bluuebunny/crossref_metadata_2025 huggingface dataset:
Species-Wide Transposable Element Repertoires Retrace the Evolutionary History of the Saccharomyces cerevisiae Host
Authors: Bleykasten-Grosshans Claudine , Fabrizio Romeo , Friedrich Anne , Schacherer Joseph
Published: June 2021

Transposable elements (TE) are an important source of genetic variation with a dynamic and content that greatly differ in a wide range of species. The origin of the intraspecific content variation is not always clear and little is known about the precise nature of it. Here, we surveyed the species-wide content of the Ty LTR-retrotransposons in a broad collection of 1,011 Saccharomyces cerevisiae natural isolates to understand what can stand behind the variation of the repertoire that is the type and number of Ty elements. We have compiled an exhaustive catalog of all the TE sequence variants present in the S. cerevisiae species by identifying a large set of new sequence variants. The characterization of the TE content in each isolate clearly highlighted that each subpopulation exhibits a unique and specific repertoire, retracing the evolutionary history of the species. Most interestingly, we have shown that ancient interspecific hybridization events had a major impact in the birth of new sequence variants and therefore in the shaping of the TE repertoires. We also investigated the transpositional activity of these elements in a large set of natural isolates, and we found a broad variability related to the level of ploidy as well as the genetic background. Overall, our results pointed out that the evolution of the Ty content is deeply impacted by clade-specific events such as introgressions and therefore follows the population structure. In addition, our study lays the foundation for future investigations to better understand the transpositional regulation and more broadly the TE–host interactions.
Addressing the parents’ mental wellness during their kids’ online learning
Authors: Macaraan Willard Enrique R
Published: June 2021

In a letter to Carreon and Manansala, the authors have stressed the urgency to address the psychosocial needs of the students in an online learning platform. But I argue that it is also crucial not to ignore its impact on parents who have to adapt and adopt strategies to guide their kids in their online learning process while also looking after their responsibilities as career persons. Online learning has caused a significant impact on their mental well-being, and this letter aims to address this particular concern.
Taxonomic Revision of the Banana Fusarium Wilt TR4 Pathogen Is Premature
Authors: Torres Bedoya Eliana , Bebber Daniel P. , Studholme David J.
Published: June 2021

Taxonomic revisions for pathogens of crops should be based on robust underpinning evidence. Recently, a substantial revision was proposed for the taxonomy of the causative agent of Fusarium wilt on banana. We reanalyzed the data on which this revision was based and discovered that the data do not robustly support the proposals. Several apparent discrepancies and errors in the published phylogenies cast further doubt on the conclusions drawn from them. Although we do not assert that the authors’ conclusions are incorrect, we posit that the taxonomic changes are premature, given the data currently in the public domain.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Nutrition Education for Low Income Population through Social Marketing: Insight from Cooperative Extension Agents
Authors: Hagues Rachel , Stotz Sarah , Childers Austin , Lee Jung Sun , Phua Joe , Hibbs Judy , Murray Deborah
Published: June 2021

Social Marketing (SM) is emerging as a promising method to deliver targeted nutrition and public health messages, but the current usage of SM in Supplemental Nutrition Assistance Program Education (SNAP‐Ed) programs is still limited across the nation. The purpose of this study was to conduct focus group interviews to learn from Cooperative Extension Agents (CEAs) perceptions of barriers, benefits, content, and media channels for a SM intervention designed for SNAP‐Ed eligible participants in the state of Georgia (southeastern USA). One focus group took place in each of the four Cooperative Extension Districts for a total of 4 groups. Thirty‐six female CEAs representing a range of rural – urban counties were recruited via convenience sampling. A semi‐structured interview guide was used. Focus groups were digitally recorded and transcribed. Thematic analysis was used for analysis. To ensure validity of findings, a member‐check was conducted by sending district level reports to participants from each district to review and provide feedback. CEAs had varied perceptions of SM, and tended to first think social media marketing. They expressed that SNAP‐Ed eligible individuals and families could benefit through participation in a SM intervention; however, they identified both individual level (e.g., lack of literacy and retention challenges) and community level barriers (e.g., lack of transportation, lack of available and affordable healthy food, and unreliable Internet) for a SM intervention reflecting unique social, economic, and population characteristics of urban and rural areas across the state. Agents suggested several geographic and audience segmentation strategies to address the identified barriers including recruiting participants at the places they frequent; using radio, TV, or in‐person communication (e.g., in churches, schools, libraries) in areas with unreliable Internet; and using incentives to get and maintain participation They also emphasized the use of visual methods (videos, posters, etc.) containing nutrition tips such as how to pick out produce that is in season, new food preparation methods, and how to budget food dollar resources, delivered by someone to whom low‐income population can relate. The findings of this study suggest that CEAs consider SM as a feasible SNAP‐Ed approach that has a high potential to deliver tailored nutrition education message to low‐income Georgians, which will inform a statewide SNAP‐Ed SM plan in Georgia.

Support or Funding Information

This project was funded by USDA SNAP‐Ed
Self‐reported vs. Measured Height and Weight in Young Adults
Authors: Famodu Oluremi A , Charlier Camille M , Barr Makenzie L , Colby Sarah E , Zhou Wenjun , Mathews Anne E. , Olfert Melissa Diann
Published: June 2021

Introduction

Obesity is recognized as a worldwide public health concern. It is most commonly assessed and classified using Body Mass Index (BMI). Historical data says that adults tend to under‐report their own weight and that the gap between self‐reported weight and actual weight increases with obesity. Few studies have examined how well young adults report their own height and weight.

