bluuebunny/crossref_metadata_2025 huggingface dataset:
Abandonment of intravenous volume expansion after preoperative receipt of α-blockers in patients with adrenal pheochromocytoma was not an independent risk factor for intraoperative hemodynamic instability
Authors: Yan Kun-wu , Tian Xiao-fei , Wu Yan-ni , Cai Meng , Guo Ming-tao
Published: April 2023

Background

There is no consensus on whether intravenous rehydration must be added after preoperative phenoxybenzamine (PXB) administration for pheochromocytoma. The aim of this study is to investigate whether abandonment of intravenous volume expansion after PXB administration is associated with intraoperative hemodynamic instability.

Methods

83 Patients with pheochromocytoma received surgical treatment in the Department of Urology, Handan First Hospital, between October 2014 and July 2022. All patients were subclassified into either the hemodynamic stability group (HS group) or the hemodynamic instability group (HU group) according to whether intraoperative hemodynamic instability occurred, with 51 cases in HS group and 32 cases in HU group. Differences in data between the two groups were examined, and the risk factors for intraoperative hemodynamic instability were analyzed using logistic regression.

Results

The results of the analysis showed no statistically significant differences in age, sex, location of the tumor, surgical method, body mass index (BMI) ≥ 24 kg/m2, blood and urine catecholamine test results, preoperative oral PXB followed by combined intravenous volume expansion, proportion of patients with hypertension or diabetes mellitus or coronary heart disease between the two groups (P>0.05). The size of the tumor in the HS group was smaller than that in the HU group (5.3 ± 1.9 cm vs 6.2 ± 2.4 cm P=0.010). Multivariate analyses demonstrated that abandonment of intravenous volume expansion after preoperative receipt of α-blockers in patients with adrenal pheochromocytoma was not an independent risk factor for intraoperative hemodynamic instability. Only the tumor size (P=0.025) was an independent risk factor for intraoperative hemodynamic instability.

Conclusion

The purpose of general preoperative intravenous fluid expansion is to prevent hypotension after the tumor has been resected. In the current study, we indicated that preoperative management of pheochromocytomas using the α-blocker PXB in combination with intravenous volume expansion does not further reduce the risk of intraoperative hemodynamic instability or postoperative complications compared with oral PXB alone. Therefore, our study supports preoperative management of pheochromocytoma with a single α-blocker, PXB, as sufficient.
GH treatment in pediatric Down syndrome: a systematic review and mini meta-analysis
Authors: Shaki David , Hershkovitz Eli , Tamam Shai , Bollotin Arkadi , David Odeya , Yalovitsky Guy , Loewenthal Neta , Carmon Lior , Walker Dganit , Nowak Raphael , Haim Alon
Published: April 2023

Objective

To analyze and determine the safety and efficacy of growth hormone (GH) treatment in Down syndrome (DS) pediatric patients and to weigh ethical aspects involved.

Design

Systematic review and mini meta-analysis of the literature.

Methods

A search was performed in PubMed, Embase, Scopus, and PsycINFO through August 2022. Eligible studies included those who answered at least one of the following two questions: 1) What is the effect of growth hormone treatment in children with Down syndrome? 2) What are the ethical arguments in favor and against growth hormone treatment for children with Down syndrome? Multiple reviewers independently screened each article for eligibility.

Results

In total sixteen reports detailed medical effects of GH treatment in pediatric DS patients and eight studies dealt with ethical aspects of GH treatment. Treatment with GH resulted in significantly higher growth velocity in patients with DS. The ethical complexity is great but does not present insurmountable difficulties to the therapeutic option.

Conclusions

As GH treatment is safe and effective for short-term height growth, GH therapy should be considered in long-term treatment of DS children.
Revealing the rise of a living fossil menagerie
Authors: Lidgard Scott , Kitchen Emma
Published: April 2023

The living fossil concept continues to foster development of integrative research, as it has done since Darwin’s use of the term in 1859. It has been applied to a vast menagerie of biological entities across the kingdoms of life and at many levels in the biological hierarchy. Correspondingly, a number of primary living fossil criteria emerged and persisted all the while as disciplines, theories and practices of biology transformed. In this paper we attempt the first comprehensive analysis of the use of the term ‘living fossil’ from 1860 to the present. Employing a compilation of 719 publications and 853 unique entities, we examine: (1) patterns of change in the phylogenetic diversity of living fossils, their taxonomic ranks and groups, (2) the diverse subject areas in which living fossils play a role, and (3) the primary criteria used to designate living fossil status. Our analyses reveal how the menagerie has extended and diversified alongside technological developments in biological research. The average number of living fossil criteria applied per entity has escalated even more rapidly than the menagerie has expanded. We argue that the demonstrated persistence, ever-expanding scientific and public interest, and future utilization of living fossils reflects increasingly complex challenges to deep-seated expectations at the heart of a living fossil research agenda: omnipresent evolutionary change and inevitable disappearance or extinction.
Research on the path of practical cooperation between China and European Union countries under the environment of carbon neutrality and peak carbon dioxide emissions
Authors: Cai Wangang
Published: April 2023

