bluuebunny/crossref_metadata_2025 huggingface dataset:
Fas ligand neutralization attenuates hypertension, endothelin-1, and placental inflammation in an animal model of HELLP syndrome
Authors: Gibbens Jacob , Spencer Shauna-Kay , Solis Lucia , Bowles Teylor , Kyle Patrick B. , Szczepanski Jamie L. , Dumas John Polk , Robinson Reanna , Wallace Kedra
Published: July 2020

Neutralization of FasL is linked to suppression of hypertension, placental inflammation, and endothelin system activation in an animal model of hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. During HELLP syndrome the placenta has been reported to serve as the primary source of Fas ligand (FasL), which has an impact on inflammation and hypertension during pregnancy and is dysregulated in women with severe preeclampsia and HELLP syndrome. We hypothesize that neutralization of FasL during pregnancy in an animal model of HELLP syndrome decreases inflammation and placental apoptosis, improves endothelial damage, and improves hypertension. On gestational day (GD) 12, rats were chronically infused with placental antiangiogenic factors sFlt-1 and sEng to induce HELLP syndrome. To neutralize FasL, MFL4 or FasL antibody was infused into a subset of HELLP or normal pregnant rats on GD13. IgG infusion into another group of NP and HELLP rats on GD13 was used as a control for FasL antibody, and all rats were euthanized on GD19 after blood pressure measurement. Plasma and placentas were collected to assess inflammation, apoptosis, and the degree of placental debris activation of endothelial cells. Administration of MFL4 to HELLP rats significantly decreased blood pressure compared with untreated HELLP rats and HELLP rats infused with IgG and improved the biochemistry of HELLP syndrome. Both circulating and placental FasL were significantly attenuated in response to MFL4 infusion, as were levels of placental and circulating TNFα when compared with untreated HELLP rats and HELLP rats infused with IgG. Endothelial cells exposed to placental debris and media from HP + MFL4 rats secreted significantly less endothelin-1 compared with stimulated endothelial cells from HELLP placentas. Neutralization of FasL is associated with decreased MAP and improvement in placental inflammation and endothelial damage in an animal model of HELLP syndrome.
Hereditary Hypophosphatemic Rickets with Hypercalciuria (HHRH) Presenting with Genu Valgum Deformity: Treatment with Phosphate Supplementation and Surgical Correction
Authors: Colazo Juan M. , Reasoner Seth A. , Holt Ginger , Faugere Marie C. M. , Dahir Kathryn M.
Published: July 2020

We describe a case of hereditary hypophosphatemic rickets with hypercalciuria (HHRH) in a 32-year-old female with short stature, chronic pathologic genu valgum deformity, and knee pain who was referred to endocrinology clinic after previous inconclusive workups. We present imaging spanning 10 years of untreated disease. Biochemical studies showed hypophosphatemia with undetectable fibroblast growth factor 23 (FGF23.) Renal ultrasound revealed bilateral medullary nephrocalcinosis despite no apparent hypercalciuria. Due to concern for HHRH, genetic testing was performed that determined this patient to be homozygous in the SLC34A3 gene for a previously described missense variant (c.1402C > T, p.Arg468Trp). There was no known family history of rickets. A bone biopsy with metabolic studies was performed for diagnostic and prognostic reasons. The histopathological findings along with tetracycline uptake studies were consistent with a diagnosis of HHRH. Treatment with phosphorous supplementation and surgical correction of her valgum deformity resulted in resolution of pain, but no change in bone histomorphometry.
A Novel Non-DC Biased Intensity Modulated Indoor MIMO-VLC System Using Walsh Precoder
Authors: Muneer P. , Thafasal Ijyas V. P. , Abbas Mohamed , Loukil Hassen , Algahtani Ali , Kessentini Amir , Mohammed Abdul Wase
Published: July 2020

In this paper, we propose an indoor visible light communication (VLC) system which makes use of Walsh precoding and multiple light-emitting diodes (LEDs) at the transmitter for multiplexing the data. The proposed VLC system is based on intensity modulation and uses the notion of spatial modulation for communicating the positive and negative values of the synthesized transmit signal using signal processing technique at the transmitter. We also illustrate the flexibility, ability, and easiness of the system to configure well in a multiuser environment. We have also developed a near-maximum likelihood (ML) detection technique for efficiently decoding the data bits at the receiver. The proposed near-ML reduces the search space involved in ML technique by using the initial ZF solution. The results of the simulation studies illustrate that the proposed technique offers a higher data rate and good bit error rate (BER) performance in indoor VLC environments.
Azithromycin in the Treatment of Preterm Prelabor Rupture of Membranes Demonstrates a Lower Risk of Chorioamnionitis and Postpartum Endometritis with an Equivalent Latency Period Compared with Erythromycin Antibiotic Regimens
Authors: Martingano Daniel , Singh Shailini , Mitrofanova Antonina
Published: July 2020

