bluuebunny/crossref_metadata_2025 huggingface dataset:
Brain activation in response to visual sexual stimuli in male patients with right middle cerebral artery infarction
Authors: Park Jae Hyeon , Kim Eunkyung , Cho Hyungpil , Park Dong Woo , Choi Joonho , Jang Seong Ho
Published: May 2021

Sexual dysfunction is a common problem after cerebral infarction; however, little is known about sexual arousal in poststroke patients. Thus, this study aimed to investigate brain activation in response to visual sexual stimuli in patients with right middle cerebral artery (MCA) territory infarction using functional magnetic resonance imaging (fMRI). Using fMRI in 20 participants (11 right MCA infarction patients and 9 age-matched healthy controls), we assessed brain activation elicited by visual sexual stimuli (erotic images) and visual nonsexual stimuli (landscape images). In right MCA infarction patients, the left dorsolateral prefrontal cortex and the left frontal subgyral area were more strongly activated by visual sexual stimuli than by nonvisual sexual stimuli. Brain areas that were more activated by visual sexual stimuli in right MCA infarction patients than in controls included the right parahippocampal gyrus and the bilateral frontal subgyral area. These fMRI results suggest that brain activation patterns in response to visual sexual stimuli might be influenced by right MCA infarction. Further research is needed to explore the association between sexual dysfunction and brain activation in poststroke patients.
Abnormalities of intrinsic brain activity in irritable bowel syndrome (IBS)
Authors: Li J. , Wang C. , Li Z.M. , Fu B. , Han Q. , Ye M.
Published: May 2021

Background

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal (GI) disorders affecting up to 11.5% of the general global population. The brain–gut axis has been shown to play an important role in the pathogenesis of IBS. Several studies confirmed that intrinsic brain abnormalities existed in patients with IBS. But, studies of abnormal regional homogeneity (ReHo) in IBS have reported inconsistent results. The objective of this protocol is to conduct a meta-analysis using the Seed-based d mapping software package to identify the most consistent and replicable findings of ReHo in IBS patients.

Method

We will search the following three electronic databases: MEDLINE, EMBASE and Web of Science. The primary outcome will include the peak coordinates and effect sizes of differences in ReHo between patients with IBS and healthy controls from each dataset. The secondary outcomes will be the effects of age, illness severity, illness duration, and scanner field strength. The SDM approach was used to conduct voxel-wise meta-analysis. Whole-brain voxel-based jackknife sensitivity analysis was performed to conduct jackknife sensitivity analysis. A random effects model with Q statistics is used to conduct heterogeneity and publication bias between studies and meta-regression analyses were carried out to examine the effects of age, illness severity, illness duration, and scanner field strength.

Results

The results of this paper will be submitted to a peer-reviewed journal for publication.

Conclusion

This research will determine the consistent pattern of alterations in ReHo in IBS patients.
Efficacy and safety of Buyang Huanwu-Tang (Boyang Hwano-Tang) in patients with vascular dementia
Authors: Kook Hye Jeong , Kim Da Woon , Kim Ju Yeon , Kim Sang Ho , Jung In Chul
Published: May 2021

Background:

Vascular dementia (VaD) is the second most common type of dementia; it has a significant impact on patients and exerts a great social and economic burden. However, there has been no comprehensive systematic review assessing the efficacy and safety of Buyang Huanwu-Tang (Boyang Hwano-Tang, BHT) for VaD. Therefore, this protocol was developed to conduct a comprehensive systematic review and meta-analysis to evaluate the effectiveness and safety of BHT in the treatment of VaD.

Methods:

We will perform a comprehensive electronic search including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, PsycARTICLES, Oriental Medicine Advanced Searching Integrated System, Korean Studies Information Service System, Research Information Service System, Korean Medical Database, KMbase, National Digital Science Library, China National Knowledge Infrastructure, Wanfang database, VIP database, Citation Information by NII, and other sources from their inception to November 25, 2020. This systematic review will include only randomized controlled clinical trials of BHT for VaD. The main outcomes will include the Mini-Mental State Examination, Montreal Cognitive Assessment, and Revised Hasegawa's Dementia Scale. Two researchers will independently conduct study selection, data extraction, and appraise the quality and risk of bias of the included studies. A meta-analysis will be conducted using Review Manager version 5.4. The evidence quality of each outcome will be appraised according to the Grades of Recommendation, Assessment, Development, and Evaluation.

Results:

This study will provide comprehensive understanding of the efficacy and safety of BHT for the treatment of VaD.

Conclusions:

The findings of this study will provide reliable evidence for clinical application and further study of BHT for VaD.

Ethics and dissemination:

Ethical approval is not required because individual patient data will not be included in this study. The study findings will be disseminated through conference presentations.

OSF registration DOI:

10.17605/OSF.IO/NDYGP
Lung cancer combined with diffuse peritoneal and mesenteric amyloidosis detected on 18F-FDG PET/CT
Authors: Wang JianJie , Zhao Bin , Song Tianbin , Sun Jidong
Published: May 2021

Rationale:

Amyloidosis is a heterogeneous group of diseases characterized by extracellular deposition of amyloid fibrils. Lung carcinoma is rarely reported to be associated with AA amyloidosis. With regard to the manifestation of amyloidosis infiltrating organs, most of the cases focus on the heart, liver, kidneys, and peripheral nervous system. Amyloidosis with diffuse abdominal involvement in combination with pulmonary squamous cell carcinoma carcinoma is an exceptionally rare occurrence.

Patient concerns:

A 70-year-old man was admitted to hospital for a 2-month history of repeated cough, low grade fever, hemoptysis and left back shoulder pain, which was not relieved by nonsteroid anti-inflammatory drugs. Meanwhile, he complained of intermittent diffuse abdominal discomfort and chronic persistent constipation.

