bluuebunny/crossref_metadata_2025 huggingface dataset:
Low-Vacuum Scanning Electron Microscopy to Assess Histopathological Resolution of Class V Lupus Nephritis: A Case Report
Authors: Yoshida Maria , Hirashio Shuma , Doi Toshiki , Masuda Yukinari , Shimizu Akira , Masaki Takao
Published: February 2021

Lupus nephritis (LN) is most frequently associated with poor outcomes in patients with systemic lupus erythematosus (SLE). LN manifests as histopathological changes in the kidney caused by immune complex formation and deposition. In particular, immunoglobulin G (IgG) deposits are frequently observed by immunofluorescence staining, which helps to establish the diagnosis of LN. In this case report, we describe a 57-year-old woman with SLE who had been undergoing treatment on an outpatient basis for 11 years. Her first and second renal biopsies revealed class V LN with a coarsely granular pattern of IgG deposition in the peripheral capillary walls. However, her third renal biopsy showed no IgG deposition, which indicated histopathological resolution of her class V LN. We used low-vacuum scanning electron microscopy (LV-SEM) to examine the three-dimensional structural alterations in her glomerular basement membranes. In this report, we describe findings that indicated resorption of epithelial deposits, that is, resolution of LN. The results of repeated kidney biopsies confirmed by LV-SEM suggested the possibility of a state unrelated to LN.
Hepatitis E Viral Association with Autoimmune Hepatitis: A Viral Trigger or Cross-Reactivity
Authors: Elfert Khaled A. , Qasim Hana Mahmoud , Faisal Mohanad M. , Elghazali Aya , Siddiqui Mohammed Y.A. , Petkar Mahir , Sadik Nagham
Published: February 2021

Autoimmune hepatitis (AIH) is a chronic disease characterized by hepatocellular inflammation and destruction. Its pathogenesis remains unclear. Current evidence suggests that environmental factors, including viral infections, are implicated as possible triggers. We present a case of a 36-year-old lady with systemic lupus erythematosus who presented with abdominal pain, nausea, vomiting, and jaundice. She was initially diagnosed as acute hepatitis E virus (HEV) infection based on positive serology, but she did not improve with conservative management. Subsequently, she underwent liver biopsy that showed features characteristic of AIH. We discuss the role of HEV as a possible trigger of AIH. We also highlight the possibility of cross-reactivity between liver antigens and HEV as an explanation for the positive HEV serology in AIH. We explore the management options of cases in which both acute HEV infection and AIH coexist, which might be challenging as there is no current consensus whether to start immunosuppressive therapy or to manage such cases conservatively. Moreover, we discuss previous similar cases in which different lines of management were chosen.
Association of Dietary Fluoride Intake and Diet Variables with Dental Caries in Adolescents from the ELEMENT Cohort Study
Authors: Cantoral Alejandra , Muñoz-Rocha Teresa V. , Luna-Villa Lynda , Mantilla-Rodriguez Andres , Ureña-Cirett José L. , Castiblanco Gina A. , Solano Maritsa , Hu Howard , Peterson Karen E. , Téllez-Rojo Martha M. , Martinez-Mier E. Angeles
Published: February 2021

To examine the association of dietary fluoride intake, total carbohydrate consumption and other key dietary variables with dental caries experience among adolescents, a cross-sectional analysis was conducted in a sample of 402 participants from the Early Life Exposures in Mexico to Environmental Toxicants cohort. The presence and severity of dental caries were assessed using the International Caries Detection and Assessment System (ICDAS) to calculate the number of decayed, missing, and filled teeth or surfaces (D1MFT/D4MFT). The dietary intake of fluoride, energy, carbohydrates, and food groups was estimated using a validated food frequency questionnaire (FFQ). Multivariate zero-inflated negative binomial regression models and negative binomial regression models were run to estimate the association of fluoride intake (mg/day) and total carbohydrate intake (g/day) with the D1MFT/D4MFT index. We found that 80% of the adolescents experienced dental caries (D1MFT >0), with 30% presenting cavitated lesions (D4MFT >0). The mean scores for D1MFT and D4MFT were 6.2 (SD 5.3) and 0.67 (SD 1.3), respectively. The median intake of fluoride estimated by the FFQ was 0.015 mg/kg/day. This intake was statistically higher in participants with a D4MFT = 0 compared to those with a D4MFT >0 (0.90 vs. 0.82 mg/day; 0.016 vs. 0.014 mg/kg/day; p < 0.05). For D1MFT, D1MFS, D4MFT, and D4MFS scores, a higher fluoride consumption (mg/day) from foods and beverages was associated with a statistically significant reduction in the number of lesions. The reported frequency of consumption of sugary foods in a whole day was statistically higher in those with D1MFT >0 than in those with D1MFT = 0 (p < 0.05). The total carbohydrate intake (g/day) was positively associated with dental caries experience. We conclude that a higher fluoride intake through foods and beverages is associated with a lower dental caries experience among adolescents; this effect was seen even when the dietary intake of fluoride was 0.015 mg/kg/day, which is lower than the average intake recommendation. In contrast, a higher total carbohydrate intake and the frequency of intake of sugary foods were associated with a higher dental caries experience, with no apparent threshold for the effects.
Application of the 18-Item Dementia Elderly Odayaka Scale in Japan: Evaluation before and after Intervention
Authors: Tsujimura Hiromi , Osawa Makoto , Makita Setsuko
Published: February 2021

