bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical characteristics and prognosis of ovarian clear cell carcinoma: a 10-year retrospective study
Authors: Zhu Chenchen , Zhu Jing , Qian Lili , Liu Hanyuan , Shen Zhen , Wu Dabao , Zhao Weidong , Xiao Weihua , Zhou Ying
Published: March 2021

Background

Ovarian clear cell carcinoma (OCCC) is a special pathological type of epithelial ovarian carcinoma (EOC). We conducted this research to investigate the clinical characteristics and outcomes of OCCC and to provide additional supporting evidence to aid in the clinical diagnosis and management.

Methods

This was a retrospective study investigating the clinical characteristics and survival outcomes of 86 patients with OCCC treated at our center between January 2010 and March 2020. Survival analysis was also performed on 179 patients with OCCC obtained from the Surveillance, Epidemiology and End Results (SEER) cancer registry database.

Results

The median age of participants was 49.21 ± 9.91 years old, and 74.42% of them were diagnosed at early stage. The median CA125 level was 601.48 IU/mL, while 19.77% of the patients had normal CA125 levels. Sixteen patients (18.60%) had co-existing endometriosis and 8 patients (9.3%) developed venous thromboembolism (VTE). There were 5 patients received suboptimal cytoreduction. Sixty-six patients (76.74%) underwent lymphadenectomy, and only 3 (4.55%) patients had positive lymph nodes. Patients diagnosed at an early stage had higher 3-year overall survival (OS) and progression-free survival (PFS) rates than those with advanced stage OCCC. CA19–9 (P = 0.025) and ascites (P = 0.001) were significantly associated with OS, while HE4 (P = 0.027) and ascites (P = 0.001) were significantly associated with PFS. Analysis of data from the SEER database showed that positive lymph nodes is also an independent prognostic factor for OS (P = 0.001).

Conclusions

OCCC often presents at an early stage and young age with a mildly elevated CA125. CA19–9, HE4, massive ascites, and positive lymph node are independent prognostic factors.
Diagnostic capability of different morphological parameters for primary open‐angle glaucoma in the Chinese population
Authors: Li Ruoshi , Wang Xia , Wei Yahui , Fang Yuan , Tian Tian , Kang Lei , Li Mei , Cai Yu , Pan Yingzi
Published: March 2021

Background

To assess the diagnostic capability of novel Bruch’s membrane opening (BMO)-based disc parameters, the BMO-minimum rim width (BMO-MRW) and the BMO-minimum rim area (BMO-MRA) in the Chinese population and compare them to the retinal nerve fiber layer (RNFL) from optical coherence tomography (OCT) and the rim area (RA) from the Heidelberg retinal tomograph-III (HRT-III).

Methods

In total, 200 eyes of 77 healthy and 123 primary open-angle glaucoma (POAG) subjects were included in this cross-sectional study. All participants underwent the visual field test and structural measurements by OCT and HRT-III. The areas under the receiver operating characteristic curves (AUCs) of different structural parameters were calculated to assess their diagnostic power and compared using the DeLong test.

Results

In populations with different characteristics, the BMO-MRW and BMO-MRA had better diagnostic power than the RA. In discriminating between all POAG subjects and healthy controls and between early-stage patients and controls, the global BMO-MRW had comparable AUCs with the RNFL, but the BMO-MRA had lower AUCs than the RNFL. In healthy subjects with macrodiscs, both the global and sectoral BMO-MRW were thinner than those in healthy subjects with normal disc size. The AUCs of BMO-MRA, BMO-MRW and RNFL in subjects with macrodiscs were comparable. Additionally, in the myopic population, the BMO-MRA and BMO-MRW had comparable AUCs with the RNFL.

Conclusions

The BMO-MRW had comparable diagnostic power with the RNFL, and compared with BMO-MRW, the BMO-MRA might have advantages in certain populations, such as macrodiscs. All OCT-derived parameters exceeded the RA in diagnostic capability.
Cross-sectional trend analysis of the NCHA II survey data on Canadian post-secondary student mental health and wellbeing from 2013 to 2019
Authors: Linden Brooke , Boyes Randall , Stuart Heather
Published: March 2021

Background

Canadian post-secondary students are considered to be at risk for chronic stress and languishing mental health, but there has been no longitudinal analysis of the available population-level data. The purpose of this study was to examine trends in the overall and sex-specific prevalence of self-reported stress, distress, mental illness, and help seeking behaviours among Canadian post-secondary students over the past several years.

Methods

Using the 2013, 2016, and 2019 iterations of the National College Health Assessment II Canadian Reference data, we conducted a trend analysis for each variable of interest, stratified by sex. The significance and magnitude of the changes were modelled using cumulative linked ordinal regression models and log binomial regression models.

Results

With few exceptions, we observed significant increases over time in the proportion of students reporting symptoms of psychological distress, mental illness diagnoses, and help seeking for mental health related challenges. Female students reported a higher level of stress than male students, with a statistically significant increase in the stress level reported by female students observed over time. In all cases, larger proportions of female students were observed compared to male students, with the proportion of female students who self-reported mental illness diagnoses nearly doubling that of males.

