bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic Efficiency of Adropin As A Preliminary Test To Exclude Acute Pulmonary Embolism
Authors: Orun Serhat , Celikkol Aliye , Basol Batuhan Ilbey , Yeniay Elif
Published: July 2021

Background
This study aimed to investigate the efficiency of adropin as a biomarker to exclude the diagnosis of acute pulmonary embolism (PE).
Methods
Patients presenting to the emergency department (ED) of a tertiary health center (a university hospital) between August 2019 and August 2020 and diagnosed with PE were included in this prospective cohort study. The amount of serum adropin was determined in patients with PE (who were diagnosed using computerized tomography pulmonary angiography) and compared with healthy volunteers.
Results
There were 57 participants in the study (28 controls and 29 PE patients). The mean adropin level of the PE group was 187.33 ± 62.40 pg/ml and significantly lower than the control group (524.06 ± 421.68 pg/ml) (p = 0.000). When the optimal adropin cut-off value was 213.78 pg/ml, the likelihood ratio of the adropin test was 3.4, and the sensitivity of the adropin test at this value was 82% with specificity of 75% (95% CI; AUC: 0.821). Further, the highest likelihood ratio obtained was 13.5, where the cut-off value was 304 pg/ml, the sensitivity of the test was 46%, and the specificity of the test was 96% (95% CI, AUC: 0.821).
Conclusion
The adropin test can be used to exclude the diagnosis of acute pulmonary embolism in the ED. However, more research is required to verify and support the generalizability of our study results.
The Chinese Version of The Quality of Life in Childhood Epilepsy Questionnaire-16-C (QOLCE-16-C): Translation, Validity, and Reliability
Authors: Tang Ping , Lu Qunfeng , Tang Wenjuan , Li Aiqiu , Sun Xiaomin , Sun Jingmin , Wang Lin , Jiang Yan , Yang Jie , Yang Liling , ji Jianlin
Published: July 2021

BackgroundEpilepsy is one of the most common chronic neurological diseases that adversely impact the quality of life of patients and their families. The 16-item measure of the Quality of Life Childhood Epilepsy Questionnaire (QOLCE-16) was designed to assess health-related quality of life (HRQOL) among children with epilepsy. The purpose of the study was to translate and evaluate psychometric properties of the QOLCE-16.MethodsThe 10 steps of Principles of Good Practices for translation and cultural adaptation of measures were adopted to translate the QOLCE-16 into Chinese. After that, item analysis, internal consistency, test-retest reliabilities, content validity and construct validity were conducted to test its applicability in children with epilepsy under the culture of China.ResultsA total of 414 objects were enrolled in our study. The results of item analysis showed the QOLCE-16-C had good discrimination, and each item was significantly related to the total scale (P<0.001). The Cronbach’s α value was 0.938 and the Test-retest reliability was 0.724. For validity, results showed that the QOLCE-16-C had good content validity. Exploratory factor analysis indicated it was reasonable that the QOLCE-16-C consists of four dimensions after rotation. Confirmatory factor analysis demonstrated good validity (χ2/df = 1.698, GFI = 0.913, CFI = 0.974, RMSEA = 0.058).ConclusionThe Chinese version of QOLCE-16-C appears to be a culturally appropriate, valid and reliable tool to assess the health-related quality of life of children with epilepsy in China.
Protopine Triggers Apoptosis Via The Intrinsic Pathway and Regulation of ROS/PI3K/Akt Signalling Pathway in Liver Carcinoma
Authors: Zhang Enfan , Nie Chunhui , Wang Bei , Wang Baoquan , Lv Ning , Yu Rui
Published: July 2021

Background: Protopine is an isoquinoline alkaloid that possesses various biological activities including the anti-tumour activity. However, the effects of protopine on liver carcinoma cells are still elusive. The aim of this study is to examine the effects of protopine on liver carcinoma cells both in vitro and in vivo.Methods: MTT assay was performed to measure the cell viability. Wound healing and transwell assays were conducted to assess the motility of cells. Cellular apoptosis and ROS levels were measured by the flow cytometry. Western blotting assay was used to measure the change of proteins. The cytotoxicity of protopine was also evaluated in xenograft mice.Results: Protopine inhibited viabilities and triggered apoptosis via the intrinsic pathway in a caspase-dependent manner in liver carcinoma cells. Furthermore, protopine also induced accumulation of intracellular ROS which further led to the inhibition of PI3K/Akt signalling pathway. Finally, in vivo study showed that protopine also repressed tumour growth in xenograft mice without noticeable toxicity.Conclusions: Protopine might be used as a potential therapeutic agent for the treatment of liver carcinoma.
Inflammatory Pattern of Eosinophilic COPD Involving 12/15-LOX Lipid Signals Expressed by Eosinophils
Authors: Cai Chuanxu , Wang Shuyan , Yue Huakui , Zhan Danting , Zha Yimin , Zhu Bingyi , Ye Yutian
Published: July 2021

