bluuebunny/crossref_metadata_2025 huggingface dataset:
O01 PROPHYLACTIC MESH PLACEMENT DURING FORMATION OF AN END-COLOSTOMY LONG TERM RCT ON EFFECTIVENESS AND SAFETY
Authors: Brandsma Thijs , Hansson Bibi , De Jong Nienke , Aufenacker Theo , van Westreenen Erik , van Lammeren Felix , Mahabier Chander , Donders Rogier , Steenvoorde Pascal , de Vries Reilingh Tammo , Wiezer Rene , de Wilt Hans , Rovers Maroeska , Rosman Camiel
Published: December 2021

Aim

To determine if prophylactic mesh placement is an effective, safe, and cost-effective procedure to prevent parastomal hernia (PSH) formation in the long term.

Material and Methods

In this multicenter superiority trial patients undergoing formation of a permanent colostomy were randomly assigned to either retromuscular mesh reinforcement or conventional colostomy formation. The primary endpoint was the incidence of a PSH after 5 years. Secondary endpoints were morbidity, mortality, quality of life and cost-effectiveness.

Results

A total of 150 patients were randomly assigned to the mesh group (n = 72) or non-mesh group (n = 78). For the long term follow up, we could analyse 113 patients since 37 patients were lost to follow-up. After a median follow-up of 60 months (IQR 48.6 – 64.4), 49 patients developed a PSH, 20 (27.8%) in the mesh group and 29 (37.2%) in the non-mesh group (p = 0.22; 95% CI -24 – 5.5). A total of 25 patients developed an incisional hernia, seven in the mesh group (10.4%) versus 18 in the non-mesh group (27.2%) (p = 0.013, 95% CI 3.5 – 30.0). No relevant differences were found in quality of life or cost-effectiveness between both study group.

Conclusions

Use of a prophylactic retromuscular mesh at the ostomy site delays but not reduces the incidence of PSH after 5 years of follow-up. It leads to less severe PSH according to the EHS and MM classification with fewer repairs needed. Furthermore it causes patients to have fewer stoma related complications necessitating change of appliances and it is safe without any adverse events or increase in morbidity.
O14 SHORT STITCH TRIAL 6:1 WITH 4-OH-BUTYRATE (MONOMAX) - FINAL RESULTS
Authors: Golling Markus , Zielska Zofia , Maurer Katalyn , Baumann Petra
Published: December 2021

Aim

Surgical technique and material used to close an abdominal wall incision are considered to be important determinants for the risk of developing surgical site occurences (SSOs). Aim of our prospective, non-randomized, monocentric study was a comparative analysis of the perioperative performance (6:1 suture/wound length (SL/WL)-ratio) and SSOs (surgical site infections [SSI] & 2°wound dehiscence/burst abdomen) following midline & transverse incisions.

Material and Methods

The trial is completed. It included 351 patients between 1/2013-10/2018 in a prospective database. The surgeons aimed at performing a 6:1 SL/WL-ratio in all laparotomies. Patient specific data (risk factors, intra- & postop parameters & SSI/SSO) were entered into the registry database. Satistics involved the Chi2-/ANOVA and Mann-Whitney Test.

Results

Overall, 82,3% (289/351) were operated electively, 17,7% (62/351) had an emergency laparotomy, 55% (n = 194) had a midline, 29% (n = 103) a transverse and 15% (n = 54) a combined L-shaped laparotomy (liver resection). A learning curve with respect to the bite width was encountered. While SL/WL ratio all laparotomies were similar, bite width varied but improved with experience. SSI was higher in transverse vs. median laparotomies and overall higher in emergency operations. The rate of 2°wound dehiscence (surgical site occurrence [SSO]) stayed at 1/351.

Conclusions

A learning curve is required to sufficiently perform a short stitch 6:1 suture. Median and transverse laparotomies can be closed safely by a 6:1 SL/WL ratio. SSO could be reduced compared to our historic patient cohort but did not differ within the > and < 6:1 ratio. Emergency laparotomies can also be safely performed with the short stitch technique.
O15 LESS PAIN AFTER TACK FIXATION OF MESH THAN WITH SELF-GRIPPING MESH FOLLOWING LAPAROSCOPIC INGUINAL HERNIA REPAIR: A RANDOMIZED CLINICAL TRIAL
Authors: Christensen Marie Kirk , Dinesen Malene Ørberg , Pedersen Andreas , Rosenberg Jacob , Brandenburger Nils , Hebo Ole , Hassenkam Hasse , Ghani Mohamad , Nielsen Michael
Published: December 2021

Aim

Acute pain following transabdominal preperitoneal inguinal hernia repair (TAPP) may be attributed to mesh fixation. The aim of the present study was to determine short and long-term complications following laparoscopic TAPP repair using either a self-gripping mesh or a tacked mesh.

Material and Methods

Healthy male subjects referred for unilateral inguinal hernia repair were randomized to a TAPP procedure using either a tacked mesh (Parietix, Medtronic; AbsorbaTack, Medtronic) or a self-gripping mesh (ProGripTM, Medtronic). Acute postoperative pain and short and long-term complications were recorded using an e-mail generated questionnaire preoperatively and at days 1 and 7 and at 1, 3, 6 and 12 months postoperatively. Acute pain was assessed using the visual analogue scale (VAS).

