bluuebunny/crossref_metadata_2025 huggingface dataset:
Epigenomic Profiles of African-American
Transthyretin
Val122Ile Carriers Reveals Putatively Dysregulated Amyloid Mechanisms
Authors: Pathak Gita A. , Wendt Frank R. , De Lillo Antonella , Nunez Yaira Z. , Goswami Aranyak , De Angelis Flavio , Fuciarelli Maria , Kranzler Henry R. , Gelernter Joel , Polimanti Renato
Published: January 2021

Background:

The Val122Ile mutation in
Transthyretin
(
TTR
) gene causes a rare, difficult to diagnose hereditary form of cardiac amyloidosis. This mutation is most common in the United States and mainly present in people of African descent. The carriers have an increased risk of congestive heart failure, peripheral edema, and several other noncardiac phenotypes such as carpal tunnel syndrome, and arthroplasty which are top reasons for ambulatory/outpatient surgeries (OSs) in the country.

Methods:

We conducted first-ever epigenome-wide association study using the Illumina’s EPIC array, in Val122Ile carriers of African descent for heart disease and multiple OSs—an early disease indicator. Differential methylation across genome wide cytosine-phosphate guanine (CpG) sites was tested between carriers with and without heart disease and OS. Significant CpG sites were investigated for cis-mQTLs loci, followed by gene ontology and protein-protein interaction network. We also investigated the significant CpG sites in a secondary cohort of carriers for replication.

Results:

Five differentially methylated sites (
P
≤2.1×10
−8
) in genes—
FAM129B
,
SKI
,
WDR27
,
GLS
, and an intergenic site near RP11-550A5.2, and one differentially methylated region containing
KCNA6
and
GALNT3
(
P
=1.1×10
−12
) were associated with heart disease. For OS, we observe 4 sites—2 sites in
UBE2E3
and
SEC14L5
, and other 2 in intergenic regions (
P
≤1.8×10
−7
) and 3 regions overlapping
SH3D21
,
EVA1B
,
LTB4R2
, and
CIDEB
(
P
≤3.9×10
−7
). Functional protein-interaction module analysis identified
ABCA1
(
P
=0.001) for heart disease. Six cis-mQTLs were associated with one of the significant CpG sites (
FAM129B
;
P
=4.1×10
−24
). We replicated 2 CpG sites (cg18546846 and cg06641417;
P
<0.05) in an external cohort of biopsy-confirmed cases of TTR (transthyretin) amyloidosis. The genes identified are involved in transport and clearance of amyloid deposits (
GLS
,
ABCA1
,
FAM129B
); cardiac fibrosis (
SKI
); and muscle tissue regulation (
SKI
,
FAM129B
).

Conclusions:

These findings highlight the link between a complex amyloid circuit and diverse symptoms of Val122Ile.
Association Between ECG Abnormalities and Fatal Cardiovascular Disease Among Patients With and Without Severe Mental Illness
Authors: Polcwiartek Christoffer , Atwater Brett D. , Kragholm Kristian , Friedman Daniel J. , Barcella Carlo A. , Attar Rubina , Graff Claus , Nielsen Jonas B. , Pietersen Adrian , Søgaard Peter , Torp‐Pedersen Christian , Jensen Svend E.
Published: January 2021

Background

ECG abnormalities are associated with adverse outcomes in the general population, but their prognostic significance in severe mental illness (SMI) remains unexplored. We investigated associations between no, minor, and major ECG abnormalities and fatal cardiovascular disease (CVD) among patients with SMI compared with controls without mental illness.

Methods and Results

We cross‐linked data from Danish nationwide registries and included primary care patients with digital ECGs from 2001 to 2015. Patients had SMI if they were diagnosed with schizophrenia, bipolar disorder, or severe depression before ECG recording. Controls were required to be without any prior mental illness or psychotropic medication use. Fatal CVD was assessed using hazard ratios (HRs) with 95% CIs and standardized 10‐year absolute risks. Of 346 552 patients, 10 028 had SMI (3%; median age, 54 years; male, 45%), and 336 524 were controls (97%; median age, 56 years; male, 48%). We observed an interaction between SMI and ECG abnormalities on fatal CVD (
P
<0.001). Severe mental illness was associated with fatal CVD across no (HR, 2.17; 95% CI, 1.95–2.43), minor (HR, 1.90; 95% CI, 1.49–2.42), and major (HR, 1.40; 95% CI, 1.26–1.55) ECG abnormalities compared with controls. Across age‐ and sex‐specific subgroups, SMI patients with ECG abnormalities but no CVD at baseline had highest standardized 10‐year absolute risks of fatal CVD.

Conclusions

ECG abnormalities conferred a poorer prognosis among patients with SMI compared with controls without mental illness. SMI patients with ECG abnormalities but no CVD represent a high‐risk population that may benefit from greater surveillance and risk management.
Noncontrast Computed Tomography e-Stroke Infarct Volume Is Similar to RAPID Computed Tomography Perfusion in Estimating Postreperfusion Infarct Volumes
Authors: Bouslama Mehdi , Ravindran Krishnan , Harston George , Rodrigues Gabriel M. , Pisani Leonardo , Haussen Diogo C. , Frankel Michael R. , Nogueira Raul G.
Published: January 2021

Background and Purpose:

The e-Stroke Suite software (Brainomix, Oxford, United Kingdom) is a tool designed for the automated quantification of The Alberta Stroke Program Early CT Score and ischemic core volumes on noncontrast computed tomography (NCCT). We sought to compare the prediction of postreperfusion infarct volumes and the clinical outcomes across NCCT e-Stroke software versus RAPID (IschemaView, Menlo Park, CA) computed tomography perfusion measurements.

