bluuebunny/crossref_metadata_2025 huggingface dataset:
Establishment of a Nomogram for Predicting Early Death in Viral Myocarditis
Authors: Sun Xuejun , Xie Naxin , Guo Mengling , Qiu Xuelian , Chen Hongwei , Liu Haibo , Li Hongmu
Published: May 2021

Objective. This research aimed to establish a nomogram for predicting early death in viral myocarditis (VMC) patients. Method. A total of 362 consecutive VMC patients in Fujian Medical University Affiliated First Quanzhou Hospital between January 1, 2009, and December 31, 2019, were included. A least absolute shrinkage and selection operator (LASSO) regression model was used to detect the risk factors that most consistently and correctly predicted early death in VMC. The performance of the nomogram was assessed by calibration, discrimination, and clinical utility. Result. 9 factors were screened by LASSO regression analysis for predicting the early death of VMC. Combined with the actual clinical situation, the heart failure (HF) (OR: 2.13, 95% CI: 2.76–5.95), electrocardiogram (ECG) (OR: 6.11, 95% CI: 1.05–8.66), pneumonia (OR: 3.62, 95% CI: 1.43–9.85), brain natriuretic peptide (BNP) (OR: 4.66, 95% CI: 3.07–24.06), and lactate dehydrogenase (LDH) (OR: 1.90, 95% CI: 0.19–9.39) were finally used to construct the nomogram. The nomogram’s C-index was 0.908 in the training cohort and 0.924 in the validation cohort. And the area under the receiver operating characteristic curve of the nomogram was 0.91 in the training cohort and 0.924 in the validating cohort. Decision curve analysis (DCA) also showed that the nomogram was clinically useful. Conclusion. This nomogram achieved an good prediction of the risk of early death in VMC patients.
Nemesis, Envy, and Justice in Aristotle’s Political Science
Authors: Wyllie Robert
Published: May 2021

Aristotle does not explain why ordinary citizens who lack the virtue of justice nevertheless praise justice and the law. Indignation (nemesis), defined as pain at the undeserved gains of others, is a promising candidate in the list of means regarding virtues and passions in Book 2 of the Nicomachean Ethics. However, as many scholars have noted, Aristotle’s description of indignation as a mean is flawed. Moreover, indignation is the only characteristic in the list that disappears from the inquiry thereafter. I argue that Aristotle obliquely criticizes indignation for aligning envy, a base passion, with conventional justice. Aristotle’s subtle critique reveals that envy motivates ‘the many’ to support justice, an unsavory conclusion which he does not highlight.
A Global Vista of the Epigenomic State of the Mouse Submandibular Gland
Authors: Gluck C. , Min S. , Oyelakin A. , Che M. , Horeth E. , Song E.A.C. , Bard J. , Lamb N. , Sinha S. , Romano R.A.
Published: May 2021

The parotid, submandibular, and sublingual glands represent a trio of oral secretory glands whose primary function is to produce saliva, facilitate digestion of food, provide protection against microbes, and maintain oral health. While recent studies have begun to shed light on the global gene expression patterns and profiles of salivary glands, particularly those of mice, relatively little is known about the location and identity of transcriptional control elements. Here we have established the epigenomic landscape of the mouse submandibular salivary gland (SMG) by performing chromatin immunoprecipitation sequencing experiments for 4 key histone marks. Our analysis of the comprehensive SMG data sets and comparisons with those from other adult organs have identified critical enhancers and super-enhancers of the mouse SMG. By further integrating these findings with complementary RNA-sequencing based gene expression data, we have unearthed a number of molecular regulators such as members of the Fox family of transcription factors that are enriched and likely to be functionally relevant for SMG biology. Overall, our studies provide a powerful atlas of cis-regulatory elements that can be leveraged for better understanding the transcriptional control mechanisms of the mouse SMG, discovery of novel genetic switches, and modulating tissue-specific gene expression in a targeted fashion.
Patient-reported recovery in upper abdominal cancer surgery care: A prospective study
Authors: Johansson Anna , Karlsson Jessica , Fomichov Victoria , Lindhoff Larsson Anna , Sandström Per , Björnsson Bergthor , Drott Jenny
Published: May 2021

The study aimed to describe and analyse patient-reported recovery in patients after upper abdominal cancer surgery. This study had a quantitative design and patients were consecutively included in a university hospital in southern Sweden. Twenty-four patients answered the Postoperative Recovery Profile (PRP) questionnaire at three measurement points. All five dimensions were affected. In the physical symptoms dimension, the majority of patients reported a lack of energy upon discharge. High levels of anxiety were reported. Over 50% of patients reported some degree of depressed mood at all three measurement points. In the social dimension, the majority of patients reported some degree of being dependent on help from others in everyday life at 4 weeks after discharge. Few patients are fully recovered at 4 weeks after discharge. Individual patient-reported recovery estimates may be valuable in identifying and planning interventions tailored to each patient’s needs throughout the care process.
Venous drainage for minithoracotomy approach in an adult with interrupted inferior vena cava
Authors: Watanabe Toshitaka , Okamoto Kazuma , Yoshitani Nobuyuki , Tohma Ryo , Misato Takuya , Hayashi Taro
Published: May 2021

