bluuebunny/crossref_metadata_2025 huggingface dataset:
SEX-SPECIFIC ENERGY ABSORPTION STRATEGIES DURING UNANTICIPATED SINGLE-LEG LANDINGS IN ADOLESCENTS: IMPLICATIONS FOR KNEE INJURIES
Authors: Romanchuk Nicholas J. , Bel Michael J. Del , Benoit Daniel L.
Published: April 2020

Background:

The vast majority of ACL injuries in adolescents occur during non-contact injuries, in particular single-leg landings. The magnitude of energy absorption about each joint during theses landings influences the internal and external forces acting on the joints of the lower extremity. Understanding the biomechanics of landing in adolescent male and female athletes may provide insight into these non-contact injury mechanisms.

Hypothesis/Purpose:

This study set out to identify sex-specific energy absorption strategies during single-leg landing and determine the relationship between joint strength and the observed strategies. To better represent real-world conditions, we developed a novel unanticipated drop-jump landing protocol for this population.

Methods:

Thirty-one healthy youth athletes completed unanticipated single-leg drop-jump landings on their dominant limb. Kinematics and lower-limb contributions to energy absorption were calculated over the landing phase for each jump. Independent t-tests as well as Mann-Whitney U tests determined the presence of statistical differences between sexes. Pearson and Spearman correlation coefficients determined the relationship between isometric joint strength and the observed kinematics and energy absorption.

Results:

Females participants absorbed a larger proportion of the landing forces at the ankle and smaller proportion at the hip compared to males. Females also reached larger peak negative joint power in their knee and ankle. Both hip extension and ankle plantar flexion strength were correlated with greater spine flexion and less pelvic flexion.

Conclusion:

Females adopted an energy absorption strategy which utilized distal joints to absorb a larger portion of the landing forces and tended to absorb the forces later relative to males. A greater reliance on the distal joints is related to reduced hip strength and may increase the risk for sustaining an ACL injury.
THE IMPACT OF RULE CHANGES AND LEGISLATION ON THE INCIDENCE OF CONCUSSION IN HIGH SCHOOL SOCCER
Authors: Nussbaum Eric D. , Bjornaraa Jaynie , Gatt Charles J.
Published: April 2020

Background:

There is much concern over the incidence of concussion in high school sports, with a growing focus on soccer, necessitating the need for legislation and formal rule changes for safety reasons.

Objective:

To note differences in concussive injury between boys and girls soccer and determine the change in reported concussion rates from 2011 vs. 2017 in order to study the impact of legislation and rule changes on the rates of concussion in high school soccer in the state of New Jersey.

Design:

Comparative Study

Methods:

Licensed athletic trainers working in the secondary school setting in the state of New Jersey voluntarily participated in an online survey on the incidence of concussion in boys and girls soccer. This de-identified data was compared with data collected from a similar survey conducted in 2011.

Results:

In 2017 there were 168 concussions occurred among 3255 male soccer athletes. Eight-five percent of concussions (145/168) occurred during games, with the remainder occurring in practice. Forty-five percent (76/168) occurred to varsity players with the majority occurring during games (84%). Fewer concussions were reported to junior varsity and freshman players.. In 2017, Incidence Rate (IR) for all male soccer athletes was calculated at 0.36 concussions per 1000 athletic exposures (AE). Injury Proportion (IP) was 5%. Clinical Incidence was 0.05 concussions per athlete. This represented a 38% increase in IR/1000 AE from 2011 to 2017, and a 39% increase in IP 2011 vs 2017 In 2017, a total of 2604 female soccer athletes, reported 195 concussions with the majority occurring during games (83%). Varsity athlete reported the higher number of concussions relative to junior varsity and freshman soccer athletes IR/1000 AE was 0.48 vs 0.43 in 2011 (12% increase), while IP was 7% vs 6% in 2011 (17% increase Females had a greater IR/1000 AE than males (.48 vs. .36). Clinical incidence was also greater for female soccer athletes than male soccer athletes (0.075 vs. 0.05).

Conclusion:

Despite legislation and rule changes, the incidence of concussion in both boys and girls high school soccer is increasing and particularly during games. Playing at the varsity level and game play has the highest association with injury and should be subject to greater scrutiny. Additionally, more concussions are occurring to female soccer athletes than male players. This information provides a snapshot of a significant problem that deserves greater attention.

[Table: see text][Table: see text]
ASSOCIATION BETWEEN INJURY AND SPORTS SPECIALIZATION AMONG FEMALE HIGH SCHOOL VOLLEYBALL PLAYERS
Authors: Biese Kevin , McGuine Timothy , Kliethermes Stephanie , Bell David , Watson Andrew , Brooks M. Alison , Post Eric , Lang Pamela
Published: April 2020

Background:

Volleyball participation has increased and unlike other team sports, its popularity among high school girls continues to grow. With its rise in popularity, the number of girls playing club volleyball outside of school has also grown. Sports specialization in youth athletes, or year-round intensive training in a single sport at the exclusion of others has become a concern. Overuse injuries are common among female volleyball players and specialization may be one factor that puts girls at risk of injury.

Hypothesis/ Purpose:

Evaluate the level of sports specialization among female high school volleyball players and examine its association with injury history.

Design:

Retrospective cohort study.

Methods:

Female students in grades 9-12 at 78 high schools who were committed to trying out for their high school volleyball team were recruited to participate in this study prior to the 2018 fall high school season. Athletes completed baseline assessments of sport related injuries within the previous 12 months. The athletes were asked to report their participation in interscholastic and club volleyball, including training volume and self-reported specialization. Finally, specialization of the athletes was determined using Jayanthi’s 3-point specialization scale. Athletes who had an injury that kept them out of the first day of tryouts were excluded. Univariate and multivariate analysis was performed.

