bluuebunny/crossref_metadata_2025 huggingface dataset:
Combined brain and thoracic trauma surgery in a hybrid emergency room system: a case report
Authors: Wada Daiki , Hayakawa Koichi , Saito Fukuki , Yoshiya Kazuhisa , Nakamori Yasushi , Kuwagata Yasuyuki
Published: April 2021

Background

A novel trauma workflow system called the hybrid emergency room (Hybrid ER), which combines a sliding CT scanner system with interventional radiology features (IVR-CT), was initially instituted in our emergency department in 2011. Use of the Hybrid ER enables CT diagnosis and emergency therapeutic interventions without transferring the patient to another room. We describe an illustrative case of severe multiple blunt trauma that included injuries to the brain and torso to highlight the ability to perform multiple procedures in the Hybrid ER.

Case presentation

A 46-year-old man sustained multiple injuries after falling from height. An early CT scan performed in the Hybrid ER revealed grade IIIa thoracic aortic injury, left lung contusion, and right subdural haematoma and subarachnoid haemorrhage. Without relocating the patient, all definitive procedures, including trepanation, total pneumonectomy, and thoracic endovascular aneurysm repair were performed in the Hybrid ER. At 5.72 h after definitive surgery was begun, the patient was transferred to the intensive care unit.

Conclusions

The Hybrid ER has the potential to facilitate the performance of multiple definitive procedures in combination to treat severe multiple blunt trauma including injuries to the brain and torso. Emergency departments with more than one resuscitation room would benefit from a Hybrid ER to treat complex emergency cases.
Effects of irrigation fluid temperature during flexible ureteroscopic holmium laser lithotripsy on postoperative fever and shivering: a randomized controlled trial
Authors: He Yue , Feng You-Gang , He Jun , Liang Bo , Jiang Ming-Dong , Liu Jun , Kang Yong-Ming , Ma Li-Ping , Zhang Qin , Peng Qi-Jia , Yang Tao , Liu Yao , Luo Li , Zhang Min
Published: April 2021

Background

Flexible ureteroscopic holmium laser lithotripsy is used to treat urinary tract calculi, but postoperative complications include shivering, fever and infection. To investigate the effects of irrigation fluid temperature on postoperative complications.

Methods

This randomized controlled trial included 120 consecutive patients undergoing flexible ureteroscopic holmium laser lithotripsy at the Urology Department, Suining Central Hospital, Sichuan, China between January 2017 and July 2019. Patients were randomized 1:1:1 into three groups (17 °C, 27 °C or 37 °C). Primary outcome was fever incidence (body temperature > 37.5 °C) within 48 h after surgery. Secondary outcomes included shivering incidence during recovery from anesthesia, white blood cell count (WBC), serum procalcitonin (PCT) and incidence of suspected infection (temperature > 38.5 °C and PCT > 0.5 µg/L).

Results

There were 108 patients, (17 °C group, n = 36; 27 °C group, n = 35; 37 °C group, n = 37), received flexible ureteroscopic holmium laser lithotripsy and analyzed. Age, gender distribution, body mass index, ASA grade, stone burden, preoperative creatinine, preoperative core temperature and irrigation fluid volume did not differ significantly between groups. 17 °C, 27 °C and 37 °C groups exhibited significant differences in the incidences of postoperative fever (38.9% vs. 17.1% vs. 13.5%) and shivering (22.2% vs. 5.7% vs. 2.7%) (p < 0.05 for all pairwise comparisons). There was no significant difference of WBC, PCT and incidence of suspected infection in 37 °C or 27 °C group compared with 17 °C group. One case each of flash pulmonary edema and bleeding occurred in 37 °C group.

Conclusion

Warming the irrigation fluid can reduce the incidence of postoperative fever and shivering, but further studies are needed to determine the optimal temperature.

Trial registration The trial was registered at the Chinese Clinical Trials Registry and allocated as ChiCTR2000031683. The trial was registered on 07/04/2020 and this was a retrospective registration.
Changes in decision-making process for life-sustaining treatment in patients with advanced cancer after the life-sustaining treatment decisions-making act
Authors: Kim Hyeyeong , Im Hyeon-Su , Lee Kyong Og , Min Young Joo , Jo Jae-Cheol , Choi Yunsuk , Lee Yoo Jin , Kang Daseul , Kim Changyoung , Koh Su-Jin , Cheon Jaekyung
Published: April 2021

Background

Cancer is a leading cause of death in Korea. To protect the autonomy and dignity of terminally ill patients, the Life-Sustaining Treatment Decision-Making Act (LST-Act) came into full effect in Korea in February 2018. However, it is unclear whether the LST-Act influences decision- making process for life-sustaining treatment (LST) for terminally ill cancer patients.

Methods

This was a retrospective study conducted with a medical record review of cancer patients who died at Ulsan University Hospital between July 2015 and May 2020. Patients were divided into two groups: those who died in the period before the implementation of the LST-Act (from July 2015 to October 2017, Group 1) and after the implementation of the LST-Act (from February 2018 to May 2020, Group 2). We measured the self-determination rate and the timing of documentation of do-not-resuscitate (DNR) or Physician Orders for Life-Sustaining Treatment (POLST) in both groups.

