bluuebunny/crossref_metadata_2025 huggingface dataset:
Obesity Duration and Cardiometabolic Disease
Authors: Sidhu Sharnendra K. , Aleman Jose O. , Heffron Sean P.
Published: August 2023

Cardiovascular disease risk is known to be influenced by both the severity of a risk factor and the duration of exposure (eg, LDL [low-density lipoprotein] cholesterol, tobacco smoke). However, this concept has been largely neglected within the obesity literature. While obesity severity has been closely linked with cardiometabolic diseases, the risk of developing these conditions among those with obesity may be augmented by greater obesity duration over the life span. Few longitudinal or contemporary studies have investigated the influence of both factors in combination—cumulative obesity exposure—instead generally focusing on obesity severity, often at a single time point, given ease of use and lack of established methods to encapsulate duration. Our review focuses on what is known about the influence of the duration of exposure to excess adiposity within the obesity-associated cardiometabolic disease risk equation by means of summarizing the hypothesized mechanisms for and evidence surrounding the relationships of obesity duration with diverse cardiovascular and metabolic disease. Through the synthesis of the currently available data, we aim to highlight the importance of a better understanding of the influence of obesity duration in cardiovascular and metabolic disease pathogenesis. We underscore the clinical importance of aggressive early attention to obesity identification and intervention to prevent the development of chronic diseases that arise from exposure to excess body weight.
Extracellular Matrix Stiffness Regulates Microvascular Stability by Controlling Endothelial Paracrine Signaling to Determine Pericyte Fate
Authors: Yu Yali , Leng Yu , Song Xiuyue , Mu Jie , Ma Lei , Yin Lin , Zheng Yu , Lu Yi , Li Yuanming , Qiu Xuefeng , Zhu Hai , Li Jing , Wang Dong
Published: August 2023

BACKGROUND:

The differentiation of pericytes into myofibroblasts causes microvascular degeneration, ECM (extracellular matrix) accumulation, and tissue stiffening, characteristics of fibrotic diseases. It is unclear how pericyte-myofibroblast differentiation is regulated in the microvascular environment. Our previous study established a novel 2-dimensional platform for coculturing microvascular endothelial cells (ECs) and pericytes derived from the same tissue. This study investigated how ECM stiffness regulated microvascular ECs, pericytes, and their interactions.

METHODS:

Primary microvessels were cultured in the TGM2D medium (tubular microvascular growth medium on 2-dimensional substrates). Stiff ECM was prepared by incubating ECM solution in regular culture dishes for 1 hour followed by PBS wash. Soft ECM with Young modulus of ≈6 kPa was used unless otherwise noted. Bone grafts were prepared from the rat skull. Immunostaining, RNA sequencing, RT-qPCR (real-time quantitative polymerase chain reaction), Western blotting, and knockdown experiments were performed on the cells.

RESULTS:

Primary microvascular pericytes differentiated into myofibroblasts (NG2
+
αSMA
+
) on stiff ECM, even with the TGFβ (transforming growth factor beta) signaling inhibitor A83-01. Soft ECM and A83-01 cooperatively maintained microvascular stability while inhibiting pericyte-myofibroblast differentiation (NG2
+
αSMA
−/low
). We thus defined 2 pericyte subpopulations: primary (NG2
+
αSMA
−/low
) and activated (NG2
+
αSMA
+
) pericytes. Soft ECM promoted microvascular regeneration and inhibited fibrosis in bone graft transplantation in vivo. As integrins are the major mechanosensor, we performed RT-qPCR screening of integrin family members and found Itgb1 (integrin β1) was the major subunit downregulated by soft ECM and A83-01 treatment. Knocking down
Itgb1
suppressed myofibroblast differentiation on stiff ECM. Interestingly, ITGB1 phosphorylation (Y783) was mainly located on microvascular ECs on stiff ECM, which promoted EC secretion of paracrine factors, including CTGF (connective tissue growth factor), to induce pericyte-myofibroblast differentiation. CTGF knockdown or monoclonal antibody treatment partially reduced myofibroblast differentiation, implying the participation of multiple pathways in fibrosis formation.

CONCLUSIONS:

ECM stiffness and TGFβ signaling cooperatively regulate microvascular stability and pericyte-myofibroblast differentiation. Stiff ECM promotes EC ITGB1 phosphorylation (Y783) and CTGF secretion, which induces pericyte-myofibroblast differentiation.
Checklist, typification details, and nomenclature status of ascomycetous fungi originally described in Sri Lanka
Authors: WIJAYAWARDENE NALIN N. , DAI DONG-QIN , PREMARATHNE BHAGYA M. , WIMALASENA MADHARA K. , JAYALAL R.G. UDENI , WICKRAMANAYAKE KAWMINI D. , DANGALLA HASANKA , JAYATHUNGA W. HASHINI , BRAHMANAGE RASHIKA S. , KARUNARATHNA SAMANTHA C. , WEERAKOON GOTHAMIE , ARIYAWANSA KAHANDAWA G.S.U. , YAPA P. NEELAMANIE , MADAWALA SUMEDHA , NANAYAKKARA CHANDRIKA M. , FAN XIN-LEI , KIRK PAUL M. , ZHANG GUI-QING , EDIRIWEERA ASENI , BHAT D. JAYARAMA , DAWOUD TURKI M. , TIBPROMMA SAOWALUCK , WIJESUNDARA D.S.A.
Published: August 2023

