bluuebunny/crossref_metadata_2025 huggingface dataset:
Cerebrospinal Fluid Drainage During Endovascular Aortic Aneurysm Repair: A Systematic Review of the Literature and Treatment Recommendations
Authors: Malloy Patrick C. , Raghavan Alankrita , Elder Theresa , Wright James , Wright Christina Huang , Burant Christopher , Sajatovic Martha , Hoffer Alan
Published: December 2019

Introduction:

Spinal cord injury (SCI) is a known complication of aortic aneurysm repair. Previous reports indicate that cerebrospinal fluid drainage (CSFD) may reduce incidence of SCI during open aortic aneurysm repair but its utility in endovascular repair remains poorly understood. We performed a systematic review of the literature to examine the protocols and outcomes of CSFD in patients undergoing endovascular aortic aneurysm repair.

Methods:

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were utilized to conduct a systematic literature review. PubMed, Scopus, Ovid, Cochrane, and EMBASE were queried for articles published since 2016 using search terms “(cerebrospinal fluid diversion OR CSF diversion OR lumbar drain OR subarachnoid drain OR spinal) AND (aortic aneurysm AND thoracic AND endovascular OR TEVAR).” Ninety-two articles were identified and screened by 2 independent reviewers, and 23 studies met criteria for full-text review after initial screening.

Results:

A total of 8 studies met full inclusion criteria for final analysis. Six studies reported incidence of SCI in patients with CSFD and 2 compared SCI incidence between patients with and without CSFD. Protocols for drainage most commonly included draining to a target pressure intra- and postoperatively, between 8 and 12 mm Hg. Incidence of SCI ranged from 0% to 17% in patients with CSFD, and from 0% to 50% in those without CSFD. Rates of CSFD-related complications ranged from <1% to 28%.

Conclusion:

There may be a protective benefit of CSFD in preventing SCI, but there remains significant variation in drain placement protocols. Significant potential bias exists in the reviewed data. Higher quality studies on the role of CSFD in endovascular aortic aneurysm repair are needed.
Use of the No-Touch Saphenous Vein Harvesting Technique via Small Incisions
Authors: Hayashi Ichiro , Kashima Ichiro , Yoshikawa Eiji
Published: December 2019

There are substantial data in support of improved patency using the no-touch (NT) saphenous vein (SV) harvesting technique. However, wound complications correlated with such are more significant than those associated with the skeletonized technique. To solve this, we introduced the use of the electrothermal bipolar vessel sealing device via small incisions. In this study, a cordless retractor with a built-in LED light source was utilized. The NT-SV graft was harvested with a pedicle of surrounding tissue approximately 5 mm in size and attached to the main trunk. The intima, tunica media, adventitia, and vasa vasorum appeared normal by histological analysis. Our technique combines the potential advantages of a minimally invasive endoscope approach using bipolar electrothermy and the improved patency of a NT-SV.
New explicit analytical solutions of equations for heat and mass transfer in a cooling tower energy system
Authors: Guo Qianjian , Qi Xiaoni , Sun Peng , Guo Pengjiang
Published: December 2019

The aim of this article is to develop an accurate and fast analytical method for heat and mass transfer model in a cooling tower energy system. Some algebraic explicit analytical solutions of the one-dimensional differential equation sets describing the coupled heat and mass transfer process in a cooling tower are derived. The explicit solutions have not yet been published before. The explicit equations of heat and mass transfer are expressed in elementary functions. By solving these differential equations in a cooling tower, the temperature distribution of liquid and gas, the moisture content in the air can be obtained in each section over the vertical height of the tower. A comparison of analytical and experimental results was given in this article, and good agreements were shown for the typical cases studied. The analytical solutions can serve as a benchmark to check the results of numerical calculation.
‘#YouCanTalk’: A multimodal discourse analysis of suicide prevention and peer support in the AustralianBeyondBlueplatform
Authors: Sindoni Maria Grazia
Published: December 2019

Research has shown that suicide rate in Australia is on the rise and that most people who die by suicide are not in contact with mental health services. They most likely communicate their suicidal thoughts to family members or close friends, whose responses may sound unhelpful and/or dismissive, thus reinforcing suicidal ideation. This national emergency has been tackled via a social media campaign, #YouCan Talk, launched by a government-supported digital platform, BeyondBlue. This article adopts a multimodal discourse analysis approach to investigate how peer support is encouraged and articulated in the context of mental health discourse for suicide prevention. The two case studies selected for analysis from the BeyondBlue platform are (1) the #YouCanTalk social media campaign, designed to teach carers to identify severe depression and effectively respond to suicide warning signs and (2) a sample of posts from a thread for peer support in a monitored online forum devoted to help carers who seek peer advice. Unlike previous research, the article focuses on how pronouns and verbs index interpersonal relations in a systemic-functional perspective as well as other multimodal resources, such as visuals, layout and hyperlinking, to understand how identities are entextualised by both professional health providers and peer carers in digital platforms that address mental health issues.
Do-It-Yourself Automated Insulin Delivery: A Leading Example of the Democratization of Medicine
Authors: Burnside Mercedes , Crocket Hamish , Mayo Michael , Pickering John , Tappe Adrian , de Bock Martin
Published: December 2019

