bluuebunny/crossref_metadata_2025 huggingface dataset:
Tolerance of torasemide in cats with congestive heart failure: a retrospective study on 21 cases (2016–2019)
Authors: Poissonnier Camille , Ghazal Sarra , Passavin Peggy , Alvarado Maria-Paz , Lefort Solène , Trehiou-Sechi Emilie , Saponaro Vittorio , Barbarino Alix , Delle Cave Julia , Marchal Charlie-Rose , Depré Boris , Vannucci Etienne , Tissier Renaud , Verwaerde Patrick , Chetboul Valérie
Published: September 2020

Background

In dogs with congestive heart failure (CHF), the efficacy of torasemide, a loop diuretic, has been demonstrated. However, unlike in dogs and humans little has been described about the use of torasemide in the cat with spontaneous CHF. The objectives of this retrospective study were therefore to describe the therapeutic use of oral torasemide in cats with spontaneous CHF, document its potential adverse effects while reporting the clinical course of this feline population following torasemide administration in addition to standard medical therapy.

Results

Medical records of 21 client-owned cats with CHF (median age = 10.6 years [interquartile range (IQR) = 6.5–11.2]) receiving torasemide were reviewed. Data collected included torasemide dosages, other concurrent medications, physical examination features, echocardiographic data, and potential adverse effects during follow-up. A survival analysis was performed to estimate the time from diagnosis to cardiac death. Dyspnea related to CHF was identified in all cats (pleural effusion [8/21], pulmonary edema [5/21] or both [8/21]), associated with ascites in 4/21 cats. The CHF cause was determined by echocardiography in all cats: hypertrophic (n = 10), restrictive (n = 6), arrhythmogenic right ventricular (n = 3), dilated (n = 1) cardiomyopathies, and aortic valve abnormality (n = 1). At initiation, median torasemide dosage was 0.21 mg/kg [IQR = 0.17–0.23] q24h. Clinical signs declined in most cats (20/21) during the first 2 weeks with no remarkable adverse events. Median survival time after torasemide prescription was 182 days [IQR = 46–330]. A contemporary control group including 54 cats with CHF, receiving furosemide as sole loop diuretic treatment was compared with the study group. Median (IQR) survival time of cats in the control group was not significatively different (p = 0.962) from that of the torasemide group, i.e., 148 days (9–364), although the torasemide group included significantly more cats with recurrent episodes of CHF (52%) that the control group (19%).

Conclusions

This case series demonstrates that torasemide can be used in cats with spontaneous CHF. This therapeutic interest needs to be confirmed by prospective clinical trials.
Plasma, urine and tissue concentrations of Flunixin and Meloxicam in Pigs
Authors: Nixon Emma , Mays Travis P. , Routh Patricia A. , Yeatts James L. , Fajt Virginia R. , Hairgrove Thomas , Baynes Ronald E.
Published: September 2020

Background

The objective of this study was to determine the renal clearance of flunixin and meloxicam in pigs and compare plasma and urine concentrations and tissue residues. Urine clearance is important for livestock show animals where urine is routinely tested for these drugs. Fourteen Yorkshire/Landrace cross pigs were housed in individual metabolism cages to facilitate urine collection. This is a unique feature of this study compared to other reports. Animals received either 2.2 mg/kg flunixin or 0.4 mg/kg meloxicam via intramuscular injection and samples analyzed by mass spectrometry. Pigs were euthanized when drugs were no longer detected in urine and liver and kidneys were collected to quantify residues.

Results

Drug levels in urine reached peak concentrations between 4 and 8 h post-dose for both flunixin and meloxicam. Flunixin urine concentrations were higher than maximum levels in plasma. Urine concentrations for flunixin and meloxicam were last detected above the limit of quantification at 120 h and 48 h, respectively. The renal clearance of flunixin and meloxicam was 4.72 ± 2.98 mL/h/kg and 0.16 ± 0.04 mL/h/kg, respectively. Mean apparent elimination half-life in plasma was 5.00 ± 1.89 h and 3.22 ± 1.52 h for flunixin and meloxicam, respectively. Six of seven pigs had detectable liver concentrations of flunixin (range 0.0001–0.0012 µg/g) following negative urine samples at 96 and 168 h, however all samples at 168 h were below the FDA tolerance level (0.03 µg/g). Meloxicam was detected in a single liver sample (0.0054 µg/g) at 72 h but was below the EU MRL (0.065 µg/g).

Conclusions

These data suggest that pigs given a single intramuscular dose of meloxicam at 0.4 mg/kg or flunixin at 2.2 mg/kg are likely to have detectable levels of the parent drug in urine up to 2 days and 5 days, respectively, after the first dose, but unlikely to have tissue residues above the US FDA tolerance or EU MRL following negative urine testing. This information will assist veterinarians in the therapeutic use of these drugs prior to livestock shows and also inform livestock show authorities involved in testing for these substances.
Unpack the Salt: an evaluation of the Victorian Salt Reduction Partnership’s media advocacy activities to highlight the salt content of different foods
Authors: Rosewarne Emalie , Trieu Kathy , Farrand Clare , Reimers Jenny , Potter Jane , Davidson Chelsea , Darrigan Natasha , Joldeski Elizabeth , Armstrong Sian , Webster Jacqui
Published: September 2020

Background

Australians are consuming almost double the recommended maximum salt intake. The Victorian Salt Reduction Partnership was established to coordinate efforts to reduce salt intake in the state of Victoria. As part of an intervention strategy, media advocacy strategies were used to raise public awareness and stimulate industry and government action on salt reduction. This study aimed to evaluate the Victorian Salt Reduction Partnership’s media advocacy activities by determining the extent to which activities contributed to the overall strategy aims and the effectiveness of the activities in gaining media and industry engagement.

