bluuebunny/crossref_metadata_2025 huggingface dataset:
Iodine supplementation: is there a need?
Authors: Ley Delphine , Turck Dominique
Published: February 2021

Purpose of review

To review the recent data on iodine deficiency, the impact of iodine deficiency on health outcomes and the need for iodine supplementation in at-risk populations, that is, pregnant and lactating women, infants and young children.

Recent findings

The 2019 Iodine Global Network Annual Report highlighted that only 23 countries worldwide (including Finland, Germany, and Norway in Europe) were classified as having insufficient iodine intake in 2019, down from 54 in 2003 and 113 in 1993. Even if severe iodine deficiency during pregnancy has a negative impact on cognitive outcomes later in life, the consequences of mild-to-moderate iodine deficiency on child neurodevelopment are controversial. Two 2017 and 2019 Cochrane Systematic Reviews found no evidence that iodine supplementation in women before, during or after pregnancy improved infant and child cognitive development in areas with mild-to-moderate iodine deficiency. Likewise, a 2019 Cochrane systematic review concluded that there was no evidence of a positive impact of iodine supplementation on morbidity, including cognitive impairment, and mortality in preterm infants.

There is no scientific evidence to support generalized iodine supplementation in mildly to moderately deficient settings not only in pregnant and lactating women but also in infants, either preterm or term, and in young children.
Should we prescribe anticonvulsants for acute herpes zoster neuralgia and to prevent postherpetic neuralgia?
Authors: Lu Yanqing , Liu Kun , Liang Yanchang , Zhang Xi , Liu Yue , Huang Fan , Gao Haili , Zhuang Lixing
Published: February 2021

Background:

Herpes zoster-associated pain [i.e., acute herpes zoster neuralgia (AHN) and postherpetic neuralgia (PHN)] has the potential to cause significant patients’ burden and heath resource expenditure. PHN is refractory to the existing treatments, and the consensus is preventing the transition of AHN to PHN is better than treating PHN. Anticonvulsants (e.g., gabapentin, pregabalin) have been recommended as one of the first-line therapies for PHN. In practice, anticonvulsants have also decreased the severity and duration of AHN and reduced the incidence of PHN. Nevertheless, its clinical application to AHN is hampered by inadequate evidence for its efficacy and safety. We performed this protocol for a systematic review to explore the efficacy and safety of anticonvulsants for AHN. Besides, a benefit-risk assessment of anticonvulsants for AHN would be performed to estimate the extent to which these drugs could relieve symptoms and whether the benefits outweigh harms.

Methods:

The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) was used to prepare our protocol and the results will be reported according to the PRISMA. We will search the China National Knowledge Infrastructure (CNKI), Chinese VIP Information (VIP), Cochrane Library, Embase, and PubMed databases, from inception to August 2019. Furthermore, Clinicaltrials (http://www.clinicaltrials.com) and Chinese Clinical Trial Registry (http://www.chictr.org.cn/abouten.aspx) will also be searched for relevant studies. Selection of eligible articles and data extraction will be independently performed by reviewers. We will record the characteristic information, pain outcomes, incidence of PHN and adverse effects. Data synthesis and other statistical analyses will be conducted using Review Manager Software 5.3 and STATA13.0. Furthermore, risk of bias assessment, meta-regression and subgroup analyses, publication bias assessment, grading of evidence will be performed for included studies.

Ethics and dissemination:

As this systematic review will be performed based on published data, no ethical approval is needed. The findings will be submitted in peer-reviewed journals for publication.

Systematic review registration:

PROSPERO CRD42019133449.
The timing of last hemodialysis influences the prognostic value of serum lactate levels in predicting mortality of end-stage renal disease patients with sepsis in the emergency department
Authors: Chu Chun Chieh , Su Chih Min , Chen Fu Cheng , Cheng Chi Yung , Cheng Hsien Hung , Te Kung Chia
Published: February 2021

Sepsis is a life-threatening condition, and serum lactate levels have been used to predict patient prognosis. Studies on serum lactate levels in patients undergoing regular hemodialysis who have sepsis are limited. This study aimed to determine the predictive value of serum lactate levels for sepsis-related mortality among patients who underwent last hemodialysis at three different times before admission to the emergency department (ED).

This retrospective cohort study was conducted from January 2007 to December 2013 in southern Taiwan. All hemodialysis patients with sepsis, receiving antibiotics within 24 hours of sepsis confirmation, admitted for at least 3 days, and whose serum lactate levels were known were examined to determine the difference in the serum lactate levels of patients who underwent last hemodialysis within 4 hours (Groups A), in 4–12 hours (Group B), and beyond 12 hours (Group C) before visited to the ED. All the continuous variables, categorical variables and mortality were compared by using Kruskal-Wallis test or Mann-Whitney test, the χ2 or Fisher exact tests, and multiple logistic regression model, respectively.

A total of 490 patients were enrolled in the study, and 8.0% (39), 21.5% (84), and 74.9% (367) of the patients were in Group A, Group B and Group C, respectively; the serum lactate levels (2.91 vs 2.13 vs 2.79 mmol/L, respectively; P = .175) and 28-day in-hospital mortality (17.9% vs 14.6% vs 22.9%) showed no statistically significant difference between 3 groups. The association between serum lactate levels and 28-day in-hospital mortality was reliable in Group B (P = .002) and Group C (P < .001), but it was unreliable in Group A (P = .629).

