bluuebunny/crossref_metadata_2025 huggingface dataset:
Marked Impairment of Endothelium-Dependent Digital Vasodilatations in Patients With Microvascular Angina
Authors: Ohura-Kajitani Shoko , Shiroto Takashi , Godo Shigeo , Ikumi Yosuke , Ito Akiyo , Tanaka Shuhei , Sato Koichi , Sugisawa Jun , Tsuchiya Satoshi , Suda Akira , Shindo Tomohiko , Ikeda Shohei , Hao Kiyotaka , Kikuchi Yoku , Nochioka Kotaro , Matsumoto Yasuharu , Takahashi Jun , Miyata Satoshi , Shimokawa Hiroaki
Published: April 2020

Objective:

It remains to be elucidated whether and how endothelial functions are impaired in peripheral circulation of patients with coronary functional disorders, such as vasospastic angina (VSA) and microvascular angina (MVA). We simultaneously examined endothelial functions of peripheral conduit and resistance arteries in patients with coronary functional disorders, with a special reference to NO and endothelium-dependent hyperpolarization factors.

Approach and Results:

Based on the results of invasive coronary acetylcholine testing and coronary physiological measurements, we divided 43 patients into 3 groups; VSA, MVA, and VSA+MVA. Endothelium-dependent vasodilatations of the brachial artery and fingertip arterioles to intra-arterial infusion of bradykinin were simultaneously evaluated by ultrasonography and peripheral arterial tonometry, respectively. To assess NO and endothelium-dependent hyperpolarization factors, measurements were repeated after oral aspirin and intra-arterial infusion of N
G
-monomethyl-L-arginine. Additionally, endothelium-independent vasodilatations to sublingual nitroglycerin and plasma levels of biomarkers for endothelial functions were measured. Surprisingly, digital vasodilatations to bradykinin were almost absent in patients with MVA alone and those with VSA+MVA compared with those with VSA alone. Mechanistically, both NO- and endothelium-dependent hyperpolarization–mediated digital vasodilatations were markedly impaired in patients with MVA alone. In contrast, endothelium-independent vasodilatations to nitroglycerin were comparable among the 3 groups. Plasma levels of soluble VCAM (vascular cell adhesion molecule)-1 were significantly higher in patients with MVA alone compared with those with VSA alone.

Conclusions:

These results provide the first evidence that both NO- and endothelium-dependent hyperpolarization–mediated digital vasodilatations are markedly impaired in MVA patients, suggesting that MVA is a cardiac manifestation of the systemic small artery disease.
Traffic‐Related Air Pollution and Carotid Plaque Burden in a Canadian City With Low‐Level Ambient Pollution
Authors: Johnson Markey , Brook Jeffrey R. , Brook Robert D. , Oiamo Tor H. , Luginaah Isaac , Peters Paul A. , Spence J. David
Published: April 2020

Background

The association between fine particulate matter and cardiovascular disease has been convincingly demonstrated. The role of traffic‐related air pollutants is less clear. To better understand the role of traffic‐related air pollutants in cardiovascular disease development, we examined associations between NO
2
, carotid atherosclerotic plaque, and cardiometabolic disorders associated with cardiovascular disease.

Methods and Results

Cross‐sectional analyses were conducted among 2227 patients (62.9±13.8 years; 49.5% women) from the Stroke Prevention and Atherosclerosis Research Centre (SPARC) in London, Ontario, Canada. Total carotid plaque area measured by ultrasound, cardiometabolic disorders, and residential locations were provided by SPARC medical records. Long‐term outdoor residential NO
2
concentrations were generated by a land use regression model. Associations between NO
2
, total carotid plaque area, and cardiometabolic disorders were examined using multiple regression models adjusted for age, sex, smoking, and socioeconomic status. Mean NO
2
was 5.4±1.6 ppb in London, Ontario. NO
2
was associated with a significant increase in plaque (3.4 mm
2
total carotid plaque area per 1 ppb NO
2
), exhibiting a linear dose‐response. NO
2
was also positively associated with triglycerides, total cholesterol, and the ratio of low‐ to high‐density lipoprotein cholesterol (
P
<0.05). Diabetes mellitus mediated the relationship between NO
2
and total carotid plaque area (
P
<0.05).

Conclusions

Our results demonstrate that even low levels of traffic‐related air pollutants are linked to atherosclerotic plaque burden, an association that may be partially attributable to pollution‐induced diabetes mellitus. Our findings suggest that reducing ambient concentrations in cities with NO
2
below current standards would result in additional health benefits. Given the billions of people exposed to traffic emissions, our study supports the global public health significance of reducing air pollution.
Statistical and Functional Studies Identify Epistasis of Cardiovascular Risk Genomic Variants From Genome‐Wide Association Studies
Authors: Li Yabo , Cho Hyosuk , Wang Fan , Canela‐Xandri Oriol , Luo Chunyan , Rawlik Konrad , Archacki Stephen , Xu Chengqi , Tenesa Albert , Chen Qiuyun , Wang Qing Kenneth
Published: April 2020

Background

Epistasis describes how gene‐gene interactions affect phenotypes, and could have a profound impact on human diseases such as coronary artery disease (
CAD
). The goal of this study was to identify gene‐gene interactions in
CAD
using an easily generalizable multi‐stage approach.

