bluuebunny/crossref_metadata_2025 huggingface dataset:
A visit with Viv: Empathising with a digital human character embodying the lived experiences of dementia
Authors: Papadopoulos Christopher , Kenning Gail , Bennett Jill , Kuchelmeister Volker , Ginnivan Natasha , Neidorf Melissa
Published: March 2021

The Visit, an immersive participatory artwork (viewed on a screen or virtual reality headset), was produced as part of a research programme investigating the subjective experience of dementia and the relational dynamic between people with dementia and others. It invites viewers to engage with a digital human character, ‘Viv’, as she shares her experiences of living with dementia. The experiences that Viv recounts are based on verbatim accounts from in-depth interviews with four women living with dementia. The artwork was designed with the combined aim of generating insights into the lived experience of dementia and establishing conditions under which viewers might cultivate empathy for the character portrayed. Viewers engaging with Viv were invited to complete pre- and post-engagement measures of state empathy alongside an assessment of emotional distance. State empathy was significantly greater after engaging with The Visit, and correspondingly, there was a significant decrease in emotional distance (aversion), suggesting that the aims were met.
To be or not to be human: Resolving the paradox of dehumanisation
Authors: de Ruiter Adrienne
Published: March 2021

Dehumanisation is a puzzling phenomenon. Nazi propaganda likened the Jews to rats, but also portrayed them as ‘poisoners of culture’. In the Soviet Union, the Stalinist regime called opponents vermin, yet put them on show trials. During the Rwandan genocide, the Hutus identified the Tutsis with cockroaches, but nonetheless raped Tutsi women. These examples reveal tensions in the way in which dehumanisers perceive, portray and treat victims. Dehumanisation seems to require that perpetrators both deny and acknowledge the humanity of their victims in certain ways. Several scholars have proposed solutions to this so-called ‘paradox of dehumanisation’ that question the usefulness of dehumanisation as a concept to explain genocidal violence, claim that dehumanisation is characterised by an unstable belief in the non-human essence of the dehumanised, or contend that dehumanisation revolves around a denial of metaphysical human status. The main aim of this article is to present a novel framework for theorising dehumanisation that offers a more straightforward solution to this paradox based on the idea that perpetrators deny their victims’ human standing in a moral sense without necessarily negating their biological human status or human subjectivity. The article illustrates this framework through examples drawn from Primo Levi’s memoirs of Auschwitz.
The Effect of UK Nursing Policy on Higher Education Wound Care Provision and Practice: A Critical Discourse Analysis
Authors: Munro Jane A. , Beck Anna D.
Published: March 2021

In the United Kingdom, significant ongoing inconsistency exists in wound care nursing education provision and practice. Health economists have identified this to be a major cause of the burgeoning economic and personal cost of successfully, and equitably, healing chronic wounds. While numerous wound care educational resources exist, policies intended to implement a program of reform or change are for some reason not filtering down to, or being implemented by, those who need them most. Policy making processes do not appear to be operating as efficiently as they should, and this merits further scrutiny. A critical discourse analysis of two UK professional body wound care policies provided an innovative insight into the effect of policy production to the research problem. The overarching construct of “Aspiration and Resolution” and its subconstructs were identified. Links between data, analysis, and conclusions were established using Greckhamer and Cilesiz’s (2014) framework to address criticisms over lack of transparency in critical discourse analysis methodology. Findings indicate wound care policy makers must adopt an active, not passive, approach to policy making. An active position, compared with the inertia that appears to currently exist, would take into consideration the capacity to implement policy and not merely increase awareness or disseminate. Wound healing policy making agencies need to make decisions on how to disseminate and implement policy. Active policy making would also adopt target audiences’ decisions to implement policy, instigate activities to improve knowledge and skills, facilitate change, and ensure continued use of policy as part of organizational operations.
Development and Validation of Novel Nomograms for Predicting Specific Distant Metastatic Sites and Overall Survival of Patients With Soft Tissue Sarcoma
Authors: Tu QiHao , Hu Chuan , Zhang Hao , Kong Meng , Peng Chen , Song MengXiong , Zhao Chong , Wang YuJue , Ma XueXiao
Published: March 2021

Purpose:

The goal of this study is to construct nomograms to effectively predict the distant metastatic sites and overall survival (OS) of soft tissue sarcoma (STS) patients.

Methods:

STS case data between 2010 and 2015 for retrospective study were gathered from public databases. According to the chi-square and multivariate logistic regression analysis determined independent predictive factors of specific metastatic sites, the nomograms based on these factors were consturced. Subsequently, combined metastatic information a nomogram to predict 1-, 2-, and 3-year OS of STS patients was developed. The performance of models was validated by the area under the curve (AUC), calibration plots, and decision curve analyses (DCA).

Results:

A total of 7001 STS patients were included in this retrospective study, including 4901 cases in the training group and the remaining 2,100 patients in the validation group. Three nomograms were established to predict lung, liver and bone metastasis, and satisfactory results have been obtained by internal and external validation. The AUCs for predicting lung, liver, and bone metastases in the training cohort were 0.796, 0.799, and 0.766, respectively, and in the validation cohort were 0.807, 0.787, and 0.775, respectively, which means that the nomograms have good discrimination. The calibration curves showed that the models have high precision, and the DCA manifested that the nomograms have great clinical application prospects. Through univariate and multivariate COX regression analyses, 8 independent prognosis factors of age, grade, histological type, tumor size, surgery, chemotherapy, radiatiotherapy and lung metastasis were determined. A nomogram was then constructed to predict the 1-, 2-, and 3-years OS, which has a good performance in both internal and external validations.

