bluuebunny/crossref_metadata_2025 huggingface dataset:
Accuracy of central neuro-imaging review of DIPG compared with histopathology in the International DIPG Registry
Authors: Lazow Margot A , Fuller Christine , DeWire Mariko , Lane Adam , Bandopadhayay Pratiti , Bartels Ute , Bouffet Eric , Cheng Sylvia , Cohen Kenneth J , Cooney Tabitha M , Coven Scott L , Dholaria Hetal , Diez Blanca , Dorris Kathleen , El-ayadi Moatasem , El-Sheikh Ayman , Fisher Paul G , Fonseca Adriana , Garcia Lombardi Mercedes , Greiner Robert J , Goldman Stewart , Gottardo Nicholas , Gururangan Sridharan , Hansford Jordan R , Hassall Tim , Hawkins Cynthia , Kilburn Lindsay , Koschmann Carl , Leary Sarah E , Ma Jie , Minturn Jane E , Monje-Deisseroth Michelle , Packer Roger , Samson Yvan , Sandler Eric S , Sevlever Gustavo , Tinkle Christopher L , Tsui Karen , Wagner Lars M , Zaghloul Mohamed , Ziegler David S , Chaney Brooklyn , Black Katie , Asher Anthony , Drissi Rachid , Fouladi Maryam , Jones Blaise V , Leach James L
Published: October 2021

Background

Diffuse intrinsic pontine glioma (DIPG) remains a clinico-radiologic diagnosis without routine tissue acquisition. Reliable imaging distinction between DIPG and other pontine tumors with potentially more favorable prognoses and treatment considerations is essential.

Methods

Cases submitted to the International DIPG registry (IDIPGR) with histopathologic and/or radiologic data were analyzed. Central imaging review was performed on diagnostic brain MRIs (if available) by two neuro-radiologists. Imaging features suggestive of alternative diagnoses included nonpontine origin, <50% pontine involvement, focally exophytic morphology, sharply defined margins, and/or marked diffusion restriction throughout.

Results

Among 286 patients with pathology from biopsy and/or autopsy, 23 (8%) had histologic diagnoses inconsistent with DIPG, most commonly nondiffuse low-grade gliomas and embryonal tumors. Among 569 patients with centrally-reviewed diagnostic MRIs, 40 (7%) were classified as non-DIPG, alternative diagnosis suspected. The combined analysis included 151 patients with both histopathology and centrally-reviewed MRI. Of 77 patients with imaging classified as characteristic of DIPG, 76 (99%) had histopathologic diagnoses consistent with DIPG (infiltrating grade II-IV gliomas). Of 57 patients classified as likely DIPG with some unusual imaging features, 55 (96%) had histopathologic diagnoses consistent with DIPG. Of 17 patients with imaging features suggestive of an alternative diagnosis, eight (47%) had histopathologic diagnoses inconsistent with DIPG (remaining patients were excluded due to nonpontine tumor origin). Association between central neuro-imaging review impression and histopathology was significant (p < 0.001), and central neuro-imaging impression was prognostic of overall survival.

Conclusions

The accuracy and important role of central neuro-imaging review in confirming the diagnosis of DIPG is demonstrated.
A Randomized Trial of Nicotine versus No-nicotine E-cigarettes Among African American Smokers: Changes in Smoking and Tobacco Biomarkers
Authors: Okuyemi Kolawole S , Ojo-Fati Olamide , Aremu Taiwo O , Friedrichsen Samantha C , Grude Lindsay , Oyenuga Mosunmoluwa , Shyne Michael , Murphy Sharon E , Hatsukami Dorothy , Joseph Anne M
Published: October 2021

Introduction

The objective of this clinical trial was to compare the effects of e-cigarettes with and without nicotine on patterns of combustible cigarette use and biomarkers of exposure to tobacco toxicants among African American smokers.

Methods

African American smokers (n = 234) were enrolled in a 12-week, single blind, randomized controlled trial and assigned to ad lib use of nicotine e-cigarettes with or without menthol (2.4% nicotine [equivalent to combustible cigarettes], n = 118), or no-nicotine e-cigarettes (n = 116) for 6 weeks. Surveys were administered at baseline, 2, 6, and 12 weeks, and urinary biomarkers 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and total nicotine equivalents (TNE) were assessed at baseline and 6 weeks.

Results

Participants smoked an average of 11.4 cigarettes per day (CPD) and 88% used menthol cigarettes at baseline. At Week 6, the nicotine group reported using e-cigarettes 9.1 times per day compared to 11.4 times in the no-nicotine group (p = 0.42). Combustible cigarette smoking decreased 3.0 CPD in the nicotine group compared to 2.7 CPD in the no-nicotine group (p = 0.74). Neither TNE nor NNAL changed significantly between baseline and Week 6. There were no differences in nicotine withdrawal symptoms between treatment groups. Smoking reduction persisted in both groups at Week 12.

Conclusions

Contrary to our hypotheses, nicotine e-cigarettes did not significantly reduce the use of combustible cigarettes compared to no-nicotine e-cigarettes in this cohort of African American smokers. Findings suggest e-cigarettes are modestly associated with the decreased use of combustible cigarettes among non-treatment seeking smokers, regardless of nicotine content, but without a reduction in tobacco toxicants.