Conclusions

Our analysis indicated that the proportion of students self-reporting mental health related challenges, including stress, psychological distress, and diagnosed mental illnesses increased between the 2013, 2016 and 2019 iterations of the NCHA II conducted among Canadian post-secondary students.
Permanent stoma: a quality outcome in treatment of rectal cancer and its impact on length of stay
Authors: Lemini Riccardo , Jabbal Iktej S. , Stanek Krystof , Borkar Shalmali R. , Spaulding Aaron C. , Kelley Scott R. , Colibaseanu Dorin T.
Published: March 2021

Background

This study aimed to identify socioeconomic predictors of permanent stoma in rectal cancer treatment and examine its association with length of stay at the treatment facility.

Methods

Rectal cancer patients who underwent elective surgery between January 2015 and December 2018 were identified from the Agency for Health Care Administration Florida Hospital Inpatient Discharge Dataset. Multivariate regression models were utilized to identify demographic and socioeconomic factors associated with receiving a permanent stoma as well as the associated length of stay of these patients.

Results

Of 2630 rectal cancer patients who underwent surgery for rectal cancer, 21% had a permanent stoma. The odds of receiving permanent stoma increased with higher Elixhauser score, metastatic disease, advanced age, having open surgery, residence in Southwest Florida, and having Medicaid insurance or no insurance/self-payers (p < 0.05). Patients with a permanent stoma had a significantly extended stay after surgery (p < 0.001).

Conclusions

Patients with a permanent stoma following cancer resection were more likely to have open surgery, had more comorbidities, and had a longer length of stay. Having permanent stoma was higher in patients living in South West Florida, patients with Medicaid insurance, and in the uninsured. Additionally, the payer type significantly affected the length of stay.
Photodynamic diagnostic ureteroscopy using the VISERA ELITE video system for diagnosis of upper-urinary tract urothelial carcinoma: a prospective cohort pilot study
Authors: Wada Koichiro , Araki Motoo , Tanimoto Ryuta , Sadahira Takuya , Watari Shogo , Maruyama Yuki , Mitsui Yosuke , Nakajima Hirochika , Acosta Herik , Katayama Satoshi , Iwata Takehiro , Nishimura Shingo , Takamoto Atsushi , Sako Tomoko , Edamura Kohei , Kobayashi Yasuyuki , Watanabe Masami , Watanabe Toyohiko , Nasu Yasutomo
Published: March 2021

Background

The advantages of photodynamic diagnostic technology using 5-aminolevulinic acid (ALA-PDD) have been established. The aim of this prospective cohort study was to evaluate the usefulness of ALA-PDD to diagnose upper tract urothelial carcinoma (UT-UC) using the Olympus VISERA ELITE video system.

Methods

We carried out a prospective, interventional, non-randomized, non-contrast and open label cohort pilot study that involved patients who underwent ureterorenoscopy (URS) to detect UT-UC. 5-aminolevulinic acid hydrochloride was orally administered before URS. The observational results and pathological diagnosis with ALA-PDD and traditional white light methods were compared, and the proportion of positive subjects and specimens were calculated.

Results

A total of 20 patients were enrolled and one patient who had multiple bladder tumors did not undergo URS. Fifteen of 19 patients were pathologically diagnosed with UT-UC and of these 11 (73.3%) were ALA-PDD positive. Fourteen of 19 patients were ALA-PDD positive and of these 11 were pathologically diagnosed with UC. For the 92 biopsy specimens that were malignant or benign, the sensitivity for both traditional white light observation and ALA-PDD was the same at 62.5%, whereas the specificities were 73.1% and 67.3%, respectively. Of the 38 specimens that were randomly biopsied without any abnormality under examination by both white light and ALA-PDD, 11 specimens (28.9%) from 5 patients were diagnosed with high grade UC. In contrast, four specimens from 4 patients, which were negative in traditional white light observation but positive in ALA-PDD, were diagnosed with carcinoma in situ (CIS).

Conclusions

Our results suggest that ALA-PDD using VISERA ELITE is not sufficiently applicable for UT-UC. Nevertheless, it might be better particularly for CIS than white light and superior results would be obtained using VISERA ELITE II video system.

Trial registration: The present clinical study was approved by the Okayama University Institutional Review Board prior to study initiation (Application no.: RIN 1803–002) and was registered with the UMIN Clinical Trials Registry (UMIN-CTR), Japan (Accession no.: UMIN000031205).
Dental caries in association with viral load in children living with HIV in Phnom Penh, Cambodia: a cross‐sectional study
Authors: Kikuchi Kimiyo , Yasuoka Junko , Tuot Sovannary , Okawa Sumiyo , Yem Sokunthea , Chhoun Pheak , Murayama Makoto , Huot Chantheany , Yi Siyan
Published: March 2021

Background

Oral health status is associated with the overall health among people living with human immunodeficiency virus (HIV) infection. However, it is unclear whether dental caries is associated with the viral load in this population. Particularly, dental caries among children living with HIV needs better understanding as this can affect their overall health and future well-being. This study assessed the association between dental caries and viral load among children living with HIV in Phnom Penh, Cambodia.

