bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility of ActivABLES to promote home-based exercise and physical activity of community-dwelling stroke survivors with support from caregivers: A mixed methods study
Authors: Olafsdottir Steinunn A. , Jonsdottir Helga , Bjartmarz Ingibjörg , Magnusson Charlotte , Caltenco Héctor , Kytö Mikko , Maye Laura , McGookin David , Arnadottir Solveig Asa , Hjaltadottir Ingibjörg , Hafsteinsdottir Thora B.
Published: June 2020

Background

Technical applications can promote home-based exercise and physical activity of community-dwelling stroke survivors. Caregivers are often able and willing to assist with home-based exercise and physical activity but lack the knowledge and resources to do so. ActivABLES was established to promote home-based exercise and physical activity among community-dwelling stroke survivors, with support from their caregivers. The aim of our study is to investigate the feasibility of ActivABLES in terms of acceptability, demand, implementation and practicality.

Methods

A convergent design of mixed methods research in which quantitative results were combined with personal experiences of a four-week use of ActivABLES by community-dwelling stroke survivors with support from their caregivers. Data collection before, during and after the four-week period included the Berg Balance Scale (BBS), Activities-Specific Balance Confidence Scale (ABC), Timed-Up-and-Go (TUG) and Five Times Sit to Stand Test (5xSST) and data from motion detectors. Semi-structured interviews were conducted with stroke survivors and caregivers after the four-week period. Descriptive statistics were used for quantitative data. Qualitative data was analysed with direct content analysis. Themes were identified related to the domains of feasibility: acceptability, demand, implementation and practicality. Data was integrated by examining any (dis)congruence in the quantitative and qualitative findings.

Results

Ten stroke survivors aged 55–79 years participated with their informal caregivers. Functional improvements were shown in BBS (+ 2.5), ABC (+ 0.9), TUG (− 4.2) and 5xSST (− 2.7). More physical activity was detected with motion detectors (stand up/sit down + 2, number of steps + 227, standing + 0.3 h, hours sitting/lying − 0.3 h). The qualitative interviews identified themes for each feasibility domain: (i) acceptability: appreciation, functional improvements, self-initiated activities and expressed potential for future stroke survivors; (2) demand: reported use, interest in further use and need for follow-up; (3) implementation: importance of feedback, variety of exercises and progression of exercises and (4) practicality: need for support and technical problems. The quantitative and qualitative findings converged well with each other and supported the feasibility of ActivABLES.

Conclusions

ActivABLES is feasible and can be a good asset for stroke survivors with slight or moderate disability to use in their homes. Further studies are needed with larger samples.
Construction and analysis of a lncRNA-miRNA-mRNA network based on competitive endogenous RNA reveal functional lncRNAs in oral cancer
Authors: Yin Junhao , Zeng Xiaoli , Ai Zexin , Yu Miao , Wu Yang’ou , Li Shengjiao
Published: June 2020

Background

A growing evidence suggests that long non-coding RNAs (lncRNAs) can function as a microRNA (miRNA) sponge in various diseases including oral cancer. However, the pathophysiological function of lncRNAs remains unclear.

Methods

Based on the competitive endogenous RNA (ceRNA) theory, we constructed a lncRNA-miRNA-mRNA network in oral cancer with the human expression profiles GSE74530 from the Gene Expression Omnibus (GEO) database. We used topological analysis to determine the hub lncRNAs in the regulatory ceRNA network. Then, function enrichment analysis was performed using the clusterProfiler R package. Clinical information was downloaded from The Cancer Genome Atlas (TCGA) database and survival analysis was performed with Kaplan-Meier analysis.

Results

A total of 238 potential co-dysregulated competing triples were obtained in the lncRNA-associated ceRNA network in oral cancer, which consisted of 10 lncRNA nodes, 41 miRNA nodes and 122 mRNA nodes. Additionally, we found lncRNA HCG22 exhibiting superior potential as a diagnostic and prognostic marker of oral cancer.

Conclusions

Our findings provide novel insights to understand the ceRNA regulation in oral cancer and identify a novel lncRNA as a potential molecular biomarker.
Usefulness of tissue Doppler-derived atrial electromechanical delay for identifying patients with paroxysmal atrial fibrillation
Authors: Akamatsu Kanako , Ito Takahide , Miyamura Masatoshi , Kanzaki Yumiko , Sohmiya Koichi , Hoshiga Masaaki
Published: June 2020

Background

Tissue Doppler imaging (TDI)-derived atrial electromechanical delay (AEMD) has been reported to be useful for detecting paroxysmal atrial fibrillation (PAF). However, its usefulness remains unknown when analyzed along with patients seemingly at high-risk for AF as controls. From this standpoint, we investigated whether AEMD would be of use for identifying patients with PAF.

Methods

We retrospectively analyzed TDI recordings to obtain AEMD in 63 PAF patients. Thirty-three patients with multiple cardiovascular risk factors (MRFs) but without history of AF and 50 healthy individuals served as disease and healthy controls, respectively. AEMD was defined as the time-interval between the electrocardiogram P-wave and the beginning of the spectral TDI-derived A’ for the septal (septal EMD) and lateral (lateral EMD) sides of the mitral annulus.

