bluuebunny/crossref_metadata_2025 huggingface dataset:
Geospatial Artificial Intelligence (GeoAI)
Authors: Gao Song
Published: March 2021

Nowadays, artificial intelligence (AI) is bringing tremendous new opportunities and challenges to geospatial research. Its fast development is powered by theoretical advancement, big data, computer hardware (e.g., the graphics processing unit, or GPU), and high-performance computing platforms that support the development, training, and deployment of AI models within a reasonable amount of time. Recent years have witnessed significant advances in geospatial artificial intelligence (GeoAI), which is the integration of geospatial studies and AI, especially machine learning and deep learning methods and the latest AI technologies in both academia and industry. GeoAI can be regarded as a study subject to develop intelligent computer programs to mimic the processes of human perception, spatial reasoning, and discovery about geographical phenomena and dynamics; to advance our knowledge; and to solve problems in human environmental systems and their interactions, with a focus on spatial contexts and roots in geography or geographic information science (GIScience). Thus, it would require the knowledge of AI theory, programming and computation practices as well as geographic domain knowledge to be competent in GeoAI research. There have already been increasingly collaborative GeoAI studies for GIScience, remote sensing, physical environment, and human society. It is a good time to provide a key reference list for educators, students, researchers, and practitioners to keep up with the latest GeoAI research topics. This bibliographical entry will first review the historical roots for AI in geography and GIScience and then list up to ten selective recent works with annotations that briefly describe their importance for each topic of interest in the GeoAI landscape, ranging from fundamental spatial representation learning to spatial predictions and to various advancements in cartography, earth observation, social sensing, and geospatial semantics.
Lyme Carditis in Hospitalized Children and Adults, a Case Series
Authors: Shen Richard V , McCarthy Carol A , Smith Robert P
Published: March 2021

Background

Lyme carditis is an uncommon manifestation of Lyme disease. This report compares Lyme carditis presentation, management, and outcomes in pediatric and adult populations.

Methods

Charts of pediatric and adult patients with heart block (PR interval >300 ms) and positive Lyme serologies hospitalized in Portland, Maine, between January 2010 and December 2018 were analyzed. Data on medical history, presentation, treatment, and outcomes are described.

Results

Ten children and 20 adults were admitted for Lyme carditis between June and October. Ninety percent were male, and 87% had no prior cardiac history. Seventeen had outpatient evaluation before admission. Of these, a minority (41%) had Lyme disease suspected in the outpatient setting, and fewer (12%) were initiated on Lyme disease treatment. The most common alternate diagnoses were viral illness and erythema multiforme. More children than adults had disseminated erythema migrans and fever. First-degree heart block was more prevalent in children, and Mobitz type 2 heart block was more prevalent in adults. Ten patients presented with syncope. Proportionately more adults needed temporary pacing. Children had shorter antibiotic durations compared with adults. Of the 30 cases, 27 had improved heart block, while 3 adults required a pacemaker at discharge. Nine children and 14 adults were discharged with a PR 200–300 ms. There was a single death in this series.

Conclusions

Cases tended to be younger males. Most patients had some heart block on discharge. Of patients evaluated as outpatients, Lyme disease was suspected in 41%. Improved early recognition and treatment of Lyme disease may decrease Lyme carditis.
Mortality threat mitigates interpersonal competition: an EEG-based hyperscanning study
Authors: Zhou Xiaoyu , Pan Yafeng , Zhang Ruqian , Bei Litian , Li Xianchun
Published: March 2021

Awareness of death has been shown to influence human cognition and behavior. Yet, how mortality threat (MT) impacts our daily social behavior remains elusive. To address this issue, we developed a dyadic experimental model and recruited 86 adults (43 dyads) to complete two computer-based tasks (i.e. competitive and cooperative button-pressing). We manipulated dyads’ awareness of death [MT vs neutral control (NC)] and simultaneously measured their neurophysiological activity using electroencephalography during the task. Several fundamental observations were made. First, the MT group showed significantly attenuated competition and slightly promoted cooperation. Second, compared to NC, MT significantly decreased gamma-band inter-brain synchronization (IBS) in the competitive context, which was associated with increased subjective fear of death within dyads. Notably, those effects were context-specific: we did not observe comparable results in the cooperative context. Finally, a machine-learning approach was successfully used to discriminate between the MT and NC groups based on accumulated IBS. Together, these findings indicate that MT to some extent mitigates interpersonal competition, and such mitigation might be associated with changes in gamma-band IBS.
Brain activation during the observation of real soccer game situations predicts creative goal scoring
Authors: Rominger Christian , Koschutnig Karl , Memmert Daniel , Papousek Ilona , Perchtold-Stefan Corinna M , Benedek Mathias , Schwerdtfeger Andreas R , Fink Andreas
Published: March 2021

