bluuebunny/crossref_metadata_2025 huggingface dataset:
Endothelial dysfunction and impaired arterial wall properties in patients with retinal vein occlusion
Authors: Gouliopoulos Nikolaos , Siasos Gerasimos , Moschos Marilita M , Oikonomou Evangelos , Rouvas Alexandros , Bletsa Evanthia , Stampouloglou Panagiota , Siasou Georgia , Paraskevopoulos Theodoros , Vlasis Konstantinos , Marinos Georgios , Tousoulis Dimitrios
Published: April 2020

Retinal vein occlusion (RVO) is a common retinal vascular lesion, and a leading cause of visual impairment. Patients with RVO have an increased risk for cardiovascular disease and share multiple common risk factors. In this study, we investigated the endothelial function and arterial stiffness of patients with RVO compared to healthy-control (CL) subjects. We enrolled 40 consecutive patients with RVO and 40 CL subjects. RVO was diagnosed by an ophthalmologist, endothelial function was evaluated by flow mediated dilation (FMD) in the brachial artery, and carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx) of the radial artery were measured to evaluate arterial stiffness and reflected waves, respectively. No significant differences were detected between the studied groups in sex, age, presence of hypertension or dyslipidemia, body mass index, systolic and diastolic blood pressure levels, total cholesterol levels, and smoking habits ( p > 0.05 for all). However, patients with RVO had impaired FMD ( p = 0.002) and increased PWV ( p = 0.004), even after adjustment for several confounders. Both FMD and PWV were also significantly and independently associated with the development of RVO. Furthermore, a signiﬁcant and positive correlation between PWV and systolic blood pressure existed only in the CL group. Therefore, we have shown that RVO is associated with significant endothelial dysfunction and increased arterial stiffness. Our results strengthen the vascular theory, according to which, systemic endothelial dysfunction and arteriosclerosis play a significant role in the pathogenesis of RVO.
Women and intimate partner violence: Prevalence of hospital visits and nature of injuries in the Icelandic population
Authors: Jónasdóttir Drífa , Thorsteinsdottir Thordis , Ásgeirsdóttir Tinna Laufey , Lund Sigrún H. , Arnarsson Eiríkur Örn , Ashikali Eleni , Líndal Þórhildur , Mogensen Brynjólfur
Published: April 2020

Aims: The purpose of this study was to analyse the prevalence of hospital visits and nature of injuries caused by intimate partner violence (IPV) against women and associated costs. Methods: All visits to Landspitali National University Hospital by women 18 years or older subjected to IPV, inflicted by a current or former male partner during 2005–2014, were observed and analysed. Information was obtained on number, date and time of visits and admissions, place of occurrence, patients’ and perpetrators’ age and relationship, number of perpetrators, medical diagnosis, aetiology, injury severity and cost. Results: The number of new hospital visits due to IPV was 1454, of which 92.6% were to the Emergency Department. The average age of the women was 34 years and 3.2% were admitted. According to the Injury Severity Score, physical injuries were mostly minor (92.4%) and mainly located on the upper body (64.3%) – namely, face, head and neck (37.1%) and upper limbs (27.2%). The majority of injuries were superficial (76.2%) and punching (29.7%), shoving (17.8%), kicking (10.5%) and attempted strangulation (9.8%) were the most common types of aetiology. Repeated new visits were 37.8%. The total cost for the hospital relating to IPV was €783,330. Conclusions: The total number of new visits resulting from IPV was 1454, and prevalence was 1.69 per 1000 women in the capital area over the research period. The majority of women were shown to have minor physical injuries of a superficial nature, located on the upper body. Although a low percentage of women were admitted, the associated cost for visits and admissions was substantial.
Developing the ‘best practices’ of virtual reality design: industry standards at the frontier of emerging media
Authors: LaRocco Michael
Published: April 2020

In this article, the author analyzes the ways in which the practices of virtual reality design are being standardized, focusing specifically on the Oculus Best Practices Guide (OBPG). Instructional writings like the OBPG are fruitful documents from which theories of practice can be extracted and, for companies like Oculus, they serve as alternative mission statements, articulating what Oculus wants and needs the standards and practices of its nascent product-medium to be. The author argues that the OBPG serves to create standards and practices that emphasize and maintain virtual reality (VR) user immersion in order to mitigate the weaknesses in the technology and better conform with VR’s idealized, hypothetical presentation in fiction and marketing rhetoric. The Guide plays a key role in Oculus’s larger attempts to mitigate market risk through the standardization of content across its distribution platforms in order to shape an inchoate technological object into a stable and lucrative entertainment medium. More broadly, the OBPG serves as an example of the specific ways in which market forces act on the development of new media practices, turning ‘standards’ into ‘industry standards’.
What collaborative planning practices lack and the design cycle can offer: Back to the drawing table
Authors: van Dijk Terry
Published: April 2020