Objective. To determine if antibiotic regimens including azithromycin versus erythromycin has an impact on pregnancy latency and development of clinical chorioamnionitis in the context of preterm prelabor rupture of membranes. Study Design. We conducted a prospective observational cohort study and followed all women receiving antibiotic regimens including either azithromycin or erythromycin in the context of preterm prelabor rupture of membranes. Primary outcomes were the duration of pregnancy latency period and development of chorioamnionitis. Secondary outcomes included neonatal sepsis with positive blood culture, cesarean delivery, postpartum endometritis, and meconium-stained amniotic fluid. Results. This study included 310 patients, with 142 receiving the azithromycin regimen and 168 receiving the erythromycin regimen. Patients receiving the azithromycin regimen had a statistically significant advantage in overall rates of clinical chorioamnionitis (13.4% versus 25%, p=0.010), neonatal sepsis (4.9% versus 14.9%, p=0.004), and postpartum endometritis (14.8% versus 31%, p=0.001). In crude and adjusted models, when comparing the azithromycin group with the erythromycin group, a decreased risk was noted for the development of clinical chorioamnionitis, neonatal sepsis, and postpartum endometritis. Pregnancy latency by regimen was not significantly different in crude and adjusted models. Conclusion. Our study suggests that latency antibiotic regimens substituting azithromycin for erythromycin have lower rates and decreased risk of clinical chorioamnionitis, neonatal sepsis, and postpartum endometritis with no difference in pregnancy latency.
Plasma Homocysteine and Autonomic Nervous Dysfunction: Association and Clinical Relevance in OSAS
Authors: Liu Lei , Wu Qiansheng , Yan Hong , Zheng Xilong , Zhou Qiang
Published: July 2020

Objective. Elevated plasma homocysteine (Hcy) is an independent risk factor for cardiovascular diseases, but the precise mechanism of Hcy in cardiovascular disease remains elusive. This study is aimed at evaluating the association between Hcy levels and autonomic nervous system and at investigating their clinical relevance in obstructive sleep apnea syndrome (OSAS). Methods. A total of 191 subjects with OSAS were enrolled for this cross-sectional study. Heart rate variability (HRV) represents the status of the autonomic nervous system and is a well-known index that allows studying the autonomic modulation. HRV and polysomnography parameters were collected based on Holter monitors and polysomnography system. The software computed all the basic HRV parameters including SDANN, SDNN and pNN50. Correlation analyses between Hcy and HRV parameters and echocardiographic parameters were performed. Results. Compared with the mild-moderate OSAS group, the prevalence of male and smoking and Hcy levels were considerably higher in the severe OSAS group (P=0.01, P=0.02, and P=0.01, respectively). Also, there were significant linear relationships between Hcy quartiles with the proportion of severe OSAS (P=0.01 for the trend). Interesting, there is a negative linear correlation between SDANN and Hcy quartiles (P=0.02 for the trend). Spearman’s correlation analysis showed a significant negative correlation between SDANN and Hcy levels (r=−0.17, P=0.02). Interestingly, the relationship of it remains significant after adjustment for clinical covariates (r=−0.15, P=0.04). However, echocardiographic parameters were not significantly correlated with Hcy or HRV parameters (all P>0.05). Conclusions. Elevated plasma Hcy level is linearly correlated with cardiac autonomic nervous function disorders in patients with OSAS.
Mechanical and Pharmacological Revascularization Strategies for Prevention of Microvascular Dysfunction in ST-Segment Elevation Myocardial Infarction: Analysis from Index of Microcirculatory Resistance Registry Data
Authors: Jang Ji-Hun , Lee Man-Jong , Ko Kyu-Yong , Park Jin-Hee , Baek Yong-Soo , Sung-Woo Kwon , Shin Sung-Hee , Woo Seong-Ill , Kim Dae-Hyeok , Suh Young Ju , Kwan Jun , Park Sang-Don
Published: July 2020

Objectives. We aimed to identify mechanical and pharmacological revascularization strategies correlated with the index of microcirculatory resistance (IMR) in ST-elevation myocardial infarction (STEMI) patients. Background. Microvascular dysfunction (MVD) after STEMI is correlated with infarct size and poor long-term prognosis, and the IMR is a useful analytical method for the quantitative assessment of MVD. However, therapeutic strategies that can reliably reduce MVD remain uncertain. Methods. Patients with STEMI who underwent primary percutaneous coronary intervention (PCI) were enrolled. The IMR was measured with a pressure sensor/thermistor-tipped guidewire immediately after primary PCI. High IMR was defined as values ≥66th percentile of IMR in enrolled patients (IMR > 30.9 IU). Results. A total of 160 STEMI patients were analyzed (high IMR = 54 patients). Clinical factors for Killip class P=0.006, delayed hospitalization from symptom onset P=0.004, peak troponin-I level P=0.042, and multivessel disease P=0.003 were associated with high IMR. Achieving final thrombolysis in myocardial infarction myocardial perfusion grade 3 tended to be associated with low IMR P=0.119, whereas the presence of distal embolization was significantly associated with high IMR P=0.034. In terms of therapeutic strategies that involved adjusting clinical and angiographic factors associated with IMR, preloading of third-generation P2Y12 inhibitors correlated with reducing IMR value (β = −10.30, P<0.001). Mechanical therapeutic strategies including stent diameter/length, preballoon dilatation, direct stenting, and thrombectomy were not associated with low IMR value (all P>0.05), and postballoon dilatation was associated with high IMR (β = 8.30, P=0.020). Conclusions. In our study, mechanical strategies were suboptimal in achieving myocardial salvage. Preloading of third-generation P2Y12 inhibitors revealed decreased IMR value, indicative of MVD prevention.
Inflammatory Myofibroblastic Tumor: A Rare Presentation and an Effective Treatment with Crizotinib
Authors: Khalil Sumaira , Ghafoor Tariq , Raja Amna Kaneez Fatima
Published: July 2020