Methods and Results

Our forward genetic approach consists of multiple steps that combine statistical and functional approaches, and analyze information from global gene expression profiling, functional interactions, and genetic interactions to robustly identify gene‐gene interactions. Global gene expression profiling shows that knockdown of

ANRIL

(DQ485454) at 9p21.3
GWAS
(genome‐wide association studies) CAD locus upregulates

TMEM
100

and

TMEM
106B

. Functional studies indicate that the increased monocyte adhesion to endothelial cells and transendothelial migration of monocytes, 2 critical processes in the initiation of
CAD
, by

ANRIL

knockdown are reversed by knockdown of

TMEM
106B

, but not of

TMEM
100

. Furthermore, the decreased monocyte adhesion to endothelial cells and transendothelial migration of monocytes induced by

ANRIL

overexpression was reversed by overexpressing

TMEM
106B

.

TMEM
106B

expression was upregulated by >2‐fold in
CAD
coronary arteries. A significant association was found between variants in

TMEM
106B

(but not in

TMEM
100

) and
CAD
(
P
=1.9×10
−8
). Significant gene‐gene interaction was detected between

ANRIL

variant rs2383207 and

TMEM
106B

variant rs3807865 (
P
=0.009). A similar approach also identifies significant interaction between rs6903956 in

ADTRP

and rs17465637 in

MIA
3

(
P
=0.005).

Conclusions

We demonstrate 2 pairs of epistatic interactions between
GWAS
loci for
CAD
and offer important insights into the genetic architecture and molecular mechanisms for the pathogenesis of
CAD
. Our strategy has broad applicability to the identification of epistasis in other human diseases.
Two novel species of Sisyranthus (Apocynaceae—Ceropegieae) from South Africa

Authors: SHABANGU KHANYISILE , BESTER STOFFEL P. , VAN DER BANK MICHELLE
Published: April 2020

Sisyranthus species are cryptic in both their habit and small size of their flowers making them difficult to find in the wild. The genus was last revised in Flora Capensis (1908) and since then, two new species have been described. Currently it comprises 13 recognised species endemic to southern Africa. Many of these are range-restricted and poorly known. In this contribution the genus is further expanded by describing two novel species. Full descriptions, assessment of conservation status, distribution maps and line drawings of the new taxa are presented.
A new species of Clinanthus (Amaryllidaceae: Amaryllidoideae: Clinantheae) from Cordillera de los Tarros, Northwest Peru, and notes on related species

Authors: ESQUERRE-IBAÑEZ BORIS , MEEROW ALAN W.
Published: April 2020

Clinanthus longissimus B. Esquerre & Meerow sp. nov. is described from the Department of Cajamarca in northwest Peru. This new species has affinity with C. coccineus (Ruiz. & Pav.) Meerow, C. incarnatus (Kunth) Meerow and C. variegatus (Ruiz & Pav.) Meerow, from which it can be distinguished mainly by the length of the flower, the continuous floral tube without protuberances, the size of the staminal cup and the color of the tepals. C. longissimus is so far known only from the Province of Cutervo.
New genus and species of Leptopsaltriini (Hemiptera: Cicadidae: Cicadinae) from China and Vietnam, with colour-changing behaviour reported for the first time in Cicadoidea
Authors: WEI CONG , WANG SIYUE , HAYASHI MASAMI , HE MIAO , PHAM HONG THAI
Published: April 2020

One new cicada genus Versicolora gen. nov. and two new species, V. ziyongi sp. nov. from China and V. bellula sp. nov. from China and Vietnam, are described. The new genus is placed in the tribe Leptopsaltriini of the subfamily Cicadinae. The relationship of this new genus to other related taxa is discussed. Versicolora ziyongi sp. nov. camouflages itself on the bark of the host-plants and gradually changes its body colour when captured. This colour-changing behaviour is recorded for the first time in Cicadoidea, which provides innovative information for ecomorphological study of this remarkable species and other cicadas that potentially exhibit this behaviour.
More than just the number of denticles: morphometric and limb variability in Neotropical cladoceran Alonella dadayi (Crustacea: Cladocera: Chydoridae)
Authors: SOUSA FRANCISCO DIOGO R. , ELMOOR-LOUREIRO LOURDES M. A. , MAIA SARAH SOUZA , PANARELLI ELIANA A.
Published: April 2020

The aim of this study is to describe the limb morphology of Alonella dadayi Birge (Cladocera: Chydorida) and this species’ morphometric variability regarding the carapace and postabdomen. We report for the first time a population whose individuals do not have denticles on the posteroventral corner of the carapace. Although we have observed intra- and interpopulation variability of the limbs (especially the proportion of Inner Distal Lobe setae), Alonella dadayi can also be differentiated from closely related species by the morphology of the exopodite of the second limb. The morphometric analyses show high variability in the shape of the carapace, when regarding the ventral margin and posterodorsal corner. In the postabdomen, we observed a significant variation in the preanal, anal and postanal margins. Keeping in mind the wide range of the geographic distribution of Alonella dadayi and its high morphological variability, it is possible that this taxon comprises a species complex. Such a chance needs to be tested in future studies.
Two new species of Protolychnis Meyrick, 1925 (Lepidoptera, Lecithoceridae) from the Afrotropical Region, with a world check-list of the genus
Authors: PARK KYU-TEK , KOO JUN-MO
Published: April 2020

