bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of neutrophil-to-lymphocyte ratio, radiotherapy fractionation/technique, and risk of development of distant metastasis among patients with locally advanced rectal cancer
Authors: Yang Gowoon , Chang Jee Suk , Choi Jeong Eun , Baek Eun Sil , Kim Seung-Seob , Byun Hwa Kyung , Cho Yeona , Koom Woong Sub , Yang Seung Yoon , Min Byung Soh , Shin Sang Joon
Published: May 2022

Background

We investigated the prognostic impact of the neutrophil-to-lymphocyte ratio (NLR) in patients with locally advanced rectal cancer (LARC) and whether modifiable factors in radiotherapy (RT) influenced the NLR.

Methods

Data of 1386 patients who were treated with neoadjuvant RT and concurrent or sequential chemotherapy for LARC between 2006 and 2019 were evaluated. Most patients (97.8%) were treated with long-course RT (LCRT; 50–50.4 Gy in 25–28 fractions) using three-dimensional conformal radiotherapy (3D-CRT) (n = 851) or helical tomotherapy (n = 504), and 30 patients underwent short-course RT (SCRT; 25 Gy in 5 fractions, followed by XELOX administration for 6 weeks). Absolute neutrophil and lymphocyte counts were obtained at initial diagnosis, before and during the preoperative RT course, and after preoperative concurrent chemoradiotherapy. The primary endpoint was distant metastasis-free survival (DMFS).

Results

The median follow-up time was 61.3 (4.1–173.7) months; the 5-year DMFS was 80.1% and was significantly associated with the NLR after RT but not before. A post-RT NLR ≥ 4 independently correlated with worse DMFS (hazard ratio, 1.42; 95% confidence interval, 1.12–1.80), along with higher ypT and ypN stages. Post-RT NLR (≥ 4) more frequently increased following LCRT (vs. SCRT, odds ratio [OR] 2.77, p = 0.012) or helical tomotherapy (vs. 3D-CRT, OR 1.29, p < 0.001).

Conclusions

Increased NLR after neoadjuvant RT is associated with increased distant metastasis risk and poor survival outcome in patients with LARC. Moreover, high NLR following RT is directly related to RT fractionation, delivery modality, and tumor characteristics. These results are hypothesis-generating only, and confirmatory studies are required.
Concomitant use of Sapien 3 transcatheter valve for severe MAC with Intuity Elite rapid deployment valve for aortic stenosis
Authors: Hooks Gareth J. , Ball Peter , Spence Mark S. , Jeganathan Reuben
Published: May 2022

Background

Concomitant double valve pathology in the presence of severe MAC poses significant technical challenges when planning surgical intervention. With continued evolution of valve prosthesis, innovative techniques can be considered with the potential for additional therapeutic benefit.

Case presentation

We present a novel technique of using a rapid deployment surgical aortic valve in combination with open surgical transcatheter mitral valve implantation (TMVI) for severe Mitral Annular Calcification (MAC). The Intuity Elite rapid deployment prosthesis (Edwards Lifesciences, Irvine, CA) was used concomitantly with the Sapien 3 (Edwards Lifesciences, Irvine, CA) transcatheter prosthesis trans-atrially on cardiopulmonary bypass in a patient with critical aortic stenosis and moderate-severe mixed mitral valve disease in the setting of severe MAC (off-label use).

Conclusions

We demonstrate how both technologies can, not only be accommodated, but indeed complement each other achieving an excellent outcome in a high-risk patient.
Tracheal myoepithelioma resected by using rigid bronchoscopy: a case report and review of the literature
Authors: Mardani Parviz , Ebrahimi Kamyar , Shahriarirad Reza , Geramizadeh Bita , Kamran Hooman , Niknam Tahmoores , Khosravi Mohammad Bagher , Vatankhah Pooya
Published: May 2022

Background

Endotracheal tumors are rare in the respiratory system. Myoepitheliomas are benign tumors, which are rarely reported in the respiratory system. Herein, we report a rare case of endotracheal myoepithelioma, which was resected by rigid bronchoscopy.

Case presentation

A 36-year-old man, presenting with chest pain, dyspnea, stridor, and hemoptysis, was referred to our center with radiological features of near-total tracheal obstruction due to mass. Fiberoptic bronchoscopy with argon plasma coagulation and rigid bronchoscopy with grasper forceps was utilized to resect the mass. Pathological evaluation of the mass demonstrated myoepithelioma. The patient was discharged in good condition. Now, after 6 months, the patient is symptom-free with no evidence of tumor recurrence or re-growth.

Conclusions

Despite being extremely rare, myoepithelioma should be considered a possible differential diagnosis for endotracheal tumors. Fiberoptic and rigid bronchoscopy management is an effective method for the resection of endotracheal tumors.
Application of integrated Korean forest growth dynamics model to meet NDC target by considering forest management scenarios and budget
Authors: Hong Mina , Song Cholho , Kim Moonil , Kim Jiwon , Lee Sle-gee , Lim Chul-Hee , Cho Kijong , Son Yowhan , Lee Woo-Kyun
Published: May 2022

Background

Forests are atmospheric carbon sinks, whose natural growth can contribute to climate change mitigation. However, they are also affected by climate change and various other phenomena, for example, the low growth of coniferous forests currently reported globally, including in the Republic of Korea. In response to the implementation of the Paris Agreement, the Korean government has proposed 2030 greenhouse gas roadmap to achieve a Nationally Determined Contribution (NDC), and the forest sector set a sequestration target of 26 million tons by 2030. In this study, the Korean forest growth model (KO-G-Dynamic model) was used to analyze various climate change and forest management scenarios and their capacity to address the NDC targets. A 2050 climate change adaptation strategy is suggested based on forest growth and CO2 sequestration.

