bluuebunny/crossref_metadata_2025 huggingface dataset:
Mid-infrared time-domain study of recent dust production events in the extreme debris disc of TYC 4209-1322-1
Authors: Moór Attila , Ábrahám Péter , Kóspál Ágnes , Su Kate Y L , Rieke George H , Vida Krisztián , Cataldi Gianni , Bódi Attila , Bognár Zsófia , Cseh Borbála , Csörnyei Géza , Egei Nóra , Farkas Anikó , Hanyecz Ottó , Ignácz Bernadett , Kalup Csilla , Könyves-Tóth Réka , Kriskovics Levente , Mészáros László , Pál András , Ordasi András , Sárneczky Krisztián , Seli Bálint , Sódor Ádám , Szakáts Róbert , Vinkó József , Zsidi Gabriella
Published: September 2022

Extreme debris discs are characterized by unusually strong mid-infrared excess emission, which often proves to be variable. The warm dust in these discs is of transient nature and is likely related to a recent giant collision occurring close to the star in the terrestrial region. Here we present the results of a 877 d long, gap-free photometric monitoring performed by the Spitzer Space Telescope of the recently discovered extreme debris disc around TYC 4209-1322-1. By combining these observations with other time-domain optical and mid-infrared data, we explore the disc variability of the last four decades with particular emphasis on the last 12 yr. During the latter interval the disc showed substantial changes, the most significant was the brightening and subsequent fading between 2014 and 2018 as outlined in WISE data. The Spitzer light curves outline the fading phase and a subsequent new brightening of the disc after 2018, revealing an additional flux modulation with a period of ∼39 d on top of the long-term trend. We found that all these variations can be interpreted as the outcome of a giant collision that happened at an orbital radius of ∼0.3 au sometime in 2014. Our analysis implies that a collision on a similar scale could have taken place around 2010, too. The fact that the disc was already peculiarly dust rich 40 yr ago, as implied by IRAS data, suggests that these dust production events belong to a chain of large impacts triggered by an earlier even more catastrophic collision.
Repeating fast radio bursts with high burst rates by plate collisions in neutron star crusts
Authors: Li Qiao-Chu , Yang Yuan-Pei , Wang F Y , Xu Kun , Dai Zi-Gao
Published: September 2022

Some repeating fast radio burst (FRB) sources show high burst rates, and the physical origin is still unknown. Outstandingly, the first repeater FRB 121102 appears extremely high burst rate with the maximum value reaching $122\, \mathrm{h^{-1}}$ or even higher. In this work, we propose that the high burst rate of an FRB repeater may be due to plate collisions in the crust of young neutron stars (NSs). In the crust of an NS, vortex lines are pinned to the lattice nuclei. When the relative angular velocity between the superfluid neutrons and the NS lattices is non-zero, a pinned force will act on the vortex lines, which will cause the lattice displacement and the strain on the NS crust growing. With the spin evolution, the crustal strain reaches a critical value, then the crust may crack into plates, and each of plates will collide with its adjacent ones. The Aflvén wave could be launched by the plate collisions and further produce FRBs. In this scenario, the predicted burst rate can reach $\sim 770\, \mathrm{h}^{-1}$ for an NS with the magnetic field of $10^{13}\, {\rm G}$ and the spin period of $0.01\, {\rm s}$. We further apply this model to FRB 121102, and predict the waiting time and energy distribution to be $P(t_{\mathrm{w}}) \propto t_{\text{w}}^{\alpha _{t_{\text{w}}}}$ with $\alpha _{t_{\text{w}}} \simeq -1.75$ and $N(E)\text{d}E \propto E^{\alpha _{E}}\text{d}E$ with αE ≃ −1.67, respectively. These properties are consistent with the observations of FRB 121102.
Locating the flickering source in polars
Authors: Iłkiewicz Krystian , Scaringi Simone , Littlefield Colin , Mason Paul A
Published: September 2022

Flickering is a fast variability observed in all accreting systems. It has been shown that in most cataclysmic variables flickering originates in the accretion disc. However, in polars the strong magnetic field of the white dwarf prevents the formation of an accretion disc. Therefore, the origin of flickering in polars is not clear. We analysed the changes of flickering amplitude with orbital phase in seven polars in order to reveal its site of origin. We show that at least in some polars there are two separate sources of flickering. Moreover, at least one of the sources is located at a large distance from the main source of light in the system.
Accurate measurement of microsatellite length by disrupting its tandem repeat structure
Authors: Wang Zihua , Moffitt Andrea B , Andrews Peter , Wigler Michael , Levy Dan
Published: September 2022

