bluuebunny/crossref_metadata_2025 huggingface dataset:
Meta-analysis of the association between Apolipoprotein E polymorphism and risks of myocardial infarction
Authors: Shao Aiyu , Shi Jikang , Liang Zhuoshuai , Pan Lingfeng , Zhu Wenfei , Liu Sainan , Xu Jiayi , Guo Yanbo , Cheng Yi , Qiao Yichun
Published: March 2022

Background

Myocardial infarction (MI) remains the leading cause of death and disability among cardiovascular diseases worldwide. Studies show that elevated low-density lipid protein cholesterol (LDL-C) levels confer the highest absolute risk of MI, and Apolipoprotein E (ApoE) is implicated in regulating levels of triglycerides (TGs), cholesterol, and LDL-C. Our study aimed to evaluate the association between APOE polymorphism and MI, and to provide evidence for the etiology of MI.

Methods

Case–control studies on the association between APOE polymorphisms and the risk of myocardial infarction were included by searching PubMed, Web of Science, and CNKI, and this meta-analysis was written in accordance with PRISMA guideline statement. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using either random-effects or fixed-effects models by R software.

Results

A total of 33 eligible articles involving 13,706 cases and 14,817 controls were finally selected. The pooled analysis based on the total eligible articles showed that the risk of MI was associated with ApoE epsilon 2 and epsilon 4 alleles. The results showed that patients with MI had a low frequency of the ε2 allele (OR 0.74, 95% CI 0.64–0.86) and a high frequency of the ε4 allele (OR 1.24, 95% CI 1.09–1.42).

Conclusions

APOE ε2-involved genotypes may be protective factors for MI; in contrast, ε4-involved genotypes (ε4/ε3 vs. ε3/ε3, and ε4/ε4 vs. ε3/ε3) may be risk factors for MI.
Regulation of SARS CoV-2 host factors in the kidney and heart in rats with 5/6 nephrectomy—effects of salt, ARB, DPP4 inhibitor and SGLT2 blocker
Authors: Xiong Yingquan , Delic Denis , Zeng Shufei , Chen Xin , Chu Chang , Hasan Ahmed A. , Krämer Bernhard K. , Klein Thomas , Yin Lianghong , Hocher Berthold
Published: March 2022

Background

Host factors such as angiotensin-converting enzyme 2 (ACE2) and the transmembrane protease, serine-subtype-2 (TMPRSS2) are important factors for SARS-CoV-2 infection. Clinical and pre-clinical studies demonstrated that RAAS-blocking agents can be safely used during a SARS-CoV-2 infection but it is unknown if DPP-4 inhibitors or SGLT2-blockers may promote COVID-19 by increasing the host viral entry enzymes ACE2 and TMPRSS2.

Methods

We investigated telmisartan, linagliptin and empagliflozin induced effects on renal and cardiac expression of ACE2, TMPRSS2 and key enzymes involved in RAAS (REN, AGTR2, AGT) under high-salt conditions in a non-diabetic experimental 5/6 nephrectomy (5/6 Nx) model. In the present study, the gene expression ofAce2,Tmprss2,Ren,Agtr2andAgtwas assessed with qRT-PCR and the protein expression of ACE2 and TMPRSS2 with immunohistochemistry in the following experimental groups: Sham + normal diet (ND) + placebo (PBO); 5/6Nx + ND + PBO; 5/6Nx + high salt-diet (HSD) + PBO; 5/6Nx + HSD + telmisartan; 5/6Nx + HSD + linagliptin; 5/6Nx + HSD + empagliflozin.

Results

In the kidney, the expression ofAce2was not altered on mRNA level under disease and treatment conditions. The renal TMPRSS2 levels (mRNA and protein) were not affected, whereas the cardiac level was significantly increased in 5/6Nx rats. Intriguingly, the elevated TMPRSS2 protein expression in the heart was significantly normalized after treatment with telmisartan, linagliptin and empagliflozin.

Conclusions

Our study indicated that there is no upregulation regarding host factors potentially promoting SARS-CoV-2 virus entry into host cells when the SGLT2-blocker empagliflozin, telmisartan and the DPP4-inhibitor blocker linagliptin are used. The results obtained in a preclinical, experimental non-diabetic kidney failure model need confirmation in ongoing interventional clinical trials.
Comparing different montages of transcranial direct current stimulation on dual-task walking and cortical activity in chronic stroke: double-blinded randomized controlled trial
Authors: Wong Pei-Ling , Yang Yea-Ru , Tang Shun-Chang , Huang Shih-Fong , Wang Ray-Yau
Published: March 2022

Background

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation to modulate cortical activity for improving motor function. However, the different tDCS applications for modulating cortical activity and dual task gait performance in chronic stroke have not yet been investigated. This study investigated the effects of different tDCS applications on dual task gait performance and contralesional M1 activation in chronic stroke.

Methods

Forty-eight participants were randomized to anodal, bilateral, cathodal, and sham tDCS groups. Each group received 20 min of tDCS stimulation, except the sham group. Gait performance was measured by GaitRite system during cognitive dual task (CDT) walking, motor dual task (MDT) walking, and single walking (SW). Contralesional M1 activity of unaffected tibialis anterior (TA) was measured using transcranial magnetic stimulation (TMS). Intragroup difference was analyzed by Wilconxon sign ranks test with Bonferroni correction, and Kruskal–Wallis one-way analysis of variance by ranks was used for intergroup comparisons, followed by post-hoc Mann–Whitney U tests with Bonferroni correction.

