bluuebunny/crossref_metadata_2025 huggingface dataset:
Notas territoriales y estadística en el software “R”: entender los distritos electorales en México
Authors: Luna Luis Alberto
Published: August 2021

México se divide en 32 estados que componen la Federación. En los 32 estados están localizados los 300 distritos que constituyen parte del poderLegislativo. En los años 1996 y 2005 se reconfiguró su forma lo que impactó en su estructura. Interesa mostrar que la redistritación no es un asunto de forma sin contenido, puesto que una modificación en la forma del espacio es una modificación en la esencia, es decir, es una acción técnica queimpacta en la estructura de la geografía de acciones sociales y el paisaje de los recursos, por lo tanto, es una acción improductiva que impactavalorizando o desvalorizando el espacio de las acciones productivas. En caso de desconsiderar lo anteriormente señalado, se corre el riesgo de adulterar el espacio, reduciendo sus funciones técnicas de sobrevivir. El análisis se realizó a través de la modelación cartográfica y geoestadística. Se trazó un comparativo de la distritación en ambos años, se generaron análisis de concentración-dispersión espacial, a través de la unión entre cartografía y el Censo de Población y Vivienda 2010; se modelo una matriz de correlación con las variables de residencia; y, se generaron modelos lineales que nos permitieron establecer proyecciones entre los aspectos que determinan, a escala nacional, la votación por cada uno de los tres principales partidos políticos: Partido Acción Nacional (PAN), Partido Revolucionario Institucional (PRI) y Partido de la Revolución Democrática (PRD).
Crônicas amazônicas e trocas indígenas: caminhos para uma arqueologia documental do Médio Solimões nos séculos XVI e XVII
Authors: Lopes Rafael de Almeida
Published: August 2021

O rio Solimões foi um dos principais caminhos por onde passaram os primeiros viajantes europeus que conheceram a Amazônia. Nos séculos XVI e XVII, expedições atravessaram esse rio junto a cronistas que, além das paisagens, descreveram as diversas e distintas populações indígenas que habitavam suas margens. O presente trabalho preliminar discute essas fontes históricas referentes ao médio curso do rio Solimões pela perspectiva pouco aprofundada da arqueologia. Para realizar a discussão serão apresentadas as principais fontes da época, seus contextos de produção e as problemáticas envolvidas em sua análise. Depois, serão abordadas as descrições realizadas sobre os grupos indígenas do Médio Solimões no século XVI e XVII. Então, serão elencadas análises possíveis das crônicas no levantamento de informações contextuais arqueológicas, sobre padrões de assentamento, práticas e produtos, e redes de trocas. Por fim, serão traçadas as potencialidades de uma arqueologia documental no tratamento dessas fontes para a pesquisa arqueológica e para a pesquisa histórica.
Utility of Genetically Predicted Lp(a) (Lipoprotein [a]) and ApoB Levels for Cardiovascular Risk Assessment
Authors: Wu Haoyu , Luan Jian’an , Forgetta Vincenzo , Engert James C. , Thanassoulis George , Mooser Vincent , Wareham Nicholas J. , Langenberg Claudia , Richards J. Brent
Published: August 2021

Background:

Current lipid guidelines suggest measurement of Lp(a) (lipoprotein[a]) and ApoB (apolipoprotein B) for atherosclerotic cardiovascular disease risk assessment. Polygenic risk scores (PRSs) for Lp(a) and ApoB may identify individuals unlikely to have elevated Lp(a) or ApoB and thus reduce such suggested testing.

Methods:

PRSs were developed using least absolute shrinkage and selection operator regression among 273 222 and 356 958 UK Biobank participants of white British ancestry for Lp(a) and ApoB, respectively, and validated in separate sets of 60 771 UK Biobank and 15 050 European Prospective Investigation into Cancer and Nutrition-Norfolk participants. We then assessed the proportion of participants who, based on these PRSs, were unlikely to benefit from Lp(a) or ApoB measurements, according to current lipid guidelines.

Results:

In the UK Biobank and European Prospective Investigation into Cancer and Nutrition-Norfolk cohorts, the area under the receiver operating curve for the PRS-predicted Lp(a) and ApoB to identify individuals with elevated Lp(a) and ApoB was at least 0.91 (95% CI, 0.90–0.92) and 0.74 (95% CI, 0.73–0.75), respectively. The Lp(a) PRS and measured Lp(a) showed comparable association with atherosclerotic cardiovascular disease incidence, whereas the ApoB PRS was in general less predictive of atherosclerotic cardiovascular disease risk than measured ApoB. In the context of the European Society of Cardiology/European Atherosclerosis Society lipid guidelines, at a 95% sensitivity to identify individuals with elevated Lp(a) and ApoB levels, at least 54% of Lp(a) and 24% of ApoB testing could be reduced by prescreening with a PRS while maintaining a low false-negative rate.

