bluuebunny/crossref_metadata_2025 huggingface dataset:
Is OPRM1 genotype a valuable predictor of VAS in patients undergoing laparoscopic radical resection of colorectal cancer with fentanyl?
Authors: Zhou Yan , Cao Lei , Yang Yihui , Gao Yaoyi , Li Yihao , Wang Beili , Pan Baishen , Huang Jian , Guo Wei
Published: May 2023

Objective

This study was conducted to examine the association between the A118G polymorphism of the OPRM1 gene and the risk of increased VAS scores in patients with colorectal cancer who underwent laparoscopic radical resection for which fentanyl was used.

Methods

The OPRM1 A118G genotype in subjects were detected. The relationship between the A118G polymorphism of the OPRM1 gene and increased Visual Analogue Scale (VAS) scores throughout the perioperative period was explored. A total of 101 patients receiving fentanyl anesthesia undergoing laparoscopic radical resection of colon tumors at Zhongshan Hospital, Fudan University between July 2018 and December 2020 were investigated in the present study. The relative risk between the A118G polymorphism of the OPRM1 gene and VAS ≥ 4 in the PACU was estimated using the adjusted effect relationship diagram, baseline characteristic analysis, and multiple logistic regression analysis. The relationship between the A118G polymorphism of the OPRM1 gene and VAS in the PACU, as well as perioperative fentanyl usage, was examined after confounders were adjusted.

Results

Subjects with OPRM1 A118G wild gene A were less sensitive to fentanyl, which was a risk factor for PACU VAS ≥ 4. Before the model was adjusted, the odds ratio (OR) was 14.73 (P = 0.001). After adjusting for age, sex, weight, height, and the duration of surgery, the OR increased to 16.55 (P = 0.001). When adjusting for age, sex, weight, height, surgery duration, COMT Val158Met gene polymorphism, CYP3A4 *1G gene polymorphism, and CYP3A5 *3gene polymorphism, the OR was 19.94 (P = 0.002). Moreover, OPRM1 A118G wild type gene A was found to be a risk factor for increased dosage of fentanyl in the PACU. Before the model was adjusted, the OR reached 16.90 (P = 0.0132). After adjusting for age, sex, body weight, intraoperative fentanyl dosage, surgery duration, and height, the OR was 13.81, (P = 0.0438). When adjusting for age, sex, weight, height, intraoperative fentanyl dosage, surgery duration, COMT Val158Met gene polymorphism, CYP3A4 *1G gene polymorphism, and CYP3A5 *3 gene polymorphism, the OR reached 15.23, (P = 0.0205).

Conclusion

The A118G polymorphism of the OPRM1 gene carrying wild gene A was a risk factor for VAS ≥ 4 in the PACU. Moreover, it is a risk factor for increased dosage of fentanyl in the PACU.
Frameworks for estimating causal effects in observational settings: comparing confounder adjustment and instrumental variables
Authors: Zawadzki Roy S. , Grill Joshua D. , Gillen Daniel L. ,   and for the Alzheimer’s Disease Neuroimaging Initiative
Published: May 2023

To estimate causal effects, analysts performing observational studies in health settings utilize several strategies to mitigate bias due to confounding by indication. There are two broad classes of approaches for these purposes: use of confounders and instrumental variables (IVs). Because such approaches are largely characterized by untestable assumptions, analysts must operate under an indefinite paradigm that these methods will work imperfectly. In this tutorial, we formalize a set of general principles and heuristics for estimating causal effects in the two approaches when the assumptions are potentially violated. This crucially requires reframing the process of observational studies as hypothesizing potential scenarios where the estimates from one approach are less inconsistent than the other. While most of our discussion of methodology centers around the linear setting, we touch upon complexities in non-linear settings and flexible procedures such as target minimum loss-based estimation and double machine learning. To demonstrate the application of our principles, we investigate the use of donepezil off-label for mild cognitive impairment. We compare and contrast results from confounder and IV methods, traditional and flexible, within our analysis and to a similar observational study and clinical trial.
Phosphodiesterase 5 (PDE-5) inhibitors (sildenafil, tadalafil, and vardenafil) effects on esophageal motility: a systematic review
Authors: Shafiee Arman , Bahri Razman Arabzadeh , Teymouri Athar Mohammad Mobin , Afsharrezaei Fatemeh , Gholami Mostafa
Published: May 2023

Background

Esophageal motility disorders are a group of disorders associated with dysfunctional swallowing resulting from impaired neuromuscular coordination. Phosphodiesterase 5 (PDE-5) inhibitors induce smooth relaxation and are proposed as a treatment option for esophageal motility disorders such as achalasia.

Methods

This study is conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We systematically searched MEDLINE/ PubMed, Scopus, EMBASE, and Web of Science databases for esophageal outcomes of individuals treated with PDE5 inhibitors. A random effect meta-analysis was conducted.

Results

A total of 14 studies were included. They were conducted in different countries, with Korea and Italy having the highest number of articles. The main drug assessed was sildenafil. PDE-5 inhibitors resulted in a significant reduction in lower esophageal sphincter pressure (SMD − 1.69, 95% CI: -2.39 to -0.99) and the amplitude of contractions (SMD − 2.04, 95% CI: -2.97 to -1.11). Residual pressure was not significantly different between the placebo and sildenafil groups (SMD − 0.24, 95% CI: -1.20 to 0.72). Furthermore, a recent study reported contractile integral, stating that ingestion of sildenafil leads to a significant reduction in distal contractile integral and a significant increase in proximal contractile integral.

