bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship of triglyceride–glucose index with chronic limb-threatening ischemia in lower extremity peripheral artery disease
Authors: Pala Arda Aybars , Urcun Yusuf Salim
Published: May 2021

Objectives

Triglyceride-glucose index (TyG index), which is defined as the simple and novel marker of insulin resistance, is becoming increasingly important as a promising predictive marker for atherosclerotic diseases. Chronic limb-threatening ischemia is defined as the most advanced stage of the lower extremity peripheral artery disease, whose main cause is atherosclerosis and is associated in this respect with amputation, impaired quality of life, and mortality. The main purpose of the present study was to investigate the relation between the calculated TyG index values and chronic limb-threatening ischemia development.

Methods

A total of 296 patients who were diagnosed with lower extremity peripheral artery disease in our outpatient clinic between October 2018 and October 2020 were included in this study retrospectively. Two groups were formed by clinically staging the patients according to Rutherford Classification. Patients who did not develop chronic limb-threatening ischemia were classified as “Group 1” ( n = 224) and those who developed were classified as “Group 2” ( n = 72).

Results

The mean TyG index values that were calculated in Group 2 were significantly higher than in Group 1 (9.27 ± 0.31 vs. 9.00 ± 0.34, p < 0.001). In the multivariate logistic regression analysis conducted to determine the predictors of chronic limb-threatening ischemia development, C-reactive protein (OR [Odds Ratio]: 1.220, 95% CI [confidence interval]: 1.092–1.363, p < 0.001), high-density lipoprotein cholesterol (OR: 0.775, 95% CI: 0.715–0.839, p < 0.001) and TyG index (OR: 5.796, 95% CI: 2.050–16.382, p = 0.001) were identified as independent predictors. Receiver operating characteristic analysis revealed that the cut-off value of TyG index was 9.13 (area under the curve: 0.721, p < 0.001) with 70.8% sensitivity and 65.2% specificity. The TyG index was significantly correlated with Rutherford category, high-density lipoprotein cholesterol and mean platelet volume.

Conclusions

Chronic limb-threatening ischemia development may be predicted with the TyG index value, which is calculated easily from routine biochemical parameters, in patients diagnosed with lower extremity peripheral artery disease.
Evidence-Based Design in Architectural Education: Designing the First Maggie’s Centre in Israel
Authors: Pilosof Nirit Putievsky , Grobman Yasha Jacob
Published: May 2021

Objective:

The study examines the integration of the Evidence-based Design (EBD) approach in healthcare architecture education in the context of an academic design studio.

Background:

Previous research addressed the gap between scientific research and architectural practice and the lack of research on the use of the EBD approach in architectural education.

Methods:

The research examines an undergraduate architectural studio to design a Maggie’s Centre for cancer care in Israel and evaluates the impact of the EBD approach on the design process and design outcomes. The research investigates the impact of the integration of three predesign tasks: (1) literature review of healing architecture research, (2) analysis and comparison of existing Maggie’s Centres, and (3) analysis of the context of the design project.

Results:

The literature review of scientific research supported the conceptual design and development of the projects. The analysis of existing Maggie’s centers, which demonstrated the interpretation of the evidence by different architects, developed the students’ ability to evaluate EBD in practice critically, and the study of the projects’ local context led the students to define the relevance of the evidence to support their vision for the project.

Conclusions:

The research demonstrates the advantages of practicing EBD at an early stage in healthcare architectural education to enhance awareness of the impact of architectural design on the users’ health and well-being and the potential to support creativity and innovative design. More studies in design studios are needed to assess the full impact of integrating EBD in architectural education.
Collaboration Between a School Nurse Task Force and the Local Health Department in Illinois: Development of a COVID-19 Toolkit
Authors: Kunz Donna J. , Manno Martha S. , Ruffatti Dawn M. , Blohm Suzanne L. , Wuerger Amelia A. , Keegan Amanda J. , Karras Susan L.
Published: May 2021

Multidisciplinary collaboration for healthy student outcomes is not a new concept for school nurses nor is working with public health officials in promoting school–community initiatives. The SARS-CoV-2 (COVID-19; severe acute respiratory syndrome coronavirus 2, coronavirus disease 2019) virus further highlighted the need to work together to promote best practice strategies to arm the community with information and guidance to prevent illness. The McHenry County Health Department recognized the expertise school nurses have in school health and formed a voluntary School Nurse Task Force. This collaboration worked to implement requirements for operating a school during a pandemic. The task force adapted those concepts into a toolkit to assist schools to meet health requirements throughout the most significant pandemic in over 100 years.
Understanding progressive multifocal leukoencephalopathy: links between milky-way appearance and mismatch T2/FLAIR
Authors: Ruiz Romagnoli Emiliano , Akly Manuel Perez , Miquelini Luis A , Funes Jorge , Gillanders Tatiana , Besada Cristina
Published: May 2021

Background

Magnetic resonance imaging is essential to diagnose progressive multifocal leukoencephalopathy. The broad radiological spectrum may partially be explained by genetic viral mutations and their differential neurotropism. Recent pharmacovigilance-magnetic resonance imaging studies have provided new insight into pathophysiology and radiological markers of early stages. However, how lesions evolve and why certain anatomical locations are more frequently affected remains unknown. We aim to describe a new sign – T2/fluid-attenutated inversion recovery mismatch – as a complementary marker of cavitated lesions and propose a link with the milky-way appearance, a key early sign. Furthermore, we hypothesise viral dissemination routes.

