bluuebunny/crossref_metadata_2025 huggingface dataset:
CapsNet-SSP: multilane capsule network for predicting human saliva-secretory proteins
Authors: Du Wei , Sun Yu , Li Gaoyang , Cao Huansheng , Pang Ran , Li Ying
Published: June 2020

Background

Compared with disease biomarkers in blood and urine, biomarkers in saliva have distinct advantages in clinical tests, as they can be conveniently examined through noninvasive sample collection. Therefore, identifying human saliva-secretory proteins and further detecting protein biomarkers in saliva have significant value in clinical medicine. There are only a few methods for predicting saliva-secretory proteins based on conventional machine learning algorithms, and all are highly dependent on annotated protein features. Unlike conventional machine learning algorithms, deep learning algorithms can automatically learn feature representations from input data and thus hold promise for predicting saliva-secretory proteins.

Results

We present a novel end-to-end deep learning model based on multilane capsule network (CapsNet) with differently sized convolution kernels to identify saliva-secretory proteins only from sequence information. The proposed model CapsNet-SSP outperforms existing methods based on conventional machine learning algorithms. Furthermore, the model performs better than other state-of-the-art deep learning architectures mostly used to analyze biological sequences. In addition, we further validate the effectiveness of CapsNet-SSP by comparison with human saliva-secretory proteins from existing studies and known salivary protein biomarkers of cancer.

Conclusions

The main contributions of this study are as follows: (1) an end-to-end model based on CapsNet is proposed to identify saliva-secretory proteins from the sequence information; (2) the proposed model achieves better performance and outperforms existing models; and (3) the saliva-secretory proteins predicted by our model are statistically significant compared with existing cancer biomarkers in saliva. In addition, a web server of CapsNet-SSP is developed for saliva-secretory protein identification, and it can be accessed at the following URL: http://www.csbg-jlu.info/CapsNet-SSP/. We believe that our model and web server will be useful for biomedical researchers who are interested in finding salivary protein biomarkers, especially when they have identified candidate proteins for analyzing diseased tissues near or distal to salivary glands using transcriptome or proteomics.
Impact of protein supplementation during endurance training on changes in skeletal muscle transcriptome
Authors: Knuiman Pim , Hangelbroek Roland , Boekschoten Mark , Hopman Maria , Mensink Marco
Published: June 2020

Background

Protein supplementation improves physiological adaptations to endurance training, but the impact on adaptive changes in the skeletal muscle transcriptome remains elusive. The present analysis was executed to determine the impact of protein supplementation on changes in the skeletal muscle transcriptome following 5-weeks of endurance training.

Results

Skeletal muscle tissue samples from thevastus lateraliswere taken before and after 5-weeks of endurance training to assess changes in the skeletal muscle transcriptome. One hundred and 63 genes were differentially expressed after 5-weeks of endurance training in both groups(q-value< 0.05). In addition, the number of genes differentially expressed was higher in the protein group (PRO) (892, q-value< 0.05) when compared with the control group (CON) (440, q-value< 0.05), with no time-by-treatment interaction effect (q-value> 0.05). Endurance training primarily affected expression levels of genes related to extracellular matrix and these changes tended to be greater in PRO than in CON.

Conclusions

Protein supplementation subtly impacts endurance training-induced changes in the skeletal muscle transcriptome. In addition, our transcriptomic analysis revealed that the extracellular matrix may be an important factor for skeletal muscle adaptation in response to endurance training. This trial was registered atclinicaltrials.govas NCT03462381, March 12, 2018.

Trial registration

This trial was registered atclinicaltrials.govasNCT03462381.
Gender-specific cardiovascular outcomes in patients undergoing percutaneous coronary intervention in Chinese populations
Authors: Long Juan , Zeng Fanfang , Wang Lili , Yi Chen , Chen Qiying , Zhao Honglei
Published: June 2020

Background

Data was limited on the rates of in-hospital and 30-days composite outcomes between male and female patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI).

Methods

This was a retrospective study and CHD patients undergoing PCI between January and December of 2018 were screened and recruited. Baseline characteristics, in-hospital and 30-days composite outcomes were compared by gender. The factors influencing gender-outcome associations were evaluated.

Results

A total of 672 CHD patients undergoing PCI were included into current analysis. Compared to males, females were older (53.8 ± 12.7 years vs 50.6 ± 11.8 years), more likely to be obese (32.9% vs 29.4%) and had higher prevalence of hypertension (46.7% vs 41%). Females were less likely to be smoker (30.3% vs 1.1%), have prior history of CHD (4.4% vs 10.9%), and lower socioeconomic status [SES; full-time employment (64.4% vs 71.9%), education attainment ≥ college (29.6% vs 36.8%) and annual income ≥60,000 RMB (23.7% vs 27.1%)]. Hospitalized stay was longer in females (median 5.2 vs 4.0 days), and females were more likely to experience in-hospital bleeding (3.0% vs 1.2%) and 30-days non-fatal myocardial infarction (5.9% vs 2.9%). In unadjusted model, compared to males, females had a crude odds ratio (OR) of 2.05 (95% confidence interval [CI] 1.68–2.59) for in-hospital composite outcomes and 2.16 (95% CI 1.74–2.63) for 30-days post-PCI composite outcomes. After adjustment for potential covariates, female gender remains independently associated with in-hospital and 30-days post-PCI composite outcomes. OR change was the greatest with adjustment for SES when compared to other covariates.