This article critically discusses the premises underpinning the collaborative ideal, which has become central to Western spatial planning practices. With their emphasis on a structure which focuses on the problem, actors, deliberation, agreement and acceptability, collaborative processes produce conservative choices. However, this approach might not effectively address the big challenges confronting our metropolitan areas and regions today. Instead, the essence of choosing how to respond in the face of long-term challenges is a thorough analysis of the situation (beyond just the actors’ wishes), generation of a wide array of possible actions (more creative than mere compromises), and arriving at decisions which demonstrate vision and leadership. This resembles the design cycle, which we claim enriches the collaborative model. We propose principles for a more creative governance which suggest emphasizing the exploitation of an area’s full potential instead of solving its specific problems.
Labelled as ‘risky’ in an era of control: How young people experience and respond to the stigma of criminalized identities
Authors: Deakin Jo , Fox Claire , Matos Raquel
Published: April 2020

The construction and labelling of groups of young people as ‘risky’ triggers a multifaceted and dynamic social process of stigma that frequently results in reduced life chances and limited opportunities for self-development. Drawing on case-study data from four European countries, this article focuses on the ways in which stigma is reproduced through interactions and interventions that label young people. Our analysis explores how young people experience and understand stigma, and how they respond to it. Framed within a theoretical understanding of stigma as a form of power, we examine its components and cyclical process, its role in shaping policies of social control, and its consequences for groups of ‘risky’ young people. Our analysis builds upon and develops Link and Phelan’s (2001) reconceptualization of stigma to include reference to young people’s reactions and responses: alienation and marginalization; anger and resistance; empathy and generativity. We argue that stigma acts primarily as an inhibitor of young people’s engagement in wider society, serving to further reduce access to beneficial opportunities. However, some young people are able to resist the label, and, for them, resistance can become generative and enabling.
Peripheral arterial disease and type 2 diabetes: Older patients still exhibit a survival benefit from glucose control
Authors: Höbaus Clemens , Herz Carsten Thilo , Wrba Thomas , Koppensteiner Renate , Schernthaner Gerit-Holger
Published: April 2020

Objective:

To investigate a possible beneficial effect of strict glycaemic control on all-cause mortality in patients with peripheral arterial disease and type 2 diabetes mellitus.

Methods:

A total of 367 mainly older peripheral arterial disease patients [age: 69 (62–78) years, 34% women, Fontaine stage I–II] were categorized according to glycaemic control, that is, (a) no type 2 diabetes mellitus, (b) strict glucose control (HbA1c < 53 mmol/mol) and (c) lenient glucose control (HbA1c ⩾ 53 mmol/mol) at inclusion and by mean HbA1c over the first study year. Mortality was analysed using Kaplan–Meier and Cox-regression analyses after 7 years.

Results:

The combination of type 2 diabetes mellitus and peripheral arterial disease reduced survival from 78.8% to 68.9% in comparison to patients without type 2 diabetes mellitus ( p = 0.023). Patients with strict glucose control (75%) were associated with increased survival in comparison to patients with lenient glucose control (58.9%) stratified by mean HbA1c ( p = 0.042). Baseline cardiovascular risk factors were similar in those type 2 diabetes mellitus patients. In this peripheral arterial disease cohort HbA1c (hazard ratio: 1.3, 1.04–1.63), age (hazard ratio: 1.7, 1.3–2.3) and C-reactive protein (hazard ratio: 1.5, 1.2–2.0) remained independent associates for mortality adjusted for cardiovascular risk factors and diabetes duration.

Conclusion:

Older patients with peripheral arterial disease and type 2 diabetes mellitus still benefit from strict glucose control in a cohort of patients with similar distribution of cardiovascular risk factors.
Preserving the Blood Flow of the Recipient Artery in Cross-Leg Free Flap Procedure for Lower Extremity Reconstruction
Authors: Bali Zulfukar Ulas , Karatan Berrak , Tuluy Yavuz , Kececi Yavuz , Yoleri Levent
Published: April 2020

When there is no suitable vessel in the injured leg for microsurgical transfer, cross-leg free flaps can be considered for lower extremity reconstruction. This report describes patients who experienced lower extremity trauma and underwent reconstruction with cross-leg free flaps with preserved blood flow in the recipient artery. Anterolateral thigh flap is preferred for small to moderate defects. The descending branch of the lateral femoral circumflex artery was dissected 2 cm proximally and distally and was prepared in a T-shape. The branches of the T were anastomosed to the recipient artery in the contralateral leg in the first session of the cross-leg free flap procedure. After 3 weeks, the flap artery was separated from the bifurcation. For large defects, the latissimus dorsi flap was chosen. The thoracodorsal artery was anastomosed to the contralateral posterior tibial artery in the first session. After 3 weeks, to provide recipient vessel integrity, the thoracodorsal artery was transected from the flap and anastomosed to the distal stump of the posterior tibial artery. Between January 2017 and January 2019, 8 defects were reconstructed using an anterolateral thigh flap; the remaining 4 defects were reconstructed using a latissimus dorsi flap. All flaps survived without complications. Anterograde flow distal to the anastomosis was confirmed in all recipient arteries via Doppler ultrasound. In cross-leg free flaps, the continuity of the recipient artery can be established to prevent diminished blood flow to the recipient extremity.
Evaluation of ROCEN on Burn Wound Healing and Thermal Pain: Transforming Growth Factor-β1 Activation
Authors: Goudarzi Ramin , Nasab Maryam Eskandary , Saffari Partow Mirzaee , Zamanian Golnaz , Park Chong Deok , Partoazar Alireza
Published: April 2020

