bluuebunny/crossref_metadata_2025 huggingface dataset:
Dual inhibition of the MEK/ERK and PI3K/AKT pathways prevents pulmonary GVHD suppressing perivenulitis and bronchiolitis
Authors: Muranushi Hiroyuki , Shindo Takero , Chen-Yoshikawa Toyofumi F , Yoshizawa Akihiko , Thi Ngo Huong , Gochi Fumiaki , Date Hiroshi , Takaori-Kondo Akifumi
Published: April 2022

Patients with pulmonary graft-versus-host disease (pGVHD) have a poor prognosis after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Furthermore, pGVHD pathogenesis is not fully elucidated in humans, and currently available immunosuppressants are inadequately effective. We performed pathologic evaluation of lung specimens from 45 allo-HSCT recipients with pGVHD who underwent lung transplantation. Patient pathology was characterized by bronchiolitis and subpleural perivascular inflammation, with B-cell, monocyte, and T-cell accumulation around bronchioles. Bronchiolitis, perivascular inflammation, and peribronchial macrophage aggregation were also identified in a murine pGVHD model after transplant of bone marrow cells and splenocytes from C57BL/6 to B10.BR mice. Among mitogen-activated protein kinase kinase (MEK) inhibitors, cobimetinib, but not trametinib, improved survival rates. Cobimetinib attenuated bronchiolitis, improved airway resistance and lung compliance in the mice, and suppressed activation of B cells and tumor necrosis factor α production by monocytes in vitro; these features were not suppressed by trametinib or tacrolimus. Furthermore, cobimetinib suppressed activation of phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling, resulting in B-cell and monocyte suppression. Dual inhibition of the MEK/extracellular signal-regulated kinase (ERK) and PI3K/AKT pathways using a combination of trametinib and the PI3K inhibitor taselisib strongly suppressed B-cell activation in vitro and improved mouse survival rates compared with vehicle or monotherapy with trametinib or taselisib. Imaging mass cytometry of human pGVHD revealed that T cells around bronchioles were positive for phosphorylated ERK, whereas B cells were positive for phosphorylated AKT. Thus, perivascular inflammation and bronchiolitis mediated by activation of the MEK/ERK and PI3K/AKT pathways are essential for pGVHD and represent a potential novel therapeutic target in humans.
Gut microbiota-testis axis: FMT improves systemic and testicular micro-environment to increase semen quality in type 1 diabetes
Authors: Hao Yanan , Feng Yanni , Yan Xiaowei , Chen Liang , Zhong Ruqing , Tang Xiangfang , Shen Wei , Sun Qingyuan , Sun Zhongyi , Ren Yonglin , Zhang Hongfu , Zhao Yong
Published: April 2022

Background

Clinical data suggest that male reproductive dysfunction especially infertility is a critical issue for type 1 diabetic patient (T1D) because most of them are at the reproductive age. Gut dysbiosis is involved in T1D related male infertility. However, the improved gut microbiota can be used to boost spermatogenesis and male fertility in T1D remains incompletely understood.

Methods

T1D was established in ICR (CD1) mice with streptozotocin. Alginate oligosaccharide (AOS) improved gut microbiota (fecal microbiota transplantation (FMT) from AOS improved gut microbiota; A10-FMT) was transplanted into the T1D mice by oral administration. Semen quality, gut microbiota, blood metabolism, liver, and spleen tissues were determined to investigate the beneficial effects of A10-FMT on spermatogenesis and underlying mechanisms.

Results

We found that A10-FMT significantly decreased blood glucose and glycogen, and increased semen quality in streptozotocin-induced T1D subjects. A10-FMT improved T1D-disturbed gut microbiota, especially the increase in small intestinal lactobacillus, and blood and testicular metabolome to produce n-3 polyunsaturated fatty acid (PUFA) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) to ameliorate spermatogenesis and semen quality. Moreover, A10-FMT can improve spleen and liver functions to strengthen the systemic environment for sperm development. FMT from gut microbiota of control animals (Con-FMT) produced some beneficial effects; however, to a smaller extent.

Conclusions

AOS-improved gut microbiota (specific microbes) may serve as a novel, promising therapeutic approach for the improvement of semen quality and male fertility in T1D patients via gut microbiota-testis axis.
Variance of allele balance calculated from low coverage sequencing data infers departure from a diploid state
Authors: Fletcher Kyle , Han Rongkui , Smilde Diederik , Michelmore Richard
Published: April 2022

Background

Polyploidy and heterokaryosis are common and consequential genetic phenomena that increase the number of haplotypes in an organism and complicate whole-genome sequence analysis. Allele balance has been used to infer polyploidy and heterokaryosis in diverse organisms using read sets sequenced to greater than 50× whole-genome coverage. However, sequencing to adequate depth is costly if applied to multiple individuals or large genomes.

Results

We developed VCFvariance.pl to utilize the variance of allele balance to infer polyploidy and/or heterokaryosis at low sequence coverage. This analysis requires as little as 10× whole-genome coverage and reduces the allele balance profile down to a single value, which can be used to determine if an individual has two or more haplotypes. This approach was validated using simulated, synthetic, and authentic read sets from the oomycete speciesBremia lactucaeandPhytophthora infestans, the fungal speciesSaccharomyces cerevisiae, and the plant speciesArabidopsis arenosa. This approach was deployed to determine that nine of 21 genotyped European race-type isolates ofBremia lactucaewere inconsistent with diploidy and therefore likely heterokaryotic.

