bluuebunny/crossref_metadata_2025 huggingface dataset:
Comprehensive analysis of DNA mismatch repair-deficient gastric cancer in a Japanese hospital-based population
Authors: Ito Tetsuya , Suzuki Okihide , Kamae Nao , Tamaru Jun-ichi , Arai Tomio , Yamaguchi Tatsuro , Akagi Kiwamu , Eguchi Hidetaka , Okazaki Yasushi , Mochiki Erito , Ishida Hideyuki
Published: February 2021

Background

The attention on mismatch repair-deficient (dMMR) gastric cancer has increased in this era of anti-PD-1 blockade therapy; however, the prevalence and molecular genetics of patients with dMMR gastric cancer have not been completely investigated.

Methods

Immunohistochemistry of MMR proteins (MLH1, MSH2, MSH6 and PMS2) was performed on formalin-fixed paraffin-embedded sections prepared from resected primary gastric cancers of 513 consecutive patients. Genetic and/or epigenetic alterations of the MMR genes were also investigated.

Results

Loss of expression of one or more MMR proteins was observed in 58 patients (11.3%); 54 patients showed loss of MLH1/PMS2, 3 patients showed loss of MLH1/PMS2/MSH6 and 1 patient showed loss of PMS2 alone. Among these 58 patients, 55 showed hypermethylation of the promoter region of MLH1. Genetic testing revealed that the remaining three patients had Lynch syndrome (n = 1) or Lynch-like syndrome (n = 2). A total of 15 patients (25.9% of all patients with dMMR gastric cancer and 2.9% of all patients with gastric cancer), including 11 patients with stage I–III dMMR gastric cancer who had recurrence and 4 patients with stage IV dMMR gastric cancer, are potential candidates for the use of anti-PD-1 blockades.

Conclusions

This is the first study to investigate the frequency and molecular genetic mechanisms of dMMR gastric cancer comprehensively, focusing on the benefit of using PD-1 blockades. Our observations will be beneficial in the clinical practice of metastatic gastric cancer.
The effectiveness comparisons of eugenosedin-A, glibenclamide and pioglitazone on diabetes mellitus induced by STZ/NA and high-fat diet in SHR
Authors: Lin Hui-Li , Cheng Pei-Wen , Tu Yi-Chen , Yeh Bor-Chun , Wu Bin-Nan , Shen Kuo-Ping
Published: February 2021

Objectives

Eugenosedin-A (Eu-A), an adrenergic and serotonergic antagonist, is known to have anti-metabolic syndrome effects. In this study, we evaluated its protective effects against diabetes mellitus (DM) in spontaneous hypertensive rats (SHR) and compared it with two anti-diabetes medications, glibenclamide (Gli) and pioglitazone (Pio).

Methods

We divided 10-week-old SHRs into five groups: a control group fed a normal diet; an untreated DM group induced by injecting the SHRs with STZ/NA and feeding them a high-fat diet (HFD); and three treated groups (after giving STZ/NA and HFD) gavage given with Eu-A, Gli or Pio (5 mg/kg per day) for 4 weeks.

Key findings

The untreated DM group weighed less and had hyperglycaemia, hypoinsulinemia and hyperlipidemia. They were also found to have aberrant glucose-dependent insulin pathways, glucose metabolism and lipid synthesis proteins, while the controls did not. Eu-A, Gli and Pio ameliorated the above biochemical parameters in the treatment groups. Eu-A and Pio, but not Gli, improved hypertension and tachycardia.

Conclusions

Taken together, Eu-A ameliorated DM, hypertension and tachycardia by improving glucose, lipid homeostasis and anti-adrenergic, serotonergic activities. We concluded that Eu-A could be used in the development of an effective agent for controlling DM and its complications.
Primary brachial artery aneurysm with associated basilic vein aneurysm
Authors: Hamdulay Khaleel A , Laws Peter E , Ruiz Carmen M
Published: February 2021

There are but a handful of reported brachial artery aneurysms, the majority of which are pseudoaneurysms or false aneurysms caused by trauma or fistula creation. True or primary brachial artery aneurysms are even more rare, and if they occur, they often do so in isolation. In this case report, we discuss the interesting finding of a large primary brachial aneurysm together with an adjacent aneurysmal basilic vein identified intra-operatively. This presentation was 21 years after the renal transplant and ligation of an arteriovenous fistula in that same arm. It is noteworthy that the fistula was in the forearm and far away from the site of the untouched brachial area.
Meckel’s diverticulitis in a COVID-19 adult
Authors: Marçal André , Marques Rita , Oliveira António , Pinto-de-Sousa João
Published: February 2021

Meckel’s diverticulitis is an unusual cause of acute abdomen condition in adults requiring prompt surgical treatment. We report a case of a 53-year-old male with coronavirus disease 19 (COVID-19), admitted to the emergency department with an acute abdominal pain. A computed tomography scan with intravenous contrast performed on the patient confirmed an inflamed short segment of the small bowel and the presence of a localized free peritoneal fluid. The definitive diagnosis was made intraoperatively, by means of an emergent ileal resection with primary anastomosis, which confirmed Meckel’s diverticulitis. Postoperative evolution was ordinary. The association of COVID-19 with the acute abdomen is found to be weak, therefore surgical consultation is advised to minimize delayed treatment.
Rare case of gigantic ulcerating phyllodes tumour in developed country with a review of the literature
Authors: Seow Yi Th’ng , Kunjuraman Bindu
Published: February 2021

