bluuebunny/crossref_metadata_2025 huggingface dataset:
Septal myectomy with mitral valve surgery in patients after alcohol septal ablation
Authors: Rudenko Kostiantyn V , Lazoryshynets Vasyl V , Nevmerzhytska Lidiia O , Tregubova Mariia O , Danchenko Polina A
Published: January 2022

OBJECTIVES

We studied 16 patients after failed alcohol septal ablation who underwent extended septal myectomy to analyse the results of surgical correction and identify technical pitfalls the surgeons may be confronted by.

METHODS

Between October 2017 and March 2019, 16 patients underwent surgical extended septal myectomy with accompanying anomalous secondary chordae resection, papillary muscles mobilization [in 9 (56.3%) patients], and anterior mitral leaflet plication after previously failed alcohol septal ablation. Routine preoperative computed tomography or cardiac magnetic resonance planning and intraoperative transoesophageal echocardiography were performed in each of the studied patients. Major technical features were identified and complemented during septal myectomy of the calcified interventricular septum.

RESULTS

The mean age of the studied patients accounted 50.5 ± 14.6, median—54; males—5 (31.3%). Mean cross-clamp time accounted 52 ± 7.2 min. Calcified basal interventricular septum was identified in 2 (12.5%) patients. No iatrogenic ventricular septal defect (0%) was made during surgical correction. Peak systolic pressure gradient decreased from 86 (interquartile range: 75–104.7) to 20 (16–22) mmHg (P< 0.001). No patients with moderate or severe mitral regurgitation were identified, whereas before the procedure, the number of those accounted 13 (81.2%) individuals. In-hospital and overall mortality after septal myectomy accounted 0%.

CONCLUSIONS

Extended septal myectomy in patients who previously underwent alcohol septal ablation is a safe procedure that affects all pathological manifestations of the disease. Routine preoperative computed tomography or cardiac magnetic resonance provides detailed anatomy of the anomalous left ventricle and subvalvular structures and allows to measure the extension of myectomy preventing the occurrence of iatrogenic ventricular septal defect. Septal myectomy of the calcified interventricular septum requires avoidance of ‘one-piece technique’ since fragmental myectomy allows visually control the adequacy of the left ventricle outflow tract release.
Risk factors for stroke after total aortic arch replacement using the frozen elephant trunk technique
Authors: Berger Tim , Kreibich Maximilian , Mueller Felix , Breurer-Kellner Lara , Rylski Bartosz , Kondov Stoyan , Schröfel Holger , Pingpoh Clarence , Beyersdorf Friedhelm , Siepe Matthias , Czerny Martin
Published: January 2022

OBJECTIVES

This study aimed to analyse risk factors for postoperative stroke, evaluate the underlying mechanisms and report on outcomes of patients suffering a postoperative stroke after total aortic arch replacement using the frozen elephant trunk technique.

METHODS

Two-hundred and fifty patients underwent total aortic arch replacement via the frozen elephant trunk technique between March 2013 and November 2020 for acute and chronic aortic pathologies. Postoperative strokes were evaluated interdisciplinarily by a cardiac surgeon, neurologist and radiologist, and subclassified to each’s cerebral territory. We conducted a logistic regression analysis to identify any predictors for postoperative stroke.

RESULTS

Overall in-hospital was mortality 10% (25 patients, 11 with a stroke). A symptomatic postoperative stroke occurred in 42 (16.8%) of our cohort. Eight thereof were non-disabling (3.3%), whereas 34 (13.6%) were disabling strokes. The most frequently affected region was the arteria cerebri media. Embolism was the primary underlying mechanism (n = 31; 73.8%). Mortality in patients with postoperative stroke was 26.2%. Logistic regression analysis revealed age over 75 (odds ratio = 3.25; 95% confidence interval 1.20–8.82; P = 0.021), a bovine arch (odds ratio = 4.96; 95% confidence interval 1.28–19.28; P = 0.021) and an acute preoperative neurological deficit (odds ratio = 19.82; 95% confidence interval 1.09–360.84; P = 0.044) as predictors for postoperative stroke.

CONCLUSIONS

Stroke after total aortic arch replacement using the frozen elephant trunk technique remains problematic, and most lesions are of embolic origin. Refined organ protection strategies, and sophisticated monitoring are mandatory to reduce the incidence of postoperative stroke, particularly in older patients presenting an acute preoperative neurological deficit or bovine arch.
Operative versus non-operative management of rib fractures in flail chest after cardiopulmonary resuscitation manoeuvres
Authors: Dorn Patrick , Pfister Selina , Oberhaensli Simone , Gioutsos Konstantinos , Haenggi Matthias , Kocher Gregor J
Published: January 2022

OBJECTIVES

Blunt chest trauma after mechanical resuscitation manoeuvres appears to have a significant impact on the often complicated course. Due to a lack of data in the literature, the purpose of this study was to investigate the feasibility and immediate outcome of chest wall stabilization for flail chest in this vulnerable patient population.

METHODS

We retrospectively reviewed the medical records of patients after cardiopulmonary resuscitation between January 2014 and December 2018 who were diagnosed with flail chest. We attempted to compare patients after surgery with those after conservative treatment.

RESULTS

Of a total of 56 patients with blunt chest trauma after mechanical resuscitation and after coronary angiography, 25 were diagnosed with flail chest. After the exclusion of 2 patients because of an initial decision to palliate, 13 patients after surgical stabilization could be compared with 10 patients after conservative therapy. Although there was no significant difference in the total duration of ventilatory support, there was a significant advantage when the time after stabilization to extubation was compared with the duration of ventilation in the conservative group. The presence of pulmonary contusion, poor Glasgow Coma Scale score or the development of pneumonia negatively affected the outcome, but additional sternal fracture did not.

