bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful management of donor-acquired fat embolism after lung transplantation
Authors: Glorion Matthieu , Sarsam Matthieu , de Wolf Julien , Sage Edouard
Published: February 2021

Fat embolism is a serious complication in patients with multiple traumatic injuries. It is often asymptomatic during the first hours of resuscitation, thus remains underdiagnosed in patients who progress to brain death. Lung transplantation issued from such grafts can lead to severe lung primary graft dysfunction, the management of which is deemed difficult. Herein, we report a successful management of donor-acquired fat embolism syndrome after lung transplant in a 22 years old woman for cystic fibrosis. Fat embolism was suspected because of the donor’s traumatic injuries and confirmed by histopathological analysis. An immediate postoperative primary graft dysfunction was successfully managed with veno-arterial extracorporeal membrane oxygenation. The patient is alive 31 months after surgery.
S-Variant SARS-CoV-2 Lineage B1.1.7 Is Associated With Significantly Higher Viral Load in Samples Tested by TaqPath Polymerase Chain Reaction
Authors: Kidd Michael , Richter Alex , Best Angus , Cumley Nicola , Mirza Jeremy , Percival Benita , Mayhew Megan , Megram Oliver , Ashford Fiona , White Thomas , Moles-Garcia Emma , Crawford Liam , Bosworth Andrew , Atabani Sowsan F , Plant Tim , McNally Alan
Published: February 2021

A SARS-CoV-2 variant B1.1.7 containing mutation Δ69/70 has spread rapidly in the United Kingdom and shows an identifiable profile in ThermoFisher TaqPath RT-qPCR, S gene target failure (SGTF). We analyzed recent test data for trends and significance. Linked cycle threshold (Ct) values for respiratory samples showed that a low Ct for ORF1ab and N were clearly associated with SGTF. Significantly more SGTF samples had higher inferred viral loads between 1×107 and 1×108. Our conclusion is that patients whose samples exhibit the SGTF profile are more likely to have high viral loads, which may explain higher infectivity and rapidity of spread.
Development and validation of prediction models for mechanical ventilation, renal replacement therapy, and readmission in COVID-19 patients
Authors: Rodriguez Victor Alfonso , Bhave Shreyas , Chen Ruijun , Pang Chao , Hripcsak George , Sengupta Soumitra , Elhadad Noemie , Green Robert , Adelman Jason , Metitiri Katherine Schlosser , Elias Pierre , Groves Holden , Mohan Sumit , Natarajan Karthik , Perotte Adler
Published: February 2021

Objective

Coronavirus disease 2019 (COVID-19) patients are at risk for resource-intensive outcomes including mechanical ventilation (MV), renal replacement therapy (RRT), and readmission. Accurate outcome prognostication could facilitate hospital resource allocation. We develop and validate predictive models for each outcome using retrospective electronic health record data for COVID-19 patients treated between March 2 and May 6, 2020.

Materials and Methods

For each outcome, we trained 3 classes of prediction models using clinical data for a cohort of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2)–positive patients (n = 2256). Cross-validation was used to select the best-performing models per the areas under the receiver-operating characteristic and precision-recall curves. Models were validated using a held-out cohort (n = 855). We measured each model’s calibration and evaluated feature importances to interpret model output.

Results

The predictive performance for our selected models on the held-out cohort was as follows: area under the receiver-operating characteristic curve—MV 0.743 (95% CI, 0.682-0.812), RRT 0.847 (95% CI, 0.772-0.936), readmission 0.871 (95% CI, 0.830-0.917); area under the precision-recall curve—MV 0.137 (95% CI, 0.047-0.175), RRT 0.325 (95% CI, 0.117-0.497), readmission 0.504 (95% CI, 0.388-0.604). Predictions were well calibrated, and the most important features within each model were consistent with clinical intuition.

Discussion

Our models produce performant, well-calibrated, and interpretable predictions for COVID-19 patients at risk for the target outcomes. They demonstrate the potential to accurately estimate outcome prognosis in resource-constrained care sites managing COVID-19 patients.

Conclusions

We develop and validate prognostic models targeting MV, RRT, and readmission for hospitalized COVID-19 patients which produce accurate, interpretable predictions. Additional external validation studies are needed to further verify the generalizability of our results.
Deep-learning-based automated terminology mapping in OMOP-CDM
Authors: Kang Byungkon , Yoon Jisang , Kim Ha Young , Jo Sung Jin , Lee Yourim , Kam Hye Jin
Published: February 2021

Objective

Accessing medical data from multiple institutions is difficult owing to the interinstitutional diversity of vocabularies. Standardization schemes, such as the common data model, have been proposed as solutions to this problem, but such schemes require expensive human supervision. This study aims to construct a trainable system that can automate the process of semantic interinstitutional code mapping.

Materials and Methods

To automate mapping between source and target codes, we compute the embedding-based semantic similarity between corresponding descriptive sentences. We also implement a systematic approach for preparing training data for similarity computation. Experimental results are compared to traditional word-based mappings.

Results

The proposed model is compared against the state-of-the-art automated matching system, which is called Usagi, of the Observational Medical Outcomes Partnership common data model. By incorporating multiple negative training samples per positive sample, our semantic matching method significantly outperforms Usagi. Its matching accuracy is at least 10% greater than that of Usagi, and this trend is consistent across various top-k measurements.

Discussion

The proposed deep learning-based mapping approach outperforms previous simple word-level matching algorithms because it can account for contextual and semantic information. Additionally, we demonstrate that the manner in which negative training samples are selected significantly affects the overall performance of the system.

