bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pneumocystis pneumonia secondary to intensive immunosuppression treatment for anti-GBM disease complicated with IgA nephropathy
Authors: Zhang Manyu , Yang Dingwei , Wang Weixiu , Zhao Fuhao , Zhang Xiaoxiao , Li Xue 
Published: November 2021

Abstract

Rationale:
The estimated incidence of anti-glomerular basement membrane (anti-GBM) disease complicated with immunoglobulin A (IgA) nephropathy is minimal, there have only been 15 cases (including this case) reported in the literature, and only 5 (33.33%) of them showed significant improvement in renal function after treatment. Pneumocystis pneumonia is a severe opportunistic pulmonary infection of pneumocystis jiroveci in immunocompromised patients. Here, we report a case of pneumocystis pneumonia secondary to intensive immunosuppression treatment for anti-GBM disease complicated with IgA nephropathy, with no similar reports or studies published before to our knowledge.

Patient concerns:
The patient was admitted to our hospital with a 1-week diagnosis of crescent glomerulonephritis who had been suffered from hematuria and foamy urine for more than 1 month. Before admission, the patient received pulse dose intravenous methylprednisolone and immunosuppression with rituximab, but the renal function and titer of pathogenic antibody did not improve significantly.

Diagnosis:
Crescentic glomerulonephritis, anti-glomerular basal membrane disease complicated with IgA nephropathy (Type I+II) was pathologically confirmed by renal biopsy. Secondary pneumocystis pneumonia was diagnosed by acute progressive respiratory failure, chest computed tomography and metagenomic next-generation sequencing of transbronchoscopic bronchoalveolar lavage fluid.

Interventions:
The key to successful treatment was to make the pathogenic antibody turn negative quickly by combining pulse dose intravenous methylprednisolone, immunosuppression with rituximab, and plasma exchange therapy. Early identification of pneumocystis pneumonia, accurate etiological identification, and active anti-infective treatment were also crucial.

Outcomes:
The patient was discharged after 16 days of anti-infection with secondary infection controlled and dialysis catheter removed. Up to now, the patient has been followed for a period of 28 weeks, results showed renal function had been repaired even hematuria and proteinuria were basically alleviated.

Lessons:
Our case provided experience in the treatment of anti-GBM disease complicated with IgA nephropathy, further proposed the potential therapeutic effects of rituximab, also illustrated low dose hormone combined with tacrolimus can be used as sequential therapy after plasma exchange and intensive immunosuppression. Our research also suggested that resulting in severe immune suppression, a high risk of secondary pneumocystis opportunistic infection should be aware of. metagenomic next-generation sequencing might increase the detection rate of the pathogen.
Relationship between the proficiency level and anxiety-reducing effect in a one-time heart rate variability biofeedback
Authors: Saito Ryuji , Sawamura Daisuke , Yoshida Kazuki , Sakai Shinya 
Published: November 2021

Abstract

Introduction:
Previous studies have reported that the proficiency level of heart rate variability biofeedback (HRVBF) contributes significantly to the anxiety-reducing effects in continuous HRVBF interventions. Meanwhile, anxiety-reducing effects have been confirmed in one-time HRVBF interventions as well as continuous HRVBF; however, no study has analyzed the relationship between the proficiency level of a one-time HRVBF and its anxiety-reducing effects. To pursuit the effectiveness of a one-time HRVBF intervention, it is necessary to clarify whether the proficiency level is an important predictor of anxiety-reducing effects from a dose-response relationship between these 2 variables. The purpose of this study was to examine the dose-response relationship between the proficiency level and anxiety-reducing effects of a one-time HRVBF.

Methods:
This study was a single-blinded, randomized, controlled trial with stratification based on trait anxiety of the State-Trait Anxiety Inventory-JYZ. In total, 45 healthy young males aged 20 to 30 years were allocated to the HRVBF or control group with simple breathing at rest. The intervention was performed for 15 minute in each group. The state anxiety score of the State-Trait Anxiety Inventory-JYZ was measured to evaluate the anxiety-reducing effect before and after training.

