bluuebunny/crossref_metadata_2025 huggingface dataset:
A narrative review on sacubitril/valsartan and ventricular arrhythmias
Authors: Wei Zhaoyang , Zhang Meiwei , Zhang Qian , Gong Linan , Wang Xiangyu , Wang Zanzan , Gao Ming , Zhang Zhiguo
Published: July 2022

Sacubitril/valsartan, the first angiotensin receptor neprilysin inhibitor approved by the Food and Drug Administration for marketing, has been shown to reduce the risk of cardiovascular death or heart failure hospitalization and improve symptoms in patients with chronic heart failure with a reduced ejection fraction. However, some researchers have also found that sacubitril/valsartan has an antiarrhythmic effect. The mechanism by which sacubitril/valsartan reduces the mortality associated with malignant ventricular arrhythmias is not precise. Many studies have concluded that ventricular arrhythmia is associated with a reduction in myocardial fibrosis. This article reviews the current understanding of the effects of sacubitril/valsartan on the reduction of ventricular arrhythmia and explains its possible mechanisms. The results of this study suggest that sacubitril/valsartan reduces the occurrence of appropriate implantable cardioverter-defibrillator shocks. Meanwhile, sacubitril/valsartan may reduce the occurrence of ventricular arrhythmias by affecting 3 pathways of B-type natriuretic peptide, Angiotensin II, and Bradykinin. The conclusion of this study is that sacubitril/valsartan reduces the number of implantable cardioverter-defibrillator shocks and ventricular arrhythmias in heart failure with reduced ejection fraction patients.
Plasma exchange treats severe intrahepatic cholestasis caused by dacomitinib: A case report
Authors: Qiao Fei , Chen Qinlei , Lu Weiting , Fang Nanyuan
Published: July 2022

Rationale:

Dacomitinib-induced liver injury is often manifested by mild elevations of transaminases and bilirubin, and severe intrahepatic cholestasis caused by dacomitinib for simultaneous taking orally cytochrome P450 2D6 (CYP2D6) competitive substrates has been rarely reported.

Patient concerns:

The patient was a 69-year-old woman with non–small cell lung cancer (NSCLC) who was prescribed oral dacomitinib for a month; she was given oral loratadine due to “allergic rhinitis” and metoprolol extended action tablets due to “tachycardia” separately for a few days during the course of dacomitinib treatment. The patient developed liver damage, increased fatigue, yellow urine, and pruritus, with significantly elevated serum levels of bilirubin and glutamyltranspetidase.

Diagnosis:

Intrahepatic cholestasis, drug-induced liver injury, and NSCLC.

Interventions:

After admission, the patient was prescribed adenosylmethionine, acetylcysteine, ursodeoxycholic acid capsule, methylprednisolone and fenofibrate for a month, with progressive elevation of liver biochemical parameters. Through drug enzyme gene assays in the liver tissue after percutaneous liver biopsy, we found both CYP2D6*10/*10 and ATP-binding cassette subfamily B member 1 GG variants (rs1045642) positive. After the poor response to the conventional medication, the patient underwent plasma exchange.

Outcomes:

The patient was discharged after her liver parameters improved; the parameters remained normal at several follow-up visits, and she renewed the NSCLC regimens without dacomitinib after being evaluated by oncologists.

Lessons:

Dacomitinib can induce severe intrahepatic cholestasis. It is considered that patients with intermediate metabolic CYP2D6 are susceptible to drug-induced liver injury caused by dacomitinib; plasma exchange may be an effective treatment.
Bilateral synchronous total hip arthroplasty for end-stage arthropathy in hemophilia A patients: A retrospective study
Authors: He Bang Jian , Mao Qiang , Li Ju , Lv Shuai Jie , Tong Peijian , Jin Hong Ting
Published: July 2022

Total hip arthroplasty (THA) has been an effective tool of advanced hemophiliac hip arthritis. There are only limited data of bilateral synchronous THA for end-stage arthropathy in hemophilia A patients.

The aim of this retrospective study was to analyze clinical outcome and complication rate of bilateral THA for hemophilia A patients with end-stage arthropathy of hip and review the operative strategy.

From August 2012 to July 2016, 48 hips of 24 patients with hemophilia A patients underwent THA by a single experienced chief orthopedic surgeon. Clinical and radiological evaluations were included of operation time, blood loss, the quantity of blood transfusion, clotting factor consumption, duration of hospitalization, modified Harris hip score, complication rate, and radiographic assessment.

All the 24 patients successfully completed the operation, followed up for 5 to 8 years, and the mean time was 6.5 years. The average operation time was 140 minutes (range, 120–180 minutes). The average total blood loss was 225 mL (range, 150–400 mL). The mean red blood cell transfusion amount was 2.4 U (range, 0–6 U). the mean hospitalization time was 24 days (range, 16–46 days). The mean amount of clotting factor VIII used in the perioperative period for management of hemophilia A was 30,600 U (range, 18,000–52,000 U). Average modified Harris hip score increased from 46.6 (range 28–70) points preoperatively to 90.2 (range 75–98) points at final follow-up, complications were few.