Two new species of the genus Protolychnis Meyrick are described: P. petiliella Park, sp. nov. from Uganda and P. bastini Park, sp. nov. from Democratic Republic of Congo and Kenya. Adults, male and female genitalia of both new species are illustrated. A check-list for all known species of the genus is provided.
Exploring Community Differences in Tornado Warning Reception, Comprehension, and Response across the United States
Authors: Ripberger Joseph T. , Silva Carol L. , Jenkins-Smith Hank C. , Allan Jinan , Krocak Makenzie , Wehde Wesley , Ernst Sean
Published: April 2020

Effective risk communication in the weather enterprise requires deep knowledge about the communities that enterprise members serve. This includes knowledge of the atmospheric and climate conditions in these communities as well as knowledge about the characteristics of the people living in these communities. Enterprise members often have access to data that facilitate the first type of knowledge, but relatively little social or behavioral data on the populations they serve. This article introduces an effort to overcome these challenges by developing a database of community statistics and an interactive platform that provides dynamic access to the database. Specific emphasis is given to one set of statistics in the community database: estimates of tornado warning reception, comprehension, and response by county warning area in the contiguous United States. Exploration of these estimates indicates significant variation in reception and comprehension across communities. This variation broadly aligns with tornado climatology, but there are noticeable differences within climatologically comparable regions that underline the importance of community-specific information. Verification of the estimates using independent observations from a random sample of communities confirms that the estimates are largely accurate, but there are a few consistent anomalies that prompt questions about why some communities exhibit higher or lower levels of reception, comprehension, and response than models suggest. The article concludes with a discussion of next steps and an invitation to use and contribute to the project as it progresses.
Financial divergences of equalization and their impact on regional development in Morocco
Authors: Benkada Aziza , Belouchi Mohammed
Published: April 2020

The purpose of this article is to analyse the impact of financial equalization on regional development in Morocco. While the redistribution of wealth through the financial equalization mechanism promotes equality and equity in favour of poor and disadvantaged regions, this mechanism still suffers from several shortcomings. The following analysis confirms that financial equalization has an amortization effect both on the donor regions that are forced to allocate part of their resources and on the recipient regions that risk falling into a development trap. Notwithstanding this analysis, equalization promotes solidarity and equality between territories; however, the actual situation on the ground confirms that this mechanism does not encourage beneficiary regions to improve their tax effort or develop their development strategies. The effectiveness of the equalization system therefore requires a detailed understanding of the reasons for inequalities in order to act on the causes rather than on the symptoms.

Points for practitioners

In the processes of territorial public management, the scarcity of financial resources is all the more reason to opt for more efficient investments. The quality of investments is more important than their quantity. The adoption of such an approach is a strategic move if disastrous consequences on public facilities are to be avoided in the long term. The various levels of local authorities must also take responsibility for improving their own resources and building up their development strategies.
Dynamic capillary stalls in reperfused ischemic penumbra contribute to injury: A hyperacute role for neutrophils in persistent traffic jams
Authors: Erdener Şefik E , Tang Jianbo , Kılıç Kıvılcım , Postnov Dmitry , Giblin John T , Kura Sreekanth , Chen I-chun A , Vayisoğlu Tuğberk , Sakadžić Sava , Schaffer Chris B , Boas David A
Published: April 2020

Ever since the introduction of thrombolysis and the subsequent expansion of endovascular treatments for acute ischemic stroke, it remains to be identified why the actual outcomes are less favorable despite recanalization. Here, by high spatio-temporal resolution imaging of capillary circulation in mice, we introduce the pathological phenomenon of dynamic flow stalls in cerebral capillaries, occurring persistently in salvageable penumbra after reperfusion. These stalls, which are different from permanent cellular plugs of no-reflow, were temporarily and repetitively occurring in the capillary network, impairing the overall circulation like small focal traffic jams. In vivo microscopy in the ischemic penumbra revealed leukocytes traveling slowly through capillary lumen or getting stuck, while red blood cell flow was being disturbed in the neighboring segments under reperfused conditions. Stall dynamics could be modulated, by injection of an anti-Ly6G antibody specifically targeting neutrophils. Decreased number and duration of stalls were associated with improvement in penumbral blood flow within 2–24 h after reperfusion along with increased capillary oxygenation, decreased cellular damage and improved functional outcome. Thereby, dynamic microcirculatory stall phenomenon can be a contributing factor to ongoing penumbral injury and is a potential hyperacute mechanism adding on previous observations of detrimental effects of activated neutrophils in ischemic stroke.
Examining Whether the Social Cognitive Theory Concepts Predict Childhood Obesity Prevention Outcome Expectations
Authors: Alexander Dayna S. , Cao Chunhua , Alfonso Moya L.
Published: April 2020

The social cognitive theory (SCT) has been used to explain and promote childhood obesity prevention behaviors. We examined whether the SCT concepts predicted outcome expectations of childhood obesity among the children of African American caregivers. Caregivers ( n  = 128) completed the childhood obesity perceptions paper-based survey. A multiple linear regression was conducted to determine the direct effects of moral disengagement, environment, self-efficacy, and behavioral capability on outcome expectations ( p < .05). A mediation analysis using a bootstrapping bias correction method was used to test whether self-efficacy and behavioral capability mediated the effect of moral disengagement and environment on outcome expectations. Caregivers reported high levels of moral disengagement ( M = 4.13; standard deviation [ SD] = 0.70) and self-efficacy ( M = 4.26; SD = 0.64) and moderate levels of behavioral capability ( M = 2.83; SD = 0.75) and environment ( M = 2.92; SD = 0.74). Findings indicated the hypothesized relationships in the SCT were not fully supported. In addition, the indirect effects of environment on outcome expectations were not statistically significantly mediated by behavioral capability. This research warrants more attention in testing the SCT concepts for the development of childhood obesity prevention efforts that prioritize African American families in rural communities.
Pedestrians Accept Shorter Distances to Light Vehicles Than Dark Ones When Crossing the Street
Authors: Feldstein Ilja T. , Peli Eli
Published: April 2020

