bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mitogenome Analyses Reveal Limited Introduction of Anopheles coluzzii Into the Central African Islands of São Tomé and Príncipe
Authors: Ditter Robert E. , Campos Melina , Pinto João , Cornel Anthony J. , Rompão Herodes , Lanzaro Gregory C. 
Published: April 2022

Islands possess physical characteristics that make them uniquely well-suited for initial field trials of new genetic-based technologies applied to African malaria vectors. This has led to efforts to characterize the degree of isolation of island mosquito populations. São Tomé and Príncipe (STP) is a country composed of two small islands in the Gulf of Guinea (Central Africa) where Anopheles coluzzii is the primary malaria vector. Several studies have shown a relatively high degree of genetic isolation between A. coluzzii populations in STP and the mainland compared with pairs of mainland populations separated by equivalent distances. Here, we analyzed complete mitochondrial genomes of individual A. coluzzii specimens from STP and neighboring mainland countries. The objectives are to describe the history of A. coluzzii establishment in STP, specifically to address several questions germane to their suitability as sites for a field trial release of genetically engineered mosquitoes (GEMs). These questions include: (i) What are the origins of A. coluzzii populations in STP?; (ii) How many introductions occurred?; (iii) When was A. coluzzii introduced into STP? and (iv) Is there ongoing, contemporary gene flow into STP from mainland populations? Phylogenetic analysis and haplotype networks were constructed from sequences of 345 A. coluzzii from STP, and 107 individuals from 10 countries on or near the west coast of Africa. Analysis of these data suggest that there have been two introductions of A. coluzzii onto the island of São Tomé that occurred roughly 500 years ago and that these originated from mainland West Africa. It appears that A. coluzzii has never been introduced into Príncipe Island directly from mainland Africa, but there have been at least four introductions originating from São Tomé. Our findings provide further support for the notion that contemporary populations of A. coluzzii on São Tomé and Príncipe are genetically isolated from mainland populations of this mosquito species.
Efficacy and Safety of Electro-Thumbtack Needle Therapy for Patients With Chronic Neck Pain: Protocol for a Randomized, Sham-Controlled Trial
Authors: Shi Hangyu , Wang Xinlu , Yan Yan , Zhu Lili , Chen Yu , Gao Shuai , Liu Zhishun 
Published: April 2022

BackgroundChronic neck pain is a prevalent condition adversely impacting patients' wellbeing in both life and work experience. Electro-thumbtack needle (ETN) therapy, combining acupuncture with transcutaneous stimulation, might be one of the effective complementary and alternative medicine (CAM) therapies in treating chronic neck pain, although the evidence is scarce. This study aims to estimate the efficacy and safety of ETN therapy for chronic neck pain.Methods and AnalysisThis is a sham-controlled, randomized clinical trial. A total of 180 subjects will be randomly allocated to either the ETN group or the sham ETN group. Treatment will be administrated three times a week for four consecutive weeks, with a 6-month follow-up. The primary outcome measure will be the Numerical Rating Scale for neck pain (NRS-NP) over a period of the 4 weeks. Secondary outcome measures include the Northwick Park Neck Pain Questionnaire (NPQ), Neck Disability Index (NDI), Patient Global Impression of Change (PGIC), patient expectation, and preference assessment. The chi-square test or Fisher's exact test will be used for proportions of participants having clinically meaningful improvement. Analysis of covariance or repeated-measures analysis of variance will be applied to examine changes in the outcome measures from baseline.DiscussionsThis prospective trial will contribute to evaluating the efficacy and safety of ETN in the treatment of chronic neck pain, with an intermediate-term follow-up. This study will provide further evidence for clinical neck pain management.Ethics and DisseminationThis trial has been approved by the Research Ethical Committee of Guang'anmen Hospital (ethical approval number: 2021-039-KY-01). Recruitment began in March 2022 and will continue until December 2023. Dissemination plans include posters, WeChat, websites, and bulletin boards in hospital and communities.Clinical Trial RegistrationThis trial is registered at ClinicalTrials.gov (identifier: NCT04981171).
Association Between Various Types or Statuses of Smoking and Subjective Cognitive Decline Based on a Community Health Survey of Korean Adults
Authors: Kim Ji Hee , Chang In Bok , Kim Yoo Hwan , Min Chan Yang , Yoo Dae Myoung , Choi Hyo Geun 
Published: April 2022

