bluuebunny/crossref_metadata_2025 huggingface dataset:
Association among fatigue, sleep disorders and other clinical parameters in Parkinson’s disease
Authors: Asano A , Asano N , Mota D , Gondim I , Aroxa F , Coriolano M , Lins O
Published: June 2020

Introduction Fatigue and sleep disorders are common in Parkinson disease (PD) patients. Fatigue is not always clinically recognized because of its subjective character manifested by feelings of extreme tiredness. These non-motor symptoms can occur from the early stages of the disease and tend to persist.

Objectives To evaluate fatigue in patients with PD and the possible association with sleep disorders and other clinical parameters of the PD; and to evaluate the impact of fatigue on quality of life

Methodology A cross-sectional study with 123 patients with PD was implemented. The following instruments were used: Mini Mental State Examination, the Hoehn-Yarh Scale, Beck Depression Inventory, Parkinson’s Disease Quality of Life Questionnaire, Parkinson’s Disease Sleep Scale, Epworth Sleepiness Scale, and Parkinson’s Disease Fatigue Scale.

Results Fatigue was found in 48% of patients. Patients with fatigue presented longer duration of illness, depressive symptoms, cognitive impairment, severity of motor symptoms, excessive daytime sleepiness and nocturnal sleep disorder. Fatigue combined with sleep disorder occurred in 21% of the total sample, being more frequent in females (32% vs 15%) and in patients at more advanced stages of the disease (52% in HY3). The multiple logistic regression analysis indicated that the significant independent variables for the presence of fatigue were: cognition (OR = 1.19 P = 0.02), nocturnal sleep disorder (OR = 1.03 P = 0.0001); among PDSS domains, nocturnal motor symptoms (OR = 1.09 P = 0.0005) and sleep refreshment (OR = 1.11 P = 0.02); among PDQ-39 domains, mobility (OR = 0.9323 P < 0.0001) and body discomfort (OR = 0.9767 P = 0.0428).

Conclusion Fatigue is common in PD, especially in the more advanced stages, and it seems to be associated with the female gender, nocturnal sleep disorder and cognition, having thus a negative impact on the quality of life.
Lung function in wind instrument players of philharmonic bands
Authors: Cunha I , Gonçalves L
Published: June 2020

Introduction In order to play a wind instrument one must have a good breathing control with rhythm variation, control of inspiratory and expiratory volume as well as a good control of the airflow transmitted by the musician through the different mouthpieces. The pulmonary function of the different wind instrument players has been scarcely studied generating divergent conclusions.

Objectives To characterize and compare lung function and functional capacity of musicians of different wind instruments.

Methodology One hundred and one individuals from five philharmonic bands from Aveiro and Porto districts were studied. Smokers or ex-smokers for less than one year, respiratory pathology, history of chronic pulmonary or cardiac disease were exclusion criteria. The sample was divided into three groups: "Air reed", "Reeds" and "Metals". Pulmonary function was assessed by spirometry: forced vital capacity (FVC), forced expiratory volume in first second (FEV1), Tiffeneau index (TI), peak expiratory flow (PEF) and maximal voluntary ventilation (MVV). Functional capacity was assessed using the six-minute walk test (6-MWT). Data analysis was performed in the Statistical Package for the Social Sciences with a 95% confidence interval. Chi-square test, Mann-Whitney U test, ANOVA test and Kruskal-Wallis test were used.

Results All spirometric parameters with the exception of TI were increased in "Metals" group with significant decrease in the "Air reed" parameters of FEV1 (p = 0.045) and MVV (p = 0.004). A negative correlation between FEV1 and 6-MWT was noticed in male musicians (r=-0.291; p = 0.022).

Conclusion Musicians from the “Metals” group showed better lung function when compared to other groups. There was no positive correlation between lung function and functional capacity of the studied musicians. However, there was a weak negative correlation between FEV1 of male musicians and their functional capacity.
Obstructive Sleep Apnea Syndrome - Predictive Indicators of Severity
Authors: Castro J , Silva H , Coelho P , Pereira T
Published: June 2020

Introduction Obstructive Sleep Apnea Syndrome (OSAS) is a public health issue, due to its increasing prevalence and associated morbidity and mortality, worsened by the underestimated diagnosis of this entity in clinical practice.

Objectives To correlate clinical, demographic and anthropometric indicators, and elaborate a predictive equation for OSAS severity and prevalence, in males and females.

Methodology In this cross-sectional study, all the included patients performed a type I Polysomnography in ULSM – HPH Neurophysiology Laboratory, between July 2011 and December 2017. Patient’s weight, height, body mass index (BMI), waist circumference (WC) and neck circumference (NC) were assessed. Daytime excessive sleepiness was rated through the Epworth Sleepiness Scale (ESS). The apnea-hypopnea index and the snoring presence were obtained through the polygraphic recording. Demographic, anthropometric, clinical variables and ESS punctuation were correlated with the presence of OSAS and its severity through a multivariable regression model.

Results The study included 472 patients (275 males and 197 females). OSAS prevalence was 65,7% (75,3% in males and 52,3% in females), being the males related to the most severe forms of OSAS (p < 0,001), the same happening with the age group 60-69 years. OSAS severity correlated directly with NC, WC, BMI and ESS increase. Snoring was present in 92,8% of the cases and did not correlate with OSAS severity. In females, severity correlated directly with age and BMI. Age and NC were identified as the strongest independent OSAS predictors (p-value=0,011 and p-value=0,006, respectively).

