bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanism of oxidative stress and Keap-1/Nrf2 signaling pathway in bronchopulmonary dysplasia
Authors: Ma Di , Gao Wenhui , Liu Junjiao , Kong Dan , Zhang Yunfeng , Qian Min
Published: June 2020

Bronchopulmonary dysplasia (BPD) is a chronic lung disease common in premature infants and is one of the leading causes of disability and death in newborns. The Keap-1/Nrf2 signaling pathway plays an important role in antioxidant and anti-inflammatory.

Ten clean-grade, healthy pregnant Sprague-Dawley rats (purchased from Experimental Animal Center of Peking university, China) naturally gave birth to 55 neonatal rats from which 40 were selected and randomly divided into a hyperoxia group and a control group (N = 20, each). Thirty-two BPD patient samples are from Neonatal Department of the second Hospital of Jilin University from November 30, 2016 to May 1, 2019.

In present study, we observed that lung tissues of the control group did not undergo obvious pathological changes, whereas in the hyperoxia group, lung tissues had disordered structures. With increased time of hyperoxia exposure, the alveolar wall became attenuated. Under hypoxia conditions, the activity of oxidative stress-related enzymes (CAT, GSH-Px, SOD) in lung samples was significantly lower than that before treatment. The expression level of Keap1 mRNA and protein in the hyperoxia group was slightly lower than that of control group. The expression of Nrf2 and HO-1 mRNA and protein in the hyperoxia group was significantly higher than that of control group. For the infants with BPD, we found that the activity of SOD, GSH-Px, and CAT was significantly different from those of control group.

We constructed a premature BPD animal model and found the abnormal of oxidative stress in different groups and the expression levels of Keap1/Nrf2 signaling pathway-related molecules, and we validated the results in premature infants with BPD.
The correlation between ultrasonographic features, bFGF, and the local invasiveness of thyroid papillary carcinoma
Authors: Jia Zhi-Ying , Wu Xiu-Lan , Zhang Yin-Hua , Ma Bin-Lin , Ma Fu-Cheng
Published: June 2020

The present study aimed to investigate the correlation between ultrasonographic features, basic fibroblast growth factor (bFGF), and the local invasiveness of papillary thyroid carcinoma (PTC).

A total of 350 samples of thyroid nodules were collected. Routine ultrasonography was performed before the operation and routine pathological diagnosis and bFGF detection were performed after the operation.’

These 350 samples of thyroid nodules included 90 samples of nodular goiter, 36 samples of focal thyroiditis, and 224 samples of PTC. A total of 326 thyroid nodules were examined for bFGF. The results revealed that the difference in the expression of bFGF between the benign and malignant groups was statistically significant (P < .05) and the difference in the positive expression of bFGF between the invasive and non-invasive PTC groups was statistically significant (P < .05).

Whether the shape of PTC is regular or not and whether there is micro-calcification in PTC and other ultrasonographic features, the size and location of the lesions and the age of the patient help make a preliminary prediction of local invasiveness before the operation. Postoperative detection of bFGF is helpful for further risk assessments of PTC.
Prognostic significance of preoperative albumin to fibrinogen ratio associated nomograms in patients with breast invasive ductal carcinoma
Authors: Zheng Lihua , Zhao Yaheng , Liu Feng , Liu Peng , Li Wei , Yang Yan , Zhang Hongsong , Liu Yunjiang
Published: June 2020

Plasma albumin to fibrinogen ratio is involved in human cancer, but its prognostic significance in breast cancer is controversy. In the context of breast invasive ductal carcinoma, this research aims to retrospectively evaluate by preoperative plasma albumin to fibrinogen ratio (AFR) and forecast oncological outcome and recurrence.

This retrospective study comprised 230 patients with non-metastatic breast invasive ductal carcinoma who underwent surgery between January 2009 and April 2012 in Fourth Hospital of Hebei Medical University. Patients were categorized base on an optimal value of preoperative plasma fibrinogen (Fib) and albumin. Progression-free and cancer-specific survival were assessed using Kaplan–Meier method. The associations between albumin to fibrinogen ratio and clinical outcomes were assessed with univariate and multivariate analysis. A number of risk factors were used to form nomograms to evaluate survival, and Harrell concordance index (C-index) was used to evaluate the predictive accuracy.

Plasma AFR was significantly associated with diminished disease-free survival (DFS) and overall survival (OS). Multivariate analysis revealed that plasma AFR was an independent prognostic indicator for DFS (HR = 1.346; 95% CI: 1.107–1.636; P = .03) and overall survival (OS) (HR = 1.485; 95% CI: 1.106–1.993; P = .008). Two prediction model of 3-, 5-years OS and DFS based on the AFR was developed.

Elevated preoperative plasma AFR is an independent prognostic factor for oncological outcomes in patients with breast invasive ductal carcinoma. The formulated nomogram showed superior predictive accuracy for DFS and OS.
A novel TJP1-ROS1 fusion in malignant peripheral nerve sheath tumor responding to crizotinib
Authors: Li Juming , Liu Lingxiang , Zhang Qi , Huang Yumin , Zhang Yihong , Gan Xiaoyan , Liu Siqin , Yue Zhen , Wei Yongzhong
Published: June 2020

Rationale:

Malignant peripheral nerve sheath tumor (MPNST) is a rare sarcoma. Owing to the lack of specific histological criteria, immunohistochemical, and molecular diagnostic markers, several differential diagnoses must be considered. Advances in molecular testing can provide significant insights for management of rare tumor.