Results:

2216 female high school volleyball players completed baseline evaluations (Age=15.6 ± 1.1 years old, BMI= 22.5± 3.5 kgs/m2) of whom 1588 identified volleyball as their primary sport (72%). Both moderately and highly specialized volleyball athletes were about twice as likely to report a musculoskeletal injury in the previous 12 months (Moderate: OR=1.84, 95%CI=1.29-2.62; High: OR=2.30, 95%CI=1.64-3.24). Similarly, those who played club volleyball were two times more likely to report a musculoskeletal injury in the past year (OR=2.00, 95%CI=1.48-2.71). Multisport athletes were also more likely to report a previous musculoskeletal injury (OR=1.69, 85%CI=1.24-2.32). Highly specialized volleyball players were more likely to participate in club volleyball (p<0.001), summer camps (p<0.001), and participate in both club and summer camps in the same year (p<0.001).

Conclusions:

High school girls’ volleyball players who are highly specialized were more likely to report a musculoskeletal injury in the past 12 months. Similarly, those who played club volleyball were more likely to report an injury in the past year. While sports specialization seems to be associated with increased risk of injury, it may be at least partially related to increased training volume.
FUNCTIONAL NEUROCOGNITIVE DEFICITS AND CORTICAL EVOKED POTENTIALS IN PEDIATRIC PATIENTS WITH PROLONGED POST CONCUSSIVE SYMPTOMS
Authors: Mortazavi Mo , Oakley David , Minor Jon , Thirunagari Prem Kumar , Koucheki Nassar , Prabhaker Nitin
Published: April 2020

Background:

Prolonged neurophysiological impairments have been demonstrated after brain injury utilizing tools such as auditory evoked response potentials. The objectivity and sensitivity of such tools can provide clinicians a unique perspective on patients with prolonged post concussive symptoms (PPCS), and help determine optimal management strategies. Limited research currently exists on evoked potentials and pediatric PPCS.

Purpose:

Illustrate the clinical utility of abnormal evoked potentials in adolescents with PPCS.

Methods and Study Design:

The study is a retrospective cross-sectional analysis of pediatric PPCS cases from 7/2018 to 7/2019 at a private concussion clinic in Tucson AZ. Patients were included if they had prolonged symptoms beyond 30 days from date of injury date, were 13-16 years old, and diagnosed with PPCS based on SCAT5 assessment and clinical evaluation. All patients with PPCS had moderate to severe clinical symptoms with limited academic and exertional tolerance. Patients were excluded if they had a history of learning disorders, seizure disorder, or complex concussions with a skull fracture or intracranial hemorrhage. Patients were tested using the standard oddball audio P300 EEG protocol. Measures extracted included P300 latency, P300 amplitude, and coherence frequency on mapping. The PPCS cohort (n=71) was then compared to age-matched references (n=73) obtained during baseline testing of non-injured athletes using the same protocol (and hardware) from a multitude of sites.

Results:

There was a significant correlation between PPCS and reduced P300 amplitude along with an increased coherence. The PPCS group had an average P300 amplitude of 13.7uV compared to 16.9uV in the reference group (p<0.001, CohD=.51). Increased coherence (in the alpha frequency) was observed where the average PPCS patient had 9.1 connected pairs (scalp sites) with coherences that were >2σ, compared to the expected 3.1 connections in reference group >2 σ (p<0.001, CohD=.86). There was no significant difference in P300 latency between the groups.

Conclusions:

Pediatric patients with PPCS showed decreased P300 amplitude and increased coherence on average compared to the reference group. Reduced voltages and/or increased coherence likely represent ongoing primary brain dysfunction, adaptability, and recovery. These findings suggest the need for ongoing care, and should guide a conservative care approach towards return to high-risk activities. Evoked potentials may be a critical tool to help identify primary neurologic dysfunction in PPCS and help guide management strategies. This tool may also aide in differentiating ongoing neurophysiologic recovery from commonly reported secondary psychosocial symptoms after PPCS.

[Figure: see text]
PERIOPERATIVE OPIOID EXPOSURE PATTERNS IN PEDIATRIC ACL PATIENTS: A TEN YEAR ADMINISTRATIVE DATABASE STUDY
Authors: Anandarajan Dharman , Williams Brendan A. , Markiewitz Nathan , Talwar Divya , Wells Lawrence
Published: April 2020

Background:

Pediatric patients sustaining anterior cruciate ligament (ACL) or related injuries are at high risk for opioid exposure in the acute, perioperative and postoperative phases of injury. Early and repeated exposure to these medications may increase the risk of future misuse. While variation in opioid prescribing practices has been documented in the outpatient setting and other realms of pediatric care, perioperative opioid exposure in this procedural cohort has not been previously examined on a national level.

Purpose:

To assess for demographic, temporal, regional, and hospital-level variability in perioperative opioid exposure in pediatric ACL patients.

Methods:

The Pediatric Health Information Systems Database (PHIS) was used to identify pediatric patients (≤18 years old) undergoing surgical treatment for ACL injury between January 2008 and December 2017. Perioperative opioids were converted to a morphine equivalent dose (MED) and summed for each patient. A hierarchical bayesian regression was performed to identify demographic factors that predicted opioid exposure while adjusting for the effect of hospital.