CONCLUSIONS

Surgical stabilization for chest wall instability is well tolerated even by this vulnerable patient population. Our results should be used for further randomized controlled approaches. It is necessary to evaluate the situation with all parameters in an interdisciplinary manner and to decide on a possible surgical therapy at an early stage if possible.
Surgical smoke: modern mobile smoke evacuation systems improve occupational safety in the operating theatre
Authors: Gioutsos Konstantinos , Nguyen Thanh-Long , Biber Ulrich , Enderle Markus D , Koss Abigail , Kocher Gregor J
Published: January 2022

OBJECTIVES

Evaluation of smoke capture efficiency of different mobile smoke evacuation devices with respect to volatile organic compounds and their noise emission.

METHODS

Electrosurgical incisions were performed on fresh porcine liver in an operating room with vertical laminar flow. The generated surgical smoke was analysed with proton-transfer-reaction mass spectrometry with and without the use of a mobile smoke evacuation system consisting of a smoke evacuator machine, a suction hose and a handpiece. The inlet of the mass spectrometer was positioned 40 cm above the specimen. Various devices were compared: a hard plastic funnel, a flexible foam funnel, an on-tip integrated aspirator of an electrosurgical knife and a standard secretion suction (Yankauer). Also, sound levels were measured at a distance of 40 cm from the handpieces’ inlet.

RESULTS

The smoke capture efficiency of the secretion suction was only 53%, while foam funnel, plastic funnel and integrated aspirator were all significantly more effective with a clearance of 95%, 91% and 91%, respectively. The mean sound levels were 68 and 59 A-weighted decibels with the plastic and foam funnel, respectively, 66 A-weighted decibels with the integrated aspirator and 63 A-weighted decibels with the secretion suction.

CONCLUSIONS

Carcinogenic, mutagenic and reprotoxic volatile organic compounds in surgical smoke can be efficiently reduced by mobile smoke evacuation system, providing improved protection for medical personnel. Devices specifically designed for smoke evacuation are more efficient than standard suction tools. Noise exposure for the surgeon was lowest with the flexible foam funnel and higher with the other handpieces tested.
Robotic-assisted lobectomy after bilateral lung transplantation
Authors: Romero-Vielva Laura , Ascanio-Gosling Fernando , González-Tallada Anna , Rosado-Rodríguez Joel
Published: January 2022

A 67-year-old woman diagnosed with a lung nodule on the left upper lobe was referred for surgical treatment. She had undergone a bilateral lung transplant in 2014. A robotic-assisted lobectomy with mediastinal lymph node dissection was performed. Final pathology revealed a pT3N0M0 Micropapillary Adenocarcinoma. The patient is alive and disease-free 13 months after the operation. This case report and video illustrate the safety and feasibility of a robotic-assisted lobectomy in a lung transplant recipient.
Neurostructural Differences in Adolescents With Treatment-Resistant Depression and Treatment Effects of Transcranial Magnetic Stimulation
Authors: Seewoo Bhedita J , Rodger Jennifer , Demitrack Mark A , Heart Karen L , Port John D , Strawn Jeffrey R , Croarkin Paul E
Published: January 2022

Background

Despite its morbidity and mortality, the neurobiology of treatment-resistant depression (TRD) in adolescents and the impact of treatment on this neurobiology is poorly understood.

Methods

Using automatic segmentation in FreeSurfer, we examined brain magnetic resonance imaging baseline volumetric differences among healthy adolescents (n = 30), adolescents with major depressive disorder (MDD) (n = 19), and adolescents with TRD (n = 34) based on objective antidepressant treatment rating criteria. A pooled subsample of adolescents with TRD were treated with 6 weeks of active (n = 18) or sham (n = 7) 10-Hz transcranial magnetic stimulation (TMS) applied to the left dorsolateral prefrontal cortex. Ten of the adolescents treated with active TMS were part of an open-label trial. The other adolescents treated with active (n = 8) or sham (n = 7) were participants from a randomized controlled trial.

Results

Adolescents with TRD and adolescents with MDD had decreased total amygdala (TRD and MDD: −5%, P = .032) and caudal anterior cingulate cortex volumes (TRD: −3%, P = .030; MDD: −.03%, P = .041) compared with healthy adolescents. Six weeks of active TMS increased total amygdala volumes (+4%, P < .001) and the volume of the stimulated left dorsolateral prefrontal cortex (+.4%, P = .026) in adolescents with TRD.

Conclusions

Amygdala volumes were reduced in this sample of adolescents with MDD and TRD. TMS may normalize this volumetric finding, raising the possibility that TMS has neurostructural frontolimbic effects in adolescents with TRD. TMS also appears to have positive effects proximal to the site of stimulation.
Pharmacists supporting athletes: a scoping review exploring the knowledge, role and responsibilities of pharmacists in preventing the unintentional use of prohibited substances by athletes
Authors: Greenbaum Deborah H , McLachlan Andrew J , Roubin Rebecca H , Chaar Betty B
Published: January 2022

Background

Following the establishment of the World Anti-Doping Agency in 1999, the International Pharmacy Federation (FIP) published guidelines – The Role of the Pharmacist in the Fight against Doping in Sport (2014) – intended for implementation into national standards of practice, to clarify pharmacists’ roles in supporting athletes. Despite 7 years since the publication of these guidelines, the extent of practice and knowledge regarding sport pharmacy remains unclear.