Objective

This study investigates self‐reported height, weight and subsequent BMI versus actual measurements in young adults.

Methods

Over 1,500 students across 8 U.S. universities provided their height and weight via a survey. Measurements were subsequently taken by trained professionals; both self‐reported and measured BMI were then calculated for each participant. Correlations between self‐reported and measured BMI were assessed using Spearman's rho. Kappa coefficient was used to test agreement between categorical variables of self‐reported and actual calculated BMI (i.e. underweight, normal, overweight, obese).

Results

Male and female students both underestimated their height, with males overall under‐reporting more than males. Males reported an average height of 166.4 ± 12.1 cm versus an actual average height of 175.3 ± 7.8. Females reported an average height of 157.1 ± 7.2 cm versus an actual average height of 164.6 ± 7.1 cm. Males slightly overestimated their weight, with an average self‐reported weight of 76.8 ±14.5 kg versus an actual average weight of 76.2 ± 15.7 kg. Females slightly underestimated their weight with an average self‐reported weight of 65.2 ± 14.4 kg versus an actual average weight of 65.7 ± 15.3 kg. However, the self‐reported measurements remained statistically correlated to the actual height, weight and BMI in both genders (males rs = 0.79, <0.0001, rs = 0.91, <0.0001 and rs = 0.83, <0.0001 respectively; females rs = 0.78, <0.0001, rs = 0.91, <0.0001 and rs = 0.76, <0.0001 respectively). Additionally, categorical variables of BMI from both self‐reported and actual height and weight resulted in significant agreement for both genders (Males κ = −0.09 (95% CI, −0.12 to −0.04), p < .0001; Females κ = −0.04 (95% CI, −0.07 to −0.01), p = .004).

Conclusions

This study suggests self‐reported anthropometric measurements in young adults can be used to calculate BMI for weight classification purposes. Further investigation is needed to better assess self‐reported vs. measured height and weight discrepancies across populations.

Support or Funding Information

Approval to use the data set was granted by the University of Tennessee Institutional Review Board prior to study implementation. This material is based upon work that is supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, under award number 2014‐67001‐21851.
Polysaccharide lentinan extracted from the stipe of Lentinus edodes mushroom exerts anticancer activities through the transcriptional regulation of cell cycle progression and metastatic markers in human colon cancer cells
Authors: Wang Yanhui , Xu Guanying , Tang Xinyu , Chen Hong
Published: June 2021

The edible mushroom Lentinus edodes has been shown to offer medicinal effects including antifungal, antibacterial, antiviral, antioxidant, as well as anticancer activities. Assessment of bioactivities of extracts of the mushroom indicated that the polysaccharide lentinan possesses the potential bioactivities. Currently, the stipe portion of the mushroom is mostly discarded during industrial food processing, generating a large amount of residues. The hypothesis is that the stipe as the industrial byproduct from the mushroom processing contains the similar bioactive polysaccharide that could be utilized to produce mushroom extracts for treatment of cancer. Therefore the current study was designed to examine the polysaccharide extract from the mushroom stipe and its anticancer bioactivities in human colon cancer cells. The preparation and storage methods used in the production of lentinan polysaccharide were also optimized in the study. An aqueous phase extraction method was used for the lentinan production from the stipe as well as the pileus of Lentinus edodes mushroom (LeS vs LeP). Results showed that the lentinan yield from the stipe is comparable to the pileus. WST‐1 assay indicated that at as little as 125 ug/ml, lentinan extracts from both LeS and LeP exerted inhibitory effects against cell proliferation of human colon cancer cells. Cell cycle analysis using flow cytometry indicated that the anti‐proliferative effect is partly due to the induction of cell cycle arrest at the G0/1 phase. Further analysis of gene expression showed that the cell cycle arrest induced by lentinan treatment was associated with a decrease in the mRNA level of cyclin D1 gene. This is accompanied by the reduction of transcription of oncogenes such as c‐myc and induction of gene expression for stress‐responsive pathways. Moreover, NDRG1 gene, a key regulator of cancer metastasis that was often silenced in metastatic colon cancer cells, was increased by lentinan treatment. Together, the current study demonstrates that Letinous edodes stipe is a valuable source of lentinan. Lentinan from Letinous edodes stipe extract is stable when stored under the freeze‐dried condition or at refrigeration. The anti‐proliferative effects of lentinan in colon cancer cells are the results of cell cycle arrest that was induced by the inhibition of cyclin production, combined with the induction of cellular stress‐responsive pathways as well as the transcription of metastasis suppressor genes.

Support or Funding Information

The research is supported by the Office of International Programs of College of ACES at University of Illinois at Urbana‐Champaign and USDA HATCH fund.
Clinical Evaluation of a Minimally Invasive Technique Using a Free Semitendinosus Tendon Graft for Reconstruction of a Chronic Achilles Tendon Tear With Wide Gap
Authors: Bansal Nitish , Dev Parik , Tiwari Punit , Jain Ayush
Published: June 2021

Introduction:

The conventional approach to treat a chronic Achilles tendon tear with a wide gap is associated with many problems, primarily difficulty in filling the gap and skin complications. We used a minimally invasive technique to circumvent the problems.

