CT-documented pneumonia, 94% of whom received LPV/r treatments. A total of 53 patients (38.97%) had negative polymerase chain reaction (PCR) results within 28 days. Eight (9.4%) out of 85 pneumonic patients received oxygen supplementation. Patients with initial lower respiratory symptoms showed significant delay in PCR negative conversion (> 28 days) (odds ratio [OR] 0.166; 95% confidence interval [CI] 0.067–0.477; P < 0.001). However, antiviral treatment for pneumonic patients was significantly related with early conversion within 28 days (OR 3.049; 95% CI 1.128–8.243; P = 0.028). Increasing age increased the likelihood of oxygen supplementation requirement in the pneumonic patient group (OR 1.108; 95% CI 1.021–1.202; P = 0.014).

Conclusions

Early, pneumonia targeted LPV/r-based antiviral therapy resulted in a significantly higher probability of negative conversion of PCR within 28 days compared to symptomatic treatment.
The impact of comorbidities and their stacking on short- and long-term prognosis of patients over 50 with community-acquired pneumonia
Authors: Blanc E. , Chaize G. , Fievez S. , Féger C. , Herquelot E. , Vainchtock A. , Timsit J. F. , Gaillat J.
Published: September 2021

Background

The prognosis of patients hospitalized with community-acquired pneumonia (CAP) with regards to intensive care unit (ICU) admission, short- and long-term mortality is correlated with patient’s comorbidities. For patients hospitalized for CAP, including P-CAP, we assessed the prognostic impact of comorbidities known as at-risk (AR) or high-risk (HR) of pneumococcal CAP (P-CAP), and of the number of combined comorbidities.

Methods

Data on hospitalizations for CAP among the French 50+ population were extracted from the 2014 French Information Systems Medicalization Program (PMSI), an exhaustive national hospital discharge database maintained by the French Technical Agency of Information on Hospitalization (ATIH). Their admission diagnosis, comorbidities (nature, risk type and number), other characteristics, and their subsequent hospital stays within the year following their hospitalization for CAP were analyzed. Logistic regression models were used to assess the associations between ICU transfer, short- and 1-year in-hospital mortality and all covariates.

Results

From 182,858 patients, 149,555 patients aged ≥ 50 years (nonagenarians 17.8%) were hospitalized for CAP in 2014, including 8270 with P-CAP. Overall, 33.8% and 90.5% had ≥ 1 HR and ≥ 1 AR comorbidity, respectively. Cardiac diseases were the most frequent AR comorbidity (all CAP: 77.4%). Transfer in ICU occurred for 5.4% of CAP patients and 19.4% for P-CAP. Short-term and 1-year in-hospital mortality rates were 10.9% and 23% of CAP patients, respectively, significantly lower for P-CAP patients: 9.2% and 19.8% (HR 0.88 [95% CI 0.84–0.93], p < .0001). Both terms of mortality increased mostly with age, and with the number of comorbidities and combination of AR and HR comorbidities, in addition of specific comorbidities.

Conclusions

Not only specific comorbidities, but also the number of combined comorbidities and the combination of AR and HR comorbidities may impact the outcome of hospitalized CAP and P-CAP patients.
A prospective investigation of developmental trajectories of psychosocial adjustment in adolescents facing a chronic condition - study protocol of an observational, multi-center study
Authors: Warschburger Petra , Petersen Ann-Christin , von Rezori Roman E. , Buchallik Friederike , Baumeister Harald , Holl Reinhard W. , Minden Kirsten , Müller-Stierlin Annabel S. , Reinauer Christina , Staab Doris ,   COACH consortium
Published: September 2021

Background

Relatively little is known about protective factors and the emergence and maintenance of positive outcomes in the field of adolescents with chronic conditions. Therefore, the primary aim of the study is to acquire a deeper understanding of the dynamic process of resilience factors, coping strategies and psychosocial adjustment of adolescents living with chronic conditions.

Methods/design

We plan to consecutively recruitN = 450 adolescents (12–21 years) from three German patient registries for chronic conditions (type 1 diabetes, cystic fibrosis, or juvenile idiopathic arthritis). Based on screening for anxiety and depression, adolescents are assigned to two parallel groups – “inconspicuous” (PHQ-9 and GAD-7 < 7) vs. “conspicuous” (PHQ-9 or GAD-7 ≥ 7) – participating in a prospective online survey at baseline and 12-month follow-up. At two time points (T1, T2), we assess (1) intra- and interpersonal resiliency factors, (2) coping strategies, and (3) health-related quality of life, well-being, satisfaction with life, anxiety and depression. Using a cross-lagged panel design, we will examine the bidirectional longitudinal relations between resiliency factors and coping strategies, psychological adaptation, and psychosocial adjustment. To monitor Covid-19 pandemic effects, participants are also invited to take part in an intermediate online survey.

