bluuebunny/crossref_metadata_2025 huggingface dataset:
Intracranial Pulsatility in Relation to Severity and Progression of Cerebral White Matter Hyperintensities
Authors: Kneihsl Markus , Hofer Edith , Enzinger Christian , Niederkorn Kurt , Horner Susanna , Pinter Daniela , Fandler-Höfler Simon , Eppinger Sebastian , Haidegger Melanie , Schmidt Reinhold , Gattringer Thomas
Published: September 2020

Background and Purpose:

Previous studies suggested an association between increased intracranial arterial pulsatility and the severity of microangiopathic white matter hyperintensities (WMH). However, possible confounders such as age and hypertension were seldomly considered and longitudinal data are lacking. We here aimed to explore whether increased middle cerebral artery pulsatility is associated with baseline severity and progression of cerebral small vessel disease–related WMH in elderly individuals.

Methods:

The study population consisted of elderly participants from the community-based ASPS (Austrian Stroke Prevention Study). Baseline and follow-up assessment comprised transcranial Doppler sonography, brain magnetic resonance imaging, and clinical/laboratory examination of vascular risk factors. Pulsatility index on transcranial Doppler sonography was averaged from baseline indices of both middle cerebral arteries and was correlated with baseline WMH severity and WMH progression over a median follow-up period of 5 years in uni- and multivariable analyses. WMH severity was graded according to the Fazekas scale, and WMH load was quantified by semiautomated volumetric assessment.

Results:

The study cohort comprised 491 participants (mean age: 60.7±6.9 years; female: 48.5%). Pulsatility index was increased in participants with more severe WMH at baseline (
P
<0.001) but was not associated with WMH progression during follow-up (r
s
: 0.097,
P
=0.099). In multivariable analyses, only arterial hypertension remained significantly associated with baseline severity (
P
=0.04) and progression (
P
=0.008) of WMH, although transcranial Doppler sonography pulsatility index was not predictive (
P
>0.1, respectively).

Conclusions:

This community-based cohort study of elderly individuals does not support the pulsatility index of the middle cerebral artery on transcranial Doppler sonography as an independent marker of microangiopathic WMH severity and progression over time.
Regional High Wall Shear Stress Associated With Stenosis Regression in Symptomatic Intracranial Atherosclerotic Disease
Authors: Lan Linfang , Liu Haipeng , Ip Vincent , Soo Yannie , Abrigo Jill , Fan Florence , Ma Sze Ho , Ma Karen , Ip Bonaventure , Liu Jia , Fan Yuhua , Zeng Jinsheng , Mok Vincent , Wong Lawrence , Liebeskind David , Leung Thomas , Leng Xinyi
Published: September 2020

Background and Purpose:

Understanding the mechanisms underlying progression/regression of symptomatic intracranial atherosclerotic stenosis (sICAS) will inform secondary prevention of the patients. Focal wall shear stress (WSS) may play an important role, which, however, had seldom been investigated.

Methods:

Patients with acute ischemic stroke or transient ischemic attack (TIA) attributed to 50% to 99% intracranial atherosclerotic stenosis were recruited. All patients underwent cerebral computed tomography angiography at baseline, and a computational fluid dynamics model was built based on computed tomography angiography to simulate blood flow and quantify WSS in the vicinity of the sICAS lesion. All patients received optimal medical treatment and a second computed tomography angiography at 1 year. The change in the luminal stenosis from baseline to 1 year in sICAS was defined as progression (increased >10%), quiescence (±10%), or regression (decreased >10%). Associations between baseline WSS metrics and sICAS regression were analyzed.

Results:

Among 39 patients (median age 62 years; 27 males), sICAS luminal stenosis progressed, remained quiescent and regressed in 6 (15.4%), 15 (38.5%), and 18 (46.2%) cases, respectively. A higher maximum WSS and larger high-WSS area, throughout the sICAS lesion or obtained separately in the proximal and distal parts of the lesion, were independently associated with regression of luminal stenosis in sICAS over 1 year.

Conclusions:

A majority of sICAS lesions regress or stay quiescent in the luminal stenosis over 1 year after stroke under optimal medical treatment, when higher focal WSS may facilitate stenosis regression. Further studies of the effects of hemodynamics including WSS in altering plaque vulnerability and stroke risks are needed.
Incidence and Mortality of Cerebral Venous Thrombosis in a Norwegian Population
Authors: Kristoffersen Espen Saxhaug , Harper Charlotte Elena , Vetvik Kjersti Grøtta , Zarnovicky Svetozar , Hansen Jakob Møller , Faiz Kashif Waqar
Published: September 2020

Background and Purpose:

There are conflicting figures of the incidence of cerebral venous thrombosis (CVT). The incidence was previously estimated to around 0.5/100 000/y, but more recent studies have suggested 1 to 1.5/100 000/y. The purpose of this study was to explore the incidence and mortality of CVT in a Norwegian population.

Methods:

A retrospective cross-sectional hospital population-based study conducted at Akershus University Hospital serving roughly 10% of the total Norwegian population. Patients were identified through chart reviews based on the relevant
International Classification of Diseases
(
Tenth Revision
) codes for new CVT cases in a 7-year period between January 1, 2011, and December 31, 2017. Only inhabitants living in the hospital’s catchment area were included.

