bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraoperative complications in total hip arthroplasty using a new cementless femoral implant (SP-CL®)
Authors: Tootsi Kaspar , Lees Loviisa , Geiko Boris , Märtson Aare
Published: May 2020

Background

Considering the excellent results already achieved in total hip arthroplasty (THA), new implants must be at least as safe as currently used implants and lead to longer survival. A new cementless femoral stem, SP-CL®, has been introduced. The aim of this study is to evaluate intraoperative complications and assess the risk factors of THA with the SP-CL®implant.

Materials and methods

All THA patients who were operated on using the SP-CL®(LINK, Hamburg, Germany) implant between 2015 and 2018 were included in the analysis. Data were collected from medical records from national and hospital electronic databases. Radiological measurements were made from standard pre- and postoperative radiographs.

Results

A total of 222 THA were performed using the SP-CL®implant. The average age of the patients was 56 years (14–77 years). There were 1 transient sciatic nerve injury, 1 acetabular fracture, and 11 (5.0%) intraoperative femoral fractures (IFF), of which 7 were treated with cerclage wire or titanium band during the operation while the other fractures were treated conservatively. None of the IFF patients were revised due to fracture during the follow-up period (one revision due to infection). The radiographic morphology of proximal femur was associated with increased risk of IFF (p = 0.02).

Conclusions

The results of the current study demonstrate a 5% incidence of IFF when using the LINK SP-CL®femoral stem in THA. The radiographic morphology of the proximal femur was an important predictor of IFF and should be assessed when using SP-CL®.

Level of evidence

Level 4.
Probing contacts of inhibitor locked in transition states in the catalytic triad of DENV2 type serine protease and its mutants by 1H, 19F and 15 N NMR spectroscopy
Authors: Agback Peter , Woestenenk Esmeralda , Agback Tatiana
Published: May 2020

Background

Detailed structural knowledge of enzyme-inhibitor complexes trapped in intermediate state is the key for a fundamental understanding of reaction mechanisms taking place in enzymes and is indispensable as a structure-guided drug design tool. Solution state NMR uniquely allows the study of active sites of enzymes in equilibrium between different tautomeric forms. In this study 1H, 19F and 15 N NMR spectroscopy has been used to probe the interaction contacts of inhibitors locked in transition states of the catalytic triad of a serine protease. It was demonstrated on the serotype II Dengue virus NS2B:NS3pro serine protease and its mutants, H51N and S135A, in complex with high-affinity ligands containing trifluoromethyl ketone (tfk) and boronic groups in the C-terminal of tetra-peptides.

Results

Monitoring 19F resonances, shows that only one of the two isomers of the tfk tetra-peptide binds with NS2B:NS3pro and that access to the bulk of the active site is limited. Moreover, there were no bound water found in proximity of the active site for any of the ligands manifesting in a favorable condition for formation of low barrier hydrogen bonds (LBHB) in the catalytic triad. Based on this data we were able to identify a locked conformation of the protein active site. The data also indicates that the different parts of the binding site most likely act independently of each other.

Conclusions

Our reported findings increases the knowledge of the detailed function of the catalytic triad in serine proteases and could facilitate the development of rational structure based inhibitors that can selectively target the NS3 protease of Dengue type II (DENV2) virus. In addition the results shows the usefulness of probing active sites using 19F NMR spectroscopy.
Hybridization and introgression between Helicoverpa armigera and H. zea: an adaptational bridge
Authors: Cordeiro Erick M. G. , Pantoja-Gomez Laura M. , de Paiva Julia B. , Nascimento Antônio R. B. , Omoto Celso , Michel Andrew P. , Correa Alberto S.
Published: May 2020

Background

Invasion of organisms into new ecosystems is increasingly common, due to the global trade in commodities. One of the most complex post-invasion scenarios occurs when an invasive species is related to a native pest, and even more so when they can hybridize and produce fertile progeny. The global pestHelicoverpa armigerawas first detected in Brazil in 2013 and generated a wave of speculations about the possibility of hybridization with the native sister taxonHelicoverpa zea. In the present study, we used genome-wide single nucleotide polymorphisms from field-collected individuals to estimate hybridization betweenH. armigeraandH. zeain different Brazilian agricultural landscapes.

Results

The frequency of hybridization varied from 15 to 30% depending on the statistical analyses. These methods showed more congruence in estimating that hybrids contained approximately 10% mixed ancestry (i.e. introgression) from either species. Hybridization also varied considerably depending on the geographic locations where the sample was collected, forming a ‘mosaic’ hybrid zone where introgression may be facilitated by environmental and landscape variables. Both landscape composition and bioclimatic variables indicated that maize and soybean cropland are the main factors responsible for high levels of introgression in agricultural landscapes. The impact of multipleH. armigeraincursions is reflected in the structured and inbred pattern of genetic diversity.

Conclusions

Our data showed that the landscape composition and bioclimatic variables influence the introgression rate betweenH. armigeraandH. zeain agricultural areas. Continuous monitoring of the hybridization process in the field is necessary, since agricultural expansion, climatic fluctuations, changing composition of crop species and varieties, and dynamic planting seasons are some factors in South America that could cause a sudden alteration in the introgression rate betweenHelicoverpaspecies. Introgression between invasive and native pests can dramatically impact the evolution of host ranges and resistance management.
Nanopore sequencing reveals genomic map of CTX-M-type extended-spectrum β-lactamases carried by Escherichia coli strains isolated from blue mussels (Mytilus edulis) in Norway
Authors: Grevskott Didrik H. , Salvà-Serra Francisco , Moore Edward R. B. , Marathe Nachiket P.
Published: May 2020

Background

Environmental surveillance of antibiotic resistance can contribute towards better understanding and management of human and environmental health. This study applied a combination of long-read Oxford Nanopore MinION and short-read Illumina MiSeq-based sequencing to obtain closed complete genome sequences of two CTX-M-producing multidrug-resistant Escherichia coli strains isolated from blue mussels (Mytilus edulis) in Norway, in order to understand the potential for mobility of the detected antibiotic resistance genes (ARGs).

