bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving Foundation Year doctors’ confidence with routine suprapubic catheter change using an easily reproducible simulation model
Authors: Sathanapally Ganesh SS , Henry Mei-Ling , Burbidge Oliver
Published: June 2020

Objective:

Previous studies report low confidence levels amongst junior doctors in changing suprapubic catheters (SPC). We aimed to assess and improve foundation doctors’ confidence in changing an SPC, and to identify factors contributing to a lack in confidence. A teaching session using an easily reproducible simulation model was delivered to improve confidence.

Method:

A teaching session on routine SPC changes was delivered to a cohort of 30 Foundation Year 2 doctors within a single hospital. The teaching session comprised a short presentation followed by a practical session with the teaching models. Trainees completed a questionnaire on self-reported confidence levels in catheterisation prior to, and directly after, the session.

Results:

The self-reported confidence level with SPC changes was measured using a 5-point scale (1 = not very confident, 5= very confident), and following the session, the median score increased from 1 to 4. 100% ( N = 28) of trainees felt the teaching session increased their confidence with routine SPC changes and that the simulation model was a useful tool.

Conclusion:

Some junior doctors report low confidence levels with SPC changes. A teaching session on routine SPC changes using a simulation model may improve confidence

Level of evidence:

2c
Tuberculosis in Health Care Workers and the Impact of Implementation of Hospital Infection-Control Measures
Authors: Azeredo Ana Cláudia Vasconcellos , Holler Sizuane Rieger , de Almeida Ellis Gabriela Correa , Cionek Otávio Augusto Gonçalves Dias , Loureiro Marcelle Martinez , Freitas Alana Ambos , Anton Camila , Machado Felipe Dominguez , Filho Fábio Fernandes Dantas , Silva Denise Rossato
Published: June 2020

Background: Most studies that have evaluated the impact of infection-control measures (ICM) reported a decrease in latent tuberculosis (TB) and not in TB. The objective of this study was to evaluate the impact of ICM on TB incidence among Health Care Workers (HCW’s). Methods: We conducted a retrospective record review study in a general, tertiary care, university-affiliated hospital. All TB case reports among HCWs in the hospital from 2005 to 2018 were reviewed. The TB incidence was measured before and after 2012 to evaluate the impact of ICM implemented. Findings: In total, there were 53 TB cases. The number of TB cases before and after the implementation of ICM was 42 (incidence: 100.0 cases/100,000 HCWs/year) and 11 (incidence: 26.2 cases/100,000 HCWs/year), respectively ( p < .0001). Conclusions/Application to Practice: TB incidence among HCWs reduced significantly after the implementation of ICM. The establishment of ICM, such as written TB infection control plan, monitoring, screening, training, and education, can reduce TB incidence.
Reduction of postoperative swelling with a negative pressure treatment—A prospective study
Authors: Saul Dominik , Fischer Ann-Christin , Lehmann Wolfgang , Dresing Klaus
Published: June 2020

Purpose:

Perioperative swelling and edema are the main factors that influence the time to definitive operative care, healing rate, as well as postoperative infection rate. Device-based negative pressure treatment is a new method to reduce post-traumatic and postoperative swelling of the upper extremities. The objective of this study was to evaluate a new negative pressure treatment with LymphaTouch® (Helsinki, Finland) to reduce perioperative swelling in upper extremity injuries.

Methods:

We analyzed 45 patients (26 female and 19 male) after operative treatment of upper extremity injuries. A predefined treatment algorithm of 30 min using LymphaTouch® was performed on the patients every day for five consecutive days. Swelling was measured according to the neutral-zero method with six points of measurement.

Results:

A total of 16 patients underwent an operation on their upper arm. An average of 3.5 measurements was performed per patient, with the start of therapy at a mean of 5.13 days after the operation. All of the measured circumferences except the elbow and 10 cm below the elbow were reduced from day 0 to 3. The percent reduction of swelling (relative to day 0) was 10.36%, 11.35%, 17.34%, and 3.25% for days 1–4, respectively. The greatest reduction of circumference was obtained in the metacarpus (−51.6%) and wrist (−33.1%).

Conclusion:

The LymphaTouch® system and a 30-min treatment program can reduce postoperative swelling of the upper arm, wrist, and hand on the first 5 days after surgery. The ease of learning and self-applicability of LymphaTouch® makes it interesting for further controlled randomized trials.
Ammoniotinsleyite, (NH4)Al2(PO4)2(OH)⋅2H2O, a new mineral species from the guano deposit at Pabellón de Pica, Iquique Province, Chile
Authors: Chukanov Nikita V. , Möhn Gerhard , Pekov Igor V. , Zubkova Natalia V. , Ksenofontov Dmitry A. , Belakovskiy Dmitry I. , Vozchikova Svetlana A. , Britvin Sergey N. , Desor Joy
Published: June 2020

