bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiological pattern of maxillofacial fractures in northern China
Authors: Xiao-Dong Liu , Qiu-Xu Wang , Wei-Xian Liu
Published: March 2020

This study was performed to examine the epidemiological features of maxillofacial fracture, including the incidence, causes, age and sex distribution, methods of treatment, and prognosis, in a local area.

A retrospective study was performed to investigate the epidemiological characteristics of 829 patients with maxillofacial fractures treated in a hospital in northern China from August 2011 to July 2019. Sex, age, etiology, fracture site, and treatment method were obtained from the medical records.

The average age of all 829 patients was 36.1 years, and most patients were in the 20- to 29-year age group. The male to female ratio was 3.04:1.00. Traffic accidents were the main cause of the maxillofacial fractures. The mandible was the most commonly fractured bone, and the parasymphysis was the most frequently affected site. Head injury was the most common associated injury. Open surgery with internal fixation was the first-choice treatment for most cases.

Traffic accidents were the main cause of maxillofacial fractures, followed by falling. Open surgery with internal fixation was the leading treatment choice. Both functional and esthetic outcomes should be considered in the treatment of maxillofacial fractures
Determine what to measure and how to measure in clinical trials for the treatment of pressure injury
Authors: Shi Jiyuan , Gao Ya , Si Liangliang , Ma Xinping , Liu Ming , Liao Xiang , Zhang Junmei
Published: March 2020

Background:

A core outcome set (COS) is an agreed minimum set of outcomes that should be reported in all clinical trials in specific areas of health care. A considerable amount of trials did not report essential outcomes or outcomes measurement methods, which makes it challenging to evaluate the efficacy and safety of treatment strategies for pressure injury (PI) and produced significant heterogeneity of reported outcomes. It is necessary to develop a COS, which can be used for clinical trials in PI treatment.

Methods/Design:

The development of this COS will be guided by an advisory group composed of clinicians, senior nurses, patients, and methodologists. We will search six databases and 2 registry platforms to identify currently reported PI treatment outcomes and outcome measurement instruments in randomized controlled trials, meta-analysis, and systematic reviews. We will also conduct a semi-structured interview with clinicians, nurses, and adult PI patients to collect their opinions on important outcomes. Each outcome of the initial list generated from systematic review and interviews will be scored and reach a consensus through two rounds of international Delphi survey with all key stakeholders. A face-to-face consensus meeting with key stakeholders will be conducted to finish a final COS and recommend measurement instruments for each outcome.

Results:

We will develop a COS that should be reported in future clinical trials to evaluate the effectiveness of PI treatment.

Discussion:

The COS will follow current guidance to develop a high-quality COS in the field of PI treatment to reduce heterogeneity in trial reporting, facilitate valid comparisons of new therapies, and improve the quality of clinical trials.
Diabetes mellitus as a risk factor for retinal vein occlusion
Authors: Wang Yun , Wu Shanjun , Wen Feng , Cao Qixin
Published: March 2020

Retinal vein occlusion (RVO) is the second most common etiology for vision loss. There is contrasting evidence on the association between diabetes mellitus (DM) and the risk of RVO. We performed a meta-analysis of published articles before October 31, 2019, to estimate a pooled odds ratio for the association between DM and RVO, including central and branch RVO by a fixed or random effects model. We identified 37 publications from 38 studies (1 publication was from 2 studies), published between 1985 and 2019. In total, 148,654 cases and 23,768,820 controls were included in this meta-analysis. The results of pooled analysis for all 37 publications (or 38 studies) showed a significant association between DM and the risk of RVO (OR = 1.68, 95% CI: 1.43–1.99). Subgroup analysis indicated that DM was significantly associated with CRVO (OR = 1.98, 95% CI: 1.29–3.03, I2 = 67.9%), but not significantly associated with BRVO (OR = 1.22, 95% CI: 0.95–1.56, I2 = 64.1%). In conclusion, the result of present meta-analysis suggested that DM is a risk factor for RVO. More well-designed studies on the relationship between RVO and DM should be undertaken in the future.
Low intra-abdominal pressure and deep neuromuscular blockade laparoscopic surgery and surgical space conditions
Authors: Wei Yiyong , Li Jia , Sun Fude , Zhang Donghang , Li Ming , Zuo Yunxia
Published: March 2020

Background:

Low intra-abdominal pressure (IAP) and deep neuromuscular blockade (NMB) are frequently used in laparoscopic abdominal surgery to improve surgical space conditions and decrease postoperative pain. The evidence supporting operations using low IAP and deep NMB is open to debate.

Methods:

The feasibility of the routine use of low IAP +deep NMB during laparoscopic surgery was examined. A meta-analysis is conducted with randomized controlled trials (RCTs) to compare the influence of low IAP + deep NMB vs. low IAP + moderate NMB, standard IAP +deep NMB, and standard IAP + moderate NMB during laparoscopic procedures on surgical space conditions, the duration of surgery and postoperative pain. RCTs were identified using the Cochrane, Embase, PubMed, and Web of Science databases from initiation to June 2019. Our search identified 9 eligible studies on the use of low IAP + deep NMB and surgical space conditions.

Results:

Low IAP + deep NMB during laparoscopic surgery did not improve the surgical space conditions when compared with the use of moderate NMB, with a mean difference (MD) of −0.09 (95% confidence interval (CI): −0.55–0.37). Subgroup analyses showed improved surgical space conditions with the use of low IAP + deep NMB compared with low IAP + moderate NMB, (MD = 0.63 [95% CI:0.06–1.19]), and slightly worse conditions compared with the use of standard IAP + deep NMB and standard IAP + moderate NMB, with MDs of −1.13(95% CI:−1.47 to 0.79) and −0.87(95% CI:−1.30 to 0.43), respectively. The duration of surgery did not improve with low IAP + deep NMB, (MD = 1.72 [95% CI: −1.69 to 5.14]), and no significant reduction in early postoperative pain was found in the deep-NMB group (MD = −0.14 [95% CI: −0.51 to 0.23]).

