bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential roles of dietary zeaxanthin and lutein in macular health and function
Authors: Li Xiang , Holt Roberta R , Keen Carl L , Morse Lawrence S , Zivkovic Angela M , Yiu Glenn , Hackman Robert M
Published: September 2022

Lutein, zeaxanthin, and meso-zeaxanthin are three xanthophyll carotenoid pigments that selectively concentrate in the center of the retina. Humans cannot synthesize lutein and zeaxanthin, so these compounds must be obtained from the diet or supplements, with meso-zeaxanthin being converted from lutein in the macula. Xanthophylls are major components of macular pigments that protect the retina through the provision of oxidant defense and filtering of blue light. The accumulation of these three xanthophylls in the central macula can be quantified with non-invasive methods, such as macular pigment optical density (MPOD). MPOD serves as a useful tool for assessing risk for, and progression of, age-related macular degeneration, the third leading cause of blindness worldwide. Dietary surveys suggest that the dietary intakes of lutein and zeaxanthin are decreasing. In addition to low dietary intake, pregnancy and lactation may compromise the lutein and zeaxanthin status of both the mother and infant. Lutein is found in modest amounts in some orange- and yellow-colored vegetables, yellow corn products, and in egg yolks, but rich sources of zeaxanthin are not commonly consumed. Goji berries contain the highest known levels of zeaxanthin of any food, and regular intake of these bright red berries may help protect against the development of age-related macular degeneration through an increase in MPOD. The purpose of this review is to summarize the protective function of macular xanthophylls in the eye, speculate on the compounds’ role in maternal and infant health, suggest the establishment of recommended dietary values for lutein and zeaxanthin, and introduce goji berries as a rich food source of zeaxanthin.
Access to and Affordability of World Health Organization Essential Medicines for Cancer in Sub-Saharan Africa: Examples from Kenya, Rwanda, and Uganda
Authors: Kizub Darya A , Naik Sachin , Abogan Ayokunle A , Pain Debanjan , Sammut Stephen , Shulman Lawrence N , Martei Yehoda M
Published: September 2022

Background

Cancer mortality is high in sub-Saharan Africa (SSA), partly due to inadequate treatment access. We explored access to and affordability of cancer treatment regimens for the top 10 cancers utilizing examples from Kenya, Uganda, and Rwanda.

Materials and Methods

Population, healthcare financing, minimum wage, and cancer incidence and mortality data were obtained from the WHO, World Bank, public sources, and GLOBOCAN. National Essential Medicines List (NEML) alignment with 2019 WHO EML was assessed as a proportion. Cancer regimen pricing was calculated using public and proprietary sources and methods from prior studies. Affordability through universal healthcare coverage (UHC) was assessed as 1-year cost <3× gross national income per capita; and to patients out-of-pocket (OOP), as 30-day treatment course cost <1 day of minimum wage work.

Results

A total of 93.4% of the WHO EML cancer medicines were listed on the 2019 Kenya NEML, and 70.5% and 41.1% on Uganda (2016) and Rwanda (2015) NEMLs, respectively. Generic chemotherapies were available and affordable to governments through UHC to treat non-Hodgkin’s lymphoma, cervical, breast, prostate, colorectal, ovarian cancers, and select leukemias. Newer targeted agents were not affordable through government UHC purchasing, while some capecitabine-based regimens were not affordable in Uganda and Rwanda. All therapies were not affordable OOP.

Conclusion

All cancer treatment regimens were not affordable OOP and some were not covered by governments. Newer targeted drugs were not affordable to all 3 governments. UHC of cancer drugs and improving targeted therapy affordability to LMIC governments in SSA are key to improving treatment access and health outcomes.
Evidence of Phosphite Tolerance in Phytophthora cinnamomi from New Zealand Avocado Orchards
Authors: Hunter Shannon , McDougal Rebecca , Williams Nari , Scott Peter
Published: September 2022

There is a limited number of chemical control agents for managing Phytophthora root and collar rot diseases of avocado internationally; of these, phosphite is one of the most effective. To determine whether prolonged phosphite use in New Zealand avocado orchards has led to decreased sensitivity of Phytophthora cinnamomi to phosphite, 57 isolates were collected from phosphite-treated and -untreated avocado orchards and screened for tolerance using a mycelial growth inhibition assay. The inhibitory effect of phosphite on mycelial growth was tested in vitro using six concentrations of phosphite. Based on changes in mycelial growth using optical density measurements to calculate the effective concentration to reduce growth by 50% (EC50) estimates, three phosphite-susceptible (EC50 range = 18.71 to 29.26 µg/ml) and three tolerant (EC50 range = 81.85 to 123.89 µg/ml) isolates were selected. The effects of phosphite on the colonization of lupin (Lupinus angustifolius) seedling roots and sporangia and zoospore production of three susceptible and three tolerant isolates were determined. The three tolerant isolates colonized lupin roots more extensively than the three susceptible isolates in the presence of phosphite at 5 and 10 g/liter. The tolerant isolates were able to asymptomatically colonize further above the lesion margin in the lupin treated with phosphite at 5 g/liter relative to the phosphite-susceptible isolates but no isolates were completely resistant to phosphite. The tolerant isolates produced more sporangia and, consequently, zoospores in the presence of phosphite than the susceptible isolates. The detection of phosphite tolerance by P. cinnamomi in planta and in vivo is concerning for the future efficacy of phosphite to manage Phytophthora diseases.
Association of Globodera rostochiensis (Nematoda) with Stunted and Chlorotic Potato Plants in Yunnan and Sichuan Provinces in China
Authors: Jiang Ru , Li Yunqing , Huang Liqiang , Liu Shiming , Liu Hui , Feng Xiaodong , Long Haibo , Hu Xianqi , Ge Jianjun , Bian Yong , Li Xingyue , Shao Baolin , Huang Wenkun , Kong Lin’an , Xu Chong , Peng Huan , Peng Deliang
Published: September 2022

