bluuebunny/crossref_metadata_2025 huggingface dataset:
1560 Unusual Sites of Colorectal Cancer Metastases – A Complete Systematic Review
Authors: Alfred J , Altaf K , Anuar A , Williams R , Titley-Wilson G , Shah M , Ahmed S
Published: October 2021

Background

While colorectal cancer (CRC) usually metastasizes to liver, lungs, and central nervous system, spread to more unusual sites is rarely reported in literature. We aimed to investigate unusual colorectal metastases (UCRM), their clinical course and disease progression.

Method

MEDLINE, EMBASE and Cochrane Library were searched by independent reviewers to identify clinical studies to date that reported UCRM and relevant demographic/clinical data were extracted.

Results

We identified 349 patients, involving 28 sites (bone, musculo-skeletal, skin, brain/spinal cord, head, eye, oral mucosa, thyroid, mediastinum, heart, bronchus, breast, biliary/GI tract, stomach, pancreas, spleen, adrenal, urinary tract, inguinal canal, ovaries, vagina, vulva, testes, spermatic cord, prostate, penis) with male preponderance and median age of 59 years (IQR=54.5-65). These were diagnosed at a median interval of 18 months (IQR=6-36)) after a median follow-up of 12 months (IQR=6-22.5). More were metachronous (n = 210) with recurrence rate of 15.75%. Primary CRC staging revealed T3 in 61% (28%-T4), equal distribution of N0/N1 (38%/37%) and M0 in 85%. 74% of primaries were surgically resected (96%=adenocarcinomas) and 54% underwent adjuvant therapy. UCRM were resected in 45% of cases and showed same histology as primary. 30% had chemotherapy. Only 8% were palliated. Overall morality was 35.24%.

Conclusions

This is the first comprehensive review looking at clinical course and outcomes of patients with UCRM. Most of these developed in patients with primary T3/N0 staging. Outlook of these patients is comparable to those with usual metastatic disease. Judicious and rigorous surveillance is the key to early detection and timely management.
Resting Hypoconnectivity of Theoretically Defined Addiction Networks during Early Abstinence Predicts Subsequent Relapse in Alcohol Use Disorder
Authors: Camchong J , Haynos A F , Hendrickson T , Fiecas M B , Gilmore C S , Mueller B A , Kushner M G , Lim K O
Published: October 2021

Theoretical models of addiction suggest that alterations in addiction domains including incentive salience, negative emotionality, and executive control lead to relapse in alcohol use disorder (AUD). To determine whether the functional organization of neural networks underlying these domains predict subsequent relapse, we generated theoretically defined addiction networks. We collected resting functional magnetic resonance imaging data from 45 individuals with AUD during early abstinence (number of days abstinent M = 25.40, SD = 16.51) and calculated the degree of resting-state functional connectivity (RSFC) within these networks. Regression analyses determined whether the RSFC strength in domain-defined addiction networks measured during early abstinence predicted subsequent relapse (dichotomous or continuous relapse metrics). RSFC within each addiction network measured during early abstinence was significantly lower in those that relapsed (vs. abstained) and predicted subsequent time to relapse. Lower incentive salience RSFC during early abstinence increased the odds of relapsing. Neither RSFC in a control network nor clinical self-report measures predicted relapse. The association between low incentive salience RSFC and faster relapse highlights the need to design timely interventions that enhance RSFC in AUD individuals at risk of relapsing faster.
Detecting Urban Anomalies Using Factor Analysis and One Class Support Vector Machine
Authors: Lu Cong , Huang Jianbin , Huang Longji
Published: October 2021

The detection of anomalies in spatiotemporal traffic data is not only critical for intelligent transportation systems and public safety but also very challenging. Anomalies in traffic data often exhibit complex forms in two aspects, (i) spatiotemporal complexity (i.e. we need to associate individual locations and time intervals formulating a panoramic view of an anomaly) and (ii) multi-source complexity (i.e. we need an algorithm that can model the anomaly degree of the multiple data sources of different densities, distributions and scales). To tackle these challenges, we proposed a three-step method that uses factor analysis to extract features, then uses the goodness-of-fit test to obtain the anomaly score of a single data point and then uses one class support vector machine to synthesize the anomaly score. Finally, we conduct extensive experiments on real-world trip data include taxi and bike data. And these extensive experiments demonstrate the effectiveness of our proposed approach.
Site form classification—a practical tool for guiding site-specific tropical forest landscape restoration and management
Authors: Do Ha T T , Zimmer Heidi C , Vanclay Jerome K , Grant John C , Trinh Bon N , Nguyen Hoang H , Nichols J Doland
Published: October 2021

Reliable estimates of forest productivity at the site scale can guide site-specific forest management. However, the best methods to evaluate productivity of natural forest sites, and in particular secondary natural forests, remain undefined. In this study we: (1) applied an indirect method for estimation of the potential productivity of a forest site (‘site form’) in Dong Nai Biosphere Reserve. In addition, we: (2a) investigated the influence of a range of environmental conditions on site form, (2b) built models to estimate site form from the corresponding environmental variables and (3) generated site form maps for the region. We found that Michaelis–Menten models provided the most consistent representation of tree height–diameter relationships, with reliable anamorphic curves at both plot-scale (50 m × 20 m) and multiplot-scales. Predicted tree height at 25-cm diameter (H25) was selected as the best indicator for site form as 25 cm was both a tree size, which was common in the forests, and for which height could be accurately predicted. H25 was significantly correlated with site environmental conditions, with the dominant influences being factors related to water availability. We generated site form maps for Dong Nai province based on the relationship between known environmental variables and H25. We conclude that maps such as these could have broad application in guiding tropical forest restoration measures elsewhere, particularly where there is limited knowledge of tree ages and species.
Entropy of Monomial Algebras and Derived Categories
Authors: Lu Li , Piontkovski Dmitri
Published: October 2021