Conclusion

PDE-5 inhibitors significantly reduce LES resting pressure and esophageal peristaltic vigor, decreasing esophageal body contractility and contraction reserve. Therefore, using these drugs in patients affected by esophageal motility disorders may potentially improve their condition regarding symptom relief and prevention of further associated complications. Future reports investigating larger sample size is necessary in order to establish definite evidence regarding the efficacy of these drugs.
Chronic health conditions and mortality among older adults with complex care needs in Aotearoa New Zealand
Authors: Abey-Nesbit Rebecca , Jamieson Hamish A , Bergler Hans Ulrich , Kerse Ngaire , Pickering John W , Teh Ruth
Published: May 2023

Background

Older people have more comorbidities than younger groups and multimorbidity will increase. Often chronic conditions affect quality of life, functional ability and social participation. Our study aim was to quantify the prevalence of chronic conditions over a three-year period and their association with mortality after accounting for demographics.

Methods

We conducted a retrospective cohort study using routinely collected health data including community-dwelling older adults in New Zealand who had an interRAI Home Care assessment between 1 January 2017 and 31 December 2017. Descriptive statistics and differences between variables of interest among ethnic groups were reported. Cumulative density plots of mortality were developed. Logistic regression models adjusted for age and sex to estimate mortality were created independently for each combination of ethnicity and disease diagnosis.

Results

The study cohort consisted of 31,704 people with a mean (SD) age of 82.3 years (8.0), and of whom 18,997 (59.9%) were female. Participants were followed for a median 1.1 (range 0 to 3) years. By the end of the follow-up period 15,678 (49.5%) people had died. Nearly 62% of Māori and Pacific older adults and 57% of other ethnicities had cognitive impairment. Diabetes the next most prevalent amongst Māori and Pacific peoples, and coronary heart disease amongst Non-Māori/Non-Pacific individuals. Of the 5,184 (16.3%) who had congestive heart failure (CHF), 3,450 (66.6%) died. This was the highest mortality rate of any of the diseases. There was a decrease in mortality rate with age for both sexes and all ethnicities for those with cancer.

Conclusions

Cognitive impairment was the most common condition in community dwelling older adults who had an interRAI assessment. Cardiovascular disease (CVD) has the highest mortality risk for all ethnic groups, and in non-Māori/non-Pacific group of advanced age, risk of mortality with cognitive impairment is as high as CVD risk. We observed an inverse for cancer mortality risk with age. Important differences between ethnic groups are reported.
The mediating effect of leisure activities in the relationship between depression and cognitive decline in middle age and older adults in Taiwan
Authors: Hung Yu-Chan , Lao Wai-Lam , Yeh Chih-Jung , Lee Meng-Chih
Published: May 2023

Background

Depression can affect the development of cognitive functions, and there are many people with depressive symptoms and cognitive decline in the aging population. The role of mediators between depressive symptoms and the subsequent cognitive decline remains unclear. We aimed to investigate whether depressive symptoms can slow down cognitive decline through a mediator.

Methods

A total of 3,135 samples were collected in 2003, 2007, and 2011. This study used the CES-D10 and SPMSQ (Short Portable Mental State Questionnaire) to measure depression and cognitive functions. The effect of depression trajectory on the subsequent cognitive dysfunction was analyzed using multivariable logistic regression, and the mediating effect was analyzed using the Sobel test.

Results

The results of the multivariable linear regression analysis showed that after including different variables in each model, such as leisure activities and mobility in 2003 and 2007, women had a higher percentage of depressive symptoms in each model, compared to men. The effect of depression in 2003 on cognitive decline in 2011 was mediated by intellectual leisure activities in 2007 in men (Z=-2.01) and physical activity limitation in 2007 in women (Z=-3.02).

Conclusions

The mediation effect of this study shows that people with depressive symptoms will reduce their participation in leisure activities, which will lead to the degeneration of cognitive function. We suggest that if depressive symptoms are addressed as early as possible, people will have the ability and motivation to delay the decline of cognitive function through participation in leisure activities.
Migration status, physical limitations and associated self-rated health: a study of older Indian adults
Authors: Mandal Bittu , Pradhan Kalandi Charan , Mohanty Parimala , Muhammad T.
Published: May 2023

Background

Migrant status with mobility impairment becomes a double burden for health and wellbeing of older adults. This study examined the independent relationships and multitude effects between migrant status, functional and mobility impairments and poor self-rated health (SRH) among older Indian adults.

Methods

This study utilised nationally representative Longitudinal Ageing Study in India wave-1 (LASI) data, including a sample of 30,736 individuals aged 60 years and above. The main explanatory variables were migrant status, difficulty in activities of daily living (ADL), difficulty in instrumental activities of daily living (IADL) and mobility impairments; and the outcome variable was poor-SRH. Multivariable logistic regression and stratified analyses were used to fulfil the study objectives.

Results

Overall, about 23% of older adults reported poor-SRH. Reporting poor-SRH was more prevalent (28.03%) among recent migrants (less than ten years). The prevalence of reporting poor-SRH was significantly higher among older adults who had mobility impairment (28.65%), difficulty in ADL or IADL (40.82% & 32.57%). Migrant older adults (regardless of duration) who had mobility impairment had significantly greater odds of reporting poor-SRH compared with non-migrant older adults who did not have mobility impairment. Similarly, older respondents who had problems in ADL and IADL with migration status had higher odds of reporting poor-SRH than their non-migrant counterparts with no such problems.

