bluuebunny/crossref_metadata_2025 huggingface dataset:
Systemic sclerosis manifestations and clinical outcomes in Hispanics/Latinos of the American Southwest
Authors: Nunez Sharon E , Ariza-Hutchinson Angie , Fields Roderick A , Vondenberg Jaime A , Patel Rosemina A , Emil N Suzanne , Muruganandam Maheswari , Gibb James I , Poole Janet L , Sibbitt Wilmer L
Published: April 2022

Objective:

Certain Hispanic/Latino (Hispanic) populations have been reported to have higher rates and severity of systemic sclerosis; however, little is known of systemic sclerosis in the American Southwest. This study compared manifestations of systemic sclerosis in Hispanics with non-Hispanics of New Mexico.

Methods:

This cross-sectional longitudinal study included 109 systemic sclerosis patients followed over a mean of 12.6 ± 8.9 years. Subjects were repetitively evaluated including physical examination, echocardiography, chest imaging, and serologic testing and observed for complications. Disease characteristics and long-term outcomes were statistically compared between self-identified Hispanic and non-Hispanic subjects.

Results:

A total of 73 (67%) systemic sclerosis subjects were Hispanic and 36 (33%) were non-Hispanic. The cohorts were similar in mean age, age of systemic sclerosis onset, limited versus diffuse cutaneous systemic sclerosis, telangiectases, gastroesophageal reflux disease, Raynaud’s phenomenon, autoantibody profile, interstitial lung disease, pulmonary hypertension, scleroderma renal crisis, mortality, and comorbid malignancy (all p > 0.05). However, the standardized mortality ratio was increased in both cohorts relative to age-adjusted mortality: Hispanic: 2.08, confidence interval (1.94–2.24); non-Hispanic: 1.56, confidence interval (1.46–1.68). Furthermore, the standardized incidence ratio for malignancy was increased in both cohorts: Hispanic: 1.45, confidence interval (1.35–1.56); non-Hispanic: 1.24, confidence interval (1.16–1.34). The mean age of cancer diagnosis occurred at a significantly younger age in Hispanics (Hispanics: 53.1 ± 9.7 years; non-Hispanics 63.7 ± 7.9 years; 95% confidence interval: −19 ⩽ 10.6 ⩽ 2.2; p = 0.016).

Conclusion:

Systemic sclerosis phenotype, autoantibodies, complications, outcomes, malignancy rates, and mortality are generally similar between Hispanics and non-Hispanics with systemic sclerosis in the American Southwest. However, age-adjusted comorbid malignancy and mortality rates are significantly increased in both groups.
Musculoskeletal ultrasound of the shoulder in systemic sclerosis
Authors: Surat Vatakan , Sirasaporn Patpiya , Foocharoen Chingching
Published: April 2022

Objectives:

To explore shoulder findings by ultrasonography and to find factors associated with shoulder ultrasonographic abnormalities in systemic sclerosis patients.

Methods:

A series of systemic sclerosis patients who attended the scleroderma clinic, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand, were prospectively evaluated for baseline characteristics, physical examination, and ultrasonography of both shoulders.

Results:

Seventy-four systemic sclerosis patients were enrolled in this study. Diffuse cutaneous type of systemic sclerosis was the most common type (62.2%). The three common systemic sclerosis–associated symptoms were skin tightness (28.5%), salt–pepper appearance (20.9%), and telangiectasia (11.6%). The prevalence of shoulder pain in systemic sclerosis patients was 43.2% (32/74). Sixty-eight patients (92%) had abnormal ultrasonographic findings. The most common ultrasonographic abnormalities were unilateral calcification inside the glenohumeral joint (45.9%), bilateral calcification inside the glenohumeral joint (36.5%), and bilateral supraspinatus tendinosis (28.9%). Skin edematous was the only factor associated with abnormal shoulder ultrasonographic findings. No association between shoulder pain and abnormal shoulder ultrasonographic findings was detected.

Conclusion:

Ultrasonographic abnormalities in the shoulder were common in the systemic sclerosis patients. The most frequent ultrasonographic finding of shoulder joints in systemic sclerosis patients was calcification inside the glenohumeral joint. Moreover, asymptomatic shoulder ultrasonographic abnormalities were prevalent in individuals with systemic sclerosis.
Extranodal localization of non-Hodgkin’s lymphoma in systemic sclerosis: A diagnostic challenge and review of the literature
Authors: Galoppini Giorgio , Maranini Beatrice , Ciancio Giovanni , Padovan Melissa , Casoni Gian Luca , Cavazzini Francesco , Gafà Roberta , Lanza Giovanni , Govoni Marcello
Published: April 2022

Background:

Systemic sclerosis is associated with an increased incidence of malignancies, in particular solid neoplasms. Hematological cancers have been also observed in autoimmune diseases, though rarely present with lung involvement. The latter may be misdiagnosed in systemic sclerosis patients, due to the frequent concomitant interstitial lung disease.

Case description:

Here, we present the case of a 63-year-old man affected by systemic sclerosis presenting with an atypical lung imaging and splenomegaly, who was diagnosed with splenic marginal zone lymphoma, thus raising the suspicion of lung secondarism. We discuss the diagnostic challenge of differential diagnosis in interstitial lung presentation and briefly review the available literature on this topic.