Results:

Sixty-two patients aged 0 to 80 years were identified and included. The median age was 46 years and 53% were females. The overall incidence of CVT was 1.75 (95% CI, 1.36–2.23) per 100 000/y with no significant sex differences. The incidence for children and adolescents (<18 years, n=9) was lower than for adults (≥18 years, n=53); 1.08 (0.52–1.97) versus 1.96 (1.49–2.55) per 100 000/y per year, with the highest incidence for those >50 years with 2.10 (1.38–3.07)/100 000/y. Headache was the most prevalent symptom, reported in 83%, followed by nausea, motor deficits, and seizures observed in 45%, 32%, and 32% of the patients. Transverse sinuses and the jugular vein were the most frequent sites of thrombosis. In most patients (61%), thrombosis occurred in multiple sinuses/veins. Risk factors were found in 73% of the patients, and most of the patients had a combination of 2 or more risk factors. The 30-day and 1-year mortality rates were 3% and 6%.

Conclusions:

The incidence of CVT in this population was higher than previously reported. The mortality rate was similar to previous studies.
Begonia truncatifolia (Begoniaceae, section Baryandra), a new species from Palawan Island, the Philippines

Authors: BUSTAMANTE RENE ALFRED ANTON , TANDANG DANILO N. , PRANADA MC ANDREW K. , ANG YU PIN
Published: September 2020

A new species of Begonia sect. Baryandra with 2-locular ovary and cucullate abaxial wing from the town of San Vicente, Palawan is described and illustrated. The new species, B. truncatifolia, is diagnosed against the morphologically similar B. blancii. Both species are endemic to Palawan and are similar in having spathulate leaves, 4-tepaled staminate & pistillate flowers and bilocular ovaries, but B. truncatifolia is significantly different in being comparatively smaller in size (stipules, lamina and inflorescences) and having obtusely rounded to acute lamina apices. The new species is proposed Critically Endangered following the criteria set by the IUCN.
The EU’s hegemonic interventions in the South Caucasus: Constructing ‘civil’ society, depoliticising human rights?
Authors: Luciani Laura
Published: September 2020

This article draws upon poststructuralist and postcolonial theories to examine the European Union’s (EU’s) policies of human rights promotion in the South Caucasus – notably, the EU’s engagement with local human rights activists and organisations in Armenia, Azerbaijan and Georgia. Contrary to most literature, which has been concerned with policy (in)effectiveness, this article is interested in problematising the discursive foundations of this EU-civil society ‘partnership’ in the realm of human rights promotion, as well as in retrieving the agency of actors who are ‘at the receiving end’ of EU policies. It is argued that the discursive construction of ‘civil’ society as a ‘good-Other’ of the EU-Self serves as a means to depoliticise the EU’s interventions, aiming at the approximation of ‘transitioning’ countries to the EU’s human rights standards. Although the hegemonic relation requires subaltern actors to perform the ‘civil’ society identity, processes of hybridisation and subversion arise as external interventions interact with local realities and meanings. Building on in-depth interviews and ethnographic observations, the article shows how the hegemonic identity of ‘civil’ society is negotiated by South Caucasus ‘not-quite-civil’ actors striving for local legitimacy, financial survival or ownership of their human rights work.
Validating measures of emotional abuse with behavioral observations during interpersonal conflict
Authors: Godfrey Donald A. , Kehoe Caitlin M. , Bennett Victoria E. , Bastardas-Albero Adriana , Babcock Julia C.
Published: September 2020

Emotional abuse is a form of intimate partner violence that can have detrimental effects on both individual well-being and relationship outcomes. However, differences in definitions and forms of emotional and psychological abuse have led to difficulties in its measurement. The Multi-Dimensional Measure of Emotional Abuse (MMEA) is an emotional abuse index that differentiates several different forms of psychological abuse. The current study sought to validate subscales of the MMEA by examining their relation to emotionally abusive behavior observed during interpersonal conflict. Additionally, the Conflict Tactics Scale Psychological Aggression scale and its severity subscales (CTS-PA) were compared to the MMEA. Heterosexual couples ( N = 167) participated in a conflict discussion task. Conflict discussions were coded for belligerence, contempt, domineering, and stonewalling behavior. Women completed the MMEA and CTS-PA questionnaire about their own and their partners’ emotional abuse perpetration. Results indicated that the total MMEA score for men and women was associated with belligerence, whereas the CTS-PA total score was associated with women’s contempt. The restricted engulfment subscale was associated with men’s dominance and contempt, and woman’s belligerence. The minor CTS-PA scale was associated with men and women’s contempt, and women’s stonewalling. The severe CTS-PA scale was only associated with women’s contempt. Additionally, we found significant associations between men’s stonewalling and contempt and their partner’s MMEA and CTS-PA subscales. For women, stonewalling was associated with their partner’s restricted engulfment. Men’s hostile withdrawal scale was also associated with their partner’s dominance during the conflict. Our results suggest that the MMEA multi-dimensional subscales appear to capture a wider range specific abusive behaviors compared to the CTS-PA’s severity constructs.
Association of anti-NR2 and U1RNP antibodies with neurotoxic inflammatory mediators in cerebrospinal fluid from patients with neuropsychiatric systemic lupus erythematosus
Authors: Kondo-Ishikawa Seiko , Fujii Takao , Ishigooka Nozomi , Murakami Kosaku , Nakashima Ran , Hashimoto Motomu , Yoshifuji Hajime , Tanaka Masao , Ohmura Koichiro , Mimori Tsuneyo
Published: September 2020

Background

Autoantibodies (auto Abs) and inflammatory mediators (IMs) in cerebrospinal fluid (CSF) may be involved in the pathogenesis of neuropsychiatric systemic lupus erythematosus (NPSLE). It is suggested that anti- N-methyl D-aspartate receptor NR2 subunit (NR2) Ab can develop NP manifestation after blood–brain barrier (BBB) abruption. We also reported the association between NPSLE and CSF anti-U1RNP Ab. In the present study, combined effects of CSF anti-NR2 and anti-U1RNP Abs on IMs in patients with NPSLE were examined.

