bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical use of percutaneous mechanical circulatory assistance in a patient with end-stage right-sided heart failure and massive tricuspid insufficiency due to congenital heart disease: first-in-the-world case report
Authors: García Gómez Mario , Uribarri Aitor , San Román Calvar José Alberto , Stepanenko Alexander
Published: August 2021

Background

Due to improvement in the management of patients with congenital heart disease (CHD), the likelihood of their survival to adulthood is increasing. A relevant population suffers end-stage right ventricular failure (RVF) in their 3rd–4th decade of life. Hence, heart transplantation is still gold standard of treatment of end-stage heart failure, mechanical circulatory assistance has become a valuable tool in the bridging to heart transplant or definitive therapy. Use of implantable short-term or long-term devices is reported by others. However, within this clinical context, presence of significant tricuspid regurgitation (TR) or CHD is used as exclusion criteria for insertion of a percutaneous right ventricular circulatory support.

Case summary

We described a 36-year-old patient diagnosed with Ebstein's anomaly and severe TR who is admitted to hospital due to RVF refractory to standard medical treatment. After case presentation to the heart team, an Impella RP device insertion was scheduled, in spite of the presence of TR or CHD after evaluation of pulmonary valve competency and 3D reconstruction with virtual device implantation. During support, the patient improved clinically and haemodynamically. Due to device displacement to the right ventricle, it was bedside explanted after 30 days of support. After mechanical unloading during 30 days patients’ right ventricle recovered partially, permitting patient to improve his functional class.

Discussion

Although TR and CHD are exclusion criteria for the implantation of the Impella RP device, we report clinical experience in patient with Ebstein's anomaly and severe TR supported with percutaneous device as bridge to heart transplantation during 30 days.
Use of sodium zirconium cyclosilicate for up-titration of renin–angiotensin–aldosterone system inhibitor therapy in patients with heart failure: a case series
Authors: Williams Rhys , James Alexander , Ashton Moira , Vaughan Sian , Wong Aaron
Published: August 2021

Background

Patients often receive suboptimal dosing of renin–angiotensin–aldosterone system inhibitor (RAASi) therapy over concerns of hyperkalaemia. However, studies have shown associations between suboptimal dosing or interruptions to therapy and adverse clinical events. Therefore, effective treatments for hyperkalaemia that can enable optimal RAASi therapy are needed. This case series examines eight patients whose commencement on the novel potassium binder sodium zirconium cyclosilicate (SZC) allowed for the initiation and/or up-titration of RAASi therapy.

Case summary

Eight patients aged 64–87 years with heart failure (HF) with reduced ejection fraction all developed hyperkalaemia (serum potassium (sK+) >5.0 mmol/L) while receiving RAASi therapy. Following initiation of SZC, all patients experienced eventual stabilization of sK+ levels. All patients were able to initiate, restart, or up-titrate RAASi therapy with five patients achieving optimal medical therapy. Left ventricular ejection fraction improved in four patients, two patients are now re-classified as New York Heart Association Class I, and an additional patient had improved exercise tolerance. Follow-up for Patient 8 is still ongoing.

Discussion

These real-world cases demonstrate that use of SZC to manage hyperkalaemia in patients with HF is feasible and allows optimization of RAASi therapy.
Transient complete heart block: a case report of a rare complication of tricuspid valve infective endocarditis
Authors: Singh Nikhil , Kalathiya Rohan J
Published: August 2021

Background

Right-sided tricuspid valve (TV) endocarditis can be difficult to identify and may be under-recognized in the absence of traditional risk factors. While generally identified with aortic valve pathology, infective endocarditis that extends beyond the leaflets of the TV have been reported to cause conduction disease.

Case summary

We present the case of a 63-year-old patient who presented with haemodynamically unstable complete heart block requiring temporary venous pacemaker support. Despite the absence of traditional risk factors or significant valvular disease on transthoracic echocardiogram, she was found to be persistently bacteraemic and subsequent transoesophageal echocardiogram identified large vegetation on the septal leaflet of the TV. Conduction disease was noted to reverse with antibiotic therapy and resolution of bacteraemia.

Discussion

Although rare, right-sided endocarditis involving the triangle of Koch may present with conduction disease due to local inflammation and mechanical compression. Conduction disease associated with right-sided disease appears to be readily reversible with medical therapy and temporary device support may be appropriate in the acute setting.
The Bnapus50K array: a quick and versatile genotyping tool for Brassica napus genomic breeding and research
Authors: Xiao Qing , Wang Huadong , Song Nuan , Yu Zewen , Imran Khan , Xie Weibo , Qiu Shuqing , Zhou Fasong , Wen Jing , Dai Cheng , Ma Chaozhi , Tu Jinxing , Shen Jinxiong , Fu Tingdong , Yi Bin
Published: August 2021

Rapeseed is a globally cultivated commercial crop, primarily grown for its oil. High-density single nucleotide polymorphism (SNP) arrays are widely used as a standard genotyping tool for rapeseed research, including for gene mapping, genome-wide association studies, germplasm resource analysis, and cluster analysis. Although considerable rapeseed genome sequencing data have been released, DNA arrays are still an attractive choice for providing additional genetic data in an era of high-throughput whole-genome sequencing. Here, we integrated re-sequencing DNA array data (32,216, 304 SNPs) from 505 inbred rapeseed lines, allowing us to develop a sensitive and efficient genotyping DNA array, Bnapus50K, with a more consistent genetic and physical distribution of probes. A total of 42,090 high-quality probes were filtered and synthesized, with an average distance between adjacent SNPs of 8 kb. To improve the practical application potential of this array in rapeseed breeding, we also added 1,618 functional probes related to important agronomic traits such as oil content, disease resistance, male sterility, and flowering time. The additional probes also included those specifically for detecting genetically modified material. These probes show a good detection efficiency and are therefore useful for gene mapping, along with crop variety improvement and identification. The novel Bnapus50K DNA array developed in this study could prove to be a quick and versatile genotyping tool for B. napus genomic breeding and research.
On Spectra and Spectral Measures of Schreier and Cayley Graphs
Authors: Grigorchuk Rostislav , Nagnibeda Tatiana , Pérez Aitor
Published: August 2021

