bluuebunny/crossref_metadata_2025 huggingface dataset:
Mapping structure, process and outcomes in the removal of low-value care practices in Canadian intensive care units: protocol for a mixed-methods exploratory study
Authors: Parsons Leigh Jeanna , Petersen Jennie , de Grood Chloe , Whalen-Browne Liam , Niven Daniel , Stelfox Henry Thomas
Published: December 2019

Introduction

The challenge of implementing best evidence into clinical practice is a major problem in modern healthcare that can result in ineffective, inefficient and unsafe care. There is a growing body of literature which suggests that the removal or reduction of low-value care practices (ie, deadoption) is integral to the delivery of high-quality care and the sustainability of our healthcare system. However, currently very little is known about deadoption practices in Canada. We propose to map the current state of deadoption in Canadian intensive care units (ICUs). A key deliverable of this work will include development of an inventory of barriers, facilitators and potential implementation strategies for guiding the deadoption efforts.

Methods and analysis

We will use Canadian adult general systems ICUs as our laboratory of investigation and employ a two-phased sequential exploratory mixed-methods approach: (1) semi-structured interviews with critical care stakeholders to develop an understanding of the structure (ie, healthcare context), process (ie, actions and events in healthcare) and outcomes (ie, effects on health status, quality, knowledge or behaviour) of deadoption (phase I) and (2) surveys with a broader sample of critical care stakeholders to further identify important barriers and facilitators, as well as potential implementation strategies (phase II). Interview data will be analysed through qualitative content analysis and survey data will be analysed through quantitative analyses to identify top barriers and facilitators, as well as top rated strategies.

Ethics and dissemination

Ethical approval has been obtained through the University of Calgary Research Ethics Board (REB 17–2153). Participants involved will have the opportunity to provide feedback on the final written reports to support accurate representation of the data. The findings of this study will be disseminated through peer-reviewed publications and oral presentations with critical care stakeholders across Canada. Patient and family partners will receive an executive summary of the findings.
Measuring discharge quality based on elderly patients’ experiences with discharge conversation: a cross-sectional study
Authors: Boge Ranveig Marie , Haugen Arvid Steinar , Nilsen Roy Miodini , Bruvik Frøydis , Harthug Stig
Published: December 2019

Background

Discharge conversation is an essential part of preparing patients for the period after hospitalisation. Successful communication during such conversations is associated with improved health outcomes for patients.

Objective

To investigate the association between discharge conversation and discharge quality assessed by measuring elderly patients’ experiences.

Methods

In this cross-sectional study, we surveyed all patients ≥65 years who had been discharged from two medical units in two hospitals in Western Norway 30 days prior. We measured patient experiences using two previously validated instruments: The Discharge Care Experiences Survey Modified (DICARES-M) and The Nordic Patient Experiences Questionnaire (NORPEQ). We examined differences in characteristics between patients who reported having a discharge conversation with those who did not, and used regression analyses to examine the associations of the DICARES-M and NORPEQ with the usefulness of discharge conversation.

Results

Of the 1418 invited patients, 487 (34%) returned the survey. Their mean age was 78.5 years (SD=8.3) and 52% were women. The total sample mean scores for the DICARES-M and NORPEQ were 3.9 (SD=0.7, range: 1.5–5.0) and 4.0 (SD=0.7, range: 2.2–5.0), respectively. Higher DICARES-M and NORPEQ scores were found for patients who reported having a discharge conversation (74%) compared with those who did not (15%), or were unsure (11%) whether they had a conversation (p<0.001). Patients who considered the conversation more useful had significantly higher scores on both the DICARES-M and NORPEQ (p<0.001).

Conclusions

Reported discharge conversation at the hospital was correlated with positive patient experiences measurements indicating the increased quality of hospital discharge care. The reported usefulness of the conversation had a significant association with discharge care quality.
Mechanism study of metal ion adsorption on porous hydroxyapatite: experiments and modeling
Authors: Ramdani Amina , Taleb Zoubida , Guendouzi Abdelkrim , Kadeche Abdelkader , Herbache Hayat , Mostefai Asmaa , Taleb Safia , Deratani André
Published: December 2019

In this study, low-cost biomaterial hydroxyapatite (N-Hap) prepared from bovine bones was tested for its potential to sorb copper Cu2+ and Fe3+ from aqueous solution and was compared with commercial hydroxyapatite (C-Hap). The structural characterization of N-Hap and C-Hap were carried out by Fourier transform infrared (FTIR) analysis, textural analysis (BET), morphology, and elemental analysis via scanning electron microscopy (SEM-EDX). The results obtained show that SEM images confirmed the formation of porous N-Hap with various morphologies and the average particle size ranges from 50 to 100 nm and the CaP ratio is 1.657. The presence of functional groups on N-Hap surface was confirmed by FTIR analysis. The specific surface areas of N-Hap and C-Hap are found to be 46.87 and 40.98 m2/g, respectively. Adsorption of two metals Cu2+ and Fe3+ was fast, with equilibrium attained within 30 min. Copper ions exhibited the greatest adsorption on both adsorbents because of their size and pH conditions. Metallic ion removal efficiency was favored at a slightly acidic solution pH and low temperature. The equilibrium and kinetic data were found to fit well the Langmuir model and the pseudo second order model with intraparticle diffusion. Thermodynamic parameters (ΔHads < 0 and ΔGads < 0) involved the exothermic, spontaneous, and physical adsorption process. The adsorption interaction of Cu2+ and Fe3+ with Hap surface was investigated by theoretical density functional theory (DFT) calculations. Therefore, the porous hydroxyapatite N-Hap displays potential as a new biocompatible adsorbent, and its use seems to be an interesting solution for the treatment of industrial wastewater.
Challenges and opportunities in developing decision support systems for risk assessment and management of forest invasive alien species
Authors: Lafond Valentine , Lingua Federico , Lumnitz Stefanie , Paradis Gregory , Srivastava Vivek , Griess Verena C.
Published: December 2019

