bluuebunny/crossref_metadata_2025 huggingface dataset:
Diversity, Pathogenicity, and Fungicide Sensitivity of Fungal Species Associated with Late-Season Rots of Wine Grape in the Mid-Atlantic United States
Authors: Cosseboom Scott D. , Hu Mengjun
Published: March 2021

Late-season bunch rots cause major losses in grape production every year in the Mid-Atlantic United States, but the causal agents are not well characterized. In this study, 265 fungal isolates were collected from rotten grapes from 2014 to 2020 and identified to the genus level according to internal transcribed spacer sequences. The most prevalent of the 15 genera were Botrytis, Colletotrichum, Aspergillus, Alternaria, Pestalotiopsis, and Neopestalotiopsis. Of these, isolates within three prevalent, yet understudied, genera were identified to be Aspergillus uvarum, Alternaria alternata, and Neopestalotiopsis rosae. The pathogenicity of these three fungal species was evaluated in two field trials by artificially inoculating wounded and nonwounded grapes (Vitis vinifera) of four cultivars at the phenological stages of bloom, véraison, and preharvest. Upon ripening, fruit were weighed and assessed for severity of multiple diseases. On nonwounded fruit, A. uvarum caused significantly higher disease severity than the control in both seasons. On wounded fruit, each inocula caused significantly higher disease than the respective controls in the first season, but only A. uvarum and Botrytis cinerea caused this in the second season. Also, wounding was found to have a detrimental effect on cluster weight, which was significantly influenced by inoculation timing and cultivar. Lastly, A. uvarum and N. rosae were tested for sensitivity to azoxystrobin, boscalid, and difenoconazole. The A. uvarum isolates were found to be more sensitive to boscalid and difenoconazole in general, with varying sensitivity to azoxystrobin. N. rosae isolates were resistant to boscalid and azoxystrobin but displayed much higher sensitivity to difenoconazole. Evidence from the isolate collection and field trials demonstrates that A. uvarum could be a significant pathogen of wine grapes in the Mid-Atlantic United States. Results from this study will be useful for the identification and management of the understudied Alternaria, Aspergillus, and Neopestalotiopsis fruit rots of wine grapes.
Effect of In-Furrow Application of Fluopyram on Leaf Spot Diseases of Peanut
Authors: Culbreath Albert K. , Kemerait Robert C. , Brenneman Timothy B. , Cantonwine Emily G. , Rucker Keith S.
Published: March 2021

In peanut (Arachis hypogaea) production, in-furrow applications of the premix combination of the succinate-dehydrogenase-inhibitor (SDHI) fungicide and nematicide fluopyram and the insecticide imidacloprid are used primarily for management of nematode pests and for preventing feeding damage on foliage caused by tobacco thrips (Frankliniella fusca). Fluopyram is also active against many fungal pathogens. However, the effect of in-furrow applications of fluopyram on early leaf spot (Passalora arachidicola) or late leaf spot (Nothopassalora personata) has not been characterized. The purpose of this study was to determine the effects of in-furrow applications of fluopyram + imidacloprid or fluopyram alone on leaf spot epidemics. Field experiments were conducted in Tifton, GA in 2015, 2016, and 2018 to 2020. In all experiments, in-furrow applications of fluopyram + imidacloprid provided extended suppression of early leaf spot and late leaf spot epidemics compared with the nontreated control. In 2020, there was no difference between the effects of fluopyram + imidacloprid and fluopyram alone on leaf spot epidemics. Results indicated that fluopyram could complement early-season leaf spot management programs. Use of in-furrow applications of fluopyram should be considered as an SDHI fungicide application for resistance management purposes.
The Dominance of Fusarium meridionale Over F. graminearum Causing Gibberella Ear Rot in Brazil May Be Due to Increased Aggressiveness and Competitiveness
Authors: Machado Franklin J. , Kuhnem Paulo R. , Casa Ricardo T. , McMaster Nicole , Schmale David G. , Vaillancourt Lisa J. , Del Ponte Emerson M.
Published: March 2021

In Brazil, Gibberella ear rot (GER) of maize is caused mainly by Fusarium meridionale, whereas F. graminearum is a minor contributor. To test the hypothesis that F. meridionale is more aggressive than F. graminearum on maize, six experiments were conducted in the south (summer) and one in the central-south (winter), totaling seven conditions (year × location × hybrid). Treatments consisted of F. graminearum or F. meridionale (two isolates of each) inoculated once 4 days after silk, inoculated sequentially and alternately (F. graminearum → F. meridionale or F. meridionale → F. graminearum) 6 days apart, or (in the central-south) inoculated sequentially without alternating species (F. meridionale → F. meridionale or F. graminearum → F. graminearum). Overall, severity was two times greater in the south (37.0%), where summer temperatures were warmer (20 to 25°C) than in central-south. In the south, severity was greatest in F. meridionale treatments (67.8%); followed by F. meridionale → F. graminearum (41.1%), then F. graminearum → F. meridionale (19.4%), and lowest in F. graminearum (2.1%), suggesting an antagonistic relationship. In the central-south (15 to 20°C), severity was generally higher in the sequential nonalternating inoculation treatments (F. meridionale → F. meridionale or F. graminearum → F. graminearum) than when either species was inoculated only once. Only nivalenol (NIV) or deoxynivalenol was detected when F. meridionale or F. graminearum, respectively, was inoculated singly, or sequentially with no alternation. Both toxins were found in grains harvested from the F. meridionale → F. graminearum treatment, whereas only NIV was found in kernels from the F. graminearum → F. meridionale treatment, suggesting that F. meridionale was more competitive than F. graminearum in coinoculations. The dominance of F. meridionale as a cause of GER in Brazil may be due in part to its higher aggressiveness and competitiveness compared with F. graminearum.
T cell responses in respiratory viral infections and chronic obstructive pulmonary disease
Authors: Huang Shouxiong , He Quan , Zhou Linfu
Published: March 2021