The new leucophosphite-group mineral ammoniotinsleyite is found in a guano deposit located on the Pabellón de Pica Mountain, Iquique Province, Tarapacá Region, Chile. Associated minerals are halite, gypsum, salammoniac and clay minerals. Ammoniotinsleyite occurs as pink to pale violet globular aggregates up to 3 mm across with individual single crystals ~10–15 μm. The mineral is brittle. Its Mohs hardness is 4. Dmeas. = 2.42(2) g cm–3 and Dcalc. = 2.451 g cm–3. The IR spectrum shows the presence of NH4+ and PO43– groups and H2O molecules. Ammoniotinsleyite is optically biaxial (+), α = 1.557(2), β = 1.559 (calc.), γ = 1.563(2) (λ = 589 nm); and 2Vmeas. = 75(10)°. The chemical composition (K, Mg, Ca, Al, Fe and P from electron-microprobe data; H, C and N measured by gas chromatography on products of ignition at 1200°C; wt.%) is: (NH4)2O 7.25, K2O 1.50, MgO 0.42, CaO 0.34, Al2O3 29.91, Fe2O3 2.36, P2O5 43.97, H2O 14.89, CO2 below detection limit, total 100.64. The empirical formula is [(NH4)0.88K0.10Ca0.02)]Σ1.00(Al1.86Fe3+0.09Mg0.03)Σ1.98(PO4)1.96(OH)1.05⋅2.11H2O. The idealised formula is (NH4)2Al2(PO4)2(OH)⋅2H2O. The crystal structure of ammoniotinsleyite was refined based on powder X-ray diffraction data, using the Rietveld method. The final agreement factors are: Rp = 0.0071, Rwp = 0.0093 and Robs = 0.0167. The new mineral is isostructural with tinsleyite, spheniscidite and leucophosphite. It is monoclinic, space group P21/n, a = 9.5871(1) Å, b = 9.6089(1) Å, c = 9.6467(2) Å, β = 103.4461(8)°, V = 864.31(2) Å3 and Z = 4. The strongest reflections of the powder X-ray diffraction pattern [d,Å(I,%)(hkl)] are: 7.56(23)($\bar{1}$01), 6.71(79)(011, 110), 5.947(100)(101, $\bar{1}$11), 4.676(36)(002, 200), 3.032(28)($\bar{1}$13, 031, 130), 2.958(25)($\bar{2}$22, 310, $\bar{1}$31) and 2.635(29)($\bar{2}$31).
Multilevel Resistive Switching Memory Based on a CH3NH3PbI 3−xClx Film with Potassium Chloride Additives
Authors: Lv Fengzhen , Ling Kang , Zhong Tingting , Liu Fuchi , Liang Xiaoguang , Zhu Changming , Liu Jun , Kong Wenjie
Published: June 2020

High-quality CH3NH3PbI3−xClx(MAPIC) films were prepared using potassium chloride (KCl) as an additive on indium tin oxide (ITO)-coated glass substrates using a simple one-step and low-temperature solution reaction. The Au/KCl-MAPIC/ITO/glass devices exhibited obvious multilevel resistive switching behavior, moderate endurance, and good retention performance. Electrical conduction analysis indicated that the resistive switching behavior of the KCl-doped MAPIC films was primarily attributed to the trap-controlled space-charge-limited current conduction that was caused by the iodine vacancies in the films. Moreover, the modulations of the barrier in the Au/KCl-MAPIC interface under bias voltages were thought to be responsible for the resistive switching in the carrier injection trapping/detrapping process.
Can presepsin uniformly respond to various pathogens? - an in vitro assay of new sepsis marker -
Authors: Koizumi Yusuke , Sakanashi Daisuke , Mohri Tetsuo , Watanabe Hiroki , Shiota Arufumi , Asai Nobuhiro , Kato Hideo , Hagihara Mao , Murotani Kenta , Yamagishi Yuka , Suematsu Hiroyuki , Mikamo Hiroshige
Published: June 2020

Background

Presepsin (soluble CD14 subtype) is a novel biomarker of sepsis used for early diagnosis. Originally, CD14 is known as the pattern recognition receptor for the lipopolysaccharide (LPS)/LBP complexes, and the diagnostic value of this molecule for gram-positive bacteria, which contain less amount of LPS, is uncertain. To confirm its effectiveness in the diagnosis of bacteremia caused by gram positive bacteria, and to evaluate the interspecies difference of presepsin production against various bacterial strains, we conducted an in vitro assay to evaluate presepsin levels in response to five Gram negative and four Gram positive bacteria.

Results

Whole blood was yielded from five healthy volunteers and co-cultured with bacterial strains at 37 °C for 4 h. Twenty seven clinical isolates of nine species (E. coli, K. pneumoniae, E. cloacae, P. aeruginosa, S. maltophilia, S. aureus, S. pyogenes, B. cereus, and C. striatum) derived from blood cultures of non-neutropenic bacteremia patients were used. Culture supernatants were harvested and presepsin levels were measured. The presepsin level in the gram-negative bacteria 273 (218–352) pg/mL was significantly higher than in the gram-positive bacteria 200 (143–275) pg/mL (p = 0.0002). The presepsin levels were significantly lower in C. striatum, in comparison to other bacteria, and S. pyogenes showed similar results. And the presepsin levels in P. aeruginosa were significantly lower compared to E. cloacae, K. pneumoniae, and S. aureus.

Conclusions

Presepsin production can also be evoked by gram-positive bacteria, and interspecies differences of presepsin response may exist, which should be considered in the diagnosis of sepsis, especially in certain gram-positive bacteremia such as S. pyogenes or C. striatum.
Vital members in the gut microbiotas altered by two probiotic Bifidobacterium strains against liver damage in rats
Authors: Zha Hua , Fang Dai-Qiong , van der Reis Aimee , Chang Kevin , Yang Li-Ya , Xie Jiao-Jiao , Shi Ding , Xu Qiao-Mai , Li Ya-Ting , Li Lan-Juan
Published: June 2020

Background

Probiotics are effective to rectify the imbalanced gut microbiota in the diseased cohorts. Two Bifidobacterium strains (LI09 and LI10) were found to alleviate D-galactosamine-induced liver damage (LD) in rats in our previous work. A series of bioinformatic and statistical analyses were performed to determine the vital bacteria in the gut microbiotas altered by the LI09 or LI10 in rats.

