bluuebunny/crossref_metadata_2025 huggingface dataset:
Uncertainty, Profit, and the Limits of Markets
Authors: Hirsch Roni
Published: September 2021

The neoclassical market model is the overwhelming basis for contemporary views of markets as fair, efficient, or both. But is it an appropriate starting point? The article draws on Frank Knight’s 1920s work on the economics of uncertainty to show that the ideal of perfect competition conceals a tacit trade-off between equality and certainty. Largely undetected, this trade-off continues to govern financialized capitalist democracies, evading normative and political debate. By explaining how markets and firms resolve the problem of uncertainty, Knight shows that all supposed market benefits, even allocative efficiency, are not costless to society. More specifically, Knight argued that modern markets are premised on a tacit agreement between a handful of “daring” entrepreneurs and the “risk-averse” public: the former agree to carry the uncertainties of business-life in return for a substantially larger share of its power and rewards. Despite the highly static assumptions of neoclassicism, therefore, and its linked assumption of perfect knowledge, uncertainty is far from absent in modern economics. It is built into firms and markets and manifests itself as a steep social and material hierarchy.
Using Cooperative Physical Activities in Inclusive Settings to Enhance Social Interactions for Preschoolers With Autism Spectrum Disorder in China
Authors: Lee Gabrielle T. , He Li , Xu Sheng
Published: September 2021

The purpose of the study was to evaluate the effects of cooperative physical activities on social interactions of children with autism spectrum disorder (ASD) in China. Cooperative physical activities include procedures such as peer selection, peer practice, group task completion, and an interdependent group contingency. The intervention took place during inclusive physical education (PE) classes. Generalization of interactions with peers was evaluated during free play. Three preschool boys (ages 4–5 yrs) with ASD participated in the study, which used a multiple baseline design across the participants. Results indicated that the procedure effectively increased the frequency of appropriate peer interactions for all three children in the PE and free play settings. Although the frequency of inappropriate interactions increased after the intervention in both settings, the proportion of inappropriate interactions relative to appropriate interactions decreased for two children in the PE setting and for all three children in the free play setting.
Immigration, Race, and Nation in the UK: The Politics of Belonging on Twitter
Authors: Shah Bindi V , Ogden Jessica
Published: September 2021

At a time of rising right-wing populism, the heightened political salience of immigration as an issue is linked to conceptions of ‘the national’. In this article, we analyse tweets from non-elites, defined as isolated users with low network influence, engaged in a ‘conversation’ about migration on Twitter. We investigate the values embedded in these attitudes, and what these tell us about constructions and contestations of the symbolic boundaries of the nation among ordinary people. Our corpus includes tweets posted in temporal proximity to the lifting of transitional controls on Romanian and Bulgarian migrants in the UK (1 October 2013 to 1 March 2014). Thematic analysis reveals a cohesive set of anti-immigrant or anti-immigration sentiments linked to UKIP and that express an exclusionary nationalism based on assumptions about race, ‘whiteness’ and entitlement. Also evident is a counter-narrative of pro-immigration sentiments that draw on multiple and sometimes contradictory values. Some of these values contest racialised understandings of the nation but do not coalesce in ways to disrupt the dominance of right-wing anti-immigrant sentiments on Twitter. Our findings demonstrate the importance of investigating values embedded in both anti and pro-immigration attitudes among non-elites and what these values indicate about the possibilities of re-framing migration debates among non-elites in ways that construct more inclusive symbolic national boundaries. In addition, in using the networked properties of Twitter engagement to identify non-elite users, we make a methodological contribution to scholarship on immigration attitudes.
Subxiphoid, Nonintubated, Opioid-Free, Video-Assisted Pneumonectomy: A New Frontier in Thoracic Surgery
Authors: Nizami Maria , Hogan John , Ali Jason M. , Vokshi Ismail , Patvardhan Chinmay , Peryt Adam , Coonar Aman , Aresu Giuseppe
Published: September 2021

Surgical approaches to major pulmonary resections have evolved from thoracotomy to multiportal video-assisted thoracoscopy (VATS) and subsequently uniportal VATS. The efficacy of this progress has been validated in a multitude of publications demonstrating reductions in complications, patient perception of pain, and postoperative length of stay. More recent advances include subxiphoid extrathoracic access and nonintubated, opioid-free anesthesia. Early publications have demonstrated promising results with respect to safety, technical feasibility, and enhanced recovery. However, there remains a paucity of literature relating to hybrid approaches comprising both subxiphoid and nonintubated, opioid-free anesthesia in the context of pneumonectomy. The current report is the case of a patient undergoing pneumonectomy. Both subxiphoid and nonintubated, opioid-free techniques were utilized. The authors describe preoperative workup, surgical and anesthesia-related caveats, and postoperative recovery. In conclusion, this approach is technically feasible, safe, and may be associated with enhanced recovery.
Perceiver Effects in Person Perception Reflect Acquiescence, Positivity, and Trait-Specific Content: Evidence From a Large-Scale Replication Study
Authors: Heynicke Magdalena , Rau Richard , Leising Daniel , Wessels Nele , Wiedenroth Anne
Published: September 2021