Creativity is an important source of success in soccer players. In order to be effective in soccer, unpredictable, sudden and at the same time creative (i.e. unique, original and effective) ideas are required in situations with high time pressure. Accordingly, creative task performance in soccer should be primarily driven by rapid and automatic cognitive processes. This study investigated if functional patterns of brain activation during the observation/encoding of real soccer game situations can predict creative soccer task performance. A machine learning approach (multivariate pattern recognition) was applied in a sample of 35 experienced male soccer players. The results revealed that brain activation during the observation of the soccer scenes significantly predicted creative soccer task performance, while brain activation during the subsequent ideation/elaboration period did not. The identified brain network included areas such as the angular gyrus, the supramarginal gyrus, the occipital cortex, parts of the cerebellum and (left) supplementary motor areas, which are important for semantic information processing, memory retrieval, integration of sensory information and motor control. This finding suggests that early and presumably automatized neurocognitive processes, such as (implicit) knowledge about motor movements, and the rapid integration of information from different sources are important for creative task performance in soccer.
Sleep-dependent prospective memory consolidation is impaired with aging
Authors: Leong Ruth L F , Lo June C , Chee Michael W L
Published: March 2021

Study Objectives

Existing literature suggests that sleep-dependent memory consolidation is impaired in older adults but may be preserved for personally relevant information. Prospective memory (PM) involves remembering to execute future intentions in a timely manner and has behavioral importance. As previous work suggests that N3 sleep is important for PM in young adults, we investigated if the role of N3 sleep in PM consolidation would be maintained in older adults.

Methods

Forty-nine young adults (mean age ± SD: 21.8 ± 1.61 years) and 49 healthy older adults (mean age ± SD: 65.7 ± 6.30 years) were randomized into sleep and wake groups. After a semantic categorization task, participants encoded intentions comprising four related and four unrelated cue-action pairs. They were instructed to remember to perform these actions in response to cue words presented during a second semantic categorization task 12 h later that encompassed either daytime wake (09:00 am–21:00 pm) or overnight sleep with polysomnography (21:00 pm–09:00 am).

Results

The significant condition × age group × relatedness interaction suggested that the sleep benefit on PM intentions varied according to age group and relatedness (p = 0.01). For related intentions, sleep relative to wake benefitted young adults’ performance (p < 0.001) but not older adults (p = 0.30). For unrelated intentions, sleep did not improve PM for either age group. While post-encoding N3 was significantly associated with related intentions’ execution in young adults (r = 0.43, p = 0.02), this relationship was not found for older adults (r = −0.07, p = 0.763).

Conclusions

The age-related impairment of sleep-dependent memory consolidation extends to PM. Our findings add to an existing body of work suggesting that the link between sleep and memory is functionally weakened in older adulthood.
Loss of putative GABAergic neurons in the ventrolateral medulla in multiple system atrophy
Authors: Schmeichel Ann M , Coon Elizabeth A , Parisi Joseph E , Singer Wolfgang , Low Phillip A , Benarroch Eduardo E
Published: March 2021

Study Objectives

Multiple system atrophy (MSA) is associated with disturbances in cardiovascular, sleep and respiratory control. The lateral paragigantocellular nucleus (LPGi) in the ventrolateral medulla (VLM) contains GABAergic neurons that participate in control of rapid eye movement (REM) sleep and cardiovagal responses. We sought to determine whether there was loss of putative GABAergic neurons in the LPGi and adjacent regions in MSA.

Methods

Sections of the medulla were processed for GAD65/67 immunoreactivity in eight subjects with clinical and neuropathological diagnosis of MSA and in six control subjects. These putative GABAergic LPGi neurons were mapped based on their relationship to adjacent monoaminergic VLM groups.

Results

There were markedly decreased numbers of GAD-immunoreactive neurons in the LPGi and adjacent VLM regions in MSA.

Conclusions

There is loss of GABAergic neurons in the VLM, including the LPGi in patients with MSA. Whereas these findings provide a possible mechanistic substrate, given the few cases included, further studies are necessary to determine whether they contribute to REM sleep-related cardiovagal and possibly respiratory dysregulation in MSA.
The effect of time of feeding on plasma amino acids during exercise and recovery in horses
Authors: Graham-Thiers Patty M , Bowen LaAnn K
Published: March 2021

Feeding management in horses suggests feeding horses in advance of exercise, particularly the grain portion of the diet. Plasma amino acids (AA) peak at 3 to 6 h postfeeding depending on the AA. The timeframe between feeding and exercise may affect the availability of AA during and after exercise. The purpose of this study was to observe the differences in plasma AA in horses fed prior to exercise or after exercise. Eight light type horses were fed a diet with adequate protein and AA for horses in light to moderate exercise. After an adjustment period, horses completed a standardized exercise test (SET). Relative to the SET, horses were fed either 2 h prior (PRE horses) to the SET, 1 h after completing the SET (POST horses), or horses remained fasted throughout the sampling period (FASTED horses). Plasma was drawn prior to exercise, at the peak of exercise as well as at 1, 2, 4, and 7 h postexercise. Plasma was analyzed for AA, glucose, lactate, creatinine, creatine kinase, ammonia, urea-N, and 3-methylhistdine. After completion of the SET and sampling period, horses entered a 1-wk recovery period, which was followed by another SET. The protocol repeated until horses rotated through all feeding protocols in the study (three SETs). The majority of the plasma AA were elevated in PRE horses compared with POST horses prior to the SET until 2 h postexercise where POST horses’ plasma AA concentrations became elevated and remained elevated until the end of the sampling period. In that same time frame, plasma AA for the PRE group decreased out to the end of the sampling period. The elevation of plasma AA in POST horses would be expected as they were fed at 1 h postexercise, whereas PRE horses were reaching a 4 h postfeeding time frame at this point. This elevation was not observed for plasma concentrations of isoleucine, leucine, methionine, and histidine. Concentrations of these AA initially were greater for POST horses in the postexercise period; however, they declined more rapidly than the other AA. The rapid decrease of some of the plasma AA concentrations may suggest uptake by muscle for recovery. This in conjunction with a decrease in plasma creatine kinase concentrations for POST horses suggests that feeding postexercise may facilitate better muscle protein balance (synthesis vs. breakdown) in the recovery period following exercise.
Do knowledge about sodium, health status by self-report, and having hypertension predict sodium consumption behaviors among Southern California hospital employees?
Authors: D’Addario Lia , Kuo Tony , Robles Brenda
Published: March 2021

