bluuebunny/crossref_metadata_2025 huggingface dataset:
Metabolome profiles of the alphaproteobacterial methanotroph Methylocystis sp. Rockwell in response to carbon and nitrogen source
Authors: Lazic Marina , Sugden Scott , Sauvageau Dominic , Stein Lisa Y
Published: December 2020

Methanotrophs use methane as a sole carbon source and thus play a critical role in its global consumption. Intensified interest in methanotrophs for their low-cost production of value-added products and large-scale industrialization has led to investigations of strain-to-strain variation in parameters for growth optimization and metabolic regulation. In this study, Methylocystis sp. Rockwell was grown with methane or methanol as a carbon source and ammonium or nitrate as a nitrogen source. The intracellular metabolomes and production of polyhydroxybutyrate, a bioplastic precursor, were compared among treatments to determine how the different combinations of carbon and nitrogen sources affected metabolite production. The methane–ammonium condition resulted in the highest growth, followed by the methane–nitrate, methanol–nitrate and methanol–ammonium conditions. Overall, the methane–ammonium and methane–nitrate conditions directed metabolism toward energy-conserving pathways, while methanol–ammonium and methanol–nitrate directed the metabolic response toward starvation pathways. Polyhydroxybutyrate was produced at greater abundances in methanol-grown cells, independent of the nitrogen source. Together, the results revealed how Methylocystis sp. Rockwell altered its metabolism with different combinations of carbon and nitrogen source, with implications for production of industrially relevant metabolites.
Reversal of apolipoprotein E4-dependent or chemical-induced accumulation of APP degradation products by vitamin C-induced release of heparan sulfate from glypican-1
Authors: Cheng Fang , Fransson Lars-Åke , Mani Katrin
Published: December 2020

The Apolipoprotein E4 (ApoE4) genotype is the most influential risk factor for sporadic Alzheimer’s disease. It appears to be associated with retarded endosome-to-autophagosome trafficking. The amyloid precursor protein (APP) and the heparan sulfate (HS)-containing proteoglycan glypican-1 (Gpc-1) are both processed in endosomes, and mutually regulated by the APP degradation products and the released HS. We have investigated APP and Gpc-1 processing in ApoE3 and ApoE4 expressing human fibroblasts, in human neural stem cells (NSC) exposed to the cholesterol transport inhibitor U18666A and in induced neurons obtained by reprogramming of ApoE fibroblasts (ApoE-iN). We have used immunofluorescence microscopy, flow cytometry, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis western blotting with antibodies recognizing the released HS, APP, amyloid β(Aβ), late endosomes (Rab7), autophagosomes (LC3) and neurons (Tuj1). We found that the capacity to release HS was not fully utilized in ApoE4 expressing fibroblasts and that HS-Aβ complexes accumulated in the nuclei. In ApoE3 fibroblasts, the β-cleaved APP C-terminal fragment (β-CTF) and Aβ were primarily present in late endosomes and autophagosomes. When HS release from Gpc-1 was enhanced by ascorbate in ApoE4/4 fibroblasts, there was efficient transfer of Aβ and HS from the nuclei to autophagosomes. In U18666A-treated NSC as well as in ApoE4/4-iN we repeatedly found accumulation of APP degradation products (β-CTF/Aβ). This was reversed by subsequent exposure to ascorbate or dehydroascorbic acid.
Loss of FEZ1, a gene deleted in Jacobsen syndrome, causes locomotion defects and early mortality by impairing motor neuron development
Authors: Gunaseelan Saravanan , Wang Ziyin , Tong Venetia Kok Jing , Ming Sylvester Wong Shu , Razar Rafhanah Banu Bte Abdul , Srimasorn Sumitra , Ong Wei-Yi , Lim Kah-Leong , Chua John Jia En
Published: December 2020

FEZ1-mediated axonal transport plays important roles in central nervous system development but its involvement in the peripheral nervous system is not well-characterized. FEZ1 is deleted in Jacobsen syndrome (JS), an 11q terminal deletion developmental disorder. JS patients display impaired psychomotor skills, including gross and fine motor delay, suggesting that FEZ1 deletion may be responsible for these phenotypes, given its association with the development of motor-related circuits. Supporting this hypothesis, our data show that FEZ1 is selectively expressed in the rat brain and spinal cord. Its levels progressively increase over the developmental course of human motor neurons (MN) derived from embryonic stem cells. Deletion of FEZ1 strongly impaired axon and dendrite development, and significantly delayed the transport of synaptic proteins into developing neurites. Concurring with these observations, Drosophila unc-76 mutants showed severe locomotion impairments, accompanied by a strong reduction of synaptic boutons at neuromuscular junctions. These abnormalities were ameliorated by pharmacological activation of UNC-51/ATG1, a FEZ1-activating kinase, with rapamycin and metformin. Collectively, the results highlight a role for FEZ1 in MN development and implicate its deletion as an underlying cause of motor impairments in JS patients.
Learning-based low-illumination image enhancer for underwater live crab detection
Authors: Cao Shuo , Zhao Dean , Sun Yueping , Ruan Chengzhi
Published: December 2020