Materials and Methods:

The study included 10 patients with chronic Achilles tendon tears with a wide gap (>6 cm, Kuwada type 4), who underwent reconstruction using free semitendinosus tendon graft transfer by a minimally invasive technique. Patients were followed up for 12 months. Toe walking, loss of dorsiflexion, and the American Orthopedic Foot and Ankle Score were assessed. The technique was also evaluated for any complications.

Results:

The age of the patients ranged from 40 to 53 years. The time since injury varied from 18 to 33 weeks. Full weight-bearing was achieved by 8 weeks in all the patients. All patients were able to walk on toes without assistance at 6 months. The mean American Orthopedic Foot and Ankle Score increased from 40.8 to 80.4 after the operation. Only 1 patient developed a superficial skin infection, which resolved with treatment.

Conclusions:

Semitendinosus graft transfer is a reliable method to treat chronic Achilles tendon rupture with a wide gap, as this wide gap can be covered easily, has a low risk of donor-site morbidity, and can be used even in tears at the insertion site, with good results. With the minimally invasive technique, the intervening skin bridge is maintained, leading to fewer skin complications.
Effect of intravenous dexmedetomidine and remifentanil on neonatal outcomes after caesarean section under general anaesthesia
Authors: Lee Myeongjong , Kim Hyungtae , Lee Cheol , Kang Hyun
Published: June 2021

BACKGROUND

Various strategies have been used to mitigate haemodynamic instability during general anaesthesia for caesarean section. However, the safety of these strategies for neonates remains controversial.

OBJECTIVE

To investigate the effects of intravenous dexmedetomidine and remifentanil on neonatal outcomes during caesarean section under general anaesthesia.

DESIGN

Systematic review and meta-analysis of randomised controlled trials.

DATA SOURCES

Databases of PubMed, EMBASE and CENTRAL were searched until March 2020 and updated in February 2021.

ELIGIBILITY CRITERIA

Randomised controlled trials were included if they compared dexmedetomidine and remifentanil infusion on neonatal outcomes after elective caesarean section under general anaesthesia. Primary outcomes were 1 and 5 min Apgar scores. Secondary outcomes were the incidence of neonatal mask ventilation or endotracheal intubation, and pH of the umbilical artery and vein. Studies that did not report primary outcomes were excluded.

RESULTS

Five studies with 258 patients in total were included. The Apgar score at 1 min in the remifentanil group was lower than that in the dexmedetomidine group for both quantitative [weighted mean difference (WMD): 0.75; 95% CI, 0.44 to 1.07;
τ

2
 = 0.00] and categorical outcomes (≥Apgar 7 vs. <Apgar 7) (risk ratio: 0.76; 95% CI, 0.59 to 0.99;
τ

2
 = 0.01). When trial sequential analysis (TSA) for Apgar score at 1 min was performed, the cumulative Z curve crossed both the conventional test boundary and the trial sequential monitoring boundary for the quantitative outcome but did not cross the trial sequential monitoring boundary for the categorical outcome. For both conventional meta-analysis and TSA, there were neither differences in the Apgar score at 5 min for either quantitative or categorical outcomes nor were there differences in the incidence of mask ventilation or intubation, or pH values of the umbilical artery and vein.

CONCLUSION

In our study, Apgar score at 1 min reported using both quantitative and categorical variables were lower in the remifentanil group than in the dexmedetomidine group but TSA showed that these differences were inconclusive for categorical variables. Data for other outcomes were scarce and did not allow any conclusions to be drawn. Thus, further studies with larger numbers of parturients and with neonatal outcomes as a primary endpoint are warranted to clarify the effects of intravenous dexmedetomidine and remifentanil.

TRIAL REGISTRATION

The protocol of this study has been registered in PROSPERO (CRD42019141102).
Time trends in the relation between blood pressure and dementia in 85-year-olds
Authors: Ribbe Mats , Kern Silke , Wetterberg Hanna , Rydén Lina , Zettergren Anna , Guo Xinxin , Skoog Ingmar
Published: June 2021

Objectives:

Blood pressure has decreased in the general population. We aimed to examine whether this is true also among the very old, and among persons with and without dementia. Further, we aimed to investigate how common undetected and untreated hypertension is in the very old, both among people with and without dementia.

Method:

Blood pressure was measured in representative population samples of 85-year-olds living in Gothenburg, Sweden, examined 1986–1987 (n = 484) and 2008–2010 (n = 571). Dementia was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, edition 3 revised, by the same medical doctor at both examinations.

Results:

Both systolic and diastolic blood pressure were lower in 85-year-olds examined 2008–2010 than in those examined 1986–1987, both among those with and without dementia. Participants with dementia had lower systolic blood pressure than those without dementia in both cohorts, and blood pressure levels related to dementia severity. Despite this, hypertension (≥140/90 mmHg) was found in almost half (46.5%) of those with dementia in 2008–2010.

Conclusion:

Our findings show that time-trends of lower blood pressure in western populations also applies to the very old, and that individuals with dementia continue to have lower blood pressure compared to the rest of the population. The latter finding suggests that the pathophysiological processes in dementia affect blood pressure regulating regions in the brain independent of time trends. Still, hypertension is common in dementia and needs to be detected and treated.
Effects of hormone replacement therapy on endothelial function, arterial stiffness and myocardial deformation in women with Turner syndrome
Authors: Peppa Melpomeni , Pavlidis George , Mavroeidi Ioanna , Katogiannis Konstantinos , Varoudi Maria , Thymis John , Kostelli Gavriella , Vlastos Dimitrios , Plotas Panagiotis , Bamias Aristotelis , Parissis John , Ikonomidis Ignatios
Published: June 2021

Objectives:

Turner syndrome (TS) is associated with increased cardiovascular risk. We investigated whether hormone replacement therapy (HRT) affects endothelial function, arterial stiffness and myocardial deformation in women with TS.

