bluuebunny/crossref_metadata_2025 huggingface dataset:
Tongue strength and swallowing dynamics in chronic obstructive pulmonary disease
Authors: Epiu Isabella , Gandevia Simon C. , Boswell-Ruys Claire L. , Wallace Emma , Butler Jane E. , Hudson Anna L.
Published: May 2021

Background

Swallowing disorders occur in COPD, but little is known about tongue strength and mastication. This is the first assessment in COPD of tongue strength and a test of mastication and swallowing solids (TOMASS).

Methods

Anterior tongue strength measures were obtained in 18 people with COPD, aged 73±11 years (mean±sd), and 19 healthy age-matched controls, aged 72±6 years. Swallowing dynamics were assessed using an eating assessment tool (EAT-10), timed water swallow test (TWST), and TOMASS. Swallowing measures were compared to an inhibitory reflex (IR) in the inspiratory muscles to airway occlusion (recorded previously in the same participants).

Results

Tongue strength was similar between COPD and controls (p=0.715). Self-assessed scores of dysphagia EAT-10 were higher (p=0.024) and swallowing times were prolonged for liquids (p=0.022) and solids (p=0.003) in the COPD group. During TWST, ∼30% of COPD group showed clinical signs of airway invasion (cough and wet voice), but none in the control group. For solids, the COPD group had ∼40% greater number of chews (p=0.004), and twofold-higher number of swallows (p=0.0496). Respiratory rate was 50% higher in COPD group than controls (p <0.001). The presence of an IR was not related to better swallowing outcomes, but signs of airway invasion were associated with a delayed IR.

Conclusion

Dysphagia in stable COPD is not due to impaired anterior tongue strength, but rather swallowing–breathing discoordination. To address dysphagia, aspiration and acute exacerbations in COPD, therapeutic targets to improve swallowing dynamics could be investigated further.
Interferon-γ liposome: a new system to improve drug delivery in the treatment of lung cancer
Authors: Alhawamdeh Maysa , Isreb Mohammad , Aziz Abid , Jacob Badie K. , Anderson Diana , Najafzadeh Mojgan
Published: May 2021

Lung cancer is one of the main causes of death worldwide. Published data show the use of interferons (IFNs) in treating lung tumours. IFNs also have potential for their antiproliferative, antiangiogenic, immunoregulatory and proapoptotic effects. IFN-γ functions as an anticancer agent against various forms of cancer. This study aimed to investigate the effect of IFN-γ liposome (nano) on peripheral lymphocytes from 20 individuals in each group: lung cancer patients compared to healthy individuals. The effectiveness of IFN-γ liposome against oxidative stress was also evaluated in this study. A concentration of 100 U·mL−1of IFN-γ liposome was used to treat the lymphocytes in the Comet and micronucleus assays based on the preliminary test for the optimal dose. The lymphocytes from lung cancer patients presented with higher DNA damage levels than those of healthy individuals. In healthy individuals, IFN-γ liposome did not cause any DNA damage in the lymphocytes. Also, it caused a significant reduction in DNA damage in the lymphocytes from lung cancer patients in both the Comet and micronucleus assays. The 100 U·mL−1of IFN-γ liposome significantly reduced the oxidative stress caused by H2O2and appeared to be effective in both groups using the Comet and micronucleus assays. Results from both Comet and micronucleus assays were consistent. The data obtained indicated that IFN-γ in both forms (IFN-γ bulk and IFN-γ nanoliposome) may potentially be effective for the treatment of lung cancer and showed the ability of IFN-γ liposome to reduce DNA damage more than the bulk form.
The association between intracompartmental pressure and skeletal muscle recovery after tibial diaphyseal fractures: an ambispective cohort study
Authors: Tian Shengjie , Chang Shimin , Lu Yaogang , Zhu Jianhua , Kong Xuqiang
Published: May 2021

Background

Due to the special anatomy of the lower leg, tibial diaphyseal fracture causes increased intracompartmental pressure (ICP). Not only is this increased ICP the manifestation of skeletal muscle injury, but it induces further deterioration of the injury. The aim of this study was to assess the association between short-term ICP elevation and long-term skeletal muscle recovery after severe limb trauma.

Methods

In this single-center ambispective cohort study, we retrospectively screened and recruited a cohort of tibial diaphyseal fracture patients with integrated ICP data during the early post-traumatic period, and performed a prospective observational study to evaluate their skeletal muscle recovery through long-term follow-up and MR imaging after the removal of the implants. We analyzed the association between ICP elevation and skeletal muscle recovery using statistical methods.

Results

A total of 46 patients with healed fractures underwent intramedullary nail removal and MR imaging. The absolute values of the Pearson product-moment correlation coefficients between various ICP parameters and the cross-sectional area ratio (CSAR) ranged from 0.588 to 0.793, and the correlation coefficients between the ICP parameters and the average T2-weighted signal intensity ratio (T2SIR) varied from 0.566 to 0.775. Statistically significant associations were observed between the ICP parameters and the MR imaging parameters when simple linear regression analysis was performed. Among the ICP parameters, the accumulated ΔP (ΔP = diastolic blood pressure minus ICP) had the highest determination coefficient and explained 62.1% and 59.1% of the variance in CSAR and T2SIR, respectively.

Conclusions

Short-term ICP elevation was associated with long-term skeletal muscle recovery following tibial diaphyseal fracture, especially for ICP data that integrated time factors.

