bluuebunny/crossref_metadata_2025 huggingface dataset:
Metabolic Regulation and Development of Energy Cane Setts upon Auxin Stimulus
Authors: Cunha Camila P , de Abreu Lu�s Guilherme F , Grassi Maria Carolina B , Aricetti Juliana A , Machado Eduardo C , Pereira Gon�alo A G , Oliveira Juliana V C
Published: December 2019

Energy cane is a bioenergy crop with an outstanding ability to bud sprouting and increasing yield in ratoon cycles even in marginal lands. Bud fate control is key to biomass production and crop profits due to vegetative propagation and tiller dependency, as well as phenotype plasticity to withstand harsh environmental conditions. During the establishment stage (plant cane cycle), energy cane has a tendency for low root:shoot ratio, which might hamper the ability to cope with stress. Auxin is known to modulate bud sprouting and stimulate rooting in sugarcane. Hence, we treated a slow and a fast bud sprouting energy cane cultivars with auxin or controls (with and without water soaking) for 6 h prior to planting and evaluate plant growth parameters and metabolic profiling using two techniques (gas chromatography with time-of-flight mass spectrometer and nuclear magnetic resonance) to characterize the effect and identify metabolite markers associated with bud inhibition and outgrowth. Auxin inhibited bud burst and promote rooting in setts changing the root:shoot ratio of plantlets. Metabolome allowed the identification of lactate, succinate and aspartate family amino acids as involved in bud fate control through the potential modulation of oxygen and energy status. Investigating environmental and biochemical factors that regulate bud fate can be incremental to other monocot species. Our study provides new insights into bud quiescence and outgrowth in cane hybrids, with the potential to leverage our understanding of yield-related traits, crop establishment and adaptation to global climate change.
Self-Managed Surveillance for Breast Cancer–Related Upper Body Issues: A Feasibility and Reliability Study
Authors: Rafn Bolette S , Singh Chiara A , Midtgaard Julie , Camp Pat G , McNeely Margaret L , Campbell Kristin L
Published: December 2019

Background

Early identification of breast cancer–related upper body issues is important to enable timely physical therapist treatment.

Objective

This study evaluated the feasibility and reliability of women performing self-managed prospective surveillance for upper body issues in the early postoperative phase as part of a hospital-based physical therapy program.

Design

This was a prospective, single-site, single-group feasibility and reliability study.

Methods

Presurgery arm circumference measurements were completed at home and at the hospital by participants and by a physical therapist. Instruction in self-measurement was provided using a video guide. After surgery, all circumference measurements were repeated along with self-assessment and therapist assessment for shoulder flexion and abduction active range of motion. Feasibility was determined by recruitment/retention rates and participant-reported ease of performing self-measurements (1 [very difficult] to 10 [very easy]). Reliability was determined as intrarater reliability, interrater reliability, and agreement.

Results

Thirty-three women who were 53.4 (SD = 11.4) years old participated, with recruitment and retention rates of 79% and 94%, respectively. Participant-reported ease of measurement was 8.2 (SD = 2.2) before surgery and 8.0 (SD = 1.9) after surgery. The intrarater reliability and interrater reliability were excellent before surgery (intraclass correlation coefficient [ICC] ≥ 0.94; 95% confidence interval = 0.87–0.97) and after surgery (ICC ≥ 0.91; 95% confidence interval = 0.76–0.96). Agreement between self-assessed and therapist-assessed active shoulder flexion (κ = 0.79) and abduction (κ = 0.71) was good.

Limitations

Further testing is needed using a prospective design with a longer follow-up to determine whether self-managed prospective surveillance and timely treatment can hinder the development of chronic breast cancer–related upper body issues

Conclusions

Self-measured arm circumference and shoulder range of motion are reliable, and their inclusion in a hospital-based program of prospective surveillance for upper body issues seems feasible. This approach may improve early detection and treatment
Electrocardiographic markers for the prediction of ventricular arrhythmias in patients with systemic sclerosis
Authors: Sebestyén Veronika , Szűcs Gabriella , Páll Dénes , Ujvárosy Dóra , Ötvös Tamás , Csige Imre , Pataki Tamás , Lőrincz István , Szabó Zoltán
Published: December 2019

SSc is an autoimmune disease characterized by microvascular damage, endothelial dysfunction and fibrosis of the skin and the internal organs. Cardiac manifestation in patients with SSc is one of the major organ involvements. Approximately 20% of SSc patients suffer from primary cardiovascular disease and another 20% may have secondary cardiac involvement. Although cardiac arrhythmias are mostly linked to myocardial fibrosis, atrioventricular conduction abnormalities are secondary to the fibrosis of the pulse conduction system. Despite the severe consequences of ventricular rhythm disturbances in patients with SSc, the exact role of electrocardiographic markers in the prediction of these arrhythmias has not yet been clearly elucidated. Therefore, the question is whether certain ECG parameters reflecting ventricular repolarization may help to recognize scleroderma patients with increased risk for ventricular arrhythmias and sudden cardiac death.
A TECHNOLOGY OVERVIEW OF ACTIVE IONIZING RADIATION DOSEMETERS FOR PHOTON FIELDS
Authors: Pavelic Luka , Lackovic Igor , Mihic Marija Suric , Prlic Ivica
Published: December 2019

