bluuebunny/crossref_metadata_2025 huggingface dataset:
Platelet‐activating factor acetylhydrolase is a biomarker of severe anaphylaxis in children
Authors: Upton Julia E. M. , Hoang Jennifer A. , Leon‐Ponte Matilde , Finkelstein Yaron , Du Yue (Jennifer) , Adeli Khosrow , Eiwegger Thomas , Grunebaum Eyal , Vadas Peter
Published: April 2022

Background

There is limited ability to predict the severity of allergic reactions in children. Data derived predominantly from adults have implicated the platelet‐activating factor pathway as a potential contributor to severe anaphylaxis. In this study, we sought to prospectively assess involvement of key components of the platelet‐activating factor pathway in pediatric patients with anaphylaxis.

Methods

Forty‐six pediatric patients (<18 years) presenting with acute anaphylaxis were assessed. Anaphylaxis severity was graded and serum anaphylaxis markers were measured acutely and in 36 children who returned for follow‐up >4 weeks after their acute presentation. These markers were compared with pediatric laboratory reference sera.

Results

Severe anaphylaxis was experienced by 12/46 (26%) and mild‐moderate anaphylaxis in 34/46 (74%) children. Platelet‐activating factor acetylhydrolase (PAF‐AH) activity was inversely associated with severe anaphylaxis: 9/12 children with severe anaphylaxis had reduced PAF‐AH activity as compared with 14/34 with mild‐moderate anaphylaxis (p < .05). Furthermore, 3/3 children who required intensive care had markedly reduced mean PAF‐AH (nmol/ml/min) (13.73, 95%CI: 7.42–20.03) versus 20/23 who required ward/emergency department care (17.81, 95%CI: 16.80–18.83; p < .05). In children with anaphylaxis, PAF‐AH during acute anaphylaxis was unchanged relative to the child's basal levels (mean, 17.26, 95%CI: 16.10–18.42 vs 17.50, 95%CI: 16.21–18.78, p = .63) and was lower than healthy pediatric controls (mean 19.21; 95%CI:18.21–20.21; p < .05).

Conclusion

Decreased serum PAF‐AH activity is a biomarker of severe anaphylaxis. Levels of this enzyme do not change from basal levels during acute anaphylaxis. Our results show that PAF‐AH is a biomarker of anaphylaxis severity in children. This key regulatory enzyme may modulate susceptibility to severe anaphylaxis.
Association of cigarette smoking with retinal capillary plexus: an optical coherence tomography angiography study
Authors: Zhu Xiaoxuan , Yang Kai , Xiao Yunfan , Ye Cong , Zheng Jingwei , Su Binbin , Zheng Yang , Zhang Xinyao , Shi Keai , Li Chunmei , Lu Fan , Qu Jia , Li Ming , Cui Lele
Published: April 2022

Purpose

To investigate the association between cigarette smoking and retinal capillary plexus (RCP) using optical coherence tomography angiography (OCTA) and to examine whether potential vascular risk factors could impact their association.

Methods

This is a cross‐sectional, community‐based study. The Jidong Eye Cohort Study included participants aged ≥18 years in the Jidong community (Tangshan city, northern China) from August 2019 to January 2020. All participants underwent comprehensive ophthalmic examination and completed detailed smoking questionnaires. Retinal vessel density in the superficial and deep RCP was automatically measured using OCTA.

Results

Of the 2598 participants included in the study, 2026 (78.0%) never smoked and 572 (22.0%) had a history of smoking (494 [19.0%] current smokers and 78 [3.0%] former smokers). The median (interquartile range) age was 41 (34–52) years for the non‐smoking group and 45 (35–54.5) years for the smoking group. Multivariable analysis showed that smoking history is associated with a low deep RCP vessel density in the parafovea (β, −0.53; 95% confidence interval [CI], −0.82 to −0.24) and four quadrants. Increased smoking pack‐years were associated with reduced deep RCP vessel density in the parafovea (p for trend <0.001) and four quadrants. The significant interaction between diabetes and smoking only was found for superficial RCP vessel density in the parafovea (p for interaction = 0.014) and four quadrants except for the temporal quadrants.

Conclusions

Cigarette smoking is an independent risk factor for reduced deep RCP vessel density. Our findings imply the potential detrimental effect of smoking on the occurrence of ocular diseases.
Perinatal risk factors for mortality in very preterm infants—A nationwide, population‐based discriminant analysis
Authors: Norman Mikael , Nilsson David , Trygg Johan , Håkansson Stellan
Published: April 2022

Aim

To assess the strength of associations between interrelated perinatal risk factors and mortality in very preterm infants.

Methods

Information on all live‐born infants delivered in Sweden at 22–31 weeks of gestational age (GA) from 2011 to 2019 was gathered from the Swedish Neonatal Quality Register, excluding infants with major malformations or not resuscitated because of anticipated poor prognosis. Twenty‐seven perinatal risk factors available at birth were exposures and in‐hospital mortality outcome. Orthogonal partial least squares discriminant analysis was applied to assess proximity between individual risk factors and mortality, and receiver operating characteristic (ROC) curves were used to estimate discriminant ability.

Results

In total, 638 of 8,396 (7.6%) infants died. Thirteen risk factors discriminated reduced mortality; the most important were higher Apgar scores at 5 and 10 min, GA and birthweight. Restricting the analysis to preterm infants <28 weeks’ GA (n = 2939, 16.9% mortality) added antenatal corticosteroid therapy as significantly associated with lower mortality. The area under the ROC curve (the C‐statistic) using all risk factors was 0.86, as determined after both internal and external validation.