Conclusion

Incorporating the semantics of code descriptions more significantly increases matching accuracy compared to traditional text co-occurrence-based approaches. The negative training sample collection methodology is also an important component of the proposed trainable system that can be adopted in both present and future related systems.
Parechovirus A in Hospitalized Children With Respiratory Tract Infections: A 10-Year-Long Study From Norway
Authors: Skanke Lars Høsøien , Lysvand Hilde , Heimdal Inger , Moe Nina , Krokstad Sidsel , Christensen Andreas , Risnes Kari , Nordbø Svein Arne , Døllner Henrik
Published: February 2021

Background

The role of Parechovirus A (PeV-A) in hospitalized children with respiratory tract infections (RTIs) is unclear. We studied the occurrence and impact of PeV-A over 10 years.

Methods

Children from Sør-Trøndelag County, Norway, hospitalized with RTI and a comparison group of asymptomatic children admitted to elective surgery, were prospectively enrolled from 2006 to 2016. Nasopharyngeal aspirates were cultured and analyzed with polymerase chain reaction tests for PeV-A and 19 other pathogens. The cycle threshold levels of PeV-A were reported as measures of viral genomic loads. Parechovirus A-positive samples were genotyped by amplification and sequencing of the VP3/VP1 junction.

Results

Parechovirus A was detected in 8.8% (323/3689) patients with RTI and in 10.1% (45/444) of the children in the comparison group (P = .34). Parechovirus A genotyping (n = 188) revealed PeV-A1 (n = 121), PeV-A3 (n = 15), PeV-A5 (n = 6), and PeV-A6 (n = 46). Viral codetections occurred in 95% of patients and in 84% of the children in the comparison group (P = .016). In multivariable logistic regression analysis, RTI was unrelated to PeV-A genomic loads, adjusted for other viruses and covariates. Similar results were found for PeV-A1 and PeV-A6.

Conclusions

Parechovirus A and viral codetections were common in hospitalized children with RTI and asymptomatic children in a comparison group. Our findings suggest that PeV-A has a limited role in hospitalized children with RTI.
Nrf2 signalling pathway and autophagy impact on the preventive effect of green tea extract against alcohol-induced liver injury
Authors: Zhang Yu-Pei , Yang Xue-Qin , Yu Dong-Ke , Xiao Heng-Yi , Du Jun-Rong
Published: February 2021

Objectives

To explore the potential molecular mechanism underlying the effect of green tea extract (TE), rich in tea polyphenols (TPs), on improving alcohol-induced liver injury.

Methods

Mice were intragastrically treated with 50% (v/v) alcohol administration (15 ml/kg BW) with or without three doses of TE (50, 120 and 300 mg TPs/kg BW) daily for 4 weeks, and biological changes were tested.

Key findings

The TE improved the functional and histological situations in the liver of the mice accepted alcohol administration, including enzymes for alcohol metabolism, oxidative stress and lipid accumulation. Interestingly, the TE increased the nuclear translocation of nuclear factor erythroid-2-related factor 2 (Nrf2), with the decreasing expression of kelch-like ECH-associated protein 1 (Keap1), indicating the association between the effect of TE with Nrf2-mediated antioxidant signalling. Moreover, the TE restored the activity of autophagy, showing as lifted Beclin-1 expression, LC3B-II/LC3B-I ratio, and decreased p62 expression. Importantly, all these effects were dose-dependent.

Conclusions

These findings provide a new notion for the first time that the TE preventing against alcohol-induced liver injury is closely related to accelerated metabolism of alcohol and relieved oxidative stress, which is associated with Nrf2 signalling activation and autophagy restoration, thus the reduction of lipid accumulation in liver.
An unusual cause of multiple embolic strokes: cardiac myxoma, about a case
Authors: Wazaren Hicham , Bouhdadi Hanae , El Boussaadani Badre , Derqaoui Sabrine , Hosni Abdelmoughit , Idrissa Malick , Benlafqih Chakib , Rhissassi Jaafar , Sayah Rochde , Laaroussi Mohammed
Published: February 2021

Cardiac myxomas are the most common primary intracardiac tumors, accounting for 50% of all cardiac neoplasms, with an estimated frequency of 0.5/million/inhabitants/year. Presenting symptoms are related to cerebral or peripheral embolism, and/or intracardiac obstruction. Thus, urgent management of myxoma is mandatory due to embolism’s risk. Herein, we report the case of an 82-year-old woman with a myxoma of the left atrium, revealed by a multiple ischemic strokes, to raise awareness of this entity.
Tolerance and humoral immune response to the yellow fever vaccine in sickle cell disease children treated with hydroxyurea: a multicentre prospective study
Authors: Koehl Berengere , Aupiais Camille , Schinckel Nelly , Mornand Pierre , Odièvre Marie-Hélène , Niakate Assa , Brousse Valentine , Ithier Ghislaine , Missud Florence , Holvoet Laurent , Benkerrou Malika , Sorge Frederic , Faye Albert
Published: February 2021

Background

Sickle cell disease (SCD) children are frequent travellers to countries where yellow fever (YF) is endemic, but there are no data regarding the safety and immunogenicity of the vaccine in such children treated with hydroxyurea (HU). The main objective of this study was to compare the tolerance and immune response to YF vaccination in SCD children treated or not with HU.

Method

SCD children < 18 years attending the international travel clinics of three large paediatric centres and requiring a first YF vaccination were included in a prospective study. Adverse events were collected 2 weeks after vaccination. YF vaccine antibody titres were measured ~6 months after vaccination.

