bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of intracellular histological abnormalities using cardiac magnetic resonance T1 mapping in patients with Danon disease: a case series
Authors: Suzuki Hideaki , Morita Yoshiaki , Saito Ryoko , Tatebe Shunsuke , Niihori Tetsuya , Saiki Yoshikatsu , Yasuda Satoshi , Shimokawa Hiroaki
Published: May 2021

Background

Danon disease is an X-linked dominant disorder with defects in the lysosome-associated membrane protein 2 (LAMP2) gene and is characterized histologically by intracellular autophagic vacuoles in skeletal and cardiac muscles. Cardiac magnetic resonance (CMR) T1 mapping potentially allows to differentiate intracellular and extracellular cardiac abnormalities with a combination of native T1 value and extracellular volume (ECV) fraction.

Case summary

We assessed CMR T1 mapping in two Danon disease patients (a 22-year-old man and his 48-year-old mother), who had a LAMP2 c.864G>A p. Val288Val mutation, and two blood relatives without Danon disease (his 47-year-old maternal aunt and 49-year-old father). The male patient underwent a left ventricular (LV) assist device implantation at 15 months after the image acquisition because he was inotrope dependent (INTERMACS profile 3) and had no noticeable psychological or musculoskeletal symptoms. His mother was in New York Heart Association Class II with mildly reduced LV ejection fraction (46%). The Danon group showed late gadolinium enhancement (LGE) in the anterior and posterolateral LV walls. In the interventricular wall, where evident LGE was not noted, the Danon group had high native T1 value, compared with the T1 value in the non-Danon group, and normal ECV fraction. Cardiac biopsy from the interventricular wall showed intracytoplasmic autophagic vacuoles, which are characteristics of Danon disease.

Discussion

This characteristic pattern of high native T1 and normal ECV fraction in the areas without LGE, which may reflect the existence of intracytoplasmic autophagic vacuoles, may support the differential diagnosis of Danon disease from other cardiomyopathies.
Superior vena cava prosthetic replacement for non-small cell lung cancer: is it worthwhile?
Authors: Chenesseau Josephine , Mitilian Delphine , Sharma Gaurav , Mussot Sacha , Boulate David , Haulon Stephan , Fabre Dominique , Mercier Olaf , Fadel Elie
Published: May 2021

OBJECTIVES

Direct involvement of the superior vena cava (SVC) by non-small cell lung cancer (NSCLC) requires en-bloc tumour resection with complete vascular clamping and prosthetic replacement. We report the outcomes of this highly demanding procedure in the largest patient cohort to date.

METHODS

We searched our institution’s database for patients who underwent complete en-bloc resection of NSCLC invading the SVC followed by prosthetic SVC replacement, between 1980 and 2018. Patients with cN2, cN3 or distant metastases were not eligible.

RESULTS

We identified 48 patients (38 males, 10 females; mean age of 57 years; tumour size, 1.9–17 cm). Neoadjuvant therapy was administered to 17 and adjuvant therapy to 31 patients. R0 resection was achieved in 41 (85%) patients; lymph node involvement was pN0 in 8, pN1 in 23, pN2 in 14 and pN3 in 3 patients. Five patients died within 30 days of surgery. Right pneumonectomy was significantly associated with postoperative death (P = 0.02). Postoperative complications developed in 13 other patients. No neurologic events related to SVC clamping occurred. Graft thrombosis developed in 2 patients. Median survival was 24 months; 3-, 5- and 10-year survival rates were 45%, 40% and 35%, respectively; and corresponding disease-free survival rates were 37%, 37% and 30%, respectively. By univariable analysis, only margin-free (R0) resection was associated with better survival (P = 0.02).

CONCLUSIONS

In highly selected patients with NSCLC involving the SVC, mortality is acceptable after complete en-bloc resection and prosthetic replacement done in an expert centre. SVC involvement should not preclude consideration of curative resection in selected patients.
Early-to-midterm outcomes of aortic balloon occlusion technique versus hybrid procedure for aortic arch diseases
Authors: Liang Shenghua , Liu Yanxiang , Zhang Bowen , Guo Hongwei , Qian Xiangyang , Yu Cuntao , Sun Xiaogang
Published: May 2021

OBJECTIVES

The goal of this study was to compare the early-to-midterm outcomes of patients treated with the frozen elephant trunk procedure with aortic balloon occlusion (FET-ABO) versus hybrid repair for aortic arch diseases.

METHODS

Patients who underwent the FET-ABO (n = 134) and the hybrid procedure (n = 220) from 2017 to 2020 at our institution were analysed retrospectively. Early-to-midterm outcomes were compared using inverse probability weighting. Low-risk and high-risk subgroup analyses were performed according to the cut-off of the additive European System for Cardiac Operative Evaluation value of 6.

RESULTS

The present study demonstrated similar 30-day mortality (3.7% vs 8.6%; P = 0.118) and adverse events between the FET-ABO and the hybrid groups. Fewer intraoperative red blood cell transfusions (0.54 ± 1.45 vs 1.26 ± 2.47 U; P = 0.001), decreased total hospital costs (P < 0.001) and considerable early-to-midterm survival [crude: hazard ratio (HR) 0.40, 95% confidence interval (CI) 0.17–0.91; P = 0.030; adjusted: HR 0.35, 95% CI 0.13–0.91; P = 0.032) were obtained with the FET-ABO compared to the hybrid procedure. The inverse probability weighting method substantiated the foregoing results. Adjusted subgroup analyses suggested that the FET-ABO procedure had a trend towards improved survival in low-risk patients (HR 0.17, 95% CI 0.03–0.93; P = 0.041) and achieved outcomes comparable to those of the hybrid procedure in high-risk patients (HR 0.46, 95% CI 0.15–1.42; P = 0.176).

