bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological Well-Being Among Informal Caregivers in the Canadian Longitudinal Study on Aging: Why the Location of Care Matters
Authors: Lee Yeonjung , Bierman Alex , Penning Margaret
Published: September 2020

Objectives

A caregiving stress perspective suggests that caregiving harms psychological well-being in informal caregivers, whereas a caregiving rewards perspective suggests that provision of care benefits psychological well-being. This research examines whether both perspectives apply to caregiving experiences, but differently by the primary location of caregiving (i.e., in-home, other residence, and institution), as well as by gender.

Methods

We analyzed depression and life satisfaction in the nationally representative Canadian Longitudinal Study on Aging (N = 48,648), first comparing noncaregivers (N = 27,699) to a combined caregiver group (N = 20,949) and then stratifying caregivers by the primary location of care.

Results

When considered as a single group, caregivers suffered relative to noncaregivers in terms of life satisfaction and depression. When stratified by the location of care, only in-home caregivers reported both greater depression and lower life satisfaction. Nonresidential caregivers did not differ significantly in levels of depression from noncaregivers and reported higher life satisfaction. Institutional caregivers reported greater depression than noncaregivers, but did not differ significantly in life satisfaction. These patterns were stronger among women than men.

Discussion

Both the caregiving stress and caregiving rewards perspectives are applicable to the caregiving experience, with the stress perspective more applicable to in-home caregivers and the rewards perspective more relevant to nonresidential caregivers. Recommendations include targeted practice focused on the location of care as well as the gender of the caregiver. Given that nonresidential caregivers actually benefit from providing care, interventions need to focus on identifying and bolstering positive aspects of the caregiving experience.
A positive deviance-based qualitative study of stress, coping, and feeding practices among low-income, Hispanic mothers whose children do versus do not meet guidelines for fruit and vegetable intake
Authors: Shonkoff Eleanor , Folta Sara C , Fitopoulos Theodore , Ramirez Cynthia N , Bluthenthal Ricky , Pentz Mary Ann , Chou Chih-Ping , Dunton Genevieve F
Published: September 2020

Less than 1% of children in the United States concurrently meet guidelines for fruit/vegetable intake, physical activity, screen time, and sugar-sweetened beverages. Prior evidence suggests that parents of this 1% potentially cope with stress differently. This qualitative study used a positive deviance-based approach to locate mothers whose children avoided negative feeding outcomes despite being ‘high-risk’ for obesity. Semi-structured interviews were conducted in Spanish for two groups: low-income, Hispanic mothers whose children were normal weight and met recommendations for fruits/vegetables and physical activity (n = 5); and a comparison group whose children had obesity and did not meet guidelines (n = 8). Topics included weight-related parenting practices, attitudes toward health, and stress management. Interviews were transcribed, translated, and coded using NVivo for theoretically driven thematic analysis. Results suggested that mothers viewed stress differently. Mothers of healthy weight children believed stress could be prevented, such as by paying children more attention or directing one’s attention away from stressors; comparison group mothers tended to report stress about managing their child’s eating and about financial worries. Future research is needed to understand the underlying sources of these differences (e.g. personality traits, coping practices) and test whether stress prevention interventions can promote healthy parental feeding practices.
Software Application Profile: Bayesian estimation of inverse variance weighted and MR-Egger models for two-sample Mendelian randomization studies—mrbayes
Authors: Uche-Ikonne Okezie , Dondelinger Frank , Palmer Tom
Published: September 2020

Motivation

We present our package, mrbayes, for the open source software environment R. The package implements Bayesian estimation for inverse variance weighted (IVW) and MR-Egger models, including the radial MR-Egger model, for summary-level data in Mendelian randomization (MR) analyses.

Implementation

We have implemented a choice of prior distributions for the model parameters, namely; weakly informative, non-informative, a joint prior for the MR-Egger model slope and intercept, and an informative prior (pseudo-horseshoe prior), or the user can specify their own prior distribution.

General features

Users have the option of fitting the models using either JAGS or Stan software packages with similar prior distributions; the option for the user-defined prior distribution is only in our JAGS functions. We show how to use the package through an applied example investigating the causal effect of body mass index (BMI) on acute ischaemic stroke.

Availability

The package is freely available, under the GNU General Public License v3.0, on GitHub [https://github.com/okezie94/mrbayes] or CRAN [https://CRAN.R-project.org/package=mrbayes].
Review of Methods to Monitor House Fly (Musca domestica) Abundance and Activity
Authors: Gerry Alec C
Published: September 2020

The house fly is a ubiquitous pest commonly associated with animal facilities and urban waste. When present in large numbers, house flies can negatively impact humans and animals through nuisance and the transmission of pathogens. Since the development of fly traps and sticky papers to capture flies in the late 1800s, these and other methods have been used as a means to monitor change in house fly density or fly activity over time. Methods include substrate sampling to record density of immature flies, visual observations of adult fly activity, instantaneous counts of landing or resting flies, accumulation of adult flies on/in traps, or accumulation of fly fecal and regurgitation spots deposited by flies onto white cards. These methods do not estimate true house fly density, but rather provide an index of house fly activity that is related to both fly density and the frequency of individual fly behavior (e.g., frequency of flight, landing events) and which is likely more predictive of negative impacts such as nuisance and pathogen transmission. Routine monitoring of house fly activity is a critical component of a house fly management program. Fly activity should be held to a level below a predetermined activity threshold ('action threshold') above which negative impacts are anticipated to occur. This article is a review of methods utilized for monitoring house fly (Diptera: Muscidae) activity.
Maternal and neonatal outcomes in COVID-19 infected pregnancies: a prospective cohort study
Authors: Pirjani Reihaneh , Hosseini Reihaneh , Soori Tahereh , Rabiei Maryam , Hosseini Ladan , Abiri Ameneh , Moini Ashraf , Shizarpour Arshia , Razani Ghazal , Sepidarkish Mahdi
Published: September 2020

Background

Despite the large number of pregnant women with the coronavirus disease 2019 (COVID-19), there is not enough analytical study to compare maternal and fetal consequences of COVID-19 infected with non-infected pregnancies. This cohort study aimed to compare maternal and fetal consequences of COVID-19 infected with non-infected pregnancies.