Lay Summary

A major problem in the United States is the overconsumption of high sodium foods. These foods often put people at higher risk of hypertension, heart disease, and stroke. Recent public health efforts have tackled this problem by making it easier to select/purchase healthier, lower sodium foods in different settings. Hospital employees are one such group that has been the focus of these interventions. Presently, little is known about what explains sodium-related dietary behaviors among hospital employees. To address this gap, we used data from a survey of hospital staff who were exposed to sodium reduction interventions in the workplace to examine how their knowledge, attitudes, and self-reported health status affected their sodium consumption. A key finding was being in “good health” and having the belief that salt intake matters for health predicted decreased sodium consumption among the survey participants. These and other study findings provide context and insights into ways in which further sodium reduction could be achieved among at-risk hospital employees.
Retrosplenial Cortex Contributes to Network Changes during Seizures in the GAERS Absence Epilepsy Rat Model
Authors: Wachsmuth Lydia , Datunashvili Maia , Kemper Katharina , Albers Franziska , Lambers Henriette , Lüttjohann Annika , Kreitz Silke , Budde Thomas , Faber Cornelius
Published: March 2021

Resting state-fMRI was performed to explore brain networks in Genetic Absence Epilepsy Rats from Strasbourg and in nonepileptic controls (NEC) during monitoring of the brain state by simultaneous optical Ca2+-recordings. Graph theoretical analysis allowed for the identification of acute and chronic network changes and revealed preserved small world topology before and after seizure onset. The most prominent acute change in network organization during seizures was the segregation of cortical regions from the remaining brain. Stronger connections between thalamic with limbic regions compared with preseizure state indicated network regularization during seizures. When comparing between strains, intrathalamic connections were prominent in NEC, on local level represented by higher thalamic strengths and hub scores. Subtle differences were observed for retrosplenial cortex (RS), forming more connections beyond cortex in epileptic rats, and showing a tendency to lateralization during seizures. A potential role of RS as hub between subcortical and cortical regions in epilepsy was supported by increased numbers of parvalbumin-positive (PV+) interneurons together with enhanced inhibitory synaptic activity and neuronal excitability in pyramidal neurons. By combining multimodal fMRI data, graph theoretical methods, and electrophysiological recordings, we identified the RS as promising target for modulation of seizure activity and/or comorbidities.
Effect of Steroidal Glycoalkaloids on Hatch and Reproduction of the Potato Cyst Nematode Globodera pallida
Authors: Sivasankara Pillai Syamkumar , Dandurand Louise-Marie
Published: March 2021

Steroidal glycoalkaloids (SGAs) are phytoanticipins found in solanaceous crops that act as the first line of chemical defense against pathogen attacks. Solanum sisymbriifolium, a trap crop for potato cyst nematodes, has been shown to effectively reduce populations of Globodera pallida. S. sisymbriifolium contains α-solamargine and other solasodine-type glycoalkaloids that may contribute to plant defenses. This study evaluated the influence of solanaceous SGAs on G. pallida hatch, development, and reproduction. Exposure to α-solamargine and α-solamarine reduced G. pallida hatch by 65 and 87%, respectively. Exposure of G. pallida cysts with the glycoalkaloids α-solamargine and solasodine significantly reduced infection in susceptible potato ‘Russet Burbank’ by 98 and 94% compared with the control. Exposure of cysts to either solasodine or solamargine significantly reduced reproduction of G. pallida on ‘Russet Burbank’ by 99% compared with the control. The study demonstrated the deleterious effect of SGAs on G. pallida hatch, infection, and reproduction.
A Most Welcome Spring
Authors: Kennedy Maureen Shawn
Published: March 2021

The end of this year's winter brings much-needed hope.
Continuous Physiological Monitoring Improves Patient Outcomes
Authors: Stellpflug Courtney , Pierson Laura , Roloff Devin , Mosman Elton , Gross Tera , Marsh Scott , Willis Valerie , Gabrielson Donald
Published: March 2021

Background:

General patient acuity is increasing in the United States, with more patients having multiple comorbidities and acute-on-chronic conditions. Hospitalizations may also be complicated by serious adverse events, often unrelated to the admitting medical diagnosis. In our facility, the late detection of patient deterioration on general medical units often resulted in increased length of stay (LOS) in the ICU and poor patient outcomes.

Purpose:

The purpose of this project was to improve patient surveillance and better identify early signs of patient deterioration through the use of continuous vital sign monitoring technology.

Methods:

To improve detection of patient deterioration, a nurse-led monitoring and response system was developed using a wearable, wireless device for continuous vital sign surveillance. The patient data the device provided was used with early warning scores and sepsis screening protocols for timely goal-directed interventions.

