bluuebunny/crossref_metadata_2025 huggingface dataset:
Scintigraphic peritoneography in the diagnosis of pleuroperitoneal leak complicating peritoneal dialysis
Authors: Harry Lerwine , Nyakale Nozipho , Tinarwo Partson
Published: August 2020

A pleuroperitoneal leak (PPL) is a relatively rare complication of peritoneal dialysis (PD) and early diagnosis is essential.

Patients suspected of a PPL usually present with dyspnea (marked during inflow of PD fluid) and tend to have transudative high glucose pleural effusions.

The PPL scintigraphy (PPLS) is one of the methods for objectively proving a PPL. The effectiveness of PPLS as a noninvasive method of evaluating a suspected PPL and its effectiveness in the exclusion of a leak in patients with similarly presenting comorbidities was assessed.

Patients suspected to have a PPL were considered for PPLS based on clinical presentation and pleural fluid analysis. Radiopharmaceutical was administered into the peritoneum via the dialysis port with the patient lying supine and immediate dynamic followed by delayed statics were acquired.

Of the 27 scans reviewed, 70% were found to be positive with majority detected within 12 minutes of radiopharmaceutical administration with a high predominance occurring in the right chest (P < .001). In PPLS-positive patients, when both chest X-rays and planar agreed on showing the right-sided chest predominance, the highest measurements of the pleural glucose:serum glucose ratio were recorded. A statistically significant correlation between the outcome of the scan and final decision on patient management was noted (P < .01).

The PPLS is an effective diagnostic tool for assessing PPLS. However, multicenter studies investigating its added value over other conventional methods are needed to establish it as a highly relevant diagnostic tool.
Acupuncture reduced the medical expenditure in migraine patients
Authors: Tsai Sheng-Ta , Tseng Chun-Hung , Lin Mei-Chen , Liao Hsien-Yin , Teoh Boon-Khai , San Shao , Tsai Chon-Haw , Huang Hung-Yu , Lin Yi-Wen
Published: August 2020

Objectives:

According to the data of Organisation for Economic Cooperation and Development, almost all the countries got increased medical expenditures in these years. Among the diseases, migraine is a condition that affects predominantly young and middle-aged people. It results in great economic losses. So we perform this research to investigate the acupuncture effect of reducing medical expenditure and medical resources use.

Perspective:

Acupuncture is a non-pharmacologic treatment and it became popular in recent years. In Taiwan, about 13% migraine patients visited acupuncture doctor. We hypothesized that the acupuncture had the additional effect than the medical treatment.

Setting:

We analysed the economic cost and medical visits in the real word.

Methods:

We used national cohort data from Taiwan, retrospectively gathered between 2000 and 2010. We selected newly diagnosed migraine patients who were diagnosed by registered neurologists formally licensed by the Taiwan Neurological Society. We divided these patients into two groups: with and without acupuncture treatment. The main outcome was medical expenditures and visits within 1 year after acupuncture.

Results:

In migraine patients who received acupuncture treatment, medical expenditures on emergency care and hospitalization were significantly lower than the group without acupuncture treatment.

Conclusion:

According to our real-world data, acupuncture can reduce the medical expenditure in migraine patients within 1 year after diagnosis. For the health policy maker, it is cost effective to encourage combining acupuncture and western medicine to treat migraine patients. For the doctors in routine clinical practice, who may consider to consult acupuncture doctors to deal with the migraine patients together.
Antiplatelet/anticoagulant agents for preventing thrombosis events in patients with severe COVID-19
Authors: Li Yiwei , Xu Ying , Shi Pengfei , Zhu Ying , Hu Wei , Chen Can
Published: August 2020

Background:

On March 11, 2020, World Health Organization announced that severe acute respiratory syndrome coronavirus 2 caused COVID-19 was a global pandemic. COVID-19 is associated with venous thromboembolism including deep vein thrombosis and pulmonary embolism. To further identify the current role of antiplatelet/anticoagulant therapy in the prophylaxis and treatment of COVID-19 patients is important.

Methods:

We will conduct a systematic review based on searches of major databases (eg, Pubmed, Web of Science, EMBASE, CENTRAL, MEDLINE, SCI-EXPANDED, CPCI-S, CBM, CNKI, and Wanfang Database) and clinical trial registries from inception to present without limitations of language and publication status. All published randomized control trials, quasi-randomized trials, retrospective and observational studies related to prophylactic antiplatelet/anticoagulant for severe COVID-19 will be included. Primary outcome includes incident acute thrombosis events. Second outcome is the incidence and severity of adverse effects. Full-text screening, data extraction and quality assessment will be conducted by 2 reviewers independently. The reporting quality, risk of bias, sensitivity analysis and subgroup analysis will be performed to ensure the reliability of our findings by other 2 researchers. The statistical analysis will be performed by RevMan V.5.3 software and Stata V.12.0 software.

Results:

The result of this systematic review will provide valid advice and consultation for clinicians on the management of prophylactic antiplatelet/anticoagulant for severe COVID-19 patients.

Conclusion:

This systematic review will provide evidence for prophylactic antiplatelet/anticoagulant of severe COVID-19 patients.