Tandem repeats of simple sequence motifs, also known as microsatellites, are abundant in the genome. Because their repeat structure makes replication error-prone, variant microsatellite lengths are often generated during germline and other somatic expansions. As such, microsatellite length variations can serve as markers for cancer. However, accurate error-free measurement of microsatellite lengths is difficult with current methods precisely because of this high error rate during amplification. We have solved this problem by using partial mutagenesis to disrupt enough of the repeat structure of initial templates so that their sequence lengths replicate faithfully. In this work, we use bisulfite mutagenesis to convert a C to a U, later read as T. Compared to untreated templates, we achieve three orders of magnitude reduction in the error rate per round of replication. By requiring agreement from two independent first copies of an initial template, we reach error rates below one in a million. We apply this method to a thousand microsatellite loci from the human genome, revealing microsatellite length distributions not observable without mutagenesis.
The KdmB-EcoA-RpdA-SntB chromatin complex binds regulatory genes and coordinates fungal development with mycotoxin synthesis
Authors: Karahoda Betim , Pardeshi Lakhansing , Ulas Mevlut , Dong Zhiqiang , Shirgaonkar Niranjan , Guo Shuhui , Wang Fang , Tan Kaeling , Sarikaya-Bayram Özlem , Bauer Ingo , Dowling Paul , Fleming Alastair B , Pfannenstiel Brandon T , Luciano-Rosario Dianiris , Berger Harald , Graessle Stefan , Alhussain Mohamed M , Strauss Joseph , Keller Nancy P , Wong Koon Ho , Bayram Özgür
Published: September 2022

Chromatin complexes control a vast number of epigenetic developmental processes. Filamentous fungi present an important clade of microbes with poor understanding of underlying epigenetic mechanisms. Here, we describe a chromatin binding complex in the fungus Aspergillus nidulans composing of a H3K4 histone demethylase KdmB, a cohesin acetyltransferase (EcoA), a histone deacetylase (RpdA) and a histone reader/E3 ligase protein (SntB). In vitro and in vivo evidence demonstrate that this KERS complex is assembled from the EcoA-KdmB and SntB-RpdA heterodimers. KdmB and SntB play opposing roles in regulating the cellular levels and stability of EcoA, as KdmB prevents SntB-mediated degradation of EcoA. The KERS complex is recruited to transcription initiation start sites at active core promoters exerting promoter-specific transcriptional effects. Interestingly, deletion of any one of the KERS subunits results in a common negative effect on morphogenesis and production of secondary metabolites, molecules important for niche securement in filamentous fungi. Consequently, the entire mycotoxin sterigmatocystin gene cluster is downregulated and asexual development is reduced in the four KERS mutants. The elucidation of the recruitment of epigenetic regulators to chromatin via the KERS complex provides the first mechanistic, chromatin-based understanding of how development is connected with small molecule synthesis in fungi.
Trypanosoma brucei histones are heavily modified with combinatorial post-translational modifications and mark Pol II transcription start regions with hyperacetylated H2A
Authors: Maree Johannes P , Tvardovskiy Andrey , Ravnsborg Tina , Jensen Ole N , Rudenko Gloria , Patterton Hugh-G
Published: September 2022

Trypanosomes diverged from the main eukaryotic lineage about 600 million years ago, and display some unusual genomic and epigenetic properties that provide valuable insight into the early processes employed by eukaryotic ancestors to regulate chromatin-mediated functions. We analysed Trypanosoma brucei core histones by high mass accuracy middle-down mass spectrometry to map core histone post-translational modifications (PTMs) and elucidate cis-histone combinatorial PTMs (cPTMs). T. brucei histones are heavily modified and display intricate cPTMs patterns, with numerous hypermodified cPTMs that could contribute to the formation of non-repressive euchromatic states. The Trypanosoma brucei H2A C-terminal tail is hyperacetylated, containing up to five acetylated lysine residues. MNase-ChIP-seq revealed a striking enrichment of hyperacetylated H2A at Pol II transcription start regions, and showed that H2A histones that are hyperacetylated in different combinations localised to different genomic regions, suggesting distinct epigenetic functions. Our genomics and proteomics data provide insight into the complex epigenetic mechanisms used by this parasite to regulate a genome that lacks the transcriptional control mechanisms found in later-branched eukaryotes. The findings further demonstrate the complexity of epigenetic mechanisms that were probably shared with the last eukaryotic common ancestor.
Formation and removal of 1,N6-dimethyladenosine in mammalian transfer RNA
Authors: You Xue-Jiao , Zhang Shan , Chen Juan-Juan , Tang Feng , He Jingang , Wang Jie , Qi Chu-Bo , Feng Yu-Qi , Yuan Bi-Feng
Published: September 2022

RNA molecules harbor diverse modifications that play important regulatory roles in a variety of biological processes. Over 150 modifications have been identified in RNA molecules. N6-methyladenosine (m6A) and 1-methyladenosine (m1A) are prevalent modifications occurring in various RNA species of mammals. Apart from the single methylation of adenosine (m6A and m1A), dual methylation modification occurring in the nucleobase of adenosine, such as N6,N6-dimethyladenosine (m6,6A), also has been reported to be present in RNA of mammals. Whether there are other forms of dual methylation modification occurring in the nucleobase of adenosine other than m6,6A remains elusive. Here, we reported the existence of a novel adenosine dual methylation modification, i.e. 1,N6-dimethyladenosine (m1,6A), in tRNAs of living organisms. We confirmed that m1,6A is located at position 58 of tRNAs and is prevalent in mammalian cells and tissues. The measured level of m1,6A ranged from 0.0049% to 0.047% in tRNAs. Furthermore, we demonstrated that TRMT6/61A could catalyze the formation of m1,6A in tRNAs and m1,6A could be demethylated by ALKBH3. Collectively, the discovery of m1,6A expands the diversity of RNA modifications and may elicit a new tRNA modification-mediated gene regulation pathway.
The stochastic world of emerging viruses
Authors: Gavotte Laurent , Frutos Roger
Published: September 2022

