Publications by authors named "A Heikki Lang"

2,320 Publications

  • Page 1 of 1

Bilingualism in Parkinson's disease: Relationship to cognition and quality of life.

J Clin Exp Neuropsychol 2021 Apr 8:1-14. Epub 2021 Apr 8.

Baycrest Health Sciences, Toronto, Ontario, Canada.

Some studies have found that bilingualism promotes cognitive reserve.

Objective: We aimed to determine whether bilingualism, defined as regularly (i.e. daily) using at least two languages at least since early adulthood, is associated with cognitive advantages in Parkinson's disease (PD) or whether the possible benefits of bilingualism are lost in the context of PD, possibly affecting quality of life (QoL) and independence.

Method: Participants with idiopathic PD ( = 140, mean age = 67.9 [= 6.4], 78% men) completed standard neuropsychological tasks evaluating attention/working memory, language, executive function, memory, and visuospatial ability, as well as measures of wellbeing and functional independence.

Results: Bilinguals with PD ( = 21) performed worse than monolinguals with PD ( = 92) on attention/working memory and language measures. The between-group differences in attention/working memory were restricted to verbally-based measures. When measured along a continuum, a higher degree of bilingualism was correlated with lower scores on measures of attention/working memory and language. There were no group differences in self- or informant-reported cognitive decline, PD health-related QoL, or functional independence.

Conclusions: Bilingualism in PD was not associated with better cognitive performance. Lower scores on language-based measures may reflect a distributed fund of linguistic information across more than one language, lower language proficiency in English, and/or other cultural artifacts. Furthermore, using normative data specific to the dominant language spoken or conducting neuropsychological testing in participants' self-reported most proficient language may enhance additional studies addressing this topic. Future research may also examine the roles of bilingualism over time and across other neurodegenerative diseases with and without EF impairment to illuminate further the impact of bilingualism on cognition and QoL, and shape culturally and linguistically diverse research and clinical care.
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http://dx.doi.org/10.1080/13803395.2021.1902946DOI Listing
April 2021

Call the Plumber: Impaired Meningeal Lymphatic Drainage in Parkinson's Disease.

Mov Disord 2021 Mar 30. Epub 2021 Mar 30.

Edmund J Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, Toronto, Ontario, Canada.

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http://dx.doi.org/10.1002/mds.28590DOI Listing
March 2021

"Effect of a Basic Training Nicotine-Free Policy on Soldiers in the United States Army".

Chest 2021 Mar 26. Epub 2021 Mar 26.

Department of Behavioral Health | McDonald Army Health Center, Psychiatry and Behavioral Sciences | Eastern Virginia Medical School.

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http://dx.doi.org/10.1016/j.chest.2021.03.039DOI Listing
March 2021

Teaching Cheminformatics through a Collaborative Intercollegiate Online Chemistry Course (OLCC).

J Chem Educ 2021 Feb 21;98(2):416-425. Epub 2020 Dec 21.

Department of Chemistry, University of Arkansas at Little Rock, Little Rock, Arkansas 72022, United States.

While cheminformatics skills necessary for dealing with an ever-increasing amount of chemical information are considered important for students pursuing STEM careers in the age of big data, many schools do not offer a cheminformatics course or alternative training opportunities. This paper presents the Cheminformatics Online Chemistry Course (OLCC), which is organized and run by the Committee on Computers in Chemical Education (CCCE) of the American Chemical Society (ACS)'s Division of Chemical Education (CHED). The Cheminformatics OLCC is a highly collaborative teaching project involving instructors at multiple schools who teamed up with external chemical information experts recruited across sectors, including government and industry. From 2015 to 2019, three Cheminformatics OLCCs were offered. In each program, the instructors at participating schools would meet face-to-face with the students of a class, while external content experts engaged through online discussions across campuses with both the instructors and students. All the material created in the course has been made available at the open education repositories of LibreTexts and CCCE Web sites for other institutions to adapt to their future needs.
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http://dx.doi.org/10.1021/acs.jchemed.0c01035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7976600PMC
February 2021

Combining segmental bulk- and single-cell RNA-sequencing to define the chondrocyte gene expression signature in the murine knee joint.

Osteoarthritis Cartilage 2021 Mar 21. Epub 2021 Mar 21.

German Rheumatism Research Centre (DRFZ) Berlin, A Leibniz Institute, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Rheumatology and Clinical Immunology, Berlin, Germany. Electronic address:

Objective: Due to the small size of the murine knee joint, extracting the chondrocyte transcriptome from articular cartilage (AC) is a major technical challenge. In this study, we demonstrate a new pragmatic approach of combining bulk RNA-sequencing (RNA-seq) and single cell (sc)RNA-seq to address this problem.

Design: We propose a new cutting strategy of the murine femur which produces three segments with a predictable mixed cell population, where one segment contains AC and growth plate (GP) chondrocytes, another GP chondrocytes, and the last segment only bone and bone marrow. We analysed the bulk RNA-seq of the different segments to find distinct genes between the segments. The segment containing AC chondrocytes was digested and analysed via scRNA-seq.

Results: Differential expression analysis using bulk RNA-seq identified 350 candidate chondrocyte gene in the AC segment. Gene set enrichment analysis of these genes revealed biological processes related- and non-related to chondrocytes, including, cartilage development (adj. P-value: 3.45E-17) and endochondral bone growth (adj. P-value 1.22E-4), respectively. ScRNA-seq of the AC segment found a cluster of 131 cells containing mainly chondrocytes. This cluster had 759 differentially expressed genes which enriched for extracellular matrix organisation (adj. P-value 7.76E-40) and other joint development processes. The intersection of the gene sets of bulk- and scRNA-seq contained 75 genes.

Conclusions: Based on our results, we conclude that the combination of the two RNA-seq methods is necessary to precisely delineate the chondrocyte transcriptome and to study the disease phenotypes of chondrocytes in murine OA models in the future.
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http://dx.doi.org/10.1016/j.joca.2021.03.007DOI Listing
March 2021

The Logic and Pitfalls of Parkinson's Disease as "Brain-First" Versus "Body-First" Subtypes.