Conclusion:

The nomograms for predicting specific metastatic sites and OS have good discrimination, accuracy and clinical applicability. The models could accurately predict the metastatic risk and survival information, and help clinical decision-making.
Review of Neuropsychological and Electrophysiological Correlates of Callous-unemotional Traits in Children: Implications for EEG Neurofeedback Intervention
Authors: Paul Priyanjali , Bennett Cathlyn Niranjana
Published: March 2021

Conduct disorder is a significant psychiatric disorder of childhood and adolescence. The Diagnostic and Statistical Manual of Mental Disorders, fifth version (DSM-5), added the limited prosocial specifier to identify those individuals who exhibit a more severe pattern of behavior characterized by a callous and unemotional (CU) interpersonal style across multiple settings and relationships. This review has attempted to summarize the relevant research focusing on the significance of CU interpersonal style in the development of psychopathy. The primary focus was on the electrophysiological and neuropsychological correlates of CU traits and their implication on the treatment protocol using neurofeedback training for children with such traits. The source of the literature search was PubMed, which majorly uses the MEDLINE database. The keywords used included CU traits, conduct disorder, child psychopathy, empathy, electrophysiology, criminal behavior, neuropsychology, neurofeedback training, and so on. Studies from the last 15 years were considered for the review. This review revealed that children with conduct disorder and high-CU traits with a combination of reactive and proactive aggression are more likely to develop psychopathy. Evidence suggests that these children have distinct forms of electrophysiological and neuropsychological correlates. However, research in this area is still not conclusive as they yield variation in findings. Studies on the efficacy of neurofeedback training on reducing symptoms such as impulsivity, hostility, and psychopathy indicate that neurofeedback training can be a promising treatment alternative for children with severe conduct disorder.
Long non-coding RNA PITPNA-AS1 regulates UNC5B expression in papillary thyroid cancer via sponging miR-129-5p
Authors: Mei Shijuan , Zong Huafeng , Zhou Haicheng
Published: March 2021

Background:

Long non-coding RNA (lncRNA) PITPNA antisense RNA 1 (PITPNA-AS1) expression characteristics, function, and mechanism in papillary thyroid cancer are unclear.

Methods:

Quantitative real-time polymerase chain reaction (qRT-PCR) was applied for detecting PITPNA-AS1, UNC-5 netrin receptor B (UNC5B) mRNA, and miR-129-5p expressions in papillary thyroid cancer tissues and cell lines. EdU assay, cell counting kit-8 (CCK-8) assay, wound healing assay, and flow cytometry analysis were performed to investigate the biological functions of PITPNA-AS1 in papillary thyroid cancer. Dual-luciferase reporter assay was utilized for determining whether PITPNA-AS1 and miR-129-5p, as well as UNC5B and miR-129-5p could directly bind to each other. Western blot assay was employed for measuring UNC5B protein expression level in papillary thyroid cancer cell lines.

Results:

PITPNA-AS1 and UNC5B expressions were markedly increased in papillary thyroid cancer tissues and cell lines while miR-129-5p expression was down-regulated. Knockdown of PITPNA-AS1 could significantly inhibit papillary thyroid cancer cell growth and migration and promote cell apoptosis while UNC5B overexpression plasmids or miR-129-5p inhibitors counteracted the knockdown effect of PITPNA-AS1 on papillary thyroid cancer cells. PITPNA-AS1 targeted miR-129-5p to repress its expression and miR-129-5p targeted UNC5B to repress its expression. Silencing PITPNA-AS1 reduced the expression of UNC5B via regulating miR-129-5p expression.

Conclusions:

PITPNA-AS1 facilitated papillary thyroid cancer cell proliferation and migration, and suppressed apoptosis through miR-129-5p/UNC5B axis.
Revision rates of trapeziometacarpal total joint arthroplasty in relation to occupational hand force requirements
Authors: Kirkeby Lone , Frost Poul , Svendsen Susanne W. , Hansen Torben B.
Published: March 2021

The purpose was to determine revision rates after trapeziometacarpal total joint arthroplasty in working age patients, hypothesizing that higher occupational hand force requirements lead to higher revision rates. We conducted a follow-up study of patients operated 2003–2015. Self-reported job titles at the time of primary surgery were linked with a job exposure matrix to estimate occupational hand force requirements. Time until revision was analysed using Cox regression. The study comprised 222 patients aged 39–65 years (mean 55, SD 6), including 133 patients in the labour market. The median follow-up period was 5 years (interquartile range 4–7) and the overall revision rate was 5/100 person-years. For high versus low occupational hand force requirements, the hazard ratio was 1.5 (95% confidence interval 0.5–4.4). For patients outside the labour market, the hazard ratio was 2.3 (0.9–5.6). Our results did not indicate large effects of high occupational hand force requirements on revision rates.