Patient concerns:

The patient was a 50-year-old man with a history of lumpectomy on the right back 30 years ago. He felt a stabbing pain at the right iliac fossa and went to the local hospital.

Diagnosis:

By immunohistochemistry, the tumor cells stained positively for S-100 (focal +), CD34 (strong +++) and Ki-67 (20%), and negatively for smooth muscle actin, pan-cytokeratin, neurofilament, pan-cytokeratin-L, GFAP, CD31, STAT6, ERG, myogenin, and MyoD1. Combined with the histopathology and immunohistochemistry results, our initial diagnosis was solitary fibrous tumor (SFT) or MPNST. The tissue biopsy was sent for next-generation sequencing. neurofibromatosis type 1 Q1395Hfs∗22 somatic mutation, neurofibromatosis type 1 D483Tfs∗15 germline mutation, and amplifications of BTK, MDM2, ATF1, BMPR1A, EBHA2, GNA13, PTPN11, RAD52, RPTOR, and SOX9, as well as TJP1-ROS1 fusion, CDKN2A-IL1RAPL2 fusion and CDKN2A/UBAP1 rearrangement were identified. Given that NAB2-STAT6 fusion, a specific biomarker of SFT, was not identified in our patient's tumor, the SFT was excluded by through genetic testing results. Therefore, our finally diagnosis was a MPNST by 2 or more pathologists.

Interventions and outcomes:

Subsequently, the patient received crizotinib therapy for 2 months and showed stable disease. However, after crizotinib continued treatment for 4 months, the patient's disease progressed. Soon after, the patient stopped crizotinib treatment and died in home.

Lessons:

To our knowledge, this is the first report of the TJP1-ROS1 fusion, which expands the list of gene fusions and highlights new targets for targeted therapy. Also, our case underlines the value of multi-gene panel next-generation sequencing for diagnosis of MPNST.
A comprehensive evaluation of association between homocysteine levels and single nucleotide polymorphisms with hypertension risk
Authors: Kong Yixuan , Zheng Jinghui , Xu Xiangmei , Chen Xuan , Wang Jie , Lu Liying , Ye Zhuomiao
Published: June 2020

Background:

According to the relevant reports that single nucleotide polymorphisms (SNPs) may contribute to change of homocysteine (HCY) levels and increase the risk of hypertension (HTN). During the inconsistent results, this meta-analysis purpose is systematically review and synthesized relevant data on HCY levels and SNPs in HTN.

Methods:

The systematic search database, from the following database to find out the association studies of SNPs and HTN publications up until March 2020 from the databases of PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Periodical Database (VIP) and Wan fang databases, and Chinese Biomedical Literature Database (CBM). Network meta-analysis and Thakkinstian's algorithm were used to select the most appropriate genetic model, along with false positive report probability (FPRP) for noteworthy associations. All statistical analyses were calculated with STATA software (version 14.0; StataCorp, College Station, TX).

Results:

This meta-analysis will provide high-quality evidence to the effects of SNP on HTN and levels of HCY, and find between SNPs and HTN susceptibility on in all the genetic models, and choose the best one.

Conclusions:

This meta-analysis will research which SNP is the most correlated with HTN risk.

Registration:

INPLASY202050002
Labial adhesion in a postmenopausal female
Authors: Laih Chun-Yo , Huang Chi-Ping , Chou Eric Chieh-Lung
Published: June 2020

Rationale:

Voiding difficulty is more common in males, although it is not uncommon in females. Female voiding difficulty can be caused by iatrogenic, anatomic, and neurogenic factors, and specifically urethra stricture, impaired detrusor contractility, primary bladder neck obstruction, and detrusor-external sphincter dyssynergia. Labial adhesion is a rare cause of female voiding difficulty.

The incidence of labial fusion has been reported to be 0.6% to 1.4% in children; however, the incidence in the elderly has yet to be fully elucidated.

Patient concerns:

We present the case of a postmenopausal and sexually inactive 76-year-old female patient who had nearly total vaginal and urethral occlusion due to labial adhesion. She had no underlying diseases and came to our clinic with a 10-month history of voiding difficulty, postmicturition dribbling, and involuntary urinary leakage when getting up.

Diagnosis:

A genital examination revealed nearly total fusion of the labia minor with only a 3-mm pinhole opening at the posterior end.

Interventions:

Treatment included surgical separation, the local application of estrogen cream, and self-dilatation. She also received an antimuscarinic agent to treat overactive bladder secondary to bladder outlet obstruction which was caused by labial adhesion.

Outcomes:

No surgical complications occurred. Moreover, no labial adhesion or voiding dysfunction was found immediately after the surgery or after 6 months of follow-up.

Lessons subsections:

Genital examinations are a basic but very important noninvasive skill for physicians. This case report highlights that genital examinations should be a priority for patients with gynecological or urological symptoms.
Expectant management and live birth outcomes for male balanced-translocation carriers
Authors: Fan Haitao , Wang Xiuyan , Yang Xiao , Zheng Hongshu , Feng Shuqiang
Published: June 2020

Rationale:

Couples with male balanced-translocation carriers may experience recurrent pregnancy loss (RPL). Although the expectant management of RPL has developed over many years, genetic counseling for RPL couples with male balanced-translocation carriers remains challenging. Here, we describe the expectant management of 2 male carriers of balanced translocations.

