bluuebunny/crossref_metadata_2025 huggingface dataset:
Emotions and Experience of Fathers applying Kangaroo Care in the Eastern Anatolia Region of Turkey: A Qualitative Study
Authors: Günay Ulviye , Coşkun Şimşek Didem
Published: July 2020

The aim of this study was to investigate the emotions and experiences of fathers in Eastern Anatolia Region of Turkey who applied kangaroo care in the neonatal intensive care unit. This study applied the qualitative descriptive design. The study included 12 fathers at the NICU of a university hospital. The fathers practiced kangaroo care with their babies two times a day for 15 days. Content analysis was then conducted to determine the main themes and sub-themes of the interviews. Three main themes and six sub-themes emerged from the analysis: (1) Emotions of being a father (feeling that the baby belongs to own and feeling the warmth and scent of the baby); (2) Confidence in fathering roles (self-confidence and caring for the baby); and (3) Happiness in the new parent role (seeing the baby calm down, hugging the baby and touching the baby’s skin).
Temporal Trends in New Registrations for the Ontario Cleft Lip and Palate/Craniofacial Dental Program Between 2007 and 2018
Authors: Ho Jane , Casas Michael
Published: July 2020

Background:

The Ontario Cleft Lip and Palate/Craniofacial Dental Program was established to fund dental care for those with oral clefts, craniofacial anomalies, congenital oral defects, and acquired facial/oral defects.

Aim:

To determine the annual rates of newly registered oral clefts, craniofacial anomalies, congenital oral defects, and acquired oral defects cases on the Program from 2007 to 2018 and identify trends in registration rates during this time period.

Design:

Data were obtained from the Program from 2007 to 2018. Annual, age-specific incidence rates (for age groups 0-4, 5-9, 10-14, 15-19, and 20-24 years) were calculated for new registrations in each diagnostic category, plotted and examined using Poisson regression analysis to identify trends.

Results:

Rates of new registration for oral clefts and acquired oral defects were stable from 2007 to 2018. The rates of newly registered cases of craniofacial anomalies and congenital oral defects showed an increased trend from 2007 to 2018, although year-by-year comparison of the change in rates did not reach statistical significance. For craniofacial anomalies, congenital oral defects, and acquired oral defects, the highest rates of new registrations occurred in the age group 10 to 14 years, while those aged 0 to 4 recorded the highest registration rates in the oral cleft group.

Conclusion:

Rates in new cleft and acquired oral defects registrations were stable from 2007 to 2018. Rates in newly registered cases of craniofacial anomalies and congenital oral defects increased over the 11-year period.
Successful treatment of refractory secondary immune thrombocytopenia (antiphospholipid antibody syndrome-associated) with the combination of rituximab and romiplostim at the cost of severe bone pain: A case report and review of literature
Authors: Yassa Gizem , Shakir Abdur R , Jagarlamudi Kuppuswamy , Yassa Ahmet E
Published: July 2020

Introduction

Immune thrombocytopenia is an autoimmune disorder associated with increased thrombocyte destruction and impaired production in the bone marrow. Proposed mechanisms include an antibody or autoreactive T-cell-associated autoimmunity and thrombopoietin deficiency among others. Clinical manifestations are predominantly mucocutaneous hemorrhages including petechiae, purpura, mucosal bleeding in the urinary or the gastrointestinal tracts, menorrhagia, and epistaxis. The purpose of the treatment is to prevent bleeding rather than normalizing the platelet counts. First-line treatments include corticosteroids ± intravenous immunoglobulin and Anti-D which mainly decrease antibody-mediated platelet destruction and increase the number of peripheral Tregs. Second-line and subsequent therapies include splenectomy, chimeric anti-CD20 antibody (rituximab), which eliminates B cells and act as an immunomodulatory agent, and Thrombopoietin receptor agonists (romiplostim), which promote platelet production.

Case report

We describe a 40-year-old male patient diagnosed with immune thrombocytopenia that was refractory to first-line corticosteroid and intravenous immunoglobulin and second-line romiplostim monotherapy treatments. Management and outcome: The patient was given the romiplostim and rituximab combination which not only successfully treated thrombocytopenia but also resulted in grade 3 bone pains and the patient’s subsequent refusal to continue therapy.

Discussion

Common adverse effects of rituximab are infusion reactions and prolonged immunosuppression; those of romiplostim include thrombosis, headaches, arthralgia–myalgia, and gastrointestinal symptoms. This case shows that romiplostim has not caused any discernible side effects when given alone, while combination with rituximab resulted in severe bone and joint pains. We hypothesize that this combination regimen shows a synergistic effect both in terms of efficacy and adverse-effect probability and/or severity.
Does Culture Affect Tourism Demand? A Global Perspective
Authors: Liu Anyu , Fan Daisy X. F. , Qiu Richard T. R.
Published: July 2020

Tourism studies commonly focus on the determinants of tourism demand. While most examine factors such as economic determinants, research on the effect of culture on tourism demand remains underdeveloped. This study uses a Bayesian two-stage median regression method to eliminate the potential collinearity between cultural and travel distance and to estimate the impact of cultural distance more appropriately. The results show that while there is a negative relationship between cultural distance and tourism demand, tourism demand is less sensitive to change in cultural distance; the popularity of a travel route moderates the effect of cultural distance on tourism demand; and the influence of cultural distance is different across time and different source markets.
Long-term topical bevacizumab for prevention of corneal graft rejections
Authors: Kuo Hua-Hsuan , Shen Elizabeth P
Published: July 2020

Purpose:

To evaluate the safety and efficacy of 1% topical bevacizumab (10 mg/mL) on newly formed corneal neovascularization (NV) after penetrating keratoplasty (PK).