Person judgments reflect perceiver effects: differences in how perceivers judge the average person. The factorial structure of such effects is still discussed. We present a large-scale, preregistered replication study using over 1 million person judgments (different groups of 200 perceivers judged 200 targets in one of 20 situations, using 30 personality items). Results unanimously favored a model comprising three systematic components: acquiescence (endorsing all items more than other perceivers), positivity (endorsing positive over negative items), and trait specificity (endorsing items reflecting a specific trait more). The latter two factors each accounted for approximately a quarter of the variance in perceiver effects, and acquiescence accounted for less than 10%. Positivity was more influential for evaluative items and was strongly associated with how likable perceivers found their targets to be ( r = .55). With considerable statistical power and generalizability, our findings significantly improve the knowledge base regarding the structure of perceiver effects.
The Restorative Power of Nostalgia: Thwarting Loneliness by Raising Happiness During the COVID-19 Pandemic
Authors: Zhou Xinyue , Sedikides Constantine , Mo Tiantian , Li Wanyue , Hong Emily K. , Wildschut Tim
Published: September 2021

Lockdowns during the COVID-19 pandemic increased the risk for loneliness. We tested whether nostalgia counteracts loneliness via rises in happiness. We conducted surveys in China ( N = 1,546), the United States ( N = 1,572), and the United Kingdom ( N = 603). Although feeling lonely was associated with unhappiness, it was also associated with nostalgia, which in turn conduced to increased happiness. We complemented these findings with three experiments testing MTurk workers (Study 4, N = 209; Study 5, N = 196; Study 6, N = 190), where we manipulated nostalgia and assessed happiness. Nostalgia increased happiness immediately after the manipulation (Studies 4–6) and, following an induction booster, up to 2 days later (Studies 4–5). Nostalgia is a psychological resource that can be harnessed to raise happiness and help combat loneliness.
Understanding the Outcomes of the China–England Mathematics Teacher Exchange: Observations of a Shanghai Teacher
Authors: Shi (史加祥) Jiaxiang , Jain Pinky
Published: September 2021

Highlights

This study examines the China–England Mathematics Teacher Exchange program to identify and evaluate the differences in Chinese approach to mathematics education. There are numerous differences in terms of national mathematics curricula, organization of mathematics teaching, and evaluation objectives and methods due to different educational and learning cultures. China has made great achievements in mathematics education and student academic performance but has much to learn from England.

In January 2019, Sheffield Hallam University published Longitudinal Evaluation of the Mathematics Teacher Exchange: China-England Final Report. Commissioned by the Department for Education (DfE) in England, the systematic and comprehensive report evaluated the outcomes of the Mathematics Teacher Exchange (MTE), 1 a program involving teacher exchanges between England and Shanghai and the implementation of “maths mastery pedagogy.” Initiated in 2014, the MTE sought to combine the strengths of English and Chinese mathematics education into a single, “unbeatable” system.

The Sheffield study discusses the background and progress of the MTE program in identifying the differences between English and Chinese approaches to mathematics education. In doing so, the study revealed that the gap between advanced and poor mathematics education in Shanghai and English primary schools is not due to the developments in education, but other factors such as the different approaches adopted by individual teachers in the classroom, choice of assessment methods, and educational and learning cultures. Evaluating these differences provides greater insight into both the MTE and mathematics education in China. Accordingly, this article briefly summarizes a series of evaluation reports on the MTE and examines the literature, media coverage, and experiences of the teachers involved.
Mismatch in SIRPα, a regulatory protein in innate immunity, is associated with chronic GVHD in hematopoietic stem cell transplantation
Authors: Saliba Rima M. , Greenbaum Uri , Ma Qing , Srour Samer A. , Carmazzi Yudith , Li Liang , Oran Betul , Moller Michael , Wood Janet , Ciurea Stefan O. , Kongtim Piyanuch , Rondon Gabriela , Partlow David , Li Dan , Rezvani Katayoun , Shpall Elizabeth J. , Cao Kai , Champlin Richard E. , Zou Jun
Published: September 2021

Recent compelling evidence showed that innate immune effector cells could recognize allogeneic grafts and prime an adaptive immune response. Signal regulatory protein α (SIRPα) is an immunoglobulin superfamily receptor that is expressed on myeloid cells; the interaction between SIRPα and its ubiquitously expressed ligand CD47 elicits an inhibitory signal that suppresses macrophage phagocytic function. Additional studies showed that donor-recipient mismatch in SIRPα variants might activate monocytic allorecognition, possibly as the result of non-self SIRPα-CD47 interaction. However, the frequency of SIRPα variation and its role in hematopoietic stem cell transplantation (HSCT) remains unexplored. We studied 350 patients with acute myeloid leukemia/myelodysplastic syndrome who underwent HLA-matched related HSCT and found that SIRPα allelic mismatches were present in 39% of transplantation pairs. SIRPα variant mismatch was associated with a significantly higher rate of chronic graft-versus-host disease (GVHD; hazard ratio [HR], 1.5; P = .03), especially de novo chronic GVHD (HR, 2.0; P = .01), after adjusting for other predictors. Those with mismatched SIRPα had a lower relapse rate (HR, 0.6; P = .05) and significantly longer relapse-free survival (RFS; HR, 0.6; P = .04). Notably, the effect of SIRPα variant mismatch on relapse protection was most pronounced early after HSCT and in patients who were not in remission at HSCT (cumulative incidence, 73% vs 54%; HR, 0.5; P = .01). These findings show that SIRPα variant mismatch is associated with HSCT outcomes, possibly owing to innate allorecognition. SIRPα variant matching could provide valuable information for donor selection and risk stratification in HSCT.
Activation status dictates the function of unlicensed natural killer cells in mice and humans
Authors: Aguilar Ethan G. , Dunai Cordelia , Judge Sean J. , Zamora Anthony E. , Khuat Lam T. , Vick Logan V. , Collins Craig P. , Stoffel Kevin M. , Alvarez Maite , Barao Isabel , Miller Jeffrey S. , Blazar Bruce R. , Chevallier Patrice , Retiere Christelle , Canter Robert J. , Murphy William J.
Published: September 2021