Results

Among the 52 SCD children vaccinated against YF, 17 (33%) were treated with HU. Only mild adverse events, mainly fever and local reaction, were observed in the HU group with a similar frequency in the non-HU group (57 and 35%, respectively, P = 0.30). YF antibody titres were measured in 15/17 patients in the HU group and 23/35 patients in the non-HU group after a median of 6.0 months (3.5–8.5) following vaccination. The geometric mean of YF antibody titre was similar in both groups. A protective antibody level was observed in 85% of the children in the HU group vs 100% in the non-HU group (P = 0.14), suggesting a lower effectiveness of the vaccine in patients on HU similarly to what has been described in patients on immune suppressive therapy for other vaccines.

Conclusion

YF vaccination seems to be safe and efficient in SCD children treated with HU. Considering the potential risk of severe complications in cases of YF while travelling in Africa for those patients, the benefit-to-risk ratio argues for YF vaccination in all SCD children. Control of a protective antibody titre may also be useful to ascertain an adequate response in those treated with HU.
Lexical and function words or language and text type? Abbreviation consistency in an aligned corpus of Latin and Middle English plague tracts
Authors: Honkapohja Alpo , Suomela Jukka
Published: February 2021

This study examines the consistency of medieval abbreviation practices in a parallel corpus consisting of Latin and Middle English copies of a plague treatise attributed to John of Burgundy (JB). Focusing on different versions of the treatise enables us to maximize textual and lexical overlap, comparing differences caused by text type, word type, and language. We examine how the following variables affect the consistency of abbreviating across manuscript witnesses: A language: Latin versus English; B text type: recipes versus running text; C word type: lexical versus function words; and D: the number of characters in a word. Variables A–D are compared using a parallel corpus of automatically aligned rich TEI P5 XML-tagged transcriptions of six manuscript witnesses to the JB treatise. The alignment process is based on computer–human collaboration and custom-built alignment tool which uses sections tagged in the TEI XML file and word division. The results reveal that abbreviation was overwhelmingly more consistent in Latin than in the Middle English and somewhat more consistent in recipes. High token counts of frequent lexical items had a major effect on the results. Word length worked better than division into lexical and function words.
The Sun’s distance from the Galactic Centre and mid-plane, and the Galactic old bulge’s morphology: 715 VVV Type II Cepheids
Authors: Griv Evgeny , Gedalin Michael , Pietrukowicz Pawel , Majaess Daniel , Jiang Ing-Guey
Published: February 2021

A statistical method is employed in tandem with new VISTA Variables in the Via Lactea (VVV) near-infrared observations to determine the Sun’s distance from the Galactic Centre (r0, GC), the Sun’s height from the local mid-plane (z0), and to likewise infer the shape of the Galactic ∼10 Gyr old bulge. Specifically, the conclusions stem from an investigation of 715 high-latitude (|b| > 1°) and centrally symmetric concentrated Type II Cepheids (T2Cs) recently identified in the VVV survey by Braga et al. The analysis yields r0 = 8.35 ± 0.10 kpc and z0 = 10 ± 2 pc. The T2Cs distribution within the effective bulge radius rbulge = 2–3 kpc is an ellipsoid exhibiting axial ratios of ≈1:0.7:0.6, with the major axis inclined at an angle θ ≈ −3° to the Sun–GC sightline. T2Cs do not trace a prominent barred structure at distances >1 kpc from the GC. A key conclusion is that analyses of independent optical and infrared Optical Gravitational Lensing Experiment (OGLE) and VVV observations yield consistent results (e.g. r0 > 8.0 kpc and both observations display a comparable shape of an ellipsoid), thus providing a constrained and reduced systematic uncertainty.
Motility of efferent duct cilia aids passage of sperm cells through the male reproductive system
Authors: Aprea Isabella , Nöthe-Menchen Tabea , Dougherty Gerard W , Raidt Johanna , Loges Niki T , Kaiser Thomas , Wallmeier Julia , Olbrich Heike , Strünker Timo , Kliesch Sabine , Pennekamp Petra , Omran Heymut
Published: February 2021

Motile cilia line the efferent ducts of the mammalian male reproductive tract. Several recent mouse studies have demonstrated that a reduced generation of multiple motile cilia in efferent ducts is associated with obstructive oligozoospermia and fertility issues. However, the sole impact of efferent duct cilia dysmotility on male infertility has not been studied so far either in mice or human. Using video microscopy, histological- and ultrastructural analyses, we examined male reproductive tracts of mice deficient for the axonemal motor protein DNAH5: this defect exclusively disrupts the outer dynein arm (ODA) composition of motile cilia but not the ODA composition and motility of sperm flagella. These mice have immotile efferent duct cilia that lack ODAs, which are essential for ciliary beat generation. Furthermore, they show accumulation of sperm in the efferent duct. Notably, the ultrastructure and motility of sperm from these males are unaffected. Likewise, human individuals with loss-of-function DNAH5 mutations present with reduced sperm count in the ejaculate (oligozoospermia) and dilatations of the epididymal head but normal sperm motility, similar to DNAH5 deficient mice. The findings of this translational study demonstrate, in both mice and men, that efferent duct ciliary motility is important for male reproductive fitness and uncovers a novel pathomechanism distinct from primary defects of sperm motility (asthenozoospermia). If future work can identify environmental factors or defects in genes other than DNAH5 that cause efferent duct cilia dysmotility, this will help unravel other causes of oligozoospermia and may influence future practices in genetic and fertility counseling as well as ART.
Consensus recommendations for MRI and PET imaging of primary central nervous system lymphoma: guideline statement from the International Primary CNS Lymphoma Collaborative Group (IPCG)
Authors: Barajas Ramon F , Politi Letterio S , Anzalone Nicoletta , Schöder Heiko , Fox Christopher P , Boxerman Jerrold L , Kaufmann Timothy J , Quarles C Chad , Ellingson Benjamin M , Auer Dorothee , Andronesi Ovidiu C , Ferreri Andres J M , Mrugala Maciej M , Grommes Christian , Neuwelt Edward A , Ambady Prakash , Rubenstein James L , Illerhaus Gerald , Nagane Motoo , Batchelor Tracy T , Hu Leland S
Published: February 2021

