bluuebunny/crossref_metadata_2025 huggingface dataset:
Using the theoretical domains framework to identify barriers and enabling factors to implementation of guidance for the diagnosis and management of nonalcoholic fatty liver disease: a qualitative study
Authors: Hallsworth Kate , Dombrowski Stephan U , McPherson Stuart , Anstee Quentin M , Avery Leah
Published: May 2019

Nonalcoholic fatty liver disease (NAFLD) is the most common liver condition worldwide and is steadily on the increase. In response, national and international guidance have been developed to standardize diagnosis and guide management of the condition. However, research has highlighted a discordance between published guidance and clinical practice. The purpose of this study is to identify barriers and enabling factors to implementation of guidance to inform the development of an intervention. We interviewed 21 health care professionals and 12 patients with NAFLD. Topic guides were developed with reference to national and international guidance. Data were content analyzed using the Theoretical Domains Framework. Beliefs about consequences and professional role and identity were the most prominent domains identified from health care professionals in the context of diagnosis and management of NAFLD. Environmental context and resources, memory, attention and decision processes, goals, behavioral regulation, knowledge, and skills emerged as important barriers/facilitators to implementation of guidance targeting management of NAFLD. Knowledge and beliefs about consequences were the most prominent domains from the perspective of patients. Social influences, environmental context and resources and behavioral regulation were most prominent in the context of NAFLD management. Guideline implementation can be improved by use of interventions that target standardized use of diagnostic criteria by health care professionals. Training of health care professionals was identified as important to improve care delivered to patients in order to effectively manage NAFLD. Interventions that target knowledge of patients, in particular, raising awareness that NAFLD can be progressive when not actively managed would facilitate implementation of guidance.
New Symptoms Identified in Phytoplasma-Infected Plants Reveal Extra Stages of Pathogen-Induced Meristem Fate-Derailment
Authors: Wei Wei , Davis Robert E. , Bauchan Gary R. , Zhao Yan
Published: May 2019

In flowering plants, the transition of a shoot apical meristem from vegetative to reproductive destiny is a graduated, multistage process that involves sequential conversion of the vegetative meristem to an inflorescence meristem, initiation of floral meristems, emergence of flower organ primordia, and formation of floral organs. This orderly process can be derailed by phytoplasma, a bacterium that parasitizes phloem sieve cells. In a previous study, we showed that phytoplasma-induced malformation of flowers reflects stage-specific derailment of shoot apical meristems from their genetically preprogrammed reproductive destiny. Our current study unveiled new symptoms of abnormal morphogenesis, pointing to derailment of meristem transition at additional stages previously unidentified. We also found that the fate of developing meristems may be derailed even after normal termination of the floral meristem and onset of seed production. Although previous reports by others have indicated that different symptoms may be induced by different phytoplasmal effectors, the phenomenon observed in our experiment raises interesting questions as to (i) whether effectors can act at specific stages of meristem transition and (ii) whether specific floral abnormalities are attributable to meristem fate-derailment events triggered by different effectors that each act at a specific stage in meristem transition. Research addressing such questions may lead to discoveries of an array of phytoplasmal effectors.
Morphological and Molecular Identification of Two Florida Populations of Foliar Nematodes (Aphelenchoidesspp.) Isolated From Strawberry With the Description ofAphelenchoides pseudogoodeyisp. n. (Nematoda: Aphelenchoididae) and Notes on Their Bionomics
Authors: Oliveira Clemen J. , Subbotin Sergei A. , Álvarez-Ortega Sergio , Desaeger Johan , Brito Janete A. , Xavier Katia V. , Freitas Leandro G. , Vau Silvia , Inserra Renato N.
Published: May 2019

Two Florida populations of foliar nematodes were collected from strawberries originating from Cashiers, North Carolina (USA) located west from Willard, the type locality of Aphelenchoides besseyi. Both nematodes were cultured on Monilinia fructicola and identified using morphological characteristics and molecular assays as Aphelenchoides besseyi and Aphelenchoides pseudogoodeyi sp. n., a herein described new species related to Aphelenchoides goodeyi belonging to the Group of Aphelenchoides exhibiting stellate tails. The morphological and biological characters of Florida A. besseyi fit those of the original description of this species. A. pseudogoodeyi sp. n., which was initially misidentified as Aphelenchoides fujianensis, differed from the type population of the latter species from China because it was without males, and females lacked a functional spermatheca, whereas type A. fujianensis is an amphimictic species. Phylogenetic analyses using near full-length 18S ribosomal RNA (rRNA), the D2-D3 expansion fragments of 28S rRNA, and partial COI gene sequences indicated that A. besseyi is a species complex. A. pseudogoodeyi sp. n. grouped in different clades from those of the type A. fujianensis, instead merging with populations identified of ‘A. fujianensis’ from Brazil and other countries, suggesting that the latter are conspecific and incorrectly identified. The Florida A. besseyi infected strawberry and gerbera daisy, but not soybean and alfalfa. A. pseudogoodeyi sp. n. is mainly mycetophagous. Localized inoculation of 300 specimens applied with filter paper adhering to the blade of the soybean leaves resulted in nematode penetration into the mesophyll with subsequent development of lesions limited to the inoculated area of the blade.
Transcatheter aortic valve replacement
Authors: Karycki Melody K.
Published: May 2019