Mov Disord 2021 03;36(3):594-598

UC Gardner Neuroscience Institute and Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA.

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http://dx.doi.org/10.1002/mds.28493DOI Listing
March 2021

Reply to: "The Logic and Pitfalls of Parkinson's as Brain- Versus Body-First Subtypes".

Mov Disord 2021 03;36(3):786-787

UC Gardner Neuroscience Institute and Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA.

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http://dx.doi.org/10.1002/mds.28527DOI Listing
March 2021

Is clinical assessment enough? Moving toward early differentiation of neurodegenerative parkinsonisms.

Brain 2021 Mar 16. Epub 2021 Mar 16.

Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.

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http://dx.doi.org/10.1093/brain/awab115DOI Listing
March 2021

Involvement of N-glycans in binding of Photorhabdus luminescens Tc toxin.

Cell Microbiol 2021 Mar 15:e13326. Epub 2021 Mar 15.

Institute for Experimental and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Photorhabdus luminescens Tc toxins are large tripartite ABC-type toxin complexes, composed of TcA, TcB and TcC proteins. Tc toxins are widespread and have shown a tropism for a variety of targets including insect, mammalian and human cells. However, their receptors and the specific mechanisms of uptake into target cells remain unknown. Here, we show that the TcA protein TcdA1 interacts with N-glycans, particularly Lewis X/Y antigens. This is confirmed using N-acetylglucosamine transferase I (Mgat1 gene product)-deficient Chinese hamster ovary (CHO) Lec1 cells, which are highly resistant to intoxication by the Tc toxin complex most likely due to the absence of complex N-glycans. Restoring Mgat1 gene activity, and hence complex N-glycan biosynthesis, recapitulated the sensitivity of these cells to the toxin. Exogenous addition of Lewis X trisaccharide partially inhibits intoxication in wild-type cells. Additionally, sialic acid also largely reduced binding of the Tc toxin. Moreover, proteolytic activation of TcdA1 alters glycan-binding and uptake into target cells. The data suggest that TcdA1-binding is most likely multivalent, and carbohydrates probably work cooperatively to facilitate binding and intoxication.
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http://dx.doi.org/10.1111/cmi.13326DOI Listing
March 2021

Cognitive Gain or Handicap: Magical Ideation and Self-Absorption in Clinical and Non-clinical Participants.

Front Psychol 2021 26;12:613074. Epub 2021 Feb 26.

Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary.

This study aimed to examine magical ideation and absorption traits across non-clinical and clinical groups to determine their potential adaptive and maladaptive functions. We enrolled 760 healthy participants from neighboring communities (female = 53.2%). Moreover, we recruited 318 patients (female = 66.5%), which included 25, 183, and 110 patients with schizophrenia spectrum disorders, anxiety disorders, and mood disorders, respectively. Potentially adaptive and maladaptive sociocognitive functions were measured to determine the role of magical ideation and self-absorption in patients with psychiatric disorders. The degree of magical ideation and absorption gradually increased in the following order: anxiety disorders, mood disorders, and schizophrenia spectrum disorders. Furthermore, enhanced self-absorption-related enhanced consciousness traits were essential indicators of the presence of self-integration weakness in patients with schizophrenia spectrum disorders. Magical ideation and psychological absorption may be considered as mental model construction functions, which result in both gains and handicaps in social adaptation.
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http://dx.doi.org/10.3389/fpsyg.2021.613074DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952430PMC
February 2021

Transmission of SARS-CoV-2 from asymptomatic and presymptomatic individuals in healthcare settings despite medical masks and eye protection.

Clin Infect Dis 2021 Mar 11. Epub 2021 Mar 11.

Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.

We describe 3 instances of SARS-CoV-2 transmission despite medical masks and eye protection, including transmission despite the source person being masked, transmission despite the exposed person being masked, and transmission despite both parties being masked. Whole genome sequencing confirmed perfect homology between source and exposed persons' viruses in all cases.
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http://dx.doi.org/10.1093/cid/ciab218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7989527PMC
March 2021

Proprioceptive recalibration following implicit visuomotor adaptation is preserved in Parkinson's disease.

Exp Brain Res 2021 Mar 10. Epub 2021 Mar 10.

Centre for Vision Research, York University, Toronto, Canada.

Individuals with Parkinson's disease (PD) and healthy adults demonstrate similar levels of visuomotor adaptation provided that the distortion is small or introduced gradually, and hence, implicit processes are engaged. Recently, implicit processes underlying visuomotor adaptation in healthy individuals have been proposed to include proprioceptive recalibration (i.e., shifts in one's proprioceptive sense of felt hand position to match the visual estimate of their hand experienced during reaches with altered visual feedback of the hand). In the current study, we asked if proprioceptive recalibration is preserved in PD patients. PD patients tested during their "off" and "on" medication states and age-matched healthy controls reached to visual targets, while visual feedback of their unseen hand was gradually rotated 30° clockwise or translated 4 cm rightwards of their actual hand trajectory. As expected, PD patients and controls produced significant reach aftereffects, indicating visuomotor adaptation after reaching with the gradually introduced visuomotor distortions. More importantly, following visuomotor adaptation, both patients and controls showed recalibration in hand position estimates, and the magnitude of this recalibration was comparable between PD patients and controls. No differences for any measures assessed were observed across medication status (i.e., PD off vs PD on). Results reveal that patients are able to adjust their sensorimotor mappings and recalibrate proprioception following adaptation to a gradually introduced visuomotor distortion, and that dopaminergic intervention does not affect this proprioceptive recalibration. These results suggest that proprioceptive recalibration does not involve striatal dopaminergic pathways and may contribute to the preserved visuomotor adaptation that arises implicitly in PD patients.
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http://dx.doi.org/10.1007/s00221-021-06075-yDOI Listing
March 2021

Proprioceptive recalibration following implicit visuomotor adaptation is preserved in Parkinson's disease.

Exp Brain Res 2021 Mar 10. Epub 2021 Mar 10.

Centre for Vision Research, York University, Toronto, Canada.