CONCLUSIONS

The FET-ABO technique could be better promoted in hospitals lacking experience and equipment and could be more viable and cost-effective for selected patients compared with the hybrid procedure.
Association of premature atherosclerotic cardiovascular disease with higher risk of cancer: a behavioral risk factor surveillance system study
Authors: Jain Vardhmaan , Rifai Mahmoud Al , Brinzevich Daria , Taj Mehrunnissa , Saleh Mansoor , Krittanawong Chayakrit , Patel Jaideep , Patel Ashley , Lee Michelle T , Mahtta Dhruv , Virani Salim S
Published: May 2021

Aim 

The aim of this study was to investigate a possible association between atherosclerotic cardiovascular disease (ASCVD) and risk of cancer in young adults.

Methods 

We utilized data from the Behavioral Risk Factor Surveillance System, a nationally representative US telephone-based survey to identify participants in the age group of 18–55 years who reported a history of ASCVD. These patients were defined as having premature ASCVD. Weighted multivariable logistic regression models were used to study the association between premature ASCVD and cancer including various cancer subtypes.

Results 

Between 2016 and 2019, we identified 28 522 (3.3%) participants with a history of premature ASCVD. Compared with patients without premature ASCVD, individuals with premature ASCVD were more likely to be Black adults, have lower income, lower levels of education, reside in states without Medicaid expansion, have hypertension, diabetes mellitus, chronic kidney disease, obesity, and had delays in seeking medical care. Individuals with premature ASCVD were more likely to have been diagnosed with any form of cancer (13.7% vs 3.9%), and this association remained consistent in multivariable models (odds ratio, 95% confidence interval: 2.08 [1.72–2.50], P < 0.01); this association was significant for head and neck (21.08[4.86–91.43], P < 0.01), genitourinary (18.64 [3.69–94.24], P < 0.01), and breast cancer (3.96 [1.51–10.35], P < 0.01). Furthermore, this association was consistent when results were stratified based on gender and race, and in sensitivity analysis using propensity score matching.

Conclusion 

Premature ASCVD is associated with a higher risk of cancer. These data have important implications for the design of strategies to prevent ASCVD and cancer in young adults.
Large Phylogenomic Data sets Reveal Deep Relationships and Trait Evolution in Chlorophyte Green Algae
Authors: Li Xi , Hou Zheng , Xu Chenjie , Shi Xuan , Yang Lingxiao , Lewis Louise A , Zhong Bojian
Published: May 2021

The chlorophyte green algae (Chlorophyta) are species-rich ancient groups ubiquitous in various habitats with high cytological diversity, ranging from microscopic to macroscopic organisms. However, the deep phylogeny within core Chlorophyta remains unresolved, in part due to the relatively sparse taxon and gene sampling in previous studies. Here we contribute new transcriptomic data and reconstruct phylogenetic relationships of core Chlorophyta based on four large data sets up to 2,698 genes of 70 species, representing 80% of extant orders. The impacts of outgroup choice, missing data, bootstrap-support cutoffs, and model misspecification in phylogenetic inference of core Chlorophyta are examined. The species tree topologies of core Chlorophyta from different analyses are highly congruent, with strong supports at many relationships (e.g., the Bryopsidales and the Scotinosphaerales-Dasycladales clade). The monophyly of Chlorophyceae and of Trebouxiophyceae as well as the uncertain placement of Chlorodendrophyceae and Pedinophyceae corroborate results from previous studies. The reconstruction of ancestral scenarios illustrates the evolution of the freshwater-sea and microscopic–macroscopic transition in the Ulvophyceae, and the transformation of unicellular→colonial→multicellular in the chlorophyte green algae. In addition, we provided new evidence that serine is encoded by both canonical codons and noncanonical TAG code in Scotinosphaerales, and stop-to-sense codon reassignment in the Ulvophyceae has originated independently at least three times. Our robust phylogenetic framework of core Chlorophyta unveils the evolutionary history of phycoplast, cyto-morphology, and noncanonical genetic codes in chlorophyte green algae.
Log Symplectic Manifolds and [Q,R]=0
Authors: Lin Yi , Loizides Yiannis , Sjamaar Reyer , Song Yanli
Published: May 2021

We show, under an orientation hypothesis, that a log symplectic manifold with simple normal crossing singularities has a stable almost complex structure, and hence is Spin$_c$. In the compact Hamiltonian case we prove that the index of the Spin$_c$ Dirac operator twisted by a prequantum line bundle satisfies a $[Q,R]=0$ theorem.
Comparison of women and men in biomedical informatics scientific dissemination: retrospective observational case study of the AMIA Annual Symposium: 2017–2020
Authors: Hartzler Andrea L , Leroy Gondy , Daurelle Brenda , Ochoa Magali , Williamson Jeffrey , Cohen Dasha , Stipelman Carole
Published: May 2021

Objective

Although the representation of women in science has improved, women remain underrepresented in scientific publications. This study compares women and men in scholarly dissemination through the AMIA Annual Symposium.

Materials and Methods

Through a retrospective observational study, we analyzed 2017–2020 AMIA submissions for differences in panels, papers, podium abstracts, posters, workshops, and awards for men compared with women. We assigned a label of woman or man to authors and reviewers using Genderize.io, and then compared submission and acceptance rates, performed regression analyses to evaluate the impact of the assumed gender, and performed sentiment analysis of reviewer comments.

