bluuebunny/crossref_metadata_2025 huggingface dataset:
Anatomic Repair and Reconstruction of Radial Sagittal Band Ruptures
Authors: Kruger Neil , Bain Gregory I.
Published: October 2020

Two cases of traumatic sagittal band rupture causing extensor tendon subluxation are reported. A case of subacute rupture is repaired and a new surgical technique for reconstruction of a chronic rupture is described. Extensor tendon subluxation at the metacarpophalangeal joint is a rare occurrence in patients not affected by rheumatoid arthritis. The majority of cases involve the disruption of the radial sagittal band with consequent ulnar subluxation of the extensor tendon. The technique of sagittal band reconstruction described involves harvesting a distally based ulnar-sided strip of the extensor digitorum communis tendon, passing it transversely through the radial component of the tendon, and then looping it deep to the deep transverse metacarpal ligament. From here the tendon is then sutured back onto the central tendon, creating a delta-shaped graft. This technique reconstructs the normal anatomy of the sagittal band and has been found to eliminate the subluxation of the tendon and its associated pain.
Corrective Osteotomy of Distal Radius Malunion Using a Rectangular-shaped Iliac Bone Graft and Volar Plating
Authors: Pecache Monica B. , Calleja Henry M.
Published: October 2020

Distal radius fractures are one of the most common injuries seen by orthopedists at the emergency room and clinics. Severity and configuration may vary, and therapeutic options are broad, but regardless of the course of treatment, all cases can potentially lead to malunion. When malunion requires surgical correction, the surgery can be technically demanding. Here, we demonstrate an alternative technique to perform corrective osteotomies for extra-articular or minimally displaced articular distal radius malunion. We provide simplification of the procedure by eliminating one of the planes taken into consideration when performing an osteotomy. This technique includes the use of a tricortical iliac bone graft, which we feel, provides dependable structural support, preventing collapse. The technique allows the surgeon an easy means to access the osteotomy gap and apply the graft. Finally, we supplement this surgical technique by providing our outcomes. Our data suggest that the technique effectively restores radiographic wrist parameters and provides good union rates.
Dexmedetomidine versus midazolam for sedation during endobronchial ultrasound-guided transbronchial needle aspiration
Authors: Kim Junghyun , Choi Sun Mi , Park Young Sik , Lee Chang-Hoon , Lee Sang-Min , Yoo Chul-Gyu , Kim Young Whan , Lee Jinwoo
Published: October 2020

BACKGROUND

Desaturation is a common complication of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Dexmedetomidine (DEX), a commonly used sedative in intensive care, is associated with less respiratory depression compared with other sedatives.

OBJECTIVE

We compared DEX with midazolam (MDZ) when used as a sedative during EBUS-TBNA.

DESIGN

A randomised, parallel, double-blinded trial.

SETTING

A university-affiliated teaching hospital between June 2014 and July 2015

PATIENTS

A total of 102 patients who underwent EBUS-TBNA were randomly allocated to two groups (48 DEX group, 54 MDZ group).

INTERVENTIONS

DEX group received 0.25 to 0.75 μg kg−1 h−1 (start with 0.5 μg kg−1 h−1, modulated in three steps from 0.25 to 0.75 μg kg−1 h−1) of DEX after a loading dose of 0.25 μg kg−1 h−1 for 10 min to maintain a Ramsay Sedation Scale (RSS) of 3 to 5. If the patient was agitated, 1 mg of MDZ bolus was used as a rescue drug. Patients in the MDZ group initially received 0.05 mg kg−1 of MDZ as a bolus. For maintenance and rescue, 1 mg of MDZ bolus was used.

MAIN OUTCOME MEASURES

The primary outcome was the presence of oxygen desaturation. Secondary outcomes were level of sedation (Ramsay Sedation Scale score), cough score, sedation and procedure satisfaction score.

RESULTS

The baseline characteristics of the patients, duration of EBUS-TBNA procedures and the use of rescue MDZ were not different between the groups. There was no significant difference in desaturation events between the DEX and MDZ groups (56.3 and 68.5%, respectively; P = 0.20). The level of sedation and the sedation satisfaction scores were similar between the two groups. However, cough score was significantly lower in the DEX group (41.9 vs. 53.4; P = 0.02).

CONCLUSION

The use of DEX during EBUS-TBNA was not superior to MDZ in terms of oxygen desaturation.

TRIAL REGISTRATION

Clinicaltrials.gov identifier: NCT02157818.
Cervical Length at 28–32 Weeks of Gestation Predicts Preterm Birth
Authors: Zhang Mengying , Zhang Xiaoxiao , Yang Huixia , Shi Chunyan
Published: October 2020

Objective:

To evaluate the ability of cervical length (CL) at 28–32 weeks of gestation to predict spontaneous preterm delivery and preterm premature rupture of membranes (PPROM).

Methods:

It was a retrospective cohort study that vaginal ultrasonography at approximately 28–32 weeks of gestation was performed in 14,953 women between 17–49 years old with singleton pregnancies who delivered after 28 weeks of gestation at the Peking University First Hospital from June 2008 to December 2012. The pregnancy outcomes were followed and the relationship between the CL and preterm delivery or PPROM was assessed. The relative risk was calculated to assess group differences in the likelihood of an event occurring.

