bluuebunny/crossref_metadata_2025 huggingface dataset:
Time to surgery for open hand injuries and the risk of surgical site infection: a prospective multicentre cohort study
Authors: Davies James , Roberts Tobias , Limb Richard , Mather David , Thornton Daniel , Wade Ryckie G.
Published: February 2020

Whether delaying surgery increases the risk of infection in open hand injuries is an important but unresolved topic. This prospective cohort study included 983 consecutive adults with open hand injuries treated surgically over 1 year. The risk ratio (RR) for surgical site infection was estimated by logistic regression. The median time from injury to surgery was 20 hours (range 4–90). Forty-one patients (4%) developed an infection. The risk of infection was not affected by the time to surgery (adjusted risk ratio 1.0 [95% CI: 1.0 to 1.0]) or preoperative antibiotics (adjusted risk ratio 1.8 [95% CI: 0.2 to 13]), which were provided to 95% of patients. Skin loss increased the risk of infection (adjusted risk ratio 2.6 [95% CI: 1.3 to 5.0]). Delaying surgery for open hand injuries by 4 days does not appear to increase the risk of surgical site infection.

Level of evidence: II
Refractory extensive vulvar high-grade squamous intraepithelial lesion in an immunosuppressed transplant patient treated with topical cidofovir: A case report
Authors: Lim Darosa , Belisle Annie , Funaro Deana
Published: February 2020

High-grade squamous intraepithelial lesion of the vulva is a premalignant condition which may be especially resistant to treatments among immunosuppressed patients. We present our experience with the use of topical cidofovir in a refractory case of extensive vulvar high-grade squamous intraepithelial lesion in a 37-year-old transplant patient. Eighteen cycles of cidofovir over a 2-year period led to a sustained significant improvement, mainly of the mucosal lesions and was well tolerated. To our knowledge, we have not seen this therapy described in transplant patients with extensive high-grade squamous intraepithelial lesion.
Political Economy of Rentierism in the Middle East and Disruptions from the Digital Space
Authors: Hameed Sameena
Published: February 2020

Rentierism in the Middle East and North Africa (MENA) region had emanated both from significant external rent and from the statist model of development feeding each other, where legitimacy was secured through rent distribution. The rent-led resource imbalance between the state and the society, as well as intra-societal inequalities in the region, has been less recognized and studied. The flow of external rent in tandem with internal rent-seeking has perpetuated the wealth and power of the political and economic elites and limited economic opportunities of the larger population. The rentierism that bred on vertical controls and network of privileges is set to be disrupted from flows and connectivity generated in the growth of digital commerce in the region.
Regional Power Role and Intervention: The Turkish Case Over Syria in the 2000s
Authors: Sever Ayşegül
Published: February 2020

The article elaborates how Turkey’s relations with Syria, which have been pursued by varying foreign policy instruments and conduct, have greatly affected Turkey’s standing on the Middle East during the 2000s. By employing the relevant concepts, “regional power” and “third party intervention” in the literature, the article aims to explain the changes caused by the Syrian conflict in the AKP’s ( Adalet ve Kalkınma Partisi—the Justice and Development Party) foreign policy in a better frame. After the Syrian conflict, Turkey’s increasing intervention in Syria including use of force resulted in a new power projection other than soft power in its regional relations. Neighboring a civil war state caused Ankara to organize its relations with Syria and the Middle East in a new context which requires new mechanisms, new partnerships, and new interpretations in the face of rising nongovernmental armed groups, refugee flows, changing regional alignments, and diverging interests with its major Western allies.
Individual and Organizational Predictors of White-Collar Crime: A Meta-Analysis
Authors: Pusch Natasha , Holtfreter Kristy
Published: February 2020

Studying white-collar crime presents challenges due to definitional disputes, variation in units of analysis, lack of data, and the use of proxy measures. This study employed multilevel meta-analytic methods to shed light on these issues. A total of 602 effect sizes using occupational or corporate crime as the dependent variable were included ( N = 54,205 individuals and 6,425 corporations), with predictor domains reflecting individual and organizational characteristics. Deterrence and positive personal traits showed the largest significant bivariate and multivariate effect sizes, respectively. Moderator analyses suggest that effects are largely stable regardless of whether the dependent variable reflects behavioral intentions or actual behavior, or cross-sectional or longitudinal designs are used.
Community-acquired pneumonia in critically ill very old patients: a growing problem
Authors: Cillóniz Catia , Dominedò Cristina , Pericàs Juan M. , Rodriguez-Hurtado Diana , Torres Antoni
Published: February 2020

Very old (aged ≥80 years) adults constitute an increasing proportion of the global population. Currently, this subgroup of patients represents an important percentage of patients admitted to the intensive care unit. Community-acquired pneumonia (CAP) frequently affects very old adults. However, there are no specific recommendations for the management of critically ill very old CAP patients. Multiple morbidities, polypharmacy, immunosenescence and frailty contribute to an increased risk of pneumonia in this population. CAP in critically ill very old patients is associated with higher short- and long-term mortality; however, because of its uncommon presentation, diagnosis can be very difficult. Management of critically ill very old CAP patients should be guided by their baseline characteristics, clinical presentation and risk factors for multidrug-resistant pathogens. Hospitalisation in intermediate care may be a good option for critical ill very old CAP patients who do not require invasive procedures and for whom intensive care is questionable in terms of benefit.
Early pulmonary rehabilitation after acute exacerbation of COPD: a randomised controlled trial
Authors: Kjærgaard Jakob L. , Juhl Carsten B. , Lange Peter , Wilcke Jon T.
Published: February 2020

Objectives

The aim of this study was to establish whether early pulmonary rehabilitation after severe exacerbation of chronic obstructive pulmonary disease (COPD) reduces mortality and hospital admissions, and increases physical performance and quality of life compared to rehabilitation initiated later in the stable phase of COPD.

