bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying safety zone of invasive procedures in the sternocleidomastoid muscle using ultrasonography
Authors: Kang Byung Heon , Park So Hyun , Kang Seok , Yoon Joon Shik
Published: February 2023

Dysfunctions of the sternocleidomastoid (SCM) muscle, such as myofascial syndrome, torticollis, and cervical dystonia, have been treated using several invasive procedures. In such situations, it is possible to injure the adjacent nerves. This study aimed to demonstrate the course of these nerves in healthy volunteers using ultrasound. The great auricular nerve (GAN), spinal accessory nerve (SAN), transverse cervical nerve (TCN), and supraclavicular nerve (SCN) were scanned by ultrasonography in 26 healthy volunteers. The neck was scanned in the supine position with the head turned 45° to the contralateral side. The cervical plexus was detected in half of the SCM muscle. Each nerve was then traced to the level of contact with the anterior border of the SCM muscle. The following features of the nerves were recorded bilaterally: vertical and horizontal positions of each nerve at the posterior border of the SCM and the cross-sectional area and depth of each nerve at the reference line and anterior border of the SCM. The mean proportions of GAN, SAN, TCN, and SCN were 26%, 26%, 48%, and 80%, respectively near the posterior border, whereas they were 18%, 23%, and 51% for GAN, SAN, and TCN, respectively, at the level of the reference line. Notably, SCN was not visible at the level of the reference line. The mean TCN proportion was 47% at the anterior border of the SCM. The precise location of the nerves and their relationship with the SCM muscle should be considered during invasive procedures. It is recommended that the procedure be performed in the lower half of the SCM muscle, which refers to 50 to 80% of the proportions in our study.
Comparison of general and regional anesthesia on short-term complications in patients undergoing total knee arthroplasty: A retrospective study using national health insurance service-national sample cohort
Authors: Lee SeungYoung , Kim Min Kyoung , Ahn EunJin , Jung YongHun
Published: February 2023

This retrospective study compared the mortality and short-term complications according to the choice of general anesthesia or regional anesthesia in patients who underwent a total knee arthroplasty (TKA). We searched the Korean National Health Insurance Service National Sample Cohort database to analyze data from patients who received a TKA between January 2002 and December 2015. Before comparing the general and the regional anesthesia groups, the bias was reduced by propensity score matching. After matching, the mortality and complications occurring within 30 days after a TKA were compared between the 2 groups. In the database, 6491 primary TKA cases were identified. Nine hundred forty-three patients (14.5%) had a TKA performed under general anesthesia, and 5548 (85.5%) had a TKA performed under regional anesthesia. After propensity score matching, the data of 1886 patients were analyzed, with 943 patients in each group. There was no significant difference in mortality (0.32% vs 0.00%), transfusion rate (84.52% vs 84.73%, P = .8989), and length of hospital stay (50 vs 53, P = .5391) between the general and regional anesthesia groups. Most of the complications were not significantly different, but the major complications, including myocardial infarction (1.70% vs 0.64%, P = .0414) and acute renal failure (0.85% vs 0.11%, P = .0391), were higher in the general anesthesia group than in the regional anesthesia group. Also, admission to the intensive care unit (8.48% vs 2.33%, P < .0001) and total cost (₩8067, 400 vs ₩7487, 940, P = .0002) were higher in the general anesthesia group than in the regional anesthesia group. Our study found that regional anesthesia for TKA is associated with a decrease in major complications, including myocardial infarction and acute renal failure, and medical costs.
Thoracolaparoscopic radical resection of esophagogastric junction cancers with a NOSE-like approach to extract large specimens
Authors: Zhu Tian-Yu , Deng Xiu-Mei , Wang Guo-Jun , Wang Jing-Tao , Li Rui-Xin , Gao Bu-Lang , Hu Zhi-Hao
Published: February 2023

To investigate the efficacy and safety of combined thoracoscopic and laparoscopic radical resection of esophagogastric junction cancers using a natural orifice specimen extraction-like approach for extraction of large surgical specimens. Patients who had esophagogastric junction cancers treated with thoracolaparoscopic resection using the natural orifice specimen extraction-like approach for specimen extraction were retrospectively enrolled. A 5-cm transverse incision on the abdominal wall at the middle of the superior pubic symphysis was made for surgical specimen extraction. The clinical, surgical, complications, and follow-up data were analyzed. A total of 162 patients were enrolled, and the surgery was successful in all patients (100%). The total surgical duration ranged 165 to 270 minutes, with blood loss 20 to 150 mL, hospital stay 8 to 22 days, first flatus time 2 to 7 days, extubation time of drainage tubes 1 to 26 days, first oral feeding time 5 to 10 days, number of lymph nodes resected 15 to 39, postoperative ambulation time 1 to 2 days, and postoperative residual rate of cancerous cells at the surgical margins 0. Postoperative complications occurred in 14 (8.6%), including anastomotic leakage in 4 (2.5%), anastomotic stenosis in 3 (1.9%), hydrothorax in 4 (2.5%), and incision infection in 3 (1.9%). At follow-up (mean 12 months), all patients were alive, and the transverse incision was a linear scar concealed in the suprapubic pubic hair area. The combined laparoscopic and thoracoscopic surgery for radical resection of carcinomas at the esophagogastric junction is safe and effective, and a transverse incision at the suprapubic symphysis for specimen extraction results in improved minimal invasiveness and cosmesis.
Basal cell carcinoma of the umbilicus associated with sweat gland structures: Two case reports
Authors: Kurosaki Yukiho , Itoi-Ochi Saori , Ota Asako , Miyazaki Akiko , Kato Hiroko , Nojima Satoshi , Morii Eiichi , Yokoi Kazunori , Fujimoto Manabu , Tanemura Atsushi
Published: February 2023

Rationale:

Basal cell carcinoma (BCC) arising in the umbilicus is relatively rare, and in particular, there have been few reports mentioning peritumoral sweat gland structures histopathologically. We herein, report 2 cases of umbilical BCC with sweat gland structures within and around the tumor.