On a global basis, potato cyst nematodes (Globodera spp. Skarbilovich 1959 [Behrens 1975]) are one of the most serious soilborne pathogens in potato (Solanum tuberosum L.) production. In 2019 to 2020, 188 soil samples were taken from rhizosphere soil associated with the roots of stunted and chlorotic potato plants in the main potato-growing areas of Yunnan and Sichuan Provinces of China. Globodera rostochiensis Wollenweber 1923 (Skarbilovich 1959) was recovered from 112 of the samples. Nematode identification was as confirmed by morphometric, light microscopy, electron microscopy, and molecular methodologies. Population densities of G. rostochiensis ranged from 47.0 to 69.0 eggs/g of soil. A BLASTn homology search program was used to compare the sequences of populations of G. rostrochienses from Yunnan and Sichuan Provinces with populations of other Heteroderinae spp. and populations of G. rostochiensis from other nations. Although potato has been grown in China for at least 400 years and the nation produces more potato than any other country, potato cyst nematodes were not reported in China until 2022.
Genome Sequence Data Reveal at Least Two Distinct Incursions of the Tropical Race 4 Variant of Fusarium Wilt into South America
Authors: Reyes-Herrera Paula H. , Torres-Bedoya Eliana , Lopez-Alvarez Diana , Burbano-David Diana , Carmona Sandra L. , Bebber Daniel P. , Studholme David J. , Betancourt Monica , Soto-Suarez Mauricio
Published: September 2022

The global banana industry is threatened by one of the most devastating diseases: Fusarium wilt of banana. Fusarium wilt of banana is caused by the soilborne fungus Fusarium oxysporum f. sp. cubense ( Foc), which almost annihilated the banana production in the late 1950s. A new strain of Foc, known as tropical race 4 (TR4), attacks a wide range of banana varieties, including Cavendish clones, which are the source of 99% of banana exports. In 2019, Foc TR4 was reported in Colombia, and more recently (2021) in Peru. In this study, we sequenced three fungal isolates identified as Foc TR4 from La Guajira (Colombia) and compared them against 19 whole-genome sequences of Foc TR4 publicly available, including four genome sequences recently released from Peru. To understand the genetic relatedness of the Colombian Foc TR4 isolates and those from Peru, we conducted a phylogenetic analysis based on a genome-wide set of single nucleotide polymorphisms (SNPs). Additionally, we compared the genomes of the 22 available Foc TR4 isolates, looking for the presence-absence of gene polymorphisms and genomic regions. Our results reveal that (i) the Colombian and Peruvian isolates are genetically distant, which could be better explained by independent incursions of the pathogen to the continent, and (ii) there is a high correspondence between the genetic relatedness and geographic origin of Foc TR4. The profile of present/absent genes and the distribution of missing genomic regions showed a high correspondence to the clades recovered in the phylogenetic analysis, supporting the results obtained by SNP-based phylogeny.
Comparison of cytokine mediators in type 2 inflammatory conditions on the skin and ocular surface
Authors: Chen Jamie , Bielory Leonard
Published: September 2022

Purpose of review

As the conjunctiva is embryologically modified skin, ocular surface involvement can be observed in several atopic skin diseases. The purpose of this review is to highlight and compare the roles of type 2 cytokines in the skin and ocular surface, and their resulting disorders.

Recent findings

Although there have been extensive studies identifying various type 2 cytokine pathways in the skin, there is limited analyses of pathways assessed on the ocular surface. We provide the potential overlapping cytokine impacts on the skin and eye including interleukin (IL)-4, IL-5 IL-13, IL-25, IL-33, thymic stromal lymphopoietin (TSLP), and IL-31 that may provide important immunomodulatory interventions and treatment for the more chronic and sight-threatening ocular disorders.

Dysregulation of type 2 inflammatory cytokines was found to elicit similar immunopathogenic responses on the skin and ocular surfaces, leading to barrier dysfunction, remodeling, immune cell recruitment, and symptoms such as pruritus.
Predicting Time to Death After Withdrawal of Life-Sustaining Treatment in Children
Authors: Winter Meredith C. , Ledbetter David R.
Published: September 2022

OBJECTIVES:

Accurately predicting time to death after withdrawal of life-sustaining treatment is valuable for family counseling and for identifying candidates for organ donation after cardiac death. This topic has been well studied in adults, but literature is scant in pediatrics. The purpose of this report is to assess the performance and clinical utility of the available tools for predicting time to death after treatment withdrawal in children.

DATA SOURCES:

Terms related to predicting time to death after treatment withdrawal were searched in PubMed and Embase from 1993 to November 2021.

STUDY SELECTION:

Studies endeavoring to predict time to death or describe factors related to time to death were included. Articles focusing on perceptions or practices of treatment withdrawal were excluded.

