bluuebunny/crossref_metadata_2025 huggingface dataset:
Today’s Civil Rights Fight: What’s Math Got to Do With It?
Authors: Bronson Elethia Nicole , Long Leroy L.
Published: July 2022

Research shows student success in advanced-level science, technology, engineering, and mathematics (STEM) programs is connected to future educational and economic opportunities. Yet, Black students have been excluded from participating in rigorous mathematics courses that prepare them to engage in STEM majors and careers. This article reviews research on Black student mathematics participation at the pre-college, post-secondary, and professional levels. Three systemic barriers to Black student participation are limited access, limiting mindsets and beliefs, and lack of support. Eliminating these barriers can result in an increase in Black students’ enrollment, persistence, and achievement in advanced mathematics courses. The article provides strategies proven successful in urban contexts to ensure equitable learning environments that maximize the full potential of Black students. Educational leaders must address systemic inequities rooted in racism, purposefully engage Black students in rigorous and extended learning opportunities, and provide them with peer and faculty support.
Gli1+-PDL Cells Contribute to Alveolar Bone Homeostasis and Regeneration
Authors: Shalehin N. , Seki Y. , Takebe H. , Fujii S. , Mizoguchi T. , Nakamura H. , Yoshiba N. , Yoshiba K. , Iijima M. , Shimo T. , Irie K. , Hosoya A.
Published: July 2022

The periodontal ligament (PDL) contains mesenchymal stem cells (MSCs) that can differentiate into osteoblasts, cementoblasts, and fibroblasts. Nevertheless, the distribution and characteristics of these cells remain uncertain. Gli1, an essential hedgehog signaling transcription factor, functions in undifferentiated cells during embryogenesis. Therefore, in the present study, the differentiation ability of Gli1+ cells was examined using Gli1-CreERT2/ROSA26-loxP-stop-loxP-tdTomato (iGli1/Tomato) mice. In 4-wk-old iGli1/Tomato mice, Gli1/Tomato+ cells were only slightly detected in the PDL, around endomucin-expressing blood vessels. These cells had proliferated over time, localizing in the PDL as well as on the bone and cementum surfaces at day 28. However, in 8-wk-old iGli1/Tomato mice, Gli1/Tomato+ cells were quiescent, as most cells were not immunoreactive for Ki-67. These cells in 8-wk-old mice exhibited high colony-forming unit fibroblast activity and were capable of osteogenic, chondrogenic, and adipogenic differentiation in vitro. In addition, after transplantation of teeth of iGli1/Tomato mice into the hypodermis of wild-type mice, Tomato fluorescence indicating the progeny of Gli1+ cells was detected in the osteoblasts and osteocytes of the regenerated bone. These results demonstrate that Gli1+ cells in the PDL were MSCs and could contribute to the alveolar bone regeneration.
Book review: Dave Chatterjee. 2021. Cybersecurity Readiness: A Holistic and High-Performance Approach
Authors: Aggarwal Akshay , Srivastava Shashi Kant
Published: July 2022

Dave Chatterjee. 2021. Cybersecurity Readiness: A Holistic and High-Performance Approach. SAGE Publications, pp. 308, $60.00 (Paperback). ISBN: 9781071837337 (Hardcover); ISBN: 9781071837344 (Epub)
“That Wild Month of September”: Addressing Equity and Governance in a School Board Crisis
Authors: Jones Cara S. , Jones Trevon R.
Published: July 2022

This case focuses on the Board of Trustees of a large urban school district in Texas, as they worked to decide when learners would have the option to return to in-person learning even as the COVID-19 pandemic continued to affect the community, particularly communities of color. This decision-making process included two back-to-back school board meetings with 6 hr of public comment that suggested a divided community. The case raises questions of racial equity, quality educational opportunities for students, governance, and decision making during a time of crisis. Through a deep dive into a crucial moment, this case highlights the challenging nature of governance during a crisis.
Prediction of high and low disease activity in early MS patients using multiple kernel learning identifies importance of lateral ventricle intensity
Authors: Chien Claudia , Seiler Moritz , Eitel Fabian , Schmitz-Hübsch Tanja , Paul Friedemann , Ritter Kerstin
Published: July 2022

Background

Lack of easy-to-interpret disease activity prediction methods in early MS can lead to worse patient prognosis.

Objectives

Using machine learning (multiple kernel learning – MKL) models, we assessed the prognostic value of various clinical and MRI measures for disease activity.

Methods

Early MS patients ( n = 148) with at least two associated clinical and MRI visits were investigated. T2-weighted MRIs were cropped to contain mainly the lateral ventricles (LV). High disease activity was defined as surpassing NEDA-3 Criteria more than once per year. Clinical demographic, MRI-extracted image-derived phenotypes (IDP), and MRI data were used as inputs for separate kernels to predict future disease activity with MKL. Model performance was compared using bootstrapped effect size analysis of mean differences.

Results

A total of 681 visits were included, where 81 (55%) patients had high disease activity in a combined end point measure using all follow-up visits. MKL model discrimination performance was moderate (AUC ≥ 0.62); however, modelling with combined clinical and cropped LV kernels gave the highest prediction performance (AUC = 0.70).

