bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatiotemporal regulation of NADP(H) phosphatase Nocturnin and its role in oxidative stress response
Authors: Laothamatas Isara , Gao Peng , Wickramaratne Anushka , Quintanilla Carlo G. , Dino Arianna , Khan Crystal A. , Liou Jen , Green Carla B.
Published: December 2019

An intimate link exists between circadian clocks and metabolism with nearly every metabolic pathway in the mammalian liver under circadian control. Circadian regulation of metabolism is largely driven by rhythmic transcriptional activation of clock-controlled genes. Among these output genes,
Nocturnin
(
Noct
) has one of the highest amplitude rhythms at the mRNA level. The
Noct
gene encodes a protein (NOC) that is highly conserved with the endonuclease/exonuclease/phosphatase (EEP) domain-containing CCR4 family of deadenylases, but highly purified NOC possesses little or no ribonuclease activity. Here, we show that NOC utilizes the dinucleotide NADP(H) as a substrate, removing the 2′ phosphate to generate NAD(H), and is a direct regulator of oxidative stress response through its NADPH 2′ phosphatase activity. Furthermore, we describe two isoforms of NOC in the mouse liver. The cytoplasmic form of NOC is constitutively expressed and associates externally with membranes of other organelles, including the endoplasmic reticulum, via N-terminal glycine myristoylation. In contrast, the mitochondrial form of NOC possesses high-amplitude circadian rhythmicity with peak expression level during the early dark phase. These findings suggest that NOC regulates local intracellular concentrations of NADP(H) in a manner that changes over the course of the day.
The frequency of cortical microstimulation shapes artificial touch
Authors: Callier Thierri , Brantly Nathan W. , Caravelli Attilio , Bensmaia Sliman J.
Published: December 2019

Intracortical microstimulation (ICMS) of the somatosensory cortex evokes vivid tactile sensations and can be used to convey sensory feedback from brain-controlled bionic hands. Changes in ICMS frequency lead to changes in the resulting sensation, but the discriminability of frequency has only been investigated over a narrow range of low frequencies. Furthermore, the sensory correlates of changes in ICMS frequency remain poorly understood. Specifically, it remains to be elucidated whether changes in frequency only modulate sensation magnitude—as do changes in amplitude—or whether they also modulate the quality of the sensation. To fill these gaps, we trained monkeys to discriminate the frequency of ICMS pulse trains over a wide range of frequencies (from 10 to 400 Hz). ICMS amplitude also varied across stimuli to dissociate sensation magnitude from ICMS frequency and ensure that animals could not make frequency judgments based on magnitude. We found that animals could consistently discriminate ICMS frequency up to ∼200 Hz but that the sensory correlates of frequency were highly electrode dependent: On some electrodes, changes in frequency were perceptually distinguishable from changes in amplitude—seemingly giving rise to a change in sensory quality; on others, they were not. We discuss the implications of our findings for neural coding and for brain-controlled bionic hands.
Explaining (non) participation in overseas voting: the case of overseas Filipino voters in Japan in the 2016 elections
Authors: Jaca Georgeline B. , Torneo Ador R.
Published: December 2019

This study explains the low Overseas Voting (OV) participation among Filipino migrants, by examining OV in Japan in the 2016 elections. Feddersen and Sandroni’s ([2006]. “A Theory of Participation in Elections.” American Economic Review 96 (4): 1271– 1282. doi:10.1257/aer.96.4.1271) rational model of electoral participation is adopted to produce evidence-based claims on why OV among Filipino migrants in Japan is low. By examining the perceived benefits, costs, and sense of citizen duty of the overseas Filipinos vis-à-vis their physical absence from their (imagined) homeland, this study shows that voting costs overwhelm the benefits of voting and migrants tend to exercise their citizenship through other means. The low electoral participation of overseas Filipinos is not a manifestation of the loss of allegiance to the homeland nor political disinterest. Rather, voting is not seen as an urgent need nor a responsibility as an overseas national, albeit acknowledged as a civic duty. These have important implications for improving OV participation among Filipinos and other diaspora communities that chronically have low electoral participation.
PI3K activation prevents Aβ42-induced synapse loss and favors insoluble amyloid deposit formation
Authors: Arnés Mercedes , Romero Ninovska , Casas-Tintó Sergio , Acebes Ángel , Ferrús Alberto
Published: December 2019

The toxic effects of human Aβ42 peptide on synapses can be prevented by PI3K activation. This neuroprotection is achieved by increasing the insoluble aggregates of the peptide through the PI3K-triggered phosphorylation of the Ser-26 residue in Aβ42. The Aβ42 toxicity syndrome includes the abrogation of PI3K expression.
Heterophilic cell–cell adhesion of atypical cadherins Fat and Dachsous regulate epithelial cell size dynamics duringDrosophilathorax morphogenesis
Authors: Kumar Amit , Rizvi Mohd Suhail , Athilingam Thamarailingam , Parihar Saurabh Singh , Sinha Pradip
Published: December 2019

Epithelial morphogenesis is marked by dynamic changes in cell sizes until the final adult organ is formed. Using a combination of quantitative, mathematical simulation and genetic techniques, this paper reveals a novel mechanism of epithelial cell size regulation based on heterophilic cell–cell adhesion between two atypical cadherins, Ft and Ds.
Using the BODY-Q to Evaluate Appearance and Quality of Life Following Treatment of Skin Laxity of the Outer Thigh with Microfocused Ultrasound and Calcium Hydroxylapatite
Authors: Smith Jesse R , Sheehan Michael , Casas Laurie A
Published: December 2019

Background

Two procedures that have demonstrated collagen-stimulating properties and improvements in skin laxity in a variety of aesthetic indications are microfocused ultrasound with visualization (MFU-V) and injection with calcium hydroxylapatite (CaHA).