Conclusion

Compared to male patients, female patients had a higher risk of in-hospital and 30-days composite outcomes post-PCI treatment, which were mainly attributed to the differences in SES.
Use of peripheral vascular access in the prehospital setting: is there room for improvement?
Authors: Gonvers Erin , Spichiger Thierry , Albrecht Eric , Dami Fabrice
Published: June 2020

Background

Previous studies have shown that prehospital insertion of peripheral vascular access is highly variable. The aim of this study is to establish the proportion of peripheral vascular access placement and its use with regard to both the severity of cases and the main problem suspected by the paramedics involved. Over-triage was considered to have taken place where peripheral vascular access was placed but unused and these cases were specifically analysed in order to evaluate the possibility of improving current practice.

Methods

This is a one-year (2017) retrospective study conducted throughout one State of Switzerland. Data were extracted from the state’s public health service database, collected electronically by paramedics on RescueNet® from Siemens. The following data were collected and analyzed: sex, age, main diagnosis suspected by paramedics and the National Advisory Committee for Aeronautics score (NACA) to classify the severity of cases.

Results

A total of 33,055 missions were included, 29,309 (88.7%) with a low severity. A peripheral vascular access was placed in 8603 (26.0%) cases. Among those, 3948 (45.9%) were unused and 2626 (66.5%) of these patients had a low severity score. Opiates represent 48.3% of all medications given. The most frequent diagnosis among unused peripheral vascular access were: respiratory distress (12.7%), neurological deficit without coma or trauma (9.6%), cardiac condition with thoracic pain and without trauma or loss of consciousness (9.6%) and decreased general condition of the patient (8.5%).

Conclusions

Peripheral vascular access was set in 26% of patients, nearly half of which were unused. To reduce over-triage, special attention should be dedicated to cases defined by EMS on site as low severity, as they do not require placement of a peripheral vascular access as a precautionary measure. Alternative routes, such as the intra-nasal route, should be promoted, particularly for analgesia, whose efficiency is well documented. Emergency medical services medical directors may also consider modifying protocols of acute clinical situations when data show that mandatory peripheral vascular access, in stroke cases for example, is almost never used.
Sarcopenic obesity and associations with mortality in older women and men – a prospective observational study
Authors: von Berens Å. , Obling S. R. , Nydahl M. , Koochek A. , Lissner L. , Skoog I. , Frändin K. , Skoglund E. , Rothenberg E. , Cederholm T.
Published: June 2020

Background

The combined effect of sarcopenia and obesity, i.e., sarcopenic obesity, has been associated with disability and worse outcomes in older adults, but results are conflicting. The objectives of this study were to describe the prevalence of sarcopenic obesity (SO) in older adults, and to examine how the risk of mortality is associated with SO and its various components.

Methods

Data were obtained from two Swedish population studies, the Gothenburg H70 Birth Cohort Studies of 521 women and men at the age of 75, and the Uppsala Longitudinal Study of Adult Men (ULSAM), which included 288 men aged 87 years. Sarcopenia was defined using the recently updated EWGSOP2 definition. Obesity was defined by any of three established definitions: body mass index ≥30 kg/m2, fat mass > 30%/ > 42% or waist circumference ≥ 88 cm/≥102 cm for women and men, respectively. The Kaplan-Meier survival curve and the Cox proportional hazard model were used for 10-year and 4-year survival analyses in the H70 and ULSAM cohorts, respectively.

Results

SO was observed in 4% of the women and 11% of the men in the H70 cohort, and in 10% of the ULSAM male cohort. The 75-year-old women with SO had a higher risk (HR 3.25, 95% confidence interval (1.2–8.9)) of dying within 10 years compared to those with a “normal” phenotype. A potential similar association with mortality among the 75-year-old men was not statistically significant. In the older men aged 87 years, obesity was associated with increased survival.

Conclusions

SO was observed in 4–11% of community-dwelling older adults. In 75-year-old women SO appeared to associate with an increased risk of dying within 10 years. In 87-year-old men, the results indicated that obesity without sarcopenia was related to a survival benefit over a four-year period.
Low serum albumin, aspartate aminotransferase, and body mass are risk factors for frailty in elderly people with diabetes–a cross-sectional study
Authors: Yanagita Ikumi , Fujihara Yuya , Iwaya Chikayo , Kitajima Yuichi , Tajima Misuzu , Honda Masanao , Teruya Yuji , Asakawa Hideko , Ito Tomoko , Eda Terumi , Yamaguchi Noriko , Kayashima Yumi , Yoshimoto Mihoko , Harada Mayumi , Yoshimoto Shoji , Aida Eiji , Yanase Toshihiko , Nawata Hajime , Muta Kazuo
Published: June 2020

Background

Frailty is broadly characterized by vulnerability and decline in physical, mental and social activities and is more common in elderly patients with type 2 diabetes mellitus (T2DM). Frailty is closely associated with nutrition, muscle strength, inflammation, and hormones etc. In hormones, dehydroepiandrosterone sulfate (DHEA-S) and cortisol are suggested to be such candidates affecting frailty. Little investigation has been performed using a wider range of measures of frailty to clarify risk factors for frailty including the above two hormones.