Results

Two groups of representative phylotypes could distinguish the gut microbiotas of LI09 or LI10 groups from the other groups. Among them, OTU170_Porphyromonadaceae acted as a gatekeeper in LI09 group, while OTU12_Bacteroides was determined with multiple correlations in the gut network of LI10 group. Multiple reduced OTUs associated with LC and increased OTUs associated with health were determined in LI09 or LI10 groups, among which, increased OTU51_Barnesiella and reduced OTU99_Barnesiella could be associated with the protective effects of both the two probiotics. The gut microbiotas in LI09, LI10 and positive control groups were clustered into three clusters, i.e., Cluster_1_Microbiota, Cluster_2_Microbiota and Cluster_3_Microbiota, by Partition Around Medoids clustering analysis. Cluster_2_Microbiota was determined at least dysbiotic status due to its greatest LD dysbiosis ratio, lowest levels of liver function variables and plasma cytokines compared with the two other clustered microbiotas, suggesting the treated rats in Cluster_2 were at better health status.

Conclusion

Our findings suggest that OTU170_Porphyromonadaceae and OTU12_Bacteroides are vital in the gut microbiotas altered by LI09 and LI10. Characteristics of the LD cohorts treated by LI09 or LI10 at different gut microbial colonization states could help monitor the cohorts’ health status.
Human milk fungi: environmental determinants and inter-kingdom associations with milk bacteria in the CHILD Cohort Study
Authors: Moossavi Shirin , Fehr Kelsey , Derakhshani Hooman , Sbihi Hind , Robertson Bianca , Bode Lars , Brook Jeffrey , Turvey Stuart E. , Moraes Theo J. , Becker Allan B. , Mandhane Piushkumar J. , Sears Malcolm R. , Khafipour Ehsan , Subbarao Padmaja , Azad Meghan B.
Published: June 2020

Background

Fungi constitute an important yet frequently neglected component of the human microbiota with a possible role in health and disease. Fungi and bacteria colonise the infant gastrointestinal tract in parallel, yet most infant microbiome studies have ignored fungi. Milk is a source of diverse and viable bacteria, but few studies have assessed the diversity of fungi in human milk.

Results

Here we profiled mycobiota in milk from 271 mothers in the CHILD birth cohort and detected fungi in 58 (21.4%). Samples containing detectable fungi were dominated byCandida,Alternaria, andRhodotorula, and had lower concentrations of two human milk oligosaccharides (disialyllacto-N-tetraose and lacto-N-hexaose). The presence of milk fungi was associated with multiple outdoor environmental features (city, population density, and season), maternal atopy, and early-life antibiotic exposure. In addition, despite a strong positive correlation between bacterial and fungal richness, there was a co-exclusion pattern between the most abundant fungus (Candida) and most of the core bacterial genera.

Conclusion

We profiled human milk mycobiota in a well-characterised cohort of mother-infant dyads and provide evidence of possible host-environment interactions in fungal inoculation. Further research is required to establish the role of breastfeeding in delivering fungi to the developing infant, and to assess the health impact of the milk microbiota in its entirety, including both bacterial and fungal components.
Changes in soil microbial communities at Jinsha earthen site are associated with earthen site deterioration
Authors: Li Jing , Zhang Xiaoyue , Xiao Lin , Liu Ke , Li Yue , Zhang Ziwei , Chen Qiang , Ao Xiaolin , Liao Decong , Gu Yunfu , Ma Menggen , Yu Xiumei , Xiang Quanju , Chen Ji , Zhang Xiaoping , Yang Tao , Penttinen Petri , Zhao Ke
Published: June 2020

Background

Earthen sites are immobile cultural relics and an important part of cultural heritage with historical, artistic and scientific values. The deterioration of features in earthen sites result in permanent loss of cultural information, causing immeasurable damage to the study of history and culture. Most research on the deterioration of earthen sites has concentrated on physicochemical factors, and information on microbial communities in earthen sites and their relationship with the earthen site deterioration is scarce. We used high-throughput sequencing to analyze bacterial and fungal communities in soils from earthen walls with different degree of deterioration at Jinsha earthen site to characterize the microbial communities and their correlation with environmental factors, and to compare microbial community structures and the relative abundances of individual taxa associated with different degree of deterioration for identifying possible marker taxa.

Results

The relative abundances of Proteobacteria and Firmicutes were higher and that of Actinobacteria lower with higher degree of deterioration. At the genus level, the relative abundances ofRubrobacterwere highest in all sample groups except in the most deteriorated samples where that ofBacteroideswas highest. The relative abundance of the yeast genusCandidawas highest in the severely deteriorated sample group. The bacterial phylum Bacteroidetes and genusBacteroides, and fungal class Saccharomycetes that includesCandidasp. were specific for the most deteriorated samples. For both bacteria and fungi, the differences in community composition were associated with differences in EC, moisture, pH, and the concentrations of NH4+, K+, Mg2+, Ca2+and SO42−.