Objectives

To explore the literature to ascertain knowledge held by pharmacists and pharmacy students regarding anti-doping and to determine current/potential roles and responsibilities for pharmacists in the dissemination of information about, and the reduction in unintentional use of, prohibited substances by athletes.

Method

A literature search of five databases utilising terms such as athlete, performance-enhancing and pharmacist was undertaken. Relevant articles published since 1999 were searched for knowledge, roles and responsibilities of pharmacists.

Key findings

We identified 16 research studies outlining knowledge, as well as roles and responsibilities of pharmacists in assisting athletes. Pharmacists reportedly had limited knowledge of anti-doping organisations and prohibited substances. Roles identified included counselling, education, advice about prohibited substances and dispensing. Responsibilities included medication review and assisting athletes to avoid unintentional ingestion of prohibited substances.

Conclusion

Pharmacists, by training, can play a role in providing accurate medication-related information to athletes to avoid prohibited substances. Key barriers identified were pharmacists’ lack of knowledge and the absence of guidelines articulating specific roles and responsibilities for pharmacists, highlighting the need for educational programmes and inclusion of specific responsibilities in national guidelines.
Emergence of rare carbapenemases (FRI, GES-5, IMI, SFC and SFH-1) in Enterobacterales isolated from surface waters in Japan
Authors: Gomi Ryota , Matsumura Yasufumi , Tanaka Michio , Ihara Masaru , Sugie Yoshinori , Matsuda Tomonari , Yamamoto Masaki
Published: January 2022

Objectives

Carbapenemase-producing Enterobacterales (CPE) pose serious threats to public health. Compared with clinical CPE, the genetic characteristics of environmental CPE are not well understood. This study aimed to characterize the genetic determinants of carbapenem resistance in CPE isolated from environmental waters in Japan.

Methods

Eighty-five water samples were collected from rivers and a lake in Japan. CPE were identified using selective media, and genome sequencing was performed for the obtained isolates (n = 21).

Results

Various rare/novel carbapenemases were identified: GES-5 in Raoultella planticola (n = 1), FRI-8 and FRI-11 in Enterobacter spp. (n = 8), IMI-22 and IMI-23 in Serratia ureilytica (n = 3), and SFC-1, SFC-2 and SFH-1 in Serratia fonticola (n = 9). Genomes of 11 isolates could be closed, allowing the elucidation of the genetic contexts of the carbapenemase genes. The blaGES-5 gene was located within a class 1 integron, In2071 (cassette array, blaGES-5-aacA3-aadA16), on a 33 kb IncP6 plasmid. The blaFRI-8 genes were carried on IncFII(Yp) plasmids ranging in size from 191 kb to 244 kb, and the blaFRI-11 genes were carried on 70 kb and 74 kb IncFII(pECLA)/IncR plasmids. The blaIMI-22 and blaIMI-23 genes were co-located on a 107 kb plasmid. The blaSFC and blaSFH-1 genes were found on putative genomic islands inserted at tRNA-Phe genes in chromosomes.

Conclusions

This study revealed the presence of rare/novel carbapenemases among CPE in aquatic environments, suggesting that the environment may act as a potential reservoir of these minor carbapenemases.
Biology and Management of Small Hive Beetles (Coleoptera: Nitidulidae): A Pest of European Honey Bee (Hymenoptera: Apidae) Colonies
Authors: Roth Morgan A , Wilson James M , Gross Aaron D
Published: January 2022

Small hive beetle (Aethina tumida Murray) control has become an issue of increasing importance for North American apiculturists throughout the past two decades. Aethina tumida was discovered in Florida in 1989, presumably transported from its native habitat of sub-Saharan Africa through the shipment of European honey bee (Apis mellifera L) queens. Estimates of damage from A. tumida were as high as $3 million annually in the United States by the year 2004, and A. tumida was found in nearly every state by 2008. When adult beetles emerge from pupation in soil surrounding the hive, they are attracted to A. mellifera hives through a variety of pheromones and volatile organic compounds from bees and hive products. Aethina tumida larvae and adults consume hive products and bee brood, generating fermenting waste (or slime), which can eventually lead to hive abandonment in cases of severe infestation. Pest management efforts for A. tumida have focused on trapping adults, applying lime, diatomaceous earth, pyrethroid soil drenches, and entomopathogenic nematodes to the soil surrounding A. mellifera hives. Understanding the biology and life history of A. tumida, along with current control methods, can aid apiculturists in making informed integrated pest management decisions. Additionally, understanding critical knowledge gaps in the current research is an important step in identifying promising future management tactics in the ongoing efforts to manage this invasive pest.
FOLFIRINOX as Initial Treatment for Localized Pancreatic Adenocarcinoma: A Retrospective Analysis by the Trans-Atlantic Pancreatic Surgery Consortium
Authors: Janssen Quisette P , van Dam Jacob L , Doppenberg Deesje , Prakash Laura R , van Eijck Casper H J , Jarnagin William R , O’ Reilly Eileen M , Paniccia Alessandro , Besselink Marc G , Katz Matthew H G , Tzeng Ching-Wei D , Wei Alice C , Zureikat Amer H , Groot Koerkamp Bas ,   for the Trans-Atlantic Pancreatic Surgery (TAPS) Consortium
Published: January 2022

Background

Large pragmatic studies of patients who received 5-fluorouracil with leucovorin, irinotecan, and oxaliplatin ([m]FOLFIRINOX) as initial treatment for localized pancreatic ductal adenocarcinoma (PDAC) are lacking. This study aimed to provide realistic estimates of oncologic outcomes in these patients.