Methods

We performed a cross-sectional study to investigate the risk factors for frailty in elderly T2DM patients (n = 148; ≥65 years), using a broad assessment, the clinical frailty scale. We compared parameters between the non-frail and frail groups using the unpaired t and Mann-Whitney U tests. The Jonckheere-Therpstra test was used to identify relationships with the severity of frailty, and risk factors were identified using binary regression analysis.

Results

Simple regression analysis identified a number of significant risk factors for frailty, including DHEAS < 70 μg/dL and cortisol/DHEA-S ratio ≥ 0.2. Multiple regression analysis showed that low albumin (< 4.0 g/dl) (odds ratio [OR] = 5.79, p < 0.001), low aspartate aminotransferase (AST) activity (< 25 IU/L) (OR = 4.34, p = 0.009), and low body mass (BM) (< 53 kg) (OR = 3.85, p = 0.012) were independent risk factors for frailty. A significant decrease in DHEA-S and a significant increase in the cortisol/DHEA-S ratio occurred alongside increases in the severity of frailty. DHEA-S concentration positively correlated with both serum albumin and BM.

Conclusions

Hypoalbuminemia, low AST, and low BM are independent risk factors for frailty in elderly T2DM patients, strongly implying relative malnutrition in these frail patients. DHEA-S may be important for the maintenance of liver function and BM. A decrease in DHEA-S and an increase in the cortisol/DHEAS ratio may be involved in the mechanism of the effect of malnutrition in elderly T2DM patients.
Characterization of clinical enterococci isolates, focusing on the vancomycin-resistant enterococci in a tertiary hospital in China: based on the data from 2013 to 2018
Authors: Zhou Wanqing , Zhou Hui , Sun Yuhan , Gao Shuo , Zhang Yan , Cao Xiaoli , Zhang Zhifeng , Shen Han , Zhang Chunni
Published: June 2020

Background

Vancomycin-resistant Enterococcus spp. (VRE) have spread all over the world. The present study aims to investigate the species distribution, specimen type and susceptibilities of Enterococcal species collected from Nanjing Drum Tower Hospital from 2013 to 2018. Additionally, distribution of VRE and prevalence of van gene among VRE isolates were also analyzed.

Methods

The susceptibilities of 3913 Enterococcus isolates were retrospectively investigated. Among these strains, 60 VRE strains were further anazlyed in this study. The minimum inhibitory concentrations (MICs) of the VRE strains towards vancomycin, teicoplanin and linezolid were determined by E-test. Polymerase chain reaction (PCR) and DNA sequencing were used to investigate the prevalence of van genes among VRE. Furthermore, the sequence types (STs) of VRE strains were explored by multi-locus sequence typing (MLST).

Results

Among the 3913 enterococci isolates, Enterococcus faecalis (n = 1870, 47.8%) and Enterococcus faecium (1738, 44.4%) were the main isolates. These Enterococcus strains were mainly isolated from urine (n = 1673, 42.8%), followed by secretions (n = 583, 14.9%) and ascites (n = 554, 14.2%). VRE displayed a decreasing trend year by year. Molecular analysis revealed that 49 out of 60 VRE isolates carried vanA gene, 10 carried vanM, and 1 carried both vanA and vanM genes. Sixteen distinct STs were identified among the 58 VREM, with ST78 (n = 16), ST192 (n = 8) and ST570 (n = 7) being the most dominant ones.

Conclusions

E. faecalis and E. faecium were the major enterococci strains which are the main pathogens of urinary traction infections; vanA and vanM were the main determinants conferring resistance to vancomycin; ST78, ST192 and ST570 were the leading STs of VREM which displayed a decreasing trend of prevalence year by year.
A novel pathogenic variant in the LRTOMT gene causes autosomal recessive non-syndromic hearing loss in an Iranian family
Authors: Sarmadi Akram , Nasrniya Samane , Soleimani Farsani Maryam , Narrei Sina , Nouri Zahra , Sepehrnejad Mahsa , Nilforoush Mohammad Hussein , Abtahi Hamidreza , Tabatabaiefar Mohammad Amin
Published: June 2020

Background

Hearing loss (HL) is the most common sensorineural disorder with high phenotypic and genotypic heterogeneity, which negatively affects life quality. Autosomal recessive non-syndromic hearing loss (ARNSHL) constitutes a major share of HL cases. In the present study, Whole exome sequencing (WES) was applied to investigate the underlying etiology of HL in an Iranian patient with ARNSHL.

Methods

A proband from an Iranian consanguineous family was examined via WES, followingGJB2sequencing. WES was utilized to find possible genetic etiology of the disease. Various Bioinformatics tools were used to assess the pathogenicity of the variants. Co-segregation analysis of the candidate variant was carried out. Interpretation of variants was performed according to the American College of Medical Genetics and Genomics (ACMG) guidelines.

Results

WES results showed a novel frameshift (16 bp deletion) variant (p.Ala170Alafs*20) in theLRTOMTgene. This variant, which resides in exon 6, was found to be co-segregating in the family. It fulfils the criteria set by the ACMG guidelines of being pathogenic.