Conclusion In this study, OSAS severity predictors were gender, age, NC, WC, BMI, snoring and ESS result (NC and age were the strongest independent predictors). These findings should be confirmed in more robust studies, to identify patients at risk of severe OSAS, to allow earlier diagnostic evaluation and therefore preventing OSAS associated complications.
eLearning Technologies on the follow-up of Young People with Chronic Diseases
Authors: Pascual J , García S , Pedrosa I , Lapuente I , Lapuente B , Delgado A , Azema D , Raupp A , Oliveira M , Berthier A , Bastier S , Lapeyre Y , Teixeira P
Published: June 2020

Introduction Non-communicable diseases are increasing worldwide due mainly to rapidly changing lifestyles and socio-economic status affecting the well-being and the lives of young people along their whole life. Hence, there is a need to provide adequate and useful measures to support patients living with those diseases in order to foster youth emotional and physical health and improve their daily life.

Objectives The aim of this presentation is to demonstrate the use of eLearning content to empower families, communities and young patients in dealing with the daily routine of chronic diseases.

Methodology Based on a human centred design, 176 youngsters with asthma, obesity, and diabetes aged between 3-16 years old were assessed to gather information about perceived needs and preferences in relation to disease management. Ineffective communication, lack of knowledge/skills, poor adherence to treatment and low acceptance of the disease were the main aspects highlighted. Based on those results, participants were fully involved participating in the iterative development of eLearning package to face these needs, gathering specific information about its content, design and usability.

Results The project has generated eLearning modules, using Articulate technologies, providing practical information and learning content in three languages, in partnership with health research centres, hospitals and patient associations in Portugal, Spain and France. There are lots of packages: obesity, respiratory diseases and diabetes. In each of these, the content is provided using gamification strategies and role models. eLearning is one of the components of the follow up process, being complemented by a mobile application with an interactive support chat and fun games.

Conclusion ELearning tools, along with other online tools, contribute to generate a more positive perspective on the control of the disease and to support families and patients to get reliable information and connect with medical assistance.
Association between functional physical fitness and health status of the elderly
Authors: Batista A , Flores G , Carvalho S , Sampaio M , Patrício C
Published: June 2020

Introduction Portugal currently has one of the most aging populations in Europe. Aging is usually associated with increased inactivity, decreased physical capacity and a higher incidence of disease, all of which leads to a reduction in functional changes and, consequently, loss of independence. Therefore, it is necessary to ensure that this population maintains a satisfactory level of physical and mental skills, emotional well-being and especially independence to perform day-to-day activities, and, to that end, measures are needed to promote health and allow a better quality of life.

Objectives To verify if the physical fitness components are determinant for the health status of the elderly.

Methodology A cross-sectional study was carried out on non-institutionalized elderly. For data collection, a questionnaire with sociodemographic data, the SF-12 questionnaire, to assess health status (physical and mental component), and the Senior Fitness Test (strength of lower and upper limbs, agility / balance, flexibility of the lower and upper limbs and cardiorespiratory ﬁtness) to assess functional physical fitness were conducted.

Results The sample is composed of 439 individuals, aged between 65 and 95 years old, mostly women. The set of physical fitness components: cardiorespiratory ﬁtness, agility / balance, body mass index, lower and upper limb strength, explained by 35% of the variation in physical component from SF-12. The cardiorespiratory ﬁtness and upper limb strength predict 9% of mental health status.

Conclusion Some physical fitness components determine elderly health status, especially the physical dimension. Thus, for the elderly population the training of these components of the physical fitness is recommended in order to improve their health status.
Forssman Prevalence in a Portuguese Donor Population
Authors: Mourato C , Corpuz A , Sousa J , Martins D , Pereira C , Tomaz J , Barreira R , Rocha C , Mendes F
Published: June 2020

Introduction Discovered in 1911 by Frederick Forssman, the Forssman (Fs) antigen (Ag) expression varies among species, being rarely present on human red blood cells (RBC). In 1987 three unrelated English families were identified with a phenotype designed Apae which was later classified as the 31st blood group: FORS. Since antibodies (Ab) anti-Fs has natural occurrence and the expression of the Ag occurs on the surface of the RBC, body fluids and organs, raises a potential role for this antigen in transfusion and transplantation implications.

Objectives Our main goals were to evaluate the prevalence of anti-Fs Ab and clarify its impact in transfusional medicine by classifying the type of immunoglobulin (Ig) involved.

Methodology 3-5% sheep RBC suspension with positive expression for Fs Ag was used to evaluate the presence of Ab anti-Fs in plasma samples from a Portuguese population of blood donor and classify the immunoglobulin involved. Standard tube technique was used in all the experiments.

Results From a total of 11877 donors, 117 (0,99%) showed weak reactions (between 0 and 1 in a scale from 0 to 4). All these samples would be further studied to evaluate the presence of the Arg296Gln in the GBGT1 gene. Also, from the 192 samples studied to classify the Ab involved, 52% revealed to be only IgM, being the rest a mixture between IgG and IgM.