Results

There was no significant difference in the left atrial volume index between PAF patients and disease controls (28 ± 9 mL/m2 vs. 27 ± 5 mL/m2). PAF patients had longer AEMD, particularly for the lateral EMD (75 ± 23 ms), compared with disease (62 ± 22 ms, P = 0.009) and healthy (54 ± 24 ms, P < 0.001) controls. Multivariate logistic regression analysis revealed that the lateral EMD (OR 1.25, 95%CI 1.03–1.52, P = 0.023), along with the left atrial volume index (OR 2.25, 95%CI 1.44–3.51, P < 0.001), was one of the significant independent associates of identifying PAF patients.

Conclusions

This cross-sectional study indicates that even analyzed together with MRFs patients, AEMD remains useful for identifying patients at risk for AF. Our results need to be confirmed by a large-scale prospective study.
Validation of a vision-related activity scale for patients with retinitis pigmentosa
Authors: Costela Francisco M. , Pesudovs Konrad , Sandberg Michael A. , Weigel-DiFranco Carol , Woods Russell L.
Published: June 2020

Purpose

There have been few systematic reports of vision-related activity limitations of people with retinitis pigmentosa (RP). We report a merging of data from the National Eye Institute Visual Function Questionnaire (NEI-VFQ) obtained in five previous studies. We asked whether the Vision Function Scale (VFS; Pesudovs et al., 2010) which was developed for cataract patients would apply in this new population (condition).

Methods

Five hundred ninety-four individuals completed a total of 1753 questionnaires, with 209 participants providing responses over at least 4 years. Rasch analysis showed that the 15-item VFS was poorly targeted. A new instrument created by adding four driving-related items to the VFS had better targeting. As an indirect validation, VFS-plus person scores were compared to visual field area measured using a Goldmann perimeter, to the summed score for the combined 30–2 and 30/60–1 Humphrey Field Analyzer programs (HFA), to 30-Hz full-field cone electroretinogram (ERG) amplitude, and to ETDRS visual acuity. Changes in VFS-plus person scores with age and between four common heredity groups were also examined.

Results

The Rasch model of responses to the 19 VFS-plus items had person and item separation of 2.66 and 24.43 respectively. The VFS-plus person scores were related to each vision measure (p < 0.001). Over a five-year period, there was a reduction in person scores of 0.5 logits (p < 0.001). Person scores fell by an average of 0.34 logits per decade (p < 0.0001). Participants with an X-linked hereditary pattern had, on average, lower person scores (p < 0.001).

Conclusions

The VFS-plus instrument quantified a highly-significant annual reduction in perceived vision-related ability over a five-year period. The outcome was consistent with clinical measures of vision, and detected lower perceived vision-related ability in participants with X-linked disease. It may be of use in future studies, but this needs to be tested in a representative population sample.
Resection of recurrent hepatocellular carcinoma with thrombi in the inferior vena cava, right atrium, and phrenic vein: a report of three cases
Authors: Tomita Koichi , Shimazu Motohide , Takano Kiminori , Gunji Takahiro , Ozawa Yosuke , Sano Toru , Chiba Naokazu , Abe Yuta , Kawachi Shigeyuki
Published: June 2020

Background

Prognosis for patients with advanced hepatocellular carcinoma with a tumor thrombus in the inferior vena cava or right atrium is extremely poor due to cancer progression, pulmonary embolism, and congestion of the circulatory system caused by right heart failure. Surgical resection of the tumor thrombi may potentially yield better results than non-surgical treatments through prevention of sudden death. However, the benefits of surgical resection in patients with hepatocellular carcinoma and a tumor thrombus extending to the inferior vena cava, right atrium, and potentially in the phrenic vein are unclear. Here, we report three such cases.

Case presentation

Of the total 136 patients who underwent hepatectomies for hepatocellular carcinoma in our institution, three patients with prior hepatectomies and recurrent hepatocellular carcinoma had tumor thrombi in the inferior vena cava, right atrium, and phrenic vein. Surgical resections were performed, as there was a possibility of sudden death, despite the risk of leaving residual tumor. For all patients, we performed resection of the tumor thrombi in the inferior vena cava and right atrium and combined diaphragm resection. Surgical resection was performed using the total hepatic vascular exclusion technique in all cases. Additional passive veno-venous bypass was also performed in two cases, in which complete tumor resections could not be achieved. The microscopic surgical margins of the combined resected diaphragms were positive in all cases. Progression-free survival was 20.2, 3.8, and 9.5 months for case 1, 2, and 3, respectively. The respective overall postoperative survival was 98.0, 38.9, and 30.9 months. The patients died due to liver cirrhosis, acute heart failure, and hepatocellular carcinoma, respectively. Sudden death did not occur for any of the patients.

Conclusion

Surgical resections may extend prognosis for patients with recurrent hepatocellular carcinoma with tumor thrombi in the inferior vena cava, right atrium, and phrenic vein, although the indications should be considered carefully.
Epidemiological and clinical factors associated with post-exertional malaise severity in patients with myalgic encephalomyelitis/chronic fatigue syndrome
Authors: Ghali Alaa , Richa Paul , Lacout Carole , Gury Aline , Beucher Anne-Berengere , Homedan Chadi , Lavigne Christian , Urbanski Geoffrey
Published: June 2020

Background

Post-exertional malaise (PEM), the cardinal feature of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), occurs generally after exposure to a stressor. It is characterized by the worsening of ME/CFS symptoms and results in aggravating the course of the disease and the quality of life of patients. Due to its unpredictable onset, severity, and recovery time, identifying patients with higher risk for severe PEM would allow preventing or reducing its occurrence. We thus aimed at defining possible factors that could be associated with PEM severity.