Results:

Ninety-seven percent of patient deterioration events were recognized and treated as a result of this continuous monitoring and response system. Rapid response team activations decreased by 53% between baseline and the intervention period. LOS among patients transferred to the ICU decreased from 2.82 to 2.19 days. Nurse satisfaction with use of the continuous monitoring device was positive, with 74% of nurses surveyed reporting that information provided by the device enhanced decision-making.

Conclusions:

New technology for patient surveillance, in this case a nurse-led monitoring and response system, can be successfully integrated into general care practice. Use of the nurse-led response system helped nurses recognize early signs of deterioration and continue meaningful patient interactions.
Transmission of Cervical Cancer from Mother to Child
Authors: Rosenberg Karen
Published: March 2021

According to this study:

Case reports indicate that mother-to-child transmission of uterine cervical cancer is possible during vaginal delivery.

Cesarean section should be recommended for mothers who have uterine cervical cancer.
Gene and Stem Cell Therapies for Fetal Care: A Review
Authors: O’Connell Amy E. , Guseh Stephanie , Lapteva Larissa , Cummings Christy L. , Wilkins-Haug Louise , Chan Jerry , Peranteau William H. , Almeida-Porada Graça , Kourembanas Stella
Published: March 2021

(Abstracted from JAMA Pediatr 2020;174(10):985–991)

In utero stem cell transplantation and gene therapy have the ability to cure and treat many different genetic disorders in children and adults. For some conditions, this could be applied before birth and allow for better outcomes, as well as reduce the financial burden put on families with children with genetic disorders.
Exome Sequencing for Prenatal Diagnosis in Nonimmune Hydrops Fetalis
Authors: Sparks Teresa N. , Lianoglou Billie R. , Adami Rebecca R. , Pluym Ilina D. , Holliman Kerry , Duffy Jennifer , Downum Sarah L. , Patel Sachi , Faubel Amanda , Boe Nina M. , Field Nancy T. , Murphy Aisling , Laurent Louise C. , Jolley Jennifer , Uy Cherry , Slavotinek Anne M. , Devine Patrick , Hodoglugil Ugur , van Ziffle Jessica , Sanders Stephan J. , MacKenzie Tippi C. , Norton Mary E.
Published: March 2021

(Abstracted from N Engl J Med 2020;383:1746–1756)

Nonimmune hydrops fetalis (NIHF) is a condition complicating approximately 1 in 1700 to 3000 pregnancies where the fetus develops an overload of fluid, causing a wide range of outcomes such as stillbirth, preterm birth, neonatal complications, or neonatal death. Standard genetic testing with microarray or karyotype identifies a genetic cause of hydrops approximately only 25% of the time.
Bladder Bacterial Diversity Differs in Continent and Incontinent Women: A Cross-sectional Study
Authors: Price Travis K. , Lin Huaiying , Gao Xiang , Thomas-White Krystal J. , Hilt Evann E. , Mueller Elizabeth R. , Wolfe Alan J. , Dong Qunfeng , Brubaker Linda
Published: March 2021

(Abstracted from Am J Obstet Gynecol 2020;223:729.e1–729.e10)

Interest has grown since the discovery of the bladder urobiome in determining whether the microbiota in the urobiome play a role in clinical phenotyping and provide opportunities for novel therapeutic approaches for women with the 2 most common forms of urinary incontinence (UI): stress UI (SUI) and urgency UI (UUI). However, previous studies have focused predominantly on UUI, and thus, studies on SUI have been lacking.
Can intraoperative ultrasound visualize the closed reduction and elastic intramedullary nail fixation processes of double forearm fractures in children?
Authors: Yang Xiaodong , Li Lang , Tang Xueyang , Xiang Bo , Wen Tianfu
Published: March 2021

To evaluate the feasibility of utilizing ultrasonography to monitor the fracture reduction and elastic intramedullary nail fixation processes in treating children with double forearm fractures. A retrospective analysis of 30 children with double forearm fractures treated at our hospital between January 2016 and July 2018. The children were aged 3 to 10 years. All patients were treated with closed reduction and internal fixation with elastic intramedullary nails using intraoperative ultrasound monitoring and intermittent radiographic imaging. The closed reduction and fixation were successful in all patients. The operation times ranged from 16 to 30 minutes, averaging 21 minutes. No neurovascular injuries occurred during closed reduction and nail insertion. Moreover, closed reduction was successful in the first attempt in 86.7% of patients. All patient outcomes were optimal, lacking serious complications during follow-ups. Intraoperative ultrasound monitoring can clearly show the shape and changes in fracture ends, distal growth plates, and surrounding soft tissues, and fracture reduction and passage of elastic nail processes at fracture ends during closed reduction; therefore, visualizing closed reductions can be achieved. The combination of intraoperative ultrasound and radiographic imaging can ensure operative effects and significantly reduce radiation exposure for both doctors and patients. An adequately powered prospective randomized trial is required to confirm our findings.
Increased expression of microRNA-26a-5p predicted a poor survival outcome in osteosarcoma patients
Authors: Xie Xiao-Yu , Chen Xian-Ming , Shi Ling , Liu Jun-Wei
Published: March 2021

MicroRNA (miR)-26a-5p is an oncogene significantly associated with osteosarcoma. We try to evaluate expression of circulating miR-26a-5p in osteosarcoma patients and evaluate its significance.

