bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimation of the carbon footprint of arthroscopic rotator cuff repair in France
Authors: Rougereau Gregoire , Chatelain Léonard , Conso Christel , Zadegan Frédéric
Published: March 2022

Objectives:

Global warming is certainly one of the greatest challenges of the century. The objective of this work is to estimate the carbon footprint of arthroscopic rotator cuff repair, and to evaluate the positive impact of the following actions: ambulatory surgery, performed under loco-regional anesthesia, and filtration of surgical fluids.

Methods:

The assessment protocol was compliant with the Greenhouse Gas Protocol, which has three components: 1/ use of volatile anesthetic agents; 2/ electric consumption related to the procedure (heating and air conditioning, ventilation, computer); 3/ related to patient and staff travel, implant delivery and waste management. The study covered the period from November 2020 to April 2021, and included any patient undergoing arthroscopic shoulder replacement surgery. Three actions aimed at improving the carbon footprint were taken: ambulatory surgery, performed under local anesthesia, and filtration of surgical fluids by Neptune® (Stryker). To examine the effectiveness, each patient included during the review period was matched to a patient who underwent surgery during 2018 before the implementation of this protocol.

Results:

Finally, 26 patients were included. The carbon footprint of arthroscopic rotator cuff repair was estimated at 260.5 +/- 35.03 kgCO2 eq. The main impacts could be attributed to single-use equipment (53.5%), restocking anchors (27.2%), contaminated waste incineration (5.9%), the sterilization process (5.4%), and traveling by the patient (4.1%). Setting up ambulatory surgery without the use of anesthetic gases and a water purifier reduced emissions by 25.9 +/- 2.5 kgCO2 eq (9.3%) per procedure.

Conclusion:

The carbon footprint of arthroscopic rotary cuff repair corresponds to a bit more than 60 km traveled in a car. The main factor that should be addressed is the impact related to single-use materials and inventory management.
In Vivo Static Retraction and Dynamic Elongation of Rotator Cuff Repair Tissue After Surgical Repair: A Preliminary Analysis at 3 Months
Authors: Lawrence Rebekah L. , Ruder Matthew C. , Zauel Roger , Jalics Alena , Olszewski Adam M. , Diefenbach Brian J. , Moutzouros Vasilios , Makhni Eric C. , Muh Stephanie , Bey Michael J.
Published: March 2022

Background:

Rotator cuff repair is a common orthopaedic procedure that provides pain relief for many patients, but unfortunately, an estimated 20% to 70% of repair procedures will fail. Previous research has shown that elongation (ie, retraction) of a repaired tendon is common even in patients with a repair construct that appears intact on magnetic resonance imaging. However, it is unknown how this repair tissue functions under dynamic conditions.

Purpose:

To quantify static retraction and maximum dynamic elongation of repair tissue after rotator cuff repair.

Study Design:

Case series; Level of evidence, 4.

Methods:

Data from 9 patients were analyzed for this study. During surgery, a 3.1-mm tantalum bead was sutured to the supraspinatus tendon, medial to the repair site. Glenohumeral kinematics were assessed at 1 week (static) and 3 months (static and during scapular-plane abduction) after surgery using a biplanar videoradiographic system. The 3-dimensional position of the bead was calculated relative to the tendon’s insertion on the humerus (ie, bead-to-insertion distance). Static retraction was calculated as the change in the bead-to-insertion distance under static conditions between 1 week and 3 months after surgery, and maximum dynamic elongation was calculated as the maximal positive change in the bead-to-insertion distance during dynamic motion relative to the start of motion. The magnitudes of static retraction and maximum dynamic elongation were assessed with 1-sample t tests.

Results:

At 3 months after surgery, static retraction occurred in all patients by a mean of 10.0 ± 9.1 mm ( P = .01 compared with no elongation). During scapular-plane abduction, maximum dynamic elongation averaged 1.4 ± 1.0 mm ( P < .01 compared with no elongation). Descriptively, dynamic elongation consistently took 1 of 2 forms: an initial increase in the bead-to-insertion distance (mean, 2.0 ± 0.6 mm) before decreasing until the end of motion or an immediate and substantial decrease in the bead-to-insertion distance at the onset of motion.

Conclusion:

Repair tissue elongation (static retraction and maximum dynamic elongation) appeared to be a common and significant finding at 3 months after arthroscopic rotator cuff repair. Dynamic elongation of repair tissue during scapular-plane abduction exhibited 1 of 2 distinct patterns, which may suggest different patterns of supraspinatus mechanical and neuromuscular function.
Intrauterine Vertical Transmission of SARS-CoV-2 Infection Among Confirmed Cases of Pregnant Women: “A Double Burden for the Pregnant Women”—A Systematic Review
Authors: Wake Addisu Dabi
Published: March 2022