Despite being a biodiversity-rich country, Sri Lanka’s fungal diversity remains largely unexplored. In the 19th century, British mycologists conducted extensive research, leading to the identification of more than 1,800 fungal taxa, including ascomycetous and basidiomycetous species. However, the majority of these taxa have not been revisited since their initial description, and molecular evidence is lacking. Moreover, a significant number of fungal taxa have been deemed invalid or illegitimate, indicating the need for a nomenclatural revision. To address this knowledge gap, this review provides a comprehensive list of ascomycetous taxa (including both lichen-forming and non-lichenized) that were originally described in Sri Lanka. Names are listed according to the original names which were included in the protologue. In the cases where species have been transferred to other genera, the current names and new classifications are provided. The typification details, nomenclature status, and classification are also presented. This checklist will serve as a valuable resource for the future epitypification of old taxa, as much of the existing information is poorly documented and scattered.
3. 1905–09: Experiment and Adversity
Authors: Mallinson Jonathan
Published: August 2023

In the years following success at St Louis, Moorcroft’s designs began to follow two distinct paths: some appealing to the contemporary nostalgia for eighteenth-century elegance, others developing more innovative and experimental ideas. One of his most radical creations, named ‘Flamminian’ ware, reduced ornament to a simple roundel, and focussed attention on form and glaze; it was an uncompromising challenge to the swirling lines of Art Nouveau, and was a great success both at home and in the US. Reviews published in the UK, France and Canada regularly distinguished Moorcroft’s work from much art pottery, underlining the originality of his decorative technique, the quality of his colours, and the integrity of his designs. It is a mark of his growing international reputation that he was invited to write an article for the newly founded American Pottery Gazette. But even as his reputation grew, the first signs of tension with H. Watkin, Director and General Manager at Macintyre’s, can be seen between the lines of reviews in the Pottery Gazette, where Moorcroft’s name was increasingly subordinated to that of Macintyre’s. Factory Minutes show that Watkin was tabling proposals to close down Moorcroft’s department from as early as 1905, to the evident surprise of the other Directors; surviving financial documents suggest that the reason was not the unprofitability of the Ornamental ware, as Watkin would affirm.
7. 1914–18: The Art of Survival
Authors: Mallinson Jonathan
Published: August 2023

This chapter follows Moorcroft through the war, and examines his different strategies for survival and development in challenging conditions. He is seen to expand his commercial outlets, both at home and abroad, taking full advantage of the newly established British Industries Fair(s); his displays attracted the attention of new high-end retailers, and, very significantly, of Queen Mary. We witness, too, his resourcefulness in securing government contracts to supply inhalers and other functional objects, enabling him to minimise (though not to avoid) the depletion of his workforce. Extensive correspondence and other contemporary documents reveal the impact of rising costs, shortage of materials, increasingly slow payment of invoices, and the loss of labour through conscription or compulsory redeployment; such pressures were exacerbated, by cruel coincidence, by the death of his (one) thrower. We explore, too, the significance of Moorcroft’s commitment to handcraft against the background of the Design and Industries Association, founded in 1915 in response to a growing concern about the need for more mechanised modes of production in a post-war world. Moorcroft explored the viability of creating by hand pottery both beautiful and useful in a modern industrial world. In the course of the war, his work was commercially successful, his sensitivity to the public mood eloquently expressed in his designs, and regularly praised in reviews. He was treading his own individual path, well prepared to confront the economic and cultural turbulence of the 1920s.
9. 1924–25: Recognition of the Artist Potter
Authors: Mallinson Jonathan
Published: August 2023

This chapter explores the development of Moorcroft’s work against the background of two major international exhibitions: the British Empire Exhibition at Wembley in 1924, and the Exposition des arts décoratifs et industriels in Paris the following year. His high-profile involvement in the Wembley exhibition, epitomised in his magnificent stand designed by Edward Maufe, was one of the landmarks of his career. His display enhanced his reputation as a ceramic artist, culminating in an article published in the Daily Graphic entitled ‘A Potter of Genius’. Surviving reports written to Moorcroft three or four times a week by his two assistants record the impact made by his ware on the many visitors to the stand, from celebrities to ordinary members of the public. Such was Moorcroft’s status as one of the country’s most innovative potters that he was put under considerable pressure by the Board of Trade to exhibit at the Paris Exhibition. This event would become a focus for extensive reflection about the need to modernise British industrial design. While some argued for the aesthetic and economic benefits of following more closely the European and Scandinavian styles in evidence at the Paris Exhibition, Moorcroft did not. He set out his position in a letter to The Times, arguing for design primarily as a mode of self-expression, not of commercial expediency. For all that his work did not follow the trends of ‘modern’ style, it was nevertheless awarded a Gold Medal at the Exhibition. These are the years of Moorcroft’s greatest commercial success, but this was not the basis of his reputation. He was admired for his distinctive, expressive art, described in one review as ‘cogent and articulate’.
Conclusion: Individuality by Design
Authors: Mallinson Jonathan
Published: August 2023