Results:

The overall prevalence of preterm delivery was 5.7% (858/14,953); the incidence for therapeutic preterm delivery was 2.1% (318/14,953), for spontaneous preterm delivery was 0.9% (133/14,953), and for PPROM was 2.7% (407/14,953). Excluding the 318 women who had therapeutic preterm delivery, the relative risk of preterm delivery for women with a CL between 25 mm and <30 mm, between 15 mm and <25 mm, and <15 mm was 3.7, 9.3, and 30.2, respectively. The sensitivity, specificity, and positive and negative predictive values of CL ≤25 mm at 28–32 weeks of gestation as the cut-off value for predicting preterm delivery were 19.8%, 97.5%, 23.4%, and 96.9%, respectively. For preterm delivery before 35 weeks of gestation, the sensitivity, specificity, and positive and negative predictive values of a CL ≤ 25 mm at 28–32 weeks of gestation as the cut-off value were 30.0%, 97.2%, 11.8%, and 99.1%, respectively. In addition, women with PPROM (n = 407) had significantly shorter CL (31.9 ± 7.4) mm at 28–32 weeks of gestation compared that of women without PPROM (34.0 ± 8.3) mm. The incidence of PPROM in women with a CL≤25 mm at 28–32 weeks of gestation (19.4%, 79/407) was significantly lower than that for women with a CL >25 mm (80.6%, 328/407, P < 0.05).

Conclusion:

CL at 28–32 weeks of gestation can predict spontaneous preterm delivery, and is valuable for predicting PPROM.
The Effect of Hospital Safety-Net Burden and Patient Ethnicity on In-Hospital Mortality Among Hospitalized Patients With Cirrhosis
Authors: Wong Robert J. , Hirode Grishma
Published: October 2020

Background:

Over 2.1 million individuals in the United Stats have cirrhosis, including 513,000 with decompensated cirrhosis. Hospitals with high safety-net burden disproportionately serve ethnic minorities and have reported worse outcomes in surgical literature. No studies to date have evaluated whether hospital safety-net burden negatively affects hospitalization outcomes in cirrhosis. We aim to evaluate the impact of hospitals’ safety-net burden and patients’ ethnicity on in-hospital mortality among cirrhosis patients.

Methods:

Using National Inpatient Sample data from 2012 to 2016, the largest United States all-payer inpatient health care claims database of hospital discharges, cirrhosis-related hospitalizations were stratified into tertiles of safety-net burden: high (HBH), medium (MBH), and low (LBH) burden hospitals. Safety-net burden was calculated as percentage of hospitalizations per hospital with Medicaid or uninsured payer status. Multivariable logistic regression evaluated factors associated with in-hospital mortality.

Results:

Among 322,944 cirrhosis-related hospitalizations (63.7% white, 9.9% black, 15.6% Hispanic), higher odds of hospitalization in HBHs versus MBH/LBHs was observed in blacks (OR, 1.26; 95%CI, 1.17-1.35; P<0.001) and Hispanics (OR, 1.63; 95% CI, 1.50-1.78; P<0.001) versus whites. Cirrhosis-related hospitalizations in MBHs or HBHs were associated with greater odds of in-hospital mortality versus LBHs (HBH vs. LBH: OR, 1.05; 95% CI, 1.00-1.10; P=0.044). Greater odds of in-hospital mortality was observed in blacks (OR, 1.27; 95% CI, 1.21-1.34; P<0.001) versus whites.

Conclusion:

Cirrhosis patients hospitalized in HBH experienced 5% higher mortality than those in LBH, resulting in significantly greater deaths in cirrhosis patients. Even after adjusting for safety-net burden, blacks with cirrhosis had 27% higher in-hospital mortality compared with whites.
Rescue Therapies for Helicobacter pylori Infection in Foreign Patients Treated in Italy
Authors: Saracino Ilaria M. , Pavoni Matteo , Zullo Angelo , Fiorini Giulia , Saccomanno Laura , Lazzarotto Tiziana , Antonelli Guido , Cavallo Rossana , Borghi Claudio , Vaira Dino
Published: October 2020

Background and Aims:

Helicobacter pylori prevalence remains high worldwide, especially in developing areas where infection acquisition occurs in early childhood. H. pylori eradication fails in a definite number of patients, despite one or more therapeutic attempts. Curing these patients is progressively more difficult, due to development of antibiotic resistance. While the cure rate of first-line therapies in foreigners was found to be different from that of Italians, no data are available on rescue therapies.

Materials and Methods:

Consecutive foreigner patients with H. pylori infection following at least one therapy failure were enrolled. All patients underwent upper endoscopy with gastric biopsies used for both histologic examination and culture/susceptibility test. Rescue therapies administered accordingly to susceptibility testing were rifabutin-based therapy, levofloxacin-based therapy, sequential. Pylera was prescribed regardless the resistance pattern.

Results:

A total of 103 (M/F: 27/76, mean age: 41.9 y, range: 18 to 85) were enrolled. The overall resistance rates toward clarithromycin, metronidazole, and levofloxacin were 76.7%, 66%, and 42.7%, respectively, with triple resistance present in 33.9% of bacterial isolates. Eradication rates were 71.4% on 40 patients for rifabutin-based therapy, 82.8% on 42 cases for levofloxacin-based therapy, 75% on 11 patients treated with sequential therapy, and 100% on 10 cases who received Pylera regimen.

Conclusions:

To our knowledge, this is the first study assessing H. pylori eradication rates in foreigner patients, who failed at least one therapeutic attempt, managed in Italy. Even by using a culture-based approach, the infection was not cured in a definite number of patients.
Characteristics of different histological subtypes of thyroid nodules classified with 99mTc-methoxy-isobutyl-isonitrile imaging and Thyroid Imaging Reporting And Data System
Authors: Schenke Simone Agnes , Klett Rigobert , Wagner Peer-Roman , Mott Sebastian , Zimny Michael , Feek Ulrich , Kreissl Michael Christoph
Published: October 2020

Introduction

Thyroid Imaging Reporting And Data System (TIRADS) is helpful for risk stratification of thyroid nodules. However, there is a lack of data for TIRADS classification of different histological subtypes [classical papillary thyroid cancer (PTC), follicular variant of papillary thyroid cancer (FVPTC), and follicular thyroid cancer (FTC)], and benign thyroid nodules (follicular adenoma, oncocytic adenoma, and multinodular goiter (MNG)]. Methoxy-isobutyl-isonitrile (MIBI) imaging has a high negative predictive value for the exclusion of thyroid malignancy in hypofunctioning thyroid nodules. The aim of this analysis was to compare malignant and benign subtypes of thyroid nodule using three TIRADS and MIBI imaging.