Methods

CSF samples were collected from 69 patients with NPSLE and 13 non-NPSLE controls. CSF anti-NR2 and anti-U1RNP Abs were determined using ELISA. Levels of IL-6, IL-8, and monokine induced by IFN-γ (MIG) in CSF were measured by quantitative multiplex cytokine analysis.

Results

CSF IL-6 levels were higher in CSF anti-NR2-positive than in CSF anti-NR2-negative patients ( p = 0.003) and non-NPSLE controls ( p = 0.015) and were positively correlated with anti-NR2 titer ( r = 0.42). CSF IL-8 levels were higher in CSF anti-U1RNP-positive than in CSF anti-U1RNP-negative patients ( p = 0.041). CSF MIG levels were more elevated in CSF anti-NR2-positive ( p = 0.043) and anti-U1RNP-positive patients ( p = 0.029) than in non-NPSLE controls. Additionally, in double positive (DP; both anti-NR2 and U1RNP Ab positive) group, CSF IL-6 and MIG levels were significantly higher than in the double negative (DN; both anti-NR2 and U1RNP Ab negative) group. However, combined effect of both Abs on IM elevation and clinical manifestation was not clear.

Conclusions

CSF anti-NR2 and anti-U1RNP Abs have different effects on the elevation of CSF IM levels in patients with NPSLE. Additional effect of anti-U1RNP Abs on anti-NR2 Ab-mediated NP manifestation, however, was not recognized in our study.
Martyrdom, collective memory, and the contested penal authority of racial state institutions
Authors: Buffam Bonar
Published: September 2020

Recent work in postcolonial and border criminologies has called for more extensive consideration of the complex temporal and geographic dimensions of penal authority. This article explicates new dimensions of the modern state’s penal authority by analyzing the execution and remembrance of Mewa Singh, a Sikh anticolonial activist convicted of killing Canadian immigration agent William C Hopkinson in Vancouver in 1914. Because Hopkinson was embedded in racial immigration enforcement against Indian populations as well as intelligence gathering about anticolonial activities, his death galvanized fields of penal authority that spanned the imperatives of the Canadian nation-state and the British Empire. Using archival and observational data, this article tracks how the significance of Mewa’s execution has been articulated through these penal fields as well as through recent practices of memorialization undertaken by local Sikh and Indian communities. Insofar as these mnemonic practices frame Mewa’s death as a sacrifice necessitated by state racism, my analysis illuminates the complex temporal parameters of penal fields of authority as well as the manner in which they are conditioned by racial borders and boundaries.
Patient Characteristics Associated With Readmission to 3 Neurology Services at an Urban Academic Center
Authors: Bondi Steven , Yang Dixon , Croll Leah , Torres Jose
Published: September 2020

Background and Purpose:

Hospital 30-day readmissions in patients with primary neurological problems are not well characterized. We sought to determine patient characteristics associated with readmission across 3 different inpatient neurology services at New York University Langone Hospital.

Methods:

We retrospectively reviewed all 30-day readmissions from the General Neurology, Epilepsy, and Stroke services at NYULH Brooklyn and Manhattan campuses from 2016-2017 and compared them to a random sample of non-readmitted neurology patients. We used univariate analyses to compare demographics, clinical characteristics, disease specific metrics, and discharge factors of non-readmitted and readmitted groups and binomial logistic regression to examine specific variables with adjustment for confounders.

Results:

We included 284 patients with 30-day readmissions and 306 control patients without readmissions matched by discharge location and service. After adjusting for confounders, we found that the following factors were associated with increased readmission risk: a recent hospital encounter increased risk for all services, increased number of medications at discharge, intensive care unit stay, higher length of stay, and prior history of seizure for the General Neurology Service, increased number of medications at discharge for the Epilepsy Service, and active malignancy and higher discharge modified Rankin Scale score for the Stroke Service.

Conclusion:

This study identifies potential risk factors for readmission in patients across multiple neurology services. Further research is needed to establish whether these risk factors hold across multiple institutions.
Plazomicin: a new aminoglycoside in the fight against antimicrobial resistance
Authors: Clark Justin A. , Burgess David S.
Published: September 2020

Objective:

To review the mechanism of action, mechanisms of resistance, in vitro activity, pharmacokinetics, pharmacodynamics, and clinical data for a novel aminoglycoside.

Data sources:

A PubMed search was performed from January 2006 to August 2019 using the following search terms: plazomicin and ACHN-490. Another search was conducted on clinicaltrials.gov for published clinical data. References from selected studies were also used to find additional literature.

Study selection and data extraction:

All English-language studies presenting original research ( in vitro, in vivo, pharmacokinetic, and clinical) were evaluated.

Data synthesis:

Plazomicin has in vitro activity against several multi-drug-resistant organisms, including carbapenem-resistant Enterobacteriaceae. It was Food and Drug Administration (FDA) approved to treat complicated urinary tract infections (cUTIs), including acute pyelonephritis, following phase II and III trials compared with levofloxacin and meropenem, respectively. Despite the FDA Black Box Warning for aminoglycoside class effects (nephrotoxicity, ototoxicity, neuromuscular blockade, and pregnancy risk), it exhibited a favorable safety profile with the most common adverse effects being decreased renal function (3.7%), diarrhea (2.3%), hypertension (2.3%), headache (1.3%), nausea (1.3%), vomiting (1.3%), and hypotension (1.0%) in the largest in-human trial.

