bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost Analysis With Use of Expandable Cage or Cement in Single level Thoracic Vertebrectomy in Metastasis
Authors: Katzir Miki , Rustagi Tarush , Hatef Jeffrey , Mendel Ehud
Published: December 2020

Study Design:

Retrospective case series.

Objective:

Patient with metastatic cancer frequently require spinal operations for neural decompression and stabilization, most commonly thoracic vertebrectomy with reconstruction. Objective of the study was to assess economic aspects associated with use of cement versus expandable cage in patients with single level thoracic metastatic disease. We also looked at the differences in the clinical, radiological, complications and survival differences to assess non-inferiority of PMMA over cages.

Methods:

The electronic medical records of patients undergoing single level thoracic vertebrectomy and reconstruction were reviewed. Two groups were made: PMMA and EC. Totals surgical cost, implant costs was analyzed. We also looked at the clinical/ radiological outcome, complication and survival analysis.

Results:

96 patients were identified including 70 one-level resections. For 1-level surgeries, Implant costs for use of cement—$75 compared to $9000 for cages. Overall surgical cost was significantly less for PMMA compared to use of EC. No difference was seen in clinical outcome or complication was seen. We noticed significantly better kyphosis correction in the PMMA group.

Conclusions:

Polymethylmethacrylate cement offers significant cost advantage for reconstruction after thoracic vertebrectomy. It also allows for better kyphosis correction and comparable clinical outcomes and non-inferior to cages.
Rapid Transition to Telehealth Group Exercise and Functional Assessments in Response to COVID-19
Authors: Jennings Stephen C. , Manning Kenneth M. , Bettger Janet Prvu , Hall Katherine M. , Pearson Megan , Mateas Catalin , Briggs Brandon C. , Oursler Krisann K. , Blanchard Erin , Lee Cathy C. , Castle Steven , Valencia Willy M. , Katzel Leslie I. , Giffuni Jamie , Kopp Teresa , McDonald Michelle , Harris Rebekah , Bean Jonathan F. , Althuis Katherine , Alexander Neil B. , Padala Kalpana P. , Abbate Lauren M. , Wellington Toby , Kostra James , Allsup Kelly , Forman Daniel E. , Tayade Arti S. , Wesley Alan D. , Holder Alice , Morey Miriam C.
Published: December 2020

Exercise is critical for health maintenance in late life. The COVID-19 shelter in place and social distancing orders resulted in wide-scale interruptions of exercise therapies, placing older adults at risk for the consequences of decreased mobilization. The purpose of this paper is to describe rapid transition of the Gerofit facility-based group exercise program to telehealth delivery. This Gerofit-to-Home (GTH) program continued with group-based synchronous exercise classes that ranged from 1 to 24 Veterans per class and 1 to 9 classes offered per week in the different locations. Three hundred and eight of 1149 (27%) Veterans active in the Gerofit facility-based programs made the transition to the telehealth delivered classes. Participants’ physical performance testing continued remotely as scheduled with comparisons between most recent facility-based and remote testing suggesting that participants retained physical function. Detailed protocols for remote physical performance testing and sample exercise routines are described. Translation to remote delivery of exercise programs for older adults could mitigate negative health effects.
Medication Errors in Adolescents Using Asthma Controller Medications
Authors: Clark Henry , Carpenter Delesha , Walsh Kathleen , Davis Scott A. , Garcia Nacire , Sleath Betsy
Published: December 2020

The purpose of this study was to describe the number and types of errors that adolescents and caregivers report making when using asthma controller medications. A total of 319 adolescents ages 11 to 17 with persistent asthma and their caregivers participated in this cross-sectional study. Adolescent and caregiver reports of asthma medication use were compared to the prescribed directions in the medical record. An error was defined as discrepancies between reported use and the prescribed directions. About 38% of adolescents reported 1 error in using asthma controller medications, 16% reported 2 errors, and 5% reported 3 or more errors. About 42% of caregivers reported 1 error in adolescents using asthma controller medications, 14% reported 2 errors, while 6% reported 3 or more errors. The type of error most frequently reported by both was not taking the medication at all. Providers should ask open-ended questions of adolescents with asthma during visits so they can detect and educate families on how to overcome errors in taking controller medication use.
Improving Representation of People With Disabilities in Health Education
Authors: James Tyler G. , Sullivan Meagan K. , Varnes Julia R.
Published: December 2020

Over the past two decades, there has been increasing recognition of the importance and merits of increasing representation of historically underrepresented minorities in the health professions. However, people with disabilities are less discussed in these efforts. More than one in four of U.S. adults have a disability; yet it seems that these individuals are less represented in the field of health education. This commentary discusses the merits of increasing representation of people with disabilities in the health education/promotion profession and calls for preparation programs and professional organizations to reduce systemic barriers and facilitate increased representation.
Age in relation to comorbidity and outcome in patients with high-risk TIA or minor ischemic stroke: A Swedish national observational study
Authors: Fasth Oskar , Lesén Eva , Appelros Peter , Farahmand Bahman , Hedberg Jonatan , Ladenvall Per , Mellström Carl , Åsberg Signild
Published: December 2020

Introduction

Recent trials report positive results for preventing vascular events with dual antiplatelet therapy (DAPT) in patients with high-risk TIA or minor ischemic stroke. We aimed to investigate this population regarding influence of age on vascular risk factors, hospital stay and mortality.