Individuals with Parkinson's disease (PD) and healthy adults demonstrate similar levels of visuomotor adaptation provided that the distortion is small or introduced gradually, and hence, implicit processes are engaged. Recently, implicit processes underlying visuomotor adaptation in healthy individuals have been proposed to include proprioceptive recalibration (i.e., shifts in one's proprioceptive sense of felt hand position to match the visual estimate of their hand experienced during reaches with altered visual feedback of the hand). In the current study, we asked if proprioceptive recalibration is preserved in PD patients. PD patients tested during their "off" and "on" medication states and age-matched healthy controls reached to visual targets, while visual feedback of their unseen hand was gradually rotated 30° clockwise or translated 4 cm rightwards of their actual hand trajectory. As expected, PD patients and controls produced significant reach aftereffects, indicating visuomotor adaptation after reaching with the gradually introduced visuomotor distortions. More importantly, following visuomotor adaptation, both patients and controls showed recalibration in hand position estimates, and the magnitude of this recalibration was comparable between PD patients and controls. No differences for any measures assessed were observed across medication status (i.e., PD off vs PD on). Results reveal that patients are able to adjust their sensorimotor mappings and recalibrate proprioception following adaptation to a gradually introduced visuomotor distortion, and that dopaminergic intervention does not affect this proprioceptive recalibration. These results suggest that proprioceptive recalibration does not involve striatal dopaminergic pathways and may contribute to the preserved visuomotor adaptation that arises implicitly in PD patients.
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http://dx.doi.org/10.1007/s00221-021-06075-yDOI Listing
March 2021

Prevalence and clinical, social, and health care predictors of miscarriage.

BMC Pregnancy Childbirth 2021 Mar 5;21(1):185. Epub 2021 Mar 5.

College of Nursing, University of Manitoba, Winnipeg, Canada.

Background: Pregnancy loss is common and several factors (e.g. chromosomal anomalies, parental age) are known to increase the risk of occurrence. However, much existing research focuses on recurrent loss; comparatively little is known about the predictors of a first miscarriage. Our objective was to estimate the population-level prevalence of miscarriages and to assess the contributions of clinical, social, and health care use factors as predictors of the first detected occurrence of these losses.

Methods: In this population-based cohort study, we used linked administrative health data to estimate annual rates of miscarriage in the Manitoba population from 2003 to 2014, as a share of identified pregnancies. We compared the unadjusted associations between clinical, social, and health care use factors and first detected miscarriage compared with a live birth. We estimated multivariable generalized linear models to assess whether risk factors were associated with first detected miscarriage controlling for other predictors.

Results: We estimated an average annual miscarriage rate of 11.3%. In our final sample (n = 79,978 women), the fully-adjusted model indicated that use of infertility drugs was associated with a 4 percentage point higher risk of miscarriage (95% CI 0.02, 0.06) and a past suicide attempt with a 3 percentage point higher risk (95% CI -0.002, 0.07). Women with high morbidity were twice as likely to experience a miscarriage compared to women with low morbidity (RD = 0.12, 95% CI 0.09, 0.15). Women on income assistance had a 3 percentage point lower risk (95% CI -0.04, -0.02).

Conclusions: We estimate that 1 in 9 pregnant women in Manitoba experience and seek care for a miscarriage. After adjusting for clinical factors, past health care use and morbidity contribute important additional information about the risk of first detected miscarriage. Social factors may also be informative.
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http://dx.doi.org/10.1186/s12884-021-03682-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7936485PMC
March 2021

The Collagens DPY-17 and SQT-3 Direct Anterior-Posterior Migration of the Q Neuroblasts in .

J Dev Biol 2021 Feb 19;9(1). Epub 2021 Feb 19.

Department of Molecular Biosciences, The University of Kansas, Lawrence, KS 66046, USA.

Cell adhesion molecules and their extracellular ligands control morphogenetic events such as directed cell migration. The migration of neuroblasts and neural crest cells establishes the structure of the central and peripheral nervous systems. In , the bilateral Q neuroblasts and their descendants undergo long-range migrations with left/right asymmetry. QR and its descendants on the right migrate anteriorly, and QL and its descendants on the left migrate posteriorly, despite identical patterns of cell division, cell death, and neuronal generation. The initial direction of protrusion of the Q cells relies on the left/right asymmetric functions of the transmembrane receptors UNC-40/DCC and PTP-3/LAR in the Q cells. Here, we show that Q cell left/right asymmetry of migration is independent of the GPA-16/Ga pathway which regulates other left/right asymmetries, including nervous system L/R asymmetry. No extracellular cue has been identified that guides initial Q anterior versus posterior migrations. We show that collagens DPY-17 and SQT-3 control initial Q direction of protrusion. Genetic interactions with UNC-40/DCC and PTP-3/LAR suggest that DPY-17 and SQT-3 drive posterior migration and might act with both receptors or in a parallel pathway. Analysis of mutants in other collagens and extracellular matrix components indicated that general perturbation of collagens and the extracellular matrix (ECM) did not result in directional defects, and that the effect of DPY-17 and SQT-3 on Q direction is specific. DPY-17 and SQT-3 are components of the cuticle, but a role in the basement membrane cannot be excluded. Possibly, DPY-17 and SQT-3 are part of a pattern in the cuticle and/or basement membrane that is oriented to the anterior-posterior axis of the animal and that is deciphered by the Q cells in a left-right asymmetric fashion. Alternatively, DPY-17 and SQT-3 might be involved in the production or stabilization of a guidance cue that directs Q migrations. In any case, these results describe a novel role for the DPY-17 and SQT-3 collagens in directing posterior Q neuroblast migration.
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http://dx.doi.org/10.3390/jdb9010007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8006237PMC
February 2021

Phase Identification and Ordered Vacancy Imaging in Epitaxial Metallic TaN Thin Films.

ACS Appl Mater Interfaces 2021 Mar 5;13(10):12575-12580. Epub 2021 Mar 5.

Materials Science and Technology Division, U.S. Naval Research Laboratory, Washington, District of Columbia 20375, United States.