Conclusion

Here, we report successful application of WES to identify the molecular pathogenesis of ARNSHL, which is a genetically heterogeneous disorder, in a patient with ARNSHL.
Enhancing patient mobility following cesarean-delivery – the efficacy of an improved postpartum protocol assessed with pedometers
Authors: Ganer Herman Hadas , Ben Zvi Masha , Tairy Daniel , Kleiner Ilia , Gonen Noa , Kuper Sason Limor , Bar Jacob , Kovo Michal
Published: June 2020

Background

The incidence of thromboembolic complications is highest in the immediate postpartum period, especially following caesarean delivery (CD). Ambulation following CD is important in their prevention. We examined the effect of an educational protocol on patients’ mobility following CD, with the use of digital step counters (pedometers).

Methods

Starting February 2018, we implemented an educational protocol at the maternity ward, which included nurses’ tutoring and subsequent patients’ education, regarding the importance of early ambulation. Following CD, ambulation was initiated 4 h following surgery (as compared to 6 h prior). Scheduled IV acetaminophen was administered at six-hour intervals for 48 h (as compared to only 24 h prior), while additional analgesics were given upon patient request. We compared maternal demographics, delivery and postpartum course between the pre-protocol group (n = 101) and the post-protocol group (n = 100). All patients were asked to wear pedometers for 48 h following the delivery to assess ambulation.

Results

Patients’ demographics, surgical and post-partum course were non-significant between the groups, except for surgical length (48.5 ± 14.6 vs. 53.5 ± 15.3 min in the pre and post protocol groups, respectively, p = 0.02). The pre-protocol group was treated with more additional analgesics (p = 0.02). A higher number of steps was taken in the post-protocol group as compared to the pre-protocol group (4394 ± 2985 vs.3551 ± 2931, respectively p = 0.04). In a linear regression analysis in which the number of steps served as the dependent variable, this educational protocol was independently associated with a higher number of steps [coefficient 988 steps, 95% CI 137–1838, p = 0.02], as was smoking, after adjustment for surgical length, emergent surgery, maternal age and body mass index.

Conclusion

An educational protocol which included earlier ambulation and regular interval pain control was associated with improved ambulation following CD.
Elective neck dissection versus wait-and-see policy in cT1N0 buccal squamous cell carcinoma
Authors: Fang Qigen , Gao Hua , Gao Qing , Sun Jinlan , Li Peng , Cui Meng , Zhang Enxi , Yin Wenlong , Dong Yuanyuan
Published: June 2020

Background

Our goal was to clarify the comparison between elective neck dissection (END) and the wait-and-see policy in neck management for cT1N0 buccal squamous cell carcinoma (SCC).

Methods

This was a retrospective comparison of 175 prospectively enrolled patients with cT1N0 buccal SCC. The patients were divided into two groups based on the nonrandomized management of the neck: 125 patients received END, and 50 patients were exposed to the wait-and-see policy. The main study endpoints were locoregional control (LRC) and disease-specific survival (DSS). Patients were asked to complete the shoulder domain in the University of Washington quality of life questionnaire, version 4, 1 year postoperatively.

Results

Ten of the patients undergoing END developed recurrence, and the 5-year LRC rate was 92%. Five patients undergoing the wait-and-see policy developed recurrence, and the 5-year LRC rate was 90%. The difference was not significant (p = 0.668). There were 6 deaths in patients undergoing END, and the 5-year DSS rate was 94%. There were 3 deaths in patients undergoing the wait-and-see policy, and the 5-year DSS rate was 94%; the difference was not significant (p = 0.777). The mean shoulder scores of patients undergoing END and the wait-and-see policy were 93.9 and 100, respectively, and the difference was not significant (p = 0.284).

Conclusion

Elective neck dissection does not carry a survival benefit compared to the wait-and-see policy, and it is not suggested for patients with cT1N0 buccal SCC.
Hospitalizations for viral respiratory infections in children under 2 years of age: epidemiology and in-hospital complications
Authors: Zurita-Cruz Jessie N. , Gutierrez-Gonzalez Alejandro , Manuel-Apolinar Leticia , Fernández-Gárate José Esteban , Arellano-Flores María Luisa , Correa Gonzalez Roberto Alejandro , Vázquez-Rosales Guillermo , Sanchez-Armas Rocio , Cisneros-González Nelly
Published: June 2020

Background

Viral respiratory infections (VRIs) are a frequent cause of hospitalization in children under 24 months of age. A history of prematurity or heart disease may be a risk factor for complications in patients hospitalized for VRI. The objective was to describe epidemiological data for children hospitalized for IRV and aged 1 to 24 months and to identify risk factors for the presence of in-hospital complications and mortality over a period of 5 years.

Methods

This was a cross-sectional study. Patients registered with VRI codes B974, J12, J120-J129X, J168, J17, J171, J178, J20, J203-J209, J21, J210, J211, J218, J219 (based on International Classification of Diseases [ICD-10]) from 2013 to 2017 were included. Three subanalyses were performed to compare [1] patients with pathological history (prematurity, bronchopulmonary dysplasia [BPD] and congenital heart disease [CHD]), [2] diagnoses (pneumonia, acute bronchitis, and acute bronchiolitis), and [3] admission to the pediatric intensive care unit. Days of hospital stay, in-hospital complications, invasive medical procedure and mortality were analyzed. Statistical analysis: VRI hospitalization prevalence was described. For comparison between groups, Student’s t-test, ANOVA and the Chi2 test were applied. To identify factors related to days of hospital stay, in-hospital complications and mortality, a linear and logistic regression model was performed.

