bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical Treatment of Isolated Meniscal Tears in Competitive Male Wrestlers: Reoperations, Outcomes, and Return to Sport
Authors: Marigi Erick M. , Keyt Lucas K. , LaPrade Matthew D. , Camp Christopher L. , Levy Bruce A. , Dahm Diane L. , Stuart Michael J. , Krych Aaron J.
Published: January 2021

Background:

Wrestlers are highly active, young athletes prone to meniscal injuries that often require surgery. However, there is a lack of data evaluating the results of meniscal repair or partial meniscectomy in this cohort.

Purpose:

To describe the outcomes (subjective function, return to play, complications, reoperation rates, and progression of osteoarthritis) for treatment (meniscectomy or repair) of meniscal injuries in a cohort of competitive wrestlers.

Study Design:

Case series; Level of evidence, 4.

Methods:

All competitive wrestlers (high school, collegiate, or professional leagues) with a history of a meniscal injury and isolated meniscal surgery at a single institution between 2001 and 2017 were retrospectively identified. Failure was defined as a reinjury of the operative meniscus by clinical or advanced imaging examination, reoperation, or any additional surgical treatment of the meniscus after the index procedure. All patients were contacted for determination of reinjury rates, current sport status, and International Knee Documentation Committee and Tegner activity scores.

Results:

Of 85 male wrestlers with isolated meniscal tears, 34% underwent a meniscal repair, and 66% received a partial meniscectomy. Index surgery failed for 9.4% of the cohort. Among wrestlers treated with initial meniscal repair, 21% required a subsequent partial meniscectomy at a mean 2.2 years, and of those treated with partial meniscectomy, 3% underwent a second operation ( P < .001). All secondary operations were revision partial meniscectomies occurring at a mean 3.2 years (95% CI, 0.01-6.4 years) after the index procedure. At final follow-up, 89% of patients were able to return to sport, with 65% returning to wrestling competition. There was significant improvement in the Tegner score from a mean 6.5 (95% CI, 5.9-7.2) preoperatively to 8.3 (95% CI 8.0-8.6) postoperatively ( P < .001).

Conclusion:

The reoperation rate after meniscal surgery in wrestlers was quite low, but only 65% returned to competitive wrestling. Meniscal repair and partial meniscectomy improved patient-reported outcomes and activity levels at short-term follow-up. However, 21% of wrestlers treated with initial meniscal repair required a subsequent partial meniscectomy at a mean 2.2 years.
Occurrence of anatase in reworking altered ash beds (K-bentonites and tonsteins) and discrimination of source magmas: a case study of terrestrial Permian–Triassic boundary successions in China
Authors: Hong Hanlie , Jin Xiaoxue , Wan Miao , Ji Kaipeng , Liu Chen , Algeo Thomas J. , Fang Qian
Published: January 2021

Potential secondary influences on titanium distribution should be evaluated when using ash beds as volcanic source indicators and for correlation purposes. In this study, well-correlated altered ash beds in Permian–Triassic boundary (PTB) successions of various facies in South China were investigated to better understand their use in source discrimination and stratigraphic correlation. The ash beds deposited in lacustrine and paludal facies contain significantly more Ti relative to deposits in marine facies. Neoformed anatase grains nanometres to micrometres in size are associated closely with clay minerals, whereas detrital anatase was observed in the remnants of altered ash beds of terrestrial facies. Extraction of the clay fraction of altered ash beds may exclude significantly detrital accessory minerals such as anatase and rutile added during sediment reworking, and the concentrations of immobile elements in the clay fraction may therefore be used to interpret more effectively their source igneous rocks.
Genetic ancestry and skeletal toxicities among childhood acute lymphoblastic leukemia patients in the DFCI 05-001 cohort
Authors: Yao Song , Zhu Qianqian , Cole Peter D. , Stevenson Kristen , Harris Marian H. , Schultz Emily , Kahn Justine M. , Ladas Elena J. , Athale Uma H. , Clavell Luis A. , Laverdiere Caroline , Leclerc Jean-Marie , Michon Bruno , Schorin Marshall A. , Welch Jennifer J. G. , Sallan Stephen E. , Silverman Lewis B. , Kelly Kara M.
Published: January 2021

Hispanic children have a higher incidence of acute lymphoblastic leukemia (ALL) and inferior treatment outcomes relative to non-Hispanic White children. We previously reported that Hispanic children with ALL had lower risk of fracture and osteonecrosis. To unravel the genetic root of such ethnic differences, we genotyped 449 patients from the DFCI 05-001 cohort and analyzed their ancestry. Patients with discordant clinical and genetic ancestral groups were reclassified, and those with unknown ancestry were reassigned on the basis of genetic estimates. Both clinical and genetic ancestries were analyzed in relation to risk of bone toxicities and survival outcomes. Consistent with clinically reported race/ethnicity, genetically defined Hispanic and Black patients had significantly lower risk of fracture (Hispanic: subdistribution hazard ratio [SHR], 0.42; 95% confidence interval [CI], 0.22-0.81; P = .01; Black: SHR, 0.28; 95% CI, 0.10-0.75; P = .01), and osteonecrosis (Hispanic: SHR, 0.12; 95% CI, 0.02-0.93; P = .04; Black: SHR, 0.24; 95% CI, 0.08-0.78; P = .02). The lower risk was driven by African but not Native American or Asian ancestry. In addition, patients with a higher percentage of Native American ancestry had significantly poorer overall survival and event-free survival. Our study revealed that the lower risk of bone toxicities among Black and Hispanic children treated for ALL was attributed, in part, to the percentage of African ancestry in their genetic admixture. The findings provide suggestive evidence for the protective effects of genetic factors associated with African decent against bone damage caused by ALL treatment and clues for future studies to identify underlying biological mechanisms.
IL-17A from innate and adaptive lymphocytes contributes to inflammation and damage in cystic fibrosis lung disease
Authors: Hagner Matthias , Albrecht Melanie , Guerra Matteo , Braubach Peter , Halle Olga , Zhou-Suckow Zhe , Butz Simone , Jonigk Danny , Hansen Gesine , Schultz Carsten , Dittrich Anna-Maria , Mall Marcus A.
Published: January 2021

