bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical evaluation of hyperimmune plasma for treatment of dogs with naturally occurring parvoviral enteritis
Authors: Acciacca Rachel A. , Sullivan Lauren A. , Webb Tracy L. , Johnson Valerie , Dow Steven W.
Published: July 2020

Objective

To evaluate the clinical efficacy of a single infusion of hyperimmune plasma (HIP) in dogs with canine parvovirus (CPV).

Design

Prospective, randomized, placebo‐controlled clinical trial.

Setting

University teaching hospital.

Animals

Client‐owned dogs with naturally occurring CPV.

Interventions

Dogs presenting for CPV treatment (n = 31) underwent cardiovascular resuscitation and were randomized to receive a single dose of either HIP (10 mL/kg IV) or placebo (0.9% sodium chloride [10 mL/kg IV]) during the first 6 hours of hospitalization. All dogs were treated with a standardized treatment protocol (IV fluid therapy [120 mL/kg/d isotonic crystalloids], cefoxitin [30 mg/kg IV q 8 h], maropitant [1 mg/kg IV q 24 h], and buprenorphine [0.01–0.02 mg/kg IV q 8 h]) until hospital discharge.

Measurements and main results

Dogs treated with HIP (n = 16) demonstrated a lower shock index at 24 hours (median = 0.77, range: 0.5–1.5) than those treated with placebo (n = 15, median = 1.34, range: 0.5–1.7;P = 0.02). Plasma lactate concentration was lower at 24 hours in HIP‐treated dogs (median = 1.3 mmol/L, range: 0.9–3.4 mmol/L) than in placebo‐treated dogs (median = 2.1 mmol/L, range: 1.1–3.4 mmol/L;P = 0.01). There was no difference in duration of hospitalization when comparing HIP‐treated dogs (median = 3.2 days, range: 0.83–10 days) to placebo‐treated dogs (median = 2.83 days, range: 1–8.38 days;P = 0.35). Survival was 16 of 16 (100%) for the HIP group and 14 of 15 (93.3%) for the placebo group (P = 0.32).

Conclusions

HIP at 10 mL/kg IV administered to dogs with CPV within the first 6 hours of hospitalization improves markers of shock during the initial 24 hours of hospitalization. No effects were observed on duration of hospitalization or mortality; however, this study was underpowered to evaluate these effects. HIP was well tolerated in this population of critically ill dogs.
A 28S rDNA‐based phylogeny of the nematode family Acuariidae (Spirurida) parasitic in vertebrates
Authors: Mutafchiev Yasen , Georgiev Boyko B. , Mariaux Jean
Published: July 2020

The aim of this study was to investigate the phylogenetic relationships of nematodes of the family Acuariidae using partial large subunit nuclear ribosomal DNA (28S) sequences of 15 genera represented by 18 species. The results confirmed the monophyly of the family Acuariidae and supported its close relationship with nematodes of the family Cystidicolidae. Two major clades were revealed within Acuariidae, one represented by nematodes of the subfamily Schistorophinae and another composed of members of the subfamilies Acuariinae and Seuratiinae. The collarette was shown to be a structure that arose several times within the clade Acuariinae–Seuratiinae. As a result, we suggest the suppression of the subfamily Seuratiinae and inclusion of its genera within the subfamily Acuariinae. Morphological characters, host ranges and life cycles of the taxa included in the analyses are discussed as well as the possible relationships of remaining acuariid genera within the revealed subclades. Additionally, we propose an amended generic diagnosis of Syncuaria Gilbert, 1927 to accommodate Syncuaria sagittata (Rudolphi, 1809) n. comb. and Syncuaria longevaginata (Molin, 1860) Skrjabin, Sobolev, & Ivashkin, 1965. New host and geographic records are also presented.
Effects of β‐adrenoceptor activation on haemodynamics during hypoxic stress in rats
Authors: Ji Qiaorong , Zhang Yu , Zhang Huan , Liu Jie , Cao Chengzhu , Yuan Zhouyang , Ma Qianqian , Zhang Wei
Published: July 2020

New Findings

What is the central question of this study?

The acute hypoxic compensatory reaction is based on haemodynamic changes, and β‐adrenoceptors are involved in haemodynamic regulation. What is the role of β‐adrenoceptors in haemodynamics during hypoxic exposure?

What is the main finding and its importance?

Activation of β2‐adrenoceptors attenuates the increase in pulmonary artery pressure during hypoxic exposure. This compensatory reaction activated by β2‐adrenoceptors during hypoxic stress is very important to maintain the activities of normal life.

The acute hypoxic compensatory reaction is accompanied by haemodynamic changes. We monitored the haemodynamic changes in rats undergoing acute hypoxic stress and applied antagonists of β‐adrenoceptor (β‐ARs) subtypes to reveal the regulatory role of β‐ARs on haemodynamics. Sprague–Dawley rats were randomly divided into control, atenolol (β1‐AR antagonist), ICI 118,551 (β2‐AR antagonist) and propranolol (non‐selective β‐AR antagonist) groups. Rats were continuously recorded for changes in haemodynamic indexes for 10 min after administration. Then, a hypoxic ventilation experiment [15% O2, 2200 m a.sl., 582 mmHg (0.765 Pa), 87.3 mmHg; Xining, China] was conducted, and the indexes were monitored for 5 min after induction of hypoxia. Plasma catecholamine concentrations were also measured. We found that, during normoxia, the mean arterial pressure, heart rate, ascending aortic blood flow and pulmonary artery pressure were reduced in the propranolol and atenolol groups. Catecholamine concentrations were increased significantly in the atenolol group compared with the control group. During hypoxia, mean arterial pressure and total peripheral resistance were decreased in the control, propranolol and ICI 118,551 groups. Pulmonary arterial pressure and pulmonary vascular resistance were increased in the propranolol and ICI 118,551 groups. During hypoxia, catecholamine concentrations were increased significantly in the control group, but decreased in β‐AR antagonist groups. In conclusion, the β2‐AR is involved in regulation of pulmonary haemodynamics in the acute hypoxic compensatory reaction, and the activation of β2‐ARs attenuates the increase in pulmonary arterial pressure during hypoxic stress. This compensatory reaction activated by β2‐ARs during hypoxic stress is very important to maintain activities of normal life.
A Thesis Proposal Development Course for Engineering Graduate Students
Authors: Tanaka Martin L.
Published: July 2020