Discussion

The study will provide a deeper understanding of adaptive, potentially modifiable processes and will therefore help to develop novel, tailored interventions supporting a positive adaptation in youths with a chronic condition. These strategies should not only support those at risk but also promote the maintenance of a successful adaptation.

Trial registration

German Clinical Trials Register (DRKS), no.DRKS00025125. Registered on May 17, 2021.
Disparities in excess deaths from the COVID-19 pandemic among migrant workers in Kuwait
Authors: Alahmad Barrak , AlMekhled Dawoud , Odeh Ayah , Albloushi Dalia , Gasana Janvier
Published: September 2021

Background

The actual human cost of the pandemic cannot be viewed through the COVID-19 mortality rates alone, especially when the pandemic is widening the existing health disparities among different subpopulations within the same society. In Kuwait, migrant workers were already disproportionately impacted by COVID-19 and its unintended consequences. The totality of that effect on mortality is yet to be fully understood.

Objective

To estimate excess deaths in the pandemic year of 2020 among the Kuwaiti and non-Kuwaiti migrant populations.

Methods

We analyzed publicly available retrospective data in Kuwait on total annual mortality historically (from 2005 to 2019) and in 2020. We fitted a quasi-poisson generalized linear model adjusted for yearly trend and nationality to estimate the expected deaths in 2020 in the absence of the pandemic. We calculated excess deaths as the difference between observed and expected mortality for the year of the pandemic in both Kuwaitis and non-Kuwaitis.

Results

In the absence of the pandemic, we expected the total mortality in Kuwait to be 6629 (95% CI: 6472 to 6789) deaths. However, the observed total mortality in 2020 was 9975 deaths; about 3346 (3186 to 3503) more deaths above the expected historical trend. Deaths among migrant workers would have been approximately 71.9% (67.8 to 76.0) lower in the absence of the pandemic. On the other hand, deaths among Kuwaitis would have been 32.4% (29.3 to 35.6) lower if the country had not been hit by the pandemic.

Conclusion

The burden of mortality brought on by the COVID-19 pandemic is substantially higher than what the official tally might suggest. Systematically disadvantaged migrant workers shouldered a larger burden of deaths in the pandemic year. Public health interventions must consider structural and societal determinants that give rise to the health disparities seen among migrant workers.
Qualitative ultrasonography scale of the intensity of local twitch response during dry needling and its association with modified joint range of motion: a cross-sectional study
Authors: Cruz-Montecinos Carlos , Cerda Mauricio , Becerra Pablo , Tapia Claudio , Núñez-Cortés Rodrigo , Latorre-García Rodrigo , Freitas Sandro R. , Cuesta-Vargas Antonio
Published: September 2021

Background

The relevance of local twitch response (LTR) during dry needling technique (DNT) is controversial, and it is questioned whether LTR is necessary for successful outcomes. Furthermore, because the LTR during the deep DNT may be evoked with different intensities, it is unknown whether the magnitude of LTR intensity is associated with optimal clinical results, especially concerning to the effects of joint maximal range of motion (ROM). This study aimed to (i) determine whether visual inspections can quantify the LTR intensity during the DNT through a qualitative ultrasonography scale of LTR intensity (US-LTR scale), and (ii) assess the differences of US-LTR scale associated with changes in the maximal joint ROM.

Methods

Using a cross-sectional design, seven asymptomatic individuals were treated with DNT in the latent myofascial trigger point in both medial gastrocnemius muscles. During DNT, three consecutive LTRs were collected. The US-LTR scale was used to classify the LTRs into strong, medium, and weak intensities. The categories of US-LTR were differentiated by the velocity of LTRs using the optical flow algorithm. ROM changes in ankle dorsiflexion and knee extension were assessed before and immediately after DNT.

Results

The US-LTR scale showed the third LTR was significantly smaller than the first one (p < 0.05). A significant difference in velocity was observed between US-LTR categories (p < 0.001). A significant difference in the ROM was observed between the strong and weak-medium intensity (p < 0.05).

