bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dysbiosis of Gut Microbiota Is an Independent Risk Factor of Stroke-Associated Pneumonia: A Chinese Pilot Study
Authors: Xia Geng-Hong , Zhang Ming-Si , Wu Qi-Heng , Wang Hui-Di , Zhou Hong-Wei , He Yan , Yin Jia 
Published: August 2021

Background and PurposeIdentifying risks of stroke-associated pneumonia (SAP) is important for clinical management. We aimed to evaluate the association between gut microbiome composition and SAP in patients with acute ischemic stroke (AIS).MethodsA prospective observational study was conducted, and 188 AIS patients were enrolled as the training cohort. Fecal and serum samples were collected at admission. SAP was diagnosed by specialized physicians, and disease severity scores were recorded. Fecal samples were subjected to 16S rRNA V4 tag sequencing and analysed with QIIME and LEfSe. Associations between the most relevant taxa and SAP were analysed and validated with an independent cohort. Fecal short-chain fatty acid (SCFA), serum D-lactate (D-LA), intestinal fatty acid-binding protein (iFABP) and lipopolysaccharide binding protein (LBP) levels were measured.ResultsOverall, 52 patients (27.7%) had SAP in the training cohort. The gut microbiome differed between SAP and non-SAP patients; specifically,Roseburiadepletion and opportunistic pathogen enrichment were noted in SAP patients, as confirmed in the validation cohort (n=144, 28 SAP [19.4%]). Based on multivariate analysis,Roseburiawas identified as a protective factor against SAP in both cohorts (training, aOR 0.52; 95% CI, 0.30-0.90; validation, aOR 0.44; 95% CI, 0.23-0.85). The combination of these taxa into a microbial dysbiosis index (MDI) revealed that dysbiosis increased nearly 2 times risk of SAP (training, aOR 1.95; 95% CI, 1.19-3.20; validation, aOR 2.22; 95% CI, 1.15-4.26). Lower fecal SCFA levels and higher serum D-LA levels were observed in SAP patients. Furthermore, SAP was an independent risk factor of 30-day death and 90-day unfavorable outcome.ConclusionWe demonstrate that a microbial community with depletedRoseburiaand enriched opportunistic pathogens is associated with increased risk of SAP among AIS patients. Gut microbiota screening might be useful for identifying patients at high risk for SAP and provide clues for stroke treatment.
Ivabradine: A Potential Therapeutic for Children With Refractory SVT
Authors: Younis Nour K. , Abi-Saleh Bernard , Al Amin Farah , El Sedawi Omar , Tayeh Christelle , Bitar Fadi , Arabi Mariam 
Published: August 2021

Background: In April 2015, ivabradine was approved by the Food and Drug Administration for the treatment of patients with coronary artery disease and heart failure (HF). The use of this medication has been linked with improved clinical outcomes and reduced rates of hospitalization in patients with symptomatic HF and a baseline heart rate of 70 bpm and above. Nonetheless, little is known about the use of ivabradine in pediatric patients with supraventricular tachycardia (SVT). This use is not well-studied and is only endorsed by a few case reports and case series.Aim: This study discusses the off-label utilization of ivabradine in pediatric patients with SVT, and highlights its efficacy in treating treatment-resistant (refractory) SVT.Methods: We conducted a retrospective single-center observational study involving pediatric patients with SVT treated at our center between January 2016 and October 2020. We identified the total number of patients with SVT, and the number of patients with refractory SVT treated with Ivabradine. Similarly, we performed a thorough review of the databases of PubMed, Medline and Google Scholar to compare the clinical course of our patients to those described in the literature.Results: Between January 2016 and October 2020, 79 pediatric patients with SVT were seen and treated at our center. A treatment-resistant SVT was noted only in three patients (4%). Ivabradine was used in these patients as a single or combined therapy. The rest (96%) were successfully treated with conventional anti-arrhythmics such as β-blockers, flecainide, and other approved medications. In the ivabradine group, successful reversal to sinus rhythm was achieved in two of the three patients (66%), one patient was treated with a combination therapy of amiodarone and ivabradine, and the other patient was treated only with ivabradine.Conclusion: Overall, promissory results are associated with the use of ivabradine in pediatric patients with refractory SVT. Ivabradine appears to be a safe and well-tolerated medication that can induce adequate suppression of SVT, complete reversal to sinus rhythm, and effective enhancement of left ventricular function.
Older Adult Use and Outcomes in a Digital Musculoskeletal (MSK) Program, by Generation
Authors: Wang Grace , Bailey Jeannie F. , Yang Manshu , Krauss Jeffrey 
Published: August 2021

