bluuebunny/crossref_metadata_2025 huggingface dataset:
“I’ll Be Right Behind You”: Native American Families, Land Debt, and College Affordability
Authors: Tachine Amanda R. , Cabrera Nolan L.
Published: July 2021

Family connections are critical for Native student persistence, yet families’ voices are absent in research. Using an Indigenous-specific version of educational debt, land debt, we center familial perspectives by exploring the financial struggles among Native families as their students transition to a Predominately White Institution. Findings indicate that Indigenous families experienced fear and frustration surrounding college affordability and the financial aid process. Regardless, these Native families made extreme sacrifices in paying for college. These findings were contextualized within the economic conditions created by land theft from Indigenous peoples. Returning to land debt, we argue that institutions need to begin from a perspective of what is owed to Native peoples in their policy decisions. That is, such decisions should take account of the benefits historically accrued by institutions residing on forcibly taken Indigenous land, and then examine how that debt can be repaid by supporting Native students, families, and communities.
Land as an Intermittent Commodity: Ethnographic Insights from India’s Urban–Agrarian Frontiers
Authors: Majumder Sarasij , Gururani Shubhra
Published: July 2021

Drawing on their respective ethnographies of urbanisation in Gurgaon (now known as Gurugram) and thwarted industrialisation in Singur, the authors argue that plots of land owned by smallholders are intermittent commodities. Following Igor Kopytoff’s lead, they focus on commoditisation as a process and adopt a biographical approach to consider the social life of land. The article contends that individually owned plots potentially go in and out of circulation but never get fully commodified, nor do they remain fully non-commodified. With the rising speculative value of land, neither market price nor monetary compensation fully substitutes land ownership. Hence, the landholders express regret and even resentment on having to part with their land. The ambivalence speaks, in part, to the complex attributes of land and the relations of authority, distinction and status associated with it. To maintain their caste-based status, the landowners use land as leverage. They hold on to land or demand better compensation to reiterate the land–caste–power nexus spatially.
Is it time for PET-guided therapy in follicular lymphoma?
Authors: Trotman Judith , Pettitt Andrew R.
Published: July 2021

18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) is now established as the gold-standard imaging modality for both staging and response assessment in follicular lymphoma (FL). In this Perspective, we propose where PET can, and cannot, guide clinicians in their therapeutic approach. PET at diagnosis and pretreatment is important for staging, with greater sensitivity compared with standard CT, and consequent improved outcomes in truly limited-stage FL. Small data sets suggesting that a high baseline standardized uptake value (SUVmax) identifies de novo histologic transformation (HT) have not been corroborated by data from GALLIUM, the largest prospective study to examine modern therapies for FL. Nonetheless, the role of baseline quantitative PET measures requires further clarification. The median survival of patients with newly diagnosed FL is now potentially >20 years. Treatment of symptomatic FL aims to achieve remission and optimize quality of life for as long as possible, with many patients achieving a “functional cure” at the cost of unwanted treatment effects. Several studies have identified end-of-induction (EOI) PET after initial chemoimmunotherapy in patients with a high tumor burden as strongly predictive of both progression-free and overall survival, and EOI PET is being evaluated as a platform for response-adapted treatment. Unmet needs remain: improving the inferior survival for patients remaining PET positive and quantifying the progression-free survival and time to next treatment advantage, and additional toxicity of anti-CD20 maintenance in patients who achieve complete metabolic remission. In the absence of an overall survival advantage for frontline antibody maintenance, the question of using PET to guide the therapeutic approach is more important than ever in the context of the COVID-19 pandemic.
Management of asthma exacerbations in the paediatric population: a systematic review
Authors: Manti Sara , Licari Amelia , Leonardi Salvatore , Marseglia Gian Luigi
Published: July 2021

Background

Asthma exacerbations in children is one of the most common medical conditions requiring urgent visits to primary healthcare providers or emergency departments, and even hospitalisations. Currently, there is significant variation in the management of asthma exacerbations expressed in guideline recommendationsversusclinical practice. This disconnect affects diagnostic and treatment decisions for the clinician and patient.

Objective

We systematically reviewed the available guidelines providing recommendations for diagnostic and therapeutic management of asthma exacerbations in the paediatric population.

Methods

A systematic review of the literature for guidelines published between January 2009 and October 2019 was conducted, using a protocol registered with the international prospective register of systematic reviews (PROSPERO CRD42020221562).

Results

16 asthma exacerbation clinical practice guidelines for children were included. Despite general agreement between guidelines on the definition of asthma exacerbation, there was great variability in the definition of disease severity and assessment of asthma control. This systematic review also highlighted a paucity of recommendations for criteria for hospitalisation and discharge. Many guidelines scored poorly when measured for stakeholder involvement and editorial independence.

