bluuebunny/crossref_metadata_2025 huggingface dataset:
Chaetocin Promotes Osteogenic Differentiation via Modulating Wnt/Beta-Catenin Signaling in Mesenchymal Stem Cells
Authors: Liang Youde , Liu Xin , Zhou Ruiping , Song Dawei , Jiang Yi-Zhou , Xue Weiwei
Published: February 2021

Mesenchymal stemXin cells (MSCs) are a great cell source for bone regeneration. Although combining MSCs with growth factors and scaffolds provides a useful clinical strategy for bone tissue engineering, the efficiency of MSC osteogenic differentiation remains to be improved. Epigenetic modification is related to the differentiation ability of MSCs during osteogenic induction. In this study, we evaluate the effect of Chaetocin, an inhibitor of lysine-specific histone methyltransferases, on the differentiation of MSCs. We found that MSCs treated with Chaetocin demonstrated increased osteogenic ability and reduced adipogenic ability. The expression of osteogenic markers (Runx2 and OPN) was induced in MSCs by Chaetocin during osteogenic induction. Moveover, treatment of Chaetocin in MSCs improves Wnt/β-catenin signaling pathways and its downstream targets. Finally, we showed increased bone formation of MSC and Wnt/β-catenin signaling activity by treatment of Chaetocin using in vivo bone formation assays. Our data uncovered a critical role of Chaetocin in MSC osteogenic differentiation and provide new insights into bone tissue regeneration and repair.
Sibutramine as a Cause of Sudden Cardiac Death
Authors: Rodriguez-Guerra Miguel , Yadav Mayank , Bhandari Manoj , Sinha Archna , Bella Jonathan N. , Sklyar Eduard
Published: February 2021

Importance. Sibutramine was withdrawn from the US market due to association with adverse cardiovascular outcomes especially with patients having preexisting cardiac disease. However, continued presence of sibutramine in herbal medications is a concern to public safety. Results. We report a case of a patient with no evidence of previous coronary heart disease, who presented with non-ST elevation acute coronary syndrome (NSTE-ACS). Urgent coronary catheterization showed nonobstructive coronaries. However, patient died unexpectedly within 24 hours of admission. The patient denied toxic habits but was taking over-the-counter weight loss herbal supplements. Complete autopsy was performed which showed sibutramine in the toxicology. Patient died due to complications of acute inadvertent intoxication of sibutramine. Conclusion and Relevance. This is the first case report in literature showing association of sibutramine to sudden cardiac death in patients with no prior cardiac history. The continued presence of sibutramine in some over-the-counter weight loss formulations is a very concerning public health issue.
Secondary Prevention of Potentially Life-Threatening Arrhythmia Using Implantable Cardioverter Defibrillators in Patients with Biopsy-Proven Viral Myocarditis and Preserved Ejection Fraction
Authors: Sasko Benjamin , Patschan Daniel , Nordbeck Peter , Seidlmayer Lea , Andresen Henrike , Jänsch Monique , Bramlage Peter , Ritter Oliver , Pagonas Nikolaos
Published: February 2021

Background: Arrhythmia and sudden cardiac death (SCD) are known complications of acute viral myocarditis, regardless of ejection fraction (EF) at presentation. Whether such complications confer long-term risk is unknown, especially in those who present with preserved left ventricular (LV) function. No guidelines exist to the long-term reduction of arrhythmic death in such patients. Method: In this retrospective study, we analyzed the long-term results of implantable cardioverter defibrillator (ICD) treatment in patients after an acute phase of myocarditis with life-threatening arrhythmia. Results: We identified 51 patients who had ICDs implanted following life-threatening arrhythmia presentation of confirmed acute viral myocarditis, despite preserved LVEF. Overall, 72.5% of patients had a clinical history of chest pain and viral infection with fever. Viral myocarditis was confirmed by cardiac magnetic resonance imaging (all had late enhancement) plus endomyocardial biopsies (most frequent were Epstein-Barr virus 29.4%, adenovirus 17.6%, and Coxsackie 17.6%), and 88.2% were discharged on anti-arrhythmic drugs. Overall, 12 patients (23.5%) required ICD intervention within the first 3 months, a further 7 patients (37.3% overall) between 3 and 12 months, and a further 12 patients (60.8% overall) until 58 months. During the follow-up, 3 of 51 patients (5.9%) died—deaths were due to cardiac events (n = 1), fatal infection (n = 1), and car accidents (n = 1). Of the 31 patients who had ventricular tachycardias after the acute phase of myocarditis, 11 needed radiofrequency ablation due to a high number of events or electrical storm. No baseline variables were identified that would serve as a basis for risk stratification. Conclusion: Malignant arrhythmic events due to viral myocarditis are potential predictors of future SCD in patients not only with a reduced but also with a preserved EF.
What Are the Most Challenging Aspects of Inflammatory Bowel Disease? An International Survey of Gastroenterologists Comparing Developed and Developing Countries
Authors: Gearry Richard B. , McCombie Andrew M. , Vatn Morten , Rubin David T. , Steinwurz Flavio , Loftus Edward V. , Kruis Wolfgang , Tysk Curt , Colombel Jean-Frederic , Ng Siew C. , Van Assche Gert , Bernstein Charles N. ,   International Organization for the Study of Inflammatory Bowel Diseases and the World Gastroenterology Organization
Published: February 2021