Results:

The study cohort included 23,071 patients across 52 hospitals. We report model estimates in Table 1 and mean MME by hospital in Figure 1. Compared to older adolescents (15-18yo), younger adolescents (11-14yo; b=-0.13 95% Credible Interval[-0.19, -0.07]) and children <10yo (b=-1.62 [-1.72, -1.52]) received less MED. Patients located in an observation unit (b=-1.15 [-1.25, -1.06]) or an inpatient unit (b=-1.31;[-1.42, -1.20]) received less MED than patients in an ambulatory surgical setting. Patients with commercial insurance also were dispensed more MED compared to those with other payers (b=0.10 [0.04, 0.16]). Female patients received less opioids than male patients (b=-0.08 [-0.13, -0.02]). Of the hospital random effects, the 95% credible intervals of 24 (46%) intercepts and 21 (40%) slopes did not include zero.

Conclusions:

This administrative database study identified hospital and patient-level characteristics predictive of perioperative narcotic exposure among pediatric ACL patients. Those who were older, in an ambulatory surgery setting, or had commercial insurance received more opioids. Cumulative perioperative opioid exposure has not declined on a national level in recent years and significant variability in opioid exposure exists between hospitals. Future work should seek to identify and utilize opioid-minimizing practices that appear present in some clinical settings.

[Table: see text][Figure: see text]
INCIDENCE OF 2nd SURGERY AFTER MPFL RECONSTRUCTION AND SIMULTANEOUS OSTEOCHONDRAL FRACTURE FIXATION IN PEDIATRIC PATIENTS TREATED FOR PATELLAR DISLOCATION
Authors: Schlichte Lindsay M. , Aitchison Alexandra H. , Green Daniel W.
Published: April 2020

Background:

Osteochondral fractures occur in 5-15% of cases of acute or recurrent patellar dislocations. In these settings, early surgical intervention with biodegradable fixation nails is recommended to optimize healing.

Purpose:

The purpose of this study was to determine the incidence of recurrent instability and second surgery following osteochondral fracture fixation with concomitant medial patellofemoral ligament (MPFL) reconstruction.

Methods:

We conducted a retrospective cohort study of 321 MPFL reconstructions performed by a single surgeon between 2011 and 2019. Thirty-eight knees underwent MPFL reconstruction with osteochondral fixation. Demographic data, surgical details, date of latest radiographic and clinical follow-up, and subsequent surgical procedures were collected.

Results:

Thirty-seven MPFL reconstructions with osteochondral fracture fixation in 36 patients were performed by a single surgeon from 2011 to 2019 (1 bilateral). The average age at surgery was 14.8 years (range 10.6– 19.6 years). The average length of clinical follow-up was 1.9 years (range .1– 5.5 years). The average number of biodegradable fixation nails used was 4.4 (range: 2-8). Twenty-seven (72.9%) fractures were fixed to the patella and 10 were fixed to the lateral femoral condyle or trochlea There was 1 report of recurrent instability. Ten (27%) patients required a second surgery on the ipsilateral knee, and underwent chondroplasty (n=8), removal of biodegradable fixation nails (n=4), removal of hemi-epiphysiodesis or TTO hardware (n=2), revision MPFL with tibial tubercle osteotomy (n=1), lateral meniscus repair (n=1). The one patient who required revision MPFL reconstruction has juvenile idiopathic arthritis and underwent 3 additional surgeries after the initial MPFL procedure. Eight patients (22%) underwent a second surgery to address cartilage damage or removal of nails. The mean time to second surgery was 40.0 weeks (range:11-82.7). Of the four patients who required removal of nails, the average number of nails initially placed was 7 ± 1.7. This was significantly more than the patients who did not require second surgery related to nail removal (4.1 ± 1.6, p < .05).

Conclusion:

Approximately 78% of patients undergoing MPFL reconstruction and osteochondral fracture fixation with biodegradable nails showed good fracture healing and patellar stability while 22% went on to require a second surgery. The second surgery most commonly involved debridement of an unhealed portion of the cartilage.
OUTCOMES OF CORE DECOMPRESSION WITH INJECTION OF BONE MARROW ASPIRATE FOR PEDIATRIC FEMORAL HEAD OSTEONECROSIS
Authors: Atkins Myles , Thimothee Josny , McDonald Tyler , Wright Patrick , Brooks Jaysson T.
Published: April 2020

Background:

Pediatric patients with femoral head osteonecrosis (FHON) often suffer from significant pain with decreased mobility. Once femoral head collapse occurs, few options are available short of a total hip arthroplasty (THA).[1,2] Core decompression by drilling of the femoral head is used to improve pain and prevent further femoral head collapse, however most of the literature on this technique involves adult patients.[3-5]

Purpose:

To date, there is no description of this technique or its outcomes in pediatric patients with FHON secondary to other etiologies other than sickle cell disease (SCD).[6] The purpose of our study is to determine outcomes in patients with FHON after undergoing core decompression with injection of bone marrow aspirate (BMA).

Methods:

A retrospective chart review was performed of all pediatric patients at our institution between 2007-2019 with FHON that underwent core decompression with injection of BMA. The following etiologies were identified: SCD, steroid-induced, Perthes disease (PD), slipped capital femoral epiphysis (SCFE), trauma, idiopathic, or other. To determine if core decompression with injection results in cessation of further femoral head collapse, two outcomes were assessed: Stulberg classification and number of cases that required THA. Furthermore, we evaluated whether core decompression with injection occurred in combination with any additional surgical procedure.