Conclusions

MRIs contain valuable information on future disease activity, especially in and around the LV. MKL techniques for combining different data types can be used for the prediction of disease activity in a relatively small MS cohort.
Transcriptome-wide characterization, evolutionary analysis, and expression pattern analysis of the NF-Y transcription factor gene family and salt stress response in Panax ginseng
Authors: Liu Mingming , Pan Zhaoxi , Yu Jie , Zhu Lei , Zhao Mingzhu , Wang Yanfang , Chen Ping , Liu Chang , Hu Jian , Liu Tao , Wang Kangyu , Wang Yi , Zhang Meiping
Published: July 2022

Jilin ginseng (Panax ginseng C. A. Meyer) has a long history of medicinal use worldwide. The quality of ginseng is governed by a variety of internal and external factors. Nuclear factor Y (NF-Y), an important transcription factor in eukaryotes, plays a crucial role in the plant response to abiotic stresses by binding to a specific promoter, the CCAAT box. However, the NF-Y gene family has not been reported in Panax ginseng. In this study, 115 PgNF-Y transcripts with 40 gene IDs were identified from the Jilin ginseng transcriptome database. These genes were classified into the PgNF-YA (13), PgNF-YB (14), and PgNF-YC (13) subgroups according to their subunit types, and their nucleotide sequence lengths, structural domain information, and amino acid sequence lengths were analyzed. The phylogenetic analysis showed that the 79 PgNF-Y transcripts with complete ORFs were divided into three subfamilies, NF-YA, NF-YB, and NF-YC. PgNF-Y was annotated to eight subclasses under three major functions (BP, MF, and CC) by GO annotation, indicating that these transcripts perform different functions in ginseng growth and development. Expression pattern analysis of the roots of 42 farm cultivars, 14 different tissues of 4-year-old ginseng plants, and the roots of 4 different-ages of ginseng plants showed that PgNF-Y gene expression differed across lineages and had spatiotemporal specificity. Coexpression network analysis showed that PgNF-Ys acted synergistically with each other in Jilin ginseng. In addition, the analysis of the response of PgNF-YB09, PgNF-YC02, and PgNF-YC07-04 genes to salt stress treatment was investigated by fluorescence quantitative PCR. The expression of these genes increased after salt stress treatment, indicating that they may be involved in the regulation of the response to salt stresses in ginseng. These results provide important functional genetic resources for the improvement and gene breeding of ginseng in the future.

Conclusions: This study fills a knowledge gap regarding the NF-Y gene family in ginseng, provides systematic theoretical support for subsequent research on PgNF-Y genes, and provides data resources for resistance to salt stress in ginseng.
The effect of direct admission to acute geriatric units compared to admission after an emergency department visit on length of stay, postacute care transfers and ED return visits
Authors: Naouri D. , Pelletier-Fleury N. , Lapidus N. , Yordanov Y.
Published: July 2022

Background

Compared with conventional hospitalization, admission to an acute geriatric care unit (AGU) is associated with better outcomes in elderly patients. In 2012, 50% of the hospitalizations of elderly patients were preceded by an emergency department (ED) visit. Hospital occupancy, access blocks and overcrowding experienced by patients during ED visits are associated with increased morbidity.

Objective

Our aim was to evaluate the effect of direct admission (DA) to an AGU on both the hospital length of stay and morbidity of elderly patients.

Design

This study was a retrospective cohort study conducted using electronic medical records and administrative claims data from the Greater Paris University Hospitals (APHP) health data warehouse involving 19 different AGUs.

Participants

We included all patients ≥ 75 years old who were admitted to an AGU for more than 24 h between January 1, 2013, and December 31, 2018.

Intervention

Direct admission to the AGU compared to admission after an ED visit.

Main measures

The main outcome was hospital length of stay. Two outcomes were used to analyse morbidity: postacute care and rehabilitation ward transfer at the end of the index hospitalization and ED return visit within 30 days after the index hospitalization (for those who survived to hospitalization). We used an inverse probability of treatment weighting (IPTW) approach to balance the differences in patient baseline variables between the two groups. Univariate linear and logistic regression models were built to estimate the effect of DA on hospital length of stay and the likelihood of postacute care transfer and ED return visit.

Key results

Among the 6583 patients included in the study, DA was associated with a lower hospital length of stay (estimate = -1.28; 95% CI = -1.76–0.80), and a lower likelihood of postacute care transfer (OR = 0.87; 95% CI = 0.77–0.97). It was not significantly associated with a lower risk of ED return visits (OR = 0.81; 95% CI = 0.60–1.08) in the following month.

Conclusion

DA should be prioritized, and reorganization of the geriatric pathway around DA should be encouraged due to the frailty of elderly individuals.
The survival impact of palliative chemotherapy dose modifications on metastatic colon cancer
Authors: Zainal Abidin Mohd Naqib , Omar Marhanis Salihah , Islahudin Farida , Mohamed Shah Noraida
Published: July 2022

Background

An uninterrupted dose of oxaliplatin-based cytotoxic therapy is an essential component in the standard treatment regimen of metastatic colon cancer (mCC). Data on the impacts of dose intensity reduction on the palliative treatment for patients with mCC remain scarce. Hence, this study aimed to investigate the impact of palliative chemotherapy dose modifications (DM) on the survival of patients with mCC.

Methods

Patients with stage IV colon cancer who received first-line palliative FOLFOX regimen chemotherapy between 2014 until 2018 in the Oncology Department of the National Cancer Institute were conveniently sampled retrospectively to analyse the treatment efficacy. The cumulative dose and duration of chemotherapy received by the patients were summarised as relative dose intensity (RDI) and stratified as High RDI (RDI ≥ 70%) or Low RDI (RDI < 70%). Progression-free survival (PFS) and 2-year overall survival (OS) between the two groups were analysed using Kaplan-Meier survival analysis and Cox proportional hazards models.

