bluuebunny/crossref_metadata_2025 huggingface dataset:
A clinical practice guideline for the screening and assessment of enthesitis in patients with spondyloarthritis
Authors: Wu Xinyu , Liu Dong , Li Yanfei , Xie Ya , Tu Liudan , Zhang Yanli , Zhang Xi , Fang Linkai , Luo Xiqing , Lin Zhiming , Liao Zetao , Rong Limin , Ren Jie , Zhou Yuqi , Yang Niansheng , Xu Jian , Zhang Hua , Xu Baijie , Wu Zhenbiao , Zhan Feng , Li Zhenbin , Xiao Weiguo , Liu Shengyun , Zhou Yi , Ye Shanhui , Lv Qing , Zhang Lijun , Zhao Dongbao , He Shanzhi , Zhao Like , Wu Lijun , Lin He , Zhu Yunxiao , Guo Donggeng , Yang Zehong , Liu Budian , Yang Kehu , Gu Jieruo
Published: September 2022

Objective

The aim of this review is to provide guidance on the selection of approaches to the screening and assessment of enthesitis in patients with spondyloarthritis (SpA).

Methods

Twenty-four questions regarding the approaches to the screening and assessment of enthesitis and the implementation details were devised, followed by a systemic literature review. The Grading of Recommendations Assessment, Development, and Evaluation methodology was employed in the development of this guideline, with modifications to evaluate non-interventional approaches under comprehensive consideration of costs, accessibility, and evidence strength. A consensus from the voting panel was required for the inclusion of the final recommendations and the strength of each recommendation.

Results

Seventeen recommendations (including five strong recommendations) were included in this guideline. The voting panel expressed unequivocal support for the necessity of screening and assessment of enthesitis in patients with SpA. It was agreed unanimously that symptom evaluation and physical examination should serve as the initial steps to the recognition of enthesitis, whereas Maastricht Ankylosing Spondylitis Enthesitis Score is a reliable tool in both clinical trials and daily medical practice. Ultrasound examination is another reliable tool, with power Doppler ultrasound as an informative addition. Notwithstanding its high resolution, MRI is limited by the costs and relatively low accessibility, whereas radiographs had low sensitivity and therefore should be rendered obsolete in the assessment of enthesitis. PET/CT was strongly opposed in the detection of enthesitis.

Conclusion

This guideline provides clinicians with information regarding the screening and assessment of enthesitis in patients with SpA. However, this guideline does not intend on dictating choices, and the ultimate decisions should be made in light of the actual circumstances of the facilities.
Identification of ST3GAL5 as a prognostic biomarker correlating with CD8+ T cell exhaustion in clear cell renal cell carcinoma
Authors: Liu Jiakuan , Li Meiqian , Wu Jiajun , Qi Qi , Li Yang , Wang Simei , Liang Shengjie , Zhang Yuqing , Zhu Zhitao , Huang Ruimin , Yan Jun , Zhu Rujian
Published: September 2022

Aberrant sialylation is frequently observed in tumor development, but which sialyltransferases are involved in this event are not well known. Herein, we performed comprehensive analyses on six ST3GAL family members, the α-2,3 sialyltransferases, in clear cell renal cell carcinoma (ccRCC) from public datasets. Only ST3GAL5 was consistently and significantly overexpressed in ccRCC (n = 791 in total), compared with normal kidney tissues. Its overexpression was positively correlated with tumor stage, grade, and the poor prognosis in ccRCC patients. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses indicated the involvement of ST3GAL5 in tumor immunoregulation. Then we revealed that ST3GAL5 expression showed a positive correlation with CD8+ T cell infiltration, using multiple tools on TIMER2.0 web server. Notably, ST3GAL5 overexpression was further identified to be associated with expression signature of CD8+ T cell exhaustion in ccRCC samples from three datasets (n = 867 in total; r > 0.3, p < 0.001). In our own ccRCC cohort (n = 45), immunohistochemistry and immunofluorescence staining confirmed that ST3GAL5 overexpression was accompanied by high CD8+ T cell infiltration with the increased exhaustion markers. Altogether, ST3GAL5 as a promising prognostic biomarker with CD8+ T cell exhaustion in ccRCC is indicated.
Development of a screening score for Hemophagocytic Lymphohistiocytosis among pediatric patients with acute infection of Epstein-Barr virus
Authors: Li Xun , Yan Haipeng , Xiao Zhenghui , Luo Ting , Xie Longlong , Yang Yufan , Gong Ling , Tang Zhexuan , Huang Jiaotian , Zhang Xinping , Zheng Mincui , Yao Zhenya , Zang Ping , Zhu Desheng , Lu Xiulan
Published: September 2022

Background and aims

Deciding when to suspect hemophagocytic lymphohistiocytosis (HLH) and perform diagnostic tests in patients with acute infection of Epstein-Barr virus (EBV) is challenging, given the high prevalence of EBV infection, the life-threatening risk of EBV-HLH, the relatively low incidence of EBV-HLH, and the wide spectrum of disease presentations. The aim of this study was to develop an EBV-HLH screening model for pediatric patients diagnosed with acute infection of EBV.

