bluuebunny/crossref_metadata_2025 huggingface dataset:
Complex transcatheter left atrial appendage closure using a tailored trans-jugular approach simulated by 3D printing: a case report
Authors: Ciobotaru Vlad , Tadros Victor-Xavier , Martin Claire A , Hascoet Sebastien
Published: July 2022

Background

Transcatheter left atrial appendage (LAA) closure (LAAc) is less feasible in patients with unusual LAA anatomy.

Case summary

A 65-year-old woman with persistent atrial fibrillation was referred for LAAc. Transesophageal echocardiography (TEE) revealed spontaneous contrast in the LAA without formation of a thrombus; the LAA shape was tortuous and difficult to assess. A first LAAc procedure was unsuccessful given the unsuitable sheath position. Therefore, a soft three-dimensional (3D) model printing was performed by laser sintering and revealed excessive sheath kinking with an inferior approach, but successful deployment would be feasible using a superior approach. Successful trans-jugular implantation of a Watchman FLX 31 device in stable position without residual leakage was achieved during the subsequent procedure. At 3-month follow-up, and after cessation of oral anticoagulation, the patient’s symptoms improved. Imaging demonstrated complete LAA occlusion and correct placement of the device along the LAA superior axis.

Discussion

This is the first-reported clinical case of a complex transcatheter LAAc through a trans-jugular approach. Simulating the patient’s anatomy with a laser sintering 3D-printed model showed why the transfemoral approach failed, validated the trans-jugular procedure, enabled selection of the simple curve access sheath that had the most direct trajectory towards the LAA, confirmed that transseptal puncture was possible, allowed determination of the angle of puncture, enabled selection of the most appropriate LAA device and had a very low cost compared with planning software or other printing methods.
Endomyocardial fibrosis of the right ventricle in a patient with schistosomiasis: a case report
Authors: Espinoza Romero Cristhian , Lima Ivna Cunha Vieira , Hotta Viviane Tiemi , Bocchi Edimar Alcides , Salemi Vera Maria Cury
Published: July 2022

Background

Endomyocardial fibrosis (EMF) is a rare and underdiagnosed cause of restrictive cardiomyopathy. Its aetiology is not yet defined and could be caused by the influence of different clinical factors that seem to combine with genetic aspects of individuals susceptible to an inflammatory process that leads to formation of fibrosis.

Case summary

We describe a case of a 50-year-old man from the northeastern region of Brazil, where there is high prevalence of schistosomiasis. He presented to our centre with symptoms of right heart failure. The echocardiogram showed normal left ventricular ejection fraction. Right ventricular had normal systolic function but in the apical region was filled with a homogeneous and hypoechoic image causing obliteration and restriction of the apex. The late gadolinium enhancement with cardiac magnetic resonance showed diffuse and heterogeneous subendocardial fibrosis in the right ventricle apex consistent with EMF, but declined endocardiectomy.

Discussion

This report presents an interesting case of EMF and schistosomiasis simultaneously. The hypothesis of parasitosis as a probable cause of EMF was raised by helminth-induced hypereosinophilia. Complementary imaging tests such as magnetic resonance imaging and echocardiography, in addition to clinical and epidemiological suspicion, are essential for its diagnosis. Early surgical resolution becomes crucial for long-term survival.
Left-to-right rotated single lung transplant
Authors: Chida Masayuki , Inoue Takashi , Araki Osamu , Maeda Sumiko
Published: July 2022

We successfully performed left-to-right rotated single lung transplants in 2 patients. For this procedure, the left pulmonary artery of the donor undergoes a U-shaped turn with A3 at the bottom to anastomose with the recipient’s right pulmonary artery in front of the bronchus. It is extremely important to avoid kinking the pulmonary artery at the site of the U-shaped turn.
Regional variation in biomechanical properties of ascending thoracic aortic aneurysms
Authors: Salmasi M Yousuf , Sasidharan Sumesh , Frattolin Jennifer , Edgar Lowell , Stock Ulrich , Athanasiou Thanos , Moore Jr James
Published: July 2022

OBJECTIVES

This study aims to characterize the material properties of ascending thoracic aortic aneurysmal tissue, using regional biomechanical assessment of both tensile and dissection propagation peel strength.

METHODS

Thirty-four aneurysm specimens (proximal thoracic aorta) were harvested en-bloc from patients undergoing surgery for aneurysm replacement. Specimens were processed into regional samples of similar shapes covering the whole aneurysm isosurface, according to a structured protocol, in both orientations (longitudinal and circumferential). Thickness mapping, uniaxial tensile and peel tests were conducted, enabling calculation of the following parameters: true stress/strain, tangential modulus, tensile strength, peeling force and dissection energy. Two constitutive material models were used (hyperelastic models of Delfino and Ogden) to fit the data. A circumferential strip of tissue was also obtained for computational histology [regional quantification of (i) elastin, (ii) collagen and (iii) smooth muscle cells].

RESULTS

The aortic wall was thinner on the outer curve (2.21, standard deviation (SD) 0.4 mm vs inner curve 2.50, SD 0.12 mm). Advanced patient age and higher pulse wave velocity (externally measured) were predictors of increased aortic wall thickness. Tensile strength was higher in the circumferential versus longitudinal direction when analysed according to anatomical regions. Both peel force (35.5, 22 N/m) and dissection energy (88.5, 69 J/m2) were on average lowest at the outer curve of the aneurysm in the longitudinal orientation. Delfino and Ogden model constants varied throughout anatomical regions, with the outer curve being associated a higher ɑ constant (Delfino) and lower µ1 constant (Ogden) (P < 0.05) indicating increased stiffness. Histologically, collagen abundance was significantly related to circumferential and longitudinal strength (P= 0.010), whilst smooth muscle cell count had no relation with any mechanical property (P > 0.05).

