bluuebunny/crossref_metadata_2025 huggingface dataset:
Right ventricular outflow tract Doppler flow analysis and pulmonary arterial coupling by transthoracic echocardiography in sepsis: a retrospective exploratory study
Authors: Bowcock Emma Maria , Gerhardy Benjamin , Huang Stephen , Orde Sam
Published: October 2022

Introduction

Right ventricular (RV) and pulmonary vascular dysfunction appear to be common in sepsis. RV performance is frequently assessed in isolation, yet its close relationship to afterload means combined analysis with right ventricular outflow tract (RVOT) Doppler and RV–pulmonary arterial (RV–PA) coupling may be more informative than standard assessment techniques. Data on feasibility and utility of these parameters in sepsis are lacking and were explored in this study.

Methods

This is a retrospective study over a 3-year period of one-hundred and thirty-one patients admitted to ICU with sepsis who underwent transthoracic echocardiography (TTE) with RVOT pulsed wave Doppler. RVOT Doppler flow and RV–PA coupling was evaluated alongside standard measurements of RV systolic function and pulmonary pressures. RVOT Doppler analysis included assessment of pulmonary artery acceleration time (PAAT), velocity time integral and presence of notching. RV–PA coupling was assessed using tricuspid annular planar systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP) ratio.

Results

PAAT was measurable in 106 (81%) patients, and TAPSE/PASP was measurable in 77 (73%). Seventy-three (69%) patients had a PAAT of ≤ 100 ms suggesting raised pulmonary vascular resistance (PVR) is common. RVOT flow notching occurred in 15 (14%) of patients. TRV was unable to be assessed in 24 (23%) patients where measurement of PAAT was possible. RV dysfunction (RVD) was present in 28 (26%), 26 (25%) and 36 (34%) patients if subjective assessment, TAPSE < 17 mm and RV dilatation definitions were used, respectively. There was a trend towards shorter PAAT with increasing severity of RVD. RV–PA uncoupling defined as a TAPSE/PASP < 0.31 mm/mmHg was present in 15 (19%) patients. As RV dilatation increased the RV–PA coupling ratio decreased independent of LV systolic function, whereas TAPSE appeared to be more susceptible to changes in LV systolic function.

Conclusion

Raised PVR and RV–PA uncoupling is seen in a significant proportion of patients with sepsis. Non-invasive assessment with TTE is feasible. The role of these parameters in assisting improved definitions of RVD, as well as their therapeutic and prognostic utility against standard parameters, deserves further investigation.
Impact of frailty on clinical outcomes in patients with and without COVID-19 pneumonitis admitted to intensive care units in Australia and New Zealand: a retrospective registry data analysis
Authors: Subramaniam Ashwin , Shekar Kiran , Anstey Christopher , Tiruvoipati Ravindranath , Pilcher David
Published: October 2022

Background

It is unclear if the impact of frailty on mortality differs between patients with viral pneumonitis due to COVID-19 or other causes. We aimed to determine if a difference exists between patients with and without COVID-19 pneumonitis.

Methods

This multicentre, retrospective, cohort study using the Australian and New Zealand Intensive Care Society Adult Patient Database included patients aged ≥ 16 years admitted to 153 ICUs between 01/012020 and 12/31/2021 with admission diagnostic codes for viral pneumonia or acute respiratory distress syndrome, and Clinical Frailty Scale (CFS). The primary outcome was hospital mortality.

Results

A total of 4620 patients were studied, and 3077 (66.6%) had COVID-19. The patients with COVID-19 were younger (median [IQR] 57.0 [44.7–68.3] vs. 66.1 [52.0–76.2]; p < 0.001) and less frail (median [IQR] CFS 3 [2–4] vs. 4 [3–5]; p < 0.001) than non-COVID-19 patients. The overall hospital mortality was similar between the patients with and without COVID-19 (14.7% vs. 14.9%; p = 0.82). Frailty alone as a predictor of mortality showed only moderate discrimination in differentiating survivors from those who died but was similar between patients with and without COVID-19 (AUROC 0.68 vs. 0.66; p = 0.42). Increasing frailty scores were associated with hospital mortality, after adjusting for Australian and New Zealand Risk of Death score and sex. However, the effect of frailty was similar in patients with and without COVID-19 (OR = 1.29; 95% CI: 1.19–1.41 vs. OR = 1.24; 95% CI: 1.11–1.37).

Conclusion

The presence of frailty was an independent risk factor for mortality. However, the impact of frailty on outcomes was similar in COVID-19 patients compared to other causes of viral pneumonitis.

Graphical Abstract
Krüppel-like factor 7 influences translation and pathways involved in ribosomal biogenesis in breast cancer
Authors: Lüchtenborg Anne-Marie , Metzger Patrick , Cosenza Contreras Miguel , Oria Victor , Biniossek Martin L. , Lindner Franziska , Fröhlich Klemens , Malyi Ambrus , Erbes Thalia , Gensch Nicole , Maurer Jochen , Thomsen Andreas , Boerries Melanie , Schilling Oliver , Werner Martin , Bronsert Peter
Published: October 2022

Background

Ribosomal biogenesis and ribosomal proteins have attracted attention in the context of tumor biology in recent years. Instead of being mere translational machineries, ribosomes might play an active role in tumor initiation and progression. Despite its importance, regulation of ribosomal biogenesis is still not completely understood.

