bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of pulsed-xenon ultraviolet light on reduction of Mycobacterium fortuitum
Authors: Huber Thomas W , Brackens Emma , Chatterjee Piyali , Villamaria Frank C , Sisco Lauren E , Williams Marjory D , Coppin John David , Choi Hosoon , Jinadatha Chetan
Published: October 2020

Objectives:

Hospitals and healthcare facilities rely largely on isolation and environmental disinfection to prevent transmission of pathogens. The use of no-touch technology is an accepted practice for environmental decontamination in medical care facilities, but little has been published about the effect of ultraviolet light generated by a portable pulsed-xenon device use on Mycobacteria. We used Mycobacterium fortuitum which is more resistant to ultraviolet radiation and less virulent than Mycobacterium tuberculosis, to determine the effectiveness of portable pulsed-xenon devices on Mycobacterium in a laboratory environment.

Methods:

To determine the effectiveness of pulsed-xenon devices, we measured the bactericidal effect of pulsed-xenon devices on Mycobacterium fortuitum.

Results:

In five separate experiments irradiating an average of 106 organisms, the mean (standard deviation) log-kill at 5 min was 3.98 (0.60), at 10 min was 4.96 (0.42), and at 15 min was 5.64 (0.52).

Conclusions:

Our results demonstrate that using pulsed-xenon devices is a highly effective modality to reduce microbial counts with this relatively ultraviolet germicidal irradiation–resistant mycobacterium in a time-dependent manner.
Use of lung ultrasound for diagnosis and monitoring of coronavirus disease 2019 pneumonia: A case report
Authors: Yun Debo , Cui Yan , Geng Yuan , Yang Yujiao
Published: October 2020

Knowledge of lung ultrasound characteristics of coronavirus disease 2019 pneumonia might be useful for early diagnosis and clinical monitoring of patients, and lung ultrasound can help to control the spread of infection in healthcare settings. In this case report, a 36-year-old man with severe acute respiratory syndrome coronavirus 2 infection was diagnosed by reverse transcription-polymerase chain reaction testing of a nasopharyngeal swab. The lung ultrasound findings for this patient were the interstitial-alveolar damage showing bilateral, diffuse pleural line abnormalities, subpleural consolidations, white lung areas and thick, irregular vertical artifacts. When the patient recovered from the severe acute respiratory syndrome coronavirus 2 infection, lung ultrasound images showed a normal pleural line with A-lines regularly reverberating. Performing lung ultrasound at the bedside minimizes the need to move the patient, thus reducing the risk of spreading infection among healthcare staff. Lung ultrasound is useful for early diagnosis and evaluation of the severity of coronavirus disease 2019 pneumonia and for monitoring its progress over the course of the disease.
Utility of Abdominal Imaging in Peritoneal Dialysis Patients Presenting With Peritonitis
Authors: Trinh Emilie , Bargman Joanne M.
Published: October 2020

Background:

Peritonitis remains a major complication in peritoneal dialysis (PD). Abdominal imaging is often performed in the setting of peritonitis to evaluate for concomitant intra-abdominal processes. However, the usefulness of this procedure is unknown.

Objective:

The aim of this study was to assess the prevalence of abdominal imaging performed in the setting of PD peritonitis and to evaluate clinical parameters associated with abnormal imaging results to identify clinical situations in which radiographic examinations are informative.

Design:

This is a retrospective cohort study.

Setting:

The study was conducted at the Toronto General Hospital, Ontario, Canada.

Patients:

We studied 166 episodes of PD peritonitis in 114 patients between January 1, 2011, and June 30, 2016.

Measurements:

Baseline demographics, characteristics of PD peritonitis, and characteristics of abdominal imaging performed.

Methods:

The association between relevant clinical parameters and abnormal abdominal imaging was examined using a univariate and multivariate logistic regression model.

Results:

Abdominal imaging (computed tomography [CT] scan or ultrasound) was performed in 68 cases (41%). Patients were more likely to undergo imaging if they required hospitalization, were admitted to the intensive care unit (ICU), had polymicrobial or fungal organisms causing peritonitis, had relapsing/recurrent/refractory peritonitis, had an indication for hemodialysis or PD catheter removal, or presented with hypotension, tachycardia, or an elevated serum lactate. Of the imaging performed, abnormalities were found in 32 cases (47%). The most common findings were bowel obstruction, intra-abdominal collection, and biliary abnormalities. In the univariate analysis, ICU admission (43.3% vs 14.3%, P < .01) and need for temporary or permanent hemodialysis (62.5% vs 30.6%, P < .01) were associated with imaging abnormalities. Importantly, the peritonitis organism was not associated with abnormal imaging results. In a multivariate analysis, ICU admission was the only significant clinical parameter associated with imaging abnormalities with an odds ratio (OR) of 4.4 (95% confidence interval [CI]: 1.1-17.4, P = .04).

Limitations:

Single-center study, small sample size, and lack of detailed information on the exact indications leading to abdominal imaging.