Results:
The results showed no significant linear relationship between the proficiency level and anxiety-reducing effect, and variations in the proficiency level were observed post-intervention in the HRVBF group. A significant anxiety-reducing effect was only observed in the HRVBF group (P = .001, effect size r = 0.62).

Conclusions:
These results suggest that there is no close relationship between the proficiency level and anxiety-reducing effect in one-time HRVBF and that HRVBF is effective in reducing anxiety regardless of individual differences in the proficiency level. Therefore, a one-time HRVBF may be a useful breathing technique for reducing state anxiety without specific education and breathing techniques.

Trial registration:
University Hospital Medical Information Network Clinical Trial Registry (UMIN000041760).
APOL1 renal risk variants are associated with obesity and body composition in African ancestry adults
Authors: Nadkarni Girish N. , Fei Kezhen , Galarneau Genevieve , Gao Yan , Wilson James G. , Cooper Richard , Madden Ebony B. , Denny Joshua C. , Richardson Lynne D. , Pollak Martin , Loos Ruth J. F. , Horowitz Carol R. 
Published: November 2021

Abstract
While increased obesity prevalence among persons of African ancestry (AAs) compared to persons of European ancestry (EAs) is linked to social, environmental and behavioral factors, there are no gene variants that are common and significantly associated with obesity in AA populations. We sought to explore the association between ancestry specific renal risk variants in the apolipoprotein L1 (APOL1) gene with obesity related traits in AAs.
We conducted a genotype–phenotype association study from 3 electronic medical record linked cohorts (BioMe Biobank, BioVU, nuGENE); randomized controlled trials (genetic testing to understand and address renal disease disparities) and prospective cohort study (Jackson Heart Study). We analyzed association of APOL1 renal risk variants with cross-sectional measures of obesity (average body mass index (BMI), and proportion of overweight and obesity) and with measures of body composition (in Jackson Heart Study).
We had data on 11,930 self-reported AA adults. Across cohorts, mean age was from 42 to 49 years and percentage female from 58% to 75.3%. Individuals who have 2 APOL1 risk alleles (14% of AAs) have 30% higher obesity odds compared to others (recessive model adjusted odds ratio 1.30; 95% confidence interval 1.16–1.41; P = 2.75 × 10−6). An additive model better fit the association, in which each allele (47% of AAs) increases obesity odds by 1.13-fold (adjusted odds ratio 1.13; 95% confidence interval 1.07–1.19; P = 3.07 × 10−6) and increases BMI by 0.36 kg/m2 (∼1 kg, for 1.7 m height; P = 2 × 10−4). APOL1 alleles are not associated with refined body composition traits overall but are significantly associated with fat free mass index in women [0.30 kg/m2 increment per allele; P = .03].
Thus, renal risk variants in the APOL1 gene, found in nearly half of AAs, are associated with BMI and obesity in an additive manner. These variants could, either on their own or interacting with environmental factors, explain a proportion of ethnic disparities in obesity.
Proximal gastrectomy with double-tract reconstruction versus total gastrectomy for proximal early gastric cancer
Authors: Xiang Renshen , Song Wei , Ren Jun , Lu Wei , Zhang Heng , Fu Tao 
Published: November 2021

Abstract

Background:
The incidence of proximal gastric cancer in the gastric fundus, cardia, and other parts is increasing rapidly. The purpose of this study was to systematically compare the short-term and long-term clinical effects of proximal gastrectomy with double tract reconstruction (PG-DTR) to total gastrectomy (TG) for proximal early gastric cancer (EGC).

Methods:
A systematic review and meta-analysis was conducted through searching the literature in PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, WAN FANG, and VIP databases. All clinical controlled trials and randomized controlled trials (RCTs) of PG-DTR and PG were included. Simultaneously, the relevant data were extracted, and the software RevMan version 5.1 was used for the meta-analysis.