Patient concerns:

A 32-year-old and a 28-year-old man presented at the clinic with diagnoses of infertility following spontaneous abortions by their wives.

Diagnosis:

Both patients had normal semen diagnosed by routine semen analysis and underwent cytogenetic diagnoses.

Interventions:

Following genetic counseling and informed consent, both couples voluntarily chose expectant management with natural conception.

Outcomes:

One couple experienced 2 natural pregnancies, the first of which ended in spontaneous abortion and the second produced a phenotypically normal infant. The other couple's first pregnancy resulted in a fetus with a balanced translocation confirmed by amniocentesis and cytogenetic analysis.

Lessons:

Expectant management with natural conception may be an alternative to genetic counseling in male balanced-translocation carriers with RPL, especially those who are reluctant to undergo preimplantation diagnosis.
Apatinib plus retinoic acid as maintenance for children with relapsed stage 4 high-risk neuroblastoma
Authors: Jin Mei , Zhang Dawei , Zhao Qian , Zhao Wen , Huang Cheng , Wang Xisi , Duan Chao , Su Yan , Ma Xiaoli
Published: June 2020

Introduction:

Metastatic neuroblastoma (NB) is an aggressive malignancy with a poor prognosis. Many patients present with relapsed high-risk NB after undergoing first-line treatment, and there is no standard therapy available in this setting.

Patient concerns:

The present study aimed to present the cases of 2 patients with recurrent high-risk NB.

Diagnosis:

Two children with International Neuroblastoma Stage System stage 4 high-risk NB chemotherapy. The disease recurrent after finishing the treatment.

Interventions:

Both patients (34 months old and 41 months old) experienced recurrence, received second-line treatment, and then received maintenance treatment using apatinib plus retinoic acid. The apatinib (10 mg/kg per day) and retinoic acid (160 mg/m2 per day) were administered on alternating 2-week cycles, which was continued for 1 year.

Outcomes:

The 2 patients had achieved complete response by the 1-year follow-up after starting apatinib plus retinoic acid, and did not experience any adverse drug reactions.

Conclusion:

The outcomes from these cases suggest that apatinib plus isotretinoin might be an option for maintenance therapy in patients with recurrent high-risk NB.
The efficacy and safety of sulforaphane as an adjuvant in the treatment of bipolar depressive disorder
Authors: Wu Congchong , Chen Xingyang , Lai Jianbo , Xu Yi , Hu Shaohua
Published: June 2020

Background:

Bipolar disorder (BD) is a chronic and disabling psychiatric disorder. The treatment of BD still remains a significant clinical challenge due to the complex nature of the disease. Nutraceutical therapy as adjunctive role is a promising therapy for BD. Sulforaphane (SFN), a broccoli extract, was reported to be effective for emotional problems and cognitive impairment. However, clinical research of SFN in the treatment of BD was rare. Therefore, this study is designed to evaluate the adjuvant role of SFN in the treatment of BD.

Methods:

This is a randomized, double-blinded, placebo-controlled, parallel-group clinical trial. A total of 100 patients who meet inclusion criteria will be assigned to receive quetiapine plus SFN or quetiapine plus placebo in a 1:1 ratio. The total duration of the study will be 12 weeks including 5 follow ups. The primary outcome is in the Montgomery–Asberg depression rating scale. The secondary outcomes are the quick inventory of depressive symptomatology—self report, Hamilton anxiety rating scale, young mania rating scale, cognitive function, inflammatory factors, and intestinal flora. Any adverse events will be recorded throughout the trial.

Discussion:

This trial will provide evidences to evaluate the efficacy and safety of SFN combined with quetiapine in the treatment of BD patients, as well as the adjuvant role of SFN in combination.

Trial registration:

This study protocol was registered at the Chinese clinical trial registry (ChiCTR2000028706).
Case report: An unusual presentation of acute promyelocytic leukemia in a middle aged female mimicking dengue infection
Authors: Yapor Laura , Zahid Maleeha , Shrestha Nikee , Walck Randee , Schreiber Zwi , Adrish Muhammad
Published: June 2020

Rationale:

Acute promyelocytic leukemia (APL) is an uncommon subtype of acute myeloid leukemia (AML). M3v phenotype is a less common presentation of APL and these patients usually present with leukocytosis and abnormal promyelocytes that are characterized by sparse granulation and are less likely to have faggot cells with multiple Auer rods. Distinguishing M3v phenotype from acute febrile illness can be challenging as the diagnosis relies on examination of peripheral smear.

Patient concerns:

Fifty-seven-year-old female who presented after recent trip to Dominican Republic for high grade fever and gum bleeding. She was exposed to patients with Dengue fever during her stay. At presentation, patient had leukocytosis, thrombocytopenia, and urinalysis showing bacteria and white cell. She was started on treatment for urinary tract infection. Patient remained febrile and thrombocytopenia worsened. On day 2, flow cytometry of the peripheral smear showed 43% medium sized blasts. Fluorescence in situ hybridization was positive for promyelocytic leukemia/retinoic acid receptor alpha.

