bluuebunny/crossref_metadata_2025 huggingface dataset:
Morphologic Change of CorticoCancellous Allograft Used for Anterior Cervical Discectomy and Fusion
Authors: Yang Jae Jun , Ryu Byungyoung , Moon Ji Weon , Kim Taehyun , Park Sehan
Published: March 2022

Study Design.

Retrospective cohort study

Objective.

The aim of this study was to evaluate the incidence and clinical implications of graft morphologic changes in corticocancellous allografts used for anterior cervical discectomy and fusion (ACDF), such as graft resorption or fracture.

Summary of Background Data.

Although cortico-cancellous allograft is one of the most commonly used interbody spacer for ACDF, clinical implications of allograft resorption or fracture is unclear.

Methods.

One-hundred and thirty-eight consecutive patients who underwent ACDF for degenerative cervical myelopathy or radiculopathy were retrospectively reviewed. Patients with allograft morphologic changes, including graft resorption and fracture (morphologic change group), were compared with patients without morphologic changes (unchanged group). Furthermore, operated segments with morphologic changes were compared with unchanged segments. Patient characteristics, cervical lordosis, segmental lordosis, fusion, subsidence, neck pain visual analogue scale (VAS), arm pain VAS, and neck disability index (NDi) scores were evaluated.

Results.

Ninety patients (149 segments) were included in the study. Allograft resorption or fracture was detected in 46 (51.1%) patients and 81 (54.3%) segments, respectively. The fusion rate of morphologic change segments was significantly lower than that of the unchanged segments (P < 0.001). Furthermore, segments with morphologic changes had significantly higher rates of subsidence compared to unchanged segments (P< 0.001). Segmental lordosis at the final follow-up was significantly smaller in the morphologic change segments (P< 0.001). Neck pain VAS, arm pain VAS, and NDI scores did not demonstrate significant intergroup differences.

Conclusion.

Corticocancellous allograft demonstrated a high rate of graft morphologic change (54.3%). Graft resorption or fracture was associated with increased pseudarthrosis, subsidence, and decreased postoperative segmental lordosis; however, the clinical results were not significantly affected. Caution is needed when choosing to use corticocancellous allografts for ACDF due to the high rate of graft resorption or fracture and the negative implications of these risks.
Impact of body mass index, weight gain, and metabolic disorders on survival and prognosis in patients with breast cancer who underwent chemotherapy
Authors: Yang Ping , He Yingjian , Yu Xinying , Liu Baohua , Wang Xuemei , Li Xiangping , Wang Peiyu
Published: March 2022

Background:

Weight gain during chemotherapy in patients with breast cancer contributes to their poor prognosis. However, a growing number of studies have found that metabolic disorders seem to play a more important role in breast cancer prognosis than weight gain. This study aimed to explore the prognostic effects of body mass index (BMI), weight gain, and metabolic disorders on the overall survival (OS) and prognosis of patients with breast cancer who underwent chemotherapy.

Methods:

Data from the inpatient medical records of patients with breast cancer who underwent chemotherapy at the Beijing Cancer Hospital Breast Cancer Center from January to December 2010 were retrospectively collected, and the patients were followed up until August 2020.

Results:

A total of 438 patients with stages I to III breast cancer met the inclusion and exclusion criteria. Forty-nine (11.19%) patients died, while 82 (18.72%) patients had tumor recurrence and metastasis at the last follow-up (August 2020). From the time of diagnosis until after chemotherapy, no significant differences were observed in the body weight (t = 4.694, P 
< 0.001), BMI categories (χ
2 = 19.215, P = 0.001), and incidence of metabolic disorders (χ
2 = 24.841, P < 0.001); the BMI categories and weight change had no effect on the OS. Both univariate (χ
2 = 6.771, P = 0.009) and multivariate survival analyses (hazard ratio = 2.775, 95% confidence interval [CI]: 1.326–5.807, P = 0.007) showed that low high-density lipoprotein cholesterol (HDL-C) levels at diagnosis had a negative impact on the OS. The multivariate logistic regression analysis showed that the HDL-C level at diagnosis (odds ratio [OR] = 2.200, 95% CI: 0.996–4.859, P = 0.051) and metabolic disorders after chemotherapy (OR = 1.514, 95% CI: 1.047–2.189, P = 0.028) are risk factors for poor prognosis in patients with breast cancer.

Conclusions:

Chemotherapy led to weight gain and aggravated the metabolic disorders in patients with breast cancer. Low HDL-C levels at diagnosis and metabolic disorders after chemotherapy may have negative effects on the OS and prognosis of patients with breast cancer.
Unilateral toxic anterior segment syndrome after immediate sequential bilateral phakic intraocular lens implantation
Authors: Balparda Kepa , Silva-Quintero Laura A. , Herrera-Chalarca Tatiana
Published: March 2022

Introduction:

The requirement to perform immediate sequential bilateral cataract surgery (ISBCS) is controversial. Most surgeons who do not adhere to this approach cite the possibility of bilateral complications occurring.

Patient and Clinical Findings:

A 35-year-old woman underwent bilateral implantation of phakic intraocular lenses the same day. She complained of pain and significantly decreased quality of vision in her right eye 12 hours postoperatively and was immediately examined. Physical examination of the right eye showed significant corneal edema extending from limbus to limbus and a dilated fixed pupil unresponsive to light.

