bluuebunny/crossref_metadata_2025 huggingface dataset:
Obesity is associated with postoperative outcomes in patients undergoing cardiac surgery: a cohort study
Authors: Jiang Xiaofeng , Xu Jianbo , Zhen Shuai , Zhu Yanhong
Published: January 2023

Background

The purpose of present study was to determine whether obesity was associated with increased adverse outcomes after cardiac surgery.

Methods

This is a retrospective cohort study from a large international database called the Medical Information Mart for Intensive Care III (MIMIC-III). Patients who underwent cardiac surgery and greater than 18 years old were divided into either nonobese (BMI < 30 kg/m2) or obese (BMI ≥ 30 kg/m2). The primary outcome of this study was 28-day mortality from the date of operation. Secondary outcomes included ICU mortality, 1-year mortality, incidence of postoperative atrial fibrillation (POAF), hospital length of stay (HOS_LOS) and ventilation-free days within 28 days (VFD_28).

Results

Multivariate logistic regression analysis revealed a negative effect of obesity on 28-day mortality, with an adjusted odds ratio (OR) of 1.57 (95% CI 1.14–2.16; p = 0.005). The association remained significant when PSM analysis and double robust analysis with all covariates were performed. In terms of 28-day mortality, the mediating effect of longer ventilation duration on obese patients was noticeable, and the proportion of the effect mediated was 8.2% (95% CI 2.1–25.5%; p = 0.012).

Conclusions

Among patients with cardiac surgery, obesity is associated with higher 28-day mortality. The longer ventilation duration may have mediated this effect. In future, considering the elevated incidence of the obese patients undergoing cardiac surgery, obesity stat should be included as one of the predictive variables for stratification of perioperative death risk.
Uncovering potential diagnostic biomarkers of acute myocardial infarction based on machine learning and analyzing its relationship with immune cells
Authors: Kang Ling , Zhao Qiang , Jiang Ke , Yu Xiaoyan , Chao Hui , Yin Lijuan , Wang Yueqing
Published: January 2023

Background

Acute myocardial infarction (AMI) is a common cardiovascular disease. This study aimed to mine biomarkers associated with AMI to aid in clinical diagnosis and management.

Methods

All mRNA and miRNA data were downloaded from public database. Differentially expressed mRNAs (DEmRNAs) and differentially expressed miRNAs (DEmiRNAs) were identified using the metaMA and limma packages, respectively. Functional analysis of the DEmRNAs was performed. In order to explore the relationship between miRNA and mRNA, we construct miRNA-mRNA negative regulatory network. Potential biomarkers were identified based on machine learning. Subsequently, ROC and immune correlation analysis were performed on the identified key DEmRNA biomarkers.

Results

According to the false discovery rate < 0.05, 92 DEmRNAs and 272 DEmiRNAs were identified. GSEA analysis found that kegg_peroxisome was up-regulated in AMI and kegg_steroid_hormone_biosynthesis was down-regulated in AMI compared to normal controls. 5 key DEmRNA biomarkers were identified based on machine learning, and classification diagnostic models were constructed. The random forests (RF) model has the highest accuracy. This indicates that RF model has high diagnostic value and may contribute to the early diagnosis of AMI. ROC analysis found that the area under curve of 5 key DEmRNA biomarkers were all greater than 0.7. Pearson correlation analysis showed that 5 key DEmRNA biomarkers were correlated with most of the differential infiltrating immune cells.

Conclusion

The identification of new molecular biomarkers provides potential research directions for exploring the molecular mechanism of AMI. Furthermore, it is important to explore new diagnostic genetic biomarkers for the diagnosis and treatment of AMI.
Cognitive behavioural therapy self-help intervention preferences among informal caregivers of adults with chronic kidney disease: an online cross-sectional survey
Authors: Coumoundouros Chelsea , Farrand Paul , Hamilton Alexander , von Essen Louise , Sanderman Robbert , Woodford Joanne
Published: January 2023

Background

Informal caregivers (i.e. family and friends) provide essential support to people with chronic kidney disease (CKD). Many informal caregivers experience mental health problems such as anxiety and depression due to the caregiving role, and commonly have unmet psychological support needs. One potential solution is cognitive behavioural therapy (CBT) self-help interventions that are less reliant on extensive involvement of healthcare professionals, which may increase access. Within the intervention development phase of the MRC framework, the study’s primary objective was to examine informal caregivers’ self-help intervention preferences (e.g. delivery format, content). Secondary objectives were to describe the informal caregiver’s situation (e.g. type of care activities) and mental health (symptoms of depression, anxiety, and stress).

Methods

An online cross-sectional survey conducted in the United Kingdom. Informal caregivers of adults living with CKD were recruited via social media, websites, newsletters, magazine articles, a podcast episode, and paid Facebook advertisements. The survey examined: informal caregiver characteristics; care recipient characteristics; self-help intervention preferences; and informal caregiver’s mental health using the DASS-21. Data were analysed using descriptive statistics.

Results

Sixty-five informal caregivers participated. The majority (85%) were female, caring for a male (77%) spouse/partner (74%). Responses indicated 58% of informal caregivers were experiencing at least mild depression. In total, 48% indicated they were likely to use a CBT self-help intervention, preferring an intervention provided via internet (e.g. website) (64%), workbook (56%), or individually in-person (54%). Regarding content, interventions should cover a wide range of topics including living with CKD, support services, informal caregiver’s physical health, and diet. Overall, 48% reported a preference for a supported intervention, with support delivered in-person or via email by a trained professional at a community organisation.