Let $A$ be a finitely presented associative monomial algebra. We study the category $\textsf{qgr}(A)$, which is a quotient of the category of graded finitely presented $A$-modules by the finite-dimensional ones. As this category plays a role of the category of coherent sheaves on the corresponding noncommutative variety, we consider its bounded derived category $\textbf{D}^b(\textsf{qgr}(A))$. We calculate the categorical entropy of the Serre twist functor on $\textbf{D}^b(\textsf{qgr}(A))$ and show that it is equal to the (natural) logarithm of the entropy of the algebra $A$ itself. Moreover, we relate these two kinds of entropy with the topological entropy of the Ufnarovski graph of $A$ and the entropy of the path algebra of the graph. If $A$ is a path algebra of some quiver, the categorical entropy is equal to the logarithm of the spectral radius of the quiver’s adjacency matrix.
Analysis of Severe Acute Respiratory Syndrome 2 Replication in Explant Cultures of the Human Upper Respiratory Tract Reveals Broad Tissue Tropism of Wild-Type and B.1.1.7 Variant Viruses
Authors: Schulze Jessica , Mache Christin , Balázs Anita , Frey Doris , Niemeyer Daniela , Olze Heidi , Dommerich Steffen , Drosten Christian , Hocke Andreas C , Mall Marcus A , Hippenstiel Stefan , Wolff Thorsten
Published: October 2021

Background

The upper respiratory tract (URT) is the primary entry site for severe acute respiratory syndrome 2 (SARS-CoV-2) and other respiratory viruses, but its involvement in viral amplification and pathogenesis remains incompletely understood.

Methods

In this study, we investigated primary nasal epithelial cultures, as well as vital explanted tissues, to scrutinize the tropism of wild-type SARS-CoV-2 and the recently emerged B.1.1.7 variant.

Results

Our analyses revealed a widespread replication competence of SARS-CoV-2 in polarized nasal epithelium as well as in the examined URT and salivary gland tissues, which was also shared by the B.1.1.7 virus.

Conclusions

In our analyses, we highlighted the active role of these anatomic sites in coronavirus disease 2019.
Type I interferon production elicits differential CD4+ T-cell responses in mice infected withPlasmodium bergheiANKA andP. chabaudi
Authors: Ntita Mbaya , Inoue Shin-Ichi , Jian Jiun-Yu , Bayarsaikhan Ganchimeg , Kimura Kazumi , Kimura Daisuke , Miyakoda Mana , Nozaki Eriko , Sakurai Takuya , Fernandez-Ruiz Daniel , Heath William R , Yui Katsuyuki
Published: October 2021

Abstract

Plasmodium parasites that infect humans are highly polymorphic, and induce various infections ranging from an asymptomatic state to life-threatening diseases. However, how the differences between the parasites affect host immune responses during blood-stage infection remains largely unknown. We investigated the CD4+ T-cell immune responses in mice infected with P. berghei ANKA (PbA) or P. chabaudi chabaudi AS (Pcc) using PbT-II cells, which recognize a common epitope of these parasites. In the acute phase of infection, CD4+ T-cell responses in PbA-infected mice showed a lower involvement of Th1 cells and a lower proportion of Ly6Clo effector CD4+ T cells than those in Pcc-infected mice. Transcriptome analysis of PbT-II cells indicated that type I interferon (IFN)-regulated genes were expressed at higher levels in both Th1- and Tfh-type PbT-II cells from PbA-infected mice than those from Pcc-infected mice. Moreover, IFN-α levels were considerably higher in PbA-infected mice than in Pcc-infected mice. Inhibition of type I IFN signaling increased PbT-II and partially reversed the Th1 over Tfh bias of the PbT-II cells in both PbA- and Pcc-infected mice. In the memory phase, PbT-II cells in PbA-primed mice maintained higher numbers and exhibited a better recall response to the antigen. However, recall responses were not significantly different between the infection groups after re-challenge with PbA, suggesting the effect of the inflammatory environment by the infection. These observations suggest that the differences in Plasmodium-specific CD4+ T-cell responses between PbA- and Pcc-infected mice were associated with the difference in type I IFN production during the early phase of the infection.
CREG1 administration stimulates BAT thermogenesis and improves diet-induced obesity in mice
Authors: Kusudo Tatsuya , Okada Tadashi , Hashimoto Michihiro , Takeuchi Tamaki , Endo Yuki , Niwa Ayumi , Yamashita Hitoshi
Published: October 2021