Relevance to patient care and clinical practice:

Plazomicin will likely be used in the treatment of multi-drug-resistant cUTIs or in combination to treat serious carbapenem-resistant Enterobacteriaceae infections.

Conclusions:

Plazomicin appears poised to help fill the need for new agents to treat infections caused by multi-drug-resistant Enterobacteriaceae.
STudy of Antithrombotic Treatment after IntraCerebral Haemorrhage: Protocol for a randomised controlled trial
Authors: Larsen Kristin Tveitan , Forfang Elisabeth , Pennlert Johanna , Glader Eva-Lotta , Kruuse Christina , Wester Per , Ihle-Hansen Hege , Carlsson Maria , Berge Eivind , Al-Shahi Salman Rustam , Bruun Wyller Torgeir , Rønning Ole Morten
Published: September 2020

Background and aims

Many patients with prior intracerebral haemorrhage have indications for antithrombotic treatment with antiplatelet or anticoagulant drugs for prevention of ischaemic events, but it is uncertain whether such treatment is beneficial after intracerebral haemorrhage. STudy of Antithrombotic Treatment after IntraCerebral Haemorrhage will assess (i) the effects of long-term antithrombotic treatment on the risk of recurrent intracerebral haemorrhage and occlusive vascular events after intracerebral haemorrhage and (ii) whether imaging findings, like cerebral microbleeds, modify these effects.

Methods

STudy of Antithrombotic Treatment after IntraCerebral Haemorrhage is a multicentre, randomised controlled, open trial of starting versus avoiding antithrombotic treatment after non-traumatic intracerebral haemorrhage, in patients with an indication for antithrombotic treatment. Participants with vascular disease as an indication for antiplatelet treatment are randomly allocated to antiplatelet treatment or no antithrombotic treatment. Participants with atrial fibrillation as an indication for anticoagulant treatment are randomly allocated to anticoagulant treatment or no anticoagulant treatment. Cerebral CT or MRI is performed before randomisation. Duration of follow-up is at least two years. The primary outcome is recurrent intracerebral haemorrhage. Secondary outcomes include occlusive vascular events and death. Assessment of clinical outcomes is performed blinded to treatment allocation. Target recruitment is 500 participants. Trial status: Recruitment to STudy of Antithrombotic Treatment after IntraCerebral Haemorrhage is on-going. On 30 April 2020, 44 participants had been enrolled in 31 participating hospitals. An individual patient–data meta-analysis is planned with similar randomised trials.
Cord blood CD8+ T-cell expansion following granulocyte transfusions eradicates refractory leukemia
Authors: Hiwarkar Prashant , Adams Stuart , Gilmour Kimberly , Nataraj Ramya , Bonney Denise , Poulton Kay , Wynn Robert
Published: September 2020

The action of hematopoietic cell transplantation in controlling leukemia is principally mediated by donor T cells directed against residual recipient malignant cells. However, its utility is limited by graft-versus-host disease (GVHD), where alloreactivity is extended beyond leukemic and marrow cells. In a human/murine chimeric model, we previously showed that the preferential infiltration of cord blood (CB) CD8+ T cells eradicates an Epstein-Barr virus–driven lymphoblastoid tumor without causing xenogeneic GVHD. In the clinic, however, cord blood CD8+ T-cell reconstitution is significantly delayed, and the observation of such a robust antileukemia effect mediated by cord blood CD8+ T cells has not been reported. We describe an observation of very early T-cell expansion in 4 high-risk pediatric leukemia patients receiving third-party, pooled granulocytes after T cell–replete CB transplantation (CBT). The T-cell expansion was transient but robust, including expansion of CD8+ T cells, in contrast to the delayed CD8+ T-cell expansion ordinarily observed after T cell–replete CBT. The CD8+ T cells were polyclonal, rapidly switched to memory phenotype, and had the ability to mediate cytotoxicity. This phenomenon is reproducible, and each patient remains in long-term remission without GVHD. The results suggest that fetal-derived CB CD8+ T cells can be exploited to generate robust antileukemia effects without GVHD.
AMG 701 induces cytotoxicity of multiple myeloma cells and depletes plasma cells in cynomolgus monkeys
Authors: Goldstein Rebecca L. , Goyos Ana , Li Chi-Ming , Deegen Petra , Bogner Pamela , Sternjak Alexander , Thomas Oliver , Klinger Matthias , Wahl Joachim , Friedrich Matthias , Rattel Benno , Lamas Edwin , Min Xiaoshan , Sudom Athena , Farshbaf Mozhgan , Coxon Angela , Balazs Mercedesz , Arvedson Tara
Published: September 2020

