bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in pediatric major trauma epidemiology, injury patterns, and outcome during COVID-19–associated lockdown
Authors: Pines Naama , Bala Miklosh , Gross Itai , Ohana-Sarna-Cahan Lea , Shpigel Ruth , Nama Ahmad , Asaf Kedar , Rosenberg Bsc Moriah P , Hashavya Saar
Published: September 2021

Introduction

The COVID-19 pandemic and its associated preventive measures such as national and regional lockdowns have dramatically changed the epidemiology of pediatric admissions to the emergency department. Nevertheless, there are scant data on the epidemiology and injury patterns of major pediatric trauma injuries during these lockdown periods.

Methods

A single-center retrospective study of data obtained from a tertiary level 1 trauma hospital trauma registry. The data included demographics, injury mechanisms, injury severity and type, treatment, and resource utilization in children aged 0–18 years who required trauma team activation upon arrival. The analysis compares the data from the 5-week lockdown period from March to May 2020 in Jerusalem, Israel, to its parallel periods in 2018–2019.

Results

A total of 187 trauma visits that required trauma team activation (TTA) were analyzed: 48 visits during the lockdown period vs. 139 in 2018–2019, corresponding to a 40% drop in TTA. There was a significant decrease of 34% in MVA-related injuries ( p = 0.0001) but a significant increase of 14% in burns ( p = 0.01) and a 16% increase in bicycle-related injuries ( p = 0.001). No changes in ISS, injury patterns, admission rate, PICU utilization, or need for interventions were observed.

Conclusion

There was a significant decrease in the number of overall pediatric trauma visits during the 2020 lockdown, mainly in MVA-associated trauma, but an increase in burns and bicycle injuries. These findings can thus inform policy makers as to the need to formulate prevention awareness programs alerting the public to indoor hazards and the dangers of activities outside the home. Furthermore, it can inform hospital policy decision-making in future lockdowns. The fact that PICU admissions and the need for operating rooms stayed unchanged suggests that it is vital to maintain trauma team capabilities even during lockdowns.
Efficacy of serratus anterior plane block in pain control in traumatic posterior rib fractures: A case series
Authors: Singh Paramvir , Sakharpe Ashish , Kaur Jasmeen , Dua Anterpreet , Agarwal Shvetank , Sun Zhuo , Pak Aimee
Published: September 2021

Blunt trauma patients commonly present with multiple rib fractures, which increases overall morbidity and mortality due to pulmonary complications. Effective chest wall analgesia may be challenging due to positioning difficulty, body habitus, anticoagulation issues with neuraxial interventions, etc. Serratus anterior plane block has been shown to be beneficial in anterior and lateral rib fractures in recent studies. We propose the efficacy of this block in posterior rib fractures as well, through this small case series of blunt trauma patients with posterior rib fractures, reporting significant pain relief after the block.
Remote Corticospinal Tract Degeneration After Cortical Stroke in Rats May Not Preclude Spontaneous Sensorimotor Recovery
Authors: Sinke Michel R. T. , van Tilborg Geralda A. F. , Meerwaldt Anu E. , van Heijningen Caroline L. , van der Toorn Annette , Straathof Milou , Rakib Fazle , Ali Mohamed H. M. , Al-Saad Khalid , Otte Willem M. , Dijkhuizen Rick M.
Published: September 2021

Background. Recovery of motor function after stroke appears to be related to the integrity of axonal connections in the corticospinal tract (CST) and corpus callosum, which may both be affected after cortical stroke. Objective. In the present study, we aimed to elucidate the relationship of changes in measures of the CST and transcallosal tract integrity, with the interhemispheric functional connectivity and sensorimotor performance after experimental cortical stroke. Methods. We conducted in vivo diffusion magnetic resonance imaging (MRI), resting-state functional MRI, and behavior testing in twenty-five male Sprague Dawley rats recovering from unilateral photothrombotic stroke in the sensorimotor cortex. Twenty-three healthy rats served as controls. Results. A reduction in the number of reconstructed fibers, a lower fractional anisotropy, and higher radial diffusivity in the ipsilesional but intact CST, reflected remote white matter degeneration. In contrast, transcallosal tract integrity remained preserved. Functional connectivity between the ipsi- and contralesional forelimb regions of the primary somatosensory cortex significantly reduced at week 8 post-stroke. Comparably, usage of the stroke-affected forelimb was normal at week 28, following significant initial impairment between day 1 and week 8 post-stroke. Conclusions. Our study shows that post-stroke motor recovery is possible despite degeneration in the CST and may be supported by intact neuronal communication between hemispheres.
Primary Repair of Upper Extremity Peripheral Nerve Injuries: An NSQIP Analysis From 2010 to 2016
Authors: Brennan Ryan , Carter Jordan , Gonzalez Gilberto , Herrera Fernando A.
Published: September 2021

Background

To identify the rate of 30-day complications after primary repair of upper extremity peripheral nerve injuries, associated diagnoses, and postoperative complication rate.

Methods

The American College of Surgeons National Surgical Quality Improvement Program database was reviewed from 2010 to 2016. Current Procedural Terminology codes consistent with primary nerve repair of the upper extremity were identified and included in the analysis. Patient demographics, comorbidities, type of procedure (elective/emergent), wound class, operative time, and 30-day complications were recorded. Patients with isolated upper extremity nerve injuries (isolated) were compared with those with peripheral nerve injuries in addition to bone, tendon, or soft tissue injuries (multiple).

