bluuebunny/crossref_metadata_2025 huggingface dataset:
Reversible Control of Reproduction In Queens: Mastering the use of reproductive drugs to manipulate cyclicity
Authors: Romagnoli Stefano , Ferre-Dolcet Lluis
Published: August 2022

Background:

The literature is full of papers reporting side effects of progestogens in cats; however, they are, in fact, safe drugs, as discussed in this article. Gonadotropin-releasing hormone (GnRH) agonists and melatonin are additionally a practical solution for controlling cyclicity in queens, but they also have some contraindications and need to be used carefully.

Clinical relevance:

Mastering the use of reproductive drugs allows feline practitioners to handle many more clinical situations than can be solved using surgery. It is not necessary to be a specialist in reproduction to be able to halt cyclicity in a valuable breeding queen using hormones.

Equipment and technical skills:

A sound knowledge of appropriate dosages and criteria for patient selection for all reproductive drugs currently used in feline reproduction is the best guarantee of owner satisfaction and of ensuring the queen’s health. Availability of a serum progesterone assay, either in-house or via an external laboratory, is also important, in order to confirm a queen is at an appropriate stage of the reproductive cycle for treatment.

Audience:

This article is aimed principally (but not exclusively) at veterinarians working with cat breeders and whose clientele is increasingly interested in alternative methods of controlling reproduction in pet queens. Surgery is no longer the only choice, and practitioners who manage to keep abreast of new developments will be able to address clients’ needs in a modern, professional way.

Evidence base:

This review draws on a vast body of scientific evidence-based literature. Previously, personal (and sometimes misinformed) opinions, such as the proposed dangerous side effects of progestogens, have been perpetuated in the scientific literature. The papers cited in this review have therefore been carefully scrutinised to distinguish reliable information based on controlled studies from non-evidence-based information.
2022 AAFP/EveryCat Feline Infectious Peritonitis Diagnosis Guidelines
Authors: Thayer Vicki , Gogolski Susan , Felten Sandra , Hartmann Katrin , Kennedy Melissa , Olah Glenn A
Published: August 2022

Clinical importance:

Feline infectious peritonitis (FIP) is one of the most important infectious diseases and causes of death in cats; young cats less than 2 years of age are especially vulnerable. FIP is caused by a feline coronavirus (FCoV). It has been estimated that around 0.3% to 1.4% of feline deaths at veterinary institutions are caused by FIP.

Scope:

This document has been developed by a Task Force of experts in feline clinical medicine as the 2022 AAFP/EveryCat Feline Infectious Peritonitis Diagnosis Guidelines to provide veterinarians with essential information to aid their ability to recognize cats presenting with FIP.

Testing and interpretation:

Nearly every small animal veterinary practitioner will see cases. FIP can be challenging to diagnose owing to the lack of pathognomonic clinical signs or laboratory changes, especially when no effusion is present. A good understanding of each diagnostic test’s sensitivity, specificity, predictive value, likelihood ratio and diagnostic accuracy is important when building a case for FIP. Before proceeding with any diagnostic test or commercial laboratory profile, the clinician should be able to answer the questions of ‘why this test?’ and ‘what do the results mean?’ Ultimately, the approach to diagnosing FIP must be tailored to the specific presentation of the individual cat.

Relevance:

Given that the disease is fatal when untreated, the ability to obtain a correct diagnosis is critical. The clinician must consider the individual patient’s history, signalment and comprehensive physical examination findings when selecting diagnostic tests and sample types in order to build the index of suspicion ‘brick by brick’. Research has demonstrated efficacy of new antivirals in FIP treatment, but these products are not legally available in many countries at this time. The Task Force encourages veterinarians to review the literature and stay informed on clinical trials and new drug approvals.
Assessment of Supply Water Quality Using GIS Tool for Selected Locations in Delhi—A Case Study
Authors: DeepChand  , Khan Noor Afshan , Saxena Priyanka , Goyal Sanjeev K
Published: August 2022

The importance of water quality is well understood, and it becomes even more critical when is use for drinking purposes. A case study was carried out to know the applicability of GIS tool for determining the quality of supply water. Water samples from 21 houses at different locations of Delhi were collected. Sample analysis was done for physicochemical parameters viz., pH, EC, TDS, Total Hardness, Total Alkalinity, Chloride, Fluoride, and Nitrate. The water quality data from these selected locations was analyzed using Geographical Information System (GIS) Technique. GIS software did interpolation through the inverse distance weighted (IDW) method to know the water quality (WQ) in different part of the city for various parameters mentioned above and prepare thematic maps from the analysis of water quality data as a database. These thematic maps show the distribution of different water quality parameters. Using Weighted Arithmetic Index (WAI) method, Water Quality Index is calculated. After that, the Drinking Water Quality Index (DWQI) map was generated using thematic layer, reclassification, and weight value assigned in weighted overlay tools in GIS software. Five categories viz., excellent, good, satisfactory, poor, and very poor is assign to describe DWQI. Out of all the selected locations, DWQI was good only at two locations, whereas, at the remaining sites, the DWQI was found satisfactory. However, the overall water quality was found suitable for human consumption. The analysis outcome was represented as maps that will be advantageous to know the water quality status for the area under study. The spatial database established can be a reliable technique for monitoring and managing water quality in the water supply system.
Experimental study and reliability-based analyses on the bond performance of high-strength and corrosion-resistant rebar in concrete
Authors: Huang Bin , Yue Qing-rui , Liu Xiao-gang , Liu Si-bo
Published: August 2022

