bluuebunny/crossref_metadata_2025 huggingface dataset:
What Is the Impact of Surgical Approach in the Treatment of Degenerative Cervical Myelopathy in Patients With OPLL? A Propensity-Score Matched, Multi-Center Analysis on Inpatient and Post-Discharge 90-Day Outcomes
Authors: Lee Nathan J. , Boddapati Venkat , Mathew Justin , Fields Michael , Vulapalli Meghana , Kim Jun S. , Lombardi Joseph M. , Sardar Zeeshan M. , Lehman Ronald A. , Riew K. Daniel
Published: February 2021

Study Design:

Retrospective cohort.

Objective:

Provide a comparison of surgical approach in the treatment of degenerative cervical myelopathy in patients with OPLL.

Methods:

A national database was queried to identify adult (≥18 years) patients with OPLL, who underwent at least a 2-level cervical decompression and fusion for cervical myelopathy from 2012-2014. A propensity-score-matching algorithm was employed to compare outcomes by surgical approach.

Results:

After propensity-score matching, 627 patients remained. An anterior approach was found to be an independent predictor for higher inpatient surgical complications(OR 5.9), which included dysphagia:14%[anterior]vs.1.1%[posterior] P-value < 0.001, wound hematoma:1.7%[anterior]vs.0%[posterior] P-value = 0.02, and dural tear:9.4%[anterior]vs.3.2%[posterior] P-value = 0.001. A posterior approach was an predictor for longer hospital length of stay by nearly 3 days(OR 3.4; 6.8 days[posterior]vs.4.0 days[anterior] P-value < 0.001). The reasons for readmission/reoperation did not vary by approach for 2-3-level fusions; however, for >3-level fusions, patients with an anterior approach more often had respiratory complications requiring mechanical ventilation( P-value = 0.038) and required revision fusion surgery( P-value = 0.015).

Conclusions:

The national estimates for inpatient complications(25%), readmissions(9.9%), and reoperations(3.5%) are substantial after the surgical treatment of multi-level OPLL. An anterior approach resulted in significantly higher inpatient surgical complications, but this did not result in a longer hospital length of stay and the overall 90-day complication rates requiring readmission or reoperation was similar to those seen after a posterior approach. For patients requiring >3-level fusion, an anterior approach is associated with significantly higher risk for respiratory complications requiring mechanical ventilation and revision fusion surgery. Precise neurological complications and functional outcomes were not included in this database, and should be further assessed in future studies.
Best versus worst surgical outcomes after single-level posterior lumbar interbody fusion for degenerative spondylolisthesis
Authors: Park Se-Jun , Lee Keun-Ho , Lee Chong-Suh , Kim Ki-Tack , Kim Dong Hyeon , Lee Chae Ho , Kim Gab-Lae
Published: February 2021

Purpose:

Previous studies have shown conflicting results regarding the factors affecting the clinical outcome after fusion for degenerative spondylolisthesis. However, no study has compared the best and worst clinical outcome groups using patient-reported outcome measures. We aimed to compare the characteristics of patients with best and worst outcomes following single-level lumbar fusion for degenerative spondylolisthesis.

Methods:

200 patients underwent single-level interbody fusion with a minimum 2-years follow-up were included. We excluded patients with surgical complications already-known to be associated with poor postoperative outcomes, including pseudoarthrosis and postoperative infection. According to 2-year postoperative Oswestry disability index scores, patients were divided into two groups; Best and Worst. Demographic, clinical and radiographic variables were compared between the two groups.

Results:

Compared with patients in the Best group, those in the Worst group were older (59.5 and 67.0 years, respectively; p = 0.012; odds ratio [OR], 1.143; 95% confidence interval [CI], 1.030–1.269) and had a longer duration of pain from onset (2.6 and 7.2 years, respectively; p = 0.041; OR, 1.021; 95% CI, 1.001–1.041). The cutoff value of pain duration from onset was measured as ≥3.5 years on Receiver operating characteristic analysis. Patients in the Worst group had a lower preoperative angular motion compared to those in the Best group (12.7° and 8.3°, respectively; p = 0.016; OR, 0.816; 95% CI, 0.691–0.963).

Conclusions:

Degenerative spondylolisthesis patients of good clinical outcome after single-level lumbar interbody fusion were relatively young, had a short symptom duration before surgery, and a high preoperative instability compared with the patient having poor postoperative clinical outcome. Therefore, these findings should be considered preoperatively when deciding the appropriate individual treatment plan.
Association between pre-operative anxiety and/or depression and outcomes following total hip or knee arthroplasty
Authors: Seagrave Kurt G , Lewin Adriane M , Harris Ian A , Badge Helen , Naylor Justine
Published: February 2021

Purpose:

While elective primary total hip (THA) and knee (TKA) arthroplasty are effective procedures for addressing the symptoms associated with advanced osteoarthritis, there is evidence to suggest that patient anxiety and depression are linked to poorer outcomes following surgery.

Methods:

A secondary analysis of prospectively-collected data of people undergoing primary elective THA or TKA for osteoarthritis across 19 hospitals was performed. We assessed outcomes at 1 year post-surgery for people with and without medically treated anxiety and/or depression at the time of surgery (A/D and no-A/D). We used unadjusted and adjusted analyses to compare improvement in Oxford Hip or Knee Scores, the incidences of major post-operative complications, satisfaction and index joint improvement by A/D status.