Serum lactate level has acceptable sensitivity in predicting 28-day in-hospital mortality among patients with sepsis who undergo last hemodialysis after 4 hours, but is not reliable when the last hemodialysis takes place within 4 hours.
Effectiveness and safety of acupuncture in the treatment of chronic severe functional constipation
Authors: Zhu Daocheng , Hu Jinyu , Chi Zhenhai , Ouyang Xilin , Xu Wei , Luo Zhaona , Cheng Chao , Wu Jiajia , Chen Rixin , Jiao Lin
Published: February 2021

Background:

Acupuncture has been widely used clinically to relieve chronic severe constipation. However, the efficacy of acupuncture in the treatment of chronic severe constipation is uncertain. The purpose of this study is to determine the effectiveness and safety of acupuncture in the treatment of chronic severe constipation.

Methods:

Search PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure Database, Wanfang Database, China Science, and Technology Journal Database, China Biomedical Literature Database, and search related randomized controlled trials. Two reviewers will independently select studies, collect data, and evaluate methodological quality through the Cochrane Deviation Risk Tool. Revman V.5.3 will be used for meta-analysis.

Results:

This study will evaluate the current status of acupuncture treatment for chronic severe constipation, aiming to illustrate the effectiveness and safety of acupuncture treatment.

Conclusion:

This study will provide a basis for judging whether acupotomy is effective in treating chronic severe constipation.

INPLASY registration number:

INPLASY202070002
Analytical evaluation of serum non–transferrin-bound iron and its relationships with oxidative stress and cardiac load in the general population
Authors: Sugiura Tomonori , Dohi Yasuaki , Takase Hiroyuki , Fujii Satoshi , Seo Yoshihiro , Ohte Nobuyuki
Published: February 2021

Excessive iron accumulation provokes toxic effects, especially in the cardiovascular system. Under iron overload, labile free non–transferrin-bound iron (NTBI) can induce cardiovascular damage with increased oxidative stress. However, the significance of NTBI in individuals without iron overload and overt cardiovascular disease has not been investigated. We aimed to examine the distribution of serum NTBI and its relationship with oxidative stress and cardiac load under physiological conditions in the general population.

We enrolled individuals undergoing an annual health check-up and measured serum NTBI and derivatives of reactive oxygen metabolites (d-ROM), an oxidative stress marker. In addition, we evaluated serum levels of B-type natriuretic peptide (BNP) to examine cardiac load. We excluded patients with anemia, renal dysfunction, cancer, active inflammatory disease, or a history of cardiovascular disease.

A total of 1244 individuals (57.8 ± 11.8 years) were enrolled, all of whom had detectable serum NTBI. d-ROM and BNP showed significant trends across NTBI quartiles. Multivariable regression analysis revealed that serum iron and low-density lipoprotein cholesterol were positively associated with NTBI but that age, d-ROM, and BNP showed an inverse association with this measure. In logistic regression analysis, NTBI was independently associated with a combination of higher levels of both d-ROM and BNP than the upper quartiles after adjustment for possible confounding factors.

Serum NTBI concentration is detectable in the general population and shows significant inverse associations with oxidative stress and cardiac load. These findings indicate that serum NTBI in physiological conditions does not necessarily reflect increased oxidative stress, in contrast to the implications of higher levels in states of iron overload or pathological conditions.
Clinical efficacy and safety of Shuxuetong injection for acute myocardial infarction
Authors: Yu Feng , Xin Mengxue , Huang Na , Zhang Taotao , Lu JianHui , Liu Nan
Published: February 2021

Background:

Shuxuetong injection (SXT) is a Chinese medicine injection and has been widely used for the treatment of acute myocardial infarction (AMI) in Asia. However, whether SXT has a definite efficacy and safety is poorly understood. The aim of our study was to clarify the effect of SXT on clinical symptoms alliavation and survival in AMI patients.

Methods:

A systematic reviews of SXT combined with conventional therapy treating AMI will be searched in 8 electronic databases including PubMed, Cochrane Library, Embase, Wanfang Database, China Biology Medicine (CBM), Google Scholar, Chinese Scientific Journal Database (VIP), and China National Knowledge Infrastructure (CNKI), from inception to December 2020. The literature will extracted by 2 researchers independently and the methodological quality of the included study will be evaluated. We will use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to evaluate the evidence quality of the included literature. RevMan software (version 5.3) will be applied for the original research data synthesis.

Results:

The results of our study will be published in a peer reviewed journal.

Conclusion:

Our meta-analysis will provide the latest evidence to determine whether SXT is an effective intervention for AMI patients.
Choroidal neovascularization secondary to half-dose photodynamic therapy for chronic central serous chorioretinopathy
Authors: Zhang Zhengwei , Bao Xiaona , Wu Zhifeng , Zhang Jie
Published: February 2021

Rationale:

Half-dose or reduced-fluence photodynamic therapy (PDT) with verteporfin has been well acknowledged to be the most effective and permanent treatment with very low rates of complications. However, we report a case of chronic central serous chorioretinopathy (CSC) who developed choroidal neovascularization (CNV) secondary to half-dose PDT within only 3 weeks. Such an occurrence following this short a course of treatment has not been reported previously.

Patient concerns:

A 46-year-old Chinese man who had been diagnosed as acute more than 1 year ago revisited our department recently and complained of blurred vision again in his left eye.

Diagnoses:

Fluorescein fundus angiography (FFA) and indocyanine green angiography (ICGA) revealed patchy hyperfluorescent dots and optical coherence tomography (OCT) indicated irregular flat pigment epithelium detachment (PED) in the central macula. The patient was diagnosed with chronic CSC.