Diagnoses:

The patient was diagnosed with poorly differentiated lung squamous cell carcinoma and diffuse peritoneal and mesenteric amyloidosis based on the pathological biopsy.

Interventions:

The patient received surgery and chemotherapy for lung tumor. He did not receive any treatment against amyloidosis.

Outcomes:

The patient died of a severe respiratory infection.

Lessons:

This case indicates that lung carcinoma is suspected to play a causative role in the development of amyloidosis. In addition, amyloidosis should be considered in the differential diagnosis in cases in which diffuse greater omentum, peritoneal, and mesenteric calcifications on 18F-2-fluoro-2-deoxy-D-glucose(18F-FDG) photon emission computed tomography (PET/CT).
High expression of guanine nucleotide-binding protein-like-3-like is associated with poor prognosis in esophageal cancer
Authors: Dai Guihong , Guo Zhongying , Chen Huiping , Jiang Min , Zhou Huilin , Bao Jingjing , Yu Hong , Huang Junxing
Published: May 2021

Guanine nucleotide-binding protein-like-3-like (GNL3L) is required for processing ribosomal pre-rRNA and cell proliferation and is upregulated in many types of cancer. This study is aimed to investigate the clinical significance of GNL3L in esophageal cancer. The mRNA and protein expression levels of GNL3L were determined by using quantitative real-time polymerase chain reaction and immunohistochemistry, respectively. GNL3L was localized in both cytoplasm and nucleus. The expression levels of GNL3L in esophageal cancer tissues were significantly higher than those in adjacent nonmalignant tissues. High GNL3L expression was associated with pathologic type and poor differentiation. Patients with high GNL3L expression had shorter overall survival (OS) than those with low GNL3L expression. Multivariate Cox regression analysis revealed that GNL3L expression was an independently predictive factor for the OS of patient with esophageal cancer. The Gene Expression Profiling Interactive Analysis (GEPIA) databases also showed that GNL3L was upregulated in esophageal cancer, which was closely associated with an unfavorable prognosis of patients with esophageal cancer. Taken together, our findings suggest that GNL3L is upregulated in esophageal cancer, which is linked to the progression of the disease. As a result, GNL3L could be used as a biomarker for esophageal cancer.
No evidence of tocilizumab treatment efficacy for severe to critical SARS-CoV2 infected patients
Authors: Burlacu Ruxandra , London Jonathan , Fleury Audrey , Sené Thomas , Diallo Abdourahmane , Meyssonnier Vanina , Zeller Valérie , Galland Joris , Huscenot Tessa , Rubenstein Emma , Trouiller Pierre , Amathieu Roland , Kutter Johannes , Blondeel David , Lejour Gabriel , Mouly Stéphane , Lidove Olivier , Wladimir Mauhin , Sène Damien
Published: May 2021

To assess tocilizumab (TCZ) efficacy associated to standard of care (SOC) compared to SOC alone in severe coronavirus associated disease 2019 (COVID-19) patients. In a matched case-control study from 3 French Hospital COVID-19 Departments, 27 patients with severe COVID-19 treated with TCZ and SOC were matched for baseline epidemiological and clinical features and compared to 27 severe COVID-19 patients treated with SOC alone. Baseline characteristics of the study population were comparable between groups. Eleven patients (20%) died. TCZ was not associated with clinical improvement as compared to SOC regarding oxygen-free status (44% vs 63%) and death (18.5% vs 22%), despite a higher decrease of the C-reactive protein at Day 7 (10.7 vs 52 mg/L; P < 10−3). Compared to the 43 patients alive at the end-of follow-up, patients who died were older (78 vs 64 years; P < 10−3), with 82% of them older than 72 years vs only 23% of live patients (P < 10−3). Age (OR = 1.15; 95%CI = 1.04–1.3; P = .008) and age over 72 years (OR) = 14.85; 95%CI = 2.7–80; P = .002) were independently associated with mortality. TCZ in addition to SOC for severe COVID-19 patients did not reduce mortality, subsequent need for invasive mechanical ventilation nor did it shorten the time of oxygen support, despite better control of the inflammatory response. More powerful and randomized controlled trials are warranted to determine if TCZ is effective in the management of COVID-19.
The effects of acupuncture for patients with psoriasis
Authors: Du Juan , Tao Jiming , Xu Ming , Wang Runnan , Lin Lanmei , Huang Xinyun , Li Qunyi , Lu Xiaonian
Published: May 2021

Introduction:

Psoriasis is a common chronic relapsing inflammatory skin disease, which may have considerable detrimental effects on the quality of life. Considering high costs and side effects associated with the use of conventional medications, acupuncture, as one of complementary and alternative nonpharmacological therapies, is commonly used in the management of psoriasis for reducing itching, repairing the skin lesions, etc. However, the effects of acupuncture in the management of psoriasis are still inconsistent, especially in psychosocial abnormality due to psoriasis. Therefore, we designed a randomized controlled trials (RCT) involving a placebo control to ensure participants’ blinding to investigate the effects of acupuncture for psoriasis in improving typical clinical symptoms and psychosocial abnormality.

Methods:

A singlecenter RCT was designed. 220 participants who meet the eligibility criteria will be randomly allocated into manual acupuncture group or sham acupuncture group in a 1:1 ratio. Participants will respectively receive 15 minutes manual acupuncture or sham acupuncture per session, 3 sessions per week, totally 12 weeks. Psoriasis Area and Severity Index scores, body surface area (BSA), Medical Outcomes Study 36-Item Short-Form Health Survey, Montgomery-Asberg Depression Rating Scale, and Depression, Anxiety, and Stress Scale-21 will be evaluated by blinded operators at baseline and 12 weeks. All analyses will be based on an intention-to-treat principle. The results will be published in an international peer-reviewed journal.