A total of 243 consecutive osteosarcoma patients and 96 healthy participates were enrolled. Circulating miR-26a-5p levels were evaluated by using real-time quantitative reverse transcription polymerase chain reactions (RT-PCR). The association between circulating miR-26a-5p level and survival outcomes was evaluated by univariate and multivariate analysis.

Circulating miR-26a-5p levels in osteosarcoma patients was significantly higher than that of healthy volunteers (P < .05). Upregulated miR-26a-5p was significantly related to advanced cancer and metastasis (both P < .05). Moreover, patients with a high serum miR-26a-5p had a poorer overall survival than those with a low serum miR-26a-5p levels (P < .05). Circulating miR-26a-5p level also been showed as independent risk factor for osteosarcoma in multivariate analysis (hazard ratio [HR], 0.38; 95% confidence interval [CI]: 0.11–0.98; P < .01).

Circulating miR-26a-5p was significantly upregulated in osteosarcoma patients and remarkably associated with poor prognosis, indicating that circulating miR-26a-5p might serve as a useful diagnostic and prognostic biomarker for osteosarcoma.
Effect of nursing intervention to guide early postoperative activities on rapid rehabilitation of patients undergoing abdominal surgery
Authors: Rao Lu , Liu Xinjian , Yu Li , Xiao Hui
Published: March 2021

Background:

Postoperative complications after abdominal surgery are high, and there is no reliable intervention program to prevent them. Some studies have pointed out that early postoperative activities have advantages in preventing the occurrence of complications, but lack of evidence-based basis. The purpose of this study is to systematically evaluate the effect of nursing intervention is guiding early postoperative activities on the rapid recovery of patients undergoing abdominal surgery.

Methods:

China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database and Chinese Biomedical Database, PubMed, Embase, Web of Science and the Cochrane Library will be searched by computer, and a randomized controlled study is conducted on early participation in exercise programs after abdominal surgery from the establishment of the database to January 2021. The language is limited to English and Chinese. The quality of the included study is independently extracted and the literature quality is evaluated by 2 researchers, and the included literature is analyzed by Meta using RevMan5.3 software.

Results:

This study will evaluate the effect of nursing intervention is guiding early postoperative activities on the rapid rehabilitation of patients undergoing abdominal surgery through the indexes of postoperative quality of life score, the incidence of complications, mortality, length of stay and so on.

Conclusion:

This study will provide reliable evidence-based basis for establishing a reasonable and effective postoperative activity guidance program for patients undergoing abdominal surgery.

Ethics and dissemination:

Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.

OSF Registration number:

DOI 10.17605/OSF.IO/59MD4
Neonatal hereditary spherocytosis caused by a de novo frameshift mutation of the SPTB gene characterized by hydrops fetalis
Authors: Zhang Yimin , Shao Shuming , Liu Jie , Zeng Chaomei , Han Ye , Zhang Xiaorui
Published: March 2021

Rationale:

The etiology of non-immune hydrops fetalis is complex, and its prognosis is poor. One of its main causes is anemia. There are few reports on hydrops fetalis due to anemia caused by hereditary spherocytosis (HS), especially regarding its occurrence in the neonatal period. Thus, we report on a case of neonatal HS caused by a new SPTB gene mutation that was characterized by hydrops fetalis.

Patient concerns:

A neonate with intrauterine hydrops fetalis showed severe hyperbilirubinemia and anemia, reticulocytosis, and hepatosplenomegaly. Laboratory examination findings were normal.

Diagnoses:

Gene sequencing of the patient and his parents showed a de novo frameshift mutation in the patient's SPTB gene. Ultimately, the patient was diagnosed with HS.

Interventions:

Exchange and red blood cell transfusions were performed in the neonatal period.

Outcomes:

The child was discharged from the hospital 14 days postnatal because his hemoglobin and bilirubin levels were stable. Red blood cell transfusion was performed once in infancy; however, no further red blood cell transfusions were required within 2 years of age.

Lessons:

Hydrops fetalis can be a manifestation of HS. Genetic detection can help confirm the diagnosis of suspected neonatal HS undocumented by other laboratory examinations.
Construction of a prognostic value model in papillary renal cell carcinoma by immune-related genes
Authors: Wang Leilei , Gu Weile , Ni Huijun
Published: March 2021

Papillary renal cell carcinoma (PRCC) is the second most common type of renal carcinoma following clear cell renal cell carcinoma, and the role of immune-related genes (IRGs) in tumorigenesis and metastasis is evident; its prognostic value in PRCC remains unclear. In this study, we downloaded the gene expression profiles and clinical data of patients with PRCC from The Cancer Genome Atlas (TCGA) database and obtained IRGs from the ImmPort database. A total of 371 differentially expressed IRGs (DEIRGs) were discovered between PRCC and normal kidney tissues. Prognostic DEIRGs (PDEIRGs) were identified by univariate Cox regression analysis. Then, we screened the four most representative PDEIRGs (IL13RA2, CCL19, BIRC5, and INHBE) and used them to construct a risk model to predict the prognosis of patients with PRCC. This model precisely stratified survival outcome and accurately identified mutation burden in PRCC. Thus, our results suggest that these four PDEIRGs are available prognostic predictors for PRCC. They could be used to assess the prognosis and to guide individualized treatments for patients with PRCC.
Prognostic significance and immune infiltration of microenvironment-related signatures in pancreatic cancer
Authors: Lu Qian , Zhang Yu , Chen Xiaojian , Gu Weihong , Ji Xinrong , Chen Zhong
Published: March 2021

Pancreatic ductal adenocarcinoma (PDAC) is 1 of the highly fatal and most aggressive types of malignancies and accounts for the vast majority of Pancreatic Cancer. Numerous studies have reported that the tumor microenvironment (TME) was significantly correlated with the oncogenesis, progress, and prognosis of various malignancies. Therefore, mining of TME-related genes is reasonably important to improve the overall survival of patients with PDAC.