Conclusions:

Abdominal imaging is commonly performed in the setting of PD peritonitis. Abnormalities are not infrequent and are present in almost half of the cases, with need for ICU admission being the most significant clinical parameter associated with abnormal findings. Therefore, abdominal imaging should be performed in carefully selected patients with PD peritonitis, especially if there is evidence of hemodynamic instability. While the finding of fungal or polymicrobial peritonitis was a driver for abdominal imaging, the presence of these organisms did not predict radiologic abnormalities.
Occult hepatitis C virus infection in patients with malignant lymphoproliferative disorders
Authors: Lotfi Abeya A , Mohamed Asmaa E , Shalaby Nahela A , Eissa Deena S , El-Dabaa Ehab , Sallam Ayman M , Kamel Mahmoud M , Abdelaziz Hisham , El-Afifi Amal M , Abdel-Moneim Ahmed S
Published: October 2020

Despite the link between HCV and malignant lymphoproliferative disorders has been established, the association between occult hepatitis C virus infection and malignant lymphoproliferative disorders remains obscure. The present study intended to identify the possible association between occult HCV infection and malignant lymphoproliferative disorders. Newly diagnosed patients with LPDs were screened for the presence of HCV-RNA in both plasma and PBMCs. PBMCs of the subjects were also, examined by transmission and immuno-electron microscopy. LPD patients showed a high percentage of HCV infection (71.9%): OCI-HCV (37.5%) and HCV (34.38%). Meanwhile, 28.13% of LPD patients did not show any evidence of HCV infection. Ultrastructural examination of PBMCs revealed the presence of intracytoplasmic vacuoles enclosing viral like particles, which were less prominent in occult HCV patients. The possibility of occult HCV should be considered in patients with LPDs which can be helpful in the management of the treatment protocol in order to set up a balance between the control of the tumor progression and minimizing post chemotherapy complications related to HCV infection.
What Motivates People to Vote? The Role of Selfishness, Duty, and Social Motives When Voting
Authors: Bali Valentina A. , Robison Lindon J. , Winder Richard
Published: October 2020

This study assesses the relative importance and explanatory power of five fundamental psychological motives for voting. Using United States survey data, we analyze self-reports on the motives of selfishness, duty, altruism, belonging, and social approval in relation to turnout. These motives have precedents in the literature, but they have not yet been evaluated simultaneously. We find that altruism and duty are the most important reported motives for turnout accounting for more than 60% of the allocations; selfish motives account for only about 15%. Turnout behavior responds positively to the motives of duty, altruism, and belonging, but it is dampened by the motive of selfishness. Turning out to vote emerges as an activity largely shaped by an individual’s social concerns and values.
Are Pressuring Employees to Improve Organizational Innovation Still Working? An Empirical Analysis of Manufacturing Companies in China
Authors: Lin Wei , Zhong Wei-Jun , Su Chun-Hsien , Chen Ping-Kuo
Published: October 2020

The purpose of this study is to explore when leaders of manufacturing companies in China adopt high-performance work system (HPWS) and authoritarian leadership to pressure employees to maintain their intention toward organizational innovation improvement. These two approaches can trigger employee resistance and further affect innovation and financial performance. We collected data through the responses of 224 manufacturing companies in China. Regarding the methodology, Spearman’s rank correlation coefficient and partial least squares (PLS) regression are the primary methods used. Our findings indicate that employees’ resistance as a moderator certainly affects the relationship between improving organizational innovation and achieving innovative performance, which also affects financial performance. In addition, authoritarian leadership will lead to employees’ resistance. However, if leaders adopt HPWS to promote employees’ intention toward innovation improvement, although there is a lack of direction between HPWS and employees’ resistance, employee resistance can still be triggered if leaders lack commitment. In this contribution, the research results not only remind the leaders of manufacturing companies in China to reconsider whether to adopt a new approach or to combine their current approach with a commitment to redesigning HPWS to promote employees’ intention toward organizational innovation but also remind leaders of manufacturing companies from other countries to change their approach to addressing employees’ intention toward innovation improvement when the environment, culture, or personality traits change.
Dependency as Status: Older Adults’ Presentations of Self as Recipients of Care
Authors: Timonen Virpi , Lolich Luciana
Published: October 2020

We draw on Bourdieu’s and Goffman’s theories to elaborate the novel idea of dependency as status in old age, a concept that emerged from our Grounded Theory study conducted with 46 older adults (26 women and 20 men) living in and around Dublin, Ireland. The research participants’ portrayals of (in)dependence and assistance reflected their access to and use of social and symbolic (age) capital. Older adults derived social capital from supportive family relations or trusting relationships with formal care providers, and deployed such capital to signal their status as “cared for” individuals. Age capital—constructions of deservingness drawing on advanced age, age-related disabilities, and lifelong contributions—was used by older adults to frame and justify acceptance of help. We argue that where older adults are able to draw on age capital or social capital, they can signal their position as “cared for” individuals who display and acknowledge their dependency, and transform it into a marker of status. Conversely, some participants were keen to present themselves as independent. These participants made downward comparisons with others whom they saw as “worse off” or, in their view, as insufficiently responsible for their own health and well-being. In the contemporary Western frame, dependency is to be avoided at all costs, but we argue that some older people are able to embrace dependency in a way that reflects and demonstrates their status and agency. Care professionals and members of informal networks can make a significant difference to older persons’ acceptance of help, care, and support by offering services in a manner that affirms the care recipients’ worth and agency.
Views of the Highway: Infrastructure Reality, Perceptions, and Politics
Authors: Fogg Linda M. , Hamilton Lawrence C. , Bell Erin S.
Published: October 2020

