bluuebunny/crossref_metadata_2025 huggingface dataset:
Yield of Brain Magnetic Resonance Imaging in Epilepsy Diagnosis from 1998 to 2020: A Large Retrospective Cohort Study
Authors: Stern Tomer , Kornreich Liora , Goldberg Hadassa
Published: July 2021

Background We aimed to find the clinical significance of brain abnormalities on magnetic resonance imaging (MRI) in epilepsy and the lateralization of these findings with electroencephalogram (EEG).

Methods We retrospectively analyzed the results of all EEGs and brain MRIs of 600 consecutive epilepsy patients from 1998 to 2020.

Results Data were available for 563 cases (267 females). Ninety percent of the patients were 18 years old or younger. A total of 345 patients (61.3%) had focal epilepsy, 180 (32%), generalized, and 38 (6.7%), inconclusive. In 187 (33.2%), the first MRI was abnormal and in 81 (out of 108 repeated MRI), the second was pathological. The most frequent brain abnormalities were cortical dysplasia in 41 (18.1%), other structural abnormalities in 25 (11%), various phacomatoses in 23 (10.1%), and mesial temporal sclerosis in 17 (7.5%). Among 226 patients with abnormal MRI, 171 (75.6%) had focal epilepsy when compared with 36 (15.9%) with generalized epilepsy (p <0.001). In 121 patients (53.5%), the result of the abnormal MRI contributed significantly to the understanding of the epilepsy etiology. The side of abnormality was lateralized to the EEG focus in 120 cases (53%); in 10/15 cases with infantile spasms (66%), MRI was significantly abnormal. In 33, in whom the first MRI was normal, a second MRI revealed a significant abnormality.

Conclusion Brain MRI is an important tool in epilepsy diagnosis, mainly in focal seizures and infantile spasms. A repeat MRI is mandatory in intractable focal cases to improve the yield of this test.
Urine Quantification Following Furosemide for Severe Acute Kidney Injury Prediction in Critically Ill Children
Authors: Gist Katja M. , Penk Jamie , Wald Eric L. , Kitzmiller Laura , Webb Tennille N. , Krallman Kelli , Brinton John , Soranno Danielle E. , Goldstein Stuart L. , Basu Rajit K.
Published: July 2021

A standardized, quantified assessment of furosemide responsiveness predicts acute kidney injury (AKI) in children after cardiac surgery and AKI progression in critically ill adults. The purpose of this study was to determine if response to furosemide is predictive of severe AKI in critically ill children outside of cardiac surgery. We performed a multicenter retrospective study of critically ill children. Quantification of furosemide response was based on urine flow rate (normalized for weight) measurement 0 to 6 hours after the dose. The primary outcome was presence of creatinine defined severe AKI (Kidney Disease Improving Global Outcomes stage 2 or greater) within 7 days of furosemide administration. Secondary outcomes included mortality, duration of mechanical ventilation and length of stay. A total of 110 patients were analyzed. Severe AKI occurred in 20% (n = 22). Both 2- and 6-hour urine flow rate were significantly lower in those with severe AKI compared with no AKI (p = 0.002 and p < 0.001). Cutoffs for 2- and 6-hour urine flow rate for prediction of severe AKI were <4 and <3 mL/kg/hour, respectively. The adjusted odds of developing severe AKI for 2-hour urine flow rate of <4 mL/kg/hour was 4.3 (95% confidence interval [CI]: 1.33–14.15; p = 0.02). The adjusted odds of developing severe AKI for 6-hour urine flow rate of <3 mL/kg/hour was 6.19 (95% CI: 1.85–20.70; p = 0.003). Urine flow rate in response to furosemide is predictive of severe AKI in critically ill children. A prospective assessment of urine flow rate in response to furosemide for predicting subsequent severe AKI is warranted.
YouTube as a Source of Patient Information Regarding Placenta Accreta Spectrum
Authors: Castillo Jayme , Zhu Katherine , Gray Lauren , Sachse Sydney , Berra Alexandra , Belfort Michael A. , Aalipour Soroush , Aagaard Kjersti M. , Shamshirsaz Alireza A.
Published: July 2021

Objective As the awareness of the accompanying morbidity of placenta accreta spectrum (PAS) has increased over recent decades. We sought to analyze the precision and reliability of the currently available content regarding PAS on YouTube.

Study Design A YouTube search was performed on June 17, 2019 by using the search terms “placenta accreta,” “PAS,” and “invasive placentation.” Search results were sorted by relevance, and up to 200 videos per search term were systematically evaluated by four independent reviewers. A quality assessment checklist relating to aspects of PAS was developed with a Likert's scale from 0 to 12 points to quantify video content. Videos were classified as poor educational quality (grade 0 to ≤4), moderate quality (grade >4–8), and high quality (grade >8–12).

Results Of the 318 videos identified, 99 videos met inclusion criteria. The majority of videos (61.6%) were produced by a professional source, that is, appearing to be from a hospital, university, or educational service. Of the remaining videos, 16.2% were classified as personal, that is, posted from personal YouTube accounts and depicting a personal or family member experience, and 22.2% were classified as other. The majority of the “other” category consisted of news segments and short clips from talk shows. Overall, 60.6% of videos were of poor educational quality, 32.3% were of moderate quality, and 7.1% were deemed high quality. All seven of the high-quality videos were produced by a professional source and intended for an audience of medical professionals. There were neither high-quality videos intended for the general public nor the likely affected and relevant patient population.