Methods

An inpatient cohort with 3183 pediatric patients who were diagnosed with active infection of EBV was used to construct and validate the EBV-HLH screening score model. The model parameters were selected from common laboratory parameters using the method of Akaike Information Criterion-optimal selection through cross-validation under logistic regression. Performance of the score was evaluated and compared with the performance of screening methods using the number of cytopenias lineages.

Results

The EBV-HLH screening score has five parameters, including hemoglobin, platelet, neutrophil, albumin, and lactate dehydrogenase. Using a cut-of value of 29, the scoring model had a sensitivity of 89.2% and a specificity of 89.5% in the validation set. The false negative rate, false positive rate, positive predictive value, and negative predictive value in the validation set was 10.8%, 10.5%, 26.8%, and 99.5%, respectively, similar to that of the training set.

Conclusions

With five common laboratory parameters, the EBV-HLH score provides a simple tool to assist the identification of EBV patients who require further evaluation of HLH. Further studies are needed to evaluate the generalizability of the score and optimize the diagnose process for EBV-HLH.
Function and mechanism of histone β-hydroxybutyrylation in health and disease
Authors: Zhou Tingting , Cheng Xi , He Yanqiu , Xie Yumei , Xu Fangyuan , Xu Yong , Huang Wei
Published: September 2022

Histone post-translational modifications (HPTMs) are essential epigenetic mechanisms that affect chromatin-associated nuclear processes without altering the DNA sequence. With the application of mass spectrometry-based proteomics, novel histone lysine acylation, such as propionylation, butyrylation, crotonylation, malonylation, succinylation, glutarylation, and lactoylation have been successively discovered. The emerging diversity of the lysine acylation landscape prompted us to investigate the function and mechanism of these novel HPTMs in health and disease. Recently, it has been reported that β-hydroxybutyrate (BHB), the main component of the ketone body, has various protective roles beyond alternative fuel provision during starvation. Histone lysine β-hydroxybutyrylation (Kbhb) is a novel HPTMs identified by mass spectrometry, which regulates gene transcription in response to carbohydrate restriction or elevated BHB levels in vivo and vitro. Recent studies have shown that histone Kbhb is strongly associated with the pathogenesis of metabolic cardiovascular diseases, kidney diseases, tumors, neuropsychiatric disorders, and metabolic diseases suggesting it has different functions from histone acetylation and methylation. This review focuses on the writers, erasers, sites, and underlying functions of histone Kbhb, providing a glimpse into their complex regulation mechanism.
Durable antibody and effector memory T cell responses in breastmilk from women with SARS-CoV-2
Authors: Narayanaswamy Vignesh , Pentecost Brian T. , Telfer Janice C. , Burnside Amy S. , Schneider Sallie S. , Alfandari Dominique , Baker Ryan L. , Saiju Aman , Nodiff Sam , Arcaro Kathleen F.
Published: September 2022

Background

Given that only 25% of pregnant women elect to receive a COVID-19 vaccine, maternal SARS-CoV-2 infection remains an important route of conferring protective passive immunity to breastfed infants of mothers who are not vaccinated.

Methods

We enrolled 30 lactating participants between December 2020 and March 2021 who had a positive PCR-test and their first COVID-19 symptoms within the previous 21 days. Participants were asked to provide serial bilateral milk samples at 12 timepoints (~ every 3 days) over a period of 35 days. A second set of samples was collected at least four months after the beginning of the first set. Participants also were asked to provide their dried blood spots and infant stool samples. All samples were tested for receptor-binding domain (RBD)-specific immunoglobulin (Ig)A, IgG, and IgM. Milk samples were assessed for neutralizing ability against the spike protein and four SARS-CoV-2 variants: D614G, Alpha (B.1.1.7), Beta (B.1.351), and Gamma (P.1). Permeability of the breast epithelium was assessed by measuring the sodium to potassium ions (Na:K) in milk. Using flow cytometry, memory CD4 and CD8 T cells (CD45RO+and CCR7+/-) and mucosal-homing CD4 and CD8 T cells (CD103+) were determined in cells from milk expressed at 35 days and at least 4 months after their first milk donation.

Results

Milk antibodies from SARS-CoV-2 positive participants neutralized the spike complex. Milk from 73, 90, and 53% of participants had binding reactivities to RBD-specific IgA, IgG, and IgM, respectively. In contrast to blood spots, which showed increased levels of IgG, but not IgA or IgM, the COVID-19 response in milk was associated with a robust IgA response. Twenty-seven percent of participants had increased breast-epithelium permeability, as indicated by Na:K ≥ 0.6. The percentage of CD45RO+CCR7-effector-memory T cells in the day ≥120 milk samples was significantly higher than day 35 samples (P< 0.05).