Results

In all, 785 patients were identified as having upper extremity nerve repairs (0.16%). Of them, 64% were men and 36% were women; the average patient age was 40 years. The most common indication for surgery was injury to the digits (54% of cases). Thirty-day adverse events occurred in 3% of all cases. Isolated nerve injury occurred in 43% of patients, whereas 57% had additional injuries. The multiple injury group had a significantly higher complication rate compared with the isolated group (1% vs 4.5%) ( P = .007). Repair of tendon at forearm or wrist was the most common concurrent procedure performed.

Conclusions

Thirty-day complications among upper extremity peripheral nerve injuries are low, accounting for 3% of cases. Return to the operating room accounted for nearly half of all complications. Patients in the multiple injury group accounted for more than half of these and had a significantly higher complication rate compared with patients with isolated nerve injuries.
The Rise, Demise, and Reprise of the Increasingly Protracted APA Journal Article?
Authors: Webster Gregory D. , Wongsomboon Val , Mahar Elizabeth A.
Published: September 2021

Are APA journal articles getting longer or shorter over time? Earlier work that examined changes over time in article length in 24 APA journals (1986–2005) found that pages per article increased over time for the average journal, peaking around 2001, and then plateaued thereafter. But have these trends continued during the past 14 years? The current research extends prior work by adding additional years (1986–2019) and four additional journals (28 journals, 34 years, and 865 total observations). Multilevel growth curve analyses revealed a cubic effect of time on average article length, showing an increase in the 1980s and 1990s, a plateau or slight decline in the 2000s, and a slight increase again in the 2010s. Journal impact factors (JIFs) moderated linear growth over time; journals with higher JIFs had larger linear increases in article length. Exploratory multilevel interrupted time-series analyses suggested that the average linear increase in pages per article over time was greater after the start of psychology’s credibility crisis (2012–2019) than before it (1986–2011), which may relate to an increased emphasis on reporting details and transparency. We discuss implications for article length in the contexts of publishing and psychology’s ongoing credibility crisis.
Effect of Medical Therapy in Allergic Rhinitis: A Systematic Review and Meta-Analysis
Authors: Zhang Kathy , Li Andraia R. , Miglani Amar , Nguyen Shaun A. , Schlosser Rodney J.
Published: September 2021

Background

Intranasal corticosteroids (INCS), oral antihistamines (POAH), and allergen-specific immunotherapy (ASIT) are widely used in the treatment of allergic rhinitis (AR); however, appraisal of treatment effect has been heterogenous, and few studies have interpreted these outcomes in context with measures of nasal airflow.

Objective

To provide a systematic review and meta-analysis of randomized placebo-controlled trials for common therapy classes for AR to assess standardized treatment effect on validated patient-reported outcomes and physiologic measures of airflow.

Methods

A systematic search was performed in PubMed, Scopus, OVID, and Cochrane library databases to identify randomized controlled trials meeting inclusion criteria. Treatment effects of INCS, POAH, and ASIT on total nasal symptom score (TNSS), visual analog scale (VAS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and peak nasal inspiratory flow (PNIF) were analyzed by meta-analysis.

Results

Twenty-two studies with 4673 AR patients were identified, with 5 INCS, 8 POAH, and 9 ASIT trials. INCS improved TNSS (mean difference [MD] 0.90; P = .002) and PNIF (MD 13.31 L/min [ P = .0007]. POAH improved quality of life assessed by RQLQ [MD 0.36; P < .001], but no improvement was found in PNIF. ASIT improved RQLQ [MD 0.65; P < .001], with a trend toward improvement in TNSS.

Conclusion

Overall, INCS resulted in a clinically and statistically meaningful improvement in symptom scores and physiologic measures in AR. POAH and ASIT both improved symptom scores and quality of life, but their impacts upon nasal airflow are uncertain. There is a lack of studies assessing the effect of INCS on quality of life and the effect of POAH on symptom severity, particularly for mild AR. Future studies should assess the effect of treatment for each of these patient-reported measures.
The BTS sphere: Adorable Representative M.C. for Youth’s transnational cyber-nationalism on social media
Authors: Jin Dal Yong
Published: September 2021

BTS fandom has been one of the strongest, and many Adorable Representative M.C. for Youth members have dedicated themselves to protect BTS from numerous controversies, while promoting the group’s messages, which can be identified as cyber-nationalism. By employing a critical discourse analysis on BTS fans’ social media posts and their online activities surrounding a few incidents, this article attempts to develop cyber-nationalism in the context of the BTS fandom. It investigates the formation of transnational cyber-nationalism, and then discusses how Adorable Representative M.C. for Youth members as citizens in the BTS nation utilize cyberspace, in particular, social media, not only to form alliances but also to protect BTS from any critical points of view. Finally, it articulates how transnational cyber-nationalism in tandem with BTS has shifted the notion of cyber-nationalism, which can be identified as negative, even patriotic parochialism, into constructive and socio-culturally corrected cyber-movements.
Asymmetric Impact of FDI and Exchange Rate on Tourism: Evidence From Panel Linear and Nonlinear ARDL Model
Authors: Munir Kashif , Iftikhar Mehwish
Published: September 2021