Conclusions:

A substantial proportion of suggested testing for elevated Lp(a) and a modest proportion of testing for elevated ApoB could potentially be reduced by prescreening individuals with PRSs.
A new species of Lachesilla in species group pedicularia (Psocodea: ‘Psocoptera’: Lachesillidae) and a new record of L. aethiopica (Enderlein) from India
Authors: RAMESH GURUSAMY , BABU RAJAPPA , SUBRAMANIAN KUMARAPURAM A. , NERI GARCÍA ALDRETE ALFONSO
Published: August 2021

Species of Lachesilla Westwood, in which the males have one clunial apophysis are so far known only in the Neotropics. We here describe a species of Lachesilla in the pedicularia species group from the Southern Western Ghats, India. The males present a short, distally obtusely concave apophysis in the clunium, over the area of the epiproct. Lachesilla aethiopica (Enderlein) known in the Neotropics, the USA and Africa, was collected in Tamil Nadu, India, representing a range extension to Asia.
A Novel Tuberculosis Prediction Model by Extracting Radiological Features Present in Chest X-ray Images Using Modified Discrete Grey Wolf Optimizer Based Segmentation
Authors: Senthil Kumar J. , Balamurugan S. Appavu Alias , Sasikala S.
Published: August 2021

In 2018, an invariant numbers ranging from 10 million people suffered from Tuberculosis (TB) approximately that has remained quite stable in recent years, based on the WHO 2019 survey report. This infection rate differs invariable among countries, from less than 5 to more than 500 new
infections per 1,00,000 people each year, with a global average of around 130. Around 1.2 million HIV negative deaths existed in 2018. If this prevailing disease were diagnosed earlier, the death rate would have been under control, however sophisticated testing techniques tend to be cost prohibitive
of wider acceptance. Some of the most important methods for TB diagnosis include thoracic X-ray image interpretation through image processing by the identification of various structures on thoracic X-rays and anomaly assessment is an important stage in computer-aided diagnosis systems. Chest
form and size may contain indications for serious disorders such as pneumothorax, pneumoconiosis, tuberculosis and emphysema. Substantial work might have contributed to simplify diagnosis through implementing various statistical strategies to medical images, minimizing overtime and dramatically
lowering overhead costs. In addition, recent advances in deep learning have provided magnificent results in the detection of images in different fields, but their use in diagnose TB remains limited. Thus, this work focuses on the development of a novel approach in disease detection. The concepts
presented in this work are placed into practice and linked to current literature. We also proposed an automatic approach in conventional poster anterior chest X-rays for TB identification and diagnosis. We use the chest X-ray image with modified discrete grey wolf optimizer for segmentation
techniques to eradicate abnormal areas and shape abnormality. We extract various features from the X-ray image with a shear let extraction that allows the image to be classified as normal or abnormal, based on a deep learning classifier, via the improved residual VGG net CNN with big data.
Using Shenzhen Hospital Chest X-ray data set we test the efficiency of our system. The suggested technique has competitive results with comparatively shorter training period and greater precision depending on Masientropy based discrete gray wolf optimizer segmentation with an improved residual
VGG net CNN. All the simulations are carried out in a mat lab environment.
Evaluation of Convolutional Neural Network Architecture for Feasibility Analysis on Fetal Abdomen and Brain Images
Authors: Deepika P. , Pabitha P.
Published: August 2021

This research aims to evaluate the possibilities of fetus ultrasound image classification using machine learning algorithms as normal or abnormal. Most of the earlier research works have produced a high percentage of false-negative classification results—recent research work aimed to reduce the rate of false-negative diagnoses. Also, the number of sonologists for analyzing prenatal ultrasound worldwide is very less and solved by developing an efficient algorithm, which reduces the percentage of false negatives in the diagnosis output. Several earlier research works focused on analyzing fetal abdominal image or fetal head images, making the medical industry use two different diagnostic modules separately. This work aims to design and implement a convolution frame-work named as two Convolution Neural Network (tCNN) model for diagnosing any fetal images. The proposed tCNN model diagnoses the fetal abdominal and fetal brain images and classify them as normal or abnormal. CNN1of tCNN performs segmentation and classification based on the acceptance of abdomen circumference and stomach bubble, umbilical vein, and amniotic fluid measurements. CNN2shows based on head circumference and head and abdominal circumference, femur, crown-rump, and humerus lengths measured.With clinical validation, an extensive experiment carried out and the results compared with the experts in terms of segmentation accuracy and the obstetric measurements. This paper provides a foundation for future multi-classification research works on diagnosing fetal intracranial abnormalities and differential diagnosis using machine learning algorithms.
Design of System Level Architecture of Multi-Core with Array Mapping Based on Floating Processing Factor-Fast Fourier Transform for Health Informatics Application
Authors: Sivaprakasam T. , Ramasamy M.
Published: August 2021

In FFT algorithms memory access patterns prevent multiple architectures from achieving high machine use, particularly when parallel processing is needed to achieve the desired efficiency rates. Beginning with the extremely powerful FFT heart, the on-chip memory hierarchy for the multicored
FFT processor, is co-designed and linked on-chip. We have shown that the Floating Processing Factor (FPPE) proposed achieves greater operating rate and lower power for the application of health informatics. This test mechanism aids in omission of faulty cores and autonomous detection also
makes elegant multi-core architecture degradation feasible. Experimental results illustrate that the anticipated design is scalable widely in terms of performance overhead and hardware overhead which makes it appropriate to many-cores with more than a thousand processing cores through Low
Power and High Speed.
Segmentation of Brain MR Image Using Modified Student’s t-Mixture Model
Authors: Huang Qiang , Yu Yinglei , Wen Tian , Zhang Jianwei , Yang Zhangjing , Zhang Fanlong , Zhang Hui
Published: August 2021

