bluuebunny/crossref_metadata_2025 huggingface dataset:
FOXA1 Expression by Immunohistochemistry in Carcinosarcomas of the Endometrium and Ovary/Fallopian Tube
Authors: Karpathiou Georgia , Chauleur Celine , Dal Col Pierre , Peoc’h Michel
Published: March 2021

FOXA1, a transcription factor essential for the binding of other transcription factors on chromatin, is associated with hormone receptor-associated cancers, such as breast and endometrial cancer. It is also considered an antagonist of epithelial-to-mesenchymal transition (EMT). In endometrial cancer, FOXA1 is considered a tumor suppressor; in carcinosarcoma, one of the most aggressive and rare subtypes of endometrial cancer, thought to be derived through an EMT mechanism, FOXA1 has not been studied. Thus, the aim of this study was to investigate the possible expression of FOXA1 in carcinosarcomas, and its correlation with clinicopathologic factors. This was a retrospective study of 31 patients diagnosed with carcinosarcomas of the uterus or the adnexa. Histologic and clinical factors were correlated with the immunohistochemical expression of FOXA1. FOXA1 was expressed by 38.7% of the carcinomatous components and 16.1% of the sarcomatous components. FOXA1-positive sarcomatous components were seen only with positive carcinomatous components (P=0.004). FOXA1 expression was not associated with age, primary tumor site, stage, metastases, overall survival, or tumor relapse. FOXA1 expression in the carcinomatous component was associated with an absence of lymphovascular invasion or the presence of heterologous components. FOXA1 expression in the sarcomatous component was associated with rhabdomyosarcoma, rather than the chondrosarcoma heterologous component. Carcinosarcomas harbor FOXA1 expression, although it is in their carcinomatous rather than sarcomatous components, suggesting a possible role of FOXA1 in the EMT of carcinosarcomas. FOXA1 shows no prognostic significance in this tumor group.
Bronchus-like Structures in Ovarian Teratomas: Report of a Series of a Previously Unreported Phenomenon With Potential For Misdiagnosis
Authors: Rajendran Simon , Boyd Clinton , Shah Rajeev , Stewart Colin J.R. , McCluggage W. Glenn
Published: March 2021

We report 10 cases of a previously undescribed lesion within ovarian teratomas which we designate bronchus-like structures. The lesions occurred in patients aged 16 to 56 yr (mean: 36) and involved the left ovary (n=5) or right ovary (n=5). Nine cases were mature teratomas (dermoid cysts/mature cystic teratomas or mature solid teratomas), 1 with somatic malignant transformation, and 1 was an immature teratoma. The bronchus-like structures ranged in size from 2.5 to 10 mm and were unifocal (7 cases) or multifocal (3 cases). The morphology was relatively constant in all cases and characterised by a well-formed bronchus surrounded by glandular structures, some of which were dilated, separated by stroma containing a variable amount of smooth muscle. In all but 1 case, a proportion of the glands contained abundant foamy cytoplasm. There was little or no nuclear atypia or mitotic activity. At low-power, the glands often had a somewhat “infiltrative” appearance and one case was originally diagnosed as a “pulmonary-type” adenocarcinoma arising in a dermoid cyst. In all cases, there was diffuse staining of the bronchus and glands with TTF1 and Napsin A, confirming the cell lineage. Follow-up in 4 cases (18–130 mo; median: 64 mo) showed no evidence of recurrence; 1 patient died from an unrelated malignancy. In reporting this apparently rare but possibly underrecognized benign lesion arising within ovarian teratomas, we discuss the differential diagnosis and stress that pathologists should be aware of this phenomenon in order to avoid an erroneous diagnosis of malignancy.
Precursor Lesions of Cervical Clear Cell Carcinoma: Evidence For Origin From Tubo-Endometrial Metaplasia
Authors: Talia Karen L. , Arora Rupali , McCluggage W. Glenn
Published: March 2021

Cervical clear cell carcinoma (CCC) is an HPV-independent tumor historically associated with in-utero exposure to diethylstilboestrol. With the cessation of diethylstilboestro use, most contemporary cases are sporadic and of uncertain pathogenesis, with no established precursor lesion. Following the detection of 3 incidental “early” (FIGO stage IA1) cervical CCCs, all of which displayed adjacent tubo-endometrial metaplasia, we examined further cases, including resection specimens, of this tumor in an attempt to delineate potential precursors. We identified tubo-endometrial metaplasia in proximity to the tumor in 5 of 5 additional primary cervical CCCs, with some tubo-endometrial glands exhibiting subtle mild cytologic atypia. This observation adds to the sparse existing literature proposing tubo-endometrial metaplasia as a precursor to sporadic cervical CCC, with possible progression via an “atypical” transitional phase to malignancy. We also review the published literature regarding possible precursor lesions of primary cervical CCC.
Predicting HIV Incidence in the SEARCH Trial: A Mathematical Modeling Study
Authors: Jewell Britta L. , Balzer Laura B. , Clark Tamara D. , Charlebois Edwin D. , Kwarisiima Dalsone , Kamya Moses R. , Havlir Diane V. , Petersen Maya L. , Bershteyn Anna
Published: March 2021

Background:

The SEARCH study provided community-based HIV and multidisease testing and antiretroviral therapy (ART) to 32 communities in East Africa and reported no statistically significant difference in 3-year HIV incidence. We used mathematical modeling to estimate the effect of control arm viral suppression and community mixing on SEARCH trial outcomes.