Conclusions

The study revealed the vulnerability of migrant older adults with functional and mobility disability, as well as those with limited socioeconomic resources and suffering from multimorbidity on rating their perceived health. The findings can be utilised to target outreach programmes and provision of services for migrating older individuals with mobility impairments and enhance their perceived health and ensure active ageing.
Exercise effects on functional capacity and quality of life in older patients with colorectal cancer: study protocol for the ECOOL randomized controlled trial
Authors: Macías-Valle Angela , Rodríguez-López Carlos , González-Senac Nicolas María , Mayordomo-Cava Jennifer , Vidán María Teresa , Cruz-Arnés María Luisa , Jiménez-Gómez Luis Miguel , Dujovne-Lindenbaum Paula , Pérez-Menéndez Maria Elena , Ortiz-Alonso Javier , Valenzuela Pedro L , Rodríguez-Romo Gabriel , Serra-Rexach Jose Antonio
Published: May 2023

Background

Surgery and treatment for colorectal cancer (CRC) in the elderly patient increase the risk of developing post-operative complications, losing functional independence, and worsening health-related quality of life (HRQoL). There is a lack of high-quality randomized controlled trials evaluating the potential benefit of exercise as a countermeasure. The primary aim of this study is to evaluate the effectiveness of a home-based multicomponent exercise program for improving HRQoL and functional capacity in older adults undergoing CRC surgery and treatment.

Methods

This randomized, controlled, observer-blinded, single-center trial aims to randomize 250 patients (>74 years) to either an intervention or a control group (i.e., usual care). The intervention group will perform an individualized home-based multicomponent exercise program with weekly telephone supervision from diagnosis until three months post-surgery. The primary outcomes will be HRQoL (EORTC QLQ-C30; CR29; and ELD14) and functional capacity (Barthel Index and Short Physical Performance Battery), which will be assessed at diagnosis, at discharge, and one, three, and six months after surgery. Secondary outcomes will be frailty, physical fitness, physical activity, inspiratory muscle function, sarcopenia and cachexia, anxiety and depression, ambulation ability, surgical complications, and hospital length of stay, readmission and mortality.

Discussion

This study will examine the effects of an exercise program in older patients with CRC across a range of health-related outcomes. Expected findings are improvement in HRQoL and physical functioning. If proven effective, this simple exercise program may be applied in clinical practice to improve CRC care in older patients.

Trial registration

ClinicalTrials.gov ID: NCT05448846.
Evaluation of the stiffness of normal cervix and its change with different factors using transvaginal two-dimensional shear wave elastography under strict quality control
Authors: Zhang Hui-Ping , Wu Jing-Jing , Zhang Wen-Ying , Tao Jiu-Zhi , Ma Cheng-Bin , Zhou Yu-Qing
Published: May 2023

Background

The usefulness of transvaginal two-dimensional shear wave elastography (2D SWE) for cervical lesions is still uncertain. This study was to explore the value of transvaginal 2D SWE in the evaluation of the stiffness of normal cervix and its change with different factors under strict quality control (QC).

Methods

Two hundred patients with normal cervix were included in this study and were examined using quantitative 2D SWE to evaluate cervical stiffness and its change with different factors under strict QC.

Results

Intra-observer concordance of transvaginal 2D SWE parameters in midsagittal planes were acceptable with intraclass correlation coefficients higher than 0.5. Transvaginal 2D SWE parameters were significantly higher than the corresponding transabdominal parameters. 2D SWE parameters of internal cervical os were significantly higher than the corresponding parameters of external cervical os in a transvaginal midsagittal plane. 2D SWE parameters of external cervical os increased significantly over 50 years old, while these parameters of internal cervical os didn’t change significantly with increasing age. 2D SWE parameters of internal cervical os of horizontal position cervix were significantly higher than those of vertical position cervix. SWE parameters of normal cervix did not change according to different menstrual cycles, parities and human papilloma virus test results.

Conclusions

Transvaginal 2D SWE under strict QC could provide quantitative, repeatable and reliable cervical stiffness information. Internal cervical os was stiffer than external cervical os. Menstrual cycles, parities and human papilloma virus test results wouldn’t affect cervical stiffness. However, age and cervical positions should be taken into condition while interpreting 2D SWE results of cervical stiffness.
Risk factors associated with acute kidney injury in a cohort of hospitalized patients with COVID-19
Authors: Contreras-Villamizar Kateir , Barbosa Oscar , Muñoz Ana Cecilia , Suárez Juan Sebastián , González Camilo A. , Vargas Diana Carolina , Rodríguez-Sánchez Martha Patricia , García-Padilla Paola , Valderrama-Rios Martha Carolina , Cortés Jorge Alberto
Published: May 2023

Background

Patients with COVID-19 have a high incidence of acute kidney injury (AKI), which is associated with mortality. The objective of the study was to determine the factors associated with AKI in patients with COVID-19.

Methodology

A retrospective cohort was established in two university hospitals in Bogotá, Colombia. Adults hospitalized for more than 48 h from March 6, 2020, to March 31, 2021, with confirmed COVID-19 were included. The main outcome was to determine the factors associated with AKI in patients with COVID-19 and the secondary outcome was estimate the incidence of AKI during the 28 days following hospital admission.