Methods

A framework for evaluating media advocacy strategies used in complex public health interventions was used to guide this evaluation. Media advocacy activities were monitored and documented throughout the intervention period. A content analysis of media release press statements was performed. Indicators of media coverage (media items, cumulative audience reach, advertising space rate) and food industry engagement (number of meetings, number and type of follow up actions) were tracked.

Results

Six media releases were issued between March 2017 and November 2018 on different processed food categories including breads, cooking sauces, ready meals, dips and crackers, processed meats and Asian-style sauces. Three main themes were identified in the qualitative analysis of the press statements: general information on salt and health, salt levels in foods, and calls to action for consumers, industry and/or government. These themes were aligned with the overall intervention strategy. Media items (print and online news, radio and TV) generated by each release ranged from 36 to 274, and cumulative audience reach (opportunities to see) ranged from 2.3 to 7.5 million Australians per release. One to three food manufacturers were met with per media release.

Conclusions

Disseminating sodium-monitoring data through media releases can be used as a tool to gain access to the media and reach consumers with salt reduction messages, and to engage food manufacturers in discussions about salt reduction. Characteristics of media advocacy activities, including alignment with the overall strategy, and external factors outside the of control of the program implementers, can influence media and industry engagement. When planning future nutrition interventions that include media advocacy activities, internal and external factors impacting outcomes, should be considered, documented and evaluated.
Quantification of left ventricular mass by echocardiography compared to cardiac magnet resonance imaging in hemodialysis patients
Authors: Grebe Sören Jendrik , Malzahn Uwe , Donhauser Julian , Liu Dan , Wanner Christoph , Krane Vera , Hammer Fabian
Published: September 2020

Background

Left ventricular hypertrophy (LVH), defined by the left ventricular mass index (LVMI), is highly prevalent in hemodialysis patients and a strong independent predictor of cardiovascular events. Compared to cardiac magnetic resonance imaging (CMR), echocardiography tends to overestimate the LVMI. Here, we evaluate the diagnostic performance of transthoracic echocardiography (TTE) compared to CMR regarding the assessment of LVMI in hemodialysis patients.

Methods

TTR and CMR data for 95 hemodialysis patients who participated in the MiREnDa trial were analyzed. The LVMI was calculated by two-dimensional (2D) TTE-guided M-mode measurements employing the American Society of Echocardiography (ASE) and Teichholz (Th) formulas, which were compared to the reference method, CMR.

Results

LVH was present in 44% of patients based on LVMI measured by CMR. LVMI measured by echocardiography correlated moderately with CMR, ASE: r = 0.44 (0.34–0.62); Th: r = 0.44 (0.32–0.62). Compared to CMR, both echocardiographic formulas overestimated LVMI (mean ∆LVMI (ASE-CMR): 19.5 ± 19.48 g/m2, p < 0.001; mean ∆LVMI (Th-CMR): 15.9 ± 15.89 g/m2, p < 0.001). We found greater LVMI overestimation in patients with LVH using the ASE formula compared to the Th formula. Stratification of patients into CMR LVMI quartiles showed a continuous decrease in ∆LVMI with increasing CMR LVMI quartiles for the Th formula (p < 0.001) but not for the ASE formula (p = 0.772). Bland-Altman analysis showed that the Th formula had a constant bias independent of LVMI. Both methods had good discrimination ability for the detection of LVH (ROC-AUC: 0.819 (0.737–0.901) and 0.808 (0.723–0.892) for Th and ASE, respectively).

Conclusions

The ASE and Th formulas overestimate LVMI in hemodialysis patients. However, the overestimation is less with the Th formula, particularly with increasing LVMI. The results suggest that the Th formula should be preferred for measurement of LVMI in chronic hemodialysis patients.

Trial registration

The data was derived from the following clinical trial: NCT01691053, registered on 19 September 2012 before enrollment of the first participant.
Phytotherapies in motion: French Guiana as a case study for cross-cultural ethnobotanical hybridization
Authors: Tareau M.-A. , Bonnefond A. , Palisse M. , Odonne G.
Published: September 2020

Background

French Guiana is characterized by a very multicultural population, made up of formerly settled groups (Amerindians, Maroons, Creoles) and more recent migrants (mostly from Latin America and the Caribbean). It is the ideal place to try to understand the influence of intercultural exchanges on the composition of medicinal floras and the evolution of phytotherapies under the effect of cross-culturalism.

Methods

A combination of qualitative and quantitative methods was used. Semi-directive interviews were conducted in 12 localities of French Guiana’s coast between January 2016 and June 2017, and the responses to all closed questions collected during the survey were computerized in an Excel spreadsheet to facilitate quantitative processing. Herbarium vouchers were collected and deposited at the Cayenne Herbarium to determine Linnaean names of medicinal species mentioned by the interviewees. A list of indicator species for each cultural group considered was adapted from community ecology to this ethnobiological context, according to the Dufrêne-Legendre model, via the “labdsv” package and the “indval” function, after performing a redundancy analysis (RDA).