Patient concerns:

A 61-year-old woman had a 2-year history of black exudative plaque in her umbilicus, and an 80-year-old woman had a 6-month history of dark brownish plaque in the umbilicus, with exudation 2 months prior to her first visit.

Diagnoses:

Based on the histopathological finding, both cases were confirmed as BCC. The results of immunohistochemical staining showed that the tumor cells were Ber-EP4 positive. In addition, EMA-positive glandular structures were seen within and around the tumor.

Interventions:

Curative resection at the level of the linea alba on the bottom side was performed.

Outcomes:

No relapse has been observed since resection in either patient.

Lessons:

We herein report 2 cases of umbilical BCC with sweat glands and ducts. Although whether peri- and/or intra-tumor sweat gland structures are the source of the tumor or arise by transdifferentiation from tumor cells remains unclear, these findings may provide clues to help understand the morphopathogenesis of umbilical BCC in the future.
Prevalence and predictors of arthralgia after initiation of vedolizumab in patients with inflammatory bowel disease: a retrospective cohort study
Authors: Kokkotis Georgios , Zampeli Evanthia , Tzouvala Maria , Giotis Ioannis , Orfanos Philippos , Benetou Vassiliki , Stoupaki Maria , Leontidis Nikolaos , Leonidakis Georgios , Kitsou Vassiliki , Gaki Aikaterini , Lagiou Pagona , Michopoulos Spyridon , Bamias Giorgos
Published: February 2023

Objectives

Vedolizumab is a mAb used for the treatment of moderate to severe ulcerative colitis and Crohn’s disease. There is evidence that administration of vedolizumab has been associated with either new onset or reactivation of extra-intestinal manifestations, among which arthralgia is the most prominent. We aimed to study the incidence, characteristics and predictors for the occurrence of arthralgias in patients with inflammatory bowel disease (IBD) who receive vedolizumab.

Methods

A retrospective cohort study was implemented in patients with IBD. The occurrence of new-onset and recurrent arthralgias were recorded. Multivariate Cox proportional-hazards models were used to identify factors associated with the endpoints of interest.

Results

A total of 115 vedolizumab-treated IBD patients (male = 50.4%; ulcerative colitis  = 70.4%; median follow-up = 12.7 months) participated. New-onset arthralgia occurred in 20.9%, and recurrent in 46.7% (45 patients at risk). Among patients with ulcerative colitis, multivariate Cox’s proportional-hazards models showed, that new onset arthralgia was significantly associated with extensive colitis (hazard ratio = 2.91; 95% confidence interval, 1.04–8.12). Of 15 patients with concomitant treatment of azathioprine, no one manifested new-onset arthralgia (X2
P = 0.03; Fisher’s exact test P = 0.038). No predictors were identified for recurrent arthralgia.

Conclusion

Arthralgias is a common manifestation of vedolizumab treatment. Patients with extensive ulcerative colitis demonstrate a higher risk for new-onset arthralgia, whereas, concomitant treatment with azathioprine appears to be protective. These associations may be mediated by re-directed lymphocyte trafficking and may support concomitant immunomodulator administration in specific patient subpopulations who commence treatment with vedolizumab.
Nonvisualized sentinel node on preoperative lymphoscintigraphy in primary cutaneous melanoma: an 11-year retrospective survey
Authors: Pallara Tiziano , Annovazzi Alessio , Cristiani Renzo , Vinci Federica , Bertozzi Ettore , Bonadies Antonio , Romani Claudia , Tedesco Marinella , Bellei Barbara , Papaccio Federica , Caputo Silvia , Cota Carlo , Sperduti Isabella , Govoni Flavio Andrea , Morrone Aldo , Migliano Emilia
Published: February 2023

Background

Sentinel lymph node (SLN) biopsy in cutaneous melanoma patients evaluates the regional draining basin for occult micrometastatic disease. Occasionally, nonidentification of SLN impairs the acquisition of this important prognostic factor.

Objectives

To investigate the outcomes of melanoma patients with negative lymphoscintigraphic findings and patients who underwent SLN biopsy from 2004 to 2015 (n = 1200) were retrospectively reviewed for tumor characteristics and clinical outcomes.

Methods

Patients with nonvisualized lymph nodes (NV group) who underwent only preoperative lymphoscintigraphy were separated and compared with a cohort drawn from all melanoma patients who completed the surgical procedure within the same period (V group).

Results

A negative lymphoscintigraphic scan was observed in 38 cases (3.2% of all patients). The NV group showed a significantly older age (median 66.0 vs. 48.3 years; P < 0.0001). Head and neck melanomas were more frequent in the NV group compared to the control group (25.1 vs. 7.8%; P = 0.009). Tumor characteristics such as ulceration and Breslow thickness do not influence the lymphoscintigraphy result. No differences were found in overall survival (OS) and disease-free survival (DFS) between the groups.