Transcatheter aortic valve replacement (TAVR) is indicated in some patients with severe aortic stenosis for whom surgical intervention is not deemed appropriate. This article explores when TAVR may be the preferred treatment option over surgical aortic valve replacement and discusses various prosthetic valve devices. The TAVR procedure, diagnostic screenings, complications, postoperative management, and nursing considerations are also outlined.
Estimated Thyroid Inhalation Doses Based on Body Surface Contamination Levels of Evacuees After the Fukushima Daiichi Nuclear Power Plant Accident
Authors: Ohba Takashi , Hasegawa Arifumi , Suzuki Gen
Published: May 2019

Doses of inhaled radionuclides received during evacuation might be correlated with amounts of those radionuclides on an evacuee’s body surface. The purpose of the present study was to estimate thyroid equivalent doses based on body surface contamination measured with a Geiger-Mueller survey meter on 2,087 evacuees from Tomioka, Okuma, Futaba, Naraha, Namie, Minamisoma, and other municipalities in Japan. The measurement value in cpm was translated into Bq cm−2 according to the radionuclide composition obtained by germanium gamma-spectrometry analyses of two persons’ clothing. Thyroid equivalent dose by inhalation was estimated by two-dimensional Monte Carlo simulation based on the distribution of body surface radionuclide concentration and a uniform distribution of deposition velocity. For evacuees exposed twice on 12 and 15 March, the mean, median, and 90th percentile of inhalation thyroid equivalent dose for 1-y-old children were 21.4 mSv, 4.7 mSv, and 40.1 mSv for the Namie group; 7.3 mSv, 5.1 mSv, and 14.8 mSv for the Minamisoma group; and 2.3 mSv, 0.5 mSv, and 4.0 mSv for the group comprising Tomioka, Okuma, Futaba, and Naraha. These estimates are smaller than estimates in the United Nations Scientific Committee on the Effects of Atomic Radiation 2013 report but closer to estimates based on direct thyroid 131I measurement or indirect estimates based on 134Cs measurements made with a whole-body counter under the assumption that the ratio of 131I to 134Cs is 3.8.
Cytogenetic Analysis After Temporary Residence in the Area of the Uncontrolled Ruthenium-106 Release in Russia in September 2017
Authors: Beinke C. , Wanke C. , Eder S. , Port M.
Published: May 2019

In September and October 2017, elevated atmospheric ruthenium contamination was measured in several European countries. The most probable origin of this release of radionuclides was reconstructed to be the Southern Ural region. During that time, five workers from a German company stayed up to 2 wk about 120 km from the Chelyabinsk region in Ekaterinburg, Russia. No clinical symptoms were reported during or after the suspected radiation exposure, and no internal contamination was found in whole-body measurements. However, to investigate radiation protection issues and to clarify the workers’ situation in order to reassure them, as they planned to continue working in Ekaterinburg, our laboratory was urgently requested by the company’s occupational physician to perform biodosimetry using dicentric analysis to determine if the workers have been exposed to radiation by incorporation of radionuclides. The workers’ dicentric yields have been compared to reference data of background frequencies in unexposed individuals, but, as it is not reasonable to quantify individual absorbed radiation doses from internalized beta emitters due to various confounding factors, individual dose estimation has not been performed. Dicentric frequencies for two workers differed significantly from the mean laboratory background level, which could have been induced by an exposure to incorporated radionuclides due to beta emissions by 106Ru or to gamma irradiation by the decay nuclide of 106Ru. However, the maximum absorbed radiation doses calculated for a resident in the 106Ru-contaminated area during that time does not correspond to the observed dicentric frequencies. It cannot be excluded that their dicentric frequencies were already elevated before September 2017, potentially induced by an earlier radiation exposure to diagnostic x rays or even by chance.
Radon Off-Gassing From Military Artifacts
Authors: Kelly David G. , Mumby Timothy
Published: May 2019

Military historical artifacts found in museum displays and storage locations were analyzed for their 226Ra and 222Rn progeny activities to determine the fraction of 222Rn lost to the environment. Gamma-ray spectroscopy using high-purity germanium detectors was used to determine 226Ra activity and infer 222Rn activity based on 214Pb and 214Bi. Analyses were conducted without affecting the structural integrity of the artifacts. 226Ra was measured directly after correction for solid angle and finite sample-detector distance. Although 222Rn can be similarly analyzed, the collection in charcoal of 222Rn off-gassed from the artifact after the establishment of secular equilibrium was preferable. 222Rn off-gassing rates vary greatly between the six devices studied, with a maximum off-gassing rate of 1,850 ± 50 Bq h−1. Large variations in off-gassing rate were also observed between an additional 30 nominally identical dials, with a mean and standard deviation of 7.7 ± 7.1 Bq h−1. The work is not predictive of airborne 222Rn activity within museums, where building size and ventilation are significant and unique to each location. However, the significant off-gassing rates and their large variation suggest that 222Rn activities may be elevated in enclosed locations, such as aircraft cockpits and storage facilities.
Effect of closed vacuum aspiration technique on lung collapse time in thoracoscopic anatomical segmentectomy
Authors: Zhang Zhenyang , Yang Chuangcai , Lin Jiangbo , Hong Junjie , Zhuang Yunyang , Kang Mingqiang
Published: May 2019

To investigate the effect of lung expansion and collapse method combined with closed vacuum aspiration technique on lung collapse time, reduce the waiting time of surgery.

