bluuebunny/crossref_metadata_2025 huggingface dataset:
The transitions and predictors of cognitive frailty with multi-state Markov model: a cohort study
Authors: Yuan Manqiong , Xu Chuanhai , Fang Ya
Published: July 2022

Background

Cognitive frailty (CF) is characterized by the simultaneous presence of physical frailty and cognitive impairment. Previous studies have investigated its prevalence and impact on different adverse health-related outcomes. Few studies have focused on the progression and reversibility of CF and their potential predictors.

Methods

Data were derived from the China Health and Retirement Longitudinal Study (CHARLS). A total of 4051 older adults with complete data on three waves of the survey (2011, 2013, and 2015) were included and categorized into four groups: normal state (NS), cognitive impairment (CI) only, physical frailty (PF) only and CF (with both PF and CI). A multi-state Markov model was constructed to explore the transitions and predicting factors of CF.

Results

The incidence and improvement rates of CF were 1.70 and 11.90 per 100 person-years, respectively. The 1-year transition probability of progression to CF in those with CI was higher than that in the PF population (0.340 vs. 0.054), and those with CF were more likely to move to PF (0.208). Being female [hazard ratio (HR) = 1.46, 95%CI = 1.06, 2.02)], dissatisfied with life (HR = 4.94, 95%CI = 1.04, 23.61), had a history of falls (HR = 2.36, 95%CI = 1.02, 5.51), rural household registration (HR = 2.98, 95%CI = 1.61, 5.48), multimorbidity (HR = 2.17, 95%CI = 1.03, 4.59), and depression (HR = 1.75, 95%CI = 1.26, 2.45) increased the risk of progression to CF, whereas literacy (HR = 0.46, 95%CI = 0.33, 0.64) decreased such risk. Depression (HR = 0.43, 95%CI = 0.22, 0.84) reduced the likelihood of CF improvement, whereas literacy (HR = 2.23, 95%CI = 1.63, 3.07) increased such likelihood.

Conclusions

Cognitive frailty is a dynamically changing condition in older adults. Possible interventions aimed at preventing the onset and facilitating the recovery of cognitive frailty should focus on improving cognitive function in older adults.
Development and validation of a nomogram for predicting the 6-months survival rate of patients undergoing incident hemodialysis in China
Authors: Li Guode , Jiang linsen , Li Jiangpeng , Shen Huaying , Jiang Shan , Ouyang Han , Song Kai
Published: July 2022

Background

The all-cause mortality of patients undergoing hemodialysis (HD) is higher than in the general population. The first 6 months after dialysis are important for new patients. The aim of this study was to develop and validate a nomogram for predicting the 6-month survival rate of HD patients.

Methods

A prediction model was constructed using a training cohort of 679 HD patients. Multivariate Cox regression analyses were performed to identify predictive factors. The identified factors were used to establish a nomogram. The performance of the nomogram was assessed using the C-index and calibration plots. The nomogram was validated by performing discrimination and calibration tests on an additional cohort of 173 HD patients.

Results

During a follow-up period of six months, 47 and 16 deaths occurred in the training cohort and validation cohort, respectively, representing a mortality rate of 7.3% and 9.2%, respectively. The nomogram comprised five commonly available predictors: age, temporary dialysis catheter, intradialytic hypotension, use of ACEi or ARB, and use of loop diuretics. The nomogram showed good discrimination in the training cohort [C-index 0.775(0.693–0.857)] and validation cohort [C-index 0.758(0.677–0.836)], as well as good calibration, indicating that the performance of the nomogram was good. The total score point was then divided into two risk classifications: low risk (0–90 points) and high risk (≥ 91 points). Further analysis showed that all-cause mortality was significantly different between the high-risk group and the low-risk group.

Conclusions

The constructed nomogram accurately predicted the 6-month survival rate of HD patients, and thus it can be used in clinical decision-making.
Epidemiology of geographic disparities in heart failure among US older adults: a Medicare-based analysis
Authors: Yu Bin , Akushevich Igor , Yashkin Arseniy P. , Yashin Anatoliy I. , Lyerly H. Kim , Kravchenko Julia
Published: July 2022

Background

There are prominent geographic disparities in the life expectancy (LE) of older US adults between the states with the highest (leading states) and lowest (lagging states) LE and their causes remain poorly understood. Heart failure (HF) has been proposed as a major contributor to these disparities. This study aims to investigate geographic disparities in HF outcomes between the leading and lagging states.

Methods

The study was a secondary data analysis of HF outcomes in older US adults aged 65+, using Center for Disease Control and Prevention sponsored Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database and a nationally representative 5% sample of Medicare beneficiaries over 2000–2017. Empiric estimates of death certificate-based mortality from HF as underlying cause of death (CBM-UCD)/multiple cause of death (CBM-MCD); HF incidence-based mortality (IBM); HF incidence, prevalence, and survival were compared between the leading and lagging states. Cox regression was used to investigate the effect of residence in the lagging states on HF incidence and survival.