Conclusions

Results suggest CBT self-help interventions may be an acceptable way to provide psychological support to informal caregivers, however the study is limited by the small sample size. A wide range of intervention preferences were identified indicating a need to tailor intervention content and delivery to enhance acceptability and engagement. Results will inform development of a CBT self-help intervention for informal caregivers of people with CKD.
Identification of discriminative neuroimaging markers for patients on hemodialysis with insomnia: a fractional amplitude of low frequency fluctuation-based machine learning analysis
Authors: Wen Ze-ying , Zhang Yue , Feng Meng-han , Wu Yu-chi , Fu Cheng-wei , Deng Kan , Lin Qi-zhan , Liu Bo
Published: January 2023

Background and objective

Insomnia is one of the common problems encountered in the hemodialysis (HD) population, but the mechanisms remain unclear. we aimed to (1) detect the spontaneous brain activity pattern in HD patients with insomnia (HDWI) by using fractional fractional amplitude of low frequency fluctuation (fALFF) method and (2) further identify brain regions showing altered fALFF as neural markers to discriminate HDWI patients from those on hemodialysis but without insomnia (HDWoI) and healthy controls (HCs).

Method

We compared fALFF differences among HDWI subjects (28), HDWoI subjects (28) and HCs (28), and extracted altered fALFF features for the subsequent discriminative analysis. Then, we constructed a support vector machine (SVM) classifier to identify distinct neuroimaging markers for HDWI.

Results

Compared with HCs, both HDWI and HDWoI patients exhibited significantly decreased fALFF in the bilateral calcarine (CAL), right middle occipital gyrus (MOG), left precentral gyrus (PreCG), bilateral postcentral gyrus (PoCG) and bilateral temporal middle gyrus (TMG), whereas increased fALFF in the bilateral cerebellum and right insula. Conversely, increased fALFF in the bilateral CAL/right MOG and decreased fALFF in the right cerebellum was observed in HDWI patients when compared with HDWoI patients. Moreover, the SVM classification achieved a good performance [accuracy = 82.14%, area under the curve (AUC) = 0.8202], and the consensus brain regions with the highest contributions to classification were located in the right MOG and right cerebellum.

Conclusion

Our result highlights that HDWI patients had abnormal neural activities in the right MOG and right cerebellum, which might be potential neural markers for distinguishing HDWI patients from non-insomniacs, providing further support for the pathological mechanism of HDWI.
‘No one size fits all’ – community trust-building as a strategy to reduce COVID-19-related health disparities
Authors: Rämgård Margareta , Ramji Rathi , Kottorp Anders , Forss Katarina Sjögren
Published: January 2023

Background

Citizens with low levels of social capital and social status, and relative poverty, seem to have been disproportionally exposed to COVID-19 and are at greater risk of experiencing poor health. Notably, the incidence of COVID-19 was nearly three times higher among citizens living in socially vulnerable areas. Experiences from the African Ebola epidemic show that in an environment based on trust, community partners can help to improve understanding of disease control without compromising safety. Such an approach is often driven by the civil society and local lay health promoters. However, little is known about the role of lay health promoters during a pandemic with communicable diseases in the European Union. This study had its point of departure in an already established Community Based Participatory Research health promotion programme in a socially disadvantaged area in southern Sweden. The aim of this study was to explore how citizens and local lay health promoters living in vulnerable neighbourhoods responded to the COVID-19 pandemic a year from the start of the pandemic. 

Method

In-depth interviews with the 5 lay health promoters and focus group discussions with 34 citizens from the neighbourhood who were involved in the activities within the programme were conducted in autumn 2020. The interviews and focus group discussions were transcribed verbatim and analysed using qualitative content analysis following an inductive approach. 

Results

Four themes emerged including, ‘balancing between different kinds of information’, ‘balancing between place-based activities and activities on social media’, ‘bridging between local authorities and the communities and community members’, and ‘balancing ambivalence through participatory dialogues’.

Conclusion

The study highlights that a Community Based Participatory Research programme with lay health promoters as community trust builders had a potential to work with communicable diseases during the pandemic. The lay health promoters played a key role in promoting health during the pandemic by deepening the knowledge and understanding of the role that marginalised citizens have in building resilience and sustainability in their community in preparation for future crises. Public health authorities need to take the local context into consideration within their pandemic strategies to reach out to vulnerable groups.
Impact of easing COVID-19 lockdown restrictions on traumatic injuries in Riyadh, Saudi Arabia: one-year experience at a major trauma centre
Authors: Alharbi Rayan Jafnan , Al-Jafar Rami , Chowdhury Sharfuddin , Rahman Muhammad Aziz , Almuwallad Ateeq , Alshibani Abdullah , Lewis Virginia
Published: January 2023

Introduction

Lockdown restrictions due to the COVID-19 pandemic have reduced the number of injuries recorded. However, little is known about the impact of easing COVID-19 lockdown restrictions on the nature and outcome of injuries. This study aims to compare injury patterns prior to and after the easing of COVID-19 lockdown restrictions in Saudi Arabia.

Method

Data were collected retrospectively from the Saudi TraumA Registry for the period between March 25, 2019, and June 21, 2021. These data corresponded to three periods: March 2019–February 2020 (pre-restrictions, period 1), March 2020–June 2020 (lockdown, period 2), and July 2020–June 2021 (post easing of restrictions, period 3). Data related to patients’ demographics, mechanism and severity of injury, and in-hospital mortality were collected and analysed.

