bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of Continuous Erector Spinae Catheters in Chest Trauma: A Retrospective Cohort Study
Authors: White L.D , Riley B. , Davis K. , Thang C. , Mitchell A. , Abi-fares C. , Basson W. , Anstey C. 
Published: May 2021

SummaryThe erector spinae block is an efficacious analgesic option for the management of rib fracture related pain. Despite there being minimal published data specifically addressing the safety profile of this block, many societies have made statements regarding its safety and its use as an alternative to traditional regional anaesthesia techniques in patients at risk of complications. The primary aim of this study was to characterise the safety profile of erector spinae plane block catheters by determining the incidence of early complications. The secondary aims of this study was to characterise the incidence of late adverse events, as well as, the erector spinae plane block catheter failure rate. We analysed electronic medical record data of patients who had an erector spinae plane block catheter inserted for the management of rib fractures between November 2017 to September 2020. To assess early adverse events data collection included hypotension, hypoxaemia, local anaesthetic systemic toxicity and pneumothorax thought to be associated with erector spinae plane block catheter insertion. Late complications included catheter site infection and catheter site haematoma. Two hundred and twenty four patients received a total of 244 continuous erector spinae catheters during the study period. Following the insertion of the erector spinae there were no immediate complications such as hypotension, hypoxia, local anaesthetic toxicity or pneumothorax. Of all blocks inserted 7.7% were removed due to catheter failure (OR = 8.4 per 100 catheters; 95%CI = 5.1 to 13.9 per 100 catheters). This resulted in a failure rate of 1.9 per 1000 catheter days (95%CI = 1.1 to 6.7 catheter days). Late complications included two erythematous catheter sites and two small haematomas not requiring intervention. The odds of a minor late complication was 16.7 per 1,000 catheters (95%CI = 6.1 to 45.5 per 1,000 catheters). In conclusion, this study supports the statements made by regional anaesthesia societies regarding the safety of the erector spinae plane block. Based on the results presented in this population of trauma patients, the erector spinae plane block catheter is a low risk analgesic technique which may be performed in the presence of abnormal coagulation status or systemic infection.
Cellular immunity predominates over humoral immunity after the first dose of COVID-19 vaccines in solid organ transplant recipients
Authors: Schmidt Tina , Klemis Verena , Schub David , Schneitler Sophie , Reichert Matthias C. , Wilkens Heinrike , Sester Urban , Sester Martina , Mihm Janine 
Published: May 2021

AbstractKnowledge on the vaccine-induced cellular and humoral immunity and on immunogenicity of vector-based and mRNA vaccines in solid organ transplant recipients is limited. Therefore, SARS-CoV-2 specific T-cells and antibodies were analyzed in 40 transplant recipients and 70 age-matched controls after the first dose of vector-based or mRNA vaccines. Plasmablasts and SARS-CoV-2 specific CD4 and CD8 T-cells were quantified using flow-cytometry. Specific antibodies were analyzed by ELISA and neutralization assay. SARS-CoV-2 specific antibodies and T-cells were induced in both groups with significantly lower levels in patients. While antibodies were detected in 80% of controls and 5.3% of patients, specific CD4 and/or CD8 T-cells were more frequently found in both controls (84.3%) and patients (23.7%). The two vaccine types showed notable differences, as IgG and neutralizing activity were more pronounced after mRNA vaccination (p<0.0001 each), whereas CD4 and CD8 T-cell levels were higher after vector vaccination (p=0.009; p<0.0001). Plasmablast numbers were significantly higher in controls and correlated with SARS-CoV-2 specific IgG- and CD4 T-cell levels. In conclusion, assessment of antibodies is not sufficient to identify COVID-19-vaccine responders. Together with differences in immunogenicity among vaccines, this necessitates combined analysis of humoral and cellular immunity to reliably assess responders among immunocompetent and immunocompromised individuals.
A novel protein signature from plasma extracellular vesicles for non-invasive differential diagnosis of idiopathic pulmonary fibrosis
Authors: Adduri Raju SR , Cai Kai , Alzate Karen V , Vasireddy Ravikiran , Miller Jeffrey W , de Frías Sergio Poli , de Frías Fernando Poli , Horimasu Yasushi , Iwamoto Hiroshi , Hattori Noboru , Zhang Yingze , Gibson Kevin F. , Pal Anoop K , Nicastro Daniela , Li Lily , Cherian Sujith , Sholl Lynette M , Schwartz David A , Kass Daniel J , Rosas Ivan O , Konduru Nagarjun V 
Published: May 2021

