bluuebunny/crossref_metadata_2025 huggingface dataset:
Anti-influenza virus activity of the elenolic acid rich olive leaf (Olea europaea L.) extract Isenolic®
Authors: Salamanca Aurora , Almodóvar Paula , Jarama Irene , González-Hedström Daniel , Prodanov Marin , Inarejos-García Antonio Manuel
Published: November 2021

Seasonal flu is caused by influenza infection, a virus that spreads easily in human population with periodical epidemic outbreaks. The high mutational rate of influenza viruses leads to the emergence of strains resistant to the current treatments. Due to that, scientific research is focusing on the development of new anti-influenza agents as alternative or complementary treatments. Olive tree ( Olea europaea L.) has been a source of ancestral remedies due to its antimicrobial activity. Thus, the aim of this study was to test the anti-influenza activity of a standardized olive leaf extract rich in elenolic acid (EA), Isenolic®, compared with oseltamivir. Isenolic® extract was characterized by High Performance Liquid Chromatography (HPLC)-Mass Spectrometry and its content in EA was determined by HPLC. Cytotoxicity, viral neuraminidase inhibitor activity and cell viability protection against influenza infection of Isenolic® were tested in vitro using sialic acid overexpressing Madin-Darby Canine Kidney cells. Isenolic® formulations showed a 4% and 8% dry basis. Oseltamivir and Isenolic® extracts showed anti-influenza activity. The 8% Isenolic® formulation showed a dose-dependent neuraminidase inhibitor activity higher than the 4% formulation, and preserved cell viability under viral infection. Thus, Isenolic® become a promising natural alternative to existing influenza treatments.
Exosomes isolated from melatonin-stimulated mesenchymal stem cells improve kidney function by regulating inflammation and fibrosis in a chronic kidney disease mouse model
Authors: Yea Ji-Hye , Yoon Yeo Min , Lee Jun Hee , Yun Chul Won , Lee Sang Hun
Published: November 2021

Chronic kidney disease (CKD) is defined as structural and functional abnormalities of the kidney due to inflammation and fibrosis. We investigated the therapeutic effects of exosomes secreted by melatonin-stimulated mesenchymal stem cells (Exocue) on the functional recovery of the kidney in a CKD mouse model. Exocue upregulated gene expression of micro RNAs (miRNAs) associated with anti-inflammatory and anti-fibrotic effects. Exocue-treated groups exhibited low tumor necrosis factor-α and transforming growth factor-β levels in serum and fibrosis inhibition in kidney tissues mediated through regulation of cell apoptosis and proliferation of fibrosis-related cells. Exocue treatment decreased the gene expression of CKD progression-related miRNAs. Moreover, the CKD severity was alleviated in the Exocue group via upregulation of aquaporin 2 and 5 levels and reduction of blood urea nitrogen and creatinine, resulting in functional recovery of the kidney. In conclusion, Exocue could be a novel therapeutic agent for treating CKD by regulating inflammation and fibrosis.
Identifying technology industry-led initiatives to address digital health equity
Authors: Durocher Keri , Boparai Navi , Jankowicz Damian , Strudwick Gillian
Published: November 2021

Objective

The COVID-19 pandemic has highlighted various barriers to health and the necessity of having access to digital health services. The technology industry can support addressing health barriers, promoting health equity and partnering with organizations to ensure access to digital health services for underserviced communities. The main objective of this study was to 1) identify what initiatives have been developed within the technology industry to address digital health equity; and to 2) determine whether these initiatives have been effective.

Methods

A rapid review and a grey literature scan were conducted. The academic searches were performed using four databases, including Ovid MEDLINE, Scopus, CINAHL and PsychInfo. Two reviewers screened the articles for inclusion criteria. The grey literature scan was performed through Google and Million Short. Searches of technology industry initiatives were completed through scanning technology companies listed on the New York Stock Exchange, the Toronto Stock Exchange and iShares Expanded Tech Sector – Exchange Traded Fund.

Results

Within the technology industry, 39 companies had relevant initiatives. These were identified as having one or more of the following: 1) having health-related collaborations with other companies, 2) promoting access to technology infrastructure and 3) delivering programs that supported notable inequities within the social determinants of health. Limited data are available on the effectiveness of these initiatives in reducing health inequities.

Conclusions

As technology in the delivery of health services continues to evolve, health equity initiatives must be supported through innovative strategies. Partnering with the technology industry may be one way of addressing these health equity challenges.
Impact of Service Encounter Elements on Experiential Value and Customer Loyalty: An Empirical Investigation in the Coffee Shop Context
Authors: Rashid Nadia , Nika Fayaz A. , Thomas George
Published: November 2021

The unprecedented dynamism in marketing has led to the transition of economy from service economy to experience economy. Modern age consumers give more emphasis to the hedonic attributes of offerings than to functional attributes. Consequently, the present study aims to provide a deeper understanding of experiential value, its antecedents, and consequences in the context of coffee shops. More specifically, this study examines the effect of service encounter elements on experiential value and the consequent effect of experiential value on customer loyalty. Using purposive sampling, data were collected from 387 customers of coffee shops using a questionnaire survey which was later analyzed using Structural Equation Modeling. The results reveal positive linkages between service encounter, experiential value, and customer loyalty. Positive cognition of service encounters have positive effects on experiential value and customer loyalty. Besides, experiential value also has a positive effect on customer loyalty. Lastly, experiential value partially mediates the relationship between service encounters and customer loyalty.
Preoperative Intra-articular Steroid Injections as Predictors of Hip Arthroscopy: 2-Year Outcomes
Authors: Mujahed Tala , Hassebrock Jeffrey D. , Makovicka Justin L. , Pollock Jordan R. , Wilcox Justin G. , Patel Karan A. , Economopoulos Kostas J.
Published: November 2021

Background:

In patients with femoroacetabular impingement, preoperative diagnostic injections are commonly used to establish a diagnosis of intra-articular pathology. In some cases, intra-articular steroid injections are also used for therapeutic purposes.