The acquisition of new hosts is a fundamental mechanism by which parasitic organisms expand their host range and perpetuate themselves on an evolutionary scale. Among pathogens, viruses, due to their speed of evolution, are particularly efficient in producing new emergence events. However, even though these phenomena are particularly important to the human species and therefore specifically studied, the processes of virus emergence in a new host species are very complex and difficult to comprehend in their entirety. In order to provide a structured framework for understanding emergence in a species (including humans), a comprehensive qualitative model is an indispensable cornerstone. This model explicitly describes all the stages necessary for a virus circulating in the wild to come to the crossing of the epidemic threshold. We have therefore developed a complete descriptive model explaining all the steps necessary for a virus circulating in host populations to emerge in a new species. This description of the parameters presiding over the emergence of a new virus allows us to understand their nature and importance in the emergence process.
Intellectual Property Rights and Debt Financing
Authors: Suh Paula
Published: September 2022

I examine how the investment and financing of innovation are affected by the contractual allocation of intellectual property rights using a Federal Circuit ruling that strengthened firms’ property rights to employee patents. I find that treatment firms’ total debt-to-assets ratio and R&D spending increase by 18% and 9%, respectively, as the residual control over patents increases firms’ incentives to innovate. These effects are more pronounced when ex ante holdup exposure is high. Furthermore, I find a positive marginal effect of asset complementarity as it limits the decline in employee incentives. Consistently, I show that firms’ ex post asset complementarity improves.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
SLE stratification based on BAFF and IFN-I bioactivity for biologics and implications of BAFF produced by glomeruli in lupus nephritis
Authors: Itotagawa Eri , Tomofuji Yoshihiko , Kato Yasuhiro , Konaka Hachiro , Tsujimoto Kohei , Park JeongHoon , Nagira Daiki , Hirayama Takehiro , Jo Tatsunori , Hirano Toru , Morita Takayoshi , Nishide Masayuki , Nishida Sumiyuki , Shima Yoshihito , Narazaki Masashi , Okada Yukinori , Takamatsu Hyota , Kumanogoh Atsushi
Published: September 2022

Objective

B-cell activating factor (BAFF) is implicated in SLE pathogenesis. Blocking BAFF signalling has contributed to reducing glucocorticoid dosage and preventing organ damage. However, clinical characteristics of patients who may benefit from this therapy are not yet fully elucidated. Therefore, we identified patients with high BAFF-bioactivity to investigate their clinical characteristics and BAFF-producing cells.

Methods

We established the reporter cell for BAFF and investigated the clinical characteristics of SLE patients with high BAFF-bioactivity. We identified BAFF-expressing kidney cells using publicly available scRNA-seq data and immunohistological analysis. SLE patients were stratified based on the bioactivity of BAFF and type-I IFN (IFN-I) to identify associated characteristic clinical manifestations.

Results

SLE patients, especially patients with LN, had significantly higher serum BAFF-bioactivity than healthy controls (HC) and non-LN patients. Additionally, single-cell-RNA-seq data and immunohistological analysis of kidney samples from LN patients revealed that BAFF is expressed in glomerular macrophages and mesangial cells. Notably, BAFF bioactivity was elevated in the urine of LN patients compared with that of non-LN patients, while no IFN-I bioactivity was detected in the urine. Furthermore, SLE stratification based on bioactivities of serum BAFF and IFN-I revealed the clinical characteristics of patients: high BAFF represented patients with LN and high IFN-I represented patients with blood and skin manifestations.

Conclusions

Monitoring urinary BAFF-bioactivity may be valuable in diagnosing LN. Furthermore, stratification based on serum BAFF and IFN-I bioactivities may allow the identification of appropriate patients for biologics targeting BAFF and IFN-I.
Recombinase Polymerase Amplification–Lateral Flow Dipstick Assay for Rapid Detection of Fusarium circinatum Based on a Newly Identified Unique Target Gene
Authors: Xu Jieying , Yang Xiao , Wu Cuiping , Chen Zhenpeng , Dai Tingting
Published: September 2022

Pitch canker caused by the fungus Fusarium circinatum is an important disease affecting pine trees in Europe and South Africa. Several countries, including China, have listed F. circinatum as a quarantine pathogen. Therefore, timely detection of F. circinatum could efficiently prevent its introduction into new areas or facilitate spread management in already infected sites. In this study, a recombinase polymerase amplification–lateral flow dipstick (RPA-LFD) assay was developed for rapid detection of F. circinatum based on a new target gene, Fcir2067, identified from whole-genome sequences. The assay was highly specific to F. circinatum. In fact, it exclusively detected F. circinatum isolates; 53 isolates of fungal and oomycete species and 2 nematodes of Bursaphelenchus xylophilus and B. mucronatus were not detected. By detecting as little as 10 pg of F. circinatum genomic DNA in a 50-µl reaction, the RPA-LFD assay was 10 times more sensitive than conventional PCR assays. F. circinatum was also detected in artificially inoculated pine needles of Cedrus deodara. These results demonstrated that the developed RPA-LFD assay has the potential for rapid detection of F. circinatum in regions at high risk of infection. The RPA-LFD assay might serve as an alternative method for the early detection of F. circinatum.
Plant Growth-Promoting Rhizobacteria Promote Growth of Seedlings, Regulate Soil Microbial Community, and Alleviate Damping-Off Disease Caused by Rhizoctonia solani on Pinus sylvestris var. mongolica
Authors: Song Qian , Deng Xun , Song Ruiqing , Song Xiaoshuang
Published: September 2022

