bluuebunny/crossref_metadata_2025 huggingface dataset:
From bud formation to flowering: transcriptomic state defines the cherry developmental phases of sweet cherry bud dormancy
Authors: Vimont Noémie , Fouché Mathieu , Campoy José Antonio , Tong Meixuezi , Arkoun Mustapha , Yvin Jean-Claude , Wigge Philip A. , Dirlewanger Elisabeth , Cortijo Sandra , Wenden Bénédicte
Published: December 2019

Background

Bud dormancy is a crucial stage in perennial trees and allows survival over winter to ensure optimal flowering and fruit production. Recent work highlighted physiological and molecular events occurring during bud dormancy in trees. However, they usually examined bud development or bud dormancy in isolation. In this work, we aimed to further explore the global transcriptional changes happening throughout bud development and dormancy onset, progression and release.

Results

Using next-generation sequencing and modelling, we conducted an in-depth transcriptomic analysis for all stages of flower buds in several sweet cherry (Prunus aviumL.) cultivars that are characterized for their contrasted dates of dormancy release. We find that buds in organogenesis, paradormancy, endodormancy and ecodormancy stages are defined by the expression of genes involved in specific pathways, and these are conserved between different sweet cherry cultivars. In particular, we found thatDORMANCY ASSOCIATED MADS-box(DAM), floral identity and organogenesis genes are up-regulated during the pre-dormancy stages while endodormancy is characterized by a complex array of signalling pathways, including cold response genes, ABA and oxidation-reduction processes. After dormancy release, genes associated with global cell activity, division and differentiation are activated during ecodormancy and growth resumption. We then went a step beyond the global transcriptomic analysis and we developed a model based on the transcriptional profiles of just seven genes to accurately predict the main bud dormancy stages.

Conclusions

Overall, this study has allowed us to better understand the transcriptional changes occurring throughout the different phases of flower bud development, from bud formation in the summer to flowering in the following spring. Our work sets the stage for the development of fast and cost effective diagnostic tools to molecularly define the dormancy stages. Such integrative approaches will therefore be extremely useful for a better comprehension of complex phenological processes in many species.
Complex contaminant mixtures and their associations with intima-media thickness
Authors: Liberda Eric N. , Zuk Aleksandra M. , Tsuji Leonard J. S.
Published: December 2019

Background

The burden of cardiovascular disease (CVD) morbidity and mortality is higher among Indigenous persons, who also experience greater health disparities when compared to non-Indigenous Canadians, particularly in remote regions of Canada. Assessment of carotid intima-media thickness (cIMT), a noninvasive screening tool and can be used as biomarker to assess increased CVD risk. Few studies have examined environmental contaminant body burden and its association with cIMT.

Methods

Data from the Environment-and-Health Study in the Eeyou Istchee territory of northern Québec, Canada was used to assess complex body burden mixtures of POPs, metals and metalloids among (n = 535) Indigenous people between 15 and 87 years of age with cIMT. First, Principal Component Analysis (PCA) was used to reduce the complexity of the contaminant data. Second, based on the underlying PCA profiles from the biological data, we examined each of the prominent principal component (PC) axes on cIMT using multivariable linear regression models. Lastly, based on these PC axes, cIMT was also regressed on summed (Σ) organic compound concentrations, polychlorinated biphenyl, perfluorinated compounds, respectively, ∑10 OCs, ∑13 PCBs, ∑3PFCs, and nickel.

Results

Most organochlorines and PFCs loaded primarily on PC-1 (53% variation). Nickel, selenium, and cadmium were found to load on PC-5. Carotid-IMT was significantly associated with PC-1 β = 0.004 (95 % CI 0.001, 0.007), and PC-5 β = 0.013 (95 % CI 0.002, 0.023). However, the association appears to be greater for PC-5, accounting for 3% of the variation, and mostly represented by nickel. Results show that that both nickel, and ∑3PFCs were similarly associated with cIMT β = 0.001 (95 % CI 0.0003, 0.003), and β = 0.001 (95 % CI 0.0004, 0.002), respectively. But ∑10OCs was significantly associated with a slightly greater β = 0.004 (95 % CI 0.001, 0.007) cIMT change, though with less precision. Lastly, ∑13PCBs also increased β = 0.002 (95 % CI 0.0004, 0.003) cIMT after fully adjusting for covariates.

Conclusion

Our results suggest that environmental contaminants are associated with cIMT. This is important for the Cree from the Eeyou Istchee territory who may experience higher body burdens of contaminants than non-Indigenous Canadians.
Point-of-care ultrasound in Management for Dyspneic Uremic Patients: a case report
Authors: Wang Pei-Hsiu , Lien Wan-Ching
Published: December 2019

Background

Point-of-Care Ultrasound (PoCUS) is considered as an extension of clinicians’ patient care and can be integrated into daily clinical practice. Dyspnea is a common presentation in uremic patients. With the aids of PoCUS and integrated assessments of lung, heart and inferior vena cava (IVC), the etiology of dyspnea in uremic patients can be determined earlier.

Case presentation

A 67-year-old woman presented with progressive shortness of breath and bilateral legs edema for 3 weeks. The laboratory data revealed marked elevated level of serum creatinine and blood urea. A large amount of pericardial effusion was timely detected by PoCUS. Uremic pericarditis was suspected. Emergent hemodialysis was initiated and her symptoms improved.

