bluuebunny/crossref_metadata_2025 huggingface dataset:
Pulmonary Metastases in Urogenital Cancers; Surgical Treatment and Outcomes
Authors: Ceylan Kenan Can , Batıhan Güntuğ , Kaya Seyda Ors
Published: November 2020

Background Metastasis is remaining one of the major problems in cancer treatment. Like many other malignancies, urogenital tumors originating from kidney, prostate, testes, and bladder tend to metastasize to the lungs.The aim of this retrospective study is to evaluate the results of pulmonary metastasectomy in patients with primary urogenital tumors.Methods This study was approved by the local ethical committee. This study retrospectively analyses the patients who underwent lung resections for metastases in our department between 2002 and 2018. 22 out of 126 patients referred for pulmonary metastasectomy to our department had metastases from urogenital tumors.Demographic data and clinicopathological features were extracted from the medical records. Disease-free interval (DFI) was defined as the time between the first curative surgery and the detection of pulmonary metastasis. Results Among 22 patients who underwent lung metastasectomy consisted of 17 males and five females. Their metastasis originated from renal cell carcinoma (RCC; n = 9), bladder tumor (n = 7), testis tumors (n = 4), and prostate cancer (n = 2). There was no intraoperative complication. Postoperative complications were seen in 2 patients. Conclusions Although pulmonary metastases and its surgical management in various types of tumors is well known and documented, the data is limited to the role of the surgery for metastases of urogenital cancers on literature. Despite the limitations of this study, we aim to document our promising results of pulmonary metastasectomy in patients with primary urogenital tumors.Trial registration This study was approved by the local ethical committee (Registration number: 49109414-604.02 ; Date: 11/06/2019).
Analysing the Impact of Trade Agreements on National Food Environments: The Case of Vanuatu
Authors: Ravuvu Amerita , Lui Joe Pakoa , Bani Adolphe , Tavoa Anna Wells , Vuti Raymond , Tin Si Thu Win
Published: November 2020

Background: The liberalisation of international trade and foreign direct investment through trade agreements have been influential in the changing structure and nature of food systems. They have also contributed to the increased availability of foods associated with the nutrition transition globally. Despite the large body of literature on trade liberalisation and the ways in which trade agreements can affect food systems, the ways in which trade agreements can affect national food environments has been little studied. There is a need for more systematic and objective monitoring of the impacts of trade agreements to better understand its links and impacts on the influx of food imports high in fat, sugar and salt entering a country as this has direct impacts on the availability, nutritional quality and accessibility of foods in national food environments. Using the INFORMAS trade monitoring framework, a systematic analysis of Vanuatu’s membership to the WTO under the framework’s four domains was undertaken. Results: The baseline results presented in this paper suggest a strong association between Vanuatu’s trade liberalisation and the increased availability of the diverse range of imported products: fats and oils, meat and canned fish, processed dairy products, energy-dense beverages, and processed and packaged foods.Conclusions: The analysis presented in this paper suggest that Vanuatu’s commitments to WTO Agreements do play an important role in shaping their food environment by increasing both healthy and less healthy imports. For all Pacific Island countries, the systematic and objective monitoring of the impacts of these agreements on national food environments remains a significant challenge. There is also minimal data to inform the development of effective, coherent trade and health policy approaches to promote healthier food environments that can contribute to reducing the burden of obesity and related NCDs. Nevertheless, there is scope when developing trade policies and agreements to consider NCDs as part of broader social impact assessment studies. These can be used to identify potential modifications that can be made to trade policies and agreements. These modifications can regulate food environments and reduce the impact of NCDs or ensure that mitigating complementary actions are taken.
Genome-Wide Identification of Chitinase Genes in Thalassiosira Pseudonana and Analysis of Their Expression Under Abiotic Stresses
Authors: Cheng Haomiao , Shao Zhanru , Lu Chang , Duan Delin
Published: November 2020

Background: The nitrogen-containing polysaccharide chitin is the second most abundant biopolymer on earth and is found in the cell walls of diatoms, where it serves as a scaffold for biosilica deposition. Diatom chitin is an important source of carbon and nitrogen in the marine environment, but surprisingly little is known about basic chitinase metabolism in diatoms.Results: Here, we identify and fully characterize 24 chitinase genes from the model centric diatom Thalassiosira pseudonana. We demonstrate that their expression is broadly upregulated under abiotic stresses, despite the fact that chitinase activity itself remains unchanged, and we discuss several explanations for this result. We also examine the potential transcriptional complexity of the intron-rich T. pseudonana chitinase genes and provide evidence for two separate tandem duplication events during their evolution.Conclusions: Given the many applications of chitin and chitin derivatives in suture production, wound healing, drug delivery, and other processes, new insight into diatom chitin metabolism has both theoretical and practical value.
Utility Of Angioembolization In Patients with Abdominal and Pelvic Traumatic Bleeding: Descriptive Observational Analysis From A Level 1 Trauma Center
Authors: Al-Thani Hassan , Abdelrahman Husham , Barah Ali , Asim Mohammad , El-Menyar Ayman
Published: November 2020