Conclusions

The present findings suggest that the LTR intensity can be assessed using a qualitative US-LTR scale, and the effects of DNT on joint maximal ROM is maximized with higher LTR intensity. This study reports a novel qualitative method for LTR analysis with potential applications in research and clinical settings. However, further research is needed to achieve a broader application.
The effect of mobile-app-based instruction on the physical function of female patients with knee osteoarthritis: a parallel randomized controlled trial
Authors: Arfaei Chitkar Seyed Sajad , Mohaddes Hakkak Hamid Reza , Saadati Hassan , Hosseini Seyed Hamid , Jafari Yasaman , Ganji Reza
Published: September 2021

Background

Osteoarthritis is a common disease and one of the most important causes of disability in the elderly that negatively affect the quality of their life. The purpose of this study was to evaluate the effectiveness of mobile app-based-instruction in improving physical performance of female patients with knee osteoarthritis.

Methods

The present study was a randomized clinical trial. The sample included 64 female patients (40 to 70 years old) with knee osteoarthritis in Bojnurd city in 2018. They were selected from the available patients that were randomly divided into comparison and intervention groups. Before the intervention, demographic information questionnaire, Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire, and 36-item short-form health survey (SF-36) were employed to elicit data on demographic information, arthritis condition and health status of the participants. Intervention lasted for a period of two months for each group. Intervention group received mobile-app-based instruction coupled with routine cares, while comparison group just received the routine cares. After the intervention both groups were evaluated again in terms of arthritis condition and health status using the same scales.

Results

After the intervention, significant differences were found between the intervention and comparison groups in terms of overall WOMAC score (p = 0.005), pain aspect of WOMAC (p = 0.005), physical function aspect of WOMAC (p = 0.005), physical function aspect of SF-36 (p ≤ 0.05), and vitality aspect of SF-36 (p > 0.05).

Conclusion

The use of mobile-app-based instruction can enhance the physical function and quality of life in patients with knee osteoarthritis.

Trial registration The research project was registered at Iranian Registry of Clinical Trials (IRCT20161208031300N2).
Dynamic capacity allocation in a radiology service considering different types of patients, individual no-show probabilities, and overbooking
Authors: da Silva Rodolfo Benedito Zattar , Fogliatto Flávio Sanson , Krindges André , dos Santos Cecconello Moiseis
Published: September 2021

Background

We propose a mathematical model formulated as a finite-horizon Markov Decision Process (MDP) to allocate capacity in a radiology department that serves different types of patients. To the best of our knowledge, this is the first attempt at considering radiology resources with different capacities and individual no-show probabilities of ambulatory patients in an MDP model. To mitigate the negative impacts of no-show, overbooking rules are also investigated.

Methods

The model’s main objective is to identify an optimal policy for allocating the available capacity such that waiting, overtime, and penalty costs are minimized. Optimization is carried out using traditional dynamic programming (DP). The model was applied to real data from a radiology department of a large Brazilian public hospital. The optimal policy is compared with five alternative policies, one of which resembles the one currently used by the department. We identify among alternative policies the one that performs closest to the optimal.

Results

The optimal policy presented the best performance (smallest total daily cost) in the majority of analyzed scenarios (212 out of 216). Numerical analyses allowed us to recommend the use of the optimal policy for capacity allocation with a double overbooking rule and two resources available in overtime periods. An alternative policy in which outpatients are prioritized for service (rather than inpatients) displayed results closest to the optimal policy, being also recommended due to its easy implementation.

Conclusions

Based on such recommendation and observing the state of the system at any given period (representing the number of patients waiting for service), radiology department managers should be able to make a decision (i.e., define number and type of patients) that should be selected for service such that the system’s cost is minimized.
Advances in the management of haemophilia: emerging treatments and their mechanisms
Authors: Okaygoun Dide , Oliveira Danielle D. , Soman Sooriya , Williams Riccardo
Published: September 2021

Mainstay haemophilia treatment, namely intravenous factor replacement, poses several clinical challenges including frequent injections due to the short half-life of recombinant factors, intravenous administration (which is particularly challenging in those with difficult venous access), and the risk of inhibitor development. These impact negatively upon quality of life and treatment compliance, highlighting the need for improved therapies. Several novel pharmacological therapies developed for haemophilia aim to rebalance the clotting cascade and potentially circumvent the aforementioned challenges. These therapies utilise a range of different mechanisms, namely: the extension of the circulating half-life of standard recombinant factors; the mimicking of factor VIII cofactor activity; rebalancing of coagulation through targeting of natural anticoagulants such as antithrombin and tissue factor pathway inhibitor; and inducing the production of endogenous factors with gene therapy. These therapies carry the potential of revolutionising haemophilia treatment by alleviating the current challenges presented by mainstay factor replacement. This review will provide an overview of the key trial findings related to novel therapies based on the mechanisms described above.
Effect of diabetes mellitus on the development of left ventricular contractile dysfunction in women with heart failure and preserved ejection fraction
Authors: Shi Ke , Yang Meng-Xi , Huang Shan , Yan Wei-Feng , Qian Wen-Lei , Li Yuan , Guo Ying-Kun , Yang Zhi-Gang
Published: September 2021

