bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hemorrhagic events associated with unfused or twig-like configuration of the Middle cerebral artery: A rare vascular anomaly with clinical relevance
Authors: Viso Rene , Lylyk Ivan , Albiña Pablo , Lundquist Javier , Scrivano Esteban , Lylyk Pedro 
Published: October 2020

Introduction Twig-like middle cerebral artery configuration (Tw-MCA) is a rare and commonly misdiagnosed vascular anomaly characterized by a plexiform arterial network that replaces the normal M1 segment. The prevalence and clinical relevance of this anomaly is not fully established. Material and methods We sought to explore the prevalence of Tw-MCA in patients clinically referred to digital angiography in a single academic comprehensive endovascular center and evaluated the radiological and clinical findings among patients with hemorrhagic events. Results From 2011 to 2020, a total of 10,234 patients underwent a cerebral angiography at our institution. During this period, 9 (0.088%) Tw-MCAs were identified. Out of these, 5 patients (62.5%) were admitted due to an intracranial hemorrhage. Two patients had a ruptured intracranial aneurysm on the anterior communicating artery, one with multiple brain aneurysms; two patients presented an intraparenchymal hematoma (IPH) due to the presence of a periventricular anastomosis and one patient an intraventricular hemorrhage with unclear origin. Conclusion Tw-MCA is a very rare vascular anomaly associated with hemorrhagic events. Adequate identification of this anomaly is essential in order to avoid misdiagnosis as steno-occlusive disorders.
Development of secondary bacterial pneumonia in adults presenting with influenza versus noninfluenza viral respiratory infection
Authors: Melamed Kathryn H. , Williams Justin , Wang Xiaoyan , Hu Scott , Nguyen Christopher , Cui Jing , Deng Jane C. 
Published: October 2020

Background: Respiratory viral infections, particularly influenza, are known to cause significant morbidity and mortality, often due to secondary infections. Our aim was to comparatively analyze the incidence, epidemiology, and outcomes of secondary pneumonia in adult patients hospitalized with influenza versus noninfluenza viral infections and determine whether influenza particularly predisposes to secondary infections. Methods: This was a retrospective analysis from a single tertiary medical center of adult patients admitted to the hospital between 2008 and 2010 with respiratory viral infections. Microbiological patterns and clinical outcomes were compared between those with influenza (VI, n = 57) and those with noninfluenza (NI, n = 77) respiratory viral infections. Results: The NI group was older (60.6 ± 14.0 versus 53.3 ± 19.7 years, p = 0.019) with higher rates of lung transplantation (29% versus 9%, p = 0.009) than VI. Overall, 35% developed secondary pneumonia, higher among NI (44%) than VI (23%, p = 0.017). Staphylococcus aureus was the most common cause of pneumonia in VI, whereas Gram-negative rods were most frequently identified in NI. The NI group had longer hospital [median 10 (interquartile range (IQR) 6–19) versus 6 (IQR 4–15) days, p = 0.019] and intensive care unit [median 4 (IQR 0–12) versus 0 (IQR 0–8) days, p = 0.029] stays compared with VI. Further, the NI group was more likely to be admitted to the intensive care unit compared with VI (62% versus 39%, p = 0.011). A trend towards increased mortality was observed in viral infections complicated by secondary pneumonia than primary viral infections (28% versus 15%, p = 0.122). Conclusion: Secondary pneumonia is common among adults hospitalized with viral respiratory infections. Within our population, NI results in more frequent secondary pneumonia and longer hospital stays than those with VI. Given the high number of infections caused by Gram-negative rods, monitoring local epidemiology is critical for guiding initial antibiotic selection in empirical treatment of secondary infections. The reviews of this paper are available via the supplemental material section.
Muscle Strains in the Lower Extremity of Japanese Professional Baseball Players
Authors: Kokubu Takeshi , Mifune Yutaka , Kanzaki Noriyuki , Hoshino Yuichi , Kakutani Kenichiro , Inui Atsuyuki , Hashimoto Shingo , Kuroda Ryosuke 
Published: October 2020