CONCLUSIONS

Our results suggest that the outer aortic curve is more prone to dissection propagation and perhaps less prone to rupture than the inner aortic curve. This strengthens the notion of disease heterogeneity in ascending thoracic aortic aneurysms and has implications for the pathogenesis of aortic dissection.
Obesity and outcomes after left ventricular assist device implantation: insights from the EUROMACS Registry
Authors: Angleitner Philipp , Kaider Alexandra , De By Theo M M H , Dimitrov Kamen , Schlöglhofer Thomas , Tops Laurens F , Fiane Arnt E , Rábago Gregorio , Laufer Günther , Zimpfer Daniel
Published: July 2022

OBJECTIVES

The objective was to analyse associations between obesity and outcomes after left ventricular assist device (LVAD) implantation.

METHODS

A retrospective analysis of the EUROMACS Registry was performed. Adult patients undergoing primary implantation of a continuous-flow LVAD between 2006 and 2019 were included (Medtronic HeartWare® HVAD®, Abbott HeartMate II®, Abbott HeartMate 3™). Patients were classified into 4 different groups according to body mass index at the time of surgery (body mass index <20 kg/m2: n = 254; 20–24.9 kg/m2: n = 1281; 25–29.9 kg/m2: n = 1238; ≥ 30 kg/m2: n = 691).

RESULTS

The study cohort was comprised of 3464 patients. Multivariable Cox proportional cause-specific hazards regression analysis demonstrated that obesity (body mass index ≥30 kg/m2) was independently associated with significantly increased risk of mortality (body mass index ≥30 vs 20–24.9 kg/m2: hazard ratio 1.36, 95% confidence interval 1.18–1.57, overall P < 0.001). Moreover, obesity was associated with significantly increased risk of infection and driveline infection. The probability to undergo heart transplantation was significantly decreased in obese patients (body mass index ≥30 vs 20–24.9 kg/m2: hazard ratio 0.59, 95% confidence interval 0.48–0.74, overall P < 0.001).

CONCLUSIONS

Obesity at the time of LVAD implantation is associated with significantly higher mortality and increased risk of infection as well as driveline infection. The probability to undergo heart transplantation is significantly decreased. These aspects should be considered when devising a treatment strategy before surgery.
Hypertension in children and adolescents
Authors: de Simone Giovanni , Mancusi Costantino , Hanssen Henner , Genovesi Simonetta , Lurbe Empar , Parati Gianfranco , Sendzikaite Skaiste , Valerio Giuliana , Di Bonito Procolo , Di Salvo Giovanni , Ferrini Marc , Leeson Paul , Moons Philip , Weismann Constance G , Williams Bryan
Published: July 2022

Definition and management of arterial hypertension in children and adolescents are uncertain, due to different positions of current guidelines. The European Society of Cardiology task-force, constituted by Associations and Councils with interest in arterial hypertension, has reviewed current literature and evidence, to produce a Consensus Document focused on aspects of hypertension in the age range of 6–16 years, including definition, methods of measurement of blood pressure, clinical evaluation, assessment of hypertension-mediated target organ damage, evaluation of possible vascular, renal and hormonal causes, assessment and management of concomitant risk factors with specific attention for obesity, and anti-hypertensive strategies, especially focused on life-style modifications. The Consensus Panel also suggests aspects that should be studied with high priority, including generation of multi-ethnic sex, age and height specific European normative tables, implementation of randomized clinical trials on different diagnostic and therapeutic aspects, and long-term cohort studies to link with adult cardiovascular risk. Finally, suggestions for the successful implementation of the contents of the present Consensus document are also given.
Geochemical and microbiological profiles in hydrothermal extreme acidic environments (Pisciarelli Spring, Campi Flegrei, Italy)
Authors: Crognale Simona , Venturi Stefania , Tassi Franco , Rossetti Simona , Cabassi Jacopo , Capecchiacci Francesco , Bicocchi Gabriele , Vaselli Orlando , Morrison Hilary G , Sogin Mitchell L , Fazi Stefano
Published: July 2022

Although terrestrial hydrothermal systems are considered among the most fascinating environments, how their unique and extreme conditions can affect microorganisms selection and the role in biogeochemical cycles has not yet been well elucidated. A combined geochemical and microbiological exploration in waters and sediments from 10 sampling points along a sharp temperature gradient (15–90°C) within an extremely acidic hydrothermal system (Pisciarelli Spring, Campi Flegrei area, southern Italy) displayed how hydrothermal fluids influence the microbial dynamics. This area was characterized by high levels of reduced gaseous species (e.g. H2S, H2, CH4, CO) and very low pH values (<2.3). Thermodynamic calculations revealed a high microbial catabolic potential in oxidation/reduction reactions of N-, S- and Fe-bearing species. Overall, an increase of the archaeal/bacterial abundance ratio was observed by decreasing temperature and pH values. In particular, Archaea and Bacteria were present in almost equal cell abundance (up to 1.1 × 109 and 9.3 × 108 cell/g, respectively) in the <70°C sampling points (average pH = 2.09); on the contrary, the highest temperature waters (85–90°C; average pH = 2.26) were characterized by a low abundance of archaeal cells. The high-throughput sequencing of the 16S rRNA genes indicated strong differences in archaeal and bacterial communities composition along the temperature gradient. However, the microbiome in this extreme environment was mainly constituted by chemoautotrophic microorganisms that were likely involved in N-, S- and Fe-bearing species transformations (e.g. Acidianus infernus, Ferroplasma acidarmanus, Acidithiobacillus,Sulfobacillus,Thaumarchaeota), in agreement with thermodynamic calculations.
Zinc-binding metallophores protectPseudomonas aeruginosafrom calprotectin-mediated metal starvation
Authors: Ammendola Serena , Secli Valerio , Pacello Francesca , Mastropasqua Maria Chiara , Romão Mariana A , Gomes Cláudio M , Battistoni Andrea
Published: July 2022