Conclusion:

Several reports have demonstrated an increased risk of malignancy in patients with systemic sclerosis. Still, the lack of concretely defined guidelines for systemic sclerosis, along with systemic sclerosis multifaceted organ involvement at presentation, may challenge diagnosis and management. Here, we remark the importance of clinical work-up and a multidisciplinary approach in systemic sclerosis, to early detect and treat concomitant hematological malignancies, especially during the first years of the disease.
Prefrontal Glutamate Neurotransmission in PTSD: A Novel Approach to Estimate Synaptic Strength in Vivo in Humans
Authors: Averill Lynnette A. , Jiang Lihong , Purohit Prerana , Coppoli Anastasia , Averill Christopher L. , Roscoe Jeremy , Kelmendi Benjamin , De Feyter Henk M. , de Graaf Robin A , Gueorguieva Ralitza , Sanacora Gerard , Krystal John H. , Rothman Douglas L. , Mason Graeme F. , Abdallah Chadi G.
Published: April 2022

Background

Trauma and chronic stress are believed to induce and exacerbate psychopathology by disrupting glutamate synaptic strength. However, in vivo in human methods to estimate synaptic strength are limited. In this study, we established a novel putative biomarker of glutamatergic synaptic strength, termed energy-per-cycle (EPC). Then, we used EPC to investigate the role of prefrontal neurotransmission in trauma-related psychopathology.

Methods

Healthy controls (n = 18) and patients with posttraumatic stress (PTSD; n = 16) completed 13C-acetate magnetic resonance spectroscopy (MRS) scans to estimate prefrontal EPC, which is the ratio of neuronal energetic needs per glutamate neurotransmission cycle (VTCA/VCycle).

Results

Patients with PTSD were found to have 28% reduction in prefrontal EPC ( t = 3.0; df = 32, P = .005). There was no effect of sex on EPC, but age was negatively associated with prefrontal EPC across groups ( r = –0.46, n = 34, P = .006). Controlling for age did not affect the study results.

Conclusion

The feasibility and utility of estimating prefrontal EPC using 13C-acetate MRS were established. Patients with PTSD were found to have reduced prefrontal glutamatergic synaptic strength. These findings suggest that reduced glutamatergic synaptic strength may contribute to the pathophysiology of PTSD and could be targeted by new treatments.
The Effects of Length of Instruction on Rhythm-Reading Learning and Retention on Second-Grade Students
Authors: Hollingsworth Kelly Jo
Published: April 2022

The purpose of this study was to investigate second-grade students’ ( N = 128) rhythm-reading achievement and retention after 5 or 10 min of weekly instruction for 3 weeks. Eight intact classes were placed into two groups. Group 1 received 5 min of rhythm-reading instruction during weekly music class, whereas Group 2 received 10 min of rhythm-reading instruction during weekly music class. Treatment lasted 3 weeks, after which students individually completed posttest I. After 2 weeks of no rhythm-reading instruction or practice, students were individually administered posttest II to measure retention. Results indicated that both groups successfully read rhythms after instruction and retained rhythm-reading skills after two additional weeks of no instruction. Between-group analysis suggested that 5 min of instructional time is equally as effective as 10 min on student achievement and retention. Implications include increased efficiency in planning and teaching, increased student engagement, and effective instructional practices in the elementary music classroom.
Assessment of safety and immunogenicity of MHC homozygous iPSC-derived CD34+ hematopoietic progenitors in an NHP model
Authors: D’Souza Saritha S. , Kumar Akhilesh , Maufort John , Weinfurter Jason T. , Raymond Matthew , Strelchenko Nick S. , Perrin Elizabeth , Coonen Jennifer , Mejia Andres , Simmons Heather A. , Torbett Bruce E. , Reynolds Matthew , Thomson James A. , Slukvin Igor I.
Published: April 2022

Administration of ex vivo expanded somatic myeloid progenitors has been explored as a way to facilitate a more rapid myeloid recovery and improve overall survival after myeloablation. Recent advances in induced pluripotent stem cell (iPSC) technologies have created alternative platforms for supplying off-the-shelf immunologically compatible myeloid progenitors, including cellular products derived from major histocompatibility complex (MHC) homozygous superdonors, potentially increasing the availability of MHC-matching cells and maximizing the utility of stem cell banking. However, the teratogenic and tumorigenic potential of iPSC-derived progenitor cells and whether they will induce alloreactive antibodies upon transfer remain unclear. We evaluated the safety and efficacy of using CD34+CD45+ hematopoietic progenitors derived from MHC homozygous iPSCs (iHPs) to treat cytopenia after myeloablative hematopoietic stem cell (HSC) transplantation in a Mauritian cynomolgus macaque (MCM) nonhuman primate (NHP) model. We demonstrated that infusion of iHPs was well tolerated and safe, observing no teratomas or tumors in the MCMs up to 1 year after HSC transplantation and iHP infusion. Importantly, the iHPs also did not induce significant levels of alloantibodies in MHC-matched or -mismatched immunocompetent MCMs, even after increasing MHC expression on iHPs with interferon-γ. These results support the feasibility of iHP use in the setting of myeloablation and suggest that iHP products pose a low risk of inducing alloreactive antibodies.
Physiologically based serum ferritin thresholds for iron deficiency in women of reproductive age who are blood donors
Authors: Addo O. Yaw , Mei Zuguo , Hod Eldad A. , Jefferds Maria Elena , Sharma Andrea J. , Flores-Ayala Rafael C. , Spitalnik Steven L. , Brittenham Gary M.
Published: April 2022