Objectives

By treating skin laxity with a combination of these therapies, it was hypothesized that our patients would experience improved appearance and quality of life as measured by the BODY-Q.

Methods

A total of 60 consecutive female patients aged 30 to 60 years with body mass index less than 28 kg/m2 who expressed interest in treatment for skin laxity affecting the outer thighs completed selected scales (Body Image, Appraisal of Excess Skin, Satisfaction with Hips and Outer Thighs, and Appearance-Related Psychosocial Distress) from the BODY-Q within 1 week of treatment. At the time of treatment, MFU-V was directed to the outer thighs (150 lines at focal depths of 3.0 and 4.5 mm per outer thigh). Immediately following MFU-V, patients received treatment with CaHA injected into the subdermis (1.5 mL diluted 1:1 with 1.5 mL of 2% lidocaine solution per outer thigh). At 90 days posttreatment, these patients repeated the BODY-Q.

Results

At 90 days posttreatment, with 100% follow-up among the 60 consecutive female patients treated, scores from the BODY-Q scales showed statistically significant improvement (P < 0.01).

Conclusions

Following treatment of skin laxity on the outer thighs with a combination of MFU-V and CaHA, our patients reported a statistically significant improvement in appearance and quality of life at 90 days posttreatment. This protocol may be applicable to other areas of the body.

Level of Evidence: 4
Genetic determinants of blood lipids and cerebral small vessel disease: role of high-density lipoprotein cholesterol
Authors: Georgakis Marios K , Malik Rainer , Anderson Christopher D , Parhofer Klaus G , Hopewell Jemma C , Dichgans Martin
Published: December 2019

Blood lipids are causally involved in the pathogenesis of atherosclerosis, but their role in cerebral small vessel disease remains largely elusive. Here, we explored associations of genetic determinants of blood lipid levels, lipoprotein particle components, and targets for lipid-modifying drugs with small vessel disease phenotypes. We selected genetic instruments for blood levels of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides, for cholesterol and triglycerides components of size-defined lipoprotein particles, and for lipid-modifying drug targets based on published genome-wide association studies (up to 617 303 individuals). Applying two-sample Mendelian randomization approaches we investigated associations with ischaemic and haemorrhagic manifestations of small vessel disease [small vessel stroke: 11 710 cases, 287 067 controls; white matter hyperintensities (WMH): 10 597 individuals; intracerebral haemorrhage: 1545 cases, 1481 controls]. We applied the inverse-variance weighted method and multivariable Mendelian randomization as our main analytical approaches. Genetic predisposition to higher HDL-C levels was associated with lower risk of small vessel stroke [odds ratio (OR) per standard deviation = 0.85, 95% confidence interval (CI) = 0.78–0.92] and lower WMH volume (β = –0.07, 95% CI = −0.12 to −0.02), which in multivariable Mendelian randomization remained stable after adjustments for LDL-C and triglycerides. In analyses of lipoprotein particle components by size, we found these effects to be specific for cholesterol concentration in medium-sized high-density lipoprotein, and not large or extra-large high-density lipoprotein particles. Association estimates for intracerebral haemorrhage were negatively correlated with those for small vessel stroke and WMH volume across all lipid traits and lipoprotein particle components. HDL-C raising genetic variants in the gene locus of the target of CETP inhibitors were associated with lower risk of small vessel stroke (OR: 0.82, 95% CI = 0.75–0.89) and lower WMH volume (β = −0.08, 95% CI = −0.13 to −0.02), but a higher risk of intracerebral haemorrhage (OR: 1.64, 95% CI = 1.26–2.13). Genetic predisposition to higher HDL-C, specifically to cholesterol in medium-sized high-density lipoprotein particles, is associated with both a lower risk of small vessel stroke and lower WMH volume. These analyses indicate that HDL-C raising strategies could be considered for the prevention of ischaemic small vessel disease but the net benefit of such an approach would need to be tested in a randomized controlled trial.
Sox11 is an Activity-Regulated Gene with Dentate-Gyrus-Specific Expression Upon General Neural Activation
Authors: von Wittgenstein Julia , Zheng Fang , Wittmann Marie-Theres , Balta Elli-Anna , Ferrazzi Fulvia , Schäffner Iris , Häberle Benjamin M , Valero-Aracama Maria J , Koehl Muriel , Miranda Carlos J , Kaspar Brian K , Ekici Arif B , Reis André , Abrous Djoher Nora , Alzheimer Christian , Lie D Chichung
Published: December 2019