Results

A total of 333 male subjects underwent elective repair of a medial (n = 107, 32%) or a lateral (n = 226, 68%) inguinal hernia. Patients were randomized to either a tacked (T = 178) or non-tacked procedure (N = 155). Mean follow-up time was 141 days. Mean number of tacks applied was 2.7 per operation. Mean preoperative VAS score was 2.21 (T) vs 1.78 (N) (P = 0.06). Postoperatively, the mean VAS-score (average within the observation period) was 2.80 (T) vs 3.12 (N) (P < 0.01), resulting in a 10% lower VAS-score following the tacked repair compared to the self-gripping mesh (P < 0.01). Patient-reported signs of recurrence at 12 months was 4.7% (T) vs 7.5% (N) (P = 0.35).

Conclusions

Postoperative acute pain after laparoscopic inguinal hernia repair is lower following a tacked than a non-tacked (self-adhesive mesh) procedure. Patient-reported recurrence did not differ between groups
O47 MESH-RELATED COMPLICATIONS, CHRONIC PAIN, AND ECONOMIC CLAIM COMPENSATION AFTER UMBILICAL HERNIA REPAIR
Authors: Rønnow Martin Frimand , Hoffner Mattias , Schulze Svend , Helgstrand Frederik , Hjalmarsson Claes , Bisgaard Thue
Published: December 2021

Aim

The risk of mesh-related surgical complications after umbilical hernia repair is not known and chronic pain has only sparsely been analysed. Economic claims may represent a surrogate for poor postoperative surgical outcomes. Thus, the present study used mesh-related complications and chronic pain as primary and secondary outcomes, respectively.

Material and Methods

Blinded assessment of Swedish and Danish nationwide consecutive economic claim data from 2007 –2019. The study variables and outcomes were pre-study defined. Major complications were defined as acutely life-threatening complications requiring emergency surgery, clinically important complications were defined as all complications requiring surgical intervention but not emergency surgery.

Results

During the 13-years study period 181 patients were eligible for analysis. There were 96 patients with a surgical complication. In 52 (54%) and 44 (46%) patients the complication was mesh- or non-mesh-related, respectively. In the group of mesh- and non-mesh-related complications, major complications were found in 14 (14,6%) vs 21 (21,9%) patients and clinically important complications were found in 38 (39,5%) vs 23 (23,9%) patients respectively (P < 0.05). Chronic pain was reported in 18%, followed by wound complications (14%) and cosmetic claim reasons (11%). After open repair, claim because of chronic pain was significantly more common after mesh repair (48%) compared with non-mesh repairs (32%), P = 0.05. The economic compensation after a mesh- and non-mesh complication was 3,488€ (291 – 188,186€) and 2,342€ (507€ - 58,437€) (P = 0.55), respectively.

Conclusions

Mesh-repair was related to postoperative complications and chronic pain after umbilical hernia repair
OV03 TEP IN COLORS: ANATOMICAL VIEW USING ARTICULATED FORCEPS
Authors: Guariglia Claudio Antonio , Gobbo Rafael Diaz del , Sanchez Raquel , Sanchon Lorena , Osorio Alexander , Pardo Sara , Farre Roser , Guell Merce , Collera Pablo
Published: December 2021

Aim

Present through an illustrative and educational video, an anatomical and colorful vision of the totally extraperitoneal laparoscopic approach (TEP) of inguinofemoral hernias, with the aim of favoring the learning process of this technique, facilitating the identification of the main anatomical structures, ensuring a safe and effective approach.

Material and Methods

In this video we show the laparoscopic approach to inguinofemoral hernias via TEP, highlighting the most important anatomical structures with different colors.

Additionally, the surgical technique of this approach using articulated forceps is shown, which we consider to be a good resource for dissection in a space as small as the preperitoneal one.

Results

The anatomical study of the inguinofemoral area constitutes the basis of a correct preperitoneal approach, especially in PET, where the most difficult is probably the space location and the identification of the structures.

Conclusions

The preperitoneal PET route is a relatively novel approach for inguinofemoral hernia repair. Its benefits are based on the ability to identify all the anatomical structures of the myopectineal orifice from a preperitoneal view without the need to access the peritoneal cavity.

The knowledge of preperitoneal anatomy is the cornerstone for learning the TEP approach, and we consider that anatomical videos of real surgeries are good strategies to shorten the learning curve.

Mastering the preperitoneal anatomy ensures obtaining the benefits inherent to the TEP approach, such as bilateral exploration of the myopectineal orifice, direct visualization of the pain and doom triangles, tension-free repair with mesh of all possible defects and faster postoperative recovery.
Progressive left and right heart dysfunction in coronavirus disease-19: Prospective echocardiographic evaluation
Authors: Chaturvedi Hemant , Issac Rohan , Sharma Sanjeev Kumar , Gupta Rajeev
Published: December 2021

Aims

Cardiac dysfunction in coronavirus disease-19 (COVID-19) has been reported during acute phase but serial changes have not been well studied. To determine serial changes in type and severity of echocardiographic left and right heart functions we performed a prospective study.