ObjectivesThe relationship between smoking and subjective cognitive decline (SCD), which is defined as the subjective perception of cognitive decline, is not well known. This study aimed to investigate the relationship of various types of smoking, including E-cigarette smoking and the use of E-liquid, with the incidence of SCD among Korean adults.MethodsWe evaluated the 2018 Korean Community Health Survey data collected from community-dwelling people in Korea. A total of 104,453 non-smokers, 38,607 past smokers, and 26,776 current smokers with eligible data were included in the study. SCD was assessed using the Behavioral Risk Factor Surveillance System. The past or current smoking pack-years throughout each participant's entire life were calculated. Multiple regression analyses were carried out to estimate the adjusted odds ratios (ORs) as measures of the association between each type of smoking and SCD after adjustment for potential confounders.ResultsCompared to no exposure, passive smoking was associated with higher odds of SCD. Compared to non-smokers, past smokers had a higher OR for SCD; however, current smokers did not. There were no significant associations between passive smoking and SCD in the non-smoker and past smoker groups, but there was a significant relationship between them in the current smoker group. While the cumulative dose of smoking was correlated with an increased OR of SCD in each group of current smokers and past smokers, E-cigarette smoking and the use of E-liquid were not associated with higher ORs in the current smoker group.ConclusionOur findings support that passive smoking and past smoking are significantly associated with SCD and that more cumulative exposure to smoking is correlated with a higher OR of SCD.
Comparison of Sex Differences in Outcomes of Patients With Aneurysmal Subarachnoid Hemorrhage: A Single-Center Retrospective Study
Authors: Cai Yuankun , Liu Zheng , Jia Chenguang , Zhao Jingwei , Chai Songshan , Li Zhengwei , Xu Chengshi , Zhang Tingbao , Ma Yihui , Ma Chao , Chen Xinjun , Jiang Pucha , Zhao Wenyuan , Chen Jincao , Xiong Nanxiang 
Published: April 2022

BackgroundSex differences in the outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH) remain controversial. The aim of this study was to evaluate sex differences in the outcomes of patients with aSAH.MethodThis study retrospectively analyzed the clinical data of consecutive patients with aSAH, admitted to the Department of Neurosurgery, Wuhan University Zhongnan Hospital, from May 1, 2020 to December 31, 2020. The modified Rankin Scale (mRS) score was used to evaluate the prognosis of patients at discharge. Outcome indicators included cerebral ischemia, hydrocephalus, and mRS ≥ 2 at discharge.ResultsThe majority (65%) of the 287 patients with aSAH included in the study were females. Patients were divided into female (n = 184) and male (n = 99) groups; the female patients were significantly older than the male patients (61.3 ± 8.5 years vs. 60.0 ± 8.5 years, p = 0.032). The incidence of comorbidities (hypertension, diabetes, and heart disease) was higher in the female group than in the male group, but the difference was not statistically significant. Although more female patients than male patients underwent endovascular treatment, there was no statistical difference in the treatment approach between the two groups. Comparison of post-operative complications and mRS scores at discharge revealed that the rate of cerebral ischemia and mRS ≥ 2 at discharge were significantly higher among female patients than among male patients. Moreover, this difference persisted after propensity adjustment for age and treatment approach. Analysis of risk factors for poor prognosis at discharge in both pre- and post-adjustment patients revealed cerebral ischemia and high mFisher score (mFisher = 3/4) to be independent risk factors.ConclusionFemale patients with aSAH have a worse prognosis than male patients, and this difference may be because women are more susceptible to cerebral ischemia.
Altered Resting Brain Functions in Patients With Irritable Bowel Syndrome: A Systematic Review
Authors: Yu Zheng , Liu Li-Ying , Lai Yuan-Yuan , Tian Zi-Lei , Yang Lu , Zhang Qi , Liang Fan-Rong , Yu Si-Yi , Zheng Qian-Hua 
Published: April 2022