Radiation protection and radiation dosimetry strongly rely on measurements performed by dosimetry instrumentation. Two categories of dosimetry instrumentation prevail: personal dosemeters and survey meters. Passive dosemeters were for many years the base of personal and area dosimetry (environmental, including workplace). Survey meters have been long-established between area meters due to their dose rate measurement capability, but just over a decade ago, debates over possibility that electronic personal dosemeters (EPDs) could replace passive personal dosemeters as legal monitoring devices have started. These debates have now branched into the use of EPDs, but also survey meters in various exposure scenarios, where some concerns have been reported. These concerns were mostly related to the response in pulsed X-ray fields and poor energy response. This article summarizes recent literature related to electronic dosemeters for strongly penetrating photon radiation and covers technologies used in contemporary EPDs and survey meters, their performance and future perspectives.
The challenge of mental simulation in preference-sensitive treatment decisions
Authors: Pighin Stefania , Tentori Katya
Published: December 2019

This commentary discusses the importance for preference-sensitive treatment decisions of episodic future thinking, which is the capacity to mentally simulate and pre-experience what might occur in one’s personal future. Our aim is to call attention to this important topic since patients confronted with preference-sensitive treatment decisions could benefit from professional support that promotes the construction of comprehensive and detailed mental simulations of what might affect their future well-being and satisfaction.
Genome-wide investigation of WRKY transcription factors in sweet osmanthus and their potential regulation of aroma synthesis
Authors: Ding Wenjie , Ouyang Qixia , Li Yuli , Shi Tingting , Li Ling , Yang Xiulian , Ji Kongshu , Wang Lianggui , Yue Yuanzheng
Published: December 2019

WRKY transcription factors, one of the largest transcription factor families, play important roles in regulating the synthesis of secondary metabolites. In sweet osmanthus (Osmanthus fragrans), the monoterpenes have been demonstrated as the most important volatile compounds, and the W-box, which is the cognate binding site of WRKY transcription factors, could be identified in most of the terpene-synthesis-related genes’ promoters. However, the role of the WRKY family in terpene synthesis in sweet osmanthus has rarely been examined. In this study, 154 WRKY genes with conserved WRKY domain were identified and classified into three groups. The group II was further divided into five subgroups, and almost all members of IId contained a plant zinc cluster domain. Eight OfWRKYs (OfWRKY7/19/36/38/42/84/95/139) were screened from 20 OfWRKYs for their flower-specific expression patterns in different tissues. Simultaneously, the expression patterns of OfWRKYs and emission patterns of volatile compounds during the flowering process were determined and gas chromatography-mass spectrometry results showed that monoterpenes, such as linalool and ocimene, accounted for the highest proportion, contributing to the floral scent of sweet osmanthus in two cultivars. In addition, correlation analysis revealed the expression patterns of OfWRKYs (OfWRKY7/19/36/139) were each correlated with distinct monoterpenes (linalool, linalool derivatives, ocimene and ocimene derivatives). Subcellular localization analysis showed that p35S::GFP–OfWRKY7/38/95/139 were localized in the nucleus and OfWRKY139 had very strong transactivation activity. Collectively, the results indicated potential roles of OfWRKY139 and OfWRKYs with plant zinc cluster domain in regulating synthesis of aromatic compounds in sweet osmanthus, laying the foundation for use of OfWRKYs to improve the aroma of ornamental plants.
Internal clock and the surgical ICU patient
Authors: Coppola Silvia , Caccioppola Alessio , Chiumello Davide
Published: December 2019

Purpose of review

The alteration of circadian rhythms in the postoperative period has been demonstrated to influence the outcomes. With this narrative review we would revise how anesthesia, surgery and intensive care can interfere with the circadian clock, how this could impact on the postsurgical period and how to limit the disruption of the internal clock.

Recent findings

Anesthesia affects the clock in relation to the day-time administration and the type of anesthetics, N-methyl-D-aspartate receptor antagonists or gamma-aminobutyric acid receptors agonists. Surgery causes stress and trauma with consequent alteration in the circadian release of cortisol, cytokines and melatonin. ICU represents a further challenge for the patient internal clock because of sedation, immobility, mechanical ventilation and alarms noise.