In this paper, the influence of concrete strength, diameter, cover thickness, anchorage length, and stirrups ratio on the bonding performance of the HSCR rebar in concrete are experimentally investigated. A nonlinear FE model for simulating the bond performance between HSCR and concrete is established and validated, and the influencing parameters are parametrically investigated. Moreover, the applicability of the ultimate bond strength model for HSCR-concrete is comparatively discussed, and a new model is proposed and validated to give relatively accurate prediction. Based on the proposed model, the anchorage reliability analysis is conducted, the influencing parameters as well as their variation on the reliability of bond strength are discussed, and the reliable anchorage length is recommended.
Patient Engagement in Health Coaching and Self-Management Abilities in Chronic Obstructive Pulmonary Disease
Authors: Benzo Maria V. , Kelpin Sydney S. , Werneburg Brooke , Hoult Johanna , Clark Matthew M. , Novotny Paul , Benzo Roberto
Published: August 2022

Objective: Health coaching has the potential to improve self-management abilities (SM) in patients with Chronic Obstructive Pulmonary Disease (COPD). Patient engagement with health care providers has a beneficial effect on patient outcomes. We examined the association of patient engagement with the health coach on SM abilities in patients with COPD. Methods: We analyzed the association between the degree of engagement measured by the Working Alliance Inventory (WAI-SR) and the SM measured by the Self-Management-Ability-Scale-30 (SMAS-30) at the end of a COPD health coaching intervention. Results: The cohort included 146 moderate to severe COPD patients. The WAI-SR total score was 85% of the maximum possible scores indicating a high degree of engagement between the health coach and the patients. The WAI-SR Task and Bond domains were positively associated with SM abilities after adjusting for lung function (FEV1 %) and depression symptoms (PHQ-2). Conclusion: The degree of engagement between a health coach and patients is associated with the perception of SM abilities in patients with COPD. Our results may inform self-management intervention and clinical practice.
Polishing trajectory planning method for optimal removal of full surface
Authors: Cao Yuanxun , Zhao Ji , Qu Xingtian , Wang Xin , Tian Nong
Published: August 2022

Optical free-form surface elements have better optical characteristics than traditional optical elements, but their more complex curved structure also increases the difficulty of optical processing. Aiming at the problem of insufficient equal overlap ratio spirals, this paper proposes a polishing trajectory planning method for the optimal removal of the full surface. Based on the overlap length model of the curvature change, the polishing area, track residence time and total material removal model are established, and the processing efficiency is determined. The projection method is used to map the spatial polishing trajectory to the plane, and the mathematical relationship between the material removal amount and the trajectory spacing of the circular polishing and the projection trajectory spacing is established. This paper analyzes the influence of contact area change, geodesic radius of curvature and polishing posture on the material removal of the curved surface, as well as the change trend of the material removal contour and the contour of the overlapping part. Finally, taking the rotationally symmetrical aspherical workpiece made of K9 glass as an example, the corresponding polishing plan is formulated to verify the effectiveness of the proposed method.
The effect of internal pressure change on the temperature rise and the amount of filling hydrogen of high pressure storage tank
Authors: Li Ji-Qiang , Li Ji-Chao , Kwon Jeong-Tae , Shang Chunlin
Published: August 2022

Hydrogen has been considered as a feasible energy carry for fuel cell vehicles, which offers a clean and efficient alternative for transportation. In the currently developed hydrogen compression cycle system, hydrogen is compressed through a compressor and stored in the tank as high pressure. The hydrogen is filled from high pressure station into hydrogen storage system in fuel cell vehicles. In the study, theoretical and simulation are performed by presenting a mathematical model for the temperature rise during filling process in the hydrogen storage tank at the pressure of 50 MPa compressed hydrogen system. For a high-pressure tank (HPT) that can store hydrogen at a hydrogen filling station, the temperature rise of hydrogen with the pressure change during the filling process, the amount of hydrogen filling in the tank, and the convective heat transfer coefficient in the tank were calculated. The calculated temperature was compared with numerical and theoretical methods. Appropriate theoretical formulas were presented through mathematical modeling for changes that occur when high-pressure storage tanks were filled, and hydrogen properties were analyzed using the REFPROP program. 3D modeling was performed for the high-pressure storage tank, and the analysis was conducted under adiabatic conditions. When the pressure was increased to 50 MPa in the initial vacuum state, and when the residual pressure was 18 MPa, it was 25, 50, 75,and 100 MPa, and hydrogen inside the storage tank of the temperature rise and the amount of hydrogen filling were investigated. The results of this study will be useful for the design and construction of compressed hydrogen tank for hydrogen charging system.
Use of YouTube to watch health-related videos and participation in online support groups among US adults with heart disease, diabetes, and hypertension
Authors: Langford Aisha T , Orellana Kerli T , Buderer Nancy
Published: August 2022

Objective

Social media use has grown over time. However, it is unclear how people with a self-reported history of cardiovascular disease or cardiovascular disease-related risk factors such as diabetes and hypertension use social media.

Methods

Data from the 2020 Health Information National Trends Survey (HINTS 5, Cycle 4) were analyzed (N = 3865). Only respondents with complete data for all variables of interest were included in the analyses, resulting in 306 respondents with a heart condition, 1291 with hypertension, and 608 with diabetes. We explored associations between two dependent variables: (1) participated in an online forum or support group and (2) watched a health-related video on YouTube, and sociodemographic factors and patient-provider communication. Analyses were conducted separately by medical condition. Odds ratios, 95% confidence intervals, and p-values were calculated.