Swift, non-destructive detection approaches should address the problem of insufficient sensitivity when attempting to obtain and perceive live crab information in low-light environments caused by the crab’s phototaxis. We propose a learning-based low-illumination image enhancer (LigED) for effective enhanced lighting and elimination of darkness in images. The camera response function was combined with the reflectance ground-truth mechanism of image decomposition. Self-attention units were then introduced in the reflectance restoration network to adjust the illumination to avoid visual defects, thus jointly strengthening the adaptability of dark-light enhancement and ability to perceive crab information. Convolutional neural network (CNN)-based detection methods can further enhance the algorithm’s robustness to light and adaptability to different environments, which motivated the development of a scalable lightweight live crab detector (EfficientNet-Det0) utilizing the two-stage compound scaling CNN approach. The lightness order error and natural image quality evaluator based on the proposed methods were 251.26 and 11.60, respectively. The quality of average precision detection increased by 13.84–95.40%. The fastest detection speed of a single image was 91.74/28.41 f·s−1 using a common GPU/CPU, requiring only 15.1 MB of storage, which advocates for the utilization of LigED and EfficientNet-Det0 for the efficient detection of underwater live crabs.
Gendering Heterodoxy: The Corporeal Politics ofXiejiaoin Chinese Christianity
Authors: Yuan Xiaobo
Published: December 2020

In contemporary Christian communities in mainland China, heterodox religious organizations—most often referred to as xiejiao (“evil cults”)—have been seen as perennial threats to the proper functioning of the church. State and church authorities warn against the popularization of millenarian sects like Eastern Lightning/Church of Almighty God, and ordinary churchgoers are frequently exhorted to police each other (and themselves) against heterodox thoughts and actions. This paper explores the constitution of xiejiao as an intimate threat within Chinese Protestant communities. In particular, I attend to how rural women are represented as particularly “at risk” of propagating and receiving “heterodox” religious instruction. Drawing on ethnographic research and discursive analysis, I argue that the gendered and classed dimensions of anti-cult discourse suggest a broader corporeal politics of religious identity in which spiritual endangerment and responsibility are unevenly distributed among social bodies.
Therapeutic benefit of lymphadenectomy for older patients with urothelial carcinoma of the upper urinary tract: a propensity score matching study
Authors: Ishiyama Yudai , Kondo Tsunenori , Kubota Satoshi , Shimada Katsunori , Yoshida Kazuhiko , Takagi Toshio , Iizuka Junpei , Tanabe Kazunari
Published: December 2020

Objectives

Regional lymphadenectomy for urothelial carcinoma of the upper urinary tract is sometimes avoided in older patients to reduce surgical burden. We aimed to evaluate the therapeutic impact of lymphadenectomy in older patients undergoing curative therapy for upper urinary tract urothelial carcinoma.

Methods

The patients with urothelial carcinoma of the upper urinary tract older than 75 years at the time of surgery and without lymph node or distant metastasis who underwent curative therapy at two tertiary hospitals between 1994 and 2019 were retrospectively analyzed. Complete-lymphadenectomy was performed as per our protocol. Cancer-specific survival, overall survival and metastasis-free survival after surgery were evaluated between complete-lymphadenectomy and no/incomplete-lymphadenectomy groups before and after 1:1 propensity score matching.

Results

The original cohort included 150 patients (median age, 80.71 years), and complete-lymphadenectomy was performed in 42 (28.00%) patients. Patients in complete-lymphadenectomy group were younger and less likely to be aged >80 years (both, P < 0.0001). After matching, 30 patients were allocated to each group and the ages were comparable (78.58 vs. 77.48 years, P = 0.1738). High-grade perioperative complication rates did not differ between groups both before and after matching. Cancer-specific survival, overall survival and metastasis-free survival were significantly longer in the complete-lymphadenectomy group both before and after matching (all, P < 0.05).

Conclusions

This study suggests that complete-lymphadenectomy may provide therapeutic benefits for older patients. The decision to perform complete-lymphadenectomy must be based on the patient’s physical condition, rather than his/her chronological age.
HATS-34b and HATS-46b: re-characterization using TESS and Gaia
Authors: Louden Emma M , Hartman Joel D
Published: December 2020

We present a revised characterization of the previously discovered transiting planet systems HATS-34 and HATS-46. We make use of the newly available space-based light curves from the NASA TESS mission and high-precision parallax and absolute photometry measurements from the ESA Gaia mission to determine the mass and radius of the planets and host stars with dramatically increased precision and accuracy compared to published values, with the uncertainties in some parameters reduced by as much as a factor of 7. Using an isochrone-based fit, for HATS-34 we measure a revised host star mass and radius of $0.952_{-0.020}^{+0.040}$ $\, \mathrm{M}_\odot$ and 0.9381 ± 0.0080 $\, \mathrm{R}_\odot$, respectively, and a revised mass and radius for the transiting planet of 0.951 ± 0.050 MJ and 1.282 ± 0.064 RJ, respectively. Similarly, for HATS-46 we measure a revised mass and radius for the host star of 0.869 ± 0.023 $\, \mathrm{M}_\odot$ and 0.894 ± 0.010 $\, \mathrm{R}_\odot$, respectively, and a revised mass and radius for the planet of 0.158 ± 0.042 MJ and 0.951 ± 0.029 RJ, respectively. The uncertainties that we determine on the stellar and planetary masses and radii are also substantially lower than re-determinations that incorporate the Gaia results without performing a full re-analysis of the light curves and other observational data. We argue that, in light of Gaia and TESS, a full re-analysis of previously discovered transiting planets is warranted.
MazF toxin causes alterations in Staphylococcus aureus transcriptome, translatome and proteome that underlie bacterial dormancy
Authors: Bezrukov Fedor , Prados Julien , Renzoni Adriana , Panasenko Olesya O
Published: December 2020