The synergic effect of anesthesia, surgery and postoperative intensive care on circadian rhythms require a careful approach to the patient considering a role for therapies and interventions aimed to re-establish the normal circadian rhythms. Over time, approach like the Awakening and Breathing Coordination, Delirium Monitoring and Management, Early Mobility and Family engagement and empowerment bundle can implement the clinical practice.
Overexpression of microRNA-21 decreased the sensitivity of advanced cervical cancer to chemoradiotherapy through SMAD7
Authors: Liu Qifang , Liu Shuang , Wang Danbo
Published: December 2019

Drug resistance is a major problem in the treatment of advanced cervical cancer. The oncogenic microRNA-21 (miR-21) is involved in drug resistance in various cancers. However, the regulatory role of miR-21 and its target, Smad7 in drug resistance of cervical cancer remains to be elucidated. We compared miR-21 and Smad7 levels in human samples from chemoradiotherapy-resistance cervical cancer (resistant group) and chemoradiotherapy-sensitive cervical cancer (sensitive group) patients. Then, the miR-21 level was manipulated in HeLa and SiHa cervical cancer cells and the Smad7 level was determined by PCR and western blot. We also manipulated miR-21, Smad7 or both in cells, and measured cell viability using cell counting kit-8 method and epithelial–mesenchymal transition (EMT) biomarkers using Western blot. In human samples, resistant group has significantly higher miR-21 and lower Smad7 levels than sensitive group. In-vitro analysis demonstrated downregulated Smad7 after transfection with miR-21 mimics. When cells were transfected with Smad7 inhibitor, we observed increased drug resistance and changed levels of EMT-biomarkers after chemoradiotherapy, suggesting that downregulation of Smad7 decreased the sensitivity through EMT. When the cells were transfected with miR-21 inhibitor alone, we found increased sensitivity to chemoradiotherapy through EMT. However, such effects were attenuated when Smad7 was also downregulated after cotransfection. In summary, we provided clinical and experimental evidence that decreased miR-21 may improve drug resistance through EMT by direct targeting Smad7 in cervical cancer. Our data suggest that miR-21/Smad7 pathway may be an effective target for drug resistance in cervical cancer treatment.
Invasive Streptococcus pneumoniae Infections and Vaccine Failures in Children in Ireland From the Postvaccine Era From 2007 to 2018
Authors: Corcoran Mary , Mereckiene Jolita , Cotter Suzanne , Murchan Stephen , Cunney Robert , Humphreys Hilary
Published: December 2019

Background:

Invasive pneumococcal disease (IPD) causes life-threatening illnesses including meningitis and bloodstream infection. Here, we report the impact of 7- and 13-valent pneumococcal conjugate vaccines (PCV7/PCV13) after introduction into the Irish pediatric immunization schedule in 2008 and 2010, respectively, and the clinical details surrounding suspected PCV vaccine failures.

Methods:

Serotyping and antimicrobial susceptibility testing of all culture-confirmed cases referred from children <16 years of age from July 2007 to June 2018 were assessed. Surveillance data were assessed to identify any potential vaccine failures.

Results:

The number of IPD cases has decreased by >50% since the introduction of PCVs. The most significant decline PCV serotypes in children <2 years of age, with a 97% decline in PCV7 serotypes, incidence rate ratio (IRR) 0.03, 95% confidence interval (CI): 0.00–0.21; and a 78% decline PCV13-only (PCV13-7) serotypes, IRR 0.22, 95% CI: 0.05–1.04, respectively. However, there has been an increase in non-PCV13 serotypes in children <2 years during the same period (IRR: 2.82, 95% CI: 1.02–7.84; P = 0.0463), with similar serotype trends observed for those 2–4 and 5–15 years of age. There were no clear vaccine replacement serotypes, instead a number of different serotypes emerged. Sixteen vaccine failures were identified, 10 of which were postbooster vaccine failures. Most failures were serotype 19A and resistant to antimicrobials.

Conclusions:

Further reducing the incidence of IPD is more challenging as the number of non-PCV13 serotypes has expanded and is now less susceptible to antimicrobials. Consequently, higher valency or broader target vaccines are now required to further prevent IPD in children.
Gastrointestinal peptides and nonalcoholic fatty liver disease
Authors: Tarantino Giovanni , Balsano Clara
Published: December 2019

Purpose of review

In this review, authors have selected from literature the most recent and suggestive studies on therapy of nonalcoholic fatty liver disease (NAFLD). The selected interventions regulate the action of gastrointestinal peptides, such as gastric inhibitory polypeptide (GIP), nesfatin, peptide YY, cholecystokinin, and glucagon-like peptide 1 (GLP-1). These hormones have been found frequently modified in obesity and/or type 2 diabetes mellitus, morbidities mostly associated with NAFLD. This disease has a very high prevalence worldwide and could evolve in a more severe form, that is, nonalcoholic steatohepatitis, characterized by inflammation and fibrosis. The findings shown by this article describe the metabolic effects of new drugs, mainly but not only, as well of some old substances.

Recent findings

Recent approaches, in animal models or in humans, use synthetic GLP-1 receptor agonists, a centrally administered antibody neutralizing GIP receptor, curcumin, compound being active on nesfatin, resveratrol (antiinflammatory agent), and Ginseg, both of them acting on nesfatin, a cholecystokinin receptor analogue, and finally coffee functioning on YY peptide.