Biological invasions represent an increasing threat to ecosystems worldwide, with negative ecological and socio-economic impacts, whereas risk assessment and management remain challenging. The development of decision support systems (DSS) has the potential to help decision-makers and managers mitigate invasive species, but few DSS exist for forest invasive alien species (FIAS). The use of DSS in forestry is not new but they represent an asset in decision making in times of increasing complexity of issues foresters face and factors to consider. Yet, few forest DSS address the problem of FIAS. In this review, we identify key elements of the FIAS risk-assessment and management decision-making process, discuss these elements with a model-based DSS development perspective, and summarize outstanding challenges and opportunities for FIAS DSS development. FIAS DSS should not only estimate the probability of FIAS invasion but also consider forest vulnerability and quantify exposure (i.e., value at risk), while allowing different threat scenarios and possible solutions to be compared. Such a complete risk assessment and management calls for integrative modelling approaches that explicitly link different components of FIAS invasion, management, and impact assessment into a DSS. Such integrative modelling is challenging and may require collaboration among experts of different domains. International collaboration is also needed to facilitate data exchange, as the lack of data is one of the main challenges. In many cases, data and ecological knowledge of invasive species are too limited (in quantity or quality) to constitute useful input to DSS or their components (e.g., species distribution model). Another challenge is to better consider the multiple sources of uncertainties inherent to modelling invasions (e.g., host preferences and behavior, forest vulnerability, potential impacts, and cost and benefits of mitigation actions) when assessing FIAS risk and communicating results from risk assessment. Communication with stakeholders and DSS end-users, in fact, appears as one of the keys to successful DSS development and appropriation, not only to ensure that they correspond to end-users’ needs but also to ensure ease of use, functionality, and good visualization of DSS outputs.
Effects of anisotropy on the sign-changeable interacting Tsallis holographic dark energy
Authors: Abdollahi Zadeh M. , Sheykhi A. , Bamba Kazuharu , Moradpour H.
Published: December 2019

We consider a spatially homogeneous and anisotropic Bianchi type-I universe which is filled by pressureless dark matter (DM) and Tsallis holographic dark energy (THDE). We assume the two dark components of the universe are interacting with each other throughout a sign-changeable mutual interaction term. Various infra-red (IR) cutoffs are studied, and it is obtained that all models display classical instability by themselves at the future [Formula: see text]. Moreover, we find out that some models can cross the phantom line. In order to have a more comprehensive study, the statefinder diagnostic and the [Formula: see text] plane are also investigated showing that the model parameters significantly affect the evolution trajectories in the [Formula: see text] and [Formula: see text] planes.
The preparation of Si/SiC composites by magnesium heat reduction of SiO2 aerogel and study on electrochemistry properties
Authors: Dong Bowen , Deng Bingbing , Liu Yangai
Published: December 2019

Silicon, an anode material for lithium ion batteries, has the highest theoretical specific capacity ([Formula: see text] mAh/g). The actual lithium storage capacity of [Formula: see text] mAh/g is about 10 times that of the graphite anode materials class. This study involves magnesium heat reduction of the SiO2 preparation of silicon carbon composites. The Si/SiC composite shows a high initial specific capacity of 1406.7 mAh/g with a current density of 0.1 A/g. The morphology and pore size inherited from the SiO2 aerogel counteracts the volume expansion during the lithiation/delithiation process. This paper provides an articulate methodology for designing silicon anode material for high-performance rechargeable lithium-ion batteries.
Interfacial bonding of chromium-doped copper/diamond composites fabricated by powder metallurgy method
Authors: Jia Shanquan , Su Yu , Bolzoni Leandro , Yang Fei
Published: December 2019

Copper/diamond composites can be used as heat-sink materials for high-power electronic devices due to their potential high thermal conductivity. However, it is challenging to obtain well-bonded interface between the copper matrix and the diamond particles. In this paper, we fabricated copper/diamond composites with [Formula: see text] wt.% of chromium additive ([Formula: see text], 3 and 7.4, and the corresponding composite was referred to as 1Cr-Cu/Dia, 3Cr-Cu/Dia and 7Cr-Cu/Dia, respectively) by hot forging of powder preforms. Results showed that only Cr3C2 interfacial layer formed between the copper matrix and the diamond particles for the 1Cr-Cu/Dia and 3Cr-Cu/Dia composites with a thickness of about 100 and 500 nm, respectively. A Cr/Cr3C2 dual layer interface formed in the 7Cr-Cu/Dia composite and its thickness was [Formula: see text]m. The coverage of diamond surface by the interface layer increased with increasing the adding amount of chromium in the composites. The 3Cr-Cu/Dia composite achieved the highest relative density and bonding strength, comparing to 1Cr-Cu/Dia and 7Cr-Cu/Dia composites, attributed to the formation of an optimal interface structure.
How not to be overwhelmed by obvious advice
Authors: Yaffe Philip
Published: December 2019

Each "Communication Corner" essay is self-contained; however, they build on each other. For best results, before reading this essay and doing the exercise, go to the first essay "How an Ugly Duckling Became a Swan," then read each succeeding essay.