Pseudomonas aeruginosa is known to exhibit considerable resistance to the antimicrobial activity of the metal-sequestering protein calprotectin (CP). In this study, we demonstrate that although CP induces zinc deficiency in P. aeruginosa, a strain unable to import zinc through the two most important metal acquisition systems, namely ZnuABC and ZrmABCD, maintains significant growth capacity in the presence of high concentrations of CP. Furthermore, we have shown that nicotianamine, a molecule structurally similar to the metallophore pseudopaline, can favor the acquisition of the metal even in the presence of CP. To gain insights into the mechanisms through which metallophores can promote zinc acquisition, we analyzed the effect of nicotianamine on the activity of the metallo-β-lactamase VIM-1. Our data suggest that metallophores released by bacteria in response to zinc deficiency can extract the protein-bound metal. The ability to interfere with the binding of metals to proteins, as well as favoring the acquisition of zinc, may contribute to increasing the resistance of P. aeruginosa to the antimicrobial action of CP.
Barriers to genetic manipulation of Enterococci: Current Approaches and Future Directions
Authors: Krause Alexandra L , Stinear Timothy P , Monk Ian R
Published: July 2022

Enterococcus faecalis and Enterococcus faecium are Gram-positive commensal gut bacteria that can also cause fatal infections. To study clinically relevant multi-drug resistant E. faecalis and E. faecium strains, methods are needed to overcome physical (thick cell wall) and enzymatic barriers that limit the transfer of foreign DNA and thus prevent facile genetic manipulation. Enzymatic barriers to DNA uptake identified in E. faecalis and E. faecium include type I, II and IV restriction modification systems and CRISPR-Cas. This review examines E. faecalis and E. faecium DNA defence systems and the methods with potential to overcome these barriers. DNA defence system bypass will allow the application of innovative genetic techniques to expedite molecular-level understanding of these important, but somewhat neglected, pathogens.
A Chromosome-Length Reference Genome for the Endangered Pacific Pocket Mouse Reveals Recent Inbreeding in a Historically Large Population
Authors: Wilder Aryn P , Dudchenko Olga , Curry Caitlin , Korody Marisa , Turbek Sheela P , Daly Mark , Misuraca Ann , Wang Gaojianyong , Khan Ruqayya , Weisz David , Fronczek Julie , Aiden Erez Lieberman , Houck Marlys L , Shier Debra M , Ryder Oliver A , Steiner Cynthia C
Published: July 2022

High-quality reference genomes are fundamental tools for understanding population history, and can provide estimates of genetic and demographic parameters relevant to the conservation of biodiversity. The federally endangered Pacific pocket mouse (PPM), which persists in three small, isolated populations in southern California, is a promising model for studying how demographic history shapes genetic diversity, and how diversity in turn may influence extinction risk. To facilitate these studies in PPM, we combined PacBio HiFi long reads with Omni-C and Hi-C data to generate a de novo genome assembly, and annotated the genome using RNAseq. The assembly comprised 28 chromosome-length scaffolds (N50 = 72.6 MB) and the complete mitochondrial genome, and included a long heterochromatic region on chromosome 18 not represented in the previously available short-read assembly. Heterozygosity was highly variable across the genome of the reference individual, with 18% of windows falling in runs of homozygosity (ROH) >1 MB, and nearly 9% in tracts spanning >5 MB. Yet outside of ROH, heterozygosity was relatively high (0.0027), and historical Ne estimates were large. These patterns of genetic variation suggest recent inbreeding in a formerly large population. Currently the most contiguous assembly for a heteromyid rodent, this reference genome provides insight into the past and recent demographic history of the population, and will be a critical tool for management and future studies of outbreeding depression, inbreeding depression, and genetic load.
Transmembrane helices 5 and 12 control transport dynamics, substrate affinity, and specificity in the elevator-type UapA transporter
Authors: Dimakis Dimitris , Pyrris Yiannis , Diallinas George
Published: July 2022

An increasing number of solute transporters have been shown to function with the so-called sliding-elevator mechanism. Despite structural and functional differences, all elevator-type transporters use a common mechanism of substrate translocation via reversible movements of a mobile core domain (the elevator) hosting the substrate binding site along a rigid scaffold domain stably anchored in the plasma membrane via homodimerization. One of the best-studied elevator transporters is the UapA uric acid-xanthine/H+ symporter of the filamentous fungus Aspergillus nidulans. Here, we present a genetic analysis for deciphering the role of transmembrane segments (TMS) 5 and 12 in UapA transport function. We show that specific residues in both TMS5 and TMS12 control, negatively or positively, the dynamics of transport, but also substrate binding affinity and specificity. More specifically, mutations in TMS5 can lead not only to increased rate of transport but also to an inactive transporter due to high-affinity substrate-trapping, whereas mutations in TMS12 lead to apparently uncontrolled sliding and broadened specificity, leading in specific cases to UapA-mediated purine toxicity. Our findings shed new light on how elevator transporters function and how this knowledge can be applied to genetically modify their transport characteristics.
Aging and Emotion Regulation Tactics Across the Historical Events of 2020
Authors: Wolfe Hannah E , Isaacowitz Derek M
Published: July 2022

Background and Objectives

Despite well-documented cognitive and physical declines with age, older adults tend to report higher emotional well-being than younger adults, even during the coronavirus disease 2019 (COVID-19) pandemic. To understand this paradox, as well as investigate the effects of specific historical contexts, the current study examined age differences in emotion regulation related to the events of 2020 in the United States. We predicted that, due to older adults’ theorized greater prioritization of hedonic goals and avoidance of arousal, older adults would report more positivity-upregulation and acceptance tactics than younger adults.