Results

A total of 1584 patients were included: 60.4% were men, 738 (46.5%) developed AKI, 23.6% were classified as KDIGO 3, and 11.1% had renal replacement therapy. The risk factors for developing AKI during hospitalization were male sex (OR 2.28, 95% CI 1.73–2.99), age (OR 1.02, 95% CI 1.01–1.03), history of chronic kidney disease (CKD) (OR 3.61, 95% CI 2.03–6.42), High Blood Pressure (HBP) (OR 6.51, 95% CI 2.10–20.2), higher qSOFA score to the admission (OR 1.4, 95% CI 1.14–1.71), the use of vancomycin (OR 1.57, 95% CI 1.05–2.37), piperacillin/tazobactam (OR 1.67, 95% CI 1.2–2.31), and vasopressor support (CI 2.39, 95% CI 1.53–3.74). The gross hospital mortality for AKI was 45.5% versus 11.7% without AKI.

Conclusions

This cohort showed that male sex, age, history of HBP and CKD, presentation with elevated qSOFA, in-hospital use of nephrotoxic drugs and the requirement for vasopressor support were the main risk factors for developing AKI in patients hospitalized for COVID-19.
Fetal heart rate changes and labor neuraxial analgesia: a machine learning approach
Authors: Riveros-Perez Efrain , Polania-Gutierrez Javier Jose , Avella-Molano Bibiana
Published: May 2023

Background

Neuraxial labor analgesia has been associated with fetal heart rate changes. Fetal bradycardia is multifactorial, and predicting it poses a significant challenge to clinicians. Machine learning algorithms may assist the clinician to predict fetal bradycardia and identify predictors associated with its presentation.

Methods

A retrospective analysis of 1077 healthy laboring parturients receiving neuraxial analgesia was conducted. We compared a principal components regression model with tree-based random forest, ridge regression, multiple regression, a general additive model, and elastic net in terms of prediction accuracy and interpretability for inference purposes.

Results

Multiple regression identified combined spinal-epidural (CSE) (p = 0.02), interaction between CSE and dose of phenylephrine (p < 0.0001), decelerations (p < 0.001), and the total dose of bupivacaine (p = 0.03) as associated with decrease in fetal heart rate. Random forest exhibited good predictive accuracy (mean standard error of 0.92).

Conclusion

Use of CSE, presence of decelerations, total dose of bupivacaine, and total dose of vasopressors after CSE are associated with decreases in fetal heart rate in healthy parturients during labor. Prediction of changes in fetal heart rate can be approached with a tree-based random forest model with good accuracy with important variables that are key for the prediction, such as CSE, BMI, duration of stage 1 of labor, and dose of bupivacaine.
The direct and mediating effect of social support on health-related quality of life during pregnancy among Australian women
Authors: Bedaso Asres , Adams Jon , Peng Wenbo , Sibbritt David
Published: May 2023

Background

Prenatal stress can have a negative effect on the quality of life (QoL) of pregnant women. Social support plays a vital role in improving the psychological well-being of pregnant women by enhancing their stress-coping ability. The current study assessed the association between social support and health-related quality of life (HRQoL) as well as the mediating role of social support in the linkage between perceived stress and HRQoL among pregnant Australian women.

Methods

Secondary data was obtained from 493 women who reported being pregnant in survey six of the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH). Social support and perceived stress were assessed using the Medical Outcomes Study Social Support Index (MOS-SSS-19) and the Perceived Stress Scale, respectively. The Mental Component Scale (MCS) and Physical Component Scale (PCS) of the SF-36 were used to examine the mental and physical HRQoL. A mediation model was used to examine the mediating effect of social support in the relationship between perceived stress and HRQoL. A multivariate quantile regression (QR) model was used to assess the association between social support and HRQoL after adjusting for potential confounders.

Result

The mean age of the pregnant women was 35.8 years. The mediational analysis revealed that emotional/informational support (β= -1.53; 95% CI: -2.36, -0.78), tangible support (β= -0.64; 95% CI: -1.29, -0.09), and affectionate support/positive social interaction (β= -1.33; 95% CI: -2.25, -0.48), played a significant mediating role in the relationship between perceived stress and mental health-related QoL. In addition, perceived stress had a significant indirect effect on mental health-related QoL through overall social support (β = -1.38; 95% CI: -2.28, -0.56), and the mediator accounted for approximately 14.3% of the total effect. The multivariate QR analysis indicated that all the domains of social support and overall social support scores were positively associated with higher MCS scores (p < 0.05). However, social support was found to have no significant association with PCS (p > 0.05).

Conclusion

Social support plays a direct and mediating role in improving the HRQoL of pregnant Australian women. Maternal health professionals need to consider social support as an essential tool to improve the HRQoL of pregnant women. Further, as part of routine antenatal care activity, assessing pregnant women’s level of social support is beneficial.
Analysis of stromal PDGFR-β and α-SMA expression and their clinical relevance in brain metastases of breast cancer patients
Authors: Akanda Md Rashedunnabi , Ahn Eun-Jung , Kim Yeong Jin , Salam S M Abdus , Noh Myung-Giun , Lee Tae-Kyu , Kim Sung Sun , Lee Kyung-Hwa , Moon Kyung-Sub
Published: May 2023

Background

Breast cancer brain metastasis (BCBM) is a growing therapeutic challenge and clinical concern. Stromal cancer-associated fibroblasts (CAFs) are crucial factors in the modulation of tumorigeneses and metastases. Herein, we investigated the relationship between the expression of stromal CAF markers in metastatic sites, platelet-derived growth factor receptor-beta (PDGFR-β), and alpha-smooth muscle actin (α-SMA) and the clinical and prognostic variables in BCBM patients.

Methods

Immunohistochemistry (IHC) of the stromal expression of PDGFR-β and α-SMA was performed on 50 cases of surgically resected BCBM. The expression of the CAF markers was analyzed in the context of clinico-pathological characteristics.

