bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrahigh-Resolution Computed Tomography Improves Preoperative Computed Tomography Angiography for Deep Inferior Epigastric Artery Perforator Flap Reconstruction
Authors: Ide Sayaka , Urikura Atsushi , Yoshida Tsukasa , Nakaya Yoshihiro , Endo Masahiro , Aramaki Takeshi 
Published: September 2021

Objective
The aim of the study was to compare computed tomography (CT) angiography (CTA) imaging of deep inferior epigastric artery perforator (DIEP) using the ultrahigh-resolution CT (UHRCT) and conventional multidetector CT (MDCT).

Methods
This retrospective study enrolled 20 patients who underwent CTA of DIEP flap with UHRCT and MDCT. Computed tomography values were measured at 4 large vessels (thoracic aorta, abdominal aorta, common iliac artery, and external iliac artery) and 5 peripheral vessels (proximal and distal internal thoracic artery, proximal and distal deep inferior epigastric artery, and DIEP).

Results
There were no significant differences in mean CT values of the major vessel between UHRCT and MDCT. Ultrahigh-resolution CT shows higher CT values of the peripheral vessels than MDCT (P < 0.05 for all). The median CT values of the DIEP in UHRCT were approximately 3 times higher than those in MDCT (P < 0.001).

Conclusions
Ultrahigh-resolution CT provides higher-quality CTA of DIEP compared with MDCT.
Sulforaphane-Dependent Up-Regulation of NRF2 Activity Alleviates Both Systemic Inflammatory Response and Lung Injury After Hemorrhagic Shock/Resuscitation in Mice
Authors: Liang Weiqiang , Greven Johannes , Fragoulis Athanassios , Horst Klemens , Bläsius Felix , Wruck Christoph , Pufe Thomas , Kobbe Philipp , Hildebrand Frank , Lichte Philipp 
Published: September 2021

ABSTRACT
Hemorrhagic shock/resuscitation (HS/R) is closely associated with overwhelming oxidative stress and systemic inflammation. As an effective activator of the nuclear factor-erythroid factor 2 related factor 2 (Nrf2) pathway, sulforaphane (SFN) exerts antioxidant and anti-inflammatory effects. We explored SFN's effects on alveolar macrophages (AMs), systemic inflammation, and pulmonary damage in an isolated murine HS/R model. Male C57/BL6 wild type and transgenic antioxidant response element (ARE)-luciferase (luc) mice (both n = 6 per group) were exposed to either pressure-controlled HS/R (mean arterial pressure 35–45 mm Hg for 90 min) or sham procedure (surgery without HS/R) or were sacrificed without intervention (control group). Fluid resuscitation was performed via the reinfusion of withdrawn blood and 0.9% saline. Sulforaphane or 0.9% saline (vehicle) was administrated intraperitoneally. Mice were sacrificed 6, 24, or 72 h after resuscitation. Bioluminescence imaging of ARE-luc mice was conducted to measure pulmonary Nrf2 activity. Plasma was collected to determine systemic cytokine levels. Alveolar macrophages were isolated before measuring cytokines in the supernatant and performing immunofluorescence staining, as well as Western blot for intracellular Nrf2. Histological damage was assessed via the acute lung injury score and wet/dry ratio.
Hemorrhagic shock/resuscitation was associated with pulmonary Nrf2 activation. Sulforaphane enhanced pulmonary Nrf2 activity and the Nrf2 activation of AM, while it decreased lung damage. Sulforaphane exerted down-regulatory effects on AM-generated and systemic pro-inflammatory mediators, while it did not have such effects on IL-10.
In conclusion, SFN beneficially enhances pulmonary Nrf2 activity and promotes Nrf2 accumulation in AMs’ nuclei. This may exert not only local protective effects but also systemic effects via the down-regulation of pro-inflammatory cytokines. The administration of Nrf2 activator post-HS/R may represent an innovative treatment strategy.
Impact of Clinical Sepsis Phenotypes on Mortality and Fluid Status in Critically Ill Patients
Authors: Shald Elizabeth A. , Erdman Michael J. , Ferreira Jason A. 
Published: September 2021

ABSTRACT

Background:
Sepsis is associated with high rates of in-hospital mortality, despite being the focus of medical research and public health initiatives for several years. The primary objective of this study was to determine the influence of septic phenotypes on rates of in-hospital mortality throughout intensive care unit (ICU) admission.