AbstractBackgroundIdiopathic pulmonary fibrosis (IPF) is a fibrosing interstitial pneumonia of unknown etiology often leading to respiratory failure. Over half of IPF patients present with discordant features of usual interstitial pneumonia on high-resolution computed tomography at diagnosis which warrants surgical lung biopsy to exclude the possibility of other interstitial lung diseases (ILDs). Therefore, there is a need for non-invasive biomarkers for expediting the differential diagnosis of IPF.MethodsUsing mass spectrometry, we performed proteomic analysis of plasma extracellular vesicles (EVs) in a cohort of subjects with IPF, chronic hypersensitivity pneumonitis, nonspecific interstitial pneumonitis, and healthy subjects (HS). A five-protein signature was identified by lasso regression and was validated in an independent cohort using ELISA. We evaluated the concordance between plasma EV proteome and the lung transcriptome data. Lastly, we compared the molecular pathways overrepresented in IPF by differentially expressed proteins and transcripts from EVs and lung tissues, respectively.ResultsThe five-protein signature derived from mass spectrometry data showed area under the receiver operating characteristic curve of 0.915 (95%CI: 0.819-1.011) and 0.958 (95%CI: 0.882-1.034) for differentiating IPF from other ILDs and from HS, respectively. We also found that the EV protein expression profiles mirrored their corresponding mRNA expressions in IPF lungs. Further, we observed an overlap in the EV proteome- and lung mRNA-associated molecular pathways.ConclusionsWe discovered a plasma EV-based protein signature for differential diagnosis of IPF and validated this signature in an independent cohort. The signature needs to be tested in large prospective cohorts to establish its clinical utility.
Risk assessment of COVID-19 epidemic resurgence in relation to SARS-CoV-2 variants and vaccination passes
Authors: Krueger Tyll , Gogolewski Krzysztof , Bodych Marcin , Gambin Anna , Giordano Giulia , Cuschieri Sarah , Czypionka Thomas , Perc Matjaz , Petelos Elena , Rosińska Magdalena , Szczurek Ewa 
Published: May 2021

AbstractBackgroundThe introduction of COVID-19 vaccination passes (VPs) by many countries coincided with the Delta variant fast becoming dominant across Europe. A thorough assessment of their impact on epidemic dynamics is still lacking.MethodsHere, we propose the VAP-SIRS model that considers possibly lower restrictions for the VP holders than for the rest of the population, imperfect vaccination effectiveness against infection, rates of (re-)vaccination and waning immunity, fraction of never-vaccinated, and the increased transmissibility of the Delta variant.ResultsSome predicted epidemic scenarios for realistic parameter values yield new COVID-19 infection waves within two years, and high daily case numbers in the endemic state, even without introducing VPs and granting more freedom to their holders. Still, suitable adaptive policies can avoid unfavorable outcomes.ConclusionsWhile VP holders could initially be allowed more freedom, the lack of full vaccine effectiveness and increased transmissibility will require accelerated (re-)vaccination, wide-spread immunity surveillance, and/or minimal long-term common restrictions.Plain language summaryAssessing the impact of vaccines, other public health measures, and declining immunity on SARS-CoV-2 control is challenging. This is particularly true in the context of vaccination passes, whereby vaccinated individuals have more freedom of making contacts than unvaccinated ones. Here, we use a mathematical model to simulate various scenarios and investigate the likelihood of containing COVID-19 outbreaks in example European countries. We demonstrate that both Alpha and Delta SARS-CoV-2 variants inevitably lead to recurring outbreaks when measures are lifted for vaccination pass holders. High revaccination rates and a lowered fraction of the unvaccinated population increase the benefit of vaccination passes. These observations are important for policy making, highlighting the need for continued vigilance, even where the epidemic is under control, especially when new variants of concern emerge.
Acute biliary pancreatitis management during the COVID-19 pandemic
Authors: Colak Elif , Ciftci Ahmet Burak 
Published: May 2021

