bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autopsy Cardiac Troponin I Plasma Levels Can Be Elevated in Myocardial Infarction Type 3
Authors: Omalu Bennet , Diu Stephanie , Paudel Nirmal , Parson Susan J. , Hammers Jennifer L. 
Published: January 2021

Aims
The definition of myocardial infarction (MI) type 3 does not include the possible elevation of postmortem biomarkers if measured at autopsy. We determined postmortem cardiac troponin I (cTnI) levels in plasma samples obtained at autopsy in patients who died from MI type 3 to determine whether cTnI plasma levels may be elevated.

Methods and Results
Using a chemiluminescent microparticle immunoassay system, we determined postmortem cTnI plasma levels at autopsy performed within 24 hours of death in every decedent who died from MI type 3, confirmed by an autopsy. Over 2 years, autopsy confirmed 52 decedents who died from MI type 3 due to coronary atherosclerotic disease. The age range and mean age were 40 to 78 and 60.6 years, respectively, 38 (73%) men and 14 (27%) women. Ten percent of the decedents exhibited postmortem cTnI plasma levels that were within the normal reference levels (0.01–0.30 ng/mL). Ninety percent of the decedents exhibited elevated cTnI plasma levels at autopsy, which ranged from 0.31 to greater than 4400 ng/mL. Sixty-nine percent of our decedents showed severe/significant (75%–100%) luminal occlusion in 2 or 3 major coronary arteries.

Conclusions
If cTnI plasma levels are measured in autopsy blood samples after sudden and unexpected death due to MI type 3, highly elevated cTnI plasma levels may be detected. We propose that the current MI type 3 definition be slightly modified to include the possible elevation of cTnI plasma levels if measured at autopsy in the immediate postmortem period.
Complete Clinicopathological Case Report of a Young Patient Dying of COVID-19–Related Stroke
Authors: Taylor Laura D. , Ameen Ozayr Saleh , Zaharie Stefan-Dan 
Published: January 2021

Abstract
The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic has revealed diverse neurological manifestations of coronavirus disease 2019 (COVID-19). This case report begins with a background review of the neurological effects of COVID-19, focusing on stroke, neuroinflammation, and coagulopathy. It then describes the clinical course and autopsy findings of a young patient presenting with COVID-19–associated stroke. The formal neuropathological examination is presented, along with the systemic and brain histological features. Interesting aspects include multiterritory hemorrhagic infarctions, microinfarcts throughout the cortex and white matter, and prominent mixed inflammatory cell cuffing of intracerebral blood vessels distant from the infarcts.
Telemedicine in the Coronavirus Disease 2019 Pandemic
Authors: Chen Yuxi , Kathirithamby Dona Rani , Li Jinpu , Candelario-Velazquez Coral , Bloomfield Andrew , Ambrose Anne Felicia 
Published: January 2021

Abstract
In the spring of 2020, coronavirus disease 2019 evolved into a worldwide pandemic, forcing traditional face-to-face healthcare to a standstill. Telemedicine was quickly adopted as a major tool for pediatric rehabilitation services. This article describes the national legislative response of the United States to the coronavirus disease 2019 pandemic and the opportunities and challenges of implementing telemedicine in pediatric rehabilitation outpatient settings, consultations, as well as physician and patient education. The feasibility of performing a remote pediatric musculoskeletal and neurological tele-evaluation is also discussed. Although challenges exist, telemedicine has demonstrated its potential and has proven to be a practical system. Future developments in technology and accessibility, in addition to support from government and third-party payers, have the potential to make telemedicine an effective and vital platform in a coordinated healthcare system.
Pain Symptoms in COVID-19
Authors: Şahin Tülay , Ayyildiz Aylin , Gencer-Atalay Kardelen , Akgün Cem , Özdemir Haci Mustafa , Kuran Banu 
Published: January 2021

Objective
The clinical manifestations of COVID-19 range from mild symptoms to severe pneumonia and severe organ damage. When evaluated specifically for pain, the data so far have shown that myalgia, headache, and chest pain can be seen in patients at varying rates; myalgia and headache, especially, are among the initial symptoms.

Design
This retrospective chart review, followed by a descriptive survey design study, was carried out by examining patients afflicted with COVID-19. After discharge, patients were asked about the severity and the body region of their pain, their use of analgesics, their mood and mental health, and their overall quality of life.

