bluuebunny/crossref_metadata_2025 huggingface dataset:
Systematic Review of Minimally Invasive Surgery for Mitral Valve Infective Endocarditis
Authors: Shih Emily , Squiers John J. , DiMaio J. Michael
Published: April 2021

Objective

The scope of application of minimally invasive mitral valve surgery is expanding. However, the safety and efficacy of minimally invasive mitral valve surgery in the setting of infective endocarditis is not well known. We sought to identify the best evidence available to support a minimally invasive surgical approach for mitral valve infective endocarditis.

Methods

A systematic review of minimally invasive mitral valve surgery for infective endocarditis was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.

Results

A total of 6 manuscripts describing 271 patients were identified. Mean age was 60.4 ± 14.9 years old, and 60.1% patients were male. Mean EuroSCORE II was 24.6 ± 23.2. Mitral valve repair was achieved in 32.4% of cases. The average in-hospital mortality was 9.4%, and average length of hospital stay was 21.6 days. Survival was 89.1% at 30 days, and 1-year survival was 79.3%. Rate of conversion to sternotomy was 1.8%. Postoperative complications included: 6.9% postoperative bleeding, 9.3% new postoperative dialysis, 2.3% postoperative stroke, and 3.4% recurrence of endocarditis. Reoperation over the long-term was required in 9.3% of cases.

Conclusions

Minimally invasive mitral valve surgery for infective endocarditis has acceptable perioperative morbidity as well as short- and intermediate-term mortality at experienced centers. Minimally invasive mitral valve surgery may be an acceptable alternative approach to infective endocarditis and warrants further study.
Suture Suspension Arthroplasty for Thumb Carpometacarpal Arthritis Reconstruction: 12- to 14-Year Follow-up
Authors: DelSignore Jeanne L. , Zambito Kimberly , Ballatori Sarah E.
Published: April 2021

Background

Many surgical procedures have been described for the treatment of thumb carpometacarpal (CMC) joint osteoarthritis, with significant variation. To date, none has proven to be superior. The purpose of this study was to report long-term follow-up results of suture suspension arthroplasty (SSA).

Methods

The SSA technique uses a single incision, trapeziectomy, and an intra-articular suture suspension sling anchored into the insertions of the flexor carpi radialis (FCR) and abductor pollicis longus (APL), which serves to stabilize the base of the thumb metacarpal, correct subluxation deformity, and maintain arthroplasty space. Ninety of 153 SSA reconstructions (59% recall) were evaluated at long-term follow-up (mean, 12.6 years). Data were analyzed for functional outcomes, including preoperative and postoperative grip and pinch strength, radiographs, complications, and postoperative Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores.

Results

The mean age at date of surgery was 61.7 ± 7.6 years (82% women). Significant improvement was noted in grip strength (preoperative mean, 25.0 kg; postoperative mean, 28.0 kg; P < .0001), key pinch (preoperative, 4.2 kg; postoperative, 5.1 kg; P < .0001), and tip pinch (preoperative, 2.9 kg; postoperative, 3.6 kg; P < .0001). Radiographic subsidence averaged 35% (0-90). Postoperative QuickDASH scores (mean, 6.6; range, 0-50) revealed good to excellent pain relief and function. One revision was performed, and postoperative FCR rupture occurred in 3 reconstructions.

Conclusions

The SSA technique for thumb CMC arthritis reconstruction yields good to excellent long-term clinical outcomes. Potential advantages of the SSA include short operative time, a single incision, minimal cost, and no need for tendon harvesting, pin fixation, or implantable hardware.
Scaphoid Nonunion Is a Disabling Problem in a Military Population
Authors: Lake Nicholas H. , Khan Rafae , Mombell Kyle W. , Fergus Mary , Gomez-Leonardelli Dominic
Published: April 2021

Background

Scaphoid nonunion can occur in up to 55% of displaced scaphoid fractures. Long-term functional outcomes of this injury are lacking. In addition, no study has published rate of return to active military service after this injury. Our goal was to educate providers and patients on expected functional outcomes and return to duty after treatment of scaphoid nonunion.

Methods

We conducted a retrospective review of patients who underwent scaphoid nonunion repair at our institution from 2008 to 2017. The primary outcome measures were union rates, return to duty rates, and functional outcome scores obtained by telephone call. A total of 144 patients were included and 40 responded to our call for long-term follow-up.

Results

A total of 72% of patients achieved union after surgery, 18% required revision surgery, and 74% of patients were able to return to full duty after surgery. However, this number progressively decreased at 1, 2, and 5 years after surgery. At an average of 5.9 years after surgery, the mean Quick Disabilities of the Arm, Shoulder, and Hand (qDASH) score was 23.9. The mean qDASH for patients who achieved union (21.9) was significantly lower than those with persistent nonunion (29.2) ( P = .0115).