Results

The complete genome sequence of strain 631 (E. coli sequence type 38) was assembled into a circular chromosome of 5.19 Mb and five plasmids (between 98 kb and 5 kb). The majority of ARGs cluster in close proximity to each other on the chromosome within two separate multidrug-resistance determining regions (MDRs), each flanked by IS26 transposases. MDR-1 carries blaTEM-1, tmrB, aac(3)-IId, aadA5, mph(A), mrx, sul1, qacEΔ1 and dfrA17; while MDR-2 harbors aph(3″)-Ib, aph(6)-Id, blaTEM-1, catA1, tet(D) and sul2. Four identical chromosomal copies of blaCTX-M-14 are located outside these regions, flanked by ISEc9 transposases. Strain 1500 (E. coli sequence type 191) exhibited a circular chromosome of 4.73 Mb and two plasmids (91 kb and 4 kb). The 91 kb conjugative plasmid belonging to IncI1 group carries blaCTX-M-15 and blaTEM-1 genes.

Conclusion

This study confirms the efficacy of combining Nanopore long-read and Illumina short-read sequencing for determining complete bacterial genome sequences, enabling detection and characterization of clinically important ARGs in the marine environment in Norway, with potential for further dissemination. It also highlights the need for environmental surveillance of antibiotic resistance in low prevalence settings like Norway.
Aortic annular enlargement techniques using an original patch for prosthetic valve endocarditis
Authors: Matsuzaki Kanji , Iguchi Yusuke , Tsukada Toru , Imai Akito , Konishi Taisuke , Watanabe Yasunori
Published: May 2020

Background

Prosthetic valve endocarditis (PVE) is a serious complication, and it is difficult to treat marked adhesion and infectious tissue.

Case presentation

There were four patients with aortic PVE, whose ages ranged from 59 to 80 years. In all patients, transoesophageal echocardiography revealed periannular abscess formation. We applied aortic annular enlargement techniques using a composite three-layer patch to repair the defects after radical debridement of the abscesses, and then replaced the prosthetic valves on the reconstructed annuli. All patients received antibiotics after surgery and recovered well without recurrence.

Conclusions

The aortic annular enlargement techniques provided a good field of vision at the complicated annulus, and our original patch was useful for repairing the aortic annulus and its surrounding apparatus.
Longitudinal association between housing accessibility and activities of daily living: the role of self-efficacy and control in people ageing with Parkinson’s disease
Authors: Gefenaite Giedre , Björk Jonas , Iwarsson Susanne , Slaug Björn , Schmidt Steven M. , Nilsson Maria H.
Published: May 2020

Background

External housing-related control beliefs (HCB) and general self-efficacy (GSE) influence different health outcomes in the general ageing population, but there is no information of their role in people ageing with Parkinson’s disease (PD). This study aimed to longitudinally assess the role of external HCB and GSE on the association between housing accessibility and activities of daily living (ADL) among people ageing with PD.

Methods

Baseline and 3-year follow-up data on 130 community-living participants from the Swedish project ‘Home and Health in People Ageing with PD’ were collected. Assessments addressed housing accessibility, external HCB, GSE, generic ADL and ADL specific to PD. The moderating effects of external HCB and GSE were assessed by including an interaction term in multivariable logistic regression.

Results

There were statistically significant interactions between housing accessibility and GSE on ADL (p = 0.03), and housing accessibility and external HCB on PD specific ADL (p = 0.03). After stratifying the analyses by GSE, housing accessibility problems led to more dependence and difficulty in ADL in participants with low GSE (OR 1.14; 95% CI 1.02–1.28). After stratifying by external HCB, housing accessibility increased dependence and difficulty in PD specific ADL in participants with low external HCB (OR 1.35; 95% CI 1.03–1.76).

Discussion

The results suggest that housing accessibility predicts ADL in people with PD with GSE and external HCB playing a moderating role for generic ADL and ADL specific to PD, respectively. Further longitudinal studies should validate these findings and explore their potential application in PD-related care and rehabilitation.
The role of social engagement in the association of self-reported hearing loss and health-related quality of life
Authors: Gao Jiamin , Hu Hongwei , Yao Lan
Published: May 2020

Background

Hearing loss is highly prevalent and associated with reduced well-being in older adults. But little is known about the role of social factors in the association of hearing difficulty and its health consequences. This study aims to examine the association between self-reported hearing loss and health-related quality of life (HRQoL, consisted of physical and mental component summary, PCS and MCS), and to investigate whether social engagement mediates this association.

Method

Data on 4035 older adults aged 60 years or above from a cross-sectional nationally representative database in China were obtained to address this study. HRQoL was measured by the Short Form 12 Health Survey (SF-12). Hearing loss was defined by a dichotomized measure of self-reported hearing difficulty, which has been proved to be sensitive and displayed moderate associations with audiometric assessment in elderly population. Social engagement was measured by the Index of Social Engagement Scale. Bootstrap test was applied to test for the significance of the mediating role of social engagement.

