Impact of ventilator settings during venovenous extracorporeal membrane oxygenation on clinical outcomes in influenza-associated acute respiratory distress syndrome: a multicenter retrospective cohort study
Background Patients with influenza-associated acute respiratory distress syndrome (ARDS) requiring venovenous extracorporeal membrane oxygenation (vv-ECMO) support have a high mortality rate. Ventilator settings have been known to have a substantial impact on outcomes. However, the optimal settings of mechanical ventilation during vv-ECMO are still unknown. Methods This multicenter retrospective cohort study was conducted in the intensive care units (ICUs) of three tertiary referral hospitals in Taiwan between July 2009 and December 2019. It aims to describe the effect of ventilator settings during vv-ECMO on patient outcomes. Results A total of 93 patients with influenza receiving ECMO were screened. Patients were excluded if they: were receiving venoarterial ECMO, died within three days of vv-ECMO initiation, or were transferred to the tertiary referral hospital >24 hours after vv-ECMO initiation. A total of 62 patients were included in the study, and 24 (39%) died within six months. During the first three days of ECMO, there were no differences in tidal volume (5.1 vs. 5.2 mL/kg, p = 0.833), dynamic driving pressure (15 vs. 14 cmH2O, p = 0.146), and mechanical power (11.3 vs. 11.8 J/min, p = 0.352) between survivors and non-survivors. However, respiratory rates were significantly higher in non-survivors compared with survivors (15 vs. 12 breaths/min, p = 0.013). After adjustment for important confounders, a higher mean respiratory rate of >12 breaths/min was still associated with higher mortality (adjusted hazard ratio = 3.31, 95% confidence interval = 1.10–9.97, p = 0.034). Conclusions In patients with influenza-associated ARDS receiving vv-ECMO support, we found that a higher respiratory rate was associated with higher mortality. Respiratory rate might be a modifiable factor to improve outcomes in this patient population.
Liao et al. (2022) Impact of ventilator settings during venovenous extracorporeal membrane oxygenation on clinical outcomes in influenza-associated acute respiratory distress syndrome: a multicenter retrospective cohort study. PeerJ 10:e14140 https://doi.org/10.7717/peerj.14140
A conserved role of bam in maintaining metabolic homeostasis via regulating intestinal microbiota in Drosophila
Background Previous studies have proven that bag-of-marbles (bam) plays a pivotal role in promoting early germ cell differentiation in Drosophila ovary. However, whether it functions in regulating the metabolic state of the host remains largely unknown. Methods We utilized GC-MS, qPCR, and some classical kits to examine various metabolic profiles and gut microbial composition in bam loss-of-function mutants and age-paired controls. We performed genetic manipulations to explore the tissue/organ-specific role of bam in regulating energy metabolism in Drosophila. The DSS-induced mouse colitis was generated to identify the role of Gm114, the mammalian homolog of bam, in modulating intestinal homeostasis. Results We show that loss of bam leads to an increased storage of energy in Drosophila. Silence of bam in intestines results in commensal microbial dysbiosis and metabolic dysfunction of the host. Moreover, recovery of bam expression in guts almost rescues the obese phenotype in bam loss-of-function mutants. Further examinations of mammalian Gm114 imply a similar biological function in regulating the intestinal homeostasis and energy storage with its Drosophila homolog bam. Conclusion Our studies uncover a novel biological function of bam/Gm114 in regulating the host lipid homeostasis.
Wang et al. (2022) A conserved role of bam in maintaining metabolic homeostasis via regulating intestinal microbiota in Drosophila. PeerJ 10:e14145 https://doi.org/10.7717/peerj.14145
A new bilaterally injured trilobite presents insight into attack patterns of Cambrian predators
Durophagous predation in the Cambrian is typically recorded as malformed shells and trilobites, with rarer evidence in the form of coprolites and shelly gut contents. Reporting novel evidence for shell-crushing further expands the understanding of where and when in the Cambrian durophagy was present. To expand the current documentation and present new records of malformed trilobites from the Cambrian of China, we present an injured Redlichia (Pteroredlichia) chinensis from the lower Cambrian Balang Formation, western Hunan, South China. The specimen has two distinct injuries along the thorax. The injuries show different degrees of regeneration, suggesting that the specimen was attacked twice. We propose that the individual may have been targeted more readily for the second attack. This predatory approach would have been highly energy efficient, maximizing net energy gain during the attack.
