bluuebunny/crossref_metadata_2025 huggingface dataset:
The surgical options for Hunner’s lesions: an update
Authors: Bates Anthony Simon , Rai Jaskarn S , Goddard Jonathan Charles
Published: February 2020

Hunner’s lesions, previously described as Hunner’s ulcers, are a component of bladder pain syndrome (BPS), a condition affecting the lower urinary tract, with symptoms of suprapubic pain related to bladder filling, and associated complaints of urgency and frequency. A diagnosis of BPS requires active exclusion of pathology such as constipation, endometriosis, urinary tract infection, bladder stones and pelvic cancer. Women are predisposed to the condition more than men, in a 4:1 ratio. Survey data indicates 2% of women in the USA suffer from BPS. BPS is both physically and emotionally debilitating. In this review, we look at the place of the Hunner’s lesion in BPS and focus on how a lesion might be treated using the available evidence.
Transfusion Outcomes in Patients Undergoing Unifocalization and Repair of Tetralogy of Fallot With Major Aortopulmonary Collaterals
Authors: Wise-Faberowski Lisa , Irvin Matthew , Quinonez Zoel A. , Long Jin , Asija Ritu , Margetson Tristan D. , Hanley Frank L. , McElhinney Doff B.
Published: February 2020

Background:

Surgical repair of tetralogy of Fallot and major aortopulmonary collaterals (TOF/MAPCAs) involves unifocalization of MAPCAs and reconstruction of the pulmonary arterial circulation. Surgical and cardiopulmonary bypass (CPB) times are long and suture lines are extensive. Maintaining patency of the newly anastomosed vessels while achieving hemostasis is important, and assessment of transfusion practices is critical to successful outcomes.

Methods:

Clinical, surgical, and transfusion data in patients with TOF/MAPCAs repaired at our institution (2013-2018) were reviewed. Types and volumes of blood products used in the perioperative period, in addition to the use of antifibrinolytics and/or procoagulants (factor VIII inhibitor bypassing activity [FEIBA]; anti-inhibitor coagulant complex), were assessed. Outcome measures included days on mechanical ventilation (DOMV), postoperative intensive care unit and hospital length of stay (LoS), and incidence of thrombosis.

Results:

Perioperative transfusion data from 279 patients were analyzed. Surgical (879 ± 175 minutes vs 684 ± 257 minutes) and CPB times (376 ± 124 minutes vs 234 ± 122 minutes) were longer in patients who received FEIBA than those who did not. Although the indexed volume of packed red blood cells (128.4 ± 82.2 mL/kg) and fresh frozen plasma (64.2 ± 41.1 mL/kg) was similar in patients who did and did not receive FEIBA, the amounts of cryoprecipitate (5.5 ± 5.2 mL/kg vs 5.8 ± 4.8 mL/kg) and platelets (19.5 ± 20.7 mL/kg vs 20.8 ± 13 mL/kg) transfused were more in those who did receive FEIBA.

Conclusion:

Perioperative transfusion is an important component in the overall surgical and anesthetic management of patients with TOF/MAPCAs. The intraoperative use of FEIBA was not associated with a decrease in the amount of blood products transfused, DOMV, or LoS or with an increase in thrombotic complications.
Right Anterior Mini-Incision Approach to Anomalous Right Coronary Artery Repair
Authors: Hinton Zoe W. , Meza James M. , Habermann Alyssa C. , Andersen Nicholas D. , Daneshmand Mani A. , Turek Joseph W.
Published: February 2020

The right anterior mini-incision has emerged as an effective minimally invasive approach for adult aortic root and valve operations. However, adoption of minimally invasive techniques has been limited in congenital heart surgery. We report a case of anomalous aortic origin of the right coronary artery repair performed through this approach. Following successful right coronary artery unroofing, the patient had an uncomplicated postoperative hospitalization.
Medical Illustration in the Era of Cardiac Surgery
Authors: Mavroudis Constantine , Lees Gary P. , Idriss Rachid
Published: February 2020

This article reviews the collaboration between clinician and illustrator throughout the ages while highlighting the era of cardiac surgery. Historical notes are based on Professor Sanjib Kumar Ghosh’s extensive review, literature searches, and the archives of the Johns Hopkins University Department of Art as related to Medicine in Baltimore. Personal communications were explored with medical illustrators and medical practitioners, many of whom are colleagues and trainees, to further chronicle the history of medical illustration and education in the era of cardiac surgery. Medical illustrators use their talents and expressive ideas to demonstrate procedures and give them life. These methods are (1) hovering technique; (2) hidden anatomy, ghosted views, or transparency; (3) centrally focused perspective; (4) action techniques to give life to the procedure; (5) use of insets to highlight one part of the drawing; (6) human proportionality using hands or known objects to show size; and (7) step-by-step educational process to depict the stages of a procedure. Vivid examples showing these techniques are demonstrated. The result of this observational analysis underscores the importance of the collaboration between clinician and illustrator to accurately describe intricate pathoanatomy, three-dimensional interrelated anatomic detail, and complex operations. While there are few data to measure the impact of the atlas on medical education, it is an undeniable assertion that anatomical and surgical illustrations have helped to educate and train the modern-day surgeon, cardiologist, and related health-care professionals.
Resident Behaviours to Prioritize According to Canadian Plastic Surgeons
Authors: Mankowski Peter , Demsey Daniel , Brown Erin , Knox Aaron
Published: February 2020

Introduction:

Many articles have been published outlining the resident selection process for plastic surgery training programs. However, which qualities Canadian plastic surgeons value most in their current residents remains unclear. A national survey study was conducted to identify which attributes surgeons associate with the highest resident performance and which behaviours trainees should prioritize during their training.