Results

Self-reported hearing loss was found negatively associated with HRQoL in older adults, and hearing loss was much more related to reduced mental well-being. Social engagement played a partial mediating role in the association of hearing loss and HRQoL. Social engagement account for 4.14% of the variance in the change of PCS scores and 13.72% for MCS, respectively.

Conclusion

The study lends support to the hypothesis that hearing loss is associated with aging well beings, and the use of hearing aid or proper social engagement intervention may improve the quality of life among the elderly.
Diagnostic performance of APRI and FIB-4 for confirming cirrhosis in Indonesian HIV/HCV co-infected patients
Authors: Yunihastuti Evy , Wicaksana Bramantya , Wiraguna Andrian , Hidayah Ainum Jhariah , Amelia Fhadilla , Natali Veritea , Widhani Alvina , Sulaiman Andri Sanityoso , Kurniawan Juferdy
Published: May 2020

Background

After successful of antiretroviral therapy, highly effective direct acting antiviral (DAA) make HCV elimination reasonable in HIV/HCV co-infected patients. However, in achieving this target, there are still barriers to start DAA treatment, particularly in the area of liver fibrosis assessment that determine the duration of therapy. We aimed to assess the diagnostic performance of APRI and FIB-4 for diagnosing cirrhosis in HIV/HCV co-infected patients using hepatic transient elastography (TE) as gold standard.

Method

This is a retrospective study on HIV/HCV co-infected patients who concomitantly performed hepatic TE measurement, APRI, and FIB-4 evaluation before HCV treatment initiation at a tertiary hospital in Jakarta from 2014 to 2019. Sensitivity, specificity and diagnostic accuracy of indirect biomarkers for liver stiffness measurement (LSM) ≥ 12.5 kPa was determined by receiver operator characteristics curves.

Results

223 HIV/HCV co-infected patients on stable antiretroviral therapy were included, of whom 91.5% were male with mean age of 37 (SD 5) years. Only 28.7% of patients were classified as cirrhosis (F4). Using TE as gold standard (≥12.5 kPa), the low threshold of APRI (1) had specificity 95%, sensitivity 48.4%, correctly classified 81.6% of patients, with moderate performance, AUC at 0.72 (95% CI 0.63–0.80). The optimal cut-off of FIB-4 was 1.66 [specificity 92.5%, sensitivity 53.1%, AUC at 0.73 (95% CI 0.65–0.81)] and correctly classified 81.1% of the patients.

Conclusion

APRI score ≥ 1 and FIB-4 score ≥ 1.66 had moderate performance with high specificity in diagnosing cirrhosis. These biochemical markers could be used while TE is not available.
Acute cerebral infarction with adenomyosis in a patient with fever: a case report
Authors: Zhao Yuan , Zhang Yongbo , Yang Yishu
Published: May 2020

Background

It is reported that acute cerebral infarction with adenomyosis is associated with elevated D-Dimer, elevated CA125, anemia and menstruation. However, previous reports did not notice infection known as fever, which may be a potential risk factor for developing acute cerebral infarction with adenomyosis.

Case presentation

We describe a 34-year-old woman who presented headache and fever (38 °C) for 4 days and left limb weakness for 1 day during her menstrual phase. Laboratory test data showed: Hemoglobin (HGB) (112 g/L, normal: 120–150 g/L), Carcinoembryonic antigen 125 (CA125) (937.70 U/ml, normal: 0–35 U/ml), D-Dimer (27.4 mg/L, normal: 0–1.5 mg/L). Magnetic resonance imaging (MRI) indicated acute cerebral infarction in right basal ganglia and subcortical region of right frontotemporal lobe. Further, brain computed tomography angiography (CTA) showed that the M1 segment of right middle cerebral artery was strictured and the distal branches of right middle cerebral artery were significantly less than those on the opposite side. No obvious abnormality was found in cranial magnetic resonance venogram (MRV). She had a 5-year history of adenomyosis. No tumors were found by whole body positron emission tomography-computed tomography (PET-CT). We treated this patient by using anti-infective therapy for 1 week and using anticoagulant therapy with low molecular weight heparin for 2 weeks. Subsequently, the anticoagulant therapy was discontinued and replaced by antiplatelet therapy with clopidogrel. We followed up this patient for 4 months, and no recurrence of cerebral infarction was found.

Conclusions

Acute cerebral infarction with adenomyosis may be related to elevated D-Dimer, elevated CA125, anemia and menstruation. Our report suggests that infection may be a potential risk factor for developing acute cerebral infarction with adenomyosis.
Pregnancy outcomes in asylum seekers in the North of the Netherlands: a retrospective documentary analysis
Authors: Verschuuren A. E. H. , Postma I. R. , Riksen Z. M. , Nott R. L. , Feijen-de Jong E. I. , Stekelenburg J.
Published: May 2020

Background

With more than 20,000 asylum seekers arriving every year, healthcare for this population has become an important issue. Pregnant asylum seekers seem to be at risk of poor pregnancy outcomes. This study aimed to assess the difference in pregnancy outcomes between asylum seekers and the local Dutch population and to identify potential substandard factors of care.

Methods

Using a retrospective study design we compared pregnancy outcomes of asylum-seeking and Dutch women who gave birth in a northern region of the Netherlands between January 2012 and December 2016. The following data were compared: perinatal mortality, maternal mortality, gestational age at delivery, preterm delivery, birth weight, small for gestational age children, APGAR score, intrauterine foetal death, mode of delivery and the need for pain medication. Cases of perinatal mortality in asylum seekers were reviewed for potential substandard factors.