The implications of the presented findings, if they are confirmed in larger clinical trials, likely open the door to future application in clinical practice. In fact, nowadays, patients have only diet and article (incl abstract and keywords) exercise as well accepted recommendations. Thus, there are unmet needs to find substances that could really improve the progression of nonalcoholic steatohepatitis toward liver cirrhosis and hepatocellular carcinoma.
Screening for hypertension in adults during emergency department consultation: a systematic review
Authors: Michaud André , Lamarre-Cliche Maxime , Vadeboncoeur Alain , Cloutier Lyne
Published: December 2019

A large proportion of patients affected with hypertension go undetected. A systematic review was conducted to assess the performance of a screening strategy in adults using blood pressure measurement at the time of an emergency department consultation. A systematic literature search on Embase, CINHAL and Medline was carried out. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses–Diagnostic Test Accuracy. Intervention studies with adults including at least one blood pressure measurement for all participants were included. A repeat blood pressure assessment had to have been carried out to assess the validity of the elevated blood pressure value within the next few days after the emergency department initial visit. Out of 1030 articles identified, published between 1985 and 2018, 10 articles met the inclusion criteria. There were no randomized clinical trials. Mean age of participants was 51.6 years. A single study reports that blood pressure screening was measured according to hypertension guidelines referred to in the study. The average follow-up rate was 61.9% (95% confidence interval 45.5–78.3). For diagnostic confirmation, four studies used a blood pressure measurement method based on the reported guidelines. Half of the patients (50.2%) with elevated blood pressure during the emergency department visit had blood pressure corresponding to uncontrolled elevated blood pressure at follow-up measurement. The contribution of emergency department to the screening for hypertension, by recognizing the presence of elevated blood pressure and then making a referral for diagnostic confirmation, could provide an opportunity to detect a large number of people with hypertension.
Out of hospital cardiac arrest and uncontrolled donation after circulatory death in a tertiary cardiac arrest center
Authors: Lazzeri Chiara , Bonizzoli Manuela , Franci Andrea , Cianchi Giovanni , Batacchi Stefano , Ciapetti Marco , Fulceri Giorgio Enzo , Rugna Mario , Peris Adriano
Published: December 2019

Objectives

Out of hospital cardiac arrest (OHCA) is worldwide quite a common disease, whose mortality still remains high. We aimed at assessing the number of potential donors after OHCA in a tertiary cardiac arrest center with extracorporeal membrane oxygenation (ECPR) and uncontrolled donation after circulatory death (uDCD) programs.

Methods

In our single center, prospective, observational study (June 2016 to December 2018), we included all OHCA consecutive patients aged or less 65 years.

Results

Our series included 134 OHCA patients. The percentage of patients with return of spontaneous circulation (ROSC) was 36% (48/134). Among patients with no ROSC, ECPR was implanted in 26 patients (26/86, 30%). Among patients without ROSC, 25 patients were eligible for uDCD (25/86, 29%), while 35 patients died at the emergency department. Among patients with ROSC, 15 patients died (15/48, 31%), among whom seven became donors after brain death (7/15, 49%), a percentage which did not vary during the study period. In the subgroup of the 26 patients treated with ECPR, 24 patients died (24/26, 92%) among whom eight were potential donors (33%, 8/34), and only two patients survived (7.7%, 2/26) though with good neurological outcome.

Conclusions

The implementation of ECPR and uDCD programs in a tertiary cardiac center is feasible and increased the number of donors, because despite organizational and technical challenges, the uDCD donor pool was 62.5% of all potential donors (25/40).
Nonesterified fatty acids, cognitive decline, and dementia
Authors: Mukamal Kenneth J.
Published: December 2019

Purpose of review

Dementia is rapidly growing as sources of morbidity and mortality as the US population ages, but its pathophysiology remains poorly understood. As a result, no disease-modifying treatments currently exist. We review the evidence that nonesterified fatty acids may play a key role in this condition.

Recent findings

Nonesterified fatty acids appear to influence several pathways leading to dementia. In addition to their vascular effects, these moieties cross the blood–brain barrier, where they are toxic to several cell types. They may also influence insulin metabolism in the brain directly and indirectly, and some drugs that lower circulating levels appear to slow cognitive decline and brain atrophy in diabetes.

Nonesterified fatty acids may contribute to dementia, much as they do to diabetes and cardiovascular disease. Several therapeutic agents lower circulating levels of nonesterified fatty acids and should be tested for their potential preventive effects on cognitive decline in healthy populations before irreversible neuronal attrition occurs.
Targeting RAS in pediatric cancer: is it becoming a reality?
Authors: Vaseva Angelina V. , Yohe Marielle E.
Published: December 2019

Purpose of review

The current review aims to highlight the frequency of RAS mutations in pediatric leukemias and solid tumors and to propose strategies for targeting oncogenic RAS in pediatric cancers.

Recent findings

The three RAS genes (HRAS, NRAS, and KRAS) comprise the most frequently mutated oncogene family in human cancer. RAS mutations are commonly observed in three of the leading causes of cancer death in the United States, namely lung cancer, pancreatic cancer, and colorectal cancer. The association of RAS mutations with these aggressive malignancies inspired the creation of the National Cancer Institute RAS initiative and spurred intense efforts to develop strategies to inhibit oncogenic RAS, with much recent success. RAS mutations are frequently observed in pediatric cancers; however, recent advances in anti-RAS drug development have yet to translate into pediatric clinical trials.