Diagnosis, Intervention, and Outcomes:

Physical examination showed toxic anterior segment syndrome ensued in one eye. The complication was timely managed, preventing further damage to the eye. The contralateral eye showed no signs of complication.

Conclusions:

This case highlights that, when performed with utmost care, protocols designed to avoid bilateral occurrence of complications in same-day surgeries can work in the real-world settings. This is further evidence that ISBCS may not pose an additional risk to patients.
Evaluation of the Effectiveness of Individually Tailored Lifestyle Intervention in Patients With Familial Hypercholesterolemia
Authors: Beyece İncazli Seçil , Özer Serap , Kayikçioğlu Meral
Published: March 2022

Objectives

The aim of this study was to evaluate the effect of a theoretically-based individually tailored lifestyle intervention on healthy lifestyle changes and improvement in disease management in patients with familial hypercholesterolemia (FH).

Methods

In this randomized controlled clinical trial, 120 patients with FH were randomly assigned (1:1) to receive education and counseling based upon the Transtheoretical Model of Health Behavioral Change (n = 60) or conventional clinical education (n = 60). All patients were evaluated for healthy lifestyle changes, adherence to therapy, lipid levels, blood pressure, body mass index, and waist measurement at baseline and at 12th and 24th weeks' visits.

Results

Motivational interviews resulted in a significant improvement in healthy lifestyle changes and treatment adherence in the intervention group. In addition, there were significant decreases in body mass index (−7.49%), low-density lipoprotein cholesterol (−37.14%), and blood pressure (13.3%) in the intervention group.

Conclusions

Our results showed that an individually tailored lifestyle intervention was effective in facilitating healthy lifestyle changes and improvement in treatment adherence and in decreasing cardiovascular risk factors including cholesterol levels in patients with FH.
Psychosocial Risk Factors for Health-Related Quality of Life in Adult Congenital Heart Disease
Authors: Fteropoulli Theodora , Tyagi Manavi , Hirani Shashivadan P. , Kennedy Fiona , Picaut Nathalie , Cullen Shay , Deanfield John E. , Newman Stanton P.
Published: March 2022

Background

There is variability in the impact of adult congenital heart disease (ACHD) on health-related quality of life (HRQoL). A greater insight into the impact of ACHD may be gained from investigating HRQoL in various diagnostic groups and considering the importance of psychosocial risk factors for poor HRQoL.

Objective

We compared the HRQoL of people with ACHD with normative data from the general population and among 4 diagnostic groups and identified risk factors for poor HRQoL in ACHD from a comprehensive set of sociodemographic, clinical, and psychosocial factors.

Methods

We conducted a cross-sectional study with 303 participants from 4 diagnostic groups Simple, Tetralogy of Fallot, Transposition of the Great Arteries, Single Ventricle who completed measures of illness perceptions, coping, social support, mood, and generic and disease-specific HRQoL. Data were analyzed using 1-sample t tests, analysis of variance, and hierarchical multiple regressions.

Results

There was diminished psychosocial HRQoL in the Simple group compared with the general population. Consistently significant risk factors for poor HRQoL included younger age, a perception of more severe symptoms due to ACHD, depression, and anxiety. Clinical factors were poor predictors of HRQoL.

Conclusions

The findings highlight the need to develop intervention studies aiming to improve HRQoL in people with ACHD and the routine assessment of illness perceptions and mood problems during key periods in people's lives. This will help address patient misconceptions that could be tackled by clinicians or specialist nurses during routine outpatient appointments and identify people in need of psychological support.
Four Questions Nurses Can Ask to Predict PTSD 1 Year After a Motor Vehicle Crash
Authors: Leroy Arnaud , Cottencin Olivier , Labreuche Julien , Mascarel Pauline , De Pourtales Marie-Atéa , Molenda Sylvie , Paget Virgine , Lemogne Cédric , Bougerol Thierry , Gregory Thomas , Chantelot Christophe , Demarty Anne-Laure , Meyer Samantha , Warembourg Frédérique , Duhem Stephane , Vaiva Guillaume
Published: March 2022

BACKGROUND:

The role of nurses in screening for posttraumatic stress disorder is crucial in trauma units.

OBJECTIVES:

To create and evaluate an easy and brief tool for nurses to predict chronic posttraumatic stress disorder 1 year after a motor vehicle crash.

METHODS:

We performed a 1-year follow-up multicenter study from 2007 to 2015, including 274 patients injured in a motor vehicle crash who were hospitalized in an orthopedic trauma unit. Nurses administered the DEPITAC questionnaire. Posttraumatic stress disorder was measured by the Post-Traumatic Stress Disorder Checklist of symptoms during the first year following the crash. A multivariable logistic regression model was implemented to select items significantly associated with posttraumatic stress disorder to improve the DEPITAC questionnaire. Predictive performance to predict posttraumatic stress disorder 1 year after the motor vehicle crash was examined for these different models.

RESULTS:

Of 274 patients studied, a total of 75.9% completed the questionnaire at 1 year of follow-up. We found that only two questions and two simple elements of the patient's medical record (other injury or a person dying during the crash, perception of vital threat, number of children, and length of stay in trauma) predicted posttraumatic stress disorder 1 year after a motor vehicle crash.

