bluuebunny/crossref_metadata_2025 huggingface dataset:
Interspecies relationships between nosocomial pathogens associated to preterm infants and lactic acid bacteria in dual-species biofilms
Authors: Jara Josué , Jurado Rubén , Almendro-Vedia Víctor G. , López-Montero Iván , Fernández Leonides , Rodríguez Juan Miguel , Orgaz Belén
Published: October 2022

The nasogastric enteral feeding tubes (NEFTs) used to feed preterm infants are commonly colonized by bacteria with the ability to form complex biofilms in their inner surfaces. Among them, staphylococci (mainly Staphylococcus epidermidis and Staphylococcus aureus) and some species belonging to the Family Enterobacteriaceae are of special concern since they can cause nosocomial infections in this population. NETF-associated biofilms can also include lactic acid bacteria (LAB), with the ability to compete with pathogenic species for nutrients and space. Ecological interactions among the main colonizers of these devices have not been explored yet; however, such approach could guide future strategies involving the pre-coating of the inner surfaces of NEFTs with well adapted LAB strains in order to reduce the rates of nosocomial infections in neonatal intensive care units (NICUs). In this context, this work implied the formation of dual-species biofilms involving one LAB strain (either Ligilactobacillus salivarius 20SNG2 or Limosilactobacillus reuteri 7SNG3) and one nosocomial strain (either Klebsiella pneumoniae 9SNG3, Serratia marcescens 10SNG3, Staphylococcus aureus 45SNG3 or Staphylococcus epidermidis 46SNG3). The six strains used in this study had been isolated from the inner surface of NEFTs. Changes in adhesion ability of the pathogens were characterized using a culturomic approach. Species interactions and structural changes of the resulting biofilms were analyzed using scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). No aggregation was observed in dual-species biofilms between any of the two LAB strains and either K. pneumoniae 9SNG3 or S. marcescens 10SNG3. In addition, biofilm thickness and volume were reduced, suggesting that both LAB strains can control the capacity to form biofilms of these enterobacteria. In contrast, a positive ecological relationship was observed in the combination L. reuteri 7SNG3-S. aureus 45SNG3. This relationship was accompanied by a stimulation of S. aureus matrix production when compared with its respective monospecies biofilm. The knowledge provided by this study may guide the selection of potentially probiotic strains that share the same niche with nosocomial pathogens, enabling the establishment of a healthier microbial community inside NEFTs.
Not just a game: Identity fusion and extremism in gaming cultures
Authors: Kowert Rachel , Martel Alexi , Swann William B.
Published: October 2022

Extremist ideologies have clearly become increasingly prevalent in the world of video games. What is less clear, however, is the mechanism through which these ideologies make their way into the psyches of gamers. Here we focus on the potential role of identity fusion in the radicalization of video gamers. In three studies, we show that fusion with gaming culture is uniquely predictive of a host of socially pernicious outcomes, including racism, sexism, and endorsement of extreme behaviors. We also show that specific personality attributes (e.g., insecure attachment, loneliness) may interact with fusion with gaming culture to further amplify support for extreme behavior, and that specific gaming communities (e.g., Call of Duty) may serve as catalysts that encourage strongly fused gamers to embrace antisocial attitudes and behaviors. These findings contribute to a theoretical understanding of the psychological processes that foment radicalization and guide the development of strategies for discouraging extremist ideologies in gaming spaces.
Catheter ablation for atrial fibrillation in patients with persistent left superior vena cava: Case series and systematic review
Authors: Gao Mingyang , Bian Yang , Huang Lihong , Zhang Jingrui , Li Changyi , Liu Nian , Liu Xiaoxia , Zuo Song , Guo Xueyuan , Wang Wei , Zhao Xin , Long Deyong , Sang Caihua , Tang Ribo , Li Songnan , Dong Jianzeng , Ma Changsheng
Published: October 2022

Introduction

Persistent left superior vena cava (PLSVC) is the most common form of thoracic venous abnormality. Catheter ablation (CA) for atrial fibrillation (AF) can be complicated by the existence of PLSVC, which could act as an important arrhythmogenic mechanism in AF.

Methods and results

We reported a case series of patients with PLSVC who underwent CA for AF at our center between 2018 and 2021. A systematic search was also performed on PubMed, EMBASE, and Web of Science for research reporting CA for AF in patients with PLSVC. Sixteen patients with PLSVC were identified at our center. Ablation targeting PLSVC was performed in 5 patients in the index procedures and in four patients receiving redo procedures. One patient experienced acute procedure failure. After a median follow-up period of 15 months, only 6 (37.5%) patients remained free from AF/atrial tachycardia (AT) after a single procedure. In the systematic review, 11 studies with 167 patients were identified. Based on the included studies, the estimated prevalence of PLSVC in patients undergoing CA for AF was 0.7%. Ablation targeting PLSVC was performed in 121 (74.7%) patients. Major complications in patients with PLSVC receiving AF ablation procedure included four cases of cardiac tamponades (2%), three cases of cardiac effusion (1.5%), one case of ischemic stroke, and three cases of phrenic nerve injury (1.5%) (one left phrenic nerve and two right phrenic nerve). Pooled analysis revealed that after a median follow-up period of 15.6 months (IQR 12.0–74.0 months), the long-term AF/AT-free rate was 70.6% (95% CI 62.8–78.4%, I2 = 0.0%) (Central illustration). Different ablation strategies for PLSVC were summarized and discussed in the systematic review.