This study analyzes the long run as well as short run linear and nonlinear impact of foreign direct investment (FDI) and exchange rate on tourism in South Asian countries. The study uses annual panel data of five South Asian countries that is Bangladesh, India, Nepal, Pakistan, and Sri Lanka from 1995 to 2019 and applies panel linear autoregressive distributive lag (ARDL) and nonlinear autoregressive distributive lag (NARDL) methodology to analyze the long run and short run relationship among the variables. Results show that an increase in FDI and appreciation of exchange rate contracts tourism, while a decrease in FDI and depreciation of exchange rate expands tourism in the long run. Both FDI and exchange rate shows asymmetric behavior with tourism in the long run in South Asian countries. Results of individual countries show that FDI has asymmetric impact on tourism in Bangladesh, India, Pakistan, and Sri Lanka in the short run, while exchange rate has asymmetric impact on tourism in Bangladesh, India, Nepal, and Pakistan in the short run. Moreover, unidirectional causality exits from FDI, exchange rate, partial negative sum of FDI, and partial positive sum of exchange rate to tourism as well as from tourism to partial positive sum of FDI and partial negative sum of exchange rate. Therefore, there is a need to expand tourism sector through attracting FDI in tourism sector, while FDI attraction and tourism development must be well coordinated among different departments as well as maintain exchange rate at a reasonable level to encourage international tourism.
Identifying Key Drivers of Non-Performing Assets in Indian Public Sector Banks: A Panel Data Analysis
Authors: Rahaman Sk Mujibar , Sur Debasish
Published: September 2021

The present study strives to identify the major factors influencing the non-performing assets (NPAs) of public sector banks (PSBs) in India using a panel dataset comprising of 26 PSBs over the period 1999-2000 to 2015-16. The results reveal that business per employee, operating inefficiency, priority sector lending, inflation and real interest rate have a significant positive influence on increasing NPAs of banks while credit orientation, higher capital adequacy, net interest margin, non-interest income, GDP growth, and financial intermediation are found to exert a significant favourable effect of lowering NPAs of banks. Most interestingly, the study also shows that the level of corruption and the rule of law significantly impacted the NPAs of Indian banks during the period under study.
Is Early Controlled Motion and Weightbearing Recommended for Nonoperatively Treated Acute Achilles Tendon Rupture? A Systematic Review and Meta-analysis
Authors: Zhang Yi-jun , Long Xiao , Du Jing-yu , Wang Quan , Lin Xiang-jin
Published: September 2021

Background:

There is disagreement as to whether early controlled motion and weightbearing confer a beneficial effect for nonoperatively treated acute Achilles tendon rupture (ATR) compared with immobilization and late weightbearing.

Purpose:

To conduct a meta-analysis of randomized controlled trials (RCTs) to determine whether early controlled motion and weightbearing results in different outcomes compared with immobilization and late weightbearing for nonoperatively treated patients with acute ATR.

Study Design:

Systematic review; Level of evidence, 1.

Methods:

We conducted a search in the PubMed, Web of Science, and EMBASE databases for relevant RCTs in humans from January 1981 to August 2020. The primary outcome was the Achilles Tendon Total Rupture Score (ATRS) at 1-year follow-up. The secondary outcomes were the rerupture rate, return to sports activity and work, and the heel-rise work (limb symmetry index [LSI]). Study quality was assessed using the Cochrane Collaboration risk of bias tool.

Results:

Included were 7 RCTs involving 424 participants (n = 215 treated with early controlled motion and weightbearing [early group], n = 209 treated with immobilization and late weightbearing [late group]). The quality assessment indicated a low risk of bias in all included RCTs. There was no difference between the early and late groups regarding the ATRS (mean difference [MD], -0.220; 95% CI, -4.489 to 4.049; P = .920). Likewise, we found no difference between the 2 groups in terms of the rerupture rate (odds ratio [OR], 1.107; 95% CI, 0.552 to 2.219; P = .775), the number of patients who returned to sports (OR, 0.766; 95% CI, 0.438 to 1.341; P = .351) and returned to work (OR, 0.706; 95% CI, 0.397 to 1.253; P = .234), the time to return to work (MD, -2.802 days; 95% CI, -6.525 to 0.921 days; P = .140), or the heel-rise work LSI (MD, -0.135; 95% CI, -6.243 to 5.973; P = .965).