Methods

Adult patients fulfilling ME international consensus criteria who attended the internal medicine department of University hospital Angers-France between October 2011 and December 2019 were included retrospectively. All patients were systematically hospitalized for an etiological workup and overall assessment. We reviewed their medical records for data related to the assessment: epidemiological data, fatigue features, clinical manifestations, and ME/CFS precipitants. PEM severity was appreciated by the Center for Disease Control self-reported questionnaire. The study population was classified into quartiles according to PEM severity scores. Analyses were performed with ordinal logistic regression to compare quartile groups.

Results

197 patients were included. PEM severity was found to be positively associated with age at disease onset ≥ 32 years (OR 1.8 [95% CI 1.1–3.0] (p = 0.03)), recurrent infections during the course of the disease (OR 2.1 [95% CI 1.2–3.7] (p = 0.009)), and when ME/CFS was elicited by a gastrointestinal infectious precipitant (OR 5.7 [1.7–19.3] (p = 0.006)).

Conclusion

We identified some epidemiological and clinical features, which were positively associated with PEM severity in subsets of ME/CFS patients. This could help improving disease management and patients’ quality of life.
COVID-19 pandemia and inherited cardiomyopathies and channelopathies: a short term and long term perspective
Authors: Limongelli Giuseppe , Crotti Lia
Published: June 2020

Inherited heart disease represent a very heterogenous group of cardiac disorders, characterized by inherited, acquired, and often rare disorders affecting the heart muscle (cardiomyopathies) or the cardiac electrical system (ion channel disease). They are often familial diseases, and are among the leading cause of juvenile sudden death and heart failure. The aim of this paper is to give a perspective on how to run a clinical service during an epidemic or pandemic emergency and to describe the potential COVID-19 associated risks for patients affected by inherited heart diseases.
Furosemide use in Italian neonatal intensive care units: a national survey
Authors: Manfredini Valeria Anna , Cerini Chiara , Clavenna Antonio , Dotta Andrea , Caccamo Maria Letizia , Staffler Alex , Massenzi Luca , Rezzonico Rossano Massimo ,   on the behalf of study Group of Neonatal Pharmacoterapy of the Italian Society of Neonatology
Published: June 2020

Background

Furosemide is approved in full term neonates to treat edema associated with congestive heart failure, cirrhosis and renal diseases. It is often administered off-label in premature neonates, to treat respiratory conditions and at doses greater-than-recommended. We conducted a national survey on behalf of the Neonatal Pharmacotherapy Study Group of the Italian Society of Neonatology (SIN), to investigate its use in Italian neonatal intensive care units (NICUs), in conformity with current guidelines.

Methods

Between December 2016 and June 2017, a 14-item multiple-choice online questionnaire was sent to all NICU directors from the SIN directory.

Gestational age, route of administration, posology, indications, referenced guidelines, adverse effects monitoring and the presence of Paediatric Cardiology or Cardiosurgery service on site were assessed. A chi-square test was performed 1) to evaluate differences in the distribution of responses between NICUs administering furosemide at doses higher-than-recommended; 2) to compare the proportion of NICUs administering furosemide at high doses in institutions with versus without a Paediatric Cardiology or Cardiosurgery service.

Results

The response rate was 50% (57/114). The intravenous and oral routes were chosen primarily; the intravenous administration in single doses predominated over continuous infusion. Its main therapeutic indications were congestive heart failure/overload (94.7%) and oligo-anuria (87.7%) however furosemide was also frequently used for broncopulmonary dysplasia (50.9%) and respiratory distress syndrome and/or transient tachypnea of the newborn (24.6%).

In 28/57 NICUs furosemide was administered at doses higher-than-recommended. In most NICUs the same posology was used in term and preterm neonates. Compared to the total sample, a larger proportion of NICUs administering doses greater-than-recommended referenced current literature for reasons to do so (19.3 and 32.1% respectively). The presence of a Paediatric Cardiology or Cardiosurgery service on site did not correlate with the chosen posology.

The majority of NICUs performed acoustic test and renal ultrasound for furosemide exposure greater than 2 weeks.

Conclusions

In Italian NICUs, furosemide is commonly prescribed to term and preterm newborns for label and unlabeled indications. Doses greater-than-recommended are frequently administered. Such use is not necessarily inappropriate. More research is required to assess the efficacy and safety of unlabeled use.
Predictors of cartilage degeneration in patients with subchondral insufficiency fracture of the femoral head: a retrospective study
Authors: Shimizu Tomohiro , Yokota Shunichi , Kimura Yosuke , Asano Tsuyoshi , Shimizu Hirokazu , Ishizu Hotaka , Iwasaki Norimasa , Takahashi Daisuke
Published: June 2020

Background

There is evidence that the cause of primary osteoarthritis (OA) is related to the changes in subchondral bone; however, the influence of subchondral insufficiency fracture (SIF) of the femoral head on the degeneration of the hip joint and the prognostic factors related to joint degeneration remain unclear. The objectives of this study were (1) to investigate the natural history of joint space width after the occurrence of SIF and (2) to investigate the associations between joint space narrowing and bone metabolic markers as well as magnetic resonance imaging (MRI) among the patients with SIF.