Results:

Twenty-six hips with FHON were identified with the following etiologies: 12 SCD (46.3%), 8 steroid-induced (30.8%), 2 PD (7.7%), 1 SCFE (3.8%), 1 trauma (3.8%), 1 idiopathic (3.8%), 1 other (3.8%). Mean age at the time of surgery was 12.7 years (range: 8-18). Twenty hips (76.9%) were seen in males and 6 (23.1%) were seen in females. Twenty-two hips (84.6%) were seen in black patients and 4 (15.4%) in white patients. Mean follow-up was 37.9 months (range: 0.6-77.8). Mean Stulberg classification was 3.15 (SD: 1.26). Twelve hips (46.2%) required concomitant femoral and/or pelvic osteotomies while 14 hips (53.8%) underwent core decompression with injection alone. Six hips required conversion to THA after initial core decompression and injection. All hips requiring THA were seen in patients with core decompressions and injections but no additional femoral and/or pelvic osteotomies.

Conclusion:

Most hips undergoing core decompression with injection did not require THA. Of the hips that required THA, all were seen in patients who only had core decompression and injection of BMA but no concomitant femoral and/or pelvic osteotomies.

[Figure: see text][Figure: see text][Figure: see text]
Retrograde Drilling for Osteochondral Lesion of the Talus in Juvenile Patients
Authors: Ikuta Yasunari , Nakasa Tomoyuki , Ota Yuki , Kanemitsu Munekazu , Sumii Junichi , Nekomoto Akinori , Adachi Nobuo
Published: April 2020

Background:

Retrograde drilling (RD) is generally used for treating osteochondral lesion of the talus (OLT) with a stable osteochondral fragment and nearly normal articular cartilage surface. Previous studies that included participants of various ages have reported good clinical results. This study aimed to clarify the clinical outcomes of RD for OLT in juvenile patients whose bone-forming ability and physical activity might affect the healing process.

Methods:

This retrospective study included 8 juvenile patients who underwent RD for OLT (5 boys and 3 girls, mean age 14.9 years, mean follow-up 2 years, 7 medial and 1 central lesion). American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score and ankle activity score were evaluated, and arthroscopic findings were graded according to the International Cartilage Research Society (ICRS) classification system. The condition of the underlying bone was assessed on preoperative computed tomographic images. The stability, incorporation, and subsidence of the osteochondral fragment, articular surface congruity, and the area of the bone marrow lesion (BML) were evaluated using magnetic resonance imaging (MRI).

Results:

AOFAS ankle-hindfoot score and ankle activity score significantly improved postoperatively. Arthroscopically, the lesions were classified as ICRS grade 0 or 1. Bone sclerosis or multiple small cysts of the underlying bone were observed in all patients. MRI demonstrated no signs of osteochondral fragment instability or subsidence, good or fair fragment incorporation, good articular surface congruity, or slight irregularity. The postoperative BML was reduced; however, these BMLs were still detectable at 1 year after surgery.

Conclusion:

Our data suggested that RD is an option for treating juvenile patients with OLT refractory to nonoperative treatment at short-term follow-up. Although bone sclerosis or multiple small cysts were identified in the underlying bone preoperatively and the BML under the osteochondral fragment remained postoperatively, clinical status such as pain and physical activity level were improved by RD.

Level of Evidence:

Level IV, retrospective case series.
The preparation and characterization of SnO2/rGO nanocomposites electrode materials for supercapacitor
Authors: Zhang Yingtao , Liu Manna , Sun Shishuai , Yang Liying
Published: April 2020

The ultrafine tin oxide (SnO2) nanorods/reduced graphene oxide (rGO) composites are synthesized by a two-step hydrothermal method. The prepared nanocomposites are characterized by scanning electron microscope, X-ray diffractometer, and Fourier transform infrared spectra. The results of electrochemical performance show that specific capacitance of the composite can reach 262.2 F g−1 at the current density of 100 mA g−1 in the 1 M Na2SO4 electrolyte. An initial capacitance retention of the composite is 96.1% after 6000 cycles, indicating its excellent electrochemical performance.
Glikinite, Zn3O(SO4)2, a new anhydrous zinc oxysulfate mineral structurally based on OZn4 tetrahedra.
Authors: Nazarchuk Evgeny V. , Siidra Oleg I. , Nekrasova Diana O. , Shilovskikh Vladimir V. , Borisov Artem S. , Avdontseva Evgeniya Y.
Published: April 2020

A new mineral glikinite, ideally Zn3O(SO4)2, was found in high-temperature exhalative mineral assemblages in the Arsenatnaya fumarole, Second scoria cone of the Great Tolbachik Fissure Eruption (1975–1976), Tolbachik volcano, Kamchatka Peninsula, Russia. Glikinite is associated closely with langbeinite, lammerite-β, bradaczekite, euchlorine, anhydrite, chalcocyanite and tenorite. It is monoclinic, P21/m, a = 7.298(18), b = 6.588(11), c = 7.840(12) Å, β = 117.15(3)°, V = 335.4(11) Å3 and R1 = 0.046. The eight strongest lines of the powder X-ray diffraction pattern [d in Å (I) (hkl)] are: 6.969(56)(00$\bar{1}$), 3.942(52)(101), 3.483(100)(00$\bar{2}$), 3.294(49)(020), 2.936(43)(120), 2.534(63)(201), 2.501(63)(20$\bar{3}$) and 2.395(86)(02$\bar{2}$). The chemical composition determined by electron-microprobe analysis is (wt.%): ZnO 42.47, CuO 19.50, SO3 39.96, total 101.93. The empirical formula calculated on the basis of O = 9 apfu is Zn2.07Cu0.97S1.98O9 and the simplified formula is Zn3O(SO4)2. Glikinite is a Zn,Cu analogue of synthetic Zn3O(SO4)2. The crystal structure of glikinite is based on OZn4 tetrahedra sharing common corners, thus forming [Zn3O]4+ chains. Sulfate groups interconnect [Zn3O]4+ chains into a 3D framework.
Reverse Genetics Assembly of Newcastle Disease Virus Genome Template Using Asis-Sal-Pac BioBrick Strategy
Authors: Tavassoli Amin , Soleymani Safoura , Haghparast Alireza , Hashemi Tabar Gholamreza , Bassami Mohammad Reza , Dehghani Hesam
Published: April 2020

