bluuebunny/crossref_metadata_2025 huggingface dataset:
The burden of sialorrhoea in chronic neurological conditions: current treatment options and the role of incobotulinumtoxinA (Xeomin®)
Authors: Morgante Francesca , Bavikatte Ganesh , Anwar Fahim , Mohamed Biju
Published: November 2019

Sialorrhoea is a frequent symptom of neurological diseases (e.g. Parkinson’s disease, motor neuron disease, cerebral palsy, and stroke) and is defined as excessive saliva accumulation leading to unintentional loss of saliva from the mouth. Sialorrhoea increases the overall burden on the patient and their caregivers, the impact of which can be both physical and psychosocial. Treatments for sialorrhoea range from lifestyle and behavioural guidance, to medications, surgery or radiation. Nonpharmacological interventions include advice on posture, swallowing control, cough management, dietary changes, eating and drinking techniques, and behavioural modification; however, these conservative measures may be ineffective for people with progressive neurological conditions. The pharmacological treatment of sialorrhoea is challenging because medications licensed for this purpose are limited, but treatments can include anticholinergic drugs and botulinum toxins. Surgical treatment of sialorrhoea is typically reserved as a last resort for patients. IncobotulinumtoxinA (Xeomin®) is the first botulinum toxin type A to receive US and UK marketing authorization for the symptomatic treatment of chronic sialorrhoea due to neurological disorders in adults. In this review, we discuss and compare the frequency and method of administration, location of treatment delivery, approximate annual costs and main side effects of botulinum toxin and different anticholinergic drugs. Management of patients with chronic neurological conditions requires input from multiple specialist teams and thus a multidisciplinary team (MDT) approach is considered fundamental to ensure that care is consistent and tailored to patients’ needs. To ensure that adult patients with neurological conditions receive the best care and sialorrhoea is well managed, we suggest a potential clinical care pathway for sialorrhoea with a MDT approach, which healthcare professionals could aspire to.
Stakeholder’s perceived value of surgical audit data provided by the Victorian Audit of Surgical Mortality
Authors: Cloney Thomas , Vinluan Jessele , Chen Andrew , Retegan Claudia , McCahy Philip
Published: November 2019

Background:

Clinical audits can vary in their effectiveness depending on how the information is provided and the relationship between those giving and receiving feedback. In the Australian state of Victoria, the Victorian Audit of Surgical Mortality (VASM) is a state-wide mortality audit that, prior to this study, did not have a bidirectional feedback mechanism in place to gauge perception of the audit held by its stakeholders.

Objective:

We aimed to investigate the perceived quality of the audit’s information and the effectiveness of the audit’s communication strategies from the stakeholder population.

Methods:

We used a mixed methods approach to provide open-ended explorations into stakeholders’ views while also providing structured tools for conducting annual reviews. The qualitative data were analysed using an inductive content analysis.

Results:

Between 2015 and 2017, 240 VASM stakeholders were contacted, of whom 82 (34.2%) agreed to be interviewed. The VASM’s data were perceived to be of high quality and used in a variety of ways. The audit’s communication strategies were seen to be adequate but could be more targeted to the stakeholder. There is a perception that the audit might not be relevant to hospital stakeholders that are not themselves clinicians, despite direct involvement with the audit.

Conclusion:

This study helps to explain the role the audit plays among its stakeholders and offers three overarching recommendations for improvement strategies: produce data sharing strategies that are relevant to rural or highly specialised surgical centres, improve communication to be targeted at stakeholders and explore methods to provide feedback to hospital management with more individualised feedback.
The role of a clinical nurse specialist in managing patients with trigeminal neuralgia
Authors: Ghiai Artemis , Mohamed Tay-Yibah , Hussain Mahrukh , Hayes Emma , Zakrzewska Joanna M
Published: November 2019

Background and Aims:

Patients with trigeminal neuralgia (TN) can be overwhelmed with information they are given when first seen in a specialist secondary care clinic. The purpose of this study is to evaluate the extent to which a telephone service provided by the clinical nurse specialist (CNS) with independent prescribing rights improves patient management and satisfaction and reduces costs.

Methods:

All patients with a diagnosis of TN who used the CNS telephone service in 2015 were contacted by two medical students (independent observers) using a semi-structured questionnaire. Patients who could not be contacted were sent the same questionnaire and asked to return it by post.

Results:

Fifty-two patients were identified and 34 replied to a telephone call and 10 to a questionnaire, response rate 85%. Overall, 61% of patients rated their care outstanding or excellent. Four patients could not remember their consultation, others had used it on multiple occasions. Reasons for the consultation were pain management 50%, changeover of drugs 25%, advice about drug schedules 17%, and dealing with side effects 8%. The number of general practitioner (GP) consultations decreased as a result of this service. Patients suggested that the service should be available more than once a week.

Conclusion:

The CNS telephone service cut down on the number of outpatient appointments needed and reduced travel costs. Patients were appreciative that the CNS was in contact with GPs and this ensured prescriptions were filled in a timely manner and strengthen links with practices.
Localized ulcerative nodular amyloidosis presenting as ulcerative panniculitis, an unusual clinical manifestation: A case report
Authors: Fernandes Carolina , Éthier Vincent , Marouan Sofia , Chababi-Atallah Myrna , Veilleux Mylène
Published: November 2019

Introduction and objectives:

The main objective of this article is to present and discuss a case of localized ulcerative nodular amyloidosis with deep involvement clinically manifesting as ulcerative panniculitis and discuss its impact on the choice of treatment.