Respiratory viruses are major human pathogens that cause approximately 200 million pneumonia cases annually and induce various comorbidities with chronic obstructive pulmonary disease (COPD), resulting in significant health concerns and economic burdens. Clinical manifestations in respiratory viral infections and inflammations vary from asymptomatic, mild, to severe, depending on host immune cell responses to pathogens and interactions with airway epithelia. We critically review the activation, effector, and regulation of T cells in respiratory virus infections and chronic inflammations associated with COPD. Crosstalk among T cells, innate immune cells, and airway epithelial cells is discussed as essential parts of pathogenesis and protection in viral infections and COPD. We emphasize the specificity of peptide antigens and the functional heterogeneity of conventional CD4+ and CD8+ T cells to shed some light on potential cellular and molecular candidates for the future development of therapeutics and intervention against respiratory viral infections and inflammations.
Magnitude and significance of interarm blood pressure differences in children and adolescents
Authors: Clarke Melanie M. , Harrington Hilary A. , Glenning Jonathan P. , Zannino Diana , Holmstrup Michael E. , Jensen Brock T. , Smolich Joseph J. , Cheung Michael M.H. , Mynard Jonathan P.
Published: March 2021

Background:

An interarm difference (IAD) in blood pressure (BP) of 10 mmHg or more is a potential cardiovascular risk factor in adults, given its association with cardiovascular events/mortality. In children and adolescents, accurate BP assessment is critical for identifying risk of end organ damage. However, IAD has not been systematically studied in paediatric patients; if present and of significant magnitude, measuring BP in only one arm could lead to misclassification of hypertensive status.

Method:

In 95 children/adolescents with a normal aorta (including 15 with a history of tetralogy of Fallot) aged 7–18 years attending the Royal Children's Hospital, Melbourne, we aimed to determine the magnitude of IAD, frequency of IAD of at least 10 mmHg, difference in BP classification between arms, and influence of repeat measures on IAD in a single visit. After 5 min rest, simultaneous bilateral BP was measured in triplicate with an automated device.

Results:

Absolute systolic IAD was 5.0 mmHg (median, interquartile range 2–8 mmHg) and was 10 mmHg or more in 14%, with no change on repeat measures. In patients with a history of aortic surgery, IAD of 10 mmHg or more occurred in 27% (transposition of the great arteries, n = 15) and 75% (aortic coarctation, n = 8). Differences in BP classification, based on initial left vs. right arm measures, occurred in 25% (normal aorta) and 40%/63% (aortic surgery), or 17% and 33%/50%, respectively if second and third measurements were averaged.

Conclusion:

Substantial interarm BP differences were common, even in apparently healthy children and adolescents: evaluation of IAD may, therefore, be important for BP classification in the paediatric setting.
Use of the Sports Concussion Assessment Tool 3 in Emergency Department Patients With Psychiatric Disease
Authors: Coscia Atticus , Stolz Uwe , Barczak Christopher , Wright Natalie , Mittermeyer Stephan , Shams Tanzid , Epstein Stephen , Kreitzer Natalie
Published: March 2021

Objective:

The Sports Concussion Assessment Tool 3 (SCAT3) Symptom Evaluation (SE) is used in the emergency department (ED). This study aimed to examine the effects of psychiatric history on the SCAT3 SE symptom severity score (SSS).

Setting:

Three US EDs.

Participants:

A total of 272 ED patients with suspected concussion.

Design:

Prospective, nonrandomized, nonblinded study. The SCAT3 SE SSS, demographic data, medical information, and self-reported psychiatric history were obtained from patients by clinical research staff when they presented to the ED seeking standard clinical care. Concussion diagnoses were determined following a comprehensive assessment by an ED physician trained in managing concussions and adjudicated by supervising physicians.

Main Measures:

The primary outcome measure was SSS. The association between SSS, self-reported psychiatric disease, and concussion diagnosis was analyzed using multivariable linear regression.

Results:

68.4% of subjects were diagnosed with a concussion. After controlling for age, sex, race, history of previous concussion, and interval from injury to ED presentation, self-reported psychiatric history (adjusted regression coefficient (βa): 16.9; confidence interval [CI]: 10.1, 23.6), and concussion diagnosis (βa: 21.7; CI: 14.2, 29.2) were both independently associated with a significant increase in SSS. Subjects with a history of concussion had a significantly higher SSS (βa: 9.1; CI: 1.8, 16.5). Interval from injury to ED presentation was also associated with a significant increase in SSS (βa: 1.6 per 6-hour increase; CI: 0.4, 2.8).

