bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of Standardized Residual Component Culture Criteria for Suspected Septic Transfusion Reactions Would Increase the Component Culturing Rate at a Single Academic Medical Center
Authors: Ruby Kristen N , Khan Jenna , Martin Isabella W , Dunbar Nancy M
Published: February 2022

Objectives

The 2019 SCARED study developed the Biomedical Excellence for Safer Transfusion (BEST) criteria in an effort to standardize the decision to culture residual units in the context of suspected septic transfusion reactions (STRs). The goal of this study was to apply the BEST criteria to determine the effect on the transfusion reaction decision to culture.

Methods

This retrospective, single-center, cross-sectional study assessed adult transfusion reactions identified in calendar years 2013 to 2020. Reactions following transfusion of RBCs, platelets, and plasma were included, and the decisions to culture following strict application of BEST criteria were compared with decisions to culture in actual practice.

Results

In total, 1,068 transfusion reactions were reported and 200 (19%) suspected STRs were cultured, all with negative results; 303 (28%) reactions would have been cultured per strict application of the BEST criteria. Concordance between actual culture decision and BEST criteria recommendation was 62% for cultured components and 79% for components that were not cultured.

Conclusions

BEST criteria provide objective recommendations of when to culture residual units implicated in suspected STRs, but strict application of these criteria may result in increased culture rates. Clinical correlation to aid in the decision to culture is recommended.
In the spirit of radical liberalism: a historical review of land reforms in China from the 1970s to today
Authors: Wang Xiaorui , Hu Shen
Published: February 2022

Focusing on the policy-driven land reforms in the People’s Republic of China, this article discusses the relationship between government intervention and economic growth, through the lens of economic anthropology. Inspired by Karl Polanyi’s insights into market economies, this article undertakes a historical review on the attempts made by Chinese central authority to boost the economy at the expense of rural lands, the results of these attempts and their future implications. The findings indicate that, first, the ‘socialist’ characteristics of China’s market economy imply above all the State’s strong intervention to facilitate, rather than restrict, as suggested by Polanyi, the free circulation of land in the market. This contributes greatly to China’s economic ascent, but also to severe environmental and social problems. Second, compared to the West, the democratic procedure that buffers the impacts and eases the speed of urbanisation is missing in the Chinese context.
Chronic Road Salt Exposure Across Life Stages and The Interactive Effects of Warming and Salinity in a Semiaquatic Insect
Authors: Zhang Vicki M , Martin Rosemary L , Murray Rosalind L
Published: February 2022

The salinization of freshwater habitats from winter road salt application is a growing concern. Understanding how taxa exposed to road salt run-off respond to this salinity exposure across life history transitions will be important for predicting the impacts of increasing salinity. We show that Leucorrhinia intacta Hagen, 1861 (Odonata: Libellulidae) dragonflies are robust to environmentally relevant levels of salt pollution across intrinsically stressful life history transitions (hatching, growth, and metamorphosis). Additionally, we observed no carry-over effects into adult dragonfly morphology. However, in a multiple-stressor setting, we see negative interactive effects of warming and salinity on activity, and we found that chronically warmed dragonfly larvae consumed fewer mosquitoes. Despite showing relatively high tolerance to salinity individually, we expect that decreased dragonfly performance in multiple-stressor environments could limit dragonflies’ contribution to ecosystem services such as mosquito pest control in urban freshwater environments.
Body Mass Index and Memory Across 18 Years in the Wisconsin Longitudinal Study
Authors: Moorman Sara M , Kobielski Sara
Published: February 2022

Background

Body weight is a modifiable risk factor for dementia, but results have been mixed as to the ages at which normal body weight is markedly preferable to overweight or obesity. This study assessed the association between change in body mass index (BMI) over 2 periods of the life course with change in memory between the ages of 65 and 72 for males and females.

Methods

Participants were 3 637 White high school graduates, born in 1939, from the Wisconsin Longitudinal Study. The statistical analyses were fixed-effects regression models, with moderation terms to test for sex differences. One set of models examined change in BMI between ages 54 and 65, and the other set examined change in BMI between ages 65 and 72. In both cases, cognitive change occurred between ages 65 and 72.

Results

Greater increases in BMI were associated with a greater decline in immediate recall for females only, both contemporaneously and following a lag. Increases in BMI were associated with greater contemporaneous—but not lagged—declines in both delayed recall and digit ordering for both males and females.

Conclusions

The present study adds to the evidence that for White, high school educated Americans, weight gain in midlife and young-old age is a risk factor for memory decline. Results vary according to the timing of the weight gain, the aspect of memory measured, and participant sex.
Improving phosphate use efficiency in the aquatic crop watercress (Nasturtium officinale)
Authors: Hibbert Lauren , Taylor Gail
Published: February 2022

Watercress is a nutrient-dense leafy green crop, traditionally grown in aquatic outdoor systems and increasingly seen as well-suited for indoor hydroponic systems. However, there is concern that this crop has a detrimental impact on the environment through direct phosphate additions causing environmental pollution. Phosphate-based fertilisers are supplied to enhance crop yield, but their use may contribute to eutrophication of waterways downstream of traditional watercress farms. One option is to develop a more phosphate use efficient (PUE) crop. This review identifies the key traits for this aquatic crop (the ideotype), for future selection, marker development and breeding. Traits identified as important for PUE are (i) increased root surface area through prolific root branching and adventitious root formation, (ii) aerenchyma formation and root hair growth. Functional genomic traits for improved PUE are (iii) efficacious phosphate remobilisation and scavenging strategies and (iv) the use of alternative metabolic pathways. Key genomic targets for this aquatic crop are identified as: PHT phosphate transporter genes, global transcriptional regulators such as those of the SPX family and genes involved in galactolipid and sulfolipid biosynthesis such as MGD2/3, PECP1, PSR2, PLDζ1/2 and SQD2. Breeding for enhanced PUE in watercress will be accelerated by improved molecular genetic resources such as a full reference genome sequence that is currently in development.
Indirect elections as a constitutional device of epistocracy
Authors: Bhatia Udit
Published: February 2022