Conclusions

The nonvisualization of regional lymph nodes by lymphoscintigraphy is more frequent in older patients with head and neck melanomas. From the clinical point of view, no specific recommendation emerged for patients’ management because the nonvisualization of the SLN did not show a significant influence on DFS and OS rates. However, lack of knowledge of lymph node status suggests performing a tighter follow-up eventually by ultrasound evaluation of all potential lymph node drainage basins.
Topical Tranexamic Acid in Breast Reconstruction: A Double-Blind, Randomized Controlled Trial
Authors: Safran Tyler , Vorstenbosch Joshua , Viezel-Mathieu Alex , Davison Peter , Dionisopoulos Tassos
Published: February 2023

BACKGROUND

Excess fluid accumulation (seroma/hematoma) around the breast implant post reconstruction can lead to significant complications. Topical administration of tranexamic acid (TXA) may reduce fluid accumulation and reduce post-operative complications. This trial aims to investigate if TXA treated mastectomy pockets will exhibit less postoperative fluid production and complications.

METHODS:

This paired, double-blinded, randomized-controlled trial enrolled patients undergoing bilateral mastectomies with immediate direct to implant reconstruction. In each patient, one breast was randomized to receive 3g TXA (100cc), and the other received 100cc of NS. The blinded solutions were soaked in the mastectomy pocket for five minutes before implant placement. Postoperatively, daily drain outputs, complications, and baseline demographics were recorded.

RESULTS

53 eligible patients, representing 106 breasts, were enrolled. All patients underwent bilateral nipple-sparing mastectomies. After randomization, TXA was placed in the right breast in 56.6% (n=30) of patients. The use of topical TXA resulted in a mean drain output reduction of 30.5% (RANGE: -83.6% - 26.6%). Drains on the TXA treated breast were eligible for removal 1.4(RANGE: 0-4) days sooner than the control side. TXA treated group had three complications (5.67%) versus 15 (28.3%) in the control group (Odds Ratio: 0.1920, p= 0.0129). Specifically, for operative hematomas, the TXA group had none(0%) versus three in the control group (5.7%)(Odds Ratio: 0.1348, P=0.18).

CONCLUSION

Soaking the mastectomy bed with 3% topical TXA before implant insertion leads to a decrease in drain output and a decrease in complications. Topical administration of TXA represents an option to decrease complications in alloplastic breast reconstruction.
First Experience With a Whole-Body Spectral Photon-Counting CT Clinical Prototype
Authors: Si-Mohamed Salim A. , Boccalini Sara , Villien Marjorie , Yagil Yoad , Erhard Klaus , Boussel Loic , Douek Philippe C.
Published: February 2023

Spectral photon-counting computed tomography (SPCCT) technology holds great promise for becoming the next generation of computed tomography (CT) systems. Its technical characteristics have many advantages over conventional CT imaging. For example, SPCCT provides better spatial resolution, greater dose efficiency for ultra-low-dose and low-dose protocols, and tissue contrast superior to that of conventional CT. In addition, SPCCT takes advantage of several known approaches in the field of spectral CT imaging, such as virtual monochromatic imaging and material decomposition imaging. In addition, SPCCT takes advantage of a new approach in this field, known as K-edge imaging, which allows specific and quantitative imaging of a heavy atom-based contrast agent. Hence, the high potential of SPCCT systems supports their ongoing investigation in clinical research settings. In this review, we propose an overview of our clinical research experience of a whole-body SPCCT clinical prototype, to give an insight into the potential benefits for clinical human imaging on image quality, diagnostic confidence, and new approaches in spectral CT imaging.
Comprehensive Complication Index to Monitor Morbidity and Mortality After Liver Transplantation in Primary Sclerosing Cholangitis
Authors: Vannas Marko J. , Åberg Fredrik , Nordin Arno , Tukiainen Eija , Savikko Johanna , Isoniemi Helena
Published: February 2023

Objective:

The objective of this study was to investigate the short-term and long-term morbidity after liver transplantation (LTx) in patients with primary sclerosing cholangitis (PSC).

Background:

PSC is a common indication for LTx in Scandinavia. Recently, research has focused on long-term survival and morbidity. The Comprehensive Complication Index (CCI) precisely describes postsurgical complications, by considering both number and severity.

Patients and Methods:

Two patient groups were compared: those with classical PSC symptoms (n=148) and those with increased risk of cholangiocarcinoma (n=51, premalignant group). Two CCI scores were calculated, at 1-year post-LTx and a cumulative overall score at the latest follow-up. In addition, we investigated factors potentially related to high CCI.

Results:

The 1-year median CCI were 29.6 and 26.2 in the classical and premalignant groups, respectively (P=0.308). The median overall CCI were 43.2 and 46.8 (P=0.765), respectively. Patient survival was significantly lower in patients with 1-year CCI>42. The most common complications associated with low survival were cholangitis, infections, and hypertension. One-year and overall CCI were similar between sexes and different types of biliary anastomosis. Patients with pre-LTx Model for End-stage Liver Disease scores >20 had higher 1-year and overall CCI (36.2 and 52.6, respectively) than those with lower Model for End-stage Liver Disease scores. Both low (<22) and high (>25 kg/m2) body mass indices were associated with high overall 1-year and overall CCI (50.9 and 41.8, respectively), but median body mass indices were associated with significantly lower 1-year and overall CCI (38.4, P=0.023).

Conclusions:

The previously determined 1-year CCI cutoff of 42 could significantly predict survival post-LTx. Mortality and morbidity were not significantly different between the PSC groups analyzed.
Endoscopic Resection for Vascular Anomalies in Children
Authors: Wang Huaijie , Xie Chong , Lin Weilong , Zhou Jinbang , Yang Weijia , Guo Zhengtuan
Published: February 2023

Objective:

To report an innovative endoscopic surgery for subcutaneous vascular malformations and intramuscular fibro-adipose vascular anomaly (FAVA) at our center.