Transportation infrastructure such as highways and bridges requires upgrades and maintenance. In many U.S. regions, these requirements have surpassed current funding, so new solutions are needed. One obvious though imperfect source is gasoline taxes, but raising these is politically risky, regardless of need. To illuminate this conflict, we analyze data from four random-sample telephone surveys (2016–2018, n = 2,035) that asked residents in the U.S. state of New Hampshire about their perceptions of highway and bridge conditions, and support for gas tax increases. About one third of the respondents counterfactually reported that highway and bridge conditions had improved compared with 10 or 20 years ago. At the county level, subjective perceptions correlate well with actual pavement and bridge conditions. Majorities of respondents also said they would support tax increases of 5 of 10 cents, although support falls off at higher amounts. Support for a tax increase varies not only with the proposed amount, but also with individual characteristics—especially political identity. In a structural equation model, infrastructure perceptions serve as an intervening variable between ideology and tax support: if infrastructure is falsely seen as improving, that supports an ideologically favored rejection of taxes. Partisan differences in perceptions of physical conditions, noted previously in other domains such as climate change, pose an unexpected challenge in building public support for transportation infrastructure.
The Social Responsiveness Scale (SRS-2) in school-age children with Down syndrome at low risk for autism spectrum disorder
Authors: Channell Marie Moore
Published: October 2020

Background and aims

Little is known about how autism spectrum disorder (ASD) symptoms present in individuals with Down syndrome (DS). Some behaviors may be symptomatic of comorbid ASD or more broadly representative of the DS phenotype. A prior research study documented elevated ASD-like symptoms in adolescents and young adults with DS without comorbid ASD, using a common ASD risk screening tool—the Social Responsiveness Scale (SRS). The current study applied a similar approach to younger children with DS using the SRS-2. The primary aim was to document patterns of ASD-like symptoms in children with DS at low risk of comorbid ASD to distinguish the symptoms that may be present across DS in general.

Methods

SRS-2 standard scores were analyzed in a sample of 40 children with DS, 6–11 years old, who were considered to be at low risk for ASD based on the Social Communication Questionnaire (SCQ) screener. Other developmental characteristics (i.e., age, nonverbal IQ, expressive language), social skills, and problem behaviors were also examined across the sample.

Results

SRS-2 scores were significantly elevated in this sample compared to the normative population sample. A pattern of ASD-like symptomatology was observed across SRS-2 subdomains. These findings were similar to the findings of the prior study. However, nuanced differences were observed across the two samples that may represent developmental differences across different ages in this population.

Conclusions

Replicating and extending a prior study's findings, certain ASD-like behaviors may occur in individuals with DS who are at low risk for comorbid ASD. Implications: Understanding the pattern of ASD-like behaviors that occur in children with DS who are at low risk for comorbid ASD will help clinicians in screening and identification efforts. In particular, it will lead to better specification of the behaviors or symptoms that are not characteristic of the DS phenotype and thus are red flags for comorbid ASD in this population.
The associated factors of cesarean section during COVID-19 pandemic: a cross-sectional study in nine cities of China
Authors: Zhang Jian , Zhang Yumei , Ma Yidi , Ke Yalei , Huo Shanshan , He Liping , Luo Wenjuan , Li Jing , Zhao Ai
Published: October 2020

Background

Improving and maintaining the health of mothers and newborns is indisputably a global priority, especially during a pandemic. This study intends to examine the factors associated with cesarean section (CS) during lockdown time.

Methods

A total of 678 women who just gave birth within 7 days were enrolled from maternal and children hospitals in nine cities of China from April to May 2020. The delivery modes and potential influencing factors were investigated. The subgroup analysis and sensitivity analysis were used to examine the association of CS and risk factors among populations with different characteristics and to control for possible confounding, respectively.

Results

The overall rate of cesarean delivery was 37.3%. In multi-variant model, maternal age > 30 years (OR, 95% CI = 1.71, 1.21–2.41), higher pre-gestational BMI (OR, 95% CI = 1.16, 1.10–1.23), living in regions with confirmed COVID-19 cases > 500 (OR, 95% CI = 2.45, 1.74–3.45), and excess gestational weight gain (OR, 95% CI = 1.73, 1.17–2.55) were associated with cesarean delivery. These trends of associations were not changes in sensitivity analysis and subgroup analysis. Cesarean delivery occurred more in women who got more nutrition instruction during the pandemic period in the univariant model; however, this association showed insignificance in the multiple-variant analysis.

Conclusion

A high cesarean delivery rate was found in uninfected women who experienced lockdown in their third trimester. During the COVID-19 pandemic, more medical support should be provided in severely affected regions to ensure and promote health in pregnancy.
A systematic review of active group-based dance, singing, music therapy and theatrical interventions for quality of life, functional communication, speech, motor function and cognitive status in people with Parkinson’s disease
Authors: Barnish Maxwell S. , Barran Susannah M.
Published: October 2020

Background

Parkinson’s disease (PD) is a common neurodegenerative condition associated with a wide range of motor and non-motor symptoms. There has been increasing interest in the potential benefit of performing arts as a therapeutic medium in PD. While there have been previous reviews, none have considered all performing arts modalities and most have focused on dance. This systematic review examined the potential benefit of all active group-based performing arts interventions for quality of life, functional communication, speech, motor function and cognitive status.