Setting:

Uganda and Kenya.

Methods:

Using the individual-based HIV modeling software EMOD-HIV, we configured a new model of SEARCH communities. The model was parameterized using demographic, HIV prevalence, male circumcision, and viral suppression data and calibrated to HIV prevalence, ART coverage, and population size. Using assumptions about ART scale-up in the control arm, degree of community mixing, and effect of baseline testing, we estimated comparative HIV incidence under multiple scenarios.

Results:

Before the trial results, we predicted that SEARCH would report a 4%–40% reduction between arms, depending on control arm ART linkage rates and community mixing. With universal baseline testing followed by rapidly expanded ART eligibility and uptake, modeled effect sizes were smaller than the study was powered to detect. Using interim viral suppression data, we estimated 3-year cumulative incidence would have been reduced by up to 27% in the control arm and 43% in the intervention arm compared with a counterfactual without universal baseline testing.

Conclusions:

Our model suggests that the active control arm substantially reduced expected effect size and power of the SEARCH study. However, compared with a counterfactual “true control” without increased ART linkage because of baseline testing, SEARCH reduced HIV incidence by up to 43%.
External Nose Anthropometry of Healthy Turkish Young Adults
Authors: Bahşi Ilhan , Orhan Mustafa , Kervancioğlu Piraye , Karatepe Şeyma , Sayin Semih
Published: March 2021

Although many studies in the literature examine distances and angles about the nose, there are no clear standard values for different races and ethnic groups. The aim of this study is to determine the anthropometric measurement standards related to the external nose in Turkish young adults between the ages of 18 and 25. The subjects participating in this study were 100 female and 100 male volunteers. Six landmarks (nasion, subnasale, pronasale, alar, subalar and maxillofrontale) on the nose were chosen, and these landmarks were identified on the photographs. Then, using these landmarks, a total of seven distances (nose height, dorsum of nose length, distance between the subnasale and pronasale, nose width, right nostril floor width, left nostril floor width and root of nose width) and four angles (nasofrontal, nasofacial, nasomental and nasolabial angles) measurements were made. There were statistically significant differences between gender in nine parameters. One parameter (nasofrontal angle) is higher in females, and seven parameters (nose height, dorsum of nose length, nose width, right nostril floor width, left nostril floor width, root of nose width and nasofacial angle) are higher in males. It is accepted that distances and angles about the nose differ according to race and ethnicity. The authors believe that the results obtained in this study will help determine the standard values that can be used for the Turkish population between the ages of 18 and 25.
Study of Pediatric Operative Recreational Trauma: A Retrospective Analysis of Pediatric Sports-Related Facial Fractures
Authors: Cepeda Alfredo , Konty Logan A. , Moffitt Joseph K. , Wainwright D’Arcy , Booth Justin H. , Nguyen Phuong D. , Greives Matthew R.
Published: March 2021

Background:

In the United States, most school-aged children participate in some form of organized sports. Despite the advantages to social and physical development that organized sports may have, these activities also place a significant number of America's youth at risk for facial injuries. Pediatric facial fractures resulting from sports trauma are well documented within pediatric literature. Despite knowledge of the importance of safety equipment, there is a continued need for increased awareness about fracture patterns resulting from sports injuries to develop better strategies for their prevention.

Methods:

A retrospective review of all pediatric patients (age <18) who presented to Children's Memorial Hermann Hospital as a level 1 trauma between January 2006 and December 2015 with radiologically confirmed facial fractures was performed. Data regarding patient demographic information, mechanism of injury, facial fracture location, associated injuries, hospital course, and need for surgical intervention was collected.

Results:

Of the 1274 patients reviewed, 135 (10.59%) were found to have facial fractures resulting from sports trauma and were included in our cohort. The median age was 14 with 77.8% of the cohort being male. The most common fractures identified were orbital (n = 75), mandibular (n = 42), nasal (n = 27), maxilla (n = 26). Fractures were more frequently related to involvement in baseball/softball and bicycling n = 46 and n = 31 respectively. Eighty-two (60.74%) patients required admission, 6 requiring ICU level care, 70 (51.85%) were found to require surgery. There were 14 patients who were found to have a concomitant skull fracture and 6 with TBI. There were no fatalities in this cohort of patients.

Conclusion:

Pediatric facial fractures occur in the same anatomic locations as adult facial fractures. However, their frequency, severity, and treatment vary because of important anatomical and developmental differences in these populations. Despite available knowledge on this subject and increased use of protective equipment, pediatric facial fractures continue to occur with similar distribution as historically described. While sports participation confers numerous benefits, it is vital that we continue researching pediatric facial trauma and associated fractures to develop protective equipment and protocols to mitigate the risks of these activities.
Global Research on Maxillofacial Fracture Over the Last 40 Years: A Bibliometric Study
Authors: Tekin Ahmet M. , Bahşi Ilhan
Published: March 2021

