bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors influencing depression in community-dwelling elderly patients with osteoarthritis of the knee in China: a cross-sectional study
Authors: Zheng Xiaoyan , Wang Yaya , Jin Xiaoyan , Huang Hongjie , Chen Hongbo , Wang Yan , Shang Shaomei
Published: May 2022

Background

Knee osteoarthritis (OA) and depression are both major health issues influencing the quality of elderly life. The aim of the present study was to explore the prevalence of depression and the factors influencing depression in community-dwelling elderly patients with OA of the knee in China.

Methods

We conducted a cross-sectional descriptive study. The study included 214 participants aged 60 and older diagnosed with OA of the knee. The depression of the elderly was measured by using the Geriatric Depression Scale (GDS). Participants were asked to complete a demographic questionnaire, the GDS, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the society dimension of Arthritis Impact Measurement Scales 2 (AIMS2). In addition, the participants performed a timed up and go test (TUG) and the stair-climb test (SCT).

Results

The average age of the participants was 69.2 ± 7.63 years old, their body mass index (BMI) was 25.2 ± 3.85, and their disease duration was 5.9 ± 7.72 years. The mean total score of the GDS was 4.43 ± 2.89, and the GDS scores correlated positively with pain (r = 0.45, P < 0.001), stiffness (r = 0.40, P < 0.001), physical function (r = 0.52, P < 0.001),TUG (r = 0.35, P < 0.001), and SCT (r = 0.47, P < 0.001) and negatively with social support (r = − 0.35, P < 0.001).Analysis using multiple regression demonstrated that physical function, social support, and SCT explained 36.8% of the variance in depression.

Conclusions

Our findings suggested that physical function, social support, and lower extremity strength were predictors of depressive symptoms in community-dwelling elderly people with OA of the knee. Focusing on this elderly group with increasing functional exercise, positive social interaction and support, and lower limb muscle strength training should help in the prevention of depression.
Surgical outcomes of adjustment on recessed lateral rectus muscle versus resected medial rectus muscle for intermittent exotropia
Authors: Lee Donghun , Lee So Hyung , Kim Sook Young
Published: May 2022

Background

To evaluate the effectiveness of resected muscle adjustment compared with the recessed muscle adjustment in patients with intermittent exotropia.

Methods

This retrospective clinical investigation analyzed the data of patients who underwent strabismus surgery with adjustment. Patients who were followed-up for at least one and half year after adjustment were enrolled. They were divided into two groups; patients who underwent adjustment on recessed lateral rectus muscle (LR-Adj group) and adjustment on resected medial rectus muscle (MR-Adj group). Postoperative changes were compared. Surgical success was defined as horizontal deviation < 5 prism diopters (PD) esodeviation and < 10 PD exodeviation on distance measurement at 1.5 years postoperatively.

Results

Forty patients were included; LR-Adj group included 21 and MR-Adj group included 19 patients. The mean esodeviation at distance fixation immediately after adjustment was 8.1 ± 5.4 PD in the LR-Adj group and 8.4 ± 4.7 PD in the MR-Adj group (P = 0.843). Postoperative exodrift occurred in both groups, and amount of exodeviation after 1.5 year were not significantly different. For the comparison of the amount of exodrift at near measurement, the amount of exodrift within 1 month after surgery was smaller in the MR-Adj group than that in the LR-Adj group (P = 0.01). Surgical success rates were 81.0% in the LR-Adj group and 84.2% in the MR-Adj group (P = 0.559).

Conclusions

The smaller amount of exodrift in the MR-Adj group may mean that the positional stability of the resected muscle is favorable in the early post-adjustment period. However, there was no significant difference groups in the final exodeviation and surgical success rate between the groups. Resected muscle adjustment was as effective as the conventional recessed muscle adjustment.
Impact of non-pharmaceutical interventions and vaccination on COVID-19 outbreaks in Nunavut, Canada: a Canadian Immunization Research Network (CIRN) study
Authors: Vilches Thomas N. , Abdollahi Elaheh , Cipriano Lauren E. , Haworth-Brockman Margaret , Keynan Yoav , Sheffield Holden , Langley Joanne M. , Moghadas Seyed M.
Published: May 2022

Background

Nunavut, the northernmost Arctic territory of Canada, experienced three community outbreaks of the coronavirus disease 2019 (COVID-19) from early November 2020 to mid-June 2021. We sought to investigate how non-pharmaceutical interventions (NPIs) and vaccination affected the course of these outbreaks.

Methods

We used an agent-based model of disease transmission to simulate COVID-19 outbreaks in Nunavut. The model encapsulated demographics and household structure of the population, the effect of NPIs, and daily number of vaccine doses administered. We fitted the model to inferred, back-calculated infections from incidence data reported from October 2020 to June 2021. We then compared the fit of the scenario based on case count data with several counterfactual scenarios without the effect of NPIs, without vaccination, and with a hypothetical accelerated vaccination program whereby 98% of the vaccine supply was administered to eligible individuals.