Epitaxial transition metal nitrides (TMNs) are an emerging class of crystalline thin film metals that can be heteroepitaxially integrated with common group III-nitride semiconductors such as GaN and AlN. Within a binary family of TMN compounds (.., TaN), several phases typically exist, many with similar crystal structures that are difficult to distinguish by conventional X-ray diffraction or other bulk characterization means. In this work, we demonstrate the combined power of high-resolution transmission and aberration-corrected scanning transmission electron microscopy for definitive phase identification of tantalum nitrides with different N-sublattice ordering. Analysis of molecular beam epitaxy-grown γ-TaN films on SiC substrates shows that the films are γ phase, threading dislocation-free, and Ta-deficient. The lack of Ta manifests as ordered Ta vacancy planar defects oriented in the plane perpendicular to the [0001] growth direction and accounts for the substoichiometry. Optimization of the growth parameters should reduce the Ta vacancy concentration, and alternatively, exploitation of the attractive nature of the Ta vacancies may enable novel planar structures. These findings serve as an important first step in applying this epitaxial TMN material for new electronic and superconducting device structures.
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http://dx.doi.org/10.1021/acsami.0c22244DOI Listing
March 2021

Metabolic factors and the risk of small intestine cancers: Pooled study of 800 000 individuals in the metabolic syndrome and cancer project.

Int J Cancer 2021 Feb 26. Epub 2021 Feb 26.

Department of Clinical Sciences Lund, Lund University, Lund, Sweden.

To explore the largely unknown etiology of small intestine cancer, we examined metabolic factors and risk of small intestine cancer overall and by subtypes. Among 404 220 women and 403 265 men in six European cohorts, we applied Cox regression with adjustment for smoking and body mass index (BMI), to calculate sex-specific hazard ratios (HRs) of small intestine cancer by levels of BMI, mean arterial pressure (MAP) and plasma total cholesterol, triglycerides and glucose. We also calculated HRs for these factors combined (metabolic score; MetS) and used Wald test statistics to investigate pairwise interactions between metabolic factors on risk. We also performed analyses separately per subtype (neuroendocrine tumors [NETs] and adenocarcinomas). During a median follow-up of 16.9 years, 144 women and 195 men were diagnosed with small intestine cancer, including 184 NETs and 99 adenocarcinomas. Among men, no main associations or interactions between metabolic factors were observed in relation to the risk of small intestine cancer. Among women, triglycerides were positively and linearly associated with risk (HR per standard deviation [SD]: 1.23, 95% confidence interval [CI]: 1.04-1.46), and a positive association was also observed for the MetS (HR per SD: 1.25, 95% CI: 1.02-1.52). Positive interactions were observed among women between triglycerides and cholesterol (P = .0005), and between MAP and glucose (P = .009), on risk. Glucose was positively associated with adenocarcinomas among women. This large, prospective study suggests that elevated triglycerides, and metabolic factors in interaction, confer an increased risk of small intestine cancer among women, but not among men.
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http://dx.doi.org/10.1002/ijc.33530DOI Listing
February 2021

Affective Interpersonal Touch in Close Relationships: A Cross-Cultural Perspective.

Authors:
Agnieszka Sorokowska Supreet Saluja Piotr Sorokowski Tomasz Frąckowiak Maciej Karwowski Toivo Aavik Grace Akello Charlotte Alm Naumana Amjad Afifa Anjum Kelly Asao Chiemezie S Atama Derya Atamtürk Duyar Richard Ayebare Carlota Batres Mons Bendixen Aicha Bensafia Boris Bizumic Mahmoud Boussena David M Buss Marina Butovskaya Seda Can Katarzyna Cantarero Antonin Carrier Hakan Cetinkaya Dominika Chabin Daniel Conroy-Beam Jorge Contreras-Graduño Marco Antonio Correa Varella Rosa María Cueto Marcin Czub Daria Dronova Seda Dural Izzet Duyar Berna Ertugrul Agustín Espinosa Carla Sofia Esteves Farida Guemaz Mária Haľamová Iskra Herak Ivana Hromatko Chin-Ming Hui Jas Laile Jaafar Feng Jiang Konstantinos Kafetsios Tina Kavcic Leif Edward Ottesen Kennair Nicolas O Kervyn Imran Ahmed Khilji Nils C Köbis Aleksandra Kostic András Láng Georgina R Lennard Ernesto León Torun Lindholm Giulia Lopez Zoi Manesi Rocio Martinez Sarah L McKerchar Norbert Meskó Girishwar Misra Conal Monaghan Emanuel C Mora Alba Moya-Garofano Bojan Musil Jean Carlos Natividade George Nizharadze Elisabeth Oberzaucher Anna Oleszkiewicz Ike Ernest Onyishi Baris Özener Ariela Francesca Pagani Vilmante Pakalniskiene Miriam Parise Farid Pazhoohi Marija Pejičić Annette Pisanski Katarzyna Pisanski Nejc Plohl Camelia Popa Pavol Prokop Muhammad Rizwan Mario Sainz Svjetlana Salkičević Ruta Sargautyte Ivan Sarmany-Schuller Susanne Schmehl Anam Shahid Rizwana Shaikh Shivantika Sharad Razi Sultan Siddiqui Franco Simonetti Meri Tadinac Karina Ugalde González Olga Uhryn Christin-Melanie Vauclair Luis Diego Vega Araya Dwi Ajeng Widarini Gyesook Yoo Zainab Fotowwat Zadeh Marta Zaťková Maja Zupančič Ilona Croy

Pers Soc Psychol Bull 2021 Feb 22:146167220988373. Epub 2021 Feb 22.

TU Dresden, Dresden, Germany.