Methods

This cross-sectional study, conducted at the National Pediatric Hospital as a baseline survey of a randomized controlled trial, included 328, 3–15-year-old children living with HIV and their primary caregivers. Calibrated and trained examiners conducted oral examinations for dental caries (DMFT/dmft index) in the children and retrieved the latest HIV viral load data from the hospital’s patient information system. On the dental examination day, the children and their caregivers were invited to answer a questionnaire-based interview. Multiple logistic regression analysis was conducted to assess the association between dental caries and viral load. The cut-off point for undetectable viral load was set at < 40 copies/mL.

Results

Data from 328 children were included in the analysis; 68.3% had an undetectable viral load. The mean DMFT/dmft was 7.7 (standard deviation = 5.0). Adjusted regression analysis showed that dental caries in permanent or deciduous teeth was positively associated with detectable viral load (adjusted odds ratio [AOR]: 1.07, 95% confidence interval [CI]: 1.01–1.14). Conversely, antiretroviral therapy of ≥ 1 year and self-reported better adherence to antiretroviral drugs were negatively associated with detectable viral load. Among children with detectable viral load, dental caries in permanent or deciduous teeth was positively associated with non-suppression of viral load (> 1000 copies/mL) (AOR: 1.12, CI: 1.03–1.23).

Conclusions

Dental caries was associated with viral load status detection among children living with HIV. This finding suggests that dental caries may affect their immune status. The oral health of children living with HIV should be strengthened, and further research is needed to clarify the causal relationship between viral load and oral health status.
Career choice and influential factors among medical students majoring in psychiatry in China
Authors: Zhang Ying-Jian , Yuan Kai , Chang Su-Hua , Yan Wei , Que Jian-Yu , Deng Jia-Hui , Gong Yi-Miao , Luo Jia-Ming , Yang Shi-Chang , An Cui-Xia , Kang Yi-Min , Xu Hua-Shan , Wang Yi-Ming , Zhang Li-Fang , Zhang Wen-Fang , Song Yin-Li , Xu Dong-Wu , Liu Huan-Zhong , Wang Wen-Qiang , Liu Chuan-Xin , Yang Wen-Qiong , Zhou Liang , Zhao Jiu-Bo , Yu Miao-Yu , Chen Jun-Yu , Tang Hong , Peng Juan , Zhang Xiu-Jun , Xu Yong , Zhang Ning , Kuang Li , Li Zhan-Jiang , Wang Yu-Hua , Shi Jie , Ran Mao-Sheng , Bao Yan-Ping , Shi Le , Lu Lin
Published: March 2021

Background

The undergraduate program of psychiatry has been widely established in recent years to improve the education and recruitment of psychiatrists in China. We aim to investigate the career choice of medical students majoring in psychiatry in China and the influential factors.

Method

This multicenter study was conducted in 26 medical schools in China from May to October of 2019. Participants included 4610 medical students majoring in psychiatry and 3857 medical students majoring in clinical medicine. Multivariable logistic regression was used to investigate the influential factors of students’ choices of psychiatry at matriculation and as a career.

Results

44.08% of psychiatry majored students gave psychiatry as a first choice at matriculation, and 56.67% of them would choose psychiatry as a career, which was in sharp contrast to the proportion of clinical medicine majored students who would choose psychiatry as a career (0.69%). Personal interest (59.61%), suggestions from family members (27.96%), and experiencing mental problems (23.19%) were main reasons for choosing psychiatry major at matriculation. Personal interest (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.87–2.40), experiencing a psychiatry clerkship (OR = 1.99, 95% CI = 1.28–3.08), being female (OR = 1.50, 95% CI = 1.30–1.68), experiencing mental problems (OR = 1.33, 95% CI = 1.28–1.56), and suggestions from family members (OR = 1.25, 95% CI = 1.08–1.46) correlated positively with students’ choice of psychiatry as career. Students who lacked psychiatry knowledge (OR = 0.49, 95% CI = 0.29–0.85) or chose psychiatry because of lower admission scores (OR = 0.80, 95% CI = 0.63–0.97) were less likely to choose psychiatry as a career.

Conclusion

More than half of psychiatry majored medical school students planned to choose psychiatry as their career, whereas very few students in the clinic medicine major would make this choice. Increasing students’ interest in psychiatry, strengthening psychiatry clerkships, and popularizing psychiatric knowledge are modifiable factors to increase the psychiatry career intention. The extent to which medical students’ attitudes toward psychiatry can be changed through medical school education and greater exposure to psychiatry will need further investigation.
Predictive model of multiple emergency department visits among adults: analysis of the data from the National Survey of Drug Use and Health (NSDUH)
Authors: Bobashev Georgiy , Warren Lauren , Wu Li-Tzy
Published: March 2021

Background

In this methodological paper, we use a novel, predictive approach to examine how demographics, substance use, mental and other health indicators predict multiple visits (≥3) to emergency departments (ED) within a year.

Methods

State-of-the-art predictive methods were used to evaluate predictive ability and factors predicting multiple visits to ED within a year and to identify factors that influenced the strength of the prediction. The analysis used public-use datasets from the 2015–2018 National Surveys on Drug Use and Health (NSDUH), which used the same questionnaire on the variables of interest. Analysis focused on adults aged ≥18 years. Several predictive models (regressions, trees, and random forests) were validated and compared on independent datasets.