Results

We found that, without a territory-wide lockdown during the first COVID-19 outbreak in November 2020, the peak of infections would have been 4.7 times higher with a total of 5,404 (95% CrI: 5,015—5,798) infections before the start of vaccination on January 6, 2021. Without effective NPIs, we estimated a total of 4,290 (95% CrI: 3,880—4,708) infections during the second outbreak under the pace of vaccination administered in Nunavut. In a hypothetical accelerated vaccine rollout, the total infections during the second Nunavut outbreak would have been 58% lower, to 1,812 (95% CrI: 1,593—2,039) infections. Vaccination was estimated to have the largest impact during the outbreak in April 2021, averting 15,196 (95% CrI: 14,798—15,591) infections if the disease had spread through Nunavut communities. Accelerated vaccination would have further reduced the total infections to 243 (95% CrI: 222—265) even in the absence of NPIs.

Conclusions

NPIs have been essential in mitigating pandemic outbreaks in this large, geographically distanced and remote territory. While vaccination has the greatest impact to prevent infection and severe outcomes, public health implementation of NPIs play an essential role in the short term before attaining high levels of immunity in the population.
Determinants of COVID-19 skepticism and SARS-CoV-2 vaccine hesitancy: findings from a national population survey of U.S. adults
Authors: Levin Jeff , Bradshaw Matt
Published: May 2022

Background

The enduring presence of COVID-19 skepticism and SARS-CoV-2 vaccine hesitancy is an ongoing impediment to the global response effort to the current pandemic. This study seeks to identify determinants of skepticism and vaccine hesitancy in U.S. adults.

Methods

Data are from the Values and Beliefs of the American Public Survey, conducted in 2021 by the Gallup Organization in conjunction with Baylor University. The survey used stratified random probability sampling of the U.S. adult population (N = 1222). Outcome measures were respective single items assessing COVID-19 skepticism and SARS-CoV-2 vaccine hesitancy. Exposure variables included political, religious, and sociodemographic indicators, and moderators assessed personal history of COVID-19 and losing a relative or close friend to COVID-19.

Results

Skepticism and vaccine hesitancy were strongly associated with conservative and Republican political preference and conservative religious beliefs, and less so with socioeconomic status. Personal experience with COVID-19 did not mitigate the effect of politics on skepticism and barely reduced the odds for hesitancy. Results confirm that attitudes toward COVID-19 are politically and religiously conditioned, and are especially a product of conservative political preference.

Conclusion

Skepticism about COVID-19 and hesitancy regarding SARS-CoV-2 vaccination are highest among the political and religious right. Efforts to increase immunization through public education may be inadequate; resistance appears ideological. Other solutions may need to be considered, which risk widespread pushback both politically and religiously motivated.
Using mHealth applications for self-care – An integrative review on perceptions among adults with type 1 diabetes
Authors: Stephen Divya Anna , Nordin Anna , Nilsson Jan , Persenius Mona
Published: May 2022

Background

Individually designed interventions delivered through mobile health applications (mHealth apps) may be able to effectively support diabetes self-care. Our aim was to review and synthesize available evidence in the literature regarding perception of adults with type 1 diabetes on the features of mHealth apps that help promote diabetes self-care, as well as facilitators and barriers to their use. An additional aim was to review literature on changes in patient reported outcome measures (PROMs) in the same population while using mHealth apps for diabetes self-care.

Methods

Quantitative and qualitative studies focusing on adults aged 18 years and over with type 1 diabetes in any context were included. A systematic literature search using selected databases was conducted. Data was synthesised using narrative synthesis.

Results

We found that features of mHealth apps designed to help promote and maintain diabetes self-care could be categorized into self-care data monitoring, app display, feedback & reminders, data entry, data sharing, and additional features. Factors affecting the use of mHealth apps reported in the literature were personal factors, app design or usability factors, privacy and safety factors, or socioeconomic factors. Quality of life and diabetes distress were the most commonly reported PROMs in the included studies.

Conclusion

We are unable to reach a conclusive result due to the heterogeneity of the included studies as well as the limited number of studies reporting on these areas among adults with type 1 diabetes. We therefore recommend further large-scale studies looking into these areas that can ultimately improve mHealth app use in type 1 diabetes self-care.

Systematic review registration

Prospero CRD42020157620.
Assessment of alcohol utilization during pregnancy and its associated factors among reproductive women in Mecha Woreda of North Western Ethiopia
Authors: Demeke Getaneh Bizuayehu , Bayu Eyayu Kasseye
Published: May 2022

Background

Pregnancy is a time when women are making many changes, including the patterns of alcohol consumption. Alcohol consumption during pregnancy encourages the risks of mothers and unborn child. Alcohol use during pregnancy can result in prematurity, brain damage, growth restriction, developmental delay and social, emotional and behavioral deficits, particularly in developing countries.

Methods

A community based cross-sectional study was employed. Structured questionnaires were used to assess the prevalence of alcohol utilization, and socio-demographic as well as economic characteristics of women who have pregnancy experience. Both bivariate and multivariate logistic regression models were employed. Descriptive and inferential statistical analyses were used.

Results

The study results showed that the prevalence of alcohol use and response rate was high. Factors like age group of women from 35–49 years (AOR = 0.221; 95%CI = 0.057–0.856), illiterate women(AOR = 2.697;95% CI = 1.207–6.026), currently pregnant (AOR = 0.139;95%CI = 0.057 0.343), women currently use alcohol (AOR = 0.021; 95% CI = 0.009 0.049), alcohol use pre-pregnancy (AOR = 0.016; 95% CI = 0.006–0.042), women drinking alcohol with husband during pregnancy (AOR = 0.228; 95% CI = 0.085–0.614), the risk of alcohol consumption during pregnancy is low(AOR = 0.262;95%CI = 0.074–0.925), risk alcohol consumption during pregnancy is medium (AOR = 0.296;95% CI = 0.103–0.849),utilization of alcohol during pregnancy is valuable (AOR = 0.104; 95%CI = .0.013–0.833) were statistically associated with alcohol use during pregnancy.