Conclusion:

No significant differences were found between early controlled motion and weightbearing compared with immobilization and late weightbearing regarding the ATRS, the rerupture rate, return to sports activity and work, and the heel-rise work in nonoperatively treated patients with acute ATR.
Race/ethnicity and response to blood pressure lowering treatment after intracerebral hemorrhage
Authors: Anadani Mohammad , Qureshi Adnan I , Menacho Sarah , Grandhi Ramesh , Yaghi Shadi , Jumaa Mouhammad A , de Havenon Adam
Published: September 2021

Background: It is unknown if race/ethnicity modifies the response to blood pressure (BP) lowering treatment after intracerebral hemorrhage (ICH). We aimed to examine the race/ethnicity differences in the response to BP lowering treatment after ICH. Methods: This is a post hoc analysis of the Antihypertensive Treatment of Acute Cerebral Hemorrhage II (ATACH-2) trial. The primary outcome is good outcome, defined as 90-day modified Rankin Scale 0–3. The primary predictor is race/ethnicity for which we included non-Hispanic categories of White, Black, Asian, and the category of Hispanic. We fit adjusted logistic regression models with the predictor of race/ethnicity and models with the interaction term of treatment*race/ethnicity. Results: We included a total of 953 patients in our analysis (White = 213, Black = 112, Asian = 554, and Hispanic = 74). In the models with the interaction between race/ethnicity and treatment, we found that White patients assigned to the intensive treatment arm had lower predicted probability of good outcome than those assigned to the standard treatment arm (Model 1: 56.2% vs. 68.1%, p = .027; Model 2: 53.4% vs. 68.3%, p = .009). When divided into White and non-White groups, intensive treatment was associated with higher odds of serious adverse events in White group but not in the non-White group. In addition, there was an association between intensive treatment and higher risk of hematoma expansion in White patients and lower risk of hematoma expansion in non-White patients. Conclusions: In the ATACH-2, there was an interaction between race/ethnicity and response to BP lowering treatment after ICH, with White patients having an association between intensive blood pressure reduction and worse outcome.
A Review of Bride Trafficking in India
Authors: Irshad Mohd
Published: September 2021

Human trafficking is a global phenomenon that affects people of all ages, races, gender and ethnicities. Bride trafficking is one of the worst forms of human trafficking. Many other social evils such as child marriage, domestic violence, bonded labour and prostitution are linked to bride trafficking. Bride trafficking is rampant in India since eons. Hence, there is a need to understand the underlying causes, consequences, effects and repercussions. This article explores the phenomena of bride trafficking within the larger framework of human trafficking and the available legal provisions to address it.
Preliminary Study of Chemoradiotherapy Using Modified Docetaxel, Cis‐diaminodichloroplatinum, and 5‐Fluorouracil for Sinonasal Squamous Cell Carcinoma
Authors: Katagiri Katsunori , Shiga Kiyoto , Saito Daisuke , Oikawa Shin‐ichi , Ikeda Aya , Tsuchida Kodai , Miyaguchi Jun , Kusaka Takahiro , Sariishi Takumi , Ariga Hisanori
Published: September 2021

Objective

To examine the safety and efficacy of concomitant chemoradiotherapy using a modified TPF regimen (docetaxel + cisplatin + 5‐fluorouracil) in patients with advanced sinonasal squamous cell carcinoma (SNSCC).

Study Design

Retrospective study.

Setting

Tertiary center (university hospital).

Methods

Seven patients with previously untreated T3‐T4 SNSCC were enrolled. They underwent radiotherapy once daily (total dose, 70 Gy) with 2 courses of concomitant 120‐hour infusion of 5‐fluorouracil (600 mg/m2/d), docetaxel (50 mg/m2, day 2), and cisplatin (60 mg/m2, day 2)

Results

Grade 4 leukopenia, grade 4 neutropenia, and grade 3 lymphopenia were observed in 1, 3, and 4 patients, respectively. Grade 4 creatinine elevation was observed in 1 patient. However, other grade 3 or 4 adverse events were not common. Complete response was obtained in all patients. At 60 months there was 85.7% disease‐free survival and 100% overall.

Conclusion

Concomitant chemoradiotherapy with a modified TPF regimen may be feasible and effective in patients with advanced SNSCC.
Environmental Crimes: Effect of COVID-19 on Non-human Victims
Authors: Joglekar Yashprada
Published: September 2021

The article aims at finding out the impact of COVID-19 on forest and wildlife crimes, as the novel coronavirus or COVID-19 stalled our daily activities in the most unexpected manner. Studies have shown that the origin of any influenza virus is typically from animals.2 Thus, a direct nexus can be established between wildlife trade (primarily which is illegal) and the spread of coronavirus. United Nations Environmental Programme of 2016 identified issues of upcoming zoonotic diseases while discussing their emergence and re-emergence and its link with the ecosystem. In this article, an attempt is made to understand the framework and stance of International Criminal Court in regard to the environmental crimes. Further this article mentions the role International Criminal Court can play if the office of prosecutor were to try and prosecute the cases of environmental crimes.

Further, Sustainable Development Goals 13, 14 and 153 play an important role in this secondary study. Since these goals have presented us with the opportunity to interlink goals with one another and thus discuss the need of protecting and conserving non-human victims of environmental harms along with human victims. Study of reports from international and national organizations, law journals, case laws, news reports, books, commentaries, etc., are used and finally the conclusive remark is based on the interpretation of this primary data. This article solely proposes to analyse and identify the challenges faced by non-human victims mainly forest and wildlife during the course of pandemic outbreak.
Arthroscopic Treatment of Iatrogenic Slipped Capital Femoral Epiphysis Screw Impingement and Associated Hip Pathology
Authors: Moran Thomas E. , Taleghani Eric R. , Gwathmey F. Winston
Published: September 2021

Background:

Screw impingement is an infrequently reported sequelae following in situ pinning of a slipped capital femoral epiphysis, but it may result in significant bony and chondrolabral degeneration. Hip arthroscopy may offer the advantage of screw removal in a minimally invasive manner under direct visualization, as well as providing the opportunity for management of concomitant hip pathology.