Results

Predictive ability on a test set for multiple ED visits (≥3 times within a year) measured as the area under the receiver operating characteristic (ROC) reached 0.8, which is good for a national survey. Models revealed consistency in predictive factors across the 4 survey years. The most influential variables for predicting ≥3 ED visits per year were fair/poor self-rated health, being nervous or restless/fidgety, having a lower income, asthma, heart condition/disease, having chronic obstructive pulmonary disease (COPD), nicotine dependence, African-American race, female sex, having diabetes, and being of younger age (18–20).

Conclusions

The findings reveal the need to address behavioral and mental health contributors to ED visits and reinforce the importance of developing integrated care models in primary care settings to improve mental health for medically vulnerable patients. The presented modeling approach can be broadly applied to national and other large surveys.
Outcomes of pregnancy-related referrals from rural health facilities to two central hospitals in Harare, Zimbabwe: a prospective descriptive study
Authors: Busumani William , Mundagowa Paddington T.
Published: March 2021

Background

Between the years 2000 and 2017, the global maternal mortality rate dropped by 38% however, 94% of maternal deaths still emanated from low-to middle-income countries. Rural women are at a significantly higher risk of dying from pregnancy when compared to their urban counterparts. Early detection of complications and prompt referral to higher levels of care can reduce the associated maternal and perinatal mortality. This study aimed to determine the maternal and perinatal outcomes of pregnancy-related referrals from rural health facilities to central hospitals in Harare, Zimbabwe.

Methods

A prospective descriptive study was conducted using a sample of 206 patients. All mothers who were referred from rural healthcare facilities were recruited for participation. Data were extracted from patient notes using a structured questionnaire and missing information was obtained from the mother after she had recovered. Bivariate analysis was done using IBM SPSS.

Results

The average age of study participants was 27.4 ± 7.7 years. 87.4% had booked for antenatal care and 81.6% presented to the tertiary facility with their referral notes. The major reasons for referring patients were previous cesarean section (20.4%) and hypertensive disorders in pregnancy (18.4%). There were nine maternal deaths thus a case fatality rate of 4.4% while the perinatal mortality rate was 151/1000 live births. Young mothers were at a higher risk of having adverse perinatal outcomes while primiparous mothers were more likely to have a blood transfusion. Mothers who traveled for > 100 km to the tertiary facility and those who did not attend any antenatal visit were more likely to need blood transfusion. Delivering at the rural health facility was significantly associated with receiving a blood transfusion at the tertiary facility. Mothers who did not attend antenatal visits were more likely to have negative perinatal outcomes.

Conclusion

The proportion of obstetric patients being referred from rural facilities to tertiary institutions for complications reveals how primary and secondary healthcare facilities in Zimbabwe are falling short of offering the services they should be offering. Equipping these facilities with skilled human resources as well as contemporary equipment could help decongest the central hospitals consequently reducing the adverse maternal and perinatal outcomes.
Defining safety net hospitals in the health services research literature: a systematic review and critical appraisal
Authors: Hefner Jennifer L. , Hogan Tory Harper , Opoku-Agyeman William , Menachemi Nir
Published: March 2021

Background

The aim of this study was to identify the range of ways that safety net hospitals (SNHs) have been empirically operationalized in the literature and determine the extent to which patterns could be identified in the use of empirical definitions of SNHs.

Methods

We conducted a PRISMA guided systematic review of studies published between 2009 and 2018 and analyzed 22 articles that met the inclusion criteria of hospital-level analyses with a clear SNH definition.

Results

Eleven unique SNH definitions were identified, and there were no obvious patterns in the use of a definition category (Medicaid caseload, DSH payment status, uncompensated care, facility characteristics, patient care mix) by the journal type where the article appeared, dataset used, or the year of publication.

Conclusions

Overall, there is broad variability in the conceptualization of, and variables used to define, SNHs. Our work advances the field toward the development of standards in measuring, operationalizing, and conceptualizing SNHs across research and policy questions.
The transcriptional trajectories of pluripotency and differentiation comprise genes with antithetical architecture and repetitive-element content
Authors: Telonis Aristeidis G. , Rigoutsos Isidore
Published: March 2021

Background

Extensive molecular differences exist between proliferative and differentiated cells. Here, we conduct a meta-analysis of publicly available transcriptomic datasets from preimplantation and differentiation stages examining the architectural properties and content of genes whose abundance changes significantly across developmental time points.

Results

Analysis of preimplantation embryos from human and mouse showed that short genes whose introns are enriched in Alu (human) and B (mouse) elements, respectively, have higher abundance in the blastocyst compared to the zygote. These highly expressed genes encode ribosomal proteins or metabolic enzymes. On the other hand, long genes whose introns are depleted in repetitive elements have lower abundance in the blastocyst and include genes from signaling pathways. Additionally, the sequences of the genes that are differentially expressed between the blastocyst and the zygote contain distinct collections of pyknon motifs that differ between up- and down-regulated genes. Further examination of the genes that participate in the stem cell-specific protein interaction network shows that their introns are short and enriched in Alu (human) and B (mouse) elements. As organogenesis progresses, in both human and mouse, we find that the primarily short and repeat-rich expressed genes make way for primarily longer, repeat-poor genes. With that in mind, we used a machine learning-based approach to identify gene signatures able to classify human adult tissues: we find that the most discriminatory genes comprising these signatures have long introns that are repeat-poor and include transcription factors and signaling-cascade genes. The introns of widely expressed genes across human tissues, on the other hand, are short and repeat-rich, and coincide with those with the highest expression at the blastocyst stage.