Helping engineering graduate students to write their thesis can be a difficult and time-consuming undertaking for a thesis advisor. Efficiency can be gained by having an experienced graduate student thesis advisor help multiple students at the same time. This article describes the philosophy, methods, and course design details used to develop and conduct a graduate level course on “thesis proposal development” for engineering students. The course provides structure to encourage students to engage in research and write their thesis proposal. The thesis proposal contains the student's detailed research plans and serves as the foundation for the student's final thesis. Each element of the course is described in detail with enough information that readers can implement the course at their own institution using this article as a guide. It includes detailed descriptions of individual assignments, reasons for including the assignment in the course, and Supplemental Material on the ASME Digital Collection which is downloadable from the journal. Since implementing this at our university, we have observed improvements in graduate student research projects, better written theses, and earlier thesis defense dates. The changes were implemented without altering the number of credit hours needed to graduate and we believe that the change has been beneficial.
Ultrahigh aspect ratio etching of silicon in SF6-O2 plasma: The clear-oxidize-remove-etch (CORE) sequence and chromium mask
Authors: Nguyen Vy Thi Hoang , Shkondin Evgeniy , Jensen Flemming , Hübner Jörg , Leussink Pele , Jansen Henri
Published: July 2020

Getting high aspect ratio (HAR) structures is a frequent request in directional etching of silicon using mainstream plasma tools. HAR features are useful either directly (e.g., photonic devices) or as a template for constructing more complicated structures (e.g., metamaterials). The latter is possible by adding postetch procedures such as atomic layer deposition. In this study, a procedure to fabricate ultra-HAR nanofeatures is demonstrated. It is built on a recently developed highly directional plasma etch procedure operating at room temperature called CORE (meaning clear, oxidize, remove, and etch) in which the usual fluorocarbon (FC) inhibitor of the Bosch process is replaced by oxygen. The effect of different CORE parameters on the etch rate and profile is investigated and optimized with respect to low mask undercut and high directionality. Due to the self-limiting property of the oxidation step, the CORE sequence is different from FC-based sequences, particularly concerning what type of etch mask is preferable. We show that 60 nm of chromium masking is well suited for ultra-HAR etching without complicating the plasma process or compromising the overall fabrication procedure. The nanopillar arrays (200 nm diameter, 400 nm pitch and 60 nm diameter, 500 nm pitch) have smooth straight sidewalls with aspect ratios beyond 55 for gaps and up to 200 for pillars. Due to the very mild plasma condition (less than 40 W RIE power), the mask selectivity with respect to silicon can be tuned above 500. In addition, the clean operation of the CORE sequence (no FC pileup as is typical in the Bosch process) prevents time-consuming profile tuning and enables process freedom and reproducibility.
Matched beam-intensity processing for a deep vertical line array
Authors: Zheng Guangying , Yang T. C. , Ma Qiming , Du Shuanping
Published: July 2020

A vertical line array can be deployed in deep water below the critical depth, the depth where the sound speed equals the sound speed at the surface, to take advantage of the lower ambient noise level (compared with above the critical depth) for target detection. To differentiate a submerged source from a surface source, a Fourier transform based method [McCargar and Zurk, J. Acoust. Soc. Am. 133, EL320–325 (2013)] was proposed for a narrowband signal that exploits the depth-related harmonic (oscillation) feature of the beam power time series associated with the target arrival. In this paper, incoherent matched beam processing is used to estimate the target depth. Where the replica (calculated) beam intensity or amplitude time series best matches that of the data is used to estimate the source depth. This method is shown, based on simulated data, to provide a better depth resolution in general and better ability to estimate the depth of a very shallow source (say at 10 m) and can be used to complement the Fourier transform based method. It can be extended to process (random) broadband signals and to environments where the Lloyd's mirror theory is not valid.
Passive broadband source depth estimation in the deep ocean using a single vector sensor
Authors: Qi Yubo , Zhou Shihong , Liang Yuquan , Du Shuyuan , Liu Changpeng
Published: July 2020

For an acoustic receiver deployed at the bottom of the direct arrival zone of a submerged source at short horizontal ranges in deep ocean, the interference pattern of the direct and surface-reflected acoustic arrivals shows periodic modulation, which is directly related to the source depth, source frequency, and vertical arrival angle. In this work, the interference cycle presented in the frequency domain is used to extract the broadband source depth, with the vertical arrival angle obtained from the ratio of vertical acoustic intensity and horizontal acoustic intensity from the signal recorded by a single vector sensor. Experimental results demonstrate the source depth estimation without requiring knowledge of the ocean environment.
Determination of intrinsic viscosity of native cellulose solutions in ionic liquids
Authors: Utomo Nyalaliska W. , Nazari Behzad , Parisi Daniele , Colby Ralph H.
Published: July 2020