Conclusion:

Low IAP +deep NMB is not significantly more effective than other IAP +NMB combinations for optimizing surgical space conditions, duration of surgery, or postoperative pain in this meta-analysis. Whether the use of low IAP + deep NMB results in fewer intraoperative complications, enhanced quality of recovery or both after laparoscopic surgery should be studied in the future.
5-Aminosalicylic acid for treatment of irritable bowel syndrome
Authors: Cheng Wenyuan , Li Jing , Liu Xiaoli
Published: March 2020

Background:

The global prevalence of irritable bowel syndrome (IBS) is estimated to be as high as 15%, and it is estimated that IBS has a prevalence of approximately 10% to 20% in Western countries. Some trials showed mesalazine (5-aminosalicylic acid [5-ASA]) might be effective for IBS, but the results still need to be confirmed. Hence, this meta-analysis is designed to assess the efficacy and safety of mesalazine for IBS in adults and children.

Methods:

We conducted a comprehensive database search for randomized trials of mesalazine for IBS in PubMed, EMBASE, and the Cochrane Library. The search strategy was performed from inception to December 31, 2019, without restrictions on publication status and language. The reference lists of the included articles were also checked to identify additional studies for potential inclusion. Two reviewers will independently review all literature for inclusion and assess their risk of bias. Two reviewers will independently extract data from eligible studies based on a pre-designed standardized form. Any disagreements will be resolved by consensus. Stata SE 15.0 software will be used for data synthesis.

Results:

This is the first meta-analysis focusing on mesalazine for the treatment of IBS. We predict it will provide high-quality synthesis on existing evidence for IBS and a relatively comprehensive reference for clinical practice and development of clinical guidelines for IBS.

Conclusion:

This protocol outlined the significance and methodological details of a systematic review of mesalazine for IBS. This ongoing meta-analysis will provide high-quality synthesis on existing evidence for IBS.

Registration:

The meta-analysis has been prospectively registered in PROSPERO (CRD42019147860).
Metastatic serous borderline tumor with micro-invasive ovarian carcinoma presenting as a breast lump
Authors: Dong Fengge , Xie Xiao , Wei Xue , Jiao Miao-miao , Duan Junwu , Pan Linlin , Bi Lirong , Fan Zhimin , Yang Ming
Published: March 2020

Rationale:

Breast metastasis from serous borderline tumor with micro-invasive carcinoma of ovary is a very rare condition. The breast lump as the only clinical presentation is rarely seen in ovarian carcinoma, which may lead to be misdiagnosed, and the mechanism of breast metastasis from ovarian tumors in early stage still needs to be explored. Differentiation from primary breast cancer and extramammary malignancy is crucial because the treatment and prognosis are significantly different.

Patient concerns:

A 33-year-old female presented with a painless, movable, 1.0 × 1.0 cm lump in the upper outer quadrant of the right breast for a month.

Diagnoses:

Breast metastasis of serous borderline tumor with micro-invasive ovarian carcinoma confirmed by pathology and immunohistochemistry.

Interventions:

The patient underwent lumpectomy, bilateral ovarian tumor stripping operation and prophylactic chemotherapy.

Outcomes:

No signs of recurrence have been detected in 1.5 years of follow-up.

Lessons:

Distant metastasis may occur in early stage of ovarian carcinoma. It is important to determine the origin of the primary tumor and develop an effective treatment strategy for patients. Imaging findings and pathological diagnostic criteria are important to accurately differentiate between metastasis and primary breast lesions, which may improve the patient's outcomes.
Emphysematous prostatic abscess due to candidiasis
Authors: Li Zhongyi , Wen Jiaming , Zhang Nan
Published: March 2020

Rationale:

The emphysematous prostatic abscess is a rare but potentially life-threatening clinical condition. The early diagnosis is difficult due to nonspecific symptoms.

Patient concerns:

A 72-year-old man with poorly controlled diabetes mellitus was admitted to hospital because of dysuria and acute urine retention. He had a refractory fever after admission.

Diagnoses:

The diagnosis of emphysematous prostatic abscess was confirmed by culture of catheterized urine and pelvic CT.

Interventions:

We tried to give antimicrobial treatment and control of blood glucose at first, but the infection could not be controlled by antibiotic therapy and control of blood glucose. TRUS-guided aspiration was performed, but obviously not adequate for abscess drainage and the abscess progressed. TUR was then performed and the infection was gradually controlled.

Outcomes:

Pelvic CT scan 1 month after discharge showed complete resolution of the EPA.

Lessons:

Given the poor conservative treatment effect of emphysematous prostatic abscesses, CT or TRUS should be performed in the patients with suspected diagnosis. Early and appropriate drainage with proper antibiotic therapy is important to achieve a favorable outcome.
Low myocardial transcript variant alt-a of cyclin dependent kinase inhibitor p21 expression differentiates hypothermia from cardiac/respiratory causes of death
Authors: Kaija Helena , Pakanen Lasse , Porvari Katja
Published: March 2020

