bluuebunny/crossref_metadata_2025 huggingface dataset:
A Prospective, Randomized, Controlled, Two-Center, International Trial Comparing the Fibular Nail With Open Reduction and Internal Fixation for Unstable Ankle Fractures in Younger Patients
Authors: White Tim O. , Bugler Kate E. , Olsen Lucy , Lundholm Linea Holck , Holck Kim , Madsen Bjoern Lindegaard , Duckworth Andrew D.
Published: April 2021

Objective:

To compare the outcome of fibular nailing with plate fixation for unstable fractures of the ankle in a cohort of patients under the age of 65 years.

Setting:

2 international university trauma centers.

Patients/Participants:

One hundred twenty-five patients who were 18–64 years of age with an acute unstable fracture of the ankle were included in the study.

Intervention:

Patients were randomized to fixation with a fibular nail (n = 63) or plate (n = 62) and were reviewed at 6 weeks, 3 months, 6 months, 1 year, and 2 years after surgery.

Main Outcome Measurements:

The primary outcome measure was the Olerud and Molander score at 1 year. Secondary outcomes were the rates of complications and reinterventions.

Results:

There was no difference between the 2 groups with respect to the primary outcome measure [mean Olerud and Molander score 78.4 in the nail group vs. 80.2 in the plate group (P = 0.621)]. Wound infections occurred in 2 patients who were treated with a nail and 9 patients who were treated with a plate, but this did not reach statistical significance. No difference was seen in the overall rate of complications and reinterventions between groups [28.6% in the nail group vs. 29% in the plate group (P = 0.955)].

Conclusions:

In younger patients with ankle fractures, no difference was found in the patient-reported outcome between fibular nail and plate fixation at 1 year after surgery. The fibular nail is an effective and safe option for the stabilization of ankle fractures in younger patients, although the benefits associated with reduced wound complications are not as apparent as for elderly patients.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Single-cell analysis of angiotensin-converting enzyme II expression in human kidneys and bladders reveals a potential route of 2019 novel coronavirus infection
Authors: Lin Wei , Fan Jue , Hu Long-Fei , Zhang Yan , Ooi Joshua D. , Meng Ting , Jin Peng , Ding Xiang , Peng Long-Kai , Song Lei , Tang Rong , Xiao Zhou , Ao Xiang , Xiao Xiang-Cheng , Zhou Qiao-Ling , Xiao Ping , Zhong Yong
Published: April 2021

Background:

Since 2019, a novel coronavirus named 2019 novel coronavirus (2019-nCoV) has emerged worldwide. Apart from fever and respiratory complications, acute kidney injury has been observed in a few patients with coronavirus disease 2019. Furthermore, according to recent findings, the virus has been detected in urine. Angiotensin-converting enzyme II (ACE2) has been proposed to serve as the receptor for the entry of 2019-nCoV, which is the same as that for the severe acute respiratory syndrome. This study aimed to investigate the possible cause of kidney damage and the potential route of 2019-nCoV infection in the urinary system.

Methods:

We used both published kidney and bladder cell atlas data and new independent kidney single-cell RNA sequencing data generated in-house to evaluate ACE2 gene expression in all cell types in healthy kidneys and bladders. The Pearson correlation coefficients between ACE2 and all other genes were first generated. Then, genes with r values larger than 0.1 and P values smaller than 0.01 were deemed significant co-expression genes with ACE2.

Results:

Our results showed the enriched expression of ACE2 in all subtypes of proximal tubule (PT) cells of the kidney. ACE2 expression was found in 5.12%, 5.80%, and 14.38% of the proximal convoluted tubule cells, PT cells, and proximal straight tubule cells, respectively, in three published kidney cell atlas datasets. In addition, ACE2 expression was also confirmed in 12.05%, 6.80%, and 10.20% of cells of the proximal convoluted tubule, PT, and proximal straight tubule, respectively, in our own two healthy kidney samples. For the analysis of public data from three bladder samples, ACE2 expression was low but detectable in bladder epithelial cells. Only 0.25% and 1.28% of intermediate cells and umbrella cells, respectively, had ACE2 expression.

Conclusion:

This study has provided bioinformatics evidence of the potential route of 2019-nCoV infection in the urinary system.
Associations between polygenic risk score for age at menarche and menopause, reproductive timing, and serum hormone levels in multiple race/ethnic groups
Authors: Zhao Wei , Smith Jennifer A. , Bielak Lawrence F. , Ruiz-Narvaez Edward A. , Yu Miao , Hood Michelle M. , Peyser Patricia A. , Kardia Sharon L.R. , Harlow Sioban D.
Published: April 2021

Objective:

We assessed associations of genetic loci that contribute to age at menarche and menopause with sentinel menopausal traits in multiple race/ethnic groups.

Methods:

Genetic data from the Study of Women's Health Across the Nation include 738 White, 366 Black, 139 Chinese, and 145 Japanese women aged 42 to 52 at baseline. We constructed standardized polygenic risk scores (PRSs) using single nucleotide polymorphisms identified from large-scale genome-wide association studies meta-analyses of ages at menopause and menarche, evaluating associations with each trait within each race/ethnic group.

Results:

Menopause PRS was significantly associated with age at menopause in White women after Bonferroni correction (P < 0.004) and nominally associated in Chinese and Japanese women (P < 0.05) (7.4-8.5 mo delay for one standard deviation [SD] increase in PRS). Menarche PRS was significantly associated with age at menarche in White (P < 0.004) and nominally associated in Black and Japanese women (P < 0.05) (2.6-4.8 mo delay for one SD increase). In White women, menarche and menopause PRSs were significantly associated (P < 0.004) with shorter and longer (5.9 and 9.6 mo for one SD increase) reproductive lifespans, respectively, and menopause PRS with a longer menopausal transition (7.1 mo for one SD increase). We observed a significant positive association (P < 0.004) between menopause PRS and E2 level 2 years before menopause and a nominal association (P < 0.05) 2 years after menopause in Japanese women.