Conclusions

Protein-coding genes that are characteristic of each trajectory, i.e., proliferation/pluripotency or differentiation, exhibit antithetical biases in their intronic and exonic lengths and in their repetitive-element content. While the respective human and mouse gene signatures are functionally and evolutionarily conserved, their introns and exons are enriched or depleted in organism-specific repetitive elements. We posit that these organism-specific repetitive sequences found in exons and introns are used to effect the corresponding genes’ regulation.
H3K27 modifiers regulate lifespan in C. elegans in a context-dependent manner
Authors: Guillermo Abigail R. R. , Chocian Karolina , Gavriilidis Gavriil , Vandamme Julien , Salcini Anna Elisabetta , Mellor Jane , Woollard Alison
Published: March 2021

Background

Evidence of global heterochromatin decay and aberrant gene expression in models of physiological and premature ageing have long supported the “heterochromatin loss theory of ageing”, which proposes that ageing is aetiologically linked to, and accompanied by, a progressive, generalised loss of repressive epigenetic signatures. However, the remarkable plasticity of chromatin conformation suggests that the re-establishment of such marks could potentially revert the transcriptomic architecture of animal cells to a “younger” state, promoting longevity and healthspan. To expand our understanding of the ageing process and its connection to chromatin biology, we screened an RNAi library of chromatin-associated factors for increased longevity phenotypes.

Results

We identified the lysine demethylases jmjd-3.2 and utx-1, as well as the lysine methyltransferase mes-2 as regulators of both lifespan and healthspan in C. elegans. Strikingly, we found that both overexpression and loss of function of jmjd-3.2 and utx-1 are all associated with enhanced longevity. Furthermore, we showed that the catalytic activity of UTX-1, but not JMJD-3.2, is critical for lifespan extension in the context of overexpression. In attempting to reconcile the improved longevity associated with both loss and gain of function of utx-1, we investigated the alternative lifespan pathways and tissue specificity of longevity outcomes. We demonstrated that lifespan extension caused by loss of utx-1 function is daf-16 dependent, while overexpression effects are partially independent of daf-16. In addition, lifespan extension was observed when utx-1 was knocked down or overexpressed in neurons and intestine, whereas in the epidermis, only knockdown of utx-1 conferred improved longevity.

Conclusions

We show that the regulation of longevity by chromatin modifiers can be the result of the interaction between distinct factors, such as the level and tissue of expression. Overall, we suggest that the heterochromatin loss model of ageing may be too simplistic an explanation of organismal ageing when molecular and tissue-specific effects are taken into account.
Frequency and functional translation of low muscle mass in overweight and obese patients with COPD
Authors: Machado Felipe V. C. , Spruit Martijn A. , Groenen Miriam T. J. , Houben-Wilke Sarah , van Melick Paula P. , Hernandes Nidia A. , Schols Annemie M. W. J. , Pitta Fabio , Wouters Emiel F. M. , Franssen Frits M. E.
Published: March 2021

Background

Cut offs for fat-free mass index (FFMI) and appendicular skeletal muscle mass index (ASMI) are available for diagnosing low muscle mass in patients with COPD. This study aimed to investigate: (1) the frequency of low muscle mass (FFMI and ASMI) applying different cut-offs and (2) the functional translation (clinical impact) of low muscle mass, in patients with COPD stratified into BMI categories.

Methods

Patients with COPD were assessed regarding body composition, exercise capacity, quadriceps muscle strength, symptoms of anxiety and depression, dyspnea and quality of life upon referral to pulmonary rehabilitation. The proportion of patients with low muscle mass was compared among BMI categories. Clinical outcomes between patients with normal and low muscle mass within each BMI category were compared.

Results

469 patients with COPD were included for analyses. The frequency of patients classified as low FFMI varied significantly according to the choice of cut-off (32 to 54%; P < 0.05), whereas the frequency of patients with low ASMI was 62%. When applying age-gender-BMI-specific cut-offs, 254 patients (54%) were classified as low FFMI. The choice of the cut-off affected the frequency of patients with low muscle mass in all BMI categories. Overweight and obese patients with low muscle mass were more frequently males and presented worse pulmonary function, exercise capacity and muscle strength compared with overweight and obese patients with normal muscle mass.

Conclusions

Approximately half of the overweight and obese patients with COPD have low muscle mass when applying age-gender-BMI-specific cut-offs. Low muscle mass is associated with worse functional outcomes in overweight and obese COPD patients.
Identification of a tumor microenvironment-related gene signature to improve the prediction of cervical cancer prognosis
Authors: Chen Qian , Qiu Bingqing , Zeng Xiaoyun , Hu Lang , Huang Dongping , Chen Kaihua , Qiu Xiaoqiang
Published: March 2021

Background

Previous studies have found that the microenvironment of cervical cancer (CESC) affects the progression and treatment of this disease. Thus, we constructed a multigene model to assess the survival of patients with cervical cancer.