Results

Forest growth was predicted to gradually decline, and CO2 sequestration was predicted to reach 23 million tons per year in 2050 if current climate and conditions are maintained. According to the model, sequestrations of 33 million tCO2 year−1 in 2030 and 27 million tCO2 year−1 in 2050 can be achieved if ideal forest management is implemented. It was also estimated that the current forest management budget of 317 billion KRW (264 million USD) should be twice as large at 722 billion KRW (602 million USD) in the 2030s and 618 billion KRW (516 million USD) in the 2050s to achieve NDC targets.

Conclusions

The growth trend in Korea's forests transitions from young-matured stands to over-mature forests. The presented model-based forest management plans are an appropriate response and can increase the capacity of Korea to achieve its NDC targets. Such a modeling can help the forestry sector develop plans and policies for climate change adaptation.
Differential associations of conduct disorder, callous-unemotional traits and irritability with outcome expectations and values regarding the consequences of aggression
Authors: Elowsky J. , Bajaj S. , Bashford-Largo J. , Zhang R. , Mathur A. , Schwartz A. , Dobbertin M. , Blair K. S. , Leibenluft E. , Pardini D. , Blair R. J. R.
Published: May 2022

Background

Previous work has examined the association of aggression levels and callous-unemotional traits with outcome expectations and values regarding the consequences of aggression. Less work has examined the outcome expectations and values regarding the consequences of aggression of adolescents with Conduct Disorder (CD). Also, no studies have examined links between irritability (a second socio-affective trait associated with CD) and these social cognitive processes despite the core function of anger in retaliatory aggression and establishing dominance.

Method

The current study, investigating these issues, involved 193 adolescents (typically developing [TD; N = 106], 87 cases with CD [N = 87]). Participants completed an adaptation of the Outcomes Expectations and Values Questionnaire and were assessed for CU traits and irritability via the Inventory of Callous-Unemotional traits and the Affective Reactivity Index.

Results

While CD was associated with atypical outcome expectations this was not seen within statistical models including CU traits and irritability. CU traits were associated with decreased expectation that aggression would result in feelings of remorse and victim suffering, as well as decreased concern that aggressive acts would result in punishment and victim suffering. Irritability was associated with increased expectations and concern that aggression would result in dominance and forced respect.

Conclusions

The results suggest that CU traits and irritability, often present in youth with CD, are associated with different forms of maladaptive outcome expectations and values regarding the consequences of aggression. This suggests that the atypical social cognitive processes underlying aggressive behavior among youth exhibiting CU traits may differ from those exhibiting problems regulating anger.
Direct oral anticoagulant versus low molecular weight heparin for the treatment of cancer-associated venous thromboembolism: 2022 updated systematic review and meta-analysis of randomized controlled trials
Authors: Frere Corinne , Farge Dominique , Schrag Deborah , Prata Pedro H. , Connors Jean M.
Published: May 2022

International clinical practice guidelines have progressively endorsed direct oral anticoagulants (DOACs) as an alternative to low-molecular-weight heparins (LMWHs) monotherapy for the initial and long-term treatment of cancer-associated thrombosis (CAT). Several new randomized controlled trials (RCTs) have recently reported additional results on the safety and efficacy of DOACs in this setting. We performed an updated meta-analysis of all publicly available data from RCTs comparing DOACs with LMWHs for the treatment of CAT. Six RCTs enrolling 3690 patients with CAT were included. Compared with LMWHs, DOACs significantly decreased the risk of CAT recurrence (RR, 0.67; 95%CI, 0.52–0.85), with a non-significant increase in the risk of major bleeding (RR, 1.17; 95%CI, 0.82–1.67), a significant increase in the risk of clinically relevant nonmajor bleeding (RR 1.66; 95%CI, 1.31–2.09) and no difference in all-cause mortality rates. These results increase the level of certainty of available evidence supporting the use of DOACs as an effective and safe option for the treatment of CAT in selected cancer patients.
Mass spectrometry-based proteomics identify novel serum osteoarthritis biomarkers
Authors: Tardif Ginette , Paré Frédéric , Gotti Clarisse , Roux-Dalvai Florence , Droit Arnaud , Zhai Guangju , Sun Guang , Fahmi Hassan , Pelletier Jean-Pierre , Martel-Pelletier Johanne
Published: May 2022

Background

Osteoarthritis (OA) is a slowly developing and debilitating disease, and there are no validated specific biomarkers for its early detection. To improve therapeutic approaches, identification of specific molecules/biomarkers enabling early determination of this disease is needed. This study aimed at identifying, with the use of proteomics/mass spectrometry, novel OA-specific serum biomarkers. As obesity is a major risk factor for OA, we discriminated obesity-regulated proteins to target only OA-specific proteins as biomarkers.