Results

Between 2000 and 2017, HF mortality rates (per 100,000) were higher in the lagging states (CBM-UCD: 188.5–248.6; CBM-MCD: 749.4–965.9; IBM: 2656.0–2978.4) than that in the leading states (CBM-UCD: 79.4–95.6; CBM-MCD: 441.4–574.1; IBM: 1839.5–2138.1). Compared to their leading counterparts, lagging states had higher HF incidence (2.9–3.9% vs. 2.2–2.9%), prevalence (15.6–17.2% vs. 11.3–13.0%), and pre-existing prevalence at age 65 (5.3–7.3% vs. 2.8–4.1%). The most recent rates of one- (77.1% vs. 80.4%), three- (59.0% vs. 60.7%) and five-year (45.8% vs. 49.8%) survival were lower in the lagging states. A greater risk of HF incidence (Adjusted Hazards Ratio, AHR [95%CI]: 1.29 [1.29–1.30]) and death after HF diagnosis (AHR: 1.12 [1.11–1.13]) was observed for populations in the lagging states. The study also observed recent increases in CBMs and HF incidence, and declines in HF prevalence, prevalence at age 65 and survival with a decade-long plateau stage in IBM in both leading and lagging states.

Conclusion

There are substantial geographic disparities in HF mortality, incidence, prevalence, and survival across the U.S.: HF incidence, prevalence at age 65 (age of Medicare enrollment), and survival of patients with HF contributed most to these disparities. The geographic disparities and the recent increase in incidence and decline in survival underscore the importance of HF prevention strategies.
The effect of phasic versus combined neuromuscular electrical stimulation using the StimaWELL 120MTRS system on multifidus muscle morphology and function in patients with chronic low back pain: a randomized controlled trial protocol
Authors: Fortin Maryse , Wolfe Daniel , Dover Geoffrey , Boily Mathieu
Published: July 2022

Background

Neuromuscular electrical stimulation (NMES) is used to improve muscle strength clinically when rehabilitating various musculoskeletal disorders. However, the effects of NMES on muscle morphology and function in individuals with non-specific chronic low back pain (CLBP) have scarcely been investigated. Although research links deficits in the paraspinal musculature with subjective reports of pain and disability, it is unknown if treatment with NMES can help reverse these deficits. Therefore, the primary aim of this study is to compare the effects of two muscle therapy protocols with a medium-frequency electrotherapy device (the StimaWELL 120MTRS system) on multifidus muscle morphology and function in CLBP patients. The secondary aims are to determine the effects of these protocols subjective reports of pain intensity, pain interference, disability, and catastrophizing.

Methods

A total of 30 participants with non-specific CLBP, aged 18–60, will be recruited from local orthopedic clinics and databases. Participants will be randomized (1:1) to either the phasic or combined (phasic + tonic) muscle therapy protocols on the StimaWELL 120MTRS system. Participants will undergo 20 supervised electrotherapy treatments over a 10-week period. The primary outcomes will be multifidus morphology (e.g. cross-sectional area (CSA), fat infiltration) and function (e.g., contraction measured via %thickness change from a rested to contracted state, and stiffness at rest and during contraction). Secondary outcomes will include pain intensity, interference, disability, and catastrophizing. Both primary and secondary outcomes will be obtained at baseline and at 11-weeks; secondary outcomes measured via questionnaires will also be obtained at 6-weeks, while LBP intensity will be measured before and after each treatment. Paired t-tests will be used to assess within-group changes for all primary outcome measures. A two-way repeated-measures analysis of variance will be used to assess changes in secondary outcomes over time.

Discussion

The results of this trial will help clarify the role of medium-frequency NMES on lumbar multifidus morphology and function.

Trial Registration

NCT04891692, registered retrospectively on May 18, 2021.
Comprehensive evaluation of root and root canal morphology of mandibular second molars in a Saudi subpopulation evaluated by cone-beam computed tomography
Authors: Almansour Moazzy I. , Al‑Zubaidi Saad M. , Enizy Abdulmjeed S. , Madfa Ahmed A.
Published: July 2022

Background

The study's goal was to use Cone Beam Computed Tomography (CBCT) to assess the root and root canal anatomy of mandibular second molars with C-shaped root canal configurations in residents of the Hail district. The impact of gender and side on the frequency of root canal morphology was considered.

Methods

The sample size for this study was 304 untreated mandibular second molars with completely developed roots on the right and left sides. Using CBCT on the teeth, the root form and canal morphology for each root are based on Vertucci's classification. The occurrence of canals in the shape of a C. The prevalence and resemblance of the left and right sides or men and females were investigated. The Chi-square test was performed to evaluate the findings.

Results

Of the 304 mandibular second molars studied, 286 teeth had two roots (94.1%), whilst 13 (4.3%) were C-shaped root canal systems. 77 molars (25.3%) had two canal orifices, 219 (72.0%) had three canal orifices, and six (2.0%) and one (0.3%) had four and five root canal orifices, respectively. Type IV was the most common for mesial root, accounting for 57.7% of the sample (n = 176). For distal root, the most common occurrence was type I, which occurred 282 times (96.60%). The most prevalent root canal morphology was the presence of two canals in the mesial root and one canal in the distal root of teeth with two distinct roots (variant 3). (69.4%). The overall prevalence of C-shaped root canal systems is (4.3%) (n = 13).