Methods

This international retrospective cohort study included all consecutive patients presenting with localized PDAC who received at least 1 cycle of (m)FOLFIRINOX as initial treatment in 5 referral centers from the United States and the Netherlands (2012-2019). Primary outcome was median overall survival (OS), calculated from the date of tissue diagnosis, assessed using Kaplan-Meier estimates. Log-rank test was used to compare OS between groups. A Cox proportional hazards regression model was used to assess prognostic baseline factors for OS. All statistical tests were 2-sided.

Results

Overall, 1835 patients were included, of whom 958 (52.2%) had locally advanced (LA), 531 (28.9%) had borderline resectable (BR), and 346 (18.9%) had potentially resectable (PR) PDAC. The median number of (m)FOLFIRINOX cycles was 6 (interquartile range = 4-8). Subsequent treatment included second chemotherapy (12.9%), radiotherapy (49.0%), and resection (37.9%). The resection rate was 17.6% for LA, 53.1% for BR, and 70.5% for PR PDAC (P < .001). The margin-negative resection rate (>1 mm) was 55.2% for LA, 62.6% for BR, and 79.2% for PR PDAC (P < .001). The median OS was 18.7 months (95% confidence interval [CI] = 17.7 to 19.9 months) for LA, 23.2 months (95% CI = 21.0 to 25.7 months) for BR, and 31.2 months (95% CI = 26.2 to 36.6 months) for PR PDAC (P < .001). The median OS for 695 patients who underwent a resection was 38.3 months (95% CI = 36.1 to 42.0 months). Independent prognostic factors at baseline for worse OS were more advanced stage, worse performance status, baseline carbohydrate antigen (CA) 19-9 > 500 U/mL, and body mass index ≤18.5 kg/m2.

Conclusions

This large international cohort study provides realistic estimates of resection rates and survival in patients with LA, BR, and PR PDAC who started (m)FOLFIRINOX treatment in PDAC referral centers.
Structural Effects on Implicature Calculation
Authors: Ander Mendia Jon
Published: January 2022

This paper provides an investigation of Ignorance Inferences by looking at the superlative modifier at least. The formal properties of these inferences are characterized in terms of the epistemic conditions that they impose on the speaker, thereby establishing how much can and must be inferred about what the speaker is ignorant about. The paper makes two main contributions. First, it argues that the form of these inferences depends solely on the structural properties of the expression that at least is modifying, which do not necessarily coincide with semantic entailment. Rather, rank and order seems to matter: with totally ordered associates, at least triggers Ignorance Inferences that may be formally different than those obtained with partially ordered associates (Mendia (2016b)). Second, it builds on neo-Gricean double alternative generation mechanisms (like Schwarz (2016)) arguing that one of them must be provided by focus.
Modified laparoscopic Sugarbaker repair of a recurrent ileostomy prolapse
Authors: Orovec Adele S , Minor Samuel F , Hoogerboord C Marius
Published: January 2022

A 57-year-old male who presented with a recurrent ileostomy prolapse was successfully treated with the modified laparoscopic Sugarbaker procedure. This case demonstrates a novel application of the modified laparoscopic Sugarbaker procedure and provides an alternative option for the surgeon managing this challenging problem of recurrent stomal prolapse.
How Does Back Translation Fare Against Team Translation? An Experimental Case Study in the Language Combination English–German
Authors: Behr Dorothée , Braun Michael
Published: January 2022

When it comes to quality in questionnaire translation and hence comparability in comparative research, the chosen translation method is crucial for the outcome. Few empirical studies compare different translation methods—a fact which is often deplored in the research community. To fill the gap, in this study, the team translation approach is compared against a simple back-translation approach. The starting point in both cases was the initial English–German translations of ISSP (International Social Survey Program) questions. The final translations from both approaches were assessed, with a focus on how translation issues, such as mistranslations or wording issues identified in the initial translations were addressed. While none of the twenty-nine issues in the initial translation were present in the final team translation version, twenty-two of these issues were still present in the final version after the back-translation approach. For a selected number of items, we also ran a split-ballot experiment in a web survey. Only five out of fifteen items (33 percent) that went into the experiment showed significant differences between the translations, and only one could clearly be attributed to remaining errors in the back-translation version. In sum, the final translation from the team approach clearly outperformed the final translation from the back-translation approach when it comes to text-based criteria (in particular, accuracy and fluency). The quantitative test showed that many translation issues (those remaining in the translation after the back translation step) had no effect on the estimates. Nevertheless, we ask respondents to put effort into survey responding; in the same vein, we as researchers should put effort in the survey experience by providing questions that are clearly worded and free of errors, which puts the team approach ahead of the back-translation approach.
Sialic Acid as a Suitable Marker of Clinical Disease Activity in Patients with Crohn’s Disease
Authors: Chen Yaoming , He Yuting , Zhan Xiaoxia , Chen Dubo , Feng Pinning , Yan Yan , Wang Yichong
Published: January 2022

Objective

Elevated serum levels of sialic acid (SA) have been verified in patients with various inflammatory conditions. The association between the Crohn’s disease (CD) activity and serum SA has been insufficiently studied.

Materials and Methods

Serum SA concentrations were determined using an enzymatic colorimetric assay method, and the correlation of SA with the Harvey-Bradshaw Index (HBI) and other inflammation activity markers was evaluated using the Spearman correlation. The predictive value of SA in estimating CD disease activity was assessed using the receiver operating characteristic.