Background:

Historically, open surgical resection has been the treatment of choice. Recent advances in minimally invasive surgery have led to the successful application of endoscopic resection techniques for the surgical management of diseases of soft tissue.

Methods:

Patients who underwent endoscopic resection of vascular anomalies were included in this retrospective review. Data were extracted from our Vascular Anomalies Center database between September 2019 and October 2022, including sex, age, symptoms, diagnosis, sites of surgery, previous treatment, surgery, and follow-up.

Results:

There were 13 females and 15 males in the current study, with ages ranging from 1 to 17 years. The diagnoses included microcystic lymphatic malformation (LM) (n = 8), Klippel-Trénaunay syndrome (n = 7), venous malformation (n = 6), FAVA (n = 6), and mixed cystic LM (n = 1). Surgical sites included the lower extremity (n = 24), abdominal wall (n = 2), upper extremity (n = 1), and thoracic wall (n = 1). Five patients had an intramuscular lesion (FAVA). The endoscopic technique used 2 or 3 small ports in a gas inflation manner. Surgery included thrombectomy, radical resection, and debulking of vascular anomalies. Postoperative sclerotherapy with bleomycin was performed through a drainage tube in 6 patients with microcystic LM. Technical success was obtained in 27 patients. The conversion to open surgery was performed in one patient owing to the deep location of the lesion. No wound-related complication was observed.

Conclusions:

Endoscopic surgery is a minimally invasive, effective, and safe treatment for subcutaneous vascular malformations and intramuscular FAVA. This approach can set a new standard that minimizes wound complications and reduces recovery time in patients undergoing resection for benign soft-tissue lesions.
Defining the Full Spectrum of Pediatric Firearm Injury and Death in the United States
Authors: Naik-Mathuria Bindi J. , Cain Cary M. , Alore Elizabeth A. , Chen Liang , Pompeii Lisa A.
Published: February 2023

Objective:

To characterize the full spectrum of pediatric firearm injury in the United States by describing fatal and nonfatal injury data epidemiology, vulnerable populations, and temporal trends.

Background:

Firearm injury is the leading cause of death in children and adolescents in the United States. Nonfatal injury is critical to fully define the problem, yet accurate data at the national level are lacking.

Methods:

A cross-sectional study combining national firearm injury data from the Centers for Disease Control (fatal) and the National Trauma Data Bank (nonfatal) between 2008 and 2019 for ages 0 to 17 years. Data were analyzed using descriptive and χ2 comparisons and linear regression.

Results:

Approximately 5000 children and adolescents are injured or killed by firearms each year. Nonfatal injuries are twice as common as fatal injuries. Assault accounts for the majority of injuries and deaths (67%), unintentional 15%, and self-harm 14%. Black youth suffer disproportionally higher injuries overall (crude rate: 49.43/million vs White, non-Hispanic: 15.76/million), but self-harm is highest in White youth. Children <12 years are most affected by nonfatal unintentional injuries, 12 to 14 years by suicide, and 15 to 17 years by assault. Nonfatal unintentional and assault injuries, homicides, and suicides have all increased significantly (P < 0.05).

Conclusions:

This study adds critical and contemporary data regarding the full spectrum and recent trends of pediatric firearm injury in the United States and identifies vulnerable populations to inform injury prevention intervention and policy. Reliable national surveillance for nonfatal pediatric firearm injury is vital to accurately define and tackle this growing public health crisis.
Arthrobacter mangrovi sp. nov., an actinobacterium isolated from the rhizosphere of a mangrove
Authors: Hamada Moriyuki , Saitou Satomi , Enomoto Narumi , Nanri Keiko , Hidaka Kohei , Miura Takamasa , Tamura Tomohiko
Published: February 2023

A novel actinobacterium, designated HIs16-36T, was isolated from the rhizosphere of a mangrove on Ishigaki Island, Okinawa, Japan, and its taxonomic position was investigated using a polyphasic approach. Phylogenetic analysis based on 16S rRNA gene sequence comparisons revealed that strain HIs16-36T was closely related to the members of the genus

Arthrobacter

. The highest 16S rRNA gene sequence similarity was observed with

Arthrobacter crystallopoietes

(98.5 %), followed by

Arthrobacter globiformis

(97.2 %). The peptidoglycan of strain HIs16-36T was of the A4α type, with lysine as the diagnostic diamino acid. The predominant isoprenoid quinone was MK-9(H2) and the major fatty acids were anteiso-C15 : 0 and iso-C15 : 0. The polar lipids were identified as diphosphatidylglycerol, phosphatidylglycerol, phosphatidylinositol and two glycolipids. These chemotaxonomic features corresponded to those of the genus

Arthrobacter

. Meanwhile, the differences in some phenotypic characteristics, along with the results of average nucleotide identity and digital DNA–DNA hybridization analyses, indicated that strain HIs16-36T should be distinguished from the recognized species of the genus

Arthrobacter

. Therefore, strain HIs16-36T represents a novel species of the genus

Arthrobacter

, for which the name Arthrobacter mangrovi sp. nov. is proposed. The type strain is HIs16-36T (=NBRC 112813T=TBRC 15750T).
The effect of functional calibration methods on gait kinematics in adolescents with idiopathic rotational deformity of the femur
Authors: Boekesteijn Ramon J. , van de Ven Myrthe P.F. , Wilders Lise M. , Bisseling Pepijn , Groen Brenda E. , Smulders Katrijn
Published: February 2023

Background

Due to anatomical deviations, assumptions of the conventional calibration method for gait analysis may be violated in individuals with rotational deformities of the femur. We compared functional calibration methods with conventional methods in this group for 1) localization of the hip joint center (HJC) and knee axis orientation, and 2) gait kinematics.

