bluuebunny/crossref_metadata_2025 huggingface dataset:
Reactive perforating collagenosis and systemic lupus erythematosus: A rare case report
Authors: Alenzi Fahidah
Published: December 2022

Background:

Transepidermal clearance of altered collagen and excessive excretion of keratin are characteristics of a rare cutaneous disorder known as reactive perforating collagenosis (RPC). There are different forms of RPC; however, the acquired form is the most prevalent and inherited. Reactive perforating collagenosis is rarely described in autoimmune rheumatic diseases; instead, it is typically linked to systemic conditions such as renal failure or hepatic disease.

Methods:

A 31-year-old Saudi female patient who was initially diagnosed with undifferentiated connective tissue disease. She developed RPC with a severe diffuse itchy skin rash with numerous papules and nodules with central hyperkeratotic plugs over the lower limb, upper limb, and face.

Results:

The patient tested positive for antinuclear antibody; however, a year later, patient developed Raynaud’s phenomenon, oral and nasal ulcers, malar rash, fatigue, and lupus rash around her eyes, and systemic lupus erythematosus was diagnosed clinically. The patient was treated for reactive perforating collagenosis with systemic antihistamines (diphenhydramine 50 mg orally twice daily), topical steroid cream (betamethasone dipropionate cream), and oral isotretinoin (20 mg daily). The patient was advised to undergo phototherapy. A year later, she presented with symptoms of systemic lupus erythematosus and started taking oral hydroxychloroquine 200 mg twice daily for systemic lupus erythematosus. The patient is listed on follow-up.

Conclusion:

Variable skin rash can mimic systemic lupus erythematosus and vasculitis. Therefore, reactive perforating collagenosis is a skin condition that requires high clinical suspension for diagnosis, and it might be challenging to determine whether it is an association or a complication. Furthermore, the timing of the skin biopsy may be crucial for the diagnosis of reactive perforating collagenosis.
Two possible etiologies of Guillain-Barré syndrome: mRNA-1273 (Moderna) vaccination and scrub typhus: A case report
Authors: Hwang Byoung Wook , Bong Jeong Bin
Published: December 2022

Rationale:

Guillain-Barré syndrome (GBS) is an acute inflammatory polyneuropathy related to infection with bacteria or virus and vaccination. Cases of GBS after coronavirus infection-19 (COVID-19) vaccination have been reported. However, cases of GBS after inoculation with mRNA-based COVID-19 vaccines, especially mRNA-1273, have rarely been reported compared to after inoculation with adenovirus vector-based COVID-19 vaccines. On 1 hand, GBS occurring after scrub typhus is often reported, but the exact pathological mechanism has not been elucidated. We report the case of a patient with GBS after inoculation with mRNA-1273 COVID-19 vaccine and scrub typhus.

Patient concerns:

A 47-year-old man received COVID-19 vaccination 4 weeks before admission. He had a fever, rash and general weakness 1 day after vaccination. After 3 weeks, the muscle strength of the extremities deteriorated to the extent that walking was impossible.

Diagnosis, interventions, and outcomes:

The patient developed quadriplegia with areflexia, axonal-type sensorimotor polyneuropathy was confirmed by nerve conduction study. The patient was diagnosed as GBS. Scrub typhus was also diagnosed as eschar was observed in the chest area and the serologic test of anti-R-tsutsugamushi antibody showed a strongly positive result. The patient received treatment with intravenous immunoglobulin at 0.4 g/kg daily for 5 days. Mechanical ventilation was applied during the intensive care unit. He was treated for scrub typhus simultaneously. Six months after the onset of the disease, the patient showed improvement to the point where he could work and exercise alone.

Lessons:

When GBS is suspected, early evaluation and treatment can lead to favorable outcomes. Considering that cases of GBS after COVID-19 vaccination have been reported, it is important to conduct early evaluation and management of patients with muscle weakness after COVID-19 vaccination to ensure early detection of GBS. And even if fever and rash are side effects that can occur frequently after vaccination, it is necessary to consider other diseases in addition to the side effects of the vaccine. This is to prevent delay in diagnosis and treatment of other diseases.
Buccal carcinoma associated with adult congenital pulmonary hypoplasia: A case report and literature review
Authors: Qiu Miao , Lin De-Rong
Published: December 2022

Rationale:

Congenital pulmonary hypoplasia is a relatively rare lung malformation. The disease is usually identified in the neonatal period or early childhood. Most affected patients die of respiratory insufficiency after birth. Mild congenital dysplasia is asymptomatic, while moderate congenital dysplasia manifests as respiratory distress or does not become evident until adulthood. Cases of congenital pulmonary hypoplasia in adults are rare, especially in combination with malignant tumors.

Patient concerns:

We report the case of a 64-year-old man with buccal carcinoma who was accidentally found to have hypoplasia of the left lung during treatment.

Diagnoses:

After chest computed tomography and chest radiograph, the diagnosis of adult congenital pulmonary hypoplasia was confirmed.

Interventions:

Since the patient had a history of bronchiectasis for more than 30 years and only had 1 healthy lung, the cardiopulmonary compensatory function was poor and the patient could not tolerate surgery, he was given radiotherapy and chemotherapy.

Outcomes:

Radiotherapy and chemotherapy were successfully completed, and within the patient’s tolerance, there was no serious adverse reaction of respiratory system.