Inflammatory myofibroblastic tumor (IMT) is a rare entity of neoplastic origin. It usually occurs in children and adolescents and most commonly involves pulmonary and gastrointestinal sites. Here, the authors present two cases; one is the nine months old boy with a subcutaneous IMT in the left temporal region that was treated successfully with surgical resection. To the best of our knowledge, this is the first reported case of a subcutaneous IMT in this particular region. The second is an eight years old girl with an IMT of the right hemi-pelvis. The mass had complete surgical excision with clear margins and no residual disease. She was kept on regular follow-up with ultrasound abdomen. However, her disease relapsed with the appearance of lesions in right iliac fossa, right ovary, and liver. Biopsy of the relapsed abdominal mass confirmed ALK-positive IMT. She was treated with ALK inhibitor Crizotinib. She was monitored with regular blood complete picture, hepatic and renal function test, and ultrasound abdomen. Her lesions started regressing within one month, and she achieved complete remission after 6 months of treatment.
The Role of Caspase-4 and NLRP1 in MCF7 Cell Pyroptosis Induced by hUCMSC-Secreted Factors
Authors: Jiao Yang , Wang Linlin , Lu Lin , Liu Jianjun , Li Xin , Zhao Hongbo , Hou Zongliu , Zheng Bingrong
Published: July 2020

Mesenchymal stem cells (MSCs) are being widely investigated for the development of novel therapeutic approaches for different cancers, including breast cancer, the leading form of cancer in women. Our previous study showed that the factors secreted by human umbilical cord MSCs (hUCMSCs) induced pyroptosis in the breast cancer cell line MCF7 and our RNA sequencing studies revealed an increase in the expression of the pyroptosis-related gene caspase-4 (CASP4) and nucleotide-binding, leucine-rich repeat pyrin domain-containing protein 1 (NLRP1) in pyroptotic MCF7 cells. Cellular pyroptosis can occur via the canonical pathway (involving caspase-1 and NLRP1) or the noncanonical pathway (involving caspase-4). In this study, we first confirmed that the inflammasome complex formed by NLRP1 and ASC is involved in MCF7 cell pyroptosis induced by hUCMSC-CM. Further, we investigated the role of CASP4 and NLRP1 in MCF7 cell pyroptosis induced by hUCMSC-secreted factors using shRNA-mediated transfection of CASP4 or NLRP1 in MCF7 cells. Cytotoxicity analyses revealed that neither CASP4 knockdown nor NLRP1 knockdown could inhibit the hUCMSC-CM-induced pyroptosis in MCF7 cells. Gene and protein expression analysis showed that hUCMSC-CM induced pyroptosis mainly via the canonical pathway in CASP4 knockdown MCF7 cells but mainly via the noncanonical pathway in NLRP1 knockdown MCF7 cells. Our study provides a foundation for further studies aimed at elucidating the precise mechanism underlying hUCMSC-induced pyroptosis in breast cancer cells and aid the identification of potential therapeutic targets for breast cancer.
How to Contract a Vertex Transitive 5-Connected Graph
Authors: Qin Chengfu , Yang Weihua , Guo Xiaofeng
Published: July 2020

M.Kriesell conjectured that there existed b, h such that every 5-connected graph G with at least b vertices can be contracted to a 5-connected graph G0 such that 0<VG−VG0<h. We show that this conjecture holds for vertex transitive 5-connected graphs.
Prevalence and Outcome of Potential Candidates for Left Atrial Appendage Closure After Stroke With Atrial Fibrillation
Authors: Ong Elodie , Meseguer Elena , Guidoux Celine , Lavallée Philippa C. , Hobeanu Cristina , Charles Hugo , Labreuche Julien , Cabrejo Lucie , Martin-Bechet Anna , Rigual Ricardo , Nighoghossian Norbert , Amarenco Pierre
Published: July 2020

Background and Purpose:

As a result of contraindications (eg, frailty, cognitive impairment, comorbidities) or patient refusal, many patients with stroke and atrial fibrillation cannot be discharged on oral anticoagulant. Among them, the proportion of potential candidates for left atrial appendage closure (LAAC) and their 12-month outcome is not well known.

Methods:

The prospective WATCH-AF registry (Warfarin Aspirin Ten-A Inhibitors and Cerebral Infarction and Hemorrhage and Atrial Fibrillation) enrolled consecutive patients admitted within 72 hours of an acute stroke associated with atrial fibrillation in 2 stroke centers. Scales to evaluate stroke severity, disability, functional independence, risk of fall, cognition, ischemic and hemorrhagic risk-stratification, and comorbidities were systematically collected at admission, discharge, 3, 12 months poststroke. The 2 main end points were death or dependency (modified Rankin Scale score >3) and recurrent stroke (brain infarction and brain hemorrhage).

Results:

Among 400 enrolled patients (370 with brain infarction, 30 with brain hemorrhage), 31 died before discharge and 57 (14.3%) were possible European Heart Rhythm Association/European Society of Cardiology and American Heart Association/American College of Cardiology/Heart Rhythm Society candidates for LAAC. At 12 months, the rate of death or dependency was 17.9%, and the rate of stroke recurrence was 9.8% in the 274/400 (68.5%) patients discharged on a long-term oral anticoagulant strategy, as compared with 17.5% and 24.7%, respectively, in 57 patients candidate for LAAC. As compared with patients on a long-term oral anticoagulant strategy, there was a 2-fold increase in the risk of stroke recurrence in the group with an indication for LAAC (adjusted hazard ratio, 2.58 [95% CI, 1.40–4.76]; P=0.002).