Background

The BioBrick construction as an approach in synthetic biology provides the ability to assemble various gene fragments. To date, different BioBrick strategies have been exploited for assembly and cloning of a variety of gene fragments. We present a new BioBrick strategy, here referred as Asis-Sal-Pac BioBrick, which we used for the assembly of NDV as a candidate for single-stranded non-segmented, negative-sense RNA genome viruses.

Results

In the present study, we isolated three NDVs from clinical samples which were classified into the VIId genotype based on their pathogenicity and phylogenetic analyses. Then, SalI, AsisI, and PacI enzymes were used to design and develop a novel BioBrick strategy, which enabled us to assemble the NDV genome, adopting the “rule of six”. In this method, in each assembly step, the restriction sites in the newly formed destination plasmid are reproduced, which will be used for the next insertion. In this study using two overlapping PCRs, the cleavage site of the F gene was also modified from 112RRQKRF117to 112GRQGRL117 in order to generate the attenuated recombinant NDV. Finally, in order to construct the recombinant NDV viruses, the plasmids harboring the assembled full-length genome of the NDV and the helper plasmids were co-transfected into T7-BHK cells. The rescue of the recombinant NDVwas confirmed by RT-PCR and HA tests.

Conclusions

These findings suggest that the combination of reverse genetic technology and BioBrick assembly have the potential to be applied for the development of novel vaccine candidates. This promising strategy provides an effective and reliable approach to make genotype-matched vaccines against specific NDV strains or any other virus.
The novel coronavirus (COVID-19) pneumonia with negative detection of viral ribonucleic acid from nasopharyngeal swabs: a case report
Authors: Zhang Peiyan , Cai Zhao , Wu Weibo , Peng Ling , Li Yinfeng , Chen Chuming , Chen Li , Li Jianming , Cao Mengli , Feng Shiyan , Jiang Xiao , Yuan Jing , Liu Yingxia , Yang Liang , Wang Fuxiang
Published: April 2020

Background

The novel coronavirus disease 2019 (COVID-19) outbreak started in Wuhan, Hubei, China since Dec 2019 and cases of infection have been continuously reported in various countries. It is now clear that the SARS-COV-2 coronavirus is transmissible from human to human. Nucleic acid detection is considered as the gold standard for the diagnosis of COVID-19. In this case report, we describe our experience in detection of SARS-COV-2 from a confirmed patient using nucleic acid test of bronchoalveolar-lavage fluid (BALF) samples but not nasopharyngeal swabs.

Case presentation

We present a case of severely ill SARS-COV-2 infected 46-year-old man with fever, coughing and chest tightness. We performed viral detection using his BALF samples and imaging method (CT) for confirmation. The patient received combination of interferonalfa-1b and ribavirin, lopinavir and ritonavir for antiviral treatment at different stages. Other medication was also given to him in combination for anti-inflammation, intestinal microbial regulation, phlegm elimination, liver protection and pulmonary fibrosis prevention purposes. We provided oxygen supply to him using BIPAP ventilator and high-flow humidification oxygen therapy instrument to facilitate respiration. The patient was cured and discharged.

Conclusion

This case report described an effective supportive medication scheme to treat SARS-COV-2 infected patient and emphasized the necessity of detection of the viral genome using BALF samples and its significance in the diagnosis and prognosis of the disease.
Severe pain at the end of life: a population-level observational study
Authors: Hagarty A. Meaghen , Bush Shirley H. , Talarico Robert , Lapenskie Julie , Tanuseputro Peter
Published: April 2020

Background

Pain is a prevalent symptom at the end of life and negatively impacts quality of life. Despite this, little population level data exist that describe pain frequency and associated factors at the end of life. The purpose of this study was to explore the prevalence of clinically significant pain at the end of life and identify predictors of increased pain.

Methods

Retrospective population-level cohort study of all decedents in Ontario, Canada, from April 1, 2011 to March 31, 2015 who received a home care assessment in the last 30 days of life (n = 20,349). Severe daily pain in the last 30 days of life using linked Ontario health administrative databases. Severe pain is defined using a validated pain scale combining pain frequency and intensity: daily pain of severe intensity.

Results

Severe daily pain was reported in 17.2% of 20,349 decedents. Increased risk of severe daily pain was observed in decedents who were female, younger and functionally impaired. Those who were cognitively impaired had a lower risk of reporting pain. Disease trajectory impacted pain; those who died of a terminal illness (i.e. cancer) were more likely to experience pain than those with frailty (odds ratio 1.66).