PROSPERO registration:

CRD42020186928.
Discordant retention of HIV-infected mothers and children
Authors: Nhampossa Tacilta , Fernandez Sheila , Augusto Orvalho , Fuente-Soro Laura , Maculuve S.ó.nia , Bernardo Edson , Saura Anna , Casellas Aina , Gonzalez Raquel , Ruperez Maria , Karajeans Esmeralda , Vaz Paula , Menendez Clara , Buck W. Chris , Naniche Denise , Lopez-Varela Elisa
Published: August 2020

It is often assumed that children and their caregivers either stay in care together or discontinue together, but data is lacking on caregiver–child retention concordance. We sought to describe the pattern of care among a cohort of human immunodeficiency virus (HIV) infected children and mothers enrolled in care at the Manhiça District Hospital (MDH).

This was a retrospective review of routine HIV clinical data collected under a larger prospective HIV cohort study at MDH. Children enrolling HIV care from January 2013 to November 2016 were identified and matched to their mother's HIV clinical data. Retention in care for mothers and children was assessed at 24 months after the child's enrolment. Multinomial logistic regression was performed to evaluate variables associated with retention discordance.

For the 351 mother–child pairs included in the study, only 39% of mothers had concordant care status at baseline (23% already active in care, 16% initiated care concurrently with their children). At 24-months follow up, a total of 108 (31%) mother–child pairs were concordantly retained in care, 88 (26%) pairs were concordantly lost to follow up (LTFU), and 149 (43%) had discordant retention. Pairs with concurrent registration had a higher probability of being concordantly retained in care. Children who presented with advanced clinical or immunological stage had increased probability of being concordantly LTFU.

High rates of LTFU as well as high proportions of discordant retention among mother–child pairs were found. Prioritization of a family-based care model that has the potential to improve retention for children and caregivers is recommended.
Tai Chi for coronavirus disease 2019 in recovery period
Authors: Shi Yu , Wen Dengpeng , Wang Hui , Zhang Puyue , Zhong Yanmei , Liu Donghao , Zhou Deqi
Published: August 2020

Background:

Assessing the effectiveness and safety of Tai Chi for coronavirus disease 2019 (COVID-19) in recovery period is the main purpose of this systematic review protocol.

Methods:

The following electronic databases will be searched from inception to April 2020: MEDLINE, Ovid, EMBASE, the Cochrane Library, the Allied and Complementary Medicine Database, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Database and Wanfang Database. In addition, Clinical trial registries, like the Chinese Clinical Trial Registry, the Netherlands National Trial Register and ClinicalTrials.gov, will be searched for ongoing trials with unpublished data. No language restrictions will be applied. The primary outcome will be the time of disappearance of main symptoms (including fever, asthenia, cough disappearance rate, and temperature recovery time), and serum cytokine levels. The secondary outcome will be the accompanying symptoms (such as myalgia, expectoration, stuffiness, runny nose, pharyngalgia, anhelation, chest distress, dyspnea, crackles, headache, nausea, vomiting, anorexia, diarrhea) disappear rate, negative COVID-19 results rate on 2 consecutive occasions (not on the same day), CT image improvement, average hospitalization time, occurrence rate of common type to severe form, clinical cure rate, and mortality. Two independent reviewers will conduct the study selection, data extraction and assessment. Review manager software V.5.3 will be used for the assessment of risk of bias and data synthesis.

Results:

The results will provide a high-quality synthesis of current evidence for researchers in this subject area.

Conclusion:

The conclusion of the study will provide an evidence to judge whether Tai Chi is effective and safe for COVID-19 in recovery period.

Ethics and dissemination

This protocol will not evaluate individual patient information or infringe patient rights and therefore does not require ethical approval. Results from this review will be disseminated through peer-reviewed journals and conference reports.

PROSPERO registration number CRD42020181456.
Distance between tumor and nipple as a prognostic factor in breast cancers
Authors: Yang Qianru , Yang Jiqiao , Xu Li , Zhou Chen , Lv Qing
Published: August 2020

The present study aimed to investigate the prognostic implication of distance from tumor to nipple according to clinicopathological factors with known prognostic value.

We retrospectively identified 961 patients of invasive breast cancer from January 2000 to April 2016. Clinicopathological information was extracted from hospital database and distance from tumor to nipple was objectively measured during surgeries. Overall survival (OS) and disease-free survival (DFS) were compared among patients with tumor-nipple distance ≤2, 2 to 5, and >5 cm. Subgroup analyses were performed according to age at diagnosis (≤35 vs >35), tumor size, histological features, treatment, axillary nodal metastasis and lymphovascular invasion.

A total of 627 cases were included in statistical analysis. There was no difference detected in OS or DFS among patients with different tumor-nipple distance. Better OS was associated with greater tumor-nipple distance in old patients (HR = 0.582, 95%CI: 0.345–0.982, P = 0.042), while the association between OS and tumor-nipple distance was not observed in young patients. DFS was influenced by tumor-nipple distance in both young (HR = 5.321, 95%CI: 1.151–24.595, P = 0.032) and old (HR = 0.593, 95%CI: 0.385–0.913, P = 0.018) patients with opposite effects.