Introduction. The world health organization (WHO) has declared the outbreak of novel coronavirus (2019-nCoV), which is now known as Coronavirus Disease 2019 (COVID-19). Whereas, its quick global spread has resulted in a worldwide pandemic. The present review article was intended to evaluate intrauterine vertical transmission of SARS-CoV-2 infection among confirmed cases of pregnant women. Methods. Web of Science, EMBASE, PubMed, African Journals OnLine, Scopus, PsycINFO, HINARI, Cochrane Library, Wiley Online Library, and Google scholar were used for search. Result. A total of 43 articles were included in to this systematic review. A total of 1,300 neonates born from pregnant women confirmed for COVI-19 were tested for SARS-CoV-2 infection by real-time reverse transcriptase–polymerase chain reaction (RT-PCR). From the 1,300 neonates tested for SARS-CoV-2 infection, 93 neonates were found positive for this infection by RT-PCR. From this systematic review finding, the vertical transmission rate of SARS-CoV-2 infection was 7.15%. This pandemic has stressed the entire public, particularly pregnant women and healthcare providers, while it challenged antenatal care and postnatal care by far. Thus, even being under lockdown in the middle of a global pandemic is stressful enough. Therefore, imagine the added burden of being pregnant, which could be a double burden for these women. Conclusion. There is no concrete evidence of vertical transmission of SARS-CoV-2. Therefore, due to the limited number of clinical evidences, obstetricians, pediatricians, and other healthcare providers should continuously update their knowledge and be conscious about the transmission of SARS-CoV-2 vertically during pregnancy.
Oral Diseases and Oral Health–Related Quality of Life among Kenyan Children and Adolescents with HIV
Authors: Wang Y. , Ramos-Gomez F. , Kemoli A.M. , John-Stewart G. , Wamalwa D. , Benki-Nugent S. , Slyker J. , Seminario A.L.
Published: March 2022

Introduction:

Children and adolescents living with HIV (CALHIV) have a higher risk of hard and soft oral tissue diseases as compared with their healthy peers. It is important to increase awareness regarding the need to integrate oral health within medical care among pediatric HIV populations. Studies on associations of oral diseases with oral health–related quality of life (OHRQoL) in CALHIV are lacking. This study examined the association between oral diseases and OHRQoL in Kenyan CALHIV.

Methods:

This cross-sectional analysis was nested in a longitudinal cohort study of CALHIV in Nairobi. CALHIV received oral examinations, and the World Health Organization’s Oral Health Surveys and Record Form was administered. OHRQoL was measured with the Parental-Caregiver Perceptions Questionnaire, with the subdomains of global, oral symptoms, function limitations, and emotional and social well-being, with higher scores indicating poorer OHRQoL. Linear regression was used to model associations between OHRQoL and oral diseases, adjusting for age at the time of oral examination, CD4 counts, and caregiver’s education.

Results:

Among 71 CALHIV, the mean age was 12.6 y (SD, 2.9; range, 10 to <21), and the mean composite OHRQoL score was 12.6 (SD, 11.2). Ulcers (not herpes simplex virus or aphthous) were associated with the worst overall OHRQoL (mean, 21.8; SD, 11.1; P = 0.055) and oral symptoms subdomain (mean, 7.0, SD, 2.5; P = 0.003). Children with dry mouth and untreated caries had significantly higher mean global OHRQoL scores than those without disease (P < 0.0001). In the multivariate analysis, the OHRQoL composite score was 6.3 units (95% CI, –0.3 to 12.9) higher for those who had dry mouth and untreated dental caries; dry mouth accounted for the highest percentage of variability of OHRQoL (9.6%) and the global subdomain (31.9%). Ulcers accounted for the highest percentage of variability of the oral symptoms domain (15.4%).

Conclusions:

Oral ulcers, dry mouth, and untreated caries were associated with poorer OHRQoL in CALHIV. Integrating oral health into the primary care of CALHIV may improve their OHRQoL.

Knowledge Transfer Statement:

This study aimed to determine the association of oral diseases with the oral health–related quality of life of children and adolescents living with HIV (CALHIV). The findings will form part of the evidence to incorporate oral health protocols into care programs for CALHIV. Oral health monitoring has the potential to increase the surveillance of HIV clinical status, monitor the effectiveness of antiretroviral therapy, and improve the oral health–related quality of life of CALHIV.
And then came this number PM2.5: Atmospheric particulate matter, sociotechnical imaginaries, and the politics of air quality data
Authors: Marzecová Agáta , Husberg Hanna
Published: March 2022

This article employs the concept of sociotechnical imaginaries to examine the broader political ecology of particulate air pollution, especially the connections between novel technoscientific practices of making pollution perceptible and data-driven modes of urban governance. Drawing on ethnographic material from Beijing, a city notorious for its pervasive smog, the article highlights the role of air quality data—such as particulate matter measurements (PM2.5) and air quality indexes (AQI)—not only in informing citizens of the health-threatening air pollution but also in influencing new regimes of visibility and shaping practices of urban citizenship. Through the conceptual lens of sociotechnical imaginaries, the article shows that air quality data, increasingly shared digitally in the form of real-time continuous data streams, are not merely technoscientific indexes, nor are they value-neutral. Rather, their conceptualization is informed by technocractic visions of human-air relations and shaped by digital infrastructures. Learning from Beijing, the article argues that in order to generate an expanded understanding of the life-structuring effects of urban air pollution in the era of data-driven urbanism, political ecology of urban air needs to be considerate of how the numbers, which represent pollution, are conceptualized, amassed, and circulated, as well as what and whom they include or exclude.
Optical coherence tomography patterns of diabetic macular edema and treatment response to bevacizumab: a short-term study
Authors: Sharma Sadhana , Karki Pratap , Joshi Sagun Narayan , Parajuli Sanket
Published: March 2022

Background:

The purpose of this study was to evaluate the short-term response of intravitreal bevacizumab in diabetic macular edema (DME) and assess the variation in treatment outcomes in different morphology patterns using spectral domain–optical coherence tomography (SD-OCT).

