bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Three Sample-to-Answer RT–PCR Testing Platforms for the Detection of SARS-CoV-2 RNA in Positive Nasopharyngeal and Nasal Swabs
Authors: Luethy Paul M , Johnson J Kristie
Published: June 2021

Background

The COVID-19 pandemic has strained clinical microbiology laboratories due to testing supply allocations. As a result, laboratories have had to invest in multiple COVID-19 assays performed on different testing instruments. Comparing the results achieved by testing positive samples between in-use assays can provide insights into which platforms may be interchangeable for testing in times of supply chain emergencies.

Methods

Nasopharyngeal and nasal swab specimens collected in viral transport media that tested positive on the Xpert® Xpress SARS-CoV-2 assay were tested on the ePlex® SARS-CoV-2 and BD SARS-CoV-2 Reagents for BD Max™ assays. Positive percent agreement was calculated using the Xpert Xpress SARS-CoV-2 assay as the reference method.

Results

We tested 78 positive swabs, resulting in a positive percentage agreement (PPA) of 92% (CI 84–97%) for the BD SARS-CoV-2 assay and 58% (CI 47–70%) for the ePlex assay. Following development of a new workflow for the ePlex, we detected SARS-CoV-2 in 7 additional samples, resulting in a new PPA of 68% (CI 56–78).

Conclusions

During times of supply allocation and shortage of the Xpert Xpress SARS-CoV-2 assay, the BD SARS-CoV-2 assay is well suited to test substitutions due to its high PPA.
Differential privacy in health research: A scoping review
Authors: Ficek Joseph , Wang Wei , Chen Henian , Dagne Getachew , Daley Ellen
Published: June 2021

Objective

Differential privacy is a relatively new method for data privacy that has seen growing use due its strong protections that rely on added noise. This study assesses the extent of its awareness, development, and usage in health research.

Materials and Methods

A scoping review was conducted by searching for [“differential privacy” AND “health”] in major health science databases, with additional articles obtained via expert consultation. Relevant articles were classified according to subject area and focus.

Results

A total of 54 articles met the inclusion criteria. Nine articles provided descriptive overviews, 31 focused on algorithm development, 9 presented novel data sharing systems, and 8 discussed appraisals of the privacy-utility tradeoff. The most common areas of health research where differential privacy has been discussed are genomics, neuroimaging studies, and health surveillance with personal devices. Algorithms were most commonly developed for the purposes of data release and predictive modeling. Studies on privacy-utility appraisals have considered economic cost-benefit analysis, low-utility situations, personal attitudes toward sharing health data, and mathematical interpretations of privacy risk.

Discussion

Differential privacy remains at an early stage of development for applications in health research, and accounts of real-world implementations are scant. There are few algorithms for explanatory modeling and statistical inference, particularly with correlated data. Furthermore, diminished accuracy in small datasets is problematic. Some encouraging work has been done on decision making with regard to epsilon. The dissemination of future case studies can inform successful appraisals of privacy and utility.

Conclusions

More development, case studies, and evaluations are needed before differential privacy can see widespread use in health research.
A slight bending of an α-helix in FliM creates a counterclockwise-locked structure of the flagellar motor in Vibrio
Authors: Takekawa Norihiro , Nishikino Tatsuro , Yamashita Toshiki , Hori Kiyoshiro , Onoue Yasuhiro , Ihara Kunio , Kojima Seiji , Homma Michio , Imada Katsumi
Published: June 2021

Many bacteria swim by rotating flagella. The chemotaxis system controls the direction of flagellar rotation. Vibrio alginolyticus, which has a single polar flagellum, swims smoothly by rotating the flagellar motor counterclockwise (CCW) in response to attractants. In response to repellents, the motor frequently switches its rotational direction between CCW and clockwise (CW). We isolated a mutant strain that swims with a CW-locked rotation of the flagellum, which pulls rather than pushes the cell. This CW phenotype arises from a R49P substitution in FliM, which is the component in the C-ring of the motor that binds the chemotaxis signalling protein, phosphorylated CheY. However, this phenotype is independent of CheY, indicating that the mutation produces a CW conformation of the C-ring in the absence of CheY. The crystal structure of FliM with the R49P substitution showed a conformational change in the N-terminal α-helix of the middle domain of FliM (FliMM). This helix should mediates FliM–FliM interaction. The structural models of wild type and mutant C-ring showed that the relatively small conformational change in FliMM induces a drastic rearrangement of the conformation of the FliMM domain that generates a CW conformation of the C-ring.
The Impact of the COVID-19 Pandemic on Burn Admissions at a Major Metropolitan Burn Center
Authors: Codner Jesse A , De Ayala Rafael , Gayed Rita M , Lamphier Carey K , Mittal Rohit
Published: June 2021