Results

The bilateral tDCS (p = 0.017) and cathodal tDCS (p = 0.010) improved the CDT walking speed more than sham group. The bilateral tDCS (p = 0.048) and cathodal tDCS (p = 0.048) also improved the MDT walking speed more than sham group. Furthermore, bilateral tDCS (p = 0.012) and cathodal tDCS (p = 0.040) increased the silent period (SP) more than the anodal and sham group. Thus, one-session of bilateral and cathodal tDCS improved dual task walking performance paralleled with increasing contralesional corticomotor inhibition in chronic stroke.

Conclusions

Our results indicate that one-session of bilateral and cathodal tDCS increased contralesional corticomotor inhibition and improved dual task gait performance in chronic stroke.

Trial registration

Thai Clinical Trials Registry (TCTR20180116001). Registered prospectively on 16th Jan, 2018 at http://www.thaiclinicaltrials.org.
Cumulative exposure to maternal psychological distress in the prenatal and postnatal periods and atopic dermatitis in children: findings from the TMM BirThree Cohort Study
Authors: Kawaguchi Chikana , Murakami Keiko , Ishikuro Mami , Ueno Fumihiko , Noda Aoi , Onuma Tomomi , Matsuzaki Fumiko , Metoki Hirohito , Kuriyama Shinichi , Obara Taku
Published: March 2022

Background

Maternal mental health problems in each of the prenatal period and postnatal period have been demonstrated as possible risk factors for atopic dermatitis (AD) in children. However, the cumulative impacts of maternal psychological distress in the prenatal and postnatal periods on AD in children remain unclear. This study examined the association between cumulative exposure to maternal psychological distress in the prenatal and postnatal periods and the development of AD in children.

Methods

Data were derived from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. In total, 8377 mother-child pairs in which the child had no AD at the age of 1 year were analyzed. Maternal psychological distress in early pregnancy and 1 year after delivery was defined as a K6 score ≥ 5, and the participants were categorized into four groups: no psychological distress in both the prenatal and postnatal periods; only the prenatal period; only the postnatal period; and both periods. The development of AD was defined as the presence of AD in a 2-year-old child without AD reported at the age of 1 year using the International Study of Asthma and Allergies in Childhood questionnaire. Generalized linear model analyses were conducted to examine the association between maternal psychological distress and the development of AD in children adjusted for age at delivery, educational attainment, smoking status in pregnancy, maternal history of AD, paternal history of AD, parity, maternal body mass index, and child sex.

Results

Between the ages of 1 and 2 years, 14.0% of children developed AD. Maternal psychological distress in both prenatal and postnatal periods was associated with an increased risk of AD in children compared to no psychological distress in both periods (relative risk (RR), 95% confidence interval (CI): 1.34, 1.20–1.47). Maternal psychological distress in only the postnatal period was associated with an increased risk of AD in children (RR, 95% CI: 1.23, 1.07–1.39), but not in only the prenatal period (RR, 95% CI: 1.14, 0.98–1.30).

Conclusions

Cumulative exposure to maternal psychological distress in the prenatal and postnatal periods was associated with the development of AD in children.
Context dependent isoform specific PI3K inhibition confers drug resistance in hepatocellular carcinoma cells
Authors: Narci Kubra , Kahraman Deniz Cansen , Koyas Altay , Ersahin Tulin , Tuncbag Nurcan , Atalay Rengul Cetin
Published: March 2022

Background

Targeted therapies for Primary liver cancer (HCC) is limited to the multi-kinase inhibitors, and not fully effective due to the resistance to these agents because of the heterogeneous molecular nature of HCC developed during chronic liver disease stages and cirrhosis. Although combinatorial therapy can increase the efficiency of targeted therapies through synergistic activities, isoform specific effects of the inhibitors are usually ignored. This study concentrated on PI3K/Akt/mTOR pathway and the differential combinatory bioactivities of isoform specific PI3K-α inhibitor (PIK-75) or PI3K-β inhibitor (TGX-221) with Sorafenib dependent on PTEN context.

Methods

The bioactivities of inhibitors on PTEN adequate Huh7 and deficient Mahlavu cells were investigated with real time cell growth, cell cycle and cell migration assays. Differentially expressed genes from RNA-Seq were identified by edgeR tool. Systems level network analysis of treatment specific pathways were performed with Prize Collecting Steiner Tree (PCST) on human interactome and enriched networks were visualized with Cytoscape platform.

Results

Our data from combinatory treatment of Sorafenib and PIK-75 and TGX-221 showed opposite effects; while PIK-75 displays synergistic effects on Huh7 cells leading to apoptotic cell death, Sorafenib with TGX-221 display antagonistic effects and significantly promotes cell growth in PTEN deficient Mahlavu cells. Signaling pathways were reconstructed and analyzed in-depth from RNA-Seq data to understand mechanism of differential synergistic or antagonistic effects of PI3K-α (PIK-75) and PI3K-β (TGX-221) inhibitors with Sorafenib. PCST allowed as to identify AOX1 and AGER as targets in PI3K/Akt/mTOR pathway for this combinatory effect. The siRNA knockdown of AOX1 and AGER significantly reduced cell proliferation in HCC cells.

