bluuebunny/crossref_metadata_2025 huggingface dataset:
Boosting the acetol production in methanotrophic biocatalyst Methylomonas sp. DH-1 by the coupling activity of heteroexpressed novel protein PmoD with endogenous particulate methane monooxygenase
Authors: Chau Tin Hoang Trung , Nguyen Anh Duc , Lee Eun Yeol
Published: January 2022

Background

Methylacidiphilum sp. IT6 has been validated its C3 substrate assimilation pathway via acetol as a key intermediate using the PmoCAB3, a homolog of the particulate methane monooxygenase (pMMO). From the transcriptomic data, the contribution of PmoD of strain IT6 in acetone oxidation was questioned. Methylomonas sp. DH-1, a type I methanotroph containing pmo operon without the existence of its pmoD, has been deployed as a biocatalyst for the gas-to-liquid bioconversion of methane and propane to methanol and acetone. Thus, Methylomonas sp. DH-1 is a suitable host for investigation. The PmoD-expressed Methylomonas sp. DH-1 can also be deployed for acetol production, a well-known intermediate for various industrial applications. Microbial production of acetol is a sustainable approach attracted attention so far.

Results

In this study, bioinformatics analyses elucidated that novel protein PmoD is a C-terminal transmembrane–helix membrane with the proposed function as a transport protein. Furthermore, the whole-cell biocatalyst was constructed in Methylomonas sp. DH-1 by co-expression the PmoD of Methylacidiphilum sp. IT6 with the endogenous pMMO to enable acetone oxidation. Under optimal conditions, the maximum accumulation, and specific productivity of acetol were 18.291 mM (1.35 g/L) and 0.317 mmol/g cell/h, respectively. The results showed the first coupling activity of pMMO with a heterologous protein PmoD, validated the involvement of PmoD in acetone oxidation, and demonstrated an unprecedented production of acetol from acetone in type I methanotrophic biocatalyst. From the data achieved in batch cultivation conditions, an assimilation pathway of acetone via acetol as the key intermediate was also proposed.

Conclusion

Using bioinformatics tools, the protein PmoD has been elucidated as the membrane protein with the proposed function as a transport protein. Furthermore, results from the assays of PmoD-heteroexpressed Methylomonas sp. DH-1 as a whole-cell biocatalyst validated the coupling activity of PmoD with pMMO to convert acetone to acetol, which also unlocks the potential of this recombinant biocatalyst for acetol production. The proposed acetone-assimilated pathway in the recombinant Methylomonas sp. DH-1, once validated, can extend the metabolic flexibility of Methylomonas sp. DH-1.
Epigenetics of single-site and multi-site atherosclerosis in African Americans from the Genetic Epidemiology Network of Arteriopathy (GENOA)
Authors: Ammous Farah , Zhao Wei , Lin Lisha , Ratliff Scott M. , Mosley Thomas H. , Bielak Lawrence F. , Zhou Xiang , Peyser Patricia A. , Kardia Sharon L. R. , Smith Jennifer A.
Published: January 2022

Background

DNA methylation, an epigenetic mechanism modulated by lifestyle and environmental factors, may be an important biomarker of complex diseases including cardiovascular diseases (CVD) and subclinical atherosclerosis.

Methods

DNA methylation in peripheral blood samples from 391 African-Americans from the Genetic Epidemiology Network of Arteriopathy (GENOA) was assessed at baseline, and atherosclerosis was assessed 5 and 12 years later. Using linear mixed models, we examined the association between previously identified CpGs for coronary artery calcification (CAC) and carotid plaque, both individually and aggregated into methylation risk scores (MRSCACand MRScarotid), and four measures of atherosclerosis (CAC, abdominal aorta calcification (AAC), ankle–brachial index (ABI), and multi-site atherosclerosis based on gender-specific quartiles of the single-site measures). We also examined the association between four epigenetic age acceleration measures (IEAA, EEAA, PhenoAge acceleration, and GrimAge acceleration) and the four atherosclerosis measures. Finally, we characterized the temporal stability of the epigenetic measures using repeated DNA methylation measured 5 years after baseline (N = 193).

Results

After adjusting for CVD risk factors, four CpGs (cg05575921(AHRR), cg09935388 (GFI1), cg21161138 (AHRR), and cg18168448 (LRRC52)) were associated with multi-site atherosclerosis (FDR < 0.1). cg05575921 was also associated with AAC and cg09935388 with ABI. MRSCACwas associated with ABI (Beta = 0.016,P = 0.006), and MRScarotidwas associated with both AAC (Beta = 0.605, equivalent to approximately 1.8-fold increase in the Agatston score of AAC,P = 0.004) and multi-site atherosclerosis (Beta = 0.691,P = 0.002). A 5-year increase in GrimAge acceleration (~ 1 SD) was associated with a 1.6-fold (P = 0.012) increase in the Agatston score of AAC and 0.7 units (P = 0.0003) increase in multi-site atherosclerosis, all after adjusting for CVD risk factors. All epigenetic measures were relatively stable over 5 years, with the highest intraclass correlation coefficients observed for MRScarotidand GrimAge acceleration (0.87 and 0.89, respectively).