Methods

We conducted a retrospective longitudinal study from January 2010 to January 2020, to analyse clinical and magnetic resonance imaging features of 13 progressive multifocal leukoencephalopathy individuals at the symptomatic stage (mean age 58.3 years (SD ± 16.8) – 61.5% were women).

Results

The most prevalent pathology was HIV (61.5%) and motor deficit prevailed regarding other symptoms (76.9%). Frontal lobes (76.9%), middle cerebellar peduncle (61.5%), cerebellum (61.5%), and pons (53.8%) were most commonly affected, and the cortico-ponto-cerebellar pathway seemed involved in these patients. Five patients had a pure radiological pattern. Milky-way appearance was the most frequent radiological sign (58.3%). Five patients with milky-way appearance had concomitantly T2/fluid-attenuated inversion recovery mismatch ( P = 0.02). This sign showed high sensitivity and specificity (100–71%, P = 0.02) to assess evolved lesions besides diffusion.

Conclusion

The possible tract-dependent spread, as well as clinical and genetic, have implications on the MRI variability of progressive multifocal leukoencephalopathy. The milky-way appearance could reflect a transitional phase towards evolved lesions, the latter demonstrated by T2/fluid-attenuated inversion recovery mismatch. Both could be key magnetic resonance imaging signs to diagnose progressive multifocal leukoencephalopathy at the symptomatic stage.
The efficacy of single suture for exit site wound closure and stabilization of hemodialysis central tunneled catheter
Authors: Porazko Tomasz , Piersiak Andrzej , Klinger Marian
Published: May 2021

Introduction:

The majority of the end-stage renal disease patients begin hemodialysis with the central tunneled catheter as a permanent or bridge vascular access. The procedure of central tunneled catheter insertion can be complicated by exit site bleeding, prolonged tunnel healing, and infection. The study aimed at evaluating whether the catheter exit site wound closing with a single-suture method is equally effective as the double suture method, which is most frequently applied. The assumption was that the single-suture method, which is less traumatizing for the skin, could offer an advantage for the patients with “paper” skin, that is, elderly, after long-term immunosuppressive treatment.

Methods:

Insertion of central tunneled catheter with antegrade tunnel formation was performed in 140 patients divided randomly into two groups of 70 patients using either single-suture method or double suture method.

Results:

Follow-up observations revealed a comparable number of early complications, that is, bleeding or exit site infection, in about 26% of the patients from both groups. No difference appeared in the catheter displacement, either. The percentage of patients with a prolonged central tunneled catheter exit site wound healing was not significantly lower in the single-suture method group: 5.8% versus 11.3%, p = 0.367. There was no impact of single-suture method versus double suture method on the central tunneled catheter long-term function and survival.

Conclusion:

The single-suture method of the central tunneled catheter exit closure is equal in efficacy to the double suture method. Its potential benefit for the patients with an increased risk of poor wound healing should be tested in further study.
Potentialities and challenges of digital health in psychiatry in Kashmir, India
Authors: Shoib Sheikh , Arafat SM Yasir
Published: May 2021

Telepsychiatry has been recommended as a cost-effective strategy to meet the high unmet need for mental health services to the remote and areas with conflict. The current COVID-19 pandemic along with lockdown measures to prevent the spread of the disease has worsened the mental health status of the Kashmiri population.
Otolaryngologists Practice Pattern on Oral Allergy Syndrome
Authors: Zhang, MD Yunjia , Marzouk, MD Haidy
Published: May 2021

Background

Oral allergy syndrome is a unique type of food allergy caused by cross-sensitivity between inhalant allergens and food allergens. Despite its significant prevalence and potentially serious outcome, the knowledge base and practice patterns on OAS are not well known among otolaryngologists. Our study is designed to understand the practice patterns of otolaryngologists in screening, testing, and treating OAS through a web-based survey.

Methods

Three thousand otolaryngologists were randomly selected from a membership list of the American Academy of Otolaryngology – Head and Neck Surgery. A survey was designed to include demographic questions and questions about OAS understanding, screening, and management. Surveys were sent to selected otolaryngologists via mail. Responses were de-identified and analyzed using SPSS.

Results

Out of the 50 survey responses, 46 reported treating environmental allergy in their practices. Twenty eight out of 46 reported knowing about OAS (60.9%). Fifteen out of the 28 physicians screened for OAS (53.6%). Out of the responders who knew about OAS, 12 (42.9%) reported diagnosing under 5 cases in the past year, 7 (25%) diagnosed 5 to 10 cases, and 7 (25%) reported diagnosed more than 10 cases in the past year. Eleven (39.3%) reported ordering component allergy testing for food allergies. Twenty six (92.9%) reported using avoidance, 18 (64.3%) prescribed oral antihistamine medications, 14 (50%) prescribed epi-pen, and 19 (67.9%) desensitized patients to environmental allergies as a treatment for OAS. 26 (93%) reported using more than one of the listed treatments. 10 (36%) reported using all four methods.