Background and objective:Eosinophilic chronic obstructive pulmonary disease (COPD) has been recognized as an inflammatory pattern which is importance for precise treatment interventions among COPD. However, the studies about eosinophilic COPD show conflicting results and the role of eosinophils in COPD remains unclear. In this study, LC-MS/MS-based mediator lipidomics was to determine the expression status of lipid signals in non-eosinophilic and eosinophilic COPD.Method:A totally 80 patients with COPD including 40 eosinophilic COPD and 40 non-eosinophilic COPD were enrolled over 12 months. Clinical characteristics information record, pulmonary function tests, complete blood count, serum metabolites analysis and other clinical tests were performed at baseline and follow-up. Results:There were no significant differences in pulmonary function or pulmonary function decline between eosinophilic COPD and non-eosinophilic COPD after follow-up. However, eosinophilic COPD have higher numbers of acute exacerbation patient in the last 1 year. Complete blood count (CBC) data demonstrated that Δblood eosinophil count (BEC) was significantly decreased and correlated with ΔFEV1 (% Predicted) (r = 0.314, P = 0.036) in eosinophilic COPD. Furthermore, compared to non-eosinophilic COPD, a series of 12/15-LOX-derived mediators were found increased in eosinophilic COPD. Among them, 17-HDoHE was found significantly decreased after follow-up and significantly correlated with ΔBEC (r= 0.336, P= 0.023).Conclusion:This study demonstrates that metabolic levels of non-eosinophilic COPD and eosinophilic COPD were different due to the huge difference in eosinophil level, which leads to different inflammatory patterns, and the 12/15-LOX metabolic pathway was one of them. The results might help to understand the inflammatory response and lipid metabolism of eosinophilic COPD.
Resolution of Unexplained Iron Deficiency Following Successful Eradication of Helicobacter Pylori in Children
Authors: Tanous Osama , Levin Carina , S.Suchdev Parminder , Luo Hanqi , Rinawi Firas
Published: July 2021

Background: Evidence is needed to inform whether Helicobacter pylori (HP) treatment is beneficial in children with refractory iron deficiency. We aimed to assess association between successful HP eradication and resolution of unexplained iron deficiency. Methods: Medical records of children diagnosed with HP infection (based on histopathology) and without significant upper gastrointestinal source of blood loss, were retrospectively reviewed for presence of iron deficiency. Among those with non-anemic iron deficiency (NAID) or iron deficiency anemia (IDA), hemoglobin, ferritin and C-reactive protein (CRP) levels were compared prior and 6-9 months’ post successful HP eradication. Patients with overt bleeding or subsequent iron supplement therapy post HP diagnosis were excluded. Predictors of resolution of iron deficiency following HP eradication were assessed. Results: Among 60 included children (median age 14.8, IQR12.3-16; 62% males), symptoms of anemia were observed in 20%. A total of 21 (35%) had IDA while the remainder 65% had NAID. Following successful HP eradication, 60% of these 60 patients normalized their iron status. There were significant improvements in both hemoglobin and ferritin following HP eradication with hemoglobin increasing from 12.3g/dL to 13.0 g/dL (P<0.001), and ferritin increasing from 6.3μg/l to 15.1 μg/l (P<0.001). In multivariate logistic regression that assessed sex, ethnicity, baseline hemoglobin, anemia or GI symptoms, previous iron therapy, and time from diagnosis to eradication, older age was the only factor associated with resolution of anemia following HP eradication: (OR 1.65, 95% CI 1.16-2.35, P = 0.005).Conclusion: Successful HP eradication could be helpful in improving iron status among children with refractory NAID or IDA. Older age may predict this outcome. Screening for HP should be considered in the workup of refractory IDA or NAID.
Geopotential-based Multivariate MJO Index: Extending RMM-like Indices to Pre-Satellite Era
Authors: Leung Jeremy Cheuk-Hin , Qian Weihong , Zhang Peiqun , Zhang Banglin
Published: July 2021

Model simulations suggest that Madden-Julian Oscillation (MJO) activity changes under the anthropogenic climate change background. However, satellite observations, which provide information of MJO convection activity, are not available before the 1970s, hindering research on the historical long-term variability of MJO. This study aims at extending the data length of MJO indices that include both MJO circulation and convection features, such as the widely used Real-Multivariate MJO (RMM) index, to the pre-satellite era. This paper introduces a new MJO index construction method, of which the outgoing longwave radiation (OLR) input is derived from upper-level geopotential, and names it as the Geopotential-based Multivariate MJO (GMM) index. The GMM index is derived over 1902–2008 and compared with the filtered version of RMM (FMM) index during 1981–2008. The GMM index is shown to (1) have the same climatological properties as the FMM index, (2) be statistically highly correlated to the FMM index, and (3) be able to indicate MJO activities and its convection features in the pre-satellite era. The overall bivariate correlation between FMM index and GMM index based on ERA-20C ranges from 0.959 to 0.968 in different phases. Evaluation results confirm the validity of the proposed MJO index construction method, which could capture MJO convection activity in the pre-satellite era and can be applied to all MJO indices that require input of OLR. This study provides an alternative way that overcomes the difficulty of historical MJO studies, and will be beneficial to our understanding of the long-term change of MJO.
Using Integrated Multi-Omics Data Analysis to Identify 5-gene Signature for Predicting Survival of Patients with Hepatocellular Carcinoma
Authors: Zhang Rulin , Wu Junyi , Zhao Yingying , Quan Heng , Xia Dongge , Niu Ziguang , Xu Xiang , Liu Xiaolei , Wu Jun
Published: July 2021

Due to the poor prognosis for hepatocellular carcinoma (HCC) presently, a systemic analysis supported by the multi-omics data is extremely necessary to search for gene markers for the clinical prognostic prediction of HCC. The data on RNA-seq, single nucleotide polymorphism (SNP), and copy number variation (CNV), etc. were downloaded from TCGA, leading to a final of 367 samples, which were divided into training set and testing set randomly. In the training set, both prognosis-related genes and those with SNP or CNV were screened, which were incorporated for feature selection using the random forest method. The testing and GEO verification sets (N = 265) were used to verify the constructed gene-related prognosis model. qPCR was used to detect the expression of 5 genes in clinical specimens. After including genomic variant and prognosis-related genes, we got 78 candidate genes and 5 feature genes (CISH, LHPP, MGMT, PDRG1, and LCAT) eventually through random forest feature selection. The 5-gene signature is an independent prognostic risk factor for HCC patients. In addition, the signature shows good predicting performance and clinical practicality in train- ing set, testing set and external verification set. The results of qPCR based on clinical samples showed that the expression of PDRG1 was increased in colon cancer tissues and the expression of CISH, LHPP, MGMT and LCAT were decreased in colon cancer tissues. We identify the ability of 5-gene signature to serve as an innovative marker of survival prediction for patients with HCC.
The Incidence and Outcomes of Healthcare-associated Respiratory Tract Infections in Non-ventilated Neurocritical Care Patients: Results of a 10-year Prospective Cohort Study
Authors: Ershova Ksenia , Savin Ivan , Khomenko Oleg , Wong Darren , Danilov Gleb , Shifrin Michael , Sokolova Ekaterina , O'Reilly-Shah Vikas N , Lele Abhijit V. , Ershova Olga
Published: July 2021