Interventions:

The patient was treated by half-dose PDT with verteporfin. Three weeks later, the patient complained of sudden blurred vision and fundus examination showed macular hemorrhages with a best-corrected visual acuity (BCVA) of 20/250. OCT angiography (OCTA) showed a distinct area of flower-like CNV located within the deep retinal slab. Secondary CNV had developed after a quite short course of half-dose PDT treatment. Subsequently, the patient was administered by 2 intravitreal injections of aflibercept (2 mg).

Outcomes:

Two months after the second intravitreal injection, macular hemorrhages and secondary CNV were completely resolved, and the BCVA improved to 20/25.

Lessons:

Patients of chronic CSC with irregular PED who undergo PDT should be warned of secondary CNV within a short course after treatment. If happened, it should be treated by intravitreal injections of anti-vascular endothelial growth factor agents as soon as possible.
Quality of life after intestinal transplantation
Authors: Solar Héctor , Ortega Mariana , Gondolesi Gabriel E.
Published: February 2021

Purpose of review

Intestinal transplantation (ITx) is the last therapeutic option in chronic intestinal failure (CIF) patients who develop life-threatening complication related to home parenteral nutrition (HPN). Improvement of quality of life (QoL) has been proposed as one of the nonconventional indications for ITx in these patients. This review aims to summarize the current evidence about QoL assessment in ITx recipients.

Recent findings

Several studies were conducted to determine QoL in ITx patients, with differences in the samples and instruments used to assess it. Patients evaluated for ITx had lower QoL than those on HPN without complications. QoL seems to improve in most psychological, emotional and social areas after a successful ITx, a trend that seems to increase over time. These results would support the rehabilitative role of ITx for patients with irreversible CIF and impossibility to continue receiving HPN.

Although QoL after ITx patients improved over time compared with life on HPN, the heterogeneity in the samples included in several studies, and the lack of validated assessment tools, hinder the possibility to draw conclusions about improvement of QoL after ITx.
What a Catch
Authors: Knipper Nora P. , DiCioccio Heather Condo , Albert Nancy M.
Published: February 2021

Background:

Parental fatigue rates after childbirth are high and may be associated with newborn drops that cause injury. Newborn drops and near-misses are potentially underreported due to parental embarrassment, shame, fear of reprisal, or guilt. Although newborn drops are rare, the leaders of mother–baby units need to enhance transparency of risk to assure a culture of safety.

Purpose:

To describe components and outcomes of the What A Catch program, aimed at preventing newborn drops and addressing near-misses.

Methods:

The What A Catch program was implemented in two hospital mother–baby units. The five components of the program included maintaining a respite nursery, using visual management, positively framing situational communication and actions after a near-miss, safe and appropriate staffing, and celebrating and transparently displaying program successes. Data were collected on near-miss event rates and caregivers and families provided postevent comments.

Results:

The perinatal team embraced the program at both sites. Of 9,578 live births over 1 year, 202 near-misses or good catches were documented. Program leaders revise display the board multiple times per week.

Clinical Implications:

Replication of this program is needed to determine if all five components are necessary to optimize a culture of safety. Future research may determine the scope of risk factors associated with newborn drops and near-misses, so that anticipated risk factors can be mitigated.
Biosafety of Sonography: Survey of Current Knowledge and Practice Patterns in Obstetrics Providers
Authors: Wasickanin Morgan , Lentscher Jessica , Foglia Lisa , Colburn Zachary , Estrada Sarah
Published: February 2021

(Abstracted from J Ultrasound Med 2020;39:1743–1751)

Ultrasound is used routinely in the field of obstetrics and has a high clinical utility for a number of reasons. Many people are unaware of the risks of sonography; however, there are 2 main risks associated with the use of ultrasound: diagnostic errors and biological effects.
Parental Attitudes Toward Clinical Genomic Sequencing in Children With Critical Cardiac Disease
Authors: Gal Dana B. , Deuitch Natalie , Lee Sandra Soo Jin , Simon Rosalie Tang , Char Danton S.
Published: February 2021

OBJECTIVES:

Through improving diagnostics and prognostics genomic sequencing promises to significantly impact clinical decisions for children with critical cardiac disease. Little is known about how families of children with critical cardiac disease perceive the impact of genomic sequencing on clinical care choices.

DESIGN:

Qualitative interview study.

SETTING:

A high-volume, tertiary pediatric heart center.

SUBJECTS:

Families of children with critical cardiac disease.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Thematic analysis of interview response content. Thirty-five families were interviewed. Three themes emerged: 1) benefits versus challenges of having genomic sequencing results, and 2) fears of clinical applications of genomic sequencing, and 3) nonclinical fears related to genomic sequencing. Participants struggled with perceived uses of genomic sequencing-derived knowledge. They described comfort in foreknowledge of their child’s likely disease course but articulated significant apprehension around participating in care decisions with limited knowledge of genomic sequencing, genomic sequencing uses to inform clinical resource rationing decisions, and genomic sequencing uses by third parties impacting financial pressures families experience caring for a child with critical cardiac disease.

CONCLUSIONS:

Families’ perceptions of genomic sequencing uses in critical cardiac disease appear to strain their overall trust in the health system. Erosion of trust is concerning because the potential of genomic sequencing in critical cardiac disease will be unrealized if families are unwilling to undergo genomic sequencing, let alone to participate in the ongoing research needed to link genomic sequencing variants to clinical outcomes. Our findings may have implications for genomic sequencing use in children with other critical, high-acuity diseases.
Longitudinal association between intimate partner violence and viral suppression during pregnancy and postpartum in South African women
Authors: Hatcher Abigail M. , Brittain Kirsty , Phillips Tamsin K. , Zerbe Allison , Abrams Elaine J. , Myer Landon
Published: February 2021

Objective:

We examined the longitudinal association between women's exposure to intimate partner violence (IPV) and HIV viral load during pregnancy and postpartum.