With excellent operative techniques and hematological management, bilateral synchronous THA for end-stage arthropathy in hemophilia A patients can provide satisfactory outcomes.
Risk assessment of novel coronavirus COVID-19 outbreaks in the border areas of southwest China
Authors: Chen Lihua , Xiao Yuanyuan , He Jibo , Gao Huxing , Zhao Jiang , Zhao Shiwen , Peng Xia
Published: July 2022

This study aimed to assess the risk of coronavirus disease 2019 in the border areas of southwest China, so as to provide guidance to targeted prevention and control measures in the border areas of different risk levels.

We assessed the dependence of the risk of an outbreak in the southwest China from imported cases on key parameters such as the cumulative number of infectious diseases in the border area of southwest China in the past 3 years; the connectivity of the neighboring countries with China’s Southwest border, including baseline travel numbers, travel frequencies, the effect of travel restrictions, and the length of borders with neighboring countries; the cumulative number of close contacts of coronavirus disease 2019 patients; (iv) the population density in border areas; the efficacy of control measures in border areas; experts estimated risks in border areas based on experience and then given a score; Spearman correlation and Logistic regression models were used to analyze the associated factors of novel coronavirus. According to the correlation of various factors, we assigned values to each parameter, calculated the risk score of each county, and then divided each county into high, medium, and low risk according to the sick score and took different control measure according to different risk levels. Finally, the total risk level was evaluated according to the Harvard disease risk index model.

The number of infectious diseases in the past 3 years, travel numbers, travel frequencies, experts estimated risk score, effect of travel restrictions, and the number of close contacts were associated with the incidence of new coronary pneumonia. It is concluded that bilateral transportation convenience is a risk factor for new coronary pneumonia, (odds ratio = 9.23, 95% confidence interval, 1.99–42.73); the number of observers is a risk factor for new coronary pneumonia (odds ratio = 1.04, 95% confidence interval, 1.00–1.08).

We found that in countries with travel numbers, travel frequencies, and experts' estimated risk scores were the influencing factors of novel coronavirus. The effect of travel restrictions and the cumulative number of close contacts of the case are risk factors for novel coronavirus.
Males with low income and catastrophic illnesses are important risk factors for in-hospital homicide-related deaths in Taiwan from 1998 to 2015: A cross-sectional study
Authors: Chwo Miao-Ju , Huang Yao-Ching , Huang Shi-Hao , Chung Ren-Jei , Sun Chien-An , Chung Chi-Hsiang , Wang Bing-Long , Chien Wu-Chien
Published: July 2022

This study aimed to investigate not only the differences in in-hospital deaths between male and female homicides in Taiwan from 1998 to 2015, but also the epidemiological characteristics and long-term trend analysis.

We collected data on 76,125 hospitalized patients injured in attempted homicides from January 1, 1998, to December 31, 2015, from the National Health Insurance Research Database (NHIRD), identifying 59,161 male and 16,694 female patients. Age, gender, and index date match. Multiple logistic regression was used to analyze the risks of gender differences in terms of homicide.

The death risk of male patients was 1.673 times that of female patients and the mortality risk of low-income male patients was 3.447 times greater than that of non–low-income male patients. Moreover, the in-hospital death risk was 23.584 and 5.064 times higher for male and female patients with catastrophic illness, respectively, compared to patients with noncritical diseases. There is a higher trend of male than female patients hospitalized after an attempted homicide.

Gender differences are significantly related to homicide, with males having a higher risk of death risk from homicide than females, especially in terms of low-income and catastrophic illness.
Surgical treatment of facial blushing: Patient selection and operative technique (retrospective observational study)
Authors: Park Jae Kil , Hyun Kwanyong , Moon Mi Hyoung , Lee Jungsun
Published: July 2022

Surgeons are often reluctant to offer further intervention to patients with medically intractable facial blushing. This is mainly because of the relatively high failure rate of blushing resolution and a high incidence of compensatory hyperhidrosis. In this study, we sought to identify the type of blushing that would benefit from surgery and minimize compensatory hyperhidrosis by applying diffuse sympathicotomy (DS).

This study was a retrospective review of 62 patients who underwent R2 endoscopic thoracic sympathicotomy (ETS) and preemptive DS for facial blushing. Facial blushing was classified as autonomic-mediated blushing (thermoregulatory, emotional) and vasodilator-mediated blushing (constant) based on the history and precipitating factors for blushing. DS was performed at lower-thoracic levels in the form of limited DS (right R5/7/9/11, left R5/6/8/10) or extended DS (bilateral R5-11).

Resolution of blushing (described as “almost disappeared”) was achieved in 48% of patients with a median follow-up of 19.6 months. There was a significant difference in resolution among 3 types of blushing (emotional: 55%, thermoregulatory: 28%, constant: 15%, P = .03). Multivariate analysis confirmed thermoregulatory and constant type blushing as a potential independent predictor of blushing resolution. Even though there was no difference between the DS procedures with respect to compensatory hyperhidrosis, intolerable compensatory hyperhidrosis (Hyperhidrosis Disease Severity Scale = 4) occurred in only 11% of patients. DS redistributed sweating area, being predominantly on the chest and mid-back (89%), also seen on the abdomen-waist-groin-buttocks-thighs (63%). Overall, 77% of patients experienced satisfactory results.

