bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient-reported outcome measures in systemic lupus erythematosus by a web-based application: A randomized, crossover, agreement study
Authors: Uhrenholt Line , Høstgaard Simone , Pedersen Julie F , Christensen Robin , Dreyer Lene , Leffers Henrik C B , Taylor Peter C , Strand Vibeke , Jacobsen Søren , Voss Anne , Gregersen Jon W , Kristensen Salome
Published: October 2021

Objectives

Patient-reported outcome measures (PROMs) are evaluated in randomized controlled trials (RCTs) in patients with systemic lupus erythematosus (SLE), but not widely used in clinical practice. However, interest in incorporating PROMs into the management of SLE is increasing as PROMs provide a unique insight into the patient’s perception of lupus disease activity. The objective was to assess agreement in PROMs answered using a web app versus an outpatient touchscreen among patients with SLE.

Methods

In a crossover RCT, SLE patients answered the following PROMs in a random order using the web app and the outpatient touchscreen: Systemic Lupus Erythematosus Activity Questionnaire (SLAQ) Global Health, SLAQ Symptom, SLAQ Total, SLAQ Worsening, Pain Visual Analog Scale (VAS), Fatigue VAS, Patient Global Health VAS, Health Assessment Questionnaire Disability Index (HAQ-DI), Patient Acceptable Symptom State (PASS), and an Anchoring Question. Equivalence between the two device types was demonstrated if the 95% confidence interval (95% CI) of the difference in PROM scores was within the prespecified equivalence margin. Agreement between the two device types was assessed using mixed linear models.

Results

Thirty-four patients with SLE were included. Equivalence was demonstrated between the two device types for SLAQ Global Health with a difference of −0.21 (95% CI: −0.65 to 0.23). Moreover, equivalence was also found for HAQ-DI, Pain VAS, and Fatigue VAS whereas only comparability within the limits of the Minimal Clinically Important Difference (MCID) was demonstrated for VAS Patient Global Health. Statistical comparability was demonstrated for SLAQ Total, SLAQ Worsening, PASS, and Anchoring Question (no predefined MCID/equivalence margins available). However, a statistically significant difference between device types was observed for the SLAQ Symptom of −0.56 (95% CI: −1.10 to −0.01). The difference was, however, very small when considering the scale range of 0–24; thus, it was not judged to be of clinical relevance. Preference for the web app was very high (91.2%).

Conclusion

For the first time ever, equivalence and comparability between two electronic device types for various PROMs were demonstrated among patients with SLE. Implementation of the device is expected to improve the management of SLE.
Enhancing the quality and social impacts of urban planning through community-engaged operations research
Authors: Fabusuyi Tayo , Johnson Michael P
Published: October 2021

While inquiry in operations research (OR) modeling of urban planning processes is long-standing, on the whole, the OR discipline has not influenced urban planning practice, teaching and scholarship at a level of other domains such as public policy and information technology. Urban planning presents contemporary challenges that are complex, multi-stakeholder, data-intensive, and ill structured. Could an OR approach which focuses on the complex, emergent nature of cities, the institutional environment in which urban planning strategies are designed and implemented and which puts citizen engagement and a critical approach at the center enable urban planning to better meet these challenges? Based on a review of research and practice in OR and urban planning, we argue that a prospective and prescriptive approach to planning that is inductive in nature and embraces “methodological pluralism” and mixed methods can enable researchers and practitioners develop effective interventions that are equitable and which reflect the concerns of community members and community serving organizations. We discuss recent work in transportation, housing, and community development that illustrates the benefits of embracing an enhanced OR modeling approach both in the framing of the model and in its implementation, while bringing to the fore three cautionary themes. First, a mechanistic application of decision modeling principles rooted in stylized representations of institutions and systems using mathematics and computational methods may not adequately capture the central role that human actors play in developing neighborhoods and communities. Second, as innovations such as the mass adoption of automobiles decades ago led to auto-centric city design show, technological innovations can have unanticipated negative social impacts. Third, the current COVID pandemic shows that approaches based on science and technology alone are inadequate to improving community lives. Therefore, we emphasize the important role of critical approaches, community engagement and diversity, equity, and inclusion in planning approaches that incorporate decision modeling.
The effects of inhaling hydrogen gas on macrophage polarization, fibrosis, and lung function in mice with bleomycin-induced lung injury
Authors: Aokage Toshiyuki , Seya Mizuki , Hirayama Takahiro , Nojima Tsuyoshi , Iketani Masumi , Ishikawa Michiko , Terasaki Yasuhiro , Taniguchi Akihiko , Miyahara Nobuaki , Nakao Atsunori , Ohsawa Ikuroh , Naito Hiromichi
Published: October 2021

Background

Acute respiratory distress syndrome, which is caused by acute lung injury, is a destructive respiratory disorder caused by a systemic inflammatory response. Persistent inflammation results in irreversible alveolar fibrosis. Because hydrogen gas possesses anti-inflammatory properties, we hypothesized that daily repeated inhalation of hydrogen gas could suppress persistent lung inflammation by inducing functional changes in macrophages, and consequently inhibit lung fibrosis during late-phase lung injury.

Methods

To test this hypothesis, lung injury was induced in mice by intratracheal administration of bleomycin (1.0 mg/kg). Mice were exposed to control gas (air) or hydrogen (3.2% in air) for 6 h every day for 7 or 21 days. Respiratory physiology, tissue pathology, markers of inflammation, and macrophage phenotypes were examined.