If Moorcroft is rarely considered in books on twentieth-century pottery, it is largely because he falls outside the categories of ‘studio potter’ or ‘ceramic designer’ as commonly conceived. It is significant that he was described in one obituary as a ‘post-Morrisite’. If Morris’s legacy was being sensed both in industrial modernism (by Pevsner) and in the revival of craft (by Leach), Moorcroft was seen by some as another variant on that legacy, bringing together individualised craft and serial production in ways which even Morris did not achieve, and creating well-designed, hand-made objects for more than a privileged few. Although he was clearly not responsible for all aspects of production (like the single craftsman), his practice of divided labour, in which he himself was actively involved as both designer and chemist, brought pottery closer to a performance art than a production line. Design for Moorcroft was not a rigid template, but open to his own (frequent) modifications in line or colour, just as each enactment was subject to the inevitable variations of ware made by hand and fired in a kiln; each piece was individual, and none definitive. Moorcroft is characterised by his individuality, not just because his practice was different, but because his pottery was personal. His designs, so often singled out for their harmony of form, ornament and colour were the conception of a single mind, informed by a potter’s skill – which is why some described him at the time as a studio potter. But they were informed, too, by his sense of vocation. His writings, both private and published, reveal that he did not aspire to be a pioneer, but simply to be himself, and to share with others his sensitivity to the beauty of the natural world. This is the source of the expressiveness, authenticity or ‘soulfulness’ so often identified in his work, and which make of it, as one contemporary noted, ‘no ordinary pottery’.
Introduction: William Moorcroft, Potter
Authors: Mallinson Jonathan
Published: August 2023

This sketches the distinctive individuality of William Moorcroft, one of the most celebrated and original potters of the early twentieth century. An active designer, ceramic chemist and manufacturer, he is seen to be different from contemporary ‘art potters’ who tended to be either decorators or chemists, but not both. From the start of his career he was recognised as a potter like no other, but this distinctiveness has been eroded in modern assessments which present him as a manufacturer rather than an artist, and his pottery as a trading commodity rather than as personal expression. This book seeks to recover that very individual potter.
Weathergami
Authors: Kahl Jonathan D. W.
Published: August 2023

Adapted from the sports concept of scorigami, the weathergami chart is introduced. Weathergami charts depict the frequency of occurrence of the full range of daily maximum and minimum temperature combinations observed at a location. These charts highlight essential features of climate not evident in traditional representations. A variation of the weathergami chart displays transition frequencies, which describe the likelihood of particular day-to-day changes in maximum and minimum temperatures. Likewise, weathergami anomaly charts reveal characteristics of changing climate not evident in standard time series representations. Several examples are provided, with comparisons to climate descriptions found in popular textbooks.
Spatial and temporal access to warm spaces during the winter of 2022/2023
Authors: Price Andrew , Higgs Gary , Langford Mitchel
Published: August 2023

It is estimated that over half a million people visited one network of ‘warm rooms’ during the winter of 2022 in the UK, a figure that may rise to 2.5 million people if other networks are considered. As well as offering a means to try to limit exposure to cold temperatures and reduce household energy costs, these winter warm hubs also address wider concerns such as social isolation, loneliness and mental well-being as the cost-of-living bites. This graphic demonstrates how geospatial approaches can be used to explore access via public transport and walking to a network of warm spaces in the capital city of Cardiff, Wales. By accounting for site opening times in relation to existing bus timetables for those for whom walking may not be an option, we illustrate how such information can be included in three commonly applied access measures (floating catchment area, cumulative opportunity and shortest distance) to highlight potential spatio-temporal gaps in provision across the city.
The evolution and expansion of RWP-RK gene family improve the heat adaptability of elephant grass (Pennisetum purpureum Schum.)
Authors: Jin Yarong , Luo Jinchan , Yang Yuchen , Jia Jiyuan , Sun Min , Wang Xiaoshan , Khan Imran , Huang Dejun , Huang Linkai
Published: August 2023

Background

Along with global warming, resulting in crop production, exacerbating the global food crisis. Therefore, it is urgent to study the mechanism of plant heat resistance. However, crop resistance genes were lost due to long-term artificial domestication. By analyzing the potential heat tolerance genes and molecular mechanisms in other wild materials, more genetic resources can be provided for improving the heat tolerance of crops. Elephant grass (Pennisetum purpureum Schum.) has strong adaptability to heat stress and contains abundant heat-resistant gene resources.

Results

Through sequence structure analysis, a total of 36 RWP-RK members were identified in elephant grass. Functional analysis revealed their close association with heat stress. Four randomly selected RKDs (RKD1.1, RKD4.3, RKD6.6, and RKD8.1) were analyzed for expression, and the results showed upregulation under high temperature conditions, suggesting their active role in response to heat stress. The members of RWP-RK gene family (36 genes) in elephant grass were 2.4 times higher than that of related tropical crops, rice (15 genes) and sorghum (15 genes). The 36 RWPs of elephant grass contain 15 NLPs and 21 RKDs, and 73% of RWPs are related to WGD. Among them, combined with the DAP-seq results, it was found that RWP-RK gene family expansion could improve the heat adaptability of elephant grass by enhancing nitrogen use efficiency and peroxidase gene expression.