Zong et al. (2022) A new bilaterally injured trilobite presents insight into attack patterns of Cambrian predators. PeerJ 10:e14185 https://doi.org/10.7717/peerj.14185
Self-rated oral health among elderly patients attending a university dental hospital in Thailand: a telephone-based cross-sectional survey study
Background Oral health perception is an influential predictor of both current and future health among the elderly. However, limited research has focused on self-rated oral health among older patients attending tertiary dental care. Therefore, this study aimed to explore the potential factors associated with self-rated oral health among elderly patients attending a university dental hospital in Thailand. Methods This telephone-based cross-sectional study was carried out among elderly patients older than 60 years who attended at least one dental visit at the university dental hospital in 2020. Hospital numbers (HN) were used to identify eligible candidates for this study. We calculated the sample size by assuming a finite population of 70,028 elderly patients with valid telephone numbers. The minimum sample required for this study was 398 participants. Trained interviewers conducted telephone calls between July 2021 and January 2022 using the validated modified oral health questionnaire. Self-rated oral health was assessed using a conventionally used global oral health question: “How would you describe your dental health?” with three response options: good, fair, and poor. Descriptive statistics, Fisher’s exact test, and binary logistic regression were performed to analyze the data. Results A total of 836 telephone numbers were called. There were 402 (48.10%) elderly patients who agreed to and completed the telephone interview. Most of the study participants were women (61.4%) between 61–74 years of age (83.1%) with a mean age of 69.18 years. Bivariate analyses showed associations between poor self-rated oral health and lower subjective oral functions: chewing discomfort (p < 0.001) and speaking discomfort (p = 0.013). However, the multivariate regression model indicated a significant association between poor self-rated oral health and chewing discomfort (p < 0.001). Therefore, elderly patients with chewing discomfort were more likely to perceive poor oral health. Conclusions These findings indicate that difficulty chewing could be a potential factor influencing self-rated adverse oral health among older patients attending the university dental hospital. Furthermore, our study adds that the predictive power of a single-item self-measurement supports its value as a standard measure to predict oral health risk in tertiary care institutions, as well as primary care settings and community-based survey research. Therefore, healthcare providers should routinely evaluate self-rated oral health among elderly patients to detect early signs and symptoms of oral health problems, assess the success of dental treatments, and monitor general health and well-being.
Sermsuti-anuwat et al. (2022) Self-rated oral health among elderly patients attending a university dental hospital in Thailand: a telephone-based cross-sectional survey study. PeerJ 10:e14191 https://doi.org/10.7717/peerj.14191
PLA2R-IgG4 antibody as a predictive biomarker of treatment effectiveness and prognostic evaluation in patients with idiopathic membranous nephropathy: a retrospective study
Background The Kidney Disease Improving Global Outcomes (KDIGO) 2021 guidelines recommend Rituximab (RTX) as the first-line therapy and phospholipase A2 receptor (PLA2R) antibody as a biomarker for remission and prognosis in patients with idiopathic membranous nephropathy (IMN). Methods This study was a retrospective analysis of 70 patients with IMN treated with either rituximab (RTX) or cyclophosphamide (CTX) and steroid. Quantitative detection of PLA2R-IgG and PLA2R-IgG4 antibodies at sixth month after treatment, determined using time-resolved fluoroimmunoassay (TRFIA), were used for treatment effectiveness analysis and prognostic evaluation in patients with IMN. Results After 12 months of therapy, the remission rate of proteinuria, including complete remission (CR) and partial remission (PR) in the RTX group and the CTX group, were 74% versus 67.5% (P = 0.114), respectively. Both PLA2R-IgG and PLA2R-IgG4 levels were decreased in patients with remission of proteinuria after 6 months of therapy. Receiver operating characteristic curve (ROC) curve analysis exhibited that the AUC of PLA2R-IgG4 and the PLA2R-IgG as laboratory criteria for proteinuria remission were 0.970 versus 0.886 (P = 0.0516), respectively, after 6 months of treatment. The cut-off value of PLA2R-IgG4 was 7.67 RU/mL and the sensitivity and specificity of remission rate at 6th month were 90.9% and 100%, respectively. Furthermore, the AUC of the PLA2R-IgG4 and PLA2R-IgG to predict the outcome after 12 months of treatment were 0.922 versus 0.897 (P = 0.3270), respectively. With the cut-off value of PLA2R-IgG4 being 22.985 RU/mL, the sensitivity and specificity of remission rate at 12th month were 100% and 87.1%, respectively. Logistic regression analysis revealed that the PLA2R-IgG4 level (P = 0.023), the rate of decrease of PLA2R-IgG4 level (P = 0.034), and eGFR level (P = 0.012) were significantly associated with remission. Conclusions We found that the patients in the RTX group and CTX group achieved effective remission of proteinuria after 12 months of treatment. PLA2R-IgG4 may be a more effective biomarker for treatment effectiveness analysis and prognostic assessment, compared with anti-PLA2R-IgG for PLA2R associated IMN.