Patients and Methods:
Retrospective, single-center cohort study. Medical ICU of an academic medical center. Medical ICU patients admitted between January 2016 and August 2019 with a “sepsis alert” were screened for admitting diagnosis of “sepsis” or “septic shock.” Patients were classified into one of four clinical sepsis phenotypes: multi-organ failure (MOF), respiratory dysfunction (RD), neurologic dysfunction (ND), or other patients (OP).

Results:
An analysis of 320 patients was completed. In-hospital mortality was different between groups (P < 0.001). Patients with the MOF phenotype had the highest rate of mortality (48.4%), followed by the ND phenotype (39.7%), RD phenotype (20.8%), and OP phenotype (13.7%). There were differences in volume balances between phenotypes at 48 h (P = 0.001), 72 h (P < 0.001), and 96 h (P < 0.001) after hospital presentation, with the MOF and ND phenotypes having the largest volume balances at these time points. Ventilator-free days (P < 0.001) and ICU length of stay (LOS) (P = 0.030) were different between groups. There was no difference in hospital LOS (P = 0.479).

Conclusions:
This data supports the presence of marked intra-disease differences in septic patient presentation and correlation with clinical outcomes including mortality. Additionally, significantly more positive fluid balances were observed between survivors and non-survivors in some patient subsets. Using pragmatic clinical variables readily available to providers to classify patients into septic phenotypes has the propensity to guide treatment strategies in the future.
Enhanced Recovery After Urogynecologic Surgery: A Survey of Patient Experience
Authors: Trowbridge Elisa R. , Evans Sarah L. , Podwika Sarah , Subbarao Shalini , Sarosiek Bethany M. , Hullfish Kathie L. 
Published: September 2021

Objectives
The aim of this study was to identify which aspects/components of the enhanced recovery program (ERP) were associated with a positive patient surgical experience for patients undergoing urogynecologic surgery.

Methods
A total of 198 patients who underwent pelvic reconstructive surgery requiring hospital admission were invited to complete questionnaires modeled after the validated Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey patient experience survey. Patients were asked about 3 phases of ERP interventions: (1) before surgery (patient education, carbohydrate loading), (2) during the hospital stay (pain control, nausea, early ambulation), and (3) after discharge (return of bladder and bowel function).

Results
One hundred patients completed the survey (51% response rate). Greater than 90% of patients rated their overall surgical experience favorably (≥8 on 1–10 scale) regardless of age (P = 0.98), race (P = 0.26), education level (P = 0.12), perception of overall health (P = 0.17), or number of prior surgical procedures (P = 0.86). Ninety-two percent of patients reported that preoperative teaching about surgery was “very helpful,” and specifically 90% reported that the ERP educational handbook was useful. Patients who reported a poor perception of their overall mental health were more likely to rate their surgical experience less favorably (<8 on 1–10 scale; P = 0.01), as were patients who left the hospital with a Foley catheter (P = 0.03).

Conclusions
Greater than 90% of women surveyed who rated undergoing inpatient pelvic reconstructive surgery positively perceived their surgical experience within the ERP. The majority of patients who had a positive perception of the perioperative experience found the preoperative patient education useful.
What do we know about the global methane budget? Results from four decades of atmospheric CH4observations and the way forward
Authors: Lan Xin , Nisbet Euan G. , Dlugokencky Edward J. , Michel Sylvia E. 
Published: September 2021

Atmospheric CH4is arguably the most interesting of the anthropogenically influenced, long-lived greenhouse gases. It has a diverse suite of sources, each presenting its own challenges in quantifying emissions, and while its main sink, atmospheric oxidation initiated by reaction with hydroxyl radical (OH), is well-known, determining the magnitude and trend in this and other smaller sinks remains challenging. Here, we provide an overview of the state of knowledge of the dynamic atmospheric CH4budget of sources and sinks determined from measurements of CH4andδ13CCH4in air samples collected predominantly at background air sampling sites. While nearly four decades of direct measurements provide a strong foundation of understanding, large uncertainties in some aspects of the global CH4budget still remain. More complete understanding of the global CH4budget requires significantly more observations, not just of CH4itself, but other parameters to better constrain key, but still uncertain, processes like wetlands and sinks.This article is part of a discussion meeting issue 'Rising methane: is warming feeding warming? (part 1)'.
The impact of spatially varying wetland source signatures on the atmospheric variability ofδD-CH4
Authors: Stell Angharad C. , Douglas Peter M. J. , Rigby Matthew , Ganesan Anita L. 
Published: September 2021