For atrial septal defect closure via right minithoracotomy in an adult patient with infra-hepatic interruption of the inferior vena cava with azygos connection, an alternative venous cannulation strategy was applied. In addition to bicaval cannulations to the femoral vein and the internal jugular vein, a 20 Fr straight cannula draining the hepatic vein was added to the proximal IVC through the right atrium wall via a working port. A bloodless operative field in the right atrium was afforded with bicaval encircling. Preoperative imaging test of the continuity of the IVC was important planning cardiac surgery with peripheral cannulations.
Longitudinal associations between borderline personality disorder and five-factor model traits over 24 years
Authors: Hopwood Christopher J , Schwaba Ted , Wright Aidan GC , Bleidorn Wiebke , Zanarini Mary C
Published: May 2021

Are five-factor traits and borderline personality symptoms the same features with different names? The existing literature offers reasons to think they are the same and reasons to think they are different. We examined longitudinal associations between these variables in a sample of patients assessed 12 times over 24 years using latent curve models with structured residuals. Mean trajectories for all variables were in the direction of symptom reduction/personality maturation and could be parsed into an initial, rapid improvement phase and a subsequent, gradual improvement phase. We found robust between-person associations among intercepts and long-term slopes of traits and symptoms. Specifically, higher levels of neuroticism as well as lower levels of extraversion, agreeableness, and conscientiousness were associated with higher levels of borderline personality symptoms, and changes in these traits were correlated with reduction in symptoms over time. Associations among time-structured residuals allowed for examinations of within-person deflections from these general trends at briefer (two year) intervals. All variables exhibited robust within-person carry-over effects. Other within-person effects were more specific to certain traits. These results suggest that, despite their distinct theoretical and methodological bases, normal trait and psychiatric diagnostic approaches largely converged on a similar conception of borderline personality.
Estimation and assessment of sagittal spinal curvature and thoracic muscle morphometry in different postures
Authors: Pai S Anoosha , Zhang Honglin , Ashjaee Nima , Wilson David R. , Brown Stephen HM , Fels Sidney , Street John , Oxland Thomas R
Published: May 2021

Spine models are typically developed from supine clinical imaging data, and hence clearly do not fully reflect postures that replicate subjects’ clinical symptoms. Our objectives were to develop a method to: (i) estimate the subject-specific sagittal curvature of the whole spine in different postures from limited imaging data, (ii) obtain muscle lines-of-action in different postures and analyze the effect of posture on muscle fascicle length, and (iii) correct for cosine between the magnetic resonance imaging (MRI) scan plane and dominant fiber line-of-action for muscle parameters (cross-sectional area (CSA) and position). The thoracic spines of six healthy volunteers were scanned in four postures (supine, standing, flexion, and sitting) in an upright MRI. Geometry of the sagittal spine was approximated with a circular spline. A pipeline was developed to estimate spine geometry in different postures and was validated. The lines-of-action for two muscles, erector spinae (ES) and transversospinalis (TS) were obtained for every posture and hence muscle fascicle lengths were computed. A correction factor based on published literature was then computed and applied to the muscle parameters. The maximum registration error between the estimated spine geometry and MRI data was small (average RMSE∼1.2%). The muscle fascicle length increased (up to 20%) in flexion when compared to erect postures. The correction factor reduced muscle parameters (∼5% for ES and ∼25% for TS) when compared to raw MRI data. The proposed pipeline is a preliminary step in subject-specific modeling. Direction cosines of muscles could be used while improving the inputs of spine models.
PrEP your team! Clinician initiation of HIV pre-exposure prophylaxis discussion at sexually transmissible infection testing and diagnosis in gay and bisexual men
Authors: Woodward Shannon C , Elvy Ingrid H , Martin Sarah J
Published: May 2021

HIV pre-exposure prophylaxis (PrEP) is recommended for gay and bisexual men (GBM) with recent diagnosis of rectal chlamydia (CT), rectal gonorrhoea (NG) or infectious syphilis. A retrospective medical record audit was undertaken at Canberra Sexual Health Centre (CSHC) of all GBM who met this criterion in 2019 and were thus determined to be at higher risk of acquisition of human immunodeficiency virus (HIV). Pre-exposure prophylaxis was discussed and/or commenced in 85% of GBM at higher risk of HIV. Audit results and education were provided to the team with a post-interventional audit in 2020 showing significant improvement. This audit is easily replicated and may be applicable to other settings engaged in GBM care.
Response factors associated with electrocautery treatment of intra-anal high-grade squamous intraepithelial lesions in a population of HIV-positive men who have sex with men
Authors: Fuertes Irene , Cranston Ross , de Lazzari Elisa , Rodriguez-Carunchio Leonardo , Blanco José L
Published: May 2021