CONCLUSIONS:

The brevity of this evaluation, simple scoring rules, and screening test performance suggest that this new screening tool can be easily administered in the acute care setting by nurses.
Association Between Body Mass Index and Morbidity and Mortality During Hospitalization After Trauma
Authors: Soliman Sara S. , Durling-Grover Renay , Bilaniuk Jaroslaw W. , Kong Karen , Renna Lauren , Hakakian Daniel , Rolandelli Rolando H. , Antonioli Luca , Nemeth Zoltan H.
Published: March 2022

BACKGROUND:

Literature suggests that unhealthy body mass index is a risk factor for adverse clinical outcomes.

OBJECTIVES:

To study the association between unhealthy body mass index and morbidity and mortality after trauma using the 2016 American College of Surgeons Trauma Quality Improvement Program database.

METHODS:

A retrospective review was conducted comparing the normal weight control group to the underweight, overweight, obese, severely obese, and morbidly obese groups for differences in demographic factors, injury severity score, comorbidities, length of stay, and complications.

RESULTS:

Underweight, overweight, obese, severely obese, and morbidly obese body mass indexes, in comparison to normal weight body mass index, were associated with a higher probability of developing at least one complication after trauma. Additionally, we observed a J-shaped curve when analyzing body mass index and mortality, suggesting that both high and low body mass indexes are positively associated with mortality. In fact, morbidly obese patients had the highest mortality rate, followed by underweight patients (p < .001). Interestingly, however, multivariate logistic regression demonstrated that, compared with normal weight body mass index, overweight and obese body mass indexes were independently associated with 9.6% and 10.5% lower odds of mortality, respectively (p < .001 and p = .001).

CONCLUSION:

Irrespective of preexisting comorbidities, injury severity score, and mechanism of injury, underweight, overweight, obese, severely obese, and morbidly obese body mass indexes were independently associated with higher risks of morbidity, whereas overweight and obese body mass indexes were associated with lower mortality risks. These findings emphasize the complex relationship between body mass index and clinical outcomes for trauma patients.
Buttock Ischemia in Venoarterial Extracorporeal Membrane Oxygenation: A Case Series
Authors: Wong Alfred S. K. , Ma Tammy S. K. , Chu Ying Lun Edward , Chan Ting Bun , Sin Simon W. C.
Published: March 2022

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a bridging therapy for refractory cardiogenic shock, and limb ischemia is a concern with femoral cannulation. Because of the rich collateral pelvic circulatory supply, buttock ischemia is not common and is usually a complication after aneurysmal aortic repair or internal iliac artery embolization after pelvic trauma. Gluteal necrosis occurring as an extracorporeal membrane oxygenation complication has not been reported in the literature. In this case series, we report three patients with ischemic buttock after initiating VA-ECMO and discuss the risk factors and the clinical and radiological features supportive of the diagnosis. We review the gluteal and pelvic vascular anatomy, postulate how cannula size, ethnicity, catecholamines, and reversal of gluteal arterial flow contributed to this rare entity in our patients and explain how these findings have changed our institution’s practice.
Monitoring during extracorporeal membrane oxygenation
Authors: Castro Diana Morales , Morris Idunn , Teijeiro-Paradis Ricardo , Fan Eddy
Published: March 2022

Purpose of review

Extracorporeal membrane oxygenation (ECMO) offers advanced mechanical support to patients with severe acute respiratory and/or cardiac failure. Ensuring an adequate therapeutic approach as well as prevention of ECMO-associated complications, by means of timely liberation, forms an essential part of standard ECMO care and is only achievable through continuous monitoring and evaluation. This review focus on the cardiorespiratory monitoring tools that can be used to assess and titrate adequacy of ECMO therapy; as well as methods to assess readiness to wean and/or discontinue ECMO support.

Recent findings

Surrogates of tissue perfusion and near infrared spectroscopy are not standards of care but may provide useful information in select patients. Echocardiography allows to determine cannulas position, evaluate cardiac structures, and function, and diagnose complications. Respiratory monitoring is mandatory to achieve lung protective ventilation and identify early lung recovery, surrogate measurements of respiratory effort and ECMO derived parameters are invaluable in optimally managing ECMO patients.

Novel applications of existing monitoring modalities alongside evolving technological advances enable the advanced monitoring required for safe delivery of ECMO. Liberation trials are necessary to minimize time sensitive ECMO related complications; however, these have yet to be standardized.
Small bowel lymphoma: clinical update and challenges for the gastroenterologist
Authors: Oka Priya , Sidhu Reena
Published: March 2022

Purpose of review

The diagnosis of small bowel lymphoma (SBL) can be challenging, as they are very rare and also have a varied presentation. In this review, we aim to provide a broad overview of the types of SBL and also about the various modalities used for their diagnosis. We also discuss the overview of treatment strategies for a gastroenterologist.

Recent findings

Small bowel capsule endoscopy (SBCE) and devise-assisted enteroscopy (DAE) has revolutionized the way we investigate the small bowel. DAE also makes it possible to obtain histological samples for further characterization of SBL. This has led to a significant improvement in diagnosis and management of the disease in conjunction with cross-sectional imagining.