Results:

15.2% (254/1669) of patients were identified with anxiety and/or depression at time of surgery. In the unadjusted analysis, the A/D group had greater mean Oxford score improvement by 2.1 points (95% CI 0.8 to 3.4, p = 0.001), increased major complications (OR 1.39, 95% CI 1.05 to 1.85, p = 0.02), were less likely to report a “much better” global improvement for index joint (OR 0.56, 95% CI 0.38 to 0.83, p = 0.003), and there was no statistically significant difference in the rate of satisfaction with the results of surgery (OR 0.64, 95% CI 0.37 to 1.10, p = 0.10). The adjusted analysis found no significant associations between A/D vs. no-A/D and any of the reported outcomes.

Conclusion:

After adjustment for confounding variables, people with anxiety and/or depression pre-operatively, compared to those without, have similar outcomes following hip or knee arthroplasty.
Allocation of Anchors During Labral Repair: A Multicenter Cohort Analysis of Labral Treatment in Hip Arthroscopy
Authors: McGovern Ryan P. , Christoforetti John J. , Kivlan Benjamin R. , Nho Shane J. , Wolff Andrew B. , Salvo John P. , Matsuda Dean , Ellis Thomas J. , Stubbs Allston J. , Carreira Dominic S.
Published: February 2021

Background:

While previous studies have established several techniques for suture anchor repair of the acetabular labrum to bone during arthroscopic surgery, the current literature lacks evidence defining the appropriate number of suture anchors required to effectively restore the function of the labral tissue.

Purpose/Hypothesis:

To define the location and size of labral tears identified during hip arthroscopy for acetabular labral treatment in a large multicenter cohort. The secondary purpose was to differentiate the number of anchors used during arthroscopic labral repair. The hypothesis was that the location and size of the labral tear as well as the number of anchors identified would provide a range of fixation density per acetabular region and fixation method to be used as a guide in performing arthroscopic repair.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

We used a multicenter registry of prospectively collected hip arthroscopy cases to find patients who underwent arthroscopic labral repair by 1 of 7 orthopaedic surgeons between January 2015 and January 2017. The tear location and number of anchors used during repair were described using the clockface method, where 3 o’clock denoted the anterior extent of the tear and 9 o’clock the posterior extent, regardless of sidedness (left or right). Tear size was denoted as the number of “hours” spanned per clockface arc. Chi-square and univariate analyses of variance were performed to evaluate the data for both the entire group and among surgical centers.

Results:

A total of 1978 hips underwent arthroscopic treatment of the acetabular labrum; the most common tear size had a 3-hour span (n = 820; 41.5%). Of these hips, 1645 received labral repair, with most common repair location at the 12- to 3-o’clock position (n = 537; 32.6%). The surgeons varied in number of anchors per repair according to labral size ( P < .001 for all), using 1 to 1.6 anchors for 1-hour tears, 1.7 to 2.4 anchors for 2-hour tears, 2.1 to 3.2 anchors for 3-hour tears, and 2.2 to 4.1 for 4-hour tears.

Conclusion:

Variation existed in the number of anchor implants per tear size. When labral repair involved a mean clockface arc >2 hours, at least 2 anchor points were fixated.
Return to Sport After Anterior Cruciate Ligament Reconstruction in a Cohort of Division I NCAA Athletes From a Single Institution
Authors: Zampogna Biagio , Vasta Sebastiano , Torre Guglielmo , Gupta Akhil , Hettrich Carolyn M. , Bollier Matthew J. , Wolf Brian R. , Amendola Annunziato
Published: February 2021

Background:

Anterior cruciate ligament (ACL) tears are common in collegiate athletes. The rate of return to the preinjury level of sport activities after ACL reconstruction continues to evolve.

Purpose/Hypothesis:

The purpose was to determine the return-to-sport rate after ACL reconstruction in a cohort of National Collegiate Athletic Association Division I athletes in different sports. It was hypothesized that, with intensive supervision of rehabilitation, the return-to-sport rate would be optimal.

Study Design:

Case series; Level of evidence, 4.

Methods:

We retrospectively reviewed the records of 75 collegiate athletes from a single institution who had undergone unilateral or bilateral ACL reconstruction between 2001 and 2013 and participated in an extensive supervised rehabilitation program. Prospectively collected athlete data as well as data about preinjury exposure, associated lesions, surgical technique, time lost to injury, number of games missed, time to return to full sport activity or retire, and subsequent surgical procedures were extracted from the medical and athletic trainer records.

Results:

The 75 patients (40 male, 35 female; mean age, 20.1 years) underwent 81 reconstruction procedures (73 primary, 8 revision). The mean follow-up was 19.3 months. The overall return-to-sport rate was 92%. After reconstruction, 9 athletes (12%) retired from collegiate sports, but 3 of them returned to sport activities after graduation. Overall, 8 athletes (11%) experienced an ACL graft retear.

Conclusion:

The return-to-sport rate in our National Collegiate Athletic Association Division I athletes compared favorably with that reported in other studies in the literature. The strict follow-up by the surgeon, together with the high-profile, almost daily technical and psychological support given mainly by the athletic trainers during the recovery period, may have contributed to preparing the athletes for a competitive rate of return to sport at their preinjury level.
Professional Quality of Life Factors and Relationships in Nursing and Psychiatric Nursing Students: An Exploratory Study
Authors: Chachula Kathryn M.
Published: February 2021

Introduction

Professional quality of life (ProQOL) that encompasses compassion satisfaction (CS) and compassion fatigue (CF) comprised of burnout (BO) and secondary traumatic stress (STS) has been raised as a world-wide issue for the nursing profession. Limited attention has been paid to the vulnerabilities of nursing students to ProQOL and the associated mechanisms.

