bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vacuum-Assisted Closure for the Treatment of Deep Sternal Wound Infection After Pediatric Cardiac Surgery
Authors: Sherman Gilad , Shulman-Manor Orit , Dagan Ovadia , Livni Gilat , Scheuerman Oded , Amir Gabriel , Frenkel George , Levy Itzhak 
Published: September 2019

Objectives:
Vacuum-assisted closure is being increasingly used to treat deep sternal wound infection following cardiac surgery, but most of the data refer to adults. This study investigated the safety and efficacy of vacuum-assisted closure in pediatric patients.

Design:
Retrospective file review.

Setting:
Tertiary pediatric medical center.

Patients:
All children with deep sternal wound infection treated with vacuum-assisted closure in 2003–2016.

Interventions:
Epidemiological, clinical, and microbiological data were collected from the medical records.

Measurements and Main Results:
The cohort included 50 patients (0.9% of cardiac patients operated during the study period) of median age 6.5 months (interquartile range, 2–12.75 mo; range, 1 wk to 14 yr) and median weight 5.1 kg (interquartile range, 4–9.75 kg). The most frequent heart defects were tetralogy of Fallot (22%) and ventricular septal defect (20%); 38% of patients had cyanotic heart disease. Deep sternal wound infections appeared a median of 10 days postoperatively (interquartile range, 7–14 d; range 3–100 d). Vacuum-assisted closure was applied a median of 13 days postoperatively (interquartile range, 10–18.5 d; range, 5–103 d) for a median duration of 10 days (interquartile range, 7–13.25 d; range, 1–21 d). Wound cultures were positive in 48 patients (96%); most isolates were Gram-positive (76%). The main bacterial pathogen was methicillin-susceptible Staphylococcus aureus (61%). Most patients were treated with cloxacillin for a median of 38 days (interquartile range, 28–42 d; range, 9–189 d). There were no statistically significant differences in clinical or treatment characteristics between bacteremic (56%) and nonbacteremic patients. Compared with older patients, infants less than 3 months old (36%) had a significantly longer hospitalization time (41 vs 25 d; p = 0.001) and higher Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery Mortality Category (3 vs 2; p = 0.003). All cases except one (contact dermatitis) were uneventful. In 10 patients, wounds were closed surgically after vacuum-assisted closure. Two patients required a pectoralis flap, both treated before 2005. One of the two deaths was infection-related.

Conclusions:
Vacuum-assisted closure is a feasible treatment option of deep sternal wound infection after pediatric cardiac surgery and was not associated with independent morbidity.
Unpredictable stress delays recovery from exercise-induced muscle pain: contribution of the sympathoadrenal axis
Authors: Alvarez Pedro , Green Paul G. , Levine Jon D. 
Published: September 2019

Abstract

Introduction:
Although stress is a well-establish risk factor for the development of chronic musculoskeletal pain, the underlying mechanisms, specifically the contribution of neuroendocrine stress axes, remain poorly understood.

Objective:
To evaluate the hypothesis that psychological stress-induced activation of the sympathoadrenal stress axis prolongs the muscle pain observed after strenuous exercise.

Methods:
Adult male Sprague-Dawley rats were exposed to unpredictable sound stress and eccentric exercise. The involvement of the sympathoadrenal stress axis was evaluated by means of surgical interventions, systemic administration of epinephrine, and intrathecal β2-adrenergic receptor antisense.

Results:
Although sound stress alone did not modify nociceptive threshold, it prolonged eccentric exercise-induced mechanical hyperalgesia. Adrenal medullectomy (ADMdX) attenuated, and administration of stress levels of epinephrine to ADMdX rats mimicked this effect of sound stress. Knockdown of β2-adrenergic receptors by intrathecal antisense also attenuated sound stress-induced prolongation of eccentric exercise-induced hyperalgesia.

Conclusion:
Together, these results indicate that sympathoadrenal activation, by unpredictable sound stress, disrupts the capacity of nociceptors to sense recovery from eccentric exercise, leading to the prolongation of muscle hyperalgesia. This prolonged recovery from ergonomic pain is due, at least in part, to the activation of β2-adrenergic receptors on muscle nociceptors.
Symbol Comprehension in Patients With Alzheimer Disease Dementia, Mild Cognitive Impairment, and Major Depressive Disorder
Authors: Boedeker Sebastian , Schulz Philipp , Beblo Thomas , Lenz Eva , Sammer Gebhard , Kreisel Stefan , Driessen Martin , Toepper Max 
Published: September 2019

Introduction:
Previous research suggests that specific symbol features attenuate symbol comprehension deficits in seniors suffering from Alzheimer disease dementia (ADD). However, it remains unclear whether these findings also apply to other disorders associated with cognitive dysfunctions.

