bluuebunny/crossref_metadata_2025_split huggingface dataset:
Replicative senescence and arteriosclerosis after kidney transplantation
Authors: De Vusser Katrien , Martens Dries , Lerut Evelyne , Kuypers Dirk , Nawrot Tim S , Naesens Maarten 
Published: May 2020

AbstractBackgroundReplicative senescence is associated with telomere shortening. In native kidneys, obtained prior to transplantation, we recently described and validated a significant association between shorter intrarenal telomere length and renal arteriosclerosis. After renal transplantation, animal experiments suggested that ischaemia–reperfusion injury, acute rejection episodes and cytomegalovirus disease associate with accelerated renal allograft senescence. The association between post-transplant events and replicative senescence has not yet been evaluated in a human setting.MethodsIn a cohort of 134 kidney allograft recipients, we performed protocol-specified renal allograft biopsies at 3 months, 1 year, 2 years and 5 years after transplantation (n = 579 biopsies). We used quantitative real-time polymerase chain reaction to measure intrarenal relative average telomere length (T/S ratio). The association between donor and recipient demographic factors, post-transplant clinical/histological events, renal allograft histological evolution by 5 years post-transplant and intrarenal telomere length at 5 years after transplantation was studied using multiple regression models.ResultsAt 5 years after transplantation, shorter intrarenal telomere length was associated with male donor gender, older donor age, donor history of hypertension and donor cardiovascular risk, which confirms the associations observed in native kidneys. Recipient characteristics and post-transplant events like delayed graft function, acute rejection episodes, presence of donor-specific antibodies, cytomegalovirus disease and immunosuppressive regimen did not associate with alterations of intrarenal telomere length at 5 years. Independent of donor age and donor cardiovascular risk, intrarenal arteriosclerosis in protocol biopsies obtained at 5 years after transplantation and progressive arteriosclerosis over time after transplantation associated with shorter telomere length, while this was not the case for other histological lesions. Moreover, telomere attrition augments the association between older donor age and the presence of severe arteriosclerosis. In the group with the oldest donor age and shortest telomere length, there was significantly more severe arteriosclerosis (43%) in protocol biopsies at 5 years after transplantation, compared with other combinations (13–28%) (P = 0.001). Intrarenal arteriosclerosis at 5 years after transplantation did not associate with post-transplant clinical events.ConclusionsWe demonstrate that intrarenal telomere length at 5 years after transplantation, as a marker for replicative senescence, associates with renal arteriosclerosis and reflects kidney donor characteristics, but not post-transplant events.
A Case–Control Study on the Association Between Intestinal Helminth Infections and Treatment Failure in Patients With Cutaneous Leishmaniasis
Authors: Martínez Dalila Y , Llanos-Cuentas Alejandro , Dujardin Jean-Claude , Polman Katja , Adaui Vanessa , Boelaert Marleen , Verdonck Kristien 
Published: May 2020

Abstract

Background
Endemic regions of cutaneous leishmaniasis (CL) and intestinal helminthiasis overlap. CL treatment with systemic pentavalent antimonial drugs (Sb5+) fails in 10%–30% of patients. The study objective was to assess the etiological role of intestinal helminthiasis in CL treatment failure.

Methods
An unmatched case–control study was done in 4 CL treatment sites in Peru in 2012–2015. Cases were CL patients with Sb5+ treatment failure; controls were CL patients with Sb5+ treatment success. Patients with a parasitologically confirmed CL diagnosis who had received supervised Sb5+ treatment and could be classified as cases or controls were eligible. The main exposure variables were intestinal helminthiasis and strongyloidiasis, diagnosed through direct examination, rapid sedimentation, Baermann, Kato-Katz, or agar culture of stool samples. Additional exposure variables were other infections (HIV, human T-lymphotropic virus 1, tuberculosis, hepatitis B, intestinal protozoa) and noninfectious conditions (diabetes, renal insufficiency, and immunosuppressive medication). Age, gender, CL history, probable exposure place, and Leishmania species were treated as potential confounders in multiple logistic regression.

Results
There were 94 case and 122 control subjects. Overall, infectious and noninfectious comorbidities were frequent both among cases (64%) and controls (71%). The adjusted odds ratio (OR) for the association between any intestinal helminth infection and CL treatment failure was 0.65 (95% confidence interval [CI], 0.30–1.38), and the adjusted OR for the association between strongyloidiasis and CL treatment failure was 0.34 (95% CI, 0.11–0.92).