Methods

Between January 2010 and December 2019, 238 patients in whom band pattern of the femoral head were observed on MRI visited Hokkaido University Hospital. Among these patients, 44 hips in 41 patients were diagnosed with SIF and eligible for this retrospective study. We evaluated the joint space width (JSW) of the hip on the radiograph obtained at the first and last visits, length of the band lesion on MRI, bone mineral density by dual-energy X-ray absorptiometry, and bone metabolism markers. Similarly, the factors associated with the necessity of surgery and the progression of the narrowing of the joint space were evaluated.

Results

Fifteen of the 44 hips required total hip arthroplasty (THA). A significant decrease was observed in the JSW from the first visit to the final follow-up. Changes in the JSW were associated with the length of band patterns, serum type 1 procollagen-N-propeptide (P1NP), and tartrate-resistant acid phosphatase 5b (TRACP-5b) during diagnosis. Additionally, bone metabolic markers tended to be associated with the length of the band pattern.

Conclusions

SIF could cause joint space narrowing and hip OA. In addition to MRI findings as prognostic predictors of SIF, as previously described, bone metabolic markers were equally associated with changes in JSW, suggesting that these parameters could be useful in predicting the prognosis of SIF. Considering that bone metabolic markers trended to be associated with the length of band pattern, they might reflect the local severity.
Parenchymal lung disease in adult onset Still’s disease: an emergent marker of disease severity—characterisation and predictive factors from Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) cohort of patients
Authors: Ruscitti Piero , Berardicurti Onorina , Iacono Daniela , Pantano Ilenia , Liakouli Vasiliki , Caso Francesco , Emmi Giacomo , Grembiale Rosa Daniela , Cantatore Francesco Paolo , Atzeni Fabiola , Perosa Federico , Scarpa Raffaele , Guggino Giuliana , Ciccia Francesco , Barile Antonio , Cipriani Paola , Giacomelli Roberto
Published: June 2020

Background

Adult-onset Still’s disease (AOSD) is a systemic inflammatory disorder of unknown aetiology usually affecting young adults. Interestingly, recent evidence from the juvenile counterpart of AOSD suggested the emergent high fatality rate of lung disease (LD) in these patients. In this work, we aimed to characterise LD in AOSD, to identify associated clinical features and predictive factors, and to describe long-term outcomes of the disease comparing patients with LD and those without.

Methods

A retrospective assessment of prospectively followed patients, from January 2001 to December 2019, was provided to describe the rate of LD in AOSD, associated clinical features and predictive factors, and long-term outcomes. Patients with AOSD, who were included in Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) cohort, were assessed.

Results

Out of 147 patients included in GIRRCS cohort, 18 (12.25%) patients were reported to be affected by LD, at the time of diagnosis of AOSD, who were characterised by older age, a higher prevalence of myalgia, of lymph node involvement, of pleuritis, and abdominal pain. Furthermore, patients with LD showed higher values of systemic score and ferritin. Among those clinical variables, older age and systemic score were also independently predictors of LD. Chest CT scans were also obtained, and the most common finding was the peripheral consolidations in 8 (44.4%) patients. Finally, a higher mortality rate, of 38.9%, was registered in patients with LD than others, since it was associated with a significant decreased survival rate.

Conclusions

The presence of LD could suggest an emergent cause of mortality in AOSD, as observed in juvenile counterpart recognising a further marker of severity and poor prognosis to be careful evaluated. Patients with LD were also characterised by some clinical features, higher values of systemic score and ferritin than the others, identifying a subset of patients mostly burdened by systemic signs and symptoms. Although specific designed future studies are needed to fully elucidate the significance of LD in AOSD, a more accurate evaluation and management of this feature could improve the long-term outcomes of these patients.
Stool cultures show a lack of impact in the management of acute gastroenteritis for hospitalized patients in the Bronx, New York
Authors: Fraij Omar , Castro Neva , de Leon Castro Luis A. , Brandt Lawrence J.
Published: June 2020

Background

Acute gastroenteritis (AGE) is diagnosed with a presentation of > 1
episode of vomiting and > 3 episodes of diarrhea in a 24-h period. Treatment is
supportive, however, in severe cases antibacterial treatment may be indicated. Stool
cultures can detect the responsible pathogenic bacteria and can guide antibiotic
treatment, however, the indication for and efficacy of stool cultures is debatable. This
study aimed to address the clinical utility of stool cultures in patients diagnosed with
AGE.

Methods

A retrospective, multicenter study was performed in patients admitted for
AGE from 2012 to 2014. Patient charts were obtained through hospital software using
ICD-9 codes for AGE. Inclusion criteria was a documented diagnosis of AGE, age of 18
years or older, symptoms of both upper GI symptoms of abdominal pain and/or nausea
and lower GI symptoms of diarrhea. Patients were classified into two main groups,
those in whom (1) stool culture was obtained and (2) those in whom stool culture was
not performed. Clinical features and outcomes were compared between groups. The
diagnostic yield of stool cultures was assessed. All analysis were conducted using the
Statistical Package for Social Science (SPSS).