Results

A total of 1,834 patients were included in the analysis (Group 1, n = 943; Group 2, n = 891). Documentation of DNR or POLST was completed by patients themselves in 1.5 and 63.5 % of patients in Groups 1 and 2, respectively (p < 0.001). The mean number of days between documentation of POLST or DNR and death was higher in Group 2 than in Group 1 (21.2 days vs. 14.4 days, p = 0.001). The rate of late decision, defined as documentation of DNR or POLST within 7 days prior to death, decreased significantly in Group 2 (56.1 % vs. 47.6 %, p < 0.001). In the multivariable analysis, female patients (odds ratio [OR] 0.71, p = 0.002) and patients with more than 12 years of education (OR 0.70, p = 0.019) were significantly related to a reduced rate of late decision. More than 12 years of education (OR 0.53, p = 0.018) and referral to hospice palliative care (OR 0.40, p < 0.001) were significantly related to self-determination. Enforcement of LST-Act was related to a reduced rate of surrogate decision-making (OR 0.01, p < 0.001) and late decision (OR 0.51, p < 0.001). However, physicians with clinical experience of less than 3 years had a higher rate of surrogate decision-making (OR 5.08, p = 0.030) and late decision (OR 2.47, p = 0.021).

Conclusions

After the implementation of the LST-Act, the rate of self-determination increased and decisions for LST occurred earlier than in the era before the implementation of the LST-Act.
Life during the pandemic: an international photo-elicitation study with medical students
Authors: Dworkin M. , Akintayo T. , Calem D. , Doran C. , Guth A. , Kamami E. M. , Kar J. , LaRosa J. , Liu J. C. , Pérez Jiménez I. N. , Frasso R.
Published: April 2021

Background

The SARS-CoV-2 (COVID-19) pandemic is a global event with unprecedented impact on individuals and communities around the world. The purpose of this study is to use a modified photo-elicitation methodology to examine the impact of the COVID-19 pandemic on the lives of medical students and their communities around the world.

Methods

Participating medical students were asked to take photographs for 14 days. In lieu of an interview, which is customary for photo-elicitation projects, participants were asked to share a reflection (a paragraph or two) for each photograph they contributed to the study.

Results

Between April 27th, 2020 and May 11th, 2020 26 students from 19 medical schools across 13 countries shared photographs and reflections. Qualitative analysis of written reflections revealed that medical students felt the impact of the pandemic on several levels 1) individual, 2) interpersonal, 3) educational, and 4) societal.

Conclusions

The COVID-19 pandemic has impacted the lives of medical students on multiple levels. As individuals, students felt emotional distress but found resilience through physical activity and the establishment of new routines. Many students felt isolated as their interpersonal relationships were confined due to social distancing measures. These feelings could be combated with new educational initiatives focused on group collaboration. Lastly, students reflecting on the larger societal implications were concerned with the economic ramifications of the virus and its impact on their future. This study brought together students from several different countries to engage in an applied learning program as a model for equitable global health research.
Expression of the SARS-CoV-2 receptorACE2 in human heart is associated with uncontrolled diabetes, obesity, and activation of the renin angiotensin system
Authors: Herman-Edelstein Michal , Guetta Tali , Barnea Amir , Waldman Maayan , Ben-Dor Naomi , Barac Yaron D. , Kornowski Ran , Arad Michael , Hochhauser Edith , Aravot Dan
Published: April 2021

Background

Diabetic and obese patients are at higher risk of severe disease and cardiac injury in corona virus 2 (SARS-CoV-2) infections. Cellular entry of SARS-CoV-2 is mainly via the angiotensin-converting enzyme 2 (ACE2) receptor, which is highly expressed in normal hearts. There is a disagreement regarding the effect of factors such as obesity and diabetes on ACE2 expression in the human heart and whether treatment with renin–angiotensin system inhibitors or anti-diabetic medications increases ACE2 expression and subsequently the susceptibility to infection. We designed this study to elucidate factors that control ACE2 expression in human serum, human heart biopsies, and mice.

Methods

Right atrial appendage biopsies were collected from 79 patients that underwent coronary artery bypass graft (CABG) surgery. We investigated the alteration in ACE2 mRNA and protein expression in heart tissue and serum. ACE2 expression was compared with clinical risk factors: diabetes, obesity and different anti-hypertensive or anti-diabetic therapies. WT or db/db mice were infused with Angiotensin II (ATII), treated with different anti-diabetic drugs (Metformin, GLP1A and SGLT2i) were also tested.

Results

ACE2 gene expression was increased in diabetic hearts compared to non-diabetic hearts and was positively correlated with glycosylated hemoglobin (HbA1c), body mass index (BMI), and activation of the renin angiotensin system (RAS), and negatively correlated with ejection fraction. ACE2 was not differentially expressed in patients who were on angiotensin converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) prior to the operation. We found no correlation between plasma free ACE2 and cardiac tissue ACE2 expression. Transmembrane serine protease 2 (TMPRSS2), metalloprotease ADAM10 and ADAM17 that facilitate viral-ACE2 complex entry and degradation were increased in diabetic hearts. ACE2 expression in mice was increased with ATII infusion and attenuated following anti-diabetic drugs treatment.