Background: Massive bleeding is a major preventable cause of early death in trauma. It often requires surgical or endovascular intervention. We aimed to describe the utilization of angioembolization in patients with abdominal and pelvic traumatic bleeding at a level 1 trauma center.Methods: We conducted a retrospective analysis for all trauma patients who underwent angioembolization post-traumatic bleeding between January 2012 and April 2018. Patients’s data and details of injuries, angiography procedures and outcomes were extracted from the Qatar national trauma registry.Results: A total of 175 trauma patients underwent angioembolization during the study period (103 for solid organ injury , 51 for pelvic injury and 21 for other injuries). The majority were young males. The main cause of injury was blunt trauma in 95.4% of patients. The most common indication of angioembolization was evident active bleeding on the initial CT scan (contrast pool or blushes). Blood transfusion was needed in two-third of patients. The hepatic injury cases had higher ISS, higher shock Index and more blood transfusion Absorbable particles (Gelfoam) was the most commonly used embolic material. The overall technical and clinical success rate was 93.7% and 95% respectively with low rebleeding and complication rates. The hospital and ICU length of stay were13 and 6 days respectively. The median injury to intervention time was 320 min while hospital arrival to intervention time was 274 min. The median follow-up time was 215 days. The overall cohort mortality was 15%. Conclusion: Angioembolization is an effective intervention to stop bleeding and support nonoperative management for both solid organ injuries and pelvic trauma. It has a high success rate with a careful selection and proper implementation.
Echocardiographic Parameters during Prolonged Targeted Temperature Management in Out-of-hospital Cardiac Arrest Survivors to Predict Neurological Outcome
Authors: Jensen Thomas Hvid , Juhl-Olsen Peter , Nielsen Bent Roni Ranghøj , Heiberg Johan , Duez Christophe Henri Valdemar , Jeppesen Anni Nørgaard , Frederiksen Christian Alcaraz , Kirkegaard Hans , Grejs Anders Morten
Published: November 2020

Background: Transthoracic echocardiographic (TTE) indices of myocardial function among survivors of out-of-hospital cardiac arrest (OHCA) have been related to neurological outcome; however, results are inconsistent. We aimed to evaluate whether echocardiography indices of myocardial function predicts six-month neurological outcome in comatose OHCA survivors treated with targeted temperature management (TTM).Methods: We investigated the association between peak systolic velocity of the mitral plane (s’) and six-month neurological outcome in a population of 99 patients from a randomised controlled trial comparing TTM at 33±1°C for 24 hours (h) (n=47) vs. 48h (n=52) following OHCA (TTH48-trial). TTE was conducted at 24h, 48h, and 72h after reaching target temperature. The primary outcome was 180 days neurological outcome assessed by Cerebral Performance Category score (CPC180) and the primary TTE outcome measure was s’. Secondary outcome measures were left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), e’, E/e’ and tricuspid annular plane systolic excursion (TAPSE). Results: s’, LVEF, GLS, E/e’, and TAPSE recorded on serial TTEs following OHCA were neither associated with nor did they predict CPC180. Estimated median e’ at 48h following TTM was 5.74 cm/s (95%CI: 5.27-6.22) in patients with good outcome (CPC180 1-2) vs. 4.95 cm/s (95%CI: 4.37-5.54) in patients with poor outcome (CPC180 3-5) (p=0.04). Conclusions: s’ assessed on serial TTEs in comatose survivors of OHCA treated with TTM was not associated with CPC180. Our findings suggest that serial TTEs in the early post-resuscitation phase during TTM do not aid the prognostication of neurological outcome following OHCA.Trial registration: NCT02066753. Registered 14 February 2014 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02066753
Prehospital Time of Suspected Stroke Patients Treated by Emergency Medical Service: A Nationwide Study in Thailand
Authors: Tansuwannarat Phantakan , Atiksawedparit Pongsakorn , Wibulpolprasert Arrug , Mankasetkit Natdanai
Published: November 2020

Background: This study was to study the prehospital time among suspected stroke patients who were transported by emergency medical service (EMS) system using national database. Methods: National EMS database across 77 provinces of Thailand among suspected stroke patients who were treated by EMS system between January 1, 2015 to December 31, 2018 was retrospectively analyzed. Demographic data (i.e., regions, shifts, levels of ambulance and distance to scene) and prehospital time (i.e., dispatch, activation, response, scene and transportation times) were extracted. Time parameters were also categorized according to guideline. Results: In total 53,536 subjects were included in analysis. Most of the subjects were transported during 06.00-18.00 and were in 10 kilometers from ambulance parking. Half of the subjects were treated by advanced life support (ALS) ambulance. Median total time was 29 minutes (IQR: 21, 39) which was mainly occupied for transporting patient from scene to hospital. Although most of subjects had dispatch and activation times ≤ 2 minutes, but only 48.3% had RT ≤ 8 minutes. However, 95% of service were at scene ≤ 15 minutes. ALS ambulance had the longer total time, compared to first responder and basic level (30 minutes versus 28 and 27 minutes). Conclusions: Prehospital time from EMS call to hospital was approximately 30 minutes among suspected stroke patients. This was mainly utilized for travelling from ambulance parking to scene and transporting patient from scene to hospital. Although only 48% of services had RT ≤ 8 minutes, but 95% of them had scene time ≤ 15 minutes.
Public Attitudes Towards Cardiopulmonary Resuscitation Training and Performance in Singapore
Authors: Chowdhury Susmita Roy , Anantharaman Venkataraman
Published: November 2020