Methods

Serum from the Osteoarthritis Initiative cohort was used and divided into 3 groups: controls (n=8), OA-obese (n=10) and OA-non-obese (n=10). Proteins were identified and quantified from the liquid chromatography–tandem mass spectrometry analyses using MaxQuant software. Statistical analysis used the Limma test followed by the Benjamini-Hochberg method. To compare the proteomic profiles, the multivariate unsupervised principal component analysis (PCA) followed by the pairwise comparison was used. To select the most predictive/discriminative features, the supervised linear classification model sparse partial least squares regression discriminant analysis (sPLS-DA) was employed. Validation of three differential proteins was performed with protein-specific assays using plasma from a cohort derived from the Newfoundland Osteoarthritis.

Results

In total, 509 proteins were identified, and 279 proteins were quantified. PCA-pairwise differential comparisons between the 3 groups revealed that 8 proteins were differentially regulated between the OA-obese and/or OA-non-obese with controls. Further experiments using the sPLS-DA revealed two components discriminating OA from controls (component 1, 9 proteins), and OA-obese from OA-non-obese (component 2, 23 proteins). Proteins from component 2 were considered related to obesity. In component 1, compared to controls, 7 proteins were significantly upregulated by both OA groups and 2 by the OA-obese. Among upregulated proteins from both OA groups, some of them alone would not be a suitable choice as specific OA biomarkers due to their rather non-specific role or their strong link to other pathological conditions. Altogether, data revealed that the protein CRTAC1 appears to be a strong OA biomarker candidate. Other potential new biomarker candidates are the proteins FBN1, VDBP, and possibly SERPINF1. Validation experiments revealed statistical differences between controls and OA for FBN1 (p=0.044) and VDPB (p=0.022), and a trend for SERPINF1 (p=0.064).

Conclusion

Our study suggests that 4 proteins, CRTAC1, FBN1, VDBP, and possibly SERPINF1, warrant further investigation as potential new biomarker candidates for the whole OA population.
Examining the role of person-to-person transmission during a verocytotoxigenic Escherichia coli outbreak in Ontario, Canada
Authors: Hovdey Roksolana , Sargeant Jan M. , Fisman David N. , Greer Amy L.
Published: May 2022

Objective

Person-to-person transmission can occur during outbreaks of verotoxigenic Escherichia coli (VTEC), however the impact of this transmission route is not well understood. This study aimed to examine the role of person-to-person transmission during a VTEC outbreak, and how targeting this route may reduce outbreak size. A deterministic compartmental model describing a VTEC outbreak was constructed and fit to data from a 2008 outbreak in Ontario, Canada. Using the best-fit model, simulations were run to calculate the: reduction in transmission rate after implementing interventions, proportion of cases infected through both transmission routes, and number of cases prevented by interventions. Latin hypercube sensitivity analysis was conducted to examine the sensitivity of the outbreak size to the model parameters.

Results

Based on the best-fit model, ~ 14.25% of the cases likely arose due to person-to-person transmission. Interventions reduced this transmission rate by ~ 73%, causing a reduction in outbreak size of ~ 17% (47 cases). Sensitivity analysis showed that the model was highly sensitive to changes in all parameters of the model. The model demonstrates that person-to-person could be an important transmission route during VTEC outbreaks. Targeting this route of transmission through hand hygiene and work exclusions could reduce the final outbreak size.
The new era of add-on asthma treatments: where do we stand?
Authors: Calhoun William J. , Chupp Geoffrey L.
Published: May 2022

Globally, a small proportion (5–12%) of asthma patients are estimated to have severe disease. However, severe asthma accounts for disproportionately high healthcare resource utilization. The Global Initiative for Asthma (GINA) management committee recommends treating patients with asthma with inhaled corticosteroids plus long-acting β2-agonists and, when needed, adding a long-acting muscarinic receptor antagonist or biologic agent. Five biologics, targeting different effectors in the type 2 inflammatory pathway, are approved for asthma treatment. However, biologics have not been compared against each other or add-on inhaled therapies in head-to-head clinical trials. As a result, their positioning versus that of current and anticipated small-molecule strategies is largely unknown. Furthermore, with the emergence of biomarkers for predicting response to biologics, a more personalized treatment approach—currently lacking with inhaled therapies—may be possible. To gain perspective, we reviewed recent advances in asthma pathophysiology, phenotypes, and biomarkers; the place of biologics in the management and personalized treatment of severe asthma; and the future of biologics and small-molecule drugs. We propose an algorithm for the stepwise treatment of severe asthma based on recommendations in the GINA strategy document that accounts for the broad range of phenotypes targeted by inhaled therapies and the specificity of biologics. In the future, both biologics and small molecules will continue to play key roles in the individualized treatment of severe asthma. However, as targeted therapies, their application will continue to be focused on patients with certain phenotypes who meet the specific criteria for use as identified in pivotal clinical trials.
Simultaneous retrograde venous and anterograde arterial bullet embolism: a case report
Authors: Hosseinzadeh Ahmad , Moeini Farsani Mohammad , Mahmoudi Mohamad Mahdi , Hekmatnia Ahmadreza , Ghasemi Gorji Meghdad , Asnaashari Majid , Ghoddusi Johari Hamed , Shahriarirad Reza
Published: May 2022

Background

Bullet embolus is a rare condition following gunshot injuries and represents a clinical challenge regarding both diagnosis and management.