Conclusion

Patients with uncontrolled diabetes or obesity with RAS activation have higher ACE2 expressions therefore are at higher risk for severe infection. Since ACEi or ARBs show no effect on ACE2 expression in the heart further support their safety.
Factors associated with use of insecticide-treated net for malaria prevention in Manica District, Mozambique: a community-based cross-sectional survey
Authors: Scott Julia , Kanyangarara Mufaro , Nhama Abel , Macete Eusebio , Moss William John , Saute Francisco
Published: April 2021

Background

Insecticide-treated net (ITN) use is crucial for preventing malaria infection. Despite significant improvements in ITN access and use over the past two decades, many malaria-endemic countries in sub-Saharan Africa have not yet reached global targets for universal coverage of ITNs. To reduce the gaps in ITN use, it is important to understand the factors associated with ITN use. The goal of this analysis was to determine the factors associated with ITN use in Manica District, Mozambique.

Methods

A cross-sectional community-based survey was conducted from October to November 2019. Households were randomly selected, and all members of selected households were eligible to participate. Data on socio-demographic characteristics, housing construction and the ownership, use and characteristics of ITNs were collected using structured questionnaires. Factors independently associated with ITN use were identified using generalized estimating equations multivariate logistic regression.

Results

Of the 302 households surveyed, 209 (69.2%) owned at least one ITN and 176 (58.3%) had one ITN for every two household members. The multivariate analysis indicated that the odds of ITN use was significantly lower among individuals in households with 3 or more members. However, the odds of ITN use was significantly higher among older age groups, poorer households, and as the number of ITNs in a household increased.

Conclusions

The findings of this analysis highlight the need for behaviour change communication strategies targeting young people and ITN distribution campaigns targeting larger households to increase ITN ownership, thereby improving ITN use in Manica District.
Implementation and success factors from Thailand’s 1-3-7 surveillance strategy for malaria elimination
Authors: Lertpiriyasuwat Cheewanan , Sudathip Prayuth , Kitchakarn Suravadee , Areechokchai Darin , Naowarat Sathapana , Shah Jui A. , Sintasath David , Pinyajeerapat Niparueradee , Young Felicity , Thimasarn Krongthong , Gopinath Deyer , Prempree Preecha
Published: April 2021

Thailand’s National Malaria Elimination Strategy 2017–2026 introduced the 1-3-7 strategy as a robust surveillance and response approach for elimination that would prioritize timely, evidence-based action. Under this strategy, cases are reported within 1 day, cases are investigated within 3 days, and foci are investigated and responded to within 7 days, building on Thailand’s long history of conducting case investigation since the 1980s. However, the hallmark of the 1-3-7 strategy is timeliness, with strict deadlines for reporting and response to accelerate elimination. This paper outlines Thailand’s experience adapting and implementing the 1-3-7 strategy, including success factors such as a cross-sectoral Steering Committee, participation in a collaborative regional partnership, and flexible local budgets. The programme continues to evolve to ensure prompt and high-quality case management, capacity maintenance, and adequate supply of lifesaving commodities based on surveillance data. Results from implementation suggest the 1-3-7 strategy has contributed to Thailand’s decline in malaria burden; this experience may be useful for other countries aiming to eliminate malaria.
Anthelmintic resistance in small ruminants in the Nordic-Baltic region
Authors: Beleckė Agnė , Kupčinskas Tomas , Stadalienė Inga , Höglund Johan , Thamsborg Stig Milan , Stuen Snorre , Petkevičius Saulius
Published: April 2021

Gastrointestinal nematodes (GIN) in small ruminants result in production losses, and consequently economic losses, and are an animal welfare problem in most countries in the Nordic-Baltic region. Intensive use of anthelmintics to control helminth infections has led to anthelmintic resistance (AR), which has become a major issue in many European countries. Several studies have been performed in countries in the Nordic-Baltic region (e.g. Denmark, Sweden, Norway and Lithuania) showing increasing/emerging levels of AR. The aim of this paper is to provide an overview of the problem of AR on sheep and goat farms in the Nordic-Baltic region. This region has a limited number of registered anthelmintics. However, researchers in this area have discovered some surprising findings, such as ivermectin (IVM) resistance on a farm that had never used IVM. In Sweden there is evidence of macrocyclic lactone (ML)-resistant Haemonchus contortus being introduced with sheep imported from the Netherlands. As elsewhere in the world, the livestock trade appears to be contributing to the spread of AR in the region and isolated cases of multidrug-resistant cases have also been reported. This is surprising given that the frequency of treatments here is much lower than in other countries where sheep production is economically more important. The prevailing nematodes are Haemonchus, Teledorsagia and Trichostrongylus, while on some farms Haemonchus is dominant and clinical haemonchosis has increasingly been observed in recent decades. The reasons for this are unclear, but are probably related to this parasite’s propensity to rapidly develop drug resistance and a general lack of awareness of the problem, possibly in combination with global warming and the increased livestock trade within the EU. In addition, domestic interactions through contacts with wildlife ruminants, alpacas may also be a contributing factor for transmission of AR.
Aortogenic embolic stroke after sleeve pneumonectomy with median sternotomy for lung cancer: a case report
Authors: Suzuki Hirotoshi , Noda Masafumi , Watanabe Tatsuaki , Matsuda Yasushi , Hoshikawa Yasushi , Okada Yoshinori
Published: April 2021

Background

The median sternotomy approach in sleeve pneumonectomy enables diseased lung ventilation in selected cases, which may reduce the difficulty in achieving anastomosis under intubation of the left main bronchus. However, with median sternotomy, the ascending aorta requires repeated mobilization to expose the operative field for anastomosis, which can cause an aortogenic embolic stroke.