Multiple myeloma (MM) is a hematologic malignancy that is characterized by the accumulation of abnormal plasma cells (PCs) in the bone marrow (BM). Patient outcome may be improved with BiTE (bispecific T-cell engager) molecules, which redirect T cells to lyse tumor cells. B-cell maturation antigen (BCMA) supports PC survival and is highly expressed on MM cells. A half-life extended anti-BCMA BiTE molecule (AMG 701) induced selective cytotoxicity against BCMA-expressing MM cells (average half-maximal effective concentration, 18.8 ± 14.8 pM), T-cell activation, and cytokine release in vitro. In a subcutaneous mouse xenograft model, at all doses tested, AMG 701 completely inhibited tumor formation (P < .001), as well as inhibited growth of established tumors (P ≤ .001) and extended survival in an orthotopic MM model (P ≤ .01). To evaluate AMG 701 bioactivity in cynomolgus monkeys, a PC surface phenotype and specific genes were defined to enable a quantitative digital droplet polymerase chain reaction assay (sensitivity, 0.1%). Dose-dependent pharmacokinetic and pharmacodynamic behavior was observed, with depletion of PC-specific genes reaching 93% in blood and 85% in BM. Combination with a programmed cell death protein 1 (PD-1)–blocking antibody significantly increased AMG 701 potency in vitro. A model of AMG 701 binding to BCMA and CD3 indicates that the distance between the T-cell and target cell membranes (ie, the immunological synapse) is similar to that of the major histocompatibility complex class I molecule binding to a T-cell receptor and suggests that the synapse would not be disrupted by the half-life extending Fc domain. These data support the clinical development of AMG 701.
Leishmania infection induces a limited differential gene expression in the sand fly midgut
Authors: Coutinho-Abreu Iliano V. , Serafim Tiago Donatelli , Meneses Claudio , Kamhawi Shaden , Oliveira Fabiano , Valenzuela Jesus G.
Published: September 2020

Background

Sand flies are the vectors of Leishmania parasites. To develop in the sand fly midgut, Leishmania multiplies and undergoes various stage differentiations giving rise to the infective form, the metacyclic promastigotes. To determine the changes in sand fly midgut gene expression caused by the presence of Leishmania, we performed RNA-Seq of uninfected and Leishmania infantum-infected Lutzomyia longipalpis midguts from seven different libraries corresponding to time points which cover the various Leishmania developmental stages.

Results

The combined transcriptomes resulted in the de novo assembly of 13,841 sand fly midgut transcripts. Importantly, only 113 sand fly transcripts, about 1%, were differentially expressed in the presence of Leishmania parasites. Further, we observed distinct differentially expressed sand fly midgut transcripts corresponding to the presence of each of the various Leishmania stages suggesting that each parasite stage influences midgut gene expression in a specific manner. Two main patterns of sand fly gene expression modulation were noted. At early time points (days 1–4), more transcripts were down-regulated by Leishmania infection at large fold changes (> 32 fold). Among the down-regulated genes, the transcription factor Forkhead/HNF-3 and hormone degradation enzymes were differentially regulated on day 2 and appear to be the upstream regulators of nutrient transport, digestive enzymes, and peritrophic matrix proteins. Conversely, at later time points (days 6 onwards), most of the differentially expressed transcripts were up-regulated by Leishmania infection with small fold changes (< 32 fold). The molecular functions of these genes have been associated with the metabolism of lipids and detoxification of xenobiotics.

Conclusion

Overall, our data suggest that the presence of Leishmania produces a limited change in the midgut transcript expression profile in sand flies. Further, Leishmania modulates sand fly gene expression early on in the developmental cycle in order to overcome the barriers imposed by the midgut, yet it behaves like a commensal at later time points where a massive number of parasites in the anterior midgut results only in modest changes in midgut gene expression.
Gel-based proteomic map of Arabidopsis thaliana root plastids and mitochondria
Authors: Grabsztunowicz Magda , Rokka Anne , Farooq Irum , Aro Eva-Mari , Mulo Paula
Published: September 2020

Background

Non-photosynthetic plastids of plants are known to be involved in a range of metabolic and biosynthetic reactions, even if they have been difficult to study due to their small size and lack of color. The morphology of root plastids is heterogeneous and also the plastid size, density and subcellular distribution varies depending on the cell type and developmental stage, and therefore the functional features have remained obscure. Although the root plastid proteome is likely to reveal specific functional features, Arabidopsis thaliana root plastid proteome has not been studied to date.

Results

In the present study, we separated Arabidopsis root protein fraction enriched with plastids and mitochondria by 2D-PAGE and identified 84 plastid-targeted and 77 mitochondrion-targeted proteins using LC-MS/MS. The most prevalent root plastid protein categories represented amino acid biosynthesis, carbohydrate metabolism and lipid biosynthesis pathways, while the enzymes involved in starch and sucrose metabolism were not detected. Mitochondrion-targeted proteins were classified mainly into the energetics category.

Conclusions

This is the first study presenting gel-based map of Arabidopsis thaliana root plastid and mitochondrial proteome. Our findings suggest that Arabidopsis root plastids have broad biosynthetic capacity, and that they do not play a major role in a long-term storage of carbohydrates. The proteomic map provides a tool for further studies to compare changes in the proteome, e.g. in response to environmental cues, and emphasizes the role of root plastids in nitrogen and sulfur metabolism as well as in amino acid and fatty acid biosynthesis. The results enable taking a first step towards an integrated view of root plastid/mitochondrial proteome and metabolic functions in Arabidopsis thaliana roots.
Evaluation of lateral flow immunochromatographic assay for diagnostic accuracy of cryptococcosis
Authors: Xie Li-Min , Lin Geng-Ling , Dong Hao-Neng , Liao Ying-Xia , Liu Ye-Ling , Qin Jian-Feng , Guo Xu-Guang
Published: September 2020

Background

Cryptococcus is a conditional pathogenic fungus causing cryptococcosis, which is one of the most serious fungal diseases faced by humans. Lateral flow immunochromatographic assay (LFA) is successfully applied to the rapid detection of cryptococcal antigens.