Conclusion

The microbial communities in soil with different degree of deterioration were distinctly different, and deterioration was accompanied with bigger changes in the bacterial than in the fungal community. In addition, the deteriorated soil contained higher concentrations of soluble salts. Potentially, the accumulation ofBacteroidesandCandidaplays an important role in the deterioration of earthen features. Further work is needed to conclude whether controlling the growth of the bacteria and fungi with high relative abundances in the deteriorated samples can be applied to alleviate deterioration.
The ‘goodness-of-fit’ of fit models: creating a multidimensional survey for person-organisation and person-group fit in health care
Authors: Herkes J. , Ellis L. A. , Churruca K. , Braithwaite J.
Published: June 2020

Background

Person-environment fit, which examines the individual’s perceptions of if, and in what way, he or she is compatible with aspects of the work context, offers a promising conceptual model for understanding employees and their interactions in health care environments. There are numerous potential ways an individual feels they “fit” with their environment. The construct was first noted almost thirty years ago, yet still remains elusive. Feelings of fit with one’s environment are typically measured by surveys, but current surveys encompass only a subset of the different components of fit, which may limit the conclusions drawn. Further, these surveys have rarely been conducted in a focused way in health care settings.

Method

This article describes the development of a multidimensional survey tool to measure fit in relation to the person’s work group (termed person-group (P-G) fit) and their organisation (person-organisation (P-O) fit). The participants were mental health care employees, volunteers, and university interns (n = 213 for P-O fit; n = 194 for P-G fit). Confirmatory Factor Analyses (CFAs) were conducted using LISREL.

Results

Valid and reliable sub-scales were found.

Conclusion

This advanced multidimensional survey tool can be used to measure P-O and P-G fit, and illuminates new information about the theoretical structure of the fit construct.
Identification of novel alternative splicing isoform biomarkers and their association with overall survival in colorectal cancer
Authors: Lian Haifeng , Wang Aili , Shen Yuanyuan , Wang Qian , Zhou Zhenru , Zhang Ranran , Li Kun , Liu Chengxia , Jia Hongtao
Published: June 2020

Background

Alternative splicing (AS) is an important mechanism of regulating eukaryotic gene expression. Understanding the most common AS events in colorectal cancer (CRC) will help developing diagnostic, prognostic or therapeutic tools in CRC.

Methods

Publicly available RNA-seq data of 28 pairs of CRC and normal tissues and 18 pairs of metastatic and normal tissues were used to identify AS events using PSI and DEXSeq methods.

Result

The highly significant splicing events were used to search a database of The Cancer Genome Atlas (TCGA). We identified AS events in 9 genes in CRC (more inclusion of CLK1-E4, COL6A3-E6, CD44v8–10, alternative first exon regulation of ARHGEF9, CHEK1, HKDC1 and HNF4A) or metastasis (decrease of SERPINA1-E1a, CALD-E5b, E6). Except for CHEK1, all other 8 splicing events were confirmed by TCGA data with 382 CRC tumors and 51 normal controls. The combination of three splicing events was used to build a logistic regression model that can predict sample type (CRC or normal) with near perfect performance (AUC = 1). Two splicing events (COL6A3 and HKDC1) were found to be significantly associated with patient overall survival. The AS features of the 9 genes are highly consistent with previous reports and/or relevant to cancer biology.

Conclusions

The significant association of higher expression of the COL6A3 E5-E6 junction and HKDC1 E1-E2 with better overall survival was firstly reported. This study might be of significant value in the future biomarker, prognosis marker and therapeutics development of CRC.
Aetiologies and outcomes of patients with abdominal pain presenting to an emergency department of a tertiary hospital in Tanzania: a prospective cohort study
Authors: Mjema Kilalo M. , Sawe Hendry R. , Kulola Irene , Mohamed Amour S. , Sylvanus Erasto , Mfinanga Juma A. , Weber Ellen J.
Published: June 2020

Background

Abdominal pain in adults represents a wide range of illnesses, often warranting immediate intervention. This study is to fill the gap in the knowledge about incidence, presentation, causes and mortality from abdominal pain in an established emergency department of a tertiary hospital in Tanzania.

Methods

This was a prospective cohort study of adult (age ≥ 18 years) patients presenting to the Emergency Medicine Department of Muhimbili National Hospital (EMD-MNH) in Dar Es Salaam, Tanzania with non-traumatic abdominal pain from September 2017 to October 2017. A case report form was used to record data on demographics, clinical presentation, management, diagnosis, outcomes and patient follow-up. The primary outcome of mortality was summarized using descriptive statistics; secondary outcome was, risks for mortality.

Results

Among 3381 adult patients present during the study period, 288 (8.5%) presented with abdominal pain, and of these 199 (69%) patients were enrolled in our study. Median age was 47 years (IQR 35–60 years), 126 (63%) were female, and 118 (59%) were referred from another hospital. Most common final diagnoses were malignancies 71 (36%), intestinal obstruction 11 (6%) and peptic ulcer disease 9 (5%). Most common EMD interventions given were intravenous fluids 57 (21%), analgesia 49 (25%) and antibiotics 40 (20%). 160 (80%) were admitted of which 15 (8%) underwent surgery directly from EMD. 24-h and 7-day mortality were 4 (2%) and 7 (4%) respectively, while overall in hospital-mortality was 16 (8%). Among the risk factors for mortality were male sex Relative Risk (RR) 2.88 (p = 0.03), hypoglycemia (RR) 5.7 (p = 0.004), ICU admission (RR) 14 (p < 0.0001), receipt of IV fluids (RR) 3.2 (p = 0.0151) and need for surgery (RR) 6.6 (p = 0.0001).