Huang et al. (2022) PLA2R-IgG4 antibody as a predictive biomarker of treatment effectiveness and prognostic evaluation in patients with idiopathic membranous nephropathy: a retrospective study. PeerJ 10:e14193 https://doi.org/10.7717/peerj.14193
Prevalence of G6PD deficiency and G6PD variants amongst the southern Thai population
Background Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme essential for NADPH production and protecting cells, especially red blood cells, from free radicals. The oxidative stress from drugs, chemicals, and infections can induce red blood cell hemolysis in G6PD deficiency patients, causing a genetic disorder. Objectives This study aims to provide more information on G6PD deficiency prevalence and the G6PD variants in the southern Thai population. Methods Five hundred and twenty healthy subjects in 14 provinces in the southern part of Thailand participated in the study. EDTA-blood samples were collected for a hematological parameters study, G6PD deficiency screening, and a molecular study for G6PD mutation. G6PD deficiency screening was tested using a fluorescent spot test. The types of G6PD mutation were identified by the allele-specific PCR method. Results The prevalence of G6PD deficiency in southern Thailand was 6.1% (14/228) in males and 9.6% (28/292) in females. Two homozygous and 26 heterozygous G6PD deficiencies were found in females. G6PD Viangchan (871G>A) was the most common variant with 43%, followed by G6PD Mahidol (487G>A), 24% with an allele frequency of 0.025 and 0.012, respectively. Uncharacterized mutations existed in three samples. The study volunteers had anemia in 36.6% (107/292) females and 7.5% (17/228) males. Among G6PD deficiency subjects, only ten partial G6PD deficiency females had mild anemia. Conclusions This study suggests that the prevalence of G6PD deficiency in southern Thailand aligns with that of other parts of Thailand. Newborn screening for G6PD deficiency is recommended for personal information and medical reference to prevent acute hemolysis from oxidative stressors.
Nuinoon et al. (2022) Prevalence of G6PD deficiency and G6PD variants amongst the southern Thai population. PeerJ 10:e14208 https://doi.org/10.7717/peerj.14208
Location angle of second mesio-buccal canal in maxillary molars of an Indian population: an in vivo retrospective CBCT evaluation and proposal of a new classification
Background The current investigation was designed for predicting the location angle of second mesio-buccal root canal in permanent maxillary (first and second) molars with the aid of proposed measuring points and line using cone beam computed tomography in an Indian population. Methods Three-hundred and twenty-four scans of permanent maxillary (first (n = 162) and second (n = 162)) molars with mesio-buccal 2 root canals and unassociated to the current evaluation were acquired. The maxillary molars were viewed with CSI imaging software. The images were captured and were further assessed using 3D Slicer. The assessment included of measuring the distance between the main mesio-buccal and mesio-buccal 2 canal and the angle at which the MB2 it is located utilizing proposed lines joining the disto-buccal and palatal canals. The data was tabulated for the incidence of various angles where the MB2 is located and MB-MB2 distance was determined. The angles denoted were either positive; I (0.1° to 1.9°), II (2° to 4°), III (>4°) or negative I (−0.1° to −1.9°), II (−2° to −4°), III (>−4°). On the data tabulated a new Banga Vhorkate and Pawar’s (BVP’s) angular classification for maxillary molars was proposed. Results The existence of positive angle III was found in 41.35% of maxillary first molars (36 right and 31 left of 162), whereas positive angle II appeared in 41.98% of maxillary second molars (32 right and 36 left of 162). The MB1–MB2 in maxillary 1st molar is seen to be 3.12–3.31 mm and this distance in maxillary 2nd molar is 2.8–3.1 mm. The disto-buccal to palatal canal orifice mean distance was 5.06–5.22 mm in maxillary first molars and 4.9–5.8 mm in maxillary second molars. Conclusion Accurate diagnosis of the location of second mesio-buccal canal increases the success rate of endodontic treatment and a better prognosis. The new proposed classification may be considerably helpful in the urge to locate the mesio-buccal 2 canal.