Results

A total of 5,147 traumatic injury patients were included in the analysis (pre-restrictions n = 2593; lockdown n = 218; post easing of lockdown restrictions n = 2336). An increase in trauma cases (by 7.6%) was seen in the 30–44 age group after easing restrictions (n = 648 vs. 762, p < 0.01). Motor vehicle crashes (MVC) were the leading cause of injury, followed by falls in all the three periods. MVC-related injuries decreased by 3.1% (n = 1068 vs. 890, p = 0.03) and pedestrian-related injuries decreased by 2.7% (n = 227 vs. 143, p < 0.01); however, burn injuries increased by 2.2% (n = 134 vs. 174, p < 0.01) and violence-related injuries increased by 0.9% (n = 45 vs. 60, p = 0.05) post easing of lockdown restrictions. We observed an increase in in-hospital mortality during the period of 12 months after easing of lockdown restrictions—4.9% (114/2336) compared to 12 months of pre-lockdown period—4.3% (113/2593).

Conclusion

This is one of the first studies to document trauma trends over a one-year period after easing lockdown restrictions. MVC continues to be the leading cause of injuries despite a slight decrease; overall injury cases rebounded towards pre-lockdown levels in Saudi Arabia. Injury prevention needs robust legislation with respect to road safety measures and law enforcement that can decrease the burden of traumatic injuries.
Increased interaction between endoplasmic reticulum and mitochondria following sleep deprivation
Authors: Aboufares El Alaoui Amina , Buhl Edgar , Galizia Sabrina , Hodge James J. L. , de Vivo Luisa , Bellesi Michele
Published: January 2023

Background

Prolonged cellular activity may overload cell function, leading to high rates of protein synthesis and accumulation of misfolded or unassembled proteins, which cause endoplasmic reticulum (ER) stress and activate the unfolded protein response (UPR) to re-establish normal protein homeostasis. Previous molecular work has demonstrated that sleep deprivation (SD) leads to ER stress in neurons, with a number of ER-specific proteins being upregulated to maintain optimal cellular proteostasis. It is still not clear which cellular processes activated by sleep deprivation lead to ER- stress, but increased cellular metabolism, higher request for protein synthesis, and over production of oxygen radicals have been proposed as potential contributing factors. Here, we investigate the transcriptional and ultrastructural ER and mitochondrial modifications induced by sleep loss.

Results

We used gene expression analysis in mouse forebrains to show that SD was associated with significant transcriptional modifications of genes involved in ER stress but also in ER-mitochondria interaction, calcium homeostasis, and mitochondrial respiratory activity. Using electron microscopy, we also showed that SD was associated with a general increase in the density of ER cisternae in pyramidal neurons of the motor cortex. Moreover, ER cisternae established new contact sites with mitochondria, the so-called mitochondria associated membranes (MAMs), important hubs for molecule shuttling, such as calcium and lipids, and for the modulation of ATP production and redox state. Finally, we demonstrated that Drosophila male mutant flies (elav > linker), in which the number of MAMs had been genetically increased, showed a reduction in the amount and consolidation of sleep without alterations in the homeostatic sleep response to SD.

Conclusions

We provide evidence that sleep loss induces ER stress characterized by increased crosstalk between ER and mitochondria. MAMs formation associated with SD could represent a key phenomenon for the modulation of multiple cellular processes that ensure appropriate responses to increased cell metabolism. In addition, MAMs establishment may play a role in the regulation of sleep under baseline conditions.
Lean or diabetic subtypes predict increased all-cause and disease-specific mortality in metabolic-associated fatty liver disease
Authors: Chung Goh Eun , Yu Su Jong , Yoo Jeong-Ju , Cho Yuri , Lee Kyu-na , Shin Dong Wook , Kim Donghee , Kim Yoon Jun , Yoon Jung-Hwan , Han Kyungdo , Cho Eun Ju
Published: January 2023

Background

Metabolic-associated fatty liver disease (MAFLD) encompasses diverse disease groups with potentially heterogeneous clinical outcomes. We investigated the risk of all-cause and disease-specific mortality in MAFLD subgroups.

Methods

Using the Korean National Health Insurance Service database, participants were divided into four subgroups: no MAFLD, MAFLD-diabetes, MAFLD-overweight/obese, and MAFLD-lean. Hazard ratios (HRs) and 95% confidence interval (CI) values for all-cause and disease-specific mortality according to MAFLD subgroups were analyzed using Cox proportional hazards models.

Results

Among 9,935,314 participants, those with MAFLD-diabetes showed the highest risk of all-cause and disease-specific mortality. The HRs (95% CI) for all-cause mortality were 1.61 (1.59–1.63), 1.36 (1.34–1.38), and 1.19 (1.18–1.20) in the MAFLD-diabetes, MAFLD-lean, and MAFLD-overweight/obese groups, respectively. The magnitude of cardiovascular disease and cancer-related risk showed the same pattern. The risk of liver-related mortality in the MAFLD-lean group (HR: 2.84, 95% CI: 2.72–2.97) was comparable with that in the MAFLD-diabetes group (HR: 2.85, 95% CI: 2.75–2.95). When stratified by body mass index, liver-related mortality was the highest in MAFLD-lean individuals in the underweight group (HR, 5.03, 95% CI: 4.23–5.97).