Methods

Retrospective analysis of MIBI imaging studies. Hypofunctioning thyroid nodules were classified with Kwak-TIRADS, EU-TIRADS, and K-TIRADS. MIBI imaging was visually categorized.

Results

We included 242 thyroid nodules (32 malignant, 19 PTC, 7 FVPTC, and 6 FTC). When using Kwak-TIRADS 4C and 5 as a marker for high-risk nodules, we found 85.5% of the follicular adenoma, 80.8% of the MNG, 100% of the oncocytic adenoma, 100% of the FTC, 57.1% of the FVPTC, and 42.2% of the PTC to be below this cutoff. All PTC and FVPTC were MIBI-positive, 83% of the FTC, 78% of the follicular adenoma, 75% of the oncocytic adenoma, and 60% of the MNG were MIBI-positive.

Conclusion

TIRADS is useful to detect PTC, but FVPTC and FTC may be missed. MIBI imaging seems to be more suitable to detect FVPTC and FTC. However, neither TIRADS nor MIBI imaging are able to differentiate between follicular adenoma and FTC or FVPTC.
B-acute Lymphoblastic Leukemia With Hypereosinophilia Associated With Severe Cardiac Complications: A Clinical Case
Authors: Lahfafa Anissa , de Ville de Goyet Maëlle , Boulanger Cécile , Defour Jean-Philippe , Detaille Thierry , Van Damme An , Brichard Bénédicte
Published: October 2020

Hypereosinophilia (HE) is rare but often secondary to a nonhematologic disease such as allergic disorders and parasitic infections. HE can also be associated with hematologic malignancies and be the result of a clonal proliferation or reactive to another hematologic condition. Association of HE with acute lymphoblastic leukemia (ALL) is rare in children. We reported a case of a teenager presented with HE secondary to B-ALL who experienced severe cardiac complications with severe absolute eosinophil count. We compared his clinical evolution with other published cases and we reported 2 mutations linked to B-ALL never described before in this context.
Common Variable Immunodeficiency, Autoimmune Hemolytic Anemia, and Pancytopenia Associated With a Defect in IKAROS
Authors: Yilmaz Ebru , Kuehn Hye S. , Odakir Eda , Niemela Julie E. , Ozcan Alper , Eken Ahmet , Rohlfs Meino , Cansever Murat , Gok Veysel , Aydin Firdevs , Karakukcu Musa , Hauck Fabian , Klein Christoph , Unal Ekrem , Rosenzweig Sergio D. , Patiroglu Turkan
Published: October 2020

Objective:

Mutations in IKZF1, which encodes Ikaros family zinc finger 1 (IKAROS) transcription factor, are associated with recurrent infections, cytopenia, autoimmune diseases, and hematologic malignancies. Diverse clinical phenotypes resulting from IKZF1 mutations include pulmonary fungal infections, cytopenia, autoimmune hemolytic anemia (AIHA), and malignancies. In this study, we aimed to assess the DNA-binding ability and pericentromeric (PC) localization of a variant of IKZF discovered in a patient.

Materials and Methods:

DNA-binding ability of a pathogenic IKZF variant was tested using electrophoretic mobility shift assay and PC localization of the variant was assessed by immunofluorescent microscopy in NIH3T3 cells.

Results:

Clinical features of a 3-month-old male infant who underwent hematopoietic stem cell transplantation because of an IKZF1 mutation-associated common variable immunodeficiency, AIHA, and pancytopenia are described. DNA studies revealed a heterozygous missense variant (IKZF1 NM_006060 c.427C>T; p.R143W). Cotransfection studies revealed that mutant R143W has a partial dominant-negative effect over PC targeting and DNA binding.

Conclusions:

IKZF1 mutation must be kept in mind if neonatal AIHA, common variable immunodeficiency, and pancytopenia are observed.
Clinical Outcomes of Children With Adrenocortical Carcinoma in the Context of Germline TP53 Status
Authors: Brenna Connor T.A. , Michaeli Orli , Wasserman Jonathan D. , Malkin David
Published: October 2020

Adrenocortical carcinoma (ACC) is a rare, aggressive malignancy of the adrenal cortex. This study characterizes a single-institution cohort of children treated for ACC, and explores the relationship between clinical outcomes of ACC and germline TP53 mutation status. We performed a retrospective chart review of 23 consecutive pediatric patients with ACC treated at The Hospital for Sick Children, Toronto, Canada, between 1977 and 2017. Clinical, biochemical, radiologic, pathologic, and genetic data were collected for each patient. ACC diagnosis followed a bimodal age distribution of 0 to 6 (n=17) and 12+ (n=6) years, with a female:male ratio of 3.6:1. Ten of 20 patients tested for germline TP53 status carried a pathogenic (9) or likely pathogenic (1) variant, including all but 1 male patient. Only 3 patients died of ACC-related causes, each 5 months post-diagnosis. When treated with resection and combination chemotherapy, carriers of germline TP53 mutations may respond more favorably than their wild-type counterparts. In addition, the survival of patients reported in our cohort with high-stage ACC was appreciably greater than previously described (100.0% for stage II, 50.0% for stage III, and 42.9% for stage IV), favoring aggressive intervention in these patient populations.
Pre-exposure Prophylaxis Use and Detected Sexually Transmitted Infections Among Men Who Have Sex With Men in the United States—National HIV Behavioral Surveillance, 5 US Cities, 2017
Authors: Chapin-Bardales Johanna , Johnson Jones Michelle L. , Kirkcaldy Robert D. , Bernstein Kyle T. , Paz-Bailey Gabriela , Phillips Christi , Papp John R. , Raymond Henry F. , Opoku Jenevieve , Braunstein Sarah L. , Spencer Emma C. , Khuwaja Salma , Wejnert Cyprian ,   for the NHBS STI Study Group
Published: October 2020

Background:

Men who have sex with men (MSM) using HIV pre-exposure prophylaxis (PrEP) may be at high risk for bacterial sexually transmitted infections (STIs). We examined the prevalence of extragenital gonorrhea and chlamydia by PrEP status among a multisite sample of US MSM.