Methods

Using Gene Set Enrichment Analysis of RNA sequencing and proteomical mass spectrometry data in breast cancer cells expressing Krüppel-like factor 7 (KLF7), we identified processes altered by this transcription factor. In silico analyses of a cohort of breast cancer patients in The Cancer Genome Atlas confirmed our finding. We further verified the role of KLF7 the identified ribosomal processes in in vitro assays of mammary carcinoma cell lines and analyses of breast cancer patients’ tissue slices.

Results

We identified the transcription factor Krüppel-like factor 7 (KLF7) as a regulator of ribosomal biogenesis and translation in breast cancer cells and tissue. Highly significant overlapping processes related to ribosomal biogenesis were identified in proteomics and transcriptomics data and confirmed in patients’ breast cancer RNA Seq data. Further, nucleoli, the sites of ribosomal biogenesis, were morphologically altered and quantitatively increased in KLF7-expressing cells. Pre-rRNA processing was identified as one potential process affected by KLF7. In addition, an increase in global translation independent from proliferation and transcription was observed upon exogenous KLF7 expression in vitro. Importantly, in a cohort of breast cancer patients, KLF7-expression levels correlated with aggressiveness of the intrinsic breast cancer subtype and tumor grading. Moreover, KLF7 correlated with nucleolar characteristics in human breast tumor tissue, indicating a role for KLF7 in ribosomal biogenesis.

Conclusion

In mammary carcinoma, KLF7 is involved in ribosomal biogenesis. Alterations of ribosomal biogenesis has far reaching quantitative and qualitative implications for the proteome of the cancer cells. This might influence the aggressiveness of cancer cells.
A socio-ecological approach to reduce the physical activity drop-out ratio in primary care-based patients with type 2 diabetes: the SENWI study protocol for a randomized control trial
Authors: Jabardo-Camprubí Guillem , Bort-Roig Judit , Donat-Roca Rafel , Milà-Villarroel Raimon , Sitjà-Rabert Mercè , McKenna Jim , Puig-Ribera Anna
Published: October 2022

Background

Physical activity (PA) is a key behaviour for patients with type 2 diabetes (T2DM). However, healthcare professionals’ (HCP) recommendations (walking advice), which are short-term and individually focused, did not reduce the PA drop-out ratio in the long run. Using a socio-ecological model approach may contribute to reducing patient dropout and improving adherence to PA. The aim of this study is threefold: first, to evaluate the effectiveness of a theory-driven Nordic walking intervention using a socio-ecological approach with T2DM patients in Spain; second, to explore the feasibility on the PA adherence process in T2DM patients while participating in the SENWI programme; and third, to understand the HCPs’ opinion regarding its applicability within the Spanish healthcare system.

Methods

A three-arm randomized control trial (n = 48 each group) will assess the efficacy of two primary care-based PA interventions (Nordic walking vs. Nordic walking plus socio-ecological approach; two sessions per week for twelve weeks) compared to a control group (usual HCPs’ walking advice on PA). Inclusion criteria will include physically inactive patients with T2DM, older than 40 years and without health contraindications to do PA. PA levels and drop-out ratio, quality of life and metabolic and health outcomes will be assessed at baseline, post-intervention and at 9- and 21-month follow-ups. The effect of the different interventions will be assessed by a two-factor analysis of variance: treatment group vs time. Also, a two-factor ANOVA test will be performed with linear mixed models for repeated measures.

A qualitative analysis using focus groups will explore the reasons for the (in)effectiveness of the new PA interventions. Qualitative outcomes will be assessed at post-intervention using thematic analysis.

Discussion

Compared with the general PA walking advice and Nordic walking prescriptions, integrating a socio-ecological approach into Spanish primary care visits could be an effective way to reduce the PA drop-out ratio and increase PA levels in patients with T2DM. Such interventions are necessary to understand the role that multiple socio-complex process in day-to-day PA behaviour has in patients with T2DM in the Spanish context.

Trial registration

ClinicalTrials.gov NCT05159089. Physical Activity Drop-out Ratio in Patients’ Living with Type 2 Diabetes. Prospectively registered on 15 December 2021.
Lessening the Impact of Financial Toxicity (LIFT): a protocol for a multi-site, single-arm trial examining the effect of financial navigation on financial toxicity in adult patients with cancer in rural and non-rural settings
Authors: Wheeler Stephanie B. , Biddell Caitlin B. , Manning Michelle L. , Gellin Mindy S. , Padilla Neda R. , Spees Lisa P. , Rogers Cynthia D. , Rodriguez-O’Donnell Julia , Samuel-Ryals Cleo , Birken Sarah A. , Reeder-Hayes Katherine E. , Petermann Victoria M. , Deal Allison M. , Rosenstein Donald L.
Published: October 2022

Background

Almost half of the patients with cancer report cancer-related financial hardship, termed “financial toxicity” (FT), which affects health-related quality of life, care retention, and, in extreme cases, mortality. This increasingly prevalent hardship warrants urgent intervention. Financial navigation (FN) targets FT by systematically identifying patients at high risk, assessing eligibility for existing resources, clarifying treatment cost expectations, and working with patients and caregivers to develop a plan to cope with cancer costs. This trial seeks to (1) identify FN implementation determinants and implementation outcomes, and (2) evaluate the effectiveness of FN in improving patient outcomes.

