bluuebunny/crossref_metadata_2025 huggingface dataset:
Simultaneous multiple-level magnification selective plane illumination microscopy (sMx-SPIM) imaging system
Authors: S R Rinsa , Chitre Kripa , Kurup Aditya , Nongthomba Upendra , Murty Srinivasula Srinivasa , Suheshkumar Singh Mayanglambam
Published: December 2021

We report an optical-based microscopy imaging technology—simultaneous multiple-level magnification selective plane illumination microscopy (sMx-SPIM) imaging system—that addresses a longstanding technological challenge of obtaining images, specifically of biological specimen non-destructively, at different field of views (FOVs) and spatial resolutions (or magnification powers) simultaneously in real-time. This imaging system provides not only 3D images but also time-resolved sequential images with temporal resolution ∼ msec. Magnification powers (or FOVs) of the individual images can be controlled independently that is achieved by housing two separate detection arms, in SPIM imaging system, fitted with objective lenses of different magnification powers. This unique feature holds promises to observe and study: (a) sub-microscopic details and entire structure of biological specimen side-by-side simultaneously and (b) spatio-temporal dynamics of functional activities of biological specimen. For validation study of robustness of the proposed sMx-SPIM imaging system, experiments are conducted in various biological samples including Danio rerio (zebrafish) embryo, Drosophila melanogaster, Allium cepa root, and A549 cell line. Experimental results demonstrate that the study is of significant impacts from two aspects, viz., technological implication and biological applications.
Understanding the Rayleigh instability in humping phenomenon during laser powder bed fusion process
Authors: Zhang Wenxuan , Hou Wenyuan , Deike Luc , Arnold Craig
Published: December 2021

The periodic undulation of a molten track’s height profile in laser-based powder bed fusion of metals (PBF-LB/M) is a commonly observed phenomena that can cause defects and building failure during the manufacturing process. However a quantitative analysis of such instabilities has not been fully established and so here we used Rayleigh–Plateau theory to determine the stability of a single molten track in PBF-LB/M and tested it with various processing conditions by changing laser power and beam shape. The analysis discovered that normalized enthalpy, which relates to energy input density, determines whether a molten track is initially unstable and if so, the growth rate for the instability. Additionally, whether the growth rate ultimately yields significant undulation depends on the melt duration, estimated by dwell time in our experiment.
Experience of pharmacy involvement in a disaster simulation exercise within a pediatric hospital emergency department: A pilot project
Authors: Marks Kayla , Chung Sarita , Li Joyce , Waltzman Mark , Manzi Shannon , Shah Dhara
Published: December 2021

Purpose

In this descriptive report, we describe a unique trial of pharmacist participation in a multidisciplinary pediatric emergency department disaster simulation exercise. With the number of disasters increasing worldwide, the role of pharmacists in disaster response is of particular interest to the profession.

This observational study describes pharmacist participation in a disaster simulation exercise. An evaluation tool was developed to assess participants’ performance in the following domains: communication, pharmacotherapy, problem solving/decision making, and teamwork/organization. The observers used a rating scale of “concise/prompt,” “needs improvement,” or “not done” to evaluate performance on each objective. The participants’ self-perceived knowledge of disaster response was assessed with pre- and postsimulation surveys using Likert scales. Five simulation exercises were held from June to October 2019, with 2 pharmacists participating in each simulation. Within the problem solving/decision making and communication domains, pharmacists were concise/prompt 66% of the time, while they were concise/prompt for 88.8% and 92.5% of tasks in the teamwork/organization and pharmacotherapy domains, respectively. Surveys of self-perceived knowledge revealed that while only 10% of pharmacists felt “moderately prepared” prior to the simulation exercise, 80% of pharmacists felt moderately prepared to care for patients during a disaster event after the simulation exercise.

Conclusion

This report describes a unique approach of including emergency department–trained pharmacists in disaster simulation exercises to enhance their professional development, improve team dynamics in a mass casualty scenario, and increase their own reported level of preparedness to effectively manage a surge in critically ill pediatric patients.
Aging Facial Recognition for Feature Extraction Using Adaptive Fully Recurrent Deep Neural Learning
Authors: Shoba Betcy Thanga , Shatheesh Sam I
Published: December 2021

The face recognition (FR) process identifies or confirms a person with the help of images and videos. The traditional aging FR (AFR) method encounters numerous issues as a result of age-related biological transformation. An adaptive fully recurrent deep neural learning (AFRDNL) technique is presented in this research to improve FR accuracy (FRA) with minimal time complexity (TC). Feature extraction and classification are two processes included in the proposed technique. The AFRDNL technique gathers facial images from the database and trains the face images with three layers. To learn the facial features, three hidden layers are employed in the AFRDNL technique. Finally, the AFRDNL technique utilizes the Gaussian activation function for matching extracted testing features with earlier saved training features. This process is repeated until a minimal training error with a higher FRA is achieved. Experimental evaluation is carried out with three image datasets like Face and Gesture Recognition Research Network, MORPH and Cross-Age Labeled faces in the Wild (CALFW) datasets using different metrics, such as FRA, false-positive rate (FPR), TC and F1score. The experimental results confirm that the AFRDNL technique effectively increases the FRA and F1score and minimizes the FPR and TC more effectively than the state-of-the-art methods.
Gut Epithelial-derived CXCL9 Maintains Gut Homeostasis Through Preventing Overgrown E. coli
Authors: Wei Jianmei , Zhang Chunze , Gao Yunhuan , Li Yuanyuan , Zhang Qianjing , Qi Houbao , Jin Mengli , Yang Xiaorong , Su Xiaomin , Zhang Yuan , Yang Rongcun
Published: December 2021

Background and Aims

Increased E. coli in the colon are related to the occurrence and development of multiple diseases. Chemokines are shown to possess potential antimicrobial activity, including against Gram-positive and -negative bacterial pathogens. We here investigated function[s] of chemokine CXCL9 expressed in the gut epithelial cells, and mechanism[s] of CXCL9 by which to kill E. coli.