Conclusion:

Our findings demonstrate that a history of preexisting psychiatric disease, as self-reported by patients with a suspected concussion treated in the ED, is independently associated with significantly higher scores on the SCAT3 SE. This suggests that a history of psychiatric illness may need to be accounted for when the SCAT3 SE is used in the ED for the assessment of concussion.
A Patient With a Pigmentary Disorder
Authors: Krammes Kayla
Published: March 2021

This is a case study of a 22-year-old woman presenting with a hypopigmented rash on the upper torso. A clinical question is posed, followed by a detailed review of the disease and consideration of differential diagnoses.
The Dermatology Provider's Role in the Antibiotic Resistance Crisis
Authors: Dadrass Farinoosh , Lake Eden
Published: March 2021

Dermatology healthcare providers commonly treat acne vulgaris with oral and topical antibiotics. In the face of the current antibiotic resistance crisis, alternative therapies should be considered prior to the use of antibiotics and antibiotics should be used sparingly. Alternative therapies include retinoid therapies, retinoid combination therapies, hormonal therapies, and light-based therapies, as well as various combinations of these therapies. Patients would benefit from the initial exclusion of an underlying endocrine pathology prior to initiating vitamin A-derived therapies, light-based therapies, or more subtle hormonal therapies.
Long-term recovery from a minimally responsive state with recovery of an injured ascending reticular activating system
Authors: Jang Sung Ho , Kim Seong Ho , Seo Jeong Pyo
Published: March 2021

We report on a patient with hypoxic-ischemic brain injury (HI-BI) who showed recovery from a minimally consciousness state over 6 years concurrent with recovery of an injured ascending reticular activating system (ARAS), which was demonstrated on diffusion tensor tractography (DTT).

A 31-year-old female patient, who suffered from HI-BI, showed impaired consciousness with a minimally conscious state: intermittently obeying simple motor tasks, such as “please grasp my hand.” Her consciousness showed recovery with the passage of time; rapid recovery was observed during the recent 2 years.

In the upper ARAS, the neural connectivity to both the basal forebrain and prefrontal cortex had increased on 8-year DTT compared with 1.5-year DTT. In the lower dorsal and ventral ARAS, no significant change was observed between 1.5 and 8 years DTTs.

Recovery of an injured ARAS was demonstrated in a patient who showed recovery from a minimally consciousness state over 6 years following HI-BI. Our results suggest the brain target areas for recovery of impaired awareness in patients with disorders of consciousness.
Comparison of clinical outcomes with hip replacement versus PFNA in the treatment of intertrochanteric fractures in the elderly
Authors: Chen Junming , Yue Chen , He Peilin , Huang Zeling , Li Li , Zhang Xue , Fan Yanan , Liu Youwen
Published: March 2021

Background:

The purpose of this meta-analysis was to evaluate the clinical efficacy and safety of HR and PFNA in the treatment of intertrochanteric fractures in the elderly.

Methods:

We carried out this review according to the principle of preferred reporting items for systematic reviews and meta-analyses (PRISMA) guideline. The clinical randomized controlled trials (RCTs), prospective cohort studies, retrospective cohort studies (RCSs), and case-control studies involving HR and PFNA in the treatment of intertrochanteric fractures in the elderly from 2000 to 2020 were compared by searching Web of Science, Pubmed, the Cochrane Library, and Embase. The quality of the included cohort study (CS) lines was evaluated using the Newcastle-Ottawa Scale (NOS). The quality of the included RCT lines was evaluated using Jadad. Forest plots were drawn by RevMan5.4 software based on the results and the data were analyzed.

Results:

After screening, a total of 9 articles were included, of which one was a clinical RCT and eight were RCSs with 1374 patients. The operative time of the PFNA group was shorter [WMD = 15.20; 95% CI (13.17, 17.23), P < .05] and the intraoperative blood loss was less [WMD = 178.81; 95% CI (97.24, 260.38), P < .05] than the HR group, while the first weight-bearing time of the HR group was shorter [WMD = −7.70; 95% CI (−10.54, −4.86), P 
< .05] than the PFNA group. There was no significant difference in the length of hospital stay, HHS, postoperative orthopedic complications, and postoperative medical complications between the 2 groups.

Conclusion:

With the development of HR technology and minimally invasive technology, the trauma caused by surgery is decreasing. Under the premise of improving perioperative management, such as optimizing the preoperative preparation and postoperative management, shortening the operative time, reducing intraoperative blood loss, and actively managing co-existing diseases, HR has more advantages than PFNA in the treatment of senile intertrochanteric fractures.
Prevalence of anti-dense fine speckled 70 antibodies in healthy individuals and patients with antinuclear antibody-associated autoimmune rheumatic diseases in Japan
Authors: Hayashi Nobuhide , Uto Kenichi , Imanishi Akiko , Sugiyama Daisuke , Morinobu Akio , Saegusa Jun
Published: March 2021

Previous studies from various countries have reported anti-dense fine speckled pattern (DFS)70 antibody prevalence but few studies have been from Asia. We investigated the prevalence of anti-DFS70 autoantibodies in a Japanese cohort of healthy individuals (HI) and patients with antinuclear antibody-associated autoimmune rheumatic diseases (AARD).

Enzyme-linked immunosorbent assay and indirect immunofluorescence were performed using samples from 250 HI and 276 AARD patients.

The overall anti-DFS70 antibody prevalence in HI was 16.4%, with 12.8% for males and 20.0% for females (sex difference; P = .12). In AARD patients, the anti-DFS70 antibody prevalence in systemic lupus erythematosus, mixed connective tissue disease, systemic sclerosis, dermatomyositis and polymyositis (DM/PM), Sjögren syndrome, and rheumatoid arthritis (RA) was 22.1%, 14.3%, 14.3%, 3.0%, 21.3%, and 18.1%, respectively (no significant difference between AARD patients except DM/PM and HI). The prevalence of isolated anti-DFS70 antibody in HI and all AARD patients excluding RA was 14.8% (37/250) and 4.4% (9/204), respectively (P 
< .01 vs HI). Among anti-DFS70 antibody-positive cases, 63.4% (26/41) were DFS pattern by IIF and 23.5% (8/34) were HI and AARD patients excluding RA, respectively.