Conclusion

In patients with PLSVC, recurrence of atrial arrhythmia after CA for AF is relatively common. Ablation aiming for PLSVC isolation is necessitated in most patients. The overall risk of procedural complications was within an acceptable range.
Degos disease with multiple intestinal perforations: A missed-opportunity case report and literature review
Authors: Ai Wen , Liang Zhihua , Li Feng , Yu Haihua
Published: October 2022

Introduction

Degos disease, also known as malignant atrophic papulosis (MAP), is a rare systemic obstructive vascular disease with unknown pathophysiology, which can affect multiple systems, especially gastrointestinal tract and central nervous system. Intestinal perforations with MAP is associated with high mortality rate and ambiguous treatment outcomes.

Case presentation

Here we report a missed-opportunity case of Degos disease characterized by generalized skin eruption and multiple intestinal perforations. Definite diagnosis of Degos disease was finally concluded after two exploratory laparotomy operations and skin biopsies. Due to the delayed diagnosis and treatment, the patient died after being discharged automatically in spite of application of aspirin and low-dose subcutaneous heparin. In view of such circumstances, we searched the Pubmed using “Degos [Title] OR Malignant Atrophic Papulosis [Title]” AND “perforation [Title] OR perforations [Title]” and make a detailed analysis of the result.

Conclusions

Degos disease is a rare systemic obstructive vascular disease with unknown pathologic mechanism and unavailable treatment methods. Diagnosis is usually based on the presence of pathognomonic skin lesions and tissue biopsy. Gastrointestinal involvement can cause serious and lethal conditions with high mortality. Currently, how to achieve a satisfying prognosis of MAP with intestinal perforations becomes the most urgent problem in front of medical staff.
Stroke prevention during and after transcatheter aortic valve implantation: From cerebral protection devices to antithrombotic management
Authors: Jimenez Diaz Victor Alfonso , Estevez Loureiro Rodrigo , Baz Alonso Jose Antonio , Juan Salvadores Pablo , Bastos Fernandez Guillermo , Caneiro Queija Berenice , Veiga Garcia Cesar , Iñiguez Romo Andres
Published: October 2022

Since its conception, transcatheter aortic valve implantation (TAVI) has undergone important improvements both in the implantation technique and in transcatheter devices, allowing an enthusiastic adoption of this therapeutic approach in a wide population of patients previously without a surgical option and managed conservatively. Nowadays, patients with severe symptomatic aortic stenosis are typically managed with TAVI, regardless of their risk to surgery, improving the prognosis of patients and thus achieving an exponential global expansion of its use. However, thromboembolic and hemorrhagic complications remain a latent concern in TAVI recipients. Both complications can appear simultaneously in the periprocedural period or during the follow-up, and when minor, they resolved without apparent sequelae, but in a relevant percentage of cases, they are devastating, overshadowing the benefit achieved with TAVI. Our review outlines the etiology and incidence of thromboembolic complications associated with TAVI, the main current strategies for their prevention, and the implications of its pharmacological management at the follow-up in a TAVI population, mostly frail and predisposed to bleeding complications.
Carbon emission efficiency and spatially linked network structure of China’s logistics industry
Authors: Tang Yangying , Yang Zhishan , Yao Jian , Li Xuedong , Chen Xin
Published: October 2022

This paper uses the EBM model to measure the carbon emission efficiency of the logistics industry in 30 provinces in China from 2010 to 2019 and analyzes its spatial and temporal evolution characteristics using ARCGIS visualization. On this basis, the structural characteristics of the spatial correlation network of carbon emission efficiency of the logistics industry in China and its influencing factors are explored and analyzed by using the social network analysis method and the quadratic distribution method (QAP). The study shows that: 1) The national average logistics industry carbon emission efficiency increased from 2010 to 2019, and the spatial logistics industry carbon emission efficiency shows the characteristics of East > Central > Northeast > West, and most of the provinces in China are still in the middle and low logistics industry carbon emission efficiency zone. 2) The carbon emission efficiency of logistics industry in 30 provinces in China has formed a stable spatial correlation network, and there is an obvious spatial spillover relationship. However, the structure of the spatial association network is loose, and there are obvious gaps in the status of each province in the spatial association network. The provinces in the eastern region are at the core of the spatial correlation network, while the provinces in the northeast and west are at the periphery of the spatial correlation network. 3) The reduction of geographical distance between provinces, the greater the differences in logistics development level, logistics energy intensity and logistics environmental protection level, and the higher the similarity of logistics informatization level, the more it can promote the formation of spatial correlation network.
Investigation the nexus between CO2 emissions, agricultural land, crop, and livestock production in Pakistan
Authors: Ali Sajjad , Shah Ashfaq Ahmad , Ghimire Amogh , Tariq Muhammad Atiq Ur Rehman
Published: October 2022