Results

Of 2479 patient charts reviewed, 342 met the above criteria for AGE. 119
patients (34.8%) had stool cultures collected and 223 (65.2%) did not. Demographics,
clinical features and serologic lab values are shown in Table 1. Of the 119 stool
cultures performed, only 4% (n = 5) yielded growth of pathogenic bacteria (2
Pseudomonas spp, 2 Campylobacter spp, 1 Salmonella spp). The group who
underwent stool culture had a higher percentage of patients with fevers (26% vs 13%,p < 0.003) and longer hospital length of stay (3.15 vs 2.28 days, p < 0.001) compared
to the group that did not undergo stool cultures.

Conclusion

Stool cultures are commonly ordered when AGE is suspected. In our
cohort, stool culture had a very low yield of detecting an underlying pathogen. Although
patients who had stool cultures obtained were more likely to be febrile and to have a
longer length of hospital stay than were those who did not have stool cultures, for the
vast majority of patients, stool culture played little to no role in patient management.
Further studies are needed to which patients benefit most from undergoing stool
culture.
Investigation of Burkholderia cepacia complex bacteremia outbreak in a neonatal intensive care unit: a case series
Authors: Bharara Tanisha , Chakravarti Anita , Sharma Mukesh , Agarwal Priti
Published: June 2020

Introduction

Burkholderia cepacia complex is a ubiquitous organism with a high virulence potential. It is found most commonly in moist environments. Hospital outbreaks have been reported from diverse sources such as contaminated faucets, nebulizers, disinfectant solutions, multidose antibiotic vials, tap water, bottled water, nasal sprays, and ultrasound gels. In this article, we present our experience in investigating and successfully managing an outbreak of nosocomial transmission of Burkholderia cepacia sepsis in the neonatal intensive care unit at SGT Hospital, Haryana, India.

Case presentation

During the month of March, multiple Burkholderia cepacia complex isolates were recovered from blood cultures of Caucasian babies admitted to the neonatal intensive care unit of our hospital. The organisms were multidrug-resistant, with in vitro sensitivity to meropenem alone (minimum inhibitory concentration = 4 μg/ml). An outbreak was suspected, and the neonatal intensive care unit in-charge and hospital infection control teams were alerted. Outbreak investigation was initiated, and surveillance samples were collected. Burkholderia cepacia complex was successfully isolated from suction apparatus. The isolates were phenotypically typed (biotyping and antimicrobial susceptibility testing) and found to be identical.

Conclusions

In our study, the index case might have been exposed to infection due to a physiological state of low immunity (preterm, low birth weight, and mechanical ventilation). The rest of the cases might have been exposed to this organism due to inadequate hand hygiene/improper cleaning and disinfection practices. Timely reporting and implementation of infection control measures played a significant role in curtailing this outbreak.
Research on semi-supervised multi-graph classification algorithm based on MR-MGSSL for sensor network
Authors: Gang Yang , Na Zhang , Tao Jin , Dawei Wang , Yinzhu Kang , Feng Gao
Published: June 2020

With the advent of the era of network information, the amount of data in network information is getting larger and larger, and the classification of data becomes particularly important. Current semi-supervised multi-map classification methods cannot quickly and accurately perform automatic classification and calculation of information. Therefore, this paper proposes an MR-MGSSL algorithm and applies it to the classification of semi-supervised multi-graph. By determining the basic idea and calculation framework of MR-MGSSL algorithm, the mining of optimal feature subsets in multi-graphs and the multi-graph vectorization performance time are taken as examples, and the proposed algorithm is compared with other semi-supervised multi-graph classification methods. The performance evaluation results show that compared with other classification calculation methods, MR-MGSSL algorithm has the advantages of low sensitivity to feature subgraph and short vectorization time. The method is used to extract and detect clouds in remote sensing images (GF-1 and GF-2).
Critical Reliability Issues of Common Type Alcohol-Based Handrub Dispensers
Authors: Bánsághi Száva , Soule Hervé , Guitart Chloé , Pittet Didier , Haidegger Tamás
Published: June 2020

Background

Hand hygiene can only be efficient if the whole hand surface is treated with sufficient alcohol-based handrub (ABHR); therefore, the volume of handrub applied is a critical factor in patient safety. The proper amount of ABHR should be provided by handrub dispensers. The aim of this study was to investigate the dispensing performance of wall-mounted ABHR dispensers commonly employed in hospital settings.

Method

In a multicenter study, we tested 46 dispensers (22 in laboratory and 24 in clinical environments), measuring dispensed ABHR volume during continuous use and after a period of non-use. The influence of the pumping mechanism, liquid level, ABHR formats, handrub composition, temperature, and atmospheric pressure was investigated.

