bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of TNF-α antagonists and tocilizumab in Takayasu arteritis: multicentre retrospective study of 209 patients
Authors: Mekinian Arsène , Biard Lucie , Dagna Lorenzo , Novikov Pavel , Salvarani Carlo , Espitia Olivier , Sciascia Savino , Michaud Martin , Lambert Marc , Hernández-Rodríguez José , Schleinitz Nicolas , Awisat Abid , Puéchal Xavier , Aouba Achille , Munoz Pons Helene , Smitienko Ilya , Gaultier Jean Baptiste , Le Mouel Edwige , Benhamou Ygal , Perlat Antoinette , Jego Patrick , Goulenok Tiphaine , Sacre Karim , Lioger Bertrand , Hassold Nolan , Broner Jonathan , Dufrost Virginie , Sene Thomas , Seguier Julie , Maurier Francois , Berthier Sabine , Belot Alexandre , Frikha Faten , Denis Guillaume , Audemard-Verger Alexandra , Kone Pault Isabelle , Humbert Sebastien , Woaye-Hune Pascal , Tomelleri Alessandro , Baldissera Elena , Kuwana Masataka , Lo Gullo Alberto , Gaches Francis , Zeminsky Pierre , Galli Elena , Alvarado Moya , Boiardi Luigi , Muratore Francesco , Vautier Mathieu , Campochiaro Corrado , Moiseev Sergey , Cacoub Patrice , Fain Olivier , Saadoun David ,   for the French Takayasu network
Published: August 2021

Objective

To assess the safety and the efficacy of TNF-α antagonists and tocilizumab in patients with Takayasu arteritis (TAK).

Methods

A total of 209 patients with TAK [median age 29 years (interquartile range 7–62)], 186 (89%) females] were included. They received either TNF-α antagonists [n = 132 (63%) with 172 lines; infliximab (n = 109), adalimumab (n = 45), golimumab (n = 8), certolizumab (n = 6) and etanercept (n = 5)] or tocilizumab [n = 77 (37%) with 121 lines; i.v. and s.c. in 95 and 26 cases, respectively].

Results

A complete response at 6 months was evidenced in 101/152 (66%) patients on TNF-α antagonists and 75/107 (70%) patients on tocilizumab. Age ≥30 years [odds ratio 2.09 (95% CI 1.09, 3.99)] was associated with complete response, whereas vascular signs [OR 0.26 (95% CI 0.1, 0.65)], baseline prednisone ≥20 mg/day [OR 0.51 (95% CI 0.28, 0.93)] were negatively associated with the complete response to TNF-α antagonists or tocilizumab. During a median follow-up of 36 months, 103 relapses were noted. Supra-aortic branches and thoracic aorta involvement [HR 2.44 (95% CI 1.06, 5.65) and 3.66 (1.18, 11.4), respectively] and systemic signs at baseline [HR 2.01 (95% CI 1.30, 3.11)] were significantly associated with relapse. The cumulative incidence of treatment discontinuation and relapse were similar in TNF-α antagonists and tocilizumab. Fifty-eight (20%) adverse effects occurred on biologic targeted therapies [37 (21%) on TNF-α antagonists and 21 (17%) on tocilizumab (P = 0.4), respectively].

Conclusion

This large multicentre study shows high efficacy of biologic targeted treatments in refractory TAK. Efficacy, relapse and drug retention rate were equivalent with TNF-α antagonists and tocilizumab.
Hispanic Threat and Police Strength in U.S. Municipalities: The Moderating Influences of Nativity and Region
Authors: Holmes Malcolm D , Painter Matthew A
Published: August 2021

A key question of research on crime control is whether the level of police strength in cities primarily represents citizens’ collective interest in cutting crime, or whites’ interest in exerting control over minority populations in a racially divided society. Minority threat theories maintain that whites and police authorities seek to protect their interests by mobilizing their political power to enhance police strength in cities with relatively large minority populations. Research testing this hypothesis examines the relationships of percent black and percent Hispanic to the strength of police departments. Studies of blacks support minority threat theories, but the limited research on Hispanics does not. We extend research on Hispanics by incorporating nativity and region into an analysis of cities of 100,000 or more population in 2010. Noteworthy findings include complex interactions involving those predictors. Percent native-born Hispanic has a stronger negative relationship with police strength at higher levels of Hispanic-white residential segregation, but only in southwestern cities. Percent black is associated with increased police strength at higher levels of black-white segregation, but only in non-southwestern cities. These findings indicate that nativity, segregation, and regional context may jointly shape the mobilization of coercive crime control, sometimes in unexpected ways.
In vivoeffects of exposure to Golden trumpetHandroanthus chrysotrichusin mice
Authors: Costa Márcio Tavares , da Silva Goulart Aline , Rocha Kellen Mariane Athaide , Salgueiro Andréia Caroline Fernandes , da Silva Morgana Duarte , Puntel Robson Luiz , Folmer Vanderlei
Published: August 2021