Methods

We included pregnant women with and without COVID-19 who were admitted to Arash Hospital in Tehran, Iran, from 1 March to 1 September 2020. Clinical features, treatments, and maternal and fetal outcomes were assessed.

Results

A total of 199 women enrolled, including 66 COVID-19 infected and 133 non-infected pregnant women prospectively. Caesarean section was carried out in total 105 women (52.76%). A significant difference was found in term of delivery type between COVID-19 infected and non-infected pregnant women [adjusted risk ratio (aRR): 1.31, 95% confidence interval (CI): 1.04, 1.65, P = 0.024]. No significant association was found between COVID-19 infection and preterm birth (aRR: 1.16, 95% CI: 0.54, 2.48, P = 0.689), low birth weight (aRR: 1.13, 95% CI: 0.55, 2.31, P = 0.723), gestational diabetes (aRR: 1.67, 95% CI: 0.81, 3.42, P = 0.160), pre-eclampsia (aRR: 2.02, 95% CI: 0.42, 6.78, P = 0.315), intrauterine growth restriction (aRR: 0.16, 95% CI: 0.02, 1.86, P = 0.145), preterm rupture of membrane (aRR: 0.19, 95% CI: 0.02, 2.20, P = 0.186), stillbirth (aRR: 1.41, 95% CI: 0.08, 18.37, P = 0.614), postpartum haemorrhage (aRR: 1.84, 95% CI: 0.39, 8.63, P = 0.185), neonatal intensive care unit (ICU) admission (aRR: 1.84, 95% CI: 0.77, 4.39, P = 0.168) and neonatal sepsis (aRR: 0.84, 95% CI: 0.48, 1.48, P = 0.568). The percentage of patients (4/66, 6.06%) being admitted to the ICU was significantly higher than the control group (0%) (P < 0.001).

Conclusion

Basically, although pregnancy and neonatal outcomes were not significantly different, the need for ICU care for pregnant women with COVID-19 was significantly higher compared with those without COVID-19.
DGINN, an automated and highly-flexible pipeline for the detection of genetic innovations on protein-coding genes
Authors: Picard Lea , Ganivet Quentin , Allatif Omran , Cimarelli Andrea , Guéguen Laurent , Etienne Lucie
Published: September 2020

Adaptive evolution has shaped major biological processes. Finding the protein-coding genes and the sites that have been subjected to adaptation during evolutionary time is a major endeavor. However, very few methods fully automate the identification of positively selected genes, and widespread sources of genetic innovations such as gene duplication and recombination are absent from most pipelines. Here, we developed DGINN, a highly-flexible and public pipeline to Detect Genetic INNovations and adaptive evolution in protein-coding genes. DGINN automates, from a gene's sequence, all steps of the evolutionary analyses necessary to detect the aforementioned innovations, including the search for homologs in databases, assignation of orthology groups, identification of duplication and recombination events, as well as detection of positive selection using five methods to increase precision and ranking of genes when a large panel is analyzed. DGINN was validated on nineteen genes with previously-characterized evolutionary histories in primates, including some engaged in host-pathogen arms-races. Our results confirm and also expand results from the literature, including novel findings on the Guanylate-binding protein family, GBPs. This establishes DGINN as an efficient tool to automatically detect genetic innovations and adaptive evolution in diverse datasets, from the user's gene of interest to a large gene list in any species range.
Hedgehog signaling enables repair of ribosomal DNA double-strand breaks
Authors: Lama-Sherpa Tshering D , Lin Victor T G , Metge Brandon J , Weeks Shannon E , Chen Dongquan , Samant Rajeev S , Shevde Lalita A
Published: September 2020

Ribosomal DNA (rDNA) consists of highly repeated sequences that are prone to incurring damage. Delays or failure of rDNA double-strand break (DSB) repair are deleterious, and can lead to rDNA transcriptional arrest, chromosomal translocations, genomic losses, and cell death. Here, we show that the zinc-finger transcription factor GLI1, a terminal effector of the Hedgehog (Hh) pathway, is required for the repair of rDNA DSBs. We found that GLI1 is activated in triple-negative breast cancer cells in response to ionizing radiation (IR) and localizes to rDNA sequences in response to both global DSBs generated by IR and site-specific DSBs in rDNA. Inhibiting GLI1 interferes with rDNA DSB repair and impacts RNA polymerase I activity and cell viability. Our findings tie Hh signaling to rDNA repair and this heretofore unknown function may be critically important in proliferating cancer cells.
Impaired perfusion in the myocardial microcirculation in asymptomatic patients with Stages 1–4 chronic kidney disease with intrarenal arterial lesions
Authors: Xiao Fei , Zhang Weiwei , He Ya-Ni , Yang Jie , Liu Xinghong , Wang Ling , Zhang Jianguo , Dai Huanzi
Published: September 2020

Background

Even mild renal disease is a powerful cardiovascular risk factor. However, the association between these pathophysiologic processes (especially in the early asymptomatic stage) is not known.