Conclusions

The patient's race is an undeniable factor that influences root canal anatomy. The root canal morphology of mandibular second molars revealed significant differences between Saudi subpopulations. The majority of mandibular second molars had two roots and three root canals. When treating these molars, the presence of a C-shaped root canal system must be taken into account.
How blogs support the transfer of knowledge into practice in the field of dementia palliative care: a survey of facilitators and barriers
Authors: Rukundo Aphie , Fox Siobhan , Guerin Suzanne , Kernohan George , Drennan Jonathan , O’Connor Niamh , Timmons Suzanne
Published: July 2022

Background

Blogging can help to maximise the impact of one’s work in academia and beyond by making research findings accessible for multiple knowledge users, such as healthcare professionals and the public, as well as other researchers. As part of the knowledge exchange and dissemination activities of the Model for Dementia Palliative Care Project, this study explored stakeholders’ views of blogs as a means to translate research findings.

Methods

A web-based survey was developed, piloted, and revised. It was distributed electronically via key dementia and palliative care organisations websites, newsletters, social media platforms, and within the staff mailing lists of five Universities in Ireland. Data were analysed using descriptive statistics and content analysis.

Results

Complete responses were received from 128 participants. The majority of respondents were healthcare researchers (n = 53), followed by healthcare providers (n = 46). The preferred methods of reviewing research findings were scientific papers, websites and news articles. Respondents read healthcare blogs “sometimes” (39.1%), with < 19% reading them “often” or “very often”. Receiving an email notification might increase the likelihood of reading a new blog post for 83% of respondents. Barriers to engaging with blogs included lack of time, preference for other media, lack of awareness regarding available blogs, and concerns about the credibility and source of information. An appropriate length and the author of the blog were key features that encouraged engagement with a blog.

Conclusions

Despite respondents choosing a scientific paper as their preferred method to consume research findings, many indicated an openness to reading blogs on their area of interest. Creating concise, relevant, and credible blogs, and suitably promoting them, could increase the impact and reach of healthcare research, such as in the emerging field of dementia palliative care, and thus promote translation of research findings into practice.
The baroreceptor reflex brought to life outside the classroom – an e-learning based asynchronous laboratory class using a non-supervised modified Active Standing Test
Authors: Heinrich Tobias , Sehner Susanne , Wageringel Isabel , Ehmke Heimo , Schwoerer Alexander Peter
Published: July 2022

Background

E-learning based laboratory classes can replace or enhance in-classroom laboratories. They typically offer temporal flexibility, self-determined learning speed, repeatability and do not require supervision or face-to-face contact. The aim of this feasibility study was to investigate whether the established in-classroom laboratory class on the baroreceptor reflex (BRR) can be transformed into a new e-learning based asynchronous laboratory class for untrained, non-supervised students without medical equipment. The BRR is a fundamental cardiovascular process which is regularly visualized in physiology during in-classroom laboratories by a student-performed Active Standing Test (AST). During this voluntary provocation of orthostatic stress, the BRR reliably causes a solid rise in heart rate (HR) and a stabilization or even increase in blood pressure (BP).

Methods

The conventional AST was modified by omission of BP measurements which would require medical devices and was embedded into a framework of interactive digital material allowing independent student performance. With specific adaptions, this instrument was implemented to 1st and 2nd year curricula of human medicine, dental medicine, midwifery and pharmacy. An audience response system was used to collect the students’ data on HR, epidemiology, technical problems, satisfaction and orthostatic symptoms. As primary outcome, we investigated the students’ correct performance of the modified AST regarding textbook conformity of the HR data. Secondary outcomes included technical feasibility, the students’ satisfaction and consistency of HR data within predefined subgroups (e.g., gender, curricula). Descriptive statistics are reported.

Results

The class was completed by 217 students (mean age: 23 ± 8 [SD], 81% female, 19% male). Mean reported rise of HR during standing was ~ 20 bpm (~ 30%) which is highly concordant to textbooks. Reported feasibility (~ 80% negated any technical issues) and students’ satisfaction (4.4 on 5-point Likert-scale) were high. The HR data were consistent within the subgroups.

Conclusion

This study demonstrates that the highly relevant BRR can be successfully addressed in an e-learning based asynchronous laboratory class implementing a non-supervised AST restricted to HR measurements embedded in digital material. The robust HR response and the adjustable complexity allow an application to different healthcare-related curricula. This class, therefore, provides a broad audience access to a fundamental concept of cardiovascular physiology.
Molecular detection of haemophilic pathogens reveals evidence of Candidatus Mycoplasma haemobos in dogs and parasitic ticks in central China
Authors: Shi Hongfei , Li Bozhen , Li Jie , Chen Shiwei , Wang Lulu , Bai Zhenzhen , Zhu Li , Yan Baolong , Yao Lunguang
Published: July 2022

Background

In addition to Mycoplasma haemocanis and Candidatus Mycoplasma haematoparvum, a few hemoplasma species that mainly infect other livestock have been detected in dogs. ‘Candidatus Mycoplasma haemobos’ (Ca. M. haemobos) has been found in a variety of animals in China. The present study was aimed to investigate the occurrence of ‘Ca. M. haemobos’ infections in dogs and ticks collected from the Henan province, China.