Our objective is to develop a physiologically based method to determine serum ferritin thresholds for iron deficiency in healthy individuals. The current World Health Organization threshold of <15 µg/L for iron deficiency in women is based on expert opinion. We examined the relationship between serum ferritin and 2 independently measured indicators of iron-deficient erythropoiesis, soluble transferrin receptor (sTfR) and hemoglobin, in baseline data from 286 women, 20 to 49 years, who were first-time or reactivated donors in the Retrovirus Epidemiology Donor Study-II Donor Iron Status Evaluation (REDS-RISE) study. At lower serum ferritin concentrations, median sTfR increased as hemoglobin decreased. Using restricted cubic spline regression analysis to determine thresholds for iron-deficient erythropoiesis, the thresholds identified by sTfR (serum ferritin < 25.4 µg/L) and hemoglobin (serum ferritin < 25.3 µg/L) did not differ significantly. The thresholds found in the REDS-RISE study do not differ from those identified by sTfR (serum ferritin < 25.5 µg/L) and hemoglobin (serum ferritin < 26.6 µg/L) in a previous study of 5442 women, 20 to 49 years, in the US National Health and Nutrition Examination Survey 2003 to 2018 (P = .98 and 0.83, respectively). Although international comparisons are needed, these results with US data provide additional evidence for the potential usefulness of a physiologically based method to identify serum ferritin thresholds for iron deficiency.
Modelling and Dynamic Characteristics for a Non-metal Pressurized Reservoir with Variable Volume
Authors: Wang Pei , Yao Jing , Feng Baidong , Li Mandi , Wang Dingyu
Published: April 2022

With the increasing demand to reduce emissions and save energy, hydraulic reservoirs require new architecture to optimize their weight, space, and volume. Conventional open reservoirs are large, heavy, and easily polluted, and threaten the operation of hydraulic systems. A closed reservoir provides the advantages of small volume and light weight, compared to open reservoirs. In this study, a non-metallic pressure reservoir with variable volume is designed and manufactured for closed-circuit hydraulic systems. The reservoir housing is made of rubber, and the Mooney-Rivlin model is chosen based on the rubber strain properties. The FEA simulation for the reservoir is performed using ANSYS Workbench to obtain the structural stiffness. The major contribution is the establishment of mathematical models for this reservoir, including the volume equation changing with height, flow equation, and force balance equation, to explore the output characteristics of this reservoir. Based on these results, simulation models were built to analyze the output characteristics of the reservoir. Moreover, the test rig of a conventional hydraulic system was transformed into a closed-circuit asymmetric hydraulic system for the reservoir, and preliminary verification experiments were conducted on it. The results demonstrate that the designed reservoir can absorb and discharge oil and supercharge pump inlet to benefit system operation. The changes in the volume and pressure with displacements under different volume ratios and frequencies were obtained, which verified the accuracy of the mathematical models. Owing to its lightweight design and small volume, the reservoir can replace conventional open reservoirs, and this lays a foundation for future theoretical research on this reservoir.
Real-world effectiveness of fremanezumab in migraine patients initiating treatment in the United States: results from a retrospective chart study
Authors: Driessen Maurice T. , Cohen Joshua M. , Patterson-Lomba Oscar , Thompson Stephen F. , Seminerio Michael , Carr Karen , Totev Todor I. , Sun Rochelle , Yim Erica , Mu Fan , Ayyagari Rajeev
Published: April 2022

Background

The efficacy and tolerability of fremanezumab, a fully humanized monoclonal antibody (IgG2Δa) that selectively targets calcitonin gene-related peptide (CGRP) and is approved for the preventive treatment of migraine in adults, have been demonstrated in randomized, double-blind, placebo-controlled trials. Real-world data can further support those clinical trial data and demonstrate the full clinical benefits of fremanezumab. This chart review assessed the effectiveness of fremanezumab for improving clinical outcomes in adult patients with migraine treated according to real-world clinical practice.

Methods

This retrospective, panel-based, online physician chart review study used electronic case report forms with US physicians. Patient inclusion criteria were a physician diagnosis of migraine, fremanezumab treatment initiation at ≥ 18 years of age after US Food and Drug Administration approval, ≥ 1 dose of fremanezumab treatment, and ≥ 2 assessments of monthly migraine days (MMD; 1 within 30 days before treatment initiation and ≥ 1 after initiation). Changes from baseline in MMD, monthly headache days (MHD), and Migraine Disability Assessment (MIDAS) and 6-item Headache Impact Test (HIT-6) scores were assessed over 6 months. These endpoints were evaluated in the overall population and subgroups divided by dosing schedule and number of prior migraine preventive treatment failures.

Results

This study included data from 421 clinicians and 1003 patients. Mean age at fremanezumab initiation was 39.7 years, and most patients were female (75.8%). In the overall population, mean baseline MMD and MHD were 12.7 and 14.0, respectively. Mean (percent) reductions from baseline in MMD and MHD, respectively, were − 4.6 (36.2%) and − 4.7 (33.6%) at Month 1, − 6.7 (52.8%) and − 6.8 (48.6%) at Month 3, and − 9.2 (72.4%) and − 9.8 (70.0%) at Month 6. Mean (percent) reductions from baseline in MIDAS and HIT-6 scores also increased over the 6-month study period, from − 6.2 (21.6%) and − 8.4 (14.0%) at Month 1 to − 18.1 (63.1%) and − 16.2 (27.0%) at Month 6, respectively. Improvements in these outcomes over 6 months were observed across all evaluated subgroups.