Conclusions:

Fourteen percent of patients with stroke associated with atrial fibrillation were potential candidates for LAAC. The 12-month stroke risk of these candidates was 3-fold the risk of anticoagulated patients.
Modifiable Risk Factors Associated With Moyamoya Disease
Authors: Ge Peicong , Zhang Qian , Ye Xun , Liu Xingju , Deng Xiaofeng , Wang Jia , Wang Rong , Zhang Yan , Zhang Dong , Zhao Jizong
Published: July 2020

Background and Purpose:

The cause of moyamoya disease (MMD) remains unknown. We aimed to investigate the association between modifiable risk factors and MMD in a prospective, case-control study.

Methods:

Clinical and laboratory characteristics were evaluated in consecutively recruited adult patients with MMD and age-matched healthy control individuals. The potential risk factors for MMD were estimated by logistic regression analysis.

Results:

Our prospective study included 138 adult patients and 138 healthy control subjects. Logistic regression analyses showed that increased body mass index (odds ratio [OR], 1.121 [95% CI, 1.018–1.234];
P
=0.020) and homocysteine (OR, 1.201 [95% CI, 1.081–1.334];
P
=0.001) were associated with higher risk of MMD. Whereas increased albumin (OR, 1.043 [95% CI, 1.004–1.082];
P
=0.028) and high-density lipoprotein cholesterol (OR, 1.043 [95% CI, 1.004–1.082];
P
=0.028) were correlated with a lower risk of MMD. Furthermore, homocysteine (OR, 1.070 [95% CI, 1.010–1.134];
P
=0.023) was significantly related to unilateral lesions.

Conclusions:

Increased body mass index and homocysteine were associated with a higher risk of MMD. In contrast, increased albumin and high-density lipoprotein cholesterol were correlated with a lower risk of MMD. Furthermore, increased homocysteine was related to a higher prevalence of unilateral MMD. More attention should be paid to the modifiable risk factors of MMD, as these might help us finding its cause and new therapeutic regimen.

Registration:

URL:
http://www.chictr.org
. Unique identifier: ChiCTR2000031412.
Social Service Contracting: International Experience and China Practice
Authors: Lin Wenyi , Yin Wanxia , Li Chengjie
Published: July 2020

In China, social service contracting is a new phenomenon even in the most developed cities and areas. The action that the government contracts with non-government organizations in delivering community service is merely a local initiative under the context of social administration reform. There are scarce theoretical and empirical discussions relevant to social service contracting in Chinese academic community. In the light of this gap, this article draws on literature of social service contracting in developed countries or cities to understand key elements ensuring an effective contracting and impacts of contracting. Available literature on social service contracting in China is used for discussion to understand the development of social service contracting in China. Public and social services contracting in China can be briefly divided into three models: non-competitive contracting model, competitive contracting model and informal contracting model. Factors influencing the implementation of contracting programs in China are concerned with the participation of sufficient NGOs, the roles and attitudes of government agencies and the relationship and the interaction between stakeholders. The contracting programs both have positive and negative impacts on service provision.
Six new species of the spider genus Belisana Thorell, 1898 (Araneae: Pholcidae) from southern China
Authors: ZHU WENHUI , YAO ZHIYUAN , ZHENG GUO , LI SHUQIANG
Published: July 2020

The genus Belisana Thorell, 1898 is diverse in southern China. In this study, six new species are described and illustrated: Belisana guilin sp. nov. (Guangxi; male, female), Belisana maoer sp. nov. (Sichuan; male, female), Belisana naling sp. nov. (Guangxi; male, female), Belisana xiyuan sp. nov. (Fujian; male, female), Belisana xuanguan sp. nov. (Guangxi; male) and Belisana yuexiu sp. nov. (Guangdong; male). In addition, Belisana is reported from Sichuan for the first time.
Perspectives on neuroinflammation contributing to chronic cough
Authors: Driessen Alexandria K. , Devlin Anna-Claire , Lundy Fionnuala T. , Martin S. Lorraine , Sergeant Gerard P. , Mazzone Stuart B. , McGarvey Lorcan P.
Published: July 2020

Chronic cough can be a troublesome clinical problem. Current thinking is that increased activity and/or enhanced sensitivity of the peripheral and central neural pathways mediates chronic coughviaprocesses similar to those associated with the development of chronic pain. While inflammation is widely thought to be involved in the development of chronic cough, the true mechanisms causing altered neural activity and sensitisation remain largely unknown. In this back-to-basics perspective article we explore evidence that inflammation in chronic cough may, at least in part, involve neuroinflammation orchestrated by glial cells of the nervous system. We summarise the extensive evidence for the role of both peripheral and central glial cells in chronic pain, and hypothesise that the commonalities between pain and cough pathogenesis and clinical presentation warrant investigations into the neuroinflammatory mechanisms that contribute to chronic cough. We open the debate that glial cells may represent an underappreciated therapeutic target for controlling troublesome cough in disease.
Independent risk factors for axillary lymph node metastasis in breast cancer patients with one or two positive sentinel lymph nodes
Authors: Zhang Wei , Xu Jing , Wang Ke , Tang Xiao-Jiang , Liang Hua , He Jian-Jun
Published: July 2020

Background

The benefit of axillary lymph node dissection (ALND) in breast cancer patients with one or two positive sentinel lymph nodes (SLNs) remains inconclusive. The purpose of this study was to identify risk factors independently associated with axillary lymph node (ALN) metastasis.

Methods

We retrospectively analyzed data from 389 Chinese breast cancer patients with one or two positive SLNs who underwent ALND. Univariate and multivariate logistic regression analyses were performed to identify ALN metastasis-associated risk factors.