Results
A total of 206 patients with a mean age of 56.24 ± 16.99 yrs were included in the study. Pain during COVID-19 was found to be higher compared with the preinfectious and postinfectious states. The most frequent painful areas were reported to be the neck and back before the infection, whereas the head and limbs during the infection. The most frequently used analgesic during infection was paracetamol. There was no relationship between the patients’ pain and anxiety and depression; the quality of life was found to be worse in patients with persistent pain.

Conclusions
This study showed that the head and limbs were the most common painful body regions during COVID-19. It was also found that pain can continue in the postinfection period.
Clustering of Social and Physical Pain Variables and Their Association With Mortality in Two Population-Based Cohorts
Authors: Kroenke Candyce H. , Alexeeff Stacey , Kushi Lawrence H. , Kwan Marilyn L. , Matthews Karen A. 
Published: January 2021

ABSTRACT

Objective
Social pain and physical pain are related bidirectionally, but how these variables cluster in the population is unknown.

Methods
This study included 2833 women from the Study of Women’s Health Across the Nation (SWAN), a community-based cohort of middle-aged women, and 3972 women from the Pathways Study, a population-based cohort of women diagnosed with American Joint Committee on Cancer stages I–IV breast cancer diagnosed between 2005 and 2013. Women provided data on measures related to social pain (social network size, social support, loneliness, social well-being) and physical pain (sensitivity to pain, bodily pain) at study baseline. Analyzing each cohort separately, we used latent class analysis to evaluate social-physical pain clusters, logistic regression to evaluate predictors of categorization into clusters, and Cox proportional hazards models to evaluate associations of clusters with all-cause mortality. We also performed a meta-analysis to combine cohort mortality associations.

Results
Each cluster analysis produced a “low social-physical pain” cluster (SWAN, 48.6%; Pathways, 35.2%) characterized by low social and pain symptoms, a “high social-physical pain” cluster (SWAN, 17.9%; Pathways, 17.9%) characterized by high symptoms, and a “low social/high physical pain” cluster of women with high pain and compromised social functioning but otherwise low social symptoms (SWAN, 33.5%; Pathways, 46.9%). In meta-analysis, categorization into the high social-physical pain cluster was associated with elevated mortality (adjusted hazard ratio = 1.34, 95% confidence interval = 1.05–1.71, Q statistic = 0.782), compared with those in the low social-physical pain cluster.

Conclusions
In two cohorts of women, latent class analysis produced similar sets of social-physical pain clusters, with the same proportion having both high social and pain symptoms; women in this cluster had elevated mortality.
Plasmatic Coagulation Capacity Correlates With Inflammation and Abacavir Use During Chronic HIV Infection
Authors: van der Heijden Wouter A. , Wan Jun , Van de Wijer Lisa , Jaeger Martin , Netea Mihai G. , van der Ven Andre J. , de Groot Philip G. , Roest Mark , de Mast Quirijn 
Published: January 2021

Background:
D-dimer concentrations in people living with HIV (PLHIV) on combination antiretroviral therapy (cART) are increased and have been linked to mortality. D-dimer is a biomarker of in vivo coagulation. In contrast to reports on D-dimer, data on coagulation capacity in PLHIV are conflicting. In this study, we assessed the effect of cART and inflammation on coagulation capacity.

Setting:
We explored coagulation capacity using calibrated thrombin generation (TG) and linked this to persistent inflammation and cART in a cross-sectional study including PLHIV with viral suppression and uninfected controls.

Methods:
We used multivariate analyses to identify independent factors influencing in vivo coagulation (D-dimer) and ex vivo coagulation capacity (TG).

Results:
Among 208 PLHIV, 94 (45%) were on an abacavir-containing regimen. D-dimer levels (219.1 vs 170.5 ng/mL, P = 0.001) and inflammatory makers (sCD14, sCD163, and high-sensitive C-reactive protein) were increased in PLHIV compared with those in controls (n = 56). PLHIV experienced lower TG (reflected by endogenous thrombin potential [ETP]) when compared with controls, after correction for age, sex, and antiretroviral therapy. Abacavir use was independently associated with increased ETP. Prothrombin concentrations were strongly associated with ETP and lower in PLHIV on a non–abacavir-containing regimen compared with those in controls, suggesting consumption as a possible mechanism for HIV-associated reduction in TG. D-dimer concentrations were associated with inflammation, but not TG.

