bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Preconditioning on RBC Deformability in Critically Ill Patients
Authors: Moreau Anthony , Zouaoui Boudjeltia Karim , Biston Patrick , Piagnerelli Michael
Published: September 2022

OBJECTIVES:

RBCs from critically ill patients have depressed deformability, especially in sepsis. Prolonged exposure of RBCs from healthy volunteers to physiologic shear stress (the preconditioning technique) has been associated with improved deformability, but the effect of preconditioning on RBCs from critically ill patients with or without sepsis has never been studied.

DESIGN:

Prospective study.

SETTING:

A 32-bed medico-surgical ICU and a university-affiliated cell biology laboratory.

SUBJECTS:

RBCs from 26 healthy volunteers and 40 critically ill patients (20 with and 20 without sepsis).

INTERVENTIONS:

RBC deformability was measured using the elongation index (EI) with an ektacytometer, at shear stress levels ranging from 0.3 to 50 Pa. To assess the effects of preconditioning in the three groups, we measured EI after first applying a shear stress of 5 Pa for 300 seconds. To study the potential mechanisms involved in preconditioning, we looked at deformability after incubation of an RBC solution from the healthy volunteers with glutaraldehyde, a membrane-stabilizing protein, and neuraminidase, an enzyme that releases membrane sialic acid.

MEASUREMENTS AND MAIN RESULTS:

Baseline RBC deformability was significantly depressed in the septic patients compared with the volunteers at all shear stress levels greater than or equal to 4.89 Pa. Preconditioning improved deformability only in the volunteers (at shear stress levels of 0.48 and 0.76 Pa). Among the critically ill patients, preconditioning worsened RBC deformability at higher shear stress levels. After incubation (with glutaraldehyde or neuraminidase) of RBCs from five volunteers in whom preconditioning had significantly improved deformability, the positive effect of preconditioning was lost with glutaraldehyde.

CONCLUSIONS:

RBC deformability is depressed in septic patients. There was a deleterious effect of preconditioning on RBC deformability in septic patients, unlike the positive effect on RBCs from healthy volunteers. The effect of preconditioning may be associated with elasticity of the cell membrane.
Enhanced platelet NLRP3 inflammasome expression in patients with acute coronary syndrome and stable coronary artery disease: A prospective observational study
Authors: Qi Zhiyong , Liu Xin , Zhao Gang , Ge Junbo
Published: September 2022

Background and purpose:

Nucleotide-binding domain leucine-rich repeat containing protein (NLRP3) inflammasome contributes to the development and progression of atherosclerosis and cardiovascular diseases. Enhanced expression of NLRP3 in monocytes has been reported in patients with coronary artery disease (CAD). However, NLRP3 expression in platelets, an important link between inflammation and atherosclerosis/thrombosis in CAD patients has not been evaluated. The purpose of this study was to explore the expression of NLRP3 in platelets with acute coronary syndrome (ACS) and stable CAD.

Methods:

This prospective observational study included 60 treatment-naïve patients with newly diagnosed ACS, 60 patients with stable CAD, and 60 age- and sex-matched healthy individuals with normal coronary arteries (NCA). Platelet NLRP3 expression was evaluated by flow cytometry in venous blood samples, and compared among the 3 groups. Multivariate regression analysis was conducted to identify the risk of ACS.

Results:

Platelet NLRP3 expression was highest in the ACS group, followed by the stable CAD, and lowest in the NCA group (P < 0.001 for ACS vs. stable CAD, 44.7 ± 21.3 vs. 25.9 ± 15.9, as well as for stable CAD, vs. NCA, 25.9 ± 15.9 vs. 12.4 ± 7.2). Higher platelet NLRP3 correlated with higher plasma interleukin-1β and interleukin-18 (r = 0.662 and 0.324, respectively; P < 0.001 for both). In multivariate regression analysis, higher platelet NLRP3 was independently associated with ACS (odds ratio 1.06, 95% CI: 1.02–1.10 vs. stable CAD; odds ratio 1.23, 95% CI: 1.06–1.42 vs. NCA).

Conclusion:

Platelet NLRP3 expression was highest in the ACS group, followed by the stable CAD group, and lowest in the NCA group. Also, higher platelet NLRP3 expression was independently associated the ACS.
Evaluation of Fat Excision versus Sparing in Lower Blepharoplasty Using Orbital Gray Scale Analysis
Authors: Etman Adnan Gamal , Badawy Mohamed Samir , Setta Hany Saad , Magdy Amr , EL-badawy Ahmed
Published: September 2022

Background:

Orbital septum plication provides various benefits, including eliminating the necessity for a septal incision and the ability to relocate infraorbital fat in a more anatomically suitable manner. This study aimed to compare the results of traditional lower blepharoplasty with fat excision and the orbital septal plication method using orbital grey scale analysis as a new objective method for assessment.

Methods:

We conducted a prospective cohort study on patients with bilateral baggy lower eyelids who underwent traditional lower blepharoplasty with fat excision or fat-sparing technique using orbital septal plication. All patients were followed up closely for 1 week and then after 1, 3, and 6 months postoperatively to evaluate the study’s outcomes.

Results:

The study was conducted using 40 patients (20 patients per group). The total (medial, central, and lateral) orbital grey scale analysis showed a significant reduction in the fat-sparing and traditional groups (P < 0.001, each). However, the percentage of reduction was significantly higher in the fat-sparing group (34.6 ± 2.9 versus 15.5 ± 3.3 in the traditional groups; P < 0.001).

