bluuebunny/crossref_metadata_2025 huggingface dataset:
Mutations of Helicobacter pylori RdxA are mainly related to the phylogenetic origin of the strain and not to metronidazole resistance
Authors: Zhang Shuzhen , Wang Xiangyu , Wise Michael J , He Yongsheng , Chen Haiting , Liu Aijun , Huang Haiyan , Young Sylvia , Tay Chin Yen , Marshall Barry J , Li Xuehong , Chua Eng Guan
Published: June 2020

Objectives

Drug resistance of Helicobacter pylori is a major clinical problem worldwide. The objective of the present study was to investigate the prevalence of antibiotic-resistant H. pylori in the city of Shenzhen in China, as well as to identify the genetic mutations specifically associated with drug resistance rather than unrelated phylogenetic signals.

Methods

Antibiotic susceptibility testing was performed on 238 clinical strains successfully isolated from H. pylori-positive dyspeptic patients who underwent gastroscopy at the Department of Gastroenterology in Shenzhen People’s Second Hospital. Following WGS of all strains using Illumina technology, mutation and phylogenetic analyses were performed.

Results

The resistance rates were 84.9%, 35.3%, 25.2% and 2.1% for metronidazole, clarithromycin, ciprofloxacin and rifampicin, respectively. An A2143G conversion in the 23S rRNA gene was the primary mutation observed in clarithromycin-resistant strains, whilst N87K/I and D91G/N/Y in GyrA were detected in ciprofloxacin-resistant strains. In RdxA, our results demonstrated that only R16H/C and M21A are significant contributors to metronidazole resistance; there were 15 other sites, but these are phylogenetically related and thus unrelated to metronidazole resistance.

Conclusions

There is a high prevalence of metronidazole, clarithromycin and ciprofloxacin resistance and a low prevalence of rifampicin resistance in H. pylori from Shenzhen, China. Omission of phylogenetically related sites will help to improve identification of sites genuinely related to antibiotic resistance in H. pylori and, we believe, other species.
Laboratory Tests and Outcome for Patients with Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
Authors: Alnor Anne , Sandberg Maria B , Gils Charlotte , Vinholt Pernille J
Published: June 2020

Background

Severe acute respiratory syndrome coronavirus 2 causes coronavirus disease 2019 (COVID-19) and poses substantial challenges for healthcare systems. With a vastly expanding number of publications on COVID-19, clinicians need evidence synthesis to produce guidance for handling patients with COVID-19. In this systematic review and meta-analysis, we examine which routine laboratory tests are associated with severe COVID-19 disease.

Content

PubMed (Medline), Scopus, and Web of Science were searched until March 22, 2020, for studies on COVID-19. Eligible studies were original articles reporting on laboratory tests and outcome of patients with COVID-19. Data were synthesized, and we conducted random-effects meta-analysis, and determined mean difference (MD) and standard mean difference at the biomarker level for disease severity. Risk of bias and applicability concerns were evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2.

45 studies were included, of which 21 publications were used for the meta-analysis. Studies were heterogeneous but had low risk of bias and applicability concern in terms of patient selection and reference standard. Severe disease was associated with higher white blood cell count (MD, 1.28 ×109/L), neutrophil count (MD, 1.49 ×109/L), C-reactive protein (MD, 49.2 mg/L), lactate dehydrogenase (MD, 196 U/L), D-dimer (standardized MD, 0.58), and aspartate aminotransferase (MD, 8.5 U/L); all p < 0.001. Furthermore, low lymphocyte count (MD −0.32 × 109/L), platelet count (MD −22.4 × 109/L), and hemoglobin (MD, −4.1 g/L); all p < 0.001 were also associated with severe disease. In conclusion, several routine laboratory tests are associated with disease severity in COVID-19.
Effects of Temperature on the Development and Fecundity of Atractomorpha Sinensis (Orthoptera: Pyrgomorphidae)
Authors: Li Wen-bo , Gao Yu , Cui Juan , Shi Shu-Sen
Published: June 2020

Over the recent years, Atractomorpha sinensis I. Bolivar, has emerged as an important agricultural pest in China. However, the biological characteristics of A. sinensis remain largely unknown, which can hinder the prediction of its population dynamics. Thus, understanding the impact of temperature on the developmental period of A. sinensis is crucial to predict its population dynamics. The biological characteristics of A. sinensis were systematically observed at five different temperatures (16, 20, 24, 28, and 32°C) using the age-stage, two-sex life table method. The results demonstrated that the developmental period, preadult time, adult longevity, adult preoviposition period, and total preoviposition period were significantly reduced when the temperature was elevated from 16 to 32°C. The developmental threshold temperatures of egg, nymph, preoviposition period, female adult, male adult, and generation were 9.14, 10.44, 12.53, 10.97, 12.47, and 10.58°C, respectively, with the corresponding effective accumulated temperatures of 452.31, 575.99, 169.58, 528.13, 340.81, and 1447.95 degree-days. With an increase in temperature, the intrinsic rate of increase (r) and finite rate of increase (λ) were increased, while the mean generation time (T) was shortened. The optimal values of net reproductive rate (R0= 73.00 offspring) and fecundity (244.55 eggs) were determined at 24°C. Similarly, the population trend index (I) of A. sinensis was found to be highest at 24°C. Our findings indicate that A. sinensis has the greatest rate of population growth at 24°C, which can provide a scientific basis for predicting the in-field population dynamics of A. sinensis.
Appendiculo-cecal intussusception: a case report and literature review
Authors: Agrawal Sunit , Khanal Bhawani , Gurung Roshan , Sah Suresh Prasad , Gupta Rakesh Kumar
Published: June 2020

