bluuebunny/crossref_metadata_2025 huggingface dataset:
Arthroscopic Management for Bipartite Patella: A Systematic Review
Authors: Loewen Allison , Ge Susan M. , Marwan Yousef , Burman Mark , Martineau Paul A.
Published: August 2021

Background:

Bipartite patella is a rare congenital condition that becomes painful following direct trauma or an overuse injury. If it remains painful despite nonoperative treatment, surgery may be warranted. The current gold standard is open fragment excision or lateral release; however, arthroscopic management is also possible.

Purpose:

To investigate the safety and efficacy of arthroscopic treatment of painful bipartite patella.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

Using Medline and Embase, we systematically reviewed the literature as of March 8, 2020, using the subject headings “bipartite patella” and “arthroscopy” and related key terms. All levels of evidence involving human studies in English were included. Articles were excluded if only the abstract was published or the study was related to nonsurgical treatment or nonrelated diagnoses. Data related to journal/article information, demographic/clinical data, arthroscopic technique, length of follow-up, treatment outcomes, and complications were extracted.

Results:

Eleven articles with 43 patients were included in the review. Most patients (n = 34; 79%) underwent arthroscopic lateral release, while 16% (n = 7) had arthroscopic excision of the accessory fragment and 5% (n = 2) had arthroscopic excision and release. All patients except for one, who experienced postoperative trauma, were pain-free after arthroscopic treatment and were able to return to sports after a mean 2.6 months.

Conclusion:

This review demonstrated that arthroscopic management of painful bipartite patella is a safe and effective alternative to open surgical excision or release. However, all articles were case studies or small case series, owing to the rarity of the condition. In the future, higher-level studies comparing arthroscopic techniques and postoperative rehabilitation programs should be performed.
The Expansion of Higher Education and the Education-Health Gradient in the United States
Authors: Frase Robert T. , Bauldry Shawn
Published: August 2021

The United States experienced a period of rapid higher education expansion between the mid-1940s and mid-1970s. Although this expansion likely improved the health of people able to take advantage of new education opportunities, expansion may have also intensified health inequalities between college-educated and non-college-educated people (1) through the compositional change in the relative (dis)advantage of these groups, (2) through the displacement of non-college-educated people in a more competitive post-expansion labor market, and (3) by increasing health returns to a college degree. Our analyses, rooted in a counterfactual perspective, draw on data from the Health and Retirement Study that spans birth cohorts who came of age before and after the period of expansion, allowing us to differentiate people who earned a degree because of expansion but would not otherwise (conditional-earners) from people who would or would not have earned a degree regardless of expansion (always-earners and never-earners, respectively). Comparing changes in the health of these three groups before and after education expansion permits us to individually evaluate how compositional change, displacement, and increasing returns to education exacerbated health inequalities. Our findings suggest that education expansion improved the health of conditional-earners and magnified health inequalities through the mechanism of displacement.
Accum and food adulteration: A forgotten bicentennial
Authors: Dayan Anthony D , Dayan Joshua D
Published: August 2021

In 1820, Frederick Accum published a book, best known by its biblical subtitle ‘Death in the Pot', showing the widespread fraudulent and dangerous adulteration of common foods and drinks bought in London. Despite its brief popularity, there was no effective legislation in Britain until 1875 after more extensive analytical surveys by Hassall and Letheby in 1855 and a parliamentary enquiry had confirmed the frauds and risks to public health. There were similar surveys and legal action against food adulteration in France and Germany towards the end of the 19th century. In the USA, campaigning by Harvey Wiley and others revealed the same risks and frauds and led to the Pure Foods and Drugs Act in 1906 and formation of the FDA. We should have celebrated Accum’s bicentennial in 2020 to recognise his achievement and to remind us of the continuing dangers of food adulteration today.
Improving VTE prophylaxis adherence among hospitalized adolescents using Human-Centered Design
Authors: Kim Soobin , Klugman Jessie , Norell Sarah , Kenefake Alexandra , Komos Laurel , Jain Divya , Corcoran Moire , Montero Carlos , Kreppel Andrew , Sales Jocelyn , Porto Isabel , Wang Jenny , Hsu Lewis L. , Erwin Kim
Published: August 2021

Background/problem statement

Venous thromboembolism (VTE) is the leading cause of preventable hospital mortality in the United States; however, compliance with VTE prophylaxis is poor. Most materials for education about VTE prophylaxis are oriented toward adults rather than adolescents, for whom VTE risks are lower and prophylaxis indications differ. We hypothesized that educational materials for adolescents could improve compliance with VTE prophylaxis, reduce nurse burden for initiating and maintaining VTE prevention practices, and reduce practice variation by standardizing the conversation between clinicians and patients.

Methods

A multidisciplinary team including physicians, nurses, quality experts, communication designers, service designers, and medical students applied a human-centered design (HCD) process to define, iteratively prototype, and test education tools for nurses assigned to adolescents. We piloted a suite of six educational tools for adolescent VTE prophylaxis to fit into the existing hospital workflow.

Results

An in-room poster was selected after 85% of nurses responded favorably to this intervention. Adolescent adherence with Intermittent Pneumatic Compression Device increased from 69% to 79%, attaining the benchmark goal of 78%. Staff reported greater confidence in educating adolescent patients after the intervention: 62% of nurses and 72% of residents.