Interpersonal touch behavior differs across cultures, yet no study to date has systematically tested for cultural variation in affective touch, nor examined the factors that might account for this variability. Here, over 14,000 individuals from 45 countries were asked whether they embraced, stroked, kissed, or hugged their partner, friends, and youngest child during the week preceding the study. We then examined a range of hypothesized individual-level factors (sex, age, parasitic history, conservatism, religiosity, and preferred interpersonal distance) and cultural-level factors (regional temperature, parasite stress, regional conservatism, collectivism, and religiosity) in predicting these affective-touching behaviors. Our results indicate that affective touch was most prevalent in relationships with partners and children, and its diversity was relatively higher in warmer, less conservative, and religious countries, and among younger, female, and liberal people. This research allows for a broad and integrated view of the bases of cross-cultural variability in affective touch.
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http://dx.doi.org/10.1177/0146167220988373DOI Listing
February 2021

A randomized controlled trial investigating effects of an individualized pedometer driven walking program on chronic low back pain.

BMC Musculoskelet Disord 2021 Feb 19;22(1):206. Epub 2021 Feb 19.

College of Medicine, University of Saskatchewan, Saskatoon, Canada.

Background: Walking is an easily prescribed physical activity for people with low back pain (LBP). However, the evidence for its effectiveness to improve pain and disability levels for people with chronic low back pain (CLBP) within a community setting has not been evaluated. This study evaluates the effectiveness of a clinician guided, pedometer-driven, walking intervention for increasing physical activity and improving clinical outcomes compared to education and advice.

Methods: Randomized controlled trial recruiting N = 174 adults with CLBP. Participants were randomly allocated into either a standardized care group (SG) or pedometer based walking group (WG) using minimization allocation with a 2:1 ratio to the WG. Prior to randomization all participants were given a standard package of education and advice regarding self-management and the benefits of staying active. Following randomization the WG undertook a physiotherapist guided pedometer-driven walking program for 12 weeks. This was individually tailored by weekly negotiation of daily step targets. Main outcome was the Oswestry Disability Index (ODI) recorded at baseline, 12 weeks, 6 and 12 months. Other outcomes included, numeric pain rating, International Physical Activity Questionnaire (IPAQ), Fear-Avoidance Beliefs Questionnaire (FABQ), Back Beliefs questionnaire (BBQ), Physical Activity Self-efficacy Scale, and EQ-5D-5L quality of life estimate.

Results: N = 138 (79%) participants completed all outcome measures at 12 weeks reducing to N = 96 (55%) at 12 months. Both observed and intention to treat analysis did not show any statistically significant difference in ODI change score between the WG and the SG at all post-intervention time points. There were also no significant between group differences for change scores in all secondary outcome measures. Post hoc sensitivity analyses revealed moderately disabled participants (baseline ODI ≥ 21.0) demonstrated a greater reduction in mean ODI scores at 12 months in the WG compared to SG, while WG participants with a daily baseline step count < 7500 steps demonstrated a greater reduction in mean ODI scores at 12 weeks.

Conclusions: Overall, we found no significant difference in change of levels of (ODI) disability between the SG and WG following the walking intervention. However, ODI responses to a walking program for those with moderate levels of baseline disability and those with low baseline step count offer a potential future focus for continued research into the benefit of walking as a management strategy for chronic LBP.

Trial Registration: United States National Institutes of Health Clinical Trails registry (http://ClinicalTrials.gov/) No. NCT02284958 (27/10/2014).
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http://dx.doi.org/10.1186/s12891-021-04060-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7896363PMC
February 2021

A randomized controlled trial of yoga vs nonaerobic exercise for veterans with PTSD: Understanding efficacy, mechanisms of change, and mode of delivery.

Contemp Clin Trials Commun 2021 Mar 28;21:100719. Epub 2021 Jan 28.

VA San Diego Healthcare System, UCSD Department of Preventive Medicine and Public Health, 9500 Gilman Dr., MC0725, La Jolla, CA, 92093-0725, USA.

Background And Objectives: Posttraumatic stress disorder (PTSD) is a chronic, disabling, and prevalent mental health disorder among Veterans. Despite the availability of empirically supported psychotherapies, many Veterans remain symptomatic after treatment and/or prefer to seek complementary and integrative health approaches, including yoga, to manage PTSD. The randomized controlled trial (RCT) described herein will evaluate the efficacy of a manualized yoga program as compared to nonaerobic exercise in reducing PTSD severity among Veterans. A secondary aim of this study is to better understand the mechanisms of change.

Methods: Veterans ( = 192) with PTSD will be randomized to hatha yoga or nonaerobic physical activity control; both groups consist of 12 weekly, 60-min group or online training sessions with 15-20 min of daily at-home practice. Outcome measures will be administered at baseline, mid-treatment, posttreatment, and 12-week follow-up.

Projected Outcomes: This study will evaluate changes in PTSD severity (primary outcome) as well as depression, anxiety, anger, sleep problems, and psychosocial disability (secondary outcomes). We will also use multiple mediation to examine two potential models of the mechanisms of clinical effect: the Attention Model (i.e., yoga increases attentional control, which reduces PTSD symptoms), the Coping Model (i.e., yoga increases distress tolerance, which improves coping, which reduces PTSD symptoms), and the combination of these models. This aspect of the study is innovative and important given the absence of an existing, comprehensive model for understanding yoga's impact on PTSD. Ultimately, we hope to develop guidelines for application of yoga to PTSD recovery.
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http://dx.doi.org/10.1016/j.conctc.2021.100719DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875811PMC
March 2021

Parkinson's Disease and COVID-19: Do We Need to Be More Patient?

Mov Disord 2021 02;36(2):277

Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada and Division of Neurology, University of Toronto, Toronto, Ontario, Canada.

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http://dx.doi.org/10.1002/mds.28469DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014182PMC
February 2021

COVID-19 outbreak among physicians at a Canadian curling bonspiel: a descriptive observational study.

CMAJ Open 2021 Jan-Mar;9(1):E87-E95. Epub 2021 Feb 9.