Results

A total of 205 people, belonging to 15 distinct cultural groups, were interviewed using semi-structured questionnaires. A total of 356 species (for 106 botanical families) were cited. We observed that pantropical and edible species hold a special place in these pharmacopeias. If compared to previous inventories, 31 recently introduced species can be counted. Furthermore, this study shows that the majority of the plants used are not specific to a particular group but shared by many communities. However, despite this obvious cross-culturalism of medicinal plants between the different cultural communities of French Guiana, divergent trends nevertheless appear through the importance of 29 indicator/cultural keystone species in 10 cultural groups. Finally, we have emphasized that the transmission of herbal medicine’s knowledge in French Guiana is mainly feminine and intra-cultural.

Conclusion

French Guianese medicinal flora is undoubtedly related to the multiple cultures that settled this territory through the last centuries. Cultural pharmacopeias are more hybrid than sometimes expected, but cultural keystone species nevertheless arise from a common background, allowing to understand, and define, the relationships between cultural groups.
Intensity-modulated radiation therapy versus three-dimensional conformal radiotherapy in head and neck squamous cell carcinoma: long-term and mature outcomes of a prospective randomized trial
Authors: Gupta Tejpal , Sinha Shwetabh , Ghosh-Laskar Sarbani , Budrukkar Ashwini , Mummudi Naveen , Swain Monali , Phurailatpam Reena , Prabhash Kumar , Agarwal Jai Prakash
Published: September 2020

Purpose

To compare long-term disease-related outcomes and late radiation morbidity between intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) in head and neck squamous cell carcinoma (HNSCC) in the setting of a prospective randomized controlled trial.

Methods

Previously untreated patients with early to moderately advanced non-metastatic squamous carcinoma of the oropharynx, larynx, or hypopharynx (T1-T3, N0-N2b, M0) planned for comprehensive irradiation of primary site and bilateral neck nodes were randomly assigned to either IMRT or 3D-CRT after written informed consent. Patients were treated with 6MV photons to a total dose of 70Gy/35 fractions over 7 weeks (3D-CRT) or 66Gy/30 fractions over 6 weeks (IMRT). A sample size of 60 patients was estimated to demonstrate 35% absolute difference in the incidence of ≥grade 2 acute xerostomia between the two arms. All time-to-event outcomes were calculated from date of randomization until the defined event using the Kaplan-Meier method.

Results

At a median follow-up of 140 months for surviving patients, 10-year Kaplan-Meier estimates of loco-regional control (LRC); progression-free survival (PFS); and overall survival (OS) with 95% confidence interval (95%CI) were 73.6% (95%CI: 61.2–86%); 45.2% (95%CI: 32–58.4%); and 50.3% (95%CI: 37.1–63.5%) respectively. There were no significant differences in 10-year disease-related outcomes between 3D-CRT and IMRT for LRC [79.2% (95%CI: 62.2–96.2%) vs 68.7% (95%CI: 51.1–86.3%),p = 0.39]; PFS [41.3% (95%CI: 22.3–60.3%) vs 48.6% (95%CI: 30.6–66.6%),p = 0.59]; or OS [44.9% (95%CI: 25.7–64.1%) vs 55.0% (95%CI: 37–73%),p = 0.49]. Significantly lesser proportion of patients in the IMRT arm experienced ≥grade 2 late xerostomia and subcutaneous fibrosis at all time-points. However, at longer follow-up, fewer patients remained evaluable for late radiation toxicity reducing statistical power and precision.

Conclusions

IMRT provides a clinically meaningful and sustained reduction in the incidence of moderate to severe xerostomia and subcutaneous fibrosis compared to 3D-CRT without compromising disease-related outcomes in long-term survivors of non-nasopharyngeal HNSCC.
A systematic review and meta-analysis of the pronator quadratus repair following volar plating of distal radius fractures
Authors: Lu Chun-Kuan , Liu Wen-Chih , Chang Chung-Chia , Shih Chia-Lung , Fu Yin-Chih , Jupiter Jesse B.
Published: September 2020

Background

Distal radius fracture (DRF) is the most common upper extremity fracture that requires surgery. Operative treatment with a volar locking plate has proved to be the treatment of choice for unstable fractures. However, no consensus has been reached about the benefits of pronator quadratus (PQ) repair after volar plate fixation of DRF in terms of patient-reported outcome measures, pronation strength, and wrist mobility.

Methods

We searched the PubMed, Embase, Cochrane Central, and China National Knowledge Infrastructure (CNKI) databases up to March 13, 2020, and included randomized-controlled, non-randomized controlled, or case-control cohort studies that compared cases with and without PQ repair after volar plate fixation of DRF. We used a random-effects model to pool effect sizes, which were expressed as standardized mean differences (SMDs) and 95% confidence intervals. The primary outcomes included Disabilities of the Arm, Shoulder, and Hand scores and pronation strength. The secondary outcomes included the SMDs in pain scale score, wrist mobility, and grip strength. The outcomes measured were assessed for publication bias by using a funnel plot and the Egger regression test.

Results

Five randomized controlled studies and six retrospective case-control studies were included in the meta-analysis. We found no significant difference in primary and secondary outcomes at a minimum of 6-month follow-up. In a subgroup analysis, the pronation strength in the PQ repair group for AO type B DRFs (SMD = − 0.94; 95% CI, − 1.54 to − 0.34; p < 0.01) favored PQ repair, whereas that in the PQ repair group for non-AO type B DRFs (SMD = 0.39; 95% CI, 0.07–0.70; p = 0.02) favored no PQ repair.