Phyllodes tumour (PT) is a rare type of fibroepithelial breast tumour that can present in a wide spectrum of biological behaviours, accounting for <1% of breast malignancies. Herein, we present a case of a rare gigantic ulcerating PT in a middle-aged woman from regional Western Australia, who presented with a rapidly growing right breast mass. Core biopsy showed spindle cell lesion with differentials being PT of at least borderline variety or metaplastic carcinoma. The ulcerations over the fungating tumour showed heavy growth of Staphylococcus aureus. The treating team subsequently proceeded to right total mastectomy with level 1 and 2 axillary clearance. This report emphasizes the rare presentation of PT, dilemma in investigations and the difficulties in managing non-compliant patient where treatment protocol needs to be modified.
The successful use of disparate pedicle types for bilateral therapeutic mammaplasties during breast conservation surgery
Authors: Bellizzi Annalise , Vella Baldacchino Reuben , Kazzazi Fawz , Forouhi Parto , Malata Charles M
Published: February 2021

This case illustrates the successful use of non-identical pedicles in bilateral therapeutic mammaplasty (TM). A 58-year-old patient presented with a left-sided upper inner quadrant multifocal invasive [no special type (NST)] tumour and a right-sided upper outer quadrant unifocal invasive tubular carcinoma with surrounding ductal carcinoma in situ (DCIS). Her tumour locations necessitated simultaneous bilateral TM using different pedicle types. A superomedial pedicle T-scar breast reduction was undertaken on the right to resect the upper outer quadrant tumour whilst a superolateral nipple transposition pedicle was used on the left breast to enable the wide resection of the two tumours located superomedial to the nipple. The location and size of the tumour also required the use of a secondary infero-medially based pedicle for volume displacement on the left breast. Patient received adjuvant chemotherapy and radiotherapy. A year after surgery the patient has acceptable cosmetic results in terms of symmetry, breast contour and increasingly inconspicuous scars.
Phytochromes control metabolic flux, and their action at the seedling stage determines adult plant biomass
Authors: Krahmer Johanna , Abbas Ammad , Mengin Virginie , Ishihara Hirofumi , Romanowski Andrés , Furniss James J , Moraes Thiago Alexandre , Krohn Nicole , Annunziata Maria Grazia , Feil Regina , Alseekh Saleh , Obata Toshihiro , Fernie Alisdair R , Stitt Mark , Halliday Karen J
Published: February 2021

Phytochrome photoreceptors are known to regulate plastic growth responses to vegetation shade. However, recent reports also suggest an important role for phytochromes in carbon resource management, metabolism, and growth. Here, we use 13CO2 labelling patterns in multiallele phy mutants to investigate the role of phytochrome in the control of metabolic fluxes. We also combine quantitative data of 13C incorporation into protein and cell wall polymers, gas exchange measurements, and system modelling to investigate why biomass is decreased in adult multiallele phy mutants. Phytochrome influences the synthesis of stress metabolites such as raffinose and proline, and the accumulation of sugars, possibly through regulating vacuolar sugar transport. Remarkably, despite their modified metabolism and vastly altered architecture, growth rates in adult phy mutants resemble those of wild-type plants. Our results point to delayed seedling growth and smaller cotyledon size as the cause of the adult-stage phy mutant biomass defect. Our data signify a role for phytochrome in metabolic stress physiology and carbon partitioning, and illustrate that phytochrome action at the seedling stage sets the trajectory for adult biomass production.
Corporations, comity and the ‘revenue rule’: a jurisprudence of offshore
Authors: Quentin Clair
Published: February 2021

This article contrasts the territorial unboundedness of company law, arising from ‘comity’, with the territorial constraint imposed on tax law i.e. ‘the revenue rule’. ‘Comity’ is found to be a judicial fig-leaf disguising a form of corporate sovereignty arising from the fact that economic relations are always already constituted through the corporate form before any scrutiny of their ontology. This observation is developed into a theory of ‘offshore’. The prevailing view of offshore is that the state bifurcates its sovereignty to create juridical spaces where international capital is relieved of local tax/regulatory regimes. This article seeks to underpin that view with an analysis whereby corporate capital and state sovereignty are rival species of property regime, existing in a state of mutual antagonism. On this view offshore is the juridical space, manifesting itself through the aforementioned bifurcations, where the company is sovereign over the state rather than vice-versa.
Placing LOFAR-detected quasars in C iv emission space: implications for winds, jets and star formation
Authors: Rankine Amy L , Matthews James H , Hewett Paul C , Banerji Manda , Morabito Leah K , Richards Gordon T
Published: February 2021

We present an investigation of the low-frequency radio and ultraviolet properties of a sample of ≃10 500 quasars from the Sloan Digital Sky Survey Data Release 14, observed as part of the first data release of the Low-Frequency-Array Two-metre Sky Survey. The quasars have redshifts 1.5 < z < 3.5 and luminosities $44.6 \lt \log _{10}\left(L_{\text{bol}}/\rm{erg\,s}^{-1}\right) \lt 47.2$. We employ ultraviolet spectral reconstructions based on an independent component analysis to parametrize the C iv λ1549-emission line that is used to infer the strength of accretion disc winds, and the He ii λ1640 line, an indicator of the soft X-ray flux. We find that radio-detected quasars are found in the same region of C iv blueshift versus equivalent-width space as radio-undetected quasars, but that the loudest, most luminous and largest radio sources exist preferentially at low C iv blueshifts. Additionally, the radio-detection fraction increases with blueshift whereas the radio-loud fraction decreases. In the radio-quiet population, we observe a range of He ii equivalent widths as well as a Baldwin effect with bolometric luminosity, whilst the radio-loud population has mostly strong He ii, consistent with a stronger soft X-ray flux. The presence of strong He ii is a necessary but not sufficient condition to detect radio-loud emission suggesting some degree of stochasticity in jet formation. Using energetic arguments and Monte Carlo simulations, we explore the plausibility of winds, compact jets, and star formation as sources of the radio quiet emission, ruling out none. The existence of quasars with similar ultraviolet properties but differing radio properties suggests, perhaps, that the radio and ultraviolet emission is tracing activity occurring on different time-scales.
VINTERGATAN – I. The origins of chemically, kinematically, and structurally distinct discs in a simulated Milky Way-mass galaxy
Authors: Agertz Oscar , Renaud Florent , Feltzing Sofia , Read Justin I , Ryde Nils , Andersson Eric P , Rey Martin P , Bensby Thomas , Feuillet Diane K
Published: February 2021