The present study aimed to evaluate the effect of liposomal arthrocen 2% (ROCEN) on the healing of burn wound and pain alleviation of thermal stimuli in a rat model of the second-degree burn. The results showed that ROCEN formulation significantly improved the main parameters of burn wound healing in a short period of time (7 days). The percentage of wound surface was also reduced significantly compared with the control group following once daily application of ROCEN for 14 days. The level of TGF (transforming growth factor)-β1 cytokine was also elevated significantly in the burn tissue treated with ROCEN almost the same as zinc oxide cream. Also, ROCEN showed a significant analgesic effect evaluated by 2 models of acute thermal pain, tail-flick and hotplate tests, which suggested that the formulation may act as a pain reliever in burn injuries. In conclusion, the application of the topical formulation of ROCEN may have benefits in the acceleration of the wound healing process and alleviation of the pain due to burn injuries.
Getting the Starting Point Right: Prevention of Skiving and Fibular Cortical Breach During Suture Button Placement for Syndesmotic Ankle Injuries
Authors: Kaiser Philip B. , Cronin Patrick , Stenquist Derek S. , Miller Christopher P. , Velasco Brian T. , Kwon John Y.
Published: April 2020

The use of suture button (SB) devices in the treatment of syndesmotic ankle injuries is increasing. These constructs have demonstrated better syndesmotic reduction, improved clinical outcomes, and lower rates of hardware removal compared with screw fixation. However, placing a SB device without a fibular plate can be technically challenging. In this technique tip, we use an illustrative case to demonstrate a technique tip that minimizes the risk of anterior or posterior cortical breach of the fibula and helps facilitate more accurate placement of a SB device.

Levels of Evidence: Level V: Expert opinion
“Click First!”: The Effects of Instant Activism Via a Hoax on Social Media
Authors: Park Keonyoung , Rim Hyejoon
Published: April 2020

To facilitate the immediate effects of social media activism, some activists adopt a deceptive strategy, swaying lay individuals’ perceptions and manipulating their behavior despite ethical considerations. This study identified instant activism, which targets lay individuals’ effortless supportive actions (e.g., clicking) on social media and examined its effects in the context of GMO (genetically modified organisms) labeling issues in the United States. Grounded in the situational theory of problem solving, this study investigated who engages in instant activism and what their behavioral consequences are. Results of an online survey ( n = 483) suggested that (a) individuals with a low level of issue knowledge but a high level of issue involvement tend to believe a social media hoax and (b) belief in the hoax leads individuals to engage in active communicative activities that involve problem solving and behavioral changes when mediated by situational motivation. Theoretical and practical implications were discussed.
Who to Trust on Social Media: How Opinion Leaders and Seekers Avoid Disinformation and Echo Chambers
Authors: Dubois Elizabeth , Minaeian Sara , Paquet-Labelle Ariane , Beaudry Simon
Published: April 2020

As trust in news media and social media dwindles and fears of disinformation and echo chambers spread, individuals need to find ways to access and assess reliable and trustworthy information. Despite low levels of trust in social media, they are used for accessing political information and news. In this study, we examine the information verification practices of opinion leaders (who consume political information above average and share their opinions on social media above average) and of opinion seekers (who seek out political information from friends and family) to understand similarities and differences in their news media trust, fact-checking behaviors, and likeliness of being caught in echo chambers. Based on a survey of French Internet users ( N = 2,000) we find that not only opinion leaders, but also opinion seekers, have higher rates across all three of these dependent variables. We discuss the implications of findings for the development of opinion leadership theory as well as for social media platforms wishing to increase trust.
Complications and Return to Activity After Arthroscopic Repair of Isolated Type II SLAP Lesions: A Systematic Review Comparing Knotted Versus Knotless Suture Anchors
Authors: Knapik Derrick M. , Kolaczko Jensen G. , Gillespie Robert J. , Salata Michael J. , Voos James E.
Published: April 2020

Background:

Superior labral anterior to posterior (SLAP) tears are one of the most common injuries to the shoulder, with the type II variant representing the most frequently encountered subtype.

Purpose:

To systematically review the literature to better understand outcomes after arthroscopic repair of isolated type II SLAP lesions using knotted versus knotless anchors based on implant number, implant location, patient position, and portal position.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A systematic review investigating all studies in the literature between January 2000 and June 2019 reporting on patients undergoing arthroscopic repair for isolated type II SLAP lesions using knotted versus knotless suture anchors was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the PubMed, BIOSIS Previews, SPORTDiscus, PEDro, and Embase databases.

Results:

A total of 234 patients undergoing isolated arthroscopic repair of type II SLAP lesions using suture anchors were identified, with 76% (179/234) treated using knotted anchors versus 24% (55/234) treated using knotless anchors. Complications were reported in 12% of patients treated using knotted anchors versus no patients treated using knotless anchors ( P = .008). The incidence of complications for knotted anchor repair was not significantly affected by patient position ( P = .22) or portal position ( P = .19). Using multiple regression analysis, we found no significant association with the incidence of complications when analyzing for anchor design ( R 2 = 0.02; P = .06) or anchor position ( R 2 = 0.02; P = .92). No significant difference in return-to-activity timing was appreciated based on anchor type ( P = .28), patient position ( P = .98), or portal position ( P = .97) in patients treated using knotted anchors.