Methods:

A literature review was performed to identify studies that documented attributes valued in plastic surgery applicants and characteristics of high-performing surgical residents. These qualities were extracted to construct a survey consisting of both ranking and open-ended questions. After an iterative review process, the survey was disseminated nationally to consultants and trainees of Canadian plastic surgery training programs.

Results:

Survey responses were obtained from 120 invitees and a weighted rank was calculated for each evaluated attribute. The terms integrity, professional, and work ethic were viewed as the most important attributes prized by surgeons. Dishonesty, lack of dependability, and unprofessionalism were viewed as the most concerning behaviours. Additionally, disinterest and arrogance were identified by the open-ended questions as behaviours surgeons would like to see less frequently in their trainees. When compared to surgeons, trainees undervalued the importance of knowledge and the impact of unprofessional behaviour.

Conclusions:

With the multiple roles that a resident must fulfill, understanding which attributes are of the most importance will help focus self-directed learning and development within residency programs. Ultimately, instilling the importance of integrity and professionalism is most highly valued by members of the Canadian plastic surgery community.
Epidemiology of Injuries Sustained in Boys’ High School Contact and Collision Sports, 2008-2009 Through 2012-2013
Authors: Hammer Erin , Brooks M. Alison , Hetzel Scott , Arakkal Alan , Comstock R. Dawn
Published: February 2020

Background:

Injury epidemiology for boys’ high school contact and collision sport has been described in several overlapping but fragmented studies. Comprehensive comparisons of injuries sustained in boys’ soccer, wrestling, football, ice hockey, and lacrosse are lacking.

Purpose:

To describe patterns of injury by severity, body site, and diagnosis among high school boys’ contact and collision sports in the United States.

Study Design:

Descriptive epidemiology study.

Methods:

Injury rates and rate ratios (RRs) were calculated for injuries sustained in boys’ high school soccer, wrestling, football, ice hockey, and lacrosse through use of the High School RIO (Reporting Information Online) surveillance data from 2008-2009 through 2012-2013. Injury patterns were described by site, diagnosis, time loss, and severity. Severe injury was defined as an injury that resulted in 21 days or more of time loss from sport participation. Risk of sustaining a concussion was compared between sports.

Results:

The risk of sustaining an injury was higher in competition compared with practice overall (RR, 4.01; 95% CI, 3.90-4.12); the same pattern was true for severe injuries (RR, 4.61; 95% CI, 4.34-4.90). Football players experienced the highest injury rate (3.87 per 1000 athlete-exposures [AEs]) and the highest severe injury rate (0.80 per 1000 AEs). Overall, the most commonly injured body site was the head/face (22.5%), and the most prevalent injury diagnosis was ligament sprain not requiring surgery (23.5%). The most frequently injured body site from severe injury was the knee (24.6%), and fracture or avulsion was the most prevalent severe injury diagnosis (37.0%). Football players had a significantly higher risk of sustaining a concussion compared with other contact or collision sport athletes ( P < .05).

Conclusion:

Injuries rates were higher in competition than those in practice for boys’ high school contact and collision athletes. Football players sustained the highest injury rate, the highest severe injury rate, and the highest concussion rate among the sports included in this analysis. Understanding these patterns of injury can generate policy and rule changes to make sports safer and maintain high levels of participation.
Hunting to Feel Human, the Process of Women’s Help-Seeking for Suicidality After Intimate Partner Violence: A Feminist Grounded Theory and Photovoice Study
Authors: Taylor Petrea
Published: February 2020

Women reach out to health care providers for a multitude of health problems in the aftermath of intimate partner violence, including suicidality; however, little is known about how they seek help. The purpose of this study was to explore how women seek help for suicidality after intimate partner violence using a feminist grounded theory and photovoice multiple qualitative research design. Interviews were conducted with 32 women from New Brunswick, Canada, and seven from this sample also participated in five photovoice meetings where they critically reflected on self-generated photos of their help-seeking experiences. Data were analyzed using the constant comparative analysis of grounded theory. Hunting to Feel Human involves fighting for a sense of belonging and personal value by perceiving validation from health care providers. Women battled System Entrapment, a feeling of being dehumanized, by Gauging for Validation and Taking the Path of Least Entrapment. Implications for health care providers include prioritizing validating interactions and adopting a relational approach to practice.
Stem cell donors should not be screened for clonal hematopoiesis
Authors: Gibson Christopher J. , Lindsley R. Coleman
Published: February 2020