Conclusions

RWP-RK gene family expansion in elephant grass is closely related to thermal adaptation evolution and speciation. The RKD subgroup showed a higher responsiveness than the NLP subgroup when exposed to high temperature stress. The promoter region of the RKD subgroup contains a significant number of MeJA and ABA responsive elements, which may contribute to their positive response to heat stress. These results provided a scientific basis for analyzing the heat adaptation mechanism of elephant grass and improving the heat tolerance of other crops.
Peripheral VA-ECMO and pericardial drainage connected to the ECMO circuit for cardiac tamponade from blowout rupture: a case report
Authors: Kato Taichi , Miyagawa Atsushi , Hikone Mayu , Yuri Koichi , Sugiyama Kazuhiro
Published: August 2023

Background

Left ventricular free wall rupture, particularly the blowout type, is still one of the most lethal complications of myocardial infarction and can cause catastrophic cardiac tamponade. Extracorporeal membrane oxygenation (ECMO) is often used to treat haemodynamic instability due to cardiac tamponade. However, elevated pericardial pressure can cause collapse of the right atrium, resulting in inadequate ECMO inflow and preventing the stabilisation of the circulation. Further, it can interfere with the venous return from the superior vena cava (SVC), increasing the intracranial pressure and reducing cerebral perfusion levels.

Case presentation

A 65-year-old man was hospitalised for out-of-hospital cardiac arrest. We used ECMO for cardiopulmonary resuscitation. After the establishment of ECMO, transthoracic echocardiography and left ventriculography revealed massive pericardial effusion. The treatment was supplemented with pericardial drainage since ECMO flow was frequently hampered by suction events. However, the blowout rupture led to the requirement of constant drainage from the pericardial catheter. To tend to this leak, we connected the venous cannula of ECMO and the pericardial drainage catheter. The surgery was performed with stable circulation without suction failure of ECMO. During the course of the intensive care management, the neurological prognosis of the patient was revealed to be poor, and the patient was shifted to palliative care. Unfortunately, the patient died on day 10 of hospitalisation.

Conclusion

We present a case wherein the combination of pericardial drainage and ECMO was used to maintain circulation in a patient with massive pericardial effusion due to cardiac rupture.
Association between tea consumption and colorectal cancer: a systematic review and meta-analysis of a population-based study
Authors: Huang Yu , Chen Qiang , Liu Yating , Tian Ruoxi , Yin Xu , Hao Yaoguang , Yang Yang , Yang Jian , Li Zongxuan , Yu Suyang , Li Hongyan , Wang Guiying
Published: August 2023

Purpose

A meta-analysis study was performed to systematically assess the association between tea consumption and CRC risk.

Methods

Cochrane Library, Embase, PubMed, and Web of Science were retrieved to collect articles in English since 24 July 2023. Databases were searched and evaluated by two reviewers independently.We screened the literature based on inclusion and exclusion criteria. After determining the random effect model or fixed utility model based on a heterogeneity test, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.

Results

We included fourteen articles in this meta-analysis. We analyzed the data using a random effect model to explore the association between tea consumption and CRC because of apparent heterogeneity (P < 0.001, I2 = 99.5%). The combined results of all tests showed that there is no statistically significant association between tea consumption and CRC risk (OR = 0.756, 95%CI = 0.470–1.215, P = 0.247). Subsequently, subgroup analysis and sensitivity analysis were performed. Excluding any single study, the overall results ranged from 0.73 (95%CI = 0.44–1.20) to 0.86 (95%CI = 0.53–1.40). It was determined that there was no significant publication bias between tea consumption and CRC risk (P = 0.064) by Egger's tests.

Conclusions

The results indicated that tea consumption may not be significantly associated with the development of CRC.

Implications of key findings

Tea reduces colon cancer risk by 24%, but the estimate is uncertain. The actual effect on risk can range from a reduction of 51% to an increase of 18%, but regional and population differences may cause differences.
Impact of national recommendations for routine pertussis vaccination during pregnancy on infant pertussis in Ontario, Canada: a population-based time-series study
Authors: Antoniou Tony , McCormack Daniel , Fell Deshayne B. , Kwong Jeffrey C. , Gomes Tara
Published: August 2023

Background

In February 2018, Canada’s National Advisory Committee on Immunization (NACI) recommended antenatal tetanus–diphtheria–acellular pertussis (Tdap) immunization in every pregnancy regardless of previous Tdap immunization history. We examined the impact of the NACI recommendation on rates of infant pertussis in Ontario, Canada.

Methods

We conducted a population-based time-series study of all live births in Ontario between August 1, 2011 and February 28, 2020. We used interventional autoregressive integrated moving average models to examine the impact of the NACI recommendation on monthly rates of pertussis among infants ≤ 3 months of age.

