bluuebunny/crossref_metadata_2025 huggingface dataset:
The stemness of hepatocytes is maintained by high levels of lipopolysaccharide via YAP1 activation
Authors: Shao Changchun , Yang Xue , Jing Yingying , Hou Xiaojuan , Huang Yihua , Zong Chen , Gao Lu , Liu Wenting , Jiang Jinghua , Ye Fei , Shi Junxia , Zhao Qiudong , Li Rong , Zhang Xiaoren , Wei Lixin
Published: June 2021

Background

The liver possesses a powerful regeneration ability, which is correlated with the stemness of hepatocytes in the portal vein (PV). However, the mechanism underlying the maintenance of hepatocyte stemness has not been elucidated. Here, we hypothesized that high levels of lipopolysaccharide from the portal vein might maintain the stemness of hepatocytes in the PV area.

Methods

First, we examined the location of hepatic stem cells and the concentration of lipopolysaccharide (LPS) in the portal vein and inferior vena cava. Then, we assessed the effect of LPS on stemness maintenance in mice by using antibiotics to eliminate LPS and knocking out the LPS receptor, TLR4. In vitro, the effect of LPS on the stemness of hepatocytes was investigated by colony and sphere formation assays and assessment of pluripotent and stem cell marker expression. Furthermore, we studied the mechanism by which LPS regulates the stemness of hepatocytes. Finally, we ligated the portal vein branch to further verify the effect of LPS.

Results

We found that a high level of LPS from the portal vein was correlated with the location of hepatic stem cells in the PV area, and elimination of LPS by antibiotics inhibited the expression of the stemness marker. LPS promoted colony and sphere formation and induced the upregulation of pluripotent and stem cell markers in AML12 cells. Furthermore, in the reprogramming medium, LPS facilitated the dedifferentiation of mature hepatocytes into hepatic progenitor-like cells, which exhibited a bipotent differentiation capacity in vivo and in vitro. Mechanistically, LPS bound TLR4 to regulate stemness of hepatocytes via the activation of YAP1 signaling, and blockade of YAP1 abolished the LPS-induced cell stemness and upregulation of pluripotent markers.

Conclusions

Our study implies a correlation between LPS/TLR4/YAP1 signaling and cell stemness, and LPS was shown to be involved in stemness maintenance of hepatocytes in the PV area. LPS might be used to induce the dedifferentiation of mature hepatocytes into progenitor-like cells for repair of liver injury.
Human endometrium-derived stem cell improves cardiac function after myocardial ischemic injury by enhancing angiogenesis and myocardial metabolism
Authors: Fan Xuemei , He Sheng , Song Huifang , Yin Wenjuan , Zhang Jie , Peng Zexu , Yang Kun , Zhai Xiaoyan , Zhao Lingxia , Gong Hui , Ping Yi , Jiao Xiangying , Zhang Sanyuan , Yan Changping , Wang Hongliang , Li Ren-Ke , Xie Jun
Published: June 2021

Background

The human endometrium in premenopausal women is an active site of physiological angiogenesis, with regenerative cells present, suggesting that the endometrium contains adult angiogenic stem cells. In the context of cardiac repair after ischemic injury, angiogenesis is a crucial process to rescue cardiomyocytes. We therefore investigated whether human endometrium-derived stem cells (hEMSCs) can be used for cardiac repair after ischemic injury and their possible underlying mechanisms.

Methods

Comparisons were made between hEMSCs successfully isolated from 22 premenopausal women and human bone marrow mesenchymal stem cells (hBMSCs) derived from 25 age-matched patients. Cell proliferation, migration, differentiation, and angiogenesis were evaluated through in vitro experiments, while the ability of hEMSCs to restore cardiac function was examined by in vivo cell transplantation into the infarcted nude rat hearts.

Results

In vitro data showed that hEMSCs had greater proliferative and migratory capacities, whereas hBMSCs had better adipogenic differentiation ability. Human umbilical cord vein endothelial cells, treated with conditioned medium from hEMSCs, had significantly higher tube formation than that from hBMSCs or control medium, indicating greater angiogenic potentials for hEMSCs. In vivo, hEMSC transplantation preserved cardiac function, decreased infarct size, and improved tissue repair post-injury. Cardiac metabolism, assessed by 18F-FDG uptake, showed that 18F-FDG uptake at the infarction area was significantly higher in both hBMSC and hEMSC groups, compared to the PBS control group, with hEMSCs having the highest uptake, suggesting hEMSC treatment improves cardiomyocyte metabolism and survival after injury. Mechanistic assessment of the angiogenic potential for hEMSCS revealed that angiogenesis-related factors angiopoietin 2, Fms-like tyrosine kinase 1, and FGF9 were significantly upregulated in hEMSC-implanted infarcted hearts, compared to the PBS control group.