Natural killer (NK) cells are involved in innate defense against viral infection and cancer. NK cells can be divided into subsets based on the ability of different receptors to bind to major histocompatibility (MHC) class 1 molecules, resulting in differential responses upon activation in a process called “licensing” or “arming.” NK cells expressing receptors that bind self-MHC are considered licensed due to an augmented effector lytic function capability compared with unlicensed subsets. However, we demonstrated that unlicensed NK subsets instead positively regulate the adaptive T-cell response during viral infections that are related to localization and cytokine production. In this study, the differential effects of the two types of NK subsets were contingent on the environment in viral infection and hematopoietic stem cell transplantation (HSCT) models. Infection of mice with high-dose (HD) murine cytomegalovirus (MCMC) led to a loss of licensing-associated differences, as compared with mice with low-dose (LD) infection: the unlicensed NK subset no longer localized in lymph nodes (LNs), but instead remained at the site of infection. Similarly, the patterns observed during HD infection paralleled the phenotypes of both human and mouse NK cells in an HSCT setting where NK cells exhibit an activated phenotype. However, in contrast to the effects of subset depletion in T-cell replete models, the licensed NK cell subsets still dominated antiviral responses after HSCT. Overall, our results highlight the intricate tuning of NK cells and how it affects overall immune responses with regard to licensing patterns and their dependency on the level of stimulation and activation status.
Pretransplantation EASIX predicts intensive care unit admission in allogeneic hematopoietic cell transplantation
Authors: Peña Marta , Salas Maria Queralt , Mussetti Alberto , Moreno-Gonzalez Gabriel , Bosch Anna , Patiño Beatriz , Jiménez Laura , Kara Meriem , Parody Rocío , Sureda Anna
Published: September 2021

The Endothelial Activation and Stress Index (EASIX) is a laboratory-based prognosis index defined as creatinine × lactate dehydrogenase/platelets. When measured at pretransplantation evaluation (EASIX-PRE), it predicts allogeneic hematopoietic cell transplantation (alloHCT) mortality. This study explores its ability to predict intensive care unit (ICU) admission and validates EASIX-PRE predictive power for overall survival (OS) and nonrelapse mortality (NRM) in 167 consecutive patients undergoing alloHCT. EASIX-PRE was calculated retrospectively in all patients and transformed into log2 values (log2-EASIX-PRE). Log2-EASIX-PRE predicted ICU admission (hazard ratio [HR], 1.41; P < .001), OS (HR, 1.19; P = .011), and NRM (HR, 1.28; P = .004). The most discriminating EASIX-PRE cutoff value for risk of ICU admission was the 75th percentile (2.795); for OS and NRM, it was the median value (1.703). Patients with EASIX-PRE >2.795 had higher incidence of ICU admission in comparison with patients with lower EASIX-PRE values (day +180, 35.8% vs 12.8%; HR, 2.28; P = .010). Additionally, patients with EASIX-PRE >1.073 had lower OS (2 years, 57.7% vs 68.7%; HR, 1.98; P = .006) and higher NRM (2 years, 38.7% vs 18.5%; HR, 2.92; P = .001) than patients with lower EASIX-PRE results. Log2-EASIX-PRE was not associated with incidence of transplantation-associated microangiopathy, sinusoidal obstruction syndrome, or acute graft-versus-host disease. This study proposes EASIX-PRE as a prognostic tool to identify patients undergoing alloHCT at increased risk of severe organ dysfunction and who would therefore require ICU admission. Early identification of patients at high risk of severe events could contribute to personalized intervention design. Additionally, it validates the association between EASIX-PRE and OS and NRM in those undergoing alloHCT.
Fatal late-onset CAR T-cell–mediated encephalitis after axicabtagene-ciloleucel in a patient with large B-cell lymphoma
Authors: Jung Susanne , Greiner Jochen , von Harsdorf Stephanie , Popovic Pavle , Moll Roland , Schittenhelm Jens , Kandilaris Kosmas , Daniel Volker , Kunz Alexander , Schmitt Michael , Dreger Peter
Published: September 2021

Treatment with CD19-directed (CAR) T cells has evolved as a standard of care for multiply relapsed or refractory large B-cell lymphoma (r/r LBCL). A common side effect of this treatment is the immune effector cell–associated neurotoxicity syndrome (ICANS). Severe ICANS can occur in up to 30% to 40% of patients treated with axicabtagene-ciloleucel (axi-cel), usually within the first 4 weeks after administration of the dose and usually responding well to steroids. We describe a case of progressive central neurotoxicity occurring 9 months after axi-cel infusion in a patient with r/r LBCL who had undergone a prior allogeneic hematopoietic cell transplant. Despite extensive systemic and intrathecal immunosuppression, neurological deterioration was inexorable and eventually fatal within 5 months. High CAR T-cell DNA copy numbers and elevated levels of interleukin-1 (IL-1) and IL-6 were found in the cerebral spinal fluid as clinical symptoms emerged, and CAR T-cell brain infiltration was observed on autopsy, suggesting that CAR T cells played a major pathogenetic role. This case of unexpected, devastating, late neurotoxicity warrants intensified investigation of neurological off-target effects of CD19-directed CAR T cells and highlights the need for continuous monitoring for late toxicities in this vulnerable patient population.
MicroRNA regulation of the proliferation and apoptosis of Leydig cells in diabetes
Authors: Hu Li , Wei Shaochai , Wu Yuqi , Li Shulin , Zhu Pei , Wang Xiangwei
Published: September 2021

Background

The number of patients with diabetes is increasing worldwide. Diabetic testicular damage can cause spermiogenesis disorders and sexual dysfunction. We thus explored the role of miRNAs in diabetic testicular damage, and revealed that they could serve as effective prevention and treatment therapeutic targets.