This article has a companion Point by DeZern and Gondek.
Anthracycline-related cardiotoxicity in older patients with acute myeloid leukemia: a Young SIOG review paper
Authors: Neuendorff Nina Rosa , Loh Kah Poh , Mims Alice S. , Christofyllakis Konstantinos , Soo Wee-Kheng , Bölükbasi Bediha , Oñoro-Algar Carlos , Hundley William G. , Klepin Heidi D.
Published: February 2020

The incidence of acute myeloid leukemia (AML) increases with age. Intensive induction chemotherapy containing cytarabine and an anthracycline has been part of the upfront and salvage treatment of AML for decades. Anthracyclines are associated with a significant risk of cardiotoxicity (especially anthracycline-related left ventricular dysfunction [ARLVD]). In the older adult population, the higher prevalence of cardiac comorbidities and risk factors may further increase the risk of ARLVD. In this article of the Young International Society of Geriatric Oncology group, we review the prevalence of ARLVD in patients with AML and factors predisposing to ARLVD, focusing on older adults when possible. In addition, we review the assessment of cardiac function and management of ARLVD during and after treatment. It is worth noting that only a minority of clinical trials focus on alternative treatment strategies in patients with mildly declined left ventricular ejection fraction or at a high risk for ARLVD. The limited evidence for preventive strategies to ameliorate ARLVD and alternative strategies to anthracycline use in the setting of cardiac comorbidities are discussed. Based on extrapolation of findings from younger adults and nonrandomized trials, we recommend a comprehensive baseline evaluation of cardiac function by imaging, cardiac risk factors, and symptoms to risk stratify for ARLVD. Anthracyclines remain an appropriate choice for induction although careful risk-stratification based on cardiac disease, risk factors, and predicted chemotherapy-response are warranted. In case of declined left ventricular ejection fraction, alternative strategies should be considered.
Exploring the influences on men’s engagement with weight loss services: a qualitative study
Authors: Elliott Megan , Gillison Fiona , Barnett Julie
Published: February 2020

Background

Engagement of men with commercial and UK National Health Service (NHS) weight loss services is low, and few studies report on why this may be. However, evidence shows that men who do participate in weight loss programmes tend to lose as much, or more weight than women. The present study aimed to explore men’s experiences and expectations of mainstream weight loss services in the UK, following referral from a medical professional, particular in relation to barriers and motivators.

Methods

Semi-structured interviews were conducted with 18 men with a BMI over 25 kg/m2including those who had, and had not, attended group-based or one-to-one weight loss services. Interviews were analysed using thematic analysis.

Results

Two themes were identified;'Fear as a motivation for change'(1) and'Attitudes towards existing weight loss services'(2). Within theme two, two subthemes were identified;‘Female dominated services’and‘Incompatibility of existing services for men’.The findings suggest that fear, as a result of a medical diagnosis or referral is a mechanism for motivating men to engage with weight loss services. This was often augmented by awareness of other people’s experiences of poor health due to their weight. The gender imbalance and attitudes towards existing weight loss services deterred men from engaging with or continuously attending sessions. This imbalance resulted in feelings of self-consciousness, shame and a perceived stigma for men using weight loss services. These experiences highlighted the importance of providing services which align with men’s preferences to promote engagement.

Conclusions

A medical diagnosis or referral serves as a strong motivator for men to engage with weight loss services by invoking fear of negative consequences of not losing weight. Men perceived weight loss services to be feminised spaces, in which they felt self-conscious and out of place. As a result, men were deterred from engaging and considered their options were limited. Implications for service design and commissioning are discussed. Involving men in research, service design and evaluation is key to improving their engagement and weight loss.
Compassion fatigue, watching patients suffering and emotional display rules among hospice professionals: a daily diary study
Authors: Portoghese Igor , Galletta Maura , Larkin Philip , Sardo Salvatore , Campagna Marcello , Finco Gabriele , D’Aloja Ernesto
Published: February 2020

Background

Hospice workers are required to regularly use emotional regulation strategies in an attempt to encourage and sustain terminally ill patients and families. Daily emotional regulation in reaction to constantly watching suffering patients may be intensified among those hospice professionals who have high levels of compassion fatigue. The main object of this study was to examine the relationship between daily exposition to seeing patient suffering and daily emotional work, and to assess whether compassion fatigue (secondary traumatic stress and burnout) buffers this relationship.

Methods

We used a diary research design for collecting daily fluctuations in seeing patients suffering and emotional work display. Participants filled in a general survey and daily survey over a period of eight consecutive workdays. A total of 39 hospice professionals from two Italian hospices participated in the study.

Results

Multilevel analyses demonstrated that daily fluctuations in seeing patients suffering was positively related to daily emotional work display after controlling for daily death of patients. Moreover, considering previous levels of compassion fatigue, a buffering effect of high burnout on seeing patients suffering - daily emotional work display relationship was found.