With unprecedented access to information, the internet can be a source of useful material. However many times, so-called experts share specious advice. In this article, Phil Yaffe addresses a widely discussed topic, clear writing, and dives deeper to fix the flaws found in regurgitated writing advice.
Exosomal miRNA Let-7 from Menstrual Blood-Derived Endometrial Stem Cells Alleviates Pulmonary Fibrosis through Regulating Mitochondrial DNA Damage
Authors: Sun Lifang , Zhu Min , Feng Wei , Lin Yiping , Yin Jia , Jin Juan , Wang Yunguang
Published: December 2019

Idiopathic pulmonary fibrosis (IPF) is a prototype of chronic, progressive, and fibrotic lung disease with high morbidity and high mortality. Menstrual blood-derived stem cells (MenSCs) have proven to be an attractive tool for the treatment of acute lung injury and fibrosis-related diseases through immunosuppression and antifibrosis. However, whether MenSC-derived exosomes have the similar function on pulmonary fibrosis remains unclear. In the present study, exosomes secreted from MenSCs (MenSCs-Exo) were verified by transmission electron microscope (TEM), nanoparticle tracking analyzer (NTA), and western blotting. And MenSC-Exo addition significantly improved BLM-induced lung fibrosis and alveolar epithelial cell damage in mice, mainly reflected in BLM-mediated enhancement of the fibrosis score, blue collagen deposition, dry/wet gravity ratio, hydroxyproline and malondialdehyde levels, and downregulation of glutathione peroxidase, which were all robustly reversed by MenSC-Exo management. Additionally, BLM- and TGF-β1-evoked cellular reactive oxygen species (ROS), mitochondrial DNA (mtDNA) damage, and cell apoptosis were rescued by MenSCs-Exo in vivo and in vitro. Further study indicated that the MenSCs-Exo could transport miRNA Let-7 into recipient alveolar epithelial cells. Let-7 inhibitor administration significantly blocked the exosome-mediated improvement role on lung fibrosis in mice. Mechanistically, Let-7 was able to regulate the expression of lectin-like oxidized low-density lipoprotein receptor-1 (LOX1) through binding to its 3′-UTR region. Forced expression of LOX1 promoted the expression of apoptosis-related protein and mtDNA damage markers via regulating NLRP3 which was also confirmed in BLM model mice under the combination therapy of the exosome and Let-7 inhibitor. Collectively, this study demonstrates that exosomal Let-7 from MenSCs remits pulmonary fibrosis through regulating ROS, mtDNA damage, and NLRP3 inflammasome activation. This provides a new approach of exocytosis on the treatment of fibrotic lung disease.
Comparison of the Effects of Polyacrylamide and Sodium Carboxymethylcellulose Application on Soil Water Infiltration in Sandy Loam Soils
Authors: Ning Songrui , Jumai Halidaimu , Wang Quanjiu , Zhou Beibei , Su Lijun , Shan Yuyang , Zhang Jihong
Published: December 2019

Superabsorbent polymers have been used widely in agricultural production in arid and semi-arid regions to manage the soil water holding capacity. As the common water-retention polymers, the molecular weights, and structures of polyacrylamide (PAM) and sodium carboxymethylcellulose (CMC) are obviously different. Modified soil water management with polymers (i.e., PAM and CMC) has shown great promise for water conservation. Few researchers have reported the comparison of the effects of PAM and CMC on soil infiltration characteristics, especially in coarse-textured soils (i.e., sandy loam). In this research, two high-molecular polymers (PAM and CMC) were used to investigate the effects of polymers on soil water infiltration characteristics by laboratory experiment. The infiltration reduction effects of CMC treatments were more obvious than those of PAM treatments. With the applied rates of PAM (0.2–0.8 g/kg) and CMC (1–4 g/kg) increased, the processes of soil water infiltration were inhibited. The average infiltration time of CMC with different application rates is 1.85 times than that of PAM with different treatments. The mean wetting front distances of different application rates treatments of PAM and CMC were 22.20 and 19.23 cm. At the same application rate, applied CMC is more effective in reducing soil sorptivity than applied PAM in sandy loam soils. Moreover, the cost of application of CMC is lower than the cost of application of PAM. The mean economic inputs of PAM and CMC were 153.90 and 35.24 RMB/hm2. Therefore, CMC was selected and recommended as the suitable water retention agent in sandy loam soils.
Association between Chewing Problems and Sleep among Japanese Adults
Authors: Azuma Tetsuji , Irie Koichiro , Watanabe Kazutoshi , Deguchi Fumiko , Kojima Takao , Obora Akihiro , Tomofuji Takaaki
Published: December 2019

An association between physical illness and sleep has been suggested. Disordered chewing might be a physical factor that is associated with sleep issues. This cross-sectional study aimed to determine whether chewing problems are associated with sleep in Japanese adults. Sleep and chewing issues were evaluated in 6,025 community residents using a self-reported questionnaire. The prevalence of poor sleep quality and sleeping for <6 h/day (short duration) were 15.6% and 29.4%, respectively. Multivariate logistic regression analyses showed that prevalence of poor sleep quality was significantly associated with self-reported medical history (odds ratio (OR), 1.30; p<0.001), self-reported symptoms (OR, 4.59; p<0.001), chewing problems (OR, 1.65; p<0.001), and poor glycemic control (OR, 1.43; p=0.035). The prevalence of short sleep duration was also significantly associated with female sex (OR, 1.23; p=0.001), self-reported symptoms (OR, 1.60; p<0.001), chewing problems (OR, 1.30; p=0.001), and being overweight (OR, 1.41; p<0.001). In conclusion, chewing problems were associated with poor sleep quality and short sleep duration among Japanese adults.
Metformin Protects against Oxidative Stress Injury Induced by Ischemia/Reperfusion via Regulation of the lncRNA-H19/miR-148a-3p/Rock2 Axis
Authors: Zeng Jing , Zhu Long , Liu Jing , Zhu Tao , Xie Zhaohui , Sun Xiaoou , Zhang Hao
Published: December 2019