Methods and results

Successive COVID-19 patients at discharge from the hospital from June to December 2020 were enrolled. Clinical details were obtained and echocardiography was performed using Philips IE33X-Matrix. Follow-up evaluation was performed after 3 months. In total, 1789 COVID-19 patients were evaluated. Baseline echocardiography was performed in 1000 eligible patients (men 611, women 389). Mean age was 50.2 ± 15 years, hypertension was in 44.0%, diabetes in 49.4%, and coronary disease in 10.8%. COVID-19 was mild in 47.0%, moderate in 39.5%, and severe in 13.5%. Baseline cardiac parameters were more impaired in severe vs. moderate or mild COVID-19. At 3 months, in 632 patients where baseline and follow-up data were available, decline was observed in select left [left ventricular internal diameter in diastole +0.9 ± 0.2 mm, left atrial volume +7.6 ± 0.1 mL/m2, mitral E/e′ +4.8 ± 0.1, and left ventricular ejection fraction (LVEF) −3.7 ± 0.2%] and right [right ventricular internal diameter in diastole +2.1 ± 0.1 mm, right atrial internal dimension +1.6 ± 0.1 mm, tricuspid Vmax +1.0 ± 0.1 cm, and tricuspid annulus plane systolic excursion (TAPSE) −2.7 ± 0.2 mm] heart variables (P < 0.001). Compared to mild COVID-19, decline was significantly greater in moderate/severe disease, LVEF −1.1 ± 0.3 vs. −3.8 ± 0.3%; mitral E/e′ +3.2 ± 0.1 vs. +4.8 ± 0.1, tricuspid Vmax +0.3 ± 0.1 vs. +1.0 ± 0.1 cm, and TAPSE −0.7 ± 0.2 vs. −2.7 ± 0.2 mm (P < 0.001).

Conclusion

This study shows impaired cardiac functions in severe and moderate COVID-19 compared to mild at hospital discharge and progressive decline in left and right heart functions at 3 months. Impairment is significantly greater in patients with moderate to severe disease.
Scaling-up agricultural technologies: who should be targeted?
Authors: Mellon Bedi Shaibu , Azzarri Carlo , Hundie Kotu Bekele , Kornher Lukas , von Braun Joachim
Published: December 2021

The effects of agricultural technology adoption on farm performance have been studied extensively but with limited information on who should be targeted during scaling-up. We adopt the newly defined marginal treatment effect approach in examining how farmers’ resource endowment and unobserved factors influence the marginal benefits of adopting sustainable intensification (SI) practices. We estimate both the marginal and average benefits of adopting SI practices and predict which marginal farm household entrants will benefit the most at scale. Findings indicate that farmers’ resource endowment and unobserved factors affect the marginal benefits of adopting SI practices, which also influence maize yield and net returns among adopters. Finally, results imply that scaling up SI practices will favour farm household entrants associated with the lowest probability of adoption based on observed socioeconomic characteristics.
Effect of Biochar and Manual Vegetation Control on Early Growth and Survival of Planted Jack Pine (Pinus banksiana Lamb.) Seedlings in Northern Minnesota
Authors: Slesak Robert A , Kelso Sara G , Windmuller-Campione Marcella A
Published: December 2021

Survival of planted seedlings following a regeneration harvest can be challenging and early interventions through silvicultural treatments may be required for successful stand establishment. We tested the influence of soil amendment (biochar plus compost, compost-only, or control) and vegetation control (VC; applied either initially or annually for five years using brush saws) on the growth and survival of jack pine at three sites in northern Minnesota. Application of the biochar plus compost soil amendment increased seedling survival by 30% relative to the control in the first year, but there was no significant difference in survival among soil amendment treatments after five years. Both soil amendments increased diameter growth relative to the control (14% increase with biochar plus compost, 10% increase with compost only), with most of the biochar plus compost effect attributed to the compost. Annual VC increased diameter growth by 17% relative to initial VC, but overall effects on survival and growth were generally small relative to reported effects of VC via herbicide. The limited short-term influence of biochar and manual VC on growth and survival of jack pine indicates that these practices are likely not an effective means to increase jack pine establishment, but other benefits (e.g., increased carbon storage) may become apparent with time.
Massively parallel analysis of human 3′ UTRs reveals that AU-rich element length and registration predict mRNA destabilization
Authors: Siegel David A , Le Tonqueze Olivier , Biton Anne , Zaitlen Noah , Erle David J
Published: December 2021

AU-rich elements (AREs) are 3′ UTR cis-regulatory elements that regulate the stability of mRNAs. Consensus ARE motifs have been determined, but little is known about how differences in 3′ UTR sequences that conform to these motifs affect their function. Here, we use functional annotation of sequences from 3′ UTRs (fast-UTR), a massively parallel reporter assay (MPRA), to investigate the effects of 41,288 3′ UTR sequence fragments from 4653 transcripts on gene expression and mRNA stability in Jurkat and Beas2B cells. Our analyses demonstrate that the length of an ARE and its registration (the first and last nucleotides of the repeating ARE motif) have significant effects on gene expression and stability. Based on this finding, we propose improved ARE classification and concomitant methods to categorize and predict the effect of AREs on gene expression and stability. Finally, to investigate the advantages of our general experimental design we examine other motifs including constitutive decay elements (CDEs), where we show that the length of the CDE stem-loop has a significant impact on steady-state expression and mRNA stability. We conclude that fast-UTR, in conjunction with our analytical approach, can produce improved yet simple sequence-based rules for predicting the activity of human 3′ UTRs.
Single-nucleus transcriptomes reveal evolutionary and functional properties of cell types in theDrosophilaaccessory gland
Authors: Majane Alex C , Cridland Julie M , Begun David J
Published: December 2021