Background and Aims: As inflammatory bowel disease (IBD) becomes more prevalent, the challenges that gastroenterologists face in managing these patients evolve. We aimed to describe the most important challenges facing gastroenterologists from around the world and compare these between those working in developed and developing countries. Methods: An online questionnaire was developed, and a link distributed to gastroenterologists. Data were analyzed descriptively using Friedman and Wilcoxon matched-pair signed rank tests to compare rankings for responses. Mann-Whitney U tests were used to compare rankings between responses from gastroenterologists from developed and developing countries. Lower scores reflected greater challenges. Results: Of 872 who started, 397 gastroenterologists (45.5%) completed the survey. Respondents represented 65 countries (226 [56.9%] from developed countries). Overall, the challenge ranked most important (smallest number) was increasing IBD prevalence (13.6%). There were significant differences in mean ranking scores for many simple aspects of care for those from developing countries compared to providers from developed countries, such as access to simple IBD treatments (5.52 vs. 6.02, p = 0.01), access to anti-TNF drugs including dose escalation (3.33 vs. 3.93, p < 0.01), access to good stoma care (2.57 vs. 3.03, p < 0.001), access to therapeutic drug monitoring (1.47 vs. 1.84, p < 0.001), and access to care for people from low socioeconomic status (2.77 vs. 3.37, p < 0.001). Conclusions: Increasing IBD prevalence is seen by gastroenterologists as the greatest challenge facing them. There are significant differences between the IBD challenges facing gastroenterologists from developed and developing countries that reflect inequities in access to health care.
Review of Digitalized Patient Education in Cardiology: A Future Ahead?
Authors: Oudkerk Pool Marinka D. , Hooglugt Jean-Luc Q. , Schijven Marlies P. , Mulder Barbara J.M. , Bouma Berto J. , de Winter Robbert J. , Pinto Yigal , Winter Michiel M.
Published: February 2021

Introduction: An increased focus on shared decision-making and patient empowerment in cardiology and on patient outcomes such as quality of life (QoL), depression, and anxiety underline the importance of high-quality patient education. Studies focusing on digital means of patient education performed in other disciplines of medicine demonstrated its positive effect in these areas. Therefore, a review of the current literature was performed to (i) evaluate the status of innovative, digitalized means of patient education in cardiology and (ii) assess the impact of digital patient education on outcome parameters (i.e., patient knowledge (or health literacy), QoL, depression, anxiety, and patient satisfaction). Method: A review of the current literature was performed to evaluate the effect of digitalized patient education for any purpose in the field of cardiology. Medline and EMBASE were searched for articles reporting any digital educational platform used for patient education up to May 2020. The articles were compared on their effect on patient knowledge or health literacy, QoL, depression or anxiety, and patient satisfaction. Results: The initial search yielded 279 articles, 34 of which were retained after applying in, and exclusion criteria. After full-text analysis, the total number of articles remaining was 16. Of these, 6 articles discussed the use of smartphone or tablet applications as a means of patient education, whereas 3 reviewed web-based content, and 7 evaluated the use of video (2 three-dimensional videos, from which one on a virtual reality headset). Conclusion: This review demonstrates that digital patient education increases patient knowledge. Overall, digital education increases QoL and lowers feelings of depression and anxiety. The majority of patients express satisfaction with digital platforms. It remains important that developers of digital patient education platforms remain focused on clear, structured, and comprehensible information presentation.
Clinical Application of Postmortem Magnetic Resonance Imaging in Neonates
Authors: Shany Eilon , Marks Kyla , Levitas Aviva , Golan Agneta , Abramsky Ramy , Taragin Benjamin H. , Shelef Ilan
Published: February 2021

Background: Recent reports advocate the use of MRI either as a substitute for postmortem examinations or for a more targeted autopsy. Methods: A full-body postmortem MRI (pMRI) of infants was performed as early as possible after death, and findings were compared to clinical premortem diagnoses. Results: Thirty-one infants were scanned during the study period. Median gestation at birth was 34 weeks (ranges: 24–43). In 3 (10%) cases, no new findings were detected. In 2 (6%), new minor findings not related to the cause of death were detected, and in 17 (55%), new minor findings related to the cause of death were detected. New major findings related to the cause of death were detected in 4 (13%) cases, and new major findings not related to the cause of death were detected in 5 (16%) cases. In 3 (10%), findings thought to alter the perceived cause of death were detected. Overall, in 23 (74%) cases, pMRI findings reinforced the clinical premortem diagnoses. Conclusions: pMRI is a culturally accepted alternative when autopsy is not performed and can either reinforce, refute, or add to premortem clinical diagnoses.
Bilateral Nephrectomy in Patients with Autosomal Dominant Polycystic Kidney Disease and End-Stage Chronic Renal Failure
Authors: Lubennikov Alexander E. , Petrovskii Nicolay V. , Krupinov German E. , Shilov Evgeniy M. , Trushkin Roman N. , Kotenko Oleg N. , Glybochko Petr V.
Published: February 2021

