bluuebunny/crossref_metadata_2025 huggingface dataset:
Table S1 from Targeting fatty acid reprogramming suppresses CARM1-expressing ovarian cancer
Authors: Lombardi Simona , Goldman Aaron R , Tang Hsin-Yao , Kossenkov Andrew V , Liu Heng , Zhou Wei , Herlyn Meenhard , Lin Jianhuang , Zhang Rugang
Published: May 2023

Reverse Phase Protein Assay (RPPA) analysis in control and CARM1 knockout A1847 cells.
Figure S5 from Targeting fatty acid reprogramming suppresses CARM1-expressing ovarian cancer
Authors: Lombardi Simona , Goldman Aaron R , Tang Hsin-Yao , Kossenkov Andrew V , Liu Heng , Zhou Wei , Herlyn Meenhard , Lin Jianhuang , Zhang Rugang
Published: May 2023

SCD1 inhibition suppresses CARM1-expressing ovarian cancer in vivo.
Figure S3 from Targeting fatty acid reprogramming suppresses CARM1-expressing ovarian cancer
Authors: Lombardi Simona , Goldman Aaron R , Tang Hsin-Yao , Kossenkov Andrew V , Liu Heng , Zhou Wei , Herlyn Meenhard , Lin Jianhuang , Zhang Rugang
Published: May 2023

CARM1 reprograms lipid metabolism.
Figure S1 from Targeting fatty acid reprogramming suppresses CARM1-expressing ovarian cancer
Authors: Lombardi Simona , Goldman Aaron R , Tang Hsin-Yao , Kossenkov Andrew V , Liu Heng , Zhou Wei , Herlyn Meenhard , Lin Jianhuang , Zhang Rugang
Published: May 2023

CARM1 regulates genes involved in fatty acid synthesis pathway.
Supplementary Figure S5 from Desmoplastic reaction associates with prognosis and adjuvant chemotherapy response in colorectal cancer: a multicenter retrospective study
Authors: Hu Qingru , Wang Yiting , Yao Su , Mao Yun , Liu Liu , Li Zhenhui , Chen Yonghe , Zhang Shenyan , Li Qian , Zhao Yingnan , Fan Xinjuan , Cui Yanfen , Zhao Ke , Liu Zaiyi
Published: May 2023

Prognostic significance of DR categorization in different subgroups of CRC patients
Supplementary Figure S4 from Desmoplastic reaction associates with prognosis and adjuvant chemotherapy response in colorectal cancer: a multicenter retrospective study
Authors: Hu Qingru , Wang Yiting , Yao Su , Mao Yun , Liu Liu , Li Zhenhui , Chen Yonghe , Zhang Shenyan , Li Qian , Zhao Yingnan , Fan Xinjuan , Cui Yanfen , Zhao Ke , Liu Zaiyi
Published: May 2023

Prognostic significance of DR categorization in each TNM stages of CRC patients
Supplementary Figure S2 from Desmoplastic reaction associates with prognosis and adjuvant chemotherapy response in colorectal cancer: a multicenter retrospective study
Authors: Hu Qingru , Wang Yiting , Yao Su , Mao Yun , Liu Liu , Li Zhenhui , Chen Yonghe , Zhang Shenyan , Li Qian , Zhao Yingnan , Fan Xinjuan , Cui Yanfen , Zhao Ke , Liu Zaiyi
Published: May 2023

Histological features of the desmoplastic reaction
Data from Desmoplastic reaction associates with prognosis and adjuvant chemotherapy response in colorectal cancer: a multicenter retrospective study
Authors: Hu Qingru , Wang Yiting , Yao Su , Mao Yun , Liu Liu , Li Zhenhui , Chen Yonghe , Zhang Shenyan , Li Qian , Zhao Yingnan , Fan Xinjuan , Cui Yanfen , Zhao Ke , Liu Zaiyi
Published: May 2023

Abstract
Desmoplastic reaction (DR) is one of many tumor-host interactions and is associated with the overall survival (OS) of patients with colorectal cancer (CRC). However, the clinical significance of DR requires further study in large multicenter cohorts and its predictive value in adjuvant chemotherapy (ACT) response remains unclear. Here, a total of 2225 CRC patients from five independent institutions were divided into primary (N=1012 from two centers) and validation (N=1213 from three centers) cohorts. DR were classified as immature, middle, or mature depending on the presence of myxoid stroma and hyalinized collagen bundles at the invasive front of the primary tumor. OS among different subgroups were compared, and the correlation of DR type with tumor infiltrating lymphocytes (TILs) within stroma, tumor stroma ratio (TSR) and Stroma AReactive Invasion Front Areas (SARIFA) were also analyzed. In the primary cohort, patients with mature DR had the highest 5-year survival rate. These findings were confirmed in validation cohort. Additionally, for stage II CRC, patients classified as non-mature DR would benefit from ACT compared with surgery alone. Furthermore, immature and middle DR were more associated with high TSR, less distribution of TILs within stroma and positive SARIFA compared to mature. Taken together, these data suggest that DR is a robust independent prognostic factor for CRC patients. For stage II CRC patients, non-mature DR could be a potential marker for recognizing high-risk patients who may benefit from ACT.
Data from Targeting Fatty Acid Reprogramming Suppresses CARM1-expressing Ovarian Cancer
Authors: Lombardi Simona , Goldman Aaron R. , Tang Hsin-Yao , Kossenkov Andrew V. , Liu Heng , Zhou Wei , Herlyn Meenhard , Lin Jianhuang , Zhang Rugang
Published: May 2023

