bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of a Procalcitonin-guided Antibiotic Treatment Algorithm in the Pediatric Intensive Care Unit
Authors: Katz Sophie E. , Crook Jennifer , Gillon Jessica , Stanford J. Eric , Wang Li , Colby Jennifer M. , Banerjee Ritu 
Published: November 2020

Background:
The utility of procalcitonin testing in the pediatric intensive care unit (PICU) is not known. We sought to determine the impact of a procalcitonin-guided antibiotic treatment algorithm implemented with antibiotic stewardship (AS) guidance vs. usual care on antibiotic use in critically ill children.

Methods:
Single center, pragmatic, randomized prospective clinical trial of critically ill children admitted to an ICU setting and started on intravenous antibiotics from February 15, 2018, to April 11, 2019. Patients were assigned on a monthly basis to either the procalcitonin or usual care arm. The procalcitonin arm had procalcitonin testing on hospital days 0, 1, 2, and 4 and stewardship assistance with algorithm result interpretation. Both arms had routine AS audit and feedback. The primary outcome was median antibiotic days of therapy per patient in the first 14-days after enrollment.

Results:
Among 270 patients, 137 were in the procalcitonin arm and 133 in the usual care arm. Antibiotic days of therapy (DOT) were not significantly different between the procalcitonin arm (6.6, IQR: 3.1–10.9) and the usual care arm (7.6, IQR: 3–11.8; P = 0.37). More AS recommendations were made in the procalcitonin vs. control arm (54 vs. 37; P = 0.03). Adherence with algorithm-based antibiotic recommendations was high in the procalcitonin arm (70%).

Conclusions:
We found no difference in antibiotic DOT between study arms. This trial was underpowered but demonstrates feasibility of using a procalcitonin-guided antibiotic treatment algorithm with AS audit and feedback in the PICU.
Ovarian Torsion in Pediatric and Adolescent Patients
Authors: Zander Wendy , Frederick Katherine 
Published: November 2020

Introduction
Although rare, ovarian torsion is a surgical emergency. The purpose of this article is to raise awareness of the occurrence, review anatomy and pathophysiology, and share diagnosis and management options with other healthcare providers.

Methods
This article was composed by two professional nurses who, in seeking to understand more about this dangerous condition, worked together in searching the literature for the latest information on etiology and management options for the patient.

Conclusions
The sudden onset of lower abdominal pain in female children and adolescents requires immediate evaluation by a qualified medical professional. In the case of ovarian torsion, speed is of the essence if normal function can possibly be restored or if surgical intervention for removal is required.
A comparative study of classic and HIV-viremic and aviremic AIDS Kaposi sarcoma
Authors: Séverin David , Bessaoud Faiza , Meftah Nadia , Du Thanh Aurelie , Tretarre Brigitte , Guillot Bernard , Makinson Alain 
Published: November 2020

Background:
Kaposi sarcoma in people living with HIV (PLHIV) is the most common AIDS-associated malignancy. There is increased interest in Kaposi sarcoma in PLHIV with controlled HIV viremia.

Objectives:
To describe Kaposi sarcoma occurring in PLHIV despite virological control and to compare their clinical presentations with viremic AIDS-Kaposi sarcoma (AIDS-KS) and classic Kaposi sarcoma (CKS).

Methods:
This was a monocentric retrospective study, including all Kaposi sarcoma patients registered between the 1 January of 2000 and 31 December 2017 in a comprehensive data bank for all cancers in the Hérault region, South of France. AIDS-KS were also described using chart reviews from the Infectious diseases Department, which followed more than 90% of PLHIV from the same region. We defined aviremic AIDS-KS as Kaposi sarcoma occurring in persons taking HAART with a HIV viral load less than 50 copies for more than 12 months. We compared clinical characteristics of persons with aviremic AIDS-KS, viremic AIDS-KS and CKS, using the Kriegel score and number and topography of skin lesions, and presence of lymphedema.

Results:
We retrieved 187 Kaposi sarcoma cases, of which 12 occurred in PLHIV with aviremic AIDS-KS. Kriegel score stage I was found in 10 (83%) of the aviremic AIDS-KS, 34 (68%) of CKS and 38 (58.4%) of viremic AIDS-KS cases, with similar clinical presentations between aviremic AIDS-KS and CKS groups, and viremic AIDS-KS persons having more aggressive presentations. One person with aviremic AIDS-KS had visceral involvement.