DATA EXTRACTION:

Titles, abstracts, and full text of articles were screened to determine eligibility. Data extraction was performed manually. Two-by-two tables were reconstructed with available data from each article to compare performance metrics head to head.

DATA SYNTHESIS:

Three hundred eighteen citations were identified from the initial search, resulting in 22 studies that were retained for full-text review. Among the pediatric studies, predictive models were developed using multiple logistic regression, Cox proportional hazards, and an advanced machine learning algorithm. In each of the original model derivation studies, the models demonstrated a classification accuracy ranging from 75% to 91% and positive predictive value ranging from 0.76 to 0.93.

CONCLUSIONS:

There are few tools to predict time to death after withdrawal of life-sustaining treatment in children. They are limited by small numbers and incomplete validation. Future work includes utilization of advanced machine learning models.
Complications Associated With Venovenous Extracorporeal Membrane Oxygenation—What Can Go Wrong?
Authors: Teijeiro-Paradis Ricardo , Gannon Whitney D. , Fan Eddy
Published: September 2022

OBJECTIVES:

Despite increasing use and promising outcomes, venovenous extracorporeal membrane oxygenation (V-V ECMO) introduces the risk of a number of complications across the spectrum of ECMO care. This narrative review describes the variety of short- and long-term complications that can occur during treatment with ECMO and how patient selection and management decisions may influence the risk of these complications.

DATA SOURCES:

English language articles were identified in PubMed using phrases related to V-V ECMO, acute respiratory distress syndrome, severe respiratory failure, and complications.

STUDY SELECTION:

Original research, review articles, commentaries, and published guidelines from the Extracorporeal Life support Organization were considered.

DATA EXTRACTION:

Data from relevant literature were identified, reviewed, and integrated into a concise narrative review.

DATA SYNTHESIS:

Selecting patients for V-V ECMO exposes the patient to a number of complications. Adequate knowledge of these risks is needed to weigh them against the anticipated benefit of treatment. Timing of ECMO initiation and transfer to centers capable of providing ECMO affect patient outcomes. Choosing a configuration that insufficiently addresses the patient’s physiologic deficit leads to consequences of inadequate physiologic support. Suboptimal mechanical ventilator management during ECMO may lead to worsening lung injury, delayed lung recovery, or ventilator-associated pneumonia. Premature decannulation from ECMO as lungs recover can lead to clinical worsening, and delayed decannulation can prolong exposure to complications unnecessarily. Short-term complications include bleeding, thrombosis, and hemolysis, renal and neurologic injury, concomitant infections, and technical and mechanical problems. Long-term complications reflect the physical, functional, and neurologic sequelae of critical illness. ECMO can introduce ethical and emotional challenges, particularly when bridging strategies fail.

CONCLUSIONS:

V-V ECMO is associated with a number of complications. ECMO selection, timing of initiation, and management decisions impact the presence and severity of these potential harms.
Distribution of ventilation and oxygenation in surgical obese patients ventilated with high versus low positive end-expiratory pressure
Authors: Ellenberger Christoph , Pelosi Paolo , de Abreu Marcelo Gama , Wrigge Hermann , Diaper John , Hagerman Andres , Adam Yannick , Schultz Marcus J. , Licker Marc
Published: September 2022

BACKGROUND

Intra-operative ventilation using low/physiological tidal volume and positive end-expiratory pressure (PEEP) with periodic alveolar recruitment manoeuvres (ARMs) is recommended in obese surgery patients.

OBJECTIVES

To investigate the effects of PEEP levels and ARMs on ventilation distribution, oxygenation, haemodynamic parameters and cerebral oximetry.

DESIGN

A substudy of a randomised controlled trial.

SETTING

Tertiary medical centre in Geneva, Switzerland, between 2015 and 2018.

PATIENTS

One hundred and sixty-two patients with a BMI at least 35 kg per square metre undergoing elective open or laparoscopic surgery lasting at least 120 min.

INTERVENTION

Patients were randomised to PEEP of 4 cmH2O (n = 79) or PEEP of 12 cmH2O with hourly ARMs (n = 83).

MAIN OUTCOME MEASURES

The primary endpoint was the fraction of ventilation in the dependent lung as measured by electrical impedance tomography. Secondary endpoints were the oxygen saturation index (SaO2/FIO2 ratio), respiratory and haemodynamic parameters, and cerebral tissue oximetry.

RESULTS

Compared with low PEEP, high PEEP was associated with smaller intra-operative decreases in dependent lung ventilation [-11.2%; 95% confidence interval (CI) -8.7 to -13.7 vs. -13.9%; 95% CI -11.7 to -16.5; P = 0.029], oxygen saturation index (-49.6%; 95% CI -48.0 to -51.3 vs. -51.3%; 95% CI -49.6 to -53.1; P < 0.001) and a lower driving pressure (-6.3 cmH2O; 95% CI -5.7 to -7.0). Haemodynamic parameters did not differ between the groups, except at the end of ARMs when arterial pressure and cardiac index decreased on average by -13.7 mmHg (95% CI -12.5 to -14.9) and by -0.54 l min-1 m-2 (95% CI -0.49 to -0.59) along with increased cerebral tissue oximetry (3.0 and 3.2% on left and right front brain, respectively).

CONCLUSION

In obese patients undergoing abdominal surgery, intra-operative PEEP of 12 cmH2O with periodic ARMs, compared with intra-operative PEEP of 4 cmH2O without ARMs, slightly redistributed ventilation to dependent lung zones with minor improvements in peripheral and cerebral oxygenation.