Patients and methods

Data on patients aged 40–100 years with TIA or ischemic stroke in the Swedish Stroke Register during 2012–13 were linked with national registers. To identify patients with high-risk TIA (ABCD2 ≥6) or minor ischemic stroke (NIHSS ≤5) eligible for DAPT, we excluded patients with atrial fibrillation, anticoagulant use, prior major bleeding, or unknown stroke severity.

Findings

We identified 10,053 potential DAPT-candidates (mean age 72.6 years, 45.2% female, 16.4% with TIA). With advancing age, most vascular risk factors increased. Antiplatelet treatment increased from 31.9% before the event to 95.5% after discharge. Within 1 year following index event, the proportion of patients with ≥1 re-admission increased with age (29.2% in 40–64 year-olds; 47.2% in 85–100 year-olds). All-cause death per 100 person-years was 6.9 (95% CI 6.4–7.4) within 1 year, and highest in the first 30 days (15.2; 95% CI 12.8–18.2). For each year of increased age, the risk of death increased with 3.5% (p = 0.128) in patients 40–64 years and with 11.8% (p < 0.001) in those ≥85 years.

Conclusions

While in theory representing a subset of patients with mild injury, our observational study highlights substantial use of health-care resources and high mortality rates among patients with high-risk TIA or minor ischemic stroke assumed eligible for DAPT.
Understanding Chinese tourist mobility and consumption-related behaviours in London using Sina Weibo check-ins
Authors: Ye Zi , Newing Andy , Clarke Graham
Published: December 2020

In this paper, we detail an individual-level analysis of under-exploited location-based social network (LBSN) data extracted from Sina Weibo, a comprehensive source for data-driven research focused on Chinese populations. The richness of the Sina Weibo data, coupled with high-quality venue and attraction information from Foursquare, enables us to track Chinese tourists visiting London and understand behaviours and mobility patterns revealed by their activities and venue-based ‘check-ins’. We use these check-ins to derive a series of indicators of mobility which reveal aggregate and individual-level behaviours associated with Chinese tourists in London, and which act as a tool to segment tourists based on those behaviours. Our data-driven tourist segmentation indicates that different groups of Chinese tourists have distinctive activity preferences and travel patterns. Our primary interest is in tourists’ consumption behaviours, and we reveal that tourists with similar activity preferences still exhibit individualised behaviours with regards to the nature and location of key consumption activities such as shopping and dining out. We aim to understand more about Chinese tourist shopping behaviours as a secondary activity associated with multi-purpose trips, demonstrating that these data could permit insights into tourist behaviours and mobility patterns which are not well captured by official tourism statistics, especially at a localised level. This analysis could be up-scaled to incorporate additional LBSN data sources and broader population subgroups in order to support data-driven urban analytics related to tourist mobilities and consumption behaviours.
WHOOP, Inc.: Digital Entrepreneurship During the Covid-19 Pandemic
Authors: Qermane Kenza , Mancha Rubén
Published: December 2020

This case is about WHOOP, Inc., a digital startup in the fitness technology space, how it responded to the Covid-19 pandemic, and its evolving business model and opportunities in the competitive wearables industry. WHOOP launched as a wearable device company. Its business model evolved from selling a device to providing software as a service (SaaS). Industry competitors included large digital organizations like Apple and Google, sportswear companies such as Under Armour and Nike, and global wearable device startups like Oura, a health technology firm in Finland. In early 2020, as a response to the Covid-19 pandemic, WHOOP launched research initiatives to track user wellbeing in the social-distancing conditions imposed worldwide. The company responded to disruptions to its supply chain, developed and evaluated algorithms to detect Covid-19 infection, and created partnerships with research organizations. Going forward, WHOOP proposed to define a strategic response to business disruptions and the new digital platform competitors.
Women’s Perceptions of Zika Virus Prevention Recommendations in Fortaleza, Brazil
Authors: Stolow Jeni , Kendall Carl , Leal Pinheiro Francisco Marto , Campos da Rocha Feitosa Mariana , Alves de Almeida Furtado Kelly , Ferreira Martins Adriano , Paz Albino dos Santos Mayara , Ecilda Lima Ellery Ana , Dias Livia , de Holanda Barreto Ivana Cristina , Moses Lina , Castro Arachu , Dunn Christopher , Kerr Ligia
Published: December 2020

As a response to the rise in microcephaly cases in 2015, Brazilian health authorities recommended a number of Zika virus (ZIKV) prevention behaviors. This study explores the contrast between the Brazilian health authorities’ health promotion response to the epidemic and the context in which the epidemic unfolded. Rapid Anthropological Assessment was used to assess how women in Fortaleza, Brazil, perceive ZIKV, ZIKV prevention recommendations, and the feasibility of adhering to these recommendations. Semi-structured interviews, informational interviews, and observations were used. The ZIKV recommendations and prevention did not represent best practices in health communication and promotion and failed to achieve their goals. Prevention recommendations were delivered without actionable steps and without considering cultural, socioeconomic, or environmental contexts. It is imperative to take advantage of this interepidemic period to apply best practices in health communication, education, and promotion to ensure populations at risk have adequate awareness, information, and resources to prevent infection.
The 2018 update of the US National Seismic Hazard Model: Additional period and site class data
Authors: Shumway Allison M , Petersen Mark D , Powers Peter M , Rezaeian Sanaz , Rukstales Kenneth S , Clayton Brandon S
Published: December 2020