Conclusions

We found evidence of an association between DNA methylation and atherosclerosis at multiple vascular sites in a sample of African-Americans. Further evaluation of these potential biomarkers is warranted to deepen our understanding of the relationship between epigenetics and atherosclerosis.
Angiomyomatous hamartoma of subglottic tracheal wall in a 12-year-old adolescent: a case report
Authors: Mendez Elvin M.
Published: January 2022

Background

Allergic rhinitis is the most common allergic disease encountered in a primary care setting. Diagnosis is often made clinically based on response to empiric therapy. However, with long-term treatment failure and/or atypical disease presentation, a differential diagnosis should be considered. The following is a report of an unusual and rare presentation of a subglottic tracheal angiomyomatous hamartoma in an adolescent, treated for many years as allergic rhinoconjunctivitis and asthma.

Case presentation

A 12-year-old Caucasian was referred to the allergy clinic with a lifetime history of bronchospasms and rhinoconjunctivitis symptoms, treated for many years for asthma and environmental allergies. Cough, posterior nasal drainage, self-described “choking on phlegm,” and a sensation of “a flap in the throat,”, worsened 5 months prior to the initial evaluation. Puncture skin testing for common environmental allergens was negative. Spirometry, performed due to history of chronic cough, showed blunting of the forced expiratory phase. A chest X-ray, immediately ordered to rule out possible extrapulmonary obstruction, showed bilateral bibasilar infiltrates. A noncontrast computerized tomographic scan of the chest, ordered to further elucidate X-ray findings, revealed a subglottic tracheal mass. Following a subsequent transfer and admission to a tertiary hospital center, microlaryngoscopy, bronchoscopy, and microsuspension laryngoscopy were performed to remove the tracheal mass. Pathology confirmed squamous mucosa with polypoid angiomyomatous changes and chronic inflammatory features consistent with angiomyomatous hamartoma. Surgical intervention was successful, and follow-up 1 year postoperatively revealed a healthy, asymptomatic adolescent child with normal lung function.

Conclusions

Although posterior nasal drainage and cough are typical presenting symptoms in the general patient population, they may be clinically impactful as they could disguise more serious medical conditions. A detailed history and careful physical examination may provide a high index of suspicion of disease, and can help work the differential diagnosis. This case presentation is the first documentation of subglottic hamartoma reported in the pediatric literature with clinical manifestation of environmental allergy and asthma symptoms.
Trigger point injections and dry needling can be effective in treating long COVID syndrome-related myalgia: a case report
Authors: Zha Mengyi , Chaffee Kristina , Alsarraj Jude
Published: January 2022

Introduction

Myofascial pain is a complex health condition that affects the majority of the general population. Myalgia has been recognized as a symptom of long COVID syndrome. The treatment for long COVID syndrome-related myalgia lacks research. Dry needling is a technique that involves the insertion of a needle into the tissue of, or overlaying, a pain point. Wet needling is the addition of an injection of an analgesic substance such as lidocaine while performing needling. Both dry and wet needling have are practiced as treatment modalities for myofascial pain. Limited literature exists to define long COVID syndrome-related myalgia and its relation to myofascial pain, or to examine the utility of needling techniques for this pain. We report a case of dry and wet needling as effective treatments for long COVID-related myofascial pain.

Case presentation

A 59-year-old, previously healthy Hispanic male with no comorbid conditions was diagnosed with COVID-19 pneumonia. The patient suffered moderate disease without hypoxia and was never hospitalized. Three months later, the patient continued to suffer from symptoms such as exertional dyspnea, “brain fog,” and myalgia. An extensive multisystem workup revealed normal cardiac, pulmonary, and end organ functions. The patient was then diagnosed with long COVID syndrome. The nature and chronicity of the patient’s myalgia meet the criteria for myofascial pain. Both wet and dry needling were used to treat the patient’s myofascial pain, with good short- and long-term therapeutic effects.

Conclusions

COVID-19 infection has been shown to exacerbate preexisting myofascial pain syndrome. Our case report indicates that long COVID syndrome-related myalgia is likely a form of new-onset myofascial pain. Additionally, both wet and dry needling can be utilized as an effective treatment modality for this pain syndrome, with short- and long-term benefits.
Non-emergent care visits in a turkish tertiary care emergency department after 2008 health policy changes: review and analysis
Authors: Dundar Cihad , Yaylaoglu Seydanur Dal
Published: January 2022

Background

The Turkish government liberalized national healthcare policies in 2008 enabling Turkish citizens to seek general care in hospital emergency departments (ED). The number of ED visits has exceeded the total population every year for the last ten years. To explain this phenomenon and to identify trends and risk factors for non-emergent visits, we retrospectively reviewed the ED records of a tertiary hospital and the Turkish Ministry of Health bulletin.

Methods

This retrospective record-based study was conducted at a tertiary hospital in Samsun province of Turkey. A total of 87,528 records of adult patients who visited the ED between January 1 and December 31, 2017, were included in this study. We evaluated the pattern of ED use for non-emergent patients by age, gender, nationality, time of visit, means of arrival, ICD (International Classification of Diseases) diagnostic codes, triage codes, number of repeated and out-of-hours visits. We used the Turkish Ministry of Health statistics bulletins to compare the number of ED visits across the country by year.

Results

The non-emergent visit rate in ED was found 9.9%. The rate of non-emergent ED visits was significantly higher in the 18-44 age group, in the female gender, and in those who arrived at the ED without an ambulance. The number of non-emergent visits was very similar between weekends and weekdays but was significantly higher in working hours on weekdays than out-of-hours (p<0.001). The most frequent diagnostic code was “Pain, unspecified” (R52) and the rate of repeat visits was 14.8% of non-emergent ED visits. According to binary logistic analysis, non-emergency visits were associated with 18-44 age group (OR = 2.75), female gender (OR = 1.11) and non-ambulance transportation (OR = 9.86).

