bluuebunny/crossref_metadata_2025 huggingface dataset:
Older Adults’ Daily Activity and Mood Changes Detected During the COVID-19 Pandemic Using Remote Unobtrusive Monitoring Technologies
Authors: Leese Mira I , Bernstein John P K , Dorociak Katherine E , Mattek Nora , Wu Chao-Yi , Beattie Zachary , Dodge Hiroko H , Kaye Jeffrey , Hughes Adriana M
Published: August 2021

Background and Objectives

The coronavirus disease 2019 (COVID-19) pandemic has limited older adults’ access to in-person medical care, including screenings for cognitive and functional decline. Remote, technology-based tools have shown recent promise in assessing changes in older adults’ daily activities and mood, which may serve as indicators of underlying health-related changes (e.g., cognitive decline). This study examined changes in older adults’ driving, computer use, mood, and travel events prior to and following the COVID-19 emergency declaration using unobtrusive monitoring technologies and remote online surveys. As an exploratory aim, the impact of mild cognitive impairment (MCI) on these changes was assessed.

Research Design and Methods

Participants were 59 older adults (41 cognitively intact and 18 MCI) enrolled in a longitudinal aging study. Participants had their driving and computer use behaviors recorded over a 5-month period (75 days pre- and 76 days post-COVID emergency declaration) using unobtrusive technologies. Measures of mood, overnight guests, and frequency of overnight travel were also collected weekly via remote online survey.

Results

After adjusting for age, gender, and education, participants showed a significant decrease in daily driving distance, number of driving trips, highway driving, and nighttime driving, post-COVID-19 as compared to pre-COVID-19 (p < .001) based on generalized estimating equation models. Further, participants spent more time on the computer per day post-COVID-19 (p = .03). Participants endorsed increases in blue mood (p < .01) and loneliness (p < .001) and decreases in travel away from home and overnight visitors (p < .001) from pre- to post-COVID-19. Cognitive status did not impact these relationships.

Discussion and Implications

From pre- to post-COVID-19 emergency declaration, participants drove and traveled less, used their computer more, had fewer overnight visitors, and reported greater psychological distress. These results highlight the behavioral and psychological effects of stay-at-home orders on older adults who are cognitively intact and those with MCI.
Data augmentation and its application in distributed acoustic sensing data denoising
Authors: Zhao Y X , Li Y , Wu N
Published: August 2021

As a data-driven approach, the performance of deep learning models depends largely on the quantity and quality of the training data sets, which greatly limits the application of deep learning to tasks with small data sets. Unfortunately, sometimes we need to use limited small data sets to complete our tasks, such as distributed acoustic sensing (DAS) data denoising. However, using a small data set to train the network may cause overfitting, resulting in poor network generalization. To solve this problem, we propose an approach based on the combination of a generative adversarial network and a deep convolutional neural network. First, we used a small noise data set to train a generative adversarial network to generate synthetic noise samples, and then used these synthetic noise samples to augment the noise data set. Next, we used the augmented noise data set and the signal data set obtained through forward modelling to construct a synthetic training set. Finally, a denoising network based on a convolutional neural network was trained on the constructed synthetic training set. Experimental results show that the augmented data set can effectively improve the denoising performance and generalization ability of the network, and the denoising network trained on the augmented data set can more effectively reduce various kinds of noise in the DAS data.
Machine Learning Predictive Outcomes Modeling in Inflammatory Bowel Diseases
Authors: Javaid Aamir , Shahab Omer , Adorno William , Fernandes Philip , May Eve , Syed Sana
Published: August 2021

There is a rising interest in use of big data approaches to personalize treatment of inflammatory bowel diseases (IBDs) and to predict and prevent outcomes such as disease flares and therapeutic nonresponse. Machine learning (ML) provides an avenue to identify and quantify features across vast quantities of data to produce novel insights in disease management. In this review, we cover current approaches in ML-driven predictive outcomes modeling for IBD and relate how advances in other fields of medicine may be applied to improve future IBD predictive models. Numerous studies have incorporated clinical, laboratory, or omics data to predict significant outcomes in IBD, including hospitalizations, outpatient corticosteroid use, biologic response, and refractory disease after colectomy, among others, with considerable health care dollars saved as a result. Encouraging results in other fields of medicine support efforts to use ML image analysis—including analysis of histopathology, endoscopy, and radiology—to further advance outcome predictions in IBD. Though obstacles to clinical implementation include technical barriers, bias within data sets, and incongruence between limited data sets preventing model validation in larger cohorts, ML-predictive analytics have the potential to transform the clinical management of IBD. Future directions include the development of models that synthesize all aforementioned approaches to produce more robust predictive metrics.
The Selective 5-HT1A Agonist SR57746A Protects Intestinal Epithelial Cells and Enteric Glia Cells and Promotes Mucosal Recovery in Experimental Colitis
Authors: Walldorf Jens , Porzner Marc , Neumann Martin , Joodi Golsa , Niess Jan Hendrik , von Boyen Georg , Mäder Karsten , Weissbach Julia , Kleger Alexander , Seufferlein Thomas
Published: August 2021

Background

Neurotrophic growth factors can stabilize the intestinal barrier by preventing the apoptosis of enteric glial cells (EGCs) and enterocytes. We reasoned that a selective 5-HT1A receptor agonist may have neuroprotective properties in the gut and that topical application of SR57746A might be an effective treatment strategy in inflammatory bowel disease (IBD).

