bluuebunny/crossref_metadata_2025 huggingface dataset:
Precision Medicine—A Demand Signal for Genomics Education
Authors: Doll Bruce , De Castro Mauricio J , Fries Melissa H , Pock Arnyce R , Seibert Diane , Yang Wendy
Published: December 2021

Pressed by the accumulating knowledge in genomics and the proven success of the translation of cancer genomics to clinical practice in oncology, the Obama administration unveiled a $215 million commitment for the Precision Medicine Initiative (PMI) in 2016, a pioneering research effort to improve health and treat disease using a new model of patient-powered research. The objectives of the initiative include more effective treatments for cancer and other diseases, creation of a voluntary national research cohort, adherence to privacy protections for maintaining data sharing and use, modernization of the regulatory framework, and forging public–private partnerships to facilitate these objectives. Specifically, the DoD Military Health System joined other agencies to execute a comprehensive effort for PMI. Of the many challenges to consider that may contribute to the implementation of genomics—lack of familiarity and understanding, poor access to genomic medicine expertise, needs for extensive informatics and infrastructure to integrate genomic results, privacy and security, and policy development to address the unique requirements of military medical practice—we will focus on the need to establish education in genomics appropriate to the provider’s responsibilities. Our hypothesis is that there is a growing urgency for the development of educational experiences, formal and informal, to enable clinicians to acquire competency in genomics commensurate with their level of practice. Several educational approaches, both in practice and in development, are presented to inform decision-makers and empower military providers to pursue courses of action that respond to this need.
Polarization signatures of the head-on collision model for Type Ia supernovae: how much asymmetry is too much?
Authors: Livneh Ran , Katz Boaz
Published: December 2021

In a previous paper, we showed that the asymmetric ejecta produced by (zero impact parameter) head-on collisions of carbon–oxygen white dwarfs allow these progenitor models for Type Ia supernovae (SNe Ia) to cover the observed 2D distribution of Si ii line depths (Branch plot). In this paper, we study the polarization signature associated with the 2D asymmetric ejecta of the collision model and a double-detonation model using similar tardis radiative transfer simulations along different lines of sight with a spherical photosphere, combined with a new 3D Monte Carlo polarization code. We show that the polarization Q can be parametrized as a product Q = QmaxQx of a radial structure component Qmax , which is insensitive to the model specifics and is shown to be universally around $Q_{\max }\sim 5\,{{\mathrm{ per\,cent}}}$, and a cancellation component Qx, which depends on the asymmetry details. The continuum polarization is found to be low for both the collision and double-detonation models with $Q\sim 0.5\,{{\mathrm{ per\,cent}}}$. However, the irregular Si distribution in the 2D head-on collision model results in the Si ii line polarization reaching $Q\sim 3\,{{\mathrm{ per\,cent}}}$ ($Q_{{x}} \lesssim 50\,{{\mathrm{ per\,cent}}}$) in tension with observations (mostly $\lesssim 1.2\,{{\mathrm{ per\,cent}}}$). In contrast, we show that the double-detonation model also covers the Branch plot, and yet results in low line polarization $Q\lesssim 0.7\,{{\mathrm{ per\,cent}}}$ ($Q_{ {x}} \sim 10\,{{\mathrm{ per\,cent}}}$) consistent with previous results and most SNe Ia. These results strengthen the case for asymmetric explosions as progenitors of SNe Ia, emphasizing an additional requirement for large polarization cancellations to account for the low observed line polarizations.
Epstein-Barr virus encephalitis in a patient with rheumatoid arthritis
Authors: Nakamura Jun , Yanagida Mai , Saito Keisuke , Kamata Yasuyuki , Nagashima Takao , Iwamoto Masahiro , Sato Takeo , Sato Kojiro
Published: December 2021

A 53-year-old woman with a 6-year history of rheumatoid arthritis (RA) presented with pharyngeal pain, fever, and altered mental status. The patient had been treated with methotrexate (MTX) 12 mg/week, baricitinib 4 mg/day, and tacrolimus 2 mg/day. Magnetic resonance imaging of the brain revealed diffuse high-intensity lesions in the cerebral white matter, basal ganglia, brainstem, and right cerebellar hemisphere. She was diagnosed with Epstein-Barr virus (EBV) encephalitis due to elevated levels of EBV-DNA in the cerebrospinal fluid and serum. Although MTX-associated lymphoproliferative disorders are well-known complications in patients with RA, EBV encephalitis requires careful attention for such patients undergoing treatment with multiple potent immunosuppressants.
Identification of TAZ as the essential molecular switch in orchestrating SCLC phenotypic transition and metastasis
Authors: Jin Yujuan , Zhao Qiqi , Zhu Weikang , Feng Yan , Xiao Tian , Zhang Peng , Jiang Liyan , Hou Yingyong , Guo Chenchen , Huang Hsinyi , Chen Yabin , Tong Xinyuan , Cao Jiayu , Li Fei , Zhu Xueliang , Qin Jun , Gao Dong , Liu Xin-Yuan , Zhang Hua , Chen Luonan , Thomas Roman K , Wong Kwok-Kin , Zhang Lei , Wang Yong , Hu Liang , Ji Hongbin
Published: December 2021