Conclusion

Apgar scores, gestational age and birthweight show stronger associations with mortality in very preterm infants than several other perinatal risk factors available at birth.
Capitalism, COVID‐19 and lockdowns
Authors: Bagus Philipp , Peña‐Ramos José Antonio , Sánchez‐Bayón Antonio
Published: April 2022

Commentators believe that the COVID‐19 pandemic reveals the inconveniences of capitalism and that the end of “neoliberalism” could be near. In this article we show that a capitalist ethics is capable to deal with the challenges of pandemics and comes with important advantages such as the prevention of overreactions. We apply both utilitarian and rights‐based ethics to the case of epidemics in general and COVID‐19 in particular. First a libertarian natural law ethics is used to assess the government interventions in the Corona pandemic. We maintain that these interventions cannot be justified from a libertarian point of view despite of the possible objections that are discussed such as the “potential threat argument”. Moreover, the utilitarian argument in favor of government lockdowns is evaluated. The negative effects of lockdown on mental health, addictions, domestic violence, etc. have to be taken into account. The utilitarian argument in favor of lockdown is far from convincing, as economic calculation is not possible.
Impact of COVID‐19 on perinatal care: Perceptions of family physicians in the United States
Authors: Goldstein Jessica Taylor , Eden Aimee R. , Taylor Melina K. , Dotson Andrea , Barreto Tyler
Published: April 2022

Background

Patient‐centered care is the best practice in the care of pregnant and postpartum patients. The COVID‐19 pandemic prompted changes in perinatal care policies, which were often reactive, resulting in unintended consequences, many of which made the delivery of patient‐centered care more difficult. This study aimed to understand the impact of the COVID‐19 pandemic on perinatal health care delivery from the perspective of family physicians in the United States.

Methods

From October 5 to November 4, 2020, we surveyed mid‐ to late‐career family physicians who provide perinatal care. We conducted descriptive analyses to measure the impact of COVID‐19 on prenatal care, labor and delivery, postpartum care, patient experience, and patient volume. An immersion‐crystallization approach was used to analyze qualitative data provided as open‐text comments.

Results

Of the 1518 survey respondents, 1062 (69.8%) stated that they currently attend births; 595 of those elaborated about the impact of COVID‐19 on perinatal care in free‐text comments. Eight themes emerged related to the impact of COVID‐19 on perinatal care: visitation, patient decisions, testing, personal protective equipment, care continuity, changes in care delivery, reassignment, and volume. The greatest perceived impact of COVID‐19 was on patient experience.

Conclusions

Family physicians who provided perinatal care during the COVID‐19 pandemic noted a considerable impact on patient experience, which particularly affected the ability to deliver patient‐centered and family‐centered care. Continued research is needed to understand the long‐term impact of policies affecting the delivery of patient‐centered perinatal care and to inform more evidence‐based, proactive policies to be implemented in future pandemic or disaster situations.
Independent effects of word concreteness and word valence on immediate serial recall
Authors: Tse Chi‐Shing , Altarriba Jeanette
Published: April 2022

The present study examined the roles of word concreteness and word valence in the immediate serial recall task. Emotion words (e.g. happy) were used to investigate these effects. Participants completed study‐test trials with 7‐item study lists consisting of positive or negative words with either high or low concreteness (Experiments 1 and 2) and neutral (i.e. non‐emotion) words with either high or low concreteness (Experiment 2). In serial recall performance, we replicated the typical item concreteness effect (concrete words are better recalled than abstract words) and obtained an item valence effect (positive/neutral words are better recalled than negative words). However, there was no concreteness × valence interaction. We conclude that both word valence and word concreteness independently contribute to the serial order retention of emotion words in the immediate serial recall task.
How does cognitive detachment from work influence employee creativity? A curvilinear relationship based on the cognitive perspective
Authors: He Wenxin , Liu Xinmei
Published: April 2022

During the corona virus disease of 2019 (COVID‐19) pandemic, employees have begun to lack a sense of cognitive detachment from their work. Furthermore, employees with high creativity are better able to help their organizations to survive the economic decline caused by this pandemic. However, scholars currently know relatively little about how and why cognitive detachment influences employee creativity. Leveraging boundary theory and a dual pathway to creativity model (DPCM), the present study hypothesized that cognitive detachment from work will influence employee creativity in an inverse U‐shaped pattern, with cognitive flexibility as a mediator and the boundary condition of intrinsic motivation for creativity being included. Our results, which were gained from a sample of 304 research and development (R&D) employees, indicate that employees' cognitive detachment from work and their degree of creativity possess a curvilinear relationship and that cognitive flexibility is a likely mediator between them. Notably, this inverse U‐shaped relationship is significant only if the employees have high intrinsic motivation for creativity. This study uncovers the complicated influence of cognitive detachment from work on individual creativity, while also investigating the underlying cognitive processes (i.e., cognitive flexibility) involved and the importance of intrinsic motivation.
Targeting chemoresistance in Xp11.2 translocation renal cell carcinoma using a novel polyamide–chlorambucil conjugate
Authors: Funasaki Shintaro , Mehanna Sally , Ma Wenjuan , Nishizawa Hidekazu , Kamikubo Yasuhiko , Sugiyama Hiroshi , Ikeda Shuji , Motoshima Takanobu , Hasumi Hisashi , Linehan W. Marston , Schmidt Laura S. , Ricketts Chris , Suda Toshio , Oike Yuichi , Kamba Tomomi , Baba Masaya
Published: April 2022