Many traits responsible for male reproduction evolve quickly, including gene expression phenotypes in germline and somatic male reproductive tissues. Rapid male evolution in polyandrous species is thought to be driven by competition among males for fertilizations and conflicts between male and female fitness interests that manifest in postcopulatory phenotypes. In Drosophila, seminal fluid proteins secreted by three major cell types of the male accessory gland and ejaculatory duct are required for female sperm storage and use, and influence female postcopulatory traits. Recent work has shown that these cell types have overlapping but distinct effects on female postcopulatory biology, yet relatively little is known about their evolutionary properties. Here, we use single-nucleus RNA-Seq of the accessory gland and ejaculatory duct from Drosophila melanogaster and two closely related species to comprehensively describe the cell diversity of these tissues and their transcriptome evolution for the first time. We find that seminal fluid transcripts are strongly partitioned across the major cell types, and expression of many other genes additionally defines each cell type. We also report previously undocumented diversity in main cells. Transcriptome divergence was found to be heterogeneous across cell types and lineages, revealing a complex evolutionary process. Furthermore, protein adaptation varied across cell types, with potential consequences for our understanding of selection on male postcopulatory traits.
Disentangling genetic feature selection and aggregation in transcriptome-wide association studies
Authors: Cao Chen , Kossinna Pathum , Kwok Devin , Li Qing , He Jingni , Su Liya , Guo Xingyi , Zhang Qingrun , Long Quan
Published: December 2021

The success of transcriptome-wide association studies (TWAS) has led to substantial research toward improving the predictive accuracy of its core component of genetically regulated expression (GReX). GReX links expression information with genotype and phenotype by playing two roles simultaneously: it acts as both the outcome of the genotype-based predictive models (for predicting expressions) and the linear combination of genotypes (as the predicted expressions) for association tests. From the perspective of machine learning (considering SNPs as features), these are actually two separable steps—feature selection and feature aggregation—which can be independently conducted. In this study, we show that the single approach of GReX limits the adaptability of TWAS methodology and practice. By conducting simulations and real data analysis, we demonstrate that disentangled protocols adapting straightforward approaches for feature selection (e.g., simple marker test) and aggregation (e.g., kernel machines) outperform the standard TWAS protocols that rely on GReX. Our development provides more powerful novel tools for conducting TWAS. More importantly, our characterization of the exact nature of TWAS suggests that, instead of questionably binding two distinct steps into the same statistical form (GReX), methodological research focusing on optimal combinations of feature selection and aggregation approaches will bring higher power to TWAS protocols.
The Physical, Mental, and Social Health of Middle-Aged and Older Adults Without Close Kin in Canada
Authors: Margolis Rachel , Chai Xiangnan , Verdery Ashton M , Newmyer Lauren
Published: December 2021

Objectives

We examine whether adults aged 45 and older lacking a partner and children are disadvantaged in terms of physical, mental, and social aspects of health. Then we test whether the importance of family structure for these outcomes varies by age, gender, and educational attainment.

Methods

We examine aging and social network modules from the Canadian General Social Survey to estimate associations between family structure and physical, mental, and social health, with the last measured as communication with relatives and friends, civic participation, and loneliness.

Results

Results show that middle-aged and older adults without partners have lower levels of physical and mental health and higher levels of loneliness than those with partners. Those without partners and children (the “kinless”) interact less with relatives than those who have children but not partners, but more with friends, showing some substitution. In terms of civic participation, kinless middle-aged and older adults have significantly lower odds of this type of engagement than peers with close kin. Our interaction models find some differences by age, gender, and education, which vary by the outcome.

Discussion

Our results highlight some concerns about the well-being of kinless adults in Canada, especially as related to physical and mental health and two aspects of social health, loneliness, and civic participation. We find some substitution occurring, whereby middle-aged and older adults without family are interacting more with friends than comparable peers, but such substitution is marginal.
Safety of Immunizations for the Adult Patient With Inflammatory Bowel Disease—A Systematic Review and Meta-analysis
Authors: Desalermos Athanasios , Pimienta Michael , Kalligeros Markos , Shehadeh Fadi , Diamantopoulos Leonidas , Karamanolis George , Caldera Freddy , Farraye Francis A
Published: December 2021

Background

Patients with inflammatory bowel disease (IBD) have low vaccination rates for vaccine-preventable diseases. Fear of adverse reactions (AEs) appear to negatively affect vaccination efforts. We aimed to systemically review the risks for AEs following immunization for patients with IBD.

Methods

We searched PubMed and Embase until April 15, 2020, for studies evaluating the safety of vaccinations among patients with IBD. The primary outcome was the incidence of systemic and local AEs among vaccinated patients. Secondary outcome was the rate of IBD flare following immunization. We utilized a random effects meta-analysis of proportions using the DerSimonian-Laird approach to estimate the safety of immunizations.

Results

A total of 13 studies with 2116 patients was included in our analysis after fulfilling our inclusion criteria. Seven studies examined the influenza vaccine, 4 the pneumococcal vaccine, 1 the recombinant zoster vaccine, and 1 the hepatitis B vaccine. Follow-up of patients was up to 6 months. The majority of AEs were local, with a pooled incidence of 24% (95% CI, 9%-42%) for all vaccines. Systemic AEs were mostly mild, without resulting in hospitalizations or deaths, with a pooled incidence of 16% (95% CI, 6%-29%) for all vaccines. Flare of inflammatory bowel disease after vaccination found with a pooled incidence of 2% (95% CI, 1%-4%) and we include in the analysis data from all immunizations examined.

Discussion

Our study demonstrated that AEs after vaccination are mainly local or mildly systemic and do not differ significantly from the expected AE after recommended immunizations for the general population. Thus, gastroenterologists should reinforce that vaccines are safe in patients with IBD.
Association Between Inflammatory Bowel Disease and Dementia: A Longitudinal Cohort Study
Authors: Sun Yuhao , Geng Jiawei , Chen Xuejie , Chen Hui , Wang Xiaoyan , Chen Jie , Li Xue , Hesketh Therese
Published: December 2021

Background

The association between inflammatory bowel disease (IBD) and dementia remains uncertain. We aim to investigate whether IBD is associated with higher dementia risk.