Conclusions:

In addition to menopausal timing, PRSs associated with onset and ending of reproductive life were associated with reproductive lifespan, length of the menopausal transition, and E2 levels in different race/ethnic groups.
Derivation and Internal Validation of a Prediction Model for Pediatric Hand Fracture Triage
Authors: Hartley Rebecca L. , Fraulin Frankie O.G. , Harrop A. Robertson , Faris Peter , Wick James , Ronksley Paul E.
Published: April 2021

Background:

Pediatric hand fractures are common, and most can be managed by a period of immobilization. However, it remains challenging to identify those more complex fractures requiring the expertise of a hand surgeon to ensure a good outcome. The purpose of this study was to develop a prediction model for identification of complex pediatric hand fractures requiring care by a hand surgeon.

Methods:

A 2-year retrospective cohort study of consecutively referred pediatric (<18 years) hand fracture patients was used to derive and internally validate a prediction model for identification of complex fractures requiring the expertise of a hand surgeon. These complex fractures were defined as those that required surgery, closed reduction, or four or more appointments with a hand surgeon. The model, derived by multivariable logistic regression analysis, was internally validated using bootstrapping and then translated into a risk index.

Results:

Of 1170 fractures, 416 (35.6%) met criteria for a complex fracture. Multivariable regression analysis identified six significant predictors of complex fracture: open fracture, rotational deformity, angulation, condylar involvement, dislocation or subluxation, and displacement. Internal validation demonstrated good performance of the model (C-statistic = 0.88, calibration curve p = 0.935). A threshold of ≥1 point (ie, any one of the predictors) resulted in a simple, easy-to-use tool with 96.4% sensitivity and 45.5% specificity.

Conclusions:

A high-performing and clinically useful decision support tool was developed for emergency and urgent care physicians providing initial assessment for children with hand fractures. This tool will provide the basis for development of a clinical care pathway for pediatric hand fractures.
The clinical prognostic value of lncRNA LINC00675 in cancer patients
Authors: Hua Hao , Wang Jie , Zhong Pingyong , Mou Tinggang , Liu Pan , Xie Fei
Published: April 2021

A newly discovered long non-coding RNA (lncRNA) is associated with the progression of a variety of tumors. The purpose of this meta-analysis is to explore further the relationship between clinicopathological features and the prognostic value of LINC00675 in caners.

We searched the various database, including PubMed, Web of Science, Cochrane Library, Embase together with Wanfang, and China National Knowledge Infrastructure for articles on LINC00675 and clinicopathological characteristics and prognosis of patients with cancers before February 20, 2020. According to the inclusion and exclusion criteria, the studies that meet the criteria were systematically collected through search keywords. The Newcastle Ottawa document quality assessment system was used to evaluate the quality of documents. The required data from literature were extracted, and the hazard ratio (HR), odds ratio (OR), and 95confidence interval (CI) were calculated using stata12.0 software and RevMan5.3 software.

A total of 5 studies covering 462 patients were included in this meta-analysis to evaluate the prognostic value of LINC00675 in cancers. Our results showed that high LINC00675 expression was significantly correlated with poor overall survival (OS) (HR = 1.60, 95% CI: 1.23–2.08, P = .0005). Additionally, upregulated expression of LINC00675 was significantly associated with tumor node metastasis stage (OR = 1.74, 95% CI: 1.18–2.58, P = .006) and distant metastasis (OR = 2.22, 95% CI: 1.21–4.08, P = .01).

Our study suggests that LINC00675 could be used as a biomarker to evaluate the prognosis of cancer patients. More studies to further confirm that the clinical value of LINC00675 in cancers will be required.
The incidence of herpes zoster in patients with diabetes mellitus
Authors: Lai Shih-Wei , Liu Chiu-Shong , Kuo Yu-Hung , Lin Cheng-Li , Hwang Bing-Fang , Liao Kuan-Fu
Published: April 2021

The research has correlated the risk factors of herpes zoster with some chronic diseases. This meta-analysis aimed to assess the incidence of herpes zoster in patients with diabetes mellitus.

We conducted a literature search using Web of Science and PubMed for articles published from January 1, 2000 to December 31, 2019. The incidence rate ratio and 95% confidence interval for herpes zoster associated with diabetes mellitus was calculated.

We included 5 cohort studies for a meta-analysis. The pooled incidences of herpes zoster in patients with diabetes mellitus and in patients without diabetes mellitus were 7.22 and 4.12 per 1000 person-years. The overall risk of developing herpes zoster was significantly higher in patients with diabetes mellitus when compared to those with no diabetes mellitus (incidence rate ratio = 1.60, 95% confidence interval = 1.33–1.93).

Patients with diabetes mellitus are substantially at increased risk for the development of herpes zoster. Patients with diabetes mellitus should take into consideration the vaccination to prevent herpes zoster.
Effect of portal vein thrombosis on the prognosis of patients with cirrhosis without a liver transplant
Authors: Xian Jianchun , Tang Yongzhi , Shao Hui , Wang Xuequan , Zhang Meixian , Xing Tongjing
Published: April 2021

Background:

Portal vein thrombosis (PVT) is a relatively common complication of cirrhosis. However, the effect of PVT on the prognosis might not be unequivocal. A systematic review and meta-analysis were performed to investigate the effect of PVT on the prognosis of patients with cirrhosis who have not received a liver transplant.