The ongoing adverse effects of climate change produced by carbon dioxide emissions have sparked global advocacy to face its adverse consequences with the utmost vigor. Pakistan’s contribution to global emissions is less than 1% while it is among the most vulnerable countries facing threat of climate change. The sources of carbon dioxide (CO2) emissions by particular nations must be understood to comprehend the procedures necessary to reduce emissions globally. This study is a contribution to empirics of the CO2emissions, gross domestic product, crop production index, livestock production index, population, agricultural land, land under cereal crop and agriculture value-added. This study considered annual data from 1961 to 2014 for the country of Pakistan. We performed an Autoregressive distributed lag (ARDL) bound testing approach to investigate the long-run and short-run association among all research variables. To check the stationarity of the study variables, we also employed Augmented Dickey-Fuller and Phillips-Perron (P.P.) tests. The outcomes of the long-run estimates indicate that the coefficients of agricultural land and land under cereal crop have a positive and significant relationship with CO2emissions, while the coefficients of crop production index have a negative and significant relationship with CO2emissions, respectively. The outcomes from short-run estimates show that the coefficients of crop production index and livestock production index are both positive and statistically significant, which implies that these variables are crucial in boosting carbon emissions. The error correction model value is also negative and statistically significant, indicating the deviation of CO2emissions to other variables from short-run to long-run equilibrium. According to the Pairwise Granger causality test, there is evidence of both unidirectional and bidirectional causation between the research variables. Based on the research outcomes, the government must carefully consider its regulations on agricultural and livestock production and embrace ecologically friendly techniques in the agriculture sector, which may minimize carbon emissions over time.
Influence of energy efficient infrastructure, financial inclusion, and digitalization on ecological sustainability of ASEAN countries
Authors: Chen Kenjie , Zhang Shaohui
Published: October 2022

ASEAN countries are emerging economies facing substantial, sustainable energy production and consumption challenges. Power sources’ availability, sustainability, and efficiency are imperative to ensure ecological sustainability. Therefore, these countries must explore the factors that promote sustainable energy supply. The current study investigates the interlinkages between energy infrastructure, financial inclusion, and digitalization on the ecological sustainability of ASEAN region from 1980 to 2018. The study applied the continuously updated fully modified (CUP-FM) and continuously updated bias-corrected (CUP-BC) estimators to address cross-sectional dependency and slope heterogeneity issues. The study’s findings show that energy infrastructure, financial inclusion, and digitalization help to reduce ecological footprints in the long run. Moreover, digitalization complements the impact of energy-efficient infrastructure on ecological footprints. These findings recommend that ASEAN countries should improve energy infrastructure by integrating digitalization into energy supply production, management, and distribution.
Does e-commerce participation affect green agrotechnology adoption among reservoir resettlers? The case of China’s Three Gorges Reservoir area
Authors: Zhao Xu , Cui Zhuo , Zhao Feifei
Published: October 2022

This study explores how promoting e-commerce participation impacts the adoption of green agrotechnology by resettlers in China’s Three Gorges Reservoir area and helps rural revitalization and the realization of value from ecological produce. First, we combine induced innovation model theory with the risk perception factor of expected utility theory. A model of resettlers’ green agrotechnology adoption under different levels of e-commerce participation is constructed, and research hypotheses are proposed accordingly. Survey data gathered from resettled farmers in Zigui, the first county of the studied area, are tested empirically with an ordered probit model. The results show first, that e-commerce participation significantly and positively affects the level of green agrotechnology adoption at the 1% level; and second, that expectations of the ecological value of agricultural products and the agrotechnology support provided by e-commerce are important driving factors. The promotion effect of different modes of e-commerce participation on agrotechnology adoption differ. The risk-averse behavior of resettlers can weaken the promotion effect of e-commerce participation on agrotechnology adoption.
Modeling shallow soil moisture dynamics in mountainous landslide active regions
Authors: Dai Jia-Ying , Cheng Su-Ting
Published: October 2022

Under the worsening climate change, the mountainous landslide active regions are more likely to suffer severe disasters threatening residents. To predict the occurrence of landslides, shallow soil moisture lying in the interface of the hydrological processes has been found as one of the critical factors. However, shallow soil moisture data are often scarce in the landslide active regions. To overcome the severe measurement deficiencies and provide predictions of soil moisture dynamics, we construct a physically-based shallow soil moisture model based on the assumptions of ideal flow, homogeneous and isotropic soil textures, and 1-dimensional water movement dominant by gravity forces. In the model, the meteorological conditions and the physical soil properties are taken into consideration. With limited field measurements, the model can provide reasonably accurate soil moisture predictions. In recognition of the seasonal weather characteristics, we perform a series of sensitivity analyses to examine the response of shallow soil moisture and relate the hydrological processes to air temperature, precipitation intensity, duration, and combinations thereof. Complex interactions of hydrological processes are found with variations in precipitation and air temperature, depending on the interlinked boundary conditions of the soil and water. It demonstrates a strong need for a decent forecast of the complex shallow soil moisture dynamics and the associated hydrologic processes in mountain regions to cope with climate change for landslide preparation and agricultural adaptation in the future.
How to design renewable energy support policies with imperfect carbon pricing?
Authors: Wang Ye , Cui Xiao , Bu Weisheng , Li Li
Published: October 2022