Conclusions

Simultaneously constructed and analyzed differentially expressed cellular networks presented in this study, revealed distinct consequences of isoform specific PI3K inhibition in PTEN adequate and deficient liver cancer cells. We demonstrated the importance of context dependent and isoform specific PI3K/Akt/mTOR signaling inhibition in drug resistance during combination therapies. (https://github.com/cansyl/Isoform-spesific-PI3K-inhibitor-analysis).
Comparison of survival outcomes between squamous cell carcinoma and adenocarcinoma/adenosquamous carcinoma of the cervix after radical radiotherapy and chemotherapy
Authors: Liu Ping , Ji Mei , Kong Yanxiang , Huo Zhifeng , Lv Qiubo , Xie Qinghuang , Wang Danbo , Chen Biliang , Wang Hailin , Cui Zhumei , Wang Qianqing , Bin Xiaonong , Lang Jinghe , Chen Chunlin
Published: March 2022

Background

This study aimed to compare the survival outcomes between squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) of the cervix after radical radiotherapy and chemotherapy.

Methods

Propensity score matching (1:4) was used to compare overall survival (OS) and disease-free survival (DFS) in cervical cancer patients with SCC and AC/ASC in China.

Results

Five thousand four hundred sixty-six patients were enrolled according to the criteria. The 5-year OS and DFS in the SCC group (n = 5251) were higher than those in the AC/ASC group (n = 215). After PSM (1:4), the 5-year OS and DFS in the SCC group were higher than those in the AC/ASC group (72.2% vs 56.9%, p < 0.001, HR = 1.895; 67.6% vs 47.8%, p < 0.001, HR = 2.056). In stage I-IIA2 patients, after PSM (1:4), there was no significant difference in 5-year OS between the SCC group (n = 143) and the AC/ASC group (n = 34) (68.5% vs 67.8%, P = 0.175). However, the 5-year DFS in the SCC group was higher than that in the AC/ASC group (71.0% vs 55.7%, P = 0.045; HR = 2.037, P = 0.033). In stage IIB-IV patients, after PSM (1:4), the 5-year OS and DFS in the SCC group (n = 690) were higher than those in the AC/ASC group (n = 173) (70.7% vs 54.3% P < 0.001 vs 1.940%, P < 0.001 vs 45.8%, p < 0.001).

Conclusions

For stage I-IIA2, there was no significant difference in 5-year survival time, but patients with AC/ASC were more likely to relapse. In the more advanced IIB-IV stage, the oncological outcome of radical radiotherapy and chemotherapy of cervical AC/ASC was worse than that of SCC.
Oral erythema multiforme after Pfizer-BioNTech COVID-19 vaccination: a report of four cases
Authors: Petruzzi Massimo , Galleggiante Sara , Messina Sabrina , della Vella Fedora
Published: March 2022

Background

The 2019 Coronavirus disease (Covid-19) has affected thousands of people worldwide. To date, vaccines appear to be the only method to prevent and reduce mortality. Four vaccinations have been outwardly approved by European Medicine Agency (EMA) in Europe: BNT162b2 (Comirnaty-BioNTech/Pfizer), mRNA-1273 (Spikevax-Moderna), ChAdOx1 (VaxzevriaAstrazeneca), and Ad26.COV2-S (Janssen-Johnson&Johnson). After vaccination, local and systemic adverse effects can occur. Cutaneous reactions like urticaria, local injection site pain, morbilliform rash have been documented after vaccination.

Cases presentation

We report four cases of oral erythema multiforme flare arising after BNT162b2 vaccination administration. All the patients denied previous erythema-like and herpetic manifestations history. Two of the reported cases (number 1 and 2) presented with both oral and cutaneous lesions, while cases 3 and 4 showed only oral manifestations. Three of the cases presented the erythema after the first vaccination dosage administration, only one case reported lesions after the second vaccination dosage administration. All the cases were treated with prednisone via oral administration and topical 0.05% clobetasol ointment.

Conclusions

The present reports represent some of the few cases of erythema multiforme occurring as a side effect of the BNT162b2 COVID-19 vaccination. The causal role of the vaccine for the erythema multiforme has not been proven yet; nevertheless, it is not uncommon for medications to trigger this disease. The vaccine could surface a silent herpes virus infection, which would induce the erythema multiforme instead.
Interpreter-mediated interactions between people using a signed respective spoken language across distances in real time: a scoping review
Authors: Warnicke Camilla , Granberg Sarah
Published: March 2022

Background

Communication between people who are deaf and sign and people who use a spoken language is possible by means of an interpreter. Interpreting in real time can be performed at a distance, which differs from interpreting face-to-face. Due to COVID-19, interpretation at a distance has increased.

Objective

The objective of this study was to map the existing literature to identify key characteristics by addressing the following question: What is known about interpreted mediated interactions between people using a signed respective spoken language across distances in real time?

Design

Eight online databases, complemented by a search in one nonindexed journal of relevance to the review, were used to identify original studies published in 2010–2020, and 17 publications met the inclusion criteria. Charting of the data revealed insight from 17 original studies that were extracted, summarized, and reported.

Results

Four key characteristics were identified: (1) advantages and challenges in remote interpreting; (2) the need for training in remote interpreting and video relay service (VRS); (3) regulations and organizational structures of VRS; and (4) the interpreter as an active party in VRS.