Background: Bystander cardiopulmonary resuscitation (CPR) rates remain fairly low through most communities despite multiple interventions through the years. Understanding the attitudes and fears behind CPR training and performance would help target education and training to raise the rates of bystander CPR and consequently survival rates of victims. 7909 participants at a single-day mass CPR training session in Singapore were given survey questionnaires to fill out. 6473 people submitted completed forms upon the conclusion of the training session. Some issues looked at were overall level of difficulty of CPR, difficulty levels of specific skills, attitudes towards refresher training, attitudes towards performing CPR and fears when doing so.Results: The mean level of difficulty of CPR was rated 3.98 (scale of 1-10), with those with previous CPR training rating it easier. The skills rated most difficult were performing mouth-to mouth breathing and chest compressions, while the easiest rated was recognising non-responsiveness. A majority (69.7%) would agree to go for refresher training every 2 years and 88.7% felt everyone should be trained in CPR. 71.6% would perform full CPR for a member of public in cardiac arrest and only 20.7% would prefer to only do chest-compressions. The most cited fear was a low level of confidence, and fears of acquiring infections or aversion to mouth-to-mouth breathing were low.Conclusions: The survey results show that most participants in Singapore are keen to perform conventional CPR for a member of public and can help to target future CPR training accordingly.
Parental Phone use during Mealtime with Toddlers and the Associations with Feeding Practices and Shared Family Meals: A Cross-sectional Study
Authors: Vik Frøydis Nordgård , Grasaas Erik , Polspoel Maaike E. M. , Røed Margrethe , Hillesund Elisabet R. , Øverby Nina C.
Published: November 2020

BackgroundPositive parental feeding practices and a higher frequency of family meals are related to healthier child dietary habits. Parents play an essential role when it comes to the development of their child’s eating habits. However, parents are increasingly distracted by their mobile phone during mealtime. The aim of this study was to describe the feeding practices and daily shared family meals among parents who use and do not use mobile phone during mealtime, and further to explore the associations between the use of mobile phone during mealtime and feeding practices and daily shared family meals, respectively.Methods Cross-sectional data from the Food4toddler study were used to explore the association between mobile use during meals and parental feeding practices including family meals. In 2017/2018 parents of toddlers were recruited through social media to participate in the study. In total 298 out of 404 who volunteered to participate, filled in a baseline questionnaire, including questions from the comprehensive feeding practices questionnaire (CFPQ), questions of frequency of family meals and use of mobile phone during meals. ResultsHerein, 4 out of 10 parents reported various levels of phone use (meal distraction) during mealtimes. Parental phone use was associated with lower use of positive parental feeding practices like modelling (B= -1.05 (95% CI -1.69; -0.41)) and family food environment (B= -0.77 (95% CI -1.51; -0.03)), and more use of negative parental feeding practices like emotional regulation (B= 0.73 (95% CI 0.32; 1.14)) and the use of pressure to eat (B= 1.22 (95% CI 0.41; 2.03)). Furthermore, parental phone use was associated with a lower frequency of daily family breakfast (OR= 0.50 (95% CI 0.31; 0.82)) and dinner (OR= 0.57 (95% CI 0.35; 0.93)). ConclusionsMobile phone use is common among parents during mealtimes, and findings indicate that parental phone use is associated with less healthy feeding practices and shared family meals. These findings highlight the importance of making parents aware of potential impacts of meal distractions. Trial registration: ISRCTN92980420. Registered 13 September 2017. Retrospectively registered.
Assessment of Respiratory Dust Exposure and Lung Functions Among Workers in Textile Mill (Thamine), Myanmar: A Cross-sectional Study
Authors: Oo Thet Wai , Thandar Mya , Htun Ye Minn , Soe Pa Pa , Lwin Thant Zaw , Tun Kyaw Myo , Han Zaw Myo
Published: November 2020

Background: Airborne dusts are being potentially harmful for workers in occupational environment. Exposure to respirable dust is the most important concern in textile workers for the widespread of occupational lung diseases, especially more serious in developing countries. The aim of the study was to assess the respirable dust exposure and associated factors of lung functions among textile workers.Methods: A cross-sectional study was carried out at a Textile mill (Thamine), Yangon Region, from April to December, 2018 and a total of 207 textile workers were randomly selected by using a multistage sampling procedure. Data were collected by using a structured questionnaire for respiratory symptoms, an air sampling pump for assessment of respirable dust exposure, and a spirometer for testing the lung functions. Logistic regression analysis was performed to assess the associated factors of lung functions. Odds ratios with a 95% confidence interval were computed for strength of associations at the significance level of α ≤ 0.05.Results: The mean (± standard deviation, SD) respirable dust exposure was 3.3 mg/m3 (± 0.69) and the prevalence of increased respirable dust exposure (> 3 mg/m3) was 50.7%. The level of respirable dust exposure was highest in the textile workers involving at twisting department. The means (± SD) spirometry values were FVC 82.8% (± 17.8), FEV1 83.6% (± 18.5), and FEV1/FVC 0.9 (± 0.1). Overall magnitude of reduced lung functions was 40.1%, and the prevalence of reduced FVC, FEV1, and FEV1/FVC were 36.7%, 34.3% and 3.9% respectively. The current working at twisting department, > 5 years of service duration, respiratory symptoms and increased respirable dust exposure were associated with reduction in FVC and FEV1. Conclusions: The current working department, service duration, respiratory symptoms and exposure to respirable dust were predictors of lung functions in textile workers. An adequate ventilation, good work practices, hygienic workplace, safety and health training regarding potential health effects, and periodically assessment of lung functions are the critical elements for control of respirable dust exposure and reduction of occupational lung diseases.
Association Between Spirituality/religiousness and Quality of Life Among Healthy Adults: A Systematic Review 
Authors: BORGES CEZIMAR CORREIA , SANTOS PATRÍCIA ROBERTA DOS , ALVES POLISSANDRO MORTOZA , BORGES RENATA CUSTÓDIO MACIEL , LUCCHETTI GIANCARLO , BARBOSA MARIA ALVES , PORTO CELMO CELENO
Published: November 2020