Discussion:

The results of this study are expected to clarify the effects of acupuncture on improving typical clinical symptoms and psychosocial abnormality of patients with psoriasis. It will contribute to clinical practice of acupuncture in the management of psoriasis.

Trial registration:

Chinese Clinical Trail Registry: ChiCTR2100045481. Registration date: April 17, 2021.
Anti-Müllerian hormone level may predict successful pregnancy after adenomyomectomy in patients with infertility due to adenomyosis
Authors: Won Seyeon , Hwang Ji Young , Lee Nara , Kim Miseon , Kim Mi Kyoung , Kim Mi-La , Yun Bo Seong , Seong Seok Ju , Jung Yong Wook
Published: May 2021

We aimed to determine clinical factors predicting successful pregnancy by comparing pregnancy failure and success groups after adenomyomectomy. Additionally, we analyzed fertility outcomes after adenomyomectomy.

The medical records of 43 patients who had undergone adenomyomectomy and received in vitro fertilization treatment from 2017 to 2020 were retrospectively reviewed. Patients were divided into pregnancy failure (n = 28) and pregnancy success (n = 15) groups. Patients’ demographic factors were evaluated and compared between the groups.

The age of patients was higher (39.0 [32.0–45.0] vs. 37.0 [33.0–42.0] years, P = .006) whereas the level of anti-Müllerian hormone (anti-Müllerian hormone [AMH]; 0.54 [0.01–8.54] vs. 2.91 [0.34–7.92] ng/mL, P = .002) lower in the pregnancy failure group compared to the pregnancy success group. The operative time was longer (220.0 [68.0–440.0] vs. 175.0 [65.0–305.0] min, P = .048) while the estimated blood loss higher (750 [100–2500] vs. 500 [50–2000] mL, P = .016) in the pregnancy failure group compared to the pregnancy success group. No significant difference was observed in body mass index, symptoms, cancer antigen 125, preoperative uterine volume, or type of adenomyosis. In the multivariate analysis, age and AMH were significant predictive factors for successful pregnancy.

Ovarian reserve (age and AMH) and disease severity might be predictive factors for successful pregnancy in patients who have undergone adenomyomectomy. Adenomyomectomy should be considered for women desiring pregnancy and having appropriate ovarian reserve. Our results would be beneficial for patients and clinicians before deciding on adenomyomectomy. Larger prospective studies are required to confirm our findings.
Surgical management for lumbar brucella spondylitis
Authors: Na Peng , Mingzhi Yang , Yin Xinhua , Chen Yong
Published: May 2021

There has been no ideal surgical approach for lumbar brucella spondylitis (LBS). This study aims to compare clinical efficacy and safety of posterior versus anterior approaches for the treatment of LBS.

From April 2005 to January 2015, a total of 27 adult patients with lumbar brucella spondylitis were recruited in this study. The patients were divided into 2 groups according to surgical approaches. Thirteen cases in group A underwent 1-stage anterior debridement, fusion, and fixation, and 14 cases in group B underwent posterior debridement, bone graft, and fixation. The clinical and surgical outcomes were compared in terms of operative time, intraoperative blood loss, hospitalizations, bony fusion time, complications, visual analog scale score, recovery of neurological function, deformity correction.

Lumbar brucella spondylitis was cured, and the grafted bones were fused within 11 months in all cases. It was obviously that the operative time and intraoperative blood loss of group A were more than those of group B (P = .045, P = .009, respectively). Kyphotic deformity was signifcantly corrected in both groups after surgery; however, the correction rate was higher in group B than in group A (P = .043). There were no significant differences between the two groups in hospitalizations, bony fusion time, and visual analog scale score in the last follow-up (P = .055, P = .364, P = .125, respectively).

Our results suggested that both anterior and posterior approaches can effectively cure lumbar brucella spondylitis. Nevertheless, posterior approach gives better kyphotic deformity correction, less surgical invasiveness, and less complications.
Secondary stone formation 8 weeks after percutaneous nephrolithotomy treatment
Authors: Deng Qiong , Wang Hongliang , Lai Yulin , Liang Hui
Published: May 2021

Introduction:

This work reports a patient with recurrent renal calculi subjected to three surgeries in half a year to be in the same position, and the high-throughput sequencing data showed different species in the renal pus and urine samples, which suggested that partial renal infection or stone formation can be judged by the bacteria in urine.

Patient concerns:

The female patient aged 43 years was referred to the authors’ department on April 13, 2020, due to left waist pain and fever for 3 days.

Diagnosis:

Kidney stones and hydronephrosis were determined by a urinary system computed tomography scan.

Interventions:

On April 20, 2020 and June 15, 2020, the patient was successfully treated with left percutaneous nephrolithotomy twice under general anesthesia. An investigation on the health and eating habits of the patient within 6 months was completed at the last admission. The components of the second renal calculus sample were analyzed with an infrared spectrum analyzer. The third renal stone (renal pus, triplicates) was subjected to microbial metagenome sequencing, and urine samples before and after surgery were subjected to 16S RNA sequencing by SEQHEALTH (Wuhan, China).

Outcomes:

After percutaneous nephrolithotomy, the left kidney stones were basically cleared, stone analysis revealed that the main components were calcium oxalate monohydrate, silica, and a small amount of calcium oxalate dehydrate. Although the urine samples exhibited differences, the renal pus and urine sample shared a single species.

Conclusion:

It is not clear that the prospects of partial renal infection or stone formation can be judged by the bacteria in urine.
The important role of MDM2, RPL5, and TP53 in mycophenolic acid-induced cleft lip and palate
Authors: Lin Yangyang , Song Tao , Ronde Elsa M. , Ma Gang , Cui Huiqin , Xu Meng
Published: May 2021

Mycophenolate embryopathy (MPE) is a mycophenolic acid (MPA)-induced congenital malformation with distinctive symptoms. Cleft lip/palate (CLP) is one of the most common symptoms of MPE. The aim of this study was to screen and verify hub genes involved in MPA-induced CLP and to explore the potential molecular mechanisms underlying MPE.