Methods:

Three databases, including PubMed, EMBASE, and Cochrane Library, were searched for studies published up to March 2020. The survival or mortality rate of patients with PVT served as the main index to evaluate the prognosis of these patients. Hepatic decompensation served as the index of disease progression. Meta-analyses were conducted using Review Manager software 5.2.

Results:

Sixteen clinical studies were included and analyzed. PVT was associated with an increased risk of mortality in patients with decompensated cirrhosis. According to the meta-analysis, patients with cirrhosis presenting with PVT had a lower 1-year survival rate than patients without PVT (odds ratio (OR), 0.32; 95% confidence interval (CI), 0.14–0.75; P = .008). The cumulative survival rates were similar between the 2 groups at 3 years (OR, 1.04; 95% CI, 1.00–1.08; P = .06), 5 years (OR, 1.33; 95% CI, 0.71–2.48; P = .38) and 10 years (OR, 1.24; 95% CI, 0.79–1.93; P = .35). PVT was associated with a higher mortality rate in patients with Child-Pugh class B and C disease. A significantly increased risk of death was observed in patients with complete PVT. Patients with both PVT and cirrhosis had a higher rate of decompensation than patients without PVT.

Conclusions:

The presence of PVT might exert a slight effect on the overall prognosis of patients with cirrhosis. PVT might mainly affect the short-term prognosis by increasing hepatic decompensation events in patients with cirrhosis. However, PVT might not influence the long-term prognosis of patients with cirrhosis.
Linggui Zhugan Decoction for peripheral vertigo
Authors: Ma Hongmei , Guo Liang , Chen Yong , Lan Wanning , Zheng Jiyuan , Li Danyun , Chen Ziyin , Hou Xinju
Published: April 2021

Background:

Vertigo is a sense of movement or rotation of the patient's own or an external object. At present, western medicine treatment such as vestibular suppressant medications commonly used in clinical practice are ineffective and have adverse reactions. In traditional Chinese medicine, Linggui Zhugan Decoction (LZD) was used by doctors to warm yang for resolving fluid retention, strengthen the spleen and clear away dampness, with significant effect. Recently, some clinical studies have also shown that LZD has reliable effect in treating peripheral vertigo, but there is no systematic evidence. Therefore, this study aims to objectively evaluate the efficacy and safety of LZD in the treatment of peripheral vertigo.

Methods:

Eight electronic databases will be searched from inception to August 2020 by 2 independent researchers, in order to collect qualified randomized controlled trials (RCTs) on the LZD treatment for peripheral vertigo. The therapeutic effects according to Clinical efficacy will be adopted as the primary outcomes. RevMan V.5.3 software will be used for the data synthesis and the Cochrane's risk of bias assessment tool will be used to assess the risk of bias.

Results:

This review will conduct a high-quality synthesis on present evidence of LZD for peripheral vertigo.

Conclusion:

The conclusion of the study will indicate whether LZD is an effective treatment for peripheral vertigo by providing updated evidence.

PROSPERO registration number:

PROSPERO CRD 42021238817.
Association of betatrophin amounts with 25-(OH)D levels in patients with gestational diabetes mellitus
Authors: Yang Fuyan , Yang Wenfa , Wang Guohua , Liu Yaqiong , Jin Jun
Published: April 2021

To determine the association of betatrophin amounts with 25-(OH)D levels in gestational diabetes mellitus (GDM) patients, and to provide new targets for the prevention and treatment of GDM.

This study included 40 GDM patients (GDM group) and 37 healthy pregnant women (control group). Betatrophin, 25-(OH)D, fasting blood glucose (FBG), HbA1c, hsCRP, and FINS levels in peripheral blood, as well as betatrophin and 25-(OH)D amounts in cord blood, were measured. Then, associations of betatrophin levels with 25-(OH)D amounts and other indexes were determined.

Maternal (P = .011) and cord (P = .022) blood betatrophin levels were significantly lower in the GDM group compared with control group. Cord blood betatrophin levels were higher compared with maternal blood amounts in both the GDM and control groups (both P = .000). Serum betatrophin levels were positively associated with 25-(OH)D levels (r = 0.677, P = .000), but negatively associated with hsCRP (r = −0.335, P = .037) and HOMA-IR (r = −0.346, P = .031) levels in the GDM group. Fetal weight was higher in the GDM group compared with control group (P = .023), and negatively associated with cord blood betatrophin amounts in the GDM group (r = −0.342, P = .031). However, cord blood betatrophin levels were not significantly associated with body length, Apgar score, and cord blood 25-(OH)D levels in the GDM group (all P > .05).

Serum betatrophin and 25-(OH) D levels were positively associated in women with GDM, and both significantly lower compared with control values. Fetal weight was higher in the GDM group and associated with cord blood betatrophin. These findings provide insights into developing new predictive biomarkers or therapeutic targets for GDM.
Efficacy and safety of intermittent vs continuous furosemide for heart failure concomitant renal dysfunction
Authors: Chen Siqi , Lin Yan , Zhou Meiyang , Zhou Canxin
Published: April 2021

Background:

Currently, there are no meta-analyses evaluating the efficacy and safety of intermittent vs continuous furosemide for heart failure concomitant renal dysfunction. Our protocol is conceived to evaluate the efficacy and safety of intermittent vs continuous furosemide for heart failure concomitant renal dysfunction.