Conclusions

PoCUS is a noninvasive and cost-effective imaging modality and it has been popular in the emergency department (ED). In uremic patients presenting with dyspnea, the integration of PoCUS into traditional physical examinations help emergency physicians narrow down the differential diagnoses.
A systematic review of lenvatinib and sorafenib for treating progressive, locally advanced or metastatic, differentiated thyroid cancer after treatment with radioactive iodine
Authors: Fleeman Nigel , Houten Rachel , Chaplin Marty , Beale Sophie , Boland Angela , Dundar Yenal , Greenhalgh Janette , Duarte Rui , Shenoy Aditya
Published: December 2019

Background

Treatment with radioactive iodine is effective for many patients with progressive, locally advanced or metastatic, differentiated thyroid cancer. However, some patients become refractory to treatment. These types of patients are considered to have radioactive iodine refractory differentiated thyroid cancer (RR-DTC).

Methods

We searched Embase, MEDLINE, PubMed and the Cochrane Library from January 1999 through January 2017. Reference lists of included studies and ongoing trial registries were also searched. Reports of randomized controlled trials (RCTs), prospective observational studies, and systematic reviews/indirect comparisons were eligible for inclusion. In the absence of direct clinical trial evidence comparing lenvatinib versus sorafenib, we assessed the feasibility of conducting an indirect comparison to obtain estimates of the relative efficacy and safety of these two treatments.

Results

Of 2364 citations, in total, 93 papers reporting on 2 RCTs (primary evidence), 9 observational studies and 13 evidence reviews (supporting evidence) were identified. Compared to placebo, RCT evidence demonstrated improvements with lenvatinib or sorafenib in median progression-free survival (PFS) and objective tumour response rate (ORR). Overall survival (OS) was confounded by high treatment crossover (≥75%) in both trials. Adverse events (AEs) were more common with lenvatinib or sorafenib than with placebo but the most common AEs associated with each drug differed. Primarily due to differences in the survival risk profiles of patients in the placebo arms of the RCTs, we considered it inappropriate to indirectly compare the effectiveness of lenvatinib versus sorafenib. ORR and AE findings for lenvatinib and sorafenib from the supporting evidence were broadly in line with RCT evidence. Health-related quality of life (HRQoL) data were limited.

Conclusions

Lenvatinib and sorafenib are more efficacious than placebo (a proxy for best supportive care) for treating RR-DTC. Uncertainty surrounds the extent of the impact on OS and HRQoL. Lenvatinib could not reliably be compared with sorafenib. Choice of treatment is therefore likely to depend on an individual patient’s circumstances.
Why some donors are more willing to donate platelets? ----a qualitative study on 25 regular platelet donors in Guangzhou, China
Authors: Yu Chengpu , Lau Joseph Tak-fai , Zhong Weixing , Huang Xinting , Pan Chao , Chen Yu , Lu Huanpeng , Zhao Fengxiao , Zeng Siying , Lai Jinglin , Tie Chengwei , Li Xu , Zhang Jianlin , Zhang Chuangqi , Liu Ying , Jiang Qianli
Published: December 2019

Background

Since 1998, China has gradually moved toward voluntary uncompensated blood donation. In some cities, the shortage of platelets has been noticeably severe. Mutual assistance that collects blood from one’s family and social networks is a potential solution. The measure, however, turned out problematic. There are donors who choose to donate platelets over whole blood without compensations, and donate platelets directly to blood banks instead of via the mutual assistance system. This study explores reasons behind their choices qualitatively.

Methods

This report is based on data conducted from January to February 2018; 25 uncompensated regular platelet donors were interviewed. The blood component donation service team in Guangzhou facilitated the data collection process and referred prospectively eligible blood donors to our research team. The interviews took about 30 min to two hours to complete. The qualitative data were analyzed by using the software ATLAS.ti 8.

Results

Platelet donation takes a much long time than whole blood donation and requires complicated processes. It may also cause discomfort as the other blood components are returned to the body, causing physical and psychological distress due to worries about contamination. Thus, platelet donation tends to involve higher time and psychological costs than whole blood donation. Yet, it has short collection intervals that allows for more frequent donations, and urgency of a severer shortage than whole blood. Hence, regular platelet donors may feel higher significance in platelet donation than whole blood donation, with the belief that more lives would be saved. Some whole blood donors thus switched to become platelet donors. Mutual assistance blood donation was not chosen by the participants for platelet donation, because such donations may exert moral pressure to both the donors and recipients. Furthermore, “acquaintance” has been loosely defined; the system has sometimes been manipulated to become profit-making monetary transactions. It hence failed.

Conclusions

The practice of platelet donation reinforces the understanding that blood donation is a gift giving process performed among strangers. A safe and sustainable voluntary blood supply can only be secured in the absence of monetary transactions and moral pressure.
Unilateral curved versus bipedicular vertebroplasty in the treatment of osteoporotic vertebral compression fractures
Authors: Zhong Rui , Liu Jianheng , Wang Runsheng , Liu Yihao , Chen Binbin , Jiang Wei , Mao Keya , Tang Peifu
Published: December 2019

Background

Vertebral compression fracture is one of the most common complications of osteoporosis. In this study an unilateral curved vertebroplasty device was developed, and the safety, effectiveness, and surgical parameters of curved vertebroplasty (CVP) in the treatment of painful osteoporotic vertebral compression fractures was investigated and compared with traditional bipedicular vertebroplasty (BVP).