Conclusion:

Congenital pulmonary hypoplasia’s diagnosis is challenging in adults because the condition can easily be mistaken for a more common disease. However, early diagnosis is very important to enable prompt therapy and ensure proper follow-up to detect and treat complications such as pulmonary infection and pulmonary hypertension in a timely manner.
Efficacy and safety of blood-activating herbs combined with edaravone in the treatment of acute ischemic stroke: A protocol for systematic review and meta-analysis
Authors: Su Zhuoyi , Zhang Shuai , Yu Ziqiao , Jin Hong , Sun Weichen , Yang Ziqi , Zhao Dexi
Published: December 2022

Background:

Although the combination of blood-activating herbs and western drugs has shown advantages in the treatment of ischemic stroke, there is no consensus on the safety and efficacy. This study aimed to systematically evaluate the safety and efficacy of the combination of blood-activating herbs with edaravone (EDA) in the treatment of acute ischemic stroke (AIS).

Methods:

We will implement the search strategy in 8 English and Chinese databases: Cochrane Central Register of Controlled Trials, Web of Science, PubMed, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, EMBASE and MEDLINE. The search included relevant clinical randomized controlled trials and quasi-randomized controlled trials that had been registered for publication by November 2022. Literature screening, data extraction and quality assessment will be performed by 2 authors. We will assess the risk of bias according to the Cochrane Handbook for Systematic Reviews of Interventions. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method classification will be used to assess the quality of the literature. Meta-analysis was performed using RevMan V.5.4 and STATA 16 software.

Results:

This study will provide a comprehensive analysis of the current clinical evidence on the application of blood-activating herbs combined with EDA in the treatment of AIS.

Conclusion:

This study will clarify the safety and efficacy of the combination of blood-activating herbs with EDA in the treatment of AIS.
Efficacy and safety of icotinib in the treatment of advanced EGFR mutation-positive nonsmall cell lung cancer: A meta-analysis of randomized controlled trials
Authors: Li Dailong , Yao Ling , Xu Lu , Li Wanqiang , Che Yuan
Published: December 2022

Background:

Icotinib is the first generation of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) independently developed in China, which has been widely used in the treatment of advanced EGFR mutation-positive nonsmall cell lung cancer (NSCLC). The purpose of this study was to systematically evaluate the efficacy and safety of icotinib in the treatment of advanced EGFR mutation-positive NSCLC and to provide evidence-based evidence for clinical rational drug use.

Methods:

Up to September 30, 2022, the databases of PubMed, EMBASE, Cochrane Library, ClinicalTrials.gov, China National Knowledge Infrastructure, and Wanfang were searched, and the randomized controlled trials (RCTs) of icotinib (experimental group) versus gefitinib or erlotinib (control group) in the treatment of EGFR-positive advanced NSCLC were included. Two researchers independently screened the literature, extracted data, and evaluated the quality of the included literature. Revman5.4 software was used for meta-analysis.

Results:

A total of 957 patients were included in 12 studies. The results of meta-analysis showed that the objective response rate (ORR) and disease control rate (DCR) of the experimental group were better than those of the control group (relative risk (RR) = 1.29, 95% confidence interval (CI): 1.10–1.50, P = .001; RR = 1.10, 95%CI: 1.02–1.18, P = .01). There was no significant difference in progression-free survival (PFS) and overall survival between the 2 groups (P > .05). The results of stratified analysis showed that icotinib significantly improved the ORR of EGFR-positive advanced NSCLC patients compared with gefitinib (RR = 1.20, 95%CI: 1.01–1.43, P = .03), but had no significant improvement in DCR (RR = 1.08, 95%CI: 0.99–1.16, P = .07). Compared with erlotinib, icotinib significantly improved ORR and DCR (RR = 1.69, 95%CI: 1.17–2.45, P = .005; RR = 1.21, 95%CI: 1.01–1.44, P = .04). In terms of adverse events of drugs, the incidence of nausea and vomiting in the experimental group was significantly lower than that in the control group (P < .05).

Conclusion:

Icotinib is safer than gefitinib or erlotinib in the treatment of advanced EGFR-positive NSCLC and seems to bring more clinical benefits to patients. However, there is no obvious advantage in improving the survival rate of patients, and long-term follow-up clinical studies are needed to verify its efficacy.
Associations of cardiorespiratory fitness, screen time and mental health among Chinese school children
Authors: Li Rui , Zhang Min-Zhe , Tang Bo-Wen , Zhang Jie , Qu Geng-Cong , Li Hui , Shi Yuan-Mei
Published: December 2022

To assess the independent and joint associations between cardiorespiratory fitness (CRF), screen time and mental health among Chinese school-aged children, a cross-sectional study was conducted in 3 primary schools in Wuhan city, China. Children self-reported ST, and their height, weight and CRF were measured. Mental health (anxiety, depressive symptom, and self-esteem) was assessed by self-administered questionnaires. A total of 805 children aged 9.1 ± 0.6 years participated in this study. High ST was associated with significantly increased risk for anxiety and low self-esteem, while high CRF was associated with a decreased risk of low self-esteem. In the joint model, children with low ST and high CRF showed the lowest risk for anxiety (OR: 0.42, 95%CI: 0.20–0.89) and low self-esteem (OR:0.44, 95%CI: 0.24–0.82). High ST and low CRF were negatively associated with mental health in Chinese schoolchildren. Health care and interventions on limiting ST and improving CRF level are warranted to promote the mental health in this population.
Brown adipose tissue human biomarkers: Which one fits best? A narrative review
Authors: Alito Angelo , Quartarone Angelo , Leonardi Giulia , Tisano Adriana , Bruschetta Antongiulio , Cucinotta Francesca , Milardi Demetrio , Portaro Simona
Published: December 2022