Conclusions

Our results showed that the 18-44 age group and female gender seek care in the ED for non-emergent problems more than the other parts of the population. The numbers of ED visits in the last decade continued to increase regardless of population growth. The health policy changes may have facilitated access to rapid physical and laboratory examination but also an exacerbation of the free-rider problem in ED services.
Substantial overlap between symptomatic and asymptomatic genitourinary microbiota states
Authors: Adu-Oppong Boahemaa , Thänert Robert , Wallace Meghan A. , Burnham Carey-Ann D. , Dantas Gautam
Published: January 2022

Background

The lack of a definition of urinary microbiome health convolutes diagnosis of urinary tract infections (UTIs), especially when non-traditional uropathogens or paucity of bacteria are recovered from symptomatic patients in routine standard-of-care urine tests. Here, we used shotgun metagenomic sequencing to characterize the microbial composition of asymptomatic volunteers in a set of 30 longitudinally collected urine specimens. Using permutation tests, we established a range of asymptomatic microbiota states, and use these to contextualize the microbiota of 122 urine specimens collected from patients with suspected UTIs diagnostically categorized by standard-of-care urinalysis within that range. Finally, we used a standard-of-care culture protocol to evaluate the efficiency of culture-based recovery of the urinary microbiota.

Results

The majority of genitourinary microbiota in individals suspected to have UTI overlapped with the spectrum of asymptomatic microbiota states. Longitudinal characterization of the genitourinary microbiome in urine specimens collected from asymptomatic volunteers revealed fluctuations of microbial functions and taxonomy over time. White blood cell counts from urinalysis suggested that urine specimens categorized as ‘insignificant’, ‘contaminated’, or ‘no-growth’ by conventional culture methods frequently showed signs of urinary tract inflammation, but this inflammation is not associated with genitourinary microbiota dysbiosis. Comparison of directly sequenced urine specimens with standard-of-care culturing confirmed that culture-based diagnosis biases genitourinary microbiota recovery towards the traditional uropathogens Escherichia coli and Klebsiella pneumoniae.

Conclusion

Here, we utilize shotgun metagenomic sequencing to establish a baseline of asymptomatic genitourinary microbiota states. Using this baseline we establish substantial overlap between symptomatic and asymptomatic genitourinary microbiota states. Our results establish that bacterial presence alone does not explain the onset of clinical symptoms.
Drop-out in dual VET: why we should consider the drop-out direction when analysing drop-out
Authors: Krötz Maximilian , Deutscher Viola
Published: January 2022

Despite high drop-out rates from vocational education and training (VET) throughout most countries and a long research tradition on potential drop-out reasons, little is known about the effects exerted on drop-out intentions by the quality of training. Furthermore, only rarely do scholars distinguish between different drop-out directions, and systematic insights on possibly differing causes are scarce. This study explores the factors influencing four directions of drop-out intention (‘upwards’, ‘downwards’, ‘company change’, ‘occupation change’). Linear regression modelling is used to analyse survey data on the motivation, socio-demographic aspects and competency of 562 trainees as industrial management assistants in Germany and on how they perceived the training quality. The results show that different directions of drop-out intention stem from various factors, with training quality in general having the largest effect. Additionally, the findings indicate a two-tier-scheme of influence factors, ‘core’ and ‘direction-typical’ factors.
Differential effect of pre and post cognitive skills training program: a study on healthy young children
Authors: Chaturvedi Ramesh Kumar , Verma Vishal , Mishra Kushendra
Published: January 2022

The objective of this research paper is to check the difference between pre and post-session of the Brighter Minds based Cognitive Skill Training. The exploratory and descriptive research design is used in this study. In this investigation, the nine measurement variables are selected for the study such as memory, confidence, concentration, intuition ability, and blindfold reading. All the measurement variables were tested under pre and post cognitive skill training. Apart from these behavioural variables, two variables, gender, and age were also measured. The paired t test is used for the comparison between the pre and post-session of cognitive skill training. The pie and bar chart is used for the pictorial presentation of the results. The data coding, value label, data analysis are performed through statistical software. The findings of this study concluded that there was a significant improvement in the student’s memory, confidence, concentration, intuition, and skill of reading and colour identification with a blindfold.
Pediatric trauma burden in Tanzania: analysis of prospective registry data from thirteen health facilities
Authors: Sawe Hendry R. , Milusheva Sveta , Croke Kevin , Karpe Saahil , Mfinanga Juma A.
Published: January 2022

Background

Trauma is among the leading causes of morbidity and mortality among pediatric and adolescent populations worldwide, with over ninety percent of childhood injuries occurring in low-income and middle-income countries. Lack of region-specific data on pediatric injuries is among the major challenges limiting the ability of health systems to implement interventions to prevent injuries and improve outcomes. We aim to characterize the burden of pediatric health injuries, initial healthcare interventions and outcomes seen in thirteen diverse healthcare facilities in Tanzania.

Methods

This was a prospective cohort study of children aged up to 18 years presenting to emergency units (EUs) of thirteen multi-level health facilities in Tanzania from 1st October 2019 to 30th September 2020. We describe injury patterns, mechanisms and early interventions performed at the emergency units of these health facilities.