Background: Health-related quality of life (HRQoL) is determined by multiple factors that include components such as spirituality and religiousness (S/R). Even though various systematic reviews have investigated the association between S/R and improved health outcomes in the most different groups, healthy young individuals are seldom addressed. The aim this study was to evalue the association between S/R and HRQoL among young, healthy individuals.Methods: Systematic review of papers published in the last ten years and indexed in four academic research databases (PubMed, Web of Science, Cochrane Library, and Scopus) and two gray literature databases. Inclusion criteria were studies assessing S/R and HRQoL using validated instruments and assessing healthy adults (i.e., non-clinical patients, not belonging to any specific group of chronic diseases), aged between 18 and 64 years old. Results: Ten out of 1,952 studies met the inclusion criteria: nine cross-sectional and one longitudinal cohort study, in which 89% of the participants were college students. Nine studies report a positive association between S/R and HRQoL, while one study did not report any significant association. The main HRQoL domains associated with S/R were the psychological, social relationships, and environment domains, while the S/R most influent facets/components were optimism, inner strength, peace, high control, hope, and happiness. Conclusions: Higher S/R levels among healthy adult individuals were associated with higher HRQoL levels, suggesting the S/R can be an important strategy to deal with adverse environmental situations even among those without chronic diseases, enhancing the wellbeing of individuals. Registration of systematic review: PROSPERO - CRD42018104047
Characteristics and clinical significance of spondylolisthetic and spino-pelvic sagittal parameters in kyphotic low-grade degenerative lumbar spondylolisthesis
Authors: Xu Chongqing , Yin Mengchen , Mo Wen
Published: November 2020

Background: Degenerative lumbar spondylolisthesis (DLS) has been a common disease that make increasing patients suffer from different degrees of low back pain and radicular symptoms. At present, the incidence of kyphosis in DLS and the differences in spinal sagittal morphology between kyphotic and non-kyphotic DLS still remain unclear. Our study aimed to determine the incidence of kyphosis in DLS, explore the characteristics of spondylolisthetic and spino-pelvic sagittal parameters, and evaluate the impact of kyphosis on the life quality of patients with DLS.Methods/Design: All 108 patients with L4/5 low-grade DLS were enrolled and divided into kyphotic and non-kyphotic group. 2 spine surgeons who have certain clinical experience were selected to measure the spondylolisthetic and spino-pelvic parameters, as well as visual analogue scale (VAS) and Oswestry disability index (ODI). Differences between the 2 groups and characteristics of measurements were analyzed.Results: The inter-observer agreement of all parameters between the 2 spine surgeons were excellent with each ICC > 0.75. Kyphotic group had higher SA, SD, SDM, SAM, PDH, PT and SVA, and lower ADH, SS and LL than those in non-kyphotic group (p < 0.01). There was no significant difference in PI and TK between the two groups (p > 0.05).Conclusion: The incidence of kyphotic spondylolisthesis in patients with L4/5 low-grade DLS is 16.7%. Compared with those in non-kyphotic group, patients with kyphosis show inferior results of spondylolisthetic parameters, more severe loss of LL, more obvious pelvic retroversion and trunk anteversion, which indicates worse spino-pelvic sagittal balance. In addition, their quality of life was significantly lower than that of patients in non-kyphotic group.
Radiographic analysis in reduction loss after distal radius fracture fixation with variable angle volar locking plate
Authors: Fang Pin-Chieh , Lo Tak-Yu-Yubie , Cheng Chun-Ying , Chou Ying-Chao , Chen Alvin Chao-Yu
Published: November 2020

Background Reduction loss is commonly seen even in the newly designed locking plate fixation for distal radius fractures. Our study purpose is to investigate the efficacy of the variable angle volar locking plate (VAVLP) in maintenance of fracture fixation. Methods A total of 37 patients of unilateral distal radius fractures receiving VAVLP fixation were included. Forearm radiographs immediately after surgery and those at 3 months were retrospectively reviewed for analysis of radiographic parameters including radial height (RH), ulnar variance (UV), radial inclination (RI), volar tilt (VT), tear drop angle (TDA), distal dorsal cortical distance (DDD) and Soong classification (SC). Results By comparing the 3-month measurement and normal data, the difference of RH/UV/TDA was significant (p-value < 0.001) while the difference of RI/VT was insignificant. However, there was no significant difference regarding those five parameters between postoperative and 3-month measurement. Linear regression on DDD exhibited positive dependence with p-value of 0.002 between postoperative and 3-month changes. Postoperative SC was grade 0 in 13 patients, grade 1 in 21, and grade 2 in 3. There were 7 of Gr 0 and 2 of Gr 1 making one grade up.Conclusion VAVLP fixation in distal radius fracture can maintain radiographic alignment without significant reduction loss for at least 3 months. Realignment within normal range was in RI and VT, but not in RH/UV/TDA.
Post Treatment Quality of Life among Sri Lankan Women with Breast Cancer
Authors: Jayasinghe Ravindri , Fernando Ashan , Jayarajah Umesh , Seneviratne Sanjeewa
Published: November 2020