Conclusion

Comprehensive and updated guidelines compliant with international standards for clinical guidelines may significantly improve clinical practice quality, promote evidence-based recommendations and provide uniformity of treatment between countries.
Morphometric analysis and redox state of the testicles in nandrolone decanoate and swimming treated adult male rats
Authors: Sretenovic Jasmina , Joksimovic Jovic Jovana , Srejovic Ivan , Zivkovic Vladimir , Mihajlovic Katarina , Labudovic-Borovic Milica , Trifunovic Svetlana , Milosevic Verica , Lazic Dejan , Bolevich Sergey , Jakovljevic Vladimir , Milosavljevic Zoran
Published: July 2021

Background

During the last decades, the abuse of anabolic androgenic steroids (AASs) has become popular among professional and recreational athletes. The abuse of AASs leads to decreased levels of sex hormones, but the available literature a gives very small pool of data regarding the effects of swimming alone or combined with AASs on testicle tissue. The aim of this study was to investigate the effects of four-week administration of nandrolone decanoate and swimming training alone or in combination on morphometric parameters, androgen receptor (AR) and redox state in testicle tissue. The study included Wistar albino male rats, 10 weeks old, classified into 4 groups: control (T-N-), nandrolone (T-N+), swimming training (T+N-) and swimming training with nandrolone (T+N+). The rats from nandrolone (N+) groups received nandrolone decanoate 20 mg/kg b.w.once per week. The rats from training (T+) groups, swam 1 h/day 5 days/week. The isolated testicles were measured, left testicles were routinely processed for histological analysis, while right testicles were homogenized and prepared for the analysis of the following oxidative stress biomarkers: index of lipid peroxidation (TBARS), nitrites, catalase, superoxide dismutase (SOD), and reduced glutathione (GSH).

Results

Diameter, as well as cross-section area of seminiferous tubules were decreased by 10 % and 21 % (respectively) in the T-N+ group and by 15% and 41 % (respectively) in the T+N+ group compared to control. Interstitium of the testicles was decreased in all experimental groups. Reduction of immunoreactivity of AR in T-N+ group was 22 %, in T+N+ group was 9 % compared to control. TBARS levels were increased in T+N- and T+N+ groups. Nitrites were decreased in T+N+ group. Catalase activity was increased in all experimental groups. Swimming alone or combined with nandrolone decreased the level of GSH compared to control. SOD activity was decreased in T-N+ and T+N+ groups compared to control.

Conclusions

Nandrolone alone or combined with swimming decreased morphometric parameters and amount of AR in testicle tissue. Changes in the redox state indicate reproductive dysfunction.
Bridging the research to practice gap: a systematic scoping review of implementation of interventions for cancer-related fatigue management
Authors: Agbejule Oluwaseyifunmi Andi , Hart Nicolas H. , Ekberg Stuart , Koczwara Bogda , Ladwa Rahul , Simonsen Camilla , Pinkham Elizabeth P. , Chan Raymond Javan
Published: July 2021

Background

Cancer-related fatigue (CRF) is one of the most common and distressing symptoms in people with cancer. Although efficacy of interventions for CRF have been extensively investigated, less has been done to ensure successful translation into routine clinical practice. The aim of this systematic scoping review was to synthesise knowledge surrounding the implementation of CRF interventions, summarise the processes and outcomes of implementation strategies used, and identify opportunities for further research.

Methods

PubMed, Cochrane CENTRAL, EMBASE and CINAHL databases were searched (up to December 2020). The Cochrane Effective Practice and Organisation of Care (EPOC) Group taxonomy and the RE-AIM Framework were used to guide the evaluation of implementation strategies and outcomes, respectively.

Results

Six studies were included. Three used an implementation framework (PARIHS, KTA, Cullens & Adams’ Implementation Guide) to guide implementation. Overall, the implementation strategies used across all studies were reported to have directly resulted in immediate changes at the clinician level (e.g., increased clinician behaviours, self-efficacy, attitudes, knowledge of CRF management). No clear relationship was found between the use of implementation models and the number or type of implementation strategies used. For outcomes, Effectiveness and Implementation were the most highly reported RE-AIM measures followed by Reach then Maintenance. Adoption was the least reported.

Conclusions

Despite the high prevalence of CRF and evidence-based interventions for managing CRF, there is limited evidence informing the sustainable implementation of these interventions. This systematic scoping review emphasises the lack of quality CRF implementation studies presently available in the literature leading to a disconnect between effective CRF interventions, routine clinical care, and cancer survivors at present. This review highlights the need for robust study designs guided by established frameworks to methodically design and evaluate the implementation of CRF management interventions in the future.
Predicting the onset of myopia in children: results from the CLEERE study
Authors: Mutti Donald O. , Jordan Lisa A. , Zadnik Karla
Published: July 2021

Research often attempts to identify risk factors associated with prevalent disease or that change the probability of developing disease. These factors may also help in predicting which individuals may go on to develop the condition of interest. However, risk factors may not always serve as the best predictive factors and not all predictive factors should be considered as risk factors. A child’s current refractive error, parental history of myopia, and the amount of time children spend outdoors are excellent examples. Parental myopia and time outdoors are meaningful risk factors because they alter the probability of developing myopia and point to important hereditary and environmental influences. A child’s current refractive error points to no particular mechanism and is therefore a poor risk factor. However, it serves as an excellent predictive factor for identifying children likely to develop future myopia. Risk factors may explain how a child reached a particular level of refractive error, but knowledge of that history may not be needed in order to make an accurate prediction about future refractive error. Current refractive error alone may be sufficient. This difference between risk factors and predictive factors is not always appreciated in the literature, including a recent publication in BMC Ophthalmology. This letter attempts to make that distinction and to explain why parental myopia and time outdoors are significant risk factors in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error, yet are not significant for predicting future myopia in a multivariate model that contains current refractive error.
Interaction between antibiotic use and MS4A2 gene polymorphism on childhood eczema: a prospective birth cohort study
Authors: Hua Li , Chen Qian , Liu Quan-Hua , Guo Yi-Feng , Cheng Ru-Hong , Zhang Jun , Zhang Jian-Hua , Wang Li-Wei , Ji Ruo-Xu
Published: July 2021

Background

Eczema is usually the first allergic manifestation to appear in life attributed to gene–environment interactions. IL13, IL4, MS4A2 and ILR4A are four key inflammatory genes associated with atopy. This study aimed to explore gene-environment interactions on eczema in early life among the above four genes and environmental factors in Chinese Han children.