Background

Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome with sex-specific pathophysiology. Estrogen deficiency is believed to be responsible for the development of HFpEF in women. However, estrogen deficiency does not seem to be completely responsible for the differences in HFpEF prevalence between sexes. While diabetes mellitus (DM) frequently coexists with HFpEF in women and is associated with worse outcomes, the changes in myocardial contractility among women with HFpEF and the DM phenotype is yet unknown. Therefore, we aimed to investigate sex-related differences in left ventricular (LV) contractility dysfunction in HFpEF comorbid with DM.

Methods

A total of 224 patients who underwent cardiac cine MRI were included in this study. Sex-specific differences in LV structure and function in the context of DM were determined. LV systolic strains (global longitudinal strain [GLS], circumferential strain [GCS] and radial strain [GRS]) were measured using cine MRI. The determinants of impaired myocardial strain for women and men were assessed.

Results

The prevalence of DM did not differ between sexes (p > 0.05). Despite a similar LV ejection fraction, women with DM demonstrated a greater LV mass index than women without DM (p = 0.023). The prevalence of LV geometry patterns by sex did not differ in the non-DM subgroup, but there was a trend toward a more abnormal LV geometry in women with DM (p = 0.072). The magnitudes of systolic strains were similar between sexes in the non-DM group (p > 0.05). Nevertheless, in the DM subgroup, there was significant impairment in women in systolic strains compared with men (p < 0.05). In the multivariable analysis, DM was associated with impaired systolic strains in women (GLS [β = 0.26; p = 0.007], GCS [β = 0.31; p < 0.001], and GRS [β = −0.24; p = 0.016]), whereas obesity and coronary artery disease were associated with impaired systolic strains in men (p < 0.05).

Conclusions

Women with DM demonstrated greater LV contractile dysfunction, which indicates that women with HFpEF comorbid with DM have a high-risk phenotype of cardiac failure that may require more aggressive and personalized medical treatment.
The role of XBP-1-mediated unfolded protein response in colorectal cancer progression-a regulatory mechanism associated with lncRNA-miRNA-mRNA network
Authors: Wang Yong , Zhang Jingyu , Zheng Shuang
Published: September 2021

Background

We aim to identify the expression and analyze the molecular action of dysregulated lncRNA-miRNA mediated by XBP-1 in colorectal cancer (CRC).

Methods

Here, we identified XBP-1-mediated dysregulated lncRNAs and miRNAs in CRC by bioinformatics analysis. The expression level of lncRNAs and miRNA was measured using quantitative real time PCR, and the expression of XBP-1, as well as apoptosis-related proteins, were detected by western blot. CCK-8 and TUNEL assays were performed to determine cell proliferation and apoptosis, respectively. Luciferase reporter assay was conducted to verify the binding relationship among lncRNA-miRNA-XBP-1. BALB/c nude mice were inoculated subcutaneously with HCT116 cells to establish tumor-bearing mice model. Histological analysis was carried out by HE staining and immunohistochemical staining.

Results

Six downregulated lncRNAs (SLFNL1-AS1, KCNQ1OT1, NEAT1, XIST, AC016876.2, AC026362.1), four dysregulated miRNAs (miR-500a-3p, miR-370-3p, miR-2467-3p, miR-512-3p) and upregulated XBP-1 were identified in CRC cell lines. Gain- and loss-of-function experiments showed that overexpression of KCNQ1OT1/XIST promoted cell proliferation and suppressed cell apoptosis. In addition, overexpression of KCNQ1OT1/XIST partly abolished the inhibitory effects of XBP-1u knockdown or tunicamycin, an activator of endoplasmic reticulum stress, on CRC cell viability loss and apoptosis. Furthermore, KCNQ1OT1/XIST aggravated tumor growth in vivo by regulating endoplasmic reticulum stress and cell apoptosis.