Methods

We generated CXCL9fl/flpvillin-creT mice [pvillin-cre positive mice] and their control CXCL9fl/flpvillin-crewmice [pvillin-cre negative mice], and then employed a dextran sulphate sodium [DSS]-mediated colitis model to determine the sensitivity of CXCL9fl/flpvillin-creT mice. We analysed the composition of the gut microbiota by using 16S ribosomal RNA [V3-V4 variable region] sequencing and shotgun metagenomic analyses. We generated E. coli ΔFtsX [FtsX-depleted E. coli] and E. coli ΔaceE [aceE-depleted E. coli] by using a bacterium red recombining system to investigate the mechanism[s] of CXCL9 by which to kill E. coli.

Results

CXCL9 fl/flpvillin-creTmice were more sensitive to chemically induced colitis than their control littermates, CXCL9fl/flpvillin-crewmice. After DSS treatment, there were markedly increased gut E. coli [Escherichia-Shigella] in the colonic contents of CXCL9fl/flpvillin-creT mice as compared with control CXCL9fl/flpvillin-crew mice. The increased E. coli could promote colitis through NLRC4 and caspase 1/11-mediated IL-18, which was derived from gut epithelial cells. We finally demonstrated that CXCL9 expressed in gut epithelial cells could kill the overgrown E. coli. E. coli expressed Ftsx and PDHc subunits aceE. E.coliΔaceE but not E. coliΔFtsX were resistant to CXCL9-mediated killing.

Conclusions

Gut epithelial cells-derived CXCL9 can kill the expanded E. coli through aceE, to remain gut homeostasis.
Creation of a video library for education and virtual simulation of anatomical lung resection
Authors: Tokuno Junko , Chen-Yoshikawa Toyofumi Fengshi , Nakao Megumi , Iwakura Masashi , Motoki Tamaki , Matsuda Tetsuya , Date Hiroshi
Published: December 2021

OBJECTIVES

Recently, preoperative and intraoperative simulation using three-dimensional computed tomography (CT) has attracted much attention in thoracic surgery. However, because conventional three-dimensional CT only shows static images, dynamic simulation is required for a more precise operation. We previously reported on a resection process map for pulmonary resection, which we developed to generate virtual dynamic images from preoperative patient-specific CT scans. The goal of this study was to evaluate the feasibility of the clinical use of the resection process map for anatomical lung resection.

METHODS

This study included 5 lobectomies for different lobes and 4 representative segmentectomies. Dissection of the pulmonary arteries, veins and bronchi were considered key parts of each procedure. To assess the description of images obtained from the resection process map, relevant clips from the actual surgical videos were collected, retrospectively replicated and superimposed on the resection process map to explain the procedures.

RESULTS

In all surgical procedures, the resection process map successfully and semiautomatically generated a virtual dynamic image from the patient-specific CT data. Moreover, superimposition of the virtual images on the selected clips from the surgical videos showed no major differences.

CONCLUSIONS

The resection process map could generate virtual images that corresponded to the actual surgical videos and has the potential for clinical use as preoperative and intraoperative simulation.
A taxonomic revision of the freshwater crab genusBarytelphusaAlcock, 1909 (Decapoda: Brachyura: Gecarcinucidae), with descriptions of a new genus and three new species
Authors: Pati Sameer K , Yeo Darren C J
Published: December 2021

The taxonomy of the gecarcinucid crab genus Barytelphusa Alcock, 1909, native to peninsular India, is revised. The genus was formerly known from as many as 13 species and four varieties. We examined their name-bearing type specimens, and to stabilise their taxonomy, designated lectotypes for Potamon (Potamonautes) jacquemontiRathbun, 1905, Thelphusa guerini H. Milne Edwards, 1853, and Telphusa pocockianaHenderson, 1893, and a neotype for Thelphusa cunicularis Westwood in Sykes, 1836. With most of the species already assigned to other genera in previous works, we restrict Barytelphusa s. str. further to only two species, i.e., Barytelphusa cunicularis (Westwood in Sykes, 1836), and a new species described herein, Barytelphusa inflatasp. nov.Potamon (Potamonautes) jacquemonti, the type species of the genus, is here synonymised with Barytelphusa cunicularis. A new genus, Barusagen. nov., is established to accommodate two species placed previously in Barytelphusa (Thelphusa guerini and Paratelphusa (Barytelphusa) mccanniChopra & Das, 1935) and two new species (Barusa gracillimasp. nov. (type species) and Barusa obesasp. nov.). Thelphusa planata A. Milne-Edwards, 1869, and Telphusa pocockiana remain as junior synonyms of Barusa guerini (H. Milne Edwards, 1853) comb. nov.Barusagen. nov. resembles Barytelphusa but can be differentiated by several significant characters of the carapace, antennae, cheliped, male pleon, and male first gonopod. Identification keys to the species of both genera are provided. The taxonomy of Potamon napaeum Alcock, 1909, placed previously in Barytelphusa, and more recently in TravancorianaBott, 1969, is also clarified, and the species is now reassigned to MaydelliathelphusaBott, 1969.
The Ethics of Head Transplant from the Confucian Perspective of Human Virtues
Authors: Li Jianhui , Li Yaming
Published: December 2021

