bluuebunny/crossref_metadata_2025 huggingface dataset:
Baseline Predictors of Low-Density Lipoprotein Cholesterol and Systolic Blood Pressure Goal Attainment After 1 Year in the ISCHEMIA Trial
Authors: Newman Jonathan D. , Alexander Karen P. , Gu Xiangqiong , O’Brien Sean M. , Boden William E. , Govindan Sajeev C. , Senior Roxy , Moorthy Nagaraja , Rezende Paulo C. , Demkow Marcin , Lopez-Sendon Jose Luis , Bockeria Olga , Pandit Neeraj , Gosselin Gilbert , Stone Peter H. , Spertus John A. , Stone Gregg W. , Fleg Jerome L. , Hochman Judith S. , Maron David J. ,   on behalf of the ISCHEMIA Research Group
Published: November 2019

Background:

Risk factor control is the cornerstone of managing stable ischemic heart disease but is often not achieved. Predictors of risk factor control in a randomized clinical trial have not been described.

Methods and Results:

The ISCHEMIA trial (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) randomized individuals with at least moderate inducible ischemia and obstructive coronary artery disease to an initial invasive or conservative strategy in addition to optimal medical therapy. The primary aim of this analysis was to determine predictors of meeting trial goals for LDL-C (low-density lipoprotein cholesterol, goal <70 mg/dL) or systolic blood pressure (SBP, goal <140 mm Hg) at 1 year post-randomization. We included all randomized participants in the ISCHEMIA trial with baseline and 1-year LDL-C and SBP values by January 28, 2019. Among the 3984 ISCHEMIA participants (78% of 5179 randomized) with available data, 35% were at goal for LDL-C, and 65% were at goal for SBP at baseline. At 1 year, the percent at goal increased to 52% for LDL-C and 75% for SBP. Adjusted odds of 1-year LDL-C goal attainment were greater with older age (odds ratio [OR], 1.11 [95% CI, 1.03–1.20] per 10 years), lower baseline LDL-C (OR, 1.19 [95% CI, 1.17–1.22] per 10 mg/dL), high-intensity statin use (OR, 1.30 [95% CI, 1.12–1.51]), nonwhite race (OR, 1.32 [95% CI, 1.07–1.63]), and North American enrollment compared with other regions (OR, 1.32 [95% CI, 1.06–1.66]). Women were less likely than men to achieve 1-year LDL-C goal (OR, 0.68 [95% CI, 0.58–0.80]). Adjusted odds of 1-year SBP goal attainment were greater with lower baseline SBP (OR, 1.27 [95% CI, 1.22–1.33] per 10 mm Hg) and with North American enrollment (OR, 1.35 [95% CI, 1.04–1.76]).

Conclusions:

In ISCHEMIA, older age, male sex, high-intensity statin use, lower baseline LDL-C, and North American location predicted 1-year LDL-C goal attainment, whereas lower baseline SBP and North American location predicted 1-year SBP goal attainment. Future studies should examine the effects of sex disparities, international practice patterns, and provider behavior on risk factor control.
Metabolic Dysfunction in Continuous‐Flow Left Ventricular Assist Devices Patients and Outcomes
Authors: Nguyen Ann B. , Imamura Teruhiko , Besser Stephanie , Rodgers Daniel , Chung Ben , Raikhelkar Jayant , Kalantari Sara , Smith Bryan , Sarswat Nitasha , LaBuhn Colleen , Jeevanandam Valluvan , Kim Gene , Sayer Gabriel , Uriel Nir
Published: November 2019

Background

Metabolic impairment is common in heart failure patients. Continuous‐flow left ventricular assist devices (
CF
‐
LVADs
) improve hemodynamics and outcomes in patients with advanced heart failure; however, the effect of
CF
‐
LVADs
on metabolic status is unknown. This study aims to evaluate the changes in metabolic status following
CF
‐
LVAD
implantation and measure the correlation of metabolic status with outcomes.

Methods and Results

Prospective data on
CF
‐
LVAD
patients were obtained. Metabolic evaluation, including hemoglobin A1C, free and total testosterone, thyroid‐stimulating hormone (
TSH
), and free T4, was obtained before and at multiple time points following implantation. Patients with nonelevated thyroid‐stimulating hormone and normal hemoglobin A1C and testosterone levels were defined as having normal metabolic status. Baseline characteristics, hemodynamics, and outcomes were collected. One hundred six patients were studied, of which 56 had paired data at baseline and 1‐ to 3‐month follow‐up. Before implantation, 75% of patients had insulin resistance, 86% of men and 39% of women had low free testosterone, and 44% of patients had abnormal thyroid function. There was a significant improvement in hemoglobin A1C, free testosterone, and thyroid‐stimulating hormone following implantation (
P
<0.001 for all). Patients with normal hemoglobin A1C (<5.7%) following implantation had higher 1‐year survival free of heart failure readmissions (78% versus 23%;
P
<0.001). Patients with normal metabolic status following implantation also had higher 1‐year survival free of heart failure readmissions (92% versus 54%;
P
=0.04).