Renal cell carcinoma with Xp11.2 translocation involving the TFE3 gene (TFE3‐RCC) is a recently identified subset of RCC with unique morphology and clinical presentation. The chimeric PRCC‐TFE3 protein produced by Xp11.2 translocation has been shown to transcriptionally activate its downstream target genes that play important roles in carcinogenesis and tumor development of TFE3‐RCC. However, the underlying molecular mechanisms remain poorly understood. Here we show that in TFE3‐RCC cells, PRCC‐TFE3 controls heme oxygenase 1 (HMOX1) expression to confer chemoresistance. Inhibition of HMOX1 sensitized the PRCC‐TFE3 expressing cells to genotoxic reagents. We screened for a novel chlorambucil–polyamide conjugate (Chb) to target PRCC‐TFE3‐dependent transcription, and identified Chb16 as a PRCC‐TFE3‐dependent transcriptional inhibitor of HMOX1 expression. Treatment of the patient‐derived cancer cells with Chb16 exhibited senescence and growth arrest, and increased sensitivity of the TFE3‐RCC cells to the genotoxic reagent etoposide. Thus, our data showed that the TFE3‐RCC cells acquired chemoresistance through HMOX1 expression and that inhibition of HMOX1 by Chb16 may be an effective therapeutic strategy for TFE3‐RCC.
Exosomal circGSE1 promotes immune escape of hepatocellular carcinoma by inducing the expansion of regulatory T cells
Authors: Huang Mingyao , Huang Xin , Huang Ning
Published: April 2022

Studies have shown exosomal circRNAs can regulate the immune escape of tumors by carrying cancer‐derived molecules. Regulatory T cells (Tregs) participate in the process of tumor immune escape. However, the mechanism by which exosomal circRNAs regulate Tregs to create a microenvironment for tumor immune escape is unclear. The effect of exosomes on the proliferation, migration, and invasion of tumor cells was evaluated by CCK‐8, transwell, and wound‐healing assays. The expression of circGSE1 was evaluated by real‐time quantitative PCR, and the function of exosomal circGSE1 was explored by Western blot and RNA pull‐down assays. In vivo animal metastasis models and bioluminescence imaging were used to verify the effect of exosomal circGSE1 on tumor progression. Collectively, we revealed that exosomal circGSE1 derived from hepatocellular carcinoma (HCC) cells promotes the progression of HCC by inducing Tregs expansion via regulating the miR‐324‐5p/TGFBR1/Smad3 axis. Therefore, in the future, exosomal circGSE1 can be used as a promising biomarker for immunotherapy of HCC.
Ichthyosis follicularis syndromes in patients with mutations in GJB2
Authors: Youssefian Leila , Naji Mahtab , Park Jason S. , Rajabi Fateme , Abdollahimajd Fahimeh , Mahmoudi Hamidreza , Kamyab-Hesari Kambiz , Ghalamkarpour Fariba , Zabihi Masoud , Teimoorian Mehrdad , Youssefian Laya , Zeinali Sirous , Vahidnezhad Hassan , Uitto Jouni
Published: April 2022

Ichthyosis follicularis (IF) manifests as generalized spiny follicular projections found in syndromic diseases secondary to SREBF1 and MBTPS2 mutations. We sought the genetic cause of IF in two distinct families from a cohort of 180 patients with ichthyosis. In Family 1, the proband (Patient 1) presented with IF, bilateral sensorineural hearing loss and punctate palmoplantar keratoderma. Using DNA from peripheral blood lymphocytes, two compound heterozygous mutations, c.526A>G and c.35delG, were discovered in GJB2. In Family 2, the proband (Patient 2) presented with a previously unreported IF phenotype in the context of keratitis–ichthyosis–deafness syndrome, and whole-exome sequencing found a de novo heterozygous mutation, c.148G>A in GJB2. Histopathology was consistent with porokeratotic eccrine ostial and dermal duct naevus (PEODDN) and IF in Patients 1 and 2, respectively. Our findings add to the clinical and histopathological spectrum of IF and emphasize the association of PEODDN-like entities with GJB2 variants.
SHP2's gain‐of‐function in Werner syndrome causes childhood disease onset likely resulting from negative genetic interaction
Authors: Priolo Manuela , Palermo Valentina , Aiello Francesca , Ciolfi Andrea , Pannone Luca , Muto Valentina , Motta Marialetizia , Mancini Cecilia , Radio Francesca Clementina , Niceta Marcello , Leoni Chiara , Pintomalli Letizia , Carrozzo Rosalba , Rajola Giuseppe , Mammì Corrado , Zampino Giuseppe , Martinelli Simone , Dallapiccola Bruno , Pichierri Pietro , Tartaglia Marco
Published: April 2022

Prompt diagnosis of complex phenotypes is a challenging task in clinical genetics. Whole exome sequencing has proved to be effective in solving such conditions. Here, we report on an unpredictable presentation of Werner Syndrome (WRNS) in a 12‐year‐old girl carrying a homozygous truncating variant in RECQL2, the gene mutated in WRNS, and a de novo activating missense change in PTPN11, the major Noonan syndrome gene, encoding SHP2, a protein tyrosine phosphatase positively controlling RAS function and MAPK signaling, which have tightly been associated with senescence in primary cells. All the major WRNS clinical criteria were present with an extreme precocious onset and were associated with mild intellectual disability, severe growth retardation and facial dysmorphism. Compared to primary fibroblasts from adult subjects with WRNS, proband's fibroblasts showed a dramatically reduced proliferation rate and competence, and a more accelerated senescence, in line with the anticipated WRNS features occurring in the child. In vitro functional characterization of the SHP2 mutant documented its hyperactive behavior and a significantly enhanced activation of the MAPK pathway. Based on the functional interaction of WRN and MAPK signaling in processes relevant to replicative senescence, these findings disclose a unique phenotype likely resulting from negative genetic interaction.
SIRT1: A promising therapeutic target for chronic pain
Authors: Song Fan‐He , Liu Dai‐Qiang , Zhou Ya‐Qun , Mei Wei
Published: April 2022