Head transplantation has ignited intense discussions about whether it should be done scientifically and ethically. This paper examines the ethics of head transplantation from a Confucian perspective and offers arguments against the permissibility of head transplantation. From a Confucian point of view, human beings are the most precious organisms in the world, and ren (benevolence) and li (propriety) are the basic moral principles of human beings. As long as head transplant technology remains underdeveloped, this procedure should not be done because it will pose a serious risk of harm to humans and thus violate the principles of Confucian ren and li. If head transplant technology matures to the point that it would be safe to try in humans, it still should not be performed because it would change the selfhood or identity of the head donor and the body donor and create a new person. Confucian personal virtues greatly depend on selfhood or personal identity, and selfhood or personal identity depend on one’s body cultivation and mind rectification. Through the hard effort of body cultivation and mind rectification, one transforms one’s selfhood or identity and personality. This selfhood, identity, and personality cannot be separated from one’s body but are embedded in one’s body. Thus, head transplant would destroy two persons’ identities and result in a new person, and the characteristics of this new person’s identity are still unknown.
Superior mesenteric artery aneurysm with rupture: an atypical cause of abdominal pain
Authors: Peacock Timothy , Liu Luke
Published: December 2021

Superior mesenteric artery aneurysm management has evolved in the last 20 years with a greater emphasis on interventional radiological intervention. This case reviews a 60-year-old lady who had a ruptured superior mesenteric aneurysm resulting in a large mesenteric haematoma.
Near-infrared fluorescence imaging with intraoperative administration of indocyanine green for laparoscopic radical prostatectomy: Is it a useful weapon for pelvic lymph node dissection?
Authors: Baio Raffaele , Intilla Olivier , Di Mauro Umberto , Pane Umberto , Molisso Giovanni , Sanseverino Roberto
Published: December 2021

Near-infrared fluorescence imaging with indocyanine green has emerging applications in urologic surgery. This technology is strongly used in robotic surgery for several ablative and reconstructive procedures. On the contrary, it is not used at all in the urological laparoscopic surgery. To date, bilateral pelvic lymph node dissection represents the most accurate and reliable staging procedure for the detection of lymph node invasion in prostate cancer and bladder cancer. However, it is not devoid of complications. In this field, indocyanine green fluorescence-guided sentinel lymph node identification is an emerging technique, as accurate staging of urologic cancer could be enhanced by an intraoperative lymphatic mapping. Our goal was to show a high spatial resolution, real-time intraoperative imaging technique to recognize the main lymphatic drainage networks, avoiding at same time lymphatic vessel damage. Furthermore, the use of such an imaging system represents an absolute novelty in the field of urological laparoscopy.
Spontaneous pneumomediastinum diagnosed by the Macklin effect
Authors: Kumeda Hirotaka , Saito Gaku
Published: December 2021

Vomiting-induced pneumomediastinum is often caused by oesophageal perforation or alveolar rupture due to increased pressure. A correct diagnosis is important because both diseases have different treatments and severities. We report the case of a 21-year-old man who presented with chest pain and fever after frequent vomiting and had elevated white blood cell counts on blood tests. There was extensive pneumomediastinum, and the lower oesophagus was swollen and thickened on chest computed tomography. An oesophagram was not possible due to severe nausea and vomiting. Accumulation of free air was found along the peripheral bronchi or the pulmonary vascular sheath in the left lower lobe, which was continuous with the mediastinum. Based on the presence of the Macklin effect, we diagnosed a pneumomediastinum with a high possibility of spontaneous pneumomediastinum. The Macklin effect is a finding that can likely distinguish oesophageal perforation from spontaneous pneumomediastinum.
Sugar conundrum in plant–pathogen interactions: roles of invertase and sugar transporters depend on pathosystems
Authors: Liu Yong-Hua , Song You-Hong , Ruan Yong-Ling
Published: December 2021