Background. The incidence of healthcare-associated respiratory tract infections in non-ventilated patients (NVA-HARTI) in neurosurgical intensive care units (ICU) is unknown. The impact of NVA-HARTI on patient outcomes and differences between NVA-HARTI and ventilator-associated healthcare-associated respiratory tract infections (VA-HARTI) are poorly understood. Our objectives were to report the incidence, hospital length of stay (LOS), ICU LOS, and mortality in neurosurgical ICU and compare these characteristics between NVA- and VA-HARTI.Methods. This prospective cohort study was conducted in a neurosurgical ICU in Moscow from 2011 to 2020. All patients with ICU LOS >48h were included. Time trends were analyzed for all outcomes. A competing risk model was used for survival and risk analysis.Results. A total of 3,937 ICU admissions were analyzed. NVA-HARTI vs VA-HARTI results were: cumulative incidence 7.2 (6.4-8.0) vs 15.4 (14.2-16.5) per 100 ICU admissions, incidence rate 4.2±2.0 vs 9.5±3.0 per 1000 patient-days in the ICU, median LOS 32 [21; 48.5] vs 46 [28; 76.5] days, median ICU LOS 15 [10; 28.75] vs 26 [17; 43] days, and mortality rates 12.3% (7.9-16.8) vs 16.7% (13.6-19.7). The incidence of VA-HARTI decreased in ten years while NVA-HARTI incidence did not change. VA-HARTI was found to be an independent risk factor of death, odds ratio 1.54 (1.11-2.14), p-value=0.009 while NVA-HARTI was not.Conclusion. Our findings suggest that NVA-HARTI in neurosurgical ICU patients represents a significant healthcare burden with relatively high incidence and associated poor outcomes. NVA-HARTI appeared to be different from VA-HARTI and persisted despite preventive measures; therefore, extrapolating VA-HARTI research findings to NVA-HARTI should be avoided.
CoQ10 Enhances the Efficacy of Airway Basal Stem Cell Transplantation on Bleomycin-induced Idiopathic Pulmonary Fibrosis in Mice
Authors: Liu Huanbin , Zhang Yidi , Jiang Jinjun , Luo Yulong , Zhao Jingxin , Xu Jian , Xie Yuan , Liao Weiping , Wang Wei , Nie Yichu , Li Shiyue , Deng Wenbin
Published: July 2021

Background: Recent studies have demonstrated that airway basal stem cells (BCs) transplantation can ameliorate bleomycin-induced idiopathic pulmonary fibrosis (IPF) through lung regeneration promotion. However, BCs under oxidative stress in the alveolar microenvironment are poor in survival, causing unsatisfied efficacy of BCs transplantation. In this study, we investigated whether Coenzyme Q10(CoQ10) counteracts oxidative stress in the alveolar microenvironment, thus improved the efficacy of BCs transplantation for IPF treatment.Methods: The protective effects of CoQ10 on H2O2-induced BCs apoptosis and cytoplasmic reactive oxygen species (ROS) level were tested by flow cytometry in vitro. The therapeutic effects of BCs combined with CoQ10 were compared to a single BCs transplantation protocol in IPF treatment after two weeks and were evaluated by parameters including changes of body weight and survival rate, as well as various levels of pulmonary inflammation, α-SMA expression and hydroxyproline (HYP) in IPF mice lung tissues.Results: CoQ 10 preincubation with BCs (10 mM, 24 h) significantly reduced the late apoptosis of BCs and the number of oxidative stressful BCs as a result of H2O2 stimulation (1mM, 6h) in vitro. IPF mice models were constructed through bleomycin (5 mg/Kg) intratracheal instillation. Bleomycin-induced IPF mice showed weight loss continuously and mortality increased progressively during modeling. Serious pulmonary inflammatory cell infiltration, collagen fiber proliferation, and collagen protein deposition were observed in lung tissues of IPF mice. Though BCs transplantation alone improved indicators above in bleomycin-induced IPF mice to some extent, the combination with CoQ10 improved the transplantation efficacy and obtained better therapeutic effects.Conclusion：CoQ10 blocked H2O2-induced apoptosis of BCs and ROS production in vitro, and enhanced the efficacy of BCs transplantation on bleomycin-induced IPF in mice.
Increased Climate Pressure on the New Agricultural Frontier in the Eastern Amazonia-Cerrado Transition Zone
Authors: Marengo José A. , Jimenez Juan C. , Espinoza Jhan-Carlo , Cunha Ana Paula , Aragão Luiz E. O.
Published: July 2021