Based on the emission trading scheme (ETS), this study built a design framework of renewable energy support policies (RES), which is employed to assess the interaction between RES and ETS. For RES, we consider two policy instruments: feed-in-tariff (FIT) and renewable portfolio standards (RPS). Based on the partial equilibrium model, taking the case of China’s electricity market, this study quantitatively discusses the implementation effects of six different policy mix scenarios from three aspects: emission reduction, production of green electricity, and social welfare. According to the results, there were big differences among the implementation effects of different RES instruments based on ETS. The renewable subsidy policy, on the whole, is better than renewable portfolio standards in terms of emission reduction, but worse in terms of improving the production of green electricity. In addition, different from the renewable subsidy policy, the renewable portfolio standards can reduce social welfare. When the emission quota is eased, RES can be implemented to significantly improve social welfare. These simulation results inspire China for the design of effective energy policies.
Lead exposure was associated with liver fibrosis in subjects without known chronic liver disease: An analysis of NHANES 2017–2020
Authors: Zhang Zhiqiang , Li Zhangping , Lin Haiyan , Zeng Zhiyu , Huang Jiaofeng , Li Dongliang
Published: October 2022

Lead is one of the most important toxic heavy metals in the environment; however, the relationship between blood lead levels and liver fibrosis in individuals without chronic liver diseases (CLD) is unclear. This study used data obtained from the National Health and Nutrition Examination Survey (NHANES) 2017–2020. Multivariate logistic regression was used to explore the relationship between the blood lead level and significant liver fibrosis. A total of 1962 cases without underlying CLD were included, 77 (3.9%) of whom were diagnosed with advanced liver fibrosis by transient elastography. The proportion of advanced fibrosis significantly increased with the blood lead level (p < 0.001), and the blood lead level was higher in the fibrosis group than in the non-fibrosis group (1.2 μg/dl vs 0.9 μg/dl, p < 0.001). After adjusting for relevant confounding factors, the blood lead level was found to be independently associated with advanced liver fibrosis (OR = 1.168; 95% CI, 1.006–1.356; p = 0.041). The blood lead level remained an independent risk factor for advanced liver fibrosis (OR = 1.249; 95% CI, 1.048–1.489; p = 0.013) after controlling for age and sex through propensity score matching. In conclusion, the blood lead level is associated with liver fibrosis in individuals without known CLD.
Transitioning out of illegalization: Cross-border mobility experiences
Authors: Consoli Liala , Burton-Jeangros Claudine , Jackson Yves
Published: October 2022

It is known that opportunities to cross borders legally, acquired through regularization programs, are acknowledged by previously illegalized migrants as one of the main positive effects of obtaining a residence permit. However, the impact of these policies has rarely been investigated through the “mobility lens.” To fulfill this gap, this study aims, through a case study, (1) to assess how obtaining a residence permit after having endured years of illegalization affects migrants' cross-border mobility and (2) to identify the direct and indirect transformative effects triggered by these changes in cross-border mobility. Our analysis considers regularization policies as a transformation of mobility regimes in which individual mobility trajectories are embedded. Thirty-nine migrants transitioning out of illegalization through an extraordinary regularization program implemented between 2017 and 2018 in the Canton of Geneva, Switzerland, were interviewed twice at a time interval of more than 1.5 years. Changes in actual mobility and perceived potential mobility (“motility”) were identified in the narratives. Inductive thematic analysis was used to identify related transformative effects. As a complement, descriptive statistics using two-wave panel data collected among a broader sample of migrants in the same context provided measures of cross-border mobility. Our findings highlight the importance of considering changes related to cross-border mobility when studying the impact of regularization programs on migrants' wellbeing, as they are a crucial ingredient of deeper adjustments occurring in their lives. We emphasize the importance of considering not only the subjective and objective effects triggered by increased actual mobility but also the subjective effects triggered by perceived increased potential mobility. Indeed, becoming aware of the new opportunities to cross borders leads to transforming imagined futures, subjectivities, identities, concerns, and perceived sources of stress, and it affects emotional wellbeing. The findings underline the relevance of a processual approach for two reasons: first, having experienced a long-lasting illegalization and forced immobility continues to affect individuals' experience of cross-border (im)mobility even after regularization; second, the triggered transformative effects take time to develop and observations at different times provide a richer picture.
The role of ancestral seascape discontinuity and geographical distance in structuring rockfish populations in the Pacific Northwest
Authors: Sun Cheng-He , Gozlan Rodolphe Elie , Wu Ting , Xue Dan , Lao Ye-Ling , Yu Jian-Feng , Zeng Xiao-Shu , Li Sha , Hardouin Emilie A. , Andreou Demetra , Zhang Qun
Published: October 2022

Despite the apparent absence of physical barriers in the ocean to prevent dispersal, recent studies have highlighted the importance of biological, geographical, physical, and historical barriers in the genetic structuring of marine species populations. This representation is essential for the sustainable exploitation of natural marine resources and for the setup of efficient protected area networks for the conservation of marine species. In this study, we used extensive sampling of Sebastiscus marmoratus, a commercially important inshore rockfish with high site fidelity, to characterize their population genetic structure along the China–Japan coast and to determine the effect of past geological and current biological–physical barriers on the current genetic footprint. A 461-bp fragment of the mtDNA hypervariable portion control region was sequenced for 675 individuals from 15 geographical locations. A total of 292 haplotypes were identified. The population of S. marmoratus showed high haplotype and nucleotide diversity. Pairwise fixation index (FST) and analysis of molecular variance (AMOVA) revealed significant genetic differentiation among populations. The Bayesian skyline plots and neutrality statistics showed a sudden expansion of the S. marmoratus population around the Pleistocene. The Beibu Gulf group had the lowest mean number of pairwise differences, the lowest significant genetic differentiation, and the lowest haplotype and nucleotide diversity, and should be prioritized for protection in the future. Ocean currents, seascape discontinuity, geographical distance, and ecological characteristics may play an important role in shaping the contemporary phylogeographical patterns and population structures of S. marmoratus.
Bioaccumulation of contaminants in wild seahorses collected from coastal China
Authors: Liu Ying , Shang Dongwei , Yang Yanjing , Cui Pei , Sun Jinhui
Published: October 2022