Methods and results:

We present a 73-year-old woman with a history of painful ulcerated nodules on the inferior limbs. Microscopy confirmed amyloid deposits deep in the dermis and subcutaneous fat. No systemic involvement was found. Considering that skin-directed treatments often are not able to reach subcutaneous fat or were contraindicated because of the ulcers, she was successfully treated with cyclophosphamide and prednisone.

Conclusion:

Localized ulcerative nodular amyloidosis with deep involvement is a rare clinical presentation that can present as ulcerative panniculitis. Such a clinical manifestation might be misleading. Systemic treatment might be necessary to control symptoms when conventional skin-directed therapies are contraindicated.
Creator Governance in Social Media Entertainment
Authors: Cunningham Stuart , Craig David
Published: November 2019

This article addresses the platformization of cultural production by offering a creator-centric account of industrial and governance issues in social media entertainment (SME). SME is our term for the emerging industry of native online cultural producers together with the platforms, intermediaries, and fan communities operating interdependently, and disruptively, alongside legacy media industries and across global media cultures. The central concern of the article is that these creators are not recognized as stakeholders in current debates both academic and policy on platform governance. The relationship between the platform behemoths and individual creators may seem grossly disproportionate, but insights from network economics suggest a more supple account of power. The interests of creators are examined in the “top-down” context of the exercise of platform governance and efforts, by platforms and the state, to improve it. Those interests are also canvassed from the “bottom up”—how creators and creator advocacy are organizing and acting collectively to improve prospects for creators in this emerging industry.
Commenting on Political Topics Through Twitter: Is European Politics European?
Authors: Ruiz-Soler Javier , Curini Luigi , Ceron Andrea
Published: November 2019

The aim of this study was to explore social media, and specifically Twitter’s potential to generate a European demos. Our use of data derived from social media complements the traditional use of mass media and survey data within existing studies. We selected two Twitter hashtags of European relevance, # schengen and # ttip, to test several theories on a European demos (non-demos, European democracy, or pan-European demos) and to determine which of these theories was most applicable in the case of Twitter topics of European relevance. To answer the research question, we performed sentiment analysis. Sentiment analysis performed on data gathered on social media platforms, such as Twitter, constitutes an alternative methodological approach to more formal surveys (e.g., Eurobarometer) and mass media content analysis. Three dimensions were coded: (1) sentiments toward the issue public, (2) sentiments toward the European Union (EU), and (3) the type of framing. Among all of the available algorithms for conducting sentiment analysis, integrated sentiment analysis (iSA), developed by the Blog of Voices at the University of Milan, was selected for the data analysis. This is a novel supervised algorithm that was specifically designed for analyses of social networks and the Web 2.0 sphere (Twitter, blogs, etc.), taking the abundance of noise within digital environments into consideration. An examination and discussion of the results shows that for these two hashtags, the results were more aligned with the demoicracy and “European lite identity” models than with the model of a pan-European demos.
‘A Portrait of Lower Silesia’: Researching identity through collodion photography and memory narratives
Authors: Sidorenko Ewa
Published: November 2019

In this article, I discuss a performance arts–based visual methodology based on the use of the archaic wet collodion photography. The collaboration between Street Collodion Art photography collective and myself, as a researcher, had two aims: to generate a large scale photographic and narrative portrait of Lower Silesia in Poland, and to explore identities in the region where nearly all of its inhabitants represent recent migrant populations. Data generated through this project include collodion portraits, their interpretations and narratives collected through unstructured interviews. Initial data analysis has generated identity narratives linked to work, place and belonging and ethnicity/nationality. In addition, in 2016 and 2017, three exhibitions of the portraits and a selection of edited stories took place in Lubin, Legnica and Wrocław attended by local inhabitants, including project participants. The examination of the arts-based methodology finds that the ritual character of the wet collodion photographic encounter has acted as a form of artistic intervention which, in generating memory narratives, enabled an articulation of social identities in the climate dominated by nationalist discourses. Such symbolic work emerging out of the project reveals a critical potential in the collaboration between the arts and social research. Furthermore, the project has shown that despite different traditions of practice, a collaboration between the artists and social researchers can yield rich data and access participants in ways that conventional methodologies cannot.
Patient Engagement Survey Regarding Future Double-Blinded, Randomized Controlled Trial of Tapering of Chronic Opioid Therapy
Authors: James Jared , Lai Benjamin , Witt Terrence
Published: November 2019