Previous studies have shown that metformin not only is a hypoglycemic agent but also has neuroprotective effects. However, the mechanism of action of metformin in ischemic stroke is unclear. Oxidative stress is an important factor in the pathogenesis of cerebral ischemia-reperfusion injury. It has been reported that metformin is associated with stroke risk in the clinical population. This study is aimed at investigating the effect and mechanism of metformin in an experimental model of oxidative stress induced by ischemia/reperfusion (I/R) in vivo and oxygen glucose deprivation/reperfusion (OGD/R) in vitro. Metformin (100, 200, and 300 mg/kg) was administered intraperitoneally immediately after induction of cerebral ischemia. The indicators of oxidative stress selected were antioxidant enzyme activities of catalase, malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase (SOD), and glutathione peroxidation enzyme (GSHPx). First, we demonstrated that metformin can significantly alleviate acute and chronic cerebral I/R injury and it has a strong regulatory effect on stroke-induced oxidative stress. It can reduce the elevated activities of MDA and NO and increase the levels of GSHPx and SOD in the cerebrum of mice and N2a cells exposed to I/R. Furthermore, real-time PCR and western blot were used to detect the expression of long noncoding RNA H19 (lncRNA-H19), microRNA-148a-3p (miR-148a-3p), and Rho-associated protein kinase 2 (Rock2). The direct interaction of lncRNA-H19, miR-148a-3p, and Rock2 was tested using a dual luciferase reporter assay. lncRNA-H19 altered OGD/R-induced oxidative stress by modulating miR-148a-3p to increase Rock2 expression. The expression of lncRNA-H19 and Rock2 could be downregulated with metformin in vivo and in vitro. In conclusion, our study confirmed that metformin exerts neuroprotective effects by regulating ischemic stroke-induced oxidative stress injury via the lncRNA-H19/miR-148a-3p/Rock2 axis. These results provide new evidence that metformin may represent a potential treatment for stroke-related brain injury.
Long-Term Prognosis of Suspected Myocarditis and Cardiomyopathy Associated with Viral Infection of the Myocardial Tissue: A Meta-Analysis of Cohort Studies
Authors: Chen Wen-Hao , Guo You-Sheng , Zhang Dong-Hui , Zhang Huan-Ji
Published: December 2019

Aim. Myocarditis and cardiomyopathy impose a substantial economic burden on society. Many studies have examined the effects of various predictors on the prognosis of these diseases, such as the left ventricular systolic function, the New York Heart Association glomerular filtration rate, the QT interval, and the presence of viruses. In the present study, we conducted a meta-analysis of cohort studies to investigate the significance of the presence of viruses in the myocardial tissue on the prognosis of these diseases. Methods. The Embase, PubMed, and Cochrane library databases were searched for relevant literature that had been published between January 1, 1964 and August 14, 2018. The inclusion criteria were patients over 18 years of age, suspected myocarditis or dilated cardiomyopathy, accepted myocardial biopsy, and the detection of virus in the myocardial tissue. Results. In total, 10 studies met the inclusion criteria. These studies included 1006 patients with suspected myocarditis or idiopathic heart disease for whom the primary endpoint was all-cause death, heart transplant, or re-hospitalization due to fatal arrhythmia and heart failure. There was no significant difference in the prognosis of virus-positive and virus-negative patients with myocarditis or dilated cardiomyopathy confirmed by endomyocardial biopsy (EMB) [hazard ratio (HR) = 1.40, 95% confidence interval (CI) = 0.93–2.12, P=0.11]. However, virus-negative patients had a better prognosis following nonspecific treatment (HR = 1.40, 95% CI = 1.06–1.86, P=0.02) and right ventricular biopsy (HR = 2.08, 95% CI = 1.07–4.04, P=0.03). Conclusions. The presence of a virus did not worsen the long-term prognosis of patients with suspected myocarditis or dilated cardiomyopathy. However, virus-positive patients who did not undergo specific treatment or who underwent right ventricular biopsy did have a worse prognosis. Thus, the early diagnosis of the presence of viral infection in the myocardium will improve the prognosis of patients.
Effect of Transcranial Alternating Current Stimulation for the Treatment of Chronic Insomnia: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Clinical Trial
Authors: Wang Hong-Xing , Wang Li , Zhang Wen-Rui , Xue Qing , Peng Mao , Sun Zhi-Chao , Li Li-Ping , Wang Kun , Yang Xiao-Tong , Jia Yu , Zhou Qi-Lin , Xu Zhe-Xue , Li Ning , Dong Kai , Zhang Qian , Song Hai-Qing , Zhan Shu-Qin , Min Bao-Quan , Fan Chun-Qiu , Zhou Ai-Hong , Guo Xiu-Hua , Li Hai-Bin , Liang Li-Rong , Yin Lu , Si Tian-Mei , Huang Jing , Yan Tian-Yi , Cosci Fiammetta , Kamiya Atsushi , Lu Jie , Wang Yu-Ping
Published: December 2019