Methods

Using multivariable Cox regression models, we analyzed the onset of all-cause dementia among 497,775 participants, including 5778 IBD patients in the UK Biobank as primary analysis. In secondary analysis, we further examined the difference in brain structure and cognitive function changes between IBD and non-IBD individuals. The diagnosis of IBD and dementia was confirmed with combination of primary care data, hospital inpatient data, death registry, and self-report data. Brain structure was measured by brain MRI as anatomic and tissue-specific volumes; cognitive function was tested in terms of reaction, visual episodic memory, verbal-numerical reasoning, and prospective memory.

Results

During a mean follow-up of 11.58 years, 100 and 6709 incident all-cause dementia with or without IBD were documented, respectively. In multivariable Cox regression model, hazard ratio for incident dementia among IBD patients was 1.14 (95% confidence interval [CI], 0.94-1.39; P=.182) comparing with non-IBD participants; no statistically significant difference was observed in their brain MRI measures of anatomic and tissue-specific volumes, whereas IBD patients had a significantly increased reaction time (β=12.32; 95% CI, 1.97, 22.67; P = .020). Results of subgroup and sensitivity analyses were consistent with the main analysis.

Conclusions

Our study does not support a significant association between IBD and dementia. Further studies with better design and longer follow-up are needed to elucidate the association.
Detection of Nonenveloped Hepatitis E Virus in Plasma of Infected Blood Donors
Authors: Costafreda Maria Isabel , Sauleda Silvia , Rico Angie , Piron Maria , Bes Marta
Published: December 2021

Background

Transfusion-transmitted hepatitis E virus (HEV) infections have raised many concerns regarding the safety of blood products. To date, enveloped HEV particles have been described in circulating blood, whereas nonenveloped HEV virions have only been found in feces; however, no exhaustive studies have been performed to fully characterize HEV particles in blood.

Methods

Using isopycnic ultracentrifugation, we determined the types of HEV particles in plasma of HEV-infected blood donors.

Results

Nonenveloped HEV was detected in 8 of 23 plasma samples, whereas enveloped HEV was found in all of them. No association was observed between the presence of nonenveloped HEV and viral load, gender, or age at infection. However, samples with HEV-positive serology and/or increased levels of liver injury markers contained a higher proportion of nonenveloped HEV than samples with HEV-negative serology and normal levels of liver enzymes. These results were further confirmed by analyzing paired donation and follow-up samples of 10 HEV-infected donors who were HEV seronegative at donation but had anti-HEV antibodies and/or increased levels of liver enzymes at follow up.

Conclusions

The HEV-contaminated blood products may contain nonenveloped HEV, which may pose an additional risk to blood safety by behaving differently to pathogen inactivation treatments or increasing infectivity.
Case report of combined iliac crest and ASIS apophysis avulsion fracture in an adolescent footballer
Authors: Chan Chloe , Sohail Mohammed Zain , Buddhdev Pranai
Published: December 2021

Pelvic apophyseal avulsion fractures are uncommon injuries that typically occur in adolescents during sporting activities. Iliac crest (IC) apophyseal injuries represent a small percentage avulsion fracture around the pelvis with a reported incidence rate of 5%. We present a rare case of an adolescent boy who sustained a combined anterior superior iliac spine/iliac crest apophyseal avulsion fracture while playing football. With painful limited hip range of movement and inability to weight-bear, plain film and computed tomography scan illustrated a displaced fracture which was managed conservatively with an excellent clinical and radiological outcome. A review of apophyseal fractures around the pelvis, including incidence, mechanism of injury and treatment options regarding surgical versus conservative treatment, are discussed.
Bilateral papillary thyroid cancer with normal aberrant thyroid tissue
Authors: Huang Qingqing , Chen Dongdong , Ma Yi
Published: December 2021

Ectopic thyroid tissue, 90% presenting in lingual zone, is often scanned by ultra-sonography or computed tomography. Most surgeons regard ectopic thyroid as metastatic foci from thyroid cancer, thus resection is recommended. Here, we reported a man with bilateral papillary thyroid cancer, accompany with normal ectopic thyroid tissue in right sternocleidomastoid muscle. In this case, we highlighted: (i) It is rarely reported that ectopic normal thyroid tissue presented in sternocleidomastoid muscle. (ii) The ectopic thyroid tissue may not always be metastatic foci even though bilateral thyroid tumors were confirmed to be papillary cancer. (iii) Contrary to radical excision of all ectopic thyroid tissue, we advocate that only patients who need to receive the radioactive iodine therapy after total thyroidectomy should remove the ectopic normal thyroid tissue.
Long-term persistence of antibodies and boostability after rabies intradermal pre-exposure prophylaxis
Authors: Mills Deborah J , Lau Colleen L , Mills Christine , Furuya-Kanamori Luis
Published: December 2021

Background

Currently, there is limited data on long-term persistence of antibodies and boostability of intradermal (ID) rabies pre-exposure prophylaxis (PrEP) schedules. This study investigated travellers who received a primary ID PrEP schedule at least 5 years previously to determine the persistence of antibodies and subsequent antibody response after one 0.1-ml ID booster dose.

Methods

Adults (age ≥ 18 years) who had previously received ID PrEP at a specialist travel medicine clinic in Brisbane, Australia were included. At Day 0, blood was collected for serology and one dose of 0.1-ml ID rabies vaccine (Verorab®) was administered. At Day 7, serology was repeated. At Day 14, participants were given results and enquired if they experienced adverse events following immunization (AEFIs). Antibodies were measured using Platelia Rabies II ELISA; levels ≥0.5 EU/mL were considered antibody-positive.