Conclusion

hEMSCs, compared to hBMSCs, have greater capacity to induce angiogenesis, and improved cardiac function after ischemic injury.
Kannan nonexpansive maps on generalized Cesàro backward difference sequence space of non-absolute type with applications to summable equations
Authors: Bakery Awad A. , Mohamed Om Kalthum S. K.
Published: June 2021

In this article, we investigate the notion of the pre-quasi norm on a generalized Cesàro backward difference sequence space of non-absolute type $(\Xi (\Delta,r) )_{\psi }$

(
Ξ
(
Δ
,
r
)
)

ψ

under definite function ψ. We introduce the sufficient set-up on it to form a pre-quasi Banach and a closed special space of sequences (sss), the actuality of a fixed point of a Kannan pre-quasi norm contraction mapping on $(\Xi (\Delta,r) )_{\psi }$

(
Ξ
(
Δ
,
r
)
)

ψ

, it supports the property (R) and has the pre-quasi normal structure property. The existence of a fixed point of the Kannan pre-quasi norm nonexpansive mapping on $(\Xi (\Delta,r) )_{\psi }$

(
Ξ
(
Δ
,
r
)
)

ψ

and the Kannan pre-quasi norm contraction mapping in the pre-quasi Banach operator ideal constructed by $(\Xi (\Delta,r) )_{\psi }$

(
Ξ
(
Δ
,
r
)
)

ψ

and s-numbers has been determined. Finally, we support our results by some applications to the existence of solutions of summable equations and illustrative examples.
Protective effects of sodium butyrate on rotavirus inducing endoplasmic reticulum stress-mediated apoptosis via PERK-eIF2α signaling pathway in IPEC-J2 cells
Authors: Zhao Ye , Hu Ningming , Jiang Qin , Zhu Li , Zhang Ming , Jiang Jun , Xiong Manyi , Yang Mingxian , Yang Jiandong , Shen Linyuan , Zhang Shunhua , Niu Lili , Chen Lei , Chen Daiwen
Published: June 2021

Background

Rotavirus (RV) is a major pathogen that causes severe gastroenteritis in infants and young animals. Endoplasmic reticulum (ER) stress and subsequent apoptosis play pivotal role in virus infection. However, the protective mechanisms of intestinal damage caused by RV are poorly defined, especially the molecular pathways related to enterocytes apoptosis. Thus, the aim of this study was to investigate the protective effect and mechanism of sodium butyrate (SB) on RV-induced apoptosis of IPEC-J2 cells.

Results

The RV infection led to significant cell apoptosis, increased the expression levels of ER stress (ERS) markers, phosphorylated protein kinase-like ER kinase (PERK), eukaryotic initiation factor 2 alpha (eIF2α), caspase9, and caspase3. Blocking PERK pathway using specific inhibitor GSK subsequently reversed RV-induced cell apoptosis. The SB treatment significantly inhibited RV-induced ERS by decreasing the expression of glucose regulated protein 78 (GRP78),PERK, andeIF2α. In addition, SB treatment restrained the ERS-mediated apoptotic pathway, as indicated by downregulation of C/EBP homologous protein (CHOP) mRNA level, as well as decreased cleaved caspase9 and caspase3 protein levels. Furthermore, siRNA-induced GPR109a knockdown significantly suppressed the protective effect of SB on RV-induced cell apoptosis.

Conclusions

These results indicate that SB exerts protective effects against RV-induced cell apoptosis through inhibiting ERS mediated apoptosis by regulating PERK-eIF2α signaling pathway via GPR109a, which provide new ideas for the prevention and control of RV.
Genomic adaptations enabling Acidithiobacillus distribution across wide-ranging hot spring temperatures and pHs
Authors: Sriaporn Chanenath , Campbell Kathleen A. , Van Kranendonk Martin J. , Handley Kim M.
Published: June 2021

Background

Terrestrial hot spring settings span a broad spectrum of physicochemistries. Physicochemical parameters, such as pH and temperature, are key factors influencing differences in microbial composition across diverse geothermal areas. Nonetheless, analysis of hot spring pools from the Taupo Volcanic Zone (TVZ), New Zealand, revealed that some members of the bacterial genus, Acidithiobacillus, are prevalent across wide ranges of hot spring pHs and temperatures. To determine the genomic attributes of Acidithiobacillus that inhabit such diverse conditions, we assembled the genomes of 19 uncultivated hot spring Acidithiobacillus strains from six geothermal areas and compared these to 37 publicly available Acidithiobacillus genomes from various habitats.

Results

Analysis of 16S rRNA gene amplicons from 138 samples revealed that Acidithiobacillus comprised on average 11.4 ± 16.8% of hot spring prokaryotic communities, with three Acidithiobacillus amplicon sequence variants (ASVs) (TVZ_G1, TVZ_G2, TVZ_G3) accounting for > 90% of Acidithiobacillus in terms of relative abundance, and occurring in 126 out of 138 samples across wide ranges of temperature (17.5–92.9 °C) and pH (1.0–7.5). We recovered 19 environmental genomes belonging to each of these three ASVs, as well as a fourth related group (TVZ_G4). Based on genome average nucleotide identities, the four groups (TVZ_G1-TVZ_G4) constitute distinct species (ANI < 96.5%) of which three are novel Acidithiobacillus species (TVZ_G2-TVZ_G4) and one belongs to Acidithiobacillus caldus (TVZ_G1). All four TVZ Acidithiobacillus groups were found in hot springs with temperatures above the previously known limit for the genus (up to 40 °C higher), likely due to significantly higher proline and GC contents than other Acidithiobacillus species, which are known to increase thermostability. Results also indicate hot spring-associated Acidithiobacillus have undergone genome streamlining, likely due to thermal adaptation. Moreover, our data suggest that Acidithiobacillus prevalence across varied hot spring pHs is supported by distinct strategies, whereby TVZ_G2-TVZ_G4 regulate pH homeostasis mostly through Na+/H+ antiporters and proton-efflux ATPases, whereas TVZ_G1 mainly relies on amino acid decarboxylases.