Conclusion

Only 60.9% of the responders had a knowledge of OAS. Only 53.6% of those screened for OAS. Current treatment for OAS includes avoidance of allergens, desensitization of environmental allergens, prescription of oral antihistamine and epi-pen. Nearly everyone (93%) reported using more than one treatment method.
HIV/AIDS and Substance Use Prevention for African American Young Adults: Field Evaluation of “Color it Real”
Authors: Agley Jon , Xiao Yunyu , Jayawardene Wasantha , Gay Albert , King Rosemary , Horne Kelly , Walker Roland
Published: May 2021

In the United States, African Americans continue to bear a disproportionate amount of risk from HIV and illicit drug use, highlighting the importance of culturally responsive prevention programming. Manualized HIV and substance use prevention curricula that are conceptually African centered are few, and evaluative data of such programs are sparse. This research brief aims to describe a field evaluation of the “Color it Real” (CIR) program, a 6-session, 12-hr HIV and substance use prevention curriculum for African American males and females aged 18 to 24 years. Participants ( n = 225) were recruited using convenience sampling from two cities within a high-risk county in Indiana. Attitudes, knowledge, and confidence related to HIV and substance use were assessed before and after the intervention. Wilcoxon and McNemar tests were used to compare pretest and posttest scores, and binary logistic regression models were used to examine sociodemographic associations with outcomes. Among the analytic sample ( n = 195), the CIR program was associated with several improved attitudes and increased knowledge related to HIV and substance use, but not with increased confidence in sexual negotiation skills. These findings represent the first published data from CIR since the developers’ original study, and support continued use of the curriculum by our program. Given the positive findings (i.e., attitudes and knowledge) and community receptiveness to CIR, we believe that a randomized, controlled trial of the intervention that includes longitudinal behavioral measurement would be a meaningful addition to prevention research.
Why Do Canadians Travel Abroad for Cosmetic Surgery? A Qualitative Analysis on Motivations for Cosmetic Surgery Tourism
Authors: Robertson Emilie M. , Moorman Scott W. J. , Korus Lisa J.
Published: May 2021

Background: Canadians are increasingly engaging in medial tourism. The purpose of this study was to review Canadians’ experiences with travelling abroad for cosmetic surgery, including primary motivations for seeking care outside of Canada. Methods: A qualitative analysis was conducted using semistructured interviews following a pre-determined topic guide. People who had undergone cosmetic surgery outside of Canada were interviewed. The interviews were transcribed and coded to determine motivational themes. Patients were recruited until thematic saturation was achieved. Results: Thematic saturation was achieved after recruitment of 11 patients. The most common motivational themes identified in this study for seeking cosmetic surgery outside of Canada included cost, post-operative care provided, marketing/customer service, and word-of-mouth. Member checking and theory triangulation were validation techniques used to verify identified themes. Mexico was the most common location for cosmetic tourism. The most common procedures were breast augmentation, mastopexy, and abdominoplasty. Participants gathered pre- and post-operative information primarily through pamphlets and contact with surgeons’ offices. Follow-up was only available for half of the participants in this study, and only 5 of the participants felt that they had received informed consent. Conclusions: The majority of participants engaged in cosmetic tourism due to cost reasons and the level of post-operative care provided.
The Project Communication and Trust Nexus as an Antecedents of Project Success: Moderating Role of Authentic Leadership
Authors: Majeed Haleema , Kayani Umar Nawaz , Haider Syed Arslan
Published: May 2021

The present study aims to investigate the impact of project communication on project success with the mediating role of trust and the moderating role of authentic leadership. The sample is drawn using a convenient sampling technique. The data is collected through the online survey method due to the COVID-19 pandemic, from project-based construction companies of Pakistan ( n = 245). The analyses are established using SPSS v.25 and AMOS v.23 software to test hypotheses. The results indicate that project communication is positively associated with project success; trust mediates the relationship between project communication and project success. Similarly, results also confirm that the moderating role of authentic leadership is strengthening the relationship between project communication and trust. This research is beneficial for project managers, site supervisors, and leaders, since project managers need to develop communication and trust between the employees as communication, leads to the successful completion of projects and achievement of goals. Managers should connect the employees so that the workflow does not get disturbed. Lack of communication can badly affect the success of the project and lead it toward failure. The manager or work supervisor needs to keep all the employees bound together so that they perform effectively.
Using Applied Conversation Analysis in Patient Education
Authors: Halpin Sean N. , Konomos Michael , Roulston Kathryn
Published: May 2021

The conversation strategies patients and clinicians use are important in determining patient satisfaction and adherence, and health outcomes following patient education—yet most studies are rife with surveys and interviews which often fail to account for real-time interaction. Conversation analysis (CA) is a powerful but underused sociological and linguistic technique aimed at understanding how interaction is accomplished in real-time. In the current manuscript, we provide a primer to CA in an effort to make the technique accessible to patient education researchers including; The history of CA, identifying and collecting data, transcription conventions, data analysis, and presenting the findings. Ultimately, this article provides an easily digestible demonstration of this analytic technique.
Adolescent Girls With Overweight and Obesity Feel Physically Healthy and Highlight the Importance of Mental Health
Authors: Yerges April L. , Snethen Julia A. , Carrel Aaron L.
Published: May 2021

Introduction

Obesity in adolescence is a significant ongoing public health problem that has not improved over the past decade.

Objective

This descriptive qualitative study explores the perspective of female adolescents who are overweight or obese regarding their views on health and weight within the clinic setting.

