bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evolving Role of Non-Total Resection in Management of Acoustic Neuroma in the Gamma Knife Era
Authors: Luryi Alexander L. , Kveton John F. , Babu Seilesh , Bojrab Dennis I. , Michaelides Elias M. , Schutt Christopher A. 
Published: November 2020

Objective:
To examine patients with residual tumor after vestibular schwannoma (VS) resection with focus on need for further therapy, including stereotactic radiosurgery (SRS) and revision surgery.

Study Design and Setting:
Retrospective review at two tertiary otology referral centers.

Patients and Intervention:
Patients undergoing primary surgery for VS from 2007 to 2017.

Main Outcome Measure:
Degree of resection and need for further treatment.

Results:
Of 289 patients undergoing surgery, 38 (13.1%) underwent subtotal resections (<95% of tumor resected) and 77 (26.6%) underwent near-total resections (≥95% but <100%). Patients with any residual tumor had larger tumors preoperatively (mean estimated volume 6.3 cm3 versus 2.1 cm3, p < 0.0005) but were otherwise clinically and demographically similar to the population as a whole. Further treatment (surgery or SRS) was needed in 4.6, 14.3, and 50.0% of patients after gross total, near-total, and subtotal resections, respectively (p < 0.0005). Patients undergoing additional therapy had larger residual tumors (median post- to preoperative estimated volume ratio 0.09 versus 0.01, p < 0.0005). Patients undergoing subtotal and near-total resections had poorer facial function at ultimate follow up than those undergoing gross total resections (p = 0.001), likely due to larger tumors and more difficult resections. Literature review revealed higher rates of gross total resection as well as facial palsy in the pre-SRS era.

Conclusion:
Residual tumor following VS resection is more common today than in the pre-SRS era. Availability of SRS may encourage leaving residual tumor intraoperatively to preserve neural structures. Current surgical strategies decrease surgical morbidity but necessitate further treatment in over 10% of cases.
Evaluation of the Effectiveness of In‐line Immobilized Lipase Cartridge in Enterally Fed Patients With Cystic Fibrosis
Authors: Sathe Meghana N. , Patel Dhiren , Stone Archie , First Eric 
Published: November 2020

ABSTRACTBackground:Pancreatic insufficiency occurs in most patients with cystic fibrosis (CF) contributing to malnutrition. In the United States, 3600 patients with CF require enteral feeding (EF). Oral pancreatic enzymes are commonly used with EF, despite not being designed or approved for this use. An immobilized lipase cartridge (ILC) for extracorporeal digestion of enteral feedings was developed. The sponsor provided it to patients via a structured program, which we evaluated to assess the effectiveness of the ILC on nutritional status.Methods:The program provided the ILC to patients prescribed the device while reimbursement efforts were ongoing. Baseline anthropometric data were obtained and subsequent measurements of height, weight, and body mass index (BMI) were collected at 6 and 12 months.Results:Inclusion criteria were met by 100 patients (age = 0‐‐45 years). Over 12 months of use in patients >2 years of age (n = 93), there were significant improvements seen in height and weight z‐scores with improvement trend seen in BMI. The frequency of achieving the 50th percentile increased steadily for weight and BMI from baseline to 12 months but not for height.Conclusions:This evaluation of a program to assist patient access to ILC demonstrates that better growth is possible over standard of care. The association of ILC use with significant improvements in anthropometric parameters over a 12‐month period in people with CF demonstrates the effectiveness of ILC as rational enzyme therapy during enteral feedings.
Blue Monday: Co-occurring Stimulant Use and HIV Persistence Predict Dysregulated Catecholamine Synthesis
Authors: Chahine Antonio , Koru-Sengul Tulay , Feaster Daniel J. , Dilworth Samantha E. , Antoni Michael H. , Klatt Nichole , Roach Margaret E. , Pallikkuth Suresh , Sharkey Mark , Salinas Jessica , Stevenson Mario , Pahwa Savita , Fuchs Dietmar , Carrico Adam W. 
Published: November 2020