Results

Mice with bleomycin-induced lung injury that received daily hydrogen therapy for 21 days (BH group) exhibited higher static compliance (0.056 mL/cmH2O, 95% CI 0.047–0.064) than mice with bleomycin-induced lung injury exposed only to air (BA group; 0.042 mL/cmH2O, 95% CI 0.031–0.053, p = 0.02) and lower static elastance (BH 18.8 cmH2O/mL, [95% CI 15.4–22.2] vs. BA 26.7 cmH2O/mL [95% CI 19.6–33.8], p = 0.02). When the mRNA levels of pro-inflammatory cytokines were examined 7 days after bleomycin administration, interleukin (IL)-6, IL-4 and IL-13 were significantly lower in the BH group than in the BA group. There were significantly fewer M2-biased macrophages in the alveolar interstitium of the BH group than in the BA group (3.1% [95% CI 1.6–4.5%] vs. 1.1% [95% CI 0.3–1.8%], p = 0.008).

Conclusions

The results suggest that hydrogen inhalation inhibits the deterioration of respiratory physiological function and alveolar fibrosis in this model of lung injury.
Laparoscopic subtotal cholecystectomy after percutaneous transhepatic gallbladder drainage for grade II or III acute cholecystitis
Authors: Ie Masafumi , Katsura Morihiro , Kanda Yukihiro , Kato Takashi , Sunagawa Kazuya , Mototake Hidemitsu
Published: October 2021

Background

Severe adhesions and fibrosis between the posterior wall of the gallbladder and liver bed often render total cholecystectomy after percutaneous transhepatic gallbladder drainage (PTGBD) difficult, leading to high open conversion rates. Since the publication of Tokyo Guidelines 2018 (TG18), our policy has shifted from open conversion to subtotal cholecystectomy (SC) when total laparoscopic cholecystectomy for difficult cases of cholecystitis is not feasible. Recently, SC has been frequently applied as bailout surgery for complicated cholecystitis. Nonetheless, the efficacy and validity of laparoscopic SC after PTGBD remain unclear. This study aimed to evaluate the safety and feasibility of laparoscopic SC after PTGBD for grade II or III acute cholecystitis (AC) by comparing two periods of altered surgical strategies.

Methods

This retrospective cohort study was conducted between January 2013 and December 2020. A total of 44 eligible patients with grade II or III AC were divided according to the time of cholecystitis onset into the pre-TG18 group (2013–2017, n = 17) and post-TG18 group (2018–2020, n = 27). Patients’ background demographics, surgical method, surgical results, and postoperative complications were compared.

Results

The interval between PTGBD and surgery was significantly longer in the post-TG18 group than in the pre-TG18 group (15 [interquartile range: 9–42] days vs. 8 [4–11] days; P = 0.010). The frequency of laparoscopic cholecystectomy significantly increased from 52.9% in the pre-TG18 group to 88.9% in the post-TG18 group (P = 0.007), whereas the frequency of SC was 23.5% and 40.7%, respectively, which showed no statistically significant difference (P = 0.241). However, the rate of laparoscopic SC significantly increased from 0 to 90.9% among 15 SC cases, whereas the rate of open SC significantly plummeted from 100 to 9.1% (P = 0.001). Significant differences in the operative time, amount of intraoperative bleeding, and incidence of postoperative complications (wound infection and subhepatic abscess) were not observed. Mortality, bile leakage, and bile duct injury did not occur in either group.

Conclusions

For grade II or III AC after PTGBD, aggressive adoption of SC increased the completion rate of laparoscopic surgery. Laparoscopic SC is a safe and feasible treatment option.
Recombinant expression of insoluble enzymes in Escherichia coli: a systematic review of experimental design and its manufacturing implications
Authors: Mital Suraj , Christie Graham , Dikicioglu Duygu
Published: October 2021

Recombinant enzyme expression in Escherichia coli is one of the most popular methods to produce bulk concentrations of protein product. However, this method is often limited by the inadvertent formation of inclusion bodies. Our analysis systematically reviews literature from 2010 to 2021 and details the methods and strategies researchers have utilized for expression of difficult to express (DtE), industrially relevant recombinant enzymes in E. coli expression strains. Our review identifies an absence of a coherent strategy with disparate practices being used to promote solubility. We discuss the potential to approach recombinant expression systematically, with the aid of modern bioinformatics, modelling, and ‘omics’ based systems-level analysis techniques to provide a structured, holistic approach. Our analysis also identifies potential gaps in the methods used to report metadata in publications and the impact on the reproducibility and growth of the research in this field.
A deep learning quantified stroma-immune score to predict survival of patients with stage II–III colorectal cancer
Authors: Xu Zeyan , Li Yong , Wang Yingyi , Zhang Shenyan , Huang Yanqi , Yao Su , Han Chu , Pan Xipeng , Shi Zhenwei , Mao Yun , Xu Yao , Huang Xiaomei , Lin Huan , Chen Xin , Liang Changhong , Li Zhenhui , Zhao Ke , Zhang Qingling , Liu Zaiyi
Published: October 2021

Background

Profound heterogeneity in prognosis has been observed in colorectal cancer (CRC) patients with intermediate levels of disease (stage II–III), advocating the identification of valuable biomarkers that could improve the prognostic stratification. This study aims to develop a deep learning-based pipeline for fully automatic quantification of immune infiltration within the stroma region on immunohistochemical (IHC) whole-slide images (WSIs) and further analyze its prognostic value in CRC.

Methods

Patients from two independent cohorts were divided into three groups: the development group (N = 200), the internal (N = 134), and the external validation group (N = 90). We trained a convolutional neural network for tissue classification of CD3 and CD8 stained WSIs. A scoring system, named stroma-immune score, was established by quantifying the density of CD3+ and CD8+ T-cells infiltration in the stroma region.

