bluuebunny/crossref_metadata_2025 huggingface dataset:
A Fully Integrated Infectious Diseases and Antimicrobial Stewardship Telehealth Service Improves Staphylococcus aureus Bacteremia Bundle Adherence and Outcomes in 16 Small Community Hospitals
Authors: Veillette John J , May Stephanie S , Gabrellas Alithea D , Gelman Stephanie S , Albritton Jordan , Lyons Michael D , Stenehjem Edward A , Webb Brandon J , Dalto Joseph D , Throneberry S Kyle , Stanfield Valoree , Grisel Nancy A , Vento Todd J
Published: October 2022

Background

Infectious diseases (ID) and antimicrobial stewardship (AS) improve Staphylococcus aureus bacteremia (SAB) outcomes. However, many small community hospitals (SCHs) lack on-site access to these services, and it is not known if ID telehealth (IDt) offers the same benefit for SAB. We evaluated the impact of an integrated IDt service on SAB outcomes in 16 SCHs.

Methods

An IDt service offering IDt physician consultation plus IDt pharmacist surveillance was implemented in October 2016. Patients treated for SAB in 16 SCHs between January 2009 and August 2019 were identified for review. We compared SAB bundle adherence and outcomes between patients with and without an IDt consult (IDt group and control group, respectively).

Results

A total of 423 patients met inclusion criteria: 157 in the IDt group and 266 in the control group. Baseline characteristics were similar between groups. Among patients completing their admission at an SCH, IDt consultation increased SAB bundle adherence (79% vs 23%; odds ratio [OR], 16.9; 95% CI, 9.2–31.0). Thirty-day mortality and 90-day SAB recurrence favored the IDt group, but the differences were not statistically significant (5% vs 9%; P = .2; and 2% vs 6%; P = .09; respectively). IDt consultation significantly decreased 30-day SAB-related readmissions (9% vs 17%; P = .045) and increased length of stay (median [IQR], 5 [5–8] days vs 5 [3–7] days; P = .04). In a subgroup of SAB patients with a controllable source, IDt appeared to have a mortality benefit (2% vs 9%; OR, 0.12; 95% CI, 0.01–0.98).

Conclusions

An integrated ID/AS telehealth service improved SAB management and outcomes at 16 SCHs. These findings provide important insights for other IDt programs.
Polarly localized WPR proteins interact with PAN receptors and the actin cytoskeleton during maize stomatal development
Authors: Nan Qiong , Char Si Nian , Yang Bing , Bennett Eric J , Yang Bing , Facette Michelle R
Published: October 2022

Polarization of cells prior to asymmetric cell division is crucial for correct cell divisions, cell fate, and tissue patterning. In maize (Zea mays) stomatal development, the polarization of subsidiary mother cells (SMCs) prior to asymmetric division is controlled by the BRICK (BRK)–PANGLOSS (PAN)–RHO FAMILY GTPASE (ROP) pathway. Two catalytically inactive receptor-like kinases, PAN2 and PAN1, are required for correct division plane positioning. Proteins in the BRK–PAN–ROP pathway are polarized in SMCs, with the polarization of each protein dependent on the previous one. As most of the known proteins in this pathway do not physically interact, possible interactors that might participate in the pathway are yet to be described. We identified WEAK CHLOROPLAST MOVEMENT UNDER BLUE LIGHT 1 (WEB1)/PLASTID MOVEMENT IMPAIRED 2 (PMI2)-RELATED (WPR) proteins as players during SMC polarization in maize. WPRs physically interact with PAN receptors and polarly accumulate in SMCs. The polarized localization of WPR proteins depends on PAN2 but not PAN1. CRISPR–Cas9-induced mutations result in division plane defects in SMCs, and ectopic expression of WPR-RFP results in stomatal defects and alterations to the actin cytoskeleton. We show that certain WPR proteins directly interact with F-actin through their N-terminus. Our data implicate WPR proteins as potentially regulating actin filaments, providing insight into their molecular function. These results demonstrate that WPR proteins are important for cell polarization.
Fluorescence lifetime image microscopy prediction with convolutional neural networks for cell detection and classification in tissues
Authors: Smolen Justin A , Wooley Karen L
Published: October 2022

Convolutional neural networks (CNNs) and other deep-learning models have proven to be transformative tools for the automated analysis of microscopy images, particularly in the domain of cellular and tissue imaging. These computer-vision models have primarily been applied with traditional microscopy imaging modalities (e.g. brightfield and fluorescence), likely due to the availability of large datasets in these regimes. However, more advanced microscopy imaging techniques could, potentially, allow for improved model performance in various computational histopathology tasks. In this work, we demonstrate that CNNs can achieve high accuracy in cell detection and classification without large amounts of data when applied to histology images acquired by fluorescence lifetime imaging microscopy (FLIM). This accuracy is higher than what would be achieved with regular single or dual-channel fluorescence images under the same settings, particularly for CNNs pretrained on publicly available fluorescent cell or general image datasets. Additionally, generated FLIM images could be predicted from just the fluorescence image data by using a dense U-Net CNN model trained on a subset of ground-truth FLIM images. These U-Net CNN generated FLIM images demonstrated high similarity to ground truth and improved accuracy in cell detection and classification over fluorescence alone when used as input to a variety of commonly used CNNs. This improved accuracy was maintained even when the FLIM images were generated by a U-Net CNN trained on only a few example FLIM images.
Antiphospholipid antibody positivity in early systemic lupus erythematosus is associated with subsequent vascular events
Authors: Farina Nicola , Abdulsalam Ruya , McDonnell Thomas , Pericleous Charis , D’Souza Amrita , Ripoll Vera M , Webster Jemma , Isenberg David A , Giles Ian , Rahman Anisur
Published: October 2022

