bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunotherapy‐responsive brainstem lesion accompanied with anti‐galactocerebroside antibody
Authors: Shiraishi Wataru 
Published: July 2021

AbstractBackgroundBrainstem lesions are a diagnostic challenge and clinicians have to differentiate between many diseases including acute disseminated encephalomyelitis, multiple sclerosis (MS), Bickerstaff brainstem encephalitis (BBE) and brain tumors. The anti‐galactocerebroside (Gal‐C) antibody is an anti‐glycolipid antibody that is often detected in autoimmune peripheral neuropathy. However, anti‐Gal‐C antibody is rarely detected in autoimmune central nervous system diseases. Here, we report the case of an anti‐Gal‐C antibody‐positive patient who had a brainstem lesion that mimicked MS and responded to immunotherapy.Case presentationWe report a 32‐year‐old woman who presented with subacute numbness of the right lower extremities and hemiataxia. Her cerebrospinal fluid examination showed an elevated myelin basic protein level and an oligoclonal band. Brain magnetic resonance imaging showed a T2 high‐intensity lesion from the left brainstem to the cerebellum. She was treated with steroid pulse therapy, but internuclear ophthalmoplegia and left peripheral facial palsy developed. Her brain magnetic resonance imaging showed an enlargement of the brainstem lesion. Therefore, plasma exchange therapy and high‐dose immunoglobulin therapy were administered, and her symptoms eventually ameliorated. First, we diagnosed her with MS and started dimethyl fumarate. After anti‐GM2 and anti‐Gal‐C antibody positivity was revealed, we diagnosed an anti‐Gal‐C antibody‐related brainstem lesion. There have been few reports of anti‐Gal‐C antibody‐positive central nervous system diseases.ConclusionsThe present case highlights that an anti‐Gal‐C positivity can cause brainstem inflammatory lesions, which should be differentiated from acute disseminated encephalomyelitis, Bickerstaff brainstem encephalitis and MS. The patient’s symptoms improved with intense immunotherapy, and antibody measurement led to the discontinuation of unnecessary disease‐modifying drugs.
Distance Wagner tree refinement as a heuristic approach to character‐based initial tree construction
Authors: Wheeler Ward C. 
Published: July 2021

AbstractThe distance Wagner procedure of Farris (American Naturalist, 1972, 106, 645), in its original or random addition sequence form, is a rapid method of tree construction. The original formulation did not allow for refinement of tree hypotheses via common trajectory search operations (e.g. SPR, TBR). Here, the distance Wagner method is extended to allow for refinement of initial trees produced via the four‐point condition (Mathematics and the Archeological and Historical Sciences, Edinburgh University Press, Edinburgh, 1974). The performance of the extended distance Wagner as a heuristic search procedure is evaluated with several unaligned sequences and combined source datasets within the parsimony framework. Distance Wagner both with and without refinement is shown to be a rapid and useful heuristic method to generate initial trees for further, character‐based, analysis.
Difference in absolute lymphocyte count among male and female heart transplant recipients
Authors: Perry Whitney A. , Chow Jennifer K. , Snydman David R. 
Published: July 2021

AbstractThe impact of sex on immune composition in the setting of solid organ transplantation is unknown. Immunocompetent men and women have quantitative differences in multiple markers of immunity, including lymphocyte subsets. Lymphocytes are of particular interest given the routine use of medications targeted at cell‐mediated immunity. The objective of this retrospective cohort study was to compare absolute lymphocyte count (ALC) measurements of male and female heart recipients immediately before, and 1 month after, transplantation. Data was collected on 375 adult recipients (104 female and 271 male) from 2000 to 2018 at a single center. Mean ALC was compared using Student's t‐test. Women had higher mean ALC both at baseline (female 1.6 × 103 cells/μl vs. male 1.3 × 103 cells/μl; P < .001) and at 1 month post‐transplantation (mean 1.2 × 103 cells/μl vs. .8 × 103 cells/μl; P < .001). This finding could have important implications for sex‐based differences in predisposition to rejection or response to infection or vaccination.
eDNA metabarcoding in lakes to quantify influences of landscape features and human activity on aquatic invasive species prevalence and fish community diversity
Authors: Pukk Lilian , Kanefsky Jeannette , Heathman Amanda L. , Weise Ellen M. , Nathan Lucas R. , Herbst Seth J. , Sard Nicholas M. , Scribner Kim T. , Robinson John D. 
Published: July 2021