Results

Among 18,553 trauma patients seen in all thirteen-health facilities, 4368 (23.5%) were children, of whom 2894 (66.7%) were male. The overall median age was 8 years (Interquartile range 4–12 years). Fall 1592 (36.5%) and road traffic crash (RTC) 840 (19.2%) were the top mechanisms of injury. Most patients 3748 (85.8%) arrived at EU directly from the injury site, using motorized (two or three) wheeled vehicles 2401 (55%). At EU, 651 (14.9%) were triaged as an emergency category. Multiple superficial injuries (14.4%), fracture of forearm (11.7%) and open wounds (11.1%) were the top EU diagnoses, while 223 (5.2%) had intracranial injuries. Children aged 0–4 years had the highest proportion (16.3%) of burn injuries. Being referred and being triaged as an emergency category were associated with high likelihood of serious injuries with adjusted odds ratio (AOR) 4.18 (95%CI 3.07–5.68) and 2.11 (95%CI 1.75–2.56), respectively. 1095 (25.1%) of patients were admitted to inpatient care, 14 (0.3%) taken to operation theatre, and 25 (0.6%) died in the EU.

Conclusions

In these multilevel health facilities in Tanzania, pediatric injuries accounted for nearly one-quarter of all injuries. Over half of injuries occurred at home. Fall from height was the leading mechanism of injury, followed by RTC. Most patients sustained fractures of extremities. Future studies of pediatric injuries should focus on evaluating various preventive strategies that can be instituted at home to reduce the incidence and associated impact of such injuries.
Transcatheter arterial embolization followed by surgical laparotomy for hemorrhagic shock due to intestinal bleeding: a case report
Authors: Kurita Sayumi , Kitagawa Kazuo , Toya Naoki , Kaji Mutsumi , Yoshioka Satoshi , Hiramoto Yuki , Fujioka Shuichi , Takahashi Naoto , Eto Ken
Published: January 2022

Background

Acquired jejunal diverticula are relatively rare conditions. While mostly asymptomatic, they can occasionally cause life-threatening complications requiring surgical treatment. We herein report a case of hemorrhagic shock due to jejunal diverticulum with intestinal amyloidosis that was successfully managed via transcatheter arterial embolization (TAE) and surgery.

Case presentation

An 80-year-old female presenting with hematochezia and hemorrhagic shock was transferred to our institution. Contrast-enhanced computed tomography revealed extravasation in the small bowel around the upper jejunum. Massive transfusion was performed with subsequently planning for TAE to control bleeding followed by surgical laparotomy to evaluate the ischemic intestine. First, the second jejunal artery was selectively embolized with a 1:3 mixture of N-butyl cyanoacrylate (NBCA) and iodize oil, after which laparotomy was performed. Multiple jejunal diverticula were detected near Treitz’ ligament, and an induration of NBCA was palpable in the nearby mesentery. The intraoperative diagnosis was massive bleeding from acquired jejunal diverticula for which jejunectomy including the nearby diverticulum was performed to prevent future bleeding. Her postoperative course was stable. Histological examination of the specimen revealed several false diverticula with intestinal amyloidosis.

Conclusion

Hemorrhagic shock due to jejunal diverticulum with intestinal amyloidosis is extremely rare. Combined treatment of TAE and surgical laparotomy appears to be effective, because the bleeding point can be identified by palpation of the embolic material.
Patient with gastric cancer who underwent distal gastrectomy after treatment of COVID-19 infection diagnosed by preoperative PCR screening
Authors: Kimura Akiharu , Morinaga Nobuhiro , Wada Wataru , Ogata Kyoichi , Okuyama Takayuki , Kato Hiroyuki , Sohda Makoto , Shirabe Ken , Saeki Hiroshi
Published: January 2022

Background

Because of the coronavirus disease 2019 (COVID-19) pandemic, preoperative screenings for COVID-19 infection are often performed in many institutions. Some patients are diagnosed with COVID-19 infection by antigen tests or polymerase chain reaction (PCR) testing for COVID-19, even if they have no symptoms, such as fever or respiratory symptoms. We herein describe a patient with gastric cancer who underwent distal gastrectomy 6 weeks after recovering from COVID-19 infection diagnosed by preoperative PCR.

Case presentation

An 86-year-old man was transferred to our hospital because of hematemesis and melena. A hemorrhagic gastric ulcer was found in the lesser curvature of the antrum by emergency endoscopy. Endoscopic hemostasis was performed, and he was discharged after recovery. A tumor-like lesion in the lesser curvature of the antrum was found on repeat endoscopy and was diagnosed as well-differentiated adenocarcinoma by biopsy. There was no evidence of lymph node metastasis or distant metastasis; therefore, we planned radical surgery. However, he was diagnosed with COVID-19 infection by preoperative PCR screening. Although he had no symptoms, such as fever or respiratory symptoms, he was hospitalized because of his advanced age. He was discharged 10 days after admission, and repeat COVID-19 PCR was negative. We planned radical surgery for the stomach tumor 6 weeks after recovery from the COVID-19 infection. A PCR-negative COVID-19 status was confirmed again before hospitalization. Open distal gastrectomy with Billroth I reconstruction was performed. We avoided ultrasonic scalpels and used a Crystal Vision 450D surgical smoke evacuator (I.C. Medical, Inc., Phoenix, AZ, USA) to reduce intraoperative surgical smoke. The postoperative course was uneventful.

