bluuebunny/crossref_metadata_2025 huggingface dataset:
Retrospective cohort study of paediatric splenic injuries at a major adult trauma centre in South Africa identifies areas of success and improvement
Authors: Conradie Bernike , Kong Victor , Cheung Cynthia , Varghese Chris , Elsabagh Abdallah , Rajaretnam Nigel , Bruce John , Clarke Damian , Laing Grant , Bekker Wanda
Published: March 2021

Background

Over the last 50 years, the gold standard for paediatric trauma management has grown to be non‐operative management. This study reviews a South African experience with paediatric splenic trauma in order to benchmark this against the international standard and to identify discrepancies in access to care and in surgical outcomes.

Methods

This was a retrospective study conducted at a major trauma centre in South Africa. All children less than 18 years of age who were admitted to our trauma centre following trauma between December 2012 and October 2020 were identified and all those who sustained splenic trauma were reviewed.

Results

Of the 66 patients reviewed, 48 (72%) were male, and the median age was 12 years (0–18 years). Thirty‐three (51%) were of rural origin and 61 (93%) sustained blunt trauma. Only eight (12%) had an isolated splenic injury, while the remaining 58 (88%) had other associated injuries. Forty‐five patients (68%) were managed non‐operatively whilst the remainder were subjected to laparotomy. Five (7%) required a splenectomy and one required angio‐embolisation. Twenty‐six patients (39%) required intensive care unit (ICU) admission: 15 (37%) in the non‐operative cohort required ICU admission and eight (40%) in the laparotomy group required ICU admission. Twenty‐eight (42%) patients required ventilatory support. Median length of stay was 5.5 days. Four (6%) patients died.

Conclusions

Although non‐operative management of paediatric splenic trauma can be undertaken successfully by adult trauma surgeons in a middle‐income country such as South Africa, there remains room for improvement. To achieve splenic salvage rates comparable to those in dedicated paediatric trauma centres in high‐income countries will require systematic quality improvement programmes.
A prospective multicentre study of intravitreal injections and ocular surface in 219 patients: IVIS study
Authors: Verrecchia Sarah , Chiambaretta Fredéric , Kodjikian Laurent , Nakouri Yasemin , El Chehab Hussam , Mathis Thibaud , Badri Yannis , Chudzinski Roman , Levron Antoine , Chaperon Mayeul , Agard Emilie , Pradat Pierre , Dot Corinne
Published: March 2021

Purpose

To assess the impact of intravitreal injections (IVTI) on ocular surface of patients treated with multiple injections.

Methods

Prospective, tricentric study conducted in patients treated with unilateral IVTI. An asepsis protocol with povidone‐iodine was used for all patients during IVTI. The primary endpoint was the difference between the pre‐IVTI Ocular Surface Disease Index (OSDI 1) score and that measured on day one (D1) post‐IVTI (OSDI 2). Secondary endpoints were the evaluation of predictive factors for OSDI scores, pain assessment on D1, and the Lacrydiag® analysis of tears from the injected eye versus contralateral eye before IVTI.

Results

Two hundred and nineteen patients with a mean age of 75.9 ± 10 years were included. The mean OSDI2‐OSDI1 difference was 19.2 ± 20.6 (p < 0.001). The mean noninvasive tear break‐up time was 6.41 ± 4.59 seconds in the injected eye versus 7.36 ± 4.36 seconds in the contralateral eye (p < 0.001). In the multivariate analysis, the factors significantly associated with the OSDI 2 score were the OSDI 1 score (p < 0.001), the pain score on D1 (p < 0.001) the number of instilled glaucoma eye drop (p = 0.01) and a centre effect (centres 2 and 3 versus centre 1, p < 0.001).

Conclusion

Our results confirm the impairment of the ocular surface and quality of life immediately after an IVTI. These results suggest 3 levels of action to improve the immediate tolerance: improving the basal status of the ocular surface, reducing the contact time with povidone‐iodine that might be toxic to the surface, and improving immediate post‐IVTI treatment.
Hypertension: Current trends and future perspectives
Authors: Hunter Paul G. , Chapman Fiona A. , Dhaun Neeraj
Published: March 2021

Hypertension is a significant and increasing global health issue. It is a leading cause of cardiovascular disease and premature death worldwide due to its effects on end organs, and through its associations with chronic kidney disease, diabetes mellitus and obesity. Despite current management strategies, many patients do not achieve adequate blood pressure (BP) control. Hypertension‐related cardiovascular mortality rates are rising in tandem with the increasing global prevalence of chronic kidney disease, diabetes mellitus and obesity. Improving BP control must therefore be urgently prioritised. Strategies include utilising existing antihypertensive agents more effectively, and using treatments developed for co‐existing conditions (such as sodium–glucose cotransporter 2 inhibitors for diabetes mellitus) that offer additional BP‐lowering and cardiovascular benefits. Additionally, novel therapeutic agents that target alternative prohypertensive pathways and that offer broader cardiovascular protection are under development, including dual angiotensin receptor–neprilysin inhibitors. Nonpharmacological strategies such as immunotherapy are also being explored. Finally, advancing knowledge of the human genome and molecular modification technology may usher in an exciting new era of personalised medicine, with the potential to revolutionise the management of hypertension.
Patterns of cesarean birth among women living with HIV in Ontario: A cross‐sectional, population‐level study
Authors: Shoemaker Esther S. , Saiyin Tana , Smith Stephanie , Loutfy Mona , Darling Liz , Walker Mark , Hawken Steven , Begum Jahanara , Bibeau Christine , Bertozzi Breklyn , Fraleigh Annette , Kwaramba Gladys , Johnson Kerrigan , Cousineau Ashlee , Kendall Claire E.
Published: March 2021

Background

In Canada, as is found globally, women of reproductive age are a growing demographic of persons living with HIV. Combination antiretroviral therapy (cART) treatment enables women living with HIV (WLWH) to become pregnant without perinatal transmission, and they are increasingly planning to become pregnant. Since 2014, Canadian guidelines no longer recommend routine elective cesarean birth (CB) for women who are virally suppressed and receiving cART. It is unknown whether their obstetric care has changed since this update. Our objective was to describe trends in cesarean births among WLWH in Ontario, Canada, over a 12‐year period.