Conclusions
In the Peruvian setting, high Sb5+ treatment failure rates are not explained by intestinal helminthiasis. On the contrary, strongyloidiasis had a protective effect against treatment failure.
A Recent Human Immunodeficiency Virus Outbreak Among People Who Inject Drugs in Munich, Germany, Is Associated With Consumption of Synthetic Cathinones
Authors: Hanke Kirsten , Fiedler Stefan , Grumann Christina , Ratmann Oliver , Hauser Andrea , Klink Patrycja , Meixenberger Karolin , Altmann Britta , Zimmermann Ruth , Marcus Ulrich , Bremer Viviane , Auwärter Volker , Bannert Norbert 
Published: May 2020

AbstractBackgroundNeedle and syringe sharing among people who inject drugs (PWID) can result in a rapid regional spread of a human immunodeficiency virus (HIV) variant. Such outbreaks have been identified recently in several countries and have raised public health attention because of an association with new psychoactive substances (NPS).MethodsDried serum spots from approximately 60% of newly diagnosed HIV cases in Germany in 2013–2018 were received together with statutory notification data. Samples were sequenced in the pol-region, genotyped, and viral phylogenies were analyzed. For selected samples, the hepatitis C virus (HCV) status and the presence of NPS were determined.ResultsAn outbreak of closely related 27 subtype C infections with a core of 11 cases with almost identical sequences was identified using phylogenetic analyses. The first case of the outbreak was diagnosed in 2015, and the last one was in 2018. With exception of 3 infections, all were reported from Munich, the capital of the federal state of Bavaria. Of 26 analyzed outbreak members, 24 (92.3%) had a resolved or viremic HCV coinfection. In 8 of 18 (44%) cases, α-pyrrolidinopentiothiophenone and/or the related substance α-pyrrolidinoheptiophenone was identified.ConclusionsDespite harm reduction services in place, HIV outbreaks of considerable size can occur in PWID. The establishment of a real-time molecular surveillance is advised to rapidly identify outbreaks and target prevention measures.
En Bloc Subtotal Temporal Bone Resection in a Case of Advanced Ear Cancer: 2-Dimensional Operative Video
Authors: Kimura Hidehito , Taniguchi Masaaki , Shinomiya Hirotaka , Teshima Masanori , Fujita Yuichi , Hashikawa Kazunobu , Nibu Ken-ichi , Kohmura Eiji 
Published: May 2020

Abstract
Temporal bone cancer is extremely rare; thus, the optimal surgical strategy for advanced tumors, en bloc vs piecemeal resection, remain controversial. Some authors have favored piecemeal resection and reported comparable outcomes.
1
Other authors recommend the use of en bloc subtotal temporal bone resection (STBR) for advanced tumors and reported better outcomes, although long-term cancer control remains uncertain.
2
Because of the technical difficulty and the lack of demonstrative surgical videos, STBR has not been sufficiently distributed. This video demonstrates en bloc STBR in a stepwise manner with particular focus on the neurosurgeon's role and aims to improve its safety, feasibility, and distribution. This video conforms to the description of Osawa et al
3
in the designations for each segment of the petrous ICA. A 67-yr-old man suffered from consistent otorrhea and underwent tympanoplasty at an outside hospital 1 yr earlier. Following a histopathological diagnosis of squamous cell carcinoma in the specimen, he underwent chemoradiotherapy (cisplatin + 70 Gy). However, a current imaging revealed a recurrent tumor and he was admitted to our hospital for radical resection. Computed tomography revealed a disrupted external auditory canal and magnetic resonance imaging indicated a carcinoma equivalent to Pittsburg stage T3. The patient underwent radical STBR without complications. His postoperative course was uneventful. At 2 yr postoperative, his modified Rankin scale score was 1, no recurrence was noted, and his facial nerve function was restored to House-Brackmann Grade IV. This video was reproduced with informed consent from the patient.
The Effects of Body-Worn Cameras on Violent Police Victimization
Authors: Douglas Stephen 
Published: May 2020

AbstractBody-worn cameras (BWCs) have been presented as a technological innovation to cultivate greater civility in police–citizen interactions. Attempts have been made to clarify the impact of BWCs upon various policing outcomes, but the effects of BWCs on assaults against police has received scant research attention. Existing studies have been limited to a handful of jurisdictions with limited generalizability to a broader range of police organizations. Combining a number of official data sets for the years 2011–13, the current study assesses the relationship between BWCs and police victimization by focusing on total assaults and firearm assaults against police officers in a sample of 516 police agencies. The results indicate that BWC usage is negatively associated with police victimization in both models. This suggests that BWCs can assist in preventing the occurrence of general and extreme violence against police in a wide range of law enforcement agencies in varied settings.
A prospective cohort study on predictors of mortality of delirium in an emergency observational unit
Authors: Pal S , Sharma N , Singh S M , Kumar S , Pannu A K 
Published: May 2020

Summary

Background
Delirium is often an underdiagnosed and underestimated neuropsychiatric syndrome, especially in low- and middle-income countries.