Methods:

This is a retrospective case series reporting three eyes (three patients) of with newly formed corneal NV after corneal transplantation. All eyes had pre-existing corneal NVs and were high risk corneal graft rejection cases. One percent topical bevacizumab was started immediately after corneal NV formation post-PK. Topical bevacizumab was kept at twice weekly throughout the follow-up period.

Results:

Regression of corneal NV without donor graft invasion was noted in all three patients (100%). Duration of topical bevacizumab use was 13 to 36 months. All three corneal grafts (100%) remained clear and no signs of graft rejection were noted for the period of observation. There were no associated systemic or ocular adverse effects.

Conclusion:

Long-term use of topical 1% bevacizumab may be a safe and efficient treatment for corneal NVs and prevention of graft rejections after corneal transplantation.
Evaluating integrated care for people with complex needs
Authors: Kasteridis Panagiotis , Mason Anne , Street Andrew
Published: July 2020

Objectives

As part of the Vanguard programme, two integrated care models were introduced in South Somerset for people with complex care needs: the Complex Care Team and Enhanced Primary Care. We assessed their impact on a range of utilization measures and mortality.

Methods

We used monthly individual-level linked primary and secondary care data from April 2014 to March 2018 to assess outcomes before and after the introduction of the care models. The analysis sample included 564 Complex Care Team and 841 Enhanced Primary Care cases that met specific criteria. We employed propensity score methods to identify out-of-area control patients and difference-in-differences analysis to isolate the care models’ impact.

Results

We found no evidence of significantly reduced utilization in any of the Complex Care Team or Enhanced Primary Care cohorts. The death rate was significantly lower only for those in the first Enhanced Primary Care cohort.

Conclusions

The integrated care models did not significantly reduce utilization nor consistently reduce mortality. Future research should test longer-term outcomes associated with the new models of care and quantify their contribution in the context of broader initiatives.
Health-related quality of life in young Syrian refugees recently resettled in Norway
Authors: Dangmann Cecilie R. , Solberg Øivind , Steffenak Anne K.M. , Høye Sevald , Andersen Per N.
Published: July 2020

Aims: Millions have fled from the civil unrest in Syria, and half of these are children and youth. Although they are a population with an elevated risk of health problems due to adverse pre-migratory and post-migratory experiences, few studies have explored their health-related quality of life (HRQoL). This is considered a fundamental construct in public health and might provide complementary descriptions of their health and well-being after resettling in a new country. Methods: This was a cross-sectional study of 160 Syrian youth aged 13–24 years. Using KIDSCREEN-27, the results for five dimensions of HRQoL was compared to population norm data. Demographic factors and war-related adverse events were used to predict HRQoL in hierarchical regression. Results: For most participants, the overall HRQoL was good, but it was lower in the dimensions for friends, physical well-being and psychological well-being compared to population norms. Scores in the dimensions for autonomy/parental relation and the school environment were high and were the main contributors to a positive HRQoL. Age and number of reported stressful events (SE) had the greatest impact on HRQoL, but the final regression model only accounted for 21% of the total variance. Conclusions: HRQoL is a relevant and non-invasive measure for refugee youth. Contributors to lower scores in physical and psychological well-being should be explored further and indicate the potential for future interventions focussing on general psychological well-being and networks, regardless of the SE that have been experienced. These interventions could potentially be based in schools or in families in order to benefit from these being seemingly safe environments for the majority of the group.
REFIT of the SEA Directive
Authors: Čavoški Aleksandra
Published: July 2020

The REFIT evaluation concluded that the SEA Directive still remains fit for purpose. It is successfully applied in different social, economic and administrative settings and it acts as a flexible procedural tool in pursuit of important environmental objectives. Although there are inevitable differences between member states in implementing the Directive, the evaluation exposed some of the common challenges facing all member states in implementing different aspects of the Directive in practice. They include difficulties resulting from the lack of clarity of the Directive’s scope, the timing of the SEA, the preparation of environmental reports and a lack of better public engagement.
Marine spatial planning in the UK: A review of the progress and effectiveness of the plans and their policies
Authors: Slater Anne-Michelle , Claydon Jim
Published: July 2020

