bluuebunny/crossref_metadata_2025 huggingface dataset:
Total en bloc spondylectomy is worth doing in complete paralysis spinal giant cell tumor, a minimum 1-year follow-up
Authors: Paholpak Permsak , Sangsin Apiruk , Sirichativapee Winai , Wisanuyotin Taweechok , Kosuwon Weerachai , Sumnanoont Chat , Thammaroj Puntip , Ungarreevittaya Piti , Kasai Yuichi , Murakami Hideki , Tsuchiya Hiroyuki
Published: April 2021

Objective:

To investigate the neurological recovery of Frankel A spinal giant cell tumor (GCT) patients after they had received a Total En Bloc Spondylectomy (TES).

Materials and Methods:

We retrospectively recorded data of three patients (two females) with mobile spine GCT (T6, T10, and L2) Enneking stage III with complete paralysis before surgery, who had undergone TES in our institute from January 2018 to September 2020. The duration of neurologic recovery to Frankel E was the primary outcome. The intra-operative blood loss, operative time, operative-related complications, and the local recurrence were the secondary outcomes.

Results:

The duration of suffering from Frankel A to TES surgery was 2 months for the T6 patient, 3 weeks for the T10 patient, and 1 month for the L2 patient. Three patients had achieved full neurological recovery to Frankel E within 6 months after TES (T6 for 5 months, T10 for 3 months, and L2 for 3 months). The average blood loss was 2833.33 ml and the mean operative time was 400 min. Up until the last follow-up (13–25 months), no evidence of local recurrences had been found in any of the three patients.

Conclusion:

Frankel A spinal GCT patients can achieve full neurological recovery after TES, if the procedure is performed within 3 months after complete paraplegia. TES can effectively control any local recurrences.
Patient Outcomes and Fear of Returning to Sports After Arthroscopic Bankart Repair With Remplissage
Authors: Feng Sijia , Chen Mo , Chen Jun , Li Hong , Chen Jiwu , Chen Shiyi
Published: April 2021

Background:

Although Bankart repair with remplissage is commonly performed to treat anterior shoulder instability, there is limited information on specific outcomes or patients’ fears regarding return to sports (RTS).

Purpose:

To study recurrence rates, pain, shoulder function, active range of motion (ROM), RTS rate, and patients’ fears and expectations for RTS after arthroscopic Bankart repair with remplissage for anterior shoulder instability. We compared these outcomes with those after Bankart repair alone.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective cohort study was carried out between 2007 and 2017 among patients who underwent arthroscopic Bankart repair with remplissage (group BR) and Bankart repair alone (group B). At the final follow-up, outcomes including recurrence, pain, shoulder function, active ROM, RTS rate, and fear toward RTS were assessed. The specific outcomes for RTS were evaluated based on 3 levels: return to normal life, RTS at any level (RTSA), and RTS at previous level (RTSP).

Results:

A total of 70 patients were included (29 in group BR and 41 in group B) with a mean 67.2 months of follow-up. Group BR demonstrated a significantly lower recurrence rate than did group B (0 vs 22.0%, respectively; P = .007) as well as higher postoperative Rowe score (92.8 ± 7.1 vs 83.3 ± 16.2, respectively; P = .005). There were no differences between the groups in postoperative visual analog scale for pain score, American Shoulder and Elbow Surgeons score, Oxford Shoulder Instability Score, or active ROM. The rates of RTSA (100% vs 84.2%; P = .03) and RTSP (77.8% vs 50.0%; P = .02) were higher in group BR than in group B, respectively, and significantly fewer patients in group BR reported fear of RTS (40.7% vs 63.2%; P = .04).

Conclusion:

In this study, recurrence rate, pain, shoulder function, active ROM, and RTS rate were satisfactory after arthroscopic Bankart repair with remplissage. Patients who underwent this procedure reported less fear toward RTS and higher rates of RTSA and RTSP than did those who undergo Bankart repair alone.
Creating a Femoral Tunnel Aperture at the Anteromedial Footprint Versus the Central Footprint in ACL Reconstruction: Comparison of Contact Stress Patterns
Authors: Kim Sung-Jae , Song Si Young , Kim Tae Soung , Kim Yoon Sang , Jang Seong-Wook , Seo Young-Jin
Published: April 2021

Background:

It remains unclear whether an anteromedial (AM) footprint or a central footprint anterior cruciate ligament (ACL) graft exhibits less contact stress with the femoral tunnel aperture. This contact stress can generate graft attrition forces, which can lead to potential graft failure.

Purpose/Hypothesis:

The purpose of this study was to compare the difference in contact stress patterns of the graft around a femoral tunnel that is created at the anatomic AM footprint versus the central footprint. It was hypothesized that the difference in femoral tunnel positions would influence the contact stress at the interface between the reconstructed graft and the femoral tunnel orifice.

Study Design:

Controlled laboratory study.

Methods:

A total of 24 patients who underwent anatomic single-bundle ACL reconstruction were included in this study. In 12 patients, the femoral tunnels were created at the center of the native AM footprint (AM group), and in the remaining 12 patients the center of the femoral tunnel was placed in the anatomic central footprint (central group). Three-dimensional knee models were created and manipulated using several modeling programs, and the graft-tunnel angle (GTA) was determined using a special software program. The peak contact stresses generated on the virtual ACL graft around the femoral tunnel orifice were calculated using a finite element method.

Results:

The mean GTA was significantly more obtuse in the AM group than in the central group (124.2° ± 5.9° vs 112.6° ± 7.9°; P = .001). In general, both groups showed high stress distribution on the anterior surface of the graft, which came in contact with the anterior aspect of the femoral tunnel aperture. The degree of stress in the central group (5.3 ± 2.6 MPa) was significantly higher than that in the AM group (1.2 ± 1.1 MPa) ( P < .001).