Digital innovations have led to an explosion of data in healthcare, driving processes of democratization and foreshadowing the end of the paternalistic era of medicine and the inception of a new epoch characterized by patient-centered care. We illustrate that the “do it yourself” (DIY) automated insulin delivery (AID) innovation of diabetes is a leading example of democratization of medicine as evidenced by its application to the three pillars of democratization in healthcare (intelligent computing; sharing of information; and privacy, security, and safety) outlined by Stanford but also within a broader context of democratization. The heuristic algorithms integral to DIY AID have been developed and refined by human intelligence and demonstrate intelligent computing. We deliver examples of research in artificial pancreas technology which actively pursues the use of machine learning representative of artificial intelligence (AI) and also explore alternate approaches to AI within the DIY AID example. Sharing of information symbolizes the core philosophy behind the success of the DIY AID evolution. We examine data sharing for algorithm development and refinement, for sharing of the open-source algorithm codes online, for peer to peer support, and sharing with medical and scientific communities. Do it yourself AID systems have no regulatory approval raising safety concerns as well as medico-legal and ethical implications for healthcare professionals. Other privacy and security factors are also discussed. Democratization of healthcare promises better health access for all and we recognize the limitations of DIY AID as it exists presently, however, we believe it has great potential.
Natural Coumarin Derivative Esculetin Regulates Platelet Activation via Modulating NF-κB Signaling in Cyclic Nucleotide-Independent Manner
Authors: Hsia Chih-Wei , Shyu Kou-Gi , Jayakumar Thanasekaran , Hsia Chih-Hsuan , Velusamy Marappan , Yang Chih-Hao , Sheu Joen-Rong
Published: December 2019

Esculetin, a natural coumarin derivative, shows exciting biological activities in a variety of cell and animal models. Our recent study demonstrated that esculetin exhibits antiplatelet effects by obstructing the phospholipase C γ2/protein kinase C cascade, hydroxyl radical formation, and Akt activation. In this study, we further examined the involvement of cyclic 3′-5′adenosine monophosphate/, vasodilator-stimulated phosphoprotein (VASP), integrin αIIbβ3, and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), since cyclic nucleotides reduce the phosphorylation of VASP and activate NF-κB, subsequently inducing αIIbβ3 activation that significantly involves the platelet inhibitory pathways. We found that esculetin (50 and 80 µM) did not significantly affect fibrinogen-induced aggregation of elastase-treated platelets; however, it markedly blocked integrin αIIbβ3 activation by interrupting the binding of fluorescein isothiocyanate-labeled PAC-1. In addition, neither ODQ nor SQ22536 significantly reversed esculetin-mediated antiplatelet activity stimulated by collagen. Nitroglycerin and prostaglandin E1 significantly increased VASP phosphorylation, but esculetin had no effect in this reaction, the values being almost identical with those of normal platelets. Furthermore, esculetin, at its maximum concentration of 80 μM significantly reduced the phosphorylation of IκBα and p65 and reversed IκBα degradation in collagen-induced platelets. These results suggest that the NF-κB-dependent αIIbβ3 inhibition of esculetin might represent a novel feedback inhibitory mechanism to regulate platelet functions.
Knowledge, Behaviors, and Attitudes of Polish Nurses As Compared With Evidence-Based Practice in Relation to the Guidelines of the European Resuscitation Council
Authors: Ozga Dorota , Jędrzejczyk-Cwanek Marzena , Woźniak Krystyna , Niemczyk Edyta , Mędrzycka-Dąbrowska Wioletta
Published: December 2019

Background

The emphasis on Evidence-Based Practice (EBP) is taking on new importance as the profession of nursing strives to meet the challenge of defining the direction of health care, promoting optimal outcomes, and ensuring patient safety. Therefore, Evidence-Based Practice has never been more important to nursing than in the current health-care environment.

Objective

The study was designed to assess the knowledge, behaviors, and attitudes of nurses as compared with Evidence-Based Practice in relation to the Guidelines of the European Resuscitation Council.

Methods

The study covered involved a total of 236 nurses who participated in a cardiopulmonary resuscitation course over a period of 12 months. The nurses who qualified for the study followed a complete study registration procedure.

Results

The current findings show that the lowest score was achieved in the domain of attitude toward selected Evidence-Based Practice aspects in professional work. Detailed domain questions concerned nurses’ Evidence-Based Practice and its limitations related to procedures, the lack of equipment and personnel issues, as well as the lack of scientific evidence. Furthermore, nurses saw clinical experience as being more valuable than research findings for practical decision-making than research findings, and, according to the respondents, they presented opinions that the best way to assess the effectiveness of an action was through clinical experience. In addition, the nurses gave low scores and tended to underestimate the critical literature review aspect within the domain, along with its significance for the general professional practice, believing that search for scientific evidence alone does not apply into their professional work.