Recent political events around the world have led some to advocate replacing democratic institutions with an “epistocracy” (rule by the competent). Offering a historical perspective on this debate, this article explores the neglected constitutional device of indirect elections and its use as an epistocratic mechanism. These are elections where representatives are selected by intermediary electors, rather than directly by voters. Drawing on the United States and India as case studies, I argue that such elections were historically defended as epistocratic mechanisms, aimed at securing the selection of representatives with superior virtue or ability. The epistocratic case for indirect election, however, attracted critics in both countries. While such critics presented a compelling case against the reliance on indirect election to select superior legislators, their arguments generated a further dilemma, opening representative democracy itself—direct and indirect—to challenge.
Perceived reliability of medical device alarms—a major determinant of medical errors driven by frozen medical thinking
Authors: Frankenthal Hilel , Ben Shlomo Izhar , Kurzweil Segev Yael , Bubil Ilan , K. Alon , Orkin Dina , Kobo Greenhut Ayala
Published: February 2022

This concept paper introduces the phenomenon of self-assigning a ‘perceived reliability’ value to medical device readings as a potential source of cognitive bias in medical decision-making. Medical errors can result from clinical decisions based on partial clinical data despite medical device readings providing data to the contrary. At times, this results from clinician distrust of medical device output. Consequentially, clinicians engage in a form of ‘frozen thinking’, a fixation on a particular thought process despite data to the contrary. Many medical devices, such as intensive care unit (ICU) monitors and alarms, lack validated statistics of device output reliability and validity. In its absence, clinicians assign a self-perceived reliability value to device output data and base clinical decisions therefrom. When the perceived reliability value is low, clinicians distrust the device and ignore device readings, especially when other clinical data are contrary.

We explore the cognitive and theoretical underpinnings of this ‘perceived reliability’ phenomenon. The mental assignment of a perceived reliability value stems from principles of ‘script theory’ of medical decision-making. In this conceptual framework, clinicians make decisions by comparing current situations to mental ‘scripts’ of prior clinical decisions and their outcomes. As such, the clinician utilizes scripts of prior experiences to create the perceived reliability value.

Self-assigned perceived reliability is subject to multiple dangers of reliability and cognitive biases. Some of these biases are presented. Among these is the danger of dismissing device readings as ‘noise’. This is particularly true of ICU alarms that can emit frequent false alarms and contribute to clinician sensory overload. The cognitive dangers of this ‘noise dismissal’ are elaborated via its similarity to the phenomenon of ‘spatial disorientation’ among aviation pilots.

We conclude with suggestions for reducing the potential bias of ‘perceived reliability’. First presented are regulatory/legislative and industry-based interventions for increasing the study of, and end-user access to, validated device output reliability statistics. Subsequently, we propose strategies for overcoming and preventing this phenomenon. We close with suggestions for future research and development of this ‘perceived reliability’ phenomenon.
Effects of rubber matting on feedlot cattle growth performance, locomotion, and carcass characteristics in slatted floor facilities
Authors: Dawson Cody R , Henley Parker A , Schroeder Adam R , Meteer William T , Hayes Courtney A , Felix Tara L , Shike Daniel W , McCann Joshua C
Published: February 2022

The objective was to determine effects of old and new rubber matting in a slatted, indoor cattle feeding facility on cattle growth performance, locomotion, and carcass characteristics. In experiment 1, fall-born Angus × Simmental steers (N = 207; body weight = 222 ± 38 kg) were blocked by weight and assigned to 32 pens. Pens were randomly assigned to 1 of 4 treatments: no matting/concrete (CONC1), 12-yr-old Animat Pebble matting (OLD1), new Animat Maxgrip matting (MG), and new Animat Pebble matting (PEB1). Steers were fed a common diet for 209 d with a minimum stocking density of 3.40 m2 per animal. Final body weight (BW) and average daily gain (ADG) were affected (P = 0.02 and P < 0.01, respectively) by treatment with steers on PEB1 finishing heaviest with the greatest growth, MG and CONC1 intermediate, and OLD1 finishing at the lightest final BW with the least growth. Flooring treatment did not affect overall dry matter intake (DMI; P = 0.16) or gain to feed ratio (G:F; P = 0.94). Flooring treatment did not affect (P ≥ 0.19) any carcass traits. Locomotion scores (LS) were affected (P < 0.01) by flooring treatment with CONC1 having the worst mobility while OLD1, MG, and PEB1 were similar (P ≥ 0.24). Locomotion score had a day effect (P < 0.01) where cattle gait and mobility worsened as days on feed increased. In experiment 2, fall-born Angus × Simmental steers (N = 189; BW = 352 ± 43 kg) were blocked by weight and assigned to 21 pens. Pens were randomly assigned to 1 of 3 treatments: no matting/concrete (CONC2), 15-yr-old Animat Pebble matting (OLD2), and new Animat Pebble matting (PEB2). Steers were fed a common diet for 152 d with a stocking density of 2.65 m2 per steer. After 152 d on feed, flooring treatment did not affect (P ≥ 0.30) BW, ADG, or DMI nor did treatment affect (P ≥ 0.17) carcass traits. However, steers housed on OLD2 or PEB2 had improved locomotion scores (P = 0.02) compared with steers housed on CONC2. Locomotion score had a day effect (P < 0.01) as cattle gait and mobility worsened with greater number of days on feed, regardless of treatment. Overall, results suggest that new rubber matting increased ADG and HCW during a 209-d trial when cattle were stocked at 3.4 m2 in small pens and that rubber matting regardless of age improved cattle locomotion scores in slatted indoor feeding facilities.
Novel Synthetic oviductal fluid for Conventional Freezing 1 (SCF1) culture medium improves development and cryotolerance of in vitro produced Holstein embryos
Authors: Owen Corie M , Johnson Melissa A , Rhodes-Long Katherine A , Gumber Diana J , Barceló-Fimbres Moises , Altermatt Joy L , Campos-Chillon Lino Fernando
Published: February 2022