Conclusion

Scaphoid nonunion is a difficult problem in the military. We found a high rate of persistent nonunion often requiring revision to partial or full wrist arthrodesis. In addition, our long-term functional outcome scores demonstrate significant disability after this injury, even when union is achieved. This information can help us better counsel our patients and set expectations after treatment of this injury.
The Happy Level: A New Approach to Measure Happiness at Work Using Mixed Methods
Authors: Sender Gisela , Carvalho Flavio , Guedes Gustavo
Published: April 2021

Happiness at Work is considered the Holy Grail of organizational sciences. The belief that happier workers are more productive leads to a win-win situation for both individuals and organizations. Nevertheless, years of research have not brought a convergent conclusion about the topic, mainly due to the lack of a widely accepted measure. Usually, questionnaires and self-report surveys are used; however, these methods embed shortcomings that allow studies’ results to be questioned. In order to overcome these shortcomings, the present study proposes a different approach to measure Happiness at Work, bringing mixed methods to encompass the complexity of the phenomenon. Based on work-life narratives and following Kahneman’s concepts, the proposed approach puts together Narrative Analysis and Sentiment Analysis. Although increasingly used to assess social media reviews, Sentiment Analysis is not yet applied to narratives related to Happiness at Work. Four methods to calculate the Happy Level indicator were tested on actual research data: one manual, through traditional coding processes, and three automatic methods to provide scalability. An example of the Happy Level application is also provided to illustrate how the indicator could improve analyses. The present study concludes that despite the manual method presents better results at this moment; the automatic ones are promising. The results also indicate paths for improvement of these methods.
Simulation and analysis of through-mask electrochemical machining with moving tools
Authors: Liu Chin-Wei , Chen Chian-Huei , Lee Shyong
Published: April 2021

At present, the development of through-mask micro-electrochemical machining is only limited to static machining, where the size of the tool is usually the same as that of the workpiece. However, in the electrochemical processing, metal with good electrical conductivity is chosen as the tool electrode, and it is usually very expensive. Based on the cost consideration, a moving tool with small size may be preferred. Finite element method is used in this paper to create the electric field model of through-mask micro-electrochemical machining with moving tool. The effects of the parameters, such as applied voltage, mask thickness, on the machining shape are investigated. The results show that the higher the applied voltage, the larger the machining depth and width, and also the better the aspect ratio. When the thickness of the mask is thin, the electric field is unevenly distributed and the lateral corrosion is more serious. There is an island-like phenomenon, which is related to the masking of the mask. When the moving speed is relatively slow, the relative processing time is longer. The current density accumulated on the surface of the workpiece is thus higher and the material removal rate is higher. As the processing time increases, the machining depth becomes deeper, and the forward corrosion rate is slow down.
The effect of grunting on overhead throwing velocity in collegiate baseball pitchers
Authors: Tammany Justin E , O’Connell Dennis G , Latham Sarah E , Rogers Jordan A , Sugar Taylor S
Published: April 2021

The purpose of this study was to determine the effect of grunting on overhead throwing velocity in collegiate baseball pitchers. A repeated-measures experimental design was used. Twenty-four division III collegiate baseball pitchers with a mean age of 20.3 ± 1.6 years voluntarily participated in the study. Subjects were shown a video demonstration of a pitcher grunting during the acceleration phase of pitching and asked to replicate the technique during three practice throws. Corrective verbal feedback from researchers was given regarding the timing of the grunt during practice throws. Subjects then performed randomized sets (3 grunting and 3 non-grunting trials) of overhead throws from a standard pitching mound in the stretch position with maximum effort. Throwing velocities were measured with a calibrated radar gun. Paired-samples t-tests were used to compare average throwing velocities between the grunting and non-grunting trials at the 0.05 alpha level. Mean overhead throwing velocity was significantly higher during the grunting trials than the non-grunting trials. Age, height, weight, and handedness had no impact on the effect of grunting on overhead throwing velocity. Grunting offers a simple, immediate means of enhancing overhead throwing velocity in the collegiate baseball pitching population. Additional research is needed to determine the effects in populations of greater or lesser skill.
Consumers’ Perceptions of Deal Presentations for Green Products
Authors: Tripathi Avinash , Pandey Neeraj
Published: April 2021

There is no clarity on when and why consumers prefer specific sales promotions for the green versus non-green products. This research conducts a comparative analysis through three experiments to provide a theoretical explanation. It enhances the understanding of the impact of bonus pack versus price discount promotions for different characteristics, varying purchase volume, and the effect of information on buyers’ choices. The results show that buyers do not prefer price discounts when purchasing low-involvement green products, and they do not prefer bonus packs when purchasing low-involvement non-green products. Remarkably, for high-involvement products, the buyers prefer bonus packs when purchasing green products; however, they show no specific inclination while purchasing non-green products. These effects are further influenced by emphasizing deal-savings and varying purchase volume. In addition, this research explains the reason for consumers’ deal preferences through identifying the mediating role of the anticipated regret and conditional indirect effect of perceived expertise. The findings have significant practical implications.
Spontaneous Intracranial Artery Dissection causing Subarachnoid Hemorrhage: Importance of Short-Term Surveillance
Authors: Cox Mougnyan , Thatcher Joshua , Mayer Rory , Thacker Ike , Pearson Rachel , Layton Kennith
Published: April 2021