Overlapping genes related to MPA and CLP were obtained from the GeneCards database. These genes were further analyzed via bioinformatics. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis results were visualized with the Cytoscape ClueGO plug-in. Gene protein-protein interaction (PPI) networks were constructed based on data obtained from the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database.

Overall, 58 genes related to MPA and CLP were identified. The genes most relevant to MPA-induced CLP included ABCB1, COL1A1, Rac1, TGFβ1, EDN1, and TP53, as well as the TP53-associated genes MDM2 and RPL5. GO analysis demonstrated gene enrichment regarding such terms as ear, mesenchymal, striated muscle, and ureteric development. KEGG analysis demonstrated gene enrichment in such pathways as the HIF-1 signaling pathway, glycosylphosphatidylinositol-anchor biosynthesis, the TNF signaling pathway, and hematopoietic stem cell development.

Bioinformatic analysis was performed on the genes currently known to be associated with MPA-induced CLP pathogenesis. MPA-induced CLP is mediated by multiple ribosome stress related genes and pathways. MDM2, RPL5 and TP53 could be the main contributor in this pathogenesis, along with several other genes. ABCB1 polymorphism could be related to the probability of MPA-induced CLP.
Feasibility of a patient engagement and medication safety management program for older adults suffering cardiovascular disease in community settings
Authors: Wang Wenna , Zhang Huiling , Lin Beilei , Zhang Zhenxiang
Published: May 2021

Objectives:

To assess the feasibility of a patient engagement and medication safety management (PE-MSM) program on medication errors, self-efficacy for appropriate medication and activation among older patients suffering cardiovascular disease (CVD) in Chinese communities.

Methods:

A patient engagement and medication safety management (PE-MSM) program intervention study was performed. Older patients suffering CVD in the intervention group (n = 62) received PE-MSM program, while the control group (n = 58) took a 12-week medication safety education alone.

Results:

Compared with the control group, patients having undergone the individualized PE-MSM program achieved lower incidence of medication errors (P < .001), and a statistically significant interaction was identified between treatment groups and assessment time points in terms of the total score of self-efficacy for appropriate medication use scale and the number of patients with different activation levels (P < .001).

Conclusions:

The PE-MSM program is demonstrated to be feasible. Compared with single medication safety education, the PE-MSM program is capable of decreasing the incidence of common medication errors, enhancing the self-efficacy of appropriate medication and the activation of older patients with CVD in a community.

Practice implications:

The PE-MSM program is likely to act as a promising medication management model for the routine health care of older patients suffering CVD in communities.
CHA2DS2-VASc score predicts the slow flow/no-reflow phenomenon in ST-segment elevation myocardial infarction patients with multivessel disease undergoing primary percutaneous coronary intervention
Authors: Huang Xin , Zheng Wen , Zhao Xue Dong , Nie Shao Ping
Published: May 2021

ST-segment elevation myocardial infarction (STEMI) patients with multivessel disease (MVD) have a higher incidence of slow-flow/no-reflow (SF-NR) phenomenon during primary percutaneous coronary intervention (PPCI) than those with single vessel disease. Currently, no effective tools exist to predict the risk of SF-NR in this population. The present study aimed to evaluate whether CHA2DS2-VASc score can be used as a simple tool to predict this risk.

This study consecutively included STEMI patients hospitalized in Beijing Anzhen Hospital from January 2005 to January 2015. Among these patients, 1032 patients with MVD were finally enrolled. Patients were divided into SF-NR (+) group and SF-NR (–) group according to whether SF-NR occurred during PPCI. SF-NR was defined as the thrombolysis in myocardial infarction (TIMI) grade ≤2.

There were 134 patients (13%) in the SF-NR (+) group. Compared with the SF-NR (–) group, patients in the SF-NR (+) group are elder, with lower left ventricular ejection fraction and higher CHA2DS2-VASc score. Multiple logistic regression analysis indicated that CHA2DS2-VASc score ≥3 (odds ratio [OR], 2.148; 95% confidence interval [CI], 1.389–3.320; P = .001), current smoking (OR, 1.814; 95% CI, 1.19–2.764; P = .006), atrial fibrillation (OR, 2.892; 95% CI, 1.138–7.350; P = .03), complete revascularization (OR, 2.307; 95% CI, 1.202–4.429; P = .01), and total length of stents ≥40 mm (OR, 1.482; 95% CI, 1.011–2.172; P = .04) were independent risk factors of SF-NR. The incidence of SF-NR in patients with CHA2DS2-VASc score ≥3 was 1.7 times higher than that in patients with CHA2DS2-VASc score <3. Additionally, patients with CHA2DS2-VASc score ≥3 plus ≥2 risk factors have 3 times higher incidence of SF-NR than those with CHA2DS2-VASc score ≥3 plus 0 to 1 risk factor.

CHA2DS2-VASc score ≥3 can be used as a simple and sensitive indicator to predict SF-NR phenomenon and guide the PPCI strategy in STEMI patients with MVD.
Stent insertion for inoperable hilar cholangiocarcinoma
Authors: Lin Jia , Wu An-Le , Teng Fei , Xian Yu-Tao , Xu Xin-Jian
Published: May 2021

To assess effectiveness and safety associated with radioactive stenting for hilar cholangiocarcinoma (HCCA) patients.