Results

In respondents with a heart condition, hypertension, or diabetes, 5.4%, 8.4%, and 10.3% had participated in an online support group and 29.6%, 40.4%, and 36.6% had watched health-related videos on YouTube, respectively. Univariately, the odds of using online support groups was associated with younger age (vs. > = 65) in people with a heart condition and hypertension, but not diabetes. Regarding YouTube, younger age was associated with watching health-related videos across all three medical conditions, with additional gender and education associations observed in those with hypertension. There were no associations between social media use and patient-provider communication.

Conclusions

These findings may inform the selection of social media platforms for behavioral interventions depending on the intended patient population and goals (e.g. social support vs. video-based health education).
Critical Race Structuralism and Charles Mills’ Racial Contract: Pedagogical Practices for Twenty-first-century Educators
Authors: Wiggan Greg , Teasdell Annette , Parsons Tierra
Published: August 2022

At the nexus of legislation and education lies a vigorous debate regarding teaching about racial and ethnic relations in U.S. schools. Applying critical race structuralism (CRS), a new contribution to the field, this research explores Charles Mills’ Racial Contract as a pedagogical tool to help meet the needs of twenty-first-century learners. The article examines the following question: How can teaching Charles Mills’ Racial Contract from a CRS perspective expand pedagogical practices for educators? The findings suggest that applying CRS can help prepare educators to engage learners in diversity, equity, inclusion (DEI), and beyond. This work has implications for teachers, students, policy makers, and global citizens interested in mediating the effects of racism in schools and society.
Internship Participation in the United States by Student and School Characteristics, 1994 to 2017
Authors: Shandra Carrie L.
Published: August 2022

College internships have become seemingly ubiquitous, yet evidence of when and for whom participation has changed over time remains limited. This visualization uses data from the College Senior Survey, an annual nationwide exit survey of baccalaureate graduates, to document internship participation by student and school characteristics between 1994 and 2017. Recent graduates are more than twice as likely to participate as those from the mid-1990s; however, the results indicate significant and sustained inequalities for lower income students, first-generation students, public school students, and students from less selective schools. These ongoing participation gaps for students with less individual and institutional privilege underscore the need to consider internship access as a form of educational and labor market disadvantage.
Incidence and Visual Outcomes of Endophthalmitis After Intravitreal Injection of Dexamethasone Implant vs Ranibizumab
Authors: Pancholy Maitri , Storey Philip P. , Wood Edward H. , Chaudhary Varun , Obeid Anthony , Marlow Elizabeth , Farley Nathan D. , Wolfe Jeremy D. , Garg Sunir J.
Published: August 2022

Purpose:

To compare the incidence and visual outcomes of endophthalmitis after injection of an intravitreal dexamethasone implant and injection of intravitreal ranibizumab.

Methods:

This retrospective cohort study assessed endophthalmitis in eyes receiving an intravitreal injection of a 0.7 mg dexamethasone implant (DEX group), 0.5 mg ranibizumab (R5 group), or 0.3 mg ranibizumab (R3 group) between January 1, 2016, and May 31, 2018, at 2 large retina practices in the United States.

Results:

Suspected endophthalmitis occurred in 5 eyes after 4973 DEX injections, 43 eyes after 163 974 R5 injections, and 6 eyes after 18 954 R3 injections. Suspected endophthalmitis was significantly more common in the DEX group (1/995) than in the R5 group (1/3813) ( P = .008) but not than in the R3 group (1/3159) ( P = .10). Visual acuity outcomes were similar in the 3 groups.

Conclusions:

Suspected endophthalmitis might be more common after 0.7 mg dexamethasone injections than after 0.5 mg ranibizumab injections. Culture-positive endophthalmitis rates were similar across all 3 medications.
Aloe vera Lotion Used as a Potential Alternative Couplant for Sonography, in a Low-Resource Health Care Facility
Authors: Paulinus Samson O. , Egong Akpama E. , Ukpong Ekaete V. , Erim Akwa E. , Eru Eru M. , Ojile Joshua A. , Efanga Itoro , Egbe Nneoyi O.
Published: August 2022

Objective:

This study assessed the use of Aloe vera lotion as an alternative coupling medium for ultrasound imaging.

Materials and Methods:

A prospective analytical research design was adopted. A total of 50 subjects who consented were randomly recruited into the study from the University of Calabar Teaching Hospital (UCTH), Calabar and the Gijuwie Medical Diagnostics, Calabar. A total of 50 image pairs were obtained on scanning with Aloe vera lotion (Image A) and commercial ultrasound gel (Image B) for comparison. Image quality was assessed using anatomical details (AD) and visualization of hyperechoic structures (VHS) as criteria.

Results:

A substantial agreement was seen among raters (A: k = 0.658, B = 0.691; P < .05) with acceptable level of consistency (Cronbach’s alpha scores of 0.701 and 0.825 for Aloe vera lotion and commercial gel, respectively) based on AD. Images recommended as acceptable by raters was 91.7% for Aloe vera lotion and 81.7% for commercial gel. Both methods demonstrated almost perfect agreement (kappa > 80; P < .05) with each other based on AD and VHS (Table 3).