Objective

aPL are found in the blood of 20–30% of patients with SLE. Although aPL cause vascular thrombosis in the antiphospholipid syndrome, it is not clear whether positive aPL levels in early SLE increase risk of subsequent vascular events (VE). In a previous analysis of 276 patients with SLE, we found that early positivity for ≥2 of IgG anti-cardiolipin (anti-CL), IgG anti-β2-glycoprotein I (anti-β2GPI) and anti-domain I of β2-glycoprotein I (anti-DI) showed a possible association with VE. Here we have extended that analysis.

Methods

Serum samples taken from 501 patients with SLE early in their disease had been tested for IgG anti-CL, anti-β2GPI and anti-DI by ELISA. Complete VE history was available for 423 patients of whom 23 were excluded because VE occurred before the diagnosis of SLE. For the remaining 400 patients we carried out Kaplan–Meier survival analysis to define groups at higher risk of VE.

Results

Of 400 patients, 154 (38.5%) were positive for one or more aPL, 27 (6.8%) were double/triple-positive and 127 (31.8%) were single-positive. There were 91 VE in 77 patients, of whom 42 were aPL-positive in early disease. VE were significantly increased in aPL-positive vs aPL-negative patients (P = 0.041) and in double/triple-positive vs single-positive vs aPL-negative patients (P = 0.0057). Omission of the IgG anti-DI assay would have missed 14 double/triple-positive patients of whom six had VE.

Conclusion

Double/triple-positivity for IgG anti-CL, anti-β2GPI and anti-DI in early SLE identifies a population at higher risk of subsequent VE.
Sickle cell disease treatment and management in India: a systematic review of interventional studies
Authors: Sridevi Parikipandla , Sharma Yogita , Balakrishna Sunnam L , Babu Bontha V
Published: October 2022

Sickle cell disease (SCD) affects approximately 5% of the world’s population, and India has been the second highest country in the numbers of predicted SCD births. Despite the high burden in India, there is no state-led public health programme, and very few interventions dealing with the treatment and management of SCD are available. This review highlights the dearth of SCD-related interventions, and demonstrates that these interventions effectively improve patients' conditions and are feasible to implement in India. We systematically searched three databases—PubMed/Medline, Google Scholar and Web of Science—for articles from India on SCD-related interventions. The PRISMA guidelines were followed during this review. We included 22 studies, of which 19 dealt with specific therapeutic interventions, and 3 with comprehensive SCD care. Hydroxyurea therapy was the main therapy in 15 studies and is efficacious. Three studies demonstrated the feasibility of comprehensive care in resource-limited settings. The low number of SCD-related intervention studies does not match the huge burden of SCD in India. Governments of endemic countries should consider the findings of available interventions and include them in their countries’ programmes. Comprehensive care is feasible in India and other low-resource settings, from screening to treatment and psychosocial support.
Global trends and regional differences in non-transport unintentional injuries mortality among children and adolescents, 1990 to 2019: results from the Global Burden of Disease 2019 study
Authors: Liu Yunfei , Dong Yanhui , Yan Xiaojin , Ma Ning , Dang Jiajia , Zhang Jingshu , Zhong Panliang , Li Luo , Zou Zhiyong , Song Yi , Ma Jun
Published: October 2022

Background:

Non-transport unintentional injuries (NTUIs) are major public concerns, especially among children and adolescents in low- and middle-income countries. With environmental and cognitive changes, a recent systematic description of global trends and regional differences concerning NTUIs is urgently needed for the global agenda of relevant policy-making and intervention target findings.

Methods:

We used mortality, population, and socio-demographic-index (SDI) data from Global Burden of Disease 2019 to analyze the trends of NTUIs mortality. We applied the slope index of inequality (SII) and relative index of inequality (RII) to measure the absolute and relative inequality between countries and territories. The concentration curve and concentration index (CI) were also used to measure the inequality. We conducted a sensitivity analysis to make our findings credible.

Results:

In 2019, there were 205,000 deaths due to NTUIs among children and adolescents aged 5 to 24 years, which decreased from 375,000 in 1990. In 2019, the age-standardized mortality rate (ASMR) was 8.13 per 100,000, ranging from the lowest in the Netherlands (0.90 per 100,000) to the highest in the Solomon Islands (29.34 per 100,000). The low-middle SDI group had the highest ASMR of NTUIs, while the low SDI group had the slowest decrease. After excluding the death caused by “exposure to forces of nature” and “other unintentional injuries,” drowning accounted for the most deaths in almost every SDI group, gender, and age group, but the major causes of death varied in different subgroups. For example, animal contact was a major cause in low and low-middle SDI groups but less in high SDI groups, while high and high-middle SDI groups had a higher proportion of deaths for foreign body and poisonings. The SII showed a declining trend, but the RII and CI did not, which might indicate that inequality was persistent. Similar results were found in the sensitivity analysis.