Conclusions

The validated Polish version of the Evidence-Based Practice profile questionnaire is a reliable instrument. The study demonstrates that nurses are facing a multitude of limitations due to procedures, the lack of equipment, and personnel issues. Currently perceived as very poor, the ability to make critical assessments and synthesize evidence should be improved. According to the nurses, clinical experience cannot be the only and the best way to assess the effectiveness of a given measure.
Separating Perceptions of Kaepernick From Perceptions of His Protest: An Analysis of Athlete Activism, Endorsed Brand, and Media Effects
Authors: Park Bumsoo , Park Sanghyun , Billings Andrew C.
Published: December 2019

As news media mainly focused on issues of nationalism, many people perceive Colin Kaepernick as unpatriotic, even though his protest was about police brutality and social justice. Therefore, the purpose of this study was to investigate how people perceive athlete activism relative to news media framing and to examine the effects of athlete activism on endorsed brands. Two experimental design studies were conducted. Results indicate that news media influenced individuals’ attitudes toward the protesting athlete. Additionally, prior perceptions of the protesting athlete and the brand were significantly associated with attitudes toward the protesting athlete and the endorsed brand regardless of the news media framing conditions. A strong positive relationship between the protesting athlete and the endorsed brand was found. Participants with more positive attitudes toward the protesting athlete had more positive attitudes toward the brand endorsed by the athlete.
“Yay, Another Lady Starting a Log!”: Women’s Fitness Doping and the Gendered Space of an Online Doping Forum
Authors: Henning April , Andreasson Jesper
Published: December 2019

This study aims to investigate and dissect the meanings attached to women’s use of performance and image enhancing drugs (PIEDs), how fitness doping can be understood in terms of gender and spatiality, and what implications this has for women’s communicative engagement with one another within an online forum. The study is based on a netnographic and qualitative methodology. Theoretically, it considers a women’s online forum for PIEDs and analyzes it as a community of practice (CofP) and a spatiality in which gender, bodies, and side effects are discussed and negotiated. The results show that although the women’s forum provides a space for women to share their own unique experiences, there is a limit to the extent to which the discussions mirror the experiences and experimentations of women. Instead, discussions are often dominated by men’s voices/experiences. This has two main implications. Firstly, the prevalence of men’s voices can block the development of a women’s CofP. Symbolically, men engage in a sort of cultural manspreading by encroaching on the women’s forum space. Secondly, it has implications for women’s PIED use and use practices. Women seeking out advice or the experiences of other women must navigate through and around men’s contributions.
Factors Affecting Length of Stay Following 3-Column Spinal Osteotomies in Pediatric Patients
Authors: Kato So , Dear Taylor , Lewis Stephen J.
Published: December 2019

Study Design:

A retrospective analysis.

Objectives:

Length of stay (LOS) is one of the important indicators for the quality of patient care. Although perioperative complications are known to be associated with longer LOS in general, little has been understood regarding LOS after 3-column spinal osteotomy for the rigid spinal deformity in pediatric population. The main objective of the article is to identify factors affecting the LOS in pediatric patients undergoing 3-column posterior spinal osteotomies.

Methods:

Following research ethics approval, a retrospective review was performed of 35 consecutive posterior 3-column spinal osteotomies performed on pediatric patients in a single academic institution. Patients’ demographic data, preoperative comorbidities, details of operative procedures, intraoperative complications, and postoperative complications were investigated, and LOS was compared among the groups.

Results:

The mean LOS was 9.0 days, and the median LOS was 7 days (range = 4-23 days). Low body weight and syndromic deformity were associated with longer LOS. Operation time ≥6 hours and total perioperative fluid administration greater than or equal to twice the estimated blood volume were associated with longer LOS. Among postoperative complications, those with respiratory complication had prolonged stay.

Conclusions:

Preoperative low body weight and syndromic scoliosis had longer LOS after 3-column osteotomies. Excessive fluid administration and respiratory complications were associated with longer LOS.
External Multicenter Study of Reliability and Reproducibility for Lower Cervical Spine Injuries Classification Systems—Part 2: An Analysis of the Subaxial Cervical Spine Injury Classification and Cervical Spine Injury Severity Score Scale
Authors: Grin Andrey , Krylov Vladimir , Lvov Ivan , Talypov Aleksandr , Dzukaev Dmitriy , Kordonskiy Anton , Smirnov Vladimir , Karanadze Vasily , Abdukhalikov Boburmirzo , Khushnazarov Ulugbek , Airapetyan Artem , Dmitriev Aleksandr , Kaykov Aleksandr , Peyker Alexander , Semchenko Vitaliy , Aksenov Andrey , Borzenkov Anton , Gulyy Vladimir , Torchinov Soslan , Bagaev Sergey , Toporskiy Anton , Kalandari Alik , Kasatkin Denis , Sytnik Aleksey , Lebedev Valeriy , Epifanov Dmitry , Hovrin Dmitriy , Feniksov Victor , Choriev Daniyar
Published: December 2019

Study Design:

A multicenter observational survey.

Objective:

To quantify and compare inter- and intraobserver reliability of the subaxial cervical spine injury classification (SLIC) and the cervical spine injury severity score (CSISS) in a multicentric survey of neurosurgeons with different experience levels.

Methods:

Data concerning 64 consecutive patients who had undergone cervical spine surgery between 2013 and 2017 was evaluated, and we surveyed 37 neurosurgeons from 7 different clinics. All raters were divided into 3 groups depending on their level of experience. Two assessment procedures were performed.