Background: Predicting when athletes can return to play after muscle strains is not always simple because of difficulties in evaluating the severity of such injuries. Purpose/Hypothesis: The purpose of this study was to evaluate the use of magnetic resonance imaging (MRI) to classify lower extremity muscle strains in Japanese professional baseball players. The hypothesis was that MRI grading can be used to diagnose the severity of muscle strains in the lower extremity and predict return to play in athletes. Study Design: Case series; Level of evidence, 4. Methods: A total of 55 muscle strains occurred in the lower extremity of players on a professional baseball team between the 2006 and 2015 seasons; all players had undergone MRI examination. Age, player position, location of injury, cause of injury, and duration until return to play (in days) were extracted from the medical records. MRI scans were classified using the following system: grade 0, no abnormal findings; grade 1a, T2-weighted high intensity only between muscles; grade 1b, T2-weighted high intensity between muscles and in muscle belly; grade 2, injury of musculotendinous junction; and grade 3, rupture of tendon insertion. Results: The sites of injuries were distributed as follows: hamstrings (n = 33), quadriceps (n = 6), hip adductors (n = 6), and calves (n = 10). MRI findings revealed 9 muscle strains (16%), 19 grade 1a (34%), 19 grade 1b (34%), and 8 grade 2 muscle strains (16%). The length of time until return to training and competition, respectively, was 15 and 26 days for grade 1a injuries, 19 and 36 days for grade 1b injuries, and 55 and 69 days for grade 2 injuries. Conclusion: Players with grade 1 injuries took 4 to 5 weeks to return to play, whereas players with grade 2 injuries took 10 weeks to return. MRI can be useful for diagnosing lower extremity muscle strains and predicting the time to return to play.
Arthroscopic Rotator Cuff Repair With Muscle Advancement and Artificial Biodegradable Sheet Reinforcement for Massive Rotator Cuff Tears
Authors: Yokoya Shin , Harada Yohei , Negi Hiroshi , Matsushita Ryosuke , Matsubara Norimasa , Adachi Nobuo 
Published: October 2020

Background: Because high failure rates have frequently been reported after arthroscopic rotator cuff repair (ARCR) of massive rotator cuff tears (mRCTs), we introduced the technique of ARCR with supraspinatus and infraspinatus muscle advancement (MA). However, for cases where the original footprint cannot be completely covered, additional surgery using an approved artificial biomaterial is performed. Purpose: To investigate the postoperative clinical outcomes and failure rate after MA-ARCR, with and without our reinforcement technique. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 74 patients (mean ± SD age, 68.7 ± 7.7 years) diagnosed with mRCT with a minimum postoperative follow-up of 2 years were included in the current study. Of these patients, 47 underwent MA-ARCR with polyglycolic acid (PGA) sheet reinforcement (study group), and 27 patients underwent MA-ARCR alone (control group). PGA reinforcement was performed when full coverage of the footprint could not be achieved by MA alone, but where the latter was possible, reinforcement was not required. Thus, the study group had significantly worse muscle quality than the control group ( P < .05). The pre- and postoperative range of motion (ROM), isometric muscle strength, acromiohumeral interval, and clinical outcomes were evaluated and compared between these 2 groups. Cuff integrity during the last follow-up period was assessed with magnetic resonance imaging, and the failure rate was calculated. In addition, the postoperative foreign body reaction was investigated in the study group. Results: In both groups, significant postoperative improvements were seen in acromiohumeral interval, clinical scores, ROM in anterior flexion, and isometric muscle strength in abduction, external rotation, and internal rotation ( P < .001 for all). The failure rate of the study group was 12.8% (6 patients) and that of the control group was 25.9% (7 patients). No significant differences were noted between the 2 groups on any of the data findings, even regarding the failure rate. Foreign body reactions in the early period were found in 3 patients, although these spontaneously disappeared within 3 months. Conclusion: Patients who underwent PGA patch reinforcement for MA-ARCR when the footprint could not be completely covered had clinical results similar to isolated MA-ARCR when the footprint could be covered. Both procedures resulted in significant improvement in symptoms and function compared with preoperatively.
Public and private human T-cell clones respond differentially to HCMV antigen when boosted by CD3 copotentiation
Authors: Becher Laura R. E. , Nevala Wendy K. , Sutor Shari Lee , Abergel Megan , Hoffmann Michele M. , Parks Christopher A. , Pease Larry R. , Schrum Adam G. , Markovic Svetomir N. , Gil Diana 
Published: October 2020