Conclusion The population studied revealed few samples with negative reaction against the sheep RBC confirm the low-prevalence of this blood group. The majority from the Ab to be IgM was also corroborated although the presence of an IgG portion can be clinically significant once it can cross the placental barrier.
Blueberries effects in experimental diet-induced prediabetes: a focus on renal impairment
Authors: Alves A , Preguiça I , Barbosa A , Vieira P , Martins D , Nunes S , Viana S , Reis F
Published: June 2020

Introduction Benefits arising from blueberry (BB) consumption are well-described in type 2 diabetes evolution and inherent complications. Lending further support to this thesis, previous work from our group unequivocally demonstrates BB supplementation efficacy to manage prediabetic hepatic liver steatosis. Whether a similar effect also holds truth in early renal impairment is an unsolved issue.

Objectives To address blueberry juice (BJ) ability to exert renoprotective effects in experimental prediabetes.

Methodology Diet-induced prediabetes [high-sucrose (35% Hsu) and high-fat (60% HF)] was developed in adult male Wistar rats through the ingestion of HSu for 9 weeks supplemented by HF for another 14 weeks (HSuHF, n = 16). On W9, half of the former animals orally received BJ (25g/kg BW, HSuHF+BJ). Control animals (n = 8) received standard diet during the entire protocol. Functional [serum and urinary creatinine, uric acid, glucose; glomerular filtration rate (GFR)], structural [H&E and Oil Red O staining] and molecular [triglycerides content and inflammation (RT-qPCR, WB)] markers of renal injury were assessed along with metabolic profile.

Results Even though diet-induced glucose intolerance, insulin insensitivity and plasmatic hypertriglyceridemia were significantly ameliorated upon BJ treatment, this nutraceutical intervention was unable to halt or slow down renal lipidosis and glomerular crescent-like lesions apart from a slight amelioration of both GFR and IL-6 levels in HSuHF-treated rats.

Conclusion Unlike previous results clearly demonstrating the ability of BJ nutraceutical intervention to afford protection against metabolic impairment and hepatic steatosis evolution in experimentally diet-induced prediabetes, only a modest renoprotective effect was observed in functional and morphological renal endpoints. Future studies are warranted to dissect the divergent effects of BJ on early liver and kidney impairment.
Hydrotherapy in the evaluation of enzymatic antioxidants in an elderly population
Authors: Valado A , Fortes S , Morais M , Rosado J , Figueiredo JP , Barreira R , Caseiro A
Published: June 2020

Introduction Oxidative stress is the imbalance between reactive species produced in the body during metabolic reactions and antioxidant agents that have the ability to neutralize or prevent the formation of these species. One of the effects of oxidative stress is the normal and physiological process of cell aging that arises from the accumulation of tissue damage caused by free radicals.

Objectives To assess whether the activity of enzymes superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione reductase (GR) are influenced by the hydrotherapy sessions.

Methodology 37 subjects aged 60 years old and above, of both genders, were divided into two groups (experimental and control). The experimental group underwent 15 hydrotherapy sessions supervised by a physical therapist. Two peripheral venous blood samples were collected at two different times: T0, instant before the intervention and T1, instant after the last session. The activity of SOD, GPx and GR enzymes were determined, respectively, with the Ransod superoxide dismutase, Ransel glutathione peroxidase and glutathione reductase commercial kits, from Randox Laboratories Limited, United Kingdom. The assay was performed as described in the kits and the sample results were obtained by spectrophotometric reading.

Results SOD activity at T1 tended to decrease slightly compared to T0 (1437.64 ± 593.46 vs 1421.41 ± 705.39 U/g Hb). At T1, there was a statistically significant increase in GPx activity (48.14 ± 17.22 vs 57.72 ± 19.99 U/g Hb) and in GR activity (78.44 ± 21.26 vs 100.18 ± 30.85 U/L). Regarding gender, both genders tended to have higher values of GPx and GR at T1.

Conclusion According to the obtained results, we conclude that the practice of hydrotherapy presents as a positive stimulus in the antioxidant activity of aged individuals suggesting that a regular and moderate practice of exercise induces a higher quality of life.
Targeting TRIB2 expression with oral antidiabetic drugs to overcome tumour malignancy and drug-resistance
Authors: Sousa-Coelho A
Published: June 2020

Introduction TRIB2 is one of three members of the Tribbles family, which interacts and activates the protein kinase AKT, associated to the suppression of FOXO in melanoma, which mediate insulin action on key functions involved in cell metabolism and growth. TRIB2, recently identified as a druggable protein, has been pointed as a cause of resistance to cancer therapies, and so, modulating its expression might be a suitable strategy to overcome tumour malignancy and drug-resistance. Members from the thiazolidinediones (TZDs) family of oral antidiabetic insulin-sensitizing drugs, available in clinical settings, have been previously reported to be effective in melanoma, however there are still controversial results.

Objectives Identifying new therapeutic strategies to overcome therapeutic resistance in TRIB2-positive cancers.

Methodology Analyses of TRIB2’s expression levels in different samples in response to TZDs, using GEO profiles available at public data repository with the following advanced search terms: TRIB2 [gene] AND Rosiglitazone OR Pioglitazone OR Troglitazone.

Results From a total of 15 independent studies, it was found that TRIB2 was up-regulated in Rosi-treated human dendritic cells, skeletal muscle from obese PCOS women treated with Pioglitazone, and liver from obese rats treated either with Pio or Troglitazone. By contrast, TRIB2 was down-regulated in white adipose tissue (WAT) from obese rats treated either with Pio or Troglitazone, in Rosi-treated mouse stromal vascular cells from inguinal WAT, and in PPARγ–overexpressed marrow mesenchymal stem cells treated with Rosiglitazone.