Indications:

A healthy, active 27-year-old woman with right hip dysfunction secondary to screw impingement and concomitant chondrolabral pathology following previous in situ pinning of a slipped capital femoral epiphysis.

Technique Description:

The patient elected to undergo arthroscopic removal of hardware, osteochondroplasty, and management of hip labrum pathology. After the screw was localized, a 2.8-mm pin was inserted down the cannulated center of the screw to prevent intraarticular displacement during removal. The screw and washer were removed intact, and femoroplasty was performed to remove the reactive bone and resolve the cam-type impingement. Acetabuloplasty was then performed to remove pincer-type impingement and provide an appropriate rim of bone for labral reconstruction. The pathologic labrum was then debrided and reconstructed with a semitendinosus allograft.

Results:

There were no immediate complications following surgery. Surgical management led to resolution of the patient’s mechanical symptoms and provided pain relief, which allowed return to prior baseline level of function.

Discussion/Conclusion:

Symptomatic screws that impinge the osteochondral and soft tissue anatomy of the hip require removal. Historically, these screws have been removed by open, mini-open, or percutaneous techniques. This case demonstrates the advantages of arthroscopic removal, as it affords the surgeon the ability to perform a dynamic examination, safely remove the screw, and directly visualize and manage concomitant hip pathology that may not be otherwise be recognizable. Further studies will be required to determine the ability of this technique to more clearly illustrate long-term improvement in function and prevention of the development of osteoarthritis.
Vietnamese refugees in Britain: Language, translation, and the politics of protection in camp life and beyond
Authors: Tipton Rebecca , Wilkins Annabelle
Published: September 2021

Through the lens of assemblage thinking and “territorialisation,” this article examines the operationalisation of language support by the voluntary sector in the Thorney Island and Sopley camps, which temporarily accommodated Vietnamese refugee arrivals in Britain in the late 1970s and early 1980s. Drawing on archival sources, the role and agency of interpreters are foregrounded in an analysis of the relationships between the materiality of the camps, camp practices, and their impact on refugee experience. A post-camp initiative to train refugees as parasocial workers (a role that included interpreting) reveals a more person-centred approach, in contrast to what we have termed a solutionist approach to interpreting observed in the camps.
Cortisol dysregulation among American Sign Language interpreters in different work settings: Confirmation of occupational health risks
Authors: Pollard Robert Q , Dean Robyn K , Samar Vincent J , Knigga Leslie M , Taylor Tiffany L
Published: September 2021

Cumulative motion injuries and burnout contribute to an international shortage of signed language interpreters (SLIs). Studies using the Job Content Questionnaire, a well-validated measure of occupational health risks, indicate that risk levels differ among SLI work settings. Specifically, video relay service (VRS) and primary and secondary educational settings (K–12) are associated with greater health risks. The current study validated those results by analysing the diurnal rhythm of salivary cortisol levels. Anomalies in diurnal cortisol rhythms are associated with an array of health problems. Our full-time SLI participants included VRS workers ( N = 20), K–12 workers ( N = 18), and SLIs who worked in other settings ( N = 23). Non-interpreters using sign language daily at work ( N = 18) comprised a fourth group. Saliva samples were collected four times daily over 2 working days. The VRS and K–12 SLIs demonstrated lower morning peak cortisol levels and flatter diurnal cortisol slopes from morning peak to subsequent diminution. Both findings are associated with chronic stress and greater health risks. The VRS and K–12 groups’ diurnal cortisol patterns closely resembled each other, while the Other SLI group’s curve closely resembled that of the Non-Interpreter group. Implications for SLI health, education, and job redesign are discussed in the context of the demand control schema.
Ablation of collagen VI leads to the release of platelets with altered function
Authors: Abbonante Vittorio , Gruppi Cristian , Battiston Monica , Zulian Alessandra , Di Buduo Christian Andrea , Chrisam Martina , Sereni Lucia , Laurent Pierre-Alexandre , Semplicini Claudio , Lombardi Elisabetta , Mazzucato Mario , Moccia Francesco , Petronilli Valeria , Villa Anna , Bello Luca , Pegoraro Elena , Bernardi Paolo , Braghetta Paola , De Marco Luigi , Bonaldo Paolo , Balduini Alessandra
Published: September 2021

Hemostatic abnormalities and impaired platelet function have been described in patients affected by connective tissue disorders. We observed a moderate bleeding tendency in patients affected by collagen VI–related disorders and investigated the defects in platelet functionality, whose mechanisms are unknown. We demonstrated that megakaryocytes express collagen VI that is involved in the regulation of functional platelet production. By exploiting a collagen VI–null mouse model (Col6a1−/−), we found that collagen VI–null platelets display significantly increased susceptibility to activation and intracellular calcium signaling. Col6a1−/− megakaryocytes and platelets showed increased expression of stromal interaction molecule 1 (STIM1) and ORAI1, the components of store-operated calcium entry (SOCE), and activation of the mammalian target of rapamycin (mTOR) signaling pathway. In vivo mTOR inhibition by rapamycin reduced STIM1 and ORAI1 expression and calcium flows, resulting in a normalization of platelet susceptibility to activation. These defects were cell autonomous, because transplantation of lineage-negative bone marrow cells from Col6a1−/− mice into lethally irradiated wild-type animals showed the same alteration in SOCE and platelet activation seen in Col6a1−/− mice. Peripheral blood platelets of patients affected by collagen VI–related diseases, Bethlem myopathy and Ullrich congenital muscular dystrophy, displayed increased expression of STIM1 and ORAI1 and were more prone to activation. Altogether, these data demonstrate the importance of collagen VI in the production of functional platelets by megakaryocytes in mouse models and in collagen VI–related diseases.
A systematic review of the association between anti-β-2 glycoprotein I antibodies and APS manifestations
Authors: Jiang Debbie , Lim Wendy , Crowther Mark , Garcia David
Published: September 2021