Methods

Five hundred ninety-seven children from a birth cohort who completed two-year follow-up were enrolled and their cord blood was collected. Subjects were genotyped for six polymorphisms in the aforementioned four genes. The children were followed at 6, 12 and 24 months, with epidemiologic information and medical history of eczema collected by questionnaire and eczema assessed by dermatologists.

Results

Among the 597 children, 168 were diagnosed with eczema and the others were not after 2 years of follow-up. MS4A2 rs569108 GG genotype (P = 1.68E-02, odds ratio (OR) = 4.66) and antibiotic use (P = 3.75E-4, OR = 2.02) were found independently associated with development of childhood eczema. Children with both antibiotic use and MS4A2 rs569108 GG genotype were more likely to develop eczema than those with only antibiotic use or GG homozygote (OR = 6.24 VS. 2.04 or 4.68).

Conclusions

MS4A2 rs569108 polymorphism and antibiotic use were solely associated with eczema, and they interacted with each other to increase the risk of developing the disease in Chinese Han toddlers. Long-term follow-up along with functional and replication studies are still needed.
U.S. transgender women’s preferences for microeconomic interventions to address structural determinants of HIV vulnerability: a qualitative assessment
Authors: Poteat Tonia , Mayo-Wilson Larissa Jennings , Pereira Nastacia , Wright Brittanni N. , Smout Shelby A. , Sawyer Ashlee N. , Cathers Lauretta , Zimmerman Rick S. , Grigsby Sheila R. , Benotsch Eric G.
Published: July 2021

Background

Transgender women in the United States (U.S.) experience a disproportionate burden of HIV infection and challenges to engagement in HIV prevention and care. This excess burden is driven by structural and economic inequities. Microeconomic interventions may be effective strategies for reducing HIV inequities for this population. However, few studies have explored transgender women’s preferences for microeconomic interventions to address structural determinants of HIV vulnerability.

Methods

We conducted individual interviews with 19 adult transgender women in 2 U.S. cities (Richmond, VA and St. Louis, MO) who reported one or more sexual risk behaviors and recent economic hardship related to employment/income, housing, or food security. Interviews were recorded, transcribed, and analyzed using thematic content analysis.

Results

The majority (74%) of transgender women were racial/ethnic minorities with mean age of 26.3 years. 89% were currently economically vulnerable; and 23% were employed full-time. 37% reported living with HIV. Participants expressed strong support for unrestricted vouchers, with many expressing the need for funds to support gender-affirming interventions. Assistance with how to budget and save and support for job acquisition, career planning, and employment sustainment were also preferred, including access to non-stigmatizing employment. Visible transgender leadership, group empowerment, and small (rather than large) numbers of participants were considered important aspects of intervention design for transgender women, including outreach through existing transgender networks to facilitate inclusion. Incorporating HIV counseling and testing to reduce vulnerability to HIV was acceptable. However, transgender women enrolled in the study preferred that HIV not be the focus of an intervention.

Conclusions

Flexible microeconomic interventions that support gender affirming interventions, improve financial literacy, and provide living-wage non-stigmatizing employment are desired by economically vulnerable transgender women. While not focused on HIV, such interventions have the potential to reduce the structural drivers of HIV vulnerability among transgender women.
Secondary polycythemia in chronic obstructive pulmonary disease: prevalence and risk factors
Authors: Zhang Jingzhou , DeMeo Dawn L. , Silverman Edwin K. , Make Barry J. , Wade R. Chad , Wells J. Michael , Cho Michael H. , Hobbs Brian D.
Published: July 2021

Background

Secondary polycythemia is associated with cigarette smoking and chronic obstructive pulmonary disease (COPD). However, the prevalence of polycythemia in COPD and the contributing risk factors for polycythemia in COPD have not been extensively studied.

Methods

We analyzed the presence of secondary polycythemia in current and former smokers with moderate to very severe COPD at the five-year follow-up visit in the observational COPDGene study. We used logistic regression to evaluate the association of polycythemia with age, sex, race, altitude, current smoking status, spirometry, diffusing capacity for carbon monoxide (DLCO), quantitative chest CT measurements (including emphysema, airway wall thickness, and pulmonary artery to aorta diameter ratio), resting hypoxemia, exercise-induced hypoxemia, and long-term oxygen therapy.

Results

In a total of 1928 COPDGene participants with moderate to very severe COPD, secondary polycythemia was found in 97 (9.2%) male and 31 (3.5%) female participants. In a multivariable logistic model, severe resting hypoxemia (OR 3.50, 95% CI 1.41–8.66), impaired DLCO (OR 1.28 for each 10-percent decrease in DLCO % predicted, CI 1.09–1.49), male sex (OR 3.60, CI 2.20–5.90), non-Hispanic white race (OR 3.33, CI 1.71–6.50), current smoking (OR 2.55, CI 1.49–4.38), and enrollment in the Denver clinical center (OR 4.42, CI 2.38–8.21) were associated with higher risk for polycythemia. In addition, continuous (OR 0.13, CI 0.05–0.35) and nocturnal (OR 0.46, CI 0.21–0.97) supplemental oxygen were associated with lower risk for polycythemia. Results were similar after excluding participants with anemia and participants enrolled at the Denver clinical center.