Methods

Streptozotocin (STZ) was used to generate a rat model of type 2 diabetes. Rat testicular tissues were used for miRNA and mRNA sequencing. Through bioinformatics analysis, we constructed an miRNA–mRNA diabetic testicular damage regulatory network and screened for key miRNAs. We also used Leydig cells to generate a diabetic cell model and detected the downstream target genes of miRNAs, secretion of testosterone, and proliferation and apoptotic levels to elucidate the role and mechanism of the selected miRNAs in diabetic testicular damage.

Results

Using second-generation sequencing, we identified 19 differentially expressed miRNAs and 555 mRNAs in the testes of diabetic rats. Based on computational prediction of targets and negative regulation relationships, we constructed a miRNA–mRNA regulatory network, including 12 miRNAs and 215 mRNAs. KEGG enrichment analysis revealed that genes were more concentrated on the survival signalling pathway. Based on this, we screened 2 key miRNAs, miR-504 and miR-935. In vitro, glucose could induce an increase in miR-504 and miR-935, whereas a decrease in MEK5 and MEF2C in a dose-dependent manner. Overexpression of miR-504 and miR-935 led to the decreased expression of MEK5 and MEF2C, decreased proliferation rate of Leydig cells, increased apoptotic rate, and decreased secretion of testosterone. Whereas, knockdown of miR-504 and miR-935 displayed opposite tendencies.

Conclusions

miRNAs play important roles in diabetic testicular damage. miR-504 and miR-935 might regulate testicular damage through the classic survival pathway of MEK5-ERK5-MEF2C. Targeted inhibition of miR-504 and miR-935 could reverse the high-glucose-induced testicular complications, thus posing as a potential therapeutic approach in diabetic testicular injury.
Visual and somatosensory feedback mechanisms of precision manual motor control in autism spectrum disorder
Authors: Shafer Robin L. , Wang Zheng , Bartolotti James , Mosconi Matthew W.
Published: September 2021

Background

Individuals with autism spectrum disorder (ASD) show deficits processing sensory feedback to reactively adjust ongoing motor behaviors. Atypical reliance on visual and somatosensory feedback each have been reported during motor behaviors in ASD suggesting that impairments are not specific to one sensory domain but may instead reflect a deficit in multisensory processing, resulting in reliance on unimodal feedback. The present study tested this hypothesis by examining motor behavior across different visual and somatosensory feedback conditions during a visually guided precision grip force test.

Methods

Participants with ASD (N = 43) and age-matched typically developing (TD) controls (N = 23), ages 10–20 years, completed a test of precision gripping. They pressed on force transducers with their index finger and thumb while receiving visual feedback on a computer screen in the form of a horizontal bar that moved upwards with increased force. They were instructed to press so that the bar reached the level of a static target bar and then to hold their grip force as steadily as possible. Visual feedback was manipulated by changing the gain of the force bar. Somatosensory feedback was manipulated by applying 80 Hz tendon vibration at the wrist to disrupt the somatosensory percept. Force variability (standard deviation) and irregularity (sample entropy) were examined using multilevel linear models.

Results

While TD controls showed increased force variability with the tendon vibration on compared to off, individuals with ASD showed similar levels of force variability across tendon vibration conditions. Individuals with ASD showed stronger age-associated reductions in force variability relative to controls across conditions. The ASD group also showed greater age-associated increases in force irregularity relative to controls, especially at higher gain levels and when the tendon vibrator was turned on.

Conclusions

Our findings that disrupting somatosensory feedback did not contribute to changes in force variability or regularity among individuals with ASD suggests a reduced ability to integrate somatosensory feedback information to guide ongoing precision manual motor behavior. We also document stronger age-associated gains in force control in ASD relative to TD suggesting delayed development of multisensory feedback control of motor behavior.
A genome-wide association analysis for body weight at 35 days measured on 137,343 broiler chickens
Authors: Dadousis Christos , Somavilla Adriana , Ilska Joanna J. , Johnsson Martin , Batista Lorena , Mellanby Richard J. , Headon Denis , Gottardo Paolo , Whalen Andrew , Wilson David , Dunn Ian C. , Gorjanc Gregor , Kranis Andreas , Hickey John M.
Published: September 2021

Background

Body weight (BW) is an economically important trait in the broiler (meat-type chickens) industry. Under the assumption of polygenicity, a “large” number of genes with “small” effects is expected to control BW. To detect such effects, a large sample size is required in genome-wide association studies (GWAS). Our objective was to conduct a GWAS for BW measured at 35 days of age with a large sample size.

Methods

The GWAS included 137,343 broilers spanning 15 pedigree generations and 392,295 imputed single nucleotide polymorphisms (SNPs). A false discovery rate of 1% was adopted to account for multiple testing when declaring significant SNPs. A Bayesian ridge regression model was implemented, using AlphaBayes, to estimate the contribution to the total genetic variance of each region harbouring significant SNPs (1 Mb up/downstream) and the combined regions harbouring non-significant SNPs.