Level of evidence

Level 3.
Type 2 and type 3 innate lymphoid cells at the maternal-fetal interface: implications in preterm birth
Authors: Mendes João , Rodrigues-Santos Paulo , Areia Ana Luísa , Almeida Jani-Sofia , Alves Vera , Santos-Rosa Manuel , Mota-Pinto Anabela
Published: May 2021

Background

Preterm birth (PTB) is one of the major causes of neonatal morbidity and mortality worldwide. It is commonly accepted that the act of giving birth is the final step in a proinflammatory signaling cascade, orchestrated by an intrauterine milieu coupled to hormonal cues. Consequently, the inflammatory process plays a pivotal role during the pathogenesis of human labor, both in term and preterm deliveries. The ability of innate lymphoid cells (ILCs) to act as pro-inflammatory mediators arose the interest to study their role in normal and pathological pregnancies.

The aim of this work was to analyze the relative frequencies of ILCs subsets in pregnancy and the levels of IL-4, IL-17, IL-22, and IFN-γ as inflammatory mediators. Accordingly, we hypothesized that changes in the proportions of ILCs subpopulations could be related to preterm birth.

Methods

We analyzed 15 full-term delivery samples and six preterm delivery samples. In the full-term group (FTB) peripheral blood was taken during routine blood analysis, on 3 occasions: 1st, 2nd and 3rd trimester. After delivery, peripheral blood, cord blood and placenta were collected. In PTB group, peripheral blood samples were obtained on two occasions: before and 24 h after treatment with progesterone. We used flow cytometry to analyze ILCs in maternal peripheral blood, placenta, and cord blood samples. Maternal peripheral blood and cord blood samples were analyzed by enzyme-linked immunosorbent assay for IL-4, IL-17, IL-22, and IFN-γ plasma levels at the time of labor.

Results

We observed significantly increased relative frequencies of ILC2 and ILC3 in the decidua, as well as an increase of ILC2 in cord blood samples in PTB group, compared to FTB samples. We also found a decrease in IFN-γ in peripheral blood samples of the PTB group, suggesting a functional withdrawal. Additionally, IL-4, IL-17, IL-22 levels were similar in PTB and FTB groups, denoting a relevant role in mediating labor.

Conclusion

Our results suggest that ILC2 and ILC3 play a role in PTB by mediating an inflammatory response. Further work is necessary to evaluate the importance of ILCs in the regulation of labor.
Comparison of transversus abdominis plane catheters with thoracic epidurals for cost and length of stay in open colorectal surgeries: a cohort study
Authors: Miller David , Andriakos Peter , VanBacker Justin , Macbeth Erin , Galay Igor , Sidhu Dilip , Cherukupalli Divya , Lee Edward , Valerian Brian , Chismark A. David , Canete Jonathan , Afroze Farzana
Published: May 2021

Background

Thoracic epidural analgesia has long been a common method of postoperative analgesia for major open abdominal surgeries and is frequently used within enhanced recovery after surgery programs. An alternative postoperative analgesia method is the single shot transversus abdominis plane block, which has shown promising outcomes with respect to total length of stay, cost, pain scores, and decreased opioid usage. However, far less is known regarding continuous transversus abdominis plane analgesia using catheters. We evaluated the total cost-effectiveness of transversus abdominis plane catheter analgesia compared to thoracic epidural analgesia for patients undergoing open colorectal surgeries within the enhanced recovery after surgery program at our institution.

Methods

This cohort study included patients booked under the colorectal surgery enhanced recovery after surgery program from November 2016 through March 2018 who received either bilateral transversus abdominis plane catheters (n = 52) or thoracic epidural analgesia (n = 24).

Results

There was no difference in total direct cost (p = 0.660) and indirect cost (p = 0.220), and median length of stay (p = 0.664) in the transversus abdominis plane catheter group compared to the thoracic epidural group. Additionally, the transversus abdominis plane catheter group received significantly less morphine equivalents compared to the thoracic epidural group (p = 0.008) and had a lower mean body mass index (p = 0.019). There was no significant difference between the two groups for age (p = 0.820), or sex (p = 0.330).

Conclusions

Transversus abdominis plane catheter analgesia is not associated with increased cost or longer hospital stays when compared to thoracic epidural analgesia in patients undergoing open colorectal surgery within an enhanced recovery after surgery program. Furthermore, transversus abdominis plane catheter analgesia led to decreased opioid consumption while maintaining similar pain scores, suggesting similar pain control between the two modalities.
Clinical diagnosis and treatment of common respiratory tract infections in relation to microbiological profiles in rural health facilities in China: implications for antibiotic stewardship
Authors: Shen Xingrong , Shen Jilu , Pan Yaping , Cheng Jing , Chai Jing , Bowker Karen , MacGowan Alasdair , Oliver Isabel , Lambert Helen , Wang Debing
Published: May 2021

Background

This paper tries to describe prevalence and patterns of antibiotics prescription and bacteria detection and sensitivity to antibiotics in rural China and implications for future antibiotic stewardship.

Methods

The study was implemented in one village clinic and one township health center in each of four rural residential areas in Anhui Province, China. It used mixed-methods comprising non-participative observations, exit-survey and microbiological study. Observations were conducted to record clinical diagnosis and antibiotic prescription. Semi-structured questionnaire survey was used to collect patient’s sociodemographic information and symptoms. Sputum and throat swabs were collected for bacterial culture and susceptibility testing.