Design:

Secondary analysis of an HIV-positive cohort enrolled during pregnancy at a South African antenatal clinic.

Methods:

Viral load was assessed at 10 study visits and analyzed continuously as log10 copies/ml and suppression at less than 50 copies/ml. IPV was measured at three timepoints using behaviorally specific items. We used multivariate logistic regression to examine the association between IPV and viral suppression, and cross-lagged dynamic panel modeling (DPMs) to estimate the longitudinal association between IPV (lagged by 3–6 months) and log10 viral load.

Results:

Of 471 women, 84% were virally suppressed by 6 weeks postpartum and 67% at 12 months postpartum. One-third reported IPV exposure. IPV victimization was not associated with viral suppression at delivery, but was associated with a reduced odds of viral suppression at 12 months postpartum (aOR = 0.48, 95% CI = 0.27–0.85). Findings were robust to sensitivity analyses at different timepoints and clinical cut-points. In DPMs, lagged IPV exposure was associated with higher log10 viral load after controlling for past viral load, duration on ART, age, alcohol use, and gestation at study enrolment. Each standardized increase in IPV intensity was associated with higher log10 viral load (standardized coefficient = 0.12, 95% CI = 0.05–0.23).

Conclusion:

Although viral suppression was widely achieved during pregnancy, suppression rates declined postpartum in this South African cohort. These data suggest IPV is longitudinally associated with elevated viral load postpartum. Interventions for reducing exposure to IPV are important for the health of women and may improve HIV care and treatment.
The association of human leukocyte antigen alleles with clinical disease progression in HIV-positive cohorts with varied treatment strategies
Authors: Ekenberg Christina , Reekie Joanne , Zucco Adrian G. , Murray Daniel D. , Sharma Shweta , Macpherson Cameron R. , Babiker Abdel , Kan Virginia , Lane H. Clifford , Neaton James D. , Lundgren Jens D.
Published: February 2021

Objectives:

The Strategic Timing of AntiRetroviral Treatment (START) and Strategies for Management of Antiretroviral Therapy (SMART) trials demonstrated that ART can partly reverse clinically defined immune dysfunction induced by HIV replication. As control of HIV replication is influenced by the HLA region, we explored whether HLA alleles independently influence the risk of clinical events in HIV+ individuals.

Design:

Cohort study.

Methods:

In START and SMART participants, associations between imputed HLA alleles and AIDS, infection-related cancer, herpes virus-related AIDS events, chronic inflammation-related conditions, and bacterial pneumonia were assessed. Cox regression was used to estimate hazard ratios for the risk of events among allele carriers versus noncarriers. Models were adjusted for sex, age, geography, race, time-updated CD4+ T-cell counts and HIV viral load and stratified by treatment group within trials. HLA class I and II alleles were analyzed separately. The Benjamini--Hochberg procedure was used to limit the false discovery rate to less than 5% (i.e. q value <0.05).

Results:

Among 4829 participants, there were 132 AIDS events, 136 chronic inflammation-related conditions, 167 bacterial pneumonias, 45 infection-related cancers, and 49 herpes virus-related AIDS events. Several associations with q value less than 0.05 were found: HLA-DQB1∗06:04 and HLA-DRB1∗13:02 with AIDS (adjusted HR [95% CI] 2.63 [1.5–4.6] and 2.25 [1.4–3.7], respectively), HLA-B∗15:17 and HLA-DPB1∗15:01 with bacterial pneumonia (4.93 [2.3–10.7] and 4.33 [2.0–9.3], respectively), and HLA-A∗69:01 with infection-related cancer (15.26 [3.5–66.7]). The carriage frequencies of these alleles were 10% or less.

Conclusion:

This hypothesis-generating study suggests that certain HLA alleles may influence the risk of immune dysfunction-related events irrespective of viral load and CD4+ T-cell count.
Longitudinal changes in epigenetic age in youth with perinatally acquired HIV and youth who are perinatally HIV-exposed uninfected
Authors: Shiau Stephanie , Brummel Sean S. , Kennedy Elizabeth M. , Hermetz Karen , Spector Stephen A. , Williams Paige L. , Kacanek Deborah , Smith Renee , Drury Stacy S. , Agwu Allison , Ellis Angela , Patel Kunjal , Seage George R. , Van Dyke Russell B. , Marsit Carmen J.
Published: February 2021

Objectives:

To quantify the rate of change in epigenetic age compared with chronological age over time in youth with perinatally acquired HIV (YPHIV) and youth who are perinatally HIV-exposed uninfected (YPHEU).

Design:

Longitudinal study of 32 YPHIV and 8 YPHEU with blood samples collected at two time points at least 3 years apart.

Methods:

DNA methylation was measured using the Illumina MethylationEPIC array and epigenetic age was calculated using the Horvath method. Linear mixed effects models were fit to estimate the average change in epigenetic age for a 1-year change in chronological age separately for YPHIV and YPHEU.

Results:

Median age was 10.9 and 16.8 years at time 1 and 2, respectively. Groups were balanced by sex (51% male) and race (67% black). Epigenetic age increased by 1.23 years (95% CI 1.03--1.43) for YPHIV and 0.95 years (95% CI 0.74--1.17) for YPHEU per year increase in chronological age. Among YPHIV, in a model with chronological age, a higher area under the curve (AUC) viral load was associated with an increase in epigenetic age over time [2.19 years per log10 copies/ml, (95% CI 0.65--3.74)], whereas a higher time-averaged AUC CD4+ T-cell count was associated with a decrease in epigenetic age over time [−0.34 years per 100 cells/μl, (95% CI −0.63 to −0.06)] in YPHIV.