The Golden trumpet Handroanthus chrysotrichus is a tree that presents beneficial health properties against various diseases. Thus, this study aims to verify the toxicity of H. chrysotrichus bark extract, observing the effects of exposure to this extract in mice. For this, mice were separated in groups: saline (sterile solution .9%); H. chrysotrichus crude extract (HCCE) 10; HCCE 50, and HCCE 100 mg. kg−1 (p.o.). We analyzed HCCE effects on acute (single exposure) and subchronic protocol (14 days exposure). After both exposures, acute, and subchronic, we collected samples from blood, brain, liver, and kidney tissues for biochemical evaluation. In addition, after subchronic exposure, we performed behavioral tests. Acute exposure caused an increase of lipid peroxidation in liver tissue. Moreover, we observed a significant carbonyl increase in liver and brain tissues from HCCE 50 mg. kg−1. Kidneys presented carbonyl increase in mice treated with the highest concentration. Besides, creatinine increased in the group of the acute exposure at HCCE 100 mg. kg−1. Total leukocyte count decreased in all concentrations tested. Sub-chronic exposure at HCCE 100 mg. kg−1 caused a decrease in the number of crossing and an increase in its self-grooming frequency in the open field test. In this exposure, the brain and liver had a significant increase in carbonyl levels in all concentrations. We concluded that H. chrysotrichus cause behavioral and biochemical alterations in mice. HCCE primary targets seem to be the liver, kidneys, and white cells.
Prevalence and associated factors of undernutrition among pregnant Sudanese women
Authors: Hassan Bahaeldin , Rayis Duria A , Ahmed Abdel B A , ALhabardi Nadiah , Adam Ishag
Published: August 2021

Background

Maternal undernutrition is a global health challenge, and it is associated with significant maternal and perinatal morbidity and mortality. This study aimed to assess the prevalence and the factors associated with undernutrition among pregnant women in Sudan.

Methods

A cross-sectional study was carried out in Saad Abuelela Hospital in Khartoum, Sudan, from June to December 2019. Sociodemographic and obstetric characteristics were collected through a questionnaire. Mid-upper arm circumference was measured. Undernutrition was defined as a mid-upper arm circumference of <23 cm. Multiple logistic regression was used to assess the factors associated with maternal undernutrition.

Results

Of 1801 pregnant women, 226 (12.5%) were undernourished. Multivariable analysis revealed that ≤2 antenatal care clinic visits (adjusted OR [AOR]=3.06, 95% CI 1.68 to 5.58) was associated with undernutrition. Age (AOR=0.90, 95% CI 0.87 to 0.94) and haemoglobin levels (AOR=0.81, 95% CI 0.67 to 0.97) were negatively associated with undernutrition. There was no association between parity, education, interpregnancy interval, occupation and maternal undernutrition.

Conclusions

Our findings indicated that 12.5% of the pregnant women in Khartoum were undernourished. More effort and action are need to improve the counselling and future inclusion of a supplemental food supply for undernourished pregnant women.
Courtyard Sisters: Settler Fantasy and Experiment at the International Institute of Los Angeles, 1914–1940
Authors: Dominguez Laura
Published: August 2021

This article examines the history of the International Institute of Los Angeles, one of dozens of immigrant-serving agencies to open nationwide under the Young Women’s Christian Association (YWCA) during the 1910s. Close reading of this branch reveals how related processes of domestication, democratization, and assimilation of immigrant groups buttressed the settler colonial making of the city. Through a study of the organization’s fieldwork, cultural programs, and architectural footprint, the author argues that the Institute preserved the racial fantasies of Anglo Angelenos with its efforts to Americanize women and girls in a Spanish Colonial Revival space. This article reframes the city’s institutional landscape during the interwar period, showing how social reformers helped maintain and police boundaries of belonging in western metropoles.
I English Language
Authors: Kostadinova Viktorija , Wiemann Marco , Dreschler Gea , Gregersen Sune , Gyuris Beáta , Zhong Ai , Scott Maggie , Anderwald Lieselotte , Hansen Beke , Leuckert Sven , Kraš Tihana , Ting Shawnea Sum Pok , Cogo Ida Parise Alessia , Reber Elisabeth , Ahmed Furzeen
Published: August 2021

This chapter has fourteen sections: 1. General; 2. History of English Linguistics; 3. Phonetics and Phonology; 4. Morphology; 5. Syntax; 6. Semantics; 7. Lexicography, Lexicology and Lexical Semantics; 8. Onomastics; 9. Dialectology and Sociolinguistics; 10. New Englishes and Creolistics; 11. Second Language Acquisition. 12. English as a Lingua Franca; 13. Pragmatics and Discourse Analysis, 14. Stylistics. Sections 1 and 2 are by Viktorija Kostadinova; section 3 is by Marco Wiemann; sections 4 and 5 are by Gea Dreschler and Sune Gregersen; section 6 is by Beáta Gyuris; section 7 is by Ai Zhong; section 8 is by Maggie Scott; section 9 is by Lieselotte Anderwald; section 10 is by Beke Hansen and Sven Leuckert; section 11 is by Tihana Kraš; section 12 is by Shawnea Sum Pok Ting, Ida Parise, and Alessia Cogo; section 13 is by Elisabeth Reber; section 14 is by Furzeen Ahmed.
Smart Glasses for Radial Arterial Catheterization in Pediatric Patients: A Randomized Clinical Trial
Authors: Jang Young-Eun , Cho Sung-Ae , Ji Sang-Hwan , Kim Eun-Hee , Lee Ji-Hyun , Kim Hee-Soo , Kim Jin-Tae
Published: August 2021

Background

Hand–eye coordination and ergonomics are important for the success of delicate ultrasound-guided medical procedures. These can be improved using smart glasses (head-mounted display) by decreasing the head movement on the ultrasound screen. The hypothesis was that the smart glasses could improve the success rate of ultrasound-guided pediatric radial arterial catheterization.