Methods:

All consecutive patients with anterior circulation large vessel occlusion stroke presenting at a tertiary care center between September 2010 and November 2018 who had available baseline infarct volumes on both NCCT e-Stroke Suite software and RAPID CTP as well as final infarct volume (FIV) measurements and achieved complete reperfusion (modified Thrombolysis in Cerebral Infarction scale 2c-3) post-thrombectomy were included. The associations between estimated baseline ischemic core volumes and FIV as well as 90-day functional outcomes were assessed.

Results:

Four hundred seventy-nine patients met inclusion criteria. Median age was 64 years (55–75), median e-Stroke and computed tomography perfusion ischemic core volumes were 38.4 (21.8–58) and 5 (0–17.7) mL, respectively, whereas median FIV was 22.2 (9.1–56.2) mL. The correlation between e-Stroke and CTP ischemic core volumes was moderate (R=0.44;
P
<0.001). Similarly, moderate correlations were observed between e-Stroke software ischemic core and FIV (R=0.52;
P
<0.001) and CTP core and FIV (R=0.43;
P
<0.001). Subgroup analysis showed that e-Stroke software and CTP performance was similar in the early and late (>6 hours) treatment windows. Multivariate analysis showed that both e-Stroke software NCCT baseline ischemic core volume (adjusted odds ratio, 0.98 [95% CI, 0.97–0.99]) and RAPID CTP ischemic core volume (adjusted odds ratio, 0.98 [95% CI, 0.97–0.99]) were independently and comparably associated with good outcome (modified Rankin Scale score of 0–2) at 90 days.

Conclusions:

NCCT e-Stroke Suite software performed similarly to RAPID CTP in assessing postreperfusion FIV and functional outcomes for both early- and late-presenting patients. NCCT e-Stroke volumes seems to represent a viable alternative in centers where access to advanced imaging is limited. Moreover, the future development of fusion maps of NCCT and CTP ischemic core estimates may improve upon the current performance of these tools as applied in isolation.
Excess Cerebrovascular Mortality in the United States During the COVID-19 Pandemic
Authors: Sharma Richa , Kuohn Lindsey R. , Weinberger Daniel M. , Warren Joshua L. , Sansing Lauren H. , Jasne Adam , Falcone Guido , Dhand Amar , Sheth Kevin N.
Published: January 2021

Background and Purpose:

The magnitude and drivers of excess cerebrovascular-specific mortality during the coronavirus disease 2019 (COVID-19) pandemic are unknown. We aim to quantify excess stroke-related deaths and characterize its association with social distancing behavior and COVID-19–related vascular pathology.

Methods:

United States and state-level excess cerebrovascular deaths from January to May 2020 were quantified using National Center for Health Statistic data and Poisson regression models. Excess cerebrovascular deaths were analyzed as a function of time-varying stroke-related emergency medical service (EMS) calls and cumulative COVID-19 deaths using linear regression. A state-level regression analysis was performed to determine the association between excess cerebrovascular deaths and time spent in residences, measured by Google Community Mobility Reports, during the height of the pandemic after the first COVID-19 death (February 29).

Results:

Forty states and New York City were included. Excess cerebrovascular mortality occurred nationally from the weeks ending March 28 to May 2, 2020, up to a 7.8% increase above expected levels during the week of April 18. Decreased stroke-related EMS calls were associated with excess stroke deaths one (70 deaths per 1000 fewer EMS calls [95% CI, 20–118]) and 2 weeks (85 deaths per 1000 fewer EMS calls [95% CI, 37–133]) later. Twenty-three states and New York City experienced excess cerebrovascular mortality during the pandemic height. A 10% increase in time spent at home was associated with a 4.3% increase in stroke deaths (incidence rate ratio, 1.043 [95% CI, 1.001–1.085]) after adjusting for COVID-19 deaths.

Conclusions:

Excess US cerebrovascular deaths during the COVID-19 pandemic were observed and associated with decreases in stroke-related EMS calls nationally and mobility at the state level. Public health measures are needed to identify and counter the reticence to seeking medical care for acute stroke during the COVID-19 pandemic.
United Kingdom/Norway
Authors: Barnes Richard
Published: January 2021

On 30 September 2020, the United Kingdom and Norway signed the Framework Agreement on Fisheries that will provide the basis for future cooperation in the sustainable management of their fisheries. The Agreement is the first such agreement adopted by the UK following its decision to the leave the European Union. This note provides some background to the Agreement and examines its key features. Whilst the content of the Agreement appears to be rather basic, this is broadly consistent with other framework agreements, and it does provide some insight into the direction and focus of fisheries management in the North Sea, and how cooperation may develop between coastal States and the European Union.
Legitimate Political Demands? How Young Russians of Different Political Orientation Assess Protests
Authors: Krawatzek Félix
Published: January 2021