Purpose

Determine what factors are predictive of ProQOL in a population of undergraduate nursing and psychiatric nursing students. Methods: A cross-sectional survey was conducted comprised demographic questions and four validated measures: the Professional Quality of Life Scale (version 5), Core Self-Evaluations Scale, Perceived Stress Scale, and Life Events Checklist (version 5).

Results

Students in long-term care-palliative care rotations reported significantly higher levels of BO in comparison to other care areas. Regression analysis revealed students with low self-efficacy and high perceived stress were predictive of BO. Students with increased exposures to prior traumatizing life events were predictive of STS. Students with high levels of self-efficacy and less intent-to-leave were predictive of having CS.

Conclusion

Findings assist educators, clinicians, and policy makers in understanding at-risk clinical settings and predictors of ProQOL in pre-licensure students. Curricular recommendations that include mindfulness, coping and crisis peer-debriefing, and emotional intelligence are discussed.
Review of Whole Plant Extracts With Activity Against Herpes Simplex Viruses In Vitro and In Vivo
Authors: Garber Anna , Barnard Lianna , Pickrell Chris
Published: February 2021

Herpes simplex viruses, HSV-1 and HSV-2, are highly contagious and cause lifelong, latent infections with recurrent outbreaks of oral and/or genital lesions. No cure exists for HSV-1 or HSV-2 infections, but antiviral medications are commonly used to prevent and treat outbreaks. Resistance to antivirals has begun to emerge, placing an importance on finding new and effective therapies for prophylaxis and treatment of HSV outbreaks. Botanicals may be effective HSV therapies as the constituents they contain act through a variety of mechanisms, potentially making the development of antiviral resistance more challenging. A wide variety of plants from different regions in the world have been studied for antiviral activity against HSV-1 and/or HSV-2 and showed efficacy of varying degrees. The purpose of this review is to summarize research conducted on whole plant extracts against HSV-1 and/or HSV-2 in vitro and in vivo. The majority of the research reviewed was conducted in vitro using animal cell lines, and some studies used an animal model design. Also summarized are a limited number of human trials conducted using botanical therapies on HSV lesions.
Antimalarial Activity of Seed Extracts of Schinus molle Against Plasmodium berghei in Mice
Authors: Mekuria Abebe Basazn , Geta Mestayet , Birru Eshetie Melese , Gelayee Desalegn Asmelashe
Published: February 2021

Background.

Malaria is a major public health problem in developing countries. In Ethiopian, the seeds of Schinus molle are used for the management of malaria. Therefore, the current study aimed to evaluate in vivo antimalarial activity of hydro-alcoholic crude extract and solvent fractions of Schinus molle seeds in Plasmodium berghei infected mice.

Methods.

An 80 percent of methanolic crude extract and solvent fractions of Schinus molle seeds were tested for antimalarial activity at 100, 200 and 400 mg/kg doses. The parasitemia level, packed cell volume, body weight, survival of date and rectal temperature were used to evaluate the anti-malarial activity of the extracts. One-way ANOVA followed by post hoc Tukey’s HSD multiple comparison test was employed and the result was expressed in mean ± SEM (standard error of the mean).

Results.

The curative activity of the highest dose of crude extract and aqueous fraction of Schinus molle seeds was 69.86% and 73.82% ( p < 0.001), respectively. In the prophylactic test, aqueous fraction had 72.39% ( p < 0.001) suppression antimalarial activity. Among solvent fractions, only chloroform fraction was significantly attenuated packed cell volume reduction. The mice treated with crude extract and aqueous fraction had longer survival date than vehicle-treated mice ( p < 0.001).

Conclusion.

The experiment finding showed that the crude extract and solvent fractions of Schinus molle seeds had significant curative and prophylaxis anti-plasmodial activity. This result revealed that the Schinus molle seeds extract has promising antimalarial activity against Plasmodium berghei. However, further confirmatory studies, isolation and characterization of the active constituents are recommended.
Rehabilitation of Post Stroke Sensory Dysfunction—A Scoping Review
Authors: Gandhi Dorcas B. C. , Sebastian Ivy Anne , Bhanot Komal
Published: February 2021

Sensory dysfunction is one of the common impairments that occurs post stroke. With sensory changes in all modalities, it also affects the quality of life and incites suicidal thoughts. The article attempts to review and describe the current evidence of various approaches of assessment and rehabilitation for post-stroke sensory dysfunction. After extensive electronic database search across Medline, Embase, EBSCO, and Cochrane library, it generated 2433 results. After screening according to inclusion and exclusion criteria, we included 11 studies. We categorized data based on type of sensory deficits and prevalence, role of sensory system on motor behavior, type of intervention, sensory modality targeted, and dosage of intervention and outcome measures used for rehabilitation. Results found the strong evidence of involvement of primary and secondary motor areas involved in processing and responding to somatosensation, respectively. We divided rehabilitation approaches into sensory stimulation approach and sensory retraining approach focused on using external stimuli and relearning, respectively. However, with varied aims and targeted sensory involvement, the study applicability is affected. Thus, this emerges the need of extensive research in future for evidence-based practice of assessments and rehabilitation on post-stroke sensory rehabilitation.
Fabrication and microstructural analysis of 3A21/7075 aluminum alloy cladding material based on impact jet solid–liquid compound casting
Authors: Ming Hu , Xiaoxue Ren , Jianbo Sun , Yunlong Zhang , Chunfeng Teng , Guang Qiao
Published: February 2021