Objective:

To study different morphological patterns of DME based on OCT and compare their treatment response to bevacizumab.

Methods:

Hundred and twelve eyes of 112 patients with DME were included and treated with intravitreal bevacizumab (1.25 mg/0.05 ml monthly for 3 months). The morphological patterns of DME were classified on the basis of OCT into three groups – diffuse retinal thickening (DRT), cystoid macular edema (CME), and serous retinal detachment (SRD) – and changes in central macular thickness (CMT) and best corrected visual acuity (BCVA) after treatment were compared.

Results:

A total of 112 eyes with DME were included and consisted of 40 DRT, 37 CME, and 35 SRD. Treatment with bevacizumab resulted in decrease in central macular thickness and improvement in BCVA in all three groups. The baseline visual acuity and CMT of DRT group was better than that of the other two groups. The treatment outcome was measured in terms of CMT and BCVA. Change in CMT was statistically significant among three groups and was found to be better in DRT group ( p < 0.05, 95% confidence interval). However, there was statistically no significant variation between the three groups regarding the change in BCVA ( p = 0.169, 95% confidence interval).

Conclusion:

Anatomic and visual improvement can be achieved by bevacizumab in all patterns of DME. However, individual pattern may respond differently. DRT, which appears to be the earliest form of DME, responds better than other types. Thus, the pattern of macular edema shown by OCT may provide an objective guideline in predicting the response of bevacizumab injection in DME.
Activation of the zinc-sensing receptor GPR39 promotes T-cell reconstitution after hematopoietic cell transplant in mice
Authors: Iovino Lorenzo , Cooper Kirsten , deRoos Paul , Kinsella Sinéad , Evandy Cindy , Ugrai Tamas , Mazziotta Francesco , Ensbey Kathleen S. , Granadier David , Hopwo Kayla , Smith Colton , Gagnon Alex , Galimberti Sara , Petrini Mario , Hill Geoffrey R. , Dudakov Jarrod A.
Published: March 2022

Prolonged lymphopenia represents a major clinical problem after cytoreductive therapies such as chemotherapy and the conditioning required for hematopoietic stem cell transplant (HCT), contributing to the risk of infections and malignant relapse. Restoration of T-cell immunity depends on tissue regeneration in the thymus, the primary site of T-cell development, although the capacity of the thymus to repair itself diminishes over its lifespan. However, although boosting thymic function and T-cell reconstitution is of considerable clinical importance, there are currently no approved therapies for treating lymphopenia. Here we found that zinc (Zn) is critically important for both normal T-cell development and repair after acute damage. Accumulated Zn in thymocytes during development was released into the extracellular milieu after HCT conditioning, where it triggered regeneration by stimulating endothelial cell production of BMP4 via the cell surface receptor GPR39. Dietary supplementation of Zn was sufficient to promote thymic function in a mouse model of allogeneic HCT, including enhancing the number of recent thymic emigrants in circulation although direct targeting of GPR39 with a small molecule agonist enhanced thymic function without the need for prior Zn accumulation in thymocytes. Together, these findings not only define an important pathway underlying tissue regeneration but also offer an innovative preclinical approach to treat lymphopenia in HCT recipients.
Intravenous methylprednisolone pulses in hospitalised patients with severe COVID-19 pneumonia: a double-blind, randomised, placebo-controlled trial
Authors: Salvarani Carlo , Massari Marco , Costantini Massimo , Merlo Domenico Franco , Mariani Gabriella Lucia , Viale Pierluigi , Nava Stefano , Guaraldi Giovanni , Dolci Giovanni , Boni Luca , Savoldi Luisa , Bruzzi Paolo , Turrà Caterina , Catanoso Mariagrazia , Marata Anna Maria , Barbieri Chiara , Valcavi Annamaria , Franzoni Francesca , Cavuto Silvio , Mazzi Giorgio , Corsini Romina , Trapani Fabio , Bartoloni Alessandro , Barisione Emanuela , Barbieri Chiara , Burastero Giulia Jole , Pan Angelo , Inojosa Walter , Scala Raffaele , Burattini Cecilia , Luppi Fabrizio , Codeluppi Mauro , Tarek Kamal Eldin , Cenderello Giovanni , Salio Mario , Foti Giuseppe , Dongilli Roberto , Bajocchi Gianluigi , Negri Emanuele Alberto , Ciusa Giacomo , Fornaro Giacomo , Bassi Ilaria , Zammarchi Lorenzo , Aloè Teresita , Facciolongo Nicola
Published: March 2022

Rationale

Pulse glucocorticoid therapy is used in hyperinflammation related to coronavirus disease 2019 (COVID-19). We evaluated the efficacy and safety of pulse intravenous methylprednisolone in addition to standard treatment in COVID-19 pneumonia.

Methods

In this multicentre, randomised, double-blind, placebo-controlled trial, 304 hospitalised patients with COVID-19 pneumonia were randomised to receive 1 g of methylprednisolone intravenously for three consecutive days or placebo in addition to standard dexamethasone. The primary outcome was the duration of patient hospitalisation, calculated as the time interval between randomisation and hospital discharge without the need for supplementary oxygen. The key secondary outcomes were survival free from invasive ventilation with orotracheal intubation and overall survival.