Conclusions

This study has constructed lncRNA-miRNA-mRNA networks based on XBP-1 in CRC, and disclosed the regulatory mechanism of action, providing a set of pivotal biomarkers for future molecular investigation and targeted treatment of CRC.
The association between occupational factors, depression, and health-related quality of life in military women in the Republic of Korea: a cross-sectional study
Authors: Kwon Eunji , Park Jeongok , Kim Sue , Lee Kyung Hee
Published: September 2021

Background

Health-related quality of life (HRQOL) is an important concept to consider both individuals' ability to manage their daily lives and health status across the lifespan. Despite this variable's importance, there is a lack of clarification on the factors associated with HRQOL, especially for military women. The aim of this study was to examine factors associated with HRQOL of military women in the Republic of Korea (ROK) Army.

Methods

This cross-sectional study included 196 participants who were currently within their 5-year service period. HRQOL was measured by the Korean version of the Short-Form 36 Health Survey Questionnaire version 2.0 (SF-36v2), and depression was assessed using the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Differences in HRQOL according to general and occupational factors were analyzed using the independent t-test and analysis of variance (ANOVA). Multiple linear regression analysis was performed to identify factors associated with the HRQOL of women serving as military junior officers.

Results

The mean score for the physical component summary (PCS) of SF-36v2 was 56.0 ± 5.8, and that for the mental component summary (MCS) of SF-36v2 was 47.2 ± 10.0. For depression, the mean score was 5.4 ± 5.2, whereas 19.4% of the participants scored more than 10 out of 27 points, which means moderate to severe. No variables showed statistically significant relationships with the PCS. However, military women showed a lower score for MCS when they were officers (adjusted β = − 3.52; 95% CI = − 5.47, − 1.58), had higher perceived stress (adjusted β = − 0.62, 95% CI = − 0.83, − 0.41), and a higher score for depression (adjusted β = − 0.86, 95% CI = − 1.10, − 0.63).

Conclusions

Although depression levels were not severe, it was a significant factor of HRQOL. Stress and depression were found to be significant factors associated with the MCS in military women. Therefore, to improve their HRQOL, the ROK Army should provide early screening, intervention, and management program for high-risk military women. In addition, an appropriate organizational atmosphere within the military must be created to promote such programs.
Effect of 2020 containment strategies on trauma workflow in Ile-de-France region: another benefit of lockdown?
Authors: Moyer Jean-Denis , Abback Paer-Selim , Hamada Sophie , Martinez Thibault , Werner Marie , James Arthur ,   the Traumabase®Group
Published: September 2021

Background

During the SARS-CoV-2 pandemic, the French Government imposed various containment strategies, such as severe lockdown (SL) or moderate lockdown (ML). The aim of this study was to evaluate the effect of both strategies on severe trauma admissions and ICU capacity in Ile-de-France region (Paris Area).

Main text

We conducted a multicenter cohort-based observational study from 1stJanuary 2017 to 31th December 2020, including all consecutive trauma patients admitted to the trauma centers of Ile-de-France region participating in the national registry (Traumabase®). Two periods were defined, the “non-pandemic period” (NPP) from 2017 to 2019, and the “pandemic period” (PP) concerning those admitted in 2020. The number of ICU beds released during 2020 pandemic period (overall period, SL and ML) was estimated by multiplying difference in trauma admissions by the median length of stay during the same week of pandemic period (ICU day-beds in 2020).

A 15% yearly reduction of trauma patients was observed during the PP, associated with the release of 6422 ICU day-beds in 2020. During SL and ML, the observed decrease in trauma admission was respectively 49 and 39% compared with similar dates of the NPP. The number of beds released was 1531 days-beds in SL and 679 day-beds in ML. Those reductions respectively accounted for 4.5 and 6.0% of the overall ICU admission for COVID-19 in Ile-de-France.

Conclusion

The lockdown strategies during pandemic resulted in a reduction of severe trauma admissions. In addition to the social distancing effect, lockdown strategies freed up an important number of ICU beds in trauma centers, available for severe COVID-19 patients.
Carcinogen-induced DNA structural distortion differences in the RAS gene isoforms; the importance of local sequence
Authors: Menzies Georgina E. , Prior Ian A. , Brancale Andrea , Reed Simon H. , Lewis Paul D.
Published: September 2021

Background

Local sequence context is known to have an impact on the mutational pattern seen in cancer. The RAS genes and a smoking carcinogen, Benzo[a]pyrene diol epoxide (BPDE), have been utilised to explore these context effects. BPDE is known to form an adduct at the guanines in a number of RAS gene sites, KRAS codons 12, 13 and 14, NRAS codon 12, and HRAS codons 12 and 14.

Results

Molecular modelling techniques, along with multivariate analysis, have been utilised to determine the sequence influenced differences between BPDE-adducted RAS gene sequences as well as the local distortion caused by the adducts.