Vhorkate et al. (2022) Location angle of second mesio-buccal canal in maxillary molars of an Indian population: an in vivo retrospective CBCT evaluation and proposal of a new classification. PeerJ 10:e14234 https://doi.org/10.7717/peerj.14234
Physique and performance in male sitting volleyball players: implications for classification and training
Background This study assessed whether anthropometry, physical fitness and sport-specific sprint performance vary across the three groups of sitting volleyball (SV) athletes (athletes with a disability (VS1), athletes with a minimal disability (VS2) and able-bodied SV athletes (AB)) in order to explore the validity of the current system of classification. This study also investigated how the anthropometric and physical fitness characteristics of athletes relate to their sprint performance. Methods Thirty-five SV male athletes aged 37.4 ± 10.8 years and practicing SV at a national/international level volunteered for this study. Testing consisted in the evaluation of linear anthropometry, physical fitness (body composition by-means of dual-energy X-ray absorptiometry and upper-body strength) and sprint performance (5-meter sprint tests, agility test and speed and endurance test). Results Athletes in the three groups differed in fat mass percentage (%FM) which was higher in VS1 versus AB at the sub-total level (+9%), in the arms (+15%) and in the non-impaired leg (+8%) regions. Greater hand span, greater length of the impaired lower leg, lower %FM at both the sub-total and regional level and a higher level of strength in the upper body are all associated with better performances in the considered sprint tests (P < 0.05 for all). These results do not confirm the validity of the current system of classification of athletes adopted in SV. Professionals dealing with SV athletes should include specific exercises aimed at improving whole-body and regional body composition and the strength of the trunk and upper limbs in their training programs.
Cavedon et al. (2022) Physique and performance in male sitting volleyball players: implications for classification and training. PeerJ 10:e14013 https://doi.org/10.7717/peerj.14013
Changes in whistle parameters of two common bottlenose dolphin ecotypes as a result of the physical presence of the research vessel
In the presence of vessels, dolphins have been found to change their habitat, behavior, group composition and whistle repertoire. The modification of the whistle parameters is generally considered to be a response to the engine noise. Little is known about the impact of the physical presence of vessels on dolphin acoustics. Whistle parameters of the coastal and oceanic ecotypes of common bottlenose dolphins in La Paz Bay, Mexico, were measured after the approach of the research vessel and its engine shutdown. Recordings of 10 min were made immediately after turning off the engine. For analysis, these recordings were divided from minute 0 to minute 5, and from minute 5:01 to minute 10. The whistles of the oceanic ecotype showed higher maximum, minimum and peak frequency in the second time interval compared to the first one. The whistle rate decreased in the second time interval. The whistles of the coastal ecotype showed no difference between the two time intervals. The physical presence of the research vessel could have induced a change in the whistle parameters of the oceanic dolphins until habituation to the vessel disturbance. The oceanic ecotype could increase the whistle rate and decrease the whistle frequencies to maintain acoustic contact more frequently and for longer distances. The coastal ecotype, showing no significant changes in the whistle parameters, could be more habituated to the presence of vessels and display a higher tolerance.
Antichi et al. (2022) Changes in whistle parameters of two common bottlenose dolphin ecotypes as a result of the physical presence of the research vessel. PeerJ 10:e14074 https://doi.org/10.7717/peerj.14074
Dynamics of the gut microbiota in rats after hypobaric hypoxia exposure
Background Gut microbiota plays an important role in host health and is influenced by multiple factors. Hypobaric hypoxia usually existing at high altitude conditions can adversely affect normal physiological functions. However, the dynamic changes of gut microbiota influenced by hypobaric hypoxia have not been elucidated. Methods In this study, we collected fecal samples from seven rats at 14 time points from entering the hypobaric chamber (eight time points) to leaving the chamber (six time points) and five rats served as normoxic controls. Metagenome sequencing was performed on all samples and the dynamics of taxa and functions were analyzed. Results We found that the α-diversity was changed in the first 5 days after entering or leaving the hypobaric chamber. The β-diversity analysis revealed that gut microbiota structure was significantly separated among 14 time points. After entering the chamber, the relative abundance of Bacteroides decreased and the most abundant genus turned into Prevotella. The abundance of Firmicutes and Bacteroidetes showed an opposite trend and both have a significant change within 5 days after entering or leaving the hypobaric hypoxia chamber. Some obligate anaerobic bacteria belonging to Desulfovibrio and Alistipes were significantly enriched after entering the chamber for 5 weeks, whereas Probiotics like Bifidobacterium and Lactococcus, and short-chain fatty acids producers like Butyrivibrio and Pseudobutyrivibrio were significantly enriched after leaving the chamber for 3 weeks. Microbial functions like ‘Two-component regulatory system’, ‘beta-carotene biosynthesis’ and ‘Fatty acid biosynthesis’ were significantly enriched after entering the chamber for 5 weeks. Hypobaric hypoxia conditions could deeply affect the diversity and structure of gut microbiota. The alterations of abundance of dominant taxa (Firmicutes and Bacteroidetes), increased anaerobes and decreased probiotics induced by hypobaric hypoxia conditions might affect the host health.
Han et al. (2022) Dynamics of the gut microbiota in rats after hypobaric hypoxia exposure. PeerJ 10:e14090 https://doi.org/10.7717/peerj.14090