Conclusions

In a large cohort of individuals with moderate to very severe COPD, male sex, current smoking, enrollment at the Denver clinical center, impaired DLCO, and severe hypoxemia were associated with increased risk for secondary polycythemia. Continuous or nocturnal supplemental oxygen use were associated with decreased risk for polycythemia.
Individualization of risk factors for postoperative complication after lung cancer surgery: a retrospective study
Authors: Motono Nozomu , Ishikawa Masahito , Iwai Shun , Iijima Yoshihito , Usuda Katsuo , Uramoto Hidetaka
Published: July 2021

Background

The risk factors for postoperative complications after pulmonary resection in patients with non-small cell lung cancer (NSCLC) have not been elucidated.

Methods

Clinical data of 956 patients with NSCLC were analyzed. Patient factors such as sex, age, comorbidities, smoking history, respiratory function, and the lobe involved in lung cancer and operative factors such as operative approach and operative procedures were collected and analyzed.

Results

Male sex (odds ratio [OR]: 1.73, 95% confidence interval [CI]: 1.09–2.75, p = 0.01), coexistence of asthma (OR 2.68, 95% CI 1.19–6.02, p = 0.01), low percentage of forced expiratory volume in 1 s (FEV1) (OR 1.41, 95% CI 1.02–1.95, p = 0.03), and lobectomy or greater resection (OR 2.47, 95% CI 1.66–3.68, p < 0.01) were identified as significant risk factors for postoperative complications. Male sex (OR 1.98; 95% CI 1.03–3.81, p = 0.03) and complete video-assisted thoracic surgery and robot-assisted thoracic surgery (OR 1.64; 95% CI 1.09–2.45; p = 0.01) were identified as significant risk factors for postoperative air leakage. Coexistence of asthma (OR 9.97; 95% CI 3.66–27.38; p < 0.01) was identified as a significant risk factor for postoperative atelectasis or pneumonia. Lobectomy or greater resection (OR 19.71; 95% CI 2.70–143.57; p < 0.01) was identified as a significant risk factor for postoperative arrhythmia.

Conclusion

Male sex, coexistence of asthma, low percentage of FEV1, and operative procedure were significant risk factors for postoperative complications. Furthermore, risk factors varied according to postoperative complications.
My mind is still mine: a self-portrait in a photography project for adolescents and young adults with cancer
Authors: Ferrari Andrea , Patriccioli Alice , Silva Matteo , Bonvicini Matteo Davide , Massimino Maura
Published: July 2021

This commentary describes the unusual self-portrait contributed by a 26-year-old receiving treatment for relapsing medulloblastoma to a photography project undertaken by a group of patients as part of the Youth Project, a scheme dedicated to young cancer patients with the dual aim of optimizing medical aspects of their care and promoting a holistic approach to their needs. The article briefly describes how creative projects can play an important part in giving young people with cancer new ways to tell their stories and express their feelings. There is still a limited understanding of the specific needs of adolescents and young adults with cancer, and it is important to draw attention to them and to the need to devise a person-centered approach to cancer patients in this age group.
Protective effect of Glechoma hederacea extract against gallstone formation in rodent models
Authors: Xiao Min , Yang Mengbi , Ji Xiaoyu , Li Dan , Xie Yuning , Lyu Yuanfeng , Zuo Zhong
Published: July 2021

Background

Our current study aimed to evaluate the effect of an Glechoma hederacea extract (Hitrechol®) in normal rats and gallstone diseased mice to explore its underlying mechanisms. Normal rats and C57BL/6 mice with/without cholesterol gallstone were used in this study.

Methods

To monitor the effect of Hitrechol® on bile secretion, bile flow rates at 15 min interval until 2 h post-dosing in normal rats treated with vehicle and Hitrechol® were compared using multiple t-test with a p < 0.05 considered as statistically significant different. To further evaluate the effect of Hitrechol® against the development of gallstone in lithogenic diet treated mice, mice were treated with vehicle or Hitrechol® (QD-once daily or TID-three times daily) for 3 weeks followed by comparing the levels of bile composition among the treatment groups. In addition, the anti-oxidative biomarkers in liver and anti-inflammatory biomarkers in serum were detected and compared among all the treatment groups to evaluate the hepato-protective effect of Hitrechol®. The obtained levels of biomarkers and bile composition were compared among different treatment groups using one-way ANOVA tests followed by Tukey’s multiple comparisons with p < 0.05 considered as statistically significant.

Results

Despite no significant impact on the bile flow rate, Hitrechol® TID treatment dramatically decreased size and amount of gallstone crystals and total cholesterol level (p < 0.05), as well as total bile acid (p < 0.05) and several types of bile acid (p < 0.05) levels in gallstone disease model mice. Hitrechol® TID treatment could significantly decrease the frequencies of hepatocyte necrosis and lipid aggregation notably as well as increase the antioxidant enzyme level (p < 0.05) in the liver.