Conclusions

Metabolic dysfunction is highly prevalent in advanced heart failure patients and improves after
CF
‐
LVAD
implantation. Normal metabolic status is associated with a significantly higher rate of 1‐year survival free of heart failure readmissions.
Childhood Research Beyond Children: Public Engagement and the Rights of the Child
Authors: Zhang Chao , Wang Jingyi
Published: November 2019

With the globalization of technology and the changes of society, the boundaries between childhood and adulthood have become increasingly blurred. Children’s studies begin to re-examine the modern thinking and the binary opposition in childhood research, and propose that in order to adapt to the diversity and continuous influence of childhood, childhood research must look for and effectively use non-dualistic theoretical analysis resources. On the one hand, “actor-network theory” and “complexity theory” have provided such research with a theoretical basis, transcending the perspective of binary opposition, focusing on the long-term effects of childhood on individual public character and the public participation of children. On the other hand, information media technology and community participation play an important role in the building of contemporary childhood, especially for the vulnerable groups of children to gain the ability of public participation and enter the public sector. Childhood research requires a broad theoretical perspective and an interdisciplinary approach. It also requires attention to the processes and mechanisms of how children’s participation influences the acquisition of individual public character. How to effectively use information technology to promote public participation, expand the existing public space and form an effective connection with practical community participation is the key to realizing a “good society” in the future for children.
Begonia bachulkarii (Begoniaceae, sect. Reichenheimia), a new species from the southern Western Ghats with notes on sect. Reichenheimia in India

Authors: AITAWADE MAKARAND MOHANRAO , KATTUKUNNEL JOSEPH JOHN , YADAV SHRIRANG RAMCHANDRA
Published: November 2019

A new species of Begonia, B. bachulkarii has been described from the southern Western Ghats of India, which appears to be a narrow endemic restricted to its type locality. It is closely allied to B. floccifera. Morphological similarities and differences between both species and with the remaining species of sect. Reichenheimia from India are discussed. An artificial key is provided for the identification of species of sect. Reichenheimia from India.
Recognition of Large-Scale ncRNA Data Using a Novel Multitask Cross-Learning 0-Order TSK Fuzzy Classifier
Authors: Jiang Yizhang , Zhu Jiaqi , Gu Xiaoqing , Xue Jing , Zhao Kaifa , Ni Tongguang , Qian Pengjiang
Published: November 2019

Recognizing noncoding ribonucleic acid (ncRNA) data is helpful in realizing the regulation of tumor formation and certain aspects of life mechanisms, such as growth, differentiation, development, and immunity. However, the scale of ncRNA data is usually very large. Using machine learning
(ML) methods to automatically analyze these data can obtain more precise results than manually analyzing these data, but the traditional ML algorithms can process only small-scale training data. To solve this problem, a novel multitask cross-learning 0-order Takagi–Sugeno–Kang
fuzzy classifier (MT-CL-0-TSK-FC) is proposed that uses a multitask cross-learning mechanism to solve the large-scale learning problem of ncRNA data. In addition, the proposed MT-CL-0-TSK-FC method naturally inherits the interpretability of traditional fuzzy systems and eventually generates
an interpretable rulesbased database to recognize the ncRNA data. The experimental results indicate that the proposed MT-CL-0TSK-FC method has a faster running time and better classification accuracy than traditional ML methods.
Application of Principal Component Analysis and Adaptive Median Filter to Improve Real-Time Prostate Capsula Detection
Authors: Wu Shixiao , Guo Chengcheng , Wang Xinghuan
Published: November 2019

This study investigated the potential for using Principal Component Analysis (PCA) and Adaptive Median Filter (AMF) to improve real-time prostate capsula detection with the traditional Region-based Fully Convolutional Network (R-FCN), Faster Region-based Convolutional Neural Network
(Faster R-CNN), You Only Look Once-Version 3 (YOLOv3) and Single Shot Multibox Detector (SSD) algorithms. The processing steps included data augmentation (rotation, vertical flip, and horizontal flip) to increase the size of the dataset from 149 to 596 images, PCA-based feature extraction,
AMF-based image denoising and a training phase incorporating the sample image set. The data were then used to test a series of combined methods that were applied to the detection of prostate capsula (PC). The results showed that application of PCA and AMF to Faster R-CNN increased the mean
average precision (mAP) for the PC images by 9.4%. The application of PCA and AMF to R-FCN, YOLOv3 and SSD increased the mAP by 7.22%, 7.14% and 3.29% for the same dataset, respectively. This study represents the first application of PCA and AMF to traditional object detection algorithms,
such as R-FCN, Faster R-CNN, YOLOv3, or SSD, and the improved mAP results suggest that this approach is a robust tool for improving multiple network architectures.
All Paths Leading to the Library: Youth Mobility and Community-Based Planning
Authors: Sarmiento Carolina S. , Duarte Catherine
Published: November 2019

In the context of a community-based planning process to relocate a neighborhood public library in Madison, Wisconsin, this research examines youth’s everyday mobility to improve their access to public space. Through an analysis of field notes, cognitive maps, and interviews with fifth and eighth graders, researchers find that youth move relatively independently every day while using different place-making strategies. The research also finds that mobility options among youth are racialized experiences with important implications in accessing services like the library. The article identifies library planning as an important process for building inclusive community spaces.
Global Positioning System Monitoring of High-Risk Sex Offenders: Implementation Challenges and Lessons Learned
Authors: Chamberlain Alyssa W. , Smith Sarah M. , Turner Susan F. , Jannetta Jesse
Published: November 2019