Adipose tissue (AT) is an endocrine metabolically dynamic active tissue that plays a central role in the systemic energy balance and metabolic regulation. Brown AT represents approximately 1% of adult human AT, with an energy-burning function that uses fat to create heat. Brown AT activity was measured using 18F-fluorodeoxyglucose positron emission tomography/computed tomography. It has been shown that cold exposure could promote brown AT activation. However, many factors, such as aging and body mass index, may interfere with this activity. Many authors have discussed the role of factors specifically secreted by the AT in response to cold exposure. The aim of this review is to properly understand the effects of cold on AT and biomarkers and their possible application in rehabilitation medicine. A comprehensive literature review was performed to identify published studies regarding biomarkers of cold effects on Brown AT searching the following databases: PubMed, Science Direct, and Web of Science, from 2012 to 2022. After evaluation of the inclusion and exclusion criteria, 9 studies were included in this review. We reported the overall influence of cold exposure on brown AT activity, its related biomarkers, and metabolism, demonstrating that the therapeutic role of cold exposure needs to be better standardized. From our data, it is important to design proper clinical trials because most cold applied protocols lack a common and homogeneous methodology.
Association between presence of Bacillus Calmette–Guerin vaccine scar and coronavirus disease 2019
Authors: Caliskaner Ozturk Buket , Vardaloglu Ilgim , Ongel Harbiyeli Deniz , Gungordu Nejdiye , Senkardesler Gizem , Aliyeva Nigar , Ismayilova Aytan , Can Gunay , Balkan Ilker Inanc , Gemicioglu Bilun , Borekci Sermin
Published: December 2022

Bacillus Calmette–Guerin vaccine is administered for protection against tuberculosis and may also have beneficial effects against some viral respiratory tract infections. In this study, it was aimed to investigate the relationship between Bacillus Calmette–Guerin vaccination which is confirmed by BCG scar, and the frequency and course of Coronavirus disease 2019 (COVID-19). Among 490 patients, 400 patients who accepted to participate in the study were included. After the consent of patients, age, gender, body mass index, comorbidities, smoking, history, and the progress of COVID-19 of these patients were investigated; the presence and number of Bacillus Calmette–Guerin scars were recorded by a physician. Data from groups with and without COVID-19 history were compared. There was no relation between presence and number of the BCG scar and COVID-19 related hospitalization and intensive care unit admission. When groups with and without COVID-19 history compared, no statistically significant difference was found with the presence and number of Bacillus Calmette–Guerin scars (P > 0,05). No association was found between the presence or number of BCG scars and the frequency and course of COVID-19 in individuals with Bacillus Calmette–Guerin vaccination history confirmed by the presence of Bacillus Calmette–Guerin vaccine scars. Currently, the most important protection against COVID-19 is the COVID-19 vaccine.
Prolonged electrocardiography registration does not lead to increased diagnosis of atrial fibrillation in pulmonary embolism patients, but sex affects generic health-related quality of life: Findings from a randomized clinical trial
Authors: Westerlund Eli , Fili Awat , Svennberg Emma
Published: December 2022

Background:

Pulmonary embolism (PE) is the third most common cause of cardiovascular death. Atrial fibrillation (AF) is the most common arrhythmia and is commonly detected in patients after embolic stroke. In this study, we set out to study if undiagnosed AF could be detected in patients with PE. In survivors of PE, persisting symptoms and exercise limitations are common. The disease burden of PE on quality of life (QoL) has received scarce attention. The primary aim was to study the prevalence of AF in patients with newly diagnosed PE. The secondary aim was to study QoL in PE patients.

Methods:

Patients with newly diagnosed acute PE were randomized 1:1 to long-term electrocardiogram (ECG) screening for AF (handheld ECG or ECG patch) or standard-of-care. The study participants were asked to complete RAND-36 questionnaires upon inclusion.

Results:

In total 89 PE patients (mean age 74.6 years) were included, and 40 out of these patients were randomized to AF screening. The study was terminated early due to futility when analysis 1 year after inclusion did not find any patients with newly detected AF.

RAND-36 showed that QoL was affected in PE patients. Interestingly, sex differences were found; women had a significantly lower QoL in the dimensions of vitality (P = .006), general health (P = .039), and mental health (P = .041).