Methods

We investigated 104 vertebral augmentation procedures performed over 36 months. CVP and BVP procedures were compared for baseline clinical variables, pain relief (Visual Analog Scale, VAS), disability improvement (Oswestry Disability Index, ODI), operation time, number of fluoroscopic images, volume of cement per level, and cement leakage rate for each level treated. Complications and refracture incidence were also recorded in the two groups.

Results

The VAS and ODI in both group had no significant difference preoperative (P > 0.05), and a significant postoperative improvement in the VAS scores and ODI was found in both group (P < 0.001). However, the CVP group had significantly lower operation time, number of fluoroscopic images, and cement leakage rate per level than the BVP group (P < 0.05); however, the volumes of cement per level were similar in the two groups (P > 0.05). Neither group had any serious complications. Five and two patients in the BVP group developed refractures at non-adjacent and adjacent levels, respectively, with one patient developing refractures twice; however, none of the patients in the CVP group developed refractures at any level.

Conclusions

Our findings revealed that both CVP and BVP were safe and effective treatments for osteoporotic vertebral compression fractures, and CVP entails a shorter operation time, less exposure to fluoroscopy, and lower rate of cement leakage.
The impact of population ageing on end-of-life care in Scotland: projections of place of death and recommendations for future service provision
Authors: Finucane Anne M. , Bone Anna E. , Evans Catherine J. , Gomes Barbara , Meade Richard , Higginson Irene J. , Murray Scott A.
Published: December 2019

Background

Global annual deaths are rising. It is essential to examine where future deaths may occur to facilitate decisions regarding future service provision and resource allocation.

Aims

To project where people will die from 2017 to 2040 in an ageing country with advanced integrated palliative care, and to prioritise recommendations based on these trends.

Methods

Population-based trend analysis of place of death for people that died in Scotland (2004–2016) and projections using simple linear modelling (2017–2040); Transparent Expert Consultation to prioritise recommendations in response to projections.

Results

Deaths are projected to increase by 15.9% from 56,728 in 2016 (32.8% aged 85+ years) to 65,757 deaths in 2040 (45% aged 85+ years). Between 2004 and 2016, proportions of home and care home deaths increased (19.8–23.4% and 14.5–18.8%), while the proportion of hospital deaths declined (58.0–50.1%). If current trends continue, the numbers of deaths at home and in care homes will increase, and two-thirds will die outside hospital by 2040. To sustain current trends, priorities include: 1) to increase and upskill a community health and social care workforce through education, training and valuing of care work; 2) to build community care capacity through informal carer support and community engagement; 3) to stimulate a realistic public debate on death, dying and sustainable funding.

Conclusion

To sustain current trends, health and social care provision in the community needs to grow to support nearly 60% more people at the end-of-life by 2040; otherwise hospital deaths will increase.
Factors related to the role of programme directors in association with quality in postgraduate medical education – a cross-sectional study
Authors: Wijk Hanna , Ponzer Sari , Järnbert-Pettersson Hans , Kihlström Lars , Nordquist Jonas
Published: December 2019

Background

Educational leaders have been pointed out as being important for quality of medical education. However, their actual influence on the education can be limited. At the postgraduate level, educational leadership and its connection with quality is underexplored and knowledge about how to increase its impact is lacking. An increased understanding could be used in order to prioritize actions for strengthening the role. The aim of this study was to investigate factors related to the role of programme director associated with quality in postgraduate medical education.

Methods

A cross-sectional study was carried out. A questionnaire was sent to programme directors in Sweden (n = 519) comprising questions about background factors, work characteristics, work tasks, hindering and enabling factors, and the Utrecht Work Engagement Scale. A logistic regression and classification tree were used to identify factors associated with high qualitative education, defined as compliance with national regulations.

Results

The response rate was 54% (n = 279). In total, 62% of the programme directors reported high quality and factors associated with high quality included experiences of communication with residents, superiors and supervisors, and support from the supervisors. Other factors were consensus regarding postgraduate medical education at the workplace, adequate financial resources, the programme directors’ competence, and their perceived impact on education. Factors of particular importance seemed to differ depending on whether the programme directors were responsible for one or for multiple units. Most high-quality education was found in cases where programme directors were responsible for a single unit and perceived sufficient impact on education.

Conclusions

These results indicated that there was an association between factors related to programme director and quality in postgraduate medical education. The findings pointed out the importance of combining activities at both individual, group and organizational levels. Relational aspects should not be underestimated; faculty development and involvement are crucial.
What are the mechanisms that support healthcare professionals to adopt assisted decision-making practice? A rapid realist review
Authors: Davies Carmel , Fattori Francesco , O’Donnell Deirdre , Donnelly Sarah , Ní Shé Éidín , O. Shea Marie , Prihodova Lucia , Gleeson Caoimhe , Flynn Áine , Rock Bernadette , Grogan Jacqueline , O’Brien Michelle , O’Hanlon Shane , Cooney Marie Therese , Tighe Marie , Kroll Thilo
Published: December 2019

Background

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) establishes a right to legal capacity for all people, including those with support needs. People with disabilities have a legal right to be given the appropriate supports to make informed decisions in all aspects of their lives, including health. In Ireland, the Assisted Decision-Making (Capacity) Act (2015) ratifies the Convention and has established a legal framework for Assisted Decision Making (ADM). The main provisions of the Act are not yet implemented. Codes of Practice to guide health and social care professionals are currently being developed. Internationally, concerns are expressed that ADM implementation is poorly understood. Using realist synthesis, this study aims to identify Programme Theory (PT) that will inform ADM implementation in healthcare.

