bluuebunny/crossref_metadata_2025_split huggingface dataset:
Follicular Eruption With Folliculotropic Lymphocytic Infiltrates Associated With Iatrogenic Immunosuppression: Report and Study of 3 Cases, and Review of the Literature
Authors: Avitan-Hersh Emily , Dias-Polak David , Ramon Michal , Sahar Dvora , Magen Daniella , Pollack Shirley , Bergman Reuven 
Published: December 2019

Background:
Several cases of folliculotropic mycosis fungoides, associated with immunosuppressive therapy, including calcineurin inhibitors, have been reported in solid organ transplant patients. We have encountered 3 patients on immunosuppressive therapy who developed follicular eruptions with folliculocentric infiltrates of nonatypical lymphocytes.

Objective:
To characterize these follicular eruptions and review the literature.

Methods:
Three patients, aged 7–15 years, who were treated with systemic immunosuppressive therapy developed follicular eruptions characterized histopathologically by folliculocentric lymphocytic infiltrates. These were studied clinically, histopathologically, immunophenotypically, and molecularly for T-cell receptor (TCR) gene rearrangement.

Results:
All 3 cases were characterized histopathologically by folliculocentric infiltrates of nonatypical CD3+ T lymphocytes with variable follicular exocytosis. Two cases also showed follicular mucinosis. Marked reduction in CD7+ staining, and marked predominance of CD4+ cells over CD8+ cells was observed in all 3 cases. The TCR gene rearrangement studies were monoclonal in 2 cases. Oral calcineurin inhibitors (2 cyclosporine A and 1 tacrolimus) were part of the therapeutic regimen in all 3 patients. Their cessation along with local corticosteroid creams in 2 patients, and phototherapy with oral acitretin in one patient, was associated with complete clinical remission.

Conclusions:
Patients undergoing systemic immunosuppressive therapy that includes calcineurin inhibitors might develop follicular eruption with some immunophenotypical variations and a monoclonal TCR gene rearrangement but lack sufficient cytomorphological features of folliculotropic mycosis fungoides. Altering the immunosuppressive agent including calcineurin inhibitors may result in regression of the eruptions.
Circulating Mesencephalic Astrocyte-Derived Neurotrophic Factor Negatively Correlates With Atrial Apoptosis in Human Chronic Atrial Fibrillation
Authors: Wang Changhui , Yu Shujun , Bao Qin , Qiang Weimin , Wu Chaoran , Zhang Chengxin , Jiang Yan , Cai Yongping , Huang Dake , Chen Ying , Hou Chao , Wang Dong 
Published: December 2019

Abstract:
Atrial apoptosis has been found to be majorly involved in the pathogenesis of human atrial fibrillation (AF). Mesencephalic astrocyte-derived neurotrophic factor exerts an antiapoptotic effect for multiple cell types. However, the correlation between MANF and atrial apoptosis in AF is still undefined. In this study, 59 patients with valvular or congenital heart disease were divided into 2 groups: AF group and sinus rhythm (SR) group. We found that the apoptotic atrial myocytes in the right atrial appendage tissues of the AF group were significantly more than those of the SR group, whereas mRNA and protein levels of MANF in the AF group were significantly down-regulated compared with those in the SR group. The serum MANF in patients with AF was markedly lower than that in patients with SR, which was inversely correlated with atrial apoptosis in patients with AF. In addition, the AF group had the greater inflammation and endoplasmic reticulum stress compared with the SR group. These findings suggest that MANF downregulation may lead to more atrial apoptosis in human chronic AF, indicating MANF as a potential therapeutic agent in AF treatment.
Isavuconazole in Hematological Patients: Results of a Real-Life Multicentre Observational Seifem Study
Authors: Cattaneo Chiara , Busca Alessandro , Gramegna Doriana , Farina Francesca , Candoni Anna , Piedimonte Monica , Fracchiolla Nicola , Pagani Chiara , Principe Maria Ilaria Del , Tisi Maria Chiara , Offidani Massimo , Fanci Rosa , Ballanti Stelvio , Spolzino Angelica , Criscuolo Marianna , Marchesi Francesco , Nadali Gianpaolo , Delia Mario , Picardi Marco , Sciumé Margherita , Mancini Valentina , Olivieri Attilio , Tumbarello Mario , Rossi Giuseppe , Pagano Livio 
Published: December 2019