Results

Patients with higher stroma-immune scores had much longer survival. In the development group, 5-year survival rates of the low and high scores were 55.7% and 80.8% (hazard ratio [HR] for high vs. low 0.39, 95% confidence interval [CI] 0.24–0.63, P < 0.001). These results were confirmed in the internal and external validation groups with 5-year survival rates of low and high scores were 57.1% and 78.8%, 63.9% and 88.9%, respectively (internal: HR for high vs. low 0.49, 95% CI 0.28–0.88, P = 0.017; external: HR for high vs. low 0.35, 95% CI 0.15–0.83, P = 0.018). The combination of stroma-immune score and tumor-node-metastasis (TNM) stage showed better discrimination ability for survival prediction than using the TNM stage alone.

Conclusions

We proposed a stroma-immune score via a deep learning-based pipeline to quantify CD3+ and CD8+ T-cells densities within the stroma region on WSIs of CRC and further predict survival.
Nanomedicine for increasing the oral bioavailability of cancer treatments
Authors: Parodi Alessandro , Buzaeva Polina , Nigovora Daria , Baldin Alexey , Kostyushev Dmitry , Chulanov Vladimir , Savvateeva Lyudmila V. , Zamyatnin Andrey A.
Published: October 2021

Oral administration is an appealing route of delivering cancer treatments. However, the gastrointestinal tract is characterized by specific and efficient physical, chemical, and biological barriers that decrease the bioavailability of medications, including chemotherapeutics. In recent decades, the fields of material science and nanomedicine have generated several delivery platforms with high potential for overcoming multiple barriers associated to oral administration. This review describes the properties of several nanodelivery systems that improve the bioavailability of orally administered therapeutics, highlighting their advantages and disadvantages in generating successful anticancer oral nanomedicines.

Graphical Abstract
The Bridge Building Model: connecting evidence-based practice, evidence-based research, public involvement and needs led research
Authors: Ormstad Heidi , Jamtvedt Gro , Svege Ida , Crowe Sally
Published: October 2021

This paper describes a model developed by an interdisciplinary team of research and public engagement specialists, with backgrounds in health and social care research, higher education, evidence-based practice, leadership, commissioning research and public involvement and engagement. The model we propose combinesevidence-based practice,evidence-based research,public involvementandneeds led research. Our aim is to capitalise on the joining of the rationale and methods for these approaches, which have all been highlighted as important, but for which there has been a lack of models for integration. Our ambition is to argue for and show an effective and evidence-based way of working that bridges health and social care needs identification, evidence-based practice and research.
Obsessive–compulsive disorder post-COVID-19: a case presentation
Authors: Alkhamees Abdulmajeed A.
Published: October 2021

Background

Since the emergence of the COVID-19 pandemic and the significant changes that impacted because of it, people around the world have been left dealing with its consequences—fear of becoming ill and dying, fear of losing loved ones, uncertainty about the future, and imposed social isolation—several elements which could lead to psychological consequences. Moreover, as suggested by recent evidence, the virus acts as a factor in causing psychological symptoms, including depression, anxiety, fatigue, and post-traumatic stress disorder.

Case presentation

Here, we report a case of a patient with new-onset OCD after his recovery from the coronavirus disease, which presented in the form of recurrent and persistent intrusive thoughts and doubts which responded to medication.

Conclusions

This case shows the potential of COVID-19-associated inflammatory triggers to precipitate or induce obsessive–compulsive symptoms. Although this case cannot support causation, it does stress the bidirectional effects that physical and mental illness share.
The associations between coronary artery disease, and non-alcoholic fatty liver disease by computed tomography
Authors: Saraya Samira , Saraya Mahmoud , Mahmoud Mohamed , Galal Mohamed , Soliman Hazem Hamed , Raafat Mariam
Published: October 2021

Background

Non-alcoholic fatty liver disease (NAFLD) is increasing in recognition as a hepatic condition that is unrelated to significant alcoholic consumption, but has rather, been suggested to constitute cardiovascular risk (irrespective of traditional risk factors and high-risk plaque features). Both coronary artery disease and NAFLD share the same pathophysiology and metabolic profile. NAFLD can theoretically be a source/initiator for coronary artery disease (CAD). We aimed to study the association between NAFLD, CAD, the presence of high-risk plaque features, and the severity of stenosis.

Results

We recruited 800 patients with suspected obstructive CAD and planned for coronary computed tomography angiography (CCTA), Exclusion criteria: heavy alcohol consumption; contraindications to contrast media; unevaluated coronary-artery segments; other known liver disease; and use of oral corticosteroids and/or amiodarone. Non-enhanced Computed Tomography abdomen was performed before the CCTA to detect NAFLD. To study the association between NAFLD and the presence of CAD, patients were classified as to either have, or not have CAD. The CAD group were then further studied for the presence of high-risk plaque features: napkin ring sign, Positive remodelling, Low Hounsfield unit (HU), and Spotty calcium; and their association with NAFLD. Thirty-two per cent of patients had NAFLD and 45% had CAD. A significant association between NAFLD and CAD was found (OR 4.21, 95% CI (confidence interval) (2.83–6.25), p = 0.000). In CAD patients, significant associations were present between NAFLD and high-risk plaque features: Napkin ring sign, Positive remodelling, Low HU, and Spotty calcium (OR 7.88, 95% CI (4.39–14.12), p < 0.001, OR 5.84, 95% (3.85–8.85), p < 0.001, OR 7.25, 95% CI (3.31–15.90), p < 0.001 and OR 6.66, 95% CI (3.75–11.82), p < 0.001), respectively. NAFLD was present in 39.30%, 50.00%, 20.00%, 54.50% and 100.00% of patients with CAD; and 1–24%; 25–49%; 50–69%; 7 = 0–99%, LMD (Left Main Disease) > 50% stenosis or 3V disease, and Total occlusion, respectively, p < 0.001.