Conclusions

Antibodies in milk from participants with recent SARS-CoV-2 infection and those who recovered can neutralize the spike complex. For the first time we show that breastmilk T cells are enriched for mucosal memory T cells, further emphasizing the passive protection against SARS-CoV-2 conferred to infantsviabreastmilk.
Spatial genetic structure reveals migration directionality in Mediterranean Ruppia spiralis (Western Sicily)
Authors: Bossaer Laura , Beirinckx Lise , Sierens Tim , Mannino Anna M. , Triest Ludwig
Published: September 2022

Mediterranean salinas, originally built for salt production, function as alternative wetlands. A variety of accompanying lagoon, ditch, and marsh systems are suitable habitats for salt-tolerant submerged macrophytes and often characterized by monospecific beds ofRuppia. Traditionally, birds are considered the main dispersal vector of submerged macrophytes. However,Ruppia spiralishabitats are under marine influence and therefore interference of coastal currents in their connectivity might be expected. In this study, we aim to infer connectivity and spatial patterns from population genetic structures. Using nuclear microsatellite loci, the nuclear ribosomal cistron and chloroplast sequences, we investigated the genetic diversity, genetic structure, and demographic history of 10R. spiralispopulations along a 25-km coastal stretch of western Sicily encompassing a variety of saline habitats. We tested for local fine-scaled structures, hypotheses of regional isolation by distance, and migration directionality. Our results revealed a high degree of allele and gene diversity that was locally maintained by outcrossing. At the regional level, we detected isolation by distance and identified three genetically differentiated clusters, with a significant structure that matches an overall north-to-south unidirectional migration model. This directionality follows the main sea current, hence indicating the importance of hydrological connectivity in regional conservation management. Significant fine-scale spatial structures only emerged in some populations and were absent in the ‘salina fridda’ habitat that showed the largest clonal richness. The local site-dependent patterns emphasize a need to examine the influence of disturbances on seed recruitment and clonal growth over small distances.
Analysis of body color formation of leopard coral grouper Plectropomus leopardus
Authors: Hao Ruijuan , Zhu Xiaowen , Tian Changxu , Zhu Chunhua , Li Guangli
Published: September 2022

Body color is an essential ecological phenotypic trait determining the ability of aquatic animals to adapt to or survive in a treacherous environment. However, researches regarding its underlying molecular mechanism in leopard coral groupers has been limited. Therefore, mRNAs, metabolites, and miRNAs of different-colored leopard coral grouper (Plectropomus leopardus) were sequenced to investigate the body color formation mechanism. The transcriptome analysis identified 1236 genes as differentially expressed genes (DEGs), of which 579 were up-regulated and 657 were down-regulated in the red-colored group compared with the brown-colored group (FDR < 0.01 and |log2FC| > 1). Metabolome analysis revealed 439 and 84 SDMs in POS and NEG of liquid chromatography-mass spectrometry, respectively (VIP > 1 and P < 0.05). The miRNA analysis exhibited 149 (120 up-regulated and 29 down-regulated) differentially expressed miRNAs (DEMs) in the analysis of the brown-colored vs. red-colored groups (P < 0.05 and |log2FC| > 1), including miR-144, miR-185, miR-192, miR-2188, miR-6316, novel-m0015, and novel-m0040. Integrated analysis of multiple omics exhibited that carotenoid metabolism, immune response, lipid metabolism, and amino acid metabolism were involved in the body color formation and adaptation to the environment. Therefore, the present multiomics research prepared a foundation for bright body color formation and promoted the process of preferred body-color breeding.
Predictive biophysical models of bivalve larvae dispersal in Scotland
Authors: Corrochano-Fraile Ana , Adams Thomas P. , Aleynik Dmitry , Bekaert Michaël , Carboni Stefano
Published: September 2022

In Scotland, bivalves are widely distributed. However, their larvae dispersion is still largely unknown and difficult to assess in situ. And, while Mytilus spp. dominate shellfish production, it is mostly dependent on natural spat recruitment from wild populations. Understanding the larval distribution pattern would safeguard natural resources while also ensuring sustainable farming practises. The feasibility of a model that simulates biophysical interactions between larval behaviour and ocean motions was investigated. We employed an unstructured tri-dimensional hydrodynamic model (finite volume coastal ocean model) to drive a particle tracking model, where prediction of larval movement and dispersal at defined locations might aid in population monitoring and spat recruitment. Our findings reveal a strong link between larval distribution and meteorological factors such as wind forces and currents velocity. The model, also, depicts a fast and considerable larval movement, resulting in a substantial mix of plankton and bivalve larvae, forming a large connection between the southern and northern regions of Scotland’s West coast. This enables us to forecast the breeding grounds of any area of interest, potentially charting connectivity between cultivated and wild populations. These results have significant implications for the dynamics of ecologically and economically important species, such as population growth and loss, harvesting and agricultural management in the context of climate change, and sustainable shellfish fisheries management. Furthermore, the observations on Scottish water flow suggest that tracking particles with similar behaviour to bivalve larvae, such as other pelagic larval stages of keystone species and potential pathogens such as sea lice, may have policy and farming implications, as well as disease control amid global warming issues.
A comparative study of magnetic seals by ferrofluids, magnetorheological fluids and magnetic powders
Authors: Li Zhenghao , Li Decai
Published: September 2022