Results

Overall, 112 (75.4%) out of 151 patients in the pulse methylprednisolone arm and 111 (75.2%) of 150 in the placebo arm were discharged from hospital without oxygen within 30 days from randomisation. Median time to discharge was similar in both groups (15 days, 95% CI 13.0–17.0 days and 16 days, 95% CI 13.8–18.2 days, respectively; hazard ratio (HR) 0.92, 95% CI 0.71–1.20; p=0.528). No significant differences between pulse methylprednisolone and placebo arms were observed in terms of admission to intensive care unit with orotracheal intubation or death (20.0%versus16.1%; HR 1.26, 95% CI 0.74–2.16; p=0.176) or overall mortality (10.0%versus12.2%; HR 0.83, 95% CI 0.42–1.64; p=0.584). Serious adverse events occurred with similar frequency in the two groups.

Conclusions

Methylprenisolone pulse therapy added to dexamethasone was not of benefit in patients with COVID-19 pneumonia.
Cancer risk in severe alpha-1-antitrypsin deficiency
Authors: Hiller Adriana-Maria , Ekström Magnus , Piitulainen Eeva , Lindberg Anne , Rönmark Eva , Tanash Hanan
Published: March 2022

Background

Severe alpha-1-antitrypsin deficiency (AATD), phenotype PiZZ, is a risk factor for pulmonary emphysema and liver disease, but its effect on cancer risk is unknown. Our aim was to evaluate the risk and the risk factors for incident cancer in PiZZ individuals compared with the general population with known smoking habits.

Methods

A longitudinal study of PiZZ individuals (n=1595) from the Swedish National AATD Register, and controls (n=5999) from Swedish population-based cohorts. Data on cancer and mortality were obtained by cross-linkage with national registers. Individuals who had undergone lung transplantation (n=10) and those with a cancer diagnosis within 5 years prior to inclusion (n=63) were excluded. The risk factors for developing cancer were analysed using proportional hazards and Fine–Gray regression models, adjusting for age, sex, smoking habits and the presence of liver disease.

Results

The median follow-up time was 17 years (interquartile range 11 years) for the whole study population. The incidence rates of hepatic and non-hepatic cancer per 1000 person-years were 1.6 (95% CI 1.1–2.3) and 8.5 (95% CI 7.2–10.0), respectively, for the PiZZ individuals, and 0.1 (95% CI 0.04–0.2) and 6.6 (95% CI 6.0–7.1), respectively, for the controls. The adjusted hazard ratios for hepatic and for non-hepatic cancer were 23.4 (95% CI 9.9–55.4) and 1.3 (95% CI 1.1–1.5), respectively, in the PiZZ individuals compared with the controls.

Conclusion

These results suggest that individuals with severe AATD may have an increased risk of developing both hepatic and non-hepatic cancer, compared with the general population.
LANDMark: an ensemble approach to the supervised selection of biomarkers in high-throughput sequencing data
Authors: Rudar Josip , Porter Teresita M. , Wright Michael , Golding G. Brian , Hajibabaei Mehrdad
Published: March 2022

Background

Identification of biomarkers, which are measurable characteristics of biological datasets, can be challenging. Although amplicon sequence variants (ASVs) can be considered potential biomarkers, identifying important ASVs in high-throughput sequencing datasets is challenging. Noise, algorithmic failures to account for specific distributional properties, and feature interactions can complicate the discovery of ASV biomarkers. In addition, these issues can impact the replicability of various models and elevate false-discovery rates. Contemporary machine learning approaches can be leveraged to address these issues. Ensembles of decision trees are particularly effective at classifying the types of data commonly generated in high-throughput sequencing (HTS) studies due to their robustness when the number of features in the training data is orders of magnitude larger than the number of samples. In addition, when combined with appropriate model introspection algorithms, machine learning algorithms can also be used to discover and select potential biomarkers. However, the construction of these models could introduce various biases which potentially obfuscate feature discovery.

Results

We developed a decision tree ensemble, LANDMark, which uses oblique and non-linear cuts at each node. In synthetic and toy tests LANDMark consistently ranked as the best classifier and often outperformed the Random Forest classifier. When trained on the full metabarcoding dataset obtained from Canada’s Wood Buffalo National Park, LANDMark was able to create highly predictive models and achieved an overall balanced accuracy score of 0.96 ± 0.06. The use of recursive feature elimination did not impact LANDMark’s generalization performance and, when trained on data from the BE amplicon, it was able to outperform the Linear Support Vector Machine, Logistic Regression models, and Stochastic Gradient Descent models (p ≤ 0.05). Finally, LANDMark distinguishes itself due to its ability to learn smoother non-linear decision boundaries.

Conclusions

Our work introduces LANDMark, a meta-classifier which blends the characteristics of several machine learning models into a decision tree and ensemble learning framework. To our knowledge, this is the first study to apply this type of ensemble approach to amplicon sequencing data and we have shown that analyzing these datasets using LANDMark can produce highly predictive and consistent models.
classifieR a flexible interactive cloud-application for functional annotation of cancer transcriptomes
Authors: Quinn Gerard P. , Sessler Tamas , Ahmaderaghi Baharak , Lambe Shauna , VanSteenhouse Harper , Lawler Mark , Wappett Mark , Seligmann Bruce , Longley Daniel B. , McDade Simon S.
Published: March 2022

Background

Transcriptionally informed predictions are increasingly important for sub-typing cancer patients, understanding underlying biology and to inform novel treatment strategies. For instance, colorectal cancers (CRCs) can be classified into four CRC consensus molecular subgroups (CMS) or five intrinsic (CRIS) sub-types that have prognostic and predictive value. Breast cancer (BRCA) has five PAM50 molecular subgroups with similar value, and the OncotypeDX test provides transcriptomic based clinically actionable treatment-risk stratification. However, assigning samples to these subtypes and other transcriptionally inferred predictions is time consuming and requires significant bioinformatics experience. There is no "universal" method of using data from diverse assay/sequencing platforms to provide subgroup classification using the established classifier sets of genes (CMS, CRIS, PAM50, OncotypeDX), nor one which in provides additional useful functional annotations such as cellular composition, single-sample Gene Set Enrichment Analysis, or prediction of transcription factor activity.