Ten years after the Marine and Coastal Access Act 2009 that introduced marine planning to UK, this article investigates the progress and effectiveness of marine plans. It identifies that initial plans are still being produced in parts of the UK. Scotland has led the way with a National Marine Plan that has already been reviewed. England’s approach has been to produce a sequence of regional plans with two adopted. Wales adopted its National Marine Plan in November 2019 and Northern Ireland’s national marine plans are under preparation. The article examines the effectiveness of the plans through a framework informed by implementation theory assuming that plan-making indicates a ‘top-down’ approach to policy. The plans and their policies are assessed to draw reflections on the soundness of the documents. Marine licensing decisions are considered to assess the extent to which they reflect adopted policies. Limited evidence of the explicit influence of policies in those decisions was established. The findings were supplemented by interviews with key actors including applicants. This revealed a culture of conciliation and cooperation among decision-makers. Analysis and reflection led to positive and challenging conclusions for the future development of marine plan-making in the UK and elsewhere.
The future of climate policymaking in light of Urgenda Foundation v the Netherlands
Authors: Antonopoulos Irene
Published: July 2020

The decision of the Dutch Supreme Court in The State of the Netherlands v Urgenda Foundation represents a breakthrough and a step forward in addressing the human rights aspects of climate change. The significance of the case has been recognised by commentators and the UN Human Rights Commissioner, who asked for a repeat of Urgenda’s journey in other jurisdictions. Despite the implication that other states have similar obligations to those construed by the Dutch Supreme Court, the influence of the case in other jurisdictions is yet to be seen. This article recognises the significance of the Urgenda case to the definition of state obligations to reduce their greenhouse gas emissions as part of their commitments under the European Convention on Human Rights. In particular, the article discusses the progress made in interpreting Articles 2 and 8 of the European Convention on Human Rights in clarifying state obligations to take decisive measures to tackle climate change in line with their climate action commitments.
Climate change and nationally significant infrastructure projects: R (on the application of Plan B Earth) v Secretary of State for Transport
Authors: Mitchell Edward
Published: July 2020

In R ( on the application of Plan B Earth) v Secretary of State for Transport [2020] EWCA Civ 214, [2020] 2 WLUK 372, the Court of Appeal held that the Secretary of State had acted unlawfully by failing to take into account the UK’s commitments in the 2015 Paris Agreement when he decided to designate a policy formulated to enable the construction of a third runway at Heathrow airport as a ‘national policy statement’ under the Planning Act 2008. An appeal to the Supreme Court is pending. The outcome of that appeal should help to clarify the legal significance of the Paris Agreement and will have significant implications both for expansion at Heathrow airport, for other major infrastructure projects and for other planning and environmental litigation.
The impact of EU institutional advertising on public support for European integration
Authors: Hernández Enrique , Pannico Roberto
Published: July 2020

Utilitarian theories propose that support for the EU is based on an instrumental calculus about the costs and benefits of European integration. Drawing on these theories, we analyze whether and how ads produced by European institutions affect public support for the EU. Our findings, based on a panel survey experiment, indicate that these ads increase support for the EU, and that ads emphasizing the policy benefits of European integration are more effective than ads emphasizing its reduced costs. However, these positive effects are short-lived, since they had disappeared one year after citizens were initially exposed to the ads. In a context of increasing negativity towards the EU, these findings, based on realistic treatments, have relevant theoretical and policy implications.
Reduced kinetic model for the combustion of n-cetane and heptamethylnonane based on a primary reference fuel reduced kinetic model
Authors: Kawanabe Hiroshi , Ishiyama Takuji
Published: July 2020

A reduced kinetic model for the combustion of n-heptane, i-octane, n-cetane and heptamethylnonane was developed based on a prior model designed for use with a primary reference fuel consisting of n-heptane and i-octane. The present model, which can be easily employed in conjunction with a conventional computational fluid dynamics code, contains 59 chemical species and 96 reactions. Predicted ignition delay times under high pressure and temperature conditions were generated using this new kinetic model and compared with those obtained from full kinetic models. The results indicate that the general trends exhibited by the ignition delay times as temperature and pressure are varied are accurately predicted with this reduced model. The present model was also combined with a commercial computational fluid dynamics code and used to simulate the ignition of a diesel spray at high pressure and temperature. Finally, the effects of the cetane number of the fuel on the ignition process were investigated.
Ammonia injection optimization for selective catalytic reduction aftertreatment systems
Authors: Pla Benjamin , Bares Pau , Sanchis Enrique , Aronis André
Published: July 2020

This work presents an optimized ammonia injection strategy for the Worldwide Harmonized Light Vehicles Test Cycle and its potential benefits in terms of NO x emissions and ammonia consumption in selective catalytic reduction. An optimization tool based on optimal control was used to improve the ammonia injection in the selective catalytic reduction with different NO x emission limits. This optimal control can be used in two ways: one to minimize NO x emission and another to reduce the ammonia consumption in the selective catalytic reduction. The optimized strategy and the standard ammonia injection strategy were tested and compared on a fully instrumented engine test bench when applied in a Worldwide Harmonized Light Vehicles Test Cycle. The results showed a considerable improvement in the use of the optimization tool. When compared to the standard calibration, the new injection strategy for the same amount of ammonia injection reduced NO x emissions by 13.7%, and for the same NO x concentration emissions 33.5% of ammonia consumption was saved.
How Partisanship Influences What Congress Says Online and How They Say It
Authors: Wang Richard T. , Tucker Patrick D.
Published: July 2020