Introduction: We have developed the Dementia Elderly Odayaka Scale (DEOS) to evaluate psychosocial aspects in older people. The DEOS can be used to assess well-being, such as personhood and social interaction. Objective: The aim of this study was to apply the 18-item DEOS in participants with dementia and to examine the characteristics and usefulness of this scale. Methods: Facility staff provided care for the participants while taking into consideration each participant’s individuality and strong points. The DEOS was applied at the beginning of the interventions and at 1 and 2 months after the start of the interventions. The changes in the participants’ behaviors and their DEOS scores were then evaluated over time. Results: We examined 13 participants (2 men, 11 women) between the ages of 68 and 91 years. In 60% of the participants the DEOS score increased over time. When care interventions were tailored toward communication and leadership for the 2 men, according to each of their individualities, we observed increases in their scores for “social interaction” at 1 and 2 months thereafter. We also observed increases in the scores for “Expression of emotions” category in 2 of the 5 cases who received an aromatherapy massage. Discussion/Conclusion: The changes in the scores over time and the contents of the field notes were consistent with each other, suggesting that the DEOS can be used both to evaluate the effects of interventions and to plan care that takes advantage of each participant’s positive aspects.
Large Fundic Gland Polyp Associated with Long-Term Proton Pump Inhibitor Administration Mimicking Gastric-Type Neoplasm
Authors: Ochiai Yorinari , Kikuchi Daisuke , Ito Shinji , Takazawa Yutaka , Hoteya Shu
Published: February 2021

A 57-year-old man with a 10-year history of proton pump inhibitor (PPI) use presented with multiple fundic gland polyps (FGPs) including one >20 mm, whitish, semi-pedunculated polyp. Black spots and cobblestone-like mucosa were also observed in the stomach upon endoscopy; therefore, the lesion was considered to result from long-term PPI administration. Endoscopically, we diagnosed this polyp as a neoplastic lesion with gastric phenotype rather than a non-neoplastic lesion. Biopsy revealed an atypical glandular lesion that was indeterminate for neoplasia; therefore, we performed en bloc resection via endoscopic submucosal dissection (ESD) of the 22 × 22 × 10 mm-sized polyp. Histologically, the polyp was composed of hyperplastic foveolar epithelia in the upper half of the mucosa and hyperplastic fundic glands in the lower half of the mucosa, with luminal dilatation and parietal cell protrusion. The pathological diagnosis for this ESD specimen was FGP associated with PPI administration. We herein describe this rare case of a large FGP in Helicobacter pylori-uninfected gastric mucosa associated with long-term PPI administration, which was mimicking gastric-type neoplasm and resected by endoscopy.
The Clinical Efficacy of Nitrofurantoin for Treating Uncomplicated Urinary Tract Infection in Adults: A Systematic Review of Randomized Control Trials
Authors: Porreca Angelo , D’Agostino Daniele , Romagnoli Daniele , Del Giudice Francesco , Maggi Martina , Palmer Katie , Falabella Roberto , De Berardinis Ettore , Sciarra Alessandro , Ferro Matteo , Artibani Walter , Mirone Vincenzo , Busetto Gian Maria
Published: February 2021

Objective: To provide an updated systematic review of randomized control trials (RCTs) to investigate the clinical and microbiological efficacy of nitrofurantoin compared to other antibiotics or placebo for treatment of uncomplicated urinary tract infections (uUTI). A secondary aim is to assess whether nitrofurantoin use is associated with increased side effects compared to other treatment regimens. Summary: The review was performed according to PRISMA guidelines. We searched 4 databases for articles published from database inception to May 6, 2020: (1) PubMed electronic database of the National Library of Medicine, (2) Web of Science, (3) Embase, and (4) Cochrane Library. Nine RCTs were selected for the review. RCTs were a mixture of double-blind, single-blind, and open-label trials. The most common comparators were trimethoprim-sulfamethoxazole and fosfomycin tromethamine. Overall study quality was poor with a high risk of bias. The clinical cure rates in nitrofurantoin ranged from 51 to 94% depending on the length of follow-up, and bacteriological cure rates ranged from 61 to 92%. Overall the evidence suggests that nitrofurantoin is at least comparable with other uUTI treatments in terms of efficacy. Patients taking nitrofurantoin reported fewer side effects than other drugs and the most commonly reported were gastrointestinal and central nervous system symptoms. Key Messages: Evidence on the clinical and bacteriological efficacy of nitrofurantoin is sparse, with a lack of new data, and hampered by high risk of bias. Although no firm conclusions can be made on the current base of evidence, the studies generally suggest that nitrofurantoin is at least comparable to other common uUTI treatments in terms of clinical and bacteriological cure. More robust research with well-designed double-blinded RCTs is needed.
Real-Time Digital Biometric Monitoring during Elite Athletic Competition: System Feasibility with a Wearable Medical-Grade Sensor
Authors: Gorski Mark A. , Mimoto Stanley M. , Khare Vivek , Bhatkar Viprali , Combs Arthur H.
Published: February 2021