The arginine methyltransferase CARM1 exhibits high expression levels in several human cancers, with the trend also observed in ovarian cancer. However, therapeutic approaches targeting tumors that overexpress CARM1 have not been explored. Cancer cells exploit metabolic reprogramming such as fatty acids for their survival. Here we report that CARM1 promotes monounsaturated fatty acid synthesis and fatty acid reprogramming represents a metabolic vulnerability for CARM1-expressing ovarian cancer. CARM1 promotes the expression of genes encoding rate-limiting enzymes of de novo fatty acid metabolism such as acetyl-CoA carboxylase 1 (ACC1) and fatty acid synthase (FASN). In addition, CARM1 upregulates stearoyl-CoA desaturase 1 (SCD1) that produces monounsaturated fatty acid by desaturation. Thus, CARM1 enhances de novo fatty acids synthesis which was subsequently utilized for synthesis of monounsaturated fatty acids. Consequently, inhibition of SCD1 suppresses the growth of ovarian cancer cells in a CARM1 status–dependent manner, which was rescued by the addition of monounsaturated fatty acids. Consistently, CARM1-expressing cells were more tolerant to the addition of saturated fatty acids. Indeed, SCD1 inhibition demonstrated efficacy against ovarian cancer in both orthotopic xenograft and syngeneic mouse models in a CARM1-dependent manner. In summary, our data show that CARM1 reprograms fatty acid metabolism and targeting SCD1 through pharmacological inhibition can serve as a potent therapeutic approach for CARM1-expressing ovarian cancers.
Significance:
CARM1 reprograms fatty acid metabolism transcriptionally to support ovarian cancer growth by producing monounsaturated fatty acids, supporting SCD1 inhibition as a rational strategy for treating CARM1-expressing ovarian cancer.
An annotated checklist of flora of Overa-Aru wildlife sanctuary, Kashmir Himalaya
Authors: ISLAM TAJAMUL , KHUROO ANZAR AHMAD , NAWCHOO IRSHAD A.
Published: May 2023

The Overa-Aru wildlife sanctuary is one of the largest protected areas in terms of area (425 km2) in Kashmir Himalaya. Here, we present an annotated checklist of flora of the sanctuary, which includes 397 taxa (392 species, 1 subspecies, 3 varieties and 1 forma) belonging to 254 genera in 76 families. Asteraceae was the dominant family with 57 species, followed by Rosaceae and Lamiaceae with 28 and 27 species respectively. Likewise, Salix and Veronica were the dominant genera with 7 species each, followed by Artemisia with 6 species. The herbs were dominant (307 species, 77.33%) followed by trees (41, 10.33%). Lifespan wise, perennials were dominant (318 species, 80.1%), followed by annuals (66, 16.62%). The hemicryptophytes were the dominant life forms (224 species, 56.42%), followed by phanerophytes (80, 20.15%). Further, nine species occurring in sanctuary are currently recognized under different IUCN threat categories. The checklist provides the first-ever comprehensive documentation of the flora from this Kashmir Himalayan protected area, supplemented with details on natural life-history traits and up-to-date conservation status. Hopefully, the study will be immensely useful in guiding suitable conservation strategies and management planning of protected areas in the region.
Multi-scale finite element simulation of the thermoforming of a woven fabric glass fiber/polyetherimide thermoplastic composite
Authors: Zhai Hongzhou , Wu Qi , Bai Tengfei , Yoshikawa Nobuhiro , Xiong Ke , Chen Changhao
Published: May 2023

Understanding the thermoforming process for thermoplastic composites is of great importance to ensure the quality of the composite product but is difficult because of the complex material constitutive models and thermo-mechanical coupling in the thermoforming process. In this study, a woven fabric thermoplastic composite consisting of glass fiber and polyetherimide resin was thermoformed under one-sided cooling conditions. After the effective material properties are homogenized with newly developed, two-step asymptotic homogenization methods, and the temperature and pressure boundary conditions are measured experimentally, a 3D composite laminate sandwiched by interfacial layers and metal molds was finite element simulated in the macroscale. The simulated warpage, which was caused by the in-plane residual stresses, was consistent with the experimental results when reasonable tool–part interactions were considered. Subsequently, the temperature, displacement, strain, and stress were comprehensively discussed in terms of their spatial distribution, temporal evolution, and correlations with the others.
An adaptive finite-time control method for antilock braking system with experimental analysis
Authors: He Youguo , Zhou Yu , Liu Xin , Cai Yingfeng , Yuan Chaochun , Tian Liwei
Published: May 2023

The antilock braking system (ABS) is a representative technology to improve the safety of hard braking in automobiles. The slip rate control has been a challenging issue due to the complicated characteristics of tires and the strong nonlinearity of the system. In this paper, a novel adaptive finite-time controller for ABS is developed to improve braking performance. Different from the current control strategies for ABS, the extended finite-time stability theory and state constraint are comprehensively considered in the proposed control strategy. The extended finite-time stability theory is applied to deal with the system uncertainties, by which the convergence of slip rate tracking error is achieved. And the asymmetric tan-type barrier Lyapunov function (BLF) is used to ensure that the wheel slip ratio is within a smaller and more stable area. Finally, according to the simulation and experiment, compared with the existing BLF controller, a faster convergence rate, better robustness and anti-disturbance performance of ABS can be achieved with the proposed strategy.
The therapeutic and prognostic role of cuproptosis-related genes in triple negative breast cancer
Authors: Shi Bingye , Zhang Wei , Wang Tao , Cui Zhenyu
Published: May 2023

Background

This study aimed to observe the potential impact of known cuproptosis-related genes (CRGs) on triple negative breast cancer (TNBC) development, as well as their associated molecular mechanisms, immune infiltration mechanisms and potential therapeutic agents.