Conclusion This study suggests that the currently available videos on YouTube regarding PAS are poor educational sources for patients seeking information, and demonstrates a need for high-quality content videos produced by medical professionals specifically focused on meeting the needs of patient population.

Key Points
A Comparative Analysis of Microscopy, Coproantigen Serology, and Nested Multiplex PCR in the Laboratory Diagnosis of Entamoeba histolytica Infection
Authors: Das Sindhusuta , Rajkumari Nonika , Gunalan Anitha , Rajavelu Dhanalakshmi , Olickal Jeby Jose
Published: July 2021

Objectives Amoebiasis is caused by the most common intestinal protozoan parasite Entamoeba histolytica. This parasite causes amoebic colitis, which is manifested by diarrhea, followed by dysentery. The laboratory diagnosis of intestinal amoebiasis in most cases is by microscopic examination of stool samples. Other nonroutine methods include coproantigen enzyme-linked immunosorbent assay (ELISA) from stool samples, serum ELISA for antibodies, stool culture, isoenzyme analysis, and polymerase chain reaction (PCR). The present study aimed to comparatively analyze the different diagnostic modalities used for the detection of E. histolytica from the stool sample of patients with intestinal amoebiasis.

Materials and Methods This study was undertaken with 631 patients, during a period of 3 years, from January 2017 to December 2019. Stool specimen obtained from each patient was subjected to direct microscopic wet mount examination, coproantigen ELISA, and nested multiplex PCR, respectively.

Results Out of all the patients tested, 5.2% were positive for E. histolytica. Among the positive cases, stool microscopy was positive in 3.17%, coproantigen ELISA was positive in 29 (4.6%) cases, and PCR was positive in 30 (4.75%) cases.

Statistical Analysis The prevalence of E. histolytica infection was summarized as percentages. The three diagnostic tests done were statistically analyzed, taking microscopy as the gold standard. The agreement between techniques (microscopy, coproantigen ELISA, and PCR) was analyzed with kappa statistics. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were summarized as percentage with 95% confidence interval.

Conclusion In all suspected amoebiasis cases, a combination of stool microscopy, coproantigen testing with molecular detection of the parasite offers the best approach to diagnosis of this parasitic infection.
Nonaccidental Trauma Managed with Open Spinal Fixation and Instrumentation and a Review of the Literature
Authors: Gigliotti Michael J. , Farou Noa , Savaliya Sandip , Rizk Elias
Published: July 2021

Nonaccidental trauma (NAT), causing spinal injury is rare and occurs in up to 3% of cases. Management of these injuries is typically conservative, and thus surgical management is not widely reported in the literature. In this case report, we presented three patients to review the effectiveness of spinal instrumentation and posterior fusion in pediatric patients due to NAT. All patients recovered well and were neurologically intact at last follow-up with no postprocedural complications noted. Spinal arthrodesis is a safe, effective way to manage spinal injuries due to NAT in cases of fracture-dislocation, distraction injuries, as well as cases involving neurologic compromise.
Exciton confined states in conjugated polymers studied by spectroscopic fluorescence polarization measurements
Authors: Vaught S. , Park H.
Published: July 2021

Spectroscopic fluorescence polarization (P) measurements have been used to investigate exciton dynamics in conjugated polymers. We apply photoluminescence anisotropy to ensembles of non-interacting organic semiconductor molecules to explore exciton migration. An experimental observation shows linearly decreasing P values as the emission wavelength increases in partially oxidized poly[2-methoxy-5-(2-ethyloxy)-1,4-phenylenevinylene] (MEH-PPV) ensemble molecules. We discuss the origin of the experimental data with a computational simulation and P values for single chromophore perylene diimide dye molecules. We propose that the physical mechanism responsible for this behavior is the presence of exciton confined and blocking states at blue-shifted emission sites, which arise from excitons in partially oxidized parts of MEH-PPV.
New contrast agents for photoacoustic imaging and theranostics: Recent 5-year overview on phthalocyanine/naphthalocyanine-based nanoparticles
Authors: Park Eun-Yeong , Oh Donghyeon , Park Sinyoung , Kim Wangyu , Kim Chulhong
Published: July 2021

The phthalocyanine (Pc) and naphthalocyanine (Nc) nanoagents have drawn much attention as contrast agents for photoacoustic (PA) imaging due to their large extinction coefficients and long absorption wavelengths in the near-infrared region. Many investigations have been conducted to enhance Pc/Ncs' photophysical properties and address their poor solubility in an aqueous solution. Many diverse strategies have been adopted, including centric metal chelation, structure modification, and peripheral substitution. This review highlights recent advances on Pc/Nc-based PA agents and their extended use for multiplexed biomedical imaging, multimodal diagnostic imaging, and image-guided phototherapy.
Observation of spatially resolved Rashba states on the surface of CH3NH3PbBr3 single crystals
Authors: Huang Zhengjie , Vardeny Shai R. , Wang Tonghui , Ahmad Zeeshan , Chanana Ashish , Vetter Eric , Yang Shijia , Liu Xiaojie , Galli Giulia , Amassian Aram , Vardeny Z. Valy , Sun Dali
Published: July 2021