Methods

Our research is co‐led and codesigned with WLWH. We conducted a retrospective population‐level cohort study using linked health administrative databases at ICES (formally, the Institute for Clinical and Evaluative Sciences). Participants were all women who gave birth in Ontario, between 2006/07 and 2017/18. We assessed their intrapartum characteristics and used multivariable regression to determine an association between HIV status and CB, controlling for sociodemographic and clinical variables.

Results

Since 2014, the overall proportion of CB among WLWH remained stable and was higher than among women without HIV (39.9% vs 29.0%, P < 0.001). In addition, the proportion of primary CB decreased between 2006 and 2010 and between 2014 and 2018 (28.5%‐19.3%), whereas the proportion of repeat CB increased (13.1%‐20.5%, P = 0.013).

Conclusions

Because of decreasing HIV‐related indications for CB, more practitioners may be following the guidelines for first‐time mothers. Currently, no guidelines exist for care of WLWH with a previous CB, and opportunities for vaginal birth may be missed in this population.
Bone marrow-derived mesenchymal stem cells inhibit CD8+ T cell immune responses via PD-1/PD-L1 pathway in multiple myeloma
Authors: Liu Z , Mi F , Han M , Tian M , Deng L , Meng N , Luo J , Fu R
Published: March 2021

High expression of the inhibitory receptor programmed cell death ligand 1 (PD-L1) on tumor cells and tumor stromal cells have been found to play a key role in tumor immune evasion in several human malignancies. However, the expression of PD-L1 on bone marrow mesenchymal stem cells (BMSCs) and whether the programmed cell death 1 (PD-1)/PD-L1 signal pathway is involved in the BMSCs versus T cell immune response in multiple myeloma (MM) remains poorly defined. In this study, we explored the expression of PD-L1 on BMSCs from newly diagnosed MM (NDMM) patients and the role of PD-1/PD-L1 pathway in BMSC-mediated regulation of CD8+ T cells. The data showed that the expression of PD-L1 on BMSCs in NDMM patients was significantly increased compared to that in normal controls (NC) (18·81 ± 1·61 versus 2·78± 0·70%; P < 0·001). Furthermore, the PD-1 expression on CD8+ T cells with NDMM patients was significantly higher than that in normal controls (43·22 ± 2·98 versus 20·71 ± 1·08%; P < 0·001). However, there was no significant difference in PD-1 expression of CD4+ T cells and natural killer (NK) cells between the NDMM and NC groups. Additionally, the co-culture assays revealed that BMSCs significantly suppressed CD8+ T cell function. However, the PD-L1 inhibitor effectively reversed BMSC-mediated suppression in CD8+ T cells. We also found that the combination of PD-L1 inhibitor and pomalidomide can further enhance the killing effect of CD8+ T cells on MM cells. In summary, our findings demonstrated that BMSCs in patients with MM may induce apoptosis of CD8+ T cells through the PD-1/PD-L1 axis and inhibit the release of perforin and granzyme B from CD8+ T cells to promote the immune escape of MM.
Pentoxifylline or theophylline use in hospitalized COVID‐19 patients requiring oxygen support
Authors: Wall Geoffrey C. , Smith Hayden L. , Trump Matthew W. , Mohr Jason D. , DuMontier Samuel P. , Sabates Becca L. , Ganapathiraju Iaswarya , Kable Tim J.
Published: March 2021

Introduction

The phosphodiesterase inhibitors theophylline and pentoxifylline have anti‐inflammatory properties that may make them useful in COVID‐19 pneumonia. We conducted a retrospective review of hospitalized COVID‐19 patients requiring oxygen who received these drugs.

Objectives

To examine the potential efficacy and safety of theophylline and pentoxifylline in COVID‐19 pneumonia patients.

Methods

Adults with a positive test for SARS‐COV2 and were hospitalized due to pneumonia requiring either high flow nasal cannula or mechanical ventilation were included. Patients with a history of asthma or chronic obstructive pulmonary disease were preferentially given theophylline. All other patients received pentoxifylline 400 mg orally TID. A group of hospitalized COVID‐19 patients receiving standard of care acted as a comparison group. The coprimary outcomes were a change in C‐reactive protein (CRP) and ROX score between groups from day 1 to day 4 of therapy.

Results

Two hundred and nine inpatients were reviewed. Fifty‐eight patients received pentoxifylline/theophylline, with 151 patients serving as the comparison group. Active therapy was associated with an increase in the ROX score (mean: 2.9 (95% CI: 0.6, 5.1)) and decrease in CRP (mean: −0.7 (95% CI: −4.7, 3.2). Mortality rates were theophylline/pentoxifylline 24% and comparison group had a 26%, respectively.