Methods

We recruited 243 asymptomatic patients with Stages 1–4 chronic kidney disease (CKD) without obstructive coronary artery disease (CAD). We distinguished different degrees of severity of intrarenal arterial lesions (IALs) according to the Oxford classification. Myocardial microcirculation perfusion was measured using single-photon emission computed tomography (SPECT). Summed scores of 17 stress and rest image segments produced the summed stress score (SSS) and summed rest score (SRS), respectively. The summed difference score (SDS) was calculated as the difference between the SSS and SRS. Coronary microvascular disease (CMD) was defined as abnormal SPECT (SSS ≥4 or SDS ≥2) in the absence of obstructive CAD.

Results

Participants showed a stepwise increase in CMD severity with IAL aggravation. SSS of no/mild/moderate/severe IALs was 1.64 ± 1.08, 2.56 ± 1.35, 4.42 ± 2.17 and 6.48 ± 3.52, respectively (P < 0.05 for all). SDS of no/mild/moderate/severe IALs was 1.29 ± 0.49, 1.75 ± 0.56, 3.06 ± 1.12 and 4.16 ± 1.85, respectively (P < 0.05 for all). The percentage of subclinical CMD in CKD patients with IALs was significantly higher than in those without IALs (69.57% versus 14.71%; P = 0.01). Multiple regression analysis showed that renal arteriolar hyalinization (odds ratio = 1.578, P = 0.009) was associated independently with subclinical CMD.

Conclusions

We demonstrated, for the first time, that impaired perfusion in the myocardial microcirculation in asymptomatic patients with Stages 1–4 CKD with IALs. Renal arteriolar hyalinization may be a useful marker of CMD in CKD.
A multiaxial lead-free two-dimensional organic-inorganic perovskite ferroelectric
Authors: Huang Chao-Ran , Luo Xuzhong , Chen Xiao-Gang , Song Xian-Jiang , Zhang Zhi-Xu , Xiong Ren-Gen
Published: September 2020

Two-dimensional (2D) hybrid organic-inorganic perovskites (HOIPs) have recently gained tremendous interest because of their unique features in contrast to three-dimensional counterparts and traditional 2D materials. However, although some 2D HOIP ferroelectrics have been achieved, the issue of toxic Pb and uniaxial nature impede their further application. Herein, for the first time, we report a lead-free 2D HOIP multiaxial ferroelectric, [3,3-difluorocyclobutylammonium]2CuCl4 (1), which shows four ferroelectric axes and eight equivalent polarization directions, more than those of the other 2D HOIP ferroelectrics and even the inorganic perovskite ferroelectric BaTiO3 (three ferroelectric axes and six equivalent polarization directions). 1 also features a high Curie temperature of 380 K and exhibits remarkable thermochromism of color change from green-yellow to dark brown. To our knowledge, 1 is the first multiaxial lead-free 2D HOIP ferroelectric. This work sheds light on the exploration of better lead-free 2D HOIP ferroelectrics.
Phrase
Authors: Schmalfeldt Janet
Published: September 2020

Like so many foundational music-theoretical terms, “phrase” has been adopted in divergent ways, sometimes unreflectively. Notions of phrase are necessarily contingent upon styles, genres, historical and cultural contexts, social functions, and ties to syntax, cadence, and form. Although no global definition is feasible, commonalities among appropriations of the term emerge. This chapter explores the ineluctable association of phrase with text and punctuation, from Western medieval chant to Stravinsky; but conflicting theories of phrase functions and cadences raise questions for non-texted music. Influential eighteenth-century definitions of phrase and phrase expansion suggest the strong, regularizing influence of galant dance. The young Beethoven flaunts the ever-increasing potency of phrase repetition and expansion; Schumann shows how to undercut the emerging problem of “foursquareness”; excerpts from Messiaen, Ligeti, and Ghanaian Agbadza music demonstrate that phrase is not reliant upon tonaltity. Just the same, composers, listeners, analysts, and especially performers depend upon the perception of “phrases” implicated in so much music of different styles, eras, and cultures.
Key and Modulation
Authors: Clark Suzannah
Published: September 2020

What harmonic features are involved when a musical passage, or a work, is in a particular key? How is balance achieved between modulations that reinforce the home key and those that supplant it altogether? The chapter starts by analyzing “Im wunderschönen Monat Mai,” the opening song in Robert Schumann’s song-cycle Dichterliebe. It considers the criteria for identifying keys and provides a brief history of the role of closure in the definition of key before discussing how composers move between keys and what kinds of key relations they choose. It then explores new theoretical insights on common-tone modulation, along with the issue of content versus cadence in determining degrees of certainty about the establishment of new internal keys. It also compares definitions of tonicization and modulation and concludes with an assessment of how key relations have been shaped into tonal spaces. An important observation—one that highlights the tension between contents and cadences—is that the presence or absence of a final cadence is commonly used to ascertain whether or not a key has been fully articulated. The chapter describes a range of scenarios of such tension as well as the views of various theorists and analysts regarding the relative importance of content versus cadence.
Trusts and jurisdiction clauses—Crociani revisited Ivanishvili, Bidzina and others v Credit Suisse Trust Ltd [2020] SGCA 62
Authors: Kian Peng Soh
Published: September 2020