We present the first spatially resolved distribution of theδD-CH4signature of wetland methane emissions and assess its impact on atmosphericδD-CH4. TheδD-CH4signature map is derived by relatingδD-H2Oof precipitation to measuredδD-CH4of methane wetland emissions at a variety of wetland types and locations. This results in strong latitudinal variation in the wetlandδD-CH4source signature. WhenδD-CH4is simulated in a global atmospheric model, little difference is found in global mean, inter-hemispheric difference and seasonal cycle if the spatially varyingδD-CH4source signature distribution is used instead of a globally uniform value. This is because atmosphericδD-CH4is largely controlled by OH fractionation. However, we show that despite these small differences, using atmospheric records ofδD-CH4to infer changes in the wetland emissions distribution requires the use of the more accurate spatially varyingδD-CH4source signature. We find that models will only be sensitive to changes in emissions distribution if spatial information can be exploited through the spatially resolved source signatures. In addition, we also find that on a regional scale, at sites measuring excursions ofδD-CH4from background levels, substantial differences are simulated in atmosphericδD-CH4if using spatially varying or uniform source signatures.This article is part of a discussion meeting issue ‘Rising methane: is warming feeding warming? (part 1)’.
Methods for quantifying methane emissions using unmanned aerial vehicles: a review
Authors: Shaw Jacob T. , Shah Adil , Yong Han , Allen Grant 
Published: September 2021

Methane is an important greenhouse gas, emissions of which have vital consequences for global climate change. Understanding and quantifying the sources (and sinks) of atmospheric methane is integral for climate change mitigation and emission reduction strategies, such as those outlined in the 2015 UN Paris Agreement on Climate Change. There are ongoing international efforts to constrain the global methane budget, using a wide variety of measurement platforms across a range of spatial and temporal scales. The advancements in unmanned aerial vehicle (UAV) technology over the past decade have opened up a new avenue for methane emission quantification. UAVs can be uniquely equipped to monitor natural and anthropogenic emissions at local scales, displaying clear advantages in versatility and manoeuvrability relative to other platforms. Their use is not without challenge, however: further miniaturization of high-performance methane instrumentation is needed to fully use the benefits UAVs afford. Developments in the models used to simulate atmospheric transport and dispersion across small, local scales are also crucial to improved flux accuracy and precision. This paper aims to provide an overview of currently available UAV-based technologies and sampling methodologies which can be used to quantify methane emission fluxes at local scales.This article is part of a discussion meeting issue 'Rising methane: is warming feeding warming? (part 1)'.
Coal seam gas industry methane emissions in the Surat Basin, Australia: comparing airborne measurements with inventories
Authors: Neininger Bruno G. , Kelly Bryce F. J. , Hacker Jorg M. , LU Xinyi , Schwietzke Stefan 
Published: September 2021

Coal seam gas (CSG) accounts for about one-quarter of natural gas production in Australia and rapidly increasing amounts globally. This is the first study worldwide using airborne measurement techniques to quantify methane (CH4) emissions from a producing CSG field: the Surat Basin, Queensland, Australia. Spatially resolved CH4emissions were quantified from all major sources based on top-down (TD) and bottom-up (BU) approaches, the latter using Australia's UNFCCC reporting workflow. Based on our TD-validated BU inventory, CSG sources emit about 0.4% of the produced gas, comparable to onshore dry gas fields in the USA and The Netherlands, but substantially smaller than in other onshore regions, especially those where oil is co-produced (wet gas). The CSG CH4emission per unit of gas production determined in this study is two to three times higher than existing inventories for the region. Our results indicate that the BU emission factors for feedlots and grazing cattle need review, possibly requiring an increase for Queensland's conditions. In some subregions, the BU estimate for gathering and boosting stations is potentially too high. The results from our iterative BU inventory process, which feeds into TD data, illustrate how global characterization of CH4emissions could be improved by incorporating empirical TD verification surveys into national reporting.This article is part of a discussion meeting issue ‘Rising methane: is warming feeding warming? (part 1)’.
Methane removal and the proportional reductions in surface temperature and ozone
Authors: Abernethy S. , O'Connor F. M. , Jones C. D. , Jackson R. B. 
Published: September 2021