Conclusion

In this retrospective study, theophylline and pentoxifylline were associated with an increase in ROX score and nominal decreases in CRP and mortality. Treatment was safe with few adverse reactions documented. We believe that this study could the basis for randomized‐controlled trials to further explore these drugs’ role in COVID‐19.
Shark and ray diversity, abundance and temporal variation around an Indian Ocean Island, inferred by eDNA metabarcoding
Authors: Mariani Stefano , Fernandez Chloe , Baillie Charles , Magalon Helene , Jaquemet Sebastien
Published: March 2021

Sharks embody several major aspects of modern marine management: they are traditionally antagonized, exploited or by‐caught by humans, typically vulnerable to extirpation, pursued as luxury food, yet valued as wildlife and essential as top‐down regulators in marine food webs. Due to their generally large size, elusiveness, high mobility, and potentially dangerous nature, elasmobranchs pose substantial technical challenges to biodiversity monitoring, which prompted recent efforts to harness the power of environmental DNA (eDNA) as a noninvasive survey method for these taxa. Here we deployed an elasmobranch‐specific metabarcoding assay to characterize shark and ray diversity around Reunion Island, during the austral summer, detecting at least 14 species and a strong overall correlation between frequency of species detection and read abundance. Over 90% of sequence reads belonged to three large predators: scalloped hammerhead (Sphyrna lewini), tiger shark (Galeocerdo cuvier) and bull shark (Carcharhinus leucas). While the importance of tiger and bull sharks is well established in Reunion Island, and a major focus of the local shark control program, the prevalence and abundance of scalloped hammerhead has so far been grossly neglected. We also confirm the absence of typical “tropical reef sharks” around the island and reveal an important temporal fluctuation in tiger shark during the study period. Collectively, results show how eDNA can help circumvent barriers, bias and drawbacks associated with monitoring shark populations using visual and capture‐based techniques, and generate spatial and temporal biodiversity data on these species for rapid consideration by marine environmental managers.
Light‐induced local gene expression in primary chick cell culture system
Authors: Kitajima Keiichi , Kawahira Naofumi , Lee Sang‐Woo , Tamura Koji , Morishita Yoshihiro , Ohtsuka Daisuke
Published: March 2021

The ability to manipulate gene expression at a specific region in a tissue or cell culture system is critical for analysis of target gene function. For chick embryos/cells, several gene introduction/induction methods have been established such as those involving retrovirus, electroporation, sonoporation, and lipofection. However, these methods have limitations in the accurate induction of localized gene expression. Here we demonstrate the effective application of a recently developed light‐dependent gene expression induction system (LightOn system) using the Neurospora crassa photoreceptor Vivid fused with a Gal4 DNA binding domain and p65 activation domain (GAVPO) that alters its activity in response to light stimulus in a primary chicken cell culture system. We show that the gene expression level and induction specificity in this system are strongly dependent on the light irradiation conditions. Especially, the irradiation interval is an important parameter for modulating gene expression; for shorter time intervals, higher induction specificity can be achieved. Further, by adjusting light irradiation conditions, the expression level in primary chicken cells can be regulated in a multiple step manner, in contrast to the binary expression seen for gene disruption or introduction (i.e., null or overexpression). This result indicates that the light‐dependent expression control method can be a useful technique in chick models to examine how gene function is affected by gradual changes in gene expression levels. We applied this light induction system to regulate Sox9 expression in cultures of chick limb mesenchyme cells and showed that induced SOX9 protein could modulate expression of downstream genes.
Learning Theory, Classroom Assessment, and Equity
Authors: Kang Hosun , Furtak Erin M.
Published: March 2021

Despite increasing awareness about the role of classroom assessments in perpetuating educational inequities, the research community continues to struggle with how to support teachers to design and use classroom assessments for achieving equity. In response to recent calls to better connect learning theory to the design of classroom assessments, we explore the links among contemporary learning theories, classroom assessments, equity, and teachers’ professional learning. Building a conceptual argument that we should shift our attention from assessment tasks to a classroom activity system to better support minoritized students’ learning via classroom assessment, we examine how teachers participate in assessment codesign activities in two research‐practice partnerships (RPPs), and then identify emerging tensions in relation to promoting equity. Each RPP drew upon contemporary learning theories—sociocognitive and sociocultural learning theories, respectively—to create a coherent system of curriculum, instruction, and assessment. The examples show that the tensions emerging from each project are at least partially related to the learning theory that led the researchers to set up professional learning settings in a particular way. Our findings suggest that managing these tensions is an inherent part of the work as researchers seek to support equitable student learning. We discuss specific implications for the assessment community.
Retinal layer thinning predicts treatment failure in relapsing multiple sclerosis
Authors: Bsteh Gabriel , Hegen Harald , Altmann Patrick , Auer Michael , Berek Klaus , Di Pauli Franziska , Leutmezer Fritz , Rommer Paulus , Wurth Sebastian , Zinganell Anne , Zrzavy Tobias , Deisenhammer Florian , Berger Thomas
Published: March 2021

Background and purpose

Peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell plus inner plexiform layer (GCIPL) thinning are markers of neuroaxonal degeneration in multiple sclerosis (MS), which is reduced by disease‐modifying treatment (DMT). We aimed to investigate the potential of pRNFL and GCIPL thinning for prediction of DMT failure in relapsing MS (RMS).

Methods

In this 4‐year prospective observational study on 113 RMS patients, pRNFL and GCIPL were measured at DMT initiation and after 12 months (M12) and 24 months (M24). Treatment failure was defined as 6‐month confirmed Expanded Disability Status Scale (EDSS) progression and/or Symbol Digit Modalities Test (SDMT) worsening. Optimal cutoff values for predicting treatment failure were determined by receiver operating characteristic analyses and hazard ratios (HRs) by multivariable Cox regression adjusting for age, sex, disease duration, EDSS/SDMT, and DMT class.