Conclusions:
Abacavir use was associated with increased TG and could serve as an additional factor in the reported increase in thrombotic events during abacavir use. Increased exposure to triggers that propagate coagulation, such as inflammation, likely underlie increased D-dimer concentrations found in most PLHIV.
Interorganizational Collaboration in Emergency Cardiovascular Care
Authors: Langabeer James R. , Champagne-Langabeer Tiffany , Helton Jeffrey R. , Segrest Wendy , Kash Bita , DelliFraine Jami , Fowler Raymond 
Published: January 2021

Background:
Interorganizational collaboration management theory contends that cooperation between distinct but related organizations can yield innovation and competitive advantage to the participating organization. Yet, it is unclear if a multi-institutional collaborative can improve quality outcomes across communities.

Methods:
We developed a large regional collaborative network of 15 hospitals and 24 emergency medical service agencies surrounding Dallas, Texas, and collected patient-level data on treatment times for acute myocardial infarctions. Using a pre-/posttest research design, we applied median tests of differences to explore outcome changes between groups and over the 6-year period, using data extracted from participating hospital electronic health records.

Results:
We analyzed temporal trends and changes in treatment times for 2302 patients with ST-elevation myocardial infarction between the pre- and posttest groups. We found a statistically significant 19-minute median reduction in the key outcome metric (total ischemic time, the time difference between the patient's first reported symptoms and the definitive opening of the artery). This represents a 10.8% community-wide improvement over time.

Conclusions:
Interorganizational collaboration focused on quality improvement can impact population health across a community. This study provides a basis for broader understanding and participation by health care organizations in multi-institutional community change efforts.
Genetic Polymorphisms in Patients With Systemic Lupus Erythematosus and Jaccoud Arthropathy
Authors: Sousa Anna Paula Mota Duque , de Souza Costa Giselle Calasans , de Oliveira Costa Gustavo Nunes , Barbosa Lúcio Macedo , Grassi Maria Fernanda Rios , Monteiro Maria Eduarda Haerdy , dos Reis Mitermayer Galvão , Barreto Maurício Lima , Pedreira Ana Luisa , Ribeiro Daniel Sá , Lins Carolina Freitas , Galvão Verena , Santos Willer Gonçalves Dourado , Machicado Viviane , da Fonseca Emanuela Pimenta , Silva Carla Baleeiro Rodrigues , Santiago Mittermayer Barreto 
Published: January 2021

Introduction
Jaccoud arthropathy (JA) is a nonerosive and deforming arthropathy experienced frequently by patients with systemic lupus erythematosus (SLE). Although genetic polymorphisms are associated with SLE development, the association between genetic polymorphisms and JA has not been studied to date. The main objective of this study was to evaluate an association between HLA, STAT4, IRF5, and BLK polymorphisms and the presence of JA in Brazilian individuals with SLE.

Methods
Patients were selected from a cohort of individuals with SLE followed at 2 rheumatology reference centers in Salvador, Bahia, Brazil. The JA diagnosis was based on clinical and radiological criteria. The participants were genotyped for rs9271100, rs7574865, rs10488631, and rs13277113 polymorphisms in the HLA, STAT4, IRF5, and BLK genes, respectively, using real-time polymerase chain reaction. The presence of JA was correlated with allele frequencies, and clinical and laboratory data.

Results
One hundred forty-four individuals with SLE (38 with JA and 106 with SLE without JA) were studied. The mean age of the patients was 45 ± 12 years; the majority were women and had brown skin. Patients with JA had a longer disease duration than patients without JA. Serositis and neuropsychiatric manifestations were more frequent in the JA population. The A allele of rs13277113 in the BLK gene was associated with the presence of JA.

Conclusions
The rs13277113 polymorphism in the BLK gene was found to be a possible genetic risk for JA development. However, further studies in larger populations should be performed to confirm this finding.
Physicians' Biological Drug Preference in Patients With Rheumatoid Arthritis and Spondyloarthritis With a History of Malignancy
Authors: Tekgoz Emre , Colak Seda , Yardimci Kubra G. , Kucuksahin Orhan , Cinar Muhammet , Yilmaz Sedat , Kasifoglu Timucin , Bes Cemal , Yagiz Burcu , Erden Abdulsamet , Kilic Levent , Kanitez Nilufer A. , Ertenli Ali I. , Coskun Belkis N. , Ediboglu Elif D. , Mercan Ridvan , Kiraz Sedat , Yazisiz Veli , Karadag Omer , Atagunduz Pamir , Kalyoncu Umut 
Published: January 2021

Objective
Because of concerns about malignancy risks, using biological disease-modifying antirheumatic drugs (bDMARDs) in patients with a history of malignancy remains a challenging issue in rheumatology practice. This study aimed to investigate bDMARD preferences of physicians when treating of rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients with a history of malignancy.