We find that RAS is mutated in common and rare pediatric malignancies and that oncogenic RAS confers a functional dependency in these cancers. Many strategies for targeting RAS are being pursued for malignancies that primarily affect adults and there is a clear need for inclusion of pediatric patients in clinical trials of these agents.
Immunosuppression in sensitized recipients
Authors: Echterdiek Fabian , Latus Joerg , Schwenger Vedat
Published: December 2019

Purpose of review

Due to a substantial lack of kidney donor organs and an increasing number of sensitized recipients, a growing number of kidney transplantations has to be performed across human leukocyte antigen (HLA) and ABO barriers. These transplantations carry an inherent risk of antibody-mediated rejection (AMR) with subsequently impaired graft and patient survival. This review focuses on new developments in desensitization strategies and dedicated programs for sensitized allograft recipients.

Recent findings

Whereas ABO-incompatible kidney transplantation using rituximab-based desensitization achieves long-term survival rates comparable with ABO-compatible kidney transplantation, HLA-incompatible living kidney transplantation shows no definite survival advantage as compared with staying on the waiting list for an HLA-compatible organ. To overcome HLA-incompatibilities dedicated programs for highly sensitized recipients (such as the Eurotransplant Acceptable Mismatch program) have been established. For optimal graft outcome, these programs should be based on proven acceptable mismatches and not just on avoiding unacceptable antigens. Novel desensitizing agents (e.g. complement inhibitors) that specifically inhibit the molecular pathways of AMR have shown promising results in HLA-incompatible kidney transplantation in smaller studies.

Despite ever more challenging conditions, kidney transplantation in highly sensitized patients can be achieved with the use of dedicated programs, well established desensitizing agents and new drugs that specifically inhibit the molecular processes of AMR.
Flexible ureteroscopy: reuse? Or is single use the new direction?
Authors: Ventimiglia Eugenio , Somani Bhaskar K. , Traxer Olivier
Published: December 2019

Purpose of review

Single-use flexible ureteroscopes (su-fURS) aim at overcoming the main limitations of conventional reusable ureteroscopes in terms of acquisition and maintenance costs, breakages, and reprocessing. However, little data exist to date regarding the superiority of su-fURS at this regard. We aimed to perform a systematic literature review on available su-fURS performance with a focus on clinical data for all articles in the last 10 years.

Recent findings

To date, more than 10 different su-fURS are available on the market, with different characteristics and performance. Some of these devices have top-level features, almost catching up with those observed in reusable flexible ureteroscopes. Clinical evidence is mainly available only for two models, LithoVue and Uscope PU3022, and to date it is not strong enough to support routine adoption and use of su-fURS, with a consequent lack of consensus of specific clinical indications. Cost-effectiveness analyses seem to indicate an economic disadvantage in the routine adoption of su-fURS. Environmental issues related to the use of su-fURS also remain to be inquired and addressed.

Since their introduction, su-fURS have gained widespread popularity. Despite their ability at addressing reusable ureteroscope limitations, high-cost and a substantial lack of evidence are still limiting their routine adoption.
Pulmonary Metastasis of Low-risk Perinatal Neuroblastoma After Resection: Implications for Surveillance
Authors: Ullrich Sarah J. , Worhunsky David , Rodwin Rozalyn , Pashankar Farzana , Christison-Lagay Emily , Ozgediz Doruk
Published: December 2019

In the wake of the Children’s Oncology Group (COG) ANBL00P2 trial and the ongoing ANBL1232 trial, an increasing number of children with neonatal neuroblastoma are being managed nonoperatively. We report the case of a patient with low-risk, non-MYCN amplified, neuroblastoma that was diagnosed and resected in the neonatal period but subsequently developed pulmonary metastases by the age of 7 months. Though rare, the possibility of low-risk disease metastasizing during surveillance should be recognized and may not be identified by current protocols.
Perceptions of Birth Fathers about their Open Adoption
Authors: Clutter Lynn B.
Published: December 2019

Background:

Birth fathers are the least known of the adoption triad (adoptee, birth family, adoptive family). There is a gap in evidence about birth father involvement in open adoptions.

Purpose:

The purpose of the study was to explore birth fathers' experiences of open adoption and contact patterns with birth children.

Methods:

Ten birth fathers of open adoptions were recruited from two agencies. Birth fathers participated in recorded telephone interviews using naturalistic inquiry. Verbatim transcripts were analyzed for qualitative content themes.

Results:

At conception and birth, birth fathers were not in a situation suitable to raising a child but wanted to do the right thing and have ongoing contact. Birth fathers' experiences and contact patterns within the adoption triad revealed positive impact on their own lives and on other triad members. Openness provided opportunities to develop relationships. Contact and time together were beneficial and valued. Birth fathers believed themselves to be an important part of the village needed to raise the child well and emerge as a new kind of family.