The weight-average molecular weights of six native cellulose samples in ionic liquids were determined through steady shear viscosity measurements in the ionic liquid butyl methyl imidazolium chloride. The intrinsic viscosity [η] in ethyl methyl imidazolium acetate (EMImAc) is measured using a gravity-driven glass capillary viscometer and found to be independent of temperature in the range of 30–80 °C, disproving a literature report of [η] in EMImAc, exhibiting a strong temperature dependence. Findings are contrasted with values of intrinsic viscosity in cupriethylenediamine hydroxide, the most widely used solvent to dissolve and analyze the molecular weight of cellulose pulps in industry. Differences are tentatively attributed to the different temporary association properties of cellulose chains in the two solvents. Finally, it is demonstrated that cellulose adsorbs at the air/solution interface in three different ionic liquids to create a viscoelastic liquid interfacial layer of higher concentration. Adsorption at the air/solution interface gives an extra contribution to the measured torque in various rotational rheometer geometries, which apparently simply adds to the torque from the pure bulk solution.
Epigenetically heterogeneous tumor cells direct collective invasion through filopodia-driven fibronectin micropatterning
Authors: Summerbell Emily R. , Mouw Janna K. , Bell Joshua S. K. , Knippler Christina M. , Pedro Brian , Arnst Jamie L. , Khatib Tala O. , Commander Rachel , Barwick Benjamin G. , Konen Jessica , Dwivedi Bhakti , Seby Sandra , Kowalski Jeanne , Vertino Paula M. , Marcus Adam I.
Published: July 2020

Specialized leader cells use stable filopodia to create linear fibronectin tracks to promote collective cancer invasion.
A potentiometric mechanotransduction mechanism for novel electronic skins
Authors: Wu Xiaodong , Ahmed Maruf , Khan Yasser , Payne Margaret E. , Zhu Juan , Lu Canhui , Evans James W. , Arias Ana C.
Published: July 2020

A potentiometric mechanotransduction mechanism is developed for strain-insensitive sensors and single-electrode e-skins.
Meteorite evidence for partial differentiation and protracted accretion of planetesimals
Authors: Maurel Clara , Bryson James F. J. , Lyons Richard J. , Ball Matthew R. , Chopdekar Rajesh V. , Scholl Andreas , Ciesla Fred J. , Bottke William F. , Weiss Benjamin P.
Published: July 2020

A broad spectrum of fully differentiated, partially melted, and possibly unmelted objects populated the early solar system.
Dermal exosomes containing miR-218-5p promote hair regeneration by regulating β-catenin signaling
Authors: Hu Shiqi , Li Zhenhua , Lutz Halle , Huang Ke , Su Teng , Cores Jhon , Dinh Phuong-Uyen Cao , Cheng Ke
Published: July 2020

Exosomes derived from dermal papilla spheroids express a high level of miR-218-5p, which directly regulates hair regeneration.
Epitaxial antiperovskite/perovskite heterostructures for materials design
Authors: Quintela Camilo X. , Song Kyung , Shao Ding-Fu , Xie Lin , Nan Tianxiang , Paudel Tula R. , Campbell Neil , Pan Xiaoqing , Tybell Thomas , Rzchowski Mark S. , Tsymbal Evgeny Y. , Choi Si-Young , Eom Chang-Beom
Published: July 2020

Atomic-scale structure, composition, and bonding at the heterointerface between antiperovskites and perovskites.
PET, image-guided HDAC inhibition of pediatric diffuse midline glioma improves survival in murine models
Authors: Tosi Umberto , Kommidi Harikrishna , Adeuyan Oluwaseyi , Guo Hua , Maachani Uday Bhanu , Chen Nandi , Su Taojunfeng , Zhang Guoan , Pisapia David J. , Dahmane Nadia , Ting Richard , Souweidane Mark M.
Published: July 2020

In vivo, real-time image-guided CED of a PET-imageable HDAC inhibitor is needed to improve survival in murine models of DIPG.
Neurotransmitter-derived lipidoids (NT-lipidoids) for enhanced brain delivery through intravenous injection
Authors: Ma Feihe , Yang Liu , Sun Zhuorui , Chen Jinjin , Rui Xuehui , Glass Zachary , Xu Qiaobing
Published: July 2020

Tryptamine-derived lipidoid-doped lipid nanoparticle formulations facilitate cargos crossing the blood-brain barrier.
Epigenetic transcriptional reprogramming by WT1 mediates a repair response during podocyte injury
Authors: Ettou Sandrine , Jung Youngsook L. , Miyoshi Tomoya , Jain Dhawal , Hiratsuka Ken , Schumacher Valerie , Taglienti Mary E. , Morizane Ryuji , Park Peter J. , Kreidberg Jordan A.
Published: July 2020

The Wilms tumor-1 transcription factor regulates a repair process, providing insights on the pathogenesis of kidney disease.
An alternate conformation of HCV E2 neutralizing face as an additional vaccine target
Authors: Tzarum Netanel , Giang Erick , Kadam Rameshwar U. , Chen Fang , Nagy Kenna , Augestad Elias H. , Velázquez-Moctezuma Rodrigo , Keck Zhen-Yong , Hua Yuanzi , Stanfield Robyn L. , Dreux Marlene , Prentoe Jannick , Foung Steven K. H. , Bukh Jens , Wilson Ian A. , Law Mansun
Published: July 2020

An alternate conformation is found for the major antibody target on hepatitis C virus to aid in rational vaccine design.
Accessing new magnetic regimes by tuning the ligand spin-orbit coupling in van der Waals magnets
Authors: Tartaglia Thomas A. , Tang Joseph N. , Lado Jose L. , Bahrami Faranak , Abramchuk Mykola , McCandless Gregory T. , Doyle Meaghan C. , Burch Kenneth S. , Ran Ying , Chan Julia Y. , Tafti Fazel
Published: July 2020