Results

Out of the 414 patients identified, 95 patients with mCC were eligible and included in the final analysis. About half of the patients (n = 47) completed the 12-cycle chemotherapy regimen and one patient received the complete (100%) RDI. The overall median RDI was 68.7%. The Low RDI group (n = 49) had a 1.5 times higher mortality risk than the High RDI group [OS, Hazard Ratio (HR) = 1.5, 95% Cl: 1.19–1.82] with a significant median OS difference (9.1 vs. 16.0 months, p <  0.01). Furthermore, patients with lower dose intensity showed double the risk of disease progression (PFS, HR = 2.0, 95% CI: 1.23–3.13) with a significant difference of 4.5 months of median PFS (p <  0.01). Gender and RDI were the independent prognostic factors of both OS and PFS.

Conclusion

Reduction in the dose intensity of palliative chemotherapy may adversely affect both disease progression and overall survival among mCC patients.
Relationship between meibomian gland loss in infrared meibography and meibum quality in dry eye patients
Authors: Ha Minji , Oh Si-Eun , Whang Woong-Joo , Na Kyung-Sun , Kim Eun Chul , Kim Hyun-Seung , Kim Jin Soo , Hwang Ho Sik
Published: July 2022

Background

In the present study, we evaluated the correlation between meibomian gland dropout and meibum quality in the same central 8 meibomian glands of the eyelid.

Methods

Ninety-nine eyes of 91 patients with dry eye were included in the study. Dropout of the 8 central meibomian glands of the eyelids was graded as 0, 1, 2, or 3, according to the dropout area. The meibum quality was graded as follows: grade 0, no secretion; 1, inspissated/toothpaste consistency; 2, cloudy liquid secretion; and 3, clear liquid secretion. For 68 eyes of 68 patients, correlation analysis between dropout and meibum quality was performed. To precisely analyze the direct correlation between meibomian gland dropout in meibography and meibum quality, we evaluated 31 eyes of 23 patients with focal dropout in meibography.

Results

The median (interquartile range) meiboscore was 1.0 (2.0) in the upper eyelids and 0.0 (1.0) in the lower eyelids. The median (interquartile range) meibum quality grade was 3.0 (1.0) in the upper eyelids and 1.0 (1.0) in the lower eyelids. No significant correlation between the meiboscore and meibum quality grade was detected in the upper (p =0.746) or lower (p =0.551) eyelids. Analysis of the direct correlation between meibomian gland dropout in meibography and meibum quality in patients with focal dropout (loss of 1 or 2 adjacent meibomian glands), however, indicated that meibomian glands with dropout secreted little to no meibum.

Conclusions

Overall analysis revealed no relationship between meibomian gland dropout and meibum quality, but more detailed investigation of each meibomian gland alone revealed that meibomian glands with dropout secrete little to no meibum.
Electronic screen device usage and screen time among preschool-attending children in a suburban area of Sri Lanka
Authors: Rathnasiri Asanka , Rathnayaka Harsha , Yasara Nirmani , Mettananda Sachith
Published: July 2022

Background

Excessive use of screen devices and screen time are increasing health problems in children. We aim to describe the electronic screen device usage and determine the factors associated with their use among preschool-attending children in a suburban population in Sri Lanka.

Methods

A cross-sectional study was conducted in a suburban Medical Officer of Health area of Sri Lanka from January to March 2020. All children aged between 36–59 months attending ten randomly selected preschools were recruited. Data were collected using a parent-administered questionnaire and analysed using binary logistic regression in SPSS. The prevalence of electronic device usage, the average time spent on each device, and factors associated with individual device usage were analysed.

Results

A total of 340 children (Male-48%; mean age-50.1 ± 6.9 months) were recruited. Electronic devices were used by 96% of children. The most common devices were the television (87%) and the smartphone (63%). Of the children who used electronic devices, 60% exceeded the recommended screen time limit of one hour per day, 21% used devices for more than two hours per day, and 51% commenced using devices by two years of age. The higher education level of the father was independently associated with the use of smartphones and laptops and daily screen time of more than one hour (p < 0.05 for all). Male sex and being the only child were significantly associated with the use of smartphones, whereas maternal employment was associated with the use of laptops (p < 0.05 for all).

Conclusions

Electronic screen devices were used by 96% of preschool-attending children, and over 60% used them for more than the recommended daily upper limit of one hour. Higher paternal education, maternal employment and being the only child were significantly associated with electronic screen device use.
The role of pornography in the sex life of young adults-a cross-sectional cohort study on female and male German medical students
Authors: Jahnen Matthias , Zeng Leopold , Kron Martina , Meissner Valentin H. , Korte Alexander , Schiele Stefan , Schulwitz Helga , Dinkel Andreas , Gschwend Jürgen E. , Herkommer Kathleen
Published: July 2022

Background

Due to easy online accessibility of pornography its consumption is popular among adolescents and young adults. Considering recently developed frameworks on the effects of sexual media, we assessed how increased consumption of pornography is associated with the experience of certain aspects of offline and online sexual activity in German medical students.

Methods

Between April 2018 and March 2020 medical students from the Technical University of Munich in Germany were anonymously surveyed with regards to their sexual behavior, consumption of pornography, and use of social media. 468 students (female: n = 293; male: n = 175) were included in the current analysis. Data was analyzed using simple and multiple Poisson regression analysis.