Advanced molecular and pathophysiologic characterization of primary central nervous system lymphoma (PCNSL) has revealed insights into promising targeted therapeutic approaches. Medical imaging plays a fundamental role in PCNSL diagnosis, staging, and response assessment. Institutional imaging variation and inconsistent clinical trial reporting diminishes the reliability and reproducibility of clinical response assessment. In this context, we aimed to: (1) critically review the use of advanced positron emission tomography (PET) and magnetic resonance imaging (MRI) in the setting of PCNSL; (2) provide results from an international survey of clinical sites describing the current practices for routine and advanced imaging, and (3) provide biologically based recommendations from the International PCNSL Collaborative Group (IPCG) on adaptation of standardized imaging practices. The IPCG provides PET and MRI consensus recommendations built upon previous recommendations for standardized brain tumor imaging protocols (BTIP) in primary and metastatic disease. A biologically integrated approach is provided to addresses the unique challenges associated with the imaging assessment of PCNSL. Detailed imaging parameters facilitate the adoption of these recommendations by researchers and clinicians. To enhance clinical feasibility, we have developed both “ideal” and “minimum standard” protocols at 3T and 1.5T MR systems that will facilitate widespread adoption.
Prolonged Symptoms After COVID-19 Infection in Outpatients
Authors: Ramakrishnan Aditi , Zreloff Jennifer , Moore Miranda A , Bergquist Sharon H , Cellai Michele , Higdon Jason , O’Keefe James B , Roberts David , Wu Henry M
Published: February 2021

We review 127 encounters for polymerase chain reaction–confirmed coronavirus disease 2019 (COVID-19) infection at a multidisciplinary outpatient clinic. We describe the symptomatology, time course, exam, and radiographic findings in this population. Patients with COVID-19 can experience persistent symptoms, primarily respiratory in nature, which can be severe enough to warrant hospitalization.
A Multicenter Evaluation of the US Prevalence and Regional Variation in Macrolide-Resistant S. pneumoniae in Ambulatory and Hospitalized Adult Patients in the United States
Authors: Gupta Vikas , Yu Kalvin C , Schranz Jennifer , Gelone Steven P
Published: February 2021

Macrolide resistance was found in 39.5% of 3626 nonduplicate Streptococcus pneumoniae isolates from adult ambulatory and inpatient settings at 329 US hospitals (2018–2019). Macrolide resistance was significantly higher for respiratory vs blood isolates and ambulatory vs inpatient settings. Despite geographic variation, S. pneumoniae macrolide resistance was >25% in most regions.
Efficacy and Safety of N-Acetylcysteine for the Management of Chronic Pain in Adults: A Systematic Review and Meta-Analysis
Authors: Mohiuddin Mohammed , Pivetta Bianca , Gilron Ian , Khan James S
Published: February 2021

Objective

To assess the efficacy and safety of N-acetylcysteine in the treatment of chronic pain.

Methods

A systematic search was carried out until April 2020 for clinical studies of N-acetylcysteine in the management of any persistent or recurrent chronic pain condition for adults ≥ 18 years old. Risk of bias was assessed using the validated risk of bias tools. When appropriate, a meta-analysis using a random-effects model was performed, with a fixed-effect model for sensitivity analysis.

Results

Nine studies (n = 863) were included (five randomized controlled trials [RCTs], two open-label non-comparative studies and two comparative studies), that evaluated patients with sickle cell disease (3), complex regional pain syndrome (1), pelvic pain/endometriosis (2), rheumatoid arthritis (1), diabetic neuropathy (1), and chronic neuropathic pain (1). In the pooled analysis of three RCTs, N-acetylcysteine did not reduce pain intensities (SMD −0.21, 95% confidence interval [CI]: −0.33 to 0.75, random-effects), improve functional outcomes (SMD 0.21, 95% CI −0.33 to 0.75) or quality of life (SMD 0.60, 95% CI: −4.44 to 5.64); however, sensitivity analysis with a fixed effect model demonstrated an effect for pain intensities and function. Due to adverse events being inconsistently reported, no conclusion could be made regarding safety of N-acetylcysteine in chronic pain.

Conclusions

While there is some evidence to indicate N-acetylcysteine may provide analgesic efficacy for certain pain conditions, there is insufficient evidence to provide definitive evidence on NAC in chronic pain management. Larger-size RCTs spanning a variety of chronic pain conditions are needed to determine N-acetylcysteine’s role, if any, in pain medicine.
Short-Term Effect of Scalp Acupuncture on Pain, Sleep Disorders, and Quality of Life in Patients with Temporomandibular Disorders: A A Randomized Clinical Trial
Authors: Peixoto Karen Oliveira , da Silva Bezerra Aliane , Melo Rafaela Albuquerque , de Resende Camila Maria Bastos Machado , de Almeida Erika Oliveira , Barbosa Gustavo Augusto Seabra
Published: February 2021

Objetive

To evaluate the effects of Chinese scalp acupuncture in patients diagnosed with temporomandibular disorders (TMD) on pain, sleep, and quality of life (QOL), and compare these results with the results from traditional therapies.

