bluuebunny/crossref_metadata_2025 huggingface dataset:
A Robust and Efficient Compressed Sensing Algorithm for Wideband Acoustic Imaging
Authors: Ning Fangli , Liu Zhe , Song Jiahao , Pan Feng , Han Pengcheng , Wei Juan
Published: December 2020

Wideband acoustic imaging, which combines compressed sensing (CS) and microphone arrays, is widely used for locating acoustic sources. However, the location results of this method are unstable, and the computational efficiency is low. In this work, in order to improve the robustness and reduce the computational cost, a DCS-SOMP-SVD compressed sensing method, which combines the distributed compressed sensing using simultaneously orthogonal matching pursuit (DCS-SOMP) and singular value decomposition (SVD) is proposed. The performance of the DCS-SOMP-SVD is studied through both simulation and experiment. In the simulation, the locating results of the DCS-SOMP-SVD method are compared with the wideband BP method and the DCS-SOMP method. In terms of computational efficiency, the proposed method is as efficient as the DCS-SOMP method and more efficient than the wideband BP method. In terms of locating accuracy, the proposed method can still locate all sources when the signal to noise ratio (SNR) is − 20 dB, while the wideband BP method and the DCS-SOMP method can only locate all sources when the SNR is higher than 0 dB. The performance of the proposed method can be improved by expanding the frequency range. Moreover, there is no extra source in the maps of the proposed method, even though the target sparsity is overestimated. Finally, a gas leak experiment is conducted to verify the feasibility of the DCS-SOMP-SVD method in the practical engineering environment. The experimental results show that the proposed method can locate both two leak sources in different frequency ranges. This research proposes a DCS-SOMP-SVD method which has sufficient robustness and low computational cost for wideband acoustic imaging.
Correction to: The knockdown of Neuropeptide FF receptor 2 inhibits capsaicin-induced CGRP Upregulation in mouse trigeminal ganglion
Authors: Lin Ya-Tin , Yu Zachary , Tsai Sze-Chi , Hsu Po-Hung , Chen Jin-Chung
Published: December 2020

An amendment to this paper has been published and can be accessed via the original article.
Tear proteomic profile in three distinct ocular surface diseases: keratoconus, pterygium, and dry eye related to graft-versus-host disease
Authors: de Almeida Borges Daniel , Alborghetti Marcos Rodrigo , Franco Paes Leme Adriana , Ramos Domingues Romenia , Duarte Bruna , Veiga Melina , Trindade Ferrer Marilia , Viana Wanzeler Ana Claudia , Leite Arieta Carlos Eduardo , Alves Monica
Published: December 2020

Background

Diseases of the anterior segment of the eye may present different mechanisms, intensity of symptoms, and impact on the patients’ quality of life and vision. The tear film is in direct contact with the ocular surface and cornea and can be easily accessed for sample collection, figuring as a promising source of potential biomarkers for diagnosis and treatment control. This study aimed to evaluate tear proteomic profile in 3 distinct ocular diseases: keratoconus (corneal ectasia), severe dry eye related to graft-versus-host-disease (tear film dysfunction and ocular inflammatory condition) and pterygium (conjunctival fibrovascular degenerative disease).

Methods

Tear samples were collected from patients of each condition and a control group. By using mass spectrometric analysis combined with statistics and bioinformatics tools, a detailed comparison of protein profile was performed.

Results

After Student’s t-test analyses comparing each condition to the control group, we found the following number of differentially expressed proteins: 7 in keratoconus group, 29 in pterygium group, and 79 in GVHD group. Following multivariate analyses, we also report potential candidates as biomarkers for each disease.

Conclusions

We demonstrated herein that mass spectrometry-based proteomics was able to indicate proteins that differentiate three distinct ocular conditions, which is a promising tool for the diagnosis of ocular diseases.
OsNAC45 is Involved in ABA Response and Salt Tolerance in Rice
Authors: Zhang Xiang , Long Yan , Huang Jingjing , Xia Jixing
Published: December 2020

Background

Salt stress threatens crop yields all over the world. Many NAC transcription factors have been reported to be involved in different abiotic stress responses, but it remains unclear how loss of these transcription factors alters the transcriptomes of plants. Previous reports have demonstrated that overexpression ofOsNAC45enhances salt and drought tolerance in rice, and that OsNAC45 may regulate the expression of two specific genes,OsPM1andOsLEA3–1.

Results

Here, we found that ABA repressed, and NaCl promoted, the expression ofOsNAC45in roots. Immunostaining showed that OsNAC45 was localized in all root cells and was mainly expressed in the stele. Loss ofOsNAC45decreased the sensitivity of rice plants to ABA and over-expressing this gene had the opposite effect, which demonstrated thatOsNAC45played an important role during ABA signal responses. Knockout ofOsNAC45also resulted in more ROS accumulation in roots and increased sensitivity of rice to salt stress. Transcriptome sequencing assay found that thousands of genes were differently expressed inOsNAC45-knockout plants. Most of the down-regulated genes participated in plant stress responses. Quantitative real time RT-PCR suggested that seven genes may be regulated byOsNAC45includingOsCYP89G1,OsDREB1F,OsEREBP2,OsERF104,OsPM1, OsSAMDC2,andOsSIK1.