Results

Only 7.3% of female students but the majority of male students (79.1%) consumed pornography more than 4 times in the last 4 weeks. Female and male students who reported to be inspired by pornography (female: 52.0%, male: 74.6%) and who have enjoyed the experience of anal intercourse in their life (female: 17.1%, male: 32.2%) consumed pornography more frequently. Female students who have experienced a “threesome” (9.0%), have sent erotic pictures of themselves (33.5%), or use social media in their dating life (27.6%) consumed pornography more frequently. Male students who did not experience a sexual transmitted disease (82.9%) and did not cheat on their partner (68.0%) consumed pornography more frequently (results of multiple Poisson regression analysis; all p < 0.05).

Conclusions

Many students consider pornography as inspiration for their sex life and frequent consumption of pornography seems to be associated with gender specific characteristics congruent with short-term sexual quality. The desire of adolescents and young adults for practical information about sexual intercourse should be addressed openly and a proper understanding of the sexuality shown in pornography should be taught.
Appropriate and acceptable health assessments for people experiencing homelessness
Authors: Gordon Susan Jayne , Baker Nicky , Steffens Margie
Published: July 2022

Background

Appropriate and acceptable recruitment strategies and assessment tools are essential to determine the health needs for people experiencing homelessness. Based on a systematic review and known feasible community-based health assessments for people who are not homeless, a set of health assessments were trialled with people experiencing homelessness.

Methods

Participants were recruited via support agencies. They completed a health risk assessment, demographic and self-report health questionnaires, and objective assessments across 17 domains of health.

Results

Fifty-three participants (43.3% female, mean age 49.1 years) consented and completed 83–96% of assessments. Consent was reversed for assessments of grip, foot sensation, body measures (11%), and walking (30%), and initially refused for stress, sleep, cognition (6%); balance, walk test (9%) and oral examination (11%). There was one adverse event. Most assessments were both appropriate and acceptable. Some required modification for the context of homelessness, in particular the K10 was over-familiar to participants resulting in memorised responses. Recruitment strategies and practices must increase trust and ensure participants feel safe.

Conclusions

This set of health assessments are appropriate and acceptable for administration with people experiencing homelessness. Outcomes of these assessments are essential to inform public and primary health service priorities to improve the health of people experiencing homelessness.
Prognostic value of the ratio of maximum to minimum diameter of primary tumor in metastatic clear cell renal cell carcinoma
Authors: Shi Hongzhe , Cao Chuanzhen , Wen Li , Zhang Lianyu , Zhang Jin , Ma Jianhui , Shou Jianzhong , Li Changling
Published: July 2022

Background

Several models and markers were developed and found to predict outcome of advanced renal cell carcinoma. This study aimed to evaluate the prognostic value of the ratio of maximum to minimum tumor diameter (ROD) in metastatic clear cell renal cell carcinoma (mccRCC).

Methods

Patients with mccRCC (n = 213) treated with sunitinib from January 2008 to December 2018 were identified. Cutoff value for ROD was determined using receiver operating characteristic. Patients with different ROD scores were grouped and evaluated. Survival outcomes were estimated by Kaplan–Meier method.

Results

The optimal ROD cutoff value of 1.34 was determined for progression free survival (PFS) and overall survival (OS). Patients in ROD ≥ 1.34 group had shorter PFS (9.6 versus 17.7 months, p < 0.001) and OS (25.5 versus 32.6 months, p < 0.001) than patients in ROD < 1.34 group. After adjustment for other factors, multivariate analysis showed ROD ≥ 1.34 was an independent prognostic factor for PFS (p < 0.001) and OS (p = 0.006). Patients in ROD ≥ 1.34 group presented higher proportions of pT3/4 stage (89.2% versus 10.8%, p = 0.021), WHO/ISUP grade III/IV (72.0% versus 28.0%, p = 0.010), tumor necrosis (71.0% versus 29.0%, p = 0.039), sarcomatoid differentiation (79.1% versus 20.9%, p = 0.007), poor MSKCC risk score (78.4% versus 21.6%, p < 0.001) and poor IMDC risk score (74.4% versus 25.6%, p < 0.001) than ROD < 1.34 group.

Conclusion

Primary tumor with higher ROD was an independently prognostic factor for both PFS and OS in patients with mccRCC who received targeted therapy. Higher ROD was also associated with high pT stage, high WHO/ISUP grade, sarcomatoid features, tumor necrosis, poor MSKCC and IMDC risk score.
Current situation of menstruation and gynecological diseases prevalence among Chinese women: a cross-sectional study
Authors: Bigambo Francis Manyori , Wang Dandan , Zhang Yuqing , Mzava Sabitina Mrisho , Dai Rongrong , Wang Xu
Published: July 2022

Background

Gynecological diseases have been taken attention and studied worldwide. Although, no recent studies have delineated the magnitude of gynecological diseases among Chinese women. This study aims to evaluate the current situation of menstruation and gynecological diseases prevalence among Chinese women.

Methods

A cross-sectional study was conducted at a hospital affiliated with Nanjing medical university in Nanjing, China between September 2021 and February 2022. A sample size of 977 women aged 18–52 years participated in a face-to-face interview questionnaire. Logistic regression was performed to determine whether pubertal timing and menstrual characteristics were associated with gynecological diseases.