Results

GWAS revealed 25 genomic regions harbouring 96 significant SNPs on 13Gallus gallusautosomes (GGA1 to 4, 8, 10 to 15, 19 and 27), with the strongest associations on GGA4 at 65.67–66.31 Mb (Galgal4 assembly). The association of these regions points to several strong candidate genes including: (i) growth factors (GGA1, 4, 8, 13 and 14); (ii) leptin receptor overlapping transcript (LEPROT)/leptin receptor (LEPR) locus (GGA8), and theSTAT3/STAT5Blocus (GGA27), in connection with the JAK/STAT signalling pathway; (iii) T-box gene (TBX3/TBX5) on GGA15 andCHST11(GGA1), which are both related to heart/skeleton development); and (iv)PLAG1(GGA2). Combined together, these 25 genomic regions explained ~ 30% of the total genetic variance. The region harbouring significant SNPs that explained the largest portion of the total genetic variance (4.37%) was on GGA4 (~ 65.67–66.31 Mb).

Conclusions

To the best of our knowledge, this is the largest GWAS that has been conducted for BW in chicken to date. In spite of the identified regions, which showed a strong association with BW, the high proportion of genetic variance attributed to regions harbouring non-significant SNPs supports the hypothesis that the genetic architecture of BW35 is polygenic and complex. Our results also suggest that a large sample size will be required for future GWAS of BW35.
Meta-analysis of the impact of plant invasions on soil microbial communities
Authors: Torres Nardi , Herrera Ileana , Fajardo Laurie , Bustamante Ramiro O.
Published: September 2021

Background

One of the ecological impacts of exotic plant invasions may be alteration of the soil microbial community, which may cause changes to the diversity, richness and function of these communities. In order to explore to what extent invasive plants affect the soil microbial community, we performed a meta-analysis based on 46 scientific articles to document the effect of invasive plants on species richness and diversity of bacteria and fungi. We conducted our study across a range of invaded ecosystems including native communities, and evaluated biomass, richness and diversity. We use a random effects model to determine the increase or decrease in the values of the response variables in the presence of invasive plants.

Results

The results indicated that the response variable that changed with the invasion of plants was the diversity of bacteria. Bacterial diversity in the soil increases with the presence of invasive plants, specifically herbaceous plants producing allelopathic substances growing in forest ecosystems of temperate zones.

Conclusions

We provide evidence that invasive plants affect the soil biota differentially; however, it is important to consider more variables such as the N and C cycles, since these processes are mediated by soil biota and litter, and chemical compounds released by plants influence them. Changes in bacterial diversity have consequences for the nutrient cycle, enzymatic activity, mineralization rates and soil carbon and nitrogen content.
Optimal angle of needle insertion for spinal anesthesia in patients with spondylolisthesis: an ultrasonographic study
Authors: Kim Youngwon , Yoo Seokha , Park Sun-Kyung , Bae Hansu , Lim Young-Jin , Kim Jin-Tae
Published: September 2021

Background

Spondylolisthesis is a common degenerative spinal deformity. At the level of spondylolisthesis, the anatomy of the interlaminar space may differ from normal spine, in which case optimal angle of the needle insertion for spinal anesthesia may change. This study compared the optimal angle of needle insertion during spinal anesthesia in patients with and without lumbar spondylolisthesis using ultrasound.

Methods

We recruited 40 patients, 20 with and 20 without lumbar spondylolisthesis (group S and N, respectively). Ultrasonography was performed in the transverse midline and parasagittal oblique views at the spondylolisthesis level and the adjacent upper level. We measured the probe application angle with the longest interlaminar height of the ligamentum flavum-dura mater complex (LFD), depth from the skin to the LFD, depth from the skin to the anterior complex, and intrathecal space width. A positive angle represented a cephalad angulation.

Results

The optimal needle insertion angle in the transverse midline view at the spondylolisthesis level was (-) 2.7 ± 3.4° in group S and 0.8 ± 2.5° in group N (P$$<$$
<
0.001). In the parasagittal oblique view, it was (-) 2.7 ± 4.5° in group S and 1.0 ± 3.2° in group N (P = 0.004). There were no between-group differences in the angles at the upper level, with all cephalad angles in both views. Other ultrasound image data were comparable between groups.

Conclusion

In patients with spondylolisthesis, caudad angulation of the spinal needle can aid successful spinal puncture at spondylolisthesis level, both in the midline and paramedian approaches.

Trial registration

www.ClinicalTrials.gov (NCT04426916); registered 11 June 2020.
Relationship between serum lipid levels and ischemic stroke in patients with atrial fibrillation: a nested case–control study based on the China Atrial Fibrillation Registry
Authors: Li Fei , Du Xin , He Liu , Jiang Chao , Xia Shijun , Ma Changsheng , Dong Jianzeng
Published: September 2021

Background

Atrial fibrillation (AF) is an important risk factor for acute ischemic stroke.

Methods

A nested case–control study was conducted among patients diagnosed with AF, whose information was acquired from the prospective China Atrial Fibrillation Registry (China-AF), from August 2011 to December 2018.