Emotional blushing proved to be an established indication of ETS where good long-term results can be expected. Expansion of surgical indication to thermoregulatory or constant type blushing needs to be validated in future studies. Additionally, compensatory hyperhidrosis, another hurdle for ETS, can be minimized by preemptive DS, resulting in redistribution and decrease of sweating.
P2Y12 inhibitor pretreatment in patients with nonST-segment elevation acute coronary syndrome: A meta-analysis
Authors: Yan Longhui , Zhou Yan , Yu Zhangjie , Xuan Mengmei , Xu Buyun , Peng Fang
Published: July 2022

Background:

The 2020 European Society of Cardiology guidelines do not recommend pretreatment for nonST-segment elevation myocardial infarction (NSTEMI) patients with unclear coronary anatomy, which is inconsistent with our routine preoperative approach to loading P2Y12 receptor inhibitors (e.g., preoperative loading of 300 mg of clopidogrel).

Objectives:

The purpose of our study was to compare the safety and effectiveness of P2Y12 inhibitors administered before coronary angiography or at least before percutaneous coronary intervention (PCI) with during or after PCI.

Methods:

Cochrane, PubMed, and Embase databases were searched. The primary effect endpoint and safety endpoint were any-cause death and major bleeding, respectively. Major adverse cardiovascular events, myocardial infarction and revascularization were also analyzed.

Results:

Our search identified 9 trials. P2Y12 inhibitor pretreatment was associated with lower death from any cause (OR 0.62, 95% CI 0.53–0.72, P < 0.00001) without increasing the risk of bleeding (OR 1.02, 95% CI 0.80–1.30, P = 0.89). However, prasugrel or ticagrelor pretreatment was not associated with a lower risk of mortality (OR 0.70, 95% CI 0.31–1.59, P = 0.40) and increased the risk of bleeding (OR 1.67, 95% CI 1.10–2.54, P = 0.02).

Conclusions:

In summary, clopidogrel pretreatment was associated with significantly lower mortality, major adverse cardiovascular events, myocardial infarction and revascularization with no increase in major bleeding. However, these advantages were not observed with prasugrel or ticagrelor pretreatment.
Significance of immunohistochemistry and FISH of TFE3 in the diagnosis of alveolar soft part sarcoma: A case report
Authors: Huang Yan-Ying , Yang Wan-Rui , Geng Yan-Hua , Zhang Yue
Published: July 2022

Rationale:

Alveolar soft part sarcoma (ASPS) is a rare soft tissue sarcoma harboring an ASPL-TFE3 fusion gene. Herein, we report a case of ASPS associated with brain metastasis. Immunohistochemistry (IHC) for TFE3 antigen expression and fluorescence in situ hybridization (FISH) for TFE3 rearrangement were performed to arrive at an accurate diagnosis.

Patient concerns:

A 47-year-old man was hospitalized for a headache and numbness of the lower limbs.

Diagnoses:

Preoperative computed tomography and magnetic resonance imaging revealed 2 brain masses, 1 each in the right parietal and temporal bones. We diagnosed this case as ASPS with brain metastasis based on histological morphology, IHC, and FISH.

Interventions:

The patient underwent right skull titanium mesh implantation and supratentorial superficial lesion resection.

Outcomes

: The patient recovered well after discharged from hospital.

Lessons:

The diagnosis of ASPS depends on careful clinical, radiographic, histopathological, IHC, and FISH assessments to arrive at the correct diagnosis. Thus, TFE3 may be useful in the diagnosis and treatment of ASPS.
Antitumor necrosis factor treatment in patients with inflammatory bowel disease does not promote psoriasis development: A meta-analysis
Authors: Jun Yu Kyung , Park Joo Young , Koh Seong-Joon , Park Hyunsun , Kang Hyoun Woo , Im Jong Pil , Kim Joo Sung
Published: July 2022

Background:

Recent case reports have suggested that anti-tumor necrosis factor (TNF) agents are associated with an increased risk of developing psoriasis in patients with inflammatory bowel disease (IBD).

Aims:

This meta-analysis of published studies aimed to evaluate the association between anti-TNF treatment and psoriasis in patients with IBD.

Methods:

An electronic search for original articles published before April 7, 2022, was performed using PubMed, EMBASE, and the Cochrane Library. Independent reviewers conducted the article screening and data extraction. Psoriasis development between anti-TNF-treated and anti-TNF-naïve patients was compared. Patients with ulcerative colitis and Crohn disease were compared with determine the differences in anti-TNF-induced psoriasis. Also, psoriasis development was compared according to the types of anti-TNF agents. Random-effects model meta-analyses, network meta-analysis, funnel plot asymmetry, Begg rank correlation test, and Egger regression test were performed to generate summary estimates and explore the possibility of publication bias.

Results:

We analyzed a total of 10,778 articles searched and 14 articles were selected to analyze. There was no significant difference in psoriasis development between anti-TNF-treated and anti-TNF-naïve patients (relative risk = 1.14; 95% confidence interval = 0.77-1.68). No differences were found for psoriasis development between anti-TNF-treated ulcerative colitis and Crohn disease patients (relative risk = 1.30; 95% confidence interval = 0.87-1.95). No significant difference was reported with respect to psoriasis development according to the types of anti-TNF agents. We found no definitive publication bias in our analyses.