Methods:

We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines and the recommendations of the Cochrane Collaboration to conduct this meta-analysis. The systematic review protocol has been registered in Open Science Framework registries. The following databases including PubMed, Cochrane Library, Web of Science, and EMBASE will be searched using the key phrases “loop diuretics,” “furosemide,” “heart failure,” and “renal dysfunction” for all randomized clinical trials (RCTs) published up to May 2021. Revman 5.3 (Nordic Cochrane Centre, Denmark) will be used to complete the meta-analysis and generate forest plots. We will choose between a fixed effects and random effects model based upon the heterogeneity of included studies. Significance will be set at P < .05.

Results:

Our protocol is conceived to test the hypothesis that continuous furosemide could lead to better outcomes in patients presenting with heart failure concomitant renal dysfunction.

Registration number:

10.17605/OSF.IO/CQZRS.
Developing Effective Senior Nurse Leaders
Authors: Sisk Bryan W. , Mosier Sammie S. , Williams Marjory D. , Coppin John D. , Robinson Denise
Published: April 2021

OBJECTIVE

The aim of this study was to measure structural empowerment (SE) and capture short-term changes in perception for senior nurse leaders before and after a formal development experience.

BACKGROUND

The body of literature related to SE in senior nurse leaders is limited. Applying the SE concept to senior levels of nursing leadership provides a vehicle to impact nurse leader retention and ultimately the organization beyond singular units.

METHODS

The Advanced Leadership Program (ALP) was designed in collaboration with the American Nurses Association to support personal and professional development for senior nurse leaders. The sample included 28 participants from the United States and the United Kingdom over a 6-month period.

RESULTS

The effect of the intervention was seen in the postintervention survey rating SE higher in 5 of 7 domains as compared with the preintervention survey, reduction in overall turnover, and improvements in patient experience scores. Additionally, the participants evaluated the program in top categories, and comments were highly positive around peer support, improved working relationships, and expectations.

CONCLUSION

The ALP has shown promise in strengthening SE for senior nurse leaders by supporting leadership skill development, follow-up training, and peer network development.
Prediction Models of Adnexal Masses: State-of-the-Art Review
Authors: Mina Maria , Kosmas Ioannis , Tsakiridis Ioannis , Mamopoulos Apostolos , Kalogiannidis Ioannis , Athanasiadis Apostolos , Dagklis Themistoklis
Published: April 2021

Importance

Several predictive models and scoring systems have been developed to differentiate between benign and malignant ovarian masses, in order to guide effective management. These models use combinations of patient characteristics, ultrasound markers, and biochemical markers.

Objective

The aim of this study was to describe, compare, and prioritize, according to their strengths and qualities, all the adnexal prediction models.

Evidence Acquisition

This was a state-of-the-art review, synthesizing the findings of the current published literature on the available prediction models of adnexal masses.

Results

The existing models include subjective assessment by expert sonographers, the International Ovarian Tumor Analysis models (logistic regression models 1 and 2, Simple Rules, 3-step strategy, and ADNEX [Assessment of Different NEoplasias in the adneXa] model), the Risk of Malignancy Index, the Risk of Malignancy Ovarian Algorithm, the Gynecologic Imaging Reporting and Data System, and the Ovarian-Adnexal Reporting and Data System. Overall, subjective assessment appears to be superior to all prediction models. However, the International Ovarian Tumor Analysis models are probably the best available methods for nonexpert examiners. The Ovarian-Adnexal Reporting and Data System is an international approach that incorporates both the common European and North American approaches, but still needs to be validated.

Conclusions

Many prediction models exist for the assessment of adnexal masses. The adoption of a particular model is based on local guidelines, as well as sonographer's experience. The safety of expectant management of adnexal masses with benign ultrasound morphology is still under investigation.

Target Audience

Obstetricians and gynecologists, family physicians.

Learning Objectives

After participating in this activity, the learner should be better able to explain all the aspects on the available prediction models of adnexal masses; assess the available prediction models of adnexal masses in terms of their accuracy; and describe the sonographic findings of an adnexal mass and estimate the relevant malignancy risk.
Outcomes of Enhanced Recovery After Surgery (ERAS) in Gynecologic Oncology—A Systematic Review and Meta-analysis
Authors: Bisch S. P. , Jago C. A. , Kalogera E. , Ganshorn H. , Meyer L. A. , Ramirez P. T. , Dowdy S. C. , Nelson G.
Published: April 2021

(Abstracted from Gynecol Oncol 2021;161:46–55)

Enhanced recovery after surgery (ERAS) pathways aim to reduce length of stay (LOS) and complications postoperatively and have demonstrated substantial benefit in these metrics across a wide range of surgical fields. Despite this evidence, the adoption of ERAS in gynecologic oncology on a global scale remains low, and some centers show minimal improvement in clinical outcomes after ERAS adoption.
Assessing the Performance of the De Novo Postoperative Stress Urinary Incontinence Calculator
Authors: Ross James H. , Carter-Brooks Charelle M. , Ruppert Kristine M. , Giugale Lauren E. , Shepherd Jonathan P. , Zyczynski Halina M.
Published: April 2021

(Abstracted from Female Pelvic Med Reconstr Surg 2021;27:23–27)

In recent years, the evidence-based recommendation that a prophylactic incontinence procedure be performed at the time of advanced prolapse surgery (to reduce the incidence of de novo stress urinary incontinence [SUI]) has been challenged. Reduction stress testing and surgeon's judgment may be unreliable, further challenging benefits of a prophylactic concomitant incontinence procedure.
The Effect of Spinal Hypotension and Anesthesia-to-Delivery Time Interval on Neonatal Outcomes in Planned Cesarean Delivery
Authors: Knigin David , Avidan Alexander , Weiniger Carolyn F.
Published: April 2021