We are interested in various aspects of spectral rigidity of Cayley and Schreier graphs of finitely generated groups. For each pair of integers $d\geq 2$ and $m \ge 1$, we consider an uncountable family of groups of automorphisms of the rooted $d$-regular tree, which provide examples of the following interesting phenomena. For $d=2$ and any $m\geq 2$, we get an uncountable family of non-quasi-isometric Cayley graphs with the same Laplacian spectrum, a union of two intervals, which we compute explicitly. Some of the groups provide examples where the spectrum of the Cayley graph is connected for one generating set and has a gap for another. For each $d\geq 3, m\geq 1$, we exhibit infinite Schreier graphs of these groups with the spectrum a Cantor set of Lebesgue measure zero union a countable set of isolated points accumulating on it. The Kesten spectral measures of the Laplacian on these Schreier graphs are discrete and concentrated on the isolated points. We construct, moreover, a complete system of eigenfunctions that are strongly localized.
Term Limits and Environmental Treaty Commitments
Authors: DiLorenzo Matthew , Stone Talor
Published: August 2021

How does political accountability in democracies affect leaders’ incentives for international cooperation? We consider how term limits should affect international environmental agreement (IEA) participation. Pursuing environmental protection as a public good coincides with the political survival incentives of democratic leaders. Term limits decouple leaders’ policy priorities from their political survival incentives, discouraging IEA participation. However, prioritization of environmental concerns increases with economic development. As such, the effect of term limits on IEA participation should be strongest in rich democracies. We test these arguments using data from the International Environmental Agreements Database from 1970 to 2011. Democratic leaders, particularly in rich democracies, sign fewer IEAs when freed from the reelection motive. We also consider the potential that term limits could favor IEA participation if doing so aligns with a leader's preferences. This potential should be greatest in poor democracies where citizens place less emphasis on environmental protection, though we find little evidence for this expectation. The findings have important implications for understanding the determinants of IEA participation and the political accountability–international cooperation relationship. Whereas some argue that electoral incentives that cause leaders to favor present over future concerns undermine environmental cooperation, our results suggest that political accountability in democracies can promote treaty participation.
Study on Sialic Acid Binding State in Stewed Bird's Nest and Optimization of Enzymatic Extraction of Free and Oligosaccharide-Bound Sialic Acid
Authors: Dai Yuwei , Cao Jie , Zhang Yu , He Feng , Jiang Lin
Published: August 2021

Background

As a traditional Chinese health food, edible bird's nest (EBN) has high medicinal value, which is mostly attributed to the high content of sialic acid (SA). SA mainly exists in protein-bound, oligosaccharide-bound, and free forms and the binding forms of SA are closely related to the functions of EBN.

Objective

To establish a simple but robust method to distinguish and determinate the free and oligosaccharide-bound SA content and the protein-bound SA content, and investigate the changes to SA binding states in EBN during different processing.

Methods

Protein-bound SA in EBN was separated from other forms of SA by trichloroacetic acid precipitation, and SA content was determined by HPLC. The effects of stewing conditions on the distribution of SA in EBN were investigated and response surface methodology was used to explore the optimal conditions for enzymatic extraction of free and oligosaccharide-bound SA from EBN.

Results

The average recoveries of free and oligosaccharide-bound SA and protein-bound SA were 97.82–98.92% and 94.67–95.75%, respectively. The content of free and oligosaccharide-bound SA in stewed EBN was proportional to the stewing temperature, stewing time, and liquid to material ratio, while that of protein-bound SA was inversely proportional to those factors. Through response surface analysis, we found that the optimum technological parameters were as follows: liquid to material ratio, 60:1; enzymolysis time, 2 h; enzyme dosage; 12 000 U/g (alkaline protease); pH, 11; enzymolysis temperature, 60°C.

Conclusion

This method can not only distinguish between free and oligosaccharide-bound SA and protein-bound SA effectively, but can also determine the contents of them. The results of the investigation on stewing conditions and response surface analysis can be used as the theoretical basis for further pharmacological research of EBN, and can also provide theoretical guidance for the development of EBN products.

Highlights

A method for the determination of free and oligosaccharide-bound SA and protein-bound SA in EBN by HPLC was established, and the extraction process of free and oligosaccharide-bound SA was optimized.
Pure Radial Scars Do Not Require Surgical Excision When Concordant and Benign at Image-guided Breast Biopsy
Authors: Piraner Maria , D’Amico Kelly , Gilliland Lawrence L , Newell Mary S , Cohen Michael A
Published: August 2021

Objective

To determine the best management option (surgical excision versus imaging surveillance) following the diagnosis of pure radial scars (RSs) and RSs with associated additional high-risk lesions (HRLs) encountered on percutaneous core-needle breast biopsy.