Agencies incorporating new technology inevitably face challenges in the implementation process. In response to the passage of Proposition 83, which mandated lifelong supervision of people convicted of sex offenses in California, San Diego County initiated a pilot program assessing Global Positioning System (GPS) monitoring of such offenders considered high risk for reoffending. Using interviews of parole agents and administrators, parole agent records of supervision, and GPS monitoring data, we assess the challenges and lessons learned from the program which help inform the current policy context of electronic monitoring. Results show that rigorous GPS supervision involves substantial workload and resource increases for parole agencies, and may not be appropriate for all individuals convicted of sex offenses. The ethical and legal challenges of electronic monitoring, more generally, require further attention. The future of GPS monitoring will depend on how programs are implemented and resources are managed, as well as how ethical issues are addressed.
Spiritual Care Perceptions of Baccalaureate Nursing Students
Authors: Pipkins Cynthia M. , Rinker Martha A. , Curl Eileen
Published: November 2019

Purpose: The purpose of this study was to examine baccalaureate nursing (BSN) students’ perception of spirituality and spiritual care as a component of holistic nursing practice. Aim: The specific aim of this study was to determine the perception levels of spiritual care, religiosity, and spirituality in first- and last-semester BSN students. Method: This descriptive cross-sectional study used a convenience sample of BSN students. Participants ( n = 150) completed demographics with self-reflected levels of religiosity and spirituality, the Spiritual Care-Giving Scale (SCGS), and the Spirituality and Spiritual Care Rating Scale (SSCRS). Findings: First-semester and last-semester BSN students were predominately single, female, Caucasian, and Christian. First-semester BSN students completed the SCGS and SSCRS upon entrance and exit in the first semester of the nursing program with no significant differences found. However, the last-semester BSN students scored significantly higher than the first-semester BSN students on the SCGS and the SSCRS. Conclusion: Over the course of the nursing program, the last-semester BSN students gained insight into spiritual care placing a higher emphasis on spirituality and less on religiosity. This supports the threading of spiritual nursing care throughout the nursing curriculum. Further study validation is needed.
Longitudinal associations of active renal disease with irreversible organ damage accrual in systemic lupus erythematosus
Authors: Kandane-Rathnayake R , Kent J R , Louthrenoo W , Luo S -F , Wu Y -JJ , Lateef A , Golder V , Sockalingam S , Navarra S a , Zamora L , Hamijoyo L , Katsumata Y , Harigai M , Chan M , O’Neill S , Goldblatt F , Lau C S , Hoi A , Nikpour M , Morand E
Published: November 2019

Objective

To examine longitudinal associations of active lupus nephritis with organ damage accrual in patients with systemic lupus erythematosus (SLE).

Methods

This study was performed using data from a large multinational prospective cohort. Active lupus nephritis at any visit was defined by the presence of urinary casts, proteinuria, haematuria or pyuria, as indicated by the cut-offs in the SLE Disease Activity Index (SLEDAI)-2K, collected at each visit. Organ damage accrual was defined as a change of SLICC-ACR Damage Index (SDI) score >0 units between baseline and final annual visits. Renal damage accrual was defined if there was new damage recorded in renal SDI domains (estimated glomerular filtration rate <50%/proteinuria >3.5 g per 24 h/end-stage kidney disease). Time-dependent hazard regression analyses were used to examine the associations between active lupus nephritis and damage accrual.

Results

Patients ( N = 1735) were studied during 12,717 visits for a median (inter-quartile range) follow-up period of 795 (532, 1087) days. Forty per cent of patients had evidence of active lupus nephritis at least once during the study period, and active lupus nephritis was observed in 3030 (24%) visits. Forty-eight per cent of patients had organ damage at baseline and 14% accrued organ damage. Patients with active lupus nephritis were 52% more likely to accrue any organ damage compared with those without active lupus nephritis (adjusted hazard ratio = 1.52 (95% confidence interval (CI): 1.16, 1.97), p < 0.02). Active lupus nephritis was strongly associated with damage accrual in renal but not in non-renal organ domains (hazard ratios = 13.0 (95% CI: 6.58, 25.5) p < 0.001 and 0.96 (95% CI: 0.69, 1.32) p = 0.8, respectively). There was no effect of ethnicity on renal damage accrual, but Asian ethnicity was significantly associated with reduced non-renal damage accrual.

Conclusion

Active lupus nephritis measured using the SLEDAI-2K domain cut-offs is associated with renal, but not non-renal, damage accrual in SLE.
Spiritual Care: Minimizing the Vulnerability of Parents Whose Children With Cancer Face the End of Life
Authors: Petersen Cheryl L.
Published: November 2019

There is a distinct lack of literature related to the spiritual care of parents whose children with cancer are at the end of life. This has led to a dearth in evidence about how nurses may intervene with spiritual care interventions to best support these vulnerable parents. The purpose of this scoping review was to examine the evidence regarding the value of spirituality/spiritual care in minimizing the vulnerability of parents whose children were diagnosed with cancer and who faced the end of life. The Arksey and O’Malley methodological framework guided the analysis of the reviewed quantitative and qualitative literature. Spirituality and spiritual care provided bereaved parents and parents of children with cancer with necessary support and enhanced coping to allow them to better deal with this devastating experience. Spirituality and spiritual care instilled hope, assisted in the search for meaning and purpose, and guided parents to develop continuing bonds with their child. Through skillful communication, pediatric oncology nurses may guide parents of children who face the end of life to strengthen relationships that offer support, plan activities that provide opportunities for hope and connection, and identify sources of meaning in their experiences.
Advocacy With Survivors of Intimate Partner Violence: What It Is, What It Isn’t, and Why It’s Critically Important
Authors: Sullivan Cris M. , Goodman Lisa A.
Published: November 2019