Conclusion:

Compared with the AM footprint ACL graft, the central footprint ACL graft developed significantly higher contact stress in the extended position, especially around the anterior aspect of the femoral tunnel orifice.

Clinical Relevance:

The contact stress of the ACL graft at the extended position of the knee may be minimized by creating the femoral tunnel at the AM-oriented footprint.
Trump Paradox: How Immigration and Trade Affected White Voting and Attitudes
Authors: Hinojosa Ojeda Raul , Telles Edward
Published: April 2021

Donald Trump presented immigration and trade as the cause of the diminished prospects of white working-class voters, the core of his political base. The authors’ research—the first that examines actual immigration and trade exposure with attitudes and Trump voting—demonstrates that white voting for Trump was unrelated to immigration levels and, paradoxically, strongest in counties with low levels of trade. Anti-immigrant and antitrade attitudes more consistently and strongly explain voting for Trump and Republicans in 2016 and 2018 than actual immigration and trade. The authors also find descriptive support that over four years, Trump’s false narrative unraveled as his support declined in those counties most exposed to immigration and trade. Although Trump elaborated a white nationalist narrative on the basis of anti-immigrant and antitrade politics that was widely accepted as truth, the authors show that virtually no aspects of Trump’s simple narrative have any factual basis in actual reality.
Million Trees for Warsaw: Managing pollution crisis through green renewal
Authors: Hrckova Jana
Published: April 2021

The article proposes the notion of a “spectacle of repair,” a carefully calibrated social technology of green governance aimed at managing the environmental degradation through control over images in Warsaw, Poland. Using case studies Million Trees for Warsaw project and a candidacy for the Green Capital of Europe and building on political ecology literature that addresses the rise of new opportunities for capitalist expansion through restoration activity, this article claims that the production of the green policy sphere allows for a creation of an array of possible “green” actions in the city that are presented as interchangeable and effectively commensurable. As the municipality heavily invests in greenery and a removal of visible signs of messiness and dirt in the city, the depoliticized spectacle of a clean and green urban space focuses on creating an image of the authorities actively combating the pollution as well as working towards making Warsaw more “livable.” At the same time, the two major roots of pollution found in ever-increasing car traffic and old coal-heating systems remain insufficiently addressed amid a lack of political will. The paper argues that mitigation strategy of the city hall thus heavily relies on a management of visibilities; attempting to alleviate the citizens’ pressure to tackle the largely invisible air pollution by delivering the tidy greenery desired by the urban elites, keeping the city fit for competing in the global neoliberal economy.
A phase 1 randomized study of hemodynamic effects and pharmacokinetic interactions during concomitant use of rimegepant and sumatriptan in healthy adults
Authors: Croop Robert , Ivans Andrea , Anderson Matt S , Stringfellow Joseph , Bertz Richard , Hanna Michael , Healy Francine , Stock David A , Coric Vladimir , Lipton Richard B
Published: April 2021

Objective:

This randomized, partially-blinded, placebo-controlled study evaluated hemodynamic effects, pharmacokinetic interactions, and safety of concomitant administration of oral rimegepant and subcutaneous sumatriptan.

Methods:

Healthy non-smokers aged ≥18 and ≤40 years (men) or ≥18 and ≤50 years (women) were enrolled. On Day 1, subjects received 12 mg of sumatriptan as 2 subcutaneous 6 mg injections separated by 1 hour. From Days 2 to 4, subjects received rimegepant or placebo once daily (randomized 6 to 1, rimegepant to placebo). On Day 5, subjects received rimegepant or placebo, followed 2 hours later by 2 subcutaneous 6 mg injections of sumatriptan, separated by 1 hour. Sumatriptan was administered at the same times as on Day 1.

Results:

All 42 dosed subjects were analyzed. There were no significant differences in the time-weighted average of mean arterial pressure, diastolic blood pressure, or systolic blood pressure between treatment with rimegepant + sumatriptan and sumatriptan alone. Co-administration of rimegepant and sumatriptan had no effect on the pharmacokinetics of either drug. Overall, 93% (39/42) of subjects experienced ≥1 adverse event; injection site reaction was most common (60% [29/42]).

Conclusions:

Concomitant administration of oral rimegepant and subcutaneous sumatriptan to healthy adults was without hemodynamic or pharmacokinetic interaction and was safe and well tolerated.
Art, memory, and disappearance in contemporary Mexico: A conversation with Alfredo López Casanova
Authors: López Casanova Alfredo , Melenotte Sabrina , Vallejo Flores Verónica
Published: April 2021

In his work, the Mexican sculptor Alfredo López Casanova pushes the boundaries of both art and politics. For Violence: An international journal, he takes a look back at his personal and collective trajectory, from his early and “natural” political and social commitment in his neighborhood to the tragic reality of contemporary Mexico. He reflects on several of his previous individual works, such as the bronze sculpture Fray Antonio Alcalde, and collective projects he is a part of, such as “Huellas de la Memoria” (Footprints of Memory). For the latter initiative, the intimate recollections of the families of disappeared persons are engraved on the soles of shoes, powerfully illustrating how the construction of memory goes hand in hand with calls for justice and truth.
Multisite 11-year experience of less-intensive vs intensive therapies in acute myeloid leukemia
Authors: Sorror Mohamed L. , Storer Barry E. , Fathi Amir T. , Brunner Andrew , Gerds Aaron T. , Sekeres Mikkael A. , Mukherjee Sudipto , Medeiros Bruno C. , Wang Eunice S. , Vachhani Pankit , Shami Paul J. , Peña Esteban , Elsawy Mahmoud , Adekola Kehinde , Luger Selina , Baer Maria R. , Rizzieri David , Wildes Tanya M. , Koprivnikar Jamie , Smith Julie , Garrison Mitchell , Kojouri Kiarash , Leisenring Wendy , Onstad Lynn , Nyland Jennifer E. , Becker Pamela S. , McCune Jeannine S. , Lee Stephanie J. , Sandmaier Brenda M. , Appelbaum Frederick R. , Estey Elihu H.
Published: April 2021