We investigate the influence of partisanship on congressional communication by analyzing 180,000 press releases issued by members of Congress (MCs) between 2005 and 2019. Specifically, we examine whether partisan factors such as party control of the White House and/or Congress influence the tone used by MCs and whether MCs are more likely to focus on issues that their respective party owns. Our analyses include the use of multiple OLS models, the machine learning approach gradient boosting, and Grimmer’s topical modeling software “expAgenda.” We find that (1) partisanship influences the tone MCs use when communicating online; and (2) MCs are unable to prioritize discussing issues that their respective party own but devote slightly greater attention to their party’s issues than MCs from the opposite party. Our study ultimately finds strong evidence of partisan influence in the way MCs design their press releases and has important implications for online congressional communication.
Defining and Handling Research Misconduct: A Comparison Between Chinese and European Institutional Policies
Authors: Li Dan , Cornelis Gustaaf
Published: July 2020

Research institutions are responsible for promoting research integrity and handling allegations of research misconduct. Due to various cultural and social contexts, institutional policies from different cultural backgrounds exhibit many differences, such as their primary concern and mechanisms for dealing with allegations of research misconduct. This comparative study analyses research misconduct policies from 21 Chinese and 22 European universities. The results show that definitions of research misconduct from all retrieved policies go beyond fabrication, falsification, and plagiarism but include different types of questionable research practices. Their procedures for handling research misconduct differ in, for example, confidentiality and disclosure of conflict of interest. Differences can also be found in their governance approaches (“bottom-up” versus “top-down”).
Cangrelor dose titration using platelet function testing during cerebrovascular stent placement
Authors: Entezami Pouya , Holden Devin N , Boulos Alan S , Paul Alexandra R , Field Nicholas C , Nourollahzadeh Emad , Yamamoto Junichi , Dalfino John C
Published: July 2020

Background

Optimal antiplatelet inhibition is vital during cerebrovascular stenting procedures, yet no standardized recommendation exists for antithrombotic therapy in these scenarios. Cangrelor is an intravenous P2Y12 inhibitor with a favorable pharmacokinetic profile for use during neuroendovascular stenting.

Methods

A retrospective review of all neuroendovascular patients who underwent stenting between 1 January 2019 and 22 March 2020 and were treated with cangrelor was conducted. Thirty-seven patients met inclusion criteria.

Results

All patients were administered a bolus of 5 mcg/kg of cangrelor followed by a maintenance infusion. Antiplatelet effects of cangrelor were monitored using platelet reactivity units (PRU). Based on the initial PRU, seven patients’ doses were adjusted with subsequent PRUs in or near the goal range of 50–150. One patient experienced an acute intraprocedural occlusion likely related to a subtherapeutic PRU which subsequently resolved with cangrelor dose adjustment and intra-arterial tirofiban administration, and one patient experienced a post-procedure stent occlusion which required a thrombectomy and intra-arterial tirofiban administration. No hemorrhagic complications occurred.

Discussion

Cangrelor utilization during neuroendovascular stenting with maintenance doses of <2 mcg/kg/min with dose adjustments based on platelet function testing has not been previously described. Cangrelor presents many advantages compared to standard therapy in patients undergoing stent placement related to its pharmacokinetic profile, rapid onset of action, ease of transition to oral P2Y12 antiplatelet agents, and measurability.

Conclusion

Cangrelor is a promising alternative to currently available therapies, especially in patients with a high hemorrhagic risk.
Making “Sustainable Consumption” Matter: The Indoor Microclimate as Contested Cultural Artifact
Authors: Sahakian Marlyne , Rau Henrike , Wallenborn Grégoire
Published: July 2020

This article demonstrates how a cultural reading of consumption that focuses on the meaning and materiality of domestic indoor microclimates can contribute to conceptual developments in the field of practice theory that refocus attention on cultural patterns, including prevailing norms and prescriptions regarding indoor temperature and thermal comfort. Drawing on evidence collected during a research-led change initiative that encouraged people to reduce energy use in the home by lowering indoor temperature to 18°C, we deploy the heuristic device of “indoor microclimate as artifact” to show how the manifestation of this new artifact initiated significant changes in everyday practices that revolve around heating. We observe that these changes may also spill over into the public sphere – from home to workplace. By making the microclimate a tangible and visible thing, we describe how people appropriate and appreciate this new object of consumption, what it says about different bodies in diverse and bounded spaces, and what the artifact as a commodity reveals about broader systems of heating and energy provision, and associated actors. Due to the increasing spread of central heating and the growing importance of complex technological devices to monitor and control indoor temperature, heating is no longer a practice in and of itself for many urban dwellers in Europe. However, when people appropriate the indoor microclimate, new heating-related practices emerge that can lead to energy sufficiency. We thus argue that by deliberately “materializing” domestic indoor microclimate as part of a change initiative, more sustainable forms of energy use can be made to matter.
Development and validation of a hypoxia-related gene signature to predict overall survival in early-stage lung adenocarcinoma patients
Authors: Sun Jing , Zhao Tianyu , Zhao Di , Qi Xin , Bao Xuanwen , Shi Run , Su Chuan
Published: July 2020

Background:

Patients with early-stage lung adenocarcinoma (LUAD) exhibit significant heterogeneity in overall survival. The current tumour-node-metastasis staging system is insufficient to provide precise prediction for prognosis.