Conclusions

The MAFLD-lean and MAFLD-diabetes groups had a higher risk of all-cause and disease-specific mortality than did the MAFLD-overweight/obese group. Classifying MAFLD subgroups based on metabolic phenotypes might help risk stratification of patients with MAFLD.
Colonization of Fusobacterium nucleatum is an independent predictor of poor prognosis in gastric cancer patients with venous thromboembolism: a retrospective cohort study
Authors: Liu Chang , Yang Zhou , Tang Xiance , Zhao Fangfang , He Mengke , Liu Changpeng , Zhou Dongmin , Wang Lifeng , Gu Bo , Yuan Yiqiang , Chen Xiaobing
Published: January 2023

Background

Fusobacterium nucleatum (F. nucleatum) often colonizes cancerous gastric tissues and is characterized by the promotion of platelet aggregation and the development of visceral thrombosis. Venous thromboembolism (VTE) leads to a significant increase in the mortality of gastric cancer (GC) patients. However, the relationship between the colonization of F. nucleatum and the prognosis of GC patients is still unknown.

Aim

The aim of this study was to explore whether the colonization of F. nucleatum is related to the prognosis of GC patients complicated with VTE and to explore other potential risk factors.

Methods

From 2017–2021, the data of 304 patients with new VTEs during the treatment of GC at the Affiliated Cancer Hospital of Zhengzhou University were collected. Fluorescence in situ hybridization of F. nucleatum was performed on pathological sections of cancer tissues from the patients. Survival analysis methods, including the Kaplan‒Meier method and Cox proportional hazard model, were performed.

Results

F. nucleatum colonization was significantly associated with splanchnic vein thrombosis, higher platelet-lymphocyte ratio (PLR), and lower absolute lymphocyte count. In the multivariable Cox model, F. nucleatum colonization was found to be an independent risk factor for the prognosis of GC, with an adjusted HR of 1.77 (95% CI, 1.17 to 2.69 [P = 0.007]). In addition, patients with high PLR (HR: 2.65, P = 0.004) or VTE occurring during four cycles of chemotherapy (HR: 2.32, P = 0.012) exhibited shorter survival. Conversely, those experiencing VTE later (HR per month from diagnosis of GC: 0.95, P = 0.006) or using IVC filters (HR: 0.27, P = 0.011) had longer survival.

Conclusion

Colonization of F. nucleatum in GC tissues was associated with lower absolute lymphocyte count and higher PLR in GC patients with VTE. F. nucleatum colonization also appeared to be associated with the development of VTE in specific sites, in particular the splanchnic vein. Colonization of F. nucleatum may potentially represent an independent predictor of poor prognosis in GC patients. Additional research is necessary to validate these findings.
Colchicine treatment can be discontinued in a selected group of pediatric FMF patients
Authors: Cohen Keren , Spielman Shiri , Semo-Oz Rotem , Bitansky Guy , Gerstein Maya , Yacobi Yonatan , Vivante Asaf , Tirosh Irit
Published: January 2023

Objectives

Familial Mediterranean Fever (FMF) patients are required to adhere to a life-long treatment with colchicine, primarily for preventing amyloidosis. As some patients may be asymptomatic for long periods of time, it remains unclear whether it is possible to discontinue colchicine treatment in a selective group of patients. We aimed to identify predictive characteristics for a successful cessation of colchicine therapy.

Methods

Out of 646 FMF pediatric patients followed in our referral FMF clinic, colchicine treatment was discontinued in 51 patients. In this study we compared the genetic, demographic, and clinical characteristics between patients for whom a successful cessation of therapy was made (Group 1; n = 21) and patients for whom cessation of therapy was deemed a failure (Group 2; n = 30) and consequently had to resume colchicine therapy.

Results

Patients for whom a successful cessation of therapy was achieved had no biallelic pathogenic MEFV mutations, were less likely to have “severe attacks” (two or more FMF characteristic symptoms) (24% vs 80%; P = 0.000067) and did not require higher than 1 mg/day of colchicine, prior to the drug cessation. Remission duration under colchicine treatment was significantly higher in group 1 compared with group 2 (4.36 years ±2.12 vs 2.53 years ±2; P = 0.0036).

Conclusion

This study supports the concept of colchicine free remission in a minority of FMF patients (3%). Holding treatment, under close monitoring, may be reasonable when selecting the appropriate patients.
Vascular lipidomics analysis reveales increased levels of phosphocholine and lysophosphocholine in atherosclerotic mice
Authors: Zhang Li , Xiong Liling , Fan Li , Diao Haoyang , Tang Mi , Luo Erdan , Guo Wenmei , Yang Xiao , Xing Shasha
Published: January 2023

Objective

Atherosclerosis (AS) is the major cause of cardiovascular disease, and dyslipidemia is a principal determinant of the initiation and progression of AS. Numerous works have analyzed the lipid signature of blood, but scarce information on the lipidome of vascular tissue is available. This study investigated the lipid profile in the aorta ofApoE−/−mice.

Method

ApoE−/−mice were randomly divided into two groups: (1) the normal diet (ND) group and (2) the high-fat diet (HFD) group. After feeding for 8 weeks, the plasma low-density lipoprotein (LDL), total cholesterol (TC), and triglyceride (TGs) levels were measured. UHPLC-Q Exactive plus MS was used to assess the lipid profile using both positive and negative ionization modes.

Results

LDL and TC levels were significantly increased in HFD mice, and lipid deposition, plaque area and collagen fiber levels were increased in HFD group. In addition, a total of 131 differential lipids were characterized, including 57 lipids with levels that were increased in the HFD group and 74 with levels that were decreased. Further analysis revealed that the levels of several differentially expressed phosphocholines (PCs) and lysophosphocholines (LPCs) were significantly increased. These PCs included PC (38:3), PC (36:4), PC (36:3), PC (36:2), PC (36:1), PC (34:1e), PC (34:1), PC (32:1), PC (18:0/18:1), and PC (38:5), and the LPCs included LPC (18:1), LPC (18:0) and LPC (16:0).