Conclusion

An HCD process helped nurses improve VTE prophylaxis for adolescents with an in-room poster and messaging strategy. Engaging staff in the design increased receptivity and adoption. The piloted materials also helped to create an environment of shared priority among the clinicians.
Effect of higher layer thickness on laser powder bed fusion built single tracks of Ni-Cr-Fe-Nb-Mo alloy
Authors: Nayak S. K. , Mishra S. K. , Paul C. P. , Bindra K. S.
Published: August 2021

Laser Powder Bed Fusion (LPBF) is one of the revolutionary technologies that can fabricate complex-shaped components by selective melting of the pre-placed powder layer, using high-power laser as directed by the input digital files. Generally, research on the LPBF process is called out for layer thickness (LT) up to 50 µm and smaller beam diameter (≤100 µm), but it has lower productivity. In LPBF, higher productivity can be achieved with higher LT (>50 µm), but it consists of various process instabilities. In the present work, parametric studies are performed by laying Ni-Cr-Fe-Nb-Mo single tracks, using LPBF at higher LT. The process parameters such as laser power ( P), scan speed ( v), and LT are varied among 150–450 W, 0.04–0.1 m s−1, and 80–160 µm, respectively, at three levels each. For the range of parameters under investigation, the maximum track width of 610 µm and aspect ratio of 7.63 are achieved at a P of 450 W and v of 0.04 m s−1 at 80 µm LT. It is observed that an increase in the energy density and layer thickness resulted in the reduction of track width and aspect ratio due to material vaporization occurring from poor heat conductivity due to unconventionally high powder layer thickness. It is also observed that the build rate increases with an increase in P, v, and LT. As single tracks are basic building blocks, the obtained results can provide an insight into the effect of process parameters on LPBF-built single tracks at higher LT for building engineering components of required width with higher build rate. Furthermore, the track dilution is also found to increase with the increase in P and decrease in v.
How Values Ground Value Creation: The practical inference framework
Authors: Donaldson Thomas
Published: August 2021

After more than two decades of searching, the holy grail of integrating norms into management and organization research remains elusive. Researchers still lack a clear framework that explains value creation in relation to normative values, and, in turn, a means to incorporate values into research methods and generate value-based practical insights. To fill that need, this article presents an epistemological framework for understanding value creation. The practical inference framework centers on the activity of practical reasoning, a kind of reasoning that is legitimized by intrinsic values. It turns the ordinary epistemic equation on its head by seeking reasons rather than causes, and justifications rather than descriptions. In doing so, it shows how both factor analytic and newer, divergent methods of research can integrate with a robust architecture of value creation in ways that offer relevant knowledge for managers and society.
Obesity, tidal volume, and pulmonary deposition of fine particulate matter in children with asthma
Authors: Afshar-Mohajer Nima , Wu Tianshi David , Shade Rebecca , Brigham Emily , Woo Han , Wood Megan , Koehl Rachelle , Koehler Kirsten , Kirkness Jason , Hansel Nadia N. , Ramchandran Gurumurthy , McCormack Meredith C.
Published: August 2021

Background

Obese children with asthma are more vulnerable to air pollution, especially fine particulate matter (PM2.5), but reasons are poorly understood. We hypothesised that differences in breathing patterns (tidal volume, respiratory rate and minute ventilation) due to elevated body mass index (BMI) may contribute to this finding.

Objective

To investigate the association of BMI with breathing patterns and deposition of inhaled PM2.5.

Methods

Baseline data from a prospective study of children with asthma were analysed (n=174). Tidal breathing was measured by a pitot-tube flowmeter, from which tidal volume, respiratory rate and minute ventilation were obtained. The association of BMI z-score with breathing patterns was estimated in a multivariable model adjusted for age, height, race, sex and asthma severity. A particle dosimetry model simulated PM2.5lung deposition based on BMI-associated changes in breathing patterns.

Results

Higher BMI was associated with higher tidal volume (adjusted mean difference (aMD) between obese and normal-range BMI of 25 mL, 95% CI 5–45 mL) and minute ventilation (aMD 453 mL·min−1, 95% CI 123–784 mL·min−1). Higher tidal volumes caused higher fractional deposition of PM2.5in the lung, driven by greater alveolar deposition. This translated into obese participants having greater per-breath retention of inhaled PM2.5(aMD in alveolar deposition fraction of 3.4%, 95% CI 1.3–5.5%), leading to worse PM2.5deposition rates.

Conclusions

Obese children with asthma breathe at higher tidal volumes that may increase the efficiency of PM2.5deposition in the lung. This finding may partially explain why obese children with asthma exhibit greater sensitivity to air pollution.
Efficacy and safety of inhaled ENaC inhibitor BI 1265162 in patients with cystic fibrosis: BALANCE-CF 1, a randomised, phase II study
Authors: Goss Christopher H. , Fajac Isabelle , Jain Raksha , Seibold Wolfgang , Gupta Abhya , Hsu Ming-Chi , Sutharsan Sivagurunathan , Davies Jane C. , Mall Marcus A.
Published: August 2021

Background

Inhibition of the epithelial sodium channel (ENaC) in cystic fibrosis (CF) airways provides a mutation-agnostic approach that could improve mucociliary clearance in all CF patients. BI 1265162 is an ENaC inhibitor with demonstrated pre-clinical efficacy and safety already demonstrated in humans.

Objective

We present results from BALANCE-CFTM1, a phase II, placebo-controlled, randomised, double-blind study of four dose levels of BI 1265162versusplacebo for 4 weeks on top of standard of care in adults and adolescents with CF.