Methods

Searches were conducted in February 2020 on five scholarly databases. Supplementary searches were conducted. Included studies were quantitative in design, and assessed the potential benefit of any active group-based performing arts intervention for quality of life, functional communication, speech, motor function or cognitive status in people with PD. Full text papers were eligible for inclusion, as were conference abstracts since January 2018. Screening, data extraction, narrative synthesis and quality assessment were conducted independently by two reviewers. Quality assessment used the SURE checklists.

Results

Fifty-six studies were eligible for inclusion in this systematic review, reported in 67 publications. Published from 1989 to 2020, these studies included a total of 1531 people with PD from 12 countries, and covered four broad performing arts modalities: dance, singing, music therapy and theatre. Dance remains the most commonly studied performing arts modality for PD (38 studies), while there were 12 studies on singing interventions, four on music therapy, and only two on theatrical interventions. There was evidence for a beneficial effect of all four performing arts modalities on at least some outcome domains.

Conclusions

This is the first systematic review to assess the potential benefit of all active group-based performing arts interventions in PD. The evidence suggests that performing arts may be a useful therapeutic medium in PD. However, a substantial limitation of the evidence base is that no studies compared interventions from different performing arts modalities. Moreover, not all performing arts modalities were assessed for all outcome domains. Therefore it is not currently possible to determine which performing arts modalities are most beneficial for which specific outcomes.
Capillary blood reference intervals for platelet parameters in healthy full-term neonates in China
Authors: Cui Dongyan , Hou Yan , Feng Ling , Li Guo , Zhang Chi , Huang Yanli , Fan Jiubo , Hu Qun
Published: October 2020

Background

No consensus has been reached on capillary blood reference intervals for platelet parameters in full-term neonates. We aimed to establish neonatal capillary blood reference intervals for platelet parameters and evaluate influences of sex, gestational age and postnatal age on platelet parameters.

Methods

This study was a prospective investigation and implemented in 594 healthy full-term neonates from 12 to 84 h of age, using SYSMEX XN-9000 haematology automatic analyser by means of capillary blood. Reference intervals for platelet parameters were defined by an interval of 2.5th − 97.5th percentiles.

Results

Capillary reference interval for platelet count was (152–464) × 109/L. No significance was found between sex-divided reference intervals for platelet parameters. The values of platelet count changed minimally across gestational age (37–41 weeks) and postnatal age (12–84 h). Reference intervals for other platelet parameters were affected by these factors to a different extent.

Conclusions

We established capillary blood reference intervals for platelet parameters in the first days after birth of full-term neonates in China.
Correction to: Musculoskeletal disorders and their associations with health- and work-related factors: a cross-sectional comparison between Swedish air force personnel and army soldiers
Authors: Tegern Matthias , Aasa Ulrika , Äng Björn O. , Larsson Helena
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
Biomechanical comparison of tenodesis reconstruction for subtalar instability: a finite element analysis
Authors: Can Xu , Mingqing Li , Chenggong Wang , Hua Liu
Published: October 2020

Background

There are several types of tenodesis reconstruction designed for subtalar instability. However, no comprehensive comparison has been conducted among these procedures in terms of their correcting power so far. The objective of this study is to evaluate the biomechanical behaviors of 5 representative procedures through finite element analysis.

Methods

Finite element models were established and validated based on one of our previous studies. The Pisani interosseous talocalcaneal ligament (ITCL) reconstruction, Schon cervical ligament (CL) reconstruction and Choisne calcaneofibular ligament (CFL) reconstruction were compared on the model with the CFL, ITCL and CL sectioned. The Schon triligamentous reconstruction and Mann triligamentous reconstruction were compared on the model with the CFL, ITCL and CL, as well as the ATFL sectioned. The inversion and external/internal rotation were quantified at different ankle positions based on the rotational moment. Then, the stress in ligaments and reconstructed grafts and the contact characteristics of the subtalar joint under inversional stress test were calculated and compared accordingly.

Results

For single ligament reconstruction, the Choisne CFL reconstruction provided the greatest degree of correction for subtalar instability, followed by the Schon CL reconstruction and then the Pisani ITCL reconstruction. For triligamentous reconstruction, the Mann procedure outperformed the Schon procedure in alleviating the subtalar instability.

Conclusion

The finite element analysis showed that the Choisne CFL reconstruction and Mann triligamentous reconstruction provided the greatest degree of immediate postoperative subtalar stability. However, both procedures could not restore the biomechanical behaviors of the subtalar joint to normal. The long-term efficacy of these procedures warrants further investigation using a substantially larger sample of clinical cases.
A protocol for chronic pain outcome measurement enhancement by linking PROMIS-29 scale to legacy measures and improving chronic pain stratification
Authors: Herman Patricia M. , Edelen Maria O. , Rodriguez Anthony , Hilton Lara G. , Hays Ron D.
Published: October 2020

Background

Substantial investment has gone into research on the efficacy and effectiveness of pharmaceutical and nonpharmacologic interventions for chronic pain. However, synthesizing this extensive literature is challenging because of differences in the outcome measures used in studies of similar or competing interventions. The absence of a common metric makes it difficult to replicate findings, pool data from multiple studies, resolve conflicting conclusions, or reach consensus when interpreting findings.