Spectroscopic surveys of the Milky Way’s stars have revealed spatial, chemical, and kinematical structures that encode its history. In this work, we study their origins using a cosmological zoom simulation, VINTERGATAN, of a Milky Way-mass disc galaxy. We find that in connection to the last major merger at z ∼ 1.5, cosmological accretion leads to the rapid formation of an outer, metal-poor, low-[α/Fe] gas disc around the inner, metal-rich galaxy containing the old high-[α/Fe] stars. This event leads to a bimodality in [α/Fe] over a range of [Fe/H]. A detailed analysis of how the galaxy evolves since z ∼ 1 is presented. We demonstrate the way in which inside-out growth shapes the radial surface density and metallicity profile and how radial migration preferentially relocates stars from the inner disc to the outer disc. Secular disc heating is found to give rise to increasing velocity dispersions and scale heights with stellar age, which together with disc flaring explains several trends observed in the Milky Way, including shallower radial [Fe/H] profiles above the mid-plane. We show how the galaxy formation scenario imprints non-trivial mappings between structural associations (i.e. thick and thin discs), velocity dispersions, α-enhancements, and ages of stars; e.g. the most metal-poor stars in the low-[α/Fe] sequence are found to have a scale height comparable to old high-[α/Fe] stars. Finally, we illustrate how at low spatial resolution, comparable to the thickness of the galaxy, the proposed pathway to distinct sequences in [α/Fe]–[Fe/H] cannot be captured.
Degeneracy between mass and peculiar acceleration for the double white dwarfs in the LISA band
Authors: Xuan Zeyuan , Peng Peng , Chen Xian
Published: February 2021

Mass and distance are fundamental quantities to measure in gravitational wave (GW) astronomy. However, recent studies suggest that the measurement may be biased due to the acceleration of GW source. Here, we develop an analytical method to quantify such a bias induced by a tertiary star on a double white dwarf (DWD), since DWDs are the most common GW sources in the milli-Hertz band. We show that in a large parameter space the mass is degenerate with the peculiar acceleration, so that from the waveform we can only retrieve a mass of ${\cal M}(1+\Gamma)^{3/5}$, where ${\cal M}$ is the real chirp mass of the DWD and Γ is a dimensionless factor proportional to the peculiar acceleration. Based on our analytical method, we conduct mock observation of DWDs by the Laser Interferometer Space Antenna. We find that in about $9{{\ \rm per\ cent}}$ of the cases the measured chirp mass is biased by $(5-30){{\ \rm per\ cent}}$ due to the presence of a tertiary. Even more extreme biases are found in about a dozen DWDs and they may be misclassified as double neutron stars, binary black holes, DWDs undergoing mass transfer, or even binaries containing lower-mass-gap objects and primordial black holes. The bias in mass also affects the measured distance, resulting in a seemingly overdensity of DWDs within a heliocentric distance of 1 kpc as well as beyond 100 kpc. Our result highlights the necessity of modelling the astrophysical environments of GW sources to retrieve their correct physical parameters.
How the bar properties affect the induced spiral structure
Authors: Garma-Oehmichen L , Martinez-Medina L , Hernández-Toledo H , Puerari I
Published: February 2021

Stellar bars and spiral arms coexist and co-evolve in most disc galaxies in the local Universe. However, the physical nature of this interaction remains a matter of debate. In this work, we present a set of numerical simulations based on isolated galactic models aimed to explore how the bar properties affect the induced spiral structure. We cover a large combination of bar properties, including the bar length, axial ratio, mass, and rotation rate. We use three galactic models describing galaxies with rising, flat, and declining rotation curves. We found that the pitch angle best correlates with the bar pattern speed and the spiral amplitude with the bar quadrupole moment. Our results suggest that galaxies with declining rotation curves are the most efficient forming grand design spiral structure, evidenced by spirals with larger amplitude and pitch angle. We also test the effects of the velocity ellipsoid in a subset of simulations. We found that as we increase the radial anisotropy, spirals increase their pitch angle but become less coherent with smaller amplitude.
Torsional waves with force-free magnetic fields in solar plasma structures
Authors: Ebadi H , Shahmorad S , Vasheghani Farahani S
Published: February 2021