Conclusion

Our findings indicate the presence of a comprehensive lipid profile in the vascular tissue of atherosclerotic mice, particularly involving PC and LPC, which exhibited significantly increased levels in AS.
Non-producer multiple myeloma presenting with acute hyperammonemic encephalopathy: case report
Authors: Verma Karina , Zhang Tina , Mueller David , Li Julie , Sanchorawala Vaishali , Staron Andrew
Published: January 2023

Background

Hyperammonemic encephalopathy (HE) is a rare and life-threatening complication of multiple myeloma, with underlying mechanisms that are not fully understood. In contrast to previously reported cases, most of which have been associated with IgG or IgA isotypes, we describe a patient with HE as the presenting symptom of non-producer multiple myeloma (NPMM).

Case presentation

A 60-year-old man developed lethargy that progressed into coma. He was found to have an elevated ammonia level, despite normal hepatic function. He was diagnosed with HE secondary to NPMM, demonstrating 80% plasma cells without light chain expression in the bone marrow and absence of a monoclonal protein in the serum or urine, including by matrix-assisted laser desorption ionization time-of-flight mass-spectrometry (MASS-FIX). Myeloma-directed therapy with daratumumab, bortezomib, cyclophosphamide and dexamethasone successfully reversed his HE. At clinical relapse, he received salvage chemotherapy followed by venetoclax therapy, leading to a short period of neurological recovery.

Conclusions

This case demonstrates that HE can occur in a patient with NPMM and challenges the mechanism suggested by limited prior studies; i.e., that excess ammonia in multiple myeloma arises from degradation of M-proteins. We postulate that the neoplastic plasma cells in NPMM have amplified amino acid metabolism, despite lacking detectable intracellular or secreted immunoglobulins.
Quantitative evaluation of hemodynamic parameters by echocardiography in patients with post-cardiotomy cardiac shock supported by extracorporeal membrane oxygenation
Authors: Ye Fuyong , Yang Yuwen , Liang Yinting , Liu Jianhua
Published: January 2023

Background

When drugs fail to reverse post-cardiotomy cardiac shock (PCS), extracorporeal membrane oxygenation (ECMO) is considered the most effective adjuvant strategy. Transthoracic echocardiography is a useful imaging modality for monitoring of cardiac hemodynamics. The aim of this study was to investigate the value of echocardiography for monitoring the left and right heart hemodynamics in PCS patients before, during, and after weaning from ECMO.

Methods

Fifty-two patients were divided into successful weaning group (group A, n = 23) and non-successful weaning group (group B, n = 29). Hemodynamic parameters measured by echocardiography were collected before, during, and after ECMO. The intra-group changes and inter-group differences were retrospectively analyzed.

Results

In group A, the central venous pressure (CVP), proximal right ventricular outflow tract (RVOT), tricuspid annular plane systolic excursion (TAPSE), velocity of tricuspid valve (TVDV), and systolic velocity of tricuspid annulus ($${\text{s}}_{{{\text{TV}}}}^{{\prime }}$$

s

TV

′

) during ECMO were significantly lower than those before ECMO. After ECMO, left ventricular ejection fraction (LVEF), systolic velocity of mitral annulus ($${\text{s}}_{{{\text{MV}}}}^{{\prime }}$$

s

MV

′

), and velocity–time integral of LV outflow tract (LVOT-VTI) were higher than pre-ECMO levels, and CVP, LVEF, $${\text{s}}_{{{\text{MV}}}}^{{\prime }}$$

s

MV

′

, LVOT-VTI, RVOT, TAPSE, TVDV and $${\text{s}}_{{{\text{TV}}}}^{{\prime }}$$

s

TV

′

were higher than those during ECMO (all P < 0.05).

In group B, compared to pre-ECMO, subjects exhibited decreased CVP, RVOT, TAPSE, TVDV and $${\text{s}}_{{{\text{TV}}}}^{{\prime }}$$

s

TV

′

during ECMO. TAPSE, TVDV, and $${\text{s}}_{{{\text{TV}}}}^{{\prime }}$$

s

TV

′

were continuously lower after ECMO, while CVP and RVOT increased after ECMO (all P < 0.05). After ECMO, LVEF, $${\text{s}}_{{{\text{MV}}}}^{{\prime }}$$

s

MV

′

, LVOT-VTI, TAPSE, TVDV and $${\text{s}}_{{{\text{TV}}}}^{{\prime }}$$

s

TV

′

in group A were higher than those in group B (all P < 0.05). Inter-group comparison showed the LVEF and RV Tei indices of group A were significantly different than those of group B before, during, and after ECMO.

Conclusion

Quantitative assessment of both LV and RV by echocardiography is important for ECMO weaning. Patients with better LVEF and lower RV Tei index may have a better chance of successful weaning from ECMO.
Hepatocellular carcinoma detection via targeted enzymatic methyl sequencing of plasma cell-free DNA
Authors: Guo Ping , Zheng Hailing , Li Yihan , Li Yuntong , Xiao Yue , Zheng Jin , Zhu Xingqiang , Xu Huan , He Zhi , Zhang Qian , Chen Jinchun , Qiu Mingshan , Jiang Min , Liu Pingguo , Chen Hongliang
Published: January 2023

Background

Epigenetic variants carried by circulating tumor DNA can be used as biomarkers for early detection of hepatocellular carcinoma (HCC) by noninvasive liquid biopsy. However, traditional methylation analysis method, bisulfite sequencing, with disadvantages of severe DNA damage, is limited in application of low-amount cfDNA analysis.