Diagnoses:

The patient was diagnosed with APL.

Interventions:

Patient was started on treatment with all-trans retinoic acid and arsenic trioxide along with supportive care

Outcomes:

Patient had a favorable clinical response and her symptoms subsided.

Lessons:

Flow cytometry of the peripheral smear is key to diagnosis of suspected APL. One must maintain high suspicion for this life-threatening condition as early diagnosis saves lives.
Patterns of Prior and Subsequent Neoplasms in Children and Adolescents With Soft Tissue Sarcomas
Authors: Uckunkaya Oliver , Nöllke Peter , Hallmen Erika , Becker Cornelia , Stegmaier Sabine , Sparber-Sauer Monika , Vokuhl Christian , Koscielniak Ewa , Hettmer Simone
Published: June 2020

Background:

The occurrence of prior, concurrent and subsequent neoplasms (SN) represents a serious problem in children and adolescents with soft tissue sarcomas. Pathogenic germline variants contribute to the diagnosis of multiple neoplasms in sarcoma survivors.

Materials and Methods:

The records of 748 children and adolescents, diagnosed with soft tissue sarcomas and registered in trials/registries by the cooperative soft tissue sarcoma (Cooperative Weichteilsarkom Studie) group, were reviewed for the occurrence of SNs. Reference histology review was available for all cases; the presence of oncogenic fusions known at the time of diagnosis was confirmed for fusion-positive (F+) entities.

Results:

Concurrent or subsequent SNs developed in 13 of 473 survivors of fusion-negative (F−) sarcomas, for an 8-year cumulative SN incidence of 5% in survivors of F− sarcomas. In contrast, only 1 of 278 survivors of F+ sarcoma developed an SN. Twenty of 748 patients with soft tissue sarcomas had a history of prior neoplasms. Six of 14 patients who developed SNs after their index sarcomas met Chompret criteria for Li-Fraumeni syndrome. Nine of 20 patients who had tumors before their index sarcoma diagnosis had neurofibromatosis type 1 or neurofibromatosis type 1 spectrum tumors.

Conclusion:

Sarcoma phenotype/genotype and the sequence and nature of prior and subsequent neoplasms provide a window into underlying germline genetic susceptibilities in children and adolescents with soft tissue sarcomas.
What is the novel coronavirus disease 2019 (COVID-19) that paralyze the world?
Authors: Ozturk Ali , Abdulmajed Olkar , Ibrahim Bashar
Published: June 2020

The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 infection has recently spread worldwide was declared a pandemic on March 11. The most common symptoms of COVID-19 disease are fever, fatigue, and dry cough. Some patients may experience pain and aches, nasal congestion, cold, sore throat or diarrhea. These symptoms are usually mild and begin gradually. Currently, the source of the virus is still unknown. However, all available evidence indicates that the origin of this virus is a natural animal and that it is not a manufactured virus. The virus spreads faster than its two ancestors the severe acute respiratory syndrome coronavirus and Middle East Respiratory Syndrome Coronavirus. The effects of COVID-19 disease on people are that the elderly and people with preexisting medical conditions (such as hypertension, heart disease, and diabetes) have more severe symptoms than others. Some potential vaccines and drugs specifically needed to treat this disease are being investigated and are being tested by clinical trials.
Adverse Events Related to Accidental Unintentional Ingestions From Cough and Cold Medications in Children
Authors: Wang George Sam , Reynolds Kate M. , Banner William , Bond G. Randall , Kauffman Ralph E. , Palmer Robert B. , Paul Ian M. , Rapp-Olsson Malin , Green Jody L. , Dart Richard C.
Published: June 2020

Objectives

Previous research has demonstrated that accidental unsupervised ingestions (AUIs) were responsible for the majority of cough and cold medication (CCM) ingestions leading to significant adverse events (AEs) in children. The objective of this analysis was to characterize the role of AUIs in the morbidity associated with CCM exposure in children.

Methods

This surveillance study collected data from 5 United States data sources from 2009 to 2016, in children younger than 6 years with an AE from an AUI involving at least 1 CCM over-the-counter pharmaceutical ingredient. An expert panel reviewed each case to determine causality.

Results

From 4756 total cases reviewed, 3134 (65.9%) had an AE from an AUI determined to be at least potentially related to a CCM ingredient. The majority (61.3%) of cases occurred in children aged 2 to younger than 4 years. Most exposures occurred in the child's own residence (94.9%), and 43.8% were admitted to a health care facility (22.0% to a critical care unit). Dextromethorphan and diphenhydramine, when packaged alone or in combination products, contributed to 96.0% of AUIs. The most common specific products involved were single-ingredient pediatric liquid diphenhydramine (30.1%) and single-ingredient pediatric liquid dextromethorphan (21.4%). There were 3 deaths from solid diphenhydramine formulations.

Conclusions

There continues to be opportunities for the implementation of interventions to prevent AUIs of CCM in children. Additional emphasis on engineering controls, such as flow restrictors for liquid formulations targeting diphenhydramine and dextromethorphan products, represent additional opportunities to further reduce AEs from AUIs of CCM.
Digital Phenotyping to Quantify Psychosocial Well-Being Trajectories After Spinal Cord Injury
Authors: Mercier Hannah W. , Hamner Jason W. , Torous John , Onnela Jukka Pekka , Taylor J. Andrew
Published: June 2020

Objective

The aim of the study was to explore feasibility of smartphone-based digital phenotyping methods to examine depression and its relation to psychosocial well-being indicators after spinal cord injury.