Objective: There is a lack of evidence regarding tapering opioid medications in patients with chronic non-cancer pain. The purpose of this survey was to gather perspectives on future research into opioid tapering from utilizers of chronic opioid therapy (COT) or other people affected by chronic noncancer pain. Methods: The survey was distributed in paper form to patients on COT and via an online platform to patients self-enrolled in the chronic pain patient engagement group. The survey included a layman’s description of a possible tapering trial of opioid medications and elicited binary responses regarding willingness to participate and reasoning as well as qualitative freeform responses. Thematic analysis was performed to identify themes in narrative responses. Results: A total of 190 surveys were returned with 72.1% of all respondents answering positively regarding their willingness to participate in a proposed study. The most common reasons for participating in the study included concerns regarding opioid dependence, adding to society’s knowledge of opioid medications, and determining if the respondent would personally receive benefit from opioid medications. Patients recently on COT felt it was important to be able to withdraw from the study and return to usual care at any time (41.8% for recent COT and 15.5% for no recent COT, P < .05). The most common reason for unwillingness to participate was that respondents did not feel they had enough information to feel comfortable participating. The narrative responses showed a group of respondents felt COT was the only answer to their or their loved ones’ chronic pain and that a study would demonstrate the need to continue these medications long-term. There were also stories of side effects and dependence with decreasing effectiveness of opioids for pain control. When prompted to comment on study design, respondents indicated the study should include alternative pain management options. This was accompanied by responses with the assumption that pain will worsen as opioid medications are decreased. Conclusion: Patient concerns regarding opioid medications and discontinuation reflect the lack of evidence available to prescribers. There appears to be patient support for future research into the effects of tapering opioid medications.
Is There a Role for Preoperative Local Infiltration of Tranexamic Acid in Elective Spine Surgery? A Prospective Randomized Controlled Trial Analyzing the Efficacy of Intravenous, Local Infiltration, and Topical Administration of Tranexamic Acid
Authors: Arun-Kumar Viswanadha , Naresh-Babu J.
Published: November 2019

Study Design:

Randomized control trial.

Objective:

The purpose of the study is to evaluate the safety and efficacy of tranexamic acid in reducing blood loss when administered through various routes in instrumented spine surgeries.

Methods:

A total of 104 patients undergoing instrumented spine surgery were randomly assigned to 4 groups (n = 26 in each group). Groups included (1) ivTXA—intravenous administration of tranexamic acid (TXA) 1 hour prior to surgery, (2) loTXA—local infiltration of TXA bilaterally into the paraspinal musculature prior to incision, (3) tTXA—topical application of TXA just before wound closure, and (4) control group. Outcome measures included intraoperative blood loss, postoperative blood loss, need for blood transfusion, length of hospital stay, and hematological parameters.

Results:

All the 3 different modes of TXA administration were found to be effective in reducing blood loss in the treated groups compared with the control group. Intraoperative blood loss was significantly reduced in ivTXA (223.6 ± 40.1 mL, P < .0001) and loTXA (256.07 ± 119 mL, P = .0039) groups when compared with controls (344 ± 88.5 mL).The postoperative blood loss was least in tTXA followed by ivTXA, loTXA, and controls. There was 67% reduction in need for blood transfusion in tTXA group, 55.5% reduction in ivTXA group, and 33% reduction in loTXA group when compared with the control group.

Conclusion:

In instrumented spine surgery, ivTXA and loTXA were found to be equally effective in reducing the intraoperative blood loss. The tTXA has better postoperative blood conserving effects. This is the first study to detail about safety and efficacy on local infiltration of TXA in spine surgery, which is an effective and safe method for reducing intraoperative blood loss.
Opportunistic Computed Tomography and Spine Surgery: A Narrative Review
Authors: Shirley Matthew , Wanderman Nathan , Keaveny Tony , Anderson Paul , Freedman Brett A.
Published: November 2019

Study Design:

Narrative review.

Objective:

This article seeks to provide a narrative review regarding the ability of opportunistic information available from computed tomography (CT) scans to guide decisions in spine surgery related to patient bone quality.

Methods:

A review of the literature (limited to human and English language) was performed via PubMed and Google Scholar using the search terms; “osteoporosis” AND “opportunistic” AND “computed tomography” AND “spine surgery.” The titles and then abstracts of all identified citations were reviewed for inclusion by 2 of the authors (MS, BAF). Relevant articles were then studied in full text.

Results:

A review of the literature found 25 articles that were selected for inclusion in this narrative review. These articles were broadly divided into 4 subcategories: (1) opportunistic CT (oCT) and osteoporosis detection, (2) oCT data and the quality of screw fixation, (3) utilization of Hounsfield units to assess clinical and/or radiographic outcomes following spine fusion, and (4) virtual stress testing in spine surgery.

Conclusion:

The literature on oCT, as well as associated virtual stress-testing techniques, demonstrate the potential to enhance spine surgery outcomes by preoperatively identifying at-risk patients in need of bone health optimization and informing best techniques for performing spinal fusion surgery on patients with diminished bone quality. While our narrative summary of the limited literature to date suggests a promising future for oCT data, significant additional research and/or radiographic workflow standardization is needed to validate these methods for clinical use.
Does Smoking Status Influence Health-Related Quality of Life Outcome Measures in Patients Undergoing ACDF?
Authors: Mangan John J. , Goyal Dhruv K. C. , Divi Srikanth N. , Bowles Daniel R. , Nicholson Kristen J. , Mujica Victor E. , Lee Thomas J. , DePaola Rosalie V. , Saline Austin , Fang Taolin , Galetta Matthew S. , Kaye I. David , Kurd Mark F. , Woods Barrett I. , Radcliff Kris E. , Rihn Jeffery A. , Anderson D. Greg , Hilibrand Alan S. , Kepler Christopher K. , Vaccaro Alexander R. , Schroeder Gregory D.
Published: November 2019

Study design:

Retrospective comparative study.