Anti-β-2 glycoprotein I antibodies (anti-B2GPI) are often cited as the major pathogenically relevant antibody in antiphospholipid syndrome (APS), but it is unclear if there is clinical evidence to support this theory. We performed a systematic review to determine if immunoglobulin G anti-B2GPI positivity was independently associated with thrombotic and/or obstetric manifestations of APS. We searched MEDLINE, EMBASE, The Cochrane Library, and clinicaltrials.gov electronic databases through April 2020 for prospective studies that met prespecified design criteria. Of 4758 articles identified through computer-assisted search, 4 studies examining obstetric outcomes and 2 studies examining thrombotic outcomes were included for qualitative assessment. The presence of anti-B2GPI had only a weak independent association with thrombosis and was, at best, inconsistently associated with obstetric complications. A quantitative assessment could not be performed because of study heterogeneity. The overall quality of the evidence was very low. Although anti-B2GPI are commonly thought to mediate APS manifestations, clinical evidence is lacking with very low-quality data to support a weak association with thrombosis.
Industry and workplace characteristics associated with the downloading of a COVID-19 contact tracing app in Japan: a nation-wide cross-sectional study
Authors: Ishimaru Tomohiro , Ibayashi Koki , Nagata Masako , Hino Ayako , Tateishi Seiichiro , Tsuji Mayumi , Ogami Akira , Matsuda Shinya , Fujino Yoshihisa ,   for the CORoNaWork Project, Fujino Yoshihisa , Ando Hajime , Eguchi Hisashi , Ikegami Kazunori , Ishimaru Tomohiro , Harada Arisa , Hino Ayako , Kitagawa Kyoko , Mafune Kosuke , Matsuda Shinya , Matsugaki Ryutaro , Mori Koji , Muramatsu Keiji , Nagata Masako , Nagata Tomohisa , Liu Ning , Ogami Akira , Tanaka Rie , Tateishi Seiishiro , Tokutsu Kei , Tsuji Mayumi
Published: September 2021

Background

To combat coronavirus disease 2019 (COVID-19), many countries have used contact tracing apps, including Japan’s voluntary-use contact-confirming application (COCOA). The current study aimed to identify industry and workplace characteristics associated with the downloading of this COVID-19 contact tracing app.

Methods

This cross-sectional study of full-time workers used an online survey. Multiple logistic regression analysis was used to evaluate the associations of industry and workplace characteristics with contact tracing app use.

Results

Of the 27,036 participants, 25.1% had downloaded the COCOA. Workers in the public service (adjusted odds ratio [aOR] = 1.29, 95% confidence interval [CI] 1.14–1.45) and information technology (aOR = 1.38, 95% CI 1.20–1.58) industries were more likely to use the app than were those in the manufacturing industry. In contrast, app usage was less common among workers in the retail and wholesale (aOR = 0.87, 95% CI 0.76–0.99) and food/beverage (aOR = 0.81, 95% CI 0.70–0.94) industries, but further adjustment for company size attenuated these associations. Workers at larger companies were more likely to use the app. Compared with permanent employees, the odds of using the app were higher for managers and civil servants but lower for those who were self-employed.

Conclusions

Downloading of COCOA among Japanese workers was insufficient; thus, the mitigating effect of COCOA on the COVID-19 pandemic is considered to be limited. One possible reason for the under-implementation of the contact tracing app in the retail and wholesale and food/beverage industries is small company size, as suggested by the fully adjusted model results. An awareness campaign should be conducted to promote the widespread use of the contact tracing app in these industries.
Transcriptome profiling of Malus sieversii under freezing stress after being cold-acclimated
Authors: Zhou Ping , Li Xiaoshuang , Liu Xiaojie , Wen Xuejing , Zhang Yan , Zhang Daoyuan
Published: September 2021

Background

Freezing temperatures are an abiotic stress that has a serious impact on plant growth and development in temperate regions and even threatens plant survival. The wild apple tree (Malus sieversii) needs to undergo a cold acclimation process to enhance its freezing tolerance in winter. Changes that occur at the molecular level in response to low temperatures are poorly understood in wild apple trees.