Methods

A Rapid Realist Review using collaborative methods was chosen to appraise relevant literature and engage knowledge users from Irish health and social care. The review was led by an expert panel of relevant stakeholders that developed the research question which asks, ‘what mechanisms enable healthcare professionals to adopt ADM into practice?’

To ensure the PT was inclusive of local contextual influences, five reference panels were conducted with healthcare professionals, family carers and people with dementia. PT was refined and tested iteratively through knowledge synthesis informed by forty-seven primary studies, reference panel discussions and expert panel refinement and consensus.

Results

The review has developed an explanatory PT on ADM implementation in healthcare practice. The review identified four implementation domains as significant. These are Personalisation of Health & ADM Service Provision, Culture & Leadership, Environmental & Social Re-structuring and Education, Training & Enablement. Each domain is presented as an explanatory PT statement using realist convention that identifies context, mechanism and outcome configurations.

Conclusions

This realist review makes a unique contribution to this field. The PT can be applied by policymakers to inform intervention development and implementation strategy. It informs the imminent policy and practice developments in Ireland and has relevance for other worldwide healthcare systems dealing with similar legislative changes in line with UNCRPD.
Fibrosis independent atrial fibrillation in older patients is driven by substrate leukocyte infiltration: diagnostic and prognostic implications to patients undergoing cardiac surgery
Authors: Aguiar Christie M. , Gawdat Kareem , Legere Stephanie , Marshall Jean , Hassan Ansar , Kienesberger Petra C. , Pulinilkunnil Thomas , Castonguay Mathieu , Brunt Keith R. , Legare Jean-Francois
Published: December 2019

Background

The objectives of the study were to characterize and quantify cellular inflammation and structural remodeling of human atria and correlate findings with molecular markers of inflammation and patient surrogate outcome.

Methods

Voluntary participants undergoing heart surgery were enrolled in the study and blood samples were collected prior to surgery, and right atrium samples were harvested intraoperatively. Blood samples were analyzed by flow cytometry and complete blood counts. Atrial samples were divided for fixed fibrosis analysis, homogenized for cytokine analysis and digested for single cell suspension flow cytometry.

Results

A total of 18 patients were enrolled and samples assessed. Isolated cells from the atria revealed a CD45+ population of ~ 20%, confirming a large number of leukocytes. Further characterization revealed this population as 57% lymphocytes and 26% monocyte/macrophages (MoΦ), with the majority of the latter cells being classical (CD14++/CD16−). Interstitial fibrosis was present in 87% of samples and correlated significantly with patient age. Older patients (> 65) had significantly more atrial fibrosis and cellular inflammation. AFib patients had no distinguishing feature of atrial fibrosis and had significantly greater CD45+ MoΦ, increased expression of MMP9 and presented with a significant correlation in length of stay to CCL-2/MCP-1 and NLR (neutrophil-to-lymphocyte ratio).

Conclusion

Atrial fibrosis is correlated with age and not determinate to AFib. However, severity of atrial leukocyte infiltration and markers of matrix degradation are determinant to AFib. This also correlated with CCL2 (or MCP-1) and NLR-indicative of marked inflammation. These data show the potential importance of diagnostic and prognostic assessments that could inform clinical decision making in regard to the intensity of AFib patient management.
Zoledronic acid ameliorates the effects of secondary osteoporosis in rheumatoid arthritis patients
Authors: Xie Jun , Li Shaohua , Xiao Lianbo , Ouyang Guilin , Zheng Lin , Gu Yubiao , Gao Chengxin , Han Xiuwei
Published: December 2019

Background

Secondary osteoporosis may occur in patients with rheumatoid arthritis (RA), causing irreversible joint damage and disability. Bisphosphonates, the recently developed bone resorption inhibitors, have demonstrated significant therapeutic effects on senile and postmenopausal osteoporosis. This study evaluated the efficacy and safety of zoledronic acid (ZOL), with or without methotrexate (MTX), for the prevention and treatment of bone destruction in RA patients.

Methods

We recruited 66 RA patients with symptoms of secondary osteoporosis. They were randomized into three treatment groups—combined treatment with MTX and ZOL, ZOL monotherapy, or MTX monotherapy—in two consecutive 6-month periods. The participants were followed for 12 months. At the end of each treatment period, improvement in disease activity, bone destruction, and fracture risk were evaluated.

Results

Combined treatment with ZOL and MTX had significantly better clinical efficacy compared with either ZOL or MTX monotherapy (P < 0.05). The combination significantly improved the lumbar spine and hip BMD and reduced FRAX scores, suggesting that ZOL combined with MTX reduces bone loss and risk of hip fracture in RA patients with secondary osteoporosis.