Small-cell lung cancer (SCLC) is a recalcitrant cancer characterized by high metastasis. However, the exact cell type contributing to metastasis remains elusive. Using a Rb1L/L/Trp53L/L mouse model, we identify the NCAMhiCD44lo/– subpopulation as the SCLC metastasizing cell (SMC), which is progressively transitioned from the non-metastasizing NCAMloCD44hi cell (non-SMC). Integrative chromatin accessibility and gene expression profiling studies reveal the important role of the SWI/SNF complex, and knockout of its central component, Brg1, significantly inhibits such phenotypic transition and metastasis. Mechanistically, TAZ is silenced by the SWI/SNF complex during SCLC malignant progression, and its knockdown promotes SMC transition and metastasis. Importantly, ectopic TAZ expression reversely drives SMC-to-non-SMC transition and alleviates metastasis. Single-cell RNA-sequencing analyses identify SMC as the dominant subpopulation in human SCLC metastasis, and immunostaining data show a positive correlation between TAZ and patient prognosis. These data uncover high SCLC plasticity and identify TAZ as the key molecular switch in orchestrating SCLC phenotypic transition and metastasis.
Short-Term Safety of Booster Immunization With BNT162b2 mRNA COVID-19 Vaccine in Healthcare Workers
Authors: Paran Yael , Saiag Esther , Spitzer Avishay , Angel Yoel , Yakubovsky Michal , Padova Hagit , Ben-Ami Ronen , Goldinger Ilana , Gamzu Ronni , Sprecher Eli , Zeltser David , Henig Oryan
Published: December 2021

This study demonstrated a favorable short-term safety profile after a third dose of the BNT162b2 vaccine among healthcare workers (HCWs). There were more frequent local reactions and less systemic reactions compared to the second dose. The HCWs who reported reactions had higher prebooster titer of anti-S1 antibodies compared to those who reported no reactions.
Governance Networks, Bureaucracy, and Democracy
Authors: Morçöl Göktuğ , Shafi Saahir , Menon Aravind
Published: December 2021

Are bureaucratic and network forms of organization compatible with democracy? Two observations made in the literature inspire this question: Liberal democracies around the world have been challenged by populist authoritarian movements and leaders, and multicentric forms of governance (i.e., governance networks) are utilized increasingly in public policymaking and service delivery in many of these democracies. Based on these observations, we propose that a conceptual investigation of the possible links between three ideal types of democracy (i.e., liberal, deliberative/discursive, and practice-based democracy) and two ideal types of social organization (bureaucracy and governance networks) can help us to better understand the challenges in public policy making and administration in the early 21st century. In doing so, we adopt Max Weber’s conceptual analytical method of using ideal typical abstractions and understanding their historical contexts. With our conceptual analysis, we demonstrate that governance networks may be problematic for liberal and deliberative forms of democracy and are most compatible with practice-based democracy. We propose that a configurational approach should be used in conceptualizing the relations between the ideal types of democracy and social organization.
Chiral waves in structured elastic systems: dynamics of a meta-waveguide
Authors: Jones I S , Movchan N V , Movchan A B
Published: December 2021

The notion of meta-surfaces is well established for waves interacting with arrays of periodic resonators. Here, an infinite elastic rod, attached to a system of gyroscopic spinners, is considered. This forms a waveguide with unusual dispersion properties and will be referred to as a chiral meta-waveguide. A class of transient and time-harmonic formulations describing waves in elastic chiral meta-waveguides is addressed. Consideration of a chiral elastic chain leads to the governing equations of the homogenised continuous system. Both analytical and numerical solutions are presented. Features observed for chiral waveforms show resemblance with formulations of quantum physics rather than linear elasticity. For an elementary example related to an elastic chiral rod, with the absence of pre-tension, it is noted that the longitudinal velocity satisfies the Klein–Gordon equation. For full vector problems, corresponding to an elastic chiral rod with pre-tension, time-harmonic Green’s matrix functions are derived for the case of large values of the gyricity parameter. This case is especially interesting because of the presence of both exponentially localised and oscillatory terms in the representation of Green’s matrix components.
INVESTIGATION OF ENVIRONMENTAL RADIOACTIVITY AT A DECOMMISSIONED URANIUM MINE IN SOUTHERN CHINA
Authors: Wu Hexi , Di Runjie , Liu Yibao , Liu Yujuan , Xiong Chao , Shi Yuke
Published: December 2021

An environmental radioactivity survey was performed on a uranium mine that has been decommissioned for >10 y. According to the characteristics of this uranium mine, the relevant parameters, such as the surface-absorbed dose rate in air, the radon and radon progeny concentrations in the air, the radon exhalation rate from the soil surface and the concentrations of natural radionuclides in soil and surface water, were measured. The results show that the maximum annual effective doses of residents and employees in the uranium mine caused by radon and radon progenies inhalation were 1.48 and 1.74 mSv, respectively, and the maximum annual effective doses of residents and employees caused by gamma-ray external radiation were 1.16 and 1.32 mSv, respectively.
Contextual influences on implementation of online behavioral obesity treatment in primary care: formative evaluation guided by the consolidated framework for implementation research
Authors: Espel-Huynh Hallie M , Goldstein Carly M , Stephens Michael L , Finnegan Olivia L , Elwy A Rani , Wing Rena R , Thomas J Graham
Published: December 2021