Clinical Implications:

Nurses interface with birth fathers and adoption triads in a variety of settings. Birth father status and degree of openness in the adoption placement can have an impact on his wellbeing. Nurses can participate in optimizing outcomes during pregnancy, childbirth, and childhood.
Measures of Motor and Functional Skills for Children With Cerebral Palsy: A Systematic Review
Authors: Ferre-Fernández Marina , Murcia-González María Antonia , Barnuevo Espinosa María Dolores , Ríos-Díaz José
Published: December 2019

Purpose:

To review the level of evidence of the psychometric properties of outcome measures for motor or functional skills for children with cerebral palsy classified across I to V levels of the Gross Motor Function Classification System.

Methods:

A systematic search was completed in PubMed/MEDLINE, ISI Web of Science, CINAHL, and 4 complementary databases. The COSMIN Risk of Bias checklist and the updated criteria for good measurement properties were applied to assess the quality.

Results:

Four outcome measures were identified from 12 articles: Gross Motor Function Measure, Gross Motor Performance Measure, Pediatric Evaluation of Disability Inventory, and Functional Independence Measure for Children. Evidence levels for validity, reliability, and responsiveness varied among measures.

Conclusions:

Gross Motor Function Measure in all versions was the most investigated measure providing the best results, with the strongest evidence for validity and responsiveness properties. Reliability evidence should be improved to determine stability.
Facilitating supportive care in cardiac intensive care units
Authors: Romanò Massimo
Published: December 2019

Purpose of review

The number of patients who die in the hospital in the Western world is high, and 20–30% of them are admitted to an ICU in the last month of life, including those in cardiac ICUs (CICUs) where invasive procedures are performed and mortality is high. Palliative consultation is provided in only a few cases. The ethical and decisional aspects associated with the advanced stages of illness are very rarely discussed.

Recent findings

The epidemiological and clinical landscape of CICUs has changed in the last decade; the incidence of acute coronary syndromes has decreased, whereas noncardiovascular diseases, comorbidities, the patients’ age and clinical and therapeutic complexity have increased. The use of advanced and invasive treatments, such as mechanical ventilation, mechanical circulatory support and renal replacement therapies, has increased. This evolution increases the possibility of developing a life-threatening clinical event.

This review aimed to analyze the main epidemiological, clinical, ethical and training aspects that can facilitate the introduction of supportive/palliative care programs in the CICU to improve symptom management during the advanced/terminal stages of illness, and address such issues as advance care planning, withdrawing/withholding life-sustaining treatments, deactivation of implantable defibrillators and palliative sedation.
Living Donor Liver Transplantation in Children: Perioperative Risk Factors and a Nomogram for Prediction of Survival
Authors: Lu Yu-Gang , Pan Zhi-Ying , Zhang Song , Lu Ye-Feng , Zhang Wei , Wang Long , Meng Xiao-Yan , Yu Wei-Feng
Published: December 2019

Background.

Living donor liver transplantation (LDLT) in children has achieved promising outcomes during the past few decades. However, it still poses various challenges. This study aimed to analyze perioperative risk factors for postoperative death in pediatric LDLT.

Methods.

We retrospectively analyzed medical records of pediatric patients who underwent LDLT surgery from January 1, 2014, to December 31, 2016, in our hospital. Predictors of mortality following LDLT were analyzed in 430 children. Cox regression and Kaplan–Meier curve analysis were used for covariates selection. A nomogram was developed to estimate overall survival probability. The performance of the nomogram was assessed using calibration curve, decision curve analysis, and time-dependent receiver operating characteristic curve.

Results.

Among the 430 patients in this cohort (median [interquartile range] age, 7 [6.10] mo; 189 [43.9%] female; 391 [90.9%] biliary atresia), the overall survival was 91.4% (95% confidence interval, 89.2-94.4), and most of the death events (36/37) happened within 6 months after the surgery. Multivariate analysis indicated that the Pediatric End-stage Liver Disease score, neutrophil lymphocyte ratio, graft-to-recipient weight ratio, and intraoperative norepinephrine infusion were independent prognostic factors. A novel nomogram was developed based on these prognostic factors. The C index for the final model was 0.764 (95% confidence interval, 0.701-0.819). Decision curve analysis and time-dependent receiver operating characteristic curve suggested that this novel nomogram performed well at predicting mortality of pediatric LDLT.

Conclusions.

We identified several perioperative risk factors for mortality of pediatric LDLT. And the newly developed nomogram can be a convenient individualized tool in estimating the prognosis of pediatric LDLT.
What Is Hot and New in Basic and Translational Science in Liver Transplantation in 2019? Report of the Basic and Translational Research Committee of the International Liver Transplantation Society
Authors: Taner Timucin , Martins Paulo N. , Ling Qi , Ng Kevin T. , Huang Kuang-Tzu , Eymard Corey , Bhat Mamatha , Bonaccorsi-Riani Eliano , Mas Valeria R. , Selzner Markus , Ekser Burcin
Published: December 2019

The International Liver Transplantation Society (ILTS) 2019 Annual Congress was held in Toronto, Canada, in May 2019. Members of the ILTS Basic and Translational Research Committee attended all sessions of the meeting and selected the most promising, innovative, and novel research presented. A total of 900 abstracts were presented at the meeting. The percentage of abstracts presented at the ILTS Congress that contains basic or translational research continues to increase, accounting for 15% of all the abstracts in 2019, up from 10% in 2018. Here, we summarize the “what’s hot what’s new” in 5 main themes: liver immunobiology and tolerance, ischemia/reperfusion injury and organ preservation, bioengineering and liver regeneration, hepatic primary tumor biology, and pathophysiology of liver failure.
Sex and gender impacts on the behavioural presentation and recognition of autism
Authors: Lai Meng-Chuan , Szatmari Peter
Published: December 2019

Purpose of review

With increasing awareness of potential differences of autism presentation in nonmale versus male individuals, this review summarizes the rapidly evolving literature on sex and gender impacts on autism across nosology, behavioural presentation, developmental change and contextual recognition biases.