The impact of the coronavirus disease 2019 (COVID-19) pandemic on admission patterns and outcomes at a burn center is still largely unknown. The aim of this study was to determine how the COVID-19 pandemic affected the epidemiology of burn admissions at a major metropolitan burn center. This retrospective cohort study examined how the COVID-19 pandemic affected burn volumes and time to presentation. All burn admissions were included from January 20 to August 31 for the years 2020, 2019, and 2018. The COVID-19 pandemic group included admissions from January 20, 2020 to August 31, 2020 and was compared to the nonpandemic group comprised of admissions from January 20 to August 31 in 2018 and 2019. Subgroup analysis was performed according to meaningful dates during the COVID-19 pandemic including the first U.S. COVID-19 case, shelter-in-place, and state reopening orders. Admission volumes were 403 patients in the COVID-19 pandemic group compared to a mean of 429 patients in the nonpandemic group, which correlated to a 5.8% decrease in volume during the pandemic. The pandemic group showed an increase in time to presentation of 1 day (P < .0001). Subgroup analysis demonstrated stable admission volumes and an increase in time to presentation of 1 day (P < .0001) at each time point. During shelter-in-place orders, there were higher rates of second/third-degree burns and operative burns (94.7 vs 56.3% and 45.6 vs 27%, P < .0001, P = .013). During the pandemic, there were stable admission volumes, delayed time to admission, and an increase in operative burns during shelter-in-place orders. This reinforces the need to maintain appropriate burn center staffing and resources during the COVID-19 pandemic.
Following Social Media Influencers in Early Adolescence: Fear of Missing Out, Social Well-Being and Supportive Communication with Parents
Authors: Schmuck Desirée
Published: June 2021

Social media influencers who use video blogging, so-called “vloggers,” are highly popular among adolescents. Receiving video updates on a constant basis may not only serve adolescents’ informational or entertainment needs, but also fuel their fear of missing out (FoMO), which can lower their social well-being in the long term. Supportive communication with parents about digital media use might be an important resource in preventing these negative outcomes. This study used a national quota-based two-wave panel survey of early adolescents between 10 and 14 years (NT2 = 384) to investigate the influence of adolescents’ perceived quality of communication with their parents on the relation between following vloggers, FoMO, and social well-being. Findings of an autoregressive panel model revealed that supportive communication with parents decreased early adolescents’ FoMO directly and prevented them from experiencing FoMO in response to following vloggers. Higher levels of FoMO in turn resulted in lower social well-being over time.
Comparison of Diet Preferences of Laboratory-Reared and Apartment-Collected German Cockroaches
Authors: McPherson Samantha , Wada-Katsumata Ayako , Hatano Eduardo , Silverman Jules , Schal Coby
Published: June 2021

The German cockroach, Blattella germanica (L.) (Blattodea: Ectobiidae), is a common pest of human-built structures worldwide. German cockroaches are generalist omnivores able to survive on a wide variety of foods. A number of studies have concluded that laboratory-reared B. germanica self-select diets with an approximate 1P:3C (protein-to-carbohydrate) ratio. We predicted that field-collected insects would exhibit more variable dietary preferences, related to the wide-ranging quality, quantity, and patchiness of foods available to them. We compared diet self-selection of B. germanica within apartments and in the laboratory by offering them a choice of two complementary diets with 1P:1C and 1P:11C ratios. We observed high variation in the population-level self-selection of these diets among individual apartment sites as well as among various life stages tested in laboratory-based assays. Significant differences between populations in various apartments as well as between populations maintained in the laboratory suggested that factors beyond temporary food scarcity influence diet choice. Nevertheless, we found significant correlations between the amounts of diets ingested by cockroaches in apartments and cockroaches from the same populations assayed in the laboratory, as well as between males, females, and nymphs from these populations. These findings suggest that females, males, and nymphs within apartments adapt to the local conditions and convergently prefer similar amounts of food of similar dietary protein content.
Draftde novoGenome Assembly of the Elusive Jaguarundi,Puma yagouaroundi
Authors: Tamazian Gaik , Dobrynin Pavel , Zhuk Anna , Zhernakova Daria V , Perelman Polina L , Serdyukova Natalia A , Graphodatsky Alexander S , Komissarov Aleksey , Kliver Sergei , Cherkasov Nikolay , Scott Alan F , Mohr David W , Koepfli Klaus-Peter , O’Brien Stephen J , Krasheninnikova Ksenia
Published: June 2021

The Puma lineage within the family Felidae consists of 3 species that last shared a common ancestor around 4.9 million years ago. Whole-genome sequences of 2 species from the lineage were previously reported: the cheetah (Acinonyx jubatus) and the mountain lion (Puma concolor). The present report describes a whole-genome assembly of the remaining species, the jaguarundi (Puma yagouaroundi). We sequenced the genome of a male jaguarundi with 10X Genomics linked reads and assembled the whole-genome sequence. The assembled genome contains a series of scaffolds that reach the length of chromosome arms and is similar in scaffold contiguity to the genome assemblies of cheetah and puma, with a contig N50 = 100.2 kbp and a scaffold N50 = 49.27 Mbp. We assessed the assembled sequence of the jaguarundi genome using BUSCO, aligned reads of the sequenced individual and another published female jaguarundi to the assembled genome, annotated protein-coding genes, repeats, genomic variants and their effects with respect to the protein-coding genes, and analyzed differences of the 2 jaguarundis from the reference mitochondrial genome. The jaguarundi genome assembly and its annotation were compared in quality, variants, and features to the previously reported genome assemblies of puma and cheetah. Computational analyzes used in the study were implemented in transparent and reproducible way to allow their further reuse and modification.
The septin complex links the catenin complex to the actin cytoskeleton for establishing epithelial cell polarity
Authors: Wang Xueying , Wang Wenwen , Wang Xiwei , Wang Ming , Zhu Lijuan , Garba Fatima , Fu Chuanhai , Zieger Barbara , Liu Xu , Liu Xing , Yao Xuebiao
Published: June 2021