Methods

The therapeutic potential of 5-HT1A receptor agonist SR57746A in IBD was evaluated in vitro (nontransformed NCM460 colonic epithelial cells, SW480 colorectal carcinoma cells) and in vivo (murine dextran sulfate sodium [DSS] colitis and CD4-T-cell transfer colitis). In vitro, we analyzed the effect of SR57746A on apoptosis in intestinal epithelial cells (IECs) and EGCs, and upon proliferation, migration, and intracellular signaling in IECs. In vivo, the effect of topical application of SR57746 on disease activity and on histological and endoscopic findings was compared with intraperitoneal infliximab and placebo, respectively.

Results

The SR57746A activates PI3-K/AKT- and ERK-signaling in IECs. Depending on ERK- and AKT activation, SR57746A potently prevents apoptosis of IECs without inducing proliferation or migration in these cells. Moreover, SR57746A prevented apoptosis in EGCs in vitro. Topical SR57746A treatment significantly reduced mucosal injury in 2 experimental murine colitis models and was as effective as intraperitoneal infliximab treatment.

Conclusions

Treatment with SR57746A prevents inflammatory cell damage and apoptosis in IECs and EGCs, similar to the neurotrophic effects of EGCs on IECs. Topical treatment with SR57746A could be a candidate for clinical evaluation in the treatment of IBD.
Oral Delivery of Encapsulated All-Trans Retinoic Acid Ameliorates Disease in Rodent Models of Colitis
Authors: Nicoletti Ferdinando , Hammer Laura , Furtado Stacia , Mangano Katia , Mathiowitz Edith , Green Benjamin , Auci Dominick L
Published: August 2021

Background

All-trans retinoic acid (ATRA) is a biologically active isomer of retinoic acid (RA). Topical ATRA (retin-a, retin-a micro, atralin, renova, and avita) is the active pharmaceutical ingredient for FDA-approved treatments for acne and skin wrinkles. Oral formulations (Vesanoid) treat acute promyelocytic leukemia, but oral dosing can induce severe side effects. Despite benefits in various rodent models of inflammatory bowel disease (IBD), toxicity and controversial clinical observations have diminished enthusiasm for ATRA IBD clinical trials. To circumvent these issues and to use ATRA’s key role in maintaining gut tolerance, we developed a poly(lactic-co-glycolic acid) (PLGA) microsphere (MS) encapsulated ATRA formulation aimed at directing ATRA delivery to immune structures of the gut, limiting systemic exposure. Initially, ATRA MS was developed as a component of a combinatorial product (TreXTAM) that also contained encapsulated transforming growth factor (TGF)-β and ATRA in a 1:2 w/w ratio. Although the combination was optimal, benefit was also observed when ATRA MS was given alone in the CD4+ CD25-T-cell adoptive transfer (ACT) colitis model.

Methods

We used the ACT and DSS-induced murine models of colitis to expand on the dose-dependent effects of oral ATRA MS when given alone. The DSS model was also used to compare the efficacy of ATRA MS and soluble ATRA, while healthy animals were used to compare the pharmacokinetics of the two drugs.

Results

In both the ACT and DSS-induced murine models of colitis, ATRA MS was observed to be effective in ameliorating disease. ATRA MS was also observed to be more effective than soluble ATRA in these models and displayed more favorable pharmacokinetics.

Conclusions

We suggest ATRA MS, as a standalone product, may attenuate IBD and perhaps limit fibrosis, while limiting systemic side effects.
Joint Estimation of Generation Time and Incubation Period for Coronavirus Disease 2019
Authors: Lau Yiu Chung , Tsang Tim K , Kennedy-Shaffer Lee , Kahn Rebecca , Lau Eric H Y , Chen Dongxuan , Wong Jessica Y , Ali Sheikh Taslim , Wu Peng , Cowling Benjamin J
Published: August 2021

Background

Coronavirus disease 2019 (COVID-19) has caused a heavy disease burden globally. The impact of process and timing of data collection on the accuracy of estimation of key epidemiological distributions are unclear. Because infection times are typically unobserved, there are relatively few estimates of generation time distribution.

Methods

We developed a statistical framework to jointly estimate generation time and incubation period from human-to-human transmission pairs, accounting for sampling biases. We applied the framework on 80 laboratory-confirmed human-to-human transmission pairs in China. We further inferred the infectiousness profile, serial interval distribution, proportions of presymptomatic transmission, and basic reproduction number (R0) for COVID-19.

Results

The estimated mean incubation period was 4.8 days (95% confidence interval [CI], 4.1–5.6), and mean generation time was 5.7 days (95% CI, 4.8–6.5). The estimated R0 based on the estimated generation time was 2.2 (95% CI, 1.9–2.4). A simulation study suggested that our approach could provide unbiased estimates, insensitive to the width of exposure windows.

Conclusions

Properly accounting for the timing and process of data collection is critical to have correct estimates of generation time and incubation period. R0 can be biased when it is derived based on serial interval as the proxy of generation time.
How does former Salter innominate osteotomy in patients with Legg–Calvé–Perthes disease influence acetabular orientation? An MRI-based study
Authors: Bellova Petri , Goronzy Jens , Blum Sophia , Bürger Simon , Hartmann Albrecht , Günther Klaus-Peter , Thielemann Falk
Published: August 2021