Antibiotic resistance is a serious problem which may be caused by bacterial dormancy. It has been suggested that bacterial toxin–antitoxin systems induce dormancy. We analyzed the genome-wide role of Staphylococcus aureus endoribonuclease toxin MazF using RNA-Seq, Ribo-Seq and quantitative proteomics. We characterized changes in transcriptome, translatome and proteome caused by MazF, and proposed that MazF decreases translation directly by cleaving mRNAs, and indirectly, by decreasing translation factors and by promoting ribosome hibernation. Important pathways affected during the early stage of MazF induction were identified: MazF increases cell wall thickness and decreases cell division; MazF activates SsrA-system which rescues stalled ribosomes, appearing as a result of MazF mRNA cleavage. These pathways may be promising targets for new antibacterial drugs that prevent bacteria dormancy. Finally, we described the overall impact of MazF on S. aureus cell physiology, and propose one of the mechanisms by which MazF might regulate cellular changes leading to dormancy.
OCCURRENCE AND DOSE FROM INTAKE OF RADON IN DRINKING GROUNDWATER IN OGUN STATE, NIGERIA
Authors: Fatoki Olusola Odunayo , Ademola Janet Ayobami
Published: December 2020

Radon-222 concentrations in groundwater from 10 local government areas (LGAs) of Ogun State were measured using AlphaGUARD radon detector and AquaKIT. The mean activity concentration of radon ranged from 1.23 ± 0.21 to 12.68 ± 18.11 Bq.l−1 corresponding to geometric means (GMs) of 1.22– 6.39 Bq.l−1. The radon concentrations of all the samples were below the World Health Organization and European Commission guidance level of 100 Bq.l−1, with 17% higher than 11.1 Bq.l−1, recommended by the United States Environmental Protection Agency. Mean annual effective dose due to ingestion ranged from 0.020 ± 0.004 to 0.254 ± 0.353 mSv.y−1 (adults), 0.041 ± 0.007 to 0.509 ± 0.705 mSv.y−1 (children) and 0.024 ± 0.004 to 0.297 ± 0.411 mSv.y−1 (infants). That of inhalation varied from 0.303 ± 0.053 to 3.108 ± 4.440 μSv.y−1. The mean annual effective doses of some of the LGAs were higher than the International Commission for Radiological Protection recommended reference dose level of committed effective dose of 0.1 mSv from 1-year consumption of drinking water.
Unusual Clinical Manifestations and Outcome of Multisystem Inflammatory Syndrome in Children (MIS-C) in a Tertiary Care Hospital of North India
Authors: Gupta DCH Shobhna , Chopra MD Nidhi , Singh MD Amitabh , Gera Rani , Chellani MD Harish , Pandey PhD Ravindra , Arora MD Balvinder Singh
Published: December 2020

Till date, there is paucity of published literature on clinical manifestations of Coronavirus disease 2019 (COVID-19) in children from low-middle-income countries (LMIC). Most of the reports are from Europe, USA or China. Our study aimed to capture data on varied and unusual clinical presentation and management of MIS-C (Multisystem Inflammatory Syndrome in Children) with COVID-19 and compare the MIS-C and non-MIS-C children. This was a single-centre cohort study of 41 COVID positive children 0–12 years age hospitalized between 1 April 2020 and 31 July 2020. Data were entered into standardized WHO Case Report Form and analysed using strata 15.0 statistical software. Twenty out of 41 children fulfilled the criteria of MIS-C. Male-to-female ratio in the cohort was 1.73:1. In MIS-C cases, predominant clinical manifestation was fever (100%), neurological manifestations (80%), lower respiratory tract infection (50%), rash (35%) and acute gastroenteritis (25%). They were categorized into Acute Encephalitis-like illness in 35%, Kawasaki-like disease, Toxic Shock-like syndrome and Comorbidity with systemic complications in 20% each. Ninety percent of MIS-C cases required oxygen supplementation with odds ratio (OR) 18 (3.22–100.48), whereas 65% required mechanical ventilation with OR 37.14 (4.08–338.10). Most of them had raised inflammatory markers and hepatic enzymes derangement. Steroids, Intravenous immunoglobulin and supportive therapy were mainstay of management for MIS-C group. Most MIS-C group children had multisystem involvement with predominant neurological manifestations at time of presentation. Delay in diagnosis and referral may have adversely affected the prognosis and outcome.
Anemia and insomnia: a cross-sectional study and meta-analysis
Authors: Neumann Samantha N. , Li Jun-Juan , Yuan Xiao-Dong , Chen Shuo-Hua , Ma Chao-Ran , Murray-Kolb Laura E. , Shen Yun , Wu Shou-Ling , Gao Xiang
Published: December 2020

Background

Several recent genome-wide association studies suggested insomnia and anemia may share some common genetic components. We thus examined whether adults with anemia had higher odds of having insomnia relative to those without anemia in a cross-sectional study and a meta-analysis.

Methods

Included in this cross-sectional study were 12,614 Chinese adults who participated in an ongoing cohort, the Kailuan Study. Anemia was defined as hemoglobin levels below 12.0 g/dL in women and 13.0 g/dL in men. Insomnia was assessed using the Chinese version of the Athens Insomnia Scale (AIS). A total AIS score ≥6 was considered insomnia. The association between anemia and insomnia was assessed using a logistic regression model, adjusting for potential confounders such as age, sex, chronic disease status, and plasma C-reactive protein concentrations. A meta-analysis was conducted using the fixed effects model to pool results from our study and three previously published cross-sectional studies on this topic in adult populations.

Results

Individuals with anemia had greater odds of having insomnia (adjusted odds ratio [OR]: 1.32; 95% confidence interval [CI]: 1.03–1.70) compared with individuals without anemia. A significant association persisted after we excluded individuals with chronic inflammation, as suggested by C-reactive protein levels >1 mg/L (adjusted OR: 1.68; 95% CI: 1.22–2.32). The meta-analysis results, including 22,134 participants, also identified a positive association between anemia and insomnia (pooled OR: 1.39; 95% CI: 1.22–1.57).