Conclusion

The result inferred that there is a high level of alcohol use throughout pregnancy. Due to the differences in the culture and communal means of drinking alcohol, the frequency of alcohol consumption during pregnancy varies among different regional studies and countries.
PGM1 suppresses colorectal cancer cell migration and invasion by regulating the PI3K/AKT pathway
Authors: Zheng Zhewen , Zhang Xue , Bai Jian , Long Long , Liu Di , Zhou Yunfeng
Published: May 2022

Background

Phosphoglucomutase 1 (PGM1) is known for its involvement in cancer pathogenesis. However, its biological role in colorectal cancer (CRC) has remained unknown. Here, we studied the functions and mechanisms of PGM1 in CRC.

Methods

We verified PGM-1 as a differentially expressed gene (DEG) by employing a comprehensive strategy of TCGA-COAD dataset mining and computational biology. Relative levels of PGM-1 in CRC tumors and adjoining peritumoral tissues were determined by qRT-PCR, western blotting (WB), and immunohistochemical (IHC) staining in a tissue microarray. PGM1 functions were analyzed by CCK8, EdU, colony formation, cell cycle, apoptosis, and Transwell migration and invasion assays. The influence of PGM1 was further investigated by studying tumor formation in vivo.

Results

The levels of PGM1 mRNA and protein were both reduced in CRC tissues, and the reductions were related to CRC pathology and overall survival. PGM1 knockdown stimulated both cell proliferation and colony formation, and inhibited cell cycle arrest and apoptosis, while overexpression of PGM1 produced the opposite effects in CRC cells both in vivo and in vitro. Furthermore, the effects of PGM1 were related to the PI3K/ AKT pathway.

Conclusion

We verified that PGM1 suppresses CRC progression via the PI3K/AKT pathway. These results suggest the potential for targeting PGM1 in treatment of CRC.
Prospective association between dietary pesticide exposure profiles and type 2 diabetes risk in the NutriNet-Santé cohort
Authors: Rebouillat Pauline , Vidal Rodolphe , Cravedi Jean-Pierre , Taupier-Letage Bruno , Debrauwer Laurent , Gamet-Payrastre Laurence , Guillou Hervé , Touvier Mathilde , Fezeu Léopold K. , Hercberg Serge , Lairon Denis , Baudry Julia , Kesse-Guyot Emmanuelle
Published: May 2022

Background

Studies focusing on dietary pesticides in population-based samples are scarce and little is known about potential mixture effects. We aimed to assess associations between dietary pesticide exposure profiles and Type 2 Diabetes (T2D) among NutriNet-Santé cohort participants.

Methods

Participants completed a Food Frequency Questionnaire at baseline, assessing conventional and organic food consumption. Exposures to 25 active substances used in European Union pesticides were estimated using the Chemisches und Veterinäruntersuchungsamt Stuttgart residue database accounting for farming practices. T2D were identified through several sources.

Exposure profiles were established using Non-Negative Matrix Factorization (NMF), adapted for sparse data. Cox models adjusted for known confounders were used to estimate hazard ratios (HR) and 95% confidence interval (95% CI), for the associations between four NMF components, divided into quintiles (Q) and T2D risk.

Results

The sample comprised 33,013 participants aged 53 years old on average, including 76% of women. During follow-up (median: 5.95 years), 340 incident T2D cases were diagnosed.

Positive associations were detected between NMF component 1 (reflecting highest exposure to several synthetic pesticides) and T2D risk on the whole sample: HRQ5vsQ1 = 1.47, 95% CI (1.00, 2.18). NMF Component 3 (reflecting low exposure to several synthetic pesticides) was associated with a decrease in T2D risk, among those with high dietary quality only (high adherence to French dietary guidelines, including high plant foods consumption): HRQ5vsQ1 = 0.31, 95% CI (0.10, 0.94).

Conclusions

These findings suggest a role of dietary pesticide exposure in T2D risk, with different effects depending on which types of pesticide mixture participants are exposed to. These associations need to be confirmed in other types of studies and settings, and could have important implications for developing prevention strategies (regulation, dietary guidelines).

Trial Registration

This study is registered in ClinicalTrials.gov (NCT03335644).
Low awareness of risk mitigation prescribing in response to dual crises of COVID-19 and overdose deaths among people who use unregulated drugs in Vancouver, Canada
Authors: Moshkforoush Mana , DeBeck Kora , Brar Rupinder , Fairbairn Nadia , Cui Zishan , Milloy M.-J. , Buxton Jane , Oldenburger Tanis , McLellan Will , Kendall Perry , Sedgemore Kali , Wilson Dean , Kerr Thomas , Hayashi Kanna
Published: May 2022

Background

When the novel coronavirus pandemic emerged in March 2020, many settings across Canada and the USA were already contending with an existing crisis of drug overdoses due to the toxic unregulated drug supply. In response, the Canadian province of British Columbia (BC) released innovative risk mitigation prescribing (RMP) guidelines for medical professionals to prescribe pharmaceutical alternatives to unregulated drugs in an effort to support the self-isolation of people who use unregulated drugs (PWUD) in preventing both SARS-CoV-2 virus infection and overdoses. We sought to assess the level of awareness of RMP and identify factors associated with this awareness among PWUD in Vancouver, BC.