Results

A total of 344 Asylum-seeking women and 2323 Dutch women were included. Asylum seekers had a higher rate of perinatal mortality (3.2% vs. 0.6%, p = 0.000) including a higher rate of intrauterine foetal death (2.3% vs. 0.2%, p = 0.000), higher gestational age at birth (39 + 4 vs. 38 + 6 weeks, p = 0.000), labour was less often induced (36.9 vs. 43.8, p = 0.016), postnatal hospitalization was longer (2.24 vs. 1.72 days p = 0.006) and they received more opioid analgesics (27.3% vs. 22%, p = 0.029). Babies born from asylum-seeking women had lower birth weights (3265 vs. 3385 g, p = 0.000) and were more often small for gestational age (13.9% vs. 8.4%, p = 0.002). Multivariate analysis showed that the increased risk of perinatal mortality in asylum-seeking women was independent of parity, birth weight and gestational age at birth. Review of the perinatal mortality cases in asylum seekers revealed possible substandard factors, such as late initiation of antenatal care, missed appointments because of transportation problems, not recognising alarm symptoms, not knowing who to contact and transfer to other locations during pregnancy.

Conclusion

Pregnant asylum seekers have an increased risk of adverse pregnancy outcomes. More research is needed to identify which specific risk factors are involved in poor perinatal outcomes in asylum seekers and to identify strategies to improve perinatal care for this group of vulnerable women.
Early-stage clinical outcomes and rotational stability of TECNIS toric intraocular lens implantation in cataract cases with long axial length
Authors: He Suhong , Chen Xiang , Wu Xingdi , Ma Yajuan , Yu Xuewen , Xu Wen
Published: May 2020

Background

A major focus of toric intraocular lens (IOL) implantation is the rotational stability, especially in the patients with long axial length (AL). In this study, we aimed to evaluate the clinical outcomes after implantation of TECNIS toric IOL in eyes with long AL and identify factors influencing their early-stage stability with preoperative corneal astigmatism.

Methods

The study population consisted of 64 eyes from 52 cataract patients, and these patients had preoperative corneal astigmatism between 1.0 and 3.7 diopters (D) and underwent phacoemulsification and TECNIS toric IOL implantation. Ophthalmic biological measurements were carried out preoperatively, including AL, anterior chamber depth (ACD), lens thickness (LT), vitreous length (VL), anterior chamber volume (ACV), sulcus-to-sulcus (STS) and keratometric value (K). Clinical examinations, including visual acuity, manifest refraction, keratometry, digital anterior segment photographs with pupillary dilation, were performed at 1 and 3 months after surgery.

Results

The mean best corrected distance visual acuity (BCDVA) was improved from 0.93 ± 0.35 logarithms of the minimal angle of resolution (logMAR) preoperatively to 0.07 ± 0.10 logMAR postoperatively at 3 months after surgery. The mean residual astigmatism (RAS) was 0.91 ± 0.74D at 3 months, which was significantly decreased compared with the preoperative corneal astigmatism of 1.71 ± 0.55 D. The mean absolute rotation of TECNIS toric IOL at 1 and 3 months was 7.42 ± 11.32 degree (°) (0–79°) and 7.48 ± 11.19°(0–79°), respectively. The mean area of capsulorhexis and the overlapped area between capsulorhexis and IOL optic intraoperatively was 21.04 ± 3.30 mm2 and 7.40 ± 2.87 mm2.A positive correlation was found between IOL rotation and the area of capsulorhexis (p = 0.017) at 3 months after surgery. No correlation was found between IOL rotation and AL (p = 0.876), ACD (p = 0.387), LT (p = 0.523), VL (p = 0.546), ACV (p = 0.480), STS (p = 0.884), K1 (p = 0.429), K2 (p = 0.644), average of K1 and K2 (p = 0.520), intraoperative IOL axial direction (p = 0.396), preoperative corneal astigmatism (p = 0.269) or the overlapped area between capsulorhexis and IOL optic intraoperatively (p = 0.131) .

Conclusions

The large CCC was a risk factor for toric IOL rotation. An appropriately smaller sized CCC was conducive to increase the rotational stability of TECNIS toric IOL implantation in cataract cases with long AL.
Anterior segment optical coherence tomography imaging in peripheral ulcerative keratitis, a corneal structural description
Authors: Bonnet Clemence , Debillon Louis , Al-Hashimi Saba , Hoogewoud Florence , Monnet Dominique , Bourges Jean-Louis , Brézin Antoine
Published: May 2020

Background

Anterior segment optical coherence tomography (AS OCT) is a helpful tool used to diagnose and manage many corneal conditions, but its use has not been reported in case of peripheral ulcerative keratitis (PUK). The aim of this study is to describe AS OCT findings in cases of PUK.

Methods

Retrospective observational case series of six eyes presenting with a PUK and proven systemic vasculitis. Clinical course, slit lamp photographs, and AS OCT findings were the main outcomes.

Results

The AS OCT findings were found to correlate with the ocular disease’s level of activity. In the acute stage, an absence of corneal epithelium, a scrambled appearance of the anterior stroma and a heterogeneous stromal reflectivity were observed. During the reduction of disease level activity, an irregular hyporeflective epithelium, a smoother anterior stroma, and a homogenous hyperreflective stroma were seen. At the healed stage, a filling of the corneal defect by a hyporeflective thick epithelium, the persistence of the hyperreflective underlying stroma, and a demarcation line were observed. The mean total corneal thickness at last follow-up was significantly thicker (509 ± 147 μm) compared with the mean corneal thickness at onset (408 ± 131 μm; P = 0.03).