Less-intensive induction therapies are increasingly used in older patients with acute myeloid leukemia (AML). Using an AML composite model (AML-CM) assigning higher scores to older age, increased comorbidity burdens, and adverse cytogenetic risks, we defined 3 distinct prognostic groups and compared outcomes after less-intensive vs intensive induction therapies in a multicenter retrospective cohort (n = 1292) treated at 6 institutions from 2008 to 2012 and a prospective cohort (n = 695) treated at 13 institutions from 2013 to 2017. Prospective study included impacts of Karnofsky performance status (KPS), quality of life (QOL), and physician perception of cure. In the retrospective cohort, recipients of less-intensive therapies were older and had more comorbidities, more adverse cytogenetics, and worse KPS. Less-intensive therapies were associated with higher risks of mortality in AML-CM scores of 4 to 6, 7 to 9, and ≥10. Results were independent of allogeneic transplantation and similar in those age 70 to 79 years. In the prospective cohort, the 2 groups were similar in baseline QOL, geriatric assessment, and patient outcome preferences. Higher mortality risks were seen after less-intensive therapies. However, in models adjusted for age, physician-assigned KPS, and chance of cure, mortality risks and QOL were similar. Less-intensive therapy recipients had shorter length of hospitalization (LOH). Our study questions the survival and QOL benefits (except LOH) of less-intensive therapies in patients with AML, including those age 70 to 79 years or with high comorbidity burdens. A randomized trial in older/medically infirm patients is required to better assess the value of less-intensive and intensive therapies or their combination. This trial was registered at www.clinicaltrials.gov as #NCT01929408.
Involvement of CFTR in the pathogenesis of pulmonary arterial hypertension
Authors: Le Ribeuz Hélène , To Lucie , Ghigna Maria-Rosa , Martin Clémence , Nagaraj Chandran , Dreano Elise , Rucker-Martin Catherine , Girerd Barbara , Bouligand Jérôme , Pechoux Christine , Lambert Mélanie , Boet Angèle , Issard Justin , Mercier Olaf , Hoetzenecker Konrad , Manoury Boris , Becq Frédéric , Burgel Pierre-Régis , Cottart Charles-Henry , Olschewski Andrea , Sermet-Gaudelus Isabelle , Perros Frédéric , Humbert Marc , Montani David , Antigny Fabrice
Published: April 2021

Introduction

A reduction in pulmonary artery relaxation is a key event in the pathogenesis of pulmonary arterial hypertension (PAH). Cystic fibrosis transmembrane conductance regulator (CFTR) dysfunction in airway epithelial cells plays a central role in cystic fibrosis; CFTR is also expressed in pulmonary arteries and has been shown to control endothelium-independent relaxation.

Aim and objectives

We aimed to delineate the role of CFTR in PAH pathogenesis through observational and interventional experiments in human tissues and animal models.

Methods and results

Reverse-transcriptase quantitative PCR, confocal imaging and electron microscopy showed that CFTR expression was reduced in pulmonary arteries from patients with idiopathic PAH (iPAH) and in rats with monocrotaline-induced pulmonary hypertension (PH). Moreover, using myography on human, pig and rat pulmonary arteries, we demonstrated that CFTR activation induces pulmonary artery relaxation. CFTR-mediated pulmonary artery relaxation was reduced in pulmonary arteries from iPAH patients and rats with monocrotaline- or chronic hypoxia-induced PH. Long-termin vivoCFTR inhibition in rats significantly increased right ventricular systolic pressure, which was related to exaggerated pulmonary vascular cell proliferationin situand vessel neomuscularisation. Pathologic assessment of lungs from patients with severe cystic fibrosis (F508del-CFTR) revealed severe pulmonary artery remodelling with intimal fibrosis and medial hypertrophy. Lungs from homozygousF508delCftrrats exhibited pulmonary vessel neomuscularisation. The elevations in right ventricular systolic pressure and end diastolic pressure in monocrotaline-exposed rats with chronic CFTR inhibition were more prominent than those in vehicle-exposed rats.

Conclusions

CFTR expression is strongly decreased in pulmonary artery smooth muscle and endothelial cells in human and animal models of PH. CFTR inhibition increases vascular cell proliferation and strongly reduces pulmonary artery relaxation.
Diagnostic accuracy of a novel point-of-care urine lipoarabinomannan assay for the detection of tuberculosis among adult outpatients in Zambia: a prospective cross-sectional study
Authors: Muyoyeta Monde , Kerkhoff Andrew D. , Chilukutu Lophina , Moreau Emmanuel , Schumacher Samuel G. , Ruhwald Morten
Published: April 2021

Background

A novel, rapid, point-of-care urine-based lipoarabinomannan assay (Fujifilm SILVAMP TB LAM (“FujiLAM”)) has previously demonstrated substantially higher sensitivity for tuberculosis (TB) compared with the commercially available Determine TB LAM assay using biobanked specimens. However, FujiLAM has not been prospectively evaluated using fresh urine specimens. Therefore, we determined the diagnostic accuracy of FujiLAM among HIV-positive and HIV-negative outpatients with presumptive TB in Zambia.