Neuronal activity initiates transcriptional programs that shape long-term changes in plasticity. Although neuron subtypes differ in their plasticity response, most activity-dependent transcription factors (TFs) are broadly expressed across neuron subtypes and brain regions. Thus, how region- and neuronal subtype-specific plasticity are established on the transcriptional level remains poorly understood. We report that in young adult (i.e., 6–8 weeks old) mice, the developmental TF SOX11 is induced in neurons within 6 h either by electroconvulsive stimulation or by exploration of a novel environment. Strikingly, SOX11 induction was restricted to the dentate gyrus (DG) of the hippocampus. In the novel environment paradigm, SOX11 was observed in a subset of c-FOS expressing neurons (ca. 15%); whereas around 75% of SOX11+ DG granule neurons were c-FOS+, indicating that SOX11 was induced in an activity-dependent fashion in a subset of neurons. Environmental enrichment or virus-mediated overexpression of SOX11 enhanced the excitability of DG granule cells and downregulated the expression of different potassium channel subunits, whereas conditional Sox11/4 knock-out mice presented the opposite phenotype. We propose that Sox11 is regulated in an activity-dependent fashion, which is specific to the DG, and speculate that activity-dependent Sox11 expression may participate in the modulation of DG neuron plasticity.
The Predictive Value of Inflammation at Ileocecal Resection Margins for Postoperative Crohn’s Recurrence: A Cohort Study
Authors: Wasmann Karin A T G M , van Amesfoort Jojanneke , van Montfoort Maurits L , Koens Lianne , Bemelman Willem A , Buskens Christianne J
Published: December 2019

Background

Resections for Crohn’s disease should be limited and only resect macroscopically affected bowel. However, recent studies suggest microscopic inflammation at resection margins as a predictor for postoperative recurrence. The clinical impact remains unclear, as non-uniform pathological criteria have been used. The aim of this study was to assess the predictive value of pathological characteristics at ileocecal resection margins for recurrence.

Methods

Both resection margins of 106 consecutive patients undergoing ileocecal resection for Crohn’s disease between 2002 and 2009 were revised and scored for active inflammation, myenteric plexitis, and granulomas. Pathological findings were correlated to recurrence, defined as recurrent disease activity demonstrated by endoscopy (modified Rutgeerts score ≥i2) requiring upscaling medical treatment, using multivariate analysis.

Results

Active inflammation was found at the proximal and distal resection margin in 27% and 15% of patients, respectively, myenteric plexitis in 37% and 32%, respectively, and granulomas in 4% and 6%, respectively. In total, 47 out of 106 patients developed recurrence. Only active inflammation at the distal colonic resection margin was an independent significant predictor for recurrence (88% vs 43% vs 51% for distal, proximal, and no involved margins, respectively; P < 0.01).

Conclusion

Active inflammation at the distal colonic resection margin after ileocecal resection identifies a patient group at high risk for postoperative recurrence both at the anastomotic site and the colon because it identifies undiagnosed L3 disease. These patients have a different and more aggressive natural history and require more intense medical treatment. Therefore, pathological evaluation of the distal resection margin should be implemented in daily practice.
Development of prime–boost-type next-generation mucosal vaccines
Authors: Fujimoto Kosuke , Uematsu Satoshi
Published: December 2019

Our bodies are constantly exposed to a wide variety of pathogenic micro-organisms through mucosal sites. Therefore, effective vaccines that can protect at the mucosa are vital; however, only a few clinically established mucosal vaccines are available. Although conventional injectable vaccines can induce antigen-specific serum immunoglobulin G (IgG) and prevent severe infection, it is difficult to efficiently inhibit the invasion of pathogens at mucosal surfaces because of the inadequate ability to induce antigen-specific IgA. Recently, we have developed a parenteral vaccine with emulsified curdlan and CpG oligodeoxynucleotides and reported its application. Unlike other conventional injectable vaccines, this immunization contributes to the induction of antigen-specific mucosal and systemic immune responses. Even if antigen-specific IgA at the mucosa disappears, this immunization can induce high-titer IgA after boosting with a small amount of antigen on the target mucosal surface. Indeed, vaccination with Streptococcus pneumoniae antigen effectively prevented lung infection induced by this bacterium. In addition, vaccination with Clostridium ramosum, which is a representative pathobiont associated with obesity and diabetes in humans, reduced obesity in mice colonized with this microorganism. This immunization approach might be an effective treatment for intestinal bacteria-mediated diseases that have been difficult to regulate so far, as well as common infectious diseases.
Individual training for farmers based on results from protein and ATP rapid tests and microbiological conventional cultural methods improves hygiene in pig fattening pens
Authors: Heinemann Céline , Meyer Isabell , Bögel Franziska T , Schmid Simone M , Hayer Jason J , Steinhoff-Wagner Julia
Published: December 2019