This single-center retrospective study compared baseline and treatment data of recruited consecutive patients with HCCA underwent either normal or radioactive stenting between January 2016 and December 2019. Clinical success was defined by total bilirubin (TBIL) levels falling below 70% of the preoperative baseline within 2 weeks post stent insertion.

Sixty-five patients with inoperable HCCA underwent normal (n = 35) or radioactive (n = 30) stenting at our center. Technical success of both types of the normal and radioactive stent insertion was 100%. Each patient received 1 stent. In the radioactive stent group, each patient received 1 radioactive seed strand (RSS), containing 10 to 12 radioactive seeds. Clinical success rates were 86.8% and 100% in normal and radioactive groups, respectively (P = .495). We observed stent dysfunction in 9 patients (normal group) and 7 patients (radioactive group) (P = .824). Median duration of stent patency was 165 days (normal group) and 226 days (radioactive group) (P < .001). During follow-up, all patients died from tumor progression, with respective median survival of 198 days (normal group) and 256 days (radioactive group) (P < .001). Seven and 5 patients in the normal and radioactive groups suffered from stent-related complications (P = .730).

Radioactive stenting is effective and safe for inoperable HCCA patient and may prolong stent patency and survival.
Incidence and risk factors for 30-day readmission in ulcerative colitis: nationwide analysis in biologic era
Authors: Vohra Ishaan , Attar Bashar , Haghbin Hossein , Mutneja Hemant , Katiyar Vatsala , Sharma Sachit , Abegunde Ayokunle T. , Demetria Melchor , Gandhi Seema
Published: May 2021

Background and study aim

Ulcerative colitis (UC) is a chronic relapsing and remitting disease requiring frequent hospitalization. Biologics have become the recommended initial therapy for Biologics in patients with moderate to severe UC. Our aim was to estimate the changes in Nationwide Healthcare utilization and assess predictive factors of 30-day readmission, morbidity and mortality of UC.

Methods

This is a retrospective observational study analyzing the Nationwide Readmission database from 2016 to 2017 using ICD-10 codes. The primary outcomes of the study were to assess the predictors of 30-day readmission in patients with UC.

Results

Of the 54 138 adult patients with a primary diagnosis of UC, 13.2% were readmitted within 30 days of index hospitalization. The mortality rate (1.4 vs. 0.3%, P < 0.01), length of stay (7 vs. 4.9 days, P < 0.01) and hospital cost ($62 552 vs. $46 971, P < 0.01) were higher on readmission as compared to index hospitalization. We identified multiple patient-related factors (age <65years, men, VTE, protein calorie malnutrition, electrolyte imbalance, anemia, anxiety and alcohol abuse), hospital-related factors (teaching hospitals, high quintile hospitals), as independent predictors of 30-day UC readmission. Colonoscopy, Cannabis use, and colectomy were associated with decreased odds of 30-day readmission. The most common cause of UC was septicemia.

Conclusions

This is the largest nationwide study demonstrating predictors of 30-day readmission, mortality and morbidity associated with UC. Identification and amelioration of these risk factors will decrease readmission rate and mortality amongst UC patients.
Mucosal defect size predicts the adequacy of resection of ≤10 mm nonpedunculated colorectal polyps using a new cold snare polypectomy technique
Authors: Kudo Takahiro , Horiuchi Akira , Kyodo Reiko , Tokita Kazuhide , Tanaka Naoki , Horiuchi Ichitaro , Sano Kenji
Published: May 2021

Objectives

There is still room for improvement in the methods used to achieve complete polyp resection. The aim of this study was to develop a cold snare polypectomy technique that will reliably result in resections containing the muscularis mucosae and the lateral polyp margins.

Materials and methods

Nonpedunculated polyps ≤10 mm were resected using a dedicated cold snare with the goal of creating a mucosal defect approximately 1 cm in dia. The completeness of resection of the lateral and vertical polyp margins was examined histologically.

Results

The cases of 201 patients (mean age 67 ± 13 years; 115 men) with 500 eligible polyps were enrolled. The mean polyp size was 6.1 ± 1.8 mm (range 1–10 mm). The mean mucosal defect size immediately after resection was 7.7 ± 2.5 mm (range 3–15 mm). Overall, the complete resection rate in which the lateral and vertical margins were free from the neoplasia tissue was 92% (417/454, 95% CI, 89–94); in the remaining 8% of cases, the vertical margins showed complete resection but the lateral margins could not be evaluated due to the fragmentation of resected polyps. A mucosal defect ≥7 mm predicted complete resection of the mucosal layer containing the muscularis mucosae.

Conclusion

Complete mucosal layer resection of nonpedunculated colorectal polyps ≤10 mm was reliably achieved using a cold snare technique that produced a mucosal defect ≥7 mm in dia.
Subacute Cerebral Infarction With Accumulation of 99mTc-TRODAT in the Parkinson Disease Patient
Authors: Kao Chun-Hao , Chiu Chuang-Hsin
Published: May 2021

We report the accumulation of 99mTc-TRODAT-1 in the region of subacute cerebral ischemic infarction in an 81-year-old woman with Parkinson disease. The dopamine transporter SPECT imaging was performed on the 15th day after the onset of acute cerebral ischemic clinical symptoms. Overexpression of dopamine transporters after infarction in subacute phase may explain the accumulation.
Primary Adenosquamous Carcinoma of the Liver on FDG PET/CT
Authors: Filizoglu Nuh , Oksuzoglu Kevser , Ozguven Salih
Published: May 2021

Primary adenosquamous carcinoma (ASC) of the liver is a rare subtype of intrahepatic cholangiocarcinoma. Hepatic ASC consists of both adenocarcinoma and squamous cell carcinoma components. Because hepatic ASC is extremely rare, only a few cases describing the imaging findings of hepatic ASC were reported before. Herein, we present FDG PET/CT findings of hepatic ASC in a 78-year-old woman who was admitted to hospital with a 4-week history of right upper quadrant pain.
FDG PET/CT in Tenosynovial Giant Cell Tumor of the Lumbar Facet Joint
Authors: Zhang Jian , Li Yuhan , Zhu Yanfang , Duan Ying , Zhu Yuzhao
Published: May 2021