Implications

Although e-cigarettes have the potential to reduce harm if substituted for combusted cigarettes (or if they promoted cessation) because of lower levels of tobacco toxicants, this study suggests ad lib use of e-cigarettes among African American smokers, with or without nicotine, results in modest smoking reduction but does not change toxicant exposure in a cohort where smoking cessation or reduction is not the goal. These data suggest that testing future harm reduction interventions using e-cigarettes should include more specific behavioral change coaching, including substituting for or completely stopping combusted cigarettes.

Clinical Trial Registration

ClinicalTrials.gov – NCT03084315
Characterizing Heated Tobacco Product Use Among Adult Cigarette Smokers and Nicotine Vaping Product Users in the 2018 ITC Four Country Smoking & Vaping Survey
Authors: Miller Connor R , Sutanto Edward , Smith Danielle M , Hitchman Sara C , Gravely Shannon , Yong Hua-Hie , Borland Ron , O’Connor Richard J , Cummings K Michael , Fong Geoffrey T , Hyland Andrew , Quah Anne C K , Goniewicz Maciej L
Published: October 2021

Introduction

Heated tobacco products (HTP) have diversified global tobacco markets, and user characteristics remain understudied. This study evaluated sociodemographic characteristics, nicotine-related perceptions, and behaviors of current HTP users within a sample of adult (18+ years) nicotine users across four countries.

Aims and Methods

Data were from current smokers or nicotine vaping product (NVP; known as “e-cigarettes”) users from Canada, England, the United States, and Australia (n = 11 421) who participated in the 2018 ITC Four Country Smoking and Vaping Survey. Current (at-least-monthly) HTP users were characterized (n = 441), and weighted multivariable logistic regressions examined correlates of HTP use.

Results

Compared to nonusers, current HTP users were younger (mean age: 44.4 vs 31.0 years; p < .001) and had higher socioeconomic status (p < .001). A majority of current HTP users used HTPs nondaily (daily: 40.3% vs nondaily: 59.7%). Most HTP users concurrently used both cigarettes and NVPs (90.5%). Among concurrent cigarette-HTP-NVP users, 36.2% used all three products daily. Use of other combusted tobacco products (cigars, cigarillos, pipe, waterpipe/hookah), cannabis, and binge drinking were each associated with current HTP use. HTP use was more common among smokers intending to quit within 6 months or reporting a quit attempt in the past 18 months, and vapers who had experienced negative side effects.

Conclusion

HTP users in this sample tended to be younger and more affluent. Most reported concurrent use of multiple nicotine products and other substances. Those cigarette smokers who used HTPs appeared more interested in smoking cessation, while some characteristics of concurrent HTP-NVP users were suggestive of dissatisfaction with NVPs.

Implications

Few studies have scrutinized characteristics of HTP early adopters in emerging markets. Our results indicate that in 2018, characteristics of established nicotine users who adopted HTP use in four high-income Western countries mirror those of HTP users in East Asian markets (South Korea and Japan) where HTPs are popular. HTP users reported high levels of concurrent use of noncigarette-combusted tobacco products (e.g., cigars, pipe tobacco). These findings point to the need for future longitudinal studies of HTP use given the implications of those use patterns on the harm reduction potential of HTPs. HTP user characteristics may yield important information to consider in regulation of these products.
Age- and Sex-Dependent Nicotine Pretreatment Effects on the Enhancement of Methamphetamine Self-administration in Sprague-Dawley Rats
Authors: Cardenas Anjelica , Lotfipour Shahrdad
Published: October 2021

Introduction

Initiation of tobacco products typically occurs in adolescence. Adolescence is a critical period in development where the maturation of brain neurocircuitry is vulnerable to nicotine. Nicotine-containing products and psychostimulants, such as methamphetamine (METH), are often coabused. Rodent studies have shown that nicotine exposure in early adolescence increases subsequent drug intake and reward. Given the exponential increase in e-cigarette use among adolescents, there is a pressing need to understand whether adolescent nicotine exposure impacts concurrent increased METH use. The objective of this study is to evaluate age, sex, and longitudinal effects of nicotine pretreatment on METH reinforcement.

Aims and Methods

Male and female Sprague-Dawley rats were pretreated with a subchronic, low-dose nicotine (2×, 30 µg/kg/0.1 mL, intravenous) or saline during early adolescence (postnatal days [PN] 28–31) or adulthood (PN 86–89). Following nicotine pretreatment, on PN 32 or PN 90, animals underwent operant intravenous self-administration for METH (20 µg/kg/inf) over a 2-hour period for five consecutive days.

Results

Early adolescent nicotine exposure enhances intravenous METH self-administration in male, but not female adolescents. Male adult rats self-administer METH over the 5-day testing period, independent of nicotine exposure. In contrast, nicotine exposure increases METH self-administration in female adults during the later sessions of the 5-day testing period.

Conclusions

Taken together, our data highlight age- and sex-dependent effects of low dose, subchronic nicotine pretreatment on subsequent intravenous METH self-administration.