Conclusion:

Patients treated using knotted anchors were significantly more likely to experience a postoperative complication compared with patients treated using knotless anchors after arthroscopic repair of isolated type II SLAP lesions. Despite the increased incidence of a postoperative complication after knotted anchor fixation compared with knotless anchor fixation, multiple regression analysis showed that anchor design and anchor position were not significantly predictive of the incidence of complications. Given the increasing popularity of knotless anchor fixation, further study on the long-term outcomes after knotless repair for isolated type II SLAP lesions is warranted.
Improving adherence to pulmonary hypertension screening in patients with systemic sclerosis: Overcoming the provider-level barriers
Authors: Wigger Gregory W , Zafar Muhammad A , Elwing Jean M
Published: April 2020

Background:

Pulmonary arterial hypertension is a life-limiting complication in patients with systemic sclerosis. Current recommendations suggest a minimum screening of an annual transthoracic echocardiogram and pulmonary function test. We hypothesize that modifiable provider-level hurdles contribute to inadequate screening and can be alleviated.

Methods and Results:

We performed a longitudinal study over 23 months of all systemic sclerosis patients seen in pulmonary and/or rheumatology clinics. Pulmonary arterial hypertension screening was measured monthly as percentage of patients with up-to-date transthoracic echocardiogram and pulmonary function test out of the total systemic sclerosis patients with an outpatient encounter that month. Tests were considered “up-to-date” if they were performed 12 months prior or within the next 6 months post-encounter. Baseline adherence to PAH screening was assessed using a 9-month preproject period. Physicians in rheumatology and pulmonary clinics were surveyed for knowledge and perceived as barriers to screening. Interventions focused on provider-level hurdles to improve the screening rate to >90%. Adherence to systemic sclerosis–associated pulmonary arterial hypertension was compared between baseline and post-intervention phases as a continuous variable using nonparametric Mann–Whitney–Wilcoxon test and as categorical variable using chi-square test for overall adherence rate. A total of 18 providers were surveyed, of which 67% knew minimal screening recommendations and 44% identified “difficulty ordering tests” as a barrier. Our interventions were as follows: (1) didactic education and literature dissemination and (2) best practice alert in the electronic medical record to facilitate just-in-time ordering of screening. Adherence was measured for 23 months, comprising 166 systemic sclerosis patients. Monthly adherence to pulmonary arterial hypertension screening increased by 10.4% (69.2%–79.6%, p = 0.01 with chi-square and p = 0.09 with Mann–Whitney–Wilcoxon test), with an increase in transthoracic echocardiogram by 7.5% and pulmonary function test by 4.9%.

Conclusion:

Provider-level hurdles contribute to sub-optimal systemic sclerosis–associated pulmonary arterial hypertension screening. Lack of knowledge and difficulty in ordering tests were major barriers. Structured education and decision-support aids improve screening. These interventions, however, were insufficient to improve screening to a goal target of >90%.
Identifying GPCR-drug interaction based on wordbook learning from sequences
Authors: Wang Pu , Huang Xiaotong , Qiu Wangren , Xiao Xuan
Published: April 2020

Background

G protein-coupled receptors (GPCRs) mediate a variety of important physiological functions, are closely related to many diseases, and constitute the most important target family of modern drugs. Therefore, the research of GPCR analysis and GPCR ligand screening is the hotspot of new drug development. Accurately identifying the GPCR-drug interaction is one of the key steps for designing GPCR-targeted drugs. However, it is prohibitively expensive to experimentally ascertain the interaction of GPCR-drug pairs on a large scale. Therefore, it is of great significance to predict the interaction of GPCR-drug pairs directly from the molecular sequences. With the accumulation of known GPCR-drug interaction data, it is feasible to develop sequence-based machine learning models for query GPCR-drug pairs.

Results

In this paper, a new sequence-based method is proposed to identify GPCR-drug interactions. For GPCRs, we use a novel bag-of-words (BoW) model to extract sequence features, which can extract more pattern information from low-order to high-order and limit the feature space dimension. For drug molecules, we use discrete Fourier transform (DFT) to extract higher-order pattern information from the original molecular fingerprints. The feature vectors of two kinds of molecules are concatenated and input into a simple prediction engine distance-weighted K-nearest-neighbor (DWKNN). This basic method is easy to be enhanced through ensemble learning. Through testing on recently constructed GPCR-drug interaction datasets, it is found that the proposed methods are better than the existing sequence-based machine learning methods in generalization ability, even an unconventional method in which the prediction performance was further improved by post-processing procedure (PPP).

Conclusions

The proposed methods are effective for GPCR-drug interaction prediction, and may also be potential methods for other target-drug interaction prediction, or protein-protein interaction prediction. In addition, the new proposed feature extraction method for GPCR sequences is the modified version of the traditional BoW model and may be useful to solve problems of protein classification or attribute prediction. The source code of the proposed methods is freely available for academic research at https://github.com/wp3751/GPCR-Drug-Interaction.
Genome-wide genetic structure and selection signatures for color in 10 traditional Chinese yellow-feathered chicken breeds
Authors: Huang Xunhe , Otecko Newton O. , Peng Minsheng , Weng Zhuoxian , Li Weina , Chen Jiebo , Zhong Ming , Zhong Fusheng , Jin Sihua , Geng Zhaoyu , Luo Wei , He Danlin , Ma Cheng , Han Jianlin , Ommeh Sheila C. , Zhang Yaping , Zhang Xiquan , Du Bingwang
Published: April 2020

Background

Yellow-feathered chickens (YFCs) have a long history in China. They are well-known for the nutritional and commercial importance attributable to their yellow color phenotype. Currently, there is a huge paucity in knowledge of the genetic determinants responsible for phenotypic and biochemical properties of these iconic chickens. This study aimed to uncover the genetic structure and the molecular underpinnings of the YFCs trademark coloration.