Popular unrest is a source of worry also for seemingly stable authoritarian regimes. Young faces have become the image of protest in Russia over the last two years, and they convey the importance of protests that may emerge in any authoritarian regime. Nevertheless, it remains unclear what kind of young people are taking to the street and how their mobilisation is judged by their peers. This paper draws on survey data from 2018 and 2019 on the political attitudes of young Russians alongside focus group interviews generated in 2019 in Yekaterinburg and St. Petersburg. The combination of these two sources allows us to explore the shifting assessments of political and environmental protests and young people’s participation therein. It is argued that young Russians of different political orientation agree that Putin has been in power for too long and that also regime supporters do not, in principle, oppose regime critical protests. Rather, supporters insist on the importance for protests to be officially approved but question the genuine political nature of oppositional mobilisation. Friendship networks and institutional trust emerge as the key variables for understanding assessment of protests.
Their Spirits are High and Willing but That is Not Enough: Profiling the Cameroon Separatist Anglophone Radical Militia (Amba Boys)
Authors: Ngam Confidence Chia
Published: January 2021

If spiritual and determined engagements plus commitment were sufficient to ensure victory in any War adventure, the present armed conflict (war) between the Cameroon government and the Separatist Radical Militia (Amba Boys) could have long secured the independence of the country yearned for by separatist Anglophone Militita. Indeed, for close to four years running the armed Separatist militia of the English speaking regions of Cameroon known as Amba boys have been passionately engaged in an armed confrontation replete with varied forms of violence and extremism which constitute a serious impediment to peace and development within this area. The Amba boys in context are constituted by groups of brainwashed and radicalized boys and to some limited extent girls men and women. This scheme of constant radicalization has pushed them to believe that war and violence remains the only option left to erect, create or resurrect a state corresponding specifically to the Southern British-administered Cameroon passionately referred to as Ambazonia.

This article premises its discourse on evidence gathered on the narratives in praise of war as a solution to the Anglophone problem in Cameroon from primary and secondary sources to weigh the ‘invincibility’ of Amba Boys and all those on their support network. It examines the relevance or sustainability of engaging a majority of ill-prepared, ill-equipped, ill-trained, poorly fed and brainwashed youths in a war with hope of quick victory against an organized and well-equipped army. By profiling the different set of people involved in the militia plus the war strategies and radicalization schemes by those in the leadership of armed groups, this paper asserts that high spirits and determination like that of the Amba Boys are necessary war ingredients but not enough to guarantee success and the separation in focus.
Assimilation of Radial Velocity from Coastal NEXRAD into HWRF for Improved Forecasts of Landfalling Hurricanes
Authors: Wang Ying , Pu Zhaoxia
Published: January 2021

The benefits of assimilating Next Generation Weather Radar (NEXRAD) radial velocity data for convective systems have been demonstrated in previous studies. However, impacts of assimilation of such high spatial and temporal resolution observations on hurricane forecasts have not been demonstrated with the National Centers for Environmental Prediction (NCEP) Hurricane Weather and Research Forecasting (HWRF) system. This study investigates impacts of NEXRAD radial velocity data on forecasts of the evolution of landfalling hurricanes with different configurations of data assimilation. The sensitivity of data assimilation results to influencing parameters within the data assimilation system, such as the maximum range of the radar data, superobservations, horizontal and vertical localization correlation length scale, and weight of background error covariances, are examined. Two hurricane cases, Florence and Michael, which occurred in the summer of 2018 are chosen to conduct a series of experiments. Results show that hurricane intensity, asymmetric structure of inland wind and precipitation, and quantitative precipitation forecasting are improved. Suggestions for implementation of operational configurations are provided.
Influence of texture geometries on the performance parameters of hydrodynamic journal bearing
Authors: Singh Niranjan , Awasthi Rajeev Kumar
Published: January 2021

The operating and geometric parameters of textures affect the static, dynamic, and stability performance characteristics of a journal-bearing system. The present work investigates the influence of spherical-, cylindrical-, triangular-, and kite-shaped textures on the performance parameters of a journal-bearing system. The flow of a lubricant is assumed to be Newtonian and iso-viscous. Reynold's equation governing the flow of a lubricant between the space in the bearing and the journal is solved by a finite-element method. The computed results indicate that the spherically textured journal bearing provides better improvement in the performance parameters vis-a-vis other textured bearings. In general, the effect of texture shapes is more pronounced at the aspect ratio of surface textures is 1.0.
Measuring density and Young’s modulus of a log through the vibration test without measuring its weight
Authors: Kubojima Yoshitaka , Sonoda Satomi , Kato Hideo
Published: January 2021

This study examines a simple estimation method for the measurement of the mass of an on-site log through a vibration test. In this method, rather than the log itself, a cut end portion is weighed. For this purpose, the vibration method with additional mass (VAM) was applied to Sitka spruce (Picea sitchensis Carr.) circular truncated cones (model log) and Japanese cedar (Cryptomeria japonica D. Don) logs. Longitudinal vibration tests were performed on the circular truncated cones with/without an additional mass. Furthermore, the cut end portions of the circular truncated cones and logs were used as the virtual additional mass in the VAM. From the results of the vibration test using specimens with/without the concentrated mass, it is possible to estimate the mass of a circular truncated cone with 10% error by the VAM. The cut end portion of a circular truncated cone could be used as the virtual mass in the VAM. From the experimental and theoretical results, to maintain high estimation accuracy, the specimen length must not be too short as shown in our previous study for a specimen with constant cross-sectional shape. The cut end portion of the logs could be used for the virtual mass of the VAM.
Effects of short-term exposure to ambient airborne pollutants on COPD-related mortality among the elderly residents of Chengdu city in Southwest China
Authors: Chen Jianyu , Shi Chunli , Li Yang , Ni Hongzhen , Zeng Jie , Lu Rong , Zhang Li
Published: January 2021