Results

A total of 1068 (51.0% male vs 49.0% female) patients completed the study with diagnosis of respiratory tract infection (326,30.5%), bronchitis/tracheitis (249,23.3%), pharyngitis (119,11.1%) and others (374, 35.0%). They provided 683 sputum and 385 throat swab specimens. Antibiotics were prescribed for 88% of the RTI patients. Of all the specimens tested, 329 (31%) were isolated with bacteria. The most frequently detected bacteria wereK. pneumonia(24% in all specimens),H. influenza(16%),H. parainfluenzae(15%),P. aeruginosa(6%),S.aureus(5%),M. catarrhalis(3%) andS. pneumoniae(2%).

Conclusions

The study establishes the feasibility of conducting microbiological testing outside Tier 2 and 3 hospitals in rural China. It reveals that prescription of antibiotics, especially broad-spectrum and combined antibiotics, is still very common and there is a clear need for stewardship programs aimed at both reducing the number of prescriptions and promoting single and narrow-spectrum antibiotics.
The emerging epidemic of inflammatory bowel disease in Asia and Iran by 2035: A modeling study
Authors: Olfatifar Meysam , Zali Mohammad Reza , Pourhoseingholi Mohamad Amin , Balaii Hedieh , Ghavami Shaghayegh Baradaran , Ivanchuk Maria , Ivanchuk Pavlo , Nazari Saeed hashemi , shahrokh Shabnam , Sabour Siamak , Khodakarim Soheila , Aghdaei Hamid Asadzadeh , Rohani Pejman , Mehralian Gholamhossein
Published: May 2021

Background

The projection studies are imperative to satisfy demands for health care systems and proper response to the public health problems such as inflammatory bowel disease (IBD).

Methods

To accomplish this, we established an illness-death model based on available data to project the future prevalence of IBD in Asia, Iran in particular, separately from 2017 to 2035. We applied two deterministic and stochastic approaches.

Results

In 2035, as compared to 2020, we expected a 2.5-fold rise in prevalence for Iran with 69 thousand cases, a 2.3-fold increment for North Africa and the Middle East with 220 thousand cases, quadrupling of the prevalence for India with 2.2 million cases, a 1.5-fold increase for East Asia region with 4.5 million cases, and a 1.6-fold elevation in prevalence for high‐income Asia‐Pacific and Southeast Asia regions with 183 and 199 thousand cases respectively.

Conclusions

Our results showed an emerging epidemic for the prevalence of IBD in Asia regions and/or countries. Hence, we suggest the need for immediate action to control this increasing trend in Asia and Iran. However, we were virtually unable to use information about age groups, gender, and other factors influencing the evolution of IBD in our model due to lack of access to reliable data.
Associations of sarcopenia and its defining components with cognitive function in community-dwelling oldest old
Authors: Bai Anying , Xu Weihao , Sun Jing , Liu Juan , Deng Xinli , Wu Linna , Zou Xiao , Zuo Jing , Zou Lin , Liu Yunxia , Xie Hengge , Zhang Xiaohong , Fan Li , Hu Yixin
Published: May 2021

Background

This study aimed to investigate the associations of sarcopenia and its defining components with cognitive function in community-dwelling oldest old (over 80 years old) in China.

Methods

Sarcopenia was diagnosed by the 2019 Asian Working Group for Sarcopenia (AWGS) criteria. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA). Logistic and linear regression models were used to explore the associations of sarcopenia and its defining components with risk of mild cognitive impairment (MCI), and performance on multiple cognitive domains among 428 adults aged 80 years and older.

Results

The overall prevalence of sarcopenia was 35.5%, with 40.34% for men and 32.14% for women. The prevalence of MCI was higher among sarcopenic oldest old than non-sarcopenic oldest old (28.95% vs. 17.39%, p = 0.005). Multivariate logistic regression analyses showed that sarcopenia [odds ratio (OR) = 1.86, 95% confidence interval (CI): 1.04–3.33], low handgrip strength (HS) [OR = 2.33, 95% CI: 1.40–3.87] and slow gait speed (GS) [OR = 2.31, 95% CI: 1.13–4.72] were significantly and independently associated with risk of MCI. Multivariate linear regression analyses showed that low HS was associated with worse performance in global cognitive function, visuospatial and executive function, naming and delayed recall.

Conclusions

Sarcopenia, low HS and low GS was significantly associated with MCI in community-dwelling oldest old. The associations between sarcopenia and its defining components with different cognitive subdomains could be further explored in the future.
Frequent attenders of three outpatient health care schemes in Finland: characteristics and association with long-term sickness absences, 2016–2018
Authors: Perhoniemi Riku , Blomgren Jenni
Published: May 2021

Objectives

Frequent attenders (FAs) impose a significant burden on service capacity and public health funding. Although the characteristics of the group and their risk for sickness absences (SA) have been studied, an understanding of FAs in different health care schemes is lacking. The aim of the study was to investigate FAs and their SA risk in the working-age population in public care, occupational health services (OHS) and private care schemes. The average number of SA days was also examined by diagnostic group.

Setting and participants

Register data on the use of outpatient health care, sickness allowance spells and background characteristics (2015–2018) for 25–64 year old residents of the city of Oulu, Finland, (n = 91,737) were used. Subjects were categorized into non-attenders, non-frequent attenders and FAs (top decile of attenders) both for all outpatient health care and specifically for each care scheme in 2016. The number of sickness absence days was measured yearly in 2016, 2017 and 2018. The data were analyzed with descriptive methods and negative binomial regression models.