Background: Ablative treatment of anal high-grade squamous intraepithelial lesions (HSIL) reduces the risk of progression to anal squamous cell carcinoma. Objectives: To identify factors that influence the response to treatment of anal HSIL by electrocautery ablation (ECA) in a population of HIV-positive men who have sex with men (MSM). Design: Retrospective study of ECA treatment response in a prospectively followed anal dysplasia cohort. HIV-positive MSM diagnosed with anal HSIL were included. Demographic and HIV data were recorded. Response to treatment was assessed by biopsy after at least 18 months of follow-up. Results: One hundred and twenty-eight HSILs in 91 men were included in this study. The overall response rate at 18 months was 70.3%. The number of electrocautery sessions required (2 ECA sessions vs 1: adjusted odds ratio [aOR] = 0.36 (95%CI 0.13-1.01); >=3 sessions vs 1: aOR = 0.10 (95%CI 0.04-0.29); p < 0.001]) and the history of previous HPV-related anal pathology (previous anal lesions vs no previous lesions AOR = 2.83 (95%CI 1.14-7.02), p = 0.024) were independently associated with response at 18 months. No serious adverse events were reported. Conclusions: Consideration should be given to alternative therapies in patients with unresolved HSIL after 1 ECA treatment.
Anifrolumab reduces flare rates in patients with moderate to severe systemic lupus erythematosus
Authors: Furie Richard , Morand Eric F , Askanase Anca D , Vital Edward M , Merrill Joan T , Kalyani Rubana N , Abreu Gabriel , Pineda Lilia , Tummala Raj
Published: May 2021

Background

Systemic lupus erythematosus (SLE) management objectives include preventing disease flares while minimizing glucocorticoid exposure. Pooled data from the phase 3 TULIP-1 and TULIP-2 trials in patients with moderate to severe SLE were analyzed to determine anifrolumab’s effect on flares, including those arising with glucocorticoid taper.

Methods

TULIP-1 and TULIP-2 were randomized, placebo-controlled, 52-week trials of intravenous anifrolumab (300 mg every 4 weeks for 48 weeks). For patients receiving baseline glucocorticoid ≥10 mg/day, attempted taper to ≤7.5 mg/day prednisone or equivalent from Weeks 8–40 was required and defined as sustained reduction when maintained through Week 52. Flares were defined as ≥1 new BILAG-2004 A or ≥2 new BILAG-2004 B scores versus the previous visit. Flare assessments were compared for patients receiving anifrolumab versus placebo.

Results

Compared with placebo (n = 366), anifrolumab (n = 360) was associated with lower annualized flare rates (rate ratio 0.75, 95% confidence interval [CI] 0.60–0.95), prolonged time to first flare (hazard ratio 0.70, 95% CI 0.55–0.89), and fewer patients with ≥1 flare (difference −9.3%, 95% CI −16.3 to −2.3), as well as flares in organ domains commonly active at baseline (musculoskeletal, mucocutaneous). Fewer BILAG-based Composite Lupus Assessment responders had ≥1 flare with anifrolumab (21.1%, 36/171) versus placebo (30.4%, 34/112). Of patients who achieved sustained glucocorticoid reductions from ≥10 mg/day at baseline, more remained flare free with anifrolumab (40.0%, 76/190) versus placebo (17.3%, 32/185).

Conclusions

Analyses of pooled TULIP-1 and TULIP-2 data support that anifrolumab reduces flares while permitting glucocorticoid taper in patients with SLE. ClinicalTrials.gov identifiers TULIP-1 NCT02446912 (clinicaltrials.gov/ct2/show/NCT02446912); TULIP-2 NCT02446899 (clinicaltrials.gov/ct2/show/NCT02446899).
Entrepreneurship, Self-Organization, and Eudaimonic Well-Being: A Dynamic Approach
Authors: Shir Nadav , Ryff Carol D.
Published: May 2021

As a self-organizing act, entrepreneurship is a significant feature of and force within modern life that is intimately related to individuals’ growth, development, and well-being. We present a dynamic perspective on entrepreneurship and eudaimonic well-being, anchored in philosophical and psychological views on the essence of well-being as well as the essence of entrepreneurship as a value-driven form of agency. Drawing on the action-phase model, which we adapt to the venture creation phases of deliberation, planning, implementation, and reflection, key propositions are developed regarding how, and under what conditions, core aspects of psychological well-being come into play along the enterprising process.
The Productivity of Unemployment and the Temporality of Employment-to-Come: Older Disadvantaged Job Seekers
Authors: Gerrard Jessica , Watson Juliet
Published: May 2021

This article demonstrates how unemployment is made productive through workfare activities for older disadvantaged job seekers. We suggest that the requirement to look for work, engage in education and training, and participate in voluntary work blurs the boundaries between employment and unemployment. Drawing on in-depth qualitative research with older disadvantaged job seekers, we demonstrate how this obligatory productivity is lived and felt, characterised by shame and frustration and framed by the temporality of waiting and searching for work. We suggest that this experience of ‘productive’ unemployment can be described as a dissonant state of ‘transitional stasis’, whereby job seekers are expected to transition out of unemployment and poverty while experiencing the long-term and ongoing effects of immobility.
Civil liability and the 50%+ standard of proof
Authors: Smith Martin
Published: May 2021

The standard of proof applied in civil trials is the preponderance of evidence, often said to be met when a proposition is shown to be more than 50% likely to be true. A number of theorists have argued that this 50%+ standard is too weak—there are circumstances in which a court should find that the defendant is not liable, even though the evidence presented makes it more than 50% likely that the plaintiff’s claim is true. In this paper, I will recapitulate the familiar arguments for this thesis, before defending a more radical one: The 50%+ standard is also too strong—there are circumstances in which a court should find that a defendant is liable, even though the evidence presented makes it less than 50% likely that the plaintiff’s claim is true. I will argue that the latter thesis follows naturally from the former once we accept that the parties in a civil trial are to be treated equally. I will conclude by sketching an alternative interpretation of the civil standard of proof
Conceptualising ethical consumption within theories of practice
Authors: Gram-Hanssen Kirsten
Published: May 2021