Eighty-four wild seahorses, including three of China’s dominant species, were collected from seven coastal provinces to evaluate their common contaminant contents. Heavy metals (including Cu, Pb, Cd, Cr, and Hg), Benzo(a)pyrene (B[a]P), and microplastics were detected in the collected seahorses. The results indicate that considerable contamination variations are present in seahorses from different regions and species. Elevated concentrations of Cu and Cr, compared to other heavy metals, were observed in most sampled locations. In addition, B[a]P concentrations were far greater in Hippocampus mohnikei and H.trimaculatus compared with H.kelloggi (P < 0.05). Substantial changes in microplastic concentrations were also observed in seahorses from different locations, and significant differences were observed between sampled species (P < 0.05). Further, a correlation analysis obtained strong correlations among four heavy metals (Cu, Pb, Cd, and Cr), except Hg. A significant correlation was identified between B[a]P and microplastics (P < 0.01), suggesting potential synergistic effects between these two contaminants. In brief, this study indicates that wild seahorse populations are experiencing environmental pollution.
Effect of dietary arginine levels on growth performance, protein synthesis, antioxidant capacity and immunity of postlarval mud crab Scylla paramamosain
Authors: Wu Duoting , Feng Wenping , Li Xinyu , Xu Hanying , Luan Xueyao , Han Tao , Wang Jiteng
Published: October 2022

This study investigated the effects of different dietary arginine (Arg) levels on the growth, protein synthesis, antioxidant capacity, and immunity of postlarval mud crab Scylla Paramamosain. Six isonitrogenous and isolipidic diets were formulated to contain 1.51%, 1.81%, 2.16%, 2.35%, 2.73%, and 3.07% dietary Arg levels (dry matter). There were four replicates for each diet treatment (26 crabs per replicate, initial body weight: 7.40 ± 0.15 mg). After eight weeks of feeding trial, the survival and molting frequency (MF) of crabs were not affected by the experimental treatment (P>0.05). Crabs fed the 2.50% Arg diet achieved the highest weight gain (WG) and specific growth rate (SGR) (P<0.05). The whole-body protein content of the 2.16% and 2.73% Arg groups were significantly higher than that of the 1.51% Arg group (P<0.05). Crabs in the 2.35% group obtained the highest levels of phenylalanine and leucine (P<0.05). Superoxide dismutase (SOD), catalase (CAT), and total antioxidant capacity (T-AOC) activity in the 2.16%, 2.35% and 2.73% Arg groups were significantly higher than that in other treatments (P<0.05). Malondialdehyde (MDA) concentration and alkaline phosphatase (AKP) activity were not significantly affected by the treatments. The transcript levels of insulin-like growth factor 1 (igf-1), rapamycinin (TOR), S6 kinase-polypeptide 1 (s6k1) in crabs fed with 2.16% and 2.35% dietary Arg were significantly higher than those in crabs fed with 1.51% and 3.07% dietary Arg (P<0.05). The lowest prophenoloxidase (proPO), relish, and lysozyme transcript levels were observed in crabs fed the 1.51% dietary Arg. The current study founded that the Arg requirement for postlaval S.paramamosain was 2.34% (5.20% of the dietary protein), based on the second order polynomial regression analysis of WG.
Modeling systems from partial observations
Authors: Champaney Victor , Amores Víctor J. , Garois Sevan , Irastorza-Valera Luis , Ghnatios Chady , Montáns Francisco J. , Cueto Elías , Chinesta Francisco
Published: October 2022

Modeling systems from collected data faces two main difficulties: the first one concerns the choice of measurable variables that will define the learnt model features, which should be the ones concerned by the addressed physics, optimally neither more nor less than the essential ones. The second one is linked to accessibility to data since, generally, only limited parts of the system are accessible to perform measurements. This work revisits some aspects related to the observation, description, and modeling of systems that are only partially accessible and shows that a model can be defined when the loading in unresolved degrees of freedom remains unaltered in the different experiments.
Comparison of epidural dexmedetomidine to fentanyl in reducing ropivacaine dose in Programmed Intermittent Epidural Bolus plus Patient Controlled Epidural Analgesia during labor: A randomized, double-blind, controlled study
Authors: Pang Ru-Ying , Shen Yao-Hua , Jin Xiao-Qin , Xu Hai-Feng , Wang Yang , Zhu Bin-Xiang , Lin Su-Feng , Xiao Fei
Published: October 2022

Background

Dexmedetomidine has been documented to reduce the dose of both intrathecal local anesthetic during cesarean delivery, and the concentration of ropivacaine needed for inducing analgesia during labor. However, few studies have compared adjuvant dexmedetomidine to fentanyl on how they impact the dose of ropivacaine required during labor. The aim of the current study was to evaluate the efficacy of epidural dexmedetomidine at doses of 0.3, 0.4, or 0.5 and 2 μg/ml of fentanyl (the traditional clinical concentration), when added to epidural 0.125% ropivacaine.