Conclusion

Abdominal pain was associated with significant morbidity and mortality as evidenced by a very high admission rate, need for surgical intervention and a high in-hospital mortality rate. Future studies and quality improvement efforts should focus on identifying why such differences exist and how to reduce the mortality.
Comparing the case-mix of frail older people at home and of those being admitted into residential care: a longitudinal study
Authors: de Almeida Mello Johanna , Cès Sophie , Vanneste Dirk , Van Durme Thérèse , Van Audenhove Chantal , Macq Jean , Fries Brant , Declercq Anja
Published: June 2020

Background

In order to optimize interventions and services in the community, it is important to identify the profile of persons who are able to stay at home and of those who are being admitted into residential care. Understanding their needs and their use of resources is essential. The main objective of the study is to identify persons who are likely to enter residential care based upon their needs and resource utilization, so that care providers can plan interventions effectively and optimize services and resources to meet the persons’ needs.

Methods

This is a longitudinal quasi-experimental study. The data consists of primary data from the community setting collected every six months during the period of 2010–2016. Interventions had the goal of keeping older people longer at home. Participants were at least 65 years old and were living in the community. The interRAI Resource Utilization Group system (RUG-III) was used to calculate the case-mix indexes (CMI) of all participants. Comparisons were made between the case-mix of those who were still living at home and those who were admitted into residential care at follow-up.

Results

A total of 10,289 older persons participated in the study (81.2 ± 7.1 yrs., 69.1% female). From this population, 853 participants (8.3%) were admitted into residential care. The CMI of the persons receiving night care at home were the highest (1.6 at baseline and 1.7 at the entry point of residential care), followed by persons receiving occupational therapy (1.5 at baseline and 1.6 at the entry point of residential care) and persons enrolled in case management interventions with rehabilitation (1.4 at baseline and 1.6 at the entry point of residential care). The CMIs at follow-up were significantly higher than at baseline and the linear regression model showed that admission to residential care was a significant factor in the model.

Conclusions

The study showed that the RUG-III system offers possibilities for identifying persons at risk of institutionalization. Interventions designed to avoid early nursing home admission can make use of the RUG-III system to optimize care planning and the allocation of services and resources. Based on the RUG-III case-mix, resources can be allocated to keep older persons at home longer, bearing in mind the complexity of care and the availability of services in the community.
The gut microbiota profile of adults with kidney disease and kidney stones: a systematic review of the literature
Authors: Stanford Jordan , Charlton Karen , Stefoska-Needham Anita , Ibrahim Rukayat , Lambert Kelly
Published: June 2020

Background

There is mounting evidence that individuals with kidney disease and kidney stones have an abnormal gut microbiota composition. No studies to date have summarised the evidence to categorise how the gut microbiota profile of these individuals may differ from controls. Synthesis of this evidence is essential to inform future clinical trials. This systematic review aims to characterise differences of the gut microbial community in adults with kidney disease and kidney stones, as well as to describe the functional capacity of the gut microbiota and reporting of diet as a confounder in these studies.

Methods

Included studies were those that investigated the gut microbial community in adults with kidney disease or kidney stones and compared this to the profile of controls. Six scientific databases (CINHAL, Medline, PubMed, Scopus, Web of Science and Cochrane Library), as well as selected grey literature sources, were searched. Quality assessment was undertaken independently by three authors. The system of evidence level criteria was employed to quantitatively evaluate the alteration of microbiota by strictly considering the number, methodological quality and consistency of the findings. Additional findings relating to altered functions of the gut microbiota, dietary intakes and dietary methodologies used were qualitatively summarised.

Results

Twenty-five articles met the eligibility criteria and included data from a total of 892 adults with kidney disease or kidney stones and 1400 controls. Compared to controls, adults with kidney disease had increased abundances of several microbes including Enterobacteriaceae, Streptococcaceae, Streptococcus and decreased abundances of Prevotellaceae, Prevotella, Prevotella 9 and Roseburia among other taxa. Adults with kidney stones also had an altered microbial composition with variations to Bacteroides, Lachnospiraceae NK4A136 group, Ruminiclostridium 5 group, Dorea, Enterobacter, Christensenellaceae and its genus Christensenellaceae R7 group. Differences in the functional potential of the microbial community between controls and adults with kidney disease or kidney stones were also identified. Only three of the 25 articles presented dietary data, and of these studies, only two used a valid dietary assessment method.

Conclusions

The gut microbiota profile of adults with kidney disease and kidney stones differs from controls. Future study designs should include adequate reporting of important confounders such as dietary intake to assist with interpretation of findings.
Spontaneous necrotizing granuloma of the cerebellum: a case report
Authors: Godbe Kerilyn N. , Saway Brian F. , Guilliams Evin L. , Entwistle John J. , Jarrett Robert W.
Published: June 2020

Background

Intracranial necrotizing granulomatous space-occupying lesions are sparsely reported in literature. Variability in presenting symptomatology and radiographic features makes diagnostic work-up difficult.

Case presentation

This report presents the case of a 77-year-old female with sinusitis and fatigue who underwent an MRI revealing a posterior fossa lesion compressing the fourth ventricle. Subsequent contrast CT of the chest, abdomen, and pelvis was negative for primary malignancy. Histopathologic examination of the lesion following biopsy showed it to be a necrotizing granuloma in an antineutrophil cytoplasmic antibody (ANCA) negative patient. The most likely diagnosis was determined to be spontaneous necrotizing granuloma, a rare entity with only one previous report noted.

Conclusions

Spontaneous necrotizing granuloma of the CNS is a rare entity that represents an important differential consideration in the work-up of space occupying lesions of the CNS.
Normal fertilisation rates and serum 25-OHD levels among couples undergoing in-vitro fertilisation: a prospective cohort study
Authors: Jiang Liu , Yang Juan , Song Jianyuan , Hu Yajun , Qian Kun
Published: June 2020

Background

The aim of this study was to explore the correlation between serum vitamin D levels in couples undergoing in-vitro fertilisation (IVF) and normal fertilisation process.