Conclusions:

The application of the fat-sparing technique is associated with favorable cosmetic outcomes and a lower complication rate than those of the traditional technique with fat excision. Further studies with a longer duration of follow-up and a larger sample size are required to estimate the risk of recurrence and the need for a revision procedure.
Thinking Out of the Box: Use of the Radial Artery Distally to the Snuffbox as Recipient Vessel
Authors: Troisi Luigi , Zanchetta Francesco , Vizcay Macarena , Stucchi Sara , Baez Antonio , Pajardi Eugenio
Published: September 2022

Background:

The use of the radial artery (RA) as a recipient vessel in the hand is mainly described in the snuffbox. However, we believe that employing the RA distally to the extensor pollicis longus (EPL) tendon may provide remarkable advantages.

Methods:

We conducted a prospective study from June 2019 until December 2021, which included all patients who underwent reconstructive procedures with the RA distally to the snuffbox as the recipient vessel. We reviewed patients’ medical records: demographics, type of trauma, defect characteristics, microsurgical procedure, reoperations, and short- and long-term complications.

Results:

We found 23 patients eligible for this study; 22 patients required a reconstructive procedure due to a trauma and one for a congenital malformation. RA distal to snuffbox was always identified and judged reliable and apt as a recipient vessel. There were no issues with the anastomosis and no total flap failure in all cases. The morbidity in the recipient area was also minimal, with no mobility deficits, loss of sensation, or neuroma development.

Conclusions:

The RA is the primary vessel in the dorsum of the distal upper limb; performing the anastomosis distally to the EPL tendon may offer various advantages, making the surgery safer and less invasive.
Tailored Skin Flaps for Hand Reconstruction
Authors: Vizcay Macarena , Pajardi Giorgio Eugenio , Zanchetta Francesco , Stucchi Sara , Baez Antonio , Troisi Luigi
Published: September 2022

Introduction:

Acquired soft-tissue defects of the hand can be a result of different types of trauma, infection, tumor resection, or burns. The evolution of the design and types of flaps have optimized the reconstruction and, nowadays, it is important to achieve not only a functional result but also an aesthetic result. The aim of the present study is to propose a model for treating a wide variety of skin defects in the hands based on our flap experience.

Methods:

We conducted a retrospective study from February 2019 to January 2022, which included all patients who underwent a skin flap for hand reconstruction. Patients’ medical records were reviewed and data collected included demographics, smoking status, presence of risk factors, type of trauma, flap reconstruction, dimensions, reoperations, and long-term complications.

Results:

A total of 99 patients underwent skin flap-based reconstruction for hand trauma between February 2019 until January 2022. The mean age was 43.9 (range 38.3–49.5), 87.9% of patients were male, and follow-up was between 2 and 30 months; 90.9% of the flaps were free flaps, and the rest were pedicle flaps (3% of them being propeller flaps).

Conclusions:

When planning a hand reconstruction, it is vital to ensure that the outcomes are not only functional but also aesthetic, with minimum donor site morbidity; in this study, we showed a variety of flaps that can be applied to achieve this goal. We believe that the final decision should be made after comprehending the defect and the patient’s preferences.
High Molecular and Cytogenetic Risk in Myelofibrosis Does Not Benefit From Higher Intensity Conditioning Before Hematopoietic Cell Transplantation: An International Collaborative Analysis
Authors: Gagelmann Nico , Salit Rachel B. , Schroeder Thomas , Badbaran Anita , Rautenberg Christina , Panagiota Victoria , Wolschke Christine , Thol Felicitas , Cassinat Bruno , Robin Marie , Heuser Michael , Reinhardt Hans Christian , Scott Bart L. , Kröger Nicolaus
Published: September 2022

There is no direct evidence to recommend specific conditioning intensities in myelofibrosis undergoing allogeneic hematopoietic cell transplantation, especially in the molecular era. We aimed to compare outcomes of reduced intensity (RIC) or myeloablative conditioning (MAC) transplantation in myelofibrosis with molecular information. The study included 645 genetically annotated patients (with at least driver mutation status available), of whom 414 received RIC and 231 patients received MAC. The median follow-up time from transplantation was 6.0 years for RIC and 9.4 years for MAC. The 6-year overall survival rates for RIC and MAC were 63% (95% confidence interval [CI], 58%-68%) and 59% (95% CI, 52%-66%; P = 0.34) and progression-free survival was 52% (95% CI, 47%-57%) and 52% (95% CI, 45%-59%; P = 0.64). The 2-year cumulative incidence of nonrelapse mortality was 26% (95% CI, 21%-31%) for RIC and 29% (95% CI, 23%-34%) for MAC (P = 0.51). In terms of progression/relapse, the 2-year cumulative incidence was 10% (95% CI, 5%-19%) for RIC and 9% (95% CI, 4%-14%) for MAC (P = 0.46). Higher intensity conditioning did not seem to improve outcomes for higher-risk disease, according to mutational, cytogenetic, and clinical profile. In contrast, patients with reduced performance status, matched unrelated donors, and ASXL1 mutations appeared to benefit from RIC in terms of overall survival.
Unilateral vortex keratopathy of unknown etiology
Authors: Moshirfar Majid , Payne Carter , Tauber Jenna , Kang Joann J. , Mifflin Mark D. , Pasricha Neel , Djalilian Ali , Soleimani Mohammad
Published: September 2022

A 54-year-old man with noncontributory medical history presented to an ophthalmologist in January 2022 after 10 days of irritation in his right eye. The patient recounts having felt something get into his eye and under his contact lens (CL) while he was climbing into his car, but he was unsure what the foreign body may have been. Initial examination by the clinician found uncorrected distance visual acuity of 20/100-2 with a corneal abrasion, 4+ corneal edema, and 3+ conjunctival injection, for which he was placed on topical antibiotics (ocuflox and tobradex) with a bandage CL. 1 week later, visual acuity was 20/80, corneal edema had improved, and he was noted to have corneal scarring and an epithelial defect. Tobradex was continued while prednisolone drops and preservative-free artificial tears were started. 1 week later, the patient had worsening visual acuity to 20/250 and was referred to our tertiary center.