Since the turn of the century, sociological consumer research has had a strong focus on ordinary, routinised consumption, especially within the sustainability context. This approach has been a welcome alternative when understanding sustainable consumption compared with relying on individualistic psychological or identity-communicative approaches. However, with the shift towards a practice theoretical approach, there has been a tendency to ignore variation in consumer practices. Specifically, questions regarding the extent to which ethical concern can explain variance have not yet been included. Important questions, such as whether and how ethics takes part in changing practices in more sustainable directions, have similarly been neglected. This theoretically based article intends to contribute to further developing theories of practice by bringing together three discussions: how variation in carrying and performing practices can be conceptualised, how different approaches to consumption have conceptualised ethics and how ethics of care and the concept of general understandings can be used to conceptualise ethical aspects of consumption within theories of practice. The article concludes by summarising the findings from these discussions and raising questions of further empirical and theoretical concern.
Improving academic performance: Strengthening the relation between theory and practice through prompted reflection
Authors: Radović Slaviša , Firssova Olga , Hummel Hans GK , Vermeulen Marjan
Published: May 2021

The importance of reflection during learning process is widely recognized. Drawing on the literature, this article presents a study where students were stimulated to reflect during experiential learning, in order to both re- and de- contextualize their knowledge. We describe how different levels of prompted reflection can be related to academic performance and perceptions of the learning process. We found positive relationships between prompting reflection and the academic performance. It is therefore argued that prompting reflection leads to higher levels of reflection and better performance in writing. The results also show that higher levels of reflection do not have to diminish students’ motivation, perception of usefulness, interest and enjoyment during learning. Finally, the results reveal needs for encouraging more collaborative reflection during learning.
Low Back Pain Versus Back-Related Leg Pain: How Do Patient Expectations and Outcomes of Lumbar Spine Surgery Compare?
Authors: Brusalis Christopher M. , Duculan Roland , Cammisa Frank P. , Sama Andrew A. , Hughes Alexander P. , Mancuso Carol A. , Girardi Federico P.
Published: May 2021

Background: An increasing number of lumbar spine conditions are treated surgically. Such intervention, however, is commonly thought to be more effective in addressing leg pain than low back pain. Patient expectations may also contribute to self-reported surgical outcomes. Questions/Purposes: We sought to compare the expectations of patients in 2 groups undergoing lumbar spine surgery: those with predominantly low back pain and those with predominantly leg pain. We also sought to evaluate how these expectations were fulfilled for each group. Methods: We carried out a retrospective analysis of prospectively collected data from a prior study in which patients scheduled for lumbar spine surgery at a single institution completed validated surveys preoperatively and at 2 years postoperatively, including a 20-item survey on expectations for lumbar spine surgery. The patients were enrolled in the study between February 2010 and August 2012, and were divided into 2 cohorts: a “Back > Leg” group that consisted of patients with back pain that was isolated or greater than leg pain, and a “Leg ≥ Back” group that consisted of patients with leg pain that equaled or exceeded back pain. The primary analysis compared composite expectation scores (range, 0–100) between groups. Results: A total of 366 patients were deemed eligible for the study; of these, 162 patients were allocated to the Back > Leg group and 204 patients were allocated to the Leg ≥ Back group. Patients in the Leg ≥ Back group had a greater mean preoperative expectation score compared with those in the Back > Leg group. Multivariate analysis demonstrated that higher preoperative expectations were associated with leg pain symptoms after controlling for disease diagnosis. Both groups reported similar proportions of fulfilled expectations. Conclusion: Patients with predominantly leg pain hold greater preoperative expectations for lumbar spine surgery than do patients with predominantly back pain. That these patient groups reported similar fulfillment of their expectations at 2 years postoperatively illustrates the greater clinical outcomes achieved among patients who presented with predominantly leg pain.
Aging-in-Place: Residents’ Attitudes and Floor Plan Potential in Apartment Buildings From 1990 to 2015
Authors: Andersson Morgan , Granath Kaj , Nylander Ola
Published: May 2021

Objectives:

We investigated apartment designs in apartment blocks built 1990–2015 in Gothenburg, Sweden. We investigated the residents’ attitudes toward their previous, present, and future housing and their perceived possibilities for aging-in-place. We analyzed their apartments, focusing on the possibilities for aging-in-place in future care situations concerning bedroom capacity in a care situation; spatial proximity between bathroom, bedroom, storage, and entrance; and functional autonomy in a care situation without too much disturbance for a partner.

Background:

Since the 2000s, the ambition in Sweden is to enable older people to remain in ordinary housing. The possibilities for aging-in-place should therefore be considered already in the design stage, also when producing standard apartments.

Methods:

Semi-structured interviews were made with 30 households, with one or more resident 65 years or older. Floor plan analyses were made of their present apartments.

Results:

The majority displayed a pragmatic attitude toward aging, high satisfaction with their present housing situation, and good chances for aging-in-place in future homecare scenarios. The floor plan analysis shows that the three concepts of bedroom capacity, spatial proximity, and functional autonomy can be used to determine the potential for aging-in-place.