Hybrid organic-inorganic perovskites (HOIPs) are prime candidates for studying Rashba effects due to the heavy metal and halogen atoms in their crystal structure coupled with predicted inversion symmetry breaking. Nevertheless, observation of the Rashba effect in cubic CH3NH3PbBr3 single crystals that possess bulk inversion symmetry is the subject of extensive debate due to the lack of conclusive experiments and theoretical explanations. Here, we provide experimental evidence that Rashba state in cubic CH3NH3PbBr3 single crystals at room temperature occurs exclusively on the crystal surface and depends on specific surface termination that results in local symmetry breaking. We demonstrate this using a suite of spatially resolved and depth-sensitive techniques, including circular photogalvanic effect, inverse spin Hall effect, and multiphoton microscopy, that are supported by first principle calculations. Our work suggests using surface Rashba states in these materials for spintronic applications.
Comparative effects of salinity and drought on seed germination, seedling growth, photosynthetic productivity, pigments content and antioxidant enzymes of castor bean (
Authors: Song Xudong , Zhou Guisheng , Shi Lv , Ahmad Irshad , Shi Xiaoxu , Zhu Guanglong , Jiao Xiurong
Published: July 2021

Salinity and drought are major abiotic stresses limiting plant growth and crop productivity. To evaluate the comparative effects of salt and drought stress on castor bean (Ricinus communis L.) germination and early seedling growth, a germination experiment and a seedling experiment were conducted to determine the responses of castor bean (cvs Zibi 5 and Zibi 9) to polyethylene glycol (PEG-6000) and sodium chloride (NaCl) with a range of gradient water potential levels, including 0 (control), –0.13 MPa, –0.2 MPa and –0.6 MPa. Results showed that both stresses caused by NaCl and PEG-6000 decreased germination percentage (GP), germination index (GI), fresh weight (FW), leaf gas exchange parameters (Pn, Ci and Tr) and chlorophyll pigments (Chl a and Chl b). The PEG-treated plants suffered higher restrictions in seed germination and seedlings growth than the NaCl-treated plants. Moreover, the PEG treatments caused more significant reductions in GP, Chl a, FW and Tr, as compared with NaCl treatment. On average, the GP under PEG stress was decreased by 22.3% and 22.0% for Zibi 5 and Zibi 9, respectively, in comparison to NaCl stress. Our study showed that both salt and water stress caused similar reductions in germination percentage, biomass accumulation, leaf gas exchange and chlorophyll pigments, while severer detrimental effects were induced by water stress as compared with salt stress.
Progesterone and anandamide diminish the inhibitory effect of zinc on mature human sperm
Authors: Matavos-Aramyan Hedieh , Keshtgar Sara , Ebrahimi Bahareh , Haghani Masoud , Maleki Setareh
Published: July 2021

Zinc ion (Zn2+) homeostasis is very important for sperm capacitation and hyperactivation. Zn2+ is a specific inhibitor of the voltage-dependent proton channel (Hv1). Intracellular alkalisation of human spermatozoa is mainly dependent on opening of Hv1. Anandamide may affect spermatozoa through activation of Hv1. An increase in intracellular pH and progesterone (P4) activate cation channels of spermatozoa (CatSper). This study was designed to elucidate the interaction between ZnCl2, P4 and anandamide on human sperm function and intracellular calcium concentrations ([Ca2+]i). Human normal semen samples (n = 30) were diluted (20 × 106 spermatozoa mL−1) and divided into control and ethanol (0.01%)-, anandamide (1 nM)-, ZnCl2 (1 mM)-, P4 (10µM)-, anandamide+ZnCl2- and P4+ZnCl2-treated groups. Sperm kinematics, viability, acrosome status and [Ca2+]i were assessed. The percentage of viable and motile spermatozoa and sperm velocity was reduced in the ZnCl2-treated groups. Anandamide and P4 attenuated the inhibitory effects of ZnCl2 on sperm kinematics. Loss of the acrosome membrane was observed in all experimental groups. P4 and anandamide are present naturally in secretions of the female reproductive tract and modulate the inhibitory effects of ZnCl2 on sperm kinematics. This attenuation is probably due to a change in [Ca2+]i and prevention of Hv1 inactivation by P4 and anandamide respectively.
The split word orders APV and PAV of Nuosu Yi
Authors: Hu Suhua
Published: July 2021

Nuosu Yi is a Tibeto-Burman (henceforth TB) language lacking sufficient core case markers. Depending on the telicity and aspectuality of the predicates, its basic word order splits into APV and rigid PAV. To be specific, the atelic and/or imperfective predicates are APV, while the telic predicates indicated by the resultativity or perfect aspect are PAV. This paper describes the semantics and syntax of the syntactic PAV and APV of Nuosu Yi thoroughly; and compares them to other TB languages in terms of role marking strategies. I propose that the conditions of split word order in Nuosu Yi are on a par with those of the split ergativity encoded by the morphological marking in Tibetan and some other TB languages; namely, the rigid PAV corresponds to the ergative alignment, and the rigid APV corresponds to the accusative alignment. The study will deepen Nuosu Yi’s morpho-syntax study and show the word order diversity to the studies of linguistic typology. Additionally, the study sheds light on the possibility of extending the definition of ergativity and its potential counterpart.
An aggregate approach to diachronic variation in modern Chinese writings and translations
Authors: Li Jialei
Published: July 2021