Conclusion:

We observed an increase in the rate of epigenetic aging over time in YPHIV, but not in YPHEU. In YPHIV, higher viral load and lower CD4+ T-cell count were associated with accelerated epigenetic aging, emphasizing the importance of early and sustained suppressive treatment for YPHIV, who will receive lifelong ART.
Differential impact of antiretroviral therapy initiated before or during pregnancy on placenta pathology in HIV-positive women
Authors: Ikumi Nadia M. , Malaba Thokozile R. , Pillay Komala , Cohen Marta C. , Madlala Hlengiwe P. , Matjila Mushi , Anumba Dilly , Myer Landon , Newell Marie-Louise , Gray Clive M.
Published: February 2021

Objective:

To examine the association between timing of antiretroviral treatment (ART) initiation in HIV-infected women and placental histopathology.

Design:

A nested substudy in a larger cohort of HIV-infected women which examined the association between ART status and birth outcomes.

Methods:

Placentas (n = 130) were examined for histopathology from two ART groups: stable (n = 53), who initiated ART before conception and initiating (n = 77), who started ART during pregnancy [median (interquartile range) 15 weeks gestation (11–18)]. Using binomial regression we quantified associations between ART initiation timing with placental histopathology and pregnancy outcomes.

Results:

One-third of all placentas were less than 10th percentile weight-for-gestation and there was no significant difference between ART groups. Placental diameter, thickness, cord insertion position and foetal–placental weight ratio were also similar by group. However, placentas from the stable group showed increased maternal vascular malperfusion (MVM) (39.6 vs. 19.4%), and decreased weight (392 vs. 422 g, P = 0.09). MVM risk was twice as high [risk ratios 2.03 (95% confidence interval: 1.16–3.57); P = 0.01] in the stable group; the increased risk remaining significant when adjusting for maternal age [risk ratios 2.04 (95% confidence interval: 1.12–3.72); P = 0.02]. Furthermore, MVM was significantly associated with preterm delivery and low birth weight (P = 0.002 and <0.0001, respectively).

Conclusion:

Preconception initiation of ART was associated with an increased MVM risk, and may contribute to placental dysfunction. The association between MVM with preterm delivery and low birth weight suggests that a placenta-mediated mechanism likely links the putative association between long-term use of ART and adverse birth outcomes.
COVID-19 mRNA Vaccination–Induced Lymphadenopathy Mimics Lymphoma Progression on FDG PET/CT
Authors: Xu Guofan , Lu Yang
Published: February 2021

We present here a 72-year-old man with mantle cell lymphoma who has completed chemotherapy and achieved complete metabolic response to the therapy 10 months ago. Series follow-up FDG PET/CT scans have been negative for lymphoma. Current FDG PET/CT scan showed a new cluster of subcentimeter left axillary lymphadenopathy with avid FDG uptake. There was also focal FDG uptake in the left upper arm deltoid muscle and adjacent subcutaneous soft tissue, with no other abnormal FDG-avid lesion or suspicious CT image findings. The medical history revealed that the patient received COVID-19 mRNA vaccine 2 days before the FDG PET/CT examination.
Routine Esophagograms After Hiatus Hernia Repair Minimizes Reoperative Morbidity
Authors: Liu David S. , Wee Melissa Y. , Grantham James P. , Ong Bee S. , Ng Stephanie G. , To Minh-Son , Zhou Xuanyu , Irvine Tanya , Bright Tim , Thompson Sarah K. , Dandie Lachlan , Shenfine Jonathan , Watson David I.
Published: February 2021

Objective:

Determine the utility of routine esophagograms after hiatus hernia repair and its impact on patient outcomes.

Background:

Hiatus hernia repairs are common. Early complications such as

re-herniation, esophageal obstruction and perforation, although infrequent, incur significant morbidity. Whether routine postoperative esophagograms enable early recognition of these complications, expedite surgical management, reduce reoperative morbidity, and improve functional outcomes are unclear.

Methods:

Analysis of a prospectively-maintained database of hiatus hernia repairs in 14 hospitals, and review of esophagograms in this cohort. Results: A total of 1829 hiatus hernias were repaired. Of these, 1571 (85.9%) patients underwent a postoperative esophagogram. Overall, 1 in 48 esophagograms resulted in an early (<14 days) reoperation, which was undertaken in 44 (2.4%) patients. Compared to those without an esophagogram, patients who received this test before reoperation (n = 37) had a shorter time to diagnosis (2.4 vs 3.9 days, P = 0.041) and treatment (2.4 vs 4.3 days, P = 0.037) of their complications. This was associated with lower rates of open surgery (10.8% vs 42.9%, P = 0.034), gastric resection (0.0% vs 28.6%, P = 0.022), postoperative morbidity (13.5% vs 85.7%, P < 0.001), unplanned intensive care admission (16.2% vs 85.7%, P < 0.001), and decreased length-of-stay (7.3 vs 18.3 days, P = 0.009). Furthermore, we identified less intraoperative and postoperative complications, and superior functional outcomes at 1-year follow-up in patients who underwent early reoperations for an esophagogram-detected asymptomatic re-herniation than those who needed surgery for late symptomatic recurrences.