Results

This study compared patients with stroke group (n = 145) with a matched control group (n = 577). Demographic data were similar except for body mass index (BMI), diastolic blood pressure (DBP) which were higher, and new oral anticoagulant (NOAC) treatment rate which was lower in the stroke group (allP < 0.05). Baseline median [IQR] levels of including triglyceride (TG) were higher in the stroke group (21.96 [16.74, 21.52], mg/dL) than the control group (19.62 [14.76, 27.36], mg/dL) (P = 0.012), while the total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were similar between the two groups. Elevated TG and HDL-C were positively associated with ischemic stroke (OR 1.01, 95% CI 1.00–1.02,P = 0.032; OR 1.03, 95% CI 1.00–1.05,P = 0.025), after adjustment for BMI, systolic blood pressure, DBP, CHA2DS2-VASc score, HAS-BLED score, NOAC, LDL-C and HDL-C. However, NOAC (OR 0.20, 95% CI 0.05–0.84,P = 0.029) could decrease the likelihood of ischemic stroke in patients with AF. In subgroup analysis, higher TG level remained significantly associated with ischemic stroke for AF patients without a history of smoking (OR 1.26, 95% CI 1.02–1.55,P = 0.028).

Conclusion

Higher level of TG and HDL-C were positively associated with ischemic stroke in patients with AF.
Clinical profile of bloodstream infections in COVID-19 patients: a retrospective cohort study
Authors: Palanisamy Naveenraj , Vihari Nakka , Meena Durga Shankar , Kumar Deepak , Midha Naresh , Tak Vibhor , Sharma Ankur , Bohra Gopal Krishana , Kothari Nikhil , Dutt Naveen , Bhatia Pradeep Kumar , Garg Mahendra Kumar , Misra Sanjeev
Published: September 2021

Background

Bloodstream infections (BSIs) are an emerging cause of significant morbidity and mortality in severe Coronavirus disease 2019 (COVID-19). We aimed to assess the prevalence, clinical profile and outcome of BSIs in critically ill COVID-19 patients.

Methods

This was a single-centre retrospective study conducted at a tertiary care hospital in Western India. All patients (age > 18 years) with reverse-transcription polymerase chain reaction (RT-PCR) confirmed COVID-19 admitted in the intensive care unit (ICU) were included. Hospital electronic records were searched for demographic data, time of bloodstream infection since admission, clinical profile, antimicrobial resistance pattern and clinical outcome of all patients who developed BSIs.

Results

Out of 750 patients admitted in COVID ICU, 8.5% developed secondary BSIs. All severe COVID-19 patients who developed BSIs succumbed to illness. A significant proportion of BSIs were Gram-negative pathogens (53/64, 82.8%). Acinetobacter baumannii was the commonest isolate, followed by Klebsiella pneumoniae (32.8% and 21.9%, respectively). Multidrug-resistance organisms (MDRO) were found in 57.8% of the cases. The majority of MDRO belonged to K. pneumoniae and Enterococcus groups. The proportion of Gram-negative bacteria resistant to carbapenems was 47.2% (25/53). On multivariate analysis, raised total leukocyte counts, mechanical ventilation and presence of comorbidities were significantly associated with the incidence of BSIs.

Conclusion

We found a significant prevalence of Acinetobacter baumannii in COVID-19 associated BSIs. The presence of comorbidities raised leukocyte counts and mechanical ventilation should alarm clinicians for possible BSIs. The timely initiation of empirical antibiotics and rapid de-escalation is vital to improve the outcome. At the same time, strict compliance of infection control practices should be accomplished to reduce the occurrence of MDRO.
Determinants of nutritional status and outcome in adults with RCSE: a retrospective cohort study
Authors: Yu Zhang , Ling Liu
Published: September 2021

Background

This study aimed to investigate the association between nutritional characteristics in patients with refractory convulsive status epilepticus.

Methods

We retrospectively enrolled 73 patients with refractory convulsive status epilepticus over 18 years of age at the West China Hospital between January 2017 and May 2019. All patients met the 2016 International League Against Epilepsy diagnostic criteria for refractory convulsive status epilepticus. A logistic regression model was used to evaluate the association between malnutrition and refractory convulsive status epilepticus.

Results

Of the 73 patients with refractory convulsive status epilepticus, 33 (45.21 %) suffered from malnutrition during hospitalization, and duration of hospitalization in days (OR = 1.251; 95 % CI,–1.067–1.384; P = 0.007), nasal feeding (OR = 22.623; 95 % CI: 1.091-286.899; P = 0.013), and malnutrition on admission (OR = 30.760; 95 % CI: 1.064–89.797; P = 0.046) were significantly associated with malnutrition in patients with refractory convulsive status epilepticus.

Conclusions

Malnutrition is a common complication during hospitalization in patients with refractory convulsive status epilepticus. The duration of hospitalization (days), nasal feeding, and malnutrition at admission are associated with malnutrition in patients with refractory convulsive status epilepticus. Further longitudinal studies are needed to identify the relationship between refractory convulsive status epilepticus and adverse outcomes.
Analysis of clinical characteristics and genetic testing in patients with acute fatty liver of pregnancy: a retrospective study
Authors: Shi Yixian , Wu Haicong , Zhou Xiaoling , Xu Qingling , Zheng Liqing , Li Dongliang , Yao Lvfeng
Published: September 2021

Background

Acute fatty liver of pregnancy (AFLP) is an acute, rare and potentially lethal disease typically occurring in the third trimester of pregnancy. So far, there is no effective means of prevention. Therefore, in this study, we retrospectively analyzed the clinical features of AFLP patients for a better understanding. Meanwhile, for the first time, the genetic background associated with the onset of AFLP was discussed by high-throughput sequencing, hoping to provide evidence for genetic counseling and prenatal diagnosis of AFLP.