Does the brightness of an approaching vehicle affect a pedestrian’s crossing decision? Thirty participants indicated their street-crossing intentions when facing approaching light or dark vehicles. The experiment was conducted in a real daylight environment and, additionally, in a corresponding virtual one. A real road with actual cars provides high face validity, while a virtual environment ensures the scenario’s precise reproducibility and repeatability for each participant. In both settings, participants judged dark vehicles to be a more imminent threat—either closer or moving faster—when compared with light ones. Secondary results showed that participants accepted a significantly shorter time-to-contact when crossing the street in the virtual setting than on the real road.
Moral distress: Developing strategies from experience
Authors: Helmers Andrew , Palmer Karen Dryden , Greenberg Rebecca A
Published: April 2020

Background

Moral distress was first described by Jameton in 1984, and has been defined as distress experienced by an individual when they are unable to carry out what they believe to be the right course of action because of real or perceived constraints on that action. This complex phenomenon has been studied extensively among healthcare providers, and intensive care professionals in particular report high levels of moral distress. This distress has been associated with provider burnout and associated consequences such as job attrition, with potential impacts on patient and family care. There is a paucity of literature exploring how middle and late career healthcare providers experience and cope with moral distress.

Objectives

We explore the experience of moral distress and the strategies and resources invoked to mitigate that distress in mid- and late-career healthcare providers practicing in paediatric intensive care, in order to identify ways in which the work environment can build a culture of moral resilience.

Research design

An exploratory, qualitative quality improvement project utilizing focus group and semi-structured interviews with pediatric intensive care front-line providers.

Participants

Mid-and-later career (10 + years in practice) pediatric intensive care front line providers in a tertiary pediatric hospital.

Research context

This work focuses on paediatric intensive care providers in a single critical care unit, in order to explore the site-specific perspectives of health care providers in that context with respect to moral distress coping strategies.

Ethical considerations

The study was approved by the Quality Management Office at the institution; consent was obtained from participants, and no identifying data was included in this project.

Findings

Participants endorsed perspective-building and described strategies for positive adaptation including; active, reflective and structured supports. Participants articulated interest in enhanced and accessible formal supports.

Discussion

Findings in this study resonate with the current literature in healthcare provider moral distress, and exposed ways in which the work environment could support a culture of moral resilience. Avenues are described for the management and mitigation of moral distress in this setting.

Conclusion

This exploratory work lays the groundwork for interventions that facilitate personal growth and meaning in the midst of moral crises in critical care practice.
Bleeding Risk Associated With Hemodynamically Stable Low-Energy Pelvic Fracture
Authors: Sng Marcus , Gentle Juliette , Asadollahi Saeed
Published: April 2020

Introduction:

Life-threatening hemorrhage associated with low-energy pelvic fracture has been described in single cases in the literature. However, there is limited evidence available on the bleeding risk associated with hemodynamically stable osteoporotic pelvic fractures. The objective of this study was to estimate the bleeding risk associated with low-energy osteoporotic pelvic fractures in the elderly population.

Materials and Methods:

A retrospective review of patients aged > 65 years old with pelvic fractures admitted between 2015 and 2018 was performed. Eighty-two patients were identified: 12 males and 70 females with a median age of 86 years. The median Charlson comorbidity index was 6 (interquartile range = 5-7). Eighty-one fractures were classified as lateral compression I or Tile A2, and 1 fracture was classified as lateral compression II or Tile B2. Forty patients were on concurrent anticoagulation treatment. In 4 patients on warfarin, this treatment was reversed on admission.

Results:

The mean hemoglobin (Hb) level on arrival was 12.36 g/dL (±1.67 g/dL). There were significant drops in Hb levels on day 1 (Hb = 11.22 ± 1.86 g/dL, P < .001) and day 4 (Hb = 10.97 ± 1.6 g/dL, P < .001). Nine percent of patients required a blood transfusion. The mean baseline Hb level pre-transfusion was 8.33 g/dL (±1.15). Preexisting anticoagulation treatment did not predispose patients to greater decreases in Hb levels on day 1 (mean difference = 0.16 g/dL, P = .62) or day 4 (mean difference = 0.29 g/dL, P = .48) post-admission.

Discussion:

An observed mean decrease in Hb level of up to 1.4 g/dL can occur in hemodynamically stable elderly patients with osteoporotic pelvic fractures, reflecting an approximate loss of 1.4 units of packed red blood cells.