Results

To address this bottleneck, we developed classifieR, an easy-to-use R-Shiny based web application that supports flexible rapid single sample annotation of transcriptional profiles derived from cancer patient samples form diverse platforms. We demonstrate the utility of the " classifieR" framework to applications focused on the analysis of transcriptional profiles from colorectal (classifieRc) and breast (classifieRb). Samples are annotated with disease relevant transcriptional subgroups (CMS/CRIS sub-types in classifieRc and PAM50/inferred OncotypeDX in classifieRb), estimation of cellular composition using MCP-counter and xCell, single-sample Gene Set Enrichment Analysis (ssGSEA) and transcription factor activity predictions with Discriminant Regulon Expression Analysis (DoRothEA).

Conclusions

classifieR provides a framework which enables labs without access to a dedicated bioinformation can get information on the molecular makeup of their samples, providing an insight into patient prognosis, druggability and also as a tool for analysis and discovery. Applications are hosted online athttps://generatr.qub.ac.uk/app/classifieRcandhttps://generatr.qub.ac.uk/app/classifieRbafter signing up for an account onhttps://generatr.qub.ac.uk.
Context-dependent DNA polymerization effects can masquerade as DNA modification signals
Authors: Takahashi Yusuke , Shoura Massa , Fire Andrew , Morishita Shinichi
Published: March 2022

Background

Single molecule measurements of DNA polymerization kinetics provide a sensitive means to detect both secondary structures in DNA and deviations from primary chemical structure as a result of modified bases. In one approach to such analysis, deviations can be inferred by monitoring the behavior of DNA polymerase using single-molecule, real-time sequencing with zero-mode waveguide. This approach uses a Single Molecule Real Time (SMRT)-sequencing measurement of time between fluorescence pulse signals from consecutive nucleosides incorporated during DNA replication, called the interpulse duration (IPD).

Results

In this paper we present an analysis of loci with high IPDs in two genomes, a bacterial genome (E. coli) and a eukaryotic genome (C. elegans). To distinguish the potential effects of DNA modification on DNA polymerization speed, we paired an analysis of native genomic DNA with whole-genome amplified (WGA) material in which DNA modifications were effectively removed. Adenine modification sites for E. coli are known and we observed the expected IPD shifts at these sites in the native but not WGA samples. For C. elegans, such differences were not observed. Instead, we found a number of novel sequence contexts where IPDs were raised relative to the average IPDs for each of the four nucleotides, but for which the raised IPD was present in both native and WGA samples.

Conclusion

The latter results argue strongly against DNA modification as the underlying driver for high IPD segments for C. elegans, and provide a framework for separating effects of DNA modification from context-dependent DNA polymerase kinetic patterns inherent in underlying DNA sequence for a complex eukaryotic genome.
Impacts of autofluorescence on fluorescence based techniques to study microglia
Authors: Zhang Haozhe , Tan Chen , Shi Xiaoyue , Xu Ji
Published: March 2022

Background

Microglia, the resident immune cells in the central nervous system, accrue autofluorescent granules inside their cytoplasm throughout their lifespan. In this report, we studied the impacts of autofluorescence on widely used fluorescence-based techniques to study microglia, including flow cytometry, immunofluorescence staining, and live imaging.

Results

The failed attempt of using fluorescein isothiocyanate (FITC) conjugated antibody to detect lymphocyte-activation gene 3 protein in microglia prompted us to compare the sensitivity of FITC, phycoerythrin (PE) and allophycocyanin (APC) conjugated antibodies to detect surface protein expression in microglia. We found that PE outperformed FITC and APC as the fluorophore conjugated to antibody for flow cytometry by overcoming the interference from microglia autofluorescence. To identify the location and source of microglia autofluorescence, we did confocal imaging and spectral analysis of microglia autofluorescence on fixed brain tissues, revealing that microglia autofluorescence emitted from cytoplasmic granules and displayed a multi-peak emission spectrum. We recommended removing autofluorescence by lipofuscin removing agents when staining intracellular proteins in microglia with the immunofluorescence techniques. On live brain slices, autofluorescent granules reduced the amplitudes of calcium signals in microglial somata derived from GCaMP6s fluorescence and thus needed to be excluded when selecting regions of interest (ROI).

Conclusions

In conclusion, autofluorescence is a critical factor to consider when designing experiments and interpreting results based on fluorescence-based techniques to study microglia.
Comparison of fibrosing mediastinitis patients with vs. without markedly increased systolic pulmonary arterial pressure: a single-center retrospective study
Authors: Zhang Xinyuan , Zhang Shu , Wang Jianfeng , Jiang Wei , Sun Lanlan , Li Yuanzhi , Guo Dichen , Yang Yuanhua , Lu Xiuzhang , Li Yidan
Published: March 2022

Introduction

Fibrosing mediastinitis (FM) complicated with pulmonary hypertension (PH) has been considered as an important cause of morbidity and mortality. This study was designed to observe the possible effects of abnormal hemodynamics on patients by conducting a between-group comparison according to the presence of markedly increased systolic pulmonary arterial pressure (SPAP), so as to provide more information for clinical management.