Results

Initially, 28 randomised subjects (BI 1265162 200 µg twice daily n=14, placebo twice daily n=14) were assessed at an interim futility analysis. Compared with placebo, numerical changes of –0.8% (95% CI –6.6 to 4.9%) in percentage predicted forced expiratory volume in 1s (ppFEV1) and +2.1 units (95% CI –2.4 to 6.5 units) in lung clearance index (LCI) were observed in the active group, meeting a pre-defined stopping rule; accordingly, the study was terminated. Recruitment had continued during the interim analysis and pending results; 24 patients were added across three dose levels and placebo. The final results including these patients (+1.5% ppFEV1, 200 µg twice-daily doseversusplacebo) were not supportive of relevant clinical effect. Furthermore, LCI change was not supportive, although interpretation was limited due to insufficient traces meeting quality criteria. A 9.4-point improvement in the Cystic Fibrosis Questionnaire – Revised Respiratory Domain was observed in the 200 µg twice daily dose groupversusplacebo. BI 1265162 up to 200 µg twice daily was safe and well-tolerated. Pharmacokinetics were similar to those in healthy volunteers.

Conclusion

BI 1265162 was safe, but did not demonstrate a potential for clinical benefit. Development has been terminated.
Asthma and COVID-19 risk: a systematic review and meta-analysis
Authors: Sunjaya Anthony P. , Allida Sabine M. , Di Tanna Gian Luca , Jenkins Christine R.
Published: August 2021

Background

Individual case series and cohort studies have reported conflicting results in people with asthma on the vulnerability to and risk of mortality from coronavirus disease 2019 (COVID-19).

Research question

Are people with asthma at a higher risk of being infected or hospitalised or poorer clinical outcomes from COVID-19?

Methods

A systematic review and meta-analysis based on five main databases including the World Health Organization COVID-19 database between 1 December 2019 and 11 July 2021 on studies with a control (non-asthma) group was conducted. Prevalence and risk ratios were pooled using Sidik–Jonkman random-effects meta-analyses.

Findings

51 studies with an 8.08% (95% CI 6.87–9.30%) pooled prevalence of people with asthma among COVID-19 positive cases. The risk ratios were 0.83 (95% CI 0.73–0.95, p=0.01) for acquiring COVID-19; 1.18 (95% CI 0.98–1.42, p=0.08) for hospitalisation; 1.21 (95% CI 0.97–1.51, p=0.09) for intensive care unit (ICU) admission; 1.06 (95% CI 0.82–1.36, p=0.65) for ventilator use; and 0.94 (95% CI 0.76–1.17, p=0.58) for mortality for people with asthma. Subgroup analyses by continent revealed a significant difference in risk of acquiring COVID-19, ICU admission, ventilator use and death between the continents.

Interpretation

The risk of being infected with severe acute respiratory syndrome coronavirus 2 was reduced compared to the non-asthma group. No statistically significant differences in hospitalisation, ICU admission and ventilator use were found between groups. Subgroup analyses showed significant differences in outcomes from COVID-19 between America, Europe and Asia. Additional studies are required to confirm this risk profile, particularly in Africa and South America, where few studies originate.
An updated approach to determine minimal clinically important differences in idiopathic pulmonary fibrosis
Authors: Kang Mohleen , Veeraraghavan Srihari , Martin Greg S. , Kempker Jordan A.
Published: August 2021

Introduction

Current medications for idiopathic pulmonary fibrosis (IPF) have not been shown to impact patient-reported outcome measures (PROMs), highlighting the need for accurate minimal clinically important difference (MCID) values. Recently published consensus standards for MCID studies support using anchor-based over distribution-based methods. The aim of this study was to estimate MCID values for worsening in IPF using only an anchor-based approach.

Methods

We conducted secondary analyses of three randomised controlled trials with different inclusion criteria and follow-up intervals. The health transition question in the 36-Item Short-Form Health Survey (SF-36) questionnaire was used as the anchor. We used receiver operating curves to assess responsiveness between the anchor and 10 variables (four physiological measures and six PROMs). We used an anchor-based method to determine the MCID values of variables that met the responsiveness criteria (area under the curve ≥0.70).

Results

6-min walk distance (6MWD), the St George's Respiratory Questionnaire (SGRQ), physical component score (PCS) of SF-36 and University of California, San Diego, Shortness of Breath Questionnaire (UCSD SOBQ) met the responsiveness criteria. The MCID value for 6MWD was −75 m; the MCID value for SF-36 PCS was −7 points; the MCID value for SGRQ was 11 points; and the MCID value for the UCSD SOBQ was 11 points.

Conclusions

The MCID estimates of 6MWD, SGRQ, SF-36 and UCSD SOBQ using only anchor-based methods were considerably higher compared to previously proposed values. A single MCID value may not be applicable across all classes of disease severity or durations of follow-up time.
Epidemiology and economic burden of bronchiectasis requiring hospitalisation in Singapore
Authors: Phua Hwee Pin , Lim Wei-Yen , Ganesan Ganga , Yoong Joanne , Tan Kelvin Bryan , Abisheganaden John Arputhan , Lim Albert Yick Hou
Published: August 2021

Background and objective

Little is known about the epidemiology and cost of bronchiectasis in Asia. This study describes the disease burden of bronchiectasis in Singapore.

Methods

A nationwide administrative dataset was used to identify hospitalisations with bronchiectasis as a diagnosis. Population statistics and medical encounter data were used to estimate the incidence, mortality, prevalence and direct medical costs associated with bronchiectasis requiring hospitalisation.