Methods
The data for this cross-sectional study were gathered from the TReasure database using a date range of December 2017 and January 2020. Biological disease-modifying antirheumatic drug preferences were analyzed for 40 RA patients and 25 SpA patients with a history of malignancy.

Results
The most frequently prescribed bDMARD was rituximab, which was given to 28 RA patients (70%). For 25 patients (62.5%), the time between the diagnosis of malignancy and starting on a bDMARD regimen was less than 60 months, with a median interval of 43.5 months. Among SpA patients, the preferred bDMARDs were secukinumab and etanercept, which were each administered to 7 patients (28%). For 13 SpA patients (52%), the time between the diagnosis of malignancy and starting on bDMARDs was less than 60 months, with a median interval of 97 months.

Conclusions
The observed bDMARD preferences may be related to the therapeutic effects of rituximab on lymphoproliferative malignancies, the protective effects of secukinumab on tumor progression, and the short half-life of etanercept. Biological disease-modifying antirheumatic drugs should be used in RA and SpA patients with malignancy in case of high inflammatory activity.
Metastatic Adamantinoma of the Femur on FDG PET/CT
Authors: Martineau Patrick , Bloise Ingrid , Gowdy Claire , Worsley Daniel 
Published: January 2021

Abstract
Adamantinomas are rare malignant primary bone tumors, which typically arise in young patients, are generally low-grade tumors, and classically arise from the anterior tibial diaphysis. We present the case of a 70-year-old woman who underwent repeat imaging with FDG PET for a pathologically proven case of femoral adamantinoma who experienced a relatively rapid development of metastatic disease with an atypical distribution of lesions.
Impact of a Long Linear Staplers on the Incidence of Stricture after Triangulating Esophagogastric Anastomosis
Authors: Toyota Satoshi , Kimura Yasue , Jogo Tomoko , Hu Qingjiang , Hokonohara Kentaro , Nakanishi Ryota , Hisamatsu Yuichi , Ando Koji , Oki Eiji , Mori Masaki 
Published: January 2021

Background:
Various techniques have been reported for esophagogastric anastomosis to prevent anastomotic leakage. Recently, not only postoperative anastomotic leakage but also anastomotic stricture is considered important because stricture contributes to the patient’s postoperative quality of life. However, the best procedure for anastomosis has not been established.

Materials and Methods:
The authors divided 101 patients with thoracic or abdominal esophageal cancer who underwent cervical triangulating esophagogastric anastomosis using a linear stapler between May 2017 and May 2020 into 2 groups: surgery with a short (45 mm) linear stapler (SS group, n=59) or a long (60 mm) stapler (LS group, n=42). The frequencies of anastomotic leakage and stricture were compared between the 2 groups.

Results:
The incidence of anastomotic leakage and stricture without leakage were significantly lower in the LS versus SS group (respectively: leakage: 15% vs. 0%, P=0.01; stricture: 36% vs. 7%, P=0.01). A short linear stapler and anastomotic leakage were independent risk factors for anastomotic stricture in the multivariate analysis (short stapler: odds ratio, 3.27; 95% confidence interval, 1.08-9.9; P=0.03; anastomotic leakage: odds ratio, 2.78; 95% confidence interval, 1.02-8.5; P=0.04).

Conclusion:
A long linear stapler is preferable for cervical triangulating esophagogastric anastomosis.
TXN, a Xanthohumol Derivative, Attenuates High-Fat Diet Induced Hepatic Steatosis by Antagonizing PPARγ
Authors: Zhang Yang , Bobe Gerd , Miranda Cristobal L. , Lowry Malcolm B. , Hsu Victor L. , Löhr Christiane V. , Wong Carmen P. , Jump Donald B. , Robinson Matthew M. , Sharpton Thomas J. , Maier Claudia S. , Stevens Jan F. , Gombart Adrian F. 
Published: January 2021