Salter innominate osteotomy (SIO) has been successfully used in the treatment of Legg–Calvé–Perthes disease (LCPD). Recent studies that have raised concerns about acetabular retroversion after SIO have been based on plain radiographs. In order to assess the true acetabular orientation, the present study uses a specific magnetic resonance imaging (MRI) technique. In addition, the association between acetabular morphology and clinical function as well as health-related quality of life was assessed. Twenty-three patients with 24 operated hips who underwent SIO for LCPD between January 2004 and November 2014 were included. Mean age was 8.5 ± 2.2 years at surgery and 18.5 ± 2.9 years at follow-up. MRIs were conducted at 1.5 T using radial sequences. The analysis included the acetabular version, acetabular sector angles (ASAs) and alpha angles. Plain radiographs were used in order to obtain the Stulberg classification. Patient-related outcome measures included the international Hip Outcome Tool and Euroqol-5 dimensions scores. In comparison to the non-operated side, the MRI of previously operated hips showed no difference of version at the center of the femoral head but significantly decreased version just below the roof level. As a marker for posterior acetabular coverage, the ASAs between 9 and 11 o’clock were significantly decreased when compared with non-operated hips. In hips with a mild acetabular retroversion (<15°), the function was significantly decreased when compared with non-retroverted hips. The SIO is an effective tool in order to restore acetabular containment in LCPD. When compared with the non-operated hips, our collective displays only moderate changes of acetabular orientation and coverage.
Field Report and Survey ofFiorinia phantasma(Hemiptera: Diaspididae), Potential Pest of Palms, and Ornamental Plants in the United States
Authors: Ahmed Muhammad Z , Miller Douglass R , Rohrig Eric A , Hodges Greg S , Roda Amy L , McKenzie Cindy L , Osborne Lance S
Published: August 2021

Fiorinia phantasma Cockerell & Robinson is an invasive, polyphagous pest recently found causing frond losses in ornamental palms in Miami-Dade County and in nurseries in Palm Beach County, Florida, USA. In this article, we document the discovery of this pest, its associated damage, closely related species, potential host plant species, a field guide, basic diagnostics, field dispersal, and available management options. Fiorinia phantasma is a pest of concern for ornamental plants demanding quick development of its management in Florida and preventative measures for other states in the United States. This article will help in detecting, identifying, and managing its early infestations.
Hypopituitarism in patients with metastatic renal cell carcinoma treated with ipilimumab and nivolumab combination therapy
Authors: Takagi Toshio , Yoshida Kazuhiko , Kondo Tsunenori , Fukuda Hironori , Ishihara Hiroki , Kobayashi Hirohito , Iizuka Junpei , Ishida Hideki , Tanabe Kazunari
Published: August 2021

Objective

We investigated the incidence of hypopituitarism in Japanese patients with metastatic renal cell carcinoma (mRCC) who received ipilimumab and nivolumab (I-P) therapy and compared patient characteristics and survival rates between patients with hypopituitarism and those without.

Methods

Twenty-two patients with mRCC who received I-P therapy as first-line treatment were the subjects of this retrospective study. The diagnosis of hypopituitarism was based on the hormone loading test.

Results

Hypopituitarism occurred in 41% (9/22) patients who received I-P therapy. Median time of diagnosis was 12 weeks (IQR: 9.5–20). Clinical symptoms, such as fatigue, weakness or fever, were observed in 7 patients, while 2 patients had no clinical presentation. The following deficiency patterns were observed: isolated ACTH in 4 patients, ACTH and GH in 2 patients, ACTH and TSH in 2 patients and triple deficiency (ACTH, GH and TSH) in 1 patient. All patients with hypopituitarism were in the IMDC intermediate group, while 46% of those without hypopituitarism were in the IMDC intermediate group. Other patient characteristics were not different between the two groups. Object response rate was 33% (3/9) in patients with hypopituitarism and 23% (3/13) in those without (P = 0.5954). Progression free survival (PFS) was significantly longer in those with hypopituitarism than those without (median: 24.7 vs. 4.5 months, P = 0.0008), while overall survival did not differ (P = 0.136).

Conclusions

Compared with the clinical trial, the incidence of hypopituitarism was higher than expected. Patients with hypopituitarism tended to have longer PFS, which may suggest that optimal management of hypopituitarism results in better prognosis.
Television, Continuity, and Change: A Meta-Analysis of Five Decades of Cultivation Research
Authors: Hermann Erik , Morgan Michael , Shanahan James
Published: August 2021

This study is a meta-analysis of cultivation research from the 1970s to the present, based on three-level analyses of 3842 effect sizes from 406 independent samples. We found an overall effect size of .107 that varies only within a fairly narrow range across many potential moderators. Cultivation effects remain stable over the decades, implying an enduring relationship between television’s message system and viewers’ conceptions of social reality, despite immense changes in the institutional structure and technology of television. That bolsters a “traditional” perspective on cultivation, which is further corroborated by a stronger positive effect of overall viewing compared with genre viewing. However, this (stronger) effect weakens over time, which provides at least partial support for a “reformist” perspective on cultivation. Moreover, sample size and mode of data collection also moderate cultivation effects, with larger effects in smaller samples and in data collected via questionnaires compared with other methods.
A Latent Profile Analysis of Undocumented College Students’ Protection-Oriented Family Communication and Strengths-Based Psychological Coping
Authors: Kam Jennifer A , Cornejo Monica , Marcoulides Katerina M
Published: August 2021

Drawing from resilience theory, this study explored subgroups of undocumented college students (UCS) based on their patterns of protection-oriented family communication and strengths-based psychological coping. Using survey data from 237 UCS, latent profile analyses revealed three subgroups. Safe optimistic copers reported occasional documentation-seeking and know-your-rights communication, but higher means in prevention and right path communication, as well as optimistic coping. Comprehensive copers scored moderately high in all types of protection-oriented communication and psychological coping. Strengths-based psychological copers infrequently engaged in protection-oriented communication, yet they scored moderately to moderately high in positive psychological coping. Compared to the other two profiles, safe optimistic copers reported the worst wellbeing (highest mean anxiety, depressive symptoms, and sleep disturbances; lowest mean perceived health and wellbeing). Comprehensive copers fared worse in anxiety, depressive symptoms, and sleep disturbances compared to strengths-based psychological copers; however, comprehensive copers reported greater wellbeing, perceived health, and academic motivation.
Acute hemorrhagic necrotizing pancreatitis in patient with COVID-19: a case report and review of literature
Authors: Basukala Sunil , Shah Kunda Bikram , Karki Bibek , Thapa Narayan , Basukala Bikram , Karki Saurav , Pathak Bishnu Deep
Published: August 2021