Globalization is increasing daily with the development of the world economy and society. International conflicts, cooperation, and interdependence in international environmental relations have become increasingly prominent, laying a theoretical and practical basis for international environmental cooperation. The ecological protection industries of China and the EU (European Union) are facing great development opportunities. Many EU member states have advantages in developing the environmental protection industry, which facilitates all-around cooperation in the environmental protection industry with my country. Based on the target policy background of PCDE (peak carbon dioxide emissions) and CN (carbon neutrality) and domestic and foreign research, this paper proposes a study on the practical cooperation path between China and EU countries. Based on international input–output data, an economic output CDE (carbon dioxide emission) matrix is constructed to characterize countries’ economic and CDE correlation, thus forming a global CDE network. The analysis shows that the contribution rate of energy structure effect and energy intensity fluctuates slowly, indicating a positive and negative alternation; Our government should adopt an active energy optimization policy, speed up the formulation of macro policies such as carbon tax on energy-consuming industries, continuously optimize the energy structure and reduce the CDE intensity. By 2023, China’s unit GDP will remain the same by 40–50% compared with 2022. Furthermore, the practical cooperation path proposed in this paper can provide valuable insights for policymakers and stakeholders in both China and the EU to promote the development of the environmental protection industry and achieve the common goal of carbon neutrality. The findings of this study can be used to inform the design and implementation of policies and initiatives aimed at reducing carbon emissions, improving energy efficiency, and promoting sustainable economic growth. Additionally, the international CDE network constructed in this study can serve as a useful tool for monitoring and evaluating the effectiveness of environmental policies and initiatives at the international level. Overall, this paper contributes to the scientific understanding of the complex relationship between economic development and environmental protection and provides practical guidance for promoting international cooperation in the environmental protection industry.
Are inflammatory bowel diseases associated with an increased risk of COVID-19 susceptibility and severity? A two-sample Mendelian randomization study
Authors: Ai Qixiong , Yang Bo
Published: April 2023

Background: Due to inconsistent findings in observational studies regarding the relationship between inflammatory bowel disease (IBD), encompassing ulcerative colitis (UC) and Crohn’s disease (CD), and COVID-19, our objective is to explore a potential causative correlation between IBD and COVID-19 susceptibility and its severity using a two-sample Mendelian randomization (MR) analysis.

Methods: Using summary data from genome-wide association studies, IBD, including UC and CD, were used as exposure instruments, while COVID-19 susceptibility, hospitalization, and very severe illness were employed as the outcome. The five analysis methods were adopted to evaluate the causal relationship between two diseases, with the inverse variance weighted (IVW) method being the most important. Also, sensitivity analyses were done to make sure that the main results of the MR analyses were reliable.

Results: In the analysis using five methods, all p-values were higher than 0.05. There was no association between IBD and COVID-19 susceptibility, hospitalization, and severity in our MR study. The random-effect model was applied due to the existence of heterogeneity. MR-Egger regression revealed no indication of directional pleiotropy, and sensitivity analysis revealed similar relationships.

Conclusion: This MR study found no evidence to support that IBD (which includes UC and CD) increases the risk of COVID-19 susceptibility or severity. Our result needs further confirmation through larger epidemiological studies.
Research progress of extracellular vesicles as biomarkers in immunotherapy for non-small cell lung cancer
Authors: Ge Yang , Ye Ting , Fu Siyun , Jiang Xiaoying , Song Hang , Liu Bin , Wang Guoquan , Wang Jinghui
Published: April 2023

Lung cancer is one of the most severe forms of malignancy and a leading cause of cancer-related death worldwide, of which non-small cell lung cancer (NSCLC) is the most primary type observed in the clinic. NSCLC is mainly treated with surgery, radiotherapy, and chemotherapy. Additionally, targeted therapy and immunotherapy have also shown promising results. Several immunotherapies, including immune checkpoint inhibitors, have been developed for clinical use and have benefited patients with NSCLC. However, immunotherapy faces several challenges like poor response and unknown effective population. It is essential to identify novel predictive markers to further advance precision immunotherapy for NSCLC. Extracellular vesicles (EVs) present an important research direction. In this review, we focus on the role of EVs as a biomarker in NSCLC immunotherapy considering various perspectives, including the definition and properties of EVs, their role as biomarkers in current NSCLC immunotherapy, and different EV components as biomarkers in NSCLC immunotherapy research. We describe the cross-talk between the role of EVs as biomarkers and novel technical approaches or research concepts in NSCLC immunotherapy, such as neoadjuvants, multi-omics analysis, and the tumour microenvironment. This review will provide a reference for future research to improve the benefits of immunotherapy for patients with NSCLC.
mRNA-1273 boost after BNT162b2 vaccination generates comparable SARS-CoV-2-specific functional responses in naïve and COVID-19-recovered individuals
Authors: Lozano-Rodríguez Roberto , Avendaño-Ortíz José , Terrón Verónica , Montalbán-Hernández Karla , Casalvilla-Dueñas José , Bergón-Gutiérrez Marta , Mata-Martínez Pablo , Martín-Quirós Alejandro , García-Garrido Miguel Ángel , del Balzo-Castillo Álvaro , Peinado María , Gómez Laura , Llorente-Fernández Irene , Martín-Miguel Gema , Herrero-Benito Carmen , López-Morejón Lissette , Vela-Olmo Carmen , Cubillos-Zapata Carolina , López-Collazo Eduardo , del Fresno Carlos
Published: April 2023

Introduction

COVID-19 vaccines based on mRNA have represented a revolution in the biomedical research field. The initial two-dose vaccination schedule generates potent humoral and cellular responses, with a massive protective effect against severe COVID-19 and death. Months after this vaccination, levels of antibodies against SARS-CoV-2 waned, and this promoted the recommendation of a third vaccination dose.

