bluuebunny/crossref_metadata_2025 huggingface dataset:
TroR Negatively Regulates the TroABCD System and Is Required for Resistance to Metal Toxicity and Virulence in Streptococcus suis
Authors: Zheng Chengkun , Wei Man , Qiu Jun , Jia Mengdie , Zhou Xiaohui , Jiao Xinan
Published: August 2021

Metals are essential nutrients for life; however, the accumulation of excess metals in cells can be toxic to bacteria. In the present study, we identified a metalloregulator, TroR, in
Streptococcus suis
, which is an emerging zoonotic pathogen.
Giardia duodenalis: Biology and Pathogenesis
Authors: Adam Rodney D.
Published: August 2021

Giardia duodenaliscaptured the attention of Leeuwenhoek in 1681 while he was examining his own diarrheal stool, but, ironically, it did not really gain attention as a human pathogen until the 1960s, when outbreaks were reported. Key technological advances, includingin vitrocultivation, genomic and proteomic databases, and advances in microscopic and molecular approaches, have led to understand that this is a eukaryotic organism with a reduced genome rather than a truly premitochondriate eukaryote.
Canine and Feline Parasitology: Analogies, Differences, and Relevance for Human Health
Authors: Morelli Simone , Diakou Anastasia , Di Cesare Angela , Colombo Mariasole , Traversa Donato
Published: August 2021

Cats and dogs are treated as family members by most pet owners. Therefore, a high quality of veterinary care and preventive medicine is imperative for animal health and welfare and for the protection of humans from zoonotic pathogens.
SARS-CoV-2 Genome Sequencing Methods Differ in Their Abilities To Detect Variants from Low-Viral-Load Samples
Authors: Lam C. , Gray K. , Gall M. , Sadsad R. , Arnott A. , Johnson-Mackinnon J. , Fong W. , Basile K. , Kok J. , Dwyer D. E. , Sintchenko V. , Rockett R. J.
Published: August 2021

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomic surveillance has been vital in understanding the spread of coronavirus disease 2019 (COVID-19), the emergence of viral escape mutants, and variants of concern. However, low viral loads in clinical specimens affect variant calling for phylogenetic analyses and detection of low-frequency variants, important in uncovering infection transmission chains.
A Methyltransferase-Defective Vesicular Stomatitis Virus-Based SARS-CoV-2 Vaccine Candidate Provides Complete Protection against SARS-CoV-2 Infection in Hamsters
Authors: Lu Mijia , Zhang Yuexiu , Dravid Piyush , Li Anzhong , Zeng Cong , KC Mahesh , Trivedi Sheetal , Sharma Himanshu , Chaiwatpongsakorn Supranee , Zani Ashley , Kenney Adam , Cai Chuanxi , Ye Chengjin , Liang Xueya , Qiu Jianming , Martinez-Sobrido Luis , Yount Jacob S. , Boyaka Prosper N. , Liu Shan-Lu , Peeples Mark E. , Kapoor Amit , Li Jianrong
Published: August 2021

Viral mRNA cap methyltransferase (MTase) is essential for mRNA stability, protein translation, and innate immune evasion. Thus, viral mRNA cap MTase activity is a novel target for development of live attenuated or live vectored vaccine candidates.
Pseudorabies Virus Inhibits Type I and Type III Interferon-Induced Signaling via Proteasomal Degradation of Janus Kinases
Authors: Yin Yue , Romero Nicolás , Favoreel Herman W.
Published: August 2021

Type I and III interferons (IFNs) trigger signaling via Janus kinases that phosphorylate and activate signal transducer and activator of transcription (STAT) transcription factors, leading to the expression of antiviral interferon-stimulated genes (ISGs) that result in an antiviral state of host cells. Viruses have evolved various mechanisms to evade this response.
NbPsbO1 Interacts Specifically with the
Bamboo Mosaic Virus
(BaMV) Subgenomic RNA (sgRNA) Promoter and Is Required for Efficient BaMV sgRNA Transcription
Authors: Huang Ying Wen , Sun Chu I , Hu Chung Chi , Tsai Ching Hsiu , Meng Menghsiao , Lin Na Sheng , Hsu Yau Heiu
Published: August 2021

Production of subgenomic RNAs (sgRNAs) for efficient translation of downstream viral proteins is one of the major strategies adapted for viruses that contain a multicistronic RNA genome. Both viral genomic RNA (gRNA) replication and sgRNA transcription rely on the combined activities of viral replicase and host proteins, which recognize promoter regions for the initiation of RNA synthesis.
Enterovirus A71 Induces Neurological Diseases and Dynamic Variants in Oral Infection of Human SCARB2-Transgenic Weaned Mice
Authors: Lin Jing-Yi , Weng Kuo-Feng , Chang Chih-Kuang , Gong Yu-Nong , Huang Guo-Jen , Lee Hui-Lan , Chen Yen-Cheng , Huang Chien-Chih , Lu Jia-Ying , Huang Peng-Nien , Chiang Huan-Jung , Chen Che-Min , Shih Shin-Ru
Published: August 2021

Enterovirus A71 (EV-A71), a positive-strand RNA virus of the
Picornaviridae
, poses a persistent global public health problem. EV-A71 is primarily transmitted through the fecal-oral route, and thus suitable animal models of oral infection are needed to investigate viral pathogenesis.
Profiling Human Cytomegalovirus-Specific T Cell Responses Reveals Novel Immunogenic Open Reading Frames
Authors: Dhanwani Rekha , Dhanda Sandeep Kumar , Pham John , Williams Gregory P. , Sidney John , Grifoni Alba , Picarda Gaelle , Lindestam Arlehamn Cecilia S. , Sette Alessandro , Benedict Chris A.
Published: August 2021