Objective: We investigated use and clinical outcomes in a digital musculoskeletal (MSK) program, by generation.Method: This longitudinal study uses retrospective data collected online or by app. The study included adults with 12 or more weeks of pain who took part in a digital MSK program. We compared Gen Z and Millennials, Gen X, working age Baby Boomers, and retiree age Baby Boomer and Silent Generation. Program use outcomes were program start, program completion, and number of exercises, educational articles, and messages to coaches. Clinical outcomes were changes in pain, depression, and anxiety from baseline to 12 weeks. We calculated descriptive statistics and conducted adjusted regression models.Results: Odds of starting the program were significantly higher for Gen Xers (OR: 1.12) and working age Baby Boomers (OR: 1.37) vs. Gen Zers and Millennials. Compared to Gen Zers and Millennials, we observed significantly higher odds of program completion among Gen Xers (OR: 1.62), working age Baby Boomers (OR: 2.24), and retirees (OR: 2.36). Compared to Gen Zers and Millennials, retirees had 19 more exercise sessions (IRR: 1.69), accessed 11 more articles (IRR: 1.84), and sent 4 more messages to coaches (IRR: 1.26). Compared to Gen Z and Millennials, we observed no significant differences in change in pain for Gen Xers, working age Baby Boomers, or retirees.Conclusions: Adults from multiple generations took part in a digital MSK program. Findings suggest that older generations used a digital MSK program more than younger generations, but had similar pain outcomes.
Experimental Study on Influencing Factors of Aerosol Retention by Pool Scrubbing
Authors: Li Yuxiang , Tong Lili , Cao Xuewu 
Published: August 2021

During the process of containment depressurization venting, a high-temperature and high-pressure carrier gas with aerosol may be released into the spent fuel pool by a multihole injector. This aerosol in the carrier gas can be removed by pool scrubbing. A small-scale pool scrubbing facility was built to study the aerosol pool scrubbing phenomenon using a multihole injector. In this study, a gaseous mixture of nitrogen and steam is used to simulate a carrier gas, and insoluble solid particles of TiO2 are used to simulate aerosols in the carrier gas. Seven tests were performed to examine the dependence of the decontamination factor (DF) on the pool depth, particle diameter, and steam mass fraction. The results show that log(1/(1–Xm)) has a linear relationship with log(DF). DF varies exponentially with the pool depth, which has an influence on the retention of aerosols with a larger particle diameter. Particle diameters in the range of 0.2–0.52 μm have little effect on the DF. For a low-depth pool scrubbing, the steam condensation mechanism is dominant and the particle diameter does not have a significant effect on the DF. Moreover, the pool scrubbing model is discussed, and an empirical correlation is proposed to evaluate the DF of a pool.
Phenotype and Genotype Study of Chinese POMT2-Related α-Dystroglycanopathy
Authors: Chen Xiao-Yu , Song Dan-Yu , Jiang Li , Tan Dan-Dan , Liu Yi-Dan , Liu Jie-Yu , Chang Xing-Zhi , Xing Guo-Gang , Toda Tatsushi , Xiong Hui 
Published: August 2021