Research Design and Methods

Eighty-one younger adults (aged 18–25) and 85 older adults (age 55+) completed a retrospective survey on their emotion regulation tactic usage for 3 specific events: the COVID-19 pandemic outbreak, the killing of George Floyd, and the presidential election.

Results

Older adults tended to rely most on acceptance-focused tactics, while younger adults tended to rely on a more even variety of tactics. However, age differences in tactic preferences varied by event, possibly due to younger adults’ greater emotion regulation flexibility.

Discussion and Implications

Older adults’ higher emotional well-being may not be primarily a result of age differences in positivity-related emotion regulation tactics but more about differences in acceptance use.
A new 3-D finite-fault model of the Southwest Iceland bookshelf transform zone
Authors: Bayat Farnaz , Kowsari Milad , Halldorsson Benedikt
Published: July 2022

The largest earthquakes in Iceland occur in the South Iceland seismic zone (SISZ) and the Tjörnes fracture zone in the northeast. With the latter being primarily offshore, the seismic risk in Iceland is highest in the relatively densely populated SISZ. Past probabilistic seismic hazard assessment (PSHA) efforts in Iceland have, however, been based on statistical analyses of various historical earthquake catalogues and limited ground motion models (GMMs), all subject to varying types and degrees of uncertainties. Moreover, they relied on simplistic source descriptions and largely ignored that the unique ‘bookshelf’ strike-slip fault system of the SISZ extends along the plate margins towards the west and over the entire Reykjanes Peninsula Oblique Rift (RPOR) zone. Namely, the bookshelf fault system in Southwest Iceland is twice as long as previously thought and it dominates the strain release of transcurrent plate motion in Southwest Iceland, having potentially important implications for PSHA. In this study, therefore, we propose a new 3-D finite-fault model of the Southwest Iceland bookshelf transform zone. The model has been calibrated on the basis of first principles to the rate of transcurrent plate motions across the transform zone and constrained by the salient features of the fault system geometry as reported in the literature. We model the systematic spatial variability of the seismogenic potential along the zone by its provisional subdivision into six distinct zones. The fault system model allows both deterministic and random fault locations, with each realization completely specified in terms of the maximum expected magnitude of each fault, its maximum dimensions and its long-term slip rate. The variability of the model has been estimated through sensitivity analyses of its key parameters. The total seismic moment rates produced by the fault system model are completely consistent with those reported in the literature. The new model allows the derivation of simple but self-consistent zone-specific Gutenberg–Richter (GR) relationships, and the total long-term seismic activity predicted by the new 3-D fault system model effectively explains the historical earthquake catalogue of the SISZ–RPOR transform zone in Southwest Iceland. We are therefore confident that the model can serve as the foundation for future time-independent physics-based PSHA for Southwest Iceland. Moreover, the consistency and versatility of the model allows its application in conventional approaches to PSHA, which has the potential of bridging the gap between physics-based and conventional approaches to PSHA in Southwest Iceland. Such efforts will improve our understanding of the key elements that affect the hazard, thus improving the reliability of hazard estimates, with important practical implications for the optimized assessment of seismic risk.
BrAN contributes to leafy head formation by regulating leaf width in Chinese cabbage (Brassica rapa L. ssp. pekinensis)
Authors: Xin Yue , Tan Chong , Wang Che , Wu Yanji , Huang Shengnan , Gao Yue , Wang Lu , Wang Nan , Liu Zhiyong , Feng Hui
Published: July 2022

Leafy head is an important agronomic trait that determines the yield and quality of Chinese cabbage. The molecular mechanism underlying heading in Chinese cabbage has been the focus of research, and wide leaves are a prerequisite for leafy head formation. In our study, two allelic leafy heading-deficient mutants (lhd1 and lhd2) with narrow leaf phenotypes were screened in an ethyl methanesulfonate mutagenized population from a heading Chinese cabbage double haploid line ‘FT’. Genetic analysis revealed that the mutant trait was controlled by a recessive nuclear gene, which was found to be BraA10g000480.3C by MutMap and Kompetitive allele-specific PCR analyses. As BraA10g000480.3C was the ortholog of ANGUSTIFOLIA in Arabidopsis, which has been found to regulate leaf width by controlling cortical microtubule arrangement and pavement cell shape, we named it BrAN. BrAN in mutant lhd1 carried an SNP (G to A) on intron 2 that co-segregated with the mutant phenotype, and disrupted the exon-intron splice junction generating intron retention and a putative truncated protein. BrAN in mutant lhd2 carried an SNP (G to A) on exon 4 leading to a premature stop codon. The ectopic overexpression of BrAN restored normal leaf phenotype due to abnormal cortical microtubule arrangement and pavement cell shape in the Arabidopsis an-t1 mutant. However, transformation of Bran did not rescue the an-t1 phenotype. These results indicate that BrAN contributes to leafy head formation of Chinese cabbage.
Pulmonary embolism due to an indefinite plug: 5-year follow-up
Authors: Çil E , Şahin K E
Published: July 2022