Methods

In a randomised controlled trial of 150 patients hospitalised with an exacerbation of COPD, participants were allocated to pulmonary rehabilitation either within 2 weeks after discharge or the same rehabilitation programme but initiated 2 months after discharge.

Results

Early pulmonary rehabilitation did not prolong time to first hospital admission or time to death (hazard ratio 0.79, 95% CI 0.47–1.23, p=0.33) compared to rehabilitation in stable phase. However, 2 months after inclusion, pulmonary rehabilitation resulted in a significantly better improvement in the incremental shuttle walk test (33.9 m, 95% CI 4.18–63.7, p=0.02) compared to that in the stable phase. The difference in the endurance shuttle walk test was of borderline significance (140 s, 95% CI −2.03–282.76, p=0.05), but there was no significant difference concerning the COPD assessment test (−1.43 points, 95% CI −3.44–0.59, p=0.17).

Conclusion

Early pulmonary rehabilitation after acute exacerbation of COPD led to a faster improvement in physical performance compared to rehabilitation initiated later in the stable phase, but did not improve survival or prolong time to hospital readmission.
Altered lateral geniculate nucleus functional connectivity in migraine without aura: a resting-state functional MRI study
Authors: Zhang Di , Huang Xiaobin , Su Wen , Chen Yuchen , Wang Peng , Mao Cunnan , Miao Zhengfei , Liu Chunmei , Xu Chenjie , Yin Xindao , Wu Xinying
Published: February 2020

Objectives

To investigate the structural and functional connectivity changes of lateral geniculate nucleus (LGN) and their relationships with clinical characteristics in patients without aura.

Methods

Conventional MRI, 3D structure images and resting state functional MRI were performed in 30 migraine patients without aura (MwoA) and 22 healthy controls (HC). The lateral geniculate nucleus volumes and the functional connectivity (FC) of bilateral lateral geniculate nucleus were computed and compared between groups.

Results

The lateral geniculate nucleus volumes in patient groups did not differ from the controls. The brain regions with increased FC of the left LGN mainly located in the left cerebellum and right lingual gyrus in MwoA compared with HC. The increased FC of right LGN located in left inferior frontal gyrus in MwoA compared with HC. The correlation analysis showed a positive correlation between VLSQ-8 score and the increased FC of left cerebellum and right lingual gyrus.

Conclusions

Photophobia in MwoA could be mediated by abnormal resting state functional connectivity in visual processing regions, the pain perception regulatory network and emotion regulation network. This result is valuable to further understanding about the clinical manifestation and pathogenesis of migraine.
Comparison of the performance of an amplicon sequencing assay based on Oxford Nanopore technology to real-time PCR assays for detecting bacterial biodefense pathogens
Authors: Player Robert , Verratti Kathleen , Staab Andrea , Bradburne Christopher , Grady Sarah , Goodwin Bruce , Sozhamannan Shanmuga
Published: February 2020

Background

The state-of-the-art in nucleic acid based biodetection continues to be polymerase chain reaction (PCR), and many real-time PCR assays targeting biodefense pathogens for biosurveillance are in widespread use. These assays are predominantly singleplex; i.e. one assay tests for the presence of one target, found in a single organism, one sample at a time. Due to the intrinsic limitations of such tests, there exists a critical need for high-throughput multiplex assays to reduce the time and cost incurred when screening multiple targets, in multiple pathogens, and in multiple samples. Such assays allow users to make an actionable call while maximizing the utility of the small volumes of test samples. Unfortunately, current multiplex real-time PCR assays are limited in the number of targets that can be probed simultaneously due to the availability of fluorescence channels in real-time PCR instruments.

Results

To address this gap, we developed a pipeline in which the amplicons produced by a 14-plex end-point PCR assay using spiked samples were subsequently sequenced using Nanopore technology. We used bar codes to sequence multiple samples simultaneously, leading to the generation and subsequent analysis of sequence data resulting from a short sequencing run time (< 10 min). We compared the limits of detection (LoD) of real-time PCR assays to Oxford Nanopore Technologies (ONT)-based amplicon sequencing and estimated the sample-to-answer time needed for this approach. Overall, LoDs determined from the first 10 min of sequencing data were at least one to two orders of magnitude lower than real-time PCR. Given enough time, the amplicon sequencing approach is approximately 100 times more sensitive than real-time PCR, with detection of amplicon specific reads even at the lowest tested spiking concentration (around 2.5–50 Colony Forming Units (CFU)/ml).

Conclusions

Based on these results, we propose amplicon sequencing assay as a viable alternative to replace the current real-time PCR based singleplex assays for higher throughput biodefense applications. We note, however, that targeted amplicon specific reads were not detectable even at the highest tested spike concentrations (2.5 X 104–5.0 X105 CFU/ml) without an initial amplification step, indicating that PCR is still necessary when utilizing this protocol.
A 14-bp insertion in endothelin receptor B-like (EDNRB2) is associated with white plumage in Chinese geese
Authors: Xi Yang , Wang Lei , Liu Hehe , Ma Shengchao , Li Yanying , Li Liang , Wang Jiwen , Chunchun Han , Bai Lili , Mustafa Ahsan , He Hua
Published: February 2020

Background

Gang goose is a native species with gray plumage in Sichuan, China. As a result of overhunting, the number of gray Gang geese has decreased dramatically. To keep the species from extinction, conservation work for Gang geese was undertaken. In the process of pure breeding of gray Gang geese, approximately 2% of the offspring of each generation were white. This study aims to explain the genetic mechanism of this phenomenon and provide reliable molecular markers for goose-related plumage color breeding.