Results

Expression of PDGFR-β and α-SMA was lower in the triple-negative (TN) subtype than in other molecular subtypes (p = 0.073 and p = 0.016, respectively). And their expressions were related to a specific pattern of CAF distribution (PDGFR-β, p = 0.009; α-SMA, p = 0.043) and BM solidity (p = 0.009 and p = 0.002, respectively). High PDGFR-β expression was significantly related to longer recurrence-free survival (RFS) (p = 0.011). TN molecular subtype and PDGFR-β expression were independent prognostic factors of recurrence-free survival (p = 0.029 and p = 0.030, respectively) and TN molecular subtype was an independent prognostic factor of overall survival (p < 0.001).

Conclusions

Expression of PDGFR-β in the stroma of BM was associated with RFS in BCBM patients, and the clinical implication was uniquely linked to the low expression of PDGFR-β and α-SMA in the aggressive form of the TN subtype.
Validity and reliability of the arabic version of the self-report single-item self-esteem scale (A-SISE)
Authors: Fekih-Romdhane Feten , Bitar Zeinab , Rogoza Radosław , Sarray El Dine Abir , Malaeb Diana , Rashid Tabassum , Obeid Sahar , Hallit Souheil
Published: May 2023

Background

Meta-analytic findings documented a substantial impact of self-esteem on a broad range of psychological and behavioral indicators, thus highlighting its high clinical relevance. Proving a simple and cost-effective measure of global self-esteem to the Arabic-speaking community, who mostly live in low- and middle-income countries, and where research may be challenging, would be highly valuable. In this context, we sought to investigate the psychometric characteristics of an Arabic translation of the Single-Item Self-Esteem Scale (A-SISE) in terms of factor structure, reliability, and construct validity.

Methods

A total of 451 participants were enrolled between October and December 2022. An anonymous self-administered Google Forms link was shared on WhatsApp. To examine the factor structure of the A-SISE, we used the FACTOR software. We conducted an exploratory factor analysis (EFA), using a principal component analysis on the Rosenberg Self-Esteem Scale (RSES) items first, then after adding the A-SISE.

Results

The results of the EFA of the RSES revealed two factors (F1 = negatively-worded items; F2 = positively-worded items), which explained 60.63% of the common variance. When adding the A-SISE, the two-factor solution obtained explained 58.74% of the variance, with the A-SISE loading on the second factor. Both RSES and A-SISE correlated significantly and positively with each other, as well as with extroversion, agreeableness, conscientiousness, open mindedness and satisfaction with life. Moreover, they correlated significantly and negatively with negative emotionality and depression.

Conclusion

These results suggest that the A-SISE is a simple-to-use, cost-effective, valid and reliable measure of self-esteem. We thus recommend its use in future research among Arabic-speaking people in Arab clinical and research settings, particularly when researchers are limited by time or resources constraints.
Bronchoscopy in the post-acute phase of COVID-19: an observational study
Authors: Mondoni Michele , Rinaldo Rocco Francesco , Cefalo Jacopo , Saderi Laura , Vigo Beatrice , Carlucci Paolo , Tirelli Claudio , Cariboni Umberto , Santus Pierachille , Centanni Stefano , Sotgiu Giovanni
Published: May 2023

Background

Bronchoscopy is a useful technique adopted in the management of patients with COVID-19. 10–40% of COVID-19 survivors experience persistent symptoms. A comprehensive description of the utility and safety of bronchoscopy in the management of patients with COVID-19 sequelae is lacking. The aim of the study was to evaluate the role of bronchoscopy in patients with suspected post-acute sequelae of COVID-19.

Methods

An observational, retrospective study was carried out in Italy. Patients requiring bronchoscopy for suspected COVID-19 sequelae were enrolled.

Results

45 (21, 46.7%, female) patients were recruited. Bronchoscopy was more frequently indicated for patients with a previous critical disease. The most frequent indications were tracheal complications, mostly performed in patients who were hospitalized during the acute phase than treated at home (14, 48.3% VS. 1, 6.3%; p-value: 0.007) and persistent parenchymal infiltrates, more frequent in those treated at home (9, 56.3% VS. 5, 17.2%; p-value: 0.008). 3 (6.6%) patients after the first bronchoscopy required higher oxygen flow. Four patients were diagnosed with lung cancer.

Conclusion

Bronchoscopy is a useful and safe technique in patients with suspected post-acute sequelae of COVID-19. The severity of acute disease plays a role in the rate and indications of bronchoscopy. Endoscopic procedures were mostly performed for tracheal complications in critical, hospitalized patients and for persistent lung parenchymal infiltrates in mild-moderate infections treated at home.
An automated detection of epileptic seizures EEG using CNN classifier based on feature fusion with high accuracy
Authors: Chen Wenna , Wang Yixing , Ren Yuhao , Jiang Hongwei , Du Ganqin , Zhang Jincan , Li Jinghua
Published: May 2023

Background

Epilepsy is a neurological disorder that is usually detected by electroencephalogram (EEG) signals. Since manual examination of epilepsy seizures is a laborious and time-consuming process, lots of automatic epilepsy detection algorithms have been proposed. However, most of the available classification algorithms for epilepsy EEG signals adopted a single feature extraction, in turn to result in low classification accuracy. Although a small account of studies have carried out feature fusion, the computational efficiency is reduced due to too many features, because there are also some poor features that interfere with the classification results.