Results

Among the 389 patients, 174 (44.7%) had ALN metastasis, while 215 (55.3%) showed no evidence of ALN metastasis. Univariate analysis revealed significant differences in age (< 60 or ≥ 60 years), human epidermal growth factor receptor-2 (Her-2) status, and the ratio of positive to total SLNs between the ALN metastasis and non-metastasis groups (P < 0.05). The multivariate analysis indicated that age, the ratio of positive to total SLNs, and occupations were significantly different between the two groups. Lastly, younger age (< 60 years), a higher ratio of positive to total SLNs, and manual labor jobs were independently associated with ALN metastasis (P < 0.05).

Conclusions

The risk of ALN metastasis in breast cancer patients with one or two positive SLNs can be further increased by younger age, manual labor jobs, and a high ratio of positive to total SLNs. Our findings may also aid in identifying which patients with one or two positive SLNs may not require ALND.
Remediation of learners struggling with communication skills: a systematic review
Authors: Al-Sheikhly Deema , Östlundh Linda , Arayssi Thurayya
Published: July 2020

Background

Communication skills is a core area of competency for healthcare practitioners. However, trainees deficient in those skills are not identified early enough to address the deficiency. Furthermore, faculty often struggle to identify effective remediation strategies for those who fail to meet expectations. We undertook a systematic review to determine which assessment methods are appropriate to identify learners that struggle with communication skills and the strategies used to remediate them.

Methods

The literature was searched from January 1998 through to May 2019 using academic databases and grey literature. Trainees were defined as healthcare practitioners in undergraduate, graduate and continuing education. Characteristics of studies, assessment and intervention strategies and outcomes were synthesized qualitatively and summarized in tables.

Results

From an initial 1636 records, 16 (1%) studies met the review criteria. Majority of the learners were medical students. A few studies (44%) included students from other disciplines, residents and physicians in practice. The remediation programs, in the studies, ranged from 1 week to 1 year. Around half of the studies focused solely on learners struggling with communication skills. The majority of studies used a format of a clinical OSCE to identify struggling learners. None of the studies had a single intervention strategy with the majority including an experiential component with feedback.

Conclusions

A few studies collectively described the diagnosis, remediation intervention and the assessment of the outcomes of remediation of communication skills. For a remediation strategy to be successful it is important to ensure: (i) early identification and diagnosis, (ii) the development of an individualized plan and (iii) providing reassessment with feedback to the learner.
The cholesterol-lowering effect of unripe Rubus coreanus is associated with decreased oxidized LDL and apolipoprotein B levels in subjects with borderline-high cholesterol levels: a randomized controlled trial
Authors: Cho Jung Min , Chae Jisuk , Jeong Sa Rang , Moon Min Jung , Ha Ki-Chan , Kim Sunoh , Lee Jong Ho
Published: July 2020

Background

Rubus coreanus (R. coreanus) possesses properties that may decrease cholesterol levels.

Methods

The effects of unripe R. coreanus (uRC) consumption on low-density lipoprotein (LDL) and total cholesterol levels related to decreased circulating apolipoprotein (Apo) B and oxidized LDL levels were evaluated. This randomized, double-blind, placebo-controlled study included subjects with borderline-high cholesterol levels (between 200 and 239 mg/dL) who consumed one capsule daily containing 600 mg of freeze-dried uRC extract (n = 39) or the placebo (n = 38).

Results

After 12 weeks, the uRC group showed reductions of 21.23 ± 4.36 mg/dL in total cholesterol levels (P = 0.007) and 15.61 ± 4.16 mg/dL in LDL cholesterol levels (P = 0.032). In addition, significantly greater reductions in Apo B levels were observed in the uRC group (− 3.48 ± 3.40 mg/dL), but Apo B levels were increased in the placebo group (6.21 ± 2.84 mg/dL; P = 0.032). Furthermore, a remarkably lower oxidized LDL level was detected in the uRC group (57.76 ± 2.07 U/L) than in the placebo group (66.09 ± 3.47 U/L) after 12 weeks of consumption (P = 0.044).

Conclusions

Because of its cholesterol-lowering effect, uRC shows great promise as a therapeutic agent for subjects with borderline-high total blood cholesterol levels.

Trial registration

ClinicalTrials.gov Identifier: NCT03649620 (8/28/2018, retrospectively registered).
Deep sequencing reveals new roles for MuB in transposition immunity and target-capture, and redefines the insular Ter region of E. coli
Authors: Walker David M. , Harshey Rasika M.
Published: July 2020

Background

The target capture protein MuB is responsible for the high efficiency of phage Mu transposition within the E. coli genome. However, some targets are off-limits, such as regions immediately outside the Mu ends (cis-immunity) as well as the entire ~ 37 kb genome of Mu (Mu genome immunity). Paradoxically, MuB is responsible for cis-immunity and is also implicated in Mu genome immunity, but via different mechanisms. This study was undertaken to dissect the role of MuB in target choice in vivo.

Results

We tracked Mu transposition from six different starting locations on the E. coli genome, in the presence and absence of MuB. The data reveal that Mu’s ability to sample the entire genome during a single hop in a clonal population is independent of MuB, and that MuB is responsible for cis-immunity, plays a minor role in Mu genome immunity, and facilitates insertions into transcriptionally active regions. Unexpectedly, transposition patterns in the absence of MuB have helped extend the boundaries of the insular Ter segment of the E. coli genome.

