bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal positive end-expiratory pressure to prevent anaesthesia-induced atelectasis in infants
Authors: Park Sujung , Lee Jae Hoon , Kim Hyun Joo , Choi Haegi , Lee Jeong-Rim 
Published: March 2021

BACKGROUND
Paediatric patients have a particularly high incidence of anaesthesia-induced atelectasis. Applying positive end-expiratory pressure (PEEP) with an alveolar recruitment manoeuvre has been substantially studied and adopted in adults; however, few studies have been conducted in children.

OBJECTIVE
We compared the effects of three levels of PEEP (3, 6 and 9 cmH2O) on anaesthesia-induced atelectasis measured by ultrasound in infants between 6 and 12 months of age who were undergoing general anaesthesia.

DESIGN
A prospective, randomised, double-blind trial.

SETTING
Department of Anaesthesia, single centre, South Korea, from May 2019 to March 2020.

PATIENTS
Children who were 6 to 12 months of age, whose American Society of Anesthesiologists (ASA) physical status was 1 or 2, whose height and weight were within two standard deviations of those of their peers, and who were scheduled for elective urological or general surgery were included in the study.

MAIN OUTCOME MEASURES
The primary outcome was the lung ultrasound score at the end of the procedure. The secondary outcomes included dynamic compliance, peak inspiratory pressure, driving pressure, cardiac index, mean arterial pressure and heart rate before and after applying PEEP.

RESULTS
The mean lung ultrasound score at the end of operation was 12.8 at PEEP 6 cmH2O and 12.1 at PEEP 9 cmH2O. Both were significantly lower than 18.4 at PEEP 3 cmH2O (P = 0.0002 and 0.00003, respectively). However, there was no significant difference between the scores of PEEP 6 cmH2O and PEEP 9 cmH2O. The Δ cardiac index (the cardiac index after PEEP – the cardiac index at 3 cmH2O of PEEP) was comparable among the three groups.

CONCLUSION
To reduce anaesthesia-induced atelectasis measured by ultrasound in healthy infants undergoing low abdominal, genitourinary or superficial regional operations, 6 cmH2O of PEEP was more effective than 3 cmH2O. PEEP of 9 cmH2O was comparable with 6 cmH2O.

TRIAL REGISTRATION
ClinicalTrials.gov identifier NCT03969173
New Guidance on Cytochrome P450 2C19 Phenotype-based Use of Proton Pump Inhibitors
Authors: Sabet Samie , McGhee Jessica E. 
Published: March 2021

ABSTRACT
Since the approval of the first proton pump inhibitor (PPI) in 1989, our knowledge regarding this class of medications has further developed. An increasing amount of data now supports the association between cytochrome P450 2C19 (CYP2C19) phenotype and PPI safety and efficacy. This includes pediatric studies, such as those published here and in other pediatric journals within the past year. Moreover, the most recent pediatric Helicobacter pylori guidelines stated that using the PPIs that are less dependent on CYP2C19 for inactivation may be preferred for H pylori eradication among populations that are more likely to have rapid clearance of CYP2C19-metabolized PPIs. Conversely, pantoprazole package insert recommends a dose reduction in known pediatric CYP2C19 poor metabolizers (PMs), citing a 6-fold increase in serum concentrations compared with normal metabolizers (NMs). The purpose of this communication is to introduce a recently published Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2C19 and PPI dosing.
Compartment syndrome following use of tissue plasminogen activator for frostbite in the setting of concomitant diaphyseal tibia fracture
Authors: Joseph Noah M. , Alfonso Nicholas , Hirschfeld Adam G. 
Published: March 2021

Abstract

Background:
Tissue plasminogen activator (tPA) is a thrombolytic agent increasingly being employed for the treatment of acute frostbite. Although tPA has been shown with success to increase digit salvage rates, data on potential complications, including risk of hemorrhage, is limited. As a result, acute trauma is considered a contraindication to use in many institution-based protocols. Currently, there is a paucity in the literature regarding use of tPA for frostbite in patients with concomitant extremity fractures.

