bluuebunny/crossref_metadata_2025 huggingface dataset:
Metal-Organic Frameworks With Variable Valence Metal-Photoactive Components: Emerging Platform for Volatile Organic Compounds Photocatalytic Degradation
Authors: Qian Yuhang , Ma Dongge , Zhong Junbo
Published: November 2021

With their outstanding diversities in both structures and performances, newly emerging metal-organic frameworks (MOFs) materials are considered to be the most promising artificial catalysts to meet multiple challenges in the fields of energy and environment. Especially in absorption and conversion of solar energy, a variety of MOFs can be readily designed to cover and harvest the sun irradiation of ultraviolet (UV), visible and near-infrared region through tuning both organic linkers and metal nodes to create optimal photocatalytic efficiency. Nowadays, a variety of MOFs were successfully synthesized as powerful photocatalysts for important redox reactions such as water-splitting, CO2 reduction and aqueous environmental pollutants detoxification. MOFs applications in indoor-air VOCs pollutants cleaning, however, are less concerned partially because of limited diffusion of both gaseous pollutant molecules and photo-induced active species in very porous MOFs structures. In this mini-review, we focus on the major breakthroughs of MOFs as photocatalysts for the effective removal of indoor-air VOCs such as aldehydes, aromatics and short-chain alcohols. According to their nature of photoactive centers, herein MOFs photocatalysts are divided into two categories to comment, that is, MOFs with variable valence metal nodes as direct photoactive centers and MOFs with non-variable valence metal nodes but after combining other photoactive variable valence metal centers as excellent concentrated and concerted electron-transfer materials. The mechanisms and current challenges of the photocatalytic degradation of indoor-air VOC pollutants by these MOFs will be discussed as deeply as possible.
Protein and Water Distribution Across Visual Axis in Mouse Lens: A Confocal Raman MicroSpectroscopic Study for Cold Cataract
Authors: Li Yao , Li Yuxing , Liu Xi , He Yonghong , Guan Tian
Published: November 2021

Purpose: The aims of the study were to investigate cellular mechanisms of cold cataract in young lenses of wild-type C57BL/6J (B6WT) mice treated at different temperatures and to test a hypothesis that cold cataract formation is associated with the changes in lens protein and water distribution at different regions across lens fiber cells by Raman spectroscopy (RS).

Methods: RS was utilized to scan the mouse lens at different regions with/without cold cataract. Three regions with various opacification along the equatorial axis in the anterior–posterior lens section were scanned. The intensity ratio of Raman bands at 2,935 and 3,390 cm−1 (Ip/Iw) were used to evaluate lens protein and water distribution. We further determined water molecular changes through Gaussian profiles of water Raman spectra.

Results: Three specific regions 1, 2, and 3, located at 790–809, 515–534, and 415–434 μm away from the lens center, of postnatal day 14 B6WT lenses, were subjected to RS analysis. At 37°C, all three regions were transparent. At 25°C, only region 3 became opaque, while at 4°C, both regions 2 and 3 showed opacity. The sum of the difference between Ip/Iw and the value of linear fitting line from scattered-line at each scanning point was considered as fluctuation degree (FD) in each region. Among different temperatures, opaque regions showed relatively higher FD values (0.63 and 0.79 for regions 2 and 3, respectively, at 4°C, and 0.53 for region 3 at 25°C), while transparent regions provided lower FD values (less than 0.27). In addition, the decrease in Gaussian peak II and the rising of Gaussian peak III and IV from water Raman spectra indicated the instability of water molecule structure in the regions with cold cataract.

Conclusion: Fluctuation degrees of RS data reveal new mechanistic information about cold cataract formation, which is associated with uneven distribution of lens proteins and water across lens fiber cells. It is possible that RS data partly reveals cold temperature-induced redistribution of lens proteins such as intermediate filaments in inner fiber cells. This lens protein redistribution might be related to unstable structure of water molecules according to Gaussian profiles of water RS.
Valorization of Urban Street Tree Pruning Residues in Biorefineries by Steam Refining: Conversion Into Fibers, Emulsifiers, and Biogas
Authors: Hagel Sebastian , Lüssenhop Phillipp , Walk Steffen , Kirjoranta Satu , Ritter Annalena , Bastidas Jurado Carla Gabriela , Mikkonen Kirsi S. , Tenkanen Maija , Körner Ina , Saake Bodo
Published: November 2021

Street tree pruning residues are a widely available and currently undervalorized bioresource. Their utilization could help alleviate an increasing biomass shortage and offset costs of the pruning process for the municipalities. In this work, a holistic valorization pathway of pruning residues leading to fibers, oligosaccharides, biogas, and compost is presented. For this, representative mixtures of tree pruning materials from the most prevalent street tree genera (oak, linden, maple) found in Hamburg (Germany) were prepared by shredding and cleaning procedures. Collection of sample material was performed in summer and winter to account for seasonality. A steam-based fractionation was conducted using treatment severities ranging from log R0= 2.5 to 4.0. At the highest severity, a fiber yield of around 66%, and liquor yield of 26–30% was determined. The fibers were evaluated with respect to their properties for paper product applications, with higher treatment severities leading to higher paper strengths. From the oligosaccharide-rich liquor, emulsions were created, which showed promising stability properties over 8 weeks of storage. The liquors and the rejects from the material preparation also displayed good potential for biomethane production. Overall, the differences between material collected in summer and winter were found to be small, indicating the possibility for a year-round utilization of pruning residues. For the presented utilization pathway, high severity treatments were the most promising, featuring a high liquor yield, good biomethane potential, and the highest paper strengths.
Interventional Treatment of Access Site Complications During Transfemoral TAVI: A Single Center Experience
Authors: Thieme Marcus , Moebius-Winkler Sven , Franz Marcus , Baez Laura , Schulze Christian P. , Butter Christian , Edlinger Christoph , Kretzschmar Daniel
Published: November 2021

Introduction:Transcatheter aortic valve implantation (TAVI) has rapidly developed over the last decade and is nowadays the treatment of choice in the elderly patients irrespective of surgical risk. The outcome of these patients is mainly determined not only by the interventional procedure itself, but also by its complications.