Magnetic seals as a class of non-contact sealing technology have been a research focus. In these seals, magnetic materials, usually ferrofluids or magnetorheological fluids are attracted in sealing gaps as sealing medium. Recently, a novel sealing method using nano-micron sized magnetic powders has been raised up as well. However, the working performance of these magnetic seals has not been studied thoroughly and comparatively yet. Here, we provide a comparative study of magnetic seals by ferrofluid, magnetorheological fluid and magnetic powder theoretically and experimentally. The formulas of pressure capability are derived based on their different properties. A modified empirical formula of magnetic powder seals is proposed, taking the frictional effect into consideration. The magnetic field distribution is calculated by the finite element method. Finally, a test bench for static magnetic seals is established. The pressure capability and leakage rate of three materials are measured by sealing experiments. The differences in mechanism of pressure transfer and the ability of self-recovery are discussed. This research summarizes the characteristics of different magnetic seals, and provides a guidance for sealing medium selection and structure design.
Sticky bacteria: Combined effect of galactose and high ferric iron concentration on extracellular polymeric substances production and the attachment of Acidithiobacillus ferrooxidans on a polymetallic sulfide ore surface
Authors: Moncayo Eduardo A. , Debut Alexis , Vizuete Karla , Jumbo-Flores Diana , Aguirre Paulina
Published: September 2022

Adaptation and microbial attachment mechanisms for the degradation of sulfide ores are mediated by the production of extracellular polymeric substances (EPS) and their role in biofilm formation. EPS production responds to induction mechanisms associated with environmental conditions. In this study, the double induction of EPS with galactose and high ferric iron concentrations in planktonic cells of Acidithiobacillus ferrooxidans, and their attachment on the surface of a polymetallic sulfide ore from Bella Rica-Azuay in Ecuador were evaluated. A. ferrooxidans cells were previously adapted to different concentrations of galactose [0, 0.15, and 0.25% (w/v)], using two ferrous iron concentrations as an energy source (9 and 18 g L–1) in a 9K culture medium. EPS production and its effect on mineral attachment were determined at the time point of maximal growth. The results obtained show a maximum cell attachment of 94.1% within 2 h at 0.15% of galactose and 18 g⋅L–1 of ferric iron concentration, compared to 71.4% without galactose and 9 g⋅L–1 of ferric iron. The maximum concentration of EPS was obtained with a 0.25% galactose concentration; however, it did not result in greater attachment compared to 0.15% galactose concentration. Through the combined induction of low galactose concentration and high ferric iron concentration, the percentage of bacterial attachment can be increased and, therefore, a possible increase in the rate of biooxidation and bioleaching could be obtained.
How to simply and efficiently screen microbial strains capable of anaerobic biosynthesis of biosurfactants: Method establishment, influencing factors and application example evaluation
Authors: Zhao Feng , Wang Yujing , Hu Xin , Huang Xinyu
Published: September 2022

Microbial resources capable of anaerobic biosynthesis of biosurfactants are increasingly interested for their application in oxygen-deficient environments, such as in-situ microbial enhanced oil recovery and anaerobic bioremediation. How to simply and efficiently screen microbial strains capable of anaerobic biosynthesis of biosurfactants need be further studied in depth. In this study, an efficient and simple screening method was established based on the oil displacement characteristic of biosurfactants combined with the anaerobic culture technology using microplate assays. Strains whose anaerobic culture in microwells can form oil displacement circles with diameters larger than 10 mm were screened for scale-up culture in anaerobic tubes. The screened strains which can reduce the surface tension of anaerobic culture to lower than 45 mN/m were verified as positive strains. Using this screening method, eight positive strains and thirteen positive strains were screened from oil reservoir produced water and oily sludge, respectively. Through phylogenetic analysis, some screened strains were identified as Pseudomonas sp., Bacillus sp., and Enterobacter sp. This study also found that more microbial strains might be isolated after enrichment culture of environmental samples, whereas more microbial species would be isolated without enrichment. Suspension of environmental samples prepared with distilled water or normal saline had no significant effect. The established screening method is highly targeted and efficient for microbial strains capable of anaerobic biosynthesis of biosurfactants. The diameter of oil displacement circle is a reliable screening indicator. This study will contribute to explore more microbial resources which can anaerobically biosynthesize biosurfactants.
Microbial-assisted soil chromium immobilization through zinc and iron-enriched rice husk biochar
Authors: Batool Masooma , Rahman Shafeeq ur , Ali Muhammad , Nadeem Faisal , Ashraf Muhammad Nadeem , Harris Muhammad , Du Zhenjie , Khan Waqas-ud-Din
Published: September 2022