Tenosynovial giant cell tumor rarely affects the facet joints of the spine. We describe FDG PET/CT findings in a case of tenosynovial giant cell tumor arising from the left L2 to L3 facet joint. The tumor caused osteolytic bone destruction of the facet joint and showed intense FDG uptake with SUVmax of 10.4. This case indicates tenosynovial giant cell tumor should be included in the differential diagnosis of abnormal facet joint FDG accumulation.
Diffuse Large B-cell Lymphoma
Authors: Sakurada Hiroki , Koyasu Sho , Sugimoto Akihiko , Nakanishi Etsuro , Nakamoto Yuji
Published: May 2021

A 77-year-old man with parkinsonism was referred to the department of neurology for further examination. Cardiac 123I-MIBG scintigraphy unexpectedly showed strong uptake in the left shoulder, suggestive of MIBG-avid tumors including paraganglioma. MRI revealed multiple nodules suggestive of lymphoma. A biopsy was performed, which led to the pathological diagnosis of diffuse large B-cell lymphoma. Cardiac MIBG scintigraphy sometimes shows unexpected findings outside the mediastinum. In addition, lymphoma should also be added to the list of differential diagnoses for MIBG-positive tumors.
Selective Prehospital Advanced Resuscitative Care – Developing a Strategy to Prevent Prehospital Deaths From Noncompressible Torso Hemorrhage
Authors: Qasim Zaffer , Butler Frank K. , Holcomb John B. , Kotora Joseph G. , Eastridge Brian J. , Brohi Karim , Scalea Thomas M. , Schwab C. William , Drew Brendon , Gurney Jennifer , Jansen Jan O. , Kaplan Lewis J. , Martin Matthew J. , Rasmussen Todd E. , Shackelford Stacy A. , Bank Eric A. , Braude Darren , Brenner Megan , Guyette Francis X. , Joseph Bellal , Hinckley William R. , Sperry Jason L. , Duchesne Juan
Published: May 2021

Hemorrhage, and particularly noncompressible torso hemorrhage remains a leading cause of potentially preventable prehospital death from trauma in the United States and globally. A subset of severely injured patients either die in the field or develop irreversible hemorrhagic shock before they can receive hospital definitive care, resulting in poor outcomes. The focus of this opinion paper is to delineate
Amazonocrinis nigriterrae gen. nov., sp. nov., Atlanticothrix silvestris gen. nov., sp. nov. and Dendronalium phyllosphericum gen. nov., sp. nov., nostocacean cyanobacteria from Brazilian environments
Authors: Alvarenga Danillo Oliveira , Andreote Ana Paula Dini , Branco Luis Henrique Zanini , Delbaje Endrews , Cruz Renata Beatriz , Varani Alessandro de Mello , Fiore Marli Fátima
Published: May 2021

The cyanobacterial genus

Nostoc

is an important contributor to carbon and nitrogen bioavailability in terrestrial ecosystems and a frequent partner in symbiotic relationships with non-diazotrophic organisms. However, since this currently is a polyphyletic genus, the diversity of

Nostoc

-like cyanobacteria is considerably underestimated at this moment. While reviewing the phylogenetic placement of previously isolated

Nostoc

-like cyanobacteria originating from Brazilian Amazon, Caatinga and Atlantic forest samples, we detected 17 strains isolated from soil, freshwater, rock and tree surfaces presenting patterns that diverged significantly from related strains when ecological, morphological, molecular and genomic traits were also considered. These observations led to the identification of the evaluated strains as representative of three novel nostocacean genera and species: Amazonocrinis nigriterrae gen. nov., sp. nov.; Atlanticothrix silvestris gen. nov., sp. nov.; and Dendronalium phyllosphericum gen. nov., sp. nov., which are herein described according to the rules of the International Code of Nomenclature for algae, fungi and plants. This finding highlights the great importance of tropical and equatorial South American ecosystems for harbouring an unknown microbial diversity in the face of the anthropogenic threats with which they increasingly struggle.
Surveillance of colistin-resistance andmcr genes inmulti-drug resistant Enterobacteriaceae
Authors: Kawamoto Yasuhide , Kaku Norihito , Akamatsu Norihiko , Sakamoto Kei , Kosai Kosuke , Morinaga Yoshitomo , Ohmagari Norio , Izumikawa Koichi , Yamamoto Yoshihiro , Mikamo Hiroshige , Kaku Mitsuo , Oishi Kazunori , Yanagihara Katsunori
Published: May 2021

Background

The plasmid-mediated bacterial colistin-resistant (mcr) gene is a global concern in clinical health care. This study aimed to clarify the prevalence of colistin resistance through ninemcrgenes in ESBL-producing and CRE isolated Enterobacteriaceae in Japan.

Methods

We collected strains from August 2016 to March 2017 from five tertiary hospitals. MICs were measured using the microdilution method. PCR was performed to detectmcr-1tomcr-9genes in all strains. Additionally, we performed whole-genome sequencing of themcrgene-positive strain.

Results

The rate of colistin resistance was 7.7%. Themcr-5andmcr-9gene were detected in one ESBL-producingE. colistrain (0.37%) and three CRE strains (1.1%), respectively. Since the ESBL-producingE. colistrain was the first clinical strain withmcr-5in Japan, whole-genome sequencing analysis was performed for the strain. The sequenece type of themcr-5positive strain was ST1642 and it carried two distinct plasmids, ESBL gene-carrying pN-ES-6-1 andmcr-5.1-carrying pN-ES-6-2.