Results

We observed 675 incident cases of pertussis among 1,368,024 infants 3 months of age or less between August 2011 and February 2020. The average monthly percent change in infant pertussis during the period up to and including publication of the NACI guidance and the period following publication were 0.0% (95% CI: -0.4–0.3%) and − 0.8% (95% CI -2.3% to -0.1%), respectively. Following interventional ARIMA modelling, publication of the NACI guidance was not associated with a statistically significant decrease in the monthly pertussis incidence trend (-0.67 cases per 100,000 infants; p = 0.73).

Conclusion

Publication of national recommendations for antenatal Tdap immunization in every pregnancy did not significantly reduce infant pertussis rates. This may reflect the persistently low rate of antenatal vaccination following publication of the recommendations. Expanding the scope of practice of allied health care providers to include antenatal Tdap immunization and patient education regarding antenatal pertussis immunization should be considered to further optimize uptake of vaccination.
Depression and burnout among Chinese nurses during COVID-19 pandemic: a mediation and moderation analysis model among frontline nurses and nonfrontline nurses caring for COVID-19 patients
Authors: Wang Jingjun , Huang Xia , Wang Mengmeng , Huang Lei , Wang Ya
Published: August 2023

Background

During the COVID-19 pandemic, nurses' workload increased dramatically, and nurses faced the risk of infection and multiple ethical dilemmas. In such a situation, nurse burnout was elevated, which tended to exacerbate depression in nurses. Although previous studies have demonstrated the relationship between burnout and depression among nurses, the exact mechanisms remain unclear. Furthermore, environmental factors are also essential to a person's psychological health. Therefore, this study intended to investigate the potential mechanisms of depression caused by nurse burnout and whether burnout among frontline nurses during the COVID-19 pandemic exacerbated its effect on depression in nurses as an environmental factor.

Methods

A total of 4517 nurses were enrolled in this study. A moderated mediation model was established to investigate the relationship between burnout and positive coping styles, interpersonal relationships, and depression utilizing the SPSS PROCESS 3.3 macro. The direct effect of burnout on depression was also investigated with the moderated mediation model.

Results

The indirect effects of positive coping styles (β = 0.04, 95% CI: 0.03 to 0.04) and interpersonal relationships (β = 0.12, 95% CI: 0.10 to 0.13) were revealed. Being a frontline nurse caring for COVID-19 patients moderated the direct effect of burnout on depression (β = 0.12, 95% CI: 0.08 to 0.16).

Conclusion

This study offers strong evidence for the mediating role of positive coping styles and interpersonal relationships in the relationship between nurse burnout and depression, in addition to illustrating the need for more psychological support for frontline nurses caring for COVID-19 patients.
Community Walks: a cluster randomized controlled trial of a multilevel physical activity intervention for low income public housing residents
Authors: Quintiliani Lisa M. , Dedier Julien , Amezquita Marislena , Sierra-Ruiz Melibea , Romero Dariela , Murillo Jennifer , Mahar Sarah , Goodman Melody , Kane John B. , Cummings Doreen , Woolley Timothy G. , Spinola Iolando , Crouter Scott E.
Published: August 2023

Background

Physical activity behavioral interventions to change individual-level drivers of activity, like motivation, attitudes, and self-efficacy, are often not sustained beyond the intervention period. Interventions at both environmental and individual levels might facilitate durable change. This community-based study seeks to test a multilevel, multicomponent intervention to increase moderate intensity physical activity among people with low incomes living in U.S. public housing developments, over a 2 year period.

Methods

The study design is a prospective, cluster randomized controlled trial, with housing developments (n=12) as the units of randomization. In a four-group, factorial trial, we will compare an environmental intervention (E) alone (3 developments), an individual intervention (I) alone (3 developments), an environmental plus individual (E+I) intervention (3 developments), against an assessment only control group (3 developments). The environmental only intervention consists of community health workers leading walking groups and indoor activities, a walking advocacy program for residents, and provision of walking maps/signage. The individual only intervention consists of a 12-week automated telephone program to increase physical activity motivation and self-efficacy. All residents are invited to participate in the intervention activities being delivered at their development. The primary outcome is change in moderate intensity physical activity measured via an accelerometer-based device among an evaluation cohort (n=50 individuals at each of the 12 developments) from baseline to 24-month follow up. Mediation (e.g., neighborhood walkability, motivation) and moderation (e.g., neighborhood stress) of our interventions will be assessed. Lastly, we will interview key informants to assess factors from the Consolidated Framework for Implementation Research domains to inform future implementation.

Discussion

We hypothesize participants living in developments in any of the three intervention groups (E only, I only, and E+I combined) will increase minutes of moderate intensity physical activity more than participants in control group developments. We expect delivery of an intervention package targeting environmental and social factors to become active, combined with the individual level intervention, will improve overall physical activity levels to recommended guidelines at the development level. If effective, this trial has the potential for implementation through other federal and state housing authorities.