Methods

The Lessening the Impact of Financial Toxicity (LIFT) study is a multi-site Phase 2 clinical trial. We use a pre-/post- single-arm intervention to examine the effect of FN on FT in adults with cancer. The LIFT trial is being conducted at nine oncology care settings across North Carolina in the United States. Sites vary in geography (five rural, four non-rural), size (21–974 inpatient beds), and ownership structure (governmental, non-profit). The study will enroll 780 patients total over approximately 2 years. Eligible patients must be 18 years or older, have a confirmed cancer diagnosis (any type) within the past 5 years or be living with advanced disease, and screen positive for cancer-related financial distress. LIFT will be delivered by full- or part-time financial navigators and consists of 3 components: (1) systematic FT screening identification and comprehensive intake assessment; (2) connecting patients experiencing FT to financial support resources via trained oncology financial navigators; and (3) ongoing check-ins and electronic tracking of patients’ progress and outcomes by financial navigators. We will measure intervention effectiveness by evaluating change in FT (via the validated Comprehensive Score of Financial Toxicity, or COST instrument) (primary outcome), as well as health-related quality of life (PROMIS Global Health Questionnaire), and patient-reported delayed or forgone care due to cost. We also assess patient- and stakeholder-reported implementation and service outcomes post-intervention, including uptake, fidelity, acceptability, cost, patient-centeredness, and timeliness.

Discussion

This study adds to the growing evidence on FN by evaluating its implementation and effectiveness across diverse oncology care settings.

Trial registration

ClinicalTrials.gov NCT04931251. Registered on June 18, 2021.
Deep learning-based automatic-bone-destruction-evaluation system using contextual information from other joints
Authors: Miyama Kazuki , Bise Ryoma , Ikemura Satoshi , Kai Kazuhiro , Kanahori Masaya , Arisumi Shinkichi , Uchida Taisuke , Nakashima Yasuharu , Uchida Seiichi
Published: October 2022

Background

X-ray images are commonly used to assess the bone destruction of rheumatoid arthritis. The purpose of this study is to propose an automatic-bone-destruction-evaluation system fully utilizing deep neural networks (DNN). This system detects all target joints of the modified Sharp/van der Heijde score (SHS) from a hand X-ray image. It then classifies every target joint as intact (SHS = 0) or non-intact (SHS ≥ 1).

Methods

We used 226 hand X-ray images of 40 rheumatoid arthritis patients. As for detection, we used a DNN model called DeepLabCut. As for classification, we built four classification models that classify the detected joint as intact or non-intact. The first model classifies each joint independently, whereas the second model does it while comparing the same contralateral joint. The third model compares the same joint group (e.g., the proximal interphalangeal joints) of one hand and the fourth model compares the same joint group of both hands. We evaluated DeepLabCut’s detection performance and classification models’ performances. The classification models’ performances were compared to three orthopedic surgeons.

Results

Detection rates for all the target joints were 98.0% and 97.3% for erosion and joint space narrowing (JSN). Among the four classification models, the model that compares the same contralateral joint showed the best F-measure (0.70, 0.81) and area under the curve of the precision-recall curve (PR-AUC) (0.73, 0.85) regarding erosion and JSN. As for erosion, the F-measure and PR-AUC of this model were better than the best of the orthopedic surgeons.

Conclusions

The proposed system was useful. All the target joints were detected with high accuracy. The classification model that compared the same contralateral joint showed better performance than the orthopedic surgeons regarding erosion.
Lafora disease: a case report
Authors: Zeka Naim , Zogaj Leonore , Gerguri Abdurrahim , Bejiqi Ramush , Ratkoceri Ragip , Maloku Arlinda , Mustafa Aferdita , Shahini Labinot , Maxharaj Jeton
Published: October 2022

Background

Lafora disease is a rare genetic disorder involving glycogen metabolism disorder. It is inherited by autosomal recessive pattern presenting as a progressive myoclonus epilepsy and neurologic deterioration beginning in adolescence. It is characterized by Lafora bodies in tissues such as brain, skin, muscle, and liver.

Case presentation

We report a rare case of Lafora disease in a 16-year-old Albanian girl who presented at a tertiary health care center with generalized tonic–clonic seizures, eyelid twitches, hallucinations, headache, and cognitive dysfunction. She was initially treated for generalized epilepsy and received an antiepileptic drug. However, owing to resistance of seizures to this antiepileptic drug, a second drug was introduced. However, seizures continued despite compliance with therapy, and general neurological status began to deteriorate. The child began to have hallucinations and decline of cognitive function. She developed dysarthria and unsteady gait. When admitted to the hospital, blood tests and imaging examinations were planned. The blood tests were unremarkable. There was no relevant family history and no consanguinity. Electroencephalography showed multifocal discharges in both hemispheres, and brain magnetic resonance imaging revealed no abnormality. Axillary skin biopsy revealed inclusion bodies in apocrine glands. Consequently, the child was referred to an advanced center for genetic testing, which also confirmed diagnosis of Lafora disease with a positive mutation onNHLRC1gene.