Forty patients with pulmonary peripheral nodules under thoracoscopic anatomical segmentectomy were divided into 20 cases of natural collapse group and 20 cases of modified collapse group. The natural collapse group used the traditional natural collapse method, and the modified collapse group used a lung expansion and collapse method combined with closed vacuum aspiration technique to record the lung collapse time and compare them.

Thoracoscopic anatomical segmentectomy was successfully performed in both groups. The lung collapse time in the natural collapse group and the modified collapse group was 17.08 ± 1.35, 8.90 ± 0.39, respectively, P < .05.

The lung expansion and collapse method combined with closed vacuum aspiration technique can reduced the waiting time of lung collapse during thoracoscopic anatomical segmentectomy, and can processed the inter-segment boundary better, thereby reduced the waiting time of surgery.
Efficacy of ultrasound-guided percutaneous lavage for rotator cuff calcific tendinopathy
Authors: Zhang Tao , Duan Yanji , Chen Jing , Chen Xiao
Published: May 2019

Background:

Rotator cuff calcific tendinopathy (RCCT) is frequently diagnosed in patients with shoulder pain, but there is no consensus on its treatment such as rest, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, subacromial corticosteroid injection (SAI), extracorporeal shock wave therapy (ESWT), and ultrasound-guided percutaneous lavage (UGPL). The aim of the study was to compare the effectiveness of UGPL with other techniques in the treatment of RCCT.

Methods:

Literature searches of PubMed, EMBASE, OVID, Cochrane Library, Web of Science, Chinese Biomedical Literature, Wanfang, Weipu Journal, and CNKI databases were performed up to August 2018. Only randomized controlled trials (RCTs) comparing UGPL vs other methods for RCCT were included. Data collection and extraction, quality assessment, and data analyses were performed according to the Cochrane standards.

Results:

Eight RCTs were included with 617 cases in all. The result of meta-analysis showed that: there were significant differences between the UGPL and ESWT group in 12-month follow-up VAS, constant shoulder score (CSS), the average particle size of the calcium deposition, and the calcification disappearance rate. However, there was no significant difference in complication between 2 groups.

Conclusion:

The present meta-analysis indicates that UGPL has certain clinical effect for calcifying tendinitis of rotator cuff. Compared with ESWT, UGPL may be superior in clinical pain relief and calcification clearance. However, owing to the limited quality and quantity of the included studies, additional high-quality RCTs are needed to confirm these findings.
Comparison among cryoablation, radiofrequency ablation, and partial nephrectomy for renal cell carcinomas sized smaller than 2 cm or sized 2–4 cm
Authors: Yan Shuai , Yang Wei , Zhu Cheng-mei , Yan Pei-meng , Wang Zhi-chao
Published: May 2019

This study aimed to compare radiofrequency ablation (RFA), cryoablation (CRA), and partial nephrectomy (PN) for renal cell carcinoma (RCC) sized ≤2 cm or 2 to 4 cm.

The Surveillance, Epidemiology, and End Results (SEER) database was used to identify 17,234 patients diagnosed with T1aN0M0 RCC from 2004 to 2015. Overall survival (OS) and cancer-specific survival (CSS) were compared among patients who were treated using PN, CRA, or RFA. The Cox proportional hazards model was used to determine prognostic factors for survival.

In patients with RCCs sized 2 to 4 cm, better OS and CSS were observed with PN than with CRA or RFA. On multivariable analysis, compared to PN, CRA and RFA were independently associated with poor OS and CSS in patients with RCCs sized 2 to 4 cm. In patients with RCCs sized ≤2 cm, better OS was observed with PN than with CRA or RFA; however, CSS was similar. On multivariable analysis, compared to PN, RFA was independently associated with poor OS in patients with RCCs sized ≤2 cm.

CRA or RFA should not be recommended for patients with RCCs sized 2 to 4 cm; PN is an effective treatment modality in these patients. For patients with RCCs sized ≤2 cm, CRA can be an equally effective alternative to PN.
Drug-coated balloon versus drug-eluting stent in de novo small coronary vessel disease
Authors: Li Min , Guo Chen , Lv Yong-Hui , Zhang Ming-Bo , Wang Zhi-Lu
Published: May 2019

Background:

Drug-coated balloon as a novel therapeutic strategy has been used to treat restenosis in cases of bare metal and drug-eluting stents. However, evidence of its safety and efficacy is scarce in de novo small coronary artery vessel disease. This meta-analysis aimed to compare the safety and efficacy of the drug-coated balloon and the drug-eluting stent.

Methods:

The PubMed, EMBASE, Web of Science, and Cochrane library databases were searched for studies published up to October 17, 2018. Studies comparing the drug-coated balloon with the drug-eluting stent strategy in patients with de novo small coronary artery vessel disease (reference diameter, <3 mm) were identified. The clinical outcomes were nonfatal myocardial infarction, cardiac death, all-cause death, target lesion revascularization, and target-vessel revascularization. Data were analyzed using the statistical software RevMan (version 5.3). Fixed effects models were performed to calculate the pooled odds ratios (ORs) and 95% confidence intervals (95% CIs). Sensitivity analyses were used to detect potential sources of heterogeneity, while subgroup analyses were implemented to assess the differential effects.