The anti-DFS70 antibody prevalence in HI and AARD patients in Japan was similar. Furthermore, the anti-DFS70 antibody prevalence in HI and AARD in Japan is higher than in HI and AARD in regions other than Asia. This makes AARD differential diagnosis by antinuclear antibody screening difficult.
Effects of attentional focus on upper extremity motor performance in post stroke patients
Authors: Gomes Camila L. A. , Cacho Roberta O. , Nobrega Viviane T. B. , Galvão Fabio , de Araújo Denise S. , Medeiros Ana Loyse de S. , Silva Emanoelle C. V. , Barreto Rodrigo L. , Cacho Enio W. A.
Published: March 2021

Introduction:

To facilitate the command to the learner, therapist can use verbal cues for guidance: internal focus (own body) and external focus (consequence of movement in the environment).

Objective:

To examine the effects of different attentional focus on upper limb motor performance in post-stroke.

Methods:

Randomized controlled trial with 2 groups. Study realized at Integrated Clinic of the Faculty of Health Science at Trairi (Santa Cruz, Rio Grande do Norte, Brazil). Twelve participants allocated into 2 groups. Two motor tasks were used: task 1, reach-point; task 2, reach-grasp-fit, with the paretic extremity, using verbal commands directed by a trained therapist. In the first phase, Group 1 received commands with internal focus, while Group 2 was instructed with commands with external focus. After 1 week, the command type was changed between groups. The variables collected was movement time, velocity and number of peaks velocity

Results:

Both attentional focus promoted significant differences in movement time and velocity, however, only Internal Focus provided significant results in both tasks of the same variables.

Discussion:

The benefits of 1 attentional focus on the other are not fully confirmed. However, not receiving any kind of attention guidance compromises motor performance. The results support the hypothesis that the benefits of the External Focus are accentuated when preceded by the Internal Focus.

Clinical Trial Registration:

Research Ethics Committee of the Faculty of Helth Science at Trairi (Facisa - UFRN)- Number CAAE 2.625.609, approved on April 13, 2018; Brazilian Registry of Clinical Trials - RBR-4995cr approved on July 4, 2019 retrospectively registered (http://www.ensaiosclinicos.gov.br/rg/RBR-4995cr/).
Associations of maternal diabetes mellitus and adiponectin gene polymorphisms with congenital heart disease in offspring
Authors: Luo Liu , Zhang Senmao , Wang Tingting , Diao Jingyi , Li Jinqi , Li Yihuan , Zhao Lijuan , Chen Letao , Ye Ziwei , Huang Peng , Qin Jiabi
Published: March 2021

This study aimed at assessing the association of maternal diabetes mellitus (DM), the adiponectin gene (APM1) gene polymorphisms, and their interactions with risk of congenital heart disease (CHD) in offspring.

A case-control study of 464 mothers of CHD patients and 504 mothers of healthy children was conducted.

After adjusting for potential confounding factors, our study suggested that mothers with gestational DM (GDM) during this pregnancy (adjusted odds ratio [aOR = 2.96]), GDM in previous pregnancy experiences (aOR = 3.16), and pregestational DM in the 3 months before this pregnancy (aOR = 4.52) were at a significantly higher risk of CHD in offspring, when compared with those without any diabetes. The polymorphisms of maternal APM1 gene at rs1501299 (T/T vs G/G: aOR = 3.45; T/G vs G/G: aOR = 1.73) and rs2241766 (G/G vs T/T, aOR = 3.36; G/T vs T/T, aOR = 1.93) were significantly associated with risk of CHD in offspring. In addition, significant interactions between maternal DM and the APM1 genetic variants on the development of CHD were found.

Our findings indicate that maternal DM, APM1 gene genetic variants, and their interactions are significantly associated with risk of CHD in offspring. However, more studies in different ethnic populations and with a larger sample and prospective design are required to confirm our findings.
The role of trans-thoracic echocardiography in the assessment of aortic annular diameter
Authors: Naguib Khaled I. , Attia Mohamed A. , Bashandy Mohamed S. , Reihan Muhammad Saad , Dabash Tarek Ahmed , El-Salam Ahmed B. Abd , Helal Hosam H. , Bahbah Eshak I.
Published: March 2021

We aimed to compare two-dimension transthoracic echocardiogram (2D-TTE) and three-dimension transthoracic echocardiogram (3D-TTE) measurements of the aortic annular diameter using multi-detector CT (MDCT) as a gold standard.

This prospective observational study included 50 consecutive patients who came to the cardiology department, Al-Azhar University Hospital, New Damietta, for MDCT coronary angiography. The study was carried out in the period from July 2016 until February 2017. All patients were subjected to informed consent, clinical history, physical examination, transthoracic echocardiography 2D and 3D, and MDCT.

The aortic annular areas measured by MDCT and 3D-TTE were significantly larger than areas by 2D-TTE. A good correlation (r = 0.82) was observed between the areas obtained by 3D-TTE and MDCT; however, the correlation between the values by 2D-TTE and MDCT was rough (r = 0.30). Eccentricity Index (EI) values in 28% of the patients were greater than 0.1, that is, the aortic annulus was elliptical.