Conclusion

Remote interpreting has several challenges but also advantages. Knowledge of these kinds of interactions is limited, and further research must be initiated and realized, not least due to technological developments and the increased number of interpreting events.
Reprogramming of arachidonate metabolism confers temozolomide resistance to glioblastoma through enhancing mitochondrial activity in fatty acid oxidation
Authors: Tsai Yu-Ting , Lo Wei-Lun , Chen Pin-Yuan , Ko Chiung-Yuan , Chuang Jian-Ying , Kao Tzu-Jen , Yang Wen-Bing , Chang Kwang-Yu , Hung Chia-Yang , Kikkawa Ushio , Chang Wen-Chang , Hsu Tsung-I.
Published: March 2022

Background

Sp1 is involved in the recurrence of glioblastoma (GBM) due to the acquirement of resistance to temozolomide (TMZ). Particularly, the role of Sp1 in metabolic reprogramming for drug resistance remains unknown.

Methods

RNA-Seq and mass spectrometry were used to analyze gene expression and metabolites amounts in paired GBM specimens (primary vs. recurrent) and in paired GBM cells (sensitive vs. resistant). ω-3/6 fatty acid and arachidonic acid (AA) metabolism in GBM patients were analyzed by targeted metabolome. Mitochondrial functions were determined by Seahorse XF Mito Stress Test, RNA-Seq, metabolome and substrate utilization for producing ATP. Therapeutic options targeting prostaglandin (PG) E2 in TMZ-resistant GBM were validated in vitro and in vivo.

Results

Among the metabolic pathways, Sp1 increased the prostaglandin-endoperoxide synthase 2 expression and PGE2 production in TMZ-resistant GBM. Mitochondrial genes and metabolites were obviously increased by PGE2, and these characteristics were required for developing resistance in GBM cells. For inducing TMZ resistance, PGE2 activated mitochondrial functions, including fatty acid β-oxidation (FAO) and tricarboxylic acid (TCA) cycle progression, through PGE2 receptors, E-type prostanoid (EP)1 and EP3. Additionally, EP1 antagonist ONO-8713 inhibited the survival of TMZ-resistant GBM synergistically with TMZ.

Conclusion

Sp1-regulated PGE2 production activates FAO and TCA cycle in mitochondria, through EP1 and EP3 receptors, resulting in TMZ resistance in GBM. These results will provide us a new strategy to attenuate drug resistance or to re-sensitize recurred GBM.
Perplexity: evaluating transcript abundance estimation in the absence of ground truth
Authors: Fan Jason , Chan Skylar , Patro Rob
Published: March 2022

Background

There has been rapid development of probabilistic models and inference methods for transcript abundance estimation from RNA-seq data. These models aim to accurately estimate transcript-level abundances, to account for different biases in the measurement process, and even to assess uncertainty in resulting estimates that can be propagated to subsequent analyses. The assumed accuracy of the estimates inferred by such methods underpin gene expression based analysis routinely carried out in the lab. Although hyperparameter selection is known to affect the distributions of inferred abundances (e.g. producing smooth versus sparse estimates), strategies for performing model selection in experimental data have been addressed informally at best.

Results

We derive perplexity for evaluating abundance estimates on fragment sets directly. We adapt perplexity from the analogous metric used to evaluate language and topic models and extend the metric to carefully account for corner cases unique to RNA-seq. In experimental data, estimates with the best perplexity also best correlate with qPCR measurements. In simulated data, perplexity is well behaved and concordant with genome-wide measurements against ground truth and differential expression analysis. Furthermore, we demonstrate theoretically and experimentally that perplexity can be computed for arbitrary transcript abundance estimation models.

Conclusions

Alongside the derivation and implementation of perplexity for transcript abundance estimation, our study is the first to make possible model selection for transcript abundance estimation on experimental data in the absence of ground truth.
Epigenetic remodelling in human hepatocellular carcinoma
Authors: Braghini Maria Rita , Lo Re Oriana , Romito Ilaria , Fernandez-Barrena Maite G. , Barbaro Barbara , Pomella Silvia , Rota Rossella , Vinciguerra Manlio , Avila Matias A. , Alisi Anna
Published: March 2022

Hepatocellular carcinoma (HCC) is the most frequent primary liver cancer, being the sixth most commonly diagnosed cancer and the fourth leading cause of cancer-related death. As other heterogeneous solid tumours, HCC results from a unique synergistic combination of genetic alterations mixed with epigenetic modifications.

In HCC the patterns and frequencies of somatic variations change depending on the nearby chromatin. On the other hand, epigenetic alterations often induce genomic instability prone to mutations. Epigenetics refers to heritable states of gene expression without alteration to the DNA sequence itself and, unlike genetic changes, the epigenetic modifications are reversible and affect gene expression more extensively than genetic changes. Thus, studies of epigenetic regulation and the involved molecular machinery are greatly contributing to the understanding of the mechanisms that underline HCC onset and heterogeneity. Moreover, this knowledge may help to identify biomarkers for HCC diagnosis and prognosis, as well as future new targets for more efficacious therapeutic approaches.

In this comprehensive review we will discuss the state-of-the-art knowledge about the epigenetic landscape in hepatocarcinogenesis, including evidence on the diagnostic and prognostic role of non-coding RNAs, modifications occurring at the chromatin level, and their role in the era of precision medicine.