Gene expressions in the myocardium have been shown to vary between different causes of death, which can be utilized in the recognition of varied processes. Our previous work with a limited number of cases showed a high messenger ribonucleic acid expression of the transcript variant alt-a of cyclin dependent kinase inhibitor p21 (p21 alt-a) in chronic cardiac ischemia deaths and a low expression in hypothermia deaths and acute myocardial ischemia deaths. In present work, p21 alt-a expression in the myocardium of human cadavers was calculated using glyceraldehyde-3-phosphate dehydrogenase (GAPDH) as reference gene. In this collection of 143 samples, the p21 alt-a expression was significantly lower in hypothermia than in chronic cardiac ischemic heart disease with (P < .001) or without (P < .001) acute myocardial infarction and in other cardiac and respiratory disease deaths (P < .000). Chronic ischemic heart disease in hypothermia cases did not increase the expression. The p21 alt-a expression did not correlate with postmortem interval, quality of RNA or with the age of the deceased. The p21 alt-a referenced to GAPDH expression in cadaver myocardium has apparent potential as a marker distinguishing between hypothermia and cardiac/respiratory diseases as causes of death.
Association between biologic disease modifying anti-rheumatic drugs and incident hypertension in patients with rheumatoid arthritis
Authors: Kim Seong-Kyu , Kwak Sang Gyu , Choe Jung-Yoon
Published: March 2020

There has been some debate between biologic disease modifying anti-rheumatic drugs (bDMARDs) treatment and hypertension (HTN) in rheumatoid arthritis (RA). The aim of this study was to determine the effect of bDMARDs on the development of HTN in patients with RA.

A total of 996 patients eligible for analysis were recruited from the Korean College of Rheumatology Biologics & Targeted Therapy (KOBIO) registry from 2012 to 2018. The bDMARDs were tumor necrosis factor (TNF) inhibitors, abatacept, and tocilizumab. The cDMARDs included methotrexate, hydroxychloroquine, and leflunomide. The incidence rate and 95% confidence interval of HTN were estimated using the Kaplan–Meier method. Hazard ratio (HR) of risk factors associated with hypertension was assessed by cox proportional hazard model analysis.

Among the 996 patients, 62 patients (6.2%) were newly diagnosed with HTN. There were differences in incidence rate of HTN among conventional DMARDs (cDMARDs), TNF inhibitors, tocilizumab, and abatacept during the follow-up period (P = .015). Kaplan–Meier analysis showed that there was a significant difference in incident HTN only between cDMARDs and tocilizumab (P = .001). Systolic blood pressure and positive rheumatoid factor were associated with development of HTN (HR = 1.049, P = .016 and HR = 1.386, P = .010, respectively). Cox proportional hazard model analysis showed no difference in the development of HTN between bDMARDs and cDMARDs in RA.

This study showed that bDMARDs treatment might not increase risk of incident HTN in patients with RA, compared to cDMARDs.
Performance and cutoffs for liver fibrosis staging of a two-dimensional shear wave elastography technique
Authors: Ferraioli Giovanna , Maiocchi Laura , Dellafiore Carolina , Tinelli Carmine , Above Elisabetta , Filice Carlo
Published: March 2020

Objectives:

To assess performance and cutoffs of the 2-dimensional shear wave elastography technique available on the Aplio i800 ultrasound system (Canon Medical Systems, Japan), using transient elastography as reference standard, and to assess the correlation of shear-wave-speed dispersion with liver fibrosis or steatosis.

Methods:

This was a single-center cross-sectional study. The correlations between values obtained with transient elastography and 2-dimensional-shear wave elastography, and between shear-wave-speed dispersion and fibrosis or steatosis, were assessed with Pearson’s r. The diagnostic performance of the 2-dimensional-shear wave elastography for staging significant fibrosis and severe fibrosis compared to transient elastography was assessed using the area under the receiver operating characteristic curve analysis.

Results:

Three hundred sixty-seven patients (198 males and 169 females) were studied. There was a high correlation between 2-dimensional-shear wave elastography and transient elastography (r = 0.87, P < 0.0001). The area under the receiver operating characteristics of 2-dimensional-shear wave elastography for staging significant fibrosis (F2) and severe fibrosis (F3–F4), respectively, were 0.97 (95% confidence interval, 0.91–0.98) and 0.97 (95% confidence interval, 0.95–0.99). The best cutoffs for significant fibrosis and severe fibrosis, respectively, were > 7 and > 9 kPa. Shear-wave-speed dispersion showed a high correlation with fibrosis (r = 0.85, P < 0.0001), whereas there was a very weak correlation with steatosis.

Conclusions:

The results of this study show that this 2-dimensional-shear wave elastography technique is accurate for staging liver fibrosis. Shear-wave-speed dispersion is highly correlated with liver fibrosis but not with steatosis.
Hereditary hemochromatosis and risk of joint replacement surgery: a systematic review and meta-analysis
Authors: Wijarnpreecha Karn , Aby Elizabeth S. , Panjawatanan Panadeekarn , Kroner Paul T. , Harnois Denise M. , Palmer William C. , Ungprasert Patompong
Published: March 2020

Background/Objectives:

Arthritis is a known manifestation of hereditary hemochromatosis. However, whether patients with hereditary hemochromatosis have an increased risk of having joint replacement surgery compared to the general population is still unknown. This meta-analysis was conducted to better characterize this risk.

Methods:

A comprehensive literature review was conducted utilizing the MEDLINE and EMBASE databases through September 2019 to identify all cohort studies that compared prevalence or incidence of joint replacement surgery (hip, ankle, or knee) between patients with hereditary hemochromatosis and individuals without hereditary hemochromatosis. Effect estimates from each study were extracted and combined together using the random-effect, generic inverse variance method of DerSimonian and Laird.