Cell polarity is essential for spatially regulating of physiological processes in metazoans by which hormonal stimulation‒secretion coupling is precisely coupled for tissue homeostasis and organ communications. However, the molecular mechanisms underlying epithelial cell polarity establishment remain elusive. Here, we show that septin cytoskeleton interacts with catenin complex to organize a functional domain to separate apical from basal membranes in polarized epithelial cells. Using polarized epithelial cell monolayer as a model system with transepithelial electrical resistance as functional readout, our studies show that septins are essential for epithelial cell polarization. Our proteomic analyses discovered a novel septin‒catenin complex during epithelial cell polarization. The functional relevance of septin‒catenin complex was then examined in three-dimensional (3D) culture in which suppression of septins resulted in deformation of apical lumen in cysts, a hallmark seen in polarity-deficient 3D cultures and animals. Mechanistically, septin cytoskeleton stabilizes the association of adherens catenin complex with actin cytoskeleton, and depletion or disruption of septin cytoskeleton liberates adherens junction and polarity complexes into the cytoplasm. Together, these findings reveal a previously unrecognized role for septin cytoskeleton in the polarization of the apical‒basal axis and lumen formation in polarized epithelial cells.
Differences in floral traits and flower visitation rates in mating systems inPrunella vulgaris(Lamiaceae)
Authors: Ling Tial C , Wang Lin-Lin , Yang Yong-Ping , Duan Yuan-Wen
Published: June 2021

Floral traits and the number of visitors are expected to change with different mating systems. We tested this hypothesis by comparing flowers of Prunella vulgaris (Lamiaceae) with inserted and exserted styles across a strongly exserted style biased, an exserted style biased, and a strongly inserted style biased subalpine population. We examined flowering phenology, floral morphology, flower visitation rate, capacity for autonomous self-pollination and visitor contribution to seed production for each style type and in each population. We also examined inbreeding depression (ID) by comparing the relative performance of progeny from self- and cross-pollination. Exserted style plants had larger and more open flowers, increased pollen production, higher amounts of nectar rewards and higher visitation and outcrossing rates than inserted style plants. Similarly on the population level, the visitation rates were higher in the exserted style-biased populations than in the inserted style-biased population. Inserted style plants provided a stronger reproductive assurance (RA) through autonomous selfing than exserted style plants. RA and outcrossing rates did not differ among populations, showing low visitation rates may be sufficient for adequate seed production in P. vulgaris. Although inserted style plants had a lower ID level than exserted style plants, the ID of both was less than 0.5, suggesting that an ID should not counteract the evolution of selfing in this species. Inserted style plants provide RA through autonomous selfing, and exserted style plants ensure outcrossing through pollinator services, supporting a stable mixed mating system in this subalpine plant.
Bridging the intracranial pressure gap: a smooth transition strategy for slit ventricle syndrome
Authors: Yoon Sang-Youl , Kim Seung-Ki , Phi Ji Hoon
Published: June 2021

Slit ventricle syndrome (SVS) is a well-known complication of long-standing shunts. Patients develop intermittent severe headache, vomiting with other symptoms of increased intra-cranial pressure. Brain computed tomography (CT) usually reveals slit-like ventricles with nearly obstructed proximal catheters. Treatment for SVS usually involves upgrading the shunt valve pressure setting. Currently, many patients carry programmable shunts and pressure setting can be adjusted noninvasively. However, when the programmable valve pressure setting is upgraded, some patients with SVS experience worsened symptoms. This is caused by the time gap between ICP increase and real ventricular expansion (and freeing proximal catheter) after shunt upgrading. Therefore, it is important to control a patient’s symptoms during the transition period. We report our experience in controlling ICP in a patient with SVS using external ventricular drainage.
EVI1 activates tumor-promoting transcriptional enhancers in pancreatic cancer
Authors: Kim Hwa-Ryeon , Yim Juhye , Yoo Hye-Been , Lee Seung Eon , Oh Sumin , Jung Sungju , Hwang Chang-il , Shin Dong-Myung , Kim TaeSoo , Yoo Kyung Hyun , Kim You-Sun , Lee Han-Woong , Roe Jae-Seok
Published: June 2021

Cancer cells utilize epigenetic alterations to acquire autonomous capabilities for tumor maintenance. Here, we show that pancreatic ductal adenocarcinoma (PDA) cells utilize super-enhancers (SEs) to activate the transcription factor EVI1 (ecotropic viral integration site 1) gene, resulting in activation of an EVI1-dependent transcription program conferring PDA tumorigenesis. Our data indicate that SE is the vital cis-acting element to maintain aberrant EVI1 transcription in PDA cells. Consistent with disease progression and inferior survival outcomes of PDA patients, we further show that EVI1 upregulation is a major cause of aggressive tumor phenotypes. Specifically, EVI1 promotes anchorage-independent growth and motility in vitro and enhances tumor propagation in vivo. Mechanistically, EVI1-dependent activation of tumor-promoting gene expression programs through the stepwise configuration of the active enhancer chromatin attributes to these phenotypes. In sum, our findings support the premise that EVI1 is a crucial driver of oncogenic transcription programs in PDA cells. Further, we emphasize the instructive role of epigenetic aberrancy in establishing PDA tumorigenesis.
Spike-in normalization for single-cell RNA-seq reveals dynamic global transcriptional activity mediating anticancer drug response
Authors: Wang Xin , Frederick Jane , Wang Hongbin , Hui Sheng , Backman Vadim , Ji Zhe
Published: June 2021