Methods

Adult (≥18 years old) presumptive TB patients presenting to two outpatient public health facilities in Lusaka were included. All patients submitted sputa samples for smear microscopy, Xpert MTB/RIF and mycobacterial culture, and urine samples for the FujiLAM assay. Microbiologically confirmed TB was defined by the detection ofMycobacterium tuberculosisin sputum using culture; this served as the reference standard to assess the diagnostic accuracy of FujiLAM.

Results

151 adults with paired sputum microbiological tests and urine FujiLAM results were included; 45% were HIV-positive. Overall, 34 out of 151 (23%) patients had culture-confirmed pulmonary TB. The overall sensitivity and specificity of FujiLAM was 77% (95% CI 59–89%) and 92% (95% CI 86–96%), respectively. FujiLAM's sensitivity among HIV-positive patients was 75% (95% CI 43–95%) compared with 75% (95% CI 51–91%) among HIV-negative patients. The sensitivity of FujiLAM in patients with smear-positive, confirmed pulmonary TB was 87% (95% CI 60–98%) compared with 68% (95% CI 43–87%) among patients with smear-negative, confirmed pulmonary TB.

Conclusions

FujiLAM demonstrated high sensitivity for the detection of TB among both HIV-positive and HIV-negative adults, and also demonstrated good specificity despite the lack of systematic extrapulmonary sampling to inform a comprehensive microbiological reference standard.
Pulmonary granulomatosis of genetic origin
Authors: Bode Sebastian F.N. , Rohr Jan , Müller Quernheim Joachim , Seidl Maximilan , Speckmann Carsten , Heinzmann Andrea
Published: April 2021

Granulomatous inflammation of the lung can be a manifestation of different conditions and can be caused by endogenous inflammation or external triggers. A multitude of different genetic mutations can either predispose patients to infections with granuloma-forming pathogens or cause autoinflammatory disorders, both leading to the phenotype of pulmonary granulomatosis. Based on a detailed patient history, physical examination and a diagnostic approach including laboratory workup, pulmonary function tests (PFTs), computed tomography (CT) scans, bronchoscopy with bronchoalveolar lavage (BAL), lung biopsies and specialised microbiological and immunological diagnostics, a correct diagnosis of an underlying cause of pulmonary granulomatosis of genetic origin can be made and appropriate therapy can be initiated. Depending on the underlying disorder, treatment approaches can include antimicrobial therapy, immunosuppression and even haematopoietic stem cell transplantation (HSCT). Patients with immunodeficiencies and autoinflammatory conditions are at the highest risk of developing pulmonary granulomatosis of genetic origin. Here we provide a review on these disorders and discuss pathogenesis, clinical presentation, diagnostic approach and treatment.
Effect of pulmonary hypertension on exercise tolerance in patients with COPD: a prognostic systematic review and meta-analysis
Authors: Torres-Castro Rodrigo , Gimeno-Santos Elena , Vilaró Jordi , Roqué-Figuls Marta , Moisés Jorge , Vasconcello-Castillo Luis , Orizaga Tanya , Barberà Joan Albert , Blanco Isabel
Published: April 2021

Background

Pulmonary hypertension (PH) is a frequent complication in patients with COPD.

Objective

To determine if, in patients with COPD, the presence of PH decreases exercise tolerance.

Methods

We included studies that analysed exercise tolerance using a cardiopulmonary exercise test (CPET) in patients with COPD with PH (COPD-PH) and without PH (COPD-nonPH). Two independent reviewers analysed the studies, extracted the data and assessed the quality of the evidence.

Results

Of the 4915 articles initially identified, seven reported 257 patients with COPD-PH and 404 patients with COPD-nonPH. The COPD-PH group showed differences in peak oxygen consumption (V′O2peak), −3.09 mL·kg−1·min−1(95% CI −4.74 to −1.43, p=0.0003); maximum workload (Wmax), −20.5 W (95% CI −34.4 to −6.5, p=0.004); and oxygen pulse (O2pulse), −1.24 mL·beat−1(95% CI −2.40 to −0.09, p=0.03), in comparison to the group with COPD-nonPH. If we excluded studies with lung transplant candidates, the sensitivity analyses showed even bigger differences:V′O2, −4.26 mL·min−1·kg−1(95% CI −5.50 to −3.02 mL·kg−1·min−1, p<0.00001); Wmax, −26.6 W (95% CI −32.1 to −21.1 W, p<0.00001); and O2pulse, −2.04 mL·beat−1(95% CI −2.92 to −1.15 mL·beat−1, p<0.0001).

Conclusion

Exercise tolerance was significantly lower in patients with COPD-PH than in patients with COPD-nonPH, particularly in nontransplant candidates.
Interstitial lung disease in lysosomal storage disorders
Authors: Borie Raphaël , Crestani Bruno , Guyard Alice , Lidove Olivier
Published: April 2021