Methods

Twenty-four adolescents with idiopathic rotational deformity of the femur underwent gait analysis and a CT scan. During standing, distance between HJCs and knee axis orientation were compared between calibration methods, with CT serving as reference for HJC estimation. Gait kinematics were compared using statistical parameter mapping (SPM).

Findings

Functional calibration methods estimated the HJC closer to the CT reference (26±21mm more lateral) than the conventional method (38±21mm more medial). In the full sample, orientation of the knee joint axis was not different between calibration methods, but in adolescents with increased femoral anteversion, the knee was more internally rotated with the functional method (3.3±6.2°). During gait, SPM revealed significantly more hip flexion, more internal hip rotation during the stance phase, less knee varus-valgus motion, and larger knee flexion angles when applying the functional calibration method.

Interpretation

Functional calibration methods better approximated the HJC, and showed a knee axis orientation that was more towards the direction of the deformity. This resulted in less knee joint angle crosstalk during gait. Although differences between calibration methods on gait kinematics were within clinically acceptable limits for the sagittal plane, relatively larger differences on transversal hip kinematics may hold clinical importance.
Genomic surveillance reveals early detection and transition of Delta to Omicron Lineages of SARS-CoV-2 Variants in wastewater treatment plants of Pune, India
Authors: Rajput Vinay , Pramanik Rinka , Malik Vinita , Yadav Rakeshkumar , Kadam Pradnya , Bhalerao Unnati , Tupekar Manisha , Deshpande Dipti , Shah Priyanki , Shashidhara LS , Boargaonkar Radhika , Patil Dhawal , Kale Saurabh , Bhalerao Asim , Jain Nidhi , Kamble Sanjay , Dastager Syed , Karmodiya Krishanpal , Dharne Mahesh
Published: February 2023

The COVID-19 pandemic has emphasized the urgency for rapid public health surveillance methods in early detection and monitoring of the transmission of infectious diseases. The wastewater-based epidemiology (WBE) has emerged as a promising tool to analyze and enumerate the prevalence of infectious pathogens in a population ahead of time. In the present study, real time quantitative polymerase chain reaction (RT-qPCR) and Illumina sequencing was performed to determine the SARS-CoV-2 load trend and dynamics of variants over a longitudinal scale in 442 wastewater (WW) samples collected from 10 sewage treatment plants (STPs) of Pune city, India, during November 2021 to April-2022. In total 426 distinct lineages representing 17 highly transmissible variants of SARS-CoV-2 were identified. The SARS-CoV-2 Omicron variant fragments were detected in WW samples prior to its detection in clinical cases. Moreover, highly contagious sub-lineages of Omicron, such as BA.2.12 (0.8-0.25%), BA.2.38 (0.8-1.0%), BA.2.75 (0.01-0.02%), BA.3 (0.09-6.3%), BA.4 (0.24-0.29%), and XBB (0.01-13.7%) fragments were significantly detected. The longitudinal analysis also suggested the presence of the BA.5 lineage in November 2021, which was not reported in the clinical settings throughout the duration of this study, indicative of silent variant persistence. Overall, the present study demonstrated the practicality of WBE in early detection of SARS CoV-2 variants, which could be useful in tracking future outbreaks of SARS-CoV-2. Such approaches could be implicated in the monitoring of the infectious agents before they appear in clinical cases.

Highlights

□

Omicron fragments were detected in the sewershed samples prior to clinical samples.

□

Omicron sub-lineages BA.2.12, BA.2.38, BA.2.75, BA.3, BA.4, and XBB were prevalent.

□

Lineage composition analysis indicated transition from Delta to Omicron variant indicated cause of third wave in India.

□

Overall, 426 lineages of 17 highly transmissible variants of SARS-CoV-2 were detected in the study.
COVID-19 preventive measures in Rohingya refugee camps: An assessment of knowledge, attitude and practice toward COVID-19
Authors: Halder Charls Erik , Hasan Md Abeed , Mohamud Yussuf Mohamed , Nyawara Marsela , Okello James Charles , Mizan Md Nahid , Sayum Md Abu
Published: February 2023

Background: Although many studies were conducted on COVID-19 knowledge, attitude, and practice among the general population in many countries, very little is known about refugees, particularly Rohingya refugees in Cox's Bazar. A vast array of Risk Communication and Community Engagement (RCCE) interventions were implemented in Cox’s Bazar with the intent of reducing disease transmission by empowering the community to adopt public health measures. Objectives: The study aimed to evaluate the current state of knowledge, attitude, and practice among Rohingya refugees as a result of RCCE initiatives.   Materials and Methods: A cross-sectional study was conducted with 500 Rohingya individuals. Participants in the study were Rohingya refugees residing in five randomly selected camps where IOM health was operating. Using a structured questionnaire, skilled community health workers surveyed the Rohingya population. In addition to the survey on knowledge, attitude, and practice, the study gathered information on the perspectives and relevance of sociodemographic factors that influence KAP. Results: The study findings indicate that the mean scores for knowledge, attitude, and practice were 9.93 (out of 14), 7.55 (out of 11), and 2.71 (out of 7) respectively. Association was found between knowledge and practice level and age group – elderly age group (>/= 61 years) had less level of knowledge (AOR 0.42, P value= 0.05) and the late mid age group (46 – 60 years) had better practice level (AOR 2.67, P value <0.001). A significant association was also found between good knowledge level and medium family size (5 – 6 members) (P value= 0.02). Conclusions:  The study reveals that the Cox's Bazar Rohingya refugee community has a low knowledge and attitude score about COVID-19 prevention measures. Especially the KAP scores were found significantly low in elderly population. Despite RCCE interventions, the practice level of these measures exhibited a considerably low score. Poor implementation of preventive measures must be identified and remedied, involving the community in future outbreaks of a similar nature.
The cerebellum and cognitive function: anatomical evidence from a transdiagnostic sample
Authors: Bègue Indrit , Elandaloussi Yannis , Delavari Farnaz , Cao Hengyi , Moussa-Tooks Alexandra , Roser Mathilde , Coupé Pierrick , Leboyer Marion , Kaiser Stefan , Houenou Josselin , Brady Roscoe , Laidi Charles
Published: February 2023