Accuracy of aortic annular diameter measurement by 3D-TTE was superior to that by 2D-TTE. Three-D TTE and MDCT revealed that the shape of the aortic annulus was elliptical in 28% to 30% respectively of study subjects. There is a strong concordance between the minimum and the maximum diameter determine by 3D-TTE and MDCT.
Percutaneous endoscopic lumbar discectomy compared with other surgeries for lumbar disc herniation
Authors: Bai Xiaoliang , Lian Yong , Wang Jie , Zhang Hongxin , Jiang Meichao , Zhang Hao , Pei Bo , Hu Changqing , Yang Qiang
Published: March 2021

Objective:

This meta-analysis was performed to investigate whether percutaneous endoscopic lumbar discectomy (PELD) had a superior effect than other surgeries in the treatment of patients with lumbar disc herniation (LDH).

Method:

We searched PubMed, Embase, and Web of Science through February 2018 to identify eligible studies that compared the effects and complications between PELD and other surgical interventions in LDH. The outcomes included success rate, recurrence rate, complication rate, operation time, hospital stay, blood loss, visual analog scale (VAS) score for back pain and leg pain, 12-item Short Form Health Survey (SF12) physical component score, mental component score, Japanese Orthopaedic Association Score, Oswestry Disability Index. A random-effects or fixed-effects model was used to pool the estimate, according to the heterogeneity among the included studies.

Results:

Fourteen studies (involving 2,528 patients) were included in this meta-analysis. Compared with other surgeries, PELD had favorable clinical outcomes for LDH, including shorter operation time (weight mean difference, WMD=−18.14 minutes, 95%CI: −25.24, −11.05; P < .001) and hospital stay (WMD = −2.59 days, 95%CI: −3.87, −1.31; P < .001), less blood loss (WMD = −30.14 ml, 95%CI: −43.16, −17.13; P < .001), and improved SF12- mental component score (WMD = 2.28, 95%CI: 0.50, 4.06; P = .012)) and SF12- physical component score (WMD = 1.04, 95%CI: 0.37, 1.71; P = .02). However, it also was associated with a significantly higher rate of recurrent disc herniation (relative risk [RR] = 1.65, 95%CI: 1.08, 2.52; P = .021). There were no significant differences between the PELD group and other surgical group in terms of success rate (RR = 1.01, 95%CI: 0.97, 1.04; P = .733), complication rate (RR = 0.86, 95%CI: 0.63, 1.18; P = .361), Japanese Orthopaedic Association Score score (WMD = 0.19, 95%CI: −1.90, 2.27; P = .861), visual analog scale score for back pain (WMD = −0.17, 95%CI: −0.55, 0.21; P = .384) and leg pain (WMD = 0.00, 95%CI: −0.10, 0.10; P = .991), and Oswestry Disability Index score (WMD = −0.29, 95%CI: −1.00, 0.43; P = .434).

Conclusion:

PELD was associated with better effects and similar complications with other surgeries in LDH. However, it also resulted in a higher recurrence rate. Considering the potential limitations in the present study, further large-scale, well-performed randomized trials are needed to verify our findings.
Association of chronic rhinosinusitis with bronchial asthma and its severity
Authors: Pan Yangwang , Zang Hongrui
Published: March 2021

Background:

To explore the association of chronic rhinosinusitis (CRS) with bronchial asthma (BA) as well as its severity.

Methods:

A comprehensive database search will be performed from PubMed, Embase, Cochrane Library, and Web of science for related literatures. Heterogeneity test will be used to assess each outcome indicator. If heterogeneity statistics I
2 ≥ 50%, the random effects model will be applied; if I
2 < 50%, the fixed effects model will be performed. Sensitivity analysis will be performed in all models. STATA 15.0 software (Stata Corporation, College Station, TX) will be used for statistical analysis. Risk ratio (RR) will be used as the effect size for enumeration data. P < .05 is considered statistically significant.

Conclusion:

This study will evaluate the association of CRS with the prevalence of BA as well as its severity.

OSF registration number:

10.17605/OSF.IO/GCTM9.
The effectiveness and safety of Chuna manual therapy on scoliosis
Authors: Park Seo-Hyun , Sung Won-Suk , Lee Sun-Haeng , Lee Yoon-Jae , Ha In-Hyuk , Seo Byung-Kwan , Chang Gyu-Tae , Yang Hoe-Cheon , Keum Dong-Ho , Kim Eun-Jung
Published: March 2021

Background:

Scoliosis is a spinal deformity and is diagnosed as Cobb angle being greater than 10°. Because it is accompanied with structural dysfunction, it can cause pain, worsen the patient's general health and quality of life. The prevalence of scoliosis has been increasing and many treatments, including surgical treatment and conservative treatment, such as observation, bracing, physiotherapy, and Chuna manual therapy (CMT), have been suggested. CMT is a manual therapy in Korean medicine that provides effective stimulation to the patient's body structure to treat structural dysfunction. After Korean national health insurance's coverage of CMT in 2019, the application of CMT for scoliosis has increased, and many studies have been reported. There have been attempts to elucidate the effectiveness of CMT on scoliosis; however, its effectiveness still remains unconfirmed. Therefore, the aim of this study is to evaluate the effectiveness and safety of CMT on scoliosis.