Chronic pain remains an unresolved problem. Current treatments have limited efficacy. Thus, novel therapeutic targets are urgently required for the development of more effective analgesics. An increasing number of studies have proved that sirtuin 1 (SIRT1) agonists can relieve chronic pain. In this review, we summarize recent progress in understanding the roles and mechanisms of SIRT1 in mediating chronic pain associated with peripheral nerve injury, chemotherapy‐induced peripheral neuropathy, spinal cord injury, bone cancer, and complete Freund's adjuvant injection. Emerging studies have indicated that SIRT1 activation may exert positive effects on chronic pain relief by regulating inflammation, oxidative stress, and mitochondrial dysfunction. Therefore, SIRT1 agonists may serve as potential therapeutic drugs for chronic pain.
Laryngoscopic findings of age‐related vocal fold atrophy are reliable but not specific
Authors: Song Jin Soo , Campbell Ross , Lin Rui Jun , Jeffery Caroline C.
Published: April 2022

Objectives

We aimed to evaluate the reliability of laryngoscopic features of vocal fold atrophy as assessed by novice otolaryngology trainees and expert laryngologists.

Design

Two expert fellowship‐trained laryngologists and three non‐expert otolaryngology resident trainees were recruited to view 50 anonymised laryngo‐stroboscopic examinations of patients presenting with dysphonia and non‐voice, laryngeal complaints. Reviewers were asked to stratify the patient's age, provide an opinion about the presence of age‐related vocal fold atrophy and specify which laryngoscopy features were present to make the diagnosis.

Setting

Tertiary care laryngology practice.

Participants

Two fellowship‐trained laryngologists and three trainee otolaryngologists.

Main outcome measures

Accuracy of age categorisation was determined and Kappa analysis was performed to assess inter‐rater agreement.

Results

The mean age of patients was 54.9 years old with near equal male to female distribution. The overall accuracy of age category determination by raters was only 30.8%. Kappa analysis demonstrated fair agreement regarding the presence of vocal fold atrophy in non‐expert reviewers, and moderate agreement amongst expert reviewers. Features of glottic gap, muscular atrophy of vocal folds and prominent vocal processes were all identified with high agreement (>80.0%).

Conclusion

Our study illustrates that while raters can agree on the presence of age‐related vocal fold atrophy, the findings may be non‐specific and do not necessarily correlate with age.
The feasibility of baroreflex sensitivity measurements in heart failure subjects: The role of slow‐patterned breathing
Authors: Urbancsek Réka , Csanádi Zoltán , Forgács Ildikó N. , Papp Tímea B. , Boczán Judit , Barta Judit , Jenei Csaba , Nagy László , Rudas László
Published: April 2022

Introduction

Increased muscle sympathetic nerve activity (MSNA) indicates an adverse outcome in heart failure. Decreased baroreflex modulation of MSNA is a well‐known feature of the disease. The determinability of cardiovagal baroreflex sensitivity (BRS) in heart failure is low, however, the determinability of sympathetic BRS is not known.

Methods

We have assessed the spontaneous, MSNA burst incidence‐based baroreflex index (BRSsymp) in 33 stable heart failure patients and in 10 healthy controls using the traditional r ≥ .5 cutoff for acceptable individual diastolic pressure‐burst incidence slopes, and also a more stringent r ≥ .7 cutoff. We have also assessed the influence of 6/min breathing.

Results

The determinability of BRSsymp in heart failure patients was 64% during spontaneous breathing with r ≥ .5 cutoff, and 39% using the r ≥ .7 cutoff. The determinability of these indices further decreased during 6/min breathing, dropping to 29% with the r ≥ .7 cutoff. In contrast, the determinability of the cardiovagal BRS indices increased significantly with 6/min breathing (from 24% to 66%; p < .001). Patients who still had determinable BRSsymp at the r ≥ .7 cutoff had a significantly lower baseline burst incidence than those with an undeterminable index (70 ± 14 vs. 89 ± 10 burst/100 cycles; p < .002). Neither the 6/min breathing, nor the r ≥ .7 cutoff limit influenced the high availability of BRSsymp in healthy subjects.

Conclusion

The determinability of BRSsymp in heart failure patients is limited, especially with the 0.7 limit for correlation. Undeterminable BRSsymp in patients is associated with higher sympathetic activity. 6/min breathing improves the determinability of cardiovagal BRS indices, but not that of BRSsymp.
A comparison of variability between absolute and relative blood flow restriction pressures
Authors: Stanford Daphney M. , Chatlaong Matthew A. , Miller William M. , Mouser J. Grant , Dankel Scott J. , Jessee Matthew B.
Published: April 2022

Introduction

Recommendations are that blood flow restriction (BFR) be applied relative to arterial occlusion pressure (AOP) to provide a similar stimulus.

Purpose

Compare variability of the change in blood flow, shear rate and discomfort between recommended relative pressures and an absolute pressure.