Results

We used the method of pooled whole genome sequencing and Fst (fixation statistics) to identify the differentiation degree of alleles between gray Gang geese and white Gang geese from their offspring. In this way, EDNRB2, a key gene that affects the migration of melanoblasts, was identified. Then, the transcriptome was sequenced for the two geese plumage color populations, and the DEGs (differentially expressed genes) were analyzed. The results indicated that EDNRB2, as a possible candidate gene, had a significantly differential mRNA expression. In addition, a 14-bp insertion (NW_013185915.1: g. 750,748–750,735 insertion. CACAGGTGAGCTCT) in exon 3 of EDNRB2 was analyzed and found to have a significant association between gray geese and Chinese white breeds (P = 0.00), while this mutation was not found in European geese. Meanwhile, the insertion was homozygous in all the white geese we detected and heterozygous in gray geese, indicating that this mutation is recessive. Furthermore, this 14-bp insertion leads to a frameshift mutation in the EDNRB2 coding region and nonsense-mediated mRNA decay.

Conclusion

Our study strongly suggests that the 14-bp insertion in exon 3 of the EDNRB2 gene is associated with the white plumage phenotype in Chinese geese. This study is the first to investigate the relationship between EDNRB2 and white plumage in geese.
Metatranscriptomic dynamics after Verticillium dahliae infection and root damage in Olea europaea
Authors: Martí Jose Manuel , Arias-Giraldo Luis F. , Díaz-Villanueva Wladimiro , Arnau Vicente , Rodríguez-Franco Antonio , Garay Carlos P.
Published: February 2020

Background

The olive tree is of particular economic interest in the Mediterranean basin. Researchers have conducted several studies on one of the most devastating disorders affecting this tree, the Verticillium wilt, which causes substantial economic losses in numerous areas. We analyzed metatranscriptomic samples taken from a previous study conducted on leaves and roots of Olea europaea that were infected with Verticillium dahliae. In addition, we also analyzed mechanically damaged roots. The aim of our approach is to describe the dynamics of the root microbiome after severe perturbations.

Results

Our results not only describe the dynamics of the microbial community associated with the disturbance, but also show the high complexity of these systems and explain how this can lead to a conflicting assignment of the various types of parasitism observed in a specific organism.

Conclusions

Our findings indicate that this infection, although led by Verticillium, is driven not by a single species, but by a polymicrobial consortium that also includes natural endophytes of the olive tree. This community contains both biotrophic and necrotrophic organisms that alternate and live together during the infection. In addition, opportunistic organisms appear that take profit not from plant tissues, but from new emerging populations of microorganisms. Therefore, this system can be described as a complex biological system composed of different interacting communities. Notably, our work has important considerations when it comes to classifying the type of parasitism of a given species.
Granulocyte colony-stimulating factor attenuates myocardial remodeling and ventricular arrhythmia susceptibility via the JAK2-STAT3 pathway in a rabbit model of coronary microembolization
Authors: Wang Weiwei , Ye Shuhua , Zhang Lutao , Jiang Qiong , Chen Jianhua , Chen Xuehai , Zhang Feilong , Wu Hangzhou
Published: February 2020

Background

Coronary microembolization (CME) has a poor prognosis, with ventricular arrhythmia being the most serious consequence. Understanding the underlying mechanisms could improve its management. We investigated the effects of granulocyte colony-stimulating factor (G-CSF) on connexin-43 (Cx43) expression and ventricular arrhythmia susceptibility after CME.

Methods

Forty male rabbits were randomized into four groups (n = 10 each): Sham, CME, G-CSF, and AG490 (a JAK2 selective inhibitor). Rabbits in the CME, G-CSF, and AG490 groups underwent left anterior descending (LAD) artery catheterization and CME. Animals in the G-CSF and AG490 groups received intraperitoneal injection of G-CSF and G-CSF + AG490, respectively. The ventricular structure was assessed by echocardiography. Ventricular electrical properties were analyzed using cardiac electrophysiology. The myocardial interstitial collagen content and morphologic characteristics were evaluated using Masson and hematoxylin-eosin staining, respectively.

Results

Western blot and immunohistochemistry were employed to analyze the expressions of Cx43, G-CSF receptor (G-CSFR), JAK2, and STAT3. The ventricular effective refractory period (VERP), VERP dispersion, and inducibility and lethality of ventricular tachycardia/fibrillation were lower in the G-CSF than in the CME group (P < 0.01), indicating less severe myocardial damage and arrhythmias. The G-CSF group showed higher phosphorylated-Cx43 expression (P < 0.01 vs. CME). Those G-CSF-induced changes were reversed by A490, indicating the involvement of JAK2. G-CSFR, phosphorylated-JAK2, and phosphorylated-STAT3 protein levels were higher in the G-CSF group than in the AG490 (P < 0.01) and Sham (P < 0.05) groups.