Results

Overall, 55 dog blood samples and 378 ticks on skins were collected from anemic and healthy dogs, and these samples were subjected to PCR, sequence analysis, and identification. The results showed that Haemaphysalis longicornis (266) and Rhipicephalus (Boophilus) microplus (112) were the only two parasitic ticks on dogs. Molecular detection revealed that 163 M. haemocanis, 88 ‘Ca. M. haemobos’ and 32 Anaplasma platys positive amplicons could be amplified from dogs, H. longicornis and R. (B.) microplus. In addition, co-infections (M. haemocanis + A. platys and ‘Ca. M. haemobos’+ A. platys) could be also detected.

Conclusions

To the best of our knowledge, this is the first molecular evidence of ‘Ca. M. haemobos’ natural infection in dogs and tick species identified as H. longicornis and R. (B.) microplus from China.
Exosomal microRNAs in diabetic heart disease
Authors: Chandrasekera Dhananjie , Katare Rajesh
Published: July 2022

Diabetes is a metabolic disorder that affects millions of people worldwide. Diabetic heart disease (DHD) comprises coronary artery disease, heart failure, cardiac autonomic neuropathy, peripheral arterial disease, and diabetic cardiomyopathy. The onset and progression of DHD have been attributed to molecular alterations in response to hyperglycemia in diabetes. In this context, microRNAs (miRNAs) have been demonstrated to have a significant role in the development and progression of DHD. In addition to their effects on the host cells, miRNAs can be released into circulation after encapsulation within the exosomes. Exosomes are extracellular nanovesicles ranging from 30 to 180 nm in diameter secreted by all cell types. They carry diverse cargos that are altered in response to various conditions in their parent cells. Exosomal miRNAs have been extensively studied in recent years due to their role and therapeutic potential in DHD. This review will first provide an overview of exosomes, their biogenesis and function, followed by the role of exosomes in cardiovascular disease and then focuses on the known role of exosomes and associated miRNAs in DHD.
Subsequent malaria enhances virus-specific T cell immunity in SIV-infected Chinese rhesus macaques
Authors: Liu Guangjie , Qin Li , Li Youjia , Zhao Siting , Shugay Mikhail , Yan Yongxiang , Ye Yijian , Chen Yue , Huang Cuizhu , Bayaer Nashun , Adah Dickson , Zhang Hui , Su Zhong , Chen Xiaoping
Published: July 2022

Background

Coinfection with HIV and Plasmodium parasites is fairly common, but the sequence of infection with these two pathogens and their impact on disease progression are poorly understood.

Methods

A Chinese rhesus macaque HIV and Plasmodium coinfection model was established to compare the impact of pre-existing and subsequent malaria on the progression of SIV infection.

Results

We found that a pre-existing malaria caused animals to produce a greater number of CD4+CCR5+ T cells for SIV replication, resulting in higher viral loads. Conversely, subsequent malaria induced a substantially larger proportion of CD4+CD28highCD95high central memory T cells and a stronger SIV-specific T cell response, maintained the repertoire diversity of SIV-specific T cell receptors, and generated new SIV-specific T cell clonotypes to trace SIV antigenic variation, resulting in improved survival of SIV-infected animals.

Conclusion

The complex outcomes of this study may have important implications for research on human HIV and malaria coinfection. The infection order of the two pathogens (HIV and malaria parasites) should be emphasized.
Investigating the experience of receiving podiatry care in a tertiary care hospital clinic for people with diabetes related foot ulcers
Authors: Ong Emilee Kim Ming , Fryer Caroline , Graham Kristin , Causby Ryan Scott
Published: July 2022

Background

Diabetes related foot ulcers can have physical, social, emotional, and financial impacts on the daily life and wellbeing of many people living with diabetes. Effective treatment of diabetes related foot ulcers requires a multi‐faceted, multi‐disciplinary approach involving a podiatrist, other healthcare professionals, and the person with diabetes however, limited research has been conducted on the lived experience of podiatric treatment for diabetes related foot ulcers to understand how people are engaged in their ulcer management. Therefore, this study aimed to explore the lived experience of receiving podiatric treatment for diabetes related foot ulcers in a tertiary care outpatient setting.

Methods

Ten participants were interviewed. All were male, with mean age of 69 (SD 15) years and currently undergoing podiatric treatment for a diabetes related foot ulcer in a tertiary care setting. Participants with diabetes related foot ulcers were purposively recruited from the outpatient podiatry clinic at a tertiary hospital in a metropolitan region of South Australia. Semi‐structured interviews were conducted to gain insight into the lived experience of people receiving podiatric treatment for their foot ulcer and understand how this experience impacts their regular lifestyle. Data were analysed using a thematic analysis method.

Results

Four themes were identified that add an understanding of the lived experience of participants: ‘Trusting the podiatrists with the right expertise’, ‘Personalised care’, ‘Happy with the service, but not always with prescribed care’, and ‘It's a long journey’. Participants described professional behaviour including high organisation and hygiene practices and demonstrated expertise as key factors influencing their trust of a podiatrist's care. Information tailored to individual needs was helpful for participants. Offloading devices and ulcer dressings were often burdensome. Podiatric treatment for foot ulcers was a lengthy and onerous experience for all participants.