To understand the crucial role of adaptive immunity in controlling cytomegalovirus infection and disease, we systematically analyzed the CMV “ORFeome” to identify new CMV epitopes targeted primarily by CD4 T cells in humans. Our study identified >200 new T cell epitopes derived from both canonical and novel ORFs, highlighting the substantial breadth of the anti-CMV T cell response and providing new targets for vaccine design.
Paramyxovirus-Like Particles as Protein Delivery Vehicles
Authors: Panthi Santosh , Schmitt Phuong Tieu , Lorenz F. Jeffrey , Stanfield Brent A. , Schmitt Anthony P.
Published: August 2021

Therapeutic proteins including transcription factors and genome editors have enormous clinical potential but are currently limited in part due to the challenges of safely and efficiently delivering these proteins to the interiors of target cells. Here, we have developed a new strategy for protein delivery based on manipulation of paramyxovirus genome packaging interactions.
The Potential of Neuraminidase as an Antigen for Nasal Vaccines To Increase Cross-Protection against Influenza Viruses
Authors: Kawai Atsushi , Yamamoto Yasuyuki , Nogimori Takuto , Takeshita Kohei , Yamamoto Takuya , Yoshioka Yasuo
Published: August 2021

Because mismatch between vaccine strains and epidemic strains cannot always be avoided, the development of influenza vaccines that induce broad cross-protection against antigenically mismatched heterologous strains is needed. Although the importance of NA-specific antibodies to cross-protection in humans and experimental animals is becoming clear, the potential of NA as an antigen for providing cross-protection through nasal vaccines is unknown.
Ex Vivo
Infection of Human Skin with Herpes Simplex Virus 1 Reveals Mechanical Wounds as Insufficient Entry Portals via the Skin Surface
Authors: De La Cruz Nydia C. , Möckel Maureen , Wirtz Lisa , Sunaoglu Katharina , Malter Wolfram , Zinser Max , Knebel-Mörsdorf Dagmar
Published: August 2021

The human pathogen herpes simplex virus 1 (HSV-1) invades its host via the skin and mucosa, which leads to primary infection of the epithelium. As the various epithelial barriers effectively protect the tissue against viral invasion, successful infection most likely depends on tissue damage.
Truffle Microbiome Is Driven by Fruit Body Compartmentalization Rather than Soils Conditioned by Different Host Trees
Authors: Liu Dong , Pérez-Moreno Jesus , He Xinhua , Garibay-Orijel Roberto , Yu Fuqiang
Published: August 2021

Currently. the factors that drive the microbiome associated with truffles, the most highly prized fungi in the world, are largely unknown. We demonstrate for the first time here that truffle microbiome composition is strongly driven by associated compartments rather than by symbiotic host trees.
Direct Antibiotic Activity of Bacillibactin Broadens the Biocontrol Range of Bacillus amyloliquefaciens MBI600
Authors: Dimopoulou Anastasia , Theologidis Ioannis , Benaki Dimitra , Koukounia Marilena , Zervakou Amalia , Tzima Aliki , Diallinas George , Hatzinikolaou Dimitris G. , Skandalis Nicholas
Published: August 2021

Siderophores have mostly been studied concerning their contribution to the fitness and virulence of bacterial pathogens. In the present work, we isolated and characterized for the first time the siderophore bacillibactin from a commercial bacterial biocontrol agent.
A Toxic Friend: Genotoxic and Mutagenic Activity of the Probiotic Strain Escherichia coli Nissle 1917
Authors: Nougayrède Jean-Philippe , Chagneau Camille V. , Motta Jean-Paul , Bossuet-Greif Nadège , Belloy Marcy , Taieb Frédéric , Gratadoux Jean-Jacques , Thomas Muriel , Langella Philippe , Oswald Eric
Published: August 2021

Nissle 1917 is sold as a probiotic and considered safe even though it has been known since 2006 that it harbors the genes for colibactin synthesis. Colibactin is a potent genotoxin that is now linked to causative mutations found in human colorectal cancer.
Comparative Genomic and Transcriptomic Analysis of Naegleria fowleri Clinical and Environmental Isolates
Authors: Joseph Sandeep J. , Park Subin , Kelley Alyssa , Roy Shantanu , Cope Jennifer R. , Ali Ibne Karim M.
Published: August 2021

N. fowleri
, the only known
Naegleria
species to infect humans, causes fatal brain disease. PAM cases from 1965 to 2016 showed <20 cases per year globally.
Use of Recombinant Endolysin to Improve Accuracy of Group B Streptococcus Tests
Authors: Matsui Hidehito , Uchiyama Jumpei , Ogata Masaya , Nasukawa Tadahiro , Takemura-Uchiyama Iyo , Kato Shin-ichiro , Murakami Hironobu , Higashide Masato , Hanaki Hideaki
Published: August 2021

Endolysin is a bacteriophage-derived enzyme that degrades the peptidoglycan in the cell wall of host bacteria; it could be used as an antimicrobial agent for selectively eliminating specific bacterial genera/species. Group B
Streptococcus
(GBS) causes neonatal infection via vertical transmission; prenatal GBS screening test, in which enrichment culture is followed by bacterial identification, is used to detect the presence of GBS in pregnant women.
TMPRSS2 and RNA-Dependent RNA Polymerase Are Effective Targets of Therapeutic Intervention for Treatment of COVID-19 Caused by SARS-CoV-2 Variants (B.1.1.7 and B.1.351)
Authors: Lee Jihye , Lee JinAh , Kim Hyeon Ju , Ko Meehyun , Jee Youngmee , Kim Seungtaek
Published: August 2021