Conclusions

The results in this study demonstrate unambiguously the operation of two distinct mechanisms of Mu target immunity, only one of which is wholly dependent on MuB. The study also reveals several interesting and hitherto unknown aspects of Mu target choice in vivo, particularly the role of MuB in facilitating the capture of promoter and translation start site targets, likely by displacing macromolecular complexes engaged in gene expression. So also, MuB facilitates transposition into the restricted Ter region of the genome.
Spinal anesthesia in a patient with Schwartz–Jampel syndrome
Authors: Shaalan Osama , Daoud Mahmoud , EL-Molla Ashraf , Al-Otaibi Rashed , Alatassi Abdulaleem
Published: July 2020

Background

Schwartz–Jampel syndrome (SJS) is a very rare inherited disorder characterized by multiple skeletal deformities, limited joint mobility, micrognathia, blepharophimosis, myotonia, and growth retardation. SJS is caused by mutations in the gene encoding perlecan (heparan sulfate proteoglycan). Anesthetic management of these patients is challenging. The use of spinal anesthesia in these patients has not been reported.

Case presentation

A 14-year-old boy was scheduled for inguinal hernia and hydrocele repair. The diagnosis of SJS was based on his dysmorphic features, electromyographic (EMG) pattern and genetic testing. General anesthesia may encounter difficult airway management, resistance to muscle relaxants, or possibility of malignant hyperthermia. Regional anesthesia may be difficult or even harmful due to skeletal deformities. We report successful management of spinal anesthesia and surgery was done. The patient had an uneventful recovery and was discharged home. We describe the special precautions against pitfalls for using this technique in patients with SJS.

Conclusion

Spinal anesthesia may be an effective and safe technique for patients with SJS and it may
Hypertensive patients’ knowledge of cardiovascular disease in Calabar, Nigeria
Authors: Omoronyia Ogban , Ayuk Agam , Nwafor Kenneth , Legogie Annette
Published: July 2020

Background

This study aimed at assessing knowledge of cardiovascular disease risk factors and prevention, among hypertensive patients in a developing country setting with high cardiometabolic disease morbidity and mortality.

Methods

Using descriptive cross-sectional study design and random sampling method, a 30-item questionnaire was used to obtain quantitative data on knowledge of key aspects of cardiovascular disease and practice of preventive measures among hypertensive patients in Calabar.

Result

Two hundred and twelve (212) respondents were surveyed with mean age of 45.5 ± 10.8 years. Approximately two-thirds of respondents (67.9%) had unsatisfactory level of knowledge of CVD. Most respondents had unsatisfactory level of knowledge of appropriate diet (77.4%), basic epidemiology (80.2%), risk factors (63.2%), and symptoms of CVD (74.5%). The mean score for knowledge of risk factors was significantly higher among females compared with males (p < 0.05). Consumers compared with non-consumers of alcohol had significantly lower mean scores for knowledge of appropriate diet and symptoms of CVD (p < 0.05). Except for medical knowledge where mean score of knowledge was significantly higher among respondents occasionally exercised or consumed fresh fruits compared with other groups, there was no significant difference in mean score of knowledge for other components comparing the various categories of active exercise and consumption of fresh fruits (p > 0.05).

Conclusion

Unsatisfactory level of knowledge of cardiovascular disease among hypertensive patients in the study setting was high. There is urgent need to improve efforts and strategies for health education and counseling of patients toward sustainable adoption of preventive behaviors.
Microbiome–host co-oscillation patterns in remodeling of colonic homeostasis during adaptation to a high-grain diet in a sheep model
Authors: Lin Limei , Wang Yue , Xu Lei , Liu Junhua , Zhu Weiyun , Mao Shengyong
Published: July 2020

Background

Ruminant gastrointestinal tract homeostasis deploys interactive microbiome–host metabolic communication and signaling axes to underpin the fitness of the host. After this stable niche is destroyed by environmental triggers, remodeling of homeostasis can occur as a spontaneous physiological compensatory actor.

Results

In this study, 20 sheep were randomly divided into four groups: a hay-fed control (CON) group and a high-grain (HG) diet group for 7, 14, or 28 days. Then, we examined 16S rRNA gene sequences and transcriptome sequences to outline the microbiome–host co-oscillation patterns in remodeling of colonic homeostasis in a sheep model during adaptation to a HG diet. Our data revealed that with durations of an HG diet, the higher starch levels directly affected the colonic lumen environment (lower pH and higher fermentation parameters), which in turn filtered lumen-specific functional taxonomic groups (HG-sensitive and HG-tolerant taxa). The colonic epithelium then gave rise to a new niche that triggered endoplasmic reticulum stress to activate unfolded protein response, if the duration of endoplasmic reticulum stress was overlong, this process would regulate cell apoptosis (Caspase-3, Caspase-8, and TNFRSF21) to achieve a functional transformation.

Conclusions

Our results provide a holistic view of the colonic microbial assemblages and epithelium functional profile co-oscillation patterns in remodeling of colonic homeostasis during adaptation to an HG diet in a sheep model. These findings also provide a proof of concept that the microbe–host collaboration is vital for maintaining hindgut homeostasis to adapt to dietary dichotomies.
Factors affecting the clinical outcomes including patient satisfaction after Oxford unicompartmental knee arthroplasty: a retrospective study
Authors: Chen Yang , Fang Xinyu , Huang Zida , Li Wenbo , Zhang Wenming
Published: July 2020

Background

Oxford unicompartmental knee arthroplasty (UKA) is widely used for treating patients with unicompartmental knee diseases. However, the factors affecting the outcomes of and patients’ satisfaction with Oxford UKA remain controversial. The aims of this study were to evaluate the clinical and radiological outcomes, including patient satisfaction, after Oxford UKA and identify the influencing factors related to patients’ satisfaction.