Conclusion:

This degree of decrease in Hb may be clinically significant in geriatric patients with chronic anemia and a history of cardiovascular disease.
A case of unilateral recurrent laryngeal nerve palsy caused by neck extension injury
Authors: Komata Tadashi , Komatsu Shintaro , Sugahara Shoko , Hasegawa Mitsuko , Nagai Natsumi , Yamazaki Ryo , Kikuchi Tatsuya , Sakimura Yoko
Published: April 2020

A 63-year-old man collided with a vehicle while riding a motorcycle. At an emergency hospital, he was diagnosed with cerebral concussion, incomplete cervical cord injury, C6 fracture, facial bone fractures, and lacerations. Radiographical findings indicated that his neck was forced into an extended position. At our rehabilitation hospital, we evaluated the patient’s hoarseness and dysphagia 1 month posttrauma and determined the diagnosis to be due to “traumatic right recurrent laryngeal nerve palsy (RLNP).” We followed the patient’s RLNP during admission and at our outpatient clinic. His right RLNP gradually recovered and finally disappeared 6 months after the accident. We describe this case within the context of a review of the literature.
The Initial Use of the Home Medication Experience Questionnaire (HOME-Q) in Community-Based Pharmacy
Authors: Witry Matthew J , Pham Kassi , Viyyuri Brahmendra , Doucette William , Kennelty Korey
Published: April 2020

The Home Medication Experience Questionnaire (HOME-Q) was developed to systematically gather information on the medication experience of patients. The objectives of this study were to (1) assess the frequencies of medication experience issues for a sample of patients and (2) report pharmacist recommendations to address issues and patient implementation of recommendations. This study used a single-group design with 3-month follow-up. A convenience sample of patients aged 55 years and older and taking 4 or more chronic medications self-administered the HOME-Q and discussed responses with a pharmacist from 2 community pharmacies. A researcher called or visited participants at 3 months to readminister the HOME-Q and inquire about recommendations. Thirty-three patients completed questionnaires, and 30 participated in the follow-up. At 3 months, the HOME-Q median did not decrease (4 at both administrations). There were 51 pharmacist interventions/recommendations, and 47% were reported adopted. The HOME-Q prompted pharmacists to respond to medication experience issues that may not have been identified otherwise. More work is needed to test the impact of the HOME-Q and better understand medication experience discussions between patients and pharmacists.
Middle-age-onset cerebellar ataxia caused by a homozygous TWNK variant: a case report
Authors: Kume Kodai , Morino Hiroyuki , Miyamoto Ryosuke , Matsuda Yukiko , Ohsawa Ryosuke , Kanaya Yuhei , Tada Yui , Kurashige Takashi , Kawakami Hideshi
Published: April 2020

Background

TheTWNKgene encodes the twinkle protein, which is a mitochondrial helicase for DNA replication. The dominantTWNKvariants cause progressive external ophthalmoplegia with mitochondrial DNA deletions, autosomal dominant 3, while the recessive variants cause mitochondrial DNA depletion syndrome 7 and Perrault syndrome 5. Perrault syndrome is characterized by sensorineural hearing loss in both males and females and gonadal dysfunction in females. Patients with Perrault syndrome may present early-onset cerebellar ataxia, whereas middle-age-onset cerebellar ataxia caused byTWNKvariants is rare.

Case presentation

A Japanese female born to consanguineous parents presented hearing loss at age 48, a staggering gait at age 53, and numbness in her distal extremities at age 57. Neurological examination revealed sensorineural hearing loss, cerebellar ataxia, decreased deep tendon reflexes, and sensory disturbance in the distal extremities. Laboratory tests showed no abnormal findings other than a moderate elevation of pyruvate concentration levels. Brain magnetic resonance imaging revealed mild cerebellar atrophy. Using exome sequencing, we identified a homozygousTWNKvariant (NM_021830: c.1358G>A, p.R453Q).

Conclusions

TWNKvariants could cause middle-age-onset cerebellar ataxia. Screening forTWNKvariants should be considered in cases of cerebellar ataxia associated with deafness and/or peripheral neuropathy, even if the onset is not early.
Characteristics of sleep/wake problems and delivery outcomes among pregnant Japanese women without gestational complications
Authors: Umeno Shiho , Kato Chiho , Nagaura Yuki , Kondo Hideaki , Eto Hiromi
Published: April 2020

Background

Frequently observed sleep/wake problems among pregnant women need comprehensive evaluation. This study was conducted to clarify the sleep/wake problems among pregnant women without gestational complications during the second and third trimester and the effects of sleep/wake problems on delivery outcomes.

Methods

A total of 88 Japanese pregnant women participated in this study. In their second and third trimester, subjective sleep quality, insomnia severity, excessive daytime sleepiness (EDS), and restless legs syndrome/Willis-Ekbom disease (RLS/WED) were assessed using questionnaires; also, sleep disordered breathing (SDB) was screened using a pulse oximeter.

Results

From the second to the third trimester, an increasing tendency of sleep/wake problems was observed. During the third trimester, the percentages of women experiencing decreased subjective sleep quality, difficulty maintaining sleep (DMS), EDS, RLS/WED, and 3% oxygen desaturation index (ODI) values ≥5/h were 62.5, 45.5, 48.9, 9.1, and 29.5%, respectively. In a logistic regression analysis for EDS in the third trimester, the adjusted odds ratio (95% confidence interval) of total sleep duration < 6 h, moderate to severe DMS, and 3% ODI values ≥5/h were 3.25 (1.16–9.10), 4.74 (1.60–14.00), and 0.90 (0.28–2.89), respectively. Although short sleep durations, decreased subjective sleep quality, EDS, and SDB did not affect delivery outcomes or the infant’s condition, the percentage of women undergoing cesarean sections in the severe insomnia group was significantly higher (p = 0.008).