Case presentation

A 70-year-old Asian man presenting 6 months after developing hemoptysis was diagnosed with right upper lobe lung cancer (stage T4N0M0), invading the lower trachea and basal bronchus. Preoperative computed tomography revealed ascending aorta calcification. Right sleeve pneumonectomy was performed using median sternotomy with diseased lung ventilation. The ascending aorta was repeatedly mobilized to adequately expose the tracheobronchial bifurcation. Surgery was uneventful, but he did not recover complete consciousness even after termination of anesthesia. Mild paralysis of both upper extremities was observed. Head magnetic resonance imaging on postoperative day 1 revealed multiple small acute infarctions in the brain, possibly caused by mobilization of the aorta. He received anticoagulation therapy and rehabilitation and was discharged on postoperative day 30.

Conclusion

The median sternotomy approach in sleeve pneumonectomy enables diseased lung ventilation. However, the possibility of aortogenic embolic stroke should be considered when calcification of the ascending aorta is observed on preoperative computed tomography.
Correction to: Treating primary immunodeficiencies with defects in NK cells: from stem cell therapy to gene editing
Authors: Eguizabal C. , Herrera L. , Inglés-Ferrándiz M. , Belmonte J. C. Izpisua
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.
Variability in chemical composition and antimicrobial activity of essential oil of Rosa × damascena Herrm. from mountainous regions of Iran
Authors: Ghavam Mansureh , Afzali Afsaneh , Manconi Maria , Bacchetta Gianluigi , Manca Maria Letizia
Published: April 2021

Background

Essential oil ofRosa × damascenaHerrm. is one of the most valuable and important raw materials for the flavor and fragrance industry. The cultivation of this plant has ancient origins, and Kashan was one of the first mountainous regions of Iran dealing with the cultivation ofR. × damascena.In this study, both chemical composition and antimicrobial activity of different rose essential oils obtained from five mountainous areas of Kashan region (Maragh, Qamsar, Sadeh, Javinan, and Kamoo) has been investigated along with the influence of the environmental conditions on these properties.

Results

Results showed that yield and chemical composition of essential oils obtained fromRosa×damascenawere significantly affected by the collection area. In particular, the yield of oils varied from ~0.08 to ~0.132% and citronellol (36.70-9.18%), geraniol (12.82-0.47%), nonadecane (22.73-10.36%), heneicosane (31.7-11.43%), and 1-nonadecene (6.03-3.93%) have been detected as main compounds in all the plants collected, but at different concentrations depending on the collection area. The best fragrance and the highest yield were found in the oil from Kamoo area. Similarly to the chemical composition, the antimicrobial activity of the essential oils was affected by their origin, and essential oil obtained from plants collected from Kamoo area disclosed the highest antibacterial and antifungal efficacy. Its inhibition halos were 17.33±0.58 mm againstAspergillus brasiliensis, 15.67±0.58 mm againstStaphylococcus aureus, and 12.33±0. 58 mm againstStreptococcus pyogenes. Essential oils ofR. damascenawere also effective against Gram-negativePseudomonas aeruginosaand they had a MIC value of 62.50 μg/mL irrespective of the collection area (except the oil from Javinan area). On the contrary, the highest antifungal power againstCandida albicansyeast was reached using the essential oil obtained from plants collected in Javinan region (MIC and MBC ~62.50 μg/mL).

Conclusions

Overall results underline the influence of environmental conditions of the different areas of Kashan region, on the chemical composition of and antimicrobial activity of the essential oils ofRosa × damascena.In addition, results disclosed that Kamoo seemed to be the most suitable area for the competitive cultivation ofR. × damascenato the intensive production of aromatic flower oil and natural antimicrobial essential oils.
Cohort study of medical cannabis authorization and motor vehicle crash-related healthcare visits in 2014–2017 in Ontario, Canada
Authors: Lee Cerina , Voaklander Don , Minhas-Sandhu Jasjeet K. , Hanlon John G. , Hyshka Elaine , Dyck Jason R. B. , Eurich Dean T.
Published: April 2021

Background

With increasing numbers of countries/jurisdictions legalizing cannabis, cannabis impaired driving has become a serious public health concern. Despite substantive research linking cannabis use with higher rates of motor vehicle crashes (MVC), there is an absence of conclusive evidence linking MVC risk with medical cannabis use. In fact, there is no clear understanding of the impact of medical cannabis use on short- and long-term motor vehicle-related healthcare visits. This study assesses the impact of medical cannabis authorization on motor vehicle-related health utilization visits (hospitalizations, ambulatory care, emergency department visits, etc) between 2014 and 2017 in Ontario, Canada.

Methods

A matched cohort study was conducted on patients authorized to use medical cannabis and controls who did not receive authorization for medical cannabis – in Ontario, Canada. Overall, 29,153 adult patients were identified and subsequently linked to the administrative databases of the Ontario Ministry of Health, providing up to at least 6 months of longitudinal follow-up data following the initial medical cannabis consultation. Interrupted time series analyses was conducted to evaluate the change in rates of healthcare utilization as a result of MVC 6 months before and 6 months after medical cannabis authorization.