Methods

During one visit, brachial arterial blood flow was measured in 91 participants using pulse‐wave Doppler ultrasonography. After 5‐min seated rest, AOP was measured. Following another 5‐min rest, blood flow and discomfort were assessed twice before cuff inflation as controls (C1 and C2), then again with a cuff inflated to each BFR pressure (all measures separated by 1‐min). Change scores from C1 to all subsequent measures were calculated (i.e., C2‐C1; 40% AOP‐C1; 80% AOP‐C1; 100 mmHg‐C1). Variability of the changes were compared via pairwise modified Pitman–Morgan tests (α = 0.008).

Results

Variance (95% CI) of the change for blood flow (ml/min), shear rate (1/s), and discomfort (AU) had similar trends. C2‐C1 differed from all conditions (all p < 0.001), 40% AOP‐C1 differed from 80% AOP‐C1 and 100 mmHg‐C1 (all p < 0.001), which did not differ (both p ≥ 0.117). Blood flow: C2‐C1 = 469.79 (357.90, 644.07), 40% AOP‐C1 = 1263.18 (962.34, 1731.80), 80% AOP‐C1 = 1752.90 (1335.42, 2403.18), 100 mmHg‐C1 = 1603.18 (1221.36, 2197.92); shear rate: C2‐C1 = 6248.24 (4760.10, 8566.15), 40% AOP‐C1 = 14 625.30 (11 142.06, 20 050.95), 80% AOP‐C1 = 22 064.02 (16 809.13, 30 249.27), 100 mmHg‐C1 = 20 778.76 (15 829.98, 28 487.21); discomfort: C2‐C1 = 0.07 (0.05, 0.08), 40% AOP‐C1 = 2.03 (1.55, 2.78), 80% AOP‐C1 = 4.26 (3.25, 5.84), 100 mmHg‐C1 = 4.50 (3.43, 6.17).

Conclusion

Contrary to previous suggestions, applying relative pressures does not necessarily guarantee a similar stimulus. It seems that higher pressures produce more variable changes even if the external pressure applied is made relative to each individual.
Acute kidney injury during pregnancy in kidney transplant recipients
Authors: Yadav Anju , Salas Maria Aurora Posadas , Coscia Lisa , Basu Arpita , Rossi Ana Paula , Sawinski Deirdre , Shah Silvi
Published: April 2022

Pregnancy‐related acute kidney injury (AKI) is a public health problem and remains an important cause of maternal and fetal morbidity and mortality. The incidence of pregnancy‐related AKI has increased in developed countries due to increase in maternal age and higher detection rates. Pregnancy in women with kidney transplants is associated with higher adverse outcomes like preeclampsia, preterm births, and allograft dysfunction, but limited data exists on causes and outcomes of pregnancy‐related AKI in the kidney transplant population. Diagnosis of AKI during pregnancy remains challenging in kidney transplant recipients due to lack of diagnostic criteria. Management of pregnancy‐related AKI in the kidney transplant population requires a multidisciplinary team consisting of transplant nephrologists, high‐risk obstetricians, and neonatologists. In this review, we discuss pregnancy‐related AKI in women with kidney transplants, etiologies, pregnancy outcomes, and management strategies.
Modified N score is helpful for identifying patients who need endoscopic intervention among those with black stools without hematemesis
Authors: Ito Nobuhito , Funasaka Kohei , Fujiyoshi Toshihisa , Furukawa Kazuhiro , Kakushima Naomi , Furune Satoshi , Ishikawa Eri , Mizutani Yasuyuki , Sawada Tsunaki , Maeda Keiko , Ishikawa Takuya , Yamamura Takeshi , Ohno Eizaburo , Nakamura Masanao , Kawashima Hiroki , Miyahara Ryoji , Hirooka Yoshiki , Haruta Jun‐Ichi , Fujishiro Mitsuhiro
Published: April 2022

Objectives

Although black stools are one of the signs of upper gastrointestinal bleeding, not all patients without hematemesis need endoscopic intervention. There is no apparent indicator to select who needs treatment thus far. The aim of this study was to establish a novel score that predicts the need for endoscopic intervention in patients with black stools without hematemesis.

Methods

We retrospectively enrolled 721 consecutive patients with black stools without hematemesis who underwent emergency endoscopy from two facilities. In the development stage (from January 2016 to December 2018), risk factors that predict the need for endoscopic intervention were determined from the data of 422 patients by multivariate logistic regression analysis, and a novel scoring system, named the modified Nagoya University score (modified N score), was developed. In the validation stage (from January 2019 to September 2020), we evaluated the diagnostic value of the modified N score for 299 patients.

Results

Multivariate logistic regression analysis revealed four predictive factors for endoscopic intervention: syncope, the blood urea nitrogen (BUN) level, and the BUN/creatinine ratio as positive indicators and anticoagulant drug use as a negative indicator. In the validation stage, the area under the curve of the modified N score was 0.731, and the modified N score showed a sensitivity of 82.0% and a specificity of 58.8%.

Conclusions

Our modified N score, which consists of only four factors, can identify patients who need endoscopic intervention among those with black stools without hematemesis.
Use of health services and unmet needs among adults with cerebral palsy in Ireland
Authors: Manikandan Manjula , Casey Claire , Doyle Anne , Kerr Claire , Walsh Michael , Walsh Aisling , M Ryan Jennifer
Published: April 2022

Aim

To describe use of health services, unmet needs relating to health services, and identify factors associated with service use among adults with cerebral palsy (CP) in Ireland.