Results

158 participants were included [64.6% female, median age at enrolment 56.4 years, interquartile range (IQR) 42.4–65.2 years], and median time since the primary ID PrEP was 8.5 years (IQR 6.9–11.7 years). The majority of participants (82.3%) were antibody-positive at Day 0. The proportion of participants who were antibody-positive at Day 0 was higher among those who were younger at primary vaccination (87.0% if aged<50 years, 75.8% of aged ≥50 years). The proportion of participants who were antibody-positive declined as median time since primary vaccination increased, though the trend was not statistically significant (p-trend = 0.187). All except one participant (99.4%) were antibody-positive after one ID booster dose. AEFIs were reported by 42.4% of participants and were mainly mild.

Conclusions

Rabies antibodies persist for many years after ID PrEP and can be rapidly boosted with a single ID dose. Future studies are needed to confirm that ID PrEP primes the immune system sufficiently so that boosters are not routinely needed, and only given in the event of a rabies-prone exposure.
Melnick 33Na: a very massive colliding-wind binary system in 30 Doradus
Authors: Bestenlehner Joachim M , Crowther Paul A , Broos Patrick S , Pollock Andrew M T , Townsley Leisa K
Published: December 2021

We present spectroscopic analysis of the luminous X-ray source Melnick 33Na (Mk 33Na, HSH95 16) in the Large Magellanic Cloud (LMC) 30 Doradus region (Tarantula Nebula), utilizing new time-series Very Large Telescope/Ultraviolet and Visual Echelle Spectrograph spectroscopy. We confirm Mk 33Na as a double-lined O-type spectroscopic binary with a mass ratio q = 0.63 ± 0.02, e = 0.33 ± 0.01, and orbital period of 18.3 ± 0.1 d, supporting the favoured period from X-ray observations obtained via the Tarantula – Revealed by X-rays survey. Disentangled spectra of each component provide spectral types of OC2.5 If* and O4 V for the primary and secondary, respectively. Unusually for an O supergiant the primary exhibits strong C  iv 4658 emission and weak N v 4603-20, justifying the OC classification. Spectroscopic analysis favours extreme physical properties for the primary (Teff = 50 kK, log L/L⊙ = 6.15) with system components of M1 = 83 ± 19 M⊙ and M2 = 48 ± 11 M⊙ obtained from evolutionary models, which can be reconciled with results from our orbital analysis (e.g. M1sin 3i = 20.0 ± 1.2 M⊙) if the system inclination is ∼38° and it has an age of 0.9–1.6 Myr. This establishes Mk 33Na as one of the highest mass binary systems in the LMC, alongside other X-ray luminous early-type binaries Mk34 (WN5h+WN5h), R144 (WN5/6h+WN6/7h), and especially R139 (O6.5 Iafc + O6 Iaf).
MUSE spectroscopy of planetary nebulae with high abundance discrepancies
Authors: García-Rojas J , Morisset C , Jones D , Wesson R , Boffin H M J , Monteiro H , Corradi R L M , Rodríguez-Gil P
Published: December 2021

We present MUSE deep integral-field unit spectroscopy of three planetary nebulae (PNe) with high-abundance discrepancy factors (ADF > 20): NGC 6778, M 1–42, and Hf 2–2. We have constructed flux maps for more than 40 emission lines, and use them to build extinction, electron temperature (Te), electron density (ne), and ionic abundances maps of a number of ionic species. The effects of the contribution of recombination to the auroral [N ii] and [O ii] lines on Te and the abundance maps of low-ionization species are evaluated using recombination diagnostics. As a result, low Te values and a downward gradient of Te are found toward the inner zones of each PN. Spatially, this nearly coincides with the increase of abundances of heavy elements measured using recombination lines in the inner regions of PNe, and strongly supports the presence of two distinct gas phases: a cold and metal-rich and a warm one with ‘normal’ metal content. We have simultaneously constructed, for the first time, the ADF maps of O+ and O2+ and found that they centrally peak for all three PNe under study. We show that the main issue when trying to compute realistic abundances from either ORLs or CELs is to estimate the relative contribution of each gas component to the H i emission, and we present a method to evaluate it. It is also found that, for the studied high-ADF PNe, the amount of oxygen in the cold and warm regions is of the same order.
Island Biogeography Revisited: Museomics Reveals Affinities of Shelf Island Birds Determined by Bathymetry and Paleo-Rivers, Not by Distance to Mainland
Authors: Garg Kritika M , Chattopadhyay Balaji , Cros Emilie , Tomassi Suzanne , Benedick Suzan , Edwards David P , Rheindt Frank E
Published: December 2021

Island biogeography is one of the most powerful subdisciplines of ecology: its mathematical predictions that island size and distance to mainland determine diversity have withstood the test of time. A key question is whether these predictions follow at a population-genomic level. Using rigorous ancient-DNA protocols, we retrieved approximately 1,000 genomic markers from approximately 100 historic specimens of two Southeast Asian songbird complexes from across the Sunda Shelf archipelago collected 1893–1957. We show that the genetic affinities of populations on small shelf islands defy the predictions of geographic distance and appear governed by Earth-historic factors including the position of terrestrial barriers (paleo-rivers) and persistence of corridors (Quaternary land bridges). Our analyses suggest that classic island-biogeographic predictors may not hold well for population-genomic dynamics on the thousands of shelf islands across the globe, which are exposed to dynamic changes in land distribution during Quaternary climate change.
Novel Insights on Obligate Symbiont Lifestyle and Adaptation to Chemosynthetic Environment as Revealed by the Giant Tubeworm Genome
Authors: de Oliveira André Luiz , Mitchell Jessica , Girguis Peter , Bright Monika
Published: December 2021