Level of evidence: IV
Novel risk factors and outcomes in inflammatory bowel disease patients with Clostridioides difficile infection
Authors: Voth Elida , Solanky Dipesh , Loftus Edward V. , Pardi Darrell S. , Khanna Sahil
Published: March 2021

Background:

Patients with inflammatory bowel disease (IBD) are at significantly increased risk for Clostridioides difficile infection (CDI) with an increased risk of adverse outcomes including increased in-hospital mortality, IBD treatment failure, re-hospitalization, and high CDI recurrence rates. The existing literature on predictors of these adverse outcomes is limited. We evaluated four potentially modifiable novel risk factors [body mass index (BMI), statin use, opioid use, and antidepressant use] on CDI risk and adverse outcomes in these patients.

Methods:

Using a retrospective design, variables were abstracted from records for patients with IBD and CDI from 2008 to 2013. Statistical analysis comprised descriptive statistics and univariate and multivariate logistic regression analyses.

Results:

There were 137 patients with IBD and CDI included in this study. On multivariate analysis controlling for age, 43% of patients in the overweight BMI category had severe or severe, complicated CDI, compared with 22% of patients in the underweight/normal BMI [odds ratio (OR) 2.85, p = 0.02] and 19% in the obese category (OR 3.95, p = 0.04). Statin use was associated with severe or severe, complicated CDI when controlling for age and BMI (OR 5.66, p = 0.01). There was no association between statin use and IBD exacerbations following CDI. Opioid and antidepressant use were not associated with disease severity or frequency of IBD exacerbations following CDI.

Conclusions:

An overweight BMI and statin use were associated with severe or severe, complicated CDI in IBD patients. Further studies are needed to better understand how these factors impact management of patients with IBD to improve clinical outcomes and potentially reduce the risk of complications from CDI.
Brand Display Magnitudes and Young Children’s Brand Recognition
Authors: Wang Shasha , Japutra Arnold
Published: March 2021

Young children (i.e., younger than 8) have low persuasion knowledge (children’s persuasion knowledge [CPK]) of advertisements, low skepticism about advertising false claims, and a high tendency to recognize advertised brands, so they are seen as a vulnerable group by most of the society. These vulnerability issues can be largely influenced by the display magnitude of brands (i.e., prominently or nonprominently) due to these children’s limited capacity for memory, yet no researchers have studied this influence. An experiment-based study ( N = 233, 4- to 7-year olds) with structured interviews were undertaken to understand the impacts of brand display magnitude. Results show that CPK increases with young children’s recognition of the prominently displayed brand but decreases with their recognition of the nonprominently displayed brand. Skepticism toward the advertising message increases with the participant’s recognition of the prominently displayed brand and has no relationship with their recognition of the nonprominently displayed brand. Academic and managerial implications are discussed.
The Role of Risk Preferences in Responses to Messaging About COVID-19 Vaccine Take-Up
Authors: Trueblood Jennifer S. , Sussman Abigail B. , O’Leary Daniel
Published: March 2021

Development of an effective COVID-19 vaccine is widely considered as one of the best paths to ending the current health crisis. While the ability to distribute a vaccine in the short-term remains uncertain, the availability of a vaccine alone will not be sufficient to stop disease spread. Instead, policy makers will need to overcome the additional hurdle of rapid widespread adoption. In a large-scale nationally representative survey ( N = 34,200), the current work identifies monetary risk preferences as a correlate of take-up of an anticipated COVID-19 vaccine. A complementary experiment ( N = 1,003) leverages this insight to create effective messaging encouraging vaccine take-up. Individual differences in risk preferences moderate responses to messaging that provides benchmarks for vaccine efficacy (by comparing it to the flu vaccine), while messaging that describes pro-social benefits of vaccination (specifically herd immunity) speeds vaccine take-up irrespective of risk preferences. Findings suggest that policy makers should consider risk preferences when targeting vaccine-related communications.
Gaze Parameters in the Analysis of Ambiguous Geometric Shapes
Authors: Krauze Linda , Ceple Ilze , Skilters Jurgis , Delesa–Velina Mara , Pinna Baingio , Krumina Gunta
Published: March 2021

This study explores perceptual organisation and shape perception when viewing a tetragon and an additional element (a dot) that is located at varying positions and distances next to the tetragon. The aim of the study is to determine the factors that can alter the interpretation of object configuration and impact whether the presented tetragon is perceived as a diamond or a square. Methods used in this study are a forced-choice task as a subjective measurement and eye tracking as an objective measurement of perceptual processes. Overall, 31 stimuli were presented to the participants: a tetragon in two different sizes with an additional element (a dot) located inside or outside the object at three different positions at three distances. The results indicate significant changes in shape perception, depending on the location of the additional element. The results are complemented with eye movement analysis indicating that as the distance between the elements increases, there is a higher probability of either of the two shape interpretations and the gaze is less likely to be directed to the area between the stimuli. Furthermore, the subjective perception of shape is codetermined by the shape perception when the tetragon is presented without the additional element.
Complications and surgical results of stone-directed antegrade pyelography compared to the retrograde pyelographic access method in percutaneous nephrolithotomy using ‘bull’s eye’ technique: A randomized clinical trial
Authors: Irani Dariush , Haghpanah Abdolreza , Hosseini Mohammad Mehdi , Malekmakan Leila , Ashraf Mohammad Ali , Raeisi Shahraki Hadi
Published: March 2021

Objectives:

This study aimed to evaluate the differences in outcomes and complications in stone-directed antegrade pyelography using the ‘bull’s eye’ technique in patients with renal stones versus the conventional method of percutaneous nephrolithotomy (PCNL). Although conventional PCNL access using retrograde pyelography is useful, it is time-consuming and may cause postoperative discomfort. Herein, we report our experience in the application of this new technique.