Background:This longitudinal study examined whether co-occurring stimulant use and HIV disease processes predicted greater risk for depression via dysregulated metabolism of amino acid precursors for neurotransmitters.Methods:In total, 110 sexual minority men (ie, gay, bisexual, and other men who have sex with men) living with HIV who had biologically confirmed recent methamphetamine use were enrolled in a randomized controlled trial. The kynurenine/tryptophan (K/T) and phenylalanine/tyrosine (P/T) ratios were measured over 15 months to index dysregulated metabolism of amino acid precursors for serotonin and catecholamines. Markers of gut-immune dysregulation such as lipopolysaccharide binding protein and soluble CD14 (sCD14), HIV persistence in immune cells (ie, proviral HIV DNA), and stimulant use were examined as predictors. These bio-behavioral measures, including the K/T and P/T ratios, were also examined as predictors of greater risk for depression over 15 months.Results:Higher time-varying sCD14 levels (β = 0.13;P= 0.04) and time-varying detectable viral loads (β = 0.71;P< 0.001) were independent predictors of a higher K/T ratio. Time-varying reactive urine toxicology results for stimulants (β = 0.53;P< 0.001) and greater proviral HIV DNA at baseline (β = 0.34;P< 0.001) independently predicted an increased P/T ratio. Greater time-varying, self-reported methamphetamine use uniquely predicted higher odds of screening positive for depression (Adjusted Odds Ratio = 1.08; 95% confidence interval: 1.01 to 1.17).Conclusions:Ongoing stimulant use and HIV persistence independently predict dysregulated metabolism of amino acid precursors for catecholamines, but this did not explain amplified risk for depression.
Hybrid emergency room shows maximum effect on trauma resuscitation when used in patients with higher severity
Authors: Umemura Yutaka , Watanabe Atsushi , Kinoshita Takahiro , Morita Natsuhiro , Yamakawa Kazuma , Fujimi Satoshi 
Published: November 2020

BACKGROUND
The hybrid emergency room (ER) system is a novel trauma workflow that uses angio–computed tomography equipment in a trauma resuscitation room. Although the hybrid ER system decreases time to start surgery and endovascular treatments and improves mortality, the optimal target benefitting from this system remained unclear. We aimed to identify a subset of trauma patients likely to receive the greatest benefits from the hybrid ER.

METHODS
This retrospective cohort study was conducted in a tertiary hospital in Japan from August 2007 to January 2020. We consecutively included severe adult blunt trauma patients (Injury Severity Score [ISS], ≥16) and divided them into two groups: conventional group (August 2007 to July 2011) and hybrid ER (August 2011 to January 2020) group. We evaluated the association between the hybrid ER group and 28-day mortality using multivariable logistic regression analysis. The 28-day mortality trend during the study period was evaluated with restricted cubic spline analysis. To evaluate heterogeneity of effects within various patient severities, we evaluated whether the patients’ ISS modified the effect of the hybrid ER on survival.

RESULTS
Among 1,050 trauma patients, the conventional group comprised 360 patients and the hybrid ER group comprised 690 patients. Injury Severity Score and probability of survival (Ps) were not significantly different between the groups. Twenty-eight-day mortality was significantly lower in the hybrid ER group (Ps-adjusted odds ratio, 0.48; 95% confidence interval, 0.32–0.71; p < 0.001). Restricted cubic spline analysis revealed that Ps-adjusted 28-day mortality sharply decreased approximately 200 days after installation of the hybrid ER. Increase of survival probabilities according to the increase of ISS was significantly improved in hybrid ER group (p = 0.014). Because ISS increased to >25, survival probabilities in the hybrid ER group were higher compared with those in the conventional group.

CONCLUSION
The hybrid ER may improve posttraumatic mortality, especially in patients with higher baseline severity.

LEVEL OF EVIDENCE
Therapeutic/care management, level IV.
Nicotine induces P2X4 receptor, interleukin-1 beta, and brain-derived neurotrophic factor expression in BV2 microglia cells
Authors: Guo Lina , Zhang Yang , Lv Qing , Zhang Zongwang 
Published: November 2020

Objective
Upregulation of P2X4 receptor (P2X4R), brain-derived neurotrophic factor (BDNF), and interleukin-1 beta (IL-1β) in activated microglia is associated with hyperalgesia. This study investigated whether nicotine increases pain hypersensitivity by altering the expression of these molecules in microglia. We also examined the role of interferon regulatory factor 8 (IRF8) in this process.

Methods
Experiments were performed in BV2 microglial cells. IRF8 was knocked down or overexpressed using lentiviruses harboring a short hairpin RNA targeting IRF8 or an IRF8 overexpression construct, respectively. P2X4R, BDNF, and IL-1β mRNA and protein levels were evaluated by real-time PCR and western blotting, respectively, and BDNF and IL-1β secretion was assessed by ELISA.

Results
Chronic nicotine exposure enhanced the expression of P2X4R, BDNF, and IL-1β in BV2 cells, and stimulated the release of BDNF and IL-1β in the presence of ATP. IRF8 was found to mediate the nicotine-induced increases in BDNF and IL-1β mRNA and P2X4R protein levels in BV2 cells.