Methods

We scored 307 CESC samples from The Cancer Genome Atlas (TCGA) and divided them into high and low matrix and immune scores using the ESTIMATE algorithm for differential gene analysis. Cervical cancer patients were randomly divided into a training group, testing group and combined group. The multigene signature prognostic model was constructed by Cox analyses. Multivariate Cox analysis was applied to evaluate the significance of the multigene signature for cervical cancer prognosis. Prognosis was assessed by Kaplan–Meier curves comparing the different groups, and the accuracy of the prognostic model was analyzed by receiver operating characteristic-area under the curve (ROC-AUC) analysis and calibration curve. The Tumor Immune Estimation Resource (TIMER) database was used to analyze the relationship between the multigene signature and immune cell infiltration.

Results

We obtained 420 differentially expressed genes in the tumor microenvironment from 307 patients with cervical cancer. A three-gene signature (SLAMF1, CD27, SELL) model related to the tumor microenvironment was constructed to assess patient survival. Kaplan–Meier analysis showed that patients with high risk scores had a poor prognosis. The ROC-AUC value indicated that the model was an accurate predictor of cervical cancer prognosis. Multivariate cox analysis showed the three-gene signature to be an independent risk factor for the prognosis of cervical cancer. A nomogram combining the three-gene signature and clinical features was constructed, and calibration plots showed that the nomogram resulted in an accurate prognosis for patients. The three-gene signature was associated with T stage, M stage and degree of immune infiltration in patients with cervical cancer.

Conclusions

This research suggests that the developed three-gene signature may be applied as a biomarker to predict the prognosis of and personalized therapy for CESC.
Validation of SYBR green I based closed‐tube loop‐mediated isothermal amplification (LAMP) assay for diagnosis of knowlesi malaria
Authors: Lai Meng Yee , Ooi Choo Huck , Lau Yee Ling
Published: March 2021

Background

As an alternative to PCR methods, LAMP is increasingly being used in the field of molecular diagnostics. Under isothermal conditions at 65 °C, the entire procedure takes approximately 30 min to complete. In this study, we establish a sensitive and visualized LAMP method in a closed-tube system for the detection ofPlasmodium knowlesi.

Methods

A total of 71 malaria microscopy positive blood samples collected in blood spots were obtained from the Sarawak State Health Department. Using18s rRNAas the target gene, nested PCR and SYBR green I LAMP assay were performed following the DNA extraction. The colour changes of LAMP end products were observed by naked eyes.

Results

LAMP assay demonstrated a detection limit of 10 copies/µL in comparison with 100 copies/µL nested PCR. Of 71P. knowlesiblood samples collected, LAMP detected 69 microscopy-positive samples. LAMP exhibited higher sensitivity than nested PCR assay. The SYBR green I LAMP assay was 97.1% sensitive (95% CI 90.2–99.7%) and 100% specific (95% CI 83.2–100%). Without opening the cap, incorporation of SYBR green I into the inner cap of the tube enabled the direct visualization of results upon completion of amplification. The positives instantaneously turned green while the negatives remained orange.

Conclusions

These results indicate that SYBR green I LAMP assay is a convenient diagnosis tool for the detection ofP. knowlesiin remote settings.
Retraction Note to: Antimicrobial misuse in pediatric urinary tract infections: recurrences and renal scarring
Authors: Jayaweera Jayaweera Arachchige Asela Sampath , Reyes Mohommed
Published: March 2021

This article has been
retracted. Please see the Retraction Notice for more detail:
https://doi.org/10.1186/s12941-018-0279-4
Thrombotic antiphospholipid syndrome in a child with human immunodeficiency virus: a rare case report
Authors: Dong Rong-Jing , Lei Su-Yun , Li Jun , Yang Xin-Ping , Li Yu-Ye , Zhang Yun-Gui
Published: March 2021

Background

Antiphospholipid syndrome (APS) is a non-inflammatory autoimmune disorder induced by antiphospholipid antibodies, which occurs exceedingly rarely in pediatric population and even more rarely reported in HIV positive children.

Case summary

A case of 11 years old boy had a sudden onset of swelling in his left lower leg along with pain which were worsening gradually. Initially, topical ointment was applied for 1 month which were ineffective in reducing pain and swelling. Instead, the symptoms were aggravated and suddenly spread to the proximal thigh, accompanied by dyskinesia of left lower leg. Both color doppler ultrasonography and vascular CT scan of left lower leg revealed deep venous thrombosis. His serum anti-phospholipid antibodies (aPLs) were tested positive. He was a known case of HIV virological failure with substantial HIV viral load (VL) despite receiving regular antiretroviral therapy (ART). His symptoms improved after giving aggressive antithrombotic and high dose corticosteroid treatments.