In vitro produced (IVP) embryos hold great promise in the cattle industry; however, suboptimal in vitro culture conditions induce metabolic dysfunction, resulting in poor development and low cryotolerance of IVP embryos. This limits the use of IVP embryos in the cattle industry for embryo transfer and commercial scale-up. Previous studies have reported the use of individual metabolic regulators in culture media to improve blastocyst development rates and cryopreservation. In this study, we hypothesized that using a combination of select regulators, chosen for their unique synergistic potential, would alleviate metabolic dysfunction and improve the development of in vitro produced embryos to make them more closely resemble in vivo derived embryos. To test this, we first compared lipid content between Holstein and Jersey embryos produced in vivo and in vitro, and then systematically determined the combination of metabolic regulators that led to the greatest improvements in embryonic development, lipid content, mitochondrial polarity, and cryotolerance. We also tested different slow freezing techniques to further improve cryotolerance and finally validated our results via a clinical trial. Overall, we found that the use of multiple metabolic regulators in one culture media, which we refer to as Synthetic oviductal fluid for Conventional Freezing 1 (SCF1), and an optimized slow freezing technique resulted in improved pregnancy rates for frozen IVP embryos compared to embryos cultured in a synthetic oviductal fluid media. Additionally, there was no difference in pregnancy rate between frozen and fresh IVP embryos cultured in SCF1. This suggests that optimizing culture conditions and slow freezing technique can produce cryotolerance IVP and should allow further dissemination of this assisted reproductive technology.
Shotgun and TMT-Labeled Proteomic Analysis of the Ovarian Proteins of an Insect Vector, Aedes aegypti (Diptera: Culicidae)
Authors: Geiser Dawn L , Li Wenzhou , Pham Daphne Q-D , Wysocki Vicki H , Winzerling Joy J
Published: February 2022

Aedes aegypti [Linnaeus in Hasselquist; yellow fever mosquito] transmits several viruses that infect millions of people each year, including Zika, dengue, yellow fever, chikungunya, and West Nile. Pathogen transmission occurs during blood feeding. Only the females blood feed as they require a bloodmeal for oogenesis; in the bloodmeal, holo-transferrin and hemoglobin provide the females with a high iron load. We are interested in the effects of the bloodmeal on the expression of iron-associated proteins in oogenesis. Previous data showed that following digestion of a bloodmeal, ovarian iron concentrations doubles by 72 hr. We have used shotgun proteomics to identify proteins expressed in Ae. aegypti ovaries at two oogenesis developmental stages following blood feeding, and tandem mass tag-labeling proteomics to quantify proteins expressed at one stage following feeding of a controlled iron diet. Our findings provide the first report of mosquito ovarian protein expression in early and late oogenesis. We identify proteins differentially expressed in the two oogenesis development stages. We establish that metal-associated proteins play an important role in Ae. aegypti oogenesis and we identify new candidate proteins that might be involved in mosquito iron metabolism. Finally, this work identified a unique second ferritin light chain subunit, the first reported in any species. The shotgun proteomic data are available via ProteomeXchange with identifier PXD005893, while the tandem mass tag-labeled proteomic data are available with identifier PXD028242.
Foley catheter erosion through bladder wall causing intraperitoneal bladder injury: a case report
Authors: Alzughaibi Mohand , Althonayan Naif , Alrabeeah Khalid , Alkhayal Abdullah
Published: February 2022

Bladder perforation due to indwelling catheters is regarded to be a very rare incident. Most cases of catheter-induced rupture were in patients with chronic catheterization due to chronic bladder diseases. An 80-year-old male with neurogenic bladder on chronic catheterization presented to the emergency room with abdominal pain and anuria. On CT, the tip of the catheter was eroding through the bladder into the peritoneum. The patient underwent a laparotomy with adhesiolysis. The tip of the Foley catheter was seen eroding through the bladder dome. A new open tip catheter was inserted per urethra to prevent the catheter tip from eroding again through the bladder wall. Bladder erosion or rupture is associated with high morbidity and mortality. Our case demonstrates the deleterious effects of chronic catheterization and the need for a high level of suspicion when dealing with such cases.
Prospective validation of a new imaging scorecard to assess leptomeningeal metastasis: A joint EORTC BTG and RANO effort
Authors: Le Rhun Emilie , Devos Patrick , Winklhofer Sebastian , Lmalem Hafida , Brandsma Dieta , Kumthekar Priya , Castellano Antonella , Compter Annette , Dhermain Frederic , Franceschi Enrico , Forsyth Peter , Furtner Julia , Galldiks Norbert , Gállego Pérez-Larraya Jaime , Gempt Jens , Hattingen Elke , Hempel Johann Martin , Lukacova Slavka , Minniti Giuseppe , O’Brien Barbara , Postma Tjeerd J , Roth Patrick , Rudà Roberta , Schaefer Niklas , Schmidt Nils O , Snijders Tom J , Thust Steffi , van den Bent Martin , van der Hoorn Anouk , Vogin Guillaume , Smits Marion , Tonn Joerg C , Jaeckle Kurt A , Preusser Matthias , Glantz Michael , Wen Patrick Y , Bendszus Martin , Weller Michael
Published: February 2022