Online behavioral obesity treatment is a promising first-line approach to weight management in primary care. However, little is known about contextual influences on implementation. Understand qualitative contextual factors that affect the implementation process, as experienced by key primary care stakeholders implementing the program. Online behavioral obesity treatment was implemented across a 60-clinic primary care practice network. Patients were enrolled by nurse care managers (NCMs; N = 14), each serving 2–5 practices. NCMs were randomized to one of two implementation conditions—“Basic” (standard implementation) or “Enhanced” (i.e., with added patient tracking features and more implementation strategies employed). NCMs completed qualitative interviews guided by the Consolidated Framework for Implementation Research (CFIR). Interviews were transcribed and analyzed via directed content analysis. Emergent categories were summarized by implementation condition and assigned a valence according to positive/negative influence. Individuals in the Enhanced condition viewed two aspects of the intervention as more positively influencing than Basic NCMs: Design Quality & Packaging (i.e., online program aesthetics), and Cost (i.e., no-cost program, clinician time savings). In both conditions, strongly facilitating factors included: Compatibility between intervention and clinical context; Intervention Source (from a trusted local university); and Evidence Strength & Quality supporting effectiveness. Findings highlight the importance of considering stakeholders’ perspectives on the most valued types of evidence when introducing a new intervention, ensuring the program aligns with organizational priorities, and considering how training resources and feedback on patient progress can improve implementation success for online behavioral obesity treatment in primary care.
Sequencing SARS-CoV-2 genomes from saliva
Authors: Alpert Tara , Vogels Chantal B F , Breban Mallery I , Petrone Mary E , Wyllie Anne L , Grubaugh Nathan D , Fauver Joseph R
Published: December 2021

Genomic sequencing is crucial to understanding the epidemiology and evolution of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Often, genomic studies rely on remnant diagnostic material, typically nasopharyngeal (NP) swabs, as input into whole-genome SARS-CoV-2 next-generation sequencing pipelines. Saliva has proven to be a safe and stable specimen for the detection of SARS-CoV-2 RNA via traditional diagnostic assays; however, saliva is not commonly used for SARS-CoV-2 sequencing. Using the ARTIC Network amplicon-generation approach with sequencing on the Oxford Nanopore MinION, we demonstrate that sequencing SARS-CoV-2 from saliva produces genomes comparable to those from NP swabs, and that RNA extraction is necessary to generate complete genomes from saliva. In this study, we show that saliva is a useful specimen type for genomic studies of SARS-CoV-2.
Cinematic Simulation
Authors: Sheridan Rhonda , Williams Jacque
Published: December 2021

With fewer clinical placements for psychiatric mental health (PMH) education and a steady increase in student enrollment, faculty search for creative ways to replace patient care experiences for students to achieve high-quality learning outcomes. Simulation is an acceptable practice for patient care experiences, but research related to PMH simulation is limited. This article describes the development, implementation, and evaluation of cinematic simulation, an innovative PMH clinical experience where students engage in watching films while performing the various aspects of the nursing role.
Cutaneous Plasmacytosis and Idiopathic Multicentric Castleman Disease: A Spectrum of Disease?
Authors: Drissi Madeeha , Dunlap Rachel , Clayton Lara , Raess Philipp W. , Mengden Koon Stephanie , White Kevin
Published: December 2021

Cutaneous/systemic plasmacytosis (C/SP) is a plasma cell disorder characterized by reddish–brown patches, lymphadenopathy, and hypergammaglobulinemia. The degree to which C/SP overlaps with other plasma cell proliferative disorders and neoplasms is incompletely understood. We present the case of a patient with a several-year history of cutaneous plasmacytosis and evidence of systemic involvement with concurrent idiopathic multicentric Castleman disease (iMCD) involving a lymph node. There have been only a few reports of systemic iMCD preceded by a long, asymptomatic phase of cutaneous manifestations. We discuss the relationship between C/SP and iMCD and elaborate on the pathophysiological overlap of these 2 conditions and potential similarities in their pathogenesis. We suggest that the 2 diseases may represent the same entity presenting on a spectrum, with individuals diagnosed with C/SP at risk for progression to iMCD.
Melanocytic Panfolliculoma: A Case Report of a Rare Benign Follicular Tumor
Authors: Preston Allie , West Cameron , McCollough Martha , Hosler Gregory A.
Published: December 2021

Panfolliculomas (PF) are rare, benign, follicular tumors that differentiate toward multiple components of the hair follicle, and several variants have been described. We present a case of a rare pigmented PF presenting on actinically damaged skin in an 83-year-old man, which was clinically concerning for malignancy. This tumor arose near an area of atypical squamous proliferation and has evidence of infundibular, outer root sheath, and matrical differentiation and foci of heavy melanin pigmentation and increased melanocytes. We propose the novel designation of “melanocytic PF,” akin to melanocytic matricoma but with panfollicular differentiation.
Prolonged viral positivity induced recurrent coronavirus disease 2019 (COVID-19) pneumonia in patients receiving anti-CD20 monoclonal antibody treatment
Authors: Deveci Burak , Saba Rabin
Published: December 2021

Introduction:

The outbreak of novel coronavirus (severe acute respiratory syndrome coronavirus 2), which causes the coronavirus disease 2019 (COVID-19), is the most important current health problem. The number of patients is increasing worldwide. Pneumonia is the most life-threatening complication of the disease. Prolonged viral shedding in hematological patients with COVID-19 has been demonstrated; however, data on COVID-19 patients receiving anti-CD20 monoclonal antibody therapy are limited. Accordingly, focusing on humoral immunity, herein, we present 4 COVID-19 patients who were on anti-CD20 monoclonal antibody treatment and had prolonged pneumonia.

Patient concerns:

Two of 4 patients were on rituximab and the other 2 were on obinutuzumab therapy.

Diagnosis:

The polymerase chain reaction test results for severe acute respiratory syndrome coronavirus 2 were positive for all 4 patients and their COVID pneumonia lasted for >50 days.