Lysosomes are intracellular organelles that are responsible for degrading and recycling macromolecules. Lysosomal storage diseases (LSDs) are a group of inherited diseases caused by mutations affecting genes that encode the function of the lysosomal enzymes. Three LSDs are associated with lung involvement and/or interstitial lung disease (ILD): Gaucher disease (GD); Niemann–Pick disease, also known as acid sphingomyelinase deficiency (ASMD); and Fabry disease (FD). In GD and in ASMD, analysis of bronchoalveolar lavage fluid and lung biopsy can be informative, showing foamy cells. In GD, ILD is rare. Enzyme replacement therapy (ERT) has been available since 1991 and has greatly changed the natural history of GD, with pulmonary failure and death reported before the ERT era. In ASMD, ILD is frequent and is usually associated with spleen enlargement, low platelet cell count and low level of high-density lipoprotein-cholesterol. Results of ERT are promising regarding preliminary results of olipudase alfa in paediatric and adult ASMD populations. The most frequent respiratory manifestation in FD is COPD-like symptoms regardless of smoking habit and dyspnoea due to congestive heart failure. Early diagnosis of these three LSDs is crucial to prevent irreversible organ damage. Early initiation of ERT can, at least in part, prevent organ failure.
Home-based pulmonary rehabilitation in people with bronchiectasis: a randomised controlled trial
Authors: José Anderson , Holland Anne E. , Selman Jessyca P.R. , de Camargo Cristiane Oliveira , Fonseca Diogo Simões , Athanazio Rodrigo A. , Rached Samia Z. , Cukier Alberto , Stelmach Rafael , Dal Corso Simone
Published: April 2021

Aim

To investigate the short- and long-term effects of home-based pulmonary rehabilitation (HBPR) on functional capacity, quality of life, peripheral muscle strength, dyspnoea and daily physical activity in people with bronchiectasis.

Methods

Randomised controlled trial with 63 participants with bronchiectasis. The HBPR group performed three sessions per week for 8 weeks (aerobic exercise: step training for 20 min; resistance training: exercises for quadriceps, hamstrings, deltoids and biceps brachii using elastic bands). The control group received a recommendation to walk at moderate intensity, three times per week. A weekly phone call was conducted for all participants, and the HBPR group received a home visit every 15 days. The primary outcome was distance in the incremental shuttle walk test (ISWT). Secondary outcomes were time in the endurance shuttle walk test (ESWT), number of steps in the incremental step test, quality of life, quadriceps muscle strength and daily physical activity. Measures were taken before and after intervention and 6 months later.

Results

After the intervention, the HBPR group had increased ISWT distance compared with the control group with between-group difference 87.9 m (95% CI 32.4–143.5 m). In addition, between-group differences were found in the ESWT, incremental step test, quality of life and quadriceps muscle strength, favouring the HBPR group. After 6 months, no differences were observed between the groups.

Conclusion

HBPR is an effective alternative offering of pulmonary rehabilitation for people with bronchiectasis. However, the programme was not effective in maintaining the benefits after 6 months of follow-up.
Delivered dose with jet and mesh nebulisers during spontaneous breathing, noninvasive ventilation and mechanical ventilation using adult lung models
Authors: Ari Arzu , Fink James B.
Published: April 2021

What is the delivered dose with jet and mesh nebulisers during spontaneous breathing (SB), noninvasive ventilation (NIV), and mechanical ventilation (MV) using an adult lung model with exhaled humidity (EH)?

The delivery of salbutamol sulfate (2.5 mg per 3 mL) with jet (Mistymax10) and mesh nebulisers (Aerogen Solo) was compared during SB, NIV, and MV using breathing parameters (tidal volume 450 mL, respiratory rate 20 breaths per min, inspiratory:expiratory ratio 1:3) with three lung models simulating exhaled humidity. A manikin was attached to a sinusoidal pumpviaa filter at the bronchi to simulate an adult with SB. A ventilator (V60) was attachedviaa facemask to a manikin with a filter at the bronchi connected to a test lung to simulate an adult receiving NIV. A ventilator-dependent adult was simulated through a ventilator (Servo-i) operated with a heated humidifier (Fisher & Paykel) attached to an endotracheal tube (ETT) with a heated-wire circuit. The ETT was inserted into a filter (Respirgard II). A heated humidifier was placed between the filter and test lung to simulate exhaled humidity (35±2°C, 100% relative humidity). Nebulisers were placed at the Y-piece of the inspiratory limb during MV and positioned between the facemask and the leak-port during NIV. A mouthpiece was used during SB. The delivered dose was collected in an absolute filter that was attached to the bronchi of the mannequin during each aerosol treatment and measured with spectrophotometry.

Drug delivery during MV was significantly greater than during NIV and SB with a mesh nebuliser (p=0.0001) but not with a jet nebuliser (p=0.384). Delivery efficiency of the mesh nebuliser was greater than the jet nebuliser during MV (p=0.0001), NIV (p=0.0001), and SB (p=0.0001).

Aerosol deposition obtained with a mesh nebuliser was greater and differed between MV, NIV, and SB, while deposition was low with a jet nebuliser and similar between the modes of ventilation tested.
ERS International Congress 2020: highlights from the Clinical Techniques, Imaging and Endoscopy assembly
Authors: Pietersen Pia Iben , Klap Bibi , Hersch Nicole , Laursen Christian B. , Walsh Simon , Annema Jouke , Gompelmann Daniela
Published: April 2021

The European Respiratory Society congress in the year 2020, a year dominated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, was the first virtual congress planned with an innovative and interactive congress programme upfront. It was a large, novel platform for scientific discussion and presentations of cutting-edge innovative developments. This article summarises a selection of the scientific highlights from the Clinical Techniques, Imaging and Endoscopy assembly (assembly 14). In addition to presentations on the important role of bronchoscopy, imaging and ultrasound techniques in the field of SARS-CoV-2 infection, novel diagnostic approaches and innovative therapeutic strategies in patients with lung cancer, interstitial lung disease, obstructive airway disorders and infectious diseases were discussed.
Endobronchial autologous bone marrow–mesenchymal stromal cells in idiopathic pulmonary fibrosis: a phase I trial
Authors: Campo Arantza , González-Ruiz José María , Andreu Enrique , Alcaide Ana B. , Ocón María M. , De-Torres Juan , Pueyo Jesús , Cordovilla Rosa , Villaron Eva , Sanchez-Guijo Fermín , Barrueco Miguel , Nuñez-Córdoba Jorge , Prósper Felipe , Zulueta Javier J.
Published: April 2021

Rationale

Idiopathic pulmonary fibrosis (IPF) has a dismal prognosis. Mesenchymal stromal cells (MSCs) have shown benefit in other inflammatory diseases.