Background This study was conducted to evaluate post-treatment long-term quality of life (QOL) in breast cancer patients and to determine its association with the type of surgery.Methods All women with non-metastatic breast cancer who underwent surgery for breast cancer at the Professorial Surgical Unit, Colombo during 2015–2018 and completed a minimum of one year follow up after surgery were invited to participate in the study. Fifty-four women who responded were analysed using the validated EORTC QLQ-C30 and QLQ-BR23 questionnaires. Non-parametric tests were used for statistical analyses.Results The mean age was 59 years (range 36–81). A majority (61%, n = 33) underwent mastectomy and the rest (n = 19, 45%) breast conservation surgery (BCS). The mean QLQ-C30 score was 68.8 (range 8.3–100) and the mean scores for physical function, role function, emotional function, cognitive function, and social function were 71.4, 81.5, 77.0, 80.2, and 86.4, respectively. The mean scores for body image, sexual functioning, sexual enjoyment, future perspective, systemic therapy, breast symptoms, arm symptoms, and hair loss assessed by the QLQ-BR23 were 76.4, 18.3, 33.3, 73.6, 30.5, 16.2, 23.4 and 32.7, respectively. No significant differences (P > 0.05) were noted in global health status, physical function, role function, emotional function, cognitive function and social function between BCS and mastectomy. QLQ-BR23 body image, sexual functioning, sexual enjoyment and future perspective also did not differ significantly (p > 0.05) between the two groups.Conclusions Sexual functioning and enjoyment, breast and arm symptoms and hair loss contributed to poor QOL while the impact on global health status including physical, social and emotional functions were minimal. Type of surgery did not appear to be associated with QOL. Future studies with a larger sample sizes will be helpful to further study these factors.
An Investigation of Risk Factors Affecting Short Term Mortality of Patients Referring to the Hospital Emergency Department
Authors: Peyravi Elham , Hamrah Hadid , Masoudi Mohammad Sadegh , Marzaleh Milad Ahmadi , Peyravi Mahmoudreza
Published: November 2020

Background and Objective: One of the causes of short-term mortality in patients is the lower quality of services provided by hospital emergency departments. Given the particular importance of the hospital emergency system and the presence of numerous problems, as well as short term mortality rates in hospitals, this study aimed to investigate the risk factors affecting short term mortality of patients presenting to the Emergency Department at Nemazi Hospital in Shiraz, Fars province in 2019.Methods: This is a retrospective study with a case control-analytical design. The sample size was 768 subjects. In the present study, the emergency department overcrowding was measured by the NEDOCS (National Emergency Department Overcrowding Scale) criterion. The severity of the disease was also evaluated based on the level of the triage of patients through the Emergency Severity Index (ESI) system and vital signs.Results: With each year increase in age, the chance of short-term mortality increases by 0.8%. People with O2 sat% <90% are 7.3 times more likely to experience short term mortality in an emergency department compared to people with O2 sat%> 90%. A significant relationship was noted between short term mortality and SBP (systolic blood pressure) in the hospital's emergency department. It was also found out that as the triage score increases, short term mortality decreases significantly. As hospital stay increases, the chance of the patients' mortality decreases by 0.5%.Conclusion: The percentage of arterial blood oxygen saturation, systolic blood pressure, respiration rate per minute, triage score, the way the patient arrives at the hospital, working shifts, hospitalization duration, age, and comorbidities were regarded as the risk factors for short term mortality. Therefore, promoting professional knowledge and skills of nurses and physicians in the hospitals' emergency department and up-to-dating and reviewing emergency protocols as well as similar research can greatly help reduce short term mortality in the hospital's emergency department.
Multipotent Adult Progenitor Cells induce Regulatory T cells and promote their Suppressive Phenotype via TGFβ and Monocyte-dependent Mechanisms
Authors: Valentin-Torres Alice , Day Cora , Taggart Jennifer M , Williams Nicholas , Stubblefield Samantha R. , Ting Anthony E.
Published: November 2020