Conclusions

Our findings for the first time demonstrated the beneficial effect of Hitrechol® against gallstone via its litholytic, liver-protective and antioxidant activities.
AFibNet: an implementation of atrial fibrillation detection with convolutional neural network
Authors: Tutuko Bambang , Nurmaini Siti , Tondas Alexander Edo , Rachmatullah Muhammad Naufal , Darmawahyuni Annisa , Esafri Ria , Firdaus Firdaus , Sapitri Ade Iriani
Published: July 2021

Background

Generalization model capacity of deep learning (DL) approach for atrial fibrillation (AF) detection remains lacking. It can be seen from previous researches, the DL model formation used only a single frequency sampling of the specific device. Besides, each electrocardiogram (ECG) acquisition dataset produces a different length and sampling frequency to ensure sufficient precision of the R–R intervals to determine the heart rate variability (HRV). An accurate HRV is the gold standard for predicting the AF condition; therefore, a current challenge is to determine whether a DL approach can be used to analyze raw ECG data in a broad range of devices. This paper demonstrates powerful results for end-to-end implementation of AF detection based on a convolutional neural network (AFibNet). The method used a single learning system without considering the variety of signal lengths and frequency samplings. For implementation, the AFibNet is processed with a computational cloud-based DL approach. This study utilized a one-dimension convolutional neural networks (1D-CNNs) model for 11,842 subjects. It was trained and validated with 8232 records based on three datasets and tested with 3610 records based on eight datasets. The predicted results, when compared with the diagnosis results indicated by human practitioners, showed a 99.80% accuracy, sensitivity, and specificity.

Result

Meanwhile, when tested using unseen data, the AF detection reaches 98.94% accuracy, 98.97% sensitivity, and 98.97% specificity at a sample period of 0.02 seconds using the DL Cloud System. To improve the confidence of the AFibNet model, it also validated with 18 arrhythmias condition defined as Non-AF-class. Thus, the data is increased from 11,842 to 26,349 instances for three-class, i.e., Normal sinus (N), AF and Non-AF. The result found 96.36% accuracy, 93.65% sensitivity, and 96.92% specificity.

Conclusion

These findings demonstrate that the proposed approach can use unknown data to derive feature maps and reliably detect the AF periods. We have found that our cloud-DL system is suitable for practical deployment
Molecular mechanism study of HGF/c-MET pathway activation and immune regulation for a tumor diagnosis model
Authors: Shen Zhibo , Xue Wenhua , Zheng Yuanyuan , Geng Qishun , Wang Le , Fan Zhirui , Wang Wenbin , Yue Ying , Zhai Yunkai , Li Lifeng , Zhao Jie
Published: July 2021

Background

Hepatocyte growth factor (HGF) binds to the c-mesenchymal-epithelial transition (C-MET) receptor and activates downstream signaling pathways, playing an essential role in the development of various cancers. Given the role of this signaling pathway, the primary therapeutic direction focuses on identifying and designing HGF inhibitors, antagonists and other molecules to block the binding of HGF to C-MET, thereby limiting the abnormal state of other downstream genes.

Methods

This study focuses on the analysis of immune-related genes and corresponding immune functions that are significantly associated with the HGF/c-MET pathway using transcriptome data from 11 solid tumors.

Results

We systematically analyzed 11 different cancers, including expression correlation, immune infiltration, tumor diagnosis and survival prognosis from HGF/c-MET pathway and immune regulation, two biological mechanisms having received extensive attention in cancer analysis.

Conclusion

We found that the HGF/c-MET pathway affected the tumor microenvironment mainly by interfering with expression levels of other genes. Immune infiltration is another critical factor involved in changes to the tumor microenvironment. The downstream immune-related genes activated by the HGF/c-MET pathway regulate immune-related pathways, which in turn affect the degree of infiltration of immune cells. Immune infiltration is significantly associated with cancer development and prognosis.
Effects of exposure to surrounding green, air pollution and traffic noise with non-accidental and cause-specific mortality in the Dutch national cohort
Authors: Klompmaker Jochem O. , Janssen Nicole A. H. , Bloemsma Lizan D. , Marra Marten , Lebret Erik , Gehring Ulrike , Hoek Gerard
Published: July 2021

Background

Everyday people are exposed to multiple environmental factors, such as surrounding green, air pollution and traffic noise. These exposures are generally spatially correlated. Hence, when estimating associations of surrounding green, air pollution or traffic noise with health outcomes, the other exposures should be taken into account. The aim of this study was to evaluate associations of long-term residential exposure to surrounding green, air pollution and traffic noise with mortality.

Methods

We followed approximately 10.5 million adults (aged ≥ 30 years) living in the Netherlands from 1 January 2013 until 31 December 2018. We used Cox proportional hazard models to evaluate associations of residential surrounding green (including the average Normalized Difference Vegetation Index (NDVI) in buffers of 300 and 1000 m), annual average ambient air pollutant concentrations [including particulate matter (PM2.5), nitrogen dioxide (NO2)] and traffic noise with non-accidental and cause-specific mortality, adjusting for potential confounders.

Results

In single-exposure models, surrounding green was negatively associated with all mortality outcomes, while air pollution was positively associated with all outcomes. In two-exposure models, associations of surrounding green and air pollution attenuated but remained. For respiratory mortality, in a two-exposure model with NO2 and NDVI 300 m, the HR of NO2 was 1.040 (95%CI: 1.022, 1.059) per IQR increase (8.3 µg/m3) and the HR of NDVI 300 m was 0.964 (95%CI: 0.952, 0.976) per IQR increase (0.14). Road-traffic noise was positively associated with lung cancer mortality only, also after adjustment for air pollution or surrounding green.