Conclusions:

Anti-TNF treatment did not contribute to the psoriasis development in patients with IBD. Based on our study, anti-TNF agents may be used for IBD treatment without concern for psoriasis development.
Cerebral hemodynamics in children with sickle cell disease in India: An observational cohort study
Authors: Gajjar Bhakti , Sharma Sanjay , Khan Erum , Sharma Pranita , Jain Pawan , Goel Vikas , Neral Arvind , Patel Jyotish , Parmar Mamta , Sharma Kanika , Sharma Vijay K. , Sharma Arvind K.
Published: July 2022

India has the second highest number of cases of sickle cell disease (SCD) and affects the most socioeconomically disadvantaged communities living in a horizontal belt from Gujarat to Odisha state. Despite high prevalence, information about cerebral hemodynamics among children with SCD in India remains scarcely described.

We performed transcranial Doppler (TCD) to assess cerebral hemodynamics among Indian children with SCD and evaluated their association with clinical and hematological parameters.

Children aged 3-18years, diagnosed with SCD living in Raipur in Chhattisgarh and Ahmedabad in Gujarat state were recruited. TCD was performed to obtain flow velocities from middle cerebral (MCA), intracranial internal carotid (ICA) and basilar artery. Associations were evaluated between timed-average-mean-maximum velocities (TAMMV) and various clinical and hematological parameters.

Our prospective study included 62 consecutive children with known SCD. Mean ± SD age of the study population was 9.8 ± 3.9 years and 31 (50%) were male. Mean ± SD hemoglobin was 8.64 ± 1.34 Gm/dL while the mean HbSS ± SD was 70.25 ± 15.27%. While 6 (9.6%) children had suffered from stroke during previous 2 years, 7 (11%) demonstrated abnormal TAMMV. Higher HbSS level along with history of iron chelation therapy, blood transfusion and/or stroke showed a trend towards having higher TAMMV.

Stroke and cerebral hemodynamic alterations are common among Indian children with SCD. Larger studies with detailed neuroimaging and genetic evaluations are needed for better understanding, characterization, risk stratification as well as optimization of the timing of blood transfusion to reduce physical disabilities among Indian children with SCD.
Comparison of the efficacy and safety between oral sulfate tablet and polyethylene glycol for bowel preparation before colonoscopy according to age
Authors: Kim Jae Hyun , Park Yong Eun , Kim Tae Oh , Park Jongha , Oh Gyu Man , Moon Won , Park Seun Ja ,   Busan Ulsan Gyeongnam Intestinal Study Group Society (BIGS)
Published: July 2022

Background:

Recently, a novel oral sulfate tablet (OST) has been introduced for bowel preparation before colonoscopy. However, whether elderly patients can take OST is not yet clear, as OST consists of 28 tablets. We aimed to compare the efficacy and safety of OST and polyethylene glycol (PEG) for bowel preparation for colonoscopy according to age.

Methods:

We randomly divided subjects into an OST group and a PEG group and compared Boston Bowel Preparation Score (BBPS), bubble score, patient compliance and satisfaction, and safety between the 2 groups according to age (under 65 years of age vs 65 years of age and older).

Results:

Among the 179 participants, 61 were 65 years of age and older. The BBPS and bubble score of the OST group were better than that of the PEG group, regardless of age. The satisfaction of the OST group was better than that of the PEG group, regardless of age. The compliance was not different between the 2 groups; however, the OST group under 65 years of age had a higher rate of completing the dose within 2 hours compared with the PEG group under 65 years of age. Adverse events including abdominal distension, abdominal pain, nausea, or vomiting were not different between the 2 groups.

Conclusion:

The use of OST for bowel preparation before colonoscopy is as effective and safe as PEG, and these results were consistent in elderly people 65 years of age and older.
Analysis of related complications of totally implantable venous access ports in children’s chemotherapy: Single center experience
Authors: Zhang Songze , Xiao Zhangsheng , Yang Feibiao
Published: July 2022

Totally implantable venous access port (TIVAP) has become an important infusion channel for children who need chemotherapy. With the popularization of TIVAP, its related complications have gradually received clinical attention. However, there are few studies on the complications of TIVAP in children. Therefore, this study intends to analyze the risk factors of complications in children’s infusion port, so as to provide basis for guiding clinical prevention and intervention.

This paper retrospectively analyzed 182 children who received TIVAP implantation in our hospital from January 2018 to January 2021. According to the demographic data, basic disease status and operation related data obtained through Hospital Information System and manual follow-up, the complications and related influencing factors after implantation and implantation were summarized and analyzed. SPSS software was used to analyze the influencing factors between the complication group and the control group.

There were 182 cases of children implanted in intravenous infusion port, of which 71 cases had complications, infection was the most common complication in 50 cases, followed by catheter blockage in 23 cases. Among the infection factors, catheter-related blood stream infection accounted for the highest proportion in 31 cases (17.0%), and Staphylococcus epidermidis was the most common pathogen. A total of 19 cases were pulled out early, and the unplanned pullout rate of catheter-related blood stream infection was the highest. In the analysis of influencing factors, age had significant differences in catheter-related infection, all complications and no complications (P < .05).