Background

Validation of the 2016 RANO MRI scorecard for leptomeningeal metastasis failed for multiple reasons. Accordingly, this joint EORTC Brain Tumor Group and RANO effort sought to prospectively validate a revised MRI scorecard for response assessment in leptomeningeal metastasis.

Methods

Coded paired cerebrospinal MRI of 20 patients with leptomeningeal metastases from solid cancers at baseline and follow-up after treatment and instructions for assessment were provided via the EORTC imaging platform. The Kappa coefficient was used to evaluate the interobserver pairwise agreement.

Results

Thirty-five raters participated, including 9 neuroradiologists, 17 neurologists, 4 radiation oncologists, 3 neurosurgeons, and 2 medical oncologists. Among single leptomeningeal metastases-related imaging findings at baseline, the best median concordance was noted for hydrocephalus (Kappa = 0.63), and the worst median concordance for spinal linear enhancing disease (Kappa = 0.46). The median concordance of raters for the overall response assessment was moderate (Kappa = 0.44). Notably, the interobserver agreement for the presence of parenchymal brain metastases at baseline was fair (Kappa = 0.29) and virtually absent for their response to treatment. 394 of 700 ratings (20 patients x 35 raters, 56%) were fully completed. In 308 of 394 fully completed ratings (78%), the overall response assessment perfectly matched the summary interpretation of the single ratings as proposed in the scorecard instructions.

Conclusion

This study confirms the principle utility of the new scorecard, but also indicates the need for training of MRI assessment with a dedicated reviewer panel in clinical trials. Electronic case report forms with “blocking options” may be required to enforce completeness and quality of scoring.
Maize RNA 3'-terminal phosphate cyclase-like protein promotes 18S pre-rRNA cleavage and is important for kernel development
Authors: Wang Tao , Chang Yumei , Zhao Kai , Dong Qing , Yang Jun
Published: February 2022

Plant ribosomes contain four specialized ribonucleic acids, the 5S, 5.8S, 18S, and 25S ribosomal RNAs (rRNAs). Maturation of the latter three rRNAs requires cooperative processing of a single transcript by several endonucleases and exonucleases at specific sites. In maize (Zea mays), the exact nucleases and components required for rRNA processing remain poorly understood. Here, we characterized a conserved RNA 3′-terminal phosphate cyclase (RCL)-like protein, RCL1, that functions in 18S rRNA maturation. RCL1 is highly expressed in the embryo and endosperm during early seed development. Loss of RCL1 function resulted in lethality due to aborted embryo cell differentiation. We also observed pleiotropic defects in the rcl1 endosperm, including abnormal basal transfer cell layer growth and aleurone cell identity, and reduced storage reserve accumulation. The rcl1 seeds had lower levels of mature 18S rRNA and the related precursors were altered in abundance compared with wild type. Analysis of transcript levels and protein accumulation in rcl1 revealed that the observed lower levels of zein and starch synthesis enzymes mainly resulted from effects at the transcriptional and translational levels, respectively. These results demonstrate that RCL1-mediated 18S pre-rRNA processing is essential for ribosome function and messenger RNA translation during maize seed development.
Transcriptome and miRNAome analysis reveals components regulating tissue differentiation of bamboo shoots
Authors: Li Ying , Zhang Deqiang , Zhang Shuqin , Lou Yongfeng , An Xinmin , Jiang Zehui , Gao Zhimin
Published: February 2022

Primary thickening determines bamboo yield and wood property. However, little is known about the regulatory networks involved in this process. This study identified a total of 58,652 genes and 150 miRNAs via transcriptome and small RNA sequencing using the underground thickening shoot samples of wild-type (WT) Moso bamboo (Phyllostachys edulis) and a thick wall (TW) variant (P. edulis “Pachyloen”) at five developmental stages (WTS1/TWS1-WTS5/TWS5). A total of 14,029 (65.17%) differentially expressed genes and 68 (45.33%) differentially expressed miRNAs were identified from the WT, TW, and WTTW groups. The first two groups were composed of four pairwise combinations, each between two successive stages (WTS2/TWS2_versus_WTS1/TWS1, WTS3/TWS3_versus_WTS2/TWS2, WTS4/TWS4_versus_WTS3/TWS3, and WTS5/TWS5_versus_WTS4/TWS4), and the WTTW group was composed of five combinations, each between two relative stages (TWS1–5_versus_WTS1–5). Additionally, among the phytohormones, zeatin showed more remarkable changes in concentrations than indole-3-acetic acid, gibberellic acid, and abscisic acid throughout the five stages in the WT and the TW groups. Moreover, 125 cleavage sites were identified for 387 miRNA–mRNA pairs via degradome sequencing (P < 0.05). The dual-luciferase reporter assay confirmed that 13 miRNAs bound to 12 targets. Fluorescence in situ hybridization localized miR166 and miR160 in the shoot apical meristem and the procambium of Moso bamboo shoots at the S1 stage. Thus, primary thickening is a complex process regulated by miRNA–gene–phytohormone networks, and the miRNAome and transcriptome dynamics regulate phenotypic plasticity. These findings provide insights into the molecular mechanisms underlying wood formation and properties and propose targets for bamboo breeding.
Donne, Drummond, and The Beautie of the Remarkable Yeare
Authors: Parkinson David J
Published: February 2022