As part of the update of the 2018 National Seismic Hazard Model (NSHM) for the conterminous United States (CONUS), new ground motion and site effect models for the central and eastern United States were incorporated, as well as basin depths from local seismic velocity models in four western US (WUS) urban areas. These additions allow us, for the first time, to calculate probabilistic seismic hazard curves for an expanded set of spectral periods (0.01 to 10 s) and site classes (VS30 = 150 to 1500 m/s) for the CONUS, as well as account for amplification of long-period ground motions in deep sedimentary basins in the Los Angeles, San Francisco Bay, Seattle, and Salt Lake City areas. Two sets of 2018 NSHM hazard data (hazard curves and uniform-hazard ground motions) are available: (1) 0.05°-latitude-by-0.05°-longitude gridded data for the CONUS and (2) higher resolution 0.01°-latitude-by-0.01°-longitude gridded data for the four WUS basins. Both sets of data contain basin effects in the WUS deep sedimentary basins. Uniform-hazard ground motion data are interpolated for 2, 5, and 10% probability of exceedance in 50 years from the hazard curves. The gridded data for the hazard curves and uniform-hazard ground motions, for all periods and site classes, are available for download at the U.S. Geological Survey ScienceBase Catalog ( https://doi.org/10.5066/P9RQMREV ). The design ground motions derived from the hazard curves have been accepted by the Building Seismic Safety Council for adoption in the 2020 National Earthquake Hazard Reduction Program Recommended Seismic Provisions.
Genetic Diversity of Landraces and Improved Varieties of Rice (Oryza sativa L.) in Taiwan
Authors: Hour Ai-ling , Hsieh Wei-hsun , Chang Su-huang , Wu Yong-pei , Chin Han-shiuan , Lin Yann-rong
Published: December 2020

Background

Rice, the most important crop in Asia, has been cultivated in Taiwan for more than 5000 years. The landraces preserved by indigenous peoples and brought by immigrants from China hundreds of years ago exhibit large variation in morphology, implying that they comprise rich genetic resources. Breeding goals according to the preferences of farmers, consumers and government policies also alter gene pools and genetic diversity of improved varieties. To unveil how genetic diversity is affected by natural, farmers’, and breeders’ selections is crucial for germplasm conservation and crop improvement.

Results

A diversity panel of 148 rice accessions, including 47 cultivars and 59 landraces from Taiwan and 42 accessions from other countries, were genotyped by using 75 molecular markers that revealed an average of 12.7 alleles per locus with mean polymorphism information content of 0.72. These accessions could be grouped into five subpopulations corresponding to wild rice,japonicalandraces,indicalandraces,indicacultivars, andjaponicacultivars. The genetic diversity within subpopulations was: wild rices > landraces > cultivars; andindicarice >japonicarice. Despite having less variation among cultivars,japonicalandraces had greater genetic variation thanindicalandraces because the majority of Taiwanesejaponicalandraces preserved by indigenous peoples were classified astropical japonica. Two major clusters ofindicalandraces were formed by phylogenetic analysis, in accordance with immigration from two origins. Genetic erosion had occurred in laterjaponicavarieties due to a narrow selection of germplasm being incorporated into breeding programs for premium grain quality. Genetic differentiation between early and late cultivars was significant injaponica(FST = 0.3751) but not inindica(FST = 0.0045), indicating effects of different breeding goals on modern germplasm. Indigenous landraces with unique intermediate and admixed genetic backgrounds were untapped, representing valuable resources for rice breeding.

Conclusions

The genetic diversity of improved rice varieties has been substantially shaped by breeding goals, leading to differentiation betweenindicaandjaponicacultivars. Taiwanese landraces with different origins possess various and unique genetic backgrounds. Taiwanese rice germplasm provides diverse genetic variation for association mapping to unveil useful genes and is a precious genetic reservoir for rice improvement.
Comparison of fundus fluorescein angiography, optical coherence tomography and optical coherence tomography angiography features of macular changes in Eales disease: a case series
Authors: Rajurkar Ketaki , Thakar Meenakshi , Gupta Priyadarshi , Rastogi Anju
Published: December 2020

Purpose

To study the macular features in Eales disease patients observed with fundus fluorescein angiography (FA), optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA).

Methods

A cross-sectional study was done on treatment naïve 31 eyes (23 patients) with Eales disease. Baseline parameters such as Best-corrected visual acuity (BCVA), slit-lamp bio microscopy (SLB), indirect ophthalmoscopy, FA, spectral-domain OCT {quantitative (central macular thickness [CMT]) and qualitative analysis on SD-OCT} and OCTA were performed. Any media opacity precluding the above investigations was excluded.

Results

Macular findings comprised of- epiretinal membrane, macular exudation, full thickness macular hole, sub internal limiting membrane bleed, cystoid macular oedema, neurosensory detachment and retinal thickening. Sixteen (51.6%) of our patients had macular changes as seen on all modalities together. SLB and indirect ophthalmoscopy missed macular findings in 50% patients and FA in 18.8% patients. OCT and OCTA diagnosed all macular findings. On comparison of mean BCVA in patients with macular involvement on FA, OCT and OCTA, compared to those without macular involvement, patients with macular involvement had lower BCVA (p 0.000, 0.01 and 0.001 respectively). Thus, FA missed many patients who had significant macular involvement and hence less vision.