Design

Smartphone research platform obtained smartphone sensor and survey data among community-living adult wheelchair users with spinal cord injury. Weekly measurements for 4 mos included Patient Health Questionnaire 8, Spinal Cord Injury–Quality of Life Satisfaction with and ability to participate in social roles and activities, global positioning system–derived community mobility metrics, health conditions, and physical activity.

Results

Forty-three individuals were enrolled. Study retention was higher among individuals offered financial incentives (78%) compared with participants enrolled before incentives (50%). Participants who dropped out more commonly had nontraumatic or acute spinal cord injury, were older, and had less satisfaction and lower participation in social roles and activities. Among 15 individuals with complete data, half had 1 wk or more of mild depression. Those with depression had frequent health issues, less satisfaction, and lower participation in social roles and activities. Those without depression experienced increased social engagement over time. Average community mobility was similar across depression groups. Relationships were typically in-phase but also varied by individual.

Conclusions

Smartphone-based digital phenotyping of psychosocial well-being after spinal cord injury is feasible but not without attrition challenges. Individual differences in depression patterns highlight clinical utility of scaling these methods.
Public Perceptions on Breast Implant–Associated Anaplastic Large Cell Lymphoma
Authors: Lee Erica , Khavanin Nima , He Waverley , Darrach Halley , Kraenzlin Franca , Jenny Hillary , Yang Robin , Sacks Justin M.
Published: June 2020

Background:

Breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) has entered the spotlight, as several high-profile media outlets have begun to relay the evolving science to the public. This study aimed to gauge the baseline knowledge and concern regarding BIA-ALCL among adult laywomen within the United States.

Methods:

Mechanical Turk was used to survey 500 American women on self-reported demographics, prior experience with breast implants, and 11 questions regarding their knowledge and concern regarding BIA-ALCL. Responses were reviewed for quality control before study inclusion.

Results:

Overall, 12 percent of respondents had received breast implants and 73 percent knew someone with implants; 13.6 percent of respondents (including 51.7 percent of respondents with implants) had previously heard of BIA-ALCL. After providing information about its risk, 58.4 percent of respondents were still willing to receive a reconstructive implant and 45.8 percent a cosmetic implant; 35.8 percent reported they would be less likely to receive an implant. Of the respondents with breast implants, 66.7 percent reported some degree of concern regarding BIA-ALCL and 35.0 percent are strongly considering removing their implants. Those who had heard of BIA-ALCL consumed information from several sources, predominantly health professionals or media/health care blogs. Different sources of information were not associated with a respondent’s degree of concern.

Conclusions:

Only a minority of American women have heard of BIA-ALCL and understand its association with breast implants. As plastic surgeons who perform breast reconstruction, we can promote the spread of information through the popular media and health care blogs to address this growing concern, particularly among women with existing breast implants.
Nonaesthetic Applications for Botulinum Toxin in Plastic Surgery
Authors: Freeman Matthew D. , Margulies Ilana G. , Sanati-Mehrizy Paymon , Burish Nikki , Taub Peter J.
Published: June 2020

Background:

Since their introduction to clinical medicine in 1989, botulinum toxin injections have been used for many indications. First used for nonsurgical management of strabismus, botulinum toxin injections are now widely used in plastic and reconstructive surgery for aesthetic indications; however, nonaesthetic indications of botulinum toxin have grown tremendously over the past two decades and span numerous specialties, including urology, dermatology, ophthalmology, otolaryngology, gynecology, plastic surgery, general surgery, and neurology. The present review aims to highlight nonaesthetic indications of botulinum toxin that are most relevant to the plastic surgeon with an emphasis on evidence-based practice.

Methods:

A PubMed search with manual reference checking was conducted to find the most relevant and influential articles on the nonaesthetic uses of botulinum toxin within the realm of adult plastic surgery. Studies were then categorized into areas of use, and quality of evidence for each category was highlighted.

Results:

Botulinum toxin has numerous nonaesthetic indications in plastic surgery, including for select pain-related disorders, skeletal muscle activity disorders, exocrine gland hyperfunction, wound healing, Raynaud phenomenon, abdominal wall reconstruction, and prosthetic breast reconstruction and augmentation. Although these indications have been widely reported, high-quality evidence supporting efficacy, optimal dose, and injection protocol with randomized controlled trials is lacking in many areas.

Conclusions:

Botulinum toxin is widely used in plastic surgery for a variety of nonaesthetic indications. Future studies should focus on investigating efficacy and best practice with high level of evidence research.
Allogeneic Decellularized Muscle Scaffold Is Less Fibrogenic and Inflammatory than Acellular Dermal Matrices in a Rat Model of Skeletal Muscle Regeneration
Authors: Iyer Hari , Lanier Steven , Dolivo David , Arenas Gabriel A. , Hong Seok Jong , Mustoe Thomas A. , Galiano Robert D.
Published: June 2020

Background:

Skeletal muscle trauma can produce grave functional deficits, but therapeutic options remain limited. The authors studied whether a decellularized skeletal muscle scaffold would provide benefits in inducing skeletal muscle regeneration over acellular dermal matrices.