The Estimation of STromal and Immune cells in MAlignant Tumor tissues using Expression data algorithm was applied to identify differential expressed genes. Functional and pathway enrichment analyses, protein–protein interaction network construction and module analysis, overall survival analysis and tumor immune estimation resource database analysis were then performed on differential expressed genes.

Data analysis indicated that higher immune scores were correlated with better overall survival (P = 0.033). Differential expression analysis obtained 90 intersection genes influencing both stromal and immune scores. Among these intersection genes, CA9, EBI3, SPOCK2, WDFY4, CD1D, and CCL22 were significantly correlated with overall survival in PDAC patients. Moreover, multivariate Cox analysis revealed that CA9, SPOCK2, and CD1D were the most significant prognostic genes, and were closely correlated with immune infiltration in TCGA cohort. Further analysis indicated that CD1D were significantly related with immune cell biomarkers for PDAC patients.

In summary, our findings provide a more comprehensive insight into TME and show a list of prognostic immune associated genes in PDAC. However, further studies on these genes need to be performed to gain additional understanding of the association between TME and prognosis in PDAC.
Comorbidities’ potential impacts on severe and non-severe patients with COVID-19
Authors: Cheng Sixiang , Zhao Yuxin , Wang Fenxiao , Chen Yan , Kaminga Atipatsa Chiwanda , Xu Huilan
Published: March 2021

Background:

An ongoing outbreak of pneumonia associated with the severe acute respiratory coronavirus (SARS-CoV-2) emerged in December 2019 in Wuhan, China. Epidemiologic evidence suggests that patients with comorbidities and novel coronavirus disease 2019 (COVID-19) infection may have poor survival outcomes. However, the risk of these coexisting medical conditions in severe and non-severe cases has not been systematically reported.

Purpose:

The present study aimed to estimate the association of chronic comorbidities in severe and non-severe cases.

Methods:

A literature search was conducted using the databases PubMed, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang Database, Chinese Scientific Journals Full-text Database (CQVIP) from the inception dates to April 1, 2020, to identify cohort studies assessing comorbidity and risk of adverse outcome. Either a fixed- or random-effects model was used to calculate the overall combined risk estimates.

Results:

A total of 22 studies involving 3286 patients with laboratory-confirmed COVID-19 were included in the analysis. Overall, compared with the patients with non-severe cases, the pooled odds ratios (ORs) of hypertension, diabetes mellitus, and cardiovascular, cerebrovascular, and respiratory diseases in patients with severe cases were 2.79 (95% confidence intervals [95% CI]: 1.66–4.69), 1.64 (95% CI: 2.30–1.08), 1.79 (95% CI: 1.08–2.96), 3.92 (95% CI: 2.45–6.28), and 1.98 (95% CI: 1.26–3.12), respectively.

Conclusions:

This meta-analysis supports the finding that chronic comorbidities may contribute to severe outcome in patients with COVID-19. According to the findings of the present study, old age and 2 or more comorbidities are significantly impactful to COVID-19 outcomes in hospitalized patients in China.
Efficacy and safety of fire acupuncture for psoriasis vulgaris
Authors: Cheng Xueli , Lai Jiawen , Zhang Yuelin , Lin Liyun , Xu Donghan , Zhong Zhenghong , Wu Qibiao , Liu Jing
Published: March 2021

Introduction:

Fire acupuncture is commonly used for the treatment of psoriasis vulgaris, but the efficacy and safety of fire acupuncture for psoriasis vulgaris remain unclear.

Methods:

This systematic review and meta-analysis will be conducted and reported strictly according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five databases including China National Knowledge Infrastructure (CNKI), Wanfang, VIP, Chinese biomedical literature, and Pubmed will be retrieved for potentially eligible studies from their inception to Jan. 2021. All randomized clinical trials comparing fire acupuncture versus no fire acupuncture in the treatment of psoriasis vulgaris will be retrieved and assessed for inclusion. RevMan5.3 software provided by Cochrane collaboration will be used for the analysis. Randomized Clinical Trials Data will be extracted by 2 researchers independently, risk of bias of the meta-analysis will be evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions. The primary endpoint is the total effective rate, the secondary outcomes are the Psoriasis Area Severity Index (PASI) score, the recurrence rate and the adverse reactions.

Results:

This study will systematically evaluate the efficacy and safety of fire acupuncture for psoriasis vulgaris. The results will be published in a peer-reviewed journal.

Conclusion:

This systematic review will evaluate the effects of fire acupuncture in patients with psoriasis vulgaris, thus providing evidence to the clinical application of this therapy.
Hemophagocytic lymphohistiocytosis in COVID-19
Authors: Schnaubelt Sebastian , Tihanyi Daniel , Strassl Robert , Schmidt Ralf , Anders Sonja , Laggner Anton N. , Agis Hermine , Domanovits Hans
Published: March 2021

Rationale:

The immunologic syndrome induced by severe acute coronavirus disease 2019 (COVID-19) is yet not fully understood. Typical patterns of clinical and laboratory features match secondary hemophagocytic lymphohistiocytosis (sHLH). However, the optimal approach to COVID-19 patients testing positive for sHLH is still unclear.