Methods

Studies were retrieved systematically from the Embase, PubMed, Web of Science, and Cochrane Library before July 2019. The quality of the studies was assessed by Review Manager 5.0 based on the Quality Assessment of Diagnostic Accuracy Study guidelines. The extracted data from the included studies were analyzed by Meta-DiSc 1.4. Stata 12.0 software was used to detect the publication bias.

Results

A total of 15 articles with 31 fourfold tables were adopted by inclusion and exclusion criteria. The merged sensitivity and specificity in serum were 0.98 and 0.98, respectively, and those in the cerebrospinal fluid were 0.99 and 0.99, respectively.

Conclusions

Compared to the urine and other samples, LFA in serum and cerebrospinal fluid is favorable evidence for the diagnosis of cryptococcosis with high specificity and sensitivity.
Early clinical predictors for the prognosis of invasive pneumococcal disease
Authors: Wu Shuiyan , Guo Xubei , Xu Zhong , Han Meilin , Huang Lili , Tao Yunzhen , Li Ying , Li Yanhong , Zhang Tao , Bai Zhenjiang
Published: September 2020

Background

Risk factors related to mortality due to invasive pneumococcal disease (IPD) have been unveiled previously, but early clinical manifestations of IPD based on prognosis remain uncovered.

Methods

The demographic characteristics, clinical features, serotype, antibiotic susceptibility, and outcomes of 97 hospitalized children with laboratory-confirmed IPD from Suzhou, China, were collected and analyzed retrospectively.

Results

The median age was 0.69 (0.49–1.55) years in the non-survivor group compared with 2.39 (0.90–3.81) years in the survivor group. The mortality of 97 children with laboratory-confirmed IPD was 17.5% (17/97), and 53.6% of them were aged less than 2 years. Pathogens were mainly from the blood and cerebrospinal fluid, and sepsis was the most frequent type. Statistically significant differences were found in hyperpyrexia, vomiting, anorexia, lethargy, poor perfusion of extremities, Hb level, and Plt count between the nonsurvival and survival groups. Further, the multivariate regression analysis showed that early signs, including hyperpyrexia, vomiting, anorexia, lethargy, and poor perfusion of extremities, were independent risk factors for the in-hospital mortality of children with laboratory-confirmed IPD. The mortality was also associated with antimicrobial sensitivity in pneumococcal isolates. The microbes in 1/17 (5.9%) children who were prescribed an antibiotic showed antimicrobial sensitivity in the nonsurvival group, compared with 21/80 (26.3%) children who survived. The most common serotypes identified were 6B (35.3%, 6/17), 14 (23.5%, 4/17), 19F (23.5%, 4/17), 19A (5.9%, 1/17), 23F (5.9%, 1/17), and 20 (5.9%, 1/17) in the nonsurvival group. The coverage of IPD serotypes of the 7-valent pneumococcal conjugate vaccine (PCV7) was 88.2% (15/17), while that of the 13-valent S. pneumoniae vaccine (PCV13) was 94.1% (16/17) of the coverage in the nonsurvival group.

Conclusions

Recurrent hyperpyrexia, vomiting, anorexia, lethargy, and poor perfusion of extremities in the early stage were independent predictors for the in-hospital mortality of children with laboratory-confirmed IPD. Appropriate use of antibiotics and PCV immunization were the keys to improve the outcome of IPD.
A group-based mental health intervention for young people living with HIV in Tanzania: results of a pilot individually randomized group treatment trial
Authors: Dow Dorothy E. , Mmbaga Blandina T. , Gallis John A. , Turner Elizabeth L. , Gandhi Monica , Cunningham Coleen K. , O’Donnell Karen E.
Published: September 2020

Background

Increasing numbers of young people living with HIV (YPLWH) have unaddressed mental health challenges. Such challenges are associated with poor antiretroviral therapy (ART) adherence and high mortality. Few evidence-based mental health interventions exist to improve HIV outcomes among YPLWH.

Methods

This pilot group treatment trial individually randomized YPLWH from two clinical sites in Tanzania, evaluated acceptability, feasibility, and preliminary effectiveness of a mental health intervention, Sauti ya Vijana (SYV; The Voice of Youth), was compared to the local standard-of-care (SOC) for improving ART adherence and virologic suppression. Enrolled YPLWH were 12–24 years of age and responded to mental health and stigma questionnaires, self-reported adherence, objective adherence measures (ART concentration in hair), and HIV RNA at baseline and 6-months (post-intervention). Feasibility and acceptability were evaluated, and potential effectiveness was assessed by comparing outcomes between arms using mixed effects modeling.

Results

Between June 2016 and July 2017, 128 YPLWH enrolled; 105 were randomized and 93 (55 in SYV) followed-up at 6-months and were thereby included in this analysis. Mean age was 18.1 years; 51% were female; and 84% were HIV-infected perinatally. Attendance to intervention sessions was 86%; 6-month follow-up was 88%, and fidelity to the protocol approached 100%. Exploratory analyses of effectiveness demonstrated self-reported adherence improved by 7.3 percentage points (95% CI: 2.2, 12.3); and the pooled standard deviation for all ART concentration values increased by 0.17 units (95% CI: − 0.52, 0.85) in the SYV arm compared to SOC. Virologic suppression rates (HIV RNA < 400 copies/mL) at baseline were 65% in both arms but increased to 75% in the SYV arm while staying the same in the SOC arm (RR 1.13; 95% CI: 0.94, 1.36).