Results:

For the SLIC, we observed excellent agreement regarding management among experienced surgeons, whereas agreement among less experienced neurosurgeons was moderate and almost twice as unlikely. The sensitivity of SLIC relating to treatment tactics reached as high as 92.2%. For the CSISS, agreement regarding management ranged from medium to substantial, depending on a neurosurgeon’s experience. For less experienced neurosurgeons, the level of agreement concerning surgical management was the same as for the SLIC in not exceeding a moderate level. However, this scale had insufficient sensitivity (slightly exceeding 50%). The reproducibility of both scales was excellent among all raters regardless of their experience level.

Conclusions:

Our study demonstrated better management reliability, sensitivity, and reproducibility for the SLIC, which provided moderate interrater agreement with moderate to excellent intraclass correlation coefficient indicators for all raters. The CSISS demonstrated high reproducibility; however, large variability in answers prevented raters from reaching a moderate level of agreement. Magnetic resonance imaging integration may increase sensitivity of CSISS in relation to fracture management.
Clinical, radiological, and histological outcomes after the fibrin–matrix autologous chondrocyte implantation for chondral lesions of the knee in patients more than 50 years old: A prospective case series with minimum 2-year follow-up
Authors: Kim Myung Ku , Park Jun Sung , Jeon Yun Moon , Jeon Yoon Sang
Published: December 2019

Background:

The purpose of this study was to evaluate clinical and radiological outcomes and to analyze the histological findings of repaired cartilage in patients more than 50 years old with underwent fibrin–matrix autologous chondrocyte implantation (ACI).

Methods:

From January 2013 to February 2014, a prospective study was conducted on 16 patients (16 knees) who underwent fibrin–matrix ACI for International Cartilage Repair Society grade 3 or 4 chondral lesions of the knee. The major lesion was in the medial femoral condyle in all patients. The mean age of the patients was 58.1 ± 6.2 (range 51–66) years, and the minimum follow-up period was 2 years. All patients had clinical and radiological evaluations at 3 months, 6 months, 1 year, and 2 years after surgery. Twelve patients had second-look arthroscopies at 1 year after surgery, and implanted chondral biopsies were performed in 11 of these 12 patients for histological analysis.

Results:

Functional disability assessment scales for the knee significantly improved after fibrin–matrix ACI ( p < 0.05). The visual analog scale score significantly decreased from 6.7 ± 1.2 to 2.0 ± 1.8 ( p < 0.001). The mean modified magnetic resonance observation of cartilage repair tissue score was 83.8 ± 17.3 at 1 year after surgery and 74.0 ± 19.2 at 2 years after surgery. Repair of the tissue with hyaline cartilage was confirmed histologically.

Conclusions:

Satisfactory clinical and radiological outcomes were obtained from gel-type fibrin–matrix ACI technique in older patients with a cartilage defect of the knee. Histological analysis confirmed that the new repaired tissue with hyaline cartilage filled the cartilage defect area. Therefore, fibrin–matrix ACI is believed to be an applicable treatment for older patients with chondral lesions of the knee.

Level of evidence:

Level IV.
How Do We End Sex-trafficking? A Day in the Life of Two Social Workers
Authors: Henin Bernard
Published: December 2019

This photo essay captures the grassroots work of Indian non-governmental organisation (NGO), Apne Aap Women Worldwide, to end sex-trafficking, in a nomadic community outside Delhi, where prostitution is passed down from mother-in-law to daughter-in-law. Young women are pushed into prostitution, after the birth of their first son. Their husbands and fathers-in-law are often the pimps. This nomadic group called the Perans and Saperas were labelled as Criminal Tribes under British colonialism and forced to give up their livelihood of making and selling dairy products, meat and indigenous medicine. Apne Aap social workers recruit girls to go to school, help them with homework, and try and make them stay in school, to break the cycle of inter-generational prostitution.
Acalabrutinib monotherapy in patients with relapsed/refractory chronic lymphocytic leukemia: updated phase 2 results
Authors: Byrd John C. , Wierda William G. , Schuh Anna , Devereux Stephen , Chaves Jorge M. , Brown Jennifer R. , Hillmen Peter , Martin Peter , Awan Farrukh T. , Stephens Deborah M. , Ghia Paolo , Barrientos Jacqueline , Pagel John M. , Woyach Jennifer A. , Burke Kathleen , Covey Todd , Gulrajani Michael , Hamdy Ahmed , Izumi Raquel , Frigault Melanie M. , Patel Priti , Rothbaum Wayne , Wang Min Hui , O’Brien Susan , Furman Richard R.
Published: December 2019