In conventional brain image analysis, it is a critical step to segment brain magnetic resonance (MR) image into three major tissues: Gray Matter (GM), White Matter (WM) and Cerebrospinal Fluid (CSF). The main difficulties for segmenting brain MR image are partial volume effect, intensity
inhomogeneity and noise, which result in challenging segmentation task. In this paper, we propose a novel modified method based on the basis of the conventional Student’s t-Mixture Model (SMM), for segmentation of brain MR image and correction of bias field. The advantages of our model
are introduced as follows. First, we take account of the influence on the probabilities of the pixels in the adjacent region and take full advantage of the local spatial information and class information. Second, our modified SMM is derived from the traditional finite mixture model (FMM) by
adding the bias field correction model; the logarithmic likelihood function of traditional FMM is revised. Third, the noise and bias field can be easily extended to combine with the SMM model and EM algorithm. Last but not least, the exponential coefficients are employed to control the results
of segmentation details. As a result, our effective and highly accurate method exhibits high robustness on both simulated and real MR image segmentation, compared to the state-of-the-art algorithms.
Effect of mixing ratio on mechanical properties of mixture of chitin nanofibers and microfibrillated cellulose reinforced PVA hybrid nanocomposites
Authors: Li Yong-Ping , Takagi Hitoshi , Nakagaito Antonio N. , Watanabe Takumi
Published: August 2021

In order to explore the possibility of polyvinyl alcohol (PVA) reinforced by mixture of chitin nanofibers (ChNFs) and microfibrillated cellulose (MFC) instead of a single reinforcing phase, mechanical properties of PVA based hybrid nanocomposites reinforced with combination of ChNFs
and MFC in various mixing ratios were investigated. For comparison, two different experiments were conducted to prepare nanocomposite films by casting technical processing, where ratios of ChNFs to MFC were mixed varying from 1:0, 4:1, 3:2, 1:1, 2:3, 1:4, and 0:1 in both projects, while in
Project 1 the weights of PVA and ChNFs were always kept constant and the weight of PVA only was kept constant in Project 2. The results were as follows: (1) The hybrid ternary nanocomposites acquired the highest Young’s modulus and tensile strength when ratio of ChNFs to MFC was 1:1,
which exhibited higher Young’s modulus and higher tensile strength than PVA/ChNFs composites, but delivered higher Young’s modulus and similar tensile strength comparing to PVA/MFC composites; (2) Aggregations and voids inside nanocomposites were detrimental to mechanical properties
of PVA based hybrid nanocomposites. In some industries such as food packing, PVA based hybrid nanocomposites at mixing ratio 1:1 of ChNFs to MFC are applied presumably with ChNFs partly instead of MFC in the future.
Comparative Analysis of Susceptibility and Severity of COVID-19 in Countries from the Eastern and the Western World Till March ‘21
Authors: Chawla Shashi , Chawla Shubhaa
Published: August 2021

Majority of the world’s human population today is affected by Covid-19. The disease has not only exhibited differences in susceptibility among people of different countries, but also the mortality rate. In general, Western world has been reporting a greater number of infected cases than eastern countries. Even the mortality rates are quite high there. The aim of this study was to analyse the data available on the infectivity and mortality rates of Covid-19 in different countries till March’21 and then reviewed the literature to find reasons for the differences in susceptibility and severity in eastern and western countries. The reasons for the observed differences may be: (i) Eastern countries followed stricter modalities and got grace period to create better healthcare facilities to tackle COVID-19. This probably also slowed the transmission of virus and its evolution, (ii) Vaccination policies in the east may have provided some immunity due to cross reactivity, (iii) Frequent exposure to infections at young age in eastern countries might be helping in better immunity, (iv) Mutations in viral genome may be geography based and (v) Genetic differences in the immune system of the hosts with respect to ACE receptors and MHC may be playing an important role. In this article, an attempt has been made to put forth and discuss these plausible reasons along with suitable evidences. These findings may help in future research on the diagnosis, treatment and prevention of Covid-19.
Altered synthesis of genes associated with short-chain fatty acids in the gut of patients with atrial fibrillation
Authors: Zhang Jing , Zuo Kun , Fang Chen , Yin Xiandong , Liu Xiaoqing , Zhong Jiuchang , Li Kuibao , Li Jing , Xu Li , Yang Xinchun
Published: August 2021

Background

The gut microbiota provides health benefits in humans by producing short-chain fatty acids (SCFAs), whose deficiency causes multiple disorders and inflammatory diseases. However, gut bacteria producing SCFAs in patients with atrial fibrillation (AF), an arrhythmia with increasing prevalence, have not been reported. To investigate major gut microbial organisms related to SCFA synthesis, SCFAs-associated KEGG orthologues (KOs), enzymatic genes, and potential producers were examined according to metagenomic data-mining in a northern Chinese cohort comprising 50 non-AF control and 50 AF patients.

Results

Compared with non-AF controls, individuals with AF had marked differences in microbial genes involved in SCFA-related synthesis, including 125 KOs and 5 SCFAs-related enzymatic genes. Furthermore, there were 10 species that harbored SCFA-synthesis related enzymatic genes, and were markedly decreased in the gut of AF patients. Notably, discriminative features about SCFA-synthesis related function, including 8 KOs (K01752, K01738, K00175, K03737, K01006, K01653, K01647 and K15023), 4 genes (menI, tesB, yciA and CO dehydrogenase acetyl-CoA synthase complex) and 2 species (Coprococcus catus and Firmicutes bacterium CAG:103), were selected as key factors based on LASSO analysis. Furthermore, PLS-SEM analysis showed that 72.8 and 91.14 % of the overall effects on gut microbiota diversity and key species on AF, respectively, were mediated by the key KOs. Meanwhile, 46.31 % of the total effects of SCFA-synthesis related function on left atrial enlargement was mediated by hsCRP. Upon incorporation of clinical properties in AF, the KO score was still significantly associated with AF incidence (OR = 0.004, P = 0.001).