ObjectiveAlpha-dystroglycanopathy (α-DGP) is a subtype of muscular dystrophy caused by defects in the posttranslational glycosylation of α-dystroglycan (α-DG). Our study aimed to summarize the clinical and genetic features of POMT2-related α-DGP in a cohort of patients in China.MethodsPedigrees, clinical data, and laboratory tests of patients diagnosed with POMT2-related α-DGP were analyzed retrospectively. The pathogenicity of variants in POMT2 were predicted by bioinformatics software. The variants with uncertain significance were verified by further analysis.ResultsThe 11 patients, comprising eight males and three females, were from nine non-consanguineous families. They exhibited different degrees of muscle weakness, ambulation, and intellectual impairment. Among them, three had a muscle-eye-brain disease (MEB)-like phenotype, five presented congenital muscular dystrophy with intellectual disability (CMD-ID), and three presented limb-girdle muscular dystrophy (LGMD). Overall, nine novel variants of POMT2, including two non-sense, one frameshift and six missense variants, were identified. The pathogenicity of two missense variants, c.1891G &gt; C and c.874G &gt; C, was uncertain based on bioinformatics software prediction. In vitro minigene analysis showed that c.1891G &gt; C affects the splicing of POMT2. Immunofluorescence staining with the IIH6C4 antibody of muscle biopsy from the patient carrying the c.874G &gt; C variant showed an apparent lack of expression.ConclusionThis study summarizes the clinical and genetic characteristics of a cohort of POMT2-related α-DGP patients in China for the first time, expanding the mutational spectrum of the disease. Further study of the pathogenicity of some missense variants based on enzyme activity detection is needed.
Case Report: Acquired Disseminated BCG in the Context of a Delayed Immune Reconstitution After Hematological Malignancy
Authors: Gies Vincent , Dieudonné Yannick , Morel Florence , Sougakoff Wladimir , Carapito Raphaël , Martin Aurélie , Weingertner Noëlle , Jacquel Léa , Hubele Fabrice , Kuhnert Cornelia , Jung Sophie , Schramm Frederic , Boyer Pierre , Hansmann Yves , Danion François , Korganow Anne-Sophie , Guffroy Aurélien 
Published: August 2021

ContextDisseminated infections due to Mycobacterium bovis Bacillus Calmette-Guérin (BCG) are unusual and occur mostly in patients with inborn error of immunity (IEI) or acquired immunodeficiency. However, cases of secondary BCGosis due to intravesical BCG instillation have been described. Herein, we present a case of severe BCGosis occurring in an unusual situation.Case DescriptionWe report one case of severe disseminated BCG disease occurring after hematological malignancy in a 48-year-old man without BCG instillation and previously vaccinated in infancy with no complication. Laboratory investigations demonstrated that he was not affected by any known or candidate gene of IEI or intrinsic cellular defect involving IFNγ pathway. Whole genome sequencing of the BCG strain showed that it was most closely related to the M. bovis BCG Tice strain, suggesting an unexpected relationship between the secondary immunodeficiency of the patient and the acquired BCG infection.ConclusionThis case highlights the fact that, in addition to the IEI, physicians, as well as microbiologists and pharmacists should be aware of possible acquired disseminated BCG disease in secondary immunocompromised patients treated in centers that administrate BCG for bladder cancers.
miR-124-3p Inhibits Microglial Secondary Inflammation After Basal Ganglia Hemorrhage by Targeting TRAF6 and Repressing the Activation of NLRP3 Inflammasome
Authors: Fang Yudan , Hong Xiaoqin 
Published: August 2021

Objectives: Intracerebral hemorrhage (ICH) represents a serious central nervous system emergency with high morbidity and mortality, and the basal ganglia is the most commonly affected brain region. Differentially expressed microRNAs (miRs) have recently been highlighted to serve as potential diagnostic biomarkers and therapeutic targets for ICH. This study investigated the mechanism of miR-124-3p in microglial secondary inflammation after ICH.Methods: In this study, 48 patients with primary basal ganglia ICH and 48 healthy volunteers were selected and venous blood was collected from all patients on the second morning of admission (within 24 h of stroke onset). The expression of miR-124-3p in serum was detected by RT-qPCR. Three months after ICH, the patients were assessed by modified Rankin Scale (mRS), and the correlation between miR-124-3p expression and mRS score was analyzed by Pearson. The inflammatory response of microglia was induced by lipopolysaccharide (LPS) to establish the cell model of microglial inflammation. miR-124-3p expression patterns were detected in the serum of ICH patients and healthy volunteers, normal microglia, and LPS-induced microglia. The miR-124-3p mimic was transfected into LPS-induced microglia, followed by measurement of the inflammatory factors, apoptosis rate, and cell viability. The target gene of miR-124-3p was predicted and verified. The expression patterns of tumor necrosis factor receptor-associated factor 6 (TRAF6) were detected. pcDNA3.1 and pcDNA3.1-TRAF6 were transfected into LPS-induced HMC3 cells, and nucleotide-binding oligomerization domain-like receptor (NLR) pyrin domain-containing 3 (NLRP3) expression patterns were determined. Lastly, the effects of TRAF6 overexpression on apoptosis, cell viability, and inflammation in HMC3 cells were measured.Results: miR-124-3p was downregulated in the serum of basal ganglia ICH patients and LPS-induced microglia, and miR-124-3p expression was negatively correlated with mRS. Overexpression of miR-124-3p reduced the inflammatory factors and apoptosis rate and promoted cell activity in LPS-induced microglia. miR-124-3p was found to target TRAF6. Overexpression of TRAF6 enhanced the expression of NLRP3 inflammasome, inflammatory factors and apoptosis rate, and reduced cell viability.Conclusion: Our findings indicate that miR-124-3p repressed the activation of NLRP3 inflammasome by targeting TRAF6, thus inhibiting microglial secondary inflammation after ICH in basal ganglia.
Racial and Ethnic Disparities in Pain Management of Children With Limb Fractures or Suspected Appendicitis: A Retrospective Cross-Sectional Study
Authors: Guedj Romain , Marini Maddalena , Kossowsky Joe , Berde Charles B. , Kimia Amir A. , Fleegler Eric W. 
Published: August 2021