Discussion

We found no functional benefit of PQ repair after volar plate fixation of DRF on the basis of the present evidence. However, PQ muscle repair showed different effects on pronation strength in different groups of DRFs. Future studies are needed to confirm the relationship between PQ repair and pronation strength among different patterns of DRF.

Registration

This study was registered in the PROSPERO registry under registration ID No. CRD42020188343.

Level of evidence

Therapeutic III
Children and young people’s experiences of completing mental health and wellbeing measures for research: learning from two school-based pilot projects
Authors: Demkowicz Ola , Ashworth Emma , Mansfield Rosie , Stapley Emily , Miles Helena , Hayes Daniel , Burrell Kim , Moore Anna , Deighton Jessica
Published: September 2020

Background

In recent years there has been growing interest in child and adolescent mental health and wellbeing, alongside increasing emphasis on schools as a crucial site for research and intervention. This has coincided with an increased use of self-report mental health and wellbeing measures in research with this population, including in school-based research projects. We set out to explore the way that children and young people perceive and experience completing mental health and wellbeing measures, with a specific focus on completion in a school context, in order to inform future measure and research design.

Methods

We conducted semi-structured interviews and focus groups with 133 participants aged 8–16 years following their completion of mental health and wellbeing measures as part of school-based research programmes, using thematic analysis to identify patterns of experience.

Findings

We identified six themes: Reflecting on emotions during completion; the importance of anonymity; understanding what is going to happen; ease of responding to items; level of demand; and interacting with the measure format.

Conclusions

Our findings offer greater insight into children and young people’s perceptions and experiences in reporting on their mental health and wellbeing. Such understanding can be used to support more ethical and robust data collection procedures in child and adolescent mental health research, both for data quality and ethical purposes. We offer several practical recommendations for researchers, including facilitating this in a school context.
Bedside surgery in the newborn infants: survey of the Italian society of pediatric surgery
Authors: Pelizzo Gloria , Bagolan Pietro , Morini Francesco , Aceti Mariagrazia , Alberti Daniele , Andermarcher Mario , Avolio Luigi , Bartoli Fabio , Briganti Vito , Cacciaguerra Sebastiano , Camoglio Francesco S. , Ceccarelli Pierluca , Cheli Maurizio , Chiarenza Fabio , Ciardini Enrico , Cimador Marcello , Clemente Ennio , Cozzi Denis A. , Dall’ Oglio Luigi , De Luca Ugo , Del Rossi Carmine , Esposito Ciro , Falchetti Diego , Federici Silvana , Gamba Piergiorgio , Gentilino Valerio , Mattioli Girolamo , Martino Ascanio , Messina Mario , Noccioli Bruno , Inserra Alessandro , Lelli Chiesa Pierluigi , Leva Ernesto , Licciardi Francesco , Midrio Paola , Nobili Maria , Papparella Alfonso , Paradies Guglielmo , Piazza Giuseppe , Pini Prato Alessio , Rossi Fabio , Riccipetitoni Giovanna , Romeo Carmelo , Salerno Domenico , Settimi Alessandro , Schleef Jurgen , Milazzo Mario , Calcaterra Valeria , Lima Mario
Published: September 2020

Introduction

This is the report of the first official survey from the Italian Society of Pediatric Surgery (ISPS) to appraise the distribution and organization of bedside surgery in the neonatal intensive care units (NICU) in Italy.

Methods

A questionnaire requesting general data, staff data and workload data of the centers was developed and sent by means of an online cloud-based software instrument to all Italian pediatric surgery Units.

Results

The survey was answered by 34 (65%) out of 52 centers. NICU bedside surgery is reported in 81.8% of the pediatric surgery centers. A lower prevalence of bedside surgical practice in the NICU was reported for Southern Italy and the islands than for Northern Italy and Central Italy (Southern <Northern<Central, p < 0.03). The most frequent clinical characteristics of neonates was preterm neonates with birthweight < 1200 g, with cardiorespiratory instability and/or ventilatory dependence. The most frequently selected indications to surgery were pneumothorax, pleural effusion, pericardial effusion, central venous catheter (CVC) positioning, intestinal perforation, patent ductus arteriosus ligation and congenital diaphragmatic hernia. More than 60% of respondents report no institutional recommendations and dedicated informed consent on bedside surgical procedures. The lack of dedicated areas and infrastructures is considered a relative contraindication to the performance of bedside surgery.

Conclusion

Bedside surgery is performed in the majority of the Italian pediatric surgery centers included in this census. The introduction of a national set of surgery guidelines would be widely welcomed.
AMDock: a versatile graphical tool for assisting molecular docking with Autodock Vina and Autodock4
Authors: Valdés-Tresanco Mario S. , Valdés-Tresanco Mario E. , Valiente Pedro A. , Moreno Ernesto
Published: September 2020

AMDock (Assisted Molecular Docking) is a user-friendly graphical tool to assist in the docking of protein-ligand complexes using Autodock Vina and AutoDock4, including the option of using the Autodock4Zn force field for metalloproteins. AMDock integrates several external programs (Open Babel, PDB2PQR, AutoLigand, ADT scripts) to accurately prepare the input structure files and to optimally define the search space, offering several alternatives and different degrees of user supervision. For visualization of molecular structures, AMDock uses PyMOL, starting it automatically with several predefined visualization schemes to aid in setting up the box defining the search space and to visualize and analyze the docking results. One particularly useful feature implemented in AMDock is the off-target docking procedure that allows to conduct ligand selectivity studies easily. In summary, AMDock’s functional versatility makes it a very useful tool to conduct different docking studies, especially for beginners. The program is available, either for Windows or Linux, at https://github.com/Valdes-Tresanco-MS.