Conclusions

This study provides insights into the distribution of Acidithiobacillus species across diverse hot spring physichochemistries and determines genomic features and adaptations that potentially enable Acidithiobacillus species to colonize a broad range of temperatures and pHs in geothermal environments.
Lower BCL11B expression is associated with adverse clinical outcome for patients with myelodysplastic syndrome
Authors: Huang Xin , Chen Cunte , Zhong Mengjun , Geng Suxia , Zhao Yujie , Li Minming , Deng Chenxin , Zeng Lingji , Wu Ping , Lu Zesheng , Weng Jianyu , Du Xin , Li Yangqiu
Published: June 2021

Myelodysplastic syndrome (MDS) is an aggressive and genetically heterogeneous disease with poor prognosis. Cellular immune disorder is a common characteristic of this disease and is thought to be related to clinical outcome. Alterations in T cell clonal expansion and T cell dysfunction has been detected in MDS patients. Little is known about whether there are immune biomarkers to evaluate the T cell alterations with clinical outcome. Previous studies have demonstrated that B-cell leukemia/lymphoma 11B (BCL11B) plays an important role in regulating T cell development and proliferation. In this study, the prognostic value of BCL11B for MDS patients was explored by analyzing RNA-seq data from 270 patients in two datasets in the Gene Expression Omnibus (GEO) database and real-time quantitative PCR data (qRT-PCR) of 31 bone marrow (BM) samples of MDS and 6 BM samples of patients with MDS progress to secondary acute myeloid leukemia (sAML) from our clinical center. The results demonstrated that BCL11B is significantly down-regulated in MDS patients as compared with healthy individuals (HIs). Importantly, lower BCL11B expression was found in MDS patients who were of high/very high risk, older than 60 y, or male and patients with sAML. Furthermore, low BCL11B expression appeared to be associated with poor overall survival (OS) for MDS patients, though the data were not yet significant enough at this point. In addition, BCL11B low-expressing MDS patients had shorter restricted mean survival time (RMST) than those with high BCL11B expression. Interestingly, BCL11B positively correlated with naive and activated memory CD4 + T cells, CD8 + T cells, and the T cell receptor complex genes CD3E and CD3G, but it negatively correlated with regulatory T cells (Treg). Additionally, co-occurrence of low BCL11B expression and CD3E and CD3G was associated with poor OS and shorter RMST. In conclusion, lower BCL11B expression in BM samples of MDS patients was associated with adverse clinical outcome.
Radiogenic heat production in granitoids from the Sierras de Córdoba, Argentina
Authors: Pleitavino M. , Carro Pérez M. E. , García Aráoz E. , Cioccale M. A.
Published: June 2021

One of the most important processes of heat generation from the Earth's interior is the radioactive decay of isotopes. The main hosts of the major radiogenic elements U, Th and K in the crust are granitoids. The Sierras de Córdoba are formed of dissimilar granitic intrusions emplaced by a series of magmatic events that occurred during the Paleozoic. The different granitoids are classified as A-type, I-type, and S-type, and there is also a magmatic expression corresponding to the Famatinian period which exhibits TTG-type characteristics. In this work, the geochemical concentrations of the radiogenic elements of the granitic intrusions making up the Sierras de Córdoba were compiled in a single database. The radiogenic heat production of the Sierras de Córdoba granitoids was evaluated, making this the first study of radiogenic heat generation in the area. The radiogenic heat production showed variability for the different events, with the highest values found in Achalian magmatism and early Carboniferous magmatism, which are represented by A-type granitoids. The Capilla del Monte pluton has the highest heat production rate, with a value of 4.54 ± 1.38 µW/m3. The lowest values were found in the TTG-type granitoids and in the S-type granitoids, all of which belong to the Famatinian magmatic event. The range of values for this magmatic event goes from 0.26 ± 0.05 µW/m3 for the San Agustin pluton to 1.19 ± 0.50 µW/m3 for the La Playa pluton. An empirical ternary model is presented for the Sierras de Córdoba that involves the concentrations of the elements U, Th and K, and the radiogenic heat production, with a distinction for the petrogenetic types according to the S-I-A-M classification. The thermal manifestations located on the Capilla del Monte pluton could be related to the radioactive heat generation of the intrusion, involving both the neotectonic activity of the area and the radiogenic heat production. The results provide new opportunities for studying temperature variation within some of these intrusions and to evaluate the geothermal potential of the granitoids of Córdoba.
Highly efficient production of transfructosylating enzymes using low-cost sugarcane molasses by A. pullulans FRR 5284
Authors: Khatun Most Sheauly , Hassanpour Morteza , Harrison Mark D. , Speight Robert E. , O’Hara Ian M. , Zhang Zhanying
Published: June 2021