It has been increasingly recognized that CWIN (cell wall invertase) and sugar transporters including STP (sugar transport protein) and SWEET (sugar will eventually be exported transporters) play important roles in plant–pathogen interactions. However, the information available in the literature comes from diverse systems and often yields contradictory findings and conclusions. To solve this puzzle, we provide here a comprehensive assessment of the topic. Our analyses revealed that the regulation of plant–microbe interactions by CWIN, SWEET, and STP is conditioned by the specific pathosystems involved. The roles of CWINs in plant resistance are largely determined by the lifestyle of pathogens (biotrophs versus necrotrophs or hemibiotrophs), possibly through CWIN-mediated salicylic acid or jasmonic acid signaling and programmed cell death pathways. The up-regulation of SWEETs and STPs may enhance or reduce plant resistance, depending on the cellular sites from which pathogens acquire sugars from the host cells. Finally, plants employ unique mechanisms to defend against viral infection, in part through a sugar-based regulation of plasmodesmatal development or aperture. Our appraisal further calls for attention to be paid to the involvement of microbial sugar metabolism and transport in plant–pathogen interactions, which is an integrated but overlooked component of such interactions.
Astrometric excess noise in Gaia EDR3 and the search for X-ray binaries
Authors: Gandhi P , Buckley D A H , Charles P A , Hodgkin S , Scaringi S , Knigge C , Rao A , Paice J A , Zhao Y
Published: December 2021

Astrometric noise (ϵ) in excess of parallax and proper motion is a potential signature of orbital wobble (ω) of individual components in binary star systems. The combination of X-ray selection with astrometric noise could then be a powerful tool for robustly isolating accreting binaries in large surveys. Here, we mine the Gaia EDR3 catalogue for Galactic sources with significant values of astrometric noise over the parameter space expected for known and candidate X-ray binaries (XRBs). Cross-matching our sample with the Chandra Source Catalogue returns a primary sample of ≈6500 X-ray sources with significant ϵ. X-ray detection efficiency for objects with significant ϵ is a factor of ≈4.5 times higher than in a matched control sample exhibiting low ϵ. The primary sample branches off the main sequence much more than control objects in colour–mag space, and includes a higher fraction of known binaries, variables, and young stellar object class types. However, values of ϵ reported in the Gaia pipeline releases so far can exceed expectations for individual XRBs with known semimajor axis size and other system parameters. It is likely that other factors (possibly attitude and modelling uncertainties, as well as source variability) currently dominate the observed excess noise in such systems. Confirmation of their nature must therefore await future Gaia releases. The full X-ray matched catalogue is released here to enable legacy follow-up.
Association Between SARS-CoV-2 RNAemia and Postacute Sequelae of COVID-19
Authors: Ram-Mohan Nikhil , Kim David , Rogers Angela J , Blish Catherine A , Nadeau Kari C , Blomkalns Andra L , Yang Samuel
Published: December 2021

Determinants of Post-Acute Sequelae of COVID-19 are not known. Here we show that 83.3% of patients with viral RNA in blood (RNAemia) at presentation were symptomatic in the post-acute phase. RNAemia at presentation successfully predicted PASC, independent of patient demographics, worst disease severity, and length of symptoms.
Red dwarf contact binary V0627 Hydrae
Authors: Xu Hu-Shan , Zhu Li-Ying , Thawicharat Sarotsakulchai , Boonrucksar Soonthornthum , Liu Liang
Published: December 2021

New complete light curves in B, V, RC, and IC bands for the short-period eclipsing binary V0627 Hya (period shorter than 0.22 d) are presented. From the longer wavelength to the shorter one, the amplitudes of the light variation become larger. The different height of the successive maxima in each band’s light curve could be seen clearly. We analyzed those multi-wavelength light curves using the Wilson–Devinney code and derived the photometric solutions of V0627 Hya for the first time. It is found that V0627 Hya is a W-type shallow-contact binary. Combined with the GAIA parallax, the absolute parameters of this system are obtained: M1 = 0.31 M⊙, M2 = 0.64 M⊙, R1 = 0.50 R⊙, R2 = 0.69 R⊙, L1 = 0.06 L⊙, L2 = 0.08 L⊙. Thus, V0627 Hya is a new member of the red dwarf contact binary class. The asymmetry in the light curves could be explained by the spot model due to the magnetic activity of its late-type component. The amplitude differences in the different bands’ light curves imply the existence of a cool third body, which is supported by the third light contribution in the photometric solutions. The third body in this system may play an important role in its formation and evolution by removing the angular momentum. More red dwarf contact binaries need to be found and studied, since they are rare and not enough is known to reveal their mysteries at present.
Characterization and associated risk factors of Pneumocystis jirovecii pneumonia in patients with AIRD: a retrospective study
Authors: Zhao Zichu , Huang Yanli , Ming Bingxia , Zhong Jixin , Dong Lingli
Published: December 2021

Objectives

To explore clinical features of autoimmune inflammatory rheumatic disease (AIRD) patients with Pneumocystis jirovecii pneumonia (PJP) and identify potential risk factors and prognostic factors.

Methods

AIRD patients who had respiratory symptoms and underwent P. jirovecii detection were identified from the database in our department from November 2018 to October 2020. These patients were categorized into PJP and non-PJP groups according to the diagnostic criteria of PJP. Univariate and multivariate analyses were conducted.

Results

A total of 173 patients were enrolled and 46 of them had laboratory-confirmed PJP. Glucocorticoid increased the risk of PJP in a dose-dependent manner. In addition, shorter duration of immunosuppressive therapy (IST), combination therapy with CSA and chronic pulmonary comorbidities were also strongly associated with a higher risk of PJP. Combination of IgM and IgA could well identify AIRD patients with PJP from other AIRD patients with respiratory symptoms, with the optimal cut-off value of −0.96 g/l. Seven of 46 AIRD patients with PJP died (15.2%). A higher level of serum LDH, dyspnoea and ARDS, and the presence of extensive ground glass opacity (GGO) in radiologic examinations were more common in deceased patients.