Introduction

The cerebellum, most known for its role in motor control, exerts a key role in cognition. Multiple lines of evidence across human functional, lesion and animal data point to a role of the cerebellum, in particular of Crus I, Crus II and Lobule VIIB, in cognitive function. However, whether cerebellar substrates pertaining to distinct facets of cognitive function exist is not known.

Methods

We analyzed structural neuroimaging data from the Healthy Brain Network (HBN). Cerebellar parcellation was performed via a standard validated automated segmentation pipeline (CERES) with stringent visual quality check (n = 662 subjects retained from initial n = 1452). We used data-driven canonical correlation analyses (CCA) to examine regional gray matter volumetric (GMV) differences in association to cognitive function assessed with the NIH Toolbox Cognition Domain (NIH-TB). Our multivariate analyses accounted for psychopathology severity, age, sex, scan location and intracranial volume.

Results

Multivariate CCA uncovered a significant correlation between two components entailing a latent cognitive canonical variate composed of NIH-TB subscales and the brain canonical variate (cerebellar regions’ GMV and intracranial volume, ICV). A bootstrapping and a permutation procedure ensured the results are statistically significant and the CCA model, stable. The identified components correspond to only partly shared cerebellar -cognitive function relationship with a first map encompassing cognitive flexibility (r=0.89) and speed of processing (r=0.65) associated with regional gray matter volume in Crus II (r=0.57) and Lobule X (r=0.59) and a second map including the Crus I (r=0.49) and Lobule VI (r=0.49) associated with cognitive control (r=-0.51). Working memory associations were similarly present in both these maps (Crus II, Lobule X, Crus I and Lobule VI) for the first (r=0.52) and second (r=0.51) component.

Discussion

Our results show evidence in favor of structural sub-specialization in the cerebellum, independently of psychopathology contributions to cognitive function and brain structure. Overall, these findings highlight a prominent role for the human cerebellum in cognitive function for flexible and stable adaptive behavior.
Detecting adrenal lesions on 3D CT scans using a 2.5D deep learning model
Authors: Poon Sanson T. S. , Hanna Fahmy W. F. , Lemarchand François , George Cherian , Clark Alexander , Lea Simon , Coleman Charlie , Sollazzo Giuseppe
Published: February 2023

Many cases of adrenal lesions, known as adrenal incidentalomas, are discovered incidentally on CT scans performed for other medical conditions. Whilst they are largely benign, these lesions can be secretory and/or malignant. Therefore, early investigation is crucial to promptly and efficiently manage those requiring intervention whilst to reassuring the remaining majority in a timely manner. Traditionally, the detection of adrenal lesions on CT scans relies on manual analysis by radiologists, which can be time-consuming and unsystematic. Using AI and deep learning, we examined whether or not applying these technology can augment the detection of adrenal incidentalomas in CT scans. We developed a 2.5D deep learning model to perform image classification on 3D CT scans of patients to classify between lesion and healthy adrenal glands. When tested on an independent test set, our 2.5D model obtained an AUC of the ROC curve of 0.95, and a classification sensitivity of 0.86, and specificity of 0.89. These results suggest that deep learning may be a promising tool for detecting adrenal lesions and improving patient care.
Criticality supports cross-frequency cortical-thalamic information transfer during conscious states
Authors: Toker Daniel , Müller Eli , Miyamoto Hiroyuki , Riga Maurizio S. , Lladó-Pelfort Laia , Yamakawa Kazuhiro , Artigas Francesc , Shine James M. , Hudson Andrew E. , Pouratian Nader , Monti Martin M.
Published: February 2023

Consciousness is thought to be regulated by bidirectional information transfer between the cortex and thalamus, but the nature of this bidirectional communication - and its possible disruption in unconsciousness - remains poorly understood. Here, we present two main findings elucidating mechanisms of corticothalamic information transfer during conscious states. First, we identify a highly preserved spectral channel of cortical-thalamic communication which is present during conscious states but which is diminished during the loss of consciousness and enhanced during psychedelic states. Specifically, we show that in humans, mice, and rats, information sent from either the cortex or thalamus viaδ/θ/αwaves (~1.5-13 Hz) is consistently encoded by the other brain region by highγwaves (~50-100 Hz); moroever, unconsciousness induced by propofol anesthesia or generalized spike-and-wave seizures diminishes this cross-frequency communication, whereas the psychedelic 5-methoxy-N,N/-dimethyltryptamine (5-MeO-DMT) enhances this interregional communication. Second, we leverage numerical simulations and neural electrophysiology recordings from the thalamus and cortex of human patients, rats, and mice to show that these changes in cross-frequency cortical-thalamic information transfer are mediated by excursions of low-frequency thalamocortical electrodynamics toward/away from edge-of-chaos criticality, or the phase transition from stability to chaos. Overall, our findings link thalamic-cortical communication to consciousness, and further offer a novel, mathematically well-defined framework to explain the disruption to thalamic-cortical information transfer during unconscious states.
Burden of lower respiratory tract infections preventable by adult immunization with 15- and 20-valent pneumococcal conjugate vaccines in the United States
Authors: Lewnard Joseph A. , Hong Vennis , Bruxvoort Katia J. , Grant Lindsay R. , Jódar Luis , Cané Alejandro , Arguedas Adriano , Pomichowski Magdalena E. , Gessner Bradford D. , Tartof Sara Y.
Published: February 2023

Background

Updated 2022 recommendations indicate all US adults aged ≥65 years and adults aged <65 years with comorbid conditions should receive 15- and 20-valent pneumococcal conjugate vaccines (PCV15/20). We aimed to assess the potential impact of these recommendations on the burden of lower respiratory tract infections (LRTIs) among adults.