The coronavirus disease 2019 (COVID-19) pandemic is causing unprecedented global problems in both public health and human society. While some vaccines and monoclonal antibodies were successfully developed very quickly and are currently being used, numerous variants of the causative agent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are emerging and threatening the efficacy of vaccines and monoclonal antibodies.
The Tudor Domain-Containing Protein BbTdp1 Contributes to Fungal Cell Development, the Cell Cycle, Virulence, and Transcriptional Regulation in the Insect Pathogenic Fungus Beauveria bassiana
Authors: Qiu Lei , Li Ze , Zhang Li , Zhang Tong-Sheng , Hu Shun-Juan , Song Ji-Zheng , Liu Jia-Hua , Zhang Jing , Wang Juan-Juan , Cheng Wen
Published: August 2021

In this study, we used
Beauveria
bassiana
as a biological model to report the role of BbTdp1 in entomopathogenic fungi. Our findings indicated that BbTdp1 contributed significantly to cell development, the cell cycle, and virulence in
B. bassiana
. In addition, deletion of
BbTdp1
led to drastic fluctuations in the transcriptional profile. BbTdp1 can be developed as a novel target for
B. bassiana
development and pathogenicity, which also provides a framework for the study of Tdp1 in other fungi.
Bacteriophage: A Useful Tool for Studying Gut Bacteria Function of Housefly Larvae, Musca domestica
Authors: Zhang Xinyu , Wang Shumin , Li Ting , Zhang Qian , Zhang Ruiling , Zhang Zhong
Published: August 2021

The well-balanced gut microbiota ensures appropriate development of the host insect, such as mosquitoes, cockroaches, and flies. Various intestinal symbiotic bacteria have different influences on the host gut community structure and thus exert different effects on host health.
An NAD-Specific 6-Hydroxy-3-Succinoyl-Semialdehyde-Pyridine Dehydrogenase from Nicotine-Degrading Agrobacterium tumefaciens Strain S33
Authors: Shang Jinmeng , Wang Xia , Zhang Meng , Li Lexin , Wang Rufei , Huang Haiyan , Wang Shuning
Published: August 2021

Nicotine is one of the major toxic
N
-heterocyclic aromatic alkaloids produced in tobacco plants. Manufacturing tobacco and smoking may lead to some environmental and public health problems.
Supplemental Material: Near-constant retreat rate of a terrestrial margin of the Laurentide Ice Sheet during the last deglaciation
Authors: Lowell Thomas V , al. et
Published: August 2021

Methods description, 10Be sample metadata, and modeling results and error calculations.
Supplemental Material: Extreme event-driven sediment aggradation and erosional buffering along a tectonic gradient in southern Taiwan
Authors: DeLisle Clarke , al. et
Published: August 2021

Methods for landslide volume estimation, channel aggradation mapping, sediment transport modeling, and recurrence estimate.
Congenital ADAMTS-13 deficiency presenting as life-threatening thrombosis during pregnancy
Authors: Hasan Faheema , Gupta Anshul , Chandra Dinesh , Nityanand Soniya
Published: August 2021

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease characterised by thrombocytopenia, microangiopathic haemolytic anaemia and microvascular thrombosis. Congenital TTP accounting for less than 5% of all TTP cases can have a late presentation in adulthood mostly triggered by predisposing factors such as infection, pregnancy and inflammation. We present a case of a 23-year-old woman who presented to us in the postpartum period with mesenteric artery thrombosis with infarcts and later was diagnosed as a case of TTP based on congenital a disintegrin and metalloproteinase with thrombospondin type 1 repeats 13 (ADAMTS-13) deficiency detected on ADAMTS-13 levels and gene sequencing. She was successfully managed initially with therapeutic plasma exchanges and is now on prophylactic fortnightly fresh frozen plasma infusions at 15 mL/kg body weight and continues to be in remission.
Acute liver failure in pregnancy due to autoimmune hepatitis
Authors: Sajja Sonia , Idler Jay , Saad Jaber , Bahado-Singh Ray
Published: August 2021

Autoimmune hepatitis is a diagnosis rarely made in pregnancy, especially in the setting of acute liver failure. If unrecognised and untreated, it can result in significant fetal and maternal morbidity and mortality. We report a case of acute liver failure in a patient presenting at 17 weeks’ gestation. She was diagnosed with autoimmune hepatitis via transjugular liver biopsy. Prednisone therapy was initiated, resulting in disease remission for the remainder of her pregnancy. Induction of labour at 37 weeks’ gestation resulted in delivery of a healthy small for gestational age neonate. Prompt diagnosis of a non-obstetrical aetiology for acute liver failure in pregnancy is critical to provide the appropriate therapy to achieve an optimal pregnancy outcome.
Worsening membranous nephropathy in a patient with GIST treated with sunitinib
Authors: Zonoozi Shahrzad , Palmer Matthew , Ursina Teitelbaum , Geara Abdallah
Published: August 2021

Tyrosine kinase inhibitors (TKI) are anticancer agents widely used for a variety of malignancies including gastrointestinal stromal tumours (GIST). Although generally well-tolerated, TKIs have been associated with a number of adverse events including hypertension, proteinuria and nephrotic syndrome. We present the case of a 70-year-old patient with metastatic GIST on long-standing sunitinib who developed hypertension, oedema and hypoalbuminemia with a rising serum creatinine and was found to have nephrotic syndrome. Workup revealed elevated antiphospholipase A2 receptor (PLA2R) antibody IgG titres and a kidney biopsy confirmed PLA2R-positive membranous nephropathy without findings of thrombotic microangiopathy. Cessation of sunitinib led to reduction in anti-PLA2R antibody IgG titres while resumption, due to concern for cancer progression, led to worsening symptoms. Treatment with rituximab led to undetectable anti-PLA2R IgG titres. We highlight the importance of maintaining a systematic approach for evaluating nephrotic syndrome and provide a case showing that TKIs can exacerbate underlying nephrotic syndrome.
Cardiac tamponade secondary to Dressler’s syndrome
Authors: Connaire Stephanie , Elchinova Elena , Bucciarelli-Ducci Chiara , Campbell Philip
Published: August 2021