Implications

A majority of polysubstance users begin smoking before the age of 18. Mounting evidence highlights adolescent susceptibility to nicotine exposure on brain and behavior. With the escalation in nicotine-containing products and stimulant use among adolescents, it is important to identify the consequences from adolescent nicotine use, including polysubstance use. Our study provides evidence that adolescent nicotine exposure enhances subsequent METH use, with important sex- and age-dependent effects.
Comparative phylogeography of Cyclops vicinus Uljanin, 1875 and Cyclops kikuchii Smirnov, 1932 with implications for differences in their ecological characteristics
Authors: Sioud Imane , Makino Wataru , Urabe Jotaro
Published: October 2021

Cyclops kikuchii and Cyclops vicinus are lentic freshwater cyclopoid copepods commonly found in Eurasia, including the Japanese archipelago, where a recent study revealed they were morphologically and molecularly distinguishable. However, their distribution patterns and ecological characteristics are not yet understood. We sought to establish their spatial distributions in Japan and determine whether they have similar phylogeographic patterns using mitochondrial cytochrome c oxidase subunit I. We found that C. vicinus appeared frequently in the south of Japan as opposed to the north, where C. kikuchii dominated. The Japanese C. kikuchii consists of two phylogroups with a large genetic differentiation (ca. 0.1 as the Kimura 2 Parameter distance), suggesting a case of secondary contact. Neither species showed clear signs of demographic expansion after bottleneck events in Japan. Unlike C. kikuchii, which had many private haplotypes across Japan, C. vicinus possessed several geographically widespread haplotypes, suggesting that its realized range of dispersal and frequency of effective dispersal are larger than those of C. kikuchii’s. We thus argue that the dispersal ability is stronger in C. vicinus than in C. kikuchii. Judging from the data of our present and previous studies, this argument may hold for their entire geographic range.
Asymmetric expression of Argonautes in reproductive tissues
Authors: Jullien P E , Schröder J A , Bonnet D M V , Pumplin N , Voinnet O
Published: October 2021

The Arabidopsis genome encodes ten Argonautes proteins showing distinct expression pattern as well as intracellular localisation during sexual reproduction.
Epigenetics and the International Classification of Functioning, Disability and Health Model: Bridging Nature, Nurture, and Patient-Centered Population Health
Authors: Shields Richard K , Dudley-Javoroski Shauna
Published: October 2021

Epigenetic processes enable environmental inputs such as diet, exercise, and health behaviors to reversibly tag DNA with chemical “marks” that increase or decrease the expression of an individual’s genetic template. Over time, epigenetic adaptations enable the effects of healthy or unhealthy stresses to become stably expressed in the tissue of an organism, with important consequences for health and disease. New research indicates that seemingly non-biological factors such as social stress, poverty, and childhood hardship initiate epigenetic adaptations in gene pathways that govern inflammation and immunity, two of the greatest contributors to chronic diseases such as diabetes and obesity. Epigenetic processes therefore provide a biological bridge between the genome—an individual’s genetic inheritance—and the Social Determinants of Health—the conditions in which they are born, grow, live, work, and age. This Perspective paper argues that physical therapy clinicians, researchers, and educators can use the theoretical framework provided by the International Classification of Functioning, Disability, and Health (ICF model) to harmonize new discoveries from both public health research and medically focused genomic research. The ICF model likewise captures the essential role played by physical activity and exercise, which initiate powerful and widespread epigenetic adaptations that promote health and functioning. In this proposed framework, epigenetic processes transduce the effects of the social determinants of health and behaviors such as exercise into stable biological adaptations that affect an individual’s daily activities and their participation in social roles. By harmonizing “nature” and “nurture,” physical therapists can approach patient care with a more integrated perspective, capitalizing on novel discoveries in precision medicine, rehabilitation science, and in population-level research. As the experts in physical activity and exercise, physical therapists are ideally positioned to drive progress in the new era of patient-centered population health care.
The Lexicographical Lesbian: Remaking the Body in Anne Lister’s Erotic Glossary
Authors: Turton Stephen
Published: October 2021

In recent years, literary criticism has witnessed a flourishing of what Paula Blank presciently called ‘etymological moments’: playful tracings of the roots of words that unearth unexpected links between the past and the present, and in so doing unsettle our certainties about both. Many of these moments have occurred under the rubric of queer philology, which has particularly called into question scholarly assumptions about the historical transmission of discourses on gender, sexuality, and embodiment. However, this impulse to reclaim the discursive history of the sexed and sexual body is not new. Between 1814 and 1820, the Yorkshire gentlewoman Anne Lister—now famous for her diary’s candid accounts of her love affairs with women—pored through English, Latin, and Greek dictionaries, looking up terms for sexual acts and anatomies and collating what she found into a personal glossary. Lister’s citing and rewriting of these definitions illuminate the protean forms that a dictionary can take for its writers and users: a source of knowledge, a moral guide, and even an erotic aid. Through lexicography, Lister found new ways of reading the body and reimagining its borders, the better to fit the contours of her own desires.
THREE-DIMENSIONAL DOSIMETRY OF MAMMOGRAPHY USING A BLOCK CUBE BREAST PHANTOM AND RADIOCHROMIC FILM
Authors: Gotanda Tatsuhiro , Katsuda Toshizo , Yatake Hidetoshi , Kawaji Yasuyuki , Gotanda Rumi , Imai Shinya , Akagawa Takuya , Sasaki Masashi
Published: October 2021