Thoracic computed tomography angiography revealed a filling defect with an internal air density in the lower lobar branch of the left pulmonary artery accompanied by pleural fluid, in a patient who applied with sudden onset chest pain and dyspnoea. The filling defect remained stable after anticoagulant treatment. No progression or complications were observed in 5-year follow-up. In pulmonary embolism that does not resolve despite adequate treatment, non-thrombotic sources, particularly foreign body, should be considered.
Viscosity reduction of heavy crude oil by co-heating with hydrothermal liquid product of cotton stalk
Authors: Ming Hui , Yang Xiao , Yang Kun , Yang Zhilin , Wang Tianqi , Guo Xuqiang , Zhang Libo
Published: July 2022

Hydrothermal process (HT) is an economical and simple method in upgrading agriculture wastes. The liquid product obtained from HT is interesting because of abundant active chemical group. The present work tried to co-heat the HT liquid product of cotton stalk (CS) with heavy crude oil to reduce its viscosity. The optimization study was performed to obtain the best condition of co-heating and mechanism study was completed by comparing the viscosity reduction efficiency and analyzing group composition of crude oil before and after co-heating with HT liquid products of CS, cellulose, hemicellulose and lignin. The results show that the crude oil viscosity reduced obviously after co-heating with CS-HT liquid product under the optimized condition (220°C, 1 h, 3 g treatment liquid, 30 ml crude oil). The preliminary mechanism study results suggest that the main function component of CS that cause viscosity reduction of heavy oil is lignin. The current work provides a new idea of lignocellulosic biomass upgrading and heavy crude oil viscosity reduction.
Observer-based feedback stabilization of a reaction-diffusion equation with variable coefficients and boundary input delay
Authors: Zhu Hong-Li , Xu Gen-Qi
Published: July 2022

In this paper, we consider the stabilization issues of a reaction-diffusion equation with variable coefficients and boundary input delay. At first, we design an observer based on the system output to estimate the state of the system. Due to the present of time delay in control, we design a dynamic feedback controller based on the state information of observer, that is called the integral-type controller. By selecting appropriate kernel functions, we prove that the closed-loop system is exponentially stable. Herein, our approach mainly is based on the idea of ‘feedback equivalence’. By some equivalence transformations, we establish connection between the closed-loop system and a stable system.
Memory B-Cell Development After Asymptomatic or Mild Symptomatic SARS-CoV-2 Infection
Authors: Kato Yu , Bloom Nathaniel I , Sun Peifang , Balinsky Corey A , Qiu Qi , Cheng Ying , Jani Vihasi , Schilling Megan A , Goforth Carl W , Weir Dawn L , Ramos Irene , Sealfon Stuart C , Letizia Andrew G , Crotty Shane
Published: July 2022

Background

The development of memory B cells after asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is not well understood.

Methods

We compared spike antibody titers, pseudovirus neutralizing antibody titers, and memory B-cell responses among SARS-CoV-2 PCR-positive Marine recruits who either reported asymptomatic or symptomatic infection.

Results

Thirty-six asymptomatic participants exhibited similar spike IgG titers, spike IgA titers, and pseudovirus neutralization titers compared to 30 symptomatic participants. Pseudovirus neutralization and spike IgG titers showed significant positive correlations with frequency of memory B cells.

Conclusions

Among young adults, asymptomatic SARS-CoV-2 infection induced antibody and memory B-cell responses comparable to mild symptomatic infection.
Casirivimab and Imdevimab for the Treatment of Hospitalized Patients With COVID-19
Authors: Somersan-Karakaya Selin , Mylonakis Eleftherios , Menon Vidya P , Wells Jason C , Ali Shazia , Sivapalasingam Sumathi , Sun Yiping , Bhore Rafia , Mei Jingning , Miller Jutta , Cupelli Lisa , Forleo-Neto Eduardo , Hooper Andrea T , Hamilton Jennifer D , Pan Cynthia , Pham Viet , Zhao Yuming , Hosain Romana , Mahmood Adnan , Davis John D , Turner Kenneth C , Kim Yunji , Cook Amanda , Kowal Bari , Soo Yuhwen , DiCioccio A Thomas , Geba Gregory P , Stahl Neil , Lipsich Leah , Braunstein Ned , Herman Gary A , Yancopoulos George D , Weinreich David M ,   for the COVID-19 Phase 2/3 Hospitalized Trial Team
Published: July 2022

Background

The open-label RECOVERY study reported improved survival in hospitalized, SARS-CoV-2 seronegative patients treated with casirivimab and imdevimab (CAS + IMD).

Methods

In this phase 1/2/3, double-blind, placebo-controlled trial conducted prior to widespread circulation of Delta and Omicron, hospitalized COVID-19 patients were randomized (1:1:1) to 2.4 g or 8.0 g CAS + IMD or placebo, and characterized at baseline for viral load and SARS-CoV-2 serostatus.

Results

In total, 1336 patients on low-flow or no supplemental (low-flow/no) oxygen were treated. The primary endpoint was met in seronegative patients, the least-squares mean difference (CAS + IMD versus placebo) for time-weighted average change from baseline in viral load through day 7 was −0.28 log10 copies/mL (95% confidence interval [CI], −.51 to −.05; P = .0172). The primary clinical analysis of death or mechanical ventilation from day 6 to 29 in patients with high viral load had a strong positive trend but did not reach significance. CAS + IMD numerically reduced all-cause mortality in seronegative patients through day 29 (relative risk reduction, 55.6%; 95% CI, 24.2%–74.0%). No safety concerns were noted.