Methods

We retrospectively analyzed the data of patients who underwent UKA in our medical institution from 2013 to 2018. Demographic information, clinical scores, patient satisfaction and imaging findings were recorded. The patients were followed up for at least 1 year. Multivariate Logistic regression analysis was performed to identify influencing factors related to clinical outcomes including patient satisfaction.

Results

A total of 80 patients (involving 87 knees) were included. The Numerical Rating Scale (NRS) scores and Knee Society Scores (KSS) were significantly improved after operation as compared to preoperative scores (6.0 vs. 1.0, P < 0.001; 113.0 ± 27.2 vs. 167.2 ± 23.9, P < 0.001), and the varus deformity was corrected (181.0 vs. 176.0, P < 0.05). Six patients (7.5%) developed postoperative complications, and no case suffered from prosthesis loosening. The time since operation (TSO) and angle E were found to be predictors of KSS improvement (P = 0.009; P = 0.024). The postoperative KSS and angle E were found to be predictors of patient satisfaction (P = 0.001; P = 0.032).

Conclusion

Oxford UKA can improve the NRS score and KSS and correct varus deformities. A shorter TSO and smaller angle E are indicators of a greater KSS improvement. A higher KSS and smaller angle E are indicative of higher patient satisfaction.
Effects of core stability exercise combined with virtual reality in collegiate athletes with nonspecific low back pain: a randomized clinical trial
Authors: Abdelraouf Osama Ragaa , Abdel-aziem Amr Almaz , Selim Ali Osman , Ali Olfat Ibrahim
Published: July 2020

Background

Nonspecific low back pain (LBP) in collegiate athletes is shown to be accompanied by poor core endurance. Consequently, trunk muscle stabilization exercises for lumbar instability are widely used. Virtual reality (VR) training can activate the cerebral cortex and enhance the cortex to control balance and improve motion function. The purpose of the study was to assess the effect of combined core stability exercises (CSE) and VR training in improving body balance and function in collegiate male athletes with nonspecific low back pain (LBP).

Results

The post-values of the experimental group were significantly higher than that of the control group for the dynamic balance in anterior (p = 0.031), posterolateral (p = 0.034), and posteromedial (p = 0.037) directions. Moreover, there was a significant difference in the post-values of both groups regarding reducing the Micheli Functional Scale in favor of the experimental group (p = 0.012).

Conclusions

CSE training plus virtual reality is more effective than CSE training alone in improving total body balance and dysfunction level in collegiate male athletes with nonspecific LBP. It is recommended that clinicians consider CSE combined with VR to maximize the improvement in overall body balance when developing rehabilitation programs for collegiate athletes with nonspecific low back pain.

Trial registration

Pan African Clinical Trial Registry, PACTR201907749053096. Retrospectively registered on 15 April 2019. https://pactr.samrc.ac.za/Researcher/ManageTrials.aspx
The effect of scapular dyskinesia on the scapular balance angle and upper extremity sensorimotor function in stroke patients with spasticity
Authors: Mahmoud Lama Saad El-Din , Aly Sobhy Mahmoud
Published: July 2020

Background

Post-stroke scapular dyskinesia is a predisposing factor for the affection of motor and somatosensory functions of the hemiparetic upper extremity.

Objective

The purpose of the study was to investigate the effect of scapular dyskinesia on the scapular balance angle and upper extremity sensorimotor function in stroke patients with spasticity.

Subjects and methods

Sixty patients with spasticity post-stroke participated in this study. The patients were assigned to one of the two groups as determined by the lateral scapular slide test (LSST) using the palpation meter (PALM); group A with scapular dyskinesia and group B stroke patients without scapular dyskinesia. The scapular position was determined by a measurement of scapular balance angle (SBA), and the upper extremity sensorimotor function was evaluated using Fugl-Meyer Assessment upper extremity (FMAUE) scale. The scapular balance angle and Fugl-Meyer upper extremity scores were compared between groups.

Results

There was a significant increase in the scapular balance angle of group A compared with that of group B (p < 0.001). Also, there was a significant decrease in sensory and motor functions of group A as measured by Fugl-Meyer upper extremity compared with that of group B (p < 0.001).

Conclusion

Scapular dyskinesia had a significant effect on the scapular balance angle and upper extremity sensorimotor function in stroke patients with spasticity. Management of scapular dyskinesia should be emphasized in the rehabilitation program for stroke patients with spasticity.
Simplified Method to Measure Mouse Fertility
Authors: Handelsman David J , Walters Kirsty A , Ly Lam P
Published: July 2020

Estimating breeding performance from mouse mating trials has focused on lifetime mating trials, which are too slow and costly for characterizing the many novel genetic mouse lines produced in fertility research, an underpinning of reproductive pathophysiology research. This study introduces the fertility index, defined as the slope of the regression of cumulative number of pups produced by a female over elapsed time in a monogamous mating trial. By using a robust resampling technique, the Theil-Sen estimator (widely available in free or niche statistical software), to estimate the fertility index, the present study of 410 mating trials of mice from 7 genotypes lasting a median of 10 litters shows that it is possible to estimate the fertility index reliably over as few as 4 litters.
Recurrence After Liver Resection of Colorectal Liver Metastases: Repeat Resection or Ablation Followed by Hepatic Arterial Infusion Pump Chemotherapy
Authors: Buisman Florian E. , Filipe Wills F. , Kemeny Nancy E. , Narayan Raja R. , Srouji Rami M. , Balachandran Vinod P. , Boerner Thomas , Drebin Jeffrey A. , Jarnagin William R. , Kingham T. Peter , Wei Alice C. , Grünhagen Dirk J. , Verhoef Cornelis , Koerkamp Bas Groot , D’Angelica Michael I.
Published: July 2020

Background

The aim of this study was to investigate the effectiveness of adjuvant hepatic arterial infusion pump (HAIP) chemotherapy after complete resection or ablation of recurrent colorectal liver metastases (CRLM).