Conclusions

Variance of allele balance is a reliable metric to detect departures from a diploid state, including polyploidy, heterokaryosis, a mixed sample, or chromosomal copy number variation. Deploying this strategy is computationally inexpensive, can reduce the cost of sequencing by up to 80%, and used to test any organism.
A qualitative systematic review on the experiences of homelessness among older adults
Authors: Om Phuntsho , Whitehead Lisa , Vafeas Caroline , Towell-Barnard Amanda
Published: April 2022

Adults who experience homelessness for an extended period of time also experience accelerated ageing and other negative impacts on their general health and wellbeing. Homelessness amongst older adults is on the rise, yet there are few systematic reviews investigating their experiences. Thus, this review classifies and synthesises qualitative research findings of studies published between 1990 to 2020 that have examined the needs and challenges of homeless older adults to elucidate their journey of homelessness. Seven papers met the requirements for inclusion. Three main themes were identified in the review: - (1) Pathways to homelessness, (2) Impact of homelessness, and (3) Outcomes and resolutions. This review collates current evidence on what is known about the experience of homelessness among older adults. In this study, homeless older adults identified a wide range of challenges associated with the experience of homelessness.
COVID-19 GPH: tracking the contribution of genomics and precision health to the COVID-19 pandemic response
Authors: Yu Wei , Drzymalla Emily , Gwinn Marta , Khoury Muin J.
Published: April 2022

The scientific response to the COVID-19 pandemic has produced an abundance of publications, including peer-reviewed articles and preprints, across a wide array of disciplines, from microbiology to medicine and social sciences. Genomics and precision health (GPH) technologies have had a particularly prominent role in medical and public health investigations and response; however, these domains are not simply defined and it is difficult to search for relevant information using traditional strategies. To quantify and track the ongoing contributions of GPH to the COVID-19 response, the Office of Genomics and Precision Public Health at the Centers for Disease Control and Prevention created the COVID-19 Genomics and Precision Health database (COVID-19 GPH), an open access knowledge management system and publications database that is continuously updated through machine learning and manual curation. As of February 11, 2022, COVID-GPH contained 31,597 articles, mostly on pathogen and human genomics (72%). The database also includes articles describing applications of machine learning and artificial intelligence to the investigation and control of COVID-19 (28%). COVID-GPH represents about 10% (22983/221241) of the literature on COVID-19 on PubMed. This unique knowledge management database makes it easier to explore, describe, and track how the pandemic response is accelerating the applications of genomics and precision health technologies. COVID-19 GPH can be freely accessed via https://phgkb.cdc.gov/PHGKB/coVInfoStartPage.action.
Paraplegia secondary to disseminated mucormycosis: case report and literature review
Authors: Shi Xiangjun , Qi Lei , Du Boran , Yao Xingchen , Du Xinru
Published: April 2022

Background

We report a case of spine infection with mucormycosis that manifested signs of paraplegia in a patient suffering from disseminated mucormycosis. Timely and effective surgery was performed. A review of the literature is included.

Case presentation

A patient with diabetic ketoacidosis complained of back pain and fatigue for one month, and his right lower extremity activity had been limited for 10 days. T4–T6 vertebral and paravertebral soft tissue-involved infections were identified by MRI, which were derived from right lung pneumonia. He underwent abscess debridement, spinal canal decompression, pedicle screw fixation and amphotericin B liposome injection. Histopathological examination revealed broad aseptate hyphae suggestive of invasive mucormycosis. There was improvement in neurological function after surgical and medical treatment. Three months after the surgery, the patient died of uncontrollable massive bleeding of the urinary system. Mucormycosis is characterized by rapid development and a high mortality rate. This case shows the significance of a multidisciplinary team in the diagnosis and treatment of patients with mucormycosis. In addition, orthopedic surgeons should design appropriate surgery plans for spine-involved mucormycosis patients.

Conclusion

This case present a patient with paraplegia caused by the spread of pulmonary mucormycosis to the vertebral and paravertebral soft tissue of levels T4–T6. After medical treatment, surgical debridement and internal fixation, the patient recovered well but later patient died of possible disease dissemination to the renal or urinary tract which resulted in massive haemorrhage.
Long-term effect of additional rehabilitation following botulinum toxin-A on upper limb activity in chronic stroke: the InTENSE randomised trial
Authors: Lannin Natasha A. , Ada Louise , English Coralie , Ratcliffe Julie , Faux Steven , Palit Mithu , Gonzalez Senen , Olver John , Schneider Emma , Crotty Maria , Cameron Ian D.
Published: April 2022

Background

It is common for people with persistent spasticity due to a stroke to receive an injection of botulinum toxin-A in the upper limb, however post-injection intervention varies.

Aim

To determine the long-term effect of additional upper limb rehabilitation following botulinum toxin-A in chronic stroke.