Methods

In-depth interviews were conducted with female adolescents (age 13–19 years old; BMI ≥85th percentile) from the mid-west region of the United States (N = 28). Inductive thematic analysis using Braun & Clarke’s methods was utilized.

Results

The findings from this study revealed that the adolescents’ view of health encompasses physical, mental, and psychosocial health dimensions, and despite being overweight and obese, the participants felt healthy. Participants discussed the need to eat healthier and increase their daily physical activity, but were unable to transform this into action. Within the clinical setting, the adolescents were sensitive to weight discussions.

Conclusion

Results from this study can increase providers’ understanding of the adolescent, increase awareness of adolescent sensitivity, and assist researchers in developing age-appropriate interventions for effective treatment and prevention of childhood obesity.
Is There a Brain Microbiome?
Authors: Link Christopher D
Published: May 2021

Numerous studies have identified microbial sequences or epitopes in pathological and non-pathological human brain samples. It has not been resolved if these observations are artifactual, or truly represent population of the brain by microbes. Given the tempting speculation that resident microbes could play a role in the many neuropsychiatric and neurodegenerative diseases that currently lack clear etiologies, there is a strong motivation to determine the “ground truth” of microbial existence in living brains. Here I argue that the evidence for the presence of microbes in diseased brains is quite strong, but a compelling demonstration of resident microbes in the healthy human brain remains to be done. Dedicated animal models studies may be required to determine if there is indeed a “brain microbiome.”
Novel insights into surfactant protein C trafficking revealed through the study of a pathogenic mutant
Authors: Dickens Jennifer A. , Rutherford Eimear N. , Abreu Susana , Chambers Joseph E. , Ellis Matthew O. , van Schadewijk Annemarie , Hiemstra Pieter S. , Marciniak Stefan J.
Published: May 2021

Background

Alveolar epithelial cell dysfunction plays an important role in the pathogenesis of idiopathic pulmonary fibrosis (IPF), but remains incompletely understood. Some monogenic forms of pulmonary fibrosis are associated with expression of mutant surfactant protein C (SFTPC). The commonest pathogenic mutant, I73T, mislocalises to the alveolar epithelial cell plasma membrane and displays a toxic gain of function. Because the mechanisms explaining the link between this mutant and IPF are incompletely understood, we sought to interrogate SFTPC trafficking in health and disease to understand the functional significance of SFTPC-I73T relocalisation.

Methods

We performed mechanistic analysis of SFTPC trafficking in a cell model that reproduces thein vivophenotype and validated findings in human primary alveolar organoids.

Results

We show that wild-type SFTPC takes an unexpected indirect trafficking routeviathe plasma membrane and undergoes the first of multiple cleavage events before reaching the multivesicular body (MVB) for further processing. SFTPC-I73T takes this same route, but its progress is retarded both at the cell surface and due to failure of trafficking into the MVB. Unable to undergo onward trafficking, it is recycled to the plasma membrane as a partially cleaved intermediate.

Conclusion

These data show for the first time that all SFTPC transits the cell surface during normal trafficking, and the I73T mutation accumulates at the cell surface through both retarded trafficking and active recycling. This understanding of normal SFTPC trafficking and how the I73T mutant disturbs it provides novel insight into SFTPC biology in health and disease, and in the contribution of the SFTPC mutant to IPF development.
A prospective multicentre diagnostic accuracy study for the Truenat tuberculosis assays
Authors: Penn-Nicholson Adam , Gomathi Sivaramakrishnan N. , Ugarte-Gil Cesar , Meaza Abyot , Lavu Evelyn , Patel Pranav , Choudhury Bandana , Rodrigues Camilla , Chadha Sarabjit , Kazi Mubin , Macé Aurélien , Nabeta Pamela , Boehme Catharina , Gangakhedkar Raman R. , Sarin Sanjay , Tesfaye Ephrem , Gotuzzo Eduardo , du Cros Philipp , Tripathy Srikanth , Ruhwald Morten , Singh Manjula , Denkinger Claudia M. , Schumacher Samuel G. ,   the Truenat Trial Consortium
Published: May 2021

Background

Bringing reliable and accurate tuberculosis (TB) diagnosis closer to patients is a key priority for global TB control. Molbio Diagnostics have developed the Truenat point-of-care molecular assays for detection of TB and rifampicin (RIF) resistance.

Methods

We conducted a prospective multicentre diagnostic accuracy study at 19 primary healthcare centres and seven reference laboratories in Peru, India, Ethiopia and Papua New Guinea to estimate the diagnostic accuracy of the point-of-care Truenat MTB, MTB Plus and MTB-RIF Dx assays for pulmonary TB using culture and phenotypic drug susceptibility testing as the reference standard, compared with Xpert MTB/RIF or Ultra.

Results

Of 1807 enrolled participants with TB signs/symptoms, 24% were culture-positive forMycobacterium tuberculosis, of which 15% were RIF-resistant. In microscopy centres, the pooled sensitivity of Truenat MTB and Truenat MTB Plus was 73% (95% CI 67–78%) and 80% (95% CI 75–84%), respectively. Among smear-negative specimens, sensitivities were 36% (95% CI 27–47%) and 47% (95% CI 37–58%), respectively. Sensitivity of Truenat MTB-RIF was 84% (95% CI 62–95%). Truenat assays showed high specificity. Head-to-head comparison in the central reference laboratories suggested that the Truenat assays have similar performance to Xpert MTB/RIF.