Materials and methods

Fifty-one patients with clinically diagnosed FM were divided in two groups (SPAP < 50 mmHg group; SPAP ≥ 50 mmHg group) and retrospectively included in the study. Data mainly including demographic factors, echocardiographic data, results of right heart catheter and computed tomography (CT) examination were retrieved from the medical database. Echocardiographic parameters pre- and post- balloon pulmonary angioplasty (BPA) treatment were also collected in 8 patients.

Results

Significant changes in cardiac structure, hemodynamics and cardiac function were detected in patients complicated with markedly increased SPAP. Patients in the SPAP ≥ 50 mmHg group had increased right heart diameter, right heart ratio and velocity of tricuspid regurgitation (VTR) (p < 0.05). Deteriorated right heart function was also observed. There was no significant difference in CT findings between the two groups, except that more patients in the SPAP ≥ 50 mmHg group had pleural effusion (p < 0.05). After primary BPA in 8 patients, improvement in the right atrium proportion was observed.

Conclusions

Changes due to significantly increased SPAP in patients with FM include adverse structure and function of the right heart, but differences in CT findings were not significant. Echocardiography has advantages as a noninvasive tool for the evaluation of cardiac structure, function and hemodynamics in patients with FM.
Preprocedural and procedural variables that predict new-onset conduction disturbances after transcatheter aortic valve replacement
Authors: Boonyakiatwattana Wongsaput , Maneesai Adisak , Chaithiraphan Vithaya , Jakrapanichakul Decho , Sakiyalak Pranya , Chunhamaneewat Narathip , Slisatkorn Worawong , Chotinaiwattarakul Chunhakasem , Pongakasira Rungtiwa , Wongpraparut Nattawut
Published: March 2022

Background

Conduction disturbances are a common complication after transcatheter aortic valve replacement (TAVR). The aim of this study was to investigate the preprocedural and procedural variables that predict new-onset conduction disturbances post-TAVR (hereafter CD/CDs).

Methods

Consecutive patients who underwent TAVR during December 2009–March 2021 at the Faculty of Medicine Siriraj Hospital, Mahidol University—Thailand’s largest national tertiary referral center—were enrolled. Patients with prior implantation of a cardiac device, periprocedural death, or unsuccessful procedure were excluded. Clinical and electrocardiographic data, preprocedural imaging, including membranous septum (MS) length, and procedural variables, including implantation depth (ID), were analyzed. CD was defined as new left or right bundle branch block, significant intraventricular conduction disturbance with QRS interval ≥ 120 ms, new high-grade atrioventricular block, or complete heart block. Multivariate binary logistic analysis and receiver operating characteristic (ROC) curve analysis were used to identify independent predictors and the optimal ∆MSID (difference between the MS length and ID) cutoff value, respectively.

Results

A total of 124 TAVR patients (mean age: 84.3 ± 6.3 years, 62.1% female) were included. The mean Society of Thoracic Surgeons score was 7.3%, and 85% of patients received a balloon expandable transcatheter heart valve. Thirty-five patients (28.2%) experienced a CD, and one-third of those required pacemaker implantation. The significant preprocedural and procedural factors identified from univariate analysis included intraventricular conduction delay, mitral annular calcification, MS length ≤ 6.43 mm, self-expanding device, small left ventricular cavity, and ID ≥ 6 mm. Multivariate analysis revealed MS length ≤ 6.43 mm (adjusted odds ratio [aOR] 9.54; 95% CI 2.56–35.47; p = 0.001) and ∆MSID < 0 mm (adjusted odds ratio [aOR] 10.77; 95% CI 2.86–40.62; p =  < 0.001) to be independent predictors of CD. The optimal ∆MSID cutoff value for predicting conduction disturbances was less than 0 mm (area under the receiver operating characteristic curve [AuROC]: 0.896).

Conclusion

This study identified MS length ≤ 6.43 mm and ∆MSID < 0 mm as independent predictors of CDs. ∆MSID < 0 was the strongest and only modifiable predictor. Importantly, we expanded the CD criteria to cover all spectrum of TAVR-related conduction injury to lower the threshold of this sole modifiable risk. The optimal ∆MSID cutoff value was < 0 mm.

Trial registration: TCTR, TCTR20210818002. Registered 17 August 2021—Retrospectively registered, http://www.thaiclinicaltrials.org/show/TCTR 20210818002.
Implementation and findings on a one-minute sit-stand test for prehospital triage in patients with suspected COVID-19—a pilot project
Authors: Kjerulff Julie , Bach Allan , Væggemose Ulla , Skaarup Søren Helbo , Bøtker Morten Thingemann
Published: March 2022

Introduction

During the initial Coronavirus Disease 2019 (COVID-19) pandemic wave, sparse personal protection equipment made telephone triage of suscpeted COVID-19 patients for ambulance transport necessary. To spare resources, stable patients were often treated and released on-scene, but reports from Italy suggested that some later detoriated. We implemented a prehospital sit-stand test to identify patients in risk for detoriation.