Methods:

MSM aged ≥18 years were recruited through venue-based sampling to participate in the 2017 National HIV Behavioral Surveillance. In 5 cities (San Francisco, Washington DC, New York City, Miami, and Houston), participants completed a questionnaire, HIV testing, and pharyngeal and rectal STI specimen self-collection. We measured prevalence of pharyngeal and rectal gonorrhea and chlamydia among self-reported non–HIV-positive MSM who reported using or not using PrEP in the previous 12 months.

Results:

Overall, 29.6% (481/1627) of non–HIV-positive MSM reported PrEP use in the past year. MSM who reported PrEP use were more likely to have any STI (ie, extragenital gonorrhea and/or chlamydia) than MSM not on PrEP [14.6% vs. 12.0%, adjusted prevalence ratio (aPR) = 1.5, 95% confidence interval (CI) : 1.1 to 2.0], reflecting differences in rectal chlamydia prevalence (8.7% vs. 6.0%, aPR = 1.6, 95% CI: 1.1 to 2.4). PrEP use was not associated with pharyngeal chlamydia, pharyngeal gonorrhea, or rectal gonorrhea.

Conclusions:

The prevalence of extragenital STI was high for both MSM on PrEP and those not on PrEP in the past year. MSM on PrEP were more likely to have rectal chlamydia but not pharyngeal STIs or rectal gonorrhea. Our findings support regular STI testing at exposed anatomic sites as recommended for sexually active MSM, including those on PrEP.
Does Fixation of Gastric Sleeve Prevent Functional Stenosis in Sleeve Gastrectomy Patients?
Authors: Şen Ozan , Sekmen Ümit , Türkçapar Ahmet G. , Yerdel Mehmet A.
Published: October 2020

Aim:

The aim of this study is to determine whether gastric sleeve fixation prevents functional stenosis (twist or kink) and to investigate its effects on symptoms such as nausea and vomiting after laparoscopic sleeve gastrectomy (LSG).

Methods:

A total of 717 patients who underwent primary LSG for morbid obesity and completed at least 1 year of follow-up between 2012 and 2019 were included in the study. All operations were performed by the same surgical team using the same technique. The patients were divided into 2 groups, that is, group 1: standard LSG and group 2: gastric sleeve fixation with LSG. These 2 groups were compared in terms of demographic characteristics, baseline body mass index, follow-up duration, bleeding, leaks, gastric stenosis, postoperative nausea, vomiting, and the need for antiemetics. In the follow-up period, patients with suspected gastric stenosis underwent endoscopy and upper gastrointestinal series.

Results:

LSG was performed in 717 patients (55.2% female) with a mean age of 37.8±11.5 years and a median body mass index of 42.2 (30.2 to 74.2) kg/m2. The 241 patients in the first group underwent LSG without fixation, and the 476 patients in the second group with fixation. Functional stenosis was detected in 8 patients, all of whom were in group 1. One patient in group 1 had a leak on the background of functional stenosis. There was bleeding that required transfusion in 2 patients (group 1) and reoperation in 2 patients (group 2). None of the study patients died. During the in-hospital period, 122 (50.6%) patients in group 1 and 159 (33.4%) patients in group 2 had nausea and vomiting that required antiemetic treatment (P<0.001).

Conclusion:

Gastric sleeve fixation in LSG prevents complications that may arise because of improper gastric mobilization. This method is effective in reducing nausea and vomiting in LSG patients.
Evaluating Children in U.S. Public Schools With Speech Sound Disorders
Authors: Ireland Marie , McLeod Sharynne , Farquharson Kelly , Crowe Kathryn
Published: October 2020

More than half of U.S. speech–language pathologists (SLPs) currently practice in the school setting and 92.6% of SLPs who work in schools provide services focused on children's speech sound production (articulation and/or phonology). This article describes evaluation and eligibility requirements for children with speech sound disorders in the United States focusing on four sources of information: (1) federal requirements, specifically the Individuals with Disabilities Education Act (IDEA), (2) state and local requirements and guidance, (3) other sources of guidance (e.g., from professional associations), and (4) research. To be eligible to receive services under the IDEA, three conditions must be met: (1) the student has an impairment, (2) that impairment results in an educational impact, and (3) the student requires specially designed instruction to make progress. Civil rights and diversity (cultural, linguistic, and gender) within these contexts also are considered. Case examples are provided to highlight eligibility criteria and to guide SLP practice. The information and examples provided in this article will enable SLPs in the United States to navigate IDEA evaluation and eligibility requirements to ensure children with speech sound disorders who are eligible under the IDEA receive appropriate services.
Arenibacterium halophilum gen. nov., sp. nov., a halotolerant bacterium in the family Rhodobacteraceae isolated from a coastal sand dune
Authors: Baek Jihye , Kim Jong-Hwa , Yoon Jung-Hoon , Lee Jung-Sook , Sukhoom Ampaitip , Kim Wonyong
Published: October 2020