Results:
Eight studies with a total of 753 patients were eligible for the meta-analysis. There were no significant differences in the operation time, intraoperative blood loss, postoperative hospital stay, early complications (anastomotic fistula and anastomotic bleeding), late complications (reflux symptoms and anastomotic stenosis), and 5-year survival rate between PG-DTR and TG. However, the levels of partial nutritional indicators (vitamin B12 supplements and vitamin B12 deficiency) were significantly higher in the PG-DTR group than in the TG group.

Conclusion:
This study showed ample evidence to suggest that PG-DTR improved the postoperative nutritional status without compromising patient safety while providing the same surgical characteristics and postoperative morbidity as TG.
Severe types of fetopathy are associated with changes in the serological proteome of diabetic mothers
Authors: Kopylov Arthur T. , Papysheva Olga , Gribova Iveta , Kaysheva Anna L. , Kotaysch Galina , Kharitonova Lubov , Mayatskaya Tatiana , Nurbekov Malik K. , Schipkova Ekaterina , Terekhina Olga , Morozov Sergey G. 
Published: November 2021

Abstract
Pregestational or gestational diabetes are the main risk factors for diabetic fetopathy. There are no generalized signs of fetopathy before the late gestational age due to insufficient sensitivity of currently employed instrumental methods. In this cross-sectional observational study, we investigated several types of severe diabetic fetopathy (cardiomyopathy, central nervous system defects, and hepatomegaly) established in type 2 diabetic mothers during 30 to 35 gestational weeks and confirmed upon delivery. We examined peripheral blood plasma and determined a small proportion of proteins strongly associated with a specific type of fetopathy or anatomical malfunction. Most of the examined markers participate in critical processes at different stages of embryogenesis and regulate various phases of morphogenesis. Alterations in CDCL5 had a significant impact on mRNA splicing and DNA repair. Patients with central nervous system defects were characterized by the greatest depletion (ca. 7% of the basal level) of DFP3, a neurotrophic factor needed for the proper specialization of oligodendrocytes. Dysregulation of noncanonical wingless-related integration site signaling pathway (Wnt) signaling guided by pigment epithelium-derived factor (PEDF) and disheveled-associated activator of morphogenesis 2 (DAAM2) was also profound. In addition, deficiency in retinoic acid and thyroxine transport was exhibited by the dramatic increase of transthyretin (TTHY). The molecular interplay between the identified serological markers leads to pathologies in fetal development on the background of a diabetic condition. These warning serological markers can be quantitatively examined, and their profile may reflect different severe types of diabetic fetopathy, producing a beneficial effect on the current standard care for pregnant women and infants.
Effects of flexible reamer on the femoral tunnel characteristics in anterior cruciate ligament reconstruction
Authors: Seo Young-Jin , Song Si Young , Im Woo-Young , Kim Yoon Sang , Jang Seong-wook 
Published: November 2021

Abstract
To compare the femoral tunnel characteristics using a rigid versus flexible reamer during anterior cruciate ligament reconstruction. It was hypothesized that the employment of a flexible reamer along with femoral tunnel would exhibit longer tunnel length and more acute femoral graft tunnel angle compared to the case of a rigid reamer.
The study population included 28 patients who underwent anatomical single-bundle anterior cruciate ligament reconstruction using transportal technique and were able to take postoperative computed tomography (CT) evaluation. Of these, the femoral tunnel of 14 cases was drilled with a flexible reamer (group I) and in another 14 cases drill was performed with a conventional rigid reamer (group II). The femoral tunnel in group I was made at 90° of knee flexion. In group II, the femoral tunnel was created at 120° of knee flexion. The parameters of the femoral tunnels were compared in terms of the femoral tunnel length and femoral graft tunnel angle. Special software was used to create and manipulate (3-D) 3-dimensional knee models.
The difference in the mean femoral tunnel locations expressed in percentage distance between the 2 groups was not significantly different. The mean femoral tunnel length of group I was significantly longer than that of group II, (P = .03, 36.7 ± 2.9 vs 32.9 ± 9.0 mm). The angle formed by the femoral tunnel and the graft in group I was significantly smaller than in group II (P = .01, 109.8° ± 9.4° vs 118.1° ± 7.2°).
Our data suggest that the flexible reamer can provide sufficient tunnel length for the suspensory fixation with a fixed loop. Whereas, the femoral graft-tunnel angle through flexible reaming at 90° of knee flexion was more acute compared to rigid reaming at 120° of knee flexion.