Methods

This prospective, single-blinded, randomized controlled, single-center study enrolled pediatric patients (n = 116, age less than 2 yr) requiring radial artery cannulation during general anesthesia. The participants were randomized into the ultrasound screen group (control) or the smart glasses group. After inducing general anesthesia, ultrasound-guided radial artery catheterization was performed. The primary outcome was the first-attempt success rate. The secondary outcomes included the first-attempt procedure time, the overall complication rate, and operators’ ergonomic satisfaction (5-point scale).

Results

In total, 116 children were included in the analysis. The smart glasses group had a higher first-attempt success rate than the control group (87.9% [51/58] vs. 72.4% [42/58]; P = 0.036; odds ratio, 2.78; 95% CI, 1.04 to 7.4; absolute risk reduction, –15.5%; 95% CI, −29.8 to −12.8%). The smart glasses group had a shorter first-attempt procedure time (median, 33 s; interquartile range, 23 to 47 s; range, 10 to 141 s) than the control group (median, 43 s; interquartile range, 31 to 67 s; range, 17 to 248 s; P = 0.007). The overall complication rate was lower in the smart glasses group than in the control group (5.2% [3/58] vs. 29.3% [17/58]; P = 0.001; odds ratio, 0.132; 95% CI, 0.036 to 0.48; absolute risk reduction, 24.1%; 95% CI, 11.1 to 37.2%). The proportion of positive ergonomic satisfaction (4 = good or 5 = best) was higher in the smart glasses group than in the control group (65.5% [38/58] vs. 20.7% [12/58]; P <0.001; odds ratio, 7.3; 95% CI, 3.16 to 16.8; absolute risk reduction, –44.8%; 95% CI, –60.9% to –28.8%).

Conclusions

Smart glasses-assisted ultrasound-guided radial artery catheterization improved the first-attempt success rate and ergonomic satisfaction while reducing the first-attempt procedure time and overall complication rates in small pediatric patients.

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A Practical Approach to Antibiotic Use in Critically Ill Obstetric Patients
Authors: Pacheco Luis D. , Saad Antonio F. , Saade George R.
Published: August 2021

In recent years, several new antimicrobials have become available that are safer and more effective compared with older agents commonly used in obstetrics. Basic knowledge of these agents is of paramount importance to obstetricians and maternal fetal medicine specialists, as administration of early adequate broad-spectrum empiric antibiotic coverage plays a pivotal role in the management of septic patients. Of particular importance is the critically ill pregnant patient with life-threatening infectious processes in whom poor initial antibiotic selection may result in higher mortality and significant side effects from antibiotics themselves. In this article we aim to provide a guide for clinicians to select an adequate empirical antibiotic regimen for the most common severe infections that may affect pregnant individuals.
Outcomes Associated With Hypertensive Disorders of Pregnancy in Twin Compared With Singleton Gestations
Authors: Aviram Amir , Berger Howard , Abdulaziz Kasim E. , Barrett Jon F. R. , Murray-Davis Beth , McDonald Sarah D. , Geary Michael , Melamed Nir ,   for DOH-NET (Diabetes, Obesity and Hypertension in Pregnancy Research Network) and SOON (Southern Ontario Obstetrical Network) Investigators
Published: August 2021

OBJECTIVE:

To evaluate whether pregnancy outcomes associated with hypertensive disorders of pregnancy in twin pregnancies differ relatively from those in singleton pregnancy.

METHODS:

We conducted a retrospective, population-based cohort study of all women with a liveborn singleton or twin hospital birth in Ontario, Canada, between 2012 and 2019. Data were obtained from the Better Outcomes Registry & Network Ontario. Pregnancy outcomes were compared between women with and without hypertensive disorders of pregnancy in twin gestations, and separately in singleton gestations. Adjusted relative risks (aRRs) and 95% CIs were generated using modified Poisson regression and were compared between twins and singletons using relative risk ratios.

RESULTS:

Overall, 932,218 women met the study criteria, of whom 917,542 (98.4%) and 14,676 (1.6%) had singleton and twin gestations, respectively. The incidence of hypertensive disorders of pregnancy was higher in women with twin compared with singleton gestations (14.4% vs 6.4%, aRR 1.85 [1.76–1.94]). Hypertensive disorders of pregnancy were associated with certain adverse outcomes in singleton gestations only and with other adverse outcomes in both the singleton and twin gestations, but the aRR was lower in twins. For example, preterm birth before 37 weeks of gestation (singletons: 15.2% [hypertensive disorders of pregnancy] vs 5.4% [no hypertensive disorders of pregnancy], aRR 2.42; twins: 67.5% [hypertensive disorders of pregnancy] vs 50.4% [no hypertensive disorders of pregnancy], aRR 1.30) and neonatal respiratory morbidity (singletons: 16.3% [hypertensive disorders of pregnancy] vs 8.7% [no hypertensive disorders of pregnancy], aRR 1.50; twins: 39.8% [hypertensive disorders of pregnancy] vs 32.7% [no hypertensive disorders of pregnancy], aRR 1.13). These findings persisted in the subgroups of women with preeclampsia and early-onset preeclampsia.

CONCLUSIONS:

Although the absolute risk of adverse maternal and neonatal outcomes is higher in twin compared with singleton pregnancies, the incremental risk of adverse outcomes associated with hypertensive disorders in twin pregnancies is lower than the incremental risk in singleton pregnancies. These findings may be attributed in part to the higher baseline risk of preterm birth and adverse maternal and perinatal outcomes in twin compared with singleton pregnancies.
The Michigan Plan for Appropriate Tailored Health Care in Pregnancy Prenatal Care Recommendations
Authors: Peahl Alex Friedman , Zahn Christopher M. , Turrentine Mark , Barfield Wanda , Blackwell Sean D. , Roberts Suni Jo , Powell Allison R. , Chopra Vineet , Bernstein Steven J.
Published: August 2021

OBJECTIVE:

To describe MiPATH (the Michigan Plan for Appropriate Tailored Healthcare) in pregnancy panel process and key recommendations for prenatal care delivery.