Conclusions:

Postoperative esophagograms decrease the morbidity associated with early and late reoperations, and should be considered for routine use after hiatus hernia surgery.
The Role of Targeted Versus Standard Antibiotic Prophylaxis in Pancreatoduodenectomy in Reducing Postoperative Infectious Complications
Authors: Pham Helen , Chen Andy , Nahm Christopher B. , Lam Vincent , Pang Tony , Richardson Arthur J.
Published: February 2021

Introduction:

Infectious complications are common after pancreatoduodenectomy, which in turn are associated with preoperative biliary drainage. Current guidelines recommend a first-generation cephalosporin as perioperative antibiotic prophylaxis. However, some studies support the use of targeted antibiotics. The aim of this systematic review and meta-analysis is to evaluate the role of prophylactic targeted antibiotics compared to standard antibiotics in reducing postoperative infections after pancreatoduodenectomy.

Methods:

A search from MEDLINE, EMBASE, and Cochrane library from 1946 to July 2020 was conducted. Studies were included if they compared targeted antibiotics with standard perioperative antibiotics while including outcome data on surgical site infections (SSI). Targeted therapy was defined as perioperative antibiotics targeting organisms prevalent in bile instrumentation or by culture data obtained from the patient or institution. Outcomes assessed were the rate of SSIs and their microbiology profile. Analyses included demographic data, perioperative antibiotics, postoperative outcomes including microbiology data, and meta-analysis was performed where applicable.

Results:

Seven studies were included, with a total of 849 patients undergoing pancreatoduodenectomy. Targeted antibiotics were associated with a significantly lower rate of postoperative SSI compared to standard antibiotic therapy [21.1% vs 41.9%; risk ratios (RR) 0.55, 95% confidence interval 0.37–0.81]. Wound/incisional site infections and organ space infections were lower in patients receiving targeted antibiotic prophylaxis (RR 0.33, P = 0.0002 and RR 0.54, P = 0.0004, respectively). Enterococcus species were the most common bacteria reported.

Conclusion:

There was a significant reduction in overall SSI rates when targeted antibiotics was used. Current standard antibiotic prophylaxis is inadequate in covering microbes prevalent in postoperative infections developing after pancreatoduodenectomy.
miR-19-3p Promotes Autophagy and Apoptosis in Pelvic Organ Prolapse Through the AKT/mTOR/p70S6K Pathway: Function of miR-19-3p on Vaginal Fibroblasts by Targeting IGF-1
Authors: Yin Yitong , Qin Meiying , Luan Meng , Xia Zhijun
Published: February 2021

Objective

Pelvic organ prolapse (POP) is a common condition in older women. A decrease in collagen 1 (Col-1) expression is one of the main causes of POP. Many microRNAs play an important role in regulating target genes. The relationship between miR-19-3p and POP is investigated in this study, and the molecular mechanism was also explored to find whether miR-19-3p may be a potential target for early diagnosis and prevention of POP.

Methods

A total of 60 patients with POP and 60 patients without POP were included in this study. Reverse transcription-polymerase chain reaction and Western blot were used to detect the expression of miR-19-3p, insulin-like growth factor 1 (IGF-1), and the Akt/mTOR/p70S6K pathway. Cell cycle was defined by flow cytometric analysis. The combination of miR-19-3p and IGF-1 was revealed by luciferase assays.

Results

The results of this study show that miR-19-3p was upregulated in the tissue of patients with POP, whereas COL-1 and IGF-1 expressions were lower in the POP group. miR-19-3p promoted excessive fibroblast autophagy and apoptosis. miR-19-3p negatively regulated the Akt/mTOR/p70S6K pathway and inhibited COL-1 secretion. Luciferase reporter assay showed that miR-19-3p regulated IGF-1 expression by direct target binding.

Conclusions

miR-19-3p has negative associations with the expression of Col-1. Our study highlights that miR-19-3p may affect the synthesis of Col-1 by targeting IGF-1 and that it may play an vital role in POP.
Copy number variations in Japanese children with autism spectrum disorder
Authors: Sakamoto Yui , Shimoyama Shuji , Furukawa Tomonori , Adachi Masaki , Takahashi Michio , Mikami Tamaki , Kuribayashi Michito , Osato Ayako , Tsushima Daiki , Saito Manabu , Ueno Shinya , Nakamura Kazuhiko
Published: February 2021

Objective

Although autism spectrum disorder (ASD) occurs worldwide, most genomic studies on ASD were performed on those of Western ancestry. We hypothesized ASD-related copy number variations (CNVs) of Japanese individuals might be different from those of Western individuals.

Methods

Subjects were recruited from the Hirosaki 5-year-old children’s developmental health check-up (HFC) between 2013 and 2016 (ASD group; n = 68, control group; n = 124). This study conducted CNV analysis using genomic DNA from peripheral blood of 5-year-old Japanese children. Fisher’s exact test was applied for profiling subjects and CNV loci.

Results

Four ASD-related CNVs: deletion at 12p11.1, duplications at 4q13.2, 8p23.1 and 18q12.3 were detected (P = 0.015, 0.024, 0.009, 0.004, respectively). Specifically, the odds ratio of duplication at 18q12.3 was highest among the 4 CNVs (odds ratio, 8.13).