Conclusions

Lower surrounding green and higher air pollution were associated with a higher risk of non-accidental and cause-specific mortality. Studies including only one of these correlated exposures may overestimate the associations with mortality of that exposure.
The acute effect of incorporating lettuce or watercress into a moderately high-fat meal on postprandial lipid, glycemic response, and plasma inflammatory cytokines in healthy young men: a randomized crossover trial
Authors: Shokraei Sahar , Khandouzi Nafiseh , Sina Zahra , Nasrollahzadeh Javad
Published: July 2021

Background

Postprandial responses to food mostly depend on the composition of the meal and the consumption of vegetables may modulate this postprandial state. In this study, the effects of lettuce or watercress consumption with a moderately high-fat meal (40% kcal from fat) on postprandial lipemia, glycemia, and inflammatory cytokines were determined in healthy men.

Methods

This randomized, 3-arm, crossover study was conducted in sixteen healthy young men with a mean ± SEM age and body mass index (in kg/m2) of 22.8 ± 0.5 years old and 23.7 ± 1.16, respectively. Lettuce and watercress were added to the test meal in portions of 100 g and cellulose was added to the control meal. Thereafter, blood samples were collected by passing 0, 1, 2, 3, and 4 h for analysis. The postprandial response was measured in plasma glucose, triglycerides (TG), total cholesterol, high-density-lipoproteins cholesterol (HDL-C), and low-density-lipoproteins cholesterol (LDL-C), as the area under the postprandial curve (AUC). Moreover, plasma tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined once before and once 4 h after the meal’s consumption.

Results

The 0–4-h AUCs for glucose (385.7, 361.9, and 382.3 mg/dL for the control, lettuce, and watercress meals, respectively) were calculated to be lower when meal was consumed with lettuce compared to the control (P < 0.05) and watercress (P < 0.01) meals. The maximum values of insulin were obtained as 43.8 ± 18.8, 33.5 ± 19.5, and 42.8 ± 17.7 μIU/mL for the control, lettuce, and watercress meals, respectively. As well, the lettuce-containing meal more reduced the AUC for insulin compared with the control (P < 0.05), but not watercress. Notably, plasma TG, total cholesterol, HDL-C, and LDL-C had no significant differences among the meals. Moreover, the levels of plasma IL-6 and TNF-α did not differ among the meals.

Conclusion

In this study on healthy men, the addition of lettuce to a moderately high-fat meal delayed the postprandial glycemic response. However, the effect of the consumption of these vegetables on postprandial responses in subjects with cardiometabolic risk factors remains to be elucidated yet.

This clinical trial was registered at the Iran Clinical Trials Registration Office (IRCT) on March 3, 2018, with an ID of IRCT20160702028742N4 (https://www.irct.ir/user/trial/23233/view).
Near infrared light fluorescence imaging-guided biomimetic nanoparticles of extracellular vesicles deliver indocyanine green and paclitaxel for hyperthermia combined with chemotherapy against glioma
Authors: Wang Meng , Lv Chen-Yan , Li Shu-Ang , Wang Jun-Kuan , Luo Wen-Zheng , Zhao Pei-Chao , Liu Xue-You , Wang Ze-Ming , Jiao Yang , Sun Hong-Wei , Zhao Yi , Zhang Peng
Published: July 2021

Background

We investigated the therapeutic effect of targeting extracellular vesicles (EVs) loaded with indocyanine green (ICG) and paclitaxel (PTX) on glioma.

Methods

Raw264.7 cells were harvested to extract EVs for the preparation of ICG/PTX@RGE-EV by electroporation and click chemistry. We evaluated the success of modifying Neuropilin-1 targeting peptide (RGE) on the EV membrane of ICG/PTX@RGE-EV using super-resolution fluorescence microscopy and flow cytometry. Spectrophotometry and high performance liquid chromatography (HPLC) were implemented for qualitative and quantitative analysis of the ICG and PTX loaded in EVs. Photothermal properties of the vesicles were evaluated by exposing to 808-nm laser light. Western blot analysis, cell counting kit 8 (CCK-8), Calcein Acetoxymethyl Ester/propidium iodide (Calcein-AM/PI) staining, and flow cytometry were utilized for assessing effects of vesicle treatment on cellular behaviors. A nude mouse model bearing glioma was established to test the targeting ability and anti-tumor action of ICG/PTX@RGE-EV in vivo.

Results

Under exposure to 808-nm laser light, ICG/PTX@RGE-EV showed good photothermal properties and promotion of PTX release from EVs. ICG/PTX@RGE-EV effectively targeted U251 cells, with activation of the Caspase-3 pathway and elevated apoptosis in U251 cells through chemotherapy combined with hyperthermia. The anti-tumor function of ICG/PTX@RGE-EV was confirmed in the glioma mice via increased accumulation of PTX in the ICG/PTX@RGE-EV group and an increased median survival of 48 days in the ICG/PTX@RGE-EV group as compared to 25 days in the PBS group.

Conclusion

ICG/PTX@RGE-EV might actively target glioma to repress tumor growth by accelerating glioma cell apoptosis through combined chemotherapy-hyperthermia.