Methods

We have performed an integral and longitudinal study of the immunological responses triggered by the booster mRNA-1273 vaccination, in a cohort of health workers previously vaccinated with two doses of the BNT162b2 vaccine at University Hospital La Paz located in Madrid, Spain. Circulating humoral responses and SARS-CoV-2-specific cellular reactions, after ex vivo restimulation of both T and B cells (cytokines production, proliferation, class switching), have been analyzed. Importantly, all along these studies, the analyses have been performed comparing naïve and subjects recovered from COVID-19, addressing the influence of a previous infection by SARS-CoV-2. Furthermore, as the injection of the third vaccination dose was contemporary to the rise of the Omicron BA.1 variant of concern, T- and B-cell-mediated cellular responses have been comparatively analyzed in response to this variant.

Results

All these analyses indicated that differential responses to vaccination due to a previous SARS-CoV-2 infection were balanced following the boost. The increase in circulating humoral responses due to this booster dropped after 6 months, whereas T-cell-mediated responses were more stable along the time. Finally, all the analyzed immunological features were dampened in response to the Omicron variant of concern, particularly late after the booster vaccination.

Conclusion

This work represents a follow-up longitudinal study for almost 1.5 years, analyzing in an integral manner the immunological responses triggered by the prime-boost mRNA-based vaccination schedule against COVID-19.
Prognostic significances of PD-L1- and CTLA-4-positive T cells and positive correlations of immunosuppressive marker expression between cancer tissue and peripheral blood in patients with gastric cancer
Authors: Lee Kun Hee , Kim So Jung , Woo Jin Seok , Lee Seung Yoon , Jhun Jooyeon , Moon Jeonghyeon , Jung Yoon Ju , Cho Mi-La , Song Kyo Young
Published: April 2023

Introduction

Although tumor, node, metastasis (TNM) staging has been used for prognostic assessment of gastric cancer (GC), the prognosis may vary among patients with the same TNM stage. Recently, the TNM-Immune (TNM-I) classification staging system has been used for prognostic assessment of colorectal cancer based on intra-tumor T-cell status, which is a superior prognostic factor compared with the American Joint Committee on Cancer staging manual. However, an immunoscoring system with prognostic significance for GC has not been established.

Method

Here, we evaluated immune phenotypes in cancer and normal tissues, then examined correlations between tissues and peripheral blood. GC patients who underwent gastrectomy at Seoul St. Mary’s Hospital between February 2000 and May 2021 were included. We collected 43 peripheral blood samples preoperatively and a pair of gastric mucosal samples postoperatively, including normal and cancer mucosa, which did not influence tumor diagnosis and staging. Tissue microarray samples of GC were collected from 136 patients during surgery. We investigated correlations of immune phenotypes between tissues and peripheral blood using immunofluorescence imaging and flow cytometry, respectively. GC mucosa exhibited an increased number of CD4+ T cells, as well as increased expression levels of immunosuppressive markers (e.g., programmed death-ligand-1 [PD-L1], cytotoxic T lymphocyte antigen-4 [CTLA-4], and interleukin-10), in CD4+ T cells and non-T cells.

Result

The expression levels of immunosuppressive markers were significantly increased in cancer tissues and peripheral blood mononuclear cells. In gastric mucosal tissues and peripheral blood of GC patients, similar immunosuppression phenotypes were observed, including increased numbers of PD-L1- and CTLA-4-positive T cells.

Discussion

Therefore, peripheral blood analysis may be an important tool for prognostic assessment of GC patients.
Efficacy and safety of serplulimab plus nab-paclitaxel in previously treated patients with PD-L1–positive advanced cervical cancer: a phase II, single-arm study
Authors: An Jusheng , Li Xiumin , Wang Jing , Zhu Lijing , An Ruifang , Jiang Kui , Huang Yi , Wang Ke , Li Guiling , Wang Chunyan , Yuan Jianlin , Hou Xiaoli , Yang Guiyu , Li Jing , Wang Qingyu , Zhu Jun , Wu Lingying
Published: April 2023

Objective

We report the efficacy and safety of serplulimab, a novel humanized anti–programmed death-1 antibody, plus nanoparticle albumin-bound (nab)-paclitaxel in previously treated patients with programmed death ligand-1 (PD-L1)–positive advanced cervical cancer.

Methods

Patients diagnosed with PD-L1–positive (combined positive score ≥1) cervical cancer were enrolled in this single-arm, open-label, phase II study. They were given serplulimab 4.5 mg/kg for up to 2 years (35 dosing cycles) plus nab-paclitaxel 260 mg/m2 for up to six cycles once every 3 weeks. Primary endpoints were safety and objective response rate (ORR) assessed by independent radiological review committee (IRRC) per RECIST version 1.1. Secondary endpoints included ORR assessed by the investigator, duration of response (DOR), progression-free survival (PFS), and overall survival (OS).