Conclusion

G-CSF might attenuate myocardial remodeling via JAK2-STAT3 signaling and thereby reduce ventricular arrhythmia susceptibility after CME.
Perspectives of older adults, caregivers, and healthcare providers on frailty screening: a qualitative study
Authors: Van Damme Jill , Neiterman Elena , Oremus Mark , Lemmon Kassandra , Stolee Paul
Published: February 2020

Background

Screening is an important component of understanding and managing frailty. This study examined older adults’, caregivers’ and healthcare providers’ perspectives on frailty and frailty screening.

Methods

Fourteen older adults and caregivers and 14 healthcare providers completed individual or focus group interviews. Interviews were audio recorded, transcribed verbatim, and analyzed using line-by-line emergent coding techniques and inductive thematic analysis.

Results

The interviews yielded several themes with associated subthemes: definitions and conceptualizations of frailty, perceptions of “frail”, factors contributing to frailty (physical,, cognitive, social, pharmaceutical, nutritional), and frailty screening (current practices, tools in use, limitations, recommendations).

Conclusion

Older adults, caregivers and healthcare providers have similar perspectives regarding frailty; both identified frailty as multi-dimensional and dynamic. Healthcare providers need clear “next steps” to provide meaning to frailty screening practices, which may improve use of frailty-screening tools.
The influence of race in older adults with infective endocarditis
Authors: Harris Ché Matthew , Khaliq Waseem , Albaeni Aiham , Norris Keith C.
Published: February 2020

Background

Age is a risk factor for infective endocarditis, and almost half of diagnosed patients are age ≥ 60 years. Large national studies have not evaluated inpatient mortality and surgical valvular interventions between older White and Black patients hospitalized with infective endocarditis.

Methods

We used the Nationwide Inpatient Sample database to identify older adults ≥60 years in North America with a principle diagnosis of infective endocarditis. Multivariate logistic regression was used to compare in-hospital mortality and valvular repairs/replacement between older Black and White patients.

Results

Of 10,390 adults, age ≥ 60 years hospitalized for infective endocarditis during 2013 and 2014, 7356 were White and 1089 Black. Blacks were younger (mean age: 70.5 ± 0.5 vs. 73.5 ± 0.2 years, p < 0.01), lived in more zip codes with a median annual income <$39,000/yr. (40.4% vs 18.8%, p < 0.01), and had higher co-morbidity burden (Charlson comorbidity score ≥ 3: 54.6% vs 40.7%, p < 0.01). After multivariate adjustment, Blacks had higher odds for in-hospital mortality (Odds Ratio (OR) = 2.0, [Confidence Interval (CI) 1.1–3.8]; p = 0.020), and lower odds for mitral valve repairs/replacements (OR = 0.53, CI: 0.29–0.99, p = 0.049).

Conclusions

Blacks age ≥ 60 years hospitalized in North America with infective endocarditis are less likely to undergo mitral valvular repairs/replacement and had higher in-hospital mortality compared to White patients.
Qualitative investigation of the factors that generate ambivalent feelings in women who give birth after receiving negative results from non-invasive prenatal testing
Authors:   Japan NIPT Consortium, Yotsumoto Junko , Sekizawa Akihiko , Inoue Satomi , Suzumori Nobuhiro , Samura Osamu , Yamada Takahiro , Miura Kiyonori , Masuzaki Hideaki , Sawai Hideaki , Murotsuki Jun , Hamanoue Haruka , Kamei Yoshimasa , Endo Toshiaki , Fukushima Akimune , Katagiri Yukiko , Takeshita Naoki , Ogawa Masaki , Nishizawa Haruki , Okamoto Yoko , Tairaku Shinya , Kaji Takashi , Maeda Kazuhisa , Matsubara Keiichi , Ogawa Masanobu , Osada Hisao , Ohba Takashi , Kawano Yukie , Sasaki Aiko , Sago Haruhiko
Published: February 2020

Background

Women who receive negative results from non-invasive prenatal genetic testing (NIPT) may find that they later have mixed or ambivalent feelings, for example, feelings of accepting NIPT and regretting undergoing the test. This study aimed to investigate the factors generating ambivalent feelings among women who gave birth after having received negative results from NIPT.

Methods

A questionnaire was sent to women who received a negative NIPT result, and a contents analysis was conducted focusing on ambivalent expressions for those 1562 women who responded the questionnaire. The qualitative data gathered from the questionnaire were analyzed using the N-Vivo software package.

Results

Environmental factors, genetic counseling-related factors, and increased anticipatory anxiety, affected the feeling of ambivalence among pregnant women. Furthermore, pregnant women desired more information regarding the detailed prognosis for individuals with Down syndrome and living with them and/or termination, assuming the possibility that they were positive.

Conclusions

Three major interrelated factors affected the feeling of ambivalence in women. Highlighting and discussing such factors during genetic counseling may resolve some of these ambivalences, thereby enhancing the quality of decisions made by pregnant women.
Combining breastfeeding and work: findings from the Epifane population-based birth cohort
Authors: Castetbon Katia , Boudet-Berquier Julie , Salanave Benoit
Published: February 2020

Background

Return to work is often cited as a reason for early cessation of breastfeeding (BF). Our objectives were to study the time span during which women employed prior to pregnancy returned to work according to BF duration category, and to identify sociodemographic, behavioral and pregnancy characteristics of women who continued BF after returning to work.

Methods

Information on BF mode and work status was prospectively collected in a French nation-wide birth cohort up to 1 year after delivery. Time of return to work according to BF category was addressed using Kaplan-Meier curves and Poisson regression adjusted on co-variates. Multiple logistic regression enabled to identify characteristics associated with the combination of BF with work.