Trial registration

Clinical Trails.gov PRS Protocol Registration and Results System, NCT05147298. Registered 28 November 2021.
Association between chronic obstructive pulmonary disease and cardiovascular disease in adults aged 40 years and above: data from NHANES 2013–2018
Authors: Chen Hong , Luo Xiaojia , Du Yuejun , He Chenyun , Lu Yanjun , Shi Zixuan , Zhou Jin
Published: August 2023

Background

Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) are two major age-related diseases prevalent in the elderly. However, it is unclear whether there is a higher prevalence of one or more CVDs in COPD patients compared to those without COPD, and the magnitude of this increased prevalence.

Methods

This population-based cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2013–2018 among American adults aged 40 years and above. Multivariable logistic regression models (including unadjusted model, minimally adjusted model, and fully adjusted model) were conducted to investigate the association between COPD and the prevalence of one or more CVDs, including coronary heart disease, heart failure, angina pectoris, heart attack, diabetes, and stroke.

Results

This study included 11,425 participants, consisting of 661 participants with COPD and 10,764 participants without COPD. COPD patients had a significantly higher prevalence of CVD than those without COPD (59.6% vs. 28.4%). After adjusting for covariates, COPD was significantly associated with the prevalence of one CVD (OR = 2.2, 95% CI = 1.6–3.0, p < 0.001), two or more CVDs (OR = 3.3, 95% CI = 2.2–5.0, p < 0.001), and three or more CVDs (OR = 4.3, 95% CI = 2.9–6.5, p < 0.001).

Conclusions

Patients with COPD have a higher prevalence of one or more CVDs compared with those without COPD. Our findings highlight the importance of CVD prevention and management in patients with COPD.
Conservative endodontic microsurgery to protect critical anatomical structures–selective curettage: a case series
Authors: Li Nan , Zhang Rui , Qiao Weiwei , Meng Liuyan
Published: August 2023

Background

Endodontic microsurgery has yielded highly successful outcomes in preserving teeth with persistent or recurrent cases of periapical periodontitis that could not be successfully treated by nonsurgical endodontic approaches. To avoid complications in conditions in which periapical lesions invade anatomical structures such as the nasopalatine nerve tube and mandibular canal, selective curettage has been proposed as an alternative choice of complete curettage in surgery.

Case presentation

The 8 cases reported herein had undergone root canal treatment and/or retreatment but still presented with symptoms, such as recurring sinus tracts and persistent dull pain. The radiographic examination indicated a large area of radiolucency that was associated with the tooth and had invaded adjacent critical anatomical structures. The patients opted for selective curettage via endodontic microsurgery, and the lesions were histologically confirmed as periapical cysts or granulomas. The follow-up results for one year or more indicated that the affected teeth were clinically asymptomatic and exhibited complete or incomplete healing radiographically.

Conclusion

This case series provides clinical evidence for the feasibility of selective curettage in endodontic microsurgery, which can avoid complications caused by damage to the adjacent critical anatomical structures.
Application of artificial neural network in daily prediction of bleeding in ICU patients treated with anti-thrombotic therapy
Authors: Chen Daonan , Wang Rui , Jiang Yihan , Xing Zijian , Sheng Qiuyang , Liu Xiaoqing , Wang Ruilan , Xie Hui , Zhao Lina
Published: August 2023

Objectives

Anti-thrombotic therapy is the basis of thrombosis prevention and treatment. Bleeding is the main adverse event of anti-thrombosis. Existing laboratory indicators cannot accurately reflect the real-time coagulation function. It is necessary to develop tools to dynamically evaluate the risk and benefits of anti-thrombosis to prescribe accurate anti-thrombotic therapy.

Methods

The prediction model,daily prediction of bleeding risk in ICU patients treated with anti-thrombotic therapy, was built using deep learning algorithm recurrent neural networks, and the model results and performance were compared with clinicians.

Results

There was no significant statistical discrepancy in the baseline. ROC curves of the four models in the validation and test set were drawn, respectively. One-layer GRU of the validation set had a larger AUC (0.9462; 95%CI, 0.9147–0.9778). Analysis was conducted in the test set, and the ROC curve showed the superiority of two layers LSTM over one-layer GRU, while the former AUC was 0.8391(95%CI, 0.7786–0.8997). One-layer GRU in the test set possessed a better specificity (sensitivity 0.5942; specificity 0.9300). The Fleiss’ k of junior clinicians, senior clinicians, and machine learning classifiers is 0.0984, 0.4562, and 0.8012, respectively.

Conclusions

Recurrent neural networks were first applied for daily prediction of bleeding risk in ICU patients treated with anti-thrombotic therapy. Deep learning classifiers are more reliable and consistent than human classifiers. The machine learning classifier suggested strong reliability. The deep learning algorithm significantly outperformed human classifiers in prediction time.
Daily work variability in falls prevention of hospitalized patients: nursing team’s perception
Authors: de Quadros Deise Vacario , Wachs Priscila , de Magalhães Ana Maria Müller , Severo Isis Marques , Tavares Juliana Petri , Dal Pai Daiane
Published: August 2023

Background

The identification of safety incidents and establishment of systematic methodologies in health services to reduce risks and provide quality care was implemented by The World Health Organization. These safety incidents allowed the visualization of a vast panorama, ranging from preventable incidents to adverse events with catastrophic outcomes. In this scenario, the issue of fall(s) is inserted, which, despite being a preventable event, can lead to several consequences for the patient, family, and the healthcare system, being the second cause of death by accidental injury worldwide, this study aims to identify the variability inherent in the daily work in fall prevention, the strategies used by professionals to deal with it and the opportunities for improvement of the management of work-as-imagined.