This study developed a phantom with a shape similar to that of the breast and use GAFCHROMIC films that can be placed inside the phantom to measure the detailed breast dose distribution in mammography. GAFCHROMIC EBT3 was placed on the block cube breast phantom and irradiated with a mammography device to measure the absorbed dose distribution inside the phantom in the horizontal and depth directions. The dose distribution in the horizontal plane was the highest in the centre on the chest wall side, and it decreased in a fan shape. Along the depth of the phantom, the doses absorbed across the entire cross-section were 16.15 mGy at the surface and 7.51, 3.25 and 1.68 mGy at depths of 10, 20 and 30 mm, respectively. Compared with the mean glandular dose, the proposed method can measure breast dose distributions in greater detail and is applicable to various breast shapes.
Review of potential risks associated with supplemental dietary exposure to nitrate-containing compounds in swine—a paradox in light of emerging benefits
Authors: Doepker Candace L , Heintz Melissa M , van de Ligt Jennifer , Wikoff Daniele S
Published: October 2021

Calcium nitrate has been reported to benefit reproductive outcomes in sows and their offspring when administered via the feed (15 to 19 mg/kg-body weight [bw]/day) during the periparturient period. Traditionally, dietary nitrate had been considered a methemoglobinemia (MetHb) risk in swine. Similar hazard concerns have existed in humans, but a recent benefit/risk analysis established that nitrate levels associated with well-recognized health benefits outweigh potential risks. A similar benefit/risk perspective in swine was lacking and challenged by sparse published hazard data, often referenced within larger reviews related to all livestock. The objective of this review was to better characterize the potential for adverse health and performance effects reported in the literature for swine consuming nitrate and to provide metrics for evaluating the reliability of the studies reviewed. Supplemental exposure via feed or drinking water was considered for any life stage, dose, and exposure duration. More than 30 relevant studies, including case reports and reviews, examined calcium, potassium, sodium, or unspecified nitrate salts at doses up to 1,800 mg nitrate/kg-bw/day for exposures ranging from 1 to 105 d. The studies primarily evaluated weight gain, blood methemoglobin levels, or vitamin A homeostasis in sows or growing swine. An extensive review of the literature showed reports of adverse effects at low nitrate doses to be of low reliability. Conversely, reliable studies corroborate nitrate intake from feed or drinking water at levels equal to or greater than the European Food Safety Authority’s no-observed-adverse-effect level (NOAEL) for swine of 410 mg nitrate/kg-bw/day, with no MetHb or other adverse effects on reproduction, growth, or vitamin A levels. Using a weight-of-evidence evaluation, we have moderate-to-high confidence that the NOAEL for nitrate supplementation in swine is likely between 600 and 800 mg/kg-bw/day. These levels are several-fold higher than dietary nitrate concentrations (19 mg/kg-bw/day) that are known to benefit birth outcomes in sows. This review elucidates the quality and reliability of the information sources historically used to characterize nitrate in swine feed as a contaminant of concern. Results from this evaluation can assist risk managers (e.g., regulatory officials and veterinarians) in consideration of proposed benefits as well as reassuring swine producers that low-level nitrate supplementation is not anticipated to be a concern.
Risk of Epidemic Development in Nurseries from Soil Inoculum of Phytophthora ramorum
Authors: Peterson Ebba K. , Grünwald Niklaus J. , Parke Jennifer L.
Published: October 2021

Soilborne inoculum arising from buried, infested leaf debris may contribute to the persistence of Phytophthora ramorum at recurrently positive nurseries. To initiate new epidemics, inoculum must not only survive but also produce sporangia during times conducive to infection at the soil surface. To assess this risk, we performed two year-long experiments in a soil plot at the National Ornamentals Research Site at Dominican University of California. Inoculated rhododendron leaf disks were buried at a depth of 5 or 15 cm in the early summer of 2014 or 2015. Inoculum was baited at the soil surface with noninfested leaf disks (2014 only) and then retrieved to assess pathogen viability and sporulation capacity every 5 weeks. Two 14-week-long trials were conducted in 2016. We were able to consistently culture P. ramorum over all time periods. Soil incubation rapidly reduced the capacity of inoculum to sporulate, especially at 5 cm; however, sporulation capacity increased with the onset of seasonally cooler temperatures. P. ramorum was baited most frequently between November and January, especially from inoculum buried at 5 cm 1 day before the baiting period; in January we also baited P. ramorum from inoculum buried at 15 cm the previous June. We validate prior observations that P. ramorum poses a greater risk after exposure to cooler temperatures and provide evidence that infested leaf debris plays a role in the perpetuation of P. ramorum in nurseries. This work provides novel insights into the survival and epidemic behavior of P. ramorum in nursery soils.
Amplification Self-Adjustment: Controls and Repeatability
Authors: Boothroyd Arthur , Retana Jennifer , Mackersie Carol L.
Published: October 2021

Objectives:

This study was a continuation of work on an explore-and-select approach to the self-adjustment of amplification. Goals were to determine (i) the effect of changing the number of adjustment controls from three to two, (ii) the effect of changing the initial adjustment from overall output to high-frequency output, (iii) individual repeatability, (iv) the effect on phoneme recognition of increasing and decreasing overall output relative to the starting and adjusted conditions, and (v) listener reactions to, and opinions of, the self-adjustment procedure.