Background

Chronic obstructive pulmonary disease (COPD) has become a severe global burden in terms of both health and the economy. Few studies, however, have thoroughly assessed the influence of air pollution on COPD-related mortality among elderly people in developing areas in the hinterland of southwestern China. This study is the first to examine the association between short-term exposure to ambient airborne pollutants and COPD-related mortality among elderly people in the central Sichuan Basin of southwestern China.

Methods

Data on COPD-related mortality among elderly people aged 60 and older were obtained from the Population Death Information Registration and Management System (PDIRMS). Data on airborne pollutants comprised of particulate matter < 2.5 μm in aerodynamic diameter (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) were derived from 23 municipal environmental monitoring sites. Data on weather conditions, including daily mean temperature and relative humidity, were obtained from the Chengdu Meteorological Bureau. All data were collected from January 1, 2015, to December 31, 2018. A quasi-Poisson general additive model (GAM) was utilized to assess the effects of short-term exposure to airborne pollutants on COPD-related mortality among elderly people.

Results

A total of 61,058 COPD-related deaths of people aged 60 and older were obtained. Controlling the influences of daily temperature and relative humidity, interquartile range (IQR) concentration increases of PM2.5 (43 μg/m3), SO2 (8 μg/m3), NO2 (18 μg/m3), CO (0.4 mg/m3), and O3 (78 μg/m3) were associated with 2.7% (95% CI 1.0–4.4%), 4.3% (95% CI 2.1–6.4%), 3.6% (95% CI 1.7–5.6%), 2.7% (95% CI 0.6–4.8%), and 7.4% (95% CI 3.6–11.3%) increases in COPD-related mortality in people aged 60 and older, respectively. The exposure-response curves between each pollutant and the log-relative risk of COPD-related mortality exhibited linear relationships. Statistically significant differences in the associations between pollutants and COPD-related mortality were not observed among sociodemographic factors including age, gender, and marital status. The effects of O3 remained steady after adjusting for PM2.5, SO2, NO2, and CO each time in the two-pollutant models.

Conclusions

Increased concentrations of ambient airborne pollutants composed of PM2.5, SO2, NO2, O3, and CO were significantly and positively associated with COPD-related mortality in the central Sichuan Basin, which is located in the hinterland of southwestern China. The adverse effects of O3 were stable, a finding that should receive more attention.
Effect of professional certification on employees’ return-to-work rate after occupational injuries in Korea: focusing on vulnerable groups
Authors: Bae Suk Won
Published: January 2021

Background

One effective way to improve return-to-work (RTW) performance may be to convince the employer that the worker has the necessary skills. The aim of this paper is to investigate the effect of having a professional certification among workers injured in occupational injuries on their return to work.

Methods

The Panel Study of Workers’ Compensation Insurance (PSWCI) targets workers who completed medical care in 2012 after an occupational injury. The study population (n = 2000) was stratified by gender, age, region, disability grade, and rehabilitation service use. A total of 1458 workers were finally selected for this study.

The effect of having a certification on RTW status was calculated with an odds ratio and 95% confidence intervals using binomial and multinomial logistic regression analyses. In the binomial logistic regression analysis, the RTW group was made up as a combination of the return to original work and the reemployment groups.

Results

The ORs of RTW among those with a certification compared to those without certification were 1.38 (1.16–1.65) in Model 1, 1.25 (1.05–1.50) in Model 2, and 1.22 (1.01–1.47) in Model 3. Among female workers with a certification, the OR of RTW was 4.60 (2.68–7.91), that of return to original work was 3.21 (1.74–5.91), and that of reemployment was 5.85 (3.34–10.27). Among daily workers with a certification, the OR of RTW was 1.32 (1.03–1.69) and that of reemployment was 1.37 (1.07–1.76).

Conclusion

In conclusion, injured workers with a certification generally had a higher RTW rate. In particular, the RTW rate was higher among female workers and daily workers with a certification than among those without.
Interleukin-6 promotes primitive endoderm development in bovine blastocysts
Authors: Wooldridge Lydia K. , Ealy Alan D.
Published: January 2021

Background

Interleukin-6 (IL6) was recently identified as an embryotrophic factor in bovine embryos, where it acts primarily to mediate inner cell mass (ICM) size. This work explored whether IL6 affects epiblast (EPI) and primitive endoderm (PE) development, the two embryonic lineages generated from the ICM after its formation. Nuclear markers for EPI (NANOG) and PE (GATA6) were used to differentiate the two cell types.