Methods:

We quantified the levels of various hallmarks of cancer and identified hypoxia as the primary risk factor for overall survival in early-stage LUAD. Different bioinformatic and statistical methods were combined to construct a robust hypoxia-related gene signature for prognosis. Furthermore, a decision tree and a nomogram were constructed based on the gene signature and clinicopathological features to improve risk stratification and quantify risk assessment for individual patients.

Results:

The hypoxia-related gene signature discriminated high-risk patients at an early stage in our investigated cohorts. Survival analyses demonstrated that our gene signature served as an independent risk factor for overall survival. The decision tree identified risk subgroups powerfully, and the nomogram exhibited high accuracy.

Conclusions:

Our study might contribute to the optimization of risk stratification for survival and personalized management of early-stage LUAD.
Does the Association Between Illness-Related and Religious Searches on the Internet Depend on the Level of Religiosity?
Authors: Alper Sinan
Published: July 2020

Recent research suggested that illness-related search predicts religious search on Google. In the current research, I aimed to replicate this finding and investigate whether such association depends on the existing level of religiosity. In Study 1, I reanalyze an existing data set on search behavior for 630 consecutive weeks and show that although illness-related search predicts religious search in 16 different countries, this association does not depend on the religiosity level of the countries. The same finding was replicated in within-nation comparisons of the U.S. states (Study 2) and Turkish provinces (Study 3). In all studies, during a period of 235 consecutive weeks, illness-related search predicted religious search, but the differences in religiosity among regions did not influence this association, which arguably might not be consistent with the terror management theory. I argue that such a finding shows the necessity of considering all alternative theories when interpreting the effects of mortality salience.
The Disruptive Effects of Estrogen Removal Before Puberty on Risk for Binge Eating in Female Rats
Authors: Klump Kelly L. , Sinclair Elaine B. , Hildebrandt Britny A. , Kashy Deborah A. , O’Connor Shannon , Mikhail Megan E. , Culbert Kristen M. , Johnson Alexander , Sisk Cheryl L.
Published: July 2020

Recent research suggests that estrogen is protective against binge eating in adult females and that pubertal estrogen may be critical for these effects. Nonetheless, to date, no study has examined the role of pubertal estrogen in adult binge-eating phenotypes in females, potentially because of difficulties experimentally manipulating estrogen in humans to examine causal effects. We used a novel animal model to examine whether estrogen removal before puberty (via prepubertal ovariectomy, or P-OVX) increased rates of binge-eating-prone (BEP) phenotypes in adulthood in female rats. Seventy-seven P-OVX rats and 79 intact rats were followed from prepuberty into adulthood and phenotyped for BEP status in adulthood. Results showed significantly increased rates (~2–8 times higher) of adult BEP phenotypes in P-OVX compared with intact rats. Findings confirm that estrogen removal substantially increases later risk for binge eating in females, potentially by disrupting typical adolescent brain development.
The frequency of endometriosis in the general and selected populations: A systematic review
Authors: Parazzini Fabio , Roncella Elena , Cipriani Sonia , Trojano Giuseppe , Barbera Valeria , Herranz Barbara , Colli Enrico
Published: July 2020

Background:

In this article, we have reviewed available data on the frequency of endometriosis considering separately the incidence and the prevalence of the disease using data from papers published from 2000 to June 2019.

Study design:

Systematic review and meta-analysis. PubMed and EMBASE were searched for observational studies reporting data on the incidence or prevalence rates or ratios for the following pre-speciﬁed populations: general population, infertile women, women reporting pelvic pain, women who underwent pelvic surgical procedures unrelated with endometriosis.

Results:

A total of 42 papers were included in this review. Considering the 11 studies that have analysed the prevalence of endometriosis in the general population, the reported prevalence ranged from 0.8% to 28.6% with an overall estimated of 4.4% (95% CI 3.6–5.2). When we considered separately the estimates reported in each study according to geographic area, the pooled estimate was lower in the European studies (1.4%), increased to 5.7% in the US studies and was 15.4% in the Asian ones. The pooled estimated prevalence of endometriosis was 33.5% (95% CI 24.3–42.8, Figure 2(c)) in women who underwent surgery for benign gynaecological conditions, 23.8% (95% CI 16.1–31.5, Figure 2(d)) in infertile women, and 49.7 % (95% CI 14.4–85.0) in women with chronic pelvic pain.