Design:

Twenty-two adults with hearing loss, 10 of whom were hearing aid users, adjusted level and spectrum of connected speech to preference, using three configurations of number and order of adjustment parameters. The three adjustments were replicated to give a total of six. Presentation was monaural, in quiet, using the ear with the better threshold at 2 kHz. The starting condition was a generic prescription for a typical mild-to-moderate hearing loss. Real ear output spectra were measured for the 6 self-adjustments, the generic starting condition, and the individual NAL-NL2 prescriptions for speech at 65 dB SPL. Monaural phoneme recognition in monosyllables was assessed, in quiet, at levels of −14, −7, 0 and +7 dB relative to both the starting and the self-adjusted conditions. Participants completed a questionnaire and their comments on each question were transcribed.

Results:

Changing the number of listener controls from 3 to 2 reduced mean adjustment time by around 50% but had negligible effect on group-mean output response. Starting adjustment with high-frequency output rather than overall output resulted in a 2 to 3 dB reduction of group-mean self-adjusted output below 1 kHz. Individual self-adjustments were within ±5 dB of NAL-NL2 prescription (for a 65 dB SPL speech input) for two-thirds of the participants in the high frequencies and for just over half in the low frequencies. In six self-adjustments, individuals self-adjusted, on average, to within ±4 dB of their own mean in both high and low frequencies. There was no evidence that these findings differed for hearing aid users and nonusers. Changes of overall output by ±7 dB after self-adjustment did not significantly affect group mean phoneme recognition. Preference for number and order of self-adjustment differed among participants, as did opinions on self-fitting of hearing aids.

Conclusions:

These findings support the conclusion that, for many adults with hearing loss, an explore-and-select procedure for self-adjustment of amplification leads to output values that are repeatable within a few dB, are relatively immune to the number and order of adjustment parameters, and place the average listener well along the plateau of a phoneme recognition versus amplitude function.
A Transcriptomic Severity Metric That Predicts Clinical Outcomes in Critically Ill Surgical Sepsis Patients
Authors: Brakenridge Scott C. , Starostik Petr , Ghita Gabriella , Midic Uros , Darden Dijoia , Fenner Brittany , Wacker James , Efron Philip A. , Liesenfeld Oliver , Sweeney Timothy E. , Moldawer Lyle L.
Published: October 2021

OBJECTIVES:

Clinically deployable methods for the rapid and accurate prediction of sepsis severity that could elicit a meaningful change in clinical practice are currently lacking. We evaluated a whole-blood, multiplex host-messenger RNA expression metric, Inflammatix-Severity-2, for identifying septic, hospitalized patients’ likelihood of 30-day mortality, development of chronic critical illness, discharge disposition, and/or secondary infections.

DESIGN:

Retrospective, validation cohort analysis.

SETTING:

Single, academic health center ICU.

PATIENTS:

Three hundred thirty-five critically ill adult surgical patients with sepsis.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Whole blood was collected in PAXgene Blood RNA collection tubes at 24 hours after sepsis diagnosis and analyzed using a custom 29-messenger RNA classifier (Inflammatix-Severity-2) in a Clinical Laboratory Improvement Amendments certified diagnostic laboratory using the NanoString FLEX platform. Among patients meeting Sepsis-3 criteria, the Inflammatix-Severity-2 severity score was significantly better (p < 0.05) at predicting secondary infections (area under the receiver operating curve 0.71) and adverse clinical outcomes (area under the receiver operating curve 0.75) than C-reactive protein, absolute lymphocyte counts, total WBC count, age, and Charlson comorbidity index (and better, albeit nonsignificantly, than interleukin-6 and Acute Physiology and Chronic Health Evaluation II). Using multivariate logistic regression analysis, only combining the Charlson comorbidity index (area under the receiver operating curve 0.80) or Acute Physiology and Chronic Health Evaluation II (area under the receiver operating curve 0.81) with Inflammatix-Severity-2 significantly improved prediction of adverse clinical outcomes, and combining with the Charlson comorbidity index for predicting 30-day mortality (area under the receiver operating curve 0.79).

CONCLUSIONS:

The Inflammatix-Severity-2 severity score was superior at predicting secondary infections and overall adverse clinical outcomes compared with other common metrics. Combining a rapidly measured transcriptomic metric with clinical or physiologic indices offers the potential to optimize risk-based resource utilization and patient management adjustments that may improve outcomes in surgical sepsis. Hospitalized patients who are septic and present with an elevated IMX-SEV2 severity score and preexisting comorbidities may be ideal candidates for clinical interventions aimed at reducing the risk of secondary infections and adverse clinical outcomes.
Schroth exercises improve health-related quality of life and radiographic parameters in adolescent idiopathic scoliosis patients
Authors: Gao Ang , Li Jun-Yu , Shao Rui , Wu Tong-Xuan , Wang Yong-Qiang , Liu Xiao-Guang , Yu Miao
Published: October 2021

Background:

Finding an optimal treatment strategy for adolescent idiopathic scoliosis (AIS) patients remains challenging because of its intrinsic complexity. For mild to moderate scoliosis patients with lower skeletal growth potential (Risser 3–5), most clinicians agree with observation treatment; however, the curve progression that occurs during puberty, the adolescent period, and even in adulthood, remains a challenging issue for clinicians. The aim of the study is to investigate the efficacy of Schroth exercise in AIS patients with lower skeletal growth potential (Risser 3–5) and moderate scoliosis (Cobb angle 20°–40°).