TRIAL REGISTRATION

NCT02148692, https://clinicaltrials.gov/ct2
Impact of donor hypertension on graft survival and function in living and deceased donor kidney transplantation: a nationwide prospective cohort study
Authors: Lee Yu Ho , Kim Jin Sug , Song Sang Heon , Song Seung Hwan , Shin Ho Sik , Yang Jaeseok , Ahn Curie , Jeong Kyung Hwan , Hwang Hyeon Seok
Published: September 2022

Objectives:

Hypertensive living donors are potential candidates to expand the kidney donor pool. However, the impact of donor hypertension on graft survival and function remains to be clarified.

Methods:

We analyzed 3907 kidney transplant recipients registered in a nationwide prospective cohort from 2014 to 2018. Patients were divided by donor types and the presence of donor hypertension. The primary and secondary outcome was the occurrence of death-censored graft failure and renal allograft function, respectively.

Results:

The prevalence of hypertension was 9.4% (258/2740) and 19.9% (232/1167) in living and deceased donors, respectively. During a median follow-up of 21.8 months, death-censored graft survival rate was significantly worse in recipients of hypertensive living donors than in those of normotensive living donors (P = 0.008). In multivariable analysis, recipients of hypertensive living donors had a significantly increased risk of graft loss (adjusted hazard ratio 2.91; P = 0.009). The risk of allograft loss was not different between recipients of hypertensive living and normotensive deceased donors. Propensity score-matched analyses had consistent worse graft survival rate in recipients of hypertensive living donors compared to those of normotensive living donors (P = 0.027), while it was not different between recipients of hypertensive living and normotensive deceased donors. Hypertension in living donors had a significant negative impact on one-year graft function (adjusted unstandardized β −3.64; P = 0.011).

Conclusions:

Hypertensive living donor recipients have significantly higher risks of renal allograft loss than normotensive living donor recipients, and showed similar outcomes compared to recipients of normotensive deceased donors.
An overview of peripapillary hyperreflective ovoid mass-like structures
Authors: Chapman Jacqueline J. , Heidary Gena , Gise Ryan
Published: September 2022

Purpose of review

The purpose of this review is to provide an overview of the ophthalmic findings associated with peripapillary hyperreflective ovoid mass-like structures (PHOMS) in both adult and pediatric patients.

Recent findings

PHOMS have recently been identified in a number of different ophthalmic disease entities ranging from nonpathologic to pathologic, including but not limited to anatomic abnormalities (tilting in myopia), optic nerve head drusen, optic disc edema from inflammation (optic neuritis, white dot syndromes), vascular insults (ischemic optic neuropathy, retinal vascular occlusion), and papilledema. The mechanism underlying the formation of PHOMS has not been fully elucidated although it has been hypothesized that PHOMS occur secondary to axoplasmic stasis from crowding at the optic nerve head.

Although the clinical significance of the presence of PHOMS remains unclear, PHOMS are associated with several disease processes. Understanding the mechanism behind their formation and their impact on optic nerve head structure and visual function may be relevant in patients with optic nerve head pathology. The presence of PHOMS may also correlate with disease severity and duration. Future studies to evaluate whether the formation of PHOMS may be useful as an early indicator of disease or a prognostic tool are warranted.
Recent Stressful Life Events, Lifetime Traumatic Events, Missed Visits, and Antiretroviral Adherence Among Black Women With HIV in the Southeastern United States: A Cross-sectional Study
Authors: Chapman Lambert Crystal , Wright Nicole C. , Elopre Latesha , Fazeli Pariya , King Kiko , Raper James L. , Holstad Marcia M. , Azuero Andres , Turan Janet M. , Mugavero Michael J.
Published: September 2022

Lifetime traumatic events are prevalent among people with HIV and consistently associated with deleterious HIV outcomes. Yet, little is known about the impact of recent stressful events on health outcomes among Black women with HIV (WWH). This cross-sectional study assessed the prevalence of recent stressful events and lifetime traumatic events and their association with HIV outcomes in Black WWH (n = 200) in the Southeastern United States. We evaluated the association between stressful events and HIV outcomes using chi-square tests and unadjusted and adjusted logistic regression analyses. In the unadjusted analyses, missed visits were associated with higher odds of recent stressful events (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.04–1.16) and lifetime traumatic events (OR 1.15, 95% CI 1.05–1.26). In the adjusted analysis, exposure to recent stressful events was independently associated with missed visits (adjusted OR 1.08, 95% CI 1.01–1.15). Interventions addressing recent stressful events are warranted.
Nonsteroidal Anti-inflammatory Drugs Are Not Associated With Increased Bleeding in Blunt Solid Organ Injury
Authors: Hill Joshua H. , Kuhlman Jamie , LaRiccia Aimee , Ngo Anna , Hyland Sara Jordan , Spalding Marshall C.
Published: September 2022

BACKGROUND:

Nonsteroidal anti-inflammatory drugs are an effective nonopiate option for pain control. However, the antiplatelet aggregation of cyclooxygenase-1 (COX-1) inhibitors presents a concern in that they may exacerbate bleeding in patients with solid organ injuries.

OBJECTIVE:

The aim of the study is to evaluate the impact of nonsteroidal anti-inflammatory drugs on blunt solid organ injury. We hypothesized that nonsteroidal anti-inflammatory drugs would not contribute to intra-abdominal bleed progression.