Conclusions

Sleep/wake problems were frequent during pregnancy, especially during the third trimester. EDS among pregnant women was associated with shorter sleep durations and DMS rather than SDB. The effect of factors related to insomnia on delivery outcomes should thus be considered a crucial problem among pregnant Japanese women without gestational complications in clinical practice.
Etiological serotype and genotype distributions and clinical characteristics of group B streptococcus-inducing invasive disease among infants in South China
Authors: Zhu Yao , Wu Jiayin , Zheng Xinyi , Liu Dengli , Xu Liping , Chen Dongmei , Qiu Wenying , Huang Zhongling , Zhong Ronghua , Chen Ling , He Mingyuan , Ma Simin , Lin Yayin , Lin Xinzhu , Chen Chao
Published: April 2020

Background

Group B streptococcus (GBS)-induced invasive disease is a major cause of illness and death among infants aged under 90 days in China; however, invasive GBS infection remains unknown in China. We aimed to describe the serotype and genotype distributions of early-onset disease (EOD) and late-onset disease (LOD), and to show the clinical correlations among various GBS serotypes and genotypes obtained from infants with invasive GBS infections.

Methods

Between June 1, 2016 and June 1, 2018, 84 GBS strains were collected from patients younger than 90 days at seven Chinese hospitals. Clinical data were retrospectively reviewed. GBS serotyping was conducted and multi-locus sequence typing was performed.

Results

Serotypes Ia, Ib, II, III, and V were detected. Serotype III (60.71%) was the most common, followed by Ia (16.67%) and Ib (14.29%). Intrapartum temperature ≥ 37.5 °C, chorioamnionitis, and mortality were noted in 28.57, 42.86, and 28.57% of patients with serotype Ia, respectively, and these rates were higher than those in patients with serotypes Ib and III (P = 0.041, P = 0.031, and P = 0.023, respectively). The incidence of respiratory distress was lower (P = 0.039) while that of purulent meningitis was higher (P = 0.026) in the serotype III group. Eighteen sequence types were detected among isolates, and ST17 [42.86% (36/84)] was the most prevalent.

Conclusions

GBS isolates belonging to serotypes Ia, Ib, and III are common in southern mainland China, and ST17 is highly prevalent. Differences were found in the clinical manifestations of invasive GBS disease induced by serotypes Ia and III.
Cost-effectiveness and resource allocation (CERA) 18 years of evolution: maturity of adulthood and promise beyond tomorrow
Authors: Jakovljevic Mihajlo , Matter-Walstra Klazien , Sugahara Takuma , Sharma Tarang , Reshetnikov Vladimir , Merrick Joav , Yamada Tetsuji , Youngkong Sitaporn , Rovira Joan
Published: April 2020

Since its inception in 2003, Cost Effectiveness and Resource Allocation journal has come a long way over the past 18 years. Possibly much longer than many of its contemporaries in the blossoming science of health economics might have anticipated. Today, entering 2020 it celebrates the Age of Maturity. We believe that in the third decade of XXI century the interdisciplinary science of health economics, will rejuvenate and come back to us younger than ever from its early historical roots almost a century ago. The spreading of economic globalization in several distinctive ways, either led by multinational business corporations or newly emerged Asian leadership, or both, is likely to make challenges for contemporary health systems far more serious. The fourth industrial revolution (cyber physical systems and artificial intelligence technology) and accelerated innovation in the field of E-Health and digital health, will probably change the workflow in medical and health care, and inevitably transform the labour market in the upcoming decades. So, let us be up to the task. Let us provide academic centres, industry-sponsored pharmaceutical and medical device innovation hubs, and governing authorities alike, with a powerful forum for debate on cost-effective resource allocation in the years to come.
Oncology nurses’ compassion fatigue, burn out and compassion satisfaction
Authors: Jarrad Reem Ahmad , Hammad Sawsan
Published: April 2020

Background

For oncology nurses, compassion fatigue, burn out and compassion satisfactions are frequently experienced psychosocial consequences of the oncology work environment. Surveying such phenomena helps to understand how nurses feel and behave when cancer care is provided. Besides, tracking the evolving nature of those three concepts can lend a hand for the early detection of personal and professional suffering of nurses while offering some healing remedies to their struggling bodies and souls.

Purpose

The purpose of this study was to explore the level of compassion fatigue, burn out and compassion satisfaction among a group of specialized oncology nurses. Besides, this study aimed to detect some probable interesting inferences between compassion satisfaction and the concept of rest and leisure. Correlations between compassion fatigue, burn out and compassion satisfaction were investigated. Correlations between oncology nurses’ scores on the three subscales and a group of demographic, organizational and leisure-related variables were examined.

Methods

This study adopted a descriptive correlation design to survey compassion fatigue, burn out and compassion satisfaction among a convenient sample of 100 oncology nurses who work in a specialized cancer care centre. Participants completed compassion fatigue self-test developed by Figely (Compassion fatigue, New York: Brunner/Mazel. B. HudnallStamm, Traumatic Stress Research Group; 1995–1998. http://www.dartmouth.edu/~bhstamm/index.htm, 1995) and a literature-based demographic survey. Analysis of data included descriptive statistics and Pearson correlation co-efficient.