Conclusions

The current study revealed that dysbiotic gut microbiota in AF is coupled with disrupted SCFA-synthesis related genes, characterized by decreased abundances of KEGG orthologues, synthesis enzymatic genes and harboring species.
Investigator initiated trials versus industry sponsored trials - translation of randomized controlled trials into clinical practice (IMPACT)
Authors: Blümle Anette , Wollmann Katharina , Bischoff Karin , Kapp Philipp , Lohner Szimonetta , Nury Edris , Nitschke Kai , Zähringer Jasmin , Rücker Gerta , Schumacher Martin
Published: August 2021

Background

Healthcare decisions are ideally based on clinical trial results, published in study registries, as journal articles or summarized in secondary research articles. In this research project, we investigated the impact of academically and commercially sponsored clinical trials on medical practice by measuring the proportion of trials published and cited by systematic reviews and clinical guidelines.

Methods

We examined 691 multicenter, randomized controlled trials that started in 2005 or later and were completed by the end of 2016. To determine whether sponsorship/funding and place of conduct influence a trial’s impact, we created four sub-cohorts of investigator initiated trials (IITs) and industry sponsored trials (ISTs): 120 IITs and 171 ISTs with German contribution compared to 200 IITs and 200 ISTs without German contribution. We balanced the groups for study phase and place of conduct. German IITs were funded by the German Research Foundation (DFG), the Federal Ministry of Education and Research (BMBF), or by another non-commercial research organization. All other trials were drawn from the German Clinical Trials Register or ClinicalTrials.gov. We investigated, to what extent study characteristics were associated with publication and impact using multivariable logistic regressions.

Results

For 80% of the 691 trials, results were published as result articles in a medical journal and/or study registry, 52% were cited by a systematic review, and 26% reached impact in a clinical guideline. Drug trials and larger trials were associated with a higher probability to be published and to have an impact than non-drug trials and smaller trials. Results of IITs were more often published as a journal article while results of ISTs were more often published in study registries. International ISTs less often gained impact by inclusion in systematic reviews or guidelines than IITs.

Conclusion

An encouraging high proportion of the clinical trials were published, and a considerable proportion gained impact on clinical practice. However, there is still room for improvement. For publishing study results, study registries have become an alternative or complement to journal articles, especially for ISTs. IITs funded by governmental bodies in Germany reached an impact that is comparable to international IITs and ISTs.
Assessing multiple sclerosis-related quality of life among Iranian patients using the MSQOL-54 tool: a cross-sectional study
Authors: Ziaie Shadi , Namazi Niloofar , Afzal Golnaz , Barati Saghar , Mohebbi Rezvaneh , Mir Mahshad , Esmaily Hadi , Mehralian Gholamhossein
Published: August 2021

Background

Multiple sclerosis (MS) is a chronic autoimmune disease and is one of the most costly medical conditions that imposed families with catastrophic health expenditures. There is an increasing trend in using alternative medicines including, dietary supplements, herbs, vitamins, and minerals. To date, the association between dietary as well as herbal supplements and QoL in MS patients is under researched; thus, this study aimed to assess the association between the self-reported supplement used and QoL between MS patients.

Methods

This cross-sectional study was conducted on patients with MS referring to Shahid Kazemi Pharmacy, based in the city of Tehran, Iran, as a national pharmacy providing specialized pharmaceutical products and pharmaceutical care to patients. The Multiple Sclerosis Quality of Life-54 (MSQoL-54) tools was performed to evaluate MS patients QoL.

Results

A total number of 382 patients with MS participated in this study. They include 89 (23.3%) men and 293 (76.7%) women, aged 40 ± 10.9 years old. The overall score of the MSQoL-54 questionnaire was 41.58 out of 100. Physical health composite (PHC) and mental health composite (MHC) were 69.60 and 62.99 from 100, respectively. This study revealed that 76.4% of patients used at least one vitamin daily; 92.4% of patients do not receive any herbal product. Vitamin D is the most widely used supplement, followed by calcium, while vitamin C is the least consumed. No correlation was observed regarding supplement use and overall QoL, PHC, or MHC. There were no significant differences between QoL’s dimensions score in patients who used supplements. The results showed that increasing the number of supplements used did not relate to overall QoL, PHC, or MHC. In addition, there was not any correlation between the duration used of supplements and QoL’s dimensions score in MS patients (p-value> 0.05).

Conclusions

The dietary supplement appears to be popular among MS patients. The study results showed that the number of supplementations and their long-term use in patients with MS were not associated with higher QoL. Similarly, the herbal supplements have failed to improve QoL.
Vascular endothelial growth factor-A is an Immunohistochemical biomarker for the efficacy of bevacizumab-containing chemotherapy for duodenal and jejunal adenocarcinoma
Authors: Amano Takahiro , Iijima Hideki , Shinzaki Shinichiro , Tashiro Taku , Iwatani Shuko , Tani Mizuki , Otake Yuriko , Yoshihara Takeo , Sugimoto Aya , Egawa Satoshi , Yamaguchi Shinjiro , Kinoshita Kazuo , Araki Manabu , Hirao Motohiro , Sakakibara Yuko , Hiyama Satoshi , Ogawa Hiroyuki , Nagaike Koji , Murata Jun , Komori Masato , Okuda Yorihide , Kizu Takashi , Tsujii Yoshiki , Hayashi Yoshito , Inoue Takahiro , Takahashi Hidekazu , Mizushima Tsunekazu , Morii Eiichi , Takehara Tetsuo
Published: August 2021

Background

The efficacy and safety of bevacizumab-containing chemotherapy for patients with metastatic duodenal and jejunal adenocarcinoma (mDJA) are unclear. The present study aimed to evaluate the efficacy of bevacizumab and to explore immunohistochemical markers that can predict the efficacy of bevacizumab for patients with mDJA.