Conclusions:

Despite the declining trend of the mortality rate and the narrowing gap between countries, there were still a large number of children and adolescents dying from NTUIs, and those experiencing social-economic disadvantages remained at high mortality. Embedding the prevention of NTUIs into sustainable development goals might contribute to the progress of reducing death and inequalities, which ensures that no one is left behind.
Pigmented Multinucleate Cell Angiohistiocytoma: First Case
Authors: Fernandez-Flores Angel , Cassarino David
Published: October 2022

Multinucleate cell angiohistiocytoma (MCAH) is a benign vascular and fibrohistiocytic (probably reactive) proliferation with peculiar multinucleate cells which most authors interpret as degenerated macrophages. Several clinical variants of MCAH have been described, some of them with brownish-appearing lesions clinically. However, no histologically identified pigment has been described in the cytoplasm of the multinucleate cells so far. We present a pigmented MCAH with cytoplasmic brownish pigment, which was positive with a Masson–Fontana stain and negative with an iron stain, consistent with melanin, in a 33-year-old woman with multiple papules and plaques on the right elbow, right jawline, and left flank.
Isolated Vitreous Metastasis in a Patient with an ALK Positive Lung Cancer Treated with Lorlatinib
Authors: Suzani Martina , Benatti Eleonora , Ceola Stefano , Coppola Michele
Published: October 2022

Purpose:

To describe the ocular clinical and imaging findings of a patient with isolated vitreous metastasis, confirmed by vitreous biopsy, from an anaplastic lymphoma kinase (ALK) positive metastatic lung cancer

Methods:

case report

Results:

A 47-year-old female with a history of metastatic ALK positive lung cancer was referred by her oncologist due to unilateral blurred vision over 4 weeks. The fundus examination showed vitreous opacities with clumps of non-pigmented cells, without vasculitis or retinitis while optical coherence tomography (OCT) showed hyper-reflective deposits on the inner retinal surface with no retinal involvement. Diagnostic vitrectomy revealed neoplastic cells with ALK mutation.

Conclusion:

This is the first report that documents a case of isolated vitreous metastasis from ALK positive lung carcer in a patient under targeted therapy to treat metastatic lung cancer. We emphasize the importance of multimodal imaging, diagnostic vitrectomy, and a pathologist’s cooperation to provide essential information about diagnosis and effective treatment.
A Suspected Case of Multisystem Inflammatory Disease in Children Following COVID-19 Vaccination: A Case Report and Systematic Literature Review
Authors: Lee Jue Seong , Cho Kyu Sik , Choe Young June
Published: October 2022

Multisystem inflammatory syndrome in children (MIS-C) is rare but can be a potentially serious complication following SARS-CoV-2 infection in children.
1
Introduction of coronavirus disease 2019 (COVID-19) vaccines are effective in lowering the burden due to SARS-CoV-2. However, there have been reports of MIS occurrence following COVID-19 vaccination in adults.
2
The potential public health implication of MIS-C following COVID-19 vaccination is not clear in children. Our objective is to describe the spectrum of clinical disease, therapy, and outcomes of MIS-C following COVID-19 vaccination in children.
COVID-19: dealing with ventilator shortage
Authors: Santini Alessandro , Messina Antonio , Costantini Elena , Protti Alessandro , Cecconi Maurizio
Published: October 2022

Purpose of review

To describe different strategies adopted during coronavirus disease 2019 pandemic to cope with the shortage of mechanical ventilators.

Recent findings

Short-term interventions aimed to increase ventilator supply and decrease demand. They included: redistributing and centralizing patients, repurposing operating rooms into intensive care units (ICUs) and boosting ventilator production and using stocks and back-ups; support by the critical care outreach team to optimize treatment of patients in the ward and permit early discharge from the ICU, ethical allocation of mechanical ventilators to patients who could benefit more from intensive treatment and short term ICU trials for selected patients with uncertain prognosis, respectively. Long-term strategies included education and training of non-ICU physicians and nurses to the care of critically-ill patients and measures to decrease viral spread among the population and the progression from mild to severe disease.

The experience and evidence gained during the current pandemic is of paramount importance for physicians and law-makers to plan in advance an appropriate response to any future similar crisis. Intensive care unit, hospital, national and international policies can all be improved to build systems capable of treating an unexpectedly large number of patients, while keeping a high standard of safety.
Irritable Bowel Syndrome Symptoms in Nonalcoholic Fatty Liver Disease Patients Are an Indicator of Depression and Anxiety
Authors: Franco Lissa , Jones-Pauley Michelle , Tamimi Omar , Neshatian Leila , Nguyen Duc , Graviss Edward , Quigley Eamonn MM , Victor David
Published: October 2022

Goals:

Determine factors associated with Irritable bowel syndrome (IBS) in nonalcoholic fatty liver disease (NAFLD) patients.

Background:

IBS affects 10% to 15% of the adult population worldwide and is linked to anxiety and depression. The impact of IBS-type symptoms in NAFLD patients is not well described.

Study:

A cross-sectional study of patients in the hepatology clinic at Houston Methodist Hospital was performed based on a respondent postal survey. IBS was defined by the Rome IV questionnaire, anxiety and depression were assessed with the Hospital Anxiety Depression scale. Patients with inflammatory bowel disease, colorectal carcinoma, or small bowel tumors were excluded. Patients were divided based on Rome IV diagnostic criteria for IBS and Hospital Anxiety Depression scale.