Conclusions

The presence of anemia was significantly associated with a higher likelihood of having insomnia in adults. Due to the nature of the cross-sectional study design, results should be interpreted with caution.
Spicy food consumption is associated with cognition and cerebrospinal fluid biomarkers of Alzheimer disease
Authors: Tian Ding-Yuan , Wang Jun , Sun Bin-Lu , Wang Zhen , Xu Wei , Chen Yang , Shen Ying-Ying , Li Hui-Yun , Chen Dong-Wan , Zhou Fa-Ying , Yi Xu , Zeng Gui-Hua , Xu Zhi-Qiang , Chen Li-Yong , Yu Jin-Tai , Wang Yan-Jiang
Published: December 2020

Background:

Recent studies suggest that a healthy diet helps to prevent the development of Alzheimer disease (AD). This study aimed to investigate whether spicy food consumption is associated with cognition and cerebrospinal fluid (CSF) biomarkers of AD in the Chinese population.

Methods:

We enrolled 55 AD patients and 55 age- and gender-matched cognitively normal (CN) subjects in a case-control study, as well as a cohort of 131 participants without subjective cognitive decline (non-AD) in a cross-sectional study. Spicy food consumption was assessed using the Food Frequency Questionnaire (FFQ). Associations of FFQ scores with cognition and CSF biomarkers of AD were analyzed.

Results:

In the case-control study, spicy food consumption was lower in AD patients than that in CNs (4.0 [4.0–8.0] vs. 8.0 [4.5–10.0], P < 0.001); FFQ scores were positively associated with Mini-Mental Status Examination scores in the total sample (r = 0.218, P = 0.014). In the cross-sectional study, the association between spicy food consumption and cognition levels was verified in non-AD subjects (r = 0.264, P = 0.0023). Moreover, higher FFQ scores were significantly associated with higher β-Amyloid (1–42) (Aβ42) levels and lower phospho-tau/Aβ42 and total tau/Aβ42 ratios in the CSF of non-AD subjects (P < 0.05).

Conclusion:

Spicy food consumption is closely related to higher cognition levels and reversed AD biomarkers in the CSF, suggesting that a capsaicin-rich diet might have the potential to modify the cognitive status and cerebral pathologies associated with AD.
Initial development of a brief assessment of cocaine demand
Authors: Yoon Jin H. , de Dios Constanza , Suchting Robert , Vincent Jessica N. , McKay Sarah A. , Lane Scott D. , Schmitz Joy M.
Published: December 2020

Cocaine demand is a behavioral economic measure assessing drug reward value and motivation to use drug. The purpose of the current study was to develop a brief assessment of cocaine demand (BACD). Results from the BACD were compared with self-report measures of cocaine use. Participants consisted of treatment-seeking individuals with cocaine use disorder (N = 22). Results revealed that indices of brief demand were significantly associated with various self-report measures of cocaine use. Overall, these results support the utility of a BACD for assessing cocaine demand.
IVF and the exogenous progesterone-free luteal phase
Authors: Kol Shahar , Humaidan Peter
Published: December 2020

Purpose of review

In a conventional IVF cycle, final oocyte maturation and ovulation is triggered with a bolus of hCG, followed by progesterone-based luteal support that spans several weeks if pregnancy is achieved. This article summarizes several approaches of the exogenous progesterone-free luteal support in IVF.

Recent findings

Triggering ovulation with GnRH agonist may serve as an alternative to hCG, with well established advantages. In addition, the luteal phase can be individualized in order to achieve a more physiologic hormonal milieu, and a more patient friendly treatment, alleviating the burden of a lengthy exogenous progesterone therapy.

GnRH agonist trigger followed by a ‘freeze all’ policy is undoubtedly the best approach towards the ‘OHSS-free clinic’. If fresh embryo transfer is considered well tolerated after GnRH agonist trigger, rescue of the corpora lutea by LH activity supplementation is mandatory. Herein we discuss the different approaches of corpus luteum rescue.
Antithrombotic therapy after transcatheter aortic valve replacement: current perspective
Authors: Eckstein Janine , Liu Shuangbo , Toleva Olga , Yanagawa Bobby , Verma Subodh , Cheema Asim N.
Published: December 2020

Purpose of review

Transcatheter aortic valve replacement (TAVR) has expanded as a treatment option for severe aortic stenosis throughout the surgical risk spectrum. Decreasing procedural risk and inclusion of lower risk population has shifted the focus to optimization of postprocedural management and balancing the thrombotic and bleeding complications. In this review, we outline various patient and procedure related factors affecting choice of antithrombotic therapy post TAVR and provide an update of recent development in this area.

Recent findings

Multiple studies have confirmed the high incidence of both ischemic and bleeding complications in the early to midterm post-TAVR. In addition, new data has emerged for the role of high resolution computed tomography to detect decreased leaflet mobility and leaflet micro thrombi associated with implications for bioprosthetic valve dysfunction and cerebrovascular events post TAVR. Randomized clinical trials have reported increased bleeding with dual antiplatelet therapy (DAPT) and oral anticoagulation (OAC) plus antiplatelet therapy. These findings suggest that aspirin monotherapy or OAC monotherapy likely provides the appropriate balance for antithrombotic protection and risk of bleeding.