Methods

Sixty patients diagnosed with TMD using the research diagnostic criteria for temporomandibular disorders (RDC/TMD) were allocated into four treatment groups: counseling (C = 15), occlusal splint (OS = 15), scalp acupuncture (SA = 15), and manual therapy (MT = 15). Participants were re-evaluated within 1 month. Three questionnaires were used to access sleep disorders, QOL, and pain: The Pittsburgh Sleep Quality Index (PSQI), World Health Organization Quality of Life (WHOQOL-bref), and the Visual Analogue Scale (VAS), respectively. The data obtained were analyzed using the Statistical Package for the Social Science program (SPSS 22.0).

Results

The SA group significantly improved pain (P = .015), as well as the OS (P = .01) and MT groups (P = .014). Only the OS (P = .002) and MT (P = .029) groups improved sleep. MT group significantly improved QOL in terms of the physical domain of the WHOQOL-bref (P = .011) and the OS group in the psychological domain (P = .012).

Conclusions

The scalp acupuncture proved to be another alternative for pain relief in patients with TMD, demonstrating positive results in the short term. However, it was not as effective in improving quality of life and sleep.
Change in Brain Oscillations as a Mechanism of Mindfulness-Meditation, Cognitive Therapy, and Mindfulness-Based Cognitive Therapy for Chronic Low Back Pain
Authors: Day Melissa A , Matthews Natasha , Mattingley Jason B , Ehde Dawn M , Turner Aaron P , Williams Rhonda M , Jensen Mark P
Published: February 2021

Objective

Psychological treatments for chronic low back pain (CLBP) are effective. However, limited research has investigated their neurophysiological mechanisms. This study examined electroencephalography- (EEG-) assessed brain oscillation changes as potential mechanisms of cognitive therapy (CT), mindfulness-meditation (MM), and mindfulness-based cognitive therapy (MBCT) for CLBP. The a priori bandwidths of interest were changes in theta, alpha and beta power, measured at pre- and post-treatment.

Design

A secondary analysis of a clinical trial.

Setting

University of Queensland Psychology Clinic.

Subjects

Adults (N = 57) with CLBP who completed pre- and post-treatment EEG and pain outcome assessments.

Methods

EEG data were examined for five regions of interest (ROIs); the primary outcome was pain intensity.

Results

A significant reduction in theta (P=.015) and alpha (P=.006) power in the left frontal ROI across all treatments was found, although change in theta and alpha power in this region was not differentially associated with outcome across treatments. There were significant reductions in beta power in all five ROIs across all treatments (P≤.013). Beta power reduction in the central ROI showed a significant association with reduced pain intensity in MBCT only (P=.028). Changes in other regions were not statistically significant.

Conclusions

These findings provide support for the capacity of psychological CLBP treatments to induce changes in brain activity. The reduced beta power in all five ROIs indicated that all three treatments engendered a state of lowered cortical arousal. The growing body of research in this area could potentially inform novel directions towards remedying central nervous system abnormalities associated with CLBP.
Acceleration of Bone-Tendon Interface Healing by Low-Intensity Pulsed Ultrasound Is Mediated by Macrophages
Authors: Li Shengcan , Xu Zihan , Wang Zhanwen , Xiang Jie , Zhang Tao , Lu Hongbin
Published: February 2021

Objective

Low-intensity pulsed ultrasound (LIPUS) has been proven to facilitate bone-tendon interface (BTI) healing and regulate some inflammatory cytokines. However, the role of macrophages, a key type of inflammatory cell, during treatment remains unknown. This study aimed to investigate the role of macrophages in the treatment of BTI injury with LIPUS in a rotator cuff tear animal model.

Methods

In this experimental and comparative study, a total of 160 C57BL/6 mature male mice that underwent supraspinatus tendon detachment and repair were randomly assigned to 4 groups: daily ultrasonic treatment and liposomal clodronate (LIPUS+LC), daily ultrasonic treatment and liposomes (LIPUS), daily mock sonication and liposomal clodronate (LC), and daily mock sonication and liposomes (control [CTL]). LIPUS treatment was initiated immediately postoperatively and continued daily until the end of the experimental period.

Results

The failure load and stiffness of the supraspinatus tendon–humerus junction were significantly higher in the LIPUS group than in the other groups at postoperative weeks 2 and 4, whereas those in the LIPUS+LC and LC groups were lower than those in the CTL group at postoperative week 4. The LIPUS, LIPUS+LC, and LC groups exhibited significantly more fibrocartilage than the CTL group at 2 weeks. Only the LIPUS group had more fibrocartilage than the CTL group at 4 weeks. Micro-computed tomography results indicated that LIPUS treatment could improve the bone quality of the attachment site after both 2 and 4 weeks. When macrophages were depleted by LC, the bone quality–promoting effect of LIPUS treatment was significantly reduced.

Conclusion

The enhancement of BTI healing by LIPUS might be mediated by macrophages.