Method

An analysis of long-term outcomes from national, multicenter, Phase III randomised trial with concealed allocation, blinded measurement and intention-to-treat analysis was carried out. Participants were 140 stroke survivors who were scheduled to receive botulinum toxin-A in any muscle(s) that cross the wrist because of moderate to severe spasticity after a stroke greater than 3 months ago, who had completed formal rehabilitation and had no significant cognitive impairment. Experimental group received botulinum toxin-A plus 3 months of evidence-based movement training while the control group received botulinum toxin-A plus a handout of exercises. Primary outcomes were goal attainment (Goal Attainment Scale) and upper limb activity (Box and Block Test) at 12 months (ie, 9 months beyond the intervention). Secondary outcomes were spasticity, range of motion, strength, pain, burden of care, and health-related quality of life.

Results

By 12 months, the experimental group scored the same as the control group on the Goal Attainment Scale (MD 0 T-score, 95% CI -5 to 5) and on the Box and Block Test (MD 0.01 blocks/s, 95% CI -0.01 to 0.03). There were no differences between groups on any secondary outcome.

Conclusion

Additional intensive upper limb rehabilitation following botulinum toxin-A in chronic stroke survivors with a disabled upper limb is not more effective in the long-term.

Trial Registration

ACTRN12615000616572 (12/06/2015).
Associations between socioeconomic status and pregnancy outcomes: a greater magnitude of inequalities in perinatal health in Montreal than in Brussels
Authors: Sow Mouctar , Raynault Marie-France , De Spiegelaere Myriam
Published: April 2022

Background

Comparing health inequalities between countries helps us to highlight some factors specific to each context that contribute to these inequalities, thus contributing to the identification of courses of action likely to reduce them. This paper compares the associations between socioeconomic status (SES) and 1) low birth weight (LBW) and 2) preterm birth, in Brussels and Montreal (in general population, natives-born mothers, and immigrant mothers).

Methods

A population-based study examining associations between SES and pregnancy outcomes was conducted in each city, using administrative databases from Belgian and Quebec birth records (N = 97,844 and 214,620 births in Brussels and Montreal, respectively). Logistic regression models were developed in order to estimate the relationship between SES (maternal education and income quintile) and pregnancy outcomes, in each region. The analyses were first carried out for all births, then stratified according to the mother’s origin.

Results

For the general population, SES is associated with LBW and preterm birth in both regions, except for income and preterm birth in Brussels. The association is stronger for mothers born in Belgium and Canada than for those born abroad. The main difference between the two regions concerns the magnitude of inequalities in perintal health, which is greater in Montreal than in Brussels among the general population. For native-born mothers, the magnitude of inequalities in perinatal health is also greater for mothers born in Canada than for those born in Belgium, except for the association between income and preterm birth. The socioeconomic gradient in perinatal health is less marked among immigrant mothers than native mothers.

Conclusion

Significant differences in inequalities in perinatal health are observed between Brussels and Montreal. These differences can be explained by : on the one hand, the existence of greater social inequalities in Montreal than in Brussels and, on the other hand, the lower vulnerability of immigrants with low SES in Brussels. Future studies seeking to understand the mechanisms that lead to inequalities in health in different contexts should take into account a comparison of immigration and poverty contexts, as well as the public policies related to these factors.
Functional outcomes are preserved in adult acetabular dysplasia with radiographic evidence of lumbosacral spine anomalies: an investigation in hip-spine syndrome
Authors: Shi Aaron , Sun Joshua , Chhabra Avneesh , Thakur Uma , Xi Yin , Kohli Ajay , Wells Joel
Published: April 2022

Purpose

Acetabular dysplasia (AD) is a debilitating condition which results in impaired hip function, leading to hip-spine syndrome with anomalies identifiable on plain radiographs. However, no study to date has investigated the association between radiographic spine anomalies and functional outcomes in AD. We hypothesize that AD patients with radiographic evidence of lumbar spine anomalies are associated with decreased function in comparison to those without such radiographic findings.

Patients and methods

One hundred thirty-five hips underwent a full four-view hip radiograph series, and two observers analyzed hip and spine variables using standard radiographs and obtained Castellvi grade, assessment of spondylolisthesis, and L4-S1 interpedicular distance. A comprehensive hip questionnaire was administered which included Harris Hip Score (HHS) and Hip Disability and Osteoarthritis Outcome Score (HOOS) to assess patient function. Correlations between HHS and HOOS and radiographic spinal measurements were calculated, and p-values were corrected for multiple comparison using the Holm’s method.

Results

Out of 135 patients, 119 were female (88.1%) and 16 were male (11.9%). Average age of presentation was 34.2 years, and average BMI was 26. There was no statistically significant correlation between Castellvi grade, presence of spondylolisthesis, or L4-S1 interpedicular distance and the patient-reported outcome measures HHS or HOOS. Conversely, a significant correlation was observed between Femoro-Epiphyseal Acetabular Roof (FEAR) index and HOOS of the contralateral hip (correlation coefficient = 0.38, adjusted p = 0.03) and Tönnis angle of AD severity and HHS of the contralateral hip (correlation coefficient = − 0.33, adjusted p = 0.04).