Results

Increases (P < 0.05) in total ICM cell numbers and PE cell numbers were detected in bovine blastocysts at day 8 and 9 post-fertilization after exposure to 100 ng/ml recombinant bovine IL6. Also, IL6 increased (P < 0.05) the number of undifferentiated ICM cells (cells containing both PE and EPI markers). The effects of IL6 on EPI cell numbers were inconsistent. Studies were also completed to explore the importance of Janus kinase 2 (JAK2)-dependent signaling in bovine PE cells. Definitive activation of STAT3, a downstream target for JAK2, was observed in PE cells. Also, pharmacological inhibition of JAK2 decreased (P < 0.05) PE cell numbers.

Conclusions

To conclude, IL6 manipulates ICM development after EPI/PE cell fates are established. The PE cells are the target for IL6, where a JAK-dependent signal is used to regulate PE numbers.
Risk factors for unplanned reintubation caused by acute airway compromise after general anesthesia: a case-control study
Authors: Chen Si , Zhang Yuelun , Che Lu , Shen Le , Huang Yuguang
Published: January 2021

Background

This study aimed to identify the risk factors and evaluate the prognosis of unplanned reintubation caused by acute airway compromise (AAC) after general anesthesia.

Methods

This case-control study included surgical patients who underwent unplanned reintubation in the operating room and postanesthesia care unit after general anesthesia between January 1, 2014, and December 31, 2018. Cases due to AAC were matched 1:4 with randomly selected controls.

Results

A total of 123,068 patients were included, and reintubation due to AAC was performed in 36 patients (approximate incidence 0.03%). Univariable analysis revealed that male sex, age > 65, ASA physical status 3, sepsis, heart disease history, cerebral infarction history, Cormack Lehane grade, surgery type, fresh frozen plasma infusion, increased intubation duration, white blood cell count, and creatinine clearance rate were related to AAC-caused unplanned reintubation. Multivariable analysis revealed that age > 65 (OR = 7.50, 95% CI 2.47–22.81, P < 0.001), ASA physical status 3 (OR = 6.51, 95% CI 1.18–35.92, P = 0.032), head-neck surgery (OR = 4.94, 95% CI 1.33–18.36, P = 0.017) or thoracic surgery (OR = 12.56, 95% CI 2.93–53.90, P < 0.001) and a high fluid load (OR = 3.04, 95% CI 1.16–7.99, P = 0.024) were associated with AAC-caused unplanned reintubation. AAC-caused unplanned reintubation patients had longer postoperative hospital (OR = 5.26, 95% CI 1.57–8.95, P < 0.001) and intensive care unit days (OR = 3.94, 95% CI 1.69–6.18, P < 0.001).

Conclusions

Age > 65, ASA physical status 3, head-neck or thoracic surgery and high fluid load were found to be associated with AAC-caused unplanned reintubation.
Epidemiology and prognostic implications of panic disorder and generalized anxiety disorder in patients with coronary artery disease: rationale and design for a longitudinal cohort study
Authors: Foldes-Busque Guillaume , Dionne Clermont E. , Turcotte Stéphane , Tully Phillip J. , Tremblay Marie-Andrée , Poirier Paul , Denis Isabelle
Published: January 2021

Background

Anxiety is associated with poorer prognosis in patients with coronary artery disease (CAD). Due to their severity and chronic course, anxiety disorders, particularly generalized anxiety disorder (GAD) and panic disorder (PD), are of considerable interest and clinical importance in this population. This study has two main objectives: (1) to estimate the prevalence and incidence of GAD and PD in patients with CAD over a 2-year period and (2) to prospectively assess the association between PD or GAD and adverse cardiac events, treatment adherence, CAD-related health behaviors, quality of life and psychological distress.

Design/Method

This is a longitudinal cohort study in which 3610 participants will be recruited following a CAD-related revascularization procedure. They will complete an interview and questionnaires at 5 time points over a 2-year period (baseline and follow-ups after 3, 6, 12 and 24 months). The presence of PD or GAD, adherence to recommended treatments, health behaviors, quality of life and psychological distress will be assessed at each time point. Data regarding mortality and adverse cardiac events will be collected with a combination of interviews and review of medical files.

Discussion

This study will provide essential information on the prevalence and incidence of anxiety disorders in patients with CAD and on the consequences of these comorbidities. Such data is necessary in order to develop clear clinical recommendations for the management of PD and GAD in patients with CAD. This will help improve the prognosis of patients suffering from both conditions.
The association between T wave inversion in leads with ST-elevation and patency of the infarct-related artery
Authors: Ranjbar Abdolmohammad , Sohrabi Bahram , Sadat-Ebrahimi Seyyed-Reza , Ghaffari Samad , Kazemi Babak , Aslanabadi Naser , Seyvani Babak , Hajizadeh Reza
Published: January 2021

Background

Up to over half of the patients with ST-segment elevation myocardial infarction (STEMI) are reported to undergo spontaneous reperfusion without therapeutic interventions. Our objective was to evaluate the applicability of T wave inversion in electrocardiography (ECG) of patients with STEMI as an indicator of early spontaneous reperfusion.

Methods

In this prospective study, patients with STEMI admitted to a tertiary referral hospital were studied over a 3-year period. ECG was obtained at the time of admission and patients underwent a PPCI. The association between early T wave inversion and patency of the infarct-related artery was investigated in both anterior and non-anterior STEMI.