Objective: To evaluate whether racial/ethnical differences in analgesia administration existed in two different cohorts of children with painful conditions: children with either limb fracture or suspected appendicitis.Methods: Retrospective cross-sectional analysis of children visiting a pediatric emergency department (Boston Children Hospital) for limb fracture or suspected appendicitis from 2011 to 2015. We computed the proportion of children that received any analgesic treatment and any opioid analgesia. We performed multivariable logistic regressions to investigate race/ethnicity differences in analgesic and opioid administration, after adjusting for pain score, demographics and visit covariates.Results: Among the 8,347 children with a limb fracture and the 4,780 with suspected appendicitis, 65.0 and 60.9% received any analgesic treatment, and 35.9 and 33.4% an opioid analgesia, respectively. Compared to White non-Hispanic Children, Black non-Hispanic children and Hispanic children were less likely to receive opioid analgesia in both the limb fracture cohort [Black: aOR = 0.61 (95% CI, 0.50–0.75); Hispanic aOR = 0.66 (95% CI, 0.55–0.80)] and in the suspected appendicitis cohort [Black: aOR = 0.75 (95% CI, 0.58–0.96); Hispanic aOR = 0.78 (95% CI, 0.63–0.96)]. In the limb fracture cohort, Black non-Hispanic children and Hispanic children were more likely to receive any analgesic treatment (non-opioid or opioid) than White non-Hispanic children [Black: aOR = 1.63 (95% CI, 1.33–2.01); Hispanic aOR = 1.43 (95% CI, 1.19–1.72)].Conclusion: Racial and ethnic disparities exist in the pain management of two different painful conditions, which suggests true inequities in health care delivery. To provide equitable analgesic care, emergency departments should monitor variation in analgesic management and develop appropriate universal interventions.
The U-Shaped Association Between Serum Uric Acid and Red Blood Cell Distribution Width in Acute Ischemic Stroke
Authors: Rong Ning , Zhao Pei , Yang Jin , Fan Qing-Lei , Zhang Qiang , Han Zhi-Gang , Cai Jian , Zhu De-Sheng 
Published: August 2021

Objective: The U-shaped association between serum uric acid (SUA) and the functional outcome has been found in acute ischemic stroke (AIS). However, it is unclear if SUA is associated with red blood cell morphology in AIS. This study aimed to determine the relationship between SUA and red blood cell distribution width (RDW) in patients with AIS.Methods: A cross-sectional study including 438 consecutive patients with AIS was conducted. SUA and RDW, biochemical parameters that reflect the heterogeneity of red blood cell volume, were evaluated on admission. We evaluated the association between SUA and RDW through linear curve fitting analyses and two-piecewise regression analyses.Results: The association between SUA levels and RDW followed a U-shape in all patients. In females, the values of RDW significantly decreased with the increment of SUA (per mg/dl: β, −1.45; 95% CI: −2.15 to −0.75; p &lt; 0.001) in patients with SUA &lt;3.86 mg/dl and increased with the increment of SUA (per mg/dl: β, 0.60; 95% CI: 0.22–0.97; p = 0.002) in patients with SUA ≥ 3.86 mg/dl. Similar results were observed in males with the turning point of SUA = 4.82 mg/dl. After adjusting for potential confounders, a U-shaped association between SUA and RDW was maintained in females, but no statistical significance was maintained in patients with SUA ≥ 4.82 mg/dl in males (p = 0.206).Conclusion: In the sample of patients with AIS, we found a U-shaped relationship between SUA levels and RDW, with the turning point of SUA (3.96 mg/dl in females and 4.82 mg/dl in males) by the threshold effect analysis.
Diagnosis and Assessment of Apathy in Elderly Chinese Patients With Cerebral Small Vessel Disease
Authors: Zhào Hóngyi , Liu Yu , Xia Zhenxi , Xie Hongyang , Huang Yonghua 
Published: August 2021