Conclusion:

Screening for AF in PE patients did not yield a significant proportion of new cases. QoL is more affected in female patients with PE, and increased awareness of this is suggested.
Efficacy of three types of circumcision for children in the treatment of phimosis: A retrospective study
Authors: Zhu Dongsheng , Zhu Hongqi
Published: December 2022

Phimosis is a common condition of the urinary system in children and often requires surgical treatment. However, the optimal method of circumcision for children has not been determined. Herein, we analyzed the efficacy of 3 circumcision methods for children with phimosis. A retrospective analysis of 112 cases of pediatric phimosis after circumcision was conducted at our hospital. Among them, 36 cases were subjected to conventional operation (group A), 43 cases to ring circumcision (group B), and 33 cases to suturing device circumcision (group C). The duration of operation, amount of bleeding, pain, complications, healing time, and the satisfaction of the guardians were calculated. The operation time of group B and C was (6.26 ± 1.31) min and (7.67 ± 1.29) min, respectively, which was shorter than group A (27.42 ± 2.42) min (P < .05); besides, group A had the most blood loss volume, (9.67 ± 1.67) mL, and group B was the least (1.26 ± 0.44) mL (P < .05); group B had the strongest postoperative pain (4.05 ± 0.37), the longest pain time (6.84 ± 1.29) days, and the longest healing time (21.84 ± 4.23) days (P < .05). Postoperative complications were lowest in group C (11.11% vs 20.93% vs 6.06%), satisfaction of guardians was highest in group C (86.11% vs 85.27% vs 89.99%), but the difference was not statistically significant (P > .05). Three types of surgical procedures present with advantages and disadvantages. The conventional surgery led to longer operation time and more bleeding but did not require special medical equipment and was easy to carry out; ring surgery had the shortest operation time, the least bleeding, accompanied by the longest recovery time and pain duration; the complications of the suturing device were the least, the parents had the highest degree of satisfaction, however, it also needs a specific suturing device. Therefore, each type had its distinctive characteristics and may be flexibly selected based on their own conditions.
How to improve the diagnosis of neoplastic transformation of gastric hyperplastic polyps in the context of autoimmune gastritis?: A case report and lierature review
Authors: Xing Yunqi , Han Haixiao , Wang Yuxuan , Sun Zhongmei , Wang Linheng , Peng Dan , Guo Xiaoyuan , Yao Na , Yuan Yali , Zhang Wenji , Mao Tangyou , Liu Yuyue
Published: December 2022

Rationale:

Gastric hyperplastic polyp (GHP) commonly arises in the abnormal background mucosa, which makes it easy to be misdiagnosed and missed, and has a potential risk of malignant transformation over time. Here, we present a case of neoplastic transformation of GHP in a context of autoimmune gastritis (AIG).

Patient concerns:

In 2020, a 67-year-old woman was admitted for endoscopic review 6 years after gastric polyp resection, the histological diagnosis of gastric polyp was neoplastic transformation of GHP as before. The patient had undergone multiple polypectomies at the same part. Then histological examination revealed that partial epithelial hyperplasia and dysplasia, and the neoplastic areas were interlaced with normal mucosa.

Diagnoses and interventions:

We further found that the background diagnosis was AIG. These results supported the diagnosis of neoplastic transformation of GHP in a context of AIG. With the doubt of missed diagnose, we retrospectively analyzed the medical history in 2014, 2015 and 2016, confirmed the presence of AIG. Unfortunately, serological tests and special treatment were not performed.

Outcomes:

The correct diagnosis was eventually confirmed in 2020, which enables patients to receive normal treatment and monitoring, and avoids further deterioration of the disease.

Lessons:

The purpose of this case report is to increase clinical awareness of neoplastic transformation of GHP in a context of AIG, and hope promise for early diagnosis and treatment.
Targeting inflammation in hypertension
Authors: Deussen Andreas , Kopaliani Irakli
Published: December 2022

Purpose of review

Hypertension remains a global health and socioeconomic burden. Immune mechanisms are now recognized as integral part of the multifactorial etiology of hypertension and related organ damage. The present review addresses inflammatory pathways and immune targets in hypertension, which may be important for an immunomodulatory treatment of hypertension aside from lowering arterial pressure.

Recent findings

Anti-inflammatory interventions targeting single interleukins or almost the entire immune system show different beneficial effects. While immunomodulation (targeting specific portion of immune system) shows beneficial outcomes in certain groups of hypertensives, this does not pertain to immunosuppression (targeting entire immune system). Immunomodulatory interventions improve outcomes of hypertension independent of arterial pressure. The studies reveal interleukins, such as interleukin (IL)-1β and IL-17 as targets of immunomodulation. Besides interleukins, targeting αvβ-3 integrin and matrix metalloproteinase-2 or using experimental cell-therapy demonstrate beneficial effects in hypertensive organ damage. The NLR family pyrin domain containing 3 (NLRP3) inflammasome/IL-1β/endothelial cell/T-cell axis seems to be an important mediator in sustained inflammation during hypertension.

Although immunomodulation may be advantageous as a causal therapy in hypertension, targeting immune networks rather than single interleukins appears of major importance. Further research is required to better identify these networks and their links to human hypertension.
The Experience of Uncertainty in Individuals With High Risk for Pancreatic Cancer
Authors: Underhill-Blazey Meghan L. , Zhang Yingzi , Stanek Susan , Norton Sally
Published: December 2022

Background

Individuals with a strong family history of pancreatic cancer or a known hereditary cancer syndrome that is associated with pancreatic cancer are considered at high risk for developing pancreatic cancer. Living with a high risk for often fatal cancer is accompanied by high levels of uncertainty. Uncertainty is also independently associated with negative health outcomes. By understanding issues, sources, and responses to uncertainty, targeted supportive care strategies can be provided.