Objective:

Whereas smoking has been shown to affect the fusion rates for patients undergoing an anterior cervical discectomy and fusion (ACDF), the relationship between smoking and health-related quality of life outcome measurements after an ACDF is less clear. The purpose of this study was to evaluate whether smoking negatively affects patient outcomes after an ACDF for cervical degenerative pathology.

Methods:

Patients with tumor, trauma, infection, and previous cervical spine surgery and those with less than a year of follow-up were excluded. Smoking status was assessed by self-reported smoking history. Patient outcomes, including Neck Disability Index, Short Form 12 Mental Component Score, Short Form 12 Physical Component Score (PCS-12), Visual Analogue Scale (VAS) arm pain, VAS neck pain, and pseudarthrosis rates were evaluated. Outcomes were compared between smoking groups using multiple linear and logistic regression, controlling for age, sex, and body mass index (BMI), among other factors. A P value <.05 was considered significant.

Results:

A total of 264 patients were included, with a mean follow-up of 19.8 months, age of 53.1 years, and BMI of 29.6 kg/m2. There were 43 current, 69 former, and 152 nonsmokers in the cohort. At baseline, nonsmokers had higher PCS-12 scores than current smokers ( P = .010), lower VAS neck pain than current ( P = .035) and former ( P = .014) smokers, as well as lower VAS arm pain than former smokers ( P = .006). Postoperatively, nonsmokers had higher PCS-12 scores than both current ( P = .030) and former smokers ( P = .035). Smoking status was not a significant predictor of change in patient outcome in multivariate analysis.

Conclusions:

Whereas nonsmokers had higher function and lower pain than former or current smokers preoperatively, smoking status overall was not found to be an independent predictor of outcome scores after ACDF. This supports the notion that smoking status alone should not deter patients from undergoing ACDF for cervical degenerative pathology.
State of Whistleblowing Research: A Thematic Analysis
Authors: Mehrotra Shweta , Mishra R. K. , Srikanth V. , Tiwari Govind Prasad , Kumar E. V. Mahesh
Published: November 2019

The relative starring role of whistleblowing incidences in exposing the corporate wrongdoings and money laundering to combat corruption impeding the development of the economy offers a platform to explore the whistleblowing literature and map the state of scholarship in different national and international journals in the period 2012–2018. It also provides a gap analysis assessment through thematic analysis of the ghettoized articles and brings into focus the possible research lacunas. The outcomes of the analysis reveal that much evolvement has set in motion in terms of many articles published in a varied range of peer-reviewed journals on a myriad of themes focusing mainly on the USA. However, whistleblowing research in India as the cohort is still in its infancy. The convergence of the importance of specific topics such as regulatory mechanisms and reforms, incentives and awards system for promoting the whistleblowing activities as an anti-corruption instrument, and the other fundamental driving forces triggering or hindering the whistleblowing intent signals the presence of the collective body of knowledge in this field. This study may contribute constructively to escalating the advanced research particularly on Indian perspective in order to bring more clarity to streamline the whistleblowing policies and mechanisms with full proof protections against retaliation involved in detecting and disclosing the corrupt practices.
Merchants and state society: Some case studies from early historic period and the ‘threshold times’ (c. 600 bc to ad 700)
Authors: Chakravarti Ranabir
Published: November 2019

The history of the evolution of state in India, or any country, cannot be studied in isolation from the evolution of other institutions of society. We are thus entitled to trace the evolution of the ‘state society’ meaning a society that had the state as its major institution; and this further obliges us to trace, among other factors behind the evolution of state, the factor of trade, its organisation and requirements, security being a major factor behind its own growth—one that could only be provided, in its turn, by the state. The present article draws on the varied evidence available to us from the so-called ‘threshold times’, ending c. 1300, on the evolving relationship between the mercantile world and the state. Both literary texts and inscriptions are put to use in our enquiry. It brings into question the widespread assumption that there was a decline of trading activities in the late centuries of the period the article deals with.
Religion, accumulation and credit in Mughal times—Evidence from the Vrindavan archives
Authors: Habib Irfan
Published: November 2019

This is a study of how the holy men of Vrindavan—the Gosā’ins of the Chaitanya sect—accumulated wealth and property, and how this enabled them to further augment it by investing in land, credit and usury. They lent money against mortgage of peasant-held land, which resulted in further land-acquisitions. The study is based on the large amount of private papers preserved by the Gosā’ins since c. 1550, mainly in Persian but also in Braj. This material in the form of photographs and xerox copies was collected by the late Dr Tarapada Mukherjee.
A half century of γ-aminobutyric acid
Authors: Smart Trevor G , Stephenson F Anne
Published: November 2019