AbstractObjectiveTo analyze acute biliary pancreatitis (ABP) management during the COVID-19 pandemic.MethodsThis was a retrospective cohort study conducted with ABP patients during two discrete periods: a control period from March 16, 2019, through March 15, 2020 (period 1); and a COVID-19 era between March 16, 2020, and March 15, 2021 (period 2).ResultsA total of 89 patients with ABP were identified, 58 in period 1 and 31 in period 2, which equates to a 46.6% reduction. The mean age of the patients was 62.75±16.59 years, and 51 (57.3%) of the patients were female. qSOFA and WSES scores are significantly higher in the patients in period 2 (p=0.031, p=0.032). There were no significant differences regarding hematological parameters except lactate. Lactate levels were significantly higher in period 2 (p=0.012). Twenty-two patients (37.9%) in period 1 and six (19.3%) patients in period 2 underwent cholecystectomy (p=0.072). Cholecystectomy was performed laparoscopically in 18 (81.8%) patients in period 1 and in five (83.3%) patients in period 2 (p=0.932). There were no significant differences regarding surgical intervention between the two periods. Three patients were diagnosed COVID-19 in period 2. All of these patients died. The severity of ABP was significantly worse in SARS-CoV-2-positive patients, with over 100% of patients in this group developing severe pancreatitis. Six patients (10.3%) in period 1, 10 (32.2%) patients in period 2 were admitted in ICU (p=0.010). The median length of stay was 5 (1-40) days in period 1 and 4 (2-75) days in period 2 (p= 0.641). The hospital mortality rate was 3.4% and 19.3% in period l and period 2, respectively. Mortality was significantly higher in period 2 (p=0.012).ConclusionDuring the COVID-19 outbreak, a significant decrease in the number of patients with ABP and increased severity was observed. Additionally, it can be said that SARS-CoV-2 infection has a mortal course in patients with ABP. Analysis and evaluation of ABP patients during the pandemic period is important to draw conclusions that will help confront future health crises.
Do people with low back pain walk differently? A systematic review and meta-analysis
Authors: Smith Jo Armour , Stabbert Heidi , Bagwell Jennifer J. , Teng Hsiang-Ling , Wade Vernie , Lee Szu-Ping 
Published: May 2021

ABSTRACTObjectiveTo identify differences in biomechanics during gait in individuals with acute and persistent low back pain compared with back-healthy controls.DesignSystematic reviewData SourcesA search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020.Eligibility criteriaStudies were included if they reported biomechanical characteristics of individuals with and without low back pain during steady-state or perturbed walking and running. Biomechanical data included spatiotemporal, kinematic, kinetic, and electromyography variables. The reporting quality and potential for bias of each study was assessed. Data were pooled where possible to compare the standardized mean differences (SMD) between groups.ResultsNinety-seven studies were included. Two studies investigated acute pain and the rest investigated persistent pain. Eight studies investigated running gait. 20% of studies had high reporting quality/low risk of bias. In comparison with back-healthy controls, individuals with persistent low back pain walked more slowly (SMD -0.59 [95% CI -0.77 to -0.42]) and with shorter stride length (−0.38 [-0.60 to -0.16]). There were no differences in the amplitude of motion in the thoracic or lumbar spine, pelvis, or hips in individuals with LBP. During walking, coordination of motion between the thorax and the lumbar spine/pelvis was significantly more in-phase in the LBP groups (−0.60 [-0.90 to -0-.30]), and individuals with LBP exhibited greater amplitude of activation in the paraspinal muscles (0.52 [0.23 to 0.80]).Summary/ConclusionThere is moderate to strong evidence that individuals with persistent LBP demonstrate impairments in walking gait compared with back-healthy controls.
HISTOPATHOLOGICAL AND IMMUNOHISTOCHEMICAL PROGNOSTIC FACTORS IN HIGH-GRADE NON-ENDOMETRIOID CARCINOMAS OF THE ENDOMETRIUM (HG-NECs). IS IT POSSIBLE TO IDENTIFY SUB-GROUPS AT INCREASED RISK?
Authors: Vellone Valerio Gaetano , Paudice Michele , Biatta Chiara Maria , Scaglione Giulia , Barra Fabio , Ferrero Simone , Greppi Marco , Paleari Laura , Marcenaro Emanuela ,   Gyn DMT
Published: May 2021