Methods:

The published randomized controlled trials that evaluated the effectiveness and safety of CMT for scoliosis will be searched for in multiple electronic databases without the limitation of country and language. Data on characteristics of studies, interventions, comparators, outcome measures, results, and information for assessment of study quality will be extracted. The primary outcome will be the Cobb angle and the secondary outcomes will be the scales of pain, function, quality of life and disability, and adverse events. Data synthesis and analysis will be conducted using the Review Manager software for Windows (RevMan ver. 5.3.; Copenhagen; The Nordic Cochrane Center, The Cochrane Collaboration, 2014). Subgroup analysis to identify the differences between different CMT maneuvers will also be performed. For risk of bias assessment, the “risk of bias” tool from Cochrane Collaboration will be used.

Results:

This study will present the clinical evidence on the effectiveness and safety of CMT on scoliosis.

Conclusion:

This study will propose useful evidence for treatment, further research, and health policies in the future.
Incidence of low back pain and potential risk factors among pharmacists
Authors: Wang Hue-Yu , Feng Yu-Tung , Wang Jhi-Joung , Lim Sher-Wei , Ho Chung-Han
Published: March 2021

Low back pain (LBP) is one of the most common symptoms of work-related musculoskeletal disorders in pharmacists. This can impede the physical functions of the body and lead to incapacitation, resulting in significant social and economic burden. This study aimed to investigate the incidence and risk factors that correlate with LBP in Taiwanese pharmacists.

A retrospective cohort study was conducted among all registered pharmacists aged 20 to 40 years using the National Health Insurance Research Database (2000–2013) in Taiwan. The LBP diagnosis was confirmed with one episode of hospitalization or at least three claimed outpatient visits for LBP. Data on workplace characteristics as well as comorbidities were also collected for the analyses. A Cox proportional hazard regression was used to estimate the risk factors for LBP.

The incidence rate of LBP among pharmacists was 16.60% in this study. Older pharmacists (28.49%; P < .01) and those who worked at district hospitals (23.51%; P < .01) showed a higher proportion of LBP. Furthermore, after adjustment for selected potential confounding factors, female pharmacists [adjusted hazard ratio (aHR): 1.12, 95% confidence interval (95% CI): 1.01–1.24, P = .0354] and pharmacists with diabetes (aHR: 1.55; 95% CI: 1.20–2.01; P = .0008) and gout (aHR: 1.70; 95% CI: 1.37–2.09; P < .0001) had significantly higher risks of LBP.

In conclusion, age was positively correlated with LBP, and the workplace was an important factor in the development of LBP in pharmacists. We suggest that pharmacists who work in district hospitals should pay more attention to the development of LBP.
Maternal fever during preconception and conception is associated with congenital heart diseases in offspring
Authors: Yang Guihong , Deng Xicheng , Xiao Jianfeng , Huang Peng , Zhang Kai , Li Yunfei
Published: March 2021

Backgrounds:

Many studies have evaluated the effect of maternal fever on the development risk of congenital heart diseases (CHDs) in offspring, but the findings were inconsistent. Furthermore, a complete overview of the existing data was also missing. Therefore, we intend to provide updated epidemiologic evidence to estimate the association between maternal fever and the risk of overall CHDs and specific CHD phenotypes in offspring.

Methods:

Pubmed, Embase, and Web of Science were searched through March 2020 to identify eligible studies that assessed the association between maternal fever and CHDs risk in offspring. The summary risk estimates were calculated using random-effects models. Potential heterogeneity source was explored by subgroup analyses and potential publication bias was assessed by Begg funnel plots and Begg rank correlation test.

Results:

Sixteen studies involving 31,922 CHDs cases among 183,563 participants were included in this meta-analysis. Overall, mothers who had a fever experience during preconception and conception periods had a significantly higher risk of overall CHDs in offspring (odds ratio [OR] = 1.45, 95% confidence interval [CI]: 1.21–1.73) when compared with those who did not have a fever experience. For specific CHD phenotypes in offspring, a statistically significant association was found between maternal fever and risk of conotruncal defects (CTD) (OR = 1.38, 95%CI: 1.01–1.89), atrial septal defects (ASD) (OR = 1.48, 95% CI: 1.01–2.17), transposition of the great vessels (TGA) (OR = 1.81, 95% CI: 1.14–2.88), and right ventricular outflow tract obstruction (RVOTO) (OR = 1.66, 95% CI: 1.04–2.65). Relevant heterogeneity moderators have been identified by subgroup analyses, and sensitivity analyses yielded consistent results.

Conclusions:

Although the role of potential bias and evidence of heterogeneity should be carefully evaluated, our review indicates that maternal fever is significantly associated with the risk of CHDs in offspring, which highlights that preventing maternal fever during the preconception and conception periods play an important role in decreasing the risk of CHDs in offspring. However, given the limited number of current case-control studies, larger-sample prospective studies are required to further confirm our results. Besides, due to the underlying mechanisms between maternal fever and the risk of specific CHD phenotypes in offspring are still unreported, more research is needed to explore the possible mechanisms.
Comparison of the surgeries for the ossification of the posterior longitudinal ligament-related cervical spondylosis
Authors: Li Sihan , Peng Jiajie , Xu Ruoying , Zheng Rong , Huang Minghan , Xu Yongzhen , He Youcheng , Chai Yujuan , Song Hongmei , Asakawa Tetsuya
Published: March 2021

Objective:

We designed and performed a network meta-analysis to compare the clinical outcomes among the 5 surgeries—anterior cervical corpectomy and fusion (ACCF), anterior controllable antedisplacement fusion (ACAF), laminoplasty (LP), laminectomy (LC), and posterior decompression with instrumented fusion (PDF)—for patients with cervical spondylosis related to the ossification of the posterior longitudinal ligament (OPLL).