Methods

In order to solve the above problems, an automatic recognition method of epilepsy EEG signals based on feature fusion and selection is proposed in this paper. Firstly, the Approximate Entropy (ApEn), Fuzzy Entropy (FuzzyEn), Sample Entropy (SampEn), and Standard Deviation (STD) mixed features of the subband obtained by the Discrete Wavelet Transform (DWT) decomposition of EEG signals are extracted. Secondly, the random forest algorithm is used for feature selection. Finally, the Convolutional Neural Network (CNN) is used to classify epilepsy EEG signals.

Results

The empirical evaluation of the presented algorithm is performed on the benchmark Bonn EEG datasets and New Delhi datasets. In the interictal and ictal classification tasks of Bonn datasets, the proposed model achieves an accuracy of 99.9%, a sensitivity of 100%, a precision of 99.81%, and a specificity of 99.8%. For the interictal-ictal case of New Delhi datasets, the proposed model achieves a classification accuracy of 100%, a sensitivity of 100%, a specificity of 100%, and a precision of 100%.

Conclusion

The proposed model can effectively realize the high-precision automatic detection and classification of epilepsy EEG signals. This model can provide high-precision automatic detection capability for clinical epilepsy EEG detection. We hope to provide positive implications for the prediction of seizure EEG.
Next steps after airing disagreement on a scientific issue with policy implications: a meta-analysis, multi-lab replication and adversarial collaboration
Authors: Nakagawa Shinichi , Lagisz Malgorzata
Published: May 2023

Canadian policymakers are interested in determining whether farmed Atlantic salmon, frequently infected with Piscine orthoreovirus (PRV), may threaten wild salmon populations in the Pacific Northwest. A relevant work has been published in BMC Biology by Polinksi and colleagues, but their conclusion that PRV has a negligible impact on the energy expenditure and respiratory performance of sockeye salmon is disputed by Mordecai and colleagues, whose re-analysis is presented in a correspondence article. So, what is the true effect and what should follow this unresolved dispute? We suggest a ‘registered multi-lab replication with adversaries’.
Zn-MOF hydrogel: regulation of ROS-mediated inflammatory microenvironment for treatment of atopic dermatitis
Authors: Qiu Lirong , Ouyang Chengcheng , Zhang Wei , Liu Jia , Yu Luting , Chen Guoguang , Ren Lili
Published: May 2023

Atopic dermatitis (AD) is a chronic and recurrent inflammation disease associated with immune dysfunction. The high level of reactive oxygen species (ROS) causes high oxidative stress and further results in the deterioration of AD. At the same time, the ROS produced by bacterial infection can further aggravate AD. Here, the prepared PVA-based hydrogel (Gel) has a high ROS scavenging ability, and the antibacterial agent Zn-MOF(ZIF-8) loaded into the hydrogel shows a lasting and effective antibacterial activity. Thus, a Zn-MOF hydrogel (Gel@ZIF-8) is prepared to regulate ROS-mediated inflammatory microenvironment. In vitro experiments show that Gel@ZIF-8 has good antibacterial effect and cell biocompatibility. In the AD-induced mouse model, Gel@ZIF-8 can significantly enhance the therapeutic effect, such as reduce the thickness of epidermis, the number of mast cells and IgE antibodies. The results indicate that the ROS-scavenging hydrogel could treat the AD by regulating the inflammatory microenvironment, providing a promising treatment for managing AD.
Expression pattern analysis of m6A regulators reveals IGF2BP3 as a key modulator in osteoarthritis synovial macrophages
Authors: Lu Yuheng , Zhang Hongbo , Pan Haoyan , Zhang Zhicheng , Zeng Hua , Xie Haoyu , Yin Jianbin , Tang Wen , Lin Rengui , Zeng Chun , Cai Daozhang
Published: May 2023

Background

Disruption of N6 methyl adenosine (m6A) modulation hampers gene expression and cellular functions, leading to various illnesses. However, the role of m6A modification in osteoarthritis (OA) synovitis remains unclear. This study aimed to explore the expression patterns of m6A regulators in OA synovial cell clusters and identify key m6A regulators that mediate synovial macrophage phenotypes.

Methods

The expression patterns of m6A regulators in the OA synovium were illustrated by analyzing bulk RNA-seq data. Next, we built an OA LASSO-Cox regression prediction model to identify the core m6A regulators. Potential target genes of these m6A regulators were identified by analyzing data from the RM2target database. A molecular functional network based on core m6A regulators and their target genes was constructed using the STRING database. Single-cell RNA-seq data were collected to verify the effects of m6A regulators on synovial cell clusters. Conjoint analyses of bulk and single-cell RNA-seq data were performed to validate the correlation between m6A regulators, synovial clusters, and disease conditions. After IGF2BP3 was screened as a potential modulator in OA macrophages, the IGF2BP3 expression level was tested in OA synovium and macrophages, and its functions were further tested by overexpression and knockdown in vitro.

Results

OA synovium showed aberrant expression patterns of m6A regulators. Based on these regulators, we constructed a well-fitting OA prediction model comprising six factors (FTO, YTHDC1, METTL5, IGF2BP3, ZC3H13, and HNRNPC). The functional network indicated that these factors were closely associated with OA synovial phenotypic alterations. Among these regulators, the m6A reader IGF2BP3 was identified as a potential macrophage mediator. Finally, IGF2BP3 upregulation was verified in the OA synovium, which promoted macrophage M1 polarization and inflammation.