Methods:
Ninety healthy controls, 30 patients with major depressive disorder (MDD), 35 patients with mild cognitive impairment (MCI), and 55 patients with ADD performed a Symbol Processing Task with 4 different symbol categories. Nonparametric between×within subjects analyses were conducted to examine the impact of different symbol categories on performance accuracy in all experimental groups.

Results:
Analyses revealed a higher symbol comprehension accuracy in healthy seniors than in MDD, MCI, and ADD patients, with the lowest accuracy rates shown by ADD patients. Although the type of symbol hardly affected performance accuracy in healthy seniors and MDD patients, different symbol categories influenced the performance of MCI and ADD patients significantly.

Conclusions:
Our findings indicate that symbols with distracting features impede symbol comprehension in ADD and MCI. Symbols with visual cues, by contrast, facilitate symbol comprehension in ADD and may even be advantageous over standardized symbols used in public life.
Impact of banning smoking in cars with children on exposure to second-hand smoke: a natural experiment in England and Scotland
Authors: Laverty Anthony A , Hone Thomas , Anyanwu Philip E. , Robinson David Taylor , de Vocht Frank , Millett Christopher , Hopkinson Nicholas S 
Published: September 2019

ABSTRACTA ban on smoking in cars with children was implemented in April 2015 in England and December 2016 in Scotland. With survey data from both countries (NEngland=3,483-6,920 and NScotland=232-319), we used this natural experiment to assess the impact of the ban using a difference-in-differences approach. We conducted logistic regression analyses within a Difference-in-Difference framework and adjusted for age, sex, a marker of deprivation and survey weighting for non-response. Among children aged 13-15 years, self-reported levels of regular exposure to smoke in cars were 3.4% in 2012, 2.2% in 2014 and 1.3% in 2016 for Scotland and 6.3%, 5.9% and 1.6% in England. The ban was associated with a 73% reduction (95%CI -59%, -81%) in self-reported exposure to tobacco smoke among children.
Investigating the clinico-anatomical dissociation in the behavioral variant of Alzheimer’s disease
Authors: Singleton Ellen H. , Pijnenburg Yolande A. L. , Sudre Carole H. , Groot Colin , Kochova Elena , Barkhof Frederik , Joie Renaud La , Rosen Howard J. , Seeley William W. , Miller Bruce , Cardoso M. Jorge , Papma Janne , Scheltens Philip , Rabinovici Gil D. , Ossenkoppele Rik 
Published: September 2019

ABSTRACTObjectiveWe previously found temporoparietal “Alzheimer-typical” atrophy in patients with the behavioral variant of Alzheimer’s disease (bvAD) with relative sparing of frontal regions. Here, we aimed to understand the pathophysiological mechanisms of bvAD based on alternative neuroimaging markers.MethodsWe retrospectively included 150 participants at the University of California San Francisco and University of Berkeley, including 29 bvAD, 28 “typical” amnestic-predominant AD (tAD), 28 behavioral variant of frontotemporal dementia (bvFTD), and 65 cognitively normal participants. Patients with bvAD were compared with other groups on glucose metabolism and metabolic connectivity on [18F]FDG-PET, and subcortical gray matter volumes and white matter hyperintensity volumes (WMHV) on MRI. A receiver-operating-characteristic-analysis was performed to determine the measures yielding the highest contrast between groups.ResultsbvAD and tAD showed predominant temporoparietal hypometabolism compared to controls, and did not differ in direct contrasts. However, overlaying statistical maps from contrasts between patients and controls revealed broader frontoinsular hypometabolism in bvAD compared to tAD, partially overlapping with bvFTD. Metabolic connectivity analyses indicated greater anterior default mode network (DMN) involvement in bvAD compared to tAD, mimicking bvFTD. Analyses of subcortical volume and WMHV showed no relevant group differences. The top-3 discriminative measures for bvAD vs. bvFTD were: metabolism in posterior (bvAD<bvFTD), anterior DMN (bvAD>bvFTD) and parietal cortex (bvAD<bvFTD; AUC: 0.80-0.91, p<0.01), while the top-3 discriminators for bvAD vs. tAD were amygdalar volume (bvAD>tAD), anterior DMN (bvAD<tAD) and salience network metabolism (bvAD<tAD; AUC: 0.66-0.75, p<0.05).ConclusionSubtle frontoinsular hypometabolism and anterior DMN involvement may underlie the prominent behavioral phenotype in bvAD.
Life out of water: Genomic and physiological mechanisms underlying skin phenotypic plasticity
Authors: Dong Yun-wei , Blanchard Tessa S. , Noll Angela , Vasquez Picasso , Schmitz Juergen , Kelly Scott P. , Wright Patricia A. , Whitehead Andrew 
Published: September 2019