The transcriptional plasticity of cancer cells promotes intercellular heterogeneity in response to anticancer drugs and facilitates the generation of subpopulation surviving cells. Characterizing single-cell transcriptional heterogeneity after drug treatments can provide mechanistic insights into drug efficacy. Here, we used single-cell RNA-seq to examine transcriptomic profiles of cancer cells treated with paclitaxel, celecoxib and the combination of the two drugs. By normalizing the expression of endogenous genes to spike-in molecules, we found that cellular mRNA abundance shows dynamic regulation after drug treatment. Using a random forest model, we identified gene signatures classifying single cells into three states: transcriptional repression, amplification and control-like. Treatment with paclitaxel or celecoxib alone generally repressed gene transcription across single cells. Interestingly, the drug combination resulted in transcriptional amplification and hyperactivation of mitochondrial oxidative phosphorylation pathway linking to enhanced cell killing efficiency. Finally, we identified a regulatory module enriched with metabolism and inflammation-related genes activated in a subpopulation of paclitaxel-treated cells, the expression of which predicted paclitaxel efficacy across cancer cell lines and in vivo patient samples. Our study highlights the dynamic global transcriptional activity driving single-cell heterogeneity during drug response and emphasizes the importance of adding spike-in molecules to study gene expression regulation using single-cell RNA-seq.
Urinary Dickkopf-3: a new biomarker for CKD progression and mortality
Authors: Sánchez-Álamo Beatriz , García-Iñigo Francisco José , Shabaka Amir , Acedo Juan Manuel , Cases-Corona Clara , Domínguez-Torres Patricia , Diaz-Enamorado Yunayka , Landaluce Eugenia , Navarro-González Juan F , Gorriz José Luis , Martínez-Castelao Alberto , Fernández-Juárez Gema
Published: June 2021

Background

Kidney fibrosis has been reported to be a prognostic factor in chronic kidney disease (CKD) progression. Previous studies have shown that the assessment of urinary Dickkopf-3 (uDKK3), a stress-induced tubular epithelial-derived profibrotic glycoprotein, might be a potential tubulointerstitial fibrosis biomarker and might identify patients at short-term risk of glomerular filtration rate loss. We aim to evaluate uDKK3 as a potential biomarker for progression of CKD in a cohort with various aetiologies of CKD and subsequently in an overt diabetic nephropathy cohort.

Methods

We prospectively studied two independent cohorts comprising a total of 351 patients with Stages 2 and 3 CKD. Combined primary outcome consisted of a 50% increase in serum creatinine, end-stage kidney disease or death. The Progreser cohort included patients with heterogeneous aetiologies and the Pronedi cohort (101 patients) with overt diabetic nephropathy. The median follow-up time was 36 months [interquartile range (IQR) 30–39] and 36 (16–48), respectively.

Results

At baseline, median uDKK3 was 2200 pg/mg (IQR 671–7617) in the Progreser cohort and 3042 pg/mg (IQR 661–9747) in the Pronedi cohort. There were no statistically significant differences in the uDKK3 ratio between both cohorts nor between CKD aetiologies. Baseline uDKK3 was significantly higher in patients who reached the primary outcome. In the Cox proportional hazards model, the highest levels of uDKK3 were found to be an independent factor for renal progression in the Progreser cohort {hazard ratio [HR] 1.91 [95% confidence interval (CI) 1.04–3.52]} and in the Pronedi cohort [HR 3.03 (95% CI 1.03–8.92)]. uDKK3 gradually increased in the following months, especially in patients with higher proteinuria. Treatment with renin–angiotensin–aldosterone system blockers did not modify uDKK3 after 4 or 12 months of treatment.

Conclusions

uDKK3 identifies patients at high risk of CKD progression regardless of the cause of kidney injury. uDKK3 might serve as a useful biomarker for kidney disease progression and therefore could be used by clinicians to optimize staging for renal progression and monitor the response to potential treatments.
A neuroendocrine perspective on the origin and evolution of cooperative breeding
Authors: Potticary Ahva L , Duckworth Renée A
Published: June 2021

Cooperative breeding behavior in birds ranges from inducible to obligate strategies and has evolved across diverse taxa, in species that display a wide range of social and reproductive behavior. It is often thought to evolve when independent breeding is constrained, and cooperation increases fitness. Yet many systems show variable, even maladaptive, fitness effects. This observation, together with the wide range in the form and frequency of cooperative breeding, raises the question of how the recurrent appearance of cooperative breeding and its extensive variation across species—from inducible to obligate—can be explained. Here, we take a proximate perspective on the evolution of cooperative breeding to argue that cooperative strategies are delineated by the history of prior adaptations and emerge through the rearrangement of preexisting neuroendocrine mechanisms underlying social, dispersal, and parental behaviors. Natural selection sorts among the resultant variants to alter regulation of cooperation, producing stabilization through either greater developmental entrenchment or greater reliance on environmental cues. Thus, species showing inducible cooperative behavior may be at a transitory stage in this process. To assess this possibility, we first evaluate evidence that the components of cooperative breeding are common across taxa. Then, we review the neuroendocrine mechanisms that regulate the pathways underlying cooperative strategies. Finally, we assess the evidence for neuroendocrine linkages during development that may channel coexpression of some components of cooperative breeding and facilitate its evolution. We conclude that understanding the mechanistic bases of the behaviors comprising cooperative breeding strategies may provide novel insight into the recurrent emergence of this strategy across disparate environments and avian taxa.
Improved virus-induced gene silencing allows discovery of a serpentine synthase gene in Catharanthus roseus
Authors: Yamamoto Kotaro , Grzech Dagny , Koudounas Konstantinos , Stander Emily Amor , Caputi Lorenzo , Mimura Tetsuro , Courdavault Vincent , O’Connor Sarah E.
Published: June 2021