Conclusions

We conclude that G:C > T:A mutations at KRAS codon 12 in the tumours of lung cancer patients (who smoke), proposed to be predominantly caused by BPDE, are due to the effect of the interaction methyl group at the C5 position of the thymine base in the KRAS sequence with the BPDE carcinogen investigated causing increased distortion. We further suggest methylated cytosine would have a similar effect, showing the importance of methylation in cancer development.
Quantitative evaluation of interim positron emission tomography in peripheral T-cell lymphoma
Authors: Kurch Lars , Dührsen Ulrich , Hüttmann Andreas , Georgi Thomas W. , Sabri Osama , Kluge Regine , Hasenclever Dirk
Published: September 2021

Background

Interim [18F]fluoro-deoxyglucose-positron emission tomography predicts outcome in peripheral T-cell lymphoma (PTCL). We compared two quantitative evaluation methods.

Methods

Interim scans from 43 patients with anaplastic lymphoma kinase-negative PTCL from the ‘Positron Emission Tomography-Guided Therapy of Aggressive Non-Hodgkin Lymphomas’ trial were re-analyzed by qPET (relating residual lymphoma-related uptake to liver uptake) and ∆SUVmax (relating interim scan to baseline scan). The endpoint was progression-free survival.

Results

qPET and ∆SUVmax were closely correlated (Pearson’s r = 0.627). Up to the 60th percentile of values ranked by increasing residual activity, the positive predictive value for progression or death increased from 60 to 95%, with stable negative predictive values (NPV) of 60%. Beyond the 60th percentile, the NPV decreased to 40%. qPET ≥ 2 and ∆SUVmax < 50% identified high-risk populations comprising 41.9% and 39.5% of patients, with 3-year progression-free survival rates of 5.6% (95% confidence interval, 0.8–37.3) and 0%, respectively, as compared to 63.7% (47.4–85.8) and 61.3% (45.1–83.3) in low-risk patients.

Conclusions

qPET and ∆SUVmax identify large fractions of PTCL patients destined to experience treatment failure. qPET may be preferred because it requires a single PET scan, halving the diagnostic effort.
Disruptive innovation in a dynamic environment: a winning strategy? An illustration through the analysis of the yoghurt industry in Algeria
Authors: Chemma Nawal
Published: September 2021

Disruptive strategies have only been studied in stable environments. To overcome this limitation, this article aims to show through an in-depth study of the main actors in the yoghurt industry in Algeria that these strategies are possible in a dynamic environment. This research was carried out on the basis of an exploratory qualitative study. We have focused our efforts on two types of players, including new entrants and incumbent businesses.

Our results show that the strong factors of the competitive dynamics pushed companies and industries to undertake disruptive innovation, which strategy became an indispensable element to survive and succeed for all the actors in the industry. Overall, our study indicates that the link between the competitive dynamics and disruptive innovation is not only in need of, but is deserving of, more consideration.
Fibroblast growth factor 21 in dairy cows: current knowledge and potential relevance
Authors: Eder Klaus , Gessner Denise K. , Ringseis Robert
Published: September 2021

Fibroblast growth factor 21 (FGF21) has been identified as an important regulator of carbohydrate and lipid metabolism, which plays an important role for metabolic regulation, particularly under conditions of energy deprivation or stress conditions. Dairy cows are subjected to a negative energy balance and various kinds of stress particularly during the periparturient phase and during early lactation. It has been shown that the plasma concentration of FGF21 in dairy cows is dramatically increased at parturition and remains high during the first weeks of lactation. This finding suggests that FGF21 might exert similar functions in dairy cows than in other species, such as mice or humans. However, the role of FGF21 in dairy cows has been less investigated so far. Following a brief summary of the previous findings about the function of FGF21 in humans and mice, the present review aims to present the current state of knowledge about the role of FGF21 in dairy cows. The first part of the review deals with the tissue localization of FGF21 and with conditions leading to an upregulation of FGF21 expression in the liver of dairy cows. In the second part, the influence of nutrition on FGF21 expression and the role of FGF21 for metabolic diseases in dairy cows is addressed. In the third part, findings of exogenous FGF21 application on metabolism in dairy cows are reported. Finally, the potential relevance of FGF21 in dairy cows is discussed. It is concluded that FGF21 might be of great importance for metabolic adaptation to negative energy balance and stress conditions in dairy cows. However, further studies are needed for a better understanding of the functions of FGF21 in dairy cows.
Changes in the b value in and around the focal areas of the M6.9 and M6.8 earthquakes off the coast of Miyagi prefecture, Japan, in 2021
Authors: Nanjo K. Z. , Yoshida A.
Published: September 2021