Impact

In our study, LIPUS treatment appeared to accelerate BTI healing, which was associated with macrophages based on our murine rotator cuff repair model. The expressions of macrophage under LIPUS treatment may offer a potential mechanism to explain BTI healing and the effects of LIPUS on BTI healing.
The modulatory effect of taurine on benzo (a) pyrene-induced hepatorenal toxicity
Authors: Owumi Solomon E , Adeniyi Gideon , Oyelere Adegboyega K
Published: February 2021

Toxicities linked with Benzo (a) pyrene B[a]P exposure, particularly in liver and kidney have been reported in both animals and humans. Taurine (2-aminoethane sulfonic acid) is an intracellular β-amino acid reported to elicit hepatorenal protective functions. However, the modulatory effect of taurine on hepatorenal toxicity associated with exposure to B[a]P has not been reported. This study evaluated the effects of taurine on the hepatorenal toxicities induced in cohorts of rats exposed to B[a]P. Experimental rats were treated as follows: B[a]P (10 mg/kg); co-treated cohorts –B[a]P (10 mg/kg) plus taurine (100 or 200 mg/kg) for 4 successive weeks. Results show that co-dosing with taurine significantly (P < 0.05) improved B[a]P-induced distortion of oxidative stress markers (catalase, superoxide dismutase, glutathione S-transferase, glutathione peroxidase, total sulphydryl, reduced glutathione, lipid peroxidation and xanthine oxidase), renal function (urea and creatinine) and liver function marker enzymes (alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase and gamma glutamyl transferase). Moreover, taurine effectively mitigated increase in myeloperoxidase activity, levels of reactive oxygen and nitrogen species, nitric oxide and interleukin-1β in kidney and liver of rats treated with B[a]P. In conclusion, taurine modulates hepatorenal toxicity in B[a]P-exposed rats by suppressing hepatic and renal damage indices, oxidative injury and inflammatory stress.
A Single Microbiome Gene Alters Murine Susceptibility to Acute Arsenic Exposure
Authors: Wang Qian , McDermott Timothy R , Walk Seth T
Published: February 2021

Environmental toxicant exposure contributes to morbidity and mortality of many human diseases. With respect to arsenic, microbially driven chemical transformations dictate its toxicity and mobility in virtually every environment yet studied, so a general hypothesis is that the human gut microbiome determines disease outcome following exposure. However, the complex nature of the gut microbiome and the myriad of potential interactions with human cells/tissues make it challenging to quantify the influence of specific arsenic-active functions—a requisite step in developing effective disease prevention and/or clinical intervention strategies. To control both mammalian and microbial function during toxicant exposure, we genetically defined the gut microbiome of mice using only Escherichia coli strain, AW3110 (▵arsRBC), or the same strain carrying a single genome copy of the Fucus vesiculosus metallothionein gene (AW3110::fmt); a cysteine-rich peptide that complexes with arsenite, facilitating bioaccumulation and reducing its toxic effects. AW3110::fmt bioaccumulated significantly more arsenic and gnotobiotic mice colonized by this strain excreted significantly more arsenic in stool and accumulated significantly less arsenic in organs. Moreover, AW3110::fmt gnotobiotic mice were protected from acute toxicity exposure (20 ppm AsIII) relative to controls. This study demonstrates—in a highly controlled fashion—that a single microbiome function (arsenic bioaccumulation) encoded by a single gene in a single human gut microbiome bacterium significantly alters mammalian host arsenic exposure. The experimental model described herein allows for a highly controlled and directed assessment of microbiome functions, and is useful to quantify the influence of specific microbiome-arsenic interactions that help mitigate human disease.
Seasonal and elevational variability in the induction of specialized compounds from mountain birch (Betula pubescens var. pumila) by winter moth larvae (Operophtera brumata)
Authors: Ryde Ingvild , Li Tao , Rieksta Jolanta , dos Santos Bruna M , Neilson Elizabeth H J , Gericke Oliver , Jepsen Jane U , Bork Louise R H , Holm Hildur S , Rinnan Riikka
Published: February 2021

The mountain birch [Betula pubescens var. pumila (L.)] forest in the Subarctic is periodically exposed to insect outbreaks, which are expected to intensify due to climate change. To mitigate abiotic and biotic stresses, plants have evolved chemical defenses, including volatile organic compounds (VOCs) and non-volatile specialized compounds (NVSCs). Constitutive and induced production of these compounds, however, are poorly studied in Subarctic populations of mountain birch. Here, we assessed the joint effects of insect herbivory, elevation and season on foliar VOC emissions and NVSC contents of mountain birch. The VOCs were sampled in situ by an enclosure technique and analyzed by gas chromatography–mass spectrometry. NVSCs were analyzed by liquid chromatography–mass spectrometry using an untargeted approach. At low elevation, experimental herbivory by winter moth larvae (Operophtera brumata) increased emissions of monoterpenes and homoterpenes over the 3-week feeding period, and sesquiterpenes and green leaf volatiles at the end of the feeding period. At high elevation, however, herbivory augmented only homoterpene emissions. The more pronounced herbivory effects at low elevation were likely due to higher herbivory intensity. Of the individual compounds, linalool, ocimene, 4,8-dimethylnona-1,3,7-triene, 2-methyl butanenitrile and benzyl nitrile were among the most responsive compounds in herbivory treatments. Herbivory also altered foliar NVSC profiles at both low and high elevations, with the most responsive compounds likely belonging to fatty acyl glycosides and terpene glycosides. Additionally, VOC emissions from non-infested branches were higher at high than low elevation, particularly during the early season, which was mainly driven by phenological differences. The VOC emissions varied substantially over the season, largely reflecting the seasonal variations in temperature and light levels. Our results suggest that if insect herbivory pressure continues to rise in the mountain birch forest with ongoing climate change, it will significantly increase VOC emissions with important consequences for local trophic interactions and climate.
Digital RNA-seq transcriptome plus tissue anatomy analyses reveal the developmental mechanism of the calabash-shaped root in Tetrastigma hemsleyanum
Authors: Xiang Taihe , Li Jiangshan , Bao Shuying , Xu Zhengxian , Wang Leizhen , Long Fazong , He Chenjing
Published: February 2021