Methods

A retrospective cohort study was conducted of patients from two centers who were treated with resection and/or ablation of recurrent CRLM only between 1992 and 2018. Overall survival (OS) and hepatic disease-free survival (hDFS) were estimated using the Kaplan–Meier method. The Cox regression method was used to calculate hazard ratios (HRs) with corresponding 95% confidence intervals (CI).

Results

Of 374 eligible patients, 81 (22%) were treated with adjuvant HAIP chemotherapy. The median follow-up for survivors was 65 months (IQR 32–118 months). Patients receiving adjuvant HAIP were more likely to have multifocal disease and receive perioperative systemic chemotherapy at time of resection for recurrence. A median hDFS of 46 months (95% CI 29–81 months) was found in patients treated with adjuvant HAIP compared with 18 months (95% CI 15–26 months) in patients treated with resection and/or ablation alone (p = 0.001). The median OS and 5-year OS were 89 months (95% CI 52–126 months) and 66%, respectively, in patients treated with adjuvant HAIP compared with 57 months (95% CI 47–67 months) and 47%, respectively, in patients treated with resection and/or ablation only (p = 0.002). Adjuvant HAIP was associated with superior hDFS (adjusted HR 0.599, 95% CI 0.38–0.93, p = 0.02) and OS (adjusted HR 0.59, 95% CI 0.38–0.92, p = 0.02) in multivariable analysis.

Conclusion

Adjuvant HAIP chemotherapy after resection and/or ablation of recurrent CRLM is associated with superior hDFS and OS.
Impact of COVID-19 on the access to hearing health care services for children with cochlear implants: a survey of parents
Authors: Ayas Mohammed , Ali Al Amadi Ahmad Mohd Haider , Khaled Duaa , Alwaa Ahmad Munzer
Published: July 2020

Background: The COVID-19 pandemic has affected the world in an unprecedented manner. It has aggravated psychological distress in parents of children with cochlear implants. Continuous use of a speech sound processor is critical for auditory stimulation in children with cochlear implants. However, movement restrictions imposed have affected access to hearing healthcare services. The current study explores the impact of the COVID-19 pandemic on hearing healthcare access for children with cochlear implants.

Methods: An online questionnaire survey was conducted among parents of children with cochlear implants.

Results: A total of 24 parents responded to the questionnaire. All the respondents reported that COVID-19 has a significant impact on access to hearing health services for their children. Speech processor breakdown and disconnection from the auditory mode of communication had a critical influence on behavioral changes in children.

Conclusions: The current study highlights the hurdles faced by the parents in order to access hearing health services for their children. The use of innovative methods such as remote tele-audiology will be the way forward to tackle challenges faced by the parents.
Research of personality types of employees of internal affairs agencies with negative mental states
Authors: Ruseckaya Dar'ya , Lebedev Igor'
Published: July 2020

The article deals with the problem of negative mental States that occur in employees of internal Affairs bodies when performing professional tasks. The analysis of modern scientific research on the studied problem is carried out. As part of this study, a psychodiagnostic tool was developed and tested to study negative mental States in police officers. The authors studied the negative mental States of employees of internal Affairs agencies and based on the data obtained, conducted a factor analysis that allowed us to determine the main factors for the occurrence of these conditions. Next, a cluster analysis was conducted, which revealed three types of personality of ATS employees with negative mental States: resistant to the effects of negative mental States; little exposed to the effects of negative mental States; exposed to negative mental States. Thanks to the data obtained in the course of the pilot study, the prospects for studying this problem are determined. The set of research methods corresponds to the tasks set; the choice of mathematical statistics methods corresponds to the characteristics of the sample population and takes into account the features of the psychological experiment. The value of the research is to update the study of the problem of negative mental States as a factor of maladaptation of professional activity of police officers.
Ewolucja ustroju politycznego V Republiki
Authors: Jamróz Adam
Published: July 2020

Evolution of the Constitutional System of the V Republic. A Few Reflections

The Constitution of the Fifth Republic of France after the reform of 1962 (introduction of the presidential election in a general vote) establishes, on a legal level, a semi-presidential system. Depending on the results of the presidential and parliamentary elections – in particular to the National Assembly – their result pointed towards “presidentialisation” of the system, meaning that the President could have in practice full executive powers (the government was responsible) or periods of cohabitation (cooperation), when the parliamentary majority represented an opposition option to the President of the Republic and the constitutional system revealed its parliamentary characteristics. The domination of the president in the Fifth Republic resulted not only (though mainly) from the political forces active at the time. Its sources are elucidated in article 5 of the Constitution, defining the functions of the president as the guardian of the Constitution and ensuring, through its arbitration, the regular functioning of public authorities and the continuity of the state. It is a tradition of republican France that political practice gives constitutional shape to legal constitutional norms; this was the case in the Fourth Republic, and even more so in the Third Republic.