We investigated changes in the b value of the Gutenberg–Richter’s law in and around the focal areas of earthquakes on March 20 and on May 1, 2021, with magnitude (M) 6.9 and 6.8, respectively, which occurred off the Pacific coast of Miyagi prefecture, northeastern Japan. We showed that the b value in these focal areas had been noticeably small, especially within a few years before the occurrence of the M6.9 earthquake in its vicinity, indicating that differential stress had been high in the focal areas. The coseismic slip of the 2011 Tohoku earthquake seems to have stopped just short of the east side of the focus of the M6.9 earthquake. Furthermore, the afterslip of the 2011 Tohoku earthquake was relatively small in the focal areas of the M6.9 and M6.8 earthquakes, compared to the surrounding regions. In addition, the focus of the M6.9 earthquake was situated close to the border point where the interplate slip in the period from 2012 through 2021 has been considerably larger on the northern side than on the southern side. The high-stress state inferred by the b-value analysis is concordant with those characteristics of interplate slip events. We found that the M6.8 earthquake on May 1 occurred near an area where the b value remained small, even after the M6.9 quake. The ruptured areas by the two earthquakes now seem to almost coincide with the small-b-value region that had existed before their occurrence. The b value on the east side of the focal areas of the M6.9 and M6.8 earthquakes which corresponds to the eastern part of the source region of the 1978 off-Miyagi prefecture earthquake was consistently large, while the seismicity enhanced by the two earthquakes also shows a large b value, implying that stress in the region has not been very high.
Screening of single nucleotide polymorphisms among fuchs’ endothelial corneal dystrophy subjects in Malaysia
Authors: Ng Ker Hsin , Subrayan Visvaraja , Ramachandran Vasudevan , Ismail Fazliana
Published: September 2021

Background

The pathophysiology underlying Fuchs' Endothelial Corneal Dystrophy (FECD), especially in older individuals, remains unclear, with a genetic predisposition being reported as the single best predictor of the disease. Genetic studies have shown that several genes in various loci such as COL8A2, SLC4A11, TCF8/ZEB1 and TCF4 are associated with FECD in different populations and ethnicities. A case–control study was conducted to determine the association between genetic variants and FECD in a tertiary care setting in Malaysia. A total number of 12 patients with clinically diagnosed FECD and 12 age, gender and race matched control subjects were recruited. Extracted genomic DNA were genotyped using Infinium Global Screening Array (GSA)-24 version 1.0 BeadChip with iScan high-throughput system. Illumina GenomeStudio 2.0 Data Analysis and PLINK version 1.9 software were used to perform association tests and determine the distribution of obtained variants among the cases and controls.

Results

A significant novel genetic variant, rs11626651, a variant of the LOC105370676 gene or known as the LINC02320 gene, located at chromosome 14, has been identified as a suggestive association with FECD (p < 5 × 10−6). Further analysis in this study suggested that candidate genes such as COL8A2, ZEB1/TCF8, TCF4 and SLC4A11 had no significant associations with FECD.

Conclusions

The discovery of a novel variant may influence the underlying pathogenic basis of FECD in Malaysia. The current study is the first genetic study on FECD to use Infinium GSA. It is the first comprehensive report in Malaysia to provide genetic information of potential relevance to FECD, which may pave the way for new therapeutic strategies in the future. A detailed analysis with a larger sample size is recommended for further evaluation.
Insulin Increases Adipose Adiponectin in Pregnancy by Inhibiting Ubiquitination and Degradation: Impact of Obesity
Authors: Aye Irving L M H , Rosario Fredrick J , Kramer Anita , Kristiansen Oddrun , Michelsen Trond M , Powell Theresa L , Jansson Thomas
Published: September 2021

Context

Circulating adiponectin levels are decreased in pregnant women with obesity or gestational diabetes, and this is believed to contribute to the insulin resistance and increased risk of fetal overgrowth associated with these conditions. However, the molecular mechanisms regulating adiponectin secretion from maternal adipose tissues in pregnancy are poorly understood.

Objective

We tested the hypothesis that obesity in pregnancy is associated with adipose tissue insulin resistance and increased adiponectin ubiquitination and degradation, caused by inflammation and endoplasmic reticulum (ER) stress.