Methods

Between March 2016 and March 2017, we performed a prospective cohort study at an academic reproductive medicine centre to measure serum 25-hydroxyvitaminD (25-OHD) levels of 1232 couples before controlled ovarian stimulation. Generalized linear regression and binary multivariate logistic regression were employed to assess whether 25-OHD levels in men and women correlated with normal fertilisation rates and low fertilisation rate (LFR).

Results

Serum 25-OHD levels in women were classified into three groups: Group A, less than 10%; Group B, between 10 and 90%; and Group C, greater than 90%. Using generalized linear regression, we observed that female 25-OHD levels were related to normal fertilisation rates. Adjusted normal fertilisation rates from Group A to Group C in women were 59.50, 62.72, and 66.13%, respectively (P = 0.007). After binary logistic regression analysis, for women, compared with Group C, the ORs for LFR were 4.814 in Group A (95% CI, 1.266–18.309, P = 0.021) and were 3.204 in Group B (95% CI, 0.949–10.812, P = 0.061). Male 25-OHD levels were not related to the probability of low fertilisation rate (P > 0.05).

Conclusions

Circulating 25-OHD concentrations in women appear to be associated with normal fertilisation rates and low fertilisation rates in IVF cycles, but not in men. A further randomized controlled trial with vitamin D supplementation is needed to demonstrate whether female vitamin D levels exert an effect on the normal fertilisation process.

Trial registration

https://clinicaltrials.gov/;NCT03305510; Registered 08 October 2017 - Retrospectively registered.
miR-874 inhibits gastric cancer cell proliferation by targeting SPAG9
Authors: Sun Qin Hui , Yin Zong Xiu , Li Zhi , Tian Shu Bo , Wang Hong Chang , Zhang Fang Xu , Li Le Ping , Zheng Chun Ning , Kong Shuai
Published: June 2020

Background

microRNAs (miRNAs) play essential roles in the development and progression of gastric cancer (GC). Although aberrant miR-874 expression has been reported in various human cancers, its role in GC remains obscure.

Methods

miR-874 expression was assessed by real-time quantitative polymerase chain reaction (RT-qPCR) in 62 matched GC and adjacent normal tissues, as well as in GC cell lines and immortalized human gastric epithelial cells. CCK8 assay, colony formation assay, and flow cytometry were used to assess the role of miR-874 in GC cell proliferation and apoptosis in vitro. Additionally, to determine the effects of miR-874 on GC cell proliferation and apoptosis in vivo, BALB/c nude mice were injected with GC cells transfected with a miR-874 mimic. The role of miR-874 in SPAG9 expression was assessed by luciferase assay, Western blotting, and RT-qPCR.

Results

miR-874 was downregulated in GC cell lines and tissues. miR-874 overexpression in GC cells led to inhibition of cell proliferation and induction of apoptosis. Moreover, SPAG9 was identified as a direct miR-874 target, the expression of which was suppressed by miR-874. SPAG9 overexpression markedly promoted GC cell proliferation.

Conclusions

miR-874 inhibited cell proliferation and induced apoptosis in GC cells. SPAG9 downregulation was crucial for the tumor-suppressive effects of miR-874. Hence, the miR-874/SPAG9 axis could serve as a novel therapeutic target in GC.
Activity of PD1 inhibitor therapy in advanced sarcoma: a single-center retrospective analysis
Authors: Quiroga Dionisia , Liebner David A. , Philippon Jennifer S. , Hoffman Sarah , Tan Yubo , Chen James L. , Lenobel Scott , Wakely Paul E. , Pollock Raphael , Tinoco Gabriel
Published: June 2020

Background

Sarcomas constitute a heterogeneous group of tumors with different clinical behaviors and variable responses to systemic therapies. Recent immunotherapy studies with PD1 inhibitors (PD1i) show promising results with use in certain soft-tissue sarcomas; however, the clinical and molecular features that best predict response to PD1i remain unclear.

Methods

Demographic, imaging, histologic, and genetic sequencing data was collected for sarcoma patients who received nivolumab or pembrolizumab (PD1i) treatment at our institution between January 1st 2015 and April 23rd 2018. The primary objective was to determine progression-free survival (PFS) in patients with advanced sarcomas receiving PD1i. Secondary objectives included determining overall survival (OS) and assessment of characteristics associated with response to PD1i. Fifty-six patients who were treated with PD1i therapy met inclusion criteria for this study.

Results

Partial response towards PD1i treatment was seen in 3 in 26 evaluable patients, but no complete responses were observed (overall response rate 11.5%). Within this group of patients, the 90 day PFS was found to be 48.8%. In patients in whom PD1 expression was known, there was a statistically significant positive correlation between expression of PD1 and longer PFS and OS rates. Patients that were treated with more than four cycles of PD1i therapy were also more likely to have a greater OS.

Conclusions

This study suggests activity of PD1i in a pretreated cohort of advanced sarcoma patients, particularly for the subset of patients with PD1 positive tumors. Our results highlight the importance of further research to better target the optimal patient population and markers of response.
Meeting psychosocial needs to improve health: a prospective cohort study
Authors: Snowden Austyn , Young Jenny , Savinc Jan
Published: June 2020

Background

Cancer impacts on patients and their families across a range of different domains. For that reason, optimal cancer care has moved away from a disease-centric focus to a more holistic approach in order to proactively support people with their individual needs and concerns. While international policy clearly advocates this agenda, implementation into routine care is limited. Therefore, relevant interventions that measurably improve patient outcomes are essential to understand if this ideal is to become routine multidisciplinary practice. The aim of this study was to analyse the impact of a proactive, holistic, community-based intervention on health-related quality of life in a cohort of people diagnosed with cancer. Secondary aim was to explore the relationship between changes in health status and: cancer type, cancer stage, number of concerns expressed and change in severity of concerns pre and post intervention.