On initial consultation, the patient had an uncorrected distance visual acuity of 20/500 and an uncorrected near visual acuity of >J10 in the right eye. Slitlamp examination of the right eye was significant for vortex keratopathy and mild corneal pannus with 360-degree subtle conjunctivalization of the limbus (Figure 1

JOURNAL/jcrs/04.03/02158034-202210000-00022/figure1/v/2023-08-19T002642Z/r/image-tiff

). The corneal topograph was obtained showing significant surface irregularity on the Placido image (Figure 2

JOURNAL/jcrs/04.03/02158034-202210000-00022/figure2/v/2023-08-19T002642Z/r/image-tiff

). Examination of the left eye was unremarkable. The ocular history is significant for myopia of −4.0 diopters and CL use for 20 years. The patient admits to regularly wearing soft CLs for several days straight and only removing them for a few hours. Antibiotics were discontinued, corticosteroid drops were reduced in frequency, and the patient was continued on preservative-free artificial tears.

What imaging might you consider? What is your differential diagnosis at this point? What would be the most appropriate surgical and/or medical interventions? What would you counsel in prognosis for this patient?
Low-to-Moderate Risk Transient Ischemic Attack Patients Can Be Safely Discharged From the Emergency Department to a Nurse Practitioner–Led Clinic
Authors: Alfandy Fnu , Brecht Mary-Lynn , Cardin Suzette , DeVon Holli A.
Published: September 2022

BACKGROUND: Unnecessary admissions fuel rising healthcare costs and take away resources from higher acuity patients without evidence of increased safety. The purpose of this quality improvement project was to determine whether the care diversion for transient ischemic attack (TIA), from inpatient to a nurse practitioner (NP)-led specialty clinic, resulted in no increase in stroke incidence at 90 days. METHODS: The sample included all adults presenting to the emergency department with TIA at a low-to-moderate risk for stroke. Risks were defined by the ABCD2 score and noninvasive vessel imaging. Patients who met the criteria were discharged and evaluated by a stroke NP at the TIA clinic within 7 days. These patients were compared with those who were admitted before clinic launch. Medical record reviews were conducted to determine stroke incidence at 90 days post TIA. Descriptive statistics were used to evaluate clinical variables, and Fisher exact test was used to assess difference in stroke rates. Patient satisfaction score was collected using the existing institutional survey. RESULTS: Eighty-one participants were included, 40 in the clinic group and 41 in the admission group. The mean ages in the clinic and admission groups were 72.8 and 75.2 years, respectively (P = .37). Women comprised 45% of patients in the clinic group, compared with 51.2% in the admission group (P = .58). The mean ABCD2 scores were 4.08 and 3.95 in the clinic and admission groups, respectively (P = .63). The median clinic follow-up time was 6 days. There was no stroke incidence in the clinic group and 1 in the admission group within 90 days post TIA. Patient satisfaction score metrics for the NP exceeded the institutional benchmark of 90%. CONCLUSION: Referral to an NP-led clinic in patients with low- to moderate-risk TIA was equally safe as hospital admission.
Clinical Application of Gaofang (Medicated Paste) in Cardiovascular Disease
Authors: Nian Hua , Zhang Qun-Qun , Ma Ming-Hua , Zhang Yi-Jun , Wu Tie-Jun , Liu Jing , Fu De-Yu , Xu Ling-Ling , Wang Ke
Published: September 2022

Gaofang (medicated paste), also known as gaoji in Chinese, is one of the eight dosage forms of traditional Chinese medicine. Originated in the Han and Tang dynasties, it is widely used in Shanghai, Jiangsu, Zhejiang, and Guangdong of China at present. It is generally believed that Gaofang can help reinforce deficiency, delay aging, and regulate the overall health status. Currently, Gaofang has been extensively used in the treatment of cardiovascular disease. Based on the relevant literature and clinical experience, this article reviews the general situation and the clinical application of Gaofang as well as the common Chinese medicines in Gaofang for cardiovascular diseases.
Cholecystectomy before, simultaneously, or after ERCP in patients with acute cholecystitis: A protocol for systematic review and/or meta analysis
Authors: de Medeiros Kleyton Santos , Aragão Fernandes Ana Clara , Fulco Gonçalves Giuliana , Villarim Camila Vilar Oliveira , Costa e Silva Laura Cristina , de Sousa Victor Matheus Câmara , Meneses Rêgo Amália Cinthia , Araújo-Filho Irami
Published: September 2022

Introduction:

Cholecystectomy is the intervention of choice for treating acute cholecystitis; when conservative management does not work, it operates on the patient outside the critical condition. It can be performed together with or after endoscopic papillotomy through endoscopic retrograde cholangiopancreatography (ERCP) when it is concurrent with a situation of cholechodocolithiasis or when there is compression and consequent increase in pressure in the bile duct caused by a calculus jammed in the vesicular infundibulum (Mirizzi’s syndrome), with or without jaundice, fever, and pain in the right hypochondrium (Charcot’s Triad), which can progress to sepsis of biliary origin. This review aims to assess whether the timing of cholecystectomy (before or after ERCP) interferes with the postoperative period and clinical outcome in patients with acute cholecystitis.