Results

Based on the Cox Proportional Hazard Model, 11 CRGs may be especially important in TNBC development and progression (considered as the Key-TNBC-CRGs). The expression of several Key-TNBC-CRGs (e.g., ATP7A, PIK3CA, LIAS, and LIPT) are associated with common mutations. The SCNA variation of 11 Key-TNBC-CRGs are related to differences immune infiltration profiles. In particular, depletion of ATP7A, ATP7B, CLS, LIAS, and SCL31A1 and while high amplification of NLRP3 and LIPT2 are correlated with decreased immune infiltration. In our Cox proportional hazards regression model, there is a significant difference in the overall survival between high-risk and low-risk groups. The HR in the high-risk group is 3.891 versus the low-risk group. And this model has a satisfactory performance in Prediction of 5–15-year survival, in particular in the 10-year survival (AUC = 0.836). Finally, we discovered some potential drugs for TNBC treatment based on the strategy of targeting 11 Key-TNBC-CRGs, such as Dasatinib combined with ABT-737, Erastin or Methotrexate, and Docetaxel/Ispinesib combination.

Conclusion

In conclusion, CRGs may play important roles in TNBC development, and they can impact tumor immune microenvironment and patient survival. The Key-TNBC-CRGs interact mutually and can be influenced by common BC-related mutations. Additionally, we established a 11-gene risk model with a robust performance in prediction of 5–15-year survival. As well, some new drugs are proposed potentially effective in TNBC based on the CRG strategy.
Identification of fusarium head blight resistance markers in a genome-wide association study of CIMMYT spring synthetic hexaploid derived wheat lines
Authors: Serajazari Mitra , Torkamaneh Davoud , Gordon Emily , Lee Elizabeth , Booker Helen , Pauls Karl Peter , Navabi Alireza
Published: May 2023

Fusarium head blight (FHB), caused by Fusarium graminearum, is one of the most destructive wheat diseases worldwide. FHB infection can dramatically reduce grain yield and quality due to mycotoxins contamination. Wheat resistance to FHB is quantitatively inherited and many low-effect quantitative trait loci (QTL) have been mapped in the wheat genome. Synthetic hexaploid wheat (SHW) represents a novel source of FHB resistance derived from Aegilops tauschii and Triticum turgidum that can be transferred into common wheat (T. aestivum). In this study, a panel of 194 spring Synthetic Hexaploid Derived Wheat (SHDW) lines from the International Maize and Wheat Improvement Center (CIMMYT) was evaluated for FHB response under field conditions over three years (2017–2019). A significant phenotypic variation was found for disease incidence, severity, index, number of Fusarium Damaged Kernels (FDKs), and deoxynivalenol (DON) content. Further, 11 accessions displayed < 10 ppm DON in 2017 and 2019. Genotyping of the SHDW panel using a 90 K Single Nucleotide Polymorphism (SNP) chip array revealed 31 K polymorphic SNPs with a minor allele frequency (MAF) > 5%, which were used for a Genome-Wide Association Study (GWAS) of FHB resistance. A total of 52 significant marker-trait associations for FHB resistance were identified. These included 5 for DON content, 13 for the percentage of FDKs, 11 for the FHB index, 3 for disease incidence, and 20 for disease severity. A survey of genes associated with the markers identified 395 candidate genes that may be involved in FHB resistance. Collectively, our results strongly support the view that utilization of synthetic hexaploid wheat in wheat breeding would enhance diversity and introduce new sources of resistance against FHB into the common wheat gene pool. Further, validated SNP markers associated with FHB resistance may facilitate the screening of wheat populations for FHB resistance.
SmartMoms – a web application to raise awareness and provide information on postpartum depression
Authors: Daehn Daria , Martens Claudia , Loew Viola , Kemmler Luisa , Rudolf Sophie , Kochen Eileen , Renneberg Babette , Pawils Silke
Published: May 2023

Background

Postpartum depression is a major public health concern, which is associated with negative consequences for both mothers and children. Unfortunately, many affected women neither understand the warning signs of postpartum depression nor do they know where to seek help. The aim of this study was to evaluate the feasibility of SmartMoms, a German mobile web application (web app) designed to inform women about postpartum depression, support them, and provide an easily accessible self-screening instrument.

Methods

After its development, SmartMoms was distributed through healthcare providers and social media. Feasibility was assessed by examining (1) the experience of postpartum women with the web app, (2) user behaviour, and (3) the experience of healthcare providers with the web app and its distribution. A mixed methods approach was used, including online surveys, usage data, and interviews.

Results

Most women used SmartMoms to prevent postpartum depression and rated the web app as good (on average 4.36 out of 5 stars). The majority of women (62.2%) accessing the self-screening instrument showed a risk for postpartum depression (Edinburgh Postnatal Depression scale score ≥ 12). Most providers (n = 12/13) felt supported through SmartMoms in discussing postpartum depression and considered it a useful offer. Suggestions for improvement were provided.