Tumor-nipple distance can be adopted as a prognostic factor of breast cancer and it functions oppositely in young and old patients. Multicenter prospective studies with larger sample size are needed to validate the result.
Burnout in emergency medicine physicians
Authors: Zhang Qin , Mu Ming-chun , He Yan , Cai Zhao-lun , Li Zheng-chi
Published: August 2020

Background:

Physician burnout has been a global problem that affects severely the mental status among doctors, especially in emergency medicine (EM). However, few studies have focused on emergency medicine physicians, and the published data are inconsistent. Thus, this meta-analysis is performed to systematically evaluate the prevalence of burnout among emergency medicine physicians.

Methods:

We systematically searched databases including PubMed, Embase, PsychINFO and the Cochrane Library from inception to September, 2019 for English-language articles. We selected all the original articles those used Maslach Burnout Inventory to assess the prevalence of burnout and its 3 dimensions emotional exhaustion (EE), depersonalization, and personal accomplishment (PA) in emergency medicine physicians. After literature screening, quality evaluation was performed for eligible studies by using the Joanna Briggs Institute (JBI) critical appraisal checklist for studies reporting prevalence data; then, Begg test and Egger test was used to assess publication bias. Pooled prevalence rates were assessed by conducting a meta-analysis using random effects models. Then sensitivity analysis followed to test the stability of the result and detected the source of heterogeneity.

Results:

A total of 1943 EM physicians provided burnout data. The pooled prevalence rates of high levels of emotional exhaustion, high levels of depersonalization and low levels of PA were 40% (95% CI: 26%–55%; I2 = 97.4%), 41% (95% CI: 30%–52%; I2 = 94.5%) and 35% (95% CI: 19%–52%; I2 = 99.0%), respectively. The mean burnout scores were 23.95 (SD = 11.88) for emotional exhaustion, 11.63 (SD = 6.85) for depersonalization, and 34.69 (SD = 7.71) for PA.

Conclusions:

This meta-analysis demonstrate a high level of burnout prevalent in EM physicians that approximately 40% experience high levels of EE and depersonalization. Our findings also suggest that EM physicians are more susceptible to burnout compared with physicians in other departments and other medical staffs in EM. More attention should be payed to mental status of EM physicians and further investigation concerning how to reduce burnout would be beneficial for EM physicians.

Registration: INPLASY202060060 in inplasy.com (doi.org/10.37766/inplasy2020.6.0060)
Protective effect of probiotics in patients with non-alcoholic fatty liver disease
Authors: Cai Gen-shen , Su Hui , Zhang Jing
Published: August 2020

To investigate the effects of probiotics on liver function, glucose and lipids metabolism, and hepatic fatty deposition in patients with non-alcoholic fatty liver disease (NAFLD).

Totally 140 NAFLD cases diagnosed in our hospital from March 2017 to March 2019 were randomly divided into the observation group and control group, 70 cases in each. The control group received the diet and exercise therapy, while the observation group received oral probiotics based on the control group, and the intervention in 2 groups lasted for 3 months. The indexes of liver function, glucose and lipids metabolism, NAFLD activity score (NAS), and conditions of fecal flora in 2 groups were compared before and after the treatment.

Before the treatment, there were no significant differences on alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamine transferase (GGT), total bilirubin (TBIL), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), insulin resistance index (HOMA-IR), NAFLD activity score (NAS), and conditions of fecal flora in 2 groups (P > .05). After the treatment, ALT, AST, GGT, TC, TG, HOMA-IR, NAS, and conditions of fecal flora in the observation group were better than those in the control group, and the observation group was better after treatment than before. All these above differences were statistically significant (P < .05).

Probiotics can improve some liver functions, glucose and lipids metabolism, hepatic fatty deposition in patients with NAFLD, which will enhance the therapeutic effects of NAFLD.
The therapeutic effect of repetitive transcranial magnetic stimulation in elderly depression patients
Authors: Dai Lilei , Wang Peng , Zhang Panpan , Guo Qingshan , Du Hui , Li Fen , He Xinfu , Luan Rongrong
Published: August 2020

Background:

Depression, a common psychiatric disorder in elderly, serves as a remarkable precipitating factor for suicide among the elderly people. Here, a randomized double-blinded study was performed to investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) on improving the clinical symptoms and reducing suicidal ideation in elderly patients with depression.

Methods:

In this study, 103 elderly patients with depression and suicidal ideation were randomly divided into 2 groups, 48 cases in the rTMS group and 55 cases in the control group (sham rTMS). Both groups received routine drug therapy with rTMS or sham rTMS. The patients received evaluation by Hamilton depression scale and self-rating idea of suicide scale before treatment and after 2 and 4 weeks of treatment, respectively.

Results:

The measurement from the present study demonstrated that Hamilton depression scale and self-rating idea of suicide scale scores decreased to varying degrees in the 2 groups after treatment, and the decrease was more significant in rTMS group. The rate of marked effectiveness was much higher in rTMS group after 2 weeks of treatment compared with the control group. Furthermore, the rate of moderate effectiveness at 4 weeks after treatment was significantly higher in rTMS group compared with the control group.