Apart from other better-known risk factors that predispose to the development of HCC, characterization of the epigenetic remodelling that occurs during hepatocarcinogenesis could open the way to the identification of personalized biomarkers. It may also enable a more accurate diagnosis and stratification of patients, and the discovery of new targets for more efficient therapeutic approaches.
Remitting seronegative symmetrical synovitis with pitting edema: a case report
Authors: Tanaka Yasushi , Kohchi Kohki , Kitamoto Kazuhiro
Published: March 2022

Background

Edema occurs in various disorders. One of those is remitting seronegative symmetrical synovitis with pitting edema, a rare syndrome whose pathophysiology is not clearly understood. We report herein a case of refractory edema diagnosed as remitting seronegative symmetrical synovitis with pitting edema.

Case presentation

A 82-year-old Asian male was admitted to the Department of General Internal Medicine with a 2-month history of symmetrical swelling of both hands. Despite treatment with loop diuretic furosemide 40 mg daily, his condition did not respond to the medication and his quality of life deteriorated. An examination of the joints showed tenderness suggestive of synovitis with restricted movements in bilateral proximal interphalangeal joint. Laboratory findings revealed hyperglycemia, elevated erythrocyte sedimentation rate 118 mm/hour, and elevated C-reactive protein 6.58 mg/dL. Plain radiographs of both hands showed soft tissue swelling, changes consistent with osteoarthritis, and no erosions. The diagnosis of bilateral remitting seronegative symmetrical synovitis with pitting edema was made. Treatment with prednisolone 15 mg daily was instituted.

Conclusions

Although remitting seronegative symmetrical synovitis with pitting edema is rare, it should be remembered as a disease that causes edema in the elderly.
Considerations and challenges for sex-aware drug repurposing
Authors: Fisher Jennifer L. , Jones Emma F. , Flanary Victoria L. , Williams Avery S. , Ramsey Elizabeth J. , Lasseigne Brittany N.
Published: March 2022

Sex differences are essential factors in disease etiology and manifestation in many diseases such as cardiovascular disease, cancer, and neurodegeneration [33]. The biological influence of sex differences (including genomic, epigenetic, hormonal, immunological, and metabolic differences between males and females) and the lack of biomedical studies considering sex differences in their study design has led to several policies. For example, the National Institute of Health’s (NIH) sex as a biological variable (SABV) and Sex and Gender Equity in Research (SAGER) policies to motivate researchers to consider sex differences [204]. However, drug repurposing, a promising alternative to traditional drug discovery by identifying novel uses for FDA-approved drugs, lacks sex-aware methods that can improve the identification of drugs that have sex-specific responses [7, 11, 14, 33]. Sex-aware drug repurposing methods either select drug candidates that are more efficacious in one sex or deprioritize drug candidates based on if they are predicted to cause a sex-bias adverse event (SBAE), unintended therapeutic effects that are more likely to occur in one sex. Computational drug repurposing methods are encouraging approaches to develop for sex-aware drug repurposing because they can prioritize sex-specific drug candidates or SBAEs at lower cost and time than traditional drug discovery. Sex-aware methods currently exist for clinical, genomic, and transcriptomic information [1, 7, 155]. They have not expanded to other data types, such as DNA variation, which has been beneficial in other drug repurposing methods that do not consider sex [114]. Additionally, some sex-aware methods suffer from poorer performance because a disproportionate number of male and female samples are available to train computational methods [7]. However, there is development potential for several different categories (i.e., data mining, ligand binding predictions, molecular associations, and networks). Low-dimensional representations of molecular association and network approaches are also especially promising candidates for future sex-aware drug repurposing methodologies because they reduce the multiple hypothesis testing burden and capture sex-specific variation better than the other methods [151, 159]. Here we review how sex influences drug response, the current state of drug repurposing including with respect to sex-bias drug response, and how model organism study design choices influence drug repurposing validation.
The importance of having good quality indicators for care of patients with COPD: a look at hospital readmission rates
Authors: Shani Michal , Comaneshter Doron , Segel Michael J.
Published: March 2022

Background

Readmission after hospitalization for acute COPD exacerbation (AE-COPD) has been proposed as a healthcare quality indicator (QI) in Israel. We studied patients hospitalized for AE-COPD, towards determining whether AE-COPD readmission is an appropriate national QI in order to improve COPD patient care.

Methods

Data were retrieved for all Clalit Health Service (CHS) members age 40–90 years hospitalized in CHS hospitals during 2016 with a diagnosis of acute COPD exacerbation. Information retrieved included demographics, medical history, Charleson comorbidity score, readmissions within 90 days, chronic medication use and family physician and pulmonologist visits. Patients readmitted within 90 days were compared to those who were not readmitted. Patients were also analyzed according to whether they were hospitalized during the year before the index hospitalization.

Results

In 2016 there were 70,601 members with a recorded diagnosis of COPD in CHS. Of these, 1,203 patients (1.7%) were hospitalized in a CHS hospital with a diagnosis of acute COPD exacerbation during 2016. Average age was 70.6 years, 63% were men. 78% were active smokers. 61% of the patients were readmitted to internal medicine wards within 90 days of the index hospitalization. Patients who were readmitted were more likely to have been hospitalized during the year before the index hospitalization (Odds ratio (OR) 2.5, Confidence Interval ((CI)(1.85, 3.38)) and had a higher Charlson comorbidity score (OR 1.07 (CI 1.01, 1.11)). Healthcare utilization by patients who were readmitted, both before and after admission, was generally greater. One yr mortality was 15.1% and 9.2% in those readmitted and not readmitted, respectively (p = 0.003).