(Abstracted from Am J Obstet Gynecol 2020;223:747.e1–747.e13)

Maternal hypotension after spinal anesthesia is a common complication. Previous studies have shown that spinal hypotension is associated with neonatal acidosis.
Acellular Dermal Matrix–Associated Complications in Implant-Based Breast Reconstruction: A Multicenter, Prospective, Randomized Controlled Clinical Trial Comparing Two Human Tissues
Authors: Broyles Justin M. , Liao Eric C. , Kim John , Heistein Jonathan , Sisco Mark , Karp Nolan , Lau Frank H. , Chun Yoon S.
Published: April 2021

Background:

Implant-based breast reconstruction accounts for the vast majority of breast reconstruction procedures and is commonly performed with human acellular dermal matrix. There is no consensus as to the optimal human acellular dermal matrix preparation, and high-quality evidence concerning comparative effectiveness is lacking. This study is the first prospective, multicenter, randomized controlled clinical trial to compare human acellular dermal matrix–related complications of the two most commonly used human acellular dermal matrices in implant-based breast reconstruction. The authors hypothesize that there will be no difference in infection, seroma, and reconstructive failure between FlexHD Pliable and AlloDerm RTU.

Methods:

The authors conducted a Level 1 prospective, randomized, controlled, multicenter clinical trial to assess complications associated with the use of two human acellular dermal matrices in immediate postmastectomy implant-based breast reconstruction across seven clinical sites. Group A patients received FlexHD Pliable (113 patients with 187 breast reconstructions), and group B patients received AlloDerm RTU (117 patients with 197 breast reconstructions).

Results:

There was no significant difference with respect to patient demographics, indications, comorbidities, and reconstruction approach between groups. Mean follow-up time was 10.7 ± 3.2 months. There was no statistical difference in the overall matrix-related complications between groups A and B (4.3 percent versus 7.1 percent, p = 0.233). Obesity (OR, 1.14; 95 percent CI, 1.05 to 1.24; p = 0.001) and prepectoral placement of matrix (OR, 4.53; 95 percent CI, 1.82 to 11.3; p = 0.001) were independently associated with greater risks of overall matrix-related complications.

Conclusion:

This work supports the use of human acellular dermal matrices in implant-based breast reconstruction and demonstrates no significant difference in matrix-related complication rates between FlexHD Pliable and AlloDerm RTU.

Clinical Question/Level of Evidence:

Therapeutic, I.
Lipidome association with vascular disease and inflammation in HIV+ Ugandan children
Authors: Dirajlal-Fargo Sahera , Sattar Abdus , Yu Jiao , Albar Zainab , Chaves Fabio C. , Riedl Ken , Kityo Cissy , Bowman Emily , McComsey Grace A. , Funderburg Nicholas
Published: April 2021

Objective:

HIV infection and antiretroviral therapy (ART) have both been linked to dyslipidemia and increased cardiovascular disease (CVD). The relationships among the lipidome, immune activation, and subclinical vascular disease in children with perinatally acquired HIV (PHIV) have not been investigated.

Methods:

Serum lipid composition, including 13 lipid classes constituting 850 different lipid species were measured by direct infusion-tandem mass spectrometry in samples from 20 ART-treated PHIV and 20 age-matched and sex-matched HIV− Ugandan children. All participants were between 10 and 18 years of age with no other known active infections. PHIVs had HIV-1 RNA level 50 copies/ml or less. In addition, common carotid artery intima--media thickness (IMT), as well as plasma marker of systemic inflammation (hsCRP, IL6, sTNFRa I), monocyte activation (soluble CD14 and CD163), and T-cell activation (expression of CD38 and HLA-DR on CD4+ and CD8+) were evaluated.

Results:

Median age (Q1, Q3) of study participants was 13 years (11, 15), 37% were boys, 75% were on an NNRTI-based ART regimen. The concentrations of cholesterol ester, LCER, phosphatidylcholines, and sphingomyelin lipid classes were significantly increased in serum of PHIV compared with HIV (P≤0.04). Biomarkers associated with CVD risk including hsCRP, sCD163, and T-cell activation were directly correlated with lipid species in PHIV (P ≤ 0.04). Contents of free fatty acids including palmitic (16 : 0), stearic (18 : 0), and arachidic acid (20 : 0) were positively correlated with IMT in PHIV.

Conclusion:

Serum lipidome is altered in young virally suppressed PHIV on ART. A direct association between inflammation and lipid species known to be associated with CVD was observed.
The multiplicity of analysis strategies jeopardizes replicability: lessons learned across disciplines
Authors: Hoffmann Sabine , Schönbrodt Felix , Elsas Ralf , Wilson Rory , Strasser Ulrich , Boulesteix Anne-Laure
Published: April 2021

For a given research question, there are usually a large variety of possible analysis strategies acceptable according to the scientific standards of the field, and there are concerns that this multiplicity of analysis strategies plays an important role in the non-replicability of research findings. Here, we define a general framework on common sources of uncertainty arising in computational analyses that lead to this multiplicity, and apply this framework within an overview of approaches proposed across disciplines to address the issue. Armed with this framework, and a set of recommendations derived therefrom, researchers will be able to recognize strategies applicable to their field and use them to generate findings more likely to be replicated in future studies, ultimately improving the credibility of the scientific process.
Inhibition mechanism and antibacterial activity of natural antibacterial agent citral on bamboo mould and its anti-mildew effect on bamboo
Authors: Zhang Jingjing , Du Chungui , Li Qi , Hu Ailian , Peng Rui , Sun Fangli , Zhang Weigang
Published: April 2021