Intussusception of the appendix is a rare disease that constitutes a diagnostic challenge to the surgeon. Intussusception is defined as the telescoping of a segment of the gastrointestinal tract into an adjacent one. We are reporting a case of a 14-year-old boy who presented in our institution with the features of acute appendicitis. On exploration appendiculo-cecal intussusception was found for which right hemicolectomy with ileotransverse colon anastomosis was done.
Impact of COVID-19 on tourism in Nepal
Authors: Sah Ranjit , Sigdel Shailendra , Ozaki Akihiko , Kotera Yasuhiro , Bhandari Divya , Regmi Priyanka , Rabaan Ali A , Mehta Rachana , Adhikari Mahesh , Roy Namrata , Dhama Kuldeep , Tanimoto Tetsuya , Rodríguez-Morales Alfonso J , Dhakal Rachana
Published: June 2020

The effects of COVID-19 on the global economy have been and will be, catastrophic. However, the full global impact, in both economic and health terms, remains unknown. The consequences in Low- and Middle-Income countries, such as Nepal, where national economies rely on a small number of services and industries, are deeply worrying.
Arabidopsis MADS-box factor AGL16 negatively regulates drought resistance via stomatal density and stomatal movement
Authors: Zhao Ping-Xia , Miao Zi-Qing , Zhang Jing , Chen Si-Yan , Liu Qian-Qian , Xiang Cheng-Bin
Published: June 2020

Drought is one of the most important environmental factors limiting plant growth and productivity. The molecular mechanisms underlying plant drought resistance are complex and not yet fully understood. Here, we show that the Arabidopsis MADS-box transcription factor AGL16 acts as a negative regulator in drought resistance by regulating stomatal density and movement. Loss-of-AGL16 mutants were more resistant to drought stress and had higher relative water content, which was attributed to lower leaf stomatal density and more sensitive stomatal closure due to higher leaf ABA levels compared with the wild type. AGL16-overexpressing lines displayed the opposite phenotypes. AGL16 is preferentially expressed in guard cells and down-regulated in response to drought stress. The expression of CYP707A3 and AAO3 in ABA metabolism and SDD1 in stomatal development was altered in agl16 and overexpression lines, making them potential targets of AGL16. Using chromatin immunoprecipitation, transient transactivation, yeast one-hybrid, and electrophoretic mobility shift assays, we demonstrated that AGL16 was able to bind the CArG motifs in the promoters of the CYP707A3, AAO3, and SDD1 and regulate their transcription, leading to altered leaf stomatal density and ABA levels. Taking our findings together, AGL16 acts as a negative regulator of drought resistance by modulating leaf stomatal density and ABA accumulation.
Chilli veinal mottle virus HCPro interacts with catalase to facilitate virus infection in Nicotiana tabacum
Authors: Yang Ting , Qiu Long , Huang Wanying , Xu Qianyi , Zou Jialing , Peng Qiding , Lin Honghui , Xi Dehui
Published: June 2020

Plant symptoms are derived from specific interactions between virus and host components. However, little is known about viral or host factors that participate in the establishment of systemic necrosis. Here, we showed that helper component proteinase (HCPro), encoded by Chilli veinal mottle virus (ChiVMV), could directly interact with catalase 1 (CAT1) and catalase 3 (CAT3) in the cytoplasm of tobacco (Nicotiana tabacum) plants to facilitate viral infection. In vitro, the activities of CAT1 and CAT3 were inhibited by the interaction between HCPro and CATs. The C-terminus of HCPro was essential for their interaction and was also required for the decrease of enzyme activities. Interestingly, the mRNA and protein level of CATs were up-regulated in tobacco plants in response to ChiVMV infection. Nicotiana tabacum plants with HCPro overexpression or CAT1 knockout were more susceptible to ChiVMV infection, which was similar to the case of H2O2-pre-treated plants, and the overexpression of CAT1 inhibited ChiVMV accumulation. Also, neither CAT1 nor CAT3 could affect the RNA silencing suppression (RSS) activity of HCPro. Our results showed that the interaction between HCPro and CATs promoted the development of plant systemic necrosis, revealing a novel role for HCPro in virus infection and pathogenicity.
Preoperative Chlorhexidine Gluconate Bathing on a Military Medical-Surgical Unit
Authors: Scallan Ross M , Gerathy Stephanie , Price Joyce , Lazarus Ann Marie , Metter E Jeffrey , Talbot Laura A
Published: June 2020

INTRODUCTION AND SCOPE OF THE PROBLEM

Surgical site infections (SSIs) are associated with increased length of hospital stays, poor patient outcomes, and increased health care costs making prevention of SSI a high priority for the U.S. Military Health Care System. The focus of this project was to develop and pilot a preoperative antiseptic bathing regimen on an inpatient medical-surgical telemetry unit using 4% chlorhexidine gluconate (CHG), and to compare SSI rates with this new protocol to previous SSI rates on the unit.

MATERIALS AND METHODS

A literature review guided the development of the protocol and clinical question. A unit project was conducted using SSI rates from an inpatient military medical-surgical telemetry unit over 4 yr. From 2014 to 2016, 3 yr before implementing the protocol, a non-standardized CHG scrub was compared to 12 mo after implementing the standardized 4% CHG protocol in 2017 using up to four daily washings (three evenings and one morning surgery) on inpatient admissions to the unit. SSI rates were compared.