Specialized metabolites are chemically complex small molecules with a myriad of biological functions. To investigate plant-specialized metabolite biosynthesis more effectively, we developed an improved method for virus-induced gene silencing (VIGS). We designed a plasmid that incorporates fragments of both the target gene and knockdown marker gene (phytoene desaturase, PDS), which identifies tissues that have been successfully silenced in planta. To demonstrate the utility of this method, we used the terpenoid indole alkaloid (TIA) pathway in Madagascar periwinkle (Catharanthus roseus) as a model system. Catharanthus roseus is a medicinal plant well known for producing many bioactive compounds, such as vinblastine and vincristine. Our VIGS method enabled the discovery of a previously unknown biosynthetic enzyme, serpentine synthase (SS). This enzyme is a cytochrome P450 (CYP) that produces the β-carboline alkaloids serpentine and alstonine, compounds with strong blue autofluorescence and potential pharmacological activity. The discovery of this enzyme highlights the complexity of TIA biosynthesis and demonstrates the utility of this improved VIGS method for discovering unidentified metabolic enzymes in plants.
Thick Social Equity
Authors: Frederickson H George
Published: June 2021

This is the third of four Last Lectures delivered by George Frederickson before his death in 2020. In “Thick Social Equity,” Frederickson returns to an abiding theme of his scholarship: the advancement of social equity in public administration research and practice. He traces the progress in the literature over the decades from “thin” to “thick” social equity, praising advancements in theory and empirical research in the twenty-first century, while decrying the current state of social inequity, particularly in the United States.
Improved parameter identification algorithm for ship model based on nonlinear innovation decorated by sigmoid function
Authors: Zhang Xianku , Zhao Baigang , Zhang Guoqing
Published: June 2021

This paper investigates the problem of parameter identification for ship nonlinear Nomoto model with small test data, a nonlinear innovation-based identification algorithm is presented by embedding sigmoid function in the stochastic gradient algorithm. To demonstrate the validity of the algorithm, an identification test is carried out on the ship ‘SWAN’ with only 26 sets of test data. Furthermore, the identification effects of the least squares algorithm, original stochastic gradient algorithm and the improved stochastic gradient algorithm based on nonlinear innovation are compared. Generally, the stochastic gradient algorithm is not suitable for the condition of small test data. The simulation results indicate that the improved stochastic gradient algorithm with sigmoid function greatly increases its accuracy of parameter identification and has 14.2% up compared with the least squares algorithm. Then the effectiveness of the algorithm is verified by another identification test on the ship ‘Galaxy’, the accuracy of parameter identification can reach more than 95% which can be used in ship motion simulation and controller design. The proposed algorithm has advantages of the small test data, fast speed and high accuracy of identification, which can be extended to other parameter identification systems with less sample data.
Analysis of moose-vehicle collisions countermeasures in northern climates
Authors: Abaza Osama , Moran Colleen C
Published: June 2021

This research investigates the reliability of two measures intended to reduce moose-vehicle collisions (MVCs): continuous lighting and clearing/grubbing of roadway corridors. Individual analyses and a combined regression analysis were conducted to measure the effects of several combinations of variables on MVC rates, including clearing and grubbing, continuous lighting, clearing without grubbing, moose population, precipitation, snowfall, and maximum snow depth. Nine corridor improvement projects were analyzed based on the variables present.

In previous studies, it has been hypothesized that MVC rates are influenced by environmental conditions such as snowfall and daylight. The Alaska Department of Transportation and Public Facilities (DOT&PF) has performed many studies on MVCs along several corridors. Some corridors showed a significant drop in the number of MVCs after the installation of continuous lighting.

The results show there is a consistent drop in MVCs after clearing and grubbing, with the exception of one corridor. The combined clearing/grubbing and continuous lighting projects also resulted in a consistent drop in MVCs. The projects with clearing and grubbing as a component had varying trends in MVCs, which may indicate that DOT&PF Maintenance and Operations performed clearing of re-vegetated areas, or that older growth is less of an attractant for moose.
SGLT2 inhibitors
Authors: Lenahan Christy McDonald , Harrington Deedra , Stueben Frances
Published: June 2021

Sodium-glucose cotransporter-2 (SGLT2) inhibitors can decrease risk for heart failure in patients with type 2 diabetes and can decrease risk of major cardiovascular events in patients with heart failure (HF) and diabetes. Specific SGLT2 inhibitors can also decrease major cardiovascular events in patients with HF only.
CircRNA ACAP2 Is Overexpressed in Myocardial Infarction and Promotes the Maturation of miR-532 to Induce the Apoptosis of Cardiomyocyte
Authors: Zhang Jun , Tang Yanrong , Zhang Jing , Wang Jing , He Jiyun , Zhang Zhenzhen , Liu Fuqiang
Published: June 2021