Background

Elevated levels of interleukin (IL)-17A were detected in the airways of patients with cystic fibrosis (CF), but its cellular sources and role in the pathogenesis of CF lung disease remain poorly understood. The aim of this study was to determine the sources of IL-17A and its role in airway inflammation and lung damage in CF.

Methods

We performed flow cytometry to identify IL-17A-producing cells in lungs and peripheral blood from CF patients and β-epithelial Na+ channel transgenic (Scnn1b-Tg) mice with CF-like lung disease, and determined the effects of genetic deletion of Il17a and Rag1 on the pulmonary phenotype of Scnn1b-Tg mice.

Results

T-helper 17 cells, CD3+CD8+ T-cells, γδ T-cells, invariant natural killer T-cells and innate lymphoid cells contribute to IL-17A secretion in lung tissue, lymph nodes and peripheral blood of patients with CF. Scnn1b-Tg mice displayed increased pulmonary expression of Il17a and elevated IL-17A-producing innate and adaptive lymphocytes with a major contribution by γδ T-cells. Lack of IL-17A, but not the recombination activating protein RAG1, reduced neutrophilic airway inflammation in Scnn1b-Tg mice. Genetic deletion of Il17a or Rag1 had no effect on mucus obstruction, but reduced structural lung damage and revealed an IL-17A-dependent macrophage activation in Scnn1b-Tg mice.

Conclusions

We identify innate and adaptive sources of IL-17A in CF lung disease. Our data demonstrate that IL-17A contributes to airway neutrophilia, macrophage activation and structural lung damage in CF-like lung disease in mice. These results suggest IL-17A as a novel target for anti-inflammatory therapy of CF lung disease.
High eosinophil counts predict decline in FEV1: results from the CanCOLD study
Authors: Tan Wan C. , Bourbeau Jean , Nadeau Gilbert , Wang Wendy , Barnes Neil , Landis Sarah H. , Kirby Miranda , Hogg James C. , Sin Don D.
Published: January 2021

Introduction

The aim of this study was to examine the association between blood eosinophil levels and the decline in lung function in individuals aged >40 years from the general population.

Methods

The study evaluated the eosinophil counts from thawed blood in 1120 participants (mean age 65 years) from the prospective population-based Canadian Cohort of Obstructive Lung Disease (CanCOLD) study. Participants answered interviewer-administered respiratory questionnaires and performed pre-/post-bronchodilator spirometric tests at 18-month intervals; computed tomography (CT) imaging was performed at baseline. Statistical analyses to describe the relationship between eosinophil levels and decline in forced expiratory volume in 1 s (FEV1) were performed using random mixed-effects regression models with adjustments for demographics, smoking, baseline FEV1, ever-asthma and history of exacerbations in the previous 12 months. CT measurements were compared between eosinophil subgroups using ANOVA.

Results

Participants who had a peripheral eosinophil count of ≥300 cells·µL−1(n=273) had a greater decline in FEV1compared with those with eosinophil counts of <150 cells·µL−1(n=430; p=0.003) (reference group) and 150–<300 cells·µL−1(n=417; p=0.003). The absolute change in FEV1was −32.99 mL·year−1for participants with eosinophil counts <150 cells·µL−1; −38.78 mL·year−1for those with 150–<300 cells·µL−1and −67.30 mL·year−1for participants with ≥300 cells·µL−1. In COPD, higher eosinophil count was associated with quantitative CT measurements reflecting both small and large airway abnormalities.

Conclusion

A blood eosinophil count of ≥300 cells·µL−1is an independent risk factor for accelerated lung function decline in older adults and is related to undetected structural airway abnormalities.
Markers of disease activity in COPD: an 8-year mortality study in the ECLIPSE cohort
Authors: Celli Bartolome , Locantore Nicholas , Yates Julie C. , Bakke Per , Calverley Peter M.A. , Crim Courtney , Coxson Harvey O. , Lomas David A. , MacNee William , Miller Bruce E. , Mullerova Hana , Rennard Stephen I. , Silverman Edwin K. , Wouters Emiel , Tal-Singer Ruth , Agusti Alvar , Vestbo Jørgen
Published: January 2021

Rationale

There are no validated measures of disease activity in COPD. Since “active” disease is expected to have worse outcomes (e.g.mortality), we explored potential markers of disease activity in patients enrolled in the ECLIPSE cohort in relation to 8-year all-cause mortality.

Methods

We investigated 1) how changes in relevant clinical variables over time (1 or 3 years) relate to 8-year mortality; 2) whether these variables inter-relate; and 3) if any clinical, imaging and/or biological marker measured cross-sectionally at baseline relates to any activity component.