Conclusions

The findings of this study suggest podiatrists can use practical strategies of maintaining consistency in who provides podiatry care for the person, demonstration of high organisational and hygiene standards, and using innovation to adapt information and equipment to suit an individual's lifestyle to support positive experiences of podiatric ulcer care. There is a need for further research to understand how a person's experience of podiatric ulcer care differs amongst genders, cultural groups, and healthcare settings to facilitate positive care experiences and reduce treatment burden for all people with diabetes requiring podiatric ulcer treatment.
Clinical predictors of response to methotrexate in patients with rheumatoid arthritis: a machine learning approach using clinical trial data
Authors: Duong Stephanie Q. , Crowson Cynthia S. , Athreya Arjun , Atkinson Elizabeth J. , Davis John M. , Warrington Kenneth J. , Matteson Eric L. , Weinshilboum Richard , Wang Liewei , Myasoedova Elena
Published: July 2022

Background

Methotrexate is the preferred initial disease-modifying antirheumatic drug (DMARD) for rheumatoid arthritis (RA). However, clinically useful tools for individualized prediction of response to methotrexate treatment in patients with RA are lacking. We aimed to identify clinical predictors of response to methotrexate in patients with rheumatoid arthritis (RA) using machine learning methods.

Methods

Randomized clinical trials (RCT) of patients with RA who were DMARD-naïve and randomized to placebo plus methotrexate were identified and accessed through the Clinical Study Data Request Consortium and Vivli Center for Global Clinical Research Data. Studies with available Disease Activity Score with 28-joint count and erythrocyte sedimentation rate (DAS28-ESR) at baseline and 12 and 24 weeks were included. Latent class modeling of methotrexate response was performed. The least absolute shrinkage and selection operator (LASSO) and random forests methods were used to identify predictors of response.

Results

A total of 775 patients from 4 RCTs were included (mean age 50 years, 80% female). Two distinct classes of patients were identified based on DAS28-ESR change over 24 weeks: “good responders” and “poor responders.” Baseline DAS28-ESR, anti-citrullinated protein antibody (ACPA), and Health Assessment Questionnaire (HAQ) score were the top predictors of good response using LASSO (area under the curve [AUC] 0.79) and random forests (AUC 0.68) in the external validation set. DAS28-ESR ≤ 7.4, ACPA positive, and HAQ ≤ 2 provided the highest likelihood of response. Among patients with 12-week DAS28-ESR > 3.2, ≥ 1 point improvement in DAS28-ESR baseline-to-12-week was predictive of achieving DAS28-ESR ≤ 3.2 at 24 weeks.

Conclusions

We have developed and externally validated a prediction model for response to methotrexate within 24 weeks in DMARD-naïve patients with RA, providing variably weighted clinical features and defined cutoffs for clinical decision-making.
Loss of tau expression attenuates neurodegeneration associated with α-synucleinopathy
Authors: Vermilyea Scott C. , Christensen Anne , Meints Joyce , Singh Balvindar , Martell-Martínez Héctor , Karim Md. Razaul , Lee Michael K.
Published: July 2022

Background

Neuronal dysfunction and degeneration linked to α-synuclein (αS) pathology is thought to be responsible for the progressive nature of Parkinson’s disease and related dementia with Lewy bodies. Studies have indicated bidirectional pathological relationships between αS pathology and tau abnormalities. We recently showed that A53T mutant human αS (HuαS) can cause post-synaptic and cognitive deficits that require microtubule-associated protein tau expression. However, the role of tau in the development of αS pathology and subsequent neuronal dysfunction has been controversial. Herein, we set out to determine the role of tau in the onset and progression of αS pathology (α-synucleinopathy) using a transgenic mouse model of α-synucleinopathy lacking mouse tau expression.

Methods

Transgenic mice expressing A53T mutant HuαS (TgA53T) were crossed with mTau−/− mice to generate TgA53T/mTau−/−. To achieve more uniform induction of α-synucleinopathy in mice, we used intramuscular injections of αS preformed fibrils (PFF) in non-transgenic (nTg), TgA53T, TgA53T/mTau−/−, and mTau−/− mice. Motor behavior was analyzed at 70 days post inoculation (dpi) of PFF and tissues for biochemical and neuropathological analysis were collected at 40 dpi, 70 dpi, and end stage.

Results

Loss of tau expression significantly delayed the onset of motor deficits in the TgA53T model and the progression of α-synucleinopathy disease, as evidenced by a significant reduction in histopathological and behavioral markers of neurodegeneration and disease, and a significant improvement in survival. In vitro application of PFF to primary mouse hippocampal neurons demonstrated no changes in PFF uptake and processing or pS129 αS aggregation as a function of tau expression. However, PFF-induced neurotoxicity, including morphological deficits in nTg neurons, was prevented with tau removal.

Conclusions

Collectively, our data suggest that tau is likely acting downstream of αS pathology to affect neuronal homeostasis and survival. This work further supports the investigation of tau in α-synucleinopathies to identify novel disease-modifying therapeutic strategies.
The association between variability, intensity, and persistence of suicidal ideation and prospective suicidal behavior in the systematic treatment enhancement program for bipolar disorder (STEP-BD) study
Authors: Bloomfield-Clagett Bartholt , Greenstein Dede K. , Zarate Carlos A. , Ballard Elizabeth D.
Published: July 2022

Background

This study sought to examine the association between prospective suicidal behavior and variability, intensity, and persistence of suicidal ideation (SI) in bipolar disorder (BD).