Results:

130 patients were included in the analysis, 38 satisfied Rome IV criteria for IBS (IBS group) versus 92 who did not (non-IBS group). Depression was more prevalent in the IBS group (18.4% vs 5.4%, P=0.01). Anxiety was also greater in the IBS group (31.6% vs 9.8%, P=0.002). Female sex, depression, and body mass index (BMI)>30 were independent predictors of IBS in NAFLD in 4 multiple logistic regression models. In newly diagnosed IBS patients, gamma-glutamyl transferase levels were lower (67.5 vs 28, P=0.04). Current abdominal pain was higher than 100% versus 81.3% (P=0.045), as was pain associated with the change in stool frequency (96.3% vs 50%; P<0.001).

Conclusion:

Our study highlights the increased rate of IBS symptoms, depression, and anxiety in patients with NAFLD. Clinicians should be alert when IBS symptoms are reported by a NAFLD patient and be aware of the impact of these comorbidities on quality of life and response to therapy.
The efficacy of irinotecan supplementation for colorectal cancer: A meta-analysis of randomized controlled studies
Authors: Jiang Wei , Liu Qiying , Yang Donglin , Yang Shi-bin
Published: October 2022

Background:

The efficacy of irinotecan as the adjunctive therapy to fluorouracil and leucovorin remains controversial in patients with colorectal cancer. We conduct this meta-analysis to explore the efficacy of irinotecan supplementation for colorectal cancer.

Methods:

We have searched PubMed, EMBASE, Web of science, EBSCO, and Cochrane library databases through March 19, 2020, and included randomized controlled trials assessing the efficacy of irinotecan plus fluorouracil and leucovorin for colorectal cancer.

Results:

Five randomized controlled trials were included in the meta-analysis. Compared with fluorouracil and leucovorin for colorectal cancer, irinotecan supplementation could significantly improve progression-free survival rate (hazard ratio = 0.72; 95% confidence interval [CI] = 0.58–0.90; P = .003), median progression-free survival (standard mean difference = –0.30; 95% CI = –0.44 to –0.15; P < .0001), overall survival rate (hazard ratio = 0.77; 95% CI = 0.66–0.90; P = .001), and objective response (risk ratio [RR] = 0.57; 95% CI = 0.49–0.66; P < .00001) and decrease progressive disease (RR = 2.10; 95% CI = 1.40–3.14; P = .0003), but revealed no obvious effect on complete response (RR = 0.88; 95% CI = 0.33–2.29; P = .79). The incidence of grade ≥3 adverse events in irinotecan supplementation group was increased compared to control group (RR = 0.67; 95% CI = 0.57–0.79; P < .00001).

Conclusions:

Irinotecan as the adjunctive therapy to fluorouracil and leucovorin can increase the survival and objective response of patients with colorectal cancer, but the incidence of grade ≥3 adverse events is found to be increased after irinotecan supplementation.
“Reasonable threshold” of spinopelvic parameters after fixation on distal stenosis in patients with degenerative thoracolumbar kyphosis: A STROBE-compliant article
Authors: Xu Shuai , Jin Linyu , Guo Chen , Liang Yan , Liu Haiying
Published: October 2022

The short-segment instrument for precision treatment of lumbar stenosis syndrome (LSS) combined with degenerative thoracolumbar kyphosis (DTLK) receives more attention and the reasonable range of sagittal parameters is debatable in these elderly patients. This study aimed to include LSS patients combined with DTLK performed short-segmental fixation on LSS, to evaluate the efficacy of this procedure, and to determine the reasonable threshold of sagittal parameters. Overall 138 patients (female, 62.3%) were eligible (mean age of 68.8 ± 7.7 years) with a follow-up time of 24.6 ± 11.1 months. Spinopelvic sagittal parameters containing TLK, lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), and sagittal vertical axis were obtained at baseline and final visit, where |PI-LL|, PT, and sagittal vertical axis were seen as the main parameters. Quality of life was evaluated by the Oswestry Disability Index (ODI), which were divided into 4 quarters orderly. The reasonable threshold of parameters corresponding to ODI was determined by both linear regression and logistic regression. For all participants, TLK decreased by a mean of 8.3° and cases got TLK correction occupied 40.4%. ODI got improvement by the change of 29.9 ± 9.9. At baseline, ODI was correlated to |PI-LL|, while at final, ODI was correlated to |PI-LL| and PT. The independent factor affecting preoperative ODI was |PI-LL|, with ODI = 0.19 × |PI-LL| + 36.9 and the mean threshold of preoperative |PI-LL| was 10.7°. At final, PT was the influencing factor with ODI = 0.21 × PT + 3.16 and PT = 0.60 × |PI-LL| + 12.22. The mean threshold of postoperative |PI-LL| was 16.0° and PT was 23.1° by both linear regression and logistic regression. With short-segment fixation on LSS, >40% of patients with DTLK acquired TLK correction. |PI-LL| = 16.0° and PT = 23.1° was the “reasonable threshold” of sagittal parameters with the procedure for this population.
Observation for the feasibility of a bile duct biopsy technique using a loop-tip guidewire during endoscopic retrograde cholangiopancreatography
Authors: Lee Kang Won , Lee Jae Min , Choi Hyuk Soon , Kim Eun Sun , Keum Bora , Jeen Yoon Tae , Chun Hoon Jai , Lee Hong Sik
Published: October 2022