Aim
To document the prevalence and clinical profile of delirium and to detect the baseline parameters associated with in-hospital mortality.

Design
A prospective cohort study conducted between January 2016 to December 2016 at an adult medical emergency observational unit of an academic hospital in north India.

Methods
Confusion Assessment Method for the intensive care unit was used for screening and diagnosis of delirium. Subtypes of delirium and severity were defined with the Richmond agitation-sedation scale and Delirium Rating Scale-Revised-98 (DRS-R-98).

Results
Out of 939 screened patients, 312 (33.2%) had delirium, including 73.7% unrecognized cases. The mean age was 49.1 ± 17.3 years (range 17–90), and only 33.3% of the patients were above 60 years. The prevalence of hypoactive, mixed and hyperactive delirium was 39.1, 33.7 and 27.2%, respectively. Usual predisposing factors were alcohol use disorder (57.4%) and hypertension (51.0%), and infections remain the most common precipitating factors (42.0%). In total, 96.1% of patients received midazolam before delirium onset, and physical restraints were used in 73.4%. Mortality was higher in delirium (19.9% vs. 6.4%). The independent predictors of death in delirium were low diastolic blood pressure (P-value = 0.000), Glasgow coma scale score &lt;15 (P = 0.026), high Acute Physiology and Chronic Health Evaluation II score (P = 0.007), high DRS-R-98 severity score (P = 0.000) and hyperactive delirium (P = 0.024).

Conclusion
Rapid screening with Confusion Assessment Method for the intensive care unit detected a high prevalence of delirium (even in young patients), and it associated with high mortality.
Definition of fibromyalgia severity: findings from a cross-sectional survey of 2339 Italian patients
Authors: Salaffi Fausto , Di Carlo Marco , Bazzichi Laura , Atzeni Fabiola , Govoni Marcello , Biasi Giovanni , Di Franco Manuela , Mozzani Flavio , Gremese Elisa , Dagna Lorenzo , Batticciotto Alberto , Fischetti Fabio , Giacomelli Roberto , Guiducci Serena , Guggino Giuliana , Bentivegna Mario , Gerli Roberto , Salvarani Carlo , Bajocchi Gianluigi , Ghini Marco , Iannone Florenzo , Giorgi Valeria , Farah Sonia , Cirillo Mariateresa , Bonazza Sara , Barbagli Stefano , Gioia Chiara , Santilli Daniele , Capacci Annunziata , Cavalli Giulio , Carubbi Francesco , Nacci Francesca , Riccucci Ilenia , Sinigaglia Luigi , Masullo Maurizio , Polizzi Bianca Maria , Cutolo Maurizio , Sarzi-Puttini Piercarlo 
Published: May 2020

Abstract

Objective
To establish optimal cut-off values for the scores of the revised Fibromyalgia Impact Questionnaire (FIQR), the modified Fibromialgia Assessment Scale (FAS 2019mod), and the Polysymptomatic Distress Scale (PDS) in order to distinguish five levels of FM disease severity.

Methods
Consecutive FM patients were evaluated with the three clinimetric indices, and each patient was required to answer the anchor question: ‘In general, would you say your health is 1 = very good, 2 = good, 3 = fair, 4 = poor, or 5 = very poor?’—which represented the external criterion. Cut-off points were established through the interquartile reconciliation approach.

Results
The study sample consisted of 2181 women (93.2%) and 158 men (6.8%), with a mean age of 51.9 (11.5) years, and mean disease duration was 7.3 (6.9) years. The overall median FIQR, FAS 2019 mod and PDS scores (25th–75th percentiles) were respectively 61.16 (41.16–77.00), 27.00 (19.00–32.00) and 19.0 (13.00–24.00). Reconciliation of the mean 75th and 25th percentiles of adjacent categories defined the severity states for FIQR: 0–23 for remission, 24–40 for mild disease, 41–63 for moderate disease, 64–82 for severe disease and &gt;83 for very severe disease; FAS 2019 mod: 0–12 for remission, 13–20 for mild disease, 21–28 for moderate disease, 29–33 for severe disease and &gt;33 for very severe disease; PDS: 0–5 for remission, 6–15 for mild disease, 16–20 for moderate disease, 21–25 for severe disease and &gt;25 for very severe disease.