Reviewers

This article was reviewed by Alexander Krah and Thomas Gaillard.
Can low-dose methotrexate reduce effusion-synovitis and symptoms in patients with mid- to late-stage knee osteoarthritis? Study protocol for a randomised, double-blind, and placebo-controlled trial
Authors: Zhu Zhaohua , Yu Qinghong , Leng Xiaomei , Han Weiyu , Li Zhanguo , Huang Cibo , Gu Jieruo , Zhao Yi , Wang Kang , Li Tianwang , Mei Yifang , Xu Jianhua , Zhang Zhiyi , Hunter David , Cicuttini Flavia , Zeng Xiaofeng , Ding Changhai
Published: September 2020

Background

Osteoarthritis (OA) is a common chronic disease in older adults. Currently, there are no effective therapies to reduce disease severity and progression of knee OA (KOA), particularly in mid- to late-stages. This study aims to examine the effect of methotrexate (MTX) on knee effusion-synovitis and pain in symptomatic patients with mid- to late-stage KOA.

Methods/design

This protocol describes a multicentre randomised placebo-controlled clinical trial aiming to recruit 200 participants with mid- to late-stage symptomatic KOA and with effusion-synovitis grade of ≥ 2. Participants will be randomly allocated to the MTX group (start from 5 mg per week for the first 2 weeks and increase to 10 mg per week for the second 2 weeks and 15 mg per week for the remaining period if tolerated) or the placebo group. Primary outcomes are effusion-synovitis size measured by magnetic resonance imaging (MRI) and knee pain assessed by visual analogue scale (VAS). Secondary outcomes are signal intensity alteration within infrapatellar fat pad (IPFP) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score and subscores, and the Outcome Measures in Rheumatology Arthritis Clinical Trials-Osteoarthritis Research Society International (OMERACT-OARSI) responders. Both intention-to-treat and per-protocol analyses will be performed.

Discussion

If MTX intervention can relieve symptoms and reduce inflammation in patients with mid- to late-stage KOA, it has the potential for significant clinical and public health impact as this low-cost and commonly used intervention would delay the time to knee replacement, leading to substantial cost savings and improve quality of life.

Trial registration

ClinicalTrials.gov NCT03815448. Registered on 21 January 2019.
Double-blind, placebo-controlled trial of mifepristone on cognition and depression in alcohol dependence
Authors: Donoghue Kim , Rose Abigail , Coulton Simon , Coleman Rachel , Milward Joanna , Philips Thomas , Drummond Colin , Little Hilary
Published: September 2020

Background

Alcohol dependence is a significant issue contributing to disease burden. Changes in cortisol concentrations during alcohol withdrawal are associated with cognitive deficits and symptoms of depression. Current treatments are only successful for a small proportion of people and do not target cognitive deficits and symptoms of depression experienced by those who are alcohol dependent. The aim of this research is to determine the potential efficacy of mifepristone, a type II glucocorticoid receptor antagonist, to prevent symptoms of depression and cognitive deficits following alcohol detoxification.

Methods

This was a phase 2 therapeutic use trial. It was a double-blind randomised controlled clinical trial of mifepristone versus inactive placebo treatment. The trial aimed to recruit 120 participants who met the inclusion criteria: (1) male, (2) aged 18–60 years inclusive, and (3) alcohol dependent for 5 or more years. Participants were randomised to 600 mg a day mifepristone (200 mg morning, afternoon, and evening) for 7 days and 400 mg for the subsequent 7 days (200 mg morning and evening) or the equivalent number of placebo tablets for 14 days. Primary outcome measures were cognitive function (measured using the Cambridge Neuropsychological Test Automated Battery (CANTAB)) and symptoms of depression (measured using the Beck Depression Inventory (BDI)) at 4 weeks post-randomisation.

Results

Difficulties recruiting participants due to significant changes in the provision of inpatient care for alcohol dependence resulted in only 27 participants recruited to the trial, with data available for 21 participants. Fourteen participants were randomised to receive mifepristone and 13 to receive placebo.

Conclusion

Larger trials would be needed to draw conclusions about the efficacy of mifepristone.

Trial registration

ISRCTN registry ISRCTN54001953. Registered on 29 September 2011.
Lipids monitoring in Scenedesmus obliquus based on terahertz technology
Authors: Shao Yongni , Gu Weimin , Qiu Y ating , Wang Shengfeng , Peng Yan , Zhu YiMing , Zhuang Songlin
Published: September 2020

Background

Microalgae are considered as a source of low pollution and renewable fuel due to their ability to synthesize an abundance of lipids. Conventional methods for lipid quantification are time-consuming and chemically contaminated, while spectroscopic method combined with mathematical model is much more attractive due to its ability of qualitative and quantitative analysis of material composition, in this sense, terahertz technology provides not only timely and non-destructive testing without chemical pollution, but also provides information on the functional group vibration mode and structure of the measured components. Therefore, terahertz technology is utilized in our investigation and proposed for microalgae metabolism detection.