Results

Phytohormone and physiology profiles and transcriptome analysis were used to elaborate on the dynamic response mechanism. We determined that JA, IAA, and ABA accumulated in the cold acclimation stage and decreased during freezing stress in response to freezing stress. To elucidate the molecular mechanisms of freezing stress after cold acclimation, we employed single molecular real-time (SMRT) and RNA-seq technologies to study genome-wide expression profiles in wild apple. Using the PacBio and Illumina platform, we obtained 20.79G subreads. These reads were assembled into 61,908 transcripts, and 24,716 differentially expressed transcripts were obtained. Among them, 4410 transcripts were differentially expressed during the whole process of freezing stress, and these were examined for enrichment via GO and KEGG analyses. Pathway analysis indicated that “plant hormone signal transduction”, “starch and sucrose metabolism”, “peroxisome” and “photosynthesis” might play a vital role in wild apple responses to freezing stress. Furthermore, the transcription factors DREB1/CBF, MYC2, WRKY70, WRKY71, MYB4 and MYB88 were strongly induced during the whole stress period.

Conclusions

Our study presents a global survey of the transcriptome profiles of wild apple trees in dynamic response to freezing stress after two days cold acclimation and provides insights into the molecular mechanisms of freezing adaptation of wild apple plants for the first time. The study also provides valuable information for further research on the antifreezing reaction mechanism and genetic improvement of M. sieversii after cold acclimation.
Altered metabolomic states elicited by Flg22 and FlgII-28 in Solanum lycopersicum: intracellular perturbations and metabolite defenses
Authors: Zeiss Dylan R. , Steenkamp Paul A. , Piater Lizelle A. , Dubery Ian A.
Published: September 2021

Background

Surveillance of potential pathogens is a key feature of plant innate immunity. For non-self-recognition plants rely on the perception of pathogen-derived molecules. Early post-perception events activate signaling cascades, leading to the synthesis of defense-related proteins and specialized metabolites, thereby providing a broad-spectrum antimicrobial coverage. This study was concerned with tracking changes in the tomato plant metabolome following perception of the flagellum-derived elicitors (Flg22 and FlgII-28).

Results

Following an untargeted metabolomics workflow, the metabolic profiles of a Solanum lycopersicum cultivar were monitored over a time range of 16–32 h post-treatment. Liquid chromatography was used to resolve the complex mixture of metabolites and mass spectrometry for the detection of differences associated with the elicitor treatments. Stringent data processing and multivariate statistical tools were applied to the complex dataset to extract relevant metabolite features associated with the elicitor treatments. Following perception of Flg22 and FlgII-28, both elicitors triggered an oxidative burst, albeit with different kinetic responses. Signatory biomarkers were annotated from diverse metabolite classes which included amino acid derivatives, lipid species, steroidal glycoalkaloids, hydroxybenzoic acids, hydroxycinnamic acids and derivatives, as well as flavonoids.

Conclusions

An untargeted metabolomics approach adequately captured the subtle and nuanced perturbations associated with elicitor-linked plant defense responses. The shared and unique features characterizing the metabolite profiles suggest a divergence of signal transduction events following perception of Flg22 vs. FlgII-28, leading to a differential reorganization of downstream metabolic pathways.
Effect of sodium-glucose cotransporter 2 (SGLT2) inhibitors on left ventricular remodelling and longitudinal strain: a prospective observational study
Authors: Gamaza-Chulián Sergio , Díaz-Retamino Enrique , González-Testón Fátima , Gaitero José Carlos , Castillo María José , Alfaro Raquel , Rodríguez Elías , González-Caballero Eva , Martín-Santana Antonio
Published: September 2021

Background

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) lower cardiovascular events in type 2 diabetes mellitus (T2DM) patients, although the mechanisms underlying these benefits are not clearly understood. Our aim was to study the effects of SGLT2i on left ventricular remodelling and longitudinal strain.

Methods

Between November 2019 and April 2020, we included 52 patients with T2DM ≥ 18 years old, with HbA1c between 6.5 and 10.0%, and estimated glomerular filtration ≥ 45 ml/min/1.73 m2. Patients were classified into SGLT2i group and control group, according to prescribed treatment by their referring physician. Conventional and speckle tracking echocardiography were performed by blinded sonographers, at baseline and after 6 months of treatment.

Results

Among the 52 included patients (44% females, mean age 66.8 ± 8.6 years, mean HbA1c was 7.40 ± 0.7%), 30 patients were prescribed SGLT2i and 22 patients were classified as control group. Mean change in indexed left ventricular mass (LVM) was − 0.85 ± 3.31 g/m2(p = 0.003) in the SGLT2i group, and + 2.34 ± 4.13 g/m2(p = 0.58) in the control group. Absolute value of Global Longitudinal Strain (GLS) increased by a mean of 1.29 ± 0.47 (p = 0.011) in the SGLT2i group, and 0.40 ± 0.62 (p = 0.34) in the control group. We did not find correlations between changes in LVM and GLS, and other variables like change in HbA1c.

Conclusions

Among patients with T2DM, SGLT2i were associated with a significant reduction in indexed LVM and a significant increment in longitudinal strain measured by speckle tracking echocardiography, which may explain in part the clinical benefits found in clinical trials.
Mitigating selection bias in organ allocation models
Authors: Schnellinger Erin M. , Cantu Edward , Harhay Michael O. , Schaubel Douglas E. , Kimmel Stephen E. , Stephens-Shields Alisa J.
Published: September 2021

Background

The lung allocation system in the U.S. prioritizes lung transplant candidates based on estimated pre- and post-transplant survival via the Lung Allocation Scores (LAS). However, these models do not account for selection bias, which results from individuals being removed from the waitlist due to receipt of transplant, as well as transplanted individuals necessarily having survived long enough to receive a transplant. Such selection biases lead to inaccurate predictions.