Conclusions

Readmitted COPD patients appear to be the sickest group of COPD patients with advanced disease and poor prognosis, and it may not be possible to prevent readmissions. This questions the utility of COPD readmissions as a healthcare quality indicator.
On the methodology of fingerprint template protection schemes conception : meditations on the reliability
Authors: Lahmidi Ayoub , Moujahdi Chouaib , Minaoui Khalid , Rziza Mohammed
Published: March 2022

Among the most major potential attacks against fingerprint authentication systems are those that target the stored reference templates. These threats are extremely damaging as they can lead to the invasion of user privacy. The countermeasures to secure fingerprint templates are therefore an indisputable necessity. In literature, although there are so many approaches that address this kind of vulnerability, it turns out to be very difficult to generalize their uses. Given that each system has its own particularities, going from the fingerprint trait acquisition to the matching process, the majority of protection schemes, that are proposed as generic solutions, are not sufficiently mature for large-scale deployment. Consequently, we believe that the methodology of fingerprint template protection schemes conception should be oriented to build specific protection schemes for every unprotected system, which will provide the best compromise between performance and security compared to any generic protection solution. By adopting this methodology, we propose in this paper a new protection scheme for fingerprint templates that is well adapted to a well-known existing unprotected fingerprint minutia system. Our experimental results, obtained using standard benchmarks such as FVC 2002 DB1 and DB2, have proven that the proposed technique meets the requirements of revocability, unlinkability, non-invertibility, and high recognition accuracy.
Trajectories in nitrogen availability during forest secondary succession: illustrated by foliar δ15N
Authors: Tu Ying , Wang Ang , Zhu Feifei , Gurmesa Geshere Abdisa , Hobbie Erik A. , Zhu Weixing , Fang Yunting
Published: March 2022

Background

Forest succession is an important ecological process and has been studied for more than a century. However, changes in nitrogen (N) availability during succession remain unclear as they may lead to either N saturation or N limitation. Here, we propose a conceptual model to illustrate changes in N availability during four stages of secondary succession using the natural abundance of 15N in plant leaves (foliar δ15N). We predicted that N availability would decline in the early stages of succession and then increase in late stages, coinciding with the changes in foliar δ15N, with the inflection point varying in different climate zones. Data on foliar δ15N from 16 succession sequences were synthesized to explore changes in N availability during forest succession.

Results

The compiled data were consistent with the proposed conceptual model. Foliar δ15N in boreal and temperate forests decreased significantly in the first two stages of succession (estimated to last at least 66 years in temperate forests), at a rate of 0.18‰ and 0.38‰ per decade, respectively, and decreased slightly in tropical forests in the first 23 years. Foliar δ15N is projected to increase in later stages in all forests, which is supported by observations in both temperate and tropical forests. The inflection points of N availability when N limitation peaked during succession were different in different climate zones, implying different ecosystem N turnovers.

Conclusions

Our study reconciles the controversies regarding changes in N availability during forest secondary succession. Our findings are also useful for predicting the recovery of N and carbon accumulation during succession. Nonetheless, studies on forest secondary succession using foliar δ15N have thus far been limited, and more research should be conducted to further verify the conceptual model proposed here.
Metagenomic strain detection with SameStr: identification of a persisting core gut microbiota transferable by fecal transplantation
Authors: Podlesny Daniel , Arze Cesar , Dörner Elisabeth , Verma Sandeep , Dutta Sudhir , Walter Jens , Fricke W. Florian
Published: March 2022

Background

The understanding of how microbiomes assemble, function, and evolve requires metagenomic tools that can resolve microbiota compositions at the strain level. However, the identification and tracking of microbial strains in fecal metagenomes is challenging and available tools variably classify subspecies lineages, which affects their applicability to infer microbial persistence and transfer.

Results

We introduce SameStr, a bioinformatic tool that identifies shared strains in metagenomes by determining single-nucleotide variants (SNV) in species-specific marker genes, which are compared based on a maximum variant profile similarity. We validated SameStr on mock strain populations, available human fecal metagenomes from healthy individuals and newly generated data from recurrent Clostridioides difficile infection (rCDI) patients treated with fecal microbiota transplantation (FMT). SameStr demonstrated enhanced sensitivity to detect shared dominant and subdominant strains in related samples (where strain persistence or transfer would be expected) when compared to other tools, while being robust against false-positive shared strain calls between unrelated samples (where neither strain persistence nor transfer would be expected). We applied SameStr to identify strains that are stably maintained in fecal microbiomes of healthy adults over time (strain persistence) and that successfully engraft in rCDI patients after FMT (strain engraftment). Taxonomy-dependent strain persistence and engraftment frequencies were positively correlated, indicating that a specific core microbiota of intestinal species is adapted to be competitive both in healthy microbiomes and during post-FMT microbiome assembly. We explored other use cases for strain-level microbiota profiling, as a metagenomics quality control measure and to identify individuals based on the persisting core gut microbiota.