Maxillofacial injuries are widely investigated worldwide as it consists a significant portion of trauma patients. Many researchers from various regions have reported the clinical and statistical analyses of maxillofacial fractures (MFFs) as the statistical data of MMFs are of great importance for both effective control and prevention of these cases. The number of studies concerning the diagnosis and treatment modalities of MFFs has significantly increased over the years. The bibliometric method was used to analyze publication outputs, countries, journals, most citations, and trends. In this study, the bibliometric analysis method was used in the publications related to MFFs published between 1980 and 2019, which were Science Citation Index Expanded indexed in the Web of Science database. Bibliometric analysis is applied to evaluate existing data in an evidence-based manner. The highest number of scientific articles on MFFs came from the USA, which was also the most cited country among others. When the distribution of the words in abstracts and titles by years was examined, it was seen that there was a significant change in the words “navigation,” “computer,” and “technology” between 2009 and 2012. The authors predict that our study would provide a novel perspective to the studies about MFFs and contribute to the researchers about the limits of the topic, and being aware of the active journals that publish the papers on this issue would facilitate the work of the researchers.
Biomechanical Impact of a Zygoma Complex Fracture Using Human Cadaver
Authors: Ip Kenneth K.C. , You Peng , Ferreira Louis M. , Moore Corey C.
Published: March 2021

Zygomaticomaxillary complex fractures are common in midface trauma, with treatment often involving repair using titanium mini plates. However, the need for plate fixation along the zygomaticomaxillary suture on the infraorbital rim remains controversial. This study utilized a previously reported bite force simulator to investigate craniofacial strain patterns following zygomaticomaxillary complex fracture repairs with and without plating of the infraorbital rim. Osteotomies were made to 6 fresh-frozen cadaveric heads to simulate 2 types of zygomatic complex fractures: a dipod fracture with osteotomies at the zygomaticofrontal and zygomaticomaxillary sutures, and a tripod fracture with an additional osteotomies at the zygomaticotemporal suture. Repairs with and without the use of a titanium mini plate across the infraorbital rim were compared in both dipod and tripod fractures. Physiologically proportional masticatory loads were applied using the bite force simulator by actuating intrinsic muscle lines of action. The outcome metric was facial bone strains measured using uniaxial strain gauges. Mixed-effects linear models did not find a significant main effect on the overall strain pattern with the use of an infraorbital rim plate in both dipod (P = 0.198) and tripod (P = 0.117) fracture repairs. However, statistically significant differences were found locally at the zygomatic buttress (P = 0.019) and the zygomatic arch (P = 0.027) on the fractured side in dipod fractures. This is the first known study that successfully utilized a mechanical simulator to reproduce physiological intrinsic masticatory loads in a fracture fixation study. This new technology opens avenues for future biomechanical investigations on maxillofacial fracture repairs and other surgical treatments.
Empowerment of Parents of Children With Cleft Lip and Palate by Objective Scoring of Patient Information Websites
Authors: Rangaraju Madu , Lloyd Mark Sheldon , Khan Khurram
Published: March 2021

Background:

Whether a new diagnosis or for ongoing care, the Internet is now an established and massively frequented resource for parents and patients with cleft lip and/or palate. The purpose of this study was to assess the correlation between the first 50 ranked websites for cleft lip and palate via the Google search engine versus those ranked with an objective patient information scoring tool.

Methods:

The first 50 websites ranked by Google were recorded for the search items “Cleft Lip,” “Cleft Palate” and “Cleft Lip and Palate.” Quality assessment was performed using the DISCERN score, an objective and validated patient information website scoring tool. The Google rank was compared to the DISCERN rank to assess for correlation. The top five websites for each search item were then ranked by blinded cleft health professionals for quality.

Results:

Based on Google ranking, 36% of websites were the same across the search terms used. The DISCERN ranking scores demonstrated no evidence of positive or negative correlation when compared to Google ranking. In the top 10 DISCERN ranked websites for each search item, 4 websites appear in the top 10 Google rankings.

Conclusion:

This is the first study that demonstrates that high-quality information on cleft lip and palate is available on the Internet. However, this may be difficult and confusing for parents and patients to access due to the ranking system used by internet search engines. Cleft healthcare professionals should be aware of these problems when recommending websites to families and patients
Severity of Airway Obstruction May Not Correlate With Weight Gain or Failure to Thrive in Infants With Robin Sequence: A Pilot Study
Authors: Mantilla-Rivas Esperanza , Boyajian Michael K. , Rana Md Sohel , Bryant Justin R. , Salinero Lauren , Tan Pamela , Rada Erin M. , Boyajian Michael J. , Rogers Gary F. , Oh Albert K.
Published: March 2021

Objective:

Patients with Robin sequence (RS) can present with varying degrees of upper airway obstruction, difficulty maintaining adequate weight gain, and failure to thrive (FTT). Although inductive reasoning would suggest that these issues should be interrelated, the relationships between these factors have not been formally studied. This investigation explores the correlation between polysomnographic (PSG) findings, weight gain, and FTT in patients with RS.

Design:

A prospective database for baseline PSG parameters and serial weight measurements in infants with RS who were admitted for airway obstruction was reviewed. The association between PSG variables and calorie intake with FTT was assessed using univariate and multivariable logistic regression. Categorical analysis of the PSG variables against FTT was explored with a Poisson regression, and linear regression was performed to evaluate the correlation between PSG parameters and percentage of weight gain.