Previously unknown magnetic regimes and phenomena are revealed by tuning the competition between two types of spin-orbit coupling.
Community Structure of Arbuscular Mycorrhizal Fungi in Soils of Switchgrass Harvested for Bioenergy
Authors: Dirks Alden C. , Jackson Randall D.
Published: July 2020

We assessed the different species of beneficial fungi living in agricultural fields of switchgrass, a large grass grown for biofuels, using high-resolution DNA sequencing. Contrary to our expectations, the fungi were not greatly affected by fertilization. However, we found a positive relationship between plant productivity and the number of families of beneficial fungi at one site. Furthermore, we sequenced many species that could not be identified with existing reference databases. One group of fungi was highlighted in an earlier study for being widely distributed but of unknown taxonomy. We discovered that this group belonged to a family called
Pervetustaceae
, which may benefit switchgrass in stressful environments. To produce higher-yielding switchgrass in a more sustainable manner, it could help to study these undescribed fungi and the ways in which they may contribute to greater switchgrass yield in the absence of fertilization.
Psychiatric comorbidity is common in dystonia and other movement disorders
Authors: Lorentzos Michelle S , Heyman Isobel , Baig Benjamin J , Coughtrey Anna E , McWilliams Andrew , Dossetor David R , Waugh Mary-Clare , Evans Ruth A , Hollywood Josie , Burns Joshua , Menezes Manoj P , Mohammad Shekeeb S , Grattan-Smith Padraig , Gorman Kathleen M , Crowe Belinda H A , Goodman Robert , Kurian Manju A , Dale Russell C
Published: July 2020

Objective

To determine rates of psychiatric comorbidity in a clinical sample of childhood movement disorders (MDs).

Design

Cohort study.

Setting

Tertiary children’s hospital MD clinics in Sydney, Australia and London, UK.

Patients

Cases were children with tic MDs (n=158) and non-tic MDs (n=102), including 66 children with dystonia. Comparison was made with emergency department controls (n=100), neurology controls with peripheral neuropathy or epilepsy (n=37), and community controls (n=10 438).

Interventions

On-line development and well-being assessment which was additionally clinically rated by experienced child psychiatrists.

Main outcome measures

Diagnostic schedule and manual of mental disorders-5 criteria for psychiatric diagnoses.

Results

Psychiatric comorbidity in the non-tic MD cohort (39.2%) was comparable to the tic cohort (41.8%) (not significant). Psychiatric comorbidity in the non-tic MD cohort was greater than the emergency control group (18%, p<0.0001) and the community cohort (9.5%, p<0.00001), but not the neurology controls (29.7%, p=0.31). Almost half of the patients within the tic cohort with psychiatric comorbidity were receiving medical psychiatric treatment (45.5%) or psychology interventions (43.9%), compared with only 22.5% and 15.0%, respectively, of the non-tic MD cohort with psychiatric comorbidity.

Conclusions

Psychiatric comorbidity is common in non-tic MDs such as dystonia. These psychiatric comorbidities appear to be under-recognised and undertreated.
Evolution of therapies for the corneal endothelium: past, present and future approaches
Authors: Ong Hon Shing , Ang Marcus , Mehta Jodhbir
Published: July 2020

Corneal endothelial diseases are leading indications for corneal transplantations. With significant advancement in medical science and surgical techniques, corneal transplant surgeries are now increasingly effective at restoring vision in patients with corneal diseases. In the last 15 years, the introduction of endothelial keratoplasty (EK) procedures, where diseased corneal endothelium (CE) are selectively replaced, has significantly transformed the field of corneal transplantation. Compared to traditional penetrating keratoplasty, EK procedures, namely Descemet’s stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK), offer faster visual recovery, lower immunological rejection rates, and improved graft survival. Although these modern techniques can achieve high success, there are fundamental impediments to conventional transplantations. A lack of suitable donor corneas worldwide restricts the number of transplants that can be performed. Other barriers include the need for specialized expertise, high cost, and risks of graft rejection or failure. Research is underway to develop alternative treatments for corneal endothelial diseases, which are less dependent on the availability of allogeneic tissues – regenerative medicine and cell-based therapies. In this review, an overview of past and present transplantation procedures used to treat corneal endothelial diseases are described. Potential novel therapies that may be translated into clinical practice will also be presented.
Assessing guideline adherence in the management of type 1 diabetes mellitus in Australian children: a population-based sample survey
Authors: McGee Richard G , Cowell Chris T , Arnolda Gaston , Ting Hsuen P , Hibbert Peter , Dowton S Bruce , Braithwaite Jeffrey
Published: July 2020

Introduction

To estimate adherence to clinical practice guidelines in selected settings at a population level for Australian children with type 1 diabetes mellitus.

Research design and methods

Medical records of children with type 1 diabetes mellitus aged 0–15 years in 2012–2013 were targeted for sampling across inpatient, emergency department and community visits with specialist pediatricians in regional and metropolitan areas and tertiary pediatric hospitals in three states where approximately 60% of Australian children reside. Clinical recommendations extracted from two clinical practice guidelines were used to audit adherence. Results were aggregated across types of care (diagnosis, routine care, emergency care).