Conclusions

NAFLD is strongly associated with CAD, high-risk plaque features and higher grade of stenosis.
Increased Risk of Type 2 Diabetes in Patients With Thyroid Cancer After Thyroidectomy: A Nationwide Cohort Study
Authors: Roh Eun , Noh Eunjin , Hwang Soon Young , Kim Jung A , Song Eyun , Park Minjeong , Choi Kyung Mook , Baik Sei Hyun , Cho Geum Joon , Yoo Hye Jin
Published: October 2021

Context

Abnormal thyroid function after thyroidectomy and subsequent thyroid-stimulating hormone suppression can have detrimental effects on glucose homeostasis in patients with thyroid cancer.

Objective

To investigate whether thyroidectomy increases the risk of type 2 diabetes in patients with thyroid cancer and to explore the association between levothyroxine dosage and type 2 diabetes risk.

Methods

A retrospective population-based cohort study using the Korean National Health Insurance database. We included 36 377 thyroid cancer patients without known diabetes who underwent thyroidectomy between 2004 and 2013. Matched subjects with nonthyroid cancer were selected using 1:1 propensity score matching. The main outcome measure was newly developed type 2 diabetes mellitus.

Results

Patients with thyroid cancer who underwent thyroidectomy had a higher risk of developing type 2 diabetes mellitus than the matched controls (hazard ratio [HR] 1.43, 95% CI 1.39-1.47). Among patients with thyroid cancer, when the second quartile group (in terms of the mean levothyroxine dosage; 101-127 μg/day) was considered the reference group, the risk of type 2 diabetes mellitus increased in the first quartile (<101 μg/day; HR 1.45, 95% CI 1.36-1.54) and fourth quartile groups (≥150 μg/day; HR 1.37, 95% CI 1.29-1.45); meanwhile, the risk decreased in the third quartile group (128-149 μg/day; HR 0.91, 95% CI 0.85-0.97).

Conclusion

Patients with thyroid cancer who underwent thyroidectomy were more likely to develop type 2 diabetes mellitus than the matched controls. There was a U-shaped dose-dependent relationship between the levothyroxine dosage and type 2 diabetes mellitus risk.
Variations of C14ORF39 and SYCE1 Identified in Idiopathic Premature Ovarian Insufficiency and Nonobstructive Azoospermia
Authors: Hou Dong , Yao Chencheng , Xu Bingying , Luo Wei , Ke Hanni , Li Zheng , Qin Yingying , Guo Ting
Published: October 2021

Context

Premature ovarian insufficiency (POI) and nonobstructive azoospermia (NOA) are the most severe diseases causing irreversible infertility in females and males, respectively. The contribution of synaptonemal complex (SC) gene variations in the pathogenesis of sporadic patients with POI and NOA has not been systematically illustrated.

Objective

To investigate the role of SC genes in the pathogenesis of sporadic POI and NOA.

Design

Genetic and functional study.

Setting

University-based reproductive medicine center.

Patient(s)

A total of 1030 patients with sporadic POI and 400 patients with sporadic NOA.

Intervention(s)

The variations of SC genes were filtered in the in-house database of whole exome sequencing performed in 1030 patients with sporadic POI and 400 patients with sporadic NOA. The pathogenic or likely pathogenic variations following recessive inheritance mode were selected according to American College of Medical Genetics and Genomics (ACMG) guidelines and confirmed by Sanger sequencing. The pathogenic effects of the variations were verified by functional studies.

Main Outcome Measure(s)

ACMG classification and functional characteristics.

Result(s)

Two homozygous variations of C14ORF39 and 2 recessive variations of SYCE1 were first identified in sporadic patients with POI and NOA, respectively. Functional studies showed the C14ORF39 variations significantly accelerated the protein degradation and the variations in SYCE1 disrupted its interaction with SYCP1 or C14ORF39, both of which affected SC assembly and meiosis.

Conclusion(s)

Our study identified novel pathogenic variations of C14ORF39 and SYCE1 in sporadic patients with POI or NOA, highlighting the essential role of SC genes in the maintenance of ovarian and testicular function.
TRIB3 Is Highly Expressed in the Adipose Tissue of Obese Patients and Is Associated With Insulin Resistance
Authors: Lee Seul Ki , Park Chan Yoon , Kim Jimin , Kim Donguk , Choe Han , Kim Jong-Hyeok , Hong Joon Pio , Lee Yeon Ji , Heo Yoonseok , Park Hye Soon , Jang Yeon Jin
Published: October 2021

Context

The upregulation of TRIB3 (Tribbles homolog 3), a stress-inducible gene encoding a pseudokinase, has been implicated in the development of insulin resistance in the skeletal muscle and liver of patients with obesity and type 2 diabetes. However, there is little information regarding TRIB3 expression in human adipose tissue.

Objective

To investigate whether TRIB3 expression is dysregulated in human adipose tissue in the context of obesity and type 2 diabetes and whether TRIB3 expression in adipose tissues is associated with insulin resistance.

Methods

We measured metabolic parameters and TRIB3 expression in abdominal subcutaneous and visceral adipose tissue in obese (with or without type 2 diabetes) and normal-weight women. Regulation of TRIB3 expression was studied in human adipocytes.

Results

TRIB3 expression in both fat depots was higher in patients with obesity and/or type 2 diabetes; in addition, the expression level was significantly associated with insulin resistance. Incubating adipocytes under conditions mimicking the microenvironment of obese adipose tissue, including increased endoplasmic reticulum (ER) stress, induced TRIB3 expression. In human adipocytes, the overexpression of TRIB3 impaired insulin-stimulated protein kinase B (AKT) phosphorylation and caused dysregulation of the transcription of genes encoding bioactive molecules released from adipocytes, such as proinflammatory cytokines, adiponectin, and leptin. Pioglitazone, an insulin-sensitizing agent, reduced both these effects of TRIB3 and the ER stressor–induced expression of TRB3.