Recent findings

Most studies have not differentiated sex versus gender impacts. Regarding behavioural presentation, measurement invariance across sex/gender was found in several standard measures. On this basis, diagnosed females overall showed lower restricted/repetitive behaviour/interests/activities (RRBI) than males, with small and variable effects depending on age, developmental level and kinds of RRBI. Differences insufficiently captured by standard measures may include autistic females displaying female-gender-typical narrow interests, higher social attention, linguistic abilities, motivation for friendship and more camouflaging than autistic males. Regarding developmental change, diagnosed young girls were more likely to have better cognitive development, less intense autistic symptoms and reduction of symptoms over time. Difficulties in adaptive functioning and social challenges, however, may emerge more for females in adolescence. Regarding diagnosis, general expectancy biases and gender-stereotypes may impede timely recognition of autism in females.

Appreciating the multilevel sex and gender impacts on presentation, development, and diagnosis is key to sex-equitable and gender-equitable care for autistic individuals. A holistic approach to understanding the person in the contexts of sex and gender is essential for timely and accurate diagnosis and support.
From partitions to Hodge numbers of Hilbert schemes of surfaces
Authors: Gillman Nate , Gonzalez Xavier , Ono Ken , Rolen Larry , Schoenbauer Matthew
Published: December 2019

We celebrate the 100th anniversary of Srinivasa Ramanujan's election as a Fellow of the Royal Society, which was largely based on his work with G. H. Hardy on the asymptotic properties of the partition function. After recalling this revolutionary work, marking the birth of the ‘circle method’, we present a contemporary example of its legacy in topology. We deduce the equidistribution of Hodge numbers for Hilbert schemes of suitable smooth projective surfaces.

This article is part of a discussion meeting issue ‘Srinivasa Ramanujan: in celebration of the centenary of his election as FRS’.
Ramanujan's influence on string theory, black holes and moonshine
Authors: Harvey Jeffrey A.
Published: December 2019

Ramanujan influenced many areas of mathematics, but his work on
q
-series, on the growth of coefficients of modular forms and on mock modular forms stands out for its depth and breadth of applications. I will give a brief overview of how this part of Ramanujan's work has influenced physics with an emphasis on applications to string theory, counting of black hole states and moonshine. This paper contains the material from my presentation at the meeting celebrating the centenary of Ramanujan's election as FRS and adds some additional material on black hole entropy and the AdS/CFT correspondence.

This article is part of a discussion meeting issue ‘Srinivasa Ramanujan: in celebration of the centenary of his election as FRS’.
The Ramanujan conjecture and its applications
Authors: Winnie Li Wen-Ching
Published: December 2019

In this paper, we review the Ramanujan conjecture in classical and modern settings and explain its various applications in computer science, including the explicit constructions of the spectrally extremal combinatorial objects, called Ramanujan graphs and Ramanujan complexes, points uniformly distributed on spheres, and Golden-Gate Sets in quantum computing. The connection between Ramanujan graphs/complexes and their zeta functions satisfying the Riemann hypothesis is also discussed.

This article is part of a discussion meeting issue ‘Srinivasa Ramanujan: in celebration of the centenary of his election as FRS’.
Enough evidence and other endings: a descriptive study of stable Cochrane systematic reviews in 2019
Authors: Bastian Hilda , Hemkens Lars G.
Published: December 2019

Background

From 2006 to 2019, Cochrane reviews could be designated “stable” if they were not being updated but highly likely to be current. This provides an opportunity to observe practice in ending systematic reviewing and what is regarded as enough evidence.

Methods

We identified Cochrane reviews designated stable in 2013 and 2019 and reasons for this designation. For those with conclusions stated to be so firm that new evidence is unlikely to change them, we assessed conclusions, strength of evidence ratings, and recommendations for further research. We assessed the fate of the 2013 stable reviews. We also estimated usage of formal analytic methods to determine when there is enough evidence in protocols for Cochrane reviews.

Results

Cochrane reviews were rarely designated stable. In 2019, there were 507 stable Cochrane reviews (6.6% of 7,645 non-withdrawn reviews). The most common reasons related to no, little, or infrequent research activity expected (331 of 505; 65.5%). Only 39 reviews were stable because of firm conclusions unlikely to be changed by new evidence (7.7%), but that declaration was mostly not supported by judgments made in the review about strength of evidence and implications for research. Among the 180 reviews stable in 2013, 16 reverted to normal status (8.9%), with 2 of those changing conclusions because of new studies. Few Cochrane protocols specified an analytic method for determining when there was enough evidence to stop updating the review (116 of 2,415; 4.8%).