METHODS:

This is a retrospective cohort study of blunt solid organ injury evaluated from June 1, 2015, to June 30, 2019, at an urban midwestern Level I trauma center. Patients receiving and those not receiving nonsterioidal anti-inflammatory drugs were compared on intra-abdominal bleeding progression as assessed by surgical intervention, angioembolization, and blood transfusions.

RESULTS:

We analyzed 706 patients, of whom 206 were given nonsteroidal anti-inflammatory drugs during their hospital course. Compared with those who were not given nonsteroidal anti-inflammatory drugs, patients given nonsteroidal anti-inflammatory drugs were less likely to have an operation (odds ratio, OR 0.46, 95% confidence interval, CI [0.25, 0.85], p = .012) and were less likely to have an embolization (OR 0.27, 95% CI [0.11, 0.70], p = .004). There was no difference in the need for packed red blood cell transfusion between the nonsteroidal anti-inflammatory drug and non- nonsteroidal anti-inflammatory drug groups (95% CI [0.91, 1.99], p = .13).

CONCLUSION:

Patients given nonsteroidal anti-inflammatory drugs had a decreased likelihood of receiving an organ-specific procedure or needing a blood transfusion and had no difference in mortality. Our findings indicate that nonsteroidal anti-inflammatory drugs in patients with blunt solid organ injuries were not associated with an increased risk of adverse events related to intra-abdominal bleeding.
Validation of the Nelson Tool: A Scoring Tool for Nonsurgical Service Admission of Injured Patients
Authors: Cofran Jessica M. , Teasley-Bennett Jamie M. , McFann Kim , Dunn Julie A. , Martin Kathleen D.
Published: September 2022

BACKGROUND:

Trauma performance improvement programs are required by the American College of Surgeons to review all nonsurgical admissions if the annual rate exceeds 10%. These reviews can have varying consistency between reviewers, are time consuming, and the consequent aggregate data are difficult to evaluate for trends.

OBJECTIVE:

This study set forth to standardize nonsurgical admission review through validation of the Nelson tool, which is a published objective scoring tool to determine the appropriateness of nonsurgical admissions. We hypothesized that implementation of this tool would facilitate earlier identification of events resulting in meaningful intervention and a reduction of inappropriate nonsurgical admissions.

METHODS:

The Nelson tool and scoring was integrated into the nonsurgical admission review process. A customized audit filter and report were built in the trauma registry. Data were reviewed with respect to scores and admitting service. Statistical analysis included using analysis of variance and t tests to examine differences between admitting services, χ2 test of independence or Fisher's exact to test the association of categorical variables, and ordinal logistic regression to test the ability of the total Nelson tool to predict appropriateness of admission.

RESULTS:

Using the Nelson tool, scores resulted in appropriate admission service in over 90% of cases. Implementation of the tool resulted in a decreased performance improvement workload with a 78% reduction in nonsurgical admission cases required to go to secondary level of review.

CONCLUSIONS:

Utilization of a validated scoring tool decreases performance improvement workload without compromising patient safety.
Sleep characteristics associated with nocturnal blood pressure nondipping in healthy individuals: a systematic review
Authors: Forshaw Philippa Eileen , Correia Arron Taylor Lund , Roden Laura Catherine , Lambert Estelle Victoria , Rae Dale Elizabeth
Published: September 2022

Objective

The current literature investigating nocturnal blood pressure (BP) nondipping has largely focused on clinical populations, however, conditions such as hypertension, obstructive sleep apnoea and insomnia are recognized confounding factors for BP dipping. The exact mechanisms responsible for BP nondipping remain unclear, therefore, there is a need to investigate BP nondipping in healthy individuals to better understand the underlying mechanisms. This review identifies sleep characteristics that may contribute to BP nondipping in healthy individuals. It is anticipated that an understanding of the sleep characteristics that contribute to BP nondipping may inform future sleep-related behavioral interventions to ultimately reducing the burden of cardiovascular disease.

Methods

The PubMed, Scopus and Web of Science databases were searched for relevant, English language, peer-reviewed publications (from inception to March 2022). The search identified 550 studies. After duplicates were removed, the titles and abstracts of the remaining 306 studies were screened. Of these, 250 studies were excluded leaving 56 studies to test for eligibility. Thirty-nine studies were excluded such that 17 studies fully met the inclusion criteria for the review.

Results

Findings from this review indicate that short sleep duration, more sleep fragmentation, less sleep depth and increased variability in sleep timing may be associated with BP nondipping in healthy individuals.

Conclusion

While there is no evidence-based approach for the treatment of nocturnal BP nondipping, it seems promising that addressing one’s sleep health may be an important starting point to reduce the prevalence of BP nondipping and perhaps the progression to cardiovascular disease.
Current recommendations regarding evaluation of cognitive functioning in organ transplant candidates
Authors: Jesse Michelle T. , Haver D. Brian
Published: September 2022

Purpose of review

Cognitive impairment is associated with negative effects on solid organ transplant candidates, recipients, and their care partners. However, because of the heterogeneity of mechanisms, presentations, and assessment measures, research suggests a wide array of impairments, patterns of impairments, and unclear trajectories posttransplant. This review provides an abbreviated synthesis of recent research on cognitive impairments observed in organ-eligible candidates and potential trajectories through posttransplant, current clinical recommendations regarding integration of assessment into routine clinical transplant practice, as well as recommendations for future research.