Results

Thinning of GCIPL >0.5 μm/year at M24 showed superior value for treatment failure prediction (HR: 4.5, 95% confidence interval [CI]: 1.8–7.6, p < 0.001; specificity 91%, sensitivity 81%), followed by GCIPL >0.5 μm at M12 (odds ratio [OR]: 3.9, 95% CI: 1.4–6.9, p < 0.001; specificity 85%, sensitivity 78%), and pRNFL ≥2 μm/year at M24 (OR: 3.7, 95% CI: 1.1–6.5, p = 0.023; specificity 84%, sensitivity 69%), whereas pRNFL at M12 was not predictive.

Conclusions

GCIPL, and to a lesser degree pRNFL, thinning predicts disability progression after DMT initiation and may be a useful and accessible biomarker of treatment failure in RMS.
Social outcome and psychiatric comorbidity of generalized epilepsies – A case‐control study
Authors: Gesche Joanna , Antonson Sussie , Dreier Julie Werenberg , Christensen Jakob , Beier Christoph Patrick
Published: March 2021

Objective

To investigate social outcome and psychiatric comorbidity of patients with idiopathic/genetic generalized epilepsies (IGEs) and its subtypes (epilepsy with generalized tonic‐clonic seizures alone [EGTCS], juvenile absence epilepsy [JAE], and juvenile myoclonic epilepsy [JME]).

Methods

A cohort of 402 adult patients with IGE from the Danish island Funen was matched with 4020 randomly selected geography‐, age‐, and sex‐matched controls via the Danish Civil Registration System. Based on register data, we compared social status measured by cohabitant status, educational attainment, income, affiliation to labor market, and psychiatric comorbidity.

Results

As compared to controls, patients with IGE had similar cohabitant status but fewer children (no children: 59.0% vs 50.9%), and lower educational level (primary school only: 46.0% vs 37.3%), employment rate (outside of workforce: 56.7% vs 46.5%), and income (low income: 32.6% vs 24.9%) (P < 0.001 for all comparisons). Having IGE was associated with higher a proportion of psychiatric comorbidity (IGE, 22.6%; controls, 13.0%) (P < 0.001). Seizure‐free patients did not differ from controls; patients with persistent seizures had lower incomes and employment rates. In the IGE subgroup analyses, JME was associated with worse social status in all parameters studied (eg, 65.9% of JME patients were outside the workforce vs 44.5% of matched controls; P < 0.001), whereas no adverse social status was identified in patients with EGTCS and JAE.

Significance

Patients with IGE in general and JME in particular have poorer social status and more psychiatric comorbidity than matched population controls without epilepsy. Poor seizure control was associated with social status and may contribute to negative socioeconomic consequences associated with IGE.
Learning from mistakes: Improving spelling correction performance with automatic generation of realistic misspellings
Authors: Büyük Osman , Arslan Levent M.
Published: March 2021

Sequence to sequence models (seq2seq) require a large amount of labelled training data to learn the mapping between the input and output. A large set of misspelled words together with their corrections is needed to train a seq2seq spelling correction system. Low‐resource languages such as Turkish usually lack such large annotated datasets. Although misspelling‐reference pairs can be synthesized with a random procedure, the generated dataset may not well match to genuine human‐made misspellings. This might degrade the performance in realistic test scenarios. In this paper, we propose a novel procedure to automatically introduce human‐like misspellings to legitimate words in Turkish language. Generated human‐like misspellings are used to improve the performance of a seq2seq spelling correction system. The proposed system consists of two separate models; a misspelling generator and a spelling corrector. The generator is trained using a relatively small number of human‐made misspellings and their manual corrections. Reference words and their misspellings are used as inputs and outputs of the generator, respectively. As a result, it is trained to add realistic spelling errors to the valid words. Training data of the spelling corrector is augmented by the generator's human‐like misspellings. In the experiments, we observe that the data augmentation significantly improves the spelling correction performance. Our proposed method yields 5% absolute improvement over the state‐of‐the‐art Turkish spelling correction systems in a test set which contains human‐made misspellings from Twitter messages.
Isotopic Characterization of Sulfate in a Shallow Aquifer Impacted by Agricultural Fertilizer
Authors: Spoelstra John , Leal Kristen A. , Senger Natalie D. , Schiff Sherry L. , Post Ryan
Published: March 2021

The stable isotope ratios of groundwater sulfate (34S/32S, 18O/16O) are often used as tracers to help determine the origin of groundwater or groundwater contaminants. In agricultural watersheds, little is known about how the increased use of sulfur as a soil amendment to optimize crop production is affecting the isotopic composition of groundwater sulfate, especially in shallow aquifers. We investigated the isotopic composition of synthetic agricultural fertilizers and groundwater sulfate in an area of intensive agricultural activity, in Ontario, Canada. Groundwater samples from an unconfined surficial sand aquifer (Lake Algonquin Sand Aquifer) were analyzed from multi‐level monitoring wells, riverbank seeps, and private domestic wells. Fertilizers used in the area were analyzed for sulfur/sulfate content and stable isotopic composition (δ18O and/or δ34S). Fertilizers were isotopically distinct from geological sources of groundwater sulfate in the watershed and groundwater sulfate exhibited a wide range of δ34S (−6.9 to +20.0‰) and δ18O (−5.0 to +13.7‰) values. Quantitative apportionment of sulfate sources based on stable isotope data alone was not possible, largely because two of the potential fertilizer sulfate sources had an isotopic composition on the mixing line between two natural geological sources of sulfate in the aquifer. This study demonstrates that, when sulfate isotope analysis is being used as a tracer or co‐tracer of the origin of groundwater or of contaminants in groundwater, sulfate derived from synthetic fertilizer needs to be considered as a potential source, especially when other parameters such as nitrate independently indicate fertilizer impacts to groundwater quality.
Effect of low dialysate sodium in the management of intradialytic hypertension in maintenance hemodialysis patients: A single‐center Indian experience
Authors: Nair Sanjeev V. , Balasubramanian Karthikeyan , Ramasamy Ashok , Thamizhselvam Haripriya , Gharia Shivangi , Periasamy Soundararajan
Published: March 2021