Methods

Visceral adipose tissues were collected from lean and obese pregnant humans and mice. Total and ubiquitinated adiponectin, and markers of inflammation, ER stress, and insulin resistance were examined in adipose tissues. The role of insulin, inflammation, and ER stress in mediating adiponectin ubiquitination and degradation was examined using 3T3L-1 adipocytes.

Results

Obesity in pregnancy is associated with adipose tissue inflammation, ER stress, insulin resistance, increased adiponectin ubiquitination, and decreased total abundance of adiponectin. Adiponectin ubiquitination was increased in visceral fat of obese pregnant women as compared to lean pregnant women. We further observed that insulin prevents, whereas ER stress and inflammation promote, adiponectin ubiquitination and degradation in differentiated 3T3-L1 adipocytes.

Conclusion

We have identified adiponectin ubiquitination as a key mechanism by which obesity diminishes adiponectin secretion in pregnancy. This information will help us better understand the mechanisms controlling maternal insulin resistance and fetal growth in pregnancy and may provide a foundation for the development of strategies aimed at improving adiponectin production in pregnant women with obesity or gestational diabetes.
Obesity and Postmenopausal Hormone Receptor-positive Breast Cancer: Epidemiology and Mechanisms
Authors: Zuo Qianying , Band Shoham , Kesavadas Mrinali , Madak Erdogan Zeynep
Published: September 2021

Obesity is a potential risk for several cancers, including postmenopausal, hormone dependent breast cancers. In this review, we summarize recent studies on the impact of obesity on postmenopausal women’s health and discuss several mechanisms that were proposed to increase the risk of breast carcinogenesis.
The Deconstruction of Sex
Authors: Nancy Jean-Luc , Goh Irving
Published: September 2021

In The Deconstruction of Sex, Jean-Luc Nancy and Irving Goh discuss how a deconstructive approach to sex helps us negotiate discourses about sex and foster a better understanding of how sex complicates our everyday existence in the age of #MeToo. Throughout their conversation, Nancy and Goh engage with topics ranging from relation, penetration, and subjection to touch, erotics, and jouissance. They show how despite its entrenchment in social norms and centrality to our being-in-the-world, sex lacks a clearly defined essence. At the same time, they point to the potentiality of literature to inscribe the senses of sex. In so doing, Nancy and Goh prompt us to reconsider our relations with ourselves and others through sex in more sensitive, respectful, and humble ways without bracketing the troubling aspects of sex.
Predicting clinical outcomes in COVID-19 using radiomics on chest radiographs
Authors: Varghese Bino Abel , Shin Heeseop , Desai Bhushan , Gholamrezanezhad Ali , Lei Xiaomeng , Perkins Melissa , Oberai Assad , Nanda Neha , Cen Steven , Duddalwar Vinay
Published: September 2021

Objectives

For optimal utilization of healthcare resources, there is a critical need for early identification of COVID-19 patients at risk of poor prognosis as defined by the need for intensive unit care and mechanical ventilation. We tested the feasibility of chest X-ray (CXR)-based radiomics metrics to develop machine-learning algorithms for predicting patients with poor outcomes.

Methods

In this Institutional Review Board (IRB) approved, Health Insurance Portability and Accountability Act (HIPAA) compliant, retrospective study, we evaluated CXRs performed around the time of admission from 167 COVID-19 patients. Of the 167 patients, 68 (40.72%) required intensive care during their stay, 45 (26.95%) required intubation, and 25 (14.97%) died. Lung opacities were manually segmented using ITK-SNAP (open-source software). CaPTk (open-source software) was used to perform 2D radiomics analysis.

Results

Of all the algorithms considered, the AdaBoost classifier performed the best with AUC = 0.72 to predict the need for intubation, AUC = 0.71 to predict death, and AUC = 0.61 to predict the need for admission to the intensive care unit (ICU). AdaBoost had similar performance with ElasticNet in predicting the need for admission to ICU. Analysis of the key radiomic metrics that drive model prediction and performance showed the importance of first-order texture metrics compared to other radiomics panel metrics. Using a Venn-diagram analysis, two first-order texture metrics and one second-order texture metric that consistently played an important role in driving model performance in all three outcome predictions were identified.

Conclusions:

Considering the quantitative nature and reliability of radiomic metrics, they can be used prospectively as prognostic markers to individualize treatment plans for COVID-19 patients and also assist with healthcare resource management.

Advances in knowledge

We report on the performance of CXR-based imaging metrics extracted from RT-PCR positive COVID-19 patients at admission to develop machine-learning algorithms for predicting the need for ICU, the need for intubation, and mortality, respectively.