Conclusion

Eales disease though described in literature as classically being peripheral retina disease process, also has macular involvement. OCT and OCTA are useful guides to evaluation of macular involvement in these patients. The latter seems to be superior to FA in detecting macular abnormalities in this ailment. OCTA is non-invasive and shows deep capillary plexus changes which are not shown by any other modality.
Potential predictors of type-2 diabetes risk: machine learning, synthetic data and wearable health devices
Authors: Stolfi Paola , Valentini Ilaria , Palumbo Maria Concetta , Tieri Paolo , Grignolio Andrea , Castiglione Filippo
Published: December 2020

Background

The aim of a recent research project was the investigation of the mechanisms involved in the onset of type 2 diabetes in the absence of familiarity. This has led to the development of a computational model that recapitulates the aetiology of the disease and simulates the immunological and metabolic alterations linked to type-2 diabetes subjected to clinical, physiological, and behavioural features of prototypical human individuals.

Results

We analysed the time course of 46,170 virtual subjects, experiencing different lifestyle conditions. We then set up a statistical model able to recapitulate the simulated outcomes.

Conclusions

The resulting machine learning model adequately predicts the synthetic dataset and can, therefore, be used as a computationally-cheaper version of the detailed mathematical model, ready to be implemented on mobile devices to allow self-assessment by informed and aware individuals.
The computational model used to generate the dataset of this work is available as a web-service at the following address: http://kraken.iac.rm.cnr.it/T2DM.
Extracellular signal-regulated kinase 1/2 is required for complement component C1q and fibronectin dependent enhancement of Fcγ- receptor mediated phagocytosis in mouse and human cells
Authors: Willmann Emily A. , Pandurovic Vesna , Jokinen Anna , Beckley Danielle , Bohlson Suzanne S.
Published: December 2020

Background

C1q is a soluble pattern recognition protein that regulates multiple leukocyte functions, and deficiency in C1q results in autoimmunity. C1q stimulates enhanced phagocytic function through multiple mechanisms including the rapid enhancement of Fcγ receptor (FcγR) -mediated phagocytosis. The molecular mechanism responsible for this rapid enhancement of phagocytic function is unknown. The purpose of this study was to investigate the molecular pathway required for C1q-dependent enhanced phagocytosis.

Results

Leukocyte associated immunoglobulin like receptor-1 (LAIR-1) is a receptor that mediates C1q-dependent activation of leukocytes; however, using LAIR-1 deficient mouse bone marrow derived macrophages (BMDM), we demonstrated that LAIR-1 was not required for C1q-dependent enhanced FcγR-mediated phagocytosis. A phospho-kinase array identified extracellular signal-regulated kinase (ERK) 1/2 as dysregulated following activation with C1q. Validation of the array in BMDM and the human monocyte cell line THP-1 demonstrated a decrease in basal ERK1/2 phosphorylation in C1q-stimulated cells compared to control cells. However, subsequent stimulation with immune complexes stimulated rapid upregulation of phosphorylation. The extracellular matrix protein fibronectin regulates enhanced phagocytic activity in macrophages similar to C1q, and both C1q and fibronectin-dependent enhanced phagocytosis required ERK1/2 since both were blocked by pharmacologic inhibition of ERK1/2. Furthermore, diminished C1q-dependent ERK1/2 phosphorylation was sustained after four-hour treatment with lipopolysaccharide and correlated with a significant reduction in TNFα production.

Conclusions

These data demonstrate that C1q and fibronectin utilize a similar ERK1/2-dependent mechanism for enhanced phagocytosis, which should lead to development of novel approaches to modulate C1q-dependent regulation of macrophage activation, inflammation and autoimmunity.
SlGT11 controls floral organ patterning and floral determinacy in tomato
Authors: Yang Liling , Qi Shilian , Touqeer Arfa , Li Haiyang , Zhang Xiaolan , Liu Xiaofeng , Wu Shuang
Published: December 2020

Background

Flower development directly affects fruit production in tomato. Despite the framework mediated by ABC genes have been established in Arabidopsis, the spatiotemporal precision of floral development in tomato has not been well examined.

Results

Here, we analyzed a novel tomatostamenless like flower(slf) mutant in which the development of stamens and carpels is disturbed, with carpelloid structure formed in the third whorl and ectopic formation of floral and shoot apical meristem in the fourth whorl. Using bulked segregant analysis (BSA), we assigned the causal mutation to the geneSolanum lycopersicum GT11(SlGT11) that encodes a transcription factor belonging to Trihelix gene family.SlGT11is expressed in the early stages of the flower and the expression becomes more specific to the primordium position corresponding to stamens and carpels in later stages of the floral development. Further RNAi silencing ofSlGT11verifies the defective phenotypes of theslfmutant. The carpelloid stamen inslfmutant indicates that SlGT11 is required for B-function activity in the third whorl. The failed termination of floral meristem and the occurrence of floral reversion inslfindicate that part of the C-function requires SlGT11 activity in the fourth whorl. Furthermore, we find that at higher temperature, the defects ofslfmutant are substantially enhanced, with petals transformed into sepals, all stamens disappeared, and the frequency of ectopic shoot/floral meristem in fourth whorl increased, indicating that SlGT11 functions in the development of the three inner floral whorls. Consistent with the observed phenotypes, it was found that B, C and an E-type MADS-box genes were in part down regulated inslfmutants.