Results:

A total of five studies with 1 293 407 participants fulfilled the eligibility criteria and were included in the meta-analysis. Overall, the risk of having joint replacement surgery was significantly increased in patients with hereditary hemochromatosis compared to individuals without hereditary hemochromatosis with the pooled relative risk (RR) of 3.32 [95% confidence interval (CI), 1.60–6.86; I
2 88%]. Analysis by joint found a significantly increased risk of having hip and ankle replacement surgery among patients with hereditary hemochromatosis compared with the pooled RR of 2.62 (95% CI, 2.09–3.30; I
2 47%) and 8.94 (95% CI, 3.85–20.78; I
2 14%), respectively. The risk of having knee replacement surgery was also increased but was not statistically significant (pooled RR 1.57, 95% CI, 0.83–2.98; I
2 66%).

Conclusions:

A significantly increased risk of needed joint replacement surgery among patients with hereditary hemochromatosis compared to patients without hereditary hemochromatosis was demonstrated in this study. Further studies are required to determine whether this association is causal.
Diamond-Blackfan Anemia: 2 Cases With a Twist
Authors: Kossiva Lydia , Markande Aikaterini , Vagianou Fotini , Delaporta Polyxeni , Kattamis Antonis
Published: March 2020

Background:

Diamond-Blackfan anemia is a rare inherited bone marrow failure disease. Typical findings include hypoplastic macrocytic anemia, congenital anomalies, and a predisposition to cancer. The molecular basis of the disease is heterozygous mutations of ribosomal proteins without a strict correlation between genotype and phenotype.

Observation:

We present 2 cases of Diamond-Blackfan anemia diagnosed during infancy with interesting clinical, molecular, and family characteristics.

Conclusions:

A thorough evaluation of all family members is imperative to identify possible ‘silent carriers’ who are those with no physical stigmata and minor or absent hematologic manifestations. New mutations could add in the map of the disease.
Enriched, Task-Specific Therapy in the Chronic Phase After Stroke: An Exploratory Study
Authors: Vive Sara , af Geijerstam Jean-Luc , Kuhn H. Georg , Bunketorp-Käll Lina
Published: March 2020

Background and Purpose:

There is a need to translate promising basic research about environmental enrichment to clinical stroke settings. The aim of this study was to assess the effectiveness of enriched, task-specific therapy in individuals with chronic stroke.

Methods:

This is an exploratory study with a within-subject, repeated-measures design. The intervention was preceded by a baseline period to determine the stability of the outcome measures. Forty-one participants were enrolled at a mean of 36 months poststroke. The 3-week intervention combined physical therapy with social and cognitive stimulation inherent to environmental enrichment. The primary outcome was motor recovery measured by Modified Motor Assessment Scale (M-MAS). Secondary outcomes included balance, walking, distance walked in 6 minutes, grip strength, dexterity, and multiple dimensions of health. Assessments were made at baseline, immediately before and after the intervention, and at 3 and 6 months.

Results:

The baseline measures were stable. The 39 participants (95%) who completed the intervention had increases of 2.3 points in the M-MAS UAS and 5 points on the Berg Balance Scale (both P < 0.001; SRM >0.90), an improvement of comfortable and fast gait speed of 0.13 and 0.23 m/s, respectively. (P < 0.001; SRM = 0.88), an increased distance walked over 6 minutes (24.2 m; P < 0.001; SRM = 0.64), and significant improvements in multiple dimensions of health. The improvements were sustained at 6 months.

Discussion and Conclusions:

Enriched, task-specific therapy may provide durable benefits across a wide spectrum of motor deficits and impairments after stroke. Although the results must be interpreted cautiously, the findings have implications for enriching strategies in stroke rehabilitation.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A304).
Metoclopramide-Induced Acute Dystonia
Authors: Yarar Coskun , Yakut Ayten , Carman Kursat Bora , Sahin Sabiha , Kocak Ozan , Ozkan Serhat , Bal Cengiz
Published: March 2020

Objectives

Metoclopramide is a commonly used medication in pediatric practice, and dystonia is a common adverse effect of it. The present study aims to evaluate the clinical characteristics of metoclopramide-induced acute dystonic reactions (MIADRs) in pediatric patients admitted to the pediatric emergency unit.

Methods

Twenty-eight patients were admitted with MIADRs between June 2004 and April 2016; they were enrolled into the study retrospectively.

Results

The study group was composed of 13 females and 15 males with the mean ± SD age of the females higher than that of the males, 12.3 ± 4.5 and 7.8 ± 4.3 years, respectively. Only 9 (32.1%) of the patients were diagnosed as MIADRs at the time of admission. Seventeen patients (60.7%) received over the recommended daily dose of metoclopramide. Dystonia was focal in most of the patients, with the most affected parts consisting of the neck, eyes, and orolingual regions. In 9 of the patients, the dystonia was episodic in nature. Pharmacological treatment was used for 18 patients. No patients died, and none suffered long-term injury related to MIADRs.

Conclusions

Metoclopramide administration may be associated with the occurrence of acute dystonic reaction. Metoclopramide-induced acute dystonic reactions may be misdiagnosed, so detailed medical history gathering and a high index of suspicion are warranted. Our data suggest that MIADRs may be dose related and that there may be age- and sex-related differences in the epidemiology of MIADRs.
Incidence and Outcome of Community-Acquired Acute Kidney Injury in Pediatric Patients Seen at an Emergency Department
Authors: Safdar Osama , Alaydarous Shahad Adnan , Arafsha Yara , Arafsha Lara , Almaimani Nuha , Bahomeed Rhaf , Al Beiruty Melissa , Norah Abdulrhman , Kari Jameela A. , Shalaby Mohammed
Published: March 2020

Objectives

Acute kidney injury (AKI) has significant morbidity and mortality rates among young patients. This study aimed to determine the incidence and outcome of community-acquired AKI among pediatric patients seen in the emergency department of King Abdulaziz University Hospital for more than 3 years.