Methods

This was a randomized, double-blinded study that comprised one hundred eighty-eight patients, allocated into four groups receiving either epidural fentanyl at 2 μg/ml, or dexmedetomidine at 0.3, 0.4, or 0.5 μg/ml for labor analgesia. The primary outcome was the amount of ropivacaine necessary per hour. Secondary outcomes included visual analogue pain scale (VAS), motor block (Bromage Scale), side effects, patient satisfaction, and neonatal outcomes.

Results

At the completion of the study, data from 165 participants were analyzed. The mean hourly amount of epidural ropivacaine administered was 16.2 ± 3.3, 14.0 ± 3.1, 13.1 ± 3.7 and 12.1 ± 2.5 ml/h in the 2 μg/ml fentanyl group, and the 0.3, 0.4 and 0.5 μg/ml dexmedetomidine groups, respectively. There was a significant difference among groups in the mean hourly consumption of epidural ropivacaine (P < 0.0001 for 1 way ANOVA). The frequency of PCEA (patient-controlled epidural analgesia) was significantly higher in the fentanyl group than in the three dexmedetomidine groups (P < 0.001), and similar among the dexmedetomidine groups. The mean values of the VAS among all groups were similar over time, P > 0.05. The incidence of pruritus in the fentanyl group was 17.5%, whereas no patient experienced pruritus in any of the dexmedetomidine groups, P < 0.0001.

Conclusion

The study demonstrated that epidural dexmedetomidine (0.3 and 0.4 μg/ml) was superior to standard dose epidural fentanyl in reducing the mean hourly amount of ropivacaine administered, and minimizing opioid-related side effects. Further large and multicenter studies would be necessary to confirm the benefits of dexmedetomidine, and potentially serve as an alternative to opioids for routine use in labor analgesia.

Clinical trial registration

[http://www.chictr.org.cn/showproj.aspx?proj=62846], identifier [ChiCTR2000039067].
Epidemiology, management, and outcome of infection, sepsis, and septic shock in a German emergency department (EpiSEP study)
Authors: Wolfertz Nicole , Böhm Lennert , Keitel Verena , Hannappel Oliver , Kümpers Philipp , Bernhard Michael , Michael Mark
Published: October 2022

Background

The adjacent conditions infection, sepsis, and septic shock are among the most common causes of treatment in the emergency department (ED). Most available data come from intensive care units (ICU) and include nosocomial infections acquired during hospitalization. Epidemiological data from German EDs are not yet available, although the ED is one of the first points of contact for patients. The aim of this study was to investigate the epidemiology, causes, diagnosis, mortality, and treatment of patients with infections in the ED.

Materials and methods

In this retrospective, single-center observational study, routinely collected data from the patient data management system and from the hospital information system were analyzed. All adult patients who presented to the ED in connection with an infection during the study period from 01/01 to 28/02/2019 were included. Exclusion criteria were age ≤ 17 years and incomplete records. Three groups (I. Infection, II. Sepsis, and III. Septic shock) were defined according to SEPSIS-3 definitions.

Results

During the study period, a total of 6,607 patients were treated in the ED. Of these patients, 19.3% (n = 1,278) had an infection (mean age 56 ± 23 years, 50% female). The sites of infection were distributed as follows: Respiratory tract 35%, genitourinary tract 18%, maxillofacial/ears/nose/throat 14%, intraabdominal 13%, soft tissues 10%, central nervous system 1%, other cause 3%, or unknown cause 6%. Infection only, sepsis and septic shock were present in 86, 10, and 3%, respectively. There were significant differences in vital signs as well as in the various emergency sepsis scores across the predefined groups [I vs. II vs. III: SOFA (pts.): 1 ± 1 vs. 4 ± 2 vs. 7 ± 3 (p < 0.0001), systolic blood pressure (mmHg): 137 ± 25 vs. 128 ± 32 vs. 107 ± 34 (p < 0.05), heart rate (bpm): 92 ± 18 vs. 99 ± 23 vs. 113 ± 30 (p < 0.05), respiratory rate (min-1): 18 ± 4 vs. 20 ± 7 vs. 24 ± 10 (p < 0.05)]. In the three groups, blood cultures were obtained in 34, 81, and 86%, of cases, respectively and antibiotics were administered in the ED in 50, 89, and 86%, of cases respectively. The 30-day mortality rate in the three groups was 1.6, 12.0, and 38.1%, respectively.