Optimal hygiene management is an essential part of maintaining a high standard of health in conventional pig production systems and for the successful interruption of infection chains. Currently, efficiency assessments on cleaning and disinfection are only performed by visual inspection or are neglected completely. The aim of this study was to evaluate the available methods for on farm monitoring of hygiene, identify critical points in pig pens and use the data obtained for training purposes. In addition to visual inspection by assessing the cleanliness, microbiological swab samples, i.e., aerobic total viable count (TVC), total coliform count, methicillin-resistant Staphylococcus aureus (MRSA), and extended-spectrum β-lactamases-producing bacteria (ESBL), swab samples for ATP as well as protein residues and agar contact plates combined with 3 different culture media, were applied and ranked according to their suitability for livestock farming. Samples were collected on at least 15 critical points from one representative pen on 6 pig fattening farms with various hygiene management practices after cleaning and disinfection. After the first sampling, farmers were trained with their individual results, and sampling was repeated 6 mo after training. Nipple drinkers, feeding tubes (external and inner surface), and troughs (external and inner surface) showed the greatest bacterial loads (TVC: 4.5–6.7 log10 cfu cm-2) and values for ATP and protein residues; therefore, these surfaces could be identified as the most important critical points. Spearman rank correlations (P < 0.01) were found between the different assessment methods, especially for the TVC and ATP (r = 0.82, P < 0.001). For rapid assessment on farms, ATP tests represented an accurate and cost-efficient alternative to microbiological techniques. Training improved cleaning performance as indicated by a lower rating for visual inspection, TVC, ATP, MRSA, and ESBL in the second assessment. The monitoring of cleaning efficiency in pig pens followed by training of the staff constitutes a valuable strategy to limit the spread of infectious diseases and antibiotic-resistant bacteria. Special attention should be paid to the sufficient hygiene of drinkers and feeders.
Introduction: Gender and Disability in the Two World Wars
Authors: Salvante Martina
Published: December 2019

This introduction explains the reasons behind this special issue, which is devoted to analyzing historically gendered experiences of war-related disability in post-conflict societies. It refers to a variety of multidisciplinary works on disability, gender, conflict, and transition theory to posit the special issue at the intersection of disability, gender, and war studies. It briefly describes the five articles composing the issue, while emphasizing their contribution to understanding the impact of the two world wars on the lives of men and women and on cultural ideas of masculinity and femininity in a variety of national and colonial contexts.
Primary Blast Lung Injury: The UK Military Experience
Authors: Scott Timothy E , Johnston Andrew M , Keene Damian D , Rana Meenal , Mahoney Peter F
Published: December 2019

Introduction

Primary blast lung injury occurs when an explosive shock wave passes through the thorax and transits through tissues of varying densities. It requires close proximity to an explosion and presents quick with respiratory distress in survivors.

Materials and Methods

The Joint Theatre Trauma Registry and the Defence Statistics (Health) Database were interrogated for casualties injured as a result of an explosion during the conflict in Afghanistan. The case notes and imaging of casualties meeting the criteria for diagnosis were reviewed. Demographic and clinical data on casualties with primary blast lung injury were analyzed.

Results

848 blast-exposed casualties survived to discharge from intensive care, and 238 blast-exposed casualties were killed in action. Following exclusions, 111 case notes and all postmortem reports were reviewed in detail. About, 25 casualties had isolated primary blast lung injury (2.9% of casualties surviving to discharge from intensive care) and 31 nonsurvivors (13% of nonsurvivors) had the disease documented at postmortem. Severe cases of primary blast lung injury required an estimated average of 4.5 days of conventional mechanical ventilation.

Conclusions

8.1% of blast exposed casualties suffered primary blast lung injury. It was a less severe disease than other nontraumatic forms of acute lung injury and did not cause deaths once a casualty had reached a combat support hospital. It was well managed with a relatively brief period of conventional mechanical ventilation.
LncRNA39026 Enhances Tomato Resistance to Phytophthora infestans by Decoying miR168a and Inducing PR Gene Expression
Authors: Hou Xinxin , Cui Jun , Liu Weiwei , Jiang Ning , Zhou Xiaoxu , Qi Hongyan , Meng Jun , Luan Yushi
Published: December 2019

Our previous study has indicated that a long noncoding RNA (lncRNA), lncRNA39026, can be responsive to Phytophthora infestans infection. However, the function and regulation mechanism of lncRNA39026 during tomato resistance to P. infestans are unknown. In this study, an lncRNA39026 sequence was cloned from tomato Zaofen No. 2, and this sequence contained an endogenous target mimicry for miR168a, which might suppress the expression of miR168a. LncRNA39026 was strongly downregulated at 3 h in the tomato plants infected with P. infestans, and its expression level displayed a negative correlation with the expression level of miR168a and a positive correlation with the expression levels of SlAGO1 genes (target gene of miR168a) upon P. infestans infection. Tomato plants in which lncRNA39026 was overexpressed displayed enhanced resistance to P. infestans, decreased level of miR168a, and increased level of SlAGO1, whereas the resistance was impaired, level of miR168a was increased, and level of SlAGO1 was decreased after lncRNA39026 silencing. In addition, lncRNA39026 could also induce the expression of pathogenesis-related (PR) genes, as shown by increased and decreased expression levels of PR genes in tomato plants with overexpressed and silenced lncRNA39026, respectively. The result demonstrated that lncRNA39026 might function to decoy miR168a and affect the expression of PR genes in tomato plants, increasing resistance to disease.
Traumatic Stress Among Children After Surgical Intervention for Congenital Melanocytic Nevi: A Pilot Study
Authors: Ben-Ari Amichai , Margalit Daniella , Nachshoni Liat , Benarroch Fortu
Published: December 2019

BACKGROUND

Hospitalization and surgery are traumatic experiences that can result after traumatic stress symptoms (PTSS). Surgical interventions for congenital melanocytic nevus (CMN) can be very stressful, but their potential for causing PTSS has not been studied. We aim to determine prospectively whether children undergoing surgery for CMN develop PTSS and what are the specific risk factors for such an event.

OBJECTIVE

The authors aim to determine prospectively whether children undergoing surgery for CMN develop PTSS and what the specific risk factors for such an event are.