Methods

This study has a seven-member Advisory Council of chronic pain experts. Preliminary analyses will be performed on data from several large existing datasets; intermediate analyses will be performed using primary data collected from Amazon’s Mechanical Turk (MTurk); and cross-validation will use primary data collected from a nationally-representative, probability-based panel. Target sample size for both primary datasets is 1500. The three study aims are as follows:

Aim 1 will develop and evaluate links between the 29-item Patient-Reported Outcomes Measurement Information System (PROMIS®-29) and legacy measures used for chronic pain such as the Roland-Morris Disability Questionnaire (RMDQ) and the Oswestry Disability Index (ODI). We will assess the best method of score linking and create crosswalk tables.

Aim 2 will evaluate and refine the Impact Stratification Score (ISS) based on 9 PROMIS-29 items and proposed by the NIH Research Task Force on chronic low back pain. We will evaluate the ISS in terms of other indicators of condition severity and patient prognosis and outcomes and identify cut-points to stratify chronic pain patients into subgroups.

Aim 3 will evaluate the strengths and limitations of MTurk as a data collection platform for estimating chronic pain by comparing its data to other data sources.

Discussion

The accomplishment of Aims 1 and 2 will allow direct comparison of results across past and future studies of chronic pain. These comparisons will help us to understand different results from seemingly similar studies, and to determine the relative effectiveness of all pharmaceutical and nonpharmacologic interventions for chronic pain across different trials. Aim 3 findings will provide valuable information to researchers about the pros and cons of using the MTurk platform for research-based data collection.

Trial registration

ClinicalTrials.gov: NCT04426812; June 10, 2020.
Early failure for wear after ceramic-on-highly cross-linked polyethylene total hip arthroplasty: a case report
Authors: Li Chenkai , Zhang Haining
Published: October 2020

Background

Highly cross-linked polyethylene (HXLPE) enhances the anti-wear characteristics of the conventional polyethylene (PE). Early failure for wear after ceramic-on-highly cross-linked polyethylene (CoHXLPE) total hip arthroplasty (THA) is extremely rare.

Case presentation

We described the case of a 60-year-old man who underwent right CoHXLPE THA because of the developmental dysplasia hip (DDH) complained pain 32 months after this procedure. Plain radiographs showed that eccentric wear existed at the polyethylene insert. However, the patient refused surgery at that time and did not stop weight-bearing. The right hip pain continued for 7 months. Plain radiographs of the pelvis showed that the HXLPE liner was penetrated and partial inner wall of acetabular shell was worn. Acetabular cup revision was performed, and the ceramic head and HXLPE were exchanged.

Conclusions

Difficult reduction during primary THA, especially for DDH, can result in higher abductor tension, which may lead to early eccentric wear of the prosthesis. Whenever eccentric wear of HXLPE liner was found, weight-bearing must be stopped to avoid the accelerated wear and adverse reactions to metal debris (ARMD).
The contribution of serum cortisone and glucocorticoid metabolites to detrimental bone health in patients receiving hydrocortisone therapy
Authors: Dineen Rosemary , Behan Lucy-Ann , Kelleher Grainne , Hannon Mark J. , Brady Jennifer J. , Rogers Bairbre , Keevil Brian G. , Tormey William , Smith Diarmuid , Thompson Christopher J. , McKenna Malachi J. , Arlt Wiebke , Stewart Paul M. , Agha Amar , Sherlock Mark
Published: October 2020

Background

Glucocorticoid therapy is the most common cause of iatrogenic osteoporosis. Less is known regarding the effect of glucocorticoids when used as replacement therapy on bone remodelling in patients with adrenal insufficiency. Enhanced intracellular conversion of inactive cortisone to active cortisol, by 11 beta-hydroxysteroid dehydrogenase type 1(11β-HSD1) and other enzymes leading to alterations in glucocorticoid metabolism, may contribute to a deleterious effect on bone health in this patient group.

Methods

Study design: An open crossover prospective study randomizing ten hypopituitary men, with severe ACTH deficiency, to three commonly used hydrocortisone dose regimens.

Measurements: Following 6 weeks of each regimen, patients underwent 24-h serum cortisol/cortisone sampling, measurement of bone turnover markers, and a 24-h urine collection for measurement of urinary steroid metabolites by gas chromatography-mass spectrometry (GC-MS). Serum cortisone and cortisol were analysed by liquid chromatography-mass spectrometry (LC-MS).

Results

Dose-related and circadian variations in serum cortisone were seen to parallel those for cortisol, indicating conversion of ingested hydrocortisone to cortisone. The median area under the curve (AUC) of serum cortisone was significantly higher in patients on dose A (20 mg/10 mg) [670.5 (IQR 621–809.2)] compared to those on dose C (10 mg/5 mg) [562.8 (IQR 520.1–619.6), p = 0.01]. A negative correlation was observed between serum cortisone and bone formation markers, OC [1–49] (r = − 0.42, p = 0.03), and PINP (r = − 0.49, p = 0.01). There was a negative correlation between the AUC of night-time serum cortisone levels with the bone formation marker, OC [1–49] (r = − 0.41, p = 0.03) but there were no significant correlations between day-time serum cortisone or cortisol with bone turnover markers. There was a negative correlation between total urinary cortisol metabolites and the bone formation markers, PINP (r = − 0.39, p = 0.04), and OC [1–49] (r = − 0.35, p = 0.06).