Division of Gastroenterology and Hepatology (Burak), Department of Medicine, and Physician Learning Program (Burak, Law, Rice), Continuing Medical Education and Professional Development, and Cumming School of Medicine, University of Calgary; Alberta Health Services (Hu); Department of Community Health Sciences (Hu), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Radiology and Diagnostic Imaging (Fung), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Division of Orthopedic Surgery (Woo), Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, Sask.; Provincial Laboratory for Public Health (Fonseca), Alberta Precision Laboratories; Department of Microbiology, Immunology and Infectious Diseases (Fonseca), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Roy Romano Provincial Lab (Lang), Saskatchewan Health Authority, Regina, Sask.; Division of Infectious Diseases (Kanji), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta; Provincial Laboratory for Public Health (Kanji), Alberta Precision Laboratories, Edmonton, Alta.; Division of Infectious Diseases (Meatherall), Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alta.

Background: Transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is known to occur among individuals who congregate in large groups, especially during indoor activities. Our objective was to provide a detailed clinical description of an outbreak of coronavirus disease 2019 (COVID-19) that occurred after a sporting and social event during the early days of the pandemic.

Methods: We conducted a descriptive study of a curling bonspiel in Edmonton held on Mar. 11-14, 2020. We used standardized interviews between Apr. 17 and May 5, 2020, to collect demographic data, travel history, symptoms (type, onset and duration), self-reported testing results for SARS-CoV-2 ribonucleic acid (RNA) using reverse transcription polymerase chain reaction (RT-PCR), and clinical outcomes. We also obtained results of convalescent SARS-CoV-2 immunoglobulin G serology.

Results: All 73 curlers (55 active health care workers) who participated in the bonspiel were interviewed for the study. Convalescent SARS-CoV-2 immunoglobulin G serology was completed in 62 (85%) participants. Of the 73 participants (55 [75%] male, median age 51 [range 26-79] yr, 58 [79%] physicians), 40 curlers (55%) tested positive for SARS-CoV-2 RNA by RT-PCR; an additional 16 participants developed symptoms but had negative swabs or were not tested (14 were probable cases), for a 74% attack rate (confirmed or probable cases). Anosmia with ageusia or dysgeusia occurred in 39 of 54 (72%) confirmed or probable cases. The clinical course was mild in most participants (1 emergency visit, no hospital admissions). Transmission likely occurred from multiple individuals with minor nonspecific symptoms during the event, possibly during shared meals.

Interpretation: The 74% attack rate (confirmed or probable cases) highlights the infectivity of SARS-CoV-2 during sporting and social events. This reinforces the need for public health measures (masking, physical distancing and limiting the size of social gatherings) during future waves of COVID-19 in Canada.
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http://dx.doi.org/10.9778/cmajo.20200115DOI Listing
February 2021

A SARS-CoV-2 Cluster in an Acute Care Hospital.

Ann Intern Med 2021 Feb 9. Epub 2021 Feb 9.

Brigham and Women's Hospital, Boston, Massachusetts (R.T., K.F., D.G., C.B., H.S., N.W., E.G., A.R., M.P., K.B., J.S., C.A.M.).

Background: Little is known about clusters of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in acute care hospitals.

Objective: To describe the detection, mitigation, and analysis of a large cluster of SARS-CoV-2 infections in an acute care hospital with mature infection control policies.

Design: Descriptive study.

Setting: Brigham and Women's Hospital, Boston, Massachusetts.

Participants: Patients and staff with cluster-related SARS-CoV-2 infections.

Intervention: Close contacts of infected patients and staff were identified and tested every 3 days, patients on affected units were preemptively isolated and repeatedly tested, affected units were cleaned, room ventilation was measured, and specimens were sent for whole-genome sequencing. A case-control study was done to compare clinical interactions, personal protective equipment use, and breakroom and workroom practices in SARS-CoV-2-positive versus negative staff.

Measurements: Description of the cluster, mitigation activities, and risk factor analysis.

Results: Fourteen patients and 38 staff members were included in the cluster per whole-genome sequencing and epidemiologic associations. The index case was a symptomatic patient in whom isolation was discontinued after 2 negative results on nasopharyngeal polymerase chain reaction testing. The patient subsequently infected multiple roommates and staff, who then infected others. Seven of 52 (13%) secondary infections were detected only on second or subsequent tests. Eight of 9 (89%) patients who shared rooms with potentially contagious patients became infected. Potential contributing factors included high viral loads, nebulization, and positive pressure in the index patient's room. Risk factors for transmission to staff included presence during nebulization, caring for patients with dyspnea or cough, lack of eye protection, at least 15 minutes of exposure to case patients, and interactions with SARS-CoV-2-positive staff in clinical areas. Whole-genome sequencing confirmed that 2 staff members were infected despite wearing surgical masks and eye protection.

Limitation: Findings may not be generalizable.

Conclusion: SARS-CoV-2 clusters can occur in hospitals despite robust infection control policies. Insights from this cluster may inform additional measures to protect patients and staff.

Primary Funding Source: None.
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http://dx.doi.org/10.7326/M20-7567DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924623PMC
February 2021

Severity of Chest Imaging is Correlated with Risk of Acute Neuroimaging Findings among Patients with COVID-19.

AJNR Am J Neuroradiol 2021 Feb 4. Epub 2021 Feb 4.

From the Departments of Radiology (M.L., M.D.L., B.C.Y., D.P.M., E.J.F., S.P.R., W.A.M., J.C., S.Y.H., J.K.-C., B.P.L., K.B.).

Background And Purpose: Severe respiratory distress in patients with COVID-19 has been associated with higher rate of neurologic manifestations. Our aim was to investigate whether the severity of chest imaging findings among patients with coronavirus disease 2019 (COVID-19) correlates with the risk of acute neuroimaging findings.

Materials And Methods: This retrospective study included all patients with COVID-19 who received care at our hospital between March 3, 2020, and May 6, 2020, and underwent chest imaging within 10 days of neuroimaging. Chest radiographs were assessed using a previously validated automated neural network algorithm for COVID-19 (Pulmonary X-ray Severity score). Chest CTs were graded using a Chest CT Severity scoring system based on involvement of each lobe. Associations between chest imaging severity scores and acute neuroimaging findings were assessed using multivariable logistic regression.

