bluuebunny/crossref_metadata_2025 huggingface dataset:
Serial prophylactic exchange blood transfusion in pregnant women with sickle cell disease (TAPS-2): study protocol for a randomised controlled feasibility trial
Authors: Oakley Laura L. , Awogbade Moji , Brien Sarah , Briley Annette , Chorozoglou Maria , Drasar Emma , Johns Jemma , Rhodes Elizabeth , Robinson Vicky , Seed Paul , Sharif Joseph , Singh Claire , Telfer Paul , Thompson Hilary , Watt-Coote Ingrid , Howard Jo , Oteng-Ntim Eugene
Published: April 2020

Background

Pregnancies in women with sickle cell disease (SCD) are associated with a higher risk of sickle and pregnancy complications. Limited options exist for treating SCD during pregnancy. Serial prophylactic exchange blood transfusion (SPEBT) has been shown to be effective in treating SCD outside pregnancy, but evidence is lacking regarding its use during pregnancy. The aim of this study is to assess the feasibility and acceptability of conducting a future phase 3 randomised controlled trial (RCT) to establish the clinical and cost effectiveness of SPEBT in pregnant women with SCD.

Methods

The study is an individually randomised, two-arm, feasibility trial with embedded qualitative and health economic studies. Fifty women, 18 years of age and older, with SCD and a singleton pregnancy at ≤ 18 weeks’ gestation will be recruited from six hospitals in England. Randomisation will be conducted using a secure online database and minimised by centre, SCD genotype and maternal age. Women allocated to the intervention arm will receive SPEBT commencing at ≤ 18 weeks’ gestation, performed using automated erythrocytapheresis every 6–10 weeks until the end of pregnancy, aiming to maintain HbS% or combined HbS/HbC% below 30%. Women in the standard care arm will only receive transfusion when clinically indicated. The primary outcome will be the recruitment rate. Additional endpoints include reasons for refusal to participate, attrition rate, protocol adherence, and maternal and neonatal outcomes. Women will be monitored throughout pregnancy to assess maternal, sickle, and foetal complications. Detailed information about adverse events (including hospital admission) and birth outcomes will be extracted from medical records and via interview at 6 weeks postpartum. An embedded qualitative study will consist of interviews with (a) 15–25 trial participants to assess experiences and acceptability, (b) 5–15 women who decline to participate to identify barriers to recruitment and (c) 15–20 clinical staff to explore fidelity and acceptability. A health economic study will inform a future cost effectiveness and cost-utility analysis.

Discussion

This feasibility study aims to rigorously evaluate SPEBT as a treatment for SCD in pregnancy and its impact on maternal and infant outcomes.

Trial registration

NIH registry (www.clinicaltrials.gov), registration number NCT03975894 (registered 05/06/19); ISRCTN (www.isrctn.com), registration number ISRCTN52684446 (retrospectively registered 02/08/19).
Stray dogs in Nepal have high prevalence of vector-borne pathogens: a molecular survey
Authors: Díaz-Regañón David , Agulla Beatriz , Piya Bidur , Fernández-Ruiz Natalia , Villaescusa Alejandra , García-Sancho Mercedes , Rodríguez-Franco Fernando , Sainz Ángel
Published: April 2020

Background

Population of stray dogs is significant in large cities of Nepal, such as Kathmandu. Most of stray dogs suffer a lack of basic health care. Considering the clinical relevance, the broad distribution and the lack of information of canine vector borne diseases (CVBD) in Nepal, the aim of this study was to evaluate the prevalence of different vector-borne pathogens (VBP) in stray dogs living in the metropolitan area of Kathmandu, and to assess different traits as possible risk factors.

Methods

A total of 70 canine blood samples from stray dogs attended at the Kathmandu Animal Treatment Centre during August 2017 were collected on filter paper (Flinders Technology Associates (FTA) cards). Data regarding signalment, clinical signs and epidemiological characteristics were recorded for each animal. Real-time polymerase chain reaction assays were performed for Leishmania spp., Ehrlichia spp./Anaplasma spp., Babesia spp./Theileria spp. and Hepatozoon canis.

Results

The overall prevalence detected was 31.43% for Hepatozoon canis, 31.43% for Anaplasma platys, 27.14% for Ehrlichia canis, 18.57% for Leishmania donovani species complex, 12.86% for isolates corresponding to Theileria spp., 12.86% for Babesia vogeli and 2.86% for B. gibsoni. A total of 81.43% of the dogs were positive to at least one of the VBP tested. Co-infections were detected in 41.43% of the dogs. Dogs positive to any of the VBP tested, and particularly to E. canis, were older than those that were negative.