Results

Of the 4687 submissions for which Genderize.io could predict man or woman based on first name, 40% were led by women and 60% were led by men. The acceptance rate was smilar. Although submission and acceptance rates for women increased over the 4 years, women-led podium abstracts, panels, and workshops were underrepresented. Men reviewers increased the odds of rejection. Men provided longer reviews and lower reviewer scores, but women provided reviews that had more positive words.

Discussion

Overall, our findings reflect significant gains for women in the 4 years of conference data analyzed. However, there remain opportunities to improve representation of women in workshop submissions, panel and podium abstract speakers, and balanced peer reviews. Future analyses could be strengthened by collecting gender directly from authors, including diverse genders such as non-binary.

Conclusion

We found little evidence of major bias against women in submission, acceptance, and awards associated with the AMIA Annual Symposium from 2017 to 2020. Our study is unique because of the analysis of both authors and reviewers. The encouraging findings raise awareness of progress and remaining opportunities in biomedical informatics scientific dissemination.
Effect of Type of Tissue on the Development of Chrysomya rufifacies (Diptera: Calliphoridae) in Sri Lanka
Authors: Bambaradeniya Y T B , Karunaratne W A I P , Tomberlin J K , Magni P A
Published: May 2021

Chrysomya rufifacies (Macquart), the hairy maggot blow fly, is of great importance for the field of forensic entomology due to its habit as an early colonizer of decomposing vertebrate remains and myiasis producer. Development studies on this species have been conducted in scattered regions of the world, using types of tissue from several species of animals as a rearing medium. Despite the commonality of C. rufifacies in Sri Lanka, developmental studies have never been performed in this region. As well, the effects of diet on development have not been tested. In the current study, C. rufifacies immatures were reared on skeletal muscle, liver, and heart from domestic swine, with flies from colonies maintained at 25 and 28°C. The minimum time needed to complete each stage at 25°C on liver (224.14 h) was fastest followed by skeletal muscle (249.33 h) and heart (251.64 h) respectively, whereas at 28°C, fly development was quickest on heart muscle (178.27 h) followed by liver (178.50 h) and skeletal muscle (186.17 h) respectively. A significant difference in total development time was determined for temperature, while the rearing medium was not significant. Temperature also showed a significant effect on the length and the width of the larvae, while the type of tissue statistically impacted only the width.
Trophic Behavior and Species Diversity of the Anopheles barbirostris Complex (Diptera: Culicidae) in Thailand
Authors: Udom Chanya , Thanispong Kanutcharee , Manguin Sylvie , Chareonviriyaphap Theeraphap , Fungfuang Wirasak
Published: May 2021

Species of the Anopheles barbirostris complex (Myzorhynchus Series of the subgenus Anopheles) are potential vectors of malaria and filariasis parasites. Owing to the lack of reliable identification methods, the biting activity and host preference of the species within this complex have not been previous described. In this study, the trophic behavior and host preferences of the species in the complex were determined in Thailand, and a map of their geographical distributions constructed. Adult female mosquitoes in Chanthaburi and Prachuap Khiri Khan provinces were collected using human landings (indoor and outdoor) and cow-bait. Morphological characters were used to initially identify the mosquitoes, and then, species were further separated by multiplex PCR. Four species were identified in the An. barbirostris complex: An. wejchoochotei Taai & Harbach (Diptera: Culicidae), An. saeungae Taai & Harbach (Diptera: Culicidae), An. dissidens Taai & Harbach (Diptera: Culicidae), and An. campestris Reid (Diptera: Culicidae). The species showed exophagic and zoophilic behavior, except An. wejchoochotei in Chanthaburi, which displayed slight endophilic behavior. Indoor and outdoor blood feeding behavior of An. wejchoochotei and An. saeungae peaked at 2000 h. An updated distribution map of the An. barbirostris complex in Thailand is presented. With a better understanding of the sibling vector species and their spatial distributions, more specific and effective control strategies for vectors of malaria and filariasis in Thailand can be achieved.
Rapid Parallel Adaptation to Anthropogenic Heavy Metal Pollution
Authors: Papadopulos Alexander S T , Helmstetter Andrew J , Osborne Owen G , Comeault Aaron A , Wood Daniel P , Straw Edward A , Mason Laurence , Fay Michael F , Parker Joe , Dunning Luke T , Foote Andrew D , Smith Rhian J , Lighten Jackie
Published: May 2021

The impact of human-mediated environmental change on the evolutionary trajectories of wild organisms is poorly understood. In particular, capacity of species to adapt rapidly (in hundreds of generations or less), reproducibly and predictably to extreme environmental change is unclear. Silene uniflora is predominantly a coastal species, but it has also colonized isolated, disused mines with phytotoxic, zinc-contaminated soils. To test whether rapid, parallel adaptation to anthropogenic pollution has taken place, we used reduced representation sequencing (ddRAD) to reconstruct the evolutionary history of geographically proximate mine and coastal population pairs and found largely independent colonization of mines from different coastal sites. Furthermore, our results show that parallel evolution of zinc tolerance has occurred without gene flow spreading adaptive alleles between mine populations. In genomic regions where signatures of selection were detected across multiple mine-coast pairs, we identified genes with functions linked to physiological differences between the putative ecotypes, although genetic differentiation at specific loci is only partially shared between mine populations. Our results are consistent with a complex, polygenic genetic architecture underpinning rapid adaptation. This shows that even under a scenario of strong selection and rapid adaptation, evolutionary responses to human activities (and other environmental challenges) may be idiosyncratic at the genetic level and, therefore, difficult to predict from genomic data.
Intragenic complementation at the Lotus japonicus CELLULOSE SYNTHASE-LIKE D1 locus rescues root hair defects
Authors: Karas Bogumil J , Ross Loretta , Novero Mara , Amyot Lisa , Shrestha Arina , Inada Sayaka , Nakano Michiharu , Sakai Tatsuya , Bonetta Dario , Sato Sushei , Murray Jeremy D , Bonfante Paola , Szczyglowski Krzysztof
Published: May 2021