Conclusions

A central finding of our study is that fluctuations in daily witness of patients suffering are positively related to daily use of positive emotional regulations. Further, our results show that burnout buffers this relationship such that hospice professionals with high burnout use more emotional display in days where they recurrently witness patients suffering.
The duration of chemoprophylaxis against malaria after treatment with artesunate-amodiaquine and artemether-lumefantrine and the effects of pfmdr1 86Y and pfcrt 76T: a meta-analysis of individual patient data
Authors: Bretscher Michael T. , Dahal Prabin , Griffin Jamie , Stepniewska Kasia , Bassat Quique , Baudin Elisabeth , D’Alessandro Umberto , Djimde Abdoulaye A. , Dorsey Grant , Espié Emmanuelle , Fofana Bakary , González Raquel , Juma Elizabeth , Karema Corine , Lasry Estrella , Lell Bertrand , Lima Nines , Menéndez Clara , Mombo-Ngoma Ghyslain , Moreira Clarissa , Nikiema Frederic , Ouédraogo Jean B. , Staedke Sarah G. , Tinto Halidou , Valea Innocent , Yeka Adoke , Ghani Azra C. , Guerin Philippe J. , Okell Lucy C.
Published: February 2020

Background

The majority of Plasmodium falciparum malaria cases in Africa are treated with the artemisinin combination therapies artemether-lumefantrine (AL) and artesunate-amodiaquine (AS-AQ), with amodiaquine being also widely used as part of seasonal malaria chemoprevention programs combined with sulfadoxine-pyrimethamine. While artemisinin derivatives have a short half-life, lumefantrine and amodiaquine may give rise to differing durations of post-treatment prophylaxis, an important additional benefit to patients in higher transmission areas.

Methods

We analyzed individual patient data from 8 clinical trials of AL versus AS-AQ in 12 sites in Africa (n = 4214 individuals). The time to PCR-confirmed reinfection after treatment was used to estimate the duration of post-treatment protection, accounting for variation in transmission intensity between settings using hidden semi-Markov models. Accelerated failure-time models were used to identify potential effects of covariates on the time to reinfection. The estimated duration of chemoprophylaxis was then used in a mathematical model of malaria transmission to determine the potential public health impact of each drug when used for first-line treatment.

Results

We estimated a mean duration of post-treatment protection of 13.0 days (95% CI 10.7–15.7) for AL and 15.2 days (95% CI 12.8–18.4) for AS-AQ overall. However, the duration varied significantly between trial sites, from 8.7–18.6 days for AL and 10.2–18.7 days for AS-AQ. Significant predictors of time to reinfection in multivariable models were transmission intensity, age, drug, and parasite genotype. Where wild type pfmdr1 and pfcrt parasite genotypes predominated (<=20% 86Y and 76T mutants, respectively), AS-AQ provided ~ 2-fold longer protection than AL. Conversely, at a higher prevalence of 86Y and 76T mutant parasites (> 80%), AL provided up to 1.5-fold longer protection than AS-AQ. Our simulations found that these differences in the duration of protection could alter population-level clinical incidence of malaria by up to 14% in under-5-year-old children when the drugs were used as first-line treatments in areas with high, seasonal transmission.

Conclusion

Choosing a first-line treatment which provides optimal post-treatment prophylaxis given the local prevalence of resistance-associated markers could make a significant contribution to reducing malaria morbidity.
The risk of sudden cardiac arrest and ventricular arrhythmia with rosiglitazone versus pioglitazone: real-world evidence on thiazolidinedione safety
Authors: Leonard Charles E. , Brensinger Colleen M. , Dawwas Ghadeer K. , Deo Rajat , Bilker Warren B. , Soprano Samantha E. , Dhopeshwarkar Neil , Flory James H. , Bloomgarden Zachary T. , Gagne Joshua J. , Aquilante Christina L. , Kimmel Stephen E. , Hennessy Sean
Published: February 2020

Background

The low cost of thiazolidinediones makes them a potentially valuable therapeutic option for the > 300 million economically disadvantaged persons worldwide with type 2 diabetes mellitus. Differential selectivity of thiazolidinediones for peroxisome proliferator-activated receptors in the myocardium may lead to disparate arrhythmogenic effects. We examined real-world effects of thiazolidinediones on outpatient-originating sudden cardiac arrest (SCA) and ventricular arrhythmia (VA).

Methods

We conducted population-based high-dimensional propensity score-matched cohort studies in five Medicaid programs (California, Florida, New York, Ohio, Pennsylvania | 1999–2012) and a commercial health insurance plan (Optum Clinformatics | 2000–2016). We defined exposure based on incident rosiglitazone or pioglitazone dispensings; the latter served as an active comparator. We controlled for confounding by matching exposure groups on propensity score, informed by baseline covariates identified via a data adaptive approach. We ascertained SCA/VA outcomes precipitating hospital presentation using a validated, diagnosis-based algorithm. We generated marginal hazard ratios (HRs) via Cox proportional hazards regression that accounted for clustering within matched pairs. We prespecified Medicaid and Optum findings as primary and secondary, respectively; the latter served as a conceptual replication dataset.