Results

A total of 66,304 hospitalizations were reported. The average age was 14.7 weeks; hospitalization events were higher in winter (39%), followed by autumn (27.3%). A total of 371 (0.56%) patients died. A total of 7068 (10.6%) hospitalized patients with pathological histories were identified. The presence of BPD (coefficient = 1.6), CHD (coefficient = 1.2), diagnosis of pneumonia (coefficient = 1.2), in-hospital complications (coefficient = 2.1) and invasive medical procedures (coefficient = 15.7) were the most common factors that increased the length of hospital stay. Risk factors for in-hospital complications and mortality were invasive medical procedure (OR = 3.3 & 11.7), BPD (OR = 1.8 & 1.6), CHD (OR = 4.6 & 3.4) and diagnosis of pneumonia (OR = 1.8 & 4.2).

Conclusions

Risk factors for morbidity and mortality in patients hospitalized for VRIs are BPD and CHD, diagnosis of pneumonia and invasive medical procedure.
A 8- year Bangladeshi girl with disseminated histoplasmosis, presented as chronic liver disease with portal hypertension: a rare case report
Authors: Nahar Luthfun , Benzamin Md , Sarkar Naznin , Roy Urmi , Nahar Kamrun , Rukunuzzaman Md , Nahid Khan Lamia , Karim A. S. M. Bazlul , Dey Bishnu Pada
Published: June 2020

Background

Histoplasmosis is a rare infectious condition with mainly pulmonary involvement. Disseminated histoplasmosis may occur in immunocompromised condition. It can present in different ways but jaundice and ascites is very uncommon.

Case presentation

A 8- year old girl visited to department of pediatric gastroenterology & nutrition, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Child presented with fever, jaundice and abdominal distension for 2 ½ months. There was no history of contact with tuberculosis patient and travelling to kala-azar, malaria endemic zone and no history of previous jaundice, blood or blood product transfusion, history of sib death, family history of jaundice or neuropsychiatric disorder, significant weight loss. On general examination she was fretful, febrile, moderately icteric, mildly pale, vitally stable, severely wasted and moderately stunted, skin survey revealed infected scabies, BCG vaccine mark was absent, generalized lymphadenopathy, hepato-splenomegaly and ascites present. After evaluating the physical findings, several investigations was done including lymphnode biopsy, then the case was finally diagnosed as Disseminated histoplasmosis with portal hypertension. Child was treated with injectable Deoxycholate Amphotericin B for 28 days and improved on follow up.

Conclusion

We suggest that children presenting with fever, jaundice, lymphadenopathy and hepatosplenomegaly and portal hypertension, disseminated histoplasmosis can be one differential.
Psychosocial work exposures and suicide ideation: a study of multiple exposures using the French national working conditions survey
Authors: Niedhammer Isabelle , Bèque Maryline , Chastang Jean-François , Bertrais Sandrine
Published: June 2020

Background

Our study aimed to explore the associations between psychosocial work exposures, as well as other occupational exposures, and suicide ideation in the French national working population. An additional objective was to study the cumulative role of occupational exposures in this outcome.

Methods

The study was based on a nationally representative sample of the French working population of 20,430 employees, 8579 men and 11,851 women (2016 French national Working Conditions survey). Occupational exposures included 21 psychosocial work factors, 4 factors related to working time/hours and 4 factors related to the physical work environment. Suicide ideation within the last 12 months was the outcome. The associations between exposures and outcome were studied using weighted logistic regression models adjusted for covariates.

Results

The 12-month prevalence of suicide ideation was 5.2% among men and 5.7% among women. Among the occupational exposures, psychosocial work factors were found to be associated with suicide ideation: quantitative and cognitive demands, low influence and possibilities for development, low meaning at work, low sense of community, role conflict, job insecurity, temporary employment, changes at work, and internal violence. Some rare differences in these associations were observed between genders. Linear associations were observed between the number of psychosocial work exposures and suicide ideation.

Conclusions

Psychosocial work factors were found to play a major role in suicide ideation, and their effects were cumulative on this outcome. More research on multiple and cumulative exposures and suicide ideation and more prevention towards the psychosocial work environment are needed.
Risk factors associated with the detection of pulmonary emphysema in older asymptomatic respiratory subjects
Authors: Buendia-Roldan Ivette , Palma-Lopez Alexia , Chan-Padilla Danaireth , Herrera Iliana , Maldonado Mariel , Fernández Rosario , Martínez-Briseño David , Mejia Mayra , Selman Moises
Published: June 2020

Background

Several lung structural and functional abnormalities may occur associated with aging, including emphysema. In this study, we evaluated the frequency and risk factors associated with emphysema in respiratory asymptomatic individuals enrolled in our Lung Aging Program. From a cohort of 687 subjects, we found by high-resolution computed tomography (HRCT) 29 individuals (4%) with emphysematous changes that were compared with 87 controls (3:1) randomly selected from the same cohort.

Methods

This was a transversal, observational, case-control study where we examined demographics and functional characteristics, as well as telomere length and serum Klotho concentration, two conditions that have been associated with aging and some aging-associated diseases including emphysema.