Interventions:

Although all patients were treated with an adequate amount of convalescent plasma, prolonged polymerase chain reaction positivity and prolonged pneumonia were possibly due to the lack of ability of the immune system to initiate its antibody response.

Outcomes:

Despite the administration of standard therapies, recurrent pneumonia observed in the present case series of non-neutropenic patients, in whom primary malignancies were under control.

Conclusions:

It is suggested that further investigations should be performed to understand the underlying pathophysiology.
Comparison of Sodium Bicarbonate and Lactated Ringers Hydration for High-dose Methotrexate Chemotherapy in Children
Authors: Kendrick Jennifer , Jacques Lisa , Baadjes Björn , Carr Roxane
Published: December 2021

Background:

High-dose methotrexate is part of the treatment of pediatric cancers. To reduce the risk of toxicity, supportive measures, including hydration and alkalinization, are recommended. At our institution, we switched from intravenous sodium bicarbonate to Lactated Ringers during a worldwide shortage.

Procedure:

This was a retrospective cohort of children who received high-dose methotrexate from January 1, 2016 to August 31, 2018. The primary outcome was the prevalence of delayed methotrexate clearance. Secondary outcomes were proportion of cycles with delayed methotrexate clearance, time to methotrexate clearance, adverse events, risk factors for delayed clearance, and association between hydration type and delayed clearance.

Results:

Eighty-two patients, with a total of 325 methotrexate cycles, were included. Forty-four patients received sodium bicarbonate, 31 received Lactated Ringers, and 7 received both. There was no difference in the prevalence of delayed methotrexate clearance between those who received sodium bicarbonate and Lactated Ringers (64% vs. 68%). The proportion of cycles with delayed methotrexate clearance, time to methotrexate clearance, and adverse events were similar between groups. Cancer type, methotrexate dose, and vomiting were associated with delayed clearance.

Conclusions:

Our study suggests that Lactated Ringers may be used in place of sodium bicarbonate for intravenous hydration during high-dose methotrexate.
Adaptation of Metabolomics and Microbiomic Research Protocols During the COVID-19 Pandemic
Authors: Butts Brittany , Alford Taqiyya , Brewster Glenna , Carlson Nicole , Coleman Ebony , Davis Erica , Ferranti Erin , Kimble Laura P. , Narapareddy Laren , Wells Jessica , Yang Irene
Published: December 2021

Background

When the COVID-19 pandemic hit in 2020, researchers in the P30 Center for the Study of Symptom Science, Metabolomics, and Multiple Chronic Conditions at Emory University’s Nell Hodgson Woodruff School of Nursing faced major challenges in recruitment and data collection because of limited access to the clinic and community facilities and the risk of COVID-19 exposure associated with in-person study contact.

Objectives

The purpose of this article is to (a) describe how a cadre of pilot/supplement principal investigators adapted their studies to allow for safe and trustworthy data collection during the COVID-19 pandemic (March 2020 through date of publication) and (b) discuss steps that facilitated the technical aspects of remote data collection, especially involving biological specimens.

Results

Four pilot studies and two administrative supplements within the center—all at different stages of execution—adopted various alternative remote recruitment, enrollment, and data and specimen collection approaches to continue their research endeavors in a way that maximized the safety of both the research participants and the research teams.

Discussion

The article concludes with a discussion on the importance of a participant-centered approach when using remote methods, actions, or steps initiated to facilitate the technical aspects of remote data collection and reflections on the continued use of remote research strategies beyond the COVID-19 pandemic.
Effectiveness of Ultrasound-Guided Versus Anatomic Landmark–Guided Corticosteroid Injection on Pain, Physical Function, and Safety in Patients With Subacromial Impingement Syndrome
Authors: Deng Xiaoyan , Zhu Siyi , Li Daishun , Luo Yi , Zhang Xin , Tan Yanling , Li Juan , He Xia
Published: December 2021

Objective

The aim of the study was to compare the efficacy and safety of ultrasound-guided versus anatomic landmark–guided corticosteroid injection for the treatment of subacromial impingement syndrome.

Design

PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, Scopus, ClinicalTrials.gov, CBM, CNKI, and Wanfang databases were searched from inception to August 15, 2021, for randomized controlled trials comparing ultrasound-guided versus anatomic landmark–guided injections of corticosteroids for the treatment of subacromial impingement syndrome.

Results

Twelve randomized controlled trials with 891 patients were included in this study; 454 patients received ultrasound-guided injections and 437 received anatomic landmark–guided injections. Pooled results showed that ultrasound-guided injection was more beneficial for pain relief (10 trials; mean difference = −0.58; 95% confidence interval = −1.05 to −0.10; P = 0.017) and functional improvement (11 trials; standard mean difference = −0.84; 95% confidence interval = −1.41 to −0.27; P = 0.004). There was no significant difference in shoulder range of motion. In the subgroup analysis, there was a significant difference in pain relief and functional improvement at 6–8 wks and with methylprednisolone.

Conclusions

Ultrasound-guided injection of corticosteroids is potentially superior to anatomic landmark–guided injection in improving the clinical symptoms of subacromial impingement syndrome; however, these findings should be interpreted with some caution as the quality of evidence was rated as moderate to very low.
Impacts of HIV-1 Subtype Diversity on Long-Term Clinical Outcomes in Antiretroviral Therapy in Guangxi, China
Authors: Jiang He , Lan Guanghua , Zhu Qiuying , Feng Yi , Liang Shujia , Li Jianjun , Zhou Xinjuan , Lin Mei , Shao Yiming
Published: December 2021

Background:

Comprehensively estimating the impacts of HIV-1 subtype diversity on long-term clinical outcomes during antiretroviral therapy (ART) can help inform program recommendations.