Endoscopists frequently have difficulty approaching biliary lesions using biopsy forceps. The aim of this study was not only to describe an easy technique for biliary biopsy assisted by a looped guidewire but also to present preliminary results regarding its safety and feasibility. A preliminary proof-of-concept study was performed at a single tertiary medical center. Between August 2019 and January 2020, 13 patients with bile duct strictures underwent endoscopic retrograde cholangiopancreatography (ERCP) with a new loop guidewire-assisted forceps approach technique. The efficacy and safety were evaluated using the success rate as the primary outcome and diagnostic yield and complication rates as secondary outcomes. The tissue sampling success rate was 100% (13/13). All samples were acceptable for histopathological analysis. Eleven specimens were confirmed to be adenocarcinomas. After reexamination of the remaining 2 patients, all cases were eventually diagnosed as being malignant. The sensitivity of the single procedure was 84.6% (11/13). There were 2 patients with mild hyperamylasemia, but there were no severe complications with respect to safety. This new technique could enhance the success rate and diagnostic yield and reduce the risk of failure when using the biopsy forceps approach during ERCP.
Three months-longitudinal changes in relative telomere length, blood chemistries, and self-report questionnaires in meditation practitioners compared to novice individuals during midlife
Authors: Sung Min-Kyu , Koh Eugene , Kang Yunjeong , Lee Jin-Hee , Park Ji-Yeon , Kim Ji Young , Shin So-Young , Kim Yeon-Hee , Setou Noriko , Lee Ul Soon , Yang Hyun-Jeong
Published: October 2022

Aging accelerates during midlife. Researches have shown the health benefits of mind-body intervention (MBI). However, whether MBI is involved with aging process has not been well understood. In this study, we approach to examine the relations of MBI with this process by investigating an aging marker of the peripheral blood, blood chemistry, and self-report questionnaires. A quasi-experimental design was applied. Experienced MBI practitioners participated in a 3-month intensive meditation training, while the age, gender-matched MBI-naïve controls led a normal daily life. Measurements were taken at before and after the 3 months for relative telomere length (RTL), blood chemistry, and self-report questionnaires including items about sleep quality, somatic symptoms, depression, anxiety, stress, emotional intelligence (EI), and self-regulation. For RTL, the repeated measures analysis of variance showed a significant group*time interaction (P = .013) with a significant post hoc result (P = .030) within the control group: RTL was significantly reduced in the control while it was maintained in the meditation group. In repeated measures analysis of variance for blood chemistries, there were significant group differences between the groups in glucose and total protein. In the post hoc comparison analysis, at post measurements, the meditation group exhibited significantly lower values than the control group in both glucose and total protein. There were significant group-wise differences in the correlations of RTL with triglyceride (TG), high-density lipoprotein (HDL), glutamic oxaloacetic transaminase and glutamic pyruvic transaminase. Any of self-report results did not show significant changes in group*time interaction. However, there were group differences with significant (P < .05) or a tendency (.05 < P < .1) level. There were significant improvements in depression, stress and EI as well as tendencies of improvement in sleep quality and anxiety, in the meditation group compared to the control group. Our results suggest that meditation practice may have a potential to modify aging process in molecular cellular level combined with changes in psychological dimension.
A novel gene signature derived from the CXC subfamily of chemokine receptors predicts the prognosis and immune infiltration of patients with lung adenocarcinoma
Authors: Deng Kun , Lin Shenghua , Xu Zhanyu , Qin Junqi , Yuan Liqiang , Sun Yu , Wei Jiangbo , Zheng Tiaozhan , Zheng Zhiwen , Qin Fanglu , Li Shikang
Published: October 2022

The highly malignant nature of lung adenocarcinoma (LUAD) makes its early diagnosis and prognostic assessment particularly important. However, whether the CXC subfamily of chemokine receptors (CXCR) is involved in the development and prognosis of LUAD remains unclear. Here, differentially expressed genes (DEGs) associated with overall survival (OS) were selected from the cancer genome atlas (TCGA) dataset using univariate Cox analysis and least absolute shrinkage and selection operator (LASSO) regression analysis. Then, a prognostic gene signature was constructed, which was evaluated using Kaplan–Meier curves, receiver operating characteristics curves, nomogram curves, and an external gene expression omnibus (GEO) dataset. Finally, we verified the functions of the genes comprising the signature using the gene expression profiling interactive analysis (GEPIA) and the immune system interaction database (TISIDB) web portals. We constructed a 7-gene signature (SHC1, PRKCD, VEGFC, RPS6KA1, CAT, CDC25C, and GPI) that stratified patients into high- and low-risk categories. Notably, the risk score of the signature was a separate and effective predictor for OS (P < .001). Patients in the low-risk category had a better prognosis than those in the high-risk category. The receiver operating characteristics and nomogram curves verified the predictive power of the signature. Moreover, in both categories, biological processes and pathways associated with cell migration were enriched. Immune infiltration statuses differed between the 2 risk categories. Critically, the results from the GEPIA and TISIDB web portals indicated that the expression of the 7-gene signature was associated with survival, clinical stage, and immune subtypes of LUAD patients. We identified a CXCR-related gene signature that could assess prognosis and provide a reference for the diagnosis and treatment of LUAD.
Effectiveness and safety of Tai Chi for anxiety disorder of COVID-19: A protocol of systematic review and meta-analysis
Authors: Zhang Shiqiang , Zhu Luwen , Liang Runyu , Yin Xia , Wang Ruoyu , Ma Xiyuan , Li Hongyu , Tang Qiang
Published: October 2022

Background:

Anxiety disorders pose a significant threat to the clinical rehabilitation of patients with coronavirus disease 2019 (COVID-19). Tai Chi is a therapeutic exercise that can be used to treat anxiety disorders. We aim to conduct a systematic review and meta-analysis to evaluate the effectiveness and safety of Tai Chi for treating patients with anxiety disorders caused by COVID-19.