Methods

Data were drawn from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), a naturalistic study of 4360 outpatients 15 years or older with BD. In separate models, logistic regressions with suicidal behavior (first attempt or death by suicide) as the outcome variable and SI variability (fluctuating levels of SI over time, measured as ordinal dispersion of SI score), intensity (median SI score over time in study), or persistence (number of visits with reported SI) as the explanatory variables were used to examine the relationship between SI characteristics and odds of future suicidal behavior events.

Results

After adjusting for possible confounders, the odds of prospective suicidal behavior were 1.2 times greater per 10% increase in SI variability. SI persistence was not associated with suicidal behavior. For SI intensity, a median SI score of ‘rare/fleeting’ or ‘several days’ of SI was not associated with suicidal behavior, but the odds of prospective suicidal behavior were nearly five times greater for participants with the highest observed median SI intensity score of ‘nearly every day’.

Conclusions

The findings suggest that, in BD participants, monitoring SI variability may be clinically useful for assessing suicide risk.
Hash-based signature revisited
Authors: Li Lingyun , Lu Xianhui , Wang Kunpeng
Published: July 2022

The current development toward quantum attack has shocked our confidence on classical digital signature schemes. As one of the mainstreams of post quantum cryptography primitives, hash-based signature has attracted more and more concern in both cryptographic research and application in recent years. The goal of this paper is to present, classify and discuss different solutions for hash-based signature. Firstly, this paper discusses the research progress in the component of hash-based signature, i.e., one-time signature and few-time signature; then classifies the tree-based public key authentication schemes of hash-based signature into limited number and stateful schemes, unlimited number and stateful schemes and unlimited number and stateless schemes. The above discussion aims to analyze the overall design idea of different categories of hash-based signatures, as well as the construction, security reduction and performance efficiency of specific schemes. Finally, the perspectives and possible development directions of hash-based signature are briefly discussed.
Open-source software for two-dimensional Fourier processing of gridded magnetic data
Authors: Smith Richard S. , Roots Eric A. , Rainsford Desmond
Published: July 2022

Magnetic data are widely available and useful in many exploration and applied-geophysics projects. The magnetic data are usually processed, imaged, and interpreted in commercial software packages. The algorithms used in these packages are sometimes difficult to check or tune, and the code is not available for review. However, these packages often have an application programming interface (API) for people to access data and undertake their own processing and data enhancement. In many cases, these APIs use the Python programming language. In the course of developing a new method for transforming magnetic data called reduction to pole and vertical dip (RTPVD), the initial test code was written in Python. This initial code was then rewritten and incorporated into GAMS, an open-source software package capable of using a Python API to read from and then write transformed (or enhanced) data to a commercial database. In addition to RTPVD, the other enhancements GAMS can generate are the zeroth-order analytic-signal amplitude (ASA0), tilt, spatial derivatives of ASA0, the zeroth-order local wavenumber, the first-order analytic-signal amplitude, and the apparent susceptibility. These transformations require that the data be transformed to the wavenumber domain using a fast Fourier transform (FFT), operated on, and then transformed back to the space domain. The FFT and some of the preprocessing steps can be done with a number of built-in Python tools. For the preprocessing steps, some of the available Python options are fast, but they can occasionally introduce unwanted artifacts. Our open-source tool allows users to test the different options and check the intermediate steps to ensure the result is appropriate.
Optimizing Multidisciplinary Treatment-Related Adverse Effects Detection and Reduction in Patients Undergoing Active Cancer Treatments in Ambulatory Infusion Centers
Authors: Chung Clement , Rome Alison , Desai Monica , Abanonu Fred , De la Casas Cesar
Published: July 2022

PURPOSE:

The objective of this study was to describe the implementation of an interdisciplinary supportive care program for treatment-related adverse effects (TRAEs) of patients with cancer in two ambulatory infusion centers affiliated with a major health system.

METHODS:

A management program of TRAEs was developed on the basis of the collaboration between oncologists, infusion center oncology nurses, and a board-certified oncology clinical pharmacist for patients with cancer in two outpatient infusion centers. Patients received multidisciplinary interventions or oncologist-driven interventions on the basis of their reported symptoms during their cancer treatments. They were followed prospectively at regular intervals for further symptom management interventions. To evaluate this program, a retrospective chart review was performed, and data were collected regarding the number and nature of these TRAEs. The outcomes of their interventions were assessed up to 3 months since initial encounters. Data for patient satisfaction were also collected before and after implementation of the program.

RESULTS:

A total of 308 patients received 469 interventions initiated either by the multidisciplinary team or by oncologists over a 3-year period. Compared with oncologist-led interventions, multidisciplinary interventions were statistically significant in the number of interventions ( P = .004; 95% CI, 17.9 to 36.2) and in reducing occurrences of TRAEs ( P = .03; 95% CI, 33.8 to 72.4) such as dermatological toxicities, diarrhea, immune-related adverse effects, mucositis, and nausea or vomiting after 1-month follow-up. Multidisciplinary team captured approximately 40% of TRAEs of all grades that were escalated to oncologists for further management, which led to an overall improvement in management of TRAEs.