Patient concerns:

Three patients with COVID-19 are reviewed. All showed hyperinflammation and cytokine storm, necessitating intensive care treatment including mechanical ventilation.

Diagnosis:

Secondary hemophagocytic lymphohistiocytosis due to severe COVID-19; diagnosed via HScore.

Interventions:

A treatment regimen of methylprednisolone, pentaglobin, and anakinra was developed and administered.

Outcomes:

One patient survived the ICU stay. Two other patients, in whom sHLH was diagnosed too late, deceased.

Lessons:

A routine screening of COVID-19 patients for secondary HLH by using the HScore is feasible; especially those patients deteriorating clinically with no sufficient response to shock management might be at particular high risk. A stepwise therapeutic approach comprising corticosteroids, immunoglobulins and anakinra, accompanied by immunoadsorption, may dampen cytokine storm effects, and potentially reduce mortality.
A delayed diagnosis of atypical immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome
Authors: Zhang Ying , Liu Hanmin , Ai Tao , Xia Wanmin , Chen Tingting , Zhang Lei , Luo Xiulan , Duan Yaping
Published: March 2021

Introduction:

Immune dysregulation, polyendocrinopathy, enteropathy, and X-linked (IPEX) syndrome is a rare monogenic autoimmune disease, which is caused by mutations in the forkhead box protein 3 gene, can affect various systems. The typical clinical manifestations of IPEX are enteropathy, type 1 diabetes mellitus, and skin diseases. However, some atypical phenotypes can easily be misdiagnosed clinically.

Patient concerns:

A 9-year-and-7-month old patient suffered from recurrent wheezing, hematochezia, and eczematous dermatitis at the age of six months, but did not have any manifestations of autoimmune endocrinopathy. The patient was treated with glucocorticoids for more than six years, and he developed bronchiectasis.

Diagnosis:

Whole exome sequencing revealed a hemizygous pathogenic mutation c.1010G>A, p. (Arg337Gln) in Forkhead box protein 3 gene (NM_014009.3).

Interventions:

The patient was treated with oral mycophenolate mofetil combined with inhaled budesonide formoterol for six months after diagnosis.

Outcomes:

The respiratory symptoms of the patient seemed to be controlled but eczematous dermatitis progressed, which led the patient to give up the treatment.

Conclusion:

Early diagnosis and treatment of IPEX are crucial. Lung injury may be a major problem in the later stages of atypical IPEX, and mycophenolate mofetil seems to control the respiratory symptoms, but could induce significant skin side effects.
Inter-specialty variation of the Press Ganey Outpatient Medical Practice Survey
Authors: Stephens Andrew R. , Presson Angela P. , Chen Danli , Tyser Andrew R. , Kazmers Nikolas H.
Published: March 2021

Measuring patient satisfaction scores and interpreting factors that impact their variation is of importance as scores influence various aspects of health care administration. Our objective was to evaluate if Press Ganey scores differ between medical specialties.

New patient visits between January 2014 and December 2016 at a single tertiary academic center were included in this study. Press Ganey scores were compared between specialties using a multivariable logistic mixed effects model. Secondary outcomes included a comparison between surgical versus non-surgical specialties, and pediatric versus adult specialties. Due to the survey's high ceiling effect, satisfaction was defined as a perfect total score.

Forty four thousand four hundred ninety six patients met inclusion criteria. Compared to internal medicine, plastic surgery, general surgery, dermatology, and family medicine were more likely to achieve a perfect overall score, as, with odds ratios of 1.46 (P = .02), 1.29 (P = .002), 1.22 (P = .004), and 1.16 (P = .02) respectively. Orthopaedics, pediatric medicine, pediatric neurology, neurology, and pain management were less likely to achieve satisfaction with odds ratios of 0.85 (P = .047), 0.71 (P < .001), 0.63 (P = .005), 0.57 (P < .001), and 0.51 (P = .006), respectively. Compared to pediatric specialties, adult specialties were more likely to achieve satisfaction (OR 1.73; P < .001). There were no significant differences between surgical versus non-surgical specialties.

Press Ganey scores systematically differ between specialties within the studied institution. These differences should be considered by healthcare systems that use patient satisfaction data to modify provider reimbursement.
Utility of lung ultrasound to identify interstitial lung disease
Authors: Yan Jun-Hong , Pan Lei , Gao Yan-Bing , Cui Guang-He , Wang Yue-Heng
Published: March 2021

Lung ultrasound (LUS) has recently been used to identify interstitial lung disease (ILD). However, data on the role of LUS in the detection of ILD remain limited. The aim of this study was to investigate the diagnostic value of LUS compared with high-resolution computed tomography (HRCT) in patients with ILD.

The retrospective study was carried out by reviewing the medical records of patients with respiratory signs and symptoms discharged from the respiratory ward. Only patients with suspected ILD who underwent HRCT and LUS within a week were selected. ILD was identified with a semi-quantitative score of B-lines >5 and a Warrick score >0 points. The endpoints of LUS in diagnosing ILD (i.e., sensitivity, specificity, positive likelihood ratio [PLR], negative likelihood ratio [NLR], positive predictive value [PPV], and negative predictive value [NPV], and receiver operating characteristic [ROC] curve) was compared with that of HRCT. The reference standard used for the diagnosis of ILD was based on history, clinical findings and examination, and laboratory and instrumental tests, including pulmonary function tests, lung histopathology, and HRCT (without LUS findings).