Results

Nurses reported a low level of compassion satisfaction, moderate risk for burn out and an extremely high risk for compassion fatigue. Results revealed significant negative relationships among compassion satisfaction and the number of dependents per nurse. Additionally the correlation between compassion satisfaction and the nurses’ number of hours slept was positive. Only two components of the concept rest and leisure yielded statistical significance when correlated to the concept of compassion satisfaction. A significant negative relationship was observed between compassion satisfaction and compassion fatigue while a strong positive relationship was observed between compassion fatigue and burn out.

Conclusions

The studied oncology nurses sample had evidently low level of compassion satisfaction when contrasted to the significantly increased risks of burn out and compassion fatigue. Thus, health authorities and management are advised to care, in a holistic approach, for nurses who work in oncology departments. Staff-oriented services that offer comfort, reward, leisure, screening, consultation and support are urgently recommended.
Lamina-associated domains: peripheral matters and internal affairs
Authors: Briand Nolwenn , Collas Philippe
Published: April 2020

At the nuclear periphery, associations of chromatin with the nuclear lamina through lamina-associated domains (LADs) aid functional organization of the genome. We review the organization of LADs and provide evidence of LAD heterogeneity from cell ensemble and single-cell data. LADs are typically repressive environments in the genome; nonetheless, we discuss findings of lamin interactions with regulatory elements of active genes, and the role lamins may play in genome regulation. We address the relationship between LADs and other genome organizers, and the involvement of LADs in laminopathies. The current data lay the basis for future studies on the significance of lamin-chromatin interactions in health and disease.
SMASH standardised perioperative management of patients operated with acute abdominal surgery in a high-risk setting
Authors: Timan Terje Jansson , Sernert Ninni , Karlsson Ove , Prytz Mattias
Published: April 2020

Objective of the study

Emergency laparotomy and other high-risk acute abdominal surgery procedures have a high mortality rate. The perioperative management of these patients is complex and poses several challenges. The objective of the study is to implement and evaluate the outcome of protocol-based standardised care for patients in need of acute abdominal surgery in a Swedish setting. NÄL is a large county hospital in Sweden serving a population of approximately 270,000 inhabitants. The study seeks to determine whether standardised protocol-based perioperative management in emergency abdominal surgical procedures leads to a better outcome measured as short- and long-term mortality and postoperative complications compared with the present standard in Swedish routine care. The study is ongoing, and this article describes the methodology used in the study and discusses the benefits and limitations the study design.

Results

There are no results so far. The inclusion rate for the first 22 months is as expected; 404 patients have been included and protocols have been followed and reviewed according to the study plan. 25 patients have been missed and demographic data and outcome data for these patients will be collected and analysed.
Association between retinal thickness and β-amyloid brain accumulation in individuals with subjective cognitive decline: Fundació ACE Healthy Brain Initiative
Authors:   on behalf of the FACEHBI study group, Marquié Marta , Valero Sergi , Castilla-Marti Miguel , Martínez Joan , Rodríguez-Gómez Octavio , Sanabria Ángela , Tartari Juan Pablo , Monté-Rubio Gemma C. , Sotolongo-Grau Oscar , Alegret Montserrat , Pérez-Cordón Alba , Roberto Natalia , de Rojas Itziar , Moreno-Grau Sonia , Montrreal Laura , Hernández Isabel , Rosende-Roca Maitee , Mauleón Ana , Vargas Liliana , Abdelnour Carla , Gil Silvia , Esteban-De Antonio Ester , Espinosa Ana , Ortega Gemma , Lomeña Francisco , Pavia Javier , Vivas Assumpta , Tejero Miguel Ángel , Gómez-Chiari Marta , Simó Rafael , Ciudin Andreea , Hernández Cristina , Orellana Adelina , Benaque Alba , Ruiz Agustín , Tárraga Lluís , Boada Mercè
Published: April 2020

Background

Optical coherence tomography (OCT) of the retina is a fast and easily accessible tool for the quantification of retinal structural measurements. Multiple studies show that patients with Alzheimer’s disease (AD) exhibit thinning in several retinal layers compared to age-matched controls. Subjective cognitive decline (SCD) has been proposed as a risk factor for progression to AD. There is little data about retinal changes in preclinical AD and their correlation with amyloid-β (Aβ) uptake.

Aims

We investigated the association of retinal thickness quantified by OCT with Aβ accumulation and conversion to mild cognitive impairment (MCI) over 24 months in individuals with SCD.

Methods

One hundred twenty-nine individuals with SCD enrolled in Fundació ACE Healthy Brain Initiative underwent comprehensive neuropsychological testing, OCT scan of the retina and florbetaben (FBB) positron emission tomography (PET) at baseline (v0) and after 24 months (v2). We assessed the association of sixteen retinal thickness measurements at baseline with FBB-PET status (+/−) and global standardize uptake value ratio (SUVR) as a continuous measure at v0 and v2 and their predictive value on clinical status change (conversion to mild cognitive impairment (MCI)) at v2.

Results

Mean age of the sample was 64.72 ± 7.27 years; 62.8% were females. Fifteen participants were classified as FBB-PET+ at baseline and 22 at v2. Every 1 μm of increased thickness in the inner nasal macular region conferred 8% and 6% higher probability of presenting a FBB-PET+ status at v0 (OR = 1.08, 95% CI = 1.02–1.14, p = 0.007) and v2 (OR = 1.06, 95% CI = 1.02–1.11, p = 0.004), respectively. Inner nasal macular thickness also positively correlated with global SUVR (at v0: β = 0.23, p = 0.004; at v2: β = 0.26, p = 0.001). No retinal measurements were associated to conversion to MCI over 24 months.

