bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and serological outcomes in patients treated with oral doxycycline for early neurosyphilis
Authors: Girometti Nicolò , Junejo Muhammad H , Nugent Diarmuid , McOwan Alan , Whitlock Gary ,   the 56 Dean Street Collaborative Group, Gedela Keerti , Patel Sheel , Suchak Tara , Tittle Victoria 
Published: March 2021

AbstractObjectivesPenicillin-based antibiotic treatment for syphilis infection with CNS involvement (early neurosyphilis) is not always a suitable treatment option. We compared outcomes of patients diagnosed with early neurosyphilis and treated with doxycycline or procaine G penicillin.MethodsSerological and clinical outcomes were analysed in patients diagnosed with early neurosyphilis between January 2015 and October 2019 at 56 Dean Street, a combined sexual health and HIV service based in London, UK. Acute onset of CNS, ocular and/or otic symptomatology and a documented seroconverting syphilis serology or a &gt;4-fold increase in rapid plasma reagin (‘RPR)’ test titre within the previous 12 months were criteria used to define a case. Mann–Whitney U-test and χ2 tests were used to test distributions between baseline characteristics and outcomes according to treatment administered.ResultsEighty-seven patients were included: median age = 35 years (IQR = 31–45), 98% MSM, 79% white ethnicity, 53% HIV-1 positive and 40% previously diagnosed with syphilis at any stage. They were treated exclusively with either intramuscular (IM) procaine G penicillin (71%) or oral doxycycline (18%). Patients received doxycycline treatment over a penicillin-based regimen due to IM treatment declined (31%), inability to attend for IM injections (31%) or penicillin allergy (19%). Serological response was achieved by all patients; 91% reported full symptom resolution at 30 days from end of treatment. Similar rates of clinical and serological response and seroreversion were observed in the groups treated with procaine G penicillin versus doxycycline.ConclusionsThe clinical and serological outcomes seen with penicillin-based versus doxycycline treatments were similar. A randomized controlled trial is needed to establish the effectiveness of doxycycline in the treatment of early neurosyphilis.
Soft tissue sarcoma in adolescent and young adult patients: a retrospective study using a nationwide bone and soft tissue tumor registry in Japan
Authors: Fukushima Takashi , Ogura Koichi , Akiyama Toru , Takeshita Katsushi , Kawai Akira 
Published: March 2021

Abstract

Objective
The relationship between the adolescent and young adult age groups and poor overall survival in soft tissue sarcoma and the risk factors for poor outcomes in adolescent and young adult patients with soft tissue sarcoma were analyzed.

Methods
The medical records of 7759 Japanese patients diagnosed with soft tissue sarcoma from 2006–13 were accessed from the Bone and Soft Tissue Tumor registry. The epidemiological features of adolescent and young adult patients were compared with those of other age groups. The cancer survival rates were calculated using the Kaplan-Meier method. The prognostic factors for cancer survival were analyzed with the Cox proportional hazards models. The primary endpoint for prognosis was tumor-related death.

Results
There were 210 children, 1467 adolescent and young adults, 2771 adults and 3311 elderly among the 7759 patients identified with soft tissue sarcoma. Compared with other age groups, the proportions of myxoid/round cell liposarcoma, synovial sarcoma, malignant peripheral nerve sheath tumor, primitive neuroectodermal tumor and rhabdomyosarcoma in adolescent and young adult patients were the highest, but none was significantly more prevalent in adolescent and young adult patients. On multivariate analysis, age was not a prognostic factor for poor cancer survival among adolescent and young adult patients with soft tissue sarcoma. The cancer survival rates of adolescent and young adult patients with malignant peripheral nerve sheath tumor were poorer than those of the other age groups; however, adolescent and young adult age was not a prognostic factor on multivariate analysis in malignant peripheral nerve sheath tumor patients.