Background: In patients with autosomal dominant polycystic kidney disease (ADPKD) and end-stage kidney disease, bilateral nephrectomy (BN) is currently performed predominantly via the laparoscopic approach. We analysed the results of BN depending on the approach and preoperative and perioperative factors. Patients and Methods: This was a single-centre retrospective study carried out from April 2010 to March 2020, including a total of 142 patients presenting with ADPKD who were treated by BN. Of these, 108 patients meeting the inclusion criteria were selected to analyse the results. We compared therapeutic outcomes depending on the surgical approach (laparotomy or laparoscopy) and the type of the operation (emergent or elective). Results: Of the 108 eligible patients, 36 (group I) underwent laparoscopic BN and the remaining 72 patients (group II) were subjected to midline laparotomy. Sixty-nine patients underwent elective surgery and 39 endured emergent operations. The most frequent indications (87 patients, 80.6%) for surgical treatment were urinary tract infection and infected cysts. The median length of hospital stay for group I and group II patients amounted to 8 days (IQR: 7.5–9) and 12.5 days (IQR: 9–16.5), respectively (p < 0.001). However, comparing the patients operated on electively, the actual difference in the length of hospital stay was inconsiderable: median 8 days (IQR: 7–9) in group I and 9 days (IQR: 9–11.5) in group II. The median duration of the operation was significantly (p < 0.001) longer in group I amounting to 217.5 min (IQR: 197.5–305) than in group II equalling 115 min (IQR: 107.5–145). The frequency of postoperative complications, lethal outcomes, and blood loss volume did not statistically significantly differ depending on the surgical approach. Only patients operated on emergency underwent releparotomy due to intraoperative large bowel injury. Lethal outcomes (n = 18, 16.7%) after surgery were observed only in emergent patients. Sepsis prior to surgery, systemic inflammation response syndrome (SIRS) with the CRP level above 173 mg/mL, prolonged preoperative antibacterial therapy, and undiagnosed large bowel injury were associated with a lethal outcome after BN. Conclusion: The results of open and laparoscopic BN in elective surgery were comparable. Emergency operations for infected renal cysts and SIRS were associated with increased incidence of large bowel injury and lethal outcomes.
Uterine Leiomyomas with an Apparently Normal Karyotype Comprise Minor Heteroploid Subpopulations Differently Represented in vivo and in vitro
Authors: Koltsova Alla S. , Efimova Olga A. , Pendina Anna A. , Chiryaeva Olga G. , Osinovskaya Natalia S. , Shved Natalia Y. , Yarmolinskaya Maria I. , Polenov Nikolai I. , Kunitsa Vladislava V. , Sagurova Yanina M. , Tral Tatyana G. , Tolibova Gulrukhsor K. , Baranov Vladislav S.
Published: February 2021

In the present study, we aimed to check whether uterine leiomyomas (ULs) with an apparently normal karyotype in vitro comprise “hidden” cell subpopulations with numerical chromosome abnormalities (heteroploid cells). A total of 32 ULs obtained from 32 patients were analyzed in the study. Each UL was sampled for in vivo and in vitro cytogenetic studies. Karyotyping was performed on metaphase preparations from the cultured UL samples. A normal karyotype was revealed in 20 out of the 32 ULs, of which 9 were selected for further study based on the good quality of the interphase preparations. Then, using interphase FISH with centromeric DNA probes, we analyzed the copy number of chromosomes 7 and 16 in 1,000 uncultured and 1,000 cultured cells of each selected UL. All of the ULs included both disomic cells representing a predominant subpopulation and heteroploid cells reaching a maximum frequency of 21.6% (mean 9.8%) in vivo and 11.5% (mean 6.1%) in vitro. The spectrum of heteroploid cells was similar in vivo and in vitro and mostly consisted of monosomic and tetrasomic cells. However, their frequencies in the cultured samples differed from those in the uncultured ones: while the monosomic cells decreased in number, the tetrasomic cells became more numerous. The frequency of either monosomic or tetrasomic cells both in vivo and in vitro was not associated with the presence of MED12 exon 2 mutations in the tumors. Our results suggest that ULs with an apparently normal karyotype consist of both karyotypically normal and heteroploid cells, implying that the occurrence of minor cell subpopulations with numerical chromosome abnormalities may be considered a characteristic of UL tumorigenesis. Different frequencies of heteroploid cells in vivo and in vitro suggest their dependence on microenvironmental conditions, thus providing a pathway for regulation of their propagation, which may be important for the UL pathogenesis.
An Atypical Presentation of a Colonic Lipoma: Avoiding Surgery with a Deeper Endoscopic Look
Authors: João Mafalda , Cunha Inês , Gravito-Soares Elisa , Gravito-Soares Marta , Amaro Pedro , Figueiredo Pedro
Published: February 2021

