bluuebunny/crossref_metadata_2025 huggingface dataset:
Dietary phytoestrogen intake and lung cancer risk: an analysis of the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial
Authors: Wang Qian , Ru Meng , Zhang Yaning , Kurbanova Tamara , Boffetta Paolo
Published: August 2021

Phytoestrogens (PEs) have estrogen-like activity and were found to lower incidences of several hormone-dependent cancers. Emerging evidence suggests that estrogen may play a role in lung cancer carcinogenesis. We aim to evaluate dietary PE intake and lung cancer risk using data from the Prostate, Lung, Colorectal and Ovarian cancer screening trial. A total of 1706 lung cancer cases were identified. The association between lung cancer risk and PE intake (in quartiles) was calculated using the Cox proportional hazard models adjusting for potential confounders. Stratified analyses by smoking status, sex and histology were also performed. The highest quartile of total PE intake was associated with a reduced risk of lung cancer compared with the lowest quartile [hazard ratio (HR) = 0.85, 95% confidence interval (CI): 0.73–0.99 for >1030 μg/day versus <290 μg/day] (P trend = 0.56). Similar patterns were observed among ever smokers (HR = 0.84, 95% CI: 0.71–0.98), non-small cell histology (HR = 0.84, 95% CI: 0.72–0.99), male (HR = 0.84, 95% CI: 0.69–1.03) and female (HR = 0.80, 95% CI: 0.64–0.99 for 510–1030 μg/day, HR = 0.84, 95% CI: 0.67–1.06 for >1030 μg/day versus <290 μg/day) subjects with no significant linear trend observed. Despite a lower consumption compared with the Asian population, increased PE intake still appears to decrease lung cancer risk in a Caucasian-dominant population. Future studies are needed to replicate these results in independent cohorts and shed a light on the potential mechanism of the protective effect of PEs on lung carcinogenesis and the interaction between PEs, smoking and endogenous estrogens.
Respiratory Microbiome Disruption and Risk for Ventilator-Associated Lower Respiratory Tract Infection
Authors: Harrigan James J , Abdallah Hatem O , Clarke Erik L , Oganisian Arman , Roy Jason A , Lautenbach Ebbing , Reesey Emily , Wernovsky Magda , Tolomeo Pam , Morawski Zygmunt , Jacob Jerry , Grippi Michael A , Kelly Brendan J
Published: August 2021

Background

Ventilator-associated lower respiratory tract infection (VA-LRTI) is common among critically ill patients and has been associated with increased morbidity and mortality. In acute critical illness, respiratory microbiome disruption indices (MDIs) have been shown to predict risk for VA-LRTI, but their utility beyond the first days of critical illness is unknown. We sought to characterize how MDIs previously shown to predict VA-LRTI at initiation of mechanical ventilation change with prolonged mechanical ventilation, and if they remain associated with VA-LRTI risk.

Methods

We developed a cohort of 83 subjects admitted to a long-term acute care hospital due to their prolonged dependence on mechanical ventilation; performed dense, longitudinal sampling of the lower respiratory tract, collecting 1066 specimens; and characterized the lower respiratory microbiome by 16S rRNA sequencing as well as total bacterial abundance by 16S rRNA quantitative polymerase chain reaction.

Results

Cross-sectional MDIs, including low Shannon diversity and high total bacterial abundance, were associated with risk for VA-LRTI, but associations had wide posterior credible intervals. Persistent lower respiratory microbiome disruption showed a more robust association with VA-LRTI risk, with each day of (base e) Shannon diversity <2.0 associated with a VA-LRTI odds ratio of 1.36 (95% credible interval, 1.10–1.72). The observed association was consistent across multiple clinical definitions of VA-LRTI.

Conclusions

Cross-sectional MDIs have limited ability to discriminate VA-LRTI risk during prolonged mechanical ventilation, but persistent lower respiratory tract microbiome disruption, best characterized by consecutive days with low Shannon diversity, may identify a population at high risk for infection and may help target infection-prevention interventions.
Viral Load of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Respiratory Aerosols Emitted by Patients With Coronavirus Disease 2019 (COVID-19) While Breathing, Talking, and Singing
Authors: Coleman Kristen K , Tay Douglas Jie Wen , Tan Kai Sen , Ong Sean Wei Xiang , Than The Son , Koh Ming Hui , Chin Yi Qing , Nasir Haziq , Mak Tze Minn , Chu Justin Jang Hann , Milton Donald K , Chow Vincent T K , Tambyah Paul Anantharajah , Chen Mark , Tham Kwok Wai
Published: August 2021

Background

Multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) superspreading events suggest that aerosols play an important role in driving the coronavirus disease 2019 (COVID-19) pandemic. To better understand how airborne SARS-CoV-2 transmission occurs, we sought to determine viral loads within coarse (>5 μm) and fine (≤5 μm) respiratory aerosols produced when breathing, talking, and singing.

Methods

Using a G-II exhaled breath collector, we measured viral RNA in coarse and fine respiratory aerosols emitted by COVID-19 patients during 30 minutes of breathing, 15 minutes of talking, and 15 minutes of singing.

Results

Thirteen participants (59%) emitted detectable levels of SARS-CoV-2 RNA in respiratory aerosols, including 3 asymptomatic and 1 presymptomatic patient. Viral loads ranged from 63–5821 N gene copies per expiratory activity per participant, with high person-to-person variation. Patients earlier in illness were more likely to emit detectable RNA. Two participants, sampled on day 3 of illness, accounted for 52% of total viral load. Overall, 94% of SARS-CoV-2 RNA copies were emitted by talking and singing. Interestingly, 7 participants emitted more virus from talking than singing. Overall, fine aerosols constituted 85% of the viral load detected in our study. Virus cultures were negative.