Results

The adjusted HR for SCA/VA among rosiglitazone (vs. pioglitazone) users was 0.91 (0.75–1.10) in Medicaid and 0.88 (0.61–1.28) in Optum. Among Medicaid but not Optum enrollees, we found treatment effect heterogeneity by sex (adjusted HRs = 0.71 [0.54–0.93] and 1.16 [0.89–1.52] in men and women respectively, interaction term p-value = 0.01).

Conclusions

Rosiglitazone and pioglitazone appear to be associated with similar risks of SCA/VA.
Molecular implications of MUC5AC-CD44 axis in colorectal cancer progression and chemoresistance
Authors: Pothuraju Ramesh , Rachagani Satyanarayana , Krishn Shiv Ram , Chaudhary Sanjib , Nimmakayala Rama Krishna , Siddiqui Jawed A. , Ganguly Koelina , Lakshmanan Imayavaramban , Cox Jesse L. , Mallya Kavita , Kaur Sukhwinder , Batra Surinder K.
Published: February 2020

Background

Differential expression of mucins has been associated with several cancers including colorectal cancer (CRC). In normal physiological conditions, secretory mucin MUC5AC is not expressed in the colonic mucosa, whereas its aberrant expression is observed during development of colon cancer and its precursor lesions. To date, the molecular mechanism of MUC5AC in CRC progression and drug resistance remains obscure.

Methods

MUC5AC expression was determined in colon tissue microarray by immunohistochemistry. A RNA interference and CRISPR/Cas9-mediated system was used to knockdown/knockout the MUC5AC in CRC cell lines to delineate its role in CRC tumorigenesis using in vitro functional assays and in vivo (sub-cutaneous and colon orthotopic) mouse models. Finally, CRC cell lines and xenograft models were used to identify the mechanism of action of MUC5AC.

Results

Overexpression of MUC5AC is observed in CRC patient tissues and cell lines. MUC5AC expression resulted in enhanced cell invasion and migration, and decreased apoptosis of CRC cells. MUC5AC interacted with CD44 physically, which was accompanied by the activation of Src signaling. Further, the presence of MUC5AC resulted in enhanced tumorigenesis and appearance of metastatic lesions in orthotopic mouse model. Additionally, up-regulation of MUC5AC resulted in resistance to 5-fluorouracil (5-FU) and oxaliplatin, and its knockout increased sensitivity to these drugs. Finally, we observed that up-regulation of MUC5AC conferred resistance to 5-FU through down-regulation of p53 and its target genep21and up-regulation of β-catenin and its target genesCD44andLgr5.

Conclusion

Our findings suggest that differential expression of secretory mucin MUC5AC results in enhanced tumorigenesis and also confers chemoresistance via CD44/β-catenin/p53/p21 signaling.
The safety of spinal manipulative therapy in children under 10 years: a rapid review
Authors: Corso Melissa , Cancelliere Carol , Mior Silvano , Taylor-Vaisey Anne , Côté Pierre
Published: February 2020

Introduction

The safety of spinal manipulative therapy (SMT) in children is controversial. We were mandated by the College of Chiropractors of British Columbia to review the evidence on this issue.

Objectives

We conducted a rapid review of the safety of SMT in children (< 10 years). We aimed to: 1) describe adverse events; 2) report the incidence of adverse events; and 3) determine whether SMT increases the risk of adverse events compared to other interventions.

Evidence review

We searched MEDLINE, CINAHL, and Index to Chiropractic Literature from January 1, 1990 to August 1, 2019. We used rapid review methodology recommended by the World Health Organization. Eligible studies (case reports/series, cohort studies and randomized controlled trials) were critically appraised. Studies of high and acceptable methodological quality were included. The lead author extracted data. Data extraction was independently validated by a second reviewer. We conducted a qualitative synthesis of the evidence.

Findings

Most adverse events are mild (e.g., increased crying, soreness). One case report describes a severe adverse event (rib fracture in a 21-day-old) and another an indirect harm in a 4-month-old. The incidence of mild adverse events ranges from 0.3% (95% CI: 0.06, 1.82) to 22.22% (95% CI: 6.32, 54.74). Whether SMT increases the risk of adverse events in children is unknown.

Conclusion

The risk of moderate and severe adverse events is unknown in children treated with SMT. It is unclear whether SMT increases the risk of adverse events in children < 10 years.
Identification of small RNAs involved in nitrogen fixation in Anabaena sp. PCC 7120 based on RNA-seq under steady state conditions
Authors: He Ping , Cai Xiaodan , Chen Kangming , Fu Xuelin
Published: February 2020

Purpose

Anabaena sp. PCC7120 is a genetically tractable model organism for nitrogen fixation and photosynthesis research. The importance of small regulatory RNAs (sRNAs) as mediators of a number of cellular processes in bacteria has begun to be recognized. Bacterial sRNA binds to target genes through base pairing, and play a regulatory role. Many studies have shown that bacterial sRNA can regulate cell stress response, carbon and nitrogen fixation, and so on. However, little is known about sRNAs in Anabaena sp. PCC 7120 regarded to nitrogen fixation under later steady state.