Methods

This multicentre study included patients with histologically confirmed small bowel adenocarcinoma who received palliative chemotherapy from 2008 to 2017 at 15 hospitals. Immunostaining was performed for vascular endothelial growth factor-A (VEGF-A), TP53, Ki67, β-catenin, CD10, MUC2, MUC5AC, MUC6, and mismatch repair proteins.

Results

A total of 74 patients were enrolled, including 65 patients with mDJA and 9 with metastatic ileal adenocarcinoma. Patients with mDJA who received platinum-based chemotherapy with bevacizumab as first-line treatment tended to have a longer progression-free survival and overall survival than those treated without bevacizumab (P = 0.075 and 0.077, respectively). Multivariate analysis extracted high VEGF-A expression as a factor prolonging progression-free survival (hazard ratio: 0.52, 95% confidence interval: 0.30–0.91). In mDJA patients with high VEGF-A expression, those who received platinum-based chemotherapy with bevacizumab as a first-line treatment had significantly longer progression-free survival and tended to have longer overall survival than those treated without bevacizumab (P = 0.025 and P = 0.056, respectively), whereas no differences were observed in mDJA patients with low VEGF-A expression.

Conclusion

Immunohistochemical expression of VEGF-A is a potentially useful biomarker for predicting the efficacy of bevacizumab-containing chemotherapy for patients with mDJA.
Protocol of the Snuggle Bug/Acurrucadito Study: a longitudinal study investigating the influences of sleep-wake patterns and gut microbiome development in infancy on rapid weight gain, an early risk factor for obesity
Authors: Petrov Megan E. , Jiao Nana , Panchanathan Sarada S. , Reifsnider Elizabeth , Coonrod Dean V. , Liu Li , Krajmalnik-Brown Rosa , Gu Haiwei , Davidson Laurie A. , Chapkin Robert S. , Whisner Corrie M.
Published: August 2021

Background

Overweight, obesity, and associated comorbidities are a pressing global issue among children of all ages, particularly among low-income populations. Rapid weight gain (RWG) in the first 6 months of infancy contributes to childhood obesity. Suboptimal sleep-wake patterns and gut microbiota (GM) have also been associated with childhood obesity, but little is known about their influences on early infant RWG. Sleep may alter the GM and infant metabolism, and ultimately impact obesity; however, data on the interaction between sleep-wake patterns and GM development on infant growth are scarce. In this study, we aim to investigate associations of infant sleep-wake patterns and GM development with RWG at 6 months and weight gain at 12 months. We also aim to evaluate whether temporal interactions exist between infant sleep-wake patterns and GM, and if these relations influence RWG.

Methods

The Snuggle Bug/ Acurrucadito study is an observational, longitudinal study investigating whether 24-h, actigraphy-assessed, sleep-wake patterns and GM development are associated with RWG among infants in their first year. Based on the Ecological Model of Growth, we propose a novel conceptual framework to incorporate sleep-wake patterns and the GM as metabolic contributors for RWG in the context of maternal-infant interactions, and familial and socio-physical environments. In total, 192 mother-infant pairs will be recruited, and sleep-wake patterns and GM development assessed at 3 and 8 weeks, and 3, 6, 9, and 12 months postpartum. Covariates including maternal and child characteristics, family and environmental factors, feeding practices and dietary intake of infants and mothers, and stool-derived metabolome and exfoliome data will be assessed. The study will apply machine learning techniques combined with logistic time-varying effect models to capture infant growth and aid in elucidating the dynamic associations between study variables and RWG.

Discussion

Repeated, valid, and objective assessment at clinically and developmentally meaningful intervals will provide robust measures of longitudinal sleep, GM, and growth. Project findings will provide evidence for future interventions to prevent RWG in infancy and subsequent obesity. The work also may spur the development of evidence-based guidelines to address modifiable factors that influence sleep-wake and GM development and prevent childhood obesity.
Neonatal rebound hyperkalemia associated with ritodrine alone: a case report
Authors: Osumi Keita , Suga Kenichi , Suzue Masashi , Nakagawa Ryuji , Kagami Shoji
Published: August 2021

Background

Betamimetics have been used for tocolysis extensively in the past, and one of them, ritodrine is widely used in Japan. Various adverse events have been reported for this agent, including newborn hypoglycemia and hypokalemia, as well as maternal hypokalemia and rebound hyperkalemia; however, cases of neonatal rebound hyperkalemia are not described in the literature.