Introduction: Real-time digital heart rate (HR) monitoring in sports can provide unique physiological insights into athletic performance. However, most HR monitoring of elite athletes is limited to non-real-time, non-competition settings while utilizing sensors that are cumbersome. The present study was undertaken to test the feasibility of using small, wearable medical-grade sensors, paired with a novel technology system, to capture and process real-time HR data from elite athletes during professional competition. Methods: We examined the performance of the BioStamp nPoint® sensor compared to the Polar chest strap HR sensor in 15 Professional Squash Association (PSA) tournament matches in 2019–2020. Fourteen male professional squash players volunteered for the study (age = 23.8 ± 4.9 years; height = 177.9 ± 7.1 cm; weight = 71 ± 7.0 kg), which was approved by the PSA in accordance with their Code of General Conduct and Ethics. Algorithms developed by Sports Data Labs (SDL; Detroit, MI, USA) used proprietary data collection, transmission, and signal processing protocols to produce HR values in real-time during matches. We calculated the mean and maximum HR from both sensors and used widely accepted measures of agreement to compare their performance. Results: The system captured 99.8% of HR data across all matches (range 98.3–100%). The BioStamp’s mean HR was 170.4 ± 20.3 bpm, while the Polar’s mean HR was 169.4 ± 21.7 bpm. Maximum HR ranged from 182 to 202 bpm (Polar) and 185 to 203 bpm (BioStamp). Spearman’s correlation coefficient (rs) was 0.986 (p < 0.001), indicating a strong correlation between the 2 devices. The mean difference (d) in HR was 1.0 bpm, the mean absolute error was 2.2 bpm, and the percent difference was 0.72%, demonstrating high agreement between device measurements. Conclusions: It is feasible to accurately measure and monitor real-time HR in elite athletes during competition using BioStamp’s and SDL’s proprietary system. This system facilitates development and understanding of physiological digital biomarkers of athletic performance and physical and psychosocial demands in elite athletic competition.
Effect of Inotropes on Patient-Reported Health Status in End-Stage Heart Failure
Authors: Clarke John-Ross D. , Riello Ralph , Allen Larry A. , Psotka Mitchell A. , Teerlink John R. , Lindenfeld JoAnn , Desai Nihar R. , Ahmad Tariq
Published: February 2021

Background:

A growing population of patients with end-stage heart failure (HF) with reduced ejection fraction has limited treatment options to improve their quality and quantity of life. Although positive inotropes have failed to show survival benefit, these agents may enhance patient-reported health status, that is, symptoms, functional status, and health-related quality of life. We sought to review the available clinical trial data on positive inotrope use in patients with end-stage HF and to summarize evidence supporting the use of these agents to improve health status of patients with end-stage HF.

Methods:

A literature review of randomized controlled trials examining the use of positive inotropy in HF with reduced ejection fraction was conducted. We searched MEDLINE, SCOPUS, and Web of Science between January 1980 to December 2018 for randomized controlled trials that used as their main outcome measures the effects of inotrope therapy on (1) morbidity/mortality, (2) symptoms, (3) functional status, or (4) health-related quality of life. Inotropes of interest included adrenergic agents, phosphodiesterase inhibitors, calcium sensitizers, myosin activators, and SERCA2a (sarcoplasmic reticulum Ca
2+
-ATPase) modulators.

Results:

Twenty-two out of 26 inotrope randomized controlled trials measured the effect of inotropes on at least one patient-reported health status domain. Among the 22 studies with patient-related health status outcomes, 11 (50%) gauged symptom response, 15 (68%) reported functional capacity changes, and 12 (54%) reported health-related quality of life measures. Fourteen (64%) of these trials noted positive outcomes in at least one health status domain measured; 11 (79%) of these positive studies used agents that worked through phosphodiesterase inhibition.

Conclusions:

There has been a lack of standardization surrounding measurement of patient-centered outcomes in studies of inotropes for end-stage HF with reduced ejection fraction. The degree to which positive inotropes can improve patient-reported health status and the adverse risk they pose remains unknown.
Patients With
LDLR
and
PCSK9
Gene Variants Experienced Higher Incidence of Cardiovascular Outcomes in Heterozygous Familial Hypercholesterolemia
Authors: Doi Takahito , Hori Mika , Harada‐Shiba Mariko , Kataoka Yu , Onozuka Daisuke , Nishimura Kunihiro , Nishikawa Ryo , Tsuda Kosuke , Ogura Masatsune , Son Cheol , Miyamoto Yoshihiro , Noguchi Teruo , Shimokawa Hiroaki , Yasuda Satoshi
Published: February 2021

Background

Patients with familial hypercholesterolemia who harbored both low‐density lipoprotein receptor (
LDLR
) and
PCSK9
(proprotein convertase subtilisin/kexin type 9) gene variants exhibit severe phenotype associated with substantially high levels of low‐density lipoprotein cholesterol. In this study, we investigated the cardiovascular outcomes in patients with both
LDLR
and
PCSK9
gene variants.