Methods

Thirteen AFLP patients admitted to our hospital and other hospital from March 2012 to February 2020 were selected. Clinical data about general condition, laboratory test, liver biopsy and the prognosis of mother and fetus were collected for retrospective analysis. In addition, the peripheral blood of five patients with AFLP and one newborn infant of his mother with AFLP was sequenced with whole-exome sequencing and gene mutation was analyzed by bioinformatics methods.

Results

The initial symptoms of AFLP varied differently, with jaundice (9/13, 69%), fatigue (8/13, 62%) and nausea and vomiting (6/13, 46%) being the most common. Moreover, the main maternal complications were coagulopathy (13/13, 100%), followed by acute renal dysfunction (10/13, 77%). Raised serum bilirubin, transaminases and uric acid were found in all patients (100%), hypoglycemia was found in six patients (46%) and fatty liver on ultrasound was seen in five patients (5/12, 42%). One (7%) maternal death occurred and all neonates survived delivery. In addition, to our surprise, whole-exome sequencing showed that no gene mutation in related enzymes involved in fatty acid metabolism was noted in the pregnant women and children receiving genetic testing.

Conclusions

Early visit, early detection, early termination of pregnancy and multidisciplinary comprehensive treatment are the key factors to improve the prognosis of AFLP patients and their newborn infants. Furthermore, although limited size of study, to our knowledge, this report is the first to present the lack of common mutation involved in fatty acid oxidation in Chinese patients with AFLP via whole-exome sequencing. Thus, further studies are needed with larger and more varied samples to validate the conclusion.
Dysregulated paired related homeobox 1 impacts on hepatocellular carcinoma phenotypes
Authors: Piorońska Weronika , Nwosu Zeribe Chike , Han Mei , Büttner Michael , Ebert Matthias Philip , Dooley Steven , Meyer Christoph
Published: September 2021

Background

Hepatocellular carcinoma (HCC) is a major cause of cancer-related death. Paired related homeobox 1 (PRRX1) is a transcription factor that regulates cell growth and differentiation, but its importance in HCC is unclear.

Methods

We examined the expression pattern of PRRX1 in nine microarray datasets of human HCC tumour samples (n > 1100) and analyzed its function in HCC cell lines. In addition, we performed gene set enrichment, Kaplan-Meier overall survival analysis, metabolomics and functional assays.

Results

PRRX1 is frequently upregulated in human HCC. Pathway enrichment analysis predicted a direct correlation between PRRX1 and focal adhesion and epithelial-mesenchymal transition. High expression of PRRX1 and low ZEB1 or high ZEB2 significantly predicted better overall survival in HCC patients. In contrast, metabolic processes correlated inversely and transcriptional analyses revealed that glycolysis, TCA cycle and amino acid metabolism were affected. These findings were confirmed by metabolomics analysis. At the phenotypic level, PRRX1 knockdown accelerated proliferation and clonogenicity in HCC cell lines.

Conclusions

Our results suggest that PRRX1 controls metabolism, has a tumour suppressive role, and may function in cooperation with ZEB1/2. These findings have functional relevance in HCC, including in understanding transcriptional control of distinct cancer hallmarks.
Distinct tumour antigen-specific T-cell immune response profiles at different hepatocellular carcinoma stages
Authors: Zang Chaoran , Zhao Yan , Qin Ling , Liu Guihai , Sun Jianping , Li Kang , Zhao Yanan , Sheng Shoupeng , Zhang Honghai , He Ning , Zhao Peng , Wang Qi , Li Xi , Peng Yanchun , Dong Tao , Zhang Yonghong
Published: September 2021

Background

Cancer-testis antigens (CTAs) and tumour-associated antigens (TAAs) are frequently expressed in hepatocellular carcinoma (HCC); however, the role of tumour-antigen-specific T cell immunity in HCC progression is poorly defined. We characterized CTA- and TAA-specific T cell responses in different HCC stages and investigated their alterations during HCC progression.

Methods

Fifty-eight HCC patients, 15 liver cirrhosis patients, 15 chronic hepatitis B patients and 10 heathy controls were enrolled in total. IFN-γ ELSPOT using CTAs, including MAGE-A1, MAGE-A3, NY-ESO-1, and SSX2, and two TAAs, SALL4 and AFP, was performed to characterize the T-cell immune response in the enrolled individuals. The functional phenotype of T cells and the responsive T cell populations were analyzed using short-term T-cell culture.

Results

T cell responses against CTAs and TAAs were specific to HCC. In early-stage HCC patients, the SALL4-specific response was the strongest, followed by MAGE-A3, NY-ESO-1, MAGE-A1 and SSX2. One-year recurrence-free survival after transcatheter arterial chemoembolization plus radiofrequency ablation treatment suggested the protective role of CTA-specific responses. The four CTA- and SALL4-specific T cell responses decreased with the progression of HCC, while the AFP-specific T cell response increased. A higher proportion of CD4+ T cells specific to CTA/SALL4 was observed than AFP-specific T cell responses.