Background

High dialysate sodium is a significant contributor to intradialytic hypertension (IDH) in maintenance hemodialysis patients. In this study, we aimed to study the effect of low dialysate sodium on IDH in Indian hemodialysis patients.

Materials and Methods

Fifty patients on maintenance hemodialysis for atleast 3 months with episodes of IDH were enrolled in this study. The study was performed in two different stages. In the first phase, patients were dialyzed with standard dialysate sodium (140 mEq/L) for eight consecutive sessions and in the second phase, they were dialyzed with low sodium dialysate (136 mEq/L) for eight consecutive sessions. Differences in pre, intradialytic, and post‐HD blood pressure, interdialytic weight gain, mean serum sodium, intradialytic adverse events, and number of IDH episodes requiring intervention between the two phases were assessed.

Results

The mean age of the study population was 52 years (36 males,14 females). The mean post‐HD systolic and diastolic BP was 163.26 ± 9.58 mmHg and 88.60 ± 5.27 mmHg in the standard dialysate phase and 142.38 ± 14.09 mmHg and 84.58 ± 4.276 mmHg, respectively, in the low dialysate phase (p < 0.01). Interdialytic weight gain was 3.34 ± 0.9 and 3.11 ± 0.86 in the standard and low sodium dialysate phases, respectively (p = 0.19).The mean pre‐HD plasma sodium level was 138.48 ± 3.69 and 135.80 ± 1.35 mEq/dl, respectively, in standard and low dialysate phases (p = 0.01). There was significant reduction in number of IDH episodes requiring intervention. There was no difference in hypotensive episodes, adverse events between the two phases.

Conclusion

In patients with intradialytic hypertension, low dialysate sodium significantly reduces the post‐HD blood pressure and intradialytic hypertensive episodes, when compared with standard sodium dialysate.
Inflammatory profile of apical periodontitis associated with liver fibrosis in rats: histological and immunohistochemical analysis
Authors: Cantiga‐Silva C. , Estrela C. , Segura‐Egea J. J. , Azevedo J. P. , de Oliveira P. H. C. , Cardoso C. B. M. , Pinheiro T. N. , Ervolino E. , Sivieri‐Araújo G. , Cintra L. T. A.
Published: March 2021

Aim

To investigate the effects of liver fibrosis (LF) on the pro‐inflammatory mediators and periapical bone resorption of apical periodontitis (AP) in rats.

Methodology

Forty male Wistar rats were distributed into four groups: C – control, AP – rats with AP, LF – rats with LF, AP + LF – rats with AP and LF. LF was induced by carbon tetrachloride administration for 8 weeks and surgical bile duct ligation for 4 weeks; AP was induced in the teeth of rats by dental pulp exposure to the oral environment for 30 days. Jaws and livers were removed after euthanasia. Haematoxylin and Eosin (H&E) and Picrosirius Red (PSR) staining were used to confirm fibrosis in the livers. The jaws were analysed using H&E staining, immunohistochemical assays of interleukin (IL)‐1β, IL‐6 and tumour necrosis factor‐alpha (TNF‐α). Student’s t‐test and Mann–Whitney’s U‐test were used for statistical analysis (P < 0.05).

Results

Inflammatory infiltrate was moderate in the AP group and severe in the AP + LF group (P < 0.05). Periapical bone resorption was significantly larger in the AP + LF group compared with the AP group (P < 0.05). IL‐1β, IL‐6 and TNF‐α levels were significantly higher in AP + LF group when compared to the AP group (P < 0.05).

Conclusion

More intense inflammatory infiltrate, greater amounts of pro‐inflammatory cytokines and increased periapical bone resorption were observed in the presence of liver fibrosis in rats with exposed pulps.
Suggested role of silent information regulator 1 (SIRT1) gene in female infertility: A cross‐sectional study in Pakistan
Authors: Alam Faiza , Rehman Rehana , Fatima Syeda Sadia , Ashraf Mussarat , Khan Taseer Ahmed
Published: March 2021

Aim & Objective

Silent information regulator 1 (SIRT1) gene stimulates the expression of antioxidants and repairs damaged cells. It affects the mitochondrial activity within the oocytes to overcome the oxidant stress. We aimed to assess an association of SIRT1 polymorphism (Tag SNPs rs10509291 and rs12778366) with fertility, and assess serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), oestradiol, progesterone, manganese superoxide (MnSOD) and SIRT1.

Material and Methods

In this cross‐sectional study, 207 fertile and 135 infertile subjects between the ages of 18‐45 years were recruited. Polymerase chain reaction (PCR) was performed; products were electrophoresed in a 2% agarose gel. Descriptive analysis of continuous variables was expressed as mean ± standard deviation. Mann‐Whitney test was performed for comparison of groups, P value <.001 was considered significant. Single Nucleotide Polymorphism (SNP) data were analysed by applying chi‐squared statistics.