Results

Over the 6-month follow-up period, MVC-related visits in medical cannabis patients were 0.50 visits/10000 patients (p = 0.61) and − 0.31 visits/10000 patients (p = 0.64) for MVC-related visits in controls. Overall, authorization for medical cannabis was associated with an immediate decrease in MVC-related visits of − 2.42 visits/10000 patients (p = 0.014) followed by a statistically significant increased rate of MVC-related visits (+ 0.89 events/10,000 in those authorized medical cannabis) relative to controls in the period following their authorization(p = 0.0019). Overall, after accounting for both the immediate and trend effects, authorization for medical cannabis was associated with an increase of 2.92 events/10,000 (95%CI 0.64 to 5.19) over the entire follow-up period. This effect was largely driven by MVC-related emergency department visits (+ 0.80 events/10,000, p < 0.001).

Conclusions

Overall, there was an association between medical cannabis authorization and healthcare utilization, at the population level, in Ontario, Canada. These findings have public health importance and patients and clinicians should be fully educated on the potential risks. Continued follow-up of medically authorized cannabis patients is warranted to fully comprehend long-term impact on motor vehicle crash risk.
INI1-negative colorectal undifferentiated carcinoma with rhabdoid features and postoperative rapidly growing liver metastases: a case report and review of the literature
Authors: Kojima Masatsugu , Miyake Toru , Ueki Tomoyuki , Ohta Hiroyuki , Kushima Ryoji , Shiohara Masanori , Mizuta Hiroo , Iida Hiroya , Yamaguchi Tsuyoshi , Kaida Sachiko , Takebayashi Katsushi , Maehira Hiromitsu , Nishina Yusuke , Shimizu Tomoharu , Mekata Eiji , Tani Masaji
Published: April 2021

Background

Malignant tumors with rhabdoid features are extremely rare. They can occur in various organs, including the gastrointestinal tract, with common clinical features of high malignancy and poor prognosis.

Case presentation

A 41-year-old man visited our hospital complaining of lower abdominal pain and fever. Computed tomography (CT) revealed two wall-thickening lesions in the rectum and sigmoid colon, with the latter invading the small intestine and abdominal wall. Lymph nodes were swollen in the sigmoid mesocolon and at the roots of the inferior mesenteric artery. Colonoscopy revealed a circular type 3 lesion in the sigmoid colon and a semicircular type 2 lesion in the rectum. Biopsies of the sigmoid colon and rectum lesions revealed poorly and moderately differentiated adenocarcinoma cells, respectively. The sigmoid colon, rectum, invaded small intestine, and abdominal wall were resected; lymph node dissection was also performed. Histopathological finding of the sigmoid colon lesion revealed that the tumor cells had poor connectivity with each other, and each cell had eosinophilic cytoplasm and a polymorphic nucleus. These characteristics are termed rhabdoid features, because the morphology of these cells is similar to that of rhabdomyosarcoma tumor cells. Immunohistochemical examination showed that the tumor cells were positive for both epithelial (cytokeratin AE1/AE3) and mesenchymal cell markers (vimentin); however, they were negative for integrase interactor 1 (INI1). Therefore, the sigmoid colorectal cancer was diagnosed as an INI1-negative undifferentiated carcinoma with rhabdoid features. The patient continued to experience high fever after surgery; thus, we performed an abdominal CT scan that revealed cystic lesions in the liver 4 days after surgery. These were absent in the positron emission tomography (PET)-CT scan performed 14 days before surgery. These tumors grew rapidly, and fine needle aspiration cytology revealed that they were undifferentiated carcinomas compatible with metastatic lesions from the undifferentiated carcinoma with rhabdoid features from the sigmoid colon. Chemotherapy was administered but was not effective. The patient died 60 days after surgery.

Conclusions

INI1-negative colorectal undifferentiated carcinomas with rhabdoid features are extremely rare, have high histological malignancy, and a poor prognosis. Chemotherapy is not effective. Effective systemic therapy is desired.
Increasing plant density increases Bt toxin concentration of boll wall in cotton by decreasing boll setting speed
Authors: ZHOU Mingyuan , CHEN Chen , TAMBEL Leila I. M. , CHEN Yuan , ZHANG Xiang , CHEN Yuan , CHEN Dehua
Published: April 2021

Background

In order to uncover the mechanism of significantly reduced insect resistance at the late developmental stage in cotton (Gossypium hirsutum L.), the relationship between boll setting rate under different planting densities and Bacillus thuringiensis (Bt) insecticidal concentrations in the boll wall were investigated in the present study. Two studies were arranged at Yangzhou, China during the 2017–2018 cotton growth seasons. Five planting densities (15 000, 25 000, 45 000, 60 000 and 75 000 plants per hectare) and the flower-removal treatment were imposed separately on Bt cotton cultivar Sikang3 to arrange different boll setting rates, and the boll setting rates and Bt toxin content were compared.

Results

Higher boll setting rate together with lower Bt toxin contents in boll wall was observed under low planting density, whereas lower boll setting rate and higher Bt toxin contents were found under high planting density. Also, higher Bt protein concentration was associated with higher soluble protein content, glutamic-pyruvic transaminase (GPT), and glutamic oxaloacetate transaminase (GOT) activities, but lower amino acid content, and protease and peptidase activities. It was further confirmed that a higher boll setting rate with lower Bt protein content under flower-removal.