Conclusion:

Aloe vera lotion, which is locally available and relatively affordable, has the potential to be used as acoustic coupling medium in diagnostic sonography.
Functional improvement in children and adolescents with primary headache after an interdisciplinary multimodal therapy program: the DreKiP study
Authors: Sobe Hanna , Richter Matthias , Berner Reinhard , von der Hagen Maja , Hähner Antje , Röder Ingo , Koch Thea , Sabatowski Rainer , Klimova Anna , Gossrau Gudrun
Published: August 2022

Background

More than 2/3 of children and adolescents in Germany regularly suffer from headaches. Headache-related limitations in everyday life, school drop-out and educational impairment are common. Structured therapy programs for young headache patients are widely missing.

Methods

One hundred eleven patients with frequent migraine and/or tension type headache were treated in a 15 hour group program in afternoons, parallel with school, parents received 7 hours of therapy. At the beginning of the program (T0), 6 (T1) and 12 months (T2) after completion, data on headache related disability (PedMidas), headache frequency, intensity, and pediatric pain disability score (PPDI) were prospectively collected to investigate the effects of the therapy.

Results

Seventy-five patients (9-19 years, median = 14; 66.7% female) and their parents provided patient reported outcome measures showing at T1 (65 patients) and T2 (47 patients) reduced headache frequency (last 3 months headache days median T0: 30 days; T1: 18 days, reduction of median 12 days since T0; T2: 13 days, reduction of median 17 days since T0). Linear mixed models revealed significant reduction (T0/T1 p = 0,002; T0/T2 p = 0,001). Reduced headache disability has been reported at T1 and T2 (PedMidas median T0 = 30, T1 = 15, T2 = 7; p < 0,001, p < 0,001 respectively). Follow up data of a subgroup of patients 24 months after the treatment point to sustainable effects.

Conclusions

The interdisciplinary multimodal headache therapy program DreKiP reduces headache frequency and headache related disability significantly 6-12 months following its completion.

Trial registration

DRKS00027523, retrospectively registered.
Cervical cord reperfusion injury: a rare complication of spine surgery
Authors: Hasan Wafa , Khan Khalid , Alomani Najla
Published: August 2022

Background

Anterior cervical discectomy and fusion procedure has been considered the surgical procedure of choice for the management of degenerative cervical myelopathy. Postoperative paresis is one of the most serious and concerning complications. The occurrence of such complications without any clear anatomic explanation (e.g., epidural hematoma) is unusual.

Case presentation

A 62-year-old man underwent cervical spine decompression via the anterior approach for marked central canal stenosis and spinal cord compression due to degenerative changes. The operation was performed under neuromonitoring, and a complete discectomy for the levels C3/C4, C5/C6, and C6/C7 was performed. Fluoroscopy confirmed the correct placement of the inserted plates and screws. No motor or sensory deficits were evident after postoperative recovery. However, 1 day later, the patient experienced progressive weakness in his both upper and lower extremities. A whole spine MRI study was performed to exclude epidural hematoma as the possible etiology. Although no localized fluid collection or hematoma was observed, the study demonstrated abnormal signal intensity in the spinal cord on T2-weighted images at the levels C5 to C7. Such findings were consistent with changes in cord reperfusion syndrome. The patient was administered intravenous methylprednisolone therapy. Gradual improvement in the muscle power in his both extremities was noted, and the patient was discharged with a satisfactory outcome. One month later, the MRI study was repeated and showed regression of the previously seen high T2 signal intensity in the cervical spine.

Conclusion

Cervical cord reperfusion injury is an extremely rare etiology of neurological deterioration following spinal cord decompressive surgeries. Clinicians need to maintain a high index of suspicion for this complication and should be familiar with its imaging appearance.
Changes in primary care management of atrial fibrillation patients following the shift from warfarin to non-vitamin K antagonist oral anticoagulants: a Norwegian population based study
Authors: Halvorsen Sigrun , Smith Jørgen Anton , Söderdahl Fabian , Thuresson Marcus , Solli Oddvar , Ulvestad Maria , Jonasson Christian
Published: August 2022

Background

To assess baseline characteristics, drug utilisation and healthcare use for oral anticoagulants (OACs) following the introduction of non-vitamin K antagonist oral anticoagulants among patients with atrial fibrillation in primary care in Norway.

Methods

In this retrospective longitudinal cohort study, 92,936 patients with atrial fibrillation were identified from the Norwegian Primary Care Registry between 2010 and 2018. Linking to the Norwegian Prescription Database, we identified 64,112 patients (69.0%) treated with OACs and 28,824 (31%) who were untreated. Participants were followed until 15 May 2019, death, or loss to follow-up, whichever came first. For each OAC, predictors of initiation were assessed by modelling the probability of initiating the OAC using logistic regression, and predictors of the first switch after index date were assessed using multivariable Cox proportional hazards models. The numbers of primary care visits per quarter by index OAC were plotted and analysed with negative binomial regression analyses offset for the log of days at risk.

Results

Patients treated with OACs were older, had more comorbidities, and higher CHA2DS2-VASc scores than untreated patients. However, the mean CHA2DS2-VASc in the non-OAC group was 1.58 for men and 3.13 for women, suggesting an indication for OAC therapy. The percentage of patients with atrial fibrillation initiating OACs increased from 59% in 2010 to 79% in 2018. Non-vitamin K antagonist oral anticoagulant use increased throughout the study period to 95% of new OAC-treated patients in 2018, and switches from warfarin to non-vitamin K antagonist oral anticoagulants were common. The persistence of OAC treatment was > 60% after four years, with greatest persistence for apixaban. Patients treated with non-vitamin K antagonist oral anticoagulants had fewer primary care visits compared with those treated with warfarin (incidence rate ratio: 0.73, 95% confidence interval 0.71 to 0.75).