Conclusions

AS OCT provides an assessment of structural changes occurring in PUK, useful for its diagnosis and monitoring.
Multimodal imaging of aberrant macular microvessel crossing the foveal avascular zone in two young adults
Authors: Jiang Xianming , Zheng Cong , Du Fangfang , Ai Shibei
Published: May 2020

Background

The traditional view is that there are no vessels in the foveal avascular zone. The two cases we report show microvessels crossing the foveal avascular zone.

Case presentation

A man and a woman, both 25 years old, were both incidentally found on optical coherence tomography angiography (OCTA) to have unilateral aberrant microvessels crossing the foveal avascular zone in their left eyes. Visual acuity was preserved in both patients. The vessel density (VD) and perfusion density (PD) of the eyes with the aberrant microvessels were all higher than those of the contralateral eyes. Nevertheless, measurements of foveal avascular zone (FAZ) dimensions, including its area, perimeter and circularity, were smaller in the left eyes than in the right eyes. No complications were recorded.

Conclusions

To date, aberrant microvessels crossing the foveal avascular zone have not been found to impair visual function. OCTA is a non-invasive and quick method that does not require dilation or the use of fluorescein dye. It is a reliable tool for the detection of aberrant microvessels crossing the foveal avascular zone.
Primary Ewing’s sarcoma in a small intestine – a case report and review of the literature
Authors: Kolosov Andrej , Dulskas Audrius , Pauza Kastytis , Selichova Veslava , Seinin Dmitrij , Stratilatovas Eugenijus
Published: May 2020

Background

Ewing’s sarcoma usually presents in paediatric patients with its primary location being bone tissue. Nevertheless, we present such an adult case which arises from the small intestine. We registered thirty one cases of such origin published so far excluding ours.

Case presentation

We report a case of 30 year old female who was admitted due to the persistent anaemia. Whole body computed tomography scan revealed abdominal mass in her left upper abdominal compartment. Surgery on the mass originating from jejunum was performed, although due to extremely complicated postoperative period and rapid dissemination no additional therapy had been performed. The tumour was positive for CD99, ERG, CD56, Synaptophysin, PanCK, Cam5.2.

Conclusion

Extraosseus Ewing’s sarcoma is extremely rare entity, with poor prognosis.
Facilitating the design of HL7 domain models through a model-driven solution
Authors: Olivero M. A. , Domínguez-Mayo F. J. , Parra-Calderón C. L. , Escalona M. J. , Martínez-García A.
Published: May 2020

Background and goal

Health information systems are increasingly sophisticated and developing them is a challenge for software developers. Software engineers usually make use of UML as a standard model language that allows defining health information system entities and their relations. However, working with health system requires learning HL7 standards, that defines and manages standards related to health information systems. HL7 standards are varied, however this work focusses on v2 and v3 since these are the most used one on the area that this work is being conducted. This works aims to allow modeling HL7 standard by using UML.

Methods

Several techniques based on the MDE (Model-Driven Engineering) paradigm have been used to cope with it.

Results

A useful reference framework, reducing final users learning curve and allowing modeling maintainable and easy-going health information systems.

Conclusions

By using this approach, a software engineer without any previous knowledge about HL7 would be able to solve the problem of modeling HL7-based health information systems. Reducing the learning curve when working in projects that need HL7 standards.
Harnessing health plan enrollee data to boost membership in patient-powered research networks
Authors: Chen Xiaoxue , Agiro Abiy , Nowell W. Benjamin , Loud Sara , McBurney Robert , Young Kalen , Sutphen Rebecca , Bourquardez Clark Elizabeth , Burroughs Cristina M. , Curtis Jeffrey R. , Sreih Antoine G. , Merkel Peter A. , Haynes Kevin
Published: May 2020

Background

Patient-powered research networks (PPRNs) have been employing and exploring different methods to engage patients in research activities specific to their conditions. One way to intensify patient engagement is to partner with payer stakeholders. The objective of this study was to evaluate the effectiveness of two common payer-initiated outreach methods (postal mail versus email) for inviting prospective candidates to participate in their initiatives.

Methods

This descriptive study linked members of a nationally-representative private insurance network to four disease-specific PPRN registries. Eligible members meeting diagnostic criteria who were not registered in any of the four PPRNs by 02/28/2018 were identified, and randomly assigned to either the mail or email group. They were contacted in two outreach efforts: first on 04/23/2018, and one follow-up on 05/23/2018. New registration rates by outreach method as of 8/31/2018 were determined by relinking. We compared registrants and non-registrants using bivariate analysis.

Results

A total of 14,571 patients were assigned to the mail group, and 14,574 to the email group. Invitations were successfully delivered to 13,834 (94.9%) mail group and 10,205 (70.0%) email group members. A small but significantly larger proportion of mail group members, (n = 78; 0.54, 95% Confidence Interval [CI] {0.42–0.67%}) registered in PPRNs relative to the email group (n = 24; 0.16, 95% CI {0.11–0.25%}), p < 0.001. Members who registered had more comorbidities, were more likely to be female, and had marginally greater medical utilization, especially emergency room visits, relative to non-registrants (52.0% vs. 42.5%, p = 0.05).