Conclusions

This study demonstrated that the insecticidal efficacy of boll walls was significantly impacted by boll formation. Reduced protein synthesis and enhanced protein degradation were related to the reduced Bt toxin concentration.
Anatomical In Vitro Investigations of the Pediatric Larynx: A Call for Manufacturer Redesign of Tracheal Tube Cuff Location and Perhaps a Call to Reconsider the Use of Uncuffed Tracheal Tubes
Authors: Isa Malaak , Holzki Josef , Hagemeier Anna , Rothschild Markus A. , Coté Charles J.
Published: April 2021

BACKGROUND:

Some in vivo studies question the traditional “funnel-shaped” infant larynx; further anatomic examinations were warranted. Examination of fixative free fresh autopsy laryngeal and upper tracheal specimens and multiple measurements was needed to determine consistency between current tracheal tube designs and anatomic observations.

METHODS:

Larynges from 19 males and 11 females (Caucasian term newborn to 126 months) were examined by the same forensic pathologist. Measurements included anterior/posterior (A/P) and transverse (T) diameters of the cricoid outlet (CO), interarytenoid diameter (IAD), cricothyroid membrane (CTM), distance from the vocal cords (VC) to CO (VC-CO), and calibration of the larynx lumen with uncuffed tracheal tubes as measuring rods. Assessment of “safe tracheal tube placement” was assessed using manufacturer recommended cuffed Microcuff (Kimberly-Clark, Koblenz, Germany) tubes.

RESULTS:

In 77% (95% confidence interval [CI], 58-90) of specimens, the proximal end of the cuff was within the CO and in 23% even with or close to the CO. The VC-CO varied from 9.1 to 13.17 mm in infants, 11.55 to 15.17 mm in toddlers, and 13.19 to 18.34 mm in children. The A-P/T ratio of the CO was nearly 0.99 in most larynges; the IAD was greater than CO in all specimens. The CTM could be minimally distended in all specimens.

CONCLUSIONS:

First, despite being marketed as a safer tracheal tube design, the proximal end of the Microcuff cuff rested within or close to the cricoid cartilage theoretically increasing potential cuff-induced injury when using the VC markings for positioning. Our data suggest that the optimal cuff free distance (VC-CO) would be ~13.5 mm for a Microcuff internal diameter (ID) size 3.0, ~15 mm for size 3.5, and ~16 to 19 mm for greater sizes.

Second, the CO was virtually circular in all specimens, suggesting that appropriately sized uncuffed tubes should provide an adequate seal in most neonates and toddlers, thus avoiding the potential for cuff-related necrosis injury.

Third, the IAD was always greater than CO confirming that the narrowest point of the infant larynx is the nondistensible cricoid cartilage and not the easily distended glottis.

Fourth, appropriately sized Microcuff tubes with the cuff deflated completely filled the lumen of the CO and proximal trachea in all specimens. Our data suggest the need for all manufacturers to further evaluate tracheal tube cuff locations and lengths in relation to the VC safe insertion markings, particularly for neonates and toddlers.

Fifth, the CTM is minimally distensible, thus having important implications for emergency surgical airway access with most currently available emergency airway devices.
Induction and Differentiation of an Epithelial Tumour in the Newt (Triturus cristatus)
Authors: Seilern-Aspang F. , Kratochwil K.
Published: April 2021

Epithelial tumours have been induced in T. cristatus by any of several carcinogens. The tumours arise from the mucous glands of the skin. The tumours showed infiltrative and destructive growth, sometimes penetrating into the peritoneal cavity. Metastasis also occurred. The tumours thus appeared to be malignant. In spite of its malignant characteristics this carcinogen-induced epithelial tumour often regressed. This regression of an apparently malignant tumour occurred spontaneously. During regression of the tumour, differentiation of the tumour cells into normal, non-malignant tissues occurred. Expansively growing tumours differentiated independently of their location into pigment cell layers, cornified layers, mucous glands, and epithelium of the integument. In contrast, infiltrating tumours differentiated in accordance with their surroundings and even connective-tissue-like cells were formed. Tumour metastases differentiated by the formation of degenerative mucous cells or in the same ways as expansively growing tumours. If no differentiation occurred, the tumours were lethal. The capacity of newts to bring their tumour cells under control again by a differentiation process is attributed to the great regeneration power of these animals.
The Influence of Hydrocortisone on the Metaplastic Action of Vitamin A on the Epidermis of Embryonic Chicken Skin in Organ Culture
Authors: Fell Honor B.
Published: April 2021