A Gram-stain-negative, non-pigmented, non-spore-forming, motile, strictly aerobic bacterial strain, designated CAU 1492T, was isolated from a coastal sand dune and its taxonomic position was examined using a polyphasic approach. Cells of strain CAU 1492T grew optimally at 30 °C, pH 7.0 and in 3 % (w/v) NaCl. Phylogenetic analysis based on the 16S rRNA gene sequence of CAU 1492T showed that it formed a distinct lineage within the family

Rhodobacteraceae

as a separate deep branch, with 96.8 % or lower sequence similarity values to representatives of the genera

Marivita

,

Donghicola

,

Sulfitobacter

,

Marinovum

,

Phaeobacter

,

Primorskyibacter

,

Roseovarius

and

Aestuariihabitans

. Strain CAU 1492T was closely related to

Marivita geojedonensis

DPG-138T (96.8 %),

Donghicola eburneus

SW-277T (96.7 %),

Sulfitobacter porphyrae

SCM-1T (96.7 %),

Marinovum algicola

FF3T (96.6 %) and

Aestuariihabitans beolgyonensis

BB-MW15T (96.4 %) based on 16S rRNA gene sequences. The major cellular fatty acids of strain CAU 1492T were cyclo-C19 : 0
 ω8c and summed feature 8 (C18 : 1
 ω7c/C18 : 1
 ω6c). The polar lipid pattern was composed of phosphatidylglycerol, phosphatidylethanolamine, an unidentified phospholipid and an unidentified aminolipid. The strain contained Q-10 as the sole respiratory quinone. The draft genome of strain CAU 1492T was 4.63 Mb with a DNA G+C content of 63.1 mol%. The genome includes 4292 protein-coding genes and a five rRNA operons. On the basis of the phenotypic, chemotaxonomic and genomic data, strain CAU 1492T represents a novel genus in the family

Rhodobacteraceae

for which the name Arenibacterium halophilum gen. nov., sp. nov. is proposed. The type strain of Arenibacterium halophilum is CAU 1492T (=KCTC 62998T=NBRC 113696T).
Radiobacillus deserti gen. nov., sp. nov., a UV-resistant bacterium isolated from desert soil
Authors: Li Juan , Zhang Binglin , Liu Guangxiu , Liu Yang , Yang Hui , Yang Ruiqi , Huang Yixuan , Li Shiweng , Chen Tuo , Zhang Wei , Zhang Gaosen
Published: October 2020

A Gram-stain-positive, aerobic, rod-shaped, non-motile, endospore-forming and UV-resistant bacterial strain, designated strain TKL69T, was isolated from sandy soil sampled in the Taklimakan Desert. The strain grew at 20–50 °C, pH 6–9 and with 0–12 % (w/v) NaCl. The major fatty acids were anteiso-C15 : 0, iso-C15 : 0 and C16 : 0. The only respiratory quinone was MK-7. The cell-wall peptidoglycan was meso-diaminopimelic acid. Diphosphatidyl glycerol, two unidentified aminophospholipids and one unidentified phospholipid were identified as the major polar lipids. Genomic DNA analysis revealed a G+C content of 38.5 mol%. Phylogenetic analysis based on 16S rRNA gene sequences showed that strain TKL69T has the highest similarity to

Salinibacillus xinjiangensis

CGMCC 1.12331T (96.9 %) but belongs to an independent taxon separated from other genera of the family

Bacillaceae

. Phylogenetic, phenotypic and chemotaxonomic analyses suggested that strain TKL69T represents a novel species of a new genus, for which the name Radiobacillus gen. nov., sp. nov. is proposed, with the type strain being Radiobacillus deserti TKL69T (=JCM 33497T=CICC 24779T).
The Impact of the “Muslim Ban” Executive Order on Healthcare Utilization in Minneapolis-St. Paul, Minnesota
Authors: Samuels Elizabeth A. , Orr Lilla , White Elizabeth B. , Saadi Altaf , Padela Aasim I. , Westerhaus Michael , Bhatt Aarti D. , Agrawal Pooja , Wang Dennis , Gonsalves Gregg
Published: October 2020

Objective

Determine whether the 2017 “Muslim Ban” Executive Order impacted healthcare utilization by people born in Order-targeted nations living in the United States.

Methods

We conducted a retrospective cohort study of people living in Minneapolis-St. Paul, MN in 2016-2017 who were: 1) born in Order-targeted nations, 2) born in Muslim-majority nations not listed in the Order, and 3) born in the United States and non-Latinx. Primary outcomes were: 1) primary care visits, 2) missed primary care appointments, 3) primary care diagnoses for stress-responsive conditions, 4) emergency department visits, and 5) emergency department visits for stress-responsive diagnoses. We evaluated visit trends before and after Order issuance using linear regression and differences between study groups using a difference-in-difference analyses.

Results

In early 2016, primary care visits and stress-responsive diagnoses increased among individuals from Muslim majority nations. Following the Order, there was an immediate increase in emergency department visits among individuals from Order-targeted nations.