Results

The whole-genomes of 100 YFCs from 10 major traditional breeds and 10 Huaibei partridge chickens from China were re-sequenced. Comparative population genomics based on autosomal single nucleotide polymorphisms (SNPs) revealed three geographically based clusters among the YFCs. Compared to other Chinese indigenous chicken genomes incorporated from previous studies, a closer genetic proximity within YFC breeds than between YFC breeds and other chicken populations is evident. Through genome-wide scans for selective sweeps, we identified RALY heterogeneous nuclear ribonucleoprotein (RALY), leucine rich repeat containing G protein-coupled receptor 4 (LGR4), solute carrier family 23 member 2 (SLC23A2), and solute carrier family 2 member 14 (SLC2A14), besides the classical beta-carotene dioxygenase 2 (BCDO2), as major candidates pigment determining genes in the YFCs.

Conclusion

We provide the first comprehensive genomic data of the YFCs. Our analyses show phylogeographical patterns among the YFCs and potential candidate genes giving rise to the yellow color trait of the YFCs. This study lays the foundation for further research on the genome-phenotype cross-talks that define important poultry traits and for formulating genetic breeding and conservation strategies for the YFCs.
The erector spinae plane block causes only cutaneous sensory loss on ipsilateral posterior thorax: a prospective observational volunteer study
Authors: Zhang Jingxiong , He Yuting , Wang Shi , Chen Zhengjie , Zhang Yu , Gao Yuan , Wang Quanguang , Xia Yun , Papadimos Thomas J. , Zhou Riyong
Published: April 2020

Background

Ultrasound-guided erector spine plane (ESP) block is widely used in perioperative analgesia for back, chest and abdominal surgery. The extent and distribution of this block remain controversial. This study was performed to assess the analgesia range of an ultrasound-guided ESP block.

Methods

This prospective observational volunteer study consisted of 12 healthy volunteers. All volunteers received an erector spinae plane block at the left T5 transverse process using real-time ultrasound guidance. Measured the cutaneous sensory loss area (CSLA) and cutaneous sensory declination area (CSDA) using cold stimulation at different time points after blockade until its disappearance. The CSLA and CSDA were mapped and then calculated. The block range was described by spinous process level and lateral extension. The effective block duration for each volunteer was determined and recorded.

Results

The cold sensory loss concentrates at T6-T9. The decline concentrates primarily at T4-T11. The lateral diffusion of block to the left side did not cross the posterior axillary line, and reached the posterior median line on the right. The area of cutaneous sensory loss was (172 ± 57) cm2, and the area of cutaneous sensory decline was (414 ± 143) cm2. The duration of cutaneous sensory decline was (586 ± 28) minutes.

Conclusion

Ultrasound-guided erector spine plane block with 20 mL of 0. 5% ropivacaine provided a widespread cutaneous sensory block in the posterior thorax, but did not reach the anterior chest, lateral chest, or abdominal walls. The range of the blockade suggested that the dorsal branch of spinal nerve was blocked.

Trial registration

Chinese Clinical Trial Registry, CHiCTR1800014438. Registered 13 January 2018
Comparison of the new flexible tip bougie catheter and standard bougie stylet for tracheal intubation by anesthesiologists in different difficult airway scenarios: a randomized crossover trial
Authors: Ruetzler Kurt , Smereka Jacek , Abelairas-Gomez Cristian , Frass Michael , Dabrowski Marek , Bialka Szymon , Misiolek Hanna , Plusa Tadeusz , Robak Oliver , Aniolek Olga , Ladny Jerzy Robert , Gorczyca Damian , Ahuja Sanchit , Szarpak Lukasz
Published: April 2020

Background

Incidence of difficult endotracheal intubation ranges between 3 and 10%. Bougies have been recommended as an airway adjunct for difficult intubation, but reported success rates are variable. A new generation flexible tip bougie appears promising but was not investigated so far. We therefore compared the new flexible tip with a standard bougie in simulated normal and difficult airway scenarios, and used by experienced anesthesiologists.

Methods

We conducted a observational, randomized, cross-over simulation study. Following standardized training, experienced anesthesiologists performed endotracheal intubation using a Macintosh blade and one of the bougies in six different airway scenarios in a randomized sequence: normal airway, tongue edema, pharyngeal obstruction, manual cervical inline stabilization, cervical collar stabilization, cervical collar stabilization and pharyngeal obstruction.Overall success rate with a maximum of 3 intubation attempts was the primary endpoint. Secondary endpoints included number of intubation attempts, time to intubation and dental compression.

Results

Thirty-two anesthesiologist participated in this study between January 2019 and May 2019. Overall success rate was similar for the flexible tip bougie and the standard bougie. The flexible tip bougie tended to need less intubation attempts in more difficult airway scenarios. Time to intubation was less if using the flexible tip bougie compared to the standard bougie. Reduced severity of dental compression was noted for the flexible tip bougie in difficult airway scenarios except cervical collar stabilization.