The aim here is to model torsional waves in homogeneous and expanding twisted flux tubes of solar coronal magnetic plasma structures. For the sake of simplicity, a force-free condition applicable to solar magnetic structures is presented to determine the existing three-dimensional equilibrium magnetic fields. The determined magnetic field is implemented to study the effects of the magnetic twist parameter on the eigenvalues and eigenfunctions of torsional waves. Solenoidal and force-free conditions are applied to find the three-dimensional components of the magnetic field with respect to the numerical flux function. The obtained differential equation is linear where the technique of the separation of variables is implemented in order to solve it. The equilibrium magnetic field components and appropriate vector potential are extracted. Using the provided components in the magnetohydrodynamic theory, a differential equation that governs the frequency dependence of the torsional wave is obtained, whereby the differential transform method is solved. Both eigenvalues and eigenfunctions of torsional waves are calculated numerically. The obtained values for the frequency of the fundamental mode and its first harmonic, together with appropriate functions, exhibit a fine consistency with observations, with regards to the ratio of ω2/ω1, which is estimated to be around 2. At a fixed distance from the tube axis, the ratio increases with the increase of the twist parameter. The higher the applied twist parameter, the more variations of the ω2/ω1 ratio are observed. We cannot find significant variations of the eigenfunctions of torsional waves due to the twist parameter. The consistency between analytical results and observations proves adequate for implementing a force-free equilibrium magnetic field subject to conditions in solar plasma structures regarding torsional wave propagation.
Probing the physical properties of the intergalactic medium using gamma-ray bursts
Authors: Dalton Tony , Morris Simon L , Fumagalli Michele
Published: February 2021

We use gamma-ray burst (GRB) spectra total continuum absorption to estimate the key intergalactic medium (IGM) properties of hydrogen column density ($\mathit {N}_{\mathrm{HXIGM}}$), metallicity, temperature, and ionization parameter over a redshift range of 1.6 ≤ z ≤ 6.3, using photoionization equilibrium (PIE) and collisional ionization equilibrium (CIE) models for the ionized plasma. We use more realistic host metallicity, dust corrected where available, in generating the host absorption model, assuming that the host intrinsic hydrogen column density is equal to the measured ionization corrected intrinsic neutral column from UV spectra (${\it N}_{\mathrm{H}\,{\small I,IC}}$). We find that the IGM property results are similar, regardless of whether the model assumes all PIE or CIE. The $\mathit {N}_{\mathrm{HXIGM}}$ scales as (1 + z)1.0–1.9, with equivalent hydrogen mean density at z = 0 of $n_0 = 1.8^{+1.5}_{-1.2} \times 10^{-7}$ cm−3. The metallicity ranges from $\sim 0.1\, \mathrm{Z}_{\odot }$ at redshift z ∼ 2 to $\sim 0.001\, \mathrm{Z}_{\odot }$ at redshift z > 4. The PIE model implies a less rapid decline in average metallicity with redshift compared to CIE. Under CIE, the temperature ranges between 5.0 < log (T/K) < 7.1. For PIE the ionization parameter ranges between 0.1 < log (ξ) < 2.9. Using our model, we conclude that the IGM contributes substantially to the total absorption seen in GRB spectra and that this contribution rises with redshift, explaining why the hydrogen column density inferred from X-rays is substantially in excess of the intrinsic host contribution measured in UV.
The oxidative reactivity of three manganese(III) porphyrin complexes with hydrogen peroxide and nitrite toward catalytic nitration of protein tyrosine
Authors: Li Jiayu , Wei Jingjing , Gao Zhonghong , Yin Guochuan , Li Hailing
Published: February 2021

Understanding the toxicological properties of MnIII-porphyrins (MnTPPS, MnTMPyP, or MnTBAP) can provide important biochemical rationales in developing them as the therapeutic drugs against protein tyrosine nitration-induced inflammation diseases. Here, we present a comprehensive understanding of the pH-dependent redox behaviors of these MnIII-porphyrins and their structural effects on catalyzing bovine serum albumin (BSA) nitration in the presence of H2O2 and NO2−. It was found that both MnTPPS and MnTBAP stand out in catalyzing BSA nitration at physiologically close condition (pH 8), yet they are less effective at pH 6 and 10. MnTMPyP was shown to have no ability to catalyze BSA nitration under all tested pHs (pH 6, 8, and 10). The kinetics and active intermediate determination through electrochemistry method revealed that both the pH-dependent redox behavior of the central metal cation and the antioxidant capability of porphin derivative contribute to the catalytic activities of three MnIII-porphyrins in BSA nitration in the presence of H2O2/NO2−. These comprehensive studies on the oxidative reactivity of MnIII-porphyrins toward BSA nitration may provide new clues for searching the manganese-based therapeutic drugs against the inflammation-related diseases.
Acute kidney injury as a risk factor for mortality in oncological patients receiving checkpoint inhibitors
Authors: García-Carro Clara , Bolufer Mónica , Bury Roxana , Castañeda Zaira , Muñoz Eva , Felip Enriqueta , Lorente David , Carreras María Josep , Gabaldon Alejandra , Agraz Irene , Serón Daniel , Soler María José
Published: February 2021

Background

Checkpoint inhibitors (CPIs) have drastically improved metastatic cancer outcomes. However, immunotherapy is associated with multiple toxicities, including acute kidney injury (AKI). Data about CPI-related AKI are limited. Our aim was to determine risk factors for CPI-related AKI as well as its clinical characteristics and its impact on mortality in patients undergoing immunotherapy.

Methods

All patients under CPI at our centre between March 2018 and May 2019 and with a follow-up through April 2020 were included. Demographic, clinical and laboratory data were collected. AKI was defined according to the Kidney Disease: Improving Global Outcomes guidelines. We performed a logistic regression model to identify independent risk factors for AKI and actuarial survival analysis to establish risk factors for mortality in this population.