Results

A total of 7 out of the 22 investigated dispensers (32%) lost a significant amount of handrub; greater than 30% of the nominal volume after 8 h of non-use, thus frequently dispensing suboptimal volume, as measured in laboratory settings. Key influencing factors were found to be handrub format (gel or liquid), handrub level in the container and type of dispenser. When gel ABHR was used, after 4 h of non-use of the dispensers, the volume of the dispensed amount of ABHR insignificantly changed (97% of the original amount), while it technically decreased to zero in the case of liquid ABHR (1% of the original amount). The liquid level had a medium effect on the dispensed volume in each investigated case; the magnitude of this effect varied widely depending on the dispensing mechanism. When dispensers were in continuous use, they dispensed a cumulated 3 mL of ABHR from two consecutive pushes, while when they were not in use for 1 h, up to 4 consecutive pushes were necessary to provide a total of 3 mL ABHR. Design and production quality were also identified as important contributing factors with respect to the volume dispensed. Data collected in clinical settings confirmed these findings, for multiple types of dispensers.

Conclusion

All ABHR dispensers should be regularly audited to control the reference volume distributed, with particular attention paid to regular mechanical pump units filled with liquid handrub.
RNA sequencing reveals that Prx II gene knockout can down-regulate the allograft rejection of dermal mesenchymal stem cells
Authors: Han Ying-Hao , Mao Ying-Ying , Yu Nan-Nan , Jin Mei-Hua , Jin Ying-Hua , Wang Ai-Guo , Zhang Yong-Qing , Shen Gui-Nan , Cui Yu-Dong , Yu Li-Yun , Lee Dong-Seok , Jo Yu-Jin , Sun Hu-Nan , Kwon Jeongwoo , Kwon Taeho
Published: June 2020

In this study, we used RNA sequencing (RNA-seq) to analyze and compare bulk cell samples from wild-type (WT) dermal mesenchymal stem cells (DMSCs) (n = 3) andPrx IIknockout DMSCs (n = 3). The purpose of the study was to elucidate the role ofPrx IIon allogeneic immune rejection of transplanted DMSCs. The results revealed differential expression of 472 genes (176 up-regulated and 296 down-regulated;p ≤ 0.05) between the PrxII+/+(WT) and PrxII−/−sample groups. When highly regulated genes were categorized according to the Gene Ontology (GO) molecular function classification and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, the PrxII−/−samples showed a robust downward trend in allograft rejection. The study identified 43 all immunologically rejected differentially expressed genes, of which 41 showed lower expression in the PrxII−/−vs. PrxII+/+(WT) samples. These findings suggest thatPrx IIgene knockout may down-regulate the allograft rejection that occurs during DMSCs transplantation and improve the survival rate of DMSCs in the host. This study provides a new perspective on the clinical treatment of stem cell transplantation.
The relationship between age and suicidal thoughts and attempted suicide among prisoners
Authors: Stoliker Bryce E. , Verdun-Jones Simon N. , Vaughan Adam D.
Published: June 2020

Background

Suicide is a major problem across the lifespan, yet rates are highest among middle-aged and older adults; a trend which remains relatively stable across varying sociological settings, including prisons. Despite this understanding, there is limited knowledge on the nature of suicidal thoughts and attempts among older prisoners, especially with respect to how they compare to younger counterparts. The present study aimed to increase insight into the relationship between age and suicidal thoughts and attempted suicide among prisoners, with particular focus on factors that may explain age-based variability.

Results

Cross-sectional data were drawn from a nationally representative sample of 18,185 prisoners housed within 326 prisons across the United States. In general, analyses revealed that: (a) attempted suicide was more commonly reported among younger prisoners, while suicidal ideation was more commonly reported among older prisoners; (b) the relationship between age and probability of reporting suicidal thoughts and behavior is curvilinear; (c) younger and older prisoners exhibit somewhat differing predictive patterns of suicidal thoughts and behavior (e.g., physical illness is directly associated with suicidal history for younger prisoners, whereas the effect of physical illness on suicidal history for older prisoners is mediated by depression).

Conclusions

There is evidence to suggest that suicidal thoughts and behavior may manifest differently for younger and older prisoners, with differing patterns of risk. More research is needed on age-based variability in suicidal thoughts and attempted suicide among prisoners, as well as those factors that might explain this variability. Importantly, future research must continue to investigate the nature of suicidal thoughts and behavior among older prisoners.
Early prediction of high flow nasal cannula therapy outcomes using a modified ROX index incorporating heart rate
Authors: Goh Ken Junyang , Chai Hui Zhong , Ong Thun How , Sewa Duu Wen , Phua Ghee Chee , Tan Qiao Li
Published: June 2020

Background

The ROX index (ratio of pulse oximetry/FIO2 to respiratory rate) has been validated to predict high flow nasal cannula therapy (HFNC) outcomes in patients with pneumonia. We evaluated a modified ROX index incorporating heart rate (HR) in patients initiated on HFNC for acute hypoxemic respiratory failure and as a preventative treatment following planned extubation.

Methods

We performed a prospective observational cohort study of 145 patients treated with HFNC. ROX-HR index was defined as the ratio of ROX index over HR (beats/min), multiplied by a factor of 100. Evaluation was performed using area under the receiving operating characteristic curve (AUROC) and cutoffs assessed for prediction of HFNC failure: defined as the need for mechanical ventilation.