Conclusion

ZOL has a synergistic effect when combined with MTX, inhibiting RA disease activity, reducing fracture risk, and improving quality of life in RA patients with secondary osteoporosis.

Trial registration

Chinese Clinical Trial Registry, ChiCTR1800019290. Registered 3 November 2018–Retrospective registered, http://www.chictr.org.cn/showproj.aspx?proj = 31758
SOLO taxonomy as EFL students’ disciplinary literacy evaluation tool in technology-enhanced integrated astronomy course
Authors: Chubko Nadezhda , Morris Julia E. , McKinnon David H. , Slater Eileen V. , Lummis Geoffrey W.
Published: December 2019

Whilst the role of disciplinary literacy in science, technology, engineering, and mathematics (STEM) education is becoming more prominent, there appears to be little adaptation or allowance made for English as a foreign or second language (EFL/ESL) students learning science in English, as well as no clear understanding of what comprises disciplinary literacy in science. In this article, we define the construct of disciplinary literacy in science education and justify the use of theStructure of the Observed Learning Outcome(SOLO) taxonomy (Biggs and Collis,Teaching for quality learning at university1982) as a tool for measuring EFL students’ disciplinary literacy development. This SOLO taxonomy was trialled in a STEM integrated astronomy course enhanced with a digital storytelling approach. Data were collected from adolescent EFL students’ written responses in their pre- and post-Astronomy Diagnostic Test. The results show a positive change in participants’ science disciplinary literacy development and contribute to the understanding of the EFL/ESL students’ science disciplinary literacy development and assessment.
Identification and prioritization of critical success factors in faith-based and non-faith-based organizations’ humanitarian supply chain
Authors: Azmat Muhammad , Atif Muhammad , Kummer Sebastian
Published: December 2019

In the last few decades, an exponential increase in the number of disasters, and their complexity has been reported, which ultimately put much pressure on relief organizations. These organizations cannot usually respond to the disaster on their own, and therefore, all actors involved in relief efforts should have end-to-end synchronization in order to provide relief effectively and efficiently. Consequently, to smoothen the flow of relief operation, a shared understanding of critical success factors in humanitarian supply chain serves as a pre-requisite for successful relief operation. Therefore, any member of the humanitarian supply chain might disrupt this synchronization by neglecting one or several of these critical success factors. However, in this study, we try to investigate how faith-based and non-faith-based relief organizations treat these critical success factors. Moreover, we also try to identify any differences between Islamic and Christian relief organizations in identifying and prioritizing these factors. To achieve the objective of this study, we used a two-stage approach; in the first stage, we collected the critical success factors from existing humanitarian literature. Whereas, in the second stage, using an online questionnaire, we collected data on the importance of selected factors from humanitarian relief organizations from around the world in collaboration with World Association of Non-Governmental Organizations (WANGO). Later, responses were analyzed to answer the research questions using non-parametric Binomial and Wilcoxon Rank-Sum tests. Test results indicate that for RQ1, two but all factors are significant for successful relief operation. For RQ2, we found significant differences for some CSF among faith-based and non-faith-based relief organizations. Similarly for RQ3, we found significant differences for some CSF among Islamic and Christian relief organizations.
Validation of housekeeping genes as candidate internal references for quantitative expression studies in healthy and nervous necrosis virus-infected seven-band grouper (Hyporthodus septemfasciatus)
Authors: Krishnan Rahul , Qadiri Syed Shariq Nazir , Kim Jong-Oh , Kim Jae-Ok , Oh Myung-Joo
Published: December 2019

Background

In the present study, we evaluated four commonly used housekeeping genes, viz., actin-β, elongation factor-1α (EF1α), acidic ribosomal protein (ARP), and glyceraldehyde 3-phosphate dehydrogenase (GAPDH) as internal references for quantitative analysis of immune genes in nervous necrosis virus (NNV)-infected seven-band grouper, Hyporthodus septemfasciatus.

Methods

Expression profiles of the four genes were estimated in 12 tissues of healthy and infected seven-band grouper. Expression stability of the genes was calculated using the delta Ct method, BestKeeper, NormFinder, and geNorm algorithms. Consensus ranking was performed using RefFinder, and statistical analysis was done using GraphpadPrism 5.0.

Results

Tissue-specific variations were observed in the four tested housekeeping genes of healthy and NNV-infected seven-band grouper. Fold change calculation for interferon-1 and Mx expression using the four housekeeping genes as internal references presented varied profiles for each tissue. EF1α and actin-β was the most stable expressed gene in tissues of healthy and NNV-infected seven-band grouper, respectively. Consensus ranking using RefFinder suggested EF1α as the least variable and highly stable gene in the healthy and infected animals.

Conclusions

These results suggest that EF1α can be a fairly better internal reference in comparison to other tested genes in this study during the NNV infection process. This forms the pilot study on the validation of reference genes in Hyporthodus septemfasciatus, in the context of NNV infection.
Serum and urine ghrelin in adult epileptic patients
Authors: Mohamed Wafaa S. , Nageeb Rania S. , Elsaid Hanaa H.
Published: December 2019

Background

Several neuropeptides have concerned with epilepsy pathogenesis; ghrelin showed an anticonvulsant effect. There is a potential relation between its level and antiepileptic drug (AEDs) response.