Conclusions

Fine aerosols produced by talking and singing contain more SARS-CoV-2 copies than coarse aerosols and may play a significant role in SARS-CoV-2 transmission. Exposure to fine aerosols, especially indoors, should be mitigated. Isolating viable SARS-CoV-2 from respiratory aerosol samples remains challenging; whether this can be more easily accomplished for emerging SARS-CoV-2 variants is an urgent enquiry necessitating larger-scale studies.
Vitamin K antagonist use induces calcification and atherosclerotic plaque progression resulting in increased hypercoagulability
Authors: van Gorp Rick H , Baaten Constance C F M J , Habibi Anxhela , Jaminon Armand M G , Peeters Frederique E C M , Leenders Peter , Crijns Harry J G M C , Heemskerk Johan W M , Reutelingsperger Chris P , Spronk Henri M , Schurgers Leon J
Published: August 2021

Aims

Vascular calcification is a hallmark of atherosclerotic burden and can predict the cardiovascular outcome. Vitamin K antagonists (VKA) are widely used anticoagulant drugs to treat patients at risk of arterial and venous thrombosis but are also associated with increase vascular calcification progression. We aim to unravel the paradox that VKA suppresses plasma coagulation but promotes vascular calcification and subsequent atherosclerosis-dependent coagulability of the vessel wall.

Methods and results

Apoe −/− mice were placed on western-type diet enriched with the VKA warfarin for 18 weeks to measure atherosclerotic plaque burden, calcification, and coagulation. Patients (n = 54) displaying paroxysmal atrial fibrillation with a low cardiovascular risk, who were treated with VKA were included to measure pre-thrombotic state. Finally, primary vascular smooth muscle cells (VSMC) derived from human tissue explants were used for in vitro experiments. In Apoe−/− mice, VKA increases both atherosclerotic plaque size and calcification. Higher plaque calcification was associated with increased plasma levels of thrombin-antithrombin and factor IXa-antithrombin complexes in mice and patients treated with VKA. Mechanistically, phenotypic switching of VSMC into synthetic VSMC promotes thrombin generation, which is enhanced in a tissue-factor (TF)-dependent manner by VSMC calcification. Moreover, calcified VSMC exposed to whole blood under flow significantly enhanced platelet deposition and TF-dependent fibrin formation.

Conclusions

Oral anticoagulation with VKA aggravates vascular calcification and atherosclerosis. VSMC phenotype differentiation impacts coagulation potential in a TF-dependent manner. VKA-induced vascular calcification increases hypercoagulability and could thereby potentially positively affect atherothrombosis.
Pericoronary and periaortic adipose tissue density are associated with inflammatory disease activity in Takayasu arteritis and atherosclerosis
Authors: Wall Christopher , Huang Yuan , Le Elizabeth P V , Ćorović Andrej , Uy Christopher P , Gopalan Deepa , Ma Chuoxin , Manavaki Roido , Fryer Tim D , Aloj Luigi , Graves Martin J , Tombetti Enrico , Ariff Ben , Bambrough Paul , Hoole Stephen P , Rusk Rosemary A , Jayne David R , Dweck Marc R , Newby David , Fayad Zahi A , Bennett Martin R , Peters James E , Slomka Piotr , Dey Damini , Mason Justin C , Rudd James H F , Tarkin Jason M
Published: August 2021

Aims

To examine pericoronary adipose tissue (PCAT) and periaortic adipose tissue (PAAT) density on coronary computed tomography angiography for assessing arterial inflammation in Takayasu arteritis (TAK) and atherosclerosis.

Methods and results

PCAT and PAAT density was measured in coronary (n = 1016) and aortic (n = 108) segments from 108 subjects [TAK + coronary artery disease (CAD), n = 36; TAK, n = 18; atherosclerotic CAD, n = 32; matched controls, n = 22]. Median PCAT and PAAT densities varied between groups (mPCAT: P < 0.0001; PAAT: P = 0.0002). PCAT density was 7.01 ± standard error of the mean (SEM) 1.78 Hounsfield Unit (HU) higher in coronary segments from TAK + CAD patients than stable CAD patients (P = 0.0002), and 8.20 ± SEM 2.04 HU higher in TAK patients without CAD than controls (P = 0.0001). mPCAT density was correlated with Indian Takayasu Clinical Activity Score (r = 0.43, P = 0.001) and C-reactive protein (r = 0.41, P < 0.0001) and was higher in active vs. inactive TAK (P = 0.002). mPCAT density above −74 HU had 100% sensitivity and 95% specificity for differentiating active TAK from controls [area under the curve = 0.99 (95% confidence interval 0.97–1)]. The association of PCAT density and coronary arterial inflammation measured by 68Ga-DOTATATE positron emission tomography (PET) equated to an increase of 2.44 ± SEM 0.77 HU in PCAT density for each unit increase in 68Ga-DOTATATE maximum tissue-to-blood ratio (P = 0.002). These findings remained in multivariable sensitivity analyses adjusted for potential confounders.