Results

The SA levels were positively correlated with HBI and C-reactive protein (CRP) levels. The correlation of SA with the HBI was superior to that of CRP with the HBI. The area under the curve for SA was higher than that for CRP, with an optimal cutoff value of 53.14 mg/dL for active CD.

Conclusion

Serum SA correlates with the HBI score better and has better predictive value in monitoring CD disease activity than CRP or other inflammatory markers.
A Novel USP25::PDGFRA Gene Fusion in a 78 Year Old Patient with a Myeloid Neoplasm
Authors: Dalland Joanna C , Blackburn Patrick R , Reichard Kaaren K , Johnson Sarah H , Smadbeck James B , Vasmatzis George , Hoppman Nicole L , Xu Xinjie , Greipp Patricia T , Baughn Linda B , Peterson Jess F
Published: January 2022

The World Health Organization category of myeloid/lymphoid neoplasms with eosinophilia and PDGFRA rearrangements is composed of a heterogeneous group of neoplasms that can present as a myeloproliferative neoplasm, acute myeloid leukemia, myeloid sarcoma, or lymphoblastic leukemia/lymphoma. The overall outcome of these neoplasms is favorable with imatinib therapy. Herein, we describe an adult female patient with a myeloid neoplasm accompanied by eosinophilia and a novel USP25::PDGFRA gene fusion.
The luminosity-dependent contribution from the broad-line region to the wavelength-dependent lags in Mrk 110
Authors: Vincentelli F M , McHardy I , Hernández Santisteban J V , Cackett E M , Gelbord J , Horne Keith , Miller J A , Lobban A
Published: January 2022

We have measured the wavelength-dependent lags between the X-ray, ultraviolet, and optical bands in the high-accretion rate ($L/L_{\rm Edd}\approx 40{{\ \rm per\ cent}}$) active galactic nucleus (AGN) Mrk 110 during two intensive monitoring campaigns in February and September 2019. After including the 2017 data published by Vincentelli et al., we divided the observations into three intervals with different X-ray luminosities. The first interval has the lowest X-ray luminosity and did not exhibit the U-band excess positive lag, or the X-ray excess negative lag that is seen in most AGNs. However, these excess lags are seen in the two subsequent intervals of higher X-ray luminosity. Although the data are limited, the excess lags appear to scale with X-ray luminosity. Our modelling shows that lags expected from reprocessing of X-rays by the accretion disc vary hardly at all with increasing luminosity. Therefore, as the U-band excess almost certainly arises from Balmer-continuum emission from the broad-line region (BLR), we attribute these lag changes to changes in the contribution from the BLR. The change is easily explained by the usual increase in the inner radius of the BLR with increasing ionizing luminosity.
COVID-19 outbreak in vaccinated patients from a haemodialysis unit: antibody titres as a marker of protection from infection
Authors: Boudhabhay Idris , Serris Alexandra , Servais Aude , Planas Delphine , Hummel Aurélie , Guery Bruno , Parize Perrine , Aguilar Claire , Dao Myriam , Rouzaud Claire , Ferriere Elsa , Knebelmann Bertrand , Sakhi Hamza , Leruez Marianne , Joly Dominique , Schwartz Olivier , Lanternier Fanny , Bruel Timothée
Published: January 2022

Background

Patients on maintenance haemodialysis (HD) have an increased risk of severe coronavirus disease 2019 (COVID-19) and a reduced response to vaccines. Data are needed to identify immune correlates of protection in this population.

Methods

Following a COVID-19 outbreak among vaccinated patients in a HD unit, clinical data and serological response to BNT162b2 vaccine were retrospectively recorded.

Results

Among 53 patients present in the dialysis room, 14 were infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) alpha variant (COVID_Pos) and 39 were not. Compared with uninfected patients, COVID_Pos patients more frequently had additional causes of immunosuppression (50% versus 21%; P = .046) and were more often scheduled on the Monday–Wednesday–Friday (MWF) shift (86% versus 39%; P = .002). Moreover, COVID_Pos had lower anti-spike (S) immunoglobulin G (IgG) titres than uninfected patients {median 24 BAU/mL [interquartile range (IQR) 3–1163] versus 435 [99–2555]; P = .001} and lower neutralization titres [median 108 (IQR 17–224) versus 2483 (481–43 908); P = .007]. Anti-S and neutralization antibody titres are correlated (r = 0.92, P < .001). In multivariable analysis, an MWF schedule {odds ratio [OR] 10.74 [95% confidence interval (CI) 1.9–93.5], P = .014} and anti-S IgG titres 1 month before the outbreak [<205 BAU/mL: OR 0.046 (95% CI 0.002–0.29), P = .006] were independently associated with COVID-19 infection. None of the patients with anti-S IgG >284 BAU/mL got infected. Ten of 14 COVID_Pos patients were treated with casirivimab and imdevimab. No patient developed severe disease.

Conclusions

Anti-S IgG titre measured prior to exposure correlates to protection from SARS-CoV-2 infection in HD patients. BNT162b2 vaccination alone or in combination with monoclonal antibodies prevented severe COVID-19.
Heterologous immunization with BNT162b2 followed by mRNA-1273 in dialysis patients: seroconversion and presence of neutralizing antibodies
Authors: Kohmer Niko , Rabenau Holger F , Ciesek Sandra , Krämer Bernhard K , Göttmann Uwe , Keller Christine , Rose Daniela , Blume Carsten , Thomas Michael , Lammert Alexander , Lammert Anne
Published: January 2022

Introduction

The vital renal replacement therapy makes it impossible for dialysis patients to distance themselves socially. This results in a high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and developing coronavuris disease 2019, with excess mortality due to disease burden and immunosuppression. We determined the efficacy of a 100-µg booster of mRNA-1273 (Moderna, Cambridge, MA, USA) 6 months after two doses of BNT162b2 (BioNTech/Pfizer, Mainz, Germany/New York, USA) in 194 SARS-CoV-2-naïve dialysis patients.