Results

FAs consumed 31 to 44% of all visits depending on scheme in 2016. Frequent attendance was common among low socioeconomic groups in the public scheme, among lower non-manual employees and manual workers in OHS, and among entrepreneurs in the private scheme. FAs had a higher average number of SA days than others in each scheme, although group differences decreased from 2016 to 2017 and 2018. In public care, the adjusted effect of frequent attendance was strong especially for SA due to mental disorders (adjusted incidence rate ratio [IRR] for FAs 13.40), and in OHS for SA due to musculoskeletal disorders (adjusted IRR for FAs 8.68).

Conclusion

In each outpatient health care scheme, frequent attenders pose a great challenge both by consuming services and through their increased risk of disability. FAs in different schemes have partially different characteristics and risks. Common patient registers covering various service schemes would enable an identification of FAs visiting multiple schemes and services. Better coordinated services are needed for public care FAs in particular.
Prognostic marker for severe acute exacerbation of chronic obstructive pulmonary disease: analysis of diffusing capacity of the lung for carbon monoxide (DLCO) and forced expiratory volume in one second (FEV1)
Authors: Choi Juwhan , Sim Jae Kyeom , Oh Jee Youn , Lee Young Seok , Hur Gyu Young , Lee Sung Yong , Shim Jae Jeong , Rhee Chin Kook , Min Kyung Hoon
Published: May 2021

Background

It is important to assess the prognosis of patients with chronic obstructive pulmonary disease (COPD) and acute exacerbation of COPD (AECOPD). Recently, it was suggested that diffusing capacity of the lung for carbon monoxide (DLCO) should be added to multidimensional tools for assessing COPD. This study aimed to compare the DLCO and forced expiratory volume in one second (FEV1) to identify better prognostic factors for admitted patients with AECOPD.

Methods

We retrospectively analyzed 342 patients with AECOPD receiving inpatient treatment. We classified 342 severe AECOPD patients by severity of DLCO and FEV1 (≤ vs. > 50% predicted). We tested the association of FEV1 and DLCO with the following outcomes: in-hospital mortality, need for mechanical ventilation, need for intensive care unit (ICU) care. We analyzed the prognostic factors by multivariate analysis using logistic regression. In addition, we conducted a correlation analysis and receiver operating characteristic (ROC) curve analysis.

Results

In multivariate analyses, DLCO was associated with mortality (odds ratio = 4.408; 95% CI 1.070–18.167; P = 0.040) and need for mechanical ventilation (odds ratio = 2.855; 95% CI 1.216–6.704; P = 0.016) and ICU care (odds ratios = 2.685; 95% CI 1.290–5.590; P = 0.008). However, there was no statistically significant difference in mortality rate when using FEV1 classification (P = 0.075). In multivariate linear regression analyses, DLCO (B = − 0.542 ± 0.121, P < 0.001) and FEV1 (B = − 0.106 ± 0.106, P = 0.006) were negatively associated with length of hospital stay. In addition, DLCO showed better predictive ability than FEV1 in ROC curve analysis. The area under the curve (AUC) of DLCO was greater than 0.68 for all prognostic factors, and in contrast, the AUC of FEV1 was less than 0.68.

Conclusion

DLCO was likely to be as good as or better prognostic marker than FEV1 in severe AECOPD.
A nomogram for individualized prediction of overall survival in patients with newly diagnosed glioblastoma: a real-world retrospective cohort study
Authors: Kudulaiti Nijiati , Zhou Zhirui , Luo Chen , Zhang Jie , Zhu Fengping , Wu Jinsong
Published: May 2021

Background

This study aimed to identify the most valuable predictors of prognosis in glioblastoma (GBM) patients and develop and validate a nomogram to estimate individualized survival probability.

Methods

We conducted a real-world retrospective cohort study of 987 GBM patients diagnosed between September 2010 and December 2018. Computer generated random numbers were used to assign patients into a training cohort (694 patients) and internal validation cohort (293 patients). A least absolute shrinkage and selection operator (LASSO)-Cox model was used to select candidate variables for the prediction model. Cox proportional hazards regression was used to estimate overall survival. Models were internally validated using the bootstrap method and generated individualized predicted survival probabilities at 6, 12, and 24 months, which were compared with actual survival.

Results

The final nomogram was developed using the Cox proportional hazards model, which was the model with best fit and calibration. Gender, age at surgery, extent of tumor resection, radiotherapy, chemotherapy, and IDH1 mutation status were used as variables. The concordance indices for 6-, 12-, 18-, and 24-month survival probabilities were 0.776, 0.677, 0.643, and 0.629 in the training set, and 0.725, 0.695, 0.652, and 0.634 in the validation set, respectively.

Conclusions

Our nomogram that assesses individualized survival probabilities (6-, 12-, and 24-month) in newly diagnosed GBM patients can assist healthcare providers in optimizing treatment and counseling patients.

Trial registration: retrospectively registered.
Crossing vessels with suspension versus transposition in laparoscopic pyeloplasty of patients with ureteropelvic junction obstruction: a retrospective study
Authors: Liu Jun , Zhang Jingjun , Chen Weinan , Xiong Liulin , Huang Xiaobo , Ye Xiongjun
Published: May 2021

Purpose

To compare the effects of two different methods of laparoscopic pyeloplasty for the treatment of crossing vessels.