Conclusion

When pediatric patients develop thrombotic disease, APS also needs to be ruled out. The autoantibodies levels should be routinely tested to look for recurrent thrombosis in children with HIV/AIDS.
What do Australian adults eat for breakfast? A latent variable mixture modelling approach for understanding combinations of foods at eating occasions
Authors: Leech Rebecca M. , Boushey Carol J. , McNaughton Sarah A.
Published: March 2021

Background

The patterning of food intake at eating occasions is a poorly understood, albeit important, step towards achieving a healthy dietary pattern. However, to capture the many permutations of food combinations at eating occasions, novel analytic approaches are required. We applied a latent variable mixture modelling (LVMM) approach to understand how foods are consumed in relation to each other at breakfast.

Methods

Dietary intake at breakfast (n = 8145 occasions) was assessed via 24-h recall during the 2011–12 Australian National Nutrition and Physical Activity Survey (n = 3545 men and n = 4127 women, ⩾19 y). LVMM was used to determine breakfast food profiles based on 35 food group variables, reflecting compliance with Australian Dietary Guidelines. F and adjusted-chi2 tests assessed differences in timing of consumption and participant characteristics between the breakfast profiles. Regression models, adjusted for covariates, were used to examine associations between breakfast food profiles and objective adiposity measures (BMI and waist circumference).

Results

Five distinct profiles were found. Three were similar for men and women. These were labelled: “Wholegrain cereals and milks” (men: 16%, women: 17%), “Protein-foods” (men and women: 11%) and “Mixed cereals and milks” (men: 33%, women: 37%). Two “Breads and spreads” profiles were also found that were differentiated by their accompanying beverages (men) or type of grain (women). Profiles were found to vary by timing of consumption, participant characteristics and adiposity indicators. For example, the “Protein-foods” profile occurred more frequently on weekends and after 9 am. Men with a “Bread and spreads (plus tea/coffee)” profile were older (P < 0.001) and had lower income and education levels (P < 0.05), when compared to the other profiles. Women with a “Protein-foods” profile were younger (P < 0.001) and less likely to be married (P < 0.01). Both men and women with a “Wholegrain cereals and milks” profile had the most favourable adiposity estimates (P < 0.05).

Conclusions

We identified five breakfast food profiles in adults that varied by timing of consumption, participant characteristics and adiposity indicators. LVMM was a useful approach for capturing the complexity of food combinations at breakfast. Future research could collect contextual information about eating occasions to understand the complex factors that influence food choices.
Multi-omics characterization and validation of invasiveness-related molecular features across multiple cancer types
Authors: Bi Guoshu , Liang Jiaqi , Zheng Yuansheng , Li Runmei , Zhao Mengnan , Huang Yiwei , Zhan Cheng , Xu Songtao , Fan Hong
Published: March 2021

Background

Tumor invasiveness reflects many biological changes associated with tumorigenesis, progression, metastasis, and drug resistance. Therefore, we performed a systematic assessment of invasiveness-related molecular features across multiple human cancers.

Materials and methods

Multi-omics data, including gene expression, miRNA, DNA methylation, and somatic mutation, in approximately 10,000 patients across 30 cancer types from The Cancer Genome Atlas, Gene Expression Omnibus, PRECOG, and our institution were enrolled in this study.

Results

Based on a robust gene signature, we established an invasiveness score and found that the score was significantly associated with worse prognosis in almost all cancers. Then, we identified common invasiveness-associated dysregulated molecular features between high- and low-invasiveness score group across multiple cancers, as well as investigated their mutual interfering relationships thus determining whether the dysregulation of invasiveness-related genes was caused by abnormal promoter methylation or miRNA expression. We also analyzed the correlations between the drug sensitivity data from cancer cell lines and the expression level of 685 invasiveness-related genes differentially expressed in at least ten cancer types. An integrated analysis of the correlations among invasiveness-related genetic features and drug response were conducted in esophageal carcinoma patients to outline the complicated regulatory mechanism of tumor invasiveness status in multiple dimensions. Moreover, functional enrichment suggests the invasiveness score might serve as a predictive biomarker for cancer patients receiving immunotherapy.

Conclusion

Our pan-cancer study provides a comprehensive atlas of tumor invasiveness and may guide more precise therapeutic strategies for tumor patients.
Variability in phenotype and response to treatment in chronic nonbacterial osteomyelitis; the Irish experience of a national cohort
Authors: O’Leary Daire , Wilson Anthony G. , MacDermott Emma-Jane , Lowry Clodagh , Killeen Orla G.
Published: March 2021

Background

Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory disease affecting bone with considerable phenotypic heterogeneity and variable association with other autoinflammatory conditions. Disease pathogenesis is incompletely understood, and treatment protocols vary between physicians with no clinical treatment guidelines available prior to 2017. Although CNO was previously considered benign, it is now clear that long-term sequelae do occur.

The aim of this study is to provide a detailed phenotypic description of children and adolescents with CNO who attended tertiary paediatric rheumatology services in Ireland between September 2017 and September 2019, their disease course, treatment and outcomes.

Methods

This study involved retrospective review of clinical notes, laboratory, radiology and histology results of Irish children and adolescents with CNO who are currently attending tertiary paediatric rheumatology services. The Bristol diagnostic criteria were applied retrospectively; only patients who met these criteria were included. Criteria for remission and partial response were based on the Childhood Arthritis and Rheumatology Research Alliance (CARRA) criteria for treatment failure.