Conclusions

Together with the spatiotemporal expression pattern, we suggest thatSlGT11functions in floral organ patterning and maintenance of floral determinacy in tomato.
Nutraceuticals, phytochemicals, and radical quenching ability of selected drought-tolerant advance lines of vegetable amaranth
Authors: Sarker Umakanta , Oba Shinya
Published: December 2020

Background

Vegetable amaranth is a source of natural phytopigments and functional components of the commercial food industry for sustainable health benefits across the globe. It is guessed that recently identified amaranth (drought-tolerant) genotypes may contain ample phytopigments and phytochemicals suitable to extract juice as drinks. Hence, phytopigments and phytochemicals content of amaranth were assessed in detail for suitability as drinks to feed the phytochemicals deficient community across the globe.

Results

The selected amaranth contained adequate carbohydrates, protein, moisture, and dietary fiber, phytopigments, minerals, phytochemicals including the ability to scavenge radicals. Nine flavonoids compounds were estimated in amaranth genotypes including six flavonols, one flavanol, one flavone, and one flavanone. It is the first effort in which we identified one flavonol such as myricetin, one flavanol, such as catechin, one flavone i. e., apigenin, and one flavanone, like naringenin in drought-tolerant vegetable amaranth. Across six flavonols, quercetin and rutin were the most noteworthy compounds followed by myricetin and isoquercetin. Across the accessions, AT7 and AT15 had abundant phytochemicals, and radical quenching ability including considerable proximate, nutraceuticals, and phytopigments in comparison to the accessions AT3 and AT11. AT15 demonstrated the maximum total flavonols including the highest rutin and hyperoside. AT7 showed high total flavonols including the highest quercetin, isoquercetin, myricetin, and kaempferol. The association of values revealed that studied phytopigments and phytochemicals of vegetable amaranth accessions demonstrated good radical quenching ability of 2,2-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) and 2,2- Diphenyl-1-picrylhydrazyl equivalent to Trolox.

Conclusions

These advance lines AT7 and AT15 had abundant nutraceuticals, phytopigments, and phytochemicals including radical quenching ability. These lines might significantly contribute to the promotion of health benefits and feeding the community across the globe deficit in nutraceuticals and antioxidants. Identified flavonoid compounds open the new route for pharmacological study.
Improving mucosal anesthesia for awake endotracheal intubation with a novel method: a prospective, assessor-blinded, randomized controlled trial
Authors: Han Chunji , Li Peng , Guo Zhenggang , Guo Ying , Sun Li , Chen Gang , Qiu Xiaojue , Mi Weidong , Zhang Changsheng , Berra Lorenzo
Published: December 2020

Background

Topical anesthesia is a crucial step in awake endotracheal intubation for providing favorable intubation conditions. The standard of care technique for awake intubation at our institution, which consists of oropharyngeal tetracaine spray, can result in inadequate mucosal anesthesia. Therefore, we sought to compare the effectiveness of dyclonine hydrochloride mucilage to the standard of care tetracaine in achieving anesthesia of the upper airways for awake endotracheal intubation.

Methods

This is a randomized, assessor-blinded, prospective study. From Jun. 1st, 2019 to Aug. 1st, 2019, patients scheduled for either endoscopic submucosal dissection or peroral endoscopic myotomy were enrolled and randomly allocated into two groups after obtaining written informed consent: patients allocated to novel awake intubation care (Group N-AIC) received a single administration of oral dyclonine hydrochloride mucilage, whereas patients allocated to standard awake intubation care (Group S-AIC) received three oropharyngeal tetracaine sprays before transcricoid tetracaine injection before awake intubation. Mean arterial pressure (MAP), which was the primary outcome of this study, as well as heart rate (HR) were recorded throughout the procedure and compared between the two groups. Feeling of numbness, nausea, and intubation conditions after topical anesthesia were also assessed.

Results

Sixty patients were enrolled and completed the study. Baseline MAP and HR were similar between the two groups. However, hemodynamic responses to intubation and gastrointestinal endoscopy, especially MAP, were significantly less elevated in Group N-AIC. The degree of numbness of the oropharyngeal mucosa after topical anesthesia did not differ between the two groups, neither did the feeling of nausea during laryngoscopy. The amount of pharyngeal secretions before intubation was less in Group N-AIC. Total intubation time was significantly shorter in Group N-AIC when compared to Group S-AIC (18.4 ± 2.86 vs. 22.3 ± 6.47, P < 0.05). Extubation bucking was significantly less frequent in Group N-AIC (13.3% vs. 76.7%). Patients received in Group N-AIC had a lower rate of post-extubation sore throat compared to Group S-AIC (6.7% vs. 43.3%). No adverse side effects attributable to either tetracaine or dyclonine were observed in this study.

Conclusions

In awake endotracheal intubation, novel care using oral dyclonine hydrochloride mucilage can provide more favorable mucosal anesthesia and better intubation conditions compared to standard of care practice using oropharyngeal tetracaine spray.

Trial registration

ChiCTR1900023151. Date of registration: May 14th, 2019.
Relationship between angiography timing and angiographic visualization of extravasation in patients with acute non-variceal gastrointestinal bleeding
Authors: Choi Chungjo , Lim Hyun , Kim Min-Jeong , Lee Bo Young , Kim Sung-Yeun , Soh Jae Seung , Kang Ho Suk , Moon Sung Hoon , Kim Jong Hyeok
Published: December 2020

Background

Angiographic embolization is now considered the first-line therapy for acute gastrointestinal (GI) bleeding refractory to endoscopic therapy. The success of angiographic embolization depends on the detection of the bleeding site. This study aimed to identify the clinical and procedural predictors for the angiographic visualization of extravasation, including angiography timing, as well as analyze the outcomes of angiographic embolization according to the angiographic visualization of extravasation.