Results

Individuals with subclinical pulmonary emphysema were older (72 ± 9 versus 67 ± 6 years), and primarily smoker males with low body mass index. Despite that they were asymptomatic, two of them exhibited a decrease of forced expiratory volume in 1 s (FEV1), with a lower FEV1/FVC suggesting airway obstruction. Cigarette smoking (OR = 5.43, CI95% 1.8–16.7), family history of lung disease (OR = 4.32, CI95% 1.0–19.0) and lower body mass index (OR 7.22, CI95% 1.2–3.5) were risk factors for the development of lung emphysematous changes. No association was found with telomere length and Klotho serum concentration.

Conclusion

Our findings reveal that a small but important percentage of older people without respiratory symptoms, present pulmonary emphysema and indicate that smoking exposure and genetic background may contribute to etiological factors.
Risk factors for non-specific neck pain in young adults. A systematic review
Authors: Jahre Henriette , Grotle Margreth , Smedbråten Kaja , Dunn Kate M. , Øiestad Britt Elin
Published: June 2020

Background

Young adulthood is a sensitive period of life where development of musculoskeletal neck pain may be established and impact future health. The objective of this systematic review was to investigate risk factors for non-specific neck pain in young adults.

Methods

Systematic searches were conducted in six databases in September 2019. Prospective cohorts and registry studies including participants in whom the risk factor or the outcome (neck pain) was registered in the ages 18–29 years old were included. The Quality in Prognosis Studies tool was used for quality assessment. A modification of the Grading of Recommendations Assessments, Development and Evaluation was used to assess the overall quality of the evidence. Potential risk factors investigated in more than one study were summarised.

Results

Searches yielded 4527 articles, of which six matched the eligibility criteria. Fifty-six potential risk factors were investigated in the six studies, covering a broad range of domains. Five risk factors were investigated in more than one study (female sex, body mass index (BMI), physical activity, duration of computer use and perceived stress). Physical activity and BMI showed no association with neck pain, and inconsistent results were found for female sex, duration of daily computer use and perceived stress. Risk of bias was moderate or high in all studies, and the overall quality of evidence was very low.

Conclusion

The studies included many potential risk factors, but none of them showed consistent associations with neck pain. There is a paucity of high-quality studies investigating risk factors for neck pain in young adults.
Anatomic healing after non-operative treatment of a large, displaced anterior glenoid rim fracture after primary traumatic anterior shoulder dislocation – a case report
Authors: Ernstbrunner Lukas , Jessen Malik , Wieser Karl
Published: June 2020

Background

Large, displaced anterior glenoid rim fractures after primary traumatic anterior shoulder dislocation are usually managed by surgical stabilization. Although there is little evidence supporting surgical management, it is often preferred over non-operative treatment. This case report describes non-operative management of such large, displaced anterior glenoid rim fracture with CT- and MRI-based documentation of anatomical healing of the fracture fragment, a finding that has not been described previously.

Case presentation

This case report describes a 49-year-old male, right-hand dominant, carpenter, who had a left-sided primary anterior shoulder dislocation after a fall while skiing. Initial plain radiographs showed a reduced glenohumeral joint with a large, displaced anterior glenoid rim fracture. CT-evaluation showed a centered humeral head, and as per our institutional protocol, non-operative management was initiated. Longitudinal radiographic assessment at 2 weeks, 4.5 months and 12 months showed reduction of the initially severely displaced fracture fragment. MRI- and CT-evaluation after 12 months confirmed anatomical healing of the fragment. At final follow-up, the patient was highly satisfied, although the healing process was complicated by posttraumatic frozen shoulder, which has had almost fully resolved after 12 months.

Conclusions

Given that the glenohumeral joint is concentrically reduced, large (displaced) anterior glenoid rim fractures after traumatic primary shoulder dislocation can be successfully treated non-operatively, with the potential of anatomical fracture fragment healing. Therefore, it remains subject to conservative treatment at our institution and surgical stabilization is reserved for patients with a decentered humeral head or persistent glenohumeral instability.
Influence of femoral implant design modification on anterior knee pain and patellar crepitus in patients who underwent total knee arthroplasty without patella resurfacing
Authors: Huang Yi-Fan , Gao Yu-Hang , Ding Lu , Liu Bo , Liu Jian-Guo , Qi Xin
Published: June 2020

Background

The incidence of patient dissatisfaction due to anterior knee pain (AKP) and patellar crepitus after total knee arthroplasty (TKA) remains a concern. However, it has been shown that improvements in the femoral component of traditional prostheses could reduce these instances of pain in the case of TKA performed with patellar resurfacing. This study aims to investigate whether TKA without patellar resurfacing can also benefit from the aforementioned femoral component modification in reducing AKP and patellar crepitus post-TKA.

Methods

Sixty-two patients (85 knees) who underwent TKA using the modern prosthesis and 62 age- and sex-matched patients (90 knees) fitted with the traditional prosthesis were enrolled in this study. The occurrence of AKP and patellar crepitus as well as the Knee Society Score (KSS) were consequently recorded, and the data was analyzed in order to determine whether there was a statistically significant difference between the two groups.

Results

The incidence of AKP was significantly lower in the study group compared with the control group at the 3-month and 1-year follow-ups (4.7% vs. 13.3% [p = 0.048] and 3.5% vs. 13.3% [p = 0.021], respectively). In addition, the incidence of patellar crepitus was also significantly lower in the study group compared with the control group at the 3-month and 1-year follow-ups (15.3% vs. 34.4% [p = 0.004] and 10.6% vs. 28.9% [p = 0.002], respectively). There was no significant difference in the KSS between the two groups.