Method

Data relating to demographics, secondary diagnoses, current use of health services and assistive devices, and unmet needs for both were obtained on adults with CP from the National Physical and Sensory Disability Database. Logistic regression was used to identify factors associated with service use.

Results

A total of 1268 adults with CP were included in this study. Over half were male (56%) and 78% lived with parents, siblings, or other family relatives. Physiotherapy, occupational therapy, and orthotics/prosthetic services were the most commonly used services, used by 57%, 48%, and 35% of the sample respectively. Unmet needs were highest for physiotherapy (23%) and occupational therapy services (13%). Age, sex, living arrangements, and wheelchair use were frequently associated with current service use.

Interpretation

Adults with CP used a wide range of health services and unmet needs were reported for all services. The findings highlight a need for planning and development of services to meet their needs, regardless of their age, mobility level, or living arrangements.

What this paper adds

Adults with cerebral palsy (CP) in Ireland used a wide range of therapeutic, respite, personal assistance, and support services.

Unmet needs were highest for physiotherapy and occupational therapy services.

Adults aged 25 years and above were less likely to use therapy services compared with younger adults.

Adults living with parents, siblings, or family relatives were less likely to use personal assistance and physiotherapy services.
Relationship of body mass index to clinical outcomes after percutaneous coronary intervention
Authors: Morishita Tetsuji , Uzui Hiroyasu , Mitsuke Yasuhiko , Tada Hiroshi
Published: April 2022

Background

Elevated body mass index (BMI) demonstrates lower all‐cause and cardiovascular mortalities compared with normal‐weight or lean patients in chronic diseases. This study investigated relationships between BMI and clinical outcomes following percutaneous coronary intervention (PCI) in coronary artery disease (CAD) patients, together with the sex‐specific impacts of BMI on mortality.

Methods

We reviewed 1104 CAD patients who underwent PCI between 2006 and 2015. Patients were divided by BMI into three groups: lean, <18.5 kg/m2; normal, 18.5–24.9 kg/m2; and overweight/obese, ≥25 kg/m2. The primary endpoint was all‐cause mortality, and the secondary endpoint was 3‐point major adverse cardiovascular events (MACE).

Results

Kaplan–Meier survival analysis demonstrated risks of all‐cause death, and 3‐point MACE were higher in lean patients compared with normal‐weight and overweight/obese subjects (log‐rank p < .001). Cox proportional hazard modelling showed overweight/obese was significantly associated with all‐cause death (hazard ratio (HR) 0.68, 95% confidence interval (CI) 0.48–0.95; p = .03), and lean was significantly associated with 3‐point MACE (HR 2.02, 95% CI 1.15–3.53; p = .01). Cox proportional hazard analysis with restricted cubic spline showed non‐linear associations between BMI and both all‐cause mortality and 3‐point MACE (p for effect = .002 and = .003, respectively). No significant interaction was evident between sex and BMI for all‐cause mortality (p for interaction = .104) or 3‐point MACE (p for interaction =0.122).

Conclusions

Lean category was associated with adverse outcomes among CAD patients. An obesity paradox regarding the independent association of elevated BMI with reduced mortality after PCI is evident in both males and females.
Stage‐specific abiotic and biotic associations of the imperilled Silver ShinerNotropis photogenisin an urban drainage
Authors: Lamothe Karl A. , Drake D. Andrew R.
Published: April 2022

Stage‐specific abiotic and biotic associations are often poorly described for imperilled freshwater fishes, including Silver Shiner (Notropis photogenis; Threatened), which may limit species protection and recovery efforts. Here, we used fish and habitat sampling data from an urban drainage in southern Ontario, Canada to quantify abiotic and biotic associations for juvenile and adult Silver Shiner, while considering the potential effects of imperfect detection on sampled fishes. Detection probability of Silver Shiner was high (>0.80) across life‐stages, but occupancy models for adults and juveniles included different covariates. The top‐selected occupancy model (lowest Akaike's Information Criterion [AICc]) for adults included a positive effect of site depth, whereas sampling year was included in the top‐selected occupancy model for juveniles. A redundancy analysis suggested unique stage‐specific biotic associations; a positive association was observed between the abundance of adult Silver Shiner and Rosyface Shiner (Notropis rubellus), whereas positive associations were observed between juvenile Silver Shiner and the abundance of Fathead Minnow (Pimephales promelas) and Smallmouth Bass (Micropterus dolomieu). Overall, the results of this study advance the knowledge of stage‐specific abiotic and biotic associations of Silver Shiner, and the probability of species detection, which will inform future monitoring and protection of the species in Canada. More broadly, continued efforts are needed to quantify early life‐stage habitat requirements for informing the recovery of imperilled freshwater species.
COVID‐19 did not result in increased hospitalization for stroke and transient ischemic attack: A nationwide study
Authors: Simonsen Claus Z. , Blauenfeldt Rolf A. , Hedegaard Jakob N. , Kruuse Christina , Gaist David , Wienecke Troels , Modrau Boris , Johnsen Søren P. , Andersen Grethe
Published: April 2022

Background

The risk of thrombosis increases in infectious diseases, yet observational studies from single centers have shown a decrease in admission of acute ischemic stroke patients during the COVID‐19 pandemic. To investigate unselected stroke admission rates we performed a nationwide study in Denmark.

Methods

We extracted information from Danish national health registries. The following mutually exclusive time periods were compared to the year before the lockdown: (1) first national lockdown, (2) gradual reopening, (3) few restrictions, (4) regional lockdown, and (5) second national lockdown.