Majority of patients undergoing TAVR have multiple comorbidities and are at increased risk of ischemic and bleeding complications. In the absence of robust clinical evidence, there is significant variability among guideline recommendations and antithrombotic therapy post TAVR across institutions. The available evidence confirms a high rate of bleeding with more potent and prolonged antithrombotic regimens without a documented benefit for clinical endpoints. The authors favor a conservative anti thrombotic approach and suggest monotherapy with aspirin or systemic anticoagulation based upon an individual's risk of thromboembolic complications. DAPT is reserved for patients with recent stenting and OAC plus aspirin is prescribed for patients with established CAD in the post TAVR setting.
Combined transcatheter mitral and tricuspid edge-to-edge repair: expanding the horizons of interventional heart failure
Authors: Ong Geraldine , Fam Neil P.
Published: December 2020

Purpose of review

The combination of mitral regurgitation and tricuspid regurgitation is common in patients with multiple valvular disease and patient management can be challenging. Surgical combined mitral and tricuspid valve surgery is a treatment option for patients meeting criteria but has demonstrated inconsistent long-term benefits.

Recent findings

Transcatheter mitral and tricuspid edge-to-edge repair has demonstrated early promising results in patients with a prohibitive surgical risk, making it an interesting treatment option. The present review will discuss the physiopathology of this complex disease and contemporary data regarding treatment options for the treatment of combined mitral and tricuspid regurgitation.

Combined transcatheter mitral and tricuspid edge-to-edge repair is a novel treatment option for patients with multiple valvular disease. Further studies are needed to determine optimal patient selection and timing of intervention and demonstrate survival benefit and improvement in clinical outcomes. Advances in technology, with dedicated devices and enhanced imaging techniques may also improve patient outcomes.
Limited reliability of heart rate as a sympathetic marker in chronic kidney disease
Authors: Dell’Oro Raffaella , Quarti-Trevano Fosca , Seravalle Gino , Bertoli Silvio , Lovati Chiara , Mancia Giuseppe , Grassi Guido
Published: December 2020

Background:

Chronic kidney disease (CKD) is characterized by a pronounced sympathetic overactivity as documented by the marked increase in muscle sympathetic nerve traffic (MSNA) and in plasma norepinephrine reported in this condition. Whether and to what extent in CKD heart rate (HR) reflects the adrenergic overdrive remains undefined. It is also undefined the relative validity of the different adrenergic markers in reflecting renal dysfunction.

Materials and methods:

In 82 CKD patients, aged 58.4 ± 1.1 years (mean ± SEM), we measured resting clinic blood pressure, HR (EKG), venous NE (HPLC) and MSNA (microneurography). The same measurements were made in 24 age-matched healthy controls.

Results:

HR was significantly greater in CKD than in controls (74.0 ± 1.1 versus 68.2 ± 1.8 bpm, P < 0.02) and significantly directly related to the elevated plasma norepinephrine and MSNA values (r = 0.22 and 0.39, P < 0.05 and <0.0003, respectively). Both MSNA and plasma norepinephrine were significantly and inversely related to the estimated glomerular filtration rate. The correlation did not achieve statistical significance for HR. Similar results were obtained examining the relationships with left ventricular mass index.

Conclusion:

Our data show that in CKD not only peripheral but also cardiac sympathetic drive is markedly enhanced and HR can be regarded as a marker of the adrenergic overdrive characterizing this condition. The reliability of HR as sympathetic marker appears to be limited, however, this variable being unable to closely reflect, at variance from MSNA and plasma norepinephrine, the interindividual differences in renal dysfunction and the accompanying structural cardiovascular alterations.
Surgical Observations From the First 120 Cases of Subretinal Gene Therapy for Inherited Retinal Diseases
Authors: Gregori Ninel Z. , Davis Janet L.
Published: December 2020

Purpose:

To report surgical observations formulated during the first 120 cases of subretinal gene therapy in patients with inherited retinal degenerations (IRDs).

Methods:

A two-surgeon team compiled surgical observations and formulated surgical pearls based on the consecutive cases of subretinal viral vector injection in patients enrolled in clinical trials focusing on choroideremia, achromatopsia, and RP GTPase regulator associated retinitis pigmentosa, as well as patients with retinal pigment epithelium-specific-65-kDa (RPE65) associated Leber congenital amaurosis receiving Food and Drug Administration-approved voretigene neparvovec-rzyl therapy.

Results:

One hundred twenty subretinal surgeries were performed by a two-surgeon team. Key anatomical features pertinent to surgical management were noted and are described in this article. Surgical decision making for successful subretinal administration of viral vectors and management of potential surgical challenges were formulated.

Conclusion:

Lessons learned during subretinal gene therapy cases may be helpful to other surgeons entering clinical trials or performing postapproval gene therapy administration. Surgical pearls outlined in this article may also be helpful for other targeted subretinal therapies, such as cellular transplantation or retinal prosthesis implantation.
ASSESSING REFRACTIVE OUTCOMES AND ACCURACY OF BIOMETRY IN PHACOVITRECTOMY AND SEQUENTIAL OPERATIONS IN PATIENTS WITH RETINAL DETACHMENT COMPARED WITH ROUTINE CATARACT SURGERY
Authors: Moussa George , Sachdev Amun , Mohite Abhijit A. , Hero Mark , Ch'ng Soon Wai , Andreatta Walter
Published: December 2020

Purpose:

To compare refractive outcomes and accuracy of modern optical biometry, swept-source optical coherence tomography, ultrasound biometry, and effect of the macula status in rhegmatogenous retinal detachment managed with either combined phacovitrectomy or sequential vitrectomy and cataract surgery compared with a control, phacoemulsification alone.

Methods:

Retrospective, comparative, consecutive study of 154 eyes; Group 1 underwent phacovitrectomy (n: 70), Group 2 underwent vitrectomy with subsequent cataract surgery (n: 41), and Group 3 underwent cataract surgery alone (n: 43).