Introduction: Colonic lipomas are common mesenchymal tumours. They are usually asymptomatic and incidentally diagnosed during endoscopic or radiological examinations. Taking into account their typical endoscopic and radiological features and benign nature, tissue sampling, resection or follow-up are generally not required. Case Report: A 61-year-old woman with poor surgical fitness presented with colonic subocclusion and lower gastrointestinal bleeding. A colonoscopy performed 1 month earlier showed a large polypoid lesion with necrotic and ulcerated areas occupying the lumen of the proximal ascending colon with inconclusive histology. An abdominopelvic computed tomography scan with intravenous contrast was done revealing a cecal-colonic intussusception of a heterogeneous mass. The patient was successfully managed conservatively. A delayed revision colonoscopy showed a significantly smaller atypical subepithelial lesion with no necrosis or ulceration. A single, large and deep incision with a pre-cut needle-knife® allowed the direct collection of lesion tissue using standard biopsy forceps through the so-called single-incision needle-knife® (SINK) biopsy technique. Histological examination was compatible with submucosal lipoma. After 18 months of follow-up, the patient remains asymptomatic. Discussion/Conclusion: Colonic lipoma complications are rare and can lead to misdiagnosis; in general, they are surgically managed. A conservative approach and a minimally invasive endoscopic procedure allowed a definite diagnosis avoiding the morbidity and mortality of a major surgical intervention in a high-risk patient.
Teacher Incentives and Student Performance: Evidence from Brazil
Authors: Lépine Andrea
Published: February 2021

This paper provides evidence on a large-scale teacher incentive program in the state of São Paulo, Brazil, which awarded group bonuses to teachers and school staff conditional on improvements in student performance. By using a difference-in-differences and triple-differences framework with a series of alternative counterfactual groups, I show that the program had positive effects on student achievement up to seven years after implementation, although improvements vary across grades and subjects. Although it could be expected that free-riding effects increase with the number of teachers in schools, limiting the impact of the program, this does not seem to be the case.
A Direct Comparison of Spatial Attention and Stimulus–Response Compatibility between Mice and Humans
Authors: Schnabel Ulf H. , Van der Bijl Tobias , Roelfsema Pieter R. , Lorteije Jeannette A. M.
Published: February 2021

Mice are becoming an increasingly popular model for investigating the neural substrates of visual processing and higher cognitive functions. To validate the translation of mouse visual attention and sensorimotor processing to humans, we compared their performance in the same visual task. Mice and human participants judged the orientation of a grating presented on either the right or left side in the visual field. To induce shifts of spatial attention, we varied the stimulus probability on each side. As expected, human participants showed faster RTs and a higher accuracy for the side with a higher probability, a well-established effect of visual attention. The attentional effect was only present in mice when their response was slow. Although the task demanded a judgment of grating orientation, the accuracy of the mice was strongly affected by whether the side of the stimulus corresponded to the side of the behavioral response. This stimulus–response compatibility (Simon) effect was much weaker in humans and only significant for their fastest responses. Both species exhibited a speed–accuracy trade-off in their responses, because slower responses were more accurate than faster responses. We found that mice typically respond very fast, which contributes to the stronger stimulus–response compatibility and weaker attentional effects, which were only apparent in the trials with slowest responses. Humans responded slower and had stronger attentional effects, combined with a weak influence of stimulus–response compatibility, which was only apparent in trials with fast responses. We conclude that spatial attention and stimulus–response compatibility influence the responses of humans and mice but that strategy differences between species determine the dominance of these effects.
Contributions of Brain Function and Structure to Three Different Domains of Cognitive Control in Normal Aging
Authors: Rieck Jenny R. , Baracchini Giulia , Grady Cheryl L.
Published: February 2021

Cognitive control involves the flexible allocation of mental resources during goal-directed behavior and comprises three correlated but distinct domains—inhibition, shifting, and working memory. The work of Don Stuss and others has demonstrated that frontal and parietal cortices are crucial to cognitive control, particularly in normal aging, which is characterized by reduced control mechanisms. However, the structure–function relationships specific to each domain and subsequent impact on performance are not well understood. In the current study, we examined both age and individual differences in functional activity associated with core domains of cognitive control in relation to fronto-parietal structure and task performance. Participants (n = 140, aged 20–86 years) completed three fMRI tasks: go/no-go (inhibition), task switching (shifting), and n-back (working memory), in addition to structural and diffusion imaging. All three tasks engaged a common set of fronto-parietal regions; however, the contributions of age, brain structure, and task performance to functional activity were unique to each domain. Aging was associated with differences in functional activity for all tasks, largely in regions outside common fronto-parietal control regions. Shifting and inhibition showed greater contributions of structure to overall decreases in brain activity, suggesting that more intact fronto-parietal structure may serve as a scaffold for efficient functional response. Working memory showed no contribution of structure to functional activity but had strong effects of age and task performance. Together, these results provide a comprehensive and novel examination of the joint contributions of aging, performance, and brain structure to functional activity across multiple domains of cognitive control.
Interpreting the History of Evolutionary Biology through a Kuhnian Prism: Sense or Nonsense?
Authors: Tanghe Koen B. , Pauwels Lieven , De Tiège Alexis , Braeckman Johan
Published: February 2021