Conclusions

PCAT and PAAT density are higher in TAK than atherosclerotic CAD or controls and are associated with clinical, biochemical, and PET markers of inflammation. Owing to excellent diagnostic accuracy, PCAT density could be useful as a clinical adjunct for assessing disease activity in TAK.
Immune complexes, innate immunity, and NETosis in ChAdOx1 vaccine-induced thrombocytopenia
Authors: Holm Sverre , Kared Hassen , Michelsen Annika E , Kong Xiang Yi , Dahl Tuva B , Schultz Nina H , Nyman Tuula A , Fladeby Cathrine , Seljeflot Ingebjørg , Ueland Thor , Stensland Maria , Mjaaland Siri , Goll Guro Løvik , Nissen-Meyer Lise Sofie , Aukrust Pål , Skagen Karolina , Gregersen Ida , Skjelland Mona , Holme Pål A , Munthe Ludvig A , Halvorsen Bente
Published: August 2021

Aims

We recently reported five cases of vaccine-induced immune thrombotic thrombocytopenia (VITT) 7–10 days after receiving the first dose of the ChAdOx1 nCoV-19 adenoviral vector vaccine against corona virus disease 2019 (COVID-19). We aimed to investigate the pathogenic immunological responses operating in these patients.

Methods and results

We assessed circulating inflammatory markers by immune assays and immune cell phenotyping by flow cytometry analyses and performed immunoprecipitation with anti-platelet factor (PF)4 antibody in plasma samples followed by mass spectrometry from all five patients. A thrombus was retrieved from the sinus sagittal superior of one patient and analysed by immunohistochemistry and flow cytometry. Precipitated immune complexes revealed multiple innate immune pathway triggers for platelet and leucocyte activation. Plasma contained increased levels of innate immune response cytokines and markers of systemic inflammation, extensive degranulation of neutrophils, and tissue and endothelial damage. Blood analyses showed activation of neutrophils and increased levels of circulating H3Cit, dsDNA, and myeloperoxidase–DNA complex. The thrombus had extensive infiltration of neutrophils, formation of neutrophil extracellular traps (NETs), and IgG deposits.

Conclusions

The results show that anti-PF4/polyanion IgG-mediated thrombus formation in VITT patients is accompanied by a massive innate immune activation and particularly the fulminant activation of neutrophils including NETosis. These results provide novel data on the immune response in this rare adenoviral vector-induced VITT.
Long-term prognosis of patients undergoing radiofrequency catheter ablation for atrial fibrillation: comparison between heart failure subtypes based on left ventricular ejection fraction
Authors: Fujimoto Hajime , Doi Naofumi , Okayama Satoshi , Naito Masaki , Kobori Atsushi , Kaitani Kazuaki , Inoue Koichi , Kurotobi Toshiya , Morishima Itsuro , Yamaji Hirosuke , Matsui Yumie , Nakazawa Yuko , Kusano Kengo , Hirai Kaeko , Nakai Takehito , Suzuki Megumi , Yano Hiroki , Sakai Satoshi , Kimura Takeshi , Shizuta Satoshi , Saito Yoshihiko ,   the KPAF investigators
Published: August 2021

Aims

Heart failure (HF) prognosis has been reported similar in patients with preserved vs. reduced left ventricular ejection fraction (LVEF). This study compared the long-term prognosis of HF patients undergoing radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF).

Methods and results

Among 5010 patients undergoing RFCA in Kansai Plus AF registry, 656 patients (13.1%) with a documented history of HF were enrolled in the study before RFCA. The primary endpoint was a composite of all-cause death, HF hospitalization, and stroke or systemic embolism. Patients with reduced (<40%), mid-range (40–49%), and preserved (≥50%) LVEF were 98 (14.9%), 107 (16.3%), and 451 (68.8%) patients, respectively. The prevalence of ischaemic heart disease and cardiomyopathies was higher among patients with reduced as compared with preserved LVEF (27.6% vs. 10.0%, P < 0.05 and 36.7% vs. 15.3%, P < 0.05, respectively). The median follow-up period was 2.9 years. The 3-year cumulative risk for the primary endpoint was higher in patients with reduced LVEF (32.7%) compared to those with mid-range (11.7%) or preserved (11.6%) LVEF (P < 0.001). Reduced LVEF was the most significant independent risk factor for primary endpoint (hazard ratio, 2.83; 95% confidence interval 1.74–4.61, P < 0.001). The 3-year arrhythmia recurrence rate was similar among the groups (48.2%, 42.8%, and 47.3%, respectively, P = 0.75).

Conclusion 

This study raises hypothesis that patients with HFrEF and AF had approximately three times higher risk for a composite of all-cause death, HF hospitalization, and stroke or systemic embolism after AF ablation compared with patients with HFmrEF or HFpEF.
MicroRNAs and extracellular vesicles in the gut: new host modulators of the microbiome?
Authors: Du Xiaochen , Ley Ruth , Buck Amy H
Published: August 2021

The gut microbiota plays an integral role in human health and its dysbiosis is associated with many chronic diseases. There are still large gaps in understanding the host and environmental factors that directly regulate the gut microbiota, and few effective strategies exist to modulate the microbiota in therapeutic applications. Recent reports suggest that certain microRNAs (miRNAs) released by mammalian cells can regulate bacterial gene expression to influence the microbiome composition and propose extracellular vesicles as one natural mechanism for miRNA transport in the gut. These new findings interface with a burgeoning body of data showing that miRNAs are present in a stable form in extracellular environments and can mediate cell-to-cell communication in mammals. Here, we review the literature on RNA-mediated modulation of the microbiome to bring cross-disciplinary perspective to this new type of interaction and its potential implications in biology and medicine.
Socioemotional Selectivity Theory: The Role of Perceived Endings in Human Motivation
Authors: Carstensen Laura L
Published: August 2021