Hemorrhagic intracranial artery dissections are unstable lesions, with a high propensity for rebleeding (up to 40%) in the acute period. Imaging plays an important role in the diagnosis and management of intracranial artery dissections. In this paper, we describe 2 cases in which the dissected intracranial artery underwent rapid morphological change within 3 days or less, highlighting the importance of short-term follow-up imaging in patients with these hemorrhagic lesions.
“Aarogya Setu”: The mobile application that monitors and mitigates the risks of COVID-19 pandemic spread in India
Authors: Nagori Viral
Published: April 2021

The case study demonstrates the journey of the ‘Aarogya Setu’ app - A contact tracing the mechanism developed in the form of a mobile application to monitor and mitigate the risk of COVID-19 pandemic spread in India. The case describes how Aarogya Setu mobile app works, how it identifies the hotspot areas, its features and privacy policies, and the reasons why the app had been in the news due to positive and negative perceptions of the citizens related to the app. However, the case can be used as a pedagogical tool for the various subjects in the discipline of Information Systems and Digital Technologies. The case helps to understand how to design and develop mobile application features and functions that protect individual privacy. In the end, the case throws challenging questions to the users on different aspects of gamification and m-governance.
Habitual Behavior as a Mediator Between Food-Related Behavioral Activation and Change in Symptoms of Depression in the MooDFOOD Trial
Authors: Owens Matthew , Watkins Ed , Bot Mariska , Brouwer Ingeborg A. , Roca Miquel , Kohls Elisabeth , Penninx Brenda W. J. H. , van Grootheest Gerard , Hegerl Ulrich , Gili Margalida , Visser Marjolein
Published: April 2021

In this study, we tested potential mediators that may explain change in depressive symptoms following exposure to a food-related behavioral activation intervention (F-BA). These included behavioral activation, avoidance and rumination, eating styles, body mass index, and dietary behavior at baseline and 3-month and 12-month follow-up. The trial used a community sample of 1,025 overweight adults with elevated depressive symptoms without current major depression. Participants were randomly assigned to one of four trial arms: either daily nutritional supplements (vs. placebo) alone or in combination with F-BA (vs. no F-BA) over 12 months. Although F-BA did not significantly reduce depressive symptoms (standardized regression coefficient [ b] = −0.223, SE = 0.129; p = .084), significant mediators included emotional eating ( b = −0.028, SE = 0.014; p = .042) and uncontrolled eating ( b = −0.039, SE = 0.016; p = .013), suggesting that learning adaptive responses to emotional and food cues may underlie effects of F-BA on depressive symptoms.
Nonverbal Synchrony and the Alliance in Psychotherapy for Major Depression: Disentangling State-Like and Trait-Like Effects
Authors: Cohen Keren , Ramseyer Fabian T. , Tal Shachaf , Zilcha-Mano Sigal
Published: April 2021

Given the importance of the alliance in psychotherapy, nonverbal synchrony has been suggested as a promising automatic objective marker of its levels and development. Accumulating research presents mixed results regarding the association between alliance and nonverbal synchrony. In the current study, we propose that one of the reasons for the inconsistencies is that previous studies did not disentangle trait-like characteristics from state-like changes occurring throughout treatment. To test this, we had 86 patients enrolled in an ongoing randomized controlled trial, along with their therapists, report their alliance levels after every session. Nonverbal movement synchrony was quantified by motion energy analysis for each of the 16 sessions of treatment. Findings suggest a significant association between nonverbal synchrony and the state-like effect of patient-reported alliance ( p < .0001) but not for the trait-like effect. The results confirm the importance of disentangling the state-like and trait-like components because they may have distinct effects.
Quadriceps Strength After Anterior Cruciate Ligament Reconstruction Compared With Uninjured Matched Controls: A Systematic Review and Meta-analysis
Authors: Brown Conlan , Marinko Lee , LaValley Michael P. , Kumar Deepak
Published: April 2021

Background:

The limb symmetry index may overestimate the recovery of quadriceps muscle strength after anterior cruciate ligament reconstruction. Comparison of individuals who have had anterior cruciate ligament reconstruction with age-, sex-, and activity-matched individuals might be more appropriate to guide rehabilitation interventions.

Purpose:

To compare the quadriceps strength between the injured limb of people with anterior cruciate ligament reconstruction and the limb of an age-, sex-, and activity-matched control group.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

MEDLINE, CINAHL, EMBASE, SCOPUS, and SPORTDiscus were searched between inception and April 2019. Studies were included if they reported the peak quadriceps strength for persons with anterior cruciate ligament reconstruction and age-, sex-, and activity-matched control groups measured using isometric or isokinetic dynamometry. Risk of bias was assessed, and meta-analyses and metaregression (for effect of time since surgery) were performed.

Results:

A total of 2759 studies were identified and 21 were included for analyses. Quadriceps strength was lower in the limbs with anterior cruciate ligament reconstruction compared with the limb from matched controls within 6 months of anterior cruciate ligament reconstruction (standardized mean difference [SMD], –1.42; 95% CI, –1.62 to –1.23), 6 to 18 months after anterior cruciate ligament reconstruction (SMD, –0.92; 95% CI, –1.18 to –0.66), and >18 to 48 months after anterior cruciate ligament reconstruction (SMD, –0.38; 95% CI, –0.79 to 0.03). Results of the metaregression were significant, with the difference between anterior cruciate ligament reconstruction and matched controls decreasing with time since surgery ( P < .001).