In the recent Singapore Court of Appeal decision of Ivanishvili, Bidzina and others v Credit Suisse Trust Ltd, the court analysed the effect of a forum administration clause in the trust context, holding that while the clause in question was a jurisdiction clause, it was not an exclusive jurisdiction clause governing the dispute between the trustees and beneficiaries.
Adapting to disruption of research during the COVID-19 pandemic while testing nonpharmacological approaches to pain management
Authors: Coleman Brian C , Kean Jacob , Brandt Cynthia A , Peduzzi Peter , Kerns Robert D
Published: September 2020

The COVID-19 pandemic has slowed research progress, with particularly disruptive effects on investigations of addressing urgent public health challenges, such as chronic pain. The National Institutes of Health (NIH) Department of Defense (DoD) Department of Veterans Affairs (VA) Pain Management Collaboratory (PMC) supports 11 large-scale, multisite, embedded pragmatic clinical trials (PCTs) in military and veteran health systems. The PMC rapidly developed and enacted a plan to address key issues in response to the COVID-19 pandemic. The PMC tracked and collaborated in developing plans for addressing COVID-19 impacts across multiple domains and characterized the impact of COVID-19 on PCT operations, including delays in recruitment and revisions of study protocols. A harmonized participant questionnaire will facilitate later meta-analyses and cross-study comparisons of the impact of COVID-19 across all 11 PCTs. The pandemic has affected intervention delivery, outcomes, regulatory and ethics issues, participant recruitment, and study design. The PMC took concrete steps to ensure scientific rigor while encouraging flexibility in the PCTs, while paying close attention to minimizing the burden on research participants, investigators, and clinical care teams. Sudden changes in the delivery of pain management interventions will probably alter treatment effects measured via PMC PCTs. Through the use of harmonized instruments and surveys, we are capturing these changes and plan to monitor the impact on research practices, as well as on health outcomes. Analyses of patient-reported measures over time will inform potential relationships between chronic pain, mental health, and various socioeconomic stressors common among Americans during the COVID-19 pandemic.
Heated Humidified High-Flow Nasal Cannula vs. Nasal Continuous Positive Airway Pressure for Post-extubation Respiratory Support in Preterm Infants: A Randomized Controlled Trial
Authors: Yengkhom Rameshwor , Suryawanshi Pradeep , Gupta Bhvya , Deshpande Sujata
Published: September 2020

Objective

The objective of this study was to compare the efficacy and safety of heated humidified high-flow nasal cannula (HHHFNC) and nasal continuous positive airway pressure (nCPAP) for prevention of extubation failure in preterm infants.

Methods

Preterm infants (gestation ≥28 weeks) were randomized to HHHFNC or nCPAP after extubation. Primary outcome was extubation failure within 72 h of extubation.

Results

A total of 128 preterm infants were randomized to receive either HHHFNC (n = 63) or nCPAP (n = 65) after extubation. The primary outcome of extubation failure within 72 h after extubation was not different between the two groups (HHHFNC, 22.2% vs. nCPAP, 18.5%, risk difference of 3.7% and 95% CI −10.3 to 17.6, p = 0.604). The incidence of nasal trauma was significantly lower in the HHHFNC group than in the nCPAP group 6.3% vs. 21.5%, p = 0.020.

Conclusions

In our study, HHHFNC was as effective as nCPAP for prevention of extubation failure in preterm infants. Also, HHHFNC was associated with significantly less nasal trauma compared with nCPAP.
Evaluating the Microbiome of Hemp
Authors: Barnett Samuel E. , Cala Ali R. , Hansen Julie L. , Crawford Jamie , Viands Donald R. , Smart Lawrence B. , Smart Christine D. , Buckley Daniel H.
Published: September 2020

Plant microbiomes contribute to plant fitness and crop yields through a variety of mechanisms. Determining variability in microbiome composition among individuals of a species, and identifying core microbiome membership, are essential first steps for exploring host–microbe interactions. Members of a core microbiome are microorganisms that are tightly associated with and are found widespread across individuals of a plant genotype or species. Hemp (Cannabis sativa L.) is an economically important crop that has gained a resurgence following its removal from the list of controlled substances by the U.S. government. Despite renewed interest in this crop, the microbiome of hemp has not been well studied. We analyzed the bacterial and fungal communities associated with four plant compartments (rhizosphere, root tissue, leaf surface, and flowers) of C. sativa ‘Anka’ across six fields in the Finger Lakes region of New York, United States. We found that both bacterial and fungal community composition varied significantly among plant compartments. Rhizosphere communities were largely similar to the bulk soil communities but root tissue, leaf, and flower communities had distinct compositions. We identified candidate core microbiome members of each plant compartment (bacterial core taxa: root tissue [n = 6], leaves [n = 11], and flowers [n = 7]; fungal core taxa: rhizosphere [n = 1], leaves [n = 14], and flowers [n = 2]). Many of these candidate core microbiome members were related to organisms previously associated with plant growth promotion or pathogen resistance in various plants. The core microbiome identified in this study can be further investigated to improve cultivation of this important crop.