METHODS

Thirty children who were consecutively hospitalized in a pediatric surgery ward for CMN removal during the study period were recruited voluntarily. About 4 months after discharge from the hospital, the children and their parents were assessed for psychological distress.

RESULTS

At the assessment 4 months after hospitalization, the children displayed a significant increase in symptoms of distress in comparison with baseline levels. Moreover, 33.3% met full post-traumatic stress disorder (PTSD) diagnostic criteria. The number of invasive procedures, family resources, and parental distress predicted 40% of the variance in PTSS, with parental distress predicting it most significantly.

CONCLUSION

The high prevalence of PTSS among children undergoing CMN removal and among their parents emphasizes the importance of actions for prevention and early treatment of psychological distress.
Dexmedetomidine versus propofol sedation in reducing delirium among older adults in the ICU
Authors: Pereira Jarett V. , Sanjanwala Rohan M. , Mohammed Mohammed K. , Le Me-Linh , Arora Rakesh C.
Published: December 2019

BACKGROUND

Delirium is common in the ICU, with incidence rates reported to be upwards of 70%. Due to the significant morbidity and mortality associated with delirium, it is hypothesised that a delirium-free sedative agent will improve outcomes in older adults admitted to the ICU.

OBJECTIVES

To assess if dexmedetomidine sedation is associated with a reduction in ICU delirium among older adults, and to evaluate its risks and benefits compared with propofol sedation.

DESIGN

Systematic review of randomised controlled trials and cohort studies with meta-analyses.

DATA SOURCES

Articles published from database inception to 8 April 2019 were retrieved from Medline, EMBASE, Evidence-based Medicine Reviews, International Pharmaceutical Abstracts, Scopus, ClinicalTrials.gov and WHO Trials.

ELIGIBILITY

Studies were included if they compared dexmedetomidine sedation with propofol in the ICU, reported the incidence of delirium as an outcome and had a mean/median sample age of at least 60. Studies that examined dexmedetomidine and propofol use intra-operatively or as part of general anaesthesia were excluded.

RESULTS

Dexmedetomidine sedation was associated with a lower incidence of delirium when compared with propofol: seven studies, n=1249; risk ratio 0.70; 95% confidence interval (CI) 0.52 to 0.95; P = 0.02. There was no statistically significant difference in the incidence of bradycardia: three studies, n=278; risk ratio 1.52; 95% CI 0.85 to 2.72; P = 0.16, and hypotension: six studies, n=867 patients; risk ratio 1.12; 95% CI 0.86 to 1.45; P = 0.42. Dexmedetomidine sedation did not reduce hospital length of stay, ICU length of stay or duration of mechanical ventilation compared with propofol.

CONCLUSION

Compared with propofol, dexmedetomidine sedation in the ICU is associated with lower delirium incidence among older adults with no significant increase in adverse events. In older adult ICU patients at risk of developing delirium, sedation with dexmedetomidine should be considered. Further research is warranted to elucidate and explain the mechanisms underlying this process, and to confirm our findings with large, multicentre trials.

TRIAL REGISTRATION

The study protocol has been registered in PROSPERO (CRD42018099339).
Pre-induction checklists and discomfort in patients. An observational study
Authors: Nabecker Sabine , Schwendimann Désirée , Theiler Lorenz , Pedersen Tina , Greif Robert
Published: December 2019

BACKGROUND

Since the WHO release of the Safe Surgery Saves Lives Program in 2008, peri-operative checklists minimise errors and improve patient safety worldwide. Anaesthesia professionals are often reluctant to use these checklists in front of patients because they fear causing patients’ discomfort before anaesthesia and surgery.

OBJECTIVE

To assess and compare the subjective level of patient discomfort caused by the use of pre-induction checklists with the patient discomfort estimated by anaesthesia providers.

DESIGN

Prospective observational study.

SETTING

The current single-centre trial included 110 anaesthesia providers and 125 nonpremedicated ear, nose and throat or maxillofacial surgery patients in Switzerland from June to August 2016. Inclusion criterion: signed general research consent. Exclusion criteria: received premedication, less than 18 years old, day-care patients, dementia or other mental illnesses.

INTERVENTIONS

Anaesthesia healthcare providers and patients before surgery and on the first postoperative day were asked to rate three statements:

MAIN OUTCOME MEASURES

All statements were rated on a 100-mm visual analogue scale, where 0 meant no agreement and 100 meant total agreement.

RESULTS

Patients overwhelmingly agreed that anaesthesia providers should use checklists in front of them. Anaesthesia providers rated the patient discomfort much higher than actually perceived by patients. Both, patients and anaesthesia providers rated the possibility of reducing the risk of errors high.

CONCLUSION

Patients experience far less discomfort observing the use of pre-induction checklists than anaesthesia providers expect. Patients value the potential safety benefit significantly higher than anaesthesia providers. These results further support the implementation of peri-operative checklists in the operating room environment.

TRIAL REGISTRATION

The current observational study had no intervention, therefore, was not registered.
COMPARING INTRAVITREAL AIR AND GAS FOR THE TREATMENT OF VITREOMACULAR TRACTION
Authors: Gruchociak Sophie , Djerada Zoubir , Afriat Mickael , Chia Valen , Santorini Melissa , Denoyer Alexandre , Arndt Carl
Published: December 2019

Purpose:

To compare the effect of intravitreal injections of air with gas on vitreomacular traction (VMT) release and attempt to analyze predictive factors for success.