Methods and Analysis:

By searching the MEDLINE/PubMed, Embase, Web of Science, ScienceDirect, ClinicalTrials.gov, CINAHAL, Latin American and Caribbean Literature in Health Sciences, Scopus and Cochrane Central databases, Controlled Trials Registry Randomized clinical trials will be searched to analyze whether ERCP performed before or after open or laparoscopic cholecystectomy (LC) in patients with acute cholecystitis is beneficial or not, through the analysis of postoperative complications. No language or publication period restrictions will be imposed. The primary outcome will be postoperative complications (postoperative morbidity and mortality). Four independent reviewers will select the studies and extract data from the original publications, with a fifth reviewer in case of disagreement regarding the inclusion or not of particular research in the present review. The risk of bias will be assessed using The Risk of Bias 2 (RoB 2.0) tool, and the certainty of evidence will be evaluated using the grading of recommendations assessment, development, and evaluation. Data synthesis will be performed using the Review Manager software (RevMan V.5.2.3). To assess heterogeneity, we will calculate the I
2 statistics. Additionally, a quantitative synthesis will be performed if the included studies are sufficiently homogeneous.

Ethics and Disclosure:

Since the present study will review secondary data, previously published and scientifically validated, it will not be necessary to obtain ethical approval. The results of this systematic review will be published in a peer-reviewed journal.

Prospero registration number:

International Prospective Registry of Systematic Reviews (PROSPERO) CRD42021290726.
Prognostic value of MTV and TLG of 18 F-FDG PET in patients with head and neck squamous cell carcinoma: A meta-analysis
Authors: Jin Aihua , Lin Xing , Yin Xuezhe , Cui Yinfeng , Ma Liguang
Published: September 2022

Background:

The current systematic review and meta-analysis explored the value of metabolic tumor volume (MTV) as well as total lesion glycolysis (TLG) in predicting the prognosis of head and neck squamous cell carcinoma (HNSCC) using 18 F-FDG PET parameters.

Methods:

This work identified relevant studies in the English language by searching several electronic databases, like Cochrane Library, EMBASE, and PubMed. In addition, pooled hazard ratios (HRs) were also calculated to analyze whether MTV and TLG were significant in predicting prognosis.

Results:

The present study included 15 primary studies involving HNSCC cases. As for the elevated TLG, it attained the pooled HR of 1.85 (95% confidence interval [CI], 1.16–2.94; P = .000; I
2 = 78.3%) in predicting overall survival (OS), whereas that for elevated MTV was1.22 (95%CI, 1.09–1.36; P = .000; I
2 = 82.4%). Besides, for elevated MTV, it attained the pooled HR of 1.34 (95%CI, 1.15–1.56, P = .000; I
2 = 86.0%) in predicting disease-free survival (DFS); while the elevated TLG was related to DFS. Sensitivity analysis confirmed that our results are reliable. As for MTV, the ROC-stratified subgroups for DFS and multivariate analyses-stratified subgroups for OS showed statistically significant differences, with no obvious heterogeneities across different studies. For TLG, other methods-stratified subgroups for OS showed statistically significant differences, with no obvious heterogeneity across different studies.

Conclusion:

This work indicated that PET/CT is of predictive significance across HNSCC cases. Although the included articles used different methods and recruited HNSCC cases with high clinical heterogeneity; however, our findings confirmed that an elevated MTV can predict the increased risk of side reactions or even death among HNSCC cases and that an elevated TLG can predict a higher death risk.
Prognostic and clinicopathological significance of nm23-H1 expression in non-small cell lung cancer: A meta-analysis
Authors: Li Dailong , Li Wanqiang , Tian Cheng , Pang Yaqi , Xu Lu , Wang Yuke , Xu Xinhua
Published: September 2022

Background:

The relationship between the expression of nm23-H1 and the invasion and prognosis of non-small cell lung cancer (NSCLC) is still controversial. Therefore, we conducted a meta-analysis to determine the prognostic value of nm23-H1 in patients with NSCLC. And to explore the relationship between the expression of nm23-H1 and clinicopathological features in patients with NSCLC.

Methods:

Literature search in PubMed, EMBASE, Cochrane Library, CNKI, and WanFang database was performed up to June 14, 2021. Studies on the expression and clinical significance of nm23-H1 in NSCLC were included. According to the inclusion and exclusion criteria, 2 researchers independently screened the literatures, extracted the data, and evaluated the quality. Meta-analysis was performed using RevMan 5.4 software (Nordic Cochran Centre, Copenhagen, Denmark).

Results:

Twenty-five studies met our inclusion criteria and were finally included for the analysis, involving 2198 participants. Our meta-analysis revealed that nm23-H1 expression was associated with tumor differentiation (OR = 0.54, 95% CI: 0.42–0.70, P < .00001), TNM stage (OR = 1.70, 95% CI: 1.23–2.34, P = .001), and lymph node status (OR = 0.26, 95% CI, 0.17–0.39, P < .00001), but have no associate with sex, age, pathological type, and T stages. Additionally, low nm23-H1 expression reduced the 3-year survival rate (OR = 2.74, 95% CI: 1.54–4.86, P = .0006) and 5-year survival rate (OR = 2.78, 95% CI: 1.36–5.69, P = .005).