Mitigating climate change requires a diverse portfolio of technologies and approaches, including negative emissions or removal of greenhouse gases. Previous literature focuses primarily on carbon dioxide removal, but methane removal may be an important complement to future efforts. Methane removal has at least two key benefits: reducing temperature more rapidly than carbon dioxide removal and improving air quality by reducing surface ozone concentration. While some removal technologies are being developed, modelling of their impacts is limited. Here, we conduct the first simulations using a methane emissions-driven Earth System Model to quantify the climate and air quality co-benefits of methane removal, including different rates and timings of removal. We define a novel metric, the effective cumulative removal, and use it to show that each effective petagram of methane removed causes a mean global surface temperature reduction of 0.21 ± 0.04°C and a mean global surface ozone reduction of 1.0 ± 0.2 parts per billion. Our results demonstrate the effectiveness of methane removal in delaying warming thresholds and reducing peak temperatures, and also allow for direct comparisons between the impacts of methane and carbon dioxide removal that could guide future research and climate policy.This article is part of a discussion meeting issue 'Rising methane: is warming feeding warming? (part 1)'.
Double reduction estimation and equilibrium tests in natural autopolyploid populations
Authors: Gerard David 
Published: September 2021

AbstractMany bioinformatics pipelines include tests for equilibrium. Tests for diploids are well studied and widely available, but extending these approaches to autopolyploids is hampered by the presence of double reduction, the co-migration of sister chromatid segments into the same gamete during meiosis. Though a hindrance for equilibrium tests, double reduction rates are quantities of interest in their own right, as they provide insights about the meiotic behavior of autopolyploid organisms. Here, we develop procedures to (i) test for equilibrium while accounting for double reduction, and (ii) estimate double reduction given equilibrium. To do so, we take two approaches: a likelihood approach, and a novel U-statistic minimization approach that we show generalizes the classical equilibrium χ2 test in diploids. For small sample sizes and uncertain genotypes, we further develop a bootstrap procedure based on our U-statistic to test for equilibrium. Finally, we highlight the difficulty in distinguishing between random mating and equilibrium in tetraploids at biallelic loci. Our methods are implemented in the hwep R package on GitHub https://github.com/dcgerard/hwep.
SARS-CoV-2 spike-specific memory B cells express markers of durable immunity after non-severe COVID-19 but not after severe disease
Authors: Reyes Raphael A. , Clarke Kathleen , Gonzales S. Jake , Cantwell Angelene M. , Garza Rolando , Catano Gabriel , Tragus Robin E. , Patterson Thomas F. , Bol Sebastiaan , Bunnik Evelien M. 
Published: September 2021

ABSTRACTSARS-CoV-2 infection elicits a robust B cell response, resulting in the generation of long-lived plasma cells and memory B cells. Here, we aimed to determine the effect of COVID-19 severity on the memory B cell response and characterize changes in the memory B cell compartment between recovery and five months post-symptom onset. Using high-parameter spectral flow cytometry, we analyzed the phenotype of memory B cells with reactivity against the SARS-CoV-2 spike protein or the spike receptor binding domain (RBD) in recovered individuals who had been hospitalized with non-severe (n=8) or severe (n=5) COVID-19. One month after symptom onset, a substantial proportion of spike-specific IgG+B cells showed an activated phenotype. In individuals who experienced non-severe disease, spike-specific IgG+B cells showed increased expression of markers associated with durable B cell memory, including T-bet, FcRL5, and CD11c, which was not observed after severe disease. Five months post-symptom onset, the majority of spike-specific memory B cells had a resting phenotype and the percentage of spike-specific T-bet+IgG+memory B cells decreased to baseline levels. Collectively, our results suggest that the memory B cell response elicited during non-severe COVID-19 may be of higher quality than the response after severe disease.
COVID-19 attack ratio among children critically depends on the time to removal and activity levels
Authors: Wu Jianhong , Bragazzi Nicola Luigi , Scarabel Francesca , McCarthy Zachary , David Jummy ,   the LIAM/ADERSIM COVID-19 Reopening and Recovery Modeling Group
Published: September 2021