Results:

Univariate and multivariate logistic regression in RS patients with (n = 13) and without (n = 20) FTT showed no significant association between apnea-hypopnea index (adjusted odds ratio [aOR]: 0.99, P-value = 0.403), O2 nadir (aOR: 0.98, P-value = 0.577), time of O2 saturation below 90% (aOR: 1.03, P-value = 0.574), maximum end tidal carbon dioxide (aOR: 1.0, P-value = 0.977), and average calorie intake (OR:1.02; P-value = 0.984). Furthermore, no significant associations were identified between these variables and weight gain.

Conclusions:

This pilot study questions the widely held and intuitively logical belief that poor weight gain and/or FTT should correlate with the severity of upper airway obstruction in patients with RS. Large prospective investigations should be initiated to better explore the authors’ findings. Our results also underscore the importance of individualized treatment for these challenging patients.
Bypass Surgery to Treat Giant Cavernous Carotid Artery Aneurysms
Authors: Sun Yang , Zhang Wenchao , Wang Benlin , Li Qi , Shi Minggang , Tong Xiaoguang
Published: March 2021

Background:

With the development of bypass technique, more and more complex aneurysms can be treated with bypass surgery. The goal of this study is to evaluate the efficacy and safety of bypass in patients with giant cavernous carotid aneurysms (GCCAs). To further discuss the treatment of asymptomatic GCCAs.

Methods:

The authors retrospectively reviewed our experience of the internal carotid artery (ICA) ligation/constriction combined with high/low-flow bypass surgery in the treatment of GCCAs.

Results:

Among the entire cohort, 4 patients underwent ICA ligation combined with high-flow bypass, 7 patients underwent ICA ligation/constriction combined with low-flow bypass. The postoperative symptom improvement: of 9 patients with preoperative ophthalmoplegia, the symptom resolved in 2 patients, improved in 7 patients, of 7 patients with preoperative pain, the symptom resolved in 2 patients, improved in 4 patients and was unchanged in 1 patient. The results of following-up were measured using the modified Rankin scale (mRS). During the follow-up, there were 9 patients with mRS score 0 to 1, 1 patient with mRS score 2, and 1 patient with mRS score 3. The long-term graft patency rate was 100%. All patients had no recurrence of intracranial aneurysm.

Conclusions:

Bypass surgery is a safe and effective method to treat GCCAs. Because of the risk of GCCAs and the improvement of bypass surgery technology, active surgical strategies should be adopted for asymptomatic or mild symptomatic GCCAs.
An Extended 45-year Long-term Follow-up on a 1–13 Rare Facial Cleft Patient
Authors: Raposo-Amaral Cassio Eduardo , Oliveira Yuri Moresco , Denadai Rafael , Ghizoni Enrico , Raposo-Amaral Cesar Augusto
Published: March 2021

We present here the unique case of a patient with a Tessier 1-13 rare facial cleft accompanied by cleft lip and palate and Tessier grade 2 hypertelorism. The patient described in this article has a twin brother who shares a number of genetic traits and physical features but does not present facial cleft or hypertelorism. The 45-year follow-up in this case is believed to be the longest follow-up to date to have been reported in the literature, and sheds significant light on the importance of extended longitudinal follow-up to maximize patient outcomes.
Long-term Dependency Outcomes in Older Adults Following Hepato-Pancreato-Biliary Surgery for Cancer
Authors: Bennett Sean , Chesney Tyler , Coburn Natalie , Zuk Victoria , Haas Barbara , Zhao Haoyu , Hsu Amy , Mahar Alyson , Hallet Julie ,   members of the REcovery after Surgical Therapy for Older adults Research – Cancer (RESTORE-Cancer) group
Published: March 2021

Objective:

To evaluate healthcare dependency following hepatopancreato-biliary cancer surgery in older adults (OA).

Summary Background Data:

Functional outcomes are central to decisionmaking by OA, but long-term risks of dependency have not been described beyond 1 year in this population.

Methods:

All patients over age 70 undergoing hepatectomy or pancreatec-tomy for cancer between 2007 and 2017 in Ontario were analyzed. Outcomes were 1) receipt of homecare and 2) time at home. Homecare was analyzed with cumulative incidence functions, and time at home with Kaplan-Meier and Cox multivariate models.

Results:

A total of 902 and 1283 patients underwent hepatectomy and pancreatectomy, respectively. Homecare use was highest (72.3%) in postoperative month-1, decreasing to stabilize between year-1 (25.5%) and year-5 (18.3%). Repeated receipt of homecare was associated with female sex (HR 1.18, 95% CI 1.05–1.32), receipt of adjuvant therapy (HR 1.56, 1.37–1.78), and more recent year of surgery (HR 3.80, 3.05–4.72). The ratio of home nursing care versus personal support services reversed from 68%/26% in year-1, to 29/64% in year-5. High time at home (>350 days) at 1 and 5 years were 40.6% (95% CI 38.5%–42.6%) and 28.1% (25.9%–30.3%), respectively. The ratio of institution-days in acute care versus nursing homes went from 77%/14% in year-1 to 23%/70% in year-5. Low time at home was associated with duodenal (HR 1.45, 1.15–1.70) and pancreas cancer (HR 1.20, 1.02–1.42), and with rural residence (HR 1.24, 1.04–1.48). High time at home was associated with more recent year of surgery (HR 0.84, 0.76–0.93) and perioperative cancer therapy (HR 0.88, 0.78–0.99). Increasing age was neither associated with homecare receipt nor time at home.