AbstractAimOur goal was to use eDNA metabarcoding to characterize fish community diversity, detect aquatic invasive species (AIS) and assess how measures of community (or AIS) diversity are influenced by lake physical and environmental covariates, measures of hydrological connectivity and human accessibility.LocationMichigan, USA.MethodseDNA samples collected from 22 lakes were sequenced using two mitochondrial gene regions (12S and 16S rRNA). Metabarcoding data were compared to traditional fisheries survey data for a subset of lakes, and data from all 22 lakes were combined with environmental information to identify significant associations with community diversity and AIS relative abundance.ResultsOccupancy modelling indicated that detection probabilities were generally higher with eDNA than traditional fisheries gear. Measures of connectivity with upstream aquatic habitats were positively associated with both AIS relative abundance and fish species diversity. We also demonstrate the use of spatial interpolation methods to map distributions of species diversity and AIS relative abundance within lakes.Main conclusionseDNA metabarcoding methods provided information on the composition and diversity of fish assemblages and the presence of AIS in freshwater lakes that varied greatly in drainage connectivity and anthropogenic development. Our case study identified associations between environmental covariates and fish diversity or AIS relative abundance across lakes. This information is of particular importance given increasing anthropogenic disturbance, invasive species spread and associated declines in aquatic biodiversity. Incorporating eDNA metabarcoding as a supplement to traditional fisheries surveys will permit managers to identify greater numbers of taxa, including early detection of AIS, with less field effort and fish mortality. Further, eDNA methods may more accurately identify physical and biological features that correlate with diversity and abundance and allow agencies to more effectively direct AIS management activities.
Modelling the biodiversity enhancement value of seagrass beds
Authors: McHenry Jennifer , Rassweiler Andrew , Hernan Gema , Uejio Christopher K. , Pau Stephanie , Dubel Alexandra K. , Lester Sarah E. 
Published: July 2021

AbstractAimSeagrass beds are declining globally and are increasingly vulnerable to sea level rise (SLR), which could have consequences for the rich biodiversity they support. Spatial variation in the role of seagrass beds in enhancing biodiversity is poorly resolved, limiting our ability to set priorities for conservation and restoration. We aimed to model the biodiversity enhancement value of seagrass beds.LocationFlorida Gulf Coast, USA.MethodsWe used generalized additive mixed models (GAMMs) to describe the distribution, total cover and species composition of seagrass beds and to estimate their effects on spatial patterns of faunal species richness under three scenarios. Specifically, we: (a) quantified the biodiversity enhancement value of current seagrass beds, (b) inferred the biodiversity value of potential restoration areas and (c) projected potential changes in the distribution and biodiversity enhancement value of seagrass beds due to SLR using low (+0.50 m) and high (+1.0 m) SLR forecasts for 2100.ResultsCurrent seagrass beds supported 43%–64% more species than unvegetated habitats, even when accounting for spatial variability in predicted faunal richness due to other environmental, seascape, temporal and geographic factors. Seagrass restoration in potential habitats would also increase biodiversity in the near‐term (i.e., 43%–45% above unvegetated levels). However, model projections indicate that SLR could result in significant losses of current seagrass beds and potential restoration areas, causing contracted distributions and lower seagrass cover. Overall, these changes could result in significant reductions in the enhancement value provided by seagrasses. Although, there could also be many suitable locations for seagrasses by 2100, with some having either comparable or potentially increased enhancement value.Main conclusionsOur findings highlight the importance of considering spatial variation in biodiversity benefits when planning for seagrass conservation and restoration and when managing the impacts of SLR.
Randomized trial comparing the 25G and 22G Franseen needles in endoscopic ultrasound‐guided tissue acquisition from solid pancreatic masses for adequate histological assessment
Authors: Tomoda Takeshi , Kato Hironari , Fujii Yuuki , Yamazaki Tatsuhiro , Matsumoto Kazuyuki , Horiguchi Shigeru , Tsutsumi Koichiro , Inoue Hirofumi , Tanaka Takehiro , Mitsuhashi Toshiharu , Okada Hiroyuki 
Published: July 2021