AbstractThe Devonian radiation of vertebrates from aquatic into terrestrial habitats required behavioral, physiological, and morphological adaptations. Changes to skin structure and function were likely crucial, but adaptations were needed to resolve contrasting demands of maintaining a mechanical and physiological barrier while also facilitating ion and gas transport. Little is known of the mechanisms that underlie skin plasticity and adaptation between water and air. We performed experiments using two isogenic lineages of an amphibious killifish (Kryptolebias marmoratusfrom brackish and freshwater habitats) and used transcriptional and morphological data to reveal mechanisms recruited to resolve the dual challenges of skin providing both a barrier and an exchange interface during terrestrial acclimation. Transcriptional regulators of skin morphogenesis were quickly activated upon emersion. Regulation of cell-cell adhesion complexes, coupled with pathways homologous with those that regulate stratum corneum formation, was consistent with barrier function and mechanical reinforcement. Cutaneous respiration was associated with regulation of angiogenesis pathways and with blood vessel architecture that facilitated extremely short diffusion distances and direct delivery to ionocyotes. Evolutionary analyses revealed directional selection operating on proteins involved in barrier and respiratory functions, reinforcing the importance of these mechanisms for enabling the amphibious lifestyle ofK. marmoratus. Fish from brackish niches were more resilient to emersion and also differed from freshwater fish in ionoregulatory responses to emersion. We conclude that plasticity of barrier, respiratory, and ionoregulatory functions in skin evolved to support the amphibious lifestyle ofK. marmoratus; similar processes may have facilitated the terrestrial radiation of ancient fishes.Significance statementThe transition of vertebrate life from water to land coincided with solving multiple physiological challenges including avoiding drying out while also exchanging gases and ions with the environment. Though changes in the skin were likely important, little is known of the mechanisms that underlie skin flexibility and adaptation between water and air. We performed air exposure experiments with an amphibious killifish; gene expression profiling, microscopy, and evolutionary analysis of proteins revealed cell structures, proteins, and molecular pathways that support skin flexibility and adaptations during air exposure, and ion regulation contributed to differences in killifish abilities to adjust to air. Amphibious killifish are useful models to help us understand changes that enable water to air transitions in contemporary and ancient fishes.
Machine Learning Analysis of Motor Evoked Potential Time Series to Predict Disability Progression in Multiple Sclerosis
Authors: Yperman Jan , Becker Thijs , Valkenborg Dirk , Popescu Veronica , Hellings Niels , Wijmeersch Bart Van , Peeters Liesbet M 
Published: September 2019

AbstractBackgroundEvoked potentials (EPs) are a measure of the conductivity of the central nervous system. They are used to monitor disease progression of multiple sclerosis patients. Previous studies only extracted a few variables from the EPs, which are often further condensed into a single variable: the EP score. We perform a machine learning analysis of motor EP that uses the whole time series, instead of a few variables, to predict disability progression after two years. Obtaining realistic performance estimates of this task has been difficult because of small data set sizes. We recently extracted a dataset of EPs from the Rehabiliation & MS Center in Overpelt, Belgium. Our data set is large enough to obtain, for the first time, a performance estimate on an independent test set containing different patients.MethodsWe extracted a large number of time series features from the motor EPs with the highly comparative time series analysis software package. Mutual information with the target and the Boruta method are used to find features which contain information not included in the features studied in the literature. We use random forests (RF) and logistic regression (LR) classifiers to predict disability progression after two years. Statistical significance of the performance increase when adding extra features is checked with the DeLong hypothesis test.ResultsIncluding extra time series features in motor EPs leads to a statistically significant improvement compared to using only the known features, although the effect is limited in magnitude (∆AUC = 0.02 for RF and ∆AUC = 0.05 for LR). RF with extra time series features obtains the best performance (AUC = 0.75 ± 0.07), which is good considering the limited number of biomarkers in the model. RF (a nonlinear classifier) outperforms LR (a linear classifier).ConclusionsUsing machine learning methods on EPs shows promising predictive performance. Using additional EP time series features beyond those already in use leads to a modest increase in performance. Larger datasets, preferably multi-center, are needed for further research. Given a large enough dataset, these models may be used to support clinicians in their decision making process regarding future treatment.
Compartmentalization of intestinal bacteria by hepatic ILC3s prevents infections after surgery
Authors: Jakob Manuel O. , Sanchez-Taltavull Daniel , Yilmaz Bahtiyar , Malinka Thomas , Mooser Catherine , Daniel Spari , Salm Lilian A. , Freiburghaus Katrin , Pereyra David , Hapfelmeier Siegfried , Masoodi Mojgan , Starlinger Patrick , Stroka Deborah , Tschan Franziska , Candinas Daniel , de Agüero Mercedes Gomez , Beldi Guido 
Published: September 2019