Results

Results showed that 1) after 1 year, hospitalisation for COPD, exacerbation frequency, worsening of body mass index, airflow obstruction, dyspnoea and exercise (BODE) index or health status (St George's Respiratory Questionnaire (SGRQ)) and persistence of systemic inflammation were significantly associated with 8-year mortality; 2) at 3 years, the same markers, plus forced expiratory volume in 1 s (FEV1) decline and to a lesser degree computed tomography (CT) emphysema, showed association, thus qualifying as markers of disease activity; 3) changes in FEV1, inflammatory cytokines and CT emphysema were not inter-related, while the multidimensional indices (BODE and SGRQ) showed modest correlations; and 4) changes in these markers could not be predicted by any baseline cross-sectional measure.

Conclusions

In COPD, 1- and 3-year changes in exacerbation frequency, systemic inflammation, BODE and SGRQ scores and FEV1decline are independent markers of disease activity associated with 8-year all-cause mortality. These disease activity markers are generally independent and not predictable from baseline measurements.
TLR2-mediated innate immune priming boosts lung anti-viral immunity
Authors: Girkin Jason , Loo Su-Ling , Esneau Camille , Maltby Steven , Mercuri Francesca , Chua Brendon , Reid Andrew T. , Veerati Punnam Chander , Grainge Chris L. , Wark Peter A.B. , Knight Darryl , Jackson David , Demaison Christophe , Bartlett Nathan W.
Published: January 2021

Background

We assessed whether Toll-like receptor (TLR)2 activation boosts the innate immune response to rhinovirus infection, as a treatment strategy for virus-induced respiratory diseases.

Methods

We employed treatment with a novel TLR2 agonist (INNA-X) prior to rhinovirus infection in mice, and INNA-X treatment in differentiated human bronchial epithelial cells derived from asthmatic-donors. We assessed viral load, immune cell recruitment, cytokines, type I and III interferon (IFN) production, as well as the lung tissue and epithelial cell immune transcriptome.

Results

We show,in vivo, that a single INNA-X treatment induced innate immune priming characterised by low-level IFN-λ, Fas ligand, chemokine expression and airway lymphocyte recruitment. Treatment 7 days before infection significantly reduced lung viral load, increased IFN-β/λ expression and inhibited neutrophilic inflammation. Corticosteroid treatment enhanced the anti-inflammatory effects of INNA-X. Treatment 1 day before infection increased expression of 190 lung tissue immune genes. This tissue gene expression signature was absent with INNA-X treatment 7 days before infection, suggesting an alternate mechanism, potentiallyviaestablishment of immune cell-mediated mucosal innate immunity.In vitro, INNA-X treatment induced a priming response defined by upregulated IFN-λ, chemokine and anti-microbial gene expression that preceded an accelerated response to infection enriched for nuclear factor (NF)-κB-regulated genes and reduced viral loads, even in epithelial cells derived from asthmatic donors with intrinsic delayed anti-viral immune response.

Conclusion

Airway epithelial cell TLR2 activation induces prolonged innate immune priming, defined by early NF-κB activation, IFN-λ expression and lymphocyte recruitment. This response enhanced anti-viral innate immunity and reduced virus-induced airway inflammation.
Machine learning can predict disease manifestations and outcomes in lymphangioleiomyomatosis
Authors: Chernbumroong Saisakul , Johnson Janice , Gupta Nishant , Miller Suzanne , McCormack Francis X. , Garibaldi Jonathan M. , Johnson Simon R.
Published: January 2021

Background

Lymphangioleiomyomatosis (LAM) is a rare multisystem disease with variable clinical manifestations and differing rates of progression that make management decisions and giving prognostic advice difficult. We used machine learning to identify clusters of associated features which could be used to stratify patients and predict outcomes in individuals.

Patients and methods

Using unsupervised machine learning we generated patient clusters using data from 173 women with LAM from the UK and 186 replication subjects from the US National Heart, Lung, and Blood Institute (NHLBI) LAM registry. Prospective outcomes were associated with cluster results.

Results

Two- and three-cluster models were developed. A three-cluster model separated a large group of subjects presenting with dyspnoea or pneumothorax from a second cluster with a high prevalence of angiomyolipoma symptoms (p=0.0001) and tuberous sclerosis complex (TSC) (p=0.041). Patients in the third cluster were older, never presented with dyspnoea or pneumothorax (p=0.0001) and had better lung function. Similar clusters were reproduced in the NHLBI cohort. Assigning patients to clusters predicted prospective outcomes: in a two-cluster model the future risk of pneumothorax was 3.3 (95% CI 1.7–5.6)-fold greater in cluster 1 than cluster 2 (p=0.0002). Using the three-cluster model, the need for intervention for angiomyolipoma was lower in clusters 2 and 3 than cluster 1 (p<0.00001). In the NHLBI cohort, the incidence of death or lung transplant was much lower in clusters 2 and 3 (p=0.0045).

Conclusions

Machine learning has identified clinically relevant clusters associated with complications and outcome. Assigning individuals to clusters could improve decision making and prognostic information for patients.
Long-term exposure to low-level air pollution and incidence of asthma: the ELAPSE project
Authors: Liu Shuo , Jørgensen Jeanette Therming , Ljungman Petter , Pershagen Göran , Bellander Tom , Leander Karin , Magnusson Patrik K.E. , Rizzuto Debora , Hvidtfeldt Ulla A. , Raaschou-Nielsen Ole , Wolf Kathrin , Hoffmann Barbara , Brunekreef Bert , Strak Maciej , Chen Jie , Mehta Amar , Atkinson Richard W. , Bauwelinck Mariska , Varraso Raphaëlle , Boutron-Ruault Marie-Christine , Brandt Jørgen , Cesaroni Giulia , Forastiere Francesco , Fecht Daniela , Gulliver John , Hertel Ole , de Hoogh Kees , Janssen Nicole A.H. , Katsouyanni Klea , Ketzel Matthias , Klompmaker Jochem O. , Nagel Gabriele , Oftedal Bente , Peters Annette , Tjønneland Anne , Rodopoulou Sophia P. , Samoli Evangelia , Kristoffersen Doris Tove , Sigsgaard Torben , Stafoggia Massimo , Vienneau Danielle , Weinmayr Gudrun , Hoek Gerard , Andersen Zorana Jovanovic
Published: January 2021

Background

Long-term exposure to ambient air pollution has been linked to childhood-onset asthma, although evidence is still insufficient. Within the multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we examined the associations of long-term exposures to particulate matter with a diameter <2.5 µm (PM2.5), nitrogen dioxide (NO2) and black carbon (BC) with asthma incidence in adults.