BackgroundThe effects of the Franseen needle size in endoscopic ultrasound‐guided fine‐needle biopsy (EUS‐FNB) of solid pancreatic masses remain unclear. This study aimed to compare 25G and 22G Franseen needles in terms of adequate tissue acquisition from solid pancreatic masses.MethodsIn this single‐center, crossover, randomized noninferiority trial, eligible patients underwent EUS‐FNB with both 25G and 22G Franseen needles in a randomized order between November 2018 and August 2020. Tissue specimens from each pass were separately evaluated based on the cellularity scoring system. The primary outcome was the proportion of acquired specimens allowing adequate histological assessment (cellularity score ≥3). A –15% noninferiority margin was assumed.ResultsData from 88 patients were analyzed, which showed malignant and benign lesions in 84 (95.5%) and four (4.5%) patients, respectively. Of the 88 specimens, 62 (70.5%) and 69 (78.4%) acquired using 25G and 22G needles, respectively, allowed adequate histological assessment.The adjusted proportion difference was –6.6% (95% confidence interval –8.8% to –4.5%), indicating noninferiority of the 25G Franseen needle (P < 0.001). The diagnostic accuracies of the 25G and 22G needles were 86.4% and 89.8%, respectively, with no significant difference (P = 0.180). Adverse events occurred in one patient.ConclusionsThe 25G Franseen needle showed a noninferior adequate tissue acquisition and similar diagnostic performance compared to that of the 22G Franseen needle. However, a 15% noninferiority margin was high for clinical use; thus, further consideration is needed (Clinical Trial Registry no. UMIN000034596).
The SARS‐CoV‐2 pandemic is associated with increased severity of presentation of childhood onset type 1 diabetes mellitus: A multi‐centre study of the first COVID‐19 wave
Authors: McGlacken‐Byrne Sinéad M. , Drew Samantha E. V. , Turner Kelly , Peters Catherine , Amin Rakesh 
Published: July 2021

AbstractObjectiveChildren are usually mildly affected by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2, COVID‐19). However, the pandemic has caused collateral damage to those with non‐COVID‐19 diseases. We aimed to determine the impact of the COVID‐19 pandemic on the presentation of newly diagnosed childhood onset type 1 diabetes.MethodsThis was a cross‐sectional study conducted over a 1‐year period. We compared the severity of presentation of new‐onset type 1 diabetes in children under the age of 18 presenting to the multi‐centre North Central London diabetes network before (1 July 2019 to 22 March 2020) and during (23 March 2020 to 30 June 2020) the first wave of the COVID‐19 pandemic in the United Kingdom.ResultsOver the 1‐year study period, a total of 30 children presented with new‐onset type 1 diabetes during the pre‐pandemic period and 17 presented during the first COVID‐19 wave. Children presented more frequently in diabetic ketoacidosis (DKA) during the first COVID‐19 wave compared with pre‐pandemic (pre‐pandemic: mild 13%, moderate 6.7%, severe 10%; first COVID‐19 wave: mild 5.9%, moderate 24%, severe 47%; p = 0.002). During the first COVID‐19 wave, DKA presentations in children with a family history of type 1 diabetes were fewer compared to those without a family history (33.3% vs. 100.0%; p = 0.006). Children presenting in severe DKA pre‐pandemic were younger than those not in severe DKA (3.9 years vs. 12.2 years, p < 0.001) but this difference was not significant during the first COVID‐19 wave (10.1 years vs. 11.2 years, p = 0.568). Presenting HbA1c measurement was higher in those presenting during the first COVID‐19 wave (13.0 ± 1.7 vs. 10.4 ± 3.2%; 119 ± 19 vs. 90 ± 35 mmol/mol; p = 0.008).ConclusionThe COVID‐19 pandemic is associated with increased severity of presentation of childhood onset type 1 diabetes. Whatever the context, young people with suspected new‐onset type 1 diabetes should be referred for urgent clinical review.
Validation of non‐formal and informal learning to support disadvantaged learners: Alternative assessments
Authors: Looney Janet , Santibañez Barbara 
Published: July 2021

AbstractThe European Union has set the goal to make lifelong learning a reality for more people through the creation of flexible pathways to improve access to higher levels of education and employment. Validation of non‐formal and informal learning (VNFIL), which is intended to make learning from everyday work and life visible, is an important means to this goal. Nevertheless, in many countries take‐up of VNFIL remains low among disadvantaged groups. While a variety of factors, such as outreach and accessibility of VNFIL, may affect take‐up, the VNFIL approach and quality of assessment are important factors. This article describes alternative VNFIL assessment approaches identified in Innoval (2016–2018), an Erasmus+ project focused on supporting and empowering disadvantaged learners as they pursue further education, employment and/or certification.
Risk of infection according to the gamma globulin level in the 100 days following allogeneic stem cell transplantations
Authors: Lacombe Valentin , Nunes Gomes Christopher , Robin Jean‐Baptiste , Thépot Sylvain , François Sylvie , Cottin Laurane , Ugo Valérie , Dieu Xavier , Abgueguen Pierre , Daniel Valérie , Giltat Aurélien , Hunault Mathilde , Riou Jérémie , Orvain Corentin , Schmidt Aline 
Published: July 2021