Conclusions

AIRD patients with high-dose glucocorticoid treatment, recent initiation of IST, combination therapy with CSA and history of chronic pulmonary diseases had a greater risk of PJP infection. PJP patients with a higher level of serum LDH, dyspnoea, moderate and severe ARDS, and the presence of extensive GGO in radiologic examinations had poorer prognosis.

Trial registration

Chinese Clinical Trial Register; https://www.chictr.org.cn/; ChiCTR2100044095.
The modern application of the rule in Keech v Sandford
Authors: Pawlowski Mark
Published: December 2021

The article examines the current law on the application of the rule in Keech v Sandford with a view to identifying its scope and ambit, and to argue that, despite earlier caselaw, it should be viewed today as an application of the broad principle of equity that a trustee or fiduciary must not make a profit out of the trust or his fiduciary position.
Pit aspiration causes an apparent loss of xylem hydraulic conductivity in a subalpine fir (Abies mariesiiMast.) overwintering at the alpine timberline
Authors: Maruta Emiko , Yazaki Kenichi , Ogasa Mayumi Y , Taneda Haruhiko
Published: December 2021

Conifers growing at the alpine timberline are exposed to combinatorial stresses that induce embolism in xylem during winter. We collected branches of Abies mariesii Mast. at the timberline on Mt Norikura of central Japan to evaluate the seasonal changes in the loss of xylem hydraulic conductivity (percent loss of hydraulic conductivity; PLC). Concurrently, we evaluated the distribution of embolized tracheids in native samples via cryo-scanning electron microscopic (cryo-SEM) observation in comparison with the drought-induced embolism samples used for the vulnerability curve. The twigs collected in late winter showed 100 PLC at a water potential of ~−3 MPa, and air-filled tracheids were observed sporadically in the cryo-SEM images. The cryo-SEM images also showed that nearly all pits of the samples from the timberline were aspirated in the xylem with 100 PLC. Conversely, in drought-induced samples used for vulnerability analysis, lower frequency of aspirated pits was observed at similar water potentials and all tracheids in the earlywood of xylem with 100 PLC were filled with air. We hypothesized that pit aspiration is the primary cause of the pronounced winter xylem conductivity loss at the timberline when water potential is near, but still above, the drought-induced vulnerability threshold. Pit aspiration before water loss may be an adaptation to severe winter conditions at timberlines to prevent widespread xylem embolism. The possible causes of pit aspiration are discussed in relation to complex stresses under harsh winter conditions at timberlines.
Barriers to Engagement in Opioid Use Disorder Treatment After Buprenorphine Induction
Authors: Simpson Scott A. , Hordes Melissa , Blum Joshua , Rinehart Deborah , Al-Tayyib Alia
Published: December 2021

Objectives

Expanded access to buprenorphine induction, including via emergency departments, increases the likelihood of treatment engagement for patients with opioid use disorder (OUD). However, longer-term retention among these patients remains a challenge. In this study, we aimed to identify barriers to engaging and retaining patients with OUD in care and additional services that might improve retention.

Methods

We surveyed counselors at an urban safety net addictions treatment clinic.

Results

Twenty-five of 27 (93%) eligible counselors responded. Counselors described patients who were homeless, had no prior treatment history, or lacked health insurance as hardest to retain in treatment. Housing assistance, residential treatment placement, regular access to a phone, and mental health services were thought to be most beneficial for improving retention. Respondents most often reported that screening for services should happen at intake, and almost all respondents agreed that “retention of patients receiving treatment for OUD would improve with a dedicated case manager and/or more coordinated case management services.”

Conclusions

Engagement in OUD treatment would be improved with interventions to mitigate the significant social and psychiatric comorbidities of addiction. Community- and emergency department-initiated buprenorphine is a promising intervention whose full promise cannot be realized without interventions to improve treatment retention.
A Standardized Assessment of Movement-evoked Pain Ratings Is Associated With Functional Outcomes in Older Adults With Chronic Low Back Pain
Authors: Knox Patrick J. , Simon Corey B. , Pohlig Ryan T. , Pugliese Jenifer M. , Coyle Peter C. , Sions Jaclyn M. , Hicks Gregory E.
Published: December 2021

Objective:

Despite high prevalence estimates, chronic low back pain (CLBP) remains poorly understood among older adults. Movement-evoked pain (MeP) is an understudied factor in this population that may importantly contribute to disability. This study investigated whether a novel MeP paradigm contributed to self-reported and performance-based function in older adults with CLBP.

Materials and Methods:

This secondary analysis includes baseline data from 230 older adults with CLBP in the context of a prospective cohort study. The Repeated Chair Rise Test, Six Minute Walk Test, and Stair Climbing Test were used to elicit pain posttest LBP ratings were aggregated to yield the MeP variable. Self-reported and performance-based function were measured by the Late Life Function and Disability Index (LLFDI) scaled function score and Timed Up-and-Go Test (TUG), respectively. Robust regression with HC3 standard errors was used to model adjusted associations between MeP and both functional outcomes; age, sex, body mass index, and pain characteristics (ie, intensity, quality, and duration) were utilized as covariates.