Therapeutic targeting of Bruton tyrosine kinase (BTK) has dramatically improved survival outcomes for patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL). Acalabrutinib is an oral, highly selective BTK inhibitor that allows for twice-daily dosing due to its selectivity. In this phase 1b/2 study, 134 patients with relapsed/refractory CLL or SLL (median age, 66 years [range, 42-85 years]; median prior therapies, 2 [range, 1-13]) received acalabrutinib 100 mg twice daily for a median of 41 months (range, 0.2-58 months). Median trough BTK occupancy at steady state was 97%. Most adverse events (AEs) were mild or moderate, and were most commonly diarrhea (52%) and headache (51%). Grade ≥3 AEs (occurring in ≥5% of patients) were neutropenia (14%), pneumonia (11%), hypertension (7%), anemia (7%), and diarrhea (5%). Atrial fibrillation and major bleeding AEs (all grades) occurred in 7% and 5% of patients, respectively. Most patients (56%) remain on treatment; the primary reasons for discontinuation were progressive disease (21%) and AEs (11%). The overall response rate, including partial response with lymphocytosis, with acalabrutinib was 94%; responses were similar regardless of genomic features (presence of del(11)(q22.3), del(17)(p13.1), complex karyotype, or immunoglobulin variable region heavy chain mutation status). Median duration of response and progression-free survival (PFS) have not been reached; the estimated 45-month PFS was 62% (95% confidence interval, 51% to 71%). BTK mutation was detected in 6 of 9 patients (67%) at relapse. This updated and expanded study confirms the efficacy, durability of response, and long-term safety of acalabrutinib, justifying its further investigation in previously untreated and treated patients with CLL/SLL. This trial was registered at www.clinicaltrials.gov as #NCT02029443.
Intellectual functioning and behavioural features associated with mosaicism in fragile X syndrome
Authors: Baker Emma K. , Arpone Marta , Vera Solange Aliaga , Bretherton Lesley , Ure Alexandra , Kraan Claudine M. , Bui Minh , Ling Ling , Francis David , Hunter Matthew F. , Elliott Justine , Rogers Carolyn , Field Michael J. , Cohen Jonathan , Maria Lorena Santa , Faundes Victor , Curotto Bianca , Morales Paulina , Trigo Cesar , Salas Isabel , Alliende Angelica M. , Amor David J. , Godler David E.
Published: December 2019

Background

Fragile X syndrome (FXS) is a common cause of intellectual disability and autism spectrum disorder (ASD) usually associated with a CGG expansion, termed full mutation (FM: CGG ≥ 200), increased DNA methylation of theFMR1promoter and silencing of the gene. Mosaicism for presence of cells with either methylated FM or smaller unmethylated pre-mutation (PM: CGG 55–199) alleles in the same individual have been associated with better cognitive functioning. This study compares age- and sex-matched FM-only and PM/FM mosaic individuals on intellectual functioning, ASD features and maladaptive behaviours.

Methods

This study comprised a large international cohort of 126 male and female participants with FXS (aged 1.15 to 43.17 years) separated into FM-only and PM/FM mosaic groups (90 males, 77.8% FM-only; 36 females, 77.8% FM-only). Intellectual functioning was assessed with age appropriate developmental or intelligence tests. The Autism Diagnostic Observation Schedule-2nd Edition was used to examine ASD features while the Aberrant Behavior Checklist-Community assessed maladaptive behaviours.

Results

Comparing males and females (FM-only + PM/FM mosaic), males had poorer intellectual functioning on all domains (p< 0.0001). Although females had less ASD features and less parent-reported maladaptive behaviours, these differences were no longer significant after controlling for intellectual functioning. Participants with PM/FM mosaicism, regardless of sex, presented with better intellectual functioning and less maladaptive behaviours compared with their age- and sex-matched FM-only counterparts (p< 0.05). ASD features were similar between FM-only and PM/FM mosaics within each sex, after controlling for overall intellectual functioning.

Conclusions

Males with FXS had significantly lower intellectual functioning than females with FXS. However, there were no significant differences in ASD features and maladaptive behaviours, after controlling for intellectual functioning, independent of the presence or absence of mosaicism. This suggests that interventions that primarily target cognitive abilities may in turn reduce the severity of maladaptive behaviours including ASD features in FXS.
A multivariate analysis with direct additive and inbreeding depression load effects
Authors: Varona Luis , Altarriba Juan , Moreno Carlos , Martínez-Castillero María , Casellas Joaquim
Published: December 2019

Background

Inbreeding is caused by mating between related individuals and its most common consequence is inbreeding depression. Several studies have detected heterogeneity in inbreeding depression among founder individuals, and recently a procedure for predicting hidden inbreeding depression loads associated with founders and the Mendelian sampling of non-founders has been developed. The objectives of our study were to expand this model to predict the inbreeding loads for all individuals in the pedigree and to estimate the covariance between the inbreeding loads and the additive genetic effects for the trait of interest. We tested the proposed approach with simulated data and with two datasets of records on weaning weight from the Spanish Pirenaica and Rubia Gallega beef cattle breeds.

Results

The posterior estimates of the variance components with the simulated datasets did not differ significantly from the simulation parameters. In addition, the correlation between the predicted and simulated inbreeding loads were always positive and ranged from 0.27 to 0.82. The beef cattle datasets comprised 35,126 and 75,194 records on weights between 170 and 250 days of age, and pedigrees of 308,836 and 384,434 individual-sire-dam entries for the Pirenaica and Rubia Gallega breeds, respectively. The posterior mean estimates of the variance of inbreeding depression loads were 29,967.8 and 28,222.4 for the Pirenaica and Rubia Gallega breeds, respectively. They were larger than those of the additive variance (695.0 and 439.8 for Pirenaica and Rubia Gallega, respectively), because they should be understood as the variance of the inbreeding depression achieved by a fully inbred (100%) descendant. Therefore, the inbreeding loads have to be rescaled for smaller inbreeding coefficients. In addition, a strong negative correlation (− 0.43 ± 0.10) between additive effects and inbreeding loads was detected in the Pirenaica, but not in the Rubia Gallega breed.