The effects of hydrocortisone, vitamin A, and both agents together were compared in explants of skin from 9-day chick embryos grown in organ culture. In normal medium the periderm degenerated and was shed in the usual way. The epidermis differentiated and keratinized more rapidly than in the embryo; the feather germs differentiated into sheath and barb rudiments and keratinized, after which development ceased. Hydrocortisone alone caused extreme dilation of the peridermal cells which later were sloughed. The differentiation of the epidermis was much accelerated as compared with that of controls in normal medium. The feather germs aborted at an early stage, probably owing to precocious histological differentiation. With vitamin A alone the peridermal cells actively secreted mucus and many formed cilia-like processes; the periderm formed an integral part of the epithelium. In the epidermis keratinization was suppressed and mucous cells differentiated. The feathers remained almost unchanged; the epithelium failed to keratinize and often became secretory. In explants exposed to both agents together, during the first 2 days the periderm secreted copiously a dense, viscid substance the nature of which was unknown, but which appeared to contain both keratinous and mucous material; a similar secretion was sometimes produced by the epidermis at a later stage when the concentration of added vitamin A was low (5 i.u./ml.). The hormone and the vitamin were mutually antagonistic in their action on the epidermis. At first the hydrocortisone prevailed, and large areas of the epithelium often became squamous and keratinized; later the vitamin predominated, the keratin was sloughed, and mucous cells were formed. In two days, feather germs exposed to both agents at once, swelled to several times their original size. Changes like those produced by the hormone and vitamin together appeared in explants grown for 8 days in the presence of vitamin A and then transferred to medium containing hydrocortisone, but not in skin pretreated with the vitamin and then placed in normal medium. These effects were not seen in skin transplanted from medium with hydrocortisone to one containing vitamin A; the epidermis showed the usual changes produced by vitamin A alone.
Different contributions of pannier and wingless to the patterning of the dorsal mesothorax of Drosophila
Authors: García-García María J. , Ramain Philippe , Simpson Pat , Modolell Juan
Published: April 2021

In Drosophila, the GATA family transcription factor Pannier and the Wnt secreted protein Wingless are known to be important for the patterning of the notum, a part of the dorsal mesothorax of the fly. Thus, both proteins are necessary for the development of the dorsocentral mechanosensory bristles, although their roles in this process have not been clarified. Here, we show that Pannier directly activates the proneural genes achaete and scute by binding to the enhancer responsible for the expression of these genes in the dorsocentral proneural cluster. Moreover, the boundary of the expression domain of Pannier appears to delimit the proneural cluster laterally, while antagonism of Pannier function by the Zn-finger protein U-shaped sets its limit dorsally. So, Pannier and U-shaped provide positional information for the patterning of the dorsocentral cluster. In contrast and contrary to previous suggestions, Wingless does not play a similar role, since the levels and vectorial orientation of its concentration gradient in the dorsocentral area can be greatly modified without affecting the position of the dorsocentral cluster. Thus, Wingless has only a permissive role on dorsocentral achaete-scute expression. We also provide evidence indicating that Pannier and U-shaped are main effectors of the regulation of wingless expression in the presumptive notum.
Initiation of shoot apical meristem in rice: characterization of four SHOOTLESS genes
Authors: Satoh Namiko , Hong Soon-Kwan , Nishimura Asuka , Matsuoka Makoto , Kitano Hidemi , Nagato Yasuo
Published: April 2021

The regulatory mechanism of shoot apical meristem (SAM) initiation is an important subject in developmental plant biology. We characterized nine recessive mutations derived from four independent loci (SHL1-SHL4) causing the deletion of the SAM. Radicles were produced in these mutant embryos. Concomitant with the loss of SAM, two embryo-specific organs, coleoptile and epiblast, were lost, but the scutellum was formed normally. Therefore, differentiation of radicle and scutellum is regulated independently of SAM, but that of coleoptile and epiblast may depend on SAM. Regeneration experiments using adventitious shoots from the scutellum-derived calli showed that no adventitious shoots were regenerated in any shl mutant. However, small adventitious leaves were observed in both mutant and wild-type calli, but they soon became necrotic and showed no extensive growth. Thus, leaf primordia can initiate in the absence of SAM, but their extensive growth requires the SAM. An in situ hybridization experiment using a rice homeobox gene, OSH1, as a probe revealed that shl1 and shl2 modified the expression domain of OSH1, but normal expression of OSH1 was observed in shl3 and shl4 embryos. Accordingly, SHL1 and SHL2 function upstream of OSH1, and SHL3 and SHL4 downstream or independently of OSH1. These shl mutants are useful for elucidating the genetic program driving SAM initiation and for unraveling the interrelationships among various organs in grass embryos.
Rescuing the N-cadherin knockout by cardiac-specific expression of N- or E-cadherin
Authors: Luo Yang , Ferreira-Cornwell M. Celeste , Baldwin H. Scott , Kostetskii Igor , Lenox Jennifer M. , Lieberman Melanie , Radice Glenn L.
Published: April 2021

Cell-cell adhesion mediated by some members of the cadherin family is essential for embryonic survival. The N-cadherin-null embryo dies during mid-gestation, with multiple developmental defects. We show that N-cadherin-null embryos expressing cadherins using muscle-specific promoters, α- or β-myosin heavy chain, are partially rescued. Somewhat surprisingly, either N-cadherin or E-cadherin was effective in rescuing the embryos. The rescued embryos exhibited an increased number of somites, branchial arches and the presence of forelimb buds; however, in contrast, brain development was severely impaired. In rescued animals, the aberrant yolk sac morphology seen in N-cadherin-null embryos was corrected, demonstrating that this phenotype was secondary to the cardiac defect. Dye injection studies and analysis of chimeric animals that have both wild-type and N-cadherin-null cells support the conclusion that obstruction of the cardiac outflow tract represents a major defect that is likely to be the primary cause of pericardial swelling seen in null embryos. Although rescued embryos were more developed than null embryos, they were smaller than wild-type embryos, even though the integrity of the cardiovascular system appeared normal. The smaller size of rescued embryos may be due, at least in part, to increased apoptosis observed in tissues not rescued by transgene expression, indicating that N-cadherin-mediated cell adhesion provides an essential survival signal for embryonic cells. Our data provide in vivo evidence that cadherin adhesion is essential for cell survival and for normal heart development. Our data also show that E-cadherin can functionally substitute for N-cadherin during cardiogenesis, suggesting a critical role for cadherin-mediated cell-cell adhesion, but not cadherin family member-specific signaling, at the looping stage of heart development.
MEIS-WNT5A axis regulates development of fourth ventricle choroid plexus
Authors: Kaiser Karol , Jang Ahram , Kompanikova Petra , Lun Melody P. , Prochazka Jan , Machon Ondrej , Dani Neil , Prochazkova Michaela , Laurent Benoit , Gyllborg Daniel , van Amerongen Renee , Fame Ryann M. , Gupta Suhasini , Wu Feizhen , Barker Roger A. , Bukova Ivana , Sedlacek Radislav , Kozmik Zbynek , Arenas Ernest , Lehtinen Maria K. , Bryja Vitezslav
Published: April 2021