Conclusion

Pain is a common fear of those contemplating end of life, but severe pain is reported in less than 1 in 5 of our population in the last month of life. Certain subpopulations may be more likely to report severe pain at the end of life and may benefit from earlier palliative care referral and intervention.
Microtubule self-organisation during seed germination in Arabidopsis
Authors: Yan Huifang , Chaumont Nicole , Gilles Jean François , Bolte Susanne , Hamant Olivier , Bailly Christophe
Published: April 2020

Background

Upon water uptake and release of seed dormancy, embryonic plant cells expand, while being mechanically constrained by the seed coat. Cortical microtubules (CMTs) are key players of cell elongation in plants: their anisotropic orientation channels the axis of cell elongation through the guidance of oriented deposition of load-bearing cellulose microfibrils in the cell wall. Interestingly, CMTs align with tensile stress, and consistently, they reorient upon compressive stress in growing hypocotyls. How CMTs first organise in germinating embryos is unknown, and their relation with mechanical stress has not been investigated at such an early developing stage.

Results

Here, we analysed CMT dynamics in dormant and non-dormantArabidopsisseeds by microscopy of fluorescently tagged microtubule markers at different developmental time points and in response to abscisic acid and gibberellins. We found that CMTs first appear as very few thick bundles in dormant seeds. Consistently, analysis of available transcriptome and translatome datasets show that limiting amounts of tubulin and microtubule regulators initially hinder microtubule self-organisation. Seeds imbibed in the presence of gibberellic acid or abscisic acid displayed altered microtubule organisation and transcriptional regulation. Upon the release of dormancy, CMTs then self-organise into multiple parallel transverse arrays. Such behaviour matches the tensile stress patterns in such mechanically constrained embryos. This suggests that, as CMTs first self-organise, they also align with shape-derived tensile stress patterns.

Conclusions

Our results provide a scenario in which dormancy release in the embryo triggers microtubule self-organisation and alignment with tensile stress prior to germination and anisotropic growth.
A scoping review of network meta-analyses assessing the efficacy and safety of complementary and alternative medicine interventions
Authors: Pratt Misty , Wieland Susan , Ahmadzai Nadera , Butler Claire , Wolfe Dianna , Pussagoda Kusala , Skidmore Becky , Veroniki Argie , Rios Patricia , Tricco Andrea C. , Hutton Brian
Published: April 2020

Background

Network meta-analysis (NMA) has rapidly grown in use during the past decade for the comparison of healthcare interventions. While its general use in the comparison of conventional medicines has been studied previously, to our awareness, its use to assess complementary and alternative medicines (CAM) has not been studied. A scoping review of the literature was performed to identify systematic reviews incorporating NMAs involving one or more CAM interventions.

Methods

An information specialist executed a multi-database search (e.g., MEDLINE, Embase, Cochrane), and two reviewers performed study selection and data collection. Information on publication characteristics, diseases studied, interventions compared, reporting transparency, outcomes assessed, and other parameters were extracted from each review.

Results

A total of 89 SR/NMAs were included. The largest number of NMAs was conducted in China (39.3%), followed by the United Kingdom (12.4%) and the United States (9.0%). Reviews were published between 2010 and 2018, with the majority published between 2015 and 2018. More than 90 different CAM therapies appeared at least once, and the median number per NMA was 2 (IQR 1–4); 20.2% of reviews consisted of only CAM therapies. Dietary supplements (51.1%) and vitamins and minerals (42.2%) were the most commonly studied therapies, followed by electrical stimulation (31.1%), herbal medicines (24.4%), and acupuncture and related treatments (22.2%). A diverse set of conditions was identified, the most common being various forms of cancer (11.1%), osteoarthritis of the hip/knee (7.8%), and depression (5.9%). Most reviews adequately addressed a majority of the PRISMA NMA extension items; however, there were limitations in indication of an existing review protocol, exploration of network geometry, and exploration of risk of bias across studies, such as publication bias.

Conclusion

The use of NMA to assess the effectiveness of CAM interventions is growing rapidly. Efforts to identify priority topics for future CAM-related NMAs and to enhance methods for CAM comparisons with conventional medicine are needed.

Systematic review registration

https://ruor.uottawa.ca/handle/10393/35658
Infection with the sheep gastrointestinal nematode Teladorsagia circumcincta increases luminal pathobionts
Authors: Cortés Alba , Wills John , Su Xiaopei , Hewitt Rachel E. , Robertson Jack , Scotti Riccardo , Price Daniel R. G. , Bartley Yvonne , McNeilly Tom N. , Krause Lutz , Powell Jonathan J. , Nisbet Alasdair J. , Cantacessi Cinzia
Published: April 2020

Background

The multifaceted interactions between gastrointestinal (GI) helminth parasites, host gut microbiota and immune system are emerging as a key area of research within the field of host-parasite relationships. In spite of the plethora of data available on the impact that GI helminths exert on the composition of the gut microflora, whether alterations of microbial profiles are caused by direct parasite-bacteria interactions or, indirectly, by alterations of the GI environment (e.g. mucosal immunity) remains to be determined. Furthermore, no data is thus far available on the downstream roles that qualitative and quantitative changes in gut microbial composition play in the overall pathophysiology of parasite infection and disease.

Results

In this study, we investigated the fluctuations in microbiota composition and local immune microenvironment of sheep vaccinated against, and experimentally infected with, the ‘brown stomach worm’Teladorsagia circumcincta, a parasite of worldwide socio-economic significance. We compared the faecal microbial profiles of vaccinated and subsequently infected sheep with those obtained from groups of unvaccinated/infected and unvaccinated/uninfected animals. We show that alterations of gut microbial composition are associated mainly with parasite infection, and that this involves the expansion of populations of bacteria with known pro-inflammatory properties that may contribute to the immunopathology of helminth disease. Using novel quantitative approaches for the analysis of confocal microscopy-derived images, we also show that gastric tissue infiltration of T cells is driven by parasitic infection rather than anti-helminth vaccination.