Conclusion

Our data indicate that TRIB3 expression in adipose tissue is enhanced in patients with obesity and suggest that increased TRIB3 dysregulates adipocyte function, which may contribute to the development of insulin resistance.
Long-Term Effects of Metreleptin in Rabson-Mendenhall Syndrome on Glycemia, Growth, and Kidney Function
Authors: Okawa Marinna C , Cochran Elaine , Lightbourne Marissa , Brown Rebecca J
Published: October 2021

Context

Rabson-Mendenhall syndrome (RMS) is caused by biallelic pathogenic variants in the insulin receptor gene (INSR) leading to insulin-resistant diabetes, microvascular complications, and growth hormone resistance with short stature. Small, uncontrolled studies suggest that 1-year treatment with recombinant leptin (metreleptin) improves glycemia in RMS.

Objective

This study aimed to determine effects of long-term metreleptin in RMS on glycemia, anthropometrics, the growth hormone axis, and kidney function.

Methods

We compared RMS patients during nonrandomized open-label treatment with metreleptin (≥ 0.15 mg/kg/day) vs no metreleptin over 90 months (5 subjects in both groups at different times, 4 only in metreleptin group, 2 only in control group). Main outcome measures were A1c; glucose; insulin; 24-hour urine glucose; standard deviation scores (SDS) for height, weight, body mass index (BMI), and insulin-like growth factor 1 (IGF-1); growth hormone; and estimated glomerular filtration rate.

Results

Over time, metreleptin-treated subjects maintained 1.8 percentage point lower A1c vs controls (P = 0.007), which remained significant after accounting for changes in insulin doses. Metreleptin-treated subjects had a reduction in BMI SDS, which predicted decreased A1c. Growth hormone increased after metreleptin treatment vs control, with no difference in SDS between groups for IGF-1 or height. Reduced BMI predicted higher growth hormone, while reduced A1c predicted higher IGF-1.

Conclusion

Metreleptin alters the natural history of rising A1c in RMS, leading to lower A1c throughout long-term follow-up. Improved glycemia with metreleptin is likely attributable to appetite suppression and lower BMI SDS. Lower BMI after metreleptin may also worsen growth hormone resistance in RMS, resulting in a null effect on IGF-1 and growth despite improved glycemia.
Management of Childhood-onset Craniopharyngioma in Italy: A Multicenter, 7-Year Follow-up Study of 145 Patients
Authors: Zucchini Stefano , Di Iorgi Natascia , Pozzobon Gabriella , Pedicelli Stefania , Parpagnoli Maria , Driul Daniela , Matarazzo Patrizia , Baronio Federico , Crocco Marco , Iudica Giovanna , Partenope Cristina , Nardini Beatrice , Ubertini Graziamaria , Menardi Rachele , Guzzetti Chiara , Iughetti Lorenzo , Aversa Tommaso , Di Mase Raffaella , Cassio Alessandra ,   Physiopathology of Growth Processes and Puberty Study Group of the Italian Society for Pediatric Endocrinology and Diabetology, Cianfarani Stefano , Maghnie Mohamad , Tuli Gerdi , Loche Sandro , Bruzzi Patrizia , Wasniewska Malgorzata , Salerno Mariacarolina , Rutigliano Irene , Iezzi Maria Laura , Cherubini Valentino , Grandone Anna , Faienza Maria Felicia , Tumini Stefano , Baldoli Cristina , Consales Alessandro , Genitori Lorenzo , Marras Carlo Efisio , MIlanaccio Claudia , Mortini Pietro , Vindigni Marco , Zenga Francesco , Zucchelli Mino
Published: October 2021

Context

Nationwide data on children diagnosed with craniopharyngioma (CP) are not available in Italy.

Objective

This work aimed to identify patients’ characteristics, type of surgical approach, complications and recurrences, number of pituitary deficits, and number of patients starting growth hormone (GH) treatment.

Methods

A retrospective multicenter collection took place of 145 patients aged 0 to 18 years who underwent surgery for CP between 2000 and 2018, and followed up in 17 Italian centers of pediatric endocrinology.

Results

Age at diagnosis was 8.4 ± 4.1 years. Duration of symptoms was 10.8 ± 12.5 months and headache was most frequent (54%), followed by impaired growth (48%) and visual disturbances (44%). Most lesions were suprasellar (85%), and histology was adamantinomatous in all cases but two. Surgical approach was transcranial (TC) in 67.5% of cases and transsphenoidal (TS) in 31.%. The TC approach was prevalent in all age groups. Postsurgery complications occurred in 53% of cases, with water-electrolyte disturbances most frequent. Radiotherapy was used in 39% of cases. All patients but one presented with at least one hormone pituitary deficiency, with thyrotropin deficiency most frequent (98.3%), followed by adrenocorticotropin (96.8%), arginine vasopressin (91.1%), and GH (77.4%). Body mass index (BMI) significantly increased over time. A hypothalamic disturbance was present in 55% of cases. GH therapy was started during follow-up in 112 patients at a mean age of 10.6 years, and 54 developed a recurrence or regrowth of the residual lesion.

Conclusion

CP is often diagnosed late in Italy, with TC more frequent than the TS surgical approach. Postsurgery complications were not rare, and hypopituitarism developed almost in all cases. BMI shows a tendency to increase overtime.
Cardiometabolic and Mental Health in Women With Early Gestational Diabetes Mellitus: A Prospective Cohort Study
Authors: Quansah Dan Yedu , Gross Justine , Gilbert Leah , Pauchet Amelie , Horsch Antje , Benhalima Katrien , Cosson Emmanuel , Puder Jardena J
Published: October 2021

Context

Early diagnosis and treatment of gestational diabetes (GDM) may reduce adverse obstetric and neonatal outcomes, especially in high-risk women. However, there is a lack of data for other outcomes.