Background: Dysregulation of the immune system can initiate chronic inflammatory responses that exacerbate disease pathology. Multipotent adult progenitor cells (MAPC® cells), an adult, adherent bone-marrow derived stromal cell, have been observed to promote the resolution of uncontrolled inflammatory responses in a variety of clinical conditions including: acute ischemic stroke, acute myocardial infarction (AMI), graft vs host disease (GvHD), and acute respiratory distress syndrome (ARDS). One of the proposed mechanisms by which MAPC cells modulate immune responses is via the induction of regulatory T cells (Tregs), however, the mechanism(s) involved remains to be fully elucidated. Methods: To examine MAPC cell mediated Treg induction, peripheral mononuclear cells (PBMCs) were co-cultured with MAPC cells at various PBMC: MAPC cell ratios. Treg frequencies and phenotype was determined by flow cytometry. The mechanisms involved in MAPC cell induction of Tregs were assessed using transforming growth factor β (TGF) and indoleamine 2, 3 dioxygenase (IDO) inhibitors. Monocyte involvement in MAPC cell induction of Tregs was also explored.Results: Herein, we demonstrate that, in an in vitro setting, MAPC cells increase Treg frequencies by promoting Treg proliferation and CD4+ T cell differentiation into Tregs. Moreover, MAPC cell-induced Tregs (miTregs) have a more suppressive phenotype characterized by increased expression of CTLA-4, HLA-DR, and PD-L1 and T cell suppression capacity. MAPC cells also promoted Treg activation by inducing CD45RA+ CD45RO+ transitional Tregs. Additionally, we identify TGFβ as an essential factor for Treg induction secreted by MAPC cells. Furthermore, IDO resulted in decreased Treg induction by MAPC cells demonstrating IDO involvement. Our studies also show that CD14+ monocytes play a critical role in Treg induction by MAPC cells. Conclusions Our study describes MAPC cell dependent Treg phenotypic changes and provides evidence of potential mechanisms by which MAPC cells promote Treg differentiation.
Acquisition of Oral Microbiota is Driven by Environment, Not Host Genetics
Authors: Mukherjee Chiranjit , Moyer Christina O. , Steinkamp Heidi M. , Hashmi Shahr B. , Beall Clifford J. , Guo Xiaohan , Ni Ai , Leys Eugene J. , Griffen Ann L.
Published: November 2020

Background: The oral microbiota is acquired very early, but the factors shaping its acquisition are not well understood. Previous studies comparing monozygotic (MZ) and dizygotic (DZ) twins have suggested that host genetics plays a role. However, all twins share an equal portion of their parent’s genome, so this model is not informative for studying parent-to-child transmission. We used a novel study design that allowed us to directly examine the genetics of transmission by comparing the oral microbiota of biological versus adoptive mother-child dyads. Results: No difference was observed in how closely oral bacterial community profiles matched for adoptive versus biological mother-child pairs, indicating little if any effect of host genetics on the fidelity of transmission. Both adopted and biologic children more closely resembled their own mother as compared to unrelated women, supporting the role of contact and environment. Mother-child strain similarity increased with the age of the child, ruling out early effects of host genetic influence that are lost over time. No effect on the fidelity of mother-child strain sharing from vaginal birth or breast feeding was seen. Analysis of extended families showed that fathers and mothers were equally similar to their children, and that cohabitating couples showed even greater strain similarity than mother-child pairs. These findings support the role of contact and shared environment, and age, but not genetics, as determinants of microbial transmission, and were consistent at both species and strain level resolutions, and across multiple oral habitats. In addition, analysis of individual species all showed similar results. Conclusions: The host is clearly active in shaping the composition of the oral microbiome, since only a few of the many bacterial species in the larger environment are capable of colonizing the human oral cavity. Our findings suggest that these host mechanisms are universally shared among humans, since no effect of genetic relatedness on fidelity of microbial transmission could be detected. Instead our findings point towards contact and shared environment being the driving factors of microbial transmission, with a unique combination of these factors ultimately shaping the highly personalized human oral microbiome.
Reframing the magnetotelluric phase tensor for monitoring applications: improved accuracy and precision in strike determinations
Authors: Bravo-Osuna Ana Gabriela , Gómez-Treviño Enrique , Cortés-Arroyo Olaf Josafat , Delgadillo-Jáuregui Néstor Fernando , Arellano-Castro Rocío Fabiola
Published: November 2020

The magnetotelluric method is increasingly being used to monitor electrical resistivity changes in the subsurface. One of the preferred parameters derived from the surface impedance is the strike direction, which is very sensitive to changes in the direction of the subsurface electrical current flow. The preferred method for estimating the strike changes is that provided by the phase tensor because it is immune to galvanic distortions. However, it is also a fact that the associated analytic formula is unstable for noisy data, something that limits its applicability for monitoring purposes, because in general this involves comparison of two or more very similar data sets. One of the issues is that the noise complicates the distribution of estimates between the four quadrants. This can be handled by sending all values to the same quadrant by adding or subtracting the appropriate amount. This is justified by showing that the analytic formula is also a least squares solution. This is equivalent to define penalty functions for the matrix of eigenvalues and then select the minima numerically. Contrary to the analytic formula this numerical approach can be generalized to compute strikes using windows of any number of periods, thus providing tradeoffs between variance and resolution. The performance of the proposed approach is illustrated by its application to synthetic data and to real data from a monitoring array in the Cerro Prieto geothermal field, México.
Determining sample size for progression criteria for pragmatic pilot RCTs: The Hypothesis test Strikes Back!
Authors: Lewis Martyn , Bromley Kieran , Sutton Christopher J , McCray Gareth , Myers Helen Lucy , Lancaster Gillian A
Published: November 2020