Conclusions

Teladorsagia circumcinctainfection leads to an expansion of potentially pro-inflammatory gut microbial species and abomasal T cells. This data paves the way for future experiments aimed to determine the contribution of the gut flora to the pathophysiology of parasitic disease, with the ultimate aim to design and develop novel treatment/control strategies focused on preventing and/or restricting bacterial-mediated inflammation upon infection by GI helminths.
Gut bacterial ClpB-like gene function is associated with decreased body weight and a characteristic microbiota profile
Authors: Arnoriaga-Rodríguez María , Mayneris-Perxachs Jordi , Burokas Aurelijus , Pérez-Brocal Vicente , Moya Andrés , Portero-Otin Manuel , Ricart Wifredo , Maldonado Rafael , Fernández-Real José-Manuel
Published: April 2020

Background

The chaperone ClpB, a bacterial protein, is a conformational antigen-mimetic of α-melanocyte-stimulating hormone (α-MSH) implicated in body weight regulation in mice. We here investigated the potential associations of gut bacterial ClpB-like gene function with obesity status and gut microbiota in humans.

Results

Gut microbiota ClpB KEGG function was negatively associated with body mass index, waist circumference, and total fat mass (DEXA). The relative abundance (RA) of several phyla and families directly associated with ClpB was decreased in subjects with obesity. Specifically, the RA ofRikenellaceae,Clostridiaceaeand not assignedFirmicutes were lower in subjects with obesity and positively associated with gut bacterial ClpB-like gene function (not assignedFirmicutes(r =0.405, FDR = 2.93 × 10−2),Rikenellaceae(r =0.217, FDR = 0.031), andClostridiaceae(r =0.239, FDR = 0.017)). The gut bacterial ClpB-like gene function was also linked to specific plasma metabolites (hippuric acid and 3-indolepropionic acid) and fecal lupeol. The α-MSH-like epitope similar to that ofEscherichia coliClpB was also identified in some sequences of those bacterial families.

After fecal transplantation from humans to mice, the families that more contributed to ClpB-like gene function in humans were also associated with ClpB-like gene function in mice after adjusting for the donor’s body mass index (not assignedFirmicutes(r =0.621,p =0.003),Prevotellaceae(r =0.725,p =4.1 × 10−7),Rikenellaceae(r =0.702,p =3.9 × 10−4), andRuminococcaceae(r =0.526,p =0.014)).Clostridiaceae(r =− 0.445,p =0.038) andPrevotellaceaeRA (r = −0.479,p =0.024) and were also negatively associated with weight gain in mice. The absolute abundance (AA) ofPrevotellaceaein mice was also positively associated with the gut bacterial ClpB-like gene function in mice. DESeq2 identified species ofPrevotellaceae, both negatively associated with mice’ weight gain and positively with gut bacterial ClpB-like gene function.

Conclusions

In summary, gut bacterial ClpB-like gene function is associated with obesity status, a specific gut microbiota composition and a plasma metabolomics profile in humans that could be partially transplanted to mice.
Clinical evidence based review and systematic scientific review in the identification of malignant transformation of inverted papilloma
Authors: Long Cai , Jabarin Basel , Harvey Alexandra , Ham Jennifer , Javer Amin , Janjua Arif , Thamboo Andrew
Published: April 2020

Background

Inverted papilloma (IP) is an unusual type of benign tumor that has high recurrence rates and the potential to transform into squamous cell carcinomas (SCC). The mechanism of the transformation process from IP to IP-SCC is uncertain and there is no consensus regarding the best practice for IP-SCC detection. The goal of this study is to identify the best clinical methods to detect for IP-SCC.

Methods

An evidence-based review was performed using Medline and Ovid to obtain all articles up to October 10th, 2019 pertaining to identification of IP malignant transformation. All manuscripts discussing clinical methods or biomarkers were included.

Results

Based on clinical research studies, convoluted cerebriform pattern and apparent diffusion coefficient values on Magnetic Resonance Imaging (MRI) can help differentiate benign IP from SCC and increased SUVmax on PET/CT is associated with higher probability of malignancy although not as specific. No consensus about the best biomarker for IP-SCC has been reached among researchers and continues to be exploratory.

Conclusion

Endoscopy with biopsy is the gold standard practice to identify IP-SCC; however, MRI is the preferred imaging modality to recognize malignant transformation in cases where biopsy is difficult. Multiple biomarkers have shown positive results, but no single indicator with clinical significance for monitoring malignant transformation process has been found.
Comparing the intestinal bacterial communies of sympatric wintering Hooded Crane (Grus monacha) and Domestic Goose (Anser anser domesticus)
Authors: Fu Rong , Xiang Xingjia , Dong Yuanqiu , Cheng Lei , Zhou Lizhi
Published: April 2020

Background

Gut microbiota play crucial roles in host health. Wild birds and domestic poultry often occupy sympatric habitats, which facilitate the mutual transmission of intestinal microbes. However, the distinct intestinal microbial communities between sympatric wild birds and poultry remain unknown. At present, the risk of interspecies transmission of pathogenic bacteria between wild and domestic host birds is also a research hotspot.

Methods

This study compared the intestinal bacterial communities of the overwintering Hooded Crane (Grus monacha) and the Domestic Goose (Anser anser domesticus) at Shengjin Lake, China, using Illumina high-throughput sequencing technology (Mi-Seq platform).