Results

The aim of this study was to use terahertz spectroscopy to observe lipid content in Scenedesmus obliquus (S. obliquus). We collected the THz spectra of S. obliquus which were cultivated under nitrogen stress and terahertz spectroscopy was used to analyze changes in substance components (lipids, proteins, carbohydrates and β-carotene). The PLS algorithm was used to model the terahertz data to distinguish the different lipid content of S. obliquus under nitrogen stress. The correlation coefficient of the prediction results of the lipid characteristic band modeling was above 0.991, and the root mean square error was less than 0.132. It indicated that terahertz technology can be used to discriminate S. obliquus cells under different nitrogen stress effectively. The correlation between the terahertz characteristic peak (9.3 THz) and the total lipid content determined by gravimetry reaches 0.960. The final results were compared with the commonly used spectroscopic methods for lipid observation (Raman spectroscopy).

Conclusions

In this article, we demonstrated the effectiveness of terahertz spectroscopy to monitor changes in microalgae lipid content under nitrogen stress. Terahertz spectroscopy is more suitable for industrial production or ordinary laboratories which require intermediate result with low-frequency screening. When quantifying microalgae lipids, the constraint of terahertz spectroscopy is far less than that of Raman spectroscopy, and it is easier for operator to accurately quantify microalgae lipid. In addition, it is still in early stage for the study of microalgae using terahertz spectroscopy technology, there is still much potential for us to explore.
Chronic seronegative spondyloarthropathy following acute Mycoplasma pneumoniae infection in a human leukocyte antigen B27-positive patient: a case report
Authors: Pilianidis Georgios , Tsinari Ariti , Pandis Dimitrios , Tsolakidou Hara , Petridis Nikolaos
Published: September 2020

Background

We report a case of a 30-year-old patient who presented with acute Mycoplasma pneumoniae infection that was complicated by reactive arthritis and asymmetric proximal myopathy and progressed to chronic spondyloarthropathy. Reactive arthritis and sacroiliitis are unusual extrapulmonary manifestations of M. pneumoniae infection, which is a common condition.

Case presentation

A 30-year-old Greek previously healthy man presented to our emergency department with fever, progressively worsening bilateral lower limb weakness, and asymmetric oligoarthritis. Our diagnosis was based on a positive polymerase chain reaction test for M. pneumoniae using blood and cerebrospinal fluid and magnetic resonance imaging findings that suggested sacroiliitis. Our patient was also found to be human leukocyte antigen B27 positive. His infection was successfully treated with a 14-day course of doxycycline; the arthritis was treated with naproxen and corticosteroids. His arthritis, which restricted his mobility, improved progressively, and he was discharged without any neurological symptoms.

Conclusions

In our case, an acute M. pneumoniae infection eventually progressed to chronic spondyloarthropathy. In our patient, M. pneumoniae infection may represent a random event, or it might be a necessary factor for the development of reactive arthritis, asymmetric proximal myopathy, and sacroiliitis, always in combination with the appropriate genetic background. Extrapulmonary manifestations of M. pneumoniae may occur even in the complete absence of respiratory symptoms, and the diagnosis of unusual complications, such as reactive arthritis, requires high clinical suspicion and extensive investigation.
The effect of control measures on COVID-19 transmission in Italy: Comparison with Guangdong province in China
Authors: Liu Pei-Yu , He Sha , Rong Li-Bin , Tang San-Yi
Published: September 2020

Background

COVID-19 has spread all around the world. Italy is one of the worst affected countries in Europe. Although there is a trend of relief, the epidemic situation hasn’t stabilized yet. This study aims to investigate the dynamics of the disease spread in Italy and provide some suggestions on containing the epidemic.

Methods

We compared Italy’s status at the outbreak stage and control measures with Guangdong Province in China by data observation and analysis. A modified autonomous SEIR model was used to study the COVID-19 epidemic and transmission potential during the early stage of the outbreak in Italy. We also utilized a time-dependent dynamic model to study the future disease dynamics in Italy. The impact of various non-pharmaceutical control measures on epidemic was investigated through uncertainty and sensitivity analyses.

Results

The comparison of specific measures implemented in the two places and the time when the measures were initiated shows that the initial prevention and control actions in Italy were not sufficiently timely and effective. We estimated parameter values based on available cumulative data and calculated the basic reproduction number to be 4.32 before the national lockdown in Italy. Based on the estimated parameter values, we performed numerical simulations to predict the epidemic trend and evaluate the impact of contact limitation, detection and diagnosis, and individual behavior change due to media coverage on the epidemic.

Conclusions

Italy was in a severe epidemic status and the control measures were not sufficiently timely and effective in the beginning. Non-pharmaceutical interventions, including contact restrictions and improvement of case recognition, play an important role in containing the COVID-19 epidemic. The effect of individual behavior changes due to media update of the outbreak cannot be ignored. For policy-makers, early and strict blockade measures, fast detection and improving media publicity are key to containing the epidemic.
Deep bradycardia after sugammadex: is it due to anaphylaxis or by any other unknown mechanism(s) of sugammadex?
Authors: Yilmaz Fulya , Bas Koray
Published: September 2020

Background

Sugammadex is a ɣ-cyclodextrin containing 8-thiopropionate side chains, which selectively binds to nondepolarizing aminosteroid neuromuscular blocking agents. Here, we report a case who developed deep bradycardia after administration of sugammadex.

Case presentation

A 38-year-old-man was scheduled for laparoscopic right hemicolectomy. Besides history of light smoking, he had no other medical/surgical history that included any allergic reactions. At the end of the operation, 200 mg sugammadex was administered to antagonize residual neuromuscular blockade. One minute after the administration of sugammadex, the patient had deep bradycardia (25 beat min−1) and his systolic blood pressure fell below a measurable level. The patient’s blood pressure was restored to 95/55 mmHg and heart rate 110 beats min−1 with the administration of a total dose of ephedrine 10 mg, atropine sulfate 0.5 mg, 0.9% saline 1 L, and 6% hydroxyethylated starch 500 mL over 15 min. Then, he was extubated uneventfully and transferred to the intensive care unit for closer monitoring.