Methods:

Twenty-five women with TS were studied in the estrogen phase of the HRT and two months after discontinuation of HRT. The following measurements were made: flow-mediated dilation (FMD) of the brachial artery, pulse wave velocity (PWV-Complior) and central systolic blood pressure (cSBP), carotid intima-media thickness (cIMT), aortic (Ao) elastic indexes – namely Ao strain, distensibility, stiffness index and pressure strain modulus (E
p) – and left ventricular (LV) global longitudinal strain (GLS) using speckle-tracking echocardiography. Ten healthy female of similar age and BMI served as a control group.

Results:

Compared to controls, women with TS on HRT had higher PWV (9.1 ± 2.4 vs. 7.5 ± 0.5 m/s), cSBP (130 ± 15 vs. 121 ± 6 mmHg), cIMT (0.66 ± 0.06 vs. 0.55 ± 0.05 mm), aortic stiffness index, E
p and LA strain, and lower FMD (7.2 ± 4 vs. 10.5 ± 2.3%), Ao strain, Ao distensibility and GLS (−18.8 ± 2.7 vs. −21.9 ± 1.5%) (P < 0.05 for all comparisons). Two months after discontinuation of HRT, all women increased FMD (11.7 ± 6 vs. 7.2 ± 4%) and reduced PWV (7.8 ± 1.7 vs. 9.1 ± 2.4 m/s) and cSBP (123 ± 14 vs. 130 ± 15 mmHg). There were no statistically significant changes in BMI, cIMT and GLS (P > 0.05 for all comparisons). The percentage decrease of cSBP was associated with the percentage decrease of PWV (r = 0.54) and reversely related with the percentage increase of FMD (r = −0.57; P < 0.05 for all comparisons).

Conclusions:

HRT in women with TS may deteriorate endothelial function contributing to increased arterial stiffness and central arterial blood pressure.
Synergistic harmful interaction between sustained physical inactivity and hypertension/diabetes mellitus on the risk of all-cause mortality: a retrospective observational cohort study
Authors: Lee Chang-Hoon , Han Kyung-Do , Yoo Juhwan , Kwak Min-Sun
Published: June 2021

Objective:

Hypertension, diabetes mellitus and physical inactivity can cause cardiovascular complications or premature death. However, it has not been clarified whether those major comorbidities and physical activity interact in affecting health outcomes. The aim of this study is to evaluate the potential interaction between temporal physical activity profiles and hypertension or diabetes mellitus on the risk for all-cause mortality.

Methods:

This study used Korea National Health Insurance Service (KNHIS) database and included about 6.5 million participants who underwent health screening in 2009 and 2011. Physical activity was evaluated as 2-year change based on self-reported survey using 7-day recall method, and grouped as remained active, inactive-to-active, active-to-inactive, or remained inactive. Participants were categorized into groups according to the presence of hypertension/diabetes mellitus. Outcome included all-cause mortality.

Results:

In total, 6 554 082 participants (48.4 ± 13.3 years; 56.7% men) were included. During a median 6.4-year follow-up, 83 241 deaths occurred. Compared with the ‘remained active’ group, other groups had a higher mortality risk after adjustment for covariates [adjusted hazard ratio (aHR) 1.17, 95% CI 1.13–1.21 in the ‘inactive-to-active’ group, aHR 1.28, 95% CI 1.24–1.32 in the ‘active-to-inactive’ group, aHR 1.52, 95% CI 1.48–1.57 in the ‘remained inactive’ group). Hypertension and diabetes mellitus were significant effect modifiers in the association between physical activity and the risk of all-cause mortality (P for interaction <0.001). The harmful effects of persistent physical inactivity on all-cause mortality were the most obvious in those with both hypertension and diabetes mellitus among groups.

Conclusion:

Sustained physical inactivity was associated with increased risk of all-cause mortality in those with hypertension or diabetes mellitus more strongly than in those without. Physicians should emphasize sustained physical activity even more in patients with hypertension or diabetes mellitus.
Hypertension and heart failure with preserved ejection fraction: position paper by the European Society of Hypertension
Authors: Kasiakogias Alexandros , Rosei Enrico Agabiti , Camafort Miguel , Ehret Georg , Faconti Luca , Ferreira João Pedro , Brguljan Jana , Januszewicz Andrzej , Kahan Thomas , Manolis Athanasios , Tsioufis Konstantinos , Weber Thomas , von Lueder Thomas G. , Smiseth Otto A. , Wachtell Kristian , Kjeldsen Sverre E. , Zannad Faiez , Mancia Giuseppe , Kreutz Reinhold
Published: June 2021