RESULTS

After implementing a 4-d preoperative bathing regimen with 4% CHG for patients scheduled for surgery, SSI rates decreased from an average rate of 0.0072 infections (7.2 infections per 1,000 surgeries) to 0.0035 infections (3.5 infections per 1,000 surgeries) in the subsequent year of data collection. Although not a statistically significant change, further analysis using a Bayesian Poisson regression model found an 84% probability the new protocol would lower SSI rate by 1 or more cases per 1,000 surgeries on this inpatient unit.

CONCLUSION

The findings suggest the proposed approach to control infection that may reduce the number of SSIs on a military medical-surgical unit, but this needs to be demonstrated through further longitudinal research on military surgical units.
Formation of aqua planets with water of nebular origin: effects of water enrichment on the structure and mass of captured atmospheres of terrestrial planets
Authors: Kimura Tadahiro , Ikoma Masahiro
Published: June 2020

Recent detection of exoplanets with Earth-like insolation attracts growing interest in how common Earth-like aqua planets are beyond the Solar system. While terrestrial planets are often assumed to capture icy or water-rich planetesimals, a primordial atmosphere of nebular origin itself can produce water through oxidation of the atmospheric hydrogen with oxidizing minerals from incoming planetesimals or the magma ocean. Thermodynamically, normal oxygen buffers produce water comparable in mole number equal to or more than hydrogen. Thus, the primordial atmosphere would likely be highly enriched with water vapour; however, the primordial atmospheres have been always assumed to have the solar abundances. Here we integrate the 1D structure of such an enriched atmosphere of sub-Earths embedded in a protoplanetary disc around an M dwarf of 0.3$\, \mathrm{M}_\odot$ and investigate the effects of water enrichment on the atmospheric properties with focus on water amount. We find that the well-mixed highly enriched atmosphere is more massive by a few orders of magnitude than the solar-abundance atmosphere, and that even a Mars-mass planet can obtain water comparable to the present Earth’s oceans. Although close-in Mars-mass planets likely lose the captured water via disc dispersal and photoevaporation, these results suggest that there are more sub-Earths with Earth-like water contents than previously predicted. How much water terrestrial planets really obtain and retain against subsequent loss, however, depends on efficiencies of water production, mixing in the atmosphere and magma ocean, and photoevaporation, detailed investigation for which should be made in the future.
Evolution of galaxies in groups in the Coma Supercluster
Authors: Seth Ruchika , Raychaudhury Somak
Published: June 2020

We take a close look at the galaxies in the Coma Supercluster and assess the role of the environment (in the form of cluster, group, and supercluster filament) in their evolution, in particular, examining the role of groups. We characterize the groups according to intrinsic properties such as richness and halo mass, as well as their position in the supercluster and proximity to the two rich clusters, Abell 1656 (Coma) and Abell 1367. We devise a new way of characterizing the local environment using a kernel density estimator. We find that apart from the dominant effects of the galaxy mass, the effect of the environment on galaxies is a complex combination of the overdensities on various scales, which is characterized in terms of membership of groups, and also of the position of the galaxy on filaments and their proximity to the infall regions of clusters. Whether the gas can be turned into stars depends upon the level of pre-processing, which plays a role in how star formation is enhanced in a given environment. Our results are consistent with gas accreted in the cold mode from the filaments, being made available to enhance star formation. Finally, we show that the Abell 1367 end of the supercluster is in the process of assembly at present, leading to heightened star formation activity, in contrast with the Coma-end of the filament system.
J1615+5452: a remnant radio galaxy in the ELAIS-N1 field
Authors: Randriamanakoto Z , Ishwara-Chandra C H , Taylor A R
Published: June 2020

We report the discovery of a remnant radio active galactic nucleus (AGN) J1615+5452 in the field of ELAIS-N1. GMRT continuum observations at 150, 325, and 610 MHz combined with archival data from the 1.4 GHz NVSS survey were used to derive the radio spectrum of the source. At a redshift z ∼ 0.33, J1615+5452 has a linear size of ∼100 kpc and spectral indices ranging between $\alpha ^{1400}_{610} \lt -1.5$ and $\alpha ^{325}_{150} = -0.61 \pm 0.12$. While the source has a diffuse radio emission at low frequencies, we do not find evidence of core, jets, or hotspots in the 1.4 GHz VLA data of ∼5 arcsec angular resolution. Such morphological properties coupled with a curved radio spectrum suggest that the AGN fueling mechanisms undergo a shortage of energy supply which is typical of a dying radio AGN. This is consistent with the observed steep curvature in the spectrum Δα ≈ −1, the estimated synchrotron age of $t_{\rm s}=76.0\, ^{+7.4}_{-8.7}$ Myr and a toff/ts ratio of ∼0.3.
Detecting pulsar polarization below 100 MHz with the Long Wavelength Array
Authors: Dike V , Taylor G B , Dowell J , Stovall K
Published: June 2020