Material and Methods:We analyzed the outcome and procedural events of transfemoral TAVI procedures performed per year at our institution. The mean age of these patients is 79.2 years and 49% are female. All the patients underwent duplex ultrasonography of the iliac arteries and inguinal vessels before the procedure and CT of the aorta and iliac arteries.

Results:Transfemoral access route is associated with a number of challenges and complications, especially in the patients suffering from peripheral artery disease (PAD). The rate of vascular complications at our center was 2.76% (19/689). Typical vascular complications (VC) include bleeding and pseudoaneurysms at the puncture site, acute or subacute occlusion of the access vessel, and dissection or perforation of the iliac vessels. In addition, there is the need for primary PTA of the access pathway in the presence of additional PAD of the common femoral artery (CFA) and iliac vessels. Balloon angioplasty, implantation of covered and uncovered stents, lithoplasty, and ultrasound-guided thrombin injection are available to treat the described issues.

Conclusion:Interventional therapy of access vessels can preoperatively enable the transfemoral approach and successfully treat post-operative VC in most of the cases. Training the heart team to address these issues is a key focus, and an interventional vascular specialist should be part of this team.
Performance Improvement Strategies for Discrete Wide Bandgap Devices: A Systematic Review
Authors: Tahir Mustafa , Hu Sideng , He Xiangning
Published: November 2021

Wide bandgap (WBG) devices are becoming increasingly popular due to their excellent material properties. WBG devices are commercially available in discrete and module packages. Many studies have investigated the design, structure and benefits of module packages. However, a comprehensive and in-depth overview of the discrete package is lacking. Discrete package has the advantages of flexibility, scalability and reduced cost; however, challenges of severe switching oscillations and limited current capacity are associated with it. This review encompasses the switching oscillations and limited current capacity issues of discrete devices. Switching oscillations are categorized in terms of voltage. The underlying oscillation mechanisms are explored in detail. For the current imbalance, the types, root causes and adverse effects in parallel-connected discrete devices application are reviewed. Besides, the most recent techniques to extract stray parameters are also explored. Finally, state-of-the-art methods to mitigate the switching oscillations and the current imbalance are summarized and evaluated. The performance improvement strategies discussed in this paper can assist researchers to better use the discrete package and can stimulate them to come up with new solutions.
The Leptin Axis and Its Association With the Adaptive Immune System in Breast Cancer
Authors: García-Estevez Laura , González-Martínez Silvia , Moreno-Bueno Gema
Published: November 2021

Adipose tissue secretes various peptides, including leptin. This hormone acts through the leptin receptor (Ob-R), which is expressed ubiquitously on the surface of various cells, including breast cancer cells and immune cells. Increasing evidence points to an interaction between the tumor microenvironment, tumor cells, and the immune system. Leptin plays an important role in breast cancer tumorigenesis and may be implicated in activation of the immune system. While breast cancer cannot be considered an immunogenic cancer, the triple-negative subtype is an exception. Specific immune cells - tumor infiltrating lymphocytes - are involved in the immune response and act as predictive and prognostic factors in certain breast cancer subtypes. The aim of this article is to review the interaction between adipose tissue, through the expression of leptin and its receptor, and the adaptive immune system in breast cancer.
A Fuzzy-Based Framework for Assessing Uncertainty in Drift Prediction Using Observed Currents and Winds
Authors: Blanken Hauke , Valeo Caterina , Hannah Charles , Khan Usman T. , Juhász Tamás
Published: November 2021

This paper proposes a fuzzy number—based framework for quantifying and propagating uncertainties through a model for the trajectories of objects drifting at the ocean surface. Various sources of uncertainty that should be considered are discussed. This model is used to explore the effect of parameterizing direct wind drag on the drifting object based on its geometry, and using measured winds to parameterize shear and rotational dynamics in the ocean surface currents along with wave-driven circulation and near-surface wind shear. Parameterizations are formulated in a deterministic manner that avoids the commonly required specification of empirical leeway coefficients. Observations of ocean currents and winds at Ocean Station Papa in the northeast Pacific are used to force the trajectory model in order to focus on uncertainties arising from physical processes, rather than uncertainties introduced by the use of atmospheric and hydrodynamic models. Computed trajectories are compared against observed trajectories from five different types of surface drifters, and optimal combinations of forcing parameterizations are identified for each type of drifter. The model performance is assessed using a novel skill metric that combines traditional assessment of trajectory accuracy with penalties for overestimation of uncertainty. Comparison to the more commonly used leeway method shows similar performance, without requiring the specification of empirical coefficients. When using optimal parameterizations, the model is shown to correctly identify the area in which drifters are expected to be found for the duration of a seven day simulation.
Derivation and Evaluation of Satellite-Based Surface Current
Authors: Choi Jun Myoung , Kim Wonkook , Hong Tran Thy My , Park Young-Gyu
Published: November 2021