Methods:

The HIV-1 sequence data and clinical records of 5950 patients from all 14 prefectures in Guangxi, China, during 2008–2020 were included. Evolutional trends of CD4+ T-lymphocyte count and viral load were explored, and the effects of HIV-1 subtypes on clinical outcomes were estimated by the Cox proportional hazards model. The polymorphisms involved in drug resistance mutation were analyzed.

Results:

Compared with patients with CRF07_BC, patients with CRF01_AE and CRF08_BC showed poor immunologic and virologic responses to antiretroviral therapy. Although the median expected time from ART initiation to virologic suppression for all patients was approximately 12 months, patients with CRF01_AE and CRF08_BC had a long time to achieve immune recovery and a short time to occur immunologic failure, compared with patients with CRF07_BC. Adjusted analysis showed that both CRF01_AE and CRF08_BC were the negative factors in immune recovery and long-term mortality. In addition, CRF08_BC was a negative factor in virologic suppression and a risk factor of virologic failure. This poor virologic response might result from the high prevalence of drug resistance mutation in CRF08_BC.

Conclusions:

Compared with patients with CRF07_BC, patients with CRF01_AE could benefit more from immediate ART, and patients with CRF08_BC are more suitable for PI-based regimens. These data emphasize the importance of routine HIV-1 genotyping before ART, immediate ART, and personalized ART regimens to improve the prognosis for patients undergoing ART.
Review of Our Experience Using Modified Staple Line Suturing Technique in Laparoscopic Sleeve Gastrectomy
Authors: Şen Ozan , Türkçapar Ahmet G.
Published: December 2021

Background:

Laparoscopic sleeve gastrectomy (LSG) has become the most common bariatric surgical method in recent years. Although LSG provides good outcomes, serious complications such as leakage, bleeding, and stenosis may develop postoperatively. Numerous staple line reinforcement methods have been used to reduce complications. Whether each one of these practices is effective remains controversial.

Aim:

Our study aims to assess outcomes and safety of modified (purse-string+oversewing) staple line suturing technique for patients who underwent LSG.

Materials and Methods:

A total of 505 patients who underwent LSG with modified staple line suturing technique between March 2018 and February 2021 were included in this retrospective study. Age, sex, body mass index, operation time, perioperative and postoperative 30-day complications were recorded in all patients.

Results:

Of 505 patients (59.6% female) with a mean age of 37.6 years (minimum to maximum: 12 to 68 y) and median body mass index of 40.2 kg/m2 (minimum to maximum: 32 to 75 kg/m2) underwent LSG. LSG was performed as revision surgery in 17 (3.4%) patients. Five (1%) patients also underwent concomitant cholecystectomy. The mean operation time was 92 minutes (75 to 110 min) in our primary LSG cases. Operative complications included minor hepatic injury in 8 (1.6%) and anesthesia awareness in 3 (0.6%) patients. Postoperative complications included bleeding which occurred in 2 (0.4%) patients, portomesenteric vein thrombosis in 1 (0.2%), and minor wound infection in 3 (0.6%) patients. There was no leak, no stenosis, and no mortality.

Conclusion:

Sleeve gastrectomy with modified staple line suturing technique is an effective method and could be safely applied with low morbidity.
Preferential Mobilization of Colonic Hepatic Flexure Facilitates Pancreaticoduodenectomy Procedures
Authors: Liang Hongyin , Cheng Long , Yan Hongtao , Cui Jianfeng
Published: December 2021

Background:

Several studies recommend that colonic hepatic flexure (CHF) should be mobilized preliminarily in minimally invasive pancreaticoduodenectomy (PD). However, there are little data to support that preferential mobilization of the CHF can positively affect the perioperative events of PD. We aimed to assess the effect of preferential mobilization of the CHF in PD.

Methods:

A retrospective cohort study of patients who underwent PD was performed between 2016 and 2019. Clinical characteristics, operative data, and postoperative surgical complications were recorded.

Results:

The study included 668 patients; 486 patients underwent open pancreaticoduodenectomy (OPD) and 182 patients underwent laparoscopic pancreaticoduodenectomy (LPD). Patients were divided into CHF-M (OPD, n=129; LPD, n=95) and conventional (OPD, n=357; LPD, n=87) groups according to preferential CHF mobilization. There were no differences between the groups regarding most demographics. Within patients who underwent OPD, decreased estimated blood loss (EBL) (251.2±146.4 vs. 307.3±173.5 mL, P<0.05) was observed in CHF-M group. Within patients who underwent LPD, operative time (328.7±66.3 vs. 406.5±85.5 min, P<0.001), EBL (166.8±96.4 vs. 271.8±130.7 mL, P<0.001), the incidence of clinically relevant pancreaticfistula (7.4% vs. 23.0%, P<0.05), and length of stay (12.3±5.1 vs. 16.0±7.4 d, P<0.05) were decreased in CHF-M group. Moreover, patients with high body mass index who underwent LPD showed more significant differences in operative time (336.0±67.7 vs. 431.9±79.1, P<0.001) and EBL (179.6±97.8 vs. 278.2±135.6, P<0.001) between groups.