Conclusions:

The results suggest that architectural qualities related to aging-in-place are not automatically connected to floor size or number of rooms. Small apartments can perform better than larger ones, depending on spatio-functional organization and connections between different functions. The residents’ perceived chances for aging-in-place confirm this relation. Future studies should compare different locations, production periods, and relations between size, space efficiency, and accessibility.
Neurohospitalist Practice and Well-Being During the COVID-19 Pandemic
Authors: Goyal Tarini , Probasco John C. , Gold Carl A. , Klein Joshua P. , Weathered Natalie R. , Thakur Kiran T.
Published: May 2021

Background and Purpose:

Neurohospitalists play an important role in, and have been variably affected by, the ongoing COVID-19 pandemic. In this study, we survey neurohospitalists to characterize practice changes and the impact of the pandemic on their well-being.

Methods:

A 22-item survey was distributed to neurohospitalists through the Neurohospitalist Society and the American Academy of Neurology Neurohospitalist, Stroke & Vascular Neurology, and Critical Care & Emergency Neurology Sections.

Results:

After 2 weeks of collection, 123 responses were received, with 57% of respondents practicing in academic settings, 23% in private practice, and 7% in community hospitals. A minority of neurohospitalists (8%) were redeployed to care for COVID-19 or non-COVID-19 medicine patients. The most common neurologic diagnoses they reported in COVID-19 patients were delirium (85%), cerebrovascular events (75%), and seizure (35%); however, most neurohospitalists (59%) had evaluated fewer than 10 patients with COVID-19. Respondents observed that fewer patients with unrelated neurological diseases were admitted to the hospital compared to before the pandemic. Neurohospitalists experienced changes in administrative (27%), educational (15%), and research duties (11%), and had overall worse well-being and work-life balance (77%).

Conclusions:

The most common neurologic diagnoses seen in COVID-19 patients by neurohospitalists in this sample are delirium, cerebrovascular disease, and seizure. Though the majority of survey respondents reported not being primary frontline providers, they report key clinical and operational roles during the pandemic, and report worse well-being as compared to before the pandemic. Our data suggests that there are opportunities to improve neurohospitalists’ experience through flexible work practices and providing family care support.
Electric light and the visualization of Catholic power in Spain during the Restoration Era (1874–1931)
Authors: Pérez-Zapico Daniel
Published: May 2021

This article analyses the contested adoption of electric lights by the Spanish Catholic church during the Bourbon Restoration era (1874–1931). Through a careful reading of primary sources, namely Catholic popular magazines, and official documents, it will show how Catholic authorities and practitioners resisted, negotiated and, ultimately, engaged with electricity in religious spaces. The article argues that electric light contributed to wider exchanges in a non-monolithic Spanish Catholicism on the observance of traditional values or the possibilities of the church’s modernization. However, amid a particularly tense moment regarding the secular–clerical relations, the systematic use of electric lights in churches at the turn of the twentieth century—but also in other public ceremonies—contributed to the making of religious sensations aimed at attracting new believers and reasserting the presence of the institution in a disputed public space.
Combination of Side-Bending and Traction Radiographs Do Not Influence Selection of Fusion Levels Compared to Either One Alone in Adolescent Idiopathic Scoliosis
Authors: Arima Hideyuki , Dimar John R. , Glassman Steven D , Gum Jeffrey L. , Carreon Leah Y.
Published: May 2021

Study Design:

A retrospective study.

Objectives:

Curve flexibility in patients with adolescent idiopathic scoliosis (AIS) can be evaluated using different techniques. This study aimed to determine whether the combination of side-bending (SB) and traction (TX) radiographs influences preoperative planning for AIS than either radiograph alone.

Methods:

Thirty-two spine surgeons were asked to review 30 AIS Lenke type 1 cases and select an upper instrumented vertebra (UIV) and lower instrumented vertebra (LIV) for the posterior spinal instrumentation of each case. Each rater reviewed the cases 3 times in each round. The raters were provided with the full-length posteroanterior (PA) and lateral standing and SB radiographs for round 1; PA, lateral, and TX radiographs for round 2; and PA, lateral, SB, and TX radiographs for round 3. Intra- and inter-rater reliabilities were evaluated using Kappa statistics.

Results:

The intra-rater reliability for UIV and LIV was 0.657 and 0.612 between rounds 1 and 2, 0.634 and 0.692 between rounds 1 and 3, and 0.659 and 0.638 between rounds 2 and 3, respectively, which indicated substantial agreement between rounds. The inter-rater kappa reliabilities for UIV and LIV selection were 0.103 and 0.412 for round 1, 0.121 and 0.380 for round 2, and 0.125 and 0.368 for round 3, indicating slight to moderate agreement between raters.

Conclusions:

Whether raters used either SB or TX radiography, or both in addition to PA and lateral standing radiographs, did not influence the decision making for UIV or LIV of AIS Lenke type 1 surgery.
Abdominal wall endometriosis: Is structure in imaging related to nodule localisation? A retrospective study
Authors: Figuier Claire , Montoriol Pierre-François , Pereira Bruno , Chauvet Pauline , Bourdel Nicolas , Canis Michel
Published: May 2021

Objective:

Investigate the relationship between the structure of abdominal wall endometriotic nodules in MRI and their localisation in abdominal wall layers in order to better understand nodule origins.

Design:

Women who had an MRI prior to surgical treatment of an abdominal wall endometriotic nodule between 2005 and 2016.

Population:

Thirty-six patients including four patients with two nodules.

Methods:

MRI images were reviewed. Each nodule was analysed according to its structure (fibrous, cystic, mixed), localisation (subcutaneous fat, intra muscular, intermediary position), and size.