Methods:

Between January 2017 and June 2018, 100 patients participated in this randomized clinical trial. Stone-directed antegrade pyelography using the ‘bull’s eye’ technique under fluoroscopic guidance was used for percutaneous access in the intervention group. The second group, consisting of those who had undergone conventional PCNL using retrograde pyelography and ‘bull’s eye’ technique in the same period, were considered as the controls. Pre- and postoperative laboratory examinations, surgical results and complications were recorded and compared between the two groups.

Results:

A single calyceal puncture in partial staghorn and staghorn stone patients was sufficient in 72.2% of the antegrade group and in 78.9% of the retrograde group ( p=0.69). The double-puncture technique was necessary for 71.9% of renal pelvis stones in the antegrade group and for 9.4% in the retrograde group ( p<0.001). The antegrade approach reduced the mean operative time and analgesic requirement significantly ( p<0.001). No statistically significant difference, however, was found between the two groups regarding stone migration to the ureter, radiation time and postoperative complications.

Conclusions:

The stone-directed antegrade approach using the ‘bull’s eye’ technique is a safe and accurate method in PCNL access in patients with radiopaque and semi-opaque renal stones.
Informal caregivers and persons with dementia’s everyday life coping
Authors: Nordtug Bente , Malmedal Wenche K , Alnes Rigmor Einang , Blindheim Kari , Steinsheim Gunn , Moe Aud
Published: March 2021

This qualitative study explores informal caregivers’ experiences of supporting persons with dementia’s everyday life coping. In the future, there will be fewer health personnel, increased dementia prevalence and limited nursing home availability. Accordingly, close relatives may be compelled to assume greater care responsibilities. Knowledge concerning persons with dementia’s everyday coping from the perspective of informal caregivers remains insufficient, despite these people’s importance for those with dementia. This investigation analyses informal caregivers’ perceived challenges and pleasures in providing care, how home health care affects everyday life coping and the factors that are most important to informal caregivers in supporting care receivers.
Low-dose CT for diagnosing intestinal obstruction and pneumoperitoneum; need for retakes and diagnostic accuracy
Authors: Larsen Nis E , Mikkelsen Eva , Knudsen Anders R , Larsen Lars P
Published: March 2021

Background

One of the main concerns using low-dose (LD) CT for evaluation of patients with suspected intestinal obstruction or pneumoperitoneum is the potential need to make an additional standard-dose (SD) CT scan (retake) due to insufficient diagnostic accuracy of the LD CT.

Purpose

To determine the frequency of retakes and evaluate the diagnostic accuracy of LD CT for the assessment of intestinal obstruction and pneumoperitoneum.

Material and Methods

This retrospective study registered all LD CT scans over a one-year period at Aarhus University Hospital, Denmark in patients with suspected intestinal obstruction or perforation, comprising a total of 643 LD CT scans. A retake was defined as a SD CT scan of the abdomen and pelvis performed with or without intravenous contrast within 72 h after the initial LD CT due to either continued suspicion of intestinal obstruction or perforation or due to unclarified secondary findings. The sensitivity and specificity of LD CT for diagnosing intestinal obstruction and pneumoperitoneum compared to the discharge diagnoses of the scanned patients were determined.

Results

The frequency of retakes was 3%. The overall LD CT sensitivity and specificity for assessment of patients with suspected intestinal obstruction and pneumoperitoneum was 83% and 99%, respectively, but higher in certain subgroups.

Conclusions

LD CT led to few retakes and had a high diagnostic accuracy for diagnosing intestinal obstruction and pneumoperitoneum. Thus, LD CT can be recommended as the examination of choice in patients with suspected intestinal obstruction or perforation in order to reduce radiation dose.
Tripterygium glycoside improves regulatory T cells and attenuates acute organ dysfunction in septic mice
Authors: Zhang Xiaoming , Zhou Xiaojie
Published: March 2021

Sepsis is a fatal infectious disease accompanied by multiple organ failure. Immune dysfunction and inflammatory response play an important role in the progression of the disease. Tripterygium glycoside (TG) has immune suppression and anti-inflammatory effects. Here, we investigated the effects of TG on cecal ligation and puncture (CLP)-induced sepsis. Septic mice model was induced by cecal ligation and puncture(CLP), after administration of TG, specimens are collected at designated time points. Histopathology changes of lung tissues and Kidney tissues were observed under light microscope, magnetic microbeads were used to isolate splenic CD4+CD25+ regulatory T cells (Tregs), and phenotypes were then analyzed by flow cytometry. ELISA method was employed to detect the concentrations of plasma TNF-α, IL-6, and IL-10. Nuclear p-NF-κB and Cytoplasmic IkB-a was detected by western blot. TG administration significantly alleviated lung and kidney inflammatory injury and improved the survival of septic mice. Furthermore, the suppressive function of regulatory T cells was enhanced and plasma expression of IL-10 was increased following TG treatment. The NF-B signaling pathway and secretion of plasma TNF-α and IL-6 was notably inhibited in septic mice treated with TG. TG exerts protective effects through improving regulatory T cells and attenuating pro-inflammatory cytokines in septic mice.
The Abbreviated Mental Test Score; Is There a Need for a Contemporaneous Update?
Authors: Peters Kizzie A. , Howe Thomas J. , Rossiter Daniel , Hutchinson Kirsty J. , Rosell Philip A.
Published: March 2021

Introduction:

Designed in 1972 the Abbreviated Mental Test Score (AMTS) is widely used to assess a cognition on hospital admission. The Nottingham Hip Fracture Score uses this in predicting morbidity/mortality in neck of femur fracture. The consequences of misappropriating cognitive impairment could have lasting implications. Questions about the monarchy or World War One and Two may be inappropriate for today’s diverse society.