Conclusion:

Together, the present study shows that rTMS with routine drug therapy exhibited effect with quick onset to improve the clinical symptoms and reduce suicidal ideation in elderly patients with depression.
Chinese herbal medicine si-miao-san decoction for acute gouty arthritis
Authors: Wang Heting , Duan Hua , Chen Shiyin , Luo Yong , Zhang Yuan , Liu Qingsong , Zhang Xiyu
Published: August 2020

Background:

The prevalence of gout is increasing worldwide, and the symptoms of acute arthritis appearing in gout patients seriously affect the quality of life. The pain and functional limitation caused by acute gouty arthritis (AGA) bring great pain to patients. At present, mainstream drugs have problems such as poor efficacy and side effects. Traditional Chinese medicine has extensive clinical experience in the prevention and treatment of gout, and it also shows clear advantages in the treatment of AGA. Clinical studies have confirmed that si-miao-san decoction (SMSD), a traditional Chinese medicine decoction, can improve the clinical symptoms and signs of AGA patients. Therefore, we will conduct a systematic review to clarify the effectiveness and safety of SMSD for AGA.

Methods:

We will search different database from the built-in to October 2020. The electronic database includes PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang, VIP, and CBM. At the same time, we will also search for clinical registration tests and gray literatures. This study only screened clinical randomized controlled trials (RCT) for SMSD for AGA. The 2 researchers independently conducted literature selection, data extraction, and quality assessment. Dichotomous data are represented by relative risk (RR), continuous data are represented by mean difference (MD) or standard mean deviation (SMD), and the final data are fixed effect model (FEM) or random effect model (REM), depending on whether it exists heterogeneity. The main outcomes are clinical efficacy, including pain score, joint function, and degree of swelling. The secondary outcomes include: blood uric acid (BUA), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Finally, a meta-analysis was conducted through Review Manager software version 5.3.

Results:

This study will conduct a comprehensive analysis based on the currently released Si-Miao-San data for the treatment of AGA and provide high-quality evidence of clinical efficacy and safety.

Conclusion:

This systematic review aims to provide new options for SMSD treatment of AGA in terms of its efficacy and safety.

Ethics and dissemination:

The review is based solely on a secondary study of published literatures and does not require ethics committee approval. Its conclusion will be disseminated in conference papers, magazines, or peer-reviewed journals.

INPLASY registration number:

INPLASY202040163.
Extraluminal bronchial blocker placement using both nostrils for lung isolation in a patient with limited mouth opening
Authors: Zheng XianHe , Zhang ChangFeng , Lian ShuMei , Liu ShuYun , Jiang ZongMing
Published: August 2020

Rationale:

The establishment of lung isolation is often particularly challenging for the anesthesiologist in patients with difficult airway. Usually, orotracheal intubation with double lumen tube is the commonly used technique for achieving 1 lung anesthesia. Whereas, in patients with limited mouth opening and restricted cervical mobility, this technique becomes extremely difficult and hazardous. We report a case in which bronchial blocker placement was succeeded via both nostrils in a difficult airway due to restricted mouth opening.

Patient concerns:

A 50-year-old, non-smoking female with a painless mass in the left upper lobe. She had a 10-year history of ankylosing spondylitis and squamous cell carcinoma of the floor of the mouth after 5 operations 4 years previously.

Diagnoses:

Left upper lobe adenocarcinoma, ankylosing spondylitis and oral squamous cell carcinoma.

Interventions:

To achieve 1 lung anesthesia, both nostrils were used for extraluminal bronchial blocker placement.

Outcomes:

Initially, oral intubation was selected for establishing a patent airway but failed. Then switched to nasal canal for insertion, after several attempts, a conventional nasal intubation tube (internal diameter 6.0 mm) was placed via 1 nostril under topical anesthesia, with the aid of a flexible fiberoptic bronchoscope, and a bronchial blocker was advanced to the desired position via the other nostril.

Lessons:

In difficult airway with limited mouth opening and restricted cervical mobility, multidisciplinary experts participated discussion is a prerequisite for contemplating a scientific plan. Preoperative computed tomography scan and 3-dimensional computed tomography reconstruction would be helpful in detecting the narrowest part of airway conduit and determining a safe, reliable, and feasible airway program.
Improving staff safety with checklists during novel coronavirus disease (COVID-19) pandemic
Authors: Huang Jing , Liu Xiaoyan , Wu Zhoupeng , Zhang Lin , Yang Xinghai
Published: August 2020

Novel coronavirus disease (COVID-19) emerged in Wuhan in December 2019, has spread in many countries affected people globally. In response to the economic requirement of the nation and meet the need of patient's, a momentous event was going back to work step by step as fighting against COVID-19. Safety in clinical work is of priority as elective surgery in the department of surgery progressing. We used checklists based on our experiences on COVID-19 control and reality of clinical work from February to March in the West China Hospital, involving events of screening patient, chaperonage, and healthcare workers. Checklist summarized the actual clinical nursing work and management practices, hope to provide a reference for the order of surgery during the epidemic prevention and control, and standardize the clinical nursing work of surgery during pandemic.
Association between serum Cystatin C and renal injury in patients with chronic hepatitis B
Authors: Zheng Hui , Liu Haidong , Hao Anhua , Zhang Min , Wang Dexin
Published: August 2020

To explore the association between serum cystatin C (Cys-C) and renal damage in patients with chronic hepatitis B.

We retrospectively analyzed the clinical data of 425 patients with chronic hepatitis B virus (HBV) infection. Liver stiffness measured by FibroScan was used to diagnosis liver fibrosis. Cys-C levels were detected via latex-enhanced immunoturbidimetric assay.