Background: Not all adults with chronic insomnia respond to the recommended therapeutic options of cognitive behavioral therapy and approved hypnotic drugs. Transcranial alternating current stimulation (tACS) may offer a novel potential treatment modality for insomnia. Objectives: This study aimed to examine the efficacy and safety of tACS for treating adult patients with chronic insomnia. Methods: Sixty-two participants with chronic primary insomnia received 20 daily 40-min, 77.5-Hz, 15-mA sessions of active or sham tACS targeting the forehead and both mastoid areas in the laboratory on weekdays for 4 consecutive weeks, followed by a 4-week follow-up period. The primary outcome was response rate measured by the Pittsburgh Sleep Quality Index (PSQI) at week 8. Secondary outcomes were remission rate, insomnia severity, sleep onset latency (SOL), total sleep time (TST), sleep efficiency, sleep quality, daily disturbances, and adverse events at the end of the 4-week intervention and at the 4-week follow-up. Results: Of 62 randomized patients, 60 completed the trial. During the 4-week intervention, 1 subject per group withdrew due to loss of interest and time restriction, respectively. Based on PSQI, at 4-week follow-up, the active group had a higher response rate compared to the sham group (53.4% [16/30] vs. 16.7% [5/30], p = 0.009), but remission rates were not different between groups. At the end of the 4-week intervention, the active group had higher response and remission rates than the sham group (p < 0.001 and p = 0.026, respectively). During the trial, compared with the sham group, the active group showed a statistically significant decrease in PSQI total score, a shortened SOL, an increased TST, improved sleep efficiency, and improved sleep quality (p < 0.05 or p < 0.001). Post hoc analysis revealed that, in comparison with the sham group, the active group had improved symptoms, except for daily disturbances, at the end of the 4-week intervention, and significant improvements in all symptoms at the 4-week follow-up. No adverse events or serious adverse responses occurred during the study. Conclusion: The findings show that the tACS applied in the present study has potential as an effective and safe intervention for chronic insomnia within 8 weeks.
Endoscopic Lung Volume Reduction in COPD: The Impact of Coil Implantation on Patients’ Physical Activity
Authors: Biener Leonie , Skowasch Dirk , Hollmann Sophia , Schreiber Tina , Nickenig Georg , Fimmers Rolf , Pizarro Carmen
Published: December 2019

Endoscopic lung volume reduction (ELVR) is an emerging therapy option for the treatment of severe emphysema in COPD. To which extent patients profit from lung volume reduction via coils (LVRC) regarding morbidity, mortality, and quality of life is not clear yet. In this monocentric prospective cohort study, 13 COPD patients with severe emphysema (residual volume [RV] >225%) were enrolled at the University Hospital of Bonn. Activity measurements were assessed by a validated accelerometer wristband. By LVRC, RV could be reduced by 0.13 L to 5.54 ± 1.29 L. We could show a clinically relevant improvement in patients’ physical activity after LVRC, measured as daily step count (497.7 ± 72.6 vs. 1,913.7 ± 182.7 steps/day, p = 0.03) and mean daily active energy expenditure (714.4 ± 73.6 vs. 2,321.3 ± 163.9 joules, p = 0.03). This improvement in physical activity is possibly associated with a positive effect on patients’ morbidity and mortality.
Detection of Simple, Complex, and Clonal Chromosome Translocations Induced by Internal Radioiodine Exposure: A Cytogenetic Follow-Up Case Study after 25 Years
Authors: Livingston Gordon K. , Ryan Terri L. , Smith Tammy L. , Escalona Maria B. , Foster Alvis E. , Balajee Adayabalam S.
Published: December 2019

Here, we report the findings of a 25-year cytogenetic follow-up study on a male patient who received 2 rounds of radioiodine treatment within a span of 26 months (1.78 GBq in 1992 and 14.5 GBq in 1994). The patient was 34 years old with a body mass index of 25 at the time of the first radioiodine treatment. Multicolor FISH and multicolor banding (mBAND) techniques performed on the patient detected inter- and intrachromosomal exchanges. Although the frequency of chromosome translocations remained essentially the same as reported in our earlier study (0.09/cell), the percentage of reciprocal (balanced) translocations increased from 54.38 to 80.30% in the current study. In addition to simple chromosome translocations, complex exchanges (0.29%) involving more than 2 chromosomes were detected for the first time in this patient. Strikingly, a clonal translocation involving chromosomes 14 and 15, t(14p;15q), was found in 7 of the 677 cells examined (1.03%). The presence of complex and clonal translocations indicates the onset of chromosomal instability induced by internal radioiodine exposure. mBAND analysis using probes specific for chromosomes 1, 2, 4, 5, and 10 revealed 5 inversions in a total of 717 cells (0.69%), and this inversion frequency is several-fold higher than the baseline frequency reported in healthy individuals using the classical G-banding technique. Collectively, our study suggests that stable chromosome aberrations such as translocations and inversions can be useful not only for retrospective biodosimetry but also for long-term monitoring of chromosomal instability caused by past radioiodine exposure.
New Comparative Cytogenetic Data on Three Genera of Armored Catfishes of Ancistrini (Loricariidae: Hypostominae)
Authors: Mariotto Sandra , Centofante Liano , Venere Paulo C. , Ferreira Daniela C. , Artoni Roberto F.
Published: December 2019

The karyotypes and other chromosomal markers of 4 catfish species, namely Lasiancistrus schomburgkii, Lasiancistrus sp., Araichthysloro, and Megalancistrus sp., members of a taxonomically complex and speciose tribe of catfishes Ancistrini, Hypostominae, were examined using conventional (Giemsa staining, Ag-NOR, and C-banding) and molecular cytogenetic protocols (FISH) and DNA barcoding. In L. schomburgkii, Lasiancistrus sp., and A.loro a diploid number 2n = 54 was observed, with karyotypes composed of 28m + 16sm + 10st, 36m + 12sm + 6st chromosomes, while Megalancistrus sp. had 2n = 52, with the karyotype composed of 28m + 16sm + 8st chromosomes. The Ag-NOR phenotypes were simple in all 4 species, which was confirmed by FISH with an 18S rDNA probe. However, the positive 5S rDNA sites varied among species: 2 chromosome pairs in L. schomburgkii, Lasiancistrus sp., and A. loro, and only 1 pair in Megalancistrus sp. The blocks of constitutive heterochromatin were poorly visible in the pericentromeric and telomeric regions of most chromosomes of the examined species by C-banding. The genetic distance analysis, based on mtDNA COI gene sequences (DNA barcoding), confirmed the species as 4 taxonomic units. Ours and other published data indicate that karyotype differentiation among Ancistrini is complex and divergent and indicates the occurrence of common chromosomal rearrangements, such as pericentric inversions conserving the diploid number, and other rearrangements that are more frequent in some genera, such as centric fusions in Ancistrus.
Cyclooxygenase-2 Gene Polymorphisms –765G>C and –1195A>G and Mycosis Fungoides Risk
Authors: Sayed Khadiga Sayed , Mohammed Faisal Nouredin , Abdel Hay Rania Mounir , Amr Khalda Sayed , AlOrbani Aya M.
Published: December 2019