Survivors of intimate partner violence arrive at the doors of domestic violence (DV) programs with a wide variety of needs, including long-term safety and healing, housing, economic stability, health and well-being, and community connection. Although some DV programs offer holistic approaches to survivors, many focus the vast majority of their attention and resources on providing emotional support and safety planning rather than advocating with survivors for their access to needed resources and opportunities. Although services focused on emotional support and safety planning are important, they alone are not likely to result in the life changes that many survivors are seeking. Programs that provide genuine advocacy for survivors—defined as partnering with them to represent their rights and interests while linking them to concrete resources, protections, and opportunities—have been found to be effective and well received. Although an early pillar of DV programs, this type of advocacy has fallen by the wayside in many agencies. In this article, the authors make a case for re-invigorating advocacy efforts designed to improve the life circumstances of survivors. We argue that such efforts will make DV programs more relevant and sought after by a wider range of survivors and that agencies will see real change occur at both the individual and community levels.
The United Kingdom’s special responsibilities at the United Nations: Diplomatic practice in normative context
Authors: Ralph Jason , Gifkins Jess , Jarvis Samuel
Published: November 2019

In a 2017 speech to the United Nations, Theresa May referred to the United Kingdom’s ‘special responsibilities’. This article examines how the United Kingdom can properly discharge those responsibilities at the United Nations. We offer an innovative analytical framework that merges English School theory of international society with diplomatic practice theory, and find that there are limits to the claim that the United Kingdom compensates for its relative material decline through diplomatic activism. We identify the special responsibility of the permanent member in terms of a capacity to reconcile the ‘concert’ and ‘governance’ functions of the Council, and to contribute materially to the achievement of governance objectives in areas where consensus is possible. Drawing on extensive interview data, and illustrating with reference to current debates on peacekeeping, we find that a state’s capacity to ‘punch above its weight’ diplomatically is linked to its material commitments and to a more inclusive approach in the Council.
High-intensity interval training has a greater effect on reverse cholesterol transport elements compared with moderate-intensity continuous training in obese male rats
Authors: Rahmati-Ahmadabad Saleh , Azarbayjani Mohammad-Ali , Farzanegi Parvin , Moradi Lida
Published: November 2019

Objectives

The present study compares the effect of high-intensity interval training (HIIT; 18 min) and moderate-intensity continuous training (MIT; 1 h) on reverse cholesterol transport (RCT) elements in obese subjects.

Methods

Thirty adult male rats were induced high-fat diet (HFD) for 12 weeks. After four weeks, the rats were randomly divided into three groups while simultaneously continuing the HFD for the remaining eight weeks. Group specificities were HFD–control, HFD–MIT and HFD–HIIT. The rats were sacrificed 48 h after the last training session and the samples were collected. Analysis of variance and Pearson’s correlation test were used for the statistical analyses (significance level: p ≤ 0.05).

Results

The results showed that both HIIT and MIT improved heart ABCA1, ABCG1, ABCG4, ABCG5, ABCG8, LXR-α and PPARγ gene expression as well as plasma Apo A1, LCAT, lipids and lipoproteins (p ≤ 0.05). Moreover, higher cardiac ABCA1, ABCG1, ABCG4, ABCG5, ABCG8 and PPARγ expression and plasma high-density lipoprotein cholesterol (p ≤ 0.05) concentrations were found in the HFD–HIIT group compared with the HFD–MIT group.

Conclusion

HIIT may have more cardioprotective effects than MIT against atherosclerosis, along with saving time, as supported by the changes observed in the main factors involved in the RCT process.
Fc-modified HIT-like monoclonal antibody as a novel treatment for sepsis
Authors: Gollomp Kandace , Sarkar Amrita , Harikumar Sanjiv , Seeholzer Steven H. , Arepally Gowthami M. , Hudock Kristin , Rauova Lubica , Kowalska M. Anna , Poncz Mortimer
Published: November 2019

Sepsis is characterized by multiorgan system dysfunction that occurs because of infection. It is associated with high morbidity and mortality and is in need of improved therapeutic interventions. Neutrophils play a crucial role in sepsis, releasing neutrophil extracellular traps (NETs) composed of DNA complexed with histones and toxic antimicrobial proteins that ensnare pathogens, but also damage host tissues. At presentation, patients often have a significant NET burden contributing to the multiorgan damage. Therefore, interventions that inhibit NET release would likely be ineffective at preventing NET-based injury. Treatments that enhance NET degradation may liberate captured bacteria and toxic NET degradation products (NDPs) and likely be of limited therapeutic benefit as well. We propose that interventions that stabilize NETs and sequester NDPs may be protective in sepsis. We showed that platelet factor 4 (PF4), a platelet-associated chemokine, binds and compacts NETs, increasing their resistance to DNase I. We now show that PF4 increases NET-mediated bacterial capture, reduces the release of NDPs, and improves outcome in murine models of sepsis. A monoclonal antibody KKO which binds to PF4-NET complexes, further enhances DNase resistance. However, the Fc portion of this antibody activates the immune response and increases thrombotic risk, negating any protective effects in sepsis. Therefore, we developed an Fc-modified KKO that does not induce these negative outcomes. Treatment with this antibody augmented the effects of PF4, decreasing NDP release and bacterial dissemination and increasing survival in murine sepsis models, supporting a novel NET-targeting approach to improve outcomes in sepsis.
The translational network for metabolic disease – from protein interaction to disease co-occurrence
Authors: Nam Yonghyun , Lee Dong-gi , Bang Sunjoo , Kim Ju Han , Kim Jae-Hoon , Shin Hyunjung
Published: November 2019