Methods

From January 2016 to August 2019, 33 patients with ureteropelvic junction obstruction (UPJO) underwent laparoscopic pyeloplasty at our center, including 21 men and 12 women, ranging from 14 to 66 years of age. There were 20 and 13 cases on the left and right sides, respectively. Patients underwent laparoscopic pyeloplasty (Anderson-Hynes operation). During the operation, either a Hem-o-lok clip suspension or transposition was used to treat the crossing vessels. The double-J stent was removed 8 weeks after the operation. The clinical data of patients were collected and follow-ups were regularly performed after the operation.

Results

All the crossing vessels were successfully preserved, and none of them were severed during the operation. The average operation time was 210.6 ± 58.9 min in this group and the average time to manage the crossing vessel was 8.0 ± 3.5 min, 5.9 ± 1.4 min in the suspension group, and 11.7 ± 3.0 min in the transposition group. The dilation of the affected side was 4.8 ± 1.5 cm before operation and 1.2 ± 1.3 cm 3 months after operation. The difference was statistically significant (P < 0.05). Follow-up to February 2020 showed no significant changes in the kidney size in all patients and hydronephrosis was relieved.

Conclusion

For UPJO patients with crossing vessel compression, the method of Hem-o-lok suspension or vascular transposition can be used to relieve crossing vascular compression and improve the success of pyeloplasty.
Determinants of knowledge and prevention measures towards COVID-19 pandemic among Lebanese dentists: a cross sectional survey
Authors: Hleyhel Mira , Haddad Christine , Haidar Nour , Charbachy Maria , Saleh Nadine
Published: May 2021

Background

Coronavirus Disease 2019 (COVID-19) is a major global threat. Healthcare professionals including dentists are facing real challenges during this pandemic. This study aimed to evaluate knowledge, attitudes, and prevention measures of Lebanese dentists towards COVID-19 and determinants of high level of knowledge and prevention practices.

Methods

A cross-sectional study was conducted between May and August 2020 in Lebanon on a random sample of 323 Lebanese dentists. Data were collected through an online survey questionnaire. A multivariate linear regression model was used to evaluate factors associated with COVID-19 knowledge. A multivariate logistic regression was conducted to evaluate the factors associated with high level of prevention measures towards COVID-19.

Results

The mean COVID-19 knowledge index was 24.5 over 38 with only 15% achieving high knowledge level. The mean prevention measures index was 11.4 over 16 with only 35% achieving high prevention level. Higher knowledge index was associated with younger age, being employed, and considering dentist’s role significant in teaching others about COVID-19. General dental practitioners, dentists living with family members and concerned about their family members to get infected because of their occupational exposure were more likely to report higher level of adopted prevention measures. Higher knowledge was associated with high level of prevention measures.

Conclusions

Given the rapid evolution of information related to COVID-19 pandemic, dentists should be regularly educated through trainings, workshops, and updates of national guidelines for dental healthcare.
Psychometric properties of brief-COPE inventory among nurses
Authors: Abdul Rahman Hanif , Bani Issa Wegdan , Naing Lin
Published: May 2021

Objective

Brief-COPE inventory is widely used to assess coping; however, validation evidence is absent and previous results were inconsistent. This study aimed to validate psychometric properties of this inventory to ensure culturally appropriate usage.

Methods

Preliminary validation study on 423 female nurses from the United Arab Emirates. Confirmatory factor analysis (CFA) with maximum likelihood estimation was computed to test four different previous models. Exploratory factor analysis (EFA) protocol was used to determine underlying domain structure of Brief-COPE in this population.

Results

The four previous models on CFA had inadequate fit indexes. Two-factor (22-items) second-order model that explained 37.0% of the total variance with Cronbach’s alpha at 0.81 and 0.88, respectively, was suggested.

Conclusion

This validation of Brief-COPE is timely considering nurses enduring different types of stressors. In addition, cultural diversity needs to be considered in coping research. Re-assessment of this exploratory structure is necessary to ensure accurate measurement of coping strategies.
The genome of a wild Medicago species provides insights into the tolerant mechanisms of legume forage to environmental stress
Authors: Wang Tianzuo , Ren Lifei , Li Caihong , Zhang Di , Zhang Xiuxiu , Zhou Gang , Gao Dan , Chen Rujin , Chen Yuhui , Wang Zhaolan , Shi Fengling , Farmer Andrew D. , Li Yansu , Zhou Mengyan , Young Nevin D. , Zhang Wen-Hao
Published: May 2021

Background

Medicago ruthenica, a wild and perennial legume forage widely distributed in semi-arid grasslands, is distinguished by its outstanding tolerance to environmental stress. It is a close relative of commonly cultivated forage of alfalfa (Medicago sativa). The high tolerance of M. ruthenica to environmental stress makes this species a valuable genetic resource for understanding and improving traits associated with tolerance to harsh environments.

Results

We sequenced and assembled genome of M. ruthenica using an integrated approach, including PacBio, Illumina, 10×Genomics, and Hi-C. The assembled genome was 904.13 Mb with scaffold N50 of 99.39 Mb, and 50,162 protein-coding genes were annotated. Comparative genomics and transcriptomic analyses were used to elucidate mechanisms underlying its tolerance to environmental stress. The expanded FHY3/FAR1 family was identified to be involved in tolerance of M. ruthenica to drought stress. Many genes involved in tolerance to abiotic stress were retained in M. ruthenica compared to other cultivated Medicago species. Hundreds of candidate genes associated with drought tolerance were identified by analyzing variations in single nucleotide polymorphism using accessions of M. ruthenica with varying tolerance to drought. Transcriptomic data demonstrated the involvements of genes related to transcriptional regulation, stress response, and metabolic regulation in tolerance of M. ruthenica.