METHODS:

We conducted an appropriateness study using the RAND Corporation and University of California Los Angeles Appropriateness Method, a modified e-Delphi process, to develop MiPATH recommendations using sequential steps: 1) definition and scope of key terms, 2) literature review and data synthesis, 3) case scenario development, 4) panel selection and scenario revisions, and 5) two rounds of panel appropriateness ratings with deliberation. Recommendations were developed for average-risk pregnant individuals (eg, individuals not requiring care by maternal–fetal medicine specialists). Because prenatal services (eg, laboratory tests, vaccinations) have robust evidence, panelists considered only how services are delivered (eg, visit frequency, telemedicine).

RESULTS:

The appropriateness of key aspects of prenatal care delivery across individuals with and without common medical and pregnancy complications, as well as social and structural determinants of health, was determined by the panel. Panelists agreed that a risk assessment for medical, social, and structural determinants of health should be completed as soon as individuals present for care. Additionally, the panel provided recommendations for: 1) prenatal visit schedules (care initiation, visit timing and frequency, routine pregnancy assessments), 2) integration of telemedicine (virtual visits and home devices), and 3) care individualization. Panelists recognized significant gaps in existing evidence and the need for policy changes to support equitable care with changing practices.

CONCLUSION:

The MiPATH recommendations offer more flexible prenatal care delivery for average-risk individuals.
Fixation at the Inferior Orbital Rim in Medially Rotated Zygomatic Complex Fractures
Authors: Al-Qattan Mohammad M. , Gelidan Adnan
Published: August 2021

Background:

Zygomatic complex fractures are quadri-pod fractures because of the involvement of the zygomaticotemporal, zygomaticomaxillary, zygomaticofrontal, and zygomaticosphenoid junctions. The need to address one or more fixation points of these four articulations mainly depends on the degree of displacement. In this article, the authors present a series of medially rotated zygomatic complex fractures to demonstrate that one-point fixation at the inferior orbital rim (IOR) is sufficient in most cases.

Methods:

This is a retrospective study of all medially rotated zygomatic complex fractures treated by the authors over the last 4 years.

Results:

The patients were six men with a mean age of 41 years. All patients sustained medially rotated zygomatic complex fractures. Three patients had symptomatic orbital floor defects. One patient had concurrent displaced superior orbital rim fracture. Surgery was done using the transconjunctival approach. A titanium mesh was used to fix the IOR. For orbital floor reconstruction, the same titanium mesh was extended into the floor to cover the defect. The patient with concurrent superior orbital rim fracture required a second point of fixation at the lateral orbital rim.

Conclusions:

Single-point of fixation at the IOR is sufficient in most medially rotated zygomatic complex fractures as long as there is minimal displacement at other fracture points. Some of these patients may have symptomatic orbital floor defects. Simultaneous fixation of the IOR and orbital floor reconstruction may be done via a transconjunctival approach.
Delirium awareness day: a portuguese perspective
Authors: Regueira Patrícia , Firmino Horácio , Cerejeira Joaquim
Published: August 2021

Delirium is a syndrome characterized by impairment of awareness and inattention, that represents a change from the patient's baseline cognitive functioning. It is triggered by an underlying medical condition, reaching a prevalence of 24.7% in geriatric wards. However, undiagnosed delirium remains a reality among inpatient individuals, with an estimated frequency of 24.1%. The inappropriate knowledge of diagnostic criteria and standard screening tools was pointed out as a relevant contributing factor to this paradigm.

Liaison Psychiatry Services guarantee psychiatric approach and treatment to patients attending general hospitals. Considering that older adult patient care requires a well-trained and skilled team, the Centro Hospitalar e Universitário de Coimbra has a Geriatric Psychiatry Liaison Service, where delirium is one of the prevailing clinical conditions assessed by this team. The International Delirium Awareness Day is going to be worldwide celebrated on the 11th of March. Given that delirium has been consistently associated with the economic burden and adverse outcomes this symbolic day works as a huge opportunity to raise insight into the preventive strategies that could be implemented among healthcare professionals, patients, and caregivers. Within the Portuguese National Health System there is a need to build a set of systematic epidemiological data about delirium prevalence and incidence in the different settings and it would be essential the employment of a multicomponent intervention package delivered by a multidisciplinary team trained and competent in delirium prevention into routine care.
Comparison of the efficacy and safety indicators of DMARDs for rheumatoid arthritis
Authors: Wang Zunlian , Huang Min , Yu Bin , Huang Yilan , Zheng Silin , Yang Xuping , Ning Hong
Published: August 2021

Objective:

To compare efficacy and safety indicators of disease-modifying antirheumatic drugs, Sarilumab, Sirukumab, Baricitinib, Tocilizumab and Adalimumab in rheumatoid arthritis treatment by a network meta-analysis.

Methods:

Medline, Embase, Web of Science, The Food and Drug Administration web site, and Cochrane library were searched from build to June 1, 2020. Clinical randomized controlled trails of these 5 drugs for rheumatoid arthritis were collected for network meta-analysis.

Results:

A total of 4 randomized controlled trails with 2070 patients were obtained. The results of the network meta-analysis showed that:

The results of the ranked probability plot indicated that Tocilizumab and Sarilumab outperform other drugs in terms of efficacy and safety.