Socioemotional selectivity theory (SST) is a theory of life-span development grounded in the uniquely human ability to monitor time. SST maintains that the approach of endings—whether due to aging or other endings such as geographic relocations and severe illness—elicits motivational changes in which emotionally meaningful goals are prioritized over exploration. Research guided by SST has informed preferences, social networks, and emotional experience and led to the discovery of the positivity effect in cognitive processing. This article, based on my 2015 Robert W. Kleemeier Award Lecture, describes the development of SST and its related program of empirical research.
X-factors in human disease: impact of gene content and dosage regulation
Authors: Fang He , Deng Xinxian , Disteche Christine M
Published: August 2021

The gene content of the X and Y chromosomes has dramatically diverged during evolution. The ensuing dosage imbalance within the genome of males and females has led to unique chromosome-wide regulatory mechanisms with significant and sex-specific impacts on X-linked gene expression. X inactivation or silencing of most genes on one X chromosome chosen at random in females profoundly affects the manifestation of X-linked diseases, as males inherit a single maternal allele, while females express maternal and paternal alleles in a mosaic manner. An additional complication is the existence of genes that escape X inactivation and thus are ubiquitously expressed from both alleles in females. The mosaic nature of X-linked gene expression and the potential for escape can vary between individuals, tissues, cell types and stages of life. Our understanding of the specialized nature of X-linked genes and of the multilayer epigenetic regulation that influence their expression throughout the organism has been helped by molecular studies conducted by tissue-specific and single-cell-specific approaches. In turn, the definition of molecular events that control X silencing has helped develop new approaches for the treatment of some X-linked disorders. This review focuses on the peculiarities of the X chromosome genetic content and epigenetic regulation in shaping the manifestation of congenital and acquired X-linked disorders in a sex-specific manner.
Intrapulmonary pharmacokinetic profile of cefiderocol in mechanically ventilated patients with pneumonia
Authors: Katsube Takayuki , Nicolau David P , Rodvold Keith A , Wunderink Richard G , Echols Roger , Matsunaga Yuko , Menon Anju , Portsmouth Simon , Wajima Toshihiro
Published: August 2021

Objectives

Lung penetration of cefiderocol, a novel siderophore cephalosporin approved for treatment of nosocomial pneumonia, has previously been evaluated in healthy subjects. This study assessed the intrapulmonary pharmacokinetic profile of cefiderocol at steady state in hospitalized, mechanically ventilated pneumonia patients.

Methods

Patients received cefiderocol 2 g (or ≤1.5 g if renally impaired), administered IV q8h as a 3 h infusion, or 2 g q6h if patients had augmented renal function (estimated CLCR > 120 mL/min). After multiple doses, each patient underwent a single bronchoalveolar lavage (BAL) procedure either at the end of the infusion or at 2 h after the end of infusion. Plasma samples were collected at 1, 3, 5 and 7 h after the start of infusion. After correcting for BAL dilution, cefiderocol concentrations in epithelial lining fluid (ELF) for each patient and the ELF/unbound plasma concentration ratio (RC, E/P) were calculated. Safety was assessed up to 7 days after the last cefiderocol dose.

Results

Seven patients received cefiderocol. Geometric mean ELF concentration of cefiderocol was 7.63 mg/L at the end of infusion and 10.40 mg/L at 2 h after the end of infusion. RC, E/P was 0.212 at the end of infusion and 0.547 at 2 h after the end of infusion, suggesting delayed lung distribution. There were no adverse drug reactions.

Conclusions

The results suggest that cefiderocol penetrates the ELF in critically ill pneumonia patients with concentrations that are sufficient to treat Gram-negative bacteria with an MIC of ≤4 mg/L.
Crohn’s and Colitis Canada’s 2021 Impact of COVID-19 and Inflammatory Bowel Disease in Canada: Children and Expectant Mothers With Inflammatory Bowel Disease
Authors: Benchimol Eric I , Carroll Matthew W , Geist Rose , Griffiths Anne M , Huang James Guoxian , Mack David R , Bernstein Charles N , Bitton Alain , Jones Jennifer L , Kaplan Gilaad G , Kuenzig M Ellen , Lee Kate , Mukhtar Mariam S , Murthy Sanjay K , Tandon Parul , Targownik Laura E , Windsor Joseph W , Seow Cynthia H
Published: August 2021

Coronavirus disease 2019 (COVID-19) in children with inflammatory bowel disease (IBD) typically results in a mild infection, similar to those without IBD. Children and adolescents have less severe manifestations of COVID-19 compared to older people, whether or not they have IBD. However, some IBD medications (in particular, corticosteroids) are associated with more severe COVID-19. During the first year of the global pandemic, more IBD care was provided with online technology, necessitated by efforts to reduce hospital and clinic visits. Additionally, non-endoscopic monitoring of inflammation has been required due to the cancellation of non-urgent procedures, resulting in longer endoscopy wait-times. In contrast, pregnant people (with and without IBD) who contract COVID-19 are at increased risk of severe manifestations, death and preterm delivery, making them a priority for severe acute respiratory syndrome coronavirus 2 protective measures and vaccination. Few studies have examined effect of COVID-19 on IBD-related disease activity in pregnant people with IBD. The pandemic has significantly affected the mental health and sense of well-being of children and their families, as well as pregnant people with IBD. These groups were much more likely to experience anxiety and depression compared with prior to the pandemic, even while concern has mostly abated regarding the effect of IBD medications and COVID-19 severity. Unfortunately, the availability of mental health care providers who specialize in people with IBD has not kept pace with the increasing demand.
MAMP and DAMP signaling contributes resistance to Fusarium graminearum in Arabidopsis
Authors: Manes Nimrat , Brauer Elizabeth K , Hepworth Shelley , Subramaniam Rajagopal
Published: August 2021