Purpose/Hypothesis:

The purpose of this study was to determine if a positive response to intra-articular steroid injection was predictive of superior outcomes after hip arthroscopy to determine if the response to intra-articular steroid injection was predictive of outcomes after hip arthroscopy. It was hypothesized that a positive response to a preoperative hip injection would be predictive of improved short- to midterm outcomes after hip arthroscopy.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This was a retrospective study of 208 patients who elected to have ultrasound-guided intra-articular steroid injection before they underwent hip arthroscopy between January 2016 and December 2016. Patients were divided into 2 groups: those who showed improvement in pain after the injection (steroid responder group) and those who showed no response (nonresponder group). The authors compared the preoperative and 2-year postoperative patient-reported outcomes (modified Harris Hip Score [mHHS] and Hip Outcome Score–Activities of Daily Living [HOS-ADL]) and radiographic findings between groups. Clinical endpoints, including rates of revision and conversion to total hip arthroplasty, were also reviewed.

Results:

There were 88 patients in the nonresponder group and 120 patients in the responder group, with no significant between-group differences in preoperative descriptive variables. The responder group had significantly higher 2-year mHHS and HOS-ADL, pre- to postoperative change in mHHS and HOS-ADL, percentage of patients achieving the patient acceptable symptomatic state (PASS) on the mHHS, and percentage of patients reaching the minimum clinically important difference and the PASS on the HOS-ADL. There was no difference in Tönnis grade, acetabular labrum articular disruption grade, revision rate, or conversion to total hip arthroplasty between the 2 groups.

Conclusion:

The response to preoperative intra-articular injection did aid in predicting 2-year patient-reported outcomes of hip arthroscopy for femoroacetabular impingement. Overall, the result of a preoperative intra-articular injection can be a helpful clinical tool for surgical decision-making and counseling patients on expected outcomes after hip arthroscopy.
Propagation of epistemic uncertainty in magnitude–frequency relations through PSHA using predictive distributions
Authors: Ordaz Mario , Arroyo Danny
Published: November 2021

The current practice of Probabilistic Seismic Hazard Analysis (PSHA) considers the inclusion of epistemic uncertainties involved in different parts of the analysis via the logic-tree approach. Given the complexity of modern PSHA models, numerous branches are needed, which in some cases leads to concerns regarding performance issues. We introduce the use of a magnitude exceedance rate which, following Bayesian conventions, we call predictive exceedance rate. This rate is the original Gutenberg–Richter relation after having included the effect of the epistemic uncertainty in parameter β. The predictive exceedance rate was first proposed by Campbell but to our best knowledge is seldom used in current PSHA. We show that the predictive exceedance rate is as accurate as the typical logic-tree approach but allows for much faster computations, a very useful property given the complexity of some modern PSHA models.
LNK (SH2B3) inhibition expands healthy and Fanconi anemia human hematopoietic stem and progenitor cells
Authors: Holdreith Nicholas , Lee Grace , Chandra Vemika , Salinas Carlo Salas , Nicholas Peter , Olson Timothy S. , Tong Wei
Published: November 2021

Hematopoietic stem cell transplantation (HSCT) remains the only curative treatment for a variety of hematological diseases. Allogenic HSCT requires hematopoietic stem cells (HSCs) from matched donors and comes with cytotoxicity and mortality. Recent advances in genome modification of HSCs have demonstrated the possibility of using autologous HSCT-based gene therapy to alleviate hematologic symptoms in monogenic diseases, such as the inherited bone marrow failure (BMF) syndrome Fanconi anemia (FA). However, for FA and other BMF syndromes, insufficient HSC numbers with functional defects results in delayed hematopoietic recovery and increased risk of graft failure. We and others previously identified the adaptor protein LNK (SH2B3) as a critical negative regulator of murine HSC homeostasis. However, whether LNK controls human HSCs has not been studied. Here, we demonstrate that depletion of LNK via lentiviral expression of miR30-based short hairpin RNAs results in robust expansion of transplantable human HSCs that provided balanced multilineage reconstitution in primary and secondary mouse recipients. Importantly, LNK depletion enhances cytokine-mediated JAK/STAT activation in CD34+ hematopoietic stem and progenitor cells (HSPCs). Moreover, we demonstrate that LNK depletion expands primary HSPCs associated with FA. In xenotransplant, engraftment of FANCD2-depleted FA-like HSCs was markedly improved by LNK inhibition. Finally, targeting LNK in primary bone marrow HSPCs from FA patients enhanced their colony forming potential in vitro. Together, these results demonstrate the potential of targeting LNK to expand HSCs to improve HSCT and HSCT-based gene therapy.
Construction of yeast one-hybrid library and screening of transcription factors regulating LhMYBSPLATTER expression in Asiatic hybrid lilies (Lilium spp.)
Authors: Cao Yuwei , Bi Mengmeng , Yang Panpan , Song Meng , He Guoren , Wang Jing , Yang Yue , Xu Leifeng , Ming Jun
Published: November 2021