Materials and Methods:

100 patients were questioned during routine fracture clinic appointments. Patients were asked: In what year did WWII start? Who is the current monarch? Please state a memorable event in your lifetime that you would not expect another person of the same age to forget. Two-tailed Z-tests were performed between the observed proportions and those from the original AMTS validation study.

Results:

Only 47% (n = 47) were able to correctly answer the year in which WW2 started. A statistically significant difference when compared to the upper and lower limits from the original study (z = -4.191, p < .001.). Significance was not seen in the second question, with 97% (n-97) identifying the monarch correctly. 51% (n = 51) of participants suggested the terrorist attack on the World Trade Centre in New York as an alternative memorable event.

Discussion:

Some hospitals now use the 4 “A”s Test (4-AT) as a screening tool for delirium. Without amendments to the Nottingham Hip Fracture Score, AMTS use is likely to continue in orthogeriatric patients. Over time there will be a need for the AMTS to be reviewed so that it remains a true assessment of cognition. Its limitations regarding language and culture is widely acknowledged and several validated variants have been published in the literaure.

Conclusions:

We highlight a potential future issue with the AMTS and raise considerations for the development of an alternative question to better meet the needs of the orthogeriatric population.
Reevaluating the Alliance–Outcome Relationship in the Early Sessions of Cognitive Behavioral Therapy of Depression
Authors: Whelen Megan L. , Murphy Samuel T. , Strunk Daniel R.
Published: March 2021

The therapeutic alliance has been reliably associated with outcome across psychotherapies. We investigated the alliance–outcome relationship in the early sessions of cognitive behavioral therapy of depression using a model that disaggregates within- and between-persons variance while estimating the reciprocal relation between variables. We used this model in a combined data set from two studies totaling 191 patients. In our primary model, we found evidence for a predictive within-patients relationship between alliance and symptoms such that symptoms predicted regressed change in alliance and alliance predicted regressed change in symptoms. In a more conservative detrended model, these relationships were not significant. Given that (a) most of the variability in alliance scores is between patients, (b) the size of the alliance–outcome relationship is modest, and (c) the alliance–outcome relationship is not robust to detrending, our findings suggest that alliance plays at most a small role in improving patient outcomes in cognitive behavioral therapy of depression.
Physical Distancing and Mental Health During the COVID-19 Pandemic: Factors Associated With Psychological Symptoms and Adherence to Pandemic Mitigation Strategies
Authors: Ebrahimi Omid V. , Hoffart Asle , Johnson Sverre Urnes
Published: March 2021

In this epidemiological investigation, we assessed the prevalence of depression and anxiety symptoms during the COVID-19 pandemic. A total of 10,061 adults participated in the study. Symptoms of depression and anxiety were 2 to 3 times higher compared with prepandemic samples. Participants who predominantly socially distanced themselves revealed substantially higher symptoms than their counterparts. Females, ethnic and sexual-orientation minorities, younger adults, unemployed individuals, and participants with a psychiatric diagnosis reported higher prevalence of psychological symptoms. Worry about prolonged duration of physical-distancing protocols and frustration of autonomy was associated with elevation in symptoms of depression and anxiety. Increased competence to deal with the pandemic crisis was associated with fewer adverse symptoms. Physical exercise, experiencing nature, and distraction with activities were associated with reduced depressive symptoms but not anxiety. The extent of information access about the pandemic was associated with reduced anxiety symptoms. Furthermore, adherence to mitigation protocols was investigated. Younger adults and males reported lowest adherence. Altruistic attitudes, in addition to mandatory as opposed to voluntary adherence, were associated with higher adherence rates. Worrying about the health of significant others was associated with higher adherence rates, whereas worry about duration of pandemic protocols was associated with lower adherence rates.
Assessing the Association Between Nutritional Status, Caries, and Gingivitis in Schoolchildren: A Cross-Sectional Study
Authors: Barbosa Mariane C.F. , Reis Caio L.B. , Lopes Célia M.C.F. , Madalena Isabela R. , Küchler Erika C. , Baratto-Filho Flares , Storrer Carmen L.M. , Lima Daniela C. , Oliveira Daniela S.B.
Published: March 2021

Objective. To evaluate if nutritional status is associated with caries and gingivitis in Brazilian schoolchildren. Material and methods. Children of both genders, age ranging from 8 to 11 years old, were included in this study. Caries was diagnosed using ICDAS (International System for Detection and Assessment of Carious Lesions) and gingivitis was diagnosed using the Community Periodontal Index. The nutritional status of each child was defined by BMI Z-score calculation. Data on oral health behavior and dietary habit were collected through parent’s questionnaires. Parametric analyzes were performed to compare the groups. The established alpha was 5%. Results. The sample consisted of 353 schoolchildren: 16 underweight children, 247 eutrophic children, 64 overweight children, and 26 were obese children. Overweight, Obese and Overweight + Obese children presented less cavitated caries lesion than Eutrophic children ( P < .05). Gingivitis was not associated with nutritional status ( P > .05). Conclusion. Caries was associated with overweight and obesity in Brazilian schoolchildren.
Autophagy is dispensable for the maintenance of hematopoietic stem cells in neonates
Authors: Hashimoto Michihiro , Umemoto Terumasa , Nakamura-Ishizu Ayako , Matsumura Takayoshi , Yokomizo Tomomasa , Sezaki Maiko , Takizawa Hitoshi , Suda Toshio
Published: March 2021