A total of 425 patients were enrolled. Among them, 217 were patients with CHB with an eGFR > 90 mL/min/1.73 m2 and 208 with an eGFR ≤90 mL/min/1.73 m2. Cys-C levels significantly differed in patients with eGFR > 90 mL/min/1.73 m2 compared with patients with eGFR ≤90 mL/min/1.73 m2 (0.81 ± 0.05 vs 1.05 ± 0.06 mg/L, P < .001). Moreover, the Cys-C levels were 0.82 ± 0.04 mg/L in patients without liver fibrosis, 0.98 ± 0.05 mg/L in patients with mild liver fibrosis, 1.05 ± 0.08 mg/L in patients with advanced liver fibrosis, and 1.12 ± 0.07 mg/L in patients with liver cirrhosis (P < .001). Multivariate analyses were conducted to explore the independent factors associated with a decreased eGFR. Multivariate analysis suggested that T2DM (P = .032), liver fibrosis (P = .013), and Cys-C level (P = .035) were the independent factors associated with the decreased eGFR in patients with CHB. While age (P = .020) and Cys-C level (P = .001) were the independent factors associated with the decreased eGFR in patients with CHB-related fibrosis.

The fibrosis group had significantly higher Cys-C levels than those without fibrosis. Routine monitoring of Cys-C levels is of positive significance in preventing the development of renal impairment of CHB patients.
Effect of early enteral nutrition support for the management of acute severe pancreatitis
Authors: Guo Yong-bo , Liu Yan , Ma Jing , Cai Ying , Jiang Xiao-ming , Zhang Hong
Published: August 2020

Background:

This study aims to assess the effect of early enteral nutrition support (EENS) for the management of acute severe pancreatitis (ASP).

Methods:

This study will search Cochrane Library, PUBMED, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, CNKI, and WANGFANG from their inception to the present without language limitations. In addition, this study will also search clinical trial registry and reference lists of included trials. Eligible comparators will be standard care, medications, and any other interventions. Two authors will independently scan all citations, titles/abstracts, and full-text studies. The study methodological quality will be appraised using Cochrane risk of bias tool. If it is possible, we will pool out data and perform meta-analysis. Strength of evidence for each main outcome will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation.

Results:

This study will summarize the most recent evidence to assess the effect of EENS for the management of ASP.

Conclusion:

The findings of this study will help to determine whether EENS is effective for patients with ASP.

Study registration:

INPLASY202070009.
Guipi decoction for coronary heart disease
Authors: Gao Huanjia , Liu Shiyu , Cai Hairong , Chen Dongjie , Fu Xue , Zhao Shuai , Chen Bojun
Published: August 2020

Background:

Coronary heart disease (CHD) is the leading cause of morbidity and mortality worldwide. Guipi Decoction (GPD) is a classical traditional Chinese medication used to treat CHD. However, systematic review and meta-analysis regarding its efficacy and safety has not been systematically evaluated. The objective of this protocol is to determine the efficacy and safety of GPD in the treatment of CHD.

Methods:

Randomized controlled trials evaluating the effectiveness and safety of GPD in the treatment of CHD will be retrieved from 8 electronic databases, including PubMed, EMBASE, Cochrane Library, Web of science, China National Knowledge Infrastructure Database, VIP Database, Wanfang Database and China Biology Medicine Database. Study selection, data collection, risk of bias assessment, and evaluation of the quality of evidence will be performed in order. Data will be analyzed by RevMan V.5.3.5 software.

Results:

This study will evaluate the efficacy and safety of GPD in the treatment of CHD.

Conclusion:

This systematic review will provide evidence for determining whether or not GPD is an effective and safe intervention for CHD.

PROSPERO registration number:

PROSPERO CRD 42020156420.
Effect of butylphthalide on new cerebral microbleeds in patients with acute ischemic stroke
Authors: Ding Yunlong , Gu Zhiqun , Zhai Tingting , Wang Wenjuan , Zhang Yanrong , Wei Can , Liu Yan , Niu Jiali
Published: August 2020

Background:

To evaluate the effect of dl-3-N-butylphthalide (NBP) on new cerebral microbleeds (CMBs) in patients with acute ischemic stroke (AIS).

Methods:

We will prospectively enroll patients with AIS admitted to the stroke center of Jingjiang People's Hospital. Qualified participants will be randomly assigned to either the NBP group (NBP injection) or the control group (NBP injection placebo) in a ratio of 1:1. Patients will complete the brain magnetic resonance imaging within 48 hours and 14 days after stroke onset to observe the CMBs through susceptibility weighted imaging, and evaluate whether the use of NBP will affect the new CMBs in AIS patients. SPSS 20.0 will be used for statistical analyses.

Result:

We will provide practical and targeted results assessing the safety of NBP for AIS patients, to provide reference for clinical use of NBP.

Conclusion:

The stronger evidence about the effect of NBP on new CMBs in AIS patients will be provided for clinicians.
Psychometric properties of the short-form Chinese Community Nurses Stress Scale
Authors: Zhu Wei , Guo Hongxia , Li Jiping
Published: August 2020

Job-related stress had adverse effects on both patients and community nurses. To evaluate stress, an effective and reliable instrument was needed. The aim of this study was to develop a short-form Chinese Community Nurse Stress Scale and examine its psychometric properties.