Modern Chinese took the place of classical Chinese and has been the standard form of writing since the early 1920s. While several studies have been carried out on diachronic variation in modern written Chinese, these include few aggregate investigations. This study examines the diachronic variation in modern Chinese writings and translations from the 1900s to the 2000s. Frequencies of multiple linguistic features sensitive to historical change were drawn from a multi-genre comparable corpus, ‘DCMCWT’, containing five periods: 1900–1911, 1919–1930, 1931–1949, 1950–1966, and 1978–2012. Hierarchical agglomerative clustering was employed for periodisation, while multidimensional scaling supplemented the developmental path. The results suggest that Chinese writings and translations fall into three broad periods: 1900–1911, 1919–1966, and 1978–2012. Chinese translations follow a similar evolutionary path as the writings, and the gap between them, narrowed from 1900 to 2012. This developmental path corresponds to the socio-historical backgrounds in Chinese history and shares similarities and differences with the development of English. Diachronic variation in early modern Chinese mirrors that of English in that both languages developed to be more colloquial and interactive. However, early modern Chinese is different from English, as diglossia has played a crucial evolutionary role.
Developing beginning language learners’ (meta-)cultural understanding via student-led Linguistic Landscape research
Authors: Li Yu , Lee Hakyoon , Choi Bumyong
Published: July 2021

Practitioners of additional-language (AL) education have consistently argued for the pedagogical benefits of engaging students in Linguistic Landscape (LL) research. The potential of how LL study may contribute to students’ development in (meta-)cultural understanding is yet to be explored. Additionally, while a number of present studies target students at the intermediate or advanced level, student-led LL research projects designed for learners with beginning AL proficiency are under-explored. This paper seeks to fill these gaps by offering a study of undergraduate students learning Chinese and those learning Korean in their first year in the United States. Analysis of student work and pre- and post-project survey data demonstrates that engaging beginning learners of AL in LL research enables them to develop enriched and nuanced understanding of cultural authenticity as well as a deeper appreciation of their target culture. In other words, it is beneficial for promoting their meta-cultural as well as culture-specific learning.
A solid–liquid hybrid electrolyte for lithium ion batteries enabled by a single-body polymer/indium tin oxide architecture
Authors: Kim Taehoon , Son Dae-Yong , Ono Luis K , Jiang Yan , Qi Yabing
Published: July 2021

Solid-state electrolytes have received much attention because of their high safety and cycling stability for lithium ion batteries. However, the interfacial contact issue of solid electrolytes with the electrode and active material hinders their practical use. Herein, for the first time, we demonstrate a hybrid electrolyte that combines a solid polyethylene terephthalate (PET) electrolyte with an organic liquid electrolyte to provide synergetic benefits over a single electrolyte. The single-body PET electrolyte/In2O3–SnO2 (ITO; 110 nm, 150 nm, 260 nm and 340 nm) electrode was prepared by vacuum sputtering deposition. The simplicity of the electrode composite (e.g., conductive additive-free, solvent-free and binder-free) and its gapless structure between the polymer substrate and the active material significantly impede the formation of by-products from the decomposed electrolyte as well as the growth of an unstable solid electrolyte interphase upon cycling. In addition, the cell configuration of the Li metal/organic electrolyte/PET/ITO electrode enables a process called ‘Li+ caging’, which leaves some of the lithium ions in the PET due to the different ion transfer kinetics of the heteroionic interfaces. The hybrid electrolyte cell not only shows an excellent rate capability at 100–400 mA g−1, but also exhibits high cycling stability (>1200 cycles). Our study lays a cornerstone for the development of practical hybrid electrolytes for lithium ion batteries with improved stability.
Pressure-induced topological quantum phase transition in the magnetic topological insulator MnBi2Te4
Authors: Guo Wen-Ti , Huang Lu , Yang Yanmin , Huang Zhigao , Zhang Jian-Min
Published: July 2021

In this paper, topological quantum phase transition was reported in the magnetic topological insulator MnBi2Te4 under pressure strain. Electronic and topological properties of the bulk anti-ferromagnetic MnBi2Te4 were investigated by first-principles calculations. We found that the band structure of MnBi2Te4 changes with the strain, resulting in a phase transition between metal and insulator. From the variation of charge-density distribution with strain, it was found that hydrostatic tensile strain is beneficial for increasing the interlayer spacing, thereby reducing the anti-ferromagnetic interaction between layers. On the contrary, the compressive strain promotes the strengthening of the bonding between the Te and Bi atomic layers. It was worth noting that the phase transition occurs at 2.12% strain when the band crossing is observed at Γ point, suggesting that the band gap has just closed. In addition, through the calculation of surface states, it is observed that, after the action of 2.12% strain, the bulk band gap of the system closes with the surface band gap reopens, achieving an intrinsic mechanism of strain modulation of the MnBi2Te4 antiferromagnetic bulk structure to undergoes a topological quantum phase transition. Our results provide feasible guidance not only for pressure-strain engineering of MnBi2Te4 experimentally but also for developing a meaningful strain-control mechanism for the electronic structures of other potential intrinsic magnetic insulators.
Master equation approach to the stochastic accumulation dynamics of bacterial cell cycle
Authors: Luo Liang , Bai Yang , Fu Xiongfei
Published: July 2021

The mechanism of bacterial cell size control has been a mystery for decades, which involves the well-coordinated growth and division in the cell cycle. The revolutionary modern techniques of microfluidics and the advanced live imaging analysis techniques allow long term observations and high-throughput analysis of bacterial growth on single cell level, promoting a new wave of quantitative investigations on this puzzle. Taking the opportunity, this theoretical study aims to clarify the stochastic nature of bacterial cell size control under the assumption of the accumulation mechanism, which is favoured by recent experiments on species of bacteria. Via the master equation approach with properly chosen boundary conditions, the distributions concerned in cell size control are estimated and are confirmed by experiments. In this analysis, the inter-generation Green’s function is analytically evaluated as the key to bridge two kinds of statistics used in batch-culture and mother machine experiments. This framework allows us to quantify the noise level in growth and accumulation according to experimental data. As a consequence of non-Gaussian noises of the added sizes, the non-equilibrium nature of bacterial cell size homeostasis is predicted, of which the biological meaning requires further investigation.
New type of fallout found a decade after Fukushima disaster
Authors: Randall Ian
Published: July 2021