Conclusions

These results indicate thatOsNAC45plays vital roles in ABA signal responses and salt tolerance in rice. Further characterization of this gene may help us understand ABA signal pathway and breed rice plants that are more tolerant to salt stress.
Postnatal management of children with antenatal hydronephrosis
Authors: ElSheemy Mohammed S.
Published: December 2020

Background

Postnatal management of infants with antenatal hydronephrosis (ANH) is still one of the most controversial issues. The majority of infants with ANH are asymptomatic with only few children who develop renal insufficiency. Thus, the biggest challenge for pediatric urologists is to distinguish children who will require further investigations and possible intervention prior to the development of symptoms, complications or renal damage in a cost effective manner without exposing them to the hazards of unnecessary investigations.

Main body

In this review article, literature on ANH were reviewed to present the current suggestions, recommendations, guidelines and their rational for postnatal management of ANH. It is agreed that a large portion of infants with ANH will improve; thus, the protocol of management is based mainly on observation and follow-up by ultrasound to detect either resolution, stabilization or worsening of hydronephrosis. The first 2 years of life are critical for this follow-up as the final picture is mostly reached during that period. Advanced imaging using voiding cystourethrography or renal scintigraphy are required for children at risk. Then, surgical intervention is selected only for a subgroup of these infants who showed worsening of hydronephrosis or renal function.

Conclusions

The protocol of management is based mainly on observation and follow-up by US to detect either resolution, stabilization or worsening of hydronephrosis. Postnatal evaluation should be performed for any neonate with a history ANH at any stage during pregnancy even if it was resolved during third trimester. Exclusion of UTI should be performed by urinalysis for all cases followed by urine culture if indicated. Serum creatinine should be performed especially in patients with bilateral ANH. US is the initial standard diagnostic imaging technique. Other imaging modalities like VCUG and nuclear renal scans may be required according to the results of the US evaluation. The most important items in decision making are the presence of bilateral or unilateral hydronephrosis, presence or absence of hydroureter, presence of lower urinary tract obstruction and degree of hydronephrosis on the initial postnatal US. Then an intervention is selected only for a subgroup of these patients who showed deterioration in renal function or degree of hydronephrosis or were complicated by UTIs. All these recommendations are based on the available literature. However, management of ANH is still a controversial issue due to lack of high evidence-based recommendations. Randomised controlled studies are still needed to provide a high level evidence for different aspects of management.
Targeted generation of polyploids in Hydrangea macrophylla through cross-based breeding
Authors: Tränkner Conny , Günther Kristina , Sahr Peter , Engel Frauke , Hohe Annette
Published: December 2020

Background

Up to now, diploid and triploid cultivars were reported for the ornamental cropHydrangea macrophylla. Especially, the origin of triploids and their crossing behaviors are unknown, but the underlying mechanisms are highly relevant for breeding polyploids.

Results

By screening a cultivar collection, we identified diploid, triploid, tetraploid and even aneuploidH. macrophyllavarieties. The pollen viability of triploids and tetraploids was comparable to that of diploids. Systematic crosses with these cultivars resulted in viable diploid, triploid, tetraploid and aneuploid offspring. Interestingly, crosses between diploids produced diploid and 0 or 1–94% triploid offspring, depending on the cultivars used as pollen parent. This finding suggests that specific diploids form unreduced pollen, either at low or high frequencies. In contrast, crosses of triploids with diploids or tetraploids produced many viable aneuploids, whose 2C DNA contents ranged between the parental 2C values. As expected, crosses between diploid and tetraploid individuals generated triploid offspring. Putative tetraploid plants were obtained at low frequencies in crosses between diploids and in interploid crosses of triploids with either diploid or tetraploid plants. The analysis of offspring populations indicated the production of1n = 2xgametes for tetraploid plants, whereas triploids produced obviously reduced, aneuploid gametes with chromosome numbers ranging between haploid and diploid level. While euploid offspring grew normally, aneuploid plants showed mostly an abnormal development and a huge phenotypic variation within offspring populations, most likely due to the variation in chromosome numbers. Subsequent crosses with putative diploid, triploid and aneuploid offspring plants from interploid crosses resulted in viable offspring and germination rates ranging from 21 to 100%.

Conclusions

The existence of diploids that form unreduced pollen and of tetraploids allows the targeted breeding of polyploidH. macrophylla. Different ploidy levels can be addressed by combining the appropriate crossing partners. In contrast to artificial polyploidization, cross-based polyploidization is easy, cheap and results in genetically variable offspring that allows the direct selection of more robust and stress tolerant polyploid varieties. Furthermore, the generation of polyploidH. macrophyllaplants will favor interspecific breeding programs within the genusHydrangea.
Genome-wide characterization, expression analyses, and functional prediction of the NPF family in Brassica napus
Authors: Wen Jing , Li Peng-Feng , Ran Feng , Guo Peng-Cheng , Zhu Jia-Tian , Yang Jin , Zhang Lan-Lan , Chen Ping , Li Jia-Na , Du Hai
Published: December 2020

Background

NITRATE TRANSPORTER 1/PEPTIDE TRANSPORTER (NRT1/PTR) family (NPF) members are essential transporters for many substrates in plants, including nitrate, hormones, peptides, and secondary metabolites. Here, we report the global characterization of NPF in the important oil crop Brassica napus, including that for phylogeny, gene/protein structures, duplications, and expression patterns.