Hypertension constitutes a major risk factor for heart failure with preserved ejection fraction (HFpEF). HFpEF is a prevalent clinical syndrome with increased cardiovascular morbidity and mortality. Specific guideline-directed medical therapy (GDMT) for HFpEF is not established due to lack of positive outcome data from randomized controlled trials (RCTs) and limitations of available studies. Although available evidence is limited, control of blood pressure (BP) is widely regarded as central to the prevention and clinical care in HFpEF. Thus, in current guidelines including the 2018 European Society of Cardiology (ESC) and European Society of Hypertension (ESH) Guidelines, blockade of the renin-angiotensin system (RAS) with either angiotensin-converting enzyme inhibitors or angiotensin receptor blockers provides the backbone of BP-lowering therapy in hypertensive patients. Although superiority of RAS blockers has not been clearly shown in dedicated RCTs designed for HFpEF, we propose that this core drug treatment strategy is also applicable for hypertensive patients with HFpEF with the addition of some modifications. The latter apply to the use of spironolactone apart from the treatment of resistant hypertension and the use of the angiotensin receptor neprilysin inhibitor. In addition, novel agents such as sodium-glucose co-transporter-2 inhibitors, currently already indicated for high-risk patients with diabetes to reduce heart failure hospitalizations, and finerenone represent promising therapies and results from ongoing RCTs are eagerly awaited. The development of an effective and practical classification of HFpEF phenotypes and GDMT through dedicated high-quality RCTs are major unmet needs in hypertension research and calls for action.
Blood pressure in adults with cerebral palsy: a systematic review and meta-analysis of individual participant data
Authors: Noten Suzie , van den Berg-Emons Rita J.G. , Thorpe Deborah E. , Heyn Patricia C. , Marciniak Christina M. , McPhee Patrick G. , Lamberts Robert P. , Langerak Nelleke G. , Verschuren Olaf , Salokivi Tommi , Morrison Katherine M. , Peterson Mark D. , Limsakul Chonnanid , Stam Henk J. , Papageorgiou Grigorios , Versmissen Jorie , Van Der Slot Wilma M.A.
Published: June 2021

Objectives:

This systematic review and meta-analysis was designed to determine the overall mean blood pressure and prevalence of hypertension among a representative sample of adults living with cerebral palsy by combining individual participant data. Additional objectives included estimating variations between subgroups and investigating potential risk factors for hypertension.

Methods:

Potential datasets were identified by literature searches for studies published between January 2000 and November 2017 and by experts in the field. Samples of adults with cerebral palsy (n ≥ 10, age ≥ 18 years) were included if blood pressure data, cerebral palsy-related factors (e.g. cerebral palsy subtype), and sociodemographic variables (e.g. age, sex) were available. Hypertension was defined as at least 140/90 mmHg and/or use of antihypertensive medication.

Results:

We included data from 11 international cohorts representing 444 adults with cerebral palsy [median (IQR) age of the sample was 29.0 (23.0–38.0); 51% men; 89% spastic type; Gross Motor Function Classification System levels I–V]. Overall mean SBP was 124.9 mmHg [95% confidence interval (CI) 121.7–128.1] and overall mean DBP was 79.9 mmHg (95% CI 77.2–82.5). Overall prevalence of hypertension was 28.7% (95% CI 18.8–39.8%). Subgroup analysis indicated higher blood pressure levels or higher prevalence of hypertension in adults with cerebral palsy above 40 years of age, men, those with spastic cerebral palsy or those who lived in Africa. BMI, resting heart rate and alcohol consumption were risk factors that were associated with blood pressure or hypertension.

Conclusion:

Our findings underscore the importance of clinical screening for blood pressure in individuals with cerebral palsy beginning in young adulthood.
Guidelines for the diagnosis and treatment of pancreatic cancer in China (2021)
Authors: Yang Yinmo , Bai Xueli , Bian Dapeng , Cai Shouwang , Chen Rufu , Cao Feng , Dai Menghua , Fang Chihua , Fu Deliang , Ge Chunlin , Guo Xiaochao , Hao Chunyi , Hao Jihui , Huang Heguang , Jian Zhixiang , Jin Gang , Li Fei , Li Haimin , Li Shengping , Li Weiqin , Li Yixiong , Li Hongzhen , Liang Tingbo , Liu Xubao , Lou Wenhui , Miao Yi , Mou Yiping , Peng Chenghong , Qin Renyi , Shao Chenghao , Sun Bei , Tan Guang , Tian Xiaodong , Wang Huaizhi , Wang Lei , Wang Wei , Wang Weilin , Wei Junmin , Wu Heshui , Wu Wenming , Wu Zheng , Xu Jingyong , Yan Changqing , Yin Xiaoyu , Yu Xianjun , Yuan Chunhui , Zhang Taiping , Zhang Jixin , Zhou Jun , Zhao Yupei
Published: June 2021

The incidence of pancreatic cancer has been rising worldwide, and its clinical diagnosis and treatment remain a great challenge. To present the update and improvements in the clinical diagnosis and treatment of pancreatic cancer in recent years, Chinese Pancreatic Association, the Chinese Society of Surgery, Chinese Medical Association revised the Guidelines for the Diagnosis and Treatment of Pancreatic Cancer in China (2014) after reviewing evidence-based and problem-oriented literature published during 2015–2021, mainly focusing on highlight issues regarding diagnosis and surgical treatment of pancreatic cancer, conversion strategies for locally advanced pancreatic cancer, treatment of pancreatic cancer with oligo metastasis, adjuvant and neoadjuvant therapy, standardized processing of surgical specimens and evaluation of surgical margin status, systemic treatment for unresectable pancreatic cancer, genetic testing, as well as postoperative follow up of patients with pancreatic cancer. Forty recommendation items were finally proposed based on the above issues, and the quality of evidence and strength of recommendations were graded using the Grades of Recommendation, Assessment, Development, and Evaluation system. This guideline aims to standardize the clinical diagnosis and therapy, especially surgical treatment of pancreatic cancer in China, and further improve the prognosis of patients with pancreatic cancer.
Hereditary factor V deficiency from heterozygous mutations with a novel variant p.Pro798Leufs∗13 in the F5 gene
Authors: Deng Yuping , Zhu Jiajin , Gong Yuxiang , Yi Xiaoqing , Zhou Liyan , Xie Yaosheng , Wang Mingshan , Wu Wenhe
Published: June 2021