Brown and beige adipocytes, which express thermogenic uncoupling protein-1 (UCP1), stimulate glucose and lipid metabolism, improving obesity and metabolic diseases such as type 2 diabetes and hyperlipidemia. Overexpression of cellular repressor of E1A-stimulated genes 1 (CREG1) promotes adipose tissue browning and inhibits diet-induced obesity (DIO) in mice. In this study, we investigated the effects of CREG1 administration on DIO inhibition and adipose browning. Subcutaneous administration of recombinant CREG1 protein to C57BL/6 mice stimulated UCP1 expression in interscapular brown adipose tissue (IBAT) and improved DIO, glucose tolerance and fatty liver compared with those in phosphate-buffered saline-treated mice. Injection of Creg1-expressing adenovirus into inguinal white adipose tissue (IWAT) significantly increased browning and mRNA expression of beige adipocyte marker genes compared with that in mice injected with control virus. The effect of Creg1 induction on beige adipocyte differentiation was supported in primary culture using preadipocytes isolated from IWAT of Creg1-transgenic mice compared with that of wild-type mice. Our results indicate a therapeutic effect of CREG1 on obesity and its associated pathology and a potential of CREG1 to stimulate brown/beige adipocyte formation.
The Criminalization of Cyber-operations Under the Rome Statute
Authors: Trahan Jennifer
Published: October 2021

This article examines how a cyber-operation that has consequences similar to a kinetic or physical attack — causing serious loss of life or physical damage — could be encompassed within the crimes prosecuted before the International Criminal Court (ICC). It explains when and how such a cyber-operation could fall within the ambit of the ICC’s crimes — genocide, crimes against humanity, war crimes, and the crime of aggression. The article additionally acknowledges some limitations as to which cyber-operations would be encompassed, given the ICC’s gravity threshold as well as the potential difficulty of attributing conduct to a particular suspect through admissible evidence that could meet the requirement of proof beyond a reasonable doubt. Notwithstanding such limitations, increased awareness of the previously largely overlooked potential of the Rome Statute to cover certain cyber-operations could potentially contribute to deterring such crimes.
Articulated Homogeneity in Cumulative Sentences
Authors: Chatain Keny
Published: October 2021

In this work, I use cumulative readings of every (Champollion, 2010, 2016a; Haslinger & Schmitt, 2018; Kratzer, 2003; Schein, 1993) as a tool to investigate homogeneity in cumulative readings in general. Based on a new observation about the homogeneity properties of cumulative readings of every, I argue that the homogeneity properties of cumulative readings arise from the interaction of multiple operators, each operator contributing one exhaustive participation inference which disappears in negative contexts. I identify these operators with the thematic role heads in a Neo-Davidsonian semantics. The resulting theory is able to predict the homogeneity properties of cumulative sentences from the homogeneity properties of their arguments and the position of these arguments.
Health Mindsets in Pediatric Chronic Headache
Authors: Caruso Alessandra , Grolnick Wendy , Mueller Claudia , Kaczynski Karen , Chang Cindy Yu-Hsing , Lebel Alyssa
Published: October 2021

Objective

Given how frequently youth with chronic headache and migraine experience setbacks in treatment, identifying factors that promote coping and resilience is critical. Mindsets have gained attention as predictors of behavior and targets of intervention across contexts, including health. Health mindsets may help to explain how children with chronic pain interpret and respond to treatment. This study evaluated whether growth health mindsets might relate to adaptive outcomes in patients with chronic pediatric headache.

Methods

Participants were 88 children and adolescents (ages 10–17 years) with headache or migraine contacted following an appointment at a pediatric headache clinic, and their parent. Patients rated their beliefs about health as more fixed versus growth-oriented. They were presented with vignettes depicting hypothetical treatment setbacks and instructed to reflect upon real-life setbacks. Patients completed questionnaires about their cognitive appraisals of setbacks, coping, quality of life, life satisfaction, and functional impairment.

Results

The higher children rated their growth health mindsets, the less likely they were to appraise setbacks as threatening and endorse quality-of-life problems. Children with higher growth mindsets reported higher life satisfaction and lower functional disability. There was also an indirect relation between children’s mindsets and coping through cognitive appraisals of setbacks as a threat, but not challenge.

Conclusion

This research extends the health mindsets literature by contributing preliminary evidence of health mindsets as tied to adaptive outcomes in youth with chronic headache. These findings may be of interest to clinicians and parents, as health mindsets may offer an avenue by which resilience is promoted and maladaptive appraisals are minimized.
Influences of accreting primordial black holes on the global 21 cm signal in the dark ages
Authors: Yang Yupeng
Published: October 2021

Baryonic matter can be accreted on to primordial back holes (PBHs) formed in the early Universe. The radiation from accreting PBHs is capable of altering the evolution of the intergalactic medium (IGM), leaving marks on the global 21 cm signal in the dark ages. For accreting PBHs with mass MPBH = 103(104) M⊙ and mass fraction fPBH = 10−1(10−3), the brightness temperature deviation ΔδTb reaches $\sim 18~(26)~\rm mK$ at redshift z ∼ 90 ($\nu \sim 16~\rm MHz$), and the gradient of the brightness temperature dδTb/dν reaches $\sim 0.8~(0.5)~\rm mK~MHz^{-1}$ at frequency $\nu \sim 28~\rm MHz$ (z ∼ 50). For larger PBHs with higher mass fraction, the brightness temperature deviation is larger in the redshift range z ∼ 30–300 ($\nu \sim 5\!-\!46~\rm MHz$), and the gradient is lower at the frequency range $\nu \sim 20\!-\!60~\rm MHz$ (z ∼ 23–70). It is impossible to detect these low-frequency radio signals from the Earth due to the influence of the Earth’s ionosphere. However, after taking care of the essential factors properly, e.g. the foreground and interference, a future radio telescope in lunar orbit or on the farside surface of the Moon has a chance of detecting the global 21 cm signals impacted by accreting PBHs and distinguishing them from the standard model.
Characterization and prognosis of temozolomide-induced aplastic anemia in patients with central nervous system malignancies
Authors: Park Albert K , Waheed Anem , Forst Deborah A , Al-Samkari Hanny
Published: October 2021

Background

Temozolomide-induced aplastic anemia (TIAA) is a rare but highly challenging complication of temozolomide (TMZ) therapy. Evidence describing prognosis, clinical characteristics, and treatment of this entity is very limited.