Conclusions

We present a high-quality genome assembly and identification of drought-related genes in the wild species of M. ruthenica, providing a valuable resource for genomic studies on perennial legume forages.
Coordinated regulation of immune contexture: crosstalk between STAT3 and immune cells during breast cancer progression
Authors: Jin Jing , Li Yi , Zhao Qijie , Chen Yue , Fu Shaozhi , Wu JingBo
Published: May 2021

Recent insights into the molecular and cellular mechanisms underlying cancer development have revealed the tumor microenvironment (TME) immune cells to functionally affect the development and progression of breast cancer. However, insufficient evidence of TME immune modulators limit the clinical application of immunotherapy for advanced and metastatic breast cancers. Intercellular STAT3 activation of immune cells plays a central role in breast cancer TME immunosuppression and distant metastasis. Accumulating evidence suggests that targeting STAT3 and/or in combination with radiotherapy may enhance anti-cancer immune responses and rescue the systemic immunologic microenvironment in breast cancer. Indeed, apart from its oncogenic role in tumor cells, the functions of STAT3 in TME of breast cancer involve multiple types of immunosuppression and is associated with tumor cell metastasis. In this review, we summarize the available information on the functions of STAT3-related immune cells in TME of breast cancer, as well as the specific upstream and downstream targets. Additionally, we provide insights about the potential immunosuppression mechanisms of each type of evaluated immune cells.
Evidence of neuroplasticity with robotic hand exoskeleton for post-stroke rehabilitation: a randomized controlled trial
Authors: Singh Neha , Saini Megha , Kumar Nand , Srivastava M. V. Padma , Mehndiratta Amit
Published: May 2021

Background

A novel electromechanical robotic-exoskeleton was designed in-house for the rehabilitation of wrist joint and Metacarpophalangeal (MCP) joint.

Objective

The objective was to compare the rehabilitation effectiveness (clinical-scales and neurophysiological-measures) of robotic-therapy training sessions with dose-matched conventional therapy in patients with stroke.

Methods

A pilot prospective parallel randomized controlled study at clinical settings was designed for patients with stroke within 2 years of chronicity. Patients were randomly assigned to receive an intervention of 20 sessions of 45 min each, five days a week for four weeks, in Robotic-therapy Group (RG) (n = 12) and conventional upper-limb rehabilitation in Control-Group (CG) (n = 11). We intended to evaluate the effects of a novel exoskeleton based therapy on the functional rehabilitation outcomes of upper-limb and cortical-excitability in patients with stroke as compared to the conventional-rehabilitation. Clinical-scales– Modified Ashworth Scale, Active Range of Motion, Barthel-Index, Brunnstrom-stage and Fugl-Meyer (FM) scale and neurophysiological measures of cortical-excitability (using Transcranial Magnetic Stimulation) –Motor Evoked Potential and Resting Motor threshold, were acquired pre- and post-therapy.

Results

No side effects were noticed in any of the patients. Both RG and CG showed significant (p < 0.05) improvement in all clinical motor-outcomes except Modified Ashworth Scale in CG. RG showed significantly (p < 0.05) higher improvement over CG in Modified Ashworth Scale, Active Range of Motion and Fugl-Meyer scale and FM Wrist-/Hand component. An increase in cortical-excitability in ipsilesional-hemisphere was found to be statistically significant (p < 0.05) in RG over CG, as indexed by a decrease in Resting Motor Threshold and increase in the amplitude of Motor Evoked Potential. No significant changes were shown by the contralesional-hemisphere. Interhemispheric RMT-asymmetry evidenced significant (p < 0.05) changes in RG over CG indicating increased cortical-excitability in ipsilesional-hemisphere along with interhemispheric changes.

Conclusion

Robotic-exoskeleton training showed improvement in motor outcomes and cortical-excitability in patients with stroke. Neurophysiological changes in RG could most likely be a consequence of plastic reorganization and use-dependent plasticity.

Trial registry number: ISRCTN95291802
Comparison of liver exposure in CT-guided high-dose rate (HDR) interstitial brachytherapy versus SBRT in hepatocellular carcinoma
Authors: Walter Franziska , Nierer Lukas , Rottler Maya , Duque Anna Sophie , Weingandt Helmut , Well Justus , Shpani Roel , Landry Guillaume , Seidensticker Max , Streitparth Florian , Ricke Jens , Belka Claus , Corradini Stefanie
Published: May 2021

Background

In unresectable hepatocellular carcinoma several local ablative treatments are available. Among others, radiation based treatments such as stereotactic body radiotherapy (SBRT) and high-dose rate interstitial brachytherapy (HDR BT) have shown good local control rates.

Methods

We conducted a dose comparison between actually performed HDR BT versus virtually planned SBRT to evaluate the respective clinically relevant radiation exposure to uninvolved liver tissue. Moreover, dose coverage and conformity indices were assessed.

Results

Overall, 46 treatment sessions (71 lesions, 38 patients) were evaluated. HDR BT was applied in a single fraction with a dose prescription of 1 × 15 Gy. D98 was 17.9 ± 1.3 Gy, D50 was 41.8 ± 8.1 Gy. The SBRT was planned with a prescribed dose of 3 × 12.5 Gy (65%-Isodose), D98 was 50.7 ± 3.1 Gy, D2 was 57.0 ± 2.3 Gy, and D50 was 55.2 ± 2.3 Gy.