Case presentation

We report the case of a 35-year-old Iranian (Middle-Eastern) male patient with a shotgun injury to both buttocks, which traveled to the heart and the popliteal area through the femoral vein and superficial femoral artery, respectively. Surgical intervention was applied for the popliteal pellet, and the patient was discharged without further complications.

Conclusion

Although bullet emboli can be a clinical challenge, with the advent of modern procedures, removal has become safer. X-ray, computed tomography, and transthoracic and/or transesophageal echocardiography may be used as adjuncts to help establish the diagnosis.
Focal seizures during adrenocorticotropic hormone therapy in a school-aged boy: a case report
Authors: Ota Yoshitaka , Shimakawa Shuichi , Tsuda-Kitahara Hikaru , Fukui Miho , Kashiwagi Mitsuru , Ashida Akira
Published: May 2022

Background

Adrenocorticotropic hormone therapy for infantile spasms, including West syndrome, has been previously reported to induce seizures. We present the findings for a school-aged child with epilepsy who developed new focal seizures during adrenocorticotropic hormone therapy.

Case presentation

The Japanese patient had posttraumatic epilepsy and developed intractable focal seizures at the age of 13 years. Adrenocorticotropic hormone therapy was administered when the patient was 14 years of age. On day 10 of treatment, he developed new focal seizures, which were characterized by left arm contractions followed by movements of touching things with his right hand and writhing and rocking his body left and right and back and forth as automatisms. The focal seizures clustered for 40 minutes and disappeared after suppository administration of 10 mg diazepam. These focal seizures did not reoccur after more than 2 years of follow-up.

Conclusion

Adrenocorticotropic hormone-induced seizures can occur in children older than previously reported, and can occur in children with intractable seizures other than epileptic spasms.
Acute bilateral ureteropelvic junction obstruction as a rare cause of hypertensive crisis: a case report
Authors: Casipit Bruce Adrian , Pelayo Jerald , Paguio Joseph Alexander , Yao Jasper Seth , Shah Niel
Published: May 2022

Background

Bilateral ureteropelvic junction obstruction is a common cause of secondary hypertension in the pediatric population, often due to congenital malformation. On the other hand, it is less frequently encountered in the adult population and is usually due to an acquired condition, most commonly by a bilaterally obstructing nephrolithiasis causing hydronephrosis and subsequent hypertension. The aim of this study was to investigate and highlight the underlying mechanisms by which acute bilateral ureteropelvic junction obstruction causes hypertensive crisis and why early detection and prompt treatment are necessary to mitigate the effects of elevated blood pressure on target organs.

Case presentation

A 41-year-old African American man with hypertensive cardiomyopathy presented with anuria. He was found to have elevated blood pressure with evidence of target organ damage on laboratory examination, demonstrated by sudden elevation of his serum creatinine level. He was initially treated with oral and intravenous antihypertensives, with minimal improvement. The work-up was unremarkable apart from the imaging finding of acute bilateral ureteropelvic junction obstruction from obstructing nephrolithiasis causing hydronephrosis. Bilateral ureteral stents were placed for decompression, with resolution of the hypertensive crisis and improvement of renal function.

Conclusion

This case highlights the importance of prompt diagnosis and treatment of underlying acute bilateral ureteropelvic junction obstruction to mitigate the deleterious effects of sudden blood pressure elevation on target organs.
Myoglobin expression by alternative transcript in different mesenchymal stem cells compartments
Authors: Scrima Rosella , Agriesti Francesca , Pacelli Consiglia , Piccoli Claudia , Pucci Pietro , Amoresano Angela , Cela Olga , Nappi Luigi , Tataranni Tiziana , Mori Giorgio , Formisano Pietro , Capitanio Nazzareno
Published: May 2022

Background

The metabolic phenotype of stem cells is increasingly recognized as a hallmark of their pluripotency with mitochondrial and oxygen-related metabolism playing a not completely defined role in this context. In a previous study, we reported the ectopic expression of myoglobin (MB) in bone marrow-derived hematopoietic stem/progenitor cells. Here, we have extended the analysis to mesenchymal stem cells (MSCs) isolated from different tissues.

Methods

MSCs were isolated from human placental membrane, mammary adipose tissue and dental pulp and subjected to RT-PCR, Western blotting and mass spectrometry to investigate the expression of MB. A combination of metabolic flux analysis and cyto-imaging was used to profile the metabolic phenotype and the mitochondria dynamics in the different MSCs.

Results

As for the hematopoietic stem/progenitor cells, the expression of Mb was largely driven by an alternative transcript with the protein occurring both in the monomer and in the dimer forms as confirmed by mass spectrometry analysis. Comparing the metabolic fluxes between neonatal placental membrane-derived and adult mammary adipose tissue-derived MSCs, we showed a significantly more active bioenergetics profile in the former that correlated with a larger co-localization of myoglobin with the mitochondrial compartment. Differences in the structure of the mitochondrial network as well as in the expression of factors controlling the organelle dynamics were also observed between neonatal and adult mesenchymal stem cells. Finally, the expression of myoglobin was found to be strongly reduced following osteogenic differentiation of dental pulp-derived MSCs, while it was upregulated following reprogramming of human fibroblasts to induce pluripotent stem cells.