Methods

An IRB–approved retrospective review of the breast imaging reporting system database was performed to identify all cases of pure RS alone or RS plus an additional HRL (papilloma, atypia, lobular neoplasia) diagnosed on core-needle biopsy, from 2007 to 2016, at four breast centers in our institution. Cases with associated malignancy, discordant radiologic-pathologic results, or those lost to follow-up were excluded. The remaining cases were evaluated to determine results of either subsequent surgical excision or long-term follow-up imaging (minimum of two years). Additional data recorded included clinical presentation, breast density, personal and family history of breast cancer, lesion imaging characteristics, and biopsy method.

Results

The study cohort included 111 patients with 111 lesions: 56.8% (63/111) with RS alone (pure) and 43.2% (48/111) with RS plus additional HRL(s). Out of the 63 radiologic-pathologic concordant pure RSs, there were no upgrades to malignancy in 51 subsequent surgical excisions or 12 long-term surveillance cases (0/63, 0%). Out of the 48 RSs plus additional HRL(s), there were 2 upgrades to malignancy (2/48, 4.2%).

Conclusion

Cases of radiologic-pathologic concordant pure RS diagnosed at core-needle biopsy do not require surgical excision. On the other hand, surgical excision should be considered for RS plus additional HRLs diagnosed at core-needle biopsy.
BI-RADS 3 on Screening Breast Ultrasound: What Is It and What Is the Appropriate Management?
Authors: Berg Wendie A
Published: August 2021

US is widely used in breast imaging for diagnostic purposes and is also used increasingly for supplemental screening in women with dense breasts. US frequently depicts masses that are occult on mammography, even after tomosynthesis, and the vast majority of such masses are benign. Many masses seen only on screening US are easily recognized as benign simple cysts. Probably benign, BI-RADS 3, or low suspicion, BI-RADS 4A masses are also common and often prompt short-interval follow-up or biopsy, respectively, yet the vast majority of these are benign. This review details appropriate characterization, classification, and new approaches to the management of probably benign masses seen on screening US that can reduce false positives and, thereby, reduce costs and patient anxiety.
Crohn’s and Colitis Canada’s 2021 Impact of COVID-19 and Inflammatory Bowel Disease in Canada: COVID-19 Vaccines—Biology, Current Evidence and Recommendations
Authors: Murthy Sanjay K , Kuenzig M Ellen , Windsor Joseph W , Ghia Jean-Eric , Griffiths Anne M , Panaccione Remo , Seow Cynthia H , Benchimol Eric I , Bernstein Charles N , Bitton Alain , Huang James Guoxian , Jones Jennifer L , Lee Kate , Kaplan Gilaad G , Mukhtar Mariam S , Tandon Parul , Targownik Laura E , Gibson Deanna L
Published: August 2021

The COVID-19 pandemic has ushered a globally focused vaccine development program that produced multiple successful vaccines within a year. Four SARS-CoV-2 vaccines have been approved for use in Canada, using two different technologies, all of which have shown excellent efficacy in reducing the rate of symptomatic COVID-19 infection and 100% efficacy in preventing death from COVID-19. People with inflammatory bowel disease (IBD), like many others with immune-mediated chronic diseases, were excluded from the pivotal trials of these vaccines, leading to early hesitancy by regulatory bodies to endorse administering the vaccines to these groups. However, recent data has shown that the adverse event rate to SARS-CoV-2 vaccine among people with IBD is similar to the general population. Early data has further shown that people with IBD are capable of mounting a robust immune response to SARS-CoV-2 vaccines, particularly following a second dose, whereas the response to the first dose is blunted in those receiving anti-TNF therapy or conventional immunosuppressants (azathioprine, 6-mercaptopurine, methotrexate). Based on these data and evidence from previous vaccine programs among people with IBD, multiple national and international expert panels have recommended that individuals with IBD receive complete vaccination against SARS-CoV-2 as soon as possible.
Basic and applied research on multiple aminoglycoside antibiotic resistance of actinomycetes: an old-timer's recollection
Authors: Hotta Kunimoto
Published: August 2021

A list of our research achievements on multiple aminoglycoside antibiotic (AG) resistance in AG-producing actinomycetes is outlined. In 1979, the author discovered a novel AG (istamycin)-producing Streptomyces tenjimariensis SS-939 by screening actinomycetes with kanamycin (KM)-resistance and plasmid profiles. This discovery directed our biochemical and genetic approaches to multiple AG resistance (AGR) of AG producers. In this article, the following discoveries will be outlined: (1) AGR profiles correlating with the productivity of AGs in AG-producers, (2) Wide distribution of multiple AG resistance in AG-nonproducing actinomycetes, (3) Involvement of ribosomal resistance and AG-acetylating enzymes as underlying AGR factors, (4) Activation by single nucleotide substitution of a silent gene coding for aminoglycoside 3-N-acetyltransferase, AAC(3), in S. griseus, (5) Discovery of a novel antibiotic indolizomycin through protoplast fusion treatment between S. tenjimariensis and S. griseus strains with different AGR phenotypes, and (6) Double stage-acting activity of arbekacin (ABK; an anti-MRSA semisynthetic AG) discovered by acetylation of ABK with cloned AACs; that is both ABK and its acetylated derivatives showed remarkable antibiotic activities.
Are small airplanes safe with regards to COVID-19 transmission?
Authors: Saretzki Charlotte , Bergmann Ole , Dahmann Peter , Janser Frank , Keimer Jona , Machado Patricia , Morrison Audry , Page Henry , Pluta Emil , Stübing Felix , Küpper Thomas
Published: August 2021