Study Design: level of evidence III
How Are Attention-deficit Hyperactivity and Internet Gaming Disorders Related in Children and Youth?
Authors: Muzwagi Ashraf B. , Motiwala Fatima B. , Manikkara Geetha , Rizvi Abid , Varela Mark A. , Rush A. John , Zafar Muhammad K. , Jain Shailesh B. 
Published: November 2021

Objectives:
This review addresses important practical questions facing clinicians regarding internet gaming disorder (IGD) and attention-deficit/hyperactivity disorder (ADHD) in children and youth (C-Y). The authors investigated data concerning the risk that C-Y who have ADHD will develop IGD, whether effective treatment of ADHD positively influences the course of IGD in C-Y who have both, and other findings that might be of benefit to clinicians who treat C-Y with these conditions.

Methods:
We conducted a literature review using 4 databases: PubMed, Scopus, PsychInfo, and Embase.

Results:
C-Y with ADHD are at greater risk for developing IGD than those without ADHD. A close association exists between the severity of ADHD symptoms and the severity of IGD. It is unknown what proportion of C-Y with ADHD will develop IGD during their developmental trajectory; however, C-Y with IGD are at risk for developing ADHD, and ADHD can also increase the vulnerability of C-Y to IGD. Adolescents with ADHD and IGD have greater deficits in social skills than those with ADHD but no IGD. Lower parental occupational and socioeconomic status and poor family relationships are associated with more severe IGD symptoms. Atomoxetine and methylphenidate are equally effective in alleviating IGD symptoms comorbid with ADHD.

Conclusions:
C-Y with ADHD are at increased risk for developing IGD compared with C-Y without ADHD, but it has not been determined at what developmental stage IGD is likely to emerge. Since IGD and ADHD are strongly associated, it is imperative to consider ADHD as a significant risk factor for IGD and vice versa, which can help psychiatrists be alert for early signs of IGD and manage them accordingly.
Noninvasive neuromodulation and rehabilitation to promote functional restoration in persons with spinal cord injury
Authors: Iddings Jennifer A. , Zarkou Anastasia , Field-Fote Edelle C. 
Published: November 2021

Purpose of review
This review will focus on the use of clinically accessible neuromodulatory approaches for functional restoration in persons with spinal cord injury (SCI).

Recent findings
Functional restoration is a primary rehabilitation priority for individuals with SCI. High-tech neuromodulatory modalities have been used in laboratory settings to improve hand and walking function as well as to reduce spasticity and pain in persons with SCI. However, the cost, limited accessibility, and required expertise are prohibitive for clinical applicability of these high-tech modalities. Recent literature indicates that noninvasive and clinically accessible approaches targeting supraspinal, spinal, and peripheral neural structures can modulate neural excitability. Although a limited number of studies have examined the use of these approaches for functional restoration and amelioration of secondary complications in SCI, early evidence investigating their efficacy when combined with training is encouraging.

Summary
Larger sample studies addressing both biomarker identification and dosing are crucial next steps in the field of neurorehabilitation research before novel noninvasive stimulation approaches can be incorporated into standard clinical practice.
Integration of vascular progenitors into functional blood vessels represents a novel mechanism of vascular growth
Authors: Metikala Sanjeeva , Warkala Michael , Chetty Satish Casie , Chestnut Brendan , Plender Elizabeth , Nester Olivia , Astrof Sophie , Sumanas Saulius 
Published: November 2021