Several large-scale drivers of both anthropogenic and natural environmental changes are interacting nonlinearly in the transition zone between eastern Amazonia and the adjacent Cerrado, considered to be the new Brazilian agricultural frontier. Land-use change for agrobusiness expansion together with climate change in the transition zone between eastern Amazonia and the adjacent Cerrado may have induced a worsening of severe drought conditions over the last decade. The largest warming and drying trends observed over tropical South America during the last four decades are found to be precisely in this eastern Amazonia-Cerrado transition region, where they induce delayed wet-season onset. Here we show that the largest warming and drying trends over tropical South America during the last four decades are observed to be precisely in the eastern Amazonia-Cerrado transition region, with a worsening of severe drought conditions over the last decade. Our results evidence an increase in temperature, vapor pressure deficit, subsidence, dry-day frequency, and a decrease in precipitation, humidity, and evaporation, plus a delay in the onset of the wet season, inducing a higher risk of fire during the dry-to-wet transition season. These findings provide observational evidence of the increasing climatic pressure in this area, which is sensitive for global food security, and the need to reconcile agricultural expansion and protection of natural tropical biomes.
Review Adult Upper-limb Forearm Cystic Lymphangioma (Cystic Hygroma): A Case Report
Authors: Cui Kai , Zhu Yingkang , Lu Fatai , Wang Rui , Zhang Haifei , Liu Zunpeng
Published: July 2021

Background: Cystic lymphangioma that is the most common type of lymphangioma, but it rarely occurs in the forearm. It may show localized invasive behavior, but is benign. Case presentation: A 42-year-old woman was admitted to the hospital because she had discovered a right forearm mass approximately 3 years earlier.Ultrasound had shown a subcutaneous hypoechoic strip on the right forearm (nature to be determined). Magnetic resonance imaging (MRI) showed characteristics of a lymphangioma with irregular strips, and surrounding irregular small blood vessels showed hypointensity or isointensity relative to the T1-weighted imaging (WI) signals for nearby muscle and hyperintensity on T2WI.Hematoxylin–eosin (H&E) staining showed a dilated cystic space lined with flat endothelial cells, and the cyst wall was rich in mature lymphocytes, smooth muscle, and irregular fatty small cysts.Immunohistochemical (IHC) staining of monoclonal antibody D2-40–labeled cystic lymphangioma endothelial cells was performed and showed focal expression of D2-40.Conclusions: The atypicality of clinical symptoms and imaging findings makes preoperative diagnosis difficult, so histological examination is necessary for the diagnosis of cystic lymphangioma. At present, if the disease affects the function or appearance of the body, the ideal treatment is radical resection to reduce recurrence. Incomplete resection causes relapse of the disease.
Pulmonary eosinophilia may indicate onset stage of allergic bronchopulmonary aspergillosis
Authors: miki mari , Tsujino Kazuyuki , Kawasaki Takahiro , Kuge Tomoki , Yamamoto Yuji , Matuki Takanori , Miki Keisuke , Kida Hiroshi
Published: July 2021

Background
Allergic bronchopulmonary aspergillosis (ABPA) and chronic eosinophilic pneumonia (CEP) both display peripheral eosinophilia and pulmonary infiltration, a condition described as pulmonary eosinophilia, and differentiation is sometimes problematic. This study therefore examined the distinctions between ABPA with and without CEP-like shadows.
Methods
This retrospective cohort study from a single center included 25 outpatients (median age, 65 years) with ABPA diagnosed between April 2015 and March 2019 using criteria proposed by the International Society of Human and Animal Mycology (ISHAM). Patients were assigned to either the eosinophilic pneumonia (EP) group or Non-EP group, defined according to findings on high-resolution computed tomography (HRCT). The EP group included patients with HRCT findings compatible with CEP; i.e., the presence of peripheral consolidation (p-consolidation) or ground-glass opacities (GGO), with no evidence of high-attenuation mucus. The Non-EP group comprised the remaining patients, who showed classical findings of ABPA such as mucoid impaction. Differences between the groups were analyzed.
Results
Baseline characteristics, frequency of a history of CEP (EP, 50% vs. Non-EP, 26%) and tentative diagnosis of CEP (67% vs. 16%) did not differ significantly between groups. Although elevated absolute eosinophil count and Aspergillus-specific immunoglobulin E titers did not differ significantly between groups, the Non-EP group showed a strong positive correlation between these values (R = 0.7878, p = 0.0003). The Non-EP group displayed significantly higher levels of the fungal marker beta-D glucan (median, 11.7 pg/ml; interquartile range, 6.7–18.4 pg/ml) than the EP group (median, 6.6 pg/ml; interquartile range, 5.2–9.3 pg/ml). Both groups exhibited frequent recurrence of shadows on X-rays but no cases in the EP group had progressed to the Non-EP group at the time of relapse.
Conclusions
The ABPA subgroup with imaging findings resembling CEP experienced frequent recurrences, as in typical ABPA. In pulmonary eosinophilia, even if there are no shadows indicating apparent mucous change, the Aspergillus-specific immunoglobulin E level is important in obtaining an accurate diagnosis and in the selection of appropriate therapies for this type of ABPA.
Association of regular leisure-time physical activity with self-reported body mass index and obesity risk among middle-aged and older adults in Taiwan
Authors: Chen Yun-Tsung , Lee Po-Fu , Lin Chi-Fang , Chang Andy , Chung Yu-Chun , Ho Chien-Chang
Published: July 2021