Results:

MeP was present in 81.3% of participants, with an average rating of 5.09 (SD=5.4). Greater aggregated posttest MeP was associated with decreased LLFDI scores (b=−0.30,t=−2.81,P=0.005) and poorer TUG performance (b=0.081,t=2.35,P=0.020), independent of covariates. LBP intensity, quality and duration were not associated with the LLFDI or TUG, (allP>0.05).

Discussion:

Aggregated posttest MeP independently contributed to worse self-reported and performance-based function among older adults with CLBP. To understand long-term consequences of MeP, future studies should examine longitudinal associations between MeP and function in this population.
Chylous ascites has a higher incidence after robotic surgery and is associated with poor recurrence-free survival after rectal cancer surgery
Authors: Wang Xiaojie , Zheng Zhifang , Chen Min , Huang Shenghui , Lu Xingrong , Huang Ying , Chi Pan
Published: December 2021

Background:

Postoperative chylous ascites is an infrequent condition after colorectal surgery and is easily treatable. However, its effect on the long-term oncological prognosis is not well established. This study aimed to investigate the short-term and long-term impact of chylous ascites treated with neoadjuvant therapy followed by rectal cancer surgery and to evaluate the incidence of chylous ascites after different surgical approaches.

Methods:

A total of 898 locally advanced rectal cancer patients treated with neoadjuvant chemoradiotherapy followed by surgery between January 2010 and December 2018 were included. The clinicopathological data and outcomes of the patients with chylous ascites were compared with those of the patients without chylous ascites. The primary endpoint was recurrence-free survival (RFS). To balance baseline confounders between groups, propensity score matching (PSM) was performed for each patient with a logistic regression model.

Results:

Chylous ascites was detected in 3.8% (34/898) of the patients. The incidence of chylous ascites was highest after robotic surgery (6.9%, 6/86), followed by laparoscopic surgery (4.2%, 26/618) and open surgery (1.0%, 2/192, P = 0.021). The patients with chylous ascites had a significantly higher number of lymph nodes harvested (15.6 vs. 12.8, P = 0.009) and a 3-day longer postoperative hospital stay (P = 0.017). The 5-year RFS rate was 64.5% in the chylous ascites group, which was significantly lower than the rate in the no chylous ascites group (79.9%; P = 0.007). The results remained unchanged after PSM was performed. The chylous ascites group showed a nonsignificant trend towards a higher peritoneal metastasis risk (5.9% vs. 1.6%, P = 0.120). Univariate analysis and multivariate analysis confirmed chylous ascites (hazard ratio= 3.038, P < 0.001) as an independent negative prognostic factor for RFS.

Conclusions:

Considering the higher incidence of chylous ascites after laparoscopic and robotic surgery and its adverse prognosis, we recommend sufficient coagulation of the lymphatic tissue near the vessel origins, especially during minimally invasive surgery.
Specialized pro-resolving mediators in respiratory diseases
Authors: Cagnina R. Elaine , Duvall Melody G. , Nijmeh Julie , Levy Bruce D.
Published: December 2021

Purpose of review

Persistent unresolved inflammation results in a number of pathologic respiratory diseases including asthma, cystic fibrosis, acute respiratory distress syndrome (ARDS) and coronavirus disease 2019 (COVID-19)-associated ARDS. Inflammation resolution is an active series of biologic processes orchestrated by a family of bioactive specialized pro-resolving mediators (SPMs) derived from essential omega-3 and omega-6 polyunsaturated fatty acids (PUFAs). In this review, we highlight recent findings on dysregulated inflammation resolution in common respiratory diseases and recent literature on SPM generation with PUFA dietary supplementation with relevance to diseases of respiratory inflammation.

Recent findings

Human studies and preclinical models of diseases of lung inflammation have revealed disequilibrium in the levels of pro-inflammatory versus pro-resolving mediators. Recent studies identified actions for SPMs on regulating prophlogistic host responses and stimulating inflammation resolution pathways in inflammatory respiratory diseases.

Dietary marine oils are enriched in PUFAs and contain parent omega-3 and omega-6 fatty acids and precursors for conversion to SPMs. Nutritional supplementation with fish oils can boost SPM levels and offer a therapeutic approach targeting inflammation resolution pathways for diseases of lung inflammation.
En bloc resection for nonmuscle-invasive bladder cancer: selecting a proper laser
Authors: Enikeev Dmitry , Babjuk Marek , Shpikina Anastasia , Shariat Shahrokh , Glybochko Petr
Published: December 2021

Purpose of review

To discuss the most recent surgical lasers that have been made available to us and to evaluate their potential in performing en bloc resection of nonmuscle invasive bladder cancer.

Recent findings

Laser en bloc resection of bladder tumors (ERBT) can be performed with a number of laser systems including Ho:YAG, GreenLight, diode, Tm:YAG and thulium fiber lasers (TFL). The data that is currently available suggests that the water-targeting devices (utilizing water as a primary chromophore – Ho:YAG, Tm:YAG, TFL) may have a number of advantages over hemoglobin-targeting systems (potassium titanyl phosphate:YAG, lithium triborate:YAG). One recent addition to the surgical armamentarium Moses effect enhanced Ho:YAG and the TFL (being able to work both in quasi-continuous and SuperPulsed modes) necessitates careful discussion and comparison with the other available devices.