Conclusion:

We first demonstrated that preferential mobilization of the CHF can facilitate PD. The patients who underwent minimally invasive surgery and the patients with high body mass index may benefit more from this technique.
The Feasibility and Potential Advantages of Laparoscopic Management of Incarcerated Obturator Hernia Over the Open Approach
Authors: Zhang Zhi , Yuan Jianmao , Gu Zhigang , Tu Zhengbin , Huang Weixian , Shen Genhai
Published: December 2021

Purpose:

The purpose of this study was to explore the feasibility and potential advantages of laparoscopic surgery in the treatment of incarcerated obturator hernia (IOH).

Materials and Methods:

Clinical data of 23 patients with IOH who underwent emergency surgery at our hospital from June 2015 to October 2020 were retrospectively analyzed. The clinical characteristics and surgery outcomes were compared between the laparoscopic group, open group, and the previously published data.

Results:

Twelve patients with IOH were treated by laparoscopic management, while 11 patients with IOH underwent open surgery. There was no statistically significant difference in preoperative general data between the 2 groups, while the laparoscopic group had less intraoperative blood loss, shorter postoperative hospital stay, and lower postoperative complications compared with open group. Furthermore, when compared with the open group reported in previous literature, which showed similar conclusions.

Conclusion:

Laparoscopic surgery for IOH showed more favorable advantages including less intraoperative blood loss, shorter postoperative hospital stay, and lower postoperative complications compared with an open approach, which is a safe and feasible minimally invasive strategy and has certain advantages.
Deoxycholic acid liganded HBs contributes to HBV maturation
Authors: Gao Yuxue , Ning Qiqi , Yang Pengxiang , Zhang Yulin , Guan Yuanyue , Liu Ning , Ben Haijing , Wang Yang , Liu Mengcheng , Yang Tongwang , Cai Yuying , Hu Zhongjie , Jiang Mengxi , Chen Dexi
Published: December 2021

Understanding the underlying mechanism of HBV maturation and subviral particle production is critical to control HBV infection and develop new antiviral strategies. Here, we demonstrate that deoxycholic acid (DCA) plays a central role in HBV production. HBV infection increased DCA levels, whereas elimination of DCA-producing microbiome decreased HBV viral load. DCA can bind to HBs antigen via LXXLL motif at TM1 and TM2 region to regulate HBs-HBc interaction and the production of mature HBV. Plasma DCA levels from patients undergoing antiviral therapy were significantly higher in those with positive HBV viral load. These results suggest that intestinal DCA-producing microbiome can affect the efficiency of antiviral therapy and provide a potential novel strategy for HBV antiviral therapy.

One Sentence Summary

We demonstrate that DCA-promoted HBs-HBc interaction and contributes to HBV maturation.
Evaluation of the Cepheid Xpert Xpress SARS-CoV-2 test for bronchoalveolar lavage
Authors: Phan Tung , Mays Ashley , McCullough Melissa , Wells Alan
Published: December 2021

Accurate and rapid laboratory tests are essential for the prompt diagnosis of COVID-19, which is important to patients and infection control. The Xpert Xpress SARS-CoV-2 test is a real-time RT-PCR intended for the qualitative detection of nucleic acid from SARS-CoV-2 in upper respiratory specimens. In this study, we assessed the analytical and clinical performance characteristics of this rapid test for SARS-CoV-2 in 60 bronchoalveolar lavage (BAL) specimens. BAL is a specimen type that is not authorized under EUA for the Xpert Xpress SARS-CoV-2 test. The limit of detection of the Xpert Xpress SARS-CoV-2 test was 500 copies/ml. The overall agreement of the Xpert Xpress SARS-CoV-2 test was 100%. The Xpert Xpress SARS-CoV-2 test is sensitive and specific to aid in diagnosis of COVID-19 using bronchoalveolar lavage.
Disentangling Socioeconomic Status and Race in Infant Outcomes: A Neural Network Analysis
Authors: Sarullo Kathryn , Barch Deanna M. , Smyser Christopher D. , Rogers Cynthia , Warner Barbara B. , Miller J. Philip , England Sarah K. , Luby Joan , Swamidass S. Joshua
Published: December 2021

Race is commonly used as a proxy for multiple features including socioeconomic status. It is critical to dissociate these factors, identify mechanisms that impact infant outcomes, such as birthweight, and direct appropriate interventions and shape public policy. Demographic, socioeconomic, and clinical variables were used to model infant birthweight. Non-linear neural networks better model infant birthweight than linear models (R2 = 0.172 vs. R2 = 0.145, p-value=0.005). In contrast to linear models, non-linear models ranked income, neighborhood disadvantage, and experiences of discrimination higher in importance while modeling birthweight than race. Consistent with extant social science literature, findings suggest race is a linear proxy for non-linear factors. The ability to disentangle and identify the source of effects for socioeconomic status and other social factors that often correlate with race is critical for the ability to appropriately target interventions and public policies designed to improve infant outcomes as well as point out the disparities in these outcomes.
Soluble immune checkpoints are dysregulated in COVID-19 and heavy alcohol users with HIV infection
Authors: Li Wei , Syed Fahim , Yu Richard , Yang Jing , Xia Ying , Relich Ryan F. , Zhang Shanxiang , Khalili Mandana , Huang Laurence , Kacena Melissa A. , Zheng Xiaoqun , Yu Qigui
Published: December 2021