Traditionally, Thomas S. Kuhn’s The Structure of Scientific Revolutions (1962) is largely identified with his analysis of the structure of scientific revolutions. Here, we contribute to a minority tradition in the Kuhn literature by interpreting the history of evolutionary biology through the prism of the entire historical developmental model of sciences that he elaborates in The Structure. This research not only reveals a certain match between this model and the history of evolutionary biology but, more importantly, also sheds new light on several episodes in that history, and particularly on the publication of Charles Darwin’s On the Origin of Species (1859), the construction of the modern evolutionary synthesis, the chronic discontent with it, and the latest expression of that discontent, called the extended evolutionary synthesis. Lastly, we also explain why this kind of analysis hasn’t been done before.
Joining the Global Environmental Protection Movement: an Exploration of Public Environmental Concern in the UAE
Authors: Alibeli Madalla , Nair Satish
Published: February 2021

This study explores levels of concern about the environment in the United Arab Emirates (UAE). Data for the study were obtained from the 2019 ‘Levels of Concern about the Environment in the UAE’ survey. A convenience sample of 1520 respondents were selected, contacted and interviewed by research assistants. Per the study’s findings, respondents did endorse three out of five dimensions of the Revised NEW Ecological Paradigm scale including the anthropocentric view of nature, balance of nature, and the possibility of eco-crisis. Nevertheless, respondents failed to support the other two dimensions of the given paradigm: limit to growth and human Exemptionalism.
A remarkable new species of Teledapus Pascoe, 1871 from China (Coleoptera: Cerambycidae: Lepturinae: Teledapini)
Authors: HUANG GUI-QIANG , LI SONG , ZHANG GUI-MEI
Published: February 2021

Teledapus linyejiei sp. nov. is described from Yunnan, China and its adult habitus, hind wings and terminalia are described and illustrated.
Resilience to Extreme Rainfall Starts with Science
Authors: Wright Daniel B. , Samaras Constantine , Lopez-Cantu Tania
Published: February 2021

Intensification of extreme rainfall due to climate change means that federally published rainfall metrics such as the “100-yr storm” are outdated throughout much of the United States. Given their central role in a wide range of infrastructure designs and risk management decisions, updating these metrics to reflect recent and future changes is essential to protect communities. There have been considerable advances in recent years in data collection, statistical methods, and climate modeling that can now be brought to bear on the problem. Scientists must take a lead in this updating process, which should be open, inclusive, and leverage recent scientific advances.
Importance of Human-Induced Nitrogen Flux Increases for Simulated Arctic Warming
Authors: Lim Hyung-Gyu , Park Jong-Yeon , Dunne John P. , Stock Charles A. , Kang Sung-Ho , Kug Jong-Seong
Published: February 2021

Human activities such as fossil fuel combustion, land-use change, nitrogen (N) fertilizer use, emission of livestock, and waste excretion accelerate the transformation of reactive N and its impact on the marine environment. This study elucidates that anthropogenic N fluxes (ANFs) from atmospheric and river deposition exacerbate Arctic warming and sea ice loss via physical–biological feedback. The impact of physical–biological feedback is quantified through a suite of experiments using a coupled climate–ocean–biogeochemical model (GFDL-CM2.1-TOPAZ) by prescribing the preindustrial and contemporary amounts of riverine and atmospheric N fluxes into the Arctic Ocean. The experiment forced by ANFs represents the increase in ocean N inventory and chlorophyll concentrations in present and projected future Arctic Ocean relative to the experiment forced by preindustrial N flux inputs. The enhanced chlorophyll concentrations by ANFs reinforce shortwave attenuation in the upper ocean, generating additional warming in the Arctic Ocean. The strongest responses are simulated in the Eurasian shelf seas (Kara, Barents, and Laptev Seas; 65°–90°N, 20°–160°E) due to increased N fluxes, where the annual mean surface temperature increase by 12% and the annual mean sea ice concentration decrease by 17% relative to the future projection, forced by preindustrial N inputs.
A trajectory data publishing algorithm satisfying local suppression
Authors: Li Xiaohui , Bai Yuliang , Wang Yajun , Li Bo
Published: February 2021

Suppressing the trajectory data to be released can effectively reduce the risk of user privacy leakage. However, the global suppression of the data set to meet the traditional privacy model method reduces the availability of trajectory data. Therefore, we propose a trajectory data differential privacy protection algorithm based on local suppression Trajectory privacy protection based on local suppression (TPLS) to provide the user with the ability and flexibility of protecting data through local suppression. The main contributions of this article include as follows: (1) introducing privacy protection method in trajectory data release, (2) performing effective local suppression judgment on the points in the minimum violation sequence of the trajectory data set, and (3) proposing a differential privacy protection algorithm based on local suppression. In the algorithm, we achieve the purpose Maximal frequent sequence (MFS) sequence loss rate in the trajectory data set by effective local inhibition judgment and updating the minimum violation sequence set, and then establish a classification tree and add noise to the leaf nodes to improve the security of the data to be published. Simulation results show that the proposed algorithm is effective, which can reduce the data loss rate and improve data availability while reducing the risk of user privacy leakage.
Neutrophil Extracellular Traps Promote Joint Injury in Hemophilia
Authors: Kaminski Tomasz W. , Brzoska Tomasz , Tutuncuoglu Egemen , Ragni Margaret V. , Sundd Prithu
Published: February 2021