Results

Surveyors conducted 6346 indicator assessments from an audit of 539 healthcare visits by 251 children. Average adherence across all indicators was estimated at 79.9% (95% CI 69.5 to 88.0). Children with type 1 diabetes mellitus have higher rates of behavioral and psychological disorders, but only a third of children (37.9%; 95% CI 11.7 to 70.7) with suboptimal glycemic control (eg, hemoglobin A1c >10% or 86 mmol/mol) were screened for psychological disorders using a validated tool; this was the only indicator with <50% estimated adherence. Adherence by care type was: 86.1% for diagnosis (95% CI 76.7 to 92.7); 78.8% for routine care (95% CI 65.4 to 88.9) and 83.9% for emergency care (95% CI 78.4 to 88.5).

Conclusions

Most indicators for care of children with type 1 diabetes mellitus were adhered to. However, there remains room to improve adherence to guidelines for optimization of practice consistency and minimization of future disease burden.
Association between compliance with quality indicators and hospitalisation expenses in patients with heart failure: a retrospective study using quantile regression model in China
Authors: Fu Rong , Feng Shaodan , Wu Yilong , He Fei , Lin Zheng , Jiang Yixian , Hu Zhijian
Published: July 2020

Objective

To explore the association between compliance with quality indicators and hospitalisation expenses in patients with heart failure.

Design

Generalised linear model and quantile regression model were used to examine the association between compliance with five quality indicators and hospitalisation expenses.

Setting

Grade A hospital in Fujian Province, China.

Participants

Data on 2568 heart failure admissions between 2010 and 2015 were analysed.

Results

The median (IQR) of hospitalisation expenses of 2568 patients was ¥10.9 (¥6.9–¥31.6) thousand. The rates of compliance with five quality indicators were 90.3% for evaluation of left ventricular function, 43.8% for diuretics, 62.0% for ACE inhibitors (ACEI) or angiotensin receptor blockers (ARB), 67.4% for beta-blockers, and 58.9% for aldosterone receptor antagonists. After adjustment for gender, age, residence, method of payment, number of diseases before admission, number of diseases at admission, number of emergency treatments during hospital stay and length of stay, patients who received evaluation for left ventricular function, diuretics, or ACEI or ARB had lower hospitalisation expenses, and patients who received beta-blockers had higher hospitalisation expenses, compared with their counterparts in generalised linear models. Differences in hospitalisation expenses between compliance and non-compliance with quality indicators became larger across quantile levels of hospitalisation expenses, and were found to be statistically significant when quantile level exceeded 0.80 (¥39.7 thousand) in quantile regression models.

Conclusions

The quality of care for patients with heart failure was below the target level. There was a negative relationship between compliance with quality indicators and hospitalisation expenses at the extreme quantile of expenses. More attention should be given to patients who may experience extreme expenses, and effective measures should be taken to improve the quality of care they receive.
SEPSIS project: a protocol for studying biomarkers of neonatal sepsis and immune responses of infants in a malaria-endemic region
Authors: Fievet Nadine , Ezinmegnon Sem , Agbota Gino , Sossou Darius , Ladekpo Rodolphe , Gbedande Komi , Briand Valerie , Cottrell Gilles , Vachot Laurence , Yugueros Marcos Javier , Pachot Alexandre , Textoris Julien , Blein Sophie , Lausten-Thomsen Ulrik , Massougbodji Achille , Bagnan Lehila , Tchiakpe Nicole , d'Almeida Marceline , Alao Jules , Dossou-Dagba Ida , Tissieres Pierre
Published: July 2020

Introduction

Neonatal sepsis outreaches all causes of neonatal mortality worldwide and remains a major societal burden in low and middle income countries. In addition to limited resources, endemic morbidities, such as malaria and prematurity, predispose neonates and infants to invasive infection by altering neonatal immune response to pathogens. Nevertheless, thoughtful epidemiological, diagnostic and immunological evaluation of neonatal sepsis and the impact of gestational malaria have never been performed.

Methods and analysis

A prospective longitudinal multicentre follow-up of 580 infants from birth to 3 months of age in urban and suburban Benin will be performed. At delivery, and every other week, all children will be examined and clinically evaluated for occurrence of sepsis. At delivery, cord blood systematic analysis of selected plasma and transcriptomic biomarkers (procalcitonin, interleukin (IL)-6, IL-10, IP10,CD74andCX3CR1) associated with sepsis pathophysiology will be evaluated in all live births as well as during the follow-up, and when sepsis will be suspected. In addition, whole blood response to selected innate stimuli and extensive peripheral blood mononuclear cells phenotypic characterisation will be performed. Reference intervals specific to sub-Saharan neonates will be determined from this cohort and biomarkers performances for neonatal sepsis diagnosis and prognosis tested.

Ethics and dissemination

Ethical approval has been obtained from the Comité d’Ethique de la Recherche – Institut des Sciences Biomédicales Appliquées (CER-ISBA 85 - 5 April 2016, extended on 3 February 2017). Results will be disseminated through international presentations at scientific meetings and publications in peer-reviewed journals.

Trial registration number

ClinicalTrials.gov registration number:NCT03780712.
New model of integrated care for uncontrolled type 2 diabetes in a retrospective, underserved adult population in the USA: a study protocol for an effectiveness and cost-effectiveness analysis
Authors: Bosetti Rita , Tabatabai Laila , Naufal George , Brito Rosbel , Kash Bita
Published: July 2020

Introduction

Type 2 diabetes prevalence is increasing in the USA, especially in underserved populations. Patient outcomes can be improved by providing access to specialty care within Federally Qualified Health Centers, possibly improving the cost-effectiveness of diabetes care.