To solve thickness problem for high-strength aluminum alloy used as plastic mold materials and eliminate oxide film on the surface of aluminum alloy, a new compound casting, namely impact jet solid–liquid compound casting, was developed to fabricate 3A21/7075 aluminum alloy cladding material. Then, optical microscope (OM), electron-backscattered diffraction (EBSD) technique, and transmission electron microscope (TEM) together with energy-dispersive spectrometer (EDS) were used to analyze microstructure of 3A21/7075 aluminum alloy cladding material. The OM and EBSD results showed that the 3A21/7075 aluminum alloy cladding material was composed of 3A21 cladding layer, fusion zone (FZ), heat-affected zone, and 7075 matrix. The grain morphology on both sides of FZ had great differences. Moreover, the TEM and EDS results showed that the 3A21 cladding layer showed a bulk phase and lots of fine and dispersed granular phases, while the 7075 matrix appeared undetermined strip phases and amounts of fine and dispersed rod-like phases. Moreover, FZ existed a great deal of fine and dispersed granular phases and rod-like phases. The 3A21/7075 aluminum alloy cladding material could effectively solve the problems mentioned above and the in-depth analysis of microstructures of 3A21/7075 aluminum alloy cladding material was of great importance in terms of engineering value and academic significance.
Low-density PD-1 expression on resting human natural killer cells is functional and upregulated after transplantation
Authors: Davis Zachary , Felices Martin , Lenvik Todd , Badal Sujan , Walker Joshua T. , Hinderlie Peter , Riley James L. , Vallera Daniel A. , Blazar Bruce R. , Miller Jeffrey S.
Published: February 2021

Expression of programmed cell death protein 1 (PD-1) on natural killer (NK) cells has been difficult to analyze on human NK cells. By testing commercial clones and novel anti-PD-1 reagents, we found expression of functional PD-1 on resting human NK cells in healthy individuals and reconstituting NK cells early after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Peripheral blood samples from healthy individuals and transplant recipients were stained for PD-1 expression using the commercial anti-PD-1 clone PD1.3.1.3, fluorescein isothiocyanate (FITC)–labeled pembrolizumab, or an FITC-labeled single-chain variable fragment (scFv) reagent made from pembrolizumab. These reagents identified low yet consistent basal PD-1 expression on resting NK cells, a finding verified by finding lower PD-1 transcripts in sorted NK cells compared with those in resting or activated T cells. An increase in PD-1 expression was identified on paired resting NK cells after allo-HSCT. Blockade of PD-1 on resting NK cells from healthy donors with pembrolizumab did not enhance NK function against programmed death-ligand 1 (PD-L1)–expressing tumor lines, but blocking with its scFv derivative resulted in a twofold increase in NK cell degranulation and up to a fourfold increase in cytokine production. In support of this mechanism, PD-L1 overexpression of K562 targets suppressed NK cell function. Interleukin-15 (IL-15) activity was potent and could not be further enhanced by PD-1 blockade. A similar increase in function was observed with scFv PD-1 blockade on resting blood NK cells after allo-HSCT. We identify the functional importance of the PD-1/PD-L1 axis on human NK cells in which blockade or activation to overcome inhibition will enhance NK cell–mediated antitumor control.
Bleeding and related mortality with NOACs and VKAs in newly diagnosed atrial fibrillation: results from the GARFIELD-AF registry
Authors: Bassand Jean-Pierre , Virdone Saverio , Badoz Marc , Verheugt Freek W. A. , Camm A. John , Cools Frank , Fox Keith A. A. , Goldhaber Samuel Z. , Goto Shinya , Haas Sylvia , Hacke Werner , Kayani Gloria , Misselwitz Frank , Pieper Karen S. , Turpie Alexander G. G. , van Eickels Martin , Kakkar Ajay K.
Published: February 2021

In atrial fibrillation (AF), lower risks of death and bleeding with non-vitamin-K oral anticoagulants (NOACs) were reported in meta-analyses of controlled trials, but whether these findings hold true in real-world practice remains uncertain. Risks of bleeding and death were assessed in 52 032 patients with newly diagnosed AF enrolled in GARFIELD-AF (Global Anticoagulant Registry in the FIELD–Atrial Fibrillation), a worldwide prospective registry. Baseline treatment was vitamin K antagonists (VKAs) with or without antiplatelet (AP) agents (VKA ± AP) (20 151; 39.3%), NOACs ± AP agents (14 103; 27.5%), AP agents only (10 748; 21.0%), or no antithrombotics (6219; 12.1%). One-year follow-up event rates (95% confidence interval [CI]) of minor, clinically relevant nonmajor (CRNM), and major bleedings were 2.29 (2.16-2.43), 1.10 (1.01-1.20), and 1.31 (1.21-1.41) per 100 patient-years, respectively. Bleeding risk was lower with NOACs than VKAs for any bleeding (hazard ratio (HR) [95% CI]), 0.85 [0.73-0.98]) or major bleeding (0.79 [0.60-1.04]). Compared with no bleeding, the risk of death was higher with minor bleeding (adjusted HR [aHR], 1.53 [1.07-2.19]), CRNM bleeding (aHR, 2.59 [1.80-3.73]), and major bleeding (aHR, 8.24 [6.76-10.04]). The all-cause mortality rate was lower with NOACs than with VKAs (aHR, 0.73 [0.62-0.85]). Forty-five percent (114) of all deaths occurred within 30 days, and 40% of these were from intracranial/intraspinal hemorrhage (ICH). The rates of any bleeding and all-cause death were lower with NOACs than with VKAs. Major bleeding was associated with the highest risk of death. CRNM bleeding and minor bleeding were associated with a higher risk of death compared to no bleeding. Death within 30 days after a major bleed was most frequently related to ICH. This trial was registered at www.clinicaltrials.gov as #NCT01090362.
Potential of bacteriophages as disinfectants to control of Staphylococcus aureus biofilms
Authors: Song Jun , Ruan Hongri , Chen Li , Jin Yuqi , Zheng Jiasan , Wu Rui , Sun Dongbo
Published: February 2021