Conclusions

 Even though rare as a condition, Lafora disease should be considered on differential diagnosis in progressive and drug-refractory epilepsy in adolescents, especially when followed by cognitive decline.
Chronic expanding hematoma of the left erector spinae muscle after stereotactic body radiotherapy for renal cell carcinoma: a case report
Authors: Ishikawa Yojiro , Yamamoto Takaya , Umezawa Rei , Takahashi Noriyoshi , Takeda Kazuya , Suzuki Yu , Jingu Keiichi
Published: October 2022

Background

Hematomas that slowly increase in size for more than 1 month after the initial hemorrhage are referred to as chronic expanding hematomas. Chronic expanding hematoma can also occur after radiosurgery; however, there have been no reports about chronic expanding hematoma in the trunk after stereotactic body radiotherapy. We report a case of chronic expanding hematoma of the left erector spinae muscle after stereotactic body radiotherapy for renal cell carcinoma.

Case presentation

A 74-year-old Japanese male complained of back pain 7 years after stereotactic body radiotherapy for renal cell carcinoma of the left kidney. There was no history of surgery or trauma to his back. After stereotactic body radiotherapy, there was no acute or late complication of more than grade 2. The renal cell carcinoma did not show shrinkage or progression, and he was diagnosed with stable disease on computed tomography. The patient remains in a stable disease condition 7 years after treatment without surgery or chemotherapy; however, he came to the hospital with gradually worsening back pain for several months. Computed tomography revealed the left erector spinae muscle to be swollen compared with the contralateral side at the third lumbar level. Ultrasonography showed a tumor of 30 mm in size without blood flow in the left paraspinal muscle. Positron emission tomography–computed tomography revealed uptake in the left paraspinal muscle. Pathological examination showed radiation-induced chronic expanding hematoma.

Conclusions

We present the first case report of chronic expanding hematoma of the left erector spinae muscle after stereotactic body radiotherapy for renal cell carcinoma. Usually, stereotactic body radiotherapy for renal cell carcinoma would be considered unlikely to cause chronic expanding hematoma, but the introduction of dialysis and antiplatelet drugs may have increased the risk.
The effect of medical cannabis on cognitive functions: a systematic review
Authors: Wieghorst Anders , Roessler Kirsten Kaya , Hendricks Oliver , Andersen Tonny Elmose
Published: October 2022

Background

Cannabis-based medicines are widely used in the treatment of a number of medical conditions. Unfortunately, cognitive disturbances are often reported as adverse events, although conversely, cognitive improvements have been reported. Hence, the objective of the present study was to identify, critically appraise and synthesise research findings on the potential impact of cannabis-based medicines on cognitive functioning.

Methods

Four databases (EMBASE, PsycINFO, PubMed and Scopus) were systematically searched. Studies were included if they provided findings on the impact of cannabis-based medicines in controlled settings on cognitive functioning measured by recognised cognitive tests in human adults. Study participants were required to be their own case-control, and neither studies on abuse, abstinences, patients with severe neurodegenerative diseases nor cancer-related pain conditions were included. Screening, risk of bias assessment and data extraction were conducted independently by two researchers. Findings were tabulated and synthesised by outcome.

Findings

Twenty-three studies were included, comprising a total of N = 917. Eight studies used Sativex as the cannabis-based medicine two used Epidiolex, two other studies used sprays, three studies used gelatine capsules, five smoked cannabis, two other and finally one studied cannabis withdrawal. Fifteen studies reported non-significant findings; six reported cognitive impairments; one study found cognitive improvement and a single study found improvement following withdrawal. Thirteen studies had cognitive or neuropsychological functioning as the primary outcome.

Conclusions

Due to a large heterogeneity and methodological limitations across studies, it is not possible to make any definite conclusions about the impact of cannabis-based medicines on cognitive functioning. However, the majority of high-quality evidence points in the direction that the negative impact of cannabis-based medicines on cognitive functioning is minor, provided that the doses of THC are low to moderate. On the other hand, long-term use of cannabis based medicines may still adversely affect cognitive functioning. In the studies that found impaired cognitive functioning to be significant, all of the test scores were either within the normal range or below what would be characterised as a neuropsychologically cognitive impairment.
Understanding the perceived indicators of food sovereignty and food security for rice growers and rural organizations in Mazandaran Province, Iran
Authors: Zamanialaei Maryam , McCarty Jessica L. , Fain Justin J. , Hughes Michael R.
Published: October 2022

Background

Food sovereignty and food security are inseparable from agricultural development policies, particularly regarding how to increase food production and productivity to meet future demand. This study investigates the status and perceptions of food sovereignty and food security of small-scale rice growers’ households in the Mazandaran Province of northern Iran. The study region is one of the most important places for domestic rice production, with nearly 230,000 hectares of rice lands in the country and 45% of total domestic rice production. The role of the Rice Research Institute of Iran (RRII) as an innovative rural institution was highlighted by the rice producers for contributing to food sovereignty and food security. A survey was distributed among 127 rice farmers’ households to obtain indicators of food sovereignty (localization of food systems, values for food providers, concentration of local control of the food system, building knowledge and skills, right to food, working with nature) and food security (availability, accessibility, utility, quality). Principal Component Analysis and Partial Correlation tests were used for finding the relationship between variables and focused indicators.

Results

Results show that food sovereignty in Northern Iran focused on localizing the food system by gaining access to financial assets and local markets, investing in human capital and local training and improving access to the water resources; food security focused on environmental and climate extension, increasing household’s revenues by improving food policies and food quality from rice farmers’ perspectives. In addition, the results of this study demonstrate the desire in Northern Iran for the role of innovative rural organizations as vital linkages between rice farmers and the public sector (i.e., Ministry of Agriculture Jihad).