Results

Between December 2019 and June 2020, 52 patients were screened and 21 were enrolled. IRRC-assessed ORR was 57.1% (95% confidence interval [CI] 34.0–78.2%); 3 (14.3%) patients achieved complete response and 9 (42.9%) partial response. The median DOR was not reached (NR) (95% CI 4.1–NR). IRRC-assessed median PFS was 5.7 months (95% CI 3.0–NR), and median OS was 15.5 months (95% CI 10.5–NR). Investigator-assessed ORR was 47.6% (95% CI 25.7–70.2%). Seventeen (81.0%) patients experienced grade ≥3 treatment-emergent adverse events. Grade ≥3 adverse drug reactions were reported in 7 (33.3%) patients. Immune-related adverse events occurred in 12 (57.1%) patients.

Conclusions

In previously treated patients with PD-L1–positive advanced cervical cancer, serplulimab plus nab-paclitaxel provided durable clinical activity and a manageable safety profile.

Clinical trial registration

ClinicalTrials.gov, identifier NCT04150575.
Etiology of viral induced acute liver failure and defensins as potential therapeutic agents in ALF treatment
Authors: Hrynkiewicz Rafał , Niedźwiedzka-Rystwej Paulina
Published: April 2023

Acute liver failure (ALF) is a rare and severe disease, which, despite continuous advances in medicine, is still characterized by high mortality (65-85%). Very often, a liver transplant is the only effective treatment for ALF. Despite the implementation of prophylactic vaccinations in the world, the viral background of ALF is still a problem and leads to many deaths. Depending on the cause of ALF, it is sometimes possible to reverse this condition with appropriate therapies, which is why the search for effective antiviral agents seems to be a very desirable direction of research. Defensins, which are our natural antimicrobial peptides, have a very high potential to be used as therapeutic agents for infectious liver diseases. Previous studies on the expression of human defensins have shown that increased expression of human α and β-defensins in HCV and HBV infections is associated with a better response to treatment. Unfortunately, conducting clinical trials for ALF is very difficult due to the severity of the disease and the low incidence, therefore animal models are important for the development of new therapeutic strategies. One of the best animal models that has real reference to research on acute liver failure (ALF) is rabbit hemorrhagic disease in rabbits caused by the Lagovirus europaeus virus. So far, there have been no studies on the potential of defensins in rabbits infected with Lagovirus europaeus virus.
First records of the blurred lantern shark Etmopterus bigelowi from the Cayman Islands, Western Atlantic
Authors: Gallagher Austin J. , Shipley Oliver N. , De Silva Christine , Kohler Johanna K. , Fernandes Teresa F. , Austin Timothy , Ormond Rupert F. , Gore Mauvis A.
Published: April 2023

The genus Etmopterus is the most speciose group of small bodied deep-sea sharks found throughout the tropical and subtropical Western Atlantic. Despite exhibiting a global distribution at the genus-level, the blurred lantern shark (Etempoterus bigelowi) is known only from a few records in the Western and Southern Atlantic Ocean. Through in-situ video observations using deep-sea landers, we provide two new locality records of the blurred lantern shark from the deep waters off the Cayman Islands, Caribbean Sea. Three unique individuals were recorded across two separate deployments between 653m – 668m. These observations provide the first records of this species in the Caribbean Sea, adding to the minimal knowledge of the species’ distribution throughout the Western Atlantic Ocean.
Diversity, distribution, and functional potentials of magroviruses from marine and brackish waters
Authors: Xu Bu , Fan Lu , Wang Wenxiu , Zhu Yuanqing , Zhang Chuanlun
Published: April 2023

Marine group II (MGII) archaea (Ca. Poseidoniales) are among the most abundant microbes in global oceanic surface waters and play an important role in driving marine biogeochemical cycles. Magroviruses – the viruses of MGII archaea have been recently found to occur ubiquitously in surface ocean. However, their diversity, distribution, and potential ecological functions in coastal zones especially brackish waters are unknown. Here we obtained 234 non-redundant magroviral genomes from brackish surface waters by using homology searches for viral signature proteins highlighting the uncovered vast diversity of this novel viral group. Phylogenetic analysis based on these brackish magroviruses along with previously reported marine ones identified six taxonomic groups with close evolutionary connection to both haloviruses and the viruses of Marine Group I archaea. Magroviruses were present abundantly both in brackish and open ocean samples with some showing habitat specification and others having broad spectrums of distribution between different habitats. Genome annotation suggests they may be involved in regulating multiple metabolic pathways of MGII archaea. Our results uncover the previously overlooked diversity and ecological potentials of a major archaeal virial group in global ocean and brackish waters and shed light on the cryptic evolutionary history of archaeal viruses.
Field scale biodegradation of total petroleum hydrocarbons and soil restoration by Ecopiles: microbiological analysis of the process
Authors: Martínez-Cuesta Ruben , Conlon Robert , Wang Mutian , Blanco-Romero Esther , Durán David , Redondo-Nieto Miguel , Dowling David , Garrido-Sanz Daniel , Martin Marta , Germaine Kieran , Rivilla Rafael
Published: April 2023