Results

A total of 199 B. napus (BnaNPFs) NPF-coding genes were identified. Phylogenetic analyses categorized these genes into 11 subfamilies, including three new ones. Sequence feature analysis revealed that members of each subfamily contain conserved gene and protein structures. Many hormone−/abiotic stress-responsive cis-acting elements and transcription factor binding sites were identified in BnaNPF promoter regions. Chromosome distribution analysis indicated that BnaNPFs within a subfamily tend to cluster on one chromosome. Syntenic relationship analysis showed that allotetraploid creation by its ancestors (Brassica rapa and Brassica oleracea) (57.89%) and small-scale duplication events (39.85%) contributed to rapid BnaNPF expansion in B. napus. A genome-wide spatiotemporal expression survey showed that NPF genes of each Arabidopsis and B. napus subfamily have preferential expression patterns across developmental stages, most of them are expressed in a few organs. RNA-seq analysis showed that many BnaNPFs (32.66%) have wide exogenous hormone-inductive profiles, suggesting important hormone-mediated patterns in diverse bioprocesses. Homologs in a clade or branch within a given subfamily have conserved organ/spatiotemporal and hormone-inductive profiles, indicating functional conservation during evolution. qRT-PCR-based comparative expression analysis of the 12 BnaNPFs in the NPF2–1 subfamily between high- and low-glucosinolate (GLS) content B. napus varieties revealed that homologs of AtNPF2.9 (BnaNPF2.12, BnaNPF2.13, and BnaNPF2.14), AtNPF2.10 (BnaNPF2.19 and BnaNPF2.20), and AtNPF2.11 (BnaNPF2.26 and BnaNPF2.28) might be involved in GLS transport. qRT-PCR further confirmed the hormone-responsive expression profiles of these putative GLS transporter genes.

Conclusion

We identified 199 B. napus BnaNPFs; these were divided into 11 subfamilies. Allopolyploidy and small-scale duplication events contributed to the immense expansion of BnaNPFs in B. napus. The BnaNPFs had preferential expression patterns in different tissues/organs and wide hormone-induced expression profiles. Four BnaNPFs in the NPF2–1 subfamily may be involved in GLS transport. Our results provide an abundant gene resource for further functional analysis of BnaNPFs.
Transcriptome profiles of sturgeon lateral line electroreceptor and mechanoreceptor during regeneration
Authors: Wang Jian , Lu Chengcheng , Zhao Yifan , Tang Zhijiao , Song Jiakun , Fan Chunxin
Published: December 2020

Background

The electrosensory ampullary organs (AOs) and mechanosensory neuromasts (NMs) found in sturgeon and some other non-neopterygian fish or amphibians are both originated from lateral line placodes. However, these two sensory organs have characteristic morphological and physiological differences. The molecular mechanisms for the specification of AOs and NMs are not clearly understood.

Results

We sequenced the transcriptome for neomycin treated sturgeon AOs and NMs in the early regeneration stages, and de novo assembled a sturgeon transcriptome. By comparing the gene expression differences among untreated AOs, NMs and general epithelia (EPs), we located some specific genes for these two sensory organs. In sturgeon lateral line, the voltage-gated calcium channels and voltage-gated potassium channels were predominant calcium and potassium channel subtypes, respectively. And by correlating gene expression with the regeneration process, we predicated several candidate key transcriptional regulation related genes might be involved in AOs and NMs regeneration.

Conclusions

Genes with specific expression in the two lateral line sensory organs suggests their important roles in mechanoreceptor and electroreceptor formation. The candidate transcriptional regulation related genes may be important for mechano- and electro- receptor specification, in a “dosage-related” manner. These results suggested the molecular basis for specification of these two sensory organs in sturgeon.
Distraction by a cognitive task has a higher impact on electrophysiological measures compared with conditioned pain modulation
Authors: Do A. T. L. , Enax-Krumova E. K. , Özgül Ö. , Eitner L. B. , Heba S. , Tegenthoff M. , Maier C. , Höffken O.
Published: December 2020

Background

Conditioned pain modulation (CPM) evaluates the effect of a painful conditioning stimulus (CS) on a painful test stimulus (TS). Using painful cutaneous electrical stimulation (PCES) as TS and painful cold water as CS, the pain relief was paralleled by a decrease in evoked potentials (PCES-EPs). We now aimed to compare the effect of CPM with cognitive distraction on PCES-induced pain and PCES-EP amplitudes.

Methods

PCES was performed using surface electrodes inducing a painful sensation of 60 (NRS 0–100) on one hand. In a crossover design healthy subjects (included: n = 38, analyzed: n = 23) immersed the contralateral hand into 10 °C cold water (CS) for CPM evaluation and performed the 1-back task for cognitive distraction. Before and during the CS and 1-back task, respectively, subjects rated the pain intensity of PCES and simultaneously cortical evoked potentials were recorded.

Results

Both CPM and cognitive distraction significantly reduced PCES-EP amplitudes (CPM: 27.6 ± 12.0 μV to 20.2 ± 9.5 μV, cognitive distraction: 30.3 ± 14.2 µV to 13.6 ± 5.2 μV, p < 0.001) and PCES-induced pain (on a 0–100 numerical rating scale: CPM: 58 ± 4 to 41.1 ± 12.3, cognitive distraction: 58.3 ± 4.4 to 38.0 ± 13.0, p < 0.001), though the changes in pain intensity and PCES-amplitude did not correlate. The changes of the PCES-EP amplitudes during cognitive distraction were more pronounced than during CPM (p = 0.001).