Methods

Cross-sectional data were derived from participants enrolled in three community-recruited prospective cohort studies of PWUD in Vancouver, interviewed between July and November 2020. Multivariable logistic regression analysis was used to identify factors associated with awareness of RMP.

Results

Among 633 participants, 302 (47.7%) had heard of RMP. Of those 302 participants, 199 (65.9%) had never tried to access RMP services, ten (3.3%) made an unsuccessful attempt to access RMP, and 93 (30.8%) received RMP. In the multivariable analysis, participants who had awareness of RMP guidelines were more likely to self-identify as white (adjusted odds ratio [AOR] = 1.47; 95% confidence interval [CI]: 1.01, 2.13), to have completed secondary school education or higher (AOR = 1.67; 95% CI: 1.16, 2.39), to have used drugs at a supervised consumption or overdose prevention site in the past six months (AOR = 1.66; 95% CI: 1.10, 2.52), and to have received opioid agonist therapy as treatment for opioid use disorder in the past six months (AOR = 1.51; 95% CI: 1.02, 2.24).

Conclusion

At least four months after the release of the guidelines, RMP was known to less than half of our study participants, warranting urgent educational efforts for PWUD, particularly among racialized groups and those who were not accessing other harm reduction services. Furthermore, the majority of participants who were aware of RMP guidelines had never tried to access the service, suggesting the need to improve perceived accessibility and knowledge of eligibility criteria.
“They say it’s fentanyl, but they honestly look like Perc 30s”: Initiation and use of counterfeit fentanyl pills
Authors: Daniulaityte Raminta , Sweeney Kaylin , Ki Seol , Doebbeling Bradley N. , Mendoza Natasha
Published: May 2022

Background

Worsening of the overdose crisis in the USA has been linked to the continuing proliferation of non-pharmaceutical fentanyl (NPF). The recent wave of NPF spread in the USA has been fueled by an increased presence of counterfeit pills that contain NPF. This qualitative study aims to characterize the motivation and practices of counterfeit NPF pill initiation and use among individuals using illicit opioids in Arizona.

Methods

Between October 2020 and May 2021, semi-structured interviews were conducted with 22 individuals meeting the following eligibility criteria: (1) 18 years or older; (2) residence in Arizona; and (3) use of illicit opioids in the past 30 days and/or opioid use disorder treatment in the past 12 months. Participants were recruited through referrals by a harm reduction organization, craigslist ads, and referrals by other participants. Interviews were conducted virtually via Zoom. Qualitative interviews were transcribed and analyzed thematically using NVivo.

Results

Out of 22 participants, 64% were male, and 45% were ethnic minorities. Age ranged between 25 and 51 years old. Participants noted significant recent increases in the availability of counterfeit NPF pills (“blues,” “dirty oxys”) that were most commonly used by smoking. The majority indicated first trying NPF pills in the past year, and the first use often occurred in situations of reduced access to heroin or pharmaceutical opioids. Participant decisions to switch over to more frequent NPF pill use or to maintain some levels of heroin use were shaped by local drug availability trends and personal experiences with NPF effects. They were also influenced by conflicting views of social acceptability of pharmaceutical-like drugs, perceived harms of NPF in terms of overdose risks and increased difficulty of quitting, and perceived benefits of switching to the non-injection route of opioid administration (e.g., from injecting heroin to smoking NPF pills).

Conclusion

Our findings highlight the need for the implementation of novel policy, treatment, and harm reduction approaches to address the growing unpredictability of drug supply and NPF pill-specific risks, attitudes, and behaviors.
Exploring the importance of controlling heteroskedasticity and heterogeneity in health valuation: a case study on Dutch EQ-5D-5L
Authors: Karim Suzana , Craig Benjamin M. , Groothuis-Oudshoorn Catharina G. M.
Published: May 2022

Background

Respondents in a health valuation study may have different sources of error (i.e., heteroskedasticity), tastes (differences in the relative effects of each attribute level), and scales (differences in the absolute effects of all attributes). Although prior studies have compared values by preference-elicitation tasks (e.g., paired comparison [PC] and best–worst scaling case 2 [BWS]), no study has yet controlled for heteroskedasticity and heterogeneity (taste and scale) simultaneously in health valuation.

Methods

Preferences on EQ-5D-5L profiles were elicited from a random sample of 380 adults from the general population of the Netherlands, using 24 PC and 25 BWS case 2 tasks. To control for heteroskedasticity and heterogeneity (taste and scale) simultaneously, we estimated Dutch EQ-5D-5L values using conditional, heteroskedastic, and scale-adjusted latent class (SALC) logit models by maximum likelihood.

Results

After controlling for heteroskedasticity, the PC and BWS values were highly correlated (Pearson's correlation: 0.9167, CI: 0.9109–0.9222) and largely agreed (Lin's concordance: 0.7658, CI: 0.7542–0.7769) on a pits scale. In terms of preference heterogeneity, some respondents (mostly young men) failed to account for any of the EQ-5D-5L attributes (i.e., garbage class), and others had a lower scale (59%; p-value: 0.123). Overall, the SALC model produced a consistent Dutch EQ-5D-5L value set on a pits scale, like the original study (Pearson's correlation:0.7295; Lin's concordance: 0.6904).