Methods:

Eighty-two rat muscle defects were surgically created and assigned to no intervention or implantation of AlloDerm, Strattice, decellularized rat muscle, or decellularized rat dermis to 30 or 60 days. Decellularized rat muscle and dermis were prepared using a negative pressure–assisted protocol. Assessment for cellularity, neovascularization, myogenesis, inflammation and fibrosis were done histologically and by polymerase chain reaction.

Results:

Histology showed relative hypercellularity of AlloDerm (p < 0.003); Strattice appeared encapsulated. Immunofluorescence for CD31 and myosin heavy chain in decellularized rat muscle revealed dense microvasculature and peripheral islands of myogenesis. MyoD expression in muscle scaffolds was 23-fold higher than in controls (p < 0.01). Decellularized rat muscle showed no up-regulation of COX-2 (p < 0.05), with less expression than decellularized rat dermis and Strattice (p < 0.002). Decellularized rat muscle scaffolds expressed tumor necrosis factor-α less than Strattice, AlloDerm, and decellularized rat dermis (p < 0.01); collagen-1a less than decellularized rat dermis and Strattice (p < 0.04); α-smooth muscle actin 7-fold less than AlloDerm (p = 0.04); and connective tissue growth factor less than Strattice, AlloDerm, and decellularized rat dermis (p < 0.02).

Conclusion:

Decellularized muscle matrix appears to reduce inflammation and fibrosis in an animal muscle defect as compared with dermal matrices and promotes greater expression of myocyte differentiation-inducing genes.
Low HIV incidence among women following sexually transmitted infection does not support national pre-exposure prophylaxis recommendations
Authors: Berzkalns Anna E. , Barbee Lindley A. , Dombrowski Julie C. , Golden Matthew R.
Published: June 2020

Current United States guidelines recommend that clinicians offer HIV pre-exposure prophylaxis (PrEP) to women with gonorrhea or syphilis. We estimated HIV incidence among women following a syphilis, gonorrhea, or chlamydia diagnosis among women in King County, WA using surveillance data from 2008 to 2018. Among women with diagnosed with gonorrhea and among women diagnosed with chlamydia the estimated HIV incidence rates were 0.06 and 0.02 per 100 person years, respectively. No women reported with syphilis were diagnosed with HIV.
Quantifying the Dynamics of HIV Decline in Perinatally Infected Neonates on Antiretroviral Therapy
Authors: Morris Sinead E. , Dziobek-Garrett Luise , Strehlau Renate , Schröter Juliane , Shiau Stephanie , Anelone Anet J. N. , Paximadis Maria , de Boer Rob J. , Abrams Elaine J. , Tiemessen Caroline T. , Kuhn Louise , Yates Andrew J. ,   on behalf of the EPIICAL Consortium and the LEOPARD study team
Published: June 2020

Background:

Mathematical modeling has provided important insights into HIV infection dynamics in adults undergoing antiretroviral treatment (ART). However, much less is known about the corresponding dynamics in perinatally infected neonates initiating early ART.

Setting:

From 2014 to 2017, HIV viral load (VL) was monitored in 122 perinatally infected infants identified at birth and initiating ART within a median of 2 days. Pretreatment infant and maternal covariates, including CD4 T cell counts and percentages, were also measured.

Methods:

From the initial cohort, 53 infants demonstrated consistent decline and suppressed VL below the detection threshold (20 copies mL−1) within 1 year. For 43 of these infants with sufficient VL data, we fit a mathematical model describing the loss of short-lived and long-lived infected cells during ART. We then estimated the lifespans of infected cells and the time to viral suppression, and tested for correlations with pretreatment covariates.

Results:

Most parameters governing the kinetics of VL decline were consistent with those obtained previously from adults and other infants. However, our estimates of the lifespan of short-lived infected cells were longer than published values. This difference may reflect sparse sampling during the early stages of VL decline, when the loss of short-lived cells is most apparent. In addition, infants with higher pretreatment CD4 percentage or lower pretreatment VL trended toward more rapid viral suppression.

Conclusions:

HIV dynamics in perinatally infected neonates initiating early ART are broadly similar to those observed in other age groups. Accelerated viral suppression is also associated with higher CD4 percentage and lower VL.
Association Between Hospital Accreditation and Outcomes: The Analysis of Inhospital Mortality From the National Claims Data of the Universal Coverage Scheme in Thailand
Authors: Sriratanaban Jiruth , Ngamkiatpaisarn Sureerat , Charoenmukayananta Suwaree
Published: June 2020

Background:

In Thailand, hospital accreditation (HA) is widely recognized as one of the system tools to promote effective operation of universal health coverage. This nationwide study aims to examine the relationship between accredited statuses of the provincial hospitals and their mortality outcomes.

Method:

A 5-year retrospective analysis of the Universal Coverage Scheme's claim dataset was conducted, using 1 297 869 inpatient discharges from 76 provincial hospital networks under the Ministry of Public Health. Mortality outcomes of 3 major acute care conditions, including acute myocardial infarction, acute stroke, and sepsis, were selected.