Results

There were 420 incident hospitalised bronchiectasis patients in 2017, giving an incidence rate of 10.6 per 100 000. Age-standardised incidence declined on average by 2.7% per year between 2007 and 2017. Incidence rates increased strongly with age in both men and women. Tuberculosis was a secondary diagnosis in 37.5% of incident hospitalisations in 2007, but has declined sharply since then. Patient survival was considerably lower in both men (5-year relative survival ratios (RSR) 0.63, 95% CI 0.59–0.66) and women (5-year RSR 0.75, 95% CI 0.72–0.78). The point prevalence of bronchiectasis was 147.1 per 100 000 in 2017, and increased sharply with age, with >1% of people aged ≥75 years having bronchiectasis. Total first-year costs among incident bronchiectasis patients in 2016 varied widely, with a mean±sdUSD 7331±8863. Approximately 10% of the patients admitted in 2016 had total first-year costs of more than USD 14 380.

Conclusion

Bronchiectasis is common and imposes a substantial burden on healthcare costs and survival rates of patients in Singapore.
Lung function, COPD and Alternative Healthy Eating Index in US adults
Authors: Ducharme-Smith Kirstie , Mora-Garcia Gustavo , de Castro Mendes Francisca , Ruiz-Diaz Maria Stephany , Moreira Andre , Villegas Rodrigo , Garcia-Larsen Vanessa
Published: August 2021

Background

There is a large burden of COPD in the US. The purpose of this study was to investigate the association between diet quality with lung function, spirometric restriction and spirometrically defined COPD in a nationally representative sample of US adults.

Methods

Adults (19–70 years of age) from the National Health and Nutrition Examination Survey 2007–2012 cycles were included (n=10 428). Diet quality was determined using the Alternative Healthy Eating Index (AHEI-2010). Pre-bronchodilator measurements of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and the FEV1/FVC were described. Calibrated lower limit of normal (LLN) estimates were derived to determine prevalence of spirometric restriction (FVC<LLN) and COPD (FEV1/FVC ratio<LLN). Population-weighted linear and logistic regression models were used to investigate the association of AHEI-2010 and respiratory outcomes.

Results

The mean±SD AHEI was 45.3±12.2, equivalent to meeting 41% of the daily recommendations for optimal diet quality. Those in the highest quartile of AHEI had better FEV1(adjusted (a)β 47.92, 95% CI 2.27–93.57) and FVC (aβ 80.23, 95% CI 34.03–126.42; p-value interaction (*) of AHEI and smoking >0.05) compared to those in quartile 1. Higher AHEI was also associated with lower odds of spirometric restriction (OR 0.23, 95% CI 0.08–0.67; p-value AHEI*ethnicity >0.05).

Conclusions

Diet quality was independently associated with better FEV1and FVC and with lower odds of spirometric restriction. These findings highlight the need for research to further elucidate the possible beneficial role of diet in the preservation of lung function.
The role and mechanism of long non-coding RNA H19 in stem cell osteogenic differentiation
Authors: Wang Liang , Qi Lei
Published: August 2021

Background

In recent years, H19, as one of the most well-known long non-coding RNA, has been reported to play important roles in many biological and physiological processes. H19 has been identified to regulate the osteogenic differentiation of various stem cells in many studies. However, the detailed role and regulation mechanism of H19 was not consistent in the reported studies.

Main body of the manuscript

In this review article we summarized the effect and mechanism of lncRNA H19 on osteogenic differentiation of various stem cells reported in the published literatures. The role and mechanism of H19, H19 expression changes, effect of H19 on cell proliferation in osteogenic differentiation were respectively reviewed.

Conclusions

An increasing number of studies have provided evidence that H19 play its role in the regulation of stem cell osteogenic differentiation by different mechanisms. Most of the studies favored the positive regulatory effect of H19 through lncRNA-miRNA pathway. The function and underlying mechanisms by which H19 contributes to osteogenic differentiation require further investigation.
Acute prolonged motor aura resembling ischemic stroke after COVID − 19 vaccination (CoronaVac): the first case report
Authors: Rattanawong Wanakorn , Akaratanawat Wasan , Tepmongkol Supatporn , Chutinet Aurauma , Tantivatana Jarturon , Suwanwela Nijasri Charnnarong
Published: August 2021

Background

We report the first case of a patient who suffered transient focal neurological deficit mimicking stroke following CoronaVac vaccination. However, instead of an ischemic stroke, motor aura was suspected.

Case presentations

A 24 year-old Thai female presented with left hemiparesis fifteen minutes after receiving CoronaVac. She also had numbness of her left arm and legs, flashing lights, and headaches. On physical examination, her BMI was 32.8. Her vital signs were normal. She had moderate left hemiparesis (MRC grade III), numbness on her left face, arms, and legs. Her weakness continued for 5 days. A brain CT scan was done showing no evidence of acute infarction. Acute treatment with aspirin was given. MRI in conjunction with MRA was performed in which no restricted diffusion was seen. A SPECT was performed to evaluate the function of the brain showing significant hypoperfusion of the right hemisphere. The patient gradually improved and was discharged.