The Beautie of the Remarkable Yeare of Grace, 1638 celebrates the Scottish National Covenant in high, ecstatic style. Unenthusiastic about the Covenant, Scotland’s leading poet William Drummond of Hawthornden engages critically with topics and even terms that are central to The Beautie. Identification of some allusions to Donne in The Beautie enables a revaluation of Drummond’s well-known criticism of metaphysical style. Rather than deprecating Donne, Drummond can be shown to be chafing against the appropriation of Donnean topics and phrases in the Covenanting high style.
Population Development of the Root-Lesion Nematode Pratylenchus dakotaensis on Soybean Cultivars
Authors: Chowdhury Intiaz Amin , Yan Guiping , Kandel Hans , Plaisance Addison
Published: February 2022

Two greenhouse experiments were conducted with the new species of root-lesion nematode, Pratylenchus dakotaensis, discovered in North Dakota, USA in 2017 and named in 2021. Experiment 1 was conducted to ascertain resistance levels of soybean (Glycine max [L.] Merr.) cultivars to the new species P. dakotaensis and Experiment 2 was conducted to evaluate the population levels of P. dakotaensis in roots versus soil. A total of 20 soybean cultivars, and the positive control, cultivar Barnes, accompanying a nonplanted control, were evaluated in both experiments; they each had five replicates and the experiments were repeated. Among the 20 soybean cultivars evaluated, a cultivar with the ID# 13 consistently produced the greatest population densities of P. dakotaensis across all the experiments and therefore it was selected as the susceptible check. The ratio of the final nematode population density of a test cultivar relative to the final population density of the susceptible check was used to scale resistance rating. Combined results of all the trials indicated that seven of the cultivars were moderately resistant, nine of the cultivars plus ‘Barnes’ were moderately susceptible, and four of the cultivars were susceptible. However, none of the cultivars tested were classified as resistant. Analysis of P. dakotaensis population levels revealed that ≥50% of the population resided in the root habitat and the remaining nematodes were recovered from soil at 9 weeks after planting for a majority of the cultivars tested. These results provide an insight into the virulence of P. dakotaensis on commercial soybean cultivars.
Music Therapy for Preoperative Anxiety Reduction in Women Undergoing Total Laparoscopic Hysterectomy: A Randomized Controlled Trial
Authors: Casarin Jvan , Cromi Antonella , Sgobbi Barbara , Di Siena Anna , Serati Maurizio , Bolis Maria Elena , Ghezzi Fabio
Published: February 2022

(Abstracted from J Minim Invasive Gynecol 2021;28:1618–1624)

Previous studies suggested that women undergoing hysterectomy and other major surgical procedure may experience preoperative anxiety. Contributing factors include an unfamiliar environment, loss of control, perceived or actual physical risk, and fear of postoperative pain.
Global, Regional, and National Estimates and Trends in Stillbirths From 2000 to 2019: A Systematic Assessment
Authors: Hug Lucia , You Danzhen , Blencowe Hannah , Mishra Anu , Wang Zhengfan , Fix Miranda J. , Wakefield Jon , Moran Allisyn C. , Gaigbe-Togbe Victor , Suzuki Emi , Blau Dianna M. , Cousens Simon , Creanga Andreea , Croft Trevor , Hill Kenneth , Joseph K. S. , Maswime Salome , McClure Elizabeth M. , Pattinson Robert , Pedersen Jon , Smith Lucy K. , Zeitlin Jennifer , Alkema Leontine
Published: February 2022

(Abstracted from Lancet 2021;398:772–785)

Stillbirths are a public health issue as well as an example of the inequality of care during pregnancy and birth. Groups such as the UN Global Strategy for Women's, Children's, and Adolescents' Health and the Every Newborn Action Plan aim to prevent stillbirths.
Determinants of Major Adverse Kidney Events in Extracorporeal Membrane Oxygenation Survivors
Authors: Bobba Aniesh , Costanian Christy , Bahous Sola A. , Tohme Fadi A.
Published: February 2022

OBJECTIVES:

The majority of extracorporeal membrane oxygenation patients develop acute kidney injury, and 40–60% require renal replacement therapy. This study aimed to examine determinants of major adverse kidney events in extracorporeal membrane oxygenation survivors.

DESIGN:

Retrospective cohort study.

SETTING:

Barnes Jewish Hospital, St. Louis, MO.

PATIENTS:

Patients admitted at Barnes Jewish hospital between 2008 and 2017 and requiring extracorporeal membrane oxygenation. Patients 18 years old and older who survived to hospital discharge were considered for the study.

INTERVENTIONS:

None.