Objective

We compared cardiometabolic and mental health outcomes in women with early (eGDM) and classical (cGDM) GDM.

Methods

This prospective cohort included 1185 All women with cGDM and 76 women with eGDM. The eGDM group had GDM risk factors (BMI >30 kg/m2, family history of diabetes, history of GDM, ethnicity), were tested at <20 weeks gestational age, and diagnosed using American Diabetes Association prediabetes criteria. All women underwent lifestyle adaptations. Obstetric, neonatal, mental, and cardiometabolic outcomes were assessed during pregnancy and postpartum.

Results

The eGDM group had lower gestational weight gain than cGDM (10.7 ± 6.2 vs 12.6 ± 6.4; P = 0.03) but needed more medical treatment (66% vs 42%; P < 0.001). They had similar rates of adverse maternal and neonatal outcomes, except for increased large-for-gestational-age infants (25% vs 15%; P = 0.02). Mental health during pregnancy and postpartum did not differ between groups. eGDM had more atherogenic postpartum lipid profile than cGDM (P ≤ 0.001). In eGDM, the postpartum prevalence of the metabolic syndrome (MetS) was 1.8-fold, prediabetes was 3.1-fold, and diabetes was 7.4-fold higher than cGDM (waist circumference-based MetS: 62% vs 34%/BMI-based MetS: 46% vs 24%; prediabetes: 47.5% vs 15.3%; diabetes: 11.9% vs 1.6%, all P < 0.001). These differences remained unchanged after adjusting for GDM risk factors.

Conclusion

Compared with cGDM, eGDM was not associated with differences in mental health, but with increased adverse cardiometabolic outcomes, independent of GDM risk factors and gestational weight gain. This hints to a preexisting risk profile in eGDM.
Maternal 11-Ketoandrostenedione Rises Through Normal Pregnancy and Is the Dominant 11-Oxygenated Androgen in Cord Blood
Authors: He Xin , Banker Margaret , Puttabyatappa Muraly , Padmanabhan Vasantha , Auchus Richard J
Published: October 2021

Context

Adrenal-derived 11-oxygenated androgens (11oAs) are known important contributors to human physiology and disease but have not been studied in pregnancy.

Objective

We characterize 11oAs in normal human pregnancy and neonatal period and assess the ratios between 11oAs and compare with ratios of other steroids that undergo placental metabolism.

Design

Prospective cohort study, 2010-2018.

Setting

Academic institution.

Patients

Pairs of pregnant women and newborns (n = 120) were studied. Inclusion criteria were maternal age between 18 and 42 years old, spontaneous singleton pregnancies, and intention to deliver at University of Michigan.

Intervention

Maternal venous blood was collected during first trimester and at term. Neonatal cord blood was collected following delivery. Steroids were measured via liquid chromatography-tandem mass spectrometry.

Main Outcome Measures

Levels of 11β-hydroxyandrostenedione (11OHA4), 11-ketoandrostenedione (11KA4), 11β-hydroxytestosterone, and 11-ketotestoterone (11KT) in maternal first trimester, maternal term, and neonatal cord blood were compared. 11OHA4-to-11KA4 ratios were correlated with cortisol-to-cortisone ratios.

Results

Dominant 11oAs in pregnancy and the cord blood are 11OHA4 and 11KA4, compared to 11OHA4 and 11KT in adult men and nonpregnant women. We found a rise in 11oA concentrations, particularly 11KA4, from first to third trimester. In cord blood, the concentration of 11KA4 exceeded those of both 11OHA4 and 11KT, reflecting placental 11β-hydroxysteroid dehydrogenase type 2 (11βHSD2) and 17β-hydroxysteroid dehydrogenase (17βHSD2) activities, respectively. 11OHA4-to-11KA4 ratios are concordant with cortisol-to-cortisone ratios across all maternal and fetal compartments, reflecting placental 11βHSD2 activity.

Conclusions

Placental 17βHSD2 activity defends the fetus against the androgen 11KT. Our normative values may be used in future studies of 11oAs in complicated pregnancies.
Crosstalk Between Adipose and Lymphatics in Health and Disease
Authors: Westcott Gregory P , Rosen Evan D
Published: October 2021

Adipose tissue, once thought to be an inert receptacle for energy storage, is now recognized as a complex tissue with multiple resident cell populations that actively collaborate in response to diverse local and systemic metabolic, thermal, and inflammatory signals. A key participant in adipose tissue homeostasis that has only recently captured broad scientific attention is the lymphatic vasculature. The lymphatic system’s role in lipid trafficking and mediating inflammation makes it a natural partner in regulating adipose tissue, and evidence supporting a bidirectional relationship between lymphatics and adipose tissue has accumulated in recent years. Obesity is now understood to impair lymphatic function, whereas altered lymphatic function results in aberrant adipose tissue deposition, though the molecular mechanisms governing these phenomena have yet to be fully elucidated. We will review our current understanding of the relationship between adipose tissue and the lymphatic system here, focusing on known mechanisms of lymphatic-adipose crosstalk.
EFFECTIVE MANAGEMENT OF ARCTIC TOURISM SAFETY BASED ON BIOMEDICAL PREDICTIVE MODELS OF ADAPTATION TO EXTREME CONDITIONS
Authors: Chistova Viktoriya V. , Logunova Ekaterina V. , Pashinskaya Ksenia O. , Ryzhikova Elena M. , Romanova Ekaterina D. , Vasiliev Alexander G. , Udalov Alexander N.
Published: October 2021