Conclusion:

This review offers an overview of the available data on the frequency of endometriosis in the general population and in selected population, in particular among infertile women and women with chronic pelvic pain.
Single-cell analyses and machine learning define hematopoietic progenitor and HSC-like cells derived from human PSCs
Authors: Fidanza Antonella , Stumpf Patrick S. , Ramachandran Prakash , Tamagno Sara , Babtie Ann , Lopez-Yrigoyen Martha , Taylor A. Helen , Easterbrook Jennifer , Henderson Beth E. P. , Axton Richard , Henderson Neil C. , Medvinsky Alexander , Ottersbach Katrin , Romanò Nicola , Forrester Lesley M.
Published: July 2020

Hematopoietic stem and progenitor cells (HSPCs) develop in distinct waves at various anatomical sites during embryonic development. The in vitro differentiation of human pluripotent stem cells (hPSCs) recapitulates some of these processes; however, it has proven difficult to generate functional hematopoietic stem cells (HSCs). To define the dynamics and heterogeneity of HSPCs that can be generated in vitro from hPSCs, we explored single-cell RNA sequencing (scRNAseq) in combination with single-cell protein expression analysis. Bioinformatics analyses and functional validation defined the transcriptomes of naïve progenitors and erythroid-, megakaryocyte-, and leukocyte-committed progenitors, and we identified CD44, CD326, ICAM2/CD9, and CD18, respectively, as markers of these progenitors. Using an artificial neural network that we trained on scRNAseq derived from human fetal liver, we identified a wide range of hPSC-derived HSPCs phenotypes, including a small group classified as HSCs. This transient HSC-like population decreased as differentiation proceeded, and was completely missing in the data set that had been generated using cells selected on the basis of CD43 expression. By comparing the single-cell transcriptome of in vitro–generated HSC-like cells with those generated within the fetal liver, we identified transcription factors and molecular pathways that can be explored in the future to improve the in vitro production of HSCs.
Toxicity of Gold Nanoparticles in Mice due to Nanoparticle/Drug Interaction Induces Acute Kidney Damage
Authors: Isoda Katsuhiro , Tanaka Anju , Fuzimori Chisaki , Echigoya Miyuki , Taira Yuichiro , Taira Ikuko , Shimizu Yoshimi , Akimoto Yoshihiro , Kawakami Hayato , Ishida Isao
Published: July 2020

Nanomaterials are innovative materials with many useful properties, but there is concern regarding their many unknown effects on living organisms. Gold nanoparticles are widely used as industrial materials because of their excellent properties. The potential biological hazards of gold nanoparticles are unknown, and thus, here we examined the in vivo effects of gold nanoparticles 10, 50, and 100 nm in diameter (GnP10, GnP50, and GnP100, respectively) and their interactions with drugs in mice to clarify their safety in mammals. Cisplatin, paraquat, and 5-aminosalicylic acid cause side-effect damage to the liver and kidney in mice. No hepatotoxicity or nephrotoxicity was observed when any of the gold nanoparticles alone were administered via the tail vein. In contrast, co-administration of GnP-10 with cisplatin, paraquat, or 5-aminosalicylic acid caused side-effect damage to the kidney. This suggests that gold nanoparticles with a particle size of 10 nm are potentially nephrotoxic due to their interaction with drugs.
The effects of serial casting on lower limb function for children with Cerebral Palsy: a systematic review with meta-analysis
Authors: Milne Nikki , Miao Michelle , Beattie Emma
Published: July 2020

Background

Lower limb serial casting is commonly used therapeutically in paediatric clinical practice with some evidence to support its efficacy. This systematic review aimed to determine the effects of serial casting in isolation or combination with other therapies for the management of lower limb dysfunction in children with Cerebral Palsy (CP).

Methods

A systematic literature search was conducted in February 2019 across eight databases (PUBMED, EMBASE, CINAHL, PEDro, OTSeeker, Cochrane, Scopus and Proquest) using key terms ‘Cerebral Palsy’ and ‘serial casting’ and associated synonyms. A meta-synthesis and meta-analysis were undertaken when sufficient results were available showing the effect of serial casting on functional outcomes including: Ankle range of motion; neurological measures of hypertonicity and spasticity, functional gait measures and; gross motor function.

Results

Twenty-five articles from 3219 possible citations were included. Serial casting was found to be effective for: Improving ankle dorsiflexion (DF) passive range of motion (PROM) in the immediate to short-term, decreasing hypertonicity measured by Modified Ashworth Scale (MAS) in the short-term and, enhancing functional gait outcomes in the mid-term. Serial casting with or without botulinum toxin type-A (BTX-A) did not significantly affect gross motor capacity measured by Gross Motor Function Measure (GMFM). Serial casting with pharmacological intervention achieved significantly more DF PROM than serial casting alone (MD − 3.19 degrees; 95% CI − 5.76 to − 0.62; P = 0.01; I2 = 0%), however the clinical importance of improving ankle DF PROM by an additional three degrees remains unclear.