Abstract
Human cytomegalovirus (HCMV) induces long-lasting T-cell immune responses that control but do not clear infection. Typical responses involve private T-cell clones, expressing T-cell antigen receptors (TCRs) unique to a person, and public T-cell clones with identical TCRs active in different people. Here, we report the development of a pretherapeutic immunostimulation modality against HCMV for human T cells, CD3 copotentiation, and the clonal analysis of its effects in recall assays at single-cell resolution. CD3 copotentiation of human T cells required identification of an intrinsically inert anti-CD3 Fab fragment that conditionally augmented signaling only when TCR was coengaged with antigen. When applied in recall assays, CD3 copotentiation enhanced the expansion of both public and private T-cell clones responding to autologous HLA-A2(+) antigen-presenting cells and immunodominant NLVPMVATV (NLV) peptide from HCMV pp65 protein. Interestingly, public vs private TCR expression was associated with distinct clonal expansion signatures in response to recall stimulus. This implied that besides possible differences in their generation and selection in an immune response, public and private T cells may respond differently to pharmacoimmunomodulation. Furthermore, a third clonal expansion profile was observed upon CD3 copotentiation of T-cell clones from HLA-A2(−) donors and 1 HLA-A2(+) presumed-uninfected donor, where NLV was of low intrinsic potency. We conclude that human T-cell copotentiation can increase the expansion of different classes of T-cell clones responding to recall antigens of different strengths, and this may be exploitable for therapeutic development against chronic, persistent infections such as HCMV.
Do probiotics help prevent ventilator-associated pneumonia in critically ill patients? A systematic review with meta-analysis
Authors: Zhao Jie , Li Lei-qing , Chen Cheng-yang , Zhang Gen-sheng , Cui Wei , Tian Bao-ping 
Published: October 2020

BackgroundProbiotic treatments might contribute to the prevention of ventilator-associated pneumonia (VAP). Due to its unclear clinical effects, here we intend to assess the preventive effect and safety of probiotics on intensive care unit (ICU) patients.MethodsEligible randomised controlled trials were selected in databases until 30 September 2019. The characteristics of the studies were extracted, including study design, definition of VAP, probiotics intervention, category of included patients, incidence of VAP, mortality, duration of mechanical ventilation (MV) and ICU stay. Heterogeneity was evaluated by Chi-squared and I2tests.Results15 studies involving 2039 patients were identified for analysis. The pooled analysis suggests significant reduction on VAP (risk ratio, 0.68; 95% Cl, 0.60 to 0.77; p<0.00001) in a fixed-effects model. Subgroup analyses performed on the category of clinical and microbiological criteria both support the above conclusion; however, there were no significant differences in duration of MV or length of ICU stay in a random-effects model. Also, no significant differences in total mortality, overall mortality, 28-day mortality or 90-day mortality were found in the fixed-effects model.ConclusionsThe probiotics helped to prevent VAP without impacting the duration of MV, length of ICU stay or mortality.
m5CPred-SVM: a novel method for predicting m5C sites of RNA
Authors: Chen Xiao , Xiong Yi , Liu Yinbo , Chen Yuqing , Bi Shoudong , Zhu Xiaolei 
Published: October 2020

Abstract

Background
As one of the most common post-transcriptional modifications (PTCM) in RNA, 5-cytosine-methylation plays important roles in many biological functions such as RNA metabolism and cell fate decision. Through accurate identification of 5-methylcytosine (m5C) sites on RNA, researchers can better understand the exact role of 5-cytosine-methylation in these biological functions. In recent years, computational methods of predicting m5C sites have attracted lots of interests because of its efficiency and low-cost. However, both the accuracy and efficiency of these methods are not satisfactory yet and need further improvement.

Results
In this work, we have developed a new computational method, m5CPred-SVM, to identify m5C sites in three species, H. sapiens, M. musculus and A. thaliana. To build this model, we first collected benchmark datasets following three recently published methods. Then, six types of sequence-based features were generated based on RNA segments and the sequential forward feature selection strategy was used to obtain the optimal feature subset. After that, the performance of models based on different learning algorithms were compared, and the model based on the support vector machine provided the highest prediction accuracy. Finally, our proposed method, m5CPred-SVM was compared with several existing methods, and the result showed that m5CPred-SVM offered substantially higher prediction accuracy than previously published methods. It is expected that our method, m5CPred-SVM, can become a useful tool for accurate identification of m5C sites.