Conclusion:
We showed that Kaposi sarcoma in PLHIV with controlled viremia were generally indolent, similarly to CKS. Visceral involvement is, however, possible.
Cerebral Infarction With Increased Uptake on 123I-FP-CIT SPECT
Authors: Nakajima Satoshi , Fushimi Yasutaka , Kawashima Hirotsugu , Murai Toshiya , Nakamoto Yuji 
Published: November 2020

Abstract
A 76-year-old woman underwent 123I-FP-CIT brain SPECT due to postural reflex impairment. The transverse slices demonstrated increased uptake in the right middle cerebral artery territory. MR images obtained 2 weeks earlier showed cerebral infarction in the corresponding area. 123I-FP-CIT has high binding affinity for dopamine transporters, especially in the nerve endings of nigrostriatal dopaminergic neurons.
Will Baseline Total Lesion Glycolysis Play a Role in Improving the Prognostic Value of the NCCN-IPI in Primary Gastric Diffuse Large B-Cell Lymphoma Patients Treated With the R-CHOP Regimen?
Authors: Jiang Chong , Ding Chongyang , Xu Jingyan , Teng Yue , Chen Jieyu , Wang Zhen , Zhou Zhengyang 
Published: November 2020

Purpose
The aim was to explore whether baseline total lesion glycolysis (TLG) can improve the prognostic value of the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) in primary gastric diffuse large B-cell lymphoma (PG-DLBCL) patients treated with an R-CHOP–like regimen.

Materials and Methods
Ninety-four PG-DLBCL patients who underwent baseline PET/CT between July 2010 and May 2019 were included in this retrospective study. FDG-avid lesions in each patient were segmented to calculate the SUVmax, total metabolic tumor volume (TMTV), and TLG. Progression-free survival (PFS) and overall survival (OS) were used as end points to evaluate prognosis.

Results
During the follow-up period of 5 to 108 months (35.3 ± 23.5 months), high TLG and a high NCCN-IPI were significantly associated with poor PFS and OS. Total lesion glycolysis and the NCCN-IPI were independent predictors of PFS and OS. Patients were stratified into 3 groups according to the combination of TLG and the NCCN-IPI for PFS (P < 0.001) and OS (P < 0.001): high-risk group (TLG > 1159.1 and NCCN-IPI 4–8) (PFS and OS, 57.7% and 61.5%, respectively, n = 42), intermediate-risk group (TLG > 1159.1 or NCCN-IPI 4–8) (PFS and OS, both 76.9%, n = 26), and low-risk group (TLG ≤ 1159.1 and NCCN-IPI 0–3) (PFS and OS, 97.6% and 100.0%, respectively, n = 26).

Conclusions
Both TLG and the NCCN-IPI are independent predictors of PG-DLBCL patient survival. Moreover, the combination of TLG and the NCCN-IPI improved patient risk stratification and might help personalize therapeutic regimens.
Detection of Unexpected Brown Tumors Due to Hyperparathyroidism Diagnosed by 18F-FDG PET/CT
Authors: Geysen Astrid , Van Laere Koen , Verscuren Raf 
Published: November 2020

Abstract
A 27-year-old man was called to receive a kidney transplant. The preoperative CT of the chest showed multiple osteolytic lesions, as well as a hypodense structure posterior in the right thyroid lobe. Blood analysis showed elevated parathyroid hormone, phosphorus, and alkaline phosphatase levels, with normal calcium and 25-OH-vitamin D. 18F-FDG PET/CT demonstrated generalized elevated FDG uptake in the bone (due to hyperparathyroidism), as well as multiple hypermetabolic focal lesions spread throughout the bone (fitting brown tumors). The nodule posterior of the right thyroid lobe showed an intense FDG uptake as well, suggestive of a parathyroid adenoma/hyperplasia. Histopathology confirmed the diagnosis.
Anomalous Origin and Course of Right Vertebral Artery With Aberrant Right Subclavian Artery
Authors: Taydas Onur , Sakci Zakir , Ogul Hayri 
Published: November 2020

Abstract
Origin and course anomalies of the vertebral arteries are rare. They are considered a congenital anomaly that occurs in the early stages of embryonic development. Thanks to magnetic resonance angiography, these anomalies can be diagnosed easily. Detecting these anomalies is especially important before endovascular interventional procedures. In this case report, we present magnetic resonance angiography findings of a patient with extraforaminal vertebral artery that originated from right common carotid artery and also with aberrant right subclavian artery.
Experiment of Mechanical Properties of a Customized Distractor Based on Three-Dimensional Printing Technology
Authors: Zhao Xinran , Li Guangwei , Shen Guofang , Wei Jianhe , Cai Ming 
Published: November 2020