Conclusion

Severity of spinal anomalies measured by Castellvi grade and spondylolisthesis in patients with AD was not associated with decreased patient function in the ipsilateral diseased hip. To our knowledge, this is the first study to date to report the relationship between radiographically identifiable lumbosacral abnormalities and hip function in AD.
Effect of complete reduction of hernia sac and transection of hernia sac during laparoscopic indirect inguinal hernia repair on seroma
Authors: Pan Chunpeng , Xu Xin , Si Xianke , Yu Jiwei
Published: April 2022

Introduction

This study investigated the effect of complete reduction and transection of the hernia sac during laparoscopic indirect inguinal hernia repair on seroma.

Methods

Retrospective analysis was performed on 1763 cases undergoing laparoscopic indirect inguinal hernia repair in three centers from January 2017 to September 2019, among them, 311 patients with transection of hernia sac and 1452 patients with reduction of hernia sac, the data of the two groups were tested by t-test. Logistic univariate analysis was performed on 233 cases of postoperative seroma, and variables p < 0.05 in univariate analysis were included for multivariate analysis. Then, the transection group and the reduction group were matched with 1:1 propensity score matching, and the caliper value was set at 0.05. Finally, 274 patients matched in each group were analyzed by univariate analysis again to evaluate whether the transection of hernia sac had an impact on postoperative seroma.

Results

The results of univariate analysis of 233 patients with postoperative seroma showed that: ASA-3 p = 0.031, classification-L3 p < 0.001, surgery-TEP p < 0.001, transect group p = 0.005. The results of multivariate analysis show that: ASA-3 p < 0.001, classification-L3 p < 0.001, surgery-TEP p < 0.001, transect group p = 0.020. The results of univariate analysis after propensity score matching showed that transection of the hernia sac is significant for postoperative seroma (p < 0.001).

Conclusion

Transection of the hernia sac during laparoscopic indirect inguinal hernia repair can significantly lead to postoperative seroma.
Perceptions of the academic learning environment among occupational therapy students – changes across a three-year undergraduate study program
Authors: Stigen Linda , Mørk Gry , Carstensen Tove , Magne Trine A. , Gramstad Astrid , Johnson Susanne G. , Småstuen Milada C. , Bonsaksen Tore
Published: April 2022

Introduction

Although the learning environment influences students’ motivation, learning outcomes, and satisfaction with the study program, less is known about how these factors change as the students’ progress through the study program.

Aim

The aim of this study was to examine changes in occupational therapy students’ perceptions of the academic learning environment during their three-year study program and to examine factors associated with the students’ perceptions of the learning environment.

Materials and methods

A longitudinal cohort study was conducted throughout the three-year study program. Data were collected annually using the Course Experience Questionnaire (CEQ). In total, 263 students from six occupational therapy programs participated in at least one data gathering point. The number of participants was 186 in the first year, 168 in the second year and 200 in the third year. Of the 263 students who participated in the study, 87 participated in only one point of data collection, 58 at two points and 118 at all three points of the data collection. Data were analyzed with linear mixed models.

Results

The results showed statistically significant temporal changes on the “Emphasis on independence”, “Good teaching” and “Generic skills” scales. There was a significant decrease in scores from the first to the second year of study and the scores remained at this level in the third study year on both the “Emphasis on independence” and “Good teaching” scales. In addition, associations were found between study effort and educational institution related to the “Appropriate workload” scale, as well as between age and the “Generic skills” scale.

Conclusion

The temporal changes of the students’ perceptions of the “Emphasis on independence” as well as “Good teaching” scales are noteworthy. Both scales indicated a significant decrease in scores, indicating that the students perceived that they were less independent from first to second and third year, as well as a perceived decline in the quality of teaching from first to second and third year. The results of this study are central when planning to facilitate learning, especially related to independence and perceptions of good teaching for students in occupational therapy programs.
The implementation of scribing within a medical school’s pre-clinical curriculum: pilot study
Authors: Palomares Vanessa , Patel Arpan , Wagner Ellen , McCarthy Elisa , Adams William , Fitz Matthew
Published: April 2022

Background

Medical students matriculating from their preclinical curriculum into clinical clerkships face a significant learning curve when using an electronic medical record (EMR) system for clinical documentation. With the trend toward reduction in preclinical medical education, students now have fewer opportunities to optimize their note-writing and overall clinical skills before transitioning to patient-care settings.

Methods

This study sought to investigate how a structured medical scribing program in an outpatient clinic helps bridge the gap between traditional preclinical and clinical curricula in medical education. A small cohort of medical students were trained in medical scribing within our institutions’ existing preclinical preceptorship program. We surveyed students, preceptors, and patients during the project to better understand confidence around documentation, the EMR, and the impact of the scribing program on workflow efficiency and patient satisfaction.

Results

There was no significant difference between the scribe and non- scribe students in their confidence documenting a patient encounter or navigating EMR (all p > .05). Our study demonstrated that preceptors for scribe students reported a significant decrease in documentation time compared to non-scribes (Mdiff = − 5.75, p = .02), with no negative impact on patient satisfaction.