Background

Anthocyanins, which belong to flavonoids, are widely colored among red-purple pigments in the Asiatic hybrid lilies (Lilium spp.). Transcription factor (TF) LhMYBSPLATTER (formerly known as LhMYB12-Lat), identified as the major kernel protein, regulating the anthocyanin biosynthesis pathway in ‘Tiny Padhye’ of Tango Series cultivars, which the pigmentation density is high in the lower half of tepals and this patterning is of exceptional ornamental value. However, the research on mechanism of regulating the spatial and temporal expression differences of LhMYBSPLATTER, which belongs to the R2R3-MYB subfamily, is still not well established. To explore the molecular mechanism of directly related regulatory proteins of LhMYBSPLATTER in the anthocyanin pigmentation, the yeast one-hybrid (Y1H) cDNA library was constructed and characterized.

Results

In this study, we describe a yeast one-hybrid library to screen transcription factors that regulate LhMYBSPLATTER gene expression in Lilium, with the library recombinant efficiency of over 98%. The lengths of inserted fragments ranged from 400 to 2000 bp, and the library capacity reached 1.6 × 106 CFU of cDNA insert, which is suitable to fulfill subsequent screening. Finally, seven prey proteins, including BTF3, MYB4, IAA6-like, ERF4, ARR1, ERF WIN1-like, and ERF061 were screened by the recombinant bait plasmid and verified by interaction with the LhMYBSPLATTER promoter. Among them, ERFs, AUX/IAA, and BTF3 may participate in the negative regulation of the anthocyanin biosynthesis pathway in Lilium.

Conclusion

A yeast one-hybrid library of lily was successfully constructed in the tepals for the first time. Seven candidate TFs of LhMYBSPLATTER were screened, which may provide a theoretical basis for the study of floral pigmentation.
Bacterial and fungal profile, drug resistance pattern and associated factors of isolates recovered from blood samples of patients referred to Ethiopian Public Health Institute: cross-sectional study
Authors: Tsegaye Etsehiwot Adamu , Teklu Dejenie Shiferaw , Bonger Zelalem Tazu , Negeri Abebe Aseffa , Bedada Tesfaye Legesse , Bitew Adane
Published: November 2021

Background

Blood stream infections are serious infections that usually induce prolongation of hospital stay, morbidity and mortality in several countries including Ethiopia. The aim of this study was to determine bacterial and fungal profile, their drug resistance patterns, and risk factors associated with blood stream infections.

Methods

A cross sectional study design was conducted from February 23 to June 23, 2020 at Ethiopian public health. A structured questionnaire was used to collect data on socio-demographic factors and clinical conditions. Blood specimens were analyzed using standard microbiological techniques. Antimicrobial susceptibility tests were performed using Kirby–Bauer disc diffusion technique and Vitek compact 2. Simple and multiple logistic regressions were used to assess the potential risk factors.

Results

A total of 175 pathogens isolated from 346 blood specimens. Of these, 60% Gram-negative bacteria, 30.86% Gram-positive bacteria and 9.14% fungal isolates were identified.Burkholderia cepaciaandCoagulase negative staphylococcuswere the predominant pathogen among Gram-negative and Gram-positive bacteria respectively. Among fungus,Candida krusei(56.25%) was the most predominant isolate. The highest proportions of antibacterial resistance were observed among 3rd generation cephalosporin and penicillin. Most fungal isolates expressed resistance to fluconazole. Sex (P = 0.007), age (P < 0.001) and use of invasive medical devices (P = 0.003) were identified as risk factors for bacterial blood stream infections.

Conclusion

The study showed high prevalence of blood stream infection was due toB. cepaciaand non-C. albicansspp. This finding alarming ongoing investigation of blood stream infection is important for recognizing future potential preventive strategies including environmental hygiene and management of comorbid medical diseases to reduce the problem.
Fracture profiles of a 4-year cohort of 266,324 first incident upper extremity fractures from population health data in Ontario
Authors: MacDermid Joy C. , McClure J. Andrew , Richard Lucie , Faber Kenneth J. , Jaglal Susan
Published: November 2021

Background

Understanding the profiles of different upper extremity fractures, particularly those presenting as a 1st incident can inform prevention and management strategies. The purpose of this population-level study was to describe first incident fractures of the upper extremity in terms of fracture characteristics and demographics.

Methods

Cases with a first adult upper extremity (UE) fracture from the years 2013 to 2017 were extracted from administrative data in Ontario. Fracture locations (ICD-10 codes) and associated characteristics (open/closed, associated hospitalization within 1-day, associated nerve, or tendon injury) were described by fracture type, age category and sex. Standardized mean differences of at least 10% (clinical significance) and statistical significance (p < 0.01) in ANOVA were used to identify group differences (age/sex).