γ-aminobutyric acid has become one of the most widely known neurotransmitter molecules in the brain over the last 50 years, recognised for its pivotal role in inhibiting neural excitability. It emerged from studies of crustacean muscle and neurons before its significance to the mammalian nervous system was appreciated. Now, after five decades of investigation, we know that most neurons are γ-aminobutyric-acid-sensitive, it is a cornerstone of neural physiology and dysfunction to γ-aminobutyric acid signalling is increasingly documented in a range of neurological diseases. In this review, we briefly chart the neurodevelopment of γ-aminobutyric acid and its two major receptor subtypes: the γ-aminobutyric acidA and γ-aminobutyric acidB receptors, starting from the humble invertebrate origins of being an ‘interesting molecule’ acting at a single γ-aminobutyric acid receptor type, to one of the brain’s most important neurochemical components and vital drug targets for major therapeutic classes of drugs. We document the period of molecular cloning and the explosive influence this had on the field of neuroscience and pharmacology up to the present day and the production of atomic γ-aminobutyric acidA and γ-aminobutyric acidB receptor structures. γ-Aminobutyric acid is no longer a humble molecule but the instigator of rich and powerful signalling processes that are absolutely vital for healthy brain function.
Effect of the Strengthening Opioid Misuse Prevention (STOP) Act on Opioid Prescription Practices After Ankle Fracture Fixation
Authors: Hussaini S. Hanif , Wang Kevin Y. , Luo T. David , Scott Aaron T.
Published: November 2019

Background:

In North Carolina, the Strengthen Opioid Misuse Prevention Act of 2017 (STOP Act) went into effect on January 1, 2018, intending to increase oversight over opioid prescriptions. This study compares postoperative narcotic prescription practices following operative fixation of ankle fractures before and after the STOP Act.

Methods:

This study was a retrospective review of patients 18 years and older who underwent operative fixation of ankle fractures between January 1 and June 30, 2017 (before STOP Act), and between January 1 and June 30, 2018 (after STOP Act). Variables of interest included demographics, amount of opioids prescribed postoperatively, number of prescription refills, and number of pain-related calls or visits to the emergency department (ED) or clinic after surgery. This study assessed 71 patients in the Pre group and 47 patients in the Post group.

Results:

There was a statistically significant decrease in the average number of postoperative narcotic pills prescribed after the STOP Act (52.7 vs 76.2, P < .001). There was also a statistically significant decrease in the average number of prescription refills (0.6 vs 1.0, P = .037). There were no significant changes in pain-related clinic calls (35.2% Pre vs 34.0% Post, P = .896), pain-related clinic visits ahead of schedule (4.2% Pre vs 6.4% Post, P = .681), or pain-related ED visits (2.8% Pre vs 10.6% Post, P = .113).

Conclusion:

In the postoperative period after operative fixation of ankle fractures, the volume of narcotic prescriptions decreased after the new legislation, without an associated strain on medical resources.

Level of Evidence:

Level III, therapeutic, comparative study.
Weight Changes (in kg) in Mandible Fracture Patients After IMF: A Prospective Study
Authors: Lone Parveen Akhter , Khaliq Mohammed Israr ul , Sharma Mandeep , Malik Owais Ahmed , Lone Bashir Ahmed
Published: November 2019

Background: This prospective study is done to assess weight loss due to maxillomandibular fixation (MMF) in patients who have undergone treatment for maxillofacial fractures. This fixation method is a closed reduction technique that can interfere with normal nutrition intake of solid and semisolid foods and thus can result in weight loss and malnutrition. Therefore, in this study we explain the degree and pattern of weight loss in patients treated with MMF.

Materials and Methods: We treated 300 patients for 4 to 6 weeks of MMF. We measured and compared the weight before and after MMF.

Results: The loss of weight was statistically significant ( P < .001) with MMF treatment.

Conclusion: MMF caused mild to moderate malnutrition in some cases so protein diet was recommended to such patients post treatment.
Ergodic site amplification model for central and eastern North America
Authors: Stewart Jonathan P. , Parker Grace A. , Atkinson Gail M. , Boore David M. , Hashash Youssef M. A. , Silva Walter J.
Published: November 2019

The United States Geological Survey national seismic hazard maps have historically been produced for a reference site condition of VS30 = 760 m/s. For other site conditions, site factors are used, which heretofore have been developed using ground motion data and simulations for shallow earthquakes in active tectonic regions. Research results from the Next Generation Attenuation–East (NGA-East) project, as well as previous and contemporaneous related research, demonstrate different levels of site amplification in central and eastern North America (CENA) as compared to active regions. We provide recommendations for modeling of ergodic site amplification in CENA based primarily on research results from the literature. The recommended model has three additive terms in natural logarithmic units. Two describe linear site amplification: an empirically constrained VS30-scaling term relative to a 760 m/s reference and a simulation-based term to adjust site amplification from the 760 m/s reference to the CENA reference of VS = 3000 m/s. The third term is a nonlinear model that is described in a companion document. All median model components are accompanied by epistemic uncertainty models.
The Migration of an Angular Pregnancy to a Centric Position: A Case Report
Authors: Fernandez Carlos M. , Levine Elliot M. , Tadros Katherine , Shashoua Abraham , Locher Stephen
Published: November 2019

This case report illustrates the sequential imaging of pregnancy beginning as an angular pregnancy, and eventually descending to a centric location within the uterine cavity. This case also describes the potential benefit of three-dimensional sonography in the management of a pregnancy, initially recognized as an angular pregnancy.
Quality of life questionnaire for women with gestational diabetes mellitus (GDMQ-36): development and psychometric properties
Authors: Mokhlesi S. , Simbar M. , Ramezani Tehrani F. , Kariman N. , Alavi Majd H.
Published: November 2019

Background

Gestational diabetes mellitus carries serious risks to mother and fetus and causes social, mental, and psychological consequences which can affect mothers’ quality of life. Accordingly, this study aims to develop and assess the psychometric properties of quality of life questionnaire for women with gestational diabetes mellitus.