Results

The most prevalent gynecological disease was dysmenorrhea (45.96%), followed by polycystic ovary syndrome, PCOS (19.04%), uterine fibroids (14.23%), spontaneous abortion (13.20%), trouble conceiving (12.59%), ovarian dysfunction (11.16%) and endometriosis (4.09%). In the adjusted model, heavy bleeding with large clots was associated with an increased risk of dysmenorrhea (odds ratio, OR = 5.01, 95% Confidence interval, CI 2.26, 11.10; p = 0.000), while history of precocious puberty diagnosis was associated with a reduced risk of dysmenorrhea (OR = 0.50, 95%CI: 0.26, 0.94; p = 0.031). Regular menstrual cycle in the past 12 months and regular menstrual periods were associated with decreased risk of PCOS (OR = 0.44, 95%CI 0.30, 0.65; p = 0.000) and (OR = 0.52, 95%CI 0.36, 0.74; p = 0.000), respectively. Histories of early thelarche, early menarche, and precocious puberty diagnosis were associated with increased risk of ovarian dysfunction (OR = 1.96, 95%CI 1.25, 3.08, p = 0.004), (OR = 2.26, 95%CI 1.24, 4.13; p = 0.008) and (OR = 2.79, 95%CI 1.36, 5.74; p = 0.005), respectively. Heavy bleeding and heavy bleeding with large clots were associated with endometriosis (OR = 4.92, 95%CI 1.50, 16.15, p = 0.009) and (OR = 5.67, 95%CI 1.42, 22.56; p = 0.014), respectively.

Conclusions

The prevalence of gynecological diseases is increasing among Chinese women and pubertal timing and menstrual characteristics may be associated with some gynecological diseases, specifically dysmenorrhea, PCOS, ovarian dysfunction, and endometriosis.
Redo pancreaticojejunal anastomosis for late-onset complete pancreaticocutaneous fistula after pancreaticojejunostomy
Authors: Yamamoto Michihiro , Zaima Masazumi , Yazawa Tekefumi , Yamamoto Hidekazu , Harada Hideki , Yamada Masahiro , Tani Masaki
Published: July 2022

Background

Pancreaticojejunal (PJ) anastomosis occasionally fails several months after pancreaticoduodenectomy (PD) with Child reconstruction and can ultimately result in a late-onset complete pancreaticocutaneous fistula (Lc-PF). Since the remnant pancreas is an isolated segment, surgical intervention is necessary to create internal drainage for the pancreatic juice; however, surgery at the previous PJ anastomosis site is technically challenging even for experienced surgeons. Here we describe a simple surgical procedure for Lc-PF, termed redo PJ anastomosis, which was developed at our facility. 

Methods

Between January 2008 and December 2020, six consecutive patients with Lc-PF after PD underwent a redo PJ anastomosis, and the short- and long-term clinical outcomes have been evaluated.

The abdominal cavity is carefully dissected through a 10-cm midline skin incision, and the PJ anastomosis site is identified using a percutaneous drain through the fistula tract as a guide, along with the main pancreatic duct (MPD) stump on the pancreatic stump. Next, the pancreatic stump is deliberately immobilized from the dorsal plane to prevent injury to the underlying major vessels. After fixing a stent tube to both the MPD and the Roux-limb using two-sided purse-string sutures, the redo PJ anastomosis is completed using single-layer interrupted sutures. Full-thickness pancreatic sutures are deliberately avoided by passing the needle through only two-thirds of the anterior side of the pancreatic stump.

Results

The redo PJ anastomosis was performed without any intraoperative complications in all cases. The median intraoperative bleeding and operative time were 71 (range 10–137) mL and 123 (range 56–175) min, respectively. Even though a new mild pancreatic fistula developed postoperatively in all cases, it could be conservatively treated within 3 weeks, and no other postoperative complications were recorded. During the median follow-up period of 92 (range 12–112) months, no complications at the redo PJ anastomosis site were observed.

Conclusions

This research shows that the redo PJ anastomosis for Lc-PF we developed is a safe, feasible, and technically no demanding procedure with acceptable short- and long-term clinical outcomes. This procedure has the potential to become the preferred treatment strategy for Lc-PF after PD.
Clinical outcomes in patients receiving edoxaban or phenprocoumon for prevention of stroke in atrial fibrillation: a German real-world cohort study
Authors: Hohmann Christopher , Lutz Magnus , Vignali Sheila , Borchert Kathrin , Seidel Karolin , Braun Sebastian , Baldus Stephan , Näbauer Michael
Published: July 2022

Background

Appropriate and timely anticoagulant therapy with vitamin K antagonists (VKAs) or non-vitamin K oral antagonists (NOACs) is essential for stroke prevention in non-valvular atrial fibrillation (NVAF). Comparative data regarding effectiveness and safety for edoxaban vs phenprocoumon, the predominant VKA in Germany, are scarce.

Objectives

The study evaluates effectiveness and safety of edoxaban vs phenprocoumon in NVAF patients in a German real-world setting.

Methods

German statutory health insurance claims data of the Institute for Applied Health Research Berlin (InGef) Research Database from 2014 until 2019 were analyzed. In NVAF patients, new users of edoxaban and phenprocoumon were compared to assess effectiveness (stroke/systemic embolism (SE)) and safety (bleeding) during therapy. Hazard ratios (HR) were estimated through multiple outcome-specific cox proportional hazard models adjusting for baseline characteristics. Outcomes of geriatric patients were analyzed in subgroup analyses.