New, large and highly radioactive particles have been identified in the fallout from the 2011 Fukushima Daiichi nuclear disaster in Japan by an international team of researchers.
Iceberg melting driven by geometry, experiments reveal
Authors: Hestericová Martina Ribar
Published: July 2021

Experimental studies of ice blocks that are moving in water have revealed that they melt faster on their sides compared to the base.
Space editor quits over fraud claims
Authors: Allen Michael
Published: July 2021

David Baker, the editor of the British Interplanetary Society’s SpaceFlight magazine, has resigned in the wake of allegations that he stretched the truth about his qualifications and professional scientific background. Michael Allen investigates
Namibia telescope officials plot path through pandemic
Authors: Makoni Munyaradzi
Published: July 2021

Astronomers working on the €23m African Millimetre Telescope (ATM) in Namibia remain confident that the project will pass a “critical design review” by the end of 2022 despite being delayed a year by the COVID-19 pandemic.
Stock exchange listing for quantum firm
Authors: Gwynne Peter
Published: July 2021

The quantum start-up firm IonQ has become the first company specializing solely in quantum computing to be publicly traded on the stock market.
Scientists decry cuts to overseas support
Authors: Ravilious Kate
Published: July 2021

More than 4500 researchers have signed an open letter warning of significant long-term damage due to cuts made to UK research funded through international aid money
Licensing Arm
Authors: McKenzie James
Published: July 2021

Arm Holdings’ chips power countless smart phones, tablets and TVs, but the company – a great intellectual-property success story – is facing an uncertain future. James McKenzie explains
Combat robotics
Authors: Crease Robert P
Published: July 2021

TV robot fights are not just entertainment – they can also help turn students on to physics and engineering, as Robert P Crease finds out
Fritz Zwicky and the earliest prediction of dark matter
Authors: Zwicky Barbarina , Meyling Johannes , Appell David
Published: July 2021

In response to the feature article “The 10 greatest predictions in physics” by the science writer David Appell (January pp36–40), which included Vera Rubin and Kent Ford Jr’s prediction that dark matter can account for the unusual motion of outer stars in the Andromeda galaxy.
Staying grounded
Authors: Foote Peter , Gehring Brian , Tucker Colin
Published: July 2021

In response to James McKenzie’s Transactions article “Grounds for optimism” (March p27) and his 1 April appearance on the Physics World Weekly podcast, in which he discusses the clean-energy potential of heat pumps that warm homes with heat extracted from the ground.
Fuelling doubt
Authors: Lovins Amory B
Published: July 2021

In response to Michael Allen’s feature “Improving nuclear fuel safety” (February pp33–36) in which he discusses technologies in development to improve the safety of nuclear power stations, to increase trust in them as a safe way of mitigating climate change.
Ruffled feathers
Authors: Hoptroff Richard
Published: July 2021

In response to the Quanta article “Chicken slap down” (February p3), which reports the calculation that a chicken could be cooked by a single slap of a hand moving at about 1660 m/s.
The Turing Test 2.0
Authors: Bawagan Juanita
Published: July 2021

When Alan Turing devised his famous test to see if machines could think, computers were slow, primitive objects that filled entire rooms. Juanita Bawagan discovers how modern algorithms have transformed our understanding of the “Turing Test” and what it means for artificial intelligence
Assessment of a Line Immunoassay for the Detection of Mi-2 Antibodies: Results From a Single Academic Center Investigation
Authors: Skemp-Dymond Grace , Lebiedz-Odrobina Dorota , Zuromski Lauren M , Rhoads Jamie L W , Tebo Anne E
Published: July 2021

Objectives

To evaluate the performance characteristics of a line immunoassay (LIA) for the detection of Mi-2 antibodies associated with dermatomyositis (DM).

Methods

In total, 432 consecutive patient specimens were tested for Mi-2 antibodies concurrently by LIA (Mi-2α or Mi-2β) or immunoprecipitation (IP) test and antinuclear antibody by indirect immunofluorescence assay using HEp-2 substrate. Following antibody evaluation, results for patients positive in any of the assays for Mi-2 antibody had a retrospective chart review for diagnostic categorization. The performance of all tests was evaluated based on the extracted clinical data.

Results

Forty patients were positive in at least one of the Mi-2 assays. The frequency of Mi-2β antibody by LIA was highest (75.0%), followed by Mi-2 by IP (35.0%) and Mi-2α by LIA (20.0%), respectively. Mi-2 by IP had the best total percent agreement for DM (95.0%) compared with 70.0% and 25.0% for the LIA Mi-2α and Mi-2β, respectively. Positivity of the Mi-2β antibody was significantly associated with non-DM diagnosis.

Conclusions

Agreement for DM with assays for detecting Mi-2 is variable. Additional studies are required to validate Mi-2 immunoassays for routine patient evaluation.
Linear Relationships Between Total Hydrocarbons and Benzene, Toluene, Ethylbenzene, Xylene, and n-Hexane during the Deepwater Horizon Response and Clean-up
Authors: Groth Caroline P , Huynh Tran B , Banerjee Sudipto , Ramachandran Gurumurthy , Stewart Patricia A , Quick Harrison , Sandler Dale P , Blair Aaron , Engel Lawrence S , Kwok Richard K , Stenzel Mark R
Published: July 2021

Objectives

Our objectives were to (i) determine correlations between measurements of THC and of BTEX-H, (ii) apply these linear relationships to predict BTEX-H from measured THC, (iii) use these correlations as informative priors in Bayesian analyses to estimate exposures.