CircRNA ACAP2 and miR-532 both promotes the apoptosis of cardiomyocytes, which contributes to myocardial infarction (MI). Therefore, ACAP2 and miR-532 may interact with each other to participate in MI. Plasma samples from both patients with MI (n = 65) and healthy controls (n = 65) were subjected to RNA extractions and real-time quantitative polymerase chain reaction to analyze the expression of ACAP2, mature miR-532, and premature miR-532. Correlations among them were analyzed by Pearson's correlation coefficient. Expression of both mature miR-532 and premature miR-532 in cardiomyocytes with ACAP2 overexpression was analyzed by real-time quantitative polymerase chain reaction to study the effects of ACAP2 overexpression on the maturation of miR-532. The role of ACAP2 and miR-532 in regulating the apoptosis of cardiomyocytes induced by hypoxia was analyzed by cell apoptosis assay. In this study, we found that ACAP2 and mature miR-532 were both upregulated in plasma from patients with MI. ACAP2 and mature miR-532 were inversely correlated, whereas ACAP2 and premature miR-532 were not significantly correlated. In cardiomyocytes, overexpression of ACAP2 increased the expression of mature miR-532, but not premature miR-532. Cell apoptosis analysis showed that ACAP2 and miR-532 overexpression promoted the apoptosis of cardiomyocytes induced by hypoxia treatment. In addition, miR-532 inhibitor reduced the effects of ACAP2 overexpression. ACAP2 is overexpressed in MI and may promote the maturation of miR-532 to induce the apoptosis of cardiomyocyte.
Comparative analysis of ischemic changes in electrocardiogram and coronary angiography results
Authors: Liu Yun , Ping Jing , Qiu LiCheng , Sun Chenglong , Chen Ming
Published: June 2021

To improve the correct diagnosis rate of coronary heart disease and to explore the guiding value of electrocardiogram (ECG) ST-T ischemic changes in the clinical diagnosis of coronary heart disease.

A retrospective analysis was conducted on a total of 310 cases who underwent a conventional 12-lead ECG, 12-lead dynamic ECG (DECG, Holter) with ST-T ischemic changes, and then coronary angiography (CA) within 1 week in Qingdao Sttarr Heart Hospital from June 2015 to April 2020 in the study. Ischemic ST-T changes were evaluated using conventional diagnostic criteria, and Judkins diagnostic criteria were used in CA. The sensitivity and specificity of ECG were analyzed.

The specificity of ST-T changes in conventional ECG for the diagnosis of coronary heart disease is 33.7% and the sensitivity is 66.0%. The specificity of ST-T changes in Holter in the diagnosis of coronary heart disease is 55.6% and the sensitivity is 32.2%. The sensitivity of conventional ECG for the diagnosis of coronary heart disease is better than Holter, but its specificity is inferior to Holter. The negative likelihood ratios of the 2 ECGs for the diagnosis of coronary heart disease were 1.0 and 1.22, both >0.1, and the positive likelihood ratios were 0.99 and 0.73, both <10. The positive results of ST-T in conventional ECG were 128 males (65.7%), 77 females (66.9%), (P < .05), 148 cases (74.7%) in the group ≥60 years old, and 75 cases in the group less than 60 years (67%), (P > .05). The positive results of ST-T change of DECG were 135 males (69.2%), 69 females (60.0%), (P < .05), 152 cases (78.7%) in the group ≥60 years, and 83 cases (70.9%) in the group less than 60 years, (P > .05). Coronary heart disease-related factors: symptoms, hypertension, diabetes, cancer, family history, smoking history as independent variables, and a binary multivariate logistic regression analysis was performed.

The sensitivity of DECG in the diagnosis of myocardial ischemia in women and the elderly was slightly higher than that in men and young cases. ST-T ischemic changes in ECG are more significant for the diagnosis of coronary heart disease in male patients. Smoking, hypertension, diabetes, and family history are all high-risk factors for coronary heart disease.
Comparison of intragastric pressure between endotracheal tube and supraglottic airway devices in laparoscopic hepatectomy
Authors: Ahn Jin Hee , Jeong Ji Seon , Kang Se Hee , Yeon Ji Eun , Cho Eun A. , Choi Gyu Sung , Kim Jong Man , Kim Gaab Soo
Published: June 2021

Background:

Supraglottic airway (SGA) devices do not definitively protect the airway from regurgitation of gastric contents. Increased gastric pressure and long operation time are associated with development of complications such as aspiration pneumonia. The aim of this study was to compare intragastric pressure between second-generation SGA and endotracheal tube (ETT) devices during long-duration laparoscopic hepatectomy.

Methods:

A total of 66 patients was randomly assigned to 2 groups; 33 patients each in the ETT and SGA groups. Intragastric pressure was continuously measured via a gastric drainage tube with a three-way stopcock connected to the pressure monitoring device. Normal saline was added to the end of the gastric drainage tube at each operation time point.

Results:

Intragastric pressure during pneumoperitoneum was no different between the 2 groups (P = .146) or over time (P = .094). The mean (standard deviation [SD]) pH of the SGA tip measured after operation was 6.7 (0.4), and a pH <4 was not observed. Relative risk of postoperative complications was significantly higher in the ETT group relative to the SGA group (sore throat, 5.5; cough,13.0).