Case presentation:
We report the case of a 36-year-old male treated with tPA for frostbite to digits of his bilateral hands in the setting of a concomitant diaphyseal tibia fracture. He subsequently developed acute compartment syndrome in his lower extremity. This was followed by emergent fasciotomy and staged fracture fixation with serial wound debridement and subsequent closure. Despite this complication, the patient went on to early radiographic and clinical union of his tibia fracture. His frostbite wounds healed without functional deficits.

Conclusions:
In patients with severe frostbite injury with digital perfusion defects, tPA for thrombolysis may be indicated. Use of thrombolytics for frostbite in trauma patients or those with concomitant extremity fractures requires a multidisciplinary discussion regarding potential risks. Contingency planning is essential to ensure that potential bleeding complications, including development of compartment syndrome, are diagnosed and treated early. Given the paucity in the current literature regarding use of thrombolytics in trauma patients, further study is warranted to inform the surgical community on instances in which the benefits of tPA administration may outweigh the risks.

Level of evidence:
Case report; Level V.
Orthopaedic trauma care during the early COVID-19 pandemic in the Asia-Pacific region
Authors: Kurozumi Taketo , Minehara Hiroaki , Kim Joon-Woo , Oh Chang-Wung , Miclau Elizabeth E. , Balogh Zsolt J. 
Published: March 2021

Abstract
The Asia-Pacific region countries, with their large and socioeconomically diverse populations and infrastructures, were amongst the earliest to have to respond to the COVID-19 pandemic. Although the disease is not one of surgical trauma, its effects on orthopaedic injuries have been significant. Medical systems had to adapt to better focus on patients with a highly communicable disease, while continuing to provide essential services. Even though many countries saw a decrease in traumatic injuries during the initial periods, orthopaedic trauma services nevertheless had to adapt accordingly to system-wide organizational changes. While each country took their individual approaches to address the pandemic, there were also consistencies in how musculoskeletal injuries and conditions were handled during these early stages of the pandemic. This article reviews those early management approaches to musculoskeletal injury care during the COVID-19 pandemic in different countries throughout the Asia-Pacific region following the initial outbreak in China: Australia, South Korea, and Japan.
The local and systemic response to SARS-CoV-2 infection in children and adults
Authors: Yoshida Masahiro , Worlock Kaylee B. , Huang Ni , Lindeboom Rik G.H. , Butler Colin R. , Kumasaka Natsuhiko , Conde Cecilia Dominguez , Mamanova Lira , Bolt Liam , Richardson Laura , Polanski Krzysztof , Madissoon Elo , Barnes Josephine L. , Allen-Hyttinen Jessica , Kilich Eliz , Jones Brendan C. , de Wilton Angus , Wilbrey-Clark Anna , Sungnak Waradon , Pett J. Patrick , Prigmore Elena , Yung Henry , Mehta Puja , Saleh Aarash , Saigal Anita , Chu Vivian , Cohen Jonathan M. , Cane Clare , Iordanidou Aikaterini , Shibuya Soichi , Reuschl Ann-Kathrin , Argento A. Christine , Wunderink Richard G. , Smith Sean B. , Poor Taylor A. , Gao Catherine A. , Dematte Jane E. ,   NU SCRIPT Study Investigators, Reynolds Gary , Haniffa Muzlifah , Bowyer Georgina S. , Coates Matthew , Clatworthy Menna R. , Calero-Nieto Fernando J. , Göttgens Berthold , O’Callaghan Christopher , Sebire Neil J. , Jolly Clare , de Coppi Paolo , Smith Claire M. , Misharin Alexander V. , Janes Sam M. , Teichmann Sarah A. , Nikolić Marko Z. , Meyer Kerstin B. 
Published: March 2021