Soil chromium toxicity usually caused by the tannery effluent compromises the environment and causes serious health hazards. The microbial role in strengthening biochar for its soil chromium immobilization remains largely unknown. Hence, this study evaluated the effectiveness of zinc and iron-enriched rice husk biochar (ZnBC and FeBC) with microbial combinations to facilitate the chromium immobilization in sandy loam soil. We performed morphological and molecular characterization of fungal [Trichoderma harzianum (F1), Trichoderma viride (F2)] and bacterial [Pseudomonas fluorescence (B1), Bacillus subtilis (B2)] species before their application as soil ameliorants. There were twenty-five treatments having ZnBC and FeBC @ 1.5 and 3% inoculated with bacterial and fungal isolates parallel to wastewater in triplicates. The soil analyses were conducted in three intervals each after 20, 30, and 40 days. The combination of FeBC 3%+F2 reduced the soil DTPA-extractable chromium by 96.8% after 40 days of incubation (DAI) relative to wastewater. Similarly, 92.81% reduction in chromium concentration was achieved through ZnBC 3%+B1 after 40 DAI compared to wastewater. Under the respective treatments, soil Cr(VI) retention trend increased with time such as 40 > 30 > 20 DAI. Langmuir adsorption isotherm verified the highest chromium adsorption capacity (41.6 mg g−1) with FeBC 3% at 40 DAI. Likewise, principal component analysis (PCA) and heat map disclosed electrical conductivity-chromium positive, while cation exchange capacity-chromium and pH-organic matter negative correlations. PCA suggested the ZnBC-bacterial while FeBC-fungal combinations as effective Cr(VI) immobilizers with >70% data variance at 40 DAI. Overall, the study showed that microbes + ZnBC/FeBC resulted in low pH, high OM, and CEC, which ultimately played a role in maximum Cr(VI) adsorption from wastewater applied to the soil. The study also revealed the interrelation and alternations in soil dynamics with pollution control treatments. Based on primitive soil characteristics such as soil metal concentration, its acidity, and alkalinity, the selection criteria can be set for treatments application to regulate the soil properties. Additionally, FeBC with Trichoderma viride should be tested on the field scale to remediate the Cr(VI) toxicity.
Efficacy of intranasal insulin in improving cognition in mild cognitive impairment or dementia: a systematic review and meta-analysis
Authors: Long Cong , Han Xuke , Yang Yunjiao , Li Tongyi , Zhou Qian , Chen Qiu
Published: September 2022

Background

Insulin regulates many aspects of brain function related to mild cognitive impairment (MCI) or dementia, which can be delivered to the brain center via intranasal (IN) devices. Some small, single-site studies indicated that intranasal insulin can enhance memory in patients with MCI or dementia. The pathophysiology of Alzheimer's disease (AD) and diabetes mellitus (DM) overlap, making insulin an attractive therapy for people suffering from MCI or dementia.

Objective

The goal of the study is to evaluate the effectiveness of IN insulin on cognition in patients with MCI or dementia.

Methods

We searched the electronic database for randomized controlled trials (RCTs) that verified the effects of insulin on patients with MCI or dementia.16 studies (899 patients) were identified.

Results

The pooled standard mean difference (SMD) showed no significant difference between IN insulin and placebo groups; however, statistical results suggested a difference between study groups in the effects of ADCS-ADL; AD patients with APOE4 (-) also showed improved performance in verbal memory; other cognitions did not improve significantly.

Conclusion

In view of IN insulin's promising potential, more researches should be conducted at a larger dose after proper selection of insulin types and patients.

Systematic review registration

http://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022353546.
An EEG-based asynchronous MI-BCI system to reduce false positives with a small number of channels for neurorehabilitation: A pilot study
Authors: Song Minsu , Jeong Hojun , Kim Jongbum , Jang Sung-Ho , Kim Jonghyun
Published: September 2022

Many studies have used motor imagery-based brain–computer interface (MI-BCI) systems for stroke rehabilitation to induce brain plasticity. However, they mainly focused on detecting motor imagery but did not consider the effect of false positive (FP) detection. The FP could be a threat to patients with stroke as it can induce wrong-directed brain plasticity that would result in adverse effects. In this study, we proposed a rehabilitative MI-BCI system that focuses on rejecting the FP. To this end, we first identified numerous electroencephalogram (EEG) signals as the causes of the FP, and based on the characteristics of the signals, we designed a novel two-phase classifier using a small number of EEG channels, including the source of the FP. Through experiments with eight healthy participants and nine patients with stroke, our proposed MI-BCI system showed 71.76% selectivity and 13.70% FP rate by using only four EEG channels in the patient group with stroke. Moreover, our system can compensate for day-to-day variations for prolonged session intervals by recalibration. The results suggest that our proposed system, a practical approach for the clinical setting, could improve the therapeutic effect of MI-BCI by reducing the adverse effect of the FP.
Dual vs. mono antiplatelet therapy for acute ischemic stroke or transient ischemic attack with evidence of large artery atherosclerosis
Authors: Lin Chun-Jen , Tseng Tzu-Yun , Saver Jeffrey L.
Published: September 2022

Background and purpose

Current pieces of evidence support the short-term use of dual antiplatelet (DAPT) in minor ischemic stroke or transient ischemic attack (TIA) based on the studies performed in patients with a broad range of non-cardioembolic stroke mechanisms. However, the efficacy and safety of DAPT use in ischemic stroke patients with large artery atherosclerosis (LAA) are still uncertain. We undertook a systemic search and formal meta-analysis to compare DAPT vs. mono-antiplatelet therapy (MAPT) in patients with etiology specifically presumed to be symptomatic LAA.

Methods

We conducted a systemic online search for completed randomized controlled trials that (1) compared DAPT vs. MAPT in patients with acute ischemic stroke or TIA, and (2) were confined to or had available subgroup data regarding population with symptomatic extra- or intracranial artery stenosis. Study-level meta-analysis was performed for outcomes, including ischemic stroke (IS) recurrence, intracranial hemorrhage (ICH), and major bleeding with the Mantel-Haenszel method and random effect models, and was described as risk difference (RD) and 95% CI.