Conclusion
Nicotine may increase pain hypersensitivity by promoting the expression of P2X4R, BDNF, and IL-1β through modulation of IRF8 levels in microglial cells.
Ice giant system exploration in the 2020s: an introduction
Authors: Fletcher L. N. , Simon A. A. , Hofstadter M. D. , Arridge C. S. , Cohen Ian J. , Masters A. , Mandt K. , Coustenis A. 
Published: November 2020

The international planetary science community met in London in January 2020, united in the goal of realizing the first dedicated robotic mission to the distant ice giants, Uranus and Neptune, as the only major class of solar system planet yet to be comprehensively explored. Ice-giant-sized worlds appear to be a common outcome of the planet formation process, and pose unique and extreme tests to our understanding of exotic water-rich planetary interiors, dynamic and frigid atmospheres, complex magnetospheric configurations, geologically-rich icy satellites (both natural and captured), and delicate planetary rings. This article introduces a special issue on ice giant system exploration at the start of the 2020s. We review the scientific potential and existing mission design concepts for an ambitious international partnership for exploring Uranus and/or Neptune in the coming decades.This article is part of a discussion meeting issue ‘Future exploration of ice giant systems’.
Symptomatic SARS-CoV-2 re-infection of a health care worker in a Belgian nosocomial outbreak despite primary neutralizing antibody response
Authors: Selhorst Philippe , Van Ierssel Sabrina , Michiels Jo , Mariën Joachim , Bartholomeeusen Koen , Dirinck Eveline , Vandamme Sarah , Jansens Hilde , Ariën Kevin K. 
Published: November 2020

AbstractBackgroundIt is currently unclear whether SARS-CoV-2 re-infection will remain a rare event, only occurring in individuals who fail to mount an effective immune response, or whether it will occur more frequently when humoral immunity wanes following primary infection.MethodsA case of re-infection was observed in a Belgian nosocomial outbreak involving 3 patients and 2 health care workers. To distinguish re-infection from persistent infection and detect potential transmission clusters, whole genome sequencing was performed on nasopharyngeal swabs of all individuals including the re-infection case’s first episode. IgA, IgM, and IgG and neutralizing antibody responses were quantified in serum of all individuals, and viral infectiousness was measured in the swabs of the reinfection case.ResultsRe-infection was confirmed in a young, immunocompetent health care worker as viral genomes derived from the first and second episode belonged to different SARS-CoV-2 clades. The symptomatic re-infection occurred after an interval of 185 days, despite the development of an effective humoral immune response following symptomatic primary infection. The second episode, however, was milder and characterized by a fast rise in serum IgG and neutralizing antibodies. Although contact tracing and virus culture remained inconclusive, the health care worker formed a transmission cluster with 3 patients and showed evidence of virus replication but not of neutralizing antibodies in her nasopharyngeal swabs.ConclusionIf this case is representative of most Covid-19 patients, long-lived protective immunity against SARS-CoV-2 might not be likely.
Variation in Mycobacterium tuberculosis genotype and molecular phenotype influence clinical phenotype of Pulmonary tuberculosis and Tuberculous Meningitis infection in host
Authors: Husain Aliabbas A. , Tikariha Hitesh , Nayak Amit R. , Gupta Umesh D. , Bhullar Shraddha S. , Chandak Nitin C. , Monaghan Tanya M. , Daginawla Hatim F. , Singh Lokendra R. , Purohit Hemant J. , Kashyap Rajpal S. 
Published: November 2020

AbstractIn the present study, we investigated tissue specific colonization and virulence characteristics of two different Mycobacterium tuberculosis (MTB) clinical isolates derived from patients with Pulmonary TB (PTB) and Tuberculous Meningitis (TBM). We retrospectively studied a total of 1458 patients diagnosed with TB between 2003 and 2013. Of these, archived sputum and CSF samples were available for 323 TBM and 157 PTB patients. We selected a total of 10 sputum and CSF isolates from each group for further molecular characterization. Methodologies employed included, Gas chromatographic analyses of Fatty Acid Methyl Esters (GC-FAME) followed by MTB genotyping to assess strain diversity. We further assessed the molecular phenotype of each strain through in-vitro cytokine assays & murine MTB model. Our comparative genomics data illustrated two diverse genotypes belonging to H37RV (PTB) and CCDC5079 linkage (TBM), highlighting major variation in membrane protein composition and enzymes that make different mycolic acids. The differential cytokine response by both the strains & GC-FAME analysis further corroborated this variation in membrane composition. This was in agreement with KasIII enzyme, LppA and desaturase related variation in protein. Both MTB strains in mice showed diverse pathogenesis with CCDC5079 infected mice exhibiting higher dissemination to brain compared to the H37RV strain which developed progressive pulmonary disease. These observations suggest that variation in the MTB membrane composition could play an important role in differential colonization of these strains. The study warrants further investigation of membrane proteins with respect to blood brain barrier invasion and pathogenesis.
Optimal test-assisted quarantine strategies for COVID-19
Authors: Peng Bo , Zhou Wen , Pettit Rowland W. , Yu Patrick , Matos Peter G. , Greninger Alexander L. , McCashin Julie , Amos Christopher I. 
Published: November 2020