Methods

This retrospective study reviewed electronic medical records for all pediatric patients aged 1 month to 18 years who visited the emergency department of King Abdulaziz University Hospital from January 1, 2015, until December 31, 2017. Acute kidney injury was diagnosed and classified according to the Kidney Disease: Improving Global Outcomes criteria.

Results

Of 6038 patients, 1581 were included. Acute kidney injury occurred in 135 patients (8.5%), of which 77 (57%) were in stage 1, 42 (31.1%) were in stage 2, and 16 (11.9%) were in stage 3. Mortality was higher in the AKI group (4.4%) than in the non-AKI group (0.2%; P < 0.01). On long-term observation, 14.8% did not return for follow-up, 58.5% of survivors recovered completely, and 22.2% progressed to chronic kidney disease. The most affected age group was 1 month to 2 years (26%). Common admission causes were chemotherapy-induced AKI (31.9%) and pneumonia (10.4%). There was a significant inverse relationship between AKI and age group (P < 0.001) and a positive association between AKI and death (P < 0.001). However, no association was found between AKI stages and outcomes.

Conclusions

Community-acquired AKI remains a common condition affecting the pediatric population. It is associated with a higher mortality rate. Infants were more susceptible to AKI, and a significant number of patients with AKI progressed to chronic kidney disease.
Course Review
Authors: Saeed Ayman , McGhee James T. , Atkinson Kieran
Published: March 2020

In this review, we share our experience attending the 15th International North East Flap course as delegates, and discuss how it has changed since its seventh edition in 2011.
The Effect of Simulator-Integrated Tutoring for Guidance in Virtual Reality Simulation Training
Authors: Andersen Steven Arild Wuyts , Mikkelsen Peter Trier , Sørensen Mads Sølvsten
Published: March 2020

Introduction

Simulation-integrated tutoring in virtual reality (VR) simulation training by green lighting is a common learning support in simulation-based temporal bone surgical training. However, tutoring overreliance can negatively affect learning. We therefore wanted to investigate the effects of simulator-integrated tutoring on performance and learning.

Methods

A prospective, educational cohort study of a learning intervention (simulator-integrated tutoring) during repeated and distributed VR simulation training for directed, self-regulated learning of the mastoidectomy procedure. Two cohorts of novices (medical students) were recruited: 16 participants were trained using the intervention program (intermittent simulator-integrated tutoring) and 14 participants constituted a nontutored reference cohort. Outcomes were final-product performance assessed by 2 blinded raters and simulator-recorded metrics.

Results

Simulator-integrated tutoring had a large and positive effect on the final-product performance while turned on (mean difference = 3.8 points, P < 0.0001). However, this did not translate to a better final-product performance in subsequent nontutored procedures. The tutored cohort had a better metrics-based score, reflecting higher efficiency of drilling (mean difference = 3.6%, P = 0.001). For the individual metrics, simulator-integrated tutoring had mixed effects both during procedures and on the tutored cohort in general (learning effect).

Conclusions

Simulator-integrated tutoring by green lighting did not induce a better final-product performance but increased efficiency. The mixed effects on learning could be caused by tutoring overreliance, resulting from a lack of cognitive engagement when the tutor function is on. Further learning strategies such as feedback should be explored to support novice learning and cognitive engagement.
Preoperative Stoma Site Marking Decreases Stoma and Peristomal Complications
Authors: Hsu Mei-Yu , Lin Jui-Ping , Hsu Hsiao-Hui , Lai Hsing-Ling , Wu Yu-Lin
Published: March 2020

PURPOSE:

We systematically reviewed the literature in order to determine whether evidence indicated that preoperative stoma site marking reduces the occurrence of postoperative stoma and peristomal complications.

DESIGN:

Systematic review with meta-analysis of pooled findings.

SUBJECTS/SETTING:

We systematically reviewed 6 electronic databases including PubMed, MEDLINE, CINAHL, Cochrane Library for English language articles, along with the Airiti Library and Wanfang Data for Chinese articles for evidence related to the effects of stoma site marking on stoma and peristomal complications. We sought articles published from their inception to January 31, 2018.

METHODS:

Ten studies that included 2109 participants, each comparing 2 groups of patients who did and did not undergo preoperative stoma site marking, were retrieved and analyzed.

RESULTS:

In patients who underwent stoma site marking, the marking was associated with reduced stoma and peristomal complications in all stoma types (odds ratio [OR] = 0.52; 95% CI, 0.42-0.64; P < .001). Patients who underwent stoma and had fecal ostomies experienced fewer complications (OR = 0.34; 95% CI, 0.25-0.47; P < .001) than patients with unmarked stomas. In contrast, patients with urostomies did not experience fewer complications when compared to those with unmarked ostomies (OR = 0.531; 95% CI, 0.23-1.21; P = .132). Persons with fecal ostomies also had fewer hernias and peristomal skin complications (ORs = 0.25 and 0.30; 95% CIs, 0.09-0.71 and 0.20-0.44, respectively; both Ps < .001). The results revealed that stoma site marking was associated with reduced early and late stoma and peristomal complications (ORs = 0.76 and 0.38; 95% CIs, 0.61-0.94 and 0.32-0.46; P = .010 and P < .001, respectively).

CONCLUSIONS:

Preoperative stoma site marking is associated with a reduced occurrence of stoma and peristomal complications and should be considered as a standard of preoperative care.
The Tendency of Modified Electroconvulsive Therapy–Related Working Memory and Subjective Memory Deficits in Depression
Authors: Chen Yanchao , Liu Jin , Li Zexuan , Liu Bangshan , Ji Yajuan , Ju Yumeng , Fang Han , Zheng Qi , Wang Mi , Guo Weilong , Li Haolun , Lu Xiaowen , Li Lingjiang
Published: March 2020

Objective

The aim of the study was to explore the tendency of modified electroconvulsive therapy (MECT)-related working memory and subjective memory deficits in depressed patients.