Conclusions

Increases in healthcare utilization among people born in Muslim majority countries before and after the “Muslim Ban” likely reflect elevated cumulative stress including the impact of the Order.
Re-analysis of genetic risks for Chronic Fatigue Syndrome from 23andMe data finds few remain
Authors: Bedford Felice L. , Tzovaras Bastian Greshake
Published: October 2020

It is tempting to mine the abundance of DNA data that is now available from direct-to-consumer genetic tests but this approach also has its pitfalls A recent study put forth a list of 50 single nucleotide polymorphisms (SNPs) that predispose to Chronic Fatigue Syndrome (CFS), a potentially major advance in understanding this still mysterious condition. However, only the patient cohort data came from a commercial company (23andMe) while the control was from a genetic database. The extent to which 23andMe data agree with genetic reference databases is unknown. We reanalyzed the 50 purported CFS SNPs by comparing to control data specifically from 23andMe which are available through public platform OpenSNP. In addition, large high-quality database ALFA was used as an additional control. The analysis lead to dramatic change with the top of the leaderboard for CFS risk reduced and reversed from an astronomical 129,000 times to 0.8. Errors were found both within 23andMe data and the original study-reported Kaviar database control. Only 3 of 50 SNPs survived initial study criterion of at least twice as prevalent in patients, EFCAB4B, involved in calcium ion channel activation, LINC01171, and MORN2 genes. We conclude that the reported top-50 deleterious polymorphisms for Chronic Fatigue Syndrome were more likely the top-50 errors in the 23andMe and Kaviar databases. In general, however, correlation of 23andMe control with ALFA was a respectable 0.93, suggesting an overall usefulness of 23andMe results for research purposes but only if caution is taken with chips and SNPs.
Aglycone polyether ionophores as broad-spectrum agents inhibit multiple enveloped viruses including SARS-CoV-2 in vitro and successfully cure JEV infected mice
Authors: Li Jia-Qi , Huang Minjian , Zhang Ya-Nan , Liu Ran , Zhang Zhe-Rui , Zhang Qiu-Yan , Wang Yong , Liu Jing , Deng Zixin , Zhang Bo , Ye Han-Qing , Liu Tiangang
Published: October 2020

Infections with zoonotic viruses, such as flaviviruses, influenza virus, and the SARS-CoV-2 pandemic coronavirus constitute an increasing global risk. Hence, an urgent need exists for the development of broad-spectrum antivirals to prevent such outbreaks. Here, we show that the maduramycin and CP-80,219 aglycone polyether ionophores exhibit effective broad-spectrum antiviral activity, against various viruses, including Japanese encephalitis virus (JEV), Dengue virus (DENV), Zika virus (ZIKV), and Chikungunya virus (CHIKV), while also exhibiting promising activity against PR8 influenza virus and SARS-CoV-2. Moreover, liposome-encapsulated maduramycin and CP-80,219 provide full protection for mice from infection with JEVin vivo. Mechanistic studies suggest that aglycone polyether ionophores primarily inhibit the viral replication step without blocking endosome acidification to promote the fusion between viral and cellular membranes. The successful application of liposomes containing aglycone polyether ionophores in JEV-infected mice offers hope to the development of broad-spectrum antiviral drugs like penicillin back to 1940s.
Atlas of genetic effects in human microglia transcriptome across brain regions, aging and disease pathologies
Authors: de Paiva Lopes Katia , Snijders Gijsje J. L. , Humphrey Jack , Allan Amanda , Sneeboer Marjolein , Navarro Elisa , Schilder Brian M. , Vialle Ricardo A. , Parks Madison , Missall Roy , van Zuiden Welmoed , Gigase Frederieke , Kübler Raphael , van Berlekom Amber Berdenis , Böttcher Chotima , Priller Josef , Kahn René S. , de Witte Lot D. , Raj Towfique
Published: October 2020

Microglial cells have emerged as potential key players in brain aging and pathology. To capture the heterogeneity of microglia across ages and regions, and to understand how genetic risk for neurological and psychiatric brain disorders is related to microglial function, large transcriptome studies are essential. Here, we describe the transcriptome analysis of 255 primary human microglia samples isolated at autopsy from multiple brain regions of 100 human subjects. We performed systematic analyses to investigate various aspects of microglial heterogeneities, including brain region, age and sex. We mapped expression and splicing quantitative trait loci and showed that many neurological disease susceptibility loci are mediated through gene expression or splicing in microglia. Fine-mapping of these loci nominated candidate causal variants that are within microglia-specific enhancers, including novel associations with microglia expression ofUSP6NLfor Alzheimer’s disease, andP2RY12for Parkinson’s disease. In summary, we have built the most comprehensive catalog to date of genetic effects on the microglia transcriptome and propose molecular mechanisms of action of candidate functional variants in several neurological and psychiatric diseases.
Neural substrates of verbal repetition deficits in primary progressive aphasia
Authors: Miller Hilary E. , Cordella Claire , Collins Jessica A. , Ezzo Rania , Quimby Megan , Hochberg Daisy , Tourville Jason A. , Dickerson Bradford C. , Guenther Frank H.
Published: October 2020

In this cross-sectional study, we examined the relationship between cortical thickness and performance on several verbal repetition tasks in a cohort of patients with primary progressive aphasia (PPA) in order to test predictions generated by theoretical accounts of phonological working memory (PWM) that predict phonological content buffers in left posterior inferior frontal sulcus (pIFS) and supramarginal gyrus (SMG). Cortical surfaces were reconstructed from magnetic resonance imaging scans from 42 participants diagnosed with PPA. Cortical thickness was measured in a set of anatomical regions spanning the entire cerebral cortex. Correlation analyses were performed between cortical thickness and average score across three PWM related tasks: the Repetition subtest from the Western Aphasia Battery, a forward digit span task, and a backward digit span task. Significant correlations were found between average PWM score across tasks and cortical thickness in left SMG and left pIFS, in support of prior theoretical accounts of PWM. Exploratory whole-brain correlation analyses performed for each of the three behavioral tasks individually revealed a distinct set of positively-correlated regions for each task. Comparison of cortical thickness measures from different PPA subtypes to cortical thickness in age-matched controls further revealed unique patterns of atrophy in the different PPA subtypes.
A Microglial Subset at the Tumor-Stroma Interface of Glioma
Authors: Caponegro Michael D. , Oh Ki , Madeira Miguel , Radin Daniel , Sterge Nicholas , Moffitt Richard A. , Tsirka Stella E.
Published: October 2020

Background

Myeloid involvement in High Grade Gliomas, such as Glioblastoma, has become apparent and detrimental to disease outcomes. There is great interest in characterizing the HGG tumor microenvironment to understand how neoplastic lesions are supported, and to devise novel therapeutic targets. The tumor microenvironment of the central nervous system is unique as it contains neural and specialized glial cells, including the resident myeloid cells, microglia. Glioma-associated microglia and peripherally infiltrating monocytes/macrophages (GAM) accumulate within the neoplastic lesion where they facilitate tumor growth and drive immunosuppression. A longstanding limitation has been the ability to accurately differentiate microglia and macrophage roles in pathology, and identify the consequences of the spatial organization of these cells.