Conclusion

In this simulation study of normal and difficult airways scenarios, overall success rate was similar for the flexible tip and standard bougie. Especially in more difficult airway scenarios, less intubation attempts, and less optimization maneuvers were needed if using the flexible tip bougie.

Trial registration

clinicaltrials.gov Identifier:NCT03733158. 7th November 2018.
Pseudoanginal chest pain associated with vagal nerve stimulation: a case report
Authors: Nichols James B. , McCallum Abigail P. , Khattar Nicolas K. , Wei George Z. , Gopinathannair Rakesh , Nauta Haring J. W. , Neimat Joseph S.
Published: April 2020

Background

Vagal nerve stimulation (VNS) can be an effective therapy for patients with epilepsy refractory to anti-epileptic drugs or intracranial surgery. While generally well tolerated, it has been associated with laryngospasm, hoarseness, coughing, dyspnea, throat and atypical chest pain, cardiac symptoms such as bradycardia and occasionally asystole. We report on a patient receiving vagal nerve stimulation who experienced severe typical anginal chest pain during VNS firing without any evidence of cardiac ischemia or dysfunction. Thus, the pain appeared to be neuropathic from the stimulation itself rather than nociceptive secondary to an effect on heart function.

Case presentation

A 29-year-old man, with a history of intractable frontal lobe epilepsy refractory to seven anti-epileptic medications and subsequent intracranial surgery, underwent VNS implantation without complications. On beginning stimulation, he began to have intermittent chest pain that corresponded temporally to his intermittent VNS firing. The description of his pain was pathognomonic of ischemic cardiac chest pain. On initial evaluation, he displayed Levine’s sign and reported crushing substernal chest pain radiating to the left arm, as well as shortness of breath walking upstairs that improved with rest. He underwent an extensive cardiac workup, including 12-lead ECG, cardiac stress test, echocardiogram, 12-day ambulatory cardiac monitoring, and continuous ECG monitoring each with and without stimulation of his device. The workup was consistently negative. Inability to resolve the pain necessitated the disabling and eventual removal of the device.

Conclusion

To our knowledge, this is the first report of pseudoanginal chest pain associated with VNS. This occurrence prompted our review of the mechanisms of cardiac chest pain and suggests that vagal afferents may convey anginal pain separately or in parallel with known spinal cord pain mechanisms. These insights into the physiology of chest pain may be of general interest and important to surgeons implanting VNS devices who may potentially encounter such symptoms.
Parental knowledge and attitudes to childhood hearing loss and hearing services in Qassim, Saudi Arabia
Authors: Alsudays Ali Mohammed , Alharbi Abdulmajeed Abdullah , Althunayyan Faris Saleh , Alsudays Abdulrahman Abdullah , Alanazy Sultan Mohammed , Al-Wutay Osama , Alenezi Mazyad Marji
Published: April 2020

Background

Successful audiology service delivery depends on support from the community, and agreement to utilize hearing healthcare programs. Assessment of parents’ awareness regarding hearing loss (HL) and audiology services is necessary for the development of suitable hearing programs for children. Previous studies reported that early detection and intervention for hearing problems are typically strongly supported by parents. The current study sought to evaluate parents’ knowledge and attitudes regarding childhood HL and hearing services.

Methods

A cross-sectional study conducted at five centers in Qassim region of Saudi Arabia. A self-report questionnaire was administered to collect demographic data in addition to 31 questions regarding the knowledge and attitudes of parents toward HL. IBM SPSS Statistics for Windows, Version 21 was used for data analysis. A p-value cut-off point of 0.05 at 95% CI was used to determine statistical significance. The analyses examined the association between socio-demographic characteristics and knowledge and attitudes toward HL using chi-square tests.

Results

Overall, participants included in this study were 243 participants. Of these, 105 (43.2%) were fathers, and 138 (56.8%) were mothers. Ages ranged from 21 to 60+ years. Assessment of the prevalence of various aspects of knowledge and attitudes among parents toward childhood HL revealed that 103 participants (42.4%) possessed good knowledge, while 140 participants (57.6%) possessed poor knowledge. In contrast, the attitude analysis revealed that 224 participants (92.2%) expressed positive attitudes, while only 19 participants (07.8%) showed a negative attitude regarding audiology services. We found a significant association between age group and knowledge (p = 0.002).

Conclusion

Most parents in our sample possessed poor knowledge regarding childhood HL. However, most parents expressed positive attitudes regarding audiology services. The current findings suggest a need to increase awareness among parents regarding childhood HL.
How an electronic health record became a real-world research resource: comparison between London’s Whole Systems Integrated Care database and the Clinical Practice Research Datalink
Authors: Bottle Alex , Cohen Carole , Lucas Amanda , Saravanakumar Kavitha , Ul-Haq Zia , Smith Wayne , Majeed Azeem , Aylin Paul
Published: April 2020

Background

In the UK, several initiatives have resulted in the creation of local data warehouses of electronic patient records. Originally developed for commissioning and direct patient care, they are potentially useful for research, but little is known about them outside their home area. We describe one such local warehouse, the Whole Systems Integrated Care (WSIC) database in NW London, and its potential for research as the “Discover” platform. We compare Discover with the Clinical Practice Research Datalink (CPRD), a popular UK research database also based on linked primary care records.