Conclusion

A health plan outreach to invite members to participate in PPRNs was modestly effective. Regular mail outperformed less costly email. Providing more value-add to participants may be a possible way to increase recruitment success.
Benefits of glycopyrrolate/formoterol fumarate metered dose inhaler (GFF MDI) in improving lung function and reducing exacerbations in patients with moderate-to-very severe COPD: a pooled analysis of the PINNACLE studies
Authors: Martinez Fernando J. , Lipworth Brian J. , Rabe Klaus F. , Collier David J. , Ferguson Gary T. , Sethi Sanjay , Feldman Gregory J. , O’Brien Gerald , Jenkins Martin , Reisner Colin
Published: May 2020

Background

The Phase III PINNACLE studies assessed the efficacy and safety of glycopyrrolate/formoterol fumarate metered dose inhaler (GFF MDI), a dual long-acting bronchodilator for chronic obstructive pulmonary disease (COPD). Here we present a pre-specified pooled analysis of PINNACLE-1, PINNACLE-2, and PINNACLE-4.

Methods

PINNACLE-1, -2, and -4 were multicenter, double-blind, randomized controlled trials that enrolled patients with moderate-to-very severe COPD, with no requirement for exacerbation history or a high symptom burden. Patients received GFF MDI 18/9.6 μg, glycopyrrolate (GP) MDI 18 μg, formoterol fumarate (FF) MDI 9.6 μg, or placebo MDI, twice-daily for 24 weeks. The primary endpoint of the pooled analysis was the change from baseline in morning pre-dose trough forced expiratory volume in 1 s (FEV1) at week 24. Secondary endpoints included COPD exacerbations and clinically important deterioration (CID). Adverse events were also assessed.

Results

The pooled intent-to-treat population included 4983 patients; of these, 61.9% had a COPD assessment test (CAT) score ≥15, and 25.0% had experienced ≥1 moderate/severe exacerbation in the past year. At week 24, GFF MDI improved morning pre-dose trough FEV1 versus GP MDI (least squares mean [LSM] difference [95% confidence interval (CI)]: 59 mL [43, 75]), FF MDI (65 mL [48, 81]), and placebo MDI (146 mL [125, 166]); all p < 0.0001. GFF MDI reduced the risk of a moderate/severe exacerbation by 18% (p = 0.0168), 15% (p = 0.0628), and 28% (p = 0.0012) compared with GP MDI, FF MDI, and placebo MDI, respectively. In general, exacerbation risk reduction with GFF MDI versus comparators was greater in subgroups of symptomatic patients (CAT ≥15) and those who had an exacerbation history, than in the pooled intent-to-treat population. The risk of CID was also lower with GFF MDI versus GP MDI (23% decrease), FF MDI (17%), and placebo MDI (49%); all p < 0.0001. All treatments were well tolerated, with no unexpected safety signals.

Conclusions

This pooled analysis of the PINNACLE studies demonstrated that GFF MDI improved lung function and reduced the risk of exacerbations compared with monocomponents and placebo in patients with COPD. Exacerbation reductions with GFF MDI versus comparators were generally greater in patients with higher symptom burden and those with exacerbation history.

Trial registration

ClinicalTrials.gov NCT01854645, NCT01854658, and NCT02343458. Registered 13 May 2013 (NCT01854645, NCT01854658) and 6 January 2015 (NCT02343458).
Characterisation of microbiota in saliva, bronchoalveolar lavage fluid, non-malignant, peritumoural and tumour tissue in non-small cell lung cancer patients: a cross-sectional clinical trial
Authors: Bingula Rea , Filaire Edith , Molnar Ioana , Delmas Eve , Berthon Jean-Yves , Vasson Marie-Paule , Bernalier-Donadille Annick , Filaire Marc
Published: May 2020

Background

While well-characterised on its molecular base, non-small cell lung cancer (NSCLC) and its interaction with local microbiota remains scarcely explored. Moreover, current studies vary in source of lung microbiota, from bronchoalveolar lavage fluid (BAL) to tissue, introducing potentially differing results. Therefore, the objective of this study was to provide detailed characterisation of the oral and multi-source lung microbiota of direct interest in lung cancer research. Since lung tumours in lower lobes (LL) have been associated with decreased survival, characteristics of the microbiota in upper (UL) and lower tumour lobes have also been examined.

Methods

Using 16S rRNA gene sequencing technology, we analysed microbiota in saliva, BAL (obtained directly on excised lobe), non-malignant, peritumoural and tumour tissue from 18 NSCLC patients eligible for surgical treatment. Detailed taxonomy, diversity and core members were provided for each microbiota, with analysis of differential abundance on all taxonomical levels (zero-inflated binomial general linear model with Benjamini-Hochberg correction), between samples and lobe locations.

Results

Diversity and differential abundance analysis showed clear separation of oral and lung microbiota, but more importantly, of BAL and lung tissue microbiota. Phylum Proteobacteria dominated tissue samples, while Firmicutes was more abundant in BAL and saliva (with class Clostridia and Bacilli, respectively). However, all samples showed increased abundance of phylum Firmicutes in LL, with decrease in Proteobacteria. Also, clades Actinobacteria and Flavobacteriia showed inverse abundance between BAL and extratumoural tissues depending on the lobe location. While tumour microbiota seemed the least affected by location, peritumoural tissue showed the highest susceptibility with markedly increased similarity to BAL microbiota in UL. Differences between the three lung tissues were however very limited.

Conclusions

Our results confirm that BAL harbours unique lung microbiota and emphasise the importance of the sample choice for lung microbiota analysis. Further, limited differences between the tissues indicate that different local tumour-related factors, such as tumour type, stage or associated immunity, might be the ones responsible for microbiota-shaping effect. Finally, the “shift” towards Firmicutes in LL might be a sign of increased pathogenicity, as suggested in similar malignancies, and connected to worse prognosis of the LL tumours.