Methods and analysis

A new model of diabetes care based on multidisciplinary teams of clinical fellows, supported by an endocrinologist for underserved adult populations, is presented. The study uses a retrospective, non-randomised cohort of patients with diabetes who visited the community clinic between 1 January 2012 and 31 December 2018. A quasi-experimental method to analyse the causal evidence of the effect of the new model is presented. Discontinuity regression is used to compare two interventions, the intervention by a Clinical Fellow Endocrinology Programme and usual care by a primary care physician. Patients are referred to the Clinical Fellow Endocrinology Programme in case of uncontrolled diabetes (glycated haemoglobin (HbA1c)≥9%). The regression discontinuity design allows the construction of a treatment group for patients with an HbA1c equal or above the threshold in comparison with a control group for patients with an HbA1c below the threshold. The patient outcomes and cost-effectiveness of the new model are analysed. Regression models will be used to assess the differences between treatment and control groups.

Ethics and dissemination

Quantitative patient data are received by the study team in a de-identified format for analysis via an institutional review board-approved protocol. The quantitative study has been approved by the Houston Methodist Research Institute Institutional Review Board, Houston, Texas, USA. Anticipated results will not only provide evidence about the impact of patient outcomes in underserved diabetic populations, but also give an idea of the cost-effectiveness of the new model and whether or not cost savings can be attained for patients, third-party payers and society. The results will help set up evidence-based policy guidelines in diabetes care. Results will be disseminated through papers, conferences and public health/policy fora.
Bridging the gap between physical and mental illness in community pharmacy (PharMIbridge): protocol for an Australian cluster randomised controlled trial
Authors: Wheeler Amanda J , O'Reilly Claire L , El-Den Sarira , Byrnes Joshua , Ware Robert S , McMillan Sara S
Published: July 2020

Introduction

There is a significant life expectancy gap attributable to physical comorbidities for people living with severe and persistent mental illness (SPMI) compared with the general population. Medications are a major treatment for SPMI management and physical illnesses, hence pharmacists are well positioned to support mental healthcare and comorbidities. The randomised controlled trial (RCT) aim is to evaluate effectiveness of an individualised, pharmacist led, support service for people experiencing SPMI focusing on medication adherence and physical comorbidity management, compared with standard care (a medication-management service; MedsCheck).

Methods and analysis

PharMIbridge is a cluster RCT, whereby community pharmacies in four Australian regions will be randomised (1:1 ratio), to either Intervention Group (IG) or Comparator Group (CG). All IG and CG pharmacy staff will receive Blended-Mental Health First Aid training. Additionally, IG pharmacists will receive further training on medication adherence, goal setting, motivational interviewing, managing physical health concerns and complex issues relating to psychotropic medication. CG pharmacists will not receive additional training, and will provide standard care (MedsCheck). The primary outcome will be change in participants medication adherence for psychotropic medication over 6-months. Using mixed-effects logistic regression model and a cluster size of 48 pharmacies, a total of 190 participants will need to be recruited to each arm to find a statistically significant difference in medication adherence. Secondary outcomes will be changes in factors associated with cardiometabolic risk and quality of life, emphasising physical and psychological well-being; medication-related problems; adherence to other prescribed medication; pharmacists knowledge, confidence and ability to support people experiencing SPMI; and effects on healthcare utilisation. A within RCT-based economic evaluation comparing the intervention with standard care will be undertaken.

Ethics and dissemination

The protocol and pharmacist training programme received Griffith University Human Research Ethics Committee approval (HREC/2019/473 and HREC/2019/493 respectively). Results will be published in peer-reviewed journals and available at the Sixth Community Pharmacy Agreement website (http://6cpa.com.au/about-6cpa/).

Trial registration number

ANZCTR12620000577910.
Severe pain from shingles: a hydrocolloid dressing helps
Authors: Kiedrowski Miroslaw
Published: July 2020

Objective

This case report presents an uncommon case of hydrocolloid dressing efficacy in pain control in herpes zoster reactivation with vast epidermis damage.

Methods

It is an instructive tale presenting the application of hydrocolloid dressing in a ripe old age woman with locally advanced breast cancer suffering from the fourth shingles reactivation.

Results

The application of hydrocolloid dressing led to the rapid improvement of pain control (Visual Analogue Scale decreased from 9/10 to 4/10). It also improved the quality of life and promoted the rapid healing of damaged skin.

Conclusion

In light of the described case, the application of hydrocolloid dressing could be considered in patients suffering from severe neuropathic pain in shingles, especially in severe cases. Further clinical studies are recommended.
Mist1+ gastric isthmus stem cells are regulated by Wnt5a and expand in response to injury and inflammation in mice
Authors: Nienhüser Henrik , Kim Woosook , Malagola Ermanno , Ruan Tuo , Valenti Giovanni , Middelhoff Moritz , Bass Adam , Der Channing J , Hayakawa Yoku , Wang Timothy C
Published: July 2020

Background and aims

The gastric epithelium undergoes continuous turnover. Corpus epithelial stem cells located in the gastric isthmus serve as a source of tissue self-renewal. We recently identified the transcription factor Mist1 as a marker for this corpus stem cell population that can give rise to cancer. The aim here was to investigate the regulation of the Mist1+ stem cells in the response to gastric injury and inflammation.

Methods

We used Mist1CreERT;R26-Tdtomato mice in two models of injury and inflammation: the acetic acid-induced ulcer and infection with Helicobacter felis. We analysed lineage tracing at both early (7 to 30 days) and late (30 to 90 days) time points. Mist1CreERT;R26-Tdtomato;Lgr5DTR-eGFP mice were used to ablate the corpus basal Lgr5+ cell population. Constitutional and conditional Wnt5a knockout mice were used to investigate the role of Wnt5a in wound repair and lineage tracing from the Mist1+ stem cells.