Results:

Three randomized controlled trials and 3 nonrandomized controlled studies were identified. Six studies including a total of 1800 patients compared the differences between the drug-coated balloon and the drug-eluting stent strategies in patients with de novo small coronary artery vessel disease. The results indicated that the drug-coated balloon strategy was associated with a significant reduction in nonfatal myocardial infarction (OR 0.53, 95% CI 0.31–0.90, P = .02) compared with the drug-eluting stent strategy, while insignificant inter-strategy differences were observed in cardiac death (OR 1.56, 95% CI 0.73–3.33, P = .25), all-cause death (OR 0.56, 95% CI 0.25–1.23, P = .15), target lesion revascularization (OR 1.24, 95% CI 0.73–2.1, P = .43), and target-vessel revascularization (OR 0.95, 95% CI 0.59–1.52, P = .84).

Conclusions:

This meta-analysis suggests that the drug-coated balloon strategy is noninferior to the drug-eluting stent strategy, delivering a good outcome in nonfatal myocardial infarction, and can be recommended as an optimal treatment strategy in patients with de novo small coronary artery vessel disease. Larger randomized controlled studies with longer follow-up periods are needed to further confirm the benefits of the drug-coated balloon strategy.
High/positive expression of ERCC1 predicts poor treatment response and survival prognosis in nasopharyngeal carcinoma
Authors: Yang Lin , Wei Wenjie , Zhou Lei , Wang Jing , Hu Guangyuan
Published: May 2019

Background:

Excision repair cross-complementation group 1 (ERCC1) protein is a member of the nucleotide excision repair (NER) system, which plays an important role in DNA damage repair. Recently, its predictive and prognostic value in nasopharyngeal carcinoma (NPC) has been investigated by several studies. However, their results remain controversial.

Objectives:

In an attempt to address this issue, we conducted the present comprehensive meta-analysis.

Data sources:

Studies published until November 2017 were searched. Finally, total 21 literatures involving 22 cohorts and 2921 NPC patients fulfilled the inclusion criteria.

Results:

The pooled results showed that high/positive expression of ERCC1 predicted poor objective response rate (ORR) [odds ratio (OR) = 2.83; 95% confidence interval (CI) = 2.11–3.80;P <.001], overall survival (OS) [hazard ratio (HR) = 1.77; 95% CI = 1.48–2.12;P <.001], and disease-free survival (DFS) (HR = 1.60; 95% CI = 1.43–1.79;P <.001) in NPC. Low heterogeneity was detected among these studies (ORR:I2 = 0.0%,P = .776; DFS:I2 = 38.7%,P = .148; OS:I2 = 0.0%;P = .530). The results of sensitivity analyses and publication bias verified the reliability of our findings.

Conclusions:

This study suggested ERCC1 as a potential predictive and prognostic biomarker for the treatment response and survival prognosis of NPC patients.
Solitary fibrous tumor of the pineal region with delayed ectopic intracranial metastasis: A case report and review of the literature
Authors: Wang Yongjie , Zhang Jingying , Liu Qichang , Liu Fuyi , Zhu Xiangdong , Zhang Jianmin
Published: May 2019

Rationale:

Solitary fibrous tumors of central nervous system are rare spindle-cell mesenchymal tumors. Although most are benign in nature, malignant transformation and extracranial metastasis have been reported. Up to now, only one case of CSF dissemination was described. Here we described an extremely rare case of intracranial Solitary fibrous tumors arising from the pineal region with a delayed ectopic metastasis.

Patient concerns:

A 35-year-old female presented with double vision, memory disturbance and unsteady gait was referred to our center. MRI showed an irregular mass in the pineal region.

Diagnoses:

The patient was diagnosed as pineal tumor, with unknown pathology.

Interventions:

Gross total resection was achieved and the pathologic studies confirmed a solitary fibrous tumor. Thirty-nine months later local recurrence occurred and gamma-knife radiotherapy was offered. Seven months later, MRI found a metastasis in the left temporal lobe. Surgical resection was conducted and pathological analysis revealed changes in cell morphology, counts and Ki-67 level, confirmed the diagnosis of solitary fibrous tumor/hemangiopericytoma (WHO Grade III). The patient received post-operational radiotherapy.

Outcomes:

The patient was followed up for 7 months with no signs of recurrence.

Lessons:

Here, we report an extremely rare case of primary solitary fibrous tumor of pineal region with delayed intracranial ectopic metastasis, together with literature review of metastatic solitary fibrous tumors. Strict surveillance is strongly recommended, considering the malignant potential of this seemingly benign disease entity. Complete resection of the tumor is the treatment of first choice and radiotherapy might be an effective adjuvant therapy for high grade SFT/HPCs.
Opioid analgesics are the leading cause of adverse drug reactions in the obstetric population in South Korea
Authors: Choi Sae Kyung , Kim Yeon Hee , Kim Su Mi , Wie Jung Ha , Lee Dong-Gun , Kwon Ji Young , Song Jeong Hwa , Lee Su Jeong , Park In Yang
Published: May 2019

Medication use during pregnancy is gradually increasing; however, the safety of this practice remains largely unknown.

We investigated medications with the most adverse drug reactions (ADRs) among pregnant women and the clinical features of those medications.

Reports of ADRs among pregnant women were extracted from the Korea Adverse Events Reporting System (January 2012–December 2015). We analyzed the data of drugs frequently reported to cause ADRs and their clinical features among 3 age groups.