Methods:

From 2015 to 2017, data of 64 patients diagnosed with AIS in Peking University Third Hospital were reviewed. Forty-three patients underwent Schroth exercise were classified as Schroth group, and 21 patients underwent observation were classified as observation group. Outcomes were measured by health-related quality of life (HRQOL) and radiographic parameters. HRQOL was assessed using the visual analog scale (VAS) scores for back, Scoliosis Research Society-22 (SRS-22) patient questionnaire. Radiographic spinopelvic parameters were obtained from anteroposterior and lateral X-rays. The pre-treatment and post-treatment HRQOL and radiographic parameters were tested to validate Schroth exercise efficacy. The inter-rater reliability of the radiographic parameters was tested using the interclass correlation coefficient (ICC). The paired t test was used to examine HRQOL and radiographic parameters. Clinical relevance between C2-C7 sagittal vertical axis (SVA) and thoracic kyphosis was analyzed using Spearman correlation.

Results:

In Schroth group, VAS back score, SRS-22 pain, and SRS-22 self-image domain were significantly improved from pre-treatment 3.0 ± 0.8, 3.6 ± 0.5, and 3.5 ± 0.7 to post-treatment 1.6 ± 0.6 (t = 5.578, P = 0.013), 4.0 ± 0.3 (t = −3.918, P = 0.001), and 3.7 ± 0.4 (t = −6.468, P < 0.001), respectively. No significant improvements of SRS-22 function domain (t = −2.825, P = 0.088) and mental health domain (t = −3.174, P = 0.061) were observed. The mean Cobb angle decreased from 28.9 ± 5.5° to 26.3 ± 5.2° at the final follow-up, despite no statistical significance was observed (t = 1.853, P = 0.102). The mean C2-C7 SVA value decreased from 21.7 ± 8.4 mm to 17.0 ± 8.0 mm (t = −1.224 P = 0.049) and mean T1 tilt decreased from 4.9 ± 4.2 ° to 3.5 ± 3.1° (t = 2.913, P = 0.011). No significant improvement of radiographic parameters and HRQOL were observed in observation group.

Conclusions:

For AIS patients with a Risser 3–5 and a Cobb angle 20°–40°, Schroth exercises improved HRQOL and halted curve progression during the follow-up period. Both cervical spine alignment and shoulder balance were also significantly improved after Schroth exercises. We recommend Schroth exercises for patients with AIS.
A Small-Scale Survey of Bilateral Upper-Limb Loss Individuals
Authors: Sears Harold H. , Doolan Kim , Keenan Denise D.
Published: October 2021

Introduction

Bilateral upper-limb loss (Bil UL Loss) is perhaps the greatest challenge for upper-limb prosthetic care, now even more than ever as we witness the increase of sepsis as a cause of limb loss.

Methods

This small-n survey has recruited 28 individuals with Bil UL Loss, 27 of whom are prosthesis wearers. Twelve of the 28 lost four limbs to sepsis; 17 of the 27 prosthesis wearers use body-powered hooks, six use electric hooks, and four use electric hands as their dominant terminal device (within this report, dominant side is the wearer's postloss dominant side, i.e., the side the subject used more frequently). The survey used person-to-person interviews to compile the broad data about how tasks are performed, how many tasks are performed, whether two prostheses are used, and other details.

Results

Users of each type of prosthesis demonstrate a high level of function. Electric hook users scored slightly higher in number of tasks and other measures. However, no outcomes were significant statistically, except the use of the dominant side prosthesis, which was three times higher than the nondominant side usage. Users identified a dozen categories for desired improvements, with greater dependability and greater grip security as the most commonly requested.

Discussion

The information will be useful for not only for clinical guidance, but hopefully also to help guide the development of future prosthetic devices, considering that the disabled community has called for prioritizing the actual needs and desires of the consumers to guide future developments.

Conclusions

The planning and execution of this small-scale study could be a model for other groups to collect useful outcomes data without requiring a research grant, without large institutional oversight, and by only a small group of interested professionals with access to a reasonable number of individuals with a severe disability.

Clinical Relevance

All caregivers of individuals with bilateral limb loss could benefit from both the data presented and the challenges revealed by this survey group. Future prosthetic designs as well as training and other therapies will also hopefully benefit from the needs expressed directly by these consumers.
Limnovirga soli gen. nov., sp. nov., isolated from river sediment
Authors: Yim Kyung June , Jung Dong-Hyun , Jang Seok Won , Park Sanghwa
Published: October 2021

A cream-coloured, Gram-stain-negative, rod-shaped bacterium, designated strain KSC-6T, was isolated from soil sampled at the Gapcheon River watershed in Daejeon, Republic of Korea. The organism does not require NaCl for growth and grows at pH 6.0–8.0 (optimum, pH 7.0) and 10–37 °C (optimum, 25 °C). Phylogenetic trees based on the 16S rRNA gene sequences reveal that strain KSC-6T belongs to the family

Chitinophagaceae

within the order

Chitinophagales

and is most closely related to

Panacibacter ginsenosidivorans

Gsoil 1550T (95.9% similarity). The genomic DNA G+C content was 38.9 mol%. The major cellular fatty acids (>8 %) of strain KCS-6T were iso-C15:0, iso-C15 : 1 G and iso-C17 : 0 3-OH. The predominant respiratory quinone was menaquinone 7 and the predominant polar lipids were phosphatidylethanolamine, five unidentified aminolipids and two unidentified lipids. Based on genome analyses, low digital DNA–DNA hybridization, average nucleotide identity and average amino acid identity values with closely related genera, and differential chemotaxonomic and physiological properties, we suggest that strain KCS-6T represents a novel species in a new genus in the family