ABSTRACTEndometrial cancer is an emerging disease with an increase in prevalence of aggressive histotypes in recent years. In the present study potential histopathological and immunohistochemical prognostic markers are investigatedConsecutive cases of high grade non-endometrioid carcinoma (HG-NEC) of the endometrium were considered. Each surgical specimen has been routinely processed, the most representative block has been selected for immunohistochemistry and tested for ER, PR, ki67, p53, E-cadherin, β-catenin, Bcl-2 and cyclin D1. For each immunomarker the percentage of positive tumor cells were evaluated (%) and dichotomized as low and high according to the distribution in the study population. Follow-up was collected for disease-free survival (DFS) and overall survival (OS).33 cases were eligible: 19 resulted FIGO I-II, 14 resulted FIGO III-IV. 12 patients suffered a recurrent disease (mean follow-up 24.6 months); 8 patients died of the disease (mean follow-up 26.6 months).Women with recurrent disease demonstrated a significant higher bcl2% (35.84±30.96% vs 8.09±11.56% p=0.0032) while DOD patients had higher ki67% (75±13.09% vs 58.6±19.97% p=0.033) and bcl2% of border significance (34.37±34.99% vs 13±17.97% p=0.078).As expected FIGO III-IV had a worse DFS (HR=3.34; 95%CI:1.1-10.99; p=0.034) and OS (HR=5.19; 95%CI: 1.27-21.14 p= 0.0217). Bcl2-high patients (bcl2>10%) demonstrated a significant worse DFS (HR=9.11; 95%CI: 2.6-32.4; p=0.0006) and OS (HR=7.63; 95%CI:1.7-34; p=0.0084); also PR low patients (PR≤10%) had a significant worse DFS (HR=3.74; 95%CI:1.2-11.9; p=0,02).HG-NEC represent an heterogeneous group of endometrial aggressive neoplasms with a worrisome prognosis often at an advanced stage at presentation. Bcl2 and PR may represent promising markers to identify a sub-group of patients having an even worse prognosis requiring a careful and close follow-up.
Post-acute COVID-19 syndrome and its prolonged effects: An updated systematic review
Authors: Malik Jahanzeb , Zaidi Syed Muhammad Jawad , Iqbal Raafe , Khan Kashif , Ali Muhammad , Rana Abdul Sattar , Waqar Ali Umer , Ishaq Uzma 
Published: May 2021

AbstractObjectiveThis systematic review aimed at estimating the demographics, clinical characteristics, and prevalence of post-acute COVID-19 symptoms in view of published literature that studied prolonged clinical manifestations after recovery from acute COVID-19 infection.MethodsAfter protocol setting, relevant articles were searched on various databases including PubMed, Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and Web of Sciences using MeSH keywords.ResultsOut of the 153 articles reviewed, 21 articles qualified for the final analysis. The most common persistent clinical manifestations were fatigue (54.11%), dyspnea (24.38%), alopecia (23.21%), hyperhidrosis (23.6%), insomnia (25.98%), anxiety (17.29%), and arthralgia (16.35%). In addition to these symptoms, new-onset hypertension, diabetes, neuropsychiatric disorders, and bladder incontinence were also reported.ConclusionClinical features of post-acute COVID-19 infection can manifest even after 60 days of initial infection. Multidisciplinary care along with regular follow-up must be provided to such patients.
Impact of BNT162b first vaccination on the immune transcriptome of elderly patients infected with the B.1.351 SARS-CoV-2 variant
Authors: Knabl Ludwig , Lee Hye Kyung , Wieser Manuel , Mur Anna , Zabernigg August , Knabl Ludwig , Rauch Simon , Bock Matthias , Schumacher Jana , Kaiser Norbert , Furth Priscilla A. , Hennighausen Lothar 
Published: May 2021