Conclusions

This research shows that from the perspective of the surveyed rice growers in northern Iran, four main indicators that relate to investment and resources were the most significant: capital, markets, credit, and knowledge. Further studies are required for remote sensing monitoring of rice crop condition and yields, condition of irrigation systems, and geographic relationship of the agricultural infrastructure to food sovereignty and food security in northern Iran.
Chicken intestinal microbiota modulation of resistance to nephropathogenic infectious bronchitis virus infection through IFN-I
Authors: Yin Hai-chang , Liu Zhen-dong , Zhang Wei-wei , Yang Qing-zhu , Yu Tian-fei , Jiang Xin-jie
Published: October 2022

Background

Mammalian intestinal microbiomes are necessary for antagonizing systemic viral infections. However, very few studies have identified whether poultry commensal bacteria play a crucial role in protecting against systemic viral infections. Nephropathogenic infectious bronchitis virus (IBV) is a pathogenic coronavirus that causes high morbidity and multiorgan infection tropism in chickens.

Results

In this study, we used broad-spectrum oral antibiotics (ABX) to treat specific pathogen free (SPF) chickens to deplete the microbiota before infection with nephropathogenic IBV to analyze the impact of microbiota on IBV infections in vivo. Depletion of the SPF chicken microbiota increases pathogenicity and viral burden following IBV infection. The gnotobiotic chicken infection model further demonstrated that intestinal microbes are resistant to nephropathogenic IBV infection. In addition, ABX-treated chickens showed a severe reduction in macrophage activation, impaired type I IFN production, and IFN-stimulated gene expression in peripheral blood mononuclear cells and the spleen. Lactobacillus isolated from SPF chickens could restore microbiota-depleted chicken macrophage activation and the IFNAR-dependent type I IFN response to limit IBV infection. Furthermore, exopolysaccharide metabolites of Lactobacillus spp. could induce IFN-β.

Conclusions

This study revealed the resistance mechanism of SPF chicken intestinal microbiota to nephropathogenic IBV infection, providing new ideas for preventing and controlling nephropathogenic IBV.
ACSL3 regulates lipid droplet biogenesis and ferroptosis sensitivity in clear cell renal cell carcinoma
Authors: Klasson Timothy D. , LaGory Edward L. , Zhao Hongjuan , Huynh Star K. , Papandreou Ioanna , Moon Eui Jung , Giaccia Amato J.
Published: October 2022

Background

Clear cell renal cell carcinoma (ccRCC), the predominant subtype of kidney cancer, possesses characteristic alterations to multiple metabolic pathways, including the accumulation of cytosolic lipid droplets. However, the pathways that drive lipid droplet accumulation in ccRCC cells and their importance to cancer biology remain poorly understood.

Methods

We sought to identify the carbon sources necessary for lipid droplet accumulation using Oil red O staining and isotope-tracing lipidomics. The role of the acyl-CoA synthetase (ACSL) family members, an important group of lipid metabolic enzymes, was investigated using siRNA and drug mediated inhibition. CTB and XTT assays were performed to determine the effect of ACSL3 knockdown and lipid starvation on ccRCC cell viability and shRNA was used to study the effect of ACSL3 in an orthotopic mouse model. The relationship between ferroptosis susceptibility of ccRCC and ACSL3 controlled lipid metabolism was examined using CTB and FACS-based assays. The importance of 5-LOX in ferroptosis susceptibility in ccRCC was shown with XTT survival assays, and the expression level and predictive value of 5-LOX in TCGA ccRCC data was assessed.

Results

We found that ccRCC cells obtain the necessary substrates for lipid droplet accumulation by metabolizing exogenous serum derived lipids and not through de novo lipogenesis. We show that this metabolism of exogenous fatty acids into lipid droplets requires the enzyme acyl-CoA synthetase 3 (ACSL3) and not other ACSL family proteins. Importantly, genetic or pharmacologic suppression of ACSL3 is cytotoxic to ccRCC cells in vitro and causes a reduction of tumor weight in an orthotopic mouse model. Conversely, ACSL3 inhibition decreases the susceptibility of ccRCC cells to ferroptosis, a non-apoptotic form of cell death involving lipid peroxidation. The sensitivity of ccRCC to ferroptosis is also highly dependent on the composition of exogenous fatty acids and on 5-lipoxygenase (5-LOX), a leukotriene producing enzyme which produces lipid peroxides that have been implicated in other cancers but not in ccRCC.

Conclusions

ACSL3 regulates the accumulation of lipid droplets in ccRCC and is essential for tumor growth. In addition, ACSL3 also modulates ferroptosis sensitivity in a manner dependent on the composition of exogenous fatty acids. Both functions of ACSL3 could be exploited for ccRCC therapy.
Varus collapse following anterior closing wedge proximal tibial osteotomy for ACL revision reconstruction: a case series
Authors: MacLean Ian S. , Tyndall William A. , Schenck Robert C. , Miller Mark D.
Published: October 2022

A slope-correcting anterior closing wedge proximal tibial osteotomy is a powerful tool for correcting increased posterior tibial slope in the setting of a failed anterior cruciate ligament reconstruction. This case series documents three cases in which patients collapsed into varus following an anterior closing wedge proximal tibia osteotomy. Two patients had osteotomies fixated with a “suture-staple” construct, and all had medical comorbidities or reported noncompliance post-operatively. Therefore, meticulous care during the planning, execution, and rehabilitation phases is critical as multiple factors throughout the arc of care may contribute towards anterior closing wedge proximal tibial osteotomy varus collapse. Careful optimization of medical comorbidities and rigid fixation with either a plate and screws or compression staples should be used rather than a “suture-staple” to mitigate this risk.