Methods

Sixty patients with unipolar/bipolar depression were prepared and enrolled for MECT and 56 subjects were enrolled as healthy controls (HCs). Their demographics (sex, age, body mass index, years of schooling, etc) and clinical characteristics (dosage and number of MECT, etc) were compared. Depression severity, working memory, and subjective memory were measured using the Hamilton Depression Rating Scale 17 (HAMD17), a Digit Span Backwards (DSB), and self-reported assessments, respectively. Measurements were taken at baseline, within 24 hours after each MECT session, and in every month for a 6-month follow-up period.

Results

(a) The patients had poorer performance than the HCs on DSB and HAMD17 at baseline, and the DSB score and HAMD17 total scores were negatively correlated. However, after the second MECT session, the patients' HAMD17 score was significantly improved compared with that at the baseline (P < 0.05), whereas the DSB score showed no significant difference compared with the HCs (P > 0.05). (b) After the first MECT session, 62% of the patients reported subjective memory deficits, which were exacerbated over the subsequent sessions and relieved with antidepressant treatment during the follow-up period. (c) The risk factors for prolonged subjective memory deficits were overweight and the maximum MECT dosage/age (dosage/age = the percentage of output part of total dosage × 100/age, unit: 1/year) ≥ 1.5/year (odds ratio [OR] = 15.36 and 7.98).

Conclusions

Depressed patients showed poorer working memory than the HCs. Such memory deficit may be aggravated by MECT, although it may improve with the relief of depression. Although subjective memory deficits can occur after the first MECT session and gradually recover after the treatment, they may last for 6 months or longer. Persistent deficits may be related to being overweight and having a high MECT dosage.
Fourteen novel lipomycetaceous yeast species isolated from soil in Japan and transfer of Dipodascopsis anomala to the genus Babjevia based on ascospore production phenotype
Authors: Yamazaki Atsushi , Lorliam Wanlapa , Kawasaki Hiroko , Uchino Masataka , Suzuki Ken-ichiro
Published: February 2020

Fourteen novel lipomycetaceous yeasts species were isolated from soil samples collected from the Hokkaido, Chiba and Okinawa prefectures of Japan. Phylogenetic analyses of the D1/D2 domains of the large subunit rRNAs and translation elongation factor 1 alpha genes (TEF1-α) revealed that five strains of two species from the soil in Furano-shi, Hokkaido were related to Dipodascopsis anomala and 29 strains representing 12 species from soils in Kamogawa-shi, Chiba and Iriomote Island, Okinawa were in the Myxozyma clade. The two species of Dipodascopsis form globose or ellipsoid ascospores in their sac-like ascus and pseudohyphae. Furthermore, these species produce ascospores in their pseudohyphae and do not produce an acicular ascus, which is common among the three species including D. anomala. Therefore, we propose transferring D. anomala to the genus Babjevia and amending Babjevia. Two novel species were described and included in the genus Babjevia: Babjevia hyphoforaminiformans sp. nov. (holotype NBRC 111233; MycoBank no. MB 829051) and Babjevia hyphasca sp. nov. (holotype NBRC 112965; MycoBank no. MB 829053). The 12 species in the Myxozyma clade produce neither ascospores nor pseudohyphae and have different characteristics in assimilating several carbon sources from each other. Thus, we propose that the novel species of Lipomyces be classified as forma asexualis (f.a.). From Kamogawa-shi, Chiba (19 strains representing five species): Lipomyces melibiosiraffinosiphilus f.a., sp. nov. (holotype NBRC 111411; MycoBank no. MB 829034), Lipomyces kiyosumicus f.a., sp. nov. (holotype NBRC 111424; MycoBank no. MB 829035), Lipomyces chibensis f.a., sp. nov. (holotype NBRC 111413; MycoBank no. MB 829036), Lipomyces kamogawensis f.a., sp. nov. (holotype NBRC 112967; MycoBank no. MB 829037), Lipomyces amatsuensis f.a., sp. nov. (holotype NBRC 111420; MycoBank no. MB 829041). From Iriomote island, Okinawa (10 strains representing seven species): Lipomyces taketomicus f.a., sp. nov. (holotype NBRC 112966; MycoBank no. MB 829042), Lipomyces yaeyamensis f.a., sp. nov. (holotype NBRC 110433; MycoBank no. MB 829050), Lipomyces iriomotensis f.a., sp. nov. (holotype NBRC 110436; MycoBank no. MB 829045), Lipomyces haiminakanus f.a., sp. nov. (holotype NBRC 110435; MycoBank no. MB 829046), Lipomyces komiensis f.a., sp. nov. (holotype NBRC 110440; MycoBank no. MB 829047), Lipomyces nakamensis f.a., sp. nov. (holotype NBRC 110434; MycoBank no. MB 829048), Lipomyces sakishimensis f.a., sp. nov. (holotype NBRC 110439; MycoBank no. MB 829049).
Transmission characteristics of the COVID-19 outbreak in China: a study driven by data
Authors: Li Meili , Chen Pian , Yuan Qianqian , Song Baojun , Ma Junling
Published: March 2020