Conclusions

To our knowledge, this is the first molecular detection of VBP in stray dogs from Kathmandu, Nepal. The high prevalence of VBP detected highlights the need to implement a surveillance programme and control strategies for these CVBD in the population of stray dogs in this area.
Rapid clearance of Borrelia burgdorferi from the blood circulation
Authors: Liang Liucun , Wang Jinyong , Schorter Lucas , Nguyen Trong Thu Phong , Fell Shari , Ulrich Sebastian , Straubinger Reinhard K.
Published: April 2020

Background

Borrelia burgdorferi is a tick-borne spirochete that causes Lyme borreliosis (LB). After an initial tick bite, it spreads from the deposition site in the dermis to distant tissues of the host. It is generally believed that this spirochete disseminates via the hematogenous route. Borrelia persica causes relapsing fever and is able to replicate in the blood stream. Currently the exact dissemination pathway of LB pathogens in the host is not known and controversially discussed.

Methods

In this study, we established a strict intravenous infection murine model using host-adapted spirochetes. Survival capacity and infectivity of host-adapted B. burgdorferi sensu stricto (Bbss) were compared to those of B. persica (Bp) after either intradermal (ID) injection into the dorsal skin of immunocompetent mice or strict intravenous (IV) inoculation via the jugular vein. By in vitro culture and PCR, viable spirochetes and their DNA load in peripheral blood were periodically monitored during a 49/50-day course post-injection, as well as in various tissue samples collected at day 49/50. Specific antibodies in individual plasma/serum samples were detected with serological methods.

Results

Regardless of ID or IV injection, DNA of Bp was present in blood samples up to day 24 post-challenge, while no Bbss was detectable in the blood circulation during the complete observation period. In contrast to the brain tropism of Bp, Bbss spirochetes were found in ear, skin, joint, bladder, and heart tissue samples of only ID-inoculated mice. All tested tissues collected from IV-challenged mice were negative for traces of Bbss. ELISA testing of serum samples showed that Bp induced gradually increasing antibody levels after ID or IV inoculation, while Bbss did so only after ID injection but not after IV inoculation.

Conclusions

This study allows us to draw the following conclusions: (i) Bp survives in the blood and disseminates to the host’s brain via the hematogenous route; and (ii) Bbss, in contrast, is cleared rapidly from the blood stream and is a tissue-bound spirochete.
Survival of Rickettsia conorii in artificially contaminated whole and leukoreduced canine blood units during the storage period
Authors: Lucchese Laura , Ravagnan Silvia , Da Rold Graziana , Toniolo Federica , Wurzburger Wendy , Mion Monica , Carminato Antonio , Fournier Pierre-Edouard , Capelli Gioia , Natale Alda , Vascellari Marta
Published: April 2020

Background

The ability of tick-borne agents to survive in stored blood bags is a key factor for their transmissibility by blood transfusion. The aim of this study was to evaluate the survival and potential infectivity ofRickettsia conorii(RC) in artificially contaminated canine whole blood (WB) and in leukoreduced whole blood (LR-WB) during the storage period.

Methods

RC was cultured on L929 cells. We used a one-week 25-cm2flask with 70–80% of L929 infected cells to prepare the bacterial inoculum by pelleting cells and suspending the pellet in the donors’ serum. We infected five 100 ml WB units with RC within 2 h from the collection and maintained it at room temperature for 4 h prior to refrigeration. We filtered 50 ml of each WB bag to obtain leukoreduced WB (LR-WB) at day 1 post-infection (dpi). We checked WB and LR-WB bags at 1, 4, 7, 14, 21, 28, 35 dpi for RC presence and viability through real-time PCR (rPCR) for DNA and mRNA, respectively, and by isolation. Identification of isolates was confirmed by indirect immunofluorescence and rPCRs.

Results

RC survived for the entire storage period in both whole and leukoreduced blood. All bags contained viable bacteria until 7 dpi; RC viability generally decreased over time, particularly in LR-WB bags where the isolation time was longer than in WB. Viable bacteria were still isolated at 35 dpi in 3 WB and 3 LR-WB.

Conclusions

Leukoreduction reduced but did not eliminate RC in infected units. The survival and infectivity of RC in canine blood during the storage period may represent a threat for recipients.
Monitoring Leishmania infection and exposure to Phlebotomus perniciosus using minimal and non-invasive canine samples
Authors: Maia Carla , Cristóvão José , Pereira André , Kostalova Tatiana , Lestinova Tereza , Sumova Petra , Volf Petr , Campino Lenea
Published: April 2020

Background

In endemic areas of zoonotic leishmaniosis caused by L. infantum, early detection of Leishmania infection in dogs is essential to control the dissemination of the parasite to humans. The aim of this study was to evaluate the serological and/or molecular diagnostic performance of minimally and non-invasive samples (conjunctiva cells (CS) and peripheral blood (PB)) for monitoring Leishmania infection/exposure to Phlebotomus perniciosus salivary antigens in dogs at the beginning and the end of sand fly seasonal activity (May and October, respectively) and to assess associated risks factors.