Background
Through this study, we aimed to determine the association of regular leisure-time physical activity (LTPA) with self-reported body mass index (BMI) and obesity risk among middle-aged and older adults in Taiwan.
Methods
We conducted a cross-sectional study and reviewed the data derived from the Taiwan’s National Physical Activity Survey (TNPAS). Responses from 12,687 participants aged 45–108 years from the database were collected in this study. All participants completed a standardized, structured questionnaire that solicitated information regarding their demographic characteristics (age, gender, education, occupation, and self-reported health status), physical activity behaviors (regular/nonregular LTPA), and self-reported anthropometrics (height, weight, and BMI). Multiple linear and logistic regression were used to examine the association between regular LTPA and BMI as well as between regular LTPA and obesity status, respectively.
Results
Regular LTPA was associated with a male preponderance, normal weight, excellent or good self-reported health status, and a lower rate of underweight compared with nonregular LTPA. Regular LTPA was significant negatively associated with underweight (OR = 0.71, p < 0.05), whereas it had no significant relationship with BMI and obesity (p > 0.05).
Conclusions
Regular LTPA was associated with a reduced risk of underweight among middle-aged and elderly adults in Taiwan. Further research on the relevant mechanism underlying this phenomenon is warranted.
Combination of Treosulfan, Fludarabine and Cytarabine as Conditioning in Patients With Acute Myeloid Leukemia, Myelodysplastic Syndrome and Myeloproliferative Neoplasms
Authors: Henderson Samantha O'Hagan , Frietsch Jochen J , Hilgendorf Inken , Hochhaus Andreas , Köhne Claus-Henning , Casper Jochen
Published: July 2021

Treosulfan and fludarabine (Treo/Flu) were successfully introduced into toxicity-reduced conditioning for SCT. However, the risk of post-SCT relapse remains a matter of concern. We report the results of a novel individual treatment approach with Treo/Flu and cytarabine (Treo/Flu/AraC) conditioning prior to allogeneic SCT in patients with acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), or myeloproliferative neoplasms (MPN).Seventy-seven patients (median age 54 years) at high risk of disease relapse due to unfavourable cytogenetics or failure to achieve complete remission prior to SCT were included. Median follow-up was 3.2 years. One-, two- and three-year RFS rates were 47.5%, 40.7%, and 37.3% and OS rates were 59.3%, 49.3%, and 45.4%, respectively. Cumulative incidence of NRM was 10% at 100 days, 18.8% at one year and 20.1% at two years. The cumulative incidence of relapse increased from 34% at one year to 41% after three years. The cumulative incidences of engraftment, chimerism, Graft-versus-host-disease (GvHD) and toxicities were acceptable and comparable with similar patients conditioned with Treo/Flu or FLAMSA-RIC. In conclusion, Treo/Flu/AraC provides tolerable, feasible and effective conditioning for patients with AML, MDS or MPN, even in advanced disease states. The incidence of NRM and relapse is acceptable in this heavily pre-treated population with high-risk disease. Future research will aim to confirm these initial findings and include a larger number of participants in a prospective trial.
How Do Patients and Physicians Perceive Immune Thrombocytopenia (ITP) As a Disease? Results From Indian Analysis of ITP World Impact Survey (I-WISh)
Authors: Chakrabarti Prantar , George Biju , Shanmukhaiah Chandrakala , Sharma Lalit Mohan , Udupi Shashank , Ghanima Waleed
Published: July 2021

Background: Immune thrombocytopenia (ITP) is primarily considered a bleeding disorder; its impact on patients’ health-related quality of life (HRQoL) is under-recognized. We aimed to assess how aligned patient and physician perceptions are regarding ITP-associated symptoms, HRQoL, and disease management in India.Methods: Patients and physicians (hematologists/hemato-oncologists) from India who participated in the global ITP World Impact Survey (I-WISh) were included in this subgroup analysis (survey).Results: A total of 65 patients and 21 physicians were included in this study. Average disease duration from diagnosis-to-survey-completion was 5.3 years. The most severe symptoms reported by patients at diagnosis were menorrhagia (15/19;79%), anxiety surrounding unstable platelet counts (17/28;61%), and fatigue (27/46;59%); these were also the key symptoms they wanted to be resolved. In contrast, physicians perceived petechiae (19/21;90%), bleeding-from-gums [(8/21;86%), and purpura (16/21;76%) as the most common symptoms. While the important treatment goals for patients were healthy blood counts (42/65;65%), improved QoL (35/65;54%), and prevention of worsening of ITP (33/65;51%), physicians’ goals were reduction in spontaneous bleeding (17/21;81%]), better QoL (14/21;67%]), and symptom improvement (9/21;43%). More than half the patients reported that ITP affected their work life/studies, social life, and energy levels, thereby negatively impacting their QoL. Patients were almost entirely dependent on family and friends for support.Conclusions: This survey highlights the substantial discrepancy in patients’ and physicians’ perceptions regarding ITP-associated symptoms and treatment goals in India. Educating physicians on aspects of ITP beyond bleeding, and highlighting patients’ under-recognized symptoms/needs through support-systems may bring about a meaningful change.
The participation in leisure activities and the quality of life of people with psychosis in England: A multi-site cross-sectional study
Authors: Ngamaba Kayonda Hubert , Webber Martin , Xanthopoulou Penny , Chevalier Agnes , Giacco Domenico
Published: July 2021

Background

Leisure activities can improve the quality of life in the general population. For people with psychosis, negative symptoms are often a barrier to engaging in leisure social activities. However, we do not know if participation in leisure activities is associated with quality of life in this group and whether psychosocial interventions should aim to increase leisure activities amongst people with psychosis.
Aim

This study aims to investigate whether participation in leisure activities is associated with better quality of life of people with psychosis in England.
Methods

A cross-sectional survey was conducted in 6 NHS community mental health trusts. Adults aged 18–65 (N = 533) with a diagnosis of psychosis-related condition (ICD-10 F20-29) were recruited from outpatient secondary mental health services. Several measures were used: Time Use Survey (TUS), Manchester Short Assessment of Quality of Life (MANSA). Descriptive statistics and multiple regression analyses were conducted.
Results

Participation in at least one leisure activity in the last 7 days was reported by the majority of participants (n = 480, 90%). The average number of weekly leisure activities they attended was M = 2.42 (SE = 0.06). Participants’ quality of life increased with the number of leisure activities they attended. After controlling for socio-demographic factors, participation in leisure activities was positively associated with quality of life in people with psychosis (b = 0.083, SE = 0.035, p = 0.019, 95% CI [0.013 to 0.153]). We found a gender difference: For Males, the association between attendance in leisure activities and quality of life is significantly positive; b = 0.132, SE = 0.041, p = 0.002, 95% CI [0.050 to 0.213]. For females: the association between attendance in leisure activities and quality of life was no significant.
Conclusion