Conclusions:

Following hepatopancreatobiliary cancer surgery, there is a high rate of long-term healthcare dependency for OA. There is an immediate high need for homecare that reaches a new baseline after 6 months, and the majority of OA will have at least 1 year with low time at home, most commonly the first year. These findings can aid in preoperative preparation and transitional care planning.
Driving Habits of Older Adults
Authors: Bhojak Tejal , Jia Yichen , Jacobsen Erin , Snitz Beth E. , Chang Chung-Chou H. , Ganguli Mary
Published: March 2021

Objectives:

To describe factors associated with driving history, habits, and self-reported driving difficulties of 1982 older adults in a population-based survey.

Setting:

This was a community setting.

Participants:

Age-stratified random population sample drawn from publicly available voter registration list.

Design:

Participants underwent assessments including cognitive testing and self-reported current and past driving status, instrumental activities of daily living, self-rated health, social supports, physical limitations, and depressive symptoms. We built multivariable logistic regression models to identify factors associated with never having driven, having ceased driving, and reporting difficulties while driving.

Results:

In the multivariable model, “never drivers” were more likely than “ever drivers” to be older, female, less educated and to leave home less frequently. Former drivers were significantly older, more likely to be women, have lower test performance in the cognitive domain of attention, have more instrumental activity of daily living difficulties, leave home less frequently and have visual field deficits in the right eye than current drivers. Current drivers with reported driving difficulties were more likely than those without difficulties to have lower test performance in attention but higher in memory, were more likely to report depressive symptoms and to have both vision and hearing loss.

Conclusion:

Age, female sex, marital status, and education appear to be associated with driving cessation. Cognitive and functional impairments, mood symptoms and physical health also seem to influence driving cessation and reduction. Our findings may have implications for clinicians in assessing and educating their patients and families on driving safety.
Emerging infectious encephalitides
Authors: Venkatesan Arun
Published: March 2021

Purpose of review

The COVID-19 pandemic has cast increased attention on emerging infections. Clinicians and public health experts should be aware of emerging infectious causes of encephalitis, mechanisms by which they are transmitted, and clinical manifestations of disease.

Recent findings

A number of arthropod-borne viral infections -- transmitted chiefly by mosquitoes and ticks -- have emerged in recent years to cause outbreaks of encephalitis. Examples include Powassan virus in North America, Chikungunya virus in Central and South America, and tick-borne encephalitis virus in Europe. Many of these viruses exhibit complex life cycles and can infect multiple host animals in addition to humans. Factors thought to influence emergence of these diseases, including changes in climate and land use, are also believed to underlie the emergence of the rickettsial bacterium Orientia tsutsugamushi, now recognized as a major causative agent of acute encephalitis syndrome in South Asia. In addition, the COVID-19 pandemic has highlighted the role of bats as carriers of viruses. Recent studies have begun to uncover mechanisms by which the immune systems of bats are poised to allow for viral tolerance. Several bat-borne infections, including Nipah virus and Ebola virus, have resulted in recent outbreaks of encephalitis.

Infectious causes of encephalitis continue to emerge worldwide, in part because of climate change and human impacts on the environment. Expansion of surveillance measures will be critical in rapid diagnosis and limiting of outbreaks in the future.
Development of Moore Swab and Ultrafiltration Concentration and Detection Methods for Salmonella Typhi and Salmonella Paratyphi A in Wastewater and Application in Kolkata, India and Dhaka, Bangladesh
Authors: Liu Pengbo , Ibaraki Makoto , Kapoor Renuka , Amin Nuhu , Das Abhishek , Miah Md. Rana , Mukhopadhyay Asish K , Rahman Mahbubur , Dutta Shanta , Moe Christine L.
Published: March 2021

Enteric fever is a severe systemic infection caused by Salmonella enterica serovar Typhi (ST) and Salmonella enterica serovar Paratyphi A (SPA). Detection of ST and SPA in wastewater can be used as a surveillance strategy to determine burden of infection and identify priority areas for water, sanitation, and hygiene interventions and vaccination campaigns. However, sensitive and specific detection of ST and SPA in environmental samples has been challenging. In this study, we developed and validated two methods for concentrating and detecting ST/SPA from wastewater: the Moore swab trap method for qualitative results, and ultrafiltration (UF) for sensitive quantitative detection, coupled with qPCR. We then applied these methods for ST and SPA wastewater surveillance in Kolkata, India and Dhaka, Bangladesh, two enteric fever endemic areas. The qPCR assays had a limit of detection of 17 equivalent genome copies (EGC) for ST and 25 EGC for SPA with good reproducibility. In seeded trials, the Moore swab method had a limit of detection of approximately 0.05-0.005 cfu/mL for both ST and SPA. In 53 Moore swab samples collected from three Kolkata pumping stations between September 2019 to March 2020, ST was detected in 69.8% and SPA was detected in 20.8%. Analysis of sewage samples seeded with known amount of ST and SPA and concentrated via the UF method, followed by polyethylene glycol precipitation and qPCR detection demonstrated that UF can effectively recover approximately 8 log10 cfu, 5 log10 cfu, and 3 log10 cfu of seeded ST and SPA in 5 L, 10 L, and 20 L of wastewater. Using the UF method in Dhaka, ST was detected in 26.7% (8/30) of 20 L drain samples with a range of 0.11-2.10 log10 EGC per 100 mL and 100% (4/4) of 20 L canal samples with a range of 1.02 - 2.02 log10 EGC per 100 mL. These results indicate that the Moore swab and UF methods provide sensitive presence/absence and quantitative detection of ST/SPA in wastewater samples, and these two methods can be used jointly or separately for Salmonella Typhi environmental surveillance.
Molecular portrait of prostate tissue probed by MALDI Imaging Mass Spectrometry
Authors: Choubey Surya Kant , Mitra Amrita , Das Rajdeep , Rout Pritilata , Mandal Amit Kumar
Published: March 2021