The majority of available lasers have proven to be safe to use and compared to electrocautery allow for lower rates of obturator nerve reflex and result in fewer bleeding complications. The minimal penetration depth and decreased peak power of Tm:YAG and TFLs render them the devices of choice when it comes to ERBT. Unfortunately, more studies on ERBT with TFL are needed in order for us to make a sound assessment of the respective pros and cons.
Single nucleus RNA-sequencing reveals altered intercellular communication and dendritic cell activation in nonobstructive hypertrophic cardiomyopathy
Authors: Codden Christina J. , Larson Amy , Awata Junya , Perera Gayani , Chin Michael T.
Published: December 2021

End stage, nonobstructive hypertrophic cardiomyopathy (HCM) is an intractable condition with no disease-specific therapies. To gain insights into the pathogenesis of nonobstructive HCM, we performed single nucleus RNA-sequencing (snRNA-seq) on human HCM hearts explanted at the time of cardiac transplantation and organ donor hearts serving as controls. Differential gene expression analysis revealed 64 differentially expressed genes linked to specific cell types and molecular functions. Analysis of ligand-receptor pair gene expression to delineate potential intercellular communication revealed significant reductions in expressed ligand-receptor pairs affecting the extracellular matrix, growth factor binding, peptidase regulator activity, platelet-derived growth factor binding and protease binding in the HCM tissue. Changes in Integrin-β1 receptor expression were responsible for many changes related to extracellular matrix interactions, by increasing in dendritic, smooth muscle and pericyte cells while decreasing in endothelial and fibroblast cells, suggesting potential mechanisms for fibrosis and microvascular disease in HCM and a potential role for dendritic cells. In contrast, there was an increase in ligand-receptor pair expression associated with adenylate cyclase binding, calcium channel molecular functions, channel inhibitor activity, ion channel inhibitor activity, phosphatase activator activity, protein kinase activator activity and titin binding, suggesting important shifts in various signaling cascades in nonobstructive, end stage HCM.

Brief summary

End stage, nonobstructive human HCM is associated with altered intercellular communication and dendritic cell activation, providing novel insights into potential disease mechanisms.
Transcriptomic Fingerprint of Bacterial Infection in Lower Extremity Ulcers
Authors: Fritz Blaine , Bier-Kirkegaard Julius , Nielsen Claus Henrik , Kirketerp-Møller Klaus , Malone Matthew , Bjarnsholt Thomas
Published: December 2021

Clinicians and researchers utilize subjective classification systems based on clinical parameters to stratify lower extremity ulcer infections for treatment and research. This study compared clinical infection classifications (mild to severe) of lower extremity ulcers (n = 44) with transcriptomic profiles and direct measurement of bacterial RNA signatures by RNA-sequencing. Samples demonstrating similar transcriptomes were clustered and characterized by transcriptomic fingerprint. Clinical infection severity did not explain the major sources of variability among the samples and samples with the same clinical classification demonstrated high inter-sample variability. High proportions of bacterial RNA, however, resulted in a strong effect on transcription and increased expression of genes associated with immune response and inflammation. K-means clustering identified two clusters of samples, one of which contained all of the samples with high levels of bacterial RNA. A support vector classifier identified a fingerprint of 20 genes, including immune-associated genes such as CXCL8, GADD45B, and HILPDA, which accurately identified samples with signs of infection via cross-validation. This suggests that stratification of infection states based on a transcriptomic fingerprint may be a useful tool for studying host-bacterial interactions in these ulcers, as well as an objective classification method to identify the severity of infection.

Significance Statement

Clinicians and researchers utilize classification schemes based on clinically measurable parameters to describe infection severity in lower extremity ulcers. However, here we show that the local host gene expression is often discordant to clinical classification scores. We observed this inconsistency is explained by the increased presence of bacteria, which promotes increased immune and inflammatory responses. Two groups of host gene expression, predominantly differentiated by the levels of bacterial RNA, could be classified with less than 20 genes. These results provide significant insights into host response to bacterial infection where bacteria are directly observed, rather than implied from clinical observation, and illustrated the limitations of clinical observations to stratify lower extremity ulcers.
Excitatory/inhibitory imbalance in autism: the role of glutamate and GABA gene-sets in symptoms and cortical brain structure
Authors: Hollestein Viola , Poelmans Geert , Forde Natalie J , Beckmann Christian F , Ecker Christine , Mann Caroline , Schaefer Tim , Moessnang Carolin , Baumeister Sarah , Banaschewski Tobias , Bourgeron Thomas , Loth Eva , Dell’Acqua Flavio , Murphy Declan GM , Tillmann Julian , Charman Tony , Jones Emily J.H. , Mason Luke , Ambrosino Sara , Holt Rosemary , Bölte Sven , Buitelaar Jan K , Naaijen Jilly
Published: December 2021

Background

The excitatory/inhibitory (E/I) imbalance hypothesis posits that an imbalance between excitatory (glutamatergic) and inhibitory (GABAergic) mechanisms underlies the behavioral characteristics of autism spectrum disorder (autism). However, how E/I imbalance arises and how it may differ across autism symptomatology and brain regions is not well understood.