Conclusion:

The results of the ranking of the 5 drugs showed that Tocilizumab and Sarilumab had the best efficacy and safety.
Rational emotive occupational health coaching for quality of work-life among primary school administrators
Authors: Agu Patricia U. , Chigbu Baptista Chinyere , Ede Moses Onyemaechi , Okeke Chinedu Ifedi , Chinweuba Ngozi H. , Amaeze Fidelis E. , Ejionueme Lambart K. , Omeke Faith , Aye Eucharia , Diara Faith Chinwe , Edikpa Edith Chika , Onu Eucheria Amaka , Nwafor Bernadette , Ozioko Agatha , Mezieobi Daniel , Oforka Theresa O. , Vita-Agundu Uche C. , Uwakwe Stephen Iro , Nweze Ukamaka N. , Onah Sebastian O. , Ebeh Jideofor Jeremiah , Ezeaku Patricia
Published: August 2021

Background:

This study aimed at investigating the effect of rational emotive occupational health coaching on quality of work-life among primary school administrators.

Method:

This is a double blinded and randomized control design study. A total of 158 administrators were sampled, half of them were exposed to rational emotive occupational health treatment package that lasted for 12 sessions. Two self-report measures were utilized in assessing the participants using quality of work life scale. Data collected were analyzed using MANOVA statistical tool.

Result:

The results showed that rational emotive occupational health coaching is effective in improving perception of quality of work-life among public administrators. A follow-up result showed that rational emotive occupational health coaching had a significant effect on primary school administrators’ quality of work life.

Conclusion:

This study concluded rational emotive occupation health coaching is useful therapeutic strategy in improving quality of work of primary school administrators, hence, future researchers and clinical practitioners should adopt cognitive-behavioral techniques and principles in helping employers as well as employees. Based on the primary findings and limitations of this study, future studies, occupational psychotherapists should qualitatively explore the clinical relevance of rational emotive occupational health practice across cultures using different populations
Feasibility of therapeutic plasma exchange-based combination therapy in the treatment of acquired hemophilia A
Authors: Wang Lin-Yue , Shen Yan , Zeng Han-Qing , Zhang Ying , Lou Shi-Feng , Deng Jian-Chuan , Luo Yun
Published: August 2021

Poor availability and a lack of affordability of bypassing agents (recombinant activated factor VII and activated prothrombin complex concentrate) in west China prompted us to investigate an alternative cost-effective combination therapy. We aimed to explore the feasibility of therapeutic plasma exchange (TPE)-based combination therapy in the treatment of acquired hemophilia A (AHA).

We retrospectively investigated the clinical features of AHA in 6 patients who were treated with a combination of TPE, corticosteroids, and rituximab in our department for 9 years between January, 2011 and December, 2019.

We examined 1 male and 5 female patients. The median age at diagnosis of AHA was 51 years (18–66 years). In all patients, FVIII activity levels were low (median: 1.5%; 1–3%), FVIII inhibitor titers were high (median: 24.5 BU/mL; 13.2–48.6 BU/mL), and activated partial thromboplastin time was markedly prolonged (median: 99.4 s; 60.9–110.1 s). They underwent 2 to 8 cycles of plasma exchange and were given varying combinations of dexamethasone, methylprednisolone, prednisone, and rituximab. After TPE bleeding gradually stopped, and activated partial thromboplastin time decreased. After 3 months of treatment, FVIII inhibitors completely disappeared.

TPE when combined with corticosteroids and rituximab, as adjunctive immunosuppressive agents, may be an effective and reliable treatment for AHA. When there is no alternative, intensive first-line treatment including TPE may be lifesaving.
Changes in tapered endotracheal tube cuff pressure after changing position to hyperextension of neck
Authors: Park Ji-Hoon , Lee Hyo-Jin , Lee Sou Hyun , Kim Ji Seob
Published: August 2021

Background:

Endotracheal tube (ETT) with a tapered-shaped cuff had an improved sealing effect when compared to ETTs with a conventional cylindrical-shaped cuff. Positional change and neck movement typically displace an ETT and change the intracuff pressure. The aim of the current study was to compare the ETT cuff pressure in the TaperGuard ETT vs the conventional ETT after a change from the supine, neutral position to the extension of the neck and semi-Fowler position for thyroid surgery.

Methods:

This prospective, randomized clinical trial included 50 patients undergoing thyroidectomy. Patients were randomly allocated into one of the 2 groups: tracheal intubation with the TaperGuard ETT or with a conventional ETT. The ETT cuff was inflated with air and the ETT cuff pressure was set initially at 20 cmH2O using a calibrated cuff manometer. ETT cuff pressure and distance from carina to ETT tip were measured at supine and semi-Fowler positions with neck extension.

Results:

After the position change, the ETT tip migrated cephalad and cuff pressure increased in the majority of cases. ETT cuff pressure was significantly higher in the TaperGuard group than the conventional group (28.0 ± 6.6 cmH2O and 22.8 ± 4.5 cmH2O, respectively, P = .001). The degree of cephalad displacement of the ETT tip was comparable between the 2 groups (19.4 ± 6.31 mm in TaperGuard group and 21.9 ± 6.9 mm in conventional group, P = .12).

Conclusions:

After the position change from supine to hyperextension of the neck, the ETT cuff pressure was higher in the TaperGuard ETT than in the conventional ETT, although the extent of displacement of the ETT was comparable between the 2 groups.
Survival of health workers infected by SARS-CoV-2 in the context of vaccination against COVID-19 in Peru
Authors: Escobar-Agreda Stefan , Silva-Valencia Javier , Rojas-Mezarina Leonardo , Vargas-Herrera Javier
Published: August 2021

Objectives

To evaluate the survival of health workers infected by SARS-CoV-2 in the context of the vaccination process against COVID-19 in Peru.