Objective

To evaluate ghrelin effect in adult epileptic patients and in response to AEDs.

Materials and methods

This case control study included 40 adult epileptic patients and 40 healthy controls. Participants were subjected to history taking of seizure semiology, full general and neurological examination, electroencephalography, and cranial imaging. Fasting serum acylated ghrelin (AG), unacylated ghrelin (UAG), and urine AG levels were estimated to all participants by enzyme-linked immunosorbent assay (ELIZA).

Results

Serum AG, UAG, and urine AG levels were statistically higher in epileptic patients than controls (p = 0.005, 0.003, and 0.018 respectively). A significant higher level of serum AG was found among generalized epileptic patients (p = 0.038). There was higher statistically significant levels of all measured parameters among poly therapy patients (p = 0.003, 0.013, and 0.001 respectively). Also, a higher statistical significant level of serum AG and UAG in AEDs-responsive patients was found (p < 0.001). Our results demonstrated significant positive correlation between all measured parameters (serum AG, UAG, and urine AG) and epilepsy duration (p = 0.001, 0.002, and 0.009 respectively). High serum AG and UAG levels were independently associated with longer epilepsy duration (p = 0.00 and 0.008) and better response to AEDs (p < 0.001).

Conclusion

These results indicated that serum AG and UAG levels were significantly high in epileptic patients especially with prolonged epilepsy duration and good AEDs response.

Trial registration

ClinicalTrials.gov NCT03926273 (22-04-2019) “retrospectively registered.”
Occurrence of Guillain-Barré syndrome and Myasthenia Gravis in an elderly male
Authors: Karri Madhavi , Ramasamy Balakrishnan , Perumal Santhosh
Published: December 2019

Introduction

The occurrence of both Guillain-Barré syndrome(GBS) and myasthenia gravis (MG) in the same individual is rare. The underlying pathophysiology was assumed to be autoimmune humoral mechanisms and molecular mimicry with a cross-reaction between autoantibodies and myelin sheath of peripheral nerves and acetylcholine receptors of the neuromuscular junction (NMJ).

Case description

A 68-year-old male known diabetic and hypertensive with good drug compliance presented with acute onset quadriparesis with bulbar involvement for 1 day. On examination, he had mild neck flexion weakness and bulbar weakness. He had flaccid quadriparesis with absent deep tendon reflexes and negative Babinski. The rest of the neurological examination was normal.

Discussion and evaluation

Blood and electrophysiological studies showed evidence of demyelinating polyradiculoneuropathy with temporal dispersion suggestive of Guillain-Barré syndrome. He was treated with intravenous immunoglobin and complete resolution of symptoms. Two months later, he presented with new-onset asymmetrical ptosis and bulbar symptoms for 3 days. On further evaluation, repetitive nerve stimulation showed postsynaptic neuromuscular disorder pattern typical of myasthenia gravis, which was further confirmed by positive acetylcholinesterase receptor antibodies (AChR). Thymoma was ruled out by imaging. He was treated with anticholinesterases, low dose steroids, and immunosuppressants (azathioprine) following which he had improvement of symptoms.

Conclusion

Our patient, who was initially diagnosed with Guillain-Barré syndrome and recovered, presented 2 months later with a new-onset illness suggestive of myasthenia gravis. This existence of two different neurological entities in the same individual is a rarity, and early recognition is essential for treatment decision and prognostic strategies.
Magnetic Resonance Arthrography, a valuable pre-operative imaging modality in femoro-acetabular impingement
Authors: El-Liethy Nevien Ezzat , Zeitoun Rania , Kamal Heba Ahmed , El-Azeem Ahmed Hazem Abd
Published: December 2019

Background

The diagnostic accuracy of MR arthrography in preoperative assessment of labral tears and chondral abnormalities in femoroacetabular impingement patients.

A non-randomized control study including 31 FAI patients (17 male and 14 females, mean age 31.9 years). All patients underwent MR arthrography after US-guided intra-articular contrast injection. Conventional and MR arthrography images were evaluated for bone abnormalities (including alpha angle and acetabular depth measurements), labral tears, and chondral abnormalities. The results were correlated to arthroscopy as the gold standard. Sensitivity, specificity, PPV, and NPV in the detection of labral tears and chondral abnormalities were statistically calculated.

Results

The included FAI patients presented cam (mean age 30.4 years ± 6.8 years), pincer (mean age 33.6 years ± 9.8 years), and mixed (mean age 36.6 years ± 12.9 years) types with the predominance of cam type. Cam type predominated in the male, while pincer and mixed types predominated in female patients. MR arthrography detected 41 labral tears in 23 patients with 87.5%, 71.4%, 91.3%, and 62.5% sensitivity, specificity, PPV, and NPV, respectively, and detected chondral abnormalities in 13 patients with 66.7%, 92.3%, 92.3%, and 66.7% sensitivity, specificity, PPV, and NPV, respectively.