Methods

The clinical and procedural data of 138 consecutive patients (mean age, 66.5 years; 65.9% men) who underwent angiography with or without embolization for acute non-variceal GI bleeding between February 2008 and July 2018 were retrospectively analyzed.

Results

Of the 138 patients, 58 (42%) had active extravasation on initial angiography and 113 (81.9%) underwent embolization. The angiographic visualization of extravasation was significantly higher in patients with diabetes (p = 0.036), a low platelet count (p = 0.048), high maximum heart rate (p = 0.002) and AIMS65 score (p = 0.026), upper GI bleeding (p = 0.025), and short time-to-angiography (p = 0.031). The angiographic embolization was successful in all angiograms, with angiographic visualization of extravasation (100%). The clinical success of patients without angiographic visualization of extravasation (83.9%) was significantly higher than that of patients with angiographic visualization of extravasation (65.5%) (p = 0.004). In multivariate analysis, the time-to-angiography (odds ratio 0.373 [95% CI 0.154–0.903], p = 0.029) was the only significant predictor associated with the angiographic visualization of extravasation. The cutoff value of time-to-angiography was 5.0 h, with a sensitivity and specificity of 79.3% and 47.5%, respectively (p = 0.012).

Conclusions

Angiography timing is an important factor that is associated with the angiographic visualization of extravasation in patients with acute GI bleeding. Angiography should be performed early in the course of bleeding in critically ill patients.
Lusutrombopag is effective and safe in patients with chronic liver disease and severe thrombocytopenia: a multicenter retrospective study
Authors: Nomoto Hiroaki , Morimoto Naoki , Miura Kouichi , Watanabe Shunji , Takaoka Yoshinari , Maeda Hiroshi , Sasaki Takahiro , Koyashiki Yohei , Kurata Hidekazu , Numao Norikatsu , Isoda Norio , Yamamoto Hironori
Published: December 2020

Background

Chronic liver disease (CLD) is often complicated by severe thrombocytopenia (platelet count < 50,000/µL). Platelet transfusion has been a gold standard for increasing the platelet count to prevent hemorrhagic events in such patients. Lusutrombopag, a thrombopoietin receptor agonist, can increase the platelet count in such patients when invasive procedures are scheduled. Former studies on lusutrombopag included patients with a platelet count of > 50,000/µL at baseline: the proportions of patients who did not require platelet transfusion were 84–96%, which might be overestimated.

Methods

The efficacy and safety of lusutrombopag were retrospectively investigated in CLD patients with platelet count of < 50,000/µL, a criterion for platelet transfusion, in real-world settings. We examined the proportion of patients who did not require platelet transfusion in 31 CLD patients, which exceeded a minimum required sample size (21 patients) calculated by 80% power at a significance level of 5%. Lusutrombopag, 3 mg once daily, was administered 8–18 days before scheduled invasive procedures.

Results

Among 31 patients who received lusutrombopag, 23 patients (74.2%) patients showed a platelet count of ≥ 50,000/µL (Group A) and did not require platelet transfusion. The remaining 8 patients (25.8%) did not reached platelet ≥ 50,000/µL (Group B). The means of platelet increase were 38,000/µL and 12,000/µL in groups A and B, respectively. A low platelet count at baseline was a characteristic of patients in group B. Among 13 patients who repeatedly used lusutrombopag, lusutrombopag significantly increased the platelet count as the initial treatment. When all repeated uses of lusutrombopag were counted among these 13 patients, platelet transfusion was not required in 82.1% (23/28) of treatments. Although one patient showed portal thrombosis after lusutrombopag treatment, the thrombosis was disappeared by anticoagulant treatment for 35 days. The degree of platelet increase with lusutrombopag was larger than that in their previous platelet transfusion.

Conclusions

The proportion of patients who did not require platelet transfusion was 74.2%, which is smaller than that in former studies which included CLD patients with a platelet count of > 50,000/µL. However, lusutrombopag is effective and safe for CLD patients with a platelet count of < 50,000/µL.
Design of the DYNAMO study: a multi-center randomized controlled trial to investigate the effect of pre-thickened oral nutritional supplements in nursing home residents with dysphagia and malnutrition (risk)
Authors: Huppertz Viviënne A. L. , van Wijk Nick , Baijens Laura W. J. , de Groot Lisette C. P. G. M. , Halfens Ruud J. G. , Schols Jos M. G. A. , van Helvoort Ardy
Published: December 2020

Background

Oropharyngeal Dysphagia (OD) and malnutrition are frequently reported conditions in nursing home residents, and are often interrelated. Best care for dysphagic residents with, or at risk of, malnutrition should target adequate nutritional intake and the safety and efficacy of swallowing. The effect of oral nutritional supplements (ONS) suitable for nursing home residents with concurrent OD and malnutrition (risk) on nutritional status has not been investigated before. The current study aims to investigate the effect of daily use of a range of pre-thickened ONS on the body weight of nursing home residents with OD and malnutrition (risk) compared to standard OD and nutritional care.