Methods

The test was implemented as part of a new guideline in stable suspected COVID-19 patients younger than 70 years with no risk factors for serious disease triaged by general practitioners to ambulance response in the Central Denmark Region. Data were collected from April 6thto July 6th2020. The primary outcome for this study was the proportion of patients treated with oxygen within 7 days among patients decompensating vs patients not decompensating during the test.

Results

Data on 156 patients triaged to ambulance response by general practioners were analysed. In total 86/156 (55%) were tested with the sit-stand test. Due to off-guideline use of the test, 30/86 (34.8%) were either older than 70 or had risk factors for serious disease. 10/156 (6%) of patients had a positive COVID-19-test. In total, 17/86 (20%) decompensated during the test and of these, 9/17 (53%) were treated with oxygen compared to 2/69 (3%) in patients who did not decompensate (p < 0.001).

Conclusion

In a population suspected of COVID-19 but with a low COVD-19 prevalence, decompensation with the sit-stand test was observed in 20% of patients and was associated with oxygen treatment within 7 days. These findings are hypotheses-generating and suggest that physical exercise testing may be usefull for decision making in emergency settings.
Epidemiology, injury characteristics and clinical outcomes of bicycle and motorcycle accidents in the under 20 population: South Korea
Authors: Yun Hyeokmin , Bae Sung Jin , Lee Jung Il , Lee Duk Hee
Published: March 2022

Background

Bicycles and motorcycles are a main means of transportation and leisure for individuals aged under 20 years in South Korea. We aimed to identify the epidemiology of injuries and describe and compare patterns of injury and clinical outcomes of two-wheel vehicle-related accidents in these individuals.

Methods

We analysed data obtained from the National Emergency Department Information System for 401 emergency departments (EDs) from January 2016 to December 2018. We included patients aged < 20 years who experienced injuries while driving or a passenger on two-wheeled vehicles. We analysed patients with a bicycle-related injury and those with a motorcycle-related injury, and then compared two groups and performed a regression analysis for factors predicting severe trauma.

Results

This study enrolled 54,342 two-wheel vehicle injury patients (37,410 bicycle and 16,932 motorcycle-related), of which, 86.8% (bicycle) and 94.9% (motorcycle) were males. External injuries were the most common. ED mortality was 9 (0.0%) for bicycles and 53 (0.3%) for motorcycles.

Overall, 3,346 (8.9%) patients were hospitalised with bicycle injuries and 4,096 (24.2%) with motorcycle injuries. Among admitted patients with bicycle-related injuries, 48.7% had upper extremity injuries and among those admitted patients with motorcycle-related injuries, 76.0% had lower extremity injuries.

Among hospitalised patients, the mean injury severity score (ISS) was 12.0 ± 12.6 in bicycle-related injury and 17.6 ± 15.4 in motorcycle-related injury. The number of patients with ISS ≥ 16 was 27.6% for bicycle related injuries and 45.2% for motorcycle-related injuries. The mean length of hospital stay was 191.5.8 ± 224.2 h for bicycle injury, and 359.6 ± 416.7 h for motorcycles. Hospital mortality cases were 0.2% with bicycle injury and 1.2% with motorcycle injury. Motorcycle-related injuries had more severe injury (ISS ≥ 16), with an adjusted odds ratio of 2.825 (95% confidence interval 2.610–3.059) compared to bicycle-related injuries.

Conclusions

In the population aged under 20 years, two-wheel vehicle-related occurred predominantly in males. When using two-wheeled vehicles, motorcycle injuries were higher in patients aged over 14 years and were associated with higher ISS (≥ 16). Political efforts should be made to educate under 20 years of age for safe driving and to wear protective gear, including helmets to prevent severe injury.
Burden of respiratory syncytial virus-associated lower respiratory infections in children in Spain from 2012 to 2018
Authors: Heppe-Montero Marco , Walter Stefan , Hernández-Barrera Valentín , Gil-Prieto Ruth , Gil-de-Miguel Ángel
Published: March 2022

Background

Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory tract infection (ALRI) leading to infant hospitalization, morbidity and postnatal mortality in children younger than 5 years of age worldwide. The aim of this study was to collect data on hospitalizations for RSV-related ALRI in children in Spain from 2012 to 2018.

Methods

We used the discharge reports from the Minimum Basic Data Set (MBDS) to retrospectively analyze hospital discharge data in children ≤ 14 years of age with a diagnosis of acute lower respiratory tract infection, based on the ICD-9-CM and ICD-10-CM diagnosis codes, from 2012 to 2018.

Results

A total of 190,474 children, 58.1% boys and 41.9% girls, were admitted for lower respiratory tract infections in Spain, including 118,731 cases of bronchiolitis, 53,972 cases of bronchitis, 3710 cases of RSV-positive pneumonia, and 14,061 cases of RSV infections. Of these, 92,426 children (48.5%) had laboratory-confirmed RSV infection. The mean case fatality rate was almost 6 times higher for pneumonia (0.6%) than for bronchiolitis (0.1%) or bronchitis (0.1%). A significant linear increase in the mean annual hospitalization rate for pneumonia of almost 15% per year was found, with no changes in the trend over the study period.