Results

Overall, 1025 patients were included in the study. Anterior STEMI was seen in 592 patients (57.7%) and non-anterior STEMI in 433 patients (42.2%). Among those with anterior STEMI, 62 patients (10.4%) had inverted T and 530 (89.6%) had positive T waves. In patients with anterior STEMI and inverted T waves, a significantly higher TIMI flow was detected (p value = 0.001); however, this relationship was not seen in non-anterior STEMI.

Conclusion

In on-admission ECG of patients with anterior STEMI, concomitant inverted T wave in leads with ST elevation could be a proper marker of spontaneous reperfusion of infarct related artery.
Understanding participation in European cohort studies of preterm children: the views of parents, healthcare professionals and researchers
Authors:   on behalf of RECAP Preterm-WP6 QS Work Group, Marques Sandra C. S. , Doetsch Julia , Abate Georgia , Brødsgaard Anne , Colombo Grazia , Cuttini Marina , Pedersen Pernille , Barros Henrique
Published: January 2021

Background

Retention of participants in cohort studies is a major challenge. A better understanding of all elements involved in participation and attrition phenomena in particular settings is needed to develop effective retention strategies. The study aimed to achieve an in-depth understanding of participant retention in longitudinal cohorts focusing on participants’ and researcher’s perspectives, across three diverse socio-geographic and cultural settings.

Methods

This study used a triangulation of multi-situated methods to collect data on cohort studies of children born with less than 32 weeks of gestation in Denmark, Italy and Portugal. It included focus groups and individual semi-driven interviewing with involved key actors (i.e. parents, staff, healthcare professionals, researchers) and a collaborative visual methodology. A purposive sample of 48 key actors (n = 13 in Denmark; n = 13 in Italy; n = 22 in Portugal) was collected. A triangulation of phenomenological thematic analysis with discourse analysis was applied. Cross-contextual and context-specific situational elements involved in participation and attrition phenomena in these child cohorts were identified at various levels and stages.

Results

Main findings included: situational challenges affecting potential and range of possibilities for implementation strategies (geopolitical environment, societal changes, research funding models); situational elements related to particular strategies acting as deterrents (postal questionnaires) and facilitators (multiple flexible strategies, reminders, regular interaction); main motivations to enrol and participate (altruism/solidarity and gratitude/sense of duty to reciprocate); main motivational deterrents to participate to follow-up waves (lack of bonding, insufficient feedback); entanglement of clinical and research follow-up as facilitator and deterrent.

Conclusions

The multi-situated approach used, addressing the interplay of the lived experience of individuals, was of most value to understand participation variability under different implemented strategies in-context. Cross-contextual and context-specific situational elements that have been influential factors towards participation and attrition in the cohorts were identified.
Active ageing – perspectives on health, participation, and security among older adults in northeastern Thailand – a qualitative study
Authors: Wongsala Manothai , Anbäcken Els-Marie , Rosendahl Sirpa
Published: January 2021

Background

Health, participation, and security are the basic pillars of active ageing suggested by the WHO. The concept is used by professionals but requires exploration from the perspectives of older people themselves. This study aims to explore how older adults experience and describe health, participation, and security.

Methods

A qualitative research approach was used based on open-ended interviews with 20 older Thai adults aged 60–92 years. The interviews were analysed using qualitative content analysis.

Results

The results showed perspectives related to experiences of daily life and local culture. Health while ageing, was described as the absence of barriers to continued daily living, combined with a peaceful and adaptive mindset. Participation was described as maintaining social networks and being a formal volunteer, with an emphasis on the “making of merits”, of meaningful activities and being respected. Security was described as manageable living conditions and managing to finalize life well by balancing dependency and independency in relation to children to sustain the traditional value of gratitude between generations.

Conclusions

These understandings will support healthy policy planning by providing resources and activities that relate to older Thai adults’ perspectives of health, participation and security and ultimately contribute to a better quality of life.
Proposition of a corrected measure of the Lawton instrumental activities of daily living score
Authors:   the MEMORA group, Dufournet Marine , Moutet Claire , Achi Sarah , Delphin-Combe Floriane , Krolak-Salmon Pierre , Dauphinot Virginie
Published: January 2021

Background

We aimed to propose a correction of the Lawton instrumental activity of daily living (IADL) score to take into account the possibility to have never done some activities, and measured its agreement and reliability with the usual IADL score.

Methods

A cross-sectional study was conducted in outpatients attending French memory clinics between 2014 and 2017. Lawton IADL, cognitive performance, diagnosis, neuropsychiatric symptoms, and sociodemographics characteristics were collected. A corrected IADL was calculated and its agreement with the usual IADL was assessed.

Results

The study included of 2391 patients (79.9 years old, 61.7% female). Based on the usual IADL, 36.9% of patients had never carried out at least one of the activities. This proportion reached 68.8% for men and 17.7% for women. Women had a mean IADL higher than men: 4.72 vs 3.49, this difference decreased when considering the corrected IADL: 4.82 vs 4.26 respectively. Based on Bland-Altman method, 93.5% of observations lied within the limits agreement. The ICC between the 2 scores was 0.98. The relationships between patients’ characteristics and the IADL scores were similar, regardless the usual or corrected version.