Ecopiling is a method for biodegradation of hydrocarbons in soils. It derives from Biopiles, but phytoremediation is added to biostimulation with nitrogen fertilization and bioaugmentation with local bacteria. We have constructed seven Ecopiles with soil heavily polluted with hydrocarbons in Carlow (Ireland). The aim of the study was to analyze changes in the microbial community during ecopiling. In the course of 18 months of remediation, total petroleum hydrocarbons values decreased in 99 and 88% on average for aliphatics and aromatics, respectively, indicating a successful biodegradation. Community analysis showed that bacterial alfa diversity (Shannon Index), increased with the degradation of hydrocarbons, starting at an average value of 7.59 and ending at an average value of 9.38. Beta-diversity analysis, was performed using Bray-Curtis distances and PCoA ordination, where the two first principal components (PCs) explain the 17 and 14% of the observed variance, respectively. The results show that samples tend to cluster by sampling time instead of by Ecopile. This pattern is supported by the hierarchical clustering analysis, where most samples from the same timepoint clustered together. We used DSeq2 to determine the differential abundance of bacterial populations in Ecopiles at the beginning and the end of the treatment. While TPHs degraders are more abundant at the start of the experiment, these populations are substituted by bacterial populations typical of clean soils by the end of the biodegradation process. Similar results are found for the fungal community, indicating that the microbial community follows a succession along the process. This succession starts with a TPH degraders or tolerant enriched community, and finish with a microbial community typical of clean soils.
Early maladaptive schemas in episodic and chronic migraine in adolescents
Authors: Güler Aksu Gülen , Kayar Ozan , Tufan Ali Evren , Kütük Meryem Özlem , Özdağ Acarli Ayşe Nur , Sucu Damla Hazal , Taşdelen Bahar , Toros Fevziye , Özge Aynur
Published: April 2023

Introduction

Psychotherapies, such as schema therapy, are receiving increasing attention in the management of pediatric headaches. The purpose of this study was to investigate early maladaptive schemas (EMSs) in adolescents with episodic migraine (EM) and chronic migraine (CM).

Methods

This clinic-based, cross-sectional study consisted of 167 adolescents, aged 12–18, who were diagnosed with EM (n = 140) and CM (n = 27). The clinical characteristics of migraine, its accompanying symptoms, EMSs, the interrelationship of EMSs, depression, and anxiety were evaluated. We specifically analyzed psychopathology and abuse history as covariates in this study.

Results

Defectiveness/shame, mistrust/abuse, abandonment/instability, enmeshment/undeveloped self, self-sacrifice, and subjugation schemas were more prevalent in the CM group. In terms of schema domains, the CM group scored significantly higher in disconnection/rejection and other orientations. Psychopathology did not affect the EMS scores, but a history of sexual abuse did. In patients with EM, a relationship was found between the variables of anxiety, depression, and five of the EMS domains. On the other hand, the CM group showed a significant relationship with anxiety, hypervigilance/inhibition, disconnection/rejection, and other orientation domains.

Discussion

This study highlights the value of EMSs, anxiety, and depression in young people with EM and CM. Schema therapy and schema-based therapeutic interventions should be researched, especially in pediatric migraine, as they may potentially prevent the progression to treatment-resistant migraine.
EEG-based analysis for pilots’ at-risk cognitive competency identification using RF-CNN algorithm
Authors: Jiang Shaoqi , Chen Weijiong , Ren Zhenzhen , Zhu He
Published: April 2023

Cognitive competency is an essential complement to the existing ship pilot screening system that should be focused on. Situation awareness (SA), as the cognitive foundation of unsafe behaviors, is susceptible to influencing piloting performance. To address this issue, this paper develops an identification model based on random forest- convolutional neural network (RF-CNN) method for detecting at-risk cognitive competency (i.e., low SA level) using wearable EEG signal acquisition technology. In the poor visibility scene, the pilots’ SA levels were correlated with EEG frequency metrics in frontal (F) and central (C) regions, including α/β (p = 0.071 < 0.1 in F and p = 0.042 < 0.05 in C), θ/(α + θ) (p = 0.048 < 0.05 in F and p = 0.026 < 0.05 in C) and (α + θ)/β (p = 0.046 < 0.05 in F and p = 0.012 < 0.05 in C), and then a total of 12 correlation features were obtained based on a 5 s sliding time window. Using the RF algorithm developed by principal component analysis (PCA) for further feature combination, these salient combinations are used as input sets to obtain the CNN algorithm with optimal parameters for identification. The comparative results of the proposed RF-CNN (accuracy is 84.8%) against individual RF (accuracy is 78.1%) and CNN (accuracy is 81.6%) methods demonstrate that the RF-CNN with feature optimization provides the best identification of at-risk cognitive competency (accuracy increases 6.7%). Overall, the results of this paper provide key technical support for the development of an adaptive evaluation system of pilots’ cognitive competency based on intelligent technology, and lay the foundation and framework for monitoring the cognitive process and competency of ship piloting operation in China.
The cerebellum and fear extinction: evidence from rodent and human studies
Authors: Doubliez Alice , Nio Enzo , Senovilla-Sanz Fernando , Spatharioti Vasiliki , Apps Richard , Timmann Dagmar , Lawrenson Charlotte L.
Published: April 2023

The role of the cerebellum in emotional control has gained increasing interest, with studies showing it is involved in fear learning and memory in both humans and rodents. This review will focus on the contributions of the cerebellum to the extinction of learned fear responses. Extinction of fearful memories is critical for adaptive behaviour, and is clinically relevant to anxiety disorders such as post-traumatic stress disorder, in which deficits in extinction processes are thought to occur. We present evidence that supports cerebellar involvement in fear extinction, from rodent studies that investigate molecular mechanisms and functional connectivity with other brain regions of the known fear extinction network, to fMRI studies in humans. This evidence is considered in relation to the theoretical framework that the cerebellum is involved in the formation and updating of internal models of the inner and outer world by detecting errors between predicted and actual outcomes. In the case of fear conditioning, these internal models are thought to predict the occurrence of an aversive unconditioned stimulus (US), and when the aversive US is unexpectedly omitted during extinction learning the cerebellum uses prediction errors to update the internal model. Differences between human and rodent studies are highlighted to help inform future work.
Does Internet use connect smallholder farmers to a healthy diet? Evidence from rural China
Authors: Yang Mingwei , Zhang Zhiyong , Wang Zheng
Published: April 2023

Introduction

Undernutrition and micronutrient malnutrition remain problems of significant magnitude among small-scale subsistence farmers, posing a serious threat to their health and well-being. Developing a healthy diet can effectively reduce this threat. Fortunately, the Internet can speed up the process.