The COVID-19 outbreak has been a serious public health threat worldwide. We use individually documented case descriptions of COVID-19 from China (excluding Hubei Province) to estimate the distributions of the generation time, incubation period, and periods from symptom onset to isolation and to diagnosis. The recommended 14-day quarantine period may lead to a 6.7% failure for quarantine. We recommend a 22-day quarantine period. The mean generation time is 3.3 days and the mean incubation period is 7.2 days. It took 3.7 days to isolate and 6.6 days to diagnose a patient after his/her symptom onset. Patients may become infectious on average 3.9 days before showing major symptoms. This makes contact tracing and quarantine ineffective. The basic reproduction number is estimated to be 1.54 with contact tracing, quarantine and isolation, mostly driven by super spreaders.
Evaluation of Enzyme-Linked Immunoassay and Colloidal Gold-Immunochromatographic Assay Kit for Detection of Novel Coronavirus (SARS-Cov-2) Causing an Outbreak of Pneumonia (COVID-19)
Authors: Xiang Jie , Yan Mingzhe , Li Hongze , Liu Ting , Lin Chenyao , Huang Shuang , Shen Changxin
Published: March 2020

BACKGROUND

In December 2019, a novel coronavirus (SARS-CoV-2)–infected pneumonia (COVID-19) occurred in Wuhan, China. Travel-associated cases have also been reported in other countries. The number of cases has increased rapidly but laboratory diagnosis is limited.

METHODS

We collect two groups of cases diagnosed with COVID-19 for experiments. One group collected 63 samples for Enzyme-linked immunosorbent assay (ELISA) IgG and IgM antibodies. The other group collected 91 plasma samples for colloidal gold-immunochromatographic assay (GICA).

RESULTS

The sensitivity of the combined ELISA IgM and ELISA IgG detection was 55/63 ( 87.3%), The sensitivity of the combined GICA IgM and GICA IgG detection was 75/91 ( 82.4%), Both methods are negative for healthy controls, specificity of 100%. There is no significant difference between the sensitivity of between ELISA and GICA (IgM+ IgG).

CONCLUSIONS

ELISA and GICA for specific IgM and IgG antibodies are conventional serological assays, they are simple, fast, and safe, the results can be used for clinical reference, and the huge clinical diagnosis and treatment pressure can be greatly relieved.
Transmission potential of COVID-19 in South Korea
Authors: Shim Eunha , Tariq Amna , Choi Wongyeong , Lee Yiseul , Chowell Gerardo
Published: February 2020

Since the first identified individual of 2019 novel coronavirus (COVID-19) infection on Jan 20, 2020 in South Korea, the number of confirmed cases rapidly increased. As of Feb 26, 2020, 1,261 cases of COVID-19 including 12 deaths were confirmed in South Korea. Using the incidence data of COVID-19, we estimate the reproduction number at 1.5 (95% CI: 1.4-1.6), which indicates sustained transmission and support the implementation of social distancing measures to rapidly control the outbreak.
A simple ecological model captures the transmission pattern of the coronavirus COVID-19 outbreak in China
Authors: Zhang Feng , Zhang Jinmei , Cao Menglan , Hui Cang
Published: February 2020

The rapid spread of the 2019 novel coronavirus (COVID-19), initially reported in the city of Wuhan in China, and quickly transmitted to the entire nation and beyond, has become an international public health emergency. Estimating the final number of infection cases and the turning point (time with the fastest spreading rate) is crucial to assessing and improving the national and international control measures currently being applied. In this paper we develop a simple model based on infectious growth with a time-varying infection rate, and estimate the final number of infections and the turning point using data updated daily from 3 February 2020, when China escalated its initial public health measures, to 10 February. Our model provides an extremely good fit to the existing data and therefore a reasonable estimate of the time-varying infection rate that has largely captured the transmission pattern of this epidemic outbreak. Our estimation suggests that (i) the final number of infections in China could reach 78,000 with an upper 95% confidence limit of 88,880; (ii) the turning point of the fastest spread was on the 4th or the 5th of February; and (iii) the projected period for the end of the outbreak (i.e., when 95% of the final predicted number of infection is reached) will be the 24th of February, with an upper 95% confidence limit on the 19th of March. This suggests that the current control measures in China are excellent, and more than sufficient to contain the spread of this highly infectious novel coronavirus, and that the application of such measures could be considered internationally for the global control of this outbreak.
Biology and rearing of the cogongrass gall midge,Orseolia javanicaKieffer & Docters van Leeuwen-Reijnvaan (Diptera: Cecidomyiidae)
Authors: Hidayat Purnama , Arini  , Guntoro Dwi , Takasu Keiji , Overholt William A.
Published: February 2020

Imperata cylindrica(L.) Beauv. (Poaceae) is one of the most harmful weeds in the world because of its ability to spread and form high density, monospecific stands that exclude other vegetation. The cogongrass gall midge,Orseolia javanicaKieffer & Docters van Leeuwen-Reijnvaan (Diptera: Cecidomyiidae), is a stem galling insect that is only known to develop in cogongrass and has only been found on the island of Java in Indonesia. The midge attacks very young shoots, which stimulates abnormal growth, resulting in the formation of a purplish, elongate stem gall tappered to a point at the apical end. The aim of the current research was to describe the biology of the midge and develop a rearing method.Orseolia javanicacompleted its life cycle in 12-38 days with average egg, larval, and pupal periodes of 4.0 ± 0.0, 13.5 ± 3.8, and 8.6 ± 6.6 days (mean ± SD), respectively. Mated female, unmated female, and male longevities were 1.7 ± 0.47, 1.2 ± 0.41, and 1.0 ± 0.00 days (mean ± SD). Galls began to appear 29 days after larval infestation, and stem death coincided with emergence of the adult midge. The midge may have potential for biological control of cogongrass if future studies confirm a restricted host range.
Body size and composition and site-specific cancers in UK Biobank: a Mendelian randomisation study
Authors: Vithayathil Mathew , Carter Paul , Kar Siddhartha , Mason Amy M. , Burgess Stephen , Larsson Susanna C.
Published: February 2020

Objectives

To investigate the casual role of body mass index, body fat composition and height in cancer.