Results

A total of 10 trials including 5,004 patients were pooled. Comparing to MAPT, DAPT significantly reduced IS recurrence (5.99 vs. 9.55%, RD: −3%, 95% CI: −5–0%). Across all agents, out of 100 treated patients, 3 fewer had a recurrent ischemic stroke with DAPT. The safety endpoints including ICH (0.28 vs. 0.32%, RD: 0%, 95% CI: −0–0%) and major bleeding (0.73 vs. 0.51%, RD: 0%, 95% CI: −0–0%) did not differ significantly.

Conclusion

In patients with symptomatic large artery extracranial or intracranial atherosclerosis, DAPT was superior to MAPT in preventing IS recurrence without increasing bleeding risks. The optimal DAPT regimens and duration of treatment in this population need to be clarified in further studies.
Epidemiology and injectable antiseizure medication treatment patterns of seizure patients treated in United States hospitals
Authors: Beaty Silky , Rosenthal Ning , Gayle Julie , Dongre Prashant , Ricchetti-Masterson Kristen , Rhoney Denise H.
Published: September 2022

Objective

This study aimed to examine the epidemiology of seizures, clinical outcomes, and antiseizure medication treatment patterns among seizure patients treated in United States hospitals.

Design

A retrospective cross-sectional study was conducted using data from a large geographically diverse hospital discharge database.

Setting

860 acute care hospitals in the United States.

Participants

Patients aged ≥18 years with an outpatient emergency department or inpatient visit between 1 July 2016–31 December 2019 were included.

Intervention

None.

Main outcomes and measures

Key outcomes included prevalence of seizure, seizure type, admission point of origin, intensive care unit admission, discharge status, and injectable antiseizure medication utilization. Seizures were identified by the International Classification of Disease, Tenth Revision, Clinical Modification diagnosis codes.

Results

Among 36,598,627 unique emergency department outpatients (72,372,464 outpatient visits) and 16,543,592 unique inpatients (24,923,489 inpatient admissions) analyzed, seizure was present in 2.1% of outpatients (1.87% of outpatient visits) and 4.9% of inpatients (4.8% of inpatient admissions). In overall seizure patients, 49.1% were unclassified, 4.4% had generalized onset, 2.9% had focal onset, and 42.8% were categorized as other (including 38.5% with convulsion). Among seizure-associated inpatient admissions, <1% were transferred directly from skilled nursing facility or other long-term care facilities but 22.7% were discharged to such facilities. Nearly a third (31%) of all inpatients were admitted to ICU. About 88.3% of patients with injectable ASM use had monotherapy, 4.6% had polytherapy with 1 day or multiple non-consecutive days of overlap, and 7.0% had polytherapy with ≥2 consecutive days of overlap. The percentage of patients with no step down to any oral ASM ranged between 34.0–57.0%.

Conclusions

Seizures affect a substantial number of hospital-based emergency department outpatient and inpatient encounters and are associated with poor clinical outcomes and significant healthcare burden. Concomitant use of injectable ASMs is uncommon and a high percentage of IV ASM users with a diagnosis of seizure had no step down to oral therapy.

Relevance

The study findings may inform clinicians and hospital decision makers about current clinical practice and burden of seizures and identify areas to improve overall outcomes for patients with seizures.
Optimizing the social utility of judicial punishment: An evolutionary biology and neuroscience perspective
Authors: Levy Daniel A.
Published: September 2022

Punishment as a response to impairment of individual or group welfare may be found not only among humans but also among a wide range of social animals. In some cases, acts of punishment serve to increase social cooperation among conspecifics. Such phenomena motivate the search for the biological foundations of punishment among humans. Of special interest are cases of pro-social punishment of individuals harming others. Behavioral studies have shown that in economic games people punish exploiters even at a cost to their own welfare. Additionally, neuroimaging studies have reported activity during the planning of such punishment in brain areas involved in the anticipation of reward. Such findings hint that there is an evolutionarily honed basic drive to punish social offenders. I argue that the transfer of punishment authority from the individual to the group requires that social offenders be punished as a public good, even if such punishment is not effective as retribution or deterrent. Furthermore, the social need for punishment of offenders has implications for alternatives to incarceration, publicity of punishment, and judicial structure.
Hydrothermal treatment: An efficient food waste disposal technology
Authors: Zhang Xinyan , Qin Qingyu , Sun Xun , Wang Wenlong
Published: September 2022

The quantities of food waste (FW) are increasing yearly. Proper disposal of FW is essential for reusing value-added products, environmental protection, and human health. Based on the typical characteristics of high moisture content and high organic content of FW, hydrothermal treatment (HTT), as a novel thermochemical treatment technology, plays unique effects in the disposal and utilization of FW. The HTT of FW has attracted more and more attention in recent years, however, there are few conclusive reviews about the progress of the HTT of FW. HTT is an excellent approach to converting energy-rich materials into energy-dense fuels and valuable chemicals. This process can handle biomass with relatively high moisture content and allows efficient heat integration. This mini-review presents the current knowledge of recent advances in HTT of FW. The effects of HTT temperature and duration on organic nutritional compositions (including carbohydrates, starch, lipids, protein, cellulose, hemicellulose, lignin, etc.) and physicochemical properties (including pH, elemental composition, functional groups, fuel properties, etc.) and structural properties of FW are evaluated. The compositions of FW can degrade during HTT so that the physical and chemical properties of FW can be changed. The application and economic analyses of HTT in FW are summarized. Finally, the analyses of challenges and future perspectives on HTT of FW have shown that industrial reactors should be built effectively, and techno-economic analysis, overall energy balance, and life cycle assessment of the HTT process are necessary. The mini-review offers new approaches and perspectives for the efficient reuse of food waste.
Postoperative communicating hydrocephalus following glioblastoma resection: Incidence, timing and risk factors
Authors: Hönikl Lisa S. , Lange Nicole , Barz Melanie , Negwer Chiara , Meyer Bernhard , Gempt Jens , Meyer Hanno S.
Published: September 2022