As the excessive use of chemical fertilizers harms organisms and adversely affects the soil environment, the replacement of chemical fertilizers with biological fertilizers has attracted widespread attention as an environmental protection strategy. In this study, the effects of rhizosphere bacteria inoculation on growth of Pinus sylvestris var. mongolica seedlings, soil parameters, soil microbial community structure, and the biocontrol of damping-off were studied by pot experiments. The results showed that all three rhizosphere bacteria (Pseudomonas chlororaphis, Pseudomonas extremaustralis, and Acinetobacter lwoffii A07) tested exhibited growth-promoting properties, such as the production of indole-3-acetic acid, hydrolase, siderophores, and hydrogen cyanide; nitrogen fixation; and phosphorus solubilization. The application of the three bacteria increased plant biomass, root structure, and nutrient content and also increased soil nutrient content and enzyme activity. Bacterial inoculation promoted the growth of beneficial bacteria and antagonistic bacteria by adjusting the physicochemical properties of the soil, thereby improving the bacterial community structure. Among the soil features, available nitrogen, total nitrogen, available potassium, and urease activity were the main influencing factors. In addition, it was also found that bacterial inoculation significantly increased the activities of plant superoxide dismutase, catalase, peroxidase, and other defense enzymes; enhanced plant disease resistance; effectively inhibited damping-off; and promoted plant growth. In summary, the application of three rhizosphere bacteria systematically affected the interaction between plants, soil parameters, and soil microbial communities. These results provide a basis for understanding how rhizosphere bacteria promote the growth of P. sylvestris var. mongolica, thereby offering a promising sustainable alternative to chemical fertilizers.
Biopsychosocial Attributes of Single-region and Multi-region Body Pain During Early Adolescence
Authors: Senger-Carpenter Thea , Scott Eric L. , Marriott Deanna J. , Lenko Rachel , Seng Julia , Ploutz-Snyder Robert , Robinson-Lane Sheria G. , Cofield Cherie , Chen Bingxin , Voepel-Lewis Terri
Published: September 2022

Objectives:

Multi-region pain during adolescence is associated with a higher symptom burden and lower quality of life. The purpose of this study was to describe and compare the biopsychosocial attributes of single-region and multi-region pain among healthy young adolescents.

Materials and Methods:

We analyzed data from 10,320 children aged 10.6 to 14 years who self-reported pain in the Adolescent Brain and Cognitive Development Study. Pain was coded as single-region or multi-region based on body map data.

Results:

One in 5 young adolescents indicated recent multi-region pain. Sequential regression supported improved model fit when psychological and sociocultural factors were added to a biological model of pain; however, these models improved the classification of multi-region but not single-region pain. A significant interaction effect of sex and puberty remained constant across models with increased odds of pain at each advancing pubertal stage for both sexes compared with prepuberty, but no difference between girls and boys at late puberty (adjusted odds ratio [OR]=2.45 [1.72, 3.49] and adjusted OR=1.63 [1.20, 2.23], respectively). Psychological factors improved the classification of multi-region pain with significant effects of anxiety, somatic symptoms, and somnolence. Finally, compared with White and non-Hispanic children, Black and Hispanic children were less likely to report pain (adjusted OR=0.70 [0.61, 0.80]; adjusted OR=0.88 [0.78, 0.99], respectively) but had significantly higher pain interference when pain was present (adjusted OR=1.49 [1.29, 1.73] and adjusted OR=1.20 [1.06, 1.35], respectively).

Discussion:

Pain is a biopsychosocial phenomenon, but psychological and sociocultural features may be more relevant for multi-region compared with single-region pain during early adolescence.
WHO 2021 and beyond: new types, molecular markers and tools for brain tumor classification
Authors: Tran Suzanne , Bielle Franck
Published: September 2022

Purpose of review

The fifth edition of the WHO classification of central nervous system tumors was published in 2021. It implemented major advances in the current diagnostic practice such as DNA methylation profiling. The review addresses how our understanding of the diversity of brain tumors has recently much improved through omics analysis and derived molecular biomarkers.

Recent findings

Latest impactful studies identifying new diagnostic or prognostic biomarkers in frequent tumors and describing new rare tumor types are summarized about adult and pediatric gliomas, rare neuroepithelial tumors, ependymomas, medulloblastomas and meningiomas. Some controversies are debated. The role of methylation classes and surrogate immunohistochemical markers is highlighted.