Observations of real-time ocean surface currents allow one to search and rescue at ocean disaster sites and investigate the surface transport and fate of ocean contaminants. Although real-time surface currents have been mapped by high-frequency (HF) radar, shipboard instruments, satellite altimetry, and surface drifters, geostationary satellites have proved their capability in satisfying both basin-scale coverage and high spatiotemporal resolutions not offered by other observational platforms. In this paper, we suggest a strategy for the production of operational surface currents using geostationary satellite data, the particle image velocimetry (PIV) method, and deep learning-based evaluation. We used the model scalar field and its gradient to calculate the corresponding surface current via PIV, and we estimated the error between the true velocity field and calculated velocity field by the combined magnitude and relevance index (CMRI) error. We used the model datasets to train a convolutional neural network, which can be used to filter out bad vectors in the surface current produced by arbitrary model scalar fields. We also applied the pretrained network to the surface current generated from real-time Himawari-8 skin sea surface temperature (SST) data. The results showed that the deep learning network successfully filtered out bad vectors in a surface current when it was applied to model SST and created stronger dynamic features when the network was applied to Himawari SST. This strategy can help to provide a quality flag in satellite data to inform data users about the reliability of PIV-derived surface currents.
A Review of Factors Influencing the Seagrass-Sea Cucumber Association in Tropical Seagrass Meadows
Authors: Floren Adonis S. , Hayashizaki Ken-ichi , Putchakarn Sumaitt , Tuntiprapas Piyalap , Prathep Anchana
Published: November 2021

In the tropical ecosystem, sea cucumbers are associated with seagrass meadows in various ways, often forming a network of ecological interactions. From this myriad of interactions, the trophic relationship between the seagrasses and sea cucumbers has received recent attention with the advent of analytical techniques. However, little is understood about the exact mechanism by which seagrasses are sustaining the sea cucumber populations in the food chain, considering the high number of refractory components in seagrasses and the lack of digestive enzymes among sea cucumbers. This manuscript aims to review existing concepts in ecology concerning the association between tropical seagrasses and sea cucumbers to provide directions for research and management of this vital resource. We searched literature from electronic databases and identified key concepts concerning sea cucumber and seagrass communities based on geographic distribution, nutrient compositions, seagrass decomposition process, and trophic enrichments in the food chain. A conceptual model was then developed detailing the factors influencing the association between the seagrass meadows and sea cucumbers. Despite the limited published information on the seagrass–sea cucumber association, a synthesis of the current understanding of this topic is provided to address the declining sea cucumber populations in the tropical seagrass meadows. We suggest that the successful restoration of sea cucumber fisheries requires a thorough understanding of the seagrass decomposition process, which is vital to the diet of sea cucumbers.
“Pink Pattern” Visualized in Magnifying Endoscopy With Narrow-Band Imaging Is a Novel Feature of Early Differentiated Gastric Cancer: A Bridge Between Endoscopic Images and Histopathological Changes
Authors: Chen Shengsen , Yu Jiangping , Ruan Rongwei , Li Yandong , Tao Yali , Shen Qiwen , Cui Zhao , Shen Cheng , Wang Huogen , Jin Jiayan , Chen Ming , Jin Chaohui , Wang Shi
Published: November 2021

Background: A pink color change occasionally found by us under magnifying endoscopy with narrow-band imaging (ME-NBI) may be a special feature of early gastric cancer (EGC), and was designated the “pink pattern”. The purposes of this study were to determine the relationship between the pink pattern and the cytopathological changes in gastric cancer cells and whether the pink pattern is useful for the diagnosis of EGC.

Methods: The color features of ME-NBI images and pathological images of cancerous gastric mucosal surfaces were extracted and quantified. The cosine similarity was calculated to evaluate the correlation between the pink pattern and the nucleus-to-cytoplasm ratio of cancerous epithelial cells. Two diagnostic tests were performed by 12 endoscopists using stored ME-NBI images of 185 gastric lesions to investigate the diagnostic efficacy of the pink pattern for EGC. The diagnostic values, such as the area under the curve (AUC), the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), of test 1 and test 2 were compared.

Results: The cosine similarity between the color values of ME-NBI images and pathological images of 20 lesions was at least 0.744. The median AUC, accuracy, sensitivity, specificity, PPV, and NPV of test 2 were significantly better than those of test 1 for all endoscopists and for the junior and experienced groups.

Conclusions: The pink pattern observed in ME-NBI images correlated strongly with the change in the nucleus-to-cytoplasm ratio of gastric epithelial cells, and could be considered a useful marker for the diagnosis of differentiated EGC.
Impact of COVID-19 on Continuing Medical Education—Results of an Online Survey Among Users of a Non-profit Multi-Specialty Live Online Education Platform
Authors: Schulte Tobias L. , Gröning Thilo , Ramsauer Babett , Weimann Jörg , Pin Martin , Jerusalem Karen , Ridwan Sami
Published: November 2021

Background: The Coronavirus Disease-2019 (COVID-19) pandemic accelerated digitalization in medical education. Continuing medical education (CME) as a substantial component of this system was relevantly affected. Here, we present the results of an online survey highlighting the impact on and the role of online CME.