Conclusion:

In people with anterior cruciate ligament reconstruction, the injured limb had lower quadriceps strength compared with the limb of age-, sex-, and activity-matched controls up to 4 years after surgery. Clinicians should consider comparison with matched cohorts for return to sports decision making.
Cultivating Health Policy Analysis and Communication Skills in Undergraduate Public Health Education: An Active Learning Approach
Authors: Payán Denise D.
Published: April 2021

Public health programs are increasingly offering health policy content to meet workforce demand for public health professionals with health policy analysis and communication skills. Undergraduate public health education in health policy and related curriculum is lacking. Existing work describes service- and experiential learning approaches, which may not be feasible in large courses or public health programs with limited administrative or financial resources. This article describes health policy curriculum, learning objectives, and course activities (i.e., individual writing assignment, mock policy debate, and policy analysis exercise) that integrate an active learning approach and use simulation to develop policy analysis and communication skills in an undergraduate classroom setting. An active learning approach can increase teaching effectiveness, critical thinking, peer interaction, and student engagement to cultivate these applied skills. The described curriculum has been used in various modalities (in-person, hybrid, and remote) with positive reception in a public research university with a high percentage of first-generation college students. Student course evaluations and an independent assessment of the policy analysis exercise reflect high student interest, engagement, problem solving, satisfaction, perceived benefits, and application of policy analysis and communication skills, providing support for teaching health policy curriculum to undergraduate students using an active learning approach. The discussion includes strategies to address resistance by public health instructors and students to using active learning techniques.
Mass Incarceration and Public Health at the Undergraduate Level: Course Design and Rationale for Bachelor of Science in Public Health Programs
Authors: Przybyla Sarahmona M. , Kruger Jessica S.
Published: April 2021

Schools and programs of public health are appropriately positioned to advance student learning opportunities on structural drivers of health inequities, including mass incarceration. Although there are often undergraduate-level public health courses about general topics such as health inequities or social determinants of health, courses on the intersection of public health and mass incarceration at the baccalaureate level are rare. This article describes the design, development, and implementation of a baccalaureate-level public health course focused on mass incarceration to afford the public health workforce the opportunity to gain foundational exposure to the historical and structural forces influencing social drivers of inequality and the critical role of the discipline of public health to address and tackle such inequities using evidence-based approaches.
Task-Modulated Brain Activity Predicts Antidepressant Responses of Prefrontal Repetitive Transcranial Magnetic Stimulation: A Randomized Sham-Control Study
Authors: Li Cheng-Ta , Cheng Chih-Ming , Juan Chi-Hung , Tsai Yi-Chun , Chen Mu-Hong , Bai Ya-Mei , Tsai Shih-Jen , Su Tung-Ping
Published: April 2021

Background

Prolonged intermittent theta-burst stimulation (piTBS) and repetitive transcranial magnetic stimulation (rTMS) are effective antidepressant interventions for major depressive disorder (MDD). Cognition-modulated frontal theta (frontalθ) activity had been identified to predict the antidepressant response to 10-Hz left prefrontal rTMS. However, whether this marker also predicts that of piTBS needs further investigation.

Methods

The present double-blind randomized trial recruited 105 patients with MDD who showed no response to at least one adequate antidepressant treatment in the current episode. The recruited patients were randomly assigned to one of three groups: group A received piTBS monotherapy; group B received rTMS monotherapy; and group C received sham stimulation. Before a 2-week acute treatment period, electroencephalopgraphy (EEG) and cognition-modulated frontal theta changes (Δfrontalθ) were measured. Depression scores were evaluated at baseline, 1 week, and 2 weeks after the initiation of treatment.

Results

The Δfrontalθ at baseline was significantly correlated with depression score changes at week 1 (r = −0.383, p = 0.025) and at week 2 for rTMS group (r = −0.419, p = 0.014), but not for the piTBS and sham groups. The area under the receiver operating characteristic curve for Δfrontalθ was 0.800 for the rTMS group (p = 0.003) and was 0.549 for the piTBS group (p = 0.619).

Conclusion

The predictive value of higher baseline Δfrontalθ for antidepressant efficacy for rTMS not only replicates previous results but also implies that the antidepressant responses to rTMS could be predicted reliably at baseline and both piTBS and rTMS could be effective through different neurobiological mechanisms.
Paulo Freirean Ideas at the Grassroots: From Problem Posing Education to Critical Consciousness
Authors: Khandekar Sujata
Published: April 2021

This article aims to reflectively analyse the personal and organisational trajectory of a grassroots activist—researcher in translating abstract praxis-related theoretical ideas to practise through a two-way process of learning. It critically discuses an evolving process of collective actions and associated reflections that progressively brought clarity on the theoretical aspects of the Freirean concepts. The process of the application and usefulness of the problem posing education, conscientisation and critical consciousness in transforming the lives of women and communities is reflectively narrated. The author argues that Freire’s transformative conceptualisations not only have the impact on the ‘oppressed’, but also on the ‘privileged’ who chose to work with them. Despite some limitations, the author, as a community practitioner/activist, finds Freire’s ideas as a gift in the political purpose and politics of her work. These reflections will be of use to community practitioners and members working in similar contexts.
How I treat primary ITP in adult patients who are unresponsive to or dependent on corticosteroid treatment
Authors: Ghanima Waleed , Gernsheimer Terry , Kuter David J.
Published: April 2021