A total of 5642 ADRs among 3428 patients were analyzed. The number of ADR reports increased annually. The most common drug categories causing ADRs were analgesics, followed by gynecologic, uterotocolytic, anti-infective, antidiabetic, analgesic, and antihypertensive drugs. Analgesics comprised 6 opioids (morphine, fentanyl, hydromorphone, oxycodone, tramadol, pethidine) and an anti-pyretics (nefopam and ketorolac). As an individual drug, ritodrine (24.4%) was the most frequently reported, followed by morphine, 5-HT3 serotonin antagonist, nefopam, fentanyl, magnesium sulfate, insulin lispro, cefazedone, sodium chloride, hydromorphone, oxycodone, cefotetan, nifedipine, human insulin, tramadol, ketorolac, pethidine, methylergometrine, metoclopramide, and misoprostol (in that order). ADRs most frequently occurred in women aged 25 to 34 years, and the trend of ADR with the 20 most commonly reported medications significantly differed among the age groups (P = .011). In addition, the kind of common causative drugs was different among the age groups.

Knowledge of medications and clinical conditions resulting in the highest ADR rates among pregnant women is necessary for medical practitioners to administer proper care.
Which is the optimal adjuvant chemotherapy for resected pancreatic ductal adenocarcinoma?
Authors: Hu Qiancheng , Wang Xin , Chen Ye , Li Xiaofen , Cao Peng , Cao Dan
Published: May 2019

Background:

Although adjuvant chemotherapy has been shown to reduce relapse and prolong survival after surgery, it is still unclear which adjuvant chemotherapy regimen will be favorable over the all adjuvant treatments evaluated for patients with resected pancreatic ductal adenocarcinoma.

Methods:

PubMed, Embase (Ovid version), Cochrane Library, the American Society of Clinical Oncology, and ClinicalTrials.gov database will be searched from their inception to January 19, 2019. We will include studies that contain adjuvant chemotherapy following surgery in patients with pancreatic ductal adenocarcinoma. The outcomes are overall survival, disease-free survival, and grade 3–4 hematological and nonhematological toxicity. The risk of bias for each randomized controlled trial will be assessed as low, moderate, or high using Cochrane Collaboration's tool independently. Pairwise and network meta-analysis will be performed using STATA 13.0, GeMTC, and WinBUGS, respectively. The competing adjuvant chemotherapy regimens will be ranked by an advantage index.

Results:

The study is ongoing and the results will be submitted to a peer-reviewed journal for publication.

Conclusion:

This network meta-analysis will systematically provide suggestions to select optimum adjuvant treatment for clinical practice in the future.

PROSPERO registration number: CRD42019123907 (https://www.crd.york.ac.uk/PROSPERO/#searchadvanced).
Effects of pneumoperitoneum and steep Trendelenburg position on cerebral hemodynamics during robotic-assisted laparoscopic radical prostatectomy
Authors: Chen Ke , Wang Lizhen , Wang Qing , Liu Xuesheng , Lu Yao , Li Yuanhai , Wong Gordon Tin Chun
Published: May 2019

Background:

We evaluated the relationship between ultrasonographical acquired parameters and short-term postoperative cognitive function in patients undergoing robotic-assisted radical prostatectomy (RALP).

Methods:

Ninety elderly patients scheduled for RALP had their optic nerve sheath diameter (ONSD), the cross-sectional area (CSA) of the internal jugular vein (IJV) and the IJV valve (IJVV) competency assessed by ultrasound. The patients were analyzed in 2 groups based on whether displayed IJVV incompetency (IJVVI). The 3 parameters were measured before anesthesia (T0), immediately after induction of general anesthesia (T1), 5 minutes after establishing pneumoperitoneum (T2), 5 minutes after placing the patient in the Trendelenburg position (T3), and 5 minutes after the release of the pneumoperitoneum in the supine position (T4). Regional cerebral tissue oxygen saturation (rSO2) was also measured by near-infrared spectroscopy intraoperatively. The Mini-Mental State Examination (MMSE) and Confusion Assessment Method (CAM) were performed the day before surgery and on postoperative days 1, 3, and 7.

Results:

We found that 52% of patients had evidence of IJVVI after being placed in the Trendelenburg position after pneumoperitoneum was established (T4). Patient with IJVVI showed a significant increase of ONSD and CSA at T1, T2, T3, T4 but there was no associated decrease in rSO2. MMSE scores were reduced at postoperative day 1 and the 7 patients that developed postoperative delirium came from Group IJVVI.

Conclusions:

Our observations suggest that elderly patients that show IJVVI after adequate positioning for RALP may develop elevated intracranial pressure as well as mildly compromised postoperative cognitive function in the short term.
KEGG-expressed genes and pathways in intervertebral disc degeneration
Authors: Mo Sen , Liu Chong , Chen Liyi , Ma Yuan , Liang Tuo , Xue Jiang , Zeng HaoPeng , Zhan Xinli
Published: May 2019

miRNAs and genes play significant roles in the etiology and pathogenesis of intervertebral disc degeneration (IDD). This study aimed to identify aberrantly expressed miRNAs, genes, and pathways in IDD through a comprehensive bioinformatics analysis.