Conclusions

Medical scribing can be a tool to further develop medical trainees in clinical documentation and help prepare them for the responsibilities during clinical years. When summing the per encounter time savings over the course of a half or full clinic day, scribing can return a significant amount of time back to preceptors. The time saved by the preceptor needs to be further investigated to determine if the time can lend itself towards better patient care, student-specific feedback, focused teaching, or even mentoring.
A pragmatic approach for implementation of value-based healthcare in Amsterdam UMC, the Netherlands
Authors: Heijsters Florence A. C. J. , van Breda Fenna G. F. , van Nassau Femke , van der Steen Marije K. J. , ter Wee Piet M. , Mullender Margriet G. , de Bruijne Martine C.
Published: April 2022

Background

The emphasis on implementation of value-based healthcare (VBHC) has increased in the Dutch healthcare system. Yet, the translation of the theoretical principles of VBHC towards actual implementation in daily practice has been rarely described. Our aim is to present a pragmatic step-by-step approach for VBHC implementation, developed and applied in Amsterdam UMC, to share our key elements. The approach may inspire others and can be used as a template for implementing VBHC principles in other hospitals.

Methods

The local approach is developed in a major academic hospital in the Netherlands, based at two locations with 15,000 employees in total. Experience-based co-design is used, building on our learning experiences from implementing VBHC for 14 specific patient groups. The described steps and activities devolved from iterative and participative co-design sessions with various experienced stakeholders involved in the implementation of one or more VBHC pathways.

Results

The approach includes five phases; preparation, design (team introduction, outcome selection, action agenda), building (outcome set integration in daily practice), implementation (training, outcome registration and implementation) and the continuous improvement cycle. We described two cases for illustration of the approach; the Cleft Lip and Palate and the Chronic Kidney Disease patient groups. For a good start, involvement of a clinical leader as driving force, ensuring participation of patient representatives and sufficient resources are needed.

Conclusion

We have experienced that several defining features of the development and implementation of this approach may have contributed to its completeness and applicability. Key elements for success have been organisational readiness and clinical leadership. In conclusion, the approach has provided a first step towards VBHC in our hospital. Further research is needed for evaluation of its effectiveness including impact on value for patients.
Total care expenditures and their drivers among older adults: A study on health and long-term care expenditures in South Korea
Authors: Lee Hyo Young , Chin Young-Ran
Published: April 2022

Background

South Korea operates two different national insurance systems: health care insurance covers medical services and long-term care (LTC) insurance covers residential care and home care services. Total care expenditures include benefits from both these insurance schemes and personal payments made for receiving these services. This study aims to identify total care expenditures per older person along with related factors and their effects on care expenditures.

Methods

We analyzed claims data of 2017 for LTC and health care insurance in Korea using multiple regression analysis. Participants were recipients of LTC insurance, aged 60 years or above (n = 650,059). The variables of interest included socioeconomic characteristics, disabilities, chronic diseases, and care needs levels.

Results

The total expenditures were approximately USD 9,808,922,016 for 650,059 older people (USD 15,089.28 ± 8,006.57 per person) in 2017. The benefits of national health insurance accounted for 86.03% of the total, while personal payments accounted for 13.97%. Comparing the expenditure across services, the total amount was found to be much higher for LTC services. The personal payments were similar for the two insurance schemes, and the proportion of expenses by service type (to total expenses) was greater for LTC (LTC versus health care expenditures: 63.25% versus 36.15% of the total expenditures). The total care expenditures differed significantly according to recipient characteristics. Older adults who were women, between 75–84 years old, with higher care needs levels, and who suffered from diseases and lived in the residential facilities were associated with an increase in total expenditures. Moreover, factors such as any type of disability and living alone were related to a decrease in total care expenditures.

Conclusions

The increase in care expenditures should be monitored from an integrated perspective on overall health care and LTC, and to reduce care needs. In addition, we should focus on the factors involved in using (receiving) services for older individuals and complementing the lack of or inadequate services to enhance and sustain the LTC and health care service systems. Older adults receiving full basic livelihood security and living alone should receive greater attention from the perspective of social equity.
Quantitative phenotyping and evaluation for lettuce leaves of multiple semantic components
Authors: Du Jianjun , Li Bo , Lu Xianju , Yang Xiaozeng , Guo Xinyu , Zhao Chunjiang
Published: April 2022

Background

Classification and phenotype identification of lettuce leaves urgently require fine quantification of their multi-semantic traits. Different components of lettuce leaves undertake specific physiological functions and can be quantitatively described and interpreted using their observable properties. In particular, petiole and veins determine mechanical support and material transport performance of leaves, while other components may be closely related to photosynthesis. Currently, lettuce leaf phenotyping does not accurately differentiate leaf components, and there is no comparative evaluation for positive-back of the same lettuce leaf. In addition, a few traits of leaf components can be measured manually, but it is time-consuming, laborious, and inaccurate. Although several studies have been on image-based phenotyping of leaves, there is still a lack of robust methods to extract and validate multi-semantic traits of large-scale lettuce leaves automatically.

Results

In this study, we developed an automated phenotyping pipeline to recognize the components of detached lettuce leaves and calculate multi-semantic traits for phenotype identification. Six semantic segmentation models were constructed to extract leaf components from visible images of lettuce leaves. And then, the leaf normalization technique was used to rotate and scale different leaf sizes to the “size-free” space for consistent leaf phenotyping. A novel lamina-based approach was also utilized to determine the petiole, first-order vein, and second-order veins. The proposed pipeline contributed 30 geometry-, 20 venation-, and 216 color-based traits to characterize each lettuce leaf. Eleven manually measured traits were evaluated and demonstrated high correlations with computation results. Further, positive-back images of leaves were used to verify the accuracy of the proposed method and evaluate the trait differences.