Regarding liver exposure Vliver10GyBT was compared to Vliver15.9GySBRT, Vliver16.2GySBRT (EQD2 equivalent doses), and Vliver20GySBRT (clinically relevant dose), all results showed significant differences (p < .001). In a case by case analysis Vliver10GyBT was smaller than Vliver20GySBRT in 38/46 cases (83%). Dmean of the liver was significantly smaller in BT compared to SBRT (p < .001).

GTV volume was correlated to the liver exposure and showed an advantage of HDR BT over SBRT in comparison of clinically relevant doses, and for EQD2 equivalent doses. The advantage was more pronounced for greater liver lesions The Conformity Index (CI) was significantly better for BT, while Healthy Tissue Conformity Index (HTCI) and Conformation Number (CN) showed an advantage for SBRT (p < .001).

Conclusion

HDR BT can be advantageous in respect of sparing of normal liver tissue as compared to SBRT, while providing excellent target conformity.
Clinical and laboratory prognosticators of atrophic papulosis (Degos disease): a systematic review
Authors: Lu Justin D. , Sachdeva Muskaan , Silverberg Orli M. , Shapiro Lee , Croitoru David , Levy Rebecca
Published: May 2021

Background

Degos disease is a rare vascular disorder with a cutaneous-limited form, benign atrophic papulosis (BAP), and a systemic variant, malignant atrophic papulosis (MAP). Despite the poor prognosis of MAP, no study has established features associated with systemic disease.

Objectives

The aims of this systematic review were to: (1) summarize clinical features and treatments implemented for patients with MAP and BAP (2) identify clinical and laboratory factors associated with the development of MAP, compared to BAP.

Methods

We systematically searched MEDLINE and Embase from inception to April 2020. Demographic and clinical features of Degos patients were presented descriptively; multivariable logistic regression was performed to identify associations with MAP.

Results

We identified 99 case studies, comprising 105 patients. MAP (64%) had a 2.15 year median survival time from cutaneous onset, most often with gastrointestinal or central nervous system involvement. We found that elevations in either of erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) were associated with systemic involvement (OR 2.27, p = 0.023). Degos secondary to an autoimmune connective tissue disease was found to be inversely associated with MAP (OR 0.08, p = 0.048).

Conclusions

Elevated ESR or CRP is associated with MAP and may be a predictor of systemic involvement for patients with Degos disease. In addition, secondary Degos disease is associated with a favourable prognosis. Clinicians should be aware of the differences between primary and secondary Degos and the utility of ESR or CRP in identifying disease evolution to systemic involvement. The utility of ESR and CRP to identify systemic involvement should be further explored.
A survey of pre-weaning calf management in Norwegian dairy herds
Authors: Johnsen Julie Føske , Holmøy Ingrid Hunter , Nødtvedt Ane , Mejdell Cecilie Marie
Published: May 2021

The knowledge on dairy calves’ needs with regards to milk feeding and social housing is expanding but to be able to make improvements, knowledge is needed on how calves are managed at present in Norway. The aim of this study was to describe selected milk-feeding practices and social housing procedures for young (pre-weaning) dairy calves in Norwegian herds. A short questionnaire was distributed to a random sample of 912 dairy producers. For each herd, we asked how much milk was fed to 3 week old dairy calves, number of daily milk feedings, usage of milk replacer, number of weeks calves were housed in single pens, and whether calves at 3 weeks had free access to drinking water. In total, 508 herd managers responded to the questionnaire (56% response rate). Descriptive statistics showed that median milk allowance for 3 week old calves was seven (IQR 6–8) L milk/d, ranging from 2 to 15 L/day. Consequently, 311 (61%) herds reportedly fed less than the current industry recommendation in Norway (8 L milk/d to young calves). Automatic milk feeders were used by 30 herds (6%). In herds feeding milk manually (n = 471), half of the herds (50%) fed milk twice daily. Median number of daily milk feedings was 3 (31%) while 13% fed four times/day or more frequent (6%). Of the 226 producers (46%) who reported to use milk replacer, this milk type was used from the calf age of (median) 2 weeks. Of all herds, 82 (16%) did not provide their 3 week old calves with free access to drinking water. In the surveyed herds, calves were housed in single pens for (median) 2 weeks (IQR 2–3), while legislation allows single housing until the age of 8 weeks. In conclusion, the milk allowances reported in this survey are low compared to industry recommendations which again are low compared to voluntary intakes of young dairy calves. Free access to drinking water is important to calf welfare but was not granted to all dairy calves. Most calves were reportedly group housed at an early age, which indicates an improved awareness with regards to the importance of social housing.
Towards sustainable production and utilization of plant-biomass-based nanomaterials: a review and analysis of recent developments
Authors: Zhu J. Y. , Agarwal Umesh P. , Ciesielski Peter N. , Himmel Michael E. , Gao Runan , Deng Yulin , Morits Maria , Österberg Monika
Published: May 2021