Conclusion

In this Norwegian primary care study, we found that the shift from warfarin to non-vitamin K antagonist oral anticoagulants was successful with 95% use in patients initiating OACs in 2018, and associated with fewer general practitioner visits. Persistence with OACs was high, particularly for apixaban. However, many patients eligible for treatment with OACs remained untreated.
Agreement between standard and self-reported assessments of physical frailty syndrome and its components in a registry of community-dwelling older adults
Authors: Buta Brian , Zheng Scott , Langdon Jackie , Adeosun Bukola , Bandeen-Roche Karen , Walston Jeremy , Xue Qian-Li
Published: August 2022

Background

The ability to identify frail older adults using a self-reported version of the physical frailty phenotype (PFP) that has been validated with the standard PFP could facilitate physical frailty detection in clinical settings.

Methods

We collected data from volunteers (N = 182), ages 65 years and older, in an aging research registry in Baltimore, Maryland. Measurements included: standard PFP (walking speed, grip strength, weight loss, activity, exhaustion); and self-reported questions about walking and handgrip strength. We compared objectively-measured gait speed and grip strength to self-reported questions using Cohen’s Kappa and diagnostic accuracy tests. We used these measures to compare the standard PFP with self-reported versions of the PFP, focusing on a dichotomized identification of frail versus pre- or non-frail participants.

Results

Self-reported slowness had fair-to-moderate agreement (Kappa(k) = 0.34–0.56) with measured slowness; self-reported and objective weakness had slight-to-borderline-fair agreement (k = 0.10–0.21). Combining three self-reported slowness questions had highest sensitivity (81%) and negative predictive value (NPV; 91%). For weakness, three questions combined had highest sensitivity (72%), while all combinations had comparable NPV. Follow-up questions on level of difficulty led to minimal changes in agreement and decreased sensitivity. Substituting subjective for objective measures in our PFP model dichotomized by frail versus non/pre-frail, we found substantial (k = 0.76–0.78) agreement between standard and self-reported PFPs. We found highest sensitivity (86.4%) and NPV (98.7%) when comparing the dichotomized standard PFP to a self-reported version combining all slowness and weakness questions. Substitutions in a three-level model (frail, vs pre-frail, vs. non-frail) resulted in fair-to-moderate agreement (k = 0.33–0.50) with the standard PFP.

Conclusions

Our results show potential utility as well as challenges of using certain self-reported questions in a modified frailty phenotype. A self-reported PFP with high agreement to the standard phenotype could be a valuable frailty screening assessment in clinical settings.
Combining metabolome and clinical indicators with machine learning provides some promising diagnostic markers to precisely detect smear-positive/negative pulmonary tuberculosis
Authors: Hu Xin , Wang Jie , Ju Yingjiao , Zhang Xiuli , Qimanguli Wushou’er , Li Cuidan , Yue Liya , Tuohetaerbaike Bahetibieke , Li Ying , Wen Hao , Zhang Wenbao , Chen Changbin , Yang Yefeng , Wang Jing , Chen Fei
Published: August 2022

Background

Tuberculosis (TB) had been the leading lethal infectious disease worldwide for a long time (2014–2019) until the COVID-19 global pandemic, and it is still one of the top 10 death causes worldwide. One important reason why there are so many TB patients and death cases in the world is because of the difficulties in precise diagnosis of TB using common detection methods, especially for some smear-negative pulmonary tuberculosis (SNPT) cases. The rapid development of metabolome and machine learning offers a great opportunity for precision diagnosis of TB. However, the metabolite biomarkers for the precision diagnosis of smear-positive and smear-negative pulmonary tuberculosis (SPPT/SNPT) remain to be uncovered. In this study, we combined metabolomics and clinical indicators with machine learning to screen out newly diagnostic biomarkers for the precise identification of SPPT and SNPT patients.

Methods

Untargeted plasma metabolomic profiling was performed for 27 SPPT patients, 37 SNPT patients and controls. The orthogonal partial least squares-discriminant analysis (OPLS-DA) was then conducted to screen differential metabolites among the three groups. Metabolite enriched pathways, random forest (RF), support vector machines (SVM) and multilayer perceptron neural network (MLP) were performed using Metaboanalyst 5.0, “caret” R package, “e1071” R package and “Tensorflow” Python package, respectively.

Results

Metabolomic analysis revealed significant enrichment of fatty acid and amino acid metabolites in the plasma of SPPT and SNPT patients, where SPPT samples showed a more serious dysfunction in fatty acid and amino acid metabolisms. Further RF analysis revealed four optimized diagnostic biomarker combinations including ten features (two lipid/lipid-like molecules and seven organic acids/derivatives, and one clinical indicator) for the identification of SPPT, SNPT patients and controls with high accuracy (83–93%), which were further verified by SVM and MLP. Among them, MLP displayed the best classification performance on simultaneously precise identification of the three groups (94.74%), suggesting the advantage of MLP over RF/SVM to some extent.