Results

All subjects were age matched (P = .896). SIRT1 levels were significantly lower in infertile females when compared with fertile subjects (P < .001). AA (rs10509291) and CC (rs12778366) variant frequency was higher in the infertile than fertile subjects (P < .01). Similarly, the frequency of A allele (rs10509291) and C allele (rs12778366) was higher in infertile subjects (P < .001). Infertile females (29%) showed existence of SNP rs10509291 while 49% demonstrated genetic variation of rs12778366. MnSOD and SIRT1 levels were found to be lower in these subjects.

Conclusion

The presence of SIRT1 genetic variants (rs10509291 and rs12778366) apparently disturbs the expression of SIRT1 deteriorating mitochondrial antioxidant function within the oocytes, instigating oxidative stress within. Their probable effect on modulating oocyte maturation may be the cause of infertility in females.
The relationship between gestational week and QT dispersion in cesarean section patients undergoing spinal anaesthesia: A prospective study
Authors: Karahan Mahmut Alp , Büyükfırat Evren , Altay Nuray , Binici Orhan , Uyanıkoğlu Hacer , Beşli Feyzullah , Demir Mustafa
Published: March 2021

Background

Pregnancy affects the cardiovascular system, particularly the cardiac conduction system, thereby increasing the susceptibility of patients towards arrhythmia. QT interval results in ventricular arrhythmias, predominantly polymorphic ventricular tachycardia. The present study was planned to investigate the relationship between a gestational week and QT dispersion in cesarean section patients undergoing spinal anaesthesia.

Methods

The study included 40 patients between the ages of 18 and 45 who had no symptoms of anaemia and undergoing elective cesarean section. The patients were separated into two groups based on the gestational week as Group I <39 weeks and Group II ≥39 weeks. The patient was given a sitting position and the puncture site was cleansed with 10% povidone‐iodine antiseptic solution. After placing a sterile drape on the patient, the subarachnoid space was punctured through an appropriate vertebral space (L3‐L4 or L4‐L5) using a pencil‐point 25G spinal needle, followed by intrathecal injection of 12.5 mg (2.5 mL) 5% hyperbaric bupivacaine hydrochloride. Electrocardiographic (ECG) records were obtained both preoperatively and at 1, 5, and 10 minutes after spinal block, and the QT, QTc, QTd, and corrected QTd (QTcd) intervals were estimated using Bazett's formula.

Results

There was no significant difference between the two groups within the QT and QTc intervals. QTcd measured after post‐operative was significantly higher in Group II (P = .007).

Conclusion

The results indicated that spinal anaesthesia may prolong the QTdc interval in patients with a gestational week of ≥39 weeks undergoing cesarean section.
The role of new technologies in myeloproliferative neoplasms: Application of next‐generation sequencing in myelofibrosis
Authors: Navrátilová Jana , Palová Miroslava , Szotkowski Tomáš , Hluší Antonín , Katrincsáková Beáta , Papajík Tomáš , Indrák Karel
Published: March 2021

Introduction

Driver mutations in Philadelphia chromosome‐negative myeloproliferative neoplasms are well known. In the past, whole‐genome sequencing identified nondriver mutations in other genes, potentially contributing to evolution of malignant clones.

Methods

Next‐generation sequencing was used to assess the presence of any mutations in 14 candidate genes at the point of diagnosis and the resultant impact on the clinical course of the disease.

Results

The study analysed 63 patients with myelofibrosis (MF). Nondriver mutations were detected in 44% of them. The most frequently affected genes were ASXL1 (27%), TET2 (11%) and SF3B1 (6%). The frequency of such mutations was highest in primary MF (59%) and lowest in the prefibrotic phase of primary MF (21%). Patients with prognostically unfavourable sequence variants in genes had significantly worse overall survival (53 vs 71 months; HR = 2.77; 95% CI 1.17‐6.56; P = .017).

Conclusion

In our study, multivariate analysis proved DIPSS to be the only significant factor to predict patient survival. DIPSS contains all of the important clinical and laboratory factors except genetic changes. Stratification of patients according to DIPSS is still beneficial although there are newer and improved scoring systems like GIPSS or MIPSS70. Assessing subclonal mutations in candidate genes during diagnosis may aid in the identification of high‐risk MF patients and is therefore relevant for making a prediction for overall survival more accurate.
Effectiveness of biofeedback relaxation and audio‐visual distraction on dental anxiety among 7‐ to 12‐year‐old children while administering local anaesthesia: A randomized clinical trial
Authors: Padminee Krishnan , Hemalatha R , Shankar Paulindraraj , Senthil D , Jayakaran Trophimus Gnanabagyan , Kabita Sahoo
Published: March 2021

Background

Local anaesthesia (LA) administration provokes dental anxiety in children. BrightHearts is a biofeedback relaxation application designed to reduce anxiety in children during painful procedural interventions.

Aim

To compare the effectiveness of biofeedback relaxation (BR) and audio‐visual (AV) distraction on dental anxiety among 7‐ to 12‐year‐old children while administering LA.

Design

A total of 70 children requiring dental treatment under LA for three visits were recruited for this single‐blinded randomized control trial. They were randomly divided into two equal groups. Group A received BR and Group B received AV distraction during LA delivery in the first two visits, and both groups did not receive any intervention during LA in third visit. Outcomes were measured using heart rate and a cartoon‐based anxiety measuring scale (Chotta Bheem‐Chutki (CBC) scale).