SummaryDuring embryogenesis, the initial vascular network is thought to form by the process of vasculogenesis, or the specification of vascular progenitors de novo. After the initial blood circulation has been established, the majority of later-forming vessels are thought to arise by angiogenesis from the already established vasculature. Here we show that new vascular progenitors in zebrafish embryos contribute to functional vasculature even after blood circulation has been established. Based on the expression analysis of early vascular progenitor markers etv2 and tal1, we characterized a novel site of late vasculogenesis (termed secondary vascular field, SVF), located bilaterally along the yolk extension. Using time-lapse imaging of etv2 reporter lines, we show that SVF cells migrate and incorporate into functional blood vessels and contribute to the formation of the posterior cardinal vein and subintestinal vasculature, suggesting a novel mode of vascular growth. We further demonstrate that SVF cells participate in vascular recovery after chemical ablation of vascular endothelial cells. Inducible inhibition of etv2 function prevented SVF cell differentiation and resulted in the defective formation of subintestinal vasculature. In addition, we performed single-cell RNA-seq analysis to identify the transcriptional profile of SVF cells, which demonstrated similarities and differences between the transcriptomes of SVF cells and early vascular progenitors. Our results characterize a novel mechanism of how new vascular progenitors incorporate into established vasculature and revise our understanding of basic mechanisms that regulate vascular development.
Toeholder: a Software for Automated Design andIn SilicoValidation of Toehold Riboswitches
Authors: Cisneros Angel F. , Rouleau François D. , Bautista Carla , Lemieux Pascale , Dumont-Leblond Nathan 
Published: November 2021

AbstractSynthetic biology aims to engineer biological circuits, which often involve gene expression. A particularly promising group of regulatory elements are riboswitches because of their versatility with respect to their targets, but early synthetic designs were not as attractive because of a reduced dynamic range with respect to protein regulators. Only recently, the creation of toehold switches helped overcome this obstacle by also providing an unprecedented degree of orthogonality. However, a lack of automated design and optimization tools prevents the widespread and effective use of toehold switches in high throughput experiments. To address this, we developed Toeholder, a comprehensive open-source software for toehold design andin silicocomparison. Toeholder takes into consideration sequence constraints from experimentally tested switches, as well as data derived from molecular dynamics simulations of a toehold switch. We describe the software and itsin silicovalidation results, as well as its potential applications and impacts on the management and design of toehold switches.
Total virome characterizations of game animals in China reveals a spectrum of emerging viral pathogens
Authors: He Wan-Ting , Hou Xin , Zhao Jin , Sun Jiumeng , He Haijian , Si Wei , Wang Jing , Jiang Zhiwen , Yan Ziqing , Xing Gang , Lu Meng , Suchard Marc A. , Ji Xiang , Gong Wenjie , He Biao , Li Jun , Lemey Philippe , Guo Deyin , Tu Changchun , Holmes Edward C. , Shi Mang , Su Shuo 
Published: November 2021

AbstractGame animals are wildlife species often traded and consumed as exotic food, and are potential reservoirs for SARS-CoV and SARS-CoV-2. We performed a meta-transcriptomic analysis of 1725 game animals, representing 16 species and five mammalian orders, sampled across China. From this we identified 71 mammalian viruses, with 45 described for the first time. Eighteen viruses were considered as potentially high risk to humans and domestic animals. Civets (Paguma larvata) carried the highest number of potentially high risk viruses. We identified the transmission of Bat coronavirus HKU8 from a bat to a civet, as well as cross-species jumps of coronaviruses from bats to hedgehogs and from birds to porcupines. We similarly identified avian Influenza A virus H9N2 in civets and Asian badgers, with the latter displaying respiratory symptoms, as well as cases of likely human-to-wildlife virus transmission. These data highlight the importance of game animals as potential drivers of disease emergence.Highlights1725 game animals from five mammalian orders were surveyed for viruses71 mammalian viruses were discovered, 18 with a potential risk to humansCivets harbored the highest number of potential ‘high risk’ virusesA species jump of an alphacoronavirus from bats to a civet was identifiedH9N2 influenza virus was detected in a civet and an Asian badgerHumans viruses were also identified in game animals