MEASURES AND MAIN RESULTS:

Patients who were admitted to a single center between 2008 and 2017, were on extracorporeal membrane oxygenation for more than 24 hours and survived hospital discharge were included. Major adverse kidney event was defined as either doubling serum creatinine, incident end-stage renal disease, or death. Acute kidney injury was defined as Kidney Disease: Improving Global Outcomes stages 2–3. Complete acute kidney injury recovery was defined as a return to 50% of baseline serum creatinine and partial recovery as an improvement in acute kidney injury stage without a return to 50% of baseline serum creatinine. Survival analysis plots and Cox regression models were fitted to examine the associations of acute kidney injury status, acute kidney injury recovery, and other factors with major adverse kidney event. Among 188 extracorporeal membrane oxygenation patients who survived until hospital discharge, 63% had acute kidney injury and 41% required renal replacement therapy. The mean follow-up time was 3.4 years. Kaplan-Meier survival curves showed that patients with no/partial recovery from acute kidney injury had a higher rate of major adverse kidney event compared with those with no acute kidney injury. Multivariate analysis showed that acute kidney injury (adjusted hazard ratio =1.79 [95% CI = 1.00–3.21]), no/partial recovery from acute kidney injury (adjusted hazard ratio = 2.94 [95% CI = 1.46–5.92]), and initiation of renal replacement therapy on the day or after extracorporeal membrane oxygenation (adjusted hazard ratio = 5.4 [95% CI = 1.14–25.6]) were significant determinants of major adverse kidney event after adjustment for potential confounders.

CONCLUSIONS:

Acute kidney injury, acute kidney injury recovery status, and timing of initiation of renal replacement therapy are determinants of major adverse kidney events in patients who received extracorporeal membrane oxygenation.
Fat Grafting following Internal Tissue Expansion: An Option for Breast Reconstruction after Total Mastectomy
Authors: Kolasinski Jerzy , Pyka Pawel
Published: February 2022

Background:

Breast reconstruction is currently performed as standard practice.

Methods:

A prospective study was performed of patients after total mastectomy who underwent autologous breast reconstruction with fat grafting (FG) combined with internal tissue expansion between September 2015 and December 2020. The patients were classified into groups A to F depending on the steps of breast reconstruction. Groups A and B described patients with completed breast reconstruction with FG and expander removal, with or without nipple/areola complex reconstruction. C described patients during deflation of the expander combined with simultaneous FG. D described patients after expander implantation and refilling. E described patients after first FG, and F included patients who discontinued reconstruction with the described method and converted to reconstruction with a breast implant.

Results:

Among 22 treated patients‚ two were after first FG (9.09%‚ group E), two were after expander implantation and refilling (9.09%‚ group D), three were during deflation of the expander combined with simultaneous FG (13.63%‚ group C), and four (18.18%) had completed breast reconstruction—two (9.09%) without NAC reconstruction and symmetrization (group B) and two (9.09%) with completed breast reconstruction (group A). In 11 patients (50%), breast reconstruction was abandoned after expander implantation and one to three FG procedures (group F), converting to breast reconstruction with a breast implant.

Conclusions:

This study demonstrated successful breast reconstruction using FG and expander implantation. Breast reconstruction using this method is safe and enables possible abandonment at any treatment stage, as well as conversion to breast reconstruction with implants.
A novel telerehabilitation with an educational program for caregivers using telelecture is feasible for fall prevention in elderly people
Authors: Moriichi Kentaro , Fujiya Mikihiro , Ro Takanori , Ota Tetsuo , Nishimiya Hitomi , Kodama Mariko , Yoshida Nana , Hattori Yukari , Hosokawa Tetsuya , Hishiyama Hohei , Kunimoto Masao , Hayashi Hiroki , Hirokawa Hiroyuki , Yoshida Akitoshi
Published: February 2022

Background:

The importance of fall prevention rehabilitations has been well recognized. Recently telerehabilitation was developed, however, there have been no reports on telerehabilitation with direct support from specialists for fall prevention among the elderly. We herein reported telerehabilitation by caregivers educated by our novel educational program.

Methods:

Caregivers were educated with our educational program using a telelecture system and supported telerehabilitation following instructions from rehabilitation specialists in our university using the telemedicine system every two to four weeks for three months. Caregivers were assessed with our original questionnaire before and after the telelecture. Participants were assessed by the Berg Balance Scale (BBS), Timed Up & Go test (TUG test), Hand-held dynamometer (HHD) and Mini-Mental State Examination (MMSE) before and after telerehabilitation. Wilcoxon's signed-rank test was used for the statistical analyses. A value of P<.05 was considered statistically significant.

Results:

Nine elderly people were enrolled. The mean age was 84.7 (78–90) years old and the sex ratio was 1:8 (males:females). The average number of telerehabilitation sessions was 4.7. The average score of nineteen caregivers before the lecture was 15.3, while that after the lecture was 18.3. Caregivers’ understanding was significantly increased after the telelecture (P<.001). No adverse events occurred during the study period. The median values of the BBSs, TUG test, right and left HHD and MMSE before and after 3 months’ telerehabilitation were 43 (95% confidence interval [CI]: 40.10, 49.01) and 49 (95% CI: 41.75, 50.91), 17.89 (95% CI: 15.51, 23.66) and 18.53 (95% CI: 14.56, 25.67), 7.95 (95% CI: 4.38, 10.14) and 11.55 (95% CI: 7.06, 13.55), 9.85 (95% CI: 6.79, 12.59) and 13.20 (95% CI: 7.96, 14.42), and 19 (95% CI: 12.34, 21.66) and 16 (95% CI: 10.81, 21.00), respectively. Although approximately half of the participants showed improvement in the BBS, TUG test, right and left HHD and MMSE, no significant changes were observed (P=.7239, P=.3446, P=.1023, P=.3538 and P=.8253, respectively).