Conclusions

Our findings reveal plasma metabolomic characteristics of SPPT and SNPT patients, provide some novel promising diagnostic markers for precision diagnosis of various types of TB, and show the potential of machine learning in screening out biomarkers from big data.
Examining the impact of excessive daytime sleepiness on utility scores in patients with obstructive sleep apnoea and/or narcolepsy in five European countries
Authors: Cambron-Mellott M. Janelle , Mettam Sam , Li Vicky W. , Rowland John C. , Castro JeanPierre Coaquira
Published: August 2022

Background

Excessive daytime sleepiness (EDS) is a cardinal symptom of narcolepsy and affects many patients with obstructive sleep apnoea (OSA). EDS is associated with reduced quality of life, increased accident risk, and poor workplace performance. Given the impact of EDS, the ability to predict health-related utility from sleepiness is valuable for examining the cost effectiveness of novel treatments. The aim of this study was to examine the association between EDS and EQ-5D in patients with OSA and/or narcolepsy by modelling EQ-5D utility scores from Epworth Sleepiness Scale (ESS) scores.

Methods

Data were obtained from the Europe 2016/2017 National Health and Wellness Survey, an online, general population survey, designed to represent the age and gender composition of each country’s adult population. Analyses included 2,348 patients self-reporting symptomatic and diagnosed OSA (n = 2,277), narcolepsy (n = 48), or both (n = 23). Multivariable models were used to examine ESS as a predictor of EQ-5D utility while adjusting for covariates of interest. Results were validated following the National Institute for Health and Care Excellence Decision Support Unit guidelines for predictive modelling.

Results

Utility decreased as EDS severity increased (no EDS: 0.711 ± 0.251, mild: 0.685 ± 0.261, moderate: 0.643 ± 0.268, severe: 0.559 ± 0.323). Whereas participants with only OSA or only narcolepsy did not differ in utility, those with both conditions had lower scores (0.685 ± 0.266 and 0.627 ± 0.325 vs. 0.439 ± 0.340, respectively). Piecewise linear regression identified a single breakpoint at ESS score of 11.29. In the final model, for each point increase in ESS score, the corresponding decrease in EQ-5D utility was larger among patients with ESS scores ≥ 12 compared to patients with ESS scores ≤ 11 (model slopes: -0.0131 vs. -0.0026, respectively). Findings from the validation sample confirmed these results.

Conclusions

This study demonstrates the impact of sleepiness on quality of life (QoL) and its negative impact irrespective of sleep condition (OSA or narcolepsy). The breakpoint identified is relatively consistent with the established ESS cutoff score ≥ 11, which demarcates pathological sleepiness. Furthermore, as EDS severity worsens (increases) on the ESS, the impact on QoL is greater.
Baseline platelet count may predict short-term functional outcome of cerebral infarction
Authors: Kanazawa Kazo , Miyamoto Nobukazu , Hira Kenichiro , Kijima Chikage , Ueno Yuji , Hattori Nobutaka
Published: August 2022

Background and aims

Platelets play an important role in homeostasis however, they have also been associated with increased mortality after myocardial infarction. In the present study, we investigated whether platelet count is associated with differences in the short-term prognosis at the time of hospital discharge and early neurological deterioration in ischemic stroke patients.

Methods

Patients with ischemic stroke were enrolled from among 661 cerebrovascular disease patients admitted between January 2018 and December 2020. Patients who received hyperacute treatment, had a pre-onset modified Rankin scale (mRS) ≥ 3, transient ischemic attack, or active malignant disease were excluded. The platelet count was divided into quartiles (Q1-4) according to the number of patients, and the relationship between platelet count and prognosis was assessed using multivariable analysis.

Results

In total, 385 patients were included in the study. Regarding the functional outcome by platelet count, there was a significant increase in mRS ≥ 3 at discharge in the Q4 (range: 243–1327 × 109/L, p = 0.013, ORs: 1.674, 95%CI: 1.253–6.681) group compared to the Q3 (range: 205–242 × 109/L) group even after adjusting for factors with P < 0.2 in univariate analysis. Furthermore, the frequency of neurological deterioration (NIHSS ≥ 4) within 1 week was significantly lower in the Q3 group than in the Q1 (range; 19–173 × 109/L) and Q4 groups even after adjustment (Q1; p = 0.020 ORs: 6.634, 95%CI: 1.352–32.557, Q4; p = 0.007 ORs: 8.765, 95%CI: 1.827–42.035).

Conclusion

Platelet count at onset may affect the prognosis of cerebral infarction and early neurological deterioration. This study may help clarify the pathogenesis of cerebral infarction to improve prognosis.
Mepolizumab-Induced Posterior Reversible Encephalopathy Syndrome (PRES), a new patient report
Authors: Puram Vikram V. , Ghazaleh Dana , Salari Apameh , McCleary Kaci , Moriarty Gerald , Nichols Kendall , Ghannam Malik , Brown Kevin , Berry Brent
Published: August 2022

Background

Posterior Reversible Encephalopathy Syndrome (PRES) is a neurotoxic state characterized by seizures, headache, vision change, paresis, and altered mental status. PRES has an important place in medicine due to the wide variety of causative diseases, infections, and medications that precipitate its mysterious onset. Although exposure to medications, particularly immunosuppressants, cancer chemotherapy, and biologic drugs, is a common occurrence in patients who develop PRES, Mepolizumab has never before been associated.

Case presentation

This report of a 67-year-old male patient outlines the first reported case of Mepolizumab-induced PRES in the literature.