Conclusions

Subtle retinal thickness changes in the macular region are already present in SCD and correlate with Aβ uptake.
Sirt6 opposes glycochenodeoxycholate-induced apoptosis of biliary epithelial cells through the AMPK/PGC-1α pathway
Authors: Li Jiye , Yu Dongsheng , Chen Sanyang , Liu Yifan , Shi Jihua , Zhang Jiakai , Wen Peihao , Wang Zhihui , Li Jie , Guo Wenzhi , Zhang Shuijun
Published: April 2020

Background

Induction of biliary epithelial cell apoptosis by toxic bile acids is involved in the development of cholestatic disease, but the underlying molecular mechanism is not clear. The purpose of this study was to investigate the molecular mechanisms involved in Sirt6 protection against the apoptosis of human intrahepatic biliary epithelial cells (HiBEC) induced by the bile acid glycochenodeoxycholate (GCDC).

Results

Sirt6 was either overexpressed or knocked down in HiBEC, with or without GCDC pretreatment. The CCK-8 assay was used to assess cell viability and, Hoechst 33258 staining was used to determine apoptotic rate. Mitochondrial DNA (mtDNA) copy number, malondialdehyde (MDA) and reactive oxygen species (ROS) production were detected to evaluate the severity of the mitochondrial dysfunction and oxidative stress. The mRNA and protein levels of PGC-1α, Nrf1, and Nrf2 were analyzed using RT-qPCR and western blot assay. The results showed that Sirt6 opposed GCDC-induced apoptosis in HiBEC via up-regulating PGC-1α expression and stabilizing mtDNA. We used agonists and inhibitors of AMPK to demonstrate that Sirt6 increased PGC-1α expression through the AMPK pathway whereas GCDC had the opposite effect. Finally, western blot, luciferase assay, and co-immunoprecipitation were used to describe a direct interaction and acetylation modification of PGC-1α by Sirt6.

Conclusion

Our data illuminated that Sirt6 ameliorated GCDC-induced HiBEC apoptosis by upregulating PGC-1α expression through the AMPK pathway and its deacetylation effect.
Hepatitis E virus seroprevalence in pets in the Netherlands and the permissiveness of canine liver cells to the infection
Authors: Li Yunlong , Qu Changbo , Spee Bart , Zhang Ruyi , Penning Louis C. , de Man Robert A. , Peppelenbosch Maikel P. , Fieten Hille , Pan Qiuwei
Published: April 2020

Hepatitis E virus (HEV) as an emerging zoonotic pathogen causes a major public health issue. Transmission from domestic, wildlife and zoo animals to human has been widely reported. Whether pets also serve as reservoirs remains an intriguing question. In this study, we found the sero-positive rates of HEV-specific antibodies in pet dogs, cats and horses of 18.52% (30/162), 14.89% (7/47) and 18.18% (4/22) in the Netherlands. Although HEV viral RNA was not detected in these animals, we have demonstrated that dog liver cells are susceptible to HEV infection in vitro. These results call more attention to address the potential role of pets in the zoonotic transmission of HEV.
Correction to: Prioritising the development of severity distributions in burden of disease studies for countries in the European region
Authors: Wyper Grant M. A. , Grant Ian , Fletcher Eilidh , Chalmers Neil , McCartney Gerry , Stockton Diane L.
Published: April 2020

In the original publication of this article [1], the author pointed out the legends of Figs. 1 and 2 are not entire. The correct legends are:
Structure and function of the Arctic and Antarctic marine microbiota as revealed by metagenomics
Authors: Cao Shunan , Zhang Weipeng , Ding Wei , Wang Meng , Fan Shen , Yang Bo , Mcminn Andrew , Wang Min , Xie Bin-bin , Qin Qi-Long , Chen Xiu-Lan , He Jianfeng , Zhang Yu-Zhong
Published: April 2020

Background

The Arctic and Antarctic are the two most geographically distant bioregions on earth. Recent sampling efforts and following metagenomics have shed light on the global ocean microbial diversity and function, yet the microbiota of polar regions has not been included in such global analyses.

Results

Here a metagenomic study of seawater samples (n= 60) collected from different depths at 28 locations in the Arctic and Antarctic zones was performed, together with metagenomes from theTaraOceans. More than 7500 (19%) polar seawater-derived operational taxonomic units could not be identified in theTaraOceans datasets, and more than 3,900,000 protein-coding gene orthologs had no hits in the Ocean Microbial Reference Gene Catalog. Analysis of 214 metagenome assembled genomes (MAGs) recovered from the polar seawater microbiomes, revealed strains that are prevalent in the polar regions while nearly undetectable in temperate seawater. Metabolic pathway reconstruction for these microbes suggested versatility for saccharide and lipids biosynthesis, nitrate and sulfate reduction, and CO2fixation. Comparison between the Arctic and Antarctic microbiomes revealed that antibiotic resistance genes were enriched in the Arctic while functions like DNA recombination were enriched in the Antarctic.

Conclusions

Our data highlight the occurrence of dominant and locally enriched microbes in the Arctic and Antarctic seawater with unique functional traits for environmental adaption, and provide a foundation for analyzing the global ocean microbiome in a more complete perspective.