Conclusions

YPLWH often have poor HIV outcomes, making interventions to improve outcomes in this population critical. This pilot trial of the Tanzania-based SYV intervention demonstrated trends towards improvement in ART adherence and virologic outcomes among YPLWH, supporting efforts to scale the intervention into a fully-powered effectiveness trial.

Trial registration

ClinicalTrials.gov Identifier: NCT02888288. Registered August 9, 2016. Retrospectively registered as first participant enrolled June 16, 2016.
Hypertension and diabetes in Zanzibar – prevalence and access to care
Authors: Jorgensen Jutta M. Adelin , Hedt Kaya Helene , Omar Omar Mwalim , Davies Justine I.
Published: September 2020

Background

Cardiovascular diseases are among the most common causes of hospital admissions and deaths in Zanzibar. This study assessed prevalence of, and antecedent factors and care access for the two common cardiovascular risk factors, hypertension and diabetes, to support health system improvements.

Methods

Data was from a population based nationally representative survey. Prevalence of hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg or a self-reported diagnosis of hypertension; diabetes was defined as a fasting blood glucose ≥6.1 mmol/L or a self-reported diagnosis of diabetes. Care-cascades for hypertension and diabetes were created with four stages: being tested, diagnosed, treated, and achieving control.

Multivariable logistic regression models were constructed to evaluate individual-level factors – including symptoms of mental illness - associated with having hypertension or diabetes, and with progressing through the hypertension care cascade. Whether people at overt increased risk of hypertension or diabetes (defined as > 50 years old, BMI > 30 kg/m2, or currently smoking) were more likely to be tested was assessed using chi squared.

Results

Prevalence of hypertension was 33.5% (CI 30.6–36.5). Older age (OR 7.7, CI 4.93–12.02), some education (OR 0.6, CI 0.44–0.89), obesity (OR 3.1, CI 2.12–4.44), and raised fasting blood glucose (OR 2.4, CI 2.38) were significantly independently associated with hypertension.

Only 10.9% (CI 8.6–13.8) of the entire hypertensive population achieved blood pressure control, associated factors were being female (OR 4.8, CI 2.33–9.88), formally employed (OR 3.0, CI 1.26–7.17), and overweight (OR 2.5, CI 1.29–4.76).

The prevalence of diabetes was 4.4% (CI 3.4–5.5), and associated with old age (OR 14.1, CI 6.05–32.65) and almost significantly with obesity (OR 2.1, CI 1.00–4.37). Only 11.9% (CI 6.6–20.6) of the diabetic population had achieved control.

Individuals at overt increased risk were more likely to have been tested for hypertension (chi2 19.4) or diabetes (chi2 33.2) compared to the rest of the population.

Symptoms of mental illness were not associated with prevalence of disease or progress through the cascade.

Conclusion

High prevalence of hypertension and suboptimal management along the care cascades indicates a large unmet need for hypertension and diabetes care in Zanzibar.
Disparities in end-of-life care, expenditures, and place of death by health insurance among cancer patients in China: a population-based, retrospective study
Authors: Li Zhong , Hung Peiyin , He Ruibo , Tu Xiaoming , Li Xiaoming , Xu Chengzhong , Lu Fangfang , Zhang Pei , Zhang Liang
Published: September 2020

Background

Disparities in the utilization, expenditures, and quality of care by insurance types have been well documented. Such comparisons have yet to be investigated in end-of-life (EOL) settings in China, where public insurance covers over 95% of the Chinese population. This study examined the associations between health insurance and EOL care in the last six months of life: outpatient visits, emergency department (ED) visits, inpatient services, intensive care unit (ICU) admissions, expenditures, and place of death among the cancer patients.

Methods

A total of 398 patients diagnosed with cancer who survived more than 6 months after diagnosis and died from July 2015 to June 2017 in urban Yichang, China, were included. Descriptive analysis and multivariate regression models were used to investigate the bivariate and independent associations, respectively, between health insurance with EOL healthcare utilization, expenditures and place of death.

Results

Urban Employee Basic Medical Insurance (UEBMI) beneficiaries visited EDs more frequently than Urban Resident-based Basic Medical Insurance (URBMI) and New Rural Cooperative Medical Scheme (NRCMS) beneficiaries (marginal effects [95% Confidence Interval]: 2.15 [1.81–2.48] and 1.92 [1.59–2.26], respectively). NRCMS and UEBMI beneficiaries had more hospitalizations than URBMI beneficiaries (1.01 [0.38–1.64] and 0.71 [0.20–1.22], respectively). Compared to URBMI beneficiaries, NRCMS beneficiaries and UEBMI beneficiaries had ¥15,722 and ¥43,241 higher expenditures. Similarly, UEBMI beneficiaries were most likely to die in hospitals, followed by NRCMS (UEBMI vs. NRCMS: 0.23 [0.11–0.36]) and URBMI (UEBMI vs. URBMI: 0.67 [0.57–0.78]) beneficiaries.

Conclusions

The disproportionately lower utilization of EOL care among NRCMS and URBMI beneficiaries, compared to UEBMI beneficiaries, raised concerns regarding quality of EOL care and financial burdens of NRCMS and URBMI beneficiaries. Purposive hospice care intervention might be warranted to address EOL care for these beneficiaries in China.
Sense of coherence, occupational stressors, and mental health among Japanese high school teachers in Nagasaki prefecture: a multiple regression analysis
Authors: Kuwato Miho , Hirano Yuko
Published: September 2020

Background

International research has indicated that teachers have an increased risk of mental disorders and work-related stress, compared with those working in other fields. In Japan, the deterioration of teachers’ mental health has recently become a serious social issue. Teaching is a high-stress occupation, and job stress can affect teachers’ physical and mental health. This study aimed to determine how sense of coherence, job satisfaction, and workplace social support contribute to the mental health status of public and private high school teachers in Nagasaki Prefecture, Japan.