Results

AV group had statistically significant higher mean heart rates than BR group (P < .001) during needle penetration and post‐intervention, respectively. CBC scale showed no statistical differences between the groups.

Conclusion

Both the interventions are effective in reducing dental anxiety during LA administration. Based on objective measures, BR is found to be better than AV distraction. Subjective scores, however, show no differences between the two.
Deletion of Smad3 protects against diabetic myocardiopathy in db/db mice
Authors: Dong Li , Li Jian‐Chun , Hu Zhong‐Jing , Huang Xiao‐Ru , Wang Li , Wang Hong‐Lian , Ma Ronald C. W. , Lan Hui‐Yao , Yang Si‐Jin
Published: March 2021

Diabetic cardiomyopathy (DCM) is a common diabetic complication characterized by diastolic relaxation abnormalities, myocardial fibrosis and chronic heart failure. Although TGF‐β/Smad3 signalling has been shown to play a critical role in chronic heart disease, the role and mechanisms of Smad3 in DCM remain unclear. We reported here the potential role of Smad3 in the development of DCM by genetically deleting the Smad3 gene from db/db mice. At the age of 32 weeks, Smad3WT‐db/db mice developed moderate to severe DCM as demonstrated by a marked increase in the left ventricular (LV) mass, a significant fall in the LV ejection fraction (EF) and LV fractional shortening (FS), and progressive myocardial fibrosis and inflammation. In contrast, db/db mice lacking Smad3 (Smad3KO‐db/db) were protected against the development of DCM with normal cardiac function and undetectable myocardial inflammation and fibrosis. Interestingly, db/db mice with deleting one copy of Smad3 (Smad3 ± db/db) did not show any cardioprotective effects. Mechanistically, we found that deletion of Smad3 from db/db mice largely protected cardiac Smad7 from Smurf2‐mediated ubiquitin proteasome degradation, thereby inducing IBα to suppress NF‐kB‐driven cardiac inflammation. In addition, deletion of Smad3 also altered Smad3‐dependent miRNAs by up‐regulating cardiac miR‐29b while suppressing miR‐21 to exhibit the cardioprotective effect on Smad3KO‐db/db mice. In conclusion, results from this study reveal that Smad3 is a key mediator in the pathogenesis of DCM. Targeting Smad3 may be a novel therapy for DCM.
Interactions of fungal entomopathogens with synthetic insecticides for the control of Kuschelorhynchusmacadamiae (Coleoptera: Curculionidae)
Authors: Khun Kim Khuy , Ash Gavin J. , Stevens Mark M. , Huwer Ruth K. , Wilson Bree A. L.
Published: March 2021

This study investigated the interactions between insecticides (acephate and indoxacarb) and fungal entomopathogens (Beauveria bassiana [Bals.‐Criv.] Vuill. strain B27, Metarhizium anisopliae [Metschn.] Sorokin strain ECS1, and a commercial B. bassiana product, Velifer® Biological Insecticide) for controlling the macadamia seed weevil, Kuschelorhynchus macadamiae Jennings and Oberprieler, in the laboratory and glasshouse. In the laboratory, additive interactions between insecticides at their full field concentrations (776 mg AI/L of acephate and 75 mg AI/L of indoxacarb) and fungal entomopathogens at 107 conidia/ml (ECS1 and B27) or at full field concentration (0.5 ml of Velifer®/L) were seen at 6 days and 12 days post‐application. Under the same experimental conditions, synergistic interactions against K. macadamiae were observed 6 days post‐application when fungal entomopathogens at 2.5 × 106 conidia/ml or at 25% of full field concentration (Velifer®) were co‐applied with insecticides at 25% of their full field concentrations, whilst additive interactions were again observed at 12 days post‐application. In the glasshouse, additive interactions between insecticides (at full field concentrations) and fungal entomopathogens (at 107 conidia/ml, or at full field concentration for Velifer®) were obtained at 6 days and 12 days post‐application. The results from this study suggest that acephate and indoxacarb have both synergistic and additive effects against K. macadamiae when deployed together with fungal entomopathogens, depending on the initial concentrations of mixture components. Combined application of entomopathogens with compatible insecticides promises to provide more effective management of K. macadamiae than individual chemical applications.
Indirect predator effects influence behaviour but not morphology of juvenile coral reefAmbon damselfishPomacentrus amboinensis
Authors: Arvizu Brittany , Allan Bridie J. M. , Rizzari Justin R.
Published: March 2021

A 6‐week laboratory experiment exposed juvenile Ambon damselfishPomacentrus amboinensisto visual and chemical cues of either a predator, a herbivore or a null control (sea water) and found no effect of predator cues on prey morphology (proportion of ocellus to eye diameter, body depth, standard length and fin area). Nonetheless, behaviour was significantly affected by predator presence, with prey less active and taking half as many feeding strikes when exposed to predators compared to fish from the null control. The presence of a herbivore also affected prey behaviour similar to that of the predator, suggesting that the presence of a non‐predator may have important effects on development.
Clinical impact of compound sarcopenia in hospitalized older adult patients with heart failure
Authors: Attaway Amy , Bellar Annette , Dieye Faty , Wajda Douglas , Welch Nicole , Dasarathy Srinivasan
Published: March 2021

Objectives

Skeletal muscle loss or sarcopenia is a frequent complication in heart failure (HF) and contributes to adverse clinical outcomes. We evaluated if age (primary) and chronic disease (secondary) related sarcopenia, that we refer to as compound sarcopenia, impacts clinical outcomes in hospitalized patients with HF.

Design

Cross‐sectional study using hospitalized patient data.