Methods: An online survey of 44 questions was completed by users of a German online CME platform receiving an invitation via newsletter. CME habits, requirements, personal perception, and impact of the pandemic were inquired. Standard statistical methods were applied.

Results: A total of 2,961 responders took the survey with 2,949 completed surveys included in the final analysis. Most contributions originated from Germany, Austria, and Switzerland. Physicians accounted for 78.3% (57.5% hospital doctors) of responses followed by midwives (7.3%) and paramedics (5.7%). Participating physicians were mainly board-certified specialists (69%; 55.75% hospital specialists, 13.25% specialists in private practice). Frequent online lectures at regular intervals (77.8%) and combined face-to-face and online CME (55.9%) were favored. A duration of 1–2 h was found ideal (57.5%). Technical issues were less a major concern since the pandemic.

Conclusion: A shift from face-to-face toward online CME events was expectedly detected since the outbreak. Online CME was accelerated and promoted by the pandemic. According to the perception of users, the CME system appears to have reacted adequately to meet their demand but does not replace human interaction.
Prevalence of Insomnia Symptoms in Older Chinese Adults During the COVID-19 Pandemic: A Meta-Analysis
Authors: Zhang Qian-Qian , Li Lan , Zhong Bao-Liang
Published: November 2021

Background: The ongoing COVID-19 pandemic has disproportionately affected the sleep health of older adults, but the limited number of studies on insomnia symptoms of older Chinese adults differed in terms of screener of insomnia, sample size, and prevalence, making mental health planning for this population difficult. This meta-analysis estimated the prevalence of insomnia symptoms in older Chinese adults during the COVID-19 pandemic.

Methods: Both Chinese (CNKI, Wanfang, VIP) and English (PubMed, EmBase, PsycInfo) databases were systematically searched to identify cross-sectional studies containing data on the prevalence of insomnia symptoms in older Chinese adults during the pandemic. Risk of bias (RoB) of included studies was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.

Results: Nine studies with a total of 27,207 older Chinese adults were included. RoB scores of these studies ranged between zero and six. The pooled prevalence rates of insomnia symptoms and moderate and severe insomnia symptoms were 24.6% [95% confidence interval (CI): 19.5–30.5%] and 11.1% (95% CI: 7.2–16.9%), respectively. In subgroup analysis, significantly higher prevalence rates were observed in studies defining insomnia symptoms as “Insomnia Severity Index (ISI) ≥ 8” than in those defining them as “ISI ≥ 15” (32.6 vs. 15.6%, P < 0.001) and in older adults living in the COVID-19 epicenter than in those living in other places (35.2 vs. 23.3%, P = 0.006).

Conclusion: Nearly one out of every four older Chinese adults suffered from insomnia symptoms during the pandemic. Mental health services for this population during the pandemic should include supportive activities aimed at improving mental well-being, periodic assessment of insomnia symptoms, and psychiatric assessment and treatment when necessary.
Elevated Red Cell Distribution Width to Platelet Ratio Is Associated With Poor Prognosis in Patients With Spontaneous, Deep-Seated Intracerebral Hemorrhage
Authors: Lehmann Felix , Schenk Lorena M. , Bernstock Joshua D. , Bode Christian , Borger Valeri , Gessler Florian A. , Güresir Erdem , Hamed Motaz , Potthoff Anna-Laura , Putensen Christian , Schneider Matthias , Zimmermann Julian , Vatter Hartmut , Schuss Patrick , Hadjiathanasiou Alexis
Published: November 2021

Object: Inflammatory response is an important determinant of subsequent brain injury after deep-seated intracerebral hemorrhage (ICH). The ratio of red blood cell (RBC) distribution width to platelet count (RPR) has been established as a new index to reflect the severity of inflammation. To the best of our knowledge, no association between RPR and prognosis after spontaneous ICH has yet been reported.

Methods: In all patients with deep-seated ICH treated at our Neurovascular Center from 2014 to 2020, initial laboratory values were obtained to determine RPR in addition to patient characteristics and known risk factors. Subsequent multivariate analysis was performed to identify independent risk factors for 90-day mortality after deep-seated ICH.

Results: Hundred and two patients with deep-seated ICH were identified and further analyzed. Patients with an initial RPR < 0.06 exhibited significantly lower mortality rate after 90 days than those with an initial RPR ≥ 0.06 (27 vs. 57%; p = 0.003). Multivariate analysis identified “ICH score ≥ 3” (p = 0.001), “anemia on admission” (p = 0.01), and “elevated RPR ≥ 0.06” (p = 0.03) as independent predictors of 90-day mortality.