A cross-sectional study was conducted. A total of 969 community nurses were selected from 56 community centers/stations in Sichuan Province. The socio-demographic data and job stress assessed by the Chinese Community Nurse Stress Scale (CNSS) were collected. After randomly splitting the sample into group 1 and group 2, exploratory and confirmatory factor analysis were carried out to shorten the scale and test its reliability and construct validity.

There were no significant differences in socio-demographic variables between group 1 (n = 488) and group 2 (n = 481). During exploratory factor analysis, 4 factors were selected, including management and interpersonal relationships (8 items), patient care (7 items), environment and resources of work (6 items), and career promotion (4 items), which explained 62.66% of all variance. Cronbachs α coefficient of the short-form CNSS was 0.94, and the cross-sample validity test supported the best fit model for this 25-item CNSS.

The results in this study supported that the 25-item CNSS had a good reliability and validity when it was administrated to Chinese community nurses.
A rare acantholytic variant of squamous cell carcinoma of the maxilla
Authors: Kim Jo-Eun , Lee Chena , Oh Kyu-Young , Huh Kyung-Hoe
Published: August 2020

Rationale:

Acantholytic squamous cell carcinoma (ASCC) is an uncommon histopathologic variant of squamous cell carcinoma (SCC), which is the most common malignancy of the oral cavity. Though ASCC showed poor prognosis, the exact diagnosis is challenging.

Patients concerns:

A 59-year-old female patient with 1-month long symptoms of pain and burning sensation in the right maxilla.

Diagnoses:

Incisional biopsy in the maxilla established the pathologic diagnosis of SCC.

Intervention:

The patient underwent mass resection with near total maxillectomy.

Outcomes:

The final diagnosis through the microscopic examination was ASCC. Palliative chemotherapy was done to relive the symptoms after the recurrence, however, the patient died of the disease at 8 months after her initial presentation.

Lessons:

Special attention should be paid to this variant of SCC because most patients with ASCC have a very poor prognosis.
Shunting outcomes in post-hemorrhagic hydrocephalus
Authors: Sun Tong , Guan Junwen , You Chao , Yang Jingguo , Li Xuepei , Yuan Yikai , Zhou Yicheng
Published: August 2020

Background:

The best treatment option for patients with post-hemorrhagic hydrocephalus (PHH) remains controversial. The objective of the current meta-analysis is to systematically evaluate the long-term outcomes of patients with PHH treated by ventriculoperitoneal shunt (VPS) and lumboperitoneal shunt (LPS).

Methods:

We search literatures through PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Periodical Database (VIP) and Wan fang databases, and Chinese Biomedical Literature Database (CBM) from its beginning to June 15, 2020. Randomized controlled trials (RCTs) and non-RCTs in English or Chinese studies will be considered. The primary outcome is the rate of shunt failure after shunt implantation

The secondary outcome is the rate of complications that are associated with shunt surgery.

Results and conclusion:

The study will compare the 2 types of shunt surgery in the treatment of PHH, providing evidence for the treatment option for the patients with PHH.

Study registration number:

The study is priorly registered through International Platform of Registered Systematic Review and Meta-analysis Protocols on June 17, 2020 (INPLASY202060063).
Diagnostic value of mean platelet volume for neonatal sepsis
Authors: Wang Jingjing , Wang Zhen , Zhang Min , Lou Zhenshuai , Deng Jiaxiang , Li Qian
Published: August 2020

Background:

An increasing number of studies in recent years have identified mean platelet volume (MPV) as a predictive marker for neonatal sepsis. However, most of these studies focused on single regions, and therefore, the findings remain inconclusive. We, in this study, aimed to evaluate the potential of MPV as a biological indicator of neonatal sepsis through a systematic review and meta-analysis.

Methods:

We searched PubMed, the Cochrane Library, Embase, and WanFang database for articles on MPV and neonatal sepsis, published from January 1, 1990 to December 31, 2018. We included 11 studies on 932 neonates with sepsis in this meta-analysis.

Results:

The overall meta-analysis showed that MPV was significantly higher in patients with neonatal sepsis compared with healthy controls. Subgroup analysis revealed that the type of diagnostic criteria, analyzer, analyte, and controls used in the studies affected the difference in MPV between patients and healthy controls.

Conclusion:

MPV was significantly higher in the neonatal sepsis group compared to the control group. Therefore, in clinical practice, MPV could be used as an indicator for the early diagnosis of neonatal sepsis.
Static elastic cloaking, low-frequency elastic wave transparency and neutral inclusions
Authors: Norris Andrew N. , Parnell William J.
Published: August 2020

New connections between static elastic cloaking, low-frequency elastic wave scattering and neutral inclusions (NIs) are established in the context of two-dimensional elasticity. A cylindrical core surrounded by a cylindrical shell is embedded in a uniform elastic matrix. Given the core and matrix properties, we answer the questions of how to select the shell material such that (i) it acts as a static elastic cloak, and (ii) it eliminates low-frequency scattering of incident elastic waves. It is shown that static cloaking (i) requires an anisotropic shell, whereas scattering reduction (ii) can be satisfied more simply with isotropic materials. Implicit solutions for the shell material are obtained by considering the core–shell composite cylinder as a neutral elastic inclusion. Two types of NI are distinguished,
weak
and
strong
with the former equivalent to low-frequency transparency and the classical Christensen and Lo generalized self-consistent result for in-plane shear from 1979. Our introduction of the
strong NI
is an important extension of this result in that we show that standard anisotropic shells can act as perfect static cloaks, contrasting previous work that has employed ‘unphysical’ materials. The relationships between low-frequency transparency, static cloaking and NIs provide the material designer with options for achieving elastic cloaking in the quasi-static limit.
Dynamics of fluid displacement in mixed-wet porous media
Authors: Scanziani Alessio , Lin Qingyang , Alhosani Abdulla , Blunt Martin J. , Bijeljic Branko
Published: August 2020