Hemophilic arthropathy (HA) is the predominant pathophysiology resulting from recurrent joint bleeding in individuals with hemophilia. HA leads to permanent joint damage, chronic pain and reduced quality of life. Despite major advances in the treatment to prevent joint bleeding, HA continues to be a major morbidity affecting hemophilia patients and the etiological mechanism contributing to the progression of HA remains elusive. Recent evidence suggests that joint-bleeding may promote the release of erythrocyte and tissue-derived damage-associated-molecular-pattern molecules (DAMPs) that can trigger the sterile inflammation in the joints, however, the innate immune pathways contributing to the development of HA remain unclear. Here, we used a model of knee joint injury-induced HA in FVIII-total knockout (F8TKO) mice and blood samples from hemophilia patients diagnosed with HA. In vivo multi-photon-excitation (MPE) fluorescence imaging of injured synovial cavity in live F8TKO or control mice was used to assess NETs formation within joint capsule. Imaging-flow-cytometry and ELISA assays were used to evaluate the number of circulating NETs in patients diagnosed with HA and mice with knee-injury. Scoring of the bleeding severity, histology, IHC and confocal imaging of joints were conducted to assess the joint injury in mice. F8TKO but not control mice manifested knee-joint injury and severity of bleeding 5-days post knee-injury. Progression of knee-joint injury was associated with increased neutrophil accumulation and NETs shedding within the synovium of F8TKO mice. Circulating NETs were significantly abundant in the plasma of hemophilia patients diagnosed with HA and F8TKO following knee-injury but not plasma of control humans or mice. These findings are the first to suggest that NETs contribute to pathogenesis of HA in hemophilia. Currently, experiments are underway to identify the innate immune pathways that promote NETs shedding, leading to joint-damage in hemophilia.

Disclosures

Ragni: Alnylam/Sanofi, ATHN, BioMarin, Bioverativ, Sangamo, Spark: Research Funding; Alnylam/Sanofi, BioMarin, Bioverativ, Spark: Consultancy; BioMarin: Consultancy, Research Funding; Bioverativ: Consultancy, Research Funding; Spark: Consultancy, Research Funding; Takeda: Research Funding; Sangamo: Consultancy, Research Funding; Alnylam Pharmaceuticals Inc., Baxalta/Takeda, BioMarin, Bioverativ, and Spark Therapeutics: Membership on an entity's Board of Directors or advisory committees; American Thrombosis Hemostasis Network: Other: Committee work; Baxalta/Takeda, CSL Behring, Genentech, a member of the Roche Group, OPKO Biologics, and Vascular Medicine Institute: Research Funding.
Comparative studies on wood structure and microtensile properties between compression and opposite wood fibers of Chinese fir plantation
Authors: Li Zhu , Zhan Tianyi , Eder Michaela , Jiang Jiali , Lyu Jianxiong , Cao Jinzhen
Published: February 2021

The microtensile properties of mechanically isolated compression wood (CW) and opposite wood (OW) tracheids of Chinese fir (Cunninghamia lanceolata) were investigated and discussed with respect to their structure. Major differences in the tensile modulus and ultimate tensile stress were found between CW and OW fibers. Compared to OW, CW showed a larger cellulose microfibril angle, less cellulose content and probably more pits, resulting in lower tensile properties. These findings contribute to a further understanding of the structural–mechanical relationships of Chinese fir wood at the cell and cell wall level, and provide a scientific basis for better utilization of plantation softwood.
Linkage analysis, GWAS, transcriptome analysis to identify candidate genes for rice seedlings in response to high temperature stress
Authors: Wei Zhaoran , Yuan Qiaoling , Lin Hai , Li Xiaoxia , Zhang Chao , Gao Hongsheng , Zhang Bin , He Huiying , Liu Tianjiao , Jie Zhang , Gao Xu , Shi Shandang , Wang Bo , Gao Zhenyu , Kong Lingrang , Qian Qian , Shang Lianguang
Published: February 2021

Background

Rice plants suffer from the rising temperature which is becoming more and more prominent. Mining heat-resistant genes and applying them to rice breeding is a feasible and effective way to solve the problem.

Result

Three main biomass traits, including shoot length, dry weight, and fresh weight, changed after abnormally high-temperature treatment in the rice seedling stage of a recombinant inbred lines and the naturalindicagermplasm population. Based on a comparison of the results of linkage analysis and genome-wide association analysis, two loci with lengths of 57 kb and 69 kb inqDW7andqFW6, respectively, were associated with the rice response to abnormally high temperatures at the seedling stage. Meanwhile, based on integrated transcriptome analysis, some genes are considered as important candidate genes. Combining with known genes and analysis of homologous genes, it was found that there are eight genes in candidate intervals that need to be focused on in subsequent research.