Methods

We performed a multicenter, 22-year observational cohort study of patients with central nervous system (CNS) malignancies treated with temozolomide who developed TIAA, retrospectively analyzing prognosis, complications, and recovery. TIAA was defined using adapted evidence-based severe aplastic anemia criteria incorporating profound cytopenias and a minimum duration (4 weeks) without hematologic recovery.

Results

Of 3821 patients with CNS malignancies receiving TMZ, 34 patients (0.89%) met criteria for TIAA. Onset was rapid, with 29 patients (85.3%) developing TIAA before completing a second TMZ cycle. 23 patients (67.6%) ultimately achieved a hematologic recovery. Patients without recovery were more likely to develop febrile neutropenia (72.7% vs. 30.4%, P = .03), infectious complications (45.5% vs. 8.7%, P = .02), require hospitalization (81.8% vs. 43.5%, P = .04), and die (100.0% vs. 60.9%, P = .02). Median overall survival from TIAA diagnosis was 752 days in patients achieving a partial hematologic recovery versus 28 days in those who did not (P < .0001). 29 patients (85.3%) received one or more hematopoietic growth factors; hematologic recovery rates were higher in patients receiving thrombopoietin receptor agonists (81.8% vs. 60.9%) but were not higher in patients receiving granulocyte colony-stimulating factors.

Conclusions

TIAA occurs in <1% of patients receiving TMZ for CNS malignancies, but is highly morbid when it occurs and frequently fatal in the one-third of patients not achieving hematologic recovery. Thrombopoietin receptor agonists may improve the likelihood of a hematologic recovery.
Breaking Isolation: Social Work in Solidarity with Migrant Workers through and beyond COVID-19
Authors: Alcaraz Nellie , Lorenzetti Liza , Thomas Sarah , Dhungel Rita
Published: October 2021

In the early months of COVID-19’s proliferation through Canadian communities, the now largely documented uneven impacts and burdens of the illness were emerging. Among the early COVID-19 casualties were workers in Alberta’s meatpacking plants, with infection rates so high that the news quickly gained international attention. The Cargill meatpacking plant, overwhelmingly staffed by temporary foreign workers with no permanent status or citizenship rights, was the site of the largest single coronavirus outbreak in Canada. The need for a community response to this emerging crisis was a focal discussion for a newly formed network of social workers. A multileveled series of actions and systems advocacy were put in place. These actions would foment a vibrant and diverse “community of communities” while also unveiling challenges and obstacles to the work during a period of a shifting health landscape, shutdowns, and changing legislation. This article focuses on the development of a grassroots and transformative community-led response to COVID-19, describing strategies, implementation, and challenges in the “real life” context of the recent pandemic. Key learnings for postpandemic community organizing and social work solidarity actions are highlighted.
Demystifying α-gal syndrome: identification and risk management in the perioperative setting
Authors: Wolaver Whitney , Thakrar Shilen , Thomas Kelvin , Thakrar Hiral , Schwartz Lawrence , Zuelzer Wilhelm , Butterworth John , Hoelting Kyle
Published: October 2021

Purpose of review

α-Gal syndrome is among a vexing perioperative consideration for anesthesiologists. Commonly referred to as ‘red meat allergy’, α-Gal syndrome is precipitated by a lone star tick bite resulting in the formation of immunoglobulin E (IgE) antibodies against the tick salivary glycoproteins and noncatarrhine mammalian tissue.

Recent findings

Up to 20% of the population in the southeastern United States may test positive for IgE antibodies to α-Gal. Increasingly, recognition of α-Gal syndrome as an immune response to red meat consumption and certain drugs, many of which may be administered within the perioperative period, has led to greater awareness of the insidious nature of its presentation – from mild urticaria and gastrointestinal symptoms to severe anaphylaxis.

With the increasing prevalence and identification of α-Gal syndrome, a safe and tailored perioperative process is needed to integrate a pathway that involves multidisciplinary communication, robust information sharing platform, and a structured peri-procedure management.
Differences and Similarities Among COVID-19 Patients Treated in Seven ICUs in Three Countries Within One Region: An Observational Cohort Study*
Authors: Mesotten Dieter , Meijs Daniek A. M. , van Bussel Bas C. T. , Stessel Björn , Mehagnoul-Schipper Jannet , Hana Anisa , Scheeren Clarissa I. E. , Strauch Ulrich , van de Poll Marcel C. G. , Ghossein-Doha Chahinda , Buhre Wolfgang F. F. A. , Bickenbach Johannes , Vander Laenen Margot , Marx Gernot , van der Horst Iwan C. C. ,   COVID Data Platform (CoDaP) Investigators
Published: October 2021

OBJECTIVES:

To investigate healthcare system–driven variation in general characteristics, interventions, and outcomes in coronavirus disease 2019 (COVID-19) patients admitted to the ICU within one Western European region across three countries.