Objective: The study aimed to estimate the frequency of apathy in Chinese patients with cerebral small vessel disease (CSVD) and investigate the relationship between apathy and neuroimaging markers of CSVD.Methods: A total of 150 CSVD aged patients were recruited for a cross-sectional observational study. Following the new revised version of diagnostic criteria for apathy (DCA), each patient was evaluated successively by the neuropsychiatric inventory (NPI-apathy), geriatric depression scale (GDS), and caregiver burden scale (CBS). The MRI presence of lacunes, white matter hyperintensities, cerebral microbleeds, and perivascular spaces were rated independently. Furthermore, presence of all these MRI markers were summed in a score of 0–4 representing all CSVD features combined.Results: According to the DCA, we found that the frequency of apathy in Chinese Alzheimer's disease patients reached 37.33%, with lack of and diminished goal-directed activities in the dimension of behavior/cognition. We did not find a close relationship between apathy and depression. Caregiver burden was positively correlated with apathy severity. Apathy, but not depression, was positively associated with total CSVD burden, rather than a separate MRI marker of CSVD.Conclusion: As a key component of neuropsychiatric symptoms, apathy was common in Chinese elderly with CSVD, more attention should be paid to apathy in clinical practice of CSVD.
Suicidality and Its Associated Factors Among Students in Rural China During COVID-19 Pandemic: A Comparative Study of Left-Behind and Non-Left-Behind Children
Authors: Hou Tianya , Mao Xiaofei , Shao Xiaoqin , Liu Fen , Dong Wei , Cai Wenpeng 
Published: August 2021

Introduction: The coronavirus disease 2019 (COVID-19) has rapidly spread worldwide. The harmful impact of COVID-19 is beyond just physical health concern. The unprecedented public health crisis has also taken its toll on the mental health of adolescents. The present study aims to estimate the prevalence of suicidal ideation and attempts and investigate the similarities and differences in the influential factors for suicidal ideation and attempts among left-behind children (LBC) and non-left-behind children (NLBC) in rural China during the COVID-19 pandemic.Method: A total of 761 rural Chinese students, of whom 468 were left behind, completed the cross-sectional questionnaires including demographic data, Cognitive Emotion Regulation Questionnaire, nine-item Patient Health Questionnaire, seven-item Generalized Anxiety Disorder Scale, suicidal ideation, and suicidal attempts. Chi-square test, independent-sample t-test, and logistic regression were performed in the statistical analysis.Results: Overall, 36.4 and 10.4% of rural Chinese students reported suicidal ideation (37.8% for LBC vs. 34.1% for NLBC) and attempts (11.3% for LBC vs. 8.9% for NLBC) during the COVID-19 pandemic. Among LBC, parental educational level (adjusted odds ratio, Adj. OR = 1.60), maladaptive strategies (Adj. OR = 1.04), anxious symptoms (Adj. OR = 2.61), and depressive symptoms (Adj. OR = 3.85) were significantly associated with suicidal ideation, while age (Adj. OR = 0.56), maladaptive strategies (Adj. OR = 1.08), symptoms of anxiety (Adj. OR = 3.85), and symptoms of depression (Adj. OR = 2.68) were significantly related to suicidal attempts during the COVID-19 outbreak. Among NLBC, gender (Adj. OR = 2.20), parental educational level (Adj. OR = 1.77), perceived family economic status (Adj. OR = 0.39), anxious symptoms (Adj. OR = 2.38), and depressive symptoms (Adj. OR = 2.77) were significantly associated with suicidal ideation, whereas only anxious symptom (Adj. OR = 5.85) was significantly related to suicidal attempts.Conclusion: Suicidal ideation and attempts are prevalent among students in rural China during the COVID-19 outbreak. Our findings also revealed the shared and unique factors for suicidal ideation and attempts among LBC and NLBC during the COVID-19 epidemic. With regard to the differences between LBC and NLBC, the use of maladaptive strategies and age might be vital factors for suicide prevention measures directed specifically toward LBC, whereas interventions sensitive to gender and perceived social economic status should be specifically designed for NLBC amid the COVID-19 pandemic.