Conclusion

This study is the first to show the incidence, management, and outcome of patients classified as infection, sepsis, and septic shock in a German ED. The findings of our real-world data are important for quality management and enable the optimization of treatment pathways for patients with infectious diseases.
Interpretable machine learning methods for predictions in systems biology from omics data
Authors: Sidak David , Schwarzerová Jana , Weckwerth Wolfram , Waldherr Steffen
Published: October 2022

Machine learning has become a powerful tool for systems biologists, from diagnosing cancer to optimizing kinetic models and predicting the state, growth dynamics, or type of a cell. Potential predictions from complex biological data sets obtained by “omics” experiments seem endless, but are often not the main objective of biological research. Often we want to understand the molecular mechanisms of a disease to develop new therapies, or we need to justify a crucial decision that is derived from a prediction. In order to gain such knowledge from data, machine learning models need to be extended. A recent trend to achieve this is to design “interpretable” models. However, the notions around interpretability are sometimes ambiguous, and a universal recipe for building well-interpretable models is missing. With this work, we want to familiarize systems biologists with the concept of model interpretability in machine learning. We consider data sets, data preparation, machine learning methods, and software tools relevant to omics research in systems biology. Finally, we try to answer the question: “What is interpretability?” We introduce views from the interpretable machine learning community and propose a scheme for categorizing studies on omics data. We then apply these tools to review and categorize recent studies where predictive machine learning models have been constructed from non-sequential omics data.
Lactate-to-albumin ratio is associated with in-hospital mortality in patients with spontaneous subarachnoid hemorrhage and a nomogram model construction
Authors: Zhang Guo-Guo , Hao Jia-Hui , Yong Qi , Nie Qian-Qian , Yuan Gui-Qiang , Zheng Zong-Qing , Li Jin-Quan
Published: October 2022

Introduction

Subarachnoid hemorrhage (SAH) is a severe hemorrhagic stroke with high mortality. However, there is a lack of clinical tools for predicting in-hospital mortality in clinical practice. LAR is a novel clinical marker that has demonstrated prognostic significance in a variety of diseases.

Methods

Critically ill patients diagnosed and SAH with their data in the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database and the eICU Collaborative Research Database (eICU-CRD) were included in our study. Multivariate logistic regression was utilized to establish the nomogram.

Results

A total of 244 patients with spontaneous SAH in the MIMIC-IV database were eligible for the study as a training set, and 83 patients in eICU-CRD were included for external validation. Data on clinical characteristics, laboratory parameters and outcomes were collected. Univariate and multivariate logistic regression analysis identified age (OR: 1.042, P-value: 0.003), LAR (OR: 2.592, P-value: 0.011), anion gap (OR: 1.134, P-value: 0.036) and APSIII (OR: 1.028, P-value: < 0.001) as independent predictors of in-hospital mortality and we developed a nomogram model based on these factors. The nomogram model incorporated with LAR, APSIII, age and anion gap demonstrated great discrimination and clinical utility both in the training set (accuracy: 77.5%, AUC: 0.811) and validation set (accuracy: 75.9%, AUC: 0.822).

Conclusion

LAR is closely associated with increased in-hospital mortality of patients with spontaneous SAH, which could serve as a novel clinical marker. The nomogram model combined with LAR, APSIII, age, and anion gap presents good predictive performance and clinical practicability.
Retinal thickness changes in different subfields reflect the volume change of cerebral white matter hyperintensity
Authors: Lv Xiaohan , Teng Zhenjie , Jia Zhiyang , Dong Yanhong , Xu Jing , Lv Peiyuan
Published: October 2022

Purpose

To investigate the relationship between the retinal thickness in different subfields and the volume of white matter hyperintensity (WMH), with the hope to provide new evidence for the potential association between the retina and the brain.

Methods

A total of 185 participants aged over 40 years were included in our study. Magnetic resonance imaging (MRI) was used to image the WMH, and WMH volume was quantitatively measured by a specific toolbox. The thickness of the total retina, the retinal nerve fiber layer (RNFL), and the ganglion cell and inner plexiform layer (GCIP) was measured by optical coherence tomography (OCT) in nine subfields. The association between retinal thickness and WMH volume was demonstrated using binary logistic regression and Pearson correlation analysis.

Results

Participants were divided into two groups by the WMH volume (‰, standardized WMH volume) median. In the quartile-stratified binary logistic regression analysis, we found that the risk of higher WMH volume showed a positive linear trend correlation with the thickness of total retina (95% CI: 0.848 to 7.034; P for trend = 0.044)/ GCIP (95% CI: 1.263 to 10.549; P for trend = 0.038) at the central fovea, and a negative linear trend correlation with the thickness of nasal inner RNFL (95% CI: 0.086 to 0.787; P for trend = 0.012), nasal outer RNFL (95% CI: 0.058 to 0.561; P for trend = 0.004), and inferior outer RNFL (95% CI: 0.081 to 0.667; P for trend = 0.004), after adjusting for possible confounders. Correlation analysis results showed that WMH volume had a significant negative correlation with superior outer RNFL thickness (r = −0.171, P = 0.02) and nasal outer RNFL thickness (r = −0.208, P = 0.004).

Conclusion

It is suggested that central fovea and outer retina thickness are respectively associated with WMH volume. OCT may be a biological marker for early detection and longitudinal monitoring of WMH.
Global trends in the research on benign paroxysmal positional vertigo: A 20-year bibliometric and visualization analysis
Authors: Zhou Fangwei , Yu Bingxi , Luo Jiali , Ma Yifei , Li Jianyao , Zhang Tian , Yu Guodong
Published: October 2022

Background

Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vestibular vertigo. Although BPPV is benign, its underlying mechanisms are complicated, and patients diagnosed with BPPV are significantly affected by it in their daily lives. Hence, this study's purpose was to investigate global trends and frontiers in the field of BPPV.