Conclusions

SmartMoms meets the needs and expectations of mothers and healthcare providers interested in postpartum depression but should be further adapted to include more specific support options and additional information for professionals.
Matrigel-based organoid culture of malignant mesothelioma reproduces cisplatin sensitivity through CTR1
Authors: Ito Fumiya , Kato Katsuhiro , Yanatori Izumi , Maeda Yuki , Murohara Toyoaki , Toyokuni Shinya
Published: May 2023

Organoids are a three-dimensional (3D) culture system that simulate actual organs. Therefore, tumor organoids are expected to predict precise response to chemotherapy in patients. However, to date, few studies have studied the drug responses in organoids of malignant mesothelioma (MM). The poor prognosis of MM emphasizes the importance of establishing a protocol for generating MM-organoid for research and clinical use. Here, we established murine MM organoids from p53+/-or wild-type C57BL/6 strain by intraperitoneal injection either with crocidolite or carbon nanotube. Established MM-organoids proliferated in Matrigel as spheroids. Subcutaneous injection assays revealed that the MM-organoids mimicked actual tissue architecture and maintained the original histological features of the primary MM. RNA sequencing and pathway analyses revealed that the significant expressional differences between the 2D- and 3D-culture systems were observed in receptor tyrosine kinases, including IGF1R and EGFR, glycosylation and cholesterol/steroid metabolism. MM-organoids exhibited a more sensitive response to cisplatin through stable plasma membrane localization of a major cisplatin transporter, copper transporter 1/Slc31A1 (Ctr1) in comparison to 2D-cultures, presumably through glycosylation and lipidation. The Matrigel culture system facilitated the localization of CTR1 on the plasma membrane, which simulated the original MMs and the subcutaneous xenografts. These results suggest that the newly developed protocol for MM-organoids is useful to study strategies to overcome chemotherapy resistance to cisplatin.
Emotional problems mediate the association between attention deficit/hyperactivity disorder and obesity in adolescents
Authors: Li Ke , Chen Liangliang , Wang Kai , Jiang Xiaodong , Ji Yiting , Fang Shuanfeng , Wei Haiyan
Published: May 2023

Background

Attention deficit/hyperactivity disorder (ADHD) has been identified as a risk factor for obesity in both children and adolescents. However, the mechanisms underlying the relationship between ADHD and obesity are still unclear. This study aimed to test a theoretical model of whether anxiety/depression is an intermediary factor in the ADHD-obesity relationship.

Methods

Data were derived from the National Health Interview Survey (NHIS), a principal source of information on the health of the civilian noninstitutionalized population of the United States. A total of 35,108 adolescents aged 12-17 years old from 2010-2015 NHIS and 2016-2018 NHIS representing 46,550,729 individuals in the weighted population, had a parent-reported previous ADHD diagnosis, emotional problems, and height and weight data. Mediation analyses were used to explore whether anxiety/depression is an intermediary factor in the relationship between ever having ADHD and obesity. Mediation analyses were performed using multiple logistic regressions.

Results

The findings showed that ADHD was a predictor of obesity. This relationship was partially mediated by depression(2010-2015: β=0.28, 95%CI:0.13-0.43; 2016-2018: β=0.26, 95%CI:0.03-0.49), as well as anxiety (2010-2015: β=0.28, 95%CI:0.18-0.38).

Conclusions

Our study suggests the hypothetical role of depression and anxiety as underlying mechanisms in the association between ever having ADHD and obesity in adolescents. When treating children with ADHD, clinicians need to be particularly attentive to whether they show emotional problems and use interventions to eliminate anxiety/depression to protect against obesity.
Associations between socioeconomic status, home food availability, parental role-modeling, and children’s fruit and vegetable consumption: a mediation analysis
Authors: Serasinghe Nithya , Vepsäläinen Henna , Lehto Reetta , Abdollahi Anna M. , Erkkola Maijaliisa , Roos Eva , Ray Carola
Published: May 2023

Background

Recent literature has suggested that associations and interactions between family socioeconomic status (SES) and home food environment influence children’s diet, but little is known about the mediation roles of parental role-modeling and food availability in the socioeconomic inequalities of children’s diet. This study aimed to determine the associations between family SES and children’s fruit and vegetable (FV) consumption and to assess the mediation roles of parental role-modeling and food availability in the above associations.

Methods

Cross-sectional data of 574 Finnish children (aged 3 to 6) were analyzed. Parents completed an FFQ assessing their children’s FV consumption frequency and a questionnaire assessing SES and home food environment. Two exposure variables: parental educational level (“low”, “middle”, and “high”) and the relative family income tertiles of the family were used. The frequencies of parental role-modeling of FV and sugary food and drink (SFD) consumption, and the availability of FV and SFD at home were calculated. Single- and multiple-mediator models were created using IBM SPSS 27.0.

Results

The positive association between high parental educational level and children’s FV consumption (direct effect coefficient: 2.76, 95% CI: 0.51–4.86) was partially mediated by more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.89, 95% CI: 0.10–1.76), higher availability of FV (indirect effect coefficient: 1.00, 95% CI: 0.35–1.77), and lower availability of SFD (indirect effect coefficient: -0.30, 95% CI: -0.72 – -0.01). The relative family income was not directly associated with the outcome. However, the higher relative family income level indirectly predicted the Children’s FV consumption (full mediation) through more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.91, 95% CI: 0.06–1.83) and higher availability of FV (indirect effect coefficient: 0.98, 95% CI: 0.40–1.67). Parental role-modeling on SFD consumption did not mediate any of the above associations.

Conclusions

Parental educational level showed more associations with children’s FV consumption than relative family income. Our findings suggest that reducing the availability of SFD is as important as increasing the availability of FV to enhance children’s FV consumption. Future interventions to improve children’s dietary behaviors should pay greater attention to the lower SES segments of society. Longitudinal studies and intervention studies supporting these findings are needed for making meaningful recommendations for health promotion.
A roadmap for using DHIS2 data to track progress in key health indicators in the Global South: experience from sub-saharan Africa
Authors: Farnham Andrea , Loss Georg , Lyatuu Isaac , Cossa Herminio , Kulinkina Alexandra V. , Winkler Mirko S.
Published: May 2023