Discussions

In this study, we present the first case of stroke mimic after CoronaVac vaccination. After negative imaging studies had been performed repeatedly, we reach a conclusion that stroke is unlikely to be the cause. Presumably, this phenomenon could possibly have abnormal functional imaging study. Therefore, we believed that it might be due to cortical spreading depression, like migraine aura, which we had conducted a literature review.
Robust optimization of SWATH-MS workflow for human blood serum proteome analysis using a quality by design approach
Authors: Serrano-Blesa Edith , Porter Andrew , Lendrem Dennis W. , Pitzalis Costantino , Barton Anne , Treumann Achim , Isaacs John D.
Published: August 2021

Background

It is not enough to optimize proteomics assays. It is critical those assays are robust to operating conditions. Without robust assays, proteomic biomarkers are unlikely to translate readily into the clinic. This study outlines a structured approach to the identification of a robust operating window for proteomics assays and applies that method to Sequential Window Acquisition of all Theoretical Spectra Mass Spectroscopy (SWATH-MS).

Methods

We used a sequential quality by design approach exploiting a fractional screening design to first identify critical SWATH-MS parameters, then using response surface methods to identify a robust operating window with good reproducibility, before validating those settings in a separate validation study.

Results

The screening experiment identified two critical SWATH-MS parameters. We modelled the number of proteins and reproducibility as a function of those parameters identifying an operating window permitting robust maximization of the number of proteins quantified in human serum. In a separate validation study, these settings were shown to give good proteome-wide coverage and high quantification reproducibility.

Conclusions

Using design of experiments permits identification of a robust operating window for SWATH-MS. The method gives a good understanding of proteomics assays and greater data-driven confidence in SWATH-MS performance.
Upper tract imaging modality to investigate haematuria: cancer detection rates and changing guidelines
Authors: Yap Lee Chien , McNicholas Daniel Peter , Walsh Anna L. , Rauf Abdul , Patterson Ken , Power Richard
Published: August 2021

Background

To assess the imaging modalities used to investigate both visible haematuria and non-visible haematuria along with their detection rate of malignancy at two hospitals and the corresponding radiological workload produced.

Methods

A retrospective study was conducted across two hospitals. All CT urograms and ultrasound scans investigating haematuria in the outpatient setting over a 12-month period were evaluated.

Results

The detection rate for upper tract urothelial cancer with visible haematuria was 0.97% and for renal cell carcinoma was 0.64%. Of all the CT urograms performed for non-visible haematuria 4.9% had suspicious findings but none of these represents an underlying malignancy. Of all the ultrasound scans performed for either visible or non-visible haematuria, none were shown to have an underlying malignancy. The detection rate was thus zero for an upper tract urinary cancer or renal cell carcinoma in the non-visible haematuria group. A CT urogram was performed in 27% and 67% of cases in each respective hospital to further investigate non-visible haematuria. CT urography makes up 2.3% and 5.2% of each hospitals overall respective workload in the CT department. CT urography to investigate non-visible haematuria could be replaced by ultrasound in low-risk patients.

Conclusions

Radiological investigations are a limited resource and better rationalisation of upper tract imaging is needed in the setting of haematuria. Risk stratification of patients would be of benefit to help prevent a significant delay in timely diagnostics for higher risk individuals presenting with haematuria.
A preliminary outcome of modified enhanced recovery protocol versus standard of care in radical cystectomy: an Indonesian experience
Authors: Hendri Ahmad Zulfan , Khalilullah Said Alfin , Aditya Gede Andi
Published: August 2021

Background

This study aimed to evaluate the outcomes of modified Enhanced Recovery After Surgery (ERAS) protocol and standard of care (SC) in bladder cancer patients who underwent radical cystectomy (RC). The length of stay and complications rates were the primary outcomes. Time functional recovery, bowel movement, mobilization, drain removal, and other perioperative outcomes were the secondary outcomes.

Methods

A cohort retrospective study was conducted to investigate the effectiveness of the modified ERAS protocol compared to SC in 61 patients who underwent RC (36 ERAS vs. 25 SC).

Results

The modified ERAS protocol was associated with shorter length of stay (9.3 ± 5.0 days vs. 12.6 ± 6.7 days,P = 0.032) and reduction in important postoperative milestones, including days to first solid diet (3.5 ± 1.6 vs. 5.5 ± 1.5,P = 0.000), days to first defecation (4.8 ± 2.4 vs. 7.2 ± 2.4,P = 0.001), days to first walking (4.7 ± 2.2 vs. 7.9 ± 2.4,P = 0.000), and days to drain removal (3.9 ± 1.3 vs. 5.9 ± 2.5P = 0.001). Postoperative complications rates were lower in the modified ERAS groups, but the result was not statistically significant (P = 0.282). Also, there were no significant differences between transfusion requiring, intensive care monitoring, re-operation, and re-admission between groups.

Conclusion

This study demonstrated that the modified ERAS protocol for RC can accelerate postoperative recovery without any adverse effects on morbidity and mortality.
Quantitative analysis of the blood transcriptome of young healthy pigs and its relationship with subsequent disease resilience
Authors: Lim Kyu-Sang , Cheng Jian , Putz Austin , Dong Qian , Bai Xuechun , Beiki Hamid , Tuggle Christopher K. , Dyck Michael K. , Canada Pig Gen , Fortin Frederic , Harding John C. S. , Plastow Graham S. , Dekkers Jack C. M.
Published: August 2021

Background

Disease resilience, which is the ability of an animal to maintain performance under disease, is important for pigs in commercial herds, where they are exposed to various pathogens. Our objective was to investigate population-level gene expression profiles in the blood of 912 healthy F1 barrows at ~ 27 days of age for associations with performance and health before and after their exposure to a natural polymicrobial disease challenge at ~ 43 days of age.