The mutualism between the giant tubeworm Riftia pachyptila and its endosymbiont Candidatus Endoriftia persephone has been extensively researched over the past 40 years. However, the lack of the host whole-genome information has impeded the full comprehension of the genotype/phenotype interface in Riftia. Here, we described the high-quality draft genome of Riftia, its complete mitogenome, and tissue-specific transcriptomic data. The Riftia genome presents signs of reductive evolution, with gene family contractions exceeding expansions. Expanded gene families are related to sulfur metabolism, detoxification, antioxidative stress, oxygen transport, immune system, and lysosomal digestion, reflecting evolutionary adaptations to the vent environment and endosymbiosis. Despite the derived body plan, the developmental gene repertoire in the gutless tubeworm is extremely conserved with the presence of a near intact and complete Hox cluster. Gene expression analyses establish that the trophosome is a multifunctional organ marked by intracellular digestion of endosymbionts, storage of excretory products, and hematopoietic functions. Overall, the plume and gonad tissues both in contact to the environment harbor highly expressed genes involved with cell cycle, programed cell death, and immunity indicating a high cell turnover and defense mechanisms against pathogens. We posit that the innate immune system plays a more prominent role into the establishment of the symbiosis during the infection in the larval stage, rather than maintaining the symbiostasis in the trophosome. This genome bridges four decades of physiological research in Riftia, whereas it simultaneously provides new insights into the development, whole organism functions, and evolution in the giant tubeworm.
Effect of anti-angiotensin II type 1 receptor antibodies on the outcomes of kidney transplantation: a systematic review and meta-analysis
Authors: Kang Zhong-Yu , Liu Chun , Liu Wei , Li Dai-Hong
Published: December 2021

Background

Anti-angiotensin II type 1 receptor antibodies (AT1R-Abs) have been recognized as non-human leukocyte antigen antibodies associated with allograft rejection and poor allograft outcomes after kidney transplantation. The aim of this study was to assess the risk anti-AT1R-Abs pose for rejection and graft loss among kidney transplant (KT) populations.

Methods

We systematically searched PubMed, Embase and the Cochrane Library databases for relevant articles published from inception until June 2021 to identify all studies concerning the role AT1R-Abs play in the clinical outcome after kidney transplantation. Two reviewers independently identified studies, abstracted outcome data and assessed the quality of the studies. The meta-analysis was summarized using fixed-effects or random-effects models, according to heterogeneity. The major outcomes included delayed graft function, acute rejection, graft loss or patient death after transplantation.

Results

Twenty-one eligible studies involving a total of 4023 KT recipients were included in the evaluation. Meta-analysis results showed that the AT1R-Ab-positive KT group had a greater incidence of antibody-mediated rejection {relative risk [RR] 1.94 [95% confidence interval (CI) 1.61–2.33]; P < 0.00001} and graft loss [RR 2.37 (95% CI 1.50–3.75); P = 0.0002] than did the AT1R-Abs-negative KT group. There was no significant statistical difference in delayed graft function rate, T-cell-mediated rejection, mixed rejection, acute cellular rejection, acute rejection and patient death rate between the AT1R-Ab-positive KT and AT1R-Ab-negative KT groups.

Conclusions

Our study shows that the presence of anti-AT1R-Abs was associated with a significantly higher risk of antibody-mediated rejection and graft loss in kidney transplantation. Future studies are still needed to evaluate the importance of routine anti-AT1R monitoring and therapeutic targeting. These results show that assessment of anti-AT1R-Abs would be helpful in determining immunologic risk and susceptibility to immunologic events for recipients.
Trends in Clinical Severity of Hospitalized Patients With Coronavirus Disease 2019—Premier Hospital Dataset, April 2020–April 2021
Authors: Whitfield Geoffrey P , Harris Aaron M , Kadri Sameer S , Warner Sara , Bamrah Morris Sapna , Giovanni Jennifer E , Rogers-Brown Jessica S , Hinckley Alison F , Kompaniyets Lyudmyla , Sircar Kanta D , Yusuf Hussain R , Koumans Emilia H , Schweitzer Beth K
Published: December 2021

Background

Clinical severity of coronavirus disease 2019 (COVID-19) may vary over time; trends in clinical severity at admission during the pandemic among hospitalized patients in the United States have been incompletely described, so a historical record of severity over time is lacking.

Methods

We classified 466677 hospital admissions for COVID-19 from April 2020 to April 2021 into 4 mutually exclusive severity grades based on indicators present on admission (from most to least severe): Grade 4 included intensive care unit (ICU) admission and invasive mechanical ventilation (IMV); grade 3 included non-IMV ICU and/or noninvasive positive pressure ventilation; grade 2 included diagnosis of acute respiratory failure; and grade 1 included none of the above indicators. Trends were stratified by sex, age, race/ethnicity, and comorbid conditions. We also examined severity in states with high vs low Alpha (B.1.1.7) variant burden.

Results

Severity tended to be lower among women, younger adults, and those with fewer comorbidities compared to their counterparts. The proportion of admissions classified as grade 1 or 2 fluctuated over time, but these less-severe grades comprised a majority (75%–85%) of admissions every month. Grades 3 and 4 consistently made up a minority of admissions (15%–25%), and grade 4 showed consistent decreases in all subgroups, including states with high Alpha variant burden.