Conclusions

The IFN-γ ELISPOT assay characterized distinct profiles of tumour-antigen-specific T cell responses in HCC patients. CTA- and SALL4-specific T cell responses may be important for controlling HCC in the early stage, whereas AFP-specific T cell responses might be a signature of malignant tumour status in the advanced stage. The application of immunotherapy at an early stage of HCC development should be considered.
Endoscopic features for early decision to evaluate superior mesenteric artery syndrome in children
Authors: Kim Jae Young , Shin Myung Seok , Lee Sunho
Published: September 2021

Background

Diagnostic delay of superior mesenteric artery syndrome (SMAS) is common due to its rarity and lack of index of clinical suspicion. Early diagnosis under suspicion is pivotal for adequate treatment. Present study aims to explore the endoscopic features for early decision to evaluate SMAS in children.

Methods

In case controlled observation study, the recruitment was limited to patients who had endoscopic finding I or finding 1 plus more as follows: a pulsating vertical or oblique band or slit like luminal narrowing of the third part of the duodenum without no expansion over one third during air insufflation for at least 15 s (finding I), a marked dilation of the duodenal first and second part during air insufflation at the third part of the duodenum (finding II), a bile mixed fluid collection (bile lake) in the stomach (finding III). SMAS was confirmed with UGI series or hypotonic duodenography in enrolled patients. We analyzed positive endoscopic findings related with SMAS.

Results

The enrolled 29 patients consisted of 18 (62.1%) with SMAS and 11 (37.9%) without SMAS. The three most common presenting symptoms were abdominal pain, postprandial discomfort, and early satiety. The clinical impressions based on history and physical examination before endoscopy were functional dyspepsia (34.6%), gastritis or gastric ulcer (31.0%), and SMAS (17.3%). The constellation of three endoscopic findings (finding I + II + III, feature D) observed in 13 (72.2%) patients of SMAS group and 3 (27.3%) patients of non SMAS group (P = 0.027). Of 16 patients with features D, SMAS was diagnosed in 13 patients (81.2%) and not detected in 3 patients (18.8%) on UGI series or hypotonic duodenography.

Conclusions

Endoscopic examination to the third part of the duodenum can provide a clue making a decision to evaluate SMAS, which consists of features of three endoscopic findings as follows: a pulsating vertical or oblique band or slit like luminal narrowing of the third part of the duodenum without no expansion over one third during air insufflation for at least 15 s, a marked dilation of the first and second part of the duodenum, and a bile lake in the stomach.
RETRACTED ARTICLE: LncRNA LINC00520 aggravates cell proliferation and migration in lung adenocarcinoma via a positive feedback loop
Authors: Huang Wen , Wang Xinxing , Wu Fubing , Xu Fanggui
Published: September 2021

Background

Lung adenocarcinoma (LUAD) is the most common histological subtype of primary lung cancer. To identify the biomarker of diagnosis for LUAD is of great significance. Long non-coding RNAs (lncRNAs) were previously revealed to exert vital effects in numerous cancers. LncRNA long intergenic non-protein coding RNA 520 (LINC00520) served as an oncogene in various cancers. Therefore, our study was specially designed to probe the role of LINC00520 in LUAD.

Results

LINC00520 expression was detected by RT-qPCR. Next, function of LINC00520 in LUAD was verified by in vitro loss-of-function experiments. DNA pull down, ChIP, RIP, and luciferase reporter assays were conducted to reveal the regulatory mechanism of LINC00520. We found that LINC00520 was upregulated in LUAD. Additionally, LINC00520 upregulation is associated with the poor prognosis for patients with LUAD. Furthermore, LINC00520 downregulation suppressed LUAD cell proliferation and migration and induced cell apoptosis. Forkhead box P3 (FOXP3) is identified as the transcription factor to transcriptionally activate LINC00520. Moreover, LINC00520 positively upregulated FOXP3 expression via sponging miR-3611 in LUAD cells. Subsequently, rescue experiments delineated that miR-3611 downregulation or FOXP3 overexpression reversed the effects of silenced LINC00520 on proliferative and migratory capabilities in LUAD cells.

Conclusion

This study innovatively indicated that lncRNA LINC00520 facilitated cell proliferative and migratory abilities in LUAD through interacting with miR-3611 and targeting FOXP3, which may provide a potential novel insight for treatment of LUAD.
Pitfalls in the management of subglottic paragangliomas at unusual location: a case report and literature review
Authors: Hu Juanjuan , Wang Haiyang , Chen Jianli , Pan Xuelin , Deng Di , Zhuo Lufang , Liu Shixi , He Maiyue , Chen Fei , Yang Hui
Published: September 2021

Background

Subglottic paragangliomas (PGs) are exceptionally rare and unpredictable, occasionally presenting at an atypical location. There are three different clinical forms of subglottic PGs: intraluminal (tracheal PGs), extraluminal (thyroid PGs) and the mixed type (both intraluminal and extraluminal, mixed-subglottic PGs). These tumors are usually misdiagnosed as other relatively common primary thyroid or laryngotracheal tumors, and the treatment is troublesome.

Case presentation

A 22-year-old male patient with subglottic PGs has been successively misdiagnosed as thyroid tumors and subglottic hemangiomas, and lastly underwent local extended lumpectomy and laryngotracheal reconstruction with a pedicled thoracoacromial artery perforator flap (PTAPF). The patient was decannulated successfully after the second-stage tracheal reconstruction with a local flap, and no evidence of local recurrence and distant metastasis of the tumor until now.

Conclusion

Subglottic PGs can be easily misdiagnosed as laryngotracheal or thyroid tumors when presented at an atypical location. It is essential for otolaryngologists and head and neck surgeons to remain vigilant against these tumors. If the tumor is not diagnosed or removed completely, patients may encounter a risk of lethal paroxysm, which is incredibly troublesome.