Methods:

The PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature, Wan Fang, and Chinese Clinical Trial Registry databases will be searched for reports of randomized controlled trials on Tai Chi for the treatment of anxiety disorders caused by COVID-19, published from December 1, 2019, to August 22, 2022. Two researchers will screen the articles and extract the relevant information.

Results:

The results will provide a systematic overview of the current evidence on the use of Tai Chi to treat anxiety disorders caused by COVID-19 among patients.

Conclusion:

The conclusions of this study will help clarify whether Tai Chi is effective and safe for treating anxiety disorders caused by COVID-19.
Magnetic resonance imaging evaluation of masticatory muscle changes in patients with primary trigeminal neuralgia before microvascular decompression
Authors: Zhang Xiaojuan , Wang Chuandong , Zheng Dan , Xiao Hui , Zhong Qun
Published: October 2022

Primary trigeminal neuralgia (PTN) is characterized by chronic neuropathic pain. There are few studies exploring masticatory muscle changes in patients with PTN. This study evaluated the changes in the masticatory muscles using magnetic resonance imaging (MRI) and the predictive factors of masticatory muscle changes in patients with PTN. The radiologic outcomes of 52 patients with PTN and 58 healthy adults were evaluated. The temporalis, lateral pterygoid, medial pterygoid, and masseter muscles were assessed using MRI. Atrophy and edema of the masticatory muscles were noted. Multivariate analyses were conducted to identify factors associated with masticatory muscle atrophy. Among the PTN group, the right side (61.5%) and mandibular branch (53.9%) were the most affected. Muscle atrophy of the temporalis (P < .001), medial pterygoid (P = .016), lateral pterygoid (P = .031), and masseter (P = .001) were significantly higher in the PTN group than in the control group. Lateral pterygoid edema was significantly higher in the PTN group (P < .001). However, no significant difference was found in the temporalis and masseter edema between the two groups. Logistic regression analysis demonstrated that neurovascular conflict (NVC) significantly predicted mastication muscle atrophy (P = .037). Patients with PTN had higher rates of masticatory muscle atrophy and edema. The assessment of NVC may be a preoperative imaging biomarker to predict atrophy in PTN.
Obese patients experience more severe OSA than non-obese patients
Authors: Hsing Shih-Chun , Chen Chu-Chieh , Huang Shi-Hao , Huang Yao-Ching , Chung Ren-Jei , Chung Chi-Hsiang , Chien Wu-Chien , Sun Chien-An , Huang Shu-Min , Yu Pi-Ching , Chiang Chun-Hsien , Tang Shih-En
Published: October 2022

To investigate whether previous exposure to obstructive sleep apnea (OSA) increases the risk of obesity in obese and nonobese patients. We identified 24,363 obese patients diagnosed between January 1, 2000, and December 31, 2015, in the Taiwan Longitudinal Health Insurance Database (LHID) 2005 National Health Insurance Research Database; 97,452 sex-, age- and index date-matched nonobese patients were identified from the same database. This study is based on the ninth edition of the International Classification of Sleep Disorders. Multiple logistic regression was used to analyze the previous exposure of obese patients to OSA. P < .05 was considered significant. The average age of 121,815 patients was 44.30 ± 15.64 years old; 42.77% were males, and 57.23% were females. Obese patients were more likely to be exposed to OSA than nonobese patients (adjusted odds ratio [AOR] = 2.927, 95% CI = 1.878–4.194, P < .001), and the more recent the exposure period was, the more severely obese the patient, with a dose-response effect (OSA exposure < 1 year, AOR = 3.895; OSA exposure

1 year, <5 years, AOR = 2.933; OSA exposure

5 years, AOR = 2.486). The probability of OSA exposure in obese patients was 2.927 times that in nonobese patients, and the longer the exposure duration was, the more severe the obesity situation, with a dose-response effect (OSA exposure < 1 year, AOR = 2.251; OSA exposure

1 year, <5 years, AOR = 2.986; OSA exposure

5 years, AOR = 3.452). The risk of obesity in subjects with OSA was found to be significantly higher in this nested case–control study; in particular, a longer exposure to OSA was associated with a higher likelihood of obesity, with a dose-response effect.
Bioinformatics analysis identified immune infiltration, risk and drug prediction models of copper-induced death genes involved in salivary glands damage of primary Sjögren’s syndrome
Authors: Zhang Naidan , Ji Chaixia , Peng Xinyin , Tang Maoju , Bao Xiao , Yuan Chengliang
Published: October 2022