Conclusion

SameStr provides for a robust identification of shared strains in metagenomic sequence data with sufficient specificity and sensitivity to examine strain persistence, transfer, and engraftment in human fecal microbiomes. Our findings identify a persisting healthy adult core gut microbiota, which should be further studied to shed light on microbiota contributions to chronic diseases.
Conversion surgery following gemcitabine plus cisplatin therapy for initially unresectable gallbladder cancer with peritoneal carcinomatosis: a case report
Authors: Wakasa Yusuke , Toyoki Yoshikazu , Kusumi Tomomi , Kameyama Yuma , Odagiri Tadashi , Jin Hiroyuki , Nakai Makoto , Aoki Kazunori , Kawashima Hiroaki , Endo Masaaki
Published: March 2022

Background

Conversion surgery, which is defined as chemotherapy or chemoradiotherapy followed by radical surgery, may improve survival of patients with initially unresectable advanced biliary tract cancer, including gallbladder cancer. However, there are few reports on conversion surgery for advanced gallbladder cancer.

Case presentation

A 69-year-old woman was referred to our hospital with initially unresectable gallbladder cancer with peritoneal carcinomatosis. She underwent gemcitabine plus cisplatin therapy for 9 months. Extended cholecystectomy, resection of the extrahepatic bile duct with regional lymph node dissection, and total omentectomy were then performed as conversion surgery. The patient has survived without recurrence for 19 months postoperatively (31 months after the initial diagnosis) while continuing chemotherapy.

Conclusions

This case suggests that conversion surgery for advanced gallbladder cancer is effective and may be curative for locally advanced disease and distant metastasis such as peritoneal carcinomatosis.
Policy analysis of socio-cultural determinants of salt, sugar and fat consumption in Iran
Authors: Amerzadeh Mohammad , Takian Amirhossein , Pouraram Hamed , Sari Ali Akbari , Ostovar Afshin
Published: March 2022

Background

Noncommunicable diseases (NCDs) are the first reason for death worldwide, in which poor diet is the leading risk factor. It is estimated that 20% of all death is related to food. The Unhealthy diet includes many foods with excessive salt, sugar and fat. This paper reports a national study on the socio-cultural determinants affecting salt, sugar and fat consumption in Iran.

Methods

This is a qualitative study. We conducted semi-structured interviews with 30 various purposefully identified key stakeholders to collect data from December 2018 until August 2019 in Iran.

Results

We identified socio-cultural determents of salt, fat and sugar consumption as follows: Inadequate structure of traditional medicine and people’s desire for traditional foods, low health literacy, the global trend of nutritional transition and its impact on Iranian society, The progressive decline of people’s trust in NGOs, and Inappropriate media management. Worse still, the global trend of nutritional transition and people’s tendency towards fast foods, unhealthy diet and junk foods, partially due to establishing children’s taste mainly with salty, high-fat and sweet foods, has jeopardized their desire to eat healthily during adulthood.

Conclusion

Reducing salt, fat and sugar consumption is problematic in Iran, mainly due to multi-dimensional socio-cultural determinants. In line with sustainable development goal (SDG) 3.4 to reduce 30% of premature death due to NCDs and related risk factors by 2030 in Iran, various stakeholders from multiple sectors need to initiate coherent series of interventions to alter people’s approach to select food so that they may reduce the consumption of foods with excessive salt, fat and sugar.
Multimodal conservative management of arthrofibrosis after total knee arthroplasty compared to manipulation under anesthesia: a feasibility study with retrospective cohort comparison
Authors: Rauzi Michelle R. , Foran Jared R. H. , Bade Michael J.
Published: March 2022

Background

The ideal treatment of early-stage arthrofibrosis after total knee arthroplasty is unclear. The purpose of this study was to determine the treatment effect, including variability, and feasibility of a multimodal physical therapy program as compared to manipulation under anesthesia.

Methods

This was a prospective feasibility study with a retrospective cohort comparison. Ten consecutive patients (aged 64 ± 9 years, 7 females) with early-stage arthrofibrosis were enrolled 6 weeks after primary total knee arthroplasty and participated in the multimodal physical therapy program. The multimodal physical therapy program consisted of manual therapy, therapeutic exercise, and static progressive splinting delivered over 4 weeks. The outcomes included knee range of motion (ROM), adherence, patient satisfaction, and safety. Data were compared to a retrospective cohort of 31 patients with arthrofibrosis (aged 65 ± 9 years, 20 females) who underwent manipulation under anesthesia followed by physical therapy.

Results

Overall, knee ROM outcomes were similar between multimodal physical therapy (110° ± 14) and manipulation under anesthesia (109° ± 11). Seven out of ten patients achieved functional ROM (≥ 110°) and avoided manipulation under anesthesia with the multimodal physical therapy program. Three out of 10 multimodal physical therapy patients required manipulation under anesthesia secondary to failure to demonstrate progress within 4 weeks of the multimodal physical therapy program. Adherence to the multimodal physical therapy program was 87 ± 9%. The median patient satisfaction with the multimodal physical therapy program was “very satisfied.” Safety concerns were minimal.

Conclusion

The use of the multimodal physical therapy program is feasible for treating early-stage arthrofibrosis after total knee arthroplasty, with 70% of patients avoiding manipulation under anesthesia. Randomized controlled trials are needed to determine the efficacy of the multimodal physical therapy program and to determine the optimal patient selection for the multimodal physical therapy program versus manipulation under anesthesia.