Conclusions

Treatment of severe asthma, asthma-exacerbations, and diseases such as eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss) with Mepolizumab is rapidly gaining popularity ever since the drug’s recent FDA-approval. This report aims to raise awareness of this potentially life-threatening and previously unreported side effect of Mepolizumab since early identification of the causative agent is the key to preventing the severe neurologic disability and possible death that may occur from the delayed treatment of PRES.
Prediction of small-for-gestational-age neonates at 33–39 weeks’ gestation in China: logistic regression modeling of the contributions of second- and third-trimester ultrasound data and maternal factors
Authors: Xu Danping , Shen Xiuzhen , Guan Heqin , Zhu Yiyang , Yan Minchan , Wu Xiafang
Published: August 2022

Objectives

A screening model for prediction of small-for-gestational-age (SGA) neonates (SGAp) was established by logistic regression using ultrasound data and maternal factors (MF). We aimed to evaluate the ability of SGAp as well as abdominal circumference (AC) and estimated fetal weight (EFW) measurements to predict SGA neonates at 33–39 weeks’ gestation.

Methods

This retrospective study evaluated 5298 singleton pregnancies that had involved three ultrasound examinations at 21+0–27+6, 28+0–32+6, and 33+0–39+6 weeks. All ultrasound data were transformed to MoM values (multiple of the median). Multivariate logistic regression was used to analyze the correlation between SGA status and various variables (ultrasound data and MF) during pregnancy to build the SGAp model. EFW was calculated according to the Hadlock formula at 33–39 weeks of gestation. The predictive performance of SGAp, AC MoM value at 33+0–39+6 weeks (AC-M), EFW MoM value (EFW-M), EFW-M plus MF, AC value at 33+0–39+6 weeks (AC), AC growth velocity, EFW, and EFW plus MF was evaluated using ROC curves. The detection rate (DR) of SGA neonate with SGAp, AC-M, EFW-M, and EFW-M plus MF at false positive rate (FPR) of 5% and 10%, and the FPR at DR of 85%, 90%, and 95% were observed.

Results

The AUCs of SGAp, AC-M, EFW-M, EFW-M plus MF, AC, AC growth velocity, EFW, and EFW plus MF for SGA neonates screening were 0.933 (95%CI: 0.916–0.950), 0.906 (95%CI: 0.887–0.925), 0.920 (95%CI: 0.903–0.936), 0.925 (95%CI: 0.909–0.941), 0.818 (95%CI: 0.791–0.845), 0.786 (95%CI: 0.752–0.821), 0.810 (95%CI: 0.782–0.838), and 0.834 (95%CI: 0.807–0.860), respectively. The screening efficiency of SGAp, AC-M, EFW-M, and EFW-M plus MF are significantly higher than AC, AC growth velocity, EFW, and EFW plus MF. The DR of SGAp, AC-M, EFW-M, and EFW-M plus MF for SGA neonates were 80.4%, 69.6%, 73.8% and 74.3% at 10% FPR. The AUCs of SGAp, AC-M, EFW-M, and EFW-M plus MF 0.950 (95%CI: 0.932–0.967), 0.929 (95%CI: 0.909–0.948), 0.938 (95%CI: 0.921–0.956) and 0.941 (95%CI: 0.924–0.957), respectively for screening SGA neonates delivered within 2 weeks after the assessment. The DR for these births increased to 85.8%, 75.8%, 80.0%, and 82.5%, respectively.

Conclusion

The rational use of ultrasound data can significantly improve the prediction of SGA statuses.
AST·MLR index and operation injury condition are novel prognostic predictor for the prediction of survival in patients with colorectal cancer liver metastases undergoing surgical resection
Authors: Chen Qichen , Li Mingxia , Chen Jinghua , Huang Zhen , Chen Xiao , Zhao Hong , Cai Jianqiang
Published: August 2022

Background

The prognostic values of preoperative aspartate aminotransferase (AST), monocyte-to-lymphocyte ratio (MLR), AST·MLR index (AMLRI) and operation injury condition in patients with colorectal cancer liver metastases (CRLM) remains unclear. This retrospective study assessed the relationship between these markers, progression-free survival (PFS), and overall survival (OS) in CRLM patients undergoing resection.

Methods

AMLRI was defined as AST × MLR. Operation injury condition was defined according to operation time and blood loss. Cox regression analyses were used to identify risk factors and to develop nomograms. C-indexes, time-dependent receiver operating characteristic (time-ROC) curves and calibration curves were used to assess the models.

Results

A total of 379 patients were enrolled. The optimal cut-off value of the AMLRI was 3.33. In the multivariable analysis, AMLRI > 3.33 (hazard ratio [HR] = 2.162, p = 0.002) and serious operation injury condition (HR = 1.539, p = 0.012) were predictive for unfavourable OS, and AMLRI > 3.33 (HR = 1.462, p = 0.021) was predictive for unfavourable PFS. The nomograms were superior to Fong’s Clinical Risk Score (CRS) according to the C-indexes (PFS: 0.682 vs. 0.600; OS: 0.730 vs. 0.586) and time-ROCs.

Conclusions

Preoperative AMLRI and operation injury condition are easily accessible predictors for prognosis. The nomograms performed better than CRS for the prediction of recurrence and survival.
METTL3 promotes non-small cell lung cancer (NSCLC) cell proliferation and colony formation in a m6A-YTHDF1 dependent way
Authors: Dou Xuejun , Wang Zhiyuan , Lu Weiqiang , Miao Libin , Zhao Yuefeng
Published: August 2022

Background

N6-methyladenosine (m6A) is the most common RNA modification, which plays a pivotal role in tumor development and progression. In this study, we assessed the role of m6A methyltransferase METTL3 in FRAS1-involved cell proliferation and colony formation of non-small cell lung cancer (NSCLC) cell lines.