This study aimed to identify copper-induced death genes in primary Sjögren’s syndrome (pSS) and explore immune infiltration, risk and drug prediction models for salivary glands (SGs) damage. The 3 datasets, including GSE40611, GSE23117, and GSE7451 from the Gene Expression Omnibus database were downloaded. The datasets were processed using the affy in R (version 4.0.3). In immune cells, copper-induced death genes were strongly expressed in “activated” dendritic cells (aDCs), macrophages and regulatory T cells (Treg). In immune functions, copper-induced death genes were strongly expressed in major histocompatibility complex (MHC) class I, human leukocyte antigen (HLA) and type I interferon (IFN) response. Correlation analysis showed that 5 genes including SLC31A1, PDHA1, DLD, ATP7B, and ATP7A were significantly correlated with immune infiltration. The nomogram suggested that the low expression of PDHA1 was significant for predicting the risk of pSS and the area under curve was 0.678. Drug model suggested that “Bathocuproine disulfonate CTD 00001350,” “Vitinoin CTD 00007069,” and “Resveratrol CTD 00002483” were the drugs most strongly associated with copper-induced death genes. In summary, copper-induced death genes are associated with SGs injury in pSS, which is worthy of clinicians’ attention.
Analysis of differentially expressed genes in individuals with noninfectious uveitis based on data in the gene expression omnibus database
Authors: Zhang Dandan , Zhang Ning , Wang Yan , Zhang Qian , Wang Jiadi , Yao Jing
Published: October 2022

Noninfectious uveitis (NIU), an intraocular inflammation caused by immune-mediated reactions to eye antigens, is associated with systemic rheumatism and several autoimmune diseases. However, the mechanisms underlying the pathogenesis of uveitis are poorly understood. Therefore, we aimed to identify differentially expressed genes (DEGs) in individuals with NIU and to explore its etiologies using bioinformatics tools.

GSE66936 and GSE18781 datasets from the gene expression omnibus (GEO) database were merged and analyzed. Functional enrichment analysis was performed, and protein-protein interaction (PPI) networks were constructed.

A total of 89 DEGs were identified. Gene ontology (GO) enrichment analysis identified 21 enriched gene sets. Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis identified four core enriched pathways: antigen processing and expression signaling, natural killer (NK) cell-mediated cytotoxicity signaling, glutathione metabolic signal transduction, and arachidonic acid metabolism pathways. PPI network analysis revealed an active component-target network with 40 nodes and 132 edges, as well as several hub genes, including CD27, LTF, NCR3, SLC4A1, CD69, KLRB1, KIR2DL3, KIR3DL1, and GZMK.

The eight potential hub genes may be associated with the risk of developing NIU. NK cell-mediated cytotoxicity signaling might be the key molecular mechanism in the occurrence and development of NIU. Our study provided new insights on NIU, its genetics, molecular pathogenesis and new therapeutic targets.
The effects of a training program for reducing nurses’ discrimination towards PLWHAs
Authors: Ju Xinmei , Tan Shaoying , Wang Tao
Published: October 2022

Performing a training program for reducing nurses’ discrimination towards AIDS clients, and then evaluating the effect of the training model and analyzing the influencing factors of the training effect to form a long-run training model. 150 clinical nurses were selected to attend the program to reduce nurses’ discrimination towards AIDS clients. The program included 3 steps: knowledge education, psychological intervention, and behavior correcting. Before the program, we conducted pre-research to learn the current situation, including existing discrimination and training needs. Selected nurses were asked to complete questionnaires before and 6 months after training, and the trainees were from several hospitals in Haikou. The research period was from March to September 2020. The scores for AIDS-related knowledge, discrimination attitudes, and nursing standard behavior before training were (49.69 ± 3.80), (47.01 ± 3.70), and (35.98 ± 3.01), respectively, and the scores from 6 months after training were (59.01 ± 3.88), (52.19 ± 4.98), and (38.12 ± 2.98), respectively. Correlation analysis revealed that the scores for the nurses’ AIDS-related knowledge and behavior were positively correlated (R = 0.31, P < .05); however, there was no correlation found between attitude and behavior (P > .05); no significant differences were observed in the 3 scores among nurses in different departments and nurses with different working durations. There was a significant difference detected among nurses in their experience caring for AIDS clients (F = 3.80, P < .05). The nurses with higher education levels also showed a significant difference compared to those with low education levels on their knowledge and behavior scores ([F = 3.49, P < .05] and [F = 4.68, P < .05], respectively). AIDS-related knowledge training and psychological intervention can effectively reduce the discriminatory attitudes of nurses towards AIDS clients.
Prevalence of adverse birth outcomes and associated factors in Jazan, Saudi Arabia: A cross-sectional study
Authors: Dallak Fatimah H. , Gosadi Ibrahim M. , Haidar Wejdan N. , Durayb Amjad A. , Alomaish Abeer R. , Alshamakhi Atheer H. , Khormi Raoud M. , Almudeer Ali H. , Alibrahim Majed A.
Published: October 2022

This study aimed to measure the prevalence of adverse birth outcomes and associated factors among mothers from the Jazan region in Saudi, Arabia. This was a cross-sectional investigation where data was collected via a semi-structured questionnaire. The questionnaire was completed during interviews to assess data regarding the participants’ demographics, morbidity, the reported adverse birth outcomes, and maternal complications during pregnancy. Chi-squared and Fisher’s Exact tests were both used to compare the distribution of demographic and obstetric risk factors according to the historical presence of adverse birth outcomes. A total of 1315 women with a combined history of 4950 pregnancies were involved in the current investigation. The mean age of the participants was 33.1 years. The total number of adverse birth outcomes was 1009. The most frequently reported adverse birth outcome was miscarriage (12.1%), followed by premature birth (2.3%) and underweight birth (1.9%). Reports of a minimum of 1 adverse birth outcome were higher among women who reported family incomes of more than 10,000 Saudi Arabian Riyal (SAR), women who were first-degree cousins of their husbands, and women with less than a secondary level education (P values <.05). This study found a relatively high prevalence of miscarriage. Further investigations are needed to assess factors associated with this high frequency level of miscarriage. Furthermore, these findings have preventive and clinical implications concerning pregnant women with a history of obesity, anemia, consanguinity, and hypertension. The goal is to target them with a better range of antenatal care services to reduce the incidence of potential adverse birth outcomes.
Pharynx volume derived from three-dimensional computed tomography is associated with difficult intubation in spinal deformity surgery: A retrospective cohort study
Authors: Li Xiaoyan , An Bei , Jiang Bailin , Xu Shuai , Liu Haiying , Zhao Hong
Published: October 2022