Conclusions

The proposed method lays an effective strategy for quantitative analysis of detached lettuce leaves' fine structure and components. Geometry, color, and vein traits of lettuce leaf and its components can be comprehensively utilized for phenotype identification and breeding of lettuce. This study provides valuable perspectives for developing automated high-throughput phenotyping application of lettuce leaves and the improvement of agronomic traits such as effective photosynthetic area and vein configuration.
The acute phase management of spinal cord injury affecting polytrauma patients: the ASAP study
Authors: Picetti Edoardo , Iaccarino Corrado , Coimbra Raul , Abu-Zidan Fikri , Tebala Giovanni D. , Balogh Zsolt J. , Biffl Walter L. , Coccolini Federico , Gupta Deepak , Maier Ronald V. , Marzi Ingo , Robba Chiara , Sartelli Massimo , Servadei Franco , Stahel Philip F. , Taccone Fabio S. , Unterberg Andreas W. , Antonini Marta Velia , Galante Joseph M. , Ansaloni Luca , Kirkpatrick Andrew W. , Rizoli Sandro , Leppaniemi Ari , Chiara Osvaldo , De Simone Belinda , Chirica Mircea , Shelat Vishal G. , Fraga Gustavo P. , Ceresoli Marco , Cattani Luca , Minardi Francesco , Tan Edward , Wani Imtiaz , Petranca Massimo , Domenichelli Francesco , Cui Yunfeng , Malchiodi Laura , Sani Emanuele , Litvin Andrey , Hecker Andreas , Montanaro Vito , Beka Solomon Gurmu , Di Saverio Salomone , Rossi Sandra , Catena Fausto
Published: April 2022

Background

Few data on the management of acute phase of traumatic spinal cord injury (tSCI) in patients suffering polytrauma are available. As the therapeutic choices in the first hours may have a deep impact on outcome of tSCI patients, we conducted an international survey investigating this topic.

Methods

The survey was composed of 29 items. The main endpoints of the survey were to examine: (1) the hemodynamic and respiratory management, (2) the coagulation management, (3) the timing of magnetic resonance imaging (MRI) and spinal surgery, (4) the use of corticosteroid therapy, (5) the role of intraspinal pressure (ISP)/spinal cord perfusion pressure (SCPP) monitoring and (6) the utilization of therapeutic hypothermia.

Results

There were 171 respondents from 139 centers worldwide. A target mean arterial pressure (MAP) target of 80–90 mmHg was chosen in almost half of the cases [n = 84 (49.1%)]. A temporary reduction in the target MAP, for the time strictly necessary to achieve bleeding control in polytrauma, was accepted by most respondents [n = 100 (58.5%)]. Sixty-one respondents (35.7%) considered acceptable a hemoglobin (Hb) level of 7 g/dl in tSCI polytraumatized patients. An arterial partial pressure of oxygen (PaO2) of 80–100 mmHg [n = 94 (55%)] and an arterial partial pressure of carbon dioxide (PaCO2) of 35–40 mmHg [n = 130 (76%)] were chosen in most cases. A little more than half of respondents considered safe a platelet (PLT) count > 100.000/mm3 [n = 99 (57.9%)] and prothrombin time (PT)/activated partial thromboplastin time (aPTT) < 1.5 times the normal control [n = 85 (49.7%)] in patients needing spinal surgery. MRI [n = 160 (93.6%)] and spinal surgery [n = 158 (92.4%)] should be performed after intracranial, hemodynamic, and respiratory stabilization by most respondents. Corticosteroids [n = 103 (60.2%)], ISP/SCPP monitoring [n = 148 (86.5%)], and therapeutic hypothermia [n = 137 (80%)] were not utilized by most respondents.

Conclusions

Our survey has shown a great worldwide variability in clinical practices for acute phase management of tSCI patients with polytrauma. These findings can be helpful to define future research in order to optimize the care of patients suffering tSCI.
Salbutamol for analgesia in renal colic: study protocol for a prospective, randomised, placebo-controlled phase II trial (SARC)
Authors: Johnson Graham , Tabner Andrew , Fakis Apostolos , Sherman Rachelle , Chester Victoria , Bedford Elizabeth , Jackson Richard , Ratan Hari , Mason Suzanne
Published: April 2022

Background

Renal colic is the pain experienced by a patient when a renal calculus (kidney stone) causes partial or complete obstruction of part of the renal outflow tract. The standard analgesic regimes for renal colic are often ineffective; in some studies, less than half of patients achieve complete pain relief, and a large proportion of patients require rescue analgesia within 4 h. Current analgesic regimes are also associated with significant side effects including nausea, vomiting, drowsiness and respiratory depression. It has been hypothesised that beta adrenoreceptor agonists, such as salbutamol, may reduce the pain of renal colic. They have been shown to impact a number of factors that target the physiological causes of pain in renal colic (ureteric spasm and increased peristalsis, increased pressure at the renal pelvis and prostaglandin release with inflammation). There is biological plausibility and a body of evidence sufficient to suggest that this novel treatment for the pain of renal colic should be taken to a phase II clinical trial. The aim of this trial is to test whether salbutamol is an efficacious analgesic adjunct when added to the standard analgesic regime for patients presenting to the ED with subsequently confirmed renal colic.