Methods and Results

A total of 232 unrelated patients with
LDLR
and/or
PCSK9
gene variants were stratified as follows: patients with
LDLR
and
PCSK9
(
LDLR/PCSK9
) gene variants, patients with
LDLR
gene variant, and patients with
PCSK9
gene variant. Clinical demographics and the occurrence of primary outcome (nonfatal myocardial infarction) were compared. The observation period of primary outcome started at the time of birth and ended at the time of the first cardiac event or the last visit. Patients with
LDLR/PCSK9
gene variants were identified in 6% of study patients. They had higher levels of low‐density lipoprotein cholesterol (
P
=0.04) than those with
LDLR
gene variants. On multivariate Cox regression model, they experienced a higher incidence of nonfatal myocardial infarction (hazard ratio, 4.62; 95% CI, 1.66–11.0;
P
=0.003 versus patients with
LDLR
gene variant). Of note, risk for nonfatal myocardial infarction was greatest in male patients with
LDLR/PCSK9
gene variants compared with those with
LDLR
gene variant (86% versus 24%;
P
<0.001).

Conclusions

Patients with
LDLR/PCSK9
gene variants were high‐risk genotype associated with atherogenic lipid profiles and worse cardiovascular outcomes. These findings underscore the importance of genetic testing to identify patients with
LDLR/PCSK9
gene variants, who require more stringent antiatherosclerotic management.
Mitochondrial DNA Content Is Linked to Cardiovascular Disease Patient Phenotypes
Authors: Wei, Ruipeng , Ni, Ying , Bazeley, Peter , Grandhi, Sneha , Wang, Janet , Li, Samuel T. , Hazen, Stanley L. , Wilson Tang, W. H. , LaFramboise, Thomas
Published: February 2021

Background

We sought to determine whether mitochondrial DNA (mtDNA) content can be used as markers for 12 key phenotypes among cardiovascular disease patients, and whether these markers are valid across patients with diverse ancestries.

Methods and Results

DNA was collected from the peripheral blood of 996 cardiovascular disease patients at the Cleveland Clinic. The mtDNA copy number and DNA‐level variation were assessed from whole‐genome sequence. Patients were also ascertained retrospectively for histories of 10 clinical events, as well as for maximum stenosis and extent of disease at baseline. Self‐reported race and maternal ancestry inferred from mtDNA sequence were recorded. MtDNA copy number and overall mtDNA rare variant load were significantly lower in patients with histories of various adverse clinical events, and mtDNA copy number was inversely correlated with extent of disease. Strong associations were also found between absence of rare variants in the genes
MT
‐ATP6
and
MT‐COII
and patient histories of hyperlipidemia and myocardial infarction, respectively. Importantly, associations were not ancestry dependent.

Conclusions

This study provides evidence that mtDNA copy number in circulation is associated with a variety of cardiovascular disease patient phenotypes. Results also suggest a protective role for some rare inherited mtDNA variants. Overall, the study supports the potential of mtDNA content and abundance as biomarkers in heart disease, in a manner that is valid across diverse ancestries.
Physical Pleasure and Moral Action: An Analogy in Augustine’s Thought
Authors: Knight Amanda
Published: February 2021

The present essay argues that Augustine’s understanding of the physical mechanism of pain and pleasure bears an analogous relationship to the internal mechanics of his moral psychology. The significance of this analogy is threefold. It corroborates emerging consensus positions regarding Augustine’s moral psychology, including recognizing the significance of Stoic influences as well as construing Augustine’s psychology as monistic; it draws attention to a greater consistency between Augustine’s earlier and later accounts of moral psychology than is typically recognized in scholarship; and it offers a schema that organizes the significant components of Augustine’s moral psychology, like his theory of action, habit, the will, and conversion, in relation to one another within a single conceptual system.
The Ilisu Dam and Its Impact on the Mesopotamian Marshes of Iraq: Implications for the Future Directions of International Water Law
Authors: Thaman Raquella Moea
Published: February 2021

The law of international watercourses has been successful in providing some measure of assistance in conflict avoidance and resolution. However, evolution of this body of law, which has been gradual in nature, is facing challenges adapting to climate change and its grave consequences. Climate change is causing the glaciers of the world to melt, and resulting in unpredictable shifts in patterns of rainfall, thus seriously impacting shared watercourses. The history and ecology of the Tigris Euphrates Basin, and the issues surrounding Turkey’s recent impoundment of water behind the Ilisu Dam on the Tigris, provide an example highlighting such challenges. This monograph argues that international collaboration over transboundary watercourses is imperative for maintaining peace and stability and should force us to think of new ways to address these newly emerging and growing challenges in this field.
A new broad-leaved species of loquat from eastern Myanmar and its phylogenetic affinity in the genus Eriobotrya (Rosaceae)

Authors: Kang Dae-Hyun , Ong Homervergel G. , Lee Jung-Hoon , Jung Eui-Kwon , Kyaw Naing-Oo , Fan Qiang , Kim Young-Dong
Published: February 2021

Eriobotrya shanense, a new species from the karst region of Shan State, eastern Myanmar, is described and illustrated. This evergreen tree is similar to the autumn and winter-flowering, large-leaved species E. malipoensis and E. japonica by having tomentose hairs on the abaxial leaf surface, but can be distinguished by its obovate, widely obelliptic or oval blade shape, leaf length-width ratio of 2:1 (vs. 3:1), and rounded or obtuse apex (vs. acute). The species also resembles less-known, undercollected Myanmar broad-leaved species E. wardii and E. platyphylla in leaf shape and length-width ratio, but can be easily differentiated by the presence of tomentose hairs on the leaves, and inflorescence. Phylogenetic analysis based on nrDNA ITS region supported its close affinity with E. malipoensis and E. japonica. Molecular data also generally grouped the 17 congeneric taxa accessions in congruence to their leaf morphology, with the entire Eriobotrya clade strongly supported to be monophyletic and separate from Rhaphiolepis.
A new species of Macrothrix (Crustacea, Branchiopoda, Macrothricidae) from the Neotropics with description of the marthae-group
Authors: SOUSA FRANCISCO DIOGO R. , DE FREITAS DANIELE FÁTIMA BASTOS , PERBICHE-NEVES GILMAR , BERTINI GIOVANA
Published: February 2021