Methods

We estimated the incidence of LRTI cases and associated hospital admissions among enrollees of Kaiser Permanente Southern California health plans from 2016-19. We used a counterfactual inference framework to estimate excess LRTI-associated risk of death up to 180 days after diagnosis. We used prior estimates of PCV13 effectiveness against all-cause and serotype-specific LRTI to model potential direct effects of PCV15/20 by age group and risk status.

Results

Use of PCV15 and PCV20, respectively, could prevent 89.3 (95% confidence interval: 41.3-131.8) and 108.6 (50.4-159.1) medically-attended LRTI cases per 10,000 person-years; 21.9 (10.1-32.0) and 26.6 (12.4-38.7) hospitalized LRTI cases per 10,000 person-years; and 7.1 (3.3-10.5) and 8.7 (4.0-12.7) excess LRTI-associated deaths per 10,000 person-years. Among at-risk adults aged <65 years not previously prioritized for receipt of PCV13, PCV15 and PCV20, respectively, could prevent 85.7 (39.6-131.5) and 102.7 (47.8-156.7) medically-attended LRTI cases per 10,000 person-years; 5.1 (2.4-8.6) and 6.2 (2.8-10.2) LRTI hospitalizations per 10,000 person-years, and 0.9 (0.4-1.4) and 1.1 (0.5-1.7) excess LRTI-associated deaths per 10,000 person-years. Expansions in serotype coverage, relative to PCV13, accounted for the majority of the expected increase in vaccine-preventable hospitalizations and deaths.

Conclusions

Our findings suggest recent recommendations including PCV15/20 within adult pneumococcal vaccine series may substantially reduce LRTI burden.

Key points

Use of PCV15/20 among US adults aged ≥65 years may prevent 521,000-626,000 LRTI cases, 127,000-154,000 hospitalizations, and 50,000-61,000 excess deaths, annually.

Updated recommendations for PCV15/20 among adults aged <65 years may prevent 441,000-526,000 LRTI cases, 39,000-46,000 hospitalizations, and 8,000-9,000 deaths annually.
The Basal and Major Pilins in theCorynebacterium diphtheriaeSpaA Pilus Adopt Similar Structures that Competitively React with the Pilin Polymerase
Authors: Sue Christopher K. , Cheung Nicole A. , Mahoney Brendan J. , McConnell Scott A. , Scully Jack M. , Fu Janine Y. , Chang Chungyu , Ton-That Hung , Loo Joseph A. , Clubb Robert T.
Published: February 2023

Many species of pathogenic gram-positive bacteria display covalently crosslinked protein polymers (called pili or fimbriae) that mediate microbial adhesion to host tissues. These structures are assembled by pilus-specific sortase enzymes that join the pilin components together via lysine-isopeptide bonds. The archetypal SpaA pilus fromCorynebacterium diphtheriaeis built by theCdSrtA pilus-specific sortase, which crosslinks lysine residues within the SpaA and SpaB pilins to build the shaft and base of the pilus, respectively. Here, we show thatCdSrtA crosslinks SpaB to SpaA via a K139(SpaB)-T494(SpaA) lysine-isopeptide bond. Despite sharing only limited sequence homology, an NMR structure of SpaB reveals striking similarities with the N-terminal domain of SpaA (NSpaA) that is also crosslinked byCdSrtA. In particular, both pilins contain similarly positioned reactive lysine residues and adjacent disordered AB loops that are predicted to be involved in the recently proposed “latch” mechanism of isopeptide bond formation. Competition experiments using an inactive SpaB variant and additional NMR studies suggest that SpaB terminates SpaA polymerization by outcompetingNSpaA for access to a shared thioester enzyme-substrate reaction intermediate.
The Geometry and Dimensionality of Brain-wide Activity
Authors: Wang Zezhen , Mai Weihao , Chai Yuming , Qi Kexin , Ren Hongtai , Shen Chen , Zhang Shiwu , Tan Guodong , Hu Yu , Wen Quan
Published: February 2023

Understanding neural activity organization is vital for deciphering brain function. By recording whole-brain calcium activity in larval zebrafish during hunting and spontaneous behaviors, we find that the shape of the neural activity space, described by the neural covariance spectrum, is scale-invariant: a smaller,randomly sampledcell assembly resembles the entire brain. This phenomenon can be explained by Euclidean Random Matrix theory, where neurons are reorganized from anatomical to functional positions based on their correlations. Three factors contribute to the observed scale invariance: slow neural correlation decay, higher functional space dimension, and neural activity heterogeneity. In addition to matching data from zebrafish and mice, our theory and analysis demonstrate how the geometry of neural activity space evolves with population sizes and sampling methods, thus revealing an organizing principle of brain-wide activity.
Tyrosine kinase inhibitors target B cells
Authors: Oksenych Valentyn
Published: February 2023