Approximately 80% of adult patients with immune thrombocytopenia (ITP) have treatment failure with corticosteroids or become dependent on them and require second-line therapy. Several new and effective therapies have been introduced during the past decade and our understanding of disease burden and its effect on quality of life has expanded. It is now recommended that splenectomy, the standard second-line therapy for decades, be delayed for at least 12 to 24 months, allowing for more patients to achieve remission on medical therapies before considering surgery. It is highly recommended that medical therapies be used that have abundant clinical trial evidence, such as the thrombopoietin receptor agonists (TPO-RAs) rituximab and fostamatinib. Unfortunately, there are no reliable biomarkers that help in treatment selection. These therapeutic medical options have variable efficacy, safety profiles, mechanisms of action, and modes of administration. This enables and mandates an individualized approach to treatment, where patient involvement, preferences and values have become central to the process of choosing the appropriate therapy. Both TPO-RAs and fostamatinib are maintenance therapies, whereas rituximab is given for a limited number of doses. Although the response is usually maintained while receiving a TPO-RA or fostamatinib therapy, half of rituximab responders will no longer respond 1 to 2 years after administration and require retreatment or other therapy.
Health care resource utilization and cost burden of hemophilia B in the United States
Authors: Buckner Tyler W. , Bocharova Iryna , Hagan Kaitlin , Bensimon Arielle G. , Yang Hongbo , Wu Eric Q. , Sawyer Eileen K. , Li Nanxin
Published: April 2021

Hemophilia B is a rare congenital blood disorder characterized by factor IX deficiency. Clinical profiles of hemophilia B range from mild to severe forms of the disease. The objective of this study was to characterize the economic burden associated with differing clinical profiles of hemophilia B from a US health system perspective. Using the IBM MarketScan database (June 2011-February 2019), a claims-based algorithm was developed to identify 4 distinct profiles (mild, moderate, moderate-severe, and severe) in adult males with hemophilia B based on the frequency of hemorrhage events and factor IX replacement claims. Mean annual health care resource use (HRU) and costs were statistically compared between patients with hemophilia B (N = 454) and 1:1 demographic-matched controls (N = 454), both overall and with stratification by clinical profile. Compared with matched controls, patients with hemophilia B had a significantly higher comorbidity burden (Charlson Comorbidity Index, mean ± standard deviation [SD]: 0.9 ± 1.7 vs 0.3 ± 0.9, P < .001). Across all clinical profiles, patients with hemophilia B had significantly higher HRU vs matched controls (mean ± SD: 0.3 ± 0.6 vs 0.1 ± 0.3 inpatient admissions; 0.6 ± 1.2 vs 0.2 ± 0.6 emergency department visits; 17.7 ± 22.9 vs 8.0 ± 11.0 outpatient visits; all P < .001). Annual total health care costs per patient among patients with hemophilia B were more than 25-fold higher vs matched controls (mean ± SD: $201 635 ± $411 530 vs $7879 ± $29 040, respectively, P < .001). Annual total health care costs per patient increased with increasing severity (mean ± SD: mild, $80 811 ± $284 313; moderate, $137 455 ± $222 021; moderate-severe, $251 619 ± $576 886; severe, $632 088 ± $501 270). The findings of this study highlight the substantial burden of illness associated with hemophilia B.
Crucial role of fatty acid oxidation in asthmatic bronchial smooth muscle remodelling
Authors: Esteves Pauline , Blanc Landry , Celle Alexis , Dupin Isabelle , Maurat Elise , Amoedo Nivea , Cardouat Guillaume , Ousova Olga , Gales Lara , Bellvert Florian , Begueret Hugues , Thumerel Matthieu , Dupuy Jean-William , Desbenoit Nicolas , Marthan Roger , Girodet Pierre-Olivier , Rossignol Rodrigue , Berger Patrick , Trian Thomas
Published: April 2021

Background

Bronchial smooth muscle (BSM) remodelling in asthma is related to an increased mitochondrial biogenesis and enhanced BSM cell proliferation in asthma. Since mitochondria produce the highest levels of cellular energy and fatty acid β-oxidation is the most powerful way to produce ATP, we hypothesised that, in asthmatic BSM cells, energetic metabolism is shifted towards the β-oxidation of fatty acids.

Objectives

We aimed to characterise BSM cell metabolism in asthma bothin vitroandex vivoto identify a novel target for reducing BSM cell proliferation.

Methods

21 asthmatic and 31 non-asthmatic patients were enrolled. We used metabolomic and proteomic approaches to study BSM cells. Oxidative stress, ATP synthesis, fatty acid endocytosis, metabolite production, metabolic capabilities, mitochondrial networks, cell proliferation and apoptosis were assessed on BSM cells. Fatty acid content was assessedin vivousing matrix-assisted laser desorption/ionisation spectrometry imaging.