Level of evidence: IV.
Descriptive analyses of maternally-derived antibody levels against porcine circovirus 2 (PCV-2) in 3- and 21-day-old piglets from farms of four European countries using different vaccination protocols in sows
Authors: Sibila M. , Llorens A. , Huerta E. , Fablet C. , Faderl M. , Ferrari L. , Rose N. , Palzer A. , Martelli P. , Venegas-Vargas M. C. , Fredrickson D. , Taylor L. , Balasch M. , Bandrick M. , Segalés J.
Published: October 2022

Background

Up to now, information on the levels of maternally-derived antibodies (MDA) against PCV-2 in suckling piglets born to sows vaccinated with different strategies is scarce in the literature. In the present observational study, the PCV-2-specific MDA titres from piglets from 109 farms (thirty 3-day-old and thirty 21-day-old piglets per farm) across four different European countries (France n = 30, Germany n = 27, Italy n = 22 and Spain n = 30) using different sow vaccination strategies (during gestation, as a gilt, as a piglet or never) were assessed.

Results

In all four countries, mean log PCV-2 MDA titres were higher in 3-day-old piglets than in the 3-week-old ones, being significant in most of all the comparisons performed. Within each country, the highest PCV-2-specific MDA titres were observed in the 3-day-old piglets born to sows vaccinated during gestation. Indeed, in the four countries, more than 60% of this subpopulation (3-day-old piglets from sows vaccinated during pregnancy) had the highest log PCV-2 titres detectable with the ELISA technique used in this study. The lowest MDA titres were more variable. Whereas in France and Germany the lowest titres corresponded to 21-day-old piglets born from sows vaccinated as a piglet, in Italy, they corresponded to 21-day-old piglets derived from sows vaccinated as a gilt and in Spain to 21-day-old piglets born from non-vaccinated sows. In this study, PCV-2-specific MDA titres at 3 and 21 days of age were not affected by sow parity.

Conclusions

Data obtained could be considered as a European global overview of PCV-2-specific MDA titres present in the pre-vaccinated piglet populations in different European countries, with titres tending to be higher in younger piglets, but with values variable among countries and sow vaccination strategies.
Revisiting functional adequacy and task-based language teaching in the GBA: insights from translanguaging
Authors: Bui Gavin , Tai Kevin W. H.
Published: October 2022

Research and practice in task-based language teaching (TBLT) as a cognitively oriented second language (L2) pedagogy have grown substantially over the last three decades. A concurrent development in language education that thrives along the sociocultural paradigm, translanguaging, is also gaining great traction due to its potential in helping to form a holistic communicative repertoire among L2 learners. Despite their different theoretical underpinnings and ideological perspectives, TBLT and translanguaging share many common grounds that are worth exploring. This article argues that translanguaging offers a practical tool for improving L2 task-based performance, especially functional adequacy. Adopting translanguaging in TBLT would be beneficial for learners with a common first language background such as Chinese but lower affect as well as limited lexical and morpho-syntactic knowledge. Implications for L2 or foreign language education policies in the Great Bay Area of China and the implementation of translanguaging in the pre-, during-, and post-task phrases in a TBLT classroom in the region are discussed.
Do digital interventions increase adherence to home exercise rehabilitation? A systematic review of randomised controlled trials
Authors: Lang Sabine , McLelland Colin , MacDonald Donnie , Hamilton David F.
Published: October 2022

Background

Home exercise regimes are a well-utilised rehabilitation intervention for many conditions; however, adherence to prescribed programmes remains low. Digital interventions are recommended as an adjunct to face-to-face interventions by the National Health Service in the UK and may offer increased exercise adherence, however the evidence for this is conflicting.

Method

A systematic review was undertaken using MEDLINE and CINAHL databases using the PRISMA guidelines. Randomised controlled trials in any clinical population evaluating the adherence to prescribed home exercise interventions with and without additional digital interventions were included. Publication quality was assessed using the Cochrane Risk of Bias tool.

Results

The search strategy returned a total of 1336 articles, of which 10 randomised controlled trials containing data for 1117 participants were eligible for inclusion. 565 participants were randomised to receive the interventions, and 552 to the control. Seven of the ten trials reported a significant difference in adherence between the control and intervention groups favouring an additional digital intervention. Three trials reported equivalent findings. These three reported longer-term outcomes, suggesting an interaction between adherence and duration of intervention. There was substantial heterogeneity in outcome assessment metrics used across the trials prohibiting formal meta-analysis. This included studies were of low to moderate quality in terms of risk of bias.

Conclusion

The addition of a digital interventions to prescribed home exercise programmes can likely increase exercise adherence in the short term, with longer term effects less certain.
Transcatheter aortic valve implantation under lower activated clotting time in a patient with hemorrhagic gastric cancer: a case report
Authors: Mitsuta Yuki , Oyoshi Takafumi , Nonaka Takahiro , Hirata Naoyuki
Published: October 2022

Background

Perioperative management of transcatheter aortic valve implantation (TAVI) in patients with a high risk of bleeding requires careful consideration.