ABSTRACTInfections after surgical interventions are assumed to be caused by contamination. We show by analyzing multicentric data of 6561 patients that surgical infections as well as sepsis had a predominantly enteric microbial signature irrespective of the type of surgery, suggesting failure of intestinal bacterial compartmentalization. In mice, we reveal that hepatic surgery induced dysregulation of intestinal and hepatic type 3 innate lymphoid cells (ILC3s) and intestinal leakage resulting in enteric bacterial translocation via lymphatic vessels. In the absence of hepatic ILC3s, inflammasome activation and the induction of antimicrobial peptide encoding genes, bacteria colonized remote systemic organs and impaired surgical outcomes. Conversely, mammalian-microbial commensalism is required for the education of host immunity to ensure optimal hepatic healing responses. In fact, microbial-derived products were sufficient for the induction of proliferative transcriptional networks in the mouse liver, as illustrated by serum transfer experiments, mass spectrometry and RNA expression analysis, indicating that the balanced exposure of the host to commensals is essential for recovery. This study reveals the intestinal origin of microbes causing complications after surgical interventions and highlights host protective mechanisms of controlled commensalism that prevent infections.One Sentence SummaryIntestinal bacteria cause surgical infections
Club cell TRPV4 as a damage sensor driving lung allergic inflammation
Authors: Wiesner Darin L. , Merkhofer Richard M. , Ober Carole , Kujoth Greg C. , Gern James E. , Schneider Rebeca Brockman , Evans Michael D. , Jackson Daniel J. , Warner Thomas , Jarjour Nizar N. , Esnault Stephane J. , Feldman Michael B. , Freeman Matthew , Mou Hongmei , Vyas Jatin M. , Klein Bruce S. 
Published: September 2019

SUMMARYAirway epithelium is the first body surface to contact inhaled irritants and report danger. We studied how epithelial cells recognize and respond to protease, which is a critical component of many allergens that provoke asthma. In a murine model, the aeroallergen alkaline protease 1 (Alp1) of Aspergillus sp. elicited helper T (Th) cell-dependent lung eosinophilia. Bronchiolar club cells responded rapidly to Alp1 by coordinating the accumulation of allergic immune cells in the lung. Alp1 degraded bronchiolar cell junctions, and club cells within the bronchioles propagated this signal via calcium and calcineurin to incite inflammation. In two human cohorts, we linked fungal sensitization and asthma with SNP/protein expression of the mechanosensitive calcium channel, TRPV4. TRPV4 was also necessary and sufficient for club cells to sensitize mice to Alp1. Thus, club cells detect junction damage as mechanical stress, which signals danger via TRPV4, calcium and calcineurin to initiate Th cell sensitization.Graphical Abstract
Gravity-based microfiltration reveals unexpected prevalence of circulating tumor cell clusters in ovarian and colorectal cancer
Authors: Meunier Anne , Hernández-Castro Javier Alejandro , Chahley Nicholas , Communal Laudine , Kheireddine Sara , Koushki Newsha , Davoudvandi Nadia , Al Habyan Sara , Péant Benjamin , Lazaris Anthoula , Ng Andy , Veres Teodor , McCaffrey Luke , Provencher Diane , Metrakos Peter , Mes-Masson Anne-Marie , Juncker David 
Published: September 2019