Methods

Anti-SARS-CoV-2 spike antibodies were measured with the Elecsys Anti-SARS-CoV-2 S assay (Roche Diagnostics, Mannheim, Germany) 4 and 10–12 weeks after two doses of BNT162b2 as well as 4 weeks after the mRNA-1273 booster. The presence of neutralizing antibodies was measured by the SARS-CoV-2 Surrogate Virus Neutralization Test (GenScript Biotech, Piscataway, NJ, USA). Two different cut-offs for positivity were used, one according to the manufacturer's specifications and one correlating with positivity in a plaque reduction neutralization test (PRNT). Receiver operating characteristics analyses were performed to match the anti-SARS-CoV-2 spike antibody cut-offs with the cut-offs in the surrogate neutralization assay accordingly.

Results

Any level of immunoreactivity determined by the anti-SARS-CoV-2 spike antibody assay was found in 87.3% (n = 144/165) and 90.6% (n = 164/181) of patients 4 and 10–12 weeks, respectively, after two doses of BNT162b2. This was reduced to 68.5% or 60.6% 4 weeks and 51.7% or 35.4% 10–12 weeks, respectively, when using the ROC cut-offs for neutralizing antibodies in the surrogate neutralization test (manufacturer's cut-off ≥103 U/mL and cut-off correlating with PRNT ≥196 U/mL). Four weeks after the mRNA-1273 booster, the concentration of anti-SARS-CoV-2 spike antibodies increased to 23 119.9 U/mL and to 97.3% for both cut-offs of neutralizing antibodies.

Conclusion

Two doses of BNT162b2 followed by one dose of mRNA-1273 within 6 months in patients receiving maintenance dialysis resulted in significant titres of SARS-CoV-2 spike antibodies. While two doses of mRNA vaccine achieved adequate humoral immunity in a minority, the third vaccination boosts the development of virus-neutralizing quantities of SARS-CoV-2 spike antibodies (against wild-type SARS-CoV-2) in almost all patients.
Development and validation of a deep-learning model for detecting brain metastases on 3D post-contrast MRI: a multi-center multi-reader evaluation study
Authors: Yin Shaohan , Luo Xiao , Yang Yadi , Shao Ying , Ma Lidi , Lin Cuiping , Yang Qiuxia , Wang Deling , Luo Yingwei , Mai Zhijun , Fan Weixiong , Zheng Dechun , Li Jianpeng , Cheng Fengyan , Zhang Yuhui , Zhong Xinwei , Shen Fangmin , Shao Guohua , Wu Jiahao , Sun Ying , Luo Huiyan , Li Chaofeng , Gao Yaozong , Shen Dinggang , Zhang Rong , Xie Chuanmiao
Published: January 2022

Background

Accurate detection is essential for brain metastasis (BM) management, but manual identification is laborious. This study developed, validated, and evaluated a BM detection (BMD) system.

Methods

Five hundred seventy-three consecutive patients (10 448 lesions) with newly diagnosed BMs and 377 patients without BMs were retrospectively enrolled to develop a multi-scale cascaded convolutional network using 3D-enhanced T1-weighted MR images. BMD was validated using a prospective validation set comprising an internal set (46 patients with 349 lesions; 44 patients without BMs) and three external sets (102 patients with 717 lesions; 108 patients without BMs). The lesion-based detection sensitivity and the number of false positives (FPs) per patient were analyzed. The detection sensitivity and reading time of three trainees and three experienced radiologists from three hospitals were evaluated using the validation set.

Results

The detection sensitivity and FPs were 95.8% and 0.39 in the test set, 96.0% and 0.27 in the internal validation set, and ranged from 88.9% to 95.5% and 0.29 to 0.66 in the external sets. The BMD system achieved higher detection sensitivity (93.2% [95% CI, 91.6–94.7%]) than all radiologists without BMD (ranging from 68.5% [95% CI, 65.7–71.3%] to 80.4% [95% CI, 78.0–82.8%], all P < .001). Radiologist detection sensitivity improved with BMD, reaching 92.7% to 95.0%. The mean reading time was reduced by 47% for trainees and 32% for experienced radiologists assisted by BMD relative to that without BMD.

Conclusions

BMD enables accurate BM detection. Reading with BMD improves radiologists’ detection sensitivity and reduces their reading times.
Are “Delayed Quitters” More Likely to Relapse Than Smokers Who Quit on Their Target Quit Date? A Retrospective Analysis of Clinical Records
Authors: Borchardt Benjamin , Schoberberger Rudolf , Hajek Peter
Published: January 2022

Introduction

Most smokers who are initially successful in their quit attempts return to smoking within the first few months. Identifying sub-populations at higher risk of relapse could help in relapse prevention efforts. We examined relapse rates in short-term abstainers who stopped smoking completely on their target quit date (TQD) and in those who needed more time to quit completely; and whether any difference in relapse between the two groups can be explained by baseline variables.

Aims and Methods

We identified 1172 smokers who achieved biochemically validated abstinence four weeks after their TQD at a stop-smoking clinic in London, and compared those who were abstinent from the TQD (immediate quitters) and those who only stopped smoking later (delayed quitters) in baseline characteristics. In a subsample of 308 clients followed up at one year, we compared relapse rates in immediate and delayed quitters while controlling for potential confounders.