High quality health data as collected by health management information systems (HMIS) is an important building block of national health systems. District Health Information System 2 (DHIS2) software is an innovation in data management and monitoring for strengthening HMIS that has been widely implemented in low and middle-income countries in the last decade. However, analysts and decision-makers still face significant challenges in fully utilizing the capabilities of DHIS2 data to pursue national and international health agendas. We aimed to (i) identify the most relevant health indicators captured by DHIS2 for tracking progress towards the Sustainable Development goals in sub-Saharan African countries and (ii) present a clear roadmap for improving DHIS2 data quality and consistency, with a special focus on immediately actionable solutions. We identified that key indicators in child and maternal health (e.g. vaccine coverage, maternal deaths) are currently being tracked in the DHIS2 of most countries, while other indicators (e.g. HIV/AIDS) would benefit from streamlining the number of indicators collected and standardizing case definitions. Common data issues included unreliable denominators for calculation of incidence, differences in reporting among health facilities, and programmatic differences in data quality. We proposed solutions for many common data pitfalls at the analysis level, including standardized data cleaning pipelines, k-means clustering to identify high performing health facilities in terms of data quality, and imputation methods. While we focus on immediately actionable solutions for DHIS2 analysts, improvements at the point of data collection are the most rigorous. By investing in improving data quality and monitoring, countries can leverage the current global attention on health data to strengthen HMIS and progress towards national and international health priorities.
Shift handover quality in Saudi critical care units: determinants from nurses’ perspectives
Authors: Abou Hashish Ebtsam Aly , Asiri Atheer Ahmed , Alnajjar Yara Khaled
Published: May 2023

Background

Nurses’ effective handover communication is vital for patient safety and quality of care. Few studies have empirically tested how certain factors influence the quality of handover in the Saudi context.

Methods

A descriptive correlational design was used with a convenience sample of all nurses (N = 201) working in Saudi hospital CCUs in 2022. Demographics and handover quality instruments were used to collect the necessary data in addition to two open-ended questions that asked about perceived barriers and facilitators to handover. The analysis was conducted using descriptive statistics and regression analysis.

Results

The majority of nurses reported good-quality handover. The regression analysis showed that staffing, cognitive capacity, the focus of attention, relationships, and safety climate factors contributed positively to the variance of handover quality. In contrast, intrusions, distractions, anxiety, time stress, and acute and chronic fatigue factors negatively affected the prediction of handover quality (p < 0.05). Nurses added types of shifts and languages as barriers to handover while emphasizing training and the use of standardized tools for handover as facilitators.

Conclusion and recommendations

Nursing handover is a multidimensional phenomenon. By understanding the determinants that contribute to or hinder handover quality, it is possible to develop targeted interventions aimed at improving communication and the quality of shift handover in CCUs. The current study’s findings highlight the need for nurses to work in a more supportive environment, receive better training, and follow a standardized handover protocol. Additionally, nurse managers should pay more attention to nurses’ well-being to control or mitigate the effect of psychological precursors on the quality of nurses’ handover. Future research should investigate handover practices and outcomes on units that have both good and bad practice environments.
The effect of CPAP on the upper airway and ventilatory flow in patients with obstructive sleep apnea
Authors: Van de Perck Eli , Kazemeini Elahe , Van den Bossche Karlien , Willemen Marc , Verbraecken Johan , Vanderveken Olivier M , Op de Beeck Sara
Published: May 2023

Background

Continuous positive airway pressure (CPAP) is the mainstay of treatment for obstructive sleep apnea (OSA). However, data about its effect on the upper airway, especially the epiglottis, are scarce. The aim of this study was to investigate the changes in upper airway dimensions and inspiratory flow in response to incremental pressure levels.

Methods

This is a secondary analysis of a prospective clinical trial in which patients with moderate to severe OSA underwent drug-induced sleep endoscopy with simultaneous recordings of flow and mask pressure. CPAP was titrated in small increments. For each pressure level a representative 3-breath segment was selected to determine specific flow features. The corresponding endoscopic footage was reviewed to assess the degree of upper airway collapse in a semi-quantitative manner.

Results

A total of 214 breath segments were obtained from 13 participants (median [Q1–Q3]; apnea-hypopnea index, 24.9 [20.1–43.9] events/h; body mass index 28.1 [25.1–31.7] kg/m²). CPAP significantly increased cross-sectional dimensions of the soft palate, lateral walls and tongue base, but not of the epiglottis, and induced epiglottis collapse in one subject. Increased pressure improved peak inspiratory flow and median ventilation in all patients, even in the presence of persistent epiglottis collapse.

Conclusion

CPAP does not effectively address epiglottis collapse in patients with OSA. However, it normalizes inspiratory flow regardless of its effect on the epiglottis. This clinical trial was registered on January 18th, 2020 on ClinicalTrials.gov with identifier NCT04232410.
Epstein-Barr virus variation in people living with human immunodeficiency virus in southeastern China
Authors: Wan Zhikai , Chen Ying , Hui Jiangjin , Guo Yongzheng , Peng Xiaorong , Wang Mengyan , Hu Caiqin , Xie Yirui , Su Junwei , Huang Ying , Xu Xiaoke , Xu Yan , Zhu Biao
Published: May 2023

Background

Patients infected with HIV are at high risk of developing Epstein-Barr Virus (EBV)-related diseases. The genotype and viral biological behavior of EBV infection in patients with human immunodeficiency virus-1 (HIV) in China remain unclear. This study analyzed the characteristics of EBV in patients infected with HIV in southeastern China.

Methods

A total of 162 HIV-infected patients and 52 patients without HIV were enrolled in this study. EBV viral load in blood was determined by fluorescence quantitative PCR. EBV typing was performed using saliva according to polymorphisms in the EBNA3C region. EBV LMP-1 carboxy terminus (C-ter) was sequenced, and compared with the epidemic strains in the world.