CONCLUSION:

Multidisciplinary care for patients in infusion centers led to improvement in treatment-related toxicities.
Symbiosis: the other cells in development
Authors: Carrier Tyler J. , Bosch Thomas C. G.
Published: July 2022

Animal development is an inherently complex process that is regulated by highly conserved genomic networks, and the resulting phenotype may remain plastic in response to environmental signals. Despite development having been studied in a more natural setting for the past few decades, this framework often precludes the role of microbial prokaryotes in these processes. Here, we address how microbial symbioses impact animal development from the onset of gametogenesis through adulthood. We then provide a first assessment of which developmental processes may or may not be influenced by microbial symbioses and, in doing so, provide a holistic view of the budding discipline of developmental symbiosis.
Hungry or angry? Experimental evidence for the effects of food availability on two measures of stress in developing wild raptor nestlings
Authors: Catitti Benedetta , Grüebler Martin U. , Kormann Urs G. , Scherler Patrick , Witczak Stephanie , van Bergen Valentijn S. , Jenni-Eiermann Susanne
Published: July 2022

Food shortage challenges the development of nestlings; yet, to cope with this stressor, nestlings can induce stress responses to adjust metabolism or behaviour. Food shortage also enhances the antagonism between siblings, but it remains unclear whether the stress response induced by food shortage operates via the individual nutritional state or via the social environment experienced. In addition, the understanding of these processes is hindered by the fact that effects of food availability often co-vary with other environmental factors. We used a food supplementation experiment to test the effect of food availability on two complementary stress measures, feather corticosterone (CORTf) and heterophil/lymphocyte ratio (H/L) in developing red kite (Milvus milvus) nestlings, a species with competitive brood hierarchy. By statistically controlling for the effect of food supplementation on the nestlings' body condition, we disentangled the effects of food and ambient temperature on nestlings during development. Experimental food supplementation increased body condition, and both CORTf and H/L were reduced in nestlings of high body condition. Additionally, CORTf decreased with age in non-supplemented nestlings. H/L decreased with age in all nestlings and was lower in supplemented last-hatched nestlings compared with non-supplemented ones. Ambient temperature showed a negative effect on H/L. Our results indicate that food shortage increases the nestlings' stress levels through a reduced food intake affecting both their nutritional state and their social environment. Thus, food availability in conjunction with ambient temperature shapes between- and within-nest differences in stress load, which may have carry-over effects on behaviour and performance in further life-history stages.
A Polygenic Risk Score for Hand Grip Strength Predicts Muscle Strength and Proximal and Distal Functional Outcomes among Older Women
Authors: HERRANEN PÄIVI , PALVIAINEN TEEMU , RANTANEN TAINA , TIAINEN KRISTINA , VILJANEN ANNE , KAPRIO JAAKKO , SILLANPÄÄ ELINA
Published: July 2022

Purpose

Hand grip strength (HGS) is a widely used indicator of overall muscle strength and general health. We computed a polygenic risk score (PRS) for HGS and examined whether it predicted muscle strength, functional capacity, and disability outcomes.

Methods

Genomewide association study summary statistics for HGS from the Pan-UK Biobank was used. PRS were calculated in the Finnish Twin Study on Aging (N = 429 women, 63–76 yr). Strength tests included HGS, isometric knee extension, and ankle plantarflexion strength. Functional capacity was examined with the Timed Up and Go, 6-min and 10-m walk tests, and dual-task tests. Disabilities in the basic activities of daily living (ADL) and instrumental ADL (IADL) were investigated with questionnaires. The proportion of variation in outcomes accounted for by PRS HGS was examined using linear mixed models and extended logistic regression.

Results

The measured HGS increased linearly over increasing PRS (β = 4.8, SE = 0.93, P < 0.001). PRS HGS independently accounted for 6.1% of the variation in the measured HGS (β = 14.2, SE = 3.1, P < 0.001), 5.4% of the variation in knee extension strength (β = 19.6, SE = 4.7, P < 0.001), 1.2% of the variation in ankle plantarflexion strength (β = 9.4, SE = 4.2, P = 0.027), and 0.1%–1.5% of the variation in functional capacity tests (P = 0.016–0.133). Further, participants with higher PRS HGS were less likely to have ADL/IADL disabilities (odds ratio = 0.74–0.76).

Conclusions

Older women with genetic risk for low muscle strength were significantly weaker than those with genetic susceptibility for high muscle strength. PRS HGS was also systematically associated with overall muscle strength and proximal and distal functional outcomes that require muscle strength.
Peak Circulatory Power during Maximal Cardiopulmonary Exercise Testing: Reference Standards from the FRIEND Registry
Authors: BUSQUE VINCENT , MYERS JONATHAN , ARENA ROSS , KAMINSKY LEONARD A. , PETERMAN JAMES E.
Published: July 2022

Purpose

Normative standards for key cardiopulmonary exercise (CPX) test variables, including peak circulatory power (CircP), are needed to guide the interpretation of clinical exercise responses in individuals with and without disease.

Objective

This study aimed to establish age- and sex-specific reference standards for peak CircP derived from a healthy cohort from the Fitness Registry and the Importance of Exercise: A National Database (FRIEND).

Methods

CPX test data from apparently healthy males and females from eight FRIEND United States exercise laboratories were considered. Inclusion criteria included ages 20–79 yr and a maximal, symptom-limited exercise test performed on a treadmill or cycle ergometer. CircP was calculated as the product of peak oxygen consumption and peak systolic blood pressure. Reference values were determined on both treadmill and cycle ergometer for males and females per age decade. A stepwise linear regression to predict CircP was derived from two-thirds of the sample while the remaining one-third was used as a validation cohort.