Conclusions

According to the current literature as well as the case we presented here, we suggest that physicians who use sugammadex especially in endoscopic/laparoscopic procedures using CO2 should be aware of the possibility of sudden bradycardia and/or cardiac arrest.
Mid-term outcome of transarterial embolization of renal artery pseudoaneurysm and arteriovenous fistula after partial nephrectomy screened by early postoperative contrast-enhanced CT
Authors: Morita Satoru , Matsuzaki Yuka , Yamamoto Takahiro , Kamoshida Kumi , Yamazaki Hiroshi , Tajima Tsuyoshi , Kondo Tsunenori , Takagi Toshio , Yoshida Kazuhiko , Tanabe Kazunari , Sakai Shuji
Published: September 2020

Purpose

To retrospectively evaluate the mid-term outcome of transarterial embolization (TAE) of renal artery pseudoaneurysm (RAP) including arteriovenous fistula (AVF) after partial nephrectomy screened by early postoperative contrast-enhanced CT (CE-CT).

Materials and methods

Eighty-two patients (7.0%) who underwent TAE after partial nephrectomy were reviewed, from 1166 partial nephrectomies performed over 6 years. In 18 patients (22.0%), TAE was performed emergently on the median postoperative day (POD) seven. In the remaining patients, elective TAE was performed on the median POD six for RAP detected by early postoperative CE-CT or that emerged on follow-up CE-CT.

Results

In one patient (1.2%), TAE was performed twice because one of two RAPs could not be embolized during the first TAE, being successfully embolized at the second TAE after readmission with hematuria. Otherwise, no bleeding recurrence or RAPs were observed during the median 1354 follow-up days. Thus, the primary and secondary success rates of TAE were 98.8% (81 of 82 patients) and 100% (82 of 82 patients), respectively. On angiography, the average number of lesions was 1.7 ± 0.9 and the average RAP size was 12.8 ± 6.0 mm. The shapes of the lesions varied: oval-round 60, oval-round + AVF 36, irregular + AVF 14, AVF 12, irregular 10, disruption 4, and extravasation 3. No major complications were observed. The median inpatient days after TAE were two. No estimated glomerular filtration rate deterioration was observed (64.6 ± 18.6 vs. 64.2 ± 18.4 mL/min/1.73 m2, p = 0.902).

Conclusion

TAE is largely effective and safe for treating bleedings or RAPs, including AVFs, after partial nephrectomy, as screened by early postoperative CE-CT.
Systematic review and meta-analysis of augmented reality in medicine, retail, and games
Authors: Parekh Pranav , Patel Shireen , Patel Nivedita , Shah Manan
Published: September 2020

This paper presents a detailed review of the applications of augmented reality (AR) in three important fields where AR use is currently increasing. The objective of this study is to highlight how AR improves and enhances the user experience in entertainment, medicine, and retail. The authors briefly introduce the topic of AR and discuss its differences from virtual reality. They also explain the software and hardware technologies required for implementing an AR system and the different types of displays required for enhancing the user experience. The growth of AR in markets is also briefly discussed. In the three sections of the paper, the applications of AR are discussed. The use of AR in multiplayer gaming, computer games, broadcasting, and multimedia videos, as an aspect of entertainment and gaming is highlighted. AR in medicine involves the use of AR in medical healing, medical training, medical teaching, surgery, and post-medical treatment. AR in retail was discussed in terms of its uses in advertisement, marketing, fashion retail, and online shopping. The authors concluded the paper by detailing the future use of AR and its advantages and disadvantages in the current scenario.
Post-traumatic stress disorder as a risk factor for dementia: systematic review and meta-analysis
Authors: Günak Mia Maria , Billings Jo , Carratu Emily , Marchant Natalie L. , Favarato Graziella , Orgeta Vasiliki
Published: September 2020

Background

Post-traumatic stress disorder (PTSD) has been identified as a potential risk factor for developing dementia. There are currently, however, no meta-analyses quantifying this risk.

Aims

To systematically review and quantify the risk of future dementia associated with PTSD across populations. PROSPERO registration number CRD42019130392.

Method

We searched nine electronic databases up to 25 October 2019 for longitudinal studies assessing PTSD and risk of dementia. We used random- and fixed-effects meta-analyses to pool estimates across studies.

Results

PTSD was associated with a significant risk for all-cause dementia: pooled hazard ratio HR = 1.61 (95% CI 1.43–1.81,I2=85.8%,P< 0.001;n= 1 693 678; 8 studies). Pooled HR was 1.61 (95% CI 1.46–1.78;I2=80.9%,P< 0.001;n= 905 896; 5 studies) in veterans, and 2.11 (95% CI 1.03–4.33,I2=91.2%,P< 0.001;n= 787 782; 3 studies) in the general population. The association between PTSD and dementia remained significant after excluding studies with high risk of bias (HR = 1.55, 95% CI 1.39–1.73,I2=83.9%,P< 0.001;n= 1 684 928; 7 studies). Most studies included were retrospective and there was evidence of high heterogeneity.