Results

Between 2015 and 2018, 7,975 and 13,319 NVAF patients newly initiated treatment with edoxaban or phenprocoumon. After adjusting for baseline confounders, the risk of stroke/SE (HR: 0.85, 95% CI: 0.70–1.02) was numerically but not significantly lower, while the risk of major bleeding (HR: 0.69, 95% CI: 0.58–0.81) was significantly lower for edoxaban. In the geriatric subgroups, homogenous results compared to the main analysis were obtained.

Conclusion

The results of this real-world analysis indicated better effectiveness and safety outcomes in patients with NVAF initiating edoxaban treatment compared to phenprocoumon. The findings confirm that the beneficial effects observed in the pivotal ENGAGE AF-TMI 48 trial can also be achieved in real-world use of edoxaban.
Acute lower limb ischemia caused by vaccine-induced immune thrombotic thrombocytopenia: focus on perioperative considerations for 2 cases
Authors: Roberge Guillaume , Côté Benoit , Calabrino Anthony , Gilbert Nathalie , Gagnon Nathalie
Published: July 2022

Background

ChAdOx1 nCoV-19 (AstraZeneca) and Ad26COV2.S (Johnson & Johnson/Janssen) adenoviral vector vaccines have been associated with vaccine-induced immune thrombotic thrombocytopenia (VITT). Arterial thrombosis and acute limb ischemia have been described in a minority of patients with VITT. These patients usually need a revascularization, but they potentially are at a higher risk of complications. Optimal perioperative care of patients undergoing vascular surgery in acute VITT is unknown and important considerations in such context need to be described.

Cases presentations

We report 2 cases of VITT presenting with acute limb ischemia who needed vascular surgery and we describe the multidisciplinary team decisions for specific treatment surrounding the interventions. Both patients’ platelet counts initially increased after either intravenous immune globulin (IVIG) or therapeutic plasma exchange (TPE). None received platelet transfusion. They both received argatroban as an alternative to heparin for their surgery. Despite persistent positivity of anti-platelet factor 4 (PF4) antibodies and serotonin-release assay with added PF4 (PF4-SRA) in both patients, only one received a repeated dose of IVIG before the intervention. Per- and post-operative courses were both unremarkable.

Conclusion

In spite of persistent anti-PF4 and PF4-SRA positivity in the setting of VITT, after platelet count improvement using either IVIG or TPE, vascular interventions using argatroban can show favorable courses. Use of repeated IVIG or TPE before such interventions still needs to be defined.
Atypical primary biliary cholangitis results in vanishing bile duct syndrome with cutaneous xanthomas: a case report
Authors: Jia Yuebo , Liu Lin , Deng Baocheng , Huang Yu , Zhao Jiaqi , Bai Guang
Published: July 2022

Background

Vanishing bile duct syndrome (VBDS) is a rare but potentially severe acquired chronic cholestatic liver disease. Bile duct deficiency is a reduction of bile ducts in the liver, which can eventually lead to cholestatic liver disease and progress to biliary cirrhosis. Primary biliary cholangitis (PBC) is one of the causes of bile duct deficiency. In addition, 75% of PBC patients may have dyslipidemia, and in case of secondary dyslipidemia, cutaneous xanthomas may occur.

Case summary

A 49-year-old woman was admitted with jaundice and multiple subcutaneous nodules. She received diagnosis of autoimmune liver disease 2 years before. Although she was treated with liver-protecting drugs, such as Essentiale and ursodeoxycholic acid, jaundice occurred repeatedly, and the color of her skin was becoming darker and more yellow.

Conclusion

This case highlights that the positivity of ANA that in PBC have a well diagnostic and prognostic significance and antinuclear antibodies giving the ‘multiple nuclear dots’ or the ‘rim-like/membranous’ pattern scan ca diagnose primary biliary cirrhosis accurately. Since the liver biopsy of PBC alone may not be sufficient to establish the diagnosis, serum antibodies should also be examined. PBC can also lead to intrahepatic cholestasis, which can cause dyslipidemia and cutaneous xanthomas.
Association between acute kidney injury and norepinephrine use following cardiac surgery: a retrospective propensity score-weighted analysis
Authors: Huette Pierre , Moussa Mouhamed Djahoum , Beyls Christophe , Guinot Pierre-Grégoire , Guilbart Mathieu , Besserve Patricia , Bouhlal Mehdi , Mounjid Sarah , Dupont Hervé , Mahjoub Yazine , Michaud Audrey , Abou-Arab Osama
Published: July 2022

Background

Excess exposure to norepinephrine can compromise microcirculation and organ function. We aimed to assess the association between norepinephrine exposure and acute kidney injury (AKI) and intensive care unit (ICU) mortality after cardiac surgery.

Methods

This retrospective observational study included adult patients who underwent cardiac surgery under cardiopulmonary bypass from January 1, 2008, to December 31, 2017, at the Amiens University Hospital in France. The primary exposure variable was postoperative norepinephrine during the ICU stay and the primary endpoint was the presence of AKI. The secondary endpoint was in-ICU mortality. As the cohort was nonrandom, inverse probability weighting (IPW) derived from propensity scores was used to reduce imbalances in the pre- and intra-operative characteristics.