Data of miRNAs expression microarrays (GSE63492) and genes microarrays (GSE23130) were obtained from GEO database. Similarly, aberrantly expressed miRNAs and genes were obtained using GEO2R. In addition, functional and enrichment analyses of selected miRNAs and genes were performed using the DAVID database. Meanwhile, protein–protein interaction (PPI) network was constructed using STRING, and then visualized in Cytoscape.

A total of 98 upregulated miRNAs were identified. They were enriched in biological processes of response to organelle, ion binding, cellular nitrogen compound metabolic process, biosynthetic process, small molecule metabolic process, cellular protein modification process, catabolic process, molecular function, neurotrophin TRK receptor signaling pathway, and protein complex. In addition, 1405 high expression protein genes were detected. It indicated enrichment in biological processes, such as translational initiation, nonsense-mediated decay, viral transcription, cell–cell adhesion, rRNA processing, translation, RP-dependent cotranslational protein targeting to membrane, nuclear-transcribed mRNA catabolic process, regulation of mRNA stability, and mRNA splicing via spliceosome and extracellular matrix organization. In addition, pathway analysis exhibited the common enrichment in focal adhesion, Hippo signaling pathway, ECM-receptor interaction, Wnt signaling pathway, PI3K-Akt signaling pathway, endocytosis, proteoglycans in cancer, and so on. The top 10 central genes of PPI network were POTEE, PPP2CA, RPL17, HSP90AA1, POTEF, RPL13A, ACTB, RPL18, RPS24, and HSPA1A.

In conclusion, our research proposed abnormally expressed miRNAs, genes, and pathways in IDD through bioinformatics methods, which may provide new insights into the pathogenesis of IDD. Thus, the Hub gene involving POTEE, PPP2CA, RPL17, HSP90AA1, POTEF, RPL13A, ACTB, RPL18, RPS24, and HSPA1A may be biomarkers for accurate diagnosis and treatment of IDD in the future.
Impact of Paediatric Versus Adult Care Setting on Health Care Utilization in Adolescents With Inflammatory Bowel Disease
Authors: Bottema Renske W.B. , de Vries Han , Houwen Roderick H.J. , van Rheenen Patrick F.
Published: May 2019

Objective:

Paediatric‐onset inflammatory bowel disease (IBD) is different from adult‐onset IBD with respect to disease severity and its effect on growth and development. Care of paediatric IBD patients in some countries is dispersed among paediatricians and adult care providers, which may result in different outcomes. This study aims to assess the effect of care setting (paediatric vs adult‐oriented) on health care utilization in adolescent IBD patients.

Methods:

This is a Dutch population‐based cohort study based on an insurance claims database covering 4.2 million insurees (approximately 25% of the Dutch population). We identified IBD patients ages 16 to 18 years and followed them until the age of 19 years or transfer to adult care, whichever came first. We categorized patients according to care setting: paediatric versus adult‐oriented. We defined outcomes as corticosteroid use, IBD‐related hospital admission, IBD‐related surgery, and biological use. We estimated Cox proportional hazards regression models to control for confounding by indication.

Results:

Among 626 patients, 380 (61%) were in paediatric and 246 (39%) in adult‐oriented care. In paediatric care, patients were less likely to be treated with corticosteroids (hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.52–0.99) or biologicals (HR 0.57, 95% CI 0.34–0.97), and had fewer IBD‐related hospital admissions (HR 0.58, 95% CI 0.37–0.92).

Conclusion:

In a large and representative community cohort of adolescents with IBD, treatment in paediatric care setting was associated with significantly lower steroid and biological use, without increase in hospital admissions. These results might be used to optimize clinical care for adolescents with IBD.
Exploring the Utility of Entrustable Professional Activities as a Framework to Enhance Nurse Practitioner Education
Authors: Anthamatten Angelina , Pfieffer Mary Lauren , Richmond Anna , Glassford Melissa
Published: May 2019

Background

Entrustable professional activities (EPAs) are used in medical education in the assessment of clinical competence, but consideration of EPAs in nurse practitioner (NP) education is emerging.

Problem

There are critical points in the NP educational trajectory when a student should demonstrate requisite knowledge and abilities. It can be challenging to assess and measure clinical proficiency in a way that can be clearly interpreted by students, faculty, and preceptors.

Approach

NP faculty reviewed a set of medical EPAs that were linked with physician competencies to determine if they related to national NP competency areas and learning activities in their curriculum.

Conclusions

Several NP competency areas (8 of 9) related to these EPAs, and the learning activities also related to multiple EPAs. Although further work would be needed to tailor EPAs to the NP role and link them specifically with NP competencies, EPAs may offer another valuable method for clinical evaluation of NP students.
Comparisons of the Incidence and Critical Risk Factors of Metabolic Syndrome in Patients With a Rheumatic Disease or Gout
Authors: Oh HyunSoo , Park JiSuk , Yoon YoungSub , Seo WhaSook
Published: May 2019

BACKGROUND:

Rheumatic disease and gout are particularly known to be associated with metabolic syndrome.

PURPOSE:

To compare incidence, physiological indices, and risk factors of metabolic syndrome in patients with rheumatic diseases or gout.

METHODS:

Data were collected from medical records of 220 patients with rheumatic disease or gout.

RESULTS:

The incidence rate and most physiological indices of metabolic syndrome (body mass index, blood pressure, serum triglyceride, and fasting blood glucose levels) were significantly higher in the gout group than in the rheumatic disease group. In terms of risk factors of metabolic syndrome, age, gender, and steroid use were significant in the rheumatic disease group, whereas smoking and gout duration were significant in the gout group.