Methods

A total of 208 sheltered dogs from endemic areas of leishmaniosis were screened. Leishmania DNA detection in PB on filter paper and CS was performed by nested-PCR (nPCR), while the detection of anti-Leishmania antibodies was performed using IFAT and ELISA. The exposure to P. perniciosus salivary antigens (SGH, rSP01 and rSP03B + rSP01) was measured by ELISA.

Results

Ninety-seven (46.6%) and 116 (55.8%) of the 208 dogs were positive to Leishmania antibodies or DNA by at least one test at the beginning and end of the sand fly season, respectively. IFAT and ELISA presented a substantial agreement in the serodiagnosis of leishmaniosis. Discrepant PB nPCR results were obtained between sampling points. Leishmania DNA was detected in CS of 72 dogs at the end of the phlebotomine season. The presence of antibodies to the parasite measured by ELISA was significantly higher in dogs presenting clinical signs compatible with leishmaniosis at both sampling points. Phlebotomus perniciosus salivary antibodies were detected in 179 (86.1%) and 198 (95.2%) of the screened dogs at the beginning and end of the phlebotomine season, respectively.

Conclusions

The association between ELISA positivity and clinical signs suggests its usefulness to confirm a clinical suspicion. CS nPCR seems to be an effective and non-invasive method for assessing early exposure to the parasite. PB nPCR should not be used as the sole diagnostic tool to monitor Leishmania infection. The correlation between the levels of antibodies to P. perniciosus saliva and Leishmania antibodies suggests the use of a humoral response to sand fly salivary antigens as biomarkers of L. infantum infection.
Correction to: Expressing a Z-disk nebulin fragment innebulin-deficient mouse muscle: effects on muscle structure and function
Authors: Li Frank , Kolb Justin , Crudele Julie , Tonino Paola , Hourani Zaynab , Smith John E. , Chamberlain Jeffrey S. , Granzier Henk
Published: April 2020

Following the publication of this paper [1], it was brought to the authors’ attention that one of the contributing authors was left off of the paper. The authors apologize for the unfortunate oversight. In this correction paper, they have included Dr. Paola Tonino in the author list section.
Correction to: Linking demyelination to compound action potential dispersion with a spike-diffuse-spike approach
Authors: Naud Richard , Longtin André
Published: April 2020

Following publication of the original article (Naud and Longtin in J Math Neurosci 9:3, 2019), the authors noticed a mistake in the first paragraph within “Altered propagation”.
Inequality in in-hospital mortality due to road traffic accident between ethnic populations in specified groups living in the same country
Authors:   Israel Trauma Group, Tiruneh Abebe , Siman-Tov Maya , Radomislensky Irina , Peleg Kobi
Published: April 2020

Background

Road traffic accidents (RTA) are not equally distributed between ethnic groups, disproportionately affecting minorities. In Israel, Arabs are at higher risk of involvement in RTA relative to their proportion in the population. This study aims to compare the risk of in-hospital mortality from RTA between Arabs and Jews in Israel and to identify the factors associated with mortality in each population group.

Methods

This study is based on the Israeli National Trauma Registry of patients hospitalized due to road traffic injuries (Injury Severity Score 16+) between 2008 and 2017. Demographic, injury and hospitalization characteristics, evacuation means and in-hospital mortality were analyzed. Hierarchical multivariate logistic regression with random intercept for the treating hospital was performed to estimate the risk of mortality.

Results

Of the 11,523 hospitalizations reported, 29% were Arabs, which is higher than their proportion in the Israeli population (21%). When comparing Arabs with Jews they were younger (ages 0–24 years - 61% vs 30%), injured as a car driver (28% vs 20%) or passenger (21% vs 15%) and less likely to be a motor cyclist (8.8% vs. 19.2%). In addition, Arabs were more likely to suffer from critical injuries (51% vs 44%) and head injuries (71% vs 66%). Although Arabs were less likely to be evacuated by ambulance (68% vs 80%), they were more likely to be evacuated by a private vehicle or an emergency medical helicopter. Transfers between hospitals were greater among Arabs (14% vs 22%), as were hospital admissions “outside official work hours” (70% vs 78%) and hospital resource utilization. After accounting for demographic, injury, and hospitalization characteristics the risk of in-hospital mortality was significantly higher among Arabs compared to Jews (OR: 1.63, 95% CI: 1.14–2.32). The significantly higher mortality among Arabs was apparent in the sub-group of patients who were critically injured and in those who arrived at the hospital “outside official work hours”.