Conclusions

Four CNVs: microdeletion at 12p11.1, microduplications at 4q13.2, 8p23.1 and 18q12.3 were detected as ASD-related CNVs in Japanese children in this study. Although these CNVs were consistent with several reports by Western countries at cytoband levels, these did not consistent at detailed genomic positions and sizes. Our data indicate the possibility that these CNVs are characteristic of Japanese children with ASD. We conclude that Japanese individuals with ASD may harbor CNVs different from those of Western individuals with ASD.
Laboratory-Developed Test for SARS-CoV-2 Using Saliva Samples at the University of California, Riverside
Authors: Hai Rong , Collin Matthew , Tsau Sophia , Raygoza Daniel , Morrison Juliet , Carrillo Alexander J. , Collier Logan A. , Bayubay Walter , Han Kenneth , Kaloshian Isgouhi , Borkovich Katherine A.
Published: February 2021

Here we describe a relatively quick, simple, economical and accurate laboratory developed test (LDT) for detection of SARS-CoV-2 in heated and diluted saliva samples without RNA extraction. Our protocol is a variation of the University of Illinois Urbana-Champaign SHIELD LDT. Differences include chilling of the samples during dilution and using a reduced volume for the qRT-PCR reactions. The level of detection for our LDT is 3125 copies/ml, which compares favorably with other saliva-based tests. Initial validation studies with a limited number of patient samples have demonstrated excellent agreement between results using our LDT and those obtained from external laboratories. The cost of consumables for our test is under $8 and a throughput of 1000 tests/day can be achieved with 3-4 personnel.
Detection and stability of SARS-CoV-2 fragments in wastewater: Impact of storage temperature
Authors: Markt Rudolf , Mayr Markus , Peer Evelyn , Wagner Andreas O. , Lackner Nina , Insam Heribert
Published: February 2021

SARS-CoV-2 wastewater epidemiology suffers from uncertainties concerning sample storage. We show the effect of storage of wastewater on the detectable SARS-CoV-2 load. Storage at 4 °C up to 9 days had no significant effect, while storage at −20 °C led to a significant reduction in gene copy numbers.

Highlights

Raw wastewater samples can be stored up to 9 days at 4°C for SARS-CoV-2 wastewater surveillance

Freezing of wastewater sample dramatically decreases RT-qPCR signal of SARS-CoV-2 from wastewater.
Effect of rearfoot strikes on the hip and knee rotational kinetic chain during the early phase of cuttings in female athletes
Authors: Ogasawara Issei , Shimokochi Yohei , Konda Shoji , Mae Tatsuo , Nakata Ken
Published: February 2021

Purpose

Biomechanical factors affecting horizontal-plane hip and knee kinetic-chain and anterior cruciate ligament (ACL) injury risks during cutting maneuvers remains unclear. This study aimed to examine whether different foot strike patterns alter horizontal-plane hip and knee kinetics and kinematics during a cutting maneuver in female athletes and clarify the individual force contribution for producing high-risk hip and knee loadings.

Methods

Twenty-five healthy female athletes performed a 60° cutting task with forefoot and rearfoot first strike conditions. Horizontal-plane hip and knee moment components, angles, and angular velocities were calculated using synchronized data of the marker positions on the body landmarks and ground reaction forces (GRF) during the task. The one-dimensional statistical parametric mapping paired t-test was used to identify the significant difference in kinetic and kinematic time-series data between foot strike conditions.

Results

In the rearfoot strike condition, large hip and knee internal rotation loadings were produced during the first 5% of stance due to the application of GRFs, causing a significantly larger hip internal rotation excursion than that of the forefoot strike condition. Dissimilarly, neither initial hip internal rotation displacement nor knee internal rotation GRF loadings were observed in the forefoot strike condition.

Conclusion

Rearfoot strike during cutting appears to increase noncontact ACL injury risks as the GRF tend to produce combined hip and knee internal rotation moments and the high-risk lower limb configuration. Conversely, forefoot strike during cutting appears to be an ACL-protecting strategy as the ACL-harmful joint loadings and lower-extremity configurations do not tend to be produced. Thus, improving foot strike patterns during cutting should be incorporated into ACL injury prevention programs.
Bacterial Cytological Profiling Identifies Rhodanine-containing PAINS Analogs as Specific Inhibitors ofE. coliThymidylate Kinasein Vivo
Authors: Montaño Elizabeth T. , Nideffer Jason F. , Sugie Joseph , Enustun Eray , Shapiro Adam B. , Tsunemoto Hannah , Derman Alan I. , Pogliano Kit , Pogliano Joe
Published: February 2021

In this study, we conducted an activity screen of 31 structural analogs of rhodanine-containing pan-assay interference compounds (PAINS). We identified nine active molecules inhibiting the growth ofE. coliand classified them according to theirin vivomechanisms of action. The mechanisms of action of PAINS are generally difficult to identify due to their promiscuity. However, we leveraged bacterial cytological profiling, a fluorescence microscopy technique, to study these complex mechanisms. Ultimately, we found that although some of our molecules promiscuously inhibit multiple cellular pathways, a few molecules specifically inhibit DNA replication despite their structural similarity to related PAINS. A genetic analysis of resistant mutants revealed that thymidylate kinase (an enzyme essential for DNA synthesis) is an intracellular target of some of these rhodanine-containing antibiotics. This finding was supported by assays ofin vitroactivity as well as experiments utilizing a thymidylate kinase overexpression system. The analog that demonstrated the lowest IC50in vitroand MICin vivodisplayed the greatest specificity for the inhibition of DNA replication inE. coli, despite containing a rhodamine moiety. While it’s generally thought that PAINS cannot be developed as antibiotics, this work highlights the utility of bacterial cytological profiling for studying thein vivospecificity of antibiotics, and it showcases novel inhibitors ofE. colithymidylate kinase.