Abstract
Invasive fungal diseases (IFDs) remain a major clinical issue in patients with hematological malignancies (HMs). To confirm the efficacy and safety of the new azole isavuconazole (ISV) in a clinical care setting, we planned a multicenter retrospective study; we collected data on all possible/probable/proven IFDs in patients with HMs treated with ISV in 17 centers. Between July 2016 and November 2018, 128 patients were enrolled, and 122 were fully evaluable. ISV was employed as the 1st line therapy in 43 (35%) patients and as a subsequent therapy in 79 (65%) patients. The response rate was 82/122 patients (67.2%); it was similar when using ISV as a 1st or 2nd line treatment (60.5% vs 70.9%, respectively; p = 0.24). In multivariate analysis, both female sex (OR: 2.992; CI: 1.22–7.34) and induction phase of treatment (OR: 3.953; CI: 1.085–14.403) were predictive of a favorable response. At a median follow-up of 5 months, 43 (35.2%) patients were dead; the 1-year overall survival (OS) was 49.9%. In multivariate analysis, the response to ISV (OR: 0.103; CI: 0.041–0.262) and IFD refractoriness to previous antifungals (OR: 3.413; CI: 1.318–8.838) were statistically significant for OS. Adverse events (AEs) were reported in 15/122 patients (12.3%); grade 3–4 AEs were reported in 5 (4%) and led to ISV discontinuation. Our study confirms the safety and tolerability of ISV, also in diseases other than acute leukemia. Phase of hematological disease, gender and refractoriness to previous antifungals are the main predictive factors for the aforementioned response and outcome.
Effect of Remnant Tissues on Outcomes of Anterior Cruciate Ligament Reconstruction at Follow-up Arthroscopy
Authors: Sueyoshi Ted , Nakatani Takuya 
Published: December 2019

Background:
Remnant-preserving anterior cruciate ligament reconstruction (ACLR) is sought to enhance vascularization and maturation of a graft and to produce positive clinical outcomes after reconstruction.

Objective:
The purpose of this study was to investigate an effect of remnant anterior cruciate ligament (ACL) tissues on outcomes of ACLR 1 year after reconstruction in younger populations.

Design:
Retrospective chart review.

Setting:
Inpatient orthopedic surgical and rehabilitation clinic.

Subjects:
The subjects were 644 patients who underwent primary ACLR.

Independent Variables:
The independent variables were age, height, and body weight of the subjects, and the presence of remnant tissue.

Main Outcome Measures:
The outcome measure was the number of subjects with secondary infra-articular injuries at a follow-up arthroscopy after ACLR. The odds ratio was calculated and compared between the remnant-preserving ACLR (ACLR-P) and remnant-resecting (ACLR-R) groups to investigate the effect of remnant tissues on postoperative outcomes.

Results:
A total of 416 cases met our inclusion criteria and were included in this study. There were 136 cases (49 males and 87 females) in the ACLR-P group with the mean age (±SD) of 17.86 ± 2.85 years. There were 280 cases (106 males and 174 females) in the ACLR-R group, and the mean age (±SD) was 18.13 ± 2.73 years. Of 136 cases in the ALCR-P group, 54 (39.7%) had abnormal arthroscopic findings that lead to a surgical intervention. Of 280 patients in the ACLR-R group, 128 (45.7%) had abnormal findings. Odds ratio was 0.78 [95% confidence interval (CI), 0.51-1.18; P = 0.24]. Four cases in the ACLR-P group and 8 in the ACLR-R group were diagnosed with ACL retear during follow-up arthroscopy. Odds ratio was 1.03 (95% CI, 0.30-3.48; P = 0.96).

Conclusions:
The presence of ACL remnant tissues did not have a significant effect on outcomes 1 year after reconstruction. However, there was a trend that lower percentage of patients with remnant-preserving ALCR had abnormal arthroscopic findings that lead to a surgical treatment at follow-up arthroscopy 1 year after initial reconstruction. The presence of remnant tissues did not have a significant effect on retear rate.
What is the evidence for fluticasone exhalation delivery system in chronic rhinosinusitis?
Authors: Kovacs Alexander J. , Goshtasbi Khodayar , Kuan Edward C. 
Published: December 2019

Purpose for review
The aim of this article is to review the current literature regarding a novel method of topically delivering nasal steroids, namely exhalation delivery system-fluticasone (EDS-FLU), for the treatment of chronic rhinosinusitis (CRS).