Publications of the last three decades demonstrated the existence of some compact species groups within the Macrothrix Baird genus (Cladocera: Macrothricidae). Many species were included in hirsuticornis-group, laticornis-group, rosea-triserialis-group and paulensis-group, but not in Macrothrix marthae group. It has a peculiar set of morphological traits not observed in any other species, so far. Studying material from Ribeira de Iguape River, Brazil, we found some individuals that resemble M. marthae, which represent a new species described herein. Macrothrix lourdesae sp. nov shares with M. marthae similar morphology of Inner Distal Lobe setae and the same modifications on the fourth and fifth limbs. The main difference between them is related to the number of setae in the exopodite of the third limb. Observing the high number of morphological traits shared, it is possible to indicate that M. lourdesae sp. nov and M. marthae form a separate species group within the genus.
A Climatology of Atmospheric Rivers in New Zealand
Authors: Prince Hamish D. , Cullen Nicolas J. , Gibson Peter B. , Conway Jono , Kingston Daniel G.
Published: February 2021

The occurrence of extreme precipitation events in New Zealand regularly results in devastating impacts to the local society and environment. An automated atmospheric river (AR) detection technique (ARDT) is applied to construct a climatology (1979–2019) of extreme midlatitude moisture fluxes conducive to extreme precipitation. A distinct seasonality exists in AR occurrence aligning with seasonal variations in the midlatitude jet streams. The formation of the Southern Hemisphere winter split jet enables AR occurrence to persist through all seasons in northern regions of New Zealand, while southern regions of the country exhibit a substantial (50%) reduction in AR occurrence as the polar jet shifts southward during the cold season. ARs making landfall on the western coast of New Zealand (90% of all events) are characterized by a dominant northwesterly moisture flux associated with a distinct dipole pressure anomaly, with low pressure to the southwest and high pressure to the northeast of New Zealand. Precipitation totals during AR events increase with AR rank (five-point scale) throughout the country, with the most substantial increase on the windward side of the Southern Alps (South Island). The largest events (rank 5 ARs) produce 3-day precipitation totals exceeding 1000 mm. ARs account for up to 78% of total precipitation and up to 94% of extreme precipitation on the west coast of the South Island. Assessment of the multiscale atmospheric processes associated with AR events governing extreme precipitation in the Southern Alps of New Zealand should remain a priority given their hydrological significance and impact on people and infrastructure.
Coupled Ocean–Atmosphere Covariances in Global Ensemble Simulations: Impact of an Eddy-Resolving Ocean
Authors: Frolov Sergey , Reynolds Carolyn A. , Alexander Michael , Flatau Maria , Barton Neil P. , Hogan Patrick , Rowley Clark
Published: February 2021

Patterns of correlations between the ocean and the atmosphere are examined using a high-resolution (1/12° ocean and ice, 1/3° atmosphere) ensemble of data assimilative, coupled, global, ocean–atmosphere forecasts. This provides a unique perspective into atmosphere–ocean interactions constrained by assimilated observations, allowing for the contrast of patterns of coupled processes across regions and the examination of processes affected by ocean mesoscale eddies. Correlations during the first 24 h of the coupled forecast between the ocean surface temperature and atmospheric variables, and between the ocean mixed layer depth and surface winds are examined as a function of region and season. Three distinct coupling regimes emerge: 1) regions characterized by strong sea surface temperature fronts, where uncertainty in the ocean mesoscale influences ocean–atmosphere exchanges; 2) regions with intense atmospheric convection over the tropical oceans, where uncertainty in the modeled atmospheric convection impacts the upper ocean; and 3) regions where the depth of the seasonal mixed layer (MLD) determines the magnitude of the coupling, which is stronger when the MLD is shallow and weaker when the MLD is deep. A comparison with models at lower horizontal (1/12° vs 1° and 1/4°) and vertical (1- vs 10-m depth of the first layer) ocean resolution reveals that coupling in the boundary currents, the tropical Indian Ocean, and the warm pool regions requires high levels of horizontal and vertical resolution. Implications for coupled data assimilation and short-term forecasting are discussed.
GEOlimma: differential expression analysis and feature selection using pre-existing microarray data
Authors: Lu Liangqun , Townsend Kevin A. , Daigle Bernie J.
Published: February 2021

Background

Differential expression and feature selection analyses are essential steps for the development of accurate diagnostic/prognostic classifiers of complicated human diseases using transcriptomics data. These steps are particularly challenging due to the curse of dimensionality and the presence of technical and biological noise. A promising strategy for overcoming these challenges is the incorporation of pre-existing transcriptomics data in the identification of differentially expressed (DE) genes. This approach has the potential to improve the quality of selected genes, increase classification performance, and enhance biological interpretability. While a number of methods have been developed that use pre-existing data for differential expression analysis, existing methods do not leverage the identities of experimental conditions to create a robust metric for identifying DE genes.