Conclusion

Because of the COVID-19 pandemic, some patients are diagnosed with COVID-19 infection by preoperative antigen tests or PCR, even if they have no symptoms. If possible, elective surgery should be performed 4 to 6 weeks after recovery from COVID-19 infection to maximize safety. Moreover, surgeons must consider intraoperative surgical smoke.
Use and awareness of emergency contraceptives among women of reproductive age in sub-Saharan Africa: a scoping review
Authors: Kwame Kelvin Amaniampong , Bain Luchuo Engelbert , Manu Emmanuel , Tarkang Elvis Enowbeyang
Published: January 2022

Background

Emergency contraception (EC) is a method used to avoid pregnancy after unprotected sexual intercourse. Emergency contraceptives can reduce the risk of unintended pregnancy by up to over 95% when taken within 72 h of sexual intercourse. EC is helpful to women who have experienced method failure, incorrect use of contraceptives, raped or have consented to unplanned, and unprotected sexual intercourse. We set out to systematically review the current literature on the awareness and usage patterns of ECs among women of reproductive age in Sub-Saharan Africa.

Method

Eight hundred and sixty-seven (867) articles were selected from EMBASE and Google Scholar databases after a search was conducted. Sixty (60) full-text articles were checked for eligibility and 27 articles met our inclusion criteria. Manual data extraction on excel sheets was used to extract the authors’ names, year of publication, country, sample size, study type, objectives, awareness levels, and the EC types.

Findings

Awareness rates ranged from 10.1 to 93.5% (both reported from Ethiopia). The level of use was relatively low (ranging from 0% in DR Congo and Ethiopia to 54.1% in Nigeria). The most used types of EC were Postinor 2 (levonorgestrel), EC pills such as Norlevo (levonorgestrel only) and Nodette (levonorgestrel and estradiol), and intrauterine contraceptive device (IUCD).

Conclusions

Although variations in use and awareness do exist between countries in SSA according to the year of study, the general level of EC awareness has been on the increase. On the other hand, the level of EC use was lower compared to the level of awareness. Postinor 2 (levonorgestrel-only pills) was reported as the most type used EC. Further, studies could be done to find out the effect of culture, religion and believes on the use of contraceptive methods. It is important to understanding barriers to EC use despite high awareness rates. Emergency Contraceptive awareness and use should be promoted among women of reproductive age in SSA to reduce unwanted pregnancies and their complications.
Ultrastructure of the gill ciliary epithelium of Limnoperna fortunei (Dunker 1857), the invasive golden mussel
Authors: Freitas Erico Tadeu Fraga , Moreira Amanda Maria Siqueira , de Paula Rayan Silva , Andrade Gabriela Rabelo , de Carvalho Marcela David , Assis Paulo Santos , Jorge Erika Cristina , Cardoso Antônio Valadão
Published: January 2022

Background

Limnoperna fortunei is a freshwater bivalve mollusc originally from southern Asia that invaded South America in the 1990’s. Due to its highly efficient water pumping and filtering, and its capacity to form strong adhesions to a variety of substrates by byssus thread, this invasive species has been able to adapt to several environments across South America, causing significant ecological and economic damages. By gaining a deeper understanding of the biological and ecological aspects of L. fortunei we will be able to establish more effective strategies to manage its invasion. The gills of the mollusc are key structures responsible for several biological functions, including respiration and feeding. In this work, we characterized the ultrastructure of L. fortunei gills and its ciliary epithelium using light microscopy, transmission and scanning electron microscopies. This is the first report of the morphology of the epithelial cells and cilia of the gill of L. fortunei visualized in high resolution.

Results

The analysis showed highly organized and abundant ciliary structures (lateral cilia, laterofrontal cirri and frontal cilia) on the entire length of the branchial epithelium. Mitochondria, smooth endoplasmic reticulum and glycogen granules were abundantly found in the epithelial cells of the gills, demonstrating the energy-demanding function of these structures. Neutral mucopolysaccharides (low viscosity mucus) were observed on the frontal surface of the gill filaments and acid mucopolysaccharides (high viscosity mucus) were observed to be spread out, mainly on the lateral tract. Spherical vesicles, possibly containing mucus, could also be observed in these cells. These findings demonstrate the importance of the mucociliary processes in particle capture and selection.

Conclusions

Our data suggest that the mechanism used by this mollusc for particle capture and selection could contribute to a better understanding of key aspects of invasion and also in the establishment of more efficient and economically viable strategies of population control.
Renal rehabilitation as a management strategy for physical frailty in CKD
Authors: Matsuzawa Ryota
Published: January 2022

An aging population and the increasing prevalence of lifestyle-related diseases have led to a worldwide increase in the rate of chronic kidney disease requiring renal replacement therapy. The mean age of individuals requiring dialysis therapy has been increasing, and Japanese patients are aging more rapidly than those in the USA and Europe. Patients undergoing renal replacement therapy are at increased risk of sarcopenia/frailty compared with people with normal kidney function due to comorbid burden, long-standing malnutrition, chronic inflammation, metabolic acidosis, anabolic resistance, hormonal changes, physical inactivity and amino acid loss via dialysis treatment in addition to aging. Sarcopenia and frailty are serious global health problems that can decrease access to kidney transplantation and lead to various adverse health outcomes, including functional dependence, hospitalizations and deaths in patients on dialysis treatment. However, sarcopenia/frailty fortunately is potentially modifiable by early identification of poor physical functioning, sustainment and enhancement of daily physical activity, and participation in exercise treatments. The Japanese Society of Renal Rehabilitation was established in 2011 and published a clinical practice guideline for “Renal Rehabilitation” targeting nondialysis-dependent and dialysis-dependent patients and renal transplant recipients, in 2019. The guideline emphasized the importance of physical management for patients with kidney diseases in addition to nutritional supports and anemia management. Kidney health professionals should manage sarcopenia and physical frailty as a part of routine clinical care for patients undergoing hemodialysis to improve poor physical functioning, functional dependence, decreased quality of life and poor prognosis.
Graphical calibration curves and the integrated calibration index (ICI) for competing risk models
Authors: Austin Peter C. , Putter Hein , Giardiello Daniele , van Klaveren David
Published: January 2022