Methods

A survival analysis was performed using data from national health databases. Data from people between 18 and 59 years old infected with SARS-CoV-2 as evidenced by molecular or antigenic tests were included. Kaplan Meier graphs were produced to compare the survival of health workers and the rest of the population during 2021 and health workers during the first and second wave of mortality in Peru in 2020 and 2021, respectively.

Results

Data from 998,295 people were included. The average age was 41.2 years (SD 15.8) and 485,167 (48.6%) were women. A higher level of survival of health workers after vaccination was found compared to the general population and to the population of health workers before vaccination. It was evidenced that, at the beginning of the second wave, the risk of dying for health workers was twice that of the first wave (HR = 2). After vaccination (in the sixth month of the second wave), the risk of dying decreased to 87.5% less than in the first wave (HR = 0.125).

Conclusions

A positive change has been evidenced in the level of survival of health workers infected by SARS-CoV-2 during the context of vaccination against COVID-19 in Peru.
Impaired SARS-CoV-2 mRNA vaccine antibody response in chronic medical conditions: a real-world data analysis
Authors: Liao Shu-Yi , Gerber Anthony N. , Zelarney Pearlanne , Make Barry , Wechsler Michael E.
Published: August 2021

This study is to investigate whether certain medical conditions may impair antibody response to the mRNA vaccines. In this unique study, participants were drawn from patients in National Jewish Health, a pulmonary specialty outpatient clinic.Our study highlights fact that 26% of our patients (n=226) who had spike protein ab measured at least 14 days post 2nd vaccine had negative spike protein ab testing. We found interstitial lung disease (ILD) to be an independent risk factor for impaired antibody response. While the exact antibody level that confers protection against SARS-CoV-2 is unknown and there may be other non-B cell-mediated protection (e.g. T cell-mediated), our study raises concerns that SARS-CoV-2 vaccination may not result in protective immunity in all populations and may have implications for some as masking and distancing strategies are abandoned.
Concentration-dependent change in hypothalamic neuronal transcriptome by the dietary fatty acids: oleic and palmitic acids
Authors: Valencia Fabiola Pacheco , Marino Amanda F. , Noutsos Christos , Poon Kinning
Published: August 2021

Prenatal high-fat diet exposure increases hypothalamic neurogenesis events in embryos and programs offspring to be obesity-prone. The molecular mechanism involved in these dietary effects of neurogenesis are unknown. This study investigated the effects of oleic and palmitic acids, which are abundant in a high-fat diet, on the hypothalamic neuronal transcriptome and how these changes impact neurogenesis events. The results show differential effects of low and high concentrations of oleic or palmitic acid treatment on differential gene transcription. Gene ontology analysis uncovered significant gene enrichment in several cellular pathways involved in gene regulation and protein production, particularly with proliferation, migration, and cell survival. The enriched signaling pathways include Wnt, integrin, PDGF, and apoptosis, in addition endocrine function signaling pathways CCKR and GnRH. Further examination of proliferation and migration show low concentrations of oleic acid to stimulate proliferation and high concentrations of both oleic and palmitic acid to stimulate apoptosis. Oleic acid also reduced hypothalamic neuronal migration, with little effects by palmitic acid. The results show direct impact of the two most abundant fatty acids in a high fat diet to directly impact hypothalamic neuronal proliferation and migration. The results also uncovered signaling pathways affected by oleic and palmitic acid and suggest a mechanism of prenatal high-fat diet induced neurogenesis events is through these two abundant fatty acids.
Predictive Functions of H3K27me3 and H4K20me3 in Primate Hippocampal Stem and Progenitor Cells
Authors: Rhodes Christopher T. , Lin Chin-Hsing Annie
Published: August 2021

Epigenetic regulations play important roles in cell fate determination during neurogenesis, a process by which different types of neurons are generated from neural stem and progenitor cells (NSPCs). Although some epigenetic changes are part of developmental and aging processes, the role of tri-methylation on histone 3 lysine 27 (H3K27me3) and histone 4 lysine 20 (H4K20me3) in primate hippocampal NSPCs remains elusive. This task is best assessed within a context resembling the human brain. As more studies emerge, the baboon represents an excellent model of human central nervous system in addition to their genomic similarity. With a focus on H3K27me3 and H4K20me3, the overarching goal of this work is to reveal their respective epigenetic landscapes in NSPCs of non-human primate baboon hippocampus. We identified putative targets of H3K27me3 and H4K20me3 that suggests a protective mechanism by dual H3K27me3/H4K20me3-mediated repression of specific-lineage gene activation important for differentiation processes while controlling the progression of the cell cycle.
The role of actin and myosin II in the cell cortex of adhered and suspended cells
Authors: Flormann D.A.D. , Kaub K.H. , Vesperini D. , Schu M. , Anton C. , Pohland M.O. , Kainka L. , Montalvo Bereau G. , Janshoff A. , Hawkins R.J. , Terriac E. , Lautenschläger F.
Published: August 2021