The overall incidence of complications in the use of TIVAP in children with chemotherapy is high, and infection is the most common complication, among which catheter-related blood stream infection is the most common cause of unplanned pullout. Lower age may be associated with a higher incidence of complications.
Imaging techniques to study diabetic bone disease
Authors: Carballido-Gamio Julio
Published: July 2022

Purpose of review

This review article presents the most recent research on bone fragility in individuals with diabetes from a medical imaging perspective.

Recent findings

The widespread availability of dual-energy X-ray absorptiometry (DXA) and trabecular bone score (TBS) software has led to recent assessments of bone fragility with this texture parameter in several studies of type 2 diabetes mellitus (T2D), but in few of type 1 diabetes mellitus (T1D). Although most studies show a trend of reduced TBS values in T2D independent of areal bone mineral density (aBMD) of the lumbar spine, some studies also show the limitations of TBS in both T2D and T1D. Given the limitations of DXA to assess bone strength and investigate the etiology of bone fragility in diabetes, more investigators are incorporating three-dimensional (3D) medical imaging techniques in their studies. Recent use of 3D medical imaging to assess bone fragility in the setting of diabetes has been mostly limited to a few cross-sectional studies predominantly incorporating high-resolution peripheral quantitative computed tomography (HR-pQCT). Although HR-pQCT studies indicate higher tibial cortical porosity in subjects with T2D, results are inconsistent in T1D due to differences in study designs, sample sizes, and subject characteristics, among other factors. With respect to central CT, recent studies support a previous finding in the literature indicating femoral neck geometrical impairments in subjects with T2D and provide encouraging results for the incorporation of finite element analysis (FEA) to assess bone strength in studies of T2D. In the recent literature, there are no studies assessing bone fragility in T1D with QCT, and only two studies used pQCT reporting tibial and radial impairments in young women and children with T1D, respectively. Magnetic resonance imaging (MRI) has not been recently used in diabetic studies of bone fragility.

As bone fragility in diabetes is not explained by DXA-derived aBMD and given the limitations of cross-sectional studies, it is imperative to use 3D imaging techniques for longitudinal assessments of the density, quality, and microenvironment of bone to improve our understanding of the effects of diabetes on bone and reduce the risk of fracture in this large and vulnerable population of subjects with diabetes.
Disease progression in patients with PI*ZZ alpha-1 antitrypsin deficiency
Authors: Shen Katie , Lyu Ruishen , Sengupta Shreya , Wakim-Fleming Jamile
Published: July 2022

Background and objective

Alpha-1 antitrypsin deficiency (AATD) is an uncommon but underdiagnosed cause of cirrhosis and lacks medical treatment options. It is important to recognize risk factors that contribute to disease progression and liver transplantation. We aimed to assess if age, sex, or smoking status was associated with liver or lung disease progression.

Methods

Forty-three patients with ZZ-AATD cirrhosis were consecutively sampled from an Institutional Review Board-approved registry of 240 patients with AATD of any genotype seen as outpatients in the Cleveland Clinic between 1999 and 2019. To determine the association between risk factors and lung or liver disease progression, linear mixed-effects models with fixed effects for linear time, risk factor, and time-by-risk factor interaction, and the random intercepts for intra-patient correlation were used.

Results

Based on the mixed-effects model analysis, there was a significant association between liver disease progression and smoking history, and no association with age or sex. There was no association between lung disease progression and age, sex, or smoking history. However, smoking history was significantly associated with lower forced expiratory volume values.

Conclusion

This study found that in a cohort of patients with PI*ZZ genotype AATD (ZZ-AATD) and cirrhosis, smoking history was associated with liver disease progression, whereas age and sex were not.
Character of cell-free genomic DNA in embryo culture medium and the prospect of its clinical application in preimplantation genetic testing
Authors: Lei Cai-Xia , Sun Xiao-Xi
Published: July 2022

There is increasing evidence that cell-free DNA (cfDNA) in spent culture media (SCM) can be amplified for genetic testing. Therefore, this paper reviews the characteristics of cfDNA, including its fragment size, amount, origin, as well as some factors affecting the success rate of its amplification, together to provide researchers with a more comprehensive perspective on embryonic cfDNA. The origin of cfDNA in SCM is complicated and poses challenges to the interpretation of genetic test results. Advanced molecular techniques should distinguish between embryonic and contaminated DNA to maximize the success rate of amplification and analysis. Recent data showed that the type of culture medium, assisted hatching or not, the type of amplification kit, and fresh or thawed embryos were not related to the success rate of amplification, but the length of culture time might affect the success rate. The longer culture time, the more cfDNA is available in the SCM. Then we focused on the concordance between trophectoderm (TE), inner cell mass, whole embryo, and embryonic cfDNA. Despite successful amplification, the concordance between TE and embryonic cfDNA was low. In summary, non-invasive genetic testing using SCM could represent a major advance in future single embryo selection, however, contamination and timing for media collection are key factors affecting the results, and current noninvasive cfDNA testing should not be directly applied to clinical practice. Further research is needed to improve the methods used for testing techniques and genetic analysis to achieve greater accuracy and trace its origins before it can be used in the clinics.
Cilia and their role in neural tube development and defects
Authors: Yan Lu , Zheng Yu-Fang
Published: July 2022