Background

The recent advances inhuman disease networkhave provided insights into establishing the relationships between the genotypes and phenotypes of diseases. In spite of the great progress, it yet remains asonly a map of topologies between diseases,but not being able to be a pragmatic diagnostic/prognostic tool in medicine. It can further evolve from a map to atranslationaltool if it equips with a function of scoring that measures the likelihoods of the association between diseases. Then, a physician, when practicing on a patient, can suggest several diseases that are highly likely to co-occur with a primary disease according to the scores. In this study, we propose a method of implementing ‘n-of-1 utility’(npotential diseases ofonepatient) to human disease network—the translational disease network.

Results

We first construct adisease networkby introducing the notion ofwalkin graph theory toprotein-protein interaction network, and then provide ascoring algorithmquantifying the likelihoods ofdisease co-occurrencegiven a primary disease. Metabolic diseases, that are highly prevalent but have found only a few associations in previous studies, are chosen as entries of the network.

Conclusions

The proposed method substantially increasedconnectivitybetween metabolic diseases and providedscoresofco-occurring diseases.The increase in connectivity turned the disease networkinfo-richer. The result lifted the AUC of random guessing up to 0.72 and appeared to be concordant with the existing literatures ondisease comorbidity.
Gain and loss events in the evolution of the apolipoprotein family in vertebrata
Authors: Liu Jia-Qian , Li Wen-Xing , Zheng Jun-Juan , Tian Qing-Nan , Huang Jing-Fei , Dai Shao-Xing
Published: November 2019

Background

Various apolipoproteins widely distributed among vertebrata play key roles in lipid metabolism and have a direct correlation with human diseases as diagnostic markers. However, the evolutionary progress of apolipoproteins in species remains unclear. Nine human apolipoproteins and well-annotated genome data of 30 species were used to identify 210 apolipoprotein family members distributed among species from fish to humans. Our study focused on the evolution of nine exchangeable apolipoproteins (ApoA-I/II/IV/V, ApoC-I~IV and ApoE) fromChondrichthyes,Holostei,Teleostei,Amphibia,Sauria (includingAves),Prototheria,MarsupialiaandEutheria.

Results

In this study, we reported the overall distribution and the frequent gain and loss evolutionary events of apolipoprotein family members in vertebrata. Phylogenetic trees of orthologous apolipoproteins indicated evident divergence between species evolution and apolipoprotein phylogeny. Successive gain and loss events were found by evaluating the presence and absence of apolipoproteins in the context of species evolution. For example, only ApoA-I and ApoA-IV occurred in cartilaginous fish as ancient apolipoproteins. ApoA-II, ApoE, and ApoC-I/ApoC-II were found inHolostei, Coelacanthiformes, andTeleostei,respectively, but the latter three apolipoproteins were absent fromAves. ApoC-I was also absent fromCetartiodactyla. The apolipoprotein ApoC-III emerged in terrestrial animals, and ApoC-IV first arose inEutheria. The results indicate that the order of the emergence of apolipoproteins is most likely ApoA-I/ApoA-IV, ApoE, ApoA-II, ApoC-I/ApoC-II, ApoA-V, ApoC-III, and ApoC-IV.

Conclusions

This study reveals not only the phylogeny of apolipoprotein family members in species fromChondrichthyestoEutheriabut also the occurrence and origin of new apolipoproteins. The broad perspective of gain and loss events and the evolutionary scenario of apolipoproteins across vertebrata provide a significant reference for the research of apolipoprotein function and related diseases.
Evolutionary balance between LRR domain loss and young NBS–LRR genes production governs disease resistance in Arachis hypogaea cv. Tifrunner
Authors: Song Hui , Guo Zhonglong , Hu Xiaohui , Qian Lang , Miao Fuhong , Zhang Xiaojun , Chen Jing
Published: November 2019

Background

Cultivated peanut (Arachis hypogaea L.) is an important oil and protein crop, but it has low disease resistance; therefore, it is important to reveal the number, sequence features, function, and evolution of genes that confer resistance. Nucleotide-binding site–leucine-rich repeats (NBS–LRRs) are resistance genes that are involved in response to various pathogens.

Results

We identified 713 full-length NBS–LRRs in A. hypogaea cv. Tifrunner. Genetic exchange events occurred on NBS–LRRs in A. hypogaea cv. Tifrunner, which were detected in the same subgenomes and also found in different subgenomes. Relaxed selection acted on NBS–LRR proteins and LRR domains in A. hypogaea cv. Tifrunner. Using quantitative trait loci (QTL), we found that NBS–LRRs were involved in response to late leaf spot, tomato spotted wilt virus, and bacterial wilt in A. duranensis (2 NBS–LRRs), A. ipaensis (39 NBS–LRRs), and A. hypogaea cv. Tifrunner (113 NBS–LRRs). In A. hypogaea cv. Tifrunner, 113 NBS–LRRs were classified as 75 young and 38 old NBS–LRRs, indicating that young NBS–LRRs were involved in response to disease after tetraploidization. However, compared to A. duranensis and A. ipaensis, fewer LRR domains were found in A. hypogaea cv. Tifrunner NBS–LRR proteins, partly explaining the lower disease resistance of the cultivated peanut.