Conclusion:

Nm23-H1 can be used as a biomarker to predict tumor invasiveness and evaluate the prognosis of patients with NSCLC.
Retrospective observational study of the effects of residual neuromuscular blockade and sugammadex on motor-evoked potential monitoring during spine surgery in Japan
Authors: Hayashi Hironobu , Yamada Miki , Okuyama Kotoba , Takatani Tsunenori , Shigematsu Hideki , Tanaka Yasuhito , Kawaguchi Masahiko
Published: September 2022

Given neuromuscular blockade (NMB) can affect the amplitude and detection success rate of motor-evoked potentials (MEP), sugammadex may be administered intraoperatively. We evaluated the factors affecting the degree of residual NMB (i.e., the train-of-four [TOF] ratio) and the relationship between TOF ratio and MEP detection success rate in Japanese patients undergoing spine surgery. This single-center retrospective observational study included adults who underwent spine surgery under propofol/remifentanil anesthesia, received rocuronium for intubation, and underwent myogenic MEP monitoring after transcranial stimulation. TOF ratios were assessed using electromyography. Sugammadex was administered after finishing the MEP setting and the TOF ratio was ≤0.7. To identify factors affecting the TOF ratio, TOF ratio and MEP detection success rate were simultaneously measured after finishing the MEP setting; to compare the time from intubation to the start of MEP monitoring after NMB recovery between sugammadex and spontaneous recovery groups, multivariable analyses were performed. Of 373 cases analyzed, sugammadex was administered to 221 (59.2%) cases. Age, blood pressure, hepatic impairment, and rocuronium dose were the main factors affecting the TOF ratio. Patients with higher TOF ratios (≥0.75) had higher MEP detection success rates. The time from intubation to the start of MEP monitoring after NMB recovery was significantly shorter in patients administered sugammadex versus patients without sugammadex (P < .0001). The MEP detection success rate was higher in patients with a TOF ratio of ≥0.75. Sugammadex shortened the time from intubation to the start of MEP monitoring after NMB recovery.
Association of thyroid autoimmunity with the presence and severity of coronary atherosclerosis in patients undergoing coronary angiography
Authors: Yang Libo , Zhang Mingliang , Zhang Hui , Zheng Guanlin , Xu Chao , Li Guangyao
Published: September 2022

Studies on the association of thyroid autoimmunity with cardiometabolic risk and coronary artery disease (CAD) have produced conflicting results. This study aimed to investigate the relationship of thyroid autoimmune bodies (thyroid peroxidase antibody [TPOAb] and thyroglobulin antibody [TgAb]) with CAD in euthyroid subjects undergoing coronary angiography.

A total of 307 subjects who underwent coronary angiography were included. The severity of coronary atherosclerosis was evaluated by using Gensini score. Serum TSH, total T3, total T4, TPOAb, TgAb, lipid levels et al were measured and compared between the groups with and without CAD. Logistic multivariate regression analysis were performed to assess the associations. Levels of thyroid hormones were comparable between the two groups.

The positive percentage of anti-Tg antibodies was higher in non-CAD group (15.22% vs 7.91%, χ2 = 3.95, p = .047) while no significant difference was observed for anti-TPO antibodies (19.57% vs 17.21%, χ2 = 0.243, p = .622). The natural log-transformed Gensini score (ln (Gensini score)) was lower in the TgAb+ group (2.94 ± 1.11 vs 2.41 ± 1.18, P = .015). There was no significant difference for ln (Gensini score) between TPOAb− and TPOAb+ group (2.90 ± 1.14 vs 2.85 ± 1.09, P = .782). Logistical regression analysis revealed that positive TgAb was inversely associated with the presence of CAD (OR: 0.387, 95% CI: 0.157–0.952, p = .039) independent of other risk factors.

The results showed that TgAb positivity might be an independent protective factor for CAD.
Cervical and scapula-focused resistance exercise program versus trapezius massage in patients with chronic neck pain: A randomized controlled trial
Authors: Kang Taewoo , Kim Beomryong
Published: September 2022

Objective:

The purpose of this study was to investigate the effects of resistance exercise in comparison with those of common exercise on chronic neck pain (CNP) to provide useful clinical guidelines for reducing pain or increasing cervical range of motion (ROM), upper trapezius tone, disability level, and quality of life (QOL).

Methods:

The subjects were randomized into a cervical and scapula-focused resistance exercise group (CSREG, n = 21) or trapezius massage group (TMG, n = 20). All groups received a 4-week, five times per week CSRE or TM program for CNP. The visual analogue scale (VAS) score, cervical ROM, myotonometer measures (upper trapezius tone, stiffness, and elasticity), neck disability index (NDI), and short form-36 (SF-36) were identified as the primary outcomes.

Results:

Within-group changes in VAS, cervical ROM, myotonometer measures, NDI, and SF-36 were significant in the CSREG and TMG (P < .05). The between-group changes in VAS, cervical rotation, myotonometer (upper trapezius tone and stiffness), NDI, and SF-36 after intervention showed significant differences between the CSREG and TMG (P < .05).

Conclusion:

These results suggest that the CSRE program is effective in improving pain, cervical ROM, upper trapezius tone, disability level, and QOL in patients with CNP. More comprehensive studies with longer follow-up durations are needed to better understand the potential effects of the CSRE program in patients with CNP.
Pandemics and Suicide Risk
Authors: Mukhtar Fahad , Candilis Philip
Published: September 2022

In its mortality and global reach, COVID-19 is among the worst pandemics to hit the globe since the 1918 influenza. During a pandemic, it is not uncommon for deaths from suicide to be downplayed as communities respond to the immediate mortality of the disease. In this analysis, we review pandemic history to uncover its impact on suicide rates, a frequent proxy for community mental health, and whether public health responses were effective. We incorporate lessons from more than 100 years of epidemics to assess whether the current public health response can benefit from the lessons of history.
Persistent Diarrhea and Eosinophilic Esophagitis Resulting From Chronic Cannabidiol Usage for Refractory Epilepsy
Authors: Patel Maitri , Middleton Jeremy P. , Goodkin Howard P. , Barnes Barrett , McGowan Emily , Eid Ryan
Published: September 2022