Conclusions

Ectopic expression of myoglobin in tissues other than muscle raises the question of understanding its function therein. Properties in addition to the canonical oxygen storage/delivery have been uncovered. Finding of Mb expressed via an alternative gene transcript in the context of different stem cells with metabolic phenotypes, its loss during differentiation and recovery in iPSCs suggest a hitherto unappreciated role of Mb in controlling the balance between aerobic metabolism and pluripotency. Understanding how Mb contributes through modulation of the mitochondrial physiology to the stem cell biology paves the way to novel perspectives in regenerative medicine as well as in cancer stem cell therapy.

Graphical abstract
Multiple in-hospital counseling increases six-month smoking abstinence among individuals participating in a hospital-initiated smoking cessation program
Authors: Kuo Chin-Wei , Chen Chuan-Yu , Wu Chih-Hsing , Chen Chang-Wen , Guo Fei-Ran , Yang Szu-Chun
Published: May 2022

Background

A cessation program for hospitalized smokers is an effective strategy to achieve smoking abstinence. The effects of multiple in-hospital counseling sessions on 6-month smoking abstinence require further investigation.

Methods

We retrospectively analyzed the data of smokers who participated in hospital-initiated cessation programs at a medical center between 2017 and 2019. Data on age, sex, comorbidities, daily number of cigarettes, cessation motivation, nicotine dependence, cessation medications, discharge diagnosis, length of hospitalization, and intensive care unit admission were collected. We conducted multiple logistic regression analysis to investigate the effect of multiple in-hospital counseling sessions on 6-month sustained smoking abstinence. Sensitivity analyses were carried out excluding participants who underwent post-discharge cessation programs and assuming that the loss to follow-up participants had failure in 6-month smoking abstinence.

Results

A total of 1943 participants aged ≥ 20 years were analyzed. Compared with single in-hospital counseling session, the adjusted odds ratios (ORs) for 2 and ≥ 3 counseling sessions were 1.44 (95% confidence interval [CI] 1.05 to 1.98) and 2.02 (95% CI 1.27 to 3.22), respectively, with a significant trend for increasing the number of counseling sessions (P < 0.001). The results remained significant after excluding participants who underwent a post-discharge cessation program or when assuming that lost to follow-up participants had failure in smoking abstinence.

Conclusion

Multiple in-hospital counseling sessions were associated with a higher 6-month sustained smoking abstinence rate. This strategy could be used to reduce the prevalence of smoking.
An empirical assessment of how the government policies influenced the performance of the SMEs in Zimbabwe
Authors: Musabayana Godfrey Tambudzayi , Mutambara Emmanuel , Ngwenya Tony
Published: May 2022

The government policy framework provides the roadmap that can be used to implement the enacted policies to support the performance of SMEs. The Zimbabwean government came up with sound policies that were deliberately crafted to improve the performance of SMEs, but the main challenge was on the communication, implementation and support of the policies hence their impact was highly insignificant. This study established the extent to which how the government policies were effective in influencing the performance of SMEs in Zimbabwe. The study used mixed research method following the sequential exploratory strategy. The findings of this study indicate that the government managed to inform the elite group, its officers who are well versed with SME policies and government intentions were clearly communicated to all the experts in the SME sector, but this information did not cascade down to the SME implementers. The findings will assist the government to re-focus and develop a new strategic framework that will bring on board all the stakeholders in the SME sector. From the findings of the study, the researcher deduces that the poor performance of Zimbabwean SMEs is basically an issue of the government which failed to communicate its intentions to the implementers and this had a ripple negative effect across the whole economy of the country.
What evidence exists on the impact of climate change on some of the worst invasive fish and shellfish? A systematic map protocol
Authors: Azra Mohamad Nor , Noor Mohd Iqbal Mohd , Sung Yeong Yik , Lawrence Elizabeth R. , Ghaffar Mazlan Abd
Published: May 2022

Background

The Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) has estimated that invasive alien species (IAS) might cause billions of dollars of losses every year across the world. One example is South-East Asia, where IAS have caused an estimated loss of 33.5 billion USD, affecting the environment, human health, and agricultural production. Factors associated with climate change, such as increased carbon dioxide (CO2), heavy precipitation, and elevated temperatures is expected to facilitate biological invasion, leading only to further financial and public health loss. Thus, further study is needed to identify, collate and categorise what evidence exists on the impacts of climate change on fish and shellfish species that contribute to the list of “One Hundred of the World’s Worst Invasive Alien Species” as identified by the International Union for Conservation of Nature’s (IUCN). Such mapping will identify regions more at risk of biological invasion as climate change progresses.