AbstractFast-spreading variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) energize the COVID-19 pandemic. The B.1.351 variant carrying the escape mutation E484K in the receptor binding domain is of particular concern due to reduced immunological protection following vaccination. Protection can manifest as early as 10 days following immunization with full protection two weeks following the second dose, but the course is not well-characterized for variants. Here, we investigated the immune transcriptome of six elderly individuals (average age 82 yr.) from an old people’s home, who contracted B.1.351, with four having received the first dose of BNT162b eight to 11 days prior to the onset of COVID-19 symptoms. The patients were hospitalized and received dexamethasone treatment. Immune transcriptomes were established from PBMCs approximately 10 and 35 days after the onset of COVID-19 symptomology. RNA-seq revealed a more intensive immune response in vaccinated patients as compared to unvaccinated ones. Specifically, transcription factors linked to the JAK/STAT pathway, interferon stimulated genes, and genes associated with innate antiviral immunity and COVID-19-SARS-CoV-2 infection were highly enriched in vaccinated patients. This rendered the transcriptomes of the older vaccinated group significantly different than older unvaccinated individuals infected at the same institution and more similar to the immune response of younger unvaccinated individuals (age range 48-62) following B.1.351 infection. All individuals in this study whether vaccinated or not were hospitalized due to B.1.351 infection and one vaccinated patient died illustrating that although an enhanced immune response was documented infection it was insufficient to protect from disease. This highlights the need for maintaining physical distancing and prevention measures throughout the time course of vaccination in older adults.
Family responsibilities and mental health of kindergarten educators during the first COVID-19 pandemic lockdown in Ontario, Canada
Authors: Spadafora Natalie , Reid-Westoby Caroline , Pottruff Molly , Janus Magdalena 
Published: May 2021

AbstractThe present study, conducted during the first wave of the COVID-19 pandemic in Ontario, Canada, addressed the association between family responsibilities and mental health (depression and anxiety) among kindergarten educators. Participants comprised 1,790 (97.9% female) kindergarten educators (73.6% kindergarten teachers; 26.4% early childhood educators) across Ontario. Results revealed that educators were more likely to report moderate levels of depressive symptoms if they had the responsibility of caring for their own children, and more likely to report moderate levels of depressive and anxious symptoms if they had the responsibility of caring for an older adult. Theoretical and practical implications are discussed.
Integrative Analyses Reveal Novel Disease-associated Loci and Genes for Idiopathic Pulmonary Fibrosis
Authors: Chen Ming , Zhang Yiliang , Adams Taylor S. , Ji Dingjue , Jiang Wei , Wain Louise V. , Cho Michael H. , Kaminski Naftali , Zhao Hongyu 
Published: May 2021

AbstractBackgroundAlthough genome-wide association studies have identified many genomic regions associated with idiopathic pulmonary fibrosis (IPF), the causal genes and functions remain largely unknown. Many bulk and single-cell expression data have become available for IPF, and there is increasing evidence suggesting a shared genetic basis between IPF and other diseases.MethodsBy leveraging shared genetic information and transcriptome data, we conducted an integrative analysis to identify novel genes for IPF. We first considered observed phenotypes, polygenic risk scores, and genetic correlations to investigate associations between IPF and other traits in the UK Biobank. We then performed local genetic correlation analysis and cross-tissue transcriptome-wide association analysis (TWAS) to identify IPF genes. We further prioritized genes using bulk and single-cell gene expression data.FindingsWe identified 25 traits correlated with IPF on the phenotype level and seven traits genetically correlated with IPF. Using local genetic correlation, we identified 12 candidate genes across 14 genomic regions, including the POT1 locus (p-value = 4·1E-4), which contained variants with protective effects on lung cancer but increasing IPF risk. Using TWAS, we identified 36 genes, including 12 novel genes for IPF. Annotation-stratified heritability estimation and differential expression analysis of downstream-regulated genes suggested regulatory roles of two candidate genes, MAFK and SMAD2, on IPF.InterpretationOur integrative analysis identified new genes for IPF susceptibility and expanded the understanding of the complex genetic architecture of IPF.FundingNIHR Leicester Biomedical Research Centre, Three Lakes Partners, the National Institutes of Health, the National Science Foundation, U01HL145567, and UH2HL123886.