Conclusion Although TRIB2 expression was modulated by the different TZDs in certain samples, depending on the cellular context, it was either up- or down-regulated. While further studies are needed, especially in a malignancy environment, TZDs treatment of TRIB2-positive cancer does not seem to be a valuable therapeutic strategy and might be even counter-productive.
Correlation of static knee angle in kinematic and radiographic in medial knee osteoarthritis
Authors: Ferreira V , Machado L , Vilaça A , Xará-Leite F , Roriz P
Published: June 2020

Introduction The hip-knee-ankle (HKA) angle measured on a full-length weight bearing X-ray made in standing position is considered the gold standard to measure the knee static alignment. However, this method requires special equipment, involves significant radiation exposure and generates extra costs. The 3D motion capture can assess knee angles in a reliable and accurate way.

Objectives This study aimed to analyse the correlation between the HKA angle achieved in full-length X-ray and the in static knee kinematic analysis in patients with medial knee osteoarthritis (OA).

Methodology A descriptive study was design. Anterior-posterior full-limb radiographs were obtained using standard procedures in the same hospital. The HKA angle was measure by an experimental orthopaedic doctor. The kinematics were obtained using Visual3D software after 3D motion capture in two static positions: static comfortable position (Static-1) and a static standard position (Static-2). Kinematic data were filtered (6 Hz) and expressed in degrees (°). The knee joint was created by the distance between the distal end of the thigh and the proximal end of the shank. The angles lower than 180° were considered as varus alignment and those higher than 180° valgus alignment.

Results This study includes 36 patients (22 females; mean age 61,6 ± 8,4; weight 75,8 ± 12,7 kg, and height 161 ± 9,2 cm) with diagnosed medial knee OA Kellgren/Lawrence grade 2 (16 patients) or 3. The patients presented a mean of HKA of 176,2° ± 3,2 in X-ray; 182,1° ± 6,0 in Static-1 and 180,0° ± 5,6 in Static-2. A significant correlation was found between HKA angle and Static-1 (r = 0,525; p = 0,001) and between HKA angle and Static-2 (r = 0,556; p = 0,000).

Conclusion A moderate but significant correlation was found between X-ray and two measure of 3D motion capture in frontal knee angle. Clinically, 3D analysis may help health care professionals in a more practical way to identify the joint angles.
Anisometropia in the 5th and 6th school years
Authors: Nunes A F , Nunes A S , Monteiro P , Martins C R , Forte H
Published: June 2020

Introduction Anisometropia is characterized by a refractive inter ocular difference greater than 1.00 dioptre (D). It is the main cause of amblyopia and loss of binocular vision. Its prevalence depends on several factors, being different values in different geographical areas of the world and in different age groups.

Objectives To estimate the frequency of anisometropia in children of the 2nd cycle of Basic Education.

Methodology A total of 519 children attending the 5th and 6th school years, from Covilhã schools, from urban and rural areas, aged between 9 and 14 years (10.8 ± 0.8 years) were enrolled in the study. The refractive error was measured with a paediatric auto refractometer (Plusoptix), without cycloplegic and in binocular conditions. Anisometropia was defined as the inter ocular difference in spherical equivalent or cylindrical, greater than 1.00 D and a separate analysis for values greater than 2.00 D.

Results The sample was symmetrically divided into genders (50.9% Male), between school grade (53% 5th year) and higher in urban areas (70.1%). The prevalence of anisometropia with cut-off points of 1.00 D and 2.00 D was 12.3% and 5.0%, respectively. There was a higher prevalence among males, in rural areas and in 6th grade. The Chi-square test (□2) shows that the difference is statistically significant only between years of schooling, with a higher prevalence in the 6th grade (p = 0.001).

Conclusion There was a slightly higher prevalence of spherical and cylindrical anisometropia (5% and 12.3%) than is reported in the literature (rates between 4.4% and 9.4%). The 6th school year presented rates significantly higher than the 5th year, which points out that anisometropia increases with age, as was also advocated by other authors. Visual screening programs in adolescence for the detection of anisometropia are fundamental, since their timely correction allows to safeguard the binocular vision.
AcGI1, a novel genomic island carrying antibiotic resistance integron In687 in multidrug resistant Achromobacter xylosoxidans in a teaching hospital in Thailand
Authors: Pongchaikul Pisut , Santanirand Pitak , Antonyuk Svetlana , Winstanley Craig , Darby Alistair C
Published: June 2020

This study investigated the genetic basis of multidrug resistance in two strains of Achromobacter xylosoxidans isolated from patients attending a hospital in Thailand in 2012. These isolates were highly resistant to cephalosporins, aminoglycosides, fluoroquinolones, co-trimoxazole and carbapenems. Whole genome sequencing revealed that the two isolates were not clonally related and identified a carbapenem resistance gene-habouring integron (In687), residing in a novel genomic island, AcGI1. This In687 shares 100% identical nucleotide sequence with ones found in Acinetobacter baumannii Aci 16, isolated from the same hospital in 2007. We report the first analysis of multidrug-resistant A. xylosoxidans isolated in Thailand, and the first example of this island in A. xylosoxidans. Our data support the idea that resistance has spread in Thailand via horizontal gene transfer between species and suggest the possibility of A. xylosoxidans may serve as a reservoir of antibiotic resistance, especially in hospital setting.
Clinical Characteristics and Factors Associated With Long-Term Viral Excretion in Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection: a Single-Center 28-Day Study
Authors: Shi Ding , Wu Wenrui , Wang Qing , Xu Kaijin , Xie Jiaojiao , Wu Jingjing , Lv Longxian , Sheng Jifang , Guo Jing , Wang Kaicen , Fang Daiqiong , Li Yating , Li Lanjuan
Published: June 2020

Background

Despite the ongoing spread of coronavirus disease 2019 (COVID-19), knowledge about factors affecting prolonged viral excretion is limited.