We identify a distinct two-phase flow invasion pattern in a mixed-wet porous medium. Time-resolved high-resolution synchrotron X-ray imaging is used to study the invasion of water through a small rock sample filled with oil, characterized by a wide non-uniform distribution of local contact angles both above and below 90
°
. The water advances in a connected front, but throats are not invaded in decreasing order of size, as predicted by invasion percolation theory for uniformly hydrophobic systems. Instead, we observe pinning of the three-phase contact between the fluids and the solid, manifested as contact angle hysteresis, which prevents snap-off and interface retraction. In the absence of viscous dissipation, we use an energy balance to find an effective, thermodynamic, contact angle for displacement and show that this angle increases during the displacement. Displacement occurs when the local contact angles overcome the advancing contact angles at a pinned interface: it is wettability which controls the filling sequence. The product of the principal interfacial curvatures, the Gaussian curvature, is negative, implying well-connected phases which is consistent with pinning at the contact line while providing a topological explanation for the high displacement efficiencies in mixed-wet media.
Pseudomonas aeruginosa is capable of natural transformation in biofilms
Authors: Nolan Laura M. , Turnbull Lynne , Katrib Marilyn , Osvath Sarah R. , Losa Davide , Lazenby James J. , Whitchurch Cynthia B.
Published: August 2020

Natural transformation is a mechanism that enables competent bacteria to acquire naked, exogenous DNA from the environment. It is a key process that facilitates the dissemination of antibiotic resistance and virulence determinants throughout bacterial populations.

Pseudomonas aeruginosa

is an opportunistic Gram-negative pathogen that produces large quantities of extracellular DNA (eDNA) that is required for biofilm formation.

P. aeruginosa

has a remarkable level of genome plasticity and diversity that suggests a high degree of horizontal gene transfer and recombination but is thought to be incapable of natural transformation. Here we show that

P. aeruginosa

possesses homologues of all proteins known to be involved in natural transformation in other bacterial species. We found that

P. aeruginosa

in biofilms is competent for natural transformation of both genomic and plasmid DNA. Furthermore, we demonstrate that type-IV pili (T4P) facilitate but are not absolutely essential for natural transformation in

P. aeruginosa

.
The PASTA domains of Bacillus subtilis PBP2B strengthen the interaction of PBP2B with DivIB
Authors: Morales Angeles Danae , Macia-Valero Alicia , Bohorquez Laura C. , Scheffers Dirk-Jan
Published: August 2020

Bacterial cell division is mediated by a protein complex known as the divisome. Many protein–protein interactions in the divisome have been characterized. In this report, we analyse the role of the PASTA (Penicillin-binding protein And Serine Threonine kinase Associated) domains of

Bacillus subtilis

PBP2B. PBP2B itself is essential and cannot be deleted, but removing the PBP2B PASTA domains results in impaired cell division and a heat-sensitive phenotype. This resembles the deletion of divIB, a known interaction partner of PBP2B. Bacterial two-hybrid and co-immunoprecipitation analyses show that the interaction between PBP2B and DivIB is weakened when the PBP2B PASTA domains are removed. Combined, our results show that the PBP2B PASTA domains are required to strengthen the interaction between PBP2B and DivIB.
Inter-diagnostician Agreement and Inter-subject Variability for Binary Diagnostic Decisions in Psychiatry
Authors: Aiken Richard Chalon
Published: August 2020

Summary

Among the many challenges in arriving at a valid psychiatric diagnosis are the variations in biologic, genetic/ epigenetic, psychological, cognitive, and behavioral attributes of the subject population: inter-subject variability. Study of nosologic classification in psychiatry has centered primarily on inter-diagnostician variability, reliability, while neglecting inter-subject variation. We present an analysis of the diagnostic process that considers variability not only in the diagnosticians but also the subjects. The conditions for which the percent agreement statistic is the preferred measure of agreement is detailed for both a general case as well as one for which the inter-subject variation is explicitly considered. Specifics are given as to the non-intuitive fact that the smaller the inter-subject variability, the poorer can be the agreement, suggesting that an agreement statistic alone may be misleading depending on the nature of the subject population. Existing agreement statistics do not measure inter-diagnostician reliability but the agreement between two diagnosticians influenced by the inter-subject variation.
Integrated tapered fibertrode for simultaneous control and readout of neural activity over small brain volumes with reduced light-induced artefacts
Authors: Spagnolo Barbara , Peixoto Rui T. , Sileo Leonardo , Pisanello Marco , Pisano Filippo , Assad John A. , Sabatini Bernardo L. , Vittorio Massimo De , Pisanello Ferruccio
Published: August 2020