Plants perceive externally produced microbe-associated molecular patterns (MAMPs) and endogenously produced danger-associated molecular patterns (DAMPs) to activate inducible immunity. While several inducible immune responses have been observed during Fusarium graminearum infection, the identity of the signaling pathways involved is only partly known. We screened 227 receptor kinase and innate immune response genes in Arabidopsis to identify nine genes with a role in F. graminearum resistance. Resistance-promoting genes included the chitin receptors LYK5 and CERK1, and the reactive oxygen species (ROS)-producing NADPH oxidase RbohF, which were required for full inducible immune responses during infection. Two of the genes identified in our screen, APEX and the PAMP-induced peptide 1 (PIP1) DAMP receptor RLK7, repressed F. graminearum resistance. Both RbohF and RLK7 were required for full chitin-induced immune responses and PIP1 precursor expression was induced by chitin and F. graminearum infection. Together, this indicates that F. graminearum resistance is mediated by MAMP and DAMP signaling pathways and that chitin-induced signaling is enhanced by PIP1 perception and ROS production.
fuPCR as diagnostic method for the detection of rare fungal pathogens, such as Trichosporon, Cryptococcus and Fusarium
Authors: Scharf Sebastian , Bartels Anna , Kondakci Mustafa , Haas Rainer , Pfeffer Klaus , Henrich Birgit
Published: August 2021

Fungal respiratory tract colonization is a common finding in patients with hematologic neoplasms due to immunosuppression inherent in the diseases and exacerbated by therapy. This greatly increases the risk of fungal infections of the lungs, which is associated with significant mortality. Therefore, reliable diagnostic methods with rapidly available results are needed to administer adequate antifungal therapy. We have established an improved method for fungal DNA extraction and amplification that allows simultaneous detection of fungal families based on a set of multiplexed real-time PCR reactions (fuPCR). We analyzed respiratory rinses and blood of 94 patients with hematological systemic diseases by fuPCR and compared it with the results of culture and serological diagnostic methods. 40 healthy subjects served as controls.

Regarding Candida species, the highest prevalence resulted from microbiological culture of respiratory rinses and from detection of antibodies in blood serum in patients (61 and 47%, respectively) and in the control group (29 and 51%, respectively). Detection of other pathogenic yeasts, such as Cryptococcus and Trichosporon, and molds, such as Fusarium, was only possible in patients by fuPCR from both respiratory rinses and whole blood and serum. These fungal species were found statistically significantly more frequent in respiratory rinses collected from patients after myeloablative therapy for stem cell transplantation compared to samples collected before treatment (P < 0.05i). The results show that fuPCR is a valuable complement to culturing and its inclusion in routine mycological diagnostics might be helpful for early detection of pathophysiologically relevant respiratory colonization for patients with hematologic neoplasms.
Antifungal susceptibility testing with YeastONE™ is not predictive of clinical outcomes of Cryptococcus neoformans var. grubii fungemia
Authors: Yang Jeng-How , Huang Po-Yen , Cheng Chun-Wen , Shie Shian-Sen , Lin Zhong-Fu , Yang Lan-Yan , Lee Chia-Hui , Wu Ting-Shu
Published: August 2021

Mortality rates due to Cryptococcus neoformans var. grubii fungemia remain significant despite treatment with antifungal drugs. The predictive function of antifungal susceptibility and its correlation with treatment outcome remains controversial. A retrospective study was conducted from January 1, 2009, to December 31, 2016, on 85 patients with C. neoformans var. grubii fungemia confirmed by matrix-assisted laser desorption ionization–time-of-flight mass spectrometry. Antifungal drug susceptibility was determined using the YeastONE™ colorimetric broth microdilution method coupled with Vizion™ System following the Clinical and Laboratory Standards Institute guidelines. Six antifungal agents—amphotericin B, fluconazole, flucytosine, itraconazole, posaconazole, and voriconazole—were tested. The patients’ demographic data and clinical information were abstracted for further analyses. Antifungal regimens consisting of amphotericin B with or without fluconazole or flucytosine were administered for induction treatment of these patients, followed with intravenous or oral fluconazole for maintenance therapy. Clinical outcomes were defined by 14- and 30-day mortality rates. Risk factors associated with outcomes were fitted in a logistic regression model by univariate or multivariate method. Eighty-five patients with C. neoformans var. grubii fungemia were enrolled in the study. The Sequential Organ Failure Assessment Score, Glasgow Coma Scale, Charlson comorbidity score, and adequate duration of therapy for amphotericin B were predictors for mortality in univariate analysis. Antifungal susceptibility testing with YeastONE™ does not predict clinical outcomes of C. neoformans var. grubii fungemia. Greater disease severity, high comorbidities, poor consciousness level, and inappropriate treatment were associated with increased mortality in cryptococcemia cases.
The origin of the soft X-ray excess in the narrow-line Seyfert 1 galaxy SBS 1353 + 564
Authors: Xu Xinpeng , Ding Nan , Gu Qiusheng , Guo Xiaotong , Contini E
Published: August 2021