Objectives

This study aimed to examine how uncertainty manifests in the experience of being at high risk to develop pancreatic cancer and to describe issues, sources of, and responses to uncertainty.

Methods

In this secondary qualitative descriptive study, we analyzed 19 interviews with persons living with inherited pancreatic cancer risk. Analysis was guided by a conceptual framework of uncertainty and responses to uncertainty.

Results

Participants described multiple personal, practical, and scientific issues of uncertainty, centering on what to expect for their future health. Participants also expressed positive and negative cognitive, emotional, and behavioral responses to uncertainty, including engaging in surveillance. Uncertainty sources were both individual experiences as well as perceptions of healthcare provider uncertainty with managing pancreatic cancer risk.

Conclusion

Pancreatic cancer risk includes issues of uncertainty related to personal mortality, defining and managing risk, and experiencing surveillance. Positive and negative responses to this uncertainty could be targeted through interventions.

Implication for Practice

The oncology nurse should assess for sources of and responses to uncertainty in persons at risk for pancreatic cancer and offer psychosocial and educational support.
The Mediating Effect of Uncertainty in Illness on Cancer Coping in Patients With Primary Malignant Brain Tumors
Authors: Hong Soomin , Lee JuHee , Lee Jiyeon , Chang Jong Hee , Park Chang Gi , Kim Tae Hee
Published: December 2022

Background

Patients with primary malignant brain tumors (PMBTs) experience uncertainty in illness (UI) because of the high recurrence rate and symptoms that occur during treatment.

Objective

To develop and test a model based on the Uncertainty in Illness Theory to predict the UI and cancer coping experienced by PMBT patients.

Methods

This was a cross-sectional study using path analysis. The participants were adults diagnosed with PMBT who completed a questionnaire about demographic and disease-related characteristics, UI, cancer coping, brain tumor symptoms, and social support. Clinical data (eg, the diagnosis, tumor location, and grade) were obtained from electronic health records. Data were analyzed using SPSS 26.0 and the MVN, psych, and lavaan packages in R 4.1.0.

Results

This study included 203 PMBT patients. The hypothesized model satisfied all statistical criteria (comparative fit index = 0.998, root mean square error of approximation = 0.044, standardized root mean square residual = 0.016). The indirect and direct associations of UI in the path from social support to cancer coping were all significant with a 95% bootstrapping confidence interval. Although the indirect and direct associations of UI in the path of brain tumor symptoms and cancer coping did not have direct or total effects, the indirect effect was statistically significant.

Conclusions

Uncertainty in illness mediated brain tumor symptoms and social support to predict cancer coping.

Implications for Practice

A nurse-led intervention for cancer coping among PMBT patients can be developed by considering symptoms and social support and UI as a mediator.
A Uniform Chart of Accounts: Strengthening Public Health Practice and Research Through Standardized Financial Data
Authors: Bekemeier Betty , Heitkemper Elizabeth , Zaichkin Dana L. , Whitman Greg , Singh Simone R. , Leider Jonathon P.
Published: December 2022

Context:

The COVID-19 pandemic made the long-standing need for a national uniform financial reporting standard for governmental public health agencies clear, as little information was available to quantify state and local public health agencies' financial needs during the pandemic response. Such a uniform system would also inform resource allocation to underresourced communities and for specific services, while filling other gaps in practice, research, and policy making. This article describes lessons learned and recommendations for ensuring broad adoption of a national Uniform Chart of Accounts (UCOA) for public health departments.

Program:

Leveraging previous efforts, the UCOA for public health systems was developed through collaboration with public health leaders. The UCOA allows state and local public health agencies to report spending on activities and funding sources, along with practice-defined program areas and capabilities.

Implementation:

To date, 78 jurisdictions have utilized the UCOA to crosswalk financial information at the program level, enabling comparisons with peers.

Evaluation:

Jurisdictions participating in the UCOA report perceptions of substantial up-front time investment to crosswalk their charts of accounts to the UCOA standard but derive a sense of valuable potential for benchmarking against peers, ability to engage in resource allocation, use of data for accountability, and general net positive value of engagement with the UCOA.

Implications for Policy and Practice:

The UCOA is considered a need among practice partners. Implementing the UCOA at scale will require government involvement, a reporting requirement and/or incentives, technical assistance, financial support for agencies to participate, and a means of visualizing the data.
The Management of Upper Limb Amputation Rehabilitation: Synopsis of the 2022 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline for Acquired Amputation
Authors: Crunkhorn Andrea , Andrews Erin , Fantini Christopher , Highsmith M. Jason , Loftsgaarden Megan , Randolph Billie , Sall James , Webster Joseph
Published: December 2022