Recognizing the neural patterns underlying different brain functions is essential to achieve a more comprehensive view on how small sets of neurons organize in complex 3D networks to determine different behaviours. In this framework, optogenetic techniques have been successfully proven as a powerful tool to control brain functions achieving millisecond temporal resolution and cell-type specificity, by combining the use of light-gated opsins andad-hoclight delivery optoelectronic devices. However, targeting small brain volumes with simultaneous electrical recording results in the introduction of photoelectric artefacts, in particular when light emission and recoding sites are very close one to each other. In this work we take advantage of the photonic properties of tapered fibers to present a fully integrated fibertrode to target small brain volumes with abated photoelectric noise. The device hosts a light emitting window just below a recording pad, and exploits the angled light emission from the window to achieve simultaneous activation and electrical readout of small groups of cells with no photoelectric artifactsin vivo. Despite the highly non-planar surface of the fiber taper, window’s size, shape and electrode’s impedance can be modulated by controlling the fabrication parameters during focused ion beam milling and deposition, thus resulting in a versatile, integrated and customizable optogenetic tool for neurobiology studies in closed-loop configuration over small brain volumes.
Broad kinase inhibition mitigates early neuronal dysfunction and cognitive deficits in tauopathy
Authors: Koren Shon A. , Hamm Matthew J. , Cloyd Ryan , Fontaine Sarah N. , Chishti Emad , Lanzillotta Chiara , Rodriguez-Rivera Jennifer , Ingram Alexandria , Bell Michelle , Galvis-Escobar Sara M. , Zulia Nicholas , Domenico Fabio Di , Duong Duc , Seyfried Nicholas T. , Powell David , Vandsburger Moriel , Frolinger Tal , Hartz Anika M.S. , Koren John , Axten Jeffrey M. , Laping Nicholas J. , Abisambra Jose F.
Published: August 2020

Tauopathies are a group of more than twenty known disorders that involve progressive neurodegeneration, cognitive decline, and pathological tau accumulation. Current therapeutic strategies provide only limited, late-stage symptomatic treatment. This is partly due to lack of understanding of the molecular mechanisms linking tau and cellular dysfunction, especially during the early stages of disease progression. In this study, we treated early stage tau transgenic mice with a multi-target kinase inhibitor to identify novel substrates that contribute to cognitive impairment and exhibit therapeutic potential. Drug treatment significantly ameliorated brain atrophy and cognitive function as determined by behavioral testing and a sensitive imaging technique called manganese-enhanced magnetic resonance imaging (MEMRI) with quantitative R1 mapping. Surprisingly, these benefits occurred despite unchanged hyperphosphorylated tau levels. To elucidate the mechanism behind these improved cognitive outcomes, we performed quantitative proteomics to determine the altered protein network during this early stage in tauopathy and compare this model with the human AD proteome. We identified a cluster of preserved pathways shared with human tauopathy with striking potential for broad multi-target kinase intervention. We further report high confidence candidate proteins as novel therapeutically relevant targets for the treatment of tauopathy.

One Sentence Summary

Multi-target kinase inhibition rescues cognitive function in early stage tauopathy mice and reverses proteomic shifts common to Alzheimer’s disease in humans.
Age and dose-dependent effects of alpha-lipoic acid on human microtubule-associated protein tau-induced endoplasmic reticulum unfolded protein response: implications for Alzheimer’s disease
Authors: Zarini-Gakiye Elahe , Sanadgol Nima , Parivar Kazem , Vaezi Gholamhassan
Published: August 2020

Background

In human tauopathies, pathological aggregation of misfolded/unfolded proteins particularly microtubule-associated protein tau (MAPT, tau) is considered to be essential mechanisms that trigger the induction of endoplasmic reticulum (ER) stress. Here we assessed the molecular effects of natural antioxidant alpha-lipoic acid (ALA) in human tauR406W(htau)-induced ER unfolded protein response (ERUPR) in the young and older flies.

Methods

In order to reduce htau neurotoxicity during brain development, we used a transgenic model of tauopathy where the maximum toxicity was observed in adult flies. Then, the effects of ALA (0.001, 0.005, and 0.025% w/w of diet) in htau-induced ERUPR in the ages 20 and 30 days were evaluated.

Results

Data from expression (mRNA and protein) patterns of htau, analysis of eyes external morphology as well as larvae olfactory memory were confirmed our tauopathy model. Moreover, expression of ERUPR-related proteins involving activating transcription factor 6 (ATF6), inositol regulating enzyme 1 (IRE1), and protein kinase RNA-like ER kinase (PERK) were upregulated and locomotor function decreased in both ages of the model flies. Remarkably, the lower dose of ALA modified ERUPR and supported the reduction of behavioral deficits in youngest adults through enhancement of GRP87/Bip, reduction of ATF6, downregulation of PERK-ATF4 pathway, and activation of the IRE1-XBP1 pathway. On the other hand, only a higher dose of ALA was able to affect the ERUPR via moderation of PERK-ATF4 signaling in the oldest adults. As ALA exerts their higher protective effects on the locomotor function of younger adults when htauR406Wexpressed in all neurons (htau-elav) and mushroom body neurons (htau-ok), we proposed that ALA has age-dependent effects in this model.

Conclusion

Taken together, based on our results we conclude that aging potentially influences the ALA effective dose and mechanism of action on tau-induced ERUPR. Further molecular studies will warrant possible therapeutic applications of ALA in age-related tauopathies.