Background

Staphylococcus aureus is the causative agent of chronic mastitis, and can form a biofilm that is difficult to completely remove once formed. Disinfectants are effective against S. aureus, but their activity is easily affected by environmental factors and they are corrosive to equipment and chemically toxic to livestock and humans. Therefore, we investigated the potential utility of a bacteriophage as a narrow-spectrum disinfectant against biofilms formed by S. aureus. In this study, we isolated and characterized bacteriophage vB_SauM_SDQ (abbreviated to SDQ) to determine its efficacy in removing S. aureus biofilms.

Results

SDQ belongs to the family Myoviridae and consists of a hexagonal head, long neck, and short tail. This phage can sterilize a 109 CFU/mL culture of S. aureus in 12 h and multiply itself 1000-fold in that time. Biofilms formed on polystyrene, milk, and mammary-gland tissue were significantly reduced after SDQ treatment. Fluorescence microscopy and scanning electron microscopy showed that SDQ destroyed the biofilm structure. Moreover, the titer of SDQ remained relatively high after the lysis of the bacteria and the removal of the biofilm, exerting a continuous bacteriostatic effect. SDQ also retained its full activity under conditions that mimic common environments, i.e., in the presence of nonionic detergents, tap water, or organic materials. A nonionic detergent (Triton X-100) enhanced the removal of biofilm by SDQ.

Conclusions

Our results suggest that SDQ, a specific lytic S. aureus phage, can be used to control biofilm infections. SDQ maintains its full activity in the presence of nonionic detergents, tap water, metal chelators, and organic materials, and can be used in combination with detergents. We propose this phage as a narrow-spectrum disinfectant against S. aureus, to augment or supplement the use of broad-spectrum disinfectants in the prevention and control of the mastitis and dairy industry contamination caused by S. aureus.
Childhood ischaemic stroke in the basal ganglia can lead to fine motor and anxiety disorders: a retrospective analysis and follow-up of 109 cases
Authors: Li Tianyi , Ma Jiannan , Hong Siqi , Luo Yuanyuan , Li Xiujuan , Li Tingsong , Jiang Li
Published: February 2021

Background

Stroke in children easily causes long-term dysfunction. Whether the prognoses of motor and anxiety disorders are related to the affected stroke area has not been reported.

Methods

One hundred nine cases of children with ischaemic stroke were reviewed and divided into three groups: lenticular nucleus lesions only (lenticular nucleus group), lenticular nucleus and caudate head lesions (caudate head group), and lenticular nucleus and thalamus lesions (thalamus group). Overall prognosis was evaluated by the mRS score. The SCAS-P was used to evaluate anxiety in children aged ≥6 years.

Results

mRS scores were ≤ 2 points (mean: 0.62), no significant difference among groups. 3/21 (14.2%) patients in the caudate head group changed handedness, which is significantly higher than other groups. Patients with lesions in thalamus group had significantly higher SCAS-P scores.

Conclusions

The overall prognosis of children with basal ganglia ischaemic stroke is good. However, hand preference changes and anxiety disorders may develop. Patients in the caudate head groups are more likely to suffer from fine motor disorders and changes in handedness. Patients within the thalamus group are more prone to anxiety than patients in the other groups. Anxiety disorders should be noted in children with basal ganglia stroke.
Exploring women’s thoughts on self-weighing during pregnancy: results of the Self-Weighing in Pregnancy: Experiences (SWIPE) study
Authors: Ferrey Anne E. , Astbury Nerys M. , Kenworthy Yvonne , Mackillop Lucy , Frie Kerstin , Jebb Susan A.
Published: February 2021

Background

Excess gestational weight gain is common and an important risk factor for adverse pregnancy outcomes. Regular weighing can be used to assess and manage weight gain, but NICE guidelines do not recommend routine weighing during antenatal care. Trials that have tested the effectiveness of self-weighing to manage GWG have been unsuccesful in engaging women in regular self-weighing, although the reasons for lack of engagement are not fully understood. This study aimed to understand why this lack of engagement occurred by exploring the naturally occurring thoughts and feelings of pregnant women (9 to 15 weeks gestational age) who were asked to weigh themselves at home.

Methods

Twenty-five women were recruited to take part. Participants completed short questionnaires at their first-trimester and 20-week scans. After recruitment, participants were asked to weigh themselves at roughly the same time each week for 8 weeks. Whilst they weighed themselves they were asked to audio-record their current weight and describe any thoughts or feelings that occurred as they weighed themselves. These audio recordings were then sent to researchers using a secure messaging service.