[Formula: see text] Copyright © 2020 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Resistance to Potassium Phosphite in Phytophthora Species Causing Citrus Brown Rot and Integrated Practices for Management of Resistant Isolates
Authors: Hao Wei , Förster Helga , Adaskaveg James E.
Published: September 2020

Phytophthora citrophthora, P. syringae, P. nicotianae, and less commonly P. hibernalis are causal agents of brown rot of citrus fruit in California. The chronic disease occurs during the winter season, requires annual management, and has limited California citrus exports because of quarantines in some markets. Potassium phosphite (KPO3) is registered as a pre- and postharvest fungicide in the United States to manage Phytophthora brown rot. We evaluated the in vitro toxicity of KPO3 to 65, 60, and 38 isolates of P. citrophthora, P. syringae, and P. nicotianae, respectively, that were obtained from major growing regions of California. Frequency distributions of effective concentrations to inhibit mycelial growth by 50% (EC50 values) were not normally distributed, with skewness values of 1.84, 1.60, and −0.51 for each species, respectively. Isolates considered sensitive (EC50 values <25 µg/ml), moderately resistant (EC50 values from 25 to 75 µg/ml), or resistant (EC50 values >75 µg/ml) were identified for each species. The majority of P. citrophthora (83.1%) and P. syringae (78.3%) isolates were sensitive, whereas most P. nicotianae isolates (86.8%) were moderately resistant or resistant. Resistance factors were calculated as 65, 19, and 10 for the three species, respectively. In preharvest field trials, KPO3 (2,280 g/ha) applications were not effective in reducing citrus brown rot incidence when orange fruit were inoculated with a resistant (EC50 = 161.9 µg/ml) isolate of P. citrophthora, demonstrating the potential for field resistance. Oxathiapiprolin (32.6 g/ha), however, was highly effective, indicating the absence of multidrug resistance. Postharvest treatments with KPO3 were only effective in reducing brown rot caused by the resistant isolate of P. citrophthora to a low incidence when high rates (8,000 µg/ml) were used in heated (54°C) applications. The sensitive and moderately resistant isolates were managed using rates of 4,000 µg/ml, but heated treatments at this rate were needed to reduce brown rot to commercially acceptable levels when decay was caused by a moderately resistant isolate.
Intraspecific Mitochondrial DNA Comparison of Mycopathogen Mycogone perniciosa Provides Insight Into Mitochondrial Transfer RNA Introns
Authors: Deng Youjin , Wu Xin , Wen Die , Huang Haichen , Chen Yilei , Mukhtar Irum , Yue Liyun , Wang Li , Wen Zhiqiang
Published: September 2020

Mycogone perniciosa is the main causative agent of wet bubble disease, which causes severe damage to the production of the cultivated mushroom Agaricus bisporus around the world. Whole-genome sequencing of 12 isolates of M. perniciosa was performed using the Illumina sequencing platform, and the obtained paired-end reads were used to assemble complete mitochondrial genomes. Intraspecific comparisons of conserved protein-coding genes, transfer RNA (tRNA) and ribosomal RNA (rRNA) genes, introns, and intergenic regions were conducted. Five different mitochondrial DNA (mtDNA) haplotypes were detected among the tested isolates, ranging from 89,080 to 93,199 bp in length. All of the mtDNAs contained the same set of 14 protein-coding genes and 2 rRNA and 27 tRNA genes, which shared high sequence similarity. In contrast, the number, insertion sites, and sequences of introns varied greatly among the mtDNAs. Eighteen of 43 intergenic regions differed among the isolates, reflecting 65 single nucleotide polymorphisms, 76 indels, and the gain/loss of nine long fragments. Intraspecific comparison revealed that two introns were located within tRNA genes, which is the first detailed description of mitochondrial tRNA introns. Intronic sequence comparison within the same insertion sites revealed the formation process of two introns, which also illustrated a fast evolutionary rate of introns among M. perniciosa isolates. Based on the intron distribution pattern, a pair of universal primers and four pairs of isolate-specific primers were designed and were used to identify the five mtDNA types. In summary, the rapid gain or loss of mitochondrial introns could be an ideal marker for population genetics analysis.
Improvement of Sleep Quality in Patients With Ankylosing Spondylitis Kyphosis After Corrective Surgery
Authors: Hu Fanqi , Song Kai , Hu Wenhao , Zhang Zhifa , Liu Chao , Wang Qi , Ji Quanbo , Zhang Xuesong
Published: September 2020

Study Design.

A retrospective study.

Objective.

The aim of this study is to investigate the changes in sleep quality in patients surgically treated for kyphosis due to ankylosing spondylitis (AS) and the correlation between these changes and spinal sagittal realignment.

Summary of Background Data.

Sleep problems are prevalent in AS patients. However, little attention has been paid to the sleep quality in patients with AS kyphosis and the effect of surgical intervention on sleep quality.

Methods.

We have retrospectively reviewed 62 patients with AS-induced thoracolumbar kyphosis who underwent surgically treatment from October 2012 to November 2016. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Preoperative and postoperative radiological characteristics and supine function were documented. We compared the above-mentioned parameters pre- and 24 months postoperatively and analyzed the correlation of the changes in the PSQI with the changes in radiological characteristics.

Results.

Fifity-one patients (82%) classified as poor sleepers preoperatively. In addition to use of sleeping medication, each domain of the PSQI and the total PSQI were increased postoperatively. Improved sleep quality was correlated with changes in spinal sagittal characteristics, among which the lumbar lordosis (LL) and the chin-brow vertical angle (CBVA) were the independent correlation factors. The number of patients with supine dysfunction decreased from 89% to 15% after surgery. Significant differences were identified in the PSQI scores between the patients with and without supine dysfunction either pre- or postoperatively.

Conclusion.

Surgical correction of spinal deformity may improve sleep quality and supine function in patients with AS. Spinal sagittal realignment may be correlated with the improvement of sleep quality.