Case presentation

A male infant born at 36 weeks of gestation by cesarean section at a local maternity clinic suddenly entered cardiopulmonary arrest with ventricular tachycardia and fibrillation due to hyperkalemia (K+, 8.7 mmol/L). No monitoring, examination of blood electrolyte levels, or infusions had been performed prior to this event. Maternal infusion of ritodrine (maximum dose, 170 μg/min) had been performed for 7 weeks prior to cesarean section. After resuscitation combined with calcium gluconate, the infant died at 4 months old due to serious respiratory failure accompanied by acute lung injury following shock. No cause of hyperkalemia other than rebound hyperkalemia associated with ritodrine was identified.

Conclusions

This case report serves as a warning regarding the potential risk of neonatal rebound hyperkalemia in association with maternal long-term ritodrine administration.
Multiple anatomic sites of infarction in a pediatric patient with M. pneumoniae infection, a case report
Authors: Hahn Devon W. , Atkinson Claire E. , Le Matthew
Published: August 2021

Background

Although M. pneumoniae (M. pneumoniae) infections have been associated with various extrapulmonary manifestations, there have been very few documented cases of thrombotic events in pediatrics, and none to our knowledge with such extensive involvement as the patient described here. We aim to contribute to the urgency of discovering the mechanism of the coagulopathy associated with M. pneumoniae infections.

Case presentation

This 10-year-old boy was admitted after 2 weeks of fever, sore throat, worsening cough, and progressive neck and back pain. During hospitalization, he developed clots in several different organs: bilateral pulmonary emboli, cardiac vegetations, multiple splenic infarcts, and deep venous thromboses in three of four extremities. He was treated with long-term antibiotics and anticoagulation, and fully recovered.

Conclusions

This is the first case known to us of a child with an extensive number of thrombotic events in multiple anatomic sites associated with M. pneumoniae infection. The mechanism by which M. pneumoniae infection is related to thrombotic events is not fully understood, but there is evidence that the interplay between the coagulation pathways and the complement cascade may be significant. This patient underwent extensive investigation, and was found to have significant coagulopathy, but minimal complement abnormalities. By better understanding the mechanisms involved in complications of M. pneumoniae infection, the clinician can more effectively investigate the progression of this disease saving time, money, morbidity, and mortality.
“This course is like a compass to us” – a qualitative study on newly settled migrants’ perceptions of civic and health orientation in Sweden
Authors: Al-Adhami Maissa , Hjelm Katarina , Wångdahl Josefin , Larsson Elin C.
Published: August 2021

Background

Migrants face structural, socio-political barriers in their resettlement processes that negatively affect their health. Migration also adversely impacts resources such as social capital and health literacy that are of importance for health and integration into society. Hence, there is a need for health promotion in the early post-migration phase. In Sweden, newly settled refugee migrants who have received a residence permit are offered an Introduction programme including a civic orientation course. The program is intended to facilitate access to the labour market and promote integration. The aim of the study was to explore participants’ perceptions and experiences of a civic orientation course with added health communication.

Methods

We performed six focus group discussions: two in Arabic, two in Farsi and two in Somali. The discussions were facilitated by native speaking moderators. Participants were 32 men and women recruited from civic orientation classes in the county of Stockholm. We used an interview guide with semi-structured questions. The data were analysed using a method for content analysis for focus group discussions.

Results

Three main categories were identified: (1) ‘The course gives valuable information but needs adjustments’, which includes that the civic and health orientation is needed earlier, during the asylum phase, and that planning and course content need adjustments. (2) ‘The health communication inspired participants to focus on their health’, which includes that the health communication was useful and inspired uptake of healthier habits. (3) ‘Participation in the course promoted independence and self-confidence’, which includes that the course gave insights into society and values in Sweden, and promoted independence and new social contacts.

Conclusion

This study adds knowledge about the users’ perspectives on the potential of civic orientation to promote the health and integration of newly settled migrants, describing ways in which civic orientation with added health communication promoted health and empowerment. However, the content and delivery of the course need adjustment to better fit the migrants’ life situations and varying pre-existing knowledge.
Delayed positive COVID19 nasopharyngeal test, a case study with clinical and pathological correlation
Authors: Zhang Lei , Vunnamadala Syam P. , Yagi Shigeo , Meraj Riffat , Carbone Michele
Published: August 2021

Background

There are various reasons for delayed positive nasopharyngeal PCR tests for coronavirus disease 2019 (COVID19) in not only asymptomatic but also severely diseased patients. The pathophysiological attributes are not known. We explore this possibility through a case report.

Case presentation

A 64-year-old male with history of pulmonary fungal infection, asthma and chronic pulmonary obstructive disease (COPD), diabetes, coronary artery disease presented with shortness of breath, fever and chest image of ground opacity, reticular interstitial thickening, highly suspicious for COVID19. However, nasopharyngeal swab tests were discordantly negative for four times in two weeks, and IgG antibody for COVID19 was also negative. However, serum IgE level was elevated. No other pathogens are identified. His symptoms deteriorated despite corticosteroid, antibiotics and bronchodilator treatment. Bronchoalveolar lavage (BAL) and open lung wedge biopsy were performed for etiology diagnosis. They demonstrated COVID19 viral RNA positive fibrosing organizing pneumonia with respiratory tract damage characterized by suspicious viral cytopathic effect, mixed neutrophilic, lymphoplasmacytic, histiocytic and eosinophilic inflammation and fibrosis besides expected asthma and COPD change. One week later, repeated COVID19 nasopharyngeal tests on day 40 and day 49 became positive.