Conclusion

We found the performance of Molbio's Truenat MTB, MTB Plus and MTB-RIF Dx assays to be comparable to that of the Xpert MTB/RIF assay. Performing the Truenat tests in primary healthcare centres with very limited infrastructure was feasible. These data supported the development of a World Health Organization policy recommendation of the Molbio assays.
Long-term modulation of airway remodelling in severe asthma following bronchial thermoplasty
Authors: Jendzjowsky Nicholas , Laing Austin , Malig Michelle , Matyas John , de Heuvel Elaine , Dumonceaux Curtis , Dumoulin Elaine , Tremblay Alain , Leigh Richard , Chee Alex , Kelly Margaret M.
Published: May 2021

Rationale

Bronchial thermoplasty is a mechanical therapeutic intervention that has been advocated as an effective treatment option for severe asthma. The mechanism is promoted as being related to the attenuation of airway smooth muscle which has been shown to occur in the short-term. However, long-term studies of the effects of bronchial thermoplasty on airway remodelling are few, with only limited assessment of airway remodelling indices.

Objectives

To evaluate the effect of bronchial thermoplasty on 1) airway epithelial and smooth muscle cells in culture and 2) airway remodelling in patients with severe asthma who have been prescribed bronchial thermoplasty up to 12 months post-treatment.

Methods

The distribution of heat within the airway by bronchial thermoplasty was assessed in a porcine model. Culture of human airway smooth muscle cells and bronchial epithelial cells evaluated the impact of thermal injury. Histological evaluation and morphometric assessment were performed on bronchial biopsies obtained from severe asthma patients at baseline, 6 weeks and 12 months following bronchial thermoplasty.

Results

Bronchial thermoplasty resulted in heterogeneous heating of the airway wall. Airway smooth muscle cell cultures sustained thermal injury, whilst bronchial epithelial cells were relatively resistant to heat. Airway smooth muscle and neural bundles were significantly reduced at 6 weeks and 12 months post-treatment. At 6 weeks post-treatment, submucosal collagen was reduced and vessel density increased, with both indices returning to baseline at 12 months. Goblet cell numbers, submucosal gland area and sub-basement membrane thickness were not significantly altered at any time point examined.

Conclusions

Bronchial thermoplasty primarily affects airway smooth muscle and nerves with the effects still present at 12 months post-treatment.
Shift from high-frequency to low-frequency episodic migraine in patients treated with Galcanezumab: results from two global randomized clinical trials
Authors: Jedynak Jakub , Eross Eric , Gendolla Astrid , Rettiganti Mallikarjuna , Stauffer Virginia L.
Published: May 2021

Background

Patients with episodic migraine (EM) with a higher-frequency of migraine headache days (HFEM: 8–14 migraine headache days/month) have a greater disease burden and a higher risk of progressing to chronic migraine (CM) with associated acute treatment overuse versus those with low-frequency EM (LFEM: 4–7 migraine headache days/month). In this post hoc analysis, we assessed the proportions of patients who shifted from HFEM to LFEM and to very low-frequency EM (VLFEM: 0–3 migraine headache days/month) status following treatment with galcanezumab versus placebo.

Methods

EVOLVE-1 and EVOLVE-2 were double-blind, Phase 3 studies in patients with EM. Patients (18–65 years) were randomized (2:1:1) to subcutaneous monthly injections of placebo, galcanezumab 120 mg (240 mg loading dose) or 240 mg, for up to 6 months. Data were pooled and endpoints were change from baseline in number of migraine headache days/month and patients who shifted from HFEM to LFEM or VLFEM status. Impact of change in HFEM status on migraine headache days/month, quality of life and disability was also assessed.

Results

A total of 66% (1176/1773) patients from EVOLVE studies had HFEM status at baseline and were included in this analysis; placebo: 592, galcanezumab 120 mg: 294 and galcanezumab 240 mg: 290. At each month, both doses of galcanezumab resulted in a higher proportion of patients who shifted to 0–7 monthly headache days/month (VLFEM or LFEM status). Patients who shifted from HFEM at baseline to VLFEM status at Month 3, a relatively larger proportion of patients on galcanezumab 120 mg versus placebo remained at VLFEM status at Months 4–6; Months 4–5 for galcanezumab 240 mg versus placebo. Among the galcanezumab-treated patients who did-not-shift or shifted to LFEM or VLFEM status for ≥3 consecutive months until the end of the study, patients who shifted from HFEM to VLFEM status experienced the largest reduction in migraine headache days/month and the largest clinically meaningful improvements in daily functioning (MSQ-RFR) and disability (MIDAS).

Conclusions

In patients with HFEM, treatment with galcanezumab (120 mg and 240 mg) significantly reduced migraine headache days/month, maintained remission status at subsequent months until the end of the study, and improved patients’ quality of life versus placebo.