Conclusions

CPM and cognitive distraction reduced the PCES-induced pain to a similar extent. The more pronounced decrease of PCES-EP amplitudes after distraction by a cognitive task implies that both conditions might not represent the general pain modulatory capacity of individuals, but may underlie different neuronal mechanisms with the final common pathway of perceived pain reduction.
Strength and size of phosphorus-rich patches determine the foraging strategy of Neyraudia reynaudiana
Authors: Cai Liping , Wang Yuzhen , Tigabu Mulualem , Hou Xiaolong , Wu Pengfei , Zhou Chuifan , Ma Xiangqing
Published: December 2020

Background

Under natural conditions, soil nutrients are heterogeneously distributed, and plants have developed adaptation strategies to efficiently forage patchily distributed nutrient. Most previous studies examined either patch strength or patch size separately and focused mainly on root morphological plasticity (increased root proliferation in nutrient-rich patch), thus the effects of both patch strength and size on morphological and physiological plasticity are not well understood. In this study, we examined the foraging strategy of Neyraudia reynaudiana (Kunth) Keng ex Hithc, a pioneer grass colonizing degraded sites, with respect to patch strength and size in heterogeneously distributed phosphorus (P), and how foraging patchily distributed P affects total plant biomass production. Plants were grown in sand-culture pots divided into ½, ¼, 1/6 compartments and full size and supplied with 0 + 0/30, 0 + 7.5/30 and 7.5 + 0/30 mg P/kg dry soil as KH2PO4 or 0 + 15/15, 0 + 18.5/ 18.5, 7.5 + 15/15 mg kg − 1 in the homogenous treatment. The first amount was the P concentration in the central region, and that the second amount was the P concentration in the outer parts of the pot.

Results

After 3 months of growth under experimental conditions, significantly (p < 0.05) high root elongation, root surface area, root volume and average root diameter was observed in large patches with high patch strength. Roots absorbed significantly more P in P-replete than P-deficient patches. Whole plant biomass production was significantly higher in larger patches with high patch strength than small patches and homogeneous P distribution.

Conclusion

The result demonstrates that root morphological and physiological plasticity are important adaptive strategies for foraging patchily distributed P and the former is largely determined by patch strength and size. The results also establish that foraging patchily distributed P resulted in increased total plant biomass production compared to homogeneous P distribution.
The genetic control of leaf and petal allometric variations in Arabidopsis thaliana
Authors: Li Xin , Zhang Yaohua , Yang Suxin , Wu Chunxia , Shao Qun , Feng Xianzhong
Published: December 2020

Background

Organ shape and size covariation (allometry) factors are essential concepts for the study of evolution and development. Although ample research has been conducted on organ shape and size, little research has considered the correlated variation of these two traits and quantitatively measured the variation in a common framework. The genetic basis of allometry variation in a single organ or among different organs is also relatively unknown.

Results

A principal component analysis (PCA) of organ landmarks and outlines was conducted and used to quantitatively capture shape and size variation in leaves and petals of multiparent advanced generation intercross (MAGIC) populations ofArabidopsis thaliana. The PCA indicated that size variation was a major component of allometry variation and revealed negatively correlated changes in leaf and petal size. After quantitative trait loci (QTL) mapping, five QTLs for the fourth leaf, 11 QTLs for the seventh leaf, and 12 QTLs for petal size and shape were identified. These QTLs were not identical to those previously identified, with the exception of the ER locus. The allometry model was also used to measure the leaf and petal allometry covariation to investigate the evolution and genetic coordination between homologous organs. In total, 12 QTLs were identified in association with the fourth leaf and petal allometry covariation, and eight QTLs were identified to be associated with the seventh leaf and petal allometry covariation. In these QTL confidence regions, there were important genes associated with cell proliferation and expansion with alleles unique to the maximal effects accession. In addition, the QTLs associated with life-history traits, such as days to bolting, stem length, and rosette leaf number, which were highly coordinated with climate change and local adaption, were QTL mapped and showed an overlap with leaf and petal allometry, which explained the genetic basis for their correlation.

Conclusions

This study explored the genetic basis for leaf and petal allometry and their interaction, which may provide important information for investigating the correlated variation and evolution of organ shape and size inArabidopsis.
Ectopic expression of a grape nitrate transporter VvNPF6.5 improves nitrate content and nitrogen use efficiency in Arabidopsis
Authors: He Yani , Xi Xiaojun , Zha Qian , Lu Yuting , Jiang Aili
Published: December 2020

Background

Nitrate plays an important role in grapevines vegetative and reproductive development. However, how grapevines uptake, translocate and utilize nitrate and the molecular mechanism still remains to be investigated.

Results

In this study, we report the functional characterization of VvNPF6.5, a member of nitrate transporter 1/peptide transporter family (NRT1/PTR/NPF) in Vitis vinifera. Subcellular localization in Arabidopsis protoplasts indicated that VvNPF6.5 is plasma membrane localized. Quantitative RT-PCR analysis indicated that VvNPF6.5 is expressed predominantly in roots and stems and its expression is rapidly induced by nitrate. Functional characterization using cRNA-injected Xenopus laevis oocytes showed that VvNPF6.5 uptake nitrate in a pH dependent way and function as a dual-affinity nitrate transporter involved in both high- and low-affinity nitrate uptake. Further ectopic expression of VvNPF6.5 in Arabidopsis resulted in more 15NO3− accumulation in shoots and roots and significantly improved nitrogen use efficiency (NUE). Moreover, VvNPF6.5 might participate in the nitrate signaling by positively regulating the expression of primary nitrate response genes.