Results

Among 2480 women holding jobs prior to pregnancy, 82.0% returned to work within a year postpartum. Women who breastfed > 4 months returned at median of 6.5 months, whereas those who did not breastfeed at all returned to their jobs at 4.0 months, those who had breastfed for less than 1 month returned at 4.5 months, and those who had breastfed for 1 to 4 months returned at 4.0 months. Around one-third of women (34.5%) combined BF and work, and breastfed for a longer duration (median: 213 days, vs. 61 days for women who stopped BF before returning to work). Women born outside of France or who were self-employed were more likely to combine BF and work, while intermediate employees, manual workers, women who quitted smoking during pregnancy, who had smoked before and during pregnancy, or who had given birth by cesarean section were less likely to combine BF and work.

Conclusion

Women who had breastfed for less than 4 months, or not at all, returned to their jobs at comparable times. This suggests that working women should be encouraged to breastfeed, even for a short duration. Moreover, only one-third of working women succeeded in combining BF and work, highlighting the need for a support system that would encourage flexibility.
Correction to: Women with a predisposition for diabetes have an increased risk of pregnancy complications, especially in combination with pregestational overweight
Authors: Moll Ulrika , Olsson Håkan , Landin-Olsson Mona
Published: February 2020

Following publication of the original article [1], we have been notified by the author that the age of women from the Result section was incorrectly tagged as references.
Persistent elevation of aspartate aminotransferase in a child after incomplete Kawasaki disease: a case report and literature review
Authors: Rohani Pejman , Imanzadeh Farid , Sayyari Aliakbar , Kazemi Aghdam Maryam , Shiari Reza
Published: February 2020

Background

Interpretation of abnormalities in liver function tests, especially in asymptomatic children, is a common problem faced by clinicians. Isolated elevation of aspartate aminotransferase may further puzzle physicians. Macro-aspartate aminotransferase (AST) results from complexes AST produces with other plasma components, such as immunoglobulin. To our knowledge, this is the first report on a case of macro-AST-associated incomplete Kawasaki disease (KD). It is to make physicians aware of this benign condition and help to prevent extensive, unnecessary investigations and invasive workups.

Case presentation

A 16-month old boy with a 7-day history of fever was admitted to our pediatric ward for pyrexia workup. After complete investigations, KD was confirmed by a pediatric rheumatologist. During his admission and serial follow-up tests, an isolated AST elevation was noted. Comprehensive tests were performed and using the polyethylene glycol (PEG) precipitation method, macro-AST was confirmed. The patient has been followed up for 3 years, and so far, the benign nature of this condition has been confirmed.

Conclusion

Clinicians should consider testing for macro-AST when elevated AST is the only abnormal lab finding. Although an uncommon finding, macro-AST may be seen in both children and adults. There are many reasons for this phenomenon, including resolved acute hepatitis or in some cases, inflammatory bowel disease, hepatic malignancy, monoclonal gammapathy, celiac disease, or KD; however, it may be observed in asymptomatic healthy children as well. Using the PEG precipitation method, a definitive diagnosis can be made. In none of these conditions does macro-AST have any prognostic significance. An appreciation of macro-AST may prevent the need for more invasive investigations to which patients may be unnecessarily subjected. It is important to recognize this condition as benign and assure patients that no specific treatment is required.
Abnormal resting-state functional connectivity of hippocampal subfields in patients with major depressive disorder
Authors: Hao Zi Yu , Zhong Yuan , Ma Zi Juan , Xu Hua Zhen , Kong Jing Ya , Wu Zhou , Wu Yun , Li Jian , Lu Xin , Zhang Ning , Wang Chun
Published: February 2020

Background

Many studies have found that the hippocampus plays a very important role in major depressive disorder (MDD). The hippocampus can be divided into three subfields: the cornu ammonis (CA), dentate gyrus (DG) and subiculum. Each subfield of the hippocampus has a unique function and are differentially associated with the pathological mechanisms of MDD. However, no research exists to describe the resting state functional connectivity of each hippocampal subfield in MDD.

Methods

Fifty-five patients with MDD and 25 healthy controls (HCs) matched for gender, age and years of education were obtained. A seed-based method that imposed a template on the whole brain was used to assess the resting-state functional connectivity (rsFC) of each hippocampal subfield.

Results

Patients with MDD demonstrated increased connectivity in the left premotor cortex (PMC) and reduced connectivity in the right insula with the CA seed region. Increased connectivity was reported in the left orbitofrontal cortex (OFC) and left ventrolateral prefrontal cortex (vlPFC) with the DG seed region. The subiculum seed region revealed increased connectivity with the left premotor cortex (PMC), the right middle frontal gyrus (MFG), the left ventrolateral prefrontal cortex (vlPFC) and reduced connectivity with the right insula. ROC curves confirmed that the differences between groups were statistically significant.

Conclusion

The results suggest that the CA, DG and subiculum have significant involvement with MDD. Specifically, the abnormal functional connectivity of the CA may be related to bias of coding and integration of information in patients with MDD. The abnormal functional connectivity of the DG may be related to the impairment of working memory in patients with MDD, and the abnormal functional connectivity of the subiculum may be related to cognitive impairment and negative emotions in patients with MDD.
Changes in overweight/obesity and central obesity status from preadolescence to adolescence: a longitudinal study among schoolchildren in Japan
Authors: Ochiai Hirotaka , Shirasawa Takako , Nishimura Rimei , Yoshimoto Takahiko , Minoura Akira , Oikawa Kosuke , Miki Ayako , Hoshino Hiromi , Kokaze Akatsuki
Published: February 2020

Background

Little is known about changes in overweight/obesity and central obesity status among schoolchildren from preadolescence to adolescence in Japan, where waist circumference (WC) is generally not measured in annual health examinations at elementary and junior high schools. This study examined changes of overweight/obesity and central obesity status among schoolboys and schoolgirls from preadolescence to adolescence in Japan.