Spinal abnormality surgery, including surgery for ankylosing spondylitis and idiopathic scoliosis, can present significant challenges to anesthesiologists because of the potential difficult airway. The bedside screening tests routinely used to detect difficult airways are highly variable. Pharynx volume calculated using three-dimensional (3D) computed tomography (CT) may play a role in predicting difficult airways.

We conducted a retrospective cohort study on patients (aged ≥14 years) who received orthopedic surgery for ankylosing spondylitis/idiopathic scoliosis under general anesthesia. Volume of the pharynx air space was calculated through volume rendering technique by 3D reconstruction of patients’ cervical spine CT. Patients were divided into 2 groups according to their pharynx volume, pharyngeal volume lower than 16 mL (n = 11) and equal or higher than 16 mL (n = 13).

Pharynx volume in low volume group was 10.4 ± 3.6 mL (n = 11), and the counterpart in high volume group was 20.8 ± 5.5 mL (n = 13). The incidence of difficult intubation was significantly higher in low pharynx volume group than in high pharynx volume group (54.5% (6/11) vs 7.6% (1/13), P = .023). Bedside screening tests including modified Mallampati test, inter-incisor gap and thyromental distance, or radiological variables such as anterior neck soft tissue thickness to vocal cords were not different between the 2 groups.

Smaller pharynx volume played an important role in difficult airways for patients undergoing orthopedic surgery for ankylosing spondylitis/idiopathic scoliosis.
Additive effects of ezetimibe, evolocumab, and alirocumab on plaque burden and lipid content as assessed by intravascular ultrasound: A PRISMA-compliant meta-analysis
Authors: Liang Di , Li Chang , Tu Yanming , Li Zhiyong , Zhang Ming
Published: October 2022

Background:

The additive effects of ezetimibe, evolocumab or alirocumab on lipid level, plaque volume, and plaque composition using intravascular ultrasound (IVUS) remain unclear.

Methods:

According to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement, we performed a systematic review and meta-analysis of trials assessing the effects of ezetimibe, evolocumab, and alirocumab on coronary atherosclerosis using IVUS. The primary outcome was change in total atheroma volume (TAV), and the secondary outcomes were changes and differences in plaque composition and lipid content.

Results:

Data were collected from 9 trials, involving 917 patients who received ezetimibe, evolocumab or alirocumab in addition to a statin and 919 patients who received statins alone. The pooled estimate demonstrated a significant reduction in TAV with the addition of ezetimibe and favorable effects of evolocumab and alirocumab on TAV. Subgroup analysis also supported favorable effects of evolocumab and alirocumab on TAV, according to baseline TAV, gender, type 2 diabetes mellitus, and prior stain use. Addition of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor to statin therapy resulted in significant reductions in low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TG), but not in high-density lipoprotein cholesterol (HDL-C). The pooled estimate also showed significant favorable effects of ezetimibe on LDL-C, TC, and TG, but an insignificant effect on HDL-C. Patients who received ezetimibe showed similar changes in the necrotic core, fibro-fatty plaque, fibrous plaque, and dense calcification compared with patients not treated with ezetimibe.

Conclusions:

The addition of ezetimibe to statin therapy may further reduce plaque and lipid burdens but may not modify plaque composition. Although current evidence supports a similar impact from the addition of PCSK9 inhibitors to statin therapy, more evidence is needed to confirm such an effect.
Doris Howes Calloway
Authors: Kretsch Molly J. , Yates Allison A. , King Janet C. , Butte Nancy F. , Murphy Suzanne P. , Blackburn Mary L.
Published: October 2022

When the US Department of Agriculture developed a new West Coast human nutrition research center in 1980, it turned to Dr Doris Calloway at the University of California at Berkeley, an internationally known and respected researcher in human nutrition, for expertise on controlled human nutrition metabolic research. This article highlights the importance and impact of Dr Calloway's leadership, expertise, and unique metabolic research methods in establishing human nutrition metabolic research at the US Department of Agriculture/Agricultural Research Service, Western Human Nutrition Research Center. It also provides a historical overview of the origins of the Western Human Nutrition Research Center and discusses the importance of a metabolic facility for human nutrition research.
Exiting the Cave
Authors: Øvretveit Karsten , Mehus Ingar
Published: October 2022

This is a follow-up of a recent case study of the Paleolithic diet that investigates dietary changes, including energy intake, food sources, and macronutrient and micronutrient distribution, associated with a transition from a Paleolithic diet toward a more omnivorous pattern. We observed a more than 40% increase in carbohydrate intake and a 10% decrease in fat intake, including 20% less energy from saturated fat, less intake of nearly all micronutrients, and a substantially greater energy contribution from nonpaleo sources, including ultraprocessed foods. This analysis of 2 full years of nutrition data provides a unique description of changing dietary patterns in a free-living individual.