Conclusions

Our findings revealed the functions of m6A regulators in OA synovium and highlighted the association between IGF2BP3 and enhanced M1 polarization and inflammation in OA macrophages, providing novel molecular targets for OA diagnosis and treatment.
Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases
Authors: Kornhuber Christine , Ensminger Stephan , Hübsch Patrick , Janich Martin , Leucht Chris Andre , Vordermark Dirk , Dietzel Christian T.
Published: May 2023

Background

In stereotactic radiotherapy, dose is prescribed to an isodose surrounding the planning target volume (PTV). However, the desired dose inhomogeneity inside the PTV leaves the specific dose distribution to the gross tumor volume (GTV) unspecified. A simultaneously integrated boost (SIB) to the GTV could solve this shortcoming. In a retrospective planning study with 20 unresected brain metastases, a SIB approach was tested against the classical prescription.

Methods

For all metastases, the GTV was isotropically enlarged by 3 mm to a PTV. Two plans were generated, one according to the classical 80% concept with 5 times 7 Gy prescribed (on D2%) to the 80% PTV surrounding isodose (with D98%(PTV) ≥ 35 Gy), and the other one following a SIB concept with 5 times 8.5 Gy average GTV dose and with D98%(PTV) ≥ 35 Gy as additional requirement. Plan pairs were compared in terms of homogeneity inside GTV, high dose in PTV rim around GTV, and dose conformity and gradients around PTV using Wilcoxon matched pairs signed rank test.

Results

The SIB concept was superior to the classical 80% concept concerning dose homogeneity inside GTV: Heterogeneity index of GTV was in the SIB concept (median 0.0513, range 0.0397–0.0757) significantly (p = 0.001) lower than in the 80% concept (median 0.0894, range 0.0447–0.1872). Dose gradients around PTV were not inferior. The other examined measures were comparable.

Conclusion

Our stereotactic SIB concept better defines the dose distribution inside PTV and can be considered for clinical use.
Magnetic resonance guided SBRT reirradiation in locally recurrent prostate cancer: a multicentric retrospective analysis
Authors: Boldrini Luca , Romano Angela , Chiloiro Giuditta , Corradini Stefanie , De Luca Viola , Verusio Valeria , D’Aviero Andrea , Castelluccia Alessandra , Alitto Anna Rita , Catucci Francesco , Grimaldi Gianmarco , Trapp Christian , Hörner-Rieber Juliane , Marchesano Domenico , Frascino Vincenzo , Mattiucci Gian Carlo , Valentini Vincenzo , Gentile Piercarlo , Gambacorta Maria Antonietta
Published: May 2023

Aims

Reirradiation of prostate cancer (PC) local recurrences represents an emerging challenge for current radiotherapy. In this context, stereotactic body radiation therapy (SBRT) allows the delivery of high doses, with curative intent. Magnetic Resonance guided Radiation Therapy (MRgRT) has shown promising results in terms of safety, feasibility and efficacy of delivering SBRT thanks to the enhanced soft tissue contrast and the online adaptive workflow. This multicentric retrospective analysis evaluates the feasibility and efficacy of PC reirradiation, using a 0.35 T hybrid MR delivery unit.

Methods

Patients affected by local recurrences of PC and treated in five institutions between 2019 and 2022 were retrospectively collected. All patients had undergone previous Radiation Therapy (RT) in definitive or adjuvant setting. Re-treatment MRgSBRT was delivered with a total dose ranging from 25 to 40 Gy in 5 fractions. Toxicity according to CTCAE v 5.0 and treatment response were assessed at the end of the treatment and at follow-up.

Results

Eighteen patients were included in this analysis. All patients had previously undergone external beam radiation therapy (EBRT) up to a total dose of 59.36 to 80 Gy. Median cumulative biologically effective dose (BED) of SBRT re-treatment was 213,3 Gy (103,1-560), considering an α/β of 1.5. Complete response was achieved in 4 patients (22.2%). No grade ≥ 2 acute genitourinary (GU) toxicity events were recorded, while gastrointestinal (GI) acute toxicity events occurred in 4 patients (22.2%).

Conclusion

The low rates of acute toxicity of this experience encourages considering MRgSBRT a feasibile therapeutic approach for the treatment of clinically relapsed PC. Accurate gating of target volumes, the online adaptive planning workflow and the high definition of MRI treatment images allow delivering high doses to the PTV while efficiently sparing organs at risk (OARs).
Causes of carcass condemnation in Norwegian aviary housed layers
Authors: Gretarsson Páll , Kittelsen Käthe , Oppermann Moe Randi , Toftaker Ingrid
Published: May 2023

Background

Meat inspection data is commonly used to monitor health and welfare in commercial broiler production; however, less used in layers. Slaughterhouse records can provide insight into animal and herd health and identify important health and welfare challenges. To gain knowledge of health issues in commercial aviary housed laying hens, the aim of this repeated cross-sectional study was to describe the occurrence and causes of carcass condemnation, including dead-on-arrivals (DOA), in commercial aviary housed layers in Norway, and to explore seasonal patterns and correlation between DOA and number of carcass condemnations.

Results

Data from January 2018 to December 2020 were collected from one poultry abattoir in Norway. In total, 759,584 layers were slaughtered during this period in 101 slaughter batches from 98 flocks and 56 farms. In total, 33,754 (4.4%) layers were condemned, including the DOA. The most common carcass condemnation causes were (percent of all slaughtered layers): abscess/cellulitis (2.03%), peritonitis (0.38%), DOA (0.22%), emaciation (0.22%), discoloration/smell (0.21%), acute skin lesions (0.21%) and ascites (0.17%). Regression analysis showed an estimated higher prevalence of total carcass condemnation during winter compared to the other seasons.