A 56-year-old woman presented to hospital with chest pain. Following review and investigations in the medical assessment unit, she was diagnosed with costochondritis and discharged home. She represented 10 days later and was mottled and hypotensive with a high lactate, raised inflammatory markers, an acute kidney injury and bilateral loin pain. A CT of the thorax, abdomen and pelvis showed pleural effusions and a large pericardial effusion with features of cardiac tamponade on subsequent echocardiography. A pericardiocentesis was performed and she was admitted to intensive care for haemofiltration. Once the patient was stable, an inpatient cardiac MRI was requested to further investigate an enhancing pericardium and echo-bright areas in the inferior, inferoseptal and inferolateral walls of the left ventricle demonstrated on echocardiography. The cardiac MRI showed evidence of a recent infarction in the right coronary artery (RCA) territory with pericardial inflammation and a resolved pericardial effusion. Overall, the findings were in keeping with Dressler’s syndrome.
Classic Eagle’s Syndrome: Styloidectomy via the Transcervical Approach
Authors: Gupta Monika , Kumar Yajas , Vig Harshita , Rizvi Aliza
Published: August 2021

Eagle’s syndrome was first described by Watt Eagle in 1937, as a syndrome of vague orofacial and cervical pain. He reported two variants, classic styloid and stylocarotid artery syndrome. Eagle’s syndrome is a non-perceived and underdiagnosed clinical condition of the head and neck. This anomalous entity presents with neck pain, globus sensation, difficulty in turning the head, dysphagia, odynophagia and various other symptoms occurring as a result of irritation to the nearby structures. The surgical management of Eagle’s syndrome consists of two major approaches: the transoral and the transcervical approaches. We report a case of classic bilateral elongated styloid process syndrome, treated with transcervical styloidectomy for painful left elongated styloid process. This gave permanent relief to the patient. The transcervical surgical approach for resection of elongated styloid process in patients with Eagle’s syndrome appears to be safe and effective, although the risk for transient marginal mandibular nerve weakness is notable.
Epidemiology of race day injury in young professional jockeys in Great Britain from 2007 to 2018: a retrospective cohort study
Authors: Davies Madeleine , Jackson Kate A , Mackinnon Anna Louise , Turner Alison , Kuznik Kerry , Hill Jerry , Newton Julia L , Sanchez Santos Maria
Published: August 2021

Introduction

There are limited injury data in professional horse racing, particularly by sex.

Objectives

To describe injury incidence, characteristics and falls in male and female, flat and jump jockeys in Great Britain.

Design and setting

Retrospective cohort study of professional jockeys in Britain.

Participants

245 jockeys licensed between 2007 and 2017.

Primary and secondary outcome measures

The primary outcome measure was injury on a race day. Injury incidence (per 1000 rides; per 1000 falls) was derived. Incidence-rate ratios (IRR) were calculated to compare incidence between flat and jump racing, male and female jockeys, and male flat and male jump jockeys for: (i) injury incidence, (ii) fall incidence and (iii) injuries per fall.

Results

234 British professional jockeys were included. Jockeys were on average 19.5±2.0 years old at licence date, 79.9% male and 58.1% flat. The time of follow-up (racing in the study) was 3.7 (SD=2.3) years. There were 278 injuries, occurring in-race (81.7%), in the stalls (10.8%) or parade ring (6.1%). After one injury was removed to preserve anonymity, 57.2% were soft tissue injuries, 25.3% fractures and 10.5% concussion. There were 1634 falls, with 92% in male jump racing. The injury incidence was higher in jump racing (5.1 vs 1.0/1000 jockey rides). The falls incidence was 1.8/1000 rides in flat and 46.2/1000 rides in jump racing (IRR 0.04, 95% CI 0.03 to 0.04). There were over five times higher injuries/1000 falls in flat than jump racing (IRR 5.56, 95% CI 4.05 to 7.53). Male flat jockeys fell less than female flat (IRR 0.57, 95% CI 0.35 to 0.97).

Conclusion

Most injuries occurred in-race and were soft tissue injuries. Jump jockeys fell more often than flat, and female flat jockeys fell more often than male flat. Flat jockeys injured more frequently when falling. No sex differences were seen for injuries per fall.
Does robotic-assisted unicompartmental knee arthroplasty have lower complication and revision rates than the conventional procedure? A systematic review and meta-analysis
Authors: Sun Yifeng , Liu Wei , Hou Jian , Hu Xiuhua , Zhang Wenqiang
Published: August 2021

Objective

We conducted this systematic review and meta-analysis of studies on patients who underwent unicompartmental knee arthroplasty (UKA) to compare the complication rates, revision rates and non-implant-specific complications between robotic-assisted and conventional UKA.

Design

Systematic review and meta-analysis.

Data sources

The PubMed, Embase, Web of Science and Cochrane databases were searched up to 30 June 2020.

Eligibility criteria

Case–control studies comparing robotic-assisted and conventional UKA.

Data extraction and synthesis

Data from all eligible articles were independently extracted by two authors. We analysed the differences in outcomes between robotic-assisted and conventional UKA by calculating the corresponding 95% CIs and pooled relative risks (RRs). Heterogeneity was assessed using the χ2and I2tests. All analyses were performed using the ‘metafor’ package of R V.3.6.2 software.

Results

A total of 16 studies involving 50 024 patients were included in the final meta-analysis. We found that robotic-assisted UKA had fewer complications (RR: 0.52, 95% CI: 0.28 to 0.96, p=0.036) and lower revision rates (RR: 0.42, 95% CI: 0.20 to 0.86, p=0.017) than conventional UKA. We observed no significant differences in non-implant-specific complications between the two surgical techniques (RR: 0.80, 95% CI: 0.61 to 1.04, p=0.96). No publication bias was found in this meta-analysis.