Using the first station of the Long Wavelength Array (LWA1), we examine polarized pulsar emission between 25 and 88 MHz. Polarized light from pulsars undergoes Faraday rotation as it passes through the magnetized interstellar medium. Observations from low-frequency telescopes are ideal for obtaining precise rotation measures (RMs) because the effect of Faraday rotation is proportional to the square of the observing wavelength. With these RMs, we obtained polarized pulse profiles to see how polarization changes in the 25–88 MHz range. The RMs were also used to derive values for the electron-density-weighted average Galactic magnetic field along the line of sight. We present RMs and polarization profiles of 15 pulsars acquired using data from LWA1. These results provide new insight into low-frequency polarization characteristics and pulsar emission heights, and complement measurements at higher frequencies.
A triple rollover: a third multiply imaged source at z ≈ 6 behind the Jackpot gravitational lens
Authors: Collett Thomas E , Smith Russell J
Published: June 2020

Using a 5-h adaptive-optics-assisted observation with Multi-Unit Spectroscopic Explorer, we have identified a doubly imaged Ly α source at a redshift of 5.975 behind the z = 0.222 lens galaxy J0946+1006 (the ‘Jackpot’). The source separation implies an Einstein radius of ∼2.5 arcsec. Combined with the two previously known Einstein rings in this lens (radii 1.4 arcsec at z = 0.609 and 2.1 arcsec at z ≈ 2.4), this system is now a unique galaxy-scale triple-source-plane lens. We show that existing lensing models for J0946+1006 successfully map the two new observed images to a common point on the z = 5.975 source plane. The new source will provide further constraints on the mass distribution in the lens and in the two previously known sources. The third source also probes two new distance scaling factors that are sensitive to the cosmological parameters of the Universe. We show that detection of a new multiply imaged emission-line source is not unexpected in observations of this depth; similar data for other known lenses should reveal a larger sample of multiple-image-plane systems for cosmography and other applications.
Comparative Genomics Reveals Evolution of a Beak Morphology Locus in a High-Altitude Songbird
Authors: Cheng Yalin , Miller Matthew J , Zhang Dezhi , Song Gang , Jia Chenxi , Qu Yanhua , Lei Fumin
Published: June 2020

The Ground Tit (Pseudopodoces humilis) has lived on the Qinghai-Tibet Plateau for ∼5.7 My and has the highest altitudinal distribution among all parids. This species has evolved an elongated beak in response to long-term selection imposed by ground-foraging and cavity-nesting habits, yet the genetic basis for beak elongation remains unknown. Here, we perform genome-wide analyses across 14 parid species and identify 25 highly divergent genomic regions that are significantly associated with beak length, finding seven candidate genes involved in bone morphogenesis and remolding. Neutrality tests indicate that a model allowing for a selective sweep in the highly conserved COL27A1 gene best explains variation in beak length. We also identify two nonsynonymous fixed mutations in the collagen domain that are predicted to be functionally deleterious yet may have facilitated beak elongation. Our study provides evidence of adaptive alleles in COL27A1 with major effects on beak elongation of Ps. humilis.
High-flow arteriovenous fistula is not associated with increased extracellular volume or right ventricular dysfunction in haemodialysis patients
Authors: Jaques David A , Davenport Andrew
Published: June 2020

Background

High-output congestive heart failure secondary to high-flow arteriovenous fistula (AVF) has been reported in haemodialysis (HD) patients. As high-flow AVF (HFA) would be expected to result in fluid retention, we conducted an observational study to characterize the relationship between AVF flow (Qa) and extracellular water (ECW) in HD patients.

Methods

We measured Qa by ultrasound dilution in prevalent HD outpatients with an AVF in two dialysis centres. The ECW:total body water (TBW) ratio was measured both pre- and post-dialysis by multifrequency bioimpedance analysis. Transthoracic echocardiograms (TTEs) were performed as part of routine clinical management.

Results

We included 140 patients, mean age 62.7 ± 15.7 years, 60.7% male, 47.9% diabetic and 22.9% with coronary revascularization. Mean Qa was 1339 ± 761 mL/min and 22 (15.7%) patients had HFA defined as Qa >2.0 L/min. Qa was positively associated with an upper arm AVF (P = 0.005), body mass index (P = 0.012) and N-terminal pro-brain natriuretic peptide (NT-proBNP) (P = 0.047) and negatively associated with diabetes (P < 0.001) and coronary revascularization (P = 0.005). The ECW:TBW ratio was positively associated with age (P < 0.001), Davies comorbidity index (P = 0.034), peripheral vascular disease (P = 0.030) and NT-proBNP (P = 0.002) and negatively associated with serum albumin (P < 0.001). Qa was not associated with the ECW:TBW ratio (P = 0.744). TTE parameters were not associated with Qa.

Conclusions

In our outpatient HD cohort, high AVF flow was not associated with ECW expansion, either pre- or post-dialysis when accounting for potential confounders. By controlling ECW, high access flow should not necessarily be perceived as a threat to cardiovascular physiology.
Phase 0 and window of opportunity clinical trial design in neuro-oncology: a RANO review
Authors: Vogelbaum Michael A , Krivosheya Daria , Borghei-Razavi Hamid , Sanai Nader , Weller Michael , Wick Wolfgang , Soffietti Riccardo , Reardon David A , Aghi Manish K , Galanis Evanthia , Wen Patrick Y , van den Bent Martin , Chang Susan
Published: June 2020