Root hair cells form the primary interface of plants with the soil environment, playing key roles in nutrient uptake and plant defense. In legumes, they are typically the first cells to become infected by nitrogen-fixing soil bacteria during root nodule symbiosis. Here, we report a role for the CELLULOSE SYNTHASE-LIKE D1 (CSLD1) gene in root hair development in the legume species Lotus japonicus. CSLD1 belongs to the cellulose synthase protein family that includes cellulose synthases and cellulose synthase-like proteins, the latter thought to be involved in the biosynthesis of hemicellulose. We describe 11 Ljcsld1 mutant alleles that impose either short (Ljcsld1-1) or variable (Ljcsld1-2 to 11) root hair length phenotypes. Examination of Ljcsld1-1 and one variable-length root hair mutant, Ljcsld1-6, revealed increased root hair cell wall thickness, which in Ljcsld1-1 was significantly more pronounced and also associated with a strong defect in root nodule symbiosis. Lotus japonicus plants heterozygous for Ljcsld1-1 exhibited intermediate root hair lengths, suggesting incomplete dominance. Intragenic complementation was observed between alleles with mutations in different CSLD1 domains, suggesting CSLD1 function is modular and that the protein may operate as a homodimer or multimer during root hair development.
A review of resting-state fMRI and its use to examine psychiatric disorders
Authors: Canario Edgar , Chen Donna , Biswal Bharat
Published: May 2021

Resting-state fMRI (rs-fMRI) has emerged as an alternative method to study brain function in human and animal models. In humans, it has been widely used to study psychiatric disorders including schizophrenia, bipolar disorder, autism spectrum disorders, and attention deficit hyperactivity disorders. In this review, rs-fMRI and its advantages over task based fMRI, its currently used analysis methods, and its application in psychiatric disorders using different analysis methods are discussed. Finally, several limitations and challenges of rs-fMRI applications are also discussed.
Abdominal arterial lesions associated with antiphospholipid antibodies: a comparative cross-sectional magnetic resonance angiography study
Authors: Sangle Shirish R , Jan Wajanat , Matar Hosam E , Rankin Sheila , D’Cruz David P
Published: May 2021

Objective

Case reports and small case series suggest that stenotic lesions of the renal, coeliac and mesenteric arteries may occur in the antiphospholipid syndrome (APS) resulting in clinical consequences such as hypertension and abdominal angina. The objective was to determine the prevalence of stenotic lesions in arteries arising from the middle aorta in patients with antiphospholipid antibodies (aPL) compared with healthy, hypertensive and atherosclerotic controls.

Methods

In a cross-sectional comparative radiological study using magnetic resonance angiography (MRA), we assessed five groups of subjects for the prevalence of stenotic lesions in arteries arising from the middle aorta: APS/aPL positive, healthy renal donors, patients with hypertension, patients with atherosclerosis defined radiologically and patients with systemic lupus erythematosus and vasculitis who were negative for aPL. All subjects underwent MRA in suspended respiration and images were assessed by two senior radiologists blinded to the clinical details.

Results

In the atherosclerosis group, vascular stenotic lesions were more prevalent (71%) than in any other group (P ≤0.000002). The prevalence of all stenotic lesions in aPL positive patients (33%) was significantly higher than in the renal donors (18%) and hypertensive patients (19%) (P ≤0.009). Renal artery stenosis was significantly more prevalent in aPL positive patients than in renal donors (P ≤0.0006) but similar to the prevalence in hypertensive patients. Coeliac and/or mesenteric lesions were significantly more common in aPL positive patients vs hypertensive patients (P ≤0.001). Stenoses did not correlate with traditional risk factors.

Conclusion

Arterial stenotic lesions in arteries arising from the middle aorta were highly prevalent in atherosclerotic subjects and were more common in aPL-positive patients than in hypertensive patients and healthy renal donors.
EXTREMELY LOW FREQUENCY ELECTROMAGNETIC EXPOSURE ASSESSMENT IN SCHOOLS: A STATISTICAL ANALYSIS OF URBAN AND SEMI-URBAN AREAS
Authors: Kiouvrekis Y , Alexias A , Softa V , Alkhorayef M , Sulieman A , Tyrakis C , Kappas C
Published: May 2021

The aim of this research paper is to estimate the mean value of extremely low frequency (ELF) exposure in schools in Greece. Detailed ELF measurements were conducted and analyzed by the Weighted Peak Method (WPM), which estimates the overall contribution of electromagnetic waves from 1 Hz to 400 kHz, including their phases. A sample of 243 schools was sampled to calculate. The mean value of ELF magnetic fields (MFs) measured in these two groups comprising 243 schools was the principal focus of interest. ELF MF measurements taken in schools situated both far from and near ELF sources had mean and maximum values well below the current International Commission on Non-Ionizing Radiation Protection (ICNIRP) standard. The mean value of ELF MFs from all sources within the sampled schools in Greece was 0.21 μΤ. A statically significant difference between the mean MFs measured in the two groups of schools was found, but the MFs in both groups were much lower than the ICNIRP standard.
Genomic evolution, transmission dynamics, and pathogenicity of avian influenza A (H5N8) viruses emerging in China, 2020
Authors: Zhang Jiahao , Li Xudong , Wang Xiaomin , Ye Hejia , Li Bo , Chen Yiqun , Chen Junhong , Zhang Tao , Qiu Ziwen , Li Huanan , Jia Weixin , Liao Ming , Qi Wenbao
Published: May 2021