Background: Cyclooxygenase-2 (COX-2) is an inducible modulator of inflammation that acts through increasing prostaglandin levels and has been described as a major mediator linking inflammation to cancer. Previous studies supported that COX-2–765G>C and –1195A>G polymorphisms were associated with increased risk of several solid tissue cancers as well as some hematological malignancies. Objective: The aim of the study was to elucidate the association between functional COX-2 genotypes (–765G>C and –1195A>G) polymorphisms and the risk of developing mycosis fungoides (MF). Methods: This was a hospital-based, case-control study of 70 MF patients and 100 MF-free controls. We genotyped COX-2 –1195A>G, –765G>C, and –8473T>C polymorphisms by using the PCR-restriction fragment length polymorphism method. Results: The AA genotype in the COX-2 –1195A>G gene polymorphism and the GC genotype in the COX-2 −765G>C gene were significantly more frequent among MF patients compared to controls (p< 0.001 and p = 0.002, respectively). Conclusion: The ­results indicate a possible role of COX-2 genes in the pathogenesis of MF. These novel findings may allow for notable future advances, as it will enable the identification of the ­individuals most susceptible to MF.
Risk Stratification for Ischemic Cerebrovascular Events and Mortality among Intracerebral Hemorrhage Patients with and without Atrial Fibrillation: A Nationwide Cohort Study
Authors: Nielsen Peter Brønnum , Overvad Thure Filskov , Andersen Søren Due , Larsen Torben Bjerregaard , Skjøth Flemming , Søgaard Mette , Lip Gregory Y.H.
Published: December 2019

Background: Intracerebral hemorrhage is a devastating clinical event, and secondary prevention is pivotal to avoid further cerebral complications, but no clear guidance exist for selecting high-risk patients. The CHA2DS2-VASc score is a widespread tool to assess the risk of stroke among patients with atrial fibrillation (AF). Objectives: We investigated the ability of the CHA2DS2-VASc score for estimating cerebrovascular ischemic events in patients with recent intracerebral hemorrhage with or without comorbid AF. Methods: Patients with a diagnosis of intracerebral hemorrhage between 2003 and 2018 were considered for inclusion. Four registries were linked to obtain individual-level information, and included patients were followed for the occurrence of cerebrovascular ischemic events and all-cause mortality. We report absolute risks at 5 years stratified by baseline CHA2DS2-VASc score and AF prevalence. Results: The study included 12,245 patients (46.4% females) of whom 19% had prevalent AF. Patients without AF were younger (mean age: 70 vs. 78 years) and had a lower CHA2DS2-VASc score (2.5 vs. 3.6). The overall 5-year risk of cerebrovascular ischemic events was 5.2% (95% CI 4.7–5.6) for patients without AF and 7.3% (95% CI 6.0–8.5) for AF patients; all-cause mortality was higher than 30 and 50% in patients without or with AF, respectively. The predictive performance of the CHA2DS2-VASc score was poor with c-statistics around 0.56 regardless of AF status. Among patients without AF, a score ≥6 was associated with a 7.0% risk of cerebrovascular ischemic events. In patients with AF, the associated risk was lowest for patients with a CHA2DS2-VASc score of 1 (4.1%) and highest among those with a score of 5 (11.9%). Conclusion: In this nationwide cohort of intracerebral hemorrhage patients with or without AF, the risk of cerebrovascular ischemic events and mortality was substantial. The CHA2DS2-VASc score may be used for the estimation of stroke risk in patients sustaining an intracerebral hemorrhage, although its discriminative performance was poor.
Multimodal Treatment of Extragonadal Choriocarcinoma with Multiple Brain and Lung Metastases: A Case Report
Authors: Uematsu Mao , Kanemasa Yusuke , Nakamura Shohei , Funasaka Chikako , Kageyama Akihiko , Shimoyama Tatsu , Omuro Yasushi
Published: December 2019

Choriocarcinoma is a highly aggressive germ cell tumor and can metastasize to the brain. Although brain metastasis has a poor prognosis, the optimal treatment strategy remains unclear due to its low incidence. A 33-year-old man presenting with multiple lung nodules on chest radiography was referred to our hospital. Computed tomography revealed bilateral lung nodules and a large pelvic mass, and brain magnetic resonance imaging (MRI) demonstrated multiple brain lesions. He developed progressive headache and nausea and underwent two craniotomies because of rapid tumor growth and intratumoral hemorrhage. Metastasis of choriocarcinoma was strongly suspected because of histological findings and detection of urine human chorionic gonadotropin (hCG). He immediately received chemotherapy with bleomycin, etoposide, and cisplatin (BEP). Although the pelvic mass and pulmonary lesions reduced in size and the β-hCG level decreased after one cycle of BEP, brain MRI displayed an increase in the size and number of brain metastases. He underwent whole-brain radiotherapy (WBRT) concurrently with 2 cycles of BEP, leading to successful reduction of brain metastases. After 4 cycles of BEP, the β-hCG level was still higher than the normal range, and the pelvic and pulmonary lesions remained. He continued chemotherapy with paclitaxel, ifosfamide, and cisplatin (TIP) and etoposide, ifosfamide, and cisplatin (VIP). The β-hCG level normalized, and the residual pelvic mass was resected, revealing no viable cancer cells. Multimodal treatment, including two craniotomies and chemotherapy concurrent with WBRT, can achieve good control of lesions of the brain and other sites.
Peripheral Blood RNA Levels of
QSOX1
and
PLBD1
Are New Independent Predictors of Left Ventricular Dysfunction After Acute Myocardial Infarction
Authors: Vanhaverbeke Maarten , Vausort Mélanie , Veltman Denise , Zhang Lu , Wu Ming , Laenen Griet , Gillijns Hilde , Moreau Yves , Bartunek Jozef , Van De Werf Frans , Devaux Yvan , Janssens Stefan , Sinnaeve Peter R. ,   on behalf of EU-CardioRNA COST Action CA17129
Published: December 2019