Trial registration

ClinicalTrials.gov ID: NCT03068663. Registered February 27, 2017.
Ubiquitin ligase CHAF1B induces cisplatin resistance in lung adenocarcinoma by promoting NCOR2 degradation
Authors: Gong Lian , Hu Yi , He Dong , Zhu Yuxing , Xiang Liang , Xiao Mengqing , Bao Ying , Liu Xiaoming , Zeng Qinghai , Liu Jianye , Zhou Ming , Zhou Yanhong , Cheng Yaxin , Zhang Yeyu , Deng Liping , Zhu Rongrong , Lan Hua , Cao Ke
Published: May 2020

Background

Lung cancer is the most common malignant tumor in the world. The Whole-proteome microarray showed that ubiquitin ligase chromatin assembly factor 1 subunit B (CHAF1B) expression in A549/DDP cells is higher than in A549 cells. Our study explored the molecular mechanism of CHAF1B affecting cisplatin resistance in lung adenocarcinoma (LUAD).

Methods

Proteome microarray quantify the differentially expressed proteins between LUAD cell line A549 and its cisplatin-resistant strain A549/DDP. Quantitative real-time quantitative polymerase chain reaction (qRT-PCR) and Western blot (WB) confirmed the CHAF1B expression. Public databases analyzed the prognosis of LUAD patients with varied LUAD expression followed by the substrates prediction of CHAF1B. Public databases showed that nuclear receptor corepressor 2 (NCOR2) may be substrates of CHAF1B. WB detected that CHAF1B expression affected the expression of NCOR2. Cell and animal experiments and clinical data detected function and integrating mechanism of CHAF1B compounds.

Results

Proteome chips results indicated that CHAF1B, PPP1R13L, and CDC20 was higher than A549 in A549/DDP. Public databases showed that high expression of CHAF1B, PPP1R13L, and CDC20 was negatively correlated with prognosis in LUAD patients. PCR and WB results indicated higher CHAF1B expression in A549/DDP cells than that in A549 cells. NCOR2 and PPP5C were confirmed to be substrates of CHAF1B. CHAF1B knockdown significantly increased the sensitivity of cisplatin in A549/DDP cells and the upregulated NCOR2 expression. CHAF1B and NCOR2 are interacting proteins and the position of interaction between CHAF1B and NCOR2 was mainly in the nucleus. CHAF1B promotes ubiquitination degradation of NCOR2. Cells and animal experiments showed that under the action of cisplatin, after knockdown of CHAF1B and NCOR2 in A549/DDP group compared with CHAF1B knockdown alone, the cell proliferation and migratory ability increased and apoptotic rate decreased, and the growth rate and size of transplanted tumor increased significantly. Immunohistochemistry suggested that Ki-67 increased, while apoptosis-related indicators caspase-3 decreased significantly. Clinical data showed that patients with high expression of CHAF1B are more susceptible to cisplatin resistance.

Conclusion

Ubiquitin ligase CAHF1B can induce cisplatin resistance in LUAD by promoting the ubiquitination degradation of NCOR2.
Why social justice matters: a context for suicide prevention efforts
Authors: Hochhauser Shirley , Rao Satya , England-Kennedy Elizabeth , Roy Sharmistha
Published: May 2020

Suicide is among the 10 leading causes of death in the US and has the potential to suddenly change many lives. It often occurs when people are disproportionately affected by societal conditions, including inequities, discrimination, oppression, and historical trauma. We posit that a social justice framework can improve suicide prevention efforts when incorporated into existing strategies because it mandates that inequities be addressed. It does so through education, engagement, advocacy, and action, and can be especially effective in states and nations with high suicide rates and entrenched societal inequities.
Progress in the seasonal variations of blood lipids: a mini-review
Authors: Ma Xiaochun , Yan Haichen , Zhang Haizhou , Wang Mansen , Zhang Qunye , Zhou Xiaoming
Published: May 2020

The seasonal variations of blood lipids have recently gained increasing interest in this field of lipid metabolism. Elucidating the seasonal patterns of blood lipids is particularly helpful for the prevention and treatment of cardiovascular and cerebrovascular diseases. However, the previous results remain controversial and the underlying mechanisms are still unclear. This mini-review is focused on summarizing the literature relevant to the seasonal variability of blood lipid parameters, as well as on discussing its significance in clinical diagnoses and management decisions.
Recovery of brain DHA-containing phosphatidylserine and ethanolamine plasmalogen after dietary DHA-enriched phosphatidylcholine and phosphatidylserine in SAMP8 mice fed with high-fat diet
Authors: Zhao Ying-Cai , Zhou Miao-Miao , Zhang Ling-Yu , Cong Pei-Xu , Xu Jie , Xue Chang-Hu , Yanagita Teruyoshi , Chi Naiqiu , Zhang Tian-Tian , Liu Feng-Hai , Wang Yu-Ming
Published: May 2020

Background

Glycerophospholipids were the main components of cerebral cortex lipids, and there was a close association between lipid homeostasis and human health. It has been reported that dietary DHA-enriched phosphatidylcholine (DHA-PC) and phosphatidylserine (DHA-PS) could improve brain function. However, it was unclear that whether supplementation of DHA-PC and DHA-PS could change lipid profiles in the brain of dementia animals.

Methods

SAMP8 mice was fed with different diet patterns for 2 months, including high-fat diet and low-fat diet. After intervention with DHA-PC and DHA-PS for another 2 months, the lipid profile in cerebral cortex was determined by lipidomics in dementia mice.