Results:

Forty nodules were analysed in MRI with no relationship found between localisation and nodule structure ( p = 0.48). 87.5% of mixed nodules were revealed to have a cystic superficial rim extending towards the subcutaneous fat layer. This finding suggests that the glandular part of the nodule is the active part of the disease from which nodule progression occurs. Intermediary and intramuscular nodules were respectively statistically larger than subcutaneous fat nodules indicating a relationship between nodule size and localisation (35 mm (22–53) vs 17 mm (17–23)) ( p = 0.03).

Conclusion:

Despite differences in environments surrounding the nodules, no significant relationship between nodule structure in imaging and abdominal wall localisation was found. Data from mixed nodules indicate however the possible role of nodule environment on structure and that the mechanism of nodule growth may be linked to development of cystic superficial rims, at the forefront of disease progression, abdominal wall nodules growing from deep to superficial. Studies are required to further investigate our findings and enable greater understanding of the origins of AWE.
Metabolomics and microbiome profiling as biomarkers in obstructive sleep apnoea: a comprehensive review
Authors: Zhang Xiaoman , Wang Shengming , Xu Huajun , Yi Hongliang , Guan Jian , Yin Shankai
Published: May 2021

Introduction

Obstructive sleep apnoea (OSA) is a common sleep disorder with a high social and economic burden. Thus, early prediction and diagnosis of OSA are important. Changes in metabolism and the microbiome may serve as biomarkers for OSA. Herein, we review the literature on the metabolomic and microbiome changes associated with OSA, and identify the metabolites and microorganisms involved.

Methods

We searched the PUBMED and EMBASE electronic databases using the following terms: “obstructive sleep apnea”, “OSA”, “sleep disordered breathing”, “SDB”, “intermittent hypoxia”, “sleep fragmentation”, and either “metabolomics” or “microbiome”. In total, 273 papers were identified, of which 28 were included in our study.

Results

Changes in the levels of certain metabolites related to fatty acid, carbohydrate and amino acid metabolism were associated with the incidence of OSA. The diversity and abundance of microflora, particularly Firmicutes and Bacteroidetes, were altered in humans and rodents with OSA.

Conclusions

Certain changes in metabolism and the microbiota play an integral role in the pathophysiology of OSA and OSA-induced cardiovascular complications. Metabolomic and microbiome biomarkers shed light on the pathogenesis of OSA, and facilitate early diagnosis and treatment.
The measurement properties of tests and tools used in cystic fibrosis studies: a systematic review
Authors: McLeod Charlie , Wood Jamie , Tong Allison , Schultz André , Norman Richard , Smith Sherie , Blyth Christopher C. , Webb Steve , Smyth Alan R. , Snelling Thomas L.
Published: May 2021

There is no consensus on how best to measure responses to interventions among children and adults with cystic fibrosis (CF). We have systematically reviewed and summarised the characteristics and measurement properties of tests and tools that have been used to capture outcomes in studies among people with CF, including their reliability, validity and responsiveness. This review is intended to guide researchers when selecting tests or tools for measuring treatment effects in CF trials. A consensus set of these tests and tools could improve consistency in how outcomes are captured and thereby facilitate comparisons and synthesis of evidence across studies.
Correction to: Loss of PTEN expression is associated with PI3K pathway-dependent metabolic reprogramming in hepatocellular carcinoma
Authors: Zhao Chuanzong , Wang Ben , Liu Enyu , Zhang Zongli
Published: May 2021

An amendment to this paper has been published and can be accessed via the original article.
Children with medical complexity and paediatric palliative care: a retrospective cross-sectional survey of prevalence and needs
Authors:   on behalf of Emilia Romagna paediatric palliative care working group, Amarri S. , Ottaviani A. , Campagna A. , De Panfilis L.
Published: May 2021

Background

Children with medical complexity (CMC) have been defined (Cohen et al., Pediatrics 127: 529–538, 2011.) as an emerging population potentially eligible for PPC. The current study investigated the prevalence of children with medical complexities eligible for a local palliative care network, including a paediatric hospice.

Methods

A retrospective cross-sectional survey has been conducted using children clinical charts from 14 local health authorities of our region (Emilia Romagna, Italy).

Results

The total number of children with life-limiting conditions was 601, with a mean age of 7.4 ± 4.8 years, a prevalence of 8.4/10.000 residents < 19 years of age and a heterogeneous presentation among the provinces in the region. Neurological diseases affect 51% of patients, followed by congenital diseases (21%) and pathologies originating in the perinatal period (6%), while only 4% of the patients had a cancer diagnosis. Patients are dependent from many devices and supports: 32% had a gastrostomy, 22% a respiratory support and 15% of patients had both of them.

Conclusions

Observed regional prevalence of complex needs is lower than that published from other European countries. More research is needed to raise awareness of palliative care for children with medical complexities in order to address specific needs.
The association between deficiency of nutrient intake and resting metabolic rate in overweight and obese women: a cross-sectional study
Authors: Sajjadi Seyedeh Forough , Mirzababaei Atieh , Abdollahi Afsoun , Shiraseb Farideh , Mirzaei Khadijeh
Published: May 2021

Objective

The double burden of malnutrition is an emerging public health concern nowadays which a correlation with obesity. This study aimed to examine the relationship between resting metabolic rate (RMR) and dietary intake of zinc, vitamin C, and riboflavin in overweight and obese women.