To explore the causative mutation for autosomal recessive inheritance factor V (FV) deficiency in a Chinese family. Relative coagulation indexes and the FV antigen were tested by the one-stage clotting method and ELISA, respectively. At the same time, the calibrated automated thrombogram (CAT) was used to analyze the mutant protein function. All 25 exons, flanking sequences, 5′ and 3′ untranslated regions of the F5 were amplified by PCR and sequenced directly, while each suspected variant was verified by reverse sequencing. The possible impact of the mutant was analyzed by the corresponding bioinformatics software. The phenotypic tests showed that the proband's FV activity has decreased to 24%, whereas the FV antigen has also reduced to 28%. The genetic analysis revealed that she was a compound heterozygote for a frameshift variant from small deletion in the exon 13 (c.2390_2390delC, p.Pro798Leufs∗13) and a missense mutation in the exon 25 (c.6665A>G, p.Asp2222Gly). Meanwhile, the online bioinformatics software indicated that the frameshift variant was disease-causing. The pathogenic variant p.Pro798Leufs∗13 and the benign variant p.Asp2222Gly largely account for the decrease of the FV deficiency in this Chinese family, of which the pathogenic variant is firstly reported in the world.
Genetic evaluation in children with short stature
Authors: Zhou Elaine , Hauser Benjamin Roland , Jee Youn Hee
Published: June 2021

Purpose of review

Short stature is a common clinical manifestation in children. Yet, a cause is often unidentifiable in the majority of children with short stature by a routine screening approach. The purpose of this review is to describe the optimal genetic approach for evaluating short stature, challenges of genetic testing, and recent advances in genetic testing for short stature.

Recent findings

Genetic testing, such as karyotype, chromosomal microarray, targeted gene sequencing, or exome sequencing, has served to identify the underlying genetic causes of short stature. When determining which short stature patient would benefit from genetic evaluation, it is important to consider whether the patient would have a single identifiable genetic cause. Specific diagnoses permit clinicians to predict responses to growth hormone treatment, to understand the phenotypic spectrum, and to understand any associated co-morbidities.

The continued progress in the field of genetics and enhanced capabilities provided by genetic testing methods expands the ability of physicians to evaluate children with short stature for underlying genetic defects. Continued effort is needed to elaborate new genetic causes of linear growth disorders, therefore, we expand the list of known genes for short stature, which will subsequently increase the rate of genetic diagnosis for children with short stature.
Pancreas Academy
Authors: Han Samuel , Akshintala Venkata S. , Coté Gregory A. , Abu-El-Haija Maisam ,   on behalf of the Collaborative Alliance for Pancreatic Education and Research
Published: June 2021

The Collaborative Alliance for Pancreatic Education and Research developed Pancreas Academy as a lecture-based conference with the goal of providing practical guidance in the diagnosis and management of pancreatic diseases for health care providers. Since its inception in 2017, attendance at Pancreas Academy has steadily grown every year, with trainees accounting for the largest proportion of attendees. The proportion of advanced practice providers and pediatric specialists attending the conference, although relatively low, has also risen each year. Despite the growth in the conference, this report highlights the need for continued outreach to primary care providers, nonphysicians, and nongastroenterologists to provide health care providers at all levels pragmatic and essential knowledge in caring for patients with pancreatic diseases.
Cotard Syndrome in an Adolescent With a First Episode of Psychosis
Authors: MCGREAL ANALISE E. , BOLES MATTHEW K. , BOYANCHEK IVETA
Published: June 2021

This case report describes a unique presentation of Cotard syndrome in an 18-year-old female patient experiencing first-episode psychosis. Cotard syndrome was first described in 1880 by Jules Cotard as a novel subtype of anxious depression and is presently understood as a rare cluster of mood and psychotic symptoms centered on nihilistic delusions including the absence of organs and a perception of being dead. Although rare, Cotard syndrome has been described in a variety of neurological and psychiatric illnesses, but it is most commonly seen in middle-aged adults with a history of chronic mood disorders. It is rarely reported in childhood or adolescence, and it has not previously been described in first-episode psychosis. This report describes a unique presentation of full Cotard syndrome in an adolescent patient experiencing first-episode psychosis without reported mood symptoms. The patient displayed limited improvement over the first week of treatment with quetiapine but improved rapidly during the second week of hospitalization after a medication change to risperidone. The patient’s rapid response to risperidone is unique, as most existing evidence suggests that electroconvulsive therapy is the most effective treatment for Cotard syndrome. This response indicates an opportunity for the implementation of a second-generation antipsychotic medication in patients with Cotard syndrome in areas where electroconvulsive therapy is not available.
Data Analysis of Plastic Surgery Instrument Trays Yields Significant Cost Savings and Efficiency Gains
Authors: Wood Benjamin C. , Konchan Sarah , Gay Samuel , Rath Sandeep , Deshpande Vinayak , Knowles Martyn
Published: June 2021

Purpose

Inpatient surgery costs have risen 30% over the past 5 years, and the operating room accounts for up to 60% of total hospital operational expense. On average, only 13.0% to 21.9% of instruments opened for a case are used, contributing to significant avoidable reprocessing, repurchase, and labor expense.