AbstractCirculating tumor cells (CTCs) are rare (few cells per milliliter of blood) and mostly isolated as single cell CTCs (scCTCs). CTC clusters (cCTCs), even rarer, are of growing interest, notably because of their higher metastatic potential, but very difficult to isolate. Here, we introduce gravity-based microfiltration (GµF) for facile isolation of cCTCs while minimizing unwanted cluster disaggregation, with ∼85% capture efficiency. GµF from orthotopic ovarian cancer mouse models, from 17 epithelial ovarian cancer (EOC) with either localized or metastatic disease, and from 13 metastatic colorectal cancer liver metastasis (CRCLM) patients uncovered cCTCs in every case, with between 2-100+ cells. cCTCs represented between 5-30% of all CTC capture events, and 10-80% of CTCs were clustered; remarkably, in 10 patients, most CTCs were circulating not as scCTCs, but as cCTCs. GµF uncovered the unexpected prevalence and frequency of cCTCs including sometimes very large ones in EOC patients, and motivates additional studies to uncover their properties and role in disease progression.
Identification of gut microbiome markers for schizophrenia delineates a potential role of Streptococcus
Authors: Zhu Feng , Ju Yanmei , Wang Wei , Wang Qi , Guo Ruijin , Ma Qingyan , Sun Qiang , Fan Yajuan , Xie Yuying , Yang Zai , Jie Zhuye , Zhao Binbin , Xiao Liang , Yang Lin , Zhang Tao , Feng Junqin , Guo Liyang , He Xiaoyan , Chen Yunchun , Chen Ce , Gao Chengge , Xu Xun , Yang Huanming , Wang Jian , Dang Yonghui , Madsen Lise , Brix Susanne , Kristiansen Karsten , Jia Huijue , Ma Xiancang 
Published: September 2019

AbstractEmerging evidence has linked the gut microbiota to schizophrenia. However, the functional changes in the gut microbiota and the biological role of individual bacterial species in schizophrenia have not been explored systematically. Here, we characterized the gut microbiota in schizophrenia using shotgun metagenomic sequencing of feces from a discovery cohort of 90 drug-free patients and 81 controls, as well as a validation cohort of 45 patients taking antipsychotics and 45 controls. We screened 83 schizophrenia-associated bacterial species and constructed a classifier comprising 26 microbial biomarkers that distinguished patients from controls with a 0.896 area under the receiver operating characteristics curve (AUC) in the discovery cohort and 0.765 AUC in the validation cohort. Our analysis of fecal metagenomes revealed that schizophrenia-associated gut–brain modules included short-chain fatty acids synthesis, tryptophan metabolism, and synthesis/degradation of neurotransmitters including glutamate, γ-aminobutyric acid, and nitric oxide. The schizophrenia-enriched gut bacterial species include several oral cavity-resident microbes, such as Streptococcus vestibularis. We transplanted Streptococcus vestibularis into the gut of the mice with antibiotic-induced microbiota depletion to explore its functional role. We observed that this microbe transiently inhabited the mouse gut and this was followed by hyperactivity and deficit in social behaviors, accompanied with altered neurotransmitter levels in peripheral tissues. In conclusion, our study identified 26 schizophrenia-associated bacterial species representing potential microbial targets for future treatment, as well as gut–brain modules, some of which may give rise to new microbial metabolites involved in the development of schizophrenia.
Native seed addition as an effective tool for post-invasion restoration
Authors: Bucharova Anna , Krahulec František 
Published: September 2019

AbstractInvasive plant species reduce biodiversity, alter ecosystem processes, and cause economic losses. Control of invasive plants is therefore highly desired by land managers and policy makers. However, invasive plant control strategies frequently fail, partly because management often concentrates only on the eradication of invasive plants and not on revegetation with native species that use the available resources and prevent reinvasion. In this study, we focused on the intracontinental invader Rumex alpinus L., which was introduced by humans from the Alps to the lower mountains of Central Europe, where it has spread to semi-natural meadows, suppresses local biodiversity, and reduces the quality of hay used as cattle fodder. The species can be effectively removed using herbicide, but this leaves behind a persistent seed bank. Without further treatment, the invader rapidly regenerates and reinvades the area. We supplemented the herbicide treatment by adding the seeds of native grasses. Addition of native-seed effectively suppressed the regeneration of the invader from the seed bank, reduced its biomass, and consequently, prevented massive reinvasion. While the invader removal was successful, the restored community remained species-poor because the dense sward of native grasses blocked the regeneration of native forbs from the seed bank. Nevertheless, the addition of native seed proved to be an effective tool in preventing reinvasion after the eradication of the invasive plant.