Autoimmune disorders and some types of blood cancer originate when B lymphocytes malfunction. In particular, when B cells produce antibodies recognizing the body’s proteins, it leads to various autoimmune disorders. And when B cells of various developmental stages transform into cancer cells, it results in blood cancers, including multiple myeloma, lymphoma, and leukemia. Thus, new methods of targeting B cells are required for various patient groups. Here, we used protein kinase inhibitors alectinib, brigatinib, ceritinib, crizotinib, entrectinib, and lorlatinib previously approved as drugs treating anaplastic lymphoma kinase (ALK)-positive lung cancer cells. We hypothesized that the same inhibitors will efficiently target leukocyte tyrosine kinase (LTK)-positive, actively protein-secreting mature B lymphocytes, including plasma cells. We isolated CD19-positive human B cells from the blood of healthy donors and used two alternative methods to stimulate cell maturation toward plasma cells. Using cell proliferation and flow cytometry assays, we found that ceritinib and entrectinib eliminate plasma cells from B cell populations. Alectinib, brigatinib, and crizotinib also inhibited B cell proliferation, while lorlatinib had no or limited effect on B cells. More generally, we concluded that several drugs previously developed to treat ALK-positive malignant cells can be also used to treat LTK-positive B cells.
Chronic administration of XBD173 ameliorates cognitive deficits and neuropathology via 18 kDa translocator protein (TSPO) in a mouse model of Alzheimer’s disease
Authors: Pradhan Arpit Kumar , Neumüller Tatjana , Klug Claudia , Fuchs Severin , Schlegel Martin , Ballmann Markus , Tartler Katharina Johanna , Pianos Antoine , Garcia-Sanchez Maria , Liere Philippe , Schumacher Michael , Kreutzer Matthias , Rupprecht Rainer , Rammes Gerhard
Published: February 2023

Alzheimer’s disease (AD) is characterized by the accumulation of β-amyloid peptide (Aβ). There is increasing evidence that depression may precede AD and may be an early manifestation of dementia, suggesting common mechanisms underlying both diseases. Ligands targeting the mitochondrial translocator protein (18 kDa) (TSPO), promote neurosteroidogenesis and may be neuroprotective. Moreover, TSPO is upregulated in AD. To study whether the TSPO ligand XBD173 may exert early neuroprotective effects in AD pathology we investigated the impact of XBD173 on amyloid toxicity and neuroplasticity in mouse models. We show that XBD173 (emapunil), via neurosteroid-mediated signaling via delta subunit-containing GABAAreceptors, prevents the neurotoxic effect of Aβ on long-term potentiation (CA1-LTP) in the hippocampus and prevents the loss of spines. Chronic but not acute administration of XBD173 ameliorates spatial learning deficits in transgenic AD mice with arctic mutation (ArcAβ) mice. The heterozygous TSPO-knockout crossed with the transgenic arctic mutation model of AD mice (het TSPOKO X ArcAβ) treated with XBD173 does not show this improvement in spatial learning suggesting TSPO is needed for procognitive effects of XBD173. The neuroprotective profile of XBD173 in AD pathology is further supported by a reduction in plaques and soluble Aβ levels in the cortex, increased synthesis of neurosteroids, rescued spine density, reduction of complement protein C1q deposits, and reduced astrocytic phagocytosis of functional synapses both in the hippocampus and cortex. Our findings suggest that XBD173 may exert therapeutic effects via TSPO in a mouse model of AD.
Release of extracellular matrix components after human traumatic brain injury
Authors: Bambrick Michael , Johnson Mark , Esko Jeffrey D. , Choudhury Biswa , Toledo Alejandro Gomez , Staley Kevin , Duhaime Ann-Christine
Published: February 2023

Most research on the evolution of damage after traumatic brain injury (TBI) focuses on cellular effects, but the analysis of human tissue slices and animal research have shown that TBI causes concomitant damage in the extracellular matrix, which can play a significant role in both short-term consequences such as edema, and late effects such as post-traumatic epilepsy (PTE). To test the hypothesis that traumatic brain injury (TBI) in human patients causes disruption of sulfated glycosaminoglycan (sGAG) in the extracellular matrix, we measured levels of these substances in the ventricular cerebrospinal fluid (CSF) in patients with severe TBI in the acute post-injury period, along with concomitant levels in blood and urine. We assessed whether levels corresponded to parenchymal injury load, distance of traumatic brain lesions from the ventricle, presence of polytrauma, or host demographic factors.

Methods

Samples of CSF, blood, and urine were obtained within 72 hours of injury in patients who received external ventricular drains as part of their treatment of severe TBI, and levels of chondroitin and heparan sGAGs were measured, along with their disaccharide constituents. Basic demographic information, presence and severity of polytrauma, brain injury load based on imaging findings, and distance of radiologically visible parenchymal injury from the ventricle were analyzed for correlation with total subtype sGAG levels in each patient.

Results

Levels were measured in 14 patients ranging in age from 17-90 years. CSF sGAG levels were variable among patients, and sGAG levels were higher in plasma than in CSF and variable in urine. Patients with polytrauma had non-significantly higher blood sGAG compared to patients with isolated head injury. Subcategories of CSF sGAG levels correlated with distance from the ventricle of parenchymal injury but not with brain injury load, which may reflect rapid metabolism in the parenchyma, contamination by blood, or bulk directional CSF flow from the ventricle to the subarachnoid space.

Conclusion

This study is the first to measure sGAG levels in ventricular CSF and also provides the first measurements in patients with TBI. Damage to the extracellular matrix may play a major role in acute and chronic injury sequelae, and these data demonstrate elevation locally of intracranial sGAGS after severe TBI and also suggest rapid local metabolism of these breakdown products. The consequences of extracellular matrix breakdown may provide unique therapeutic and preventive avenues to mitigate post-injury sequelae.