Chitinophagaceae

, for which the name Limnovirga soli gen. nov., sp. nov. (type strain KCS-6T=KCCM 43337T=NBRC 114336T) is proposed.
Construction and Validation of a Nomogram Based on the Log Odds of Positive Lymph Based on the Log Odds of Positive Lymph Nodes to Predict the Prognosis of Lung Neuroendocrine Tumors
Authors: Wang Suyu , Wei Juan , Guo Yibin , Xu Qiumeng , Lv Xin , Yu Yue , Liu Meiyun
Published: October 2021

Objectives

This study aimed to investigate the prognostic value of Log odds of positive lymph nodes (LODDS) for predicting the long-term prognosis of patients with node-positive lung neuroendocrine tumors (LNETs).

Materials and Methods

We collected 506 eligible patients with resected N1/N2 classification LNETs from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. First, we applied the Cox proportional-hazards regression model to evaluate the relationship between LODDS and study endpoints (cancer-specific survival [CSS] and overall survival [OS]) based on the entire cohort. Second, the study cohort was divided into derivation cohort (n=300) and external validation cohort (n=206) based on different geographic regions. Nomograms were constructed and validated based on these two cohorts to predict the 1-, 3- and 5-year survival of patients with LNETs. The accuracy and clinical practicability of nomograms were tested and compared by Harrell’s concordance index (C-index), integrated discrimination improvement (IDI), net reclassification improvement (NRI), calibration plots, and decision curve analyses.

Results

The Cox proportional-hazards model showed the high LODDS group (-0.33≤LODDS≤1.14) had significantly higher mortality compared to those in the low LODDS group (-1.44 ≤LODDS<-0.33) for both CSS and OS. In addition, besides LODDS, age at diagnosis, histotype, type of surgery, radiotherapy, and chemotherapy were shown as independent predictors in Cox regression analyses and included in the nomograms. The values of c-index, NRI, and IDI indicated that the established nomogram performed significantly better than the conventional eighth edition of the TNM staging system alone. The calibration plots for predictions of the 1-, 3-, and 5-year OS were in excellent agreement. Decision curve analyses showed that the nomogram had value in terms of clinical application.

Conclusions

We created visualized nomograms for CSS and OS of LNET patients, facilitating clinicians to provide highly individualized risk assessment and therapy.
Establishment of a teaching hospital-based dementia consultation service for rurally-based regional district general hospitals
Authors: Schott Björn H. , Voetlause Jakob Christian , Amoah Juliana Lisa , Kratzenberg Alexander , Belz Michael , Knipper Tobias , Timäus Charles , Beskow Carmen , Sweeney-Reed Catherine M. , Wiltfang Jens , Radenbach Katrin
Published: October 2021

Objective

The treatment of patients with dementia poses a considerable challenge to regional district general hospitals, particularly in rural areas. Here we report the establishment and initial evaluation of a dementia-specific consultation service provided by a teaching hospital-based Psychiatry Department to regional district general hospitals in surrounding smaller towns.

Methods

The consultation service was provided to patients with pre-existing or newly suspected dementia, who were in acute hospital care for concurrent conditions. An evaluation of 61 consultations – 49 on-site and 12 via telemedicine – was performed to assess the needs of the participating hospitals and the specific nature of the referrals to the consultation service.

Results

Suspected dementia or cognitive dysfunction was the primary reason for consultation requests (>50% of cases). Other common requests concerned suspected delirium, behavioral symptoms, and therapeutic recommendations. During the consultations, a diagnosis of dementia was reached in 52.5% of cases, with other common diagnoses including delirium and depression. Recommendations related to pharmacotherapy were given in 54.1% of consultations. Other recommendations included referral for outpatient neurological or psychiatric follow-up, further diagnostic assessment, or assessment in a memory clinic. Geriatric psychiatric inpatient treatment was recommended in only seven cases (11.5 %).

Conclusions

Our initial evaluation demonstrates the feasibility of providing a dementia-specific consultation service in rural areas. The service has the potential to reduce acute transfers to inpatient geriatric psychiatry and enables older patients with dementia or delirium to be treated locally by helping and empowering rurally-based regional hospitals to manage these problems and associated complications.
Disrupted reward processing in Parkinson’s Disease and its relationship with dopamine state and neuropsychiatric syndromes: a systematic review and meta-analysis
Authors: Costello Harry , Berry Alex J. , Reeves Suzanne , Weil Rimona S. , Joyce Eileen M. , Howard Robert , Roiser Jonathan P.
Published: October 2021

Background

Neuropsychiatric symptoms are common in Parkinson’s disease (PD) and predict poorer outcomes. Reward processing dysfunction is a candidate mechanism for the development of psychiatric symptoms including depression and impulse control disorders (ICD). We aimed to determine whether reward processing is impaired in PD and its relationship with neuropsychiatric syndromes and dopamine replacement therapy.

Methods

The Ovid MEDLINE/PubMed, Embase and PsycInfo databases were searched for articles published up to November 5th, 2020. Studies reporting reward processing task performance by PD patients and healthy controls were included. Summary statistics comparing reward processing between groups were converted to standardized mean difference (SMD) scores and meta-analysed using a random effects model.