Background

Assessing calibration—the agreement between estimated risk and observed proportions—is an important component of deriving and validating clinical prediction models. Methods for assessing the calibration of prognostic models for use with competing risk data have received little attention.

Methods

We propose a method for graphically assessing the calibration of competing risk regression models. Our proposed method can be used to assess the calibration of any model for estimating incidence in the presence of competing risk (e.g., a Fine-Gray subdistribution hazard model; a combination of cause-specific hazard functions; or a random survival forest). Our method is based on using the Fine-Gray subdistribution hazard model to regress the cumulative incidence function of the cause-specific outcome of interest on the predicted outcome risk of the model whose calibration we want to assess. We provide modifications of the integrated calibration index (ICI), of E50 and of E90, which are numerical calibration metrics, for use with competing risk data. We conducted a series of Monte Carlo simulations to evaluate the performance of these calibration measures when the underlying model has been correctly specified and when the model was mis-specified and when the incidence of the cause-specific outcome differed between the derivation and validation samples. We illustrated the usefulness of calibration curves and the numerical calibration metrics by comparing the calibration of a Fine-Gray subdistribution hazards regression model with that of random survival forests for predicting cardiovascular mortality in patients hospitalized with heart failure.

Results

The simulations indicated that the method for constructing graphical calibration curves and the associated calibration metrics performed as desired. We also demonstrated that the numerical calibration metrics can be used as optimization criteria when tuning machine learning methods for competing risk outcomes.

Conclusions

The calibration curves and numeric calibration metrics permit a comprehensive comparison of the calibration of different competing risk models.
Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force
Authors: Tavares Anna Carolina Faria Moreira Gomes , de Melo Ana Karla Guedes , Cruz Vítor Alves , de Souza Viviane Angelina , de Carvalho Joana Starling , Machado Ketty Lysie Libardi Lira , de Azevedo Valadares Lilian David , dos Reis Neto Edgard Torres , de Rezende Rodrigo Poubel Vieira , de Resende Guimarães Maria Fernanda Brandão , Ferreira Gilda Aparecida , de Sousa Braz Alessandra , de Abreu Vieira Rejane Maria Rodrigues , de Medeiros Pinheiro Marcelo , Ribeiro Sandra Lúcia Euzébio , Bica Blanca Elena Gomes Rios , Baptista Kátia Lino , da Costa Izaias Pereira , Marques Claudia Diniz Lopes , Lopes Maria Lúcia Lemos , Martinez José Eduardo , Giorgi Rina Dalva Neubarth , da Mota Lícia Maria Henrique , da Rocha Loures Marcos Antônio Araújo , dos Santos Paiva Eduardo , Monticielo Odirlei André , Xavier Ricardo Machado , Kakehasi Adriana Maria , Pileggi Gecilmara Cristina Salviato
Published: January 2022

Objective

To provide guidelines on the coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated rheumatic diseases (IMRD) to rheumatologists considering specific scenarios of the daily practice based on the shared-making decision (SMD) process.

Methods

A task force was constituted by 24 rheumatologists (panel members), with clinical and research expertise in immunizations and infectious diseases in immunocompromised patients, endorsed by the Brazilian Society of Rheumatology (BSR), to develop guidelines for COVID-19 vaccination in patients with IMRD. A consensus was built through the Delphi method and involved four rounds of anonymous voting, where five options were used to determine the level of agreement (LOA), based on the Likert Scale: (1) strongly disagree; (2) disagree, (3) neither agree nor disagree (neutral); (4) agree; and (5) strongly agree. Nineteen questions were addressed and discussed via teleconference to formulate the answers. In order to identify the relevant data on COVID-19 vaccines, a search with standardized descriptors and synonyms was performed on September 10th, 2021, of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and LILACS to identify studies of interest. We used the Newcastle–Ottawa Scale to assess the quality of nonrandomized studies.

Results

All the nineteen questions-answers (Q&A) were approved by the BSR Task Force with more than 80% of panelists voting options 4—agree—and 5—strongly agree—, and a consensus was reached. These Guidelines were focused in SMD on the most appropriate timing for IMRD patients to get vaccinated to reach the adequate covid-19 vaccination response.