Results

We identified 266,324 first incident UE fractures occurring over 4 years. The most commonly affected regions were the hand (93 K), wrist/forearm(80 K), shoulder (48 K) or elbow (35 K). The highest number of specific fractures were: distal radius (DRF, 47.4 K), metacarpal (30.4 K), phalangeal (29.9 K), distal phalangeal (24.4 K), proximal humerus (PHF, 21.7 K), clavicle (15.1 K), radial head (13.9 K), and scaphoid fractures (13.2 K). The most prevalent multiple fractures included: multiple radius and ulna fractures (11.8 K), fractures occurring in multiple regions of the upper extremity (8.7 K), or multiple regions in the forearm (8.4 K). Tendon (0.6% overall; 8.2% in multiple finger fractures) or nerve injuries were rarely reported (0.3% overall, 1.5% in distal humerus). Fractures were reported as being open in 4.7% of cases, most commonly for distal phalanx (23%). A similar proportion of females (51.5%) and males were present in this fracture cohort, but there were highly variant age-sex profiles across fracture subtypes. Fractures most common in 18–40-year-old males included metacarpal and finger fractures. Fractures common in older females were: DRF, PHF and radial head, which exhibited a dramatic increase in the over-50 age group.

Conclusions

UE fracture profiles vary widely by fracture type. Fracture specific prevention and management should consider fracture profiles that are highly variable according to age and sex.
Comparison of the clinical efficacy of a femoral neck system versus cannulated screws in the treatment of femoral neck fracture in young adults
Authors: He Changjun , Lu Yao , Wang Qian , Ren Cheng , Li Ming , Yang Mingyi , Xu Yibo , Li Zhong , Zhang Kun , Ma Teng
Published: November 2021

Background

To compare the clinical efficacy of a femoral neck system (FNS) and cannulated screws (CS) in the treatment of femoral neck fracture in young adults.

Methods

Data from 69 young adults, who were admitted for femoral neck fracture between March 2018 and June 2020, were retrospectively analyzed. Patients were divided into two groups according to surgical method: FNS and CS. The number of intraoperative fluoroscopies, operative duration, length of hospital stay, fracture healing time, Harris score of hip function, excellent and good rate of hip function, and postoperative complications (infection, cut out the internal fixation, nail withdrawal, and femoral neck shortening) were compared between the two groups. Hip joint function was evaluated using the Harris Hip Scoring system.

Results

All 69 patients had satisfactory reduction and were followed up for 12–24 months, with a mean follow-up of 16.91 ± 3.01 months. Mean time to fracture healing was13.82 ± 1.59 and 14.03 ± 1.78 weeks in the FNS and CS groups, respectively. There was a statistical difference in the number of intraoperative fluoroscopies between the 2 groups (P = 0.000). There were no significant differences, in operation duration, hospital length of stay, fracture healing time, complications, Harris Hip Score for hip function and excellent and good rate between the two groups (P > 0.05). The incidence of complications was 6.1%(2/33) in the FNS group lower than 25%(9/36) in the CS group, a difference that was statistically significant (P = 0.032). At the last follow-up, the Harris Hip Score of the hip joint in the FNS group was 90.42 ± 4.82and 88.44 ± 5.91 in the CS group.

Conclusions

Both treatment methods resulted in higher rates of fracture healing and excellent hip function. Compared with CS, the FNS reduced the number of intraoperative fluoroscopies, radiation exposure to medical staff and patients, and short-term complications including femoral neck shortening and bone nonunion.
Integrated knowledge translation in nursing homes: exploring the experiences of practice development nurses
Authors: Steinskog Trine-Lise Dræge , Tranvåg Oscar , Ciliska Donna , Nortvedt Monica Wammen , Graverholt Birgitte
Published: November 2021

Background

Practice Development Nurses (PDNs) in Norwegian nursing homes (NHs) hold a specific responsibility for knowledge translation in this increasingly complex healthcare setting. They were involved as end users in an integrated knowledge translation (IKT) study, developing, testing and evaluating the IMPAKT (IMPlementation of Action to Knowledge Translation) intervention. PDNs participated in an educational programme tailored to their own defined needs. In a second intervention component, the PDNs applied their new skills with facilitation, in implementing the National Early Warning Score (NEWS2) in their respective NHs. The aim of this study was to explore 1) the PDNs’ experiences of participating in an IKT educational intervention, and 2) how they applied the learning in planning, tailoring and initial implementation of the NEWS2.

Methods

This is a qualitative exploratory study based on a phenomenological hermeneutical method. Study participants were PDNs working in the nine NHs in the intervention group of the IMPAKT trial. We conducted nine in-depth interviews and eight non-participatory observational sessions of the intervention delivery.

Results

The PDNs expressed that the educational programme met their needs and enhanced their understanding about leading knowledge translation (KT). They reported a move from operating in a “big black box of implementation” to a professional and structured mode of KT. The gamechanger was a shift from KT as the PDNs’ individual responsibility to KT as an organizational matter. The PDNs reported enhanced competencies in KT and in their ability to involve and collaborate with others in their facility. Organizational contextual factors challenged their KT efforts and implementation of the NEWS2.