Conclusions

This corrected IADL score had an excellent degree of agreement with the usual version based the ICC. This simple correction could benefit both for the clinical practice by providing a more accurate description of the real clinical state of the patients allowing to manage them more precisely, and for research involving the evaluation of the functional abilities of patients.
A network-based model to explore the role of testing in the epidemiological control of the COVID-19 pandemic
Authors: Cui Yapeng , Ni Shunjiang , Shen Shifei
Published: January 2021

Background

Testing is one of the most effective means to manage the COVID-19 pandemic. However, there is an upper bound on daily testing volume because of limited healthcare staff and working hours, as well as different testing methods, such as random testing and contact-tracking testing. In this study, a network-based epidemic transmission model combined with a testing mechanism was proposed to study the role of testing in epidemic control. The aim of this study was to determine how testing affects the spread of epidemics and the daily testing volume needed to control infectious diseases.

Methods

We simulated the epidemic spread process on complex networks and introduced testing preferences to describe different testing strategies. Different networks were generated to represent social contact between individuals. An extended susceptible-exposed-infected-recovered (SEIR) epidemic model was adopted to simulate the spread of epidemics in these networks. The model establishes a testing preference of between 0 and 1; the larger the testing preference, the higher the testing priority for people in close contact with confirmed cases.

Results

The numerical simulations revealed that the higher the priority for testing individuals in close contact with confirmed cases, the smaller the infection scale. In addition, the infection peak decreased with an increase in daily testing volume and increased as the testing start time was delayed. We also discovered that when testing and other measures were adopted, the daily testing volume required to keep the infection scale below 5% was reduced by more than 40% even if other measures only reduced individuals’ infection probability by 10%. The proposed model was validated using COVID-19 testing data.

Conclusions

Although testing could effectively inhibit the spread of infectious diseases and epidemics, our results indicated that it requires a huge daily testing volume. Thus, it is highly recommended that testing be adopted in combination with measures such as wearing masks and social distancing to better manage infectious diseases. Our research contributes to understanding the role of testing in epidemic control and provides useful suggestions for the government and individuals in responding to epidemics.
A multi-centre, open label, randomised, parallel-group, superiority Trial to compare the efficacy of URsodeoxycholic acid with RIFampicin in the management of women with severe early onset Intrahepatic Cholestasis of pregnancy: the TURRIFIC randomised trial
Authors: Hague William M. , Callaway Leonie , Chambers Jennifer , Chappell Lucy , Coat Suzette , de Haan-Jebbink Jiska , Dekker Marloes , Dixon Peter , Dodd Jodie , Fuller Maria , Gordijn Sanne , Graham Dorothy , Heikinheimo Oskari , Hennessy Annemarie , Kaaja Risto , Khong Teck Yee , Lampio Laura , Louise Jennie , Makris Angela , Markus Corey , Marschall Hanns-Ulrich , Middleton Philippa , Mol Ben W. , Morris Jonathan , Newnham John P. , Ovadia Caroline , Peek Michael , Shand Antonia , Stark Michael , Thornton Jim , Timonen Susanna , Walker Susan , Warrilow David , Williamson Catherine
Published: January 2021

Background

Severe early onset (less than 34 weeks gestation) intrahepatic cholestasis of pregnancy (ICP) affects 0.1% of pregnant women in Australia and is associated with a 3-fold increased risk of stillbirth, fetal hypoxia and compromise, spontaneous preterm birth, as well as increased frequencies of pre-eclampsia and gestational diabetes. ICP is often familial and overlaps with other cholestatic disorders.

Treatment options for ICP are not well established, although there are limited data to support the use of ursodeoxycholic acid (UDCA) to relieve pruritus, the main symptom. Rifampicin, a widely used antibiotic including in pregnant women, is effective in reducing pruritus in non-pregnancy cholestasis and has been used as a supplement to UDCA in severe ICP. Many women with ICP are electively delivered preterm, although there are no randomised data to support this approach.

Methods

We have initiated an international multicentre randomised clinical trial to compare the clinical efficacy of rifampicin tablets (300 mg bd) with that of UDCA tablets (up to 2000 mg daily) in reducing pruritus in women with ICP, using visual pruritus scores as a measuring tool.

Discussion

Our study will be the first to examine the outcomes of treatment specifically in the severe early onset form of ICP, comparing “standard” UDCA therapy with rifampicin, and so be able to provide for the first-time high-quality evidence for use of rifampicin in severe ICP. It will also allow an assessment of feasibility of a future trial to test whether elective early delivery in severe ICP is beneficial.

Trial identifiers

Australian New Zealand Clinical Trials Registration Number (ANZCTR): 12618000332224p (29/08/2018).

HREC No: HREC/18/WCHN/36.

EudraCT number: 2018–004011-44.

IRAS: 272398.

NHMRC registration: APP1152418 and APP117853.
Apgar score and neonatal mortality in China: an observational study from a national surveillance system
Authors: Mu Yi , Li Mingrong , Zhu Jun , Wang Yanping , Xing Aiyun , Liu Zheng , Xie Yanxia , Wang Xiaodong , Liang Juan
Published: January 2021

Background

To examine the association between the Apgar score and neonatal mortality over gestational age in China and to explore whether this association changed when Apgar scores were combined at 1 and 5 min.

Methods

Data for all singleton live births collected from 438 hospitals between 2012 and 2016 were used in this study. Poisson regression with a robust variance estimator adjusted for a complete set of confounders was used to describe the strength of the association between the Apgar score and neonatal mortality.