Conclusions
Our study is the first to investigate soft tissue sarcoma in adolescent and young adult patients using the nationwide Bone and Soft Tissue Tumor registry. Adolescent and young adult age is not a prognostic factor for poor cancer survival among those with soft tissue sarcoma in Japan.
How kelp in drag lose their ruffles: environmental cues, growth kinematics, and mechanical constraints govern curvature
Authors: Koehl Mimi A R , Silk Wendy K 
Published: March 2021

AbstractWe reveal how patterns of growth in response to environmental cues can produce curvature in biological structures by setting up mechanical stresses that cause elastic buckling. Nereocystis luetkeana are nearshore kelp with wide ruffled blades that minimize self-shading in slow flow, but narrow flat blades that reduce hydrodynamic drag in rapid flow. Previously we showed that blade ruffling is a plastic trait associated with a transverse gradient in longitudinal growth. Here we consider expansion and displacement of tissue elements due to growth in blades, and find that growth patterns are altered by tensile stress due to hydrodynamic drag, but not by shading or nutrients. When longitudinal stress in a blade is low in slow flow, blade edges grow faster than the midline in young tissue near the blade base. Tissue elements are displaced distally by expansion of younger proximal tissue. Strain energy caused by the transverse gradient in longitudinal growth is released by elastic buckling once the blade grows wide enough, producing ruffles distal to the region where the growth inhomogeneity started. If a blade experiences higher stress in rapid flow, the edges and midline grow at the same rate, so the blade becomes flat as these new tissue elements are displaced distally.
Event, Trauma, and Ethics in Wing Tek Lum’sThe Nanjing Massacre
Authors: Sha Richard C 
Published: March 2021

AbstractWing Tek Lum’s 2012 poetry collection The Nanjing Massacre raises vital questions about trauma. How do we know when a traumatic event begins? What cognitive options are open to victims of trauma? What are the ethical implications of our theories of trauma? I thus situate this volume between Bessel van der Kolk’s and Jacques Lacan’s theories of trauma because these poems challenge their key assumptions. Lum turns to poetry to think through how trauma begins and ends, the degree to which healing the gap between body and mind is part of the “cure” or part of the disease, and how much cognitive stretching is possible in trauma’s wake.
Asteroseismic analysis of 15 solar-like oscillating evolved stars
Authors: Çelik Orhan Z , Yıldız M , Kayhan C 
Published: March 2021

ABSTRACT
Asteroseismology using space-based telescopes is vital to our understanding of stellar structure and evolution. CoRoT, Kepler, and TESS space telescopes have detected large numbers of solar-like oscillating evolved stars. Solar-like oscillation frequencies have an important role in the determination of fundamental stellar parameters; in the literature, the relations between the two is established by the so-called scaling relations. In this study, we analyse data obtained from the observation of 15 evolved solar-like oscillating stars using the Kepler and ground-based telescopes. The main purpose of the study is to determine very precisely the fundamental parameters of evolved stars by constructing interior models using asteroseismic parameters. We also fit the reference frequencies of models to the observational reference frequencies caused by the He ii ionization zone. The 15 evolved stars are found to have masses and radii within ranges of 0.79–1.47 M⊙ and 1.60–3.15 R⊙, respectively. Their model ages range from 2.19 to 12.75 Gyr. It is revealed that fitting reference frequencies typically increase the accuracy of asteroseismic radius, mass, and age. The typical uncertainties of mass and radius are ∼3–6 and ∼1–2 per cent, respectively. Accordingly, the differences between the model and literature ages are generally only a few Gyr.
Dual Regeneration of Muscle and Nerve by Intramuscular Infusion of Mitochondria in a Nerve Crush Injury Model
Authors: Sheu Meei-Ling , Shen Chiung-Chyi , Tsou Hsi-Kai , Yang Meng Yin , Su Hong-Lin , Sheehan Jason , Chang Ming-Hong , Chen Hong-Shiu , Pan Hung-Chuan 
Published: March 2021

Abstract

BACKGROUND
Peripheral nerve injuries result in muscle denervation and apoptosis of the involved muscle, which subsequently reduces mitochondrial content and causes muscle atrophy. The local injection of mitochondria has been suggested as a useful tool for restoring the function of injured nerves or the brain.

OBJECTIVE
To determine outcomes following the administration of isolated mitochondria into denervated muscle after nerve injury that have not been investigated.

METHODS
Muscle denervation was conducted in a sciatic nerve crushed by a vessel clamp and the denervated gastrocnemius muscle was subjected to 195 μg hamster green fluorescent protein (GFP)-mitochondria intramuscular infusion for 10 min.

RESULTS
The mitochondria were homogeneously distributed throughout the denervated muscle after intramuscular infusion. The increases in caspase 3, 8-oxo-dG, Bad, Bax, and ratio of Bax/Bcl-2 levels in the denervated muscle were attenuated by mitochondrial infusion, and the downregulation of Bcl-2 expression was prevented by mitochondrial infusion. In addition, the decrease in the expression of desmin and the acetylcholine receptor was counteracted by mitochondrial infusion; this effect paralleled the amount of distributed mitochondria. The restoration of the morphology of injured muscles and nerves was augmented by the local infusion of mitochondria. Mitochondrial infusion also led to improvements in sciatic functional indexes, compound muscle action potential amplitudes, and conduction latencies as well as the parameters of CatWalk (Noldus) gait analysis.