Methods

Study subjects were fourth-grade school children (9 or 10 years of age) from all four of Ina town’s elementary schools in Japan. Measurement of each participant’s height, weight, and WC were made at baseline and 3 years later. Childhood overweight/obesity was determined according to the age- and sex-specific body mass index cut-off points proposed by the International Obesity Task Force. Central obesity was defined as waist-to-height ratio ≥ 0.5. Kappa (κ) statistic was calculated to examine the tracking of overweight/obesity and central obesity.

Results

Data from 1436 participants (boys:n = 720, girls:n = 716) were analyzed. Overweight/obesity status tracked substantially from fourth grade to seventh grade in both boys (κ = 0.614,Pvalue < 0.001) and girls (κ = 0.619,Pvalue < 0.001). Among participants who were overweight/obese in fourth grade, 55.2% of boys and 63.2% of girls were still overweight/obese in seventh grade. Tracking of central obesity from fourth graders to seventh graders was substantial in boys (κ = 0.651,Pvalue < 0.001) and moderate in girls (κ = 0.544,Pvalue < 0.001). Among participants who had central obesity in fourth grade, 54.1% of boys and 52.6% of girls still had central obesity in seventh grade.

Conclusions

The present study showed that the tracking of overweight/obesity from preadolescence to adolescence was substantial in boys and girls. Moreover, more than half of those who had central obesity in preadolescence had central obesity in adolescence. This study suggests that it is important to implement a primary prevention program for overweight/obesity and central obesity in elementary schools before fourth grade.
Ficus deltoidea suppresses endothelial activation, inflammation, monocytes adhesion and oxidative stress via NF-κB and eNOS pathways in stimulated human coronary artery endothelial cells
Authors: Mohd Ariff Amirah , Abu Bakar Nurul Ain , Abd. Muid Suhaila , Omar Effat , Ismail Nor Hadiani , Ali Abdul Manaf , Mohd Kasim Noor Alicezah , Mohd Nawawi Hapizah
Published: February 2020

Background

Ficus deltoidea (FD) has been shown to have antidiabetic, anti-inflammatory, antinociceptive and antioxidant properties. However, its effects on key events in the pathogenesis of atherosclerosis are unknown.

Aim

To investigate the endothelial activation, inflammation, monocyte-endothelial cell binding and oxidative stress effects of four FD varieties.

Methods

Human coronary artery endothelial cells (HCAEC) were incubated with different concentrations of aqueous ethanolic extracts of FD var. trengganuensis (FDT), var. kunstleri (FDK), var. deltoidea (FDD) and var. intermedia (FDI), together with LPS. Protein and gene expression of vascular cell adhesion molecule-1 (VCAM-1), intercellular cell adhesion molecule-1 (ICAM-1), endothelial-leukocyte adhesion molecule-1 (E-selectin), interleukin-6 (IL-6), Nuclear factor-κB (NF-κB) p50 and p65 and endothelial nitric oxide synthase (eNOS) were measured using ELISA and QuantiGene plex, respectively. Adhesion of monocyte to HCAEC and formation of reactive oxygen species (ROS) were detected by Rose Bengal staining and 2′-7′-dichlorofluorescein diacetate (DCFH-DA) assay.

Results

FDK exhibited the highest inhibition of biomarkers in relation to endothelial activation and inflammation, second in reducing monocyte binding (17.3%) compared to other varieties. FDK (25.6%) was also the most potent at decreasing ROS production.

Conclusion

FD has anti-atherogenic effects, possibly mediated by NF-κB and eNOS pathways; with FDK being the most potent variety. It is potentially beneficial in mitigating atherogenesis.
C-reactive protein as a potential biomarker for disease progression in dengue: a multi-country observational study
Authors: Vuong Nguyen Lam , Le Duyen Huynh Thi , Lam Phung Khanh , Tam Dong Thi Hoai , Vinh Chau Nguyen Van , Van Kinh Nguyen , Chanpheaktra Ngoun , Lum Lucy Chai See , Pleités Ernesto , Jones Nick Keith , Simmons Cameron Paul , Rosenberger Kerstin , Jaenisch Thomas , Halleux Christine , Olliaro Piero Luigi , Wills Bridget , Yacoub Sophie
Published: February 2020

Background

Dengue infection can cause a wide spectrum of clinical outcomes. The severe clinical manifestations occur sufficiently late in the disease course, during day 4–6 of illness, to allow a window of opportunity for risk stratification. Markers of inflammation may be useful biomarkers. We investigated the value of C-reactive protein (CRP) measured early on illness days 1–3 to predict dengue disease outcome and the difference in CRP levels between dengue and other febrile illnesses (OFI).

Method

We performed a nested case-control study using the clinical data and samples collected from the IDAMS-consortium multi-country study. This was a prospective multi-center observational study that enrolled almost 8000 participants presenting with a dengue-like illness to outpatient facilities in 8 countries across Asia and Latin America. Predefined severity definitions of severe and intermediate dengue were used as the primary outcomes. A total of 281 cases with severe/intermediate dengue were compared to 836 uncomplicated dengue patients as controls (ratio 1:3), and also 394 patients with OFI.