Methods:

The medical records of patients with symptomatic VMT undergoing intravitreal injections (0.3 mL) of either octafluoropropane (C3F8) or air were retrospectively reviewed. The VMT release (primary end point) and the best-corrected visual acuity (secondary end point) were noted 1 month after injection. At baseline and 1 month after the injection, a macular optical coherence tomography was performed.

Results:

Twenty-four eyes of 22 patients were included. Vitreomacular traction was released in 10 cases, 7 among 11 C3F8-injected eyes (63%) and 3 among 13 air-injected eyes (23%) (P = 0.045). In eyes with released VMT, ETDRS improved from 61 ± 35 (0–100) to 65 ± 37 (0–100) 1 month after the injection (P = 0.03). All patients with VMT release had a horizontal vitreomacular adhesion of less than 600 µm. Five eyes (23%) underwent vitrectomy after the injection of gas or air.

Conclusion:

Posterior vitreous detachment in VMT can be observed with both air and gas injection with a low complication rate. The occurrence of VMT release observed with air seemed to be less frequent than that observed with gas.
Combinatorial cell surface display system in
Escherichia coli
for noninvasive colorectal cancer detection
Authors: Hsiao Chiayi , Fang Qingwei , Zheng Shuyu , He Peixiang , Zhang Kairan , Hong Yirui , Ran Yuncong , Sun Shiyu , Liu Zhixiang , Liang Zhihan , Zhong Bozitao , Wu Weiwen , Xia Ruoyu , Bai Shihao , Yao Kuan , Wang Yushu , He Lin , Ma Gang
Published: December 2019

Navigation and recognition of disease lesions remain challenging during colorectal cancer diagnosis and treatment, given that the precision and capacity of using specific surface antigens as recognition sites are relatively lacking. Moreover, the low penetration rate of noninvasive detection methods has delayed disease diagnosis in developing countries. We developed a bacterial device targeting the Thomsen–Friedenreich antigen, which is abundant on lesion tissue, and produced vesicles that serve as markers for ultrasonic detection. The device uses a bacterial cell surface display system and acoustic reporter gene to function as a screening device for colorectal cancer detection. The diagnostic efficiency of this device was determined by flow cytometry, immunohistochemistry, microfluidic chip-based assay, and ultrasonic examinations on both cellular and tissue scales. In all scales and experiments, our device showed great feasibility upon differentiating disease lesion and normal tissue, while foundation of the usage of vesicle reporter system as noninvasive method has also been laid. The application of this device provides insight into the practicability and prospect of bacterial detecting agents in the field of diagnostics. All animal studies were approved by the Institutional Animal Care and Use Committee of Shanghai Jiao Tong University, China (approval No. 201801015) on February 23, 2018.
Dropout imputation and batch effect correction for single-cell RNA sequencing data
Authors: Li Gang , Yang Yuchen , Van Buren Eric , Li Yun
Published: December 2019

Single-cell RNA sequencing (scRNA-seq) allows researchers to examine the transcriptome at the single-cell level and has been increasingly employed as technologies continue to advance. Due to technical and biological reasons unique to scRNA-seq data, denoising and batch effect correction are almost indispensable to ensure valid and powerful data analysis. However, various aspects of scRNA-seq data pose grand challenges for such essential tasks pertaining to data pre-processing, normalization or harmonization. In this review, we first discuss properties of scRNA-seq data that contribute to the challenges for denoising and batch effect correction from a computational perspective. We then focus on reviewing several state-of-the-art methods for dropout imputation and batch effect correction, comparing their strengths and weaknesses. Finally, we benchmarked three widely used correction tools using two hematopoietic scRNA-seq datasets to show their performance in a real data application.
Timeliness of Nursing Care Delivered by Stroke Certified Registered Nurses as Compared to Non–Stroke Certified Registered Nurses to Hyperacute Stroke Patients
Authors: Fant Grace N. , Lakomy Janet M.
Published: December 2019

In this retrospective, nonexperimental, comparative descriptive design using convenience sampling, the timeliness of care delivered by 11 Stroke Certified Registered Nurses (SCRNs) to 95 hyperacute stroke patients (last known well of 4.5 hours or less) on the acute stroke protocol set by Target: Stroke Phase II Campaign Manual was compared with that of 13 non-SCRNs in a small, rural, level III stroke facility in the southwestern region of the United States. There was statistical significance in the total timeliness of care delivered by SCRNs to hyperacute stroke patients as compared with the non-SCRNs (t = −4.109, P = .001) and acute stroke protocol goal times for door to stroke team activation (t = −3.291, P = .001), door to computed tomography (t = −4.020, P < .001), door to teleneurology initiation (t = −4.020, P < .001), and door to alteplase administration (t = −3.367, P = .004). Limitations included sample size, nursing documentation, and nurses studying for the SCRN examination. It was concluded that, at this facility, SCRNs had a statistically significant difference in the timeliness of care delivered to hyperacute stroke patients on meeting protocol time goals. The SCRNs also met all protocol goals, and the non-SCRNs did not meet the door-to-teleneurology initiation and door-to-alteplase administration goals. Future studies should include a larger sample size and stroke patient outcomes.
Discrepancy Among Self-Reported Adherence, Prescription Refills, and Actual Anticoagulant Control
Authors: CHIU Pai-En , TSAO Hsuan-Ming , TSAI Chuan-Hsiu
Published: December 2019

Background

Patients must adhere to their prescribed warfarin regimens and regularly monitor the anticoagulation effect to maintain therapeutic levels. The ability to evaluate regimen adherence accurately is crucial to the success of patient coaching. However, prevention of thromboembolic events is challenging when the association between medication adherence and the actual amount of anticoagulant agent taken cannot be determined.