Social distancing is impossible in small aircrafts but there is a specific, highly effective ventilation system. Measurements proved that there is no crossflow between pilot, copilot and backseaters. Terefore the risk of infection should be very low.
Confirmation of GmPPR576 as a fertility restorer gene of cytoplasmic male sterility in soybean
Authors: Wang Tanliu , He Tingting , Ding Xianlong , Zhang Qiqi , Yang Longshu , Nie Zhixing , Zhao Tuanjie , Gai Junyi , Yang Shouping
Published: August 2021

In soybean, heterosis achieved through the three-line system has been gradually applied in breeding to increase yield, but the underlying molecular mechanism remains unknown. We conducted a genetic analysis using the pollen fertility of offspring of the cross NJCMS1A×NJCMS1C. All the pollen of F1 plants was semi-sterile; in F2, the ratio of pollen-fertile plants to pollen-semi-sterile plants was 208:189. This result indicates that NJCMS1A is gametophyte sterile, and the fertility restoration of NJCMS1C to NJCMS1A is a quality trait controlled by a single gene locus. Using bulked segregant analysis, the fertility restorer gene Rf in NJCMS1C was located on chromosome 16 between the markers BARCSOYSSR_16_1067 and BARCSOYSSR_16_1078. Sequence analysis of genes in that region showed that GmPPR576 was non-functional in rf cultivars. GmPPR576 has one functional allele in Rf cultivars but three non-functional alleles in rf cultivars. Phylogenetic analysis showed that the GmPPR576 locus evolved rapidly with the presence of male-sterile cytoplasm. GmPPR576 belongs to the RFL fertility restorer gene family and is targeted to the mitochondria. GmPPR576 was knocked out in soybean N8855 using CRISPR/Cas9. The T1 plants showed sterile pollen, and T2 plants produced few pods at maturity. The results indicate that GmPPR576 is the fertility restorer gene of NJCMS1A.
Multi-epoch searches for relativistic binary pulsars and fast transients in the Galactic Centre
Authors: Eatough R P , Torne P , Desvignes G , Kramer M , Karuppusamy R , Klein B , Spitler L G , Lee K J , Champion D J , Liu K , Wharton R S , Rezzolla L , Falcke H
Published: August 2021

The high stellar density in the central parsecs around the Galactic Centre makes it a seemingly favourable environment for finding relativistic binary pulsars. These include pulsars orbiting other neutron stars, stellar-mass black holes, or the central supermassive black hole, Sagittarius A*. Here, we present multi-epoch pulsar searches of the Galactic Centre at four observing frequencies, $4.85,\, 8.35,\, 14.6,\, 18.95\, {\rm GHz}$, using the Effelsberg 100-m radio telescope. Observations were conducted 1 yr prior to the discovery of, and during monitoring observations of, the Galactic Centre magnetar PSR J1745−2900. Our data analysis features acceleration searches on progressively shorter time series to maintain sensitivity to relativistic binary pulsars. The multi-epoch observations increase the likelihood of discovering transient or nulling pulsars, or ensure orbital phases are observed at which acceleration search methods work optimally. In ${\sim}147\, {\rm h}$ of separate observations, no previously undiscovered pulsars have been detected. Through calibration observations, we conclude this might be due to insufficient instantaneous sensitivity, caused by the intense continuum emission from the Galactic Centre, its large distance, and, at higher frequencies, the aggregate effect of steep pulsar spectral indices and atmospheric contributions to the system temperature. Additionally, we find that for millisecond pulsars in wide circular orbits $({\lesssim}800\, {\rm d})$ around Sagittarius A*, linear acceleration effects cannot be fully corrected in deep observations $(9\, {\rm h})$ with existing software tools. Pulsar searches of the Galactic Centre with the next generation of radio telescopes – such as MeerKat, ngVLA, and SKA1-mid – will have improved chances of uncovering this elusive population.
A high occurrence of nuclear star clusters in faint Coma galaxies, and the roles of mass and environment
Authors: Zanatta Emílio , Sánchez-Janssen Rubén , Chies-Santos Ana L , de Souza Rafael S , Blakeslee John P
Published: August 2021

We use deep high-resolution Hubble Space Telescope (HST)/Advanced Camera for Surveys (ACS) imaging of two fields in the core of the Coma Cluster to investigate the occurrence of nuclear star clusters (NSCs) in quiescent dwarf galaxies as faint as MI = −10 mag. We employ a hierarchical Bayesian logistic regression framework to model the faint end of the nucleation fraction (fn) as a function of both galaxy luminosity and environment. We find that fn is remarkably high in Coma: at MI ≈ −13 mag half of the cluster dwarfs still host prominent NSCs. Comparison with dwarf systems in nearby clusters and groups shows that, within the uncertainties, the rate at which the probability of nucleation varies with galaxy luminosity is nearly universal. On the other hand, the fraction of nucleated galaxies at fixed luminosity does exhibit an environmental dependence. More massive environments feature higher nucleation fractions and fainter values of the half-nucleation luminosity, which roughly scales with host halo virial mass as $L_{I,f_{\mathrm{ n}50}} \propto \mathcal {M}_{200}^{-0.2}$. Our results reinforce the role of galaxy luminosity/mass as a major driver of the efficiency of NSC formation and also indicate a clear secondary dependence on the environment, hence paving the way to more refined theoretical models.
A preliminary investigation of the response ofOctopus vulgaristo experimental stimuli in the wild
Authors: O'Brien Caitlin E , Di Miccoli Valentina , Fiorito Graziano
Published: August 2021