The choroid plexus (ChP) produces cerebrospinal fluid and forms an essential brain barrier. ChP tissues form in each brain ventricle, each one adopting a distinct shape, but remarkably little is known about the mechanisms underlying ChP development. Here, we show that epithelial WNT5A is crucial for determining fourth ventricle (4V) ChP morphogenesis and size in mouse. Systemic Wnt5a knockout, or forced Wnt5a overexpression beginning at embryonic day 10.5, profoundly reduced ChP size and development. However, Wnt5a expression was enriched in Foxj1-positive epithelial cells of 4V ChP plexus, and its conditional deletion in these cells affected the branched, villous morphology of the 4V ChP. We found that WNT5A was enriched in epithelial cells localized to the distal tips of 4V ChP villi, where WNT5A acted locally to activate non-canonical WNT signaling via ROR1 and ROR2 receptors. During 4V ChP development, MEIS1 bound to the proximal Wnt5a promoter, and gain- and loss-of-function approaches demonstrated that MEIS1 regulated Wnt5a expression. Collectively, our findings demonstrate a dual function of WNT5A in ChP development and identify MEIS transcription factors as upstream regulators of Wnt5a in the 4V ChP epithelium.
Metabolically active and polyploid renal tissues rely on graded cytoprotection to drive developmental and homeostatic stress resilience
Authors: Burbridge Katie , Holcombe Jack , Weavers Helen
Published: April 2021

Body tissues are frequently exposed to stress, from toxic byproducts generated during cellular metabolism through to infection or wounding. Although it is well-established that tissues respond to exogenous injury by rapidly upregulating cytoprotective machinery, how energetically demanding tissues – vulnerable to persistent endogenous insult – withstand stress is poorly understood. Here, we show that the cytoprotective factors Nrf2 and Gadd45 act within a specific renal cell subtype, the energetically and biosynthetically active ‘principal’ cells, to drive stress resilience during Drosophila renal development and homeostasis. Renal tubules lacking Gadd45 exhibit striking morphogenetic defects (with cell death, inflammatory infiltration and reduced ploidy) and accumulate significant DNA damage in post-embryonic life. In parallel, the transcription factor Nrf2 is active during periods of intense renal physiological activity, where it protects metabolically active renal cells from oxidative damage. Despite its constitutive nature, renal cytoprotective activity must be precisely balanced and sustained at modest sub-injury levels; indeed, further experimental elevation dramatically perturbs renal development and function. We suggest that tissues requiring long-term protection must employ restrained cytoprotective activity, whereas higher levels might only be beneficial if activated transiently pre-emptive to exogenous insult.
Size of Fragment and Rate of Regeneration in Planarians
Authors: Brøndsted Agnes , Brøndsted H. V.
Published: April 2021

Neither size of regenerating piece nor extent of wound influences rate of regeneration of eyes from a given level of the body in four species of planarian.
The Effects in Chick Blastoderms of replacing the Primitive Node by a Graft of Posterior Primitive Streak
Authors: Abercrombie M. , Bellairs Ruth
Published: April 2021

In chick embryos with a full-length primitive streak the primitive node has been replaced by a graft from the posterior end of the primitive streak, and the blastoderm subsequently cultivated by Waddington’s technique for 24 hours. More than half of those embryos which developed at all showed a doubling of the anterior part of the axis, variable in extent but considerably exceeding the original extent of the graft, with convergence to a single posterior part. Prechordal head, parachordal mesoderm, and neural plate were affected by the doubling. Most specimens had two notochords fusing posteriorly into a single one, or occasionally terminating independently at a common primitive streak. Other specimens had a notochord in only one of the two axes, or in neither. Marking experiments with phosphorus32 on a few specimens showed that the graft, which had become greatly elongated, contributed the mesoderm between the notochords, but did not form any notochordal tissue. The doubled axes were often asymmetrical, and in the head region probably incomplete. The total amount of neural and notochordal tissue in a doubled embryo was not significantly different in volume from that in a single embryo. In a few specimens in which the axis remained single the place of the notochord was taken by side-plate mesoderm, probably graft-derived. Posteriorly this midline mesoderm became somitic. The neural plate in such specimens was little if at all reduced. Other specimens failed to heal and developed a split axis. They were usually devoid of notochord, but occasionally had a notochord along one side of the split, or along both sides. Finally, a few specimens formed an almost normal single axis.