Fructooligosaccharides (FOS) are a type of important prebiotics and produced by transfructosylating enzymes. In this study, sugarcane molasses was used as the substrate for production of transfructosylating enzymes by Aureobasidium pullulans FRR 5284. NaNO3 was a superior nitrogen source to yeast extract for production of transfructosylating enzymes by A. pullulans FRR 5284 and decreasing the ratio of NaNO3 to yeast extract nitrogen from 1:0 to 1:1 resulted in the reduction of the total transfructosylating activity from 109.8 U/mL to 82.5 U/mL. The addition of only 4.4 g/L NaNO3 into molasses-based medium containing 100 g/L mono- and di-saccharides resulted in total transfructosylating activity of 123.8 U/mL. Scale-up of the A. pullulans FRR 5284 transfructosylating enzyme production process from shake flasks to 1 L bioreactors improved the enzyme activity and productivity to 171.7 U/mL and 3.58 U/mL/h, 39% and 108% higher than those achieved from shake flasks, respectively. Sucrose (500 g/L) was used as a substrate for extracellular, intracellular, and total A. pullulans FRR 5284 transfructosylating enzymes, with a maximum yield of 61%. Intracellular, extracellular, and total A. pullulans FRR 5284 transfructosylating enzymes from different production systems resulted in different FOS profiles, indicating that FOS profiles can be controlled by adjusting intracellular and extracellular enzyme ratios and, hence prebiotic activity.
Argonaute with stepwise endonuclease activity promotes specific and multiplex nucleic acid detection
Authors: Xun Guanhua , Liu Qian , Chong Yuesheng , Guo Xiang , Li Zhonglei , Li Yinhua , Fei He , Li Kai , Feng Yan
Published: June 2021

Argonaute proteins (Agos) from thermophiles function as endonucleases via guide-target base-pairing cleavage for host defense. Since guides play a key role in regulating the catalytic specificity of Agos, elucidating its underlying molecular mechanisms would promote the application of Agos in the medical sciences. Here, we reveal that an Ago from Pyrococcus furiosus (PfAgo) showed a stepwise endonuclease activity, which was demonstrated through a double-stranded DNA cleavage directed by a single guide DNA (gDNA) rather than a canonical pair of gDNAs. We validated that the cleavage products with 5'-phosphorylated ends can be used as a new guide to induce a new round of cleavage. Based on the reprogrammable capacity of Ago’s stepwise activity, we established a rapid and specific platform for unambiguous multiplex gene detection, termed Renewed-gDNA Assisted DNA cleavage by Argonaute (RADAR). Combined with a pre-amplification step, RADAR achieved sensitivity at the femtomolar level and specificity with at least a di-nucleotide resolution. Furthermore, RADAR simultaneously discriminated among multiple target sequences simply by corresponding multiple guides. We successfully distinguished four human papillomavirus serotypes from patient samples in a single reaction. Our technique, based on the unique properties of Ago, provides a versatile and sensitive method for molecular diagnosis.
Free-floating thrombus of the aorta: 3 case reports
Authors: Oki Naohiko , Inoue Yoshito , Kotani Sohsyu
Published: June 2021

Background

Idiopathic free-floating thrombus (FFT) of the aorta is a rare occurrence, but it can lead to catastrophic consequences. The initial symptoms are typically cerebral or peripheral embolisms. Surgical thrombectomy and thrombolysis are two primary treatments for FFT. Here, we report three cases of patients with idiopathic FFT in the absence of coagulopathy who were treated successfully by surgery with no recurrent thrombi or relapse of symptoms.

Case presentation

Case 1 involved a 72-year-old male patient with a pedunculated thrombus in the distal aortic arch. Case 2 involved a 62-year-old female patient with a cylinder thrombus in the aortic arch and left common carotid artery. Case 3 involved a 65-year-old male patient with three pedunculated thrombi in the ascending aorta, aortic arch, and left subclavian artery. None of the patients had clinical signs of coagulopathy. Pedunculated or cylinder thrombi have a greater risk of breaking off, which can produce severe peripheral embolism in contrast with intramural thrombi (73% vs. 12%). Due to the high embolism risk for each patient, conservative medical treatment by heparinization was deemed inappropriate, so each patient underwent emergency surgical thrombus removal. After surgery, each of the three patients was treated with warfarin for secondary prevention of thromboembolism. At 7-month follow-up in outpatient practice, a computed tomography (CT) scan indicated that Patient 1 had no recurrent thrombus, and the patient has been symptom-free for 11 months. At 1-month follow-up in outpatient practice, a CT scan indicated that Patient 2 had no recurrent thrombus, and the patient has been symptom-free for 8 years. At 3-week follow-up in hospital, a CT scan indicated that Patient 3 had no recurrent thrombus, but he failed to follow-up after discharge, so his follow-up status is unknown.

Conclusions

For a large pedunculated or cylinder thrombus located in the thoracic aorta, surgical thrombectomy should be performed. And, in surgical thrombectomy, the location of the cannulas and cross-clamp should be selected carefully according to the location of the thrombus. After surgery, anticoagulant is important to prevent recurrent idiopathic thrombi.
Occupational therapy addressing the ability to perform activities of daily living among persons living with chronic conditions: a randomised controlled pilot study of ABLE 2.0
Authors: Hagelskjær Vita , Nielsen Kristina Tomra , von Bülow Cecilie , Graff Maud , Wæhrens Eva Ejlersen
Published: June 2021

Background

The ABLE intervention was developed to enhance the ability to perform activities of daily living (ADL) tasks among persons living with chronic conditions. ABLE is a generic, home-based, individualised, 8-week occupational therapy intervention program, developed to be delivered in Danish municipalities. In a previous study, the feasibility of ABLE was evaluated in terms of content and delivery. In this pilot study, the remaining feasibility aspects of a randomised controlled trial including (i) trial procedures (recruitment and retention), (ii) randomisation, (iii) adherence to program, (iv) feasibility of additional outcome measurements, and (iv) access to information on usual occupational therapy were evaluated.