Multiple recent outbreaks of highly pathogenic H5N8 viruses originating in aquatic birds frequently occurred in most European countries, Russia, South Korea, and Japan during the winter of 2020–21, and one zoonotic event of poultry workers infected with novel H5N8 viruses were reported in Russia. Strikingly, these novel H5N8 viruses had emerged and been co-circulating in wild birds and poultry in multiple provinces of China during 2020–21. In China, the population of aquatic birds has risen significantly in the past twenty years, and China is regarded as the largest reservoir for influenza viruses carried in aquatic birds across the globe. Hence, the co-circulation of these novel H5N8 viruses poses an alarming threat to not only poultry industry but also human health. In this study, we sequenced full-length genomes of these H5N8 viruses circulating in China. Phylogenetic analysis demonstrated that poultry-origin H5N8 viruses in China fell within wild birds-origin clade 2.3.4.4b H5N8 viruses from Europe during 2020–21, and notably, were genetically closely related to human-infecting H5N8 viruses in Russia. Moreover, they possessed several molecular markers associated with mammalian adaption. Bayesian coalescent analysis showed that these H5N8 viruses might have introduced into China during June–September 2020, suggesting that these H5N8 viruses might have introduced via wild bird migration or poultry trade. Besides, we also found that the effective population size of clade 2.3.4.4b H5N8 viruses dramatically increased during the winter season of 2020/21, as is consistent with previous increase of genetic diversity during the winter seasons of 2013/14 and 2016/17, which indicated that the wild bird migration accelerates the genetic diversity of these H5N8 viruses during the winter season of 2020/21. Notably, these novel H5N8 viruses were lethal to chickens and mice, highly transmissible to ducks, and were antigenically distinct from 2.3.4.4h H5 viruses circulating in China, posing considerable threats to public health. Our findings offer novel insights into the evolution and risk assessment of H5N8 viruses during the winter season of 2020–21.
Field Assessment of Six Point-Mutations in SDH Subunit Genes Conferring Varying Resistance Levels to SDHIs in Clarireedia spp.
Authors: Lee Jaemin , Elliott Michaela R. , Yamada Toshihiko , Jung Geunhwa
Published: May 2021

Dollar spot, caused by Clarireedia spp. (formerly Sclerotinia homoeocarpa F.T. Bennett), is the most economically important turfgrass disease causing considerable damage on golf courses. While cultural practices are available for reducing dollar spot infection, chemical fungicide use is often necessary for maintaining optimal turf quality. Since the release of boscalid in 2003, the succinate dehydrogenase inhibitor (SDHI) class has become an invaluable tool for managing dollar spot. However, resistance to this class has recently been reported in Clarireedia spp. and many other plant pathogenic fungi. After SDHI field failure on four golf courses and one university research plot, a total of six unique SDH mutations conferring differential in vitro sensitivities to SDHIs have been identified in Clarireedia spp. In 2018 and 2019, turf research plots were inoculated with sensitive, non-mutated isolates of Clarireedia spp., as well as resistant isolates harboring each unique identified mutation. Fungicide efficacy trials were conducted on inoculated plots to assess differential sensitivity to five SDHI active ingredients (boscalid, fluxapyroxad, isofetamid, fluopyram, and pydiflumetofen) across mutations under field conditions. Results indicate unique mutations are associated with distinct SDHI field efficacy profiles as shown in in-vitro sensitivity assays. Isolate populations with B subunit mutations (H267Y/R) were more sensitive to fluopyram, whereas isolate populations with C subunit mutations (C-G91R, C-G150R) showed resistance to all SDHIs tested. Mutation-associated differential sensitivity observed under field conditions indicates a need for a nation-wide survey and frequent monitoring of SDHI sensitivity of dollar spot populations on golf courses in the USA. Further, the information gained from this study will be useful in providing sustainable management recommendations for controlling site-specific resistant populations of Clarireedia spp.
Hepatic Resection for Hepatocellular Carcinoma in Nonalcoholic Fatty Liver Disease
Authors: Molinari Michele , Kaltenmeier Christof , Samra Patrick-Bou , Liu Hao , Wessel Charles , Lou Klem Mary , Dharmayan Stalin , Emmanuel Bishoy , Al Harakeh Hasan , Tohme Samer , Geller David , Tevar Amit , Hughes Christopher B. , Humar Abhinav , Bataller Ramon , Behari Jaideep
Published: May 2021

Objective:

To systematically review and compare the overall (OS) and disease-free (DFS) survival after hepatic resections for hepatocellular carcinoma (HCC) of patients with nonalcoholic fatty liver disease (NAFLD) versus other risk factors.

Background:

Different clinical and tumor characteristics are associated with HCC in the setting of NAFLD in comparison to other risk factors. It is still unclear whether these differences impact patient survival after radical hepatectomies.

Methods:

Randomized controlled trials and observational studies published in the English literature between July 1980 and June 2020 were searched using multiple databases. Patients’ baseline characteristics and the hazard ratios (HRs) of the OS and DFS were extracted and meta-analyses were performed.

Results:

Fifteen retrospective cohort studies with a total of 7226 patients were included. Among them, 1412 patients (19.5%) had NAFLD and 5814 (80.4%) had other risk factors (eg, viral hepatitis B or C, alcoholic cirrhosis, or cryptogenic cirrhosis). Summary statistics showed that patients with NAFLD had better DFS (HR = 0.81; 95% CI: 0.70–0.94; P = 0.006) and OS (HR = 0.78; 95% CI: 0.67–0.90; P = 0.001) than the control group. Subgroups analyses also indicated that the OS favored NAFLD patients versus patients with viral hepatitis B or C (HR = 0.80; 95% CI: 0.67–0.96; P = 0.017) or alcoholic and cryptogenic cirrhosis (HR = 0.68; 95% CI: 0.47–1.0; P = 0.05).