We tested the feasibility of conducting three standard behavioural tests modified from laboratory experiments with Octopus vulgaris in its natural habitat. Twenty wild octopuses from around the island of Capri (Mediterranean Sea) were filmed as two novel objects (a piece of white plastic and an identical piece of black plastic), an artificial prey item (a realistic rubber crab lure) and a conspecific (simulated by reflection in a mirror) were presented by experimenters on SCUBA. All of the objects elicited responses from at least 20% of the octopuses, particularly the artificial crab (50% made contact). This rate of engagement with objects (≤50%) is much lower than seen in analogous laboratory experiments (>78%). However, among those that did respond to an object, latencies to touch were in the same range as those observed in the laboratory. This demonstrates the feasibility of conducting simple behavioural assays with O. vulgaris in the field, opening the door to a more systematic approach to behavioural study of octopuses in the wild. Such studies will, however, require larger sample sizes than laboratory experiments in order to compensate for lower engagement rates.
Living Toys in Thomas Adès’s Living Toys: Transforming the Post-Tonal Topic
Authors: Donaldson James
Published: August 2021

Through an analysis of Thomas Adès’s (b. 1971) early chamber orchestra work Living Toys (1993), this article explores how pitch material associated with certain topics and topic-like objects can function as nodes of a transformational network. I build a network from two perspectives: first, three topics are related through Expansion (EXP) and Compression (CMP) transformations, and second, two further topics are related through common tonally suggestive intervals. Freed from tonal syntax, this tapestry of semantically rich objects provides an entrance to understanding the work’s harmony. But given the listener-dependence of topics—allied with transformational theory’s kaleidoscopic flexibility—these two complementary viewpoints model multiple simultaneous understandings of the harmonic language, depending on the objects prioritized.
Intraventricular Tissue Plasminogen Activator and Shunt Dependency in Aneurysmal Subarachnoid Hemorrhage Patients With Cast Ventricles
Authors: Catapano Joshua S , Rumalla Kavelin , Karahalios Katherine , Srinivasan Visish M , Labib Mohamed A , Cole Tyler S , Baranoski Jacob F , Rutledge Caleb , Rahmani Redi , Jadhav Ashutosh P , Ducruet Andrew F , Albuquerque Felipe C , Zabramski Joseph M , Lawton Michael T
Published: August 2021

BACKGROUND

Patients with intraventricular hemorrhage (IVH) are at higher risk of hydrocephalus requiring an external ventricular drain and long-term ventriculoperitoneal shunt placement.

OBJECTIVE

To investigate whether intraventricular tissue plasminogen activator (tPA) administration in patients with ventricular casting due to IVH reduces shunt dependence.

METHODS

Patients from the Post–Barrow Ruptured Aneurysm Trial (PBRAT) database treated for aneurysmal subarachnoid hemorrhage (aSAH) from August 1, 2010, to July 31, 2019, were retrospectively reviewed. Patients with and without IVH were compared. A second analysis compared IVH patients with and without ventricular casting. A third analysis compared patients with ventricular casting with and without intraventricular tPA treatment. The primary outcome was chronic hydrocephalus requiring permanent shunt placement.

RESULTS

Of 806 patients hospitalized with aSAH, 561 (69.6%) had IVH. IVH was associated with a higher incidence of shunt placement (25.7% vs 4.1%, P < .001). In multivariable logistic regression analysis, IVH was independently associated with increased likelihood of shunt placement (odds ratio [OR]: 7.8, 95% CI: 3.8-16.2, P < .001). Generalized ventricular casting was present in 80 (14.3%) patients with IVH. In a propensity-score adjusted analysis, generalized ventricular casting was an independent predictor of shunt placement (OR: 3.0, 95% CI: 1.8-4.9, P < .001) in patients with IVH. Twenty-one patients with ventricular casting received intraventricular tPA. These patients were significantly less likely to require a shunt (OR: 0.30, 95% CI: 0.010-0.93, P = .04).

CONCLUSION

Ventricular casting in aSAH patients was associated with an increased risk of chronic hydrocephalus and shunt dependency. However, this risk decreased with the administration of intraventricular tPA.
General synthesis of 2D rare-earth oxide single crystals with tailorable facets
Authors: Li Linyang , Lu Fangyun , Xiong Wenqi , Ding Yu , Lu Yangyi , Xiao Yao , Tong Xin , Wang Yao , Jia Shuangfeng , Wang Jianbo , Mendes Rafael G , Rümmeli Mark H , Yuan Shengjun , Zeng Mengqi , Fu Lei
Published: August 2021

Two-dimensional (2D) rare-earth oxides (REOs) are a large family of materials with various intriguing applications and precise facet control is essential for investigating new properties in the 2D limit. However, a bottleneck remains with regard to obtaining their 2D single crystals with specific facets because of the intrinsic non-layered structure and disparate thermodynamic stability of different facets. Herein, for the first time, we achieve the synthesis of a wide variety of high-quality 2D REO single crystals with tailorable facets via designing a hard-soft-acid-base couple for controlling the 2D nucleation of the predetermined facets and adjusting the growth mode and direction of crystals. Also, the facet-related magnetic properties of 2D REO single crystals were revealed. Our approach provides a foundation for further exploring other facet-dependent properties and various applications of 2D REO, as well as inspiration for the precise growth of other non-layered 2D materials.
Estimating the Risk of Deep Brain Stimulation in the Modern Era: 2008 to 2020
Authors: Koh Eun Jeong , Golubovsky Joshua L , Rammo Richard , Momin Arbaz , Walter Benjamin , Fernandez Hubert H , Machado Andre , Nagel Sean J
Published: August 2021

BACKGROUND

Deep brain stimulation (DBS) was first approved by the United States Food and Drug Administration in 1997. Although the fundamentals of DBS remain the same, hardware, software, and imaging have evolved significantly.