Conclusions

Although relaxed selection acted on NBS–LRR proteins and LRR domains, LRR domains were preferentially lost in A. hypogaea cv. Tifrunner compared to A. duranensis and A. ipaensis. The QTL results suggested that young NBS–LRRs were important for resistance against diseases in A. hypogaea cv. Tifrunner. Our results provid insight into the greater susceptibility of A. hypogaea cv. Tifrunner to disease compared to A. duranensis and A. ipaensis.
Prediction of kidney transplant outcome based on different DGF definitions in Chinese deceased donation
Authors: Hu Xiao-jun , Zheng Jin , Li Yang , Tian Xiao-hui , Tian Pu-xun , Xiang He-li , Pan Xiao-ming , Ding Chen-guang , Ding Xiao-ming , Xue Wu-jun
Published: November 2019

Background

Delayed graft function (DGF) is an important complication of kidney transplantation and can be diagnosed according to different definitions. DGF has been suggested to be associated with the long-term outcome of kidney transplantation surgery. However, the best DGF definition for predicting renal transplant outcomes in Chinese donations after cardiac death (DCDs) remains to be determined.

Method

A total of 372 DCD kidney transplant recipients from June 2013 to July 2017 in the First Affiliated Hospital of Xi’an Jiaotong University were included in this retrospective study to compare 6 different DGF definitions. The relationships of the DGF definitions with transplant outcome were analyzed, including graft loss (GL) and death-censored graft loss (death-censored GL). Renal function indicators, including one-year estimated glomerular filtration rate (eGFR) and three-year eGFR, and were compared between different DGF groups.

Results

The incidence of DGF varied from 4.19 to 35.22% according to the different DGF diagnoses. All DGF definitions were significantly associated with three-year GL as well as death-censored GL. DGF based on requirement of hemodialysis within the first week had the best predictive value for GL (AUC 0.77), and DGF based on sCr variation during the first 3 days post-transplant had the best predictive value for three-year death-censored GL (AUC 0.79). Combination of the 48-h sCr reduction ratio and classical DGF can improve the AUC for GL (AUC 0.85) as well as the predictive accuracy for death-censored GL (83.3%).

Conclusion

DGF was an independent risk factor for poor transplant outcome. The combination of need for hemodialysis within the first week and the 48-h serum creatinine reduction rate has a better predictive value for patient and poor graft outcome.
Patient-centered Pharmacist Care in the Hemodialysis Unit: a quasi-experimental interrupted time series study
Authors: Ismail Sherine , Al-Subhi Abrar , Youssif Eman , Ahmed Medhat , Almalki Abdullah , Seger Diane L. , Seger Andrew C. , Cook Earl
Published: November 2019

Background

Nonadherence to medications by patients requiring hemodialysis (HD) leads to unfavorable clinical outcomes. Limited data exist to demonstrate the effect of incorporating patient-centered interventions using concepts of medication therapy management and motivational interview by pharmacists on pharmacoadherence in patients requiring HD. Therefore, we assessed the impact of patient-centered pharmacist care on pharmacoadherence and its outcomes in patients requiring HD.

Methods

Adult patients who had received outpatient HD for at least 3 months were enrolled. The study was conducted from October 2016 to April 2017. Pharmacists interviewed the patients at month 1, 2, 4 and 6, and the intervention (comprehensive review) occurred at months 3 and 5. The primary outcome was the change in pharmacoadherence as assessed by pre-HD serum phosphate levels and the differences in the number of medications between patient’ self-report and medications records at the electronic healthcare records (EHRs). The secondary outcomes included changes in systolic blood pressure (SBP), glycosylated hemoglobin levels, serum low-density lipoprotein (LDL) levels, and the prevalence and types of medication-related problems (MRPs).

Results

Seventy-two patients were enrolled. Their median age was 59 (interquartile range: 47–67.5) years, and 53% were men. Pre- and post-intervention pharmacoadherence, as indicated by serum phosphate levels and the differences in the number of medications between patient’ self-report and the medication records at the EHRs, did not significantly differ (p = 0.682 and 0.348, respectively). Mean SBP and mean LDL did not significantly change post-intervention. The median number of MRPs declined between Months 3 and 5 (p = 0.002): the prevalence of MRPs at Month 3 was 44.9% (95 confidence interval [CI]: 40.4–49.3) and decreased to 29.8% (95 CI: 25.6–34.3) at Month 5. Drug use without indication was the most frequent MRP (23.9%).

Conclusions

Patient-centered pharmacist care did not result in significant changes in pharmacoadherence. However, its clinical utility as a tool to identify and mitigate MRPs in patients requiring HD is indisputable.

Trial Registration

ClinicalTrials.gov identifier: NCT03576404 (retrospectively registered on July 3rd, 2018).
A nationwide survey on neonatal medical resources in mainland China: current status and future challenges
Authors: Li Qiuping , Han Tao , Zhang Yanping , Zhang Qian , Kong Xiangyong , Yang Yonghui , Feng Zhichun
Published: November 2019

Background

With the rapid development of economy in recent two decades, neonatology has been progressing quickly in China. However, there is little knowledge about the exact developmental status of neonatal departments in China. The aim of this study was to assess resources available for care of sick newborns in mainland China.