Method

A mixed method approach was conducted, through process modeling and semi-structured interviews. The study was conducted in a public university hospital in southern Brazil. Study steps: modeling of the prescribed work, identification of falls, modeling of the daily work, and reflections on the gap between work-as-done and work-as-imagined. Medical records, management reports, notification records, protocols, and care procedures were consulted for modeling the work process, and semi-structured interviews were conducted with 21 Nursing professionals. The study was conducted between March 2019 and December 2020.

Results

From July 2018 to July 2019, 447 falls occurred, 2.7% with moderate to severe injury. The variability occurred in the orientation of the companion and the assurance of the accompanied patient's de-ambulation. The professionals identified individual strategies to prevent falls, the importance of multi-professional work, learning with the work team, and the colleague’s expertise, as well as suggesting improvements in the physical environment.

Conclusion

This study addressed the need for fall prevention in the hospital setting as one of the main adverse events that affect patients. Identifying the variability inherent to the work allows professionals to identify opportunities for improvement, understand the risks to which patients are subjected, and develop the perception of fall risk as a way to reduce the gap between work-as-imagined and work-as-done.
Impact of visceral obesity on infectious complications after resection for colorectal cancer: a retrospective cohort study
Authors: Zhai Wenshan , Yang Yi , Zhang Keyao , Sun Lei , Luo Meng , Han Xue , Wang Min , Wang Zhiping , Gao Fang
Published: August 2023

Objectives

To explore the impact of visceral obesity (VO) measured by preoperative abdominal computed tomography (CT) on postoperative infectious complications for colorectal cancer (CRC) patients and establish a predictive model.

Methods

Patients who underwent resection for colorectal cancer between January 2015 and January 2021 were enrolled in this study. All patients were measured for body mass index (BMI) and visceral fat area (VFA) preoperatively. Infectious complications were compared between the different groups according to BMI and VO categories. Univariate and multivariate logistic regression were used to analyze whether VO was an independent risk factor for postoperative infectious complications. According to the results of logistic regression, six machine learning approaches were used to establish predictive models and perform internal validation. The best-performing model was interpreted by the SHAPley Additive exPlanations value.

Results

Approximately 64.81% of 520 patients had VO. VO was significantly connected with postoperative infectious complications (P < 0.001), coronary heart disease (P = 0.004), cerebral infarction (P = 0.001), hypertension (P < 0.001), diabetes (P < 0.001), and fatty liver (P < 0.001). The rates of wound infection (P = 0.048), abdominal or pelvic infection (P = 0.006), and pneumonia (P = 0.008) increased obviously in patients with VO. Compared to the low BMI group, a high BMI was found to be significantly associated with hypertension (P=0.007), fatty liver (P＜0.001), and a higher rate of postoperative infection (P=0.003). The results of logistic regression revealed that VO (OR = 2.01, 95% CI 1.17 ~ 3.48, P = 0.012), operation time ≥ 4 h (OR = 2.52, 95% CI 1.60 ~ 3.97, P < 0.001), smoking (OR = 2.04, 95% CI 1.16 ~ 3.59, P = 0.014), ostomy (OR = 1.65, 95% CI 1.04 ~ 2.61, P = 0.033), and chronic obstructive pulmonary disease (COPD) (OR = 2.23, 95% CI 1.09 ~ 4.57, P = 0.029) were independent risk factors. The light gradient boosting machine (LGBM) model displayed the largest area under the receiver operating characteristic curve (AUC) (0.74, 95% CI 0.68 ~ 0.81).

Conclusions

In this study, VO was superior to BMI in evaluating the influence of obesity on metabolic comorbidities and postoperative infectious complications in colorectal cancer patients.
A cross-sectional study exploring the relationship between the dietary inflammatory index and hyperlipidemia based on the National Health and Nutrition Examination Survey (2005–2018)
Authors: Han Yu , Jiang Xijuan , Qin Yabin , Zhao Yile , Zhang Guying , Liu Chao
Published: August 2023

Background

Hyperlipidemia is closely associated with dietary patterns and inflammation. However, the relationship between hyperlipidemia and the inflammatory potential of diets remains unexplored. The research was conducted to examine the relationship between hyperlipidemia and dietary inflammatory index (DII).

Methods

The data utilized in the research were acquired from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. The information on dietary intake was gathered by conducting 24-h dietary recall interviews. Restricted cubic spline (RCS) and Survey-weighted logistic regression were utilized to determine the association between DII and hyperlipidemia. Furthermore, stratification analysis was carried out.