Conclusions

This real-world study demonstrated effectiveness of fremanezumab treatment for up to 6 months, irrespective of dosing regimen or number of prior migraine preventive treatment failures, reflecting ongoing, clinically meaningful improvements in patient outcomes.
Genomic variation in baboons from central Mozambique unveils complex evolutionary relationships with other Papio species
Authors: Santander Cindy , Molinaro Ludovica , Mutti Giacomo , Martínez Felipe I. , Mathe Jacinto , Ferreira da Silva Maria Joana , Caldon Matteo , Oteo-Garcia Gonzalo , Aldeias Vera , Archer Will , Bamford Marion , Biro Dora , Bobe René , Braun David R. , Hammond Philippa , Lüdecke Tina , Pinto Maria José , Meira Paulo Luis , Stalmans Marc , Regala Frederico Tátá , Bertolini Francesco , Moltke Ida , Raveane Alessandro , Pagani Luca , Carvalho Susana , Capelli Cristian
Published: April 2022

Background

Gorongosa National Park in Mozambique hosts a large population of baboons, numbering over 200 troops. Gorongosa baboons have been tentatively identified as part of Papio ursinus on the basis of previous limited morphological analysis and a handful of mitochondrial DNA sequences. However, a recent morphological and morphometric analysis of Gorongosa baboons pinpointed the occurrence of several traits intermediate between P. ursinus and P. cynocephalus, leaving open the possibility of past and/or ongoing gene flow in the baboon population of Gorongosa National Park. In order to investigate the evolutionary history of baboons in Gorongosa, we generated high and low coverage whole genome sequence data of Gorongosa baboons and compared it to available Papio genomes.

Results

We confirmed that P. ursinus is the species closest to Gorongosa baboons. However, the Gorongosa baboon genomes share more derived alleles with P. cynocephalus than P. ursinus does, but no recent gene flow between P. ursinus and P. cynocephalus was detected when available Papio genomes were analyzed. Our results, based on the analysis of autosomal, mitochondrial and Y chromosome data, suggest complex, possibly male-biased, gene flow between Gorongosa baboons and P. cynocephalus, hinting to direct or indirect contributions from baboons belonging to the “northern” Papio clade, and signal the presence of population structure within P. ursinus.

Conclusions

The analysis of genome data generated from baboon samples collected in central Mozambique highlighted a complex set of evolutionary relationships with other baboons. Our results provided new insights in the population dynamics that have shaped baboon diversity.
DeepSARS: simultaneous diagnostic detection and genomic surveillance of SARS-CoV-2
Authors: Yermanos Alexander , Hong Kai-Lin , Agrafiotis Andreas , Han Jiami , Nadeau Sarah , Valenzuela Cecilia , Azizoglu Asli , Ehling Roy , Gao Beichen , Spahr Michael , Neumeier Daniel , Chang Ching-Hsiang , Dounas Andreas , Petrillo Ezequiel , Nissen Ina , Burcklen Elodie , Feldkamp Mirjam , Beisel Christian , Oxenius Annette , Savic Miodrag , Stadler Tanja , Rudolf Fabian , Reddy Sai T.
Published: April 2022

Background

The continued spread of SARS-CoV-2 and emergence of new variants with higher transmission rates and/or partial resistance to vaccines has further highlighted the need for large-scale testing and genomic surveillance. However, current diagnostic testing (e.g., PCR) and genomic surveillance methods (e.g., whole genome sequencing) are performed separately, thus limiting the detection and tracing of SARS-CoV-2 and emerging variants.

Results

Here, we developed DeepSARS, a high-throughput platform for simultaneous diagnostic detection and genomic surveillance of SARS-CoV-2 by the integration of molecular barcoding, targeted deep sequencing, and computational phylogenetics. DeepSARS enables highly sensitive viral detection, while also capturing genomic diversity and viral evolution. We show that DeepSARS can be rapidly adapted for identification of emerging variants, such as alpha, beta, gamma, and delta strains, and profile mutational changes at the population level.

Conclusions

DeepSARS sets the foundation for quantitative diagnostics that capture viral evolution and diversity.

Graphical abstract

DeepSARS uses molecular barcodes (BCs) and multiplexed targeted deep sequencing (NGS) to enable simultaneous diagnostic detection and genomic surveillance of SARS-CoV-2. Image was created using Biorender.com.
Inferring mammalian tissue-specific regulatory conservation by predicting tissue-specific differences in open chromatin
Authors: Kaplow Irene M. , Schäffer Daniel E. , Wirthlin Morgan E. , Lawler Alyssa J. , Brown Ashley R. , Kleyman Michael , Pfenning Andreas R.
Published: April 2022

Background

Evolutionary conservation is an invaluable tool for inferring functional significance in the genome, including regions that are crucial across many species and those that have undergone convergent evolution. Computational methods to test for sequence conservation are dominated by algorithms that examine the ability of one or more nucleotides to align across large evolutionary distances. While these nucleotide alignment-based approaches have proven powerful for protein-coding genes and some non-coding elements, they fail to capture conservation of many enhancers, distal regulatory elements that control spatial and temporal patterns of gene expression. The function of enhancers is governed by a complex, often tissue- and cell type-specific code that links combinations of transcription factor binding sites and other regulation-related sequence patterns to regulatory activity. Thus, function of orthologous enhancer regions can be conserved across large evolutionary distances, even when nucleotide turnover is high.

Results

We present a new machine learning-based approach for evaluating enhancer conservation that leverages the combinatorial sequence code of enhancer activity rather than relying on the alignment of individual nucleotides. We first train a convolutional neural network model that can predict tissue-specific open chromatin, a proxy for enhancer activity, across mammals. Next, we apply that model to distinguish instances where the genome sequence would predict conserved function versus a loss of regulatory activity in that tissue. We present criteria for systematically evaluating model performance for this task and use them to demonstrate that our models accurately predict tissue-specific conservation and divergence in open chromatin between primate and rodent species, vastly out-performing leading nucleotide alignment-based approaches. We then apply our models to predict open chromatin at orthologs of brain and liver open chromatin regions across hundreds of mammals and find that brain enhancers associated with neuron activity have a stronger tendency than the general population to have predicted lineage-specific open chromatin.