CONCLUSION
The local infusion of mitochondria can successfully prevent denervated muscle atrophy and augment nerve regeneration by reducing oxidative stress in denervated muscle.
Median Age at HPV Infection Among Women in the United States: A Model-Based Analysis Informed by Real-world Data
Authors: Prabhu Vimalanand S , Roberts Craig S , Kothari Smita , Niccolai Linda 
Published: March 2021

Abstract

Background
The US Advisory Committee for Immunization Practices (ACIP) recommended shared clinical decision-making for human papillomavirus (HPV) vaccination of individuals aged 27 to 45 years (mid-adults) in June 2019. Determining the median age at causal HPV infection and CIN2+ diagnosis based on the natural history of HPV disease can help elucidate the incidence of HPV infections and the potential benefits of vaccination in mid-adults.

Methods
Real-world data on CIN2+ diagnosis from the prevaccine era were sourced from a statewide surveillance registry in Connecticut. Age distribution of CIN2+ diagnosis in 2008 and 2009 was estimated. A discrete event simulation model was developed to predict the age distribution of causal HPV infection. The optimal age distribution of causal HPV infection provided the best goodness-of-fit statistic to compare the predicted vs real-world age distribution of CIN2+ diagnosis.

Results
The median age at CIN2+ diagnosis from 2008 through 2009 in Connecticut was 28 years. The predicted median age at causal HPV infection was estimated to be 23.9 years. There was a difference of 5.2 years in the median age at acquisition of causal HPV infection and the median age at CIN2+ diagnosis.

Conclusions
Real-world data on CIN2+ diagnosis and model-based analysis indicate a substantial burden of infection and disease among women aged 27 years or older, which supports the ACIP recommendation to vaccinate some mid-adults. When natural history is known, this novel approach can also help determine the timing of causal infections for other commonly asymptomatic infectious diseases.
Emphasizing truthfulness in COVID-19 test declarations
Authors: Gozum Ivan Efreaim A , Carreon Alicia D V , Manansala Marian M 
Published: March 2021

ABSTRACT
In previous correspondence, it was explained that faking COVID-19 diagnostic tests and vaccination certifications posits serious concerns for matters of ethics and economics. With this, we suggest, in this paper, the importance of giving emphasis to being truthful in declaring their COVID-19 diagnostic test results and vaccination certificates. Also, in being truthful, it is emphasized in this paper that honesty and transparency in regard to the said results and certificates are necessary in ensuring public health and promoting awareness during the COVID-19 pandemic.
Addressing the psychosocial needs of students attending online classes during this Covid-19 pandemic
Authors: Carreon Alicia D V , Manansala Marian M 
Published: March 2021

Abstract
An earlier article discusses that the Coronavirus pandemic stirred a challenging situation for many educators in online classes. The correspondence proposes that teachers in a work-from-home environment should be provided with psychosocial supports to address the mental and emotional stresses caused by the Covid-19 pandemic. It is also noted that the outbreak of the Coronavirus disease poses a serious threat to millions of students enrolled in online classes. The shifting from face-to-face classes to online classes caused students to experience psychological or psychosocial distress. In response to the previous article, this paper presents how students’ psychosocial needs should be addressed through psychosocial supports.
The function of SUMOylation and its crucial roles in the development of neurological diseases
Authors: Chen Xu , Zhang Yuhong , Wang Qiqi , Qin Yuanyuan , Yang Xinyi , Xing Zhengcao , Shen Yajie , Wu Hongmei , Qi Yitao 
Published: March 2021