Conclusions

Clinical severity among hospitalized patients with COVID-19 has varied over time but has not consistently or markedly worsened over time. The proportion of admissions classified as grade 4 decreased in all subgroups. There was no consistent evidence of worsening severity in states with higher vs lower Alpha prevalence.
Salicylic acid carboxyl glucosyltransferase UGT87E7 regulates disease resistance inCamellia sinensis
Authors: Hu Yunqing , Zhang Mengting , Lu Mengqian , Wu Yi , Jing Tingting , Zhao Mingyue , Zhao Yifan , Feng Yingying , Wang Jingming , Gao Ting , Zhou Zixiang , Wu Bin , Jiang Hao , Wan Xiaochun , Schwab Wilfried , Song Chuankui
Published: December 2021

Plant immune response following pathogenic infection is regulated by plant hormones, and salicylic acid (SA) and its sugar conjugates play important roles in establishing basal resistance. Here, the important pathogen Pseudopestalotiopsis camelliae-sinensis (Pcs) was isolated from tea gray blight, one of the most destructive diseases in tea plantations. Transcriptomic analysis led to the discovery of the putative Camellia sinensis UDP-glucosyltransferase CsUGT87E7 whose expression was significantly induced by SA application and Pcs infection. Recombinant CsUGT87E7 glucosylates SA with a Km value of 12 µM to form SA glucose ester (SGE). Downregulation reduced the accumulation of SGE, and CsUGT87E7-silenced tea plants exhibited greater susceptibility to pathogen infection than control plants. Similarly, CsUGT87E7-silenced tea leaves accumulated significantly less SA after infection and showed reduced expression of pathogenesis-related genes. These results suggest that CsUGT87E7 is an SA carboxyl glucosyltransferase that plays a positive role in plant disease resistance by modulating SA homeostasis through a mechanism distinct from that described in Arabidopsis (Arabidopsis thaliana). This study provides insight into the mechanisms of SA metabolism and highlights the role of SGE in the modulation of plant disease resistance.
The role of light-harvesting complex I in excitation energy transfer from LHCII to photosystem I in Arabidopsis
Authors: Schiphorst Christo , Achterberg Luuk , Gómez Rodrigo , Koehorst Rob , Bassi Roberto , van Amerongen Herbert , Dall’Osto Luca , Wientjes Emilie
Published: December 2021

Photosynthesis powers nearly all life on Earth. Light absorbed by photosystems drives the conversion of water and carbon dioxide into sugars. In plants, photosystem I (PSI) and photosystem II (PSII) work in series to drive the electron transport from water to NADP+. As both photosystems largely work in series, a balanced excitation pressure is required for optimal photosynthetic performance. Both photosystems are composed of a core and light-harvesting complexes (LHCI) for PSI and LHCII for PSII. When the light conditions favor the excitation of one photosystem over the other, a mobile pool of trimeric LHCII moves between both photosystems thus tuning their antenna cross-section in a process called state transitions. When PSII is overexcited multiple LHCIIs can associate with PSI. A trimeric LHCII binds to PSI at the PsaH/L/O site to form a well-characterized PSI–LHCI–LHCII supercomplex. The binding site(s) of the “additional” LHCII is still unclear, although a mediating role for LHCI has been proposed. In this work, we measured the PSI antenna size and trapping kinetics of photosynthetic membranes from Arabidopsis (Arabidopsis thaliana) plants. Membranes from wild-type (WT) plants were compared to those of the ΔLhca mutant that completely lacks the LHCI antenna. The results showed that “additional” LHCII complexes can transfer energy directly to the PSI core in the absence of LHCI. However, the transfer is about two times faster and therefore more efficient, when LHCI is present. This suggests LHCI mediates excitation energy transfer from loosely bound LHCII to PSI in WT plants.
Biomimetic three-layered membranes comprising (poly)-ε-caprolactone, collagen and mineralized collagen for guided bone regeneration
Authors: Wu Jingjing , Yao Mengyu , Zhang Yonggang , Lin Zefeng , Zou Wenwu , Li Jiaping , Habibovic Pamela , Du Chang
Published: December 2021

The distinct structural properties and osteogenic capacity are important aspects to be taken into account when developing guided bone regeneration membranes. Herein, inspired by the structure and function of natural periosteum, we designed and fabricated using electrospinning a fibrous membrane comprising (poly)--ε-caprolactone (PCL), collagen-I (Col) and mineralized Col (MC). The three-layer membranes, having PCL as the outer layer, PCL/Col as the middle layer and PCL/Col/MC in different ratios (5/2.5/2.5 (PCM-1); 3.3/3.3/3.3 (PCM-2); 4/4/4 (PCM-3) (%, w/w/w)) as the inner layer, were produced. The physiochemical properties of the different layers were investigated and a good integration between the layers was observed. The three-layered membranes showed tensile properties in the range of those of natural periosteum. Moreover, the membranes exhibited excellent water absorption capability without changes of the thickness. In vitro experiments showed that the inner layer of the membranes supported attachment, proliferation, ingrowth and osteogenic differentiation of human bone marrow-derived stromal cells. In particular cells cultured on PCM-2 exhibited a significantly higher expression of osteogenesis-related proteins. The three-layered membranes successfully supported new bone formation inside a critical-size cranial defect in rats, with PCM-3 being the most efficient. The membranes developed here are promising candidates for guided bone regeneration applications.