Conclusions

These results revealed that TKA without patellar resurfacing will indeed benefit from the modified femoral implant design in reducing AKP and patellar crepitus, a finding that may be beneficial to surgeons who select implants for their patients when patellar resurfacing is not planned or not possible due to other reasons.
Physical function and lean body mass as predictors of bone loss after hip fracture: a prospective follow-up study
Authors: Suominen Tuuli H. , Edgren Johanna , Salpakoski Anu , Kallinen Mauri , Cervinka Tomas , Rantalainen Timo , Törmäkangas Timo , Heinonen Ari , Sipilä Sarianna
Published: June 2020

Background

Predictors of bone deterioration after hip fracture have not been well characterized. The aim of this study was to examine the associations of physical function and lean body mass (LBM) with loss of bone density and strength in older people recovering from a hip fracture.

Methods

A total of 81 over 60-year-old, community-dwelling men and women operated for a hip fracture participated in this 1-year prospective follow-up study. Distal tibia total volumetric bone mineral density (vBMDTOT, mg/cm3) and compressive strength index (BSI, g2/cm4) and mid-tibia cortical vBMD (vBMDCO, mg/cm3) and bending strength index (SSI, mm3) were assessed in both legs by peripheral quantitative computed tomography (pQCT) at baseline (on average 10 weeks after fracture) and at 12 months. At baseline, LBM was measured with a bioimpedance device and physical function with the Short Physical Performance Battery (SPPB) and perceived difficulty in walking outdoors. Robust multivariable linear regression models were used to estimate the associations of physical function and LBM with the change in bone parameters at 12-months.

Results

The mean change in distal tibia vBMDTOT and BSI in both legs ranged from − 0.9 to − 2.5%. The change in mid-tibia vBMDCO and SSI ranged from − 0.5 to − 2.1%. A lower SPPB score, difficulty in walking outdoors and lower LBM predicted greater decline in distal tibia vBMDTOT in both legs. A lower SPPB score and difficulty in walking outdoors were also associated with a greater decline in distal tibia BSI in both legs. At the midshaft site, a lower SPPB score and lower LBM were associated with greater decline in SSI on the fractured side.

Conclusions

Older hip fracture patients with low physical function and lower LBM may be at risk for greater decline in tibia bone properties during the first post-fracture year. Acknowledgement of the risk factors could assist in developing interventions and care to promote bone health and overall recovery.

Trial registration

ISRCTN, ISRCTN53680197. The trial was registered retrospectively but before the recruitment was completed. Registered March 3, 2010.
AutoDiscern: rating the quality of online health information with hierarchical encoder attention-based neural networks
Authors: Kinkead Laura , Allam Ahmed , Krauthammer Michael
Published: June 2020

Background

Patients increasingly turn to search engines and online content before, or in place of, talking with a health professional. Low quality health information, which is common on the internet, presents risks to the patient in the form of misinformation and a possibly poorer relationship with their physician. To address this, the DISCERN criteria (developed at University of Oxford) are used to evaluate the quality of online health information. However, patients are unlikely to take the time to apply these criteria to the health websites they visit.

Methods

We built an automated implementation of the DISCERN instrument (Brief version) using machine learning models. We compared the performance of a traditional model (Random Forest) with that of a hierarchical encoder attention-based neural network (HEA) model using two language embeddings, BERT and BioBERT.

Results

The HEA BERT and BioBERT models achieved average F1-macro scores across all criteria of 0.75 and 0.74, respectively, outperforming the Random Forest model (average F1-macro = 0.69). Overall, the neural network based models achieved 81% and 86% average accuracy at 100% and 80% coverage, respectively, compared to 94% manual rating accuracy. The attention mechanism implemented in the HEA architectures not only provided ’model explainability’ by identifying reasonable supporting sentences for the documents fulfilling the Brief DISCERN criteria, but also boosted F1 performance by 0.05 compared to the same architecture without an attention mechanism.

Conclusions

Our research suggests that it is feasible to automate online health information quality assessment, which is an important step towards empowering patients to become informed partners in the healthcare process.
Association between diet quality and food waste in Canadian families: a cross-sectional study
Authors: Carroll Nicholas , Wallace Angela , Jewell Kira , Darlington Gerarda , Ma David W. L. , Duncan Alison M. , Parizeau Kate , von Massow Michael , Haines Jess
Published: June 2020

Background

Higher diet quality has been associated with greater amounts of food waste among adults in the United States. This study aims to build on previous work by examining the association between diet quality and food waste, as assessed using detailed waste audits, among a sample of Canadian families.

Methods

This cross-sectional study used data from 85 Canadian families with young children. Parent and children diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015), calculated from 3-day food records. Household food waste was measured using detailed waste audits conducted over multiple weeks and these data were used to calculate daily per capita food waste. Linear regression was used to explore the association between parent and child HEI-2015 scores and daily per capita total avoidable and unavoidable food waste, as well as daily per capita avoidable and unavoidable food waste in the following categories: 1) fruits and vegetables, 2) milk, cheese and eggs, 3) meat and fish, 4) breads and cereals, 5) fats and sugars.