Adhesion induces dramatic morphological and mechanical changes to cells, which are reflected by changes to the actin cortex. Among the many different proteins involved in this sub-membranous layer, motor proteins (e.g., nonmuscle myosin II [NMII]) and actin nucleators (e.g., Arp2/3, formins) are known to have significant influences on its dynamics and structure. The different roles of NMII, Arp2/3, and formins in the dynamics, structure, and mechanics of the actin cortex depend on the adhesion state of the cell. In this study, we unravel the interplay between the dynamics, structure, and mechanics of the actin cortex in adhered cells and in cells in suspension. We show that treatments with extrinsic cellular perturbants lead to alterations of all three properties that are correlated. However, intrinsic actin cortex variations between different cell adhesion states lead to unexpected correlations. Surprisingly, we find that NMII minifilaments have a minor influence on the actin cortex. Using new microscopy techniques, we show that NMII minifilaments are not localized within the actin cortex, as previously thought, but concentrated in a layer beneath it. Our treatments affecting Arp2/3 and formin reveal correlations between the actin cortex characteristics. Our data build towards a comprehensive understanding of the actin cortex. This understanding allows the prediction and control of cortical changes, which is essential for the study of general cellular processes, such as cell migration, metastasis, and differentiation.
Complementing Tissue Testing with Plasma mutation Profiling Improves Therapeutic Decision Making for Lung Cancer Patients
Authors: Choudhury Yukti , Tan Min-Han , Shi Jun Li , Tee Augustine , Ngeow Kao Chin , Poh Jonathan , Goh Ruth Rosalyn , Mong Jamie
Published: August 2021

Background

Tissue biopsy is an integral part of the diagnostic approach to lung cancer. It is however invasive and associated with limitations of tissue heterogeneity. Liquid biopsies may complement tissue testing by providing additional molecular information and may be particularly helpful in patients from whom obtaining sufficient tissue for genomic profiling is challenging.

Methods

Patients with suspected lung cancer (n=71) were prospectively recruited. Blood and diagnostic tissue samples were collected within 48 hrs of each other. Plasma cell-free DNA (cfDNA) testing was done using an ultrasensitive amplicon-based next-generation sequencing (NGS) panel (plasma NGS testing). For cases diagnosed as non-small cell lung carcinoma (NSCLC) via histology or cytology, targeted testing for epidermal growth factor receptor (EGFR) mutations was performed using tissue biopsy samples, where available (tissueEGFRtesting). Concordance of clinically actionable mutations between methods and sample types were assessed.

Results

For confirmed NSCLC cases (n = 54), tissueEGFRtest results were available only for 70.3% (38/54) due to sample inadequacies, compared to blood samples for 98.1% (53/54) cases. TissueEGFRtesting identified sensitizingEGFR(L858R or exon 19 deletion) mutation in 31.6% (12/38) of cases. Plasma NGS identified clinically actionable mutations in 37.7% (20/53) of cases, includingEGFRmutations in two cases with no tissue EGFR results, and mutations inKRAS, BRAFandMET. Overall sensitivity ofEGFRsensitizing mutation detection by plasma NGS was 75% (9/12), and specificity was 100% (25/25) in patients tested in both tissueEGFRand plasma NGS (n=37). In this cohort of patients, tissueEGFRtesting alone informed clinical decisions in 22.2% (12/54) of cases. Adding plasma NGS to tissueEGFRtesting increased the detection rate of actionable mutations to 42.6% (23/54), representing a near doubling (1.9-fold increase) of clinically relevant findings. The average turnaround time (TAT) of plasma NGS was shorter than standard tissue testing (10 days vs. 29.9 days, p-value <0.05).

Conclusions

In the first-line setting, plasma NGS was highly concordant with tissueEGFRtesting. Plasma NGS increases the detection of actionable findings with shorter time to results. This study outlines the clinical utility of a complementary plasma mutation profiling in the routine management of lung cancer patients.
Structural racism and COVID-19 response: Higher risk of exposure drives disparate COVID-19 deaths among Black and Hispanic/Latinx residents of Illinois, USA
Authors: Holden Tobias M , Simon Melissa A. , Arnold Damon T. , Halloway Veronica , Gerardin Jaline
Published: August 2021

BACKGROUND

Structural racism has driven and continues to drive policies that create the social, economic, and community factors resulting in residential segregation, lack of access to adequate healthcare, and lack of employment opportunities that would allow economic mobility. This results in overall poorer population health for minoritized people. In 2020, Black and Hispanic/Latinx communities throughout the United States, including the state of Illinois, experienced disproportionately high rates of COVID-19 cases and deaths. Public health officials in Illinois implemented targeted programs at state and local levels to increase intervention access and reduce disparities.

METHODS

To quantify how disparities in COVID outcomes evolved through the epidemic, data on SARS-CoV-2 diagnostic tests, COVID-19 cases, and COVID-19 deaths were obtained from the Illinois National Electronic Disease Surveillance System for the period from March 1 to December 31, 2020. Relative risks of COVID-19 cases and deaths were calculated for Black and Hispanic/Latinx vs. White residents, stratified by age group and epidemic interval. Deaths attributable to racial/ethnic disparities in incidence and case fatality were estimated with counterfactual simulations.

RESULTS

Disparities in case and death rates became less drastic after May 2020, but did not disappear, and were more pronounced at younger ages. From March to May of 2020, the risk of a COVID-19 case for Black and Hispanic/Latinx populations was more than twice that of Whites across all age groups. The relative risk of COVID-19 death reached above 10 for Black and Hispanic/Latinx individuals under 50 years of age compared to age-matched Whites in the early epidemic. In all Illinois counties, relative risk of a COVID-19 case was the same or significantly increased for minoritized populations compared to the White population. 79.3% and 86.7% of disparities in deaths among Black and Hispanic/Latinx populations, respectively, were attributable to differences in age-adjusted incidence compared to White populations rather than differences in case fatality ratios.