Benign prostatic hyperplasia (BPH) is the most common condition in aging men, associated with lower urinary tract symptoms. BPH has been suggested to be a risk factor for certain urologic cancers, but the current evidence is inconsistent. The gold-standard method for the diagnosis of BPH is histopathology. Histopathology displays the cellular morphologies of tissues wherein characteristic changes pertaining specifically to BPH can be identified. However, the onset of BPH might be associated with minimal phenotypic changes in cellular morphologies in tissues that histopathology might not be able to detect successfully. Therefore, to understand the onset of a disease and its pathogenesis it is important to investigate the detailed molecular profiles associated with the disease that might help in the diagnosis and to understand the insights of the disease pathogenesis. Over the last decade, imaging mass spectrometry has been used to explore the spatial distribution and expression profiles of several molecules with their two-dimensional heterogeneity retained across the tissues. In the present study, using MALDI mass spectrometry based tissue imaging platform, we observed the expression of several proteins across human prostate tissue sections diagnosed with BPH. The proteins were identified and characterized using tissue proteomics approach. We could successfully identify the on-tissue distribution of ribonuclease T2, vinculin, isoform 2 of tropomyosin alpha-3 chain and mitochondrial citrate synthase proteins using this approach. Therefore, imaging mass spectrometry might be a potential tool to complement the findings of histopathology in diagnosis of BPH in human prostate tissues.
The health effects in the US of quarantine policies based on predicted individual risk of severe COVID-19 outcomes
Authors: Lovick Sam , Dite Gillian S. , Allman Richard
Published: March 2021

Background

Social distancing, testing and public health measures are the principal protections against COVID-19 in the US. Social distancing based on an accurate assessment of the individual risk of severe outcomes could reduce harm even as infection rates accelerate.

Methods

An SEIR dynamic transmission model of COVID-19 was created to simulate the disease in the US after October 2020. The model comprised 8 age groups with US-specific contact rates and low- and high-risk sub-groups defined in terms of the risk of a severe outcome determined by relevant comorbidities and a genetic test. Monte Carlo analysis was used to compare quarantine measures applied to at risk persons identified with and without the genetic test.

Results

Under the piecemeal social distancing measures currently in place, absent a vaccine the US can expect 114 million symptomatic infections, 4.8 million hospitalisations and 262,000 COVID-19 related deaths. Social distancing based solely on comorbidities with 80% compliance reduces symptomatic infections by between 1.2 and 2.2 million, hospitalisations by between 1.2 and 1.3 million, and deaths by between 71,800 and 80,900. Refining the definition of at risk using a test of single-nucleotide polymorphisms further reduces symptomatic infections by 1.0 to 1.2 million, hospitalisations by 0.4 million and deaths by between 20,500 and 24,100.

Conclusions

Models are now available that can accurately predict the likelihood of severe COVID-19 outcomes based on age, sex, comorbidities and polygenetic testing. Quarantine based on risk of severe outcomes could substantially reduce pandemic harm, even when infection rates outside of quarantine are high.
A realistic way to investigate the design, and mechanical properties of flow diverter stents
Authors: Velvaluri P. , Pravdivtseva M. S. , Hensler J. , Wodarg F. , Jansen O. , Quandt E. , Hövener J. B.
Published: March 2021

Purpose

Braided flow diverters (FD) are highly sophisticated, delicate, and intricate mechanical devices used to treat intracranial aneurysms and thus saving lives. Testing such devices in vitro, however, remains an unsolved challenge. Here, we evaluate methods that access flow, design, and mechanical properties in vitro.

Methods

Flow properties, cell porosity, and cell area were evaluated by placing FDs in patient-derived, 3D printed models of human vasculature. 4D flow MRI was used to measure fluid dynamics. Laser microscopy was used to measure porosity and cell area with the top of aneurysm sac cut off for the model. New testing methods were developed to investigate the bending, circumferential, and longitudinal radial force continuously over varying diameters.

Results

The placement and flow properties of the FD in the vasculature models were successfully measured by MRI, although artifacts occurred. The setup to measure porosity and cell area inside of the model proved successful. The newly discussed methods allowed us to measure the indicated forces, to our knowledge for the first time, continuously.