New diagnostic criteria and better definitions of tumor types aim at improving the management of brain tumor patients and at better evaluating new treatments in clinical trials. The rapidly evolving field of brain tumor classification opens exciting perspectives and many challenges to integrate clinical, radiological, histological and molecular information into a framework relevant for care and research.
Adrenal metastatic melanoma first identified during pregnancy: a diagnostic challenge
Authors: Schiller Tal , Vaisbuch Edi , Zornitzki Taiba , Kirzhner Alena
Published: September 2022

Adrenal nonadenomatous tumors (NAT) first identified during pregnancy are very rare and pose a diagnostic and therapeutic dilemma with significant risks for the mother and fetus. The aim of this study is to report a case of a large adrenal NAT identified in pregnancy and literature review. A literature search was conducted, and data were summarized. A 37-year-old primigravida woman, with a history of melanoma, excised 12 years before presentation without recurrence, presented at 35 weeks gestation due to intractable right flank pain. MRI demonstrated an eight cm, heterogeneous, septate, right adrenal mass suspected to be either pheochromocytoma/paraganglioma (PPGL), adrenocortical carcinoma or metastasis. Blood metanephrines were sent urgently to enable a safe delivery and were within normal range, as were cortisol and androgen levels. A biopsy was taken from a palpable breast mass as well as from an ovarian mass during the operation. At 36 weeks gestation, she was delivered by cesarean section. PET computed tomography performed after delivery revealed the extensive metastatic spread of recurring melanoma including the right adrenal gland. Timely diagnosis and management by a multidisciplinary team are important to avoid a catastrophic outcome. There is no consensus on optimal management and timing of delivery. PPGL should be ruled out before delivery.
LS-007 inhibits melanoma growth via inducing apoptosis and cell cycle arrest and regulating macrophage polarization
Authors: Yin Lijie , Liu Xinghan , Wu Jinjin , Yang Jingjing , Wang Jiali , Dou Huan , Hou Yayi
Published: September 2022

LS-007, an inhibitor of cyclin-dependent kinase 9 (CDK9), exhibits potential antitumor activity against chronic lymphocytic leukemia and ovarian cancer, but its effect on melanoma and tumor microenvironment (TME) has not been reported yet. This study aimed to investigate the role of LS-007 in B16F10 melanoma and relevant mechanisms. LS-007 significantly inhibited viability and induced apoptosis of B16F10 cells in a dose-dependent manner, which were accompanied with the increased ratio of Bax to Bcl-2 and decreased Mcl-1 mRNA level. Western blot analysis showed that LS-007 increased the expression of cleaved caspase-3 and poly ADP-ribose polymerase (PARP). Furthermore, flow cytometry analysis and qRT-PCR results showed that LS-007 treatment resulted in cell cycle arrest by changing cell cycle-related gene expression. Notably, in vivo evaluation showed that LS-007 significantly decreased the weight and volume of tumor and the expression of Ki67, promoted the expression of iNOS and inhibited the expression of CD206, suggesting that LS-007 might inhibit tumor growth by suppressing polarization of macrophages into tumor-associated macrophages (TAMs) in the TME. The increase in M1/M2 treated with LS-007 detected by flow cytometry hinted that macrophages were polarized towards an antitumor phenotype. In addition, LS-007 induced higher apoptotic rate of B16F10 cells when co-cultured B16F10 with BMDMs. LS-007 has inhibitory effects on B16F10 cells in vivo and in vitro via inducing apoptosis, cell cycle arrest, and changing macrophage function in the TME.
Perioperative Bleeding Associated With Ibrutinib in Dermatologic Surgery: A Case–Control Study
Authors: Aghazadeh Nessa , Jin Mauricio F. , Pride Renee L. , O'Byrne Jamie , Vidal Nahid Y.
Published: September 2022

BACKGROUND

Ibrutinib, an irreversible Bruton tyrosine kinase inhibitor, has been associated with an increased risk of bleeding. There is a paucity of data on the risk of bleeding in patients on ibrutinib undergoing dermatologic surgery.

OBJECTIVE

To determine the frequency of bleeding complications associated with ibrutinib in patients undergoing dermatologic surgery.

MATERIALS AND METHODS

A retrospective, single-center, case–control study of patients on ibrutinib undergoing skin surgery between January 2013 and March 2020 compared with sex, disease, and age-matched control patients undergoing cutaneous surgeries.

RESULTS

A total of 75 surgeries performed on 37 case patients and 116 surgeries performed on 64 control patients were included. Ibrutinib was associated with a statistically significant increased rate of bleeding events (6/75 [8%] vs 1/116 [0.8%], p-value = .02). Compared with ibrutinib patients who did not have a bleeding event, those on ibrutinib who suffered bleeding were all men, older (mean age 82.7 vs 73.0, p-value= .01), and had lower mean platelet counts (104.0 vs 150.5 K/μL, p-value = .03).

CONCLUSION

Ibrutinib may be associated with increased risk of bleeding in patients with hematologic malignancies, particularly older men with lower platelet levels and on multiple anticoagulants. Transient discontinuation of ibrutinib should be considered for dermatologic surgeries.
How to deal with nonsevere stenoses in coronary artery bypass grafting – a critical perspective on competitive flow and surgical precision
Authors: Doenst Torsten , Sousa-Uva Miguel
Published: September 2022

Purpose of review

For invasive treatment of coronary artery disease (CAD), we assess anatomical complexity, analyse surgical risk and make heart-team decisions for percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). With PCI, treating flow-relevant lesions is recommended, and reintervention easily treats disease progression. For CABG, some stenoses may only be borderline or nonsevere despite a clear surgical indication. As reoperations are not easy, the question on how to address these lesions has been around from the start, but has never satisfactorily been answered.