Results

In both models of gastric injury, Mist1+ isthmus stem cells more rapidly proliferate and trace entire gastric glands compared with the normal state. In regenerating tissue, the number of traced gastric chief cells was significantly reduced, and ablation of Lgr5+ chief cells did not affect Mist1-derived lineage tracing and tissue regeneration. Genetic deletion of Wnt5a impaired proliferation in the gastric isthmus and lineage tracing from Mist1+ stem cells. Similarly, depletion of innate lymphoid cells, the main source of Wnt5a, also resulted in reduced proliferation and Mist1+ isthmus cell tracing.

Conclusion

Gastric Mist1+ isthmus cells are the main supplier of regenerated glands and are activated in part through Wnt5a pathway.
Open data, trials and new ethics of using others' work
Authors: Carris Nicholas W , Cheon Byron , Wolfson Jay
Published: July 2020

Data and ideas are the capital of research productivity. Is it ethical to preempt the publication of another researcher’s unpublished data or preliminary analysis, perhaps without citation? The long-established answer is ‘certainly not’—but recent ‘open data’ use suggests otherwise. A research competition was held using data from The Systolic Blood Pressure Intervention Trial (SPRINT). This SPRINT Data Analysis Challenge created a novel environment for using open data as data became open early. This allowed third-party researchers the opportunity to assess some of the trial’s outcomes before trialists. Could this infringe on trialists’ right to analyse their data? Simultaneously, trialists had access to analyses from submissions to the competition that were not formally ‘published’ with a typical author credit or citation. Therefore, trialists had the opportunity to view the competition submissions and published on those ideas first without a typical way to cite the source of that idea. Could this infringe on researchers’ right to be credited for their ideas? This is not intended as a criticism of open data, the SPRINT Data Analysis Challenge, or similar systems/ventures, but is an effort to objectively note what may be remediable flaws in the worthwhile, growing and dynamic uses of open data. We offer preliminary analytics to shed more light and provide fodder for additional discussion.
Needs analysis of parents following sudden cardiac death in the young
Authors: McDonald Kristie , Sharpe Louise , Yeates Laura , Semsarian Christopher , Ingles Jodie
Published: July 2020

Objective

The sudden cardiac death (SCD) of a young person is a devastating event for any parent. Inherited heart disease is often either identified or assumed to be the cause. Few studies have explored the psychosocial impact to the surviving at-risk family members. We sought to investigate the needs of parents who have experienced the SCD of their child (≤45 years).

Methods

A quantitative needs analysis questionnaire was developed based on semistructured interviews, including one focus group and a review of relevant literature. Eligible participants were invited to participate in this cross-sectional survey study.

Results

There were 38 parents who completed a quantitative survey. Parents’ perceived needs for information and support spanned medical, psychosocial, spiritual and financial domains. Of the support and information needs assessed, medical needs were identified as the most important domain, followed by psychosocial, spiritual and financial. Importantly, psychosocial information and support needs were reported as the most unmet need, endorsed by 54% of parents. Medical information and support needs were reported as unmet by almost one third of parents. The two most endorsed needs were ‘To have the option of whether or not you would pursue genetic testing for yourself or family members’ and ‘To understand what happened’.

Conclusions

This work demonstrates for the first time, the multifactorial needs of parents after SCD in the young. With the greatest unmet need reported as psychosocial needs, there is clear necessity to find ways of integrating psychological support in to the care of families after SCD in the young.
Impact of selected comorbidities on the presentation and management of aortic stenosis
Authors: Rudolph Tanja K. , Messika-Zeitoun David , Frey Norbert , Thambyrajah Jeetendra , Serra Antonio , Schulz Eberhard , Maly Jiri , Aiello Marco , Lloyd Guy , Bortone Alessandro Santo , Clerici Alberto , Delle-Karth Georg , Rieber Johannes , Indolfi Ciro , Mancone Massimo , Belle Loic , Lauten Alexander , Arnold Martin , Bouma Berto J , Lutz Matthias , Deutsch Cornelia , Kurucova Jana , Thoenes Martin , Bramlage Peter , Steeds Richard P.
Published: July 2020

Background

Contemporary data regarding the impact of comorbidities on the clinical presentation and management of patients with severe aortic stenosis (AS) are scarce.

Methods

Prospective registry of severe patients with AS across 23 centres in nine European countries.

Results

Of the 2171 patients, chronic kidney disease (CKD 27.3%), left ventricular ejection fraction (LVEF) <50% (22.0%), atrial fibrillation (15.9%) and chronic obstructive pulmonary disease (11.4%) were the most prevalent comorbidities (49.3% none, 33.9% one and 16.8% ≥2 of these). The decision to perform aortic valve replacement (AVR) was taken in a comparable proportion (67%, 72% and 69%, in patients with 0, 1 and ≥2 comorbidities; p=0.186). However, the decision for TAVI was more common with more comorbidities (35.4%, 54.0% and 57.0% for no, 1 and ≥2; p<0.001), while the decision for surgical AVR (SAVR) was decreased with increasing comorbidity burden (31.9%, 17.4% and 12.3%; p<0.001). The proportion of patients with planned AVRs that were performed within 3 months was significantly higher in patients with 1 or ≥2 comorbidities than in those without (8.7%, 10.0% and 15.7%; p<0.001). Furthermore, the mean time to AVR was significantly shorter in patients with one (30.5 days) or ≥2 comorbidities (30.8 days) than in those without (35.7 days; p=0.012). Patients with reduced LVEF tended to be offered an AVR more frequently and with a shorter delay while patients with CKD were less frequently treated.