Methods

A methodological study of sequential exploratory mixed method was developed and implemented. It included qualitative (development of a quality of life questionnaire for mothers with GDM) and quantitative (assessment of psychometric prosperities of quality of life questionnaire for mothers with GDM) phases.

Results

Based on the findings of the qualitative phase and literature review, the primary questionnaire was prepared with 142 items. The outcome of face validity and content validity assessment was a 67-item questionnaire. S-CVI and S-CVR turned out to be 0.92 and 0.68, respectively. The results of exploratory factor analysis yielded an instrument with 36 items in five domains including concerns about high-risk pregnancy, perceived constraints, disease complications, medication and treatment, and support. Five factors explained 46.68% of the total variance of the questionnaire. The results indicated a moderate and significant correlation between the questionnaire of “Diabetes Clients Quality Of Life” and the researcher-made questionnaire (r = 0.63). Cronbach’s alpha coefficient for the entire scale was 0.93 and the intra-class correlation coefficient was 0.95.

Conclusion

Quality of life questionnaire for mothers with GDM is a valid and reliable tool capable of measuring the quality of life of women with GDM.
Efficacy and radiographic analysis of oblique lumbar interbody fusion for degenerative lumbar spondylolisthesis
Authors: Wu Menghui , Li Jia , Zhang Mengxin , Ding Xufeng , Qi Dongxu , Li Guimiao , Shen Yong
Published: November 2019

Background

To compare the clinical efficacy and radiographic analysis of oblique lumbar interbody fusion (OLIF) and traditional posterior lumbar interbody fusion (PLIF) in treating degenerative lumbar spondylolisthesis (DLS).

Methods

Grade I DLS patients admitted to the Third Hospital of Hebei Medical University were retrospectively reviewed. In sum, 78 patients that underwent OLIF (n = 31) and PLIF (n = 47) treatment of DLS were recruited. Clinical data including clinical and radiological evaluations were collected pre-operatively and at each follow-up. Japanese Orthopaedic Association (JOA) scores, Oswestry Disability Index (ODI), lumbar lordosis (LL), disc height (DH), and fusion rates were compared between the OLIF and PLIF groups.

Results

The operation time for both groups was 131.3 ± 14.6 min in the OLIF group and 156.9 ± 37.4 min in the PLIF group (P < 0.001). The intraoperative blood loss was 163.6 ± 63.9 ml in the OLIF group and 496.8 ± 122.6 ml in the PLIF group (P < 0.001). The length of the surgical incision was 4.63 ± 0.57 cm in the OLIF group and 11.83 ± 1.37 cm in the PLIF group (P < 0.001). The number of intraoperative and post-operative complications for both groups was 10 in the OLIF group and 20 in the PLIF group. Significant clinical improvement (P < 0.05) was observed in JOA scores and ODI when comparing pre-operative evaluation and final follow-up. After statistical analysis, there was no significant difference in the preoperative JOA scores between the two groups. There was no significant difference when comparing pre-operative LL and DH for either group. Post-operative reexamination was improved as compared to pre-operative exams. And the improvement of DH was better in the OLIF group as compared to the PLIF group.

Conclusions

For DLS patients, both OLIF and PLIF can achieve good results. Furthermore, OLIF displays marked advantages including smaller surgical incisions, shorter anesthesia times, decreased intraoperative blood loss, and post-operative pain better relieved.
Infection with carcinogenic helminth parasites and its production of metabolites induces the formation of DNA-adducts
Authors: Gouveia Maria João , Brindley Paul J. , Rinaldi Gabriel , Gärtner Fátima , da Costa José M. C. , Vale Nuno
Published: November 2019

Background

Infections classified as group 1 biological carcinogens include the helminthiases caused by Schistosoma haematobium and Opisthorchis viverrini. The molecular mediators underlying the infection with these parasites and cancer remain unclear. Although carcinogenesis is a multistep process, we have postulated that these parasites release metabolites including oxysterols and estrogen-like metabolites that interact with host cell DNA. How and why the parasite produce/excrete these metabolites remain unclear. A gene encoding a CYP enzyme was identified in schistosomes and opisthorchiids. Therefore, it is reasonable hypothesized that CYP 450 might play a role in generation of pro-inflammatory and potentially carcinogenic compounds produced by helminth parasites such as oxysterols and catechol estrogens. Here, we performed enzymatic assays using several isoforms of CYP 450 as CYP1A1, 2E1 and 3A4 which are involved in the metabolism of chemical carcinogens that have been associated with several cancer. The main aim was the analysis of the role of these enzymes in production of helminth-associated metabolites and DNA-adducts.