AbstractThe attack ratio in a subpopulation is defined as the total number of infections over the total number of individuals in this subpopulation. Using a methodology based on modified age-stratified transmission dynamics model, we estimated the attack ratio of COVID-19 among children (individuals 0-11 years) in Ontario, Canada when a large proportion of individuals eligible for vaccination (age 12 and above) are vaccinated to achieve herd immunity among this subpopulation, or the effective herd immunity with additional physical distancing measures (hence effective herd immunity). We describe the relationship between this attack ratio among children, the time to remove infected individuals from the transmission chain and the children-to-children daily contact rate, while considering the increased transmissibility of virus variants (using the Delta variant as an example). We further illustrate the generality and applicability of the methodology established by performing an analysis of the attack ratio of COVID-19 among children in the Canadian population. The clinical attack ratio, the number of symptomatic infections over the total population can be informed from the attack ratio, and both can be reduced substantially via a combination of higher vaccine coverage in the vaccine eligible population, reduced social mixing among children, and rapid testing and isolation.
Evaluation of SIGLEC1 in the diagnosis of suspected systemic lupus erythematosus
Authors: Zorn-Pauly Lydia , von Stuckrad Anne Sae Lim , Klotsche Jens , Rose Thomas , Kallinich Tilmann , Enghard Philipp , Ostendorf Lennard , Burns Marie , Doerner Thomas , Meisel Christian , Schneider Udo , Unterwalder Nadine , Burmester Gerd , Hiepe Falk , Alexander Tobias , Biesen Robert 
Published: September 2021

ABSTRACTObjectivesTo evaluate and compare the diagnostic accuracy of SIGLEC1, a surrogate marker of type I IFN, with established biomarkers in an inception cohort of systemic lupus erythematosus (SLE).MethodsSIGLEC1 was analysed by flow cytometry in 232 patients referred to our institution with suspected SLE between October 2015 and September 2020.ResultsSLE was confirmed in 76 of 232 patients (32.8%) according to the 2019 EULAR/ACR classification criteria and their SIGLEC1 values were significantly higher compared to patients without SLE (p<0.0001). A sensitivity of 98.7 %, a specificity of 82.1 %, a negative predictive value (NPV) of 99.2 % and a positive predictive value (PPV) of 72.8 % were calculated for SIGLEC1. Adjusted to the highest reported prevalence of SLE, the NPV and PPV were > 99.9 % and 0.1 %, respectively. Using ROC analysis and Delong testing, the area under the curve (AUC) for SIGLEC1 (AUC=0.95) was significantly higher than for ANA (AUC=0.88, p=0.031), C3 (AUC=0.83, p=0.001) and C4 (AUC=0.83, p=0.002) but not for anti-dsDNA antibodies (AUC=0.90, p=0.163).ConclusionIFN-I pathway activation is detectable in almost all newly diagnosed SLE patients. Thus, a negative test result for SIGLEC1 is powerful to exclude SLE in suspected cases.
Age-Specific Changes in Virulence Associated with SARS-CoV-2 Variants of Concern
Authors: Fisman David N. , Tuite Ashleigh R. 
Published: September 2021

AbstractBackgroundNovel variants of concern (VOCs) have been associated with both increased infectivity and virulence of SARS-CoV-2. The virulence of SARS-CoV-2 is closely linked to age. Whether relative increases in virulence of novel VOCs is similar across the age spectrum, or is limited to some age groups, is unknown.MethodsWe created a retrospective cohort of people in Ontario, Canada testing positive for SARS-CoV-2 and screened for VOCs, with dates of test report between February 7 and August 30, 2021 (n=233,799). Cases were classified as N501Y-positive VOC, probable Delta VOC, or VOC undetected. We constructed age-specific logistic regression models to evaluate the effects of N501Y-postive or Delta VOC infections on infection severity, using hospitalization, intensive care unit (ICU) admission, and death as outcome variables. Models were adjusted for sex, time, health unit, vaccination status, comorbidities, immune compromise, long-term care residence, healthcare worker status, and pregnancy.ResultsInfection with either N501Y-positive or Delta VOCs was associated with significant elevations in risk of hospitalization, ICU admission, and death in younger and older adults, compared to infections where a VOC was not detected. Delta VOC increased hospitalization risk in children under 10 by a factor of 2.5 (adjusted odds ratio, 95% confidence interval: 1.2 to 5.1) compared to non-VOC. For most VOC-outcome combinations there was no heterogeneity in adverse outcomes by age. However, there was an inverse relationship between age and relative increase in risk of death with delta VOC, with younger age groups showing a greater relative increase in risk of death than older individuals.InterpretationSARS-CoV-2 VOCs appear to be associated with increased relative virulence of infection in all age groups, though low absolute numbers of outcomes in younger individuals make estimates in these groups imprecise.