Conclusions

This is the first meta-analysis quantifying the association of PTSD and risk of dementia showing that PTSD is a strong and potentially modifiable risk factor for all-cause dementia. Future studies investigating potential causal mechanisms, and the protective value of treating PTSD are needed.
Randomized Controlled Trial of Trastuzumab With or Without Chemotherapy for HER2-Positive Early Breast Cancer in Older Patients
Authors: Sawaki Masataka , Taira Naruto , Uemura Yukari , Saito Tsuyoshi , Baba Shinichi , Kobayashi Kokoro , Kawashima Hiroaki , Tsuneizumi Michiko , Sagawa Noriko , Bando Hiroko , Takahashi Masato , Yamaguchi Miki , Takashima Tsutomu , Nakayama Takahiro , Kashiwaba Masahiro , Mizuno Toshiro , Yamamoto Yutaka , Iwata Hiroji , Kawahara Takuya , Ohashi Yasuo , Mukai Hirofumi ,   for the RESPECT study group
Published: September 2020

PURPOSE

Adjuvant trastuzumab monotherapy has not been compared with trastuzumab + chemotherapy. We investigated the relative value of trastuzumab monotherapy for older patients with breast cancer.

METHODS

This study was an open-label, randomized controlled study with a treatment selection design in which a noninferiority criterion was predefined. Patients aged 70-80 years with surgically treated human epidermal growth factor receptor 2–positive invasive breast cancer received trastuzumab monotherapy or trastuzumab + chemotherapy. The primary end point was disease-free survival (DFS) with assessment of prespecified hazard ratio (HR), relapse-free survival (RFS), adverse events (AEs), health-related quality of life (HRQoL), and restricted mean survival time (RMST).

RESULTS

The study involved 275 patients (mean age, 73.5 years) who were followed up for a mean of 4.1 years (range, 0.3-8.0 years). The percentages of patients by cancer stage were as follows: I (pT > 0.5 cm), 43.6%; IIA, 41.7%; IIB, 13.5%; and IIIA, 1.1%. Three-year DFS was 89.5% with trastuzumab monotherapy versus 93.8% with trastuzumab + chemotherapy (HR, 1.36; 95% CI, 0.72 to 2.58; P = .51). At 3 years, RMST differed by −0.39 months between arms (95% CI, −1.71 to 0.93; P = .56). Three-year RFS was 92.4% with trastuzumab monotherapy versus 95.3% with trastuzumab + chemotherapy (HR, 1.33; 95% CI, 0.63 to 2.79; P = .53). Common AEs were anorexia (7.4% v 44.3%; P < .0001) and alopecia (2.2% v 71.7%; P < .0001), and grade 3/4 nonhematologic AEs occurred in 11.9% versus 29.8% ( P = .0003) for trastuzumab monotherapy versus trastuzumab + chemotherapy, respectively. Clinically meaningful HRQoL deterioration rate showed significant differences at 2 months (31% for trastuzumab monotherapy v 48% for trastuzumab + chemotherapy; P = .016) and at 1 year (19% v 38%; P = .009).

CONCLUSION

The primary objective of noninferiority for trastuzumab monotherapy was not met. However, the observed loss of survival without chemotherapy was < 1 month at 3 years. Therefore, and in light of the lower toxicity and more favorable HRQoL profile, trastuzumab monotherapy can be considered an adjuvant therapy option for selected older patients.
Genome-Wide Association for HbA1c in Malay Identified Deletion on SLC4A1 that Influences HbA1c Independent of Glycemia
Authors: Chai Jin-Fang , Kao Shih-Ling , Wang Chaolong , Lim Victor Jun-Yu , Khor Ing Wei , Dou Jinzhuang , Podgornaia Anna I , Chothani Sonia , Cheng Ching-Yu , Sabanayagam Charumathi , Wong Tien-Yin , van Dam Rob M , Liu Jianjun , Reilly Dermot F , Paterson Andrew D , Sim Xueling
Published: September 2020

Context

Glycated hemoglobin A1c (HbA1c) level is used to screen and diagnose diabetes. Genetic determinants of HbA1c can vary across populations and many of the genetic variants influencing HbA1c level were specific to populations.

Objective

To discover genetic variants associated with HbA1c level in nondiabetic Malay individuals.

Design and Participants

We conducted a genome-wide association study (GWAS) analysis for HbA1c using 2 Malay studies, the Singapore Malay Eye Study (SiMES, N = 1721 on GWAS array) and the Living Biobank study (N = 983 on GWAS array and whole-exome sequenced). We built a Malay-specific reference panel to impute ethnic-specific variants and validate the associations with HbA1c at ethnic-specific variants.

Results

Meta-analysis of the 1000 Genomes imputed array data identified 4 loci at genome-wide significance (P < 5 × 10-8). Of the 4 loci, 3 (ADAM15, LINC02226, JUP) were novel for HbA1c associations. At the previously reported HbA1c locus ATXN7L3-G6PC3, association analysis using the exome data fine-mapped the HbA1c associations to a 27-bp deletion (rs769664228) at SLC4A1 that reduced HbA1c by 0.38 ± 0.06% (P = 3.5 × 10-10). Further imputation of this variant in SiMES confirmed the association with HbA1c at SLC4A1. We also showed that these genetic variants influence HbA1c level independent of glucose level.

Conclusion

We identified a deletion at SLC4A1 associated with HbA1c in Malay. The nonglycemic lowering of HbA1c at rs769664228 might cause individuals carrying this variant to be underdiagnosed for diabetes or prediabetes when HbA1c is used as the only diagnostic test for diabetes.