Conclusion

Our case and literature review indicate that allergic asthma and associated high IgE level together with corticosteroid inhalation might contribute to the delayed positive nasopharyngeal swab in upper airway; COPD related chronic airways obstruction and the addition of fibrosis induced ventilator dependence and poor prognosis in COVID19 pneumonia, and should be therapeutically targeted besides antiviral therapy.
Patients’ and professionals’ views related to ethical issues in precision medicine: a mixed research synthesis
Authors: Erdmann Anke , Rehmann-Sutter Christoph , Bozzaro Claudia
Published: August 2021

Background

Precision medicine development is driven by the possibilities of next generation sequencing, information technology and artificial intelligence and thus, raises a number of ethical questions. Empirical studies have investigated such issues from the perspectives of health care professionals, researchers and patients. We synthesize the results from these studies in this review.

Methods

We used a systematic strategy to search, screen and assess the literature for eligibility related to our research question. The initial search for empirical studies in five data bases provided 665 different records and we selected 92 of these publications for inclusion in this review. Data were extracted in a spreadsheet and categorized into different topics representing the views on ethical issues in precision medicine.

Results

Many patients and professionals expect high benefits from precision medicine and have a positive attitude towards it. However, patients and professionals also perceive some risks. Commonly perceived risks include: lack of evidence for accuracy of tests and efficacy of treatments; limited knowledge of patients, which makes informed consent more difficult; possible unavailability of access to precision medicine for underprivileged people and ethnic minorities; misuse of data by insurance companies and employers, potential of racial stigmatization due to genetic information; unwanted communication of incidental findings; changes in doctor-patient-relationship through focusing on data; and the problem that patients could feel under pressure to optimize their health.

Conclusions

National legislation and guidelines already minimize many risks associated with precision medicine. However, from our perspective some problems require more attention. Should hopes for precision medicine’s benefits be fulfilled, then the ethical principle of justice would require an unlimited access to precision medicine for all people. The potential for autonomous patients’ decisions must be greatly enhanced by improvements in patient education. Harm from test results must be avoided in any case by the highest possible data security level and communication guidelines. Changes in the doctor-patient relationship and the impact of precision medicine on the quality of life should be further investigated. Additionally, the cost-effectiveness of precision medicine should be further examined, in order to avoid malinvestment.
The face of hypervirulent Klebsiella pneumoniae isolated from clinical samples of two Iranian teaching hospitals
Authors: Sanikhani Rahimeh , Moeinirad Mohammad , Solgi Hamid , Hadadi Azar , Shahcheraghi Fereshteh , Badmasti Farzad
Published: August 2021

Hypervirulent Klebsiella pneumoniae (hvKp) has emerged as a pathogen of global concern. In this study, both phenotypic and genotypic tests were used to detect hvKp. Antimicrobial resistance profiles and clonal relatedness of clinical isolates were also determined. We found that 34.2% (163/477) of the isolates were tellurite resistant, and among them 102 hvKp isolates detected with iucA or iutA or peg-344 as molecular markers. The blaSHV (80.4%), followed by blaCTX-M-15 (76.5%) and blaTEM (67.6%), blaOXA-48 (53.9%), and blaNDM-1 (32.3%) were detected, while blaKPC-1 was not present in any hvKp isolates. It was found that the majority of hvKp isolates belonged to capsular serotype K20 and ompK36 group C, which is related to clonal group (CG) 23 (e.g. ST23). A high percentage of multidrug-resistant hvKp (76.6%) and high resistance to imipenem (67%) indicated a serious problem that should be addressed in the clinical setting.
Circular RNA circRNF13 inhibits proliferation and metastasis of nasopharyngeal carcinoma via SUMO2
Authors: Mo Yongzhen , Wang Yumin , Zhang Shuai , Xiong Fang , Yan Qijia , Jiang Xianjie , Deng Xiangying , Wang Yian , Fan Chunmei , Tang Le , Zhang Shanshan , Gong Zhaojian , Wang Fuyan , Liao Qianjin , Guo Can , Li Yong , Li Xiaoling , Li Guiyuan , Zeng Zhaoyang , Xiong Wei
Published: August 2021

Background

Circular RNAs (circRNAs) are widely expressed in human cells and are closely associated with cancer development. However, they have rarely been investigated in the context of nasopharyngeal carcinoma (NPC).

Methods

We screened a new circRNA, circRNF13, in NPC cells using next-generation sequencing of mRNA. Reverse transcription polymerase chain reaction and RNA fluorescence in situ hybridization were used to detect circRNF13 expression in 12 non-tumor nasopharyngeal epithelial (NPE) tissues and 36 NPC samples. Cell proliferation was detected using MTT and flow cytometry assays, and colony formation capability was detected using colony formation assays. Cell migration and invasion were analyzed using wound-healing and Transwell assays, respectively. Cell glycolysis was analyzed using the Seahorse glycolytic stress test. Glucose transporter type 1 (GLUT1) ubiquitination and SUMOylation modifications were analyzed using co-immunoprecipitation and western blotting. CircRNF13 and Small Ubiquitin-like Modifier 2 (SUMO2) interactions were analyzed using RNA pull-down and luciferase reporter assays. Finally, to test whether circRNF13 inhibited NPC proliferation and metastasis in vivo, we used a xenograft nude mouse model generated by means of subcutaneous or tail vein injection.