Results

High-fat diet could significantly decrease the levels of DHA-containing PS/pPE, DPA-containing PS, and AA-containing PE, which might exhibit the potential of lipid biomarkers for the prevention and diagnosis of AD. Notably, DHA-PC and DHA-PS remarkably recovered the lipid homeostasis in dementia mice. These might provide a potential novel therapy strategy and direction of dietary intervention for patients with cognitive decline.

Conclusions

DHA-PC and DHA-PS could recover the content of brain DHA-containing PS and pPE in SAMP8 mice fed with high-fat diet.

Abstract graphical
Expression of Concern to: The role of ACE2, angiotensin-(1–7) and Mas1 receptor axis in glucocorticoid-induced intrauterine growth restriction
Authors: Ghadhanfar Elham , Alsalem Aseel , Al-Kandari Shaimaa , Naser Jumana , Babiker Fawzi , Al-Bader Maie
Published: May 2020

An amendment to this paper has been published and can be accessed via the original article.
A review of reviews on principles, strategies, outcomes and impacts of research partnerships approaches: a first step in synthesising the research partnership literature
Authors:   SCI Guiding Principles Consensus Panel, Hoekstra F. , Mrklas K. J. , Khan M. , McKay R. C. , Vis-Dunbar M. , Sibley K. M. , Nguyen T. , Graham I. D. , Gainforth H. L.
Published: May 2020

Background

Conducting research in partnership with stakeholders (e.g. policy-makers, practitioners, organisations, patients) is a promising and popular approach to improving the implementation of research findings in policy and practice. This study aimed to identify the principles, strategies, outcomes and impacts reported in different types of reviews of research partnerships in order to obtain a better understanding of the scope of the research partnership literature.

Methods

This review of reviews is part of a Coordinated Multicenter Team approach to synthesise the research partnership literature with five conceptually linked literature reviews. The main research question was ‘What principles, strategies, outcomes and impacts are reported in different types of research partnership approaches?’. We included articles describing a literature review of research partnerships using a systematic search strategy. We used an adapted version of the Revised Assessment of Multiple Systematic Reviews tool to assess quality. Nine electronic databases were searched from inception to April 2018. Principles, strategies, outcomes and impacts were extracted from the included reviews and analysed using direct content analysis.

Results

We included 86 reviews using terms describing several research partnership approaches (e.g. community-based participatory research, participatory research, integrated knowledge translation). After the analyses, we synthesised 17 overarching principles and 11 overarching strategies and grouped them into one of the following subcategories: relationship between partners; co-production of knowledge; meaningful stakeholder engagement; capacity-building, support and resources; communication process; and ethical issues related to the collaborative research activities. Similarly, we synthesised 20 overarching outcomes and impacts on researchers, stakeholders, the community or society, and the research process.

Conclusions

This review of reviews is the first that presents overarching principles, strategies, outcomes and impacts of research partnerships. This review is unique in scope as we synthesised literature across multiple research areas, involving different stakeholder groups. Our findings can be used as a first step to guide the initiation and maintenance of research partnerships and to create a classification system of the key domains of research partnerships, which may improve reporting consistency in the research partnership literature.

Trial registration

This study is registered via Open Science Framework:10.17605/OSF.IO/GVR7Y.
Recommendations for older adults’ physical activity and sedentary behaviour during hospitalisation for an acute medical illness: an international Delphi study
Authors: Baldwin Claire E. , Phillips Anna C. , Edney Sarah M. , Lewis Lucy K.
Published: May 2020

Background

Immobility is major contributor to poor outcomes for older people during hospitalisation with an acute medical illness. Yet currently there is no specific mobility guidance for this population, to facilitate sustainable changes in practice. This study aimed to generate draft physical activity (PA) and sedentary behaviour (SB) recommendations for older adults’ during hospitalisation for an acute medical illness.

Methods

A 4-Round online Delphi consensus survey was conducted. International researchers, medical/nursing/physiotherapy clinicians, academics from national PA/SB guideline development teams, and patients were invited to participate. Round 1 sought responses to open-ended questions. In Rounds 2–3, participants rated the importance of items using a Likert scale (1–9); consensus was defined a priori as: ≥70% of respondents rating an item as “critical” (score ≥ 7) and ≤ 15% of respondents rating an item as “not important” (score ≤ 3). Round 4 invited participants to comment on draft statements derived from responses to Rounds 1–3; Round 4 responses subsequently informed final drafting of recommendations.

Results

Forty-nine people from nine countries were invited to each Round; response rates were 94, 90, 85 and 81% from Rounds 1–4 respectively. 43 concepts (items) from Rounds 2 and 3 were incorporated into 29 statements under themes of PA, SB, people and organisational factors in Round 4. Examples of the final draft recommendations (being the revised version of statements with highest participant endorsement under each theme) were: “some PA is better than none”,“older adults should aim to minimise long periods of uninterrupted SB during waking hours while hospitalised”, “when encouraging PA and minimising SB, people should be culturally responsive and mindful of older adults’ physical and mental capabilities”and“opportunities for PA and minimising SB should be incorporated into the daily care of older adults with a focus on function, independence and activities of daily living”.

Conclusions

These world-first consensus-based statements from expert and stakeholder consultation provide the starting point for recommendations to address PA and SB for older adults hospitalised with an acute medical illness. Further consultation and evidence review will enable validation of these draft recommendations with examples to improve their specificity and translation to clinical practice.