Conclusion

Our results suggested that VvNPF6.5 encodes a pH-dependent, dual-affinity nitrate transporter. VvNPF6.5 regulates nitrate uptake and allocation in grapevines and is involved in primary nitrate response.
Perioperative Dexmedetomidine attenuates brain ischemia reperfusion injury possibly via up-regulation of astrocyte Connexin 43
Authors: Zheng Xiaoyang , Cai Xiaoying , Ye Fang , Li Ying , Wang Qin , Zuo Zhiyi , Huang Wenqi , Wang Zhongxing
Published: December 2020

Background

Astrocyte Connexin 43 (Cx43) is essential for the trophic and protective support of neurons during brain ischemia reperfusion (I/R) injury. It is believed that dexmedetomidine participates in Cx43-mediated effects. However, its mechanisms remained unclear. This study aims to address the relationship and regulation among them.

Methods

Adult male Sprague-Dawley rats were allocated to the 90-min right middle cerebral arterial occlusion with or without dexmedetomidine pretreatment (5 μg/kg). Neurological functions were evaluated and brain lesions, as well as inflammatory factors (IL-1β, IL-6, TNF-α), were assessed. Ischemic penumbral cortex was harvested to determine the expression of astrocyte Cx43. Primary astrocytes were cultured to evaluate the effect of dexmedetomidine on Cx43 after oxygen-glucose deprivation.

Results

Dexmedetomidine pretreatment attenuated neurological injury, brain lesions and expression of inflammatory factors (IL-1β, IL-6, TNF-α) after brain ischemia (P < 0.05). Astrocyte Cx43 was down-regulated by brain I/R injury, both in vivo and in vitro, which were reversed by dexmedetomidine (P < 0.05). This effect was mediated by the phosphorylation of Akt and GSK-3β. Further studies with LY294002 (PI3K inhibitor) or SB216763 (GSK-3β inhibitor) confirmed the effect of dexmedetomidine on astrocyte Cx43.

Conclusions

Perioperative dexmedetomidine administration attenuates neurological injury after brain I/R injury, possibly through up-regulation of astrocyte Cx43. Activation of PI3K-Akt-GSK-3β pathway might contribute to this protective effect.
Continuous EEG monitoring by a new simplified wireless headset in intensive care unit
Authors: Caricato Anselmo , Della Marca Giacomo , Ioannoni Eleonora , Silva Serena , Benzi Markushi Tiziana , Stival Eleonora , Biasucci Daniele Guerino , Montano Nicola , Gelormini Camilla , Melchionda Isabella
Published: December 2020

Background

In critically ill patients continuous EEG (cEEG) is recommended in several conditions. Recently, a new wireless EEG headset (CerebAir®,Nihon-Kohden) is available. It has 8 electrodes, and its positioning seems to be easier than conventional systems.

Aim of this study was to evaluate the feasibility of this device for cEEG monitoring, if positioned by ICU physician.

Methods

Neurological patients were divided in two groups according with the admission to Neuro-ICU (Study-group:20 patients) or General-ICU (Control-group:20 patients). In Study group, cEEG was recorded by CerebAir® assembled by an ICU physician, while in Control group a simplified 8-electrodes-EEG recording positioned by an EEG technician was performed.

Results

Time for electrodes applying was shorter in Study-group than in Control-group: 6.2 ± 1.1′ vs 10.4 ± 2.3′; p < 0.0001. Thirty five interventions were necessary to correct artifacts in Study-group and 11 in Control-group. EEG abnormalities with or without epileptic meaning were respectively 7(35%) and 7(35%) in Study-group, and 5(25%) and 9(45%) in Control-group;p > 0.05. In Study-group, cEEG was interrupted for risk of skin lesions in 4 cases after 52 ± 4 h. cEEG was obtained without EEG technician in all cases in Study-group; quality of EEG was similar.

Conclusions

Although several limitations should be considered, this simplified EEG system could be feasible even if EEG technician was not present. It was faster to position if compared with standard techniques, and can be used for continuous EEG monitoring. It could be very useful as part of diagnostic process in an emergency setting.
Acute decompensated heart failure in a non cardiology tertiary referral centre, Sarawak General Hospital (SGH-HF)
Authors: Ling Hwei Sung , Chung Bui Khiong , Chua Pin Fen , Gan Kai Xin , Ho Wai Leng , Ong Elora Yoke Ling , Kueh Cindy Hui San , Chin Yie Ping , Fong Alan Yean Yip
Published: December 2020

Background

Data on clinical characteristics of acute decompensated heart failure (ADHF) in Malaysia especially in East Malaysia is lacking.

Methods

This is a prospective observational study in Sarawak General Hospital, Medical Department, from October 2017 to September 2018. Patients with primary admission diagnosis of ADHF were recruited and followed up for 90 days. Data on patient’s characteristics, precipitating factors, medications and short-term clinical outcomes were recorded.