The article analyzes the literature on the organization of tourist health safety in the Arctic. The Arctic territories of the Russian Federation have the potential and prospects for the development of tourism. Some people staying for the purpose of tourism in the Arctic have a high degree of vulnerability to the action of natural environmental factors even when creating comfortable conditions, which is determined when assessing the level of health and the adaptive potential of the body. In the Arctic, there is a threat to health safety, which is expressed by a deterioration in the functional state and exacerbation of chronic diseases. Methods for assessing the psycho-functional state of the human body in the Arctic are presented, which make it possible to identify early adaptation disorders and determine the characteristics of chronic diseases. It is concluded that it is necessary, from the standpoint of an integrated approach, to study the level of health of tourists and develop a program that will prevent the development of maladjustment and associated pathological conditions. Maintaining the initial level of health and preventing the development of maladjustment and associated pathological conditions will contribute to ensuring health safety when a tourist is in the territories that are part of the Arctic and Arctic zones of the Russian Federation.
SELF-PRESERVATION ATTITUDES OF YOUTH AND ADOLESCENTS DURING THE COVID-19 PANDEMIC
Authors: Simaeva Irina N. , Budarina Anna O.
Published: October 2021

Purpose. The study is aimed at the analysis of the fundamental structure, functions and self-preservation attitudes and manifestations in the behavior of youth and adolescents in human ecology-aware contexts during the COVID-19 pandemic.

Background. Against the backdrop of the COVID-19 pandemic, there has come up an insufficient psychological readiness of young people of many countries, including the Russian Federation, for self-preserving behavior under the threat of an infectious disease with high virulence. The results of the study make it possible to assess the possible risks and develop preventive measures for correcting the social orientation of youth and adolescents towards maintaining health among individuals and social groups of young people.

Study Design. The article presents the results of an empirical study of the cognitive, conative (stimulating) and emotional components of the self-preservation attitudes of adolescents and youth. It is shown how the latent dysfunction of the attitude towards maintaining health and impaired self-preservation behavior in the relatively safe period, manifests itself as a predisposition to the behavior that poses a threat to human health and survival during the COVID-19 pandemic. A comparative analysis of the structure, functions and phenomena of self-preservation attitudes of young people before and during the pandemic has been made based on empirical studies of the authors conducted in the Kaliningrad region of the Russian Federation within the period of 2010–2019.

Participants. 600 respondents in the city of Kaliningrad and the Kaliningrad region were examined during the period of 10 years (2010–2019). They comprised secondary school children aged 12–16 (20%), and men (34%) and women (46%) being university and college students majoring in humanitarian and technical fields of study aged 18–24.

Methods. The authorial methodology “The Readiness for Self-Preservation Behavior” in comparison with the data analysis within the contexts of the COVID-19 pandemic which were available to access from the Internet, open global media sources, public records, and the official sources.

Results. The dysfunction and weakness of the self-preserving attitude is caused by the low level and inconsistency of the cognitive, conative (behavioral), emotional and evaluative components in the structure of the self-preserving attitude settings for different spheres of life in adolescents and students in the Kaliningrad region, as well as a lack of behavioral experience that strengthens the psychological disorientation of young people in the field of health preservation.

Findings. The low psychological readiness of young people to maintain health and display human the self-preserving behavior during the COVID-19 pandemic was manifested by irrelevant behavioral phenomena: the neglect of protective equipment and hygiene measures, as well as the open and veiled resistance to the self-isolation regime.
First report of severe acute respiratory syndrome coronavirus 2 detection in two asymptomatic cats in the state of Pernambuco, Northeastern Brazil
Authors: da Silva Epifanio Ivyson , dos Santos Rodrigues Davi , de Lima Leonardo Borges , de Azevedo Nogueira Maria Aurea , do Monte Pessoa Felix Laelia Reginae , de Almeida Barbara Ferreira , da Silva Farias Claudia Kathariny , de Carvalho Otavio Valerio , de Cassia Carvalho Maia Rita , Ristow Luiz Eduardo , Barbosa David Soeiro , Galhardo Juliana Arena , Pettan-Brewer Christina , Kmetiuk Louise Bach , Agopian Rafael Garabet , Dutra Valeria , de Morais Helio Autran , dos Santos Andrea Pires , Biondo Alexander Welker , Brandespim Daniel Friguglietti
Published: October 2021

Background and Aim: Despite worldwide case reports, including Brazilian cases, no frequency study on infection of pets by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been conducted to date in Brazil. Accordingly, the present study was aimed to assess dogs and cats belonging to positive owners in Recife, Northeastern Brazil.

Materials and Methods: This was a longitudinal prospective study on dogs and cats in the city of Recife whose owners were in isolation at home due to a confirmed laboratory diagnosis of SARS-CoV-2 through reverse-transcriptase polymerase chain reaction (RT-qPCR). Oral and rectal swabs from the pets were tested for the presence of SARS-CoV-2-specific RNA by means of RT-qPCR.

Results: Among the pets tested, 0/16 dogs and 2/15 cats were positive for SARS-CoV-2. Interestingly, the two positive cats were owned by two unrelated asymptomatic veterinary students, which, therefore, post a warning to veterinarians worldwide.