Methods

We pooled data from three cohorts in Denmark and Sweden with information on asthma hospital diagnoses. The average concentrations of air pollutants in 2010 were modelled by hybrid land-use regression models at participants’ baseline residential addresses. Associations of air pollution exposures with asthma incidence were explored with Cox proportional hazard models, adjusting for potential confounders.

Results

Of 98 326 participants, 1965 developed asthma during a mean follow-up of 16.6 years. We observed associations in fully adjusted models with hazard ratios of 1.22 (95% CI 1.04–1.43) per 5 μg·m−3 for PM2.5, 1.17 (95% CI 1.10–1.25) per 10 µg·m−3 for NO2 and 1.15 (95% CI 1.08–1.23) per 0.5×10−5 m−1 for BC. Hazard ratios were larger in cohort subsets with exposure levels below the European Union and US limit values and possibly World Health Organization guidelines for PM2.5 and NO2. NO2 and BC estimates remained unchanged in two-pollutant models with PM2.5, whereas PM2.5 estimates were attenuated to unity. The concentration–response curves showed no evidence of a threshold.

Conclusions

Long-term exposure to air pollution, especially from fossil fuel combustion sources such as motorised traffic, was associated with adult-onset asthma, even at levels below the current limit values.
Cough hypersensitivity and suppression in COPD
Authors: Cho Peter S.P. , Fletcher Hannah V. , Patel Irem S. , Turner Richard D. , Jolley Caroline J. , Birring Surinder S.
Published: January 2021

Cough reflex hypersensitivity and impaired cough suppression are features of chronic refractory cough (CRC). Little is known about cough suppression and cough reflex hypersensitivity in cough associated with chronic obstructive pulmonary disease (COPD). This study investigated the ability of patients with COPD to suppress cough during a cough challenge test in comparison to patients with CRC and healthy subjects. This study also investigated whether cough reflex hypersensitivity is associated with chronic cough in COPD.

Participants with COPD (n=27) and CRC (n=11) and healthy subjects (n=13) underwent capsaicin challenge tests with and without attempts to self-suppress cough in a randomised order over two visits, 5 days apart. For patients with COPD, the presence of self-reported chronic cough was documented, and objective 24-h cough frequency was measured.

Amongst patients with COPD, those with chronic cough (n=16) demonstrated heightened cough reflex sensitivity compared to those without chronic cough (n=11): geometric mean±sdcapsaicin dose thresholds for five coughs (C5) 3.36±6.88 µmol·L−1versus44.50±5.90 µmol·L−1, respectively (p=0.003). Participants with CRC also had heightened cough reflex sensitivity compared to healthy participants: geometric mean±sdC5 3.86±5.13 µmol·L−1versus45.89±3.95 µmol·L−1, respectively (p<0.001). Participants with COPD were able to suppress capsaicin-evoked cough, regardless of the presence or absence of chronic cough: geometric mean±sdcapsaicin dose thresholds for 5 coughs without self-suppression attempts (C5) and with (CS5) were 3.36±6.88 µmol·L−1versus12.80±8.33 µmol·L−1(p<0.001) and 44.50±5.90 µmol·L−1versus183.2±6.37 µmol·L−1(p=0.006), respectively. This was also the case for healthy participants (C5versusCS5: 45.89±3.95 µmol·L−1versus254.40±3.78 µmol·L−1, p=0.033), but not those with CRC, who were unable to suppress capsaicin-evoked cough (C5versusCS5: 3.86±5.13 µmol·L−1versus3.34±5.04 µmol·L−1, p=0.922). C5 and CS5 were associated with objective 24-h cough frequency in patients with COPD: ρ= −0.430, p=0.036 and ρ= −0.420, p=0.041, respectively.

Patients with COPD-chronic cough and CRC both had heightened cough reflex sensitivity but only patients with CRC were unable to suppress capsaicin-evoked cough. This suggests differing mechanisms of cough between patients with COPD and CRC, and the need for disease-specific approaches to its management.
TNF-mediated alveolar macrophage necroptosis drives disease pathogenesis during respiratory syncytial virus infection
Authors: Santos Leonardo Duarte , Antunes Krist Helen , Muraro Stéfanie Primon , de Souza Gabriela Fabiano , da Silva Amanda Gonzalez , Felipe Jaqueline de Souza , Zanetti Larissa Cardoso , Czepielewski Rafael Sanguinetti , Magnus Karen , Scotta Marcelo , Mattiello Rita , Maito Fabio , de Souza Ana Paula Duarte , Weinlich Ricardo , Vinolo Marco Aurélio Ramirez , Porto Bárbara Nery
Published: January 2021

Respiratory syncytial virus (RSV) is the major cause of acute bronchiolitis in infants under 2 years old. Necroptosis has been implicated in the outcomes of respiratory virus infections. We report that RSV infection triggers necroptosis in primary mouse macrophages and human monocytes in a RIPK1-, RIPK3- and MLKL-dependent manner. Moreover, necroptosis pathways are harmful to RSV clearance from alveolar macrophages. Additionally,Ripk3−/−mice were protected from RSV-induced weight loss and presented with reduced viral loads in the lungs.