Conclusions

In hospitalized COVID-19 patients on low-flow/no oxygen, CAS + IMD reduced viral load and likely improves clinical outcomes in the overall population, with the benefit driven by seronegative patients, and no harm observed in seropositive patients.

Clinical Trials Registration

NCT04426695.
Careggi Re-Engineered Discharge project: standardize discharge and improve care coordination between healthcare professionals
Authors: Paolini Diana , Bonaccorsi Guglielmo , Lorini Chiara , Forni Silvia , Tanzini Michela , Toccafondi Giulio , D’arienzo Sara , Dannaoui Bassam , Niccolini Fabrizio , Tomaiuolo Matteo , Bussotti Alessandro , Petrioli Alessandra , Morettini Alessandro
Published: July 2022

Background

The hospital discharge process plays a key role in patient care. Careggi Re-Engineered Discharge (CaRED) aimed at establishing a meaningful relationship among general practitioners (GPs) and patients, throughout the discharge process.

Objective

The aim is to describe the activities and results in the period 2014–17 of the CaRED.

Methods

CaRED is a restructured discharge protocol, which foresees a different, more direct form of communication between hospital and GPs, enabled by an ad hoc electronic medical record. The 30-day hospital readmission rate and/or accesses to the emergency department were evaluated as proxy for effective communication. A pre–post survey was launched to assess the GPs’ perceived quality, and patient and family satisfaction.

Results

A total of 1549 hospitalizations were included, respectively, 717 in the pre and 832 in the post-intervention period. The 30-day hospital readmission rate decreased significantly in the post-intervention period (14.4% vs. 19.4%, χ2(1) = 8.03, P < 0.05).

Eighty-two and 52 GPs participated, respectively, in the pre- and post-survey. In the post-phase the percentage of GPs declaring the discharge letter facilitated the communication on the admission causes (χ2(1) = 0.56, P = 0.03) and on what to do if conditions change (χ2(31) = 19.0, P < 0.01) significantly increased, as well as the perception of an easier contact with the hospitalist (χ2(3) = 19.6, P < 0.01).

Two-hundred-eighty and 282 patients were enrolled in the pre- and post-survey. The level of understanding of key parts of the discharge letter (reason for hospitalization, post-discharge therapy, follow-up examinations and how to contact the hospital ward) improved significantly (P < 0.01).

Conclusions

CaRED significantly improved the discharge process and became a benchmark for local improvements in communication patterns with GPs.
Free Trade's Organized Progressive Opposition
Authors: Osgood Iain , Ro Hyeon-Young
Published: July 2022

Populist, protectionist, and progressive opposition to globalization are renascent among voters and politicians, but which of these ideologies have successfully inspired interest group mobilization? To answer this question, we collect original data on thousands of groups’ participation in highly organized coalitions opposed to US trade policy and globalization. Examining the types of groups that compose coalitions, variation in activation across issues, and coalitions’ written statements, we find that their motivations are mainly progressive, focused on the environment, human rights, economic justice, and reducing corporate power. We also focus on progressives’ labor union allies, showing that their participation in anti-trade coalitions is driven by both sincere progressive and classic protectionist motives. Thus, a progressive–labor alliance espousing mainly demands for fair trade, not plain protectionism, dominates public activism against US trade agreements. This interest group opposition has no match on the political right, suggesting that the recent efflorescence of populist anti-globalization may not last, even as progressive fair traders use their superior mobilization to endure.
Determination of the Authenticity and Origin of Panax Notoginseng: A Review
Authors: Ji Chao , Zhang Qin , Shi Rui , Li Juan , Wang Xingyu , Wu Zhiqiang , Ma Ying , Guo Junli , He Xiahong , Zheng Wenjie
Published: July 2022

Panax notoginseng, a traditional medicinal and edible plant, is widely used in medicine, health care, cosmetics, and other industries. Affected by the discrepancy between market supply and demand and price, the adulteration of P. notoginseng products with other plant-derived ingredients occurs at times. With the continuous development of technologies such as spectroscopy, chromatography, and DNA barcoding, the detection techniques for rapid and sensitive determination of the authenticity identification and origin of P. notoginseng have become more diversified to meet the needs of different regulatory goals and could effectively control practices that mislead consumers and promote false labeling. This review analyzes and summarizes the existing technologies for determining the authenticity and origin of P. notoginseng from these three aspects: morphological, chemical, and molecular biology methods from the literature since 2001; on this basis, the current problems and future research directions are discussed to provide a reference for the establishment of rapid and accurate methods to verify authenticity and origin to promote the further development and improvement of quality control technology systems for P. notoginseng.
Prediction of methane per unit of dry matter intake in growing and finishing cattle from the ratio of dietary concentrations of starch to neutral detergent fiber alone or in combination with dietary concentration of ether extract
Authors: Galyean Michael L , Hales Kristin E
Published: July 2022