We present for the first time the timing and spectral analyses for a narrow-line Seyfert 1 galaxy, SBS 1353 + 564, using XMM-Newton and Swift multiband observations from 2007 to 2019. Our main results are as follows: (1) The temporal variability of SBS 1353+564 is random, while the hardness ratio is relatively constant over a time span of 13 yr; (2) We find a prominent soft X-ray excess feature below 2 keV that cannot be well described by a simple blackbody component; (3) After comparing the two most prevailing models for interpreting the origin of the soft X-ray excess, we find that the relativistically smeared reflection model is unable to fit the data above 5 keV well and the X-ray spectra do not show any reflection features, such as the Fe K α emission line. However, the warm corona model can obtain a good fitting result. For the warm corona model, we try to use three different sets of spin values to fit the data and derive different best-fitting parameter sets; (4) We compare the UV/optical spectral data with the extrapolated values of the warm corona model to determine which spin value is more appropriate for this source, and we find that the warm corona model with non-spin can sufficiently account for the soft X-ray excess in SBS 1353 + 564.
Detecting globular cluster tidal extensions with Bayesian inference – I. Analysis of ω Centauri with Gaia EDR3
Authors: Kuzma P B , Ferguson A M N , Peñarrubia J
Published: August 2021

The peripheral regions of globular clusters (GCs) are extremely challenging to study due to their low surface brightness nature and the dominance of Milky Way contaminant populations along their sightlines. We have developed a probabilistic approach to this problem through utilizing a mixture model in spatial and proper motion space that separately models the cluster, extra-tidal, and contaminant stellar populations. We demonstrate the efficacy of our method through application to Gaia third early data release photometry and astrometry in the direction of NGC 5139 (ω Centauri, hereafter ω Cen), a highly challenging target on account of its Galactic latitude (b ≈ 15○) and low proper motion contrast with the surrounding field. We recover the spectacular tidal extensions, spanning the 10○ on the sky explored here, seen in earlier work and quantify the star count profile and ellipticity of the system out to a cluster-centric radius of 4○. We show that both RR Lyrae and blue horizontal branch stars consistent with belonging to ω Cen are found in the tidal tails, and calculate that these extensions contain at least ≈0.1 per cent of the total stellar mass in the system. Our high-probability members provide prime targets for future spectroscopic studies of ω Cen out to unprecedented radii.
Formation of massive disc galaxies in the IllustrisTNG simulation
Authors: Zeng Guangquan , Wang Lan , Gao Liang
Published: August 2021

We investigate the formation history of massive disc galaxies in hydrodynamical simulation – the IllustrisTNG, to study why massive disc galaxies survive through cosmic time. 83 galaxies in the simulation are selected with M*,z = 0 > 8 × 1010 M⊙ and kinematic bulge-to-total ratio less than 0.3. We find that 8.4 per cent of these massive disc galaxies have quiet merger histories and preserve disc morphology since formed. 54.2 per cent have a significant increase in bulge components in history, then become discs again till present time. The rest 37.3 per cent experience prominent mergers but survive to remain discy. While mergers and even major mergers do not always turn disc galaxies into ellipticals, we study the relations between various properties of mergers and the morphology of merger remnants. We find a strong dependence of remnant morphology on the orbit type of major mergers. Specifically, major mergers with a spiral-in falling orbit mostly lead to disc-dominant remnants, and major mergers of head-on galaxy–galaxy collision mostly form ellipticals. This dependence of remnant morphology on orbit type is much stronger than the dependence on cold gas fraction or orbital configuration of merger system as previously studied.
Logit function in stochastic categorizations
Authors: Wang Kai
Published: August 2021

Binary categorizations refer to the behaviour for which a decision maker puts the alternatives from a menu into binary categories (authorization category and rejection category). For example, a judge approves/denies parole for inmates, a doctor administers/withholds treatment to patients, and a teacher passes/fails essays. Categorizations are observed to exhibit randomness in various contexts, but the stochasticity in categorizations has received little attention in economic studies. We consider stochastic categorizations using a logit categorization function, which expresses the probability of authorizing an alternative from a menu in a ‘logit-like’ form. We characterize the model from a simple condition on authorization frequencies. Furthermore, we derive an empirical version of our model, which not only provides insight into applications of the model, but also gives an intuitive interpretation of the stochasticity in categorizations. We use simple examples to show that our model can bring new insights and research possibilities in the economic studies.
Task-Irrelevant Semantic Properties of Objects Impinge on Sensory Representations within the Early Visual Cortex
Authors: Nah Joseph C , Malcolm George L , Shomstein Sarah
Published: August 2021

Objects can be described in terms of low-level (e.g., boundaries) and high-level properties (e.g., object semantics). While recent behavioral findings suggest that the influence of semantic relatedness between objects on attentional allocation can be independent of task-relevance, the underlying neural substrate of semantic influences on attention remains ill-defined. Here, we employ behavioral and functional magnetic resonance imaging measures to uncover the mechanism by which semantic information increases visual processing efficiency. We demonstrate that the strength of the semantic relatedness signal decoded from the left inferior frontal gyrus: 1) influences attention, producing behavioral semantic benefits; 2) biases spatial attention maps in the intraparietal sulcus, subsequently modulating early visual cortex activity; and 3) directly predicts the magnitude of behavioral semantic benefit. Altogether, these results identify a specific mechanism driving task-independent semantic influences on attention.
Forest stand and canopy development unaltered by 12 years of CO2 enrichment*
Authors: Norby Richard J , Warren Jeffrey M , Iversen Colleen M , Childs Joanne , Jawdy Sara S , Walker Anthony P
Published: August 2021