Conclusion

The framework presented here provides a mechanism to annotate tissue-specific regulatory function across hundreds of genomes and to study enhancer evolution using predicted regulatory differences rather than nucleotide-level conservation measurements.
Impact of maternal lateral tilt on cardiac output during caesarean section under spinal anaesthesia: a prospective observational study
Authors: Sonnino Chiara , Frassanito Luciano , Piersanti Alessandra , Giuri Pietro Paolo , Zanfini Bruno Antonio , Catarci Stefano , Draisci Gaetano
Published: April 2022

Background

Left uterine displacement (LUD) has been questioned as an effective strategy to prevent aortocaval compression after spinal anesthesia (SA) for cesarean delivery (CD). We tested if LUD has a significant impact on cardiac output (CO) in patients undergoing CD under SA during continuous non-invasive hemodynamic monitoring with Clearsight.

Methods

Forty-six patients were included in the final analysis. We considered 4 timepoints of 5 min each: T1 = baseline with LUD; T2 = baseline without LUD; T3 = after SA with LUD; T4 = after SA without LUD. LUD was then repositioned for CD. The primary outcome was to assess if CO decreased from T3 to T4 of at least 1.0 L/min. We also compared CO between T1 and T2 and other hemodynamic variables: mean, systolic and diastolic blood pressure (respectively MAP, SAP and DAP), heart rate (HR), stroke volume (SV), stroke volume variation (SVV), pulse pressure variation (PPV), contractility (dP/dt), dynamic arterial elastance (Eadyn) at the different timepoints. Data on fetal Apgar scores and umbilical arterial and venous pH were collected.

Results

CO did not vary from T3 to T4 (CO mean difference -0.02 L/min [95% CI -0.88 to 0.82; P = 1). No significant variation was registered for any variable at any timepoint.

Conclusions

LUD did not show a significant impact on CO during continuous hemodynamic monitoring after SA for CD.

Trial registration

(retrospectively registered on 03/12/2021) NCT05143684.
Correction to: Ethnographic research as an evolving method for supporting healthcare improvement skills: a scoping review
Authors: Black Georgia B. , van Os Sandra , Machen Samantha , Fulop Naomi J.
Published: April 2022

An amendment to this paper has been published and can be accessed via the original article.
The necessarity of treatment for small gastric subepithelial tumors (1–2 cm) originating from muscularis propria: an analysis of 972 tumors
Authors: Hu Jinlong , Sun Xinzhu , Ge Nan , Wang Sheng , Guo Jintao , Liu Xiang , Wang Guoxin , Sun Siyu
Published: April 2022

Background and objectives

Up till now, there are still controversies about the specific indication of endoscopic resection for small gastric subepithelial tumors (gSETs) originating from muscularis propria. We aimed to investigate the safety of endoscopic resection and postoperative pathology analysis.

Method

The patients with primary small gSETs originating from muscularis propria, treated by endoscopic resection in the endoscopic center of Shengjing Hospital between January, 2011 and September, 2019 were enrolled. The complete resection rate, adverse events and clinicopathological features were recorded.

Result

A total of 936 patients with 972 gastric SETs ≤ 2 cm originating from muscularis propria were included in our study. All the lesions were successfully treated by endoscopic resection. Nearly half of lesions were proved to be gastrointestinal stromal tumor (GIST) [n = 411 (42.3%)] according to postoperative pathology. All the objects were further subdivided into 2 groups, ≤ 1 cm, > 1 and ≤ 2 cm gSETs. The risk of gastric GIST of intermediate/high risk in the group (> 1 and ≤ 2 cm gSETs) is 8.41 times as that of gastric GIST in the group (the size of gastric ≤ 1 cm gSETs) (P < 0.05).

Conclusion

Endoscopic resection is a safe and effective treatment for small gSETs. gSETs (1–2 cm) is more risky than gSETs (≤ 1 cm) and should be resected. This should be evaluated by further studies.
Association between total protein intake and low muscle mass in Korean adults
Authors: Huh Youn , Son Ki Young
Published: April 2022

Background

Adults with low muscle mass have a poor prognosis. Studies that examined the association between total protein intake and low muscle mass among adults are limited. Thus, we investigated the association between total protein intake and low muscle mass among Korean adults aged ≥19 years.

Methods

We included 15,995 adults (6528 male and 9467 female) aged ≥19 years from the Korea National Health and Nutrition Examination Surveys (2008–2011). We divided the participants into groups according to protein intake quartile: Q1, Q2, Q3 and Q4 groups. The odds ratios (ORs) and 95% confidence intervals (CIs) of low muscle mass according to protein intake were analysed via multivariable logistic regression analysis. Stratified analyses according to sex, age and comorbidities were also performed.

Results

Of the participants, 3.8% had weight-adjusted low muscle mass. The prevalence rates of low muscle mass were 1.5, 3.0, 3.9 and 7.2% in the Q4, Q3, Q2 and Q1 groups, respectively (p < 0.001). Compared with the Q4 group, the Q1 group had the highest ORs for low muscle mass, followed by the Q2 and Q3 groups (Model 5; OR, 95% CI: 2.03, 1.36–3.02 for Q3; 2.44, 1.64–3.61 for Q2; and 4.32, 2.89–6.45 for Q4) after adjusting for confounding variables (p for trend < 0.001). The associations between protein intake and low muscle mass were stronger in younger individuals, men, individuals without hypertension, those with diabetes mellitus and those without dyslipidemia.

Conclusions

The prevalence of low muscle mass in Korean adults significantly increased with lower protein intake. Nutrition education for proper protein intake is also important for adults.