Tetrastigma hemsleyanum Diels & Gilg ex Diels is a liana plant with promising medicinal and ornamental values. Its calabash-shaped roots (CRs) are served as a traditional Chinese herb. However, it takes a long growth period to form CRs. In this study, three types of architectural roots, including fibrous roots (FRs), bar-shaped roots (BRs) and CRs, were employed as materials, and the characteristics of histo-anatomy and digital RNA-seq transcriptome profiles were analyzed. Among the three types of roots, the vascular bundles in FRs were intact, while some of the vascular bundles degenerated in BRs, and only few traces of vascular bundles existed in CRs. Meanwhile, no obvious cell inclusions were found in the cytoplasm of FRs, while a few inclusions were found in BRs, and abundant inclusions were detected in CRs, which might be the main source of medicinal components in roots. The transcriptome profiles and qRT-PCR validation indicated that seven upregulated genes, encoding xyloglucan glycosyltransferase, ACC oxidase, CYP711A1, SHORT-ROOT transcript factor, galacturonosyltransferas, WAT1 and WRKY, and two downregulated genes, encoding LRR receptor-like serine/threonine-protein kinase and CYP83B1, were probably involved in the formation and development of CRs. In addition, Gene Ontology terms of intrinsic component of membrane, integral component of membrane, cell periphery, membrane part, plasma membrane, membrane, intrinsic component of plasma membrane, cellular chemical homeostasis and plasma membrane part were probably related to the formation of CRs. Kyoto Encyclopedia of Genes and Genomes pathways related to the development of CRs probably included MAPK signaling pathway–plant, plant hormone signal transduction and circadian rhythm–plant. Our finding suggested a probable mode for the formation of CRs.
Imported cystic echinococcosis in Spain: a systematic review
Authors: Zabala Andrea , Salvador Fernando , Sánchez-Montalvá Adrián , Bosch-Nicolau Pau , Escolà-Vergé Laura , Espinosa-Pereiro Juan , Molina Israel
Published: February 2021

Background

Cystic echinococcosis (CE) is a zoonosis caused by Echinococcus granulosus (sensu lato). It is a neglected tropical disease with a global distribution, affecting an estimated 2–3 million people globally. Official reporting systems in Spain lack information concerning imported cases and their country of origin.

Methods

This is a systematic review of the literature that was performed to obtain published cases of immigrant patients diagnosed with CE in Spain.

Results

From the 21 included articles, a total of 84 cases of CE imported into Spain were documented from 1995 to 2018, with an average age of 33.2 years. The main countries of origin of the patients were Morocco with 30 cases (35.7%), Romania with 12 cases (14.3%) and Peru with 8 cases (9.5%). The most involved organ was the liver (28 cases [33.3%]). We found discrepancies between the published cases of imported CE in Spain and those reported by official authorities.

Conclusions

This review of the literature shows the lack of information and clarity in the mechanisms of CE notification in Spain. The disparity between these systems and the cases documented in the literature highlights a failure or shortcoming of the current reporting system.
Early pregnancy loss
Authors: Jackson Toni , Watkins Elyse
Published: February 2021

Previously called spontaneous abortion, early pregnancy loss (EPL) is the preferred term encompassing threatened abortion, incomplete abortion, complete abortion, and anembryonic pregnancy. EPL has many causes, including chromosomal abnormalities, immunologic and infectious causes, and underlying maternal risk factors. Because many patients present with first-trimester bleeding, clinicians must know the appropriate evaluation and management techniques.
Tuberous sclerosis complex
Authors: Notaro Kelliann , Pierce Bradley
Published: February 2021

Tuberous sclerosis complex (TSC) is a genetic disorder that affects multiple organ systems but often goes unrecognized, and a delay in diagnosis can lead to multiple complications. Healthcare professionals should be educated on the many signs and symptoms associated with the disorder, know how to treat them symptomatically, and recommend routine screening to assess for complications. Correctly identifying, diagnosing, and treating TSC can give patients a better quality of life and prevent further complications associated with the disorder.
Demographic and Mental Health Predictors of Arrests Up to 10 Years Post-Traumatic Brain Injury: A Veterans Affairs TBI Model Systems Study
Authors: Miles Shannon R. , Silva Marc A. , Neumann Dawn , Dillahunt-Aspillaga Christina , Corrigan John D. , Tang Xinyu , Eapen Blessen C. , Nakase-Richardson Risa
Published: February 2021

Objective:

Examine rates and predictors of arrests in Veterans and Service Members (V/SM) who received inpatient rehabilitation for traumatic brain injury (TBI).

Setting:

Veterans Administration (VA) Polytrauma Rehabilitation Centers.

Participants:

A total of 948 V/SM drawn from the VA TBI Model Systems cohort with arrest data up to 10 years post-TBI.

Design:

Longitudinal cohort study; secondary analysis of pre-TBI characteristics predicting post-TBI arrests.

Main Measures:

Disclosure of arrests pre-TBI and up to10 years post-TBI.