Methods

Cell viability was analyzed by Cell Counting Kit (CCK-8) and colony formation. M6A RNA immunoprecipitation (IP), Ribosomal immunoprecipitation, RNA immunoprecipitation (RIP) were performed to verify the relationship between METTL3, FRAS1 and YTHDF1. Rescue experiments to confirm the regulatory mechanism of METTL3-FRAS1 promoted NSCLC cell proliferation through CDON by cooperating YTHDF1.

Results

We found that FRAS1 was correlated with poor prognosis in NSCLC patients, of which the transcript undergoes m6A modification regulated by METTL3. METTL3 silence reduced cell viability of NSCLC cells HCC827 and NCI-H1975, which could be restored by FRAS1 overexpression. The m6A modification of FRAS1 could be recognized by YTHDF1. FRAS1 silence or YTHDF1 silence could rescue the elevated NSCLC cell proliferation, colony formation, and tumor growth induced by METTL3 overexpression in vitro and in vivo.

Conclusions

Our study reveals that METTL3-FRAS1 plays a crucial role in NSCLC cell proliferation, colony formation, and tumor growth through the regulation of CDON by cooperating YTHDF1.
Does T1 slope minus cervical lordosis mismatch affect surgical outcomes of cervical laminoplasty in the absence of preoperative severe kyphosis?
Authors: Sakamoto Ryuji , Nakamoto Hideki , Yoshida Yuichi , Ohtomo Nozomu , Nagata Kosei , Kato So , Doi Toru , Matsubayashi Yoshitaka , Taniguchi Yuki , Tanaka Sakae , Oshima Yasushi
Published: August 2022

Background

The impact of the T1 slope minus cervical lordosis (T1S-CL) on surgical outcomes in patients with degenerative cervical myelopathy undergoing laminoplasty (LP) remain uncertain.

Methods

One hundred patients who underwent cervical LP were retrospectively reviewed. Radiographic measurements included C2–C7 lordosis (CL), T1 slope (T1S), and C2–C7 sagittal vertical axis (SVA). Additionally, pain numeric rating scale, neck disability index (NDI), 12-Item Short-Form Health Survey, Euro QOL 5 dimensions (EQ5D), and Japanese Orthopedic Association score were investigated. According to past reports, T1S–CL > 20° was defined as mismatched. Then, based on T1S-CL mismatching, patients were divided into 2 groups.

Results

This research understudied 67 males and 33 females with a mean age of 67 y. Preoperatively, only eight patients showed a T1S-CL mismatch. While the C2–7 Cobb angles did not change significantly after surgery, the T1 slope (T1S) angle increased, increasing the T1S-CL as a result. As we compared the clinical outcomes based on the preoperative T1S-CL mismatching, there were no significant differences between the two groups. On the other hand, the number of patients in the mismatched group increased to 21 patients postoperatively. As we compared clinical outcomes based on the postoperative T1S-CL mismatching, the postoperative NDI score and preop/postop EQ5D score were significantly worse in the mismatch group.

Conclusions

Although cervical LP showed inferior outcomes in patients with postoperative T1S-CL mismatch even in the absence of severe preoperative kyphosis (> 10°), preoperative T1S-CL mismatch was not adversely prognostic.
A new nomogram of urinary flow rate and volume based on multiple measurements per healthy adult Japanese men using a portable uroflowmeter (P-Flowdiary®)
Authors: Shinohara Masatake , Torimoto Kazumasa , Matsushita Chie , Gotoh Daisuke , Yoshida Hisashi , Saka Toshihisa , Hirao Yoshihiko , Hirayama Akihide , Fujimoto Kiyohide
Published: August 2022

Background

To develop a nomogram of urinary volume and flow based on the data of Japanese men without lower urinary tract symptoms and multiple flows per participant whose characteristics were clear.

Methods

Overall, 101 Japanese male volunteers without lower urinary tract symptoms aged between 20 and 59 years were enrolled. A portable uroflowmeter (P-Flowdiary®) was used to record urinary information (flow rate and volume) for 2 successive days. The model (quadratic, linear, or logarithmic regression) most fit for the relationship between maximum flow rate and voided volume was determined. The maximum flow rate at > 150 mL was compared among the 20–29-, 30–39-, 40–49-, and 50–59-year age groups. Nomograms appropriate for the age groups were created.

Results

The mean age, International Prostate Symptom Score, and Overactive Bladder Symptom Score were 38.5 years, 0.42, and 0.24, respectively. The quadratic regression model was the most fit because its mean coefficient determination was 0.93 ± 0.06. The mean maximum flow rate was significantly lower in the 50–59-year age group (21.8 ± 5.05 mL/s, P < 0.01) than in the younger groups (24.14 ± 4.94, 24.05 ± 6.99, and 24.64 ± 5.72 mL/s). The 2 nomograms are Y = 28.99 {1 − exp(− 0.01 × X)} and Y = 25.67 {1 − exp(− 0.01 × X)} for the 20–49- and 50–59-year age groups, respectively.

Conclusions

The nomogram can predict maximum flow rate based on voided volume in Japanese men aged 20–59 years without lower urinary tract symptoms.