AbstractWe previously reported xanthohumol (XN), and its synthetic derivative tetrahydro-XN (TXN) attenuates high-fat diet (HFD) induced obesity and metabolic syndrome in C57BL/6J mice. The objective of the current study was to determine the effect of XN and TXN on lipid accumulation in the liver. Non-supplemented mice were unable to adapt their caloric intake to 60% HFD, resulting in obesity and hepatic steatosis; however, TXN reduced weight gain and decreased hepatic steatosis. Liver transcriptomics indicated TXN might antagonize lipogenic PPARγ actionsin vivo. XN and TXN inhibited rosiglitazone-induced 3T3-L1 cell differentiation concomitant with decreased expression of lipogenesis-related genes. A PPARγ competitive binding assay showed XN and TXN bind to PPARγ with an IC50similar to pioglitazone and 8-10 times stronger than oleate. Molecular docking simulations demonstrated XN and TXN bind in the PPARγ ligand-binding domain pocket. Our findings are consistent with XN and TXN acting as antagonists of PPARγ.
Diverse functions associate with trans-species polymorphisms in humans
Authors: Velázquez-Arcelay Keila , Benton Mary Lauren , Capra John A. 
Published: January 2021

AbstractLong-term balancing selection (LTBS) can maintain allelic variation at a locus over millions of years and through speciation events. Variants shared between species, hereafter “trans-species polymorphisms” (TSPs), often result from LTBS due to host-pathogen interactions. For instance, the major histocompatibility complex (MHC) locus contains TSPs present across primates. Several hundred TSPs have been identified in humans and chimpanzees; however, because many are in non-coding regions of the genome, the functions and adaptive roles for most TSPs remain unknown. We integrated diverse genomic annotations to explore the functions of 125 previously identified non-coding TSPs that are likely under LTBS since the common ancestor of humans and chimpanzees. We analyzed genome-wide functional assays, expression quantitative trait loci (eQTL), genome-wide association studies (GWAS), and phenome-wide association studies (PheWAS). We identify functional annotations for 119 TSP regions, including 71 with evidence of gene regulatory function from GTEx or genome-wide functional genomics data and 21 with evidence of trait association from GWAS and PheWAS. TSPs in humans associate with many immune system phenotypes, including response to pathogens, but we also find associations with a range of other phenotypes, including body mass, alcohol intake, urate levels, chronotype, and risk-taking behavior. The diversity of traits associated with non-coding human TSPs suggest that functions beyond the immune system are often subject to LTBS. Furthermore, several of these trait associations provide support and candidate genetic loci for previous hypothesis about behavioral diversity in great ape populations, such as the importance of variation in sleep cycles and risk sensitivity.Significance statementMost genetic variants present in human populations are young (<100,000 years old); however, a few hundred are millions of years old with origins before the divergence of humans and chimpanzees. These trans-species polymorphisms (TSPs) were likely maintained by balancing selection—evolutionary pressure to maintain genetic diversity at a locus. However, the functions driving this selection, especially for non-coding TSPs, are largely unknown. We integrate genome-wide annotation strategies to demonstrate TSP associations with immune system function, behavior (addition, cognition, risky behavior), uric acid metabolism, and many other phenotypes. These results substantially expand our understanding of functions TSPs and suggest a substantial role for balancing selection beyond the immune system.
Effects of transcranial alternating current stimulation on spiking activity in computational models of single neocortical neurons
Authors: Tran Harry , Shirinpour Sina , Opitz Alexander 
Published: January 2021

AbstractNeural oscillations are a key mechanism for information transfer in brain circuits. Rhythmic fluctuations of local field potentials control spike timing through cyclic membrane de- and hyperpolarization. Transcranial alternating current stimulation (tACS) is a non-invasive neuromodulation method which can directly interact with brain oscillatory activity by imposing an oscillating electric field on neurons. Despite its increasing use, the basic mechanisms of tACS are still not fully understood. Here, we investigate in a computational study the effects of tACS on morphologically realistic neurons with ongoing spiking activity. We characterize the membrane polarization as a function of electric field strength and subsequent effects on spiking activity in a set of 25 neurons from different neocortical layers. We find that tACS does not affect the firing rate of investigated neurons for electric field strengths applicable to human studies. However, we find that the applied electric fields entrain the spiking activity of large pyramidal neurons at < 1mV/mm field strengths. Our model results are in line with recent experimental studies and can provide a mechanistic framework to understand the effects of oscillating electric fields on single neuron activity. They highlight the importance of neuron morphology in responsiveness to electrical stimulation and suggest that large pyramidal neurons are most likely the prime target for tACS.