Results:

Thirty-six percent of the sample had been arrested prior to their TBI; 7% were arrested post-TBI. When considering all variables simultaneously in a multivariate model, pre-TBI mental health treatment (adjusted odds ratio [aOR] = 4.30; 95% confidence interval [CI]: 2.03-9.14), pre-TBI heavy alcohol use (aOR = 3.04; CI: 1.08-8.55), and number of follow-up interviews (aOR = 2.05; CI: 1.39-4.50) were significant predictors of post-TBI arrest.

Conclusion:

Arrest rates of V/SM prior to TBI were consistent with rates of arrest for people of similar ages in the United States. Post-TBI rates were lower for V/SM than published rates of post-TBI arrests in civilians with TBI. As part of rehabilitation planning for V/SM with TBI, providers should assess for preinjury mental health services and alcohol misuse to (1) identify those who may be at risk for postinjury arrests and (2) provide relevant resources and/or supports.
Cognitive-Communication Predictors of Employment Outcomes 1 and 5 Years Posttraumatic Brain Injury
Authors: O'Neil-Pirozzi Therese M. , Lequerica Anthony H. , Chiaravalloti Nancy D. , Juengst Shannon B. , Newman Jody K.
Published: February 2021

Objective:

To examine changes in functional memory, problem solving, comprehension, expression, and social communication over the first 2 years posttraumatic brain injury (TBI) and the ability of each to predict return to work (RTW) outcomes at 1 year and 5 years postinjury.

Design:

Secondary analysis of data from a multicenter longitudinal cohort study.

Setting:

Acute inpatient rehabilitation facilities and community follow-up.

Participants:

A total of 3543 individuals between 16 and 60 years of age who were competitively employed at the time of TBI and had completed year 1, year 2, and year 5 postinjury follow-ups.

Main Outcome Measures:

Year 1 and year 5 RTW status (± competitively employed) at the time of study completion.

Results:

Greater function across each of the 5 cognitive-communication abilities was associated with RTW success at 1 year and 5 years post-TBI. At discharge, these 5 abilities showed comparable odds of predicting later employment. At year 1 and year 2 follow-ups, independence with problem solving was the most predictive of employment 5 years post-TBI, followed by social interaction, memory, expression, and comprehension.

Conclusions:

An increased rehabilitation focus on functional memory, problem solving, comprehension, expression, and social interaction post-TBI has the potential to improve RTW outcomes.
Antithrombin Dose Optimization in Extracorporeal Membrane Oxygenation in Infants
Authors: Liviskie Caren J. , Lahart Michael A. , O’Connor Nicole R. , Said Ahmed S. , McPherson Christopher C.
Published: February 2021

Anticoagulation in extracorporeal membrane oxygenation (ECMO) is challenging, with significant morbidity and mortality associated with thrombotic complications. Unfractionated heparin (UFH) is commonly used, which depends on native antithrombin (AT) function to exert anticoagulant effects. Antithrombin deficiency is common in infants on ECMO and replacement with AT concentrate may be warranted. However, dosing recommendations in this population are limited. We conducted a retrospective review of patients <1 year of age who received recombinant AT (ATryn) while on UFH and ECMO between January 1, 2010 and December 31, 2017. Commonly used dosing equations were assessed to determine their ability to predict postdose AT levels. Patient AT levels were compared with equation-predicted postdose AT levels to determine a correlation. A total of 102 doses in 41 patients were used for analysis. Baseline mean AT level was 43% (±13%) and mean AT doses were 134 units (±58.1 units) or 40.5 units/kg (±18.7 units/kg). Median increase in the AT level was 8% (interquartile range 2–17%) with a mean postdose level of 52.6% (±14.2%). Weight-based dosing poorly correlated with postdose AT levels (r2 = 0.082). Postdose levels were best predicted when using an equation that included desired change in the AT level from baseline, the patient’s weight, and added weight from the volume of the ECMO circuit (r2 = 0.427). Prospective studies are needed to evaluate optimal dosing strategies, safety, and efficacy of AT in this population.
Catastrophic Mechanical Complications of Extracorporeal Membrane Oxygenation
Authors: Kim Do Hyung , Cho Woo Hyun , Son Joohyung , Lee Sung Kwang , Yeo Hye Ju
Published: February 2021

Technical advances in extracorporeal membrane oxygenation (ECMO) have increased the number of cases that maintain longer duration. Long-term use of ECMO results in ECMO-related complications. Anticipation of the life-threatening mechanical complications and their management are critical for safe ECMO. In this study, we analyzed the incidence, nature, and risk factors of life-threatening mechanical complications during ECMO support. Furthermore, we presented our bedside algorithms to manage catastrophic ECMO complications. Data from 549 patients who underwent ECMO between December 2008 and December 2018 were retrospectively analyzed. The incidence of all life-threatening mechanical complications was 4.0%. Accidental decannulation (1.3%) was most common, followed by abrupt falling circuit flows (1.1%), pump failure (1.1%), circuit rupture (0.4%), and air in circuit (0.2%). Most (90.9%) of life-threatening events required circuit and cannula change, while 9.1% required vein collapse relief procedure. There was no death related to the event; however, six (27.3%) died during ECMO due to the underlying disease for which ECMO was required, and three (13.6%) died after weaning from ECMO. Multivariate regression analysis showed that awake ECMO and long-term ECMO support were significantly associated with life-threatening mechanical complications (p < 0.01). Our algorithm safely managed catastrophic ECMO problems without event-related deaths.