Methods

We used innovative analysis methods - combining competitive gene-set analysis and gene-expression profiles in relation to cortical thickness (CT)- to investigate the relationship between genetic variance, brain structure and autism symptomatology of participants from the EU-AIMS LEAP cohort (autism=360, male/female=259/101; neurotypical control participants=279, male/female=178/101) aged 6 to 30 years. Competitive gene-set analysis investigated associations between glutamatergic and GABAergic signaling pathway gene-sets and clinical measures, and CT. Additionally, we investigated expression profiles of the genes within those sets throughout the brain and how those profiles relate to differences in CT between autistic and neurotypical control participants in the same regions.

Results

The glutamate gene-set was associated with all autism symptom severity scores on the Autism Diagnostic Observation Schedule-2 (ADOS-2) and the Autism Diagnostic Interview-Revised (ADI-R) within the autistic group, while the GABA set was associated with sensory processing measures (using the SSP subscales) across all participants. Brain regions with greater gene expression of both glutamate and GABA genes showed greater differences in CT between autistic and neurotypical control participants.

Conclusions

Our results suggest crucial roles for glutamate and GABA genes in autism symptomatology as well as CT, where GABA is more strongly associated with sensory processing and glutamate more with autism symptom severity.
Multi-scalar data integration links glomerular angiopoietin-tie signaling pathway activation with progression of diabetic kidney disease
Authors: Liu Jiahao , Nair Viji , Zhao Yi-yang , Chang Dong-yuan , Eichinger Felix , Tanner Emily C. , Fermin Damian , Bellovich Keith A. , Steigerwalt Susan , Bhat Zeenat , Hawkins Jennifer J. , Subramanian Lalita , Rosas Sylvia E. , Sedor John R. , Vasquez Miguel A. , Waikar Sushrut S. , Bitzer Markus , Pennathur Subramaniam , Brosius Frank , Chen Min , Kretzler Matthias , Ju Wenjun ,   for the Kidney Precision Medicine Project and Michigan Translational Core C-PROBE Investigator Group
Published: December 2021

Diabetes is the leading cause of chronic kidney disease. Prognostic biomarkers reflective of underlying molecular mechanisms are critically needed for effective management of diabetic kidney disease (DKD). In the Clinical Phenotyping and Resource Biobank study, an unbiased, machine learning approach identified a three-marker panel from plasma proteomics which, when added to standard clinical parameters, improved the prediction of outcome of end-stage kidney disease (ESKD) or 40% decline in baseline glomerular filtration rate (GFR) in a discovery DKD group (N=58) and was validated in an independent group (N=68) who also had kidney transcriptomic profiles available. Of the three markers, plasma angiopoietin 2 (ANGPT2) remained significantly associated with composite outcome in 210 Chinese Cohort Study of Chronic Kidney Disease participants with DKD. The glomerular transcriptional Angiopoietin/Tie (ANG-TIE) activation scores, derived from the expression of 154 literature-curated ANG-TIE signaling mediators, positively correlated with plasma ANGPT2 levels and outcome, explained by substantially higher TEK receptor expression in glomeruli and higher ANG-TIE activation scores in endothelial cells in DKD by single cell RNA sequencing. Our work suggests that activation of glomerular ANG-TIE signaling in the kidneys underlies the association of plasma ANGPT2 with disease progression, thereby providing potential targets to prevent DKD progression.
Deep learning based quantification of the accelerated brain aging rate in glioma patients after radiotherapy
Authors: Huisman Selena I. , van der Boog Arthur T.J. , Cialdella Fia , Verhoeff Joost J.C. , David Szabolcs
Published: December 2021

Background and purpose

Changes of healthy appearing brain tissue after radiotherapy have been previously observed, however, they remain difficult to quantify. Due to these changes, patients undergoing radiotherapy may have a higher risk of cognitive decline, leading to a reduced quality of life. The experienced tissue atrophy is similar to the effects of normal aging in healthy individuals. We propose a new way to quantify tissue changes after cranial RT as accelerated brain aging using the BrainAGE framework.

Materials and methods

BrainAGE was applied to longitudinal MRI scans of 32 glioma patients, who have undergone radiotherapy. Utilizing a pre-trained deep learning model, brain age is estimated for all patients’ pre-radiotherapy planning and follow-up MRI scans to get a quantification of the changes occurring in the brain over time. Saliency maps were extracted from the model to spatially identify which areas of the brain the deep learning model weighs highest for predicting age. The predicted ages from the deep learning model were used in a linear mixed effects model to quantity aging and aging rates for patients after radiotherapy.

Results

The linear mixed effects model resulted in an accelerated aging rate of 2.78 years per year, a significant increase over a normal aging rate of 1 (p < 0.05, confidence interval (CI) = 2.54-3.02). Furthermore, the saliency maps showed numerous anatomically well-defined areas, e.g.: Heschl’s gyrus among others, determined by the model as important for brain age prediction.

Conclusion

We found that patients undergoing radiotherapy are affected by significant radiation-induced accelerated aging, with several anatomically well-defined areas contributing to this aging. The estimated brain age could provide a method for quantifying quality of life post-radiotherapy.

Highlights

Up to 3 times accelerated aging after radiotherapy. // Anatomically well-defined areas for brain age prediction. // Quantifying quality of life after radiotherapy.