Methods

A phase II, randomised, placebo-controlled trial will be performed in an acute NHS Trust in the East Midlands. Patients presenting to the emergency department with pain requiring IV analgesia and working diagnosis of renal colic will be randomised to receive standard analgesia ± a single intravenous injection of Salbutamol. Secondary study objectives will explore the feasibility of conducting a larger, phase III trial.

Discussion

The trial will provide important information about the efficacy of salbutamol as an analgesic adjunct in renal colic. It will also guide the development of a definitive phase III trial to test the cost and clinical effectiveness of salbutamol as an analgesic adjunct in renal colic. Salbutamol benefits from widespread use across the health service for multiple indications, extensive staff familiarity and a good side effect profile; therefore, its potential use for pain relief may have significant benefits for patient care.

Trial registration

ISRCTN Registry ISRCTN14552440. Registered on 22 July 2019
HLA-DRB1 haplotypes predict cardiovascular mortality in inflammatory polyarthritis independent of CRP and anti-CCP status
Authors: Sharma Seema , Plant Darren , Bowes John , Macgregor Alex , Verstappen Suzanne , Barton Anne , Viatte Sebastien
Published: April 2022

Background

Haplotypes defined by amino acids at HLA-DRB1 positions 11, 71 and 74 associated with susceptibility to rheumatoid arthritis (RA) are associated with radiological outcome, anti-TNF response and all cause-mortality in RA. RA is associated with cardiovascular (CV) morbidity and mortality, but the increased prevalence of risk factors of CV disease in RA only partially explains this association. The aim of this study was to investigate whether amino acids at positions 11, 71 and 74 of HLA-DRB1 are associated with cardiovascular (CV) mortality in inflammatory polyarthritis (IP).

Methods

The Norfolk Arthritis Register (NOAR) is an incidence register of IP: recruitment 1990–2007, final follow-up 2011. Two thousand five hundred fourteen patients had available genetic and mortality data. Amino acids at positions 11, 71 and 74 of HLA-DRB1 were determined. Univariate Cox proportional hazard models were applied to assess the association of genetic markers and both all-cause mortality and cardiovascular mortality.

Results

Among 2514 participants, 643 (25.6%) died during the study, and 343 (53.3%) of these deaths were attributed to CV causes. One thousand six hundred fifty (65.6%) participants were female, 709 (32.3%) were anti-CCP-positive and the median age of participants was 54.

HLA-DRB1 haplotypes associated with susceptibility to rheumatoid arthritis (RA) consistently show the same magnitude and direction of association for overall and CV mortality in IP. For example, the SEA-haplotype, associated with the lowest susceptibility to RA, and the best radiographic outcome, was found to be associated with decreased CV mortality (HR 0.67, 95% CI 0.47, 0.91, p=0.023). Mediation analysis revealed associations were independent of anti-CCP status.

Conclusions

HLA-DRB1 haplotypes associated with susceptibility to RA also predispose to increased risk of CV mortality in IP, independent of known CV risk factors. Associations were independent of anti-CCP status, which suggests in the future, genetic factors will add to the prediction of risk of cardiovascular mortality beyond serological markers.
Enterotoxigenic Bacteroides fragilis activates IL-8 expression through Stat3 in colorectal cancer cells
Authors: Purcell Rachel V. , Permain Jessica , Keenan Jacqueline I.
Published: April 2022

Background

Enterotoxigenic Bacteroides fragilis (ETBF) has been implicated in colorectal carcinogenesis through the actions of its toxin, B. fragilis toxin (BFT). Studies on colorectal cell lines have shown that treatment with BFT causes disruption of E-cadherin leading to increased expression of the pro-inflammatory cytokine, IL-8. Stat3 activation has also been associated with ETBF-related colitis and tumour development. However, a link between E-cadherin, IL-8 and Stat3 has not been investigated in the context of ETBF infection.

Results

We found that co-culture of HT-29 and HCT116 colorectal cell lines with ETBF, had a similar effect on activation of IL8 gene and protein expression as treatment with purified BFT. Inhibition of Stat3 resulted in a decrease in IL-8 gene and protein expression in response to ETBF in both cell lines. A reduction in E-cadherin expression in response to ETBF treatment was not restored by blocking Stat3.

Conclusion

We found that treatment of colorectal cancer cell lines with live cultures of ETBF had the equivalent effect on IL-8 expression as the use of purified toxin, and this may be a more representative model of ETBF-mediated colorectal carcinogenesis. IL-8 gene and protein expression was mediated through Stat3 in HT-29 and HCT116 cells, whereas disruption of E-cadherin appeared to be independent of Stat3 signalling.
Meary angle for the prediction of mitral valve prolapse risk in non-syndromic patients with pes planus, a cross-sectional study
Authors: AbdelMassih Antoine , Hozaien Rafeef , Mishriky Fady , Michael Mark , AmanAllah Mostafa , Ali Nada , ElGamal Nadine , Medhat Omar , Kamel Mona , Helmy Rasha , Sarhan Mai , Attalla Hams , Dawoud Omneya , Marwan Athar , Ghobashy Mohamed
Published: April 2022

Objectives

Mitral Valve Prolapse (MVP) is a common valvular abnormality accounting for 2% of the population. There is a reported association between pes planus (PP) and MVP in some syndromes such as Marfan. However, this association has not been tested in non-syndromic cases. The primary outcome of this study is to measure the prevalence of MVP in a population of patients with PP. The secondary outcome parameter is to determine if the Meary angle (MA), a measure of the severity of flat foot, can be effectively used in the prediction of the presence of MVP. Forty-one patients with PP were screened using a lateral x-ray foot to determine MA while echocardiography was utilized to identify the presence and grade of MVP.