Methods

In this study, we retrospectively collected data from 99 hospitalized patients with coronavirus disease 2019 (COVID-19) between 19 January and 17 February 2020 in Zhejiang Province, China. We classified them into 2 groups based on whether the virus test results eventually became negative. Cox proportional hazards regression was used to evaluate factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding.

Results

Among 99 patients, 61 patients had SARS-CoV-2 clearance (virus-negative group), but 38 patients had sustained positive results (virus-positive group). The median duration of SARS-CoV-2 excretion was 15 (interquartile range, 12–19) days among the virus-negative patients. The shedding time was significantly increased if the fecal SARS-CoV-2 RNA test result was positive. Male sex (hazard ratio [HR], 0.58 [95% confidence interval {CI}, .35–.98]), immunoglobulin use (HR, 0.42 [95% CI, .24–.76]), APACHE II score (HR, 0.89 [95% CI, .84–.96]), and lymphocyte count (HR, 1.81 [95% CI, 1.05–3.1]) were independent factors associated with a prolonged duration of SARS-CoV-2 shedding. Antiviral therapy and corticosteroid treatment were not independent factors.

Conclusions

SARS-CoV-2 RNA clearance time was associated with sex, disease severity, and lymphocyte function. The current antiviral protocol and low-to-moderate dosage of corticosteroid had little effect on the duration of viral excretion.
Subcutaneous administration of benzathine benzylpenicillin G has favourable pharmacokinetic characteristics for the prevention of rheumatic heart disease compared with intramuscular injection: a randomized, crossover, population pharmacokinetic study in healthy adult volunteers
Authors: Kado Joseph H , Salman Sam , Henderson Robert , Hand Robert , Wyber Rosemary , Page-Sharp Madhu , Batty Kevin , Carapetis Jonathan , Manning Laurens
Published: June 2020

Background

Benzathine penicillin G has been used as monthly deep intramuscular (IM) injections since the 1950s for secondary prevention of acute rheumatic fever and rheumatic heart disease (RHD). Injection frequency and pain are major programmatic barriers for adherence, prompting calls for development of better long-acting penicillin preparations to prevent RHD. We hypothesized that subcutaneous (SC) administration of benzathine penicillin G could delay penicillin absorption when compared with IM injections.

Methods

To compare the pharmacokinetic profile and tolerability of benzathine penicillin G according to different routes of administration, 15 healthy males participated in a randomized crossover study to receive benzathine penicillin G by either SC or IM routes, with a 10 week washout period before the second dose by the alternative route. Ultrasound guidance confirmed injection location. Penicillin concentrations and pain scores were measured for 6 weeks following injections.

Results

SC administration was well tolerated with no significant differences in pain scores. Following SC injection, the principal absorption half-life (95% CI) was 20.1 (16.3–29.5) days and 89.6% (87.1%–92.0%) of the drug was directed via this pathway compared with 10.2 (8.6–12.5) days and 71.3% (64.9%–77.4%) following IM administration. Lower peak and higher trough penicillin concentrations resulted following SC injection. Simulations demonstrated that SC infusion of higher doses of benzathine penicillin G could provide therapeutic penicillin concentrations for 3 months.

Conclusions

SC administration of benzathine penicillin G is safe and significantly delays penicillin absorption. High-dose benzathine penicillin G via the SC route would fulfil many product characteristics required for the next generation of longer-acting penicillins for use in RHD.
Population connectivity of the crab Gandalfus yunohana (Takeda, Hashimoto & Ohta, 2000) (Decapoda: Brachyura: Bythograeidae) from deep-sea hydrothermal vents in the northwestern Pacific
Authors: Watanabe Hiromi K , Chen Chong , Kojima Shigeaki , Kato Shogo , Yamamoto Hiroyuki
Published: June 2020

Genetic connectivity provides a basis for evaluating the resilience of animal communities by elucidating gene flow and serves as a proxy for realized dispersal through planktonic larval dispersal, settlement, and reproductive success. Gandalfus yunohana (Takeda, Hashimoto & Ohta, 2000) is a brachyuran crab endemic to deep-sea hydrothermal vents in the northwestern Pacific. Although an iconic and often dominant species, the connectivity among its populations is yet to be examined. We obtained barcoding sequences of the mitochondrial COI gene of G. yunohana from four vent fields including two on the Izu Arc, one on the northern Mariana Arc, and one in the Okinawa Trough. Genetic diversity of populations on the Izu and northern Mariana arcs were similar and shared the dominant haplotypes, showing no genetic subdivision regardless of the habitat depth. The Okinawa Trough population, for which only one specimen was available, was not genetically different from specimens from the Izu/Mariana arc populations. Estimation of the number of immigrants among populations suggests that the migration from north to south is higher than in the reverse direction. Our results resonate with previous laboratory-culture experiments, suggesting a high dispersal capability for G. yunohana. Visual observations and sampling, however, suggest that G. yunohana is exceedingly rare in the Okinawa Trough. This perhaps results from a lack of sufficient larval supply from the Izu-Bonin-Mariana Arc vents, and there may not be a reproductive population in the Okinawa Trough.
Comparison of survival outcomes between laparoscopic and open surgery in patients with low-risk endometrial cancer
Authors: Togami Shinichi , Kawamura Toshihiko , Yanazume Shintaro , Kamio Masaki , Kobayashi Hiroaki
Published: June 2020

Objective

To evaluate the feasibility, safety and surgical outcomes of laparoscopic surgery for the treatment of low-risk endometrial cancer.