Objectives

To evaluate the safety and feasibility of endobronchial administration of bone marrow autologous MSCs (BM-MSC) in patients with mild-to-moderate IPF.

Methods

A phase I multicentre clinical trial (ClinicalTrials.govNCT01919827) with a single endobronchial administration of autologous adult BM-MSCs in patients diagnosed with mild-to-moderate IPF. In a first escalating-dose phase, three patients were included sequentially in three dose cohorts (10×106, 50×106and 100×106cells). In a second phase, nine patients received the highest tolerated dose. Follow-up with pulmonary function testing, 6-min walk test and St George's Respiratory Questionnaire was done at 1, 2, 3, 6 and 12 months, and with computed tomography at 3, 6 and 12 months.

Results

21 bone marrow samples were obtained from 17 patients. Three patients were excluded from treatment due to chromosome aberrations detected in MSCs after culture, and one patient died before treatment. Finally, 13 patients received the BM-MSC infusion. No treatment-related severe adverse events were observed during follow-up. Compared to baseline, the mean forced vital capacity showed an initial decline of 8.1% at 3 months. The number of patients without functional progression was six (46%) at 3 months and three (23%) at 12 months.

Conclusions

The endobronchial infusion of BM-MSCs did not cause immediate serious adverse events in IPF patients, but a relevant proportion of patients suffered clinical and/or functional progression. Genomic instability of BM-MSCs during culture found in three patients may be troublesome for the use of autologous MSCs in IPF patients.
GPrimer: a fast GPU-based pipeline for primer design for qPCR experiments
Authors: Bae Jeongmin , Jeon Hajin , Kim Min-Soo
Published: April 2021

Background

Design of valid high-quality primers is essential for qPCR experiments. MRPrimer is a powerful pipeline based on MapReduce that combines both primer design for target sequences and homology tests on off-target sequences. It takes an entire sequence DB as input and returns all feasible and valid primer pairs existing in the DB. Due to the effectiveness of primers designed by MRPrimer in qPCR analysis, it has been widely used for developing many online design tools and building primer databases. However, the computational speed of MRPrimer is too slow to deal with the sizes of sequence DBs growing exponentially and thus must be improved.

Results

We develop a fast GPU-based pipeline for primer design (GPrimer) that takes the same input and returns the same output with MRPrimer. MRPrimer consists of a total of seven MapReduce steps, among which two steps are very time-consuming. GPrimer significantly improves the speed of those two steps by exploiting the computational power of GPUs. In particular, it designs data structures for coalesced memory access in GPU and workload balancing among GPU threads and copies the data structures between main memory and GPU memory in a streaming fashion. For human RefSeq DB, GPrimer achieves a speedup of 57 times for the entire steps and a speedup of 557 times for the most time-consuming step using a single machine of 4 GPUs, compared with MRPrimer running on a cluster of six machines.

Conclusions

We propose a GPU-based pipeline for primer design that takes an entire sequence DB as input and returns all feasible and valid primer pairs existing in the DB at once without an additional step using BLAST-like tools. The software is available athttps://github.com/qhtjrmin/GPrimer.git.
Searching for universal model of amyloid signaling motifs using probabilistic context-free grammars
Authors: Dyrka Witold , Gąsior-Głogowska Marlena , Szefczyk Monika , Szulc Natalia
Published: April 2021

Background

Amyloid signaling motifs are a class of protein motifs which share basic structural and functional features despite the lack of clear sequence homology. They are hard to detect in large sequence databases either with the alignment-based profile methods (due to short length and diversity) or with generic amyloid- and prion-finding tools (due to insufficient discriminative power). We propose to address the challenge with a machine learning grammatical model capable of generalizing over diverse collections of unaligned yet related motifs.

Results

First, we introduce and test improvements to our probabilistic context-free grammar framework for protein sequences that allow for inferring more sophisticated models achieving high sensitivity at low false positive rates. Then, we infer universal grammars for a collection of recently identified bacterial amyloid signaling motifs and demonstrate that the method is capable of generalizing by successfully searching for related motifs in fungi. The results are compared to available alternative methods. Finally, we conduct spectroscopy and staining analyses of selected peptides to verify their structural and functional relationship.

Conclusions

While the profile HMMs remain the method of choice for modeling homologous sets of sequences, PCFGs seem more suitable for building meta-family descriptors and extrapolating beyond the seed sample.
Genome-wide analyses of the relict gull (Larus relictus): insights and evolutionary implications
Authors: Yang Chao , Li Xuejuan , Wang Qingxiong , Yuan Hao , Huang Yuan , Xiao Hong
Published: April 2021

Background

The relict gull (Larus relictus), was classified as vulnerable on the IUCN Red List and is a first-class national protected bird in China. Genomic resources for L. relictus are lacking, which limits the study of its evolution and its conservation.

Results

In this study, based on the Illumina and PacBio sequencing platforms, we successfully assembled the genome of L. relictus, one of the few known reference genomes in genus Larus. The size of the final assembled genome was 1.21 Gb, with a contig N50 of 8.11 Mb. A total of 18,454 genes were predicted from the assembly results, with 16,967 (91.94%) of these genes annotated. The genome contained 92.52 Mb of repeat sequence, accounting for 7.63% of the assembly. A phylogenetic tree was constructed using 4902 single-copy orthologous genes, which showed L. relictus had closest relative of L. smithsonianus, with divergence time of 14.7 Mya estimated between of them. PSMC analyses indicated that L. relictus had been undergoing a long-term population decline during 0.01-0.1 Mya with a small effective population size fom 8800 to 2200 individuals.