The diagnosis and management of small bowel lymphoma remains challenging despite the development of newer techniques such as SBCE and DAE. The current available diagnostic modalities have limitations; in the absence of a gold standard, the current investigative modalities compliment each other in reaching the final diagnosis.
The role of novel imaging in prostate cancer focal therapy: treatment and follow-up
Authors: Rothberg Michael B. , Enders Jacob J. , Kozel Zachary , Gopal Nikhil , Turkbey Baris , Pinto Peter A.
Published: March 2022

Purpose of review

Multiparametric magnetic resonance imaging (mpMRI) has fundamentally changed how intraprostatic lesions are visualized, serving as a highly sensitive means for detecting clinically significant prostate cancer (csPCa) via image-targeted biopsy. However, limitations associated with mpMRI have led to the development of new imaging technologies with the goal of better characterizing intraprostatic disease burden to more accurately guide treatment planning and surveillance for prostate cancer focal therapy. Herein, we review several novel imaging modalities with an emphasis on clinical data reported within the past two years.

Recent findings

7T MRI, artificial intelligence applied to mpMRI, positron emission tomography combined with either computerized tomography or MRI, contrast-enhanced ultrasound, and micro-ultrasound are novel imaging modalities with the potential to further improve intraprostatic lesion localization for applications in focal therapy for prostate cancer. Many of these technologies have demonstrated equivalent or favorable diagnostic accuracy compared to contemporary mpMRI for identifying csPCa and some have even shown improved capabilities to define lesion borders, to provide volumetric estimates of lesions, and to assess the adequacy of focal ablation of planned treatment zones.

Novel imaging modalities with capabilities to better characterize intraprostatic lesions have the potential to improve accuracy in treatment planning, real-time assessment of the ablation zone, and posttreatment surveillance; however, many of these technologies require further validation to determine their clinical utility.
CDC26 Is a Key Factor in Human Oocyte Aging
Authors: Li Li , Xia Ye , Yang Yang , Zhang Wuwen , Yan Hua , Yin Ping , Li Kai , Chen Yuanyuan , Lu Lu , Tong Guoqing
Published: March 2022

(Abstracted from Hum Reprod 2021;36:3095–3107)

Declining oocyte fertilization capacity and developmental potential, involving deficits in both nucleus and cytoplasm contributing to aberrant meiosis, is the major contributor to declining fertility and increased rate of congenital birth defects in women older than the age of 35 years. Oocyte aging is directly affected by a variety of factors, both environmental and intrinsic; however, the precise mechanism remains unclear.
The IARC Perspective on Cervical Cancer Screening
Authors: Bouvard Véronique , Wentzensen Nicolas , Mackie Anne , Berkhof Johannes , Brotherton Julia , Giorgi-Rossi Paolo , Kupets Rachel , Smith Robert , Arrossi Silvina , Bendahhou Karima , Canfell Karen , Chirenje Z. Mike , Chung Michael H. , del Pino Marta , de Sanjosé Silvia , Elfström Miriam , Franco Eduardo L. , Hamashima Chisato , Hamers Françoise F. , Herrington C. Simon , Murillo Raúl , Sangrajrang Suleeporn , Sankaranarayanan Rengaswamy , Saraiya Mona , Schiffman Mark , Zhao Fanghui , Arbyn Marc , Prendiville Walter , Indave Ruiz Blanca I. , Mosquera-Metcalfe Isabel , Lauby-Secretan Béatrice
Published: March 2022

(Abstracted from N Engl J Med 2021;385:1908–1918)

In May 2018, the World Health Organization (WHO) called for the elimination of global cervical cancer as a major public health priority, with a 2-pronged approach focusing on effective vaccination against human papillomavirus (HPV) and the screening for and treatment of early cervical cancer. Cervical cancer is considered largely preventable through these programs; however, it continues to be disproportionately prevalent in countries with the lowest values on the Human Development Index.
The Effect of Arch Cartilage Graft and Tajima Reverse U Approach in the Secondary Reconstruction of Unilateral Cleft Lip Nasal Deformity
Authors: Lai Bo-Ru , Lo Chi-Chin , Lo Lun-Jou
Published: March 2022

Secondary cleft lip nasal deformity is complicated with wide spectrum of defect and varied reconstructive procedures. There has been no unanimous solution for a given problem. In case of a localized alar depression in unilateral cleft lip nasal deformity, the conchal cartilage applied as arch graft was proposed. Patients were recruited from database of craniofacial center who received Tajima method and arch cartilage graft. Inclusion criteria were patients with unilateral cleft lip nasal deformity after skeletal maturity. Through a reverse U incision, the lower lateral cartilage was dissected and released from the skin and the contralateral cartilage. The harvested conchal cartilage graft was trimmed to 25 to 30 by 8mm in size, and inserted as arch shape overlying the cleft side lower lateral cartilage. Transdomal fixation sutures were made. Outcome assessment was performed, and the nostril and alar dimensions were measured. Thirty-nine patients were eligible for evaluation of the surgical outcome. Majority of patients underwent simultaneous lip revision (97%). No surgery-related complications were noted in this series. Satisfaction to the nasal reconstruction was reported in 85% of patients. Further minor nasal revisions were performed in 6 patients (15%). Quantitative measurement showed statistically significant improvement in nostril height, alar height and alar width after the surgery. It is concluded that the Tajima reverse U approach plus arch cartilage graft is an effective method for secondary reconstruction of the unilateral cleft lip nasal deformity in selected patients presenting with cleft side alar depression.5
Herpes Zoster Opthalmicus–Related Ophthalmoplegia: Anatomical, Pathogenetic, and Therapeutic Perspectives
Authors: Pupic–Bakrač Ana , Pupić–Bakrač Jure , Gabrić Ivana , Vukojević Nenad , Jukić Tomislav
Published: March 2022

Objective:

To investigate the anatomical, pathogenetic, and pharmacological characteristics of herpes zoster ophthalmicus (HZO)– related ophthalmoplegia.