Trial registration

Retrospectively registered.
Prevalence and associated risk factors of soil-transmitted helminth infections in Kandahar, Afghanistan
Authors: Rahimi Bilal Ahmad , Mahboobi Bashir Ahmad , Wafa Mohammad Hashim , Sahrai Mohammad Sediq , Stanikzai Muhammad Haroon , Taylor Walter R.
Published: April 2022

Background

Soil-transmitted helminth (STH) infections are still a major health problem, especially in resource-limited countries. The community-based prevalence of STH is unknown in Afghanistan. Main objectives of this study were to estimate the prevalence and associated factors of STH among children in Daman district of Kandahar province in Afghanistan.

Methods

This was a community-based cross-sectional study, with data collected during five months (June–October, 2020) from children living in five villages of Daman district in Kandahar, Afghanistan. All the stool samples were examined by saline wet mount method. Data were analyzed by using descriptive statistics, Chi square test, and multivariate logistic regression.

Results

A total of 1426 children were studied, with majority (61.8%) of males and the mean age of 6.3 years. The overall prevalence of any intestinal parasitic infection was 39.8%. The overall prevalence of STH infection was 22.7%, with Ascaris lumbricoides (18.7%) as the most prevalent STH species, followed by hookworm (7.5%) and Trichuris trichiura (1.4%). Single, double, and triple STH infections were present in 14.9%, 7.2%, and 0.6% of the children, respectively. Multivariate logistic regression revealed that not washing hands after defecating/before eating (AOR 7.0, 95% CI 3.4–14.0), living in mud house (AOR 3.5, 95% CI 1.6–7.4), walking barefoot (AOR 2.2, 95% CI 1.6–3.1), living in overcrowded house (AOR 1.6, 95% CI 1.1–2.3), and practicing open defecation (AOR 1.4, 95% CI 1.1–2.0) as the risk factors associated with the predisposition of rural children for getting STH in Daman district of Afghanistan.

Conclusions

Prevalence of STH is high among children of Daman district in Afghanistan. Most of the risk factors are related to poverty, decreased sanitation, and improper hygiene. Improvement of socioeconomic status, sanitation, and health education to promote public awareness about health and hygiene together with periodic mass deworming programs are better strategies for the control of STH infections in Afghanistan. Also, government and international donor agencies in Afghanistan should help in improving socio-economic status of the rural areas through provision of basic facilities such as piped water, electricity, good housing, and proper toilets.
Discriminant models for the prediction of postponed viral shedding time and disease progression in COVID-19
Authors: Li Wen-Yang , Wang Daqing , Guo Yuhao , Huang Hong , Zhao Hongwen , Kang Jian , Wang Wei
Published: April 2022

Background

COVID-19 infection can cause life-threatening respiratory disease. This study aimed to fully characterize the clinical features associated with postponed viral shedding time and disease progression, then develop and validate two prognostic discriminant models.

Methods

This study included 125 hospitalized patients with COVID-19, for whom 44 parameters were recorded, including age, gender, underlying comorbidities, epidemiological features, laboratory indexes, imaging characteristics and therapeutic regimen, et al. Fisher's exact test and Mann–Whitney test were used for feature selection. All models were developed with fourfold cross-validation, and the final performances of each model were compared by the Area Under Receiving Operating Curve (AUROC). After optimizing the parameters via L2 regularization, prognostic discriminant models were built to predict postponed viral shedding time and disease progression of COVID-19 infection. The test set was then used to detect the predictive values via assessing models’ sensitivity and specificity.

Results

Sixty-nine patients had a postponed viral shedding time (> 14 days), and 28 of 125 patients progressed into severe cases. Six and eleven demographic, clinical features and therapeutic regimen were significantly associated with postponed viral shedding time and disease progressing, respectively (p < 0.05). The optimal discriminant models are: y1 (postponed viral shedding time) = − 0.244 + 0.2829x1 (the interval from the onset of symptoms to antiviral treatment) + 0.2306x4 (age) + 0.234x28 (Urea) − 0.2847x34 (Dual-antiviral therapy) + 0.3084x38 (Treatment with antibiotics) + 0.3025x21 (Treatment with Methylprednisolone); y2 (disease progression) = − 0.348–0.099x2 (interval from Jan 1st,2020 to individualized onset of symptoms) + 0.0945x4 (age) + 0.1176x5 (imaging characteristics) + 0.0398x8 (short-term exposure to Wuhan) − 0.1646x19 (lymphocyte counts) + 0.0914x20 (Neutrophil counts) + 0.1254x21 (Neutrphil/lymphocyte ratio) + 0.1397x22 (C-Reactive Protein) + 0.0814x23 (Procalcitonin) + 0.1294x24 (Lactic dehydrogenase) + 0.1099x29 (Creatine kinase).The output ≥ 0 predicted postponed viral shedding time or disease progressing to severe/critical state. These two models yielded the maximum AUROC and faired best in terms of prognostic performance (sensitivity of78.6%, 75%, and specificity of 66.7%, 88.9% for prediction of postponed viral shedding time and disease severity, respectively).

Conclusion

The two discriminant models could effectively predict the postponed viral shedding time and disease severity and could be used as early-warning tools for COVID-19.
Gender differences in measles incidence rates in a multi-year, pooled analysis, based on national data from seven high income countries
Authors: Green Manfred S. , Schwartz Naama , Peer Victoria
Published: April 2022

Background

Gender differences in a number of infectious diseases have been reported. The evidence for gender differences in clinical measles incidence rates has been variable and poorly documented over age groups, countries and time periods.