Conclusion
In this study, by introducing position-specific propensity related features, we built a new model, m5CPred-SVM, to predict RNA m5C sites of three different species. The result shows that our model outperformed the existing state-of-art models. Our model is available for users through a web server at https://zhulab.ahu.edu.cn/m5CPred-SVM.
IL6/sIL6R regulates TNFα-inflammatory response in synovial fibroblasts through modulation of transcriptional and post-transcriptional mechanisms
Authors: Valin Alvaro , Del Rey Manuel J. , Municio Cristina , Usategui Alicia , Romero Marina , Fernández-Felipe Jesús , Cañete Juan D. , Blanco Francisco J. , Ruano Yolanda , Criado Gabriel , Pablos José L. 
Published: October 2020

AbstractIntroductionThe clinical efficacy of specific interleukin-6 inhibitors has confirmed the central role of IL6 in rheumatoid arthritis (RA). However the local role of IL6, in particular in synovial fibroblasts (SF) as a direct cellular target to IL6/sIL6R signal is not well characterized. The purpose of the study was to characterize the crosstalk between TNFα and IL6/sIL6R signaling to the effector pro-inflammatory response of SF.MethodsSF lines were stimulated with either TNFα, IL6/sIL6R, or both together, for the time and dose indicated for each experiment, and where indicated, cells were treated with inhibitors actinomycin D, adalimumab, ruxolitinib and cycloheximide. mRNA expression of cytokines, chemokines and matrix metalloproteases (MMPs) were analyzed by quantitative RT-PCR. Level of IL8/CXCL8 and CCL8 in culture supernatants was measured by ELISA. Mononuclear and polymorphonuclear cells migration assays were assessed by transwell using conditioned medium from SF cultures. Statistical analyses were performed as indicated in the corresponding figure legends and ap-value < 0.05 was considered statistically significant.ResultsThe stimulation of SF with IL6/sIL6R and TNFα, cooperatively promotes the expression of mono- and lymphocytic chemokines such as IL6, CCL8 and CCL2, as well as matrix degrading enzymes such as MMP1, while inhibiting the induction of central neutrophil chemokines such as IL8/CXCL8. These changes in the pattern of chemokines expression resulted in reduced polymorphonuclear (PMN) and increased mononuclear cells (MNC) chemoattraction by SF. Mechanistic analyses of the temporal expression of genes demonstrated that the cooperative regulation mediated by these two factors is mostly induced through de novo transcriptional mechanisms activated by IL6/sIL6R. Furthermore, we also demonstrate that TNFα and IL6/sIL6R cooperation is partially mediated by the expression of secondary factors signaling through JAK/STAT pathways.ConclusionsThese results point out to a highly orchestrated response to IL6 in TNFα-induced SF and provide additional insights into the role of IL6/sIL6R in the context of RA, highlighting the contribution of IL6/sIL6R to the interplay of SF with other inflammatory cells.
The effects of human pregnancy-specific β1-glycoprotein preparation on Th17 polarization of CD4+ cells and their cytokine profile
Authors: Timganova Valeria P. , Zamorina Svetlana A. , Litvinova Larisa S. , Todosenko Natalia M. , Bochkova Maria S. , Khramtsov Pavel V. , Rayev Mikhail B. 
Published: October 2020

Abstract

Background
Pregnancy-specific β1-glycoproteins are capable of regulating innate and adaptive immunity, exerting predominantly suppressive effects. In this regard, they are of interest in terms of their pharmacological potential for the treatment of autoimmune diseases and post-transplant complications. The effect of these proteins on the main pro-inflammatory subpopulation of T lymphocytes, IL-17-producing helper T cells (Th17), has not been comprehensively studied. Therefore, the effects of the native pregnancy-specific β1-glycoprotein on the proliferation, Th17 polarization and cytokine profile of human CD4+ cells were assessed.

Results
Native human pregnancy-specific β1-glycoprotein (PSG) at а concentration of 100 μg/mL was shown to decrease the frequency of Th17 (RORγτ+) in CD4+ cell culture and to suppress the proliferation of these cells (RORγτ+Ki-67+), along with the proliferation of other cells (Ki-67+) (n = 11). A PSG concentration of 10 μg/mL showed similar effect, decreasing the frequency of Ki-67+ and RORγτ+Ki67+ cells. Using Luminex xMAP technology, it was shown that PSG decreased IL-4, IL-5, IL-8, IL-12, IL-13, IL-17, MIP-1β, IL-10, IFN-γ, TNF-α, G-CSF, and GM-CSF concentrations in Th17-polarized CD4+ cell cultures but did not affect IL-2, IL-7, and MCP-1 output.