Recent findings
Recent Food and Drug Administration approval of EDS-FLU and increasing evidence surrounding its efficacy and safety has led to an additional tool for the treatment of chronic rhinosinusitis. Compared with placebo, EDS-FLU has demonstrated significant improvements in patients’ sinonasal symptoms and overall inflammatory control as well as quality of life measures. Additionally, using EDS-FLU can lead to polyp grade improvement and polyp elimination in patients with chronic rhinosinusitis with polyps. Furthermore, compared with controls, patients who received EDS-FLU were less likely to meet predefined surgical criteria at the conclusion of the study.

Summary
EDS-FLU has demonstrated significant improvement in managing symptoms and polyps in CRS. Receiving EDS-FLU was associated with a significant reduction in the proportion of patients meeting surgical criteria. Further studies are warranted to evaluate the long-term outcomes of EDS-FLU, especially as compared with steroid sprays and topical steroid irrigations, in management of CRS.
Latest developments on topical therapies in chronic rhinosinusitis
Authors: Tan Neil C.W. , Psaltis Alkis J. 
Published: December 2019

Purpose of review
Topical therapies play an important role in the management of chronic rhinosinusitis (CRS). A detailed literature review was undertaken to appraise recent evidence surrounding current topical therapies and novel treatments used in the setting of recalcitrant CRS.

Recent findings
Effective sinus surgery aids in the delivery of topical therapies. Budesonide nasal rinses delivered by saline irrigation offer clinical and symptomatic improvements pre and postoperatively with a well-proven safety profile. Topical steroids may additionally offer direct antibacterial effects as per in-vitro testing. Topical antibiotics are not recommended in routine practice; however, they may be of benefit for short-term eradication therapy. Novel treatments are under keen investigation and include bacteriophage, colloidal silver and manuka honey. The evidence base for these treatments is not robust enough to recommend their routine use at present.

Summary
Topical steroids delivered in conjunction with saline nasal irrigation offer the best combination of treatments in CRS and should be considered a standard of care. Wide surgical access and aggressive surgical debridement of polyposis facilitates the delivery of steroid irrigations to sinonasal mucosa and is associated with improved long-term outcomes following endoscopic sinus surgery. The use of novel treatments remains within the research setting alone.
Chronic rhinosinusitis and sleep quality
Authors: Papagiannopoulos Peter , Kuan Edward C. , Tajudeen Bobby A. 
Published: December 2019

Purpose of review
To review the recent literature describing the association between chronic rhinosinusitis and its effects on sleep quality.

Recent findings
Chronic rhinosinusitis (CRS) causes significantly worse sleep by both subjective and objective measures. CRS is also strongly associated with obstructive sleep apnea. Treating CRS surgically improves subjective sleep scores.

Summary
CRS worsens sleep quality both subjectively and objectively. Sleep quality is improved after endoscopic sinus surgery.
Case Report of an Autopsy of a Child Who Died in a Drum-Type Washing Machine Tub
Authors: Tani Naoto , Ikeda Tomoya , Shida Alissa , Aoki Yayoi , Ikeda Kei , Morioka Fumiya , Ishikawa Takaki 
Published: December 2019

AbstractThe patient was a 5-year-old boy who was found in a state of cardiorespiratory arrest in the tub of a washing machine without water with the door closed. The autopsy findings included severe facial congestion and petechiae of the facial skin and palpebral conjunctiva. Several organs exhibited congestion. Hemorrhagic spots were seen on the serous membranes of various organs, with particularly marked hemorrhagic spots seen on the lungs. The heart contained fluid blood without soft clots. There were no findings indicative of marked trauma, intoxication, or hyperthermia. The examination results suggested that asphyxia had occurred in this case. However, there were no findings indicative of cervical compression, oronasal obstruction, or the presence of a foreign body in the respiratory tract. Image analysis showed the child could make postural changes inside the washing machine tub. Consequently, impaired thoracic movement and postural asphyxia were considered unlikely to have occurred. The results of blood gas analysis showed no evidence of marked hypercapnia. We, therefore, concluded that the cause of the child's death was asphyxia due to hypoxia caused by being in a closed space, that is, a washing machine tub.
Kawasaki Disease in a 3-Month-Old Infant
Authors: Nguyen Thanh , M'Buila Celestin , Bui van Tung , Barat Maxime , Loire Mathilde 
Published: December 2019

Background
Kawasaki disease is an acute vasculitis occurring between 6 months and 5 years old. Patients younger than 6 months have mostly incomplete form. This clinical symptoms lead to confusion and delayed diagnosis.