Bamboo, a natural material, has been widely used in the fields of decoration, architecture and furniture. However, bamboo is easy to mildew and lose its use value. In this paper, the inhibition mechanism and antibacterial activity of a natural antibacterial agent citral on bamboo mould and its anti-mildew effect on bamboo were studied. The results showed that citral could change the shape of mycelium, destroy the integrity of mycelium structure, cell wall and cell membrane structure, thereby causing leakage of nucleic acids, proteins and other substances in the cell, as well as destroy the pH balance of the inside and outside of the cell, to inhibit or kill mould. When the concentration of citral is 100 mg ml
−1
, the antibacterial rates of citral against
Penicillium citrinum
(PC),
Trichoderma viride
(TV),
Aspergillus niger
(AN) and a hybrid fungi group comprising PC, TV and AN (Hun) were more than 100%. However, compared with the direct effect of citral on mould, the antibacterial property of bamboo treated with citral was significantly reduced, the mildew proof effect can be achieved only if the concentration of citral to treat bamboo is increased to more than twice the concentration of citral directly acting on mould.
The role of sliding in ice stream formation
Authors: Schoof Christian , Mantelli Elisa
Published: April 2021

Ice streams are bands of fast-flowing ice in ice sheets. We investigate their formation as an example of spontaneous pattern formation, based on positive feedbacks between dissipation and basal sliding. Our focus is on temperature-dependent subtemperate sliding, where faster sliding leads to enhanced dissipation and hence warmer temperatures, weak- ening the bed further, and on a similar feedback driven by basal melt water production. Using a novel thermomechanical model, we show that formation of a steady pattern of fast and slow flow can occur through the downstream amplification of noise in basal conditions. This process can lead to the establishment of a clearly defined ice stream separated from slowly flowing, cold-based ice ridges by narrow shear margins. Our model is also able to predict the downstream widening of ice streams due to dissipation and heat transport in these margins. We also show that downward advection of cold ice induced by accelerated sliding is the primary stabilizing mechanism that can suppress ice steam formation altogether, and give an approximate, analytical criterion for pattern formation.
A deepening understanding of animal culture suggests lessons for conservation
Authors: Brakes Philippa , Carroll Emma L. , Dall Sasha R. X. , Keith Sally A. , McGregor Peter K. , Mesnick Sarah L. , Noad Michael J. , Rendell Luke , Robbins Martha M. , Rutz Christian , Thornton Alex , Whiten Andrew , Whiting Martin J. , Aplin Lucy M. , Bearhop Stuart , Ciucci Paolo , Fishlock Vicki , Ford John K. B. , Notarbartolo di Sciara Giuseppe , Simmonds Mark P. , Spina Fernando , Wade Paul R. , Whitehead Hal , Williams James , Garland Ellen C.
Published: April 2021

A key goal of conservation is to protect biodiversity by supporting the long-term persistence of viable, natural populations of wild species. Conservation practice has long been guided by genetic, ecological and demographic indicators of risk. Emerging evidence of animal culture across diverse taxa and its role as a driver of evolutionary diversification, population structure and demographic processes may be essential for augmenting these conventional conservation approaches and decision-making. Animal culture was the focus of a ground-breaking resolution under the Convention on the Conservation of Migratory Species of Wild Animals (CMS), an international treaty operating under the UN Environment Programme. Here, we synthesize existing evidence to demonstrate how social learning and animal culture interact with processes important to conservation management. Specifically, we explore how social learning might influence population viability and be an important resource in response to anthropogenic change, and provide examples of how it can result in phenotypically distinct units with different, socially learnt behavioural strategies. While identifying culture and social learning can be challenging, indirect identification and parsimonious inferences may be informative. Finally, we identify relevant methodologies and provide a framework for viewing behavioural data through a cultural lens which might provide new insights for conservation management.
Phylogenetic relationship of phototrophic heliobacteria and systematic reconsideration of species and genus assignments based on genome sequences of eight species
Authors: Kyndt John A. , Montano Salama Dayana , Meyer Terrance E. , Imhoff Johannes F.
Published: April 2021

The draft genome sequences of five species of named phototrophic heliobacteria in the order

Clostridiales

were determined. Whole genome phylogenetic and average nucleotide identity comparison for the heliobacteria suggests that

Heliobacterium chlorum

and

Heliobacillus mobilis

are closely related to one another and belong to the same genus. The three species

Heliobacterium modesticaldum

,

Heliobacterium undosum

and

Heliobacterium gestii

all belong in the same genus, but are more divergent from Hbt. chlorum and belong in a separate genus, which we suggest to be called Heliomicrobium. Heliorestis convoluta is properly recognized to be in the same genus as Heliorestis acidaminivorans. Heliophilum fasciatum is clearly unlike any other and rightfully belongs in a separate genus.
Permianibacter fluminis sp. nov., isolated from a freshwater stream
Authors: Park Miri S. , Song Jaeho , Chang Jaeho , Joung Yochan , Kang Ilnam , Cho Jang-Cheon
Published: April 2021

A Gram-stain-negative, aerobic, non-motile and rod-shaped bacterium, designated as IMCC34836T, was isolated from a freshwater stream. Phylogenetic analysis based on 16S rRNA gene sequences revealed that strain IMCC34836T was most closely related to