CONCLUSIONS:

Men with a rheumatic disease taking steroids warrant additional attention regarding metabolic syndrome development. Special supports are also needed for people with gout who are smokers and who have suffered from gout for a longer duration.
Naloxegol
Authors: Dume Roberta , Shuman Michael
Published: May 2019

Opioid-induced constipation is a known side effect of long-term opioid therapy and may contribute to increased healthcare utilization. Common laxatives such as polyethylene glycol and bisacodyl are often selected as first-line agents. However, refractory constipation may persist despite the addition of a second agent. In such situations, alternate agents may be considered. The peripherally acting mu-opioid receptor antagonist naloxegol was approved in 2014 for management of opioid-induced constipation in adult patients with chronic noncancer pain. This agent is similar to the mu-opioid antagonist naloxone but selectively blocks opioid receptors in the periphery, thereby preventing constipation while avoiding any worsening of pain scores. Given that the medication undergoes hepatic metabolism, it is important to monitor liver function prior to initiation and assess for other medications, which may increase or decrease the levels of naloxegol, to determine whether adjustment in therapy may be required.
Evaluating the quality stability of black vinegar-based salad sauce during storage
Authors: Choi Minji , Jo Yunhee , Kim Narae , Bang Chaeeun , Byeon Changse , Lee Hyunsoo , Jin Yang-Ho , Jeong Yong-Jin , Kwon Joong-Ho
Published: May 2019

Microbiological and physicochemical qualities of salad sauce prepared with naturally fermented brown rice black vinegar and citrus juice were evaluated during storage at low (4℃) and room (20℃) temperature for 3 months. No bacteria and coliforms were identified in sterilized sauce samples (85℃, 20 min) stored for 3 months, which meets the requirements of the Korean Food Standard Code. The pH and titratable acidity increased significantly over 3 months of storage, 2.89-3.25 and 1.55-2.39%, respectively, but no deterioration was observed. The Hunter’s color yellowness (b value) of stored samples decreased significantly, leading to increments in the overall color difference (ΔE) with storage time. The viscosity did not significantly change during storage at low temperature for 3 months, and emulsion stability was also maintained at over 92% when stored for 3 months at low temperature. The peroxide and TBA values increased during storage but satisfied with the fatty-foods standard. Salad sauce sterilized at 85℃ for 20 min exhibited acceptable quality stability over 3 months at low temperature in terms of microbial levels, viscosity, emulsion stability, peroxide and TBA values, demonstrating its possible use in vinegar-based salad sauce.
Free radical scavenging and α-glucosidase inhibitory activities of the extracts of Dystaenia takesimana from Ulleung Island
Authors: Kim Jeong Hun , Jeong Gyeong Han , Jeong Yong-Ha , Kim Tae Hoon
Published: May 2019

In this study, we investigated the free radical scavenging and α-glucosidase inhibitory activities of an aqueous methanolic extract from Dystaenia takesimana sourced from Ulleungdo. Seventy percent of the methanolic extract from D. takesimana was further divided into n-hexane, EtOAc and n-BuOH fractions, which yielded four solvent-soluble portions, namely n-hexane-soluble, EtOAc-soluble, n-BuOH-soluble, and H2O residues. Antioxidant properties were evaluated using the common 1,1-diphenyl-2-picrylhydrazyl (DPPH) and 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS+) radicals scavenging assays, while the anti-diabetic efficacy of the D. takesimana extract and the solvent-soluble portions were tested using an α-glucosidase assay. All samples exhibited dose-dependent radical scavenging and α-glucosidase inhibitory activities. Among the tested extracts and solvent-soluble fractions, the EtOAc-soluble portion exhibited a much higher radical scavenging activity compared to the other solvent-soluble portions. α-Glucosidase inhibitory IC50 values of 55.5±0.4 and 229.3±2.3 μg/mL were determined for the n-hexane-soluble and EtOAc-soluble portions, respectively. These results suggest that the D. takesimana extract is a potential new source of natural antioxidants and anti-diabetic agents.
Abundance and diversity of resistomes differ between healthy human oral cavities and gut
Authors: Carr Victoria R. , Witherden Elizabeth , Lee Sunjae , Shoaie Saeed , Mullany Peter , Proctor Gordon B. , Gomez-Cabrero David , Moyes David L.
Published: May 2019

The global threat of the “antimicrobial resistance apocalypse” that has arisen in recent years has driven the use of high-throughput sequencing techniques to monitor the profile of resistance genes, known as the “resistome”, in microbial populations. The human oral cavity contains a poorly explored reservoir of these genes, and little is known about their abundance and diversity, or how their profile compares with antimicrobial resistance genes in the gut. Here we analyse the resistome profiles of 788 oral cavities worldwide and compare these profiles with paired stool samples from shotgun metagenomic data. We find country and body site-specific differences in the prevalence of antimicrobial resistance genes, classes and mechanisms in oral and stool samples. However, the abundance of these antimicrobial resistance classes do not correlate with antibiotic prescription rates. A greater similarity was found in interpersonal resistomes between the same body sites than intrapersonal resistomes across different body sites. Between individuals, the oral cavity contains the highest and lowest abundances of specific antimicrobial resistance genes, but a lower diversity of resistance genes compared to the gut, which is likely influenced by differences in microbial composition and exposure to antimicrobial selection pressures. Co-occurrence analysis shows contrasting ARG-species associations between saliva and stool samples. This is the first study to date that characterises the oral cavity resistome worldwide, identifying its distinctive signatures compared to the gut.Maintenance and persistence of antimicrobial resistance is likely to vary across different body sites. Thus, we highlight the importance of characterising the resistome across body sites to uncover the antimicrobial resistance potential in the human body.
Monitoring transgenic mosquitoes using wing measurements and I3S Classic
Authors: Vyas-Patel Nayna
Published: May 2019