OBJECTIVE

To test our hypothesis that the aggregate complication rate in the medical literature in the past 12 years would be lower than what is often cited based on early experience with DBS surgery.

METHODS

PubMed, PsycINFO, and EMBASE were queried for studies from 2008 to 2020 that included patients treated with DBS from 2007 to 2019. This yielded 34 articles that evaluated all complications of DBS surgery, totaling 2249 patients.

RESULTS

The overall complication rate in this study was 16.7% per patient. There was found to be a systemic complication rate of 0.89%, intracranial complication rate of 2.7%, neurological complication rate of 4.6%, hardware complication rate of 2.2%, and surgical site complication rate of 3.4%. The infection and erosion rate was 3.0%.

CONCLUSION

This review suggests that surgical complication rates have decreased since the first decade after DBS was first FDA approved. Understanding how to minimize complications from the inception of a technique should receive more attention.
The case for free markets
Authors: Philippon Thomas
Published: August 2021

I argue that our failure to nurture free markets is partly responsible for the negative attitudes of many citizens towards capitalism. In doing so, I also revisit the broader argument that the old Washington consensus is dead.
Long-term acclimation to cadmium exposure reveals extensive phenotypic plasticity in Chlamydomonas
Authors: Thiriet-Rupert Stanislas , Gain Gwenaëlle , Jadoul Alice , Vigneron Amandine , Bosman Bernard , Carnol Monique , Motte Patrick , Cardol Pierre , Nouet Cécile , Hanikenne Marc
Published: August 2021

Increasing industrial and anthropogenic activities are producing and releasing more and more pollutants in the environment. Among them, toxic metals are one of the major threats for human health and natural ecosystems. Because photosynthetic organisms play a critical role in primary productivity and pollution management, investigating their response to metal toxicity is of major interest. Here, the green microalga Chlamydomonas (Chlamydomonas reinhardtii) was subjected to short (3 d) or chronic (6 months) exposure to 50 µM cadmium (Cd), and the recovery from chronic exposure was also examined. An extensive phenotypic characterization and transcriptomic analysis showed that the impact of Cd on biomass production of short-term (ST) exposed cells was almost entirely abolished by long-term (LT) acclimation. The underlying mechanisms were initiated at ST and further amplified after LT exposure resulting in a reversible equilibrium allowing biomass production similar to control condition. This included modification of cell wall-related gene expression and biofilm-like structure formation, dynamics of metal ion uptake and homeostasis, photosynthesis efficiency recovery and Cd acclimation through metal homeostasis adjustment. The contribution of the identified coordination of phosphorus and iron homeostasis (partly) mediated by the main phosphorus homeostasis regulator, Phosphate Starvation Response 1, and a basic Helix-Loop-Helix transcription factor (Cre05.g241636) was further investigated. The study reveals the highly dynamic physiological plasticity enabling algal cell growth in an extreme environment.
3D bioprinting of conductive hydrogel for enhanced myogenic differentiation
Authors: Wang Ying , Wang Qingshuai , Luo Shengchang , Chen Zhoujiang , Zheng Xiang , Kankala Ranjith Kumar , Chen Aizheng , Wang Shibin
Published: August 2021

Recently, hydrogels have gained enormous interest in three-dimensional (3D) bioprinting toward developing functional substitutes for tissue remolding. However, it is highly challenging to transmit electrical signals to cells due to the limited electrical conductivity of the bioprinted hydrogels. Herein, we demonstrate the 3D bioprinting-assisted fabrication of a conductive hydrogel scaffold based on poly-3,4-ethylene dioxythiophene (PEDOT) nanoparticles (NPs) deposited in gelatin methacryloyl (GelMA) for enhanced myogenic differentiation of mouse myoblasts (C2C12 cells). Initially, PEDOT NPs are dispersed in the hydrogel uniformly to enhance the conductive property of the hydrogel scaffold. Notably, the incorporated PEDOT NPs showed minimal influence on the printing ability of GelMA. Then, C2C12 cells are successfully encapsulated within GelMA/PEDOT conductive hydrogels using 3D extrusion bioprinting. Furthermore, the proliferation, migration and differentiation efficacies of C2C12 cells in the highly conductive GelMA/PEDOT composite scaffolds are demonstrated using various in vitro investigations of live/dead staining, F-actin staining, desmin and myogenin immunofluorescence staining. Finally, the effects of electrical signals on the stimulation of the scaffolds are investigated toward the myogenic differentiation of C2C12 cells and the formation of myotubes in vitro. Collectively, our findings demonstrate that the fabrication of the conductive hydrogels provides a feasible approach for the encapsulation of cells and the regeneration of the muscle tissue.
Chemically induced hypoxia by dimethyloxalylglycine (DMOG)-loaded nanoporous silica nanoparticles supports endothelial tube formation by sustained VEGF release from adipose tissue-derived stem cells
Authors: Zippusch Sarah , Besecke Karen F W , Helms Florian , Klingenberg Melanie , Lyons Anne , Behrens Peter , Haverich Axel , Wilhelmi Mathias , Ehlert Nina , Böer Ulrike
Published: August 2021