CONCLUSIONS

Racial and ethnic disparities in the COVID-19 pandemic are products of society, not biology. Considering age and geography in addition to race/ethnicity can help to identify the structural factors driving poorer outcomes for certain groups. Studies and policies aimed at reducing inequalities in disease exposure will reduce disparities in mortality more than those focused on drivers of case fatality.
Scaling up to meet new challenges of brain and behaviour through deep brain electrophysiology in freely moving sheep
Authors: Perentos Nicholas , Krstulovic Marino , Morton A Jennifer
Published: August 2021

While rodents are arguably the easiest animals to use for studying brain function, relying on them as model species for translational research comes with its own sets of limitations. Here, we propose sheep as a practical large animal species for in vivo brain function studies performed in naturalistic settings. To demonstrate their experimental usefulness, we performed proof-of-principle deep brain electrophysiological recording experiments from unrestrained sheep. Recordings were made from cortex and hippocampus both whilst sheep performed goal-directed behaviours (two-choice discrimination tasks), and across states of vigilance that included natural sleep. Hippocampal and cortical oscillatory rhythms were consistent with those seen in rodents and non-human primates, and included cortical alpha oscillations during immobility, hippocampal theta oscillations (5-6Hz) during locomotion and hippocampal sharp wave ripple oscillations (∼150 Hz) during immobility. Moreover, we found clear examples of neurons whose activity was modulated by task, speed of locomotion, spatial position, reward and vigilance states. Recordings were conducted over a period of many months. Due to the exceptional stability of individual electrodes we were able to record from some neurons repeatedly across the span of a month. Together these experiments demonstrate that sheep are an excellent experimental animal model to use in longitudinal electrophysiological and imaging studies, particularly those requiring a large brained mammal, large scale recordings across distributed neuronal networks, experimentation outside the confounds of the traditional laboratory, or all the above concomitantly.
An Open MRI Dataset for Multiscale Neuroscience
Authors: Royer Jessica , Rodríguez-Cruces Raúl , Tavakol Shahin , Larivière Sara , Herholz Peer , Li Qiongling , de Wael Reinder Vos , Paquola Casey , Benkarim Oualid , Park Bo-yong , Lowe Alexander J. , Margulies Daniel , Smallwood Jonathan , Bernasconi Andrea , Bernasconi Neda , Frauscher Birgit , Bernhardt Boris C.
Published: August 2021

Abstract

Multimodal neuroimaging grants a powerful window into the structure and function of the human brain at multiple scales. Recent methodological and conceptual advances have enabled investigations of the interplay between large-scale spatial trends (also referred to as gradients) in brain microstructure and connectivity, offering an integrative framework to study multiscale brain organization. Here, we share a multimodal MRI dataset for Microstructure-Informed Connectomics (MICA-MICs) acquired in 50 healthy adults (23 women; 29.54±5.62 years) who underwent high-resolution T1-weighted MRI, myelin-sensitive quantitative T1 relaxometry, diffusion-weighted MRI, and resting-state functional MRI at 3 Tesla. In addition to raw anonymized MRI data, this release includes brain-wide connectomes derived from i) resting-state functional imaging, ii) diffusion tractography, iii) microstructure covariance analysis, and iv) geodesic cortical distance, gathered across multiple parcellation scales. Alongside, we share large-scale gradients estimated from each modality and parcellation scale. Our dataset will facilitate future research examining the coupling between brain microstructure, connectivity, and macroscale function. MICA-MICs is available on the Canadian Open Neuroscience Platform’s data portal (https://portal.conp.ca).
Surface expressed Plasmodium circumsporozoite protein (CSP) modulates cellular flexibility and motility
Authors: Patra Aditya Prasad , Pathak Vrushali , Rameswara Reddy Segireddy , Chhatre Aditya , Dmello Crismita , Narayan Satya , Singh Dipti , Kumar Kota Arun , Ainavarapu Sri Rama Koti , Sharma Shobhona
Published: August 2021

Plasmodium falciparum circumsporozoite protein (CSP) is a critically required abundant surface protein of sporozoites and a major vaccine candidate. However, neither the structure nor the role of CSP in sporozoite motility is well understood. Our recent in vitro data, from single-molecule pulling experiments suggested a mechanically pliable structure for P. falciparum CSP. By engineering vegetative cells of the cellular slime-mold Dictyostelium discoideum with regulatable CSP surface expression, we report evidence for direct involvement of CSP towards conferring elastic properties and motility of the cells. With an increase in the surface-CSP levels by 5–8-fold, the Youngs moduli of the cells, observed through atomic force microscopy, decreased around 2-fold, with a concomitant increase in motility by about 2-fold. Interestingly, only full length CSP expression conferred maximal flexibility and motility, as opposed to repeat region alone or the flanking domains of CSP. The enhanced motility of the CSP-expressing cells was abrogated with anti-CSP antibodies as well as phospholipase cleavage of CSP, indicating specific contribution of CSP towards motility. Measurements of the Youngs moduli of Plasmodium berghei midgut (MG) and salivary gland (SG) sporozoites revealed an inverse correlation with CSP levels with a decrease from 1.1 kPa to 0.3 kPa as the CSP concentration doubled from MG to SG sporozoites. We hypothesize that high CSP level lowers the stiffness of sporozoites possibly through its pliable surface-coat, leading to cellular flexibility. These findings may explain a sporozoites developmental ability to enhance its CSP levels during transition from midgut to salivary glands to suit a migratory mode in the host, needed for successful hepatocyte invasion.