Previous research demonstrated that a fixed value of 0.2433 (SE = 0.0134) Mcal of CH4/kg of dry matter intake (DMI) could be used to predict CH4 production with accuracy and precision on par with similar equations in the literature. Slope bias was substantially less for the fixed-coefficient equation than noted for the other DMI- or gross energy intake (GEI)-based equations, but mean bias was substantially greater, presumably reflecting the failure of the fixed-coefficient approach to account for dietary factors that affect CH4 production. In this article, we report on the use of the dietary ratio of concentrations of starch to neutral detergent fiber (NDF) and dietary ether extract (EE) concentration to improve the accuracy and precision of the fixed-coefficient equation. The same development data set used to create the fixed-coefficient equation was used in the present study, which included 134 treatment means from 34 respiration calorimetry studies. Based on stepwise regression with dietary NDF, starch, crude protein, EE, and the starch:NDF ratio as possible dependent variables, the starch:NDF ratio and EE were the only dietary variables selected (P ≤ 0.15). The study-adjusted relationship with the starch:NDF ratio (r2 = 0.673; root mean square error [RMSE] = 0.0327) was: Mcal of CH4/kg of DMI = 0.2883 − 0.03474 × starch:NDF; whereas the relationship with a model that included both starch:NDF ratio and dietary EE (r2 = 0.738; RMSE = 0.0315) was: Mcal of CH4/kg of DMI = 0.3227 − 0.0334 × starch:NDF − 0.00868 × % EE. A previously published independent data set with 129 treatment means from 30 respiration calorimetry studies was used to evaluate these two equations, along with two additional equations in which g/d of CH4 was predicted directly from DMI, starch:NDF ratio, and/or dietary EE. The two Mcal of CH4/kg of DMI equations had superior fit statistics to the previously published 0.2433 Mcal of CH4/kg of DMI equation, with a substantial decrease in mean bias and improved concordance correlation coefficients. Moreover, the Mcal of CH4/kg of DMI equations resulted in improved fit relative to direct prediction of g/d of CH4 from DMI, the starch:NDF ratio, and % EE. Based on these results, further evaluation of the dietary ratio of starch-to-NDF concentrations and EE concentration to predict methane production per unit DMI in beef cattle is warranted.
Experience with Implementing a Beta-lactam Therapeutic Drug Monitoring Service in a Burn Intensive Care Unit: A Retrospective Chart Review
Authors: Alshaer Mohammad , Mazirka Pavel , Burch Gena , Peloquin Charles , Drabick Zachary , Carson Joshua
Published: July 2022

Thermal injuries alter pharmacokinetics, complicating the prediction of standard antibiotic dose effectiveness. Therapeutic drug monitoring (TDM) has been proposed to prevent subtherapeutic dosing of antibiotic therapy, but remains scarcely studied in the burn patient population. A retrospective chart review of burn patients receiving beta-lactam TDM from 2016 to 2019 was conducted. Adult patients with thermal injury receiving cefepime, piperacillin/tazobactam, or meropenem for ≥48 hours were included. Between February 2016 and July 2017, we utilized selective TDM based on clinical judgement to guide treatment. From October 2018 until July 2019, TDM was expanded to all burn patients on beta-lactams. The primary endpoint was achievement of therapeutic concentration, and the secondary endpoints were clinical cure, culture clearance, new resistance, length of stay, and mortality. The selective (control) group included 19 patients and the universal (study) group reviewed 23 patients. In both groups, skin and lungs were the most common primary infection sources, with Pseudomonas aeruginosa as the most common species. In the universal cohort, patients were older with higher risk factors, but more frequently achieved the target drug concentration, required less days to start TDM (p < .0001), and had more frequent measurements and beta-lactam dose adjustments. Positive clinical outcome was reported in 77%, and microbial eradication in 82% of all patients. All clinical outcomes were similar between the groups. The implementation of beta-lactam TDM protocol shortened the time, increased the probability of appropriate target attainment, and individualized beta-lactam therapy in burn patients.
Incorporating additive manufacturing constraints into magneto-structural topology optimization
Authors: Bai Yingchun , Cai Jiale , Wang Zixiang , Li Siqi
Published: July 2022

The sequential using of topology optimization and AM (additive manufacturing) can generate and fabricate superior-performance yet lightweight magneto-structural components. In this paper, a magneto-structural topology optimization method is proposed considering AM constraints to improve the design manufacturability of optimized designs. The design problem is formulated with the weighted combination of magnetic compliance and mechanical compliance as a single objective subjected to two types of manufacturing constraints and the volume fraction constraint. Two important AM constraints are in a sequential manner incorporated into the topology optimization model, in which the overhang angle constraint is followed by the maximum length scale constraint. Corresponding sensitivities of the objective and constraints are derived, and the optimization problem is solved by the method of moving asymptotes. Two numerical examples and a practical conceptual design of linear motor rotor structure are systematically investigated to demonstrate the effectiveness of the proposed method.
Is there a role for controlled repositioning and mini-open primary osteoplasty in the management of unstable slipped capital femoral epiphysis?
Authors: Venkatadass K , Durga Prasad V , Jain Deepak , Al Ahmadi Nasser Mohammed Mansor , Rajasekaran S
Published: July 2022