Method

Prospective observational cohort study. A convenience sample of 437 individuals were referred to the service ‘Improving the Cancer Journey (ICJ) in the UK. Each completed the Euroqol EQ-5D-3 L and visual analogue scale (VAS) and a Holistic Needs Assessment (HNA) during initial visit to the service and again at follow-up review, median 84 days later. Change between scores was tested with paired t-tests and relationships between variables with multiple regression models with heteroscedasticity-consistent standard errors.

Results

Participants were White British with median age between 50 and 64 years. Cancer type and stage were varied. EQ-5D utility scores improved at follow-up by 0.121 [0.0891–0.153],p < .001, and VAS scores improved by 7.81 [5.88–9.74],p < .001. The strongest predictor of change was a decrease in severity of concerns. Cancer stage ‘palliative care’ contributed to a reduction in health status.

Conclusion

This study is the first to show that a holistic community intervention dedicated to supporting the individual concerns of participants had both a statistically significant and clinically meaningful impact on participants’ health-related quality of life. The mean change in EQ-5D scores was more than the ‘minimally important clinical difference’ described in the literature. This is important because while quality of life has multiple determinants, this study has shown for the first time that it is possible to capture a clinically meaningful improvement as a function of reducing someone’s personally identified concerns.
Risk factors for excessive postoperative exo-drift after unilateral lateral rectus muscle recession and medial rectus muscle resection for intermittent exotropia
Authors: Morisawa Shin , Hamasaki Ichiro , Shibata Kiyo , Shimizu Takehiro , Kono Reika , Miyata Manabu , Furuse Takashi , Hasebe Satoshi , Ohtsuki Hiroshi , Morizane Yuki , Shiraga Fumio
Published: June 2020

Background

To detect significant factors associated with excessive postoperative exo-drift in young patients with intermittent exotropia who had undergone unilateral lateral rectus muscle recession and medial rectus muscle resection.

Methods

We retrospectively examined the records of 64 consecutive patients < 18 years old who underwent surgery between April 2004 and December 2011. We sought risk factors for excessive postoperative exo-drift among patients’ demographic and clinical characteristics using univariate and multivariable linear regression analysis.

Results

Younger patients (P = 0.007), and those with larger preoperative exo-deviation at distance (P = 0.033), a lower incidence of peripheral fusion at distance (P = 0.021) or a greater postoperative initial eso-deviation (P = 0.001), were significantly more likely to have an excessive postoperative exo-drift (> 20 prism diopters). Univariate analysis revealed significant associations between excessive postoperative exo-drift and age at surgery (P = 0.004), preoperative exo-deviation at distance (P = 0.017) and postoperative initial eso-deviation at distance (P < 0.001). Multivariable linear regression analysis showed that postoperative initial eso-deviation at distance (P = 0.008) was significantly associated with postoperative exo-drift.

Conclusions

Postoperative exodrift in unilateral RR is predicted by the initial postoperative eso-deviation, which may offset the overcorrection. However, the exo-drift is greater in cases with a large preoperative exo-deviation and/or at a younger age, and should be followed carefully.
Minoxidil induced central serous Chorioretinopathy treated with oral Eplerenone – a case report
Authors: Venkatesh Ramesh , Pereira Arpitha , Jain Kushagra , Yadav Naresh Kumar
Published: June 2020

Background

Minoxidil solution has routinely been used for decades for the treatment of androgenic alopecia. Central serous chorioretinopathy (CSCR) is a rare side-effect noted following prolonged topical minoxidil therapy for androgenic alopecia. In this report, we describe a case of a 41-year-old young man who developed CSCR following prolonged therapy with topical Minoxidil solution and was treated with oral eplerenone.

Case presentation

A 41-year-old male presented to the retina clinic with complaints of seeing a black spot, blurred vision and metamorphopsia involving the right eye for the past 4 months. He was on treatment for androgenic alopecia with topical 5% Minoxidil application on scalp two times a day. He noticed the symptoms 8 months after starting the treatment and had stopped the medication since the past 2 months. On examination, best-corrected visual acuity was 20/20 in both eyes. Fundoscopic examination of the right eye with +78D lens on slit lamp revealed the presence of subretinal fluid and few focal spots of retinal pigment epithelial alterations. Optical coherence tomography scan evaluation showed the presence of subretinal fluid (SRF) and pachychoroid supporting the diagnosis of CSCR. Indocyanine green angiography revealed dilated hyperpermeable choroidal vasculature on the nasal side of the fovea in the early and later phases of the angiogram. The patient was diagnosed with CSCR as a possible consequence of the topical minoxidil solution. Patient was asked to avoid future use of Minoxidil and was started on oral eplerenone therapy 50 mg/day for 4 consecutive weeks. One month later, there was complete resolution of his symptoms and SRF. At the final follow-up visit, 2 months after starting the therapy, there was no recurrence of SRF.