Canopy structure—the size and distribution of tree crowns and the spatial and temporal distribution of leaves within them—exerts dominant control over primary productivity, transpiration and energy exchange. Stand structure—the spatial arrangement of trees in the forest (height, basal area and spacing)—has a strong influence on forest growth, allocation and resource use. Forest response to elevated atmospheric CO2 is likely to be dependent on the canopy and stand structure. Here, we investigated elevated CO2 effects on the forest structure of a Liquidambar styraciflua L. stand in a free-air CO2 enrichment experiment, considering leaves, tree crowns, forest canopy and stand structure. During the 12-year experiment, the trees increased in height by 5 m and basal area increased by 37%. Basal area distribution among trees shifted from a relatively narrow distribution to a much broader one, but there was little evidence of a CO2 effect on height growth or basal area distribution. The differentiation into crown classes over time led to an increase in the number of unproductive intermediate and suppressed trees and to a greater concentration of stand basal area in the largest trees. A whole-tree harvest at the end of the experiment permitted detailed analysis of canopy structure. There was little effect of CO2 enrichment on the relative leaf area distribution within tree crowns and there was little change from 1998 to 2009. Leaf characteristics (leaf mass per unit area and nitrogen content) varied with crown depth; any effects of elevated CO2 were much smaller than the variation within the crown and were consistent throughout the crown. In this young, even-aged, monoculture plantation forest, there was little evidence that elevated CO2 accelerated tree and stand development, and there were remarkably small changes in canopy structure. Questions remain as to whether a more diverse, mixed species forest would respond similarly.
Divergent stem hydraulic strategies of Caragana korshinskii resprouts following a disturbance
Authors: Nie Zheng-Fei , Liao Zhong-Qiang , Yao Guang-Qian , Tian Xue-Qian , Bi Min-Hui , Teixeira da Silva Jaime A , Gao Tian-Peng , Fang Xiang-Wen
Published: August 2021

Resprouting plants are distributed in many vegetation communities worldwide. With increasing resprout age post-severe-disturbance, new stems grow rapidly at their early age, and decrease in their growth with gradually decreasing water status thereafter. However, there is little knowledge about how stem hydraulic strategies and anatomical traits vary post-disturbance. In this study, the stem water potential (Ψstem), maximum stem hydraulic conductivity (Kstem-max), water potential at 50% loss of hydraulic conductivity (Kstem  P50) and anatomical traits of Caragana korshinkii resprouts were measured during a 1- to 13-year post-disturbance period. We found that the Kstem-max decreased with resprout age from 1-year-old resprouts (84.2 mol m−1 s−1 MPa−1) to 13-year-old resprouts (54.2 mol m−1 s−1 MPa−1) as a result of decreases in the aperture fraction (Fap) and the sum of aperture area on per unit intervessel wall area (Aap). The Kstem  P50 of the resprouts decreased from 1-year-old resprouts (−1.8 MPa) to 13-year-old resprouts (−2.9 MPa) as a result of increases in vessel implosion resistance (t/b)2, wood density (WD), vessel grouping index (GI) and decreases in Fap and Aap. These shifts in hydraulic structure and function resulted in an age-based divergence in hydraulic strategies i.e., a change from an acquisitive strategy to a conservative strategy, with increasing resprout age post-disturbance.
Characterization of Strawberry Host Plant Resistance to Powdery Mildew Caused by Podosphaera aphanis
Authors: Palmer Michael G. , Holmes Gerald J.
Published: August 2021

Host plant resistance is an essential tool in plant disease management worldwide. Evaluations of strawberry cultivar resistance to powdery mildew were done previously in California, but many new cultivars have been released since the last evaluation in 1996 and merit evaluation for today’s growers. Two studies were conducted over the winter and summer of 2020, evaluating 10 commonly grown cultivars. Powdery mildew-free plants were established in 3-liter pots under high plastic tunnels and after 3 weeks (four- to five-leaf stage) moved into a powdery mildew-infested greenhouse. Disease incidence and severity ratings were taken weekly beginning at the first sign of disease. Ratings taken at 40 (winter) and 41 (summer) days after transfer to the greenhouse were used to make comparisons among cultivars. Significant differences were found in foliar disease severity among cultivars, but none were totally free of disease. Moderately resistant cultivars were ‘San Andreas’ and ‘Sweet Ann’. Highly susceptible cultivars were ‘BG 3.324’ and ‘Royal Royce’. Two field evaluations of the 10 cultivars confirmed the observed relative differences in host resistance under field conditions. This information is valuable to California strawberry growers, who select cultivars based in part on their susceptibility to economically important diseases such as powdery mildew.
Treatment Choice of Complete Distal Forearm Fractures in 8 to 14 Years Old Children
Authors: Liu Ya , Zhang Fu-Yong , Zhen Yun-Fang , Zhu Lun-Qing , Guo Zhi-Xiong , Wang Xiao-Dong
Published: August 2021

Background:

New surgical techniques have challenged traditional guidelines for nonsurgical treatment in pediatric and adolescent distal forearm fractures. This study was performed to compare outcomes and costs between closed reduction with percutaneous pinning (CRPP) and closed reduction with casting in the treatment of complete distal forearm fractures in children 8 to 14 years old.