Stress responses in insects can manifest as changes in size, shape and symmetry of the wings. Developing methods to measure and track such features could act as an early warning indicator of adverse events or, if all is well, provide assurance that field or laboratory colonies were fit, healthy and developing optimally. This is especially important in the case of newly developed transgenic insects, to assess morphology and as an indicator of their fitness. As body size and symmetry is known to be a significant correlate of fitness, the potential of transgenic insects is reflected in their phenotypic expression. Microsoft Paint and Photos as well as I3S Classic were used. The wings of transgenic mosquitoes DSM 1 & 2 were measured and compared to those of the parent population Anopheles gambiae G3. The right and left wings of both sexes were assessed to determine if they were symmetrical. Measurements indicated high wing symmetry in all the groups and sexes tested, indicating that the transgenic mosquitoes should be just as functional as their parents. The transgenic mosquitoes DSM 1 & 2 were found to be significantly larger in length and width than the parent population A. gambiae G3 and could be distinguished from the parent strain using I3S Classic software with 70 to 100% accuracy. I3S Classic ranked the correct sex of the test strain predominantly in the initial ranks indicating the differences in architecture of male and female wings. I3S Classic software was also used to assess wing symmetry. In keeping with the data from taking measurements, the software indicated that the wings were highly symmetrical, both the right and left wings of the correct strain were selected in the early first and second ranks in roughly equal measure. The importance of assessing the morphological characteristics of insects and of taking measurements during the investigative procedure was discussed.
Land Use Change Increases Wildlife Parasite Diversity in Anamalai Hills, Western Ghats, India
Authors: Chakraborty Debapriyo , Mahender Reddy D. , Tiwari Sunil , Umapathy Govindhaswamy
Published: May 2019

Anthropogenic landscape change such as land use change and habitat fragmentation are known to alter wildlife diversity. Since host and parasite diversities are strongly connected, landscape changes are also likely to change wildlife parasite diversity with implication for wildlife health. However, research linking anthropogenic landscape change and wildlife parasite diversity is limited, especially comparing effects of land use change and habitat fragmentation, which often cooccur but may affect parasite diversity substantially differently. Here, we assessed how anthropogenic land use change (presence of plantation, livestock foraging and human settlement) and habitat fragmentation may change the gastrointestinal parasite diversity of wild mammalian host species (n=23) in Anamalai hills, India. We found that presence of plantations, and potentially livestock, significantly increased parasite diversity due possibly to spillover of parasites from livestock to wildlife. However, effect of habitat fragmentation on parasite diversity was not significant. Together, our results showed how human activities may increase wildlife parasite diversity within human-dominated landscape and highlighted the complex pattern of parasite diversity distribution as a result of cooccurrence of multiple anthropogenic landscape changes.
Lighter compared to deeper isoflurane anaesthesia can affect recognition memory in male C57BL/6 mice
Authors: Ferreira Jorge M , Valentim Ana M
Published: May 2019

Concerns have been raised about how deeply patients are anaesthetized, and the effects that different depths of anaesthesia may have after recovery. In order to study the anaesthetic drugs per se, and to eliminate the effect of clinical variables, several animal studies have been published. Isoflurane induced transient deficits on spatial memory at low concentrations, affecting the hippocampus. However, the influence of different concentrations of isoflurane on non-spatial memory still needs clarification. Thus, our aim was to study the effects of different depths of anaesthesia (1% and 2% isoflurane) on a non-spatial memory task, the object recognition test, in C57BL/6 adult mice.

Twenty-eight 2-month-old C57BL/6 male mice were habituated to the test arena of the object recognition test for 10 min each day over 2 days before anaesthesia. Mice were then randomly allocated in different treatment groups: 1% or 2%, anaesthetized with 1% or 2% of isoflurane, respectively, for 1 h or the control group, which was not anaesthetised. Twenty-four hours after anaesthesia, the animals were placed in an arena with two identical objects and allowed to explore for 10 min-Sample Trial. One hour later, mice were allowed to explore the arena for 10 min in the presence of one of the objects presented in the previous trial (familiar object) and a novel object - Choice Trial. The time spent exploring each object was evaluated by a blinded analysis. The recognition of one object as familiar was detected based on a higher level of exploration of the novel object.

Animals that were anaesthetized previously with 2% isoflurane performed at control levels, indicating the recognition of a familiar object in the object recognition task; this contrasted with the results of the group that was anaesthetized with 1% isoflurane.

Lighter (1%) rather than deeper (2%) isoflurane anaesthesia may affect non-spatial memory in C57BL/6 male mice. Our results raise awareness of the need for careful consideration of the depth of anaesthesia used, especially the use of light isoflurane anaesthesia, which is often chosen to provide animal immobilization during non-invasive procedures.