Methods

A comprehensive review of 40 major instrument trays at UNC Rex Hospital was conducted using a technology service (OpFlow; Operative Flow Technologies, Raleigh, NC). Among the full scope of the project, the general plastics tray and breast reconstruction tray were evaluated for the plastic surgery service line over a 3-month period. Intraoperative data collection was performed on the exact instruments used across a standard breadth of cases. Data analytics were conducted stratifying instrument usage concordance among surgeons by tray and procedure type. After a surgeon-led review of the proposed new tray configurations, the optimized versions were implemented via a methodical change management process.

Results

A total of 183 plastic surgery cases were evaluated across 17 primary surgeons. On average, the instrument usage per tray was 15.8% for the general plastics tray and 23.5% for the breast reconstruction tray. After stakeholder review, 32 (45.1%) of 71 instruments were removed from the general plastics tray and 40 (36.7%) of 109 were removed from the breast reconstruction tray, resulting in a total reduction of 2652 instruments. This resulted in a decrease of 81,696 instrument sterilization cycles annually. The removal of the instruments yielded an estimated cost avoidance of US $163,800 for instrument repurchase and US $69,441 in annual resterilization savings. The instrument volume reduction is projected to save 383.5 hours of sterile processing personnel time in tray assembly annually.

Conclusions

An analytics-driven method applying empirical data on actual case-based instrument usage has implications for better efficiency, improved quality, and cost avoidance related to instrument repurchase and sterile processing. Given increasing cost constraints and the transition to value-based care models, leveraging a technology-based solution enables meaningful change in the sterile processing department as a source for cost reduction and quality of care improvement.
Objective Analysis of Fronto-Orbital Dysmorphology in Unilateral Coronal Craniosynostosis
Authors: Dvoracek Lucas A. , Bykowski Michael R. , Foglio Aaron , Ayyash Ali , Pfaff Miles J. , Losee Joseph E. , Goldstein Jesse A.
Published: June 2021

Correction (and over-correction) of asymmetries of the orbital shape and brow position in unilateral coronal craniosynostosis (UCS) is critical to successful fronto-orbital advancement. Here we quantify and three-dimensionally assess fronto-orbital irregularities in UCS patients compared to controls.

Twenty-three patients with UCS evaluated at the Children's Hospital of Pittsburgh between 2006 and 2016 were age and gender-matched to controls. Computed tomography scans were reconstructed and evaluated for orbital metrics. A three-dimensional heat map of orbital regions was generated and evaluated for shape differences.

Brow protrusion of the orbit ipsilateral to the synostotic suture did not differ significantly from healthy controls. Orbital height was significantly increased while orbital width was decreased on the UCS ipsilateral side compared to the contralateral side and controls. The ipsilateral cornea was overprojected relative to the brow and the infraorbital rim, but similar to controls relative to the lateral rim. The contralateral orbit had increased brow protrusion with decreased orbital height. The cornea was underprojected relative to the brow, but overprojected relative to the lateral orbital rim and similar to controls at the infraorbital rim. Three-dimensional comparison demonstrated significant overprojection of the contralateral brow, with some more mild and inconsistent underprojection of the lateral aspect of the ipsilateral brow.

Key orbital and brow differences exist between the affected and unaffected sides in UCS. This study provides quantitative data that further characterize the orbital dysmorphology observed in UCS and identifies unique aspects of the diagnosis that should be taken into consideration during surgical planning.
Acute Care Utilization and Costs Up to 4 Years After Index Sleeve Gastrectomy or Roux-en-Y Gastric Bypass
Authors: Callaway Kim Katherine , Argetsinger Stephanie , Wharam James Frank , Zhang Fang , Arterburn David E. , Fernandez Adolfo , Ross-Degnan Dennis , Wallace Jamie , Lewis Kristina H.
Published: June 2021

Objective:

To compare acute care utilization and costs following sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).

Summary Background Data:

Comparing postbariatric emergency department (ED) and inpatient care use patterns could assist with procedure choice and provide insights about complication risk.

Methods:

We used a national insurance claims database to identify adults undergoing SG and RYGB between 2008 and 2016. Patients were matched on age, sex, calendar-time, diabetes, and baseline acute care use. We used adjusted Cox proportional hazards to compare acute care utilization and 2-part logistic regression models to compare annual associated costs (odds of any cost, and odds of high costs, defined as ≥80th percentile), between SG and RYGB, overall and within several clinical categories.

Results:

The matched cohort included 4263 SG and 4520 RYGB patients. Up to 4 years after surgery, SG patients had slightly lower risk of ED visits [adjusted hazard ratio (aHR): 0.90; 95% confidence interval (CI): 0.85,0.96] and inpatient stays (aHR: 0.80; 95% CI: 0.73,0.88), especially for events associated with digestive-system diagnoses (ED aHR: 0.68; 95% CI: 0.62,0.75; inpatient aHR: 0.61; 95% CI: 0.53,0.72). SG patients also had lower odds of high ED and high total acute costs (eg, year-1 acute costs adjusted odds ratio (aOR) 0.77; 95% CI: 0.66,0.90) in early follow-up. However, observed cost differences decreased by years 3 and 4 (eg, year-4 acute care costs aOR 1.10; 95% CI: 0.92,1.31).