Results

Generally, admission rates were unchanged during the pandemic. In the unadjusted data, we observed a small decrease in the admission rate for all strokes under the first lockdown (incidence rate ratio: 0.93, confidence interval [CI]: 0.87–0.99) and a slight increase during the periods with gradual reopening, few restrictions, and the regional lockdown driven by ischemic strokes. We found no change in the rate of severe strokes, mild strokes, or 30‐day mortality. An exception was the higher mortality for all strokes during the first lockdown (risk ratio: crude 1.30 [CI: 1.03–1.59]; adjusted 1.17 [CI: 0.93–1.47]). The quality of care remained unchanged.

Conclusion

Stroke admission rates remained largely unchanged during the pandemic, while an increased short‐term mortality rate in patients admitted with stroke observed during the first lockdown was seen, probably reflecting that the more frail patients constituted a higher proportion of admitted patients at the beginning of the pandemic.
Rules or legacies? Industry and political revolving doors in regulators' careers in Portugal
Authors: Coroado Susana , Magalhães Pedro C.
Published: April 2022

The movement of personnel between roles in regulation, politics, and regulated industries is thought to affect the risks of politicization and industry capture of independent regulatory agencies. To test whether such movements are better explained by formal rules or by sector‐specific patterns, we employ an original dataset of the 152 appointees to 11 IRAs in Portugal over the last 3 decades. We find that variations in the formal independence of agencies have been of little consequence. Instead, revolving doors abound in the financial sector, with a disproportionate share of regulators of that sector coming from, and moving back, to the industry. In turn, appointment of regulators with political links to Portuguese IRAs seems related with legacies of sectoral public control.
Most promising alternative protein sources possible to use in sports nutrition – A review
Authors: Grdeń Adam , Sołowiej Bartosz G.
Published: April 2022

A growing world population and ongoing climate change have created a need to find new sources of high‐quality food, especially protein, that are sustainable and environmentally friendly and help to reduce unsustainable livestock production. Therefore, it is necessary to look for sources of protein from new raw materials or to use existing materials that have not been used on a large scale. The highest protein intake characterises athletes; thus, the market for high‐protein products should be targeted for them. This paper outlines the main problems associated with protein production to date, mainly from animal sources and some known plant sources such as pulses, which can cause gastrointestinal problems in athletes. This review aimed to propose several new/alternative protein sources (Single Cell Protein, edible insects, algae, and potato protein) that may have the potential for use in food, including food for athletes while solving the described problems associated with existing protein sources. Insects have the best amino acid composition; microbial and algal proteins have great potential but require further development of technology for application to food products. Potato proteins are of high value and quality but also contain glycoalkaloids. However, using them brings additional economic and environmental benefits.
Development of novel biodegradable film based on chitosan with borax (sodium tetraborate) and boron nitride and their biological activity
Authors: Kaya Burcu , Zorba Nükhet Nilüfer , Caner Cengiz
Published: April 2022

Alternative food packaging materials were prepared using chitosan (CS) that contained borax (B) and boron nitride (BN) (1% and 3% w/w). The produced films were characterised using scanning electron microscopy (SEM), Fourier‐transform infrared spectroscopy, and thermogravimetric analysis. In addition, physicochemical, biodegradation, chemical resistance, and biological activities were also investigated. According to the biodegradability study, the highest weight loss among all films was detected in CS‐BN1. The images obtained by SEM showed the presence of agglomerates as the concentration of B and BN increased. Besides, the thermal stability of the CS‐B and CS‐BN were found higher than CS. Moreover, CS‐B and CS‐BN showed antioxidant, antimicrobial, and anti‐quorum sensing activity. Their effects were decreased with increased concentration. Therefore, the CS‐B and CS‐BN are promising materials to be used in food packaging to enhance food safety, especially for fruit and vegetables by reducing water vapour loss and microbial growth.
Recent advances in the improvement of freezing time and physicochemical quality of frozen fruits and vegetables by ultrasound application
Authors: Wu Jiaxin , Jia Xiwu , Fan Kai
Published: April 2022

Freezing is widely used for the preservation of fruits and vegetables (FVs). Whereas, the conventional freezing method presents low process efficiency in frozen FVs. Ultrasound application is used as a supplementary technology to improve the freezing process of FVs. This reviewed paper shows the cavitation effect of ultrasound and the effect of ultrasound application on freezing time and the physicochemical quality of frozen FVs. The cavitation effect of ultrasound in the freezing process was described in detail. Compared with conventional freezing, ultrasound application in freezing of FVs can shorten the freezing time, and improve physicochemical quality including drip loss, colour, firmness, chemical compositions (ascorbic acid, total phenolic and anthocyanin), as well as microstructure. Therefore, the results of these studies illustrated that ultrasound is a potential technology to enhance freezing efficiency and retain the quality of FVs during freezing.
Examining the sustainability of effects of early childhood obesity prevention interventions: Follow‐up of the EPOCH individual participant data prospective meta‐analysis
Authors: Seidler Anna Lene , Hunter Kylie E. , Baur Louise , Espinoza David , Taylor Rachael W. , Wen Li Ming , Hesketh Kylie D. , Campbell Karen , Daniels Lynne , Mihrshahi Seema , Rissel Chris , Taylor Barry , Askie Lisa M.
Published: April 2022

Background

Although early childhood obesity prevention has become an important issue internationally, little evidence exists regarding longer term effects (i.e., sustainability) of early interventions.

Objective

To determine whether intervention benefits at 2 years of age were sustained at 3.5 and 5 years.