Conclusions

The results indicated several relevant loci, which would help researchers to further discover beneficial heat-resistant genes that can be applied to rice heat-resistant breeding.
Yes- mind the gap!
Authors:   TraumaRegister DGU, Hamsen Uwe , Drotleff Niklas , Lefering Rolf , Gerstmeyer Julius , Schildhauer Thomas Armin , Waydhas Christian
Published: February 2021

We totally agree with Deana and Colleagues that missing intermediate care 1) might be an explanation for unexpected unfavorable outcome and 2) strengthening of intermediate care has the potential to lower this high rate of unfavorable outcome after ICU discharge. Yes- mind the gap!
Rural healthcare providers coping with clinical care delivery challenges: lessons from three health centres in Ghana
Authors: Bawontuo Vitalis , Adomah-Afari Augustine , Amoah Williams W. , Kuupiel Desmond , Agyepong Irene Akua
Published: February 2021

Background

Rural settings in low- and middle-income countries are bedeviled with poverty and high disease burden, and lack adequate resources to deliver quality healthcare to the population. Drug shortage and inadequate number and skill-mix of healthcare providers is very common in rural health facilities. Hence, rural healthcare providers have no choice but to be innovative and introduce some strategies to cope with health delivery challenges at the health centre levels. This study explored how and why rural healthcare providers cope with clinical care delivery challenges at the health centre levels in Ghana.

Methods

This study was a multiple case studies involving three districts: Bongo, Kintampo North, and Juaboso districts. In each case study district, a cross-sectional design was used to explore the research question. Purposive sampling technique was used to select study sites and the study participants. The authors conducted 11 interviews, 9 focus group discussions (involving 61 participants), and 9-week participant observation (in 3 health centres). Transcription of the voice-recordings was done verbatim, cleaned and imported into the Nvivo version 11 platform for analysis. Data was analysed using the inductive content analysis approach. Ethical clearance was granted by the Ethics Review Committee of the Ghana Health Service.

Results

The study found three main coping strategies (borrowing, knowledge sharing and multi-tasking). First, borrowing arrangements among primary health care institutions help to address the periodic shortage of medical supplies at the health centres. Secondly, knowledge sharing among healthcare providers mitigates skills gap during service delivery; and finally, rural healthcare providers use multi-tasking to avert staff inadequacy challenges during service delivery at the health centre levels.

Conclusion

Borrowing, knowledge sharing, and multi-tasking are coping strategies that are sustaining and potentially improving health outcomes at the district levels in Ghana. We recommend that health facilities across all levels of care in Ghana and other settings with similar challenges could adopt and modify these strategies in order to ensure quality healthcare delivery amidst delivery challenges.
Self-perceived workplace discrimination and mental health among immigrant workers in Italy: a cross-sectional study
Authors: Di Napoli Anteo , Rossi Alessandra , Baralla Francesca , Ventura Martina , Gatta Rosaria , Perez Monica , Sarchiapone Marco , Mirisola Concetta , Petrelli Alessio
Published: February 2021

Background

The process of immigration is associated with poor mental and physical health. While the workplace represents an important context of social integration, previous studies evaluating the effect of discrimination experienced in the workplace found worse mental health status among immigrants. The aim of this study was to investigate whether self-perceived workplace discrimination has any role in the mental health status of immigrants living and working in Italy, evaluating the contribution of other personal experiences, such as loneliness and life satisfaction.

Methods

A cross-sectional study was conducted on a sample of 12,408 immigrants (aged 15–64) living and working in Italy. Data were derived from the first national survey on immigrants carried out by the Italian National Institute of Statistics (Istat). Mental health status was measured through the Mental Component Summary (MCS) of the SF-12 questionnaire. A linear multivariate linear regression was carried out to evaluate the association between mental health status, self-perceived workplace discrimination, and sociodemographic factors; path analysis was used to quantify the mediation effect of self-perceived loneliness, level of life satisfaction, and the Physical Component Summary (PCS).

Results

Mental health status was inversely associated (p < 0.001) with self-perceived workplace discrimination (β:-1.737), self-perceived loneliness (β:-2.653), and physical health status (β:-0.089); it was directly associated with level of life satisfaction (β:1.122). As confirmed by the path analysis, the effect of self-perceived workplace discrimination on MCS was mediated by the other factors considered: self-perceived loneliness (11.9%), level of life satisfaction (20.7%), and physical health status (3.9%).

Conclusions

Our study suggests that self-perceived workplace discrimination is associated with worse mental health status in immigrant workers through personal experiences in the workplace and explains the effect of the exposure to workplace discrimination on immigrants’ psychological well-being. Our findings suggest that an overall public health response is needed to facilitate the social integration of immigrants and their access to health services, particularly those services that address mental health issues.
Consequences of COVID-19 crisis for persons with HIV: the impact of social determinants of health
Authors: Waterfield Kristie C. , Shah Gulzar H. , Etheredge Gina D. , Ikhile Osaremhen
Published: February 2021

Background

With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases.

Discussion

As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher risk of contracting HIV, including persons who inject drugs or men that have sex with men, the risk of COVID-19 infection increases if they have certain comorbidities, are older than 60 years of age, and are homeless, orphaned, or vulnerable children. The risk of COVID-19 is also more significant for those that live in Low- and Middle-Income Countries, rural, and/or poverty-stricken areas. An additional concern for those living the HIV is the double stigma that may arise if they also test positive for COVID-19. As public health and health care workers try to tackle the needs of the populations that they serve, they are beginning to realize the need for a change in the infrastructure that will include more efficient partnerships between public health, health care, and HIV programs.