Results

Majority of the patients were classified in lower socioeconomic group and the mean age was 59 years old. Hypertension, diabetes mellitus and dyslipidaemia were the common underlying comorbidities. Heart failure with ischemic aetiology was the commonest ADHF admission precipitating factor. 48.6% of patients were having preserved ejection fraction HF and the median NT-ProBNP level was 4230 pg/mL. Prescription rate of the evidence-based heart failure medication was low. The in-patient mortality and the average length of hospital stay were 7.5% and 5 days respectively. 43% of patients required either ICU care or advanced cardiopulmonary support. The 30-day, 90-day mortality and readmission rate were 13.1%, 11.2%, 16.8% and 14% respectively.

Conclusion

Comparing with the HF data from West and Asia Pacific, the short-term mortality and readmission rate were high among the ADHF patients in our study cohort. Maladaptation to evidence-based HF prescription and the higher prevalence of cardiovascular risk factors in younger patients were among the possible issues to be addressed to improve the HF outcome in regions with similar socioeconomic background.
Overlapping-sample Mendelian randomisation with multiple exposures: a Bayesian approach
Authors: Zou Linyi , Guo Hui , Berzuini Carlo
Published: December 2020

Background

Mendelian randomization (MR) has been widely applied to causal inference in medical research. It uses genetic variants as instrumental variables (IVs) to investigate putative causal relationship between an exposure and an outcome. Traditional MR methods have mainly focussed on a two-sample setting in which IV-exposure association study and IV-outcome association study are independent. However, it is not uncommon that participants from the two studies fully overlap (one-sample) or partly overlap (overlapping-sample).

Methods

We proposed a Bayesian method that is applicable to all the three sample settings. In essence, we converted a two- or overlapping- sample MR to a one-sample MR where data were partly unmeasured. Assume that all study individuals were drawn from the same population and unmeasured data were missing at random. Then the missing data were treated au pair with the model parameters as unknown quantities, and thus, were imputed iteratively conditioning on the observed data and estimated parameters using Markov chain Monte Carlo. We generalised our model to allow for pleiotropy and multiple exposures and assessed its performance by a number of simulations using four metrics: mean, standard deviation, coverage and power. We also compared our method with classic MR methods.

Results

In our proposed method, higher sample overlapping rate and instrument strength led to more precise estimated causal effects with higher power. Pleiotropy had a notably negative impact on the estimates. Nevertheless, the coverages were high and our model performed well in all the sample settings overall. In comparison with classic MR, our method provided estimates with higher precision. When the true causal effects were non-zero, power of their estimates was consistently higher from our method. The performance of our method was similar to classic MR in terms of coverage.

Conclusions

Our model offers the flexibility of being applicable to any of the sample settings. It is an important addition to the MR literature which has restricted to one- or two- sample scenarios. Given the nature of Bayesian inference, it can be easily extended to more complex MR analysis in medical research.
Handling coarsened age information in the analysis of emergency department presentations
Authors: Rosychuk Rhonda J. , Bachman Jeff W.N. , Chen Anqi , Hu X. Joan
Published: December 2020

Background

Administrative databases offer vast amounts of data that provide opportunities for cost-effective insights. They simultaneously pose significant challenges to statistical analysis such as the redaction of data because of privacy policies and the provision of data that may not be at the level of detail required. For example, ages in years rather than birthdates available at event dates can pose challenges to the analysis of recurrent event data.

Methods

Hu and Rosychuk provided a strategy for estimating age-varying effects in a marginal regression analysis of recurrent event times when birthdates are all missing. They analyzed emergency department (ED) visits made by children and youth and privacy rules prevented all birthdates to be released, and justified their approach via a simulation and asymptotic study. With recent changes in data access rules, we requested a new extract of data for April 2010 to March 2017 that includes patient birthdates. This allows us to compare the estimates using the Hu and Rosychuk (HR) approach for coarsened ages with estimates under the true, known ages to further examine their approach numerically. The performance of the HR approach under five scenarios is considered: uniform distribution for missing birthdates, uniform distribution for missing birthdates with supplementary data on age, empirical distribution for missing birthdates, smaller sample size, and an additional year of data.

Results

Data from 33,299 subjects provided 58,166 ED visits. About 67% of subjects had one ED visit and less than 9% of subjects made over three visits during the study period. Most visits (84.0%) were made by teenagers between 13 and 17 years old. The uniform distribution and the HR modeling approach capture the main trends over age of the estimates when compared to the known birthdates. Boys had higher ED visit frequencies than girls in the younger ages whereas girls had higher ED visit frequencies than boys for the older ages. Including additional age data based on age at end of fiscal year did not sufficiently narrow the widths of potential birthdate intervals to influence estimates. The empirical distribution of the known birthdates was close to a uniform distribution and therefore, use of the empirical distribution did not change the estimates provided by assuming a uniform distribution for the missing birthdates. The HR approach performed well for a smaller sample size, although estimates were less smooth when there were very few ED visits at some younger ages. When an additional year of data is added, the estimates become better at these younger ages.

Conclusions

Overall the Hu and Rosychuk approach for coarsened ages performed well and captured the key features of the relationships between ED visit frequency and covariates.
Safely reducing haemodialysis frequency during the COVID-19 pandemic
Authors: Lodge Michelle Da Silva , Abeygunaratne Thilini , Alderson Helen , Ali Ibrahim , Brown Nina , Chrysochou Constantina , Donne Rosie , Erekosima Ibi , Evans Philip , Flanagan Emma , Gray Simon , Green Darren , Hegarty Janet , Hyde Audrey , Kalra Philip A. , Lamerton Elizabeth , Lewis David , Middleton Rachel , New David , Nipah Robert , O’Donoghue Donal , O’Riordan Edmond , Poulikakos Dimitrios , Rainone Francesco , Raman Maharajan , Ritchie James , Sinha Smeeta , Wood Grahame , Tollitt J.
Published: December 2020

Background

Patients undergoing haemodialysis (HD) are at higher risk of developing worse outcomes if they contract COVID-19. In our renal service we reduced HD frequency from thrice to twice-weekly in selected patients with the primary aim of reducing COVID 19 exposure and transmission between HD patients.