Cannabidiol is used in the care of treatment-resistant epilepsy. It has been associated with varying side effects, ranging from somnolence to diarrhea and weight loss. We present a patient on chronic cannabidiol therapy who had persistent diarrhea, abdominal pain, weight loss, and esophageal eosinophilia that improved with cannabidiol dose adjustment.
99mTc–Macroaggregated Albumin Liver Lung Shunt Study With Uptake Indicative of Patent Falciform Artery
Authors: Namous Nadia , Kushner Daniel , Dadparvar Simin
Published: September 2022

Intra-arterial injection of radioactive isotope 90-yttrium 90Y has been used for elective internal radiation therapy for the treatment of localized hepatocellular carcinoma deemed surgically unresectable. It has also been used to treat intrahepatic cholangiocarcinoma and colorectal cancer that has metastasized to the liver. To prepare for 90Y treatment, preprocedural mapping via hepatic angiography and 99mTc–macroaggregated albumin liver lung shunt study followed by postprocedural 90Y SPECT/CT is essential to ensure a targeted therapy. Therapy is contraindicated if lung shunt fraction is greater than 20% for SIR-Spheres. Anatomic variation in hepatic angiography may be present that can lead to complications if unaccounted for.
Macroscopic Anatomy of the Layered Structures of Facial Muscles and Fasciae in the Temporal-Malar-Mandible-Neck Region
Authors: Takami Hisako , Hayashi Takafumi , Sato Noboru , Ohshima Hayato
Published: September 2022

The layered structures of facial muscles and their topographical relationship with facial fasciae are still not fully understood. This study aimed to clarify the layered structures of facial muscles and fasciae in the temporal-malar-mandible-neck region. Thirty-four human cadavers were examined during gross anatomy courses at Niigata University (2017–2020). The face was composed of 3-layered (deep, middle, and superficial) fasciae and 4-layered facial muscles (first superficial, second superficial, third, and fourth muscle layers) according to the attachment of muscles and their topographical relationship with the fasciae. The deep fascia covered the temporal and masseter muscles. The parotid gland and facial nerves were enveloped in the middle fascia. The superficial fascia was continuous with the second superficial muscle layer. The connection between fourth and superficial muscles was at the malar and buccal areas, where the platysma blended with the masseter and the plural muscles blended with the buccinator. Our findings suggest that cooperation between the 4-layered structure of the facial muscles surrounding the apertures of the eyes and mouth and the superficial fascia enables humans to produce complex facial expressions. Furthermore, the spread of inflammation in the face may be owing to the layered facial muscles and fasciae, as these layered structures separate tissues into multiple compartments.
Microbe Profile: Euglena gracilis: photogenic, flexible and hardy
Authors: Zoltner Martin , Field Mark C.
Published: September 2022

Euglena gracilis is a unicellular photosynthetic eukaryotic flagellate of the Discoba supergroup, which also encompasses Kinetoplastida and Diplonema. Plastids have green algal origin and are secondarily acquired. The nuclear genome is extremely large and many genes suggest multiple endosymbiotic/gene transfer events, i.e. derivation from prokaryotes of various lineages. E. gracilis is remarkably robust and can proliferate in environments contaminated with heavy metals and acids. Extraordinary metabolic plasticity and a mixotrophic lifestyle confers an ability to thrive in a broad range of environments, as well as facilitating production of many novel metabolites, making Euglena of considerable biotechnological importance.
Incidence Rates of Medically Attended COVID-19 in Infants Less than 6 Months of Age
Authors: Griffin Isabel , Irving Stephanie A. , Arriola Carmen Sofia , Campbell Angela P. , Li De-Kun , Dawood Fatimah S. , Doughty-Skierski Caroline , Ferber Jeannette R. , Ferguson Nickolas , Hadden Louise , Henderson Jillian T. , Juergens Mary , Kancharla Venkatesh , Naleway Allison L. , Newes-Adeyi Gabriella , Nicholson Erin , Odouli Roxana , Reichle Lawrence , Sanyang Mo , Woodworth Kate , Munoz Flor M.
Published: September 2022

Objective

Studies suggest infants may be at increased risk of severe COVID-19 relative to older children, but few data exist regarding the incidence of COVID-19 episodes and associated risk factors. We estimate incidence rates and describe characteristics associated with medically attended COVID-19 episodes among infants younger than 6 months of age.

Methods

We analyzed electronic medical record data from a cohort of infants born March 1, 2020‒ February 28, 2021. Data from three health care delivery systems included demographic characteristics, maternal and infant outpatient visit and hospitalization diagnoses, and SARS-CoV-2 test results. Medically attended COVID-19 episodes were defined by positive SARS-CoV-2 clinical tests and/or COVID-19 diagnosis codes during medical care visits. Unadjusted and site-adjusted incidence rates by infant month of age, low and high SARS-CoV-2 circulation periods and maternal COVID-19 diagnosis were calculated.

Results

Among 18,192 infants aged <6 months whose mothers received prenatal care within the three systems, 173 (1.0%) had medically attended COVID-19 episodes. Incidence rates were highest among infants aged under 1 month (2.0 per 1,000 person-weeks) and 1 month (2.0 per 1,000 person-weeks) compared with older infants. Incidence rates were also higher for infants born to women with postpartum COVID-19 compared with women without known COVID-19 and women diagnosed with COVID-19 during pregnancy.