Results

Here we characterize the tumor-stroma border and identify peripheral glioma-associated microglia (PGAM) at the tumor leading edge as a unique subpopulation of GAM. Using data mining and analyses of samples derived from both murine and human sources, we show that PGAM exhibit a pro-inflammatory and chemotactic phenotype that is associated with peripheral monocyte recruitment, poorly enhancing radiomic features, and decreased overall survival.

Conclusions

PGAM act as a unique subset of GAM, at the tumor-stroma interface, corresponding to disease outcomes. We propose the application of a novel gene signature to identify these cells, and suggest that PGAM constitute a cellular target of the TME.

Graphical abstract
Characterisation of the biosurfactants from phyllosphere colonisingPseudomonadsand their effect on plant colonisation and diesel degradation
Authors: Oso S , Fuchs F , Übermuth C , Zander L , Daunaraviciute S , Remus DM , Stötzel I , Wüst M , Schreiber L , Remus-Emsermann MNP
Published: October 2020

Biosurfactant production is a common trait in leaf surface colonising bacteria that has been associated with increased survival and movement on leaves. At the same time the ability to degrade aliphatics is common in biosurfactant-producing leaf colonisers. Pseudomonads are common leaf colonisers and have been recognised for their ability to produce biosurfactants and degrade aliphatic compounds. In this study, we have investigated the role of biosurfactants in four non-plant plant pathogenicPseudomonasstrains by performing a series of experiments to characterise the surfactant properties, and their role during leaf colonisation and diesel degradation. The produced biosurfactants were identified using mass-spectrometry. Two strains produced viscosin-like biosurfactants and the other two produced Massetolide A-like biosurfactants which aligned with the phylogenetic relatedness between the strains. To further investigate the role of surfactant production, random Tn5transposon mutagenesis was performed to generate knockout mutants. The knockout mutants were compared to their respective wildtypes in their ability to colonise gnotobioticArabidopsis thalianaand to degrade diesel. It was not possible to detect negative effects during plant colonisation in direct competition or individual colonisation experiments. When grown on diesel, knockout mutants grew significantly slower compared to their respective wildtypes. By adding isolated wildtype biosurfactants it was possible to complement the growth of the knockout mutants.

Importance

Many leaf colonising bacteria produce surfactants and are able to degrade aliphatic compounds, however, if surfactant production provides a competitive advantage during leaf colonisation is unclear. Furthermore, it is unclear if leaf colonisers take advantage of the aliphatic compounds that constitute the leaf cuticle and cuticular waxes. Here we test the effect of surfactant production on leaf colonisation and demonstrate that the lack of surfactant production decreases the ability to degrade aliphatic compounds. This indicates that leaf surface dwelling, surfactant producing bacteria contribute to degradation of environmental hydrocarbons and may be able to utilise leaf surface waxes. This has implications for plant-microbe interactions and future studies.
The autumn COVID-19 surge dates in Europe are linked to latitudes and not to temperature, nor to humidity, pointing vitamin D as a contributing factor
Authors: Walrand Stephan
Published: October 2020

Purpose

Determining the triggering factor of the sudden surge of the daily new COVID-19 cases arising in most European countries during 2020 Autumn.

Methods

The dates of the surge were determined using a fitting of the two last months reported daily new cases in 18 European countries of latitude ranging from 39° to 62°.

Results

The study proves no correlation between the country surge date and its 2 weeks preceding temperature or humidity, but shows an impressive linear correlation with its latitude. The country surge date corresponds to the time when its sun UV daily dose drops below ≈ 34% of that of 0° latitude. Introducing reported seasonal blood 25-hydroxyvitamin D (25(OH)D) concentration variation into reported link between acute respiratory track infection risk with 25(OH)D concentration quantitatively explains the surge dynamics.

Conclusions

Several studies already substantiated a 25(OH)D concentration impact on COVID-19 severity. However by comparing different patients populations, discriminate whether low 25(OH)D concentration is a real factor of covid-19 severity or only a marker of another weakness being the primary severity factor can be challenging. The date of the surge is an intrapopulation observation and has the benefit to be only triggered by a parameter globally affecting the population, i.e. the sun UV daily dose decreases. The results support that low 25(OH)D concentration is thus well a contributing factor of COVID-19 severity, which joined with the previous studies makes a convincing bundle of evidence
Direct access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: results of a randomized controlled trial
Authors: Gagnon Rose , Perreault Kadija , Berthelot Simon , Matifat Eveline , Desmeules François , Achou Bertrand , Laroche Marie-Christine , Van Neste Catherine , Tremblay Stéphane , Leblond Jean , Hébert Luc J.
Published: October 2020

Context

In several countries, physiotherapists (PT) have been integrated within emergency departments (EDs) to help manage patients with musculoskeletal disorders (MSKDs). Still, research on the effects of such initiatives is scarce.

Objectives

To evaluate the effects of direct access PT on MSKD patients consulting the ED in terms of clinical outcomes and use of health care resources.

Design, Setting, Participants

Randomized controlled trial, academic ED in Quebec City (Canada), participants 18-80 years presenting with a minor MSKD.