Conclusions

The results of the simulation study confirmed the ability of the proposed procedure to predict inbreeding depression loads for all individuals in the populations. Furthermore, the results obtained from the two real datasets confirmed the variability in the inbreeding depression loads in both breeds and suggested a negative correlation of the inbreeding loads with the additive genetic effects in the Pirenaica breed.
Phenotypic plasticity of natural Populus trichocarpa populations in response to temporally environmental change in a common garden
Authors: Liu Yang , El-Kassaby Yousry A.
Published: December 2019

Background

Natural selection on fitness-related traits can be temporally heterogeneous among populations. As climate changes, understanding population-level responses is of scientific and practical importance. We examined 18 phenotypic traits associated with phenology, biomass, and ecophysiology in 403 individuals of natural Populus trichocarpa populations, growing in a common garden.

Results

Compared with tree origin settings, propagules likely underwent drought exposures in the common garden due to significantly low rainfall during the years of measurement. All study traits showed population differentiation reflecting adaptive responses due to local genetic adaptation. Phenology and biomass traits were strongly under selection and showed plastic responses between years, co-varying with latitude. While phenological events (e.g., bud set and growth period) and biomass were under positive directional selection, post-bud set period, particularly from final bud set to the onset of leaf drop, was selected against. With one exception to water-use efficiency, ecophysiology traits were under negative directional selection. Moreover, extended phenological events jointly evolved with source niches under increased temperature and decreased rainfall exposures. High biomass coevolved with climatic niches of high temperature; low rainfall promoted high photosynthetic rates evolution.

Conclusions

This work underpins that P. trichocarpa is likely to experience increased fitness (height gain) by evolving toward extended bud set and growth period, abbreviated post-bud set period, and increased drought resistance, potentially constituting a powerful mechanism for long-lived tree species in surviving unpredictably environmental extremes (e.g., drought).
The ability of single genes vs full genomes to resolve time and space in outbreak analysis
Authors: Dudas Gytis , Bedford Trevor
Published: December 2019

Background

Inexpensive pathogen genome sequencing has had a transformative effect on the field of phylodynamics, where ever increasing volumes of data have promised real-time insight into outbreaks of infectious disease. As well as the sheer volume of pathogen isolates being sequenced, the sequencing of whole pathogen genomes, rather than select loci, has allowed phylogenetic analyses to be carried out at finer time scales, often approaching serial intervals for infections caused by rapidly evolving RNA viruses. Despite its utility, whole genome sequencing of pathogens has not been adopted universally and targeted sequencing of loci is common in some pathogen-specific fields.

Results

In this study we highlighted the utility of sequencing whole genomes of pathogens by re-analysing a well-characterised collection of Ebola virus sequences in the form of complete viral genomes (≈19 kb long) or the rapidly evolving glycoprotein (GP, ≈2 kb long) gene. We have quantified changes in phylogenetic, temporal, and spatial inference resolution as a result of this reduction in data and compared these to theoretical expectations.

Conclusions

We propose a simple intuitive metric for quantifying temporal resolution, i.e. the time scale over which sequence data might be informative of various processes as a quick back-of-the-envelope calculation of statistical power available to molecular clock analyses.
A patient-centered composite endpoint weighting technique for orthopaedic trauma research
Authors: Udogwu Ugochukwu N. , Howe Andrea , Frey Katherine , Isaac Marckenley , Connelly Daniel , Marinos Dimitrius , Baker Mitchell , Castillo Renan C. , Slobogean Gerard P. , O’Toole Robert V. , O’Hara Nathan N.
Published: December 2019

Background

This study aimed to address the current limitations of the use of composite endpoints in orthopaedic trauma research by quantifying the relative importance of clinical outcomes common to orthopaedic trauma patients and use those values to develop a patient-centered composite endpoint weighting technique.

Methods

A Best-Worst Scaling choice experiment was administered to 396 adult surgically-treated fracture patients. Respondents were presented with ten choice sets, each consisting of three out of ten plausible clinical outcomes. Hierarchical Bayesian modeling was used to determine the utilities associated with the outcomes.

Results

Death was the outcome of greatest importance (mean utility = − 8.91), followed by above knee amputation (− 7.66), below knee amputation (− 6.97), severe pain (− 5.90), deep surgical site infection (SSI) (− 5.69), bone healing complications (− 5.20), and moderate pain (− 4.59). Mild pain (− 3.30) and superficial SSI (− 3.29), on the other hand, were the outcomes of least importance to respondents.

Conclusion

This study revealed that patients’ relative importance towards clinical outcomes followed a logical gradient, with distinct and quantifiable preferences for each possible component outcome. These findings were incorporated into a novel composite endpoint weighting technique.
Study protocol for the multicentre cohorts of Zika virus infection in pregnant women, infants, and acute clinical cases in Latin America and the Caribbean: the ZIKAlliance consortium
Authors:   the ZIKAlliance Clinical Study Group, Avelino-Silva Vivian I. , Mayaud Philippe , Tami Adriana , Miranda Maria C. , Rosenberger Kerstin D. , Alexander Neal , Nacul Luis , Segurado Aluisio , Pohl Moritz , Bethencourt Sarah , Villar Luis A. , Viana Isabelle F. T. , Rabello Renata , Soria Carmen , Salgado Silvia P. , Gotuzzo Eduardo , Guzmán María G. , Martínez Pedro A. , López-Gatell Hugo , Hegewisch-Taylor Jennifer , Borja-Aburto Victor H. , Gonzalez Cesar , Netto Eduardo M. , Saba Villarroel Paola M. , Hoen Bruno , Brasil Patrícia , Marques Ernesto T. A. , Rockx Barry , Koopmans Marion , de Lamballerie Xavier , Jaenisch Thomas
Published: December 2019

Background

The European Commission (EC) Horizon 2020 (H2020)-funded ZIKAlliance Consortium designed a multicentre study including pregnant women (PW), children (CH) and natural history (NH) cohorts. Clinical sites were selected over a wide geographic range within Latin America and the Caribbean, taking into account the dynamic course of the ZIKV epidemic.