Methods

Dialysis unit nephrologists identified 166 suitable patients (38.4% of our HD population) to temporarily convert to twice-weekly haemodialysis immediately prior to the peak of the COVID-19 pandemic in our area. Changes in pre-dialysis weight, systolic blood pressure (SBP) and biochemistry were recorded weekly throughout the 4-week project. Hyperkalaemic patients (serum potassium > 6.0 mmol/L) were treated with a potassium binder, sodium bicarbonate and received responsive dietary advice.

Results

There were 12 deaths (5 due to COVID-19) in the HD population, 6 of which were in the twice weekly HD group; no deaths were definitively associated with change of dialysis protocol. A further 19 patients were either hospitalised and/or developed COVID-19 and thus transferred back to thrice weekly dialysis as per protocol. 113 (68.1%) were still receiving twice-weekly HD by the end of the 4-week project. Indications for transfer back to thrice weekly were; fluid overload (19), persistent hyperkalaemia (4), patient request (4) and compliance (1). There were statistically significant increases in SBP and pre-dialysis potassium during the project.

Conclusions

Short term conversion of a large but selected HD population to twice-weekly dialysis sessions was possible and safe. This approach could help mitigate COVID-19 transmission amongst dialysis patients in centres with similar organisational pressures.
Impacts of dialysis adequacy and intradialytic hypotension on changes in dialysis recovery time
Authors: Guedes Murilo , Pecoits-Filho Roberto , Leme Juliana El Ghoz , Jiao Yue , Raimann Jochen G. , Wang Yuedong , Kotanko Peter , de Moraes Thyago Proença , Thadhani Ravi , Maddux Franklin W. , Usvyat Len A. , Larkin John W.
Published: December 2020

Background

Dialysis recovery time (DRT) surveys capture the perceived time after HD to return to performing regular activities. Prior studies suggest the majority of HD patients report a DRT > 2 h. However, the profiles of and modifiable dialysis practices associated with changes in DRT relative to the start of dialysis are unknown. We hypothesized hemodialysis (HD) dose and rates of intradialytic hypotension (IDH) would associate with changes in DRT in the first years after initiating dialysis.

Methods

We analyzed data from adult HD patients who responded to a DRT survey ≤180 days from first date of dialysis (FDD) during 2014 to 2017. DRT survey was administered with annual KDQOL survey. DRT survey asks: “How long does it take you to be able to return to your normal activities after your dialysis treatment?” Answers are: < 0.5, 0.5-to-1, 1-to-2, 2-to-4, or > 4 h. An adjusted logistic regression model computed odds ratio for a change to a longer DRT (increase above DRT > 2 h) in reference to a change to a shorter DRT (decrease below DRT < 2 h, or from DRT > 4 h). Changes in DRT were calculated from incident (≤180 days FDD) to first prevalent (> 365-to- ≤ 545 days FDD) and second prevalent (> 730-to- ≤ 910 days FDD) years.

Results

Among 98,616 incident HD patients (age 62.6 ± 14.4 years, 57.8% male) who responded to DRT survey, a higher spKt/V in the incident period was associated with 13.5% (OR = 0.865; 95%CI 0.801-to-0.935) lower risk of a change to a longer DRT in the first-prevalent year. A higher number of HD treatments with IDH episodes per month in the incident period was associated with a 0.8% (OR = 1.008; 95%CI 1.001-to-1.015) and 1.6% (OR = 1.016; 95%CI 1.006-to-1.027) higher probability of a change to a longer DRT in the first- and second-prevalent years, respectively. Consistently, an increased in incidence of IDH episodes/months was associated to a change to a longer DRT over time.

Conclusions

Incident patients who had higher spKt/V and less sessions with IDH episodes had a lower likelihood of changing to a longer DRT in first year of HD. Dose optimization strategies with cardiac stability in fluid removal should be tested.
Health-related quality of life, palliative care needs and 12-month survival among patients with end stage renal disease in Uganda: protocol for a mixed methods longitudinal study
Authors: Bagasha Peace , Leng Mhoira , Katabira Elly , Petrova Mila
Published: December 2020

Background

The prevalence of chronic kidney disease is on the rise globally and in sub-Saharan Africa. Due to its “silent” nature, many patients often present with advanced disease. At this point options for care are often limited to renal replacement therapies such as hemodialysis and kidney transplantation. In resource limited settings, these options are associated with catastrophic expenditures and increased household poverty levels. Early palliative care interventions, if shown to ensure comparable quality of life (QoL), can significantly mitigate this by focusing care on comfort, symptom control and QoL rather than primarily on prolonging survival.