Results

Most significant (q < 0.20) associations of the level of expression of individual genes in blood of young healthy pigs were identified for concurrent growth rate and subjective health scores prior to the challenge, and for mortality, a combined mortality-treatment trait, and feed conversion rate after the challenge. Gene set enrichment analyses revealed three groups of gene ontology biological process terms that were related to disease resilience: 1) immune and stress response-related terms were enriched among genes whose increased expression was unfavorably associated with both pre- and post-challenge traits, 2) heme-related terms were enriched among genes that had favorable associations with both pre- and post-challenge traits, and 3) terms related to protein localization and viral gene expression were enriched among genes that were associated with reduced performance and health traits after but not before the challenge.

Conclusions

Gene expression profiles in blood from young healthy piglets provide insight into their performance when exposed to disease and other stressors. The expression of genes involved in stress response, heme metabolism, and baseline expression of host genes related to virus propagation were found to be associated with host response to disease.
Differential effects of rat ADSCs encapsulation in fibrin matrix and combination delivery of BDNF and Gold nanoparticles on peripheral nerve regeneration
Authors: Razavi Shahnaz , Jahromi Maliheh , Vatankhah Elham , Seyedebrahimi Reihaneh
Published: August 2021

Background

Fibrin as an extracellular matrix feature like biocompatibility, creates a favorable environment for proliferation and migration of cells and it can act as a reservoir for storage and release of growth factors in tissue engineering.

Methods

In this study, the inner surface of electrospun poly (lactic-co-glycolic acid) (PLGA) nanofibrous conduit was biofunctionalized with laminin containing brain derived neurotrophic factor (BDNF) and gold nanoparticles in chitosan nanoparticle. The rats were randomly divided into five groups, including autograft group as the positive control, PLGA conduit coated by laminin and filled with DMEM/F12, PLGA conduit coated by laminin and filled with rat-adipose derived stem cells (r-ADSCs), PLGA conduit coated by laminin containing gold-chitosan nanoparticles (AuNPs-CNPs), BDNF-chitosan nanoparticles (BDNF-CNPs) and filled with r-ADSCs or filled with r-ADSCs suspended in fibrin matrix, and they were implanted into a 10 mm rat sciatic nerve gap. Eventually, axonal regeneration and functional recovery were assessed after 12 weeks.

Results

After 3 months post-surgery period, the results showed that in the PLGA conduit filled with r-ADSCs without fibrin matrix group, positive effects were obtained as compared to other implanted groups by increasing the sciatic functional index significantly (p < 0.05). In addition, the diameter nerve fibers had a significant difference mean in the PLGA conduit coated by laminin and conduit filled with r-ADSCs in fibrin matrix groups relative to the autograft group (p < 0.001). However, G-ratio and amplitude (AMP) results showed that fibrin matrix might have beneficial effects on nerve regeneration but, immunohistochemistry and real-time RT-PCR outcomes indicated that the implanted conduit which filled with r-ADSCs, with or without BDNF-CNPs and AuNPs-CNPs had significantly higher expression of S100 and MBP markers than other conduit implanted groups (p < 0.05).

Conclusions

It seems, in this study differential effects of fibrin matrix, could be interfered it with other factors thereby and further studies are required to determine the distinctive effects of fibrin matrix combination with other exogenous factors in peripheral nerve regeneration.
Enhancement of plant cold tolerance by soybean RCC1 family gene GmTCF1a
Authors: Dong Zhanghui , Wang Hui , Li Xia , Ji Hongtao
Published: August 2021

Background

Low temperature severely limits the growth, yield, and geographic distributions of soybean. Soybean plants respond to cold stress by reprogramming the expression of a series of cold-responsive genes. However, the intrinsic mechanism underlying cold-stress tolerance in soybean remains unclear. A. thaliana tolerant to chilling and freezing 1 (AtTCF1) is a regulator of chromosome condensation 1 (RCC1) family protein and regulates freezing tolerance through an independent C-repeat binding transcription factor (CBF) signaling pathway.

Results

In this study, we identified a homologous gene of AtTCF1 in soybean (named GmTCF1a), which mediates plant tolerance to low temperature. Like AtTCF1, GmTCF1a contains five RCC1 domains and is located in the nucleus. GmTCF1a is strongly and specifically induced by cold stress. Interestingly, ectopic overexpression of GmTCF1a in Arabidopsis greatly increased plant survival rate and decreased electrolyte leakage under freezing stress. A cold-responsive gene, COR15a, was highly induced in the GmTCF1a-overexpressing transgenic lines.

Conclusions

GmTCF1a responded specifically to cold stress, and ectopic expression of GmTCF1a enhanced cold tolerance and upregulated COR15a levels. These results indicate that GmTCF1a positively regulates cold tolerance in soybean and may provide novel insights into genetic improvement of cold tolerance in crops.
Declined ELABELA plasma levels in hypertension patients with atrial fibrillation: a case control study
Authors: Ma Zheng , Zhao Lei , Zhang Ye-ping , Zhong Jiu-chang , Yang Xin-chun
Published: August 2021

Background

Atrial fibrillation (AF) is a common arrhythmia in patients with hypertension. ELABELA, which has cardioprotective effects, is decreased in the plasma of patients with hypertension and might be associated with AF in the hypertensive population. This study aims to measure the ELABELA plasma levels in hypertension patients with and without AF and to analyse the related factors.