AbstractWhile a substantial proportion of adults infected with SARS-CoV-2 progress to develop severe disease, children rarely manifest respiratory complications. Therefore, understanding differences in the local and systemic response to SARS-CoV-2 infection between children and adults may provide important clues about the pathogenesis of SARS-CoV-2 infection. To address this, we first generated a healthy reference multi-omics single cell data set from children (n=30) in whom we have profiled triple matched samples: nasal and tracheal brushings and PBMCs, where we track the developmental changes for 42 airway and 31 blood cell populations from infancy, through childhood to adolescence. This has revealed the presence of naive B and T lymphocytes in neonates and infants with a unique gene expression signature bearing hallmarks of innate immunity. We then contrast the healthy reference with equivalent data from severe paediatric and adult COVID-19 patients (total n=27), from the same three types of samples: upper and lower airways and blood. We found striking differences: children with COVID-19 as opposed to adults had a higher proportion of innate lymphoid and non-clonally expanded naive T cells in peripheral blood, and a limited interferon-response signature. In the airway epithelium, we found the highest viral load in goblet and ciliated cells and describe a novel inflammatory epithelial cell population. These cells represent a transitional regenerative state between secretory and ciliated cells; they were found in healthy children and were enriched in paediatric and adult COVID-19 patients. Epithelial cells display an antiviral and neutrophil-recruiting gene signature that is weaker in severe paediatricversusadult COVID-19. Our matched blood and airway samples allowed us to study the spatial dynamics of infection. Lastly, we provide a user-friendly interface for this data1as a highly granular reference for the study of immune responses in airways and blood in children.
Oligodendrocyte Precursor Cells Sculpt the Visual System by Regulating Axonal Remodeling
Authors: Xiao Yan , Hoodless Laura J , Petrucco Luigi , Portugues Ruben , Czopka Tim 
Published: March 2021

AbstractMany oligodendrocyte precursor cells (OPCs) do not differentiate to form myelin, suggesting additional roles of this cell population. The zebrafish optic tectum contains OPCs in regions devoid of myelin. Elimination of these OPCs impaired precise control of retinal ganglion cell axon arbor size during formation and maturation of retinotectal connectivity, and in consequence impaired visual acuity. Therefore, OPCs fine-tune neural circuit structure and function independently of their canonical role to make myelin.
Durability of SARS-CoV-2-specific IgG responses in saliva for up to 8 months after infection
Authors: Randad Pranay R. , Pisanic Nora , Kruczynski Kate , Howard Tyrone , Rivera Magdielis Gregory , Spicer Kristoffer , Antar Annukka A.R. , Penson Tristan , Thomas David L. , Pekosz Andrew , Ndahiro Nelson , Aliyu Lateef , Betenbaugh Michael J. , Manley Hannah , Detrick Barbara , Katz Morgan , Cosgrove Sara , Rock Clare , Zyskind Israel , Silverberg Jonathan I. , Rosenberg Avi Z. , Duggal Priya , Manabe Yukari C. , Collins Matthew H. , Heaney Christopher D. 
Published: March 2021

ABSTRACTWe evaluated the durability of IgG responses specific to SARS-CoV-2 nucleocapsid (N), receptor binding domain (RBD), and spike (S) antigens in saliva up to 8 months after RT-PCR-confirmed COVID-19 using a multiplex salivary assay. We estimated a half-life of 64 days (d) (95% CI: 49, 80 d) for N, 100 d for RBD (95% CI: 58, 141 d), and 148 d (95% CI: 62, 238 d) for S IgG responses in saliva, consistent with half-life estimates previously reported in blood. Saliva can serve as an alternative to blood to monitor humoral immune responses on a large scale following SARS-CoV-2 infection and vaccination for surveillance and assessment of population immunity.
Novel highly divergent SARS-CoV-2 lineage with the Spike substitutions L249S and E484K
Authors: Laiton-Donato Katherine , Usme-Ciro Jose A. , Franco-Muñoz Carlos , Álvarez-Díaz Diego A. , Ruiz-Moreno Hector Alejandro , Reales-González Jhonnatan , Andrés Prada Diego , Corchuelo Sheryll , Herrera-Sepúlveda Maria T. , Naizaque Julian , Santamaría Gerardo , Wiesner Magdalena , Walteros Diana Marcela , Martínez Martha Lucia Ospina , Mercado-Reyes Marcela 
Published: March 2021

AbstractCOVID-19 pandemics has led to genetic diversification of SARS-CoV-2 and the appearance of variants with potential impact in transmissibility and viral escape from acquired immunity. We report a new lineage containing ten distinctive amino acid changes across the genome. Further studies are required for monitoring its epidemiologic impact.
Predictive and Causal Analysis of No-Shows for Medical Exams During COVID-19: A Case Study of Breast Imaging in a Nationwide Israeli Health Organization
Authors: Ozery-Flato Michal , Pinchasov Ora , Dabush-Kasa Miel , Hexter Efrat , Chodick Gabriel , Guindy Michal , Rosen-Zvi Michal 
Published: March 2021