Methods

Recruitment to the PW cohort will take place in antenatal care clinics. PW will be enrolled regardless of symptoms and followed over the course of pregnancy, approximately every 4 weeks. PW will be revisited at delivery (or after miscarriage/abortion) to assess birth outcomes, including microcephaly and other congenital abnormalities according to the evolving definition of congenital Zika syndrome (CZS).

After birth, children will be followed for 2 years in the CH cohort. Follow-up visits are scheduled at ages 1–3, 4–6, 12, and 24 months to assess neurocognitive and developmental milestones. In addition, a NH cohort for the characterization of symptomatic rash/fever illness was designed, including follow-up to capture persisting health problems.

Blood, urine, and other biological materials will be collected, and tested for ZIKV and other relevant arboviral diseases (dengue, chikungunya, yellow fever) using RT-PCR or serological methods. A virtual, decentralized biobank will be created. Reciprocal clinical monitoring has been established between partner sites.

Substudies of ZIKV seroprevalence, transmission clustering, disabilities and health economics, viral kinetics, the potential role of antibody enhancement, and co-infections will be linked to the cohort studies.

Discussion

Results of these large cohort studies will provide better risk estimates for birth defects and other developmental abnormalities associated with ZIKV infection including possible co-factors for the variability of risk estimates between other countries and regions. Additional outcomes include incidence and transmission estimates of ZIKV during and after pregnancy, characterization of short and long-term clinical course following infection and viral kinetics of ZIKV.

Study registrations

clinicaltrials.gov NCT03188731 (PW cohort), June 15, 2017; clinicaltrials.gov NCT03393286 (CH cohort), January 8, 2018; clinicaltrials.gov NCT03204409 (NH cohort), July 2, 2017.
Comparative evaluation of image registration methods with different interest regions in lung cancer radiotherapy
Authors: Cao Xiaohui , Liu Ming , Zhai Fushan , Li Nan , Li Feng , Bao Chaoen , Liu Yinliang , Chen Gang
Published: December 2019

Background

Lung cancer is a leading cause of morbidity and mortality worldwide. Radiotherapy for lung cancer is beneficial in both the radical and palliative settings, and technologic advances in recent years now afford an opportunity for this treatment to be more targeted than ever before. Although the delivery of more accurate forms of radiotherapy has minimized the risks of side-effects, how to utilize this treatment to optimize outcomes remains questionable. This study aimed to evaluate the accuracy of cone beam computed tomography (CBCT) image registration used in image-guided radiotherapy, providing reasonable guidance for clinic application of CBCT in lung cancer.

Methods

A total of 53 patients with lung carcinoma including 34 central and 19 peripheral lesions were collected in this study. Varian-IX linear accelerator on-board imaging (OBI) system was used to acquire CBCT scans in three-dimensional (3D) conformal radiotherapy before delivery. Different regions (whole lung/target/vertebrae/ipsilateral structure) were manually registered, and the position deviation and the registration time were analyzed.

Results

It was suggested that 34 cases belonged to central type and 19 cases belonged to peripheral type. The volume of left lung and right lung was 1242.98 ± 452.46 cc, 1689.69 ± 574.31 cc, respectively. Tumor size was 6.65 ± 3.87 cm in diameter, and 129.67 ± 136.48 cc in volume. The percentage of left lung and right lung was 6.17 ± 1.24%, 4.74 ± 0.38%, respectively. The position deviation value and absolute value of image registration methods of X, Y and Z axis were not significant (P > 0.05). However, registration time (s) between whole lung registration group, tumor registration group, vertebral body registration group, affected lung registration group, and artificial registration group, was 3.651 ± 0.867 s, 1.144 ± 0.129 s, 1.226 ± 0.126 s, 2.081 ± 0.427 s, 179.491 ± 71.975 s, respectively. The differences were significant (P < 0.05). The registration differences between small tumor group and large tumor group were not statistically significant (P > 0.05).

Conclusion

The automatic image matching of OBI is accuracy and high reliability in recognition of offset error. Registering body or ipsilateral structure is recommended to be used in CBCT for lung cancer.
Diagnosis and management of a giant ovarian cyst in the gravid-puerperium period: a case report
Authors: Kiemtoré Sibraogo , Zamané Hyacinthe , Sawadogo Yobi Alexis , Sib Rodrigue Sansan , Komboigo Evelyne , Ouédraogo Ali , Bonané Blandine
Published: December 2019

Background

Giant ovarian cyst is very rare in gravid-puerperium period. It is a cause of a maternal-fetal morbidity. We report a case of a giant benign ovarian cyst in gravid-puerperium period which was diagnosed and managed in a hospital of a low-resource country.