Conclusion

MR arthrography is a valuable imaging modality in preoperative assessment of FAI patients. Besides identifying the type of impingement through alpha angle and acetabular depth measurements, it detects labral tears with high sensitivity and PPV. Although less sensitive in detection of chondral abnormalities, our results showed high specificity.
Evaluation of mammography detected breast arterial calcifications as a predictor of coronary cardiac risk
Authors: Ali Engy A. , Fouad Heba , Razek Naglaa A. , Saeed Ola M. , Helmy Sameh M.
Published: December 2019

Background

Cardiovascular disease is one of the leading causes of death so detection of breast arterial calcifications on annually screening mammography can predict the possibility of future cardiovascular problems.

Results

The 100 female patients were divided into two groups according to age: 1st group with age ranging from 40 to 60 years and 2nd group with age ranging from 61 to 80 years. There is increased percentage of cardiac cases among the BAC-positive patients in the 2nd group with a significantpvalue = 0.022 and this proved that there was a correlation between presence of BAC and being a cardiac case in the 2nd group, unlike the 1st group which showed no correlation.

Conclusion

Incidental detection of breast arterial calcification in mammography in females above 60 years warrants further evaluation of their coronary atherosclerotic state and risk of future development of serious coronary artery disease.
Potential antibiotic-producing fungal strains isolated from pharmaceutical waste sludge
Authors: Omeike Sunday Osaizua , Kareem Sarafadeen Olateju , Lasisi Adebayo Aliyu
Published: December 2019

Background

Antibiotic resistance and dearth of novel compounds from natural sources warrants the need to search other environments for potential antibiotic-producing microbial species. The study investigated isolation and identification of antibiotic-producing fungi from pharmaceutical waste sludge.

Results

Seven hundred and ninety-seven isolates obtained from sludge of seven pharmaceutical industries in Sango Ota, Ogun State using several growth media, with mould isolates highest (696). Isolated species were from genera Aspergillus (28.55%), Penicillium (18.35%), Trichoderma (13.44%), Rhizopus (10.21%) and Geotrichum (4.01%), and Stachybotrys (0.13%). The CFS of strains named Geotrichum candidum OMON-1, Talaromyces pinophilus OKHAIN-12, and Penicillium citrinum PETER-OOA1 had high reproducible bioactivity against Staphylococcus aureus (32 ± 0.12 mm) and Klebsiella pneumoniae (29 ± 0.12 mm) while P. citrinum MASTER-RAA2 had activity against K. pneumoniae only. Active metabolites were successfully extracted using Diaion HP-20 and methanol:iso-propanol:acetone (6:3:1 v/v). Antibacterial-active fractions of fungal extract successfully eluted with 40–60% NaCl on ion-exchange chromatography using a cation column.

Conclusions

The study successfully screened antibiotic-producing fungal species from pharmaceutical waste storage facilities. Study also showed that similar species from same toxic environment could potentially produce different metabolites.
Association of Hypothyroidism and Mortality in the Elderly Population: A Systematic Review and Meta-Analysis
Authors: Tsai Tou-Yuan , Tu Yu-Kang , Munir Kashif M , Lin Shu-Man , Chang Rachel Huai-En , Kao Sheng-Lun , Loh Ching-Hui , Peng Carol Chiung-Hui , Huang Huei-Kai
Published: December 2019

Context

The evidence of whether hypothyroidism increases mortality in the elderly population is currently inconsistent and conflicting.

Objective

The objective of this meta-analysis is to determine the impact of hypothyroidism on mortality in the elderly population.

Data Sources

PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases were searched from inception until May 10, 2019.

Study Selection

Studies evaluating the association between hypothyroidism and all-cause and/or cardiovascular mortality in the elderly population (ages ≥ 60 years) were eligible.

Data Extraction

Two reviewers independently extracted data and assessed the quality of the studies. Relative risk (RR) was retrieved for synthesis. A random-effects model for meta-analyses was used.

Data Synthesis

A total of 27 cohort studies with 1 114 638 participants met the inclusion criteria. Overall, patients with hypothyroidism experienced a higher risk of all-cause mortality than those with euthyroidism (pooled RR = 1.26, 95% CI: 1.15-1.37); meanwhile, no significant difference in cardiovascular mortality was found between patients with hypothyroidism and those with euthyroidism (pooled RR = 1.10, 95% CI: 0.84-1.43). Subgroup analyses revealed that overt hypothyroidism (pooled RR = 1.10, 95% CI: 1.01-1.20) rather than subclinical hypothyroidism (pooled RR = 1.14, 95% CI: 0.92-1.41) was associated with increased all-cause mortality. The heterogeneity primarily originated from different study designs (prospective and retrospective) and geographic locations (Europe, North America, Asia, and Oceania).

Conclusions

Based on the current evidence, hypothyroidism is significantly associated with increased all-cause mortality instead of cardiovascular mortality among the elderly. We observed considerable heterogeneity, so caution is needed when interpreting the results. Further prospective, large-scale, high-quality studies are warranted to confirm these findings.
Specific Effects of Anorexia Nervosa and Obesity on Bone Mineral Density and Bone Turnover in Young Women
Authors: Maïmoun Laurent , Garnero Patrick , Mura Thibault , Nocca David , Lefebvre Patrick , Philibert Pascal , Seneque Maude , Gaspari Laura , Vauchot Fabien , Courtet Philippe , Sultan Ariane , Piketty Marie-Liesse , Sultan Charles , Renard Eric , Guillaume Sébastien , Mariano-Goulart Denis
Published: December 2019

Objective

The threefold aim was to (1) compare areal bone mineral density (aBMD), bone turnover markers, and periostin levels in young women with either anorexia nervosa (AN) or obesity (OB) and controls (CON); (2) model the profiles according to age; and (3) determine the parameters associated with aBMD.