Conclusion:

After hepatic resections for HCC, NAFLD patients have better DFS and OS than patients with other risk factors. Subgroup analysis and meta-regression suggested that the survival advantage of NAFLD patients was more pronounced in studies published after 2015 and from Asian centers.
The Effects of Computer-Based Simulation Game and Virtual Reality Simulation in Nursing Students' Self-evaluated Clinical Reasoning Skills
Authors: Havola Sara , Haavisto Elina , Mäkinen Henna , Engblom Janne , Koivisto Jaana-Maija
Published: May 2021

Research has shown that nursing students can learn clinical reasoning skills by engaging in simulation games. However, there has been no research regarding the effects of simulation games on clinical reasoning skills when nursing students also engage in virtual reality simulations. Furthermore, by engaging in simulation games, neither game metrics nor their impact on students' self-evaluated clinical reasoning skills has been studied. The purpose of this study was to evaluate the effects of these two kinds of simulation games using a one-group pretest-posttest design. Forty nursing students self-evaluated their clinical reasoning skills in three phases using the Clinical Reasoning Skills scale. Furthermore, the game metrics of the simulation games were analyzed, and the results clearly showed that students' self-evaluated clinical reasoning skills were systematically improved. There was a systematic association between better playing scores and better self-evaluated clinical reasoning skills in playing both kinds of simulation games. Moreover, students engaged more time in the virtual reality simulation than the computer-based simulation game. Overall, the results suggest that the use of a combination of both kinds of simulation games is an effective way for nursing students to learn clinical reasoning skills.
Behavioral and Socioemotional Outcomes of the Legacy for Children™ Randomized Control Trial to Promote Healthy Development of Children Living in Poverty, 4 to 6 Years Postintervention
Authors: Barry Caroline M. , Robinson Lara R. , Kaminski Jennifer W. , Danielson Melissa L. , Jones Corey L. , Lang Delia L.
Published: May 2021

Objective:

The objective of this article was to assess the impact on behavioral and socioemotional development, 4 to 6 years postintervention (depending on the curriculum), of Legacy for Children™, a public health approach to improve child developmental outcomes among families living in poverty.

Methods:

Mothers who were recruited prenatally or at the time of childbirth participated in a set of Legacy parallel design randomized control trials between 2001 and 2009 in Miami, Florida, or Los Angeles, California. Of the initial 574 mother-child dyads, 364 completed at least 1 behavioral or socioemotional outcome measure at the third-grade follow-up. Intention-to-treat analyses compared Legacy and comparison groups on behavioral and socioemotional outcomes.

Results:

Children of Legacy mothers in Los Angeles were at lower risk for externalizing behaviors and poor adaptive skills than children whose mothers did not participate in the intervention. No significant outcome differences by group assignment were found in Miami.

Conclusion:

Group-based positive parenting interventions such as Legacy may have a sustained impact on children's behavioral and socioemotional development several years after intervention completion.
A Validated Grading Scale for Downturned Oral Commisure in Asian Faces
Authors: Lee Jong Hun , Kim Dong Gyu , Park Eun Soo
Published: May 2021

BACKGROUND

Downturned oral commissures develop gradually with aging. Tools have been developed to evaluate the marionette line or the lower face. However, there is no validated and reproducible tool to evaluate the progress after oral commissure treatment in clinical practice.

OBJECTIVE

The authors aimed to develop a scoring system to evaluate therapeutic interventions for downturned oral commissures and to verify its reliability, reproducibility, and clinical significance.

METHODS AND MATERIALS

In the Scale Development Group, the Delphi method was used to establish a 5-graded scoring system to evaluate oral commissure position. The scoring system was applied to 50 participants. The authors recorded and compared the intrarater agreement, interrater agreement, and significance of the grade-dependent scale.

RESULTS

Delphi analysis of the scoring system verified the grade description adequacy. Intrarater agreement showed almost perfect agreement, and the intraclass correlation coefficient of the interrater agreement had a significantly higher agreement rate. The differences between the clinical grades were significant.

CONCLUSION

The Hugel Downturned Oral Commissure Scale is precise, reproducible, and reflective of the clinical differences for downturned oral commissure. Its novelty lies in the use of specific angles and ratio. This scale has clinical trial potential owing to its standardized and quantitative assessment.
Skin Preparation for Photodynamic Therapy, Chemexfoliation, and Ablative Laser Resurfacing: a Systematic Literature Review
Authors: Cox Surget V. , Zachary Christopher B. , Cohen Joel L.
Published: May 2021

BACKGROUND

Photodynamic therapy, chemexfoliation, and ablative laser resurfacing are common practices for dermatologists, yet no formal protocols exist regarding preprocedural skin preparation.

OBJECTIVE

To review and summarize the skin preparation protocols for photodynamic therapy, chemexfoliation, and ablative laser resurfacing available in the literature.

METHODS

Data Sources A systematic review of English and non-English articles using the PubMed database was performed. A manual search of bibliographies from relevant articles was also performed to collect additional studies. Study Selection Only articles in the English language with full texts available that pertained to skin preparation for photodynamic therapy, chemexfoliation, and ablative laser resurfacing were included. Data Extraction Article selection was performed by one author, and relevant sources were verified by other authors using predefined inclusion and exclusion criteria.

RESULTS

There is a paucity of scientific research regarding efficacy and safety of dermatologic preprocedural skin preparation agents. Only 2 studies have compared various cleansing agents for these measures. Yet, strong statements regarding the importance of degreasing are published without supportive data.