Trial registration

ClinicalTrials.gov Identifier: EVOLVE-1, NCT02614183; EVOLVE-2, NCT02614196.
Revisiting Theron’s hypothesis on the origin of fairy circles after four decades: Euphorbias are not the cause
Authors: Getzin Stephan , Nambwandja Ailly , Holch Sönke , Wiegand Kerstin
Published: May 2021

Background

The Euphorbia hypothesis on the origin of fairy circles (FCs) in Namibia dates back to 1979. It proposes that the remains of decaying shrubs would induce an allelopathic interaction with the grasses and thereby cause bare-soil FCs. Here, we investigated this hypothesis based on revisiting marked Euphorbias after four decades, comparing the typical size distribution of deadEuphorbia damaranaand FCs, and analyzing the spatial patterns of Euphorbias and FCs within the same drone-mapped study plots in three regions of Namibia.

Results

We found four dead Euphorbias in the southern Giribes that were marked by G.K. Theron about 40 years ago. Those locations did not develop into FCs over this time span. However, for the four dead Euphorbias, we provide photographic evidence that grass tufts were growing at the metal pins of those decaying shrubs, agreeing with previous research findings that the soil taken from beneath deadE. damaranashrubs was stimulating rather than inhibiting the growth of grasses. In the Giribes, there were very large FCs that ranged in diameter from 13.0 to 19.1 m. By contrast, the measured deadE. damarana, including the largest plants that we could find, ranged in size only between 4.2 and 11.7 m. At Brandberg, we found particularly small FCs with diameters between 2.4 and 2.7 m but the deadE. damarana, including the smallest dead shrubs in the area, ranged in size between 4.1 and 7.2 m. Hence given these size mismatches, the decaying Euphorbias cannot induce such observed FCs in the two regions. Spatial patterns ofE. damaranaand FCs in the two regions Giribes and Brandberg, as well as ofE. gummiferaand FCs near Garub, showed a strong mismatch within the same habitat: in four out of five plots the patterns differed significantly. FCs were regularly distributed while Euphorbias were predominantly clustered.

Conclusions

We reject the Euphorbia hypothesis based on the fact that grass growth was not prevented under decaying shrubs, the size of dead Euphorbias cannot explain the size of observed FCs and the spatial distribution of Euphorbias cannot cause the specific pattern signature of FCs.
Base-substitution mutation rate across the nuclear genome of Alpheus snapping shrimp and the timing of isolation by the Isthmus of Panama
Authors: Silliman Katherine , Indorf Jane L. , Knowlton Nancy , Browne William E. , Hurt Carla
Published: May 2021

Background

The formation of the Isthmus of Panama and final closure of the Central American Seaway (CAS) provides an independent calibration point for examining the rate of DNA substitutions. This vicariant event has been widely used to estimate the substitution rate across mitochondrial genomes and to date evolutionary events in other taxonomic groups. Nuclear sequence data is increasingly being used to complement mitochondrial datasets for phylogenetic and evolutionary investigations; these studies would benefit from information regarding the rate and pattern of DNA substitutions derived from the nuclear genome.

Results

To estimate the genome-wide neutral mutation rate (µ), genotype-by-sequencing (GBS) datasets were generated for three transisthmian species pairs inAlpheussnapping shrimp. A range of bioinformatic filtering parameters were evaluated in order to minimize potential bias in mutation rate estimates that may result from SNP filtering. Using a Bayesian coalescent approach (G-PhoCS) applied to 44,960 GBS loci, we estimated µ to be 2.64E−9 substitutions/site/year, when calibrated with the closure of the CAS at 3 Ma. Post-divergence gene flow was detected in one species pair. Failure to account for this post-split migration inflates our substitution rate estimates, emphasizing the importance of demographic methods that can accommodate gene flow.

Conclusions

Results from our study, both parameter estimates and bioinformatic explorations, have broad-ranging implications for phylogeographic studies in other non-model taxa using reduced representation datasets. Our best estimate of µ that accounts for coalescent and demographic processes is remarkably similar to experimentally derived mutation rates in model arthropod systems. These results contradicted recent suggestions that the closure of the Isthmus was completed much earlier (around 10 Ma), as mutation rates based on an early calibration resulted in uncharacteristically low genomic mutation rates. Also, stricter filtering parameters resulted in biased datasets that generated lower mutation rate estimates and influenced demographic parameters, serving as a cautionary tale for the adherence to conservative bioinformatic strategies when generating reduced-representation datasets at the species level. To our knowledge this is the first use of transisthmian species pairs to calibrate the rate of molecular evolution from GBS data.
LncRNA:DNA triplex-forming sites are positioned at specific areas of genome organization and are predictors for Topologically Associated Domains
Authors: Soibam Benjamin , Zhamangaraeva Ayzhamal
Published: May 2021

Background

Chromosomes are organized into units called topologically associated domains (TADs). TADs dictate regulatory landscapes and other DNA-dependent processes. Even though various factors that contribute to the specification of TADs have been proposed, the mechanism is not fully understood. Understanding the process for specification and maintenance of these units is essential in dissecting cellular processes and disease mechanisms.

Results

In this study, we report a genome-wide study that considers the idea of long noncoding RNAs (lncRNAs) mediating chromatin organization using lncRNA:DNA triplex-forming sites (TFSs). By analyzing the TFSs of expressed lncRNAs in multiple cell lines, we find that they are enriched in TADs, their boundaries, and loop anchors. However, they are evenly distributed across different regions of a TAD showing no preference for any specific portions within TADs. No relationship is observed between the locations of these TFSs and CTCF binding sites. However, TFSs are located not just in promoter regions but also in intronic, intergenic, and 3’UTR regions. We also show these triplex-forming sites can be used as predictors in machine learning models to discriminate TADs from other genomic regions. Finally, we compile a list of important “TAD-lncRNAs” which are top predictors for TADs identification.