Results:

No difference in the mean absolute error was found between Group 2 (0.41 ± 0.56) and Group 3 (0.41 ± 0.29); both were superior to Group 1 (0.74 ± 0.57). Between Group 1 and Group 2, no statistically significant difference in the mean absolute error was found between macula-on subgroups (P = 0.057), but this was statistically significant between macula-off subgroups (P = 0.009). Subgroup analysis by biometry showed that the difference in the mean absolute error between macula-off optical biometry Group 1 and Group 2 against our control, Group 3, were not significant (P = 0.078 and P = 0.119, respectively); the mean absolute error was significantly different when considering macula-off ultrasound biometry cases (P < 0.001 and P = 0.038, respectively).

Conclusion:

All three groups had comparable refractive outcomes when using optical biometry. However, phacovitrectomy macula-off cases had inferior refractive outcomes when the ultrasound biometry had to be used. In macula-off rhegmatogenous retinal detachment, when optical biometry is not reliable, it is preferable to perform sequential surgery rather than phacovitrectomy.
Fluorescent bovine serum albumin-silver nanoclusters loaded with paclitaxel can traverse the blood-brain barrier to inhibit the migration of glioma
Authors: Liu Yu , Liu Yu , Zhang Yini , Xie Weichang , Yang Yalan , Hu Kaigeng , Xin Hongbo , Hu Ping , Ai Fanrong
Published: December 2020

Objective:

Glioma is the most common and aggressive primary brain tumor. Here, we aimed to establish a nano-drug carrier system to traverse the blood-brain barrier for the treatment and inhibition of glioma migration.

Methods:

The synthesis of bovine serum albumin protected-silver nanoclusters (BSA-AgNCs) was performed using chemical reduction. The drug paclitaxel (PTX) can be loaded into BSA-AgNCs through electrostatic and hydrophobic interactions to formulate spherical BSA-AgNC-PTX nanoparticles (BSA-AgNC-PTX NPs). A glioma mouse model was established by injecting U251-GFP-Luc cells into the mouse striatum, and all surgical procedures were approved by the Animal Ethics Committee of Nanchang University (SYXK2019-0003) on December 29, 2019.

Results:

The BSA-AgNC-PTX NPs were able to efficiently pass through the blood-brain barrier, both in vitro and in vivo, to deliver the drug to the tumor site. The in vivo assessment of BSA-AgNC-PTX NPs in glioblastoma multiforme-bearing mice revealed the significant inhibition of tumor growth and migration, prolonging the survival of the mice.

Conclusion:

These results indicated that BSA-AgNCs might represent an ideal nanocarrier for the treatment of glioma and has the potential to be used in the treatment of a variety of central nervous system diseases.
Lanthanide-semiconductor probes for precise imaging-guided phototherapy and immunotherapy
Authors: Wang Yanxing , Lü Weidong , Dai Ruiyi , Lin Bi , Lv Ruichan
Published: December 2020

Objective:

Immunotherapy is an effective tumor treatment strategy. However, its long treatment cycle limits its wide application across all cancer types. In this study, we optimized upconversion nanoparticles and manganese composite particles with a porous structure as a nanoplatform for synergistic photodynamic therapy (PDT) and photothermal therapy (PTT), and subsequent longer-term immunotherapy.

Methods:

The morphology, phase, and stability were first characterized to evaluate the biocompatibility of this material. The upconversion and near infrared II luminescence properties of the material and its stimuli-response effect were assessed from the absorbance and photoluminescence spectra. Phototherapy including PDT and PTT was demonstrated in vitro and in vivo, and immunotherapy was used to enhance the phototherapy. This study was approved by the Xi’an Jiaotong University, China (approval No. XJTULAC2020-585) on April 2, 2020.

Results:

The nanoplatform showed good PDT and PTT effects with high upconversion luminescence, and exhibited a more sensitive glutathione response (detection limit: 55 μg/mL) using fluorescence recovery than that based on absorbance recovery, with the detection range extending up to 1.2 mg/mL. When the surface of the composite particles was modified with an anti-PD-L1 immune checkpoint inhibitor, it targeted A549 lung cancer cells. The resulting immune response enhanced the long-term anti-tumor effect of the therapy, especially in lung cancer patients with high PD-L1 expression.

Conclusion:

The designed composite can be simultaneously used to detect the glutathione concentration based on luminescence recovery in the tumor cells and as a theranostic nanoplatform for synergistic immuno-phototherapy when combined with an antibody.
Manufacturing Workers Have a Higher Incidence of Carpal Tunnel Syndrome
Authors: Battista Eric B. , Yedulla Nikhil R. , Koolmees Dylan S. , Montgomery Zachary A. , Ravi Karthik , Day Charles S.
Published: December 2020

Objective:

It is unclear whether clerical or labor-type work is more associated with risk for developing work-related carpal tunnel syndrome (WrCTS).

Methods:

National employment, demographic, and injury data were examined from the Bureau of Labor Statistics databases for the years 2003 to 2018. Injuries for clerical and labor industries were compared using linear regression, two-group t test, and one-way analysis of variance (ANOVA) analysis.

Results:

WrCTS injuries are decreasing over time (B = –1002.62, P < 0.001). The labor industry demonstrated a significantly higher incidence of WrCTS when compared with the clerical industries (P < 0.001). Within labor industries, the manufacturing industry had the highest incidence of WrCTS over time (P < 0.001).

Conclusions:

Our study showed WrCTS injuries have declined over time. Additionally, our findings may suggest that the labor industry has a stronger association with WrCTS than the clerical industry.
Personal Protective Equipment in COVID-19
Authors: Duan Xiaoqin , Sun Hongzhi , He Yuxuan , Yang Junling , Li Xinming , Taparia Kritika , Zheng Bin
Published: December 2020

Objective:

To assess impact of personal protective equipment (PPE) on healthcare providers (HCPs) in caring for COVID-19 patients.