BackgroundThe current CONSORT guidelines for reporting pilot trials do not recommend hypothesis testing of clinical outcomes on the basis that a pilot trial is under-powered to detect such differences and this is the aim of the main trial. It states that primary evaluation should focus on descriptive analysis of feasibility/process outcomes (e.g. recruitment, adherence, treatment fidelity). Whilst the argument for not testing clinical outcomes is justifiable, the same does not necessarily apply to feasibility/process outcomes, where differences may be large and detectable with small samples. Moreover, there remains much ambiguity around sample size for pilot trials. MethodsMany pilot trials adopt a ‘traffic light’ system for evaluating progression to the main trial determined by a set of criteria set up a priori. We construct a hypothesis-testing approach for binary feasibility outcomes focused around this system that tests against being in the RED zone (unacceptable outcome) based on an expectation of being in the GREEN zone (acceptable outcome) and choose the sample size to give high power to reject being in the RED zone if the GREEN zone holds true. Pilot point estimates falling in the RED zone will be statistically non-significant and in the GREEN zone will be significant; the AMBER zone designates potentially acceptable outcome and statistical tests may be significant or non-significant.ResultsFor example, in relation to treatment fidelity, if we assume the upper boundary of the RED zone is 50% and the lower boundary of the GREEN zone is 75% (designating unacceptable and acceptable treatment fidelity, respectively), the sample size required for analysis given 90% power and one-sided 5% alpha would be around n=35 (intervention group alone). Observed treatment fidelity in the range of 0-17 participants (0-50%) will fall into the RED zone and be statistically non-significant; 18-26 (51-74%) fall into AMBER and may or may not be significant; 27-35 (75-100%) fall into GREEN and will be significant indicating acceptable fidelity.DiscussionIn general, several key process outcomes are assessed for progression to a main trial; a composite approach would require appraising the rules of progression across all these outcomes. This methodology provides a formal framework for hypothesis-testing and sample size indication around process outcome evaluation for pilot RCTs.
Non-local means based Rician noise filtering for diffusion tensor and kurtosis imaging in human brain and spinal cord
Authors: Zhang Zhongping , Vernekar Dhanashree , Qian Wenshu , Kim Mina
Published: November 2020

Background: To investigate the effect of using an Rician nonlocal means (NLM) filter on quantification of diffusion tensor (DT)- and diffusion kurtosis (DK)-derived metrics in various anatomical regions of the human brain and the spinal cord, when combined with a constrained linear least squares (CLLS) approach.Methods: Prospective brain data from 9 healthy subjects and retrospective spinal cord data from 5 healthy subjects from a 3T MRI scanner were included in the study. Prior to tensor estimation, registered diffusion weighted images were denoised by an optimized blockwise NLM filter with CLLS. Mean kurtosis (MK), radial kurtosis (RK), axial kurtosis (AK), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD) and fractional anisotropy (FA), were determined in anatomical structures of the brain and the spinal cord. DTI and DKI metrics, signal-to-noise ratio (SNR) and Chi-square values were quantified in distinct anatomical regions for all subjects, with and without Rician denoising. Results: The averaged SNR significantly increased with Rician denoising by a factor of 2 while the averaged Chi-square values significantly decreased up to 61 % in the brain and up to 43% in the spinal cord after Rician NLM filtering. In the brain, the mean MK varied from 0.70 (putamen) to 1.27 (internal capsule) while AK and RK varied from 0.58 (corpus callosum) to 0.92 (cingulum) and from 0.70 (putamen) to 1.98 (corpus callosum), respectively. In the spinal cord, FA varied from 0.78 in lateral column to 0.81 in dorsal column while MD varied from 0.91 × 10−3 mm2/s (lateral) to 0.93 × 10−3 mm2/s (dorsal). RD varied from 0.34 × 10−3 mm2/s (dorsal) to 0.38 × 10−3 mm2/s (lateral) and AD varied from 1.96 × 10−3 mm2/s (lateral) to 2.11 × 10−3 mm2/s (dorsal).Conclusions: Our results show Rician denoising NLM filter incorporated with CLLS significantly increases SNR and reduces estimation errors of DT- and KT-derived metrics, providing the reliable metrics estimation with adequate SNR levels.
Quantitative visualization of photosynthetic pigments in tea leaves based on Raman spectroscopy and calibration model transfer
Authors: Zeng Jianjun , Ping Wen , Sanaeifar Alireza , Xu Xiao , Luo Wei , Sha Junjing , Huang Zhenxiong , Huang Yifeng , Liu Xuemei , Zhan Baishao , Zhang Hailiang , Li Xiaoli
Published: November 2020

Background: Photosynthetic pigments participating in the absorption, transformation and transfer of light energy play a very important role in plant growth. While, the spatial distribution of foliar pigments is an important indicator of environmental stress, such as pests, diseases and heavy metal stress. Results: In this paper, in situ quantitative visualization of chlorophyll and carotenoid was realized by combining the Raman spectroscopy with calibration model transfer, and a laboratory Raman spectral model was successfully extended to a portable field spectral measurement. Firstly, a nondestructive and fast model for determination of chlorophyll and carotenoid in tea leaf was established based on confocal micro-Raman spectrometer in the laboratory. Then the spectral model was extended to a real-time foliar map scanning spectra of a field portable Raman spectrometer through calibration model transfer, and the spectral variation between the confocal micro-Raman spectrometer in the laboratory and the portable Raman spectrometer were effectively corrected by the direct standardization (DS) algorithm. The portable map scanning Raman spectra of the tea leaves after the model transfer were got into the established quantitative determination model to predict the concentration of photosynthetic pigments at each pixel of the tea leaves. The predicted photosynthetic pigments concentration of each pixel was imaged to illustrate the distribution map of foliar pigments. Statistical analysis showed that the predicted pigment contents were highly correlated with the real contents.Conclusions: It can be concluded that the Raman spectroscopy was applicable for in situ, non-destructive and rapid quantitative detecting and imaging of photosynthetic pigment concentration in tea leaves, and the spectral detection model established based on the laboratory Raman spectrometer can be applied to a portable field spectrometer for quantitatively imaging of the foliar pigments.
Relationship between serum triglyceride to high-density lipoprotein cholesterol ratio and sarcopenia occurrence rate in community-dwelling Chinese adults
Authors: Wang Na , Chen Mengjun , Fang Danhong
Published: November 2020