Methods

Based on survey data from 5,114 farm households in nine provinces in China, this study quantitatively assesses the impact of Internet use on the dietary quality of smallholder farmers using OLS regression models and PSM models.

Results/Discussion

(1) Internet use can significantly contribute to dietary diversity and dietary rationality among smallholder farmers, thus optimizing their dietary structure. (2) Internet use significantly increased the average consumption amounts of milk and its products (2.9 g), fruits (21.5 g), eggs (7.5 g), and vegetables (27.1 g), while also decreasing the intake of salts (1.5 g) and oil (3.8 g). (3) The pull of internet use to improve diet quality is more significant for smallholder households with lower levels of education, older heads of households, and higher household incomes. (4) A possible mechanism is that Internet use increases household income and information access skills of rural residents, thus improving their dietary quality. In summary, governments should further promote Internet penetration in rural areas for health purposes.
Exploring the underutilized novel foods and starches for formulation of low glycemic therapeutic foods: a review
Authors: Dega Vijayalakshmi , Barbhai Mrunal Deepak
Published: April 2023

Rising incidences of life-style disorders like obesity, diabetes and cardiovascular diseases are a matter of concern coupled with escalated consumption of highly refined and high energy foods with low nutrient density. Food choices of consumers have witnessed significant changes globally with rising preference to highly processed palatable foods. Thus, it calls food scientists, researchers and nutritionists’ attention towards developing and promoting pleasant-tasting yet healthy foods with added nutritional benefits. This review highlights selected underutilized and novel ingredients from different food sources and their by-products that are gaining popularity because of their nutrient density, that can be employed to improve the nutritional quality of conventionally available empty-calorie foods. It also emphasizes on the therapeutic benefits of foods developed from these understudied grains, nuts, processing by-products of grains, fruits- and vegetable-byproducts and nutraceutical starches. This review aims to draw attention of food scientists and industrialists towards popularizing the utilization of these unconventional, yet nutrient rich foods sources in improving the nutritional profile of the conventional foods lacking in nutrient density.
Case Report: Adjuvant image-guided radiation therapy reduces surgical invasiveness in malignant peripheral nerve sheath tumors
Authors: Harikar Mandara M. , Ferini Gianluca , Palmisciano Paolo , Shakir Muhammad , Amico Paolo , Ferraresi Stefano , Umana Giuseppe E.
Published: April 2023

Introduction

Malignant peripheral nerve sheath tumors (MPNSTs) are a group of rare soft tissue sarcomas of mesenchymal origin. These tumors generally require extensive local excision owing to their aggressive potential. Though the role of radiotherapy is controversial, in this report, we present the case of an MPNST in the forearm that was treated with microsurgery followed by image-guided radiation therapy to achieve complete tumor disappearance at the 18-month follow-up.

Case report

A 69-year-old woman with underlying paranoid schizophrenia was referred to our department with pain, severe swelling, and ecchymosis of her right forearm. Physical examination showed hypoesthesia in the segments innervated by the median nerve and reduced motor strength of her right hand. A gadolinium-enhanced MRI showed a large malignant peripheral nerve sheath tumor (13 x 8 x 7 cm) of the median nerve in the forearm. She underwent microsurgical en-bloc tumor resection with sparing of the median nerve. Thirty-five days postoperatively, she underwent image-guided radiotherapy (IGRT) using volumetric modulated arc therapy (VMAT). Serial MRI scans of the forearm with Gadolinium and whole-body CT scan with contrast enhancement at 30 days, 6 months, 1 year, and 18 months postoperatively documented no tumor recurrence, remnants, or metastases.

Conclusions

In this report, we demonstrate the successful use of advanced radiotherapy techniques such as IGRT while avoiding demolitive surgery for MPNST. Though a longer follow-up is necessary, at the 18-month follow-up, the patient demonstrated good outcomes from surgical resection followed by adjuvant RT for MPNST in the forearm.
Predictive models and survival analysis of postoperative mental health disturbances in adult glioma patients
Authors: Wang Yi , Zhang Jie , Luo Chen , Yao Ye , Qin Guoyou , Wu Jinsong
Published: April 2023

Background and Objectives

Patients with primary malignant brain tumors may experience mental health disturbances that can significantly affect their daily life. This study aims to identify risk factors and generate predictive models for postoperative mental health disturbances (PMHDs) in adult glioma patients in accordance with different clinical periods; additionally, survival analyses will be performed.