Novel coronavirus disease 2019 (COVID-19) pandemic was originated in Wuhan, China, in December 2019. So far, more than 4 million people worldwide have been infected with the virus. Various manifestations of coronavirus have been reported since the pandemic began. Among them, acute abdomen is one of the manifestations of COVID-19. Some studies have reported acute pancreatitis in several patient due to COVID-19 infection. In this study, we report a rare case in whom SARS-CoV-2 caused acute severe hemorrhagic necrotizing pancreatitis.
Eating the messenger (RNA): autophagy shapes the cellular RNA landscape
Authors: Kumaran Girishkumar , Michaeli Simon
Published: August 2021

This article comments on:

Hickl D, Drews F, Girke C, Zimmer D, Mühlhaus T, Hauth J, Nordström K, Trentmann O, Neuhaus EH, Scheuring D, Fehlmann T, Keller A, Simon M, Möhlmann T. 2021. Differential degradation of RNA species by autophagy-related pathways in Arabidopsis. Journal of Experimental Botany 72, 6867–6881.
The Direct Spectrophotometric Method Is Reliable for Initial Assessment of Total Bilirubin in Neonatal Venous Plasma
Authors: Makkong Paspimon , Choosongsang Pensiri , Choosongsang Phattanapong , Trongnit Sasipong , Sriwimol Wilaiwan
Published: August 2021

Objective

To determine the consistency of bilirubin values between the direct spectrophotometric (DS) and colorimetric diazo (diazo) methods in neonatal venous plasma specimens.

Methods

We measured the total bilirubin via the DS and diazo methods in 255 neonatal venous plasma specimens and compared the overall and subgroup results.

Results

Slight underestimation of total bilirubin values in most specimens using the DS method was observed, with higher mean biases found in higher concentrations. Significantly high positive correlations were found in all groups in which most of the different values were within the limits of agreement. DS cutoff of > 12 mg/dL showed 100% for all predictive indices in comparison with the diazo cutoff > 15 mg/dL.

Conclusions

Measurement of total bilirubin in neonatal venous plasma using the DS method had favorable agreement and high correlation with the diazo method. Therefore, the direct spectrophotometric method can be used as a reliable screening method.
Incidence of Optic Neuritis and the Associated Risk of Multiple Sclerosis for Service Members of U.S. Armed Forces
Authors: Gu Weidong , Tagg Nathan T , Panchal Nileshkumar L , Brown-Bickerstaff Cherrishe A , Nyman Julie M , Reynolds Mark E
Published: August 2021

Introduction

Optic neuritis (ON), an acute inflammation of the optic nerve resulting in eye pain and temporary vision loss, is one of the leading causes of vision-related hospital bed days in the U.S. Military and may be a harbinger of multiple sclerosis (MS). We developed a case identification algorithm to estimate incidence rates of ON and the conversion rate to MS based on a retrospective assessment of medical records of service members (SMs) of the U.S. Armed Force.

Materials and Methods

Electronic medical records (EMRs) from 2006 to 2018 in the Defense Medical Surveillance System were screened using the case identification algorithms for ON and MS diagnosis. The incidences rates of ON were calculated. The rates of conversion to MS was modeled using the Kaplan–Meier survival analysis.

Results

The overall incidence rate of ON was 8.1 per 100,000 from 2006 to 2018. Females had a rate (16.9 per 100,000) three times higher than males. Most (68%) of subsequent diagnoses of MS were made within 1 year after diagnosis of ON. The overall 5-year risk of progression to MS was 15% (11%–16% for 95% CI). The risk of conversion to MS in females was significantly higher than in males.

Conclusions

We developed an efficient tool to explore the EMR database to estimate the burden of ON in the U.S. Military and the MS conversion based on a dynamic cohort. The estimated conversion rates to MS feeds into inform retention and fitness-for-duty policy in these SMs.
The dwarf galaxy population in nearby clusters from the KIWICS survey
Authors: Choque-Challapa Nelvy , Aguerri J Alfonso L , Mancera Piña Pavel E , Peletier Reynier , Venhola Aku , Verheijen Marc
Published: August 2021

We analyse a sample of 12 galaxy clusters, from the Kapteyn IAC WEAVE INT Cluster Survey (KIWICS) looking for dwarf galaxy candidates. By using photometric data in the r and g bands from the Wide Field Camera (WFC) at the 2.5-m Isaac Newton Telescope (INT), we select a sample of bright dwarf galaxies (M$_r\, \le$ −15.5 mag) in each cluster and analyse their spatial distribution, stellar colour, and as well as their Sérsic index and effective radius. We quantify the dwarf fraction inside the R200 radius of each cluster, which ranges from ∼0.7 to ∼0.9. Additionally, when comparing the fraction in the inner region with the outermost region of the clusters, we find that the fraction of dwarfs tends to increase going to the outer regions. We also study the clustercentric distance distribution of dwarf and giant galaxies (M$_r\, \lt $ −19.0 mag), and in half of the clusters of our sample, the dwarfs are distributed in a statistically different way as the giants, with the giant galaxies being closer to the cluster centre. We analyse the stellar colour of the dwarf candidates and quantify the fraction of blue dwarfs inside the R200 radius, which is found to be less than ∼0.4, but increases with distance from the cluster centre. Regarding the structural parameters, the Sérsic index for the dwarfs we visually classify as early-type dwarfs tends to be higher in the inner region of the cluster. These results indicate the role that the cluster environment plays in shaping the observational properties of low-mass haloes.
Orthogonal CRISPR-associated transposases for parallel and multiplexed chromosomal integration
Authors: Yang Siqi , Zhang Yiwen , Xu Jiaqi , Zhang Jiao , Zhang Jieze , Yang Junjie , Jiang Yu , Yang Sheng
Published: August 2021