Conclusion

Serum cortisol and cortisone and total urinary corticosteroid metabolites are negatively associated with bone turnover markers in patients receiving replacement doses of hydrocortisone, with nocturnal glucocorticoid exposure having a potentially greater influence on bone turnover.

Trial registration

Irish Medicines Board Clinical Trial Number – CT900/459/1 and EudraCT Number – 2007-005018-37. Registration date: 07-09-2007.
Candida prevalence and oral hygiene due to orthodontic therapy with conventional brackets
Authors: Grzegocka Kinga , Krzyściak Paweł , Hille-Padalis Anna , Loster Jolanta E. , Talaga-Ćwiertnia Katarzyna , Loster Bartłomiej W.
Published: October 2020

Background

Conventional brackets are often used during orthodontic therapy of patients with malocclusion. The complex construction of such brackets greatly inhibits oral hygiene, which predisposes to increased carriage of microbiota. Orthodontic brackets could act as reservoir of yeast and predispose to oral candidosis. The aim of this study was to assessCandidaprevalence and the role of oral hygiene during fixed appliance therapy.A further aim was to characterize the isolated yeasts according to their ability to form biofilms.

Methods

Seventeen participants (average age 17 ± 7 years) were monitored by taking oral rinses and elastomeric ligature samples, and by evaluating the approximal plaque index (API) and gingival bleeding index (GBI) before and after placement of the orthodontic conventional brackets for 12 weeks. Isolated yeasts were counted and biofilm formation was evaluated.

Results

One hundred and sixteen samples (67 oral rinses and 49 orthodontic elastomers) were collected. Ten patients (58.8% subjects) wereCandida-carriers (two were colonized after bracket placement) andC. albicanswas the most common species. The average number of yeasts in the oral cavity showed some fluctuation during the study, but in general had an upward trend (adj. R2 = 0.7967,p = 0.07025). A correlation was found between median number of yeasts and the periodontal indices (API, GBI). The average API values decreased in theCandida-carriers (adj.R2 = 0.95;p = 0.01709), while average GBI values increased in the noncarriers (adj.R2 = 0.92;p = 0.0256).

Conclusions

Treatment with orthodontic appliances promotesCandidayeast colonization, which is variable over time in terms of strain and species, with dominance ofC. albicans, and without increased biofilm-forming activity. The API value decreases over time in carriers, and the GBI value increases in uncolonized patients, which may have predictive significance for the development of oral candidiasis during orthodontic treatment.
Effectiveness of orthodontic temporary anchorage devices in canine retraction and anchorage preservation during the two-step technique: a systematic review and meta-analysis
Authors: Tian Haonan , Xie Congman , Lin Min , Yang Hongmei , Ren Aishu
Published: October 2020

Background

Temporary anchorage devices have been used for decades in orthodontic practice for many applications. The aim of this systematic review was to assess the effectiveness of orthodontic temporary anchorage devices in canine retraction during the two-step technique.

Methods

A search was systematically performed for articles published prior to June 30, 2019 in five electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus). The risk of bias was assessed using the Cochrane risk of bias tool for randomized controlled trials (RCTs) and the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials (CCTs). The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean differences and 95% confidence intervals were analyzed for continuous data. A meta-analysis with a random-effects model for comparable outcomes was carried out.

Results

Three RCTs and five CCTs were finally included. Meta-analysis showed a significant increase not only in anchorage preservation in the implant anchorage group in both the maxilla (1.56 mm, 95% CI: 1.14 to 1.98,P < 0.00001) and the mandible (1.62 mm, 95% CI: 1.24 to 2.01,P < 0.00001) but also in canine retraction in the implant anchorage group in both the maxilla (0.43 mm, 95% CI: 0.16 to 0.69,P = 0.001) and the mandible (0.26 mm, 95% CI: 0.02 to 0.49,P = 0.03).

Conclusions

There is very low-quality evidence showing that implant anchorage is more efficient than conventional anchorage during canine retraction. Additional high-quality studies are needed.
Integrated omics unveil the secondary metabolic landscape of a basal dinoflagellate
Authors: Beedessee Girish , Kubota Takaaki , Arimoto Asuka , Nishitsuji Koki , Waller Ross F. , Hisata Kanako , Yamasaki Shinichi , Satoh Noriyuki , Kobayashi Jun’ichi , Shoguchi Eiichi
Published: October 2020

Background

Some dinoflagellates cause harmful algal blooms, releasing toxic secondary metabolites, to the detriment of marine ecosystems and human health. Our understanding of dinoflagellate toxin biosynthesis has been hampered by their unusually large genomes. To overcome this challenge, for the first time, we sequenced the genome, microRNAs, and mRNA isoforms of a basal dinoflagellate, Amphidinium gibbosum, and employed an integrated omics approach to understand its secondary metabolite biosynthesis.

Results

We assembled the ~ 6.4-Gb A. gibbosum genome, and by probing decoded dinoflagellate genomes and transcriptomes, we identified the non-ribosomal peptide synthetase adenylation domain as essential for generation of specialized metabolites. Upon starving the cells of phosphate and nitrogen, we observed pronounced shifts in metabolite biosynthesis, suggestive of post-transcriptional regulation by microRNAs. Using Iso-Seq and RNA-seq data, we found that alternative splicing and polycistronic expression generate different transcripts for secondary metabolism.