Methods:

Case report–based systematic review was performed.

Results:

This study included 96 patients (54 [56.25%] women and 42 [43.75%] men [P = 0.221]). The mean age at presentation was 64.32 ± 17.48 years. All the patients included in the study had HZO– related ophthalmoplegia, with rash presenting as initial symptom in 87 (90.62%) cases, and diplopia in 9 (9.38%) cases. Thirty–seven (38.54%) patients achieved complete recovery, whereas 59 (61.46%) patients had permanent ophthalmoplegia. Females recovered in 26/54 cases and males in 11/42 cases (P = 0.028). Recovery rates after peroral versus intravenous antivirals (15/38 versus 19/46) and > 10 days versus ≤10 days antiviral treatment (22/54 versus 12/30) did not significantly differ (P = 0.865 and P = 0.947, respectively). immunocompetent patients treated with corticosteroids had significantly better recovery rates compared to immunodeficient counterparts (17/34 [50.00%] and 5/22 [22.73%], respectively [P = 0.041]).

Conclusions:

The outcome of HZO–related ophthalmoplegia is associated with gender, immune status, corticosteroid use, and time of antiviral treatment initiation.
Inner Ear Anomalies in Children With Apert Syndrome: A Radiological and Audiological Analysis
Authors: Hogg Emma S. , Turgut Nesrettin F. , McCann Emma , Avula Shivaram , De Sujata , Sharma Sunil D.
Published: March 2022

Introduction:

Apert syndrome is a multisystem genetic disorder typically characterized by craniosynostosis and syndactyly. Studies also report an increased incidence of hearing loss in children with Apert syndrome in comparison to the general population. The aim of this study was to gain an understanding of the inner ear radiological anatomical variations seen in children with Apert syndrome and correlate these with audiological outcomes.

Materials and Methods:

This was a retrospective review of computed tomography imaging of patients with Apert syndrome. Radiological images were examined for anatomical variations in inner ear structures. These were correlated with audiological testing.

Results:

Nineteen patients were included in the study. The most commonly observed anomaly was an absent bony window of the lateral semi-circular canal (SCC) in 11 patients (58%), followed by an enlarged lateral SCC in 12 patients (63%). This combination of anomalies was seen collectively in 42% of patients and together these give the appearance of a ’rectangular vestibular cavity’. Audiological results were available in 11 patients and 9 of these patients had a conductive hearing loss.

Conclusion:

To the authors’ knowledge, this is the first study that reports radiological findings alongside audiological testing in Apert syndrome and describes the appearance of a ’rectangular vestibular cavity’.
1. Account of experiments made with an invariable pendulum at the Royal Observatory at Greenwich, and at Port Bowen, on the eastern side of Prince Regent's Inlet.
Authors: Foster Henry
Published: March 2022

The determination of the length of the seconds pendulum in different latitudes, is a subject, that has long been considered of much interest and importance, but more especially of late years, since the practical problem has received from the ingenuity of Captain Henry Kater, certain improvements and simplifications, which have rendered its results more accurate than had ever before been obtained.
VII. A comparison of the diurnal changes of intensity in the dipping and horizontal needles, at Port Bowen.
Authors: Foster Henry
Published: March 2022

The following comparative observations on the intensity of the dipping and horizontal needles, were made with a particular object in view, which will be proper to explain before giving the details.
Nurses’ experience of using video consultation in a digital care setting and its impact on their workflow and communication
Authors: Razavi SeyedehMaryam , Farrokhnia Nasim , Davoody Nadia
Published: March 2022

Sweden as many other countries uses video consultation to increase patients’ access to primary healthcare services particularly during the COVID-19 pandemic. Working in digital care settings and using new technologies, in this case video consultations, require learning new skills and adoption to new workflow. The aim of this study is to explore nurses’ experience of using video consultation in a digital care setting and its impact on their workflow and communication. Fifteen semi-structured interviews were carried out with registered nurses recruited from a private digital healthcare provider. Interviews were recorded, transcribed, and analysed using an abductive approach. Nurses’ workflow was modeled, and several categories and subcategories were identified: nurses’ workflow (efficiency, flexibility, and information accessibility); communication (interaction with patients and interprofessional communication); user experience (change and development of the platform, challenges, and combining digital and physical care). Even though providing online care has its limitations, the nurses were positive towards using video consultations.
Gut microbiome composition better reflects host phylogeny than diet in breeding wood-warblers
Authors: Baiz Marcella D. , Benavides C. Andrea , Miller Eliot T. , Wood Andrew W. , Toews David P. L.
Published: March 2022