Conclusions:

Our telerehabilitation program exhibited significant effects in elderly people and improved the degree of understanding concerning rehabilitation among caregivers in facilities for elderly people.
Efficacy of liriope platyphylla extract for improving respiratory functions
Authors: Jung Ga Hyeon , Park Chae Hyun , Lee Hyun , Kang Jae Hui
Published: February 2022

Background:

Respiratory disease has emerged as a global issue due to COVID-19. In particular, there has been an increased frequency of occurrence of symptoms such as cough, sputum, and dyspnea, which commonly accompany chronic obstructive pulmonary disease (COPD). Liriope platyphylla (LP) extract is known to improve respiratory function. LP extract ameliorates the symptoms commonly seen in bronchitis, asthma, and COPD and enhances immunity, as it has anti-inflammatory properties. In a previous study in rats, LP effectively improved respiratory inflammation levels. However, few randomized controlled trials have verified the effects of LP in respiratory disease and there have been no studies to determine the appropriate dose and duration to make it a more convenient functional health product. Based on previous studies, we would like to proceed with this clinical trial under the assumption that LP will help improve respiratory function and produce anti-inflammatory effects.

Methods:

This will be a single-center, randomized, double-blind, placebo-controlled pilot trial. Participants will randomly be allocated to receive either 1000 mg LP or placebo. The total duration of the clinical trial will be 4 to 6 weeks. A follow-up assessment will be conducted 4 weeks after screening, and the effect and safety of LP application will be assessed at this second visit. The primary outcome will be the breathlessness, cough, and sputum scale score. Secondary outcomes will include pulmonary function, clinical symptoms of cough and sputum (reported through a questionnaire), changes in immune cells, changes in immune factors used to analyze allergic inflammation in bronchi, antioxidant enzyme activity, nitric oxide level, and COPD assessment test score.

Discussion:

This study has limited inclusion and exclusion criteria and the intervention will be well-controlled. This will be the first randomized controlled trial to assess the efficacy and safety of LP extract in adults with cough and sputum. This study will provide insight into the mechanisms of the anti-inflammatory effects and improvement of respiratory function of LP.
Delayed anterolateral radial head dislocation secondary to radial shaft fracture malunion
Authors: Wang Sung Il , Lee Seung Cheol
Published: February 2022

Rationale:

Traumatic radial head dislocation (RHD) can occur due to hyperpronation injury with sequential disruption of the annular ligament, quadrate ligament, and the interosseous membrane. Although studies have shown that traumatic RHD is generally associated with Monteggia fracture-dislocation, traumatic RHD occurring with ipsilateral radial shaft fractures has rarely been reported. Delayed RHD secondary to the malunion of isolated radial shaft fractures is extremely rare.

Patient concerns:

We report the case of a 12-year-old right-handed boy with progressive pain and limited range of motion in the right elbow.

Diagnosis:

The patient was diagnosed with delayed RHD associated with radial shaft fracture malunion.

Interventions and outcomes:

A corrective osteotomy was performed at the site of malunion with open reduction of the radial head using an extensile lateral approach. The annular ligament was disrupted. Forearm rotation causes radial head subluxation Therefore, the Bell Tawse procedure was additionally performed to reconstruct the annular ligament by turning down a strip of triceps tendon and anchoring it around the radial neck.

Lessons:

Malunion of the radial shaft can cause delayed RHD with a limited elbow range of motion. Annular reconstruction using a strip of the triceps tendon and corrective osteotomy of the radial shaft with an extensile lateral approach may be useful for treating this rare entity or situation.
Sexual maturity of children on regular hemodialysis
Authors: Soliman Ahmed S. Abdel-Halim , Kamal Naglaa M. , Abukhatwah Mohmed W. , Mashad Ghada M. El , Gowaad Iman R. Abd El , Halabi Yasser A. , Alalyani Saad A. , Qari Shahad A. , Afifi Wesam E.
Published: February 2022

A big problem is the delayed growth and sexual maturity in children with chronic kidney disease (CKD) with the consequent reduction in adults’ height. Testosterone and estradiol have significant physiologic changes in children suffering from CKD, resulting in delayed puberty. We aim to assess blood levels of these hormones in patients with CKD-5 on regular hemodialysis.

One hundred-six participants were enrolled in the current study, 56 of whom had CKD on hemodialysis 3 times a week 4 hours per session, and 60 healthy age- and gender-matched children acted as controls. Full history was taken, and a clinical review was performed on both patients and controls. The pubertal assessment was performed according to Tanner's classification and laboratory investigations of total and free serum (s.) testosterone in boys and s.estradiol in girls.

Patients’ weight and height were considerably lower than controls. The free and total s.testosterone of patients were significantly reduced. The same applies to s.estradiol levels which were substantially reduced in comparison to controls. In both patients and controls, Tanner staging & male total s.testosterone levels and female s.estradiol levels had significant positive associations. There was a negative association between the sex hormones levels and the disease's and dialysis duration in the patients’ group.