Conclusions

Our genomic findings suggest intricate integration of various metabolic enzymes that function iteratively to synthesize metabolites, providing mechanistic insights into how dinoflagellates synthesize secondary metabolites, depending upon nutrient availability. This study provides insights into toxin production associated with dinoflagellate blooms. The genome of this basal dinoflagellate provides important clues about dinoflagellate evolution and overcomes the large genome size, which has been a challenge previously.
Postpartum plasma metabolomic profile among women with preeclampsia and preterm delivery: implications for long-term health
Authors: Hong Xiumei , Zhang Boyang , Liang Liming , Zhang Yan , Ji Yuelong , Wang Guoying , Ji Hongkai , Clish Clary B. , Burd Irina , Pearson Colleen , Zuckerman Barry , Hu Frank B. , Wang Xiaobin
Published: October 2020

Background

Preeclampsia and preterm delivery (PTD) are believed to affect women’s long-term health including cardiovascular disease (CVD), but the biological underpinnings are largely unknown. We aimed to test whether maternal postpartum metabolomic profiles, especially CVD-related metabolites, varied according to PTD subtypes with and without preeclampsia, in a US urban, low-income multi-ethnic population.

Methods

This study, from the Boston Birth Cohort, included 980 women with term delivery, 79 with medically indicated PTD (mPTD) and preeclampsia, 52 with mPTD only, and 219 with spontaneous PTD (sPTD). Metabolomic profiling in postpartum plasma was conducted by liquid chromatography-mass spectrometry. Linear regression models were used to assess the associations of each metabolite with mPTD with preeclampsia, mPTD only, and sPTD, respectively, adjusting for pertinent covariates. Weighted gene coexpression network analysis was applied to investigate interconnected metabolites associated with the PTD/preeclampsia subgroups. Bonferroni correction was applied to account for multiple testing.

Results

A total of 380 known metabolites were analyzed. Compared to term controls, women with mPTD and preeclampsia showed a significant increase in 36 metabolites, mainly representing acylcarnitines and multiple classes of lipids (diacylglycerols, triacylglycerols, phosphocholines, and lysophosphocholines), as well as a decrease in 11 metabolites including nucleotides, steroids, and cholesteryl esters (CEs) (P < 1.3 × 10−4). Alterations of diacylglycerols, triacylglycerols, and CEs in women with mPTD and preeclampsia remained significant when compared to women with mPTD only. In contrast, the metabolite differences between women with mPTD only and term controls were only seen in phosphatidylethanolamine class. Women with sPTD had significantly different levels of 16 metabolites mainly in amino acid, nucleotide, and steroid classes compared to term controls, of which, anthranilic acid, bilirubin, and steroids also had shared associations in women with mPTD and preeclampsia.

Conclusion

In this sample of US high-risk women, PTD/preeclampsia subgroups each showed some unique and shared associations with maternal postpartum plasma metabolites, including those known to be predictors of future CVD. These findings, if validated, may provide new insight into metabolomic alterations underlying clinically observed PTD/preeclampsia subgroups and implications for women’s future cardiometabolic health.
Cardiovascular risks and bleeding with non-vitamin K antagonist oral anticoagulant versus warfarin in patients with type 2 diabetes: a tapered matching cohort study
Authors: Yu Dahai , Zhao Zhanzheng , Simmons David
Published: October 2020

Background

We compared the risk of bleeding and cardiovascular disease (CVD) events between non-vitamin K antagonist oral anticoagulant (NOAC) and warfarin in people with type 2 diabetes (T2DM).

Methods

862 Incident NOAC users and 626 incident warfarin users with T2DM were identified from within 40 UK general practice (1/4/2017–30/9/2018). Outcomes included incident hospitalisation for bleeding, CVD and re-hospitalisation for CVD within 12 months since first anticoagulant prescription, identified from linked hospitalisation data. A tapered matching method was applied to form comparison cohorts: coarsened exact matching restricted the comparison to areas of sufficient overlap in missingness and characteristics: (i) demographic characteristics; (ii) clinical measurements; (iii) prior bleeding and CVD history; (iv) prescriptions with bleeding; (v) anti-hypertensive treatment(s); (vi) anti-diabetes treatment(s). Entropy balancing sequentially balanced NOAC and warfarin users on their distribution of (i–vi). Weighted logistic regression modelling estimated outcome odds ratios (ORs), using entropy balancing weights from steps i–vi.

Results

The 12-month ORs of bleeding with NOAC (n = 582) vs matched/balanced warfarin (n = 486) were 1.93 (95% confidence interval 0.97–3.84), 2.14 (1.03–4.44), 2.31 (1.10–4.85), 2.42 (1.14–5.14), 2.41 (1.12–5.18), and 2.51 (1.17–5.38) through steps i–vi. ORs for CVD re-hospitalisation was increased with NOAC treatment through steps i–vi: 2.21 (1.04–4.68), 2.13 (1.01–4.52), 2.47 (1.08–5.62), 2.46 (1.02–5.94), 2.51 (1.01–6.20), and 2.66 (1.02–6.94).