Results

We identified 55 studies containing 2578 participants (1,638 PD and 940 healthy controls). Studies assessing three subcomponent categories of reward processing tasks were included: Option Valuation (n=12), Reinforcement Learning (n=37) and Reward Response Vigour (n=6). Across all studies, PD patients on medication exhibited a small-to-medium impairment versus healthy controls (SMD=0.34; 95%CI 0.14-0.53), with greater impairments observed off dopaminergic medication in within-subjects designs (SMD=0.43, 95%CI 0.29-0.57). Within-subjects subcomponent analysis revealed impaired processing off medication on Option Valuation (SMD=0.57, 95%CI 0.39-0.75) and Reward Response Vigour (SMD=0.36, 95%CI 0.13-0.59) tasks. However, the opposite applied for Reinforcement Learning, which relative to healthy controls was impaired on-medication (SMD=0.45, 95%CI 0.25-0.65) but not off-medication (SMD=0.28, 95%CI -0.03-0.59). ICD was the only neuropsychiatric syndrome with sufficient studies (n=13) for meta-analysis, but no significant impairment was identified compared to non-ICD patients (SMD=-0.02, 95%CI -0.43-0.39).

Conclusion

Reward processing disruption in PD differs according to subcomponent and dopamine medication state and warrants further study as a potential treatment target and mechanism underlying associated neuropsychiatric syndromes.
Source-sink connectivity: A novel interictal EEG marker for seizure localization
Authors: Gunnarsdottir Kristin M. , Li Adam , Smith Rachel J. , Kang Joon-Yi , Korzeniewska Anna , Crone Nathan E. , Rouse Adam G. , Cheng Jennifer J. , Kinsman Michael J. , Landazuri Patrick , Uysal Utku , Ulloa Carol M. , Cameron Nathaniel , Cajigas Iahn , Jagid Jonathan , Kanner Andres , Elarjani Turki , Bicchi Manuel Melo , Inati Sara , Zaghloul Kareem A. , Boerwinkle Varina L. , Wyckoff Sarah , Barot Niravkumar , Gonzalez-Martinez Jorge , Sarma Sridevi V.
Published: October 2021

Over 15 million epilepsy patients worldwide have drug-resistant epilepsy (DRE). Successful surgery is a standard of care treatment for DRE but can only be achieved through complete resection or disconnection of the epileptogenic zone (EZ), the brain region(s) where seizures originate. Surgical success rates vary between 20-80% because no clinically validated biological markers of the EZ exist. Localizing the EZ is a costly and time-consuming process beginning with non-invasive neuroimaging and often followed by days to weeks of intracranial EEG (iEEG) monitoring. Clinicians visually inspect iEEG data to identify abnormal activity (e.g., low-voltage high frequency activity) on individual channels occurring immediately before seizures or spikes that occur on interictal iEEG (i.e., between seizures). In the end, the clinical standard mainly relies on a small proportion of the iEEG data captured to assist in EZ localization (minutes of seizure data versus days of recordings), missing opportunities to leverage these largely ignored interictal data to better diagnose and treat patients.

Intracranial EEG offers a unique opportunity to observe epileptic cortical network dynamics but waiting for seizures increases patient risks associated with invasive monitoring. In this study, we aim to leverage interictal iEEG data by developing a new network-based interictal iEEG marker of the EZ. We hypothesize that when a patient is not clinically seizing, it is because the EZ is inhibited by other regions. We developed an algorithm that identifies two groups of nodes from the interictal iEEG network: those that are continuously inhibiting a set of neighboring nodes (“sources”) and the inhibited nodes themselves (“sinks”). Specifically, patient-specific dynamical network models (DNMs) were estimated from minutes of iEEG and their connectivity properties revealed top sources and sinks in the network, with each node being quantified by source-sink metrics (SSMs). We validated the SSMs in a retrospective analysis of 65 patients by using the SSMs of the annotated EZ to predict surgical outcomes. The SSMs predicted outcomes with an accuracy of 79% compared to an accuracy of 43% for clinicians’ predictions (surgical success rate of this dataset). In failed outcomes, we identified regions of the brain with high SSMs that were untreated. When compared to high frequency oscillations, the most commonly proposed interictal iEEG feature for EZ localization, SSMs outperformed in predictive power (by a factor of 1.2) suggesting SSMs may be an interictal iEEG fingerprint of the EZ.
A longer stance is more stable for a standing horse
Authors: Gellman Karen , Ruina Andy
Published: October 2021

What is the effect of posture on the stability of a standing horse? We address this with a 2D quasistatic model. The model horse has 3 rigid parts: a trunk, a massless fore-limb and a massless rear limb, and has hinges at the shoulder, hip, and hooves. The postural parameterℓgis the distance between the hooves. For a givenℓg, statics finds an equilibrium configuration which, with no muscle stabilization, is unstable. To measure the neuro-muscular effort to maintain stability, we add springs at the shoulder and hip; the larger the springs needed to stabilize the model, the more the neuro-muscular effort needed for stabilization. We find that a canted-in posture (smallℓg), observed in some pathological domestic horses, requires about twice the spring stiffness (representing twice the neuromuscular effort) as is needed for postures with vertical or slightly splayed-out (largeℓg) legs.