Graphic Abstract
Clinical efficacy of closed reduction and percutaneous parallel K-wire interlocking fixation of first metacarpal base fracture
Authors: Wang Wu , Zeng Min , Yang Junxiao , Wang Long , Xie Jie , Hu Yihe
Published: July 2021

Background

This study aimed to explore the clinical efficacy of treating a first metacarpal base fracture by closed reduction and percutaneous parallel K-wire interlocking fixation between the first and second metacarpals.

Methods

Twenty patients treated by the abovementioned modified technique (modified technique group) and ten patients treated by the traditional percutaneous K-wire fixation technique (traditional technique group) from October 2015 to November 2019 at our institution were retrospectively reviewed. The patients’ average age was 38 years (range, 16–61 years). The mean follow-up period was 13 months (range, 10–18 months). At the final follow-up, the functional recovery of the injured hand was assessed and compared between the modified and traditional technique groups. In addition, the functional recovery of the injured hand was compared with that of the uninjured hand within the modified technique group.

Results

All patients recovered well, with no cases of infection or nonunion. Compared with the traditional technique group, the modified technique group had a shorter operative time, lower postoperative visual analogue scale pain score, better effective range of motion score of the first carpometacarpal joint (Kapandji score), and had almost no need for auxiliary plaster fixation, enabling functional exercise to be started earlier. Within the modified technique group, the mean hand grip strength, pinch strength, and Kapandji score on the injured side did not significantly differ to the values on the uninjured side in both the extra-articular and intra-articular fracture subgroups. While the abduction and flexion–extension arcs of the thumb on the injured hand were significantly smaller than those on the uninjured hand in both the extra-articular and intra-articular fracture subgroups, the patients felt clinically well with respect to daily activities and strength.

Conclusion

The percutaneous parallel K-wire and interlocking fixation technique is simple, effective, and economical for first metacarpal base fractures.
Longitudinal association between parental-to-child-Maltreatment and self-reported Generalized Anxiety Disorder symptoms in Pakistani Adolescents
Authors: Lakhdir Maryam Pyar Ali , Peerwani Ghazal , Soomar Salman Muhammad , Nathwani Apsara Ali , Farooq Salima , Ali Naureen Akber , Khaliq Asif , Kadir Muhammad Masood , Azam Syed Iqbal
Published: July 2021

Background

Parent-to-child maltreatment is considered one of the risk factors for Generalized Anxiety Disorder (GAD) symptoms, but this hypothesis has not been adequately tested in Pakistani settings.

Aim

This study aimed to examine the association between parent-to-child maltreatment and the risk of developing GAD symptoms among adolescents.

Methods

The association of none to rare, occasionally, and frequently parent-to-child maltreatment with the incidence of GAD symptoms was investigated in a sample of 800 adolescents aged 11–17 years who were followed for two years. Parent-to-child maltreatment was assessed using ICAST-C (International child abuse screening tool). GAD Symptoms were determined by SCARED (Screen for children anxiety-related disorders). Cox Proportional Algorithm was used to estimate risk ratios.

Results

Among children with both uneducated parents, frequently maltreatment was associated with 7.31 (2.20–24.04) times the risk of GAD symptoms compared to none to rare maltreatment. In contrast, the risk of GAD symptoms in frequently maltreated children was 5.58 times (1.40–21.97) than negligibly maltreated children with either educated parent.

Conclusion

The frequency of parent-to-child maltreatment is significantly associated with an increased risk of developing GAD symptoms in which parental education plays a crucial role. Parents should be imparted with the awareness of the consequences of child maltreatment. In Pakistani settings the need to have this awareness is even more necessary due to the culturally acceptable disciplinary measures used by parents.
Disease course following High Disease Activity Status revealed patterns in SLE
Authors: Hoi Alberta , Koelmeyer Rachel , Bonin Julie , Sun Ying , Kao Amy , Gunther Oliver , Nim Hieu T. , Morand Eric
Published: July 2021

Background

We sought to examine the disease course of High Disease Activity Status (HDAS) patients and their different disease patterns in a real-world longitudinal cohort. Disease resolution till Lupus Low Disease Activity State (LLDAS) has been a general treatment goal, but there is limited information on this subset of patients who achieve this.

Methods

All consenting patients of the Monash Lupus Cohort who had at least 12 months of observation were included. HDAS was defined as SLEDAI-2K ≥ 10 ever, and HDAS episode as the period from the first HDAS clinic visit until attainment of LLDAS. We examined the associations of different HDAS patterns with the likelihood of damage accrual.

Results

Of 342 SLE patients, 151 experienced HDAS at least once, accounting for 298 HDAS episodes. The majority of HDAS patients (76.2%) experienced Recurrent HDAS (> 1 HDAS visit), and a smaller subset (47.7%) had Persistent HDAS (consecutive HDAS visits for longer than 2 months). Recurrent or Persistent HDAS patients were younger at diagnosis and more likely to experience renal or serositis manifestations; persistent HDAS patients were also more likely to experience neurological manifestations. Baseline SLEDAI greater than 10 was associated with longer HDAS episodes. Recurrent and Persistent HDAS were both associated with an increased likelihood of damage accrual. The total duration of HDAS episode greater than 2 years and experiencing multiple HDAS episodes (≥4) was also associated with an increased likelihood of damage accrual (OR 1.80, 95% CI 1.08–2.97,p= 0.02, and OR 3.31, 95% CI 1.66–13.26,p= 0.01, respectively).