Results

Delayed quitters smoked their first cigarette of the day earlier, had more past quit attempts, had lower confidence in quitting successfully, were more likely female and more likely to use varenicline. One-year relapse rates were 53% for immediate quitters and 77% for delayed quitters (OR = 2.83; 95% CI: [1.70–4.72]). In a multivariable regression adjusted for potential confounders delayed quitting remained significantly associated with relapse at one year (OR=2.41; 95% CI: [1.38–4.21]).

Conclusions

Ex-smokers who do not achieve abstinence on their TQD are at a higher risk of relapse than those who do. The effect was not explained by baseline variables.

Implications

Encouraging smokers to adhere to their TQD could improve treatment results. Relapse prevention efforts such as extended support and extended medication are likely to be particularly useful for delayed quitters.
Tyrosine Kinase Inhibitor Activity in Patients with NSCLC Harboring Uncommon EGFR Mutations: A Retrospective International Cohort Study (UpSwinG)
Authors: Popat Sanjay , Hsia Te-Chun , Hung Jen-Yu , Jung Hyun Ae , Shih Jin-Yuan , Park Cheol Kyu , Lee Seung Hyeun , Okamoto Tatsuro , Ahn Hee Kyung , Lee Yong Chul , Sato Yuki , Lee Sung Sook , Mascaux Celine , Daoud Hasan , Märten Angela , Miura Satoru
Published: January 2022

Background

Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) are standard of care for patients with EGFR mutation-positive non–small-cell lung cancer (NSCLC) with common mutations (Del19 or L858R); however, 7%-23% of NSCLC tumors harbor uncommon EGFR mutations. These mutations are highly heterogeneous, and developments in detection techniques are helping to identify mutations with little or no clinical data.

Patients and Methods

In this retrospective, global, multi-center study (NCT04179890), existing health records were identified for consecutive EGFR TKI-naïve patients with uncommon EGFR mutations (T790M, ex20ins, major uncommon [G719X, L861Q, or S768I], or “other” mutations; compound mutations) treated with erlotinib, gefitinib, afatinib, or osimertinib in first or second line. Endpoints included time-to-treatment failure (TTF), objective response rate (ORR), and overall survival (OS).

Results

Overall, 246 patients (median age: 69.5 years; Asian: 84%) were included from 9 countries. Most patients (92%) received an EGFR TKI as first-line therapy; 54%, 43% and 3% received afatinib, first-generation TKIs, and osimertinib, respectively. Median TTF and OS with EGFR TKIs were 9.9 and 24.4 months; ORR was 43%. In patients treated with first-line chemotherapy (n = 20), median TTF and ORR were 6.6 months and 41%. Outcomes were most favorable in patients with major uncommon or compound mutations. Overall, TTF was 11.3 months with afatinib and 8.8 months with first-generation EGFR TKIs across mutation categories. In most mutation categories, median OS was >2 years.

Conclusion

In a real-world setting, EGFR TKIs were the preferred treatment option in patients with uncommon EGFR mutations; strongest outcomes were seen in patients with major uncommon and compound mutations.
Global observing for phytoplankton? A perspective
Authors: Thompson Peter A , Carstensen Jacob
Published: January 2022

Environmental changes primarily caused by humans are putting our biosphere under growing pressure. The most optimistic predictions indicate that this will continue for decades, potentially much longer. Managing global ecology through these challenges requires knowledge of what species are present and how their populations are changing. Yet for vast areas of the ocean, the abundance of most species is simply unknown and not monitored. The failure to monitor means conclusions about their global ecological status cannot be robust (Bindoff, N.L., Cheung, W.W.L., Kairo, J.G., Arístegui, J., Guinder, V.A., Hallberg, R. et al. (2019) Changing ocean, marine ecosystems, and dependent communities. In Pörtner, H.-O., Roberts, D.C., Masson-Delmotte, V., Zhai, P., Tignor, M., Poloczanska, E., Mintenbeck, K., Alegría, A. et al. (eds), IPCC Special Report on the Ocean and Cryosphere in a Changing Climate. https://www.ipcc.ch/srocc/chapter/chapter-5/). Yet, this ignorance delays and limits any response. These changes are, however, disrupting the commercial and indigenous harvest of essential food resources as well as many other ecosystem services important to human well-being. While the global community has made significant progress on designing a monitoring program, there remain significant gaps, hurdles and other challenges to be overcome. Here, we consider some of these challenges and provide specific recommendations regarding potential next steps toward a minimum global monitoring program for plankton.
Fine-scale vertical distribution and diel migrations ofPyrosoma atlanticumin the northern California Current
Authors: Lyle Joanna T , Cowen Robert K , Sponaugle Su , Sutherland Kelly R
Published: January 2022

Blooms of the colonial pelagic tunicate Pyrosoma atlanticum in 2014–2018 followed a marine heatwave in the eastern Pacific Ocean. Pyrosome blooms could alter pelagic food webs of the northern California Current (NCC) by accelerating the biological pump via active transport, fecal pellet production and mortality events. Although aggregations of P. atlanticum have the potential to shape marine trophic dynamics via carbon export, little is known about pyrosome vertical distribution patterns. In this study, we estimated the distribution of P. atlanticum in the NCC along transects off of Oregon (45°N and 124°W) and northern California (41°N and 124°W), USA during February and July 2018. Depth-stratified plankton tows provided volume-normalized pyrosome abundance and biovolume estimates that complemented fine-scale counts by a vertically deployed camera system. Pyrosomes were numerous offshore during February, especially off Oregon. Colonies were distributed non-uniformly in the water column with peak numbers associated with vertical gradients in environmental parameters, notably density and chl-a. Vertical distributions shifted over the 24-h period, indicative of diel vertical migration. Understanding the vertical distribution of these gelatinous grazers in the NCC gives insight to their behavior and ecological role in biologically productive temperate ecosystems as conditions become more favorable for recurring blooms.
The magic square and half-hypermultiplets in F-theory
Authors: Kuramochi Rinto , Mizoguchi Shun’ya , Tani Taro
Published: January 2022