Recent findings

Transplantation may resolve certain disease-contributing factors to cognitive impairments but also introduces new potential neurocognitive assaults. Recent studies in kidney and lung recipients document continued impairments in subsets of patients, particularly those identified as frail. For liver candidates, new assessment measures of hepatic encephalopathy have been developed and preliminarily tested with potential for translation into routine clinical care. Clinical implications, as well as ethical considerations are discussed.

Although guidelines agree that cognitive assessment is an important part of the organ transplantation process, many questions remain of how to best assess cognition and intervene when cognitive impairment is identified in transplant populations. Further research should focus on prospective, longitudinal assessments in transplant-eligible populations through posttransplant.
Cyclothymic Temperament, Physical Neglect, and Earlier Age of Onset Predict Poor Medication Adherence in Patients With Bipolar Disorder
Authors: Li Ziyan , Liu Xinzi , Ma Rui , Feng Sitong , Zheng Sisi , Zhu Hong , Yin Dongqing , Jia Hongxiao
Published: September 2022

Individual-level risk factors may predict poor medication adherence (PMA) in bipolar disorder (BD). This study aimed to evaluate the association between affective temperament, childhood trauma, age of first onset, and PMA in patients with BD in China. A total of 168 patients completed the eight-item Morisky Medication Adherence Scale; the Short Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire; and the Childhood Trauma Questionnaire–Short Form. Scores were then compared between PMA and non-PMA groups. Binary logistic regression showed that age of first onset was negatively correlated with PMA (β = −0.106, p = 0.002), whereas physical neglect and cyclothymic temperament were positively correlated with PMA (β = 0.143, p = 0.029; β = 0.19, p = 0.001, respectively). These findings indicate that cyclothymic temperament, physical neglect, and earlier onset are predictors of PMA in patients with BD and that such patients may require further attention to improve medical compliance.
Religiosity and Stigmatization Related to Mental Illness Among African Americans and Black Immigrants
Authors: Pederson Aderonke Bamgbose , Earnshaw Valerie A. , Lewis-Fernández Roberto , Hawkins Devan , Mangale Dorothy I. , Tsai Alexander C. , Thornicroft Graham
Published: September 2022

Stigma about mental illness is a known barrier to engagement in mental health services. We conducted an online cross-sectional study, aiming to estimate the associations between religiosity and mental illness stigma among Black adults (n = 269, ages 18–65 years) in the United States. After adjusting for demographic factors (age, education, and ethnicity), respondents with higher attendance at religious services or greater engagement in religious activities (e.g., prayer, meditation, or Bible study) reported greater proximity to people living with mental health problems (rate ratio [RR], 1.72; 95% confidence interval [CI], 1.14–2.59 and RR, 1.82; 95% CI, 1.18–2.79, respectively). Despite reporting greater past or current social proximity, respondents with higher religiosity indices also reported greater future intended stigmatizing behavior (or lower future intended social proximity) (RR, 0.92–0.98). Focusing specifically on future intended stigmatizing behavior and the respondent's level of religiosity, age, and ethnicity may be critical for designing effective stigma-reducing interventions for Black adults.
Beliefs About Traumatic Memories, Thought Control Strategies, and the Impact on PTSD Symptoms After a Natural Disaster
Authors: Brown Renée L. , Innes Peter A. , Carter Janet D. , Wood Andrew , Love Steven , Kannis-Dymand Lee
Published: September 2022

This study aimed to investigate the relationships among self-reported meta-memory beliefs, thought control strategies (i.e., distraction, reappraisal, worry, social control, and punishment), and posttraumatic stress disorder (PTSD) symptomology, among a sample of earthquake survivors (N = 412). Correlational analysis and structural equation modeling were used on the responses and showed that stronger positive and negative meta-memory beliefs, and greater worry and punishment, were associated with greater PTSD symptom severity. The results also indicated that meta-memory beliefs had a prominent indirect influence toward PTSD symptomology via their effects toward thought control strategies. Follow-up analysis of variance indicated that those with a history of mental health difficulties reported higher levels of PTSD symptom severity, were more likely to score in the range of clinically relevant PTSD, and had a stronger tendency to negatively appraise unwanted thinking styles. The results of this research provide overall support for the validity of the metacognitive model for PTSD.
Update on the epidemiology and treatment of eating disorders among Hispanic/Latinx Americans in the United States
Authors: Hernández Juan C. , Perez Marisol , Hoek Hans W.
Published: September 2022

Purpose of review

This review provides a 6-year update on the prevalence and treatment of eating disorders among Hispanic/Latinx Americans in the United States.

Recent findings

Prevalence of eating disorders tends to be lower in Hispanic/Latinx American adolescents and adults relative to non-Hispanic White peers. Numerous risk factors for disordered eating symptoms have been identified, including negative body image, depression, sexual assault and culturally specific risk factors, including ethnic discrimination and acculturative stress. Hispanic/Latinx individuals seek treatment less often with the most influential barriers being cost of treatment, eating disorder stigma, eating disorder shame and mental health shame in general. Limited research on the treatment for eating disorders continue to persist. Culturally adapted cognitive behavioural therapy yielded similar outcomes to traditional cognitive behaviour therapy and had better treatment adherence and retention rates.