Abstract“No-shows”, defined as missed appointments or late cancellations, is a central problem in healthcare systems. It has appeared to intensify during the COVID-19 pandemic and the nonpharmaceutical interventions, such as closures, taken to slow its spread. No-shows interfere with patients’ continuous care, lead to inefficient utilization of medical resources, and increase healthcare costs. We present a comprehensive analysis of no-shows for breast imaging appointments made during 2020 in a large medical network in Israel. We applied advanced machine learning methods to provide insights into novel and known predictors. Additionally, we employed causal inference methodology to infer the effect of closures on no-shows, after accounting for confounding biases, and demonstrate the superiority of adversarial balancing over inverse probability weighting in correcting these biases. Our results imply that a patient’s perceived risk of cancer and the COVID-19 time-based factors are major predictors. Further, we reveal that closures impact patients over 60, but not patients undergoing advanced diagnostic examinations.
Diffusion Kurtosis Imaging of neonatal Spinal Cord in clinical routine
Authors: Trò Rosella , Roascio Monica , Tortora Domenico , Severino Mariasavina , Rossi Andrea , Cohen-Adad Julien , Fato Marco Massimo , Arnulfo Gabriele 
Published: March 2021

AbstractDiffusion Kurtosis Imaging (DKI) has undisputed advantages over more classical diffusion Magnetic Resonance Imaging (dMRI), as witnessed by a fast-increasing number of clinical applications and software packages widely adopted in brain imaging. However, in the neonatal setting, DKI is still largely underutilized in Spinal Cord (SC) imaging because of its inherently demanding technological requirements.Due to its extreme sensitivity to non-gaussian diffusion, DKI proves particularly suitable for detecting complex, subtle, fast microstructural changes occurring in this area at this early and critical stage of development, and not identifiable with only DTI. Given the multiplicity of congenital anomalies of the spinal canal, their crucial effect on later developmental outcome, and the close interconnection between SC region and the above brain, managing to apply such a method to neonatal cohort becomes of utmost importance.This study will (i) review the current methodological challenges associated with application of advanced dMRI methods like DKI in early infancy, (ii) illustrate the first semi-automated pipeline built on Spinal Cord Toolbox (SCT) for handling with DKI data of neonatal SC, from acquisition setting to estimation of diffusion measures, through accurate adjustment of processing algorithms customized for adult SC, and (iii) present preliminary results of its application in a pilot clinical case study.Results of this application agree with findings achieved in a corresponding adult survey, thus confirming validity of adopted pipeline and diagnostic value of DKI in pediatrics.
Niche partitioning facilitates coexistence of closely related gut bacteria
Authors: Brochet Silvia , Quinn Andrew , Mars Ruben A.T. , Neuschwander Nicolas , Sauer Uwe , Engel Philipp 
Published: March 2021

AbstractEcological processes underlying bacterial coexistence in the gut are not well understood. Here, we disentangled the effect of the host and the diet on the coexistence of four closely relatedLactobacillusspecies colonizing the honey bee gut. We serially passaged the four species through gnotobiotic bees and in liquid cultures in the presence of either pollen (bee diet) or simple sugars. Although the four species engaged in negative interactions, they were able to stably coexist, bothin vivoandin vitro. However, coexistence was only possible in the presence of pollen, and not in simple sugars, independent of the environment. Using metatranscriptomics and metabolomics, we found that the four species utilize different pollen-derived carbohydrate substrates indicating resource partitioning as the basis of coexistence. Our results show that despite longstanding host association, gut bacterial interactions can be recapitulatedin vitroproviding insights about bacterial coexistence when combined within vivoexperiments.
An ALE meta-analytic review of musical expertise
Authors: Criscuolo Antonio , Pando-Naude Victor , Bonetti Leonardo , Vuust Peter , Brattico Elvira 
Published: March 2021