Results

Most of the recruited women (56%) were unaware of guidelines for gestational weight gain, and only 40% could identify the ideal rate of GWG for their BMI group. Thematic analysis of the think-aloud recordings resulted in three main themes: “understanding weight gain in pregnancy”, “taking action to prevent weight gain” and “reactions to self-weighing”. Overall, there was a relatively positive response to self-weighing and some participants used self-weighing to reflect on the reasons for weight gain and plan actions they could take to avoid excess gain. Negative emotional responses tended to be related to a lack of guidance about what level of weight gain or loss was “healthy”, or to other worries about the pregnancy. Of the women recruited who submitted at least one think aloud recording (n 10), 80% found self-weighing to be useful, and said they would likely continue to self-weigh at home.

Conclusions

Women had complex emotions about self-weighing during pregnancy but overall found it useful, suggesting it could be encouraged as part of self-regulatory interventions to control GWG. Clear guidelines about appropriate gestational weight gain could help to reduce anxiety.

Trial registration

The study was prospectively registered with ISRCTN ISRCTN10035244.
Early surgical intervention for active thoracic spinal tuberculosis patients with paraparesis and paraplegia
Authors: Li Weiwei , Liu Zheng , Xiao Xiao , Xu Zhenchao , Sun Zhicheng , Zhang Zhen , Wang Xiyang
Published: February 2021

Background

To explore the therapeutic effect of early surgical intervention for active thoracic spinal tuberculosis (TB) patients with paraparesis and paraplegia.

Methods

Data on 118 active thoracic spinal TB patients with paraparesis and paraplegia who had undergone surgery at an early stage (within three weeks of paraparesis and paraplegia) from January 2008 to December 2014 were retrospectively analyzed. The operation duration, blood loss, perioperative complication rate, VAS score, ASIA grade and NASCIS score of neurological status rating, Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), kyphotic Cobb’s angle, and duration of bone graft fusion were analyzed to evaluate the therapeutic effects of surgery.

Results

The mean operating time was 194.2 minutes, and the mean blood loss was 871.2 ml. The perioperative complication rate was 5.9 %. The mean preoperative VAS score was 5.3, which significantly decreased to 3.2 after the operation and continued decreasing to 1.1 at follow up (P<0.05). All cases achieved an increase of at least one ASIA grade after operation. The rate of full neurological recovery for paraplegia (ASIA grade A and B) was 18.0 % and was significantly lower than the rate (100 %) for paraparesis (ASIA grade C and D) (P<0.05). On the NASCIS scale, the difference in the neurological improvement rate between paraplegia (22.2 % ± 14.1 % in sensation and 52.2 % ± 25.8 % in movement) and paraparesis (26.7 % ± 7.5 % in sensation and 59.4 % ± 7.3 % in movement) was remarkable (P<0.05). Mean preoperative ESR and CRP were 73.1 mm /h and 82.4 mg/L, respectively, which showed a significant increase after operation (P>0.05), then gradually decreased to 11.5 ± 1.8 mm/h and 2.6 ± 0.82 mg/L, respectively, at final follow up (P<0.05). The mean preoperative kyphotic Cobb’s angle was 21.9º, which significantly decreased to 6.5º after operation (P<0.05) while kyphotic correction was not lost during follow up (P>0.05). The mean duration of bone graft fusion was 8.6 ± 1.3 months.

Conclusions

Early surgical intervention may be beneficial for active thoracic spinal TB patients with paraparesis and paraplegia, with surgical intervention being more beneficial for recovery from paraparesis than paraplegia.
Investigate the improvement of facial skin texture with the VISIA system after total thyroidectomy
Authors: Kuo Spencer C. H. , Huang Faye , Chi Shun-Yu , Lin Hui-Ping , Chien Peng-Chen , Hsieh Ching-Hua
Published: February 2021

Background

During clinical practice we have noticed that some patients with hyperthyroidism have finer skin with less wrinkles, pores, and spots after thyroidectomy, and the improvement can be observed within a few weeks after the operation. However, there is no evidence or study in the literature to proof this finding.

Aim and objective

This study was designed to evaluate and quantify the skin characters of patients with hyperthyroidism before and after thyroidectomy.

Material and methods

This is a prospective study to include patients with hyperthyroidism who received total thyroidectomy between March 1st, 2018 and February 28th, 2019. The patients received blood test for T4 and TSH analysis and VISIA measurements for skin texture quantification, at the preoperative stage, three, and six months postoperatively. A total of 8 patients were included. Repeated measurement was used to determine the lab data and VISIA measurement changes before and after the operation. Mauchly’s sphericity test was performed to determine whether the violation of sphericity occurs, and the Greenhouse–Geisser correction was used when the violation of sphericity occurs.

Results

All the patients were female and generally healthy without systemic medical disease except the hyperthyroidism. The T4 and TSH levels were not significantly different before and after the thyroidectomy. In terms of the skin character measurements, the wrinkles, texture, pores, UV spots, and brown spots were not improved after thyroidectomy. A trend of improvement in spots, red area, and porphyrin was noted, although not statistically significant.

Conclusions

Surgical removal of the thyroid gland in patients with hyperthyroidism does not improve the skin quality and texture in examinations via the VISIA system.
Antiplasmodial activity of Ethanolic extract of Cassia spectabilis DC leaf and its inhibition effect in Heme detoxification
Authors: Ekasari Wiwied , Basuki Dewi Resty , Arwati Heny , Wahyuni Tutik Sri
Published: February 2021

Background

In previous studies, Cassia spectabilis DC leaf has shown a good antiplasmodial activity. Therefore, this study is a follow-up study of the extract of leaf of C. spectabilis DC on its in vitro and in vivo antiplasmodial activity and mechanism as an antimalarial.