Upper limb amputation (ULA) can result in significant functional impairment necessitating a comprehensive rehabilitation approach throughout the continuum of care. In 2022, the Departments of Veteran Affairs (VA) and Defense (DOD) completed an updated clinical practice guideline (CPG) for the management of ULA rehabilitation. This practice guideline was developed by a workgroup of subject-matter experts from a variety of disciplines. Twelve key questions were developed by the workgroup using the PICOTS (population, intervention, comparator, outcomes, timing of outcomes measurement, and setting) format to establish the scope of the literature review. Eighteen recommendations were developed through extensive review of the available literature and use of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria. The strength of each recommendation was determined based upon the quality of the research evidence and the additional domains of the GRADE criteria. Of the 18 recommendations, 4 were found to have sufficient evidence to suggest for use of a particular rehabilitation management strategy. Thus, the 2022 VA/DOD CPG provides updated, evidence-based information on the care and rehabilitation of persons with ULA. However, a significant lack of high-quality evidence in ULA rehabilitation limited evidence-based clinical guidance to assist healthcare providers in managing this population.
The Role of Bisphosphonates Prior to Denosumab Treatment on Rebound Fractures: A Mini Review
Authors: Inojosa Arthur Costa , Mendes Laís , Bandeira Leonardo , Bandeira Francisco
Published: December 2022

Denosumab is a potent anti-resorptive medication used to treat patients at high risk for osteoporosis; however, its beneficial effects on the skeletal system are quickly reversed after discontinuation. In contrast, bisphosphonates (BPs) are anti-resorptive agents with residual effects on the bone matrix; thus, these are capable of preserving bone mass for a long time. Therefore, subsequent anti-resorptive treatment with BPs is mandatory to prevent rebound fractures. Furthermore, BP administration before denosumab treatment appears to be a reasonable strategy for reducing hyperactivation of bone remodeling. In this review, we summarize the effects of BP administration before denosumab treatment in preventing rebound fractures after denosumab discontinuation.
Effect of Lactobacillus Fermentum as a Probiotic Agent on Bone Health in Postmenopausal Women
Authors: Han Hee Soo , Kim Jung Geul , Choi Yoon Hyo , Lee Kyoung Min , Kwon Tae Hun , Kim Sae Hun
Published: December 2022

Background: Probiotics are live microorganisms that confer health benefits on the host. Many animal studies have shown that among the probiotics, lactobacilli exert favorable effects on bone metabolism. Herein, we report the results of a randomized controlled trial performed to investigate the effect of Lactobacillus fermentum (L. fermentum) SRK414 on bone health in postmenopausal women.Methods: The bone turnover markers (BTMs) and bone mineral density (BMD) in participants in the study group (N=27; mean age, 58.4±3.4 years) and control group (N=26; mean age, 59.5±3.4 years) were compared during a 6-month trial. BTMs were measured at pretrial, 3 months post-trial, and 6 months post-trial, while BMD was measured at pre-trial and 6 months post-trial. Changes in the gut microorganisms were also evaluated.Results: Femur neck BMD showed a significant increase at 6 months post-trial in the study group (P=0.030) but not in the control group. The control group showed a decrease in osteocalcin (OC) levels (P=0.028), whereas the levels in the study group were maintained during the trial period. The change in L. fermentum concentration was significantly correlated with that in OC levels (r=0.386, P=0.047) in the study group at 3 months post-trial.Conclusions: Probiotic (L. fermentum SRK414) supplementation was found to maintain OC levels and increase femur neck BMD during a 6-month trial in postmenopausal women. Further studies with a larger number of participants and a longer study period are required to increase the utility of probiotics as an alternative to osteoporosis medication.
Homogenic Evaluation for Spatial Distribution in Osteoclast Differentiation
Authors: Lim Hyun-Sook , Shin Hong-In , Jeong Daewon
Published: December 2022

Background: Cells have heterogeneous cellular diversity in size, morphology, cell cycle, metabolism, differentiation degree, and spatial distribution. The shift of specific cells towards the desired cells is crucial for maintaining uniform cellular function and can be represented by homogeneity and heterogeneity. Here, we developed a simple and direct method for evaluating the homogeneous distribution of desired cells in a constant region.Methods: We differentiated osteoclast progenitors into bone-resorbing multinucleated giant osteoclasts in a 2-dimensional culture plate under 2 conditions. Cells were stained with tartrate-resistant acid phosphatase to assess osteoclast differentiation, images were taken using a microscope and divided into sectors, and the number of osteoclasts (≥3 nuclei) in each sector was counted. To assess the homogeneity of the spatial distribution of osteoclasts, the standard deviation (SD) was calculated from the mean number of osteoclasts within each sector.Results: From the 2 groups, a value with a SD close to 0 indicates high spatial homogeneity while a relatively high SD represents low spatial homogeneity.Conclusions: Our findings suggest that spatial homogeneity can be represented as SD.
Menstruation Hygiene Management among Secondary School Students of Chitwan, Nepal- Pre-Post Study Design
Authors: Khanal Gayatri , Shrestha Niki , Adhikari Kishor , Ghimire Usha
Published: December 2022

Introduction

Despite of significant progress towards reproductive health, still in many societies menstruation is treating as negative, shameful or dirty consequences which may increases the incidence of reproductive tract infection leading to significant negative impact to a women’s health. To manage menstruation hygienically and with dignity, it is essential that women and girls have sufficient knowledge on menstruation hygiene management to manage it. Thus, this study aim to identify the knowledge and practice of menstruation hygiene and effectiveness of a health educational intervention on MHM.

Methods

A school-based cross-sectional study was conducted between August 2021 to April 2022 among 400 secondary school girls studying in grades 9 and 10 in Chitwan District, Nepal. A total of 20 schools out of 250 schools were selected through lottery method. A further 400 girls were selected from selected schools by using systematic random method. Logistic regression analysis and Wilcoxon rank test were employed to identify predictors and evaluate effectiveness of health educational intervention on Menstrual Hygiene Management

Results

Overall, 57.7% of the girls had unsatisfactory level of knowledge. Around two third (61.4%) missed schools days. Almost 99.5% had experienced any form of cultural restrictions. After health education intervention, level of knowledge about menstruation hygiene had significantly improved (z= 17.129, p=<0.001) in satisfactory level of knowledge compared to baseline (42.3% vs 92.5%). During multivariate analysis, studied in public schools (AoR= 1.7, p= 0.026), No or one close female friend (AoR= 2.2, p= 0.011), other than Brahmin/Chhetri caste (AoR= 1.4, p= 0.05), lived in joint family (AoR= 1.6, p= 0.048) were significantly associated with unsatisfactory level of knowledge on Menstruation hygiene management.

Conclusion

Girls had unsatisfactory level of knowledge. School absenteeism and cultural restriction is very high. Ethnicity status, Types of family, Number of close female friends, types of schools and mothers’ education were associated with MHM.. Educational program conducted brings significant change in level of knowledge. Hence the education intervention demonstrate the suitability and feasibility of implementing a health educational intervention on MHM.
Dysfunctional analysis of the pre-training model on nucleotide sequences and the evaluation of different k-mer embeddings
Authors: Zhang Yao-zhong , Bai Zeheng , Imoto Seiya
Published: December 2022

Pre-training has attracted much attention in recent years. Although significant performance improvements have been achieved in many downstream tasks using pre-training, the mechanism of how a pre-training method works for downstream tasks is not fully illustrated. In this work, focusing on nucleotide sequences, we decompose a pre-training model of Bidirectional Encoder Representations from Transformers (BERT) into embedding and encoding modules to illustrate what a pre-trained model learns from pre-training data. Through dysfunctional analysis on both data and model level, we demonstrate that the context-consistent k-mer representation is the primary product that a typical BERT model learns in the embedding layer. Surprisingly, single usage of the k-mer embedding pre-trained on the random data can achieve comparable performance to that of the k-mer embedding pre-trained on actual biological sequences. We further compare the learned k-mer embeddings with other commonly used k-mer representations in downstream tasks of sequence-based functional predictions and propose a novel solution to accelerate the pre-training process.

Contact

yaozhong@ims.u-tokyo.ac.jporimoto@hgc.jp

Supplementary information

The source code and relevant data are available athttps://github.com/yaozhong/bert_investigation.
Expanded olfactory system in fishes capable of terrestrial exploration
Authors: Burguera Demian , Dionigi Francesco , Kverková Kristina , Winkler Sylke , Brown Thomas , Pippel Martin , Zhang Yicheng , Shafer Maxwell , Nichols Annika L.A. , Myers Eugene , Němec Pavel , Musilova Zuzana
Published: December 2022

Smell abilities differ greatly among vertebrate species, as reflected by the exceptional size variability of gene families and brain regions involved in odour detection. However, key environmental factors shaping the molecular and phenotypic evolution of the olfactory sensory system remain mostly unknown. Here, we investigate the association between diverse ecological traits and the number of olfactory chemoreceptors in the genomes of more than two hundred ray-finned fishes. We found independent expansions producing large gene repertoires in nocturnal amphibious fishes, generally able to perform active terrestrial exploration. Furthermore, we reinforced this finding with an additional analysis of a clariid species (Channallabes apus), a fish lineage with chemosensory-based aerial orientation. Importantly, we also detected an augmented information-processing capacity in the olfactory bulb of examined nocturnal amphibious species. Overall, we report a convergent magnification of the olfactory system in amphibious fishes potentially enhancing terrestrial orientation, revealing the likelihood of an analogous event in tetrapod ancestors during the water-to-land transition.
Extensive immune receptor repertoire diversity in disease-resistant rice landraces
Authors: Gladieux Pierre , van Oosterhout Cock , Fairhead Sebastian , Jouet Agathe , Ortiz Diana , Ravel Sebastien , Shrestha Ram-Krishna , Frouin Julien , He Xiahong , Zhu Youyong , Morel Jean-Benoit , Huang Huichuan , Kroj Thomas , Jones Jonathan D G
Published: December 2022

Plants have powerful defence mechanisms, and extensive immune receptor repertoires, yet crop monocultures are prone to epidemic diseases. Rice is susceptible to many diseases, such as rice blast caused byMagnaporthe oryzae. Varietal resistance of rice to blast relies on intracellular nucleotide binding, leucine-rich repeat (NLR) receptors that recognize specific pathogen molecules and trigger immune responses. In the Yuanyang terraces in south-west China, rice landraces rarely show severe losses to disease whereas commercial inbred lines show pronounced field susceptibility. Here, we investigate within-landrace NLR sequence diversity of nine rice landraces and eleven modern varieties ofindica, japonicaandaususing complexity reduction techniques. We find that NLRs display high sequence diversity in landraces, consistent with balancing selection, and that balancing selection at NLRs is more pervasive in landraces than modern varieties. Notably, modern varieties lack many ancient NLR haplotypes that are retained in some landraces. Our study emphasises the value of standing genetic variation that is maintained in farmer landraces as resource to make modern crops and agroecosystems less prone to disease.
Boosting wheat functional genomics via indexed EMS mutant library of KN9204
Authors: Wang Dongzhi , Li Yongpeng , Wang Haojie , Xu Yongxin , Yang Yiman , Zhou Yuxin , Chen Zhongxu , Zhou Yuqing , Gui Lixuan , Guo Yi , Zhou Chunjiang , Tang Wenqiang , Zheng Shuzhi , Wang Lei , Guo Xiulin , Zhang Yingjun , Cui Fa , Lin Xuelei , Jiao Yuling , He Yuehui , Li Junming , He Fei , Liu Xigang , Xiao Jun
Published: December 2022

A better understanding of wheat functional genomics could facilitate the targeted breeding for agronomic traits improvement and environmental adaptation. With the release of reference genomes and extensive re-sequencing data of wheat and relatives, wheat functional genomics enters a new era. However, limited transformation efficiency in wheat hampers in-depth gene functional study and genetic manipulation for breeding. Here, we generated an EMS mutagenesis library of KN9204, a widely grown elite wheat variety in northern China, with available reference genome, transcriptome, and epigenome of various tissues. The library harbors enormous developmental diversity covering important tissues and transition stages. Exome capture sequencing of 2,090 mutant lines, with probes designed by KN9204 genome, revealed that 98.79% of coding genes have mutations and 1,383 EMS-type SNPs per line averagely. Novel allelic variations for important agronomic trait-related genes, such asRht-D1, Q, TaTB1, andWFZP, were identified. We tested 100 lines with severe mutations in 80 NAC TFs under drought and salinity stresses, and found 13 lines with altered sensitivity. Three lines were further analyzed for the regulation insight of NAC TFs in stress response by combing transcriptome and available chromatin accessibility data. Hundreds of direct targets of NAC with altered transcriptional pattern in mutant lines under salt or drought stress induction were identified, includingSNAC1, DREB2B, CML16andZFP182, knowing factors in abiotic stresses response. Thus, we have generated and indexed KN9204 EMS mutant library which would facilitate functional genomics study and provide resources for genetic manipulation in wheat.
Fast and accurate protein function prediction from sequence through pretrained language model and homology-based label diffusion
Authors: Yuan Qianmu , Xie Junjie , Xie Jiancong , Zhao Huiying , Yang Yuedong
Published: December 2022

Protein function prediction is an essential task in bioinformatics which benefits disease mechanism elucidation and drug target discovery. Due to the explosive growth of proteins in sequence databases and the diversity of their functions, it remains challenging to fast and accurately predict protein functions from sequences alone. Although many methods have integrated protein structures, biological networks or literature information to improve performance, these extra features are often unavailable for most proteins. Here, we propose SPROF-GO, a Sequence-based alignment-free PROtein Function predictor which leverages a pretrained language model to efficiently extract informative sequence embeddings and employs self-attention pooling to focus on important residues. The prediction is further advanced by exploiting the homology information and accounting for the overlapping communities of proteins with related functions through the label diffusion algorithm. SPROF-GO was shown to surpass state-of-the-art sequence-based and even network-based approaches by more than 14.5%, 27.3% and 10.1% in AUPR on the three sub-ontology test sets, respectively. Our method was also demonstrated to generalize well on non-homologous proteins and unseen species. Finally, visualization based on the attention mechanism indicated that SPROF-GO is able to capture sequence domains useful for function prediction.

Key points

SPROF-GO is a sequence-based protein function predictor which leverages a pretrained language model to efficiently extract informative sequence embeddings, thus bypassing expensive database searches.

SPROF-GO employs self-attention pooling to capture sequence domains useful for function prediction and provide interpretability.

SPROF-GO applies hierarchical learning strategy to produce consistent predictions and label diffusion to exploit the homology information.

SPROF-GO is accurate and robust, with better performance than state-of-the-art sequence-based and even network-based approaches, and great generalization ability on non-homologous proteins and unseen species
Design of MEG-Based Brain-Machine Interface Control Methodology Through Time-Varying Cortical Neural Connectivity & Extreme Learning Machine
Authors: Uyulan Caglar
Published: December 2022

Human-machine interfaces contribute to the improvement of the life quality of physically disabled users. In this study, a non-invasive brain-machine interface (BMI) design methodology was proposed to control a robot arm through magnetoencephalography (MEG) based on directionally modulated MEG activity that was acquired during the user’s imagined wrist movements in four various directions. The partial directed coherence (PDC) measure derived from functional connectivity between cortical brain regions was utilized in the feature extraction process. The time-varying parameters were estimated based on a time-varying multivariate adaptive autoregressive (AAR) model, that can detect task-dependent features and non-symmetric channel relevance for mental task discrimination. An extreme learning machine (ELM), that utilizes Moore-Penrose (MP) generalized inverse to set its weights and does not necessitate a gradient-based backpropagation algorithm was employed to generate a model with the extracted feature set. The output of the task classification model was embedded into the robotic arm model for realizing control-based tasks. The classification results dictate that the proposed BMI methodology is a feasible solution for rehabilitation or assistance systems that are devised to help motor-impaired people. The proposed methodology provides very satisfactory classification performance at a fast learning speed.