Conclusion

Most medically attended COVID-19 episodes in infants aged <6 months were outpatient care encounters. Infants of women with postpartum COVID-19 had a higher risk of medically attended COVID-19 than infants born to mothers who were diagnosed during pregnancy or never diagnosed underscoring the importance of COVID-19 prevention measures for their household members and caregivers to prevent infections in infants.

Article Summary

This report describes incidence rates and characteristics of medically attended outpatient and inpatient COVID-19 episodes among infants aged <6 months during the COVID-19 pandemic.

What’s Known on This Subject

Surveillance data and case series suggest that infants aged <1 year may be more likely to be hospitalized with COVID-19 than older children, but few data are available about the risk of medically attended COVID-19 episodes among infants.

What this Study Adds

Among infants aged <6 months, few were hospitalized with COVID-19. Incidence rates of medically attended COVID-19 episodes were highest among infants aged ≤ 1 month and among infants of women with COVID-19 during the 6 month post-partum period.
Process-guidance improves predictive performance of neural networks for carbon turnover in ecosystems
Authors: Wesselkamp Marieke , Moser Niklas N , Kalweit Maria , Boedecker Joschka , Dormann Carsten F
Published: September 2022

Despite deep-learning being state-of-the-art for data-driven model predictions, it has not yet found frequent application in ecology. Given the low sample size typical in many environmental research fields, the default choice for the modelling of ecosystems and its functions remain process-based models. The process understanding coded in these models complements the sparse data and neural networks can detect hidden dynamics even in noisy data. Embedding the process model in the neural network adds information to learn from, improving interpretability and predictive performance of the combined model towards the data-only neural networks and the mechanism-only process model. At the example of carbon fluxes in forest ecosystems, we compare different approaches of guiding a neural network towards process model theory. Evaluation of the results under four classical prediction scenarios supports decision-making on the appropriate choice of a process-guided neural network.
Hypodermal ribosome synthesis inhibition induces a nutrition-uncoupled organism-wide growth quiescence in C. elegans
Authors: Zhao Qiuxia , Rangan Rekha , Weng Shinuo , Özdemir Cem , Cenik Elif Sarinay
Published: September 2022

Inter-organ communication is a key aspect of multicellular organismal growth, development, and homeostasis. Importantly, cell-non-autonomous inhibitory cues that limit tissue specific growth alterations are poorly characterized due to limitations of cell ablation approaches. Here, we report a robust system to investigate nutrition-independent organism-wide growth coordination by modulating ribosome biogenesis at distinct steps in a tissue-specific and reversible fashion in Caenorhabditis elegans. We find an organism-wide growth quiescence response upon suppression of ribosome synthesis either by depletion of an RNA polymerase I (Pol I) subunit or either of two critical ribosome biogenesis factors, RRB-1 and TSR-2, which are the chaperone proteins required for assembly of ribosomal proteins, RPL-3 and RPS-26, respectively. The observed organism-wide growth checkpoint is independent of the nutrition-dependent insulin signaling pathways and is not rescued by daf-16(mu86), a bypass mutation that suppresses the starvation-induced quiescence response. Upon systematically exploring tissues involved in this process, we find that inhibition of hypodermal ribosome synthesis is sufficient to trigger an organism-wide growth quiescence response and leads to organism-wide gene expression changes. At the RNA level, we observe over- and under-expression of several tissue-restricted genes in a wide range of cell types, including touch receptor neurons suggesting inter-organ communication upon hypodermis driven ribosome inhibition. At the protein level, we observed over-expression of secreted proteins (CPR-4, TTR family proteins) as well as an organism-wide reduction both in cytosolic and mitochondrial ribosomal proteins in response to hypodermis RNA Pol I depletion. Finally, we find that dense core vesicle secretion specifically from the hypodermis tissue by the unc-31 gene plays a significant role in mediating the quiescence phenotype. Taken together, these results suggest the presence of a nutrition-independent multicellular growth coordination initiated from the hypodermis tissue.
A spiking neural network model of cortical intraregional metastability
Authors: Venkadesh Siva , Shaikh Asmir , Shakeri Heman , Barreto Ernest , Van Horn John D.
Published: September 2022

Transient synchronization of bursting activity in neural networks, which occurs in patterns of metastable phase relationships between neurons, is a notable feature of network dynamics observedin vivo. However, the mechanisms that contribute to this dynamical complexity in neural circuits are not well understood. Local circuits in cortical regions consist of populations of neurons with diverse intrinsic oscillatory features. In this study, we numerically show that the phenomenon of transient synchronization, also referred to as metastability, emerges in an inhibitory neural population when the neurons’ intrinsic fast-spiking dynamics are appropriately modulated by slower inputs from an excitatory neural population. Using a compact model of a mesoscopic-scale network consisting of excitatory pyramidal and inhibitory fast-spiking neurons, our work demonstrates a relationship between the frequency of neural oscillations and the features of emergent metastability. In addition, a novel metric is formulated to characterize collective transitions in metastable networks. Finally, we discuss a blueprint to model the whole-brain resting-state dynamics using our scalable representation of intraregional network metastability.
evosim: fast and scalable stochastic simulations of evolutionary dynamics
Authors: Engelhardt Dalit , McDonald Thomas O.
Published: September 2022

The simulation of clonal dynamics with branching processes can provide valuable insights into disease progression and treatment optimization, but exact simulation of branching processes via the Stochastic Simulation Algorithm (SSA) is computationally prohibitive at the large population sizes associated with therapeutically-relevant scenarios. evosim is a versatile and flexible Python implementation of a fast and unbiased tau-leaping algorithm for the simulation of birth-death-mutation branching processes that is scalable to any population size. Package functionalities support the incorporation and tracking of a sequence of evolutionary changes such as therapeutic interventions as well as the analysis of population diversity. We show that runtimes scale logarithmically with population size, by contrast to the linear scaling of the SSA, and simulations exhibit strong agreement with SSA simulation results. These findings are also supported by mathematical results (Supplementary information).