Trial registration

ClinicalTrials.gov, NCT04837872.
Brief behaviour change counselling in non-communicable diseases in Mangochi, Southern Malawi: a hypothetical acceptability study
Authors: Lutala Prosper , Muula Adamson
Published: March 2022

Introduction

Brief behaviour change counselling (BBCC) approaches have shown some potential in reversing and/or decreasing the effects of behavioural risk factors (harmful alcohol, smoking, physical inactivity and unhealthy diets). However, BBCC is new in Malawi. Thus, we explored the acceptability of brief behaviour change counselling using 5 As and a guiding style from motivational interviewing (BBCC + 5 As + GS) among health providers, policy-makers and patients living with noncommunicable diseases (NCDs) in the Mangochi district located in Malawi.

Methods

An exploratory qualitative cross-sectional study used purposive sampling to select 44 respondents. We conducted group discussions with five focus groups that included patients. We also carried out nine key-informant interviews with healthcare providers and policy-makers. Data were managed and organized with Atlas.ti. cloud and analysed using the thematic framework approach.

Findings

Several themes, categories, and their subcategories emerged from the interviews. Participants perceived the introduction and delivery of BBCC + 5As + GS in Mangochi as smooth. However, they predicted a few challenges such as time and space to conduct the intervention, cultural bottlenecks caused by low education level, age differences between healthcare providers and patients, low provider- to- patient ratio and high provider turnover. For this method to be adopted, a simplified format is deemed necessary to improve effectiveness with patients. This technique can only be sustained if training opportunities are provided and if positive testimonies are given by beneficiaries. Incorporation of a continuous quality improvement cycle targeting challenges must be part of the intervention. Participants perceived that BBCC will contribute to developing the listening ability of healthcare providers. This would help in providing personalized and cost-effective care relevant to Mangochi. The participants also perceived that BBCC + 5As + GS will be affordable, credible and useful.

Conclusion

We found a high acceptability rate of BBCC among stakeholders in NCDs clinics in Mangochi. There are a number of areas where BBCC + 5As + GS could be improved to increase the acceptability. Accordingly, a study of feasibility and preliminary efficacy is warranted to determine other prerequisites for the implementation of a large-scale trial using this BBCC+ 5 As + GS, and to fully understand the implementation requirements of a full trial in Mangochi.
Mutual cultural consciousness between “Ge” and “Ju”: Fei Hsiao-tung’s cultural perspective on the pattern of unity in diversity and the community of a shared future for mankind
Authors: Zhao Xudong , Zhu Honghui
Published: March 2022

Facing the new era, we should re-examine and understand the theory of “the pattern of unity in diversity of the Chinese nation” put forward by Fei Hsiao-tung from the historical and cultural perspectives, which will bring us many new insights. The Chinese national consciousness of unity can be understood as “Ge” (格), while “Ju (局) as “layout” and “distribution”, which means in the same spatial scope and form of “Ge”, how the units within the Chinese nation are laid out and distributed. Under such “Ge” and “Ju” viewpoints, people and goods, nature and society, culture and technology, China and the world, can be connected and integrated so that a reciprocal community with “being together” could possibly come true at last, and cultural self-consciousness, consciousness of the others’ cultures and mutual cultural consciousness are inevitable. On this basis, it is meaningful to discuss the ultimate goal and state of construction of a community with a shared future for mankind and the world of “Great Harmony”.
A “cat”-astrophic case of Bartonella infective endocarditis causing secondary cryoglobulinemia: a case report
Authors: Vivekanantham Arani , Patel Rikesh , Jenkins Petra , Cleary Gavin , Porter David , Khawaja Fareed , McCarthy Eoghan
Published: March 2022

Background

Culture-negative infective endocarditis (IE) constitutes approximately 10% of all cases of IE. Bartonella endocarditis is a common cause of culture-negative endocarditis and is associated with a high mortality rate. To date, no cases of Bartonella IE has been reported in association with cryoglobulinemia in the UK. We present a unique case of Bartonella IE causing secondary cryoglobulinemia in a young female.

Case presentation

A 17-year-old female with a background of pulmonary atresia and ventricular septal defect repaired with a cardiac conduit at the age of 4, presented with a one-year history of weight loss (from 53 to 39 kg) and poor appetite. She subsequently developed a vasculitic rash and haematoproteinuria with decline in renal function, requiring urgent hospital admission. Initial blood tests showed a near normal creatinine, but a raised cystatin C. Renal biopsy showed focal necrotizing glomerulonephritis with no acute tubular necrosis or chronic change. Subsequent blood tests supported a diagnosis of cryoglobulinaemic vasculitis (high rheumatoid factor, low complement, polyclonal gammopathy, Type 3 cryoglobulin). A weak positive PR3 meant there was some uncertainty about whether this could be a primary ANCA-associated vasculitis (AAV). Initial workup for an infectious cause, including multiple blood cultures, were negative. However, an echocardiogram showed definite vegetations on her surgical conduit. The patient did not respond to empirical antimicrobials and so was referred for surgical revision of her conduit. Tissue samples obtained intra-operatively demonstrated Bartonella species. With targeted antimicrobials post-operatively, she improved with resolution of immunologic abnormalities and at last review had a normal renal profile. On reviewing her social history, she had adopted several stray cats in the preceding year; and thus, the cause of the Bartonella infection was identified.

Conclusion

This is the first reported case of Bartonella endocarditis causing secondary cryoglobulinemia reported in the UK. The key learning points from this case include that Bartonella endocarditis can present as a cryoglobulinaemic vasculitis and should be considered in any differential when the cause of cryoglobulinaemia is not clear and to enquire about relevant exposures especially when culture-negative endocarditis is suspected.