Methods

We used a Bayesian left-censored bivariate framework for all 3 objectives. First, we modeled the relationships (i.e. correlations) between THC and each BTEX-H chemical for various overarching groups of measurements using linear regression to determine if correlations derived from linear relationships differed by various exposure determinants. We then used the same linear regression relationships to predict (or impute) BTEX-H measurements from THC when only THC measurements were available. Finally, we used the same linear relationships as priors for the final exposure models that used real and predicted data to develop exposure estimate statistics for each individual exposure group.

Results

Correlations between measurements of THC and each of the BTEX-H chemicals (n = 120 for each of BTEX, 36 for n-hexane) differed substantially by area of the Gulf of Mexico and by time period that reflected different oil-spill related exposure opportunities. The correlations generally exceeded 0.5. Use of regression relationships to impute missing data resulted in the addition of >23 000 n-hexane and 541 observations for each of BTEX. The relationships were then used as priors for the calculation of exposure statistics while accounting for censored measurement data.

Conclusions

Taking advantage of observed relationships between THC and BTEX-H allowed us to develop robust exposure estimates where a large amount of data were missing, strengthening our exposure estimation process for the epidemiologic study.
Irisin restores high glucose-induced cell injury in vascular endothelial cells by activating Notch pathway via Notch receptor 1
Authors: Wang Hanrui , Pei Siying , Fang Shuqing , Jin Song , Deng Shuhua , Zhao Yanan , Feng Yao
Published: July 2021

Diabetic foot ulcers (DFU) are a vascular complication of diabetes mellitus (DM). It has been confirmed that irisin is closely related to DM. However, the effect of irisin on DFU is obscure and needs further study. After human umbilical vein endothelial cell lines (HUVECs) were treated with different concentrations’ irisin, normal glucose, high glucose (HG), HG plus irisin-high (H) or sh-Notch1, cell biological behaviors, LDH, and VEGFA were detected by cell function experiments. Apoptosis- and Notch pathway-related protein levels were evaluated by Western blot. Irisin has no cytotoxicity, and irisin-H elevated cell viability and inhibited apoptosis and LDH level in HG-induced HUVECs. Meanwhile, irisin-H restored HG-repressed migration and angiogenesis in HUVECs. Irisin-H inhibited apoptosis-related protein levels and promoted VEGFA and Notch pathway-related protein levels in HG-treated HUVECs. Additionally, sh-Notch1 reversed the protective effect of irisin-H in HG-treated HUVECs. Irisin restores HG-induced cell injury and angiogenesis in HUVECs by activating Notch pathway via Notch1.
Neural effective connectivity explains subjective fatigue in stroke
Authors: Ondobaka Sasha , De Doncker William , Ward Nick , Kuppuswamy Annapoorna
Published: July 2021

Persistent fatigue is a major debilitating symptom in many psychiatric and neurological conditions, including stroke. Post-stroke fatigue has been linked to low corticomotor excitability. Yet, it remains elusive as to what the neuronal mechanisms are that underlie motor cortex excitability and chronic persistence of fatigue.

In this cross-sectional observational study, in two experiments we examined a total of 59 non-depressed stroke survivors with minimal motoric and cognitive impairments using ‘resting-state’ MRI and single- and paired-pulse transcranial magnetic stimulation.

In the first session of Experiment 1, we assessed resting motor thresholds—a typical measure of cortical excitability—by applying transcranial magnetic stimulation to the primary motor cortex (M1) and measuring motor-evoked potentials in the hand affected by stroke. In the second session, we measured their brain activity with resting-state MRI to assess effective connectivity interactions at rest. In Experiment 2 we examined effective inter-hemispheric connectivity in an independent sample of patients using paired-pulse transcranial magnetic stimulation. We also assessed the levels of non-exercise induced, persistent fatigue using Fatigue Severity Scale (FSS-7), a self-report questionnaire that has been widely applied and validated across different conditions. We used spectral dynamic causal modelling in Experiment 1 and paired-pulse transcranial magnetic stimulation in Experiment 2 to characterize how neuronal effective connectivity relates to self-reported post-stroke fatigue. In a multiple regression analysis, we used the balance in inhibitory connectivity between homologue regions in M1 as the main predictor, and have included lesioned hemisphere, resting motor threshold and levels of depression as additional predictors.

Our novel index of inter-hemispheric inhibition balance was a significant predictor of post-stroke fatigue in Experiment 1 (β = 1.524, P = 7.56 × 10−5, confidence interval: 0.921 to 2.127) and in Experiment 2 (β = 0.541, P = 0.049, confidence interval: 0.002 to 1.080). In Experiment 2, depression scores and corticospinal excitability, a measure associated with subjective fatigue, also significantly accounted for variability in fatigue.

We suggest that the balance in inter-hemispheric inhibitory effects between primary motor regions can explain subjective post-stroke fatigue. Findings provide novel insights into neural mechanisms that underlie persistent fatigue.
Changes in Health-related Quality of Life for Hepatitis C Virus–Infected People Who Inject Drugs While on Opioid Agonist Treatment Following Sustained Virologic Response
Authors: Gormley Mirinda Ann , Akiyama Matthew J , Rennert Lior , Howard Kerry A , Norton Brianna L , Pericot-Valverde Irene , Muench Sam , Heo Moonseong , Litwin Alain H
Published: July 2021

Background

Although efforts to treat hepatitis C virus (HCV) in people who inject drugs (PWID) yield high rates of sustained virologic response (SVR), the relationship between successful HCV treatment and health-related quality of life (HRQOL) among PWID is poorly understood. We examined HRQOL changes throughout HCV treatment and post-treatment for PWID achieving SVR.