Conclusion: The findings herein indicate that cats may act as sentinels for human cases, particularly sharing households with asymptomatic human cases. Although with small sampling and convenient recruiting, the presence of infected cats by SARS-CoV-2 was most likely due to close cat-human contact with positive owners, posting a human-animal health threat when pets share the same bed and interact with owners without protection, particularly during owner self-isolation. Thus, infected owners should follow the same human preventive guidelines with their pets to avoid spreading infection.
Assessment of the inter-platform reproducibility of ultrasound attenuation examination in nonalcoholic fatty liver disease
Authors: Jeon Sun Kyung , Lee Jeong Min , Joo Ijin , Yoon Jeong Hee
Published: October 2021

Purpose: This study aimed to assess the inter-platform reproducibility of ultrasound attenuation examination in patients with nonalcoholic fatty liver disease (NAFLD).Methods: Between March 2021 and April 2021, patients with clinically suspected or known NAFLD were prospectively enrolled; each patient underwent ultrasound attenuation examinations with three different platforms (Attenuation Imaging [ATI], Canon Medical System; Tissue Attenuation Imaging [TAI], Samsung Medison; and Ultrasound-Guided Attenuation Parameter [UGAP], GE Healthcare) on the same day. The mean attenuation coefficient (AC) values of the three platforms were compared using repeated-measures analysis of variance with the Bonferroni correction. To evaluate inter-platform reproducibility, the AC values obtained for each platform were compared using Bland-Altman analysis with the calculation of 95% limits of agreement (LOA), intraclass correlation coefficients (ICCs), and coefficients of variation (CVs).Results: Forty-six patients (23 men; mean age±standard deviation, 52.3±12.4 years) were enrolled. The mean AC values showed significant differences among the three platforms (0.75±0.12, 0.80±0.11, and 0.74±0.09 dB/cm/MHz for ATI, TAI, and UGAP, respectively; P<0.001). For inter-platform reproducibility, the 95% LOAs were -0.22 to 0.11 dB/cm/MHz between ATI and TAI, -0.17 to 0.18 dB/cm/MHz between ATI and UGAP, and -0.08 to 0.20 dB/cm/MHz between TAI and UGAP, respectively. The pairwise ICCs were 0.790-0.797 in terms of absolute agreement among the three platforms; the CVs were 8.23%-9.47%.Conclusion: The AC values obtained from different ultrasound attenuation examination platforms showed significant differences, with significant inter-platform variability. Therefore, the AC values measured using different ultrasound attenuation examination techniques should not be used interchangeably for longitudinal follow-up of patients with NAFLD.
Wpływ sezonu pozyskania wybranych gatunków ryb z polskiej akwakultury na profil kwasów tłuszczowych i wskaźniki żywieniowe lipidów ich mięsa
Authors: Kaliniak Agnieszka
Published: October 2021

Celem pracy była ocena wpływu sezonu pozyskania wybranych gatunków ryb hodowanych w Polsce na profil kwasów tłuszczowych i wskaźniki żywieniowe lipidów ich mięsa. Badaniami objęto 4 gatunki ryb krajowej akwakultury: pstrąga tęczowego (Oncorhynchus mykiss), karpia (Cyprinus carpio), amura białego (Ctenopharyngodon idella) oraz szczupaka (Esox lucius). Ryby pozyskano z gospodarstw rybackich położonych w województwie lubelskim w dwóch sezonach: wiosenno-letnim i jesienno-zimowym. Analizowano skład chemiczny mięsa (zawartość: wody, związków mineralnych jako popiół, białka i tłuszczu), wartość kaloryczną, wskaźnik jakości żywieniowej (NQI), jak również profil kwasów tłuszczowych i ich proporcje oraz indeksy (aterogenny – AI, trombogenny – TI, saturacji – S/P, wartości odżywczej lipidów – NV oraz proporcję kwasów o działaniu hipo- i hipercholesterolemicznym – h/H). Niezależnie od sezonu pozyskania mięso badanych gatunków ryb stanowiło dobre źródło białka oraz było dobrze zbilansowane pod względem zawartości lipidów. Wyjątek stanowiła tkanka mięśniowa szczupaka, która była bardzo ubogim źródłem tłuszczu. W sezonie jesienno-zimowym mięso badanych gatunków ryb zawierało więcej kwasów tłuszczowych wielonienasyconych, w tym kwasów n-3 i n-3 LC-PUFA, w porównaniu z sezonem wiosenno-letnim. Mięso amura białego w sezonie jesienno-zimowym charakteryzowało się istotnie wyższą (korzystniejszą) proporcją kwasów tłuszczowych PUFA/SFA, n-3/n-6, n-3 LC-PUFA/n-6 LC-PUFA oraz wykazywało istotnie niższe właściwości aterogenne. Pod względem żywieniowym najkorzystniejsze wskaźniki, w tym najniższy poziom saturacji i najkorzystniejszą proporcję kwasów o działaniu hipo- i hipercholesterolemicznym oraz najsłabsze działanie atero- i trombogenne, wykazywało mięso pstrąga tęczowego w sezonie jesienno-zimowym.
Application of natural substances to reduce pH value of egg-based mayonnaise products
Authors: Ševelová Martina , Golian Jozef
Published: October 2021

The objective of the research study is driven by the need to reduce the pH value of gourmet foods containing eggs with regard to their quality and safety. The analyses were focused on the production of mayonnaise and mayonnaise-containing salads and egg spread. To decrease the pH value of gourmet products, a pH-reducing (‘pH minus’) ingredient was applied, which was added at a concentration of 2 % (w/w) to the aqueous phase during the production of the two types of mayonnaise. The ‘pH minus’ preparation was a clear, yellowish solution with a sour taste and aroma; it was made from lemon juice and onion essential oil. The traditional or pH-reduced mayonnaise was mixed with the egg salad and egg spread. The products manufactured were analyzed in terms of microbiological and sensory quality; then they were compared with the control samples of the original products. Those two gourmet products (egg salads and egg spreads) differed in the acidity compared to the control samples. After adding the ‘pH minus’ preparation, the acidity of egg salad and egg spread samples was, on average, 0.2 % higher compared to the control samples. On the other hand, the pH value of the samples was by 0.2 to 0.5 lower than that of the control samples of those two types of gourmet products analysed. The adding of the ‘pH minus‘ solution caused the number of the units forming filamentous fungal colonies in the samples to be reduced by 3 × 101 CFU×g-1 on average. The remaining microbiological parameters were comparable with those of the control samples.