Understanding the factors that shape microbiomes can provide insight on the importance of host-symbiont interactions and on co-evolutionary dynamics. Unlike for mammals, previous studies have found little or no support for an influence of host evolutionary history on avian gut microbiome diversity and instead have suggested a greater influence of the environment or diet due to fast gut turnover. Because effects of different factors may be conflated by captivity and sampling design, examining natural variation using large sample sizes is important. Our goal was to overcome these limitations by sampling wild birds to compare environmental, dietary, and evolutionary influences on gut microbiome structure. We performed fecal metabarcoding to characterize both the gut microbiome and diet of fifteen wood-warbler species across a four-year period and from two geographic localities. We find host taxonomy generally explained ∼10% of the variation between individuals, which is ∼6-fold more variation of any other factor considered, including diet diversity. Further, gut microbiome similarity was more congruent with the host phylogeny than with host diet similarity and we found little association between diet diversity and microbiome diversity. Together, our results suggest evolutionary history is the strongest predictor of gut microbiome differentiation among wood-warblers. Although the phylogenetic signal of the warbler gut microbiome is not very strong, our data suggest that a stronger influence of diet (as measured by diet diversity) does not account for this pattern. The mechanism underlying this phylogenetic signal is not clear, but we argue host traits may filter colonization and maintenance of microbes.
Induced pluripotent stem cell-derived astrocytes from patients with schizophrenia exhibit an inflammatory phenotype that affects vascularization
Authors: Trindade Pablo , Nascimento Juliana M. , Casas Bárbara S. , Faúndez Tomás Monteverde , Gasparotto Juciano , Ribeiro Camila Tiefensee , Devalle Sylvie , Sauma Daniela , Moreira José Claudio Fonseca , Gelain Daniel Pens , Porciuncula Lisiane O. , Palma Verónica , Martins-de-Souza Daniel , Rehen Stevens Kastrup
Published: March 2022

Molecular and functional abnormalities of astrocytes have been implicated in the etiology and pathogenesis of schizophrenia (SCZ). In this study, we examined the proteome, inflammatory responses, and secretome effects on vascularization of human induced pluripotent stem cell (hiPSC)-derived astrocytes from patients with SCZ. Proteomic analysis revealed alterations in proteins related to immune function and vascularization. Reduced expression of the nuclear factor kappa B (NF-κB) p65 subunit was observed in these astrocytes, with no incremental secretion of cytokines after tumor necrosis factor alpha (TNF-α) stimulation. Among inflammatory cytokines, secretion of interleukin (IL)-8 was found particularly elevated in SCZ-patient-derived– astrocyte conditioned medium (ASCZCM). In a chicken chorioallantoic membrane (CAM) assay, ASCZCM reduced the diameter of newly grown vessels, and this effect could be mimicked with exogenous addition of IL-8. Taken together, our results suggest that SCZ astrocytes are immunologically dysfunctional and may consequently affect vascularization through secreted factors.
Dissecting thePyrenophora tritici-repentis(tan spot of wheat) pangenome
Authors: Gourlie Ryan , McDonald Megan , Hafez Mohamed , Ortega-Polo Rodrigo , Low Kristin E. , Abbott D. Wade , Strelkov Stephen E. , Daayf Fouad , Aboukhaddour Reem
Published: March 2022

We sequenced the genome of a global collection (40 isolates) of the fungusPyrenophora tritici-repentis(Ptr), a major foliar pathogen of wheat and model for the evolution of necrotrophic pathogens. Ptr exhibited an open-pangenome, with 43% of genes in the core set and 57% defined as accessory (present in only a subset of isolates), of which 56% were singleton genes (present in only one isolate). A clear distinction between pathogenic and non-pathogenic genomes was observed in size, gene content, and phylogenetic relatedness. Chromosomal rearrangements and structural organization, specifically around the effector coding genes, were explored further using the annotated genomes of two isolates sequenced by PacBio RS II and Illumina HiSeq. The Ptr genome exhibited major chromosomal rearrangements, including chromosomal fusion, translocation, and segment duplications. An intraspecies translocation ofToxA, the necrosis-inducing effector-coding gene, was facilitated within Ptr via a 143 kb ‘Starship’transposon (dubbed ‘Horizon’). Additionally,ToxB, the gene encoding the chlorosis-inducing effector, was clustered as three copies on a 294 kb transposable element in a ToxB-producing isolate.ToxBand its carrying transposon were missing from theToxBnon-coding reference isolate, but the homologtoxband the transposon were both present in another non-coding isolate. The Ptr genome also appears to exhibit a ‘one-compartment’ organization, but may still possess a ‘two-speed genome’ that is facilitated by copy-number variation as reported in other fungal pathosystems.