Methods

Participants included 141 PWID who achieved SVR following HCV treatment onsite at 3 opioid agonist treatment (OAT) clinics in the Bronx, New York. EQ-5D-3L assesses 5 health dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), producing an index of HRQOL ranging from 0 to 1. EQ-5D-3L was measured at baseline; 4, 8, and 12 weeks during treatment; and 12 and 24 weeks post-treatment. Linear mixed effects regression models assessed changes in the mean EQ-5D-3L index over time.

Results

Mean EQ-5D-3L index baseline was 0.66 (standard error [SE] = 0.02). While over half the population reported no baseline problems with self-care (85.1%), usual activities (56.0%), and mobility (52.5%), at least two-thirds reported problems with pain/discomfort (78.0%) and anxiety/depression (66.0%). Twenty-four weeks post-treatment, proportions reporting pain/discomfort and anxiety/depression decreased by 25.7% and 24.0%, respectively. Mean EQ-5D-3L index significantly improved during treatment (P < .0001), and improvement was sustained following treatment completion, with mean EQ-5D-3L index of 0.77 (SE = 0.02) 12 weeks post-SVR.

Conclusions

HCV treatment led to sustained improvement in HRQOL for PWID on OAT who achieved SVR. Future research is necessary to determine whether improvements in HRQOL can be sustained beyond 12 weeks post-SVR.
Identification of Risk Factors for Coexisting Sinusitis and Inflammatory Bowel Disease
Authors: Rai Victoria , Traboulsi Cindy , Silfen Alexa , Ackerman Max T , Erondu Amarachi I , Karpin Jordan E , Gulotta George , Rubin David T
Published: July 2021

Background

This study aimed to analyze the association of coexisting sinusitis and inflammatory bowel disease (IBD), establish significant factors involved in their development, and enable further biological correlation between these 2 diseases.

Methods

The IBD and Sinusitis Study at UChicago Medicine (TISSUe) is a retrospective, single-center study. We reviewed patients to confirm IBD and chronic sinusitis diagnoses. Case-control propensity score matching was performed using matched controls with IBD only or sinusitis only. Statistical methods included chi-squared test and Wilcoxon rank sum test. Logistic regression analysis was performed, and factors were considered significant if P < .05.

Results

Stratifying 214 patients with coexisting IBD and sinusitis, 176 patients had IBD first and 38 patients had sinusitis first. Multivariable analysis of factors associated with subsequent disease with matched controls determined that duration of disease, UC, steroid exposure ever, and younger age of IBD diagnosis were associated with subsequent sinusitis in patients with IBD; steroid exposure ever and duration of sinusitis were significantly associated with subsequent IBD in patients with sinusitis.

Conclusion

This study suggests that IBD maintenance therapies are not associated with increased risk of sinusitis, as proposed by adverse events in clinical trial data; rather, UC diagnosis and duration of disease may be more influential in sinusitis development. While further studies are necessary, this study also demonstrates that sinusitis precedes IBD in some patients, probing its biological association with IBD and possible classification as an extraintestinal manifestation.
Diagnostic Features of Perianal Fistula in Patients With Crohn’s Disease: Analysis of a Japanese Claims Database
Authors: Mizushima Tsunekazu , Ota Mihoko , Fujitani Yasushi , Kanauchi Yuya , Iwakiri Ryuichi
Published: July 2021

Background

Perianal fistula (PAF) is a disabling complication of Crohn’s disease (CD) which greatly impacts the quality of life. To address a scarcity of data in Asian populations, we determined the prevalence of CD-associated PAF in Japan, the order of diagnosis, and medical history of patients.

Methods

A retrospective, longitudinal, observational cohort study was conducted, using an employer-based health insurance claims database. The study included patients diagnosed with CD and/or PAF from October 2013 to September 2019.

Results

The age- and gender-adjusted prevalence rates of CD-associated PAF increased from 10.33 per 100 000 in 2014, to 13.68 per 100 000 in 2019. Among patients with CD-associated PAF, 15.7% were diagnosed with PAF after diagnosis of CD, 68.6% were diagnosed with PAF before diagnosis with CD, and 15.7% were diagnosed with CD and PAF within the same month. Of the patients diagnosed with CD after PAF, approximately 30% were diagnosed with PAF by the age of 20 years, whereas less than 10% of PAF patients without CD were diagnosed with PAF by the age of 20 years.

Conclusions

The study reveals the prevalence of CD-associated PAF in Japan and that most individuals were diagnosed with CD after the diagnosis of PAF. Crohn’s disease may be underdiagnosed in patients with PAF; patients diagnosed with PAF at a young age should be monitored to allow timely diagnosis of CD.
Cardiac allograft vasculopathy: current review and future research directions
Authors: Pober Jordan S , Chih Sharon , Kobashigawa Jon , Madsen Joren C , Tellides George
Published: July 2021