Purpose

This study used self-reported medication taken and prescription refills to (a) verify warfarin medication adherence and (b) assist clinicians to determine the discrepancy between medication adherence and anticoagulant control efficacy.

Methods

This study was conducted at a national-university-affiliated hospital in Yilan County, Taiwan. Structured questionnaires and medical record reviews were adopted. A 100-point visual analog scale was used to measure the reported adherence of participants, whereas medication refill adherence was compared against self-reported adherence. Finally, degree of adherence was evaluated based on time in therapeutic range.

Results

This study included 192 participants. Half (n = 94, 49%) were women, and the mean age was 69.6 years. Mean scores were 92.2% for the visual analog scale and 87.3% for medication refill adherence. Medication adherence correlated significantly with age, as reflected in the visual analog scale scores (p < .05). The participants who were receiving polypharmacy with five types of medicines or less attained higher visual analog scale scores, whereas participants who were on warfarin for 2–12 months exhibited higher medication refill adherence. Time in therapeutic range correlated negatively with age, although stability improved with therapy duration.

Conclusions/Implications for Practice

Despite their high self-reported adherence levels, patients of advanced age require careful monitoring of their time in therapeutic range. The participants in this study who were on warfarin for a relatively longer time exhibited higher stability in the therapeutic range, despite their low medication refill adherence. The results of this study suggest that patient age, duration of warfarin therapy, and polypharmacy are factors associated with medication adherence. The findings may facilitate future assessments of warfarin adherence in patients as well as the implementation of more effective clinical nursing procedures and management practices.
Retrospective Examination of Class Attendance on Corporately Sponsored Weight Loss Programming
Authors: Earnest Conrad P. , Church Timothy S.
Published: December 2019

Objective:

To examine the effect of class participation in participants enrolled in a corporate sponsored commercial weight loss program.

Methods:

We examined 111,262 participants for percent weight loss (primary outcome) using general linear models and weight loss relative to class participation (secondary outcome).

Results:

We observed a significant trend (P < 0.001) for achieving significant weight loss for the entire cohort who lost 3.65% (99% CI, 3.62, 3.69) body weight. Individuals taking ≥4 classes (n = 87,346) lost 4.97% (99% CI, 4.53, 4.61). Those taking ≥9 classes (n = 74,525) achieved 4.95% (99% CI, 4.93, 5.01) weight loss. Similar patterns for men and women were observed within each analysis.

Conclusion:

Overall, participants lost a clinically beneficial (≥3%) amount of weight following class participation and greater class attendance produced a greater weight loss percentage approaching clinical significance (≥5%).
Comparison of the selected parameters of the anterior segment of the eye between femtosecond laser-assisted cataract surgery, microincision cataract surgery, and conventional phacoemulsification
Authors: Chlasta-Twardzik Edyta , Nowińska Anna , Wylęgała Edward
Published: December 2019

The purpose of our study was to compare the selected parameters of the anterior segment of the eye in patients after femtosecond laser-assisted cataract surgery (FLACS) with the results of microincision cataract surgery (MICS) and conventional phacoemulsification surgery (CPS). This single-center prospective randomized comparative observational study included 87 patients. Patients were randomly selected into group A (FLACS), group B (MICS) and group C (control group). All the surgeries were performed by the same experienced surgeon. Preoperative and postoperative parameters were evaluated: best-corrected visual acuity (BCVA), endothelial cell density (ECD), endothelial cell loss percentage (ECL%), central corneal thickness (CCT), central anterior and posterior corneal astigmatism induction, posterior corneal elevation map were measured. Intraoperative parameters: effective phacoemulsification time (EPT), balanced salt solution use (BSS use), total surgical time and suction time were analyzed. Examination was performed preoperatively and on the first, seventh day, one and six months postoperatively. The follow up period was 6 months. There was no statistically significant difference in BCVA, central anterior and posterior astigmatism induction between studied groups. The ECL% was statistically significant lower in the group A on the 7th day, 1 month and 6-months postoperatively (P < .05). The CCT was statistically significant lower in the group A and in the group B than in the group C on the 7th postoperative day (P = .002). However, in the 6 months follow-up there was no statistically significant difference in the CCT between studied groups (P = .133). We observed statistically significant difference in change of the posterior corneal elevation map at the periphery assessed within the 90° to 120°meridian range between group A, group B and group C at every timepoint postoperatively (P < .05). The EPT and BSS use were statistically significant lower whilst total surgery time was statistically significant higher in the FLACS group (P < .05). To conclude in the 6 months follow-up there was statistically significant difference found between eyes undergoing FLACS, MICS and CPS with respect to the posterior corneal elevation map assessed within the studied range, ECL%, EPT, BSS use and total surgery time. Postoperative BCVA, central anterior and posterior astigmatism induction, CCT were comparable between studied groups.
Demographic and clinical profiles of admitted psychiatric patients of the East London Mental Health Unit in the Eastern Cape, South Africa
Authors: Madala-Witbooi Nombulelo J , Adeniyi Oladele Vincent
Published: December 2019

Integration of psychiatric care at the Primary Health Care (PHC) could be an important strategy towards addressing the shortages of in-patient mental health care services in South Africa. This study describes the profiles of admitted psychiatric patients at the East London Mental Health Unit (ELMHU) of the Eastern Cape from January 2016 to December 2016.