Results

Among a population of 5053 patients, 1605 (32%) were exposed to norepinephrine following cardiac surgery. Before weighting, the prevalence of AKI was 25% and ICU mortality 10% for patients exposed to norepinephrine. Exposure to norepinephrine was estimated to be significantly associated with AKI by a factor of 1.95 (95% confidence interval, 1.63–2.34%; P < 0.001) in the IPW cohort and with in-ICU mortality by a factor of 1.54 (95% confidence interval, 1.19–1.99%; P < 0.001).

Conclusion

Norepinephrine was associated with AKI and in-ICU mortality following cardiac surgery. While these results discourage norepinephrine use for vasoplegic syndrome in cardiac surgery, prospective investigations are needed to substantiate findings and to suggest alternative strategies for organ protection.
Adherence to published guidelines for perioperative care of the elderly: a survey of Scottish anaesthetic departments
Authors: Clark Clair , Bennett Ella , Foo Irwin
Published: July 2022

Background

In 2010, a national enquiry into elderly patient outcomes after surgery identified that only 36% received ‘good’ care. Guidance was subsequently published by the Association of Anaesthetists of Great Britain and Ireland regarding perioperative care of the elderly and those with dementia; this study aims to assess current adherence to these guidelines in anaesthetic departments across Scotland.

Methods

A web-based survey was sent to all Scottish departments. The questions assessed department patient demographic, access to specialist pre-assessment services, availability of multidisciplinary input, perioperative care of patients with cognitive impairment and departmental training on geriatric perioperative care.

Results

Responses were collected from November-December 2020 with a 92.6% response rate. A total of 64% of departments stated that > 50% of their workload involved patients over 75. One department had a lead clinician for geriatric anaesthesia, whilst 20% could access a geriatric specialist when coordinating perioperative care. Specialist geriatric pre-assessment services operate in 20% of centres. A total of 60% of respondents used a clinical frailty score when pre-assessing patients over 75, with 48% specifically screening for cognitive impairment. The vast majority of centres, 76%, did not routinely provide information regarding post-operative delirium and 24% ‘never or very rarely’ invite caregivers to accompany patients with dementia into the department. Education sessions regarding perioperative elderly care had occurred in 56% of departments.

Conclusions

Elderly patients represent a significant proportion of anaesthetic workload in Scotland. Despite this, adherence to recommended practice is low. The vast majority of centres lack access to specialist multidisciplinary input or specialist pre-assessment services which are essential to providing good care. Reported screening for frailty and cognitive impairment is variable, with opportunities for improvement in communication and education (patient and clinician) surrounding these conditions.
The use of fibroblasts as a valuable strategy for studying mitochondrial impairment in neurological disorders
Authors: Olesen Margrethe A. , Villavicencio-Tejo Francisca , Quintanilla Rodrigo A.
Published: July 2022

Neurological disorders (NDs) are characterized by progressive neuronal dysfunction leading to synaptic failure, cognitive impairment, and motor injury. Among these diseases, Alzheimer's disease (AD), Parkinson's disease (PD), Huntington’s disease (HD), and amyotrophic lateral sclerosis (ALS) have raised a significant research interest. These disorders present common neuropathological signs, including neuronal dysfunction, protein accumulation, oxidative damage, and mitochondrial abnormalities. In this context, mitochondrial impairment is characterized by a deficiency in ATP production, excessive production of reactive oxygen species, calcium dysregulation, mitochondrial transport failure, and mitochondrial dynamics deficiencies. These defects in mitochondrial health could compromise the synaptic process, leading to early cognitive dysfunction observed in these NDs. Interestingly, skin fibroblasts from AD, PD, HD, and ALS patients have been suggested as a useful strategy to investigate and detect early mitochondrial abnormalities in these NDs. In this context, fibroblasts are considered a viable model for studying neurodegenerative changes due to their metabolic and biochemical relationships with neurons. Also, studies of our group and others have shown impairment of mitochondrial bioenergetics in fibroblasts from patients diagnosed with sporadic and genetic forms of AD, PD, HD, and ALS. Interestingly, these mitochondrial abnormalities have been observed in the brain tissues of patients suffering from the same pathologies. Therefore, fibroblasts represent a novel strategy to study the genesis and progression of mitochondrial dysfunction in AD, PD, HD, and ALS. This review discusses recent evidence that proposes fibroblasts as a potential target to study mitochondrial bioenergetics impairment in neurological disorders and consequently to search for new biomarkers of neurodegeneration.
Genome-wide identification of functional enhancers and their potential roles in pig breeding
Authors: Wu Yinqiao , Zhang Yuedong , Liu Hang , Gao Yun , Liu Yuyan , Chen Ling , Liu Lu , Irwin David M. , Hou Chunhui , Zhou Zhongyin , Zhang Yaping
Published: July 2022

Background

The pig is an economically important livestock species and is a widely applied large animal model in medical research. Enhancers are critical regulatory elements that have fundamental functions in evolution, development and disease. Genome-wide quantification of functional enhancers in the pig is needed.

Results

We performed self-transcribing active regulatory region sequencing (STARR-seq) in the porcine kidney epithelial PK15 and testicular ST cell lines, and reliably identified 2576 functional enhancers. Most of these enhancers were located in repetitive sequences and were enriched within silent and lowly expressed genes. Enhancers poorly overlapped with chromatin accessibility regions and were highly enriched in chromatin with the repressive histone modification H3K9me3, which is different from predicted pig enhancers detected using ChIP-seq for H3K27ac or/and H3K4me1 modified histones. This suggests that most pig enhancers identified with STARR-seq are endogenously repressed at the chromatin level and may function during cell type-specific development or at specific developmental stages. Additionally, the PPP3CA gene is associated with the loin muscle area trait and the QKI gene is associated with alkaline phosphatase activity that may be regulated by distal functional enhancers.