Results:

Using generalized estimating equations to adjust for area-based control variables, hospital networks with HA-accredited provincial hospitals showed significant associations with lower standardized mortality ratios of acute stroke and sepsis.

Conclusion:

Our findings added supportive evidence that HA, as an organizational and health system management tool, could help promote hospital quality and safety in a developing country, leading to better outcomes.
Improving Asthma Conditions for Children and Adolescents by Expanding the Statewide Learning Collaborative Model Through Health Homes
Authors: Fifolt Matthew , Johnson Heather H. , Benton Elizabeth Cason
Published: June 2020

Background and Objectives:

Asthma is one of the most common diseases among children in the United States. Increasing provider adherence to national asthma guidelines and connecting patients to Health Homes can increase optimal asthma care. The objectives of this article are to report the results of an asthma learning collaborative and explore the role of Health Homes in contributing to its success.

Methods:

Quantitative and qualitative data were collected regarding the experiences of 14 pediatric primary care practices and 6 Health Homes participating in a 9-month learning collaborative.

Results:

Practices exceeded process aims of 80% compliance with optimal asthma care and the use of an Asthma Action Plan among patients aged 2 to 21 years. Health Home care coordinators also reported improvements in self-management strategies for asthma conditions, including the presence of an Asthma Action Plan, medications, spacers, and proper spacing techniques. Providers and Health Home care coordinators identified role clarity, mitigation of environmental triggers, and management of asthma conditions as benefits of the experience.

Conclusions:

The results of this asthma learning collaborative increased provider adherence to national guidelines and significantly improved optimal asthma care for patients. This multipronged, holistic approach to asthma care proved successful for controlling and maintaining asthma conditions among patients.
Applying epigenetic science to the understanding of eating disorders: a promising paradigm for research and practice
Authors: Booij Linda , Steiger Howard
Published: June 2020

Purpose of review

Studies indicate that environmental factors, acting at various moments throughout the life cycle, can result in epigenetically mediated alterations in gene expression. In this article, we review recent findings on the role of epigenetic factors in eating disorders, address methodological issues that need to be considered when interpreting research findings, and comment on possible clinical applications.

Recent findings

Evidence suggests that eating disorders implicate alterations of methylation in genes involved in the mental status, metabolism, anthropometric features and immunity. Furthermore, some research in individuals with anorexia nervosa suggests the presence of reversible, malnutrition-induced epigenetic alterations that ‘reset’ as patients recover.

Epigenetic studies in the eating disorders corroborate the idea that eating disorder cause is multifactorial, and identify markers that could help inform our understanding of illness staging and subtyping that may explain the commonly progressive course of these disorders, and that may provide insights towards the development of novel interventions. Already, there is evidence to suggest that, in people with eating disorders, epigenetically informed interventions help reduce stigma and shame, and increase self-acceptance and hopes of recovery. Although findings are intriguing, further research is required as, to date, studies apply modest sample sizes and disparate methodologies.
Plastics everywhere: first evidence of polystyrene fragments inside the common Antarctic collembolan
Cryptopygus antarcticus
Authors: Bergami Elisa , Rota Emilia , Caruso Tancredi , Birarda Giovanni , Vaccari Lisa , Corsi Ilaria
Published: June 2020

There is evidence and serious concern that microplastics have reached the most remote regions of the planet, but how far have they travelled in terrestrial ecosystems? This study presents the first field-based evidence of plastic ingestion by a common and central component of Antarctic terrestrial food webs, the collembolan
Cryptopygus antarcticus
. A large piece of polystyrene (PS) foam (34 × 31 × 5 cm) covered by microalgae, moss, lichens and microfauna was found in a fellfield along the shores of the Fildes Peninsula (King George Island). The application of an improved enzymatic digestion coupled with Fourier transform infrared microscopy (µ-FTIR), unequivocally detected traces of PS (less than 100 µm) in the gut of the collembolans associated with the PS foam and documented their ability to ingest plastic. Plastics are thus entering the short Antarctic terrestrial food webs and represent a new potential stressor to polar ecosystems already facing climate change and increasing human activities. Future research should explore the effects of plastics on the composition, structure and functions of polar terrestrial biota.
Endocrine regulation of egg rejection in an avian brood parasite host
Authors: Abolins-Abols Mikus , Hauber Mark E.
Published: June 2020

Parasite–host coevolution can lead to novel behavioural adaptations in hosts to resist parasitism. In avian obligate brood parasite and host systems, many host species have evolved diverse cognitive and behavioural traits to recognize and reject parasitic eggs. Our understanding of the evolution and ecology of these defences hinges on identifying the mechanisms that regulate them. We hypothesized that corticosterone, a hormone linked to stress response, vigilance and the suppression of parental behaviour, stimulates the rejection of foreign eggs by brood parasite hosts. We experimentally reduced circulating glucocorticoid levels with mitotane injections in American robins
Turdus migratorius
and found that the mitotane-treated birds rejected foreign eggs at a lower frequency compared to the sham-treated subjects. This is the first study to causally identify a potential mechanism of a widespread defence behaviour, and it is consistent with egg rejection being mediated by stress physiology.
A snapping shrimp has the fastest vision of any aquatic animal
Authors: Kingston Alexandra C. N. , Chappell Daniel R. , Speiser Daniel I.
Published: June 2020