Conclusions

This paper shows the merits of simultaneously controlling for heteroskedasticity and heterogeneity in health valuation. In this case, the SALC model dispensed with a garbage class automatically and adjusted the scale for those who failed the PC dominant task. Future analysis may include more behavioral variables to better control heteroskedasticity and heterogeneity in health valuation.

Highlights

The Dutch EQ-5D-5L values based on paired comparison [PC] and best-worst scaling [BWS] responses were highly correlated and largely agreed after controlling for heteroskedasticity.

Controlling for taste and scale heterogeneity simultaneously enhanced the Dutch EQ-5D-5Lvalues by automatically dispensing with a garbage class and adjusting the scale for those who failed the dominant task.

After controlling for heteroskedasticity and heterogeneity, this study produced Dutch EQ-5D-5L values on a pits scale moderately concordant with the original values.
Cholecystectomy promotes colon carcinogenesis by activating the Wnt signaling pathway by increasing the deoxycholic acid level
Authors: Yao Yuxia , Li Xiangji , Xu Baohong , Luo Li , Guo Qingdong , Wang Xingyu , Sun Lan , Zhang Zheng , Li Peng
Published: May 2022

Purpose

Cholecystectomy (XGB) is widely recognized as a risk factor for colon cancer (CC). Continuous exposure of the colonic epithelium to deoxycholic acid (DCA) post-XGB may exert cytotoxic effects and be involved in the progression of CC. However, the functions of the XGB-induced DCA increase and the underlying mechanism remain unclear.

Methods

Colitis-associated CC (CAC) mouse models constructed by AOM-DSS inducement were used to confirm the effect of XGB on the CC progression. Hematoxylin & eosin staining was performed to assess the tumor morphology of CAC mouse models tissues. Various cell biological assays including EdU, live-cell imaging, wound-healing assays, and flow cytometry for cell cycle and apoptosis were used to evaluate the effect of DCA on CC progression. The correlation among XGB, DCA, and CC and their underlying mechanisms were detected with immunohistochemistry, mass spectrometry, transcriptome sequencing, qRT-PCR, and western blotting.

Results

Here we proved that XGB increased the plasma DCA level and promoted colon carcinogenesis in a colitis-associated CC mouse model. Additionally, we revealed that DCA promoted the proliferation and migration of CC cells. Further RNA sequencing showed that 120 mRNAs were upregulated, and 118 downregulated in DCA-treated CC cells versus control cells. The upregulated mRNAs were positively correlated with Wnt signaling and cell cycle-associated pathways. Moreover, DCA treatment could reduced the expression of the farnesoid X receptor (FXR) and subsequently increased the levels of β-Catenin and c-Myc in vitro and in vivo. Moreover, the FXR agonist GW4064 decreased the proliferation of CC cells by repressing the expression of β-catenin.

Conclusion

We concluded that XGB-induced DCA exposure could promote the progression of CC by inhibiting FXR expression and enhancing the Wnt-β-catenin pathway.
A Vibrio-based microbial platform for accelerated lignocellulosic sugar conversion
Authors: Woo Sunghwa , Lim Hyun Gyu , Han Yong Hee , Park Sungwoo , Noh Myung Hyun , Baek Dongyeop , Moon Jo Hyun , Seo Sang Woo , Jung Gyoo Yeol
Published: May 2022

Background

Owing to increasing concerns about climate change and the depletion of fossil fuels, the development of efficient microbial processes for biochemical production from lignocellulosic biomass has been a key issue. Because process efficiency is greatly affected by the inherent metabolic activities of host microorganisms, it is essential to utilize a microorganism that can rapidly convert biomass-derived sugars. Here, we report a novel Vibrio-based microbial platform that can rapidly and simultaneously consume three major lignocellulosic sugars (i.e., glucose, xylose, and arabinose) faster than any previously reported microorganisms.

Results

The xylose isomerase pathway was constructed in Vibrio sp. dhg, which naturally displays high metabolic activities on glucose and arabinose but lacks xylose catabolism. Subsequent adaptive laboratory evolution significantly improved xylose catabolism of initial strain and led to unprecedently high growth and sugar uptake rate (0.67 h−1 and 2.15 g gdry cell weight−1 h−1, respectively). Furthermore, we achieved co-consumption of the three sugars by deletion of PtsG and introduction of GalP. We validated its superior performance and applicability by demonstrating efficient lactate production with high productivity (1.15 g/L/h) and titer (83 g/L).

Conclusions

In this study, we developed a Vibrio-based microbial platform with rapid and simultaneous utilization of the three major sugars from lignocellulosic biomass by applying an integrated approach of rational and evolutionary engineering. We believe that the developed strain can be broadly utilized to accelerate the production of diverse biochemicals from lignocellulosic biomass.
High-throughput sequencing analysis reveals genomic similarity in phenotypic heterogeneous Photorhabdus luminescens cell populations
Authors: Dominelli Nazzareno , Jäger Heidi Yoko , Langer Angela , Brachmann Andreas , Heermann Ralf
Published: May 2022

Purpose

Phenotypic heterogeneity occurs in many bacterial populations: single cells of the same species display different phenotypes, despite being genetically identical. The Gram-negative entomopathogenic bacterium Photorhabdus luminescens is an excellent example to investigate bacterial phenotypic heterogeneity. Its dualistic life cycle includes a symbiotic stage interacting with entomopathogenic nematodes (EPNs) and a pathogenic stage killing insect larvae. P. luminescens appears in two phenotypically different cell forms: the primary (1°) and the secondary (2°) cell variants. While 1° cells are bioluminescent, pigmented, and produce a huge set of secondary metabolites, 2° cells lack all these phenotypes. The main difference between both phenotypic variants is that only 1° cells can undergo symbiosis with EPNs, a phenotype that is absent from 2° cells. Recent comparative transcriptome analysis revealed that genes mediating 1° cell-specific traits are modulated differently in 2° cells. Although it was previously suggested that heterogeneity in P. luminescens cells cultures is not genetically mediated by, e.g., larger rearrangements in the genome, the genetic similarity of both cell variants has not clearly been demonstrated yet.