Results

Forty-four children and adolescents were recruited. Demographics in terms of age of onset, gender and number of sites were similar to those previously reported. Overall, 18/44 (40.9%) had extraosseous manifestations associated with CNO; 12/44 (27.2%) had cutaneous involvement. All patients received a regular nonsteroidal anti-inflammatory drug (NSAID) after diagnosis with 27/44 (61.4%) requiring at least 1 second-line medication. Second-line agents used in this cohort were bisphosphonates, methotrexate and TNF-blockers. No patients received systemic corticosteroids.

Conclusion

This national cohort showed a high prevalence of extraosseous involvement and a low response rate to NSAID treatment. This may reflect a more inflammatory phenotype and highlights the need to define different subtypes of CNO.
The mediated effect of HIV risk perception in the relationship between peer education and HIV testing uptake among three key populations in China
Authors: Lin Yuxi , Li Chuanxi , Wang Lin , Jiao Kedi , Ma Wei
Published: March 2021

Background

Peer education and HIV risk perception are related to HIV testing uptake among key populations. We aimed to examine the association between peer education, HIV risk perception, and HIV testing uptake, as well as to evaluate the mediated effect of HIV risk perception in the relationship between peer education and HIV testing uptake.

Methods

We conducted a cross-sectional survey among 1188 HIV-uninfected or unknown participants from populations of men who have sex with men (MSM), female sex workers (FSWs), and drug users (DUs) in seven cities of China. Partial correlation analysis and regression analysis were employed to examine the associations among peer education, HIV risk perception, and HIV testing uptake. Mediation analysis was conducted to assess whether HIV risk perception mediated the hypothesized association.

Results

Receiving peer education was associated with higher odds of HIV testing uptake among MSM, FSWs and DUs. Perceiving risk of HIV infection was associated with higher odds of HIV testing uptake among MSM and DUs. Among MSM, the relationship between peer education and HIV testing uptake was mediated by moderate risk perception of HIV (indirect effect: 0.53, 95% CI 0.07 to 1.21), and by high risk perception of HIV (indirect effect: 0.50, 95% CI 0.01 to 1.17). Among DUs, the relationship between peer education and HIV testing uptake was mediated by moderate risk perception of HIV (indirect effect: 1.80, 95% CI 0.57 to 3.45).

Conclusions

Participants who received peer education tended to perceive their risk of HIV infection, which in turn was associated with increased HIV testing uptake among MSM and DUs. Therefore, in addition to peer education interventions, more report about HIV epidemic and risk assessment should also be scaled up to enhance HIV risk perception among key populations.
Factors associated with dynamic balance in people with Persistent Postural Perceptual Dizziness (PPPD): a cross-sectional study using a virtual-reality Four Square Step Test
Authors: Aharoni Moshe M. H. , Lubetzky Anat V. , Arie Liraz , Krasovsky Tal
Published: March 2021

Background

Persistent postural-perceptual dizziness (PPPD) is a condition characterized by chronic subjective dizziness and exacerbated by visual stimuli or upright movement. Typical balance tests do not replicate the environments known to increase symptoms in people with PPPD—crowded places with moving objects. Using a virtual reality system, we quantified dynamic balance in people with PPPD and healthy controls in diverse visual conditions.

Methods

Twenty-two individuals with PPPD and 29 controls performed a square-shaped fast walking task (Four-Square Step Test Virtual Reality—FSST-VR) using a head-mounted-display (HTC Vive) under 3 visual conditions (empty train platform; people moving; people and trains moving). Head kinematics was used to measure task duration, movement smoothness and anterior–posterior (AP) and medio-lateral (ML) ranges of movement (ROM). Heart rate (HR) was monitored using a chest-band. Participants also completed a functional mobility test (Timed-Up-and-Go; TUG) and questionnaires measuring anxiety (State-Trait Anxiety Inventory; STAI), balance confidence (Activities-Specific Balance Confidence; ABC), perceived disability (Dizziness Handicap Inventory) and simulator sickness (Simulator Sickness Questionnaire). Main effects of visual load and group and associations between performance, functional and self-reported outcomes were examined.

Results

State anxiety and simulator sickness did not increase following testing. AP-ROM and HR increased with high visual load in both groups (p < 0.05). There were no significant between-group differences in head kinematics. In the high visual load conditions, high trait anxiety and longer TUG duration were moderately associated with reduced AP and ML-ROM in the PPPD group and low ABC and  high perceived disability were associated with reduced AP-ROM (|r| =  0.47 to 0.53; p < 0.05). In contrast, in controls high STAI-trait, low ABC and longer TUG duration were associated with increased AP-ROM (|r| = 0.38 to 0.46; p < 0.05) and longer TUG duration was associated with increased ML-ROM (r = 0.53, p < 0.01).

Conclusions

FSST-VR may shed light on movement strategies in PPPD beyond task duration. While no main effect of group was observed, the distinct associations with self-reported and functional outcomes, identified using spatial head kinematics, suggest that some people with PPPD reduce head degrees of freedom when performing a dynamic balance task. This supports a potential link between spatial perception and PPPD symptomatology.