Conclusions

The three most common condemnation causes found in the present study were: abscess/cellulitis, peritonitis, and DOA. We found a large between-batch variation in causes of condemnation and DOA indicating that prevention might be possible. The results can be used to inform and guide further studies on layer health and welfare.
Hereditary multiple exostoses caused by a chromosomal inversion removing part of EXT1 gene
Authors: Alexandrou Angelos , Salameh Nicole , Papaevripidou Ioannis , Nicolaou Nayia , Myrianthopoulos Panayiotis , Ketoni Andria , Kousoulidou Ludmila , Anastasiou Anna-Maria , Evangelidou Paola , Tanteles George A. , Sismani Carolina
Published: May 2023

Background

Hereditary multiple exostoses (HME) is an autosomal dominant skeletal disorder characterized by the development of multiple, circumscript and usually symmetric bony protuberances called osteochondromas. Most HME are caused by EXT1 and EXT2 loss of function mutations. Most pathogenic mutations are nonsense followed by missense mutations and deletions.

Case presentation

Here we report on a patient with a rare and complex genotype resulting in a typical HME phenotype. Initial point mutation screening in EXT1 and EXT2 genes by Sanger sequencing did not reveal any pathogenic variants. The patient along with the healthy parents was subsequently referred for karyotype and array-Comparative Genomic Hybridization (CGH) analyses.

Chromosomal analysis revealed two independent de novo apparently balanced rearrangements: a balanced translocation between the long arms of chromosomes 2 and 3 at breakpoints 2q22 and 3q13.2 and a pericentric inversion with breakpoints at 8p23.1q24.1. Both breakpoints were confirmed by Fluorescence In Situ Hybridization (FISH). Subsequently, array-CGH revealed a novel heterozygous deletion within the EXT1 gene at one of the inversion breakpoints, rendering the inversion unbalanced. The mode of inheritance, as well as the size of the deletion were further investigated by Quantitative Real-time PCR (qPCR), defining the deletion as de novo and of 3.1 kb in size, removing exon 10 of EXT1. The inversion in combination with the 8p23.1 deletion most likely abolishes the transcription of EXT1 downstream of exon 10 hence resulting in a truncated protein.

Conclusions

The identification of a rare and novel genetic cause of HME, highlights the importance of additional comprehensive investigation of patients with typical clinical manifestations, even when EXT1 and EXT2 mutation analysis is negative.
New insights into the ambivalent role of YAP/TAZ in human cancers
Authors: Luo Juan , Deng Liang , Zou Hailin , Guo Yibo , Tong Tongyu , Huang Mingli , Ling Gengqiang , Li Peng
Published: May 2023

Hippo signaling was first identified in Drosophila as a key controller of organ size by regulating cell proliferation and anti-apoptosis. Subsequent studies have shown that this pathway is highly conserved in mammals, and its dysregulation is implicated in multiple events of cancer development and progression. Yes-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ) (hereafter YAP/TAZ) are the downstream effectors of the Hippo pathway. YAP/TAZ overexpression or activation is sufficient to induce tumor initiation and progression, as well as recurrence and therapeutic resistance. However, there is growing evidence that YAP/TAZ also exert a tumor-suppressive function in a context-dependent manner. Therefore, caution should be taken when targeting Hippo signaling in clinical trials in the future. In this review article, we will first give an overview of YAP/TAZ and their oncogenic roles in various cancers and then systematically summarize the tumor-suppressive functions of YAP/TAZ in different contexts. Based on these findings, we will further discuss the clinical implications of YAP/TAZ-based tumor targeted therapy and potential future directions.

Graphical Abstract
SeATAC: a tool for exploring the chromatin landscape and the role of pioneer factors
Authors: Gong Wuming , Dsouza Nikita , Garry Daniel J.
Published: May 2023

Assay for Transposase-Accessible Chromatin with sequencing (ATAC-seq) reveals chromatin accessibility across the genome. Currently, no method specifically detects differential chromatin accessibility. Here, SeATAC uses a conditional variational autoencoder model to learn the latent representation of ATAC-seq V-plots and outperforms MACS2 and NucleoATAC on six separate tasks. Applying SeATAC to several pioneer factor-induced differentiation or reprogramming ATAC-seq datasets suggests that induction of these factors not only relaxes the closed chromatin but also decreases chromatin accessibility of 20% to 30% of their target sites. SeATAC is a novel tool to accurately reveal genomic regions with differential chromatin accessibility from ATAC-seq data.
Optimal urban competitiveness assessment using cloud computing and neural network
Authors: Hu Rong
Published: May 2023

In the network economy domain, urban competitiveness refers to the comparison between cities in terms of competition and development. It is the ability to gain competitive advantage under different factors. The evaluation of urban competitiveness will help cities to learn from each other, and provides reference for the government to enhance urban competitiveness. Unlike various studies in the literature exploiting only the non-linear characteristics of urban competitiveness, this paper selects BP (Back Propagation) network as the main framework for evaluation. A Genetic Algorithm BP (GABP) network based on genetic optimization is utilized. The weights are optimized besides the crossover mutation of GA algorithm. To compensate the slow prediction in the stand-alone mode, this work proposes a MapReduce (MP) based method; MR-GABP via cloud computing. The model ensures effective urban competitiveness evaluation with improved convergence speed and threshold generation speed. The systematic experiments conducted verify effectiveness of the method while the results obtained reveal that performance of the method is better than the other methods in terms of accuracy and recall yielded as 95.1% and 92.6% respectively.