Results

In this study, we propose a novel differential expression and feature selection method—GEOlimma—which combines pre-existing microarray data from the Gene Expression Omnibus (GEO) with the widely-applied Limma method for differential expression analysis. We first quantify differential gene expression across 2481 pairwise comparisons from 602 curated GEO Datasets, and we convert differential expression frequencies to DE prior probabilities. Genes with high DE prior probabilities show enrichment in cell growth and death, signal transduction, and cancer-related biological pathways, while genes with low prior probabilities were enriched in sensory system pathways. We then applied GEOlimma to four differential expression comparisons within two human disease datasets and performed differential expression, feature selection, and supervised classification analyses. Our results suggest that use of GEOlimma provides greater experimental power to detect DE genes compared to Limma, due to its increased effective sample size. Furthermore, in a supervised classification analysis using GEOlimma as a feature selection method, we observed similar or better classification performance than Limma given small, noisy subsets of an asthma dataset.

Conclusions

Our results demonstrate that GEOlimma is a more effective method for differential gene expression and feature selection analyses compared to the standard Limma method. Due to its focus on gene-level differential expression, GEOlimma also has the potential to be applied to other high-throughput biological datasets.
Lipid profile and prognosis in patients with coronary heart disease: a meta-analysis of prospective cohort studies
Authors: Zhao Xiangmei , Wang Dongying , Qin Lijie
Published: February 2021

Background

This meta-analysis based on prospective cohort studies aimed to evaluate the associations of lipid profiles with the risk of major adverse cardiovascular outcomes in patients with coronary heart disease (CHD).

Methods

The PubMed, Embase, and Cochrane Library electronic databases were systematically searched for prospective cohort study published through December 2019, and the pooled results were calculated using the random-effects model.

Results

Twenty-one studies with a total of 76,221 patients with CHD met the inclusion criteria. The per standard deviation (SD) increase in triglyceride was associated with a reduced risk of major adverse cardiovascular events (MACE). Furthermore, the per SD increase in high-density lipoprotein cholesterol (HDL-C) was associated with a reduced risk of cardiac death, whereas patients with lower HDL-C were associated with an increased risk of MACE, all-cause mortality, and cardiac death. Finally, the risk of MACE was significantly increased in patients with CHD with high lipoprotein(a) levels.

Conclusions

The results of this study suggested that lipid profile variables could predict major cardiovascular outcomes and all-cause mortality in patients with CHD.
Interprofessional primary care during COVID-19: a survey of the provider perspective
Authors: Donnelly Catherine , Ashcroft Rachelle , Bobbette Nicole , Mills Christine , Mofina Amanda , Tran Todd , Vader Kyle , Williams Ashley , Gill Sandeep , Miller Jordan
Published: February 2021

Background

Interprofessional primary care (IPC) teams provide comprehensive and coordinated care and are ideally equipped to support those populations most at risk of adverse health outcomes during the COVID-19 pandemic, including older adults, and patients with chronic physical and mental health conditions. There has been little focus on the experiences of healthcare teams and no studies have examined IPC practice during the early phase of the COVID-19 pandemic. The objective of the study was to describe the state of interprofessional health provider practice within IPC teams during the COVID-19 pandemic.

Methods

Observational cross-sectional design. A web-based survey was deployed to IPC providers working in team-based primary care clinics in the province of Ontario, Canada. The survey included 26 close-ended and six open-ended questions. Close-ended questions were analyzed using descriptive statistics. Content analysis was used to analyze the open-ended questions.

Results

445 surveys were included in the final analysis. Service delivery shifted from in-person care (77% pre-COVID-19) to telephone (76.5% during the COVID-19 pandemic). Less than half of the respondents (40%) reported receiving any training for virtual delivery. Wait times to access team members were reported to have decreased. There has also been a shift in what IPC providers report as the most commonly seen conditions, with increases in visits related to mental health concerns, acute infections (including COVID-19), social isolation, and resource navigation. Respondents also reported a reduction in healthcare provision for multiple chronic conditions including diabetes, cardiovascular disease, and chronic pain.

Conclusions

IPC teams are rapidly shifting their practice to supporting their patients during the pandemic. A surge in mental health issues has been seen and is expected to continue to increase in response to COVID-19. Understanding early experiences can help plan for future pandemic waves.
The biometric parameters of aniso-astigmatism and its risk factor in Chinese preschool children: the Nanjing eye study
Authors: Tong Haohai , Hao Qingfeng , Wang Zijin , Wang Yue , Li Rui , Zhao Xiaoyan , Sun Qigang , Zhang Xiaohan , Chen Xuejuan , Zhu Hui , Huang Dan , Liu Hu
Published: February 2021

Backgrounds

Aniso-astigmatism may hinder normal visual development in preschool children. Knowing its prevalence, biometric parameters and risk factors is fundamental to children eye care. The purpose of this study was to determine the biometric components of aniso-astigmatism and associated maternal risk factors in Chinese preschool children.