Plant-biomass-based nanomaterials have attracted great interest recently for their potential to replace petroleum-sourced polymeric materials for sustained economic development. However, challenges associated with sustainable production of lignocellulosic nanoscale polymeric materials (NPMs) need to be addressed. Producing materials from lignocellulosic biomass is a value-added proposition compared with fuel-centric approach. This report focuses on recent progress made in understanding NPMs—specifically lignin nanoparticles (LNPs) and cellulosic nanomaterials (CNMs)—and their sustainable production. Special attention is focused on understanding key issues in nano-level deconstruction of cell walls and utilization of key properties of the resultant NPMs to allow flexibility in production to promote sustainability. Specifically, suitable processes for producing LNPs and their potential for scaled-up production, along with the resultant LNP properties and prospective applications, are discussed. In the case of CNMs, terminologies such as cellulose nanocrystals (CNCs) and cellulose nanofibrils (CNFs) used in the literature are examined. The term cellulose nano-whiskers (CNWs) is used here to describe a class of CNMs that has a morphology similar to CNCs but without specifying its crystallinity, because most applications of CNCs do not need its crystalline characteristic. Additionally, progress in enzymatic processing and drying of NPMs is also summarized. Finally, the report provides some perspective of future research that is likely to result in commercialization of plant-based NPMs.
Modelling the transmission dynamics of severe fever with thrombocytopenia syndrome in Jiangsu Province, China
Authors: Zhang Nan , Cheng Xiao-Qing , Deng Bin , Rui Jia , Qiu Luxia , Zhao Zeyu , Lin Shengnan , Liu Xingchun , Xu Jingwen , Wang Yao , Yang Meng , Zhu Yuanzhao , Huang Jiefeng , Liu Chan , Liu Weikang , Luo Li , Li Zhuoyang , Li Peihua , Yang Tianlong , Li Zhi-Feng , Liang Shu-Yi , Wang Xiao-Chen , Hu Jian-Li , Chen Tianmu
Published: May 2021

Background

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that is regionally distributed in Asia, with high fatality. Constructing the transmission model of SFTS could help provide clues for disease control and fill the gap in research on SFTS models.

Methods

We built an SFTS transmission dynamics model based on the susceptible–exposed–infectious–asymptomatic–recovered (SEIAR) model and the epidemiological characteristics of SFTS in Jiangsu Province. This model was used to evaluate the effect by cutting off different transmission routes and taking different interventions into account, to offer clues for disease prevention and control.

Results

The transmission model fits the reported data well with a minimum R2 value of 0.29 and a maximum value of 0.80, P < 0.05. Meanwhile, cutting off the environmental transmission route had the greatest effect on the prevention and control of SFTS, while isolation and shortening the course of the disease did not have much effect.

Conclusions

The model we have built can be used to simulate the transmission of SFTS to help inform disease control. It is noteworthy that cutting off the environment-to-humans transmission route in the model had the greatest effect on SFTS prevention and control.

Graphical Abstract
Angiotensin-(1–7) oral formulation improves physical performance in mountain bike athletes: a double‐blinded crossover study
Authors: de Moura Samara Silva , Mendes Adália Táci Pereira , de Assis Dias Martins-Júnior Francisco , Totou Nádia Lúcia , Coelho Daniel Barbosa , Oliveira Emerson Cruz de , Motta-Santos Daisy , dos Santos Robson Augusto Souza , Becker Lenice Kappes
Published: May 2021

Background

The ECA2/Ang-(1–7)/Mas axis is shown to be involved in effects mediated by physical exercise, as it can induce the release of nitric oxide (ON) and bradykinin (BK), which are potent vasodilators. The vasodilating action the NO/BK can contribute to increased metabolic efficiency in muscle tissue and central nervous system. The formulation HPβ-CD-Ang-(1–7) through its mechanisms of action can be a promising supplement to aid in the maintenance and improvement of performance and may also favor recovery during competitions. The premise of this study was to investigate the effects of acute oral supplementation HPβ-CD-Ang-(1–7) on the performance of mountain bike (MTB) practitioners.

Methods

Fourteen recreational athletes, involved in training programs for at least one year, participated in this crossover design study. Subjects underwent two days of testing with a seven-day interval. HPβ-CD-Ang-(1–7) (1.75 mg) and HPβCD-Placebo were provided in capsules three hours prior to tests. To determine the safety of the HPβ-CD-Ang-(1–7) formulation associated with physical effort, cardiovascular parameters heart rate (HR) and blood pressure (BP) were analyzed. Physical performance was measured using maximal oxygen uptake (VO2), total exercise time (TET), mechanical work (MW), mechanical efficiency (ME), and rating of perceived exertion (RPE). Respiratory exchange coefficient (REC), lactate and non-esterified fatty acids (NEFAs) were measured. Maximal incremental tests were performed on a progressively loaded leg cycle ergometer.

Results

There were no significant differences in terms of HR or BP at rest and maximum effort between the HPβ-CD-Ang-(1–7) and placebo groups. The VO2max showed significant differences (p = 0.04). It was higher in the Ang-(1–7)condition (66.15 mlO2.kg− 1.min− 1) compared to the placebo (60.72 mlO2.kg− 1.min− 1). This was also observed for TET (Ang-(1–7) 39.10 min vs. placebo 38.14 min; p = 0.04), MW (Ang-(1–7) 156.7 vs. placebo 148.2; p = 0.04), and at the lowest RPE (Ang-(1–7) vs. placebo; p = 0.009). No significant differences were observed for REC, NEFAs, or Lactate.

Conclusions

These results suggest that HPβ-CD-Ang-(1–7) improves the physical performance of MTB recreational athletes and could be a promising supplement.

Trial registration

RBR-2 × 56pw8, registered January 15th, 2021. The study was prospectively registered.