Case Report
We developed the diagnostic difficulties with a 3-month-old infant. At the beginning, his incomplete presentation misled pediatricians.

Conclusions
We highlight the possibilities of Kawasaki disease in infants younger than 6 months. Indeed, every diagnostic delay increases cardiovascular risk. Nonetheless, in our case, treatment was prescribed in the first 5 days, and the patient developed aneurysms.
Evaluating the use of variation graphs for the characterisation of yeast rDNA arrays
Authors: Ursani Ziauddin , Davey Robert , Dicks Jo 
Published: December 2019

Over the past decade, we have gained considerable insight into the identification of sequence variation within the rDNA array of Saccharomyces cerevisiae and its closest wild relative, Saccharomyces paradoxus. Yet considerable challenges remain in the computational characterisation of this complex genomic region. This study aimed to evaluate the use of variation graphs for this purpose, formally comparing their effectiveness with traditional linear approaches.
Specifically, we aimed to identify both partial and fixed variants (i.e. pSNPs, SNPs, pINDELs and INDELs) in the rDNA arrays of 10 diverse, haploid Saccharomyces cerevisiae strains with high quality genomic datasets. We constructed two computational pipelines using two highly different approaches. The first pipeline used the BWA read mapper and the BCFtools variant caller to identify variants against the linear S288c reference, with the second pipeline using the vg tool to call variants against a graphical reference (either based on a graphical representation of the S288c genome or a Saccharomyces cerevisiae pan-genome).
The results showed that the graph-based pipeline was able to identify more variants than the linear pipeline, and in particular partial variants, while also missing some key variants identified by BWA/BCFtools. A major discrepancy between the two pipelines was found in the read coverage at loci where the vg pipeline identified variants. In the coming months, we aim to investigate the cause of these differences and to develop a new graph-based computational pipeline that can accurately identify the full range of sequence and copy number variation within this key genomic region.
Structure and function of the bacterial protein toxin phenomycin
Authors: Hansen Bente K. , Larsen Camilla K. , Nielsen Jacob T. , Svenningsen Esben B. , Van Lan B. , Jacobsen Kristian M. , Bjerring Morten , Flygaard Rasmus K. , Jenner Lasse B. , Nejsum Lene N. , Brodersen Ditlev E. , Mulder Frans A. A. , Tørring Thomas , Poulsen Thomas B. 
Published: December 2019

SummaryPhenomycin is a bacterial mini-protein of 89 amino acids discovered more than 50 years ago with toxicity in the nanomolar regime towards mammalian cells. The protein inhibits the function of the eukaryotic ribosome in cell free systems and appears to target translation initiation. Several fundamental questions concerning the cellular activity of phenomycin have however remained unanswered. In this paper, we have used morphological profiling to show that direct inhibition of translation underlies the toxicity of phenomycin in cells. We have performed studies of the cellular uptake mechanism of phenomycin, showing that endosomal escape is the toxicity-limiting step, and we have solved a solution phase high-resolution structure of the protein using NMR spectroscopy. Through bioinformatic as well as functional comparisons between phenomycin and two homologs, we have identified a peptide segment, which constitutes one of two loops in the structure, that is critical for the toxicity of phenomycin.
Intensive infection control responses and whole genome sequencing to interrupt and resolve widespread transmission of OXA-181 Escherichia coli in a hospital setting
Authors: Roberts Leah W. , Forde Brian M. , Henderson Andrew , Playford E. Geoffrey , Runnegar Naomi , Henderson Belinda , Watson Catherine , Lindsay Margaret , Bursle Evan , Douglas Joel , Paterson David L. , Schembri Mark A , Harris Patrick N.A. , Beatson Scott A. 
Published: December 2019