CONCLUSION

Consensus guidelines for preprocedural protocols are lacking for photodynamic therapy, chemexfoliation, and ablative laser resurfacing. Further studies are warranted to explore the efficacy and safety of various preprocedural cleansing agents.
Extensive Cellulitis and Bacteremia Due to Streptococcus Pseudoporcinus in a Child With Klippel-Trenaunay Syndrome
Authors: Vergadi Eleni , Goniotakis Ioannis , Maraki Sofia , Galanakis Emmanouil
Published: May 2021

Streptococcus pseudoporcinus is a newly recognized β-hemolytic streptococcus, that is considered a rare pathogen in adults. Infections in children have not been reported. We describe a child with Klippel-Trenaunay syndrome that developed of S. pseudoporcinus cellulitis and bacteremia, which was difficult-to-treat, relapsed and required prolonged antibiotic courses. S. pseudoporcinus can cause invasive infection in children, especially in the presence of predisposing conditions.
Efficacy of Checkpoint Inhibitors in Neuroendocrine Neoplasms
Authors: Gile Jennifer J. , Liu Alex J. , McGarrah Patrick W. , Eiring Rachel A. , Hobday Timothy J. , Starr Jason S. , Sonbol Mohamad B. , Halfdanarson Thorvardur R.
Published: May 2021

Objectives

Checkpoint inhibitors (CPIs) for low- and intermediate-grade neuroendocrine tumors (NETs) have been associated with limited efficacy; recent studies suggest CPIs may represent promising treatment for high-grade neuroendocrine neoplasms (NENs).

Methods

We examined 57 patients with NENs who were treated with CPIs to determine if NETs and neuroendocrine carcinomas (NECs) respond to immunotherapy.

Results

Patients with poorly differentiated NECs on CPI monotherapy had an objective response rate (ORR) of 0% and median progression-free survival (PFS) of 2.1 months (95% confidence interval [CI], 0.5–4.6). Patients with poorly differentiated NECs on dual CPI therapy had an ORR of 13% and PFS of 3.5 months (95% CI, 1.4–not reached [NR]). Patients with poorly differentiated NECs on CPI and cytotoxic therapy had an ORR of 36% with PFS of 4.2 months (95% CI, 1.6–NR). Well-differentiated grade 1 and 2 NETs on CPI monotherapy had an ORR of 25% with PFS NR. Well-differentiated grade 3 NETs had 0% ORR with a PFS of 2.9 months (95% CI, 1.4–4.2) on CPI monotherapy.

Conclusions

Checkpoint inhibitor therapy shows limited activity in patients with NENs. Future studies should identify biomarkers that can help identify patients who are likely responders to immunotherapy.
A Low Total Psoas Muscle Area Index Is a Strong Prognostic Factor in Metastatic Pancreatic Cancer
Authors: Williet Nicolas , Fovet Marion , Maoui Khawla , Chevalier Clément , Maoui Meriem , Le Roy Bertrand , Roblin Xavier , Hag Bachir , Phelip Jean-Marc
Published: May 2021

Objectives

The total psoas area index (TPI) is an emerging alternative to the total skeletal muscle area index as a prognostic factor but has never been evaluated in metastatic pancreatic cancer (mPC).

Methods

Areas were manually recorded, as previously described. Sex-specific cutoffs were identified by optimum stratification of TPI using log-rank χ2 statistic associated with mortality to define sarcopenic psoas. Progression-free survival (PFS) and overall survival (OS) were the primary objectives. Two period groups were used as internal validation.

Results

During the period study, 79 patients were treated for mPC. The TPI was correlated with PFS (hazards ratio, 0.81; P = 0.02) and OS (hazards ratio, 0.7; P < 0.001). Optimum thresholds defining sarcopenic psoas were less than 5.73 cm2/m2 in men and less than 4.37 cm2/m2 in women. Patients with sarcopenic psoas (62.0%) had shorter median PFS (2.9 months) compared with the others (6.6 months, adjusted P log-rank = 0.01), independently to the intensity of chemotherapy, weight loss, and performance status greater than 1. Similarly, OS was independently shorter in patients with sarcopenic psoas (7.6 months) versus the others (22.2 months, adjusted P < 0.001). These results were confirmed in the 2 period groups.

Conclusions

A low TPI is a stronger independent prognostic factor in mPC.
Comparison Between Lumen-Apposing Metal Stents and Plastic Stents in Endoscopic Ultrasound–Guided Drainage of Pancreatic Fluid Collection
Authors: Lyu Yunxiao , Li Ting , Wang Bin , Cheng Yunxiao , Chen Liang , Zhao Sicong
Published: May 2021

Objectives

This study aimed to explore efficacy and safety between LAMSs (lumen-apposing metal stents) and DPPSs (double-pigtail plastic stents) in endoscopic ultrasound–guided drainage for pancreatic fluid collections.

Methods

Electronic databases were searched to identify relevant studies published until July 20, 2020.

Results

Fifteen studies were identified in this study. Endoscopic ultrasound–guided drainage with LAMS has higher clinical success (90.01% vs 82.56%) (odds ratio [OR], 2.44; 95% confidence interval [CI], 1.79–3.33; P < 0.00001), less recurrence (OR, 0.44; 95% CI, 0.29–0.68; P = 0.0002), and fewer additional interventions (OR, 0.34; 95% CI, 0.211–0.55; P < 0.001). There was no significant difference between LAMS and DPPS in technical success (97.45% vs 97.38%) (OR, 0.92; 95% CI, 0.50–1.70; P = 0.80), adverse events (OR, 0.92; 95% CI, 0.41–2.09; P = 0.84), stent-related adverse events (OR, 0.78; 95% CI, 0.39–1.54; P = 0.47), and bleeding (OR, 1.47; 95% CI, 0.57–3.28; P = 0.42). Lumen-apposing metal stents have slightly more perforations (OR, 7.10; 95% CI, 1.22–41.30; P = 0.03) in studies of walled-off necrosis.