Results

Ninety-nine (68.3%) and 46 (31.7%) patients were initiated on HFNC for acute hypoxemic respiratory failure and following a planned extubation, respectively. The majority (86.9%) of patients had pneumonia as a primary diagnosis, and 85 (56.6%) patients were immunocompromised. Sixty-one (42.1%) patients required intubation (HFNC failure). Amongst patients on HFNC for acute respiratory failure, HFNC failure was associated with a lower ROX and ROX-HR index recorded at time points between 1 and 48 h. Within the first 12 h, both indices performed with the highest AUROC at 10 h as follows: 0.723 (95% CI 0.605–0.840) and 0.739 (95% CI 0.626–0.853) for the ROX and ROX-HR index respectively. A ROX-HR index of > 6.80 was significantly associated with a lower risk of HFNC failure (hazard ratio 0.301 (95% CI 0.143–0.663)) at 10 h. This association was also observed at 2, 6, 18, and 24h, even with correction for potential confounding factors. For HFNC initiated post-extubation, only the ROX-HR index remained significantly associated with HFNC failure at all recorded time points between 1 and 24 h. A ROX-HR > 8.00 at 10 h was significantly associated with a lower risk of HFNC failure (hazard ratio 0.176 (95% CI 0.051–0.604)).

Conclusion

While validation studies are required, the ROX-HR index appears to be a promising tool for early identification of treatment failure in patients initiated on HFNC for acute hypoxemic respiratory failure or as a preventative treatment after a planned extubation.
A comparative anatomy of the lingual apparatus of Indian doves (genus: Streptopelia and Stigmatopelia), Aves: Columbidae
Authors: Trivedi Varsha
Published: June 2020

Background

The structure of the lingua of birds frequently gives some clue to the principal diet and manner of feeding of the species. The lingua is suitably modified for this purpose or does not intent the present work to understand it. The anatomical details of the lingual apparatus and their associated epidermal, musculature, and osteological elements of Indian doves (Aves: Columbidae) Eurasian collared dove (Streptopelia decaocto) and laughing dove (Stigmatopelia senegalensis) with comparison are lacking in the literature.

Results

A total of eight (n = 8/species) freshly preserved adult specimens with natural mortalities from Central Saurashtra, Western India, were examined. All the morphological features of species were observed in living as well as in preserved with the help of a pair of binoculars in the field and in the laboratory with stereo zoom dissecting microscope and camera lucida which are used for illustrations. The anatomical study includes the epidermal structures of the buccal region, lingua, apparatus hyobranchialis, and lingual muscles in relation to feeding behaviors and food. All these aspects are correlated with the food habits and finally with the muscles which bring about the suitable movements of the lingua.

Conclusion

The lingua in Eurasian collared dove (Streptopelia decaocto) and laughing dove (Stigmatopelia senegalensis) studied here does not exhibit any wide variations in appearance as such. Although the comparison between the two dove species is reflected, a relation in diverse food habits and all the morphological variables do not reflect allometric consequences of selection on body size. Finally, the assumption appears intuitively right between morphology, food habits, and variable size of the food items and clears various microhabitat choices in adverse conditions.
Uncombined precise orbit and clock determination of GPS and BDS-3
Authors: Zeng Tian , Sui Lifen , Ruan Rengui , Jia Xiaolin , Feng Laiping
Published: June 2020

There is increasing concern about the uncombined (UC) observation model in the field of global navigation satellite system (GNSS). Based on the global positioning system (GPS) and the third-generation BeiDou navigation satellite system (BDS-3), this study processed the UC precision orbit determination (POD) for single and dual systems. First, a UC observation model suitable for multi-GNSS POD was derived, and the ionospheric-free (IF) combination observation model was presented. Although the ambiguity parameters of UC and IF strategies were different after reparameterization, the difference could be removed when processing ambiguity resolution, and the equivalence was proved theoretically. To demonstrate the accuracy of BDS-3 orbits fully, the observation data of approximately 1 month were selected for determining the precise orbit for global positioning system (GPS) only, BDS-3 only, and GPS/BDS-3 systems based on the UC and IF models. The orbit precision of BDS-3 satellites was validated by using metrics, including comparison with precision products released by Wuhan University, orbit boundary discontinuity, and satellite laser ranging (SLR) residuals. The results show that the orbit accuracies of the IF and UC models are almost the same, the difference in orbits is approximately several millimeters, and the clock difference is within 0.01 ns. The GPS/BDS-3 combined solution shows better accuracy compared to other solutions. The average accuracies in the R and 3D directions are approximately 4 and 15 cm, and the clock standard deviation is approximately 0.2 ns compared to external orbit product. The root mean square of SLR residuals is approximately 4 cm.
Anti-angiogenic activity of chloride and potassium channel modulators: repurposing ion channel modulators
Authors: Kamili Chandana , Kandoti Hima Sowmya , Radhakrishnan Sharadha , Konde Abbulu , Vattikutti Uma Maheshwara Rao
Published: June 2020

Background

Excessive angiogenesis can be the root cause of many pathological conditions. Various types of ion channels are found on the endothelial cells. These ion channels play a vital role in the multi-stepped process of angiogenesis. The study aims to investigate the anti-angiogenic effects of specific ion channel modulators mefloquine (volume-regulated chloride channel blocker), lubiprostone (ClC-2 channel agonist), and 4-aminopyridine (voltage-gated potassium channel blocker).