AbstractBackgroundImmunoglobulin replacement therapy is recommended in case of severe hypogammaglobulinemia after allogeneic hematopoietic stem cell transplantation (allo‐HSCT). However, the supposed increased risk of infection in case of hypogammaglobulinemia has not been confirmed in allo‐HSCT. In this study, we assessed the relationship between the gamma globulin level and the risk of infection during the 100 days following the allo‐HSCT.MethodsWe gathered the weekly laboratory tests from day 7 to day 100 of 76 allograft patients, giving a total of 1 044 tests. 130 infections were documented clinically, by imaging, or microbiologically.ResultsAverage gamma globulin levels between D‐7 and D100 did not differ between patients with or without infection (642 ± 232 and 671 ± 246 mg/dL, respectively, P = .65). Gamma globulin level <400 mg/dl was not associated with the occurrence of infection between the test studied and the next one (aOR 1.33 [0.84‐2.15], P = .24). The gamma globulin level was not predictive of bacterial or fungal infections (AUC 0.54 [95%CI: 0.47‐0.61]) nor of viral reactivations (AUC 0.51 [95%CI: 0.43‐0.60]).ConclusionsThis confirmed that the humoral deficiency is a minor part of the immune deficiency in the 100 days post‐transplant. This questions the relevance of the indications of immunoglobulin substitution during this period.
The role of maternally transferred antibodies in maternal performance in red deer
Authors: Gauzere Julie , Walling Craig A. , Pick Joel L. , Watt Kathryn , Jack Penny , Morris Alison , Morris Sean , Pemberton Josephine M. 
Published: July 2021

AbstractMaternal effects are ubiquitous. Yet, the pathways through which maternal effects occur in wild mammals remain largely unknown. We hypothesise that maternal immune transfer is a key mechanism by which mothers can affect their offspring fitness, and that individual variation in maternally derived antibodies mainly depends on a mother's characteristics and the environmental conditions she experiences. To test this, we assayed six colostrum‐derived antibodies in the plasma of 1447 neonates in a wild red deer population. Neonatal antibody levels were mainly affected by maternal genes, environmental variation and costs of prior reproductive investment. We found consistent heterogeneity in maternal performance across traits, with mothers producing the heaviest calves also having calves with more antibodies. Unexpectedly, antibody levels were not associated with calf survival. We provide a unique example of how evolutionary theory on maternal effects can be used to gain insight into the causes of maternal effects in wild populations.
Clinical and radiological characteristics of older‐adult‐onset Alexander disease
Authors: Yoshida Tomokatsu , Mizuta Ikuko , Yasuda Rei , Mizuno Toshiki 
Published: July 2021

AbstractBackgroundAlexander disease (ALXDRD) affects a wide range of ages from infancy to adulthood. However, only a few cases involving patients with older‐adult onset over 65 years of age have been reported. In contrast, regarding in‐house data, 10.6% of 85 cases with the identification of GFAP mutations demonstrated older‐adult onset. This discrepancy may be due to poor awareness of such cases.MethodsThe subjects included 9 older‐adult‐onset cases, with an onset age of 65 years or older. We characterized older‐adult‐onset ALXDRD by assessing neurological findings and several magnetic resonance imaging (MRI) parameters.ResultsThe age at onset, mean age at diagnosis, and mean period from onset to diagnosis were 68.2 years, 70.4 years, and 2.2 years, respectively. The main neurological features at diagnosis included pyramidal signs with muscle weakness and/or cerebellar ataxia. Two‐thirds of cases were dependent, and the dependence was significantly correlated with a longer period from onset to diagnosis. Quantitative MRI evaluation for brainstem atrophy demonstrated distinctive morphological features of bulbospinal ALXDRD. The corpus callosum index tended to be negatively correlated with the period from onset to diagnosis.ConclusionsAlthough neurological and MRI findings of older‐adult‐onset ALXDRD patients showed typical features of bulbospinal ALXDRD, their disease progression was more severe than that in younger‐adult‐onset ALXDRD, and patients developed dependence within 2 years from onset. Cerebral white matter damage tended to progress in proportion to the duration of illness. Our case study may help to advance understanding of the clinical spectrum of ALXDRD.
Acute thalamic damage as a prognostic biomarker for post‐traumatic epileptogenesis
Authors: Manninen Eppu , Chary Karthik , Lapinlampi Niina , Andrade Pedro , Paananen Tomi , Sierra Alejandra , Tohka Jussi , Gröhn Olli , Pitkänen Asla 
Published: July 2021