Conclusions

This study demonstrates that an IKT approach has the potential to advance and improve staff competencies and NH readiness for KT. However, individual motivations and competencies were challenged within an organizational culture which was less receptive to this new leadership role and level of KT activity.
The viral distribution and pathological characteristics of BALB/c mice infected with highly pathogenic Influenza H7N9 virus
Authors: Wu Xiao-Xin , Tang Song-Jia , Yao Shu-Hao , Zhou Yu-Qin , Xiao Lan-Lan , Cheng Lin-Fang , Liu Fu-Ming , Wu Nan-Ping , Yao Hang-Ping , Li Lan-Juan
Published: November 2021

Background

The highly pathogenic Influenza H7N9 virus is believed to cause multiple organ infections. However, there have been few systematic animal experiments demonstrating the virus distribution after H7N9 virus infection. The present study was carried out to investigate the viral distribution and pathological changes in the main organs of mice after experimental infection with highly pathogenic H7N9 virus.

Methods

Infection of mice with A/Guangdong/GZ8H002/2017(H7N9) virus was achieved via nasal inoculation. Mice were killed at 2, 3, and 7 days post infection. The other mice were used to observe their illness status and weight changes. Reverse transcription polymerase chain reaction and viral isolation were used to analyse the characteristics of viral invasion. The pathological changes of the main organs were observed using haematoxylin and eosin staining and immunohistochemistry.

Results

The weight of H7N9 virus-infected mice increased slightly in the first two days. However, the weight of the mice decreased sharply in the following days, by up to 20%. All the mice had died by the 8th day post infection and showed multiple organ injury. The emergence of viremia in mice was synchronous with lung infection. On the third day post infection, except in the brain, the virus could be isolated from all organs (lung, heart, kidney, liver, and spleen). On the seventh day post infection, the virus could be detected in all six organs. Brain infection was detected in all mice, and the viral titre in the heart, kidney, and spleen infection was high.

Conclusion

Acute diffuse lung injury was the initial pathogenesis in highly pathogenic H7N9 virus infection. In addition to lung infection and viremia, the highly pathogenic H7N9 virus could cause multiple organ infection and injury.
The effect of spinal manipulative therapy and home stretching exercises on heart rate variability in patients with persistent or recurrent neck pain: a randomized controlled trial
Authors: Galaasen Bakken Anders , Eklund Andreas , Hallman David M. , Axén Iben
Published: November 2021

Background

Persistent or recurrent neck pain is, together with other chronic conditions, suggested to be associated with disturbances of the Autonomic Nervous System. Acute effects on the Autonomic Nervous System, commonly measured using Heart Rate Variability, have been observed with manual therapy. This study aimed to investigate the effect on Heart Rate Variability in (1) a combination of home stretching exercises and spinal manipulative therapy versus (2) home stretching exercises alone over 2 weeks in participants with persistent or recurrent neck pain.

Methods

A randomized controlled clinical trial was carried out in five multidisciplinary primary care clinics in Stockholm from January 2019 to April 2020. The study sample consisted of 131 participants with a history of persistent or recurrent neck. All participants performed home stretching exercises daily for 2 weeks and were scheduled for four treatments during this period, with the intervention group receiving spinal manipulative therapy in addition to the home exercises. Heart Rate Variability at rest was measured at baseline, after 1 week, and after 2 weeks, with RMSSD (Root mean square of successive RR interval differences) as the primary outcome. Both groups were blinded to the other group intervention. Thus, they were aware of the purpose of the trial but not the details of the “other” intervention. The researchers collecting data were blinded to treatment allocation, as was the statistician performing data analyses. The clinicians provided treatment for participants in both groups and could not be blinded. A linear mixed-effects model with continuous variables and person-specific random intercept was used to investigate the group-time interaction using an intention to treat analysis.

Results

Sixty-six participants were randomized to the intervention group and sixty-five to the control group. For RMSSD, a B coefficient of 0.4 (p value: 0.9) was found, indicating a non-significant difference in the regression slope for each time point with the control group as reference. No statistically significant differences were found between groups for any of the Heart Rate Variability indices.

Conclusion

Adding four treatments of spinal manipulation therapy to a 2-week program of daily stretching exercises gave no significant change in Heart Rate Variability.

Trial Registration: The trial was registered 03/07/2018 at ClinicalTrials.gov, registration number: NCT03576846. (https://pubmed.ncbi.nlm.nih.gov/31606042/)
Rapidly progressive brain atrophy in septic ICU patients: a retrospective descriptive study using semiautomatic CT volumetry
Authors: Nakae Ryuta , Sekine Tetsuro , Tagami Takashi , Murai Yasuo , Kodani Eigo , Warnock Geoffrey , Sato Hidetaka , Morita Akio , Yokota Hiroyuki , Yokobori Shoji
Published: November 2021

Background

Sepsis is often associated with multiple organ failure; however, changes in brain volume with sepsis are not well understood. We assessed brain atrophy in the acute phase of sepsis using brain computed tomography (CT) scans, and their findings’ relationship to risk factors and outcomes.

Methods

Patients with sepsis admitted to an intensive care unit (ICU) and who underwent at least two head CT scans during hospitalization were included (n = 48). The first brain CT scan was routinely performed on admission, and the second and further brain CT scans were obtained whenever prolonged disturbance of consciousness or abnormal neurological findings were observed. Brain volume was estimated using an automatic segmentation method and any changes in brain volume between the two scans were recorded. Patients with a brain volume change < 0% from the first CT scan to the second CT scan were defined as the “brain atrophy group (n = 42)”, and those with ≥ 0% were defined as the “no brain atrophy group (n = 6).” Use and duration of mechanical ventilation, length of ICU stay, length of hospital stay, and mortality were compared between the groups.