Conclusions

Our observations advocate the idea that lncRNA:DNA TFSs are positioned at specific areas of the genome organization and are important predictors for TADs. LncRNA:DNA triplex formation most likely is a general mechanism of action exhibited by some lncRNAs, not just for direct gene regulation but also to mediate 3D chromatin organization.
Myocardial fibrosis combined with NT-proBNP improves the accuracy of survival prediction in ADHF patients
Authors: Yao Yiling , Feng Li , Sun Yanxiang , Wang Shifei , Sun Jie , Hu Bing
Published: May 2021

Background

Soluble suppression of tumorigenesis-2 (sST2), Procollagen Type III N-Terminal Peptid (PIIINP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) have been verified their role in predicting survival in acutely decompensated heart failure (ADHF). However, whether their combination could improve more specific and sensitive prognostic information than NT-proBNP alone remains unclear.

Methods

This was a prospective study, in which 217 ADHF patients at admission were enrolled from November 2018 and August 2019 (mean age 66.18 years ± 13.60, 63.98% male). The blood samples were collected to measure the concentrations of NT-proBNP, sST2 and PIIINP in the first 24 h of hospitalizations. All-cause mortality was registered for all patients after they were discharge over a median period of 339 days.

Results

In univariate Cox analysis, the three biomarkers were predictive of short-term mortality of ADHF patients. After adjusted for some clinical variables including age, admission systolic blood pressure, peripheral edema on admission, history of chronic obstructive pulmonary disease, admission sodium < 135 mmol/L, admission hemoglobin, NT-proBNP, sST2 and PIIINP was significantly associated with the poor outcome (hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.14–1.53, P < 0.01; HR 1.21, 95% CI 1.03–1.43, P = 0.020; HR 1.40, 95% CI 1.08–1.81, P = 0.011). After added with Log2 PIIINP, but not Log2 sST2, the area under the curves (AUC) in the model of clinical variables and Log2 NT-proBNP could increase from 0.79 to 0.85 (95% CI 0.0071–0.10, P = 0.024). Furthermore, compared with the model of clinical variables, Log2 NT-proBNP, the improvement in the prognostic model of clinical variables, Log2 NT-proBNP and Log2 PIIINP had statistical significance [net reclassification improvement (NRI) 0.31, P = 0.018; integrated discrimination improvement (IDI) 0.068, P < 0.01].

Conclusions

NT-proBNP, sST2 and PIIINP are independent prognostic factors for all-cause mortality in ADHF patients. Furthermore, the combination of NT-proBNP and PIIINP may provide incremental prognostic value over NT-proBNP in the survival of ADHF patients.
Selective inhibition of soluble TNF using XPro1595 relieves pain and attenuates cerulein-induced pathology in mice
Authors: Randhi Rajasa , Damon Melissa , Dixon Kirsty J.
Published: May 2021

Background

Symptoms associated with acute pancreatitis can be debilitating, and treatment remains a challenge. This study aimed to investigate the efficacy of selectively inhibiting the soluble form of TNF (solTNF) using the biologic XPro1595 in a mouse model of acute pancreatitis.

Methods

Acute pancreatitis was induced in adult male C57Bl/6J mice by administering cerulein (8 injections of 50 µg/kg I.P., spaced an hour apart), with XPro1595 (10 mg/kg, S.C.) or vehicle being administered approximately 18 h after the last injection. Serum was collected 6 or 18 h after the last cerulein injection, pancreatic tissue was collected 2 and 7 days post-induction, and brain hippocampal tissue was collected at 7 days post-induction. The animal’s pain level was assessed 3, 5 and 7 days post-induction.

Results

The induction of acute pancreatitis promoted a strong increase in serum amylase levels, which had receded back to baseline levels by the next morning. XPro1595 treatment began after amylase levels had subsided at 18 h, and prevented pancreatic immune cell infiltration, that subsequently prevented tissue disruption and acinar cell death. These improvements in pathology were associated with a significant reduction in mechanical hypersensitivity (neuropathic pain). XPro1595 treatment also prevented an increase in hippocampal astrocyte reactivity, that may be associated with the prevention of neuropathic pain in this mouse model.

Conclusion

Overall, we observed that selectively inhibiting solTNF using XPro1595 improved the pathophysiological and neurological sequelae of cerulein-induced pancreatitis in mice, which provides support of its use in patients with pancreatitis.
Evaluation of the Psychometric Properties of PainChek® in UK Aged Care Residents with advanced dementia
Authors: Babicova Ivana , Cross Ainslea , Forman Dawn , Hughes Jeffery , Hoti Kreshnik
Published: May 2021

Background

The aim of this study was to further validate PainChek®, an electronic pain assessment instrument, with a population living with dementia in a UK care home.

Method

This study utilised a correlational design to evaluate the psychometric properties of PainChek® when compared to the Abbey Pain Scale (APS). Blinded paired pain assessments were completed at rest and immediately post-movement by a researcher and a nurse. A total of 22 participants with a diagnosis of moderate-to-severe dementia and a painful condition were recruited using opportunity sampling.