Results

In patients with confirmed dengue, median (interquartile range) of CRP level within the first 3 days was 30.2 mg/L (12.4–61.2 mg/L) (uncomplicated dengue, 28.6 (10.5–58.9); severe or intermediate dengue, 34.0 (17.4–71.8)). Higher CRP levels in the first 3 days of illness were associated with a higher risk of severe or intermediate outcome (OR 1.17, 95% CI 1.07–1.29), especially in children. Higher CRP levels, exceeding 30 mg/L, also associated with hospitalization (OR 1.37, 95% CI 1.14–1.64) and longer fever clearance time (HR 0.84, 95% CI 0.76–0.93), especially in adults. CRP levels in patients with dengue were higher than patients with potential viral infection but lower than patients with potential bacterial infection, resulting in a quadratic association between dengue diagnosis and CRP, with levels of approximately 30 mg/L associated with the highest risk of having dengue. CRP had a positive correlation with total white cell count and neutrophils and negative correlation with lymphocytes, but did not correlate with liver transaminases, albumin, or platelet nadir.

Conclusions

In summary, CRP measured in the first 3 days of illness could be a useful biomarker for early dengue risk prediction and may assist differentiating dengue from other febrile illnesses.
The role of private education in the selection of primary care careers in low and middle-income countries. Findings from a representative survey of medical residents in Brazil
Authors: Russo Giuliano , Cassenote Alex J. Flores , Guilloux Aline G. Alves , Scheffer Mário César
Published: February 2020

Background

Primary health care (PHC) doctors’ numbers are dwindling in high- as well as low-income countries, which is feared to hamper the achievement of Universal Health Coverage goals. As a large proportion of doctors are privately educated and private medical schools are becoming increasingly common in middle-income settings, there is a debate on whether private education represents a suitable mean to increase the supply of PHC physicians. We analyse the intentions to practice of medical residents in Brazil to understand whether these differ for public and private schools.

Methods

Drawing from the literature on the selection of medical specialties, we constructed a model for the determinants of medical students’ intentions to practice in PHC, and used secondary data from a nationally representative sample of 4601 medical residents in Brazil to populate it. Multivariate analysis and multilevel cluster models were employed to explore the association between perspective physicians’ choice of practice and types of schools attended, socio-economic characteristics, and their values and opinions on the profession.

Results

Only 3.7% of residents in our sample declared an intention to practice in PHC, with no significant association with the public or private nature of the medical schools attended. Instead, having attended a state secondary school (p = 0.028), having trained outside Brazil’s wealthy South East (p < 0.001), not coming from an affluent family (p = 0.037), and not having a high valuation of career development opportunities (p < 0.001) were predictors of willingness to practice in PHC. A low consideration for quality of life, for opportunities for treating patients, and for the liberal aspects of the profession were also associated with future physicians’ intentions to work in primary care (all p < 0.001).

Conclusions

In Brazil, training in public or private medical schools does not influence the intention to practice in PHC. But students from affluent backgrounds, with private secondary education, and graduating in the rich South East were found to be overrepresented in both types of training institutions, and this is what appears to negatively impact the selection of PHC careers. With a view to increasing the supply of PHC practitioners in middle-income countries, policies should focus on opening medical schools in rural areas and improving access for students from disadvantaged backgrounds.
Development of a DNA-based real-time PCR assay for the quantification of Colletotrichum camelliae growth in tea (Camellia sinensis)
Authors: He Shengnan , Chen Huchen , Wei Yi , An Tai , Liu Shouan
Published: February 2020

Background

Tea, which is produced from new shoots of existing tea plants (Camellia sinensis), is one of the most popular, non-alcoholic, healthy beverages worldwide. Colletotrichum camelliae is one of the dominant fungal pathogens of tea. The interaction of C. camelliae with tea could be a useful pathosystem to elucidate various aspects of woody, medicinal plant-fungal interactions. Currently, many studies characterizing resistance or virulence and aggressiveness use lesion size at the infection sites on the leaves to quantify the growth of the pathogen. However, this method does not offer the sensitivity needed for the robust quantification of small changes in aggressiveness or the accurate quantification of pathogen growth at the early stages of infection.

Results

A quantitative real-time polymerase chain reaction (qRT-PCR) assay was developed for the quantification of C. camelliae growth on tea plant. This method was based on the comparison of fungal DNA in relation to plant biomass. This assay was used to investigate the phenotypes of tea plant cultivars in response to C. camelliae infection. Two cultivars, Zhongcha 108 (ZC108) and Longjing 43 (LJ43), were tested with this method. ZC108 was previously reported as an anthracnose-resistant cultivar against C. camelliae, while LJ43 was susceptible. The traditional lesion measurement method showed that both cultivars were susceptible to a virulent strain of C. camelliae, while the qRT-PCR approach indicated that very little fungal growth occurred in the anthracnose-resistant cultivar ZC108. The observed results in this study were consistent with previously published research. In addition, the DNA-based real-time PCR method was applied for analysis of pathogenic differences in general C. camelliae isolates and among several Colletotrichum spp that infect tea.