Inadequate vascularization leading to insufficient oxygen and nutrient supply in deeper layers of bioartificial tissues remains a limitation in current tissue engineering approaches to which pre-vascularization offers a promising solution. Hypoxia triggering pre-vascularization by enhanced vascular endothelial growth factor (VEGF) expression can be induced chemically by dimethyloxalylglycine (DMOG). Nanoporous silica nanoparticles (NPSNPs, or mesoporous silica nanoparticles, MSNs) enable sustained delivery of molecules and potentially release DMOG allowing a durable capillarization of a construct. Here we evaluated the effects of soluble DMOG and DMOG-loaded NPSNPs on VEGF secretion of adipose tissue-derived stem cells (ASC) and on tube formation by human umbilical vein endothelial cells (HUVEC)-ASC co-cultures. Repeated doses of 100 µM and 500 µM soluble DMOG on ASC resulted in 3- to 7-fold increased VEGF levels on day 9 (P < 0.0001). Same doses of DMOG-NPSNPs enhanced VEGF secretion 7.7-fold (P < 0.0001) which could be maintained until day 12 with 500 µM DMOG-NPSNPs. In fibrin-based tube formation assays, 100 µM DMOG-NPSNPs had inhibitory effects whereas 50 µM significantly increased tube length, area and number of junctions transiently for 4 days. Thus, DMOG-NPSNPs supported endothelial tube formation by upregulated VEGF secretion from ASC and thus display a promising tool for pre-vascularization of tissue-engineered constructs. Further studies will evaluate their effect in hydrogels under perfusion.
Comparison of salivary gland MRI and ultrasonography findings among patients with Sjögren’s syndrome over a wide age range
Authors: Takagi Yukinori , Sasaki Miho , Eida Sato , Katayama Ikuo , Hashimoto Kunio , Nakamura Hideki , Shimizu Toshimasa , Morimoto Shimpei , Kawakami Atsushi , Sumi Misa
Published: August 2021

Objectives

This retrospective study compared MRI and US findings among patients with SS over a wide age range.

Methods

Ninety patients with SS aged 8–84 years who had undergone both MRI and US examinations were divided into four groups according to age, as follows: <18 years (juvenile SS, JSS), 9 patients; 18–39 years, 12 patients; 40–69 years, 53 patients; >69 years, 16 patients. Imaging findings of parotid glands (PGs) and submandibular glands (SMGs) were compared among the four groups. Furthermore, the relationships within and between imaging findings and various clinical findings were examined.

Results

On MRI, patients with JSS commonly exhibited multiple high-intensity spots in the PGs on MR sialography and fat-suppressed T2-weighted imaging. With increasing SS group age, the frequencies and numbers of the high-intensity spots were lower. Fat areas on MRI and hyperechoic bands on US were rarely observed in the PGs and SMGs of patients with JSS, whereas they were more common in patients with adult SS. In addition, the presence of hyperechoic bands on US, the presence of fat areas on MRI, and decreased salivary flow were associated with one another.

Conclusion

Salivary gland imaging findings in patients with JSS were characterized by punctate sialectasis, whereas those findings in patients with adult SS were characterized by fatty degeneration. Distinct findings in patients with JSS and adult SS are likely to reflect differences in glandular lesion stage. MRI and US are presumably useful for evaluation of glandular lesion severity during follow-up.
Hyperuricemia enhances procoagulant activity of vascular endothelial cells through TMEM16F regulated phosphatidylserine exposure and microparticle release
Authors: Yu Hongyin , Wang Zelong , Li Zhanni , An Yao , Yan Meishan , Ji Shuting , Xu Minghui , Wang Liqiu , Dong Weijun , Shi Jialan , Gao Chunyan
Published: August 2021

The link between serum uric acid (SUA) and the risk of venous thromboembolism (VTE) is well established. Recent data suggested a causative role of UA in endothelial cells (ECs) dysfunction. However, the molecular mechanism of high UA on thrombogenesis is unknown. We investigate whether high UA induce phosphatidylserine (PS) externalization and microparticle (MP) shedding in cultured EC, and contribute to UA‐induced hypercoagulable state. In the present study, we demonstrate that UA induces PS exposure and EMP release of EC in a concentration‐ and time‐dependent manner, which enhances the procoagulant activity (PCA) of EC and inhibited over 90% by lactadherin in vitro. Furthermore, hyperuricemic rat model was used to evaluate the development of thrombi following by flow stasis in the inferior vena cava (IVC). Hyperuricemia group is more likely to form large and hard thrombi compared with control. Importantly, we found that TMEM16F expression is significantly upregulated in UA‐treated EC, which is crucial for UA‐induced PS exposure and MP formation. Additionally, UA increases the generation of reactive oxygen species (ROS), lipid peroxidation, and cytosolic Ca2+ concentration in EC, which might contribute to increased TMEM16F expression. Using confocal microscopy, we also observed disruption of the actin cytoskeleton, suggesting that depolymerization of actin filaments might be required for TMEM16F activation and followed by PS exposure and membrane blebbing in UA‐treated EC. Our results demonstrate a thrombotic role of EC in hyperuricemia through TMEM16F‐mediated PS exposure and MPs release.
Endoglycan (PODXL2) is proteolytically processed by ADAM10 (a disintegrin and metalloprotease 10) and controls neurite branching in primary neurons
Authors: Hsia Hung‐En , Tüshaus Johanna , Feng Xiao , Hofmann Laura I. , Wefers Benedikt , Marciano Denise K. , Wurst Wolfgang , Lichtenthaler Stefan F.
Published: August 2021