The final clinical diagnosis of ILD was 55 in 66 patients with suspected ILD. HRCT was positive in 55 patients, whereas LUS detected ILD in 51 patients. Four patients with negative LUS findings were positive on HRCT. The results showed 93% sensitivity, 73% specificity, 3.40 PLR, 0.10 NLR, 94% PPV, and 67% NPV for LUS, whereas 100% sensitivity, 82% specificity, 5.49 PLR, 0.01 NLR, 97% PPV, and 100% NPV for HRCT. Comparison of the 2 ROC curves revealed significant difference in the diagnostic value of the 2 methods for the diagnosis of ILD (P = .048).

Our results indicated that LUS is a useful technique to identify ILD. Considering its non-radiation, portable and non-invasive advantages, LUS should be recommended as a valuable screening tool in patients with suspected ILD.
Do accountable care organizations differ according to physician-hospital integration?
Authors: Lin Meng-Yun , Hanchate Amresh D. , Frakt Austin B. , Burgess James F. , Carey Kathleen
Published: March 2021

Physician-hospital integration among accountable care organizations (ACOs) has raised concern over impacts on prices and spending. However, characteristics of ACOs with greater integration between physicians and hospitals are unknown. We examined whether ACOs systematically differ by physician-hospital integration among 16 commercial ACOs operating in Massachusetts.

Using claims data linked to information on physician affiliation, we measured hospital integration with primary care physicians for each ACO and categorized them into high-, medium-, and low-integrated ACOs. We conducted cross-sectional descriptive analysis to compare differences in patient population, organizational characteristics, and healthcare spending between the three groups. In addition, using multivariate generalized linear models, we compared ACO spending by integration level, adjusting for organization and patient characteristics. We identified non-elderly adults (aged 18–64) served by 16 Massachusetts ACOs over the period 2009 to 2013.

High- and medium-integrated ACOs were more likely to be an integrated delivery system or an organization with a large number of providers. Compared to low-integrated ACOs, higher-integrated ACOs had larger inpatient care capacity, smaller composition of primary care physicians, and were more likely to employ physicians directly or through an affiliated hospital or physician group. A greater proportion of high-/medium-integrated ACO patients lived in affluent neighborhoods or areas with a larger minority population. Healthcare spending per enrollee in high-integrated ACOs was higher, which was mainly driven by a higher spending on outpatient facility services.

This study shows that higher-integrated ACOs differ from their counterparts with low integration in many respects including higher healthcare spending, which persisted after adjusting for organizational characteristics and patient mix. Further investigation into the effects of integration on expenditures will inform the ongoing development of ACOs.
Comparison of endoscopic ultrasound-guided choledochoduodenostomy and endoscopic retrograde cholangiopancreatography in first-line biliary drainage for malignant distal bile duct obstruction
Authors: Itonaga Masahiro , Kitano Masayuki , Yoshikawa Takanori , Ashida Reiko , Yamashita Yasunobu , Hatamaru Kenichi , Takenaka Mamoru , Yamazaki Tomohiro , Ogura Takeshi , Nishioka Nobu , Sakai Arata , Masuda Atsuhiro , Shiomi Hideyuki , Shimokawa Toshio
Published: March 2021

Introduction:

In patients with malignant distal bile duct obstruction and normal gastrointestinal anatomy, endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) is indicated when endoscopic retrograde cholangiopancreatography (ERCP) fails. The ERCP drainage route passes through the tumor, whereas the EUS-CDS route does not. Therefore, EUS-CDS is expected to have a longer stent patency than ERCP. However, for first-line biliary drainage, it remains unclear whether EUS-CDS or ERCP is superior in terms of stent patency. To reduce the frequency of highly adverse events (AEs) such as bile peritonitis or stent migration following EUS-CDS, we developed an antimigration metal stent with a thin delivery system for tract dilatation. This study is designed to assess whether EUS-CDS with this novel stent is superior to ERCP with a traditional metal stent in terms of stent patency when the two techniques are used for first-line drainage of malignant distal biliary obstruction.

Methods/design:

This study is a multicenter single-blinded randomized controlled trial (RCT) involving 95 patients in four tertiary centers. Patients with malignant distal biliary obstruction that is unresectable or presents a very high surgical risk and who pass the inclusion and exclusion criteria will be randomized to EUS-CDS or ERCP in a 1:1 proportion. The primary endpoint is the stent patency rate 180 days after stent insertion. Secondary outcomes include the rates of technical success, clinical success, technical success in cases not requiring fistulous-tract dilation (only EUS-CDS group), procedure-related AEs, re-intervention success, patients receiving post-drainage chemotherapy, procedure time, and overall survival time.

Discussion:

If EUS-CDS is superior to ERCP in terms of stent patency and safety for the first-line drainage of malignant distal biliary obstruction, it is expected that the first-line drainage method will be changed from ERCP to EUS-CDS, and that interruption of chemotherapy due to stent dysfunction can be avoided.

Trial registration:

University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR), ID: UMIN000041343. Registered on August 6, 2020. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047201

Version number: 1.2, December 7, 2020.