Conclusion

Cochrane reviews were more likely to end because important future primary research activity was believed to be unlikely, than because there was enough evidence. Judgments about the strength of evidence and need for research were often inconsistent with the declaration that conclusions were unlikely to change. The inconsistencies underscore the need for reliable analytic methods to support decision-making about the conclusiveness of evidence.
Development of bioactive electrospun scaffolds suitable to support skin fibroblasts and release Lucilia sericata maggot excretion/secretion
Authors: Giacaman Annesi G , Styliari Ioanna D. , Taresco Vincenzo , Pritchard David , Alexander Cameron , Rose Felicity R
Published: December 2019

Larval therapy has been reported to exert beneficial actions upon chronic wound healing by promoting granulation tissue formation, antimicrobial activity and degrading necrotic tissue. However, the use of live maggots is problematic for patient acceptance, and thus there is a need to develop materials which can adsorb and release therapeutic biomolecules from maggot secretions. Here we describe the fabrication of a novel bioactive scaffold that can be loaded with Lucilia sericata maggot excretion/secretion (L. sericata maggot E/S) for wound therapy, and which also provides structural stability for mammalian cell-growth and migration. We show that electrospun scaffolds can be prepared from polycaprolactone-poly (ethylene glycol)–block copolymer (PCL-b-PEG) blended with PCL, to form fibres with average diameters of ~4 μm. We further demonstrate that the fibres are able to be loaded with L. sericata maggot E/S, in order to influence fibroblast migration through protease activity. Finally, we show that after 21 days, the cumulative amount of released L. sericata maggot E/S was ~14 μg/mL from PCL-b-PEG/PCL scaffolds and that the protease activity of L. sericata maggot E/S was preserved when PCL-b-PEG/PCL scaffolds were used as the release platform.
Integrated biophysical characterization of fibrillar collagen-based hydrogels
Authors: Avendano Alex , Chang Jonathan C. , Cortes-Medina Marcos G. , Seibel Aaron J. , Admasu Bitania R. , Boutelle Cassandra M. , Bushman Andrew R. , Garg Ayush Arpit , DeShetler Cameron M. , Cole Sara L. , Song Jonathan W.
Published: December 2019

This paper describes an experimental characterization scheme of the biophysical properties of reconstituted hydrogel matrices based on indentation testing, quantification of transport via microfluidics, and confocal reflectance microscopy analysis. While methods for characterizing hydrogels exist and are widely used, they often do not measure diffusive and convective transport concurrently, determine the relationship between microstructure and transport efficiency, and decouple matrix mechanics and transport properties. Our integrated approach enabled independent and quantitative measurements of the structural, mechanical, and transport properties of hydrogels in a single study. We used fibrillar type I collagen as the base matrix and investigated the effects of two different matrix modifications: 1) cross-linking with human recombinant tissue transglutaminase II (hrTGII) and 2) supplementation with the non-fibrillar matrix constituent hyaluronic acid (HA). hrTGII modified matrix structure and transport but not mechanical parameters. Furthermore, changes in matrix structure due to hrTGII were seen to be dependent on the concentration of collagen. In contrast, supplementation of HA at different collagen concentrations altered matrix microstructure and mechanical indentation behavior but not transport parameters. These experimental observations reveal the important relationship between ECM composition and biophysical properties. The integrated techniques are versatile, robust, and accessible; and as matrix-cell interactions are instrumental for many biological processes, the methods and findings described here should be broadly applicable for characterizing hydrogel materials used for 3-D tissue engineered culture models.
Functional angiogenesis requires microenvironmental cues balancing endothelial cell migration and proliferation
Authors: Wang William Y. , Lin Daphne , Jarman Evan H. , Polacheck William J. , Baker Brendon M.
Published: December 2019

Angiogenesis is a complex morphogenetic process that involves intimate interactions between multicellular endothelial structures and their extracellular milieu.In vitromodels of angiogenesis can aid in reducing the complexity of thein vivomicroenvironment and provide mechanistic insight into how soluble and physical extracellular matrix cues regulate this process. To investigate how microenvironmental cues regulate angiogenesis and the function of resulting microvasculature, we multiplexed an established angiogenesis-on-a-chip platform that affords higher throughput investigation of 3D endothelial cell sprouting emanating from a parent vessel through defined biochemical gradients and extracellular matrix. We found that two fundamental endothelial cell functions, migration and proliferation, dictate endothelial cell invasion as single cells vs. multicellular sprouts. Microenvironmental cues that elicit excessive migration speed incommensurate with proliferation resulted in microvasculature with poor barrier function and an inability to transport fluid across the microvascular bed. Restoring the balance between migration speed and proliferation rate rescued multicellular sprout invasion, providing a new framework for the design of pro-angiogenic biomaterials that guide functional microvasculature formation for regenerative therapies.