Methods

Of 155 patients with low-risk endometrial cancer, who were included in this retrospective study between May 2008 and March 2017, 82 and 73 underwent laparoscopic and open surgery, respectively. Clinicopathological and surgical data, recurrence-free survival and overall survival were analyzed.

Results

No statistically significant differences in median age, final pathological type, International Federation of Gynecology and Obstetrics stage and lymphovascular space involvement were observed between the laparoscopic and open surgery groups. No procedure in the laparoscopic surgery group was converted to open surgery. The median follow-up period was 60 months, with oncologic recurrence identified in three cases (one lung carcinoma and two pelvic cavity carcinomas) in the laparoscopic surgery group. There was no significant between-group difference in 5-year recurrence-free survival (laparoscopic surgery group: 96.3%, open surgery group: 92.6%) and overall survival (laparoscopic surgery group: 100%, open surgery group: 95.4%).

Conclusions

Laparoscopic surgery is a feasible and safe treatment for endometrial cancer and should be considered as a standard treatment option for low-risk endometrial cancer.
Multidrug-Resistant Organisms from Ophthalmic Cultures: Antibiotic Resistance and Visual Acuity
Authors: Schulte Alexandra J , Agan Brian K , Wang Heuy-Ching , McGann Patrick T , Davies Brett W , Legault Gary L , Justin Grant A
Published: June 2020

Introduction

There is a growing trend of multidrug-resistant organisms (MDRO). The goal of this study was to characterize MDRO at a single center from ophthalmic cultures to better understand how treatments were tailored and to assess effect on visual acuity.

Materials and Methods

The MDRO data were collected by the Multidrug-Resistant Organism Repository and Surveillance Network from the Brooke Army Medical Center clinical laboratory. Both patient- and isolate-specific data were collected and qualitatively analyzed. Primary outcome measures were organism and type of resistance, anatomic location of isolate, initial and final antibiotic choice, and visual acuity.

Results

Thirty-one bacterial culture samples were analyzed from 29 patients. Twenty-two (72%) were Gram-positive and all were methicillin-resistant Staphylococcus aureus (MRSA). Nine (29%) were Gram-negative and of these five were Pseudomonas spp. Fourteen (45%) isolates were cultured from the cornea, nine (29%) from the lid, four (13%) from the conjunctiva, and four (13%) from other locations. The majority (66.6%) required adjustment of initial antibiotics following ocular culture results. Sixteen adult patients had recorded initial and final visual acuities. Fifteen of those 16 patients had stable or improved visual acuities following treatment of the infection, but five patients had a final visual acuity less than 20/200.

Conclusion

This study demonstrated a high frequency of corneal MDRO infections and specifically MRSA and Pseudomonas spp. isolates. Antibiotic treatments frequently required adjustment. Further prospective study of visual outcomes from ophthalmic MDRO cultures is needed.
Comparable Disease Severity by Influenza Virus Subtype in the Acute Respiratory Infection Consortium Natural History Study
Authors: Schofield Christina , Colombo Rhonda E , Richard Stephanie A , Chen Wei-Ju , Fairchok Mary P , Maves Ryan C , Arnold John C , Danaher Patrick J , Deiss Robert G , Lalani Tahaniyat , Rajnik Michael , Millar Eugene V , Coles Christian L , Burgess Timothy H
Published: June 2020

Introduction

Since the influenza A/H1N1 pandemic of 2009 to 2010, numerous studies have described the clinical course and outcome of the different subtypes of influenza (A/H1N1, A/H3N2, and B). A recent systematic literature review concluded that there were no appreciable differences in either clinical presentation or disease severity among these subtypes, but study parameters limit the applicability of these results to military populations. We sought to evaluate differences in disease severity among influenza subtypes in a cohort of healthy, primarily outpatient adult U.S. Department of Defense beneficiaries.

Materials and Methods

From 2009 to 2014, we enrolled otherwise healthy adults age 18 to 65 years with influenza-like illness in an observational cohort study based in 5 U.S. military medical centers. Serial nasopharyngeal swabs were collected for determination of etiology and viral shedding by polymerase chain reaction. The presence and severity of symptoms was assessed by interview and patient diary.

Results

Over a 5-year period, a total of 157 adults with laboratory-confirmed influenza and influenza subtype were enrolled. Of these, 69 (44%) were positive for influenza A(H1N1), 69 (44%) for influenza A(H3N2), and 19 (12%) for influenza B. About 61% were male, 64% were active duty military personnel, and 72% had received influenza vaccine in the past 8 months. Almost 10% were hospitalized with influenza. Seasonal influenza virus distribution among enrollees mirrored that of nationwide trends each year of study. Individuals with A/H1N1 had upper respiratory composite scores that were lower than those with A/H3N2. Multivariate models indicated that individuals with A(H1N1) and B had increased lower respiratory symptom scores when compared to influenza A(H3N2) (A[H1N1]: 1.51 [95% CI 0.47, 2.55]; B: 1.46 [95% CI 0.09, 2.83]), whereas no other differences in symptom severity scores among influenza A(H1N1), influenza A(H3N2), and influenza B infection were observed. Overall, influenza season (maximum in 2012–2013 season) and female sex of the participant were found to be associated with increased influenza symptom severity.