BackgroundThe neural activity of irritable bowel syndrome (IBS) patients in the resting state without any intervention has not been systematically studied. The purpose of this study was to compare the resting-state brain functions of IBS patients with healthy controls (HCs).MethodsThe published neuroimage studies were obtained from electronic databases including PubMed, EMBASE, PsycINFO, Web of Science Core, CNKI Database, Wanfang Database, VIP Database, and CBMdisc. Search dates were from inception to March 14th, 2022. The studies were identified by the preidentified inclusion and exclusion criteria. Two independent reviewers compiled the studies and evaluated them for quality and bias.ResultsAltogether 22 fMRI studies were included in this review. The risk of bias of the included studies was generally low. The findings indicated that in IBS patients, increased or decreased brain areas were mostly associated with visceral sensations, emotional processing, and pain processing. According to brain network research, IBS may exhibit anomalies in the DMN, CEN, and emotional arousal networks. The fluctuations in emotion (anxiety, sadness) and symptoms in IBS patients were associated with alterations in the relevant brain regions.ConclusionThis study draws a preliminary conclusion that there are insufficient data to accurately distinguish the different neurological features of IBS in the resting state. Additional high-quality research undertaken by diverse geographic regions and teams is required to reach reliable results regarding resting-state changed brain regions in IBS.
Glucose-Restricted Diet Regulates the Tumor Immune Microenvironment and Prevents Tumor Growth in Lung Adenocarcinoma
Authors: Gähler Alexander , Trufa Denis I. , Chiriac Mircea T. , Tausche Patrick , Hohenberger Katja , Brunst Ann-Kathrin , Rauh Manfred , Geppert Carol I. , Rieker Ralf J. , Krammer Susanne , Leberle Anna , Neurath Markus F. , Sirbu Horia , Hartmann Arndt , Finotto Susetta 
Published: April 2022

BackgroundLung cancer is the second common cancer type in western countries and has a high mortality. During the development and progression of the tumor, the nutrients in its environment play a central role. The tumor cells depend crucially on glucose metabolism and uptake. Tumor cell metabolism is dominated by the Warburg effect, where tumor cells produce large amounts of lactate from pyruvate under aerobic conditions. We thus reasoned that, reducing carbohydrates in the diet might support anti-tumoral effects of current immunotherapy and additionally target tumor immune escape.ObjectivesThe link between reducing carbohydrates to improve current immunotherapy is not clear. We thus aimed at analyzing the effects of different glucose levels on the tumor development, progression and the anti-tumoral immune response.MethodsWe correlated the clinical parameters of our LUAD cohort with different metabolic markers. Additionally, we performed cell culture experiments with A549 tumor cell line under different glucose levels. Lastly, we investigated the effect of low and high carbohydrate diet in an experimental murine model of lung cancer on the tumor progression and different immune subsets.ResultsHere we found a positive correlation between the body mass index (BMI), blood glucose levels, reduced overall survival (OS) and the expression of Insulin-like growth factor-1 receptor (IGF1R) in the lung tumoral region of patients with lung adenocarcinoma (LUAD). Furthermore, increasing extracellular glucose induced IGF1R expression in A549 LUAD cells. Functional studies in a murine model of LUAD demonstrated that, glucose restricted diet resulted in decreased tumor load in vivo. This finding was associated with increased presence of lung infiltrating cytotoxic CD8+ T effector memory (TEM), tissue resident memory T (TRM) and natural killer cells as well as reduced IGFR mRNA expression, suggesting that glucose restriction regulates lung immunity in the tumor microenvironment.ConclusionsThese results indicate that, glucose restricted diet improves lung immune responses of the host and suppresses tumor growth in experimental lung adenocarcinoma. As glucose levels in LUAD patients were negatively correlated to postoperative survival rates, glucose-restricted diet emerges as therapeutic avenue for patients with LUAD.
Can Radiomics Provide Additional Diagnostic Value for Identifying Adrenal Lipid-Poor Adenomas From Non-Adenomas on Unenhanced CT?
Authors: Zhang Binhao , Zhang Huangqi , Li Xin , Jin Shengze , Yang Jiawen , Pan Wenting , Dong Xue , Chen Jin , Ji Wenbin 
Published: April 2022