Design

Two stage mendelian randomisation study

Setting

Previous genome wide association studies and the UK Biobank

Participants

Genetic instrumental variables for body mass index (BMI), fat mass index (FMI), fat free mass index (FFMI) and height from previous genome wide association studies and UK Biobank. Cancer outcomes from 367 586 participants of European descent from the UK Biobank.

Main outcome measures

Overall cancer risk and 22 site-specific cancers risk for genetic instrumental variables for BMI, FMI, FFMI and height.

Results

Genetically predicted BMI (per 1 kg/m2) was not associated with overall cancer risk (OR 0.99; 95% confidence interval (CI) 0-98-1.00,p=0.105). Elevated BMI was associated with increased risk of stomach cancer (OR 1.15, 95% (CI) 1.05-1.26;p=0.003) and melanoma (OR 0.96, 95% CI 0.92-1.00;p=0.044). For sex-specific cancers, BMI was positively associated with uterine cancer (OR 1.08, 95% CI 1.01-1.14;p=0.015) but inversely associated with breast (OR 0.95, 95% CI 0.92-0.98;p=0.001), prostate (OR 0.95, 95% CI 0.92-0.99;p=0.007) and testicular cancer (OR 0.89, 95% CI 0.81-0.98;p=0.017). Elevated FMI (per 1 kg/m2) was associated with gastrointestinal cancer (stomach cancer OR 4.23, 95% CI 1.18-15.13,p=0.027; colorectal cancer OR 1.94, 95% CI 1.23-3.07;p=0.004). Increased height (per 1 standard deviation, approximately 6.5cm) was associated with increased risk of overall cancer (OR 1.06; 95% 1.04-1.09;p= 2.97×10-8) and most site-specific cancers with the strongest estimates for kidney, non-Hodgkin lymphoma, colorectal, lung, melanoma and breast cancer.

Conclusions

There is little evidence for BMI as a casual risk factor for cancer. BMI may have a causal role for sex-specific cancers, although with inconsistent directions of effect, and FMI for gastrointestinal malignancies. Elevated height is a risk factor for overall cancer and multiple site cancers.
Tumor heterogeneity assessed by sequencing and fluorescencein situhybridization (FISH) data
Authors: Lei Haoyun , Gertz E. Michael , Schäffer Alejandro A. , Fu Xuecong , Tao Yifeng , Heselmeyer-Haddad Kerstin , Torres Irianna , Shi Xulian , Wu Kui , Li Guibo , Xu Liqin , Hou Yong , Dean Michael , Ried Thomas , Schwartz Russell
Published: March 2020

Computational reconstruction of clonal evolution in cancers has become a crucial tool for understanding how tumors initiate and progress and how this process varies across patients. The field still struggles, however, with special challenges of applying phylogenetic methods to cancers, such as the prevalence and importance of copy number alteration (CNA) and structural variation (SV) events in tumor evolution, which are difficult to profile accurately by prevailing sequencing methods in such a way that subsequent reconstruction by phylogenetic inference algorithms is accurate. In the present work, we develop computational methods to combine sequencing with multiplex interphase fluorescence in situ hybridization (miFISH) to exploit the complementary advantages of each technology in inferring accurate models of clonal CNA evolution accounting for both focal changes and aneuploidy at whole-genome scales. We demonstrate on simulated data that incorporation of FISH data substantially improves accurate inference of focal CNA and ploidy changes in clonal evolution from deconvolving bulk sequence data. Analysis of real glioblastoma data for which FISH, bulk sequence, and single cell sequence are all available confirms the power of FISH to enhance accurate reconstruction of clonal copy number evolution in conjunction with bulk and optionally single-cell sequence data.

Availability

github.com/CMUSchwartzLab/FISH_deconvolution

Contact

russells@andrew.cmu.edu
Precipitation of RNA with Ethanol
Authors: Green Michael R. , Sambrook Joseph
Published: March 2020

Purified RNA may need to be concentrated by precipitation for downstream applications. Precipitation of RNA with ethanol (or isopropanol) is the standard method to recover RNA from aqueous solutions.
The phospholipase A effector PlaA from Legionella pneumophila: expression, purification and crystallization
Authors: Qu Xiaoyan , Song Xiaowen , Zhang Nannan , Ma Jinming , Ge Honghua
Published: March 2020

Legionella pneumophila encodes an extracellular secreted phospholipase A named PlaA that is translocated by the type II secretion system. It plays an essential role in maintaining the integrity of Legionella-containing vacuoles in L. pneumophila pathogenesis. Here, it is shown that PlaA has a main lysophospholipase activity to hydrolyze fatty-acyl groups in lysophospholipids. Although it has a very low phospholipase A activity to catalyze the hydrolysis of fatty-acyl groups in phospholipids, PlaA can bind phospholipids such as 1,2-dipalmitoylphosphatidylcholine with a dissociation constant of 11.1 µM. Sequence-alignment analysis combined with activity assays revealed that PlaA contains a distinct substrate-binding site among the known structures of the phospholipase A family, implying that PlaA may present a novel mechanism for substrate recognition. Native PlaA and its selenomethionine (SeMet)-substituted form were purified and crystallized by vapour diffusion in hanging drops at 296 K. Diffraction data were collected to a resolution of 2.0 Å for native PlaA protein and to a resolution of 2.7 Å for SeMet-substituted PlaA protein. The crystals of native PlaA belonged to the monoclinic space group P21, while the crystals of SeMet-substituted PlaA belonged to the primitive orthorhombic space group P212121. Initial phases for PlaA were obtained from SeMet SAD data sets.