Methods

To provide a comprehensive study of sRNAs in this model organism, the sRNA (< 200 nt) extracted from Anabaena sp. PCC 7120 under nitrogen step-down treatment of 12 days, together with the sRNA from the control, was analyzed using deep RNA sequencing. Possible target genes regulated by all identified putative sRNAs were predicted by IntaRNA and further analyzed for functional categorizations for biological pathways.

Result

Totally, 14,132 transcripts were produced from the de novo assembly. Among them, transcripts that are located either in the intergenic region or antisense strand were kept, which resulted in 1219 sRNA candidates, for further analysis. RPKM-based differential expression analysis showed that 418 sRNAs were significantly differentially expressed between the samples from control (nitrogen addition, N+) and nitrogen depletion, (N−). Among them, 303 sRNAs were significantly upregulated, whereas 115 sRNAs were significantly downregulated. RT-PCR of 18 randomly chosen sRNAs showed a similar pattern as RNA-seq result, which confirmed the reliability of the RNA-seq data. In addition, the possible target genes regulated by unique sRNAs of Anabaena sp. PCC 7120 under nitrogen addition (N+) condition or that under nitrogen depletion (N−) condition were analyzed for functional categorization and biological pathways, which provided the evidences that sRNAs were indeed involved in many different metabolic pathways.

Conclusion

The information from the present study provides a valuable reference for understanding the sRNA-mediated regulation of the nitrogen fixation in Anabaena PCC 7120 under steady state conditions.
Decreased expression of LRA4, a key gene involved in rhamnose metabolism, caused up-regulated expression of the genes in this pathway and autophagy in Pichia pastoris
Authors: Jiao Jian , Wang Shuai , Tian Hui , Xu Xinxin , Zhang Yuhong , Liu Bo , Zhang Wei
Published: February 2020

In a previous study, we developed Pichia pastoris GS115m, an engineered strain with decreased expression of one key gene, LRA4, in rhamnose metabolism. P. pastoris GS115m/LacB was subsequently constructed via introducing a β-galactosidase gene, LacB, under the control of rhamnose-inducible PLRA3 into P. pastoris GS115m. P. pastoris GS115m/LacB greatly improved recombinant protein production relative to the parental strain (P. pastoris GS115/LacB). In the present study, transcriptomes of P. pastoris GS115m/LacB and P. pastoris GS115/LacB grown in YPR medium were analyzed. P. pastoris GS115m/LacB was found to suffer from the mild carbon source starvation. To attenuate the starvation stress, P. pastoris GS115m/LacB attempted to enhance rhamnose metabolism by elevating the transcription levels of rhamnose-utilization genes LRA1-3 and RhaR. The transcription level of LacB under the control of PLRA3 thereby increased, resulting in the improved production of recombinant protein in P. pastoris GS115m/LacB. It was also revealed that P. pastoris GS115m/LacB cells coped with carbon starvation mostly via autophagy.
Some logarithmic Minkowski inequalities for nonsymmetric convex bodies and related problems
Authors: Ji Lewen
Published: February 2020

In this paper, we show the existence of a solution to an even logarithmic Minkowski problem for p-capacity and prove some analogue inequalities of the logarithmic Minkowski inequality for general nonsymmetric convex bodies involving p-capacity.
Adherence to recommended practices for perioperative anesthesia care for older adults among US anesthesiologists: results from the ASA Committee on Geriatric Anesthesia-Perioperative Brain Health Initiative ASA member survey
Authors:   on behalf of the ASA Committee on Geriatric Anesthesia and the ASA Perioperative Brain Health Initiative, Deiner Stacie , Fleisher Lee A. , Leung Jacqueline M. , Peden Carol , Miller Thomas , Neuman Mark D.
Published: February 2020

Background

While specific practices for perioperative care of older adults have been recommended, little is known regarding adherence by US physician anesthesiologists to such practices. To address this gap in knowledge, the ASA Committee on Geriatric Anesthesia and the ASA Perioperative Brain Health Initiative undertook a survey of ASA members to characterize current practices related to perioperative care of older adults.

Methods

We administered a web-based questionnaire with items assessing the proportion of practice focused on delivery of care to older adults, adherence to recommended practices for older surgical patients, resource needs to improve care, and practice characteristics.

Results

Responses were collected between May 24, 2018, and June 29, 2018. A total of 25,587 ASA members were invited to participate, and 1737 answered at least one item (6.8%). 96.4% of respondents reported that they had cared for a patient aged 65 or older within the last year. 47.1% of respondents (95% confidence interval, 44.6%, 49.7%) reported using multimodal analgesia among patients aged 65 and older at least 90% of the time, and 25.5% (95% CI, 23.3%, 27.7%) provided preoperative information regarding postoperative cognitive changes at least 90% of the time. Over 80% of respondents reported that preoperative screening for frailty or dementia, postoperative screening for delirium, and preoperative geriatric consultation occurred in fewer than 10% of cases. Development of practice guidelines for geriatric anesthesia care and expansion of web-based resources were most frequently prioritized by respondents as initiatives to improve care in this domain.