Methods

The study was conducted in a Danish municipality, using a two-armed parallel randomised controlled design, planning a recruitment strategy including 20 persons living with one/more chronic conditions and experiencing problems performing ADL. The following progression criteria were used to determine if a future full-scale randomised controlled trial was feasible: (i) recruitment (50% met the eligibility criteria) and retention (80%), (ii) randomisation (80% accepted randomisation, procedure was executed as planned), (iii) adherence to program (100% followed the treatment protocol), (iv) outcome measurements (80% of the participants delivered relevantly and fully answered questionnaires), and (v) usual occupational therapy (extraction of needed information was successful).

Results

Due to the COVID-19 pandemic, the study was truncated resulting in limited but sufficient data to answer most of the study questions. (i) Eighteen of 37 eligible persons (48.6%) were recruited; of those treated (n = 6), all remained (100%); (ii) 18 accepted randomisation (100%), and procedure was effective; (iii) ABLE was delivered with adherence (100%); (iv) 92.3–100% of the participants gave relevant and complete answers in two of three questionnaires; and (v) needed information on usual occupational therapy was extractable in seven of nine aspects.

Conclusions

Proceeding to full-scale trial is recommendable; however, a few adjustments on outcome measurements, inclusion criteria and extraction of information on usual occupational therapy are needed.

Trial registration

The study was registered at ClinicalTrials.gov (Identifier: NCT04295837) on December 5th, 2019. Retrospectively registered.
Ethno-medicinal, phytochemistry, and pharmacological importance of Hunteria umbellate (K. Schum.) Hallier f. (Apocynaceae): a useful medicinal plant of sub-Saharan Africa
Authors: Fadahunsi Olumide Samuel , Adegbola Peter Ifeoluwa , Olorunnisola Olubukola Sinbad , Subair Temitayo Idris , Adepoju David Oluwasegun , Abijo Ayodeji Zabdiel
Published: June 2021

Background

Hunteria umbellate (K. Schum.) Hallier f. (Apocynaceae) is a tropical rainforest tree commonly found in sub-Saharan region of Africa. It is a useful and very popular plant among the locals due to the outstanding anti-diabetic activity of the seeds.

Methods

A comprehensive literature search on articles published on phytochemical analysis and various pharmacological activities of Hunteria umbellate was carried out using search engines such as Google Scholar, PubMed and Science Direct.

Results

In this review, it was deduced that H. umbellate is employed in folk medicine as an elixir for obesity, fever, leprosy sores, menstrual pain, infertility, yaws, intestinal worms, abdominal discomfort and stomach ache. Due to their durability and immunity against termites, the stems are coveted and desired as timbers in the construction of houses, while the bark has been reportedly exported to Europe for medicinal uses. Pharmacological activities such as fertility enhancing, aphrodisiac, hypoglycemic, anti-inflammatory, has been ascribed to the different morphological organs of H. umbellate. Moreover, compounds belonging to important classes of secondary metabolites with biological activities such as triterpenoids, flavonoids, tannins, alkaloids, quinic acids have been identified and characterized from the plant.

Conclusion

From this review, it can be inferred that, numerous and bioactive principles with known biological usefulness are present in the extracts of H. umbellate and might be responsible for the observed biological and pharmacological activities.
A forced migration from Myanmar to Bangladesh and beyond: humanitarian response to Rohingya refugee crisis
Authors: Faye Malang
Published: June 2021

It is widely agreed that the Rohingya Muslims of Myanmar are currently named as the most persecuted minority in the world. The racial prosecution is triggered by the decades of longstanding insurgency between the Government of Myanmar and the Rohingya Muslims over the issues of religious and ethnic discrepancy. This article presents the measures taken by the international community to stop these mass killings. The article offers critical insights into strategies used by Myanmar’s government to suppress the Rohingyas. This study highlights the rights violation and humanitarian struggle faced by the Rohingya people and the humanitarian response to the crises by the international community.
Sterilization and sanitizing of 3D-printed personal protective equipment using polypropylene and a Single Wall design
Authors: Luchini Karstan , Sloan Shelly N. B. , Mauro Ryan , Sargsyan Aspram , Newman Aundrea , Persaud Purnadeo , Hawkins Daniel , Wolff Dennis , Staudinger Jeff , Creamer Bradley A.
Published: June 2021

Background

The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic during the fall of 2019 and into the spring of 2020 has led to an increased demand of disposable N95 respirators and other types of personal protective equipment (PPE) as a way to prevent virus spread and help ensure the safety of healthcare workers. The sudden demand led to rapid modification, development, and dissemination of 3D printed PPE. The goal of this study was to determine the inherent sterility and re-sterilizing ability of 3D printed PPE in order to provide sterile equipment to the healthcare field and the general public.

Methods

Samples of polylactic acid (PLA), thermoplastic polyurethane (TPU) (infill-based designs) and polypropylene (single-wall hollow design) were 3D printed. Samples were inoculated withE. colifor 24 h and then sanitized using various chemical solutions or heat-based methods. The samples were then incubated for 24- or 72-h in sterile LB medium at 37°C, and bacterial growth was measured by optical density at 600nm. Statistical analysis was conducted using GraphPad Prism v8.2.1.

Results

Significant bacterial growth was observed in all PLA and TPU based samples following re-sterilization, regardless of the methods used when compared to controls (p < 0.05). The single-walled hollow polypropylene design was not only sterile following printing, but was also able to undergo re-sanitization following bacterial inoculation, with no significant bacterial growth (p > 0.05) observed regardless of sanitization method used.