Alveolar macrophage depletion also protected mice from weight loss and decreased lung RSV virus load. Importantly, alveolar macrophage depletion abolished the upregulation ofRipk3andMlklgene expression induced by RSV infection in the lung tissue.

Autocrine tumor necrosis factor (TNF)-mediated RSV-triggered macrophage necroptosis and necroptosis pathways were also involved in TNF secretion even when macrophages were committed to cell death, which can worsen lung injury during RSV infection. In line,Tnfr1−/−mice had a marked decrease inRipk3andMlklgene expression and a sharp reduction in the numbers of necrotic alveolar macrophages in the lungs. Finally, we provide evidence that elevated nasal levels of TNF are associated with disease severity in infants with RSV bronchiolitis.

We propose that targeting TNF and/or the necroptotic machinery may be valuable therapeutic approaches to reduce the respiratory morbidity caused by RSV infection in young children.
Post-intubation subglottic stenosis: aetiology at the cellular and molecular level
Authors: Dorris Emma R , Russell John , Murphy Madeline
Published: January 2021

Subglottic stenosis (SGS) is a narrowing of the airway just below the vocal cords. This narrowing typically consists of fibrotic scar tissue, which may be due to a variety of diseases. This review focuses on post-intubation (PI) SGS. SGS can result in partial or complete narrowing of the airway. This narrowing is caused by fibrosis and can cause serious breathing difficulties. It can occur in both adults and children. The pathogenesis of post-intubation SGS is not well understood; however, it is considered to be the product of an abnormal healing process. This review discusses how intubation can change the local micro-environment, leading to dysregulated tissue repair. We discuss how mucosal inflammation, local hypoxia and biomechanical stress associated with intubation can promote excess tissue deposition that occurs during the pathological process of SGS.
Transcriptomic analysis of s-methoprene resistance in the lesser grain borer, Rhyzopertha dominica, and evaluation of piperonyl butoxide as a resistance breaker
Authors: Sakka Maria K. , Riga Maria , Ioannidis Panagiotis , Baliota Georgia V. , Tselika Martha , Jagadeesan Rajeswaran , Nayak Manoj K. , Vontas John , Athanassiou Christos G.
Published: January 2021

Background

The lesser grain borer, Rhyzopertha dominica is a serious pest of stored grains. Fumigation and contact insecticides play a major role in managing this pest globally. While insects are developing genetic resistance to chemicals, hormonal analogues such as s-methoprene play a key role in reducing general pest pressure as well as managing pest populations that are resistant to fumigants and neurotoxic contact insecticides. However, resistance to s-methoprene has been reported in R. dominica with some reports showing a remarkable high resistance, questioning the use of this compound and other related analogues in grain protection. The current study attempts to identify possible molecular mechanisms that contribute in resistance to s-methoprene in R. dominica.

Results

Transcriptome analysis of resistant and susceptible strains of this pest species identified a set of differentially expressed genes related to cytochrome P450s, indicating their potential role in resistance to s-methoprene. Laboratory bioassays were performed with s-methoprene treated wheat grains in presence and absence of piperonyl butoxide (PBO), a cytochrome P450 inhibitor. The results indicate that PBO, when applied alone, at least at the concentration tested here, had no effect on R. dominica adult emergence, but has a clear synergistic effect to s-methoprene. The number of produced progeny decreased in presence of the inhibitor, especially in the resistant strain. In addition, we also identified CYP complement (CYPome) of R. dominica, annotated and analysed phylogenetically, to understand the evolutionary relationships with other species.

Conclusions

The information generated in current study suggest that PBO can effectively be used to break resistance to s-methoprene in R. dominica.
Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial
Authors: Zhang Jian , Nie Ying , Pang Qiongni , Zhang Xubiao , Wang Qianting , Tang Jing
Published: January 2021

Background

Subarachnoid hemorrhage (SAH) is a common neurosurgical emergency, and early brain injury (EBI) plays an important role in acute brain injury of SAH. Our objective is to investigate the effect of stellate ganglion block (SGB) on the clinical prognosis of patients with SAH (registration number ChiCTR2000030910).

Methods

A randomized controlled trial was conducted with 102 participants. Patients with SAH were assigned to the SGB or nSGB group. Patients in the SGB group received SGB four times (once every other day starting on the day of the surgery). In contrast, patients in the nSGB group only received standard care. Data were collected on the day before surgery (T0) and on the 1st (T1), 3rd (T2) and 7th day (T3) after surgery. The primary outcomes included EBI markers (including IL-1β, IL-6, TNF-α, ET-1, NPY, NSE and S100β), the mean cerebral blood flow velocity of the middle cerebral artery (Vm-MCA) and the basilar artery (Vm-BA). All cases were followed up for 6 months after surgery.

Results

The levels of the EBI markers in both groups were higher at T1–T3 than at T0 (P<0.05), and the Vm-MCA and Vm-BA were also increased at the same times. However, the levels of the EBI markers were lower in the SGB group than in the nSGB group (P<0.05), and the increases of Vm-MCA and Vm-BA were also lower (P<0.05). The prognosis score and neurological deficit were better in the SGB group than in the nSGB group (P<0.05).