Cilia are microtubule-based filamentous organelles that play a vital role in embryogenesis. Multiple signal transduction pathways are orchestrated by cilia, such as Hedgehog and planar cell polarity signals. Various studies, spanning over last 2 decades, have emphasized the role of cilia-mediated signaling cascades in regulating neural tube patterning and development. Moreover, the deficiency of certain ciliary genes have been reported to cause neural tube defects (NTDs), which are a set of disorders that occur due to perturbation of normal neural tube closure. However, the mechanisms underlying cilia dysfunction resulting NTDs remain unclear. Recent studies have highlighted the association of phosphoinositide signaling with cilia, thereby conferring novel insights into the function of cilia during neural tube development. Here, we have reviewed recent studies on cilia, focusing on the molecular mechanism underlying the involvement of cilia in neural tube development and the role of ciliary disruption in the development of NTDs.
Medium-chain acyl-CoA dehydrogenase deficiency: prevalence of ACADM pathogenic variants c.985A>G and c.199T>C in a healthy population in Rio Grande do Sul, Brazil
Authors: dos Santos Mariana Lopes , Randon Dévora Natalia , de Bitencourt Fernanda Hendges , Sperb-Ludwig Fernanda , Vianna Fernanda Sales Luiz , Vargas Carmen Regla , Sitta Angela , Schwartz Ida Vanessa Doederlein
Published: July 2022

Objectives:

To investigate the prevalence of ACADM pathogenic variants, c.985A>G and c.199T>C, for medium chain acyl CoA dehydrogenase deficiency (MCADD) in a healthy population in the southern region of Brazil.

Methods:

This was an observational cross-sectional study with a convenience sampling strategy. The participants were recruited from the blood bank of the Hospital de Clínicas of Porto Alegre, Brazil. A total of 1000 healthy individuals from the state of Rio Grande do Sul were included. Genotyping for the c.199T>C and c.985A>G variants was performed using real-time polymerase chain reaction (PCR) and the PCR-restriction fragment length polymorphism (RFLP) technique, respectively. Individuals considered heterozygous for c.985A>G were subjected to additional acylcarnitine profile analysis using tandem mass spectrometry. Carrier frequency was obtained by calculating the ratio of heterozygous individuals to the total number of individuals analyzed and reported with a 95% confidence interval. Allele and genotype frequencies were calculated based on the Hardy–Weinberg equilibrium.

Results:

The c.985A>G variant was detected as heterozygotes in three individuals (frequency of the heterozygous genotype = 1:333, allele frequency = 0.0015, minimum frequency of MCADD = 1:444,444) whose acylcarnitine profiles were within normal limits. The c.199T>C variant was not identified.

Conclusions:

Considering the small sample size and associated allelic heterogeneity with MCADD, these findings are believed to denote the rarity or underdiagnosis of MCADD in southern Brazil. This study provides evidence for the need for further investigation to ascertain the contribution of these diseases to child morbidity and mortality in the country.
Virulence of Staphylococcus Infection in Surgically Treated Patients With Endocarditis
Authors: Luehr Maximilian , Weber Carolyn , Misfeld Martin , Lichtenberg Artur , Tugtekin Sems-Malte , Diab Mahmoud , Saha Shekhar , Li Yupeng , Matsche Klaus , Doenst Torsten , Borger Michael A. , Wahlers Thorsten , Akhyari Payam , Hagl Christian
Published: July 2022

Objective:

Infective endocarditis (IE) caused by Staphylococcus species (spp.) is believed to be associated with higher morbidity and mortality rates. We hypothesize that Staphylococcus spp. are more virulent compared with other commonly causative bacteria of IE with regard to short-term and long-term mortality.

Background:

It remains unclear if patients suffering from IE due to Staphylococcus spp. should be referred for surgical treatment earlier than other IE patients to avoid septic embolism and to optimize perioperative outcomes.

Materials and Methods:

The database of the CAMPAIGN registry, comprising 4917 consecutive patients undergoing heart valve surgery, was retrospectively analyzed. Patients were divided into 2 groups with regard to the identified microorganisms: Staphylococcus group and the non-Staphylococcus group. The non-Staphylococcus group was subdivided for further analyses: Streptococcus group, Enterococcus group, and all other bacteria groups.

Results:

The respective mortality rates at 30 days (18.7% vs 11.8%; P<0.001), 1 year (24.7% vs 17.7%; P<0.001), and 5 years (32.2% vs 24.5%; P<0.001) were significantly higher in Staphylococcus patients (n=1260) compared with the non-Staphylococcus group (n=1787). Multivariate regression identified left ventricular ejection fraction <30% (P<0.001), chronic obstructive pulmonary disease (P=0.045), renal insufficiency (P=0.002), Staphylococcus spp. (P=0.032), and Streptococcus spp. (P=0.013) as independent risk factors for 30-day mortality. Independent risk factors for 1-year mortality were identified as: age (P<0.001), female sex (P=0.018), diabetes (P=0.018), preoperative stroke (P=0.039), chronic obstructive pulmonary disease (P=0.001), preoperative dialysis (P<0.001), and valve vegetations (P=0.004).