Results

Overall, 302 paired assessments were collected for 22 participants. Out of these 179 were conducted during rest and 123 were immediately post-movement. The results demonstrated a positive significant correlation between overall PainChek® pain scores and overall APS pain scores (r = 0.818,N = 302,p < .001, one-tailed), satisfactory internal consistency (α = 0.810), moderate single measure intraclass correlation (ICC = 0.680) and substantial inter-rater agreement (κ = 0.719).

Conclusions

PainChek® has demonstrated to be a valid and reliable instrument to assess the presence and severity of pain in people with moderate-to-severe dementia living in aged care.
Motivating healthcare professionals (nurses, nurse assistants, physicians) to integrate new practices for preventing healthcare-associated infections into the care continuum: turning Positive Deviance into positive norms
Authors: Gesser-Edelsburg Anat , Cohen Ricky , Halavi Adva Mir , Zemach Mina
Published: May 2021

Background

The literature examining healthcare-associated infections (HAI) points to two main problems in conforming to infection prevention and control (IPC) guidelines among healthcare professionals (HP). One is the discrepancy between HPs’ behavioral intentions and their implementation in practice. The other refers to how HPs maintain these practices after the intervention stage ends. The method proposed in this study seeks to address both these issues by using the Positive Deviance (PD) approach to focus on the dissemination stage of interventions. The study seeks to offer a method for disseminating 27 PD practices to 135 HPs, among them nurses, nurse assistants and physicians, so as to help them maintain IPC guidelines, offer feedback on the dissemination process and examine the impact of the dissemination stage on changes in their behavior.

Methods

The theoretical model underlying this qualitative research was the Recognition-Primed Decision (RPD) model, which we implemented in the field of healthcare-associated infections (HAIs). Moreover, we used the Discovery & Action Dialogue (DAD) and Think Aloud (TA) techniques to describe the methodological development of simulations for HPs. Feedback from the HP demonstrators underwent content analysis, while descriptive statistics were used to characterize behavioral changes.

Results

HPs’ information processing regarding infection prevention shifts from peripheral/automatic processing to intuition and analytical/central processing, turning PD practices into positive norms. The HPs personally experienced finding a solution and made repeated corrections until they overcame the barriers. Most of the HPs (69.4%) reported that the practices were fully implemented, together with additional practices.

Conclusions

Implementation of the dissemination stage indicates that in order for HPs to integrate and assimilate practices that are not in the official guidelines, merely observing simulations is not sufficient. Rather, each staff member must personally carry out the procedures.
Graves’ disease with anti-GQ1b antibody syndrome: a rare case report
Authors: Liang Tao , Zhou Zhiwei , Hu Xiaolin , Luo Zhong
Published: May 2021

Background

Graves’ disease and anti-GQ1b antibody syndrome are both autoimmune diseases, and there have been few reports on whether there is a correlation between the two. In this study, we present the case of a woman who was diagnosed with Graves’ disease and anti-GQ1b antibody syndrome in succession.

Case presentation

The chief complaints of this patient were limb weakness and blurred vision. Graves’ disease was diagnosed by examination of thyroid function and thyroid autoantibodies, but the clinical symptoms were not relieved after antihyperthyroidism treatment. Finally, it was found that Graves’ disease was complicated by anti-GQ1b antibody syndrome, and the symptoms were relieved after treatment with glucocorticoids and intravenous immunoglobulin. We also explored the possible mechanism of these diseases through a literature review.

Conclusions

We report a rare case of the cooccurrence of Graves’ disease and anti-GQ1b antibody syndrome. Immune dysregulation might be the pathogenesis of the association, but there is no precise supporting evidence, and more research is needed.
Identifying maternal needs following childbirth: comparison between pregnant women and recent mothers
Authors: Slomian Justine , Reginster Jean-Yves , Emonts Patrick , Bruyère Olivier
Published: May 2021

Background

The postnatal period is associated with new needs for mothers. Four categories of needs were highlighted in a previous study: for information, for psychological support, for the sharing of experiences and for practical and material support. To ensure that these four needs are inherent to the postpartum period, the aims of this study is to examine these needs by comparing recent mothers’ needs with the needs of pregnant women.

Methods

The 4 needs previously identified were cross-sectionally investigated by online self-reported questionnaires completed by women in their last trimester of pregnancy and by mothers who had a child between 0 and 6 months of age.

Results

The 4 needs were largely present during the postpartum period. The need for information seemed to be more present during pregnancy (92.4 %) than during the postpartum period (84.6 %, p = 0.03), but women used the Internet significantly more often to search for information after childbirth (54.8 %) than during pregnancy (41.2 %, p < 0.0001). The needs for psychological support and to share experiences seemed to be closely linked. Even if the global satisfaction with psychological support was fairly high, it weakened after childbirth (p < 0.05). Feelings of loneliness (p < 0.0001) and depression scores (p = 0.01) were also higher during the postpartum period than during pregnancy. Finally, the need for practical support was also more pronounced during the postpartum period than during pregnancy (p = 0.01).

Conclusions

All mothers seem to meet the 4 identified needs during the postpartum period but at different levels of intensity. Trying to meet these needs could offer an opportunity to improve mothers’ quality of life.