AbstractObjectiveTo evaluate the effectiveness of SARS-CoV-2 testing on shortening the duration of quarantines for COVID-19 and to identify the most effective choices of testing schedules.DesignWe performed extensive simulations to evaluate the performance of quarantine strategies when one or more SARS-CoV-2 tests were administered during the quarantine. Simulations were based on statistical models for the transmissibility and viral loads of SARS-CoV-2 infections and the sensitivities of available testing methods. Sensitivity analyses were performed to evaluate the impact of perturbations in model assumptions on the outcomes of optimal strategies.ResultsWe found that SARS-CoV-2 testing can effectively reduce the length of a quarantine without compromising safety. A single RT-PCR test performed before the end of quarantine can reduce quarantine duration to 10 days. Two tests can reduce the duration to 8 days, and three highly sensitive RT-PCR tests can justify a 6-day quarantine. More strategic testing schedules and longer quarantines are needed if tests are administered with less sensitive RT-PCR tests or antigen tests. Shorter quarantines can be utilized for applications that tolerate a residual post-quarantine transmission risk comparable to a 10-day quarantine.ConclusionsTesting could substantially reduce the length of isolation, reducing the physical and mental stress caused by lengthy quarantines. With increasing capacity and lowered costs of SARS-CoV-2 tests, test-assisted quarantines could be safer and more cost-effective than 14-day quarantines and warrant more widespread use.RESEARCH IN CONTEXTWhat is already known on this topic?Recommendations for quarantining individuals who could have been infected with COVID-19 are based on limited evidence.Despite recent theoretical and case studies of test-assisted quarantines, there has been no substantive investigation to quantify the safety and efficacy of, nor an exhaustive search for, optimal test-assisted quarantine strategies.What this study addsOur simulations indicate that the 14-day quarantine approach is overly conservative and can be safely shortened if testing is performed.Our recommendations include testing schedules that could be immediately adopted and implemented as government and industry policies.Role of the Funding SourceA major technology company asked that we perform simulations to understand the optimal strategy for managing personnel quarantining before forming cohorts of individuals who would work closely together. The funding entity did not influence the scope or output of the study but requested that we include antigen testing as a component of the quarantining process. Patrick Yu and Peter Matos are employees of Corporate Medical Advisors, and International S.O.S employs Julie McCashin. Other funding sources are research grants and did not influence the investigation.
Comparison of four methods to measure haemoglobin concentrations in whole blood donors (COMPARE): a diagnostic accuracy study
Authors: Bell Steven , Sweeting Michael , Ramond Anna , Chung Ryan , Kaptoge Stephen , Walker Matthew , Bolton Thomas , Sambrook Jennifer , Moore Carmel , McMahon Amy , Fahle Sarah , Cullen Donna , Mehenny Susan , Wood Angela M , Armitage Jane , Ouwehand Willem H , Miflin Gail , Roberts Dave J , Danesh John , Angelantonio Emanuele Di 
Published: November 2020