Conclusions:

Staphylococcus endocarditis is associated with an almost twice as high 30-day mortality and significantly inferior long-term outcome compared with IE by other commonly causative bacteria. Patients with Staphylococcus infection are more often female and critically ill, with >50% of these patients suffering from clinically relevant septic embolism. Early diagnosis and referral to a specialized center for surgical treatment are strongly recommended to reduce the incidence of preoperative deterioration and stroke due to septic embolism.
Evaluating the Accuracy and Design of Visual Abstracts in Academic Surgical Journals
Authors: Guidolin Keegan , Lin Justin , Zorigtbaatar Anudari , Nadeem Minahil , Ibrahim Tarek , Neilson Zdenka , Kim Kyung Young (Peter) , Rajendran Luckshi , Chadi Sami , Quereshy Fayez
Published: July 2022

Objective:

The objective of this study was to assess the quality and accuracy of visual abstracts published in academic surgical journals.

Background:

Visual abstracts are commonly used to disseminate medical research findings. They distill the key messages of a research article, presenting them graphically in an engaging manner so that potential readers can decide whether to read the complete manuscript.

Methods:

We developed the Visual Abstract Assessment Tool based upon published guidelines. Seven reviewers underwent iterative training to apply the tool. We collected visual abstracts published by 25 surgical journals from January 2017 to April 2021; those corresponding to systematic reviews without meta-analysis, conference abstracts, narrative reviews, video abstracts, or nonclinical research were excluded. Included visual abstracts were scored on accuracy (as compared with written abstracts) and design, and were given a “first impression” score.

Results:

Across 25 surgical journals 1325 visual abstracts were scored. We found accuracy deficits in the reporting of study design (35.8%), appropriate icon use (49%), and sample size reporting (69.2%), and design deficits in element alignment (54.8%) and symmetry (36.1%). Overall scores ranged from 9 to 14 (out of 15), accuracy scores from 4 to 8 (out of 8), and design scores from 3 to 7 (out of 7). No predictors of visual abstract score were identified.

Conclusion:

Visual abstracts vary widely in quality. As visual abstracts become integrated with the traditional components of scientific publication, they must be held to similarly high standards. We propose a checklist to be used by authors and journals to standardize the quality of visual abstracts.
Pregnancy in trauma—A Western Trauma Association algorithm
Authors: Rizzo Anne , Martin Matthew , Inaba Kenji , Schreiber Martin , Brasel Karen , Sava Jack , Ciesla David , Sperry Jason , Kozar Rosemary , Brown Carlos , Moore Ernest
Published: July 2022

BACKGROUND

The Western Trauma Association has undertaken publication of best practice clinical practice guidelines on multiple trauma topics. These guidelines are based on scientific evidence, case reports, and best practices per expert opinion. Some of the topics covered by this consensus group do not have the ability to have randomized controlled studies completed because of complexity, ethical issues, financial considerations or scarcity of experience. Care of the pregnant trauma patient is one of these clinically complex situations that is based on physiologic data, standard trauma care, trauma care experience, and outcomes.

METHODS

Review of multiple evidence- based guidelines, case reports, and expert opinion were compiled and reviewed.

RESULTS

The algorithm is attached with detailed explanation of each step, supported by data if available.

CONCLUSION

Resuscitative and trauma care of the mother is the utmost priority

Study Type

Algorithm, expert opinion, consensus

LEVEL OF EVIDENCE

Diagnostic Tests/Criteria; Level III.
Cross-attention PHV: Prediction of human and virus protein-protein interactions using cross-attention–based neural networks
Authors: Tsukiyama Sho , Kurata Hiroyuki
Published: July 2022

Viral infections represent a major health concern worldwide. The alarming rate at which SARS-CoV-2 spreads, for example, led to a worldwide pandemic. Viruses incorporate genetic material into the host genome to hijack host cell functions such as the cell cycle and apoptosis. In these viral processes, protein-protein interactions (PPIs) play critical roles. Therefore, the identification of PPIs between humans and viruses is crucial for understanding the infection mechanism and host immune responses to viral infections and for discovering effective drugs. Experimental methods such as yeast two-hybrid assays and mass spectrometry are widely used to identify human-virus PPIs, but these experimental methods are time-consuming, expensive, and laborious. To overcome this problem, we developed a novel computational predictor, named cross-attention PHV, by implementing two key technologies of the cross-attention mechanism and a one- dimensional convolutional neural network (1D-CNN). The cross-attention mechanisms were very effective in enhancing prediction and generalization abilities. Application of 1D-CNN to the word2vec-generated feature matrices reduced computational costs, thus extending the allowable length of protein sequences to 9000 amino acid residues. Cross- attention PHV outperformed existing state-of-the-art models using a benchmark dataset and accurately predicted PPIs for unknown viruses. Cross-attention PHV also predicted human–SARS-CoV-2 PPIs with area under the curve values >0.95.
Assessment of the Human Placental Microbiome in Early Pregnancy
Authors: Sharlandjieva Vassilena , Beristain Alexander G. , Terry Jefferson
Published: July 2022