Hematopoietic stem cells (HSCs) undergo self-renewal or differentiation to sustain lifelong hematopoiesis. HSCs are preserved in quiescence with low mitochondrial activity. Recent studies indicate that autophagy contributes to HSC quiescence through suppressing mitochondrial metabolism. However, it remains unclear whether autophagy is involved in the regulation of neonatal HSCs, which proliferate actively. In this study, we clarified the role of autophagy in neonatal HSCs using 2 types of autophagy-related gene 7 (Atg7)-conditional knockout mice: Mx1-Cre inducible system and Vav-Cre system. Atg7-deficient HSCs exhibited excess cell divisions with enhanced mitochondrial metabolism, leading to bone marrow failure at adult stage. However, Atg7 deficiency minimally affected hematopoiesis and metabolic state in HSCs at neonatal stage. In addition, Atg7-deficient neonatal HSCs exhibited long-term reconstructing activity, equivalent to wild-type neonatal HSCs. Taken together, autophagy is dispensable for stem cell function and hematopoietic homeostasis in neonates and provide a novel aspect into the role of autophagy in the HSC regulation.
Unmarried or less-educated patients with mantle cell lymphoma are less likely to undergo a transplant, leading to lower survival
Authors: Glimelius Ingrid , Smedby Karin E. , Albertsson-Lindblad Alexandra , Crowther Michael J. , Eloranta Sandra , Jerkeman Mats , Weibull Caroline E.
Published: March 2021

It is unknown how many mantle cell lymphoma (MCL) patients undergo consolidation with autologous hematopoietic cell transplantation (AHCT), and the reasons governing the decision, are also unknown. The prognostic impact of omitting AHCT is also understudied. We identified all MCL patients diagnosed from 2000 to 2014, aged 18 to 65 years, in the Swedish Lymphoma Register. Odds ratios (ORs) and 95% confidence intervals (CIs) from logistic regression models were used to compare the likelihood of AHCT within 18 months of diagnosis. All-cause mortality was compared between patients treated with/without AHCT using hazard ratios (HRs) and 95% CIs estimated from Cox regression models. Probabilities of being in each of the following states: alive without AHCT, alive with AHCT, dead before AHCT, and dead after AHCT, were estimated over time from an illness-death model. Among 369 patients, 148 (40%) were not treated with AHCT within 18 months. Compared with married patients, never married and divorced patients had lower likelihood of undergoing AHCT, as had patients with lower educational level, and comorbid patients. Receiving AHCT was associated with reduced all-cause mortality (HR = 0.58, 95% CI: 0.40-0.85). Transplantation-related mortality was low (2%). MCL patients not receiving an AHCT had an increased mortality rate, and furthermore, an undue concern about performing an AHCT in certain societal groups was seen. Improvements in supportive functions potentially increasing the likelihood of tolerating an AHCT and introduction of more tolerable treatments for these groups are needed.
Using mitochondrial activity to select for potent human hematopoietic stem cells
Authors: Qiu Jiajing , Gjini Jana , Arif Tasleem , Moore Kateri , Lin Miao , Ghaffari Saghi
Published: March 2021

Hematopoietic cell transplantation is a critical curative approach for many blood disorders. However, obtaining grafts with sufficient numbers of hematopoietic stem cells (HSCs) that maintain long-term engraftment remains challenging; this is due partly to metabolic modulations that restrict the potency of HSCs outside of their native environment. To address this, we focused on mitochondria. We found that human HSCs are heterogeneous in their mitochondrial activity as measured by mitochondrial membrane potential (MMP) even within the highly purified CD34+CD38−CD45RA−CD90+CD49f+ HSC population. We further found that the most potent HSCs exhibit the lowest mitochondrial activity in the population. We showed that the frequency of long-term culture initiating cells in MMP-low is significantly greater than in MMP-high CD34+CD38−CD45RA−CD90+ (CD90+) HSCs. Notably, these 2 populations were distinct in their long-term repopulating capacity when transplanted into immunodeficient mice. The level of chimerism 7 months posttransplantation was >50-fold higher in the blood of MMP-low relative to MMP-high CD90+ HSC recipients. Although more than 90% of both HSC subsets were in G0, MMP-low CD90+ HSCs exhibited delayed cell-cycle priming profile relative to MMP-high HSCs. These functional differences were associated with distinct mitochondrial morphology; MMP-low in contrast to MMP-high HSCs contained fragmented mitochondria. Our findings suggest that the lowest MMP level selects for the most potent, likely dormant, stem cells within the highly purified HSC population. These results identify a new approach for isolating highly potent human HSCs for further clinical applications. They also implicate mitochondria in the intrinsic regulation of human HSC quiescence and potency.
Dissecting pathways to thrombocytopenia in a mouse model of visceral leishmaniasis
Authors: Rani Gulab Fatima , Preham Olivier , Ashwin Helen , Brown Najmeeyah , Hitchcock Ian S. , Kaye Paul M.
Published: March 2021