Background:

The identification of patients with acute myocardial infarction (MI) at risk of subsequent left ventricular (LV) dysfunction remains challenging, but it is important to optimize therapies. The aim of this study was to determine the unbiased RNA profile in peripheral blood of patients with acute MI and to identify and validate new prognostic markers of LV dysfunction.

Methods:

We prospectively enrolled a discovery cohort with acute MI (n=143) and performed whole-blood RNA profiling at different time points. We then selected transcripts on admission that related to LV dysfunction at follow-up and validated them by quantitative polymerase chain reaction in the discovery cohort, in an external validation cohort (n=449), and in a representative porcine MI model with cardiac magnetic resonance–based measurements of infarct size and postmortem myocardial pathology (n=33).

Results:

RNA profiling in the discovery cohort showed upregulation of genes involved in chemotaxis, IL (interleukin)-6, and NF-κB (nuclear factor-κB) signaling in the acute phase of MI. Expression levels of the majority of these transcripts paralleled the rise in cardiac troponin T and decayed at 30 days. RNA levels of
QSOX1
,
PLBD1
, and
S100A8
on admission with MI correlated with LV dysfunction at follow-up. Using quantitative polymerase chain reaction, we confirmed that
QSOX1
and
PLBD1
predicted LV dysfunction (odds ratio, 2.6 [95% CI, 1.1–6.1] and 3.2 [95% CI, 1.4–7.4]), whereas
S100A8
did not. In the external validation cohort, we confirmed
QSOX1
and
PLBD1
as new independent markers of LV dysfunction (odds ratio, 1.41 [95% CI, 1.06–1.88] and 1.43 [95% CI, 1.08–1.89]).
QSOX1
had an incremental predictive value in a model consisting of clinical variables and cardiac biomarkers (including NT-proBNP [N-terminal pro-B-type natriuretic peptide]). In the porcine MI model, whole-blood levels of
QSOX1
and
PLBD1
related to neutrophil infiltration in the ischemic myocardium in an infarct size–independent manner.

Conclusions:

Peripheral blood
QSOX1
and
PLBD1
in acute MI are new independent markers of LV dysfunction post-MI.
Genetic Determinants of Lipids and Cardiovascular Disease Outcomes
Authors: Allara Elias , Morani Gabriele , Carter Paul , Gkatzionis Apostolos , Zuber Verena , Foley Christopher N. , Rees Jessica M.B. , Mason Amy M. , Bell Steven , Gill Dipender , Lindström Sara , Butterworth Adam S. , Di Angelantonio Emanuele , Peters James , Burgess Stephen ,   INVENT consortium
Published: December 2019

Background:

Evidence from randomized trials has shown that therapies that lower LDL (low-density lipoprotein)-cholesterol and triglycerides reduce coronary artery disease (CAD) risk. However, there is still uncertainty about their effects on other cardiovascular outcomes. We therefore performed a systematic investigation of causal relationships between circulating lipids and cardiovascular outcomes using a Mendelian randomization approach.

Methods:

In the primary analysis, we performed 2-sample multivariable Mendelian randomization using data from participants of European ancestry. We also conducted univariable analyses using inverse-variance weighted and robust methods, and gene-specific analyses using variants that can be considered as proxies for specific lipid-lowering medications. We obtained associations with lipid fractions from the Global Lipids Genetics Consortium, a meta-analysis of 188 577 participants, and genetic associations with cardiovascular outcomes from 367 703 participants in UK Biobank.

Results:

For LDL-cholesterol, in addition to the expected positive associations with CAD risk (odds ratio [OR] per 1 SD increase, 1.45 [95% CI, 1.35–1.57]) and other atheromatous outcomes (ischemic cerebrovascular disease and peripheral vascular disease), we found independent associations of genetically predicted LDL-cholesterol with abdominal aortic aneurysm (OR, 1.75 [95% CI, 1.40–2.17]) and aortic valve stenosis (OR, 1.46 [95% CI, 1.25–1.70]). Genetically predicted triglyceride levels were positively associated with CAD (OR, 1.25 [95% CI, 1.12–1.40]), aortic valve stenosis (OR, 1.29 [95% CI, 1.04–1.61]), and hypertension (OR, 1.17 [95% CI, 1.07–1.27]), but inversely associated with venous thromboembolism (OR, 0.79 [95% CI, 0.67–0.93]) and hemorrhagic stroke (OR, 0.78 [95% CI, 0.62–0.98]). We also found positive associations of genetically predicted LDL-cholesterol and triglycerides with heart failure that appeared to be mediated by CAD.

Conclusions:

Lowering LDL-cholesterol is likely to prevent abdominal aortic aneurysm and aortic stenosis, in addition to CAD and other atheromatous cardiovascular outcomes. Lowering triglycerides is likely to prevent CAD and aortic valve stenosis but may increase thromboembolic risk.
Prestroke Disability Predicts Adverse Poststroke Outcome
Authors: Han Thang S. , Fry Christopher H. , Gulli Giosue , Affley Brendan , Robin Jonathan , Irvin-Sellers Melanie , Fluck David , Kakar Puneet , Sharma Sapna , Sharma Pankaj
Published: December 2019

Background and Purpose—

Information on what effect disability before stroke can have on stroke outcome is lacking. We assessed prestroke disability in relation to poststroke hospital outcome.