Conclusions

This genome will be a valuable genomic resource for a range of genomic and conservation studies of L. relictus and will help to establish a foundation for further studies investigating whether the breeding population is a complex population. As the species is threatened by habitat loss and fragmentation, actions to protect L. relictus are suggested to alleviate the fragmentation of breeding populations.
Prophylactic temporary abdominal aortic balloon occlusion for patients with pernicious placenta previa: a retrospective study
Authors: Huo Fei , Liang Hansheng , Feng Yi
Published: April 2021

Background

Pernicious placenta previa (PPP) can increase the risk of perioperative complications. During caesarean section in patients with adherent placenta, intraoperative blood loss, hysterectomy rate and transfusion could be reduced by interventional methods. Our study aimed to investigate the influence of maternal hemodynamics control and neonatal outcomes of prophylactic temporary abdominal aortic balloon (PTAAB) occlusion for patients with pernicious placenta previa.

Methods

This was a retrospective study using data from the Peking University People’s Hospital from January 2014 through January 2020. Clinical records of pregnant women undergoing cesarean section were collected. Patients were divided into two groups: treatment with PTAAB placement (group A) and no balloon placement (group B). Group A was further broken down into two groups: prophylactic placement (Group C) and balloon occlusion (group D).

Results

Clinical records of 33 cases from 5205 pregnant women underwent cesarean section were collected. The number of groups A, B, C, and D were 17, 16, 5 and 12.We found that a significant difference in the post-operative uterine artery embolism rates between group A and group B (0% vs.31.3%, p = 0.018). There was a significant difference in the Apgar scores at first minute between group A and group B (8.94 ± 1.43 vs 9.81 ± 0.75,p = 0.037),and the same significant difference between two groups in the pre-operative central placenta previa (29.4% vs. 0%,p = 0.044), complete placenta previa (58.8% vs 18.8%, p = 0.032),placenta implantation (76.5% vs 31.3%, p = 0.015). We could also observe the significant difference in the amount of blood cell (2.80 ± 2.68vs.10.66 ± 11.97, p = 0.038) and blood plasma transfusion (280.00 ± 268.32 vs. 1033.33 ± 1098.20, p = 0.044) between group C and group D. The significant differences in the preoperative vaginal bleeding conditions (0% vs 75%, p = 0.009), the intraoperative application rates of vasopressors (0% vs. 58.3%, p = 0.044) and the postoperative ICU (intensive care unit) admission rates (0% vs. 58.3%, p = 0.044) were also kept.

Conclusions

PTAAB occlusion could be useful in reducing the rate of post-operative uterine artery embolism and the amount of transfusion, and be useful in coping with patients with preoperative vaginal bleeding conditions, so as to reduce the rate of intraoperative applications of vasopressors and the postoperative ICU (intensive care unit) admission. In PPP patients with placenta implantation, central placenta previa and complete placenta previa, we advocate the utilization of prophylactic temporary abdominal aortic balloon placement.
Causes of hospitalisation among a cohort of people with HIV from a London centre followed from 2011 to 2018
Authors: Rein Sophia M. , Lampe Fiona C. , Chaloner Clinton , Stafford Adam , Rodger Alison J. , Johnson Margaret A. , McDonnell Jeffrey , Burns Fiona , Madge Sara , Miners Alec , Sherr Lorraine , Collins Simon , Speakman Andrew , Phillips Andrew N. , Smith Colette J.
Published: April 2021

Background

We describe the spectrum of ICD-10 classified causes for hospitalisations occurring between 2011 and 2018 in a cohort of people living with HIV (PLHIV).

Methods

This sub-study includes 798 PLHIV participating in the Antiretroviral, Sexual Transmission Risk and Attitudes (ASTRA) questionnaire study who were recruited from a large London centre. A medical record review identified the occurrence and causes of hospitalisation from the date of questionnaire completion (February–December 2011) until 1 June 2018. Up to five causes were classified by an HIV clinician using the ICD-10 system.

Results

There were 274 hospitalisations in 153 people (rate = 5.8/100 person-years; 95% CI: 5.1, 6.5). Causes were wide-ranging; the most common were circulatory (16.8%), digestive (13.1%), respiratory (11.7%), infectious diseases (11.0%), injury/poisoning (10.6%), genitourinary diseases (9.9%) and neoplasms (9.1%). A tenth (27/274) of hospitalisations were related to at least one AIDS-defining illness. Median duration of hospitalisation was 5 days (IQR 2–9). At the time of hospitalisation, median CD4 count was high (510 cells/μl; IQR: 315–739), while median CD4 nadir was relatively low (113 cells/μl; IQR: 40–239). At admission, half of individuals (51%) had a previous AIDS-defining illness and 21% had viral load > 50 copies/ml. Individuals admitted for infectious diseases were particularly likely to have unfavourable HIV-related clinical characteristics (low CD4, viral non-suppression, not on antiretroviral therapy (ART), previous AIDS).