Method

The effect of cytochrome P450 enzymes CYP 1A1, 2E1 and 3A4 during the interaction between DNA, glycocholic acid and taurochenodeoxycholate sodium on the formation of DNA-adducts and metabolites associated with urogenital schistosomiasis (UGS) and opisthorchiasis was investigated in vitro. Liquid chromatography/mass spectrometry was used to detect and identify metabolites.

Main findings

Through the enzymatic assays we provide a deeper understanding of how metabolites derived from helminths are formed and the influence of CYP 450. The assays using compounds similar to those previously observed in helminths as glycocholic acid and taurochenodeoxycholate sodium, allowed the detection of metabolites in their oxidized form and their with DNA. Remarkably, these metabolites were previously associated with schistosomiaisis and opisthorchiasis. Thus, in the future, it may be possible to synthesize this type of metabolites through this methodology and use them in cell lines to clarify the carcinogenesis process associated with these diseases.

Principal conclusions

Metabolites similar to those detected in helminths are able to interact with DNA in vitro leading to the formation of DNA adducts. These evidences supported the previous postulate that imply helminth-like metabolites as initiators of helminthiases-associated carcinogenesis. Nonetheless, studies including these kinds of metabolites and cell lines in order to evaluate its potential carcinogenic are required.
ReorientExpress: reference-free orientation of nanopore cDNA reads with deep learning
Authors: Ruiz-Reche Angel , Srivastava Akanksha , Indi Joel A. , de la Rubia Ivan , Eyras Eduardo
Published: November 2019

We describe ReorientExpress, a method to perform reference-free orientation of transcriptomic long sequencing reads. ReorientExpress uses deep learning to correctly predict the orientation of the majority of reads, and in particular when trained on a closely related species or in combination with read clustering. ReorientExpress enables long-read transcriptomics in non-model organisms and samples without a genome reference without using additional technologies and is available athttps://github.com/comprna/reorientexpress.
The Friendship Questionnaire, autism, and gender differences: a study revisited
Authors: Sedgewick Felicity , Leppanen Jenni , Tchanturia Kate
Published: November 2019

Background

The Friendship Questionnaire (FQ) is a widely used measure of friendships in autism research and beyond. This study sought to revisit the original paper where the measure was presented, using a larger sample of both autistic and non-autistic participants to examine gender differences in scoring. It also sought to expand upon the original paper by comparing FQ results to those of the Unidimensional Relationship Closeness Scale (URCS), to examine whether there are differences in how autistic people report on their general friendships in contrast to their most significant relationships.

Methods

Participants were recruited for an online study, and 949 people (532 autistic, 417 non-autistic) aged between 18 and 81 took part. Participants completed a demographic questionnaire, the Autism Quotient-28, the Friendship Questionnaire, and the Unidimensional Relationship Closeness Scale.

Results

We used robust regressions and Pearson’s correlational analyses, conducted in R. Autistic people scored lower than non-autistic people on the FQ, and similar gender differences in the pattern of FQ scores were seen in both groups. There was a significant negative correlation between AQ and FQ scores in both groups. On the URCS, we took the data from those who rated specific close relationships and found that autistic people scored this relationship more highly than non-autistic adults did. There was a significant negative correlation between AQ and URCS scores in both groups. Also, in both groups, there was a significant positive correlation between FQ and URCS scores.

Limitations

The data is entirely self-report, and diagnoses could not be verified with a clinician, although AQ scores support self-identification as autistic. Also, the groups were not evenly matched on age and other demographic variables, although this was controlled for in analyses. It is also the case that more autistic than non-autistic people were unable to specify a close relationship to score on the URCS, meaning that a certain set of experiences are not represented in this data.

Conclusions

We conclude that our data replicates the core finding of the original FQ paper that autistic people score lower on the FQ. In contrast to that paper, however, we found that there were gender differences among the autistic population. Also, our inclusion of the URCS suggests that the intimate romantic relationships and best-friendships of autistic people can be of similar quality to those of non-autistic people, suggesting that there may be important differences in autistic people’s relations with friends in general versus close friends and romantic partners.
Thymoma complicated with myasthenia gravis and Good syndrome – a therapeutic conundrum: a case report
Authors: Paranavitane Shiran , Handagala Sumana , De Silva Rajiva , Chang Thashi
Published: November 2019

Background

Thymomas are known to be associated with myasthenia gravis and Good syndrome. Good syndrome is the association of thymoma with combined B cell and T cell immunodeficiency. The combination of all three diseases has not been reported. We discuss the therapeutic dilemma of immunosuppression in such a case.

Case presentation

A 27-year-old Sinhalese man was evaluated for persistent cough which was associated with pleuritic chest pain and was found to have pleural-based lesions in his left hemithorax. Further evaluation confirmed these lesions to be implants from a thymoma. He subsequently developed myasthenia gravis and impending myasthenic crisis precipitated by pneumonia. He was found to have hypogammaglobulinemia with low B cell counts, confirming a diagnosis of Good syndrome. Treatment with intravenously administered broad-spectrum antibiotics, acetylcholinesterase inhibitors, orally administered glucocorticoids, plasma exchange, and intravenous immunoglobulin led to clinical improvement. He subsequently underwent thymectomy and debulking of the tumor and was maintained on regular intravenous immunoglobulins combined with low-dose prednisolone.