Methods

This longitudinal cohort study included 2,243 adult patients (age at diagnosis ≥ 18 years) with nonrecurrent glioma who were pathologically diagnosed and had undergone initial surgical resection. Six indicators of distress, sadness, fear, irritability, mood and enjoyment of life, ranging from 0-10, were selected to assess PMHDs in glioma patients in the third month after surgery, mainly referring to the M.D. Anderson Symptom Inventory Brain Tumor Module (MDASI-BT). Factor analysis (FA) was applied on these indicators to divide participants into PMHD and control groups based on composite factor scores. Survival analyses were performed, and separate logistic regression models were formulated for preoperative and postoperative factors predicting PMHDs.

Results

A total of 2,243 adult glioma patients were included in this study. Based on factor analysis results, 300 glioma patients had PMHDs in the third postoperative month, and the remaining 1,943 were controls. Candidate predictors for PMHDs in the preoperative model were associated with age, clinical symptoms (intracranial space-occupying lesion, muscle weakness and memory deterioration), and tumor location (corpus callosum, basal ganglia and brainstem), whereas age, clinical symptoms (nausea and memory deterioration), tumor location (basal ganglia and brainstem), hospitalization days, WHO grade 4, postoperative chemotherapy or radiotherapy and postoperative Karnofsky Performance Scale (KPS) served as important factors in the postoperative model. In addition, the median overall survival (OS) time for glioma patients with PMHDs was 19 months, compared to 13 months for glioblastoma, IDH-wild type (GBM) patients with PMHDs.

Conclusion

The risk factors for PMHDs were identified. These findings may provide new insights into predicting the probability of PMHD occurrence in glioma patients in addition to aiding effective early intervention and improving prognosis based on different clinical stages.
Unwelcome guests – the role of gland-associated Helicobacter pylori infection in gastric carcinogenesis
Authors: Beccaceci Giulia , Sigal Michael
Published: April 2023

Helicobacter pylori (H. pylori) are Gram-negative bacteria that cause chronic gastritis and are considered the main risk factor for the development of gastric cancer. H. pylori have evolved to survive the harsh luminal environment of the stomach and are known to cause damage and signaling aberrations in gastric epithelial cells, which can result in premalignant and malignant pathology. As well as colonizing the gastric mucus and surface epithelial cells, a subpopulation of H. pylori can invade deep into the gastric glands and directly interact with progenitor and stem cells. Gland colonization therefore bears the potential to cause direct injury to long-lived cells. Moreover, this bacterial subpopulation triggers a series of host responses that cause an enhanced proliferation of stem cells. Here, we review recent insights into how gastric gland colonization by H. pylori is established, the resulting pro-carcinogenic epithelial signaling alterations, as well as new insights into stem cell responses to infection. Together these point towards a critical role of gland-associated H. pylori in the development of gastric cancer.
The new Italian registry of infantile thrombosis (RITI): A reflection on its journey, challenges and pitfalls
Authors: Pelizza Maria Federica , Martinato Matteo , Rosati Anna , Nosadini Margherita , Saracco Paola , Giordano Paola , Luciani Matteo , Ilardi Laura , Lasagni Donatella , Molinari Angelo Claudio , Bagna Rossana , Palmieri Antonella , Ramenghi Luca Antonio , Grassi Massimo , Magarotto Mariella , Magnetti Federica , Francavilla Andrea , Indolfi Giuseppe , Suppiej Agnese , Gentilomo Chiara , Restelli Roberta , Tufano Antonella , Tormene Daniela , Pin Jacopo Norberto , Tona Clarissa , Meneghesso Davide , Rota Lidia , Conti Marta , Russo Giovanna , Lorenzoni Giulia , Gregori Dario , Sartori Stefano , Simioni Paolo ,   Collaborators of the R.I.T.I. (Italian Registry of Infantile Thrombosis)
Published: April 2023

Introduction

Thrombotic events in neonates and children represent a rare although severe occurrence in view of the associated risk of mortality and sequelae. Quality evidence is limited in this field, and registry studies provide an essential base for research. The aim of this paper is to present the new Italian Registry of Infantile Thrombosis (RITI), set it into the scene of international thrombosis and stroke registries, and provide some insight on the challenges associated with registry management.

Methods

We present the detailed structure and content of the new RITI registry, a brief overview of its main data, and a reflection on its features, pitfalls and the main challenges related to its management.

Results

The RITI, initially started in 2007 and officially re-launched in 2017 after structural modifications, is a non-interventional retrospective and prospective registry study collecting data on neonatal and pediatric patients (0–18 years) who experienced a systemic or cerebral thrombotic event in Italy. The RITI is managed by a multidisciplinary team with expertise in pediatric thrombosis, and participation is open to all Italian physicians, on a voluntary basis. The overall aim of the registry is to acquire new evidence to better characterize the population of children with thrombotic events and improve their management and outcome. 48 Italian pediatric and intensive care units are actively involved in the RITI, including 85 medical doctors from 16 Italian regions. A total of 1,001 neonates and children affected by cerebral or systemic thrombosis have been enrolled.