Visceral leishmaniasis is an important yet neglected parasitic disease caused by infection with Leishmania donovani or L infantum. Disease manifestations include fever, weight loss, hepatosplenomegaly, immune dysregulation, and extensive hematological complications. Thrombocytopenia is a dominant hematological feature seen in both humans and experimental models, but the mechanisms behind this infection-driven thrombocytopenia remain poorly understood. Using a murine model of experimental visceral leishmaniasis (EVL), we demonstrated a progressive decrease in platelets from day 14 after infection, culminating in severe thrombocytopenia by day 28. Plasma thrombopoietin (TPO) levels were reduced in infected mice, at least in part because of the alterations in the liver microenvironment associated with granulomatous inflammation. Bone marrow (BM) megakaryocyte cytoplasmic maturation was significantly reduced. In addition to a production deficit, we identified significant increases in platelet clearance. L donovani–infected splenectomized mice were protected from thrombocytopenia compared with sham operated infected mice and had a greater response to exogenous TPO. Furthermore, infection led to higher levels of platelet opsonization and desialylation, both associated with platelet clearance in spleen and liver, respectively. Critically, these changes could be reversed rapidly by drug treatment to reduce parasite load or by administration of TPO agonists. In summary, our findings demonstrate that the mechanisms underpinning thrombocytopenia in EVL are multifactorial and reversible, with no obvious residual damage to the BM microenvironment.
Familial hemiplegic migraine type 2 due to a novel missense mutation in ATP1A2
Authors: Antonaci Fabio , Ravaglia Sabrina , Grieco Gaetano S. , Gagliardi Stella , Cereda Cristina , Costa Alfredo
Published: March 2021

Background

The mechanisms of genotype-phenotype interaction in Familiar Hemiplegic migraine type 2 (FHM2) are still far from clear. Different ATP1A2 mutations have been described, with a spectrum of phenotypes ranging from mild to severe. No genotype-phenotype correlations have been attempted.

Case presentation

We describe an Italian family with FHM and a missense ATP1A2 variant (L425H) not previously described. The clinical picture was mild in all the affected members.

Conclusions

Co-segregation of the variant with the aura phenotype was complete in this family, suggesting a 100% penetrance. In silico protein prediction softwares indicate that this variant may change the 3D structure of ATPA1A2 at the cytoplasmic loop between the two central transmembrane helices. Milder FHM phenotypes are rarely reported in literature, likely because case reports are biased towards the most severe phenotypes, with milder forms possibly misdiagnosed as sporadic migraine with aura forms (MAs), even with complex auras. Further studies taking into account intra-familiar variability and functional consequences on the channel protein may help clarify genotype-phenotype correlations.
Unveiling the long non-coding RNA profile of porcine reproductive and respiratory syndrome virus-infected porcine alveolar macrophages
Authors: Gao Junxin , Pan Yu , Xu Yunfei , Zhang Wenli , Zhang Lin , Li Xi , Tian Zhijun , Chen Hongyan , Wang Yue
Published: March 2021

Background

Long noncoding RNA (lncRNA) is highly associated with inflammatory response and virus-induced interferon production. By far the majority of studies have focused on the immune-related lncRNAs of mice and humans, but the function of lncRNAs in porcine immune cells are poorly understood. Porcine reproductive and respiratory syndrome virus (PRRSV) impairs local immune responses in the lungs of nursery and growing pigs, whereas the virus triggers the inflammatory responses. Porcine alveolar macrophage (PAM) is the primary target cell of PRRSV, thus PRRSV is used as an in vitro model of inflammation. Here, we profiled lncRNA and mRNA repertories from PRRSV-infected PAMs to explore the underlying mechanism of porcine lncRNAs in regulating host immune responses.

Results

In this study, a total of 350 annotated lncRNAs and 1792 novel lncRNAs in PAMs were identified through RNA-seq analysis. Among them 86 differentially expressed (DE) lncRNAs and 406 DE protein-coding mRNAs were identified upon PRRSV incubation. GO category and KEGG pathway enrichment analyses revealed that these DE lncRNAs and mRNAs were mainly involved in inflammation- and pathogen infection-induced pathways. The results of dynamic correlated expression networks between lncRNAs and their predicted target genes uncovered that numerous lncRNAs, such as XLOC-022175, XLOC-019295, and XLOC-017089, were correlated with innate immune genes. Further analysis validated that these three lncRNAs were positively correlated with their predicted target genes including CXCL2, IFI6, and CD163. This study suggests that porcine lncRNAs affect immune responses against PRRSV infection through regulating their target genes in PAMs.

Conclusion

This study provides both transcriptomic and epigenetic status of porcine macrophages. In response to PRRSV infection, comprehensive DE lncRNAs and mRNAs were profiled from PAMs. Co-expression analysis demonstrated that lncRNAs are emerging as the important modulators of immune gene activities through their critical influence upon PRRSV infection in porcine macrophages.
Supraventricular arrhythmia, N-terminal pro-brain natriuretic peptide and troponin T concentration in relation to incidence of atrial fibrillation: a prospective cohort study
Authors: Xiao Jun , Persson Anders P. , Engström Gunnar , Johnson Linda S. B.
Published: March 2021

Background

Frequent supraventricular arrhythmia is associated with increased incidence of atrial fibrillation. However, it is unknown whether the prognostic significance of supraventricular arrhythmia is modified by plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) or troponin T (TnT). This study examined the interrelationships between NT-proBNP, TnT levels and frequent supraventricular arrhythmia, and whether these biomarkers and a measure of frequent supraventricular arrhythmia could improve risk assessment for incidence of AF.