Conclusions

Regular intravenous immunoglobulins combined with low-dose immunosuppression in addition to thymectomy appear to be safe when myasthenia gravis occurs in association with Good syndrome.
Phenotypic traits of mesenchymal stem cell sheets fabricated by temperature-responsive cell culture plate: structural characteristics of MSC sheets
Authors: Nakao Mitsuyoshi , Kim Kyungsook , Nagase Kenichi , Grainger David W. , Kanazawa Hideko , Okano Teruo
Published: November 2019

Background

In most stem cell therapy strategies reported to date, stem cells are introduced to damaged tissue sites to repair and regenerate the original tissue structure and function. MSC therapeutic efficacies are inconsistent, largely attributed to transplanted MSC difficulties both in engrafting at tissue sites and in retaining their therapeutic functions from suspension formulations. MSC functional components, including cell adhesion and cell–cell junction proteins, and ECM that contribute to essential cellular therapeutic effects, are damaged or removed by proteolytic enzymes used in stem cell harvesting strategies from culture. To overcome these limitations, methods to harvest and transplant cells without disrupting critical stem cell functions are required. Cell sheet technology, exploiting temperature-responsive cell culture surfaces, permits cell harvest without cell protein damage. This study is focused on phenotypic traits of MSC sheets structurally and functionally to understand therapeutic benefits of cell sheets.

Methods/results

This study verified cleaved cellular proteins (vinculin, fibronectin, laminin, integrin β-1, and connexin 43) and increased apoptotic cell death produced under standard trypsin harvesting treatment in a time-dependent manner. However, MSC sheets produced without trypsin using only temperature-controlled sheet harvest from culture plastic exhibited intact cellular structures. Also, MSCs harvested using enzymatic treatment (i.e., chemical disruption) showed higher pYAP expression compared to MSC sheets.

Conclusion

Retention of cellular structures such as ECM, cell–cell junctions, and cell–ECM junctions is correlated with human umbilical cord mesenchymal stem cell (hUC-MSC) survival after detachment from cell culture surfaces. Retaining these proteins intact in MSC cultures using cell sheet technology is proposed to enhance stem cell survival and their function in stem cell-based therapy.
Glucose regulates tissue-specific chondro-osteogenic differentiation of human cartilage endplate stem cells via O-GlcNAcylation of Sox9 and Runx2
Authors: Sun Chao , Lan Weiren , Li Bin , Zuo Rui , Xing Hui , Liu Minghan , Li Jie , Yao Yuan , Wu Junlong , Tang Yu , Liu Huan , Zhou Yue
Published: November 2019

Background

The degenerative disc disease (DDD) is a major cause of low back pain. The physiological low-glucose microenvironment of the cartilage endplate (CEP) is disrupted in DDD. Glucose influences proteinO-GlcNAcylation via the hexosamine biosynthetic pathway (HBP), which is the key to stem cell fate. Thiamet-G is an inhibitor ofO-GlcNAcase for accumulatingO-GlcNAcylated proteins while 6-diazo-5-oxo-l-norleucine (DON) inhibits HBP. Mechanisms of DDD are incompletely understood but include CEP degeneration and calcification. We aimed to identify the molecular mechanisms of glucose in CEP calcification in DDD.

Methods

We assessed normal and degenerated CEP tissues from patients, and the effects of chondrogenesis and osteogenesis of the CEP were determined by western blot and immunohistochemical staining. Cartilage endplate stem cells (CESCs) were induced with low-, normal-, and high-glucose medium for 21 days, and chondrogenic and osteogenic differentiations were measured by Q-PCR, western blot, and immunohistochemical staining. CESCs were induced with low-glucose and high-glucose medium with or without Thiamet-G or DON for 21 days, and chondrogenic and osteogenic differentiations were measured by Q-PCR, western blot, and immunohistochemical staining. Sox9 and Runx2O-GlcNAcylation were measured by immunofluorescence. The effects ofO-GlcNAcylation on the downstream genes of Sox9 and Runx2 were determined by Q-PCR and western blot.

Results

Degenerated CEPs from DDD patients lost chondrogenesis, acquired osteogenesis, and had higher proteinO-GlcNAcylation level compared to normal CEPs from LVF patients. CESC chondrogenic differentiation gradually decreased while osteogenic differentiation gradually increased from low- to high-glucose differentiation medium. Furthermore, Thiamet-G promoted CESC osteogenic differentiation and inhibited chondrogenic differentiation in low-glucose differentiation medium; however, DON acted opposite role in high-glucose differentiation medium. Interestingly, we found that Sox9 and Runx2 wereO-GlcNAcylated in differentiated CESCs. Finally,O-GlcNAcylation of Sox9 and Runx2 decreased chondrogenesis and increased osteogenesis in CESCs.

Conclusions

Our findings demonstrate the effect of glucose concentration on regulating the chondrogenic and osteogenic differentiation potential of CESCs and provide insight into the mechanism of how glucose concentration regulates Sox9 and Runx2O-GlcNAcylation to affect the differentiation of CESCs, which may represent a target for CEP degeneration therapy.