Methods

We describe the key features of the Discover database, including scope, architecture and governance; descriptive analyses compare the population demographics and chronic disease prevalences with those in CPRD.

Results

As of June 2019, Discover held records for a total of 2.3 million currently registered patients, or 95% of the NW London population; CPRD held records for over 11 million. The Discover population matches the overall age-sex distribution of the UK and CPRD but is more ethnically diverse. Most Discover chronic disease prevalences were comparable to the national rates. Unlike CPRD, Discover has identifiable care organisations and postcodes, allowing mapping and linkage to healthcare provider variables such as staffing, and includes contacts with social, community and mental health care. Discover also includes a consent-to-contact register of over 3000 volunteers to date for prospective studies.

Conclusions

Like CPRD, Discover has been a number of years in the making, is a valuable research tool, and can serve as a model for other areas developing similar data warehouses.
Islet-expressed circular RNAs are associated with type 2 diabetes status in human primary islets and in peripheral blood
Authors: Haque Shahnaz , Ames Ryan M. , Moore Karen , Lee Benjamin P. , Jeffery Nicola , Harries Lorna W.
Published: April 2020

Background

Circular RNAs are non-coding RNA molecules with gene regulatory potential that have been associated with several human diseases. They are stable and present in the circulation, making them excellent candidates for biomarkers of disease. Despite their promise as biomarkers or future therapeutic targets, information on their expression and functionality in human pancreatic islets is a relatively unexplored subject.

Methods

Here we aimed to produce an enriched circRNAome profile for human pancreatic islets by CircleSeq, and to explore the relationship between circRNA expression, diabetes status, genotype at T2D risk loci and measures of glycaemia (insulin secretory index; SI and HbA1c) in human islet preparations from healthy control donors and donors with type 2 diabetes using ANOVA or linear regression as appropriate. We also assessed the effect of elevated glucose, cytokine and lipid and hypoxia on circRNA expression in the human beta cell line EndoC-βH1.

Results

We identified over 2600 circRNAs present in human islets. Of the five most abundant circRNAs in human islets, four (circCIRBP, circZKSCAN, circRPH3AL and circCAMSAP1) demonstrated marked associations with diabetes status. CircCIRBP demonstrated an association with insulin secretory index in isolated human islets and circCIRBP and circRPH3AL displayed altered expression with elevated fatty acid in treated EndoC-βH1 cells. CircCAMSAP1 was also noted to be associated with T2D status in human peripheral blood. No associations between circRNA expression and genotype at T2D risk loci were identified in our samples.

Conclusions

Our data suggest that circRNAs are abundantly expressed in human islets, and that some are differentially regulated in the islets of donors with type 2 diabetes. Some islet circRNAs are also expressed in peripheral blood and the expression of one, circCAMSAP1, correlates with diabetes status. These findings highlight the potential of circRNAs as biomarkers for T2D.
Long-term expansion of directly reprogrammed keratinocyte-like cells and in vitro reconstitution of human skin
Authors: Zheng Jie , Yun Wonjin , Park Junghyun , Kang Phil Jun , Lee Gilju , Song Gwonhwa , Kim In Yong , You Seungkwon
Published: April 2020

Background

Human keratinocytes and derived products are crucial for skin repair and regeneration. Despite substantial advances in engineered skin equivalents, their poor availability and immunorejection remain major challenges in skin grafting.

Methods

Induced keratinocyte-like cells (iKCs) were directly reprogrammed from human urine cells by retroviral transduction of two lineage-specific transcription factors BMI1 and △NP63α (BN). Expression of keratinocyte stem cell or their differentiation markers were assessed by PCR, immunofluorescence and RNA-Sequencing. Regeneration capacity of iKCs were assessed by reconstitution of a human skin equivalent under air-interface condition.

Results

BN-driven iKCs were similar to primary keratinocytes (pKCs) in terms of their morphology, protein expression, differentiation potential, and global gene expression. Moreover, BN-iKCs self-assembled to form stratified skin equivalents in vitro.

Conclusions

This study demonstrated an approach to generate human iKCs that could be directly reprogrammed from human somatic cells and extensively expanded in serum- and feeder cell-free systems, which will facilitate their broad applicability in an efficient and patient-specific manner.
Distance sampling for epidemiology: an interactive tool for estimating under-reporting of cases from clinic data
Authors: Nelli Luca , Guelbeogo Moussa , Ferguson Heather M. , Ouattara Daouda , Tiono Alfred , N’Fale Sagnon , Matthiopoulos Jason
Published: April 2020

Background

Distance sampling methods are widely used in ecology to estimate and map the abundance of animal and plant populations from spatial survey data. The key underlying concept in distance sampling is the detection function, the probability of detecting the occurrence of an event as a function of its distance from the observer, as well as other covariates that may influence detection. In epidemiology, the burden and distribution of infectious disease is often inferred from cases that are reported at clinics and hospitals. In areas with few public health facilities and low accessibility, the probability of detecting a case is also a function of the distance between an infected person and the “observer” (e.g. a health centre). While the problem of distance-related under-reporting is acknowledged in public health; there are few quantitative methods for assessing and correcting for this bias when mapping disease incidence. Here, we develop a modified version of distance sampling for prediction of infectious disease incidence by relaxing some of the framework’s fundamental assumptions. We illustrate the utility of this approach using as our example malaria distribution in rural Burkina Faso, where there is a large population at risk but relatively low accessibility of health facilities.