Conclusion

Persons living with HIV that also have other underlying comorbidities are a great disadvantage from the negative consequences of COVID-19. For those that may test positive for both HIV and COVID-19, the increased psychosocial burdens stemming from stress and isolation, as well as, experiencing additional barriers that inhibit access to care, may cause them to become more disenfranchised. Thus, it becomes very important during the current pandemic for these challenges and barriers to be addressed so that these persons living with HIV can maintain continuity of care, as well as, their social and mental support systems.
Effect of oblique headless compression screw fixation for metacarpal shaft fracture: a biomechanical in vitro study
Authors: Chiu Yung-Cheng , Ho Tsung-Yu , Ting Yen-Nien , Tsai Ming-Tzu , Huang Heng-Li , Hsu Cheng-En , Hsu Jui-Ting
Published: February 2021

Background

Metacarpal shaft fracture is a common fracture in hand trauma injuries. Surgical intervention is indicated when fractures are unstable or involve considerable displacement. Current fixation options include Kirschner wire, bone plates, and intramedullary headless screws. Common complications include joint stiffness, tendon irritation, implant loosening, and cartilage damage.

Objective

We propose a modified fixation approach using headless compression screws to treat transverse or short-oblique metacarpal shaft fracture.

Materials and methods

We used a saw blade to model transverse metacarpal neck fractures in 28 fresh porcine metacarpals, which were then treated with the following four fixation methods: (1) locked plate with five locked bicortical screws (LP group), (2) regular plate with five bicortical screws (RP group), (3) two Kirschner wires (K group), and (4) a headless compression screw (HC group). In the HC group, we proposed a novel fixation model in which the screw trajectory was oblique to the long axis of the metacarpal bone. The entry point of the screw was in the dorsum of the metacarpal neck, and the exit point was in the volar cortex of the supracondylar region; thus, the screw did not damage the articular cartilage. The specimens were tested using a modified three-point bending test on a material testing system. The maximum fracture forces and stiffness values of the four fixation types were determined by observing the force–displacement curves. Finally, the Kruskal–Wallis test was adopted to process the data, and the exact Wilcoxon rank sum test with Bonferroni adjustment was performed to conduct paired comparisons among the groups.

Results

The maximum fracture forces (median ± interquartile range [IQR]) of the LP, RP, HC, and K groups were 173.0 ± 81.0, 156.0 ± 117.9, 60.4 ± 21.0, and 51.8 ± 60.7 N, respectively. In addition, the stiffness values (median ± IQR) of the LP, HC, RP, and K groups were 29.6 ± 3.0, 23.1 ± 5.2, 22.6 ± 2.8, and 14.7 ± 5.6 N/mm, respectively.

Conclusion

Headless compression screw fixation provides fixation strength similar to locked and regular plates for the fixation of metacarpal shaft fractures. The headless screw was inserted obliquely to the long axis of the metacarpal bone. The entry point of the screw was in the dorsum of the metacarpal neck, and the exit point was in the volar cortex of the supracondylar region; therefore the articular cartilage iatrogenic injury can be avoidable. This modified fixation method may prevent tendon irritation and joint cartilage violation caused by plating and intramedullary headless screw fixation.
A novel posterior multiple screws distraction reducer system versus anterior release, posterior internal distraction, and subsequent spinal fusion for severe scoliosis
Authors: Feng Ganjun , Huang Yong , Huang Leizhen , Wang Yongliang , Wang Juehan , Zhou Chunguang , Wang Lei , Zhou Zhongjie , Yang Xi , Liu Limin , Song Yueming
Published: February 2021

Purpose

We previously reported anterior release, posterior internal distraction, and subsequent spinal fusion (ARPIDF) for the correction of severe scoliosis with a satisfactory correction rate. However, surgical procedures were completed in 2–3 stages. Here we compare Cobb angle of ≥90° in scoliosis correction between a novel posterior multiple screws distraction reducer (MSDR) system and ARPIDF.

Methods

Thirty-six patients with severe scoliosis treated by MSDR or ARPIDF (n = 18 in both groups). We retrospectively analyzed and compared outcome measures between the two groups over a minimum follow-up duration of 2 years. The following variables were compared between the two groups: age at surgery, sex, etiology, flexibility of the main thoracic curve, number of fused segments and screws, operation time, estimated blood loss, hospitalization time, follow-up duration, various radiological parameters, complication rate, and Scoliosis Research Society-30 score.

Results

There were no significant between-group differences with respect to age, sex, etiology, flexibility of the main thoracic curve, number of fused segments and screws, and follow-up duration. Further, there was no significant difference in terms of preoperative, postoperative, and final follow-up findings of the radiographic data. However, the ARPIDF group had longer operation and hospitalization times and greater blood loss. In the ARPIDF group, 4 patient developed complications (infection, intraoperative neuromonitoring changes, transient dyspnea); none of these events occurred in the MSDR group.

Conclusion

The use of MSDR helped achieve greater scoliosis correction with a shorter operation time, lower blood loss, and lower complication rate than the use of ARPIDF. MSDR facilitates safer and easier correction of severe scoliosis without increasing surgical risk.