Cell engineering is commonly limited to the serial manipulation of a single gene or locus. The recently discovered CRISPR-associated transposases (CASTs) could manipulate multiple sets of genes to achieve predetermined cell diversity, with orthogonal CASTs being able to manipulate them in parallel. Here, a novel CAST from Pseudoalteromonas translucida KMM520 (PtrCAST) was characterized without a protospacer adjacent motif (PAM) preference which can achieve a high insertion efficiency for larger cargo and multiplexed transposition and tolerate mismatches out of 4-nucleotide seed sequence. More importantly, PtrCAST operates orthogonally with CAST from Vibrio cholerae Tn6677 (VchCAST), though both belonging to type I-F3. The two CASTs were exclusively active on their respective mini-Tn substrate with their respective crRNAs that target the corresponding 5 and 2 loci in one Escherichia coli cell. The multiplexed orthogonal MUCICAT (MUlticopy Chromosomal Integration using CRISPR-Associated Transposases) is a powerful tool for cell programming and appears promising with applications in synthetic biology.
A 3-year study of the seasonal variability of abundance, biomass and reproductive traits of Oncaea venusta (Copepoda, Oncaeidae) in a subtropical coastal area
Authors: de Melo Júnior Mauro , Miyashita Leonardo K , Lopes Rubens M
Published: August 2021

This study reports on the abundance, biomass and reproductive traits of Oncaea venusta, a common pelagic copepod in tropical oceans, in a coastal area influenced by bottom intrusions of the cold and nutrient-rich South Atlantic Central Water (SACW). In addition to O. venusta abundance and biomass, we estimated egg production and weight-specific fecundity rates by applying the egg-ratio method and incubation experiments, at monthly intervals over 3 years (July 2005–June 2008), to understand potential SACW influences on reproductive patterns. Mean abundance and biomass were low, and no differences were detected with and without SACW intrusions. Mean clutch size (±SD) was 65.1 ± 28.9 eggs female−1 and egg production rates averaged 7.6 ± 12.4 and 9.3 ± 5.2 eggs female−1 day−1 (viability >80%), for the egg-ratio method and incubation experiments, respectively, corresponding to a female weight-specific fecundity from 0.03 ± 0.05 to 0.04 ± 0.06 day−1. Oncaea venusta abundance and biomass were positively correlated with temperature, but no SACW influence on the reproductive rates was recorded. The egg production rate and the female weight-specific fecundity were influenced by the chlorophyll a concentration and the sex ratio. Although egg production and female weight-specific fecundity rates had peak values during intrusion events, no immediate impact on population abundance was observed within the same time interval.
IgA vasculitis in patients with inflammatory bowel disease: new insights into the role of TNF-α blockers
Authors: Rasmussen Camille , Abitbol Vered , El Karoui Khalil , Bourrier Anne , Paule Romain , Vuitton Lucine , Maurier François , Laharie David , Fuméry Mathurin , Agard Christian , Collins Michael , Nancey Stephane , Rafat Cédric , Kervegant Anne-Gaëlle , Queyrel-Moranne Viviane , Moulis Guillaume , Pigneur Bénédicte , Régent Alexis , Gay Claire , Morbieu Caroline , Durel Cécile Audrey , Ducloux Didier , Aubin François , Voicu Mickaela , Joher Nizar , Szwebel Tali , Martinez-Vinson Christine , Koch Stéphane , Guillevin Loïc , Peyrin-Biroulet Laurent , Terrier Benjamin
Published: August 2021

Objective

The association of IgA vasculitis (IgAV) and IBD is rarely described, mainly during anti-TNF-α therapy. We aimed to describe the association of IgAV and IBD.

Methods

We retrospectively analysed the association of IgAV and IBD through the implication of the GETAID and FVSG networks. Characteristics of IBD and IgAV were collected using a standardized case report form.

Results

Forty-three cases were included. IBD [mainly Crohn’s disease (CD) in 58%] preceded IgAV in 38 (88%), with median interval of 9.2 (IQR 5.4–15.4) years. In these 38 patients, at IgAV diagnosis, five (13%) had active IBD and 28 (74%) were treated with anti-TNF-α for a median duration of 31.5 (IQR 19–56) months. Main IgAV manifestations were purpura all patients (100%), joints in 20/35 (57%), renal in 15/35 (43%) and gastrointestinal in 11/35 (31%) involvement. IgAV was treated with glucocorticoids in 25 (66%), colchicine in six (16%), CYC in six (16%) and anti-TNF-α were discontinued in 15/28 (54%). No IgAV relapse occurred when TNF-α blockers were stopped, vs 23% in patients pursuing it. Conversely, five (33%) had IBD flare or complication after anti-TNF-α cessation vs one (8%) in those continuing biologics. Anti-TNF-α were resumed in six (40%), with subsequent IgAV relapse in four (67%).