IMPORTANCE

Ptr is one of the most destructive wheat pathogens worldwide. Its genome is a mosaic of present and absent effectors, and serves as a model for examining the evolutionary processes behind the acquisition of virulence in necrotrophs and disease emergence. In this work, we took advantage of a diverse collection of pathogenic Ptr isolates with different global origins and applied short- and long-read sequencing technologies to dissect the Ptr genome. This study provides comprehensive insights into the Ptr genome and highlights its structural organization as an open pangenome with ‘one-compartment’. In addition, we identified the potential involvement of transposable elements in genome expansion and the movement of virulence factors. The ability of effector-coding genes to shuffle across chromosomes on large transposons was illustrated by the intraspecies translocation ofToxAand the multi-copyToxB. In terms of gene contents, the Ptr genome exhibits a large percentage of orphan genes, particularly in non-pathogenic or weakly-virulent isolates.
Differential correlation across subpopulations of single cells in subtypes of acute myeloid leukemia
Authors: McGee Reginald L. , Behbehani Gregory K. , Coombes Kevin R.
Published: March 2022

Mass cytometers can record 40-50 parameters per single cell for millions of cells in a sample, and in particular, for leukemic cells. Many methods have been developed to cluster phenotypically similar cells within cytometry data, but there are fewer methods to visualize activity and interactions of pairs of proteins across these populations. We have developed a workflow for analyzing correlations associated with predfined populations. By clustering blood samples from acute myeloid leukemia (AML) patients and normal controls using an established algorithm, we obtained a minimum spanning tree of clusters of single cells. Using surface marker expression, we identified clusters on the tree that belonged to phenotypes of interest. Next, we computed correlations between pairs of proteins in each cluster. We developed a novel, coherent, probability-based statistic to test differences between vectors of correlation coefficients. By comparing all combinations of the normal controls under the statistic, we created an empirical distribution that provided a conservative measure of differential correlation. Using this empirically-derived distribution to define significance, we compared pooled samples from AML subtypes and normal controls to detect differential correlations. Given the structure present within this cytometry data set, we found it natural to consider correlations in this manner versus aggregating all data and computing a single correlation. Our results have the advantage that we can localize the statistical measure to determine contributions from particular phenotypic populations. Differentially correlated pairs of proteins can be further explored by considering a population’s distribution of correlation coefficients or biaxially plotting protein expressions within individual cells in a given population. Our approach leads to a better understanding of the nonlinear relationships that exist in the cytometry data.

Author summary

We introduce a novel method for analyzing the abundance of single cell data collected by high-throughput technologies. Due to the high dimensionality of such datasets, there is a need for methods to identify significant interactions between genes or proteins. In particular, we are interested in statistical differences between correlations of proteins within populations of cells determined by traditional immunophenotyping techniques. In this paper, we have demonstrated the utility of this new framework in the case of blood samples from individuals with different subtypes of leukemia and compare to healthy controls. The motivation for this application is that differences between can illuminate potential drivers of the disease. We have illustrated an example of how intracellular events can be detected by our statistic. Finally, this method is flexible in that it can also be applied in a variety of contexts where there are vectors of correlation coefficients that need to be compared.
Derivation and external validation of clinical prediction rules identifying children at risk of linear growth faltering (stunting) presenting for diarrheal care
Authors: Ahmed Sharia M. , Brintz Ben J. , Pavlinac Patricia B , Shahrin Lubaba , Huq Sayeeda , Levine Adam C. , Nelson Eric J. , Platts-Mills James A , Kotloff Karen L , Leung Daniel T
Published: March 2022

Background

Nearly 150 million children under-5 years of age were stunted in 2020. We aimed to develop a clinical prediction rule (CPR) to identify children likely to experience additional stunting following acute diarrhea, to enable targeted approaches to prevent this irreversible outcome.

Methodology

We used clinical and demographic data from the Global Enteric Multicenter Study (GEMS) study to build predictive models of linear growth faltering (decrease of ≥0.5 or ≥1.0 in height-for-age z-score [HAZ] at 60 day follow-up) in children ≤59 months presenting with moderate-to-severe diarrhea (MSD), and community controls, in Africa and Asia. We screened variables using random forests, and assessed predictive performance with random forest regression and logistic regression using 5-fold cross-validation. We used the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study to A) re-derive, and B) externally validate our GEMS-derived CPR.

Results

Of 7639 children in GEMS, 1744 (22.8%) experienced severe growth faltering (≥0.5 decrease in HAZ). In MAL-ED, we analyzed 5683 diarrhea episodes from 1322 children, of which 961(16.9%) episodes experienced severe growth faltering. Top predictors of growth faltering in GEMS were: age, HAZ at enrollment, respiratory rate, temperature, and number of people living in the household. The maximum AUC was 0.75 (95% CI: 0.75, 0.75) with 20 predictors, while 2 predictors yielded an AUC of 0.71 (95% CI: 0.71, 0.72). Results were similar in the MAL-ED re-derivation. A 2-variable CPR derived from children 0-23 months in GEMS had an AUC=0.63 (95% CI 0.62, 0.65), and AUC=0.68 (95% CI: 0.63, 0.74) when externally validated in MAL-ED.

Conclusions

Our findings indicate that use of prediction rules could help identify children at risk of poor outcomes after an episode of diarrheal illness.
Altered Heterogeneity of Ageing Lung Endothelium is a Hallmark of Idiopathic Pulmonary Fibrosis
Authors: Faulkner Eamon C. , Moverley Adam A. , Hart Simon P. , Nikitenko Leonid L.
Published: March 2022

Background

Older age is the main risk factor for chronic lung diseases including idiopathic pulmonary fibrosis (IPF). Halting or reversing progression of IPF remains an unmet clinical need due to limited knowledge of underlying mechanisms. The lung circulatory system, composed of blood (pulmonary and bronchial) and lymphatic vessels networks, has been implicated in IPF pathophysiology in elderly people, based solely on reports of altered density and increased permeability of vessels.