Conclusions:

SG may have fewer complications requiring emergency care and hospitalization, especially as related to digestive system disease. However, any acute care cost advantages of SG may wane over time.
LB100 attenuates methamphetamine-induced behavioral sensitization by inhibiting the Raf1-ERK 1/2 cascade in the caudate putamen
Authors: Shang Qing , Liang Min , Xiao Jing , Gao Baoyao , Qian Hongyan , Wang Jing , Chen Gang , Fang Jie , Li Tao , Liu Xinshe
Published: June 2021

Methamphetamine (METH) abuse has become a serious social problem. Behavioral sensitization is a common behavioral paradigm used to study the neurobiological mechanism that underlies drug addiction. Our previous study demonstrated that the activity of protein phosphatase 2A (PP2A) and the level of phosphorylated extracellular signal-related kinase 1/2 (p-ERK 1/2) are increased in the caudate putamen (CPu) of METH-sensitive mice. However, the relationship between PP2A and ERK 1/2 in METH-induced behavioral sensitization remains unknown. Some studies have indicated that Raf1 may be involved in this process. In this study, LB100, a PP2A inhibitor for treating solid tumors, was first used to clarify the relationship between PP2A and ERK 1/2. In addition, Western blot was used to examine the levels of p-Raf1 (Ser 259) and p-ERK 1/2 (Thr 202/Tyr 204) in the CPu, hippocampus (Hip) and nucleus accumbens (NAc). Our results showed that 2 mg/kg LB100 significantly attenuated METH-induced behavioral sensitization. Furthermore, Western blot analysis revealed that pretreatment with 2 mg/kg LB100 remarkably reversed METH-induced reduction of p-Raf1, as well as upregulation of p-ERK 1/2 in the CPu. Taken together, these results indicate that PP2A plays an important role in METH-induced behavioral sensitization and phosphorylates ERK 1/2 by dephosphorylating p-Raf1 in the CPu to further regulate METH-induced behavioral sensitization.
Precise oculocentric mapping of transcranial magnetic stimulation-evoked phosphenes
Authors: Silva Andrew E. , Tsang Katelyn , Hasan Syeda Javeria , Thompson Benjamin
Published: June 2021

Objective

Transcranial magnetic stimulation (TMS)–evoked phosphenes are oculocentric; their perceived location depends upon eye position. We investigated the accuracy and precision of TMS-evoked phosphene oculocentric mapping.

Methods

We evoked central phosphenes by stimulating early visual cortical areas with TMS, systematically examining the effect of eye position by asking participants to report the location of the evoked phosphene. We tested whether any systematic differences in the precision or accuracy of responses occurred as a function of eye position.

Results

Perceived phosphene locations map veridically to eye position, although there are considerable individual differences in the reliability of this mapping.

Conclusions

Our results emphasize the need to carefully control eye movements when carrying out phosphene localization studies and suggest that individual differences in the reliability of the reported position of individual phosphenes must be considered.
Mining genome traits that determine the different gut colonization potential of Lactobacillus and Bifidobacterium species
Authors: Xiao Yue , Zhao Jianxin , Zhang Hao , Zhai Qixiao , Chen Wei
Published: June 2021

Although the beneficial effects of probiotics are likely to be associated with their ability to colonize the gut, little is known about the characteristics of good colonizers. In a systematic analysis of the comparative genomics, we tried to elucidate the genomic contents that account for the distinct host adaptability patterns of

Lactobacillus

and

Bifidobacterium

species. The

Bifidobacterium

species, with species-level phylogenetic structures affected by recombination among strains, broad mucin-foraging activity, and dietary-fibre-degrading ability, represented niche conservatism and tended to be host-adapted. The

Lactobacillus

species stretched across three lifestyles, namely free-living, nomadic and host-adapted, as characterized by the variations of bacterial occurrence time, guanine–cytosine (GC) content and genome size, evolution event frequency, and the presence of human-adapted bacterial genes. The numbers and activity of host-adapted factors, such as bile salt hydrolase and intestinal tissue-anchored elements, were distinctly distributed among the three lifestyles. The strains of the three lifestyles could be separated with such a collection of colonization-related genomic content (genes, genome size and GC content). Thus, our work provided valuable information for rational selection and gut engraftment prediction of probiotics. Here, we have found many interesting predictive results for bacterial gut fitness, which will be validated in vitro and in vivo.
gbpA and chiA genes are not uniformly distributed amongst diverse Vibrio cholerae
Authors: Fennell Thea G. , Blackwell Grace A. , Thomson Nicholas R. , Dorman Matthew J.
Published: June 2021

Members of the bacterial genus

Vibrio

utilize chitin both as a metabolic substrate and a signal to activate natural competence.

Vibrio cholerae

is a bacterial enteric pathogen, sub-lineages of which can cause pandemic cholera. However, the chitin metabolic pathway in

V. cholerae

has been dissected using only a limited number of laboratory strains of this species. Here, we survey the complement of key chitin metabolism genes amongst 195 diverse

V. cholerae

. We show that the gene encoding GbpA, known to be an important colonization and virulence factor in pandemic isolates, is not ubiquitous amongst

V. cholerae

. We also identify a putatively novel chitinase, and present experimental evidence in support of its functionality. Our data indicate that the chitin metabolic pathway within

V. cholerae

is more complex than previously thought, and emphasize the importance of considering genes and functions in the context of a species in its entirety, rather than simply relying on traditional reference strains.