Methods:

Databases, including PubMed, EMBASE, Cochrane Library, Google Scholar, and Web of Science (firstly available-2019) were selected for literature search. We performed a network meta-analysis with the included studies. A Newcastle-Ottawa scale was employed to assess the study quality of the included studies.

Results:

Total 23 studies with 1516 patients were included in our analysis. We found that ACCF achieved the most improvement in the Japanese Orthopaedic Association Scores and excellent and good recovery rate, ACAF achieved the best improvement of the improvement rate and lordosis. LP got the best operative time and blood loss.

Conclusions:

Our results suggested that both anterior (ACCF and ACAF) and posterior (LP, LC, and PDF) procedures have their strengths and weaknesses. Clinicians need to select the most appropriate surgery with a comprehensive consideration of the clinical condition of each patient with OPLL-related cervical spondylosis.
Activities of daily living measurement after ischemic stroke
Authors: Yang Hongyan , Chen Yuanyuan , Wang Jianmiao , Wei Hui , Chen Yanqin , Jin Jingfen
Published: March 2021

In patients with ischemic stroke, activities of daily living were used as an outcome indicator, and correct assessment is very important. We sought to examine the reliability and validity of the modified Barthel Index as an evaluation tool of activities of daily living in ischemic stroke patients by applying the Rasch analysis.

We used a prospectively collected cohort of ischemic stroke patients in the department of neurology. Rasch analysis was used for evaluating the reliability and validity of the modified Barthel Index.

A total of 231 patients were included in the analysis. The average of modified Barthel Index was 36.2 ± 17.8. The modified Barthel Index had high reliability of 0.88. There were no extremely mismatched items, and considered unidimensional, but the Point-Measure of bowels and bladder were 0.27, extremely lower than other items. The scale was stable in different sex and age, but had notable differential item functioning in muscle strength of the limbs. Rating categories were not functioning adequately in items. The item difficulty and patient ability were not matched, with a difference of 1.17 logics. 29.4% patients, no easy items could match their ability.

The modified Barthel Index had high reliability but a relatively bad matching degree between item difficulty and patient ability. It still needs further improvement to reflect the activities of daily living in ischemic stroke patients.
Effect of muscle training on dyspnea in patients with chronic obstructive pulmonary disease
Authors: Zhang Fang , Zhong Yaping , Qin Zheng , Li Xiaomeng , Wang Wei
Published: March 2021

Background:

Rehabilitation training is beneficial for patients with chronic obstructive pulmonary disease (COPD). This study was aimed at evaluating the efficacy of muscle training on dyspnea.

Methods:

We used 5 common databases for conducting a meta-analysis included PubMed, the Cochrane Library, Science Direct, Web of Science and Clinical Trials.gov, and eligible randomized controlled trials (RCTs) were included. The main results of include studies were dyspnea of patients who had a clinical diagnosis of COPD measured using Borg score and Medical Research Council (MRC) or modified Medical Research Council (mMRC) scale as the criteria before and after intervention. The intervention measures included respiratory or expiratory muscles or upper limb (UL) or lower limb (LL) training. The mean differences (MD) with the 95% confidence interval (CI) were considered for summary statistics. We also assessed risk of bias using the Cochrane collaboration's tool, and the value of I
2 was applied to evaluate the heterogeneity of the trials.

Results:

Fourteen RCTs with 18 interventions (n = 860 participants) were included. Muscle training significantly improved dyspnea during exercise and in the daily life of patients with COPD (MD, 95% CI: −0.58, −0.84 to −0.32, P 
< .0001 and −0.44, −0.65 to −0.24, P 
< .0001, respectively). In the subgroup analyses, the trials that used respiratory muscle and UL trainings significantly improved dyspnea during exercise (MD, 95% CI: −0.72, −1.13 to −0.31, P = .0005 and −0.53, −0.91 to −0.15, P = .007, respectively). The studies also showed that the participants in the rehabilitation group, who received respiratory muscle and UL trainings, had a significant improvement of dyspnea in daily life (MD, 95% CI: −0.38, −0.67 to −0.09, P = .01 and −0.51, −0.80 to −0.22, P = .0007, respectively).

Conclusion:

There were some limitations that most of the subjects in this study were patients with moderate to severe COPD and were male, and the training period and duration were different. The analyses revealed that respiratory muscle and UL trainings can improve dyspnea in patients with COPD during exercise and in daily life.
What gait features influence the amount and intensity of physical activity in people with multiple sclerosis?
Authors: Pau Massimiliano , Porta Micaela , Coghe Giancarlo , Cocco Eleonora
Published: March 2021

Although the mutual relationship between ambulation and physical activity (PA) in people with multiple sclerosis (pwMS) has been described in several studies, there is still a lack of detailed information about the way in which specific aspects of the gait cycle are associated with amount and intensity of PA. This study aimed to verify the existence of possible relationships among PA parameters and the spatio-temporal parameters of gait when both are instrumentally assessed.

Thirty-one pwMS (17F, 14 M, mean age 52.5, mean Expanded Disability Status Scale (EDSS) score 3.1) were requested to wear a tri-axial accelerometer 24 hours/day for 7 consecutive days and underwent an instrumental gait analysis, performed using an inertial sensor located on the low back, immediately before the PA assessment period. Main spatio-temporal parameters of gait (i.e., gait speed, stride length, cadence and duration of stance, swing, and double support phase) were extracted by processing trunk accelerations. PA was quantified using average number of daily steps and percentage of time spent at different PA intensity, the latter calculated using cut-point sets previously validated for MS. The existence of possible relationships between PA and gait parameters was assessed using Spearman rank correlation coefficient rho.