Case presentation

A 74-year-old man complained of chest pain and was admitted to our hospital. Close examination revealed severe aortic stenosis (AS) and hemorrhagic gastric cancer. Hemorrhage from gastric cancer was controlled using endoscopic hemostasis. While both gastric cancer and AS required surgery, we decided to perform transfemoral transcatheter aortic valve implantation (TAVI) under monitored anesthesia. To reduce bleeding from gastric cancer, we carefully adjusted the heparin dose to maintain the activated clotting time (ACT) between 180 and 200 s. TAVI with a balloon-expandable valve was completed without thrombotic complications. Laparoscopic distal gastrectomy was performed on the 6th day after TAVI.

Conclusions

We report the successful management of TAVI in a patient with hemorrhagic gastric cancer. In TAVI for patients with hemorrhagic diseases, careful consideration of antithrombotic therapy is required.
Understand group interaction and cognitive state in online collaborative problem solving: leveraging brain-to-brain synchrony data
Authors: Du Xu , Zhang Lizhao , Hung Jui-Long , Li Hao , Tang Hengtao , Xie Yiqian
Published: October 2022

The purpose of this study aimed to analyze the process of online collaborative problem solving (CPS) via brain-to-brain synchrony (BS) at the problem-understanding and problem-solving stages. Aiming to obtain additional insights than traditional approaches (survey and observation), BS refers to the synchronization of brain activity between two or more people, as an indicator of interpersonal interaction or common attention. Thirty-six undergraduate students participated. Results indicate the problem-understanding stage showed a higher level of BS than the problem-solving stage. Moreover, the level of BS at the problem-solving stage was significantly correlated with task performance. Groups with all high CPS skill students had the highest level of BS, while some of the mixed groups could achieve the same level of BS. BS is an effective indicator of CPS to group performance and individual interaction. Implications for the online CPS design and possible supports for the process of online CPS activity are also discussed.
The contribution of the 1H-MRS lipid signal to cervical cancer prognosis: a preliminary study
Authors: Dolciami Miriam , Canese Rossella , Testa Claudia , Pernazza Angelina , Santangelo Giusi , Palaia Innocenza , Rocca Carlo Della , Catalano Carlo , Manganaro Lucia
Published: October 2022

Background

The aim of this study was to investigate the role of the lipid peak derived from 1H magnetic resonance (MR) spectroscopy in assessing cervical cancer prognosis, particularly in assessing response to neoadjuvant chemotherapy (NACT) of locally advanced cervical cancer (LACC).

Methods

We enrolled 17 patients with histologically proven cervical cancer who underwent 3-T MR imaging at baseline. In addition to conventional imaging sequences for pelvic assessment, the protocol included a single-voxel point-resolved spectroscopy (PRESS) sequence, with repetition time of 1,500 ms and echo times of 28 and 144 ms. Spectra were analysed using the LCModel fitting routine, thus extracting multiple metabolites, including lipids (Lip) and total choline (tCho). Patients with LACC were treated with NACT and reassessed by MRI at term. Based on tumour volume reduction, patients were classified as good responder (GR; tumour volume reduction > 50%) and poor responder or nonresponder (PR-or-NR; tumour volume reduction ≤ 50%).

Results

Of 17 patients, 11 were LACC. Of these 11, only 6 had both completed NACT and had good-quality 1H-MR spectra; 3 GR and 3 PR-or-NR. A significant difference in lipid values was observed in the two groups of patients, particularly with higher Lip values and higher Lip/tCho ratio in PR-NR patients (p =0.040). A significant difference was also observed in choline distribution (tCho), with higher values in GR patients (p = 0.040).

Conclusions

Assessment of lipid peak at 1H-MR spectroscopy could be an additional quantitative parameter in predicting the response to NACT in patients with LACC.
Inequities in rates of variceal screening examinations
Authors: Lucioni Tomas , Hines Cambridge , Witek Lauren , Rejeski Jared
Published: October 2022

Background

The role of esophagogastroduodenoscopy (EGD) in screening for varices in patients with cirrhosis is well established. However, it is unknown how insurance status impacts the rate of variceal screening. Therefore, we examined an at-risk population to determine the effect of insurance status on the rate of variceal screening.

Results

Data were available on 111 patients who had an EGD ordered for variceal screening over this 18-month period. Analysis showed that six of sixteen (37.5%) uninsured patients versus sixty-three of ninety-five (66.4%) insured patients underwent EGD for screening purposes. Comparing these rates revealed a significant difference (p < 0.05, 95% CI 0.0841, 1.034). There were no significant differences comparing gender or ethnicity among the two groups. The unadjusted odds ratio (OR) of completing screening dependent on insurance status was 3.28 (95% CI 1.09–9.84, p = 0.03). These findings suggest that lack of insurance negatively affects EGD completion rates among the cirrhotic patient population.