Conclusions

This study suggests the need for developing appropriate interventions focusing on the Arab community in general, and according to the analysis of risk groups and areas of injury in particular, including rapid access to emergency medical services and definitive care.
Factors associated with major adverse kidney events in patients who underwent veno-arterial extracorporeal membrane oxygenation
Authors: Vinclair Camille , De Montmollin Etienne , Sonneville Romain , Reuter Jean , Lebut Jordane , Cally Radj , Mourvillier Bruno , Neuville Mathilde , Ruckly Stéphane , Timsit Jean-François , Bouadma Lila
Published: April 2020

Objective

To describe acute kidney injury (AKI) natural history and to identify predictors of major adverse kidney events (MAKE) within 1 year in patients supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO).

Design

Retrospective observational study.

Setting

Medical French intensive care unit between January 2014 and December 2016.

Patients

Consecutive patients implanted with VA-ECMO ≥ 16 years, VA-ECMO for at least ≥ 48 h, and without end-stage chronic kidney disease (CKD).

Intervention

None.

Measurements

Multivariate logistic regression of factors associated with MAKE at 1 year defined as one of the following criteria within day 360: death and receipt of renal replacement therapy (RRT) or persistent renal dysfunction, i.e., CKD ≥ stage 3 corresponding to an estimated glomerular filtration rate (eGFR) ≤ 60 ml/min/1.73 m2and MAKE at day 30 and day 90 defined as one of the following criteria within day 30 or day 90: death, receipt of renal replacement therapy and serum creatinine ≥ threefold increase.

Main results

158 consecutive patients were included (male sex: 75.9%; median and interquartile range: age: 59 [47–66], Simplified Acute Physiology Score II: 55 [39–66], Sepsis-related Organ Failure Assessment Score: 9 [7–12], time on VA-ECMO: 7.5 [4–12] days). Among them 145 (91.8%) developed an AKI during the intensive care unit (ICU) stay and 85 (53.8%) needed renal replacement therapy (RRT). 59.9% (91/152), 60.5% (89/147) and 85.1% (120/141) evaluable patients had a MAKE-30, MAKE-90 and MAKE-360, respectively. Factors significantly associated with MAKE-360 were eGFR at baseline (odds ratio (OR) 0.98, confidence interval 95% (CI) [0.97;1.00],p0.02), Kidney Disease Improving Global Outcome (KDIGO) stage at cannulation (p = 0.03), e.g., stage 3 vs. reference stage 0 OR 10.20 [1.77–58.87], and number of red blood cell (RBC) packs received while under ECMO (OR 1.14, CI 95% [1.01;1.28],p = 0.03). At 1 year among the 51 survivors, almost half of the alive patients (n = 20/51) had a decline of estimated glomerular filtration (eGFR) > 30% mL/min/1.73 m2. Their median eGFR decline was − 26.3% [− 46.6;− 10.7].

Conclusion

Patients undergoing VA-ECMO had a high risk of AKI during the ICU stay. Factors associated with MAKE 360 were mainly eGFR at baseline, KDIGO stage at cannulation and, number of RBC packs received while under ECMO. Among survivors at 1 year, almost half of the alive patients (n = 20/51) had a decline eGFR > 30%.
Flexion First Balancer: description of new technique in TKA to reproduce joint line and pre-disease mechanical alignment
Authors: van Lieshout W. A. M. , Koenraadt K. L. M. , Elmans L. H. G. J. , van Geenen R. C. I.
Published: April 2020

A considerable proportion of patients (19%) are dissatisfied after total knee arthroplasty (TKA). Possible factors contributing to this dissatisfaction are decreased posterior condylar offset (PCO) with subsequent joint line elevation, leading to mid-flexion instability. Secondly, the pre-disease mechanical alignment is changed into a neutral alignment. The Flexion First Balancer was developed to avoid these problems. This technique aims to maintain MCL isometry by restoring medial PCO and medial joint line to its pre-disease level. Also, to reconstruct the pre-disease mechanical alignment by adjusting the distal femoral angle. In this study we provide a detailed technical overview of the Flexion First Balancer technique.
Inhibition of miR-19a-3p decreases cerebral ischemia/reperfusion injury by targeting IGFBP3 in vivo and in vitro
Authors: Chai Zhaohui , Gong Jiangbiao , Zheng Peidong , Zheng Jiesheng
Published: April 2020

Background

Inflammation and apoptosis are considered to be two main factors affecting ischemic brain injury and the subsequent reperfusion damage. MiR-19a-3p has been reported to be a possible novel biomarker in ischemic stroke. However, the function and molecular mechanisms of miR-19a-3p remain unclear