Conclusions

This study showed that the DNA-based qRT-PCR technique is rapid, highly sensitive and easily applicable for routine experiments and could be used in screening for resistant tea plant cultivars or to identify differences in pathogen aggressiveness within and among Colletotrichum species.
Extracellular vesicle-mediated amyloid transfer to neural progenitor cells: implications for RAGE and HIV infection
Authors: András Ibolya E. , Garcia-Contreras Marta , Yanick Christopher , Perez Paola , Sewell Brice , Durand Leonardo , Toborek Michal
Published: February 2020

Amyloid beta (Aβ) deposition was demonstrated to be elevated in the brains of HIV-infected patients and associated with neurocognitive decline; however, the mechanisms of these processes are poorly understood. The goal of the current study was to address the hypothesis that Aβ can be transferred via extracellular vesicles (ECVs) from brain endothelial cells to neural progenitor cells (NPCs) and that this process can contribute to abnormal NPC differentiation. Mechanistically, we focused on the role of the receptor for advanced glycation end products (RAGE) and activation of the inflammasome in these events. ECVs loaded with Aβ (Aβ-ECVs) were readily taken up by NPCs and Aβ partly colocalized with the inflammasome markers ASC and NLRP3 in the nuclei of the recipient NPCs. This colocalization was affected by HIV and RAGE inhibition by a high-affinity specific inhibitor FPS-ZM1. Blocking RAGE resulted also in an increase in ECV number produced by brain endothelial cells, decreased Aβ content in ECVs, and diminished Aβ-ECVs transfer to NPC nuclei. Interestingly, both Aβ-ECVs and RAGE inhibition altered NPC differentiation. Overall, these data indicate that RAGE inhibition affects brain endothelial ECV release and Aβ-ECVs transfer to NPCs. These events may modulate ECV-mediated amyloid pathology in the HIV-infected brain and contribute to the development of HIV-associated neurocognitive disorders.
Intrapulmonary concentrations of meropenem administered by continuous infusion in critically ill patients with nosocomial pneumonia: a randomized pharmacokinetic trial
Authors: Benítez-Cano Adela , Luque Sonia , Sorlí Luisa , Carazo Jesús , Ramos Isabel , Campillo Nuria , Curull Víctor , Sánchez-Font Albert , Vilaplana Carles , Horcajada Juan P. , Adalia Ramón , Bermejo Silvia , Samsó Enric , Hope William , Grau Santiago
Published: February 2020

Background

Optimal antimicrobial drug exposure in the lung is required for successful treatment outcomes for nosocomial pneumonia. Little is known about the intrapulmonary pharmacokinetics (PK) of meropenem when administered by continuous infusion (CI). The aim of this study was to evaluate the PK of two dosages of meropenem (3 g vs 6 g/day by CI) in the plasma and epithelial lining fluid (ELF) in critically ill patients with nosocomial pneumonia.

Methods

Thirty-one patients (81% male, median (IQR) age 72 (22) years) were enrolled in a prospective, randomized, clinical trial. Sixteen patients received 1 g/8 h and 15 2 g/8 h by CI (8 h infusion). Plasma and ELF meropenem concentrations were modeled using a population methodology, and Monte Carlo simulations were performed to estimate the probability of attaining (PTA) a free ELF concentration of 50% of time above MIC (50%fT>MIC), which results in logarithmic killing and the suppression of resistance in experimental models of pneumonia.

Results

The median (IQR) of meropenem AUC0–24 hin the plasma and ELF was 287.6 (190.2) and 84.1 (78.8) mg h/L in the 1 g/8 h group vs 448.1 (231.8) and 163.0 (201.8) mg h/L in the 2 g/8 h group, respectively. The penetration ratio was approximately 30% and was comparable between the dosage groups. In the Monte Carlo simulations, only the highest approved dose of meropenem of 2 g/8 h by CI allowed to achieve an optimal PTA for all isolates with a MIC < 4 mg/L.

Conclusions

An increase in the dose of meropenem administered by CI achieved a higher exposure in the plasma and ELF. The use of the highest licensed dose of 6 g/day may be necessary to achieve an optimal coverage in ELF for all susceptible isolates (MIC ≤ 2 mg/L) in patients with conserved renal function. An alternative therapy should be considered when the presence of microorganisms with a MIC greater than 2 mg/L is suspected.

Trial registration

The trial was registered in the European Union Drug Regulating Authorities Clinical Trials Database (EudraCT-no.2016-002796-10). Registered on 27 December 2016.
Controlling mosquitoes with semiochemicals: a review
Authors: Wooding Madelien , Naudé Yvette , Rohwer Egmont , Bouwer Marc
Published: February 2020

The use of semiochemicals in odour-based traps for surveillance and control of vector mosquitoes is deemed a new and viable component for integrated vector management programmes. Over 114 semiochemicals have been identified, yet implementation of these for management of infectious diseases such as malaria, dengue, chikungunya and Rift Valley fever is still a major challenge. The difficulties arise due to variation in how different mosquito species respond to not only single chemical compounds but also complex chemical blends. Additionally, mosquitoes respond to different volatile blends when they are looking for a mating partner, oviposition sites or a meal. Analytically the challenge lies not only in correctly identifying these semiochemical signals and cues but also in developing formulations that effectively mimic blend ratios that different mosquito species respond to. Only then can the formulations be used to enhance the selectivity and efficacy of odour-based traps. Understanding how mosquitoes use semiochemical cues and signals to survive may be key to unravelling these complex interactions. An overview of the current studies of these chemical messages and the chemical ecology involved in complex behavioural patterns is given. This includes an updated list of the semiochemicals which can be used for integrated vector control management programmes. A thorough understanding of these semiochemical cues is of importance for the development of new vector control methods that can be integrated into established control strategies.