Discussion

Most survey respondents reported providing anesthesia care to older adults, but adherence to recommended practices varied across the six items assessed. Reported rates of screening for common geriatric syndromes, such as frailty, delirium, and dementia, were low among survey respondents. Respondents identified multiple opportunities for ASA initiatives to support efforts to improve care for older surgical patients.
Estimation of technical efficiency of black cumin (Nigella sativa L.) farming in northwest Ethiopia: a stochastic frontier approach
Authors: Dessie Abebe Birara , Abate Tadie Mirie , Adane Betelhem Tsedalu , Tesfa Tiru , Getu Shegaw
Published: February 2020

Ethiopia is one of the east African countries which produce and exports various spices to other countries. Black cumin (Nigella sativa L.) is an important stiff annual flowering plant which mainly grows by producers for its seeds. An increasing demand of black cumin seed and oil in local, national and international market for medicinal, consumption and commercial purpose makes the best alternative crop for small holder farmers in Ethiopia. In spite of its importance, not much has been done to improve its production and productivity in Ethiopia. Therefore, this research was designed to examining efficiency variations and factors influencing technical inefficiency levels of producers on black cumin production in northwest Ethiopia. Primary data were collected using a semi-structured questionnaire administered on 188 black cumin producers selected using systematic random sampling technique. Moreover, various data analysis methods such as descriptive statistics and stochastic frontier model were used for analyzing the data. The empirical result obtained by applying maximum likelihood estimate of stochastic frontier model revealed that seed (p < 0.01) labor (p < 0.05), chemical (p < 0.01) and land (p < 0.05) were significant input variables in determining black cumin production. The mean technical efficiency level of black cumin producer was generally low, about 53.1%. The mean value of actual yield, potential yield and yield gap was 3.131, 5.832 and 2.701 quintals, respectively. Moreover, the result of stochastic frontier model together with the inefficiency parameters revealed that market price of black cumin (p < 0.01) and access of extension service (p < 0.1) were significant variables and positively influenced the efficiency levels of black cumin producers. Whereas age of producers (p < 0.05) and distance to farm plot (p < 0.01) negatively influenced the technical efficiency levels of black cumin producers. Therefore, the study recommends that adoption of latest agricultural technologies; development of institutions, agricultural extension services and infrastructure are advisable to improve the efficiency and commercial value of black cumin production.
Structural modeling of dissatisfaction, complaint behavior, and revisiting intentions in hairdressing services
Authors: Lee Hye Won , Kim Mi Young
Published: February 2020

This study aims to present a comprehensive model that effectively explains dissatisfaction, complaint behavior, and revisiting intentions of hair service consumers through an empirical analysis. In order to empirically verify the conceptual model, a questionnaire was developed based on previous studies and responses that were collected through an online survey agency. Subjects were Korean female consumers in their 20s to 50s who experienced dissatisfaction with hair services in the salons they visited during the past year. The conceptual model suggested in the theoretical research was analyzed empirically through the structural equation modeling (SEM) test and finally suggested after ordering, eliminating unnecessary paths. According to the results, dissatisfaction with the hair service significantly affects the complaint behavior and the revisiting intentions while the complaint behavior has a mediating effect between dissatisfaction and the revisiting intentions. Analysis showed that dissatisfaction with human response services and private complaint behaviors are the factors that most negatively influence revisiting intentions. It was confirmed that businesses should focus on the management of the customer service delivered by the employees and on word of mouth. Public complaint behavior was proven to increase revisiting intentions of consumers, needing more attention. This study aims to provide plausible reasons and objective materials to the establishment of a solid theoretical base for the research on dissatisfaction, complaint behavior, and revisiting intentions of hair service consumers. It is expected that the results of this study will help create differentiated marketing strategies for unsatisfied and complaining consumers.
Music Use for Sedation in Critically ill Children (MUSiCC trial): study protocol for a pilot randomized controlled trial
Authors:   the Canadian Critical Care Trials Group, Garcia Guerra Gonzalo , Joffe Ari , Sheppard Cathy , Hewson Krista , Dinu Irina A. , de Caen Allan , Jou Hsing , Hartling Lisa , Vohra Sunita
Published: February 2020

Background

Stress induced by pain and anxiety is common in pediatric intensive care unit (PICU) patients. Sedation/analgesia in PICU is usually achieved through various analgesics and sedatives. Excessive use of these drugs can put patients at risk for hemodynamic/respiratory instability, prolonged ventilation, withdrawal, delirium, and critical illness polyneuromyopathy.

The use of non-pharmacologic interventions has been recommended by sedation guidelines. However, non-pharmacological measures in PICU, including music and noise reduction, have been inadequately studied.