Glioblastoma is a devastating disease with poor prognosis. Few effective chemotherapeutics are currently available, and much effort has been expended to identify new drugs capable of slowing tumor progression. The phase 0 trial design was developed to facilitate early identification of promising agents for cancer that should undergo accelerated approval. This design features an early in-human study that enrolls a small number of patients who receive subtherapeutic doses of medication with the goals of describing pharmacokinetics through drug blood level measurements and determining intratumoral concentrations of the investigational compound as well as pharmacodynamics by studying the biochemical and physiological effects of drugs. In neuro-oncology, however, the presence of the blood–brain barrier and difficulty in obtaining brain tumor tissue warrant a separate set of considerations. In this paper, we critically reviewed the protocols used in all brain tumor related in-human phase 0 and phase 0–like (“window of opportunity”) studies between 1993 and 2018, as well as ongoing clinical trials, and identified major challenges in trial design as applied to central nervous system tumors that include surgical specimen collection and storage, brain tumor drug level analysis, and confirmation of drug action. We therefore propose that phase 0 trials in neuro-oncology should include (i) only patients in whom a resection of the tumor is planned, (ii) use of clinical doses of an investigational agent, (iii) tissue sampling from enhancing and non-enhancing portions of the tumor, and (iv) assessment of drug-specific target effects. Standardization of clinical protocols for phase 0/window of opportunity studies can help accelerate the development of effective treatments for glioblastoma.
Coronavirus Disease 2019: Associated Multiple Organ Damage
Authors: Collange Olivier , Tacquard Charles , Delabranche Xavier , Leonard-Lorant Ian , Ohana Mickaël , Onea Mihaela , Anheim Mathieu , Solis Morgane , Sauer Arnaud , Baloglu Seyyid , Pessaux Patrick , Ohlmann Patrick , Kaeuffer Charlotte , Oulehri Walid , Kremer Stephane , Mertes Paul Michel
Published: June 2020

A 56-year-old man presented a particularly severe and multisystemic case of coronavirus disease 2019 (COVID-19). In addition to the common lung and quite common pulmonary embolism and kidney injuries, he presented ocular and intestinal injuries that, to our knowledge, have not been described in COVID-19 patients. Although it is difficult to make pathophysiological hypotheses about a single case, the multiplicity of injured organs argues for a systemic response to pulmonary infection. A better understanding of physiopathology should feed the discussion about therapeutic options in this type of multifocal damage related to severe acute respiratory syndrome coronavirus 2.
Serum Iron Level as a Potential Predictor of Coronavirus Disease 2019 Severity and Mortality: A Retrospective Study
Authors: Zhao Kang , Huang Jucun , Dai Dan , Feng Yuwei , Liu Liming , Nie Shuke
Published: June 2020

Background

Various types of pulmonary diseases are associated with iron deficiency. However, information on iron status in coronavirus disease 2019 (COVID-19) is scarce.

Methods

This study included 50 hospitalized patients with confirmed COVID-19. The role of serum iron in predicting severity and mortality of COVID-19 was evaluated.

Results

The most common symptoms of COVID-19 patients in this study were cough (82%), fever (64%), and chest distress (42%). Of the 50 patients, 45 (90%) patients had abnormally low serum iron levels (<7.8 μmol/L). The severity of COVID-19 was negatively correlated with serum iron levels before and after treatment and was positively correlated with C-reactive protein, serum amyloid A, D-dimer, lactate dehydrogenase, urea nitrogen, and myoglobin levels. Decreased serum iron level could predict the transition of COVID-19 from mild to severe and critical illness. Seven (53.8%) patients with a lower serum iron level after treatment in the critical group had died. There was a significant difference in posttreatment serum iron levels between COVID-19 survivors and nonsurvivors.

Conclusions

Serum iron deficiency was detected in the patients with COVID-19. The severity and mortality of the disease was closely correlated with serum iron levels. Low serum iron concentration was an independent risk factor for death in COVID-19 patients.
Policy Debates on Pension Reform in Chile: Economists, Masculinity and the Mobilization of Strategic Ignorance
Authors: Azocar Maria J
Published: June 2020

In 2016, nationwide protests in Chile demanded a major reform to the privatized pension system. However, experts saw protesters’ demands as not a viable policy option. In this study, I demonstrate how a group of free-market economists acquired authority as experts in pension policy by gendering their expertise. As a result, they have been able to deny, suppress, and dismiss knowledge on topics and views aligned with citizens’ demands. First, my research shows how experts, through gender relations, create knowledge and ignorance in policymaking processes. Second, I demonstrate how free-market capitalism is legitimated through the hegemony of masculinity.
A Composite Sketch of Fast-Spiking Parvalbumin-Positive Neurons
Authors: Bartholome Odile , de la Brassinne Bonardeaux Orianne , Neirinckx Virginie , Rogister Bernard
Published: June 2020

Parvalbumin-positive neurons are inhibitory neurons that release GABA and are mostly represented by fast-spiking basket or chandelier cells. They constitute a minor neuronal population, yet their peculiar profiles allow them to react quickly to any event in the brain under normal or pathological conditions. In this review, we will summarize the current knowledge about the fundamentals of fast-spiking parvalbumin-positive neurons, focusing on their morphology and specific channel/protein content. Next, we will explore their development, maturation, and migration in the brain. Finally, we will unravel their potential contribution to the physiopathology of epilepsy.
A Comparative Carbon Footprint Analysis of Disposable and Reusable Vaginal Specula
Authors: Donahue Laura M. , Hilton Stephen , Bell Sarah G. , Williams Brent C. , Keoleian Gregory A.
Published: June 2020