Conclusion

The cost effectiveness, ease of sanitization, and reusability of 3D printed PPE, using our novel single-walled polypropylene design can help meet increased demands of PPE for healthcare workers and the general public that are needed to help decrease the viral transmission of the coronavirus disease of 2019 (COVID-19) pandemic. 3D printing also has the potential to lead to the creation and production of other sterile material items for the healthcare industry in the future. The ability to re-sterilize 3D printed PPE, as our design shows, would also contribute less to the increase in biomedical waste (BMW) being experienced by COVID-19.
Review of patient-reported outcomes in periprosthetic distal femur fractures after total knee arthroplasty: a plate or intramedullary nail?
Authors: Rinehart Dustin , Youngman Tyler , Ahn Junho , Huo Michael
Published: June 2021

Purpose

This study reviewed the literature regarding the patient-reported treatment outcomes of using either open reduction and internal fixation (ORIF) with a plate and screw system or intramedullary nail (IMN) fixation for periprosthetic distal femur fractures around a total knee arthroplasty.

Methods

A total of 13 studies published in the last 20 years met the inclusion criteria. The studies included 347 patients who were allocated to ORIF (n = 249) and IMN (n = 98) groups according to the implants used. The primary outcome measures were the Knee Society Score or the Western Ontario and McMaster Universities osteoarthritis index. The secondary outcome measures included knee range of motion and the rates of complications, including non-union, malunion, infection, revision total knee arthroplasty, and reoperation. Statistical significance was set atP < 0.05.

Results

The mean Knee Society Scores of ORIF and IMN groups were 83 and 84, respectively; the mean postoperative range of motion of the knee were 99° and 100°, respectively (P < 0.05); the non-union rates were 9.4 and 3.8%, respectively (P > 0.05); the malunion rates were 1.8 and 7.5%, respectively (P < 0.05); surgical site infection rates were 2 and 1.3%, respectively (P > 0.05); the reoperation rates were 9.6 and 5.1%, respectively (P > 0.05); and revision rates of total knee arthroplasty were 2 and 1%, respectively (P > 0.05).

Conclusion

Based on the patient-reported outcome assessments, both ORIF with a plate and screw system and IMN fixation are well-accepted techniques for periprosthetic distal femur fractures around a TKA, and they produce similar functional outcomes.
Recovery
Authors: Skuse David
Published: June 2021

The concept of ‘recovery’ as applied to severe mental illness has fostered a cultural change in attitudes to the long-term outcome of conditions such as schizophrenia. ‘Recovery’ has a specific meaning in this context. It refers to the possibility that even in the presence of a chronic psychiatric disorder there is hope for a life that has value. The affected individual can still make a contribution to society; he or she can expect to live independently and with dignity. The term implies that our traditional medical model of illness lacks the longer-term perspective on how patients might learn to cope with their condition.
Evaluation of an Urdu version of the Impact of Event Scale - Revised
Authors: Tareen M. S. , McDowell C. , Naqvi K. , Bashir A. , Keenan P. , ur Rehman Aziz , Farrell D. P.
Published: June 2021

In the aftermath of the major earthquake that hit Pakistan in 2005, there appeared to be a paucity of psychometric tools validated in Urdu. It was decided to translate the Impact of Event Scale - Revised (IES-R) so as to obtain an internationally validated and recognised psychometric tool for use in research into post-traumatic stress disorder. The resulting Urdu and English versions of the IES-R were compared for linguistic, conceptual and scale equivalence. The Urdu version of the IES-R (UIES-R) can be used for clinical, psychological trauma populations in Pakistan with evidence of good reliability and satisfactory validity. In trauma research in Pakistan the UIES-R will be an extremely useful psychometric tool.
Management of Early-Stage Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer
Authors: Pernas Sonia , Tolaney Sara M.
Published: June 2021

The addition of trastuzumab to chemotherapy dramatically improved the prognosis of early-stage human epidermal growth factor receptor 2 (HER2)–positive breast cancer. However, 15%-31% of patients still develop disease recurrence, on the basis of long-term follow-up of adjuvant pivotal trials. A better understanding of tumor biology has led to the development of optimized anti-HER2 drugs and add-on strategies to further improve survival outcomes. In the neoadjuvant setting, dual HER2 blockade with trastuzumab and pertuzumab plus chemotherapy has increased the rate of pathologic complete response, a surrogate marker of improved long-term outcome; yet, in the adjuvant setting, it has led to small benefits in invasive disease-free survival. Extended adjuvant therapy with the irreversible pan-HER2 inhibitor neratinib is an option for selected patients with HER2-positive and estrogen receptor–positive disease who have received neoadjuvant or adjuvant chemotherapy plus trastuzumab. Additionally, the use of the antibody-drug conjugate trastuzumab-emtansine has led to a significant improvement in invasive disease-free survival for patients with residual disease following neoadjuvant therapy and has taught us the importance of using preoperative therapy to adapt adjuvant treatment. Nevertheless, recurrences in the brain remain an important caveat, and not all patients benefit to the same extent from anti-HER2 therapies. Biologic heterogeneity within HER2-positive disease may modulate treatment response and prognosis. De-escalating treatment strategies to avoid unnecessary treatments and toxicities, without compromising outcomes, have become a crucial focus of research. To stratify patient risks and optimize treatment selection, other biomarkers including intrinsic subtype, level of HER2, and tumor-infiltrating lymphocytes should be further evaluated. We discuss the latest evidence on the current approach of early-stage, HER2-positive breast cancer and present future perspectives on its management.
Introduction
Authors: Pierce Joseph M. , Viteri María Amelia , Trávez Diego Falconí , Vidal-Ortiz Salvador , Martínez-Echazábal Lourdes
Published: June 2021