Methods

Here, we analyzed the genomes of both 1° and 2° cells by genome sequencing of each six single 1° and 2° clones that emerged from a single 1° clone after prolonged growth. Using different bioinformatics tools, the sequence data were analyzed for clustered point mutations or genetic rearrangements with respect to the respective phenotypic variant.

Result

We demonstrate that isolated clones of 2° cells that switched from the 1° cell state do not display any noticeable mutation and do not genetically differ from 1° cells.

Conclusion

In summary, we show that the phenotypic differences in P. luminescens cell cultures are obviously not caused by mutations or genetic rearrangements in the genome but truly emerge from phenotypic heterogeneity.
Retrograde intrarenal surgery for impacted upper ureteral stone in a patient with advanced lumbar scoliosis and lower-extremity development defect: a case report
Authors: Güler Yavuz
Published: May 2022

Background

Today, retrograde intrarenal surgery is the most preferred and very successful treatment method for upper ureteral stones that do not spontaneously pass and/or do not benefit from extracorporeal wave lithotripsy. However, perioperative complications are more common in retrograde intrarenal surgery if the stone in the ureter is impacted. Moreover, urosepsis and renal dysfunction are detected more frequently in patients with impacted stones. Impacted stones, which are a risky stone group even in patients with normal vertebral anatomy, are a more challenging situation in patients with advanced vertebral scoliosis. It is difficult to achieve an operating position in these patients. In addition, the ureteral tracing is altered, curved, and tortuous, making it more difficult for the endoscope to advance through the ureter.

Case presentation

In this case report, we present a 23-year-old Caucasian male patient with right concavity and severe scoliosis, lower-extremity developmental disorder, and urosepsis. To treat the urosepsis picture, first percutaneous nephrostomy drainage was provided and the urine was sterilized with appropriate antibiotics according to the culture/antibiogram. Then, we performed ureterolithotripsy with a flexureterorenoscope. Finally, we see that flexible ureterorenoscopic lithotripsy to the upper ureteral stone with impacted stones, which is a very challenging operation even in patients with normal vertebrae, could be successfully performed in our patient with advanced scoliosis deformity.

Conclusion

High stone-free and low complication rates can be obtained with flexible ureterorenoscopic retrograde intrarenal surgery in medium-sized impacted upper ureteral stones in patients with advanced scoliosis.
South Korean validation of the COVID-related-PTSD scale in a non-clinical sample exposed to the COVID-19 pandemic
Authors: Lee Hwa Jung , Kim Ye Jin , Lee Dong Hun
Published: May 2022

The threat of COVID-19 outbreak in South Korea and around the globe challenged not only physical health but also mental health, increasing the chances of disorders such as posttraumatic stress disorder (PTSD). Such pandemic situation can be referred to a traumatic event for citizens. The present study aims to examine the psychometric properties of the PTSD Checklist (PCL-5), which is named the K-COVID-related-PTSD. The scale measures PTSD symptomology in the context of the COVID-19 pandemic in South Korea. A total of 1434 South Korean citizens were included in this study. The data were statistically analyzed using SPSS 21.0 and Mplus 8.0. The results of confirmatory factor analysis demonstrated a superior fit for the seven-factor hybrid model (x2 = 1425.445 (df = 149), CFI = 0.950, TLI = 0.937, SRMR = 0.033, RMSEA = 0.077) consisting of re-experiencing, negative affect, anxious arousal, dysphoric arousal, avoidance, anhedonia, and externalizing behaviors. Furthermore, the K-COVID-related-PTSD showed a satisfactory level of internal consistency (α = 0.793 to α = 0.939) with good convergent and discriminant validity. Finally, concurrent validity was confirmed by the significant correlations with all the negative mental health outcomes, such as PTSD symptoms, somatization, depression, anxiety, anger, negative affect, job burnout, and suicidal ideation. Overall, the current results demonstrate the K-COVID-related-PTSD is a valid scale and therefore has important implications for future pandemic-related studies.
“Foundations of a great metaphysical style”: unraveling Giorgio de Chirico’s early palette
Authors: Haddad Abed , Rogge Corina E. , Martins Ana , Dijkema Desirae
Published: May 2022