(Abstracted from Am J Obstet Gynecol 2020; doi: 10.1016/j.ajog.2020.02.007)

In an attempt to save time, as well as reduce costs and transmission of infections, many health care systems in the United States have increased use of disposable medical equipment, which generally decrease costs upfront compared with their reusable alternatives. Use of disposable instruments, however, is associated with increased solid waste production and may increase greenhouse gas emissions, negatively impacting the environment.
Anesthesia and Circulating Tumor Cells in Primary Breast Cancer Patients
Authors: Hovaguimian Frédérique , Braun Julia , Z’graggen Birgit Roth , Schläpfer Martin , Dumrese Claudia , Ewald Christina , Dedes Konstantin J. , Fink Daniel , Rölli Urs , Seeberger Manfred , Tausch Christoph , Papassotiropoulos Bärbel , Puhan Milo A. , Beck-Schimmer Beatrice
Published: June 2020

Background

The effect of anesthetic drugs on cancer outcomes remains unclear. This trial aimed to assess postoperative circulating tumor cell counts—an independent prognostic factor for breast cancer—to determine how anesthesia may indirectly affect prognosis. It was hypothesized that patients receiving sevoflurane would have higher postoperative tumor cell counts.

Methods

The parallel, randomized controlled trial was conducted in two centers in Switzerland. Patients aged 18 to 85 yr without metastases and scheduled for primary breast cancer surgery were eligible. The patients were randomly assigned to either sevoflurane or propofol anesthesia. The patients and outcome assessors were blinded. The primary outcome was circulating tumor cell counts over time, assessed at three time points postoperatively (0, 48, and 72 h) by the CellSearch assay. Secondary outcomes included maximal circulating tumor cells value, positivity (cutoff: at least 1 and at least 5 tumor cells/7.5 ml blood), and the association between natural killer cell activity and tumor cell counts. This trial was registered with ClinicalTrials.gov (NCT02005770).

Results

Between March 2014 and April 2018, 210 participants were enrolled, assigned to sevoflurane (n = 107) or propofol (n = 103) anesthesia, and eventually included in the analysis. Anesthesia type did not affect circulating tumor cell counts over time (median circulating tumor cell count [interquartile range]; for propofol: 1 [0 to 4] at 0 h, 1 [0 to 2] at 48 h, and 0 [0 to 1] at 72 h; and for sevoflurane: 1 [0 to 4] at 0 h, 0 [0 to 2] at 48 h, and 1 [0 to 2] at 72 h; rate ratio, 1.27 [95% CI, 0.95 to 1.71]; P = 0.103) or positivity. In one secondary analysis, administrating sevoflurane led to a significant increase in maximal tumor cell counts postoperatively. There was no association between natural killer cell activity and circulating tumor cell counts.

Conclusions

In this randomized controlled trial investigating the effect of anesthesia on an independent prognostic factor for breast cancer, there was no difference between sevoflurane and propofol with respect to circulating tumor cell counts over time.

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Technical Trick: Dual Plate Fixation of Periprosthetic Distal Femur Fractures
Authors: Medda Suman , Kessler Raymond B. , Halvorson Jason J. , Pilson Holly T. , Babcock Sharon , Carroll Eben A.
Published: June 2020

Treatment of periprosthetic distal femur fractures remains challenging due to assuring adequate distal fixation. Traditional treatment options include lateral locked plating and retrograde nailing, although recently dual implant constructs have been explored with promising results. Allowing immediate weight-bearing in this patient population has benefits with regards to rehabilitation and outcome. Recent literature has focused on nail–plate constructs, however plate–plate constructs are preferred at our institution as they do not require arthroplasty component compatibility, facilitate the coronal plane reduction, and allow for immediate weight-bearing.
Transmembrane protein 45A regulates the proliferation, migration, and invasion of glioma cells through nuclear factor kappa-B
Authors: Zhang Lianglong , Wu Feng , Zhao Jian
Published: June 2020

Gliomas are the most common and aggressive type of primary brain cancer in adults. The expression of transmembrane protein 45A (TMEM45A) in glioma patients and glioma cell lines was analyzed by quantitative real-time PCR. The influence of TMEM45A on the survival of glioma patients was also explored in this study. To verify the interaction between TMEM45A and key genes, correlation analysis of expression levels and the siRNA knock down method were performed. TMEM45A was upregulated in glioma tissues, and its overexpression was strongly correlated with the poor survival of glioma patients. Experiments using the overexpression and knock down of TMEM45A were carried out to demonstrate its correlation with enhanced proliferation, migration, and invasion in glioma cells. Nuclear factor kappa-B (NFκB) expression was shown to be a downstream factor of TMEM45A in glioma cells. In conclusion, TMEM45A is an oncogenic gene in glioma. The proliferation, migration, and invasion of gliomas could be effectively impeded by inhibition of TMEM45A, and the cancer-promoting effect of TMEM45A on gliomas was involved with the NFκB pathway.
A Computer-Based Tutor to Teach Nursing Trauma Care That Works as an Adjunct to High-Fidelity Simulation
Authors: Garrison Christopher M. , Ritter Frank E. , Bauchwitz Benjamin R. , Niehaus James , Weyhrauch Peter W.
Published: June 2020