Conclusion

Modern and specifically tailored techniques, some of which were presented here for the first time, allow detailed insights into the flow and mechanical properties of braided flow diverter stents.
ACE gene variants rise the risk of severe COVID-19 in patients with hypertension, dyslipidemia or diabetes. A pilot study
Authors: Íñiguez María , Pérez-Matute Patricia , Villoslada-Blanco Pablo , Recio-Fernandez Emma , Ezquerro-Pérez Diana , Alba Jorge , Ferreira-Laso M. Lourdes , Oteo José A.
Published: March 2021

Coronavirus disease 19 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection continues to scale and threaten human health and public safety. It is essential to identify those risk factors that lead to a poor prognosis of the disease. A predisposing host genetic background could be one of these factors that explain the interindividual variability to COVID-19 severity. Thus, we have studied whether the rs4341 and rs4343 polymorphisms of the angiotensin converting enzyme (ACE) gene, key regulator of the renin-aldosterone-angiotensin system (RAAS), could explain the different outcomes of 128 COVID-19 patients with diverse degree of severity (33 asymptomatic or mildly asymptomatic, 66 hospitalized in the general ward, and 29 admitted to the ICU). We found that G allele of rs4341 and rs4343 was associated with severe COVID-19 in hypertensive patients, independently of gender (p<0.05). G-carrier genotypes of both polymorphisms were also associated with higher mortality (p< 0.05) and higher severity of COVID-19 in dyslipidemic (p<0.05) and type 2 diabetic patients (p< 0.01).

In conclusion, our preliminary study suggests that the G-containing genotypes of rs4341 and rs4343 confer an additional risk of adverse COVID-19 prognosis. Thus, rs4341 and rs4343 polymorphisms of ACE could be predictive markers of severity of COVID-19 in those patients with hypertension, dyslipidemia or diabetes. The knowledge of these genetic data could contribute to precision management of SARS-CoV-2 infected patients when admitted to hospital.
Impact of the COVID-19 Pandemic on Antimicrobial Resistance (AMR) Surveillance, Prevention and Control: A Global Survey
Authors: Tomczyk Sara , Taylor Angelina , Brown Allison , Kraker Marlieke de , Eckmanns Tim , El-Saed Aiman , Alshamrani Majid , Hendriksen Rene , Jacob Megan , Löfmark Sonja , Perovic Olga , Shetty Nandini , Sievert Dawn , Smith Rachel , Stelling John , Thakur Siddhartha , Tornimbene Barbara , Vietor Ann Christin , Eremin Sergey
Published: March 2021

Synopsis

Objectives

The COVID-19 pandemic has had a substantial impact on health systems. The WHO Antimicrobial Resistance (AMR) Collaborating Centres Network conducted a survey to assess the effects of COVID-19 on AMR surveillance, prevention and control.

Methods

From October-December 2020, WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) national focal points completed a questionnaire including Likert-scales and open-ended questions. Data were descriptively analysed, income/regional differences were assessed, and free-text questions were thematically analysed.

Results

Seventy-three countries across income levels participated. During the COVID-19 pandemic, 67% reported limited ability to work with AMR partnerships; decreases in funding were frequently reported by low- and middle-income countries (LMICs; p<0.01). Reduced availability of nursing, medical and public health staff for AMR was reported by 71%, 69% and 64%, respectively, whereas 67% reported stable cleaning staff availability. The majority (58%) reported reduced reagents/consumables, particularly LMICs (p<0.01). Decreased numbers of cultures, elective procedures, chronically ill admissions and outpatients and increased intensive care unit admissions reported could bias AMR data. Reported overall infection prevention and control (IPC) improvement could decrease AMR rates, whereas increases in selected inappropriate IPC practices and antibiotic prescribing could increase rates. Most did not yet have complete data on changing AMR rates due to COVID-19.

Conclusions

This was the first survey to explore the global impact of COVID-19 on AMR among GLASS countries. Responses revealed universal patterns but also captured country variability. Although focus is understandably on COVID-19, gains in detecting and controlling AMR, a global health priority, cannot afford to be lost.
Gender Differences in Caries and Periodontal Status in UK Children
Authors: Papadaki Sofia , Douglas Gail V A , HaniBani Alaa , Kang Jing
Published: March 2021

Background

Gender inequalities in dental caries and periodontal diseases have been observed among adults. However, literature is scarce for children and evidence on gender inequalities regarding caries and/or periodontal diseases is vague. Our aim is to examine potential gender differences in UK children regarding caries experience and periodontal status using data from the UK’s 2013 Children’s Dental Health Survey (CDHS).

Methods

CDHS included children aged 5, 8, 12 and 15 years. Their dental caries experience and periodontal status were reported using the number of decayed, missing and filled teeth (DMFT or dmft for permanent or primary dentition at both D1 and D3 thresholds) and the basic periodontal examination (BPE) score, respectively. Zero-inflated negative binomial (ZINB) models were used to fit DMFT/dmft and a multinomial logistic regression (MLR) model was used for BPE scores after adjustment for possible confounding factors, to assess the gender inequality on DMFT/dmft and BPE in the UK children.

Results

The analyses included 9,866 children. No gender inequalities in caries experience were observed in the 5 and 8-year-old children regardless of the threshold at which dental caries were examined. However, for the 12- and 15-year-old adolescents, females had higher D3MFT scores compared to males (IRR: 1.28, 95% CI: 1.10-1.49 and IRR: 1.16, 95% CI: 1.00-1.35, respectively). Additionally, the 15-year-old females had lower probability to be caries free (OR: 0.59, 95% CI: 0.45-0.82), regardless of the threshold at which dental caries were examined. With regards to the periodontal status, no statistically significant gender inequalities (p>0.05) were observed.