Methods

Follow‐up of the Early Prevention of Obesity in Children (EPOCH) individual participant data prospective meta‐analysis of four randomized controlled trials including 2196 mother–child dyads at baseline. Interventions were home‐ or community‐based, commenced within 6 months of birth, ended by 2 years of age, and comprised multiple sessions. Controls received standard care. BMI z‐score (primary outcome), other anthropometric measures and weight‐related behaviours were initially measured at 1.5–2 years and followed up at 3.5 and 5 years.

Results

Positive intervention effects on BMI z‐scores at 1.5–2 years of age were not apparent by 3.5 years (−0.04 adjusted mean difference; 95% CI:−0.14, 0.06; p = 0.424), and 5 years (0.03; 95% CI: −0.08, 0.14; p = 0.60). While prolonged intervention benefits were detected for a few, but not the majority of, weight‐related behaviours at 3.5 years, these effects diminished over time.

Conclusion

This meta‐analysis found that initial positive effects of childhood obesity interventions faded out after interventions ended, pointing toward the importance of a suite of interventions implemented at multiple stages across childhood.
CLEVER assay: A visual and rapid RNA extraction-free detection of SARS-CoV-2 based on CRISPR-Cas integrated RT-LAMP technology
Authors: Bhatt Akansha , Fatima Zeeshan , Ruwali Munindra , Misra Chitra Seetharam , Rangu Shyam Sunder , Rath Devashish , Rattan Ashok , Hameed Saif
Published: April 2022

Aim

The current scenario of COVID-19 pandemic has presented an almost insurmountable challenge even for the most sophisticated hospitals equipped with modern biomedical technology. There is an urgency to develop simple, fast and highly accurate methods for the rapid identification and isolation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients. To address the ongoing challenge, the present study offers a CLEVER assay (CRISPR-Cas integrated RT-LAMP Easy, Visual and Extraction-free RNA) which will allow RNA extraction-free method to visually diagnose COVID-19. RNA extraction is a major hurdle in preventing rapid and large-scale screening of samples particularly in low-resource regions because of the logistics and costs involved.

Method and Result

Herein, the visual SARS-CoV-2 detection method consists of RNA extraction-free method directly utilizing the patient's nasopharyngeal and oropharyngeal samples for reverse transcription loop-mediated isothermal amplification (RT-LAMP). Additionally, the assay also utilizes the integration of Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-Cas12-based system using different guide RNAs of N, E and an internal control POP7 (human RNase P) genes along with visual detection via lateral flow readout-based dip sticks with unaided eye (~100 min). Overall, the clinical sensitivity and specificity of the CLEVER assay were 89.6% and 100%, respectively.

Conclusion

Together, our CLEVER assay offers a point-of-care tool with no equipment dependency and minimum technical expertise requirement for COVID-19 diagnosis.

Significance and Impact of the Study

To address the challenges associated with COVID-19 diagnosis, we need a faster, direct and more versatile detection method for an efficient epidemiological management of the COVID-19 outbreak. The present study involves developing a method for detection of SARS-CoV-2 in human body without RNA isolation step that can visually be detected with unaided eye. Taken together, our assay offers to overcome one major defect of the prior art, that is, RNA extraction step, which could limit the deployment of the previous assays in a testing site having limited lab infrastructure.
Effects of decisional conflict, decision regret and self‐stigma on quality of life for breast cancer survivors: A cross‐sectional, multisite study in China
Authors: Zhuang Hezhu , Wang Ling , Yu Xuefen , Chan Sally Wai‐chi , Gao Yixuan , Li Xiuqing , Gao Shan , Zhu Jiemin
Published: April 2022

Aims

To examine the differences in decisional conflict, decision regret, self‐stigma and quality of life among breast cancer survivors who chose different surgeries, as well as the effects of decisional conflict, decision regret and self‐stigma on quality of life.

Design

Observational study.

Methods

Paper and online surveys were used to collect data from March to September 2020. The Chinese version of the Decisional Conflict Scale, Decision Regret Scale, Self‐Stigma Form and Functional Assessment of Cancer Treatment‐B were used to measure the corresponding health outcomes for breast cancer survivors who chose different surgeries from three university‐affiliated hospitals. One‐way analysis of variance, Pearson's correlation coefficient and hierarchical multiple regression analysis were used for data analysis.

Results

Among the 448 participants, only 21% chose breast conservative surgery, while 79% chose mastectomy with or without reconstruction. Women who chose mastectomy with reconstruction reported higher decisional conflict (p = .028) and more decision regret (p = .013) than women who chose breast conservative surgery; women who chose mastectomy without reconstruction indicated higher decisional conflict (p = .015), more decision regret (p < .001), and higher self‐stigma (p = .034) than women who chose breast conservative surgery. Decisional conflict (r = −.430), decision regret (r = −.495), and self‐stigma (r = −.561) were negatively correlated with quality of life. After controlling for sociodemographic and clinical variables, decisional conflict and decision regret explained 19.7% and self‐stigma explained 12.9% of the variance in quality of life.

Conclusion

Decisional conflict, decision regret and self‐stigma vary according to different breast surgeries and are greatly associated with the quality of life of breast cancer survivors.

Impact

Future studies are warranted to investigate the decision‐making process and the underlying reasons for surgical choices. Decision support strategies pre‐surgery are needed to inform women about the risks and benefits of surgery options. Moreover, psychosocial support post‐surgery is warranted to relieve women's self‐stigma, thus improving their quality of life.