Conclusions

In summary, we generated the first functional enhancer map in PK15 and ST cells for the pig genome and highlight its potential roles in pig breeding.
A physics-based neural network for flight dynamics modelling and simulation
Authors: Stachiw Terrin , Crain Alexander , Ricciardi Joseph
Published: July 2022

The authors have developed a novel physics-based nonlinear autoregressive exogeneous neural network model architecture for flight modelling across the entire flight envelope, calledFlyNet. When using traditional parameter estimation and output-error methods, aircraft models are captured about a single point in the flight envelope using a first-order Taylor series to approximate forces and moments. To enable analysis throughout the entire operational envelope, the traditional models can be extended by interpolating or stitching between a number of these single-condition models. This paper completes the evolutionary next step in aircraft modelling to consider all second-order Taylor series terms instead of a subset of those and by exploiting the ability of neural networks to capture more complex and nonlinear behaviour for the efficient development of a continuous flight simulation model valid across the entire envelope. This method is valid for fixed- and rotary-wing aircraft. The behaviour of a conventional model is compared to FlyNet using flight test data collected from the National Research Council of Canada’s Bell 412HP in forward flight.
High-resolution label-free mapping of murine kidney vasculature by raster-scanning optoacoustic mesoscopy: an ex vivo study
Authors: Goebel Colin A. , Brown Emma , Fahlbusch Fabian B. , Wagner Alexandra L. , Buehler Adrian , Raupach Thomas , Hohmann Martin , Späth Moritz , Burton Neal , Woelfle Joachim , Schmidt Michael , Hartner Andrea , Regensburger Adrian P. , Knieling Ferdinand
Published: July 2022

Background

Chronic kidney disease (CKD) is a global burden affecting both children and adults. Novel imaging modalities hold great promise to visualize and quantify structural, functional, and molecular organ damage. The aim of the study was to visualize and quantify murine renal vasculature using label-free raster scanning optoacoustic mesoscopy (RSOM) in explanted organs from mice with renal injury.

Material and methods

For the experiments, freshly bisected kidneys of alpha 8 integrin knock-out (KO) and wildtype mice (WT) were used. A total of n=7 female (n=4 KO, n=3 WT) and n=6 male animals (n=2 KO, n=4 WT) aged 6 weeks were examined with RSOM optoacoustic imaging systems (RSOM Explorer P50 at SWL 532nm and/or ms-P50 imaging system at 532 nm, 555 nm, 579 nm, and 606 nm). Images were reconstructed using a dedicated software, analyzed for size and vascular area and compared to standard histologic sections.

Results

RSOM enabled mapping of murine kidney size and vascular area, revealing differences between kidney sizes of male (m) and female (f) mice (merged frequencies (MF) f vs. m: 52.42±6.24 mm2 vs. 69.18±15.96 mm2, p=0.0156) and absolute vascular area (MF f vs. m: 35.67±4.22 mm2 vs. 49.07±13.48 mm2, p=0.0036). Without respect to sex, the absolute kidney area was found to be smaller in knock-out (KO) than in wildtype (WT) mice (WT vs. KO: MF: p=0.0255) and showed a similar trend for the relative vessel area (WT vs. KO: MF p=0.0031). Also the absolute vessel areas of KO compared to WT were found significantly different (MF p=0.0089). A significant decrease in absolute vessel area was found in KO compared to WT male mice (MF WT vs. KO: 54.37±9.35 mm2 vs. 34.93±13.82 mm2, p=0.0232). In addition, multispectral RSOM allowed visualization of oxygenated and deoxygenated parenchymal regions by spectral unmixing.

Conclusion

This study demonstrates the capability of RSOM for label-free visualization of differences in vascular morphology in ex vivo murine renal tissue at high resolution. Due to its scalability optoacoustic imaging provides an emerging modality with potential for further preclinical and clinical imaging applications.
A world review of the bristle fly parasitoids of webspinners
Authors: Badano Davide , Lenzi Alice , O’Hara James E. , Miller Kelly B. , Di Giulio Andrea , Di Giovanni Filippo , Cerretti Pierfilippo
Published: July 2022

Background

Dipteran parasitoids of Embioptera (webspinners) are few and extremely rare but known from all biogeographical regions except Australasia/Oceania. All belong to the fly family Tachinidae, a hyperdiverse and widespread clade of parasitoids attacking a variety of arthropod orders.

Results

The webspinner-parasitizing Diptera are reviewed based mostly on records from the collecting and rearing by Edward S. Ross. A new genus is erected to accommodate a new Afrotropical species, Embiophoneus rossi gen. et sp. nov. The genus Perumyia Arnaud is reviewed and a new species, Perumyia arnaudi sp. nov., is described from Central America while P. embiaphaga Arnaud is redescribed and new host records are given. A new species of Phytomyptera Rondani, P. woodi sp. nov., is described from Myanmar, representing the first report of a member of this genus obtained from webspinners. The genus Rossimyiops Mesnil is reviewed, R. longicornis (Kugler) is redescribed and R. aeratus sp. nov., R. fuscus sp. nov. and R. rutilans sp. nov. are newly described from the Oriental Region, and an updated key to species is given.

Conclusions

Webspinners were probably colonized independently at least four times by tachinids shifting from other hosts, most likely Lepidoptera.