Conclusions

SGB can improve the prognosis of SAH patients by inhibiting the inflammatory response during EBI and by reducing endothelial dysfunction and relieving CVS.

Trial registration

Clinical trial number: ChiCTR2000030910; Registry URL: Chinese Clinical Trial Registry; Principal investigator's name: Ying Nie; Date of Trial registration: March, 2020 (retrospectively registered).
Seniors’ campus continuums: local solutions for broad spectrum seniors care
Authors: Morton-Chang Frances , Majumder Shilpi , Berta Whitney
Published: January 2021

Background

As demand and desire to “age-in-place” grows within an aging population, and new areas of need emerge, governments nationally and internationally are focusing effort and attention on innovative and integrative approaches to health and well-being. Seniors’ Campus Continuums are models of care that seek to broaden access to an array of services and housing options to meet growing health and social needs of aging populations. The objective of this study is to increase understanding of this model and factors that influence their evolution, development, ongoing functioning and capacity to integrate care for older adults wishing to age in their own home and community.

Methods

This research uses a comparative case study approach across six-bounded cases offering four geographically co-located components (mixed housing options, internal and external community supports, and a long-term care home) in various contexts across Ontario, Canada. Onsite in-person and phone interviews with senior campus staff (N = 30), and campus partners (N = 11), enhanced by direct observation at campuses explored historical and current efforts to offer health, housing and social care continuums for older adults.

Results

Analysis highlighted eight key factors. Enabling factors include i. rich historical legacies of helping people in need; ii. organizational vision and readiness to capitalize on windows of opportunity; iii. leveraging organizational structure and capacity; iv. intentional physical and social design; v. broad services mix, amenities and innovative partnerships. Impeding factors include vi. policy hurdles and rigidities; vii. human resources shortages and inequities; and viii. funding limitations. A number of benefits afforded by campuses at different levels were also observed.

Conclusion

Findings from this research highlight opportunities to optimize campus potential on many levels. At an individual level, campuses increase local access to a coordinated range of health and social care services, supports and housing options. At an organizational level, campuses offer enhanced collaboration opportunities across providers and partners to improve consistency and coordination of care, and improved access to shared resources, expertise and infrastructure. At a system level, campuses can address a diversity of health, social, financial, and housing needs to help seniors avoid premature or inappropriate use of higher intensity care settings.
Clinical course and challenging management of early COVID-19 infection after heart transplantation: case report of two patients
Authors: Tchana-Sato Vincent , Ancion Arnaud , Tridetti Julien , Sakalihasan Natzi , Hayette Marie Pierre , Detry Olivier , Delvenne Philippe , Amabili Philippe , Senard Marc , Hougrand Olivier , Szecel Delphine , Lavigne Jean-Paul , Minga Lowampa Elie , Ponte Charlotte , Maquoi Isabelle , Morimont Philippe , Van Den Bulck Melissa , Delbouille Marie Helene , Defraigne Jean Olivier , Lancellotti Patrizio
Published: January 2021

Background

There are limited data on Coronavirus disease 2019 (COVID-19) in solid organ transplant patients, especially in heart transplant recipients, with only a few case reports and case series described so far. Heart transplant recipients may be at particular high risk due to their comorbidities and immunosuppressed state.

Case presentation

This report describes the clinical course and the challenging management of early COVID-19 infection in two heart transplant recipients who tested positive for the SARS-CoV-2 virus in the perioperative period of the transplant procedure. The two patients developed a severe form of the disease and ultimately died despite the initiation of an antiviral monotherapy with hydroxychloroquine coupled with the interruption of mycophenolate mofetil.

Conclusions

These two cases illustrate the severity and poor prognosis of COVID-19 in the perioperative period of a heart transplant. Thorough screening of donors and recipients is mandatory, and the issue of asymptomatic carriers needs to be addressed.
The diagnostic value of lower glucose consumption for IDH1 mutated gliomas on FDG-PET
Authors: Liu Feng-Min , Gao Yu-fei , Kong Yanyan , Guan Yihui , Zhang Jinsen , Li Shuai-Hong , Ye Dan , Wen Wenyu , Zuo Chuantao , Hua Wei
Published: January 2021

Background

Non-invasive diagnosis of IDH1 mutation for gliomas has great clinical significance, and PET has natural advantage to detect metabolism, as IDH mutated gliomas share lower glucose consumption.

Methods

Clinical data of patients with gliomas and 18F-FDG PET were retrospectively reviewed. Receiver operating characteristic curve (ROC) analysis was conducted, and standard uptake value (SUV) was estimated in combination with grades or IDH1 mutation. The glucose consumption was investigated with U251 cells expressing wild-type or mutated IDH1 by glucose assay. Quantification of glucose was determined by HPLC in clinical tissues. Meanwhile, bioinformatics and western blot were applied to analyze the expression level of metabolic enzymes (e.g. HK1, PKM2, PC) in gliomas.

Results

Seventy-one glioma cases were enrolled, including 30 carrying IDH1 mutation. The sensitivity and specificity dependent on SUVmax (3.85) predicting IDH1 mutation reached 73.2 and 86.7%, respectively. The sensitivity and specificity of differentiating grades by SUVmax (3.1) were 92.3 and 64.4%, respectively. Glucose consumption of U251 IDH1 mutant cells (0.209 ± 0.0472 mg/ml) was obviously lower than IDH1wild-type cells (0.978 ± 0.0773 mg/ml, P = 0.0001) and astrocyte controls (0.335 ± 0.0592 mg/ml, P = 0.0451). Meanwhile, the glucose quantity in IDH1mutant glioma samples were significantly lower than those in IDH1 wild-type tissues (1.033 ± 1.19608 vs 6.361 ± 4.3909 mg/g, P = 0.0051). Silico analysis and western blot confirmed that HK1 and PKM2 in IDH1 wild-type gliomas were significantly higher than in IDH1 mutant group, while PC was significantly higher in IDH1 mutant gliomas.