Results

Asthmatic BSM cells were characterised by an increased rate of mitochondrial respiration with a stimulated ATP production and mitochondrial β-oxidation. Fatty acid consumption was increased in asthmatic BSM bothin vitroandex vivo. Proteome remodelling of asthmatic BSM occurredviatwo canonical mitochondrial pathways. The levels of carnitine palmitoyl transferase (CPT)2 and low-density lipoprotein (LDL) receptor, which internalise fatty acids through mitochondrial and cell membranes, respectively, were both increased in asthmatic BSM cells. Blocking CPT2 or LDL receptor drastically and specifically reduced asthmatic BSM cell proliferation.

Conclusion

This study demonstrates a metabolic switch towards mitochondrial β-oxidation in asthmatic BSM and identifies fatty acid metabolism as a new key target to reduce BSM remodelling in asthma.
Genetic parameters and genomic prediction for feed intake recorded at the group and individual level in different production systems for growing pigs
Authors: Gao Hongding , Su Guosheng , Jensen Just , Madsen Per , Christensen Ole F. , Ask Birgitte , Poulsen Bjarke G. , Ostersen Tage , Nielsen Bjarne
Published: April 2021

Background

In breeding programs, recording large-scale feed intake (FI) data routinely at the individual level is costly and difficult compared with other production traits. An alternative approach could be to record FI at the group level since animals such as pigs are normally housed in groups and fed by a shared feeder. However, to date there have been few investigations about the difference between group- and individual-level FI recorded in different environments. We hypothesized that group- and individual-level FI are genetically correlated but different traits. This study, based on the experiment undertaken in purebred DanBred Landrace (L) boars, was set out to estimate the genetic variances and correlations between group- and individual-level FI using a bivariate random regression model, and to examine to what extent prediction accuracy can be improved by adding information of individual-level FI to group-level FI for animals recorded in groups. For both bivariate and univariate models, single-step genomic best linear unbiased prediction (ssGBLUP) and pedigree-based BLUP (PBLUP) were implemented and compared.

Results

The variance components from group-level records and from individual-level records were similar. Heritabilities estimated from group-level FI were lower than those from individual-level FI over the test period. The estimated genetic correlations between group- and individual-level FI based on each test day were on average equal to 0.32 (SD = 0.07), and the estimated genetic correlation for the whole test period was equal to 0.23. Our results demonstrate that by adding information from individual-level FI records to group-level FI records, prediction accuracy increased by 0.018 and 0.032 compared with using group-level FI records only (bivariate vs. univariate model) for PBLUP and ssGBLUP, respectively.

Conclusions

Based on the current dataset, our findings support the hypothesis that group- and individual-level FI are different traits. Thus, the differences in FI traits under these two feeding systems need to be taken into consideration in pig breeding programs. Overall, adding information from individual records can improve prediction accuracy for animals with group records.
Uncovering salt tolerance mechanisms in pepper plants: a physiological and transcriptomic approach
Authors: López-Serrano Lidia , Calatayud Ángeles , López-Galarza Salvador , Serrano Ramón , Bueso Eduardo
Published: April 2021

Background

Pepper is one of the most cultivated crops worldwide, but is sensitive to salinity. This sensitivity is dependent on varieties and our knowledge about how they can face such stress is limited, mainly according to a molecular point of view. This is the main reason why we decided to develop this transcriptomic analysis. Tolerant and sensitive accessions, respectively called A25 and A6, were grown for 14 days under control conditions and irrigated with 70 mM of NaCl. Biomass, different physiological parameters and differentially expressed genes were analysed to give response to differential salinity mechanisms between both accessions.

Results

The genetic changes found between the accessions under both control and stress conditions could explain the physiological behaviour in A25 by the decrease of osmotic potential that could be due mainly to an increase in potassium and proline accumulation, improved growth (e.g. expansins), more efficient starch accumulation (e.g. BAM1), ion homeostasis (e.g. CBL9, HAI3, BASS1), photosynthetic protection (e.g. FIB1A, TIL, JAR1) and antioxidant activity (e.g. PSDS3, SnRK2.10). In addition, misregulation of ABA signalling (e.g. HAB1, ERD4, HAI3) and other stress signalling genes (e.g. JAR1) would appear crucial to explain the different sensitivity to NaCl in both accessions.

Conclusions

After analysing the physiological behaviour and transcriptomic results, we have concluded that A25 accession utilizes different strategies to cope better salt stress, being ABA-signalling a pivotal point of regulation. However, other strategies, such as the decrease in osmotic potential to preserve water status in leaves seem to be important to explain the defence response to salinity in pepper A25 plants.
Comparative transcriptome analysis of transcripts of uncertain coding potential in septic myocardial depression
Authors: Zhang Tie-Ning , Wen Ri , Yang Ni , Liu Chun-Feng
Published: April 2021

Background

Septic shock with myocardial depression is very common in intensive care units. However, the exact molecular mechanisms underlying sepsis-induced myocardial depression remain unclear. Whether the profiles of transcripts of uncertain coding potential (TUCPs) differ between patients with and without myocardial depression is also unknown. Our study aimed to find expression differences between groups of TUCPs and determine their potential functions in a preclinical model.

Methods

We generated rat models of hypodynamic septic shock induced by lipopolysaccharide. A total of 12 rats were established and left ventricular tissue from each was collected. We performed RNA-seq to identify TUCPs in each sample. Transcripts with an corrected P value of < 0.05 were defined as differentially expressed (DE). We also performed GO terms and KEGG analysis to identify the potential functions of DE TUCPs.