Results

Parent HEI-2015 scores ranged from 37 to 92 (out of 100) and 81% of parents’ diets scored in the “Needs Improvement (51-80)” category. Parent and child diet quality scores were significantly correlated (r = 0.61; P < 0.0001) and 82% of children’s diets scored in the “Needs Improvement” category. On average, households produced 107 g of avoidable food waste and 52 g of unavoidable food waste per person per day. Fruits and vegetables were the highest contributor for both avoidable and unavoidable food waste. Both parent and child HEI-2015 scores were not significantly associated with total daily per capita avoidable or unavoidable food waste. However, parent HEI-2015 scores were positively associated with daily per capita avoidable fruit and vegetable waste (Unstandardized β = 1.05; 95%CI: 0.11, 1.99; P = 0.03) and daily per capita unavoidable fruit and vegetable waste (Unstandardized β = 0.60; 95%CI: 0.03, 1.17; P = 0.04), after adjusting for household income.

Conclusion

This is the first study to explore the association between diet quality and food waste using detailed waste audits. Future research should explore effective strategies towards improving diet quality while simultaneously reducing food waste, especially of fruits and vegetables.
Bisphenol A shapes children’s brain and behavior: towards an integrated neurotoxicity assessment including human data
Authors: Mustieles Vicente , Fernández Mariana F.
Published: June 2020

Concerns about the effects of bisphenol A (BPA) on human brain and behavior are not novel; however, Grohs and colleagues have contributed groundbreaking data on this topic in a recent issue ofEnvironmental Health. For the first time, associations were reported between prenatal BPA exposure and differences in children’s brain microstructure, which appeared to mediate the association between this exposure and children’s behavioral symptoms. Findings in numerous previous mother-child cohorts have pointed in a similar worrying direction, linking higher BPA exposure during pregnancy to more behavioral problems throughout childhood as assessed by neuropsychological questionnaires. Notwithstanding, this body of work has not been adequately considered in risk assessment. From a toxicological perspective, results are now available from the CLARITY-BPA consortium, designed to reconcile academic and regulatory toxicology findings. In fact, the brain has consistently emerged as one of the most sensitive organs disrupted by BPA, even at doses below those considered safe by regulatory agencies such as the European Food Safety Authority (EFSA). In this Commentary, we contextualize the results of Grohs et al. within the setting of previous epidemiologic and CLARITY-BPA data and express our disquiet about the “all-or-nothing” criterion adopted to select human data in a recent EFSA report on the appraisal methodology for their upcoming BPA risk assessment. We discuss the most relevant human studies, identify emerging patterns, and highlight the need for adequate assessment and interpretation of the increasing epidemiologic literature in this field in order to support decision-making. With the aim of avoiding a myopic or biased selection of a few studies in traditional risk assessment procedures, we propose a future reevaluation of BPA focused on neurotoxicity and based on a systematic and comprehensive integration of available mechanistic, animal, and human data. Taken together, the experimental and epidemiologic evidence converge in the same direction: BPA is a probable developmental neurotoxicant at low doses. Accordingly, the precautionary principle should be followed, progressively implementing stringent preventive policies worldwide, including the banning of BPA in food contact materials and thermal receipts, with a focus on the utilization of safer substitutes.
Filling the gaps: ethnobotanical study of the Garrigues district, an arid zone in Catalonia (NE Iberian Peninsula)
Authors: Gras Airy , Vallès Joan , Garnatje Teresa
Published: June 2020

Background

This study has focused on the Garrigues district, one of the most arid regions in Catalonia (NE Iberian Peninsula), which, in general terms, has remained unexplored from the ethnobotanical point of view. This area, of 22,243 inhabitants, comprises 33 municipalities distributed across 1123.12 km2. The natural vegetation is dominated by holm oak forests and maquis called ‘garriga’, the latter giving its name to the district. During the last few decades, this landscape has been transformed by agricultural activities, nowadays in recession. The main aim of this work was to collect and analyse the ethnoflora of this area in order to fill a gap in the ethnobotanical knowledge in Catalonia.

Methods

The followed methodology was based on semi-structured interviews. The obtained data have been qualitatively and quantitatively analysed and compared with other available ones.

Results

Data were gathered from 68 interviews involving 101 informants, whose ages range from 24 to 94, the mean being 73.07. The number of taxa reported in this study was 420, belonging to 99 botanical families. The interviewed informants referred 4715 use reports (UR) of 346 useful taxa, 1741 (36.93) of them corresponding to medicinal uses, 1705 (36.16%) to food uses, and 1269 (26.91%) to other uses. This study has inventoried, apart from individual plant uses, 260 plant mixtures, of which 98 are medicinal and 162 food. In the present study, 849 vernacular names with 116 phonetic variants have been collected, as well, for 410 taxa. The informant consensus factor (FIC) obtained for our interviewees is 0.93, and the ethnobotanicity index is 23.47% for the studied area. Apart from plants belonging to the typical Catalan, Iberian or European ethnofloras, the present work contributes information on some plants from semiarid or arid regions, such as Artemisia herba-alba and Plantago albicans, much rarer in the ethnobotany of the quoted areas.

Conclusions

The results of this study reveal the persistence of ethnobotanical knowledge in the prospected area and the importance of filling the existing gaps in the ethnofloristic sampling of the Catalan territories. The almost complete dataset, now including some arid territories, will allow us to carry out a global analysis and to provide an accurate overview.