Results

The RMR/FFM showed a significant association with riboflavin (β = 1.59; 95% CI 1.04–23.26, P = 0.04) and zinc (β = 0.78; 95% CI 1.04–4.61, P = 0.03) in the crude model. Moreover, differences in vitamin C and RMR/FFM was marginal significant (β = 0.75; 95% CI 0.95–4.77, P = 0.06). After adjusting for confounders the riboflavin association change to marginal significance (β = 1.52; 95% CI 0.91–23.04, P = 0.06). After controlling for potential confounders, the associations change between zinc and RMR/FFM (β = 0.66; 95% CI 0.78–4.86, P = 0.15) and between RMR/FFM and vitamin C (β = 0.48; 95% CI 0.66–3.96, P = 0.28). Our study showed a significant association between dietary intake of zinc, riboflavin, and vitamin C and change in RMR/FFM in overweight and obese women.
The role of epigenetic modifications for the pathogenesis of Crohn's disease
Authors: Hornschuh M. , Wirthgen E. , Wolfien M. , Singh K. P. , Wolkenhauer O. , Däbritz J.
Published: May 2021

Epigenetics has become a promising field for finding new biomarkers and improving diagnosis, prognosis, and drug response in inflammatory bowel disease. The number of people suffering from inflammatory bowel diseases, especially Crohn's disease, has increased remarkably. Crohn's disease is assumed to be the result of a complex interplay between genetic susceptibility, environmental factors, and altered intestinal microbiota, leading to dysregulation of the innate and adaptive immune response. While many genetic variants have been identified to be associated with Crohn's disease, less is known about the influence of epigenetics in the pathogenesis of this disease. In this review, we provide an overview of current epigenetic studies in Crohn's disease. In particular, we enable a deeper insight into applied bioanalytical and computational tools, as well as a comprehensive update toward the cell-specific evaluation of DNA methylation and histone modifications.
Identification of prognosis-related molecular subgroups based on DNA methylation in pancreatic cancer
Authors: Yin Xiaoli , Kong Lingming , Liu Peng
Published: May 2021

Background

Pancreatic cancer (PC) is one of the most lethal and aggressive cancer malignancies. The lethality of PC is associated with delayed diagnosis, presence of distant metastasis, and its easy relapse. It is known that clinical treatment decisions are still mainly based on the clinical stage and pathological grade, which are insufficient to determine an appropriate treatment. Considering the significant heterogeneity of PC biological characteristics, the current clinical classificatory pattern relying solely on classical clinicopathological features identification needs to be urgently improved. In this study, we conducted in-depth analyses to establish prognosis-related molecular subgroups based on DNA methylation signature.

Results

DNA methylation, RNA sequencing, somatic mutation, copy number variation, and clinicopathological data of PC patients were obtained from The Cancer Genome Atlas (TCGA) dataset. A total of 178 PC samples were used to develop distinct molecular subgroups based on the 4227 prognosis-related CpG sites. By using consensus clustering analysis, four prognosis-related molecular subgroups were identified based on DNA methylation. The molecular characteristics and clinical features analyses based on the subgroups offered novel insights into the development of PC. Furthermore, we built a risk score model based on the expression data of five CpG sites to predict the prognosis of PC patients by using Lasso regression. Finally, the risk score model and other independent prognostic clinicopathological information were integrative utilised to construct a nomogram model.

Conclusion

Novel prognosis-related molecular subgroups based on the DNA methylation signature were established. The specific five CpG sites model for PC prognostic prediction and the derived nomogram model are effective and intuitive tools. Moreover, the construction of molecular subgroups based on the DNA methylation data is an innovative complement to the traditional classification of PC and may contribute to precision medicine development, therapeutic efficacy prediction, and clinical decision guidance.
MRI detection of the malignant transformation of stem cells through reporter gene expression driven by a tumor-specific promoter
Authors: Sun Jun , Huang Jie , Bao Guangcheng , Zheng Helin , Wang Cui , Wei Jie , Fu Yuanqiao , Qiu Jiawen , Liao Yifan , Cai Jinhua
Published: May 2021

Background

Existing evidence has shown that mesenchymal stem cells (MSCs) can undergo malignant transformation, which is a serious limitation of MSC-based therapies. Therefore, it is necessary to monitor malignant transformation of MSCs via a noninvasive imaging method. Although reporter gene-based magnetic resonance imaging (MRI) has been successfully applied to longitudinally monitor MSCs, this technique cannot distinguish the cells before and after malignant transformation. Herein, we investigated the feasibility of using a tumor-specific promoter to drive reporter gene expression for MRI detection of the malignant transformation of MSCs.

Methods

The reporter gene ferritin heavy chain (FTH1) was modified by adding a promoter from the tumor-specific gene progression elevated gene-3 (PEG3) and transduced into MSCs to obtain MSCs-PEG3-FTH1. Cells were induced to undergo malignant transformation via indirect coculture with C6 glioma cells, and these transformed cells were named MTMSCs-PEG3-FTH1. Western blot analysis of FTH1 expression, Prussian blue staining and transmission electron microscopy (TEM) to detect intracellular iron, and MRI to detect signal changes were performed before and after malignant transformation. Then, the cells before and after malignant transformation were inoculated subcutaneously into nude mice, and MRI was performed to observe the signal changes in the xenografts.