Methods

We outline a systematic mapping review protocol that follows the Guideline and Standards for Evidence Synthesis in Environmental Management and RepOrting standards for Systematic Evidence Syntheses (ROSES). We describe how peer-reviewed articles will be collected from Web of Science and Scopus, and then analyzed to create knowledge maps on the impact climate change has on invasive species. Finally, we speculate on how our results will aid future management of invasive species in the light of climate change.
Anti-obesity effects of isoacteoside on 3T3-L1 adipocytes
Authors: Choi Chang Geun , Lee Deok Jae , Chung Namhyun , Joo Yong Hoon
Published: May 2022

Isoacteoside is a caffeoyl phenylethanoide glycoside found in various plant parts, such as the flower of Magnolia denudata. In particular, magnolia has been studied for its anti-obesity, anticancer, and anti-inflammatory effects. However, isoacteoside has not been extensively studied, except for its anti-inflammatory effects. In this study, the anti-obesity effects of isoacteoside were investigated in 3T3-L1 mouse pre-adipocytes. Isoacteoside treatment did not induce cytotoxicity in 3T3-L1 cells up to a concentration of 1000 μM. The anti-obesity effects on 3T3-L1 cells were confirmed using oil red O staining. In addition, the expression of obesity-related proteins and genes, such as peroxisome proliferator-activated acceptor gamma (PPARγ), CCAAT/enhancer-binding protein alpha (C/EBPα), and perilipin (PLIN1), was determined by western blotting and qRT-PCR assays to confirm the anti-obesity effects of isoacteoside. The results of this study suggest that isoacteoside, a natural substance isolated from plant extracts, is not highly toxic to normal cells, such as pre-adipocytes, and displays anti-obesity effects in vitro.
A rare phenomenon of pregorexia in Pakistani women: need to understand the related behaviors
Authors: Saleem Tamkeen , Saleem Shemaila , Shoib Sheikh , Shah Jaffer , Ali Syeda Ayat-e-Zainab
Published: May 2022

Background

In Pakistan, for a decade or so, there has been a huge increase in body ideals, and thinness and eating disorders reported during pregnancy. The purpose of the present research was to study the lived experiences and behaviors characterized by pregorexia in Pakistani young women.

Method

A phenomenological approach was used to study eating disorder-related behaviors among pregnant women. A criterion sample of 15 women (22–34 years of age) having difficulty with their body image, the decline in caloric intake, skipping meals, and extensive exercise from a private gynae clinic of Islamabad was selected. The participants were screened on the DSM-5 criteria of anorexia nervosa. They were also asked questions about their diet intake, behaviors executed to lose or maintain weight, use of any medical or chemical substance to control weight, any social activities/behaviors, type of exercise if any, duration or frequency of exercise, and behaviors that made them feel better.

Results

The findings revealed that 93.33% of women met the complete criteria of Anorexia nervosa. 86.6% had never been diagnosed or treated with anorexia nervosa, however, 13.33% were diagnosed with anorexia nervosa comorbid with depression. Results indicated a likelihood of having anorexic tendencies in 40% of women and the other 60% developed the symptoms during pregnancy only. Behaviors related to pregorexia were found to be: skipping meals, eating small portions, control on calorie intake, following diet plans available on YouTube, taking fat burn tea, avoiding the presence of elders of the family while taking meals, eating alone to limit food portion, taking laxatives or medicine to control weight, induced vomiting after eating, eating to match the norm of eating (supervised eating by elders) being pregnant and later self-induced vomiting, or eating slowly and consuming more time, pretending to eat the suitable amount of food. Women also engaged in fast walking, light exercise, and intensive cardio to control weight and stay in body shape. Around 86% reported that controlling weight, calorie intake, and exercising made them feel better.

Conclusion

There is a need to understand and differentiate pregorexia from other eating behaviors and problems among pregnant women with respect to cultural context.
Focused self-explanation prompts and segmenting foster pre-service teachers’ professional vision - but only during training!
Authors: Martin Monika , Farrell Meg , Seidel Tina , Rieß Werner , Könings Karen D. , van Merriënboer Jeroen J. G. , Renkl Alexander
Published: May 2022

When analyzing classroom video, pre-service teachers can improve their professional vision, that is, their ability to notice important events in a classroom and to interpret them based on theoretical knowledge. However, learning with video is especially challenging for novice learners. Thus, video needs to be embedded into an instructional context to be effective. In an experimental study with 89 pre-service biology teachers, we investigated the effect of a short professional vision training and whether two design principles from multimedia learning research—namely segmenting and self-explanation prompts—could additionally increase training effects. In a one-hour training session on small-group tutoring strategies, participants watched practice video examples either as a whole or segmented. After each video or video segment, respectively, they received either open or focused self-explanation prompts to analyze the scene. We assessed participants’ professional vision skills before and after training. Overall, participants’ performance substantially increased from pretest to posttest. Moreover, during training, both segmented video examples and focused self-explanation prompts led to increased noticing of relevant strategies. This advantage during training, however, did not result in higher professional vision improvement in posttest scores compared to participants who worked in the less supported training phase conditions. We discuss possible explanations why additional support increased training performance but not learning gains and suggest an additional fading phase as a means to achieve persistent effects.
Comparative cytotoxic activity of Convolvulus pluricaulis against human hepatoma cell line (HepG2) and normal cell line (L929) via apoptosis pathways by flow cytometry analysis
Authors: Tamboli Ashpak Mubarak , Wadkar Kiran Anna
Published: May 2022

Background

The purpose of this study was to use the MTT test to assess the cytotoxic effects of different extracts ofConvolvulus pluricaulisleavesin vitro.Convolvulus pluricaulisleaf ethanolic extract has been demonstrated to trigger apoptosis on HepG2 cancer cell lines, implying anti-cancer activity.