People with psychosis who attend more leisure activities have a higher quality of life. Quality of life was higher amongst males who attended leisure activities. Intervention which helps improve participation in leisure activities may be beneficial for people with psychosis.
Foliar Water Uptake in the Needles of Pinus Torreyana
Authors: Tianshi Emily , Chau Pao C
Published: July 2021

In semi-arid climate systems that encounter low clouds or fog, many plants have adapted to capture atmospheric moisture on the foliar surface. The natural habitat of Pinus torreyana, the Torrey pine, is restricted to two locales in coastal Southern California that experience substantial fog and low clouds during the dry months of a Mediterranean climate. In this study, droplet contact angles were used to assess surface wettability, and droplet uptake was used to measure the foliar water uptake rate along a needle. We demonstrated that there are only remnants of epicuticular wax on the needle. The results showed that the needle surface of P. torreyana, including under the base sheath, is hydrophilic and capable of direct water uptake. There are small spatial gradients in the uptake pattern, but the variability is high and the statistical significance is not strong. However, the decrease in uptake at higher contact angles can be described by an ordinary linear regression (r2 = 0.45, p = 4 x 10-8). On average, the foliar uptake of the adaxial surface of a one-year-old needle is 2.88 ± 0.60 x 10-2 mg cm–2s–1. In comparison, the uptake rates by the adaxial surfaces of four local broadleaf plants are between 0.05 and 0.6 of that of P. torreyana.
Microbial contribution to post-fire tundra ecosystem recovery over the 21st century
Authors: Bouskill Nicholas J. , Mekonnen Zelalem , Zhu Qing , Grant Robert , Riley William
Published: July 2021

Tundra ecosystems have experienced an increased frequency of fire in recent decades, and this trend is predicted to continue throughout the 21st Century. Post-fire recovery is underpinned by complex interactions among microbial functional groups that drive nutrient cycling post-fire. Here we use a mechanistic model to demonstrate an acceleration of the nitrogen cycle post-fire driven by changes in niche space and microbial competitive dynamics. We show that over the first 5-years post-fire, fast-growing bacterial heterotrophs colonize regions of the soil previously occupied by slower-growing saprotrophic fungi. The bacterial heterotrophs mineralize organic matter, releasing organic and inorganic nutrients into the soil. This pathway outweighs new sources of nitrogen and facilitates the recovery of plant productivity. We broadly show here that while consideration of distinct microbial metabolisms related to carbon and nutrient cycling remains rare in terrestrial ecosystem models, they are important when considering the rate of ecosystem recovery post-disturbance and the feedback to soil nutrient cycles on centennial timescales.
Non-HDL Cholesterol as a Predictor for Incident Type 2 Diabetes in Community-dwelling Adults: Longitudinal Findings Over 12 Years
Authors: Seo In-Ho , Son Da-Hye , Lee Hye Sun , Lee Yong-Jae
Published: July 2021

BackgroundNon-high-density lipoprotein cholesterol (non-HDL cholesterol) is a simple measure to analyze the total amount of proatherogenic lipoproteins in the blood and to predict development of cardiovascular disease. However, it is unclear whether non-HDL cholesterol has a relationship with incident type 2 diabetes. This study aimed to evaluate the association between non-HDL cholesterol and incident type 2 diabetes with a large-sample, community-based Korean cohort over a 12-year period.MethodsAmong the 10,038 total participants, 7,608 (3,662 men and 3,946 women) without diabetes were selected from the Korean Genome and Epidemiology Study (KoGES). Their non-HDL cholesterol level was calculated as [total cholesterol – HDL cholesterol] mg/dL and divided into quartiles. Newly developed type 2 diabetes was defined as any of the following: a fasting plasma glucose level ≥ 126 mg/dL; a plasma glucose level ≥ 200 mg/dL at two hours after a 75-g oral glucose tolerance test; a glycosylated hemoglobin level ≥ 6.5%; or current treatment with oral anti-diabetic medications or insulin therapy. The hazard ratios (HRs) with 95% confidence intervals (CIs) for incident type 2 diabetes were calculated using multivariate Cox proportional hazards regression models after adjusting for potentially confounding variables.ResultsIn total, 1,442 individuals (18.9%: 1442 of 7608) developed type 2 diabetes during the 12-year follow up period, with an incident rate of 3.0–5.0. Compared to the reference first quartile, the HRs (95% CIs) of incident type 2 diabetes for the second, third, and fourth quartiles increased in a dose-response manner after adjusting for potentially confounding variables, including the HOMA-IR insulin resistance marker.ConclusionNon-HDL cholesterol level at baseline can be a useful predictor of new-onset type 2 diabetes.
Comparative analysis of ChAdOx1 nCoV-19 and Ad26.COV2.S SARS-CoV-2 vector vaccines
Authors: Michalik Stephan , Siegerist Florian , Palankar Raghavendra , Franzke Kati , Schindler Maximilian , Reder Alexander , Seifert Ulrike , Cammann Clemens , Wesche Jan , Steil Leif , Hentschker Christian , Gesell-Salazar Manuela , Reisinger Emil , Beer Martin , Endlich Nicole , Greinacher Andreas , Völker Uwe
Published: July 2021