BackgroundIt is difficult for radiologists to differentiate adrenal lipid-poor adenomas from non-adenomas; nevertheless, this differentiation is important as the clinical interventions required are different for adrenal lipid-poor adenomas and non-adenomas.PurposeTo develop an unenhanced computed tomography (CT)-based radiomics model for identifying adrenal lipid-poor adenomas to assist in clinical decision-making.Materials and methodsPatients with adrenal lesions who underwent CT between January 2015 and August 2021 were retrospectively recruited from two independent institutions. Patients from institution 1 were randomly divided into training and test sets, while those from institution 2 were used as the external validation set. The unenhanced attenuation and tumor diameter were measured to build a conventional model. Radiomics features were extracted from unenhanced CT images, and selected features were used to build a radiomics model. A nomogram model combining the conventional and radiomic features was also constructed. All the models were developed in the training set and validated in the test and external validation sets. The diagnostic performance of the models for identifying adrenal lipid-poor adenomas was compared.ResultsA total of 292 patients with 141 adrenal lipid-poor adenomas and 151 non-adenomas were analyzed. Patients with adrenal lipid-poor adenomas tend to have lower unenhanced attenuation and smoother image textures. In the training set, the areas under the curve of the conventional, radiomic, and nomogram models were 0.94, 0.93, and 0.96, respectively. There was no difference in diagnostic performance between the conventional and nomogram models in all datasets (all p &lt; 0.05).ConclusionsOur unenhanced CT-based nomogram model could effectively distinguish adrenal lipid-poor adenomas. The diagnostic power of conventional unenhanced CT imaging features may be underestimated, and further exploration is worthy.
Association of Maternal Obesity and Neonatal Hypoxic-Ischemic Encephalopathy
Authors: Monaco-Brown Meredith , Munshi Upender , Horgan Michael Joseph , Gifford Jamie L. , Khalak Rubia 
Published: April 2022

ObjectiveMore women are obese at their first prenatal visit and then subsequently gain further weight throughout pregnancy than ever before. The impact on the infant’s development of neonatal hypoxic ischemic encephalopathy (HIE) has not been well studied. Using defined physiologic and neurologic criteria, our primary aim was to determine if maternal obesity conferred an additional risk of HIE.Study DesignData from the New York State Perinatal Data System of all singleton, term births in the Northeastern New York region were reviewed using the NIH obesity definition (Body Mass Index (BMI) ≥ 30 kg/m2). Neurologic and physiologic parameters were used to make the diagnosis of HIE. Physiologic criteria included the presence of an acute perinatal event, 10-min Apgar score ≤ 5, and metabolic acidosis. Neurologic factors included hypotonia, abnormal reflexes, absent or weak suck, hyperalert, or irritable state or evidence of clinical seizures. Therapeutic hypothermia was initiated if the infant met HIE criteria when assessed by the medical team. Logistic regression analysis was used to assess the effect of maternal body mass index on the diagnosis of HIE.ResultsIn this large retrospective cohort study we evaluated outcomes of 97,488 pregnancies. Infants born to obese mothers were more likely to require ventilatory assistance and have a lower 5-min Apgar score. After adjusting for type of delivery and maternal risk factors, infants of obese mothers were diagnosed with HIE more frequently than infants of non-obese mothers, OR 1.96 (1.33–2.89) (p = 0.001).ConclusionInfants of obese mothers were significantly more likely to have the diagnosis of HIE.
Hand Hygiene Compliance in Pediatric Emergency of a Lower-Middle Income Country: A Quality Improvement Study
Authors: Angurana Suresh Kumar , Chetal Pooja , Mehta Richa , Suthar Renu , Sundaram Venkataseshan , Singh Ranjana , Kaur Rupinder , Kaur Harinder , Biswal Manisha , Kumar Praveen , Jayashree Muralidharan 
Published: April 2022

BackgroundProspective data on hand hygiene compliance in pediatric emergency department (PED) settings is limited. We studied the impact of quality improvement measures on the overall and health care personnel wise hand hygiene compliance rates in a busy PED.MethodsThe baseline hand hygiene compliance rates were audited from May–July 2018. The quality improvement interventions included various structural changes to the environment, administrative changes, education and training. During the interventions, auditing was continued for 2 months (August – September 2018). Statistical Process control charts were created.ResultsWe observed a significant increase in overall compliance rates from 31.8 to 53.9% (p &lt; 0.001). These improvements were observed in the children (29.6 to 46.4%, p &lt; 0.001) as well as neonatal area (35.7% to 59.7, p &lt; 0.001) of PED as well as amongst various health care personnel and in four out of the five moments of hand hygiene.ConclusionHand hygiene compliance improved significantly in a busy PED of a lower middle-income country following quality improvement interventions. Such improvement was observed amongst all categories of health care personnel and different types of hand hygiene opportunities. This study demonstrates the feasibility and efficacy of simple quality improvement interventions in a challenging hospital environment.
Delays in Time-To-Antibiotics for Young Febrile Infants With Serious Bacterial Infections: A Prospective Single-Center Study
Authors: Yang Jinghui , Ong Wei Jie , Piragasam Rupini , Allen John Carson , Lee Jan Hau , Chong Shu-Ling 
Published: April 2022