S.testosterone and s.estradiol levels were significantly low in CKD patients on dialysis and were positively correlated with delayed pubertal growth observed in those patients.
Risk factors and clinical outcomes of postgastrectomy sarcopenia newly developed after curative resection for gastric cancer
Authors: Kim Hye Jin , Lee Eun Sun , Kim Beom Jin , Kim Won-Seok , Park Jae Yong , Kim Jae Gyu , Park Joong-Min , Kim Jong Won , Chi Kyong-Choun , Kang Hyung
Published: February 2022

This study aimed to investigate the risk factors and clinical impact of newly developed sarcopenia after surgical resection on the prognosis of patients undergoing curative gastrectomy for gastric cancer (GC).

The clinicopathological data of 573 consecutive patients with GC who underwent curative gastrectomy were reviewed. Their skeletal muscle mass and abdominal fat volume were measured using abdominal computed tomography.

Forty six of them (8.0%) were diagnosed with preoperative sarcopenia. Among the 527 patients without sarcopenia, 57 (10.8%) were diagnosed with postgastrectomy sarcopenia newly developed 1 year after curative gastrectomy. Female sex, weight loss, proximal location of the tumor and differentiated tumor were significant risk factors of postgastectomy sarcopenia newly developed after curative gastrectomy. There was a significant difference in the 5-year overall survival among the preoperative sarcopenic, nonsarcopenic, and postgastrectomy sarcopenic groups (P = .017). Especially, there was a significant difference between nonsarcopenic and postgastrectomy sarcopenic groups (P = .009). However, there was no significant difference in the 5-year disease-free survival among the groups (P = .49).

Since newly developed sarcopenia after surgical resection had an influence on the overall survival, patients with high sarcopenia risks after curative gastrectomy may require early nutritional support.
Sister Mary Joseph nodule as cutaneous manifestations of metastatic ovarian cancer
Authors: Nie Xianglin , Chen Xing , Jiang Yi , Zhong Yi , Chen Ting , Cheng Wenjun
Published: February 2022

Rationale:

The Sister Mary Joseph's nodule is an umbilical nodule resulting from the metastasis of malignant tumors in the pelvic and/or abdominal cavity. Sister Mary Joseph's nodules are very rare, and the morphology of the skin lesions is not specific and is easily misdiagnosed. Here, we report a case of cutaneous manifestations of metastatic ovarian cancer.

Patient concerns:

The patient was admitted to our hospital because of abdominal distention, and a nodule was found in the umbilicus. A computerized tomography scan of the entire abdomen showed nodular soft tissue in the subcutaneous fat space of the umbilical area and multiple pelvic masses, which were suspected metastases of peritoneal and omentum ovarian cancer.

Interventions:

To confirm the pathological diagnosis, posterior fornix puncture was performed. Pathological biopsy showed adenocarcinoma. Histological examination revealed a mass arising from high-grade serous carcinoma of the ovary. The patient received 2 cycles of chemotherapy with paclitaxel liposomes and carboplatin and underwent interval debulking surgery. Postoperative pathology was consistent with high-grade serous carcinoma of the ovary. Cancer involvement was observed in umbilical lesions. After the operation, the patient was given 6 cycles of chemotherapy with paclitaxel liposomes and carboplatin.

Outcomes:

The patient underwent follow-up until October 2020. A computerized tomography scan of the entire abdomen showed that the lymph nodes in the abdominal cavity were larger than before, suggesting a platinum-sensitive relapse. After receiving the same regimen of chemotherapy, carbohydrate antigen 125 dropped to the normal range, and consolidated treatment was administered for 3 cycles. Owing to her BRCA1 mutations, olaparib was administered for maintenance treatment. Until now, she had been in the outpatient clinic for regular follow-up visits.

Lessons:

The umbilicus remains an infrequently examined area, which cannot be underestimated and warrants careful clinical follow-up and histological evaluation, as appropriate.
Motivational interviewing retention counseling and adherence to early infant diagnostic HIV testing schedule in South Africa
Authors: Onoya Dorina , Jinga Nelly , Nattey Cornelius , Mongwenyana Constance , Mngadi Sithabile , MacLeod William B. , Sherman Gayle
Published: February 2022

Introduction:

We report the PAEDLINK randomized trial results on the effect of motivational interviewing (MI) retention counseling on the adherence of postpartum women to the early infant diagnostic human immunodeficiency virus (HIV) testing schedule.

Methods:

HIV positive women and their babies were enrolled 3 to 6 days after delivery at 4 midwife obstetric units in the Gauteng province of South Africa and randomized into (A) MI retention counseling and telephonic tracing, (B) biannual telephonic tracing, and (C) standard care. Mother–baby pairs were followed up for 18 months via medical records. The uptake of child HIV tests and maternal retention in the 0 to 6 and 7 to 18 month periods were modeled using Log-binomial regression.

Results:

Overall, 501/711 enrolled mother–baby pairs received a second HIV polymerase chain reaction test by 6 months (70.0%, 70.5%, and 70.0% in groups A, B, and C, respectively). A higher proportion of intervention children (60.9%) were tested at 7 to 90 days than group B (48.1%, adjusted risk ratio [aRR] 0.8 for B vs A, 95% confidence interval [CI]: 0.7–0.9) and group C children (52.7%, aRR 0.9 for C vs A, 95% CI: 0.9–1.0). Child testing between 7 and 18-months was also higher in group A than C (10.7% A, vs 5.5% C, RR 2.0, 95% CI: 1.0–3.7). However, maternal retention was similar across groups, with 41.6% and 16.3% retained during the 0 to 6 and the 7 to 18-months periods, respectively.

Conclusion:

MI retention counseling can reduce delays in the early infant diagnosis testing schedule for HIV-exposed infants. However, further support is necessary to maximize later HIV tests and maternal retention.