Immune checkpoints (ICPs) consist of paired receptor-ligand molecules that exert inhibitory or stimulatory effects on immune defense, surveillance, regulation, and self-tolerance. ICPs exist in both membrane and soluble formsin vivoandin vitro. Imbalances between inhibitory and stimulatory membrane-bound ICPs (mICPs) in malignant cells and immune cells in the tumor immune microenvironment (TIME) have been well documented. Blockades of inhibitory mICPs have emerged as an immense breakthrough in cancer therapeutics. However, the origin, structure, production regulation, and biological significance of soluble ICPs (sICPs) in health and disease largely remains elusive. Soluble ICPs can be generated through either alternative mRNA splicing and secretion or protease-mediated shedding from mICPs. Since sICPs are found in the bloodstream, they likely form a circulating immune regulatory system. In fact, there is increasing evidence that sICPs exhibit biological functions including (1) regulation of antibacterial immunity, (2) interaction with their mICP compartments to positively or negatively regulate immune responses, and (3) competition with their mICP compartments for binding to the ICP blocking antibodies, thereby reducing the efficacy of ICP blockade therapies. Here, we summarize current data of sICPs in cancer and infectious diseases. We particularly focus on sICPs in COVID-19 and HIV infection as they are the two ongoing global pandemics and have created the world’s most serious public health challenges. A “storm” of sICPs occurs in the peripheral circulation of COVID-19 patients and is associated with the severity of COVID-19. Similarly, sICPs are highly dysregulated in people living with HIV (PLHIV) and some sICPs remain dysregulated in PLHIV on antiretroviral therapy (ART), indicating these sICPs may serve as biomarkers of incomplete immune reconstitution in PLHIV on ART. We reveal that HIV infection in the setting of alcohol abuse exacerbates sICP dysregulation as PLHIV with heavy alcohol consumption have significantly elevated plasma levels of many sICPs. Thus, both stimulatory and inhibitory sICPs are present in the bloodstream of healthy people and their balance can be disrupted under pathophysiological conditions such as cancer, COVID-19, HIV infection, and alcohol abuse. There is an urgent need to study the role of sICPs in immune regulation in health and disease.
Characteristics and outcomes of cases of children and adolescents with pediatric inflammatory multisystem syndrome in a tertiary care center in Mexico City
Authors: Guevara Ricardo Gil , de Lourdes Marroquín Yáñez María , Jiménez-Juárez Rodolfo Norberto , Lopez Víctor Olivar , Chávez Lopez Adrián , Monge Juan José Luis Sienra , del Carmen Jamaica Balderas Lourdes Maria , Herrera Silvia Alexandra Martínez , Domínguez-Barrera Clemen , Orellana Julio Erdmenger , González Horacio Márquez , Klünder-Klünder Miguel , Zermeño Jaime Nieto , Guillen Mónica Villa , García Nadia González , Castilla-Peon Maria F
Published: December 2021

Background

pediatric inflammatory multisystem syndrome (PIMS) is a complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children that resembles Kawasaki syndrome and places them at high risk of cardiorespiratory instability and/or cardiac damage. This study aims to describe the clinical presentation and outcomes of patients with PIMS in Mexico City.

Methods

This was an observational study of children hospitalized for PIMS based on the Centers for Disease Control and Prevention case definition criteria, in a single tertiary care pediatric center in Mexico City between May 1, 2020, and September 30, 2021. Demographic characteristics, epidemiological data, medical history, laboratory tests, cardiology evaluations, treatment, and clinical outcomes were analyzed.

Results

Seventy-five cases fulfilled the case definition criteria for PIMS (median age: 10.9 years, Interquartile range [IQR]: 5.6–15.6). Fifteen (20%) patients had a severe underlying disease, 48 (64%) were admitted to the intensive care unit, 33 (44%) required invasive mechanical ventilation and 39 (52%) received vasopressor support. The patients were clustered through latent class analysis based on identified symptoms: Cluster 1 had rash or gastrointestinal symptoms (n = 60) and cluster 2 were those with predominantly respiratory manifestations (n = 15). Two patients (2.7%) died, and both had severe underlying conditions. Five patients (6.7%), all from cluster 1, developed coronary aneurysms.

Conclusion

There were a high proportion of patients with severe respiratory involvement and positive RT-PCR SARS-CoV-2 and very few cases of coronary aneurysms in our study which suggests that a high proportion of the children had severe acute COVID-19. The clinical manifestations and outcomes are comparable to previously reported international studies.
Prediction of ADHD diagnosis using brief, low-cost, clinical measures: a competitive model evaluation
Authors: Mooney Michael A. , Neighbor Christopher , Karalunas Sarah , Dieckmann Nathan F. , Nikolas Molly , Nousen Elizabeth , Tipsord Jessica , Song Xubo , Nigg Joel T.
Published: December 2021

Proper diagnosis of ADHD is costly, requiring in-depth evaluation via interview, multi-informant and observational assessment, and scrutiny of possible other conditions. The increasing availability of data may allow the development of machine-learning algorithms capable of accurate diagnostic predictions using low-cost measures. We report on the performance of multiple classification methods used to predict a clinician-consensus ADHD diagnosis. Classification methods ranged from fairly simple (e.g., logistic regression) to more complex (e.g., random forest), and also included a multi-stage Bayesian approach. All methods were evaluated in two large (N>1000), independent cohorts. The multi-stage Bayesian classifier provides an intuitive approach that is consistent with clinical workflows, and is able to predict ADHD diagnosis with high accuracy (>86%)—though not significantly better than other commonly used classifiers, including logistic regression. Results suggest that data from parent and teacher surveys is sufficient for high-confidence classifications in the vast majority of cases using relatively straightforward methods.
Monoclonal antibody treatment drives rapid culture conversion in SARS-CoV-2 infection
Authors: Boucau Julie , Chew Kara W. , Choudhary Manish , Deo Rinki , Regan James , Flynn James P. , Crain Charles R. , Hughes Michael D. , Ritz Justin , Moser Carlee , Dragavon Joan A. , Javan Arzhang C. , Nirula Ajay , Klekotka Paul , Greninger Alexander L. , Coombs Robert W. , Fischer William A , Daar Eric S. , Wohl David A. , Eron Joseph J. , Currier Judith S. , Smith Davey M , Li Jonathan Z. , Barczak Amy K. ,   for the ACTIV-2/A5401 Study Team
Published: December 2021