Methods

In the population-based, prospective cohort Nanjing Eye Study, children were measured for noncycloplegic refractive error using an autorefractor and for biometric parameters using an optical low-coherent reflectometry. The difference of total astigmatism (TA) between both eyes was calculated using cylinder power (non-vectorial aniso-TA was defined as ≥1.00 Dioptre Cylinder [DC] between both eyes) and by vector analysis (vectorial aniso-TA was defined as a difference of ≥0.5 inJ0orJ45between both eyes which is equivalent to 1.00 DC). The prevalence of aniso-TA was presented. Interocular biometric parameters were compared between with vs. without aniso-astigmatism group. In addition, risk factors were determined using multivariate logistic regression model.

Results

Of 1131 children (66.90 ± 3.38 months, 53.31% male), the prevalence of non-vectorial aniso-TA was 1.95% (95% Confidence Interval (CI) = 1.14–2.75%), while the prevalence of vectorial aniso-TA was twice as common as non-vectorial aniso-TA, neither varying with sex or age. With aniso-TA eyes were more asymmetric in axial length and corneal curvature radius than without aniso-TA eyes. In multivariate logistic regression model, 5-min Apgar score less than 7 was significantly associated with higher risk of aniso-TA (vectorial aniso-TA: Odds Ratio (OR) = 6.42, 95%CI = 2.63–15.69,P < 0.001; non-vectorial aniso-TA: OR = 4.99, 95%CI = 1.41–17.68,P = 0.01). Being twin or triple was significantly associated with higher risk of vectorial aniso-CA (OR = 2.43, 95%CI = 1.05–5.60,P = 0.04). Pre-term delivery (OR = 2.60, 95%CI = 1.09–6.15,P = 0.03) and post-term delivery (OR = 3.61, 95%CI = 1.31–9.96,P = 0.01) were significantly associated with higher risk of vectorial aniso-CA.

Conclusions

Both corneal curvature radius and axial length asymmetry were correlated with aniso-TA. Children with 5-min Apgar score < 7 were more likely to have aniso-TA, while twin or triple, pre-term or post-term delivery were more likely to have vectorial aniso-CA.
Dopamine D4 receptor gene polymorphism (DRD4 VNTR) moderates real-world behavioural response to the food retail environment in children
Authors: Paquet Catherine , Portella Andre Krumel , Moore Spencer , Ma Yu , Dagher Alain , Meaney Michael J. , Kennedy James L. , Levitan Robert D. , Silveira Patricia P. , Dube Laurette
Published: February 2021

Background

Evidence for the impact of the food retailing environment on food-related and obesity outcomes remains equivocal, but only a few studies have attempted to identify sub-populations for whom this relationship might be stronger than others. Genetic polymorphisms related to dopamine signalling have been associated with differences in responses to rewards such as food and may be candidate markers to identify such sub-populations. This study sought to investigate whether genetic variation of the dopamine D4 receptor gene (DRD4 exon III 48 bp VNTR polymorphism) moderated the association between local exposure to food retailers on BMI and diet in a sample of 4 to12-year-old children.

Methods

Data collected from a birth cohort and a community cross-sectional study conducted in Montreal, Canada, were combined to provide DRD4 VNTR polymorphism data in terms of presence of the 7-repeat allele (DRD4-7R) for 322 children aged between 4 and 12 (M (SD): 6.8(2.8) y). Outcomes were Body Mass Index (BMI) for age and energy density derived from a Food Frequency Questionnaire. Food environment was expressed as the proportion of local food retailers classified as healthful within 3 km of participants’ residence. Linear regression models adjusted for age, sex, income, cohort, and geographic clustering were used to test gene*environment interactions.

Results

A significant gene*food environment interaction was found for energy density with results indicating that DRD4-7R carriers had more energy dense diets than non-carriers, with this effect being more pronounced in children living in areas with proportionally more unhealthy food retailers. No evidence of main or interactive effects of DRD4 VNTR and food environment was found for BMI.

Conclusions

Results of the present study suggest that a genetic marker related to dopamine pathways can identify children with potentially greater responsiveness to unhealthy local food environment. Future studies should investigate additional elements of the food environment and test whether results hold across different populations.
Social and behavioral risk reduction strategies for tuberculosis prevention in Canadian Inuit communities: a cost-effectiveness analysis
Authors: Uppal Aashna , Oxlade Olivia , Nsengiyumva Ntwali Placide , N’Diaye Dieynaba S. , Alvarez Gonzalo G. , Schwartzman Kevin
Published: February 2021

Background

Tuberculosis (TB) is an important public health problem in Inuit communities across Canada, with an annual incidence rate in 2017 that was nearly 300 times higher than in Canadian-born non-Indigenous individuals. Social and behavioral factors that are prevalent in the North, such as commercial tobacco use, excessive alcohol use, food insecurity and overcrowded housing put individuals at higher risk for TB morbidity and mortality. We examined the potential impact of mitigation strategies for these risk factors, in reducing TB burden in this setting.

Methods

We created a transmission model to simulate the epidemiology of TB in Nunavut, Canada. We then used a decision analysis model to assess the potential impact of several evidence-based strategies targeting tobacco use, excessive alcohol use, food insecurity and overcrowded housing. We predicted TB incidence, TB-related deaths, quality adjusted life years (QALYs), and associated costs and cost-effectiveness over 20 years. All costs were expressed in 2018 Canadian dollars.