Results

A total of 759 patients were included, with a median age of 64 years. A total of 59% were men and baseline median creatinine was 0.80 mg/dL. The most frequent malignancy was lung cancer and 56% were receiving anti-programmed death protein 1 (PD-1). About 15.5% developed AKI during the follow-up. Age and baseline kidney function were identified as independent risk factors for CPI-related AKI. At the end of follow-up, 52.3% of patients had died. The type of cancer (not melanoma, lung or urogenital malignance), type of CPI (not cytotoxic T-lymphocyte-associated protein 4, PD-1, programmed death-ligand 1 or their combination) and the presence of an episode of AKI were identified as risk factors for mortality.

Conclusions

A total of 15.5% of patients under immunotherapy presented with AKI. A single AKI episode was identified as an independent risk factor for mortality in these patients and age and baseline renal function were risk factors for the development of AKI.
Adding a Physical Therapist to the Health Care Team in an HIV Clinic Increases Physical Therapy Referrals and Reduces Opioid Prescriptions Provided for Chronic Musculoskeletal Pain in Patients Living With HIV
Authors: Sebanayagam Vinoja , Chakur Nichole , Baffoe Nana Ama , Reed Brian , Weinberger Jarrett , Twardy Brandon S , Veltman Jennifer
Published: February 2021

Background

Musculoskeletal (MSK) pain is common in people living with HIV (PLWH). Health care providers sometimes prescribe opioids to control pain, which may lead to opioid misuse. An interdisciplinary approach that includes physical therapy has been successful in managing MSK pain in various health care settings. Therefore, we sought to find the impact of recruiting a physical therapist (PT) on the number of opioid prescriptions and physical therapy referrals made by physicians in training to manage MSK pain in PLWH.

Methods

We performed a retrospective chart review of patients seen by Internal Medicine physicians in training in an HIV clinic in Detroit before (2017) and after (2018) recruiting a PT to the health care team and collected demographic and clinical data. We also surveyed the trainees to assess how the PT addition influenced their learning. Institutional review board waiver was obtained.

Results

Results showed that of all PLWH seen at the clinic, 28/249 (11%) and 37/178 (21%) had chronic MSK pain in the 2017 and 2018 data sets, respectively. In 2017, all 28 patients with MSK pain were prescribed opioids. This decreased in 2018 after the PT addition (10/37 patients; P < .0001). The number of physical therapy referrals significantly increased after the PT addition (2017: 5/28 patients; 2018: 17/37 patients; P = .03). Trainees felt that the PT helped improve their examination skills and develop a treatment plan for patients.

Conclusions

The addition of a PT encouraged physicians in training to utilize nonopioid management of MSK pain in PLWH and enhanced their learning experience, as perceived by the trainees.
Establishment of Monoclonal Antibody Standards for Quantitative Serological Diagnosis of SARS-CoV-2 in Low-Incidence Settings
Authors: Thomas Archana , Messer William B , Hansel Donna E , Streblow Daniel N , Kazmierczak Steven C , Lyski Zoe L , Lu Zhengchun , Slifka Mark K
Published: February 2021

Background

Serological confirmation of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical for understanding the dynamics of the pandemic and determining seroprevalence rates within afflicted communities. Common challenges with SARS-CoV-2 serological assays include poor analytical specificity and sensitivity and lack of a serological standard for quantitative assessment of antibody titers.

Methods

To overcome these obstacles, we developed a quantitative enzyme-linked immunosorbent assay based on an optimized 2-dimensional screening assay that utilizes SARS-CoV-2 receptor binding domain (RBD) of spike protein and SARS-CoV-2 spike S1 subunit.

Results

A total of 4 SARS-CoV-2-reactive monoclonal antibodies were evaluated for use as serum standards for calibrating assays performed on different days or by different laboratories. This approach provided quantitative analysis of hospitalized reverse transcription polymerase chain reaction–confirmed COVID-19 cases that in some cases reached >100 μg/mL. The assay demonstrated 72% sensitivity based on time points ranging from 2 to 52 days post–symptom onset, with 100% sensitivity at time points measured ≥13 days post–symptom onset and 100% specificity.

Conclusions

Using these optimized reagents and serological standards, we believe this approach will be useful for sensitive and specific determination of seroconversion rates and quantitatively measuring the durability of antiviral antibody responses following SARS-CoV-2 infection or vaccination.
Opioid Overdose Risk in Patients Returning to the Emergency Department for Pain
Authors: Sheikh Sophia , Booth-Norse Ashley , Holden David , Henson Morgan , Dodd Caroline , Edgerton Eric , James Divya , Kalynych Colleen , Smotherman Carmen , Hendry Phyllis
Published: February 2021

Objective

Using the Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (CIP-RIOSORD) in patients returning to the emergency department (ED) for pain and discharged with an opioid prescription, we assessed overall opioid overdose risk and compared risk in opioid naive patients to those who are non-opioid naive.

Design

This was a secondary analysis from a prospective observational study of patients ≥ 18 years old returning to the ED within 30 days. Data were collected from patient interviews and chart reviews. Patients were categorized as Group 1 (not using prescription opioids) or Group 2 (consuming prescription opioids). Statistical analyses were performed using Fisher’s exact and Wilcoxon’s rank sum tests. Risk class and probability of overdose was determined using Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (CIP-RIOSORD).

Results

Of the 389 enrollees who returned to the ED due to pain within 30 days of an initial visit, 67 (17%) were prescribed opioids. The majority of these patients were in Group 1 (60%). Both Group 1 (n = 40) and Group 2 (n = 27) held an average CIP-RIOSORD risk class of 3. Race significantly differed between groups; the majority of Group 1 self-identified as African American (80%) (P = .0267). There were no differences in age, gender, or CIP-RIOSORD risk class between groups. However, Group 2 had nearly double the number of predictive factors (median = 1.93) as Group 1 (median = 1.18) (P = .0267).