Results

The modified distance-sampling framework was used to predict the probability of reporting malaria infection at 8 rural clinics, based on road-travel distances from villages. The rate at which reporting probability dropped with distance varied between clinics, depending on road and clinic positions. The probability of case detection was estimated as 0.3–1 in the immediate vicinity of the clinic, dropping to 0.1–0.6 at a travel distance of 10 km, and effectively zero at distances > 30–40 km.

Conclusions

To enhance the method’s strategic impact, we provide an interactive mapping tool (as a self-contained R Shiny app) that can be used by non-specialists to interrogate model outputs and visualize how the overall probability of under-reporting and the catchment area of each clinic is influenced by changing the number and spatial allocation of health centres.
Protection of the transplant kidney during cold perfusion with doxycycline: proteomic analysis in a rat model
Authors: Moser Michael A. J. , Sawicka Katherine , Sawicka Jolanta , Franczak Aleksandra , Cohen Alejandro , Bil-Lula Iwona , Sawicki Grzegorz
Published: April 2020

Background

It has been previously shown that doxycycline (Doxy) protects the kidney from preservation injury by inhibition of matrix metalloproteinase. However, the precise molecular mechanism involved in this protection from injury is not known. We used a pharmaco-proteomics approach to identify potential molecular targets associated with kidney preservation injury.

Methods

Rat kidneys were cold perfused with or without doxycycline (Doxy) for 22 h. Kidneys perfusates were analyzed for the presence of injury markers such as lactate dehydrogenase (LDH), and neutrophil-gelatinase associated lipocalin (NGAL). Proteins extracted from kidney tissue were analyzed by 2-dimensional gel electrophoresis. Proteins of interest were identified by mass spectrometry.

Results

Triosephosphate isomerase, PGM, dihydropteridine reductase-2, pyridine nucleotide-disulfide oxidoreductase, phosphotriesterase-related protein, and aminoacylase-1A were not affected by cold perfusion. Perfusion with Doxy increased their levels. N(G),N(G)-dimethylarginine dimethylaminohydrolase and phosphoglycerate kinase 1 were decreased after cold perfusion. Perfusion with Doxy led to an increase in their levels.

Conclusions

This study revealed specific metabolic enzymes involved in preservation injury and in the mechanism whereby Doxy protects the kidney against injury during cold perfusion.
Clinical analysis of ultrasound-guided radiofrequency ablation for recurrent colorectal liver metastases after hepatectomy
Authors: Fan Xiao-xiang , Lv Shu-yi , Zhang Mei-wu , Dai Xiao-yu , Zhao Jian-pei , Mao Da-feng , Zhang Yan
Published: April 2020

Background

RFA is designed to produce localized tumor destruction by heating the tumor and surrounding liver tissue, especially suitable for patients who do not qualify for hepatic resection. Many studies have reported that RFA was inferior to hepatectomy in the treatment of recurrent colorectal liver metastases. However, strong evidence is lacking in the literature. This study aimed to investigate the effect and clinical outcome of percutaneous ultrasound-guided RFA and repeat hepatic resection for recurrent colorectal liver metastases after hepatectomy.

Methods

From January 2007 to January 2014, 194 patients with recurrent colorectal liver metastases after hepatectomy diagnosed in our hospital was performed, and then divided into two groups based on different regimens: repeat hepatic resection group and RFA group. The clinical data of the two groups were analyzed. After treatment, the liver function-related indexes, complication rate, survival rate, and tumor recurrence of the two groups were recorded. The difference in short-term and long-term effects between repeat hepatic resection and RFA was identified by propensity score analysis.

Results

The number of metastases and the proportion of left and right lobe involved by tumor and preoperative chemotherapy in the RFA group were higher than those in the repeat hepatic resection group. The clinical data showed no significant difference between the two groups after using propensity score analysis. Compared with the RFA group, the liver function of the repeat hepatic resection group was significantly improved. After adjustment for potential confounders, no significant difference in liver function-related indexes was found between RFA and repeat hepatic resection, and the incidence of complications in the RFA group was lower. In survival analysis, there was no significant difference in OS and DFS between the two groups.

Conclusions

RFA is a safe and effective therapeutic option for patients with recurrent colorectal liver metastases after hepatectomy.
Hi-D: nanoscale mapping of nuclear dynamics in single living cells
Authors: Shaban Haitham A. , Barth Roman , Recoules Ludmila , Bystricky Kerstin
Published: April 2020

Bulk chromatin motion has not been analyzed at high resolution. We present Hi-D, a method to quantitatively map dynamics of chromatin and abundant nuclear proteins for every pixel simultaneously over the entire nucleus from fluorescence image series. Hi-D combines reconstruction of chromatin motion and classification of local diffusion processes by Bayesian inference. We show that DNA dynamics in the nuclear interior are spatially partitioned into 0.3–3-μm domains in a mosaic-like pattern, uncoupled from chromatin compaction. This pattern was remodeled in response to transcriptional activity. Hi-D can be applied to any dense and bulk structures opening new perspectives towards understanding motion of nuclear molecules.