Results

A total of 6736 CPX tests (47% treadmill, 53% female) were included in the analysis. Overall, CircP was higher in males, higher on tests conducted on a treadmill, and decreased with age. Sex, exercise mode, age, and body mass index were the most significant contributors to CircP (multiple R = 0.75, R
2 = 0.57, root-mean-square error = 1200 mm Hg·mL O2·kg−1·min−1, P < 0.001). Using the generated prediction equation, the average percent-predicted CircP for the validation cohort was 101.3% ± 28.1%.

Conclusions

These results establish reference standards for CircP, a potentially important prognostic indicator of cardiovascular health. Future research exploring the role of percentiles and percent-predicted values for CircP is necessary as they may provide additional prognostic insight.
Human Monkeypox: Fifty-Two Years based analysis and Updates
Authors: Meo Sultan Ayoub , Ali Jawaid Shaukat
Published: July 2022

The growing prevalence of human monkeypox infection has developed an alarming situation worldwide. Monkeypox virus was first time found in 1958 in monkeys and later spread to humans. The first case of human monkeypox was reported in September 1970 in the Democratic Republic of the Congo. Human monkeypox was found outside Africa in the year 2003 in United States. More recently, from May 7 2022 to June 29, 2022, the monkeypox cases are swiftly spread worldwide, involving over 50 countries, and affecting 5115 people in Europe, the United Kingdom, North America, and South America, Asia, Australia, and the Middle East. The confirmed monkeypox cases in the United Kingdom from May 7, 2022 to June 29, 2022, are 1076 (21.03%); Germany 874 (17.08%); Spain 800 (15.64%); France 440 (8.60%); Portugal 391 (7.62%); United States 350 (6.84); Canada 276 (5.39%); Netherlands 257 (5.02%); Italy 159 (3.10); Belgium 117 (1.59%); Switzerland 81 (1.58%); Israel 33 (0.64%), Ireland, and 31 (0.64%). However, in about 35 countries, the cases are less than 20 in each country. The epidemiological trends of the human monkeypox infection are swiftly shifting from endemic regions to non-endemic countries. The global health authorities must take priority-based preventive measures to stop the outbreaks of monkeypox disease across the globe.

doi: https://doi.org/10.12669/pjms.38.6.6775

How to cite this:Meo SA, Jawaid SA. Human Monkeypox: Fifty-Two Years based analysis and Updates. Pak J Med Sci. 2022;38(6):---------.  doi: https://doi.org/10.12669/pjms.38.6.6775

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Association of leukocyte nadir with complete remission in Indonesian acute myeloid leukemia patients undergoing 7+3 remission induction chemotherapy
Authors: Hadisantoso Dwi Wahyunianto , Ranuhardy Dody , Rajabto Wulyo , Rizka Aulia , Setiawan Lyana , Rinaldi Ikhwan , Mansjoer Arif , Nelwan Erni Juwita , Shatri Hamzah
Published: July 2022

Background: The 7+3 regimen is still the main choice of remission induction chemotherapy in acute myeloid leukemia (AML). Successfully achieving complete remission (CR) and the time required to achieve it determine patient’s survival. Hence, bone marrow examination on 14th day of chemotherapy is recommended to predict CR. However, the examination is invasive and still inaccurate.

Methods: A prognostic study with retrospective cohort design was conducted at two central hospitals in Indonesia based on medical record data of AML patients who underwent 7+3 induction chemotherapy from January 1st, 2015, to December 31st, 2019. The association of nadir leukocyte level and the time required to achieve it with CR occurrence was assessed.

Results: One hundred and one subjects were recruited with median age 39 years and 55% men. A total of 55.4% subjects achieved CR. Nadir leukocyte level below 200/mcl was the most optimal cut-off point and independently associated with CR (OR 2.48; 95% CI 1.03–5.97) while time required to achieve it was not.

Conclusions: The nadir leukocyte level is associated with an increase probability of CR but not for the time required to achieve it in AML patients undergoing 7+3 induction chemotherapy.
Emerging threats and vaccination strategies of H9N2 viruses in poultry in Indonesia: A review
Authors: Rehman Saifur , Rantam Fedik Abdul , Batool Khadija , Shehzad Aamir , Effendi Mustofa Helmi , Witaningrum Adiana Mutamsari , Bilal Muhammad , Elziyad Purnama Muhammad Thohawi
Published: July 2022

Avian influenza virus subtype H9N2 was first documented in Indonesia in 2017. It has become prevalent in chickens in many provinces of Indonesia as a result of reassortment in live bird markets. Low pathogenic avian influenza subtype H9N2 virus-infected poultry provides a new direction for the influenza virus. According to the latest research, the Indonesian H9N2 viruses may have developed through antigenic drift into a new genotype, posing a significant hazard to poultry and public health. The latest proof of interspecies transmission proposes that the next human pandemic variant will be the avian influenza virus subtype H9N2. Manipulation and elimination of H9N2 viruses in Indonesia, constant surveillance of viral mutation, and vaccine updates are required to achieve effectiveness. The current review examines should be investigates/assesses/report on the development and evolution of newly identified H9N2 viruses in Indonesia and their vaccination strategy.