Results

88% of screened patients were diagnosed with MVP. MA was correlated with the grade of MVP and showed high diagnostic accuracy (sensitivity 100% and specificity 90%) in predicting MVP risk when higher than 5. Children with PP are at a higher risk for MVP than the general population. Accordingly, the utilization of MA in such a specific population for the determination of patients at a higher need for echocardiography seems to be a worthwhile strategy in diagnosing MVP.
Green synthesis and characterization of iron-oxide nanoparticles using Moringa oleifera: a potential protocol for use in low and middle income countries
Authors: Kiwumulo Henry Fenekansi , Muwonge Haruna , Ibingira Charles , Lubwama Michael , Kirabira John Baptist , Ssekitoleko Robert Tamale
Published: April 2022

Objective

Green synthesized iron(III) oxide (Fe3O4) nanoparticles are gaining appeal in targeted drug delivery systems because of their low cost, fast processing and nontoxicity. However, there is no known research work undertaken in the production of green synthesized nano-particles from the Ugandan grown Moringa Oleifera (MO). This study aims at exploring and developing an optimized protocol aimed at producing such nanoparticles from the Ugandan grown Moringa.

Results

While reducing ferric chloride solution with Moringa oleifera leaves, Iron oxide nanoparticles (Fe3O4-NPs) were synthesized through an economical and completely green biosynthetic method. The structural properties of these Fe3O4-NPs were investigated by Ultra Violet–visible (UV–Vis) spectrophotometry, X-ray diffraction (XRD), energy dispersive X-ray spectroscopy (EDX) and scanning electron microscopy (SEM). These nanoparticles exhibited UV–visible absorption peaks at 225 nm (nm) for the sixth dilution and 228 nm for the fifth dilution which indicated that the nanoparticles were photosensitive and the SEM study confirmed the spherical nature of these nanoparticles. The total synthesis time was approximately 5 h after drying the moringa leaves, and the average particle size was approximately 16 nm. Such synthesized nanoparticles can potentially be useful for drug delivery, especially in Low and Middle Income Countries (LMICs).
The association of body composition with abdominal aortic aneurysm growth after endovascular aneurysm repair
Authors: Hu Ge , Ding Ning , Wang Zhiwei , Jin Zhengyu
Published: April 2022

Background

Body composition (BC) may be associated with abdominal aortic aneurysm (AAA) growth, but the results of previous research are contradictory. This study aimed to explore the relationship between BC and postoperative aneurysm progression.

Methods

Patients with regular postoperative follow-ups were retrospectively identified. The volume change of the aneurysm was measured to evaluate AAA progression. After segmenting different body components (subcutaneous fat, visceral fat, pure muscle, and intramuscular fat), the shape features and gray features of these tissues were extracted. Uni- and multivariable methods were used to analyze the relationship between imaging features of BC and AAA growth.

Results

A total of 94 patients (68 ± 8 years) were eligible for feature analyses. Patients with expansive aneurysms (29/94; volume change > 2%) were classified into Group(+) and others with stable or shrunken aneurysms (65/94) were classified into Group(−). Compared with Group(+), Group(−) showed a higher volume percent of pure muscle (21.85% vs 19.51%; p = .042) and a lower value of intramuscular fat (1.23% vs 1.65%; p = .025). CT attenuation of muscle tissues of Group(−) got a higher mean value (31.16 HU vs 23.92 HU; p = .019) and a lower standard deviation (36.12 vs 38.82; p = .006) than Group(+). For adipose tissue, we found no evidence of a difference between the two groups. The logistic regression model containing muscle imaging features showed better discriminative accuracy than traditional factors (84% vs 73%).

Conclusions

Muscle imaging features are associated with the volume change of postoperative aneurysms and can make an early prediction. Adipose tissue is not specifically related to AAA growth.
Transperineal ultrasound-guided prostate biopsy: what the radiologist needs to know
Authors: Power Jack , Murphy Mark , Hutchinson Barry , Murphy Daragh , McNicholas Michelle , O’Malley Kiaran , Murray John , Cronin Carmel
Published: April 2022

Transperineal ultrasound-guided (TP) prostate biopsy has been shown to significantly decrease the risk of post-procedural sepsis when compared to transrectal ultrasound-guided (TRUS) prostate biopsy. With guidance from the European Urology Association favouring adoption of a TP biopsy route, it is clear that, despite being a more technically challenging procedure, TP biopsy in an outpatient setting will replace TRUS biopsy. This paper gives the reader a succinct summary of outpatient transperineal prostate biopsy under local anaesthetic utilising a free-hand ultrasound technique. Patient preparation and consent process is outlined. A comprehensive pictorial review of the procedure, pitfalls and common post-procedural outcomes is presented. This paper provides a framework and guide for those wishing to adopt the transperineal approach under local anaesthetic.