Results

A total of 4,851 TUCPs were identified in heart samples, 85 of which were expressed differently between the sepsis and control groups. Further bioinformatic analyses suggested that TUCPs play important roles in myocardial contraction, energy regulation, and metabolic processes, and are also involved in the regulation of several pathways.

Conclusion

Our results demonstrate that TUCPs both participate in and mediate the pathological process of myocardial depression. Our study improves the understanding of the basic molecular mechanisms underlying myocardial depression from a novel perspective.
Reducing prescribing of benzodiazepines in older adults: a comparison of four physician-focused interventions by a medical regulatory authority
Authors: Ashworth Nigel , Kain Nicole , Wiebe Delaney , Hernandez-Ceron Nancy , Jess Ed , Mazurek Karen
Published: April 2021

Background

The inappropriate and/or high prescribing of benzodiazepine and ‘Z’ drugs (BDZ +) is a major health concern. The purpose of this study was to determine whether physician or pharmacist led interventions or a simple letter or a personalized prescribing report from a medical regulatory authority (MRA) was the most effective intervention for reducing BDZ + prescribing by physicians to patients 65 years of age or older.

Methods

This was a four-armed, one year, blinded, randomized, parallel-group, investigational trial in Alberta, Canada. Participants were fully licensed physicians (n = 272) who had prescribed 4 times the defined daily dose (4 + DDD) or more of any BDZ + to an older patient at least once in the 3rd quarter of 2016. All physician-participants were sent a personalized prescribing profile by the MRA. They were then randomized into four groups that received either nothing more, an additional personal warning letter from the MRA, a personal phone call from an MRA pharmacist or a personal phone call from an MRA physician. The main outcomes were prescribing behavior change of physicians at one year in terms of: change in mean number of older patients receiving 4 + DDD BDZ + and mean dose BDZ + prescribed per physician. To adjust for multiple statistical testing, we used MANCOVA to test both main outcome measures simultaneously by group whilst controlling for any baseline differences.

Results

All groups experienced a significant fall in the total number of older patients receiving 4 + DDD of BDZ + by about 50% (range 43–54%) per physician at one year, and a fall in the mean dose of BDZ + prescribed of about 13% (range 10–16%). However, there was no significant difference between each group.

Conclusions

A personalized prescribing report alone sent from the MRA appears to be an effective intervention for reducing very high levels of BDZ + prescribing in older patients. Additional interventions by a pharmacist or physician did not result in additional benefit. The intervention needs to be tested further on a more general population of physicians, prescribing less extreme doses of BDZ + and that looks at more clinical and healthcare utilization outcomes.
“Helping fill that gap:” a qualitative study of aging in place after disaster through the lens of home-based care providers
Authors: Bell Sue Anne , Krienke Lydia K. , Dickey Sarah , De Vries Raymond G.
Published: April 2021

Background

During a disaster, home-based care fills the critical need for continuation of health care. Home-based care is intended to function using existing care delivery models, continuing to provide care for patients wherever they are located, including in shelters and hotels. Home-based care providers are often the closest in contact with their patients —seeing them in place, even throughout a disaster— through which they develop a unique insight into aging in place during a disaster. The purpose of this study was to identify individual and community-level support needs of older adults after a disaster through the lens of home-based care providers.

Methods

Using qualitative inquiry, five focus groups were conducted with home-based care providers (n = 25) who provided in-home care during Hurricane Irma and Hurricane Harvey. Participants were identified by contacting home health agencies listed in an open-source database of agencies participating in Centers for Medicare and Medicaid Services programs. Data were coded using an abductive analytic approach, and larger themes were generated in light of existing theory.

Results

The results were distilled into eight themes that related to the importance of community and family, informal and formal supports throughout the disaster management cycle, maintaining autonomy during a disaster, and institutional and systemic barriers to obtaining assistance.

Conclusions

In this study, home-based care providers described the challenges aging adults face in the response and recovery period after a large-scale disaster including maintaining continuity of care, encouraging individual preparedness, and accessing complex governmental support. Listening to home-based care providers offers new and important insights for developing interventions to address social and health needs for older adults aging in place after a large-scale disaster.
Vitamin D status in women with dichorionic twin pregnancies and their neonates: a pilot study in China
Authors: Li Xin , Yu Jiaxiao , Wen Li , Li Qingshu , Yan Jianying , Tian Jing , Tong Chao , Tong Qi , Qi Hongbo , Saffery Richard , Kilby Mark D. , Baker Philip N.
Published: April 2021

Background

Vitamin D deficiency is a global public health issue in women and children and is associated with adverse impacts on child growth, such as rickets. However, prior studies have mainly focused on measuring vitamin D levels in singleton pregnant women and their offspring, and very limited studies have revealed the prevalence of vitamin D deficiency in twin pregnant women and their offspring. The aim of this study was to investigate vitamin D levels in twin-pregnant women and their neonates. We also explored the correlation of maternal vitamin D levels with neonatal outcomes and infant growth.