Cell adhesion is tightly controlled in multicellular organisms, for example, through proteolytic ectodomain shedding of the adhesion‐mediating cell surface transmembrane proteins. In the brain, shedding of cell adhesion proteins is required for nervous system development and function, but the shedding of only a few adhesion proteins has been studied in detail in the mammalian brain. One such adhesion protein is the transmembrane protein endoglycan (PODXL2), which belongs to the CD34‐family of highly glycosylated sialomucins. Here, we demonstrate that endoglycan is broadly expressed in the developing mouse brains and is proteolytically shed in vitro in mouse neurons and in vivo in mouse brains. Endoglycan shedding in primary neurons was mediated by the transmembrane protease a disintegrin and metalloprotease 10 (ADAM10), but not by its homolog ADAM17. Functionally, endoglycan deficiency reduced the branching of neurites extending from primary neurons in vitro, whereas deletion of ADAM10 had the opposite effect and increased neurite branching. Taken together, our study discovers a function for endoglycan in neurite branching, establishes endoglycan as an ADAM10 substrate and suggests that ADAM10 cleavage of endoglycan may contribute to neurite branching.
The Impact of a PDMP-EHR Data Integration Combined With Clinical Decision Support on Opioid and Benzodiazepine Prescribing Across Clinicians in a Metropolitan Area
Authors: Calcaterra Susan L. , Butler Maria , Olson Katie , Blum Joshua
Published: August 2021

Introduction

Despite inconclusive evidence that prescription drug monitoring programs (PDMP) reduce opioid-related mortality, guidelines recommend PDMP review with opioid prescribing. Some reported barriers to use include time-consuming processes to obtain data and workflow disruptions.

Methods

We provided access to a PMDP-electronic health record (EHR) integrated program to 123 clinicians in one healthcare system. Remaining clinicians within the healthcare system and metropolitan area did not receive PDMP-EHR integration program access. We identified changes in opioid prescribing by linking prescription data available in the state PMDP database to individual clinicians. The primary outcome was change in receipt of high dose opioid prescriptions (>90 mg morphine equivalents) by Colorado residents before and after program integration. Secondary outcomes included changes in long-acting opioid receipt and overlapping opioid and benzodiazepine prescription days. Next, we surveyed clinicians to assess their perspectives on PDMP data acquisition before and after PDMP-EHR integration program access.

Results

High-dose opioid receipt decreased significantly across all 3 clinician groups [PDMP-EHR integration program access (27.6%, to 6.9%, P < 0.001); no program access in the same healthcare system (4.8% to 2.9%, P < 0.001), and no program access across the metropolitan area (13.5% to 6.1%, P < 0.001)]. Clinicians reported improved access to PDMP data using the PDMP-EHR integrated program compared to the state PDMP website (98.6%).

Conclusions

Further study of PDMP-EHR integration programs on patient and clinician outcomes may illuminate the role of this technology in public health and in clinical practice.
The added value of clinical faculty in building effective academic–practice partnerships
Authors: Padilla Blanca Iris , Evans-Krieder Kathryn
Published: August 2021

Clinical faculty are entrusted with providing high-quality education for nurse practitioner (NP) students while engaging in clinical practice, scholarship, and service. To provide NP students with utmost clinical training and education, clinical faculty should maintain a clinical practice in their area of expertise. The American Association of Colleges of Nursing and the National Organization of Nurse Practitioner Faculties have asserted that nursing faculty providing clinical education must be expert clinicians. The challenge many clinical faculty face is maintaining a practice while balancing the expectations of the faculty role. This article highlights the value of clinical faculty in a large private academic institution as essential members in building partnerships, supporting preceptors, and enhancing NP students' clinical training. A critical aspect of the partnership was the unique role and the added value the clinical faculty member provided in building and expanding community partnerships.
External Evaluation of the Clinical Nurse Transition Program
Authors: Seimetz John
Published: August 2021

Evaluating Nurse Transition programs has undergone an evolutionary process to more accurately report outcomes. Based on a previous work, this project used the Clinical Nurse Transition Program-Evaluation Tool to externally evaluate the effectiveness of nurse transition programs within the U.S. Army Nurse Corps. The results support the belief that a new graduate nurse performs better at 24 weeks within the Clinical Nurse Transition Program than at 12 weeks. In addition, new graduates perform above standards 6 months postgraduation.
Coexisting Epithelioid Trophoblastic Tumor and Placental Site Trophoblastic Tumor During Asymptomatic Relapse: A Case Report and Literature Review
Authors: Aiob Ala , Cohen Hector I. , Naskovica Karina , Tendler Renee , Sharon Avishalom , Bornstein Jacob
Published: August 2021

Gestational trophoblastic neoplasms are a group of trophoblastic tumors that include choriocarcinoma (CC), epithelioid trophoblastic tumors (ETTs), and placental site trophoblastic tumors (PSTTs). Mixed gestational trophoblastic neoplasms include combinations of CCs with ETTs and/or PSTTs; combinations of ETTs and PSTTs have also been described. This report describes the case of a 49-yr-old female with mixed ETT and PSTT discovered due to menstrual delay and a positive beta-human chorionic gonadotropin in serum 11 yr after normal pregnancy; it is an asymptomatic recurrence of the neoplasm after 2 yr. Moreover, only the ETT recurred without evidence of PSTT by biopsy and without any increase in human chorionic gonadotropin levels, even though human chorionic gonadotropin was positive in the first onset of the disease. We also reviewed published English literature, which revealed that there are only 36 cases of mixed trophoblastic tumors to date, of which pure mixed ETT and PSTT were reported only in four cases including our case. The most common combination is CC admixed with an ETT (52%), followed by CC with PSTT in 30.5%. CC admixed with an ETT and/or PSTT account for 83% of the cases, of which pure mixed ETT and PSTT were reported only in 4 cases (11%). The rarity of this condition entails reporting of all cases to facilitate future research and clinical management.