Availability

Package, documentation, and tutorials / usage examples are available on GitHub (https://github.com/daliten/evosim). Mathematical details of the algorithm and the pseudocode are provided in the included Supplementary information.
Maternal cortisol and emotional complaints alter breast milk’s microbiome composition
Authors: Deflorin Nadia , Ehlert Ulrike , Amiel Castro Rita T.
Published: September 2022

Breast milk (BM) is considered the “gold standard” of nutrition due to its many benefits for the infant. On the other hand, the challenges of pregnancy can lead to increased stress in some women, which may affect BM quality. Although studies have demonstrated a negative link between maternal psychopathology and child development, it remains unclear how maternal psychobiological changes can be intergenerationally transmitted.

Aims

We investigated the associations between maternal biological stress, depressive symptoms, self-reported stress and anxiety symptoms and the BM microbiome. Further, we analysed these parameters in relation to BM glucocorticoid concentrations and explored the influence of BM glucocorticoids on BM bacterial composition.

Methods

N=100 women completed standardised questionnaires (e.g. EPDS, STAI, GAS) at 34-36 weeks gestation and in the early postpartum; and sampled saliva at 34-36 and 38 weeks gestation. BM samples were collected in the early postpartum. Microbiota was analysed using 16S rRNA amplicon sequencing.

Results

Prenatal GAS and pregnancy-related symptoms (sum) were negatively correlated withAlphaproteobacteria(τ = - 0.2137, FDR = 0.0199*; τ = - 0.1805 FDR = 0.0798*), whereas in the postpartum period, the STAI-S scores were negatively correlated with different taxa. Postpartum-related symptoms (sum) were also linked to decreasedPropionibacteriales. Salivary cortisol AUCg at 34-36 weeks was negatively correlated withActinomycetia(τ = -0.1633, FDR = 0.0630*) andClostridia(τ = -0.1824, FDR = 0.0630*). BM cortisol was negatively correlated withStaphylococcus(τ = - 0.2047, FDR = 0.0885*) and positively correlated with BM alpha diversity. No associations emerged between psychobiological parameters and BM glucocorticoids.

Conclusions

Increased perinatal emotional complaints and prenatal cortisol AUCg were associated with decreased commensal bacteria, whereas enhanced BM cortisol was linked to increased alpha diversity and reducedStaphylococcus. These findings suggest a negative relation between high maternal psychobiological complaints and commensal milk microbiota.
Comprehensive analysis of intercellular communication in thermogenic adipose niche
Authors: Shamsi Farnaz , Zheng Rongbin , Ho Li-Lun , Chen Kaifu , Tseng Yu-Hua
Published: September 2022

Brown adipose tissue (BAT) is responsible for regulating body temperature through adaptive thermogenesis. The ability of thermogenic adipocytes to dissipate chemical energy as heat counteracts weight gain and has gained considerable attention as a strategy against obesity. BAT undergoes major remodeling in a cold environment. This remodeling results from changes in the number and function of brown adipocytes, expanding the network of blood vessels and sympathetic nerves, and changes in the makeup and function of immune cells. All these processes are essential for enhanced BAT thermogenesis to maintain euthermia in the cold. Such synergistic adaptation requires extensive crosstalk between the individual cells in tissues to coordinate their responses. To understand the mechanisms of intercellular communication in BAT, we applied the CellChat algorithm to single-cell transcriptomic data of mouse BAT. We constructed an integrative network of ligand-receptor interactome in BAT and identified the major signaling input and output of each cell type. By comparing the ligand-receptor interactions in BAT of mice housed at different environmental temperatures, we found that cold exposure enhances the intercellular interactions among the major cell types in BAT, including adipocytes, adipocyte progenitors, lymphatic and vascular endothelial cells, myelinated Schwann cells (MSC), nonmyelinated Schwann cells (NMSC), and immune cells. Furthermore, we identified the ligands and receptors that are regulated at the transcriptional level by temperature. These interactions are predicted to regulate the remodeling of extracellular matrix (ECM), inflammatory response, angiogenesis, and neurite growth. Together, our integrative analysis of intercellular communications in BAT and their dynamic regulation in response to housing temperatures establishes a holistic understanding of the mechanisms involved in BAT thermogenesis. The resources presented in this study provide a valuable platform for future investigations of BAT development and thermogenesis.
CREB-pCREB-PER2 feedback loop mediates transition between mania and depression-like behaviors
Authors: Wang Xin-Ling
Published: September 2022

Little is known about the mechanisms underlying the transition between mania and depression. We found here that ouabain decreased pCREB and PER2 levels in CA1 and induced mania-like behavior, which was attenuated by lithium and overexpression ofPer2in this region. Furthermore, knockdown ofPer2in CA1 induced mania-like behavior, in contrast, overexpression ofPer2resulted in depression-like behavior. Similar results were found in manipulations ofCreb1in CA1. Western blot analyses revealed that upregulations of CREB or PER2 can increase each other’s levels, besides pCREB, and vice versa. Therefore, the CREB– pCREB–PER2 pathway forms a positive feedback loop that mediates the transition between manic and depressive phenotypes.

One-Sentence Summary

A novel molecular loop underlies phase inversion of bipolar disorder