Results

We found that circRNF13 was stably expressed at low levels in NPC clinical tissues and NPC cells. In vitro and in vivo experiments showed that circRNF13 inhibited NPC proliferation and metastasis. Moreover, circRNF13 activated the SUMO2 protein by binding to the 3′- Untranslated Region (3′-UTR) of the SUMO2 gene and prolonging the half-life of SUMO2 mRNA. Upregulation of SUMO2 promotes GLUT1 degradation through SUMOylation and ubiquitination of GLUT1, which regulates the AMPK-mTOR pathway by inhibiting glycolysis, ultimately resulting in the proliferation and metastasis of NPC.

Conclusions

Our results revealed that a novel circRNF13 plays an important role in the development of NPC through the circRNF13-SUMO2-GLUT1 axis. This study implies that circRNF13 mediates glycolysis in NPC by binding to SUMO2 and provides an important theoretical basis for further elucidating the pathogenesis of NPC and targeted therapy.
A mass casualty incident of infectious diseases at the port of Hamburg: an analysis of organizational structures and emergency concepts
Authors: Klein Angelina , Heuser Julian , Henning Esther , Sprössel Nadine , Kordsmeyer Ann-Christin , Oldenburg Marcus , Mojtahedzadeh Natascha , Heidrich Jan , Militzer Kristina Carolin , Belz Lukas , von Münster Thomas , Harth Volker , Ehlers Lena , de Boer Jens , Kleine-Kampmann Scarlett , Boldt Matthias , Dirksen-Fischer Martin , Haralambiev Lyubomir , Gümbel Denis , Ekkernkamp Axel , Bakir M. Sinan
Published: August 2021

Background

The project “ARMIHN” (Adaptive Resiliency Management in Port) focuses on strengthening the capability to act in a mass casualty incident (MCI) due to an outbreak of infectious diseases (MCI-ID). In addition to the current threat from the COVID-19 pandemic and associated outbreaks on cruise ships, previous MCI-ID were especially caused by pathogens such as Influenza virus or Norovirus. The first step was, to get an overview of processes and resources using the example of the Port of Hamburg, and to show the associated interaction of involved parties. This will serve as a basis for developing an operational strategy and offers the opportunity to optimize current work processes.

Methods

A selective literature research using specified key words was performed and existing MCI concepts were received from local authorities. Identified structures and processes were analyzed in a multiple step process and also brought together through discussions in workshops with involved organizations and other experts. Additionally, the distances between the nearest rescue stations and selected hospitals from the Port of Hamburg were analyzed.

Results

The current available concepts are proven, but an adaptation to an MCI-ID shows opportunities for a further cross-organizational development. The organizational structure of an MCI-ID in the Port of Hamburg was described, including a large number of involved organizations (n = 18). There are 17 involved fire and rescue stations and the port can be reached from these locations within 6 to 35 min. Based on their specialist expertise, 14 of the 31 listed clinics were selected.

Conclusion

The purpose of the study was to provide an analysis of the current situation and show how involved parties would cope an MCI. A description of processes and resources at the Port of Hamburg will be used when designing a management plan for responding to an MCI-ID.
CIRP promotes the progression of non-small cell lung cancer through activation of Wnt/β-catenin signaling via CTNNB1
Authors: Liao Yi , Feng Jianguo , Sun Weichao , Wu Chao , Li Jingyao , Jing Tao , Liang Yuteng , Qian Yonghui , Liu Wenlan , Wang Haidong
Published: August 2021

Background

Cold-inducible RNA binding protein (CIRP) is a newly discovered proto-oncogene. In this study, we investigated the role of CIRP in the progression of non-small cell lung cancer (NSCLC) using patient tissue samples, cultured cell lines and animal lung cancer models.

Methods

Tissue arrays, IHC and HE staining, immunoblotting, and qRT-PCR were used to detect the indicated gene expression; plasmid and siRNA transfections as well as viral infection were used to manipulate gene expression; cell proliferation assay, cell cycle analysis, cell migration and invasion analysis, soft agar colony formation assay, tail intravenous injection and subcutaneous inoculation of animal models were performed to study the role of CIRP in NSCLC cells; Gene expression microarray was used to select the underlying pathways; and RNA immunoprecipitation assay, biotin pull-down assay, immunopurification assay, mRNA decay analyses and luciferase reporter assay were performed to elucidate the mechanisms. The log-rank (Mantel-Cox) test, independent sample T-test, nonparametric Mann-Whitney test, Spearman rank test and two-tailed independent sample T-test were used accordingly in our study.

Results

Our data showed that CIRP was highly expressed in NSCLC tissue, and its level was negatively correlated with the prognosis of NSCLC patients. By manipulating CIRP expression in A549, H460, H1299, and H1650 cell lines, we demonstrated that CIRP overexpression promoted the transition of G1/G0 phase to S phase and the formation of an enhanced malignant phenotype of NSCLC, reflected by increased proliferation, enhanced invasion/metastasis and greater tumorigenic capabilities both in vitro and in vivo. Transcriptome sequencing further demonstrated that CIRP acted on the cell cycle, DNA replication and Wnt signaling pathway to exert its pro-oncogenic action. Mechanistically, CIRP directly bound to the 3′- and 5′-UTRs of CTNNB1 mRNA, leading to enhanced stability and translation of CTNNB1 mRNA and promoting IRES-mediated protein synthesis, respectively. Eventually, the increased CTNNB1 protein levels mediated excessive activation of the Wnt/β-catenin signaling pathway and its downstream targets C-myc, COX-2, CCND1, MMP7, VEGFA and CD44.

Conclusion

Our results support CIRP as a candidate oncogene in NSCLC and a potential target for NSCLC therapy.