Discussion

The RITI is one of the largest available European registries of neonatal and pediatric thrombosis. National registries like the RITI represent a model for the study of rare conditions based on multidisciplinary and multicenter collaboration, aimed at overcoming the limitations due to small populations of patients, and creating a network of experts for patient referral and continuous education. Moreover, registry studies have a pivotal role in the research on pediatric thrombosis, due to the limited feasibility of high-quality studies. In our experience, the main critical stages, pitfalls and challenges in registry management include adequate registry designing, diffusion, data completeness and quality control.
Kawasaki disease complicated with shock syndrome, macrophage activation syndrome, and acute abdomen in children: Two case reports
Authors: Yi Cong , She Xiang , Chen Jia
Published: April 2023

Background

Kawasaki disease (KD) is an acute systemic vasculitis that can involve multiple organs. Few reports have been published about KD patients presenting with multiple complications such as acute abdomen, KD shock syndrome (KDSS), and macrophage activation syndrome (MAS).

Case Description

We present the cases of two males (9 and 12 years old) diagnosed with KD accompanied by rare manifestations. Case 1 is a 9-year-old male treated for acute appendicitis, KDSS, and MAS. Case 2 is a 12-year-old male who presented with KDSS, MAS, and an ileal perforation. They were treated with intravenous immunoglobulin, aspirin, high-dose corticosteroids, vasoactive drugs, and symptomatic treatment, with good outcomes.

Conclusions

Clinicians should be aware of the possibility of KD in the presence of fever and unusual manifestations, such as severe inflammatory indicators and acute abdomen that is nonresponsive to antibiotic therapy. Meanwhile, KD-related unusual complications should be recognized, such as KDSS and MAS.
Exhaled aerosols among PCR-confirmed SARS-CoV-2-infected children
Authors: Schuchmann Pia , Scheuch Gerhard , Naumann Rolf , Keute Marius , Lücke Thomas , Zielen Stefan , Brinkmann Folke
Published: April 2023

Background

Available data on aerosol emissions among children and adolescents during spontaneous breathing are limited. Our aim was to gain insight into the role of children in the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and whether aerosol measurements among children can be used to help detect so-called superspreaders—infected individuals with extremely high numbers of exhaled aerosol particles.

Methods

In this prospective study, the aerosol concentrations of SARS-CoV-2 PCR-positive and SARS-CoV-2 PCR-negative children and adolescents (2–17 years) were investigated. All subjects were asked about their current health status and medical history. The exhaled aerosol particle counts of PCR-negative and PCR-positive subjects were measured using the Resp-Aer-Meter (Palas GmbH, Karlsruhe, Germany) and compared using linear regression.

Results

A total of 250 children and adolescents were included in this study, 105 of whom were SARS-CoV-2 positive and 145 of whom were SARS-CoV-2 negative. The median age in both groups was 9 years (IQR 7–11 years). A total of 124 (49.6%) participants were female, and 126 (50.4%) participants were male. A total of 81.9% of the SARS-CoV-2-positive group had symptoms of viral infection. The median particle count of all individuals was 79.55 particles/liter (IQR 44.55–141.15). There was a tendency for older children to exhale more particles (1–5 years: 79.54 p/L; 6–11 years: 77.96 p/L; 12–17 years: 98.63 p/L). SARS-CoV-2 PCR status was not a bivariate predictor (t = 0.82, p = 0.415) of exhaled aerosol particle count; however, SARS-CoV-2 status was shown to be a significant predictor in a multiple regression model together with age, body mass index (BMI), COVID-19 vaccination, and past SARS-CoV-2 infection (t = 2.81, p = 0.005). COVID-19 vaccination status was a highly significant predictor of exhaled aerosol particles (p < .001).

Conclusion

During SARS-CoV-2 infection, children and adolescents did not have elevated aerosol levels. In addition, no superspreaders were found.
Rapid visual characterization of alkaloid changes in traditional processing of Tibetan medicine Aconitum pendulum by high-performance thin-layer chromatography coupled with desorption electrospray ionization mass spectrometry imaging
Authors: Tan Xiaoyan , He Qingxiu , Pei Zhaoqing , Liu Yue , Feng Zige , Li Congying , Tang Ce , Zhang Yi
Published: April 2023

Radix Aconiti, also known as Tie-bang-chui (TBC), Pang-a-na-bao, and Bang-na, is a typical aconitum Tibetan medicine and a perennial herb of the genus Aconitum pendulum Busch. and A. flavum Hand. -Mazz. dry roots. It has high toxicity and remarkable efficacy; as such, it is a typical “highly toxic and effective” drug that needs be processed and used. Processing methods of this Tibetan medicine include non-heating of highland barley wine (HBW) and fructus chebulae soup (FCS). This work aimed to understand differences in chemical composition between non-heat processed products and raw TBC. In this study, high-performance thin-layer chromatography (HPTLC) and desorption electrospray ionization mass spectrometry imaging (DESI-MSI) were used to analyze the chemical composition of TBC processed by FCS (F-TBC) and HBW (H-TBC). The MRM mode of HPLC-QqQ-MS/MS was selected to determine the changes of several representative alkaloids to comparison with the former results. A total of 52 chemical constituents were identified in raw and processed products, and the chemical composition of F-TBC and H-TBC changed slightly compared with that of raw TBC. The processing mechanism of H-TBC was also different from that of F-TBC, which might be related to the large amount of acidic tannins in FCS. It was found that the content of all six alkaloids decreased after processing by FCS, and all five alkaloids decreased except aconitine increased after processing by HBW. The combination of HPTLC and DESI-MSI could be an effective method for rapid identification of chemical components and changing rules in ethnic medicine. The wide application of this technology provides not only an alternative method for the traditional separation and identification of secondary metabolism but also a reference for research on the processing mechanism and quality control of ethnic medicine.