Results

Analysis of all 42 cases in the brain atrophy group showed a significant decrease in brain volume (first CT scan: 1.041 ± 0.123 L vs. second CT scan: 1.002 ± 0.121 L, t (41) = 9.436, p < 0.001). The mean percentage change in brain volume between CT scans in the brain atrophy group was –3.7% over a median of 31 days, which is equivalent to a brain volume of 38.5 cm3. The proportion of cases on mechanical ventilation (95.2% vs. 66.7%; p = 0.02) and median time on mechanical ventilation (28 [IQR 15–57] days vs. 15 [IQR 0–25] days, p = 0.04) were significantly higher in the brain atrophy group than in the no brain atrophy group.

Conclusions

Many ICU patients with severe sepsis who developed prolonged mental status changes and neurological sequelae showed signs of brain atrophy. Patients with rapidly progressive brain atrophy were more likely to have required mechanical ventilation.
Prevention of leg cramps by using compression stockings or magnesium supplements in the 50–84 age group: study protocol for a randomised controlled trial
Authors: Joensuu Jenni , Mustajoki Pertti P. , Mustonen Pekka K. , Kaila Minna , Koskela Tuomas
Published: November 2021

Background

Leg cramps are painful sensations of tightening in the muscles of the legs that commonly appear during the night and are often associated with secondary insomnia. They are common especially in older age. There is no evidence that any method of prevention of nocturnal leg cramps is both safe and effective. There are no previous trials concerning cramp prevention by using compression stockings. The objective of this study is to assess in a prospective randomised controlled trial whether leg cramps can be prevented by the daily use of knee-length compression stockings or magnesium supplements.

Methods

The study will be set in Finland, and 50–84-year-old volunteers will be recruited through Google Ads, the Finnish health library website and Finnish primary health care centres. The participants must have a minimum of two episodes of leg cramps per week for the past 4 weeks to be included in the study. The participants (n= 225) will be allocated to three equal groups: the compression stocking arm, the magnesium supplement arm and the placebo arm. The participants will go through 4 weeks of follow-up without intervention and then another 4 weeks of follow-up with the assigned intervention. The material for the study will be collected through electronic questionnaires.

Discussion

This protocol describes a study that compares compression stockings, magnesium supplements and placebo for the prevention of leg cramps. The results of this study can significantly improve knowledge on the methods of preventing leg cramps.

Trial registration

ClinicalTrials.govNCT04694417. Registered on Jan 4, 2021.
Comparison of efficacy of a 7-day versus a 14-day course of intravenous antibiotics in the treatment of uncomplicated neonatal bacterial sepsis: study protocol of a randomized controlled non-inferiority trial
Authors: Dutta Sourabh , Nangia Sushma , Jajoo Mamta , Gathwala Geeta , Nesargi Saudamini , Sundaram Mangalabharathi , Kumar Praveen , Saili Arvind , Kumar Dipti , Dalal Poonam , Suman Rao P. N. , Shanmugam Ramya , Ray Pallab , Randhawa Valinderjeet Singh , Saigal Karnika , Sharma Madhu , Nagaraj Savitha , Radhakrishnan Devasena
Published: November 2021

Background

Neonatal sepsis is a global public health problem. There is no consensus regarding the optimum duration of antibiotics for culture-proven neonatal sepsis. Published randomized controlled trials (RCTs) comparing shorter versus longer courses of antibiotics provide low-quality evidence with serious risk of bias. We hypothesized that among neonates with uncomplicated culture-proven sepsis, antibiotic duration of 7 days is not inferior to 14 days.

Methods

This is a multi-centric, parallel-group, stratified, block-randomized, active-controlled, non-inferiority trial with outcome assessment blinded. Stratification is by center and birth weight. Neonates weighing ≥1000 g at birth, with blood-culture-proven sepsis (barring Staphylococcus aureus and fungi), without conditions warranting > 14 days antibiotics, and who clinically remit, are enrolled in the RCT on day 7 of administration of sensitive antibiotics. They are randomly allocated to no further antibiotics (intervention arm: total 7 days) or 7 more days of the same antibiotics (control arm: total 14 days). Allocation is concealed by opaque, sealed envelopes. The primary outcome is “definite or probable relapse” within 21 days after antibiotic completion. Secondary outcomes include definite and probable relapses at various timepoints until day 35 post-randomization, secondary infections, and adverse events. The neonatologist adjudicating probable relapses and lab personnel are blinded. Three hundred fifty subjects will be recruited in each arm, assuming a non-inferiority margin of 7%, one-sided alpha error 5%, and power of 90%. Analysis will be per protocol and by intention-to-treat. An independent Data Safety Monitoring Board monitors adverse events and will perform one interim analysis when 50% of expected primary outcomes have occurred or 50% of subjects have completed follow-up, whichever is earlier. O’Brien-Fleming criteria will be used to stop for mid-term benefit and Pocock’s to stop for mid-term harm. A priori subgroup analyses are planned by birth weight categories, gram-stain status of pathogens, and radiological pneumonia.

Discussion

This trial will provide evidence to guide practice regarding optimum duration of antibiotics for culture-proven neonatal bacterial sepsis. If a 7-day regime is proved to be non-inferior to a 14-day regime, it is likely to reduce hospital stay, costs, adverse effects of drugs, and nosocomial infections.