Methods

Supraventricular extrasystoles (SVEs) and supraventricular tachycardias were assessed from 24-h electrocardiograph recordings in 373 individuals initially without AF. Elevated NT-pro-BNP, TnT and SVEs was defined as a measurement in the top quartile of the study population distribution. Incident cases of AF were retrieved by linkage with the Swedish National Patient Register.

Results

During a mean follow-up of 15.4 years, 88 subjects had a diagnosis of AF. After multivariable adjustment, individuals with both elevated NT-proBNP and frequent SVEs had a significantly increased incidence of AF, compared to subjects without elevated NT-proBNP or frequent SVEs (hazard ratio (HR) 4.61, 95% confidence interval (CI) 2.45–8.69), and compared to individuals with either elevated NT-proBNP or frequent SVEs (both P < 0.05). HRs for frequent SVEs alone or elevated NT-proBNP alone were 2.32 (95% CI 1.33–4.06) and 1.52 (95% CI 0.76–3.05), respectively. The addition of NT-pro-BNP and SVEs to a validated risk prediction score for AF, CHARGE-AF, resulted in improved prediction (Harrell’s C 0.751 (95% CI 0.702–0.799) vs 0.720 (95% CI 0.669–0.771), P = 0.015).

Conclusion

Subjects with both elevated NT-proBNP and frequent SVEs have substantially increased risk of AF, and the use of these variables could improve long-term prediction of incident AF.
Clinical factors associated with bloodstream infection at the emergency department
Authors: Phungoen Pariwat , Lerdprawat Nunchalit , Sawanyawisuth Kittisak , Chotmongkol Verajit , Ienghong Kamonwon , Sumritrin Sumana , Apiratwarakul Korakot
Published: March 2021

Background

Bloodstream infection (BSI) is a common urgent condition at the emergency department (ED). However, current guidelines for diagnosis do not specify the juncture at which blood cultures should be taken. The decision whether or not to obtain hemoculture is based solely upon clinical judgment and potential outcomes of inappropriately ordered cultures. This study aimed to find clinical factors present on ED arrival that are predictive of bloodstream infection.

Methods

This study was conducted retrospectively at the ED of a single tertiary care hospital in Thailand. We included adult patients with suspected infection based on blood culture who were treated with intravenous antibiotics during their ED visit. Independent positive predictors for positive blood culture were calculated by logistic regression analysis.

Results

A total of 169,578 patients visited the ED during the study period, 12,556 (7.40%) of whom were suspected of infection. Of those, 8177 met the study criteria and were categorized according to blood culture results (741 positive; 9.06%). Six clinical factors, including age over 55 years, moderate to severe CKD, solid organ tumor, liver disease, history of chills, and body temperature of over 38.3 °C, were associated with positive blood culture.

Conclusions

Clinical factors at ED arrival can be used as predictors of bloodstream infection.
Morning fatigue and structured exercise interact to affect non-exercise physical activity of fit and healthy older adults
Authors: Vetrovsky Tomas , Omcirk Dan , Malecek Jan , Stastny Petr , Steffl Michal , Tufano James J.
Published: March 2021

Background

Exercise training is crucial for maintaining physical and mental health in aging populations. However, as people participate in structured exercise training, they tend to behaviorally compensate by decreasing their non-exercise physical activity, thus potentially blunting the benefits of the training program. Furthermore, physical activity of older adults is substantially influenced by physical feelings such as fatigue. Nevertheless, how older people react to day-to-day fluctuations of fatigue and whether fatigue plays a role in non-exercise physical activity compensation is not known. Thus, the purpose of this study was twofold: (1) To explore whether the volume and intensity of habitual physical activity in older adults were affected by morning fatigue. (2) To investigate the effect of attending power and resistance exercise sessions on the levels of non-exercise physical activity later that day and the following day.

Methods

Twenty-eight older adults wore an accelerometer during a 4-week low-volume, low-intensity resistance and power training program with three exercise sessions per week and for 3 weeks preceding and 1 week following the program. During the same period, the participants were prompted every morning, using text messages, to rate their momentary fatigue on a scale from 0 to 10.

Results

Greater morning fatigue was associated with lower volume (p = 0.002) and intensity (p = 0.017) of daily physical activity. Specifically, one point greater on the fatigue scale was associated with 3.2 min (SE 1.0) less moderate-to-vigorous physical activity. Furthermore, attending an exercise session was associated with less moderate-to-vigorous physical activity later that day by 3.7 min (SE 1.9, p = 0.049) compared to days without an exercise session. During the next day, the volume of physical activity was greater, but only in participants with a body mass index up to 23 (p = 0.008).

Conclusions

Following low-volume exercise sessions, fit and healthy older adults decreased their non-exercise physical activity later that day, but this compensation did not carry over into the next day. As momentary morning fatigue negatively affects daily physical activity, we suggest that the state level of fatigue should be monitored during intensive exercise programs, especially in less fit older adults with increased fatigability.