AbstractThrough long-term training, music experts acquire complex and specialized sensorimotor skills, which are paralleled by continuous neuro-anatomical and -functional adaptations. The underlying neuroplasticity mechanisms have been extensively explored in decades of research in music, cognitive, and translational neuroscience. However, the absence of a comprehensive review and quantitative meta-analysis prevents the plethora of variegated findings to ultimately converge into a unified picture of the neuroanatomy of musical expertise. Here, we performed a comprehensive neuroimaging meta-analysis of publications investigating neuro-anatomical and -functional differences between musicians (M) and non-musicians (NM). Eighty-four studies were included in the qualitative synthesis. From these, 58 publications were included in coordinate-based meta-analyses using the anatomic/activation likelihood estimation (ALE) method. This comprehensive approach delivers a coherent cortico-subcortical network encompassing sensorimotor and limbic regions bilaterally. Particularly, M exhibited higher volume/activity in auditory, sensorimotor, interoceptive, and limbic brain areas and lower volume/activity in parietal areas as opposed to NM. Notably, we reveal topographical (dis-)similarities between the identified functional and anatomical networks and characterize their link to various cognitive functions by means of meta-analytic connectivity modelling. Overall, we effectively synthesized decades of research in the field and provide a consistent and controversies-free picture of the neuroanatomy of musical expertise.
A completely resolved phylogenetic tree of British spiders
Authors: Breitling Rainer 
Published: March 2021

AbstractThe recent accumulation of increasingly densely sampled phylogenetic analyses of spiders has greatly advanced our understanding of evolutionary relationships within this group. Here, this diverse literature is reviewed and combined with earlier morphological analyses in an attempt to reconstruct the first fully resolved phylogeny for the spider fauna of the British Isles. The resulting tree highlights parts of the group where data are still too limited for a confident assessment of relationships, proposes a number of deviations from previously suggested phylogenetic hypotheses, and can serve as a framework for evolutionary and ecological interpretations of the biology of British spiders, as well as a starting point for future studies on a larger geographical scale.
α-Helical peptidic scaffolds to target α-synuclein pathogenic species with high affinity and selectivity
Authors: Santos Jaime , Gracia Pablo , Navarro Susanna , Peña-Diaz Samuel , Pujols Jordi , Cremades Nunilo , Pallarès Irantzu , Ventura Salvador 
Published: March 2021

Abstractα-Synuclein aggregation is a key driver of neurodegeneration in Parkinson’s disease and related syndromes. Accordingly, obtaining a molecule that targets α-synuclein pathogenic assemblies with high affinity and selectivity is a long-pursued objective. Here, we have exploited the biophysical properties of toxic oligomers and amyloid fibrils to identify a family of α-helical peptides that bind selectively to these α-synuclein species with low nanomolar affinity, without interfering with the monomeric functional protein. This activity is translated into an unprecedented anti-aggregation potency and the ability to abrogate the oligomers toxicity. With a structure-function relationship in hand, we identified a human peptide expressed in the brain and in the gastrointestinal tract with exceptional binding, antiaggregation, and detoxifying properties, which suggests it might play a protective role against synucleinopathies. The chemical entities we describe here represent a new therapeutic paradigm and are promising tools to assist diagnosis by selectively detecting α-synuclein pathogenic species in biofluids.
An ecological explanation for hyperallometric scaling of reproduction
Authors: Potter Tomos , Felmy Anja 
Published: March 2021

AbstractIn wild populations, large individuals have disproportionately higher reproductive output than smaller individuals. Some theoretical models explain this pattern – termed reproductive hyperallometry – by individuals allocating a greater fraction of available energy towards reproductive effort as they grow. Here, we propose an ecological explanation for this observation: differences between individuals in rates of resource assimilation, where greater assimilation causes both increased reproduction and body size, resulting in reproductive hyperallometry at the level of the population. We illustrate this effect by determining the relationship between size and reproduction in wild and lab-reared Trinidadian guppies. We show that (i) reproduction increased disproportionately with body size in the wild but not in the lab, where resource competition was eliminated and food availability restricted; (ii) in the wild, hyperallometry was greatest during the wet season, when resource competition is strongest; and (iii) detection of hyperallometric scaling of reproduction at the population level was inevitable if individual differences in assimilation were ignored. We propose that ecologically-driven variation in assimilation – caused by size-dependent resource competition, niche expansion, and chance – contributes substantially to hyperallometric scaling of reproduction in natural populations. We recommend that mechanistic models incorporate such ecologically-caused variation when seeking to explain reproductive hyperallometry.