Results

The anti-angiogenic activity of ion channel modulators was screened by measuring its effects on the area of neovascularization and histopathological studies by in vivo (corneal neovascularization) method and by in vitro assays, endothelial cell proliferation assay, cell migration assay, and matrigel cord-like morphogenesis assay. The test and standard drug (bevacizumab) groups were compared with the control group using one-way ANOVA, followed by post hoc test, and Dunnett’s test to compare the mean of all the groups with the control mean. The results revealed that mefloquine at the dose of 0.6% w/v and 1.0% w/v, lubiprostone at the dose of 0.5% w/v and 1.0% w/v, and 4-aminopyridine at the dose of 2% w/v and 4% w/v showed significant anti-angiogenic property. In the studies on human umbilical vein endothelial cells, the test drugs (100 nM) showed significant inhibition of proliferation, migration, and decrease in network length of cord-like tubes.

Conclusion

The scientific findings indicate that the test drugs have potent anti-angiogenic activity by inhibiting the cell proliferation, inhibiting the cell volume increase, arresting the cell cycle progression and by causing membrane hyperpolarization. The potent anti-angiogenic drugs obtained by repurposing these ion channel modulators, in the further studies, will be able to treat the diseases due to excess angiogenesis from the root cause.

Graphical abstract
Antibiotic use on crops in low and middle-income countries based on recommendations made by agricultural advisors
Authors: Taylor Philip , Reeder Robert
Published: June 2020

Background

Microbial resistance to medically important antibiotics is of international concern. There is considerable attention paid to the medical and veterinary use of antibiotics but there is a paucity of data on their use in global crop production. The only well documented use of antibiotics on crops is that on top fruit in the USA. Due to the absence of other data it is generally assumed that this use comprises the bulk of antibiotics applied to plants. The goal of this study was to investigate the scale and diversity of antibiotics being recommended for managing crop health problems in LMICs and the crops and types of problems for which they are selected.

Methods

Plantwise is an international program which assists with the provision of agronomic advice to smallholder farmers in LMICs. Recommendations relating to the management of crop problems are stored in an international database, comprising over 400,000 records collected over 8 years. The extent of antibiotic use in crop production when grouped by the WHO regions was analysed using descriptive statistics.

Results

Within our data all WHO regions of the world are using antibiotics on crop plants with the exception of Africa (no data for Europe) and the main crop on which they are used is rice. In some years, and in one region, nearly 10% of the management recommendations for rice contained an antibiotic. Eleven antibiotics are being recommended on crops (often blended together) and there is considerable regional variation as to where they are used. The problems against which antibiotics are recommended are extremely varied and we speculate that they are often used as a prophylactic spray to prevent, or control, low levels of bacterial disease.

Conclusions

The data reveals that antibiotics are being recommended far more frequently and on a much greater variety of crops than previously thought. Relative to medical and veterinary use the quantities used globally are comparatively small, but this niche does provide some unique avenues by which resistance could develop in human pathogens. Results presented here have implications for those wanting to limit the spread of antibiotic resistance.
Endophytic colonization of tomato plants by the entomopathogenic fungus
Beauveria bassiana
for controlling the South American tomato pinworm,
Tuta absoluta
Authors: Silva Ana Carolina Loreti , Silva Gerson Adriano , Abib Pedro Henrique Nogueira , Carolino Aline Teixeira , Samuels Richard Ian
Published: June 2020

Background

The deployment of entomopathogenic fungi (EPF) for the control of crop pests is an important alternative to synthetic pesticides. Despite recent advances in EPF formulations and application techniques, their efficacy is still limited by abiotic and biotic factors. Entomopathogenic fungi naturally colonize plant tissues or they can be artificially inoculated, protecting the plants from insect attack.
Beauveria bassiana
is the most widely used fungal biological control agent and has potential as an endophyte to protect a range of crops. Although
B. bassiana
is known to be pathogenic to the South American tomato pinworm,
Tuta absoluta
(Meyrick), this fungus could be more efficient when deployed as an endophyte to protect tomato plants from attack.

Methods

Three
B. bassiana
isolates were screened for virulence against
T. absoluta
larvae by application of conidia to leaf surfaces. Following confirmation of virulence, tomato plants were then exposed to conidial suspensions using a forced uptake technique. Only one isolate, LPP139, colonized the leaves. Seedlings were then inoculated with LPP139 and the presence of the fungus in different plant tissues was monitored over 30 days. Possible effects of
B. bassiana
endophytic colonization on plant development were also evaluated. Following confirmation of endophytic colonization of leaf tissues,
T. absoluta
2nd or 3rd instar larvae were offered leaves and survival was monitored over a 7-day period.

Results

All three
B. bassiana
isolates were virulent to
T. absoluta
, with approximately 90% mortality over 10 days when conidia had been applied to leaf surfaces. Various plant inoculation techniques were tested but only seedling inoculation was successful. LPP139 successfully colonized all of the plant tissues. High percentages of colonization were observed in roots, stems and leaves up to 30 days after inoculation, with no negative effects on plant growth. When
T. absoluta
larvae were exposed to
B. bassiana
colonized leaves, survival was reduced to zero over a 7-day period.

Conclusions

The endophytic colonization of tomato plants with EPF is a promising method of controlling the South American tomato pinworm. The fungus was detectable for up to 30 days, longer than has been previously observed for tomato plants. Seedling inoculation could be a viable commercial option for marketing pre-colonized tomato plants.