Methods

Questionnaires were sent to the membership of the Chinese Neonatologist Association (CNA) and used to survey the scale, facilities, staff, technologies, transport systems and preterm infants’ outcomes of neonatal departments (NDs) in different areas of China from June 2012 to December 2012.

Results

The result of this survey including a total of 117 questionnaires showed that investigated ND had a mean of 65 (median 47; range 5–450) beds, including 19.59 (median 15, range 0–100) NICU beds. The overall doctor/bed and nurse/bed ratio was 1:3.84 and 1:1.43, respectively. Lack of medical equipment was one of the main problems in most NDs surveyed, and only 26 NDs (22.2%) had more than one neonatal incubator per bed. Only 70.1, 30.6, 30.8 and 4.3% NDs carried out high-frequency ventilation, hypothermia, nitric oxide inhalation, and ECMO respectively. The capacity to provide advanced therapies increased with the size of the NDs (P < .01). A total of 81 NDs (69.2%) carried out neonatal transport, but only 70 NDs (86.4%) were equipped with transport incubators, 36 NDs (44.4%) had the ability of performing intrauterine transport of the preterm infants, and 3 NDs (3.7%) had the ability of performing air transport. The survival rate of extremely preterm infants (Gestational age less than 28w) to discharge home was 47.8% in 2011.

Conclusion

NDs in mainland China are not well distributed and still face many problems, such as staff shortage, inadequate facilities, and imperfect transport. It is urgent to set up a classification of neonatal care to enhance the utilization rate of medical resources and improve the prognosis of critically ill infants.
Positive recovery for low-risk injuries screened by the short form - Örebro musculoskeletal pain screening questionnaire following road traffic injury: evidence from an inception cohort study in New South Wales, Australia
Authors: Nguyen Ha , Rebbeck Trudy , Kifley Annette , Jagnoor Jagnoor , Dinh Michael , Shetty Amith , Nicholas Michael , Cameron Ian D.
Published: November 2019

Background

Prognosis of musculoskeletal disorders following injury is essential in determining appropriate treatment and care. A generic validated prognostic tool to stratify risk of poor recovery for people with musculoskeletal injuries after road traffic crash is not available. This study aimed to examine differences in recovery, return to work and health related quality of life between low and high-risk of poor recovery people with musculoskeletal injuries stratified by the Short form - Örebro Musculoskeletal Pain Screening Questionnaire (SF-OMPSQ).

Methods

In an inception cohort study, participants with non-fracture musculoskeletal injury with the main site being the neck, lower back or lower limb were stratified into low (score ≤ 50) and high (score > 50) risk of poor recovery using the SF-OMPSQ score at baseline. We assessed the proportion of fully recovered participants (Global Perceived Effect scale ≥4), the proportion returning to work and changes in short form 12-item (SF-12) scores between baseline and 6-month follow-up in low and high-risk groups. Modified Poisson regression was used to estimate the adjusted risk ratio (RR) of being recovered and return to work in the low and high-risk groups. Paired t-test was used to compare changes in SF-12 physical and mental component summary scales, and chi-square test was used to assess the significance of the risk ratio of fully recovered between low and high-risk groups.

Results

The study included 498 participants (166 with neck, 78 with lower back and 254 with lower limb injuries). The proportion of being recovered was significantly higher in the low than the high-risk groups (Adjusted risk ratio: 2.96 [95% CI: 1.81 to 4.82]). Significantly more people in the low-risk group returned to work (91.0%) than the high-risk group (54.6%). People at low-risk had higher SF-12 scores at baseline and 6-month follow-up than those at high-risk. There were no differences between injury types for recovery and return to work at 6 months.

Conclusion

The SF-OMPSQ could be recommended as a generic prognostic tool to identify individuals with musculoskeletal injuries early after road traffic injury, who would have a higher or lower likelihood of recovering or returning fully to pre-injury work.

Trial registration

Australia New Zealand Clinical trial registry identification number - ACTRN12613000889752. Registered 09 August 2013.
Major lower extremity amputation: a contemporary analysis from an academic tertiary referral centre in a developing community
Authors: Aljarrah Qusai , Allouh Mohammed Z. , Bakkar Sohail , Aleshawi Abdelwahab , Obeidat Hasan , Hijazi Emad , Al-Zoubi Nabil , Alalem Heba , Mazahreh Tagleb
Published: November 2019

Background

We aimed to explore the surgical outcomes of major lower extremity amputation (MLEA) and influencing factors at an academic tertiary referral centre in north Jordan, optimistically providing a platform for future health care policies and initiatives to improve the outcomes of MLEA in Jordan.

Methods

Clinical records of patients who had undergone MLEA between January 2012 and December 2017 were identified and retrospectively reviewed. International Classification of Diseases codes were used to identify the study cohort from a prospectively maintained computerised database. We included adult patients of both genders who underwent amputations for ischemic lower limb (acute and chronic) and diabetic foot syndrome (DFS). We excluded patients for whom MLEA surgery was performed for other indications (trauma and tumors). Outcomes of interest included patient demographics and comorbidities, type of amputation and indications, length of hospital stay (LOS), the need for revision surgery (ipsilateral conversion to a higher level of amputation), and cumulative mortality rate at 1 year. The impact of the operating surgeon’s specialty (vascular vs. non-vascular surgeon) on outcomes was evaluated.