IntroductionFear of missed serious bacterial infections (SBIs) results in many febrile young infants receiving antibiotics. We aimed to compare the time to antibiotics between infants with SBIs and those without.Materials and MethodsWe recruited febrile infants ≤ 90 days old seen in the emergency department (ED) between December 2017 and April 2021. SBI was defined as (1) urinary tract infection, (2) bacteremia or (3) bacterial meningitis. We compared the total time (median with interquartile range, IQR) from ED arrival to infusion of antibiotics, divided into (i) time from triage to decision for antibiotics and (ii) time from decision for antibiotics to administration of antibiotics.ResultsWe analyzed 81 and 266 infants with and without SBIs. Median age of those with and without SBIs were 44 (IQR 19–72) and 29 (IQR 7–56) days, respectively (p = 0.002). All infants with SBIs and 168/266 (63.2%) infants without SBIs received antibiotics. Among 249 infants who received antibiotics, the median total time from ED arrival to infusion of antibiotics was 277.0 (IQR 236.0–385.0) mins for infants with SBIs and 304.5 (IQR 238.5–404.0) mins for those without (p = 0.561). The median time to decision for antibiotics was 156.0 (IQR 115.0–255.0) mins and 144.0 (IQR 105.5–211.0) mins, respectively (p = 0.175). Following decision for antibiotics, infants with SBIs received antibiotics much faster compared to those without [107.0 (IQR 83.0–168.0) vs. 141.0 (94.0–209.5) mins, p = 0.017].ConclusionThere was no difference in total time taken to antibiotics between infants with SBIs and without SBIs. Both recognition and administration delays were observed. While all infants with SBIs were adequately treated, more than half of the infants without SBIs received unnecessary antibiotics. This highlights the challenge in managing young febrile infants at initial presentation, and demonstrates the need to examine various aspects of care to improve the overall timeliness to antibiotics.
Analysis of the Global Disease Burden of Down Syndrome Using YLDs, YLLs, and DALYs Based on the Global Burden of Disease 2019 Data
Authors: Bu Qingting , Qiang Rong , Cheng Hua , Wang Anmin , Chen Huangtao , Pan Zhenyu 
Published: April 2022

PurposeThis study aimed to determine Down syndrome (DS) burden using years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life years (DALYs), and the trends in these parameters.MethodsWe obtained the annual YLDs, YLLs, DALYs, and age-standardized rates (ASRs) of DS from 2010 to 2019 using the Global Health Data Exchange tool. The estimated annual percentage changes (EAPCs) in ASR were used to quantify and evaluate DS burden trends. Gaussian-process regression and Pearson's correlation coefficient were used to assess the relationship between DS burden and socio-demographic index (SDI).ResultsGlobal DALYs decreased by 2.68% from 2010 to 2019 but the ASR was stable, which was mostly explained by the stability in the ASR for YLLs. The ASR of YLDs showed an increasing trend (EAPC = 1.07, 95% CI = 0.45 to 1.69). There was notable regional imbalance, with most of the DALYs or ASRs in areas with relatively low SDI. The DALY rates of DS were mostly from the YLLs of children younger than 1 year. Lower SDI areas tended to have higher DS burdens (ρ = −0.3, p &lt; 0.001).ConclusionThis systematic analysis of the global disease burden of DS from 2010 to 2019 revealed that although the global DS DALY and YLL rate is stable, the YLD rate is increasing. And the DS burden varies significantly differences among regions or countries. The present results suggest that future strategies should focus on DS-related deaths in children younger than 1 year and the DS burden in low-SDI regions or countries, since this may be effective in further reducing DS burden.