Educators are challenged to prepare nurses to care for low-frequency, high-stakes problems such as trauma. Computer-based tutors provide a cost-effective teaching strategy without risking patient safety. Evidence for the efficacy of this type of instruction is limited; thus, we tested the learning outcomes of a tutor on trauma care knowledge with senior nursing students. Participants were randomly assigned to either the tutor or a control condition (textbook learning). Instructional design elements incorporated into the tutor included use of multimedia content, emphasis of key points, frequent quizzing with instant feedback, and unfolding case studies to summarize key concepts. Use of the tutor led to a larger increase in trauma nursing knowledge than use of a textbook. In addition, the knowledge was retained as well as book-based learning. The effect size of the tutor, 1.15, was relatively high as well—the average for computer tutors is 0.79. Qualitative focus groups revealed that participants expressed favorable views of the tutor in comparison to textbook learning. They found it more engaging and more enjoyable and reported that it effectively organized the content. The results of this study support the efficacy of a well-designed computer-based tutor for learning key concepts of trauma nursing.
Mobile Health in Adherence to Oral Anticancer Drugs
Authors: Gambalunga Francesca , Iacorossi Laura , Notarnicola Ippolito , Serra Valeria , Piredda Michela , De Marinis Maria Grazia
Published: June 2020

In oncology, adherence to oral antineoplastic medication is a key element of treatment, on which the success of any therapeutic intervention depends. Given their widespread use in clinical practice, it is important to identify tools that can facilitate the monitoring and self-management of the patient at home, to avoid the consequences of employing ineffective treatment. One of the tools available today to take action on this phenomenon is mobile health technology. The aim of this review is to describe published studies relating to the use of mobile health to promote adherence to oral antineoplastic medication. This scoping review was conducted using the framework proposed by Arksey and O'Malley, adapted according to Levac et al. Of 1320 articles identified, only seven met the eligibility criteria and therefore were included in the review. All seven articles involved the use of digital means to measure adherence to treatment, patient satisfaction, acceptability and feasibility of the digital means used, and presence of symptoms, but not the effectiveness of the digital instrument used. In conclusion, the use of digital means to assist adherence of cancer patients to oral antineoplastic medication is widely recognized, but its effectiveness in clinical practice is poorly supported by the nature of the published studies.
Combination of Congenital and Deep Penetrating Nevus by Acquisition of β-Catenin Activation
Authors: Garrido Maria C , Nájera Laura , Navarro Antonia , Huerta Victoria , Garrido Enrique , Rodriguez-Peralto Jose-Luis , Requena Luis
Published: June 2020

Deep penetrating nevus (DPN) is an intradermal, sometimes compound benign melanocytic lesion, which involves the reticular dermis, occasionally reaching the subcutis, which can raise concern for melanoma both clinically and histologically. Recently, it has been genetically defined by the combination of MAPK activating and β-catenin activating mutations. We sought to investigate genetic alterations in 2 cases of combined nevi of congenital melanocytic and DPN. Case 1 was a 16-year-old woman with a pigmented lesion on the trunk since birth, which was completely excised. Histopathological examination revealed a combined congenital nevus with a DPN. Comparative genomic hybridization showed no major genetic alterations, except for gain of 6q11.1 and point mutation of B-RAF V600E. Case 2 was a 62-year-old woman with a congenital pigmented lesion on the back. The lesion was diagnosed as a combined nevus of congenital and DPN. Comparative genomic hybridization showed no genetic alterations, and the NRAS Q61K was detected in both components. DPN is in most cases part of a combined nevus. Our cases showed strong and uniform nuclear expression of β-catenin and cyclin D1 in the DPN component suggesting the evolution of the congenital nevus to the DPN clone by acquiring β-catenin activating mutation.
Flapless Intrascleral Knotting Technique for Suture Fixation of Intraocular Implants
Authors: Jin Haiying , Zhang Qi
Published: June 2020

Purpose:

We will describe a flapless/grooveless/pocketless and minimally invasive technique for scleral suture fixation of intraocular implants.

Methods:

After introducing the suture into the eye, the two ends of the suture were left exterior to the globe, the free end and the end connected to a curved needle (the needle side). A back-and-forth intrascleral suture passage was performed with the aid of a curved needle. The suture was thus supported by adequate scleral tissue. The suture was fixated to the sclera by knotting it into the sclerotomy. The ends of the suture were finally anchored intrasclerally with the aid of a 30-gauge needle.

Results:

The technique was used in 15 eyes of 15 patients. The mean postoperative follow-up period was 9.1 ± 4.6 months. Postoperatively, the intraoperative lenses of all the eyes remained well-positioned and stable. The postoperative visual acuities for all of the eyes were also improved. No suture erosion, suture loosening, hypotony, scleral atrophy, chronic inflammation, retinal tears, and/or detachments were observed within the follow-up period.

Conclusion:

The present technique provides minimal surgical invasion for the scleral suture fixation of intraocular implants.
AUTOLOGOUS NEUROSENSORY RETINAL TRANSPLANT TO TREAT REFRACTORY SEROUS RETINAL DETACHMENT SECONDARY TO OPTIC DISK COLOBOMA
Authors: Temmerman Irene M. , Mahmoud Tamer H. , Veckeneer Marc A.H.
Published: June 2020

Purpose:

To describe a novel surgical technique to treat refractory serous retinal detachment in a patient with an optic disk coloboma.

Methods:

Case report.