Results

Among HIV infected patients, the EBV strain variant was mainly EBV-1, while EBV-2 had a higher viral load than EBV-1 (P = 0.001) and EBV-1/2 (P = 0.002). HIV infected patients had higher active virus replication. The EBV LMP-1 variants were mainly the China1 variant. HIV-infected patients had different nucleic acid positions of 30-bp deletion (del30) and had a higher incidence of high 33-bp tandem repeats (rep33) copies than non-HIV-infected patients. There was a difference in the mutations of EBV LMP-1 C-ter del30 and ins15 between HIV infected patients and the control group (P < 0.001).

Conclusion

In southeastern China, EBV in HIV-infected patients had higher active virus replication; EBV infection was mainly EBV-1, and EBV-2 infection has higher EBV virus load; hotspot mutations of LMP-1 C-ter were different between HIV-infected patients and non-HIV-infected patients.

Trial registration: This study was approved by the ethics committee of the First Affiliated Hospital of Zhejiang University School of Medicine (Approval No. 2018764), and registered in Chinese Clinical Trial Registry on 3 June 2019 (ChiCTR, ChiCTR1900023600, http://www.chictr.org.cn/usercenter.aspx).
Neurofilament light chains to assess sepsis-associated encephalopathy: Are we on the track toward clinical implementation?
Authors: Bircak-Kuchtova Barbora , Chung Ha-Yeun , Wickel Jonathan , Ehler Johannes , Geis Christian
Published: May 2023

Sepsis is the most common cause of admission to intensive care units worldwide. Sepsis patients frequently suffer from sepsis-associated encephalopathy (SAE) reflecting acute brain dysfunction. SAE may result in increased mortality, extended length of hospital stay, and long-term cognitive dysfunction. The diagnosis of SAE is based on clinical assessments, but a valid biomarker to identify and confirm SAE and to assess SAE severity is missing. Several blood-based biomarkers indicating neuronal injury have been evaluated in sepsis and their potential role as early diagnosis and prognostic markers has been studied. Among those, the neuroaxonal injury marker neurofilament light chain (NfL) was identified to potentially serve as a prognostic biomarker for SAE and to predict long-term cognitive impairment. In this review, we summarize the current knowledge of biomarkers, especially NfL, in SAE and discuss a possible future clinical application considering existing limitations.
Euthyroidectomy under local versus general anesthesia in health camp settings in Uganda: a protocol for randomized prospective equivalence single-blind controlled trial
Authors: Kabuye Umaru , Fualal Jane Odubu , Lule Herman
Published: May 2023

Background

Endemic goiter is highly prevalent in Uganda at 60.2%, contributing to the high surgical burden. While compelling evidence suggest that in selected cases, thyroidectomy under local anesthesia (LA) is associated with fewer post-operative complications, low costs, and short hospital stays, local anesthesia is not considered a priority technique for thyroidectomy in resource-constrained settings such as Uganda, despite having fewer general anesthesia (GA) and critical care providers. The objective of this trial is to compare euthyroidectomy under local versus general anesthesia among patients with grade 1–2 uncomplicated euthyroid goiter in Uganda.

Methods

This prospective equivalence randomized, single-blind controlled trial protocol will be conducted among eligible participants with grade 1–2 uncomplicated euthyroid goiters. The recruitment processes will start in October 2022 and end in April 2023. Consenting participants with an indication for thyroidectomy will be randomized into two arms of 29 participants in each arm during the Bulamu Health Care Organization surgical camps in Uganda.

Discussion

The primary outcome of this trial protocol is to compare the early post-operative complications of euthyroidectomy done under LA versus GA. The outcome variables include post-operative pain based on visual analogue scale, nausea, vomiting, hematoma formation, and transient voice changes determined at an interval of 6, 12, and 24 h and at 30 days.

In addition, we shall compare the surgical site infection rates, procedure costs, hospital stay, and patients’ level of satisfaction based on a 5-point Likert scale and their willingness to undergo a similar surgery using the same anesthetic technique between the two groups. We hypothesize that euthyroidectomy under LA could potentially offer similar benefits as GA, reduce costs related to procedure, complications, and hospital stay while at the same time mitigating the unmet need for surgery attributable to shortage of general anesthesia providers and critical care facilities in low-income settings.

Trial registration

Pan African Clinical Trial Registry PACTR202208635457430. Registered on 11th August 2022. All items from the WHO trial registration data set are within the protocol. Version number and date: version 3, 15/03/2023.
Cachexia, chorea, and pain in chronic nonbacterial osteitis and inflammatory bowel disease: a case report
Authors: Agharokh Ladan , Mamola Katherine , Yu Andrew G. , Medina Annette L. , Gurram Bhaskar , Fuller Julie , Park Jason Y. , Chen Weina , Rajaram Veena , Hammer Matthew R. , Waugh Jeff L.
Published: May 2023

Background

Inflammatory bowel disease is an inflammatory disorder that primarily impacts the gastrointestinal tract, leading to malnutrition and chronic microscopic intestinal blood loss. Uncontrolled systemic inflammation can impact other parts of the body, known as extraintestinal manifestations. Up to 25% of patients with inflammatory bowel disease are reported to have these complications in their skin, joints, bones, eyes, liver, lung, and pancreas (Rogleret al.in Gastroenterology 161(4):1118–1132, 2021). Neurologic involvement as extraintestinal manifestations are less common, reported at 3–19%, including neuropathies, demyelination, and cerebrovascular events (Morís in World J Gastroenterol. 20(5):1228–1237, 2014).

Case presentation

A 13-year-old Caucasian boy presented with 1 month of progressive lower-extremity pain, weakness, and weight loss. His physical examination was notable for cachexia, lower-extremity weakness, and chorea. Labs revealed normocytic anemia and systemic inflammation. Imaging revealed symmetric abnormal marrow signal in the pelvis and upper femurs. Pathologic examination of the bone revealed chronic inflammation consistent with chronic nonbacterial osteitis. Endoscopy revealed colonic inflammation consistent with inflammatory bowel disease.