Conclusions

A substantial proportion of patients (25%) were high risk for opioid overdose. CIP-RIOSORD may prove beneficial in risk stratification of patients discharged with prescription opioids from the ED.
Handgrip Strength in People With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis
Authors: Holden Mackenzie , Fyfe Madeline , Poulin Camille , Bethune Brianna , Church Chloe , Hepburn Paula , Afreixo Vera , Brooks Dina , Oliveira Ana
Published: February 2021

Objective

The purpose of this study was to systematically review the association between handgrip strength (HGS) and mortality, morbidity, and health-related quality of life (HRQL) in individuals with chronic obstructive pulmonary disease (COPD).

Methods

The following databases were used: CENTRAL, CINAHL, EMBASE, MEDLINE Ovid, SPORTDiscus, and PsycINFO. Studies published between 2000 and 2020 in English, Portuguese, or French that examined the association of HGS with mortality, morbidity, and HRQL in individuals with stable COPD were selected. Two authors independently extracted data and assessed the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework. The study effects were pooled using random effects meta-analysis models after assessing heterogeneity. The search generated 710 studies, and 18 were included in the review. Studies evaluated a total of 12,046 individuals with stable COPD (mean percent of the predicted forced expiratory volume in 1 second = 34%–80%) using over 10 diverse protocols for HGS measurement. Statistically significant, small, and negative relationships were found between HGS and mortality (r = −0.03; 95% CI = −0.05 to −0.02). Independent of the outcome measure used to assess morbidity, the estimate of the overall relationship was small to moderate and negative: Body Mass Index, Airflow Obstruction, Dyspnea, and Exercise Index Updated (r = −0.42; 95% CI = −0.61 to −0.03); exacerbations (r = −0.02; 95% CI = −0.04 to −0.00); and hospitalizations (r = −0.69; 95% CI = −1.70 to 0.32). Similarly, for HRQL, independent of the outcome measure, the estimate of the overall relationship was small to fair and negative: COPD Assessment Test (weighted r = −0.22; 95% CI = −0.32 to −0.12), Chronic Respiratory Disease Questionnaire domains (−0.24 < r < −0.14), EuroQol Five-Dimension Questionnaire (utility score) (r = −0.17; 95% CI = −0.26 to −0.07), EuroQol Five-Dimension Questionnaire domains (−0.32 < r < −0.06), and St George Respiratory Questionnaire total (r = −0.26; 95% CI = −0.33 to −0.17). The quality of the evidence ranged from low to very low across outcomes.

Conclusion

Although heterogeneity was present among HGS measurement protocols, small to moderate associations were found, indicating that those with lower HGS have an increased likelihood of death, a higher risk of increased COPD morbidity (as assessed with Body Mass Index, Airflow Obstruction, Dyspnea and Exercise Capacity indexes), and poorer HRQL.
Early predictors of renal outcome in patients with proliferative lupus nephritis: a 36-month cohort study
Authors: Luís Mariana S F , Bultink Irene E M , da Silva José A P , Voskuyl Alexandre E , Inês Luís S
Published: February 2021

Objectives

To identify predictors of complete renal response (CRR) and renal flares in SLE patients with active proliferative LN.

Methods

This was a retrospective cohort study over 36 months including patients with biopsy-proven proliferative LN (class III/IV), from two European tertiary centres. CRR and renal flare were defined as proteinuria <0.5 g/day with normal renal function and proteinuria >1 g/day after CRR attainment, respectively. Demographic, clinical and analytic parameters were evaluated as early predictors of renal outcome, using survival analysis. Candidate variables were tested as predictors for CRR at time 0, 3 and 6 months after starting induction treatment. Potential predictors for renal flare were evaluated at time of reaching CRR. Variables with P < 0.10 on univariate analysis with log-rank tests were further tested with multivariate Cox proportional hazards regression models.

Results

We included 104 patients [81.7% female, mean (s.d.) age at baseline 32.0 (13.3) years]. Over follow-up, 91.7% reached CRR, within a median time of 6.0 months. Proteinuria <2 g/day at baseline [hazard ratio (HR) = 1.80, 95% CI 1.16, 2.79, P < 0.01] and 3 months (HR = 2.32, 95% CI 1.24, 4.32, P < 0.01) after starting induction therapy were independent predictors of CRR. Renal flares occurred in 18.4% of patients reaching CRR, after a mean time of 16.5 (8.6) months. Age up to 25 years at time of LN diagnosis (HR = 5.41, 95% CI 1.72, 16.97, P < 0.01) and positive anti-RNP (HR = 3.52, 95% CI 1.21, 10.20, P = 0.02) were independent predictors of renal flares.