Introduction

Glioblastoma (GBM) is the most common malignant primary brain tumor. Treatment includes maximally safe surgical resection followed by radiation and/or chemotherapy. However, resection can lead to ventricular opening, potentially increasing the risk for development of communicating hydrocephalus (CH). Complications such as rebleeding and infection may also lead to CH and, eventually, the need for cerebrospinal fluid (CSF) diversion surgery. In this study, we evaluated the incidence of different types of hydrocephalus and potential risk factors for the development of CH following glioblastoma resection.

Methods

726 GBM patients who underwent tumor resection at our department between 2006 and 2019 were analyzed retrospectively. Potential risk factors that were determined for each patient were age, sex, tumor location, the number of resection surgeries, ventricular opening during resection, postoperative CSF leak, ventriculitis, and rebleeding. Uni- as well as multivariate analyses were performed to identify associations with CH and independent risk factors.

Results

55 patients (7.6%) needed CSF diversion surgery (implantation of a ventriculoperitoneal or ventriculoatrial shunt) following resection surgery. 47 patients (6.5%) had CH, on median, 24 days after the last resection (interquartile range: 17-52 days). 3 patients had obstructive hydrocephalus (OH) and 5 patients had other CSF circulation disorders. Ventricular opening (odds ratio (OR): 7.9; p=0.000807), ventriculitis (OR 3.3; p=0.000754), and CSF leak (OR 2.3; p=0.028938) were identified as significant independent risk factors for the development of post-resection CH. Having more than one resection surgery was associated with CH as well (OR 2.1; p=0.0128), and frontal tumors were more likely to develop CH (OR 2.4; p=0.00275), while temporal tumors were less likely (OR 0.41; p=0.0158); However, none of those were independent risk factors. Age, sex, or rebleeding were not associated with postoperative CH.

Conclusion

Postoperative CH requiring CSF shunting is not infrequent following GBM resection and is influenced by surgery-related factors. It typically occurs several weeks after resection. If multiple risk factors are present, one should discuss the possibility of postoperative CH with the patient and maybe even consider pre-emptive shunt implantation to avoid interruption of adjuvant tumor therapy. The incidence of CH requiring shunting in GBM patients could rise in the future.
FTO promotes liver inflammation by suppressing m6A mRNA methylation of IL-17RA
Authors: Gan Xiaojie , Dai Zhihui , Ge Chunmei , Yin Haozan , Wang Yuefan , Tan Jian , Sun Shuhan , Zhou Weiping , Yuan Shengxian , Yang Fu
Published: September 2022

Background

Previous studies have demonstrated that inflammation-related interleukin-17 (IL-17) signaling plays a pivotal role in the pathogenesis of non-alcoholic steatohepatitis (NASH)- and alcoholic liver disease (ALD)-induced hepatocellular carcinoma (HCC). However, rare efforts have been intended at implementing the analysis of N6-methyladenosine (m6A) mRNA methylation to elucidate the underpinning function of the IL-17 receptor A (IL-17RA) during the inflammation-carcinogenesis transformation of HCC.

Methods

We performed methylated RNA immunoprecipitation sequencing (MeRIP-seq) using normal, HCC tumor and paired tumor adjacent tissues from patients to investigate the dynamic changes of m6A mRNA methylation in the process of HCC. Additionally, murine non-alcoholic fatty liver disease (NAFLD) model and murine chronic liver injury model were utilized to investigate the role of IL-17RA regulated by m6A mRNA modulator fat mass and obesity-associated (FTO) in chronic hepatic inflammation.

Results

MeRIP-seq revealed the reduction of m6A mRNA methylation of IL-17RA in tumor adjacent tissues with chronic inflammation, suggesting the potential role of IL-17RA in the inflammation-carcinogenesis transformation of HCC. Besides, we demonstrated that FTO, rather than methyltransferase-like 3 (METTL3), methyltransferase-like 14 (METTL14), and alkB homolog 5 (ALKBH5) functions as a main modulator for the decrease of m6A mRNA methylation of IL-17RA via knockdown and overexpression of FTO in vitro and in vivo.