Conclusions: The present study constitutes the first attempt to demonstrate that the ratio of RBC distribution width to platelets—as an independent inflammatory marker—might serve for prognostic assessment in deep-seated ICH.
Resources Underlying Visuo-Spatial Working Memory Enable Veridical Large Numerosity Perception
Authors: Castaldi Elisa , Piazza Manuela , Eger Evelyn
Published: November 2021

Humans can quickly approximate how many objects are in a visual image, but no clear consensus has been achieved on the cognitive resources underlying this ability. Previous work has lent support to the notion that mechanisms which explicitly represent the locations of multiple objects in the visual scene within a mental map are critical for both visuo-spatial working memory and enumeration (at least for relatively small numbers of items). Regarding the cognitive underpinnings of large numerosity perception, an issue currently subject to much controversy is why numerosity estimates are often non-veridical (i.e., susceptible to biases from non-numerical quantities). Such biases have been found to be particularly pronounced in individuals with developmental dyscalculia (DD), a learning disability affecting the acquisition of arithmetic skills. Motivated by findings showing that DD individuals are also often impaired in visuo-spatial working memory, we hypothesized that resources supporting this type of working memory, which allow for the simultaneous identification of multiple objects, might also be critical for precise and unbiased perception of larger numerosities. We therefore tested whether loading working memory of healthy adult participants during discrimination of large numerosities would lead to increased interference from non-numerical quantities. Participants performed a numerosity discrimination task on multi-item arrays in which numerical and non-numerical stimulus dimensions varied congruently or incongruently relative to each other, either in isolation or in the context of a concurrent visuo-spatial or verbal working memory task. During performance of the visuo-spatial, but not verbal, working memory task, precision in numerosity discrimination decreased, participants’ choices became strongly biased by item size, and the strength of this bias correlated with measures of arithmetical skills. Moreover, the interference between numerosity and working memory tasks was bidirectional, with number discrimination impacting visuo-spatial (but not verbal) performance. Overall, these results suggest that representing visual numerosity in a way that is unbiased by non-numerical quantities relies on processes which explicitly segregate/identify the locations of multiple objects that are shared with visuo-spatial (but not verbal) working memory. This shared resource may potentially be impaired in DD, explaining the observed co-occurrence of working memory and numerosity discrimination deficits in this clinical population.
The Effect of Repetitive Transcranial Magnetic Stimulation on Dysphagia After Stroke: A Systematic Review and Meta-Analysis
Authors: Yang Weiwei , Cao Xiongbin , Zhang Xiaoyun , Wang Xuebing , Li Xiaowen , Huai Yaping
Published: November 2021

Objective: The primary purpose of our study is to systemically evaluate the effect of repetitive transcranial magnetic stimulation (rTMS) on recovery of dysphagia after stroke.

Search Methods: We searched randomized controlled trials (RCTs) and non-RCTs published by PubMed, the Cochrane Library, ScienceDirect, MEDLINE, and Web of Science from inception until April 24, 2021. Language is limited to English. After screening and extracting the data, and evaluating the quality of the selected literature, we carried out the meta-analysis with software RevMan 5.3 and summarized available evidence from non-RCTs.

Results: Among 205 potentially relevant articles, 189 participants (from 10 RCTs) were recruited in the meta-analysis, and six non-RCTs were qualitatively described. The random-effects model analysis revealed a pooled effect size of SMD = 0.65 (95% CI = 0.04–1.26, p = 0.04), which indicated that rTMS therapy has a better effect than conventional therapy. However, the subgroup analysis showed that there was no significant difference between low-frequency and high-frequency groups. Even more surprisingly, there were no statistically significant differences between the two groups and the conventional training group in the subgroup analysis, but the combined effect was positive.

Conclusion: Our study suggests that rTMS might be effective in treating patients with dysphagia after stroke.
Higher Animal Protein Intake During the Second Trimester of Pregnancy Is Associated With Risk of GDM
Authors: Yong Heng Yaw , Mohd Shariff Zalilah , Mohd Yusof Barakatun Nisak , Rejali Zulida , Tee Yvonne Yee Siang , Bindels Jacques , van der Beek Eline M.
Published: November 2021

Background and Aims: This study aimed to examine the associations between the total protein intake as well as types and sources of proteins with the gestational diabetes mellitus (GDM) risk.

Method and Results: This was a prospective cohort study of the pregnant women in Malaysia. In this study, the total, animal, and plant protein intakes were assessed using a semi-quantitative food frequency questionnaire. Of the 452 women, 48 (10.62%) were diagnosed with GDM. From pre-pregnancy to second trimester, most of the women had 10–20% of energy intake from protein (88.9–90.3%) and ≥75% of recommended protein intake (74.6–86.5%). The women in the highest tertile (T3) of total animal protein intake [adjusted odds ratio (AOR) = 2.76, 95% CI = 1.27–6.04] and red meat protein (AOR = 2.69, 95% CI = 1.27–5.70), specifically in the second trimester, had significantly higher GDM risk compared with the women in the middle tertile of intake (T2). Interestingly, the women in the T3 of egg protein in the second trimester were significantly at lower GDM risk (AOR = 0.43, 95% CI = 0.18–0.91) compared with those in T2.

Conclusion: The highest tertile of animal protein (≥42.15 g/day) intake, particularly red meat protein in the second trimester was positively associated with the GDM risk, whereas the highest tertile of egg protein was inversely associated with the GDM risk. Protein intake before or during early pregnancy was not associated with the GDM risk. These findings underscore the importance of sources and types of protein intake, particularly after the first trimester of pregnancy, in relation to GDM risk.
Machine Learning-Based Radiomics Nomogram With Dynamic Contrast-Enhanced MRI of the Osteosarcoma for Evaluation of Efficacy of Neoadjuvant Chemotherapy
Authors: Zhang Lu , Ge Yinghui , Gao Qiuru , Zhao Fei , Cheng Tianming , Li Hailiang , Xia Yuwei
Published: November 2021

Objectives

This study aims to evaluate the value of machine learning-based dynamic contrast-enhanced MRI (DCE-MRI) radiomics nomogram in prediction treatment response of neoadjuvant chemotherapy (NAC) in patients with osteosarcoma.