The medical and sociopolitical climate of the United States has changed significantly since our previous review. The need for research on the effectiveness of eating disorder treatments for Hispanic/Latinx Americans remains important for one of the fastest growing populations in the U.S.
Airway Complications in Pregnant Patients Undergoing Electroconvulsive Therapy
Authors: Jhaveri Vasanti , Martinez Ramon , Trippensee Arvin , Roussos-Ross Kay , Brennan Meghan , Wendling Adam
Published: September 2022

Objectives

Electroconvulsive therapy (ECT) is an evidence-based treatment for severe depression and bipolar disorder in pregnant women. Electroconvulsive therapy involves induction of general anesthesia, muscle relaxation, and positive-pressure ventilation. Airway manipulation may lead to complications such as vocal cord injury, aspiration, inability to ventilate, and death. The purpose of this study was to determine whether there were differences in the incidence of airway complications in pregnant patients who underwent mask ventilation (MV) versus endotracheal intubation (ETI) compared with nonpregnant control subjects.

Methods

We conducted a single-center retrospective chart review of all adult pregnant patients who underwent anesthesia for ECT from June 1, 2011, to June 30, 2020. Each ECT treatment delivered to a pregnant patient was matched with 2 ECT treatments delivered to a nonpregnant female control subject. Charts were queried for airway management (MV vs ETI), gestational age, and airway complications. Each ECT treatment was considered an independent event.

Results

Seventy-six ECT treatments from 11 pregnant patients were matched with 154 ECT treatments from 13 nonpregnant patients. In pregnant patients, airway management consisted of MV in 57 of the 76 treatments: 12 of 12 in the first trimester, 33 of 44 in the second trimester, and 12 of 20 in the third trimester. All 154 ECT treatments in the control group used MV. No airway complications were experienced in pregnant or nonpregnant patients with MV or ETI.

Conclusions

No airway complications were observed in pregnant patients undergoing MV or ETI regardless of gestational age.
Exploring the mismatch between the theory and application of photosynthetic quotients in aquatic ecosystems
Authors: Trentman Matt T. , Hall Robert O. , Valett H. Maurice.
Published: September 2022

Estimates of primary productivity in aquatic ecosystems are commonly based on variation in O2, rather than CO2. The photosynthetic quotient (PQ) is used to convert primary production estimates from units of O2to C. However, there is a mismatch between the theory and application of the PQ. Aquatic ecologists use PQ=1-1.4. Meanwhile, PQ estimates from the literature support PQ=0.1-4.2. Here, we describe the theory on why PQ may vary in aquatic ecosystems. We synthesize the current understanding of how processes such as NO3−assimilation and photorespiration can affect the PQ. We test these ideas with a case study of the Clark Fork River, Montana, where theory predicts that PQ could vary in space and time due to variation in environmental conditions. Finally, we highlight research needs to improve our understanding of the PQ. We suggest departing from fixed PQ values and instead use literature-based sensitivity analyses to infer C dynamics from primary production estimated using O2.

Scientific Significance Statement

Accurate measures of primary production in aquatic ecosystems are necessary to quantify energy availability to higher trophic levels and biological effects on global CO2concentrations, among other reasons. However, we commonly measure primary production using O2because it is easier, despite our motivation to measure the rate of fixed C, and then use the photosynthetic quotient (the ratio of O2release to CO2fixed, PQ) to convert O2based metabolism to CO2. This study provides a summary of the current mismatch between our current knowledge and the application of PQ, highlights our current knowledge gaps, and emphasizes the need to use literature-based sensitivity analysis rather than uninformed fixed PQ values.
Paired evaluation defines performance landscapes for machine learning models
Authors: Nariya Maulik K. , Mills Caitlin E. , Sorger Peter K. , Sokolov Artem
Published: September 2022

The true accuracy of a machine learning model is a population-level statistic that cannot be observed directly. In practice, predictor performance is estimated against one or more test datasets, and the accuracy of this estimate strongly depends on how well the test sets represent all possible unseen datasets. Here we present paired evaluation, a simple approach for increasing the robustness of performance evaluation by systematic pairing of test samples, and use it to evaluate predictors of drug response in breast cancer cell lines and of disease severity in patients with Alzheimer’s Disease. Our results demonstrate that the choice of test data can cause estimates of performance to vary by as much as 30%, and that paired evaluation makes it possible to identify outliers, improve the accuracy of performance estimates in the presence of known confounders, and assign statistical significance when comparing machine learning models.
HRDex: a tool for deriving homologous recombination deficiency (HRD) scores from whole exome sequencing data
Authors: Pluta John , Hausler Ryan , Wubbenhorst Brad , Desai Heena , Domchek Susan M. , Nathanson Katherine L. , Maxwell Kara N.
Published: September 2022

Background

Breast and ovarian tumors in patients with biallelic BRCA1 and BRCA2 mutations either by germline mutations accompanied by allele-specific loss of heterozygosity (LOH) or truncal somatic mutations respond to PARP inhibition. The repair of double stranded DNA breaks in tumors these tumors leads to homologous recombination deficiency (HRD), which can be measured using a variety of genomic and transcriptomic signatures. However, the optimal biomarker for BRCA deficiency is unknown.

Methods

We developed HRDex to determine HRD and its composite scores from allele specific copy number data analysis of whole exome sequencing (WES) data and examined the discriminatory ability of HRDex and other genomic and transcriptomic measures to identify BRCA deficiency in breast and ovarian tumors from The Cancer Genome Atlas (TCGA).