Methods

The extract was fractionated, sub-fractionated and isolated to obtain the purified compound. In vitro antiplasmodial activity test against Plasmodium falciparum to find out the active compound. In vivo test against P. berghei ANKA-infected mice was conducted to determine prophylactic activity and antiplasmodial activity either alone or in combination with artesunate. The inhibition of heme detoxification test as one of the antimalarial mechanisms was carried out using the Basilico method.

Results

The results showed that active antimalarial compound isolated from C. spectabilis DC leaf had a structural pattern that was identical to (−)-7-hydroxycassine. Prophylactic test of 90% ethanolic extract of C. spectabilis DC leaf alone against P. berghei ANKA-infected mice obtained the highest percentage inhibition was 68.61%, while positive control (doxycycline 13 mg/kg) was 73.54%. In combination with artesunate, 150 mg/kg three times a day of C. spectabilis DC (D0-D2) + artesunate (D2) was better than the standard combination of amodiaquine + artesunate where the inhibition percentages were 99.18 and 92.88%, respectively. The IC50 of the extract for the inhibitory activity of heme detoxification was 0.375 mg/ml which was better than chloroquine diphosphate (0.682 mg/ml).

Conclusion

C. spectabilis DC leaf possessed potent antiplasmodial activity and may offer a potential agent for effective and affordable antimalarial phytomedicine.
A quality indicator set for rehabilitation services for people with rheumatic and musculoskeletal diseases demonstrates adequate responsiveness in a pre–post evaluation
Authors: Sand-Svartrud Anne-Lene , Berdal Gunnhild , Azimi Maryam , Bø Ingvild , Dager Turid Nygaard , Eppeland Siv Grødal , Fredheim Guro Ohldieck , Hagland Anne Sirnes , Klokkeide Åse , Linge Anita Dyb , Tennebø Kjetil , Valaas Helene Lindtvedt , Aasvold Ann Margret , Dagfinrud Hanne , Kjeken Ingvild
Published: February 2021

Background

Quality of care is gaining increasing attention in research, clinical practice, and health care planning. Methods for quality assessment and monitoring, such as quality indicators (QIs), are needed to ensure health services in line with norms and recommendations. The aim of this study was to assess the responsiveness of a newly developed QI set for rehabiliation for people with rheumatic and musculoskeletal diseases (RMDs).

Methods

We used two yes/no questionnaires to measure quality from both the provider and patient perspectives, scored in a range of 0–100% (best score, 100%). We collected QI data from a multicenter stepped-wedge cluster-randomized controlled trial (the BRIDGE trial) that compared traditional rehabilitation with a new BRIDGE program designed to improve quality and continuity in rehabilitation. Assessment of the responsiveness was performed as a pre–post evaluation: Providers at rehabilitation centers in Norway completed the center-reported QIs (n = 19 structure indicators) before (T1) and 6–8 weeks after (T2) adding the BRIDGE intervention. The patient-reported QIs comprised 14 process and outcomes indicators, measuring quality in health services from the patient perspective. Pre-intervention patient-reported data were collected from patients participating in the traditional program (T1), and post-intervention data were collected from patients participating in the BRIDGE program (T2). The patient groups were comparable. We used a construct approach, with a priori hypotheses regarding the expected direction and magnitude of PR changes between T1 and T2. For acceptable responsivess, at least 75% of the hypotheses needed to be confirmed.

Results

All eight participating centers and 82% of the patients (293/357) completed the QI questionnaires. Responsiveness was acceptable, with 44 of 53 hypotheses (83%) confirmed for single indicators and 3 of 4 hypotheses (75%) confirmed for the sum scores.

Conclusion

We found this QI set for rehabilitation to be responsive when applied in rehabilitation services for adults with various RMD conditions. We recommend this QI set as a timely method for establishing quality-of-rehabilitation benchmarks, promoting important progress toward high-quality rehabilitation, and tracking trends over time.

Trial registration

The study is part of the larger BRIDGE trial, registered at ClinicalTrials.gov (Identifier: NCT03102814).
Glutaminase isoforms expression switches microRNA levels and oxidative status in glioblastoma cells
Authors: de los Santos-Jiménez Juan , Campos-Sandoval José A. , Márquez-Torres Clara , Urbano-Polo Nieves , Brøndegaard David , Martín-Rufián Mercedes , Lobo Carolina , Peñalver Ana , Gómez-García María C. , Martín-Campos Janet , Cardona Carolina , Castilla Laura , da Costa Souza Felipe , Cheng Tzuling , Segura Juan A. , Alonso Francisco J. , Curi Rui , Colquhoun Alison , DeBerardinis Ralph J. , Márquez Javier , Matés José M.
Published: February 2021

Background

Glutaminase isoenzymes GLS and GLS2 play apparently opposing roles in cancer: GLS acts as an oncoprotein, while GLS2 (GAB isoform) has context specific tumour suppressive activity. Some microRNAs (miRNAs) have been implicated in progression of tumours, including gliomas. The aim was to investigate the effect of GLS and GAB expression on both miRNAs and oxidative status in glioblastoma cells.

Methods

Microarray profiling of miRNA was performed in GLS-silenced LN229 and GAB-transfected T98G human glioblastoma cells and their wild-type counterparts. Results were validated by real-time quantitative RT-PCR. Oxidative status and antioxidant enzymes were determined by spectrophotometric or fluorescence assays in GLS-silenced LN229 and T98G, and GAB-transfected LN229 and T98G.