Results:

A 32-year-old male patient with an optic disk coloboma in his right eye was referred for recurrent retinoschisis and serous macular detachment despite multiple vitrectomies. Previous surgical procedures included peeling of internal limiting membrane and juxtapapillary laser as well as different tamponade agents such as sulfur hexafluoride gas, standard silicone oil, and heavy silicone oil. Our first approach to close the cavity using autologous platelet concentrate and gas tamponade was also unsuccessful with early recurrence of the submacular fluid. In a second attempt, an autologous neurosensory retinal transplant was used to cover the optic disk cavity. At 17-month follow-up, the macula was still attached. As a postoperative complication, the patient developed high intraocular pressure, for which laser cycloablation eventually was necessary.

Conclusion:

Autologous neurosensory retinal transplant may be a reasonable treatment option for patients with recurrent optic disk cavity–associated maculopathy.
Factors with impact on magnitude of the placebo response in randomized, controlled, cross-over trials in peripheral neuropathic pain
Authors: Gillving Mimmi , Demant Dyveke , Lund Karen , Holbech Jakob V. , Otto Marit , Vase Lene , Jensen Troels S. , Bach Flemming W. , Finnerup Nanna B. , Sindrup Søren H.
Published: June 2020

The presence and magnitude of placebo responses is important for the outcome in clinical trials of analgesics. This explorative study aimed at identifying patients and trial-specific factors with impact on this response in randomized, controlled, cross-over trials in peripheral neuropathic pain. Data were derived from 7 trials and included observations on pinprick hyperalgesia, allodynia, and pain on repetitive stimulation. The studies were all performed by the same collaboration group in Denmark. Pain was rated daily using numeric 0 to 10 point rating scales (NRS) and placebo response was calculated as the difference in weekly average or median numeric rating scale from baseline to the last week of treatment. A clinically meaningful placebo response was defined as more than 30% reduction of pain on placebo. In 318 individual observations, the response was on average small (0.17 points, range −4.5 to 6). There was no significant impact on size of placebo response of trial-specific factors such as treatment sequence and chance of having placebo treatment in each period or of the patient-specific factors age, sensory signs, and pain symptoms. The findings were similar in patients having placebo in the first treatment period. There was no marked difference between patients with (n = 43) and without (n = 275) a clinically meaningful placebo response with respect to the patient-specific factors including frequency of sensory signs and symptoms. In conclusion, this study on cross-over trials in peripheral neuropathic pain found no robust impact of trial and patient-specific factors on the placebo response.
Evaluation of Evidence-Based Guidelines for Fever Management in Critically Ill Adult Patients With Brain Injury
Authors: Lee Jung Min , Moon Ju Ryoung , Kim Hye Jeong , Kwon Do Yeon , Shin Ja Young
Published: June 2020

PURPOSE: The aim of this study was to evaluate the effectiveness of evidence-based guidelines for fever management of critically ill adult patients with brain injury. METHODS: We used a pretest-posttest design with 48 patients 19 years or older admitted to an intensive care unit after surgery for brain injury. We applied evidence-based guidelines only to an experimental group of 24 patients and compared with 24 control patients who did not receive evidence-based guidelines. Experimental and control groups were matched 1:1 using the Acute Physiology and Chronic Health Evaluation II score. Data included the proportion of patients with reduced fever and time to normalized temperature. RESULTS: The proportion of patients whose temperature fell to normal after fever was 4.5 times higher in the experimental group than in the control group. The time it took the patients' highest fever to fall to normal during their intensive care unit stay was 4.84 times faster in the experimental group than in the control group (hazard ratio, 4.84; 95% confidence interval, 1.79–13.11; P = .002). CONCLUSION: Evidence-based guidelines for fever management in patients with a brain injury can be used in nursing practice with rapid response, improving healthcare efficiency and contributing to better outcomes for critically ill patients.
Assessment of ejection fraction and heart perfusion using myocardial perfusion single-photon emission computed tomography in Finland and Estonia: a multicenter phantom study
Authors: Ronkainen Ari-Petteri , Eneh Chibuzor T.M. , Linder Pia H. , Hippeläinen Eero , Heikkinen Jari O.
Published: June 2020

Objectives

Myocardial SPECT/CT imaging is frequently performed to assess myocardial perfusion and dynamic parameters of heart function, such as ejection fraction (EF). However, potential pitfalls exist in the imaging chain that can unfavorably affect diagnosis and treatment. We performed a national cardiac quality control study to investigate how much SPECT/CT protocols vary between different nuclear medicine units in Finland, and how this may affect the heart perfusion and EF values.

Methods

Altogether, 21 nuclear medicine units participated with 27 traditional SPECT/CT systems and two cardiac-centered IQ-SPECT systems. The reproducibility of EF and the uniformity of perfusion were studied using a commercial dynamic heart phantom. SPECT/CT acquisitions were performed and processed at each participating unit using their own clinical protocol and with a standardized protocol. The effects of acquisition protocols and analysis routines on EF estimates and uniformity of perfusion were studied.

Results

Considerable variation in EF estimates and in the uniformity of perfusion were observed between the units. Uniformity of perfusion was improved in some units after applying the higher count-statistic standard acquisition protocol. EF estimates varied more due to differences in analysis routines than as a result of different acquisition protocols. The results obtained with the two IQ-SPECT systems differed substantially from the traditional multipurpose cameras.

Conclusion

On average, the EF and heart perfusion were accurately estimated by SPECT/CT, but high errors could be produced if the acquisition and analysis routines were poorly optimized. Eight of the 21 participants altered their imaging protocol after this quality control tour.