Conclusions
Disease severity cut-offs can represent an important improvement in interpreting FM.
0010 Functional Brain Connectivity Alterations in Restless Legs Syndrome are Modulated by Dopaminergic Medication
Authors: Tuovinen N , Stefani A , Mitterling T , Heidbreder A , Frauscher B , Gizewski E R , Poewe W , Högl B , Scherfler C 
Published: May 2020

Abstract

Introduction
Functional brain connectivity studies revealed alterations within thalamic, salience, and default mode networks in patients with restless legs syndrome. The objective of this study was to characterize functional connectivity and network topology in a large cohort of patients with restless legs syndrome compared to healthy controls, and to investigate the modulatory effect of dopaminergic treatment upon connectivity.

Methods
82 patients with restless legs syndrome (untreated, n=30; on dopaminergic medication, n=42; on alpha-2-delta ligands as mono- or polytherapy combined with dopaminergic medication, n=10) and 82 individually age and gender matched healthy controls were studied with resting state functional MRI. Connectivity of twelve resting-state networks was compared with independent component analysis, and among 410 brain regions with graph theoretical modeling.

Results
Patients with restless legs syndrome showed significantly higher connectivity within salience (P=0.029), executive (P=0.001), somatomotor (P=0.050), and cerebellar (P=0.041) networks, as well as significantly (P&lt;0.05) lower cerebello-frontal communication compared to healthy controls. Untreated patients had significantly (P&lt;0.05) lower cerebello-parietal communication compared to healthy controls and connectivity between the thalamus and frontal regions were significantly increased in patients on dopaminergic medication compared to untreated patients and healthy controls (P&lt;0.05).

Conclusion
Networks with higher intra-network connectivity (i.e. salience, executive, somatomotor, cerebellar) and lower between regions connectivity (i.e. cerebello-frontal, cerebello-parietal) in restless legs syndrome correspond to regions associated with attention, response inhibitory control, and processing of sensory information. Dopaminergic medication normalizes the altered cerebello-parietal communication and increases thalamic connectivity to the prefrontal cortex suggesting that these regions are associated with the emergence of symptoms in restless legs syndrome.

Support
The study was funded by a Grant from Translational Research
Fund of the government of Tyrol, Austria, and in-kind resources
of the Medical University of Innsbruck.
0028 Sleep Duration Influences the Kinetics of Stress Granule Formation
Authors: Dougherty M K , Saul C , Carman L , Nelson M D , Tudor J C 
Published: May 2020

Abstract

Introduction
Stress granules are non-membrane bound aggregates of messenger ribonucleoproteins that are biomarkers of cellular stress. It has been shown in cells in vitro that suppression of the mammalian target of rapamycin (mTOR) pathway and its non-mammalian orthologue target of rapamycin (TOR) is associated with an increase in stress granule formation. It has also been shown that the mTOR pathway is suppressed in response to sleep deprivation in mice. Despite the possible connection via the TOR/mTOR pathway, there has not been any previous evidence linking sleep deprivation with stress granule formation.

Methods
Our present investigation uses the nematode Caenorhabditis elegans to model how stress granule formation and clearance are modified by sleep duration. We developed novel strains of C. elegans that model each type of sleep deprivation or enhancement and have RFP-labeled PAB-1 protein, a key component of stress granules. In addition to modifying sleep duration via genetic means, we also sleep deprived wildtype fluorescently labeled animals using mechanical disturbances.

Results
Animals with enhanced stress-induced sleep have stress granules that are smaller in size and cleared faster than wildtype, while sleep deprived animals have granules that are slower to clear (F11,473 = 7.752, ***p &lt; 0.0001, one-way ANOVA). Animals that were manually deprived of stress-induced sleep were similarly slower to clear stress granules (F5,209 = 5.476 ***p &lt; 0.0001, one-way ANOVA). Interestingly, animals genetically deprived of developmentally-timed sleep does not appear to have more stress granules in the middle of their sleep period than the sleeping wildtype stage (F2,42 = 2.659, p = 0.0729, one-way ANOVA).

Conclusion
This work demonstrates that the amount of sleep affects stress granule kinetics, which impacts the flow of genetic information inside cells.