Conclusions

This study provides evidence that robotic-assisted UKA has fewer complications and lower revision rates than conventional UKA; however, owing to important limitations, the results lack reliability, and more studies are required.

PROSPERO registration number

CRD42021246927.
Shared decision-making in the ICU from the perspective of physicians, nurses and patients: a qualitative interview study
Authors: Wubben Nina , van den Boogaard Mark , van der Hoeven JG , Zegers Marieke
Published: August 2021

Objective

To identify views, experiences and needs for shared decision-making (SDM) in the intensive care unit (ICU) according to ICU physicians, ICU nurses and former ICU patients and their close family members.

Design

Qualitative study.

Setting

Two Dutch tertiary centres.

Participants

19 interviews were held with 29 participants: seven with ICU physicians from two tertiary centres, five with ICU nurses from one tertiary centre and nine with former ICU patients, of whom seven brought one or two of their close family members who had been involved in the ICU stay.

Results

Three themes, encompassing a total of 16 categories, were identified pertaining to struggles of ICU physicians, needs of former ICU patients and their family members and the preferred role of ICU nurses. The main struggles ICU physicians encountered with SDM include uncertainty about long-term health outcomes, time constraints, feeling pressure because of having final responsibility and a fear of losing control. Former patients and family members mainly expressed aspects they missed, such as not feeling included in ICU treatment decisions and a lack of information about long-term outcomes and recovery. ICU nurses reported mainly opportunities to strengthen their role in incorporating non-medical information in the ICU decision-making process and as liaison between physicians and patients and family.

Conclusions

Interviewed stakeholders reported struggles, needs and an elucidation of their current and preferred role in the SDM process in the ICU. This study signals an essential need for more long-term outcome information, a more informal inclusion of patients and their family members in decision-making processes and a more substantial role for ICU nurses to integrate patients’ values and needs in the decision-making process.
Early diagnosis of coeliac disease in the Preventive Youth Health Care Centres in the Netherlands: study protocol of a case finding study (GLUTENSCREEN)
Authors: Meijer-Boekel Caroline , van den Akker M.Elske , van Bodegom Leti , Escher Johanna , van Geloven Nan , van Overveld Floris , Rings Edmond H H.M , Smit Lucy , de Vries Martine Charlotte , Mearin M. Luisa
Published: August 2021

Introduction

Coeliac disease (CD) occurs in 1% of the population, develops early in life and is severely underdiagnosed. Undiagnosed and untreated disease is associated with short-term and long-term complications. The current healthcare approach is unable to solve the underdiagnosis of CD and timely diagnosis and treatment is only achieved by active case finding. Aim: to perform a case finding project to detect CD children who visit the Youth Health Care Centres (YHCCs) in a well-described region in the Netherlands to evaluate whether it is feasible, cost-effective and well accepted by the population.

Methods/analysis

Prospective intervention cohort study. Parents of all children aged 12 months and 4 years attending the YHCCs for a regular visit are asked whether their child has one or more CD-related symptoms from a standardised list. If so, they will be invited to participate in the case finding study. After informed consent, a point of care test (POCT) to assess CD-specific antibodies against tissue transglutaminase (TG2A) is performed onsite the YHCCs. If the POCT is positive, CD is highly suspected and the child will be referred to hospital for definitive diagnosis according to the Guideline Coeliac Disease of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition guideline.

Main outcomes

Incidence rate of new CD diagnoses in the study region in comparison to the one in the same age diagnosed by standard of care in the rest of the Netherlands.

Feasibility and cost-effectiveness of active CD case finding at the YHCCs. All costs of active case finding, diagnostics and treatment of CD and the potential short-term and long-term consequences of the disease will be calculated for the setting with and without case finding.

Ethical acceptability: by questionnaires on parental and healthcare professionals’ satisfaction.

A statistical analysis plan was prepared and is published on the GLUTENSCREEN website (Statistical-Analysis-Plan-11-5-2021_def.pdf (glutenscreen.nl) and added as annex 1).

Ethics and dissemination

The Medical Ethics Committee Leiden approved this study. If we prove that case finding at the YHCC is feasible, cost-effective and well accepted by the population, implementation is recommended.

Trial registration number

NL63291.058.17.
Stroke in patients with secundum atrial septal defect and sequelae after transcatheter closure
Authors: Dolgner Stephen J , Steinberg Zachary Louis , Jones Thomas K , Reisman Mark , Buber Jonathan
Published: August 2021

Objective

To evaluate the frequency of and risk factors for stroke as a presenting feature in adult patients with secundum atrial septal defect (ASD); rates of post-closure atrial fibrillation (AF) and stroke were also assessed.

Methods

We retrospectively reviewed adult patients who presented with an ASD between 2002 and 2018, excluding those with known atrial arrhythmias. Risk factors for stroke were identified using multivariable logistic regression. Post-closure stroke was evaluated using survival analysis stratified by the presence of post-procedure AF.

Results

Of 346 patients with ASD (median age 44 years), 34 (10%) presented with a history of stroke. Independent risk factors included elevated body mass index over 25 (OR: 18.2; 95% CI: 4.0 to 82.2; p<0.001), smoking (OR: 9.5; 95% CI: 3.8 to 23.9; p<0.001) and a prominent Eustachian valve (OR: 9.2; 95% CI: 3.4 to 25.2; p<0.001). A scoring system based on these three parameters provided robust stroke risk stratification. During a median follow-up of 12 months after closure, 12 patients (4%) experienced AF and 4 patients (1%) had a new stroke. AF was highly associated with development of stroke post-closure (p<0.001).