Results: Twenty-four of 93 patients (26%) included in the study had positive acute neuroimaging findings, including intracranial hemorrhage ( = 7), infarction ( = 7), leukoencephalopathy ( = 6), or a combination of findings ( = 4). The average length of hospitalization, prevalence of intensive care unit admission, and proportion of patients requiring intubation were significantly greater in patients with acute neuroimaging findings than in patients without them ( < .05 for all). Compared with patients without acute neuroimaging findings, patients with acute neuroimaging findings had significantly higher mean Pulmonary X-ray Severity scores (5.0 [SD, 2.9] versus 9.2 [SD, 3.4], < .001) and mean Chest CT Severity scores (9.0 [SD, 5.1] versus 12.1 [SD, 5.0], = .041). The pulmonary x-ray severity score was a significant predictor of acute neuroimaging findings in patients with COVID-19.

Conclusions: Patients with COVID-19 and acute neuroimaging findings had more severe findings on chest imaging on both radiographs and CT compared with patients with COVID-19 without acute neuroimaging findings. The severity of findings on chest radiography was a strong predictor of acute neuroimaging findings in patients with COVID-19.
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http://dx.doi.org/10.3174/ajnr.A7032DOI Listing
February 2021

Adaptive disclosure, a combat-specific PTSD treatment, versus cognitive-processing therapy, in deployed marines and sailors: A randomized controlled non-inferiority trial.

Psychiatry Res 2021 Mar 24;297:113761. Epub 2021 Jan 24.

Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, United States; Department of Psychiatry, University of California San Diego, San Diego, CA, United States.

Adaptive Disclosure (AD) is a new emotion-focused psychotherapy for combat-related PTSD. As a second step in the evaluation process, we conducted a non-inferiority (NI) trial of AD, relative to Cognitive Processing Therapy - Cognitive Therapy version (CPT-C), an established first-line psychotherapy. Participants were 122 U.S. Marines and Sailors. The primary endpoint was PTSD symptom severity change from pre- to posttreatment, using the Clinician Administered PTSD Scale for DSM-IV. Secondary endpoints were depression (Patient Health Questionnaire-9; PHQ-9) and functioning (Veterans Rand Health Survey-12; VR-12). For cases with complete data, the mean difference in CAPS-IV change scores was 0.33 and the confidence interval (CI) did not include the predefined NI margin (95% CI =-10.10, 9.44). The mean difference in PHQ-9 change scores was -1.01 and the CI did not include the predefined margin (95% CI = -3.31, 1.28), as was the case for the VR-12 Physical Component and VR-12 Mental Component subscale scores (0.27; 95% CI = -4.50, 3.95, and -2.10; 95% CI = -7.03, 2.83, respectively). A series of intent-to-treat sensitivity analyses confirmed these results. The differential effect size for CAPS-IV was d = 0.01 (nonsignificant). As predicted, Adaptive Disclosure was found to be no less effective than a first-line psychotherapy.
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http://dx.doi.org/10.1016/j.psychres.2021.113761DOI Listing
March 2021

Functional Scaffold-Free Bone Equivalents Induce Osteogenic and Angiogenic Processes in a Human In Vitro Fracture Hematoma Model.

J Bone Miner Res 2021 Feb 3. Epub 2021 Feb 3.

Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

After trauma, the formed fracture hematoma within the fracture gap contains all the important components (immune/stem cells, mediators) to initiate bone regeneration immediately. Thus, it is of great importance but also the most susceptible to negative influences. To study the interaction between bone and immune cells within the fracture gap, up-to-date in vitro systems should be capable of recapitulating cellular and humoral interactions and the physicochemical microenvironment (eg, hypoxia). Here, we first developed and characterized scaffold-free bone-like constructs (SFBCs), which were produced from bone marrow-derived mesenchymal stromal cells (MSCs) using a macroscale mesenchymal condensation approach. SFBCs revealed permeating mineralization characterized by increased bone volume (μCT, histology) and expression of osteogenic markers (RUNX2, SPP1, RANKL). Fracture hematoma (FH) models, consisting of human peripheral blood (immune cells) mixed with MSCs, were co-cultivated with SFBCs under hypoxic conditions. As a result, FH models revealed an increased expression of osteogenic (RUNX2, SPP1), angiogenic (MMP2, VEGF), HIF-related (LDHA, PGK1), and inflammatory (IL6, IL8) markers after 12 and 48 hours co-cultivation. Osteogenic and angiogenic gene expression of the FH indicate the osteoinductive potential and, thus, the biological functionality of the SFBCs. IL-6, IL-8, GM-CSF, and MIP-1β were detectable within the supernatant after 24 and 48 hours of co-cultivation. To confirm the responsiveness of our model to modifying substances (eg, therapeutics), we used deferoxamine (DFO), which is well known to induce a cellular hypoxic adaptation response. Indeed, DFO particularly increased hypoxia-adaptive, osteogenic, and angiogenic processes within the FH models but had little effect on the SFBCs, indicating different response dynamics within the co-cultivation system. Therefore, based on our data, we have successfully modeled processes within the initial fracture healing phase in vitro and concluded that the cross-talk between bone and immune cells in the initial fracture healing phase is of particular importance for preclinical studies. © 2021 American Society for Bone and Mineral Research (ASBMR).
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http://dx.doi.org/10.1002/jbmr.4267DOI Listing
February 2021

Spectrophotometric evaluation of hemolysis in plasma by quantification of free oxyhemoglobin, methemoglobin, and methemalbumin in presence of bilirubin.

J Biophotonics 2021 Feb 1:e202000461. Epub 2021 Feb 1.

Institute of Laboratory Medicine, University Hospital, LMU Munich, Germany.