Methods

A prospective subcohort investigation was carried out among 72 dichorionic, diamniotic twin-pregnant mothers and their twin offspring from the Longitudinal Twin Study. Peripheral blood was collected from the mothers in the third trimester, and cord blood was collected from neonates at birth to identify 25[OH]D levels. Data on the characteristics of the mothers and neonates were collected. Infant growth data and food sensitivities were also collected.

Results

The average maternal 25[OH]D level was 31.78 ng/mL, with 19.4% being deficient and 20.8% insufficient, while the average neonatal 25[OH]D level was 15.37 ng/mL, with 99.3% being deficiency or insufficient. A positive correlation was found between maternal and neonatal 25[OH]D levels (beta-value: 0.43, 95% CI: 0.37, 0.49). Interestingly, the higher the maternal 25[OH]D level was, the smaller the cotwin birthweight discordance (beta-value: -2.67, 95% CI: − 5.11, − 0.23). In addition, the infants of mothers with vitamin D deficiency were more likely to be allergic to foods at 6 months than those of mothers with vitamin D sufficiency.

Conclusions

Twin neonates were at high risk of vitamin D deficiency, although their mothers’ vitamin D deficiency partially improved. Higher maternal vitamin D levels were associated with smaller discordance of cotwin birthweight.

Trial registration

Chinese Clinical Trial Registry ChiCTR-OOC-16008203, 1st April 2016.
Impact of immediate initiation of antiretroviral therapy among men who have sex with men infected with HIV in Chengdu, southwest China: trends analysis, 2008–2018
Authors: Wu Chenyao , Zhang Baiyang , Dai Zhen , Zheng Qianwen , Duan Zhenhua , He Qinying , Zhu Cairong
Published: April 2021

Background

Given the rampant HIV epidemic among men who have sex with men (MSM) in Chengdu, southwest China, Treat All policy, defined as immediate antiretroviral therapy (ART) initiation after HIV diagnosis, was implemented since 2014. Real-world research evaluating impacts of immediate ART on HIV epidemics is needed to optimize policy-making as national and international guidelines have been lowering ART eligibility threshold. The purpose of this study is to: assess temporal trends of the HIV epidemic and impacts of Treat All policy among MSM; and lay foundation for HIV-related policy evaluation using longitudinal routine data from health information systems.

Methods

Data used in this study were HIV sentinel seroprevalence, annual reported HIV cases and ART coverage rate among MSM in Chengdu from 2008 to 2018, derived from national HIV/AIDS information system. Temporal trends of the HIV epidemic were described using Joinpoint Regression Program. Interrupted time-series method was deployed to evaluate Treat All policy.

Results

HIV sentinel seroprevalence rose from 11.20% in 2008 to 17.67% in 2013 and Annual Percent Change (APC) was 8.25% (95% CI − 2.40%, 20.07%), then decreased to 5.17% in 2018 (APC = − 19.63%, 95% CI − 27.54%, − 10.86%). Newly reported HIV cases increased from 168 cases in 2008 to 1232 cases in 2015 (APC = 26.99%, 95% CI 21.32%, 32.93%), and reduced to 1014 cases in 2018 (APC = − 8.80%, 95% CI − 18.45%, 2.01%). ART coverage rate has been climbing from 11.11% in 2008 to 92.29% in 2018 and Average Annual Percent Change was 16.09% (95% CI 11.76%, 20.59%). Results of interrupted time-series models showed that compared to an annual increase of 0.87% during pre-policy period, there was a decline of 3.08% (95% CI − 0.0366%, − 0.0250%) per year of HIV sentinel seroprevalence since 2014; and compared to an annual increase of 116 cases before 2014, there was an annual drop of 158 newly reported HIV cases (95% CI − 194.87%, − 121.69%) during the post-policy period.

Conclusions

Immediate ART after HIV diagnosis could potentially curb HIV transmission at population level among MSM, along with other strategies. Future assessment of HIV prevention and control policy can be carried out using routinely collected longitudinal data from health information systems.
The role of extracorporeal membrane oxygenation in critically ill patients with COVID-19: a narrative review
Authors: Huang Shiqian , Zhao Shuai , Luo Huilin , Wu Zhouyang , Wu Jing , Xia Haifa , Chen Xiangdong
Published: April 2021

Extracorporeal life support treatments such as extracorporeal membrane oxygenation (ECMO) have been recommended for the treatment of severe acute respiratory distress syndrome (ARDS) patients with coronavirus disease 2019 (COVID-19). To date, many countries, including China, have adopted ECMO as a treatment for severe COVID-19. However, marked differences in patient survival rates have been reported, and the underlying reasons are unclear. This study aimed to summarize the experience of using ECMO to treat severe COVID-19 and provide suggestions for improving ECMO management. The effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the pathophysiology of COVID-19 and the effects of ECMO on the clinical outcomes in patients with severe cases of COVID-19 were reviewed. Recent data from frontline workers involved in the use of ECMO in Wuhan, China, and those experienced in the implementation of artificial heart and lung support strategies were analysed. There is evidence that ECMO may complicate the pathophysiological state in COVID-19 patients. However, many studies have shown that the appropriate application of ECMO improves the prognosis of such patients. To expand our understanding of the benefits of ECMO for critically ill patients with COVID-19, further prospective, multicentre clinical trials are needed.