Permianibacter aggregans

HW001T (of the family

Pseudomonadaceae

) with 95.6 % sequence similarity and formed a robust clade with

P. aggregans

HW001T. The draft genome sequence of strain IMCC34836T was 4.4 Mbp in size with 59.1 mol% DNA G+C content. Average nucleotide identity and digital DNA–DNA hybridization values between strain IMCC34836T and

P. aggregans

HW001T were 71.2 and 22.0 %, respectively, indicating that the new strain represents a novel species. The strain contained iso-C15 : 0, summed feature 3 (C16 : 1
 ω6c and/or C16 : 1
 ω7c) and summed feature 9 (iso-C17 : 1
 ω9c and/or C16 : 1 10-methyl) as the major fatty acids and harboured phosphatidylethanolamine, two unidentified aminophospholipids and three unidentified lipids as major polar lipids. The isoprenoid quinone detected in the strain was ubiquinone-8. Based on the phylogenetic and phenotypic characteristics, strain IMCC34836T is considered to represent a novel species of the genus

Permianibacter

, for which the name Permianibacter fluminis sp. nov. is proposed. The type strain is IMCC34836T (=KACC 21755T=NBRC 114416T).
Reclassification of Catabacter hongkongensis as Christensenella hongkongensis comb. nov. based on whole genome analysis
Authors: Liu Xiaoying , Sutter Jessica L. , de la Cuesta-Zuluaga Jacobo , Waters Jillian L. , Youngblut Nicholas D. , Ley Ruth E.
Published: April 2021

The genera

Catabacter

(family ‘Catabacteraceae’) and

Christensenella

(family

Christensenellaceae

) are close relatives within the phylum

Firmicutes

. Members of these genera are strictly anaerobic, non-spore-forming and short straight rods with diverse phenotypes. Phylogenetic analysis of 16S rRNA genes suggest that

Catabacter

splits

Christensenella

into a polyphyletic clade. In an effort to ensure that family/genus names represent monophyletic clades, we performed a whole-genome based analysis of the genomes available for the cultured representatives of these genera: four species of

Christensenella

and two strains of

Catabacter hongkongensis

. A concatenated alignment of 135 shared protein sequences of single-copy core genes present in the included strains indicates that

C. hongkongensis

is indeed nested within the

Christensenella

clade. Based on their evolutionary relationship, we propose the transfer of

Catabacter hongkongensis

to the genus

Christensenella

as Christensenella hongkongensis comb. nov.
Halosimplex halophilum sp. nov. and Halosimplex salinum sp. nov., isolated from saline soil and a salt mine
Authors: Yang Xiao-Yan , Yin Xue-Meng , Hou Jing , Zhu Lin , Cui Heng-Lin
Published: April 2021

A polyphasic study was undertaken to determine the taxonomic position of two halophilic archaeal strains, TH32T and YPL4T, isolated from saline soil and a salt mine in PR China, respectively. Strains TH32T and YPL4T both have two dissimilar 16S rRNA genes. The two strains exhibited sequence similarities of 91.5–95.5 % for 16S rRNA genes and 90.9 % for the rpoB′ gene. Sequence similarities of 16S rRNA genes and the rpoB′ gene between the two strains and the current four members of

Halosimplex

were 90.6–97.4 % and 91.4–93.5 %, respectively. Phylogenetic analysis revealed that the two strains formed different branches separating them from the current

Halosimplex

members. Several phenotypic characteristics differentiate strains TH32T and YPL4T from current

Halosimplex

members. The polar lipids of the two strains are phosphatidic acid, phosphatidylglycerol, phosphatidylglycerol phosphate methyl ester and four glycolipids. Two of the glycolipids are chromatographically identical to disulfated mannosyl glucosyl diether and sulfated mannosyl glucosyl diether, respectively, and the remaining two glycolipids are unidentified. The average nucleotide identity (ANI) and in silico DNA–DNA hybridization (DDH) values between the two strains and the current members of

Halosimplex

(ANI 80.4–89.2 % and in silico DDH 24.0–41.8 %) were much lower than the threshold values proposed as a species boundary, suggesting that the two strains represent novel species of

Halosimplex

. The values between the two strains (ANI 81.3 % and in silico DDH 24.9 %) were also much lower than the recommended threshold values, which revealed that the two strains represent two genomically different species of

Halosimplex

. These results showed that strains TH32T (=CGMCC 1.15190T=JCM 30840T) and YPL4T (=CGMCC 1.15329T=JCM 31108T) represent two novel species of

Halosimplex

, for which the names Halosimplex halophilum sp. nov. and Halosimplex salinum sp. nov. are proposed.
Effect of viral replication and liver fibrosis on all-cause mortality in HIV/HBV coinfected patients: a retrospective analysis of a 15-year longitudinal cohort
Authors: Dezanet Lorenza N. C. , Kassime Raisha , Miailhes Patrick , Lascoux-Combe Caroline , Chas Julie , Maylin Sarah , Gabassi Audrey , Rougier Hayette , Delaugerre Constance , Lacombe Karine , Boyd Anders
Published: April 2021

Background

In patients co-infected with HIV and hepatitis B virus (HBV), widespread tenofovir (TDF)-containing antiretroviral therapy (ART) has led to substantial decreases in HBV-DNA and HIV-RNA detection. However, the link between viral replication, liver fibrosis, and mortality remains unclear.

Methods

300 HIV-HBV co-infected patients undergoing ART were prospectively followed. Virological and clinical data were obtained at baseline and every 6-12 months. We quantified the association between HBV-DNA, HIV-RNA, and liver fibrosis with risk of all-cause mortality using a joint longitudinal-survival model. Viral detection, viral loads, and time-averaged cumulative viral loads of HIV and HBV were modeled as three separate exposures.