Vector-based SARS-CoV-2 vaccines have been associated with vaccine-induced thrombosis with thrombocytopenia syndrome (VITT/TTS), but the causative factors are still unresolved. We comprehensively analyzed ChAdOx1 nCov-19 (AstraZeneca) and Ad26.COV2.S (Johnson & Johnson). ChAdOx1 nCoV-19 contains significant amounts of host cell protein impurities, including functionally active proteasomes, and adenoviral proteins. In Ad26.COV2.S much less impurities were found. Platelet-factor 4 (PF4) formed complexes with ChAdOx1 nCoV-19 constituents, but not with purified virions from ChAdOx1 nCoV-19 or with Ad26.COV2.S. Vascular hyperpermeability was induced by ChAdOx nCoV-19 but not by Ad26.COV2.S.These differences in impurities together with EDTA-induced capillary leakage might contribute to the higher incidence rate of VITT associated with ChAdOx1 nCoV-19 compared to Ad26.COV2.S.
Carbapenem-resistant Acinetobacter Baumannii Ventilator-Associated Pneumonia in Critically Ill Patients: Potential Inference with Respiratory Tract Microbiota Dysbiosis
Authors: Xiao Tingting , Guo Qian , Zhou Yanzi , Shen Ping , Wang Yuan , Fang Qiang , Li Mo , Zhang Shuntian , Guo Lihua , Yu Xiao , Liao Yulin , Wang Chunhui , Chi Xiaohui , Kong Xiaoyang , Zhou Kai , Zheng Beiwen , Luo Qixia , Chen Yunbo , Zhu Huaiqiu , Xiao Yonghong
Published: July 2021

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) is a common cause of ventilator-associated pneumonia (VAP) in intensive care unit (ICU) patients, but infection and colonization are difficult to distinguish which aggravates the abuse of antimicrobial drugs and further accelerates the evolution of drug resistance. We sought to provide new clues for the diagnosis, pathogenesis and treatment of CRAB VAP based on lower respiratory tract (LRT) microbiota. Methods: A prospective study was conducted on patients with mechanical ventilation from July 2018 to December 2019 in a tertiary hospital. Multi-genomics studies (16S rRNA amplicon, metagenomics and whole-genome sequencing [WGS]) of endotracheal deep aspirate (ETA) were performed. Results: Fifty-two ICU patients were enrolled, including 24 with CRAB VAP (CRAB-I), 22 with CRAB colonization (CRAB-C), and six CRAB-negative patients (infection-free) (CRAB-N). Diversity of pulmonary microbiota was significantly lower in CRAB-I than in CRAB-C or CRAB-N (mean Shannon index, 1.79 vs. 2.73 vs. 4.81, P<0.05). Abundances of 11 key genera differed between the groups. Acinetobacter was most abundant in CRAB-I (76.19%), moderately abundant in CRAB-C (59.14%), and least abundant in CRAB-N (11.25%), but its interactions with other genera exhibited the opposite pattern. Metagenomics and WGS analysis showed that virulence genes were more abundant in CRAB-I than in CRAB-C. Multi-locus sequence typing (MLST) of 46 CRAB isolates revealed that the main types were ST208 (30.43%) and ST938 (15.22%), with no difference between CRAB-I and CRAB-C. Conclusions: LRT microbiota dysbiosis including elevated relative abundance of Acinetobacter and reduced bacterial interactions, and virulence enrichment may lead to CRAB VAP.
Features Derived From Blood Pressure Predict Elevated Intracranial Pressure in Critically Ill Children
Authors: Ackerman Kassi , Mohammed Akram , Chinthala Lokesh , Davis Robert L. , Kamaleswaran Rishikesan , Shafi Nadeem I.
Published: July 2021

Clinicians frequently observe hemodynamic changes preceding elevated intracranial pressure (ICP) events. We employed a machine learning approach to identify novel and differentially expressed features associated with elevated ICP (eICP) events in children with severe brain injuries. Statistical features from physiologic data streams were derived from non-overlapping 30-minute analysis windows prior to 21 eICP events; 200 records without eICP events were used as controls. Ten Monte Carlo simulations with training/testing splits provided performance benchmarks for 4 machine learning approaches. XGB yielded the best performing predictive models. SHAP analyses demonstrated that a majority of the top 20 contributing features from each simulation consistently derived from blood pressure data streams up to 240 minutes prior to eICP events, rivaling ICP-derived features at 0-60 minutes. Our AUROC benchmark at the 30-60 minutes analysis window using the XGB model bundle was 0.82 (95% CI 0.81-0.83); the AUPRC was 0.24 (95% CI 0.23-0.25), well-above the expected baseline. We conclude that physiomarkers discernable by machine learning are concentrated within blood pressure data up to 4 hours prior to eICP events and demonstrate robust benchmark performance. Future predictive modeling of elevated ICP events should leverage features contained within hemodynamic signals.
Evaluation of Staff Satisfaction After Implementation of a Routine Work Checklist in an Oral Outpatient Department and Its Effect on Work Efficiency
Authors: Zhang Wei , Ren Lizhi , Wang Xiaojing , Wang Qianqian , Zhang Xiaohong , Li Weili , Zhao Bin , Ren Xiuyun , Li Bing , Qin Haiyun , Ge Xuejun , Zhang Fang , Wang Xiangyu , Meng Xiaorui , Yu Feiyan
Published: July 2021