Methods:

A retrospective cohort study was performed of 175 displaced distal forearm fractures treated with 2 different methods in the emergency department of a children’s trauma center. One hundred and fourteen children were managed using CRPP. The remaining 61 were treated with closed reduction and casting. All patients had initial follow-up radiographs. The quality of reduction and the residual angulation in both the coronal and sagittal planes were recorded. Outcomes included the angulation after reduction, residual angulation at final follow-up, radiation exposure, total immobilization time, days absent from school, total costs, and postoperative complications.

Results:

The postreduction sagittal plane angulation was significantly lower in the CRPP group (P=0.037). While residual deformity between the groups at the 6-month final follow-up was not significantly different in either the sagittal or coronal planes (P=0.486, 0.726), patients in the nonoperative group received greater radiation than those in the operative group (P<0.001). Patients in the nonoperative group missed fewer classes and sustained lower costs (P<0.001, <0.001). The mean immobilization time in each group was not significantly different (31.4±4.4 vs. 32.8±5.9 d; P=0.227).

Conclusions:

Although the postreduction quality was a little better and radiation exposure was less in the CRPP group, there was no difference between the 2 groups in angulation, total immobilization time, or complication rates after 6 months. The cost and time absent from school of patients in the nonoperative group was significantly lower than in the operative group. There is no clear advantage to CRPP treatment on outcomes. Therefore, closed reduction and casting is recommended in complete distal forearm fractures of children 8 to 14 years old.

Level of Evidence:

Level III—therapeutic study.
Assessment of the Viability and Union Feature of Diaphysis Reconstruction Using Pasteurized Tumor Bone and Intramedullary Free Fibular After Tumor Resection
Authors: Ji Tao , Li Yuan , Xing Zhili , Tang Xiaodong , Yang Rongli , Guo Wei
Published: August 2021

Background:

Reconstruction using pasteurized tumor bone (PTM) and intramedullary-placed vascularized free fibular (VFG) has the combined advantages of mechanical strength and biological activity. The aims of this study were to investigate scintigraphic viability and radiographic union patterns of composite grafts after surgery, union rates, functional outcomes, and complication rates.

Methods:

Seventeen patients underwent intercalary composite reconstruction using PTM and VFG (12 male, 2 female, mean age: 10.9 y). Retrospective evaluation of radiography and bone scintigraphy was performed. The most common diagnosis was osteosarcoma (12/14, 85.7%). All radiography and bone scintigraphy was reviewed for bone healing and tracer uptake semiquantitatively using the ratio of the reconstructed portion to the contralateral side. Complications and oncological and functional outcomes were recorded.

Results:

At a mean follow-up of 33.1 months, primary union was achieved in all 28 host-graft junctions in all 14 patients. The respective mean times to proximal and distal junction bone union were 6.9 and 6.5 months. Metaphyseal junctions healed faster than diaphysis junctions (5.2 vs. 8.0 mo, P=0.02). Free fibular was integrated with surrounding bone after a mean of 10.1 months. The mean tracer uptake ratio was 1.1 after a mean of 4.8 months postoperatively. Half patients (50%) had higher uptake on bone scan than contralateral side. There was no significant correlation between uptake value and bone healing time. Five complications occurred in 4 patients (28.6%), and 1 patient (7.1%) contracted an infection. No fractures or breakages were observed. The mean Musculoskeletal Tumor Society 93 score was 87.6%.

Conclusions:

Reconstruction using PTM combined with VFG is associated with good short-term biological activity as indicated by bone scintigraphy, a high union rate, and an acceptable complication rate. The technique is a useful reconstruction option for large segmental bone defects after tumor resection in lower extremities.

Level of Evidence:

Level IV—therapeutic study.
Association between night-time extubation and clinical outcomes in adult patients
Authors: Ippolito Mariachiara , Catalisano Giulia , Iozzo Pasquale , Raineri Santi Maurizio , Gregoretti Cesare , Giarratano Antonino , Einav Sharon , Cortegiani Andrea
Published: August 2021

BACKGROUND

Whether night-time extubation is associated with clinical outcomes is unclear.

OBJECTIVE

The aim of this systematic review and meta-analysis was to evaluate the association between night-time extubation and the reintubation rate, mortality, ICU and in-hospital length of stay in adult patients, compared with daytime extubation.

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

PubMed, EMBASE, CINAHL and Web of Science from inception to 2 January 2021 (PROSPERO registration - CRD42020222812).

ELIGIBILITY CRITERIA

Randomised, quasi and cluster randomised, and nonrandomised studies describing associations between adult patients’ outcomes and time of extubation (daytime/night-time) in intensive care or postanaesthesia care units.

RESULTS

Seven retrospective studies were included in the systematic review and meta-analysis, for a total of 293 663 patients. All the studies were performed in United States (USA). All the studies were judged at moderate risk of bias for reintubation and mortality. The analyses were conducted with random effects models. The analyses from adjusted estimates demonstrated no association between night-time extubation and increased risk of either reintubation (OR 1.00; 95% CI 0.88 to 1.13; P = 1.00; I
2 = 66%; low-certainty evidence) or all-cause mortality at the longest available follow-up (OR 1.11; 95% CI 0.87 to 1.42; P = 0.39; I
2 = 79%; low-certainty evidence), in comparison with daytime extubation. Analyses from unadjusted data for reintubation, mortality and ICU or in-hospital length of stay showed no significant association with night-time extubation. Analyses based on type of admission, number of centres or duration of mechanical ventilation showed no significant subgroup effects.

CONCLUSION

Night-time extubation of adult patients was not associated with higher adjusted risks for reintubation or death, in comparison with daytime extubation, but the certainty of the evidence was low.