DESIGN:

Multicenter observational cohort study.

SETTING:

Seven ICUs in the Euregio Meuse-Rhine, one region across Belgium, The Netherlands, and Germany.

PATIENTS:

Consecutive COVID-19 patients supported in the ICU during the first pandemic wave.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Baseline demographic and clinical characteristics, laboratory values, and outcome data were retrieved after ethical approval and data-sharing agreements. Descriptive statistics were performed to investigate country-related practice variation. From March 2, 2020, to August 12, 2020, 551 patients were admitted. Mean age was 65.4 ± 11.2 years, and 29% were female. At admission, Acute Physiology and Chronic Health Evaluation II scores were 15.0 ± 5.5, 16.8 ± 5.5, and 15.8 ± 5.3 (p = 0.002), and Sequential Organ Failure Assessment scores were 4.4 ± 2.7, 7.4 ± 2.2, and 7.7 ± 3.2 (p < 0.001) in the Belgian, Dutch, and German parts of Euregio, respectively. The ICU mortality rate was 22%, 42%, and 44%, respectively (p < 0.001). Large differences were observed in the frequency of organ support, antimicrobial/inflammatory therapy application, and ICU capacity. Mixed-multivariable logistic regression analyses showed that differences in ICU mortality were independent of age, sex, disease severity, comorbidities, support strategies, therapies, and complications.

CONCLUSIONS:

COVID-19 patients admitted to ICUs within one region, the Euregio Meuse-Rhine, differed significantly in general characteristics, applied interventions, and outcomes despite presumed genetic and socioeconomic background, admission diagnosis, access to international literature, and data collection are similar. Variances in healthcare systems’ organization, particularly ICU capacity and admission criteria, combined with a rapidly spreading pandemic might be important drivers for the observed differences. Heterogeneity between patient groups but also healthcare systems should be presumed to interfere with outcomes in coronavirus disease 2019.
Prognostic Factors Associated With Development of Venous Thromboembolism in Critically Ill Patients—A Systematic Review and Meta-Analysis
Authors: Tran Alexandre , Fernando Shannon M. , Rochwerg Bram , Cook Deborah J. , Crowther Mark A. , Fowler Robert A. , Alhazzani Waleed , Siegal Deborah M. , Castellucci Lana A. , Zarychanski Ryan , English Shane W. , Kyeremanteng Kwadwo , Carrier Marc
Published: October 2021

OBJECTIVE:

To identify prognostic factors for the development of venous thromboembolism in the ICU.

DATA SOURCES:

We searched MEDLINE, EMBASE, and Cochrane CENTRAL from inception to March 1, 2021.

STUDY SELECTION:

We included English-language studies describing prognostic factors associated with the development of venous thromboembolism among critically ill patients.

DATA EXTRACTION:

Two authors performed data extraction and risk-of-bias assessment. We pooled adjusted odds ratios and adjusted hazard ratios for prognostic factors using random-effects model. We assessed risk of bias using the Quality in Prognosis Studies tool and certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations approach.

DATA SYNTHESIS:

We included 39 observational cohort studies involving 729,477 patients. Patient factors with high or moderate certainty of association with increased odds of venous thromboembolism include older age (adjusted odds ratio, 1.15; 95% CI, 1.02–1.29 per 10 yr), obesity (adjusted odds ratio, 1.25; 95% CI, 1.18–1.32), active malignancy (adjusted odds ratio, 1.70; 95% CI, 1.18–2.44), history of venous thromboembolism (adjusted odds ratio, 4.77; 95% CI, 3.42–6.65), and history of recent surgery (adjusted odds ratio, 1.77; 95% CI, 1.26–2.47). ICU-specific factors with high or moderate certainty of association with increased risk of venous thromboembolism include sepsis (adjusted odds ratio, 1.41; 95% CI, 1.12–1.78), lack of pharmacologic venous thromboembolism prophylaxis (adjusted odds ratio, 1.80; 95% CI, 1.14–2.84), central venous catheter (adjusted odds ratio, 2.93; 95% CI, 1.98–4.34), invasive mechanical ventilation (adjusted odds ratio, 1.74; 95% CI, 1.36–2.24), and use of vasoactive medication (adjusted odds ratio, 1.86; 95% CI, 1.23–2.81).

CONCLUSIONS:

This meta-analysis provides quantitative summaries of the association between patient-specific and ICU-related prognostic factors and the risk of venous thromboembolism in the ICU. These findings provide the foundation for the development of a venous thromboembolism risk stratification tool for critically ill patients.
Vertical transmission of hepatitis B virus: propositions and future directions
Authors: Liu Jin-Feng , Chen Tian-Yan , Zhao Ying-Ren
Published: October 2021