Cardiac allograft vasculopathy (CAV) is a pathologic immune-mediated remodelling of the vasculature in transplanted hearts and, by impairing perfusion, is the major cause of late graft loss. Although best understood following cardiac transplantation, similar forms of allograft vasculopathy occur in other vascularized organ grafts and some features of CAV may be shared with other immune-mediated vasculopathies. Here, we describe the incidence and diagnosis, the nature of the vascular remodelling, immune and non-immune contributions to pathogenesis, current therapies, and future areas of research in CAV.
Progressive valvular calcifications with critical aortic stenosis in a 25-year-old woman with end-stage renal disease on haemodialysis: a case report
Authors: Oxlund Christina Stolzenburg , Hansen Helle , Hansen Stinus , Rohold Allan
Published: July 2021

Background 

The increased risk of cardiovascular morbidity and mortality in chronic kidney disease (CKD) and end-stage renal disease (ESRD) seems particularly pronounced in patients with concomitant aortic and mitral valvular calcifications. Valvular calcification (VC) is accelerated in patients with CKD and even more so with ESRD and haemodialysis (HD) due to premature endothelial cell dysfunction. Mineral and bone disorder (CKD-MBD) is a common complication of CKD/ESRD and may play a pivotal role in VC.

Case summary 

A 25-year-old woman with congenital hypoplastic kidneys and ESRD on HD from the age of 19 was admitted to the emergency department suffering from chest pain and dyspnoea. Transthoracic echocardiogram (TTE) revealed critical aortic stenosis (AS) with indexed aortic valve area 0.4 cm2/m2, a mean gradient 58 mmHg and a moderate mitral stenosis with a mean gradient 6–8 mmHg developed over the course of 2 years, as a normal TTE was performed at that time. During HD, the patient had longstanding alterations in calcium and phosphate metabolism including secondary hyperparathyroidism that eventually progressed into tertiary hyperparathyroidism. Efforts were made to treat CKD-MBD but patient compliance was low. Subtotal parathyroidectomy was performed 6 months prior to admission. The patient had dual mechanical valve replacement.

Discussion 

Valvular calcification is common in patients with CKD/ESRD and in particular in patients on HD. Rapid progression of valve disease in this case may be related to the combination of low patient adherence and sustained disturbed calcium and phosphate metabolism with tertiary hyperparathyroidism. Transthoracic echocardiogram should be performed in patients on HD even with minor suspicion of VC and in patients with low adherence and disturbance of calcium and phosphate metabolism.
COVID-19 induced ventricular tachycardia storm unmasking a clinically silent cardiomyopathy: a case report
Authors: Mukhopadhyay Saibal , Uppal Abhimanyu , Yusuf Jamal , Muheeb Ghazi , Agarwal Rupesh
Published: July 2021

Background

Coronavirus disease (COVID-19) is a systemic illness characterized by raging impact of cytokine storm on multiple organs. This may trigger malignant ventricular arrhythmias and unmask a clinically silent cardiomyopathy.

Case summary

A 57-year-old gentleman, known case of hyperthyroidism and diabetes, was referred to our emergency department with history of two ventricular tachycardia (VT) episodes requiring direct current cardioversion in last 3 h followed by another episode in our emergency department that was cardioverted. There was no past history of cardiac illness. His 12-lead electrocardiogram (during sinus rhythm) along with screening echocardiography suggested Arrhythmogenic right ventricular cardiomyopathy (ARVC). He was coincidentally found to be COVID-19 positive by reverse transcription-polymerase chain reaction (RT-PCR) as part of our routine screening. However, he had no fever or respiratory complaints. We noted raised systemic inflammatory markers and cardiac troponin T which progressively increased over the next 4 weeks paralleled by an increase in ventricular premature contraction burden and thereafter started decreasing and returned to baseline by 6th week when the patient became COVID-19 negative by RT-PCR. Subsequently, a single-chamber automated implantable cardioverter-defibrillator implantation was done following which there was a transient increase in these biomarkers that subsided spontaneously. The patient is asymptomatic during 6 weeks of follow-up.

Discussion

COVID-19-associated cytokine surge triggering VT storm and unmasking a clinically silent ARVC has not yet been reported. The case highlights a life-threatening presentation of COVID-19 and indicates a probable link between inflammation and arrhythmogenicity.
Transoesophageal echocardiography-guided ‘primary’ valve-in-valve technique in cardiogenic shock: a case report
Authors: Polizzi Vincenzo , Cosma Joseph , Cammardella Antonio , Ranocchi Federico , Musumeci Francesco
Published: July 2021

Background

Transcatheter aortic valve implantation inside a previously implanted bioprosthesis is an alternative treatment for patients with degenerated surgical aortic bioprosthesis (AB) at high surgical risk. Pre-operative computed tomography (CT) scan provides essential information to the procedure planning, although in case of acute presentation it is not always feasible.

Case summary

A 32-year-old man with history of surgical treatment of aortic coarctation and Bio-Bentall procedure was transferred to our department in cardiogenic shock with a suspected diagnosis of acute myocarditis. A transthoracic echocardiogram (TTE) revealed a severely impaired biventricular function and AB degeneration causing severe stenosis. It was decided to undertake an urgent trans-apical valve-in-valve (ViV) procedure. Due to haemodynamic instability, a preoperative CT scan was not performed and transoesophageal echocardiography (TOE) was the main intraprocedural guiding imaging technique. Neither intraprocedural nor periprocedural complications occurred. Serial post-procedural TTE exams showed good functioning of the bioprosthesis and progressive improvement of left ventricular ejection fraction. Patient was discharged from the hospital 8 days after the intervention.

Discussion

A patient with cardiogenic shock due to severe degeneration of the AB was treated with urgent transapical ViV procedure. In this case, where urgent ViV technique was needed, TOE appeared to be a crucial alternative to CT scan and allowed us to perform a successful procedure.