Conclusion

These guidelines were developed by a BSR Task Force with a high LOA among panelists, based on the literature review of published studies and expert opinion for COVID-19 vaccination in IMRD patients. Noteworthy, in the pandemic period, up to the time of the review and the consensus process for this document, high-quality evidence was scarce. Thus, it is not a substitute for clinical judgment.
Optimized sparse polynomial chaos expansion with entropy regularization
Authors: Zeng Sijie , Duan Xiaojun , Chen Jiangtao , Yan Liang
Published: January 2022

Sparse Polynomial Chaos Expansion (PCE) is widely used in various engineering fields to quantitatively analyse the influence of uncertainty, while alleviating the problem of dimensionality curse. However, current sparse PCE techniques focus on choosing features with the largest coefficients, which may ignore uncertainties propagated with high order features. Hence, this paper proposes the idea of selecting polynomial chaos basis based on information entropy, which aims to retain the advantages of existing sparse techniques while considering entropy change as output uncertainty. A novel entropy-based optimization method is proposed to update the state-of-the-art sparse PCE models. This work further develops an entropy-based synthetic sparse model, which has higher computational efficiency. Two benchmark functions and a computational fluid dynamics (CFD) experiment are used to compare the accuracy and efficiency between the proposed method and classical methods. The results show that entropy-based methods can better capture the features of uncertainty propagation, improving accuracy and reducing sparsity while avoiding over-fitting problems.
What’s new in artificially intelligent joint surgery in China? The minutes of the 2021 IEEE ICRA and literature review
Authors: Xu Zhonghua , Zhang Yuan
Published: January 2022

Objective

To outline the main results of the 2021 International Conference on Robotics and Automation (ICRA 2021) of the Institute of Electrical and Electronics Engineers (IEEE) and review the advances in artificially intelligent joint surgery in China.

Methods

The keynote speeches of the 2021 ICRA were summarized in detail, and publications indexed by five core electronic databases (PubMed, Cochrane, Medline, Embase and CNKI) were systematically surveyed (cutoff date: July 30, 2021) in terms of the main topics of the conference. Publications directly related to artificially intelligent joint surgery in China were identified by using the search strategies of (robotic AND arthroplasty OR replacement), (navigation AND arthroplasty OR replacement), (artificial intelligent AND arthroplasty OR replacement), and (mixed reality AND arthroplasty OR replacement) and systemically reviewed.

Results

While robot-assisted arthroplasty in China is mainly performed using robots made in other countries (e.g., Mako from Stryker, USA), China’s domestic R&D of robots and clinical studies of robotic joint surgery have made some achievements. Although reports on the safety, effectiveness and clinical efficacy of China’s domestic robot-assisted joint surgery were presented at conferences, they have rarely been published in journals. Existing data indicate that, after the learning curve is overcome, robot-assisted hip and knee replacement surgery can fully achieve the established goals of precision and individualization and can significantly improve the accuracy of prosthesis placement angle and the recovery of the mechanical axis as compared with conventional surgery. The downside is that the low level of intelligentization and individualization means that existing designs are not conducive to personalization during surgery, resulting in low cost-effectiveness.

Conclusion

The safety and efficacy of domestic robot-assisted arthroplasty in China are well documented, and its accuracy and short-term clinical efficacy have been reported. However, the long-term clinical efficacy and the cost-effectiveness of large-scale clinical application of this technique warrants further study. The inadequacies of robot-assisted surgery should be remedied through the deep integration of medicine, engineering and the network.
Oral carcinoma cuniculatum: an unacquainted entity with diagnostic challenges—a case report
Authors: Baz Safaa , Amer Hatem Wael , Wahed Ali A.
Published: January 2022

Background

Oral carcinoma cuniculatum (OCC) is an unacquainted well-differentiated subtype of oral squamous cell carcinoma, which displays unique clinic-pathological features. Up to date, OCC remains rare with about 75 reported cases, and is frequently missed or even misdiagnosed.

Case presentation

The aim of the present work was: to report a case of OCC in mandibular gingiva and to highlight its main clinic-pathological diagnostic features: with an exophytic cobble-stone surface and a characteristic endophytic burrowing architecture, as well as to differentiate between it and other closely similar lesions including verrucous carcinoma, papillary squamous cell carcinoma, and well-differentiated conventional oral squamous cell carcinoma.

Conclusions

An accurate diagnosis of OCC entails awareness of the clinicians and pathologists about its entity, proper knowledge of the diagnostic clinical and histopathological evidence, and the ability to differentiate it from closely similar lesions.
Prevalence, aetiology, antimicrobial susceptibility testing, and predictors of urinary tract infection among neonates with clinical sepsis: a cross-sectional study
Authors: Lugira Yasintha S. , Kimaro Fransisca D. , Mkhoi Mkhoi L. , Mafwenga Samuel G. , Joho Angelina A. , Yahaya James J.
Published: January 2022

Background

Urinary tract infection (UTI) is the most common and life-threatening bacterial infection among neonates. This study aimed to determine the prevalence, aetiology, and susceptible antimicrobial agents among neonates with UTI.

Methods

This was a cross-sectional analytical hospital-based study that included 152 neonates with clinical sepsis who were admitted at Dodoma regional referral hospital from January to June 2020. Bacterial growth of 1 × 103 colony forming units/mL of a single uropathogen was used to define the presence of UTI. Statistical analysis was performed using SPSS version 23.0 and multivariate analysis was used to determine the predicting factors of UTI. P <0.05 was regarded statistically significant.

Results

The prevalence of UTI was 18.4% (28/152). Klebsiella pneumoniae 64.3% (18/28) and Enterobacter spp. 35.7% (10/28) were the bacterial agents isolated. The bacterial isolates were 90%, and 60% sensitive to ciprofloxacin and amikacin, respectively. Low Apgar score (AOR = 12.76, 95% CI = 4.17–39.06, p<0.001), prolonged labour (AOR = 5.36, 95% CI = 1.28–22.52, p = 0.022), positive urine nitrite test (AOR = 26.67, 95% CI = 7.75–91.70, p<0.001), and positive leucocyte esterase test (AOR = 6.64, 95% CI = 1.47–29.97, p = 0.014) were potential predictors of UTI.