In six-dimensional F-theory/heterotic string theory, half-hypermultiplets arise only when they correspond to particular quaternionic Kähler symmetric spaces, which are mostly associated with the Freudenthal–Tits magic square. Motivated by the intriguing singularity structure previously found in such F-theory models with a gauge group SU(6), SO(12), or E7, we investigate, as the final magical example, an F-theory on an elliptic fibration over a Hirzebruch surface of the non-split I6 type, in which the unbroken gauge symmetry is supposed to be Sp(3). We find significant qualitative differences between the previous F-theory models associated with the magic square and the present case. We argue that the relevant half-hypermultiplets arise at the E6 points, where half-hypermultiplets 20 of SU(6) would have appeared in the split model. We also consider the problem on the non-local matter generation near the D6 point. After stating what the problem is, we explain why this is so by using the recent result that a split/non-split transition can be regarded as a conifold transition.
The Effects of Joining Multinational Supply Chains: New Evidence from Firm-to-Firm Linkages
Authors: Alfaro-Ureña Alonso , Manelici Isabela , Vasquez Jose P
Published: January 2022

We study the effects of becoming a supplier to multinational corporations (MNCs) using tax data tracking firm-to-firm transactions in Costa Rica. Event study estimates reveal that domestic firms experience strong and persistent gains in performance after supplying to a first MNC buyer. Four years after, domestic firms employ 26% more workers and have a 4% to 9% higher total factor productivity (TFP). These effects are unlikely to be explained by demand effects or changes in tax compliance. Moreover, suppliers experience a large drop in their sales to all other buyers except the first MNC buyer in the year of the event, followed by a gradual recovery. The dynamics of adjustment in sales to others suggests that firms face short-run capacity constraints that relax over time. Four years later, the sales to others grow by 20%. Most of this growth comes from the acquisition of new buyers, which tend to be “better buyers” (e.g., larger and with more stable supplier relationships). Finally, we collected survey data from domestic firms and MNCs to provide further insights into the wide-ranging benefits of supplying to MNCs. According to our surveys, these benefits range from better managerial practices to a better reputation.
The Design of Teacher Assignment: Theory and Evidence
Authors: Combe Julien , Tercieux Olivier , Terrier Camille
Published: January 2022

To assign teachers to schools, a modified version of the well-known deferred acceptance mechanism has been proposed in the literature and is used in practice. We show that this mechanism fails to be fair and efficient for both teachers and schools. We identify a class of strategy-proof mechanisms that cannot be improved upon in terms of both efficiency and fairness. Using a rich dataset on teachers’ applications in France, we estimate teachers preferences and perform a counterfactual analysis. The results show that these mechanisms perform much better than the modified version of deferred acceptance. For instance, the number of teachers moving from their positions more than triples under our mechanism.
Altered resting-state networks in adolescent non-suicidal self-injury—a graph theory analysis
Authors: Mürner-Lavanchy Ines , Koenig Julian , Reichl Corinna , Brunner Romuald , Kaess Michael
Published: January 2022

Non-suicidal self-injury (NSSI) is a highly prevalent transdiagnostic symptom and risk marker for mental health problems among adolescents. Research on the neurobiological mechanisms underlying NSSI is needed to clarify the neural correlates associated with the behavior. We examined resting-state functional connectivity in n = 33 female adolescents aged 12–17 years engaging in NSSI, and in n = 29 age-matched healthy controls using graph theory. Mixed linear models were evaluated with the Bayes Factor to determine group differences on global and regional network measures and associations between network measures and clinical characteristics in patients. Adolescents engaging in NSSI demonstrated longer average characteristic path lengths and a smaller number of weighted hubs globally. Regional measures indicated lower efficiency and worse integration in (orbito)frontal regions and higher weighted coreness in the pericalcarine gyrus. In patients, higher orbitofrontal weighted local efficiency was associated with NSSI during the past month while lower pericalcarine nodal efficiency was associated with suicidal thoughts in the past year. Higher right but lower left pericalcarine weighted hubness was associated with more suicide attempts during the past year. Using a graph-based technique to identify functional connectivity networks, this study adds to the growing understanding of the neurobiology of NSSI.
Economic incentive instruments and environmental innovation in China: Moderating effect of marketization
Authors: Long Siying , Liao Zhongju
Published: January 2022

As an influential economic entity, China’s economic growth pattern is changing. The traditional way brought high-speed growth as well as caused environmental damage. The concept of environmental innovation, which combines the advantage of technology innovation and environmental consideration, has become a vital means to achieve sustainable development. Due to the double externality characteristic of environmental innovation, the government plays an important role in its development. Based on provincial panel data from 2008 to 2017, this paper first examines the distinct influences of various economic incentive instruments on environmental innovation. Then, the moderation role of marketization is explored. The results show that governments’ direct financial expenditure on environmental protection has a positive impact on environmental innovation, while the effect of the environmental tax is not significant. In addition, the impact is negatively moderated by marketization.