Methods

We obtained data on cases of measles by sex and age group over a period of 11–27 years from seven countries. Male to female incidence rate ratios (IRR) were computed for each year, by country and age group. For each age group, we used meta-analytic methods to combine the IRRs. Meta-regression was conducted to the estimate the effects of age, country, and time period on the IRR.

Results

In the age groups < 1, 1–4, 5–9, 10–14, 15–44, and 45–64 the pooled IRRs (with 95% CI) were 1.07 (1.02–1.11), 1.10 (1.07–1.14), 1.03 (1.00–1.05), 1.05 (0.99–1.11), 1.08 (0.95–1.23), and 0.82 (0.74–0.92) respectively. The excess incidence rates (IR) from measles in males up to age 45 are remarkably consistent across countries and time-periods. In the age group 45–64, there is an excess incidence in women.

Conclusions

The consistency of the excess incidence rates in young males suggest that the sex differences are more likely due to physiological and biological differences and not behavioral factors. At older ages, differential exposure can play a part. These findings can provide further keys to the understanding of mechanisms of infection and tailoring vaccination schedules.
A case report of native vertebral osteomyelitis caused by Cutibacterium modestum
Authors: Koyama Taiji , Ohji Goh , Nishida Masako , Nishimura Sho , Shirasugi Iku , Ohnuma Kenichiro , Kusuki Mari , Iwata Kentaro
Published: April 2022

Background

Cutibacterium modestumwas named in 2020.C. modestumwas previously calledPropionibacterium humerusii. Several implant-associated infections caused by Cutibacterium species have been previously reported, but native vertebral osteomyelitis due to these bacteria has rarely been reported.

Case presentation

A 72-year-old man, who had previously received several nerve block injections for low back pain, was referred to our hospital for deterioration in back pain in the last 1 month. MRI findings were suggestive of L5-S1 vertebral osteomyelitis. Blood cultures and bone biopsy culture revealed the presence of Gram-positive bacilli. The isolate was identified asC. modestumby 16SrRNA gene sequencing. A diagnosis of vertebral osteomyelitis caused byC. modestumwas made. Minocycline followed by oral amoxicillin was administered for 3 months. His symptom improved and did not recur after treatment completion.

Conclusion

A case of vertebral osteomyelitis caused byC. modestumwas encountered. AlthoughC. modestumis very similar toC. acnes, it could be accurately identified by 16SrRNA gene sequencing. This case represents the first documentedC. modestuminfection in humans.
Corneal confocal microscopy in the evaluation of immune-related motor neuron disease syndrome
Authors: Jiao Lin , Zhang Yuanjin , Wang Haikun , Fan Dongsheng
Published: April 2022

Background

To investigate the sensitivity and specificity of corneal confocal microscopy (CCM) in the diagnosis of immune-related motor neuron disease syndrome and evaluation of the response to immunosuppressive therapy.

Methods

Seventy-two patients with clinical manifestations of motor neuron disease (MND) were analysed. According to whether they had concomitant rheumatic immune disease or rheumatic immune antibody abnormalities, they were divided into an MND group (33 patients) and an immune-related MND syndrome group (39 patients). Another 10 healthy adults were selected as the control group. All individuals were examined by CCM.

Results

For Langerhans cell(LC) density, the area under the receiver operating characteristic(ROC)curve was 0.8, the best cut-off was 67.7 cells/mm2, the sensitivity was 79.5%, and the specificity was 72.7%. For inferior whorl length (IWL), the area under the ROC curve was 0.674, the best cut-off was 17.41 mm/mm2, the sensitivity was 69.2%, and the specificity was 66.7%. After immunosuppressive therapy in 5 patients with immune-related MND syndrome, the LCD was significantly reduced (P < 0.05), and there was no statistically significant change in the IWL (P > 0.05).

Conclusion

The LC density and IWL are ideal for distinguishing MND from immune-related MND syndrome. The LC density reflects the immunotherapy response sensitively.
The oncological safety of autologous fat grafting: a systematic review and meta-analysis
Authors: Goncalves Rodrigo , Mota Bruna Salani , Sobreira-Lima Bruno , Ricci Marcos Desidério , Soares José Maria , Munhoz Alexandre Mendonça , Baracat Edmund Chada , Filassi José Roberto
Published: April 2022

Objective

To present a systematic review of the literature and a meta-analysis evaluating the oncological safety of autologous fat grafting (AFG).

Summary background data: AFG for breast reconstruction presents difficulties during follow-up radiological exams, and the oncological potential of grafted fat is uncertain. Previous studies confirmed that the fatty tissue could be transferred under a good condition suitable would not interfere with mammographic follow-up, although the issue of oncological safety remains.

Methods

We reviewed the literature published until 01/18/2021. The outcomes were overall survival (OS), disease-free survival (DFS), and local recurrence (LR). We included studies that evaluated women with breast cancer who undergone surgery followed by reconstruction with AFG. We synthesized data using the inverse variance method on the log-HR (log of the hazard ratio) scale for time-to-event outcomes using RevMan. We assessed heterogeneity using the Chi2 and I2 statistics.

Results

Fifteen studies evaluating 8541 participants were included. The hazard ratios (HR) could be extracted from four studies, and there was no difference in OS between the AFG group and control (HR 0.9, 95% CI 0.53 to 1.54, p = 0.71, I2 = 58%, moderate certainty evidence), and publication bias was not detected. The HR for DFS could be extracted from six studies, and there was no difference between the AFG group and control (HR 1.01, 95% CI 0.73 to 1.38, p = 0.96, I2 = 0%, moderate certainty evidence). The HR for LR could be extracted from ten studies, and there was no difference between the AFG group and control (HR 0.86, 95% CI 0.66 to 1.12, p = 0.43, I2 = 1%, moderate certainty evidence).