Methods

The analytic sample comprised 370 high school teachers from eight public and three private schools in Nagasaki Prefecture who answered an anonymous survey comprising the General Health Questionnaire (GHQ-12), which is a measure of mental health status, and questions regarding sociodemographic characteristics, occupational stressors, workplace social support systems, job satisfaction, and sense of coherence. A multiple regression analysis was conducted to identify the predictors of mental health.

Results

The survey was sent to 681 people, of whom 370 responded and were included in the analysis (effective response rate: 54.3%). The analysis indicated that sense of coherence was the strongest predictor of mental health (β = −.391, p < .0001), followed by workload stressors (β = .260, p < .0001), low job control (β = .099, p = .021), and job satisfaction (β = −.088, p = .040).

Conclusion

The results suggest that a greater sense of coherence and job satisfaction are associated with greater mental health. Meanwhile, workload stressors and low job control undermined mental health status.
Biomechanical comparison of three minimally invasive fixations for unilateral pubic rami fractures
Authors: Zhao Yong , Ma Yupeng , Zou Dexin , Sun Xiujiang , Cheng Gong , Lian Wei , Dong Shengjie , Zhao Yuchi , Qu Wenqing , Wu Hao
Published: September 2020

Background

To compare the mechanical characteristics of a percutaneous superior pubic intramedullary screw, percutaneous bridging plate and percutaneous screw-rod system of the anterior ring for the treatment of unilateral vertical pubic fractures to provide a reference for clinical application.

Methods

A finite element model of pelvic anterior ring injury (unilateral vertical pubic fracture) was produced. The fractures were fixed with a percutaneous superior pubic intramedullary screw, percutaneous bridging plate and percutaneous screw-rod system of the anterior ring and their combinations in 5 types of models. The fracture stabilities under vertical, bilateral and anterior-posterior load were quantified and compared based on the displacement of the hip joints’ midpoint as quantificational index of fracture stability.

Results

In the condition of bilateral and anterior-posterior load, the vertical, bilateral and anterior-posterior displacements of the hip joints’ midpoint of different models were significantly different respectively. In general, the displacements of the 5 pelvic anterior ring fixations were ranked from maximum to minimum as follows: bridging plate, pelvic anterior screw-rod system, combination of bridging plate and pelvic anterior screw-rod system, superior pubic intramedullary screw and combination of superior pubic intramedullary screw and pelvic anterior screw-rod system.

Conclusion

For the fixation in unilateral pubic fractures of pelvic ring injury, the percutaneous superior pubic intramedullary screw is optimal, the percutaneous pelvic anterior screw-rod system is the second choice, and percutaneous bridging plate ranks the third. The percutaneous pelvic anterior screw-rod system can significantly increase fixation stability of the percutaneous superior pubic intramedullary screw and the percutaneous bridging plate.
Collaborative model of care between Orthopaedics and allied healthcare professionals trial (CONNACT) – a feasibility study in patients with knee osteoarthritis using a mixed method approach
Authors: Tan Bryan Yijia , Ding Benjamin Tze Keong , Pereira Michelle Jessica , Skou Soren Thorgaard , Thumboo Julian , Car Josip
Published: September 2020

Background

Osteoarthritis is a leading cause of global disability resulting in significant morbidity and cost to the healthcare system. Current guidelines recommend lifestyle changes such exercises and weight loss as first line treatment prior to surgical consideration. Our current model of care is inefficient with suboptimal allied health intervention for effective behaviour changes. A 12-week community based, individualized, multidisciplinary new model of care for knee osteoarthritis was developed in light of current deficiencies.

Methods

The primary aim of this study was to determine the feasibility of a full randomized controlled trial evaluating this new model of care using pre-defined progression criteria. The secondary aim was to optimize the intervention and study design through a process evaluation. A pilot exploratory, parallel arm, single blinded randomized trial design using a mixed method approach was utilized. Progression criteria for a full trial including key domains of patient recruitment and retention, outcome measure acceptability and improvement, adverse events were developed. The primary outcome measure was the Knee Injury and Osteoarthritis Outcome Score (KOOS) at baseline and 12-weeks. Secondary outcomes included quality of life, functional and psychological assessments. Semi-structured interviews were conducted with the patients at 12-weeks.

Results

20 patients (3 males, 17 females) were randomized (10 intervention, 10 control). Intervention arm patients reported better improvements in their knee function, quality of life, psychological outcome, dietary improvement and weight loss compared to the control arm at 12-weeks. Semi-structured interviews revealed several themes pertaining to feasibility and intervention optimization. 5 out of the 6 progression criteria’s domains were met (recruitment criteria not met).

Conclusion

This pilot has demonstrated the feasibility of a full randomized control trial investigating the potential effectiveness of the new proposed model of care for knee osteoarthritis using pre-defined progression criteria and process evaluation. Results from the qualitative study were used to modify and improve the intervention content, delivery model and study design for a large effectiveness-implementation hybrid randomized control trial that is currently underway.

Trial registration

Retrospectively registered on 18 January 2019 athttp://clinicaltrial.govID:NCT03809975.