Conclusions

Children and adolescents with musculoskeletal pain lasting more than 2 weeks with systemic signs or symptoms like weight loss should prompt evaluation for systemic inflammatory disorders such as chronic nonbacterial osteitis, which can occur in isolation or associated with inflammatory bowel disease. This patient also had a nonspecific neurologic abnormality, chorea, which resolved with treatment of underlying inflammatory disorder. These extraintestinal manifestations may be concurrent with or precede intestinal inflammation, requiring a high index of suspicion when investigating nonspecific systemic inflammation.
Unsupervised active sonar contact classification through anomaly detection
Authors: Stinco Pietro , Tesei Alessandra , LePage Kevin D.
Published: May 2023

Target detection and sonar contact classification with active sonar systems are not trivial especially when operating in coastal and shallow water environments with multipath propagation, high reverberation and clutter. It is even more difficult when the sonar receiver is hosted on unmanned platforms with limited maneuvering capabilities unable to perform long-lasting tracking procedures. In such environments with high clutter density, real-time classification algorithms to discriminate target contacts from clutter contacts become crucial. This paper describes a method for active sonar clutter classification that exploits the large number of undesired contacts to learn the “fingerprint” of the environmental clutter and thus to identify the target contacts as anomalies. The paper introduces the method to obtain the features of detected sonar contacts from the beamformed signal of a triplet array of hydrophones that can be towed by an autonomous underwater vehicle. The paper also shows the performance of the proposed unsupervised classification algorithm with real data collected at sea and compares it to what has been achieved by using a convolutional neural network. The results show the capability of the proposed anomaly detection algorithm to properly deal with a variety of clutter contacts without requiring labeling of training data.
A vanished gastric gastrointestinal stromal tumor
Authors: Honjo Sarah , Yamauchi Suguru , Yoshimoto Yutaro , Jun Chen , Egawa Hiroki , Kubota Akira , Tsuda Kenki , Yube Yukinori , Kaji Sanae , Orita Hajime , Fukunaga Tetsu
Published: May 2023

Background

Local resection is the standard treatment for gastrointestinal stromal tumors (GISTs). Laparoscopic and endoscopic cooperative surgery (LECS) is a minimally invasive surgery used to resect GISTs. Herein, we report an extremely rare case of a gastric GIST that grossly vanished during LECS.

Case presentation

A 50-year-old Japanese female was referred to our hospital after an abnormality was detected during an esophagogastroduodenoscopy (EGD) at her annual health checkup. Based on EGD, endoscopic ultrasound (EUS), and computer tomography (CT) findings, the patient was diagnosed with a 50-mm submucosal tumor (SMT) with intraluminal growth on the anterior wall of the lesser curvature of the upper body of the stomach. We routinely use LECS to treat the intraluminal growth type of GISTs. During the intraoperative endoscopy, the intraluminal submucosal tumor, which was detected preoperatively, had vanished. A red-white scar was observed in the regressed tumor region. LECS was performed by resecting at a distance away from the scar tissue and closing the gastric wall with intracavitary sutures. In the evaluation from the tumor section view of the original resected specimen, a 22 × 14 × 8 mm lobular neoplasm was observed that was predominantly located in the gastric submucosa to the muscularis propia. Pathological findings confirmed the diagnosis of GIST with intermediate risk indicated by the Fletcher classification. The patient continued postoperative adjuvant chemotherapy with imatinib and no recurrence was detected over 12 months after surgery.

Conclusion

LECS was performed on the vanished gastric GIST, providing the best surgical treatment and leading to an accurate diagnosis and optimal postoperative care.
Development of a Machine Learning Model to Identify Colorectal Cancer Stage in Medicare Claims
Authors: Finn Caitlin B. , Sharpe James E. , Tong Jason K. , Kaufman Elinore J. , Wachtel Heather , Aarons Cary B. , Weissman Gary E. , Kelz Rachel R.
Published: May 2023

PURPOSE

Staging information is essential for colorectal cancer research. Medicare claims are an important source of population-level data but currently lack oncologic stage. We aimed to develop a claims-based model to identify stage at diagnosis in patients with colorectal cancer.

METHODS

We included patients age 66 years or older with colorectal cancer in the SEER-Medicare registry. Using patients diagnosed from 2014 to 2016, we developed models (multinomial logistic regression, elastic net regression, and random forest) to classify patients into stage I-II, III, or IV on the basis of demographics, diagnoses, and treatment utilization identified in Medicare claims. Models developed in a training cohort (2014-2016) were applied to a testing cohort (2017), and performance was evaluated using cancer stage listed in the SEER registry as the reference standard.

RESULTS

The cohort of patients with 30,543 colorectal cancer included 14,935 (48.9%) patients with stage I-II, 9,203 (30.1%) with stage III, and 6,405 (21%) with stage IV disease. A claims-based model using elastic net regression had a scaled Brier score (SBS) of 0.45 (95% CI, 0.43 to 0.46). Performance was strongest for classifying stage IV (SBS, 0.62; 95% CI, 0.59 to 0.64; sensitivity, 93%; 95% CI, 91 to 94) followed by stage I-II (SBS, 0.45; 95% CI, 0.44 to 0.47; sensitivity, 86%; 95% CI, 85 to 76) and stage III (SBS, 0.32; 95% CI, 0.30 to 0.33; sensitivity, 62%; 95% CI, 61 to 64).