Results

The relative risks of neonatal death-associated intermediate Apgar score at 5 min peaked at 39–40 weeks of gestation and subsequently decreased if the gestational age increased to 42 weeks or above, in contrast to the low Apgar score. Among both preterm and term new-borns with Apgar scores at 5 min, new-borns that were not small for gestational age had a lower mortality rate than those that were small for gestational age. The association between Apgar score and the neonatal mortality was even stronger when scores at 1 and 5 min were combined.

Conclusions

Apgar score is not only meaningful for preterm new-borns but also useful for term new-borns, especially term new-borns that are not small for gestational age. Once the baby’s Apgar score worsens, timely intervention is needed. There is still a gap between China and high-income countries in terms of sustained treatment of new-borns with low Apgar scores.
Clinical utility of liquid biopsy for EGFR driver, T790M mutation and EGFR amplification in plasma in patients with acquired resistance to afatinib
Authors: Oya Yuko , Yoshida Tatsuya , Asada Kazuhiro , Oguri Tetsuya , Inui Naoki , Morikawa Sayako , Ito Kentaro , Kimura Tomoki , Kunii Eiji , Matsui Takashi , Kubo Akihito , Kato Tatsuo , Abe Takashi , Tsuda Takeshi , Hida Toyoaki
Published: January 2021

Background

Cell-free DNA (cfDNA) genotyping in plasma using the cobas EGFR Mutation Test v2 (cobas) is the first liquid biopsy as a companion diagnosis to identify the EGFR T790M mutation (T790M) after the failure of treatment of EGFR-tyrosine kinase inhibitors (TKIs) (1st generation, gefitinib [G] and erlotinib [E] and 2nd generation, afatinib [A]). This study investigated the clinical utility of a liquid biopsy for patients who acquired resistance to afatinib.

Methods

We prospectively collected plasma from 51 patients who had acquired resistance to afatinib between April 2015 and November 2016 to evaluate the frequency of T790M by cobas and digital droplet PCR (UMIN000025112). Additionally, we retrospectively reviewed 38 patients who tested by cobas in plasma after G/E failure to compare for T790M detection between A and with G/E.

Results

The detection rate of EGFR-driver and T790M in plasma in patients treated with A (A group) as a first-line EGFR-TKI was lower than with G/E followed by A (G/E→A group), although the differences were not significant (EGFR-driver: 41% [A] vs. 67% [G/E→A], P=0.1867; and T790M: 8% [A] vs. 17% [G/E→A], P=0.5798). In first-line setting, the detection rate for EGFR-driver and T790M in plasma by cobas was lower in A group than in G/E group, although there was no significant difference (EGFR-driver: 34% [A] vs. 52% [G/E], P=0.2072; and T790M: 10% [A] vs. 27% [G/E], P=0.1161).

Conclusion

The detection of EGFR-driver and T790M in plasma by cobas in patients treated with afatinib might be lower than with G/E in a real-world setting.
Recent incidence trend of elderly patients with glioblastoma in the United States, 2000–2017
Authors: Chen Boran , Chen Chaoyue , Zhang Yang , Xu Jianguo
Published: January 2021

Background

The incidence of glioblastoma increases significantly with age. With the growing and aging population, there is a lack of comprehensive analysis of recent glioblastoma incidence trend in the United States. This study aims to provide in-depth description of the patterns of incidence trends and to examine the age-period-cohort effects to the trends of glioblastoma specific to elderly patients.

Methods

The incidence rates were age-adjusted and reported per 100,000 population. We calculated the annual percent change (APC) in incidence using the Joinpoint Regression Program and conducted an age-period-cohort analysis of elderly glioblastoma reported between 2000 and 2017 to the Surveillance Epidemiology and End Results (SEER) 18 registry database.

Results

The overall incidence rate of elderly patients with glioblastoma was 13.16 per 100,000 (95% CI, 12.99–13.32) from 2000 to 2017. Non-Hispanic whites (20,406, 83.6%) made up the majority. The incidence rate of male was about 1.62 times that of female. The trend of incidence remained stable and there was a non-significant increasing tendency for all elderly patients (APC 0.3, 95% CI, − 0.1 to 0.7, p = 0.111). There was a significantly increasing incidence trend for non-Hispanic white (APC 0.6, 95% CI, 0.2 to 1.1, p = 0.013), supratentorial location (APC 0.7, 95% CI, 0.2 to 1.3, p = 0.016), tumor size < 4 cm (APC 2.5, 95% CI, 1.4 to 3.6, p < 0.001), and a significantly decreasing trend for overlapping/NOS location (APC -0.9, 95% CI, − 1.6 to − 0.2, p = 0.012), and unknown tumor size (APC -4.9, 95% CI, − 6.6 to − 3.3, p < 0.001). The age-period-cohort analysis showed the effect of age on incidence trends (p< 0.001, Wald test), while did not indicate the period and cohort effects of the incidence trends of glioblastoma (p = 0.063 and p =0.536, respectively, Wald test).

Conclusion

The overall incidence of glioblastoma in the elderly population remained stable between 2000 and 2017. Period and cohort effects were not evident in the trend of glioblastoma incidence. Future population-based studies exploring the difference in the trend of glioblastoma incidence by specific molecular subgroups are warranted to further our understanding of the etiology of glioblastoma.