Properly situating Giorgio de Chirico’s metaphysical works within his lifetime is complicated due to incomplete provenances, his practice of deliberately falsifying dates, and the known existence of forgeries. De Chirico’s palette may have altered over time, due to shifts in his personal taste, changes in availability of materials, and innovations in paints; elucidating his palette and variations thereof during his metaphysical period (1911–1919) offers analytical insights that complement traditional connoisseurship when attempting to correctly position a given work within his lifetime. To this end, eleven paintings from his metaphysical period, and two in his metaphysical style but painted in the 1940s and backdated to the 1910s, were analyzed by non-destructive portable X-ray fluorescence spectroscopy. Analysis of some works was further complemented with micro-destructive analysis by scanning electron microscopy coupled with energy dispersive x-ray spectrometry, as well as Raman and Fourier transform infrared spectroscopy. While the grounds of his paintings are variable, his metaphysical palette is consistent and includes: lead white, zinc white, ochres and umbers, magnetite, bone or ivory black, vermilion, chrome yellow, Naples yellow, copper acetoarsenite, chromium oxide green, and Prussian blue. Less commonly used pigments include cerulean blue and cadmium yellow, and the backdated paintings lack lead white and vermilion.
In-office communication about excessive daytime sleepiness associated with treated obstructive sleep apnea: insights from an ethnographic study of physician-patient visits
Authors: Won Christine , Bogan Richard K. , Doghramji Karl , Ojile Joseph , Bujanover Shay , Hyman Danielle L. , Hewett Kathleen A. , Thomas Robert
Published: May 2022

Background

Excessive daytime sleepiness (EDS), a primary symptom of obstructive sleep apnea (OSA), negatively affects functioning and quality of life (QoL). EDS can persist despite primary airway therapy, and often remains unmanaged, potentially due to inadequate provider-patient communication. Ethnographic research was conducted to assess provider-patient communication about EDS.

Methods

Participating physicians (primary care n = 5; pulmonologists n = 5; sleep specialists n = 3) identified adult patients (n = 33) diagnosed with OSA who were prescribed positive airway pressure (PAP) therapy ≥6 months prior and previously reported EDS. Visits and post-visit interviews were video-recorded and analyzed using standardized, validated sociolinguistic techniques.

Results

Despite 55% of patients (18/33) reporting QoL impacts post-visit, this was discussed during 28% (5/18) of visits. Epworth Sleepiness Scale was administered during 27% (9/33) of visits. Many patients (58% [19/33]) attributed EDS to factors other than OSA. Physicians provided EDS education during 24% of visits (8/33). Prior to the visit, 30% (10/33) of patients were prescribed EDS medication, of which 70% (7/10) reported currently experiencing EDS symptoms.

Conclusions

EDS was minimally discussed and rarely reassessed or treated after PAP therapy initiation in this study. Patients often attributed EDS to factors other than OSA. The findings suggest physicians and patients may benefit from dialogue tools, routine use of screening tools, and patient education.
Antimicrobial peptide expression in the cockroach gut during enterobacterial infection is specific and influenced by type III secretion
Authors: Turner Matthew , Pietri Jose E.
Published: May 2022

Omnivorous synanthropic cockroaches, such as the German cockroach (Blattella germanica), are reservoirs and vectors of enteric bacterial pathogens. A lifestyle conducive to frequent encounters with high loads of diverse bacteria may have led to the evolution of unique innate immune systems in these insects. The innate immune response of insects relies largely on generalized mechanisms to sense and eliminate foreign microbes. However, analyses of the genomes of common synanthropic cockroaches previously revealed a repertoire of pathogen associated molecular pattern (PAMP) receptors and antimicrobial peptides (AMPs) that is significantly expanded relative to most holometabolous insect models and vectors, supporting the intriguing possibility that cockroaches may encode enhanced recognition within their immune system and may possess an enhanced capacity to fine tune innate immune responses. Investigating how cockroaches respond to infection with enterobacteria provides the opportunity to expand our fundamental knowledge of the regulation of insect innate immunity in a context that is biologically and medically relevant. German cockroaches can harbor both Salmonella enterica serovar Typhimurium and Escherichia coli in their gut without experiencing pathogenesis. The former colonizes the gut and replicates while the latter persists only transiently. We hypothesized that differences in the innate immune response may contribute to or result from the difference in infection dynamics between the two enterobacteria. To test this hypothesis, we used qRT-PCR to analyze expression of five genes encoding representative AMPs (Attacins, Blattellicin, Defensins) in the gut of German cockroaches 1 and 24 h after ingestion of live or heat-killed enterobacteria. We found that robust AMP expression was induced in response to ingestion of a live wild-type strain of S. Typhimurium, but not in response to live E. coli, heat-killed S. Typhimurium, or a live mutant strain of S. Typhimurium lacking type III secretion systems. These results indicate that the cockroach immune system does not respond to stimulation with high levels of ingested bacterial PAMPs such as peptidoglycan. Rather, AMP expression in the gut appears to be induced by active bacterial colonization involving type III secretion. We speculate that this form of regulation may have evolved to prevent over activation of the immune system from frequent ingestion of innocuous, non-colonizing, or non-viable bacteria. While additional work is needed to delineate the molecular mechanisms underlying our observations, our findings provide significant novel insight into the immunological adaptation of cockroaches to life in septic environments as well as the factors that regulate bacterial pathogen transmission by these insects.
Clinical value of PET/CT in identifying patients with oligometastatic/oligoprogressive disease among first-line tyrosine kinase inhibitor-treated advanced EGFR-mutant non-small cell lung cancer: Implications from survival comparisons
Authors: Xu Dayu , Yu Fan , Guo Tiantian , Zhou Yue , Zhang Jinmeng , Li Yida , Jiang Shanshan , Mao Jiuang , Yang Xi , Chu Li , Chu Xiao , Wang Shengping , Ni Jianjiao , Zhu Zhengfei
Published: May 2022

Objective:

Local therapy (LT) could potentially prolong the survival of patient with advanced epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) receiving tyrosine kinase inhibitors (TKIs) and harboring oligometastatic/oligoprogressive disease (OMD/OPD). However, the optimal imaging method for identifying patients with OMD/OPD remains controversial. The objective of this study was to investigate the clinical value of incorporating PET/CT in detecting patients with OMD/OPD.