Conclusions

Lumen-apposing metal stents have the advantage of higher clinical success, less recurrence, and fewer additional interventions. However, LAMS may increase perforation for walled-off necrosis.
Long Noncoding RNA CERS6-AS1 Accelerates the Proliferation and Migration of Pancreatic Cancer Cells by Sequestering MicroRNA-15a-5p and MicroRNA-6838-5p and Modulating HMGA1
Authors: Shen Rongxi , Wang Xinbo , Wang Sizhen , Zhu Daojun , Li Min
Published: May 2021

Objectives

As one of the most aggressive human tumors, pancreatic cancer (PC) is accompanied by poor treatment and prognosis. Although emerging evidence has highlighted the importance of long noncoding RNAs in multiple cancers, the specific regulatory roles mostly remain obscure. Our aim was to disclose the role of CERS6 antisense RNA 1 (CERS6-AS1) in PC.

Methods

Quantitative real-time polymerase chain reaction analysis was used to examine the expression of CERS6-AS1 in PC cell lines. Western blot analysis was used to assess the protein levels of high-mobility group AT-hook 1 (HMGA1). Colony formation, 5-ethynyl-20-deoxyuridine, transwell, and wound healing assays were performed to detect the functions of CERS6-AS1 on PC development. In addition, RNA pull-down, RNA immunoprecipitation, and luciferase reporter assays were implemented to delve into the regulatory mechanism of CERS6-AS1 in PC.

Results

CERS6-AS1 was significantly upregulated in PC. CERS6-AS1 silence obviously inhibited cell proliferation and migration in PC. Furthermore, CERS6-AS1 sponged microRNA-15a-5p (miR-15a-5p) and microRNA-6838-5p (miR-6838-5p) to regulate HMGA1. Moreover, rescue assays verified that CERS6-AS1 was involved in cell proliferation and migration in PC via targeting miR-15a-5p/miR-6838-5p/HMGA1 axis.

Conclusions

CERS6-AS1 enhanced HMGA1 expression to contribute to the progression of PC by sequestering miR-15a-5p and miR-6838-5p.
Does the Initiation of Fluoxetine Postacute Stroke Result in Improved Functional Recovery?
Authors: Knox Molly G. , Demaerschalk Bart M. , Alcott Sally B. , Marks Lisa A. , Wingerchuk Dean M. , O’Carroll Cumara B.
Published: May 2021

Background:

Stroke is a leading cause of disability worldwide. Selective serotonin reuptake inhibitors are often prescribed following stroke due to high rates of depression. Interest in selective serotonin reuptake inhibitor use for poststroke motor and functional recovery was generated after the publication of the Fluoxetine for motor recovery after acute ischemic stroke (FLAME) trial in 2011, which showed improved motor recovery in ischemic stroke patients with moderate to severe motor deficits. The objective of this study was to critically assess current evidence regarding the use of fluoxetine compared with placebo for poststroke functional recovery.

Methods:

The objective was addressed through the development of a structured critically appraised topic. This included a clinical scenario and question, literature search, critical appraisal, results, evidence summary, commentary, and clinical bottom line conclusions. Participants included consultant and resident neurologists, medical librarian, clinical epidemiologists, and content experts in the field of cerebrovascular neurology and physical medicine and rehabilitation.

Results:

A randomized, placebo-controlled clinical trial was selected for critical appraisal. This trial compared the functional outcomes of subjects poststroke receiving fluoxetine versus placebo. There was no significant difference in functional outcome measured by the Modified Rankin Scale between the 2 groups. Prespecified secondary analysis showed significantly decreased rates of depression in the fluoxetine group, but significantly increased rates of bone fracture.

Conclusion:

Among patients with stroke, early initiation of fluoxetine did not result in improved functional recovery. Lower rates of depression were observed in the fluoxetine-treated group; however these patients experienced higher rates of bone fracture.
Hyperammonemia in Patients With Status Epilepticus Treated With or Without Valproic Acid
Authors: Smith Kelsey M. , Britton Jeffrey W. , Hocker Sara E. , Toledano Michel
Published: May 2021

Background:

Hyperammonemia is a common side effect of valproic acid (VPA) and can occur after generalized seizures, but the clinical significance is unclear. The aim of this study was to better understand the clinical practice and utility of ammonia testing in status epilepticus (SE) treated with or without VPA.

Methods:

Charts of adult patients with SE from St. Mary’s Hospital Intensive Care Units (ICUs) (Mayo Clinic, Rochester, MN) from 2011 to 2016 were reviewed. Clinical factors were compared between patients who had ammonia checked versus those who did not, and those with normal ammonia versus hyperammonemia (>50 µg/dL). Charts were reviewed to determine if hyperammonemia changed clinical management and if it was felt to be symptomatic.

Results:

There were 304 patients identified: 94 received VPA, 142 had ammonia checked and receiving VPA was associated with ammonia testing (P<0.001). Hyperammonemia was identified in 32 and associated with younger age, being in a non-neurological intensive care unit, and liver disease, but was not statistically associated with VPA. Only one patient had valproate-induced hyperammonemic encephalopathy; however, many patients received treatment for hyperammonemia such as lactulose, levocarnitine, or VPA dose reductions.

Conclusions:

This study demonstrated variability in ammonia testing and management changes in SE but does not support the routine monitoring of ammonia levels and showed that hyperammonemic encephalopathy was rare in this clinical setting.