Conclusions

In this study population, the incidence of stroke prior to ASD closure among patients without atrial arrhythmias was 10%. Risk factors included obesity, smoking and prominent Eustachian valve anatomy. Lifestyle changes should be recommended for at-risk patients, and it may be reasonable to consider ASD closure in the absence of haemodynamic indications in patients at increased risk of stroke.
Moderate excess alcohol consumption and adverse cardiac remodelling in dilated cardiomyopathy
Authors: Tayal Upasana , Gregson John , Buchan Rachel , Whiffin Nicola , Halliday Brian P , Lota Amrit , Roberts Angharad M , Baksi A John , Voges Inga , Jarman Julian W E , Baruah Resham , Frenneaux Michael , Cleland John G F , Barton Paul , Pennell Dudley J , Ware James S , Cook Stuart A , Prasad Sanjay K
Published: August 2021

Objective

The effect of moderate excess alcohol consumption is widely debated and has not been well defined in dilated cardiomyopathy (DCM). There is need for a greater evidence base to help advise patients. We sought to evaluate the effect of moderate excess alcohol consumption on cardiovascular structure, function and outcomes in DCM.

Methods

Prospective longitudinal observational cohort study. Patients with DCM (n=604) were evaluated for a history of moderate excess alcohol consumption (UK government guidelines; >14 units/week for women, >21 units/week for men) at cohort enrolment, had cardiovascular magnetic resonance and were followed up for the composite endpoint of cardiovascular death, heart failure and arrhythmic events. Patients meeting criteria for alcoholic cardiomyopathy were not recruited.

Results

DCM patients with a history of moderate excess alcohol consumption (n=98, 16%) had lower biventricular function and increased chamber dilatation of the left ventricle, right ventricle and left atrium, as well as increased left ventricular hypertrophy compared with patients without moderate alcohol consumption. They were more likely to be male (alcohol excess group: n=92, 94% vs n=306, 61%, p=<0.001). After adjustment for biological sex, moderate excess alcohol was not associated with adverse cardiac structure. There was no difference in midwall myocardial fibrosis between groups. Prior moderate excess alcohol consumption did not affect prognosis (HR 1.29, 95% CI 0.73 to 2.26, p=0.38) during median follow-up of 3.9 years.

Conclusion

DCM patients with moderate excess alcohol consumption have adverse cardiac structure and function at presentation, but this is largely due to biological sex. Alcohol may contribute to sex-specific phenotypic differences in DCM. These findings help to inform lifestyle discussions for patients with DCM.
Pembrolizumab for patients with leptomeningeal metastasis from solid tumors: efficacy, safety, and cerebrospinal fluid biomarkers
Authors: Naidoo Jarushka , Schreck Karisa C , Fu Wei , Hu Chen , Carvajal-Gonzalez Alexander , Connolly Roisin M , Santa-Maria Cesar A , Lipson Evan J , Holdhoff Matthias , Forde Patrick M , Douville Christopher , Riemer Joanne , Barnes Amanda , Redmond Kristin J , Kleinberg Lawrence , Page Brandi , Aygun Nafi , Kinzler Kenneth W , Papadopoulos Nickolas , Bettegowda Chetan , Venkatesan Arun , Brahmer Julie R , Grossman Stuart A
Published: August 2021

Background

The benefit of immune checkpoint inhibitors (ICIs) in patients with leptomeningeal metastases (LMM) is unknown.

Methods

We undertook a phase II trial of pembrolizumab in patients with LMM from solid tumors. Eligible patients had radiologic/cytologic LMM and Eastern Cooperative Oncology Group performance status 0–1. Pembrolizumab was administered intravenously at 200 mg q3W until disease progression/unacceptable toxicity. The primary endpoint was central nervous system (CNS) response after four cycles, defined radiologically/cytologically/clinically. Serial cerebrospinal fluid (CSF) was assessed for tumor-derived DNA (t-DNA) aneuploidy and cytokines.

Results

Thirteen of a planned 16 patients were treated between April 2017 and December 2019. The study closed early for poor accrual. Median age was 57 years (range: 22–79). Sixty-two percent of patients had tumors not traditionally ICI-responsive (hormone-receptor (HR)-positive breast carcinoma=39%; high-grade glioma=23%), while 38% had ICI-responsive tumors (non-small cell lung cancer (NSCLC)=23%, head and neck carcinoma=8%, cutaneous squamous carcinoma (CSC)=8%). CNS response was observed in 38% of patients at 12 weeks (95% CI 13.9% to 68.4%) by pre-defined criteria and LM-RANO, and 2 achieved durable complete responses (CSC=1, overall survival (OS) 3+ years; NSCLC=1, OS 9 months). Median CNS progression-free survival and OS was 2.9 months (95% CI 1.3 to NR) and 4.9 months (95% CI 3.7 to NR), respectively. Grade 3+ treatment-related adverse events occurred in 15% of patients. Sensitivity for LMM detection by t-DNA and cytopathology was 84.6% (95% CI 54.6% to 98.1%) and 53.9% (95% CI 25.1% to 80.8%), respectively. Pre-therapy and on-therapy CSF cytokine analysis demonstrated complete responders clustered together.

Conclusions

Pembrolizumab conferred a 38% CNS response rate in patients with LMM, a tolerable safety profile, and deep responses in selected patients with ICI-responsive tumors. CSF t-DNA may be sensitive for LMM detection, and immunologic subsets of CNS response warrant further study.

Trial registration number

NCT03091478
Lessons learnt from syphilis-infected blood donors: a timely reminder of missed opportunities
Authors: Harvala Heli , Reynolds Claire , Fabiana Alvin , Tossell Joanne , Bulloch Gillian , Brailsford Susan , Blackmore Stuart , Pomeroy Louise
Published: August 2021

Objective

Due to the increased number of syphilis infections diagnosed in the UK and beyond, we reviewed our data on blood donors infected with syphilis in the UK and Ireland between 2016 and 2019.