Conclusions

Comorbidities in severe patients with AS affect the presentation and management of patients with severe AS. TAVI was offered more often than SAVR and performed within a shorter time period.
Association of protein-energy wasting and inflammation status with mortality after coronary revascularisation in patients on haemodialysis
Authors: Kumada Yoshitaka , Ishii Hideki , Oshima Satoru , Ito Ryuta , Umemoto Norio , Takahashi Hiroshi , Murohara Toyoaki
Published: July 2020

Objective

Protein-energy wasting is associated with chronic inflammation and advanced atherosclerosis in haemodialysis (HD) patients. We investigated association of geriatric nutritional risk index (GNRI), C reactive protein (CRP) with prediction of mortality after coronary revascularisation in chronic HD patients.

Methods

We enrolled 721 HD patients electively undergoing coronary revascularisation. They were divided into tertiles according to preprocedural GNRI levels (tertile 1 (T1):<91.5, T2: 91.5–98.1 and T3:>98.1) and CRP levels (T1:≤1.4 mg/L, T2: 1.5–7.0 mg/L and T3:≥7.1 mg/L).

Results

Kaplan-Meier 10 years survival rates were 32.3%, 44.8% and 72.5% in T1, T2 and T3 of GNRI and 60.9%, 49.2% and 23.5% in T1, T2 and T3 of CRP, respectively (p<0.0001 in both). Declined GNRI (HR 2.40, 95% CI 1.58 to 3.74, p<0.0001 for T1 vs T3) and elevated CRP (HR 2.31, 95% CI 1.58 to 3.43, p<0.0001 for T3 vs T1) were identified as independent predictors of mortality. In combined setting of both variables, risk of mortality was 5.55 times higher (95% CI 2.64 to 13.6, p<0.0001) in T1 of GNRI with T3 of CRP than in T3 of GNRI with T1 of CRP. Addition of GNRI and CRP in a model with established risk factors improved C-statistics (0.648 to 0.724, p<0.0001) greater than that of each alone.

Conclusion

Preprocedural declined GNRI and elevated CRP were closely associated with mortality after coronary revascularisation in chronic HD patients. Furthermore, combination of both variables not only stratified risk of mortality but also improved the predictability.
Elective extra corporeal membrane oxygenation for high-risk rigid bronchoscopy
Authors: Martinod Emmanuel , Portela Ana-Maria , Uzunhan Yurdagül , Freynet Olivia , Abou Taam Salam , Vinas Florent , Dominique Stephane , Tandjaoui-Lambiotte Yacine , Otero-Lopez Manuel , Zogheib Elie , Lebreton Guillaume
Published: July 2020

The use of extracorporeal membrane oxygenation for high-risk rigid bronchoscopy has been reported in few urgent cases. We report our experience with this approach which was planned electively in five cases on 202 procedures (2.5%). It was proposed because of the potential inability to ventilate the lungs using conventional techniques due to extensive tracheobronchial lesions or the risk of major intraoperative bleeding related to disease characteristics. There were no intraoperative complications and postoperative course was favourable in all patients. With a maximum follow-up of 3 years and 7 months, all patients are alive with no tracheostomy despite major morbidities.
Mobile application-based guidelines to enhance patient care and provider education in trauma and acute care surgery
Authors: Hakes Nicholas A , Kethman William C , Spain David , Nassar Aussama K
Published: July 2020

Introduction

Providing up-to-date, universally accessible care guidelines and education within a quaternary care center is challenging. At our institution, trauma and acute care surgery guidelines have historically been published using a paper-based format. Mobile application-based guidelines were developed to address the shortcomings of paper-based guidelines.

Methods

We assessed the utility, usability, and satisfaction of healthcare providers towards paper-based versus mobile application-based guidelines. A survey was administered to providers within the emergency department and intensive care unit.

Results

Fifty of 137 providers responded (36.5% response rate). Nearly half (47.4%, 9 of 19) of those who received a copy of the paper-based guidelines lost the guidelines at least once. Regarding usage of the mobile application-based guidelines, 92.6% (25 of 27) were aware of the application; 92.6% (25 of 27) considered the application comprehensive, 85.2% (23 of 27) thought the application was organized, and 66.7% (18 of 27) thought the application was easy to use. Additionally, 88.9% (24 of 27) found the application moderately, very, or extremely helpful and 85.2% (23 of 27) judged the application moderately, very, or extremely necessary. Overall, 88.9% (24 of 27) were satisfied with the application and indicated likeliness to recommend to a colleague. Seventeen of 27 (63.0%) agreed or strongly agreed that the application improved their provision of trauma and acute care.

Conclusion

This survey demonstrates positive usability, utility, and satisfaction among trauma healthcare providers with the mobile application-based guidelines. Additionally, this quality improvement initiative highlights the importance of having comprehensive, organized, and easy-to-use trauma and acute care surgery guidelines and targeted educational materials available on demand. The successful transition from paper to mobile application-based guidelines serves as a model for other institutions to modernize and improve patient care and provider education.

Level of evidence

IV.
Primary ganglioneuroblastoma in a red deer (Cervus elaphus)
Authors: Nina Ostfeld , Stamatios Alan Tahas , Jean‐Michel Hatt , Monika Hilbe
Published: July 2020

We describe the first case of a ganglioneuroblastoma in an adult red deer (Cervus elaphus). This neoplasia showed a unique cervical localisation: it was strongly adhered to the left thyroid gland and contributed to dysphagia via oesophageal compression. Although seldom reported, neoplasias should be included in differential diagnoses for dysphagia in wildlife.