Support
This work was supported by an R15GM122058 (NIH), John P. McNulty scholars program (SJU) and summer scholars program (SJU).
0041 Heart Rate Variability Differs in Resilient vs. Vulnerable Adults from Total Sleep Deprivation and Psychological Stress and Predicts Cognitive Performance
Authors: Yamazaki E M , Rosendahl-Garcia K M , MacMullen L E , Ecker A J , Kirkpatrick J N , Goel N 
Published: May 2020

Abstract

Introduction
There are substantial individual differences (resilience and vulnerability) in neurobehavioral performance from psychosocial stress and sleep loss. However, the time course of heart rate variability (HRV) across baseline, total sleep deprivation (TSD), the combination of TSD + psychological stress, and recovery has not been investigated; in addition, it remains unknown whether HRV and blood pressure (BP) differ in resilient vs. vulnerable individuals and predict individual differences in cognitive performance.

Methods
Thirty-one healthy adults (ages 27–53; mean±SD, 35.4±7.1y; 14 females) participated in a five-day experiment consisting of two 8h time-in-bed (TIB) baseline nights, 39h TSD, and two 8h-10h TIB recovery nights. A modified Trier Social Stress Test (TSST) induced psychological stress on the TSD day. Systolic and diastolic BP and HRV (derived from echocardiographic R-R interval) were obtained at six time points (pre-study, baseline, during TSD, during TSD after the TSST, after recovery, and post-study). Cognitively resilient (n=15) and vulnerable (n=16) groups were defined by a median split on 10-minute Psychomotor Vigilance Test (PVT) TSD performance [total lapses (&gt;500ms response time) and errors]. Repeated measures ANOVA and post-hoc comparisons corrected for multiple testing, examined BP and HRV across time points between groups.

Results
HRV showed a significant time*group interaction: while resilient individuals had significantly lower HRV at pre-study compared to vulnerable individuals, their HRV increased above that of vulnerable individuals with TSD and with TSD + psychological stress. By contrast, systolic and diastolic BP did not show significant time*group interactions and did not predict cognitive vulnerability during TSD.

Conclusion
HRV differed between resilient and vulnerable individuals across TSD, psychological stress and recovery sleep and predicted individual differences in cognitive performance, whereby lower HRV during full-rested conditions predicted resilience to TSD and TSD + psychological stress. HRV, but not BP, is a reliable biomarker of sleep deprivation, psychological stress, and neurobehavioral vulnerability.

Support
NASA NNX14AN49G.
0047 The Change in Melatonin Rhythm Depending on Dementia Severity in Alzheimer’s Disease (AD) Patients
Authors: Lee J , Kim S , Lee S , Suh I , Jang J , Jhoo J 
Published: May 2020

Abstract

Introduction
In Alzheimer’s disease (AD), both sleep and circadian dysfunctions are commonly reported and these are associated with neurodegenerative change. Actually, it has been reported that changes in circadian rhythms in AD were apparently discrete from those seen in normal aging. Previous studies reported the delayed phase in the activity or core body temperature rhythms in severe AD patients compared to normal controls. However, it is unknown whether similar changes in melatonin rhythms occur in AD patients who were not severely demented. We aimed to compare melatonin rhythms depending on dementia severity in mild and moderate AD patients.

Methods
We recruited AD patients of mild or moderate degree who had the Pittsburgh Sleep Quality Index (PSQI) score of 5 or greater and/or complained insomnia symptoms more than 3 times a week for a month. The patients were classified according to their Clinical Dementia Rating (CDR) score into 3 groups (CDR=0.5, 1, 2). The dim light melatonin onset (DLMO) was determined from seven hourly saliva samples obtained in the laboratory prior to sleep onset measured by actigraphy. The phase angle between the DLMO and sleep onset (PA-SO), and that between the DLMO and midsleep time (PA-MST) were calculated. Each group included 13, 13 and 6 AD patients with the CDR score of 0.5, 1 and 2, respectively. The DLMO and PA were compared among the 3 groups, and correlation analyses of the DLMO and PA with the MMSE in the Korean version of CERAD Packet (MMSE-KC) scores were done in total patients.

Results
There was no significant difference in the DLMO and PA between the 3 groups. The MMSE-KC score was positively correlated with the DLMO and negatively correlated with the PA-MST.

Conclusion
There were no changes in melatonin rhythms according to dementia severity in mild and moderate AD patients with sleep complaints. However, our study showed that earlier melatonin phase was associated with more impaired cognitive function.

Support
Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2017R1A2B4003493)