Conclusions

Lower limb serial casting, improves several outcomes relevant to lower limb function supporting its clinical use for improving DF PROM, reducing hypertonicity and improving gait in children with CP. Further research using stronger methodological study designs, is indicated to explore long-term effects of serial casting on functional lower limb outcomes such as gross motor function in children with CP. Clinicians can use this information when developing individualised treatment plans for children who have CP during shared decision-making consultations.
Disclosure, reporting and help seeking among child survivors of violence: a cross-country analysis
Authors: Pereira Audrey , Peterman Amber , Neijhoft Anastasia Naomi , Buluma Robert , Daban Rocio Aznar , Islam Aminul , Kainja Esmie Tamanda Vilili , Kaloga Inah Fatoumata , Kheam They , Johnson Afrooz Kaviani , Maternowska M. Catherine , Potts Alina , Rottanak Chivith , Samnang Chea , Shawa Mary , Yoshikawa Miho , Palermo Tia
Published: July 2020

Background

Violence against children is a pervasive public health issue, with limited data available across multiple contexts. This study explores the rarely studied prevalence and dynamics around disclosure, reporting and help-seeking behaviours of children who ever experienced physical and/or sexual violence.

Methods

Using nationally-representative Violence Against Children Surveys in six countries: Cambodia, Haiti, Kenya, Malawi, Nigeria and Tanzania, we present descriptive statistics for prevalence of four outcomes among children aged 13–17 years: informal disclosure, knowledge of where to seek formal help, formal disclosure/help seeking and receipt of formal help. We ran country-specific multivariate logistic regressions predicting outcomes on factors at the individual, household and community levels.

Results

The prevalence of help-seeking behaviours ranged from 23 to 54% for informal disclosure, 16 to 28% for knowledge of where to seek formal help, under 1 to 25% for formal disclosure or help seeking, and 1 to 11% for receipt of formal help. Factors consistently correlated with promoting help-seeking behaviours included household number of adult females and absence of biological father, while those correlated with reduced help-seeking behaviours included being male and living in a female-headed household. Primary reasons for not seeking help varied by country, including self-blame, apathy and not needing or wanting services.

Conclusions

Across countries examined, help-seeking and receipt of formal services is low for children experiencing physical and/or sexual violence, with few consistent factors identified which facilitated help-seeking. Further understanding of help seeking, alongside improved data quality and availability will aid prevention responses, including the ability to assist child survivors in a timely manner.
Is laminectomy and fusion the better choice than laminoplasty for multilevel cervical myelopathy with signal changes on magnetic resonance imaging? A comparison of two posterior surgeries
Authors: He Xin , Zhang Jia Nan , Liu Tuan Jiang , Hao Ding Jun
Published: July 2020

Background

This study aimed to compare the clinical outcomes and complications between laminectomy and fusion (LF) and laminoplasty (LP) for multi-level cervical spondylotic myelopathy (MCSM) with increased signal intensity (ISI) on T2-weighted images (T2WI).

Methods

In this retrospective cohort study, we analyzed 52 patients with MCSM with ISI on T2WI who underwent laminoplasty (LP group). The Japanese Orthopedic Association (JOA) score, the Visual Analogue Scale (VAS) score, the physical and mental component scores (PCS and MCS) of Short-Form 36 (SF-36), and the extension and flexion ranges of motion (ROMs) were recorded. As controls, propensity score matching identified 52 patients who underwent laminectomy and fusion (LF group) from January 2014 to June 2016 using 7 independent variables (preoperation): age, sex, JOA score, SF-36 PCS, SF-36 MCS, preoperative symptom duration and high signal intensity ratio (HSIR).

Results

The operative duration in the LF group was significantly higher than that in the LP group. At the last follow-up, the JOA score, VAS score, and SF-36 (PCS and MCS) scores were all significantly improved in both groups. The extension and flexion ROMs were decreased in both groups but significantly better in the LP group than in the LF group. Both groups demonstrated similar clinical improvements at the final follow-up. The complication rate was higher in the LF group.

Conclusion

The present study demonstrates that LP for MCSM with ISI on T2WI achieves similar clinical improvement as LF. However, longer operative durations, higher complication rates and lower extension and flexion ROMs were found in the LF group.
The correlation between follow-up MRI findings and laboratory results in pyogenic spondylodiscitis
Authors: Ahn Kyung-Sik , Kang Chang Ho , Hong Suk-Joo , Kim Baek Hyun , Shim Euddeum
Published: July 2020

Background

Although MRI is the gold-standard imaging method in the diagnosis of spondylodiscitis, role of follow-up imaging is debated and there can be discrepancies with regard to the significance of bony or soft tissue responses to treatment. Purpose of our study is to test whether the MRI changes on follow-up imaging correlate with laboratory findings of treatment response.

Methods

A total of 48 patients with pyogenic spondylodiscitis who underwent baseline and follow-up MRI were retrospectively reviewed. The extent of bone marrow edema, paravertebral soft tissue inflammation, and disc height were compared on baseline and follow-up MRIs with the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels obtained from the medical records at baseline and on follow-up. Relationships between the MRI and laboratory changes were analyzed using the Spearmann correlation test.