Chronic hepatitis B virus (HBV) infection due to vertical transmission remains a critical concern with regards to eliminating HBV infection. Implementation of hepatitis B vaccine, the foundation to prevent perinatal and horizontal transmission, has reduced the prevalence of HBV by >80%. In countries where the hepatitis B immune globulin (HBIG) is available, such as China and the United States, the administration of HBIG and hepatitis B vaccine to the infants of mothers who are positive for hepatitis B surface antigen has become a standard practice and is effective in preventing vertical transmission. Accumulating evidence on the efficacy and safety of antiviral prophylaxis during pregnancy indicates the probability of attaining the goal of the World Health Organization to eliminate hepatitis by 2030. In this review, we discuss the transmission routes, diagnostic criteria, and preventive strategies for vertical transmission. A preventive program that includes screening before pregnancy, antiviral prophylaxis during pregnancy, and postpartum immunoprophylaxis provides “perfect strategies” to eliminate vertical transmission. However, there is still a notable gap between “perfect strategies” and real-world application, including insufficient coverage of timely birth dose vaccine and the efficacy and necessity of HBIG, especially in mothers who are negative for hepatitis B envelope antigen. In particular, there is a clear need for a comprehensive long-term safety profile of antiviral prophylaxis. Therefore, feasible and cost-effective preventive strategies need to be determined across regions. Access also needs to be scaled up to meet the demands for prophylaxis and prevalence targets.
Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Colorectal Peritoneal Metastases: A Systematic Review
Authors: Parikh Manasi S. , Johnson Paul , Romanes Jonathan Paul , Freitag Harvey E. , Spring Mary E. , Garcia-Henriquez Norbert , Monson John R.T.
Published: October 2021

BACKGROUND:

Combined treatment modality of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is emerging as an alternative option for colorectal peritoneal metastases, but there is ambiguity regarding patient selection, treatment protocols, and efficacy.

OBJECTIVE:

To elaborate on the patient characteristics, hyperthermic intraperitoneal chemotherapy protocol and health outcomes in colorectal peritoneal metastases patients undergoing a combination of hyperthermic intraperitoneal chemotherapy and cytoreductive surgery and provide guidance for future studies.

DATA SOURCES:

A Medline search for English language studies published between 2004 and 2019.

STUDY SELECTION:

Medical subject headings and key terms, including: hyperthermic intraperitoneal chemotherapy, colorectal peritoneal metastases, colorectal cancer and combinations thereof as per guidelines.

MAIN OUTCOME MEASURES:

Overall survival, disease-free survival, and morbidity and mortality rates.

RESULTS:

Of the 26 included studies, 42% were published between 2016 and 2019. More than half of the studies were retrospective in nature and conducted in tertiary specialized centers outside of the United States. The median age range was 44 to 62 years. Mitomycin C-based therapy was seen in 50% of studies. Mean weighted median disease-free survival for 11 studies was 15 months (9 to 36 months). Median OS ranged from 12 to 63 months, with an average of 33.6 months among 20 studies. Overall morbidity varied from 11% to 56%, with a weighted mean of 29% in 18 studies. Mortality ranged from 0 to 34%, with a weighted mean of 4% in 15 studies.

LIMITATIONS:

Despite careful study selection, variability in methodology of the included studies can limit review findings.

CONCLUSION:

Due to study heterogeneity, and a recent large, randomized trial showing no overall benefit, use of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in colorectal peritoneal metastases patients is highly controversial. Further standardized controlled studies can help uniformly define and build consensus among the medical community on patient eligibility and the optimal hyperthermic intraperitoneal chemotherapy techniques.

PROSPERO:

Registered on March 3, 2020, CRD42020146942.
Recent dynamic studies of the metabolism of atherogenic lipoproteins: elucidating the mode of action of new therapies
Authors: Chan Dick C. , Ying Qidi , Watts Gerald F.
Published: October 2021

Purpose of review

LDL, triglyceride-rich lipoprotein (TRL) and lipoprotein(a) [Lp(a)] particles are the key atherogenic lipoproteins. Deranged metabolism of these lipoproteins accounts for a spectrum of clinically important dyslipidemias, such as FH, elevated Lp(a) and diabetic dyslipidemia. We review the findings from recent dynamic and tracer studies that have contributed to expanding knowledge in this field.

Recent findings

Deficiency in LDL receptor activity does not only impair the catabolism of LDL-apoB-100 in FH, but also induces hepatic overproduction and decreases catabolism of TRLs. Patients with elevated Lp(a) are characterized by increased hepatic secretion of Lp(a) particles. Elevation of TRLs in diabetes is partly mediated by increased production of apoB-48 and apoC-III, and impaired clearance of apoB-48 in the postprandial state. Tracer kinetic studies show that proprotein convertase subtilisin/kexin type 9 mAbs alone or in combination with statin can increase the catabolism and decrease production of LDL and Lp(a) particles. By contrast, angiopoietin-like protein 3 inhibitors (e.g. evinacumab) reduce VLDL production and increase LDL clearance in FH. Glucagon-like peptide-1 receptor agonists can improve diabetic dyslipidemia by increasing the catabolism of apoB-48 and decreasing the production of apoB-48 and apoC-III.

Dynamic studies of the metabolism of atherogenic lipoproteins provide new insight into the nature of dyslipidemias and point to how new therapies with complementary modes of action may have maximal clinical impact.
Long-term HIV Pre-exposure Prophylaxis Trajectories Among Racial & Ethnic Minority Patients: Short, Declining, & Sustained Adherence
Authors: Pyra Maria , Brewer Russell , Rusie Laura , Kline Jeanelle , Willis India , Schneider John
Published: October 2021

Background:

HIV pre-exposure prophylaxis (PrEP) requires continued use at an effective dosage to reduce HIV incidence. Data suggest early PrEP drop-off among many populations. We sought to describe PrEP use over the first year among racial and ethnic minority patients in the US.