Conclusions

This large cohort suggests that TNF-α blockers may promote the onset of IgAV in IBD. Discontinuation of anti-TNF-α was associated with vasculitis remission but increased risk of IBD relapses, whereas continuation of anti-TNF-α was associated with IBD remission but vasculitis relapse.
High national rates of high-dose dopamine agonist prescribing for restless legs syndrome
Authors: Winkelman John W
Published: August 2021

Study Objectives

Long-term dopamine agonist (DA) use in restless legs syndrome (RLS) is associated with augmentation, a dose-related symptom worsening leading to further dose escalation to manage RLS. This study investigated rates and factors of high-dose DA prescribing in US RLS patients.

Methods

This retrospective analysis examined data from a US longitudinal prescriptions database (October 2017–September 2018). Patients diagnosed with RLS (ICD-10 G255.81) without Parkinson’s disease who were prescribed ropinirole, pramipexole, and/or rotigotine were included. Daily DA dosage was categorized: LOW/MID (US Food and Drug Administration [FDA]-approved/guideline or slightly above FDA-approved [pramipexole]); HIGH (101%–149%); VERY HIGH (>150%). Patient counts were converted to US national estimates. Logistic regression of patient counts evaluated factors associated with HIGH/VERY HIGH DA dosing.

Results

Of 670,404 RLS patients (131,289,331 therapy days), 58.8% were prescribed DA therapy. Overall, 19.1% of RLS patients were prescribed DAs above maximum FDA-approved/guideline daily doses—over half of these were >150% maximum recommended doses; 67.6% of HIGH/VERY HIGH-dose prescriptions were pramipexole (OR [95% CI] pramipexole vs ropinirole, 5.8 [5.7 to 6.0]). The highest 1% of DA prescriptions were ≥10× the FDA-recommended maximum daily dose. Rates of HIGH/VERY HIGH DA dosing increased with patient age. Twice as many neurologists (31.1%) prescribed HIGH/VERY HIGH doses vs other specialties (OR [95% CI], 2.1 [1.2 to 2.0]).

Conclusions

Approximately 20% of DA-treated RLS patients were prescribed doses above the approved and guideline daily maximum. Pramipexole, Neurology as specialty, and patient age were independently associated with HIGH/VERY HIGH DA dosing. Increased education is warranted regarding risks of high-dose DA exposure in RLS.
Effects of various doses of lubabegron on calculated ammonia gas emissions, growth performance, and carcass characteristics of beef cattle during the last 56 days of the feeding period
Authors: Kube John C , Holland Ben P , Word Alyssa B , Allen Janet B , Calvo-Lorenzo Michelle , McKenna David , Vogel Gary
Published: August 2021

Lubabegron (LUB; Experior, Elanco, Greenfield, IN, USA) was approved by the U.S. Food and Drug Administration in 2018 and is indicated for the reduction of ammonia (NH3) gas emissions·kg−1 body weight (BW) and hot carcass weight (HCW) when fed to feedlot cattle during the final 14 to 91 d of the finishing period. LUB demonstrates antagonistic behavior at the β 1 and β 2 receptor subtypes and agonistic behavior at the β 3 receptor subtype in cattle and is classified by the Center for Veterinary Medicine as a “beta-adrenergic agonist/antagonist.” This report describes a randomized complete block study that evaluated LUB dose (0, 1.5, 3.5, and 5.5 mg·kg−1 dry matter) during the last 56 d of the feeding period on calculated NH3 gas emissions, live weight, carcass weight, and associated ratios in beef feedlot cattle. Carcass characteristics, mobility, and health were also evaluated. All cattle received monensin and tylosin throughout the study. Ammonia gas emissions were calculated using the equation developed by Brown et al. (Brown, M. S., N. A. Cole, S. Gruber, J. Kube, and J. S. Teeter. 2019. Modeling and prediction accuracy of ammonia gas emissions from feedlot cattle. App. Anim. Sci. 35:347–356). The reduction in calculated cumulative NH3 gas emissions with LUB ranged from 1.3% to 11.0% (85 to 708 g/hd). When NH3 gas emissions were expressed on a live weight (unshrunk) and carcass weight basis, calculated NH3 gas emissions decreased by 3.0% to 12.8% and 3.8% to 14.6%, respectively. Daily dry matter intake was 2.3% greater (Ptrt < 0.05) for steers that received LUB. Average daily gain was 13.7% greater (Ptrt < 0.05; 1.68 vs. 1.91 kg), while gain efficiency was 10.8% greater (Ptrt < 0.05; 0.167 vs. 0.185) for steers fed LUB. Animal mobility was scored in the pen approximately 1 wk prior to harvest, when cattle were loaded on trucks scheduled for harvest, and at antemortem inspection during lairage. No treatment differences (Ptrt ≥ 0.170) were observed at any time for the percent of cattle receiving mobility scores of 1 or 2 (normal or minor stiffness but moving with the normal cattle, respectively). Cattle mobility scored as a 1 or 2 equaled or exceeded 92% at all times. Final BW and HCW increased (Ptrt < 0.05) 11.6 to 15.7 kg and 11.3 to 17.1 kg, respectively, in cattle receiving LUB compared to cattle receiving monensin plus tylosin alone.
Pseudotumor Cerebri Syndrome as a Neurologic Involvement of Multisystem Inflammatory Syndrome in Children: A Case Report
Authors: Sofuoğlu Ayşe İrem , Akçay Nihal , Şevketoğlu Esra , Bektaş Gonca
Published: August 2021

Background

Coronavirus disease 2019 may have neurological manifestations including meningitis, encephalitis, post-infectious brainstem encephalitis and Guillain-Barre syndrome. Neuroinflammation has been claimed as a possible cause. Here, we present a child with multisystem inflammatory syndrome in children (MIS-C) who developed pseudotumor cerebri syndrome (PTCS) during the disease course.