This special issue questions translation and its politics of (in)visibilizing certain bodies and geographies, and sheds light on queer and cuir histories that have confronted the imperial gaze, or that remain untranslatable. Part of a larger scholarly and activist project of the Feminist and Cuir/Queer Américas Working Group, the special issue situates the relationships across linguistic and cultural differences as central to a hemispheric queer/cuir dialogue. We have assembled contributions with activists, scholars, and artists working through queer and cuir studies, gender and sexuality studies, intersectional feminisms, decolonial approaches, migration studies, and hemispheric American studies. Published across three journals, GLQ in the United States, Periódicus in Brazil, and El lugar sin límites in Argentina, this special issue homes in on the production, circulation, and transformation of knowledge, and on how knowledge production relates to cultural, disciplinary, or market-based logics.
In Praise of This Prosperous and Harmonious Empire: Sanqu, Ming Anthologies, and the Imperial Court
Authors: Tan Tian Yuan
Published: June 2021

This article explores the textual world and functionalities of sanqu songs in relation to the court milieu. The imperial court is not usually considered a natural habitat for the sanqu genre, best known for its portrayal of “disengagement” and “retirement” from official life, yet one cannot ignore the presence of a substantial number of sanqu songs that addressed and engaged with various court contexts and imperial occasions. I call this type of songs “courtly sanqu songs,” written in a style suitable for presentation to the imperial court or for courtly occasions. By identifying a number of Ming dynasty qu anthologies that prominently feature courtly sanqu songs, this article examines how these anthologies, through their organizational structure, draw the reader's attention to courtly sanqu songs. Ming anthologies also act as the major source for tracing the textual lineage of courtly sanqu and the spectrum of songs contained within this textual world. Using one song suite (“Nation Blessed”) as a case study, the article traces its variations and different “positions” over time, across anthologies, and across different editions of the same anthology, thereby uncovering the status and place of such songs in the court milieu and beyond.
Derived loss of signal complexity and plasticity in a genus of weakly electric fish
Authors: Saenz David E. , Gu Tingting , Ban Yue , Winemiller Kirk O. , Markham Michael R.
Published: June 2021

Signal plasticity can maximize the usefulness of costly animal signals such as the electric organ discharges (EODs) of weakly electric fishes. Some species of the order Gymnotiformes rapidly alter their EOD amplitude and duration in response to circadian cues and social stimuli. How this plasticity is maintained across related species with different degrees of signal complexity is poorly understood. In one genus of weakly electric gymnotiform fish (Brachyhypopomus), only one species, B. bennetti, produces a monophasic signal while all other species emit complex biphasic or multiphasic EOD waveforms produced by two overlapping but asynchronous action potentials in each electric organ cell (electrocyte). One consequence of this signal complexity is the suppression of low-frequency signal content that is detectable by electroreceptive predators. In complex EODs, reduction of the EOD amplitude and duration during daytime inactivity can decrease both predation risk and the metabolic cost of EOD generation. We compared EOD plasticity and its underlying physiology in Brachyhypopomus focusing on B. bennetti. We found that B. bennetti exhibits minimal EOD plasticity, but that its electrocytes retained vestigial mechanisms of biphasic signaling and vestigial mechanisms for modulating the EOD amplitude. These results suggest that this species represents a transitional phenotypic state within a clade where signal complexity and plasticity were initially gained and then lost. Signal mimicry, mate recognition and sexual selection are potential factors maintaining the monophasic EOD phenotype in the face of detection by electroreceptive predators.
Endovascular interventions in management of renal artery aneurysm
Authors: Ghosh Sandipan , Dutta Soumya Kanti
Published: June 2021

Renal artery aneurysm (RAA) is a rare disease. With modern non-invasive imaging modalities, the disease is being increasingly diagnosed. It is a slow-growing aneurysm with high mortality in the event of rupture; especially in pregnant females for in which case patients were treated surgically. With advances in endovascular therapy, numerous techniques have been employed to manage complex RAA in artery bifurcation, branch and segmental arteries with excellent technical and clinical success. The various recent techniques include the use of flow diverter stents, remodelling with stent-assisted coil embolization (SACE), balloon-assisted coil embolization (BACE), selective embolization with coils-sac packing, inflow occlusion and coil trapping and selective embolization with liquid embolic agents-hystroacril and onyx. A combination of stent-graft with liquid embolization and liquid with microcoil embolization has been advocated with success. The most common complication encountered is renal infarction. This is mostly without impairment of renal function and secondary to embolization. Endovascular therapy has shorter operative time, less blood loss, shorter intensive care stay, done under conscious sedation and is associated with lesser postoperative morbidity compared to surgery. Reduction in hypertension, improvement of renal function and symptoms has been seen in most studies. Endovascular management of RAA has become the management of choice even with complex anatomy and technically challenging lesions.
Diagnostic interpretation of non-contrast qualitative MR imaging features for characterisation of uterine leiomyosarcoma
Authors: Sahin Hilal , Smith Janette , Zawaideh Jeries Paolo , Shakur Amreen , Carmisciano Luca , Caglic Iztok , Bruining Annemarie , Jimenez-Linan Mercedes , Freeman Sue , Addley Helen
Published: June 2021

Objective:

To assess the value of non-contrast MRI features for characterisation of uterine leiomyosarcoma (LMS) and differentiation from atypical benign leiomyomas

Methods:

This study included 57 atypical leiomyomas and 16 LMS which were referred pre-operatively for management review to the specialist gynaeoncology multidisciplinary team meeting. Non-contrast MRIs were retrospectively reviewed by five independent readers (three senior, two junior) and a 5-level Likert score (1-low/5-high) was assigned to each mass for likelihood of LMS. Evaluation of qualitative and quantitative MRI features was done using uni- and multivariable regression analysis. Inter-reader reliability for the assessment of MRI features was calculated by using Cohen’s κ values.