Setting:

Racial and ethnic minority patients initiating PrEP at a federally qualified health center in Chicago, IL.

Methods:

Using electronic health records, we determined the adherence (≥6 weekly doses) trajectories over the first year of PrEP use and compared baseline and time-varying patient characteristics.

Results:

From 2159 patients, we identified 3 PrEP use trajectories. Sustained use was the most common (40%) trajectory, followed by short use (30%) and declining use (29%). In adjusted models, younger age, Black race, as well as gender, sexual orientation, insurance status at baseline, and neighborhood were associated with trajectory assignment; within some trajectories, insurance status during follow-up was associated with odds of monthly adherence (≥6 weekly doses).

Conclusion:

Among racial and ethnic minorities, a plurality achieved sustained PrEP persistence. Access to clinics, insurance, and intersectional stigmas may be modifiable barriers to effective PrEP persistence; in addition, focus on younger users and beyond gay, cismale populations are needed.
Bifid Tongue, Congenital Tongue Tumor, and Wide Bilateral Complete Cleft Palate
Authors: Zhou Zuo , Chen Renji , Guo Siyuan
Published: October 2021

Congenital tumor of tongue is not rare, but associated with cleft palate and bifid tongue is unusual. The authors describe a case of 7-year-old patient having bifid tongue, congenital tongue tumor, and cleft palate. Clinical features, physical and pathological examinations, possible diagnosis, and surgical treatment have been elaborated in this case report.
Establishing a Novel Treatment Algorithm for Pediatric Mandibular Tumor Reconstruction
Authors: Chan Christopher , Włodarczyk Jordan R. , Wolfswinkel ErikM. , Odono Lauren T. , Urata Mark M. , Hammoudeh Jeffrey A.
Published: October 2021

Introduction:

Guidelines for pediatric mandibular reconstruction (PMR) are not well-established. One must consider the growing craniofacial skeleton, mixed dentition, long-term dental occlusion, need for secondary reconstruction, and speech development. The traditional guideline (bone defect > 5 cm) for use of vascularized bone grafts (VBG) is not applicable given the variation of pediatric mandibular size and growth. We seek to propose a novel algorithm for PMR.

Materials and Methods:

An Institutional Review Board approved retrospective review of patients who underwent PMR for tumor resections between 2005 and 2019 evaluated patients’ demographics, complications, resection index (RI) (resection length to mandibular length), and surgical outcomes. Outcomes based on RI were analyzed to establish guidelines for VBG utilization.

Results:

Twenty-four patients underwent PMR at a mean age of 9.1 years (range: 1 – 18). The mandibular defect (mean± standard deviation) fornon-VBG (n 
= 18) and VBG (n 
= 6) was 6.6 ± 3.0 cm and 12.8 ± 4.3 cm, respectively. The VBG group had fewer return trips to the operating room (P 
= 0.028) and fewer major complications (P = 0.028). When non-VBG with RI > 32% were compared to <32%, there was statistically less returns to the operating room for complications and a lower rate of early (< 30 days) major complications.

Discussion:

Our algorithm proposes an RI cutoff of 32% for VBG use for PMR. Patients with a sizable soft tissue defect, previous chemotherapy and/or radiation, planned adjuvant chemotherapy and/or radiation therapy, or a history of failed non-VBG should undergo reconstruction using VBG.
Shape matters—the interaction of gold nanoparticles with model lung surfactant monolayers
Authors: Hossain Sheikh I. , Luo Zhen , Deplazes Evelyne , Saha Suvash C.
Published: October 2021

The lung surfactant monolayer (LSM) forms the main biological barrier for any inhaled particles to enter our bloodstream, including gold nanoparticles (AuNPs) present as air pollutants and under investigation for use in biomedical applications. Understanding the interaction of AuNPs with lung surfactant can assist in understanding how AuNPs enter our lungs. In this study, we use coarse-grained molecular dynamics simulations to investigate the effect of four different shape D AuNPs (spherical, box, icosahedron and rod) on the structure and dynamics of a model LSM, with a particular focus on differences resulting from the shape of the AuNP. Monolayer-AuNP systems were simulated in two different states: the compressed state and the expanded state, representing inhalation and exhalation conditions, respectively. Our results indicate that the compressed state is more affected by the presence of the AuNPs than the expanded state. Our results show that in the compressed state, the AuNPs prevent the monolayer from reaching the close to zero surface tension required for normal exhalation. In the compressed state, all four nanoparticles (NPs) reduce the lipid order parameters and cause a thinning of the monolayer where the particles drag surfactant molecules into the water phase. Comparing the different properties shows no trend concerning which shape has the biggest effect on the monolayer, as shape-dependent effects vary among the different properties. Insights from this study might assist future work of how AuNP shapes affect the LSM during inhalation or exhalation conditions.
Ecological drivers of eggshell wettability in birds
Authors: Attard Marie R. G. , Bowen James , Corado René , Hall Linnea S. , Dorey Robert A. , Portugal Steven J.
Published: October 2021