Conclusions

RSV-related respiratory infections remain a leading cause of infant hospitalization in Spain. Effective antiviral treatments and preventive vaccines are urgently needed for the management of RSV infection in children, especially for those aged 6 to 12 months.
Value of repeat renal biopsy in the evaluation of AL amyloidosis patients lacking renal response despite of complete hematologic remission: a case report and literature review
Authors: Zhang Ping , Chen Xiuling , Zou Yurong , Wang Wei , Feng Yunlin
Published: March 2022

Backgrounds

Published literatures on repeat renal biopsy of AL amyloidosis have basically reached a consensus that amyloid material deposit does not disappear or diminish after satisfactory hematologic response, regardless of renal response. However, the need of a repeat renal biopsy in such situation is still controversial.

Case presentation

Here we reported a case of histologically confirmed λ Type renal AL amyloidosis who had been classified as Stage I and low risk at initial diagnosis. The patient received a total of six courses of CyBorD chemotherapy. She had achieved complete hematologic remission after two courses of chemotherapy but consistently had large amount of proteinuria over 10 g/day during follow up. A repeat renal biopsy was performed nine months after the first one and indicated mild to moderate increase of amyloid deposits as well as significant glomerulosclerosis and interstitial lesions, suggesting a lack of histological renal improvement despite her satisfactory hematologic response.

Conclusions

This case indicated renal involvement in AL amyloidosis could progress after successful hematologic treatment, and supported the value of repeat renal biopsy in the evaluation of AL amyloidosis patients lacking renal response despite of complete hematologic remission.
Urinary L-type fatty acid-binding protein is a predictor of cisplatin-induced acute kidney injury
Authors: Yanishi Masaaki , Kinoshita Hidefumi
Published: March 2022

Background

Although cisplatin-based chemotherapy is a standard treatment for urothelial carcinoma, it often causes acute kidney injury (AKI). AKI and dysfunction are observed in 25–35% of cisplatin-based chemotherapy patients, who may require treatment down-titration or withdrawal. In this study, we evaluated whether urinary L-FABP is a marker for early diagnosis of cisplatin-caused AKI.

Methods

We included 42 adult patients who underwent cisplatin-based chemotherapy for bladder cancer or upper tract urothelial carcinoma from January 2018 to March 2019. Urinary L-FABP and serum creatinine were measured at 2 and 6 h, and 1, 2, 3, 7 and 28 days after taking cisplatin.

Results

In the first week after receiving cisplatin, 10 patients (23.8%) were diagnosed with AKI (AKI+ group). Pre-treatment (baseline) measurements did not significantly differ between the AKI+ and AKI− groups. However, urinary L-FABP concentrations rapidly increased in the AKI+ group and were significantly greater than in the AKI− group at Hour 2, Hour 6, Day 1 and Day 2. Serum creatinine also significantly differed between the AKI+ group and the AKI− group on Days 3 and 7. ROC analysis was performed to evaluate the superiority of urinary L-FABP magnification which had the highest at the hour 6. The urinary L-FABP magnification and levels of aria under curve was 0.977. Based on ROC analysis, the best cut-off value of urinary L-FABP magnification was 10.28 times urinary L-FABP levels at the hour 0 (base line urinary L-FABP).

Conclusions

Acute renal function deterioration was predicted by increased urinary L-FABP excretion within 6 h after receiving CIS-CT and, in those with AKI, the increase in urinary L-FABP excretion preceded the rise in sCr by over 2 days. In contrast, no appreciable changes in urinary L-FABP levels were observed in patients with stable renal function throughout the whole observation period. So early increase in urinary L-FABP may identify patients at risk of cisplatin-induced AKI, who might benefit from treatment to prevent nephrotoxicity.

Trial registration

This study was retrospectively registered.
Factors affecting the emotional wellbeing of women and men who experience miscarriage in hospital settings: a scoping review
Authors: Galeotti Martina , Mitchell Gary , Tomlinson Mark , Aventin Áine
Published: March 2022

Background

Miscarriage can be a devastating event for women and men that can lead to short- and long-term emotional distress. Studies have reported associations between miscarriage and depression, anxiety, and post-traumatic stress disorder in women. Men can also experience intense grief and sadness following their partner’s miscarriage. While numerous studies have reported hospital-related factors impacting the emotional wellbeing of parents experiencing miscarriage, there is a lack of review evidence which synthesises the findings of current research.

Aims

The aim of this review was to synthesise the findings of studies of emotional distress and wellbeing among women and men experiencing miscarriage in hospital settings.

Methods

A systematic search of the literature was conducted in October 2020 across three different databases (CINAHL, MEDLINE and PsycInfo) and relevant charity organisation websites, Google, and OpenGrey. A Mixed Methods appraisal tool (MMAT) and AACODS checklist were used to assess the quality of primary studies.

Results

Thirty studies were included in this review representing qualitative (N = 21), quantitative (N = 7), and mixed-methods (N = 2) research from eleven countries. Findings indicated that women and men’s emotional wellbeing is influenced by interactions with health professionals, provision of information, and the hospital environment. Parents’ experiences in hospitals were characterised by a perceived lack of understanding among healthcare professionals of the significance of their loss and emotional support required. Parents reported that their distress was exacerbated by a lack of information, support, and feelings of isolation in the aftermath of miscarriage. Further, concerns were expressed about the hospital environment, in particular the lack of privacy.

Conclusion

Women and men are dissatisfied with the emotional support received in hospital settings and describe a number of hospital-related factors as exacerbators of emotional distress.

Implications for practice

This review highlights the need for hospitals to take evidence-informed action to improve emotional support services for people experiencing miscarriage within their services.