Results

Compared to a status quo scenario with no new interventions for these risk factors, the reduction strategy for tobacco use was most effective and cost-effective, reducing TB incidence by 5.5% (95% uncertainty range: 2.7–11%) over 20 years, with an estimated cost of $95,835 per TB case prevented and $49,671 per QALY gained. The addition of the food insecurity reduction strategy reduced incidence by a further 2% (0.5–3%) compared to the tobacco cessation strategy alone, but at significant cost.

Conclusions

Strategies that aim to reduce commercial tobacco use and improve food security will likely lead to modest reductions in TB morbidity and mortality. Although important for the communities, strategies that address excess alcohol use and overcrowding will likely have a more limited impact on TB-related outcomes at current scale, and are associated with much higher cost. Their benefits will be more substantial with scale up, which will also likely have important downstream impacts such as improved mental health, educational attainment and food security.
LncRNA LINC01116 sponges miR-93-5p to promote cell invasion and migration in small cell lung cancer
Authors: Liu Wenzhou , Liang Feihai , Yang Guangyu , Xian Lei
Published: February 2021

Background

LINC01116 is a recently identified oncogenic lncRNA in glioma. Differential expression analysis using the public gene expression analysis tool GEPIA revealed the upregulation of LINC01116 in lung cancer. We studied the functions of LINC01116 in small cell lung cancer (SCLC).

Methods

The expression of LINC01116 in several types of cancer tissue and the paired non-tumor tissues was evaluated by GEPIA. The effects of the overexpression of LINC01116 and miR-93-5p on the expression of STAT3 were evaluated. The effects of the overexpression of LINC01116, miR-93-5p and STAT3 on SHP-77 cell behaviors were evaluated by Transwell assays.

Results

LINC01116 was highly expressed in SCLC and predicted poor survival. In SCLC tissues, the expression of LINC01116 was positively correlated with STAT3. Bioinformatics analysis revealed that miR-93-5p may target LINC01116. Overexpression of LINC01116 increased STAT3 but did not affect the expression of miR-93-5p. Transwell assay showed that LINC01116 and STAT3 increased cell invasion and migration rates. MiR-93-5p played an suppressed cell behaviors and suppressed the role of LINC01116.

Conclusion

Therefore, LINC01116 might upregulate STA3 by sponging miR-93-5p, thereby promoting cell invasion and migration in SCLC.
Circumferential dissection of deep fascia as ancillary technique in circumcision: is it possible to correct phimosis increasing penis size?
Authors: Carmine Pagano , Mario Faenza , Antonio Guastafierro , Vincenzo Manfellotto , Elisa Grella , Angelo Cosenza , Gorizio Pieretti , Sara Izzo
Published: February 2021

Background

Phimosis is the inability to retract the preputium downward over the glans penis. Despite the various techniques of preputial plasty described in literature, the most performed surgical treatment is still the conventional circumcision.

Methods

In this paper we retrospectively reviewed data of a homogeneous population of 36 consecutive adult patients who underwent phimosis correction by circumcsion with dissection of the Deep Fascia. Patients were followed up by one independent plastic surgeon that measured penis length and circumference in nonerected state preoperatively and at 6 month time postoperatively.

Results

The Wilcoxon Signed Rank Test showed a significant (p < 0.0001) difference between the two groups both in terms of length and circumference.

Conclusions

In conclusion, the ancillary technique we described leads to an increase of penis size, is safe and easy to perform and does not increase significantly operative time nor complication rate to the conventional procedure.
Partial hepatectomy for treatment of multiple liver abscess in a calf: a case report
Authors: Sato Reiichiro , Yamada Kazutaka , Yokoyama Taiki , Tanimoto Koki , Takeuchi Shoko , Tatsuzawa Natsumi , Nakui Shiho , Satoh Hiroyuki , Fadul Mahmoud , Steiner Adrian
Published: February 2021

Background

Umbilical vein bacterial infections may cause liver abscesses during bacterial ascent. A single liver abscess can be surgically treated by marsupialization, but a risk of recurrence or non-healing remains. Moreover, there is no effective treatment for multiple abscesses.

Case presentation

A 17-day-old Holstein female calf exhibited reduced general condition, swelling and drainage of the umbilicus, and pressure sores in the area of the carpus, resulting in reluctance to stand up. The umbilicus showed pain at palpation; deep abdominal palpation indicated a swollen umbilical vein coursing from the umbilicus toward the liver. Ultrasonography confirmed a swollen umbilical vein with pus accumulation and multiple abscesses in the liver. Contrast-enhanced computed tomography (CT) examination confirmed that the swollen umbilical vein with fluid continued to the liver, and multiple unenhanced lesions, most likely abscesses, were confirmed in the liver. Partial hepatectomy was performed to remove as many abscesses as possible. For the resection, a vessel sealing device (LigaSureTM) was used to excise a part of the left liver lobe. As we could not remove all the abscesses in the liver during the operation, cefazolin sodium (5 mg/kg) was administered for 14 days after surgery. Post-operatively, blood accumulation was observed in the abdominal cavity, but no signs of peritonitis were found. The calf returned to the farm on day 38 after surgery. Follow-up information was obtained after 1 year, and complications were not reported.

Conclusions

To our knowledge, this is the first report of partial hepatectomy using a vessel sealing device for a calf with multiple liver abscesses. This case report suggests that the combination of partial hepatectomy and long-term administration of antibacterial drugs may restore the health of calves with multiple liver abscesses.