Conclusion

SUVmax on PET can predict IDH1 mutation with adequate sensitivity and specificity, as is supported by reduced glucose consumption in IDH1 mutant gliomas.
Augmented superior rectus muscle transposition in management of defective ocular abduction
Authors: Farid Mohamed F. , Daifalla Ahmed E. M. , Awwad Mohamed A.
Published: January 2021

Background

Superior rectus muscle transposition (SRT) is one of the proposed transposition techniques in the management of defective ocular abduction secondary to chronic sixth nerve palsy and esotropic Duane retraction syndrome (Eso-DRS). The aim of the current study is to report the outcomes of augmented SRT in treatment of Eso-DRS and chronic sixth nerve palsy.

Methods

a retrospective review of medical records of patients with Eso-DRS and complete chronic sixth nerve palsy who were treated by augmented full tendon SRT combined with medial rectus recession (MRc) when intraoperative forced duction test yielded a significant contracture. Effect on primary position esotropia (ET), abnormal head posture (AHP), limitation of ocular ductions as well as complications were reported and analyzed.

Results

a total of 21 patients were identified: 10 patients with 6th nerve palsy and 11 patients with Eso-DRS. In both groups, SRT was combined with ipsilateral MRc in 18 cases. ET, AHP and limited abduction were improved by means of 33.8PD, 26.5°, and 2.6 units in 6th nerve palsy group and by 31.1PD, 28.6°, and 2 units in Eso-DRS group respectively. Surgical success which was defined as within 10 PD of horizontal orthotropia and within 4 PD of vertical orthotropia was achieved in 15 cases (71.4%). Significant induced hypertropia of more than 4 PD was reported in 3 patients (30%) and in 2 patients (18%) in both groups, respectively.

Conclusion

augmented SRT with or without MRc is an effective tool for management of ET, AHP and limited abduction secondary to sixth nerve palsy and Eso-DRS. However, this form of augmented superior rectus muscle transposition could result in high rates of induced vertical deviation.
Surgical experience for patients with serious mental illness: a qualitative study
Authors: McBride Kate E. , Solomon Michael J. , Lambert Tim , O’Shannassy Sarah , Yates Catherine , Isbester Jemima , Glozier Nick
Published: January 2021

Background

People with serious mental illness (SMI) have significantly worse surgical outcomes compared to the general population. There are many contributing factors to this complex issue, however consideration of the surgical experience from the patient’s own perspective has never been undertaken. This lack of understanding prevents the provision of truly patient centred care and may limit the impact of potential improvement initiatives. Therefore this study aims to describe and better understand the surgical experience from the perspective of patients with SMI.

Methods

Within this qualitative study, semi-structured, audio-recorded interviews were conducted between August 2019 – June 2020, with 10 consenting participants with SMI who had surgery in the previous 2 years. A thematic analysis approach was used to explore both the positive and negative aspects of the participant’s surgical experience commencing from pre-operative consultation to hospital discharge and follow-up.

Results

Four main themes and related subthemes emerged including i) the perceived lack of mental ill health recognition, ii) highly variable patient and clinician interactions, iii) the impact of healthcare services, and iv) strategies for improvement.

Conclusion

Surgical patients with SMI want to be treated like everyone else whilst still having their mental ill health acknowledged and proactively managed despite this rarely occurring, which is valuable information for all surgical teams to consider and learn from. Participants were able to describe several readily implementable strategies to potentially improve their care and overall surgical experience, and as such highlight considerable opportunities for these to be tested and evaluated for this underserved patient group.
Maternal pesticide exposure and child neuro-development among smallholder tomato farmers in the southern corridor of Tanzania
Authors: Chilipweli Peter M. , Ngowi Aiwerasia Vera , Manji Karim
Published: January 2021

Background

Exposure to pesticides with its associated effects prenatally and in early childhood has not received much attention. There is little scientific data on this aspect in Tanzania therefore this study was meant to contribute to the deficit in the subject.

Method

A cross-sectional study was conducted to a sample of 286 participants of mother to child pair, whereby 172 and 114 were exposed and non-exposed respectively. Mothers who had been working in tomato sprayed farms were exposed and mothers who had not been working in the tomato sprayed farms were un-exposed. Child aged 0–6 years was chosen from each mother sampled but only one child found to be the youngest with the classified age was enrolled. Malawi child development Tool (M-DAT) was employed to assess the child level of development, height, and weight of the children were collected and analyzed by the WHO anthropometric calculator. A checklist and questionnaire were used to observe and assess maternal exposure. Bivariate and Multivariate analysis were conducted to assess the relationship between various factors of exposure.

Results

Overall 15% of the children examined were not well developed and the most used pesticides were those posing neuro-development effects. On the bivariate analysis model, mothers who worked while pregnant were more likely to have a child with neuro-developmental effect OR=5.8(1.29–26.3). On multivariate analyses adjusted for age of the mother, variables which remain in the model were a distance from home [AOR=9.4(4.2–20.5)], and working while pregnancy [AOR=5.8(1.29–26.3)] other were removed due to collinearity effect. None of confounders had a potential significant effect but only nutrition seems to be the effect modifier [AOR=7.8(1.29–36.3)] when analyzed with working while pregnancy.