Abstract
This study aimed to design and fabricate a customized distractor based on 3D printing technology and compare its mechanical properties with conventional distractor. The investigators designed and implemented a study composed of conventional and customized distractors. The design of customized distractor was based on the specification of conventional mandibular distractors and was fabricated using selective laser melting (SLM) technology. The same type of conventional distractors served as control group. Vickers-hardness test, three-point bending test and welding strength test were carried out for the conventional and customized distractor respectively and data was analyzed with t test using SPSS13.0 software package. The sample was composed of 18 distractors grouped as follows: customized distractor (n = 9) and conventional distractor (n = 9). The customized distractor showed better result than the conventional distractor in mechanical property tests, with statistically significant differences in Vickers-hardness and maximum load (P < 0.05), and no significant differences in yield strength and welding strength (P > 0.05). The results of this study suggest indicated that compared to the conventional distractor, the customized distractor had better mechanical properties and could be used in maxillofacial distraction osteogenesis.
Stereotactic EEG Practices: A Survey of United States Tertiary Referral Epilepsy Centers
Authors: Gavvala Jay , Zafar Muhammad , Sinha Saurabh R. , Kalamangalam Giridhar , Schuele Stephan ,   On behalf of the American SEEG Consortium, supported by The American Clinical Neurophysiology Society
Published: November 2020

Purpose:
Stereotactic EEG (SEEG) is being increasingly used in the intracranial evaluation of refractory epilepsy in the United States. In this study, the authors describe current practice of SEEG among National Association of Epilepsy Centers tertiary referral (level IV) centers.

Methods:
Using the Survey Monkey platform, a survey was sent to all National Association of Epilepsy Centers level IV center directors.

Results:
Of 192 centers polled, 104 directors completed the survey (54% response rate). Ninety-two percent currently perform SEEG. Of these, 55% of institutions reported that greater than 75% of their invasive electrode cases used SEEG. Stereotactic EEG was commonly used over subdural electrodes in cases of suspected mesial temporal lobe epilepsy (87%), nonlesional frontal lobe epilepsy (79%), insular epilepsy (100%), and individuals with prior epilepsy surgery (74%). Most centers (72%) used single-lead electrocardiogram monitoring concurrently with SEEG, but less than half used continuous pulse oximetry (47%) and only a few used respiratory belts (3%). Other significant intercenter technical variabilities included electrode nomenclature and choice of reference electrode. Patient care protocols varied among centers in patient-to-nurse ratio and allowed patient activity. Half of all centers had personnel who had prior experience in SEEG (50.5%); 20% of centers had adopted SEEG without any formal training.

Conclusions:
Stereotactic EEG has become the principal method for intracranial EEG monitoring in the majority of epilepsy surgery centers in the United States. Most report similar indications for use of SEEG, though significant variability exists in the utilization of concurrent cardiopulmonary monitoring as well as several technical and patient care practices. There is significant variability in level of background training in SEEG among practitioners. The study highlights the need for consensus statements and guidelines to benchmark SEEG practice and develop uniform standards in the United States.
Learning function from structure in neuromorphic networks
Authors: Suárez Laura E. , Richards Blake A. , Lajoie Guillaume , Misic Bratislav 
Published: November 2020

AbstractThe connection patterns of neural circuits in the brain form a complex network. Collective signaling within the network manifests as patterned neural activity, and is thought to support human cognition and adaptive behavior. Recent technological advances permit macro-scale reconstructions of biological brain networks. These maps, termed connectomes, display multiple non-random architectural features, including heavy-tailed degree distributions, segregated communities and a densely interconnected core. Yet, how computation and functional specialization emerge from network architecture remains unknown. Here we reconstruct human brain connectomes usingin vivodiffusion-weighted imaging, and use reservoir computing to implement these connectomes as artificial neural networks. We then train these neuromorphic networks to learn a cognitive task. We show that biologically realistic neural architectures perform optimally when they display critical dynamics. We find that performance is driven by network topology, and that the modular organization of large-scale functional systems is computationally relevant. Throughout, we observe a prominent interaction between network structure and dynamics, such that the same underlying architecture can support a wide range of learning capacities across dynamical regimes. This work opens new opportunities to discover how the network organization of the brain optimizes cognitive capacity, conceptually bridging neuroscience and artificial intelligence.
Characterization and structural basis of a lethal mouse-adapted SARS-CoV-2
Authors: Sun Shihui , Gu Hongjing , Cao Lei , Chen Qi , Ye Qing , Yang Guan , Li Rui-Ting , Fan Hang , Deng Yong-Qiang , Song Xiaopeng , Qi Yini , Li Min , Lan Jun , Feng Rui , Guo Yan , Zhu Na , Qin Si , Wang Lei , Zhang Yi-Fei , Zhou Chao , Zhao Lingna , Chen Yuehong , Shen Meng , Cui Yujun , Yang Xiao , Wang Xinquan , Tan Wenjie , Wang Hui , Wang Xiangxi , Qin Cheng-Feng 
Published: November 2020