Methods

The Music Use for Sedation in Critically ill Children (MUSiCC trial) pilot study is an investigator-initiated, three-arm, randomized controlled trial (RCT) on the use of music for sedation in PICU. The main goal of the study is to demonstrate feasibility of a music trial in PICU and to obtain the necessary information to plan a larger trial. The study compares music versus noise cancelation versus control in sedated and mechanically ventilated children admitted to PICU. In the music group, children receive the music (modified classical music) three times a day for 30 min at a time. Music is delivered with noise cancelation headphones. The noise cancelation group receives the same intervention but with a no music (sham playlist). The control group receives usual care with no specific intervention. Children remain in the study until extubation or a maximum of 7 days. The primary outcomes of the study are feasibility and sedation/analgesia requirements. Secondary outcomes include change in vital signs before and during the intervention, ICU delirium, and adverse effects related to the intervention. The estimated sample size is 20 subjects per group for a total of 60 children.

Discussion

Despite being recommended by current guidelines, evidence to support the use of music in PICU is lacking. Music has the potential to reduce sedation requirements and their negative side effects. This pilot RCT will demonstrate feasibility and provide the necessary information to plan a larger trial focusing on the effectiveness of the intervention.

Trial registration

The study was registered at ClinicalTrials.gov (NCT03497559) on April 13, 2018.
Examining learning engagement in MOOCs: a self-determination theoretical perspective using mixed method
Authors: Lan Min , Hew Khe Foon
Published: February 2020

MOOCs as a learning approach are gaining popularity, and helping learners and instructors understand how learning engagement is constructed in a MOOC context is of increasing importance. Although previous research has undoubtedly enriched our knowledge of MOOCs, our understanding of student engagement in the MOOC context is still limited. This study adopts a sequential explanatory mixed-methods approach to examine student engagement in MOOCs from the self-determination theory (SDT) perspective. A total of 693 valid responses to a MOOC Engagement-Motivation scale were collected and 82 MOOC participants were interviewed. The results showed significant differences between the MOOC completers and non-completers with respect to the rank of motivators for enrolment and the rank of learning activities for participation. The association between perceived competence and emotional engagement was significantly higher in the MOOC completion group. The results of a multiple regression analysis indicated that the SDT model can significantly predict student engagement. Perceived competence registered the largest positive impact, and perceived relatedness had a slight negative impact on engagement. The three components of engagement can also predict learners’ perceived learning. Emotional engagement showed the largest positive impact. However, logistic regression analysis indicated that these components of engagement poorly predicted MOOC learners’ completion. Qualitative analyses of student interview data revealed three main factors that can promote learners’ SDT needs: active learning, course resources, and instructor accessibility. Implications of the findings can help MOOC designers and educators to better engage their participants.
Correction to: Safe injection awareness and practices among nursing staff in an Egyptian and a Saudi hospital
Authors: Anwar Manal M. , Mohamed Lotfy Alshimaa M. , Alrashidy Afaf A.
Published: February 2020

Following publication of the original article [1], we have been notified that one of the authors’ given names is not reflected correctly.
Contextual influences on the impact of a peer worker-led self-stigma program for people with mental health issues: protocol for an interventional implementation science study
Authors: Banfield Michelle , Morse Alyssa R. , Gulliver Amelia
Published: February 2020

Background

Despite significant recent reforms, Australia’s mental health system faces substantial service and workforce shortages, and progress on the reorientation of services to a recovery focus is also slow. Implementing recovery-focused programs led by mental health peer workers is one way of addressing these issues, but uptake of these programs in Australia is patchy and not well evaluated.

This project will investigate the implementation of a peer-led mental health self-stigma program across three diverse settings in an Australian capital city. The project aims to (1) examine the processes and contextual influences on successful implementation of peer work roles and (2) evaluate the impact a peer worker-led program has on individuals and services.

Methods

The project will use an interventional implementation science approach: small-scale, researcher-led implementation of the Honest, Open, Proud program to explore contextual influences, and implementation, service and individual outcomes. The Consolidated Framework for Implementation Research (CFIR) will be used to guide investigation of contextual factors. Implementation outcomes (feasibility, fidelity, acceptability, sustainability) and service outcomes (safety, person-centeredness and effectiveness) will be examined in interviews with a range of staff within the services, checklists of adherence to program protocols and analysis of administrative data. Individual quantitative outcomes will include self-stigma, recovery and quality of life, measured at baseline, end of program and follow-up. Qualitative enquiry will focus on experiences with the peer worker and program.

Quantitative analyses will comprise change scores on service and individual outcome measures. Where possible, differences between settings and the effects of potential confounds will be tested using multi-level linear models, which will account for clustering of individuals within programs and settings. Qualitative data will be analysed using a framework approach, which is an effective way of combining inductive and deductive coding to test and refine a thematic frame.

Discussion

Recovery-focused, peer-led programs have the potential to provide a unique contribution to the management of mental health issues. Currently, there is little information to guide successful implementation of these roles. This project will provide important preliminary data on the factors that affect implementation and the impact peer workers can have.

Trial registration

ANZCTR - Trial Registration ID: ACTRN12619001312134. Registered 26/09/2019