Conclusions

In the modern combination antiretroviral therapy era, the spectrum of causes of hospitalisation in PLHIV in the UK is wide-ranging, highlighting the importance of holistic care for PLHIV, including prevention, early detection and treatment of comorbidities.
Correction to: The psychometric properties of the Bergen–Yale sex addiction scale for the Iranian population
Authors: Youseflu Samaneh , Kraus Shane W. , Razavinia Fatemeh , Afrashteh Majid Yousefi , Niroomand Soudabeh
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.
Social support and depressive symptoms among physicians in tertiary hospitals in China: a cross-sectional study
Authors: Fu Chang , Wang Guowen , Shi Xiuxin , Cao Fenglin
Published: April 2021

Background

Social support is an important factor for individual’s mental health. However, the association between social support and depressive symptoms among physicians in China’ tertiary hospitals has not been explored. This study aimed to investigate its association among physicians stratifying by sex.

Methods

Six hundred fifty-six physicians were enrolled from 12 tertiary hospitals of Shandong Province, China. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale. Social support was evaluated using the Social Support Rating Scale. Multiple linear regression analysis was used to examine the relationship between social support and depressive symptoms among physicians.

Results

The prevalence of depressive symptoms was 42.3% and the average social support score was 38.82 ± 7.53 among physicians. Lower subjective social support scores (male: β = − 0.317, p < 0.001; female: β = − 0.241, p < 0.001) and lower objective social support scores (male: β = − 0.218, p = 0.038; female: β = − 0.277, p = 0.035) were associated with high depressive symptoms among physicians. Lower support utilization scores (β = − 0.472, p < 0.001) were associated with high depressive symptoms among male physicians.

Conclusions

Chinese physicians had a higher prevalence of depressive symptoms and lower social support than the Chinese general population. Objective and subjective social support were inversely associated with depressive symptoms among male and female physicians while support utilization was inversely associated with depressive symptoms among male rather than female physicians. It is critical to improve physicians’ mental health through strengthening social support in China.
Effectiveness of personal protective health behaviour against COVID-19
Authors: Lio Chon Fu , Cheong Hou Hon , Lei Chin Ion , Lo Iek Long , Yao Lan , Lam Chong , Leong Iek Hou
Published: April 2021

Background

Novel coronavirus disease 2019 (COVID-19) has become a pandemic, and over 80 million cases and over 1.8 million deaths were reported in 2020. This highly contagious virus is spread primarily via respiratory droplets from face-to-face contact and contaminated surfaces as well as potential aerosol spread. Over half of transmissions occur from presymptomatic and asymptomatic carriers. Although several vaccines are currently available for emergency use, there are uncertainties regarding the duration of protection and the efficacy of preventing asymptomatic spread. Thus, personal protective health behaviour and measures against COVID-19 are still widely recommended after immunization. This study aimed to clarify the efficacy of these measures, and the results may provide valuable guidance to policymakers to educate the general public about how to reduce the individual-level risk of COVID-19 infection.

Methods

This case-control study enrolled 24 laboratory-confirmed COVID-19 patients from Centro Hospitalar Conde de São Januário (C.H.C.S.J.), which was the only hospital designated to manage COVID-19 patients in Macao SAR, China, and 1113 control participants who completed a 14-day mandatory quarantine in 12 designated hotels due to returning from high-risk countries between 17 March and 15 April 2020. A questionnaire was developed to extract demographic information, contact history, and personal health behaviour.

Results

Participants primarily came from the United Kingdom (33.2%), followed by the United States (10.5%) and Portugal (10.2%). Independent factors for COVID-19 infection were having physical contact with confirmed/suspected COVID-19 patients (adjusted OR, 12.108 [95% CI, 3.380–43.376], P < 0.005), participating in high-risk gathering activities (adjusted OR, 1.129 [95% CI, 1.048–1.216], P < 0.005), handwashing after outdoor activity (adjusted OR, 0.021 [95% CI, 0.003–0.134], P < 0.005), handwashing before touching the mouth and nose area (adjusted OR, 0.303 [95% CI, 0.114–0.808], P < 0.05), and wearing a mask whenever outdoors (adjusted OR, 0.307 [95% CI, 0.109–0.867], P < 0.05). The daily count of handwashing remained similar between groups. Only 31.6% of participants had a sufficient 20-s handwashing duration.

Conclusions

Participating in high-risk gatherings, wearing a mask whenever outdoors, and practising hand hygiene at key times should be advocated to the public to mitigate COVID-19 infection.
Does lock-down of Wuhan effectively restrict early geographic spread of novel coronavirus epidemic during chunyun in China? A spatial model study
Authors: Hu Yi , Kong Lingcai , Yao Tong , Chen Xinda , Du Wei
Published: April 2021

Background

Prior to Wuhan lock-down in 2020, chunyun, the largest population mobility on this planet, had begun. We quantified impact of Wuhan lock-down on COVID-19 spread during chunyun across the nation.

Methods

During the period of January 1 to February 9, 2020, a total of 40,278 confirmed COVID-19 cases from 319 municipalities in mainland China were considered in this study. The cross-coupled meta-population methods were employed using between-city Baidu migration index. We modelled four scenarios of geographic spread of COVID-19 including the presence of both chunyun and lock-down (baseline); lock-down without chunyun (scenario 1); chunyun without lock-down (scenario 2); and the absence of both chunyun and lock-down (scenario 3).

Results

Compared with the baseline, scenario 1 resulted in 3.84% less cases by February 9 while scenario 2 and 3 resulted in 20.22 and 32.46% more cases by February 9. The geographic distribution of cases revealed that chunyun facilitated the COVID-19 spread in the majority but not all cities, and the effectiveness of Wuhan lock-down was offset by chunyun. Impacts of Wuhan lock-down during chunyun on the COVID-19 spread demonstrated heterogenetic geographic patterns.

Conclusion

Our results strongly supported the travel restriction as one of the effective responses and highlighted the importance of developing area-specific rather than universal countermeasures.