Results

Our results revealed that Firmicutes, Actinobacteria, Proteobacteria, Bacteroidetes and Chloroflexi were the dominant bacterial phyla in both hosts. The gut bacterial community composition differed significantly between sympatric Hooded Cranes and Domestic Geese. However, the hosts exhibited little variation in gut bacterial alpha-diversity. The relative abundance of Firmicutes was significantly higher in the guts of the Hooded Cranes, while the relative abundances of Actinobacteria, Proteobacteria, Bacteroidete and Chloroflexi were significantly higher in guts of Domestic Geese. Moreover, a total of 132 potential pathogenic operational taxonomic units (OTUs) were detected in guts of Hooded Cranes and Domestic Geese, and 13 pathogenic OTUs (9.8%) were found in both host guts. Pathogenic bacterial community composition and diversity differed significantly between hosts.

Conclusions

The results showed that the gut bacterial community composition differs significantly between sympatric Hooded Cranes and Domestic Geese. In addition, potential pathogens were detected in the guts of both Hooded Cranes and Domestic Geese, with 13 pathogenic OTUs overlapping between the two hosts, suggesting that more attention should be paid to wild birds and poultry that might increase the risk of disease transmission in conspecifics and other mixed species.
Objective measurement in Parkinson’s disease: a descriptive analysis of Parkinson’s symptom scores from a large population of patients across the world using the Personal KinetiGraph®
Authors: Pahwa Rajesh , Bergquist Filip , Horne Malcolm , Minshall Michael E.
Published: April 2020

Background

The Personal KinetiGraph® (PKG®) Movement Recording System provides continuous, objective, ambulatory movement data during routine daily activities and provides information on medication compliance, motor fluctuations, immobility, and tremor for patients with Parkinson’s disease (PD). Recent evidence has proposed targets for treatable symptoms. Indications for PKG vary by country and patient selection varies by physician.

Methods

The analyses were based upon 27,834 complete and de-identified PKGs from January 2012 to August 2018 used globally for routine clinical care. Median scores for bradykinesia (BKS) and dyskinesia (DKS) as well as percent time with tremor (PTT) and percent time immobile (PTI) were included as well as proportions of PKGs above published PKG summary score target values (BKS > 25, DKS > 9, PTT > 1%, PTI > 10%). Two sub-analyses included subjects who had 2+ PKG records and scores above proposed BKS and DKS targets, respectively, on their first PKG. Median BKS and DKS scores for subsequent PKGs (1st, 2nd, etc.) were summarized and limited to those with 100+ subsequent PKGs for each data point.

Results

Significant differences between countries were found for all 4 PKG parameter median scores (all p < 0.0001). Overall, 54% of BKS scores were > 25 and ranged from 46 to 61% by country. 10% of all DKS scores were > 9 and ranged from 5 to 15% by country. Sub-analysis for BKS showed global median BKS and DKS scores across subsequent PKGs for subjects who had 2+ PKGs and had BKS > 25 on their first PKG. There were significant changes in BKS from 1st to 2nd-6th PKGs (all p < 0.0001). Sub-analysis for DKS showed global median BKS & DKS scores across subsequent PKGs for subjects who had 2+ PKGs and had DKS > 9 on their first PKG. There were significant changes in DKS from 1st to 2nd and 3rd PKGs (both p < 0.0001).

Conclusions

This analysis shows that in every country evaluated a meaningful proportion of patients have sub-optimal PD motor symptoms and substantial variations exist across countries. Continuous objective measurement (COM) in routine care of PD enables identification and quantification of PD motor symptoms, which can be used to enhance clinical decision making, track symptoms over time and improve PD symptom scores. Thus, clinicians can use these PKG scores during routine clinical management to identify PD symptoms and work to move patients into a target range or a more controlled symptom state.
Intraoperative optical coherence tomographic findings in patients undergoing subretinal gene therapy surgery
Authors: Vasconcelos Huber M. , Lujan Brandon J. , Pennesi Mark E. , Yang Paul , Lauer Andreas K.
Published: April 2020

Background

To analyze intraoperative OCT (iOCT) findings during subretinal gene therapy.

Methods

A single-center, retrospective, observational, case series study of twenty one eyes submitted to subretinal gene therapy. Intrasurgical high definition videos were included for analyzes. Cases with absence of iOCT video or unsuccessful bleb creation were excluded. Sharp needle tip (SNT) or blunted needle tip (BNT) and their interaction with neurosensory retina were evaluated. Presence of subretinal air bubbles, visible opened retinotomy, and medication reflux were also correlated and analyzed.

Results

Nineteen of twenty-one eyes were included. Of the two excluded eyes, subretinal bleb creation was unsuccessful in one and technical issues prevented OCT image acquisition in the other. Immediately before subretinal injection, needle indention/penetration of the neurosensory retina with temporary indentation of the RPE/choroid was evident in 16 (84%) of the 19 eyes. Complete RPE/choroid indentation was needed with BNT use compared to SNT (p = 0.0114). An open retinotomy was identified in 14 (74%) of 19 eyes at the conclusion of bleb injection and was more commonly associated with SNT (p = 0.0108).

Conclusions

iOCT provides valuable real-time feedback of cross-sectional retinal anatomy during subretinal gene therapy surgeries. The type of needle tip and its use during the gene therapy procedure seems to influence in the bleb creation and presence of visible open retinotomy. Further studies of iOCT findings during gene therapy delivery procedures are likely to help refine the surgical technique.