CONCLUSION

Machine learning models effectively classified colorectal cancer stage using Medicare claims. These models extend the ability of claims-based research to risk-adjust and stratify by stage.
Children's Oncology Group AALL1331: Phase III Trial of Blinatumomab in Children, Adolescents, and Young Adults With Low-Risk B-Cell ALL in First Relapse
Authors: Hogan Laura E. , Brown Patrick A. , Ji Lingyun , Xu Xinxin , Devidas Meenakshi , Bhatla Teena , Borowitz Michael J. , Raetz Elizabeth A. , Carroll Andrew , Heerema Nyla A. , Zugmaier Gerhard , Sharon Elad , Bernhardt Melanie B. , Terezakis Stephanie A. , Gore Lia , Whitlock James A. , Hunger Stephen P. , Loh Mignon L.
Published: May 2023

PURPOSE

Blinatumomab, a bispecific T-cell engager immunotherapy, is efficacious in relapsed/refractory B-cell ALL (B-ALL) and has a favorable toxicity profile. One aim of the Children's Oncology Group AALL1331 study was to compare survival of patients with low-risk (LR) first relapse of B-ALL treated with chemotherapy alone or chemotherapy plus blinatumomab.

PATIENTS AND METHODS

After block 1 reinduction, patients age 1-30 years with LR first relapse of B-ALL were randomly assigned to block 2/block 3/two continuation chemotherapy cycles/maintenance (arm C) or block 2/two cycles of continuation chemotherapy intercalated with three blinatumomab blocks/maintenance (arm D). Patients with CNS leukemia received 18 Gy cranial radiation during maintenance and intensified intrathecal chemotherapy. The primary and secondary end points were disease-free survival (DFS) and overall survival (OS).

RESULTS

The 4-year DFS/OS for the 255 LR patients accrued between December 2014 and September 2019 were 61.2% ± 5.0%/90.4% ± 3.0% for blinatumomab versus 49.5% ± 5.2%/79.6% ± 4.3% for chemotherapy ( P = .089/ P = .11). For bone marrow (BM) ± extramedullary (EM) (BM ± EM; n = 174) relapses, 4-year DFS/OS were 72.7% ± 5.8%/97.1% ± 2.1% for blinatumomab versus 53.7% ± 6.7%/84.8% ± 4.8% for chemotherapy ( P = .015/ P = .020). For isolated EM (IEM; n = 81) relapses, 4-year DFS/OS were 36.6% ± 8.2%/76.5% ± 7.5% for blinatumomab versus 38.8% ± 8.0%/68.8% ± 8.6% for chemotherapy ( P = .62/ P = .53). Blinatumomab was well tolerated and patients had low adverse event rates.

CONCLUSION

For children, adolescents, and young adults with B-ALL in LR first relapse, there was no statistically significant difference in DFS or OS between the blinatumomab and standard chemotherapy arms overall. However, blinatumomab significantly improved DFS and OS for the two thirds of patients with BM ± EM relapse, establishing a new standard of care for this population. By contrast, similar outcomes and poor DFS for both arms were observed in the one third of patients with IEM; new treatment approaches are needed for these patients (ClinicalTrials.gov identifier: NCT02101853 ).
Stop Trying to Make Academia Great Again
Authors: Kilgore Robert
Published: May 2023

Work as a university teacher post(?)-pandemic must be rethought entirely. Creating better futures—or a future at all—does not mean getting back to some happy place, but it does mean faculty must engage institutions and communities courageously, ethically, and collectively. This essay links conversations about teaching in the pandemic to those about gender, race, class, and disability, and to academic labor and faculty fights for better pay and working conditions, shared governance, and academic freedom.
No Delayed Ruptures on Long-Term Follow-Up of a Case Series of Persistently Filling Saccular Internal Carotid Artery Aneurysms After Flow Diversion With the Pipeline Embolization Device
Authors: Lee Ryan P. , Bhimreddy Meghana , Kim Jennifer , Wicks Robert T. , Xu Risheng , Bender Matthew , Yang Wuyang , Sattari Shahab Aldin , Hung Alice , Jackson Christopher M. , Gonzalez L. Fernando , Huang Judy , Tamargo Rafael , McDougall Cameron G. , Caplan Justin M.
Published: May 2023

BACKGROUND AND OBJECTIVES:

Flow diversion of intracranial aneurysms results in high occlusion rates. However, 10% to 20% remain persistently filling at 1 year. Often, these are retreated, but benefits of retreatment are not well established. A better understanding of the long-term rupture risk of persistently filling aneurysms after flow diversion is needed.

METHODS:

Our institutional database of 974 flow diversion cases was queried for persistently filling saccular aneurysms of the clinoidal, ophthalmic, and communicating segments of the internal carotid artery treated with the pipeline embolization device (PED, Medtronic). Persistent filling was defined as continued flow into the aneurysm on 1 year catheter angiogram. The clinical record was queried for retreatments and delayed ruptures. Clinical follow-up was required for at least 2 years.

RESULTS:

Ninety-four persistent aneurysms were identified. The average untreated aneurysm size was 5.6 mm. A branch vessel originated separately in 55% of cases from the body of the aneurysm in 10.6% of cases and from the neck in 34% of cases. Eighteen percent of aneurysms demonstrated >95% filling at 1 year, and 61% were filling 5% to 95% of their original size. The mean follow-up time was 4.9 years, including 41 cases with >5 years. No retreatment was undertaken in 91.5% of aneurysms. There were no cases of delayed subarachnoid hemorrhage.

CONCLUSION:

Among saccular internal carotid artery aneurysms treated with PED that demonstrated persistent aneurysm filling at 1 year, there were no instances of delayed rupture on long-term follow-up. These data suggest that observation may be appropriate for continued aneurysm filling at least in the first several years after PED placement.