Animals use their sensory systems to sample information from their environments. The physiological properties of sensory systems differ, leading animals to perceive their environments in different ways. For example, eyes have different temporal sampling rates, with faster-sampling eyes able to resolve faster-moving scenes. Eyes can also have different dynamic ranges. For every eye, there is a light level below which vision is unreliable because of an insufficient signal-to-noise ratio and a light level above which the photoreceptors are saturated. Here, we report that the eyes of the snapping shrimp
Alpheus heterochaelis
have a temporal sampling rate of at least 160 Hz, making them the fastest-sampling eyes ever described in an aquatic animal. Fast-sampling eyes help flying animals detect objects moving across their retinas at high angular velocities.
A. heterochaelis
are fast-moving animals that live in turbid, structurally complex oyster reefs and their fast-sampling eyes, like those of flying animals, may help them detect objects moving rapidly across their retinas. We also report that the eyes of
A. heterochaelis
have a broad dynamic range that spans conditions from late twilight (approx. 1 lux) to direct sunlight (approx. 100 000 lux), a finding consistent with the circatidal activity patterns of this shallow-dwelling species.
Using compartmental models to simulate directed acyclic graphs to explore competing causal mechanisms underlying epidemiological study data
Authors: Havumaki Joshua , Eisenberg Marisa C.
Published: June 2020

Accurately estimating the effect of an exposure on an outcome requires understanding how variables relevant to a study question are causally related to each other. Directed acyclic graphs (DAGs) are used in epidemiology to understand causal processes and determine appropriate statistical approaches to obtain unbiased measures of effect. Compartmental models (CMs) are also used to represent different causal mechanisms, by depicting flows between disease states on the population level. In this paper, we extend a mapping between DAGs and CMs to show how DAG-derived CMs can be used to compare competing causal mechanisms by simulating epidemiological studies and conducting statistical analyses on the simulated data. Through this framework, we can evaluate how robust simulated epidemiological study results are to different biases in study design and underlying causal mechanisms. As a case study, we simulated a longitudinal cohort study to examine the obesity paradox: the apparent protective effect of obesity on mortality among diabetic ever-smokers, but not among diabetic never-smokers. Our simulations illustrate how study design bias (e.g. reverse causation), can lead to the obesity paradox. Ultimately, we show the utility of transforming DAGs intoin silicolaboratories within which researchers can systematically evaluate bias, and inform analyses and study design.
Emergence of bursting in a network of memory dependent excitable and spiking leech-heart neurons
Authors: Sharma Sanjeev Kumar , Mondal Argha , Mondal Arnab , Upadhyay Ranjit Kumar , Hens Chittaranjan
Published: June 2020

Excitable cells often produce different oscillatory activities that help us to understand the transmitting and processing of signals in the neural system. The diverse excitabilities of an individual neuron can be reproduced by a fractional-order biophysical model that preserves several previous memory effects. However, it is not completely clear to what extent the fractional-order dynamics changes the firing properties of excitable cells. In this article, we investigate the alternation of spiking and bursting phenomena of an uncoupled and coupled fractional leech-heart (L-H) neurons. We show that a complete graph of heterogeneous de-synchronized neurons in the backdrop of diverse memory settings (a mixture of integer and fractional exponents) can eventually lead to bursting with the formation of cluster synchronization over a certain threshold of coupling strength, however, the uncoupled L-H neurons cannot reveal bursting dynamics. Using the stability analysis in fractional domain, we demarcate the parameter space where the quiescent or steady-state emerges in uncoupled L-H neuron. Finally, a reduced-order model is introduced to capture the activities of the large network of fractional-order model neurons.
Evaluating a transfer gradient assumption in a fomite-mediated microbial transmission model using an experimental and Bayesian approach
Authors: Wilson Amanda M. , King Marco-Felipe , López-García Martín , Weir Mark H. , Sexton Jonathan D. , Canales Robert A. , Kostov Georgiana E. , Julian Timothy R. , Noakes Catherine J. , Reynolds Kelly A.
Published: June 2020

Current microbial exposure models assume that microbial exchange follows a concentration gradient during hand-to-surface contacts. Our objectives were to evaluate this assumption using transfer efficiency experiments and to evaluate a model's ability to explain concentration changes using approximate Bayesian computation (ABC) on these experimental data. Experiments were conducted with two phages (MS2,
Φ
X174) simultaneously to study bidirectional transfer. Concentrations on the fingertip and surface were quantified before and after fingertip-to-surface contacts. Prior distributions for surface and fingertip swabbing efficiencies and transfer efficiency were used to estimate concentrations on the fingertip and surface post contact. To inform posterior distributions, Euclidean distances were calculated for predicted detectable concentrations (log
10
PFU cm
−2
) on the fingertip and surface post contact in comparison with experimental values. To demonstrate the usefulness of posterior distributions in calibrated model applications, posterior transfer efficiencies were used to estimate rotavirus infection risks for a fingertip-to-surface and subsequent fingertip-to-mouth contact. Experimental findings supported the transfer gradient assumption. Through ABC, the model explained concentration changes more consistently when concentrations on the fingertip and surface were similar. Future studies evaluating microbial transfer should consider accounting for differing fingertip-to-surface and surface-to-fingertip transfer efficiencies and extend this work for other microbial types.