Methods / design

The DYNAMO study is a randomized, controlled, multi-center, open label trial with two parallel groups. Study participants will be recruited in nursing homes of several care organizations in the south of the Netherlands. Study duration is 12 weeks. Residents in the control group will receive standard OD and nutritional care, and residents in the test group will receive standard OD and nutritional care with extra daily supplementation of pre-thickened ONS.

The main outcome parameter is the difference in body weight change between the control and test groups. An a priori estimation of the required sample size per group (control / test) totals 78. Other outcome parameters are differences in: nutritional intake, health-related quality of life, OD-specific quality of life, activities of daily living, vital signs, and blood nutrient and metabolite levels.

Discussion

Regular ONS could address the nutritional needs of nursing home residents with malnutrition (risk), but might be too thin and unsafe for residents with OD. Pre-thickened ONS is suitable for residents with OD. It offers the advantage of being a ready-to-use amylase-resistant product available in several consistencies which are able to increase swallowing efficacy and safety. The DYNAMO study is the first to investigate the effects of pre-thickened ONS on nutritional status in nursing home residents with concurrent OD and malnutrition (risk).

Trial registration

Netherlands Trial Register (NTR): NTR NL7898. Registered 24 July 2019, https://www.trialregister.nl/trial/7898
Novel association between FOXO3 rs2232365 polymorphism and late-onset preeclampsia: a case-control candidate genetic study
Authors: Pan Xuefeng , Wei Benjie , Wang Hong , Ma Lingyu , Du Zhaoli , Chen Ying
Published: December 2020

Background

Both genetic susceptibility and dysregulated lipid metabolism are important susceptibilities to preeclampsia. In the study, we devote to investigate the associations of FOXO3 and TLR7 genetic polymorphisms with preeclampsia in a Chinese population.

Methods

This case-control study involved 335 Han Chinese pregnant women, including 177 pregnant women with preeclampsia and 158 healthy controls. The preeclampsia group was further sub-grouped into early-onset preeclampsia (EOPE, n = 70)and late-onset preeclampsia (LOPE, n = 107. Three single nucleotide polymorphisms (SNPs), including FOXO3 (rs2232365, rs3761548), and TLR7 rs3853839 were genotyped by multiplex PCR for targeted next-generation sequencing. The χ2 test and multiple interaction effect analyses were performed to determine the association of three SNPs with serum lipid levels and thyroid function in women with preeclampsia.

Results

The genotype (CC vs. TT + CT) distribution of rs2232365 revealed a significant association with LOPE (P = 0.004, odds ratio = 3.525 (0.95 CI: 1.498–8.164)). No significant difference was found in the genotype and allele frequencies of rs3761548 and rs3853839 between controls and cases (P > 0.05). Moreover, the genotype CT/TT of rs2232365 was significantly correlated with increased TG/HDL levels in the LOPE group (p = 0.014).

Conclusions

The polymorphisms of rs2232365 are associated with the risk of LOPE and may modulate TG/HDL levels in pregnant women with LOPE.
Bile acid, glucose, lipid profile, and liver enzyme changes in prediabetic patients 1 year after sleeve gastrectomy
Authors: Mak Tsz Kin , Huang Shifang , Guan Bingsheng , Au Hoyin , Chong Tsz Hong , Peng Juzheng , Chen Fazhi , Liang Chuqiao , Lai Wanjing , Ho LongLam , Wang Cunchuan , Yang Jingge
Published: December 2020

Background

Few articles have studied individuals with prediabetes after sleeve gastrectomy. Bile acid and lipid levels remain inconsistent in postbariatric patients. The purpose of this study was to explore bile acid, glucose, lipid, and liver enzyme changes in patients with different diabetes statuses who underwent sleeve gastrectomy. The impact of bariatric surgery and its potential benefits for prediabetic patients was also discussed.

Methods

A total of 202 overweight and obese patients who underwent bariatric surgery in our hospital between January 2016 and October 2018 were retrospectively reviewed. Patients were divided into prediabetes (n = 32), nondiabetes (n = 144), and diabetes (n = 26) groups and analysed. Glucose and lipid data were collected from medical records at baseline and at each follow-up visit.

Result

Significant improvements in body weight, glucose and lipid levels, and liver enzymes (P ≤ 0.05) in prediabetic patients were found throughout the first year postoperatively. Improvement in glycaemic control was first seen one month postoperatively, followed by persistent improvement in the next 12 months. Total bile acid (TBA) decreased, which was associated with ALT improvement in prediabetic patients 1-year post-surgery. There were no significant differences in HbA1c, glucose, or triglycerides (TGs) between prediabetic and T2DM patients or between prediabetic and nondiabetic patients at 12 months post-surgery.

Conclusion

LSG is highly effective at interfering with glucose and lipid levels as well as total bile acid levels in prediabetic patients in the first year postoperatively. Thus, LSG is indeed an alternative for overweight and obese prediabetic patients.
Adenocarcinoma arising from a foregut cyst of the diaphragm: importance of multimodality treatment: a case report
Authors: Furak Jozsef , Rieth Anna , Ottlakan Aurel , Nemeth Tibor , Torday Laszlo , Tiszlavicz Laszlo , Lazar Gyorgy
Published: December 2020

Background

Benign foregut cysts usually develop in the thorax most of all in the mediastinum. Rare cases involving various abdominal organs, such as liver, stomach or pancreas have been previously published, mostly occurring in the retroperitoneum.