Conclusion

The prevalence of UTI confirmed by urine culture among neonates that were included in the present study indicates that this problem is common in the population where the study was conducted. Klebsiella pneumoniae and Enterobacter spp. were the uropathogens which were isolated. Ciprofloxacin, nitrofurantoin, and amikacin were sensitive to the isolated uropathogens.
Neutral bremsstrahlung electroluminescence in noble liquids
Authors: Borisova E. , Buzulutskov A.
Published: January 2022

Proportional electroluminescence (EL) is the physical effect used in two-phase dark matter detectors, to optically record in the gas phase the ionization signal produced by particle scattering in the liquid phase. In our previous works the presence of a new EL mechanism in noble gases, namely that of neutral bremsstrahlung (NBrS), was demonstrated both theoretically and experimentally, in addition to the ordinary EL mechanism due to excimer emission. In this work we show that the similar theoretical approach can apply to noble liquids, namely to liquid helium, neon, argon, krypton and xenon. In particular, the photon yields and spectra for NBrS EL in noble liquids have been calculated for the first time, using the electron energy and transport parameters obtained in the framework of Cohen-Lekner and Atrazhev theory. The relevance of the results obtained to the development of noble liquid detectors for dark matter searches and neutrino experiments is discussed.
Surveillance Improves Outcomes for Carriers of SDHB Pathogenic Variants: A Multicenter Study
Authors: Davidoff Dahlia F , Benn Diana E , Field Michael , Crook Ashley , Robinson Bruce G , Tucker Katherine , De Abreu Lourenco Richard , Burgess John R , Clifton-Bligh Roderick J
Published: January 2022

Context

Carriers of succinate dehydrogenase type B (SDHB) pathogenic variants (PVs) are at risk of pheochromocytoma and paraganglioma (PPGL) from a young age. It is widely recommended carriers enter a surveillance program to detect tumors, but there are limited studies addressing outcomes of surveillance protocols for SDHB PV carriers.

Objective

The purpose of this study was to describe surveillance-detected (s-d) tumors in SDHB PV carriers enrolled in a surveillance program and to compare their outcomes to probands.

Methods

This was a multicenter study of SDHB PV carriers with at least 1 surveillance episode (clinical, biochemical, imaging) in Australian genetics clinics. Data were collected by both retrospective and ongoing prospective follow-up. Median duration of follow-up was 6.0 years.

Results

181 SDHB PV carriers (33 probands and 148 nonprobands) were assessed. Tumors were detected in 20% of nonprobands undergoing surveillance (age range 9-76 years). Estimated 10-year metastasis-free survival was 66% for probands and 84% for nonprobands with s-d tumors (P = .027). S-d tumors were smaller than those in probands (median 27 mm vs 45 mm respectively, P = .001). Tumor size ≥40 mm was associated with progression to metastatic disease (OR 16.9, 95% CI 2.3-187.9, P = .001). Patients with s-d tumors had lower mortality compared to probands: 10-year overall survival was 79% for probands and 100% for nonprobands (P = .029).

Conclusion

SDHB carriers with s-d tumors had smaller tumors, reduced risk of metastatic disease, and lower mortality than probands. Our results suggest that SDHB PV carriers should undertake surveillance to improve clinical outcomes.
Circulating Levels of microRNA-122 and Hepatic Fat Change in Response to Weight-Loss Interventions: CENTRAL Trial
Authors: Wang Mengying , Xue Qiaochu , Li Xiang , Krohn Knut , Ziesche Stefanie , Ceglarek Uta , Blüher Matthias , Keller Maria , Yaskolka Meir Anat , Heianza Yoriko , Kovacs Peter , Shai Iris , Qi Lu
Published: January 2022

Purpose

Little is known about the relations between changes in circulating microRNA-122 (miR-122) and liver fat in response to weight-loss interventions. We aimed to investigate the association between miR-122 and changes of hepatic fat content during 18-month diet and physical activity interventions.

Methods

The CENTRAL trial is an 18-month randomized, controlled trial among adults with abdominal obesity or dyslipidemia. Subjects were randomly assigned to a low-fat diet or a Mediterranean/low-carbohydrate diet. After 6 months of dietary intervention, each diet group was further randomized into added physical activity groups or no added physical activity groups for the following 12 months of intervention. The current study included 220 participants at baseline and 134 participants with repeated measurements on serum miR-122 and hepatic fat content over 18 months.

Results

Serum miR-122 significantly increased from baseline to 18 months, while no difference was observed across the 4 intervention groups. We found a significant association between miR-122 and hepatic fat content at baseline, as per unit increment in log-transformed miR-122 was associated with 3.79 higher hepatic fat content (P < 0.001). Furthermore, we found that higher elevations in miR-122 were associated with less reductions in hepatic fat percentage during 18-month interventions (β = 1.56, P = 0.002). We also found a significant interaction between changes in miR-122 and baseline fasting plasma glucose with hepatic fat content changes in 18 months (P interaction = 0.02).

Conclusions

Our data indicate that participants with higher elevation in serum miR-122 may benefit less in reduction of hepatic fat content in response to diet and physical activity interventions.