Level of Evidence: 4
Practical approach to the management of smoldering myeloma
Authors: Joseph Nisha S. , Lonial Sagar
Published: September 2020

Purpose of review

The aim of this article is to review the diagnosis and risk stratification of smoldering myeloma (SMM), describe recently published data regarding the early treatment of SMM, and to provide practical strategies on how to manage patients with SMM in the clinic.

Recent findings

Recently published data from the ECOG E3A06 and GEM-CESAR studies supporting early intervention for certain subsets of high-risk SMM patients will be presented, and the relevance of these findings in relation to real-life application will be explored.

Accurate risk-stratification and standard of care for SMM is evolving, and here we summarize the pertinent clinical data and provide recommendations for clinical management of SMM patients.
Prevention of brain metastases in human epidermal growth factor receptor 2-positive breast cancer
Authors: Eberst Lauriane , Bailleux Caroline , Bachelot Thomas
Published: September 2020

Purpose of review

For patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer, treatments that could prevent or delay occurrence of brain metastases would improve outcome.

Recent findings

Few studies were specifically designed to assess brain metastasis prevention. Most evidence derives from subgroup analyses of randomized trials. In the first-line metastatic setting, lapatinib, was not superior to trastuzumab to prevent CNS metastases as first site of relapse. Pertuzumab when added to trastuzumab and taxane significantly delay occurrence of brain metastases. In the second line setting, trastuzumab–emtansine has shown to improve overall survival of patients with brain metastases when compared with capecitabine–lapatinib, but there was no significant delay in brain metastases progression. Neratinib, has shown that it was able to delay brain metastases progression. Finally, tucatinib, has demonstrated benefit in progression-free survival and overall survival in combination with trastuzumab and capecitabine over trastuzumab and capecitabine for patients with or without brain metastases.

There has been an impressive improvement of the outcome of patients with HER2-positive metastatic breast cancer, with improved control of systemic disease and delayed occurrence of CNS progression. Specific studies are needed to assess TKI for brain metastases prevention, particularly in the adjuvant setting.
Evaluation of Blood-filling Patterns in Schlemm Canal for Trabectome Surgery
Authors: Sugihara Kae , Narita Akiko , Mitsui Naruka , Okuda Seido , Seguchi Jiro , Morizane Yuki
Published: September 2020

Précis:

Regardless of the blood-filling patterns in Schlemm canal (SC) before the trabecular meshwork (TM) ablation, the trabectome surgery, combined with phacoemulsification, is effective for mild to moderate primary open-angle glaucoma patients.

Purpose:

The purpose of this study was to evaluate the association between trabectome surgery outcomes and the blood filling patterns in SC before TM ablation.

Materials and Methods:

This retrospective cohort study included 105 eyes of 84 Japanese primary open-angle glaucoma patients who had undergone trabectome surgery in combination with cataract surgery. Provocative gonioscopy was performed before TM ablation to classify the blood filling patterns in SC into 3 groups: no filling (group 1); patchy/irregular filling (group 2); and complete filling (group 3). The subjects were divided into 3 groups according to the blood filling patterns and the trabectome surgery outcomes were compared, including intraocular pressure (IOP), the percentage reduction in IOP, surgical success rate, and the number of glaucoma medications. Success was defined by IOP ≤15 mm Hg and a >20% reduction in IOP with/without glaucoma medication, and without additional glaucoma surgery after trabectome surgery combined with cataract surgery.

Results:

Twenty-four eyes were assigned to group 1, 48 to group 2, and 33 to group 3. Between-group analyses showed no significant intergroup differences in age (P=0.213), preoperative mean deviation (P=0.505), preoperative and postoperative IOP (P=0.941 and 0.458, respectively), preoperative and postoperative number of glaucoma medications (P=0.805 and 0.077, respectively), percentage IOP reduction (P=0.256), and success rates (P=0.540).

Conclusion:

Trabectome surgery is effective for mild to moderate primary open-angle glaucoma patients, independent of the blood-filling patterns in SC before the TM ablation.
Punctal Congestion Syndrome: A Reversible, Functional Punctal Stenosis Causing Epiphora in the Setting of Chronic Pretarsal Conjunctivitis
Authors: Bian Yandong , Scofield-Kaplan Stacy M. , Zemsky Christine , Campagnoli Thalmon , Ghadiali Larissa , Dagi Glass Lora R. , Sallee Brigitte , Belsito Donald V. , Winn Bryan J
Published: September 2020

Purpose:

To describe a reversible syndrome of epiphora, functional punctal stenosis, and chronic pretarsal conjunctivitis associated with corticosteroid or corticosteroid-antibiotic eyedrop use.

Methods:

This is an Institutional Review Board-approved retrospective review of patients diagnosed with epiphora, punctal stenosis, and chronic conjunctivitis by a single surgeon (B.J.W.). These patients were subsequently invited to participate in a prospective study involving allergy skin patch testing for ophthalmic drops, common excipients, and active ingredients.

Results:

Thirteen patients received a diagnosis of punctal congestion syndrome. The average age was 63 years (range, 41–93) and 69.2% were female. Findings were bilateral in 61.5%. All had used preserved drops in the affected eye(s). Various antecedent diagnoses resulted in treatment with preserved drops. Patients experienced epiphora for an average of 3.8 months (median, 3 months; mode, 3 months; range, 1–8 months) prior to presentation. Two patients had undergone punctoplasty which failed to resolve symptoms. 92.3% of patients had been taking tobramycin-dexamethasone drops, loteprednol drops, or a combination of both prior to presentation. All were taken off preserved drops. 69.2% were also treated with a preservative-free loteprednol etabonate 0.5% ophthalmic ointment taper. All improved. Partial relief of symptoms was achieved by an average of 1.6 months (median, 2 months; mode, 2 months; standard deviation, ±0.7 months) and resolution of symptoms by 2.5 months (median, 2 months; mode, 2 months; standard deviation, ±1.7 months). One patient underwent patch testing with strong positive reactions to formaldehyde and neomycin and a weak positive reaction to gentamicin.