Conclusion

In patients with SLE and proliferative LN, factors assessed at baseline and 3 months from starting induction treatment can predict CRR and renal flares once CRR is achieved.
IMAGE QUALITY AND POTENTIAL DOSE REDUCTION USING ADVANCED MODELED ITERATIVE RECONSTRUCTION (ADMIRE) IN ABDOMINAL CT - A REVIEW
Authors: Kataria B , Nilsson Althén J , Smedby Ö , Persson A , Sökjer H , Sandborg M
Published: February 2021

Traditional filtered back projection (FBP) reconstruction methods have served the computed tomography (CT) community well for over 40 years. With the increased use of CT during the last decades, efforts to minimise patient exposure, while maintaining sufficient or improved image quality, have led to the development of model-based iterative reconstruction (MBIR) algorithms from several vendors. The usefulness of the advanced modeled iterative reconstruction (ADMIRE) (Siemens Healthineers) MBIR in abdominal CT is reviewed and its noise suppression and/or dose reduction possibilities explored. Quantitative and qualitative methods with phantom and human subjects were used. Assessment of the quality of phantom images will not always correlate positively with those of patient images, particularly at the higher strength of the ADMIRE algorithm. With few exceptions, ADMIRE Strength 3 typically allows for substantial noise reduction compared to FBP and hence to significant (≈30%) patient dose reductions. The size of the dose reductions depends on the diagnostic task.
Social Exclusion and Resilience: Examining Social Network Stratification among People in Same-Sex and Different-Sex Relationships
Authors: Fischer Mirjam M
Published: February 2021

Social networks of minoritized societal groups may be exposed to a unique structural force, namely that of social exclusion. Using a national sample of people in same-sex and different-sex relationships in the Netherlands (N = 1,329), this study examines sexual orientation as stratifying factor in social networks. Specifically, it is a comparison of their size and composition. Overall, the networks are similar but a few differences stand out. People in same-sex relationships have larger networks than people in different-sex relationships, which are made up of fewer ties with the family-of-origin and more friends. This lends support to the families-of-choice hypothesis and suggests that people employ resilience strategies, such as alternative community building, to counteract social exclusion from families-of-origin. The results further show that men in same-sex relationships have the fewest same-gender ties in their networks out of both men and women in any relationship type. Overall, the results show that sexual orientation is a dimension worthwhile studying as a stratifying factor of social networks both standing alone and at the intersection with gender.
Incidence of insomnia and obstructive sleep apnea in active duty United States military service members
Authors: Moore Brian A , Tison Lynn M , Palacios Javier G , Peterson Alan L , Mysliwiec Vincent
Published: February 2021

Study Objectives

Epidemiologic studies of obstructive sleep apnea (OSA) and insomnia in the U.S. military are limited. The primary aim of this study was to report and compare OSA and insomnia diagnoses in active duty the United States military service members.

Method

Data and service branch densities used to derive the expected rates of diagnoses on insomnia and OSA were drawn from the Defense Medical Epidemiology Database. Single sample chi-square goodness of fit tests and independent samples t-tests were conducted to address the aims of the study.

Results

Between 2005 and 2019, incidence rates of OSA and insomnia increased from 11 to 333 and 6 to 272 (per 10,000), respectively. Service members in the Air Force, Navy, and Marines were diagnosed with insomnia and OSA below expected rates, while those in the Army had higher than expected rates (p < .001). Female service members were underdiagnosed in both disorders (p < .001). Comparison of diagnoses following the transition from ICD 9 to 10 codes revealed significant differences in the amounts of OSA diagnoses only (p < .05).

Conclusion

Since 2005, incidence rates of OSA and insomnia have markedly increased across all branches of the U.S. military. Despite similar requirements for overall physical and mental health and resilience, service members in the Army had higher rates of insomnia and OSA. This unexpected finding may relate to inherent differences in the branches of the military or the role of the Army in combat operations. Future studies utilizing military-specific data and directed interventions are required to reverse this negative trend.
Social Work with Environmental Migrants: Exploring the Scope for Spiritually Sensitive Practice
Authors: Pandya Samta
Published: February 2021

This article reports a survey of social workers’ (N = 1,204) views on the scope for spiritually sensitive practice with environmental migrants. Results indicated some variations in models, assessment methods, techniques, and intervention goals. Social workers from North America and South America, females, Christians, and Hindus working with environmentally forced migrants, and with higher scores on personal spirituality measures, favored the strengths perspective and model of salutogenesis, spiritual life maps, and spiritual competencies open dialogue as assessment methods; meditation and mindfulness as congruous techniques; and intervention goals as comprehensibility–manageability–meaningfulness and positive coping. Social workers from the Asia-Pacific and African regions, males, Muslims, and Buddhists working with environmental emergency and environmentally induced economic migrants, and with lower personal spirituality scores, preferred the biopsychosocial model and transpersonal spectrum models, spiritual genograms and spiritual history assessment; techniques such as guided visualization, journal keeping, physical disciplines, and active imagination; and goals of interventions such as happiness and forgiveness.
Impact of Pleistocene Eustatic Fluctuations on Evolutionary Dynamics in Southeast Asian Biodiversity Hotspots
Authors: Sholihah Arni , Delrieu-Trottin Erwan , Condamine Fabien L , Wowor Daisy , Rüber Lukas , Pouyaud Laurent , Agnèse Jean-Francçois , Hubert Nicolas
Published: February 2021