Methods

A total of 102 patients with osteosarcoma and who underwent NAC were enrolled in this study. All patients received a DCE-MRI scan before NAC. The Response Evaluation Criteria in Solid Tumors was used as the standard to evaluate the NAC response with complete remission and partial remission in the effective group, stable disease, and progressive disease in the ineffective group. The following semi-quantitative parameters of DCE-MRI were calculated: early dynamic enhancement wash-in slope (Slope), time to peak (TTP), and enhancement rate (R). The acquired data is randomly divided into 70% for training and 30% for testing. Variance threshold, univariate feature selection, and least absolute shrinkage and selection operator were used to select the optimal features. Three classifiers (K-nearest neighbor, KNN; support vector machine, SVM; and logistic regression, LR) were implemented for model establishment. The performance of different classifiers and conventional semi-quantitative parameters was evaluated by confusion matrix and receiver operating characteristic curves. Furthermore, clinically relevant risk factors including age, tumor size and site, pathological fracture, and surgical staging were collected to evaluate their predictive values for the efficacy of NAC. The selected clinical features and imaging features were combined to establish the model and the nomogram, and then the predictive efficacy was evaluated.

Results

The clinical relevance risk factor analysis demonstrates that only surgical stage was an independent predictor of NAC. A total of seven radiomic features were selected, and three machine learning models (KNN, SVM, and LR) were established based on such features. The prediction accuracy (ACC) of these three models was 0.89, 0.84, and 0.84, respectively. The area under the subject curve (AUC) of these three models was 0.86, 0.92, and 0.93, respectively. As for Slope, TTP, and R parameters, the prediction ACC was 0.91, 0.89, and 0.81, respectively, while the AUC was 0.87, 0.85, and 0.83, respectively. In both the training and testing sets, the ACC and AUC of the combined model were higher than those of the radiomics models (ACC = 0.91 and AUC = 0.95), which indicate an outstanding performance of our proposed model.

Conclusions

The radiomics nomogram demonstrates satisfactory predictive results for the treatment response of patients with osteosarcoma before NAC. This finding may provide a new decision basis to improve the treatment plan.
Biliary Tract Cancers: Treatment Updates and Future Directions in the Era of Precision Medicine and Immuno-Oncology
Authors: Manne Ashish , Woods Edward , Tsung Allan , Mittra Arjun
Published: November 2021

The effective management of biliary tract cancers (BTCs) has been hampered by limited options for systemic therapy. In recent years, the focus on precision medicine has made technologies such as next-generation sequencing (NGS) accessible to clinicians to identify targetable mutations in BTCs in tumor tissue (primarily) as well as blood, and to treat them with targeted therapies when possible. It has also expanded our understanding of functional pathways associated with genetic alterations and opened doors for identifying novel targets for treatment. Recent advances in the precision medicine approach allowed us to identify new molecular markers in BTCs, such as epigenetic changes (methylation and histone modification) and non-DNA markers such as messenger RNA, microRNA, and long non-coding RNA. It also made detecting these markers from non-traditional sources such as blood, urine, bile, and cytology (from fine-needle aspiration and biliary brushings) possible. As these tests become more accessible, we can see the integration of different molecular markers from all available sources to aid physicians in diagnosing, assessing prognosis, predicting tumor response, and screening BTCs. Currently, there are a handful of approved targeted therapies and only one class of immunotherapy agents (immune checkpoint inhibitors or ICIs) to treat BTCs. Early success with new targets, vascular endothelial growth factor receptor (VEGFR), HER2, protein kinase receptor, and Dickkopf-1 (DKK1); new drugs for known targets, fibroblast growth factor receptors (FGFRs) such as futabatinib, derazantinib, and erdafitinib; and ICIs such as durvalumab and tremelimumab is encouraging. Novel immunotherapy agents such as bispecific antibodies (bintrafusp alfa), arginase inhibitors, vaccines, and cellular therapy (chimeric antigen receptor—T cell or CAR-T, natural killer cells, tumor-infiltrating lymphocytes) have the potential to improve outcomes of BTCs in the coming years.
Identification and Validation of an 6-Metabolism-Related Gene Signature and Its Correlation With Immune Checkpoint in Hepatocellular Carcinoma
Authors: Ren He , Li Wanjing , Liu Xin , Li Shuliang , Guo Hao , Wang Wei , Zhao Na
Published: November 2021

Hepatocellular carcinoma (HCC) is a common malignant tumor with relatively high malignancy and rapid disease progression. Metabolism-related genes (MRGs) are involved in the pathogenesis of HCC. This study explored potential key MRGs and their effect on T-cell immune function in the tumor immune microenvironment to provide new insight for the treatment of HCC. Of 456 differentially expressed MRGs identified from TCGA database, 21 were screened by MCODE and cytoHubba algorithms. From the key module, GAD1, SPP1, WFS1, GOT2, EHHADH, and APOA1 were selected for validation. The six MRGs were closely correlated with survival outcomes and clinicopathological characteristics in HCC. Receiver operating characteristics analysis and Kaplan-Meier plots showed that these genes had good prognostic value for HCC. Gene set enrichment analysis of the six MRGs indicated that they were associated with HCC development. TIMER and GEPIA databases revealed that WFS1 was significantly positively correlated and EHHADH was negatively correlated with tumor immune cell infiltration and immune checkpoint expression. Finally, quantificational real-time polymerase chain reaction (qRT-PCR) confirmed the expression of WFS1 and EHHADH mRNA in our own patients’ cohort samples and four HCC cell lines. Collectively, the present study identified six potential MRG biomarkers associated with the prognosis and tumor immune infiltration of HCC, thus providing new insight into the pathogenesis and treatment of HCC.
What's the Cost? Measuring the Economic Impact of Pediatric Sepsis
Authors: Carlton Erin F. , Weiss Scott L. , Prescott Hallie C. , Prosser Lisa A.
Published: November 2021