Subjects and Methods

One hundred and fifty-two young women with ages ranging from 16.0 to 27.0 years were subdivided into 3 groups (AN, OB, CON). The CON group was age-matched by ±6 months. aBMD, bone turnover markers, and periostin levels were evaluated.

Results

aBMD modeling showed that hip aBMD was higher in OB than in the other 2 groups from 19 years, and AN presented lower values than CON from 21 years. aBMD at the lumbar spine was higher in older OB and CON women, starting from 20 to 22 years, but in AN the difference with the other 2 groups increased with age. Periostin levels were lower in OB than in AN or CON, but no variation with age was observed. Compared with controls, OB and AN presented similarly lower markers of bone formation, although markers of bone resorption were lower in OB and higher in AN. A modeling approach showed that markers of bone formation and resorption were lower in older than in younger CON, whereas the values of these bone markers remained relatively constant in AN and OB. In all groups, lean body mass (LBM) was the parameter most positively correlated with aBMD.

Conclusion

This study demonstrated that weight extremes (AN or OB) influence aBMD, bone remodeling and periostin profiles. Moreover, factors related to aBMD were specific to each condition, but LBM was the parameter most consistently associated with aBMD.
Amorphization and Semi-Dry Conversion of Crystalline Cellulose to Oligosaccharides by Impregnated Phosphoric Acid
Authors: Hirayama Jun , Kobayashi Hirokazu , Fukuoka Atsushi
Published: December 2019

Efficient conversion of crystalline cellulose to useful chemicals is a grand challenge in biorefining. In this work, we report that amorphization and semi-dry conversion of crystalline cellulose to oligosaccharides is achieved by impregnated H3PO4. Specifically, the impregnation of crystalline cellulose with H3PO4 under 5 MPa of He and subsequent drying at room temperature produces amorphous cellulose. The impregnated H3PO4 likely permeates bulk phase cellulose by dissociating the hydrogen bonding network of cellulose during the treatment. The resulting swollen solid is depolymerized to oligosaccharides in 40% yield with 72% selectivity by heat-treatment at 100 °C with no solvent. The analysis of obtained oligosaccharides using nuclear magnetic resonance and mass spectroscopy reveals that the products are oligomers of glucose linked by various kinds of glycosidic bonds that may be useful as prebiotics.
Non-invasive imaging of high-risk coronary plaque: the role of computed tomography and positron emission tomography
Authors: Bing Rong , Loganath Krithika , Adamson Philip , Newby David , Moss Alastair
Published: December 2019

Despite recent advances, cardiovascular disease remains the leading cause of death globally. As such, there is a need to optimise our current diagnostic and risk stratification pathways in order to better deliver individualised preventative therapies. Non-invasive imaging of coronary artery plaque can interrogate multiple aspects of coronary atherosclerotic disease, including plaque morphology, anatomy and flow. More recently, disease activity is being assessed to provide mechanistic insights into in vivo atherosclerosis biology. Molecular imaging using positron emission tomography is unique in this field, with the potential to identify specific biological processes using either bespoke or re-purposed radiotracers. This review provides an overview of non-invasive vulnerable plaque detection and molecular imaging of coronary atherosclerosis.
The effects of maternal preeclampsia on inflammatory cytokines and clinical outcomes in premature infants
Authors: Cakir Salih Cagri , Dorum Bayram Ali , Koksal Nilgun , Ozkan Hilal
Published: December 2019

Objective: To investigate the effects of maternal preeclampsia on inflammatory cytokines and neonatal outcomes in premature infants.

Methods: The study included preterm infants born at gestational age ≤32 weeks in a tertiary university hospital between January 2016 and January 2017. The study group consisted of infants born from mothers with preeclampsia (Group-1), and the control group consisted of infants born from normotensive mothers (Group-2). Demographic characteristics and clinical outcomes of the infants were recorded. IL-6, IL-8, IL-10, and TNF-α cytokine levels were measured from umbilical cord blood samples.

Results: A total of 108 infants were included in the study, of which 34 were in the Group-1 and 74 in the Group-2. Gestational ages (29 vs 30 weeks) of the infants in both groups were similar. There was no significant difference between the cytokine levels of infants with and without preeclampsia. The rate of small for gestational age, retinopathy of prematurity, intraventricular hemorrhage, necrotizing enterocolitis, neutropenia, and thrombocytopenia were significantly higher at the infants with preeclampsia.

Conclusion: Maternal preeclampsia leads to an increase at the neonatal morbidities in premature infants without causing a significant alteration at the cytokine levels in cord blood.

doi: https://doi.org/10.12669/pjms.36.1.1316

How to cite this:Cakir SC, Dorum BA, Koksal N, Ozkan H. The effects of maternal preeclampsia on inflammatory cytokines and clinical outcomes in premature infants. Pak J Med Sci. 2020;36(1):---------. doi: https://doi.org/10.12669/pjms.36.1.1316

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