Methods

A mixed methods longitudinal study, recruiting patients with End Stage Renal Disease (ESRD) on hemodialysis or conservative management and following them up over 12 months. The study aims are to: 1) measure and compare the health-related quality of life (HRQoL) scores of patients with ESRD receiving hemodialysis with those receiving conservative management, 2) measure and compare the palliative care needs and outcomes of patients in the two groups, 3) explore the impact of treatment modality and demographic, socio-economic and financial factors on QoL and palliative care needs and outcomes, 4) review patient survival over 12 months and 5) explore the patients’ lived experiences. The Kidney Disease Quality Of Life Short Form version 1.3 (KDQOL-SF) will be used to measure HRQoL; the African Palliative Care Association Palliative care Outcome Score (APCA POS) and the Palliative care Outcome Score for renal symptoms (POS-S Renal) will be used to assess palliative care needs and outcomes; and semi-structured in-depth interviews to explore the patients’ experiences of living with ESRD. Data collection will be carried out at 0, 3, 6, 9 and 12 months.

Discussion

To the best of our knowledge, no similar study has been conducted in sub-Saharan Africa. This will be an important step towards raising awareness of patients’ need and preferences and the strengths and limitations of available health care services for ESRD in resource limited settings.
Severe hypersomnia after unilateral infarction in the pulvinar nucleus– a case report
Authors: Hansen Peter Nørregaard , Krøigård Thomas , Nguyen Nina , Frandsen Rune Vestergaard , Jennum Poul Jørgen , Beier Christoph P.
Published: December 2020

Background

Although a central role of the thalamus for sleep regulation is undisputed, the exact localization of the crucial structures within the thalamus remains controversial.

Case presentation

Here we report a 35 year old woman with no prior comorbidities who developed severe and persistent hypersomnia with long sleep time after a small right-sided MRI-verified thalamic stroke affecting the dorsal part of the pulvinar and the dorsolateral boarders of the dorsomedial nuclei.

Conclusion

The observed symptoms suggest a crucial role of posterior thalamus but not the midline parts of the thalamus in sleep-wake control.
Polymorphisms of TGF-β1 and TGF-β3 in Chinese women with gestational diabetes mellitus
Authors: Xu Yinglei , Wei Chunlian , Wu Cuijiao , Han Mengmeng , Wang Jingli , Hou Huabin , Zhang Lu , Liu Shiguo , Chen Ying
Published: December 2020

Background

Gestational diabetes mellitus (GDM) is a pregnancy-specific carbohydrate intolerance Which can cause a large number of perinatal and postpartum complications. The members of Transforming growth factor-β (TGF-β) superfamily play key roles in the homeostasis of pancreatic β-cell and may involve in the development of GDM. This study aimed to explore the association between the polymorphisms ofTGF-β1,TGF-β3and the risk to GDM in Chinese women.

Methods

This study included 919 GDM patients (464 with preeclampsia and 455 without preeclampsia) and 1177 healthy pregnant women. TaqMan allelic discrimination real-Time PCR was used to genotype the TGF-β1 (rs4803455) and TGF-β3 (rs2284792 and rs3917201), The Hardy-Weinberg equilibrium (HWE) was evaluated by chi-square test.

Results

An increased frequency of TGF-β3 rs2284792 AA and AG genotype carriers was founded in GDM patients (AA vs. AG + GG: χ2 = 6.314,P = 0.012, OR = 1.270, 95%CI 1.054–1.530; AG vs. GG + AA: χ2 = 8.545,P = 0.003, OR = 0.773, 95%CI 0.650–0.919). But there were no significant differences in the distribution of TGF-β1 rs4803455 and TGF-β3 rs3917201 between GDM and healthy women. In addition, no significant differences were found in allele and genotype frequencies among GDM patients with preeclampsia (PE).

Conclusions

The AA and AG genotype of TGF-β3 rs2284792 polymorphism may be significantly associated with increased risk of GDM in Chinese population.
Determinants of postnatal checkup for newborns in Ethiopia: Further analysis of 2016 Ethiopia demographic and health survey
Authors: Seid Abdu , Ahmed Mohammed
Published: December 2020

Background

The absence of suitable care during the postpartum period might result in substantial ill-health and even the demise of newborns. So, identifying and intervening thus factors increase postnatal newborn care utilization thereby reducing neonatal mortality. Therefore, this study aimed to ascertain the determinants of the postnatal checkup of a newborn in Ethiopia.

Method

A cross-sectional study was accompanied using the 2016 Ethiopia Demographic and Health Survey (EDHS) data set. The samples were designated by employing a two-stage stratified cluster sampling technique. All statistical analysis were weighted in order to take into consideration complex survey design. Bivariate and multivariate logistic regression analysis was also carried out to examine the association between use of postnatal care of newborn and selected independent variables. Adjusted odds ratios (AOR) were used to state a statistically significant suggestion.

Result

A total of 7091 samples of the reproductive age of newborn mothers were included and analyzed. According to multivariate analysis, the odds of postnatal checkups of the newborn were 2.45 times higher among mothers who had 1–3 ANC visits and 3.42 times higher among mothers who had four and above visits than mother who did not have ANC visit. The odds of postnatal checkups of the newborn were 1.4 times higher among mothers who had access to media compared to their counterparts. Likewise, the odds of postnatal checkups of the newborn were 1.67 times higher among mothers who had delivered in a health facility than who delivered at home.

Conclusions

This study revealed that accessed media, being rich or middle in the wealth index category, having ANC visits, and institutional delivery was positively associated with the utilization of postnatal care checkup of the newborn. Therefore, information education and communication programs should perform a critical role in inspiring mother to take their newborns for postnatal checkup after birth.