AbstractThe ongoing SARS-CoV-2 pandemic has brought an urgent need for animal models to study the pathogenicity of the virus. Herein, we generated and characterized a novel mouse-adapted SARS-CoV-2 strain, named MASCp36, that causes severe acute respiratory symptoms and mortality in standard laboratory mice. Particularly, this model exhibits age and gender related skewed distribution of mortality akin to severe COVID-19, and the 50% lethal dose (LD50) of MASCp36 was 58 PFU in 9-month-old, male BALB/c mice. Deep sequencing identified three amino acid substitutions, N501Y, Q493H, and K417N, subsequently emerged at the receptor binding domain (RBD) of MASCp36, during in vivo passaging. All three mutations in RBD significantly enhanced the binding affinity to its endogenous receptor, mouse ACE2 (mACE2). Cryo-electron microscopy (cryo-EM) analysis of human ACE2 (hACE2) or mACE2 in complex with the RBD of MASCp36 at 3.1 to 3.7 angstrom resolution elucidates molecular basis for the receptor-binding switch driven by specific amino acid substitutions. Interestingly, N501Y and Q493H enhanced the binding affinity to human ACE2 (hACE2); while triple mutations N501Y/Q493H/K417N decreased affinity to hACE2, thus led to the reduced infectivity of MASCp36 to human cells. Our study not only provides a robust platform for studying the pathogenesis of severe COVID-19 and rapid evaluation of coutermeasures against SARS-CoV-2, but also unveils the molecular mechanism for the rapid adaption and evolution of SARS-CoV-2 in human and animals.One sentence summaryA mouse adapted SARS-CoV-2 strain that harbored specific amino acid substitutions in the RBD of S protein showed 100% mortality in aged, male BALB/c mice.
In silicoanalyses on the comparative sensing of SARS-CoV-2 mRNA by intracellular TLRs of human
Authors: Choudhury Abhigyan , Das Nabarun Chandra , Patra Ritwik , Mukherjee Suprabhat 
Published: November 2020

AbstractThe worldwide outbreak of COVID-19 pandemic caused by SARS-CoV-2 leads to loss of mankind and global economic stability. The continuous spreading of the disease and its pathogenesis takes millions of lives of peoples and the unavailability of appropriate therapeutic strategy makes it much more severe. Toll-like receptors (TLRs) are the crucial mediators and regulators of host immunity. The role of several TLRs in immunomodulation of host by SARS-CoV-2 is recently demonstrated. However, the functionality of human intracellular TLRs including TLR3,7,8 and 9 is still being untested for sensing of viral RNA. This study is hoped to rationalize the comparative binding and sensing of SARS-CoV-2 mRNA towards the intracellular TLRs, considering the solvent-based force-fields operational in the cytosolic aqueous microenvironment that predominantly drive these reactions. Ourin-silicostudy on the binding of all mRNAs with the intracellular TLRs shown that the mRNA of NSP10, S2, and E proteins of SARS-CoV-2 are potent enough to bind with TLR3, TLR9, and TLR7 and trigger downstream cascade reactions, and may be used as an option for validation of therapeutic option and immunomodulation against COVID-19.
Crop and Semi-Natural Habitat Configuration affects Diversity and Abundance of Native Bees (Hymenoptera: Anthophila) in a Large-Scale Cotton Agroecosystem
Authors: Esquivel Isaac. L. , Parys Katherine A. , Wright Karen W. , Eubanks Micky D. , Oswald John D. , Coulson Robert N. , Brewer Michael J. 
Published: November 2020