Results

Through mild enzyme-mediated conversion, enzymatic methyl sequencing (EM-seq) is ideal for precise determination of cell-free DNA methylation and provides an opportunity for HCC early detection. EM-seq of methylation control DNA showed that enzymatic conversion of unmethylated C to U was more efficient than bisulfite conversion. Moreover, a relatively large proportion of incomplete converted EM-seq reads contains more than 3 unconverted CH site (CH = CC, CT or CA), which can be removed by filtering to improve accuracy of methylation detection by EM-seq. A cohort of 241 HCC, 76 liver disease, and 279 normal plasma samples were analyzed for methylation value on 1595 CpGs using EM-seq and targeted capture. Model training identified 283 CpGs with significant differences in methylation levels between HCC and non-HCC samples. A HCC screening model based on these markers can efficiently distinguish HCC sample from non-HCC samples, with area under the curve of 0.957 (sensitivity = 90%, specificity = 97%) in the test set, performing well in different stages as well as in serum α-fetoprotein/protein induced by vitamin K absence-II negative samples.

Conclusion

Filtering of reads with ≥ 3 CHs derived from incomplete conversion can significantly reduce the noise of EM-seq detection. Based on targeted EM-seq analysis of plasma cell-free DNA, our HCC screening model can efficiently distinguish HCC patients from non-HCC individuals with high sensitivity and specificity.
Precoding-based complex field network coding strategy for multi-source UAV cooperative system
Authors: Zhao Mingfei , Xue Rui , Jiang Hang
Published: January 2023

Relay-based UAV swarm can further expand the surveillance range for more complex missions. Microsatellite swarms provide invulnerability and stability compared to conventional satellites and are selected for multi-UAVs multi-satellites systems. Determining how to recover more valuable information from the multi-source data is of significant importance. Considering that vast amounts of multi-source data from UAV swarm require higher throughput performance of transmission schemes, complex field network coding (CFNC) is selected for UAV cooperative system. However, adverse effects like inter-user interference of fading channels will limit the reliability performance of UAV cooperative system. To improve the reliability performance and recover more accurate valuable information, we propose a precoding-based CFNC strategy for multi-source UAV cooperative system. The proposed transmission scheme processes data through precoding matrix, which is obtained by the transformation of channel state matrix. Compared to conventional CFNC schemes, precoding-based CFNC scheme improves the accuracy of detections. Through theoretical analysis and experimental results, the precoding-based CFNC transmission scheme not only maintains high throughput, but also recover more valuable information and achieves better reliability performance.
The value of serum IL-4 to predict the survival of MDS patients
Authors: Liu Zhaoyun , Xu Xintong , Zheng Likun , Ding Kai , Yang Chun , Huang Jincheng , Fu Rong
Published: January 2023

Background

Immune indicators are routinely used for the detection of myelodysplastic syndrome (MDS), but these are not utilized as a reference indicator to assess prognosis in MDS-related prognostic evaluation systems, such as the World Health Organizational prognostic scoring system, the international prostate symptom score, and the revised international prostate symptom score.

Methods

We examined immune indicators, including cluster of differentiation (CD)3, CD4, CD8, CD56, CD19, interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-a, and interferon-γ in 155 newly diagnosed MDS patients. We also conducted a correlation analysis with clinical indices.

Results

IL-4 was found to be a predictor of survival in these 155 patients using the receiver operating characteristic curve, with 5.155 as the cut-off point. Patients with serum IL-4 levels ≥ 5.155 had a lower overall survival (OS) than those with IL-45.155 at diagnosis. Furthermore, multivariate analysis revealed that IL-4 levels > 5.155 were an independent predictor of OS (hazard ratio: 0.237; 95% confidence interval, 0.114–0.779; P = 0.013). In addition, serum IL-4 expression in the three different scoring systems showed significant differences in the survival of medium- to high-risk MDS patients (P = 0.014, P < 0.001, P < 0.001).

Conclusions

According to our study, IL-4 levels at the time of diagnosis can predict MDS prognosis in patients as a simple index reflecting host systemic immunity.
Efficacy and safety of nonpharmacological strategies for the treatment of oligoasthenospermia: a systematic review and Bayesian network meta-analysis
Authors: Wang Zhen , Zhou Ziyang , Zhang Lijuan , Li Xujie , Li Miaoxiu , Pan Yankun , Jiao Tiyong , Shi Xiaoyun , Liu Qing , Wang Congan , Wang Yongquan
Published: January 2023

Background

Oligoasthenospermia (OAT) is the most common cause of male infertility, and the annual incidence of the disease continues to increase due to changing lifestyle habits, increased work pressure and increased environmental pollution. A variety of nonpharmacological therapies have been reported to be effective for treating OAT; however, there is a lack of direct evidence comparing these different nonpharmacological therapies. Therefore, the optimal strategy has yet to be identified.

Objectives

A network meta-analysis was performed to evaluate the efficacy and safety of nonpharmacological treatments for OAT, thus providing an evidence-based medical reference for the clinical treatment of oligoasthenospermia.

Methods

The Web of Science, Cochrane Library, Embase, PubMed, Weipu (VIP), Wan Fang Data, China National Knowledge Infrastructure (CNKI), and China Biomedical Literature (CBM) databases were searched from inception to April 2022 to identify randomized controlled trials (RCTs) that examined nonpharmacological treatments for oligozoospermia. Grey literature was also searched. Studies that met the quality criteria were analysed using Stata 16.0 and Review Manager 5.4 software.