Conclusions

In the UK, female adolescents had experienced more carious lesions compared to males of the same age group, when dental caries were examined into dentine (D3MFT). However, 15-year-old males matched females in their caries experience, when the early enamel lesions were included in caries diagnosis (D1MFT). With regard to the periodontal status, no gender dissimilarity was confirmed among British adolescents. The increased risk of adolescent females to dental caries may signify additional needs for prevention and improved oral care.
Sudden rise in COVID-19 case fatality among young and middle-aged adults in the south of Brazil after identification of the novel B.1.1.28.1 (P.1) SARS-CoV-2 strain: analysis of data from the state of Parana
Authors: de Oliveira Maria Helena Santos , Lippi Giuseppe , Henry Brandon Michael
Published: March 2021

Brazil is currently suffering a deadly surge of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, which has been attributed to the spread of a new strain known as P.1 (B.1.1.28.1). In this investigation, we analyzed coronavirus disease 2019 (COVID-19) public health data from Parana, the largest state in southern half of Brazil, between September 1, 2020 and March 17, 2021, to evaluate recent trends in case fatality rates in different age groups. A total of 553,518 cases of SARS-CoV-2, 8,853 currently registered as fatal, were finally included in our analysis. All age groups showed either decline or stabilization of the case fatality rates (CFRs) between September 2020 and January 2021. In February 2021, an increase in CFR for almost all age groups could be instead observed. All groups above 20 years of age showed statistically significant increases in CFR when diagnosed in February 2021 as opposed to January 2021. Patients aged 20-29 years experienced a tripling of their CFR, from 0.04% to 0.13%, while those aged 30-39, 40-49, 50-59 experienced approximate CFR doubling. Individuals between 20 and 29 years of age whose diagnosis was made in February 2021 had an over 3-fold higher risk of death compared to those diagnosed in January 2021 (Risk Ratio (RR): 3.15 [95%CI: 1.52-6.53], p<0.01), while those aged 30-39, 40-49, 50-59 years experienced 93% (1.93 [95%CI:1.31-2.85], p<0.01), 110% (RR: 2.10 [95%CI:1.62-2.72], p<0.01), and 80% (RR: 1.80 [95%CI:1.50-2.16], p<0.01) increases in risk of death, respectively. Notably, the observed CFR increase coincided with the second consecutive month of declining number of diagnosed SARS-CoV-2 cases. Taken together, these preliminary findings suggest significant increases in CFR in young and middle-aged adults after identification of a novel SARS-CoV-2 strain circulating in Brazil, and this should raise public health alarms, including the need for more aggressive local and regional public health interventions and faster vaccination.
Electrophysiological and Transcriptomic Features Reveal a Circular Taxonomy of Cortical Neurons
Authors: Rodríguez-Collado Alejandro , Rueda Cristina
Published: March 2021

The complete understanding of the mammalian brain requires exact knowledge of the function of each of the neurons composing its parts. To achieve this goal, an exhaustive, precise, reproducible, and robust neuronal taxonomy should be defined. In this paper, a new circular taxonomy based on transcriptomic features and novel electrophysiological features is proposed. The approach is validated by analysing more than 1850 electrophysiological signals of different mouse visual cortex neurons proceeding from the Allen Cell Types Database.

The study is conducted on two different levels: neurons and their cell-type aggregation into Cre Lines. At the neuronal level, electrophysiological features have been extracted with a promising model that has already proved its worth in neuronal dynamics. At the Cre Line level, electrophysiological and transcriptomic features are joined on cell types with available genetic information. A taxonomy with a circular order is revealed by a simple transformation of the first two principal components that allow the characterization of the different Cre Lines. Moreover, the proposed methodology locates other Cre Lines in the taxonomy that do not have transcriptomic features available. Finally, the taxonomy is validated by Machine Learning methods which are able to discriminate the different neuron types with the proposed electrophysiological features.
Mugs and Plants: Object Semantic Knowledge Alters Perceptual Processing with Behavioral Ramifications
Authors: Dubbelde Dick , Shomstein Sarah
Published: March 2021

Neural processing of objects with action associations recruits dorsal visual regions more than objects without such associations. We hypothesized that because the dorsal and ventral visual pathways have differing proportions of magno- and parvo-cellular input, there should be behavioral differences in perceptual tasks between manipulable and non-manipulable objects. This hypothesis was tested in adults across five experiments (Ns = 26, 26, 30, 25, 25) using a gap detection task, suited to the spatial resolution of parvocellular processing, and an object flicker discrimination task, suited to the temporal resolution of magnocellular processing. Directly predicted from the cellular composition of each pathway, a strong non-manipulable object advantage was observed in gap detection, and a small manipulable object advantage in flicker discrimination. Additionally, these effects are modulated by reducing object recognition through inversion and by suppressing magnocellular processing using red light. These results establish perceptual differences between objects dependent on semantic knowledge.

Statement of Relevance

When we perceive an object, our knowledge of that object is brought to mind. Previous work has shown specifically that knowledge of object manipulability biases neural processing to areas of the brain in the parietal lobe which are relevant to motor processing. In this study we show that this neural bias, caused by knowledge of the object, has an effect on object perception. Using behavioral paradigms designed to take advantage of the specific response properties of neurons in the parietal and temporal object processing areas, we found that manipulable objects are perceived with higher temporal resolution while non-manipulable objects are perceived with higher spatial resolution. Our results demonstrate a specific neural mechanism by which prior knowledge affects current perception.