Conclusions:

Use of SGA devices does not further increase intragastric pressure, even during prolonged upper abdominal laparoscopic surgery. Also, the frequency of postoperative sore throat and cough was significantly lower when the second-generation SGA device was used.
Systematic review and meta-analysis of vitamin D deficiency in different pregnancy on preterm birth
Authors: Lian Rui-Han , Qi Ping-An , Yuan Tao , Yan Pei-Jing , Qiu Wen-Wen , Wei Ying , Hu Ya-Guang , Yang Ke-Hu , Yi Bin
Published: June 2021

Background:

Current studies suggest that vitamin D deficiency during pregnancy can produce a certain effect for preterm birth (PTB), but there is no research showing whether vitamin D deficiency has a consistent effect in different pregnancies; thus, we conducted a systematic review and meta-analysis of 24 observational studies, grouping them according to the gestational age at the time of serum sampling, to investigate whether vitamin D deficiency in different periods of gestation has different effects on PTB and to provide an evidence-based basis for pregnant women to measure and supplement vitamin D.

Methods:

The databases PubMed-Medline, EMBASE, the Cochrane Library, Web of Science, EBSCO, CBM, and CNKI were searched until February 2020. Two researchers independently assessed the eligibility and quality of studies, and STATA 12.0 software was used for meta-analysis.

Result:

Seven cohort studies, 13 case–control studies, and 4 cross-sectional studies were included from 2500 articles by inclusion and exclusion criteria. After adjusting for age, race, and other confounding factors, meta-analysis results showed that vitamin D deficiency in the first trimester, the second trimester, and the third trimester did not increase the risk of PTB (odds ratio (OR) = 1.01, 95% confidence interval (CI) (0.88, 1.16), P = .867; OR = 1.12, 95%CI (0.92, 1.37), P = .249; OR = 1.05, 95%CI (0.87, 1.27), P = .602). However, there was moderate heterogeneity in the study of vitamin D deficiency in the second trimester, and subgroup analysis suggested that vitamin D deficiency in the second trimester may increase the risk of PTB (OR = 1.33, 95%CI (1.15, 1.54), P = .000). A sensitivity analysis of the second trimester showed that excluding any 1 study did not significantly change the results.

Conclusions:

Vitamin D deficiency in early and late pregnancy may not be associated with PTB, while vitamin D deficiency in middle pregnancy is likely to have an important effect on PTB. Vitamin D levels should be measured in the second trimester of pregnancy, and vitamin D supplements should be provided if necessary.
Lymphedema complicated by protein-losing enteropathy with a 22q13.3 deletion and the potential role of CELSR1
Authors: Xia Song , Liu Zhong , Yan Huifang , Chang Kun , Sun Yuguang , Wang Jingmin , Shen Wenbin
Published: June 2021

Introduction:

22q13.3 deletion syndrome is a well-known syndrome characterized by typical clinical findings including neonatal hypotonia, absent or severely delayed speech, intellectual disability, and other various features, and detection of a heterozygous deletion of chromosome 22q13.3 with the involvement of at least part of SHANK3. It is reported that 10% to 29% of patients with 22q13.3 deletion syndrome present lymphedema. Protein-losing enteropathy (PLE) has never been reported in 22q13.3 deletion syndrome.

Patient concerns:

The patient presented to our institution for refractory hypoalbuminemia and chronic lymphedema in both legs.

Diagnosis:

The patient manifested intellectual disability, absent speech, tooth grinding, dysmorphic face, and abnormal hands and toenails. Copy-number variation sequencing confirmed the maternal deletion in 22q13.31-q13.33 (chr22:46285592–51244566, hg19). The patient was genetically diagnosed with 22q13.3 deletion syndrome.

Interventions:

Low-fat diets and medium-chain triglycerides supplements were prescribed. The patient was recommended to wear compression garments and elevate legs.

Outcomes:

The symptom of diarrhea was resolved, but hypoalbuminemia persisted. Lower extremities lymphedema was gradually becoming severe.

Conclusions:

Primary lymphedema and PLE can occur simultaneously in a patient with 22q13.3 deletion syndrome. The 2 phenotypes could share the same genetic etiology of congenital lymphatic abnormalities. CELSR1 deletion may play a role in lymphatic dysplasia. The case also provides additional proof of the pathogenic effect of CELSR1 on hereditary lymphedema.
Phenotypic spectrum and mechanism analysis of Schaff Yang syndrome
Authors: Duan Yanjie , Liu Lu , Zhang Xiujuan , Jiang Xiuyun , Xu Jin , Guan Qingbo
Published: June 2021

Rationale:

The Schaaf-Yang syndrome (SYS) is an autosomal dominant multi-system genetic disease caused by melanoma antigen L2 (MAGEL2) gene mutations imprinted by mothers and expressed by fathers on the 15q11–15q13 chromosomes in the critical region of Prader-Willi. MAGEL2 is a single exon gene and one of the protein-coding genes of the Prader-Willi domain. MAGEL2 is a matrilineal imprinted gene (i.e., the maternal chromosome is methylated). It is only expressed by unmethylated paternal alleles, and the individual is affected only when the variation occurs on the paternal allele.

Patient concerns:

We reported a patient with MAGEL2 gene new site mutation who had mild intellectual disability, social fear, small hands and feet, obesity issues, dyskinesia, growth retardation, language lag and sexual development disorder.

Diagnosis:

Whole-exome sequencing showed a heterozygous variation in the MAGEL2 gene, NM_019066.4:c.1687C > T (p.Q563X) and diagnosed as Schaaf-Yang syndrome.