Case

A 11-year-old girl presented with 5 days of fever, headache and developed disturbance of consciousness, respiratory distress, conjunctivitis and diffuse rash on her trunk. Immunoglobulin M and G antibodies against severe acute respiratory syndrome coronavirus 2 were positive in her serum. She was diagnosed with MIS-C. On day 10, she developed headache and diplopia. Left abducens paralysis and bilateral grade 3 papilledema were observed. Brain magnetic resonance imaging revealed optic nerve head protrusion, globe flattening. She was diagnosed with secondary PTCS. Papilledema and abducens paralysis improved under acetazolamide and topiramate. Neurological examination became normal after 2 months.

Conclusion

PTCS may emerge related to MIS-C.
Adenosine A2A receptor antagonism protects against hyperoxia‐induced retinal vascular loss via cellular proliferation
Authors: Zhong Ding‐Juan , Zhang Yu , Zhang Shuya , Ge Yuan‐Yuan , Tong Mengyun , Feng Yijia , You Feng , Zhao Xinyue , Wang Ke , Zhang Liping , Liu Xiaoling , Chen Jiang‐Fan
Published: August 2021

Retinopathy of prematurity (ROP) remains one of the major causes of blindness in children worldwide. While current ROP treatments are mostly disruptive to reduce proliferative neovascularization by targeting the hypoxic phase, protection against early hyperoxia‐induced retinal vascular loss represents an effective therapeutic window, but no such therapeutic strategy is available. Built upon our recent demonstration that the protection against oxygen‐induced retinopathy by adenosine A2A receptor (A2AR) antagonists is most effective when administered at the hyperoxia (not hypoxic) phase, we here uncovered the cellular mechanism underlying the A2AR‐mediated protection against early hyperoxia‐induced retinal vascular loss by reversing the inhibition of cellular proliferation via possibly multiple signaling pathways. Specifically, we revealed two distinct stages of the hyperoxia phase with greater cellular proliferation and apoptosis activities and upregulation of adenosine signaling at postnatal 9 day (P9) but reduced cellular activities and adenosine‐A2AR signaling at P12. Importantly, the A2AR‐mediated protection at P9 was associated with the reversal of hyperoxia‐induced inhibition of progenitor cells at the peripheral retina at P9 and of retinal endothelial proliferation at P9 and P12. The critical role of cellular proliferation in the hyperoxia‐induced retinal vascular loss was validated by the increased avascular areas by siRNA knockdown of the multiple signaling molecules involved in modulation of cellular proliferation, including activin receptor‐like kinase 1, DNA‐binding protein inhibitor 1, and vascular endothelial growth factor‐A.
Basics of Intra-arterial Y-90 Microsphere Therapy for Liver Tumors: Part I
Authors: Fani Bozkurt Murat
Published: August 2021

Intra-arterial yttrium-90 (Y-90) microsphere therapy is a radionuclide therapy in which therapeutic radiation-loaded microspheres are targeted to microvasculature of hepatic tumors through arterial administration. The conceptual basis of this therapy depends primarily on the unique preferential blood supply of tumor cells versus healthy hepatocytes in the liver.
“Nobody Knows How You’re Supposed to Interpret it:” End-user Perspectives on Prescription Drug Monitoring Program in Massachusetts
Authors: Hong Mina , Seymour Sarah , Stopka Thomas J. , Bandanza Lane , Crocker Erin , Morgan Allison , Beletsky Leo
Published: August 2021

Objectives

America’s overdose crisis spurred rapid expansion in the number and scope of prescription drug monitoring programs (PDMPs). As their public health impact remains contested, little is known about PDMP user experiences and perspectives. We explore perspectives of PDMP end-users in Massachusetts.

Methods

Between 2016 and 2017, we conducted semi-structured qualitative interviews on overdose crisis dynamics and PDMP experiences with a purposive sample of 18 stakeholders (prescribers, pharmacists, law enforcement, and public health regulators). Recordings were transcribed and double-coded using a grounded hermeneutic approach.

Results

Perspectives on prescription monitoring as an element of overdose crisis response differed across sectors, but narratives often critiqued PDMPs as poorly conceived to serve end-user needs. Respondents indicated that PDMP: (1) lacked clear orientation towards health promotion; (2) was not optimally configured or designed as a decision support tool, resulting in confusion over interpreting data to guide health care or law enforcement actions; and, (3) problematized communication and relationships between prescribers, pharmacists, and patients.

Conclusions

User insights must inform design, programmatic, and policy reform to maximize PDMP benefits while minimizing harm.
Renal Oxygenation (rSO2) Population Parameter Estimates in Premature Infants Routinely Monitored With Near-Infrared Spectroscopy
Authors: Marin Terri , Williams Bryan L. , Mansuri Asifhusen , Mundy Cynthia , Cockfield Christy , Mann Paul C. , Stansfield Brian K.
Published: August 2021

Background:

Currently, reference ranges for renal oxygenation measured by near-infrared spectroscopy (NIRS) in preterm infants beyond the first days of life are lacking, especially those born prior to 29 weeks' gestation. Population estimates of renal oxygenation (rSO2) levels among preterm infants over time have yet to be established, leading to reluctance in clinical application.

Purpose:

To characterize the distribution and estimate population parameters for renal oxygenation measured by NIRS during the first 14 days of life among preterm infants.

Methods:

We prospectively observed rSO2 trends of 37 infants before 34 weeks' gestation and 1800-g or less birth weight for the first 14 days of life. Analyses included distribution fit tests, ordinary least squares (OLS) regression, and t tests.

Results:

Average daily rSO2 variation steadily increased with 42% difference through the first 14 days of life. For all infants, renal rSO2 means peaked during the first 3 days of life and plateaued around 7 days. Daily rSO2 slopes were significantly lower among males and infants 29 weeks' or less gestation.