Recent findings

With a new mechanistic perspective, we had suggested that infarct-prevention by surgical collateralization is the main prognostic mechanism of CABG in chronic coronary syndrome. Importantly, the majority of infarctions arise from nonsevere coronary lesions. Thus, surgical collateralization may be a valid treatment option for nonsevere lesions, but graft patency moves more into focus here, because graft patency directly correlates with the severity of coronary stenoses. In addition, CABG may even accelerate native disease progression.

We here review the evidence for and against grafting nonsevere CAD lesions, suggesting that patency of grafts (to moderate lesions) may be improved by increasing surgical precision. In addition, we must improve our ability to predict future myocardial infarctions.
Selection and management considerations to enhance outcomes in patients supported by left ventricular assist devices
Authors: Lander Matthew , Bhardwaj Anju , Kanwar Manreet
Published: September 2022

Purpose of review

Left ventricular assist devices (LVADs) are life-saving therapies for patients in end-stage heart failure (HF) with reduced ejection fraction regardless of candidacy for heart transplantation. Multiple clinical trials have demonstrated improved morbidity and mortality with LVADs when compared to medical therapy alone. However, the uptake of LVADs as a therapeutic option in a larger section of end-stage HF patients remains limited, partly due to associated adverse events and re-hospitalization.

Recent Findings

Accurate assessment and staging of HF patients is crucial to guide appropriate use of LVADs. Innovative methods to risk stratify patients and manage cardiac and noncardiac comorbidities can translate to improved outcomes in LVAD recipients. Inclusion of quality of life metrics and measurements of adverse events can better inform heart failure cardiologists to help identify ideal LVAD candidates. Addition of machine learning algorithms to this process may guide patient selection to improve outcomes.

Patient selection and assessment of reversible medical comorbidities are critical to the postoperative success of LVAD implantation. Identifying patients most likely to benefit and least likely to experience adverse events should be a priority.
Patterns and predictors of elevated blood pressure and hypertension among primary school children in urban Kenya
Authors: Gewa Constance A. , Onyango Agatha C. , Opiyo Rose O. , Gittelsohn Joel , Cheskin Lawrence J.
Published: September 2022

Objective:

We examined the prevalence of elevated blood pressure (BP) and hypertension among 390 primary school children of different socioeconomic status (SES) in two urban settings in Kenya and explored the association between children's BP status and their sociodemographic characteristics, dietary behaviours and overweight/obesity status.

Methods:

Children's BP and anthropometric measurements were taken and parents, with the help of their children, completed questionnaires on the children's dietary behaviours. An average of three BP readings was used to calculate BP percentiles by age, sex and height. BMI-for-age z-scores, waist-circumference-to-height ratio and the sum of skinfold measures were calculated. We utilized prevalence ratio analysis to examine the association between BP and sociodemographic characteristics, dietary behaviours and overweight/obesity.

Results:

About 9% of the school children had elevated BP and 33% had stage 1 hypertension. Among overweight children, the proportion of children with elevated BP was 1.85-fold greater and the proportion of children with hypertension was 1.83-fold greater compared with children with healthy body weight. Similar patterns of significant associations were seen among obese children, children with central obesity and children with high total skinfold values. The proportion of children with hypertension was 1.42-fold greater among children with high frequency of consumption of chips/crisps compared with children with lower frequency of consumption.

Conclusion:

These results increase our understanding BP patterns and determinants among school children in Kenya and can help inform noncommunicable disease prevention efforts.
Talc Inhalation in Rats and Humans
Authors: Borm Paul J.A.
Published: September 2022

Background

Current information on the health effects and toxicology of talc suggests that this may lead to a specific target organ toxicity arising from repeated exposure (STOT-RE) classification.

Objective

To provide an assessment of the currently available inhalation toxicity data on talc and to put these data in the perspective of other poorly soluble low-toxicity particles.

Methods

A database of 177 articles was gathered from different sources.

Results

Relevant animal data sets were subjected to a quality review, and epidemiological studies on talc and lung effects published since 2016 were reviewed.

Conclusions

Of nine original inhalation studies reviewed, only one study using rats and mice met the criteria that are needed to include for a reliable evaluation for STOT-RE. Together with the pulmonary effects observed in exposed talc miners, a STOT-RE 1 classification is warranted.
Association of Gender, Race, Mechanism of Injury on Alcohol Use, Posttraumatic Stress Disorder, and Depression in Trauma
Authors: Trevino Colleen M. , Shorey Ryan C. , Bergner Carisa , Brandolino Amber , deRoon-Cassini Terri , France Christopher R.
Published: September 2022

BACKGROUND:

There is a paucity of literature documenting whether trauma patients with different mechanisms of injury have different rates of hazardous alcohol use and/or risk for depression and posttraumatic stress disorder.

OBJECTIVE:

The purpose of this article is to determine whether there are associations between mechanism of injury, hazardous drinking, depression, and posttraumatic stress disorder. Secondary objectives were to examine associations prior to and after the onset of the COVID-19 pandemic.

METHODS:

This is a retrospective cohort study of 5 years of trauma registry data of adult trauma patients (older than 18 years) admitted to a Midwestern Level I trauma center conducted from January 2016 to November 2020. Multivariable logistic regression analyses were performed to explore the association of gender, race, and mechanism of injury on hazardous drinking and posttraumatic stress disorder and depression.