Results

The mean MRI follow-up period was 42.25 days. Based on the CRP (resolved: n = 19, resolving: n = 19, and aggravated: n = 10), there was significant correlation between the laboratory results and the changes in the bone and soft tissues (p < 0.01, both). The correlation was best with soft tissue changes (rho: 0.48) followed by bony changes (rho: 0.41). Based on the ESR (resolved: n = 8, resolving: n = 22, and worsened: n = 18), the correlation was stronger with bone changes (rho: 0.45, p < 0.01) than it was with soft tissue changes (rho: 0.39, p = 0.01).

Conclusion

Follow-up MRI findings of pyogenic spondylodiscitis show variable tissue responses. CRP was best correlated with soft tissue changes, while ESR showed the best association with bony changes.
External validation of the European risk assessment tool for chronic cardio-metabolic disorders in a Middle Eastern population
Authors: Asgari Samaneh , Moosaie Fatemeh , Khalili Davood , Azizi Fereidoun , Hadaegh Farzad
Published: July 2020

Background

High burden of chronic cardio-metabolic disorders including type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), and cardiovascular disease (CVD) have been reported in the Middle East and North Africa region. We aimed to externally validate a non-laboratory risk assessment tool for the prediction of the chronic cardio-metabolic disorders in the Iranian population.

Methods

The predictors included age, body mass index, waist circumference, use of antihypertensive medications, current smoking, and family history of cardiovascular disease and/or diabetes. For external validation of the model in the Tehran lipids and glucose study (TLGS), the Area under the curve (AUC) and the Hosmer–Lemeshow (HL) goodness of fit test were performed for discrimination and calibration, respectively.

Results

Among 1310 men and 1960 women aged 28–85 years, 29.5% and 47.4% experienced chronic cardio-metabolic disorders during the 6 and 9-year follow-up, respectively. The model showed acceptable discrimination, with an AUC of 0.72 (95% CI 0.69–0.75) for men and 0.73 (95% CI 0.71–0.76) for women. The calibration of the model was good for both genders (min HL P = 0.5). Considering separate outcomes, AUC was highest for CKD (0.76 (95% CI 0.72–0.79)) and lowest for T2DM (0.65 (95% CI 0.61–0.69)), in men. As for women, AUC was highest for CVD (0.82 (95% CI 0.78–0.86)) and lowest for T2DM (0.69 (95% CI 0.66–0.73)). The 9-year follow-up demonstrated almost similar performances compared to the 6-year follow-up. Using Cox regression in place of logistic multivariable analysis, model’s discrimination and calibration were reduced for prediction of chronic cardio-metabolic disorders; the issue which had more effect on the prediction of incident CKD among women. Moreover, adding data of educational levels and marital status did not improve, the discrimination and calibration in the enhanced model.

Conclusion

This model showed acceptable discrimination and good calibration for risk prediction of chronic cardio-metabolic disorders in short and long-term follow-up in the Iranian population.
Intensive care unit-acquired hyponatremia in critically ill medical patients
Authors: Sim Jae Kyeom , Ko Ryoung-Eun , Na Soo Jin , Suh Gee Young , Jeon Kyeongman
Published: July 2020

Background

Previous research has focused on intensive care unit (ICU)-acquired hypernatremia; however, ICU-acquired hyponatremia has frequently been overlooked and has rarely been studied in surgical or mixed ICUs. The aim of this study is to investigate the incidence of ICU-acquired hyponatremia, the risk factors associated with its development, and its impact on outcomes in critically ill medical patients.

Methods

We conducted a retrospective cohort study based on the prospective registry of all critically ill patients admitted to the medical ICU from January 2015 to December 2018. Baseline characteristics and management variables were compared between ICU-acquired hyponatremia and normonatremia patients.

Results

Of 1342 patients with initial normonatremia, ICU-acquired hyponatremia developed in 217 (16.2%) patients and ICU-acquired hypernatremia developed in 117 (8.7%) patients. The Sequential Organ Failure Assessment (8.0 vs 7.0, P = 0.009) and Simplified Acute Physiology Score 3 scores (55.0 vs 51.0, P = 0.005) were higher in ICU-acquired hyponatremia patients compared with normonatremia patients. Baseline sodium (137.0 mmol/L vs 139.0 mmol/L, P < 0.001), potassium (4.2 mmol/L vs 4.0 mmol/L, P = 0.001), and creatinine (0.98 mg/dL vs 0.88 mg/dL, P = 0.034) levels were different between the two groups. Net volume balance over first 3 days was higher in ICU-acquired hyponatremia patients (19.4 mL/kg vs 11.5 mL/kg, P = 0.004) and was associated with the development of ICU-acquired hyponatremia (adjusted odds ratio, 1.004; 95% confidence interval, 1.002–1.007; P = 0.001). ICU mortality was similar in both groups (15.2% vs. 14.4%, P = 0.751), but renal replacement therapy was more commonly required in ICU-acquired hyponatremia patients (13.4% vs 7.4%, P = 0.007).

Conclusions

ICU-acquired hyponatremia is not uncommon in critically ill medical patients. Increased volume balance is associated with its development. ICU-acquired hyponatremia is related to increased use of renal replacement therapy but not to mortality.