Conclusion

HDAS episodes have a highly variable course. Recurrent and Persistent HDAS, and longer duration of HDAS episodes, increased the risk of damage accrual. In addition to a major signifier of severity in SLE, its resolution to LLDAS can determine the subsequent outcome in SLE patients.
Myeloid phenotypes in severe COVID-19 predict secondary infection and mortality: a pilot study
Authors: Marais Clémence , Claude Caroline , Semaan Nada , Charbel Ramy , Barreault Simon , Travert Brendan , Piloquet Jean-Eudes , Demailly Zoé , Morin Luc , Merchaoui Zied , Teboul Jean-Louis , Durand Philippe , Miatello Jordi , Tissières Pierre ,   for The COVID-19 Immune Suppression (CLOVIS) Study Group, Barreault Simon , Beggaz Mélissa , Charbel Ramy , Claude Caroline , Demailly Zoé , Durand Philippe , Gerschenfeld Gaspard , Giraldi Jessica , Guerra Matteo , Hily Manon , Journaux Martin , Lai Christopher , Leroux Pauline , Marais Clémence , Merchaoui Zied , Miatello Jordi , Niçaise Clarisse , Piloquet Jean-Eudes , Ren Melissa , Simbozel Marie , Semaan Nada , Teboul Jean-Louis , Tissieres Pierre , Travert Brendan
Published: July 2021

Background

De-regulated host response to severe coronavirus disease 2019 (COVID-19), directly referring to the concept of sepsis-associated immunological dysregulation, seems to be a strong signature of severe COVID-19. Myeloid cells phenotyping is well recognized to diagnose critical illness-induced immunodepression in sepsis and has not been well characterized in COVID-19. The aim of this study is to review phenotypic characteristics of myeloid cells and evaluate their relations with the occurrence of secondary infection and mortality in patients with COVID-19 admitted in an intensive care unit.

Methods

Retrospective analysis of the circulating myeloid cells phenotypes of adult COVID-19 critically ill patients. Phenotyping circulating immune cells was performed by flow cytometry daily for routine analysis and twice weekly for lymphocytes and monocytes subpopulations analysis, as well as monocyte human leukocyte antigen (mHLA)-DR expression.

Results

Out of the 29 critically ill adult patients with severe COVID-19 analyzed, 12 (41.4%) developed secondary infection and six patients died during their stay. Monocyte HLA-DR kinetics was significantly different between patients developing secondary infection and those without, respectively, at day 5–7 and 8–10 following admission. The monocytes myeloid-derived suppressor cells to total monocytes ratio was associated with 28- and 60-day mortality. Those myeloid characteristics suggest three phenotypes: hyperactivated monocyte/macrophage is significantly associated with mortality, whereas persistent immunodepression is associated with secondary infection occurrence compared to transient immunodepression.

Conclusions

Myeloid phenotypes of critically ill COVID-19 patients may be associated with development of secondary infection, 28- and 60-day mortality.
Dynamics of dark fermentation microbial communities in the light of lactate and butyrate production
Authors: Detman Anna , Laubitz Daniel , Chojnacka Aleksandra , Kiela Pawel R. , Salamon Agnieszka , Barberán Albert , Chen Yongjian , Yang Fei , Błaszczyk Mieczysław K. , Sikora Anna
Published: July 2021

Background

This study focuses on the processes occurring during the acidogenic step of anaerobic digestion, especially resulting from nutritional interactions between dark fermentation (DF) bacteria and lactic acid bacteria (LAB). Previously, we have confirmed that DF microbial communities (MCs) that fed on molasses are able to convert lactate and acetate to butyrate. The aims of the study were to recognize the biodiversity of DF-MCs able and unable to convert lactate and acetate to butyrate and to define the conditions for the transformation.

Results

MCs sampled from a DF bioreactor were grown anaerobically in mesophilic conditions on different media containing molasses or sucrose and/or lactate and acetate in five independent static batch experiments. The taxonomic composition (based on 16S_rRNA profiling) of each experimental MC was analysed in reference to its metabolites and pH of the digestive liquids. In the samples where the fermented media contained carbohydrates, the two main tendencies were observed: (i) a low pH (pH ≤ 4), lactate and ethanol as the main fermentation products, MCs dominated with Lactobacillus, Bifidobacterium, Leuconostoc and Fructobacillus was characterized by low biodiversity; (ii) pH in the range 5.0–6.0, butyrate dominated among the fermentation products, the MCs composed mainly of Clostridium (especially Clostridium_sensu_stricto_12), Lactobacillus, Bifidobacterium and Prevotella. The biodiversity increased with the ability to convert acetate and lactate to butyrate. The MC processing exclusively lactate and acetate showed the highest biodiversity and was dominated by Clostridium (especially Clostridium_sensu_stricto_12). LAB were reduced; other genera such as Terrisporobacter, Lachnoclostridium, Paraclostridium or Sutterella were found. Butyrate was the main metabolite and pH was 7. Shotgun metagenomic analysis of the selected butyrate-producing MCs independently on the substrate revealed C.tyrobutyricum as the dominant Clostridium species. Functional analysis confirmed the presence of genes encoding key enzymes of the fermentation routes.

Conclusions

Batch tests revealed the dynamics of metabolic activity and composition of DF-MCs dependent on fermentation conditions. The balance between LAB and the butyrate producers and the pH values were shown to be the most relevant for the process of lactate and acetate conversion to butyrate. To close the knowledge gaps is to find signalling factors responsible for the metabolic shift of the DF-MCs towards lactate fermentation.