AbstractNeurological diseases are relatively complex diseases of a large system; however, the detailed mechanism of their pathogenesis has not been completely elucidated, and effective treatment methods are still lacking for some of the diseases. The SUMO (small ubiquitin‐like modifier) modification is a dynamic and reversible process that is catalyzed by SUMO‐specific E1, E2, and E3 ligases and reversed by a family of SENPs (SUMO/Sentrin‐specific proteases). SUMOylation covalently conjugates numerous cellular proteins, and affects their cellular localization and biological activity in numerous cellular processes. A wide range of neuronal proteins have been identified as SUMO substrates, and the disruption of SUMOylation results in defects in synaptic plasticity, neuronal excitability, and neuronal stress responses. SUMOylation disorders cause many neurodegenerative diseases, such as Parkinson’s disease, Alzheimer’s disease, and Huntington’s disease. By modulating the ion channel subunit, SUMOylation imbalance is responsible for the development of various channelopathies. The regulation of protein SUMOylation in neurons may provide a new strategy for the development of targeted therapeutic drugs for neurodegenerative diseases and channelopathies.
Changes in Respiratory Muscle Thickness during Mechanical Ventilation: Focus on Expiratory Muscles
Authors: Shi Zhong-Hua , de Vries Heder , de Grooth Harm-Jan , Jonkman Annemijn H. , Zhang Yingrui , Haaksma Mark , van de Ven Peter M. , de Man Angelique A. M. E. , Girbes Armand , Tuinman Pieter R. , Zhou Jian-Xin , Ottenheijm Coen , Heunks Leo 
Published: March 2021

Background
The lateral abdominal wall muscles are recruited with active expiration, as may occur with high breathing effort, inspiratory muscle weakness, or pulmonary hyperinflation. The effects of critical illness and mechanical ventilation on these muscles are unknown. This study aimed to assess the reproducibility of expiratory muscle (i.e., lateral abdominal wall muscles and rectus abdominis muscle) ultrasound and the impact of tidal volume on expiratory muscle thickness, to evaluate changes in expiratory muscle thickness during mechanical ventilation, and to compare this to changes in diaphragm thickness.

Methods
Two raters assessed the interrater and intrarater reproducibility of expiratory muscle ultrasound (n = 30) and the effect of delivered tidal volume on expiratory muscle thickness (n = 10). Changes in the thickness of the expiratory muscles and the diaphragm were assessed in 77 patients with at least two serial ultrasound measurements in the first week of mechanical ventilation.

Results
The reproducibility of the measurements was excellent (interrater intraclass correlation coefficient: 0.994 [95% CI, 0.987 to 0.997]; intrarater intraclass correlation coefficient: 0.992 [95% CI, 0.957 to 0.998]). Expiratory muscle thickness decreased by 3.0 ± 1.7% (mean ± SD) with tidal volumes of 481 ± 64 ml (P < 0.001). The thickness of the expiratory muscles remained stable in 51 of 77 (66%), decreased in 17 of 77 (22%), and increased in 9 of 77 (12%) patients. Reduced thickness resulted from loss of muscular tissue, whereas increased thickness mainly resulted from increased interparietal fasciae thickness. Changes in thickness of the expiratory muscles were not associated with changes in the thickness of the diaphragm (R
2 = 0.013; P = 0.332).

Conclusions
Thickness measurement of the expiratory muscles by ultrasound has excellent reproducibility. Changes in the thickness of the expiratory muscles occurred in 34% of patients and were unrelated to changes in diaphragm thickness. Increased expiratory muscle thickness resulted from increased thickness of the fasciae.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
A Systematic Review of the Incidence and Outcomes of In-Hospital Cardiac Arrests in Patients With Coronavirus Disease 2019*
Authors: Lim Zheng Jie , Ponnapa Reddy Mallikarjuna , Curtis J. Randall , Afroz Afsana , Billah Baki , Sheth Vishad , Hayek Salim S. , Leaf David E. , Miles Jeremy A. , Shah Priyank , Yuriditsky Eugene , Jones Daryl , Shekar Kiran , Subramaniam Ashwin 
Published: March 2021

OBJECTIVES:
To investigate the incidence, characteristics, and outcomes of in-hospital cardiac arrest in patients with coronavirus disease 2019 and to describe the characteristics and outcomes for patients with in-hospital cardiac arrest within the ICU, compared with non-ICU patients with in-hospital cardiac arrest. Finally, we evaluated outcomes stratified by age.

DATA SOURCES:
A systematic review of PubMed, EMBASE, and preprint websites was conducted between January 1, 2020, and December 10, 2020. Prospective Register of Systematic Reviews identification: CRD42020203369.

STUDY SELECTION:
Studies reporting on consecutive in-hospital cardiac arrest with a resuscitation attempt among patients with coronavirus disease 2019.