Case presentation

We herein present an adenocarcinoma of a foregut cyst involving the left side of the diaphragm, left lower lobe of the lung, and left lobe of the liver, successfully removed through multivisceral resection. In between drug holidays, postoperative oncological treatment has been ongoing for nearly 4 years. In terms of chemotherapy, FOLFOX 4 regime, capacitabine monotherapy and later on next generation sequencing has been attempted, although the patient refused the later treatment option. Despite multimodality (combined surgical and oncological) treatment, local- and later on loco-regional recurrence has been detected on follow-up staging, influencing further chemotherapy regime. Taking both the fairly unknown type of the tumor and uncertain response rate to oncological therapy into account, prolonged tumor pace with fairly stable general patient state was reached throughout the course of the disease.

Conclusion

Through surgical tumor resection, and postoperative chemotherapy the patient managed to maintain an acceptable quality of life without major symptoms during ongoing treatment. During our own case, with multiple organ involvement, multivisceral resection, with multimodality treatment had considerable effect in prolonging the lifespan of the patient.
The use of hyperbaric oxygen to treat actinic rectal fistula after SpaceOAR use and radiotherapy for prostate cancer: a case report
Authors: Kashihara Tairo , Inaba Koji , Komiyama Motokiyo , Nakayama Hiroki , Iijima Kotaro , Nishioka Shie , Okamoto Hiroyuki , Kikkawa Nao , Kubo Yuko , Shima Satoshi , Nakamura Satoshi , Takahashi Ayaka , Takahashi Kana , Okuma Kae , Murakami Naoya , Igaki Hiroshi , Nakayama Yuko , Fukunaga Arinobu , Matsui Yoshiyuki , Fujimoto Hiroyuki , Itami Jun
Published: December 2020

Background

In definitive radiation therapy for prostate cancer, the SpaceOAR® System, a hydrogel spacer, is widely used to decrease the irradiated dose and toxicity of rectum. On the other hand, periprostatic abscesses formation and rectal perforation are known as rare adverse effects of SpaceOAR. Nevertheless, there is a lack of reports clarifying the association between aggravation of abscesses and radiation therapy, and hyperbaric oxygen therapy (HBOT) is effective for a peri-SpaceOAR abscess and rectal perforation.

Case presentation

We report a case of a 78-year-old high-risk prostate cancer patient. After SpaceOAR insertion into the correct space, he started to receive external beam radiation therapy (EBRT). He developed a fever, perineal pain and frequent urination after the completion of EBRT, and the magnetic resonance imaging (MRI) revealed a peri-SpaceOAR abscess. Scheduled brachytherapy was postponed, administration of antibiotics and opioid via intravenous drip was commenced, and transperineal drainage was performed. After the alleviation of the abscess, additional EBRT instead of brachytherapy was performed with MRI-guided radiation therapy (MRgRT). On the last day of the MRgRT, perineal pain reoccurred, and MRI and colonoscopy detected the rectal perforation. He received an intravenous antibiotics drip and HBOT, and fully recovered from the rectal perforation.

Conclusions

Our report indicates that EBRT can lead to a severe rectum complication by causing inflammation for patients with a peri-SpaceOAR abscess. Furthermore, HBOT was effective for the peri-SpaceOAR abscess and rectal perforation associated with EBRT.
How does cognitive function measured by the reaction time and critical flicker fusion frequency correlate with the academic performance of students?
Authors: Prabu Kumar Archana , Omprakash Abirami , Kuppusamy Maheshkumar , K.N. Maruthy , B.W.C. Sathiyasekaran , P.V. Vijayaraghavan , Ramaswamy Padmavathi
Published: December 2020

Background

The reaction time (RT) is “the time taken for the appearance of rapid voluntary reaction by an individual following a stimulus, either auditory or visual” and the Critical Flickering Fusion Frequency (CFFF) is “the rate at which successively presented light stimuli appear to be steady and continuous”. RT and CFFF are commonly used for the assessment of cognitive functions that are known to influence academic performance. However, data about the exact correlation between these are scarce, particularly in India. This research aimed to study the association between visual RT (VRT), auditory RT (ART) and CFFF and their impact on the academic performance of undergraduate students.

Methods

This cross-sectional study was conducted on 700 students of Faculty of Medicine and Dentistry at a private medical university in South India, during the period from 2015 to 2017. The VRT, ART and CFFF were evaluated, and the best out of three subsequent attempts was recorded. The mean score (in percentage) of the three best marks out of the five internal assessments for the course during each academic year was considered for analysis. The association between the different cognitive tests and the average academic performance was analysed.

Results

Female students had faster VRT (n = 345, mean = 243.97, SD = 83.87) than male students (n = 273, mean = 274.86, SD = 96.97) (p = 0.001). VRT and ART had a moderate negative correlation with academic performance (for ART,r = − 0.42,p < 0.001; for VRT;r = − 0.40,p < 0.001). CFFF had a very weak positive correlation with academic performance (r = 0.19,p = 0.01). The only independent predictors of academic performance were RT and gender (Adjusted R2 = 0.11).

Conclusion

Although there is a correlation between CFFF and cognitive function, our study showed only a weak correlation between CFFF and academic performance. Female students had faster RTs, and gender was an independent predictor of academic performance. Rather, students with faster RTs appear to have an advantage in academic performance.