Methods

We searched the research literature published from 2002 to 2021 on BPPV using two databases from the Web of Science Core Collection, and we conducted a bibliometric and visualization analysis. Bibliometric tools were used to perform co-authorship, co-citation, and co-occurrence analyses of countries or regions, institutions, authors, journals, keywords, and references.

Results

In all, 1,419 publications from 4,594 authors, 1,542 institutions, and 65 countries or regions with 71 subject categories were included in the study. The number of articles increased gradually from 2002 to 2021. Seoul National University, the University of Munich, and Osaka University were among the leading institutions with the most publications, while United States of America, South Korea, and China were the leading countries. JS Kim was the most prolific author, Otology & Neurotology was the most prolific journal, and Otorhinolaryngology was the most published subject category. The five most frequently occurring keywords were BPPV, vertigo, dizziness, nystagmus, and management and the top research hot spots were osteoporosis and vitamin D.

Conclusion

This study systematically analyzed trends in global scientific research on BPPV. The academic understanding of BPPV has improved significantly over the last two decades, with osteoporosis and vitamin D the two main research hot spots in the field of BPPV in recent years. These findings provide direction for current research to grasp the trends and research frontiers of current research.
VHL syndrome without clear family history: A rare case report and literature review of Chinese patients
Authors: Li Yaheng , Xin Xiaohong , Song Wenzhu , Zhang Xuan , Chen Shengli , Wang Qian , Li Aizhong , Li Yafeng
Published: October 2022

Objective

To analyze the clinical manifestations and imaging features of a hospitalized patient with intermittent headache who was finally diagnosed with von Hippel–Lindau (VHL) syndrome and to perform whole-exon gene detection to improve the understanding of the diagnosis and treatment strategies of the disease.

Methods

A case of suspected VHL syndrome in Shanxi Provincial People's Hospital was analyzed. Proband DNA was also extracted for whole exome sequencing and screened for causative mutation sites, which were validated by Sanger sequencing. The literature about VHL gene mutations in Chinese patients in the past 10 years were also reviewed.

Results

There is a heterozygous mutation site c.499C > G on the VHL gene on the short arm of chromosome 3 of the patient, which is a missense mutation. The mutation results in the substitution of arginine with glycine at amino acid 167 of the encoded protein, which may be primarily responsible for the disease in the patient with VHL syndrome. However, the mutation did not occur in other family members.

Conclusion

Early recognition and treatment of VHL syndrome can be available with genetic testing technology. Strengthening the understanding of this complex genetic disease and improving the diagnostic rate of VHL syndrome are helpful for the precise treatment of patients with this disease, which may help prolong the survival time of patients to a certain extent and improve their quality of life.
How is neuromuscular fatigability affected by perceived fatigue and disability in people with multiple sclerosis?
Authors: Royer Nicolas , Coates Kyla , Aboodarda Saied Jalal , Camdessanché Jean-Philippe , Millet Guillaume Y.
Published: October 2022

Whereas fatigue is recognized to be the main complaint of patients with multiple sclerosis (PwMS), its etiology, and particularly the role of resistance to fatigability and its interplay with disability level, remains unclear. The purposes of this review were to (i) clarify the relationship between fatigue/disability and neuromuscular performance in PwMS and (ii) review the corticospinal and muscular mechanisms of voluntary muscle contraction that are altered by multiple sclerosis, and how they may be influenced by disability level or fatigue. Neuromuscular function at rest and during exercise are more susceptible to impairement, due to deficits in voluntary activation, when the disability is greater. Fatigue level is related to resistance to fatigability but not to neuromuscular function at rest. Neurophysiological parameters related to signal transmission such as central motor conduction time, motor evoked potentials amplitude and latency are affected by disability and fatigue levels but their relative role in the impaired production of torque remain unclear. Nonetheless, cortical reorganization represents the most likely explanation for the heightened fatigability during exercise for highly fatigued and/or disabled PwMS. Further research is needed to decipher how the fatigue and disability could influence fatigability for an ecological task, especially at the corticospinal level.
Glutamic acid assisted hydrolysis strategy for preparing prebiotic xylooligosaccharides
Authors: Huang Rong , Zhang Rui , Yao Shuangquan , Si Mengyuan , Xia Ruowen , Zhou Xin , Fan Xingli , Jiang Kankan
Published: October 2022

Since the immune-boosting properties as well as the benefit of promoting the growth of gut bacteria, xylooligosaccharides as prebiotics have attracted considerable interest as functional feed additives around the world. A growing number of studies suggest that acidic hydrolysis is the most cost-effective method for treating xylan materials to prepare xylooligosaccharides, and organic acids were proved to be more preferable. Therefore, in this study, glutamic acid, as an edible and nutritive organic acid, was employed as a catalyst for hydrolyzing xylan materials to prepare xylooligosaccharides. Further, xylooligosaccharide yields were optimized using the response surface methodology with central composite designs. Through the response surface methodology, 28.2 g/L xylooligosaccharides with the desirable degree of polymerization (2–4) at a yield of 40.5 % could be achieved using 4.5% glutamic acid at 163°C for 41 min. Overall, the application of glutamic acid as a catalyst could be a potentially cost-effective method for producing xylooligosaccharides.