Methods:

A cross-sectional survey was conducted over 50 hospitals in China. Descriptive analyses and Chi-square tests were performed on the collected data.

Results:

All 104 frontline HCPs report negative impacts of PPE on their clinical performance, 97% of them experienced discomfort and injuries caused by wearing PPE for long hours. Frontline HCPs provided suggestions to alleviate the negative impacts and to enhance communication between healthcare staff and patients. Two hundred eighty two non-frontline HCPs also revealed similar problems; however, we recorded a few discrepancies between answers given by frontline and non-frontline HCPs.

Conclusions:

Wearing PPE for long hours degrades health performance. Measures were suggested to improve the design of PPE for protecting HCPs and enhancing their services to COVID patients.
Surgical Treatment of Labral Tears: Debridement, Repair, and Reconstruction
Authors: Nwachukwu Benedict , Rasio Jonathan , Sullivan Spencer , Okoroha Kelechi , Mather Richard C. , Nho Shane J.
Published: December 2020

Advances in hip preservation surgery have to lead to increased utilization of hip arthroscopy. With this, there has also been a growth in the understanding of various hip conditions, therefore, leading to an increase in hip conditions amenable to arthroscopic intervention. The acetabular hip labrum has been at the forefront of arthroscopic advances in the hip. The labrum is important for hip stability, provision of the suction seal, and joint proprioception. Given the labrum’s central role in hip biomechanics, there is increasing emphasis on labral preservation in the form of debridement and repair. In revision settings, advanced techniques such as labral augmentation and reconstruction may play a role in the management of labral pathology. Appropriate management of the hip labrum at the time of surgery can be an important mediator of the outcome. As such, an understanding of the evolving evidence base and surgical indications and techniques are integral to the treatment and management of labral pathology.
Femoroacetabular Impingement and Core Muscle Injury in Athletes: Diagnosis and Algorithms for Success
Authors: Padaki Ajay S. , Lynch T. Sean , Larson Christopher M. , Byrd J.W. Thomas
Published: December 2020

Athletic hip injuries account for a substantial portion of missed time from sports in high-level athletes. For both femoroacetabular impingement (FAI) and core muscles injuries, a thorough history and physical examination are paramount to guide the treatment. While advanced imaging including computed tomography and magnetic resonance imaging are frequently obtained, a wealth of information can be ascertained from standard radiographs alone. For patients with isolated or combined FAI and core muscle injuries (CMIs), the initial treatment is often nonoperative and consists of rest, activity modification, and physical therapy of the hips, core, and trunk. Injections may then aid in both confirming diagnosis and temporary symptom abatement. Arthroscopic procedures for refractory FAI in experienced hands have been shown to be both safe and efficacious. While surgical repair options for CMIs are significantly more variable, long-term studies have demonstrated the rapid resolution of symptoms and high return to play rates. More recently, anatomic and clinical correlations between FAI and CMIs have been identified. Special attention must be paid to elite athletes as the incidence of concurrent FAI with CMI is extremely high yet with significant symptom variability. Predictable return to play in athletes with coexisting symptomatic intra-articular and extra-articular symptomatology is incumbent upon the treatment of both pathologies.
Creatinine variation improves Zwolle score in selecting low-risk patients after ST-segment elevation myocardial infarction
Authors: Rodrigues Brás Diogo , Gomes António , Semedo Pedro , Santos Ana Rita , Cordeiro Piçarra Bruno , Carrington Mafalda , Pais João , Rocha Ana Rita , Congo Kisa , Neves David , Bento Ângela , Fernandes Renato , Trinca Manuel , Patrício Lino
Published: December 2020

Background

The Zwolle score is recommended to identify ST-segment elevation myocardial infarction (STEMI) patients with low-risk eligible for early discharge. Our aim was to ascertain if creatinine variation (Δ-sCr) would improve Zwolle score in the decision-making of early discharge after primary percutaneous coronary intervention (PCI).

Methods and results

A total of 3296 patients with STEMI that underwent primary PCI were gathered from the Portuguese Registry on Acute Coronary Syndromes. A Modified-Zwolle score, including Δ-sCr, was created and compared with the original Zwolle score. Δ-sCr was also compared between low (Zwolle score ≤3) and non-low-risk patients (Zwolle score >3). The primary endpoint is 30-day mortality and the secondary endpoints are in-hospital mortality and complications. Thirty-day mortality was 1.5% in low-risk patients (35 patients) and 9.2% in non-low-risk patients (92 patients). The Modified-Zwolle score had a better performance than the original Zwolle score in all endpoints: 30-day mortality (area under curve 0.853 versus 0.810, P < 0.001), in-hospital mortality (0.889 versus 0.845, P < 0.001) and complications (0.728 versus 0.719, P = 0.037). Reclassification of patients lead to a net reclassification improvement of 6.8%. Additionally, both original Zwolle score low-risk patients and non-low-risk patients who had a Δ-sCr ≥0.3 mg/dl had higher 30-day mortality (low-risk: 1% versus 6.6%, P < 0.001; non-low-risk 4.4% versus 20.7%, P < 0.001), in-hospital mortality and complications.

Conclusion

Δ-sCr enhanced the performance of Zwolle score and was associated with higher 30-day mortality, in-hospital mortality and complications in low and non-low-risk patients. This data may assist the selection of low-risk patients who will safely benefit from early discharge after STEMI.
Dyslipidemia in childhood and adolescence: from screening to management
Authors: Yeung Elizabeth , Daniels Stephen R. , Patel Sonali S.
Published: December 2020

Purpose of review

To summarize types of dyslipidemia frequently encountered during childhood and adolescence, with a focus on screening, diagnosis, and management.