Conclusion

According to the current evidence, AFG is a safe technique of breast reconstruction for patients that have undergone BC surgery and did not affect OS, DFS, or LR.
Associations between match participation, maturation, physical fitness, and hormonal levels in elite male soccer player U15: a prospective study with observational cohort
Authors: Eskandarifard Ebrahim , Nobari Hadi , Clemente Filipe Manuel , Silva Rui , Silva Ana Filipa , Figueiredo Antonio José
Published: April 2022

Objectives

The aims of this study were to analyze the relationships between minutes of play (MP) and maturity status, fitness, and hormonal levels and to explain how those measures influence the time of play.

Methods

Twenty-six youth soccer players U15 participated in this study over a full-season period. Anthropometric measures, maturity status, growth hormone (GH), insulin-like growth factor and physical levels such as maximal oxygen uptake (VO2max), fatigue index, countermovement jump (CMJ) performance were collected. At the end-season, players were assessed in 6 different tests over four days.

Results

VO2max largely correlated with GH (r = 0.57) and CMJ (r = 0.51). Also, GH largely correlated with CMJ (r = 0.55). MP had moderate correlations with VO2max (r = 0.44) and CMJ (r = 0.42). Multiple linear regression with maturation, physical fitness and hormonal levels explained R2 of 0.62 of the MP (F (8, 17) = 3.47, p = 0.015). Although each independent variable alone was not able to determine the playing time, when using the interactions, the model significantly explained the MP.

Conclusions

The combination of maturity status, physical fitness, and hormonal levels seem to play a determinant role in explaining the match participation in youth soccer players.
Secular trends in Javanese adult height: the roles of environment and educational attainment
Authors: Moelyo Annang Giri , Sitaresmi Mei Neni , Julia Madarina
Published: April 2022

Background

Since its independence in 1945, Indonesia has undergone rapid socioeconomic development. The fastest changes occurred in Java, which is the main island where more than half of the Indonesian population lives.

Objective

This study aimed to analyze the secular trend in the height of adults living in Java born between 1953 and 1995 by comparing their residence (rural, small city, or large city) and considering factors that contribute to adult height.

Methods

The analysis used the following data: birth year, body height, weight, body mass index, sex, educational attainment, share of household food expenditures, and residence of 20- to 40-year-old men and women collected by the Indonesia Family Life Survey (IFLS) waves 1 to 5. Multiple linear regression was conducted to analyze several factors that influence adult height. Significance was set at p < 0.05 with a 95% confidence interval (CI).

Results

The study included 30,656 measurements of individuals born between 1953 and 1995 (54.9% female). Positive secular trends (95% CI) were observed for men and women: 1.3 (1.1–1.4) cm and 0.9 (0.8–1.0) cm per decade, respectively. Multiple linear regression analyses showed that, in addition to the year of birth, the adult height of both males and females was independently associated with level of education and share of household food expenditure. Stratifying the data into residence in rural areas, small cities, and large cities showed that education levels influenced the adult height of men and women living in all regions, whereas the influence of birth year and share of household food expenditure differed between areas and genders.

Conclusions

We observed positive secular trends in the height of adults living in Java who were born between 1953 and 1995. The birth year, educational attainment, and share of household food expenditure significantly influenced adult height. A higher education level was consistently associated with taller adult height in both men and women living in rural areas, small cities, and large cities.
Substance use is associated with condomless anal intercourse among men who have sex with men in India: a partner-level analysis
Authors: Prabhu Sandeep , Mehta Shruti H. , McFall Allison M. , Srikrishnan Aylur K. , Vasudevan Canjeevaram K. , Lucas Gregory M. , Celentano David D. , Solomon Sunil S.
Published: April 2022

Background

Men who have sex with men (MSM) bear a disproportionately high burden of new HIV infections while lagging behind other populations with respect to engagement across the HIV care continuum. General risk factors for condomless anal intercourse (CAI) among MSM are well studied but there is a paucity of partner-level data, where emerging evidence suggests that much of the variation in condom use occurs.

Methods

MSM were recruited across 10 cities in India using respondent-driven sampling (RDS) from 2016–17. Among the individuals who reported sexual intercourse in the prior 6 months, condom use and partner characteristics of the last 4 partners were captured. Correlates of CAI at the individual and partner level were determined using Poisson regression models using generalized estimating equations and incorporating RDS-II weights, which weights estimates for the participant’s network size.

Results

Among the 8,086 individuals, 21,723 sexual partnerships were analyzed. The prevalence of CAI was 46.9% and most partners were casual or one-time (70.7%) with partner HIV status reported as unknown in 42.6% of the sexual encounters. In multivariable analyses, partner-level characteristics associated with higher likelihood of CAI included unknown partner HIV status (aPR vs. known HIV negative partner: 1.34; 95% confidence interval (CI): 1.27–1.43) and use of alcohol/ drugs prior to intercourse either sometimes (aPR 1.42; 95% CI: 1.33–1.51) or always (aPR 1.31; 95% CI: 1.23–1.41). At an individual level, any HIV treatment literacy was associated with a lower likelihood of CAI (aPR 0.80; 95% CI: 0.74–0.86).

Conclusions

To reduce HIV transmission among this population of MSM across India, combination interventions are likely needed. Interventions targeting substance use and education as well as initiatives to increase self-testing are urgently needed among MSM in India and have the potential to reduce HIV transmission in this high-risk population.

Trial registration

ClinicalTrials.gov Identifier: NCT01686750. Date of Registration: September 18, 2012.