Conclusions

Our study of influenza in a cohort of otherwise healthy, outpatient adult Department of Defense beneficiaries over 5 influenza seasons revealed few differences between influenza A(H1N1), influenza A(H3N2), and influenza B infection with respect to self-reported disease severity or clinical outcomes. This study highlights the importance of routine, active, and laboratory-based surveillance to monitor ongoing trends and severity of influenza in various populations to inform prevention measures.
Abdominal neoplastic manifestations of neurofibromatosis type 1
Authors: Dare Anna J , Gupta Abha A , Thipphavong Seng , Miettinen Markku , Gladdy Rebecca A
Published: June 2020

Neurofibromatosis type 1 (NF1) is an autosomal dominant hereditary tumor syndrome, with a wide clinicopathologic spectrum. It is defined by characteristic central nervous system, cutaneous and osseous manifestations, and by mutations in the NF1 gene, which is involved in proliferation via p21, RAS, and MAP kinase pathways. Up to 25% of NF1 patients develop intra-abdominal neoplastic manifestations including neurogenic (commonly plexiform neurofibromas and malignant peripheral nerve sheath tumors), interstitial cells of Cajal (hyperplasia, gastrointestinal stromal tumors), neuroendocrine, and embryonal tumors (rhabdomyosarcoma). Nonspecific symptoms, multifocal disease, or coexistence of 2 or more tumor types make patients challenging to diagnose and manage. Screening for intra-abdominal tumors in NF1 patients remains controversial, and currently no guidelines are established. Management decisions are complex and often informed by single-center experiences or case studies in the literature, though the field is rapidly evolving. Thus, NF1 patients should be followed in specialist centers familiar with their wide spectrum of pathology and with multidisciplinary care including specialized pathology and radiology. This review will (1) provide a contemporaneous synthesis of the literature and our multi-institutional clinical experiences with intra-abdominal neoplasms in NF1 patients, (2) present a classification framework for this heterogeneous group of disorders, and (3) outline approaches to screening, surveillance, diagnosis, and management.
Electroweak fermion triangle loop contributions to the muon anomalous magnetic moment revisited
Authors: Sasaki Ken
Published: June 2020

The contribution to the muon anomalous magnetic moment from the fermion triangle loop diagrams connected to the muon line by a photon and a $Z$ boson is re-analyzed in both the unitary gauge and the ’t Hooft–Feynman gauge. With use of the anomalous axial-vector Ward identity, it is shown that the calculation in the unitary gauge exactly coincides with the one in the ’t Hooft–Feynman gauge. The part which arises from the ordinary axial-vector Ward identity corresponds to the contribution of the neutral Goldstone boson. For the top-quark contribution, the one-parameter integral form is obtained up to the order of $m_\mu^2/m_Z^2$. The results are compared with those obtained by the asymptotic expansion method.
Risk factors associated with Pneumocystis jirovecii pneumonia in juvenile myositis in North America
Authors: Sabbagh Sara E , Neely Jessica , Chow Albert , DeGuzman Marietta , Lai Jamie , Lvovich Svetlana , McGrath Tara , Pereira Maria , Pinal-Fernandez Iago , Roberts Jordan , Rouster-Stevens Kelly , Schmeling Heinrike , Sura Anjali , Tarshish Gabriel , Tucker Lori , Rider Lisa G , Kim Susan ,   for the CARRA JDM Workgroup and the Childhood Myositis Heterogeneity Study Group
Published: June 2020

Objectives

Pneumocystis jirovecii pneumonia (PJP) is associated with significant morbidity and mortality in adult myositis patients; however, there are few studies examining PJP in juvenile myositis [juvenile idiopathic inflammatory myopathy (JIIM)]. The purpose of this study was to determine the risk factors and clinical phenotypes associated with PJP in JIIM.

Methods

An research electronic data capture (REDCap) questionnaire regarding myositis features, disease course, medications and PJP infection characteristics was completed by treating physicians for 13 JIIM patients who developed PJP (PJP+) from the USA and Canada. Myositis features and medications were compared with 147 JIIM patients without PJP (PJP–) from similar geographic regions who enrolled in National Institutes of Health natural history studies.

Results

PJP+ patients were more often of Asian ancestry than PJP– patients [odds ratio (OR) 8.7; 95% CI 1.3, 57.9]. Anti- melanoma differentiation associated protein 5 (MDA5) autoantibodies (OR 12.5; 95% CI 3.0, 52.4), digital infarcts (OR 43.8; 95% CI 4.2, 460.2), skin ulcerations (OR 12.0; 95% CI 3.5, 41.2) and interstitial lung disease (OR 10.6; 95% CI 2.1, 53.9) were more frequent in PJP+ patients. Before PJP diagnosis, patients more frequently received pulse steroids, rituximab and more immunosuppressive therapy compared with PJP– patients. Seven PJP+ patients were admitted to the intensive care unit and four patients died due to PJP or its complications.