Trial registration

Clinical Trials Registry India CTRI/2017/09/009743. Registered on 13 September 2017.
Slipping through: mobility’s influence on infectious disease risks for justice-involved women in Canada
Authors: Taylor Susie , Haworth-Brockman Margaret , Keynan Yoav
Published: November 2021

Background

The relationship between incarceration and women’s vulnerability to sexually transmitted and blood-borne infections (STBBI) is understudied in Canada, despite numerous studies showing that justice-involved women experience very high rates of infection. Justice-involved women in Canada are highly mobile, as a result of high rates of incarceration and extremely short sentences. From a public health perspective, it is productive to understand how the mobility of justice-involved women shapes their vulnerability to STBBI.

Results

This narrative review demonstrates that mobility between incarceration facilities and communities drives sexually transmitted and blood-borne disease risk for justice-involved women in Canada. Associations and interactions between epidemics of gender-based and intimate partner violence, substance use, and STBBIs shape the experiences of justice-involved women in Canada. In correctional facilities, the pre-existing vulnerability of justice-involved women is compounded by a lack of comprehensive STBBI care and limited harm reduction services. On release, unstable housing, disruptions to social support networks, interruptions in medical care, and relapse to or continuation of substance use, significantly increase individual disease risk and the likelihood of community transmission. High rates of incarceration for short periods perpetuate this cycle and complicate the delivery of healthcare.

Conclusions

The review provides evidence of the need for stronger gender-transformative public health planning and responses for incarcerated women, in both federal and provincial corrections settings in Canada. A supportive, evidence-based approach to STBBI identification and treatment for incarcerated women - one that that removes stigma, maintains privacy and improves access, combined with structural policies to prevent incarceration - could decrease STBBI incidence and interrupt the cycle of incarceration and poor health outcomes. A coordinated and accountable program of reintegration that facilitates continuity of public health interventions for STBBI, as well as safe housing, harm reduction and other supports, can improve outcomes as well. Lastly, metrics to measure performance of STBBI management during incarceration and upon release would help to identify gaps and improve outcomes for justice-involved women in the Canadian context.
Association between the dispositional optimism and depression in young people: a systematic review and meta-analysis
Authors: Uribe Fabio Alexis Rincón , de Oliveira Silvia Botelho , Junior Amauri Gouveia , da Silva Pedroso Janari
Published: November 2021

The objective of this study was to perform a meta-analysis of publications that reported the association between dispositional optimism and depression during youth, analyzing if the strength of this relationship varied according to potential factors. Systematic searches were carried out in APA PsycNet, Virtual Health Library, Embase, Web of Science, PubMed Central, and Scopus to collect English, Portuguese, or Spanish studies from 2009 onwards. Two reviewers selected the eligible articles, assessed the quality of each study, and extracted the data. For the synthesis of the results, a meta-analytic approach was used. We identified 4077 publications in the initial searches and 22 in the supplementary searches, from which 31 studies remained for analysis once the eligibility criteria were applied. The results showed a statistically significant negative association between dispositional optimism and depression in the young population, age being a factor that modifies the effect measure between these variables. This meta-analysis provides a consistent and robust synthesis on the interaction effect between dispositional optimism and depression in the young population. Based on these findings, early clinical admissions may effectively improve optimistic tendencies in young people, which could help them prevent depressive symptoms or episodes.
PollMap: a software for crop pollination mapping in agricultural landscapes
Authors: Rahimi Ehsan , Barghjelveh Shahindokht , Dong Pinliang , Pirlar Maghsoud Arshadi , Jahanbakhshian Mohammad Mehdi
Published: November 2021

Background

Ecosystem service mapping is an important tool for decision-making in landscape planning and natural resource management. Today, pollination service mapping is based on the Lonsdorf model (InVEST software) that determines the availability of nesting and floral resources for each land cover and estimates pollination according to the foraging range of the desired species. However, it is argued that the Lonsdorf model has significant limitations in estimating pollination in a landscape that can affect the results of this model.

Results

This paper presents a free software, named PollMap, that does not have the limitations of the Lonsdorf model. PollMap estimates the pollination service according to a modified version of the Lonsdorf model and assumes that only cells within the flight range of bees are important in the pollination mapping. This software is produced for estimating and mapping crop pollination in agricultural landscapes. The main assumption of this software is that in the agricultural landscapes, which are dominated by forest and agriculture ecosystems, forest patches serve only as a nesting habitat for wild bees and the surrounding fields provide floral resources.

Conclusion

The present study provided new software for mapping crop pollination in agricultural landscapes that does not have the limitations of the Lonsdorf model. We showed that the use of the Lonsdorf model for pollination mapping requires attention to the limitations of this model, and by removing these limitations, we will need new software to obtain a reliable mapping of pollination in agricultural landscapes.
A unique case of a double intra-conal cavernous hemangioma
Authors: Ulivieri Simone , Luglietto Davide , Ulivieri Matteo , Giorgio Antonio
Published: November 2021

Background

Cavernous hemangiomas are benign vascular malformations, probably representing the most common intraorbital and intraconal tumors in the adult population.

Case presentation

We report the case of a 49-year-old female with two intra-conal lesions. We performed a total resection using Ulivieri's extended lateral approach. The postoperative course was uneventful and the patient was discharged three days after surgery.