Gait speed and stride length were the parameters with the highest number of significant correlations with PA features. In particular, they were found moderately to largely correlated with number of daily steps (rho 0.62, P< .001), percentage of sedentary activity (rho = –0.44, P < .001) and percentage of moderate-to-vigorous activity (rho = 0.48, P < .001). Small to moderate significant correlations were observed between PA intensity and duration of stance, swing and double support phases.

The data obtained suggest that the most relevant determinants associated with higher and more intense levels of PA in free-living conditions are gait speed and stride length. The simultaneous quantitative assessment of gait parameters and PA levels might represent a useful support for physical therapists in tailoring optimized rehabilitative and training interventions.
MMP7 as a potential biomarker of colon cancer and its prognostic value by bioinformatics analysis
Authors: Chen Li , Ke Xueying
Published: March 2021

Colon cancer is one of the most common cancers in the world. To identify the candidate genes in the carcinogenesis and progression of colon cancer, the microarray datasets GSE10950, GSE44861 and GSE74602 were downloaded from the Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEGs) were identified, and functional enrichment analyses were performed. A total of 176 DEGs were identified, consisting of 55 genes upregulated and 121 genes downregulated in colon cancer tissues compared to non-cancerous tissues. The DEGs were mainly enriched in mineral absorption, nitrogen metabolism and complement and coagulation cascades. By using STRING database analysis, we constructed a coexpression network composed of 140 nodes and 280 edges for the DEGs with a combined score >0.4 and a significant interaction relation. Thirteen hub genes were identified, and poor OS of patients was only associated with high expression of Matrix Metallopeptidase 7 (MMP7), which may be involved in the carcinogenesis, invasion or recurrence of colon cancer. In conclusion, we propose that the DEGs and hub genes identified in the present study may be regarded as diagnostic biomarkers for colon cancer. Moreover, the overexpression of MMP7 may correlate with poor prognosis.
Coronary calcification is associated with elevated serum lipoprotein (a) levels in asymptomatic men over the age of 45 years
Authors: Chung Young Hak , Lee Byoung-Kwon , Kwon Hyuck Moon , Min Pil-Ki , Choi Eui-Young , Yoon Young Won , Hong Bum-Kee , Rim Se-Joong , Kim Jong-Youn
Published: March 2021

Lipoprotein a (Lp (a)) and coronary artery calcification (CAC) are markers of coronary artery and cardiovascular diseases. However, the association between Lp (a) and CAC in asymptomatic individuals remains unclear. In this study, we aimed to determine the influence of Lp (a) on CAC in asymptomatic individuals.

We included 2019 asymptomatic Korean adults who underwent testing for a coronary artery calcium score (CACS) and Lp (a) at the Gangnam Severance Hospital Health Checkup Center in Korea from January 2017 to August 2019. Participants were divided into 2 groups: CACS = 0 and CACS > 0. Factors affecting the CACS were analyzed by sex. Because age is a major risk factor for atherosclerosis, ≥45 years in men and ≥55 years in women, we further divided participants into 4 subgroups (≥45 and <45 in men, ≥55 and <55 in women). Factors affecting the CACS in the 4 groups were analyzed.

There was a positive correlation between the CACS and traditional cardiovascular risk factors. Lp (a) positively correlated with the CACS in men (P < .01) and remained significant after multivariable logistic regression (P < .01). The same result was observed in men aged ≥45 years (P < .01).

Lp (a) is an independently associated factor of CAC and a marker of coronary atherosclerosis in asymptomatic men aged ≥45 years. In asymptomatic men aged ≥45 years, Lp (a) should be measured, and intensive Lp (a)-lowering treatment should be considered.
A novel assessment of abdominal pseudohernia after thoracolumbar vertebral compression fractures using surface electromyography and ultrasonography
Authors: Choi Min Soo , Jang Myung Hun , Lee Byeong Ju , Shin Yong Beom , Kim Sang Hun
Published: March 2021

Rationale:

An abdominal pseudohernia is a protrusion of the abdominal wall that there is no actual muscular disruption. This report presents a case in which abdominal muscle activities were accurately and quantitatively measured using ultrasonography (US) and surface electromyography in a patient with abdominal pseudohernia.

Patient concerns:

A 62-year-old man presented with a marked protrusion on the left abdomen with increasing abdominal pressure.

Diagnoses:

First, the thickness of the abdominal muscle was measured with US while the patient constantly blew the positive expiratory pressure device. When the force was applied to the abdomen, the mean thickness of the muscle layer on the lesion site was found to be thinner. Second, the activities of the abdominal muscles were measured using surface electromyography by attaching electrodes to 8 channels at the same time. When the same pressure was applied on both sides of the abdomen, more recruitment occurred to compensate for muscle weakness at the lesion site. Through the previous 2 tests, the decrease in muscle activity in the lesion area could be quantitatively evaluated. Third, the denervation of the muscle was confirmed using US-guided needle electromyography.

Interventions:

The patient in this case was wearing an abdominal binder. In addition, he had been training his abdominal muscles through McGill exercise and breathing exercises such as with a positive expiratory pressure device.

Outcomes:

The patient was able to understand his symptoms. A follow-up test will be performed to see if there is any improvement.

Lessons:

By using these outstanding assessment methods, proper diagnosis and rehabilitation treatment strategies can be developed.