Results

The study cohort comprised 140 patients who underwent MLEA (110 below-knee amputations [BKA] and 30 above-knee amputations [AKA]; ratio: 3:1; 86 men; 54 women; mean age, 62.9 ± 1.1 years). Comorbidities included diabetes, hypertension, dyslipidaemia, ischaemic heart disease, congestive heart failure, chronic kidney disease, stroke, and Buerger disease. The only associated comorbidity was chronic kidney disease, which was more prevalent among BKA patients (p = 0.047). Indications for MLEA included DFS, and lower limb ischaemia. Acute limb ischaemia was more likely to be an indication for AKA (p = 0.006). LOS was considerably longer for AKA (p = 0.035). The cumulative mortality rate at 1 year was 30.7%. Revision surgery rates and LOS improved significantly with increased rate of vascular surgeon-led MLEA.

Conclusions

In developing countries, the adverse impact of MLEA is increased because of limited resources and increased prevalence of diabetes-related foot complications. Vascular surgeon-led MLEA is associated with decreased revision rates, LOS and possibly improved outcomes, particularly when it is performed for vascular insufficiency. It is important to formulate national health care policies to improve patient outcomes in these countries.
The utility of a shortened palliative care screening tool to predict death within 12 months – a prospective observational study in two south African hospitals with a high HIV burden
Authors: Raubenheimer Peter J. , Day Cascia , Abdullah Faried , Manning Katherine , Cupido Clint , Peter Jonny
Published: November 2019

Background

Timely identification of people who are at risk of dying is an important first component of end-of-life care. Clinicians often fail to identify such patients, thus trigger tools have been developed to assist in this process. We aimed to evaluate the performance of a identification tool (based on the Gold Standards Framework Prognostic Indicator Guidance) to predict death at 12 months in a population of hospitalised patients in South Africa.

Methods

Patients admitted to the acute medical services in two public hospitals in Cape Town, South Africa were enrolled in a prospective observational study. Demographic data were collected from patients and patient notes. Patients were assessed within two days of admission by two trained clinicians who were not the primary care givers, using the identification tool. Outcome mortality data were obtained from patient folders, the hospital electronic patient management system and the Western Cape Provincial death registry which links a unique patient identification number with national death certificate records and system wide electronic records.

Results

822 patients (median age of 52 years), admitted with a variety of medical conditions were assessed during their admission. 22% of the cohort were HIV-infected. 218 patients were identified using the screening tool as being in the last year of their lives. Mortality in this group was 56% at 12 months, compared with 7% for those not meeting any criteria. The specific indicator component of the tool performed best in predicting death in both HIV-infected and HIV-uninfected patients, with a sensitivity of 74% (68–81%), specificity of 85% (83–88%), a positive predictive value of 56% (49–63%) and a negative predictive value of 93% (91–95%). The hazard ratio of 12-month mortality for those identified vs not was 11.52 (7.87–16.9, p < 0.001).

Conclusions

The identification tool is suitable for use in hospitals in low-middle income country setting that have both a high communicable and non-communicable disease burden amongst young patients, the majority under age 60.
High triglyceride–glucose index is associated with poor prognosis in patients with acute ST-elevation myocardial infarction after percutaneous coronary intervention
Authors: Luo Erfei , Wang Dong , Yan Gaoliang , Qiao Yong , Liu Bo , Hou Jiantong , Tang Chengchun
Published: November 2019

Background

Insulin resistance (IR) is considered a pivotal risk factor for cardiometabolic diseases, and the triglyceride–glucose index (TyG index) has emerged as a reliable surrogate marker of IR. Although several recent studies have shown the association of the TyG index with vascular disease, no studies have further investigated the role of the TyG index in acute ST-elevation myocardial infarction (STEMI). The objective of the present study was to evaluate the potential role of the TyG index as a predictor of prognosis in STEMI patients after percutaneous coronary intervention (PCI).

Methods

The study included 1092 STEMI patients who underwent PCI. The patients were divided into 4 quartiles according to TyG index levels. Clinical characteristics, fasting plasma glucose (FPG), triglycerides (TGs), other biochemical parameters, and the incidence of major adverse cardiovascular and cerebral events (MACCEs) during the follow-up period were recorded. The TyG index was calculated using the following formula: ln[fasting TGs (mg/dL) × FPG (mg/dL)/2].

Results

The incidence of MACCEs and all-cause mortality within 30 days, 6 months and 1 year after PCI were higher among STEMI patients with TyG index levels in the highest quartile. The TyG index was significantly associated with an increased risk of MACCEs in STEMI patients within 1 year after PCI, independent of confounding factors, with a value of 1.529 (95% CI 1.001–2.061; P = 0.003) for those in the highest quartile. The area under the curve (AUC) of the TyG index predicting the occurrence of MACCEs in STEMI patients after PCI was 0.685 (95% CI 0.610–0.761; P = 0.001). The results also revealed that Killip class > 1, anaemia, albumin, uric acid, number of stents and left ventricular ejection fraction (LVEF) were independent predictors of MACCEs in STEMI patients after PCI (all P < 0.05).

Conclusions

This study indicated an association between higher TyG index levels and increased risk of MACCEs in STEMI patients for the first time, and the TyG index might be a valid predictor of clinical outcomes in STEMI patients undergoing PCI.

Trial Registration ChiCTR1900024577.