Methods

A total of 162 hypertension patients with or without AF were recruited for our monocentric observational study. Subjects were excluded if they had a history of valvular heart disease, rheumatic heart disease, cardiomyopathy, thyroid diseases, or heart failure. The patients’ histories were recorded, and laboratory examinations were conducted. Plasma ELABELA was detected by immunoassay. Echocardiographs were performed, and parameters were collected by two experienced doctors. Binary logistic regression analysis was used to identify the association between ELABELA plasma level and AF in patients with hypertension.

Results

Plasma ELABELA levels were lower in hypertension patients with AF than in those without AF (2.0 [1.5, 2.8] vs. 4.0 [3.4, 5.0] ng/ml, P < 0.001). ELABELA levels were correlated with age, heart rate, BNP levels and left atrial dimension. In addition to the left atrial dimension, ELABELA plasma levels were associated with AF in patients with hypertension (OR 0.081, 95% CI 0.029–0.224, P < 0.001). ELABELA levels were further decreased in the persistent AF subgroup compared with the paroxysmal AF subgroup (1.8 [1.4, 2.5] vs. 2.2 [1.8, 3.0] ng/ml, P = 0.012) and correlated with HR, BNP and ESR levels.

Conclusions

ELALABELA levels were decreased in hypertension patients with AF and further lowered in the persistent AF subgroup. Decreased ELABELA plasma levels were associated with AF in hypertension patients and may be an underlying risk factor.
Hydroxychloroquine/chloroquine in patients with COVID-19 in Wuhan, China: a retrospective cohort study
Authors: Chen Zhe , Liu Aihua , Cheng Yongjing , Wang Xutao , Xu Xiaomao , Huang Jia , Ma Yuqing , Gao Ming , Huang Cibo
Published: August 2021

Background

Since the COVID-19 pandemic, several therapeutic agents have been used in COVID-19 management. However, the results were controversial. Here, we aimed to evaluate the efficacy and safety of hydroxychloroquine (HCQ)/chloroquine (CQ) in COVID-19.

Methods

We retrospectively reviewed the medical charts of patients with COVID-19 admitted to an inpatient ward in Wuhan from 2020/Feb/08 to 2020/Mar/05. Patients with HCQ/CQ and age, gender, disease severity matched ones without HCQ/CQ were selected at a 1:2 ratio. The clinical, laboratory and imaging findings were compared between these two groups. The multivariate linear regression analysis was performed to identify the factors that might influence patients’ virus shedding periods (VSPs).

Results

A total of 14 patients with HCQ/CQ and 21 matched ones were analyzed. The HCQ/CQ treatment lasted for an average of 10.36 ± 3.12 days. The mean VSPs were longer in the HCQ/CQ treatment group (26.57 ± 10.35 days vs. 19.10 ± 7.80 days, P = 0.020). There were 3 patients deceased during inpatient period, two patients were with HCQ/CQ treatment (P = 0.551). In the multivariate linear regression analysis, disease durations at admission (t = 3.643, P = 0.001) and HCQ/CQ treatment (t = 2.637, P = 0.013) were independent parameters for patients’ VSPs. One patient with CQ had recurrent first-degree atrioventricular block (AVB) and obvious QTc elongation, another one complained about dizziness and blurred vision which disappeared after CQ discontinuation. One patient with HCQ had transient AVB.

Conclusions

In summary, we identify that the HCQ/CQ administration is not related to less mortality cases at later phase of COVID-19. More studies are needed to explore whether HCQ/CQ treatment would lead to SARS-Cov-2 RNA clearance delay or not.
Health care workers’ perceptions of episiotomy in the era of respectful maternity care: a qualitative study of an obstetric training program in Mexico
Authors: Garcia-Cerde Rodrigo , Torres-Pereda Pilar , Olvera-Garcia Marisela , Hulme Jennifer
Published: August 2021

Background

Episiotomy in Mexico is highly prevalent and often routine - performed in up to 95% of births to primiparous women. The WHO suggests that episiotomy be used in selective cases, with an expected prevalence of 15%. Training programs to date have been unsuccessful in changing this practice. This research aims to understand how and why this practice persists despite shifts in knowledge and attitudes facilitated by the implementation of an obstetric training program.

Methods

This is a descriptive and interpretative qualitative study. We conducted 53 pre and post-intervention (PRONTO© Program) semi-structured interviews with general physician, gynecologists and nurses (N = 32, 56% women). Thematic analysis was carried out using Atlas-ti© software to iteratively organize codes. Through interpretive triangulation, the team found theoretical saturation and explanatory depth on key analytical categories.

Results

Themes fell into five major themes surrounding their perceptions of episiotomy: as a preventive measure, as a procedure that resolves problems in the moment, as a practice that gives the clinician control, as a risky practice, and the role of social norms in practicing it. Results show contradictory discourses among professionals. Despite the growing support for the selective use of episiotomy, it remains positively perceived as an effective prophylaxis for the complications of childbirth while maintaining control in the hands of health care providers.

Conclusions

Perceptions of episiotomy shed light on how and why routine episiotomy persists, and provides insight into the multi-faceted approaches that will be required to affect this harmful obstetrical practice.
Awareness of euglycaemic diabetic ketoacidosis during pregnancy prevents recurrence of devastating outcomes: a case report of two pregnancies in one patient
Authors: Dargel Susanne , Schleußner Ekkehard , Kloos Christof , Groten Tanja , Weschenfelder Friederike
Published: August 2021

Background

Euglycaemic diabetic ketoacidosis (DKA) during pregnancy is a life-threatening obstetric emergency. It requires early identification and prompt action. Obstetricians’ knowledge about symptoms, diagnostic pitfalls and management during pregnancy and delivery need to be improved. We report a case of a young diabetic woman developing severe euglycaemic DKA in two consecutive pregnancies; the first pregnancy resulted in the most deviating outcome (i.e., intrauterine death), while the second pregnancy resulted in the delivery of a healthy newborn. Thus, the novelty of the case presented here is the possibility to demonstrate how the management of DKA in pregnancy can dramatically change outcomes.