Results

MiRNA-146a-5p, miRNA-140-3p, miRNA-21-5p, miRNA-1260a, and miRNA-92a-3p were downregulated, and miRNA-1246 was upregulated when GLS was knocked down. MiRNA-140-3p, miRNA-1246, miRNA-1260a, miRNA-21-5p, and miRNA-146a-5p were upregulated when GAB was overexpressed. Oxidative status (lipid peroxidation, protein carbonylation, total antioxidant capacity, and glutathione levels), as well as antioxidant enzymes (catalase, superoxide dismutase, and glutathione reductase) of silenced GLS glioblastoma cells and overexpressed GAB glioblastoma cells significantly changed versus their respective control glioblastoma cells. MiRNA-1246, miRNA-1260a, miRNA-146a-5p, and miRNA-21-5p have been characterized as strong biomarkers of glioblastoma proliferation linked to both GLS silencing and GAB overexpression. Total glutathione is a reliable biomarker of glioblastoma oxidative status steadily associated to both GLS silencing and GAB overexpression.

Conclusions

Glutaminase isoenzymes are related to the expression of some miRNAs and may contribute to either tumour progression or suppression through certain miRNA-mediated pathways, proving to be a key tool to switch cancer proliferation and redox status leading to a less malignant phenotype. Accordingly, GLS and GAB expression are especially involved in glutathione-dependent antioxidant defence.
A meta-analysis of HDL cholesterol efflux capacity and concentration in patients with rheumatoid arthritis
Authors: Xie Binbin , He Jiang , Liu Yong , Liu Ting , Liu Chaoqun
Published: February 2021

Background

Poor cholesterol efflux capacity (CEC) has been proposed to be an independent risk factor for cardiovascular diseases. However, current evidence is inconsistent, especially in rheumatoid arthritis (RA) patients. This meta-analysis aims to identify whether CEC is impaired or altered by drug therapy in RA.

Methods

The PubMed/MEDLINE, Embase, Cochrane Library andClinicalTrials.govdatabases were browsed to identify studies on CEC in RA patients. The searches mainly focused on studies in human subjects that were published before November 14, 2020, without any language restrictions. The effect size was pooled by the standardized mean differences and mean differences (SMD & MD) as well as the corresponding 95% confidence intervals (CIs) in a random or fixed effect model. Heterogeneity across the studies was tested using Cochran’s Q test andI2statistic. Newcastle-Ottawa Scale and the Downs and Black scale (D&B) were applied to evaluate the quality of included studies. The GRADE-system with its 4-grade evidence scale was used to assess the quality of evidence.

Results

A total of 11 eligible articles, including 6 observational and 5 interventional studies, were retrieved. The pooled results showed that in patients with RA, CEC was not significantly different than in healthy controls (SMD: -0.34, 95% CI: − 0.83 to 0.14), whereas the plasma HDL-C levels was significantly lower (MD: -3.91, 95% CI: − 7.15 to − 0.68). Furthermore, in the before-after studies, the CEC of RA patients (SMD: 0.20, 95% CI: 0.02 to 0.37) increased, but the plasma HDL-C levels (MD: 3.63, 95% CI: − 0.13 to 7.39) remained at a comparable quantity after anti-rheumatic treatment comparing with the baseline. In addition, the funnel plot of included studies displayed a lightly asymmetry, while Egger’s and Begg’s test did not suggest the existence of publication bias. The quality of evidence was rated according to GRADE as moderate to very low.

Conclusion

The current meta-analysis demonstrated that HDL-mediated CEC can be improved by the early control of inflammation and anti-rheumatic treatment in RA patients, which is independent of the plasma HDL-C levels. However, the results should be interpreted with caution because of low-quality and limited quantity of evidence. Future randomized controlled trials are needed to determine whether therapeutic strategies to enhance CEC in RA patients have beneficial effects for preventing CVD.
Identification and validation of a miRNA-related expression signature for tumor mutational burden in colorectal cancer
Authors: Xu Lijun , Zheng Qing
Published: February 2021

Background

Tumor mutational burden (TMB) is a promising predictor, which could stratify colorectal cancer (CRC) patients based on the response to immune checkpoint inhibitors (ICIs). MicroRNAs (miRNAs) act as the key regulators of anti-cancer immune response. However, the relationship between TMB and miRNA expression profiles is not elucidated in CRC.

Methods

Differentially expressed miRNAs (DE miRNAs) between the TMBhigh group and the TMBlow group were identified for the CRC cohort of the TCGA database. In the training cohort, a miRNA-related expression signature for predicting TMB level was developed by the least absolute shrinkage and selection operator (LASSO) method and tested with reference to its discrimination, calibration, and decision curve analysis (DCA) in the validation cohort. Functional enrichment analysis of these TMB-related miRNAs was performed. The correlation between this miRNA-related expression signature and three immune checkpoints was analyzed.

Results

Twenty-one out of 43 DE miRNAs were identified as TMB-related miRNAs, which were used to develop a miRNA-related expression signature. This TMB-related miRNA signature demonstrated great discrimination (AUCtest set = 0.970), satisfactory calibration (P > 0.05), and clinical utility in the validation cohort. Functional enrichment results revealed that these TMB-related miRNAs were mainly involved in biological processes associated with immune response and signaling pathways related with cancer. This miRNA-related expression signature showed a median positive correlation with PD-L1 (R = 0.47, P < 0.05) and CTLA4 (R = 0.39, P < 0.05) and a low positive correlation with PD-1 (R = 0.16, P < 0.05).

Conclusion

This study presents a miRNA-related expression signature which could stratify CRC patients with different TMB levels.