AbstractThe cotton agroecosystem is one of the most intensely managed, economically, and culturally important fiber crops worldwide including in the United States of America (U.S.), China, India, Pakistan, and Brazil. The composition and configuration of crop species and semi-natural habitat can have significant effects on ecosystem services such as pollination. Here we investigate the effect of crop and semi-natural habitat configuration in a large-scale cotton agroecosystem on the diversity and abundance of native bees. Interfaces sampled include cotton grown next to cotton, sorghum or semi-natural habitat. Collections of native bees across interface types revealed 32 species in 13 genera across 3 families. Average species richness ranged between 20.5 and 30.5 with the highest (30.5) at the interface of cotton and semi-natural habitat. The most abundant species wasMelissodes tepanecaCresson (> 4,000 individuals, ~75% of bees collected) with a higher number of individuals found in all cotton-crop interfaces compared to the cotton interface with semi-natural habitat or natural habitat alone. It was also found that interface type had a significant effect on the native bee communities. Communities of native bees in the cotton-crop interfaces tended to be more consistent in the abundance of species and number of species at each sampling site. While cotton grown next to semi-natural habitat had higher species richness, the number of bees collected varied. These data suggest that native bee communities persist in large-scale cotton agroecosystems and some species may thrive even when cotton-crop interfaces are dominant compared with semi-natural habitat. These data have native bee conservation implications that may improve potential pollination benefits to cotton production.
Multistep mechanism of DNA replication-coupled G-quadruplex resolution
Authors: Sato Koichi , Martin-Pintado Nerea , Post Harm , Altelaar Maarten , Knipscheer Puck 
Published: November 2020

SummaryG-quadruplex (or G4) structures are non-canonical DNA structures that form in guanine-rich sequences and threaten genome stability when not properly resolved. G4 unwinding occurs during S phase via an unknown mechanism. UsingXenopusegg extracts, we define a three-step G4 unwinding mechanism that is coupled to DNA replication. First, the replicative helicase (CMG) stalls at a leading strand G4 structure. Second, the DHX36 helicase mediates the bypass of the CMG past the intact G4 structure, which allows approach of the leading strand to the G4. Third, G4 structure unwinding by the FANCJ helicase enables the DNA polymerase to synthesize past the G4 motif. A G4 on the lagging strand template does not stall CMG, but still requires DNA replication for unwinding. DHX36 and FANCJ have partially redundant roles, conferring robustness to this pathway. Our data reveal a novel genome maintenance pathway that promotes faithful G4 replication thereby avoiding genome instability.
SANS (USH1G) regulates pre-mRNA splicing by mediating the intra-nuclear transfer of tri-snRNP complexes
Authors: Yildirim Adem , Mozaffari-Jovin Sina , Wallisch Ann-Kathrin , Ries Jessica , Ludwig Sebastian , Urlaub Henning , Lührmann Reinhard , Wolfrum Uwe 
Published: November 2020

AbstractSplicing is catalyzed by the spliceosome, a compositionally dynamic complex assembled stepwise on pre-mRNA. We reveal links between splicing machinery components with the intrinsically disordered ciliopathy protein SANS. Pathogenic mutations inSANS/USH1Glead to Usher syndrome – the most common cause of deaf-blindness. SANS functions have been associated with cytoplasmic processes so far. Here, we reveal molecular links between SANS and pre-mRNA splicing catalyzed by the spliceosome, a compositionally dynamic complex assembled stepwise on pre-mRNA in the nucleus. Here, we show SANS associates with Cajal bodies and nuclear speckles, where SANS interacts with components of spliceosomal sub-complexes such as SF3B1 and the large splicing cofactor SON but also with PRPFs and snRNAs related to the tri-snRNP complex. SANS is required for the transfer of tri-snRNPs from Cajal bodies to nuclear speckles. SANS depletion alters the kinetics of spliceosome assembly, leading to accumulation of Complex A. SANS deficiency andUSH1Gpathogenic mutations affects splicing of genes related to cell proliferation and USH. Thus, we provide the first evidence that splicing deregulation may participate in the pathophysiology of Usher syndrome.
Lipid rafts interaction of the ARID3A transcription factor with EZRIN and G-Actin regulates B cell receptor signaling
Authors: Schmidt Christian , Christian Laura , Tidwell Josephine , Kim Dongkyoon , Tucker Haley O 
Published: November 2020

ABSTRACTPreviously we demonstrated that the ARID3A transcription factor shuttles between the nucleus and the plasma membrane, where it localizes within lipid rafts. There it interacts with components of the B Cell Receptor (BCR) to reduce its ability to transmit downstream signaling. We demonstrate in this report that a direct component of ARID3A-regulated BCR signal strength is cortical Actin. ARID3A interacts with Actin exclusively within lipid rafts via the Actin binding protein EZRIN, which confines unstimulated BCRs within lipid rafts. BCR ligation discharges the ARID3A-EZRIN complex from lipid rafts allowing the BCR to initiate downstream signaling events. The ARID3A-EZRIN interaction occurs almost exclusively within unpolymerized G-Actin where EZRIN interacts with the multifunctional ARID3A REKLES domain. These observations provide a novel mechanism by which a transcription factor directly regulates BCR signaling.