The management of unstable slipped capital femoral epiphysis is controversial with variable rates of avascular necrosis (AVN). Treatment options include in-situ stabilization, gentle/positional reduction and screw fixation and modified Dunn’s procedure (MDP). We present a technique of controlled repositioning (CRP) of the epiphysis to pre-acute slip stage, screw fixation and primary osteoplasty. Between 2015 and 2020, 38 unstable slips were treated in our institution. Of these, 14 underwent successful CRP and the rest were treated with MDP. All the 14 patients who had CRP and completed 1-year follow-up were included for this study. The head–neck angle (HNA) was measured at presentation and alpha angle, head–neck offset and AVN were assessed during follow-up. The average age was 14 years (9–18) and mean follow-up was 17.7 months (12–43). The average intraoperative flexion internal rotation before osteoplasty was −18.5° (−40° to −5°) which improved to +22.1° (+15° to +30°). The average preoperative HNA was 48.7° (34.1° to 70.7°) which improved to 18.4° (1.8° to 35.7°) post-operatively. At final follow-up, the average alpha angle and head–neck offset were 46.4° (30.9° to 64.6°) and 0.22 (0.09 to 0.96), respectively. The AVN rate in the CRP group was 7.1% compared with 20.8% in the MDP group, which was not significant (P = 0.383). Two patients had screw breakage. CRP, screw fixation and mini-open primary osteoplasty is a feasible treatment option in a subgroup of patients with unstable SCFEs. The limitation with this technique is that the final decision is made intraoperatively, and hence the patient and parents need to be counselled and consented appropriately. Level of evidence: Level IV—Case series.
A probabilistic method of background removal for high energy astrophysics data
Authors: Ehlert S , Chen C T , Swartz D , Hickox R C , Lutovinov A , Semena A , Krivonos R , Shtykovsky A , Tkachenko A
Published: July 2022

We present a new statistical method for constructing background subtracted measurements from event list data gathered by X-ray and gamma-ray observatories. This method was initially developed specifically to construct images that account for the high background fraction and low overall count rates observed in survey data from the Mikhail Pavlinsky ART-XC telescope aboard the Spektrum Röntgen Gamma (SRG) mission, although the mathematical underpinnings are valid for data taken with other imaging missions and analysis applications. This method fully accounts for the expected Poisson fluctuations in both the sky photon and non-X-ray background count rates in a manner that does not result in unphysical negative counts. We derive the formulae for arbitrary confidence intervals for the source counts and show that our new measurement converges exactly to the standard background subtraction calculation in the high signal limit. Utilizing these results, we discuss several variants of images designed to optimize different science goals for both pointed and slewing telescopes. Using realistic simulated data of a galaxy cluster as observed by ART-XC, we show that our method provides a more significant and robust detection of the cluster emission as compared to a standard background subtraction. We also demonstrate its advantages using real observations of a point source from the ART-XC telescope. These calculations may have widespread applications for a number of source classes observed with high energy telescopes.
Pegasus V/Andromeda XXXIV–a newly discovered ultrafaint dwarf galaxy on the outskirts of Andromeda
Authors: Collins Michelle L M , Charles Emily J E , Martínez-Delgado David , Monelli Matteo , Karim Noushin , Donatiello Giuseppe , Tollerud Erik J , Boschin Walter
Published: July 2022

We report the discovery of an ultrafaint dwarf in the constellation of Pegasus. Pegasus V (Peg V)/Andromeda XXXIV was initially identified in the public imaging data release of the DESI Legacy Imaging Surveys and confirmed with deep imaging from Gemini/GMOS-N. The colour–magnitude diagram shows a sparse red giant branch (RGB) population and a strong overdensity of blue horizontal branch stars. We measure a distance to Peg V of $D=692^{+33}_{-31}$ kpc, making it a distant satellite of Andromeda with MV = −6.3 ± 0.2 and a half-light radius of rhalf = 89 ± 41 pc. It is located ∼260 kpc from Andromeda in the outskirts of its halo. The RGB is well fitted by a metal-poor isochrone with [Fe/H] = −3.2, suggesting it is very metal poor. This, combined with its blue horizontal branch, could imply that it is a reionization fossil. This is the first detection of an ultrafaint dwarf outside the deep Pan-Andromeda Archaeological Survey area, and points to a rich, faint satellite population in the outskirts of our nearest neighbour.
Triphenylphosphine gold(I) derivatives promote antiviral effects against the Chikungunya virus
Authors: Aires Rochanna L , Santos Igor A , Fontes Josielle V , Bergamini Fernando R G , Jardim Ana Carolina G , Abbehausen Camilla
Published: July 2022

Herein a systematic series of four [AuLL’]n+ n = 0, +1 complexes, where L = 1,3-bis(mesityl)imidazole-2-ylidene (IMes), or triphenylphosphine (PPh3), and L’ = chloride, or 4-dimethylaminopyridine (DMAP), had their in vitro antiviral activity assessed against Chikungunya virus (CHIKV). The PPh3 derivatives inhibited viral replication by 99%, whereas the IMes derivatives about 50%. The lipophilicity of the PPh3 derivatives is higher than the IMes-bearing compounds, which can be related to their more prominent antiviral activities. The dissociation of DMAP is faster than chloride in solution for both IMes and PPh3 derivatives; however, it does not significantly affect their in vitro activities, showing a higher dependence on the nature of L rather than L’ towards their antiviral effects. All complexes bind to N-acetyl-L-cysteine, with the Ph3P-bearing complexes coordinating at a faster rate to this amino acid. The binding constants to bovine serum albumin are in the order of 104, slightly higher for the DMAP complexes in both PPh3 and IMes derivatives. Mechanistic investigations of the PPh3 complexes showed a ubiquitous protective effect of the compounds in the pretreatment, early stages, and post-entry assays. The most significant inhibition was observed in post-entry activity, in which the complexes blocked viral replication in 99%, followed by up to 95% inhibition of the early stages of infection. Pretreatment assays showed a 92% and 80% replication decrease for the chloride and DMAP derivatives, respectively. dsRNA binding assays showed a significant interaction of the compounds with dsRNA, an essential biomolecule to viral replication.