Importance

We demonstrate that bacterial cytological profiling is a powerful tool for directing antibiotic discovery efforts because it can be used to determine the specificity of an antibiotic’sin vivomechanism of action. By assaying analogs of PAINS, molecules that are notoriously intractable and non-specific, we (surprisingly) identify molecules with specific activity againstE. colithymidylate kinase. This suggests that structural modifications to PAINS can confer stronger inhibition by targeting a specific cellular pathway. Whilein vitroinhibition assays are susceptible to false positive results (especially from PAINS), bacterial cytological profiling provides the resolution to identify molecules with specificin vivoactivity.
Artificial Intelligence based personalized diet: A pilot clinical study for IBS
Authors: Karakan Tarkan , Gundogdu Aycan , Alagözlü Hakan , Ekmen Nergis , Ozgul Seckin , Hora Mehmet , Beyazgul Damla , Nalbantoglu O. Ufuk
Published: February 2021

Abstract

Background and aims

Certain diets often used to manage functional gastrointestinal symptoms in patients with irritable bowel syndrome (IBS). Personalized diet-induced microbiome modulation is being preferred method for symptom improvement in IBS. Although personalized nutritional therapies targeting gut microbiota using artificial intelligence (AI) promises a great potential, this approach has not been studied in patients with IBS. Therefore, in this study we investigated the efficacy of AI-based personalized microbiome diet in patients with IBS-Mix (M).

Methods

This study was designed as a pilot, open-labelled study. We enrolled consecutive IBS-M patients (n=25, 19 females, 46.06 ± 13.11 years) according to Rome IV criteria. Fecal samples were obtained from all patients twice (pre- and post-intervention) and high-througput 16S rRNA sequencing was performed. Patients were divided into two groups based on age, gender and microbiome matched. Six weeks of AI-based microbiome diet (n=14) for group 1 and standard IBS diet (Control group, n=11) for group 2 were followed. AI-based diet was designed based on optimizing a personalized nutritional strategy by an algorithm regarding individual gut microbiome features. An algorithm assessing an IBS index score using microbiome composition attempted to design the optimized diets based on modulating microbiome towards the healthy scores. Baseline and post-intervention IBS-SSS (symptom severity scale) scores and fecal microbiome analyses were compared.

Results

The IBS-SSS evaluation for both pre- and post-intervention exhibited significant improvement (p<0.02 and p<0.001 for the control and intervention groups, respectively). While the IBS-SSS evaluation changed to moderate from severe in 82% (14 out of 17) of the intervention group, no such change was observed in the control group. After 6-weeks of intervention, a major shift in microbiota profiles in terms of alfa- or beta-diversity was not observed in both groups. A trend of decrease in Ruminococcaceae family for the intervention group was observed (p=0.17). A statistically significant increase in Faecalibacterium genus was observed in the intervention group (p = 0.04). Bacteroides and putatively probiotic genus Propionibacterium were increased in the intervention group, however Prevotella was increased in the control group. The change (delta) values in IBS-SSS scores (before-after) intervention and control groups are significantly higher in the intervention group.

Conclusion

AI-based personalized microbiome modulation through diet significantly improves IBS-related symptoms in patients with IBS-M. Further large scale, randomized placebo-controlled trials with long-term follow-up (durability) are needed.
Genome-wide association study of body fat distribution traits in Hispanics/Latinos from the HCHS/SOL Study
Authors: Justice Anne E. , Young Kristin , Gogarten Stephanie M. , Sofer Tamar , Graff Misa , Love Shelly Ann , Wang Yujie , Klimentidis Yann C. , Cruz Miguel , Guo Xiuqing , Hartwig Fernando , Petty Lauren , Yao Jie , Allison Matthew A. , Below Jennifer E. , Buchanan Thomas A. , Chen Yii-Der Ida , Goodarzi Mark O. , Hanis Craig , Highland Heather M. , Hsueh Willa A. , Ipp Eli , Parra Esteban , Palmas Walter , Raffel Leslie J. , Rotter Jerome I. , Tan Jingyi , Taylor Kent D. , Valladares Adan , Xiang Anny H. , Sánchez-Johnsen Lisa , Isasi Carmen R. , North Kari E.
Published: February 2021

Central obesity is a leading health concern with a great burden carried by ethnic minority populations, and especially Hispanics/Latinos. Genetic factors contribute to the obesity burden overall and to inter-population differences. We aim to: 1) identify novel loci associated with central adiposity measured as waist-to-hip ratio (WHR), waist circumference (WC), and hip circumference (HIP), all adjusted for body mass index (adjBMI), using the Hispanic Community Health Study/Study of Latinos (HCHS/SOL); 2) determine if differences in genetic associations differ by background group within HCHS/SOL; 3) determine whether previously reported association regions generalize to HCHS/SOL. Our analyses included 7,472 women and 5,200 men of mainland (Mexican, Central and South American) and Caribbean (Puerto Rican, Cuban, and Dominican) background residing in the US, with genome-wide array data imputed to the 1000 genomes Phase I multiethnic reference panel. We analyzed associations stratified by sex in addition to sexes combined using linear mixed-model regression. We identified 16 variants for WHRadjBMI, 22 for WCadjBMI, and 28 for HIPadjBMI that reached suggestive significance (P<1×10−6). Many of the loci exhibited differences in strength of associations by ethnic background and sex. We brought a total of 66 variants forward for validation in nine cohort studies (N=34,161) with participants of Hispanic/Latino, African and European descent. We confirmed four novel loci (ancestry-specific P<0.05 in replication, consistent direction of effect with HCHS/SOL, and P<5×10−8 after meta-analysis with HCHS/SOL), including rs13301996 in the sexes-combined analysis, and rs79478137 for women-only for WHRadjBMI; rs28692724 in women-only for HIPadjBMI; and rs3168072 in the sexes combined analysis for WCadjBMI. Also, a total of eight previously reported WHRadjBMI association regions, 12 for HIPadjBMI, and 10 for WCadjBMI generalized to HCHS/SOL. Our study findings highlight the importance of large-scale genomic studies in ancestrally diverse Hispanic/Latino populations for identifying and characterizing central obesity-susceptibility that may be ancestry-specific.