DATA EXTRACTION:
Two authors independently performed study selection and data extraction. Study quality was assessed with the Newcastle-Ottawa Scale. Data were synthesized according to the Preferred Reporting Items for Systematic Reviews guidelines. Discrepancies were resolved by consensus or through an independent third reviewer.

DATA SYNTHESIS:
Eight studies reporting on 847 in-hospital cardiac arrest were included. In-hospital cardiac arrest incidence varied between 1.5% and 5.8% among hospitalized patients and 8.0–11.4% among patients in ICU. In-hospital cardiac arrest occurred more commonly in older male patients. Most initial rhythms were nonshockable (83.9%, [asystole = 36.4% and pulseless electrical activity = 47.6%]). Return of spontaneous circulation occurred in 33.3%, with a 91.7% in-hospital mortality. In-hospital cardiac arrest events in ICU had higher incidence of return of spontaneous circulation (36.6% vs 18.7%; p < 0.001) and relatively lower mortality (88.7% vs 98.1%; p < 0.001) compared with in-hospital cardiac arrest in non-ICU locations. Patients greater than or equal to 60 years old had significantly higher in-hospital mortality than those less than 60 years (93.1% vs 87.9%; p = 0.019).

CONCLUSIONS:
Approximately, one in 20 patients hospitalized with coronavirus disease 2019 received resuscitation for an in-hospital cardiac arrest. Hospital survival after in-hospital cardiac arrest within the ICU was higher than non-ICU locations and seems comparable with prepandemic survival for nonshockable rhythms. Although the data provide guidance surrounding prognosis after in-hospital cardiac arrest, it should be interpreted cautiously given the paucity of information surrounding treatment limitations and resource constraints during the pandemic. Further research is into actual causative mechanisms is needed.
Optimal Sedation in Patients Who Receive Neuromuscular Blocking Agent Infusions for Treatment of Acute Respiratory Distress Syndrome—A Retrospective Cohort Study From a New England Health Care Network*
Authors: Wongtangman Karuna , Grabitz Stephanie D. , Hammer Maximilian , Wachtendorf Luca J. , Xu Xinling , Schaefer Maximilian S. , Fassbender Philipp , Santer Peter , Kassis Elias Baedorf , Talmor Daniel , Eikermann Matthias ,   for the SICU Optimal Mobilization Team (SOMT) Group
Published: March 2021

OBJECTIVES:
Two previously published trials (ARDS et Curarisation Systematique [ACURASYS] and Reevaluation of Systemic Early Neuromuscular Blockade [ROSE]) presented equivocal evidence on the effect of neuromuscular blocking agent infusions in patients with acute respiratory distress syndrome (acute respiratory distress syndrome). The sedation regimen differed between these trials and also within the ROSE trial between treatment and control groups. We hypothesized that the proportion of deeper sedation is a mediator of the effect of neuromuscular blocking agent infusions on mortality.

DESIGN:
Retrospective cohort study.

SETTING:
Seven ICUs in an academic hospital network, Beth Israel Deaconess Medical Center (Boston, MA).

PATIENTS:
Intubated and mechanically ventilated ICU patients with acute respiratory distress syndrome (Berlin definition) admitted between January 2008 until June 2019.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
The proportion of deeper sedation was defined as days with nonlight sedation as a fraction of mechanical ventilation days in the ICU after acute respiratory distress syndrome diagnosis. Using clinical data obtained from a hospital network registry, 3,419 patients with acute respiratory distress syndrome were included, of whom 577 (16.9%) were treated with neuromuscular blocking agent infusions, for a mean (sd) duration of 1.8 (±1.9) days. The duration of deeper sedation was prolonged in patients receiving neuromuscular blocking agent infusions (4.6 ± 2.2 d) compared with patients without neuromuscular blocking agent infusions (2.4 ± 2.2 d; p < 0.001). The proportion of deeper sedation completely mediated the negative effect of neuromuscular blocking agent infusions on in-hospital mortality (p < 0.001). Exploratory analysis in patients who received deeper sedation revealed a beneficial effect of neuromuscular blocking agent infusions on mortality (49% vs 51%; adjusted odds ratio, 0.80; 95% CI, 0.63–0.99, adjusted absolute risk difference, –0.05; p = 0.048).

CONCLUSIONS:
In acute respiratory distress syndrome patients who receive neuromuscular blocking agent infusions, a prolonged, high proportion of deeper sedation is associated with increased mortality. Our data support the view that clinicians should minimize the duration of deeper sedation after recovery from neuromuscular blocking agent infusion.