Results

During a median 10.5 years (IQR=4.0-14.6), the proportion undergoing TDF-containing ART (baseline=18.7%, end of follow-up=79.1%) and with undetectable HBV-DNA (baseline=36.7%, end of follow-up=94.8%) substantially increased. HIV-RNA was mostly undetectable during follow-up (76.6%). 42 participants died (incidence rate=1.30/100person-years, 95%CI=0.96-1.76). The leading causes of death were non-AIDS/non-liver-related malignancies (28.6%), closely followed by liver-related (16.7%), AIDS-related (16.7%), and other (16.7%). All-cause mortality was associated with HBV-DNA viral load (adjusted-HR per log10IU/mL=1.41, 95%CI=1.04-1.93,p=0.03) or time-averaged cumulative HBV-DNA (adjusted-HR per log10IU-years=1.37, 95%CI=1.03-1.83,p=0.03), but not undetectable HBV-DNA (adjusted-HR=0.30, 95%CI=0.08-1.09,p=0.08). Liver fibrosis at baseline also significantly increased mortality rates (adjusted-HR=2.35, 95%CI=1.16-4.76, p=0.02). No significant association between HIV-RNA replication and mortality was observed.

Conclusions

Concurrent and historical HBV replication and liver fibrosis are important drivers of all-cause mortality in largely TDF-treated HIV-HBV co-infected patients, despite one-fifth of deaths being liver-related. HBV-DNA and liver fibrosis remain important prognostic indicators for this patient population.

Key-points

HBV-DNA levels and cumulative exposure over time increases risk of all-cause mortality in HIV-HBV co-infected patients. Fibrosis was a major determinant of mortality; however, the leading causes of death were malignancies not related to AIDS or HBV-infection.
Proteomic Profiling of MIS-C Patients Reveals Heterogeneity Relating to Interferon Gamma Dysregulation and Vascular Endothelial Dysfunction
Authors: Diorio Caroline , Shraim Rawan , Vella Laura A. , Giles Josephine R. , Baxter Amy E. , Oldridge Derek A. , Canna Scott W. , Henrickson Sarah E. , McNerney Kevin O. , Balamuth Frances , Burudpakdee Chakkapong , Lee Jessica , Leng Tomas , Farrell Alvin , Lambert Michele P. , Sullivan Kathleen E. , John Wherry E. , Teachey David T. , Bassiri Hamid , Behrens Edward M.
Published: April 2021

Multi-system Inflammatory Syndrome in Children (MIS-C) is a major complication of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic in pediatric patients. Weeks after an often mild or asymptomatic initial infection with SARS-CoV-2 children may present with a severe shock-like picture and marked inflammation. Children with MIS-C present with varying degrees of cardiovascular and hyperinflammatory symptoms. We performed a comprehensive analysis of the plasma proteome of more than 1400 proteins in children with SARS-CoV-2. We hypothesized that the proteome would reflect heterogeneity in hyperinflammation and vascular injury, and further identify pathogenic mediators of disease. Protein signatures demonstrated overlap between MIS-C, and the inflammatory syndromes macrophage activation syndrome (MAS) and thrombotic microangiopathy (TMA). We demonstrate that PLA2G2A is a key marker of MIS-C that associates with TMA. We found that IFNγ responses are dysregulated in MIS-C patients, and that IFNγ levels delineate clinical heterogeneity.
Learning longitudinal patterns and identifying subtypes of pediatric Crohn disease treated with infliximab via trajectory cluster analysis of electronic health records
Authors: Chen Andrew , Stein Ronen , Baldassano Robert N. , Huang Jing
Published: April 2021

Background

The current classification of pediatric CD is mainly based on cross-sectional data. The objective of this study is to identify subgroups of pediatric CD through trajectory cluster analysis of disease activity using data from electronic health records.

Methods

We conducted a retrospective study of pediatric CD patients who had been treated with infliximab. The evolution of disease over time was described using trajectory analysis of longitudinal data of C-Reactive Protein (CRP). Patterns of disease evolution were extracted through functional principal components analysis and subgroups were identified based on those patterns using the Gaussian mixture model. We compared patient characteristics, a biomarker for disease activity, received treatments, and long-term surgical outcomes across subgroups.

Results

We identified four subgroups of pediatric CD patients with differential relapse-and-remission risk profiles. They had significantly different disease phenotype (p < 0.001), CRP (p < 0.001) and calprotectin (p = 0.037) at diagnosis, with increasing percentage of inflammatory phenotype and declining CRP and fecal calprotectin levels from Subgroup 1 through 4. The risk of colorectal surgery within 10 years after diagnosis was significantly different between groups (p < 0.001). We did not find statistical significance in gender or age at diagnosis across subgroups, but the BMI z-score was slightly smaller in subgroup 1 (p =0.055).

Conclusions

Readily available longitudinal data from electronic health records can be leveraged to provide a deeper characterization of pediatric Crohn disease. The identified subgroups captured novel forms of variation in pediatric Crohn disease that were not explained by baseline measurements and treatment information.

The current classification of pediatric Crohn disease mainly relies on cross-sectional data, e.g., the Paris classification. However, the phenotypic classification may evolve over time after diagnosis. Our study utilized longitudinal measures from the electronic health records and stratified pediatric Crohn disease patients with differential relapse-and-remission risk profiles based on patterns of disease evolution. We found trajectories of well-maintained low disease activity were associated with less severe disease at baseline, early initiation of infliximab treatment, and lower risk of surgery within 10 years of diagnosis, but the difference was not fully explained by phenotype at diagnosis.