Methods

The cells were grown in culture DMEM and incubated with different concentrations of the plant extracts. Survival rates were quantified by MTT assays by 24 h of exposure to (640–20 µg/ml) the PEE, CHCl3E, EAE, ETHE and AQE of the plant, while monitoring changes on cellular shapes by inverted phase contrast microscopy (PEE—petroleum ether extract, CHCl3—chloroform extract, EAE—ethyl acetate extract, ETHE—ethanol extract, AQE—aqueous extract).

Results

TheConvolvulus pluricaulisleaves extract showed IC50value < 1000 μg/ml on HepG2 and IC50value > 1000 µg/ml on L-929 cell lines. Hence,Convolvulus pluricaulisleaves extracts are non-toxic against the normal cell line L-929. Treatments with standard as a control exhibited necrotic features in both cell lines. On the basis of these findings, and because a highly effective extract ETHE has a partial polarity, this plant cytotoxicity and apoptotic activities were also investigated. On HepG2 cell line, the ETHE showed higher cytotoxicity activities compared to AQE, EAE, CHCl3E, and PEE extracts (P < 0.0001) with inhibitory concentration IC50values of 35.873 μg/ml that is < 1000 μg/ml. The percentage of apoptotic cells of ETHE was determined using propidium iodide (PI) staining of DNA fragments by flow cytometry.

Conclusions

The extract ofConvolvulus pluricaulishas cytotoxic and apoptotic action against the HepG2 cell line, indicating that it should be studied further for cancer therapies.
Microbiome differences between wild and aquarium whitespotted eagle rays (Aetobatus narinari)
Authors: Clavere-Graciette Ana G. , McWhirt Mary E. , Hoopes Lisa A. , Bassos-Hull Kim , Wilkinson Krystan A. , Stewart Frank J. , Pratte Zoe A.
Published: May 2022

Background

Animal-associated microbiomes can be influenced by both host and environmental factors. Comparing wild animals to those in zoos or aquariums can help disentangle the effects of host versus environmental factors, while also testing whether managed conditions foster a ‘natural’ host microbiome. Focusing on an endangered elasmobranch species—the whitespotted eagle rayAetobatus narinari—we compared the skin, gill, and cloaca microbiomes of wild individuals to those at Georgia Aquarium. Whitespotted eagle ray microbiomes from Georgia Aquarium were also compared to those of cownose rays (Rhinoptera bonasus) in the same exhibit, allowing us to explore the effect of host identity on the ray microbiome.

Results

Long-term veterinary monitoring indicated that the rays in managed care did not have a history of disease and maintained health parameters consistent with those of wild individuals, with one exception. Aquarium whitespotted eagle rays were regularly treated to control parasite loads, but the effects on animal health were subclinical. Microbiome α- and β-diversity differed between wild versus aquarium whitespotted eagle rays at all body sites, with α-diversity significantly higher in wild individuals. β-diversity differences in wild versus aquarium whitespotted eagle rays were greater for skin and gill microbiomes compared to those of the cloaca. At each body site, we also detected microbial taxa shared between wild and aquarium eagle rays. Additionally, the cloaca, skin, and gill microbiomes of aquarium eagle rays differed from those of cownose rays in the same exhibit. Potentially pathogenic bacteria were at low abundance in all wild and aquarium rays.

Conclusion

For whitespotted eagle rays, managed care was associated with a microbiome differing significantly from that of wild individuals. These differences were not absolute, as the microbiome of aquarium rays shared members with that of wild counterparts and was distinct from that of a cohabitating ray species. Eagle rays under managed care appear healthy, suggesting that their microbiomes are not associated with compromised host health. However, the ray microbiome is dynamic, differing with both environmental factors and host identity. Monitoring of aquarium ray microbiomes over time may identify taxonomic patterns that co-vary with host health.
Cardiac angiosarcoma: a case report of a young female with pulmonary metastasis
Authors: Pournazari Mehran , Assar Shirin , Mohamadzadeh Dena , Mahdian Maryam , Soltani Setareh
Published: May 2022

Background

Angiosarcoma is a malignant rare tumor that originates from vascular endothelial cells that cover lymphatic or blood vessels. Cardiac angiosarcoma is the most prevalent sarcoma entail the heart. It has low incidence rate and poor prognosis. Our effort through this report was raising awareness of uncommon manifestations of this disease and showing the importance of appropriate diagnosis and treatment.

Case presentation

We present a case of cardiac angiosarcoma in a young female whose symptoms included dyspnea and hemoptysis with a history of pericardial effusion and a past history of cardiac surgery for suspected atrial Myxoma. She had history of several hospitalizations and relapse of symptoms a few months after each hospital discharge.