Recent findings

It is important that screening for atherosclerotic cardiovascular disease (ASCVD) begin in childhood. Genetic testing allows for increased awareness of dyslipidemia and more targeted intervention. Pharmacologic treatment of pediatric dyslipidemias has a good safety profile and can reduce adult ASCVD risk.

Much of what is known about pediatric dyslipidemia has been extrapolated from adult data, but recently, there have been increasing investigations within the pediatric population to better guide diagnosis and management of these disorders.
Use of cardiovascular imaging in risk restratification of the diabetic patient
Authors: Bellinge Jamie W. , Lee Sing Ching , Schultz Carl J.
Published: December 2020

Purpose of review

Diabetes mellitus is no longer considered a cardiovascular disease (CVD) risk equivalent, but the optimal methods of risk stratification are a matter of debate. The coronary calcium score (CCS) is a measure of the burden of atherosclerosis and is widely used for CVD risk stratification in the general population. We review recently published data to describe the role of the CCS in people with diabetes mellitus.

Recent findings

People with diabetes mellitus have 10-year event rates for CVD and CVD mortality that are considered high, at a much lower level of CCS than the general population. Different categories of CCS are pertinent to men and women with diabetes mellitus. CCS may be particularly useful in clinical settings when CVD risk is known to be increased but difficult to quantify, for example peri-menopausal women, young persons with diabetes, type 1 diabetic individuals and others. With modern techniques, the radiation dose of a CSS has fallen to levels wherein screening and surveillance could be considered.

The CCS is able to quantify CVD risk in people with diabetes mellitus when there is clinical uncertainty and identifies those with very high event rates. Future research should aim to identify effective risk reduction strategies in this important group.
Initial Experience With Endoscopic Ultrasound‐guided Coil Placement for Pediatric Gastric Variceal Hemostasis
Authors: Barakat Monique T. , Foley Megan A. , Gugig Roberto
Published: December 2020

Background:

Gastric variceal (GV) bleeding is among the most morbid sequelae of portal hypertension, with mortality ranging from 30% to 50%. Pediatric data focused on endoscopic approaches to management are needed. The present study represents the first pediatric case series of endoscopic ultrasound (EUS)‐guided coil placement within feeding vessels as monotherapy for management of GV bleeding.

Methods:

Using our prospectively maintained endoscopy database, we identified patients 18 years and younger who underwent EUS‐guided coil placement for management of GV bleeding from 2008 to 2018. Demographics, indication, procedural interventions/findings, and available clinical outcomes data were analyzed.

Results:

Twelve patients (median age 15, range 11–18 years) underwent EUS‐guided coil placement for GV bleeding. All had portal hypertension, with EV in 58.3% and prior GV bleeding with attempted endoscopic management in 75%. Coil placement was accomplished using a linear echoendoscope and a 19‐gauge needle. A mean of 2.75 (± 0.43) coils were placed in each patient (4, 6, 8, and 10 mm Nester Embolization Coils, Cook Medical, Bloomington, Indiana, USA). Immediate hemostasis was achieved in all patients, and 25% of patients developed recurrent gastric varices at a median of 5.5 months following the initial EUS‐guided coil placement (range 4–6 months) over the median 12 month follow‐up period.

Conclusions:

The present study establishes the feasibility and efficacy of EUS‐guided coil placement as monotherapy for GV bleeding in children and adolescents. The technique was technically successful, with primary hemostasis achieved in all patients. EUS‐guided embolization with coils may represent an alternative to current approaches for management of highly morbid GV bleeding.
Diagnostic Accuracy of the Rome IV Criteria for the Diagnosis of Functional Gastrointestinal Disorders in Children
Authors: Velasco‐Benítez Carlos A. , Gómez‐Oliveros Lina F. , Rubio‐Molina Lina M. , Tovar‐Cuevas José R. , Saps Miguel
Published: December 2020

The diagnosis of functional gastrointestinal disorders (FGIDs) centers on symptoms‐based criteria (Rome criteria). The last edition of the criteria was published in 2016. Still, few data on its validity support its use in children. We conducted a study aimed at determining the diagnostic accuracy of the Rome IV criteria through the application of questionnaires (Questionnaire of Pediatric Gastrointestinal Symptoms‐Rome IV QPGS‐IV) to diagnose FGIDs in children. We hypothesized that the Rome IV criteria has adequate diagnostic accuracy supporting its use for diagnosing FGIDs in children.

Methods:

School children ages 10 to 18 years from Cali (Colombia) completed the Spanish version of the QPGS‐IV. Children with FGIDs were matched with a group of children without FGIDs. Both groups had a medical consultation with a blinded experienced pediatric gastroenterologist (criterion standard) who provided his diagnosis. The questionnaire‐based diagnoses were compared with the consultation's diagnoses.

Results:

Of 487 schoolchildren surveyed with the QPGS‐IV, 97 (20.8%) had FGIDs. Eighty‐nine with FGIDs were matched with 92 children without FGIDs (mean age 13.1 years [±1.3]). We found a higher prevalence of FGIDs during the medical visit than using the self‐report QPGS‐IV (66.3% vs 49.2%, P = 0.001), mainly in abdominal pain disorders (19.3% vs 10.5%, P = 0.013). The Rome IV diagnostic criteria using the QPGS‐IV had a sensitivity of 75% (95% confidence interval, 59–79) and 90% specificity (95% confidence interval, 83–98). Positive predictive value is 85.8%, and negative predictive value is 79.9%.

Conclusion:

Our study suggests that the QPGS‐IV has adequate diagnostic accuracy.