Conclusions

We showed that the frequency of colistin resistance andmcr-positive strains is not high in Japan. Since the MIC for colistin was low in themcr-5.1andmcr-9gene-positive strain, continuous monitoring ofmcrgenes is necessary.
Association of Intravenous Bamlanivimab Use with Reduced Hospitalization, Intensive Care Unit Admission, and Mortality in Patients with Mild to Moderate COVID-19
Authors: Ganesh Ravindra , Pawlowski Colin , O’Horo John C. , Arndt Lori L. , Arndt Richard , Bell Sarah J. , Bierle Dennis M. , Borgen Molly Destro , Hanson Sara N. , Heyliger Alexander , Larsen Jennifer J. , Lenehan Patrick , Orenstein Robert , Puranik Arjun , Speicher Leigh L. , Tulledge-Scheitel Sidna M. , Venkatakrishnan AJ , Wilker Caroline G. , Badley Andrew D. , Razonable Raymund R.
Published: May 2021

Background

Clinical data to support the use of bamlanivimab for the treatment of outpatients with mild to moderate coronavirus disease-19 (COVID-19) is needed.

Methods

2,335 patients who received single-dose bamlanivimab infusion between November 12, 2020 to February 17, 2021 were compared with a propensity-matched control of 2,335 untreated patients with mild to moderate COVID-19 at Mayo Clinic facilities across 4 states. The primary outcome was the rate of hospitalization at days 14, 21 and 28.

Results

The median age of the population was 63; 47.3% of the bamlanivimab-treated cohort were ≥65 years; 49.3% were female. High-risk characteristics included hypertension (54.2%), body mass index ≥35 (32.4%), diabetes mellitus (26.5%), chronic lung disease (25.1%), malignancy (16.6%), and renal disease (14.5%). Patients who received bamlanivimab had lower all-cause hospitalization rates at days 14 (1.5% vs 3.5%; Odds Ratio [OR], 0.38), 21 (1.9% vs 3.9%; OR, 0.46), and 28 (2.5% vs 3.9%; OR, 0.61). Secondary exploratory outcomes included lower intensive care unit admission rates at days 14 (0.14% vs 1%; OR, 0.12), 21 (0.25% vs 1%; OR: 0.24) and 28 (0.56% vs 1.1%; OR: 0.52), and lower all-cause mortality at days 14 (0% vs 0.33%), 21 (0.05% vs 0.4%; OR,0.08) and 28 (0.11% vs 0.44%; OR, 0.01). Adverse events were uncommon with bamlanivimab, occurring in 19/2355, most commonly fever (n=6), nausea (n=5), and lightheadedness (n=3).

Conclusions

Among high-risk patients with mild to moderate COVID-19, treatment with bamlanivimab was associated with a statistically significant lower rate of hospitalization compared with usual care.

Funding

Mayo Clinic.
Racial disparities in prevalence, determinants, and impacts of COVID-19 in pregnancy: Protocol for a study using data from New Jersey hospitals
Authors: Rokicki Slawa , Nguyen Pauline , Sharpe Alaine , Taylor Dyese , Spernal Suzanne , Raghunath Archana , Kantor Leslie
Published: May 2021

Introduction

Racial and ethnic disparities in COVID-19 related infections, hospitalizations, and deaths have been well-documented. However, little research has examined racial and ethnic disparities in COVID-19 prevalence, determinants, and impacts among pregnant women. Within the United States, New Jersey was an early epicenter of the pandemic and experienced high rates of disease in the fall of 2020.

Methods

This study uses data from two New Jersey hospitals, which implemented universal testing of COVID-19 of pregnant women admitted for labor and delivery starting in March 2020. We will estimate prevalence of COVID-19 between March 2020 and November 2020 and compare prevalence rates across race and ethnicity. We will conduct multivariable logistic regression analysis to examine the associations of COVID-19 infection with patient demographic and health status predictors. We will also use multivariable linear and logistic regressions to examine the impact of COVID-19 symptomatic and asymptomatic infection on maternal and infant birth outcomes.

Discussion

This study will generate important policy implications on birth equity in the time of COVID-19 and guide future research studies related to COVID-19 in pregnant women. Results of this study will help to guide interventions and policies to center safe, accessible, and equitable maternity care within the strategic response to the pandemic.
Maximum Parsimony Reconciliation in the DTLOR Model
Authors: Liu Jingyi , Mawhorter Ross , Liu Nuo , Santichaivekin Santi , Bush Eliot , Libeskind-Hadas Ran
Published: May 2021

Background

Analyses of microbial evolution often use reconciliation methods. However, the standard duplication-transfer-loss (DTL) model does not account for the fact that species trees are often not fully sampled and thus, from the perspective of reconciliation, a gene family may enter the species tree from the outside. Moreover, within the species tree, genes are often rearranged, causing them to move to new syntenic “regions.”

Results

We extend the DTL model to account for two events that commonly arise in the evolution of microbes: evolution occurring outside the sampled species tree and changes in the syntenic regions of genes in the genome due to rearrangement. We describe an efficient algorithm for maximum parsimony reconciliation in this new DTLOR model and then show how it can be extended to account for non-binary gene trees. Finally, we describe preliminary experimental results from the integration of our algorithm into the existing xenoGI tool for reconstructing the histories of genomic islands in closely related bacteria.