AbstractObjectiveTo identify magnetic resonance imaging (MRI) biomarkers for post‐traumatic epilepsy.MethodsThe EPITARGET (Targets and biomarkers for antiepileptogenesis, epitarget.eu) animal cohort completing T2 relaxation and diffusion tensor MRI follow‐up and 1‐month‐long video‐electroencephalography monitoring included 98 male Sprague‐Dawley rats with traumatic brain injury and 18 controls. T2 imaging was performed on day (D) 2, D7, and D21 and diffusion tensor imaging (DTI) on D7 and D21 using a 7‐Tesla Bruker PharmaScan MRI scanner. The mean and standard deviation (SD) of the T2 relaxation rate, multiple diffusivity measures, and diffusion anisotropy at each time‐point within the ventroposterolateral and ventroposteromedial thalamus were used as predictor variables in multi‐variable logistic regression models to distinguish rats with and without epilepsy.ResultsTwenty‐nine percent (28/98) of the rats with traumatic brain injury (TBI) developed epilepsy. The best‐performing logistic regression model utilized the D2 and D7 T2 relaxation time as well as the D7 diffusion tensor data. The model distinguished rats with and without epilepsy (Bonferroni‐corrected p‐value < .001) with a cross‐validated concordance statistic of 0.74 (95% confidence interval [CI] 0.60–0.84). In a cross‐validated classification test, the model exhibited 54% sensitivity and 91% specificity, enriching the epilepsy rate within the study population from the expected 29% to 71%. A model using the D2 T2 data only resulted in a 73% enriched epilepsy rate (regression p‐value .007, cross‐validated concordance 0.70, 95% CI 0.56–0.80, sensitivity 29%, specificity 96%).SignificanceAn MRI parameter set reporting on acute and subacute neuropathologic changes common to experimental and human TBI presents a diagnostic biomarker for post‐traumatic epileptogenesis. Significant enrichment of the study population was achieved even when using a single time‐point measurement, producing an expected epilepsy rate of 73%.
Understanding cardiovascular disease in older adults with epilepsy
Authors: Husein Nafisa , Josephson Colin B. , Keezer Mark R. 
Published: July 2021

AbstractObjectiveThis study was undertaken to investigate the distribution of social, lifestyle/behavior, and chronic disease risk factors for cardiovascular disease (CVD) in people with epilepsy as compared to the general population. We also measured the cross‐sectional association between epilepsy and CVD in older adults, with and without adjustments for a history of stroke.MethodsWe analyzed data for 44 817 participants in the Canadian Longitudinal Study on Aging, including 751 individuals with a lifetime history of epilepsy. We modeled associations using ordinal and binomial logistic regression, as well as log‐binomial regression, with multiple imputation for missing data. We measured the attributable fraction of CVD burden due to stroke.ResultsThe majority of the CVD risk factors were significantly more prevalent in people with epilepsy as compared to the general population without epilepsy, independent of age and sex. After adjusting for a history of stroke, people with epilepsy had a significantly higher prevalence of heart disease (prevalence ratio [PR] = 1.27, 95% confidence interval [CI] = 1.02–1.57) and peripheral vascular disease (PR = 1.88, 95% CI = 1.50–2.36). Stroke accounted for 36% (95% CI = 19.85–48.76) of the increased prevalence of any CVD among people with epilepsy, similar to the 32% (95% CI = 27.82–36.25) among people without epilepsy. After adjustment for all other CVD risk factors, peripheral vascular disease remained significantly more prevalent (PR = 1.65, 95% CI = 1.28–2.12) in people with epilepsy as compared to those without.SignificanceCVD risk factors are more prevalent in people with epilepsy, independent of age and sex, and the association between epilepsy and CVD is independent of the association between epilepsy and stroke. The association between peripheral vascular disease and epilepsy may differ from the associations with other types of CVD. These findings are important steps in more comprehensively understanding the origins of CVD in people with epilepsy.