Results

This study included 8982 individuals with and 3458 without hyperlipidemia. Participants with hyperlipidemia exhibited higher DII scores than those without hyperlipidemia. Following adjustment for gender, age, race, education level, marital status, poverty, drinking status, diabetes, hypertension, smoking status, body mass index (BMI), chronic kidney disease (CKD), cardiovascular disease (CVD), and hemoglobin (Hb), the association between the prevalence of hyperlipidemia and DII remained significant. The RCS data demonstrated that the hyperlipidemia prevalence did not exhibit an increase until the DII score was approximately 2.78. Stratification analysis revealed that the association between DII and hyperlipidemia persisted in all subgroups.

Conclusions

DII was associated with hyperlipidemia, and the threshold DII score for the risk of hyperlipidemia was 2.78.
Sexually dimorphic extracellular vesicle responses after chronic spinal cord injury are associated with neuroinflammation and neurodegeneration in the aged brain
Authors: Li Yun , Khan Niaz , Ritzel Rodney M. , Lei Zhuofan , Allen Samantha , Faden Alan I. , Wu Junfang
Published: August 2023

Background

Medical advances have made it increasingly possible for spinal cord injury (SCI) survivors to survive decades after the insult. But how SCI affects aging changes and aging impacts the injury process have received limited attention. Extracellular vesicles (EVs) are recognized as critical mediators of neuroinflammation after CNS injury, including at a distance from the lesion site. We have previously shown that SCI in young male mice leads to robust changes in plasma EV count and microRNA (miR) content. Here, our goal was to investigate the impact of biological sex and aging on EVs and brain after SCI.

Methods

Young adult age-matched male and female C57BL/6 mice were subjected to SCI. At 19 months post-injury, total plasma EVs were isolated by ultracentrifugation and characterized by nanoparticle tracking analysis (NTA). EVs miR cargo was examined using the Fireplex® assay. The transcriptional changes in the brain were assessed by a NanoString nCounter Neuropathology panel and validated by Western blot (WB) and flow cytometry (FC). A battery of behavioral tests was performed for assessment of neurological function.

Results

Transcriptomic changes showed a high number of changes between sham and those with SCI. Sex-specific changes were found in transcription networks related to disease association, activated microglia, and vesicle trafficking. FC showed higher microglia and myeloid counts in the injured tissue of SCI/Female compared to their male counterparts, along with higher microglial production of ROS in both injured site and the brain. In the latter, increased levels of TNF and mitochondrial membrane potential were seen in microglia from SCI/Female. WB and NTA revealed that EV markers are elevated in the plasma of SCI/Male. Particle concentration in the cortex increased after injury, with SCI/Female showing higher counts than SCI/Male. EVs cargo analysis revealed changes in miR content related to injury and sex. Behavioral testing confirmed impairment of cognition and depression at chronic time points after SCI in both sexes, without significant differences between males and females.

Conclusions

Our study is the first to show sexually dimorphic changes in brain after very long-term SCI and supports a potential sex-dependent EV-mediated mechanism that contributes to SCI-induced brain changes.
Complete fatty degeneration of thymus associates with male sex, obesity and loss of circulating naïve CD8+ T cells in a Swedish middle-aged population
Authors: Sandstedt Mårten , Chung Rosanna W S , Skoglund Camilla , Lundberg Anna K. , Östgren Carl Johan , Ernerudh Jan , Jonasson Lena
Published: August 2023

Background

Fatty degeneration of thymus (or thymus involution) has long been considered a normal ageing process. However, there is emerging evidence that thymic involution is linked to T cell aging, chronic inflammation and increased morbidity. Other factors, aside from chronological age, have been proposed to affect the involution rate. In the present study, we investigated the imaging characteristics of thymus on computed tomography (CT) in a Swedish middle-aged population. The major aims were to establish the prevalence of fatty degeneration of thymus and to determine its associations with demographic, lifestyle and clinical factors, as well as inflammation, T cell differentiation and thymic output.

Results

In total, 1 048 randomly invited individuals (aged 50–64 years, 49% females) were included and thoroughly characterized. CT evaluation of thymus included measurements of attenuation, size and a 4-point scoring system, with scale 0–3 based on the ratio of fat and soft tissue. A majority, 615 (59%) showed complete fatty degeneration, 259 (25%) predominantly fatty attenuation, 105 (10%) half fatty and half soft-tissue attenuation, while 69 (6.6%) presented with a solid thymic gland with predominantly soft-tissue attenuation. Age, male sex, high BMI, abdominal obesity and low dietary intake of fiber were independently associated with complete fatty degeneration of thymus. Also, fatty degeneration of thymus as well as low CT attenuation values were independently related to lower proportion of naïve CD8+ T cells, which in turn was related to lower thymic output, assessed by T-cell receptor excision circle (TREC) levels.

Conclusion

Among Swedish middle-aged subjects, nearly two-thirds showed complete fatty degeneration of thymus on CT. This was linked to depletion of naïve CD8+ T cells indicating that CT scans of thymus might be used to estimate immunological aging. Furthermore, our findings support the intriguing concept that obesity as well as low fiber intake contribute to immunological aging, thereby raising the possibility of preventive strategies.