Conclusions:

Functional punctal stenosis is associated with topical ophthalmic preparations, especially preserved corticosteroids and antibiotic-corticosteroid combinations. Treatment consists of removal of all preserved eyedrops. Symptoms often improve over several months.
A review of the management of uremic pruritus: current perspectives and future directions
Authors: Westby Erin P. , Purdy Kerri S. , Tennankore Karthik K.
Published: September 2020

Uremic pruritus (UP) is a common and distressing symptom experienced by up to half of all patients with end-stage renal disease (ESRD) receiving dialysis. It is associated with multiple health-related quality of life impairments and has been independently associated with mortality. Despite the prevalence and associated impact on quality of life, UP remains a difficult symptom to treat because of the relative lack of existing high quality evidence on which to base recommendations and the sheer volume of poorly studied therapeutic options. This review outlines the existing data of available treatment options including topical therapy, systemic therapy, and phototherapy as well as explore emerging data on therapies that are targeting novel pruritus pathways including the cannabinoid and opioid pathways. Overall, neuromodulators, in particular gabapentin, appear to have the most robust data in the treatment of UP. In individuals who cannot tolerate oral systemic therapy or in those with refractory generalized UP, ultraviolet phototherapy, specifically broad-band UVB, has shown significant promise. However, access is often a limiting factor. Lastly, the emergence of new therapies targeting a peripheral acting κ-opioid agonist, difelikefalin, has demonstrated effect in both early phase 2 and 3 clinical trials.
Itch-related quality of life impact across 3 autoimmune blistering diseases: a retrospective cohort study
Authors: Cole Emily F. , DeGrazia Taryn , AlShamekh Shomoukh , Feldman Ron
Published: September 2020

Introduction:

Autoimmune blistering diseases (AIBD) produce a range of debilitating symptoms potentially greatly impacting quality of life (QoL). We sought to compare the disease-related and itch-related QoL impact between AIBD including pemphigus, bullous pemphigoid (BP), and mucous membrane pemphigoid (MMP).

Methods:

We performed a retrospective cohort study of patients attending a specialty Autoimmune Blistering Disease Clinic at a single academic center between July 2017 and April 2019. Patients with an established histopathologic or serological diagnosis of pemphigus, BP or MMP with mucosal and/or cutaneous lesions on clinical examination, or patient-reported QoL impact in the past week were recruited to participate. Patients completed Autoimmune Blistering Disease Quality of Life (ABQoL), Treatment of Autoimmune Blistering Disease Quality of Life (TABQoL), and ItchyQoL survey instruments, and disease severity was assessed using the Pemphigus Disease Area Index (PDAI) (pemphigus), Bullous Pemphigoid Disease Area Index (BPDAI) (BP), and Mucous Membrane Pemphigoid Disease Area Index (MMPDAI) (MMP). Statistical analyses were performed using IBM SPSS 26.

Results:

BP and pemphigus demonstrated similar itch-related QoL impact, greater than that of MMP. Disease severity was significantly associated with itch-related QoL in BP and pemphigus, as was use of biological/targeted therapies in BP alone.

Discussion:

Itch is a significant symptom in both BP and pemphigus and can negatively affect QoL. Disease severity and treatment type play a role in itch-related QoL in pemphigus and BP. Additional studies are needed to elucidate the mechanisms for itch in AIBD, particularly in pemphigus where this symptom has only recently been described.
Evaluating the Timeliness and Specificity of CD69, CD64, and CD25 as Biomarkers of Sepsis in Mice
Authors: Goswami Dinesh G. , Garcia Luiz F. , Dodoo Christopher , Dwivedi Alok K. , Zhou Yun , Pappas Dimitri , Walker Wendy E.
Published: September 2020

Sepsis occurs when an infection induces a dysregulated immune response, and is most commonly bacterial in origin. This condition requires rapid treatment for successful patient outcomes. However, the current method to confirm infection (blood culture) requires up to 48 h for a positive result and many true cases remain culture-negative. Therefore, new diagnostic tests are urgently needed. Recent clinical studies suggest that CD69, CD64, and CD25 may serve as useful biomarkers of sepsis. In this study, we evaluated the cecal ligation and puncture and cecal slurry mouse models as tools to study these biomarkers in young and aged mice, and elucidate the timeliness and specificity of sepsis diagnosis. Fluorescence-activated cell sorting analysis revealed that all three biomarkers were elevated on blood leukocytes during sepsis. CD69 was specifically upregulated during sepsis, while CD64 and CD25 were also transiently upregulated in response to sham surgery. The optimal biomarker, or combination of biomarkers, depended on the timing of detection, mouse age, and presence of surgery. CD69 demonstrated an excellent capacity to distinguish sepsis, and in some scenarios the diagnostic performance was enhanced by combining CD69 with CD64. We also analyzed biomarker expression levels on specific cell populations (lymphocytes, monocytes, and neutrophils) and determined the cell types that upregulate each biomarker. Elevations in blood biomarkers were also detected via microfluidic analyses; in this case CD64 distinguished septic mice from naive controls. Our results suggest that CD69 and CD64 are valuable biomarkers to rapidly detect sepsis, and that mouse models are useful to study and validate sepsis biomarkers.
Admission Lactate and Base Deficit in Predicting Outcomes of Pediatric Trauma
Authors: Huh Yo , Ko Yura , Hwang Kyungjin , Jung Kyoungwon , Cha Yoon-ho , Choi Yoo Jin , Lee Jisook , Kim Jung Heon
Published: September 2020

Background:

To compare admission lactate and base deficit (BD), which physiologically reflect early hemorrhagic shock, as outcome predictors of pediatric trauma.