Conclusions

This analysis suggests that lack of insurance adversely impacts variceal screening rates among patients with cirrhosis. Recognition of this disparity is an important first step in finding methods to deliver appropriate care to these patients, reduce avoidable adverse outcomes and decrease the high cost of hospitalization associated with this pathology.
Why cancer incidence in the Arab counties is much lower than other parts of the world?
Authors: Arafa Mostafa A. , Farhat Karim H.
Published: October 2022

Despite the relatively increased cancer incidence in the last few years in the Arab countries, it is still far from the figures reported from Western countries. Several mechanisms have been adopted to explain the significant decreased incidence of cancer in the Arab countries, among them fasting, food full of special recipes filled with spices, significant lower rates of smoking and alcohol drinking, and genetic predisposition. Clinical trials are warranted on a large population scales to study, discuss, and verify such mechanisms.
Application of 320-row multidetector free-breathing cine CT in diagnosis of pediatric expiratory central airway collapse
Authors: Elmeazawy Rehab Zaki , Mubarak Amr Ahmed , Fasseeh Nader Abdelmonem , Abdelrazik Ahmad Mohammed
Published: October 2022

Background

Pediatric expiratory central airway collapse poses diagnostic challenge due to non-specific clinical presentation with further investigations needed for definite diagnosis. The purpose of this cross-sectional study was to determine the diagnostic accuracy of 320-row multidetector free-breathing cine CT in diagnosis of pediatric expiratory central airway collapse utilizing its advantageous wide z-axis coverage. End-inspiratory and end-expiratory measurement of cross-sectional area at certain points of airway was done to calculate the percentage of expiratory central airway collapse. Flexible bronchoscopy was done thereafter as a gold standard technique for comparison.

Results

Among the thirty-eight pediatric patients (20 males and 18 females) enrolled in this study, free-breathing cine CT correctly diagnosed expiratory central airway collapse in 32 patients with a sensitivity of 84.2%. However, a statistically significant difference was found between the results of bronchoscopy and free-breathing cine CT as regard the site, morphology and severity of airway collapse.

Conclusions

320-row multidetector free-breathing cine CT is still considered an effective noninvasive imaging modality in diagnosis of expiratory central airway collapse in pediatric population, despite the differences in perceived morphology and severity when compared to flexible bronchoscopy.
A functional magnetic resonance imaging study of frontal networks in obsessive-compulsive disorder during cognitive reappraisal
Authors: De la Peña-Arteaga Víctor , Morgado Pedro , Couto Beatriz , Ferreira Sónia , Castro Inês , Sousa Nuno , Soriano-Mas Carles , Picó-Pérez Maria
Published: October 2022

Background

Patients with obsessive-compulsive disorder (OCD) present difficulties in the cognitive regulation of emotions, possibly because of inefficient recruitment of distributed patterns of frontal cortex regions. The aim of the present study is to characterize the brain networks, and their dysfunctions, related to emotion regulation alterations observed during cognitive reappraisal in OCD.

Methods

Adult patients with OCD (n = 31) and healthy controls (HC; n = 30) were compared during performance of a functional magnetic resonance imaging cognitive reappraisal protocol. We used a free independent component analysis approach to analyze network-level alterations during emotional experience and regulation. Correlations with behavioral scores were also explored.

Results

Analyses were focused on six networks encompassing the frontal cortex. OCD patients showed decreased activation of the frontotemporal network in comparison with HC (F(1,58) = 7.81, p = 0.007) during cognitive reappraisal. A similar trend was observed in the left frontoparietal network.

Conclusions

The present study demonstrates that patients with OCD show decreased activation of specific networks implicating the frontal cortex during cognitive reappraisal. These outcomes should help to better characterize the psychological processes modulating fear, anxiety, and other core symptoms of patients with OCD, as well as the associated neurobiological alterations, from a system-level perspective.
Statins, Type 2 Diabetes, and Body Mass Index: A Univariable and Multivariable Mendelian Randomization Study
Authors: Yang Guoyi , Schooling C Mary
Published: October 2022

Context

Statins and possibly other lipid modifiers increase type 2 diabetes risk and body mass index (BMI). However, to what extent BMI mediates the diabetogenic effects of lipid modifiers remains unclear.

Objective

We used Mendelian randomization (MR) to investigate the effects of commonly used lipid modifiers on type 2 diabetes risk and glycemic traits, and any mediation by BMI.

Methods

Using established genetic variants to mimic commonly used lipid modifiers (ie, statins, PCSK9 inhibitors, and ezetimibe), we assessed their associations with type 2 diabetes risk, glycated hemoglobin (HbA1c), fasting insulin, fasting glucose, and BMI in the largest relevant genome-wide association studies (GWAS) in people of European ancestry, and where possible, in East Asians. We used multivariable MR to examine the role of lipid modifiers independent of BMI.

Results

Genetically mimicked effects of statins and ezetimibe, but not PCSK9 inhibitors were associated with higher risk of type 2 diabetes (odds ratio [OR] 1.74 [95% CI, 1.49 to 2.03]; 1.92 [1.22 to 3.02]; 1.06 [0.87 to 1.29] per SD reduction in low-density lipoprotein (LDL)-cholesterol). Of these lipid modifiers, only genetic mimics of statins were associated with higher BMI (0.33 SD [0.29 to 0.38] per SD reduction in LDL-cholesterol), which explained 54% of the total effect of statins on type 2 diabetes risk.

Conclusion

Higher BMI mediated more than half of the diabetogenic effects of statins, which did not extend to other commonly used lipid modifiers. Further investigations are needed to clarify drug-specific mechanisms underlying the effects of lipid modifiers on type 2 diabetes.