Case presentation

We report a case of a young diabetic woman in whom DKA was concealed by hyperemesis and oesophageal reflux. This woman presented to our delivery unit with severe euglycaemic DKA during her first pregnancy. While the mother’s condition could be successfully stabilized, the foetus died shortly after admission. Two years later, the same woman presented with similar problems. Repeated episodes of mild euglycaemic DKA could be successfully managed with consequent interdisciplinary treatment and close observation, leading to a good pregnancy outcome, i.e., the birth of a healthy child.

Conclusion

Awareness of euglycaemic DKA needs to be increased to reduce the risk of severe complications during pregnancies in diabetic women. This case report demonstrates that increased awareness of DKA with immediate recognition and a successful multidisciplinary approach are mandatory for an positive pregnancy outcomes.
Does post-operative radiotherapy improve the treatment outcomes of intracranial hemangiopericytoma? A retrospective study
Authors: Xiao Jianbiao , Xu Lanwei , Ding Yi , Wang Wei , Chen Fen , Zhou Yangshu , Zhang Fengjiao , Zhou Qiyuan , Wu Xuehui , Li Junpeng , Liang Li , Jen Yee-Min
Published: August 2021

Background

Intracranial hemangiopericytoma is a rare disease and surgery is the mainstay treatment. Although postoperative adjuvant radiotherapy is often used, there are no reports comparing different radiotherapy techniques. The purpose of this study is to analyze the impact of post-operative radiotherapy and different radiotherapy technique on the results in patients with intracranial hemangiopericytoma (HPC).

Methods

We retrospectively reviewed 66 intracranial HPC patients treated between 1999 and 2019 including 29 with surgery followed by radiotherapy (11 with intensity-modulated radiotherapy (IMRT) and 18 with stereotactic radiosurgery (SRS)) and 37 with surgery alone. Chi-square test was used to compare the clinical characteristic between the groups. The Kaplan-Meier method was used to analyze overall survival (OS) and recurrence-free survival (RFS). Multivariate Cox proportional hazards models were used to examine prognostic factors of survival. We also underwent a matched-pair analysis by using the propensity score method.

Results

The crude local control rates were 58.6% in the surgery plus post-operative radiotherapy group (PORT) and 67.6% in the surgery alone group (p = 0.453). In the subgroup analysis of the PORT patients, local controls were 72.7% in the IMRT group and 50% in the SRS group (p = 0.228). The median OS in the PORT and surgery groups were 122 months and 98 months, respectively (p = 0.169). The median RFS was 96 months in the PORT group and 72 months in the surgery alone group (p = 0.714). Regarding radiotherapy technique, the median OS and RFS of the SRS group were not significantly different from those in the IMRT group (p = 0.256, 0.960). The median RFS were 112 and 72 months for pathology grade II and III patients, respectively (p = 0.001). Propensity score matching did not change the observed results.

Conclusion

In this retrospective analysis, PORT did not improve the local control rates nor the survivals. The local control rates after IMRT and SRS were similar even though the IMRT technique had a much higher biological dose compared with the SRS technique.
Potential effects of angiogenesis-related factors on the severity of APAC and surgical outcomes of trabeculectomy
Authors: Wang Jing , Fu Ming-shui , Zhou Min-wen , Ke Bi-lian , Zhang Zhi-hua , Xu Xun
Published: August 2021

Background

EPO (erythropoietin) and PDGF (platelet derived growth factor) families are thought to be associated with angiogenesis under hypoxic condition. The sharp rise of intraocular pressure in acute primary angle closure (APAC) results in an inefficient supply of oxygen and nutrients. We aimed to measure the expression of EPO and PDGF family members in APAC eyes and demonstrate their associations with APAC’s surgical success rate.

Methods

Concentrations of EPO, PDGF-AA, -BB, -CC and -DD collected in aqueous humor samples of 55 patients recruited were measured. Before operations, correlations between target proteins and IOP (intraocular pressure) were detected between APAC (acute primary angle closure) and cataract patients. Based on the post-operative follow-up, the effects of EPO and PDGF family members on the successful rate of trabeculectomy were tested.

Results

The levels of EPO, PDGF-CC and -DD were significantly elevated in the APAC group compared to the cataract group. During the post-operative follow-up, EPO, PDGF-CC and -DD showed significant differences between the success and failure groups. In multivariable linear regression analyses, failed filtration surgery was more likely in APAC eyes with higher EPO level. The Kaplan-Meier survival plot suggested that the success rate in eyes with low EPO level was significantly higher than that in eyes with high EPO level.

Conclusion

The levels of EPO, PDGF-CC and -DD were significantly elevated in failure group. EPO level correlated with preoperative IOP and numbers of eyedrops, and higher EPO level in aqueous humor is a risk factor for trabeculectomy failure. It can be a biomarker to estimate the severity of APAC and the success rate of surgery. The investigation of mechanism of EPO in APAC a may have potential clinical applications for the surgical treatment of APAC.