Results:

In the univariate analysis, interruption of the endometrial interface and irregular tumour shape had the highest odds ratios (ORs) (64.00, p < 0.001 and 12.00, p = 0.002, respectively) for prediction of LMS. Likert score of the mass was significant in prediction (OR, 3.14; p < 0.001) with excellent reliability between readers (ICC 0.86; 95% CI, 0.76–0.92). The post-menopausal status, interruption of endometrial interface and thickened endometrial stripe were the most predictive independent variables in multivariable estimation of the risk of leiomyosarcoma with an accuracy of 0.88 (95%CI, 0.78–0.94).

Conclusion:

At any level of expertise as a radiologist reader, the loss of the normal endometrial stripe (either thickened or not seen) in a post-menopausal patient with a myometrial mass was highly likely to be LMS.

Advances in knowledge:

This study demonstrates the potential utility of non-contrast MRI features in characterisation of LMS over atypical leiomyomas, and therefore influence on optimal management of these cases.
Estimating epidemiological and economic burden and community derived disability weights for snake bite in Kerala: a study protocol
Authors: Menon Jaideep C. , John Denny , Menon Geeta R. , Joseph Joseph K. , Suseela P. Rakesh , Pillay VV , Banerjee Amitava
Published: June 2021

Background: In India, lack of data and underreporting of cases and deaths due to snakebite makes it difficult to estimate its socio-economic burden. Previous studies measuring economic burden of snakebite in low-and-middle-income countries (LMICs) using different approaches have been conducted, but none  in India. The proposed study aims to provide evidence on disability weights, epidemiological and economic burden due to snakebites in Kerala state, India.

Protocol: The study is a community based cross-sectional study recruiting victims of snakebite occurring over a 12 month period prior to start of the study , across  Ernakulam district, Kerala state, India. For the community-derived disability weights,70 adult patients who were treated within a 3 month period prior to commencement of the study at Amrita Institute of Medical Sciences, Kochi or Little Flower Hospital, Angamaly would be interviewed. The study will measure annual incidence, mortality, treatment cost of snakebites along with community-derived disability weights for snakebites in Ernakulam district.. Standard methods for analysis and reporting of mortality, morbidity, Years of Lives Lost (YLL), Years lived with disability (YLD), disability weights, and costs of treatment will be calculated. The study will be started in April 2021 and is expected to be completed by July2021..

Discussion: This protocol is the first published for estimating epidemiological, economic burden and community derived disability weights for snakebites in India. Besides, the Global Burden of Disease has not attached a particular disability weight to snakebite and this would be an attempt to do so. The protocol has been developed using guidelines for cross-sectional studies, cost of illness studies and international guidelines for conducting community derived disability weights. The evidence generated by this study will contribute significantly to knowledge regarding the epidemiology, economic burden and community-derived disability weights for snakebites in India and other countries where incidence of snakebite is high.
The impact of surveillance and other factors on detection of emergent and circulating vaccine derived polioviruses
Authors: Auzenbergs Megan , Fountain Holly , Macklin Grace , Lyons Hil , O'Reilly Kathleen M
Published: June 2021

Background: Circulating vaccine derived poliovirus (cVDPV) outbreaks remain a threat to polio eradication. To reduce cases of polio from cVDPV of serotype 2, the serotype 2 component of the vaccine has been removed from the global vaccine supply, but outbreaks of cVDPV2 have continued. The objective of this work is to understand the factors associated with later detection in order to improve detection of these unwanted events.

Methods: The number of nucleotide differences between each cVDPV outbreak and the oral polio vaccine (OPV) strain was used to approximate the time from emergence to detection. Only independent emergences were included in the analysis. Variables such as serotype, surveillance quality, and World Health Organization (WHO) region were tested in a negative binomial regression model to ascertain whether these variables were associated with higher nucleotide differences upon detection.

Results: In total, 74 outbreaks were analysed from 24 countries between 2004 and 2019. For serotype 1 (n=10), the median time from seeding until outbreak detection was 284 (95% uncertainty interval (UI) 284-2008) days, for serotype 2 (n=59), 276 (95% UI 172-765) days, and for serotype 3 (n=5), 472 (95% UI 392-603) days. Significant improvement in the time to detection was found with increasing surveillance of non-polio acute flaccid paralysis (AFP) and adequate stool collection.

Conclusions: cVDPVs remain a risk globally; all WHO regions have reported at least one VDPV outbreak since the first outbreak in 2001. Maintaining surveillance for poliomyelitis after local elimination is essential to quickly respond to both emergence of VDPVs and potential importations. Considerable variation in the time between emergence and detection of VDPVs were apparent, and other than surveillance quality and inclusion of environmental surveillance, the reasons for this remain unclear.