Sepsis, life-threatening organ dysfunction secondary to infection, hospitalizes nearly 75,000 children each year in the United States. Most children survive sepsis. However, there is increasing recognition of the longer-term consequences of pediatric sepsis hospitalization on both the child and their family, including medical, psychosocial, and financial impacts. Here, we describe family spillover effects (the impact of illness on caregivers) of pediatric sepsis, why measurement of family spillover effects is important, and the ways in which family spillover effects can be measured.
Low-Dose Piperlongumine Rescues Impaired Function of Endothelial Progenitor Cells and Reduces Cerebral Ischemic Injury in High-Fat Diet-Fed Mice
Authors: Dong Xiao-Hui , Peng Cheng , Zhang Yu-Yi , Jiang Yu , Yang Li-Jun , He Jia-Bei , Tao Xia , Zhang Chuan , Chen Alex F , Xie He-Hui
Published: November 2021

It is of great clinical significance to develop potential novel strategies to prevent cardio-cerebrovascular complications in patients with hyperlipidemia. Vascular Endothelial integrity and function play a key role in the prevention of cardio-cerebrovascular diseases. Endothelial progenitor cells (EPCs) can home to sites of ischemic injury and promote endothelial regeneration and neovascularization. Hypercholesterolemia impairs the function of EPC. The present study attempted to identify the effect of piperlongumine on EPCs’ angiogenic potential and cerebral ischemic injury in high-fat diet-fed (HFD-fed) mice. Here, we showed that treatment with low-does piperlongumine (0.25 mg/kg/day) for 8 weeks significantly improved EPCs function and reduced the cerebral ischemic injury (both infarct volumes and neurobehavioral outcomes) in HFD-fed mice. In addition, low-dose piperlongumine administration increased intracellular NO level and reduced intracellular O2- level in EPCs of HFD-fed mice. Moreover, incubation with piperlongumine (1.0 μM, 24 h) reduced thrombospondin-1/2 (TSP-1/2, a potent angiogenesis inhibitor) expression levels in EPCs from HFD-fed mice, increased the therapeutic effect of EPC from HFD-fed mice on cerebral ischemic injury reduction and angiogenesis promotion in HFD-fed mice, and the donor derived EPCs homed to the recipient ischemic brain. In conclusion, low-dose piperlongumine can enhance EPCs’ angiogenic potential and protect against cerebral ischemic injury in HFD-fed mice. It is implied that treatment with low-dose piperlongumine might be a potential option to prevent ischemic diseases (including stroke) in patients with hyperlipidemia, and priming with piperlongumine might be a feasible way to improve the efficacy of EPC-based therapy for ischemic diseases.
Modulation of Neuro-Inflammatory Signals in Microglia by Plasma Prekallikrein and Neuronal Cell Debris
Authors: Jaffa Aneese A. , Jaffa Miran A. , Moussa Mayssam , Ahmed Ibrahim A. , Karam Mia , Aldeen Kawthar Sharaf , Al Sayegh Rola , El-Achkar Ghewa A. , Nasrallah Leila , Yehya Yara , Habib Aida , Ziyadeh Fuad N. , Eid Ali H. , Kobeissy Firas H. , Jaffa Ayad A.
Published: November 2021

Microglia, the resident phagocytes of the central nervous system and one of the key modulators of the innate immune system, have been shown to play a major role in brain insults. Upon activation in response to neuroinflammation, microglia promote the release of inflammatory mediators as well as promote phagocytosis. Plasma prekallikrein (PKall) has been recently implicated as a mediator of neuroinflammation; nevertheless, its role in mediating microglial activation has not been investigated yet. In the current study, we evaluate the mechanisms through which PKall contributes to microglial activation and release of inflammatory cytokines assessing PKall-related receptors and their dynamics. Murine N9-microglial cells were exposed to PKall (2.5 ng/ml), lipopolysaccharide (100 ng/ml), bradykinin (BK, 0.1 μM), and neuronal cell debris (16.5 μg protein/ml). Gene expression of bradykinin 2 receptor (B2KR), protease-activated receptor 2 (PAR-2), along with cytokines and fibrotic mediators were studied. Bioinformatic analysis was conducted to correlate altered protein changes with microglial activation. To assess receptor dynamics, HOE-140 (1 μM) and GB-83 (2 μM) were used to antagonize the B2KR and PAR-2 receptors, respectively. Also, the role of autophagy in modulating microglial response was evaluated. Data from our work indicate that PKall, LPS, BK, and neuronal cell debris resulted in the activation of microglia and enhanced expression/secretion of inflammatory mediators. Elevated increase in inflammatory mediators was attenuated in the presence of HOE-140 and GB-83, implicating the engagement of these receptors in the activation process coupled with an increase in the expression of B2KR and PAR-2. Finally, the inhibition of autophagy significantly enhanced the release of the cytokine IL-6 which were validated via bioinformatics analysis demonstrating the role of PKall in systematic and brain inflammatory processes. Taken together, we demonstrated that PKall can modulate microglial activation via the engagement of PAR-2 and B2KR where PKall acts as a neuromodulator of inflammatory processes.
Blocking HMGB1/RAGE Signaling by Berberine Alleviates A1 Astrocyte and Attenuates Sepsis-Associated Encephalopathy
Authors: Shi Jian , Xu Huan , Cavagnaro María José , Li Xingmei , Fang Jia
Published: November 2021