Results

A total of 4629 publications were initially retrieved; ultimately, 38 RCTs were analysed, including 8 nonpharmacological therapies and 3080 patients. Each intervention outperformed the sham intervention and no treatment approaches in terms of improved efficacy. In terms of improved total effective rate and sperm concentration, warming acupuncture may be the most effective treatment (SUCRA = 80.1% and 93.4%, respectively). Electroacupuncture perhaps resulted in the best improvement in sperm motility a% and a + b% (SUCRA = 96.6% and 82.0%, respectively). In terms of the incidence of adverse reactions, the three safest interventions probably were no treatment, warming acupuncture, and sham intervention (SUCRA = 88.0%, 68.8% and 62.9%, respectively). In terms of improving the reproductive hormones FSH, LH, and T, the best interventions perhaps were hyperbaric oxygen, 2 Hz TEAS, and electroacupuncture (SUCRA = 85.1%, 96.8% and 99.4%, respectively).

Conclusions

Nonpharmacological treatments for oligoasthenospermia have good clinical efficacy. Warm acupuncture and electroacupuncture have better overall efficacy and safety. These treatment approaches can be recommended based on the actual situation. If a patient is complicated with varicoceles, they should be removed before symptomatic treatment. Due to the limitations of the quality of the included studies, the findings need to be further validated.
Reconceptualising nomadic architecture: from the body to the space creation
Authors: Trisno Rudy , Husin Denny , Lianto Fermanto
Published: January 2023

Nomadic architecture from the past until now has been adapted to the spirit of the age. The research aims to search the nomadic lifestyle that has become a phenomenon of local and global movements worldwide. This paper investigates the meaning of nomadic architecture using historical and bibliographical methods. Our exploration provides a better understanding of nomadic architecture and reconceptualises the idea of future nomadic architecture with the attention of history period; (1) Hunter-gatherer; (2) Nomadic Pastoralism; (3) Dom; (4) Neo-Nomadic Society; (5) Contemporary Nomad. In conclusion, this approach reflects a strong connection between the human body, activity, and nomadic architecture creation. The research findings are a transformation of space in nomadism that implies the hybridisation of technology and new materials towards integration with future city development.
Regional differences of the sclera in the ocular hypertensive rat model induced by circumlimbal suture
Authors: Xia Mingfang , Zhang Endong , Yao Fei , Xia Zhaohua , Zhou Mingmin , Ran Xufang , Xia Xiaobo
Published: January 2023

Purpose

To describe the regional differences of the sclera in ocular hypertension (OHT) models with the inappropriate extension of the ocular axis.

Methods

To discover the regional differences of the sclera at the early stage, OHT models were established using circumlimbal suture (CS) or sclerosant injection (SI). Axial length (AL) was measured by ultrasound and magnetic resonance imaging. The glaucoma-associated distinction was determined by intraocular pressure (IOP) and retrograde tracing of retinal ganglion cells (RGCs). The central thickness of the ganglion cell complex (GCC) was measured by optical coherence tomography. RGCs and collagen fibrils were detected using a transmission electron microscope, furthermore, anti-alpha smooth muscle actin (αSMA) was determined in the early stage after the operation.

Results

Compared with the control group, the eyes in OHT models showed an increased IOP (P < 0.001 in the CS group, P = 0.001 in the SI group), growing AL (P = 0.026 in the CS group, P = 0.043 in the SI group), reduction of central RGCs (P < 0.001 in the CS group, P = 0.017 in the SI group), thinning central GCC (P < 0.001 in the CS group), and a distinctive expression of αSMA in the central sclera in the early 4-week stage after the operation (P = 0.002 in the CS group). Compared with the SI group, the eye in the CS group showed a significantly increased AL (7.1 ± 0.4 mm, P = 0.031), reduction of central RGCs (2121.1 ± 87.2 cells/mm2, P = 0.001), thinning central GCC (71.4 ± 0.8 pixels, P = 0.015), and a distinctive expression of αSMA (P = 0.005). Additionally, ultrastructural changes in RGCs, scleral collagen fibers, and collagen crimp were observed in the different regions. Increased collagen volume fraction in the posterior segment of the eyeball wall (30.2 ± 3.1%, P = 0.022) was observed by MASSON staining in the CS group.

Conclusion

Regional differences of the sclera in the ocular hypertensive rat model induced by CS may provide a reference for further treatment of scleral-related eye disorders.
Non-CpG sites preference in G:C > A:T transition of TP53 in gastric cancer of Eastern Europe (Poland, Romania and Hungary) compared to East Asian countries (China and Japan)
Authors: Natsume Hiroko , Szczepaniak Kinga , Yamada Hidetaka , Iwashita Yuji , Gędek Marta , Šuto Jelena , Ishino Keiko , Kasajima Rika , Matsuda Tomonari , Manirakiza Felix , Nzitakera Augustin , Wu Yijia , Xiao Nong , He Qiong , Guo Wenwen , Cai Zhenming , Ohta Tsutomu , Szekely Tıberiu , Kadar Zoltan , Sekiyama Akiko , Oshima Takashi , Yoshikawa Takaki , Tsuburaya Akira , Kurono Nobuhito , Wang Yaping , Miyagi Yohei , Gurzu Simona , Sugimura Haruhiko
Published: January 2023

Aim

Mutation spectrum ofTP53in gastric cancer (GC) has been investigated world-widely, but a comparison of mutation spectrum among GCs from various regions in the world are still sparsely documented. In order to identify the difference ofTP53mutation spectrum in GCs in Eastern Europe and in East Asia, we sequencedTP53in GCs from Eastern Europe, Lujiang (China), and Yokohama, Kanagawa (Japan) and identified the feature ofTP53mutations of GC in these regions.