Conclusions

PJP is a severe infection in JIIM that can be associated with mortality. Having PJP was associated with more immunosuppressive therapy, anti-MDA5 autoantibodies, Asian race and certain clinical features, including digital infarcts, cutaneous ulcerations and interstitial lung disease. Prophylaxis for PJP should be considered in juvenile myositis patients with these features.
Self-Reported Emotional Reactivity, Depression, and Anxiety: Gender Differences among a Psychiatric Outpatient Sample
Authors: Dell Nathaniel A , Vidovic Kristina R , Huang Jin , Pelham Michelle
Published: June 2020

The objective of this study was to identify the relationship of emotional reactivity with depression and anxiety symptoms among adults diagnosed with a serious mental illness (SMI) and to explore gender differences in these relationships. Cross-sectional data were collected from intensive case management services recipients (N = 150). Hierarchical multiple regression was used to identify the associations of self-reported positive emotions, fear, sadness, and anger to depression and anxiety, while testing the interaction of gender with emotional response. Compared with men, women reported significantly higher depressive and anxiety symptoms and greater reactivity to sadness and fear. Emotional response variables explained 35.5% of the variance in depression and 38.7% in anxiety. Gender did not moderate the relationship between emotional response and depression; however, gender did moderate the relationship between reactivity to positive emotions and anxiety. Self-reported emotional response may provide clinicians with insight into the severity and presentation of co-occurring anxiety and depressive symptoms among adults with SMI. Increasing the experience of positive emotions among women with SMI may contribute to reduced anxiety symptoms. Therapists and rehabilitation counselors may consider the interplay between mood and anxiety symptoms and emotional response styles to reduce the burden of psychiatric distress among people with SMI.
Clinical Profile of Children with Mediastinal Tuberculosis
Authors: Chunawala Zainali , Shah Ira
Published: June 2020

Aim

To study clinical profile of children with mediastinal tuberculosis (TB).

Methods

This retrospective study was undertaken between January 2015 and March 2018 in children diagnosed with mediastinal TB. Clinical history, examination and radioimaging, such as chest X-ray and HRCT chest, were done in every patient at the start of therapy. The prevalence of mediastinal TB was calculated. Factors associated with mediastinal TB and associated pulmonary TB (PTB) were analysed.

Results

Out of total 1407 patients with TB, 58 (4.12%) had mediastinal involvement. Fever was seen in 49 (84.5%) patients, positive Mantoux test (MT) in 32 (68.1%), cough in 28 (48.3%), loss of appetite in 24 (41.4%) and weight loss in 17 (29.3%). Associated PTB was present in 22 (37.9%) patients. Associated extrapulmonary TB (EPTB) was observed in 12 (20.7%) patients. Fifty-one patients (87.9%) had an abnormal X-ray. Baseline HRCT chest was done in 54 (93.1%) patients and all of them showed necrotic caseous mediastinal nodes. Treatment duration of patients who completed treatment with first-line anti-tuberculous therapy was 11.67 months. Seventeen patients (29.3%) were diagnosed to have drug-resistant TB (DR-TB). Cough was seen more commonly in patients with associated PTB (68.2%) as compared to isolated mediastinal TB (36.1%) (p = 0.0296).

Conclusion

Mediastinal TB is common in children with EPTB. Associated PTB is seen in only about one-third of the patients. X-ray chest is abnormal in half the patients; hence, HRCT chest may be required to make a diagnosis. Bacteriological confirmation is necessary due to high incidence of DR-TB in these patients. Most of the patients require treatment for a longer duration as resolution takes a longer time. Computed tomography imaging on follow-up helps to determine the treatment duration.
In the Aftermath
Authors: Kennedy Maureen Shawn
Published: June 2020

After the initial surge of COVID-19, it's time for nurses to look inward and ahead.
Implications of Proposed Changes to Models of Care for Kidney Disease
Authors: Kear Tamara
Published: June 2020

A foreshadowing of changes for other populations and nursing specialties?
What Would Ellen Do?
Authors: Elpern Ellen
Published: June 2020

A nurse retires on her own terms.
Radionuclide calibrator intercomparison study of clinical PET centres in England to a single traceable 68Ge syringe source
Authors: Sanghera Bal , Fenwick Andrew , Lowe Gerry , Sullivan Keith , Wong Wai-Lup
Published: June 2020

Objectives

The aim of this study was to characterize national variation in radionuclide calibrator activity response to a single National Institute of Standards and Technology (NIST) traceable reference 68Ge source used as a surrogate for 18F at clinical PET centres in England using National Physical Laboratory approved techniques.

Methods

Readings from 20 instruments at 13 centres using local 18F and 68Ge factor settings were recorded with the source located in vial and syringe positions. Ten repeat measurements were conducted to investigate repeatability using % coefficient of variability (COV). Comparison ratios to investigate accuracy were made between calibrator responses and decay-corrected NISTref reference activity for syringe and vial position measurements.

Results

The maximum %COV was 0.79%, while 90, 95 and 80% of calibrators conformed to 5% accuracy for 18F syringe, 68Ge syringe and 68Ge vial position readings, respectively. We revealed a trend towards reduced bias in measurements using Veenstra devices for 18F and using Capintec devices for 68Ge factor settings.

Conclusions

This study demonstrated good repeatability in local device measurements. In total, 70% of English calibrators tested and 88% of all measurements performed achieved 5% accuracy. While statistically significant bias was exhibited between different vendor equipment dependent upon radioisotope selected, our study recommends regular traceability checks for optimum instrument performance conducted within National Metrology Institutes guidelines.