Conclusions

To the best of our knowledge, we report here the first case in the literature of a double intra-conal lesion.
Thromboses of major arteries and ChAdOx1 nCov-19 vaccination
Authors: Mungmunpuntipantip Rujittika , Wiwanitkit Viroj
Published: November 2021

This correspondence discussed on published article on “thromboses of major arteries and ChAdOx1 nCov-19 vaccination”.
Romidepsin Plus CHOP Versus CHOP in Patients With Previously Untreated Peripheral T-Cell Lymphoma: Results of the Ro-CHOP Phase III Study (Conducted by LYSA)
Authors: Bachy Emmanuel , Camus Vincent , Thieblemont Catherine , Sibon David , Casasnovas René-Olivier , Ysebaert Loïc , Damaj Gandhi , Guidez Stéphanie , Pica Gian Matteo , Kim Won Seog , Lim Soon Thye , André Marc , García-Sancho Alejandro Martín , Penarrubia Maria Jesus , Staber Philipp B. , Trotman Judith , Hüttmann Andreas , Stefoni Vittorio , Re Alessandro , Gaulard Philippe , Delfau-Larue Marie-Helene , de Leval Laurence , Meignan Michel , Li Ju , Morschhauser Franck , Delarue Richard
Published: November 2021

PURPOSE

Romidepsin, a histone deacetylase inhibitor, has demonstrated activity in relapsed or refractory peripheral T-cell lymphoma (PTCL) as a single agent. Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) therapy is widely used as first-line treatment of PTCL; however, it has limited efficacy. Results from a phase Ib and II study showed the feasibility of combining romidepsin with CHOP (Ro-CHOP).

METHODS

This study is a randomized phase III study of Ro-CHOP versus CHOP in adult patients with previously untreated PTCL. All patients received CHOP in 3-week cycles for six cycles. Romidepsin, 12 mg/m2, was administered intravenously over a 4-hour period on days 1 and 8 of each 3-week cycle for six cycles. The primary end point was progression-free survival (PFS) according to International Working Group 1999 criteria.

RESULTS

Between January 2013 and December 2017, 421 patients were enrolled (Ro-CHOP, n = 211; CHOP, n = 210). The median PFS for Ro-CHOP versus CHOP was 12.0 months (95% CI, 9.0 to 25.8) versus 10.2 months (95% CI, 7.4 to 13.2) with a hazard ratio of 0.81 ( P = .096). In the Ro-CHOP versus CHOP arms, the median overall survival was 51.8 versus 42.9 months and the objective response rate was 63% versus 60% with complete response plus unconfirmed complete response rates of 41% versus 37% ( P > .1 in all comparisons), respectively. Grade 3 or 4 treatment-emergent adverse events occurring in ≥ 30% of patients in the Ro-CHOP arm included thrombocytopenia (50% v 10% in the Ro-CHOP v CHOP arms, respectively), neutropenia (49% v 33%), anemia (47% v 17%), and leukopenia (32% v 20%).

CONCLUSION

The addition of romidepsin to CHOP did not improve PFS, response rates, nor overall survival and increased the frequency for grade ≥ 3 treatment-emergent adverse events. Ro-CHOP does not represent a significant advance in the standard of care for patients with previously untreated PTCL.
Poiesis as Decision Making: Shklovsky, Tynianov, Bakhtin
Authors: Steiner Peter
Published: November 2021

This article deals with the theories of Viktor Shklovsky and Iurii Tynianov from the perspective of decision science. It outlines how these two members of the Petersburg Society for the Study of Poetic Language (OPOIAZ) conceived of the writer as a rational agent pursuing a specific goal, and of the means at his or her disposal to attain it. Their approaches, the article illustrates, correspond closely with two specific types of rationality: “instrumental” and “bounded.” To conclude, the essay juxtaposes the formalists’ conceptualization of poetic creativity with Mikhail Bakhtin's view on the subject, arguing that the way he conceives of the strategies available to the literary author fits the label of “interactive rationality.”
Sinophonic Detours in Colonial Burma
Authors: Bernards Brian
Published: November 2021

Following his 1925–1931 overland trek across southwestern China to colonial Burma, Ai Wu's 1935 Travels in the South (the author's canonical collection of autobiographical travelogue fiction) represents a Sinophonic detouring of the key literary impulses of the author's May Fourth forebears and his left-wing literary contemporaries, especially with its social realist expressions of gendered frontier primitivism, interethnic romantic desire, and international leftist solidarity. Ai Wu's southbound transborder itinerary and “street education”—marked by a repetition of trespasses and evictions—develop a “counterpoetics of trespass” blurring boundaries between social realist fiction and autobiographical travelogue while intertextually rerouting romantic primitivism in depictions of indigenous women through counterpoetically anemic prose. Initially taking his cue from Lu Xun, Ai Wu similarly inscribes his literary mission as one of national redemption but in a way that conforms to the leftist internationalist ideals of the League of Left-Wing Writers, which Ai Wu joined after he was forcibly repatriated to China by British colonial authorities in 1931. Ai Wu's Sinophone transborder counterpoetics activate latent self-reflections on the narrator's own male Han-centric exoticism toward indigenous Shan and Burman women and on his unfulfilled desire to forge meaningful relationships with them. Rather than assimilating or subordinating his depictions of these women into a projection of a Chinese leftist national cause, Ai Wu ultimately sublimates his romantic desires into an allegory for Burma's anticolonial resistance movement.