Results

HRDex scores have high correlation with SNP array based HRD scores in both breast and ovarian cancers. HRDex scores have high discriminatory accuracy to distinguish BRCA deficient breast tumors, similar to SNP array based scores (AUC 0.87 vs 0.90); however, discriminatory ability for ovarian tumors was lower (AUC 0.79 vs 0.90). HRD-LST had the best discriminatory ability of the three composite HRD scores. HRDex had higher discriminatory ability for identification of BRCA deficiency than RNA expression based scores (eCARD, tp53, RPS and PARPi7) in breast and ovarian tumors. Tumor mutational burden (TMB) was associated with BRCA deficiency in breast but not ovarian cancer. Combining HRDex score with mutational signature 3 modestly increased discriminatory ability for BRCA deficient breast and ovarian tumors (breast: AUC 0.90 vs 0.87; ovarian: AUC 0.83 vs 0.79).

Conclusions

WES based HRD scores perform similarly to SNP array HRD scores, and better than other genomic or transcriptomic signatures, for identification of tumors with BRCA deficiency due to biallelic BRCA loss.
Refining epigenetic prediction of chronological and biological age
Authors: Bernabeu Elena , McCartney Daniel L , Gadd Danni A , Hillary Robert F , Lu Ake T , Murphy Lee , Wrobel Nicola , Campbell Archie , Harris Sarah E , Liewald David , Hayward Caroline , Sudlow Cathie , Cox Simon R , Evans Kathryn L , Horvath Steve , McIntosh Andrew M , Robinson Matthew R , Vallejos Catalina A , Marioni Riccardo E
Published: September 2022

Epigenetic clocks can track both chronological age (cAge) and biological age (bAge). The latter is typically defined by physiological biomarkers and risk of adverse health outcomes, including all-cause mortality. As cohort sample sizes increase, estimates of cAge and bAge become more precise. Here, we aim to refine predictors and improve understanding of the epigenomic architecture of cAge and bAge. First, we perform large-scale (N = 18,413) epigenome-wide association studies (EWAS) of chronological age and all-cause mortality. Next, to improve cAge prediction, we use methylation data from 24,673 participants from the Generation Scotland (GS) study, the Lothian Birth Cohorts (LBC) of 1921 and 1936 and 8 publicly available datasets. Through the inclusion of linear and non-linear age-CpG associations from the EWAS, feature pre-selection/dimensionality reduction in advance of elastic net regression, and a leave-one-cohort-out (LOCO) cross validation framework, we arrive at an improved cAge predictor (median absolute error = 2.3 years across 10 cohorts). In addition, we train a predictor of bAge on 1,214 all-cause mortality events in GS, based on epigenetic surrogates for 109 plasma proteins and the 8 component parts of GrimAge, the current best epigenetic predictor of all-cause mortality. We test this predictor in four external cohorts (LBC1921, LBC1936, the Framingham Heart Study and the Women’s Health Initiative study) where it outperforms GrimAge in its association to survival (HRGrimAge = 1.47 [1.40, 1.54] with p = 1.08 × 10−52, and HRbAge = 1.52 [1.44, 1.59] with p = 2.20 × 10−60). Finally, we introduce MethylBrowsR, an online tool to visualize epigenome-wide CpG-age associations.
28 Minutes Later: Investigating the role of aflatrem-like compounds in Ophiocordyceps parasite manipulation of zombie ants
Authors: Beckerson William C. , Krider Courtney , Mohammad Umar A. , de Bekker Charissa
Published: September 2022

Coevolutionary relationships between parasites and their hosts can lead to the emergence of diverse phenotypes over time, as seen inOphiocordycepsfungi that manipulate insect and arachnid behaviour to aid fungal spore transmission. The most conspicuous examples are found in ants of the Camponotini tribe, colloquially known as “zombie ants”. While the behaviours induced during infection are well described, their molecular underpinnings remain unknown. Recent genomics and transcriptomics analyses ofOphiocordyceps camponoti-floridanihave identified several highly upregulated biomolecules produced by the fungus during infection ofCamponotus floridanus. Among them is an ergot alkaloid related to the mycotoxin aflatrem, known to cause “staggers syndrome” in cows. Staggering, defined as unsteady movements side to side, is also observed inC. floridanusants during late-stage infection. To test if aflatrem-like compounds could be responsible, we injected healthy ants with aflatrem and recorded their behaviour for 30 minutes. Using both the automated object-tracking software MARGO and manual behavioural quantification, we found that aflatrem reduced ant activity and speed, and increased staggering behaviours. To examine underlying transcriptomic changes, we performed RNA-Seq on the heads of aflatrem-injected ants, keeping in step with previous transcriptomic work onOphiocordyceps-manipulated ants. We identified 261 genes that were significantly dysregulated in the aflatrem-injected ants compared to sham-injected controls. When compared with RNA-Seq data fromOphiocordyceps-manipulated ants, we found that both groups shared 113 differentially regulated genes. These includedsensory neuron membrane proteingenes, severalodorant-binding proteingenes, and musculoskeletal genes such astitinandobscurin. Together, these results indicate that aflatrem-like compounds significantly affect neuromuscular and sensory function inC. floridanus. The conservation of staggers phenotype betweenC. floridanusandBos taurussuggests that behaviour manipulating strategies exhibited across the Tree of Life may be more similar in approach, if not widely different in application, than we realize.