In this retrospective cross-sectional study, an audit of medical records of all psychiatric in-patients managed at the ELMHU during the study period was undertaken. Simple descriptive and inferential statistics were used to describe the profiles and examine the associations with the common psychiatric conditions.

Of the participants with complete data (n = 186), the majority were males (n = 108); single (72.6%) and had secondary education (45.7%). The majority of in-patients were psychotic (38%), violent (31%), manic (16%) or suicidal (9.2%) at the time of admission. Patients who were 35 years and above, resided in urban areas, and presented with suicidal and depressive symptoms were more likely to be admitted voluntarily. Schizophrenia (31.6%), cannabis-related psychiatric disorders (31.6%), bipolar Type-1 disorder (21.9%) and alcohol related disorders (15.5%) were the main reasons for admission. There was a significant association between demographic characteristics and the common psychiatric disorders of the patients.

Schizophrenia, bipolar 1 disorder, cannabis-related disorders and alcohol-related disorders are the predominant disorders leading to in- patient mental health care services being utilized in the study setting. Findings might inform training of health care workers at the PHCs with a view to integrating mental health care services in the Eastern Cape.
The expressions and prognostic implications of Twist and E-cadherin in adenocarcinomas of the gastroesophageal junction and proximal gastric carcinoma
Authors: Sun Shengbo , Gong Qing
Published: December 2019

Twist and E-cadherin are crucial for the development of different types of cancer; however, their clinical significance in adenocarcinoma of the gastroesophageal junction (AGE) remains unknown. Here, we investigated the correlation between the expression of Twist and E-cadherin and their impact on the clinical outcomes and prognosis of patients with AGE and proximal gastric carcinoma (PGC).

Using immunohistochemistry, we determined the expression of Twist and E-cadherin in the tissue samples of patients with AGE and PGC. The correlation of the expression of Twist and E-cadherin with the clinicopathological factors was assessed by using the chi-square test, Fisher exact test, and non-parametric Mann–Whitney U test. The Kaplan–Meier method along with the log-rank test and Cox proportional-hazards model were used to evaluate the correlation of Twist and E-cadherin expression with the overall survival (OS) of patients.

Overall, 94 patients with AGE (n = 45, 47.87%) or PGC (n = 49, 52.13%) who underwent primary tumor resection were included in this study. The median follow-up period was 40.5 months. We observed a significant difference in the smoking status (P < .001) and differentiation grade (P = .004) between patients with AGE and PGC. There was a significant association of a high Twist expression with T stage (only in PGC, P = .008), lymph node metastasis (AGE, P = .075; PGC, P = .051), and advanced pathological stages (AGE, P = .019; PGC, P = .006). A low E-cadherin expression showed similar results; however, it was not significantly associated with the advanced pathological stages of AGE (P = .372). A low E-cadherin expression was significantly associated with a low differentiation grade of AGE (P = .002). In addition, a significant inverse relationship was observed between Twist and E-cadherin expression. The Kaplan–Meier survival analysis and Cox regression analysis revealed that a high Twist expression and low E-cadherin expression were independent prognostic factors for short OS of patients with AGE or PGC.

A high Twist expression or low E-cadherin expression was associated with unfavorable clinicopathological factors and independently predicted short OS of patients with AGE or PGC.
A nomogram for preoperative prediction of lymphatic infiltration in colorectal cancer
Authors: Wu Guo , Liu Jun-Gang , Huang Xiao-Liang , Wei Chun-Yin , Jeen PC Franco , Xie Wei-Shun , Chen Shao-Mei , Zhang Chu-Qiao , Tang Wei-Zhong
Published: December 2019

Lymphatic infiltration (LI) is a key factor affecting the treatment of patients with colorectal cancer (CRC). Thus, the aim of this study was to develop and validate a nomogram for individual preoperative prediction of LI in patients with CRC.

We conducted a retrospective analysis of 664 patients who received their initial diagnosis of CRC at our center. Those patients were allocated to a training dataset (n = 468) and a validation dataset (n = 196). The least absolute shrinkage and selection operator regression model was used for data dimension reduction and feature selection. The nomogram was constructed from the training dataset and internally verified using the concordance index (C-index), calibration, area under the receiver operating characteristic curve and decision curve analysis (DCA).

The enhancement computed tomography reported N1/N2 classification, preoperative tumor differentiation, elevated carcinoembryonic antigen, and carbohydrate antigen19-9 level were selected as variables for the prediction nomogram. Encouragingly, the nomogram showed favorable calibration with C-index 0.757 in the training cohort and 0.725 in validation cohort. The DCA signified that the nomogram was clinically useful. The Kaplan–Meier survival curve showed that patients with LI had a worse prognosis and could benefit from postoperative adjuvant chemotherapy.

Use common clinicopathologic factors, a non-invasive scale for individualized preoperative forecasting of LI was established conveniently. LI prediction has great significance for risk stratification of prognosis and treatment of resectable CRC.