Conclusions
In the experimental model used, PSG had а mainly suppressive effect on the Th17 polarization and cytokine profile of Th17-polarized CD4+ cell cultures. As Th17 activity and a pro-inflammatory cytokine background are unfavorable during pregnancy, the observed PSG effects may play a fetoprotective role in vivo.
Healthcare pathways and resource use: mapping consequences of ambulance assessment for direct care with alternative healthcare providers
Authors: Varg Sofi , Vicente Veronica , Castren Maaret , Lindgren Peter , Rehnberg Clas 
Published: October 2020

AbstractBackgroundA decision system in the ambulance allowing alternative pathways to alternate healthcare providers has been developed for older patients in Stockholm, Sweden. However, subsequent healthcare resource use resulting from these pathways has not yet been addressed. The aim of this study was therefore to describe patient pathways, healthcare utilisation and costs following ambulance transportation to alternative healthcare providers.MethodsThe design of this study was descriptive and observational. Data from a previous RCT, where a decision system in the ambulance enabled alternative healthcare pathways to alternate healthcare providers were linked to register data. The receiving providers were: primary acute care centre or secondary geriatric ward, both located at the same community hospital, or the conventional pathway to the emergency department at an acute hospital. Resource use over 10 days, subsequent to assessment with the decision system, was mapped in terms of healthcare pathways, utilisation and costs for the 98 included cases.ResultsAlmost 90% were transported to the acute care centre or geriatric ward. The vast majority arriving to the geriatric ward stayed there until the end of follow-up or until discharged, whereas patients conveyed to the acute care centre to a large extent were admitted to hospital. The median patient had 6 hospital days, 2 outpatient visits and costed roughly 4000 euros over the 10-day period. Arrival destination geriatric ward indicated the longest hospital stay and the emergency department the shortest. However, the cost for the 10-day period was lower for cases arriving to the geriatric ward than for those arriving to the emergency department.ConclusionsThe findings support the appropriateness of admittance directly to secondary geriatric care for older adults. However, patients conveyed to the acute care centre ought to be studied in more detail with regards to appropriate level of care.
Hepatitis C virus infection and its associated factors among prisoners in a Nigerian prison
Authors: Okafor Ifeyinwa M. , Ugwu Solomon O. , Okoroiwu Henshaw U. 
Published: October 2020

Abstract

Background
The prison population is considered at high risk of acquiring infectious diseases due to confined conditions, behavioral factors, injection drug use, unprotected sexual activity, non-professional tattooing and scarification, and needle sharing. Hepatitis C virus (HCV) is a blood borne pathogen mostly transmitted via percutaneous exposure that results in inflammation of the liver. It is one of the public health problem worldwide and is the principal cause of parenterally transmitted non-A, non-B hepatitis. The study was aimed at evaluating the prevalence of HCV among prison inmates in Calabar, Cross River State, Nigeria and the associated factors.

Methods
The study took a descriptive cross sectional approach using multi-stage sampling technique. One hundred and forty-two (142) prison inmates within the age range of 18–50 years and above were recruited for this study.

Result
Forty two (42); [29.6%] of the participating prison inmates were seropositive for HCV. Gender stratification showed that 31.0% of the males were seropositive for HCV while 15.4% of the females were seropositive for HCV. Fisher exact test showed that gender, age, marital status, occupation and level of education had no association in distribution of seroprevalence of HCV (p > 0.05) but the duration in prison was significantly associated with distribution of seropositivity of HCV in the studied population (p < 0.05). Bivariate logistic regression showed that tattoo/scarification, injection drug use, history of blood transfusion, sexual experience, shaving equipment sharing and multiple sexual partners were not risk factor for distribution of HCV prevalence in the studied population (p > 0.05). However, 23.5% who had tattoo/scarification, 29.6% who used injection drug, 33.3% who had history of blood transfusion, 29.8% who had sexual experience, 21.2% who shared shaving equipment, and 28.3% who had multiple sex partners were seropositive for HCV.

Conclusion
Approximately 29.6% prevalence of Hepatitis C virus infection observed among inmates studied is high and calls for concern. Attitude and behaviors by inmates such as tattooing/scarification, injection drugs use, sharing of shaving equipment, multiple sexual partners should be discouraged.