As a life-threatening multiple organ dysfunction attributable to maladjusted host immune responses to infection, sepsis is usually the common pathway to serious prognosis and death for numerous infectious diseases all over the world. Sepsis-associated encephalopathy (SAE) is frequently complicated by septic conditions, and is one of the most important reasons for increased mortality and poor outcomes in septic patients which is still an urgent clinical problem need to be solved. In this research, a conspicuously discovery of treatment-related translational use for berberine was elaborated. The results revealed that berberine treatment significantly restored cognitive impairment in sepsis mice. Reduced expression levels of TNF-α, IL-1α, and C1qA were exhibited in the hippocampus of the berberine treatment group, and attenuated effect of declining neo-neuron, activation of microglia and astrocytes in the hippocampus of mice with sepsis were also found. Moreover, berberine inhibits microglia-stressed A1 astrocytes by inhibiting HMGB1 signaling was revealed, then the molecular mechanism of HMGB1/RAGE signaling inhibition leads to the better outcome of SAE was elucidated. To summarize, this research indicated that berberine targets HMGB1/RAGE signaling to inhibit microglia-stressed A1 astrocyte and neo-neuron decline, which consequently alleviates sepsis-induced cognitive impairment. Collectively, berberine may serve as potential therapeutic drug and HMGB1/RAGE signaling would be a novel target for medicine development for treating SAE.
Self-Management in Anxiety and Depression: A Psychometric Evaluation of a Questionnaire
Authors: Krijnen-de Bruin Esther , Draisma Stasja , Muntingh Anna D. T. , Evers Aagje , van Straten Annemieke , Sinnema Henny , Spijker Jan , Batelaan Neeltje M. , van Meijel Berno
Published: November 2021

Objective: To examine the underlying factor structure and psychometric properties of the Assessment of Self-management in Anxiety and Depression (ASAD) questionnaire, which was specifically designed for patients with (chronic) anxiety and depressive disorders. Moreover, this study assesses whether the number of items in the ASAD can be reduced without significantly reducing its precision.

Methods: The ASAD questionnaire was completed by 171 participants across two samples: one sample comprised patients with residual anxiety or depressive symptoms, while the other consisted of patients who have been formally diagnosed with a chronic anxiety or depressive disorder. All participants had previously undergone treatment. Both exploratory (EFA) and confirmatory factor analyses (CFA) were conducted. Internal consistency and test–retest reliability were also assessed.

Results: Both EFA and CFA indicated three solid factors: Seeking support, Daily life strategies and Taking ownership [Comparative Fit Index = 0.80, Tucker Lewis Index = 0.78, Root Mean Square Error of Approximation = 0.09 (CI 0.08–1.00), Standardized Root Mean Square Residual = 0.09 (χ2 = 439.35, df = 168)]. The ASAD was thus reduced from 45 items to 21 items, which resulted in the ASAD-Short Form (SF). All sub-scales had a high level of internal consistency (> α = 0.75) and test–retest reliability (ICC > 0.75).

Discussion: The first statistical evaluation of the ASAD indicated a high level of internal consistency and test–retest reliability, and identified three distinctive factors. This could aid patients and professionals’ assessment of types of self-management used by the patient. Given that this study indicated that the 21-item ASAD-SF is appropriate, this version should be further explored and validated among a sample of patients with (chronic or partially remitted) anxiety and depressive disorders. Alongside this, to increase generalizability, more studies are required to examine the English version of the ASAD within other settings and countries.
Development of Teachers’ Emotional Adjustment Performance Regarding Their Perception of Emotional Experience and Job Satisfaction During Regular School Operations, the First and the Second School Lockdown in Austria
Authors: Lindner Katharina-Theresa , Savolainen Hannu , Schwab Susanne
Published: November 2021

Starting with the COVID-19 pandemic, research intensively investigated the effects of school lockdowns on involved stakeholders, such as teachers, students and parents. However, as research projects had to be hurriedly conducted, in-depth and longitudinal studies are lacking. Therefore, the current study uses data from a longitudinal study to investigate the well-being of Austrian in-service teachers during the COVID-19 pandemic. In total 256 teachers took part at both measurement waves and participated in an online survey. Standardized questionnaires were used to assess teachers’ perception of emotional experiences and job satisfaction before COVID-19 (retrospective, t1), during the first (in situ, t2) and during the second school lockdown (in situ, t3). The results indicated that the vast majority of teachers generally felt a high level of job satisfaction. However, teachers’ satisfaction decreased between regular teaching and school lockdowns. Similarly, positive emotional activation was reduced and negative activation increased. Further, results from a positive activation cross-lagged path model indicated that the lack of positive activation led to lower job satisfaction. For negative emotional activation, job satisfaction during the first school lockdown predicted negative activation at the second lockdown.