Aim

We aimed to define heterogeneity and IPF-associated changes of lung endothelial cells (EC or endothelium) by comparing gene expression in tissues from elderly people - transplant donors and recipients with IPF.

Methods

Single-cell RNA sequencing (scRNAseq) datasets of “ageing lung” tissues were selected only from those publicly available sources that contain age-matching samples for both groups (49- 77 years old donors and IPF patients; nine pairs in total), integrated and compared. Findings were validated by immunohistochemistry using EC-specific markers.

Results

The generation of integrated single-cell maps of ageing lung tissues revealed 17 subpopulations of endothelium (12 for blood and 5 for lymphatic vessels, including 9 novel), with distinct transcriptional profiles. In IPF lung, the heterogeneity of ageing lung endothelium was significantly altered - both in terms of cell numbers (linked to disease- related changes in tissue composition) and differentially expressed genes (associated with fibrosis, inflammation, differentiation and vasodilation) in individual pulmonary, bronchial and lymphatic EC subpopulations.

Conclusions

These findings reveal underappreciated extent of heterogeneity and IPF-associated changes of ageing lung endothelium. Our data suggest direct involvement of specific subpopulations of ageing lung endothelium in IPF pathophysiology, uncovering cellular and molecular targets which may have potential diagnostic, prognostic and therapeutic relevance. This study creates a conceptual framework for appreciating the disease-specific heterogeneity of ageing lung endothelium as a hallmark of IPF.
Risk Perceptions and Private Protective Behaviors: Evidence from COVID-19 Pandemic*
Authors: Bundorf M. Kate , DeMatteis Jill , Miller Grant , Polyakova Maria , Streeter Jialu L. , Wivagg Jonathan
Published: March 2022

We analyze data from a survey we administered during the COVID-19 pandemic to investigate the relationship between people’s subjective beliefs about risks and their private protective behaviors. On average, people substantially overestimate the absolute level of risk associated with economic activity, but have correct signals about their relative risk. Subjective risk beliefs are predictive of changes in economic activities independently of government policies. Government mandates restricting economic behavior, in turn, attenuate the relationship between subjective risk beliefs and protective behaviors.
Crops grown in mixtures show niche partitioning in spatial water uptake
Authors: Schmutz Anja , Schöb Christian
Published: March 2022

More diverse plant communities generally produce more biomass than monocultures. This benefit of plant diversity is supposed to stem from resource partitioning of species in mixtures. Different plant species might use the resources spatially, temporally, or chemically in different ways. Along the same lines, for agricultural production crop mixtures outperform monocultures. Differences in vertical root distributions of crop species in mixtures could explain such higher yield.

Here we used the stable isotopes of water and a Bayesian model to investigate the spatial water uptake patterns of six different crops species and how these patterns differ depending on the crop diversity. In addition, we calculated niche overlaps of water uptake as an indicator for belowground spatial niche partitioning, compared them among the different diversity levels, and linked them to productivity.

The spatial water uptake pattern differed among crop species. The effect of crop diversity had a minor effect on water uptake but varied strongly depending on the crop species. Niche overlap in spatial water uptake was highest in monocultures and decreased strongly in mixtures. Furthermore, productivity in mixtures was higher compared to monoculture. Additionally, we showed that increased competition intensity leads to stronger changes in water uptake patterns.

Synthesis. We found evidence for niche partitioning of spatial water uptake, and therefore complementary spatial root distribution, and higher productivity in crop mixtures compared to monocultures. Consequently, a more efficient use of soil resources in intercropping systems might explain their yield benefits.
A panoramic perspective on human phosphosites
Authors: Ramasamy Pathmanaban , Vandermarliere Elien , vranken Wim , Martens Lennart
Published: March 2022

Protein phosphorylation is the most common post-translational reversible modification of proteins and is key in the regulation of many cellular processes. Due to this importance, phosphorylation is extensively studied, resulting in the availability of a large amount of mass spectrometry based phospho-proteomics data. Here, we leverage the information in these large-scale phospho-proteomics datasets, as contained in Scop3P, to analyze and characterize proteome-wide protein phosphorylation sites (P-sites). First, we set out to differentiate correctly observed P-sites from false positive sites using five complementary site properties. We then describe the context of these P-sites in terms of protein structure, solvent accessibility, structural transitions and disorder, and biophysical properties. We also investigate the relative prevalence of disease-linked mutations on and around P-sites. Moreover, we also assess structural dynamics of P-sites in their phosphorylated and unphosphorylated state. Our study shows that the residues that gets phosphorylated are more flexible than their equivalent non-phosphorylated residues. Our structural and biophysical analyses of P-sites in solvent inaccessible (buried) regions of proteins show that these sites are primarily found in multi-site phospho-proteins, where highly dynamic structural transitions can occur upon binding with another protein. Finally, our analysis of the biophysical properties of P-site mutations shows that P-site mutations that occur in structurally rigid regions are more often involved in disease.