BackgroundA study conducted on elderly Korean men showed that a high serum triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio was associated with a high risk of developing sarcopenia. We aimed to determine such an association in community-dwelling Chinese adults.MethodsFrom May 2016 to August 2017, we conducted a cross-sectional study on Chinese adults at the First Affiliated Hospital of Wenzhou Medical University. Univariate and multivariate logistic regression analyses were applied to evaluate a possible relationship between TG/HDL-C ratio and sarcopenia occurrence.ResultsWe included 2613 adults in this study, with 13.85% presenting with sarcopenia. The odds ratios (ORs) for TG and HDL-C were 0.67 (95% confidence interval [CI]: 0.51-0.87), and 1.97 (95% CI: 1.49-2.61), respectively. Moreover, TG/HDL-C ratio was independently associated with sarcopenia status (OR: 0.63; 95% CI: 0.49-0.81).ConclusionsWe found that TG and HDL-C were, respectively, negatively and positively associated with sarcopenia occurrence rate in community-dwelling Chinese adults. However, a negative association was found between sarcopenia occurrence rate and TG/HDL-C ratio.
A precise navigation device for fixation of patella fractures with modified K-wire tension band: A comparative retrospective study
Authors: Wang Fuming , Xiong Haolan , Long Xiaotao , Li Yang , Chen Xiaohua , Wang Gang
Published: November 2020

Background Traditionally, the technique of modified tension band wires (MTBW) has been the most commonly used surgical procedure. The purpose of this study is to design a precise navigation device that can obtain a standard position of K-wires for (MTBW), and to compare the precise MTBW (P-MTBW) by a navigation device with the conventional MTBW (C-MTBW) by hands in a retrospective study.Methods The device was designed by solidworks2012 software (USA), which could provide a precise guidance for obtaining a parallel K-wires. Besides, it could set the distance between two k-wires and the level of k-wires below patellar anterior surface. From June 2014 to August 2018, a total of 112 patients were employed in this retrospective study. The patients were divided into P-MTBW group and C-MTBW group according to the surgical technique with or without the precise navigation device. We needed to record and analyze the operation time and the number of fluoroscopy, postoperative internal fixation imaging, knee function and complications.Results There were 54 patients in P-MTBW group and 58 patients in C-MTBW group. There were statistically significant differences(P＜0.001) in the operation time between P-MTBW group (39.5±4.7; range, 32–49 minutes) and C-MTBW group (53.7±6.8; range, 42–71 minutes). The number of intraoperative fluoroscopy was significantly less (P＜0.001) in P-MTBW group(4.2±1.4) versus that of C-MTBW group (8.3±2.7). According to Iowa knee score, there was no significant difference (P=0.268 at one year) in function between the two groups. According to our own evaluation criteria for MTBW, anyone in the P-MTBW group was excellent and 26 patients were excellent, 20 patients were good and 2 patients were fair in the C-MTBW group.Conclusion The navigation device can reduce operation time and intraoperative fluoroscopy frequency. P-MTBW fixation is an accurate and effective surgical procedure for patella fractures.
Systematic Review on Wearable Lower-Limb Exoskeletons for Gait Training in Neuromuscular Impairments
Authors: Rodríguez-Fernández Antonio , Lobo-Prat Joan , Font-Llagunes Josep M.
Published: November 2020

Gait disorders can reduce the quality of life for people with neuromuscular impairments. Therefore, walking recovery is one of the main priorities for counteracting sedentary lifestyle, reducing secondary health conditions and restoring legged mobility. At present, wearable powered lower-limb exoskeletons are emerging as a revolutionary technology for robotic gait rehabilitation. This systematic review provides a comprehensive overview on wearable lower-limb exoskeletons for people with neuromuscular impairments, addressing the following three questions: (1) what is the current technological status of wearable lower-limb exoskeletons for gait rehabilitation?, (2) what is the methodology used in the clinical validations of wearable lower-limb exoskeletons?, and (3) what are the benefits and current evidence on clinical efficacy of wearable lower-limb exoskeletons? We analyzed 87 clinical studies focusing on both device technology (e.g., actuators, sensors, structure) and clinical aspects (e.g., training protocol, outcome measures, patient impairments), and make available the database with all the compiled information. The results of the literature survey reveal that wearable exoskeletons have potential for a number of applications including early rehabilitation, promoting physical exercise, and carrying out daily living activities both at home and the community. Likewise, wearable exoskeletons may improve mobility and independence in non-ambulatory people, and may reduce secondary health conditions related to sedentariness, with all the advantages that this entails. However, the use of this technology is still limited by heavy and bulky devices, which require supervision and the use of walking aids. In addition, evidence supporting their benefits is still limited to short-intervention trials with few participants and diversity among their clinical protocols. Wearable lower-limb exoskeletons for gait rehabilitation are still in their early stages of development and randomized control trials are needed to demonstrate their clinical efficacy.