Conclusions

The findings from this study have indicated that maternal pesticide exposure among farmworker residents in the SAGCOT area has a potential association with child developmental effect.
Relationships with caregivers and mental health outcomes among adolescents living with HIV: a prospective cohort study in South Africa
Authors: Shenderovich Yulia , Boyes Mark , Esposti Michelle Degli , Casale Marisa , Toska Elona , Roberts Kathryn J. , Cluver Lucie
Published: January 2021

Background

Mental health problems may impact adherence to anti-retroviral treatment, retention in care, and consequently the survival of adolescents living with HIV. The adolescent-caregiver relationship is an important potential source of resilience. However, there is a lack of longitudinal research in sub-Saharan Africa on which aspects of adolescent-caregiver relationships can promote mental health among adolescents living with HIV. We draw on a prospective longitudinal cohort study undertaken in South Africa to address this question.

Methods

The study traced adolescents aged 10–19 initiated on antiretroviral treatment in government health facilities (n = 53) within a health district of the Eastern Cape province. The adolescents completed standardised questionnaires during three data collection waves between 2014 and 2018. We used within-between multilevel regressions to examine the links between three aspects of adolescent-caregiver relationships (caregiver supervision, positive caregiving, and adolescent-caregiver communication) and adolescent mental health (depression symptoms and anxiety symptoms), controlling for potential confounders (age, sex, rural/urban residence, mode of infection, household resources), n=926 adolescents.

Results

Improvements in caregiver supervision were associated with reductions in anxiety (0.98, 95% CI 0.97–0.99, p=0.0002) but not depression symptoms (0.99, 95% CI 0.98–1.00, p=.151), while changes in positive caregiving were not associated with changes in mental health symptoms reported by adolescents. Improvements in adolescent-caregiver communication over time were associated with reductions in both depression (IRR=0.94, 95% CI 0.92–0.97, p<.0001) and anxiety (0.91, 95% CI 0.89–0.94, p<.0001) symptoms reported by adolescents.

Conclusions

Findings highlight open and supportive adolescent-caregiver communication and good caregiver supervision as potential factors for guarding against mental health problems among adolescents living with HIV in South Africa. Several evidence-informed parenting programmes aim to improve adolescent-caregiver communication and caregiver supervision, and their effect on depression and anxiety among adolescents living with HIV should be rigorously tested in sub-Saharan Africa. How to improve communication in other settings, such as schools and clinics, and provide communication support for caregivers, adolescents, and service providers through these existing services should also be considered.
The prevalence of sickness absence among primary school pupils – reason to be worried?
Authors: Pijl Esther Karen , Vanneste Yvonne Theodora Maria , de Rijk Angelique Eveline , Feron Frans Joseph Maria , Mathijssen Jolanda
Published: January 2021

Background

Absence from school can lead to lower educational achievement and poor health. Little is known about school absence in primary education. This study’s first aim was to examine the prevalence of school absence in primary schools and differing types of absence, including sickness absence. The second aim was to determine which pupil characteristics and types of absence were associated with extensive sickness absence.

Methods

The school absence registries for the school year 2015–2016 were analysed retrospectively in eight mainstream primary schools with 2216 pupils, and six schools for special primary education with 1000 pupils in the West-Brabant region of the Netherlands. Descriptive analyses, χ2-tests, Mann-Whitney U tests and logistic regression analyses were performed.

Results

The one-year prevalence of school absence was 85% in mainstream primary schools and 79% in special schools. Sickness absence was the most prevalent type of absence, occurring in 75 and 71% of pupils, respectively The prevalence of extensive sickness absence was 13 and 23%, respectively. In mainstream schools, extensive sickness absence was associated with a young age, low parental educational level, more doctor’s visits and unauthorised absence, and in special schools with more doctor’s visits, other authorised absence, tardiness and unauthorised absence.

Conclusions

The prevalence of extensive sickness absence was high, and as this was associated with other types of absence, these pupils missed even more days of school. Public health research, policy and practice should address sickness absence among primary school pupils, to prevent adverse effects on children’s development.
The CT pulmonary vascular parameters and disease severity in COPD patients on acute exacerbation: a correlation analysis
Authors: Yang Tao , Chen Chihua , Chen Zhongyuanlong
Published: January 2021

Background

It is necessary to analyze the CT pulmonary vascular parameters and disease severity in chronic obstructive pulmonary disease (COPD) patients to provide evidence support for the management of COPD.

Methods

COPD patients on acute exacerbation admitted to our hospital from COPD patients from January 2019 to March 2020 was selected. The characteristics and ratio of the cross-sectional area (CSA) of small pulmonary vessels to the total area of the lung field, and the ratio of pulmonary artery and aorta (PA/A) cross-sectional diameter in patients with COPD were analyzed.

Results

A total of 128 COPD patients were included. There were significant differences in the duration of COPD, smoking history, the PaO2, PaCO2, pH, and FEV1, FVC and FEV1/FVC among COPD patients with different severity (all p < 0.05). The duration of COPD, smoking, PaO2, PaCO2, CSA and PA/A were correlated with the COPD severity (all p < 0.05). Both CSA, PA/A were correlated with post BD FEV1 (all p < 0.05). The cutoff value of CSA and PA/A for the diagnosis of severe COPD was 0.61 and 0.87 respectively, and the AUC of CSA and PA/A for the diagnosis of severe COPD was 0.724 and 0.782 respectively.

Conclusions

Patients with CSA ≤ 0.61 and PA/A ≥ 0.87 may have higher risks for severe COPD, and more studies are needed in the future to further elucidate the management of COPD.