RESULTS:

A total of 9,392 trauma patients completed the Alcohol Use Disorders Identification Test—Consumption Items to identify hazardous drinking, and 5,012 completed the Injured Trauma Survivor Screen to identify risk for developing posttraumatic stress disorder and/or depression. The proportion of patients screening positive for hazardous drinking was higher for motor vehicle collisions (21.9%) than for gunshot wounds (17.6%) or falls (18.8%; χ2(2) = 14.311, p < .001). Those involved in motor vehicle collisions were also at a higher risk for the development of depression and posttraumatic stress disorder (54.5%) relative to falls (33.5%) but not gunshot wounds (50.7%; χ2(2) = 200.185, p < .001). The impact of COVID-19 revealed increased hazardous drinking, depression, and posttraumatic stress disorder in patients with falls and motor vehicle collisions but not gunshot wounds.

CONCLUSIONS:

Motor vehicle collision patients are at most risk for hazardous drinking concomitant with risk for depression and posttraumatic stress disorder. These results help focus future research efforts toward interventions that can reduce these risks.
“Was Definitely Different Because They Were Kids”: Caring for Patients From a School Shooting
Authors: McCall W. Travis , Anderson Joel G. , Myers Carole R. , Sagherian Knar , Bamwine Patricia
Published: September 2022

BACKGROUND:

Trauma nurses may experience secondary traumatic stress, compassion fatigue, and burnout as their clinical roles expose them to patients with traumatic injuries. Because traumatic events described as being most stressful for nurses involve sudden death or children and adolescents, multicasualty, school-associated shooting events are likely to be particularly stressful for nurses who care for the affected patients.

OBJECTIVE:

This research examined the psychosocial effects of caring for patients in an inpatient trauma unit following a multicasualty, school-associated shooting event.

METHODS:

This research was guided by a qualitative case series approach, a theory of secondary traumatic stress, and the compassion fatigue resilience model. Registered nurses who provided care in the trauma unit of a Level I trauma center to patients who were injured during a multicasualty, school-associated shooting event in the Southeastern United States were invited to participate.

RESULTS:

The three themes identified by this research were (a) innocence of the patients, (b) trajectories of increased emotions, and (c) processing emotional stressors. Nurses reported the benefits of peer support and provided recommendations to increase the efficacy of formal debriefing sessions.

CONCLUSIONS:

Nurses value self-care routines and peer support as coping mechanisms to foster well-being following exposure to traumatic events. Hospitals should encourage active participation in timely critical incident stress debriefings and promote the use of employee assistance services to support nursing staff after these events.
Obstructive coronary artery disease in symptomatic diabetics with zero coronary calcium score: are we missing something?
Authors: Calicchio Francesca , Manubolu Venkat Sanjay , Dahal Suraj , Kinninger April , Havistin Ruby , Lakshmanan Suvasini , Ahmad Khadije , Roy Sion K. , Budoff Matthew J.
Published: September 2022

Background

Prevalence and severity of coronary artery disease (CAD) in symptomatic patients with zero coronary artery calcium score (CACS) are unclear, particularly in regard to the diabetic population, which represents, per se, a subgroup at increased cardiovascular risk. The aim of this study was to investigate the prevalence and severity of CAD by coronary computed tomography angiography (CCTA) in a symptomatic diabetic cohort with zero CACS.

Methods

All consecutive symptomatic diabetics referred for CAD suspicion were included in this study. All subjects underwent a noncontrast coronary artery calcium scan followed by CCTA. CACS was quantified using the Agatston method. CAD was defined as a total plaque score (TPS) greater than zero. Obstructive and severe obstructive CAD were defined respectively as luminal stenosis >50% and >70% in at least one coronary segment.

Results

We identified 1722 symptomatic diabetics (mean age 62.5 ± 12.9 years, 62% men). One hundred and eleven subjects had zero CACS and TPS >0 (mean age was 49.5 ± 14.8, 58% women, 56% Hispanics). Sixty-five patients (58.5%) had one-vessel disease, followed by 30 (27%) with two-vessel disease and 14 (12.6%) with ≥ three-vessel disease. Obstructive CAD was found in 11 subjects and, among these, three were categorized as severe obstructive CAD.

Conclusion

In symptomatic diabetic patients with zero CACS, CAD, including obstructive disease, can still occur and is predominant in middle-aged adults, women and Hispanics. In symptomatic diabetics CCTA is a critical step for accurate risk stratification even when CACS would have placed some of these individuals in a lower-risk category.
Edward Spitzka's 1883 Textbook
Authors: Kendler Kenneth S.
Published: September 2022

Edward Spitzka, a prominent New York–based alienist, who spent 3 years in Germany studying psychiatry, published a textbook in 1883—the same year as the first edition of Kraepelin's textbook—that contained detailed descriptions of all the seven psychiatric syndromes that formed the basis of Kraepelin's nosologic synthesis: mania, melancholia, katatonia, secondary deteriorations, hebephrenia, circular insanity, and monomania. A study of this text provides us with a “before” picture—a view of the canvas of psychiatric diagnostic categories—from which Kraepelin worked. Studying what Spitzka's diagnostic categories contain and what they are missing highlights the key steps Kraepelin took in the development of his nosologic synthesis. For example, Spitzka does not describe a commonality in symptoms or outcome in katatonia, hebephrenia, and the move severely ill delusional monomaniacs, nor did he link together mania, melancholia, and circular insanity, but instead comments on wide differences in outcome among these three syndromes.
Health System Redesign of Cardiac Monitoring Oversight to Optimize Alarm Management, Safety, and Staff Engagement
Authors: Engel Jill R. , Lindsay Mary , O'Brien Stacey , Granger Christopher B. , Moore Eric S. , Hughes Tracey , Parker Carley , Miller Corinne , Fuchs Mary Ann
Published: September 2022

OBJECTIVE

The purpose of this quality improvement project was to improve health system patient safety by creating a cardiac monitoring structure aligned with national standards.