Conclusions

Reconciliation in the DTLOR model can offer new insights into the evolution of microbes that is not currently possible under the DTL model.
Intimate genetic relationships and fungicide resistance in multiple strains of human pathogenic fungus Aspergillus fumigatus isolated from a plant bulb
Authors: Takahashi Hiroki , Oiki Sayoko , Kusuya Yoko , Urayama Syun-ichi , Hagiwara Daisuke
Published: May 2021

Fungal infections are increasingly dangerous because of environmentally-dispersed resistance to antifungal drugs. Azoles are commonly used antifungal drugs, but they are also used as fungicides in agriculture, which may enable enrichment of azole-resistant strains of the human pathogen Aspergillus fumigatus in the environment. Understanding of environmental dissemination and enrichment of genetic variation associated with azole resistance in A. fumigatus is required to suppress resistant strains. Here, we focused on eight strains of azole-resistant A. fumigatus isolated from a single tulip bulb for sale in Japan. This set includes strains with TR34/L98H/T289A/I364V/G448S and TR46/Y121F/T289A/S363P/I364V/G448S mutations in the cyp51A gene, which showed higher tolerance to several azoles than strains harboring TR46/Y121F/T289A mutation. The strains were typed by microsatellite typing, single nucleotide polymorphism profiles, and mitochondrial and nuclear genome analyses. The strains grouped differently using each typing method, suggesting historical genetic recombination among the strains. Our data also revealed that some strains isolated from the tulip bulb showed tolerance to other classes of fungicide, such as QoI and carbendazim, followed by related amino acid alterations in the target proteins. Considering spatial-temporal factors, plant bulbs are an excellent environmental niche for fungal strains to encounter partners, and to obtain and spread resistance-associated mutations.
Psychological factors underpinning vaccine willingness in Israel, Japan and Hungary
Authors: Goodwin Robin , Ben-Ezra Menachem , Takahashi Masahito , Luu Lan-Anh Nguyen , Borsfay Krisztina , Kovács Mónika , Hou Wai-Kai , Hamama-Raz Yaira , Levin Yafit
Published: May 2021

The rapid international spread of the SARS-CoV-2 virus 19 led to unprecedented attempts to develop and administer an effective vaccine. However, there is considerable vaccine hesitancy in some countries. We investigated willingness to vaccinate in three nations with historically different levels of vaccine willingness and attitudes: Israel, Japan and Hungary. Employing an ecological-systems approach we analysed associations between demographic factors and health status, individual cognitions, normative pressures, trust in government, belief in COVID-19 myths and willingness to be vaccinated, using data from three nationally representative samples (Israel, N=1011 (Jan 2021); Japan, N= 997 (Feb 2021); Hungary, N=1131 (Apr 2021)). In Israel 74% indicated a willingness to vaccinate, but only 51% in Japan and 31% in Hungary. Multigroup regression analyses indicated greater vaccine willingness amongst those who perceived benefits to vaccination, anticipated regret if not vaccinated and trusted the government. Multi-group latent class analysis of ten COVID-19 (mis)beliefs identified three classes of myths, with concerns about the alteration of DNA (Israel), allergies (Hungary) and catching COVID-19 from the vaccine (Japan) specific to vaccine willingness for each culture. Intervention campaigns should focus on increasing trust and addressing culturally specific myths while emphasising the individual and social group benefits of vaccination.
A Promising Chemical Series of Positive Allosteric Modulators of the μ-Opioid Receptor that Enhance the Antinociceptive Efficacy of Opioids but not their Adverse Effects
Authors: Pryce Kerri D. , Kang Hye Jin , Sakloth Farhana , Liu Yongfeng , Khan Susan , Toth Katalin , Kapoor Abhijeet , Nicolais Andrew , Che Tao , Qin Lihuai , Bertherat Feodora , Kaniskan H. Ümit , Jin Jian , Cameron Michael D. , Roth Bryan L. , Zachariou Venetia , Filizola Marta
Published: May 2021

Positive allosteric modulators (PAMs) of the µ-opioid receptor (MOR) have been proposed to exhibit therapeutic potential by maximizing the analgesic properties of clinically used opioid drugs while limiting their adverse effects or risk of overdose as a result of using lower drug doses. We herein report in vitro and in vivo characterization of two small molecules from a chemical series of MOR PAMs that exhibit: (i) MOR PAM activity and receptor subtype selectivity in vitro, (ii) a differential potentiation of the antinociceptive effect of oxycodone, morphine, and methadone in mouse models of pain that roughly correlates with in vitro activity, and (iii) a lack of potentiation of adverse effects associated with opioid administration, such as somatic withdrawal, respiratory depression, and analgesic tolerance. This series of MOR PAMs holds promise for the development of adjuncts to opioid therapy to mitigate against overdose and opioid use disorders.
Reprogrammed tracrRNAs enable repurposing RNAs as crRNAs and detecting RNAs
Authors: Liu Yang , Pinto Filipe , Wan Xinyi , Peng Shuguang , Li Mengxi , Xie Zhen , French Christopher E. , Wang Baojun
Published: May 2021

In type II CRISPR systems, the guide RNA (gRNA) consists of a CRISPR RNA (crRNA) and a hybridized trans-acting CRISPR RNA (tracrRNA) which interacts directly with Cas9 and is essential to its guided DNA targeting function. Though tracrRNAs are diverse in sequences and structures across type II CRISPR systems, the programmability of crRNA-tracrRNA hybridization for particular Cas9 has not been studied adequately. Here, we revealed the high programmability of crRNA-tracrRNA hybridization for Streptococcus pyogenes Cas9. By reprogramming the crRNA-tracrRNA hybridized sequence, reprogrammed tracrRNAs can repurpose various RNAs as crRNAs to trigger CRISPR function. We showed that the engineered crRNA-tracrRNA pairs enable design of orthogonal cellular computing devices and hijacking of endogenous RNAs as crRNAs. We next designed novel RNA sensors that can monitor the transcriptional activity of specific genes on the host genome and detect SARS-CoV-2 RNA in vitro. The engineering potential of crRNA-tracrRNA interaction has therefore redefined the capabilities of CRISPR/Cas9 system.