Results

After induction of malignant transformation, MTMSCs demonstrated tumor-like features in morphology, proliferation, migration, and invasion. FTH1 expression was significantly increased in MTMSCs-PEG3-FTH1 compared with MSCs-PEG3-FTH1. Prussian blue staining and TEM showed a large amount of iron particles in MTMSCs-PEG3-FTH1 but a minimal amount in MSCs-PEG3-FTH1. MRI demonstrated that the T2 value was significantly decreased in MTMSCs-PEG3-FTH1 compared with MSCs-PEG3-FTH1. In vivo, mass formation was observed in the MTMSCs-PEG3-FTH1 group but not the MSCs-PEG3-FTH1 group. T2-weighted MRI showed a significant signal decrease, which was correlated with iron accumulation in the tissue mass.

Conclusions

We developed a novel MRI model based on FTH1 reporter gene expression driven by the tumor-specific PEG3 promoter. This approach could be applied to sensitively detect the occurrence of MSC malignant transformation.
Prevalence and incidence of venous leg ulcers—a protocol for a systematic review
Authors: Probst S. , Weller C. D. , Bobbink P. , Saini C. , Pugliese M. , Skinner Monika Buehrer , Gethin G.
Published: May 2021

Background

Venous leg ulcers (VLUs) are chronic wounds characterized by slow healing and high recurrence. Information on prevalence and incidence is essential for ascertaining the burden of VLU on the health care system and to inform epidemiological research, priority setting, and health care planning. The objective of this protocol is to present a transparent process for how we plan to review the existing international literature on the prevalence and incidence of VLU as well as the characteristics of the population reported within these studies.

Methods

An exploratory search was performed using MEDLINE via PubMed and CINHAL via Ebsco to identify concepts, keywords, MeSH terms, and headings to identify study types looking at data of VLU prevalence and/or incidence and related patient characteristics. The findings of this exploratory search will determine the final search strategy. The titles and abstracts of the identified articles will be screened independently be two authors for relevance. Study which pass the quality assessment will be included. Data extraction will be performed independently by two authors and in accordance with a pre-designed data extraction form. If the data allows, a meta-analysis will be performed otherwise a descriptive summary of the findings will be conducted.

Discussion

The results of this review will contribute to the evidence base on VLU occurrence and may inform the decision making of healthcare professionals, policy-makers, and consumers. It will also inform future research in this area of VLU care.

Systematic review registration

PROSPERO CRD42020205855
Oral administration of Moringa oleifera leaf powder relieves oxidative stress, modulates mucosal immune response and cecal microbiota after exposure to heat stress in New Zealand White rabbits
Authors: Yasoob Talat Bilal , Yu Defu , Khalid Abdur Rauf , Zhang Zhen , Zhu Xiaofeng , Saad Heba M. , Hang Suqin
Published: May 2021

Background

Heat stress (HS) disrupts the gut barrier allowing the uptake of lipopolysaccharide (LPS) and leads to an inflammatory response and changes in gut microbiota composition.Moringa oleiferaleaf powder (MOLP) has been proposed to combat HS, yet its alleviate role is currently under investigation. The current study investigated the effects of chronic HS and MOLP supplementation on changes in redox status and immune response of cecal mucosa along with alteration in cecal microbiota.

Methods

A total of 21 young New Zealand White (NZW) rabbits (male) about 32 weeks old (mean body weight of 3318 ± 171 g) reared on a commercial pelleted diet were employed; divided into three groups (n = 7): control (CON, 25 °C), heat stress (HS, 35 °C for 7 h daily), and HS supplemented orally with MOLP (HSM, 35 °C) at 200 mg/kg body weight per day for 4 weeks.

Results

The results demonstrated that MOLP supplementation increased organ index of cecal tissue compared with the HS group (P > 0.05). Levels of malonaldehyde (MDA) and activity of superoxide dismutase (SOD) as well as lactate dehydrogenase (LDH) were reduced in the cecal mucosa of the HSM group compared with the HS group. MOLP downregulated the contents of cecal mucosa LPS, several inflammatory markers (TNF-α/IL-1α/IL-1β), and myeloperoxidase (MPO) in the HSM group (P < 0.05). Secretory immunoglobulin A (SIgA) was increased in the HSM group compared with the HS group (P < 0.05). The transcriptome of cecal mucosa showed that MOLP reduced gene expression relative to several immune factors, includingIL-10,IFNG, andRLA, whereas both HS and MOLP increased the gene expression of fat digestion and absorption pathway, includingAPOA1,FABP1,FABP2,MTTP, andLOC100344166, compared to the CON group (P < 0.001). At the phylum level, the relative abundance of Proteobacteria was increased by HS, while Actinobacteria was significantly increased by HSM compared to other groups (P < 0.05). At genus level,Papillibacterwas higher in abundance in HSM groups compared to CON and HS groups (P < 0.05). Higher butyrate concentrations were observed in the HSM group than HS and CON groups (P < 0.05).

Conclusion

In conclusion, HS in growing rabbits resulted in alteration of cecal microbiota at phyla level as well as increased oxidative stress and expression of mucosal inflammatory genes. Whereas, oral MOLP supplementation elevated the relative weight of cecum, affected their immunological and cecal micro-ecosystem function by improving antioxidant status and down-regulating mucosal tissue inflammatory response.