Methods:

We reviewed the data of children with trauma who visited a Korean academic hospital from 2010 through 2018. Admission lactate and BD were compared between children with and without primary outcomes. The outcomes included in-hospital mortality, early (≤24 h) transfusion, and early surgical interventions for the torso or major vessels. Subsequently, performances of lactate and BD in predicting the outcomes were compared using receiver operating characteristic curves. Logistic regressions were conducted to identify the independent associations of the two markers with each outcome.

Results:

Of the 545 enrolled children, the mortality, transfusion, and surgical interventions occurred in 7.0%, 43.5%, and 14.9%, respectively. Cutoffs of lactate and BD for each outcome were as follows: mortality, 5.1 and 6.7 mmol/L; transfusion, 3.2 and 4.9 mmol/L; and surgical interventions, 2.9 and 5.2 mmol/L, respectively. No significant differences were found in the areas under the curve for each outcome. Of the two markers, a lactate of >5.1 mmol/L was associated with mortality (adjusted odds ratio, 6.43; 95% confidence interval, 2.61–15.84). A lactate of >3.2 mmol/L (2.82; 1.65–4.83) and a BD of >4.9 mmol/L (2.32; 1.32–4.10) were associated with transfusion, while only a BD of >5.2 mmol/L (2.17; 1.26–3.75) was done with surgical interventions.

Conclusions:

In pediatric trauma, lactate is more strongly associated with mortality. In contrast, BD may have a marginally stronger association with the need for hemorrhage-related procedures.
Enhanced Experiential Learning in Airway Management
Authors: Chandran Rajkumar , Koo Seok Hwee , Lim Yin Yu , Ramadorai Ashok , Tan Alvin Kah Leong , Singh Prit Anand , Negar Asadi , Lai Juen Bin
Published: September 2020

Introduction

Failure of airway management remains a significant source of morbidity and mortality. Advanced airway management has been addressed effectively by simulation-based training. However, simulation of difficult airways in manikins is limited by the pre-set conditions provided by the manufacturer. Life-like conditions in the form of the softness of the tissue and true anatomy as seen in cadaver models are needed to create simulated models with a closer resemblance to real patients. The goal of this study was to determine the feasibility of simulating difficult airway from submandibular abscess in cadaver models by surgical modification of the cadaver heads for use in enhanced experiential learning of the management of difficult airways.

Methods

The cadaver heads were modified surgically to simulate a submandibular abscess. The models were used in an airway course where participants provided feedback on the realistic nature of the model and its benefits for difficult airway training. The ease of tracheal intubation of the models with the assistance of video laryngoscopy was assessed.

Results

The modified cadavers were acceptable in simulating difficult airway as demonstrated by the feedback from the participants. All participants (100% [95% confidence interval = 89.1%–100%]) found the models to be realistic and beneficial for difficult airway training. A good proportion (56.3%) felt that the intubation technique was made easier with the video laryngoscopy.

Conclusions

Cadavers can be modified to simulate pathologies associated with difficult airways. These models can be used to enhance experiential learning and the management of difficult airways.
Microlunatus elymi sp. nov., a novel actinobacterium isolated from rhizospheric soil of the wild plant Elymus tsukushiensis
Authors: Son Jin-Soo , Lee Soo-Yeong , Hwang Ye-Ji , Shin Jae-Ho , Ghim Sa-Youl
Published: September 2020

An actinobacterial strain, designated KUDC0627T, was isolated from rhizospheric soil that contained Elymus tsukushiensis on the Dokdo Islands, Republic of Korea. Cells were Gram-stain-positive, facultative anaerobic, non-motile and non-endospore-forming cocci. Results of phylogenetic analysis based on 16S rRNA gene sequences indicated that strain KUDC0627T belongs to the genus

Microlunatus

and is most closely related to

Microlunatus soli

DSM 21800T (98.5 %),

Microlunatus endophyticus

DSM 100019T (97.7 %) and

Microlunatus ginsengisoli

Gsoil 633T (96.5 %). The average nucleotide identity scores and average amino acid identity values were all below the 95.0 % cut-off point. In silico DNA–DNA hybridization, using the Genome-to-Genome Distance Calculator, estimated that there is 22.3 % DNA relatedness between KUDC0627T and

M. soli

DSM 21800T. The genomic DNA G+C content was 66.9 mol%. The major menaquinone was MK-9(H4) and the major diagnostic diamino acid in the cell-wall peptidoglycan was ll-diaminopimelic acid. The polar lipid profile included diphosphatidylglycerol, phosphatidylglycerol, unidentified phospholipids, unidentified glycolipids and unidentified lipids. The major cellular fatty acids were iso-C15 : 0, anteiso-C15 : 0 and iso-C16 : 0. Based on phenotypic, chemotaxonomic, and phylogenetic data, strain KUDC0627T (=KCTC 39853T=JCM 32702T) represents a novel species, for which the name Microlunatus elymi sp. nov. is proposed.