Complex and at times extreme environments have pushed many bird species to develop unique eggshell surface properties to protect the embryo from external threats. Because microbes are usually transmitted into eggs by moisture, some species have evolved hydrophobic shell surfaces that resist water absorption, while also regulating heat loss and the exchange of gases. Here, we investigate the relationship between the wettability of eggshells from 441 bird species and their life-history traits. We measured the initial contact angle between sessile water droplets and the shell surface, and how far the droplet spread. Using phylogenetic comparative methods, we show that body mass, annual temperature and eggshell maculation primarily explained variance in water contact angle across eggshells. Species nesting in warm climates were more likely to exhibit highly hydrophobic eggshells than those nesting in cold climates, potentially to reduce microbial colonization. In non-passerines, immaculate eggs were found to have more hydrophobic surfaces than maculate eggshells. Droplets spread more quickly on eggshells incubated in open nests compared to domed nests, likely to decrease heat transfer from the egg. Here, we identify clear adaptations of eggshell wettability across a diverse range of nesting environments, driven by the need to retain heat and prevent microbial adhesion.
Inflation instability in the lung: an analytical model of a thick-walled alveolus with wavy fibres under large deformations
Authors: Jawde Samer Bou , Karrobi Kavon , Roblyer Darren , Vicario Francesco , Herrmann Jacob , Casey Dylan , Lutchen Kenneth R. , Stamenović Dimitrije , Bates Jason H. T. , Suki Béla
Published: October 2021

Inflation of hollow elastic structures can become unstable and exhibit a runaway phenomenon if the tension in their walls does not rise rapidly enough with increasing volume. Biological systems avoid such inflation instability for reasons that remain poorly understood. This is best exemplified by the lung, which inflates over its functional volume range without instability. The goal of this study was to determine how the constituents of lung parenchyma determine tissue stresses that protect alveoli from instability-related overdistension during inflation. We present an analytical model of a thick-walled alveolus composed of wavy elastic fibres, and investigate its pressure–volume behaviour under large deformations. Using second-harmonic generation imaging, we found that collagen waviness follows a beta distribution. Using this distribution to fit human pressure–volume curves, we estimated collagen and elastin effective stiffnesses to be 1247 kPa and 18.3 kPa, respectively. Furthermore, we demonstrate that linearly elastic but wavy collagen fibres are sufficient to achieve inflation stability within the physiological pressure range if the alveolar thickness-to-radius ratio is greater than 0.05. Our model thus identifies the constraints on alveolar geometry and collagen waviness required for inflation stability and provides a multiscale link between alveolar pressure and stresses on fibres in healthy and diseased lungs.
Remote patient monitoring to interrupt chains of respiratory infections in outpatient care - a case-control study during the 2020/21 infection season
Authors: Eichler Sarah , Carnarius Sebastian , Steiger Edgar , von Stillfried Dominik
Published: October 2021

Aim of the study

The aim of the study was to investigate satisfaction, saving of time and the possible reduction of patient visits to practices that use Remote Patient Monitoring (RPM) during treatment compared to usual care.

Methods

In a case-control study between October 2020 and May 2021, the participating practices were randomized into three groups (two different RPM systems, one control). The doctors were required to enroll patients with acute respiratory infection ≥ 18 years who have a web-enabled device. After a three-month study phase, the doctors were asked to describe the treatment of their patients via online survey. The patients were also questioned. The analysis was carried out descriptively and with group comparisons.

Results

51 practices with 121 patients were included. Overall, the results show a positive assessment of digital care on the patient side. As for the doctors, handling and integration of the systems into consisting practice processes seem to be a challenge. Further, the number of patient visits to the practice was not reduced by using the systems and the doctors did not save time, but the relationship to the patients was intensified.

Conclusion

Even if there were no indications for more efficiency by using the RPM systems, the doctors see great potential to intensify the interaction between doctor and patient. In particular, more intensive contact with patients with chronic diseases (e. g. COPD, long-COVID) could be of long-term interest and importance for doctors in outpatient care.

Trial Registration

DRKS00023553
A molecular surveillance-guided vector control response to concurrent dengue and West Nile virus outbreaks in a COVID-19 hotspot of Florida
Authors: Coatsworth Heather , Lippi Catherine A. , Vasquez Chalmers , Ayers Jasmine B. , Stephenson Caroline J. , Waits Christy , Florez Mary , Wilke André B. B. , Unlu Isik , Medina Johana , Alcaide Maria L. , Ryan Sadie J. , Lednicky John A. , Beier John C. , Petrie William , Dinglasan Rhoel R.
Published: October 2021

Simultaneous dengue virus (DENV) and West Nile virus (WNV) outbreaks in Florida, USA, in 2020 resulted in 71 dengue virus serotype 1 and 86 WNV human cases. Our outbreak response leveraged a molecular diagnostic screen of mosquito populations for DENV and WNV in Miami-Dade County to quickly employ targeted mosquito abatement efforts. We detected DENV serotypes 2 and 4 in mosquito pools, highlighting the silent circulation of diverse dengue serotypes in mosquitoes. Additionally, we found WNV-positive mosquito pools in areas with no historical reports of WNV transmission. These findings demonstrate the importance of proactive, strategic arbovirus surveillance in mosquito populations to prevent and control outbreaks, particularly when other illnesses (e.g., COVID-19), which present with similar symptoms are circulating concurrently. Growing evidence for substantial infection prevalence of dengue in competent mosquito vectors in the absence of local index cases suggests a higher level of dengue endemicity in Florida than previously thought.

Article Summary Line

Evidence of increasing dengue endemicity in Florida: Vector surveillance during dengue and West Nile virus outbreaks revealed widespread presence of other dengue virus serotypes in the absence of local index cases.