Subjects and method

In total, 689 tissue samples of GC were analyzed: 288 samples from East European populations (25 from Hungary, 71 from Poland and 192 from Romania), 268 from Yokohama, Kanagawa, Japan and 133 from Lujiang, Anhui province, China. DNA was extracted from FFPE tissue of Chinese, East European cases; and from frozen tissue of Japanese GCs. PCR products were direct-sequenced by Sanger method, and in ambiguous cases, PCR product was cloned and up to 8 clones were sequenced. We used No. NC_000017.11(hg38) as the reference sequence ofTP53. Mutation patterns were categorized into nine groups: six base substitutions, insertion, deletion and deletion-insertion. Within G:C > A:T mutations the mutations in CpG and non-CpG sites were divided. The Cancer Genome Atlas data (TCGA, ver.R20, July, 2019) having somatic mutation list of GCs from Whites, Asians, and other ethnicities were used as a reference for our data.

Results

The most frequent base substitutions were G:C > A:T transition in all the areas investigated. The G:C > A:T transition in non-CpG sites were prominent in East European GCs, compared with Asian ones. Mutation pattern from TCGA data revealed the same trend between GCs from White (TCGA category) vs Asian countries. Chinese and Japanese GCs showed higher ratio of G:C > A:T transition in CpG sites and A:T > G:C mutation was more prevalent in Asian countries.

Conclusion

The divergence in mutation spectrum of GC in different areas in the world may reflect various pathogeneses and etiologies of GC, region to region. Diversified mutation spectrum in GC in Eastern Europe may suggest GC in Europe has different carcinogenic pathway of those from Asia.
Drug-induced de novo thrombotic microangiopathy diagnosed 2 years after renal transplantation: a case report and literature review
Authors: Ozaki Keisuke , Fukawa Tomoya , Yamaguchi Kunihisa , Shiozaki Keito , Sasaki Yutaro , Ueda Sayo , Nagai Kohjiro , Wakino Shu , Takahashi Masayuki , Kanayama Hiro-omi
Published: January 2023

Background

Post-transplant de novo thrombotic microangiopathy (TMA) is a rare yet serious complication that generally can develop in renal transplant recipients immediately after reperfusion or several months after transplantation. Here, we report a case of systemic tacrolimus-associated TMA in a patient diagnosed 2 years after renal transplantation.

Case presentation

A 49-year-old woman presented with severe anemia 18 months after undergoing renal transplantation. Anemia was refractory to recombinant human erythropoietin and was suspected to be due to excessive menstruation. Anemia persisted even after hysterectomy, and thereafter, pancytopenia developed. A bone marrow biopsy was performed and showed no evidence of myeloproliferative neoplasms. Furthermore, an increase in serum lactate dehydrogenase level and the appearance of schistocytes on peripheral blood smear was noted 24 months post-transplant. Other possible causes of de novo TMA were excluded, and an allograft biopsy was performed. Pathological findings of the allograft biopsy showed that some afferent arterioles had formed thrombi. Suspecting tacrolimus to be the cause of TMA, 25 months after the transplant, we switched treatment to cyclosporine. Pancytopenia and renal function improved after switching to this calcineurin inhibitor. Subsequently, her allograft renal function stabilized for three years after renal transplantation.

Conclusion

We encountered a case of secondary drug-induced TMA in the late stages of renal transplantation. Therefore, TMA should be suspected when anemia with hemolysis is observed in recipients of kidney transplant.
Biomechanical analysis of different levels of constraint in TKA during daily activities
Authors: Castellarin Gianluca , Bori Edoardo , Rapallo Laurence , Pianigiani Silvia , Innocenti Bernardo
Published: January 2023

Background

Numerous total knee prosthetic implants are currently available on the orthopedic market, and this variety covers a set of different levels of constraint: among the various models available, a significant role is covered by mobile bearing cruciate-retaining design with an ultra-congruent insert, mobile bearing cruciate-retaining design, fixed-bearing posterior stabilized prosthesis and fixed-bearing constrained condylar knee. A biomechanical comparative study among them could therefore be helpful for the clinical decision-making process. This study aimed to compare the effect of these different levels of constraint in the knee biomechanics of a patient, in three different configurations representing the typical boundary conditions experienced by the knee joint during daily activities.

Method

The investigation was performed via finite element analysis with a knee model based on an already published and validated one. Four different types of prosthesis designs were analyzed: two mobile-bearing models and two fixed-bearing models, each one having a different level of constraint. The different designs were incorporated in to the 3D finite element model of the lower leg and analyzed in three different configurations reproducing the landing and the taking-off phases occurring during the gait cycle and chair-rising. Implant kinetics (in terms of polyethylene contact areas and contact pressure), polyethylene and tibial bone stresses were calculated under three different loading conditions for each design.

Results

The tibial stress distribution in the different regions of interest of the tibia remains relatively homogeneous regardless of the type of design used. The main relevant difference was observed between the mobile and fixed-bearing models, as the contact areas were significantly different between these models in the different loading conditions. As a consequence, significant changes in the stress distribution were observed at the interface between the prosthetic components, but no significant changes were noted on the tibial bone. Moreover, the different models exhibited a symmetrical medial and lateral distribution of the contact areas, which was not always common among all the currently available prostheses (i.e. medial pivot designs).

Conclusion

The changes of the prosthetic implant did not induce a big variation of the stress distribution in the different regions of the tibial bone, while they significantly changed the distribution of stress at the interface between the prosthetic components.