SUMMARYObjectiveTo compare four haemoglobin measurement methods in whole blood donors.BackgroundTo safeguard donors, blood services measure haemoglobin concentration in advance of each donation. NHS Blood and Transplant’s (NHSBT) usual method has been capillary gravimetry (copper sulphate), followed by venous HemoCue® (spectrophotometry) for donors failing gravimetry. However, gravimetry/venous HemoCue® results in 10% of donors being inappropriately bled (i.e., with haemoglobin values below the regulatory threshold).MethodsThe following were compared in 21,840 blood donors (aged ≥18 years) recruited from 10 mobile centres of NHSBT in England, with each method compared with the Sysmex XN-2000 haematology analyser, the reference standard: 1) gravimetry/venous HemoCue®; 2) “post donation” approach, i.e., estimating current haemoglobin concentration from that measured by a haematology analyser at a donor’s most recent prior donation; 3) capillary HemoCue®; and 4) non-invasive spectrometry (MBR Haemospect® or Orsense NMB200®). We assessed each method for sensitivity; specificity; proportion of donors who would have been inappropriately bled, or rejected from donation (“deferred”) incorrectly; and test preference.ResultsCompared with the reference standard, the methods ranged in test sensitivity from 17.0% (MBR Haemospect®) to 79.0% (HemoCue®) in men, and from 19.0% (MBR Haemospect®) to 82.8% (HemoCue®) in women. For specificity, the methods ranged from 87.2% (MBR Haemospect®) to 99.9% (gravimetry/venous HemoCue®) in men, and from 74.1% (Orsense NMB200®) to 99.8% (gravimetry/venous HemoCue®) in women. The proportion of donors who would have been inappropriately bled ranged from 2.2% in men for HemoCue® to 18.9% in women for MBR Haemospect®. The proportion of donors who would have been deferred incorrectly with haemoglobin concentration above the minimum threshold ranged from 0.1% in men for gravimetry/venous HemoCue® to 20.3% in women for OrSense®. Most donors preferred non-invasive spectrometry.ConclusionIn the largest study reporting head-to-head comparisons of four methods to measure haemoglobin prior to blood donation, our results support replacement of venous HemoCue® with the capillary HemoCue® when donors fail gravimetry. These results have had direct translational implications for NHS Blood and Transplant in England.
Gout, rheumatoid arthritis and the risk of death from COVID-19: an analysis of the UK Biobank
Authors: Topless Ruth K , Phipps-Green Amanda , Leask Megan , Dalbeth Nicola , Stamp Lisa K , Robinson Philip C , Merriman Tony R 
Published: November 2020

AbstractObjectivesTo assess whether gout and / or rheumatoid arthritis (RA) are risk factors for coronavirus disease 19 (COVID-19) diagnosis. To assess whether gout and / or RA are risk factors for death with COVID-19.MethodsWe used data from the UK Biobank. Multivariable-adjusted logistic regression was employed in the following analyses: Analysis A, to test for association between gout or RA and COVID-19 diagnosis (n=473,139); Analysis B, to test for association between gout or RA and death with COVID-19 in a case-control cohort of people who died or survived with COVID-19 (n=2,059); Analysis C, to test for association with gout or RA and death with COVID-19 in the entire UK Biobank cohort (n=473,139)ResultsRA, but not gout, associated with COVID-19 diagnosis in analysis A. Neither RA nor gout associated with risk of death in the COVID-19-diagnosed group in analysis B. However RA associated with risk of death related to COVID-19 using the UK Biobank cohort in analysis C independent of comorbidities and other measured risk factors (OR=1.9 [95% CI 1.2 ; 3.0]). Gout was not associated with death related to COVID-19 in the same UK Biobank analysis (OR=1.2 [95% CI 0.8 ; 1.7]).ConclusionRheumatoid arthritis is a risk factor for death with COVID-19 using the UK Biobank cohort. These findings require replication in larger data sets that also allow inclusion of a wider range of factors.Key messagesInformation on the risk of death from COVID-19 for people with gout and rheumatoid arthritis is scarce.In an analysis of the UK Biobank there is an increased risk of death related to COVID-19 for people with rheumatoid arthritis independent of included co-morbidities, but not gout.The findings need to be replicated in other datasets where the influence of therapies for rheumatoid arthritis can be tested.
Annual and 16-day rangeland production estimates for the western United States
Authors: Jones Matthew O. , Robinson Nathaniel P. , Naugle David E. , Maestas Jeremy D. , Reeves Matthew C. , Lankston Robert W. , Allred Brady W. 
Published: November 2020

AbstractRangeland production is a foundational ecosystem service and resource upon which livestock, wildlife, and people depend. Capitalizing on recent advancements in the use of remote sensing data across rangelands we provide estimates of herbaceous rangeland production from 1986-2019 at 16-day and annual time steps and 30m resolution across the western United States. A factorial comparison of this dataset and three national scale datasets is presented, and we highlight a multiple lines of evidence approach when using production estimates in decision-making. Herbaceous aboveground biomass at this scale and resolution provides critical information applicable for management and decision-making, particularly in the face of annual grass invasion and woody encroachment of rangeland systems. These readily available data remove analytical and technological barriers allowing immediate utilization for monitoring and management.