Bacteria derived from the maternal circulation have been suggested to seed the human placenta during development leading to an intrinsic placental microbiome. This concept has become controversial as numerous studies suggest that the apparent placental microbiome is mostly, if not completely, comprised of contaminants. If the maternal circulation seeds the placenta then there should be an increase in abundance and diversity of detectable bacteria with onset of maternal perfusion of the placenta around 10 weeks gestational age; however, if only contaminants are present then there should be no significant evolution of the placental microbiome with increasing gestational age. This pilot study addresses whether bacterial abundance and diversity increases in human placenta and whether there is an associated shift in the immunophenotype of the decidual immune cell complement before and after initiation of placental perfusion. Human placental and decidual tissue from 5-19 weeks gestational age are assessed by quantitative 16S polymerase chain reaction (PCR), 16S gene sequencing, and immunological flow cytometry studies. A weak positive correlation between placental bacterial abundance and gestational age is identified but is not statistically significant. No significant changes in bacterial diversity are found with increasing gestational age. The proportion of decidual activated memory T helper cells increases with gestational age but no change was observed in other lymphocyte subsets. This pilot study does not strongly support bacterial colonization of the placenta after initiation of maternal perfusion; however, the minor trends towards increases in bacterial abundance and activated memory T helper cells may represent an early stage of this process. Additional investigations in larger cohorts are warranted.
Decoding the mouse spinal cord locomotor neural network using tissue clearing, tissue expansion and tiling light sheet microscopy techniques
Authors: Feng Ruili , Xie Jiongfang , Lu Jing , Hu Huijie , Chen Yanlu , Wang Dongyue , Gao Liang
Published: July 2022

Decoding a biological neural network requires the structural information regarding the spatial organization, dendritic morphology, axonal projection and synaptic connection of the neurons in the network. Imaging physically sectioned nervous tissues using electron microscopy (EM) has been the only method to acquire such information. However, EM is inefficient for imaging and reconstructing large neural networks due to the low throughput and inability to target neural circuits of interest by labeling specific neuron populations genetically. Here, we present a method to image large nervous tissues from the cellular to synaptic level with high throughput using tiling light sheet microscopy combined with tissue clearing and tissue expansion techniques. We describe the method, demonstrate its capability and explore its utility for decoding large biological neural networks by studying the spinal cord locomotor neural network in genetically labeled fluorescent mice. We show our method could advance the decoding of large neural networks significantly.
Meta-analysis of the effects of clinically-effective therapeutics in the preclinical migraine model as a tool for design optimisation
Authors: Dolgorukova Antonina , Protsenko Ekaterina , Isaeva Julia , Gagloeva Victoria , Verbitskaya Elena , Sokolov Alexey Y.
Published: July 2022

The low reliability of the preclinical study’s findings is of critical concern. The possible sources include poor experimental design and a lack of measures to reduce the risk of bias. In this study, we focused on anti-migraine drug discovery and a particular animal model with the aim to contribute to the elimination of these sources in future research. We performed a systematic search of controlled studies testing established migraine treatments in the model of trigeminovascular nociception (EMTVN) and meta-analysis for the main outcomes to estimate the overall effect sizes. In 13 studies reporting on 21 experiments, anti-migraine drugs significantly decreased trigeminovascular nociceptive traffic compared with a control intervention. Considering these effects biologically relevant, we used them in sample size calculation for future experiments. To refine the EMTVN and inform its users, we explored the impact of methodological features on the outcome and revealed several factors potentially impacting the results obtained in this model. We also assessed the internal validity of the included studies and found that the selection bias, particularly, the lack of randomisation, is likely a main source of bias. Based on our findings, we discuss the translational potential of the EMTVN and suggest what should be addressed for its improvement. We believe that this work highlights the importance of systematic reviews and meta-analyses as tools for design optimisation in animal research.
A low-cost smartphone fluorescence microscope for research, life science education, and STEM outreach
Authors: Schaefer Madison A , Nelson Heather N , Butrum John L , Gronseth James R , Hines Jacob H
Published: July 2022

Much of our understanding of cell and tissue development, structure, and function stems from fluorescence microscopy. The acquisition of colorful and glowing images engages and excites users ranging from seasoned microscopists to STEM students. Fluorescence microscopes range in cost from several thousand to several hundred thousand US dollars. Therefore, the use of fluorescence microscopy is typically limited to well-funded institutions and biotechnology companies, research core facilities, and medical laboratories, but is financially impractical at many universities and colleges, primary and secondary schools (K-12), and in science outreach settings. In this study, we developed and characterized components that when used in combination with a smartphone or tablet, perform fluorescence microscopy at a cost of less than $50 US dollars per unit. We re-purposed recreational LED flashlights and theater stage lighting filters to enable viewing of green and red fluorophores including EGFP, DsRed, mRFP, and mCherry on a simple-to-build frame made of wood and plexiglass. These devices, which we refer to as glowscopes, were capable of 10 μm resolution, imaging fluorescence in live specimens, and were compatible with all smartphone and tablet models we tested. In comparison to scientific-grade fluorescence microscopes, glowscopes may have limitations to sensitivity needed to detect dim fluorescence and the inability to resolve subcellular structures. We demonstrate capability of viewing fluorescence within zebrafish embryos, including heart rate, rhythmicity, and regional anatomy of the central nervous system. Due to the low cost of individual glowscope units, we anticipate this device can help to equip K-12, undergraduate, and science outreach classrooms with fleets of fluorescence microscopes that can engage students with hands-on learning activities.