AbstractBackgroundOXA-48-like carbapenemases have become increasingly prevalent in healthcare settings worldwide. Their low-level activity against carbapenems makes them difficult to identify, causing problems for infection control. Here we present an outbreak of Escherichia coli producing OXA-181 (part of the OXA-48 family of carbapenemases) in a Queensland Hospital, and describe how we used whole genome sequencing (WGS) to identify the outbreak strain, determine the extent of transmission within the hospital and support infection control responses.Methods116 isolates were collected and sequenced on an Illumina NextSeq to determine species, sequence type (ST) and presence of resistance genes. Core single nucleotide polymorphisms were used to determine strain relatedness. Three isolates were also sequenced on an Oxford Nanopore MinION to determine the context of the resistance genes.ResultsOf 116 isolates, 85 (84 E. coli and one K. pneumoniae) from 78 patients (and two environmental sources) were related to the ongoing outbreak. The outbreak E. coli strain was found to be ST38 and carried blaOXA-181, blaCTX-M-15 and qnrS1 genes. Long read sequencing revealed blaOXA-181 to be carried on an IncX3 plasmid with qnrS1. blaCTX-M-15 was chromosomally integrated (via ISEcp1 insertion) in close proximity to a second qnrS1 gene. A search of the laboratory database identified an isolate with an identical unusual antibiogram from a patient recently admitted to a hospital in Vietnam, suggesting that the strain was introduced to the hospital. This conclusion was supported by WGS, as comparison of the strain to public data identified a close match to an E. coli recovered from Vietnam in 2011.ConclusionA blaOXA-181-carrying E. coli ST38 strain was introduced to a Brisbane hospital and spread undetected throughout multiple wards over several months. Using WGS, we characterized the outbreak strain and unambiguously detected its presence throughout the hospital. We show how both WGS and infection control measures can be utilized to effectively terminate widespread transmission of an elusory pathogen.
Convergent evolution of seasonal camouflage in response to reduced snow cover across the snowshoe hare range
Authors: Jones Matthew R. , Mills L. Scott , Jensen Jeffrey D. , Good Jeffrey M. 
Published: December 2019

AbstractDetermining how different populations adapt to similar environments is fundamental to understanding the limits of adaptation under changing environments. Snowshoe hares (Lepus americanus) typically molt into white winter coats to remain camouflaged against snow. In some warmer climates, hares have evolved brown winter camouflage – an adaptation that may spread under climate change. We used extensive range-wide genomic data to 1) resolve broad-scale patterns of population structure and gene flow and 2) investigate the factors shaping the origins and distribution of winter-brown camouflage variation. In coastal Pacific Northwest (PNW) populations, winter-brown camouflage is known to be determined by a recessive haplotype at theAgoutipigmentation gene. Our phylogeographic analyses revealed deep structure and limited gene flow between PNW and more northern Boreal populations, where winter-brown camouflage is rare along the range edge. Genome sequencing of a winter-brown snowshoe hare from Alaska shows that it lacks the winter-brown PNW haplotype, reflecting a history of convergent phenotypic evolution. However, the PNW haplotype does occur at low frequency in a winter-white population from Montana, consistent with the spread of a locally deleterious recessive variant that is masked from selection when rare. Simulations show that if annual snow cover dramatically declined in the same population, then the predicted selective increase in frequency of the now beneficial winter-brownAgoutiallele is likely to be extremely slow due to the same masking effect. Our findings underscore how allelic dominance can shape the geographic extent and rate of convergent adaptation in response to rapidly changing environments.
Dual-task Interference in a Simulated Driving Environment: Serial or Parallel Processing?
Authors: Abbas-Zadeh Mojtaba , Hossein-Zadeh Gholam-Ali , Vaziri-Pashkam Maryam 
Published: December 2019

AbstractWhen humans are required to perform two tasks concurrently, their performances decrease as the two tasks get closer together in time. This effect is known as dual-task interference. This limitation of the human brain could have lethal effects during demanding everyday tasks such as driving. Are the two tasks processed serially or in parallel during dual-task performance in naturalistic settings? Here, we investigated dual-task interference in a simulated driving environment and investigated the serial/parallel nature of processing during dual-task performance. Participants performed a lane change task on a desktop computer, along with an image discrimination task. We systematically varied the time difference between the onset of the two tasks (Stimulus Onset Asynchrony, SOA) and measured its effect on the amount of dual-task interference. Results showed that the reaction times (RTs) of two tasks in the dual-task condition were higher than those in the single-task condition. SOA influenced RTs of both tasks when they were presented second and the RTs of the image task when it was presented first. Manipulating the predictability of the order of the two tasks, we showed that unpredictability attenuated the effect of SOA by changing the order of the response to the two tasks. Next, using drift-diffusion modeling, we modeled the reaction time and choice of the subjects during dual-task performance in both predictable and unpredictable task order conditions. The modeling results indicated that performing two tasks concurrently, affects both the rate of evidence accumulation and the delays outside the evidence accumulation period, suggesting that the two tasks are performed in a partial-parallel manner. These results extend the findings of previous dual-task experiments to more naturalistic settings and deepen our understanding of the mechanisms of dual-task interference.