Monoclonal antibodies (mAbs) are the treatment of choice for high-risk ambulatory persons with mild to moderate COVID-19. We studied viral culture dynamics post-treatment in a subset of participants receiving the mAb bamlanivimab in the ACTIV-2 trial. Viral load by qPCR and viral culture were performed from anterior nasal swabs collected on study days 0 (day of treatment), 1, 2, 3, and 7. Treatment with mAb resulted in rapid clearance of culturable virus in participants without treatment-emergent resistance. One day after treatment, 0 of 28 (0%) participants receiving mAb and 16 of 39 (41%) receiving placebo still had culturable virus (p <0.0001); nasal viral loads were only modestly lower in the mAb-treated group at days 2 and 3. Recrudescence of culturable virus was detected in three participants with emerging mAb resistance and viral load rebound. The rapid reduction in shedding of viable SARS-CoV-2 after mAb treatment highlights the potential role of mAbs in preventing disease transmission.
STATISTICAL AND MULTIVARIATE TECHNIQUES TO TRACE THE SOURCES OF GROUND WATER CONTAMINANTS AND AFFECTING FACTORS OF GROUNDWATER POLLUTION IN AN OIL AND GAS PRODUCING WETLAND IN RIVERS STATE, NIGERIA
Authors: Raimi Olalekan Morufu , Ezekwe Clinton Ifeanyichukwu , Bowale Abiodun
Published: December 2021

Background

Groundwater is an important source of drinking water for the indigenous communities of Ebocha-Obrikom. Access to safe drinking water, in particular, is critical to one’s health and, by extension, one’s income and well-being. Underground wells are the primary supply of drinking water in the Niger Delta, and the groundwater is not always treated before consumption. As a result, water continues to be vital environmental component that affects both humans and other life forms.

Objectives

The aims of the research is to trace the sources and affecting factors of groundwater pollution via statistical and multivariate statistical techniques.

Method

The investigation made use of standard analytical procedures. All sampling, conservation, transportation and analysis followed standard procedures described in APHA (2012). To prevent degradation of the organic substances, all obtained samples were transferred to the laboratory, while keeping in an icebox.

Results

The study reveals that the greater the number of principal components extracted the greater variation in geochemical composition of the ground waters. It indicated that 34 parameters were distributed into six (6) and nine (9) principal components (PCs) extracted for groundwater samples for both rainy and dry seasons, potentially suggesting the input of different pollutants from different sources. Gas flaring, mineral dissolution/precipitation and anthropogenic input are the main sources of th physicochemical indices and trace elements in the groundwater. Groundwater chemistry is predominantly regulated by natural processes such as dissolution of carbonates, silicates, and evaporates and soil leaching, followed by human activities. Climatic factors and land use types are also important in affecting groundwater chemistry.

Conclusion

Greater efforts should be made to safeguard groundwater, which is hampered by geogenic and anthropogenic activities, in order to achieve sustainable groundwater development. As a result, communities are recommended to maintain a groundwater management policy to ensure long-term sustainability. The study is useful for understanding groundwater trace sources in Rivers State’s Ebocha- Obrikom districts. Such understanding would enable informed mitigation or eradication of the possibl detrimental health consequences of this groundwater, whether through its use as drinking water or indirectly through consumption of groundwater-irrigated crops. As a result, determining its primary probable source of pollution (MPSP) is critical since it provides a clearer and more immediate interpretation. Furthermore, the research findings can be used as a reference for groundwater pollution prevention and water resource protection in the Niger Delta region of Nigeria.
Real-time Estimation of Global CFR Ascribed to COVID-19 Confirmed Cases Applying Machine Learning Technique
Authors: Pattnaik Monalisha , Pattnaik Aryan
Published: December 2021

The COVID-19 is declared as a public health emergency of global concern by World Health Organisation (WHO) affecting a total of 201 countries across the globe during the period December 2019 to January 2021. As of January 25, 2021, it has caused a pandemic outbreak with more than 99 million confirmed cases and more than 2 million deaths worldwide. The crisp of this paper is to estimate the global risk in terms of CFR of the COVID-19 pandemic for seventy deeply affected countries. An optimal regression tree algorithm under machine learning technique is applied which identified four significant features like diabetes prevalence, total number of deaths in thousands, total number of confirmed cases in thousands, and hospital beds per 1000 out of fifteen input features. This real-time estimation will provide deep insights into the early detection of CFR for the countries under study.

CFR

as suggested by (Boldog et al., 2020, Chakraborty et al. 2019, Russell et al., 2020)

Diabetes Prevalence

proportion of a population who have diabetes in a given period of time.

Stringency Index

it provides a computable parameter to evaluate the effectiveness of the nationwide lock down in a particular country.

GDP Per Capita

it is a metric that breaks down a country’s economic output per person and is calculated by

Population Density

it is a measurement of population per unit area. It refers to the number of people living in an area per square kilometre.

HDI

it is a statistic composite index of life expectancy, education (literacy rate, gross enrolment ratio at different levels and net attendance ratio) and per capita income indicators which are used to rank countries into four tiers of human development.