Setting

Data from the Agency for Healthcare Research and Quality through the Healthcare Cost and Utilization Project (HCUP).

Participants

Hospitalized adult patients with a primary or secondary diagnosis of HF (n = 64,476) and a concurrent random 2% sample of general medical population (GMP; n = 322,217) stratified by age (<50 years of age [y], 51‐65y, >65y) from the Nationwide Inpatient Sample (NIS) database (years 2010–2014).

Measurements

In‐hospital mortality, length of stay (LoS), cost of hospitalization per admission (CoH), comorbidities and discharge disposition, with and without muscle loss phenotype, were analyzed. Muscle loss phenotype was defined using a comprehensive code set from international classification of diseases‐9 (ICD‐9).

Results

Muscle loss phenotype was observed in 8673 (13.5%) patients with HF compared to 5213 (1.6%) GMP across all age strata. In patients with HF, muscle loss phenotype was associated with higher mortality, LoS, and CoH. Patients with HF (>65y) and muscle loss phenotype had higher mortality (adjusted OR: 1.81; 95% CI 1.56–2.10), CoH (adjusted OR 1.48; 95% CI 1.44–1.1.52), and LoS (adjusted OR 1.40; 95% CI 1.37–1.43) compared to >65y GMP with muscle loss phenotype.

Conclusion

Muscle loss phenotype is more commonly associated with increasing age in hospitalized patients with HF. Clinical outcomes were significantly worse in patients with HF aged >65y compared to younger patients with HF and all age strata in GMP with and without a muscle loss phenotype.
Prevalence and concordance of oral HPV infections with cervical HPV infections in women referred to colposcopy with abnormal cytology
Authors: Tewari Prerna , Banka Prakashini , Kernan Niamh , Reynolds Stephen , White Christine , Pilkington Loretto , O’Toole Sharon , Sharp Linda , D’Arcy Tom , Murphy Cliona , Comiskey Catherine , Martin Cara M. , O’Leary John J.
Published: March 2021

Background

Considering the shared aetiology of Human Papillomavirus infections in oropharyngeal and cervical cancers and the possible role for sexual transmission, several key aspects of the relationship between cervical and oral infections merit investigation, including prevalence of concomitant oral HPV infection and type‐specific concordance with concurrent cervical infections.

Methods

A cross‐section study was performed on women referred to colposcopy clinics with cytological abnormalities and a cervical HPV infection. An oral rinse sample was taken from the participants at their baseline visit for HPV testing, and a demographic and risk factor questionnaire was also administered. HPV DNA testing was carried out on the Cobas 4800 platform and extended genotyping was carried out with the INNO‐LiPA HPV Genotyping Extra II assay. HPV genotyping was also carried out on the concurrent cervical tissue samples on all women who had a positive oral HPV infection.

Results

The prevalence of oral HPV infections was 10.0% (95%CI:5.9–13.7) in the study population. HPV18 was the most frequent genotype (7.0%). Concordant oral and cervical HPV infections were detected in 28.6% of women. Age (p = 0.005) and level of education (p = 0.02) were significantly associated with a prevalent oral HPV infection.

Conclusion

Concomitant oral HPV infections were present in 10.0% of women referred to colposcopy with a pre‐existing cervical HPV infections and cytological abnormalities. Although mild type‐specific concordance was observed between oral and cervical HPV infections, findings suggest that infections at these sites may not be independent of each other.
Descriptive screening and lexicon development of non‐aged artisanal cachaça sensorial profile using principal component analysis and Kohonen artificial neural networks
Authors: Caetano Daniela , Lima Clara M. G. , Sanson Ananda L. , Silva Débora F. , de Souza Hassemer Guilherme , Verruck Silvani , da Silva Gilmare A. , de Cássia Franco Afonso Robson J. , Coutrim Mauricio X. , Gregório Sandra R.
Published: March 2021

Cachaça is a distilled spirit made from sugarcane, exclusively produced in Brazil, and appreciated worldwide. This paper seeks to evaluate the sensory characteristics of 24 nonaged artisanal cachaça samples from Salinas (Minas Gerais, Brazil) through descriptive analysis, as well as chemometrically treat the obtained data based on principal components analysis (PCA) and Kohonen's neural network. The attributes (23) were divided between aroma (11) and flavor (12). PCA does not show good differentiation of nonaged cachaça samples. On the other hand, by using Kohonen's neural network it was possible to group samples according to their aroma and flavor characteristics in 9 and 10 distinct groups, respectively. A reduced number of descriptors could be used to describe the flavor of cachaça samples (alcohol, acidic, sweet, bitter, citric, tar, and burning), as significant correlations (R > 0.70, p < .05) exist among them with fruity, bagasse, fermented sugarcane juice, and astringent descriptors. This diminution on descriptors numbers could be able to reduce the workload of the judging panel with no losses to the sample' sensory characterization. The use of Kohonen's network chemometric treatment for treat sensory data showed to be a better alternative that PCA approach in this study.

Practical applications

The growth in production and the appreciation of cachaça in the domestic and foreign markets have directed the production of the drink in Brazil with a focus on its quality and added value, seeking to obtain international recognition and increase exports. In this sense, the lexicon development and sensory characterization of samples from Salinas‐MG is very important to compare with commercial and artisanal samples from other regions in future studies. This work created a sensory profile for samples from this region, which despite its national and international popularity, does not exist yet. Finally, this is the first study that describes a lexicon development and sensory characterization of cachaças from Salinas‐MG and describes data with artificial neural networks, a potential approach for further studies.