BACKGROUND

Excessive alarms pose patient safety threats and are often false or clinically insignificant. The Joint Commission identified reduction of nonactionable alarms as a National Patient Safety Goal.

METHODS

The conversion to structured monitoring occurred in 4 phases: 1) defining health system monitoring structure and processes; 2) co-create sessions; 3) implementation and impact analysis; and 4) ongoing evaluation and optimization.

RESULTS

Twenty-two clinical units participated. At the conclusion of phase 4, total 30-day alarm rates decreased by 74% at the academic hospital and by 92% and 95% at the community hospitals and were sustained for 12 months.

CONCLUSIONS

Decreasing alarm frequency can be safely achieved in academic and community hospitals by creating a system-wide monitoring infrastructure and standardized processes that engage interdisciplinary teams.
THE EFFECTIVENESS OF NEUROMUSCULAR ELECTRICAL STIMULATION IN PATIENTS WITH SUBACROMIAL IMPINGEMENT SYNDROME: A RANDOMIZED CONTROLLED STUDY
Authors: Karaaslan Yasemin , Sahbaz Yasemin , Dogan Dildade Dilek , Ziroglu Nezih , Altun Süleyman , Mutlu Ebru Kaya
Published: September 2022

Objective

To compare the effects of exercise training (ET) plus neuromuscular electrical stimulation (NMES) with ET alone on shoulder function, pain, range of motion (ROM), and muscle strength in patients with subacromial impingement syndrome (SIS).

Design

Patients were randomly divided into groups of ET (n:24) and ET + NMES (n:24). Shoulder function was evaluated with the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire, pain level was assessed with a Visual Analogue Scale (VAS), ROM was measured with a goniometer, muscle strength was assessed with a handheld dynamometer baseline and at the end of treatment (week 8).

Results

In both groups, shoulder function, ROM, and muscle strength (except flexion muscle strength in the ET group) increased, while pain decreased (p < 0.05). Compared with the ET group, VAS-activity and VAS-night decreased more, and external rotation ROM and whole muscle strength increased more in the ET + NMES group (p < 0.05). On the other hand, the effect sizes were medium to large for both groups.

Conclusions

The addition of NMES treatment to ET did not improve shoulder function, which is the primary outcome, more than ET alone, but increased muscle strength and ROM (external rotation only) and decreased pain (activity-night), which are the secondary outcomes.
Performance of Creatinine- and Cystatin C-Based Equations for Glomerular Filtration Rate Estimation in HIV-1-Infected Individuals Receiving Dolutegravir + Tenofovir Disoproxil Fumarate + Lamivudine as Initial Antiretroviral Therapy: A Retrospective Observational Study
Authors: Yan Dongmei , Wang Zongzheng , Wang Yan , He Shenghua , Zheng Yongli , Yang Xiaojing , Guo Zhihui , Cai Lin
Published: September 2022

Background:

Dolutegravir (DTG) may inhibit organic cation transporter-2 in renal tubules and elevate serum creatinine levels without true renal function deterioration. There are scarce data on the glomerular filtration rate (GFR) equations in Chinese HIV patients with DTG/TDF/3 TC. This retrospective study was to evaluate the changes in creatinine- and cystatin C-based estimated GFR values among Chinese adult HIV patients with initial highly active antiretroviral therapy (HAART) with DTG/TDF/3 TC for 48 weeks.

Settings:

Retrospective analysis of Chinese adult HIV patients who received initial HAART with DTG/TDF/3 TC between January 2016 and May 2021.

Methods:

We compared the changes in creatinine-based and cystatin C-based estimated GFR before and 48 weeks after HAART to determine the optimal tool for renal function estimation.

Results:

Ninety-five patients [91.58% men; median age, 34 years (interquartile range, 29–44 years)] were enrolled. The median baseline CD4+ cell count was 185 cells/µL [interquartile range, 53–303 cells/µL] and the median baseline viral load was 148,000 copies/mL [interquartile range, 26,800–596,000 copies/mL]. The estimated GFR at 4, 12, and 24 weeks was significantly different than at baseline (P < 0.05) using all 4 equations. Only the GFR estimated using the CKD-EPIcreat and CKD-EPIcys equations was significantly different at 48 weeks of treatment (P < 0.05). The modification of diet in renal disease-based decline of GFR incidence at 4, 12, 24, and 48 weeks of treatment (21.5%, 24.21%, 33.68% and 38.95%, respectively) was higher than that calculated using the other 3 GFR equations.

Conclusions:

The modification of diet in renal disease equation may not be optimal for Chinese HIV-1-infected adults receiving DTG + TDF + 3 TC as the initial antiviral therapy. Clinicians must carefully choose the GFR equation for patients with HIV/hepatitis B virus coinfection.