Methods

We used a weighted estimation strategy to account for selection bias in the pre- and post-transplant models used to calculate the LAS. We then created a modified LAS using these weights, and compared its performance to that of the existing LAS via time-dependent receiver operating characteristic (ROC) curves, calibration curves, and Bland-Altman plots.

Results

The modified LAS exhibited better discrimination and calibration than the existing LAS, and led to changes in patient prioritization.

Conclusions

Our approach to addressing selection bias is intuitive and can be applied to any organ allocation system that prioritizes patients based on estimated pre- and post-transplant survival. This work is especially relevant to current efforts to ensure more equitable distribution of organs.
Effect of sofosbuvir-based DAAs on changes in lower-density lipoprotein in HCV patients: a systematic review and meta-analysis
Authors: Wang Ying-Wen , Lee Wei-Ping , Huang Yi-Hsiang , Hou Ming-Chih , Lan Keng-Hsin
Published: September 2021

Background

Previous studies reported worsened lipid profiles in patients infected with hepatitis C virus (HCV) during direct-acting antivirals (DAAs) treatment. This study aimed to investigate the effect of sofosbuvir (SOF)-based DAAs on changes in low-density lipoprotein (LDL) in HCV patients.

Methods

A systematic review of articles published before 31 May 2021 was conducted by searching MEDLINE, Cochrane Library, EMBASE, and CINAHL Plus. Eligible studies were those comparing SOF-based DAAs and non-SOF DAAs for HCV patients and providing numerical data for changes in LDL. Risk of Bias in Non-randomized Studies- of Interventions was used for assessing risk of bias, and meta-analysis was performed for changes in LDL.

Results

Six studies comprising 1248 patients were included, 848 patients treated with SOF-based DAAs and 400 patients with non-SOF DAAs vs. SOF-based DAAs group had significantly greater increases in LDL from baseline to week 4 than non-SOF DAAs group (P = 0.001). However, changes in LDL from baseline to the end of treatment (P = 0.060), to post-treatment week 12 (P = 0.263), and to post-treatment week 24 (P = 0.319) did not significantly differ between the two groups. Further comparison of SOF/ledipasvir with asunaprevir/daclatasvir revealed a similar trend in changes in LDL.

Conclusions

For HCV patients, SOF-based DAA regimens were associated with rapid and significant increases in LDL during the initial 4 weeks of treatment, and the changes did not sustain after the end of treatment. Potential mechanism might be related to the phosphoramidate side chain of SOF.
Trends in healthcare visits and antimicrobial prescriptions for acute infectious diarrhea in individuals aged 65 years or younger in Japan from 2013 to 2018 based on administrative claims database: a retrospective observational study
Authors: Ono Akane , Aoyagi Kensuke , Muraki Yuichi , Asai Yusuke , Tsuzuki Shinya , Koizumi Ryuji , Azuma Toshiaki , Kusama Yoshiki , Ohmagari Norio
Published: September 2021

Background

The inappropriate use of antimicrobials for acute infectious diarrhea is widespread and leads to the problem of antimicrobial resistance. To improve the use of antimicrobials, it is first necessary to understand the actual situation of diarrheal disease and to identify potential targets for intervention. This study aimed to investigate the recent epidemiological characteristics of and antimicrobial prescriptions for acute infectious diarrhea in Japan.

Methods

This was a retrospective observational study of outpatients aged 0–65 years, separated into children (age 0–17 years) and adults (age 18–65 years), diagnosed with acute infectious diarrhea, using the administrative claims database of the Japan Medical Data Center from 2013 to 2018. We evaluated the number of eligible visits/number of database registrants (defined as the visit rate). The analysis of the antimicrobial prescription rate was restricted to otherwise healthy individuals diagnosed with acute infectious diarrhea alone by excluding patients with multiple disease diagnoses and with medical backgrounds of chronic bowel diseases or immunocompromised conditions. We further classified them by diagnosis of bacterial or nonbacterial acute infectious diarrhea.

Results

The total number of eligible visits for acute infectious diarrhea was 2,600,065. The visit rate, calculated based on the number of eligible visits by database registrants, was higher in children (boys, 0.264; girls, 0.229) than in adults (men, 0.070; women, 0.079), with peaks in early summer and winter. The peaks for visits in adults lagged those of children. In total, 482,484 visits were analyzed to determine the antimicrobial prescription rate; 456,655 (94.6%) were diagnosed with nonbacterial acute infectious diarrhea. Compared with children (boys, 0.305; girls, 0.304), the antimicrobial prescription rate was higher in adults, and there were differences between sexes in adults (men, 0.465; women, 0.408). Fosfomycin and fluoroquinolone were most frequently used for nonbacterial acute infectious diarrhea in children (44.1%) and adults (50.3%), respectively.

Conclusions

These results revealed overprescription of antimicrobials for acute infectious diarrhea in this administrative claims database in Japan and contribute to the development of antimicrobial stewardship strategies and the identification of targets for efficiently reducing inappropriate antimicrobial use.