Methods

Data were extracted from the surveillance database for all blood donors confirmed positive for syphilis in the UK and Ireland between 2016 and 2019, together with the total number of donations tested during that period. Data on positive cases included gender, age group, reported treatment, symptoms and confirmatory results. All cases were divided into recently acquired within 24 months and past syphilis infection. We also reviewed the information on symptoms characteristic of syphilis reported by blood donors with an untreated syphilis infection during the postdonation discussions.

Results

Screening of 8 246 600 blood donations for treponemal antibodies identified 316 blood donors with confirmed syphilis infection in the UK and Ireland between 2016 and 2019 (1.6 per 100 000 donations). 42% of them (133 of 316) were classed as a recent infection based on their donation testing results, previous donation date and clinical history provided, and they were hence considered potentially infectious. Most of these blood donors (202 of 316, 64%) had not been previously diagnosed or treated for syphilis, although 50 of them reported symptoms consistent with syphilis infection and 19 had been misdiagnosed despite seeking medical help.

Conclusions

This observational study shows that syphilis infection remains undiagnosed, especially among heterosexual men, and that infectious syphilis is often missed as a differential diagnosis even when donors have presented with genital or oral ulceration, rashes in the genital area and lymphadenopathy. Considering the recent resurgence of syphilis infections in the UK and beyond and our generally expanding sexual networks, it is important to consider syphilis in differential diagnosis even if specific risk factors have not been identified.
Effect of water-to-cement ratio on cracking resistance of concrete at early age in restrained ring specimens
Authors: Shen Dejian , Jiao Yang , Liu Ci , Kang Jiacheng , Tang Xiaojian
Published: August 2021

Nowadays, low water-to-cement (w/c) ratio has been put into widespread use in engineering practice. However, low w/c ratio may give rise to high self-desiccation, which may lead to the decrease of early-age cracking resistance. Investigating the impact of w/c ratio on cracking resistance is utterly meaningful to better understand the cracking mechanism of concrete. However, the corresponding investigations remain lacking, especially when the ring test is utilized. In the present study, ring tests for three concrete mixtures with different w/c ratios were conducted to investigate the early-age cracking resistance of concrete from multiple parameters. Results showed that (i) the development rate of shrinkage of concrete for mixture W50 was slower than that for mixtures W33 and W40; (ii) the value and development rate of residual stress of concrete decreased when the w/c ratio increased; (iii) the relaxed stress for all mixtures developed rapidly at very early age, and reached the maximum value quickly; (iv) the cracking resistance of concrete increased when the w/c ratio increased at early age.
New genetically distinct phytoplasmas and insect carriers associated with pine tree disease revealed by a survey in the Curonian Spit, Lithuania
Authors: Ivanauskas Algirdas , Valiunas Deividas , Rimsaite Jolanta , Danilov Jurij , Sneideris Donatas , Zizyte-Eidetiene Marija , Wei Wei
Published: August 2021

Our previous studies reported that phytoplasma was the causative agent of the pine disease in the Curonian Spit, Lithuania. In this study, insects from diseased pine trees and their adjacent areas were collected from 2016 to 2019 to further identify potential insect vectors that spread phytoplasmas. A total of 1018 phloem-feeding insects (order Hemiptera) were identified, 98.62% of which were aphids (Aphididae), and no known phytoplasma vectors were found. The results from semi-nested polymerase chain reaction (PCR) using phytoplasma-specific universal primers revealed that phytoplasmas were detected in Scots pine aphids (Cinara pini (Linnaeus, 1758)), waxy grey pine needle aphids (Cinara pineti (Fabricius, 1781)), and species-unknown aphids. Further sequence analysis and virtual RFLP (restriction fragment length polymorphism) analysis of aphid-harbored phytoplasma strains indicated that they were closely related to ‘Candidatus Phytoplasma pini’ (16SrXXI-A), but mainly 16SrXXI-A variants, which were also main strains identified in diseased pine trees. In addition, three new phytoplasma subgroups were delineated in the present study. Subgroups 16SrXXI-C and 16SrXXI-D were unveiled from previously identified (but classification was overlooked) Lithuanian pine phytoplasma strains. Subgroup 16SrXXI-E was discovered from the newly identified aphid-harbored phytoplasmas. Further transmission trial studies on these aphids will provide insights into the epidemiology and pathosystem of pine phytoplasma diseases, as well as disease management.
A Hybrid-Domain Deep Learning-Based BCI For Discriminating Hand Motion Planning From EEG Sources
Authors: Ieracitano Cosimo , Morabito Francesco Carlo , Hussain Amir , Mammone Nadia
Published: August 2021

In this paper, a hybrid-domain deep learning (DL)-based neural system is proposed to decode hand movement preparation phases from electroencephalographic (EEG) recordings. The system exploits information extracted from the temporal-domain and time-frequency-domain, as part of a hybrid strategy, to discriminate the temporal windows (i.e. EEG epochs) preceding hand sub-movements (open/close) and the resting state. To this end, for each EEG epoch, the associated cortical source signals in the motor cortex and the corresponding time-frequency (TF) maps are estimated via beamforming and Continuous Wavelet Transform (CWT), respectively. Two Convolutional Neural Networks (CNNs) are designed: specifically, the first CNN is trained over a dataset of temporal (T) data (i.e. EEG sources), and is referred to as T-CNN; the second CNN is trained over a dataset of TF data (i.e. TF-maps of EEG sources), and is referred to as TF-CNN. Two sets of features denoted as T-features and TF-features, extracted from T-CNN and TF-CNN, respectively, are concatenated in a single features vector (denoted as TTF-features vector) which is used as input to a standard multi-layer perceptron for classification purposes. Experimental results show a significant performance improvement of our proposed hybrid-domain DL approach as compared to temporal-only and time-frequency-only-based benchmark approaches, achieving an average accuracy of [Formula: see text]%.
Effects of alloy compositions on mechanical properties of as-cast banite iron materials for cylinder liners
Authors: Gao Hao , Wang Kun-Chieh , Wu Long , Gao Guangdong , Liu Dong , Yang Chi-Hsin
Published: August 2021