Severe intravascular hemolysis leads to the simultaneous presence of free heme pigments (oxyhemoglobin, methemoglobin, and methemalbumin) and bilirubin in human plasma. Standard spectrophotometric methods used to assess in vivo hemolysis inadequately address this complex analytical situation. Thus, we propose a novel quantification algorithm to ensure the highest analytical specificity. A corresponding second-derivative fitting algorithm was validated according to the guideline of bioanalytical method validation from the European Medicines Agency using plasma specimens (n = 1759) spiked with different concentrations of oxyhemoglobin and methemoglobin. The results were compared to standard spectrophotometric quantification methods described by Harboe, Noe, and Fairbanks. Based on the second-derivative method, simultaneous quantification of oxyhemoglobin and methemoglobin/methemalbumin in samples with total bilirubin concentrations ≤4.9 mg/dL (83.8 μmol/L) provided robust results (inaccuracy ≤20%, imprecision ≤16%). Analyzing UV/VIS spectra of plasma from patients with confirmed severe intravascular hemolysis evidenced an underestimation of up to 33% for the combined free heme pigment content. The employed second-derivative algorithm allows for automated and highly specific quantification of the free heme pigment content in diluted human plasma, which cannot be realized with standard spectrophotometric evaluation methods. An Excel-based tool readily applicable to clinical datasets accompanies this manuscript.
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http://dx.doi.org/10.1002/jbio.202000461DOI Listing
February 2021

Improved Segmentation of the Intracranial and Ventricular Volumes in Populations with Cerebrovascular Lesions and Atrophy Using 3D CNNs.

Neuroinformatics 2021 Feb 1. Epub 2021 Feb 1.

Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada.

Successful segmentation of the total intracranial vault (ICV) and ventricles is of critical importance when studying neurodegeneration through neuroimaging. We present iCVMapper and VentMapper, robust algorithms that use a convolutional neural network (CNN) to segment the ICV and ventricles from both single and multi-contrast MRI data. Our models were trained on a large dataset from two multi-site studies (N = 528 subjects for ICV, N = 501 for ventricular segmentation) consisting of older adults with varying degrees of cerebrovascular lesions and atrophy, which pose significant challenges for most segmentation approaches. The models were tested on 238 participants, including subjects with vascular cognitive impairment and high white matter hyperintensity burden. Two of the three test sets came from studies not used in the training dataset. We assessed our algorithms relative to four state-of-the-art ICV extraction methods (MONSTR, BET, Deep Extraction, FreeSurfer, DeepMedic), as well as two ventricular segmentation tools (FreeSurfer, DeepMedic). Our multi-contrast models outperformed other methods across many of the evaluation metrics, with average Dice coefficients of 0.98 and 0.96 for ICV and ventricular segmentation respectively. Both models were also the most time efficient, segmenting the structures in orders of magnitude faster than some of the other available methods. Our networks showed an increased accuracy with the use of a conditional random field (CRF) as a post-processing step. We further validated both segmentation models, highlighting their robustness to images with lower resolution and signal-to-noise ratio, compared to tested techniques. The pipeline and models are available at: https://icvmapp3r.readthedocs.io and https://ventmapp3r.readthedocs.io to enable further investigation of the roles of ICV and ventricles in relation to normal aging and neurodegeneration in large multi-site studies.
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http://dx.doi.org/10.1007/s12021-021-09510-1DOI Listing
February 2021

Investigating the Diversity and Host Range of Novel Parvoviruses from North American Ducks Using Epidemiology, Phylogenetics, Genome Structure, and Codon Usage Analysis.

Viruses 2021 01 28;13(2). Epub 2021 Jan 28.

Department of Biology, Memorial University of Newfoundland, 232 Elizabeth Ave., St. John's, NL A1B 3X9, Canada.

Parvoviruses are small single-stranded DNA viruses that can infect both vertebrates and invertebrates. We report here the full characterization of novel viruses we identified in ducks, including two viral species within the subfamily (duck-associated chapparvovirus, DAC) and a novel species within the subfamily (duck-associated ambidensovirus, DAAD). Overall, 5.7% and 21.1% of the 123 screened ducks (American black ducks, mallards, northern pintail) were positive for DAC and DAAD, respectively, and both viruses were more frequently detected in autumn than in winter. Genome organization and predicted transcription profiles of DAC and DAAD were similar to viruses of the genera and , respectively. Their association to these genera was also demonstrated by subfamily-wide phylogenetic and distance analyses of non-structural protein NS1 sequences. While DACs were included in a highly supported clade of avian viruses, no definitive conclusions could be drawn about the host type of DAAD because it was phylogenetically close to viruses found in vertebrates and invertebrates and analyses of codon usage bias and nucleotide frequencies of viruses within the family showed no clear host-based viral segregation. This study highlights the high parvoviral diversity in the avian reservoir with many avian-associated parvoviruses likely yet to be discovered.
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http://dx.doi.org/10.3390/v13020193DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912424PMC
January 2021

Uptake of circulating extracellular vesicles from rectal cancer patients and differential responses by human monocyte cultures.

FEBS Open Bio 2021 Mar 8;11(3):724-740. Epub 2021 Feb 8.

Department of Oncology, Akershus University Hospital, Lørenskog, Norway.

Extracellular vesicles (EVs) released by tumor cells can directly or indirectly modulate the phenotype and function of the immune cells of the microenvironment locally or at distant sites. The uptake of circulating EVs and the responses by human monocytes in vitro may provide new insights into the underlying biology of the invasive and metastatic processes in cancer. Although a mixed population of vesicles is obtained with most isolation techniques, we predominantly isolated exosomes (small EVs) and microvesicles (medium EVs) from the SW480 colorectal cancer cell line (established from a primary adenocarcinoma of the colon) by sequential centrifugation and ultrafiltration, and plasma EVs were prepared from 22 patients with rectal adenoma polyps or invasive adenocarcinoma by size-exclusion chromatography. The EVs were thoroughly characterized. The uptake of SW480 EVs was analyzed, and small SW480 EVs were observed to be more potent than medium SW480 EVs in inducing monocyte secretion of cytokines. The plasma EVs were also internalized by monocytes; however, their cytokine-releasing potency was lower than that of the cell line-derived vesicles. The transcriptional changes in the monocytes highlighted differences between adenoma and adenocarcinoma patient EVs in their ability to regulate biological functions, whereas the most intriguing changes were found in monocytes receiving EVs from patients with metastatic compared with localized cancer.
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http://dx.doi.org/10.1002/2211-5463.13098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931235PMC
March 2021