Intervention

Direct access PT at the ED

Control

Emergency Physicians lead management (EP).

Main Outcome Measure

Clinical outcomes (pain, interference of pain on function) and use of resources (ED return visit, interventions, diagnostic tests, consultations) were compared between groups at ED discharge and after 1 and 3 months using two-way ANOVAs, log-linear analysis and χ2 tests.

Results

Seventy-eight patients suffering from MSKDs were included (40.2 ± 17.6 years old; 44% women). Participants in the PT group (n=40) had statistically lower levels of pain and pain interference at 1- and 3-months. They were recommended fewer imaging tests (38% vs. 78%; p<.0001) and prescription medication (43% vs. 67%; p=.030) at ED discharge, had used less prescription medication (32% vs. 72%; p=.002) and had revisited significantly less often the ED (0% vs. 21%; p=.007) at 1-month than those in the EP group (n=38). At 3 months, the PT group had used less over-the-counter medication (19% vs. 43%; p=.034).

Conclusion

Patients presenting with a MSKD to the ED with direct access to a PT had better clinical outcomes and used less services and resources than those in the usual care group after ED discharge and up to 3 months after discharge. The results of this study support the implementation of such models of care for the management of this population.

Trial Registration

This trial is registered at the US National Institutes of Health (ClinicalTrials.gov) #NCT04009369

Ethical approval

This trial was approved by the Research Ethics Committee of the CHU de Québec - Université Laval #MP-20-2019-4307
Gamma-irradiated SARS-CoV-2 vaccine candidate, OZG-38.61.3, confers protection from SARS-CoV-2 challenge in human ACEII-transgenic mice
Authors: Turan Raife Dilek , Tastan Cihan , Kancagi Derya Dilek , Yurtsever Bulut , Karakus Gozde Sir , Ozer Samed , Abanuz Selen , Cakirsoy Didem , Tumentemur Gamze , Demir Sevda , Seyis Utku , Kuzay Recai , Elek Muhammer , Kocaoglu Miyase Ezgi , Ertop Gurcan , Arbak Serap , Elmas Merve Acikel , Hemsinlioglu Cansu , Ng Ozden Hatirnaz , Akyoney Sezer , Sahin Ilayda , Kayhan Cavit Kerem , Tokat Fatma , Akpinar Gurler , Kasap Murat , Kocagoz Ayse Sesin , Ozbek Ugur , Telci Dilek , Sahin Fikrettin , Yalcin Koray , Ratip Siret , Ince Umit , Ovali Ercument
Published: October 2020

The SARS-CoV-2 virus caused the most severe pandemic around the world, and vaccine development for urgent use became a crucial issue. Inactivated virus formulated vaccines such as Hepatitis A, oral polio vaccine, and smallpox proved to be reliable approaches for immunization for prolonged periods. During the pandemic, we produced an inactivated SARS-CoV-2 vaccine candidate, having the advantages of being manufactured rapidly and tested easily in comparison with recombinant vaccines. In this study, an inactivated virus vaccine that includes a gamma irradiation process for the inactivation as an alternative to classical chemical inactivation methods so that there is no extra purification required has been optimized. The vaccine candidate (OZG-38.61.3) was then applied in mice by employing the intradermal route, which decreased the requirement of a higher concentration of inactivated virus for proper immunization, unlike most of the classical inactivated vaccine treatments. Hence, the novelty of our vaccine candidate (OZG-38.61.3) is that it is a non-adjuvant added, gamma-irradiated, and intradermally applied inactive viral vaccine. Efficiency and safety dose (either 1013 or 1014 viral copy per dose) of OZG-38.61.3 was initially determined in Balb/c mice. This was followed by testing the immunogenicity and protective efficacy of OZG-38.61.3. Human ACE2-encoding transgenic mice were immunized and then infected with a dose of infective SARS-CoV-2 virus for the challenge test. Findings of this study show that vaccinated mice have lower SARS-CoV-2 viral copy number in oropharyngeal specimens along with humoral and cellular immune responses against the SARS-CoV-2, including the neutralizing antibodies similar to those shown in Balb/c mice without substantial toxicity. Subsequently, plans are being made for the commencement of Phase 1 clinical trial of the OZG-38.61.3 vaccine for the COVID-19 pandemic.
Extracellular vesicle-based vaccine platform displaying native viral envelope proteins elicits a robust anti-SARS-CoV-2 response in mice
Authors: Polak K. , Greze N. , Lachat M. , Merle D. , Chiumento S. , Bertrand-Gaday C. , Trentin B. , Mamoun R. Z.
Published: October 2020

Extracellular vesicles (EVs) emerge as essential mediators of intercellular communication. DNA vaccines encoding antigens presented on EVs efficiently induce T-cell responses and EV-based vaccines containing the Spike (S) proteins of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) are highly immunogenic in mice. Thus, EVs may serve as vaccine platforms against emerging diseases, going beyond traditional strategies, with the antigen displayed identically to the original protein embedded in the viral membrane and presented as such to the immune system. Compared to their viral and pseudotyped counterparts, EV-based vaccines overcome many safety issues including pre-existing immunity against these vectors. Here, we applied our technology in natural EV’s engineering, to express the S proteins of SARS-CoV-2 embedded in the EVs, which mimic the virus with its fully native spikes. Immunizations with a two component CoVEVax vaccine, comprising DNA vector (DNAS-EV) primes, allowingin situproduction of Spike harbouring EVs, and a boost using S-EVs produced in mammalian cells, trigger potent neutralizing and cellular responses in mice, in the absence of any adjuvants. CoVEVax would be the prototype of vaccines, where the sole exchange of the envelope proteins on EVs leads to the generation of new vaccine candidates against emerging viruses.