Case presentation

Data were collected by historical review, clinical examination, laboratory investigations, imaging examination, and by histopathological study of the excised surgical specimen. It is the case of a 25-year-old woman who was third gravida and third para with unknown pathological history. After she had given birth through vagina, a giant ovarian cyst, unknown during pregnancy, was diagnosed. A left oophorectomy carrying the cyst was performed after laparotomy in Yalgado Ouedraogo University Hospital Center of Ouagadougou (Burkina Faso). The cyst was 42 cm long and weighed 19.7 kg. The histology of the operative specimen revealed serous cystadenoma of the ovary. The postoperative course was uneventful.

Conclusion

This case reports that vaginal delivery is possible with a giant ovarian cyst associated with pregnancy. Surgical management of the cyst can be performed in the postpartum with satisfaction.
Continuous ab interno repairing of traumatic cyclodialysis cleft using a 30-gauge needle in severe ocular trauma: a clinical observation
Authors: Li Haibo , Cai Jinhong , Li Xiaofeng
Published: December 2019

Background

To investigate the efficacy and safety of continuous ab interno repairing of traumatic cyclodialysis cleft in severe ocular trauma using a 30-gauge (G) needle.

Methods

Fifteen patients (15 eyes) with traumatic cyclodialysis cleft admitted to the ocular trauma department of our hospital from July 2014 to December 2018 were included in this study. After the bulbar conjunctiva corresponding to the ciliary body was incised along the corneal limbus, an incision was made along the corneal limbus on the opposite side. A 30G needle with a 10–0 suture entered the anterior chamber from the incision and passed through the ciliary body with clefts and the sclera to fixate the ciliary body on the sclera wall with continuous mattress suture. The best corrected visual acuity (BCVA) and intraocular pressure (IOP) were observed preoperatively and postoperatively. In vivo ultrasound biomicroscopy (UBM) was performed to observe closure of cyclodialysis cleft before and after surgery.

Results

Fifteen patients successfully underwent continuous mattress suture for repair of cyclodialysis cleft. No bleeding and suture breakage were reported during surgery. After surgery, the UBM during follow-up showed satisfactory closure of the cyclodialysis cleft. The BCVA and IOP were improved to different degrees. The difference between the preoperative IOP and the postoperative IOP (1 week) was statistically significant (preoperative: 6.49 ± 0.98 mmHg, postoperative: 16.17 ± 4.65 mmHg, t = − 8.43,P < 0.05), and the difference between the preoperative IOP and the postoperative IOP (1 month) was also statistically significant (preoperative: 6.49 ± 0.98 mmHg, postoperative: 14.63 ± 3.63 mmHg, t = − 8.38,P < 0.05). Duration of outpatient follow-up was 3 to 12 months. No complications, including exposed knots, loose sutures, decompensation of corneal endothelium, sympathetic ophthalmia, endophthalmitis and choroidal detachment, were reported.

Conclusion

Continuous ab interno repairing of traumatic cyclodialysis cleft in severe ocular trauma using a 30G needle is a safe and effective procedure with simple operation, little tissue damage and few complications.
Designing an intervention to improve sexual health service use among university undergraduate students: a mixed methods study guided by the behaviour change wheel
Authors: Cassidy Christine , Steenbeek Audrey , Langille Donald , Martin-Misener Ruth , Curran Janet
Published: December 2019

Introduction

University undergraduate students are within the population at highest risk for acquiring sexually transmitted infections, unplanned pregnancy, and other negative health outcomes. Despite the availability of sexual health services at university health centres, many students delay or avoid seeking care. In this study, we describe how the Behaviour Change Wheel was used as a systematic approach to design an intervention to improve sexual health service use among university undergraduate students.

Methods

This paper describes the intervention development phase of a three-phased, sequential explanatory mixed methods study. Phases one and two included a quantitative and qualitative study that aimed to better understand students’ use of sexual health services. In phase three, we followed the Behaviour Change Wheel to integrate the quantitative and qualitative findings and conduct stakeholder consultation meetings to select intervention strategies, including intervention functions and behaviour change techniques.

Results

Key linkages between opportunity and motivation were found to influence students’ access of sexual health services. Stakeholders identified six intervention functions (education, environmental restructuring, enablement, modelling, persuasion, and incentivization) and 15 behaviour change techniques (information about health consequences, information about social and environmental consequences, feedback on behaviour, feedback on outcomes of behaviour, prompts/cues, self-monitoring of behaviour, adding objects to the environment, goal setting, problem solving, action planning, restructuring the social environment, restructuring the physical environment, demonstration of the behaviour, social support, credible source) as relevant to include in a toolbox of intervention strategies to improve sexual health service use.

Conclusions

This study details the use of the Behaviour Change Wheel to develop an intervention aimed at improving university students’ use of sexual health services. The Behaviour Change Wheel provided a comprehensive framework for integrating multiple sources of data to inform the selection of intervention strategies. Stakeholders can use these strategies to design and implement sexual health service interventions that are feasible within the context of their health centre. Future research is needed to test the effectiveness of the strategies at changing university students’ sexual health behaviour.