Implications for Practice:

Renal rSO2 during the first 14 days of life reflects normal extrauterine transition reaching stabilization around 7 days of life. Gestational age, birth weight, and gender may predict the early trajectory of rSO2 patterns. Population estimates provide parameters for renal rSO2 that may indicate early-onset tissue hypoxia when acute or significant drops from baseline occur.

Implications for Research:

We present a framework to guide future research using renal NIRS technology in preterm infants to determine deviations from expected trends that may precede renal injury.
Combined Motor and Sensory Intraoperative Neuromonitoring for Cervical Spondylotic Myelopathy Surgery Causes Confusion
Authors: Taylor Adam J. , Combs Kristen , Kay Robert D. , Bryman Jason , Tye Erik Y. , Rolfe Kevin
Published: August 2021

Study Design.

Level-1 diagnostic study.

Objective.

The purpose of this study was to evaluate the sensitivity and specificity of combined motor and sensory intraoperative neuromonitoring (IONM) for cervical spondylotic myelopathy (CSM).

Summary of Background Data.

Intraoperative neuromonitoring during spine surgery began with sensory modalities with the goal of reducing neurological complications. Motor monitoring was later added and purported to further increase sensitivity and specificity when used in concert with sensory monitoring. Debate continues, however, as to whether neuromonitoring reliably detects reversible neurologic changes during surgery or simply adds set-up time, cost, or mere medicolegal reassurance.

Methods.

Neuromonitoring data using combined motor and sensory evoked potentials for 540 patients with CSM undergoing anterior or posterior decompressive surgery were collected prospectively. Patients were examined postoperatively to determine the clinical occurrence of new neurologic deficit which correlated with monitoring alerts recorded per established standard criteria.

Results.

The overall incidence of positive IONM alerts was 1.3% (N = 7) all of which were motor alerts. All were false positives as no patient had clinical neurological deterioration post-operatively. The false-positive rate was 1.4% (N = 146) for anterior surgeries and 1.3% (N = 394) for posteriors with no statistical difference between them (P = 1.0, Fisher exact test). There were no false-negative alerts, and all negatives were true negatives (N = 533). The overall sensitivity of detecting a new neurologic deficit was 0%, overall specificity 98.7%.

Conclusion.

Combined motor and sensory neuromonitoring for CSM patients created a confusing choice between the motor or sensory data when in disagreement in 1.3% of surgical patients. Criterion standard clinical examinations confirmed all motor alerts were false positives. Surgical plan was negatively altered by following false motor alerts early on, but disregarded in later cases in favor of sensory data. Neuromonitoring added set-up time and cost, but without clear benefit in this series.

Level of Evidence: 4
Robotically Assisted Recipient Site Preparation in Hair Restoration Surgery: Surgical Safety and Clinical Outcomes in 31 Consecutive Patients
Authors: Kanayama Koji , Kato Harunosuke , Mori Masanori , Sakae Yuki , Okazaki Mutsumi
Published: August 2021

BACKGROUND

Recent advances in robotic surgery have extended to hair restoration surgery, using a robotic recipient site creation device.

OBJECTIVE

This study aimed to assess the surgical safety and postoperative clinical outcomes of using this robotic system.

MATERIALS AND METHODS

Thirty-one men diagnosed with androgenetic alopecia, who underwent hair transplantation with robotic recipient site creation, were retrospectively reviewed. Their mean age was 38.7 ± 9.5 (range, 22‒67) years.

RESULTS

The total number of robotically created recipient sites was 36,273. The average site creation speed was 1,593 ± 544 sites per hour. Postoperative crusting (54.8%) was the most frequent complication in the recipient area, followed by pruritus (12.9%), asymmetry (6.5%), and folliculitis (6.5%). The mean score of cosmetic outcomes and patient satisfaction, scored on a 5-point scale, was 4.10 ± 0.54 and 4.13 ± 0.85, respectively. No significant differences in cosmetic outcomes and patient satisfaction were found between 3 operators.

CONCLUSION

The current device can automatically make slit incisions in the recipient area with speed and consistency noninferior to manual site creation. It is both safe and reliable for clinical use, and it is also easily managed by different hair surgeons without a long learning curve.
Risk Factors for Infection After Minor Dermatologic Procedures: A Case–Control Study
Authors: Matos Sophia , Sturm Brea , Buhnerkempe Michael , Larson Rebecca , Wilson Morgan
Published: August 2021

BACKGROUND

There are limited published data regarding the incidence and risk factors for infection after minor dermatologic procedures, such as skin biopsy, shave, and curettage. Prior studies of infection risk after dermatologic procedures have often not specified the method of preparation of local anesthetic.

OBJECTIVE

To assess the incidence and risk factors for infection after minor procedures performed in a general dermatology clinic using buffered lidocaine prepared in office.

MATERIALS AND METHODS

In this retrospective case–control study, the medical record was searched for cases of infection after skin biopsies, shaves, conventional excisions, and destructions performed in a general dermatology clinic over a 4-year period. Patient and procedure characteristics were compared with uninfected controls.

RESULTS

Of 9,031 procedures performed during the study period, there were 34 infections (0.4%). The odds of infection for procedures on the arm and leg were 5.29 and 9.28 times higher, respectively, than those on the head/neck. There was no significant effect of age, sex, smoking, immunosuppression, diabetes, or anticoagulation.

CONCLUSION

The incidence of infection is low after minor dermatologic procedures performed with local anesthesia using buffered lidocaine prepared in office. There is a higher risk of infection on the arm and leg compared with the head and neck.