Methods:

Consecutive cases with metastatic EGFR-mutant NSCLC undergoing first-line EGFR-TKI treatment were retrospectively screened and those receiving baseline PET/CT and brain magnetic resonance imaging (MRI) or complete conventional imaging (CIM), including brain MRI, chest computed tomography (CT), abdomen ultrasound or CT and bone scintigraphy were included. OMD/OPD was defined as metastases/progressions documented at a maximum of five lesions and three organs, otherwise was defined as multiple metastatic/progressive disease (MMD/MPD). Progression-free survival (PFS) and overall survival (OS) were analyzed.

Results:

Of the 392 patients evaluated, baseline OMD was detected in 22.7% (53/233) of patients by PET/CT and in 18.2% (29/159) of patients by CIM (p = 0.171). Among the patients evaluated with baseline PET/CT, patients with OMD had longer PFS (p = 0.016) and tendency of improved OS (p = 0.058) than those with MMD. However, this result was not observed with patients evaluated using baseline CIM. With a median follow-up of 24.2 (range, 1.1–124.6) months, 297 patients had their first disease progression (FPD), of whom 164 (55.2%) had adequate imaging scans to analyze the tumor distributions at FPD comprehensively. OPD was detected in 63.0% (34/54) and 35.0% (39/110) of patients among the PET/CT and CIM assessed group (p = 0.003), respectively. Among the PET/CT assessed group, patients with OPD had significantly longer post-progressive overall survival (OS2) than those with MPD (p = 0.011). However, no significant difference of OS2 in the CIM assessed group was found.

Conclusion:

Patients with OMD/OPD, evaluated by PET/CT but not CIM, generally had more favorable survival outcomes than those with MMD/MPD among patients with metastatic NSCLC undergoing first-line EGFR-TKI treatment.

Advances in knowledge:

PET/CT seems to affect the survival of patients under first-line EGFR-TKI treated metastatic NSCLC with OMD/OPD.
Does the autism phenotype differ when selecting groups by neurodevelopmental versus genetic diagnosis? An observational study comparing autism and sex chromosome trisomy
Authors: Wilson Alexander C , Bishop Dorothy V M
Published: May 2022

Background: Autism is diagnosed on the basis of social and non-social behavioural features that are assumed to cluster together, and assumed to be distinct from other aspects of development, such as language ability. It is unclear, however, if these assumptions are valid. This study presents a novel approach to answering this question by investigating whether correlations between autism features are similar for groups selected on behavioural versus genetic diagnosis.

Methods: The autism phenotype was assessed by diagnostic interview in young people aged 7 to 14 diagnosed with autism (N=61) or sex chromosome trisomy (SCT; N=49). Data were analysed by confirmatory factor analysis and MANOVA.

Results: Autism features showed a similar factor structure and were distinct from language ability in both groups. However, the SCT group was more likely to show clinically-significant difficulties in just some aspects of autism and a lower level of non-social autism features for their social-communication disabilities.

Conclusions: We suggest the group differences emerged because autism diagnostic criteria do not map exactly on the autism phenotype as it manifests “naturally”. Conventional diagnostic criteria for autism miss those with uneven profiles of difficulty and those with relatively low levels of restricted and repetitive behaviours and interests.
Case Report: Systemic lupus erythematous associated with thrombotic thrombocytopenic purpura, a diagnostic challenge
Authors: Suárez-Ale Horacio , Fabian-Aquino Elizabeth , Failoc-Rojas Virgilio E. , Benites-Zapata Vicente A , Ignacio-Cconchoy Felipe
Published: May 2022

Thrombotic thrombocytopenic purpura (TTP) is an uncommon microangiopathic disease and sometimes is associated with systemic lupus erythematous (SLE). However, this probable causal relationship has not been completely proven. The diagnostic differentiation of both diseases is difficult in the first instance because they share similar characteristics that may overlap. We present a case of a 32-year-old woman with antecedents of epileptic seizures since she was 12 years old. The patient was admitted to the emergency room with a clinical picture of headaches, fever, paleness in the skin and mucosa, confused state, paresthesia, and transient spasticity of the extremities. The laboratory results revealed direct Coombs negative hemolytic anemia, severe thrombocytopenia, significant elevation of lactate dehydrogenase, and presence of schistocytes ++ in the peripheral film. In addition, positive antinuclear antibodies and positive anti-native DNA in titers of 1/320 and 1/160, respectively, were found. Urinalysis showed that serum creatinine was in normal range. Because of limited hospital resources, ADAMTS13 was not evaluated. However, based on clinical, hematological, and biochemical findings, we concluded that it was a case of TTP associated with SLE and indicated treatment with plasmapheresis and methylprednisolone pulses, obtaining a satisfactory response (normalization of biomarker levels, health condition) after the second session of plasmapheresis. Diagnosis of both SLE and TTP is often difficult to achieve; however, adequate correlation of clinical manifestations and laboratory tests, along with the help of partial therapeutic interventions, may lead to good clinical response.