Objective: To evaluate the feasibility, effectiveness and sustainability of using a checklist in the routine work of a stomatological outpatient department and investigate the satisfaction of the nursing staff with the checklist.Methods: The study was divided into two stages: design and manufacture the checklist and apply the checklist. After the expert group performed stage one, an analysis of work efficiency and work omissions and a survey of staff satisfaction were carried out. The results of the groups either using the checklist (n = 14) or not (n = 14) were analysed and compared. Results: The average time of the checklist group was 14.14±0.81 min, and the average time of the nonchecklist group was 26.07±2.37 min, P < 0.001. The working efficiency of the checklist group was significantly higher than that of the nonchecklist group. The omission rate was 0% in the checklist group and 21.43% in the nonchecklist group. Staff satisfaction with the use of the checklist was high. Conclusion: The checklist can make routine work more efficient and convenient in a stomatological outpatient department. It is recommended for use in stomatological outpatient departments or hospitals.
A 3D primary human cell-based in vitro model of non-alcoholic steatohepatitis for efficacy testing of clinical drug candidates
Authors: Ströbel Simon , Kostadinova Radina , Fiaschetti-Egli Katia , Rupp Jana , Bieri Manuela , Pawlowska Agnieszka , Busler Donna , Hofstetter Thomas , Sanchez Katarzyna , Grepper Sue , Thoma Eva
Published: July 2021

Non-alcoholic steatohepatitis (NASH) is a progressive and severe liver disease, characterized by lipid accumulation, inflammation, and downstream fibrosis. Despite its increasing prevalence, there is no approved treatment yet available for patients. This has been at least partially due to the lack of predictive preclinical models for studying this complex disease. Here, we present a 3D in vitro microtissue model that uses spheroidal, scaffold free co-culture of primary human hepatocytes, Kupffer cells, liver endothelial cells and hepatic stellate cells. Upon exposure to defined and clinically relevant lipotoxic and inflammatory stimuli, these microtissues develop key pathophysiological features of NASH within 10 days, including an increase of intracellular triglyceride content and lipids, and release of pro-inflammatory cytokines. Furthermore, fibrosis was evident through release of procollagen type I, and increased deposition of extracellular collagen fibers. Whole transcriptome analysis revealed changes in the regulation of pathways associated with NASH, such as lipid metabolism, inflammation and collagen processing. Importantly, treatment with anti-NASH drug candidates (Selonsertib and Firsocostat) decreased the measured specific disease parameter, in accordance with clinical observations. These drug treatments also significantly changed the gene expression patterns of the microtissues, thus providing mechanisms of action and revealing therapeutic potential. In summary, this human NASH model represents a promising drug discovery tool for understanding the underlying complex mechanisms in NASH, evaluating efficacy of anti-NASH drug candidates and identifying new approaches for therapeutic interventions.
Insight Into the Causative Genes and Pathways Associated With Height, Length, Length to Height Ratio and Body Weight Traits of Korean Indigenous Breed, Jindo Dog Using Gene Set Enrichment and Pathway-based GWAS Analysis
Authors: Sheet Sunirmal , Kim Jong Seok , Ko Min Jeong , Kim Na Yeon , Lim Young Jo , Park Mi Rim , Lee Seung Jin , Kim Jeong Min , Oh Seok Il , Choi Bong-Hwan
Published: July 2021

As a companion and hunting dog, height, length, length to height ratio (LHR) and body-weight are the vital economic traits for Jindo dog. Artificial breeding has produced an extraordinary diversity in these traits. Therefore, the identification of causative markers, genes and pathways that led us to understand the genetic basis of this variability is essential for their selection purposes. Here, we performed a genome-wide association study (GWAS) combined with pathway-based analysis on 757 dogs using 118,879 SNPs. A higher heritability (h2) was detected for height (0.33) and weight (0.28) trait in Jindo. At a threshold of p-value < 5E-05, 10, 6, 13, and 11 SNPs on different chromosomes were significantly associated with height, length, LHR and body-weight traits, respectively. Based on our result, HHIP, LCORL, and NCAPG for height, IGFI and FGFR3 for length, DLK1 and EFEMP1 for LHR, and PTPN2, IGFI, and RASAL2 for weight can be the potential candidate genes because the significant SNPs located in their intronic or upstream regions. An additive and dominant mode of inheritance was noticed from the phenotype-genotype correlation plot for top variants. The gene-set enrichment analysis highlighted here 9 and 7 overlapping significant (p < 0.05) GO terms and pathways among traits. Interestingly, the highlighted pathways were related to hormone synthesis, secretion and signaling were generally involved in the metabolism, growth and development process. Our data provide an insight into the significant genes and pathways if verified further, which will have a significant effect on the breeding /management of the Jindo dog’s population.
Selection of the Gridded Temperature Dataset for Assessment of Thermal Bioclimatic Environment Changes in Amu Darya River Basin
Authors: Salehie Obaidullah , Ismail Tarmizi , Shahid Shamsuddin , Sammen Saad Sh , Malik Anurag , Wang Xiaojun
Published: July 2021

Assessment of the thermal bioclimatic environmental changes is important to understand ongoing climate change implications on agriculture, ecology, and human health. This is particularly important for the climatologically diverse transboundary Amy Darya River basin, a major source of water and livelihood for millions in Central Asia. However, the absence of longer period observed temperature data is a major obstacle for such analysis. This study employed a novel approach by integrating compromise programming (CP) and multicriteria group decision–making methods (MCGDM) to evaluate the efficiency of four global gridded temperature datasets based on observation data at 44 stations. The most reliable gridded data was used to assess the spatial distribution of global warming-induced unidirectional trends in thermal bioclimatic indicators (TBI) using a modified Mann-Kendall (MMK) test. Ranking of the products revealed Climate Prediction Center (CPC) temperature as most efficient in reconstruction observed temperature, followed by TerraClimate and Climate Research Unit (CRU). Assessment of TBI trends using CPC data revealed an increase in the minimum temperature in the coldest month over the whole basin at a rate of 0.03 to 0.08\(℃\) per decade, except in the east. Besides, an increase in diurnal temperature range and isothermally increased in the east up to 0.2\(℃\) and 0.6% per decade, respectively. The results revealed negative implications of thermal bioclimatic change on water, ecology, and public health in the eastern mountainous region and positive impacts on vegetation in the west and northwest.