Pleistocene climatic fluctuations (PCF) are frequently highlighted as important evolutionary engines that triggered cycles of biome expansion and contraction. Although there is ample evidence of the impact of PCF on biodiversity of continental biomes, the consequences in insular systems depend on the geology of the islands and the ecology of the taxa inhabiting them. The idiosyncratic aspects of insular systems are exemplified by the islands of the Sunda Shelf in Southeast Asia (Sundaland), where PCF-induced eustatic fluctuations had complex interactions with the geology of the region, resulting in high species diversity and endemism. Emergent land in Southeast Asia varied drastically with sea-level fluctuations during the Pleistocene. Climate-induced fluctuations in sea level caused temporary connections between insular and continental biodiversity hotspots in Southeast Asia. These exposed lands likely had freshwater drainage systems that extended between modern islands: the Paleoriver Hypothesis. Built upon the assumption that aquatic organisms are among the most suitable models to trace ancient river boundaries and fluctuations of landmass coverage, the present study aims to examine the evolutionary consequences of PCF on the dispersal of freshwater biodiversity in Southeast Asia. Time-calibrated phylogenies of DNA-delimited species were inferred for six species-rich freshwater fish genera in Southeast Asia (Clarias, Channa, Glyptothorax, Hemirhamphodon, Dermogenys, Nomorhamphus). The results highlight rampant cryptic diversity and the temporal localization of most speciation events during the Pleistocene, with 88% of speciation events occurring during this period. Diversification analyses indicate that sea-level-dependent diversification models poorly account for species proliferation patterns for all clades excepting Channa. Ancestral area estimations point to Borneo as the most likely origin for most lineages, with two waves of dispersal to Sumatra and Java during the last 5 myr. Speciation events are more frequently associated with boundaries of the paleoriver watersheds, with 60%, than islands boundaries, with 40%. In total, one-third of speciation events are inferred to have occurred within paleorivers on a single island, suggesting that habitat heterogeneity and factors other than allopatry between islands substantially affected diversification of Sundaland fishes. Our results suggest that species proliferation in Sundaland is not wholly reliant on Pleistocene sea-level fluctuations isolating populations on different islands. [Dispersal; diversification; eustatic fluctuations; freshwater fishes; insular systems; Milankovitch cycles; paleoenvironments; vicariance.]
Different climate sensitivity for radial growth, but uniform for tree-ring stable isotopes along an aridity gradient in Polylepis tarapacana, the world’s highest elevation tree species
Authors: Rodriguez-Caton Milagros , Andreu-Hayles Laia , Morales Mariano S , Daux Valérie , Christie Duncan A , Coopman Rafael E , Alvarez Claudio , Rao Mukund Palat , Aliste Diego , Flores Felipe , Villalba Ricardo
Published: February 2021

Tree growth is generally considered to be temperature limited at upper elevation treelines, yet climate factors controlling tree growth at semiarid treelines are poorly understood. We explored the influence of climate on stem growth and stable isotopes for Polylepis tarapacana Philipi, the world’s highest elevation tree species, which is found only in the South American Altiplano. We developed tree-ring width index (RWI), oxygen (δ18O) and carbon (δ13C) chronologies for the last 60 years at four P. tarapacana stands located above 4400 m in elevation, along a 500 km latitude aridity gradient. Total annual precipitation decreased from 300 to 200 mm from the northern to the southern sites. We used RWI as a proxy of wood formation (carbon sink) and isotopic tree-ring signatures as proxies of leaf-level gas exchange processes (carbon source). We found distinct climatic conditions regulating carbon sink processes along the gradient. Current growing-season temperature regulated RWI at northern-wetter sites, while prior growing-season precipitation determined RWI at arid southern sites. This suggests that the relative importance of temperature to precipitation in regulating tree growth is driven by site water availability. By contrast, warm and dry growing seasons resulted in enriched tree-ring δ13C and δ18O at all study sites, suggesting that similar climate conditions control carbon-source processes along the gradient. Site-level δ13C and δ18O chronologies were significantly and positively related at all sites, with the strongest relationships among the southern drier stands. This indicates an overall regulation of intercellular carbon dioxide via stomatal conductance for the entire P. tarapacana network, with greater stomatal control when aridity increases. This manuscript also highlights a coupling (decoupling) between physiological processes at leaf level and wood formation as a function of similarities (differences) in their climatic sensitivity. This study contributes to a better understanding and prediction of the response of high-elevation Polylepis woodlands to rapid climate changes and projected drying in the Altiplano.
A multigene phylogeny of the eristaline flower flies (Diptera: Syrphidae), with emphasis on the subtribe Criorhinina
Authors: Moran Kevin M , Skevington Jeffrey H , Kelso Scott , Mengual Ximo , Jordaens Kurt , Young Andrew D , Ståhls Gunilla , Mutin Valerii , Bot Sander , van Zuijen Menno , Ichige Katsuyoshi , van Steenis Jeroen , Hauser Martin , van Steenis Wouter
Published: February 2021

We present the first multigene phylogeny focused on Eristalinae (Diptera: Syrphidae) utilizing a dataset containing 120 flower fly species from across all four subfamilies and representing 13 out of 16 tribes. Eight genes were used in the construction of the phylogeny: mitochondrial cytochrome c oxidase subunit I and the nuclear genes 28S ribosomal DNA, Alanylt RNA Synthetase, the carbamoyl phosphate synthase domain of CAD, Period, RNA-binding Protein 15 (RBP–15, 5’), Casein Kinase 1 and TULP for a total of ~6.7 kB of data. Eristalinae is recovered as paraphyletic with strong support for the elevation of Cerioidini, Merodontini and Volucellini to subfamilial status. Deineches, Flukea and Malometasternum render Criorhinina paraphyletic with respect to the type genus Criorhina. A clade with Criorhina, Matsumyia and Sphecomyia is strongly supported. The generic concept of Criorhina is paraphyletic, while Sphecomyia is monophyletic and Matsumyia is monophyletic but requires expansion. Evidence supports the resurrection of Romaleosyrphus and the creation of new genera. Criorhinina (stat. rev.) is restricted to contain Criorhina, Matsumyia, Romaleosyrphus and Sphecomyia. Thirteen changes to the higher classification of Syrphidae are proposed.