Conclusion

CSCR is a rare side-effect noted following prolonged topical minoxidil therapy for androgenic alopecia. While we found oral eplerenone to be safe and effective, further studies would be required before it can be routinely used in the population.
Tübingen hip flexion splints for developmental dysplasia of the hip in infants aged 0–6 months
Authors: Zhou You , Li Rong , Li Chuan , Zhou Ping , Li Yan , Ke You-hao , Jiang Fei , Kang Xiao-peng
Published: June 2020

Background

Developmental dysplasia of the hip (DDH) is a common disorder in infants. The present study aimed to evaluate the efficacy and safety of the Tübingen hip flexion splints in treating DDH in infants aged 0–6 months.

Methods

This is a retrospective study analyzing 259 hips in 195 infants with DDH of Graf type IIc or worse classifications treated between January 2015 and December 2017. Patients were followed up for at least 6 months. Avascular necrosis of the femoral head was diagnosed using plain radiographs at the last follow-up visit according to the Bucholz-Ogden classification. Successful treatment was defined as an improvement of the Graft classification to type I, or an improvement of the International Hip Dysplasia Institute classification to type I in patients aged > 6 months.

Results

Treatment was deemed successful in 128 patients (83.7%). Avascular necrosis occurred in 3 patients (3 hips). Univariate analysis showed that late treatment initiation, family history of DDH, Graf type IV and bilateral involvement were independent risk factors for treatment failure (p < 0.05). The receiver operating characteristic curve showed a cut-off value of 12 weeks for age at treatment initiation regarding successful treatment. Logistic regression analysis showed that gender, breech presentation, firstborn, swaddling, birth weight > 3.5 kg, oligohydramnios, foot deformity and torticollis did not affect the success rate of treatment (p > 0.05).

Conclusions

The Tübingen splint showed good efficacy and safety in treating DDH in infants aged 0–6 months. Family history of DDH, Graf classification of type IV, bilateral involvement and treatment initiation after 12 weeks of age are risk factors of treatment failure.

Trial registration

N/A
Examining the autistic traits in children and adolescents diagnosed with attention-deficit hyperactivity disorder and their parents
Authors: Okyar Esra , Görker Işık
Published: June 2020

Background

Attention-Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are two of the most frequently-observed neurodevelopmental disorders. Autistic traits are detected frequently in children who have ADHD. This study aimed to examine autism symptoms in children diagnosed with ADHD and their parents; and also, to investigate parental risk factors that increase autistic traits in children. Besides the risk factors related to pregnancy, birth and developmental history were examined.

Methods

Two groups were created consisting of 66 children diagnosed with ADHD and 33 children not diagnosed with ADHD and their parents. Autism symptoms were screened with the Autism Behavior Checklist (ABC) in children, and Autism Spectrum Quotient (AQ) in parents. Also, Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale and Wender Utah Rating Scale (WURS) were used to determine ADHD symptoms in parents.

Results

It was determined that there were more autism symptoms in children who were diagnosed with ADHD than in the control group without ADHD. There were more autistic symptoms in boys and the presence of Oppositional Defiant Disorder (ODD). Although there were more ADHD symptoms in the parents of children diagnosed with ADHD, it was determined that they did not differ from parents in the control group in terms of autism symptoms. It was also determined that maternal and paternal ADHD symptoms were predictive for autism symptoms in children. It was also shown that maternal smoking during pregnancy is associated with more autistic traits.

Conclusion

ASD and ADHD show high levels of comorbidity. The etiology remains unclear. Both ADHD and ASD show strong hereditary transition. We found that maternal and paternal ADHD symptoms predict autism symptoms in children with ADHD. However, more studies are needed to reveal the etiology.
Participation in the Child and Adult Care Food Program is associated with fewer barriers to serving healthier foods in early care and education
Authors: Zaltz Daniel A. , Hecht Amelie A. , Pate Russell R. , Neelon Brian , O’Neill Jennifer R. , Benjamin-Neelon Sara E.
Published: June 2020

Background

Early care and education (ECE) is an important setting for influencing young children’s dietary intake. There are several factors associated with barriers to healthy eating in ECE, and recent evidence suggests that participation in the Child and Adult Care Food Program (CACFP), the primary national food assistance program in ECE, may be associated with fewer barriers to serving healthier foods. However, no prior studies have examined differences between CACFP participants and non-participants across a large, multi-state sample. This is the first study to examine the association between CACFP participation and barriers to serving healthier foods in ECE using a random sample of directors from two regions across the country.

Methods

We conducted a cross-sectional survey among a random sample of child care center directors from four states (Massachusetts, North Carolina, Rhode Island, and South Carolina). We conducted logistic and Poisson regression to calculate the odds and incidence rate ratios of reporting 1) no barriers, 2) specific barriers (e.g., cost), and 3) the total number of barriers, by CACFP status, adjusting for covariates of interest.

Results

We received 713 surveys (36% response rate). About half (55%) of centers participated in CACFP. The most prevalent reported barriers to serving healthier foods were cost (42%) and children’s food preferences (19%). Directors from CACFP centers were twice as likely to report no barriers, compared to directors from non-CACFP centers (OR 2.03; 95% CI [1.36, 3.04];p < 0.01). Directors from CACFP centers were less likely to report cost as a barrier (OR = 0.46; 95% [CI 0.31, 0.67];p < 0.001), and reported fewer barriers overall (IRR = 0.77; 95% CI [0.64, 0.92];p < 0.01), compared to directors from non-CACFP centers.

Conclusions

CACFP directors reported fewer barriers to serving healthier foods in child care centers. Still, cost and children’s food preferences are persistent barriers to serving healthier foods in ECE. Future research should evaluate characteristics of CACFP participation that may alleviate these barriers, and whether barriers emerge or persist following 2017 rule changes to CACFP nutrition standards.