Methods—

Analysis of prospectively collected data from the Sentinel Stroke National Audit Programme. A total of 1656 men (mean age ±SD =73.1±13.2 years) and 1653 women (79.3±13.0 years) were admitted to hyperacute stroke units with acute stroke in 4 major UK between 2014 and 2016. Prestroke disability, assessed by modified Rankin Scale (mRS), was tested against poststroke adverse outcomes, adjusted for age, sex, and coexisting morbidities.

Results—

Compared with patients with prestroke mRS score =0, individuals with prestroke mRS scores =3, 4, or 5 had greater adjusted risks of moderately severe or severe stroke on arrival (4.4% versus 16.7%; odds ratio [OR], 3.2 [95% CI, 2.3–4.6]
P
<0.001); urinary tract infection or pneumonia within 7 days of admission (9.6% versus 35.9%; OR, 3.7 [95% CI, 2.8–4.8]
P
<0.001); mortality (7.2% versus 37.1%; OR, 4.9 [95% CI, 3.7–6.5]
P
<0.001); requiring help with activities of daily living on discharge (12.3% versus 26.7%; OR, 3.1 [95% CI, 2.3–4.1]
P
<0.001); and transferred to new care home (2.4% versus 9.4%; OR, 2.1 [95% CI, 1.3–3.3]
P
=0.002). Patients with mRS scores =1 or 2 had intermediate risk of adverse outcomes. Overall, those with a mRS score =1 or 2 had length of stay on hyperacute stroke units extended by 5.3 days (95% CI, 2.8–7.7;
P
<0.001) and mRS score =3, 4 or 5 by 7.2 days (95% CI, 4.0–10.5;
P
<0.001).

Conclusions—

Individuals with evidence of prestroke disability, assessed by mRS, had significantly increased risk of poststroke adverse outcomes and longer length of stay on hyperacute stroke units and higher level of care on discharge.
Taxonomic notes on the genus Satyrium Scudder, 1876 (Lepidoptera, Lycaenidae) of Afghanistan with description of two new taxa
Authors: KRUPITSKY ANATOLY V. , Pljushtch IGOR G. , Pak OLEG V.
Published: December 2019

А new species and a new subspecies of Satyrium Scudder, 1876 (subfamily Theclinae, tribe Eumaeini) from the subgenera Superflua Strand, 1910 and Armenia Dubatolov & Korshunov, 1984 respectively are described from Bamyan Province, Central Afghanistan—S. (S.) skrylniki sp. n. and S. (A.) hyrcanica bamiana ssp. n. The new species of Superflua belongs to the Iranian complex of species. It inhabits the territory of Afghanistan, being isolated from two other species of the subgenus known from the territory in question. The new subspecies of Armenia is also found in isolation both from the nominate subspecies and two Middle and Central Asian subspecies. Both findings clarify some aspects of zoogeography of the Central Afghanistan mountains.
A new species of planthopper belonging to the genus Oecleus Stål, 1862 (Hemiptera: Fulgoroidea: Cixiidae) from coconut palm (Cocos nucifera L) in Jamaica
Authors: MYRIE WAYNE , HELMICK ERICKA E. , BARTLETT CHARLES R. , BERTACCINI ASSUNTA , BAHDER BRIAN W.
Published: December 2019

A new species of cixiid planthopper (Hemiptera: Fulgoroidea) in the genus Oecleus Stål, Oecleus mackaspringi sp. n., is described from Spring Garden, Jamaica. This new taxon is associated with coconut palm (Cocos nucifera L.) and was found while surveying palm plots with active cases of lethal yellowing (LY). This is the first report of the genus Oecleus from Jamaica. Sequence data for the COI gene and 18S gene are also provided.
Fiberoptic Endoscopic Evaluation of Swallowing in Infants and Children: Protocol, Safety, and Clinical Efficacy: 25 Years of Experience
Authors: Miller Claire Kane , Willging Jay Paul
Published: December 2019

Background:

The application of fiberoptic endoscopic evaluation of swallowing (FEES) in the pediatric dysphagia protocol requires specialized knowledge of pediatric conditions that result in dysphagia, recognition of normal and abnormal laryngopharyngeal anatomy and function across ages, and the ability to identify maturational changes in anatomy and function of the aerodigestive tract that pertain to airway protection and swallowing function.

Methods:

Over the past 25 years, we have performed over 7,000 collaborative Otolaryngology and Speech-Language Pathology FEES examinations in patients ranging from 2 days of age to young adults. During this time period, we have monitored the safety of the procedure, explored the feasibility and utility of FEES across conditions, compared and contrasted FEES to the videofluoroscopic evaluation of swallowing (VFSS), and developed specific pediatric FEES protocols with operational definitions for identification and interpretation of swallowing parameters.

Results:

FEES has proved to be a safe procedure in patients across ages. There have been no significant adverse events. FEES is comparable to the VFSS in the assessment of events before and after the swallow. It provides unique information regarding laryngopharyngeal anatomy and function, airway protection integrity, sensory threshold, and secretion management ability, as well as pharyngeal swallowing dynamics and the efficacy of compensatory swallowing strategies.

Conclusions:

There are specific indications and contraindications for pediatric FEES, and unique components that characterize the pediatric FEES protocols across ages and conditions. FEES procedures performed jointly by an Otolaryngologist and Speech-Language pathologist offer a team approach to interpretation and management recommendations.