Conclusions

Incident NOAC use among T2DM is associated with increased risk of bleeding hospitalisation and CVD re-hospitalisation compared with incident warfarin use. For T2DM, caution is required in prescribing NOACs as first anticoagulant treatment. Further large-scale replication studies in external datasets are warranted.
Reproducibility of serum cytokines in an elderly population
Authors: Guo Jing , Schupf Nicole , Mayeux Richard P. , Gu Yian
Published: October 2020

Background

It is important to assess the temporal reproducibility of circulating cytokines for their utility in epidemiological studies. However, existing evidence is limited and inconsistent, especially for the elderly population.

Methods

Sixty-five elderly (mean age = 77.89 ± 6.14 years) subjects were randomly selected from an existing prospective cohort study. Levels of 41 cytokines in 195 serum samples, collected at three separate visits that were up to 15.26 years apart, were measured by the Luminex technology. The temporal reproducibility of cytokines was estimated by the intraclass correlation coefficient (ICC) calculated using a mixed-effects model. In addition, data analyses were stratified by the median (4.49 years) of time intervals across sample collection. Sensitivity analyses were performed when excluding subjects with undetectable samples.

Results

A total of 23 cytokines were detectable in more than 60% of samples. Fair to good (ICC = 0.40 to 0.75) and excellent (ICC > 0.75) reproducibility was found in 10 (Eotaxin, VEGF, FGF-2, G-CSF, MDC, GM-CSF, TGFα, IP-10, MIP-1β, IL-1RA) and 5 (GRO, IFNγ, IL-17, PDGF-AA, IL-4) cytokines, respectively. The results were not changed dramatically in the stratification and sensitivity analyses.

Conclusions

Serum levels of the selected 15 cytokines measured with Luminex technology displayed fair to excellent within-person temporal reproducibility among elderly population.
Octyl-2-cyanoacrylate tissue adhesive without subcuticular suture for wound closure after total hip arthroplasty: a prospective observational study on thirty-two cases with controls for 3 months follow-up
Authors: Wang Li-Shen , Wang Xin-Yu , Tu Hao-tian , Huang Yi-Fan , Qi Xin , Gao Yu-Hang
Published: October 2020

Background

Whether using tissue adhesive alone after subcutaneous suture can close the skin incision with safety as well as cosmetic appearance after total hip arthroplasty was not clear.

Methods

A prospective study was conducted. The same surgical methods were consistent throughout the entire study. After implanting prosthesis, the joint capsule was reconstructed. Fascial and subcutaneous layer were respectively closed by continuous running barbed suture. Patients were randomized allocated to group A with octyl-2-cyanoacrylate tissue adhesive alone, to group B with tissue adhesive after continuous subcuticular suture, or to group C with skin staples. Time of closure, drainage, pain, wound complications, and cosmesis were compared. All data were analyzed statistically.

Results

There was no significant difference in drainage, Visual Analog Scale score or early wound complications between the three groups. However, there was significant difference in time of closure (P = 0.013). In pairwise comparison, time of closure in groups A and B was significantly longer than those in group C (P = 0.001 and P = 0.023, respectively); time of closure in group A was significantly shorter than those in group B (P = 0.003). Patient and Observer Scar Assessment Scale total scores were not significantly different at 6 weeks and 3 months postoperatively (P = 0.078 and P = 0.284, respectively).

Conclusion

Tissue adhesive without subcuticular suture was similar with a combination of subcuticular suture and tissue adhesive as well skin staples in terms of safety and cosmetic appearance after total hip arthroplasty.
Adjuvant psychotherapy in early-stage bipolar disorder: study protocol for a randomized controlled trial
Authors: Stamm Thomas J. , Zwick Julia C. , O’Malley Grace , Sondergeld Lene-Marie , Hautzinger Martin
Published: October 2020

Background

Bipolar disorders are serious illnesses with a chronic course and a high rate of relapse. Typically, bipolar disorders onset during adolescence or early adulthood, with patients experiencing significant personal and social costs as a consequence of their illness. Despite this, to date, there is limited (controlled) evidence regarding the effectiveness of psychotherapy during the critical stages of the disorder (e.g., early onset). Some preliminary studies suggest that targeted, tailored early interventions in particular may improve disease prognosis. The proposed study examines the effectiveness of group psychotherapy on relapse prevention, global adaptive functioning, and neuropsychological functioning in early-stage bipolar disorder.

Methods

In this multicenter randomized controlled trial (RCT), 300 patients with bipolar disorder are randomized to one of two group psychotherapies: Specific Emotional-Cognitive Therapy (SECT; intervention group) or Emotion-Focused Supportive Therapy (EFST; active control group). Each therapy comprises of a total of 48-h sessions (delivered once a month) over a period of 4 months. Assessments take place at baseline (t1); 6 months follow-up, i.e., post-intervention (t2); 12 months follow-up (t3); and 18 months follow-up (t4), whereby 18 months follow-up is the primary time point of interest.

Discussion

The goal of this study is to test the effects of an innovative, specific group therapy relative to an active control condition in terms of rates of relapse, global functioning, and neuropsychological functioning. Pending the outcomes of the trial, it will be possible to establish a firm evidence base for accessible group psychotherapy adjuvant to routine psychiatric care for individuals with bipolar disorder.

Trial registration

USA: ClinicalTrials.gov NCT02506322. Registered on 19 December 2014; Germany: German Clinical Trials Register DRKS00006013. Registered on21 May 2015