Conclusions

The unspecific symptoms of cardiac angiosarcoma made it difficult to make in time diagnose and appropriate treatment. Awareness of unspecific presentations of cardiac angiosarcoma is necessary for proper diagnosis and treatment while delayed diagnosis may worsen the prognosis and even lead to death.
Use of a deep-learning-based lumen extraction method to detect significant stenosis on coronary computed tomography angiography in patients with severe coronary calcification
Authors: Inage Hidekazu , Tomizawa Nobuo , Otsuka Yujiro , Aoshima Chihiro , Kawaguchi Yuko , Takamura Kazuhisa , Matsumori Rie , Kamo Yuki , Nozaki Yui , Takahashi Daigo , Kudo Ayako , Hiki Makoto , Kogure Yosuke , Fujimoto Shinichiro , Minamino Tohru , Aoki Shigeki
Published: May 2022

Background

Coronary computed tomography angiography examinations are increasingly becoming established as a minimally invasive method for diagnosing coronary diseases. However, although various imaging and processing methods have been developed, coronary artery calcification remains a major limitation in the evaluation of the vascular lumen. Subtraction coronary computed tomography angiography (Sub-CCTA) is a method known to be able to reduce the influence of coronary artery calcification and is therefore feasible for improving the diagnosis of significant stenosis in patients with severe calcification. However, Sub-CCTA still involves some problems, such as the increased radiation dose due to plain (mask) imaging, extended breath-holding time, and misregistration due to differences in the imaging phase. Therefore, we considered using artificial intelligence instead of Sub-CCTA to visualize the coronary lumen with high calcification. Given this background, the present study aimed to evaluate the diagnostic performance of a deep learning-based lumen extraction method (DL-LEM) to detect significant stenosis on CCTA in 99 consecutive patients (891 segments) with severe coronary calcification from November 2015 to March 2018. We also estimated the impact of DL-LEM on the medical economics in Japan.

Results

The DL-LEM slightly improved the per-segment diagnostic accuracy from 74.5 to 76.4%, and the area under the curve (AUC) slightly improved from 0.752 to 0.767 (p = 0.030). When analyzing the 228 segments that could not be evaluated because of severe calcification on the original CCTA images, the DL-LEM improved the accuracy from 35.5 to 42.5%, and the AUC improved from 0.500 to 0.587 (p = 0.00018). As a result, DL-LEM analysis could have avoided invasive coronary angiography in 4/99 cases (per patient). From the calculated results, it was estimated that the number of exams that can be avoided in Japan in one year is approximately 747 for invasive coronary angiography, 219 for fractional flow reserve, and 248 for nuclear exam. The total amount of medical fee that could be reduced was 225,629,368 JPY.

Conclusions

These findings suggest that the DL-LEM may improve the diagnostic performance in detecting significant stenosis in patients with severe coronary calcification. In addition, the results suggest that not a small medical economic effect can be expected.
Cardiac surgery and the sustainable development goals: a review
Authors: Ghandour Hiba , Vervoort Dominique , Ravishankar Ramanish , Swain Ja Baris D.
Published: May 2022

Background

In 2015, the United Nations adopted the Sustainable Development Goals (SDGs) as key priorities to improve the global health and international development agenda in an intersectoral manner, highlighting 17 SDGs. Six billion people lack access to safe, timely, and affordable cardiac surgical care due to capacity, geographic, and financial barriers. Nevertheless, cardiac surgery is largely disregarded on the global health agenda. In this review, we explore the intersection between cardiac surgery and the SDGs to delineate potential policy and advocacy avenues for the cardiothoracic surgical community.

Main body

A narrative review was performed using the PubMed/MEDLINE, Scopus, and WHO databases with variations of the search terms “cardiac surgery,” “cardiovascular diseases,” and keywords extracted from individual SDGs. All SDGs were manually reviewed to define intersectionality with global cardiac surgery. Out of 17 SDGs, 15 are relevant and require additional attention from the cardiovascular community. SDG3, “Good Health and Well-being,” is the most relevant, although the intersection between global cardiac surgery and other SDGs is apparent. A call for interdisciplinary collaboration through increased preventive mechanisms, rigorous, all-inclusive clinical trials, advocacy with relevant legislators, and mobilizing capacity building mechanisms are made.

Conclusion

Meeting the SDGs will require recognition of cardiovascular disease management, including cardiac surgical care. Cardiac surgeons are essential stakeholders of multidisciplinary collaborations working to improve access to safe, timely, and affordable cardiac surgery for all. Their role as advocates will be vital to establish local, national, regional, and international partnerships and to ensure progress towards SDG attainment.
Osimertinib-induced hearing loss: an uncommon aftereffect of a novel drug—a case report
Authors: Lim Chee Chean , Lu Jia Lei , Kulasegarah Jeyanthi
Published: May 2022

Background

Epidermal growth factor  receptor (EGFR) tyrosine kinase inhibitors (TKIs) have significantly improved survival outcomes of advanced non-small cell lung cancer (NSCLC). Nonetheless, usage of TKIs is not without adverse effects, as it has been reported to cause irreversible sensorineural hearing loss (SNHL).

Case presentation

We describe a 72-year-old man who experienced hearing loss after taking osimertinib for 6 months. Later, his hearing further declined over a period of 1 year. Hearing rehabilitation with high-powered behind-the-ear (BTE) hearing aid has helped to improve his quality of life to some degree. There were no other known causative factors leading to the hearing deterioration. To date, there is no case report on osimertinib-induced SNHL.

Conclusion

Physicians ought to counsel patients on osimertinib of this rare side effect and monitor for early signs of hearing loss. Treatment protocol should be in place taking into account that they have either failed or likely to fail the first- or second-line treatments and have advanced stage disease.