Interventions:

Patient was advised to reduce weight, control blood lipids, blood glucose through appropriate strengthening of exercise and diet control in the future. At the same time, the family members were advised to provide mental training to the patient to strengthen the contact and communication with the outside world and improve the autistic symptoms. Because of the patient's bilateral cryptorchidism, it is recommended that the patient should be treated with bilateral cryptorchidism reduction fixation.

Outcomes:

After a follow-up of the patient for 2 months, the patient is still walking unsteadily and requires an auxiliary reference material to walk normally. There is no significant change in height compared to before, and the weight has dropped by about 2 kg in the past 2 months. The symptoms of autism have improved slightly. The patient is willing to communicate with outsiders; his intelligence has not improved significantly, and his academic performance in school is still at the middle and lower levels.

Lessons:

The pathogenesis of SYS is complex, involving multiple pathways such as Leptin-POMC, MAGEL2-USP7-TRIM27 complex and oxytocin. Our study has also found that certain fatal phenotypes such as respiratory distress have a high incidence at individual sites, and early detection and timely intervention may prolong the life span of patients. Therefore, for patients in whom SYS is highly suspected, gene detection should be carried out as soon as possible.
Efficacy and safety of danoprevir plus sofosbuvir in GT 1, 2, 3, or 6 chronic hepatitis C patients with or without cirrhosis in China
Authors: Pan Shufang , Feng Kai , Huang Ping , Zeng Yingfu , Ke Liu , Yang Xiaodong , Liu Jing , Lin Chaoshuang
Published: June 2021

All-oral direct-acting antiviral therapies are becoming the choice for hepatitis C (HCV) treatment. In this study, we aimed to evaluate the efficacy and safety of ritonavir-boosted danoprevir (DNVr) plus sofosbuvir±ribavirin on HCV genotype 1, 2, 3, or 6 in the real world in China.

In this observational, prospective, multicenter cohort, we enrolled a total of 58 patients with HCV genotype 1, 2, 3, or 6 patients from July 2018 to December 2019. All patients were treated with DNVr plus sofosbuvir ± ribavirin for 12 weeks and then followed up for 12 weeks. The primary endpoint was the rate of sustained virologic response at week 12 after the end of treatment (SVR12). The secondary endpoint was virologic response rate at end-of-treatment and adverse event outcome.

Of the 58 patients who were enrolled, 5.2% (n = 3) had genotype 1a; 43.1% (n = 25) had HCV genotype 1b; 17.2% (n = 10) had genotype 2a; 5.2% (n = 3) had genotype 3a; 8.6% (n = 5) had genotype 3b; and 20.7% (n = 12) had genotype 6a. The virologic response rate at end-of-treatment was 100% (58/58). The HCV-RNA results of 5 patients were absent at week 12 after treatment. Among the 53 patients, SVR12 rate achieved 100% (53/53) with DNVr plus sofosbuvir ± ribavirin treatment in patients with HCV genotype 1b, 2a, 3, and 6a. For compensated cirrhosis and noncirrhosis patients, SVR12 was 100% with DNVr plus sofosbuvir ± ribavirin treatment. No serious event was observed during the treatment and follow-up. Only 5 patients had mild adverse events.

DNVr plus sofosbuvir ± ribavirin for 12 weeks provided 100% SVR12 in a broad patient population and were well tolerated, which may be a promising regimen for CHC treatment.
Development of an evaluation indicator system for the rational use of proton pump inhibitors in pediatric intensive care units
Authors: Ni Xiaofeng , Lin Mao , Li Jialian , Zeng Linan , Li Wenrui , Huang Liang , Li Deyuan , Zhang Lingli
Published: June 2021

Proton pump inhibitors are frequently used to prevent gastrointestinal bleeding in critically ill patients. But there is little information in the instructions about the usages for children. It is important to monitor the appropriate use of proton pump inhibitors, especially in pediatrics. Therefore, we developed an evaluation indicator system for the rational use of proton pump inhibitors in pediatric intensive care units.

First, a systematic review was conducted to developed the initial indicators. Then 2 rounds of Delphi surveys were conducted to collecting opinions from a panel of independent experts, and the indicator system was modified to form the final indicators according to the opinions. Finally, the analytic hierarchy procedure was used to determine the weight of each indicator.

A total of 6 guidelines and 2 studies met the inclusion and exclusion criteria. Based on literature and discussion among experts, an initial indicator system including 4 first-rank indicators and 12 second-rank indicators was formed. After 2 rounds of Delphi surveys, 2 indicators were added, 5 indicators were deleted, and 1 indicator was revised, so the final indicator system contained a total of 13 indicators including 3 first-rank indicators (drug selection, drug usage and dosage, duration of drug therapy) and 10 second-rank indicators (the proportion of PPIs used in children, children under 1 year old, children who is using glucocorticoids, children with nonsteroidal anti-inflammatory drugs, children with gastroesophageal reflux disease, children with sepsis, children with ventilators in PICU; the strength of PPIs’ use, the proportion of omeprazole in children using PPIs during the same period; the average days of PPIs used in children). By analyzing scores, all coefficients met the standard, indicating the indicators were scientific and credible.

Through a two-round Delphi survey, 3 first-rank indicators and ten second-rank indicators were developed, which will help drug administrative departments to promote the rational use of PPIs for children in PICUs. What is more, our study can constitute a methodological reference for the development of other indicator systems.