Conclusions

Overall, we elaborated the underlying mechanisms of the increase of IL-17RA resulting in chronic inflammation via the demethylation of FTO in tumor adjacent tissues and demonstrated that targeting the specific m6A modulator FTO may provide an effective treatment for hepatitis patients to prevent the development of HCC.
Attaining expert consensus on diagnostic expectations of primary chronic pain diagnoses for patients referred to interdisciplinary pediatric chronic pain programs: A delphi study with pediatric chronic pain physicians and advanced practice nurses
Authors: Greenough Megan , Bucknall Tracey , Jibb Lindsay , Lewis Krystina , Lamontagne Christine , Squires Janet Elaine
Published: September 2022

Objective

Pediatric primary chronic pain disorders come with diagnostic uncertainty, which may obscure diagnostic expectations for referring providers and the decision to accept or re-direct patients into interdisciplinary pediatric chronic pain programs based on diagnostic completeness. We aimed to attain expert consensus on diagnostic expectations for patients who are referred to interdisciplinary pediatric chronic pain programs with six common primary chronic pain diagnoses.

Method

We conducted a modified Delphi study with pediatric chronic pain physicians, nurse practitioners and clinical nurse specialists to determine degree of importance on significant clinical indicators and diagnostic items relevant to each of the six primary chronic pain diagnoses. Items were identified through point of care databases and complimentary literature and were rated by participants on a 5-point Likert scale. Our consensus threshold was set at 70%.

Results

Amongst 22 experts across 14 interdisciplinary programs in round one and 16 experts across 12 interdisciplinary programs in round two, consensus was reached on 84% of diagnostic items, where the highest degree of agreement was with Complex Regional Pain Syndrome (CRPS), Type 1 (100%) and the lowest with chronic pelvic pain (67%).

Conclusion

This study demonstrated a general agreement amongst pediatric chronic pain experts regarding diagnostic expectations of patients referred to interdisciplinary chronic pain programs with primary chronic pain diagnoses. Study findings may help to clarify referral expectations and the decision to accept or re-direct patients into such programs based on diagnostic completeness while reducing the occurrence of unnecessary diagnostic tests and subsequent delays in accessing specialized care.
Designing a Visit Schedule for Longitudinal Studies in Pediatric Research
Authors: Hirschfeld Steven , Dellarco Michael , Nowinski Cindy J. , Slotkin Jerry
Published: September 2022

A challenge for longitudinal studies is combining individual assessments into visits that are scientifically logical, not burdensome for participants, well-choreographed, and operationally feasible. The visits then need to be sequenced and spaced to address the scientific goals and generate a data archive that is sufficiently robust and well-documented to support subsequent analyses. This paper summarizes comprehensive multi-disciplinary activities that were coordinated to design the content, format, and structure of the National Children's Study and concurrently serve as a model and resource for other studies.
Supportive methods for childhood acute lymphoblastic leukemia then and now: A compilation for clinical practice
Authors: Podpeskar Alexandra , Crazzolara Roman , Kropshofer Gabriele , Obexer Petra , Rabensteiner Evelyn , Michel Miriam , Salvador Christina
Published: September 2022

Survival of childhood acute lymphoblastic leukemia has significantly improved over the past decades. In the early years of chemotherapeutic development, improvement in survival rates could be attained only by increasing the cytostatic dose, also by modulation of the frequency and combination of chemotherapeutic agents associated with severe short- and long-time side-effects and toxicity in a developing child's organism. Years later, new treatment options have yielded promising results through targeted immune and molecular drugs, especially in relapsed and refractory leukemia, and are continuously added to conventional therapy or even replace first-line treatment. Compared to conventional strategies, these new therapies have different side-effects, requiring special supportive measures. Supportive treatment includes the prevention of serious acute and sometimes life-threatening events as well as managing therapy-related long-term side-effects and preemptive treatment of complications and is thus mandatory for successful oncological therapy. Inadequate supportive therapy is still one of the main causes of treatment failure, mortality, poor quality of life, and unsatisfactory long-term outcome in children with acute lymphoblastic leukemia. But nowadays it is a challenge to find a way through the flood of supportive recommendations and guidelines that are available in the literature. Furthermore, the development of new therapies for childhood leukemia has changed the range of supportive methods and must be observed in addition to conventional recommendations. This review aims to provide a clear and recent compilation of the most important supportive methods in the field of childhood leukemia, based on conventional regimes as well as the most promising new therapeutic approaches to date.
Bilateral sterile subdural effusion in Kawasaki disease-A case report
Authors: Nicolescu Corina Ramona , Duperril Marie , Stephan Jean-Louis
Published: September 2022

Kawasaki disease is an acute febrile condition that causes a self-limiting medium vessel systemic vasculitis and whose pathophysiological pathways are still not completely understood. Coronary arteries are the most affected, but inflammation can develop in all medium-sized arteries, with various organs and tissues being involved. Kawasaki disease-related neurological involvement varies in terms of clinical expression and severity. Herein, we describe an unusual neurological complication of Kawasaki disease in a 5-year-old girl. The progression of the disease was biphasic. Kawasaki disease was diagnosed on the 8th day after symptoms onset and treated by intravenous immunoglobulins, with prompt clinical regression but a less favorable biological response (persistent inflammation with hypoalbuminemia). Two weeks later, headaches and lethargy developed, and a bilateral subdural collection was identified on cerebral imaging. Subsequently, her progress was uneventful, with no residual coronary abnormalities and complete resorption of the subdural collection. Bilateral subdural collection, exceptionally reported, could be discussed as a clinical expression of systemic inflammatory vasculitis that characterizes Kawasaki disease.