The cylinder liner is a key part of an internal combustion engine. It always exposes at the worst conditions in the engine room: high temperatures, high pressures, large frictions, and large applying forces. Therefore, excellent physical properties such as surface hardness, tensile strength, heat resistance, and pressure resistance are essentially required as a cylinder liner material. Among them, the surface hardness and tensile strength are the most important properties which play decisive roles in producing a good cylinder liner. Researches on the development of new cast materials with different contents of alloying elements used in cylinder liners, which may exhibit high surface hardness as well as tensile strength, consistently draw much attention. In this regard, this study aims to experimentally investigate the effects of alloy compositions on the mechanical properties of ASBC materials for cylinder liners. Besides, we also replace the traditional-used high-price Ni with low-price Cu in order to reduce the production cost of cylinder liner materials. Results show that the best contents of C, Mo, and Cu for an as-cast banite iron (ACBI) material are found around 2.7%, 0.6–0.8%, and 0.82–1.0%, respectively, in which the highest hardness occurs. Those are found around 2.7%, 0.7–0.8%, and 0.94–1.0%, respectively, in which the highest tensile strength occurs. At the same time, without any reductions in performances of hardness and tensile strength, we successfully adopt Cu as a substitute for Ni as an important composition of ACBI material for cylinder liners.
Darboux-dressing transformation, conservation laws and bound-state solutions of the vector Lakshmanan–Porsezian–Daniel equation
Authors: Mao Jin-Jin , Cheng Wenguang , Shi Lin-Fei , Xu Tian-Zhou
Published: August 2021

The vector Lakshmanan–Porsezian–Daniel (vLPD) equations are mainly studied in this paper. The Darboux-dressing transformation (DDT) and infinitely-many conservation laws of the vLPD equations are constructed by the Lax pair. Furthermore, one soliton and bound-state solitons solutions of the vLPD equations are obtained by the DDT method. The obtained graphs can directly reflect the dynamic behavior of the aforementioned solutions.
Invariant Hermitian forms on vertex algebras
Authors: Kac Victor G. , Frajria Pierluigi Möseneder , Papi Paolo
Published: August 2021

We study invariant Hermitian forms on a conformal vertex algebra and on their (twisted) modules. We establish existence of a non-zero invariant Hermitian form on an arbitrary [Formula: see text]-algebra. We show that for a minimal simple [Formula: see text]-algebra [Formula: see text] this form can be unitary only when its [Formula: see text]-grading is compatible with parity, unless [Formula: see text] “collapses” to its affine subalgebra.
A New Hesitant Fuzzy Rule-Based System for Ranking Hydro Power Plant Site Selection
Authors: Singha Biplab , Sen Mausumi , Sinha Nidul , Dutta Dhiman
Published: August 2021

Fuzzy set was introduced in 1965 by Prof. A. Lotfi Zadeh to deal with uncertainty. Fuzzy set is an important tool for solving real life problems. Similarly, hesitant fuzzy set is the extended tool of fuzzy set which plays an important role to deal with uncertainty, imprecision and vagueness more clearly and accurately. In this paper, hesitant fuzzy base rule system is proposed which is the extension of fuzzy base rule system. A new dimension of hesitant fuzzy set i.e. hesitant fuzzy membership line (HFML) is defined and the HFML is classified into different classes (Good, Fair, Poor) according to Quality Index Parameter (QIP) which is calculated by the expert only with the best of their knowledge. Also this paper consists of two newly defined operations AND and OR operations on hesitant fuzzy sets. The effective criteria like Ecology, Hostility, Cost, Water Quality and Air Quality are considered so that decision makers make appropriate site selection of the power plant in more rational and easy evaluation method. Using all the newly proposed methods in this paper, the policy makers are able to select the best power plant most easily and effectively without any big calculation. Finally, the power plant sites are ranked according to the highest value given by a score function.
A New Interval-Valued Hesitant Fuzzy-Based Optimization Method
Authors: Bharati Shailendra Kumar
Published: August 2021

An interval-valued hesitant fuzzy set (IVHFS) is a best tool to address uncertainty and hesitation of a production planning problem (PPP) which appears in engineering, agriculture, and industrial sectors. Often, a PPP is formulated as a multiobjective linear programming problem (MOLPP) and therefore, it is very necessary to develop a suitable and realistic method to deal MOLPP with uncertainty and hesitation. In this paper, we define a set of possible interval-valued hesitant fuzzy degrees for all objectives, and using this, a MOLPP is converted into a interval-valued hesitant fuzzy linear programming (IVHFLPP). Further, we introduce a new optimization technique based on a new operation of IVHFS, and later it is implemented in a computational method to search a Pareto optimal solution of the considered problem. Further, a PPP is solved by using the proposed method and the result shows the superiority of the proposed computational method over the existing methods.
On Near-Rings with Soft Union Ideals and Applications
Authors: Sezgin Aslihan , Atagün Akin Osman , Çağman Naim , Demir Hüseyin
Published: August 2021

In this paper, we define soft union near-ring on a soft set by using soft sets, inclusion relation and union of sets. This new notion functions as a bridge among soft set theory, set theory and near-ring theory. We then derive its basic properties and investigate the relationship between soft intersection near-ring and soft union near-ring. Furthermore, we obtain some analog of classical near-ring theoretic concepts for soft union near-ring and give the applications of soft union near-ring to near-ring theory.