bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical effect and follow-up of laparoscopic radical proximal gastrectomy for upper gastric carcinoma
Authors: Meng Wei , Ya-di Huang , Wei-bo Cao , Ru-dong Zhao , Ze-wei Cheng , Ou Yang Jun , Ze-peng Yan , Chuan-qi Chen , Yi-ze Liang , Dan-ping Sun , Wen-bin Yu
Published: March 2023

Objective

To evaluate the safety and clinical effect of tubular esophagogastric anastomosis in laparoscopic radical proximal gastrectomy.

Methods

A retrospective analysis was conducted involving 191 patients who underwent laparoscopic radical proximal gastrectomy in the Department of Gastrointestinal Surgery, Qilu Hospital of Shandong University from January 2017 to October 2020. Patients were divided into tubular esophagogastric anastomosis group (TG group) and traditional esophagogastric anastomosis group (EG group) according to the digestive tract reconstruction. Their intraoperative conditions, perioperative recovery and postoperative follow-up were compared. Patients were also divided into indocyanine green group and non-indocyanine green group according to whether or not indocyanine green tracer technology was used during the operation. Their intraoperative condition and perioperative recovery were compared and analyzed after propensity score matching.

Results

The operation was successfully completed in all patients. Compared with the EG group, the TG group had less volume of gastric tube drainage, shorter gastric tube drainage time and proton pump inhibitors application time, and lower reuse rate of proton pump inhibitors. However, the TG group had a higher anastomotic stenosis at three months after surgery, as measured using anastomotic width and dysphagia score. Nevertheless, the incidence of reflux esophagitis and postoperative quality of life score in the TG group were lower compared with the EG group at 1st and 2nd year after surgery. In the indocyanine green analysis, the indocyanine green group had significantly shorter total operation time and lymph node dissection time and less intraoperative blood loss compared with the non-indocyanine green group. However, compared with the non-indocyanine green group, more postoperative lymph nodes were obtained in the indocyanine green group.

Conclusion

Laparoscopic radical proximal gastrectomy is safe and effective treatment option for upper gastric cancer. Tubular esophagogastric anastomosis has more advantages in restoring postoperative gastrointestinal function and reducing reflux, but it has a higher incidence of postoperative anastomotic stenosis compared with traditional esophagogastrostomy. The application of indocyanine green tracer technique in laparoscopic radical proximal gastrectomy has positive significance.
Hashimoto's thyroiditis, vitiligo, anemia, pituitary hyperplasia, and lupus nephritis—A case report of autoimmune polyglandular syndrome type III C + D and literature review
Authors: Sun Yongmei , Kan Xuan , Zheng Rongxiu , Hao Liping , Mao Zongtao , Jia Ying
Published: March 2023

Objective

This study aims to summarize the clinical characteristics of one teenager with autoimmune polyglandular syndrome (APS) type III C + D to improve the understanding of APS III C + D and its effect of thyroid function.

Methods

This article reported the clinical manifestations, laboratory examinations, treatment methods, and outcomes of an adolescent with anemia admitted to the Pediatrics Department of Tianjin Medical University General Hospital in July 2020 and reviewed the literature.

Results

A girl, aged 13 years and 1 month, was admitted to the hospital due to anemia for more than 4 years and episodic abdominal pain for 1 week. Four years ago, the girl went to a local hospital for “vitiligo”, and a routine blood test revealed anemia. The lowest hemoglobin (HGB) was 61 g/L, and the blood test revealed iron deficiency anemia. She had no menstrual cramps for 2 months. Urine routine showed protein 3+∼4+ and 258 red blood cells (RBCs)/high-power field. Urine protein was 3,380 mg/24 h. Free thyroxine was low, thyroid-stimulating hormone was >100 uIU/ml, thyroid peroxidase antibody was >1,000 IU/ml, and thyroglobulin antibody and thyrotropin receptor antibody were negative. Pituitary magnetic resonance imaging showed a mass in the sellar region with a uniform signal and a maximum height of about 15.8 mm. The result of the antinuclear antibody was 1:80 homogeneous type, and anti-dsDNA and anticardiolipin antibodies IgA and IgM were slightly higher. Thyroxine and iron were given for 1 month, menstruation resumed, and urine protein and RBC count decreased. After 5 months of treatment, free thyroid function, HGB, RBCs in urine, and pituitary returned to normal. Later, a renal biopsy showed changes in focal proliferative glomerulonephritis, and the girl was diagnosed with lupus glomerulonephritis type III. After 3 days of shock therapy with methylprednisolone, prednisone, mycophenolate mofetil, and other treatments were administrated for 1 year. At the time of writing, urine protein was 280 mg/24 h.

Conclusion

Co-occurrence of Hashimoto's thyroiditis, vitiligo, anemia, pituitary hyperplasia, and lupus nephritis is rare. It is very important to pay attention to the screening of thyroid function.
Analgesic effect of ropivacaine combined with dexmedetomidine in the postoperative period in children undergoing ultrasound-guided single-shot sacral epidural block: A systematic review and meta-analysis
Authors: Quan Shoubo , Lu Yuexia , Huang Yujie
Published: March 2023

Objective

This study aims to evaluate the efficacy of dexmedetomidine as an adjuvant to ropivacaine in prolonging postoperative analgesia and reducing pain scores in children undergoing surgery.

Methods

Five online databases were searched for RCTs on postoperative analgesia of pediatric patients undergoing ultrasound-guided single-shot sacral epidural block with dexmedetomidine as an adjuvant to ropivacaine up to January 2, 2023. Pain score and sedation score at 2, 4, 8, 12, and 24 h after the operation, the time of first receiving additional analgesic drugs, and the number of postoperative adverse effects were selected to compare the efficacy and safety of combined treatment with ropivacaine alone for pediatrics. The standard mean difference (SMD) or odds ratio (OR) and the corresponding 95% confidence interval (95%CI) were calculated by using a random-effects model.

Results

A total of 295 articles were retrieved, but only 20 records were included in this meta-analysis. The results showed that dexmedetomidine combined with ropivacaine for sacral epidural block in children undergoing ultrasound-guided single-shot sacral epidural block had a more prolonged analgesia effect (SMD = 3.47, 95%CI: 2.80, 4.14). There were lower analgesia scores at 2 h(T1), 4 h(T2), 8 h(T3), 12 h(T4), and 24 h(T5) in postoperative period (T1: SMD = −1.02, 95%CI: −1.31, −0.72; T2: SMD = −1.02, 95%CI: −1.32, −0.72; T3: SMD = −0.84, 95%CI: −1.12, −0.56; T4: SMD = −0.61, 95%CI: −1.03, −0.20; T5: SMD = −1.03, 95%CI: −1.28, −0.78). And the incidence of adverse effects was similar between the two groups (OR = 0.84, 95%CI: 0.59, 1.18).

Conclusions

The results of this review and meta-analysis support that dexmedetomidine, as an adjuvant to ropivacaine, can improve postoperative analgesia of surgery and significantly prolong the analgesic time in children, with a similar incidence rate of adverse symptoms when compared with ropivacaine alone.
Early vasopressin infusion improves oxygenation in infants with congenital diaphragmatic hernia
Authors: Capolupo Irma , De Rose Domenico Umberto , Mazzeo Francesca , Monaco Francesca , Giliberti Paola , Landolfo Francesca , Di Pede Alessandra , Toscano Alessandra , Conforti Andrea , Bagolan Pietro , Dotta Andrea
Published: March 2023

Objective

Congenital Diaphragmatic Hernia (CDH) is a complex disease including a diaphragmatic defect, lung hypoplasia, and pulmonary hypertension. Despite its increasing use in neonates, the literature on the use of vasopressin in neonates is limited. The aim of this work is to analyze the changes in clinical and hemodynamic variables in a cohort of CDH infants treated with vasopressin.

Methods

Among CDH infants managed at the Neonatal Intensive Care Unit (NICU) of our hospital from May 2014 to January 2019, all infants who were treated with vasopressin, because of systemic hypotension and pulmonary hypertension, were enrolled in this retrospective study. The primary outcome was the change in oxygenation index (OI) after the start of the infusion of vasopressin. The secondary outcomes were the changes in cerebral and splanchnic fractional tissue oxygen extraction (FTOEc and FTOEs) at near-infrared spectroscopy, to understand the balance between oxygen supply and tissue oxygen consumption after the start of vasopressin infusion. We also reported as secondary outcomes the changes in ratio of arterial oxygen partial pressure (PaO2) to fraction of inspired oxygen (FiO2), heart rate, mean arterial pressure, serum pH, and serum sodium.

Results

We included 27 patients with isolated CDH who received vasopressin administration. OI dramatically dropped when vasopressin infusion started, with a significant reduction according to ANOVA for repeated measures (p = 0.003). A global significant improvement in FTOEc and FTOEs was detected (p = 0.009 and p = 0.004, respectively) as a significant reduction in heart rate (p = 0.019). A global significant improvement in PaO2/FiO2 ratio was observed (p < 0.001) and also at all time points: at 6 h since infusion (p = 0.015), 12 h (p = 0.009), and 24 h (p = 0.006), respectively. A significant reduction in sodium levels was observed as expected side effect (p = 0.012). No significant changes were observed in the remaining outcomes.

Conclusion

Our data suggest that starting early vasopressin infusion in CDH infants with pulmonary hypertension could improve oxygenation index and near-infrared spectroscopy after 12 and 24 h of infusion. These pilot data represent a background for planning future larger randomized trials to evaluate the efficacy and safety of vasopressin for the CDH population.
Correlation between perioperative dexmedetomidine administration and postoperative acute kidney injury in hypertensive patients undergoing non-cardiac surgery
Authors: Li Bo , Chen Minghua , Zeng Youjie , Luo Siwan
Published: March 2023

Background: Previous studies have suggested that dexmedetomidine may have a protective effect on renal function. However, it is currently unclear whether perioperative dexmedetomidine administration is associated with postoperative acute kidney injury (AKI) incidence risk in hypertensive patients undergoing non-cardiac surgery.

Methods: This investigation was a retrospective cohort study. Hypertensive patients undergoing non-cardiac surgery in Third Xiangya Hospital of Central South University from June 2018 to December 2019 were included. The relevant data were extracted through electronic cases. The univariable analysis identified demographic, preoperative laboratory, and intraoperative factors associated with acute kidney injury. Multivariable stepwise logistic regression was used to assess the association between perioperative dexmedetomidine administration and postoperative acute kidney injury after adjusting for interference factors. In addition, we further performed sensitivity analyses in four subgroups to further validate the robustness of the results.

Results: A total of 5769 patients were included in this study, with a 7.66% incidence of postoperative acute kidney injury. The incidence of postoperative acute kidney injury was lower in the dexmedetomidine-administered group than in the control group (4.12% vs. 8.06%, p < 0.001). In the multivariable stepwise logistic regression analysis, perioperative dexmedetomidine administration significantly reduced the risk of postoperative acute kidney injury after adjusting for interference factors [odds ratio (OR) = 0.56, 95% confidence interval (CI): 0.36–0.87, p = 0.010]. In addition, sensitivity analysis in four subgroups indicated parallel findings: i) eGRF <90 mL/min·1.73/m2 subgroup (OR = 0.40, 95% CI: 0.19–0.84, p = 0.016), ii) intraoperative blood loss <1000 mL subgroup (OR = 0.58, 95% CI: 0.36–0.94, p = 0.025), iii) non-diabetes subgroup (OR = 0.51, 95% CI: 0.29–0.89, p = 0.018), and iv) older subgroup (OR = 0.55, 95% CI: 0.32–0.93, p = 0.027).

Conclusion: In conclusion, our study suggests that perioperative dexmedetomidine administration is associated with lower risk and less severity of postoperative acute kidney injury in hypertensive individuals undergoing non-cardiac surgery. Therefore, future large-scale RCT studies are necessary to validate this benefit.
Microfluidic/HPLC combination to study carnosine protective activity on challenged human microglia: Focus on oxidative stress and energy metabolism
Authors: Privitera Anna , Cardaci Vincenzo , Weerasekara Dhanushka , Saab Miriam Wissam , Diolosà Lidia , Fidilio Annamaria , Jolivet Renaud Blaise , Lazzarino Giuseppe , Amorini Angela Maria , Camarda Massimo , Lunte Susan Marie , Caraci Filippo , Caruso Giuseppe
Published: March 2023

Carnosine (β-alanyl-L-histidine) is a naturally occurring endogenous peptide widely distributed in excitable tissues such as the brain. This dipeptide possesses well-demonstrated antioxidant, anti-inflammatory, and anti-aggregation properties, and it may be useful for treatment of pathologies characterized by oxidative stress and energy unbalance such as depression and Alzheimer’s disease (AD). Microglia, the brain-resident macrophages, are involved in different physiological brain activities such synaptic plasticity and neurogenesis, but their dysregulation has been linked to the pathogenesis of numerous diseases. In AD brain, the activation of microglia towards a pro-oxidant and pro-inflammatory phenotype has found in an early phase of cognitive decline, reason why new pharmacological targets related to microglia activation are of great importance to develop innovative therapeutic strategies. In particular, microglia represent a common model of lipopolysaccharides (LPS)-induced activation to identify novel pharmacological targets for depression and AD and numerous studies have linked the impairment of energy metabolism, including ATP dyshomeostasis, to the onset of depressive episodes. In the present study, we first investigated the toxic potential of LPS + ATP in the absence or presence of carnosine. Our studies were carried out on human microglia (HMC3 cell line) in which LPS + ATP combination has shown the ability to promote cell death, oxidative stress, and inflammation. Additionally, to shed more light on the molecular mechanisms underlying the protective effect of carnosine, its ability to modulate reactive oxygen species production and the variation of parameters representative of cellular energy metabolism was evaluated by microchip electrophoresis coupled to laser-induced fluorescence and high performance liquid chromatography, respectively. In our experimental conditions, carnosine prevented LPS + ATP-induced cell death and oxidative stress, also completely restoring basal energy metabolism in human HMC3 microglia. Our results suggest a therapeutic potential of carnosine as a new pharmacological tool in the context of multifactorial disorders characterize by neuroinflammatory phenomena including depression and AD.
Developing a real-time detection tool and an early warning score using a continuous wearable multi-parameter monitor
Authors: Eisenkraft Arik , Goldstein Nir , Merin Roei , Fons Meir , Ishay Arik Ben , Nachman Dean , Gepner Yftach
Published: March 2023

Background: Currently-used tools for early recognition of clinical deterioration have high sensitivity, but with low specificity and are based on infrequent measurements. We aimed to develop a pre-symptomatic and real-time detection and warning tool for potential patients’ deterioration based on multi-parameter real-time warning score (MPRT-WS).

Methods: A total of more than 2 million measurements were collected, pooled, and analyzed from 521 participants, of which 361 were patients in general wards defined at high-risk for deterioration and 160 were healthy participants allocation as controls. The risk score stratification was based on cutoffs of multiple physiological parameters predefined by a panel of specialists, and included heart rate, blood oxygen saturation (SpO2), respiratory rate, cuffless systolic and diastolic blood pressure (SBP and DBP), body temperature, stroke volume (SV), cardiac output, and systemic vascular resistance (SVR), recorded every 5 min for a period of up to 72 h. The data was used to define the various risk levels of a real-time detection and warning tool, comparing it with the clinically-used National Early Warning Score (NEWS).

Results: When comparing risk levels among patients using both tools, 92.6%, 6.1%, and 1.3% of the readings were defined as “Low”, “Medium”, and “High” risk with NEWS, and 92.9%, 6.4%, and 0.7%, respectively, with MPRT-WS (p = 0.863 between tools). Among the 39 patients that deteriorated, 30 patients received ‘High’ or ‘Urgent’ using the MPRT-WS (42.7 ± 49.1 h before they deteriorated), and only 6 received ‘High’ score using the NEWS. The main abnormal vitals for the MPRT-WS were SpO2, SBP, and SV for the “Urgent” risk level, DBP, SVR, and SBP for the “High” risk level, and DBP, SpO2, and SVR for the “Medium” risk level.

Conclusion: As the new detection and warning tool is based on highly-frequent monitoring capabilities, it provides medical teams with timely alerts of pre-symptomatic and real-time deterioration.
Vitamin D and chronic kidney disease: Insights on lipid metabolism of tubular epithelial cell and macrophages in tubulointerstitial fibrosis
Authors: Gonçalves Luís Eduardo D. , Andrade-Silva Magaiver , Basso Paulo José , Câmara Niels O. S.
Published: March 2023

Chronic kidney disease (CKD) has been recognized as a significant global health problem due to being an important contributor to morbidity and mortality. Inflammation is the critical event that leads to CKD development orchestrated by a complex interaction between renal parenchyma and immune cells. Particularly, the crosstalk between tubular epithelial cells (TECs) and macrophages is an example of the critical cell communication in the kidney that drives kidney fibrosis, a pathological feature in CKD. Metabolism dysregulation of TECs and macrophages can be a bridge that connects inflammation and fibrogenesis. Currently, some evidence has reported how cellular lipid disturbances can affect kidney disease and cause tubulointerstitial fibrosis highlighting the importance of investigating potential molecules that can restore metabolic parameters. Vitamin D (VitD) is a hormone naturally produced by mammalian cells in a coordinated manner by the skin, liver, and kidneys. VitD deficiency or insufficiency is prevalent in patients with CKD, and serum levels of VitD are inversely correlated with the degree of kidney inflammation and renal function. Proximal TECs and macrophages produce the active form of VitD, and both express the VitD receptor (VDR) that evidence the importance of this nutrient in regulating their functions. However, whether VitD signaling drives physiological and metabolism improvement of TECs and macrophages during kidney injury is an open issue to be debated. In this review, we brought to light VitD as an important metabolic modulator of lipid metabolism in TECs and macrophages. New scientific approaches targeting VitD e VDR signaling at the cellular metabolic level can provide a better comprehension of its role in renal physiology and CKD progression.
Machine learning and reduced order modelling for the simulation of braided stent deployment
Authors: Bisighini Beatrice , Aguirre Miquel , Biancolini Marco Evangelos , Trovalusci Federica , Perrin David , Avril Stéphane , Pierrat Baptiste
Published: March 2023

Endoluminal reconstruction using flow diverters represents a novel paradigm for the minimally invasive treatment of intracranial aneurysms. The configuration assumed by these very dense braided stents once deployed within the parent vessel is not easily predictable and medical volumetric images alone may be insufficient to plan the treatment satisfactorily. Therefore, here we propose a fast and accurate machine learning and reduced order modelling framework, based on finite element simulations, to assist practitioners in the planning and interventional stages. It consists of a first classification step to determine a priori whether a simulation will be successful (good conformity between stent and vessel) or not from a clinical perspective, followed by a regression step that provides an approximated solution of the deployed stent configuration. The latter is achieved using a non-intrusive reduced order modelling scheme that combines the proper orthogonal decomposition algorithm and Gaussian process regression. The workflow was validated on an idealized intracranial artery with a saccular aneurysm and the effect of six geometrical and surgical parameters on the outcome of stent deployment was studied. We trained six machine learning models on a dataset of varying size and obtained classifiers with up to 95% accuracy in predicting the deployment outcome. The support vector machine model outperformed the others when considering a small dataset of 50 training cases, with an accuracy of 93% and a specificity of 97%. On the other hand, real-time predictions of the stent deployed configuration were achieved with an average validation error between predicted and high-fidelity results never greater than the spatial resolution of 3D rotational angiography, the imaging technique with the best spatial resolution (0.15 mm). Such accurate predictions can be reached even with a small database of 47 simulations: by increasing the training simulations to 147, the average prediction error is reduced to 0.07 mm. These results are promising as they demonstrate the ability of these techniques to achieve simulations within a few milliseconds while retaining the mechanical realism and predictability of the stent deployed configuration.
Neuronal primary cilia integrate peripheral signals with metabolic drives
Authors: DeMars Kelly M. , Ross Madeleine R. , Starr Alana , McIntyre Jeremy C.
Published: March 2023

Neuronal primary cilia have recently emerged as important contributors to the central regulation of energy homeostasis. As non-motile, microtubule-based organelles, primary cilia serve as signaling antennae for metabolic status. The impairment of ciliary structure or function can produce ciliopathies for which obesity is a hallmark phenotype and global ablation of cilia induces non-syndromic adiposity in mouse models. This organelle is not only a hub for metabolic signaling, but also for catecholamine neuromodulation that shapes neuronal circuitry in response to sensory input. The objective of this review is to highlight current research investigating the mechanisms of primary cilium-regulated metabolic drives for maintaining energy homeostasis.
Melatonin suppresses sympathetic vasomotor tone through enhancing GABAA receptor activity in the hypothalamus
Authors: Yu Qiyao , Guo Qi , Jin Sheng , Gao Chao , Zheng Peiru , Li De-Pei , Wu Yuming
Published: March 2023

Introduction: Melatonin (5-methoxy-N-acetyl-tryptamine) is a circadian hormone synthesized and secreted by the pineal gland. In addition to regulating circadian rhythms of many physiological functions, melatonin is involved in regulating autonomic nervous function and blood pressure. Hypothalamus paraventricular nucleus (PVN), receiving melatonin projections from the superchiasmatic nucleus, is a critical brain region to regulate neuroendocrine and cardiovascular function. Here, we determined the synaptic mechanisms involved in the effect of melatonin on the sympathetic outflow and blood pressure.

Methods and Results: Microinjection of melatonin into the PVN produced a depressor effect and decreased renal sympathetic nerve activity (RSNA). While microinjection of luzindole, a non-selective melatonin receptor antagonist, into the PVN did not change melatonin-induced sympathoinhibition, GABAA receptor antagonist bicuculline eliminated melatonin-induced sympathoinhibition. Furthermore, melatonin decreased firing rate of retrogradely labeled PVN neurons which project to the rostral ventrolateral medulla (RVLM), an effect was not altered by luzindole but eliminated by bicuculline. Melatonin significantly increased the amplitude of spontaneous and evoked GABAergic inhibitory synaptic currents, as well as GABA-induced currents.

Conclusion: These data suggest that melatonin in the PVN suppresses sympathetic vasomotor tone through enhancing GABAA receptor activity. This study provides novel information for understanding the cellular mechanisms involved in the effect of melatonin on regulating blood pressure and sympathetic output.
Selected indigenous drought tolerant rhizobium strains as promising biostimulants for common bean in Northern Spain
Authors: del-Canto Arantza , Sanz-Saez Álvaro , Sillero-Martínez Anna , Mintegi Eider , Lacuesta Maite
Published: March 2023

Drought is the most detrimental abiotic stress in agriculture, limiting crop growth and yield and, currently, its risk is increasing due to climate change. Thereby, ensuring food security will be one of the greatest challenges of the agriculture in the nearest future, accordingly it is essential to look for sustainable strategies to cope the negative impact of drought on crops. Inoculation of pulses with biostimulants such as rhizobium strains with high nitrogen fixation efficiency and drought-tolerance, has emerged as a promising and sustainable production strategy. However, some commercial inoculums are not effective under field conditions due to its lower effectiveness against indigenous rhizobium strains in the establishment of the symbiosis. Thus, in the present study, we evaluated the ability to improve drought tolerance in common bean plants of different indigenous rhizobia strains isolated from nearby crop fields in the Basque Country either affected by drought or salinity. The plants in this trial were grown in a climatic chamber under controlled conditions and exposed to values of 30% relative soil water content at the time of harvest, which is considered a severe drought. From the nine bacteria strains evaluated, three were found to be highly efficient under drought (namely 353, A12 and A13). These strains sustained high infectiveness (nodulation capacity) and effectiveness (shoot biomass production) under drought, even surpassing the plants inoculated with the CIAT899 reference strain, as well as the chemically N-fertilized plants. The tolerance mechanisms developed by plants inoculated with 353, A12 and A13 strains were a better adjustment of the cell wall elasticity that prevents mechanical damages in the plasma membrane, a higher WUE and an avoidance of the phenological delay caused by drought, developing a greater number of flowers. These results provide the basis for the development of efficient common bean inoculants able to increase the yield of this crop under drought conditions in the Northern Spain and, thus, to be used as biostimulants. In addition, the use of these efficient nitrogen fixation bacteria strains is a sustainable alternative to chemical fertilization, reducing cost and minimizing its negative impact on environment.
Downregulation of Brassica napus MYB69 (BnMYB69) increases biomass growth and disease susceptibility via remodeling phytohormone, chlorophyll, shikimate and lignin levels
Authors: Lin Na , Wang Mu , Jiang Jiayi , Zhou Qinyuan , Yin Jiaming , Li Jiana , Lian Jianping , Xue Yufei , Chai Yourong
Published: March 2023

MYB transcription factors are major actors regulating plant development and adaptability. Brassica napus is a staple oil crop and is hampered by lodging and diseases. Here, four B. napus MYB69 (BnMYB69s) genes were cloned and functionally characterized. They were dominantly expressed in stems during lignification. BnMYB69 RNA interference (BnMYB69i) plants showed considerable changes in morphology, anatomy, metabolism and gene expression. Stem diameter, leaves, roots and total biomass were distinctly larger, but plant height was significantly reduced. Contents of lignin, cellulose and protopectin in stems were significantly reduced, accompanied with decrease in bending resistance and Sclerotinia sclerotiorum resistance. Anatomical detection observed perturbation in vascular and fiber differentiation in stems, but promotion in parenchyma growth, accompanied with changes in cell size and cell number. In shoots, contents of IAA, shikimates and proanthocyanidin were reduced, while contents of ABA, BL and leaf chlorophyll were increased. qRT-PCR revealed changes in multiple pathways of primary and secondary metabolisms. IAA treatment could recover many phenotypes and metabolisms of BnMYB69i plants. However, roots showed trends opposite to shoots in most cases, and BnMYB69i phenotypes were light-sensitive. Conclusively, BnMYB69s might be light-regulated positive regulators of shikimates-related metabolisms, and exert profound influences on various internal and external plant traits.
Working alliance in low-intensity internet-based cognitive behavioral therapy for depression in primary care in Spain: A qualitative study
Authors: Barceló-Soler Alberto , García-Campayo Javier , Araya Ricardo , Doukani Asmae , Gili Margalida , García-Palacios Azucena , Mayoral Fermín , Montero-Marin Jesus
Published: March 2023

Introduction

Psychotherapies delivered via the Internet have been promoted as an alternative for improving access to psychological treatments. A conceptual working alliance model of blended (i.e., traditional face-to-face consultation combined with Internet-delivered psychotherapy) cognitive-behavioral therapy (b-CBT) for depression has been developed in the UK. However, little is known about how this important therapeutic process, namely the working alliance (WA), is developed and maintained in Internet-delivered cognitive-behavioral therapy without face-to-face consultation (i-CBT). The aim of this study was to evaluate the validity of the WA model of b-CBT in Spanish patients with depression receiving i-CBT.

Methods

Forty-one patients suffering from mild-moderate depression were interviewed to assess their experiences of an i-CBT program. Interviews were conducted with participants who received a self-guided application (n = 9), and low-intensity support (n = 10). Three group interviews were also conducted with patients who either did not start the program (n = 8) or did not complete it (n = 6), and with patients who did complete it (n = 8).

Results

Qualitative thematic content analysis was performed using the constant comparative method, which revealed four main themes: “bond,” “goals,” “task,” and “usability heuristics,” all consistent with the existing literature. However, a new subcategory emerged, called “anonymity,” which may highlight the social stigma that mental illness still has in the Spanish context.

Conclusion

Results suggest that the development and maintenance of the WA through i-CBT could offer a better experience of the therapeutic process and improve the clinical impact.

Clinical Trial Registration

Clinicaltrials.gov, identifier: NCT01611818.
The assessment of executive functions to test the integrity of the nigrostriatal network: A pilot study
Authors: Ilardi Ciro Rosario , di Maio Girolamo , Villano Ines , Messina Giovanni , Monda Vincenzo , Messina Antonietta , Porro Chiara , Panaro Maria Antonietta , Gamboz Nadia , Iavarone Alessandro , La Marra Marco
Published: March 2023

Background

Parkinson’s disease (PD) is a chronic neurodegenerative disorder characterized by motor and non-motor symptoms. The latter mainly include affective, sleep, and cognitive deficits. Non-demented PD patients often demonstrate impairments in several executive domains following neuropsychological evaluation. The current pilot study aims at assessing the discriminatory power of the Frontal Assessment Battery-15 (FAB15) in differentiating (i) non-demented PD patients and healthy controls and (ii) PD patients with more and less pronounced motor symptoms.

Methods

Thirty-nine non-demented early-stage PD patients in the “on” dopamine state (26 females, mean age = 64.51 years, SD = 6.47, mean disease duration = 5.49 years, SD = 2.28) and 39 healthy participants (24 females, mean age = 62.60 years, SD = 5.51) were included in the study. All participants completed the FAB15. Motor symptoms of PD patients were quantified via the Unified Parkinson’s Disease Rating Scale-Part III (UPDRS-Part III) and Hoehn and Yahr staging scale (H&Y).

Results

The FAB15 score, adjusted according to normative data for sex, age, and education, proved to be sufficiently able to discriminate PD patients from healthy controls (AUC = 0.69 [95% CI 0.60–0.75], SE = 0.06, p = 0.04, optimal cutoff = 11.29). Conversely, the battery lacked sufficient discriminative capability to differentiate PD patients based on the severity of motor symptoms.

Conclusion

The FAB15 may be a valid tool for distinguishing PD patients from healthy controls. However, it might be less sensitive in identifying clinical phenotypes characterized by visuospatial impairments resulting from posteroparietal and/or temporal dysfunctions. In line with previous evidence, the battery demonstrated to be not expendable in the clinical practice for monitoring the severity of PD-related motor symptoms.
Structuring the situation: Organizational goals trigger and direct decision-making
Authors: Greve Henrich R.
Published: March 2023

Organizational goals are assigned to individuals, and thus differ from goals that individuals voluntarily adopt. The Carnegie School has a significant research stream on how organizations are affected by goals, with a focus on how disappointing performance disrupts regular organizational behavior and triggers a search for alternative actions. We have a good understanding of the organization-level process of setting aspiration levels, triggering search for alternatives, and making decisions, but the individual-level mechanisms contributing to it are less well known. An assessment of the progress of Carnegie School research so far reveals a list of research questions that should be resolved in order to understand how individual updating of aspiration levels, triggering of search, directing of search, and decision-making help explain organizational responses to goals. The role of construal, or interpretation, in guiding these processes is a central theoretical mechanism that needs further investigation.
Introduction of the generic sense of ability to adapt scale and validation in a sample of outpatient adults with mental health problems
Authors: Franken Katinka , Schuffelen Pauline , ten Klooster Peter , van Doesum Karin , Westerhof Gerben , Bohlmeijer Ernst
Published: March 2023

Introduction

The ability to adapt is a core aspect of daily human life. Recent models and theories emphasize its essential role for health and well-being. It concerns the perceived ability to readjust and actively deal with the psychosocial consequences of challenging events. While many questionnaires measure competences related to adaptability to specific conditions, a scale that measures a generic sense of the ability to adapt is lacking. The aim of the present study is to introduce the Generic Sense of Ability to Adapt Scale (GSAAS) and to examine its psychometric properties.

Methods

The article describes two sub-studies. In the first study the items of the GSAAS were generated and field-tested in a cross-sectional non-clinical sample using item analysis, exploratory factor analysis and Rasch analysis.

Results

This resulted in a 10-item questionnaire measuring a single dimension with good reliability (Cronbach’s α = 0.87). In the second study the 10-item scale was validated using a cross-sectional sample of 496 outpatient adults with mental health problems. Confirmatory factor analysis confirmed the unidimensional structure of the GSAAS and the absence of measurement variance across gender, age and education. Reliability was high (α = 0.89) and moderate to strong correlations between the GSAAS and concurrent validation measures confirmed its convergent validity. Regarding incremental validity, the GSAAS accounted for 7.4% additional explained variance in symptomatic distress above and beyond sense of coherence.

Discussion

In conclusion, the GSAAS appears to be a reliable and valid instrument to assess people’s generic sense of the ability to adapt. It is a practical and quick tool that can be used to measure a vital aspect of health in research and clinical treatment settings.
Characteristics and outcomes of peer consultations for assisted dying request assessments: Cross-sectional survey study among attending physicians
Authors: Vissers Stijn , Dierickx Sigrid , Deliens Luc , Mortier Freddy , Cohen Joachim , Chambaere Kenneth
Published: March 2023

Background

In most jurisdictions where assisted dying practices are legal, attending physicians must consult another practitioner to assess the patient's eligibility. Consequently, in some jurisdictions, they can rely on the expertise of trained assisted dying consultants (trained consultants). However, these peer consultations remain under-researched. We examined the characteristics and outcomes of peer consultations to assess an assisted dying request with trained consultants, and explored how these characteristics influence the performance of assisted dying.

Methods

We conducted a cross-sectional survey in 2019–2020 in Belgium among attending physicians who had consulted a trained consultant for an assisted dying request assessment (N = 904).

Results

The valid response rate was 56% (502/903). The vast majority of attending physicians (92%) who had consulted a trained consultant were general practitioners. In more than half of the consultations (57%), the patient was diagnosed with cancer. In 66%, the patient was aged 70 or older. Reported as the patients' most important reasons to request assisted dying: suffering without prospect of improving in 49% of the consultations, loss of dignity in 11%, pain in 9%, and tiredness of life in 9%. In the vast majority of consultations (85%), the attending physician consulted the trained consultant because of the expertise, and in nearly half of the consultations (46%) because of the independence. In more than nine out of ten consultations (91%), the consultant gave a positive advice: i.e., substantive requirements for assisted dying were met. Eight out of ten consultations were followed by assisted dying. The likelihood of assisted dying was higher in consultations in which loss of dignity, loss of independence in daily living, or general weakness or tiredness were reasons for the request.

Conclusion

Our findings indicate that the peer consultation practice with trained consultants is most often embedded in a primary care setting. Moreover, our study corroborates previous research in that assisted dying is performed relatively less frequently in patients with cancer and more often in patients with general deterioration. Our findings suggest that attending physicians hold peer consultations with trained consultants to endorse their own decision-making and to request additional support.
Prediction of in-hospital death following acute type A aortic dissection
Authors: Chen Junquan , Bai Yunpeng , Liu Hong , Qin Mingzhen , Guo Zhigang
Published: March 2023

Background

Our goal was to create a prediction model for in-hospital death in Chinese patients with acute type A aortic dissection (ATAAD).

Methods

A retrospective derivation cohort was made up of 340 patients with ATAAD from Tianjin, and the retrospective validation cohort was made up of 153 patients with ATAAD from Nanjing. For variable selection, we used least absolute shrinkage and selection operator analysis, and for risk scoring, we used logistic regression coefficients. We categorized the patients into low-, middle-, and high-risk groups and looked into the correlation with in-hospital fatalities. We established a risk classifier based on independent baseline data using a multivariable logistic model. The prediction performance was determined based on the receiver operating characteristic curve (ROC). Individualized clinical decision-making was conducted by weighing the net benefit in each patient by decision curve analysis (DCA).

Results

We created a risk prediction model using risk scores weighted by five preoperatively chosen variables [AUC: 0.7039 (95% CI, 0.643–0.765)]: serum creatinine (Scr), D-dimer, white blood cell (WBC) count, coronary heart disease (CHD), and blood urea nitrogen (BUN). Following that, we categorized the cohort's patients as low-, intermediate-, and high-risk groups. The intermediate- and high-risk groups significantly increased hospital death rates compared to the low-risk group [adjusted OR: 3.973 (95% CI, 1.496–10.552), P < 0.01; 8.280 (95% CI, 3.054–22.448), P < 0.01, respectively). The risk score classifier exhibited better prediction ability than the triple-risk categories classifier [AUC: 0.7039 (95% CI, 0.6425–0.7652) vs. 0.6605 (95% CI, 0.6013–0.7197); P = 0.0022]. The DCA showed relatively good performance for the model in terms of clinical application if the threshold probability in the clinical decision was more than 10%.

Conclusion

A risk classifier is an effective strategy for predicting in-hospital death in patients with ATAAD, but it might be affected by the small number of participants.
MRET: Multi-resolution transformer for video quality assessment
Authors: Ke Junjie , Zhang Tianhao , Wang Yilin , Milanfar Peyman , Yang Feng
Published: March 2023

No-reference video quality assessment (NR-VQA) for user generated content (UGC) is crucial for understanding and improving visual experience. Unlike video recognition tasks, VQA tasks are sensitive to changes in input resolution. Since large amounts of UGC videos nowadays are 720p or above, the fixed and relatively small input used in conventional NR-VQA methods results in missing high-frequency details for many videos. In this paper, we propose a novel Transformer-based NR-VQA framework that preserves the high-resolution quality information. With the multi-resolution input representation and a novel multi-resolution patch sampling mechanism, our method enables a comprehensive view of both the global video composition and local high-resolution details. The proposed approach can effectively aggregate quality information across different granularities in spatial and temporal dimensions, making the model robust to input resolution variations. Our method achieves state-of-the-art performance on large-scale UGC VQA datasets LSVQ and LSVQ-1080p, and on KoNViD-1k and LIVE-VQC without fine-tuning.
On orbit performance of the solar flare trigger for the Hinode EUV imaging spectrometer
Authors: Brooks David H. , Reep Jeffrey W. , Ugarte-Urra Ignacio , Warren Harry P.
Published: March 2023

We assess the on-orbit performance of the flare event trigger for the Hinode EUV Imaging Spectrometer. Our goal is to understand the time-delay between the occurrence of a flare, as defined by a prompt rise in soft X-ray emission, and the initiation of the response observing study. Wide (266″) slit patrol images in the He II 256.32 Å spectral line are used for flare hunting, and a reponse is triggered when a pre-defined intensity threshold is reached. We use a sample of 13 > M-class flares that succesfully triggered a response, and compare the timings with soft X-ray data from GOES, and hard X-ray data from RHESSI and Fermi. Excluding complex events that are difficult to interpret, the mean on orbit response time for our sample is 2 min 10 s, with an uncertainty of 84 s. These results may be useful for planning autonomous operations for future missions, and give some guidance as to how improvements could be made to capture the important impulsive phase of flares.
RNA sequencing reveals CircRNA expression profiles in chicken embryo fibroblasts infected with velogenic Newcastle disease virus
Authors: Chen Libin , Ruan Jiayu , Chen Yiyi , Deng Wenxuan , Lai Jinyu , Fan Lei , Cai Juncheng , Ding Chan , Lin Qiuyan , Xiang Bin , Ren Tao
Published: March 2023

Introduction

Newcastle disease virus (NDV) is an important avian pathogen prevalent worldwide; it has an extensive host range and seriously harms the poultry industry. Velogenic NDV strains exhibit high pathogenicity and mortality in chickens. Circular RNAs (circRNAs) are among the most abundant and conserved eukaryotic transcripts. They are part of the innate immunity and antiviral response. However, the relationship between circRNAs and NDV infection is unclear.

Methods

In this study, we used circRNA transcriptome sequencing to analyze the differences in circRNA expression profiles post velogenic NDV infection in chicken embryo fibroblasts (CEFs). Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were used to reveal significant enrichment of differentially expressed (DE) circRNAs. The circRNA- miRNA-mRNA interaction networks were further predicted. Moreover, circ-EZH2 was selected to determine its effect on NDV infection in CEFs.

Results

NDV infection altered circRNA expression profiles in CEFs, and 86 significantly DE circRNAs were identified. GO and KEGG enrichment analyses revealed significant enrichment of DE circRNAs for metabolism-related pathways, such as lysine degradation, glutaminergic synapse, and alanine, aspartic-acid, and glutamic-acid metabolism. The circRNA- miRNA-mRNA interaction networks further demonstrated that CEFs might combat NDV infection by regulating metabolism through circRNA-targeted mRNAs and miRNAs. Furthermore, we verified that circ-EZH2 overexpression and knockdown inhibited and promoted NDV replication, respectively, indicating that circRNAs are involved in NDV replication.

Conclusions

These results demonstrate that CEFs exert antiviral responses by forming circRNAs, offering new insights into the mechanisms underlying NDV-host interactions.
Prevalence and Predictors of Combined Body Mass Index and Waist Circumference Among Indian Adults
Authors: Shri Neha , Singh Saurabh , Singh Akancha
Published: March 2023

Objective: To determine the prevalence and predictors of combined BMI-WC disease risk categories among Indian adults.

Methods: The study utilizes data from Longitudinal Ageing Study in India (LASI Wave 1) with an eligible sample of 66, 859 individuals. Bivariate analysis was done to get the proportion of individuals in different BMI-WC risk categories. Multinomial logistic regression was used to identify the predictors of BMI-WC risk categories.

Results: Poor self-rated health, female sex, urban place of residence, higher educational status, increasing MPCE quintile, and cardio-vascular disease increased with increasing BMI-WC disease risk level while increasing age, tobacco consumption, and engagement in physical activities was negatively associated with BMI-WC disease risk.

Conclusion: Elderly persons in India have a considerable higher prevalence of BMI-WC disease risk categories which make them vulnerable to developing several disease. Findings emphasize the need of using combined BMI categories and waist circumference to assess the prevalence of obesity and associated disease risk. Finally, we recommend that intervention programs with an emphasis on urbanites wealthy women and those with a higher BMI-WC risk categories be implemented.
The Systemic Risks and Regulation of BigTech : “Too Big(Tech) to Fail?
Authors: Bódi Roland , Fáykiss Péter , Nyikes Ádám
Published: March 2023

When it comes to systemically important financial institutions, people usually think of banks, insurers or financial holding companies, but large technology firms (socalled BigTech) are increasingly part of this category. This paper examines regulatory approaches with which the systemic importance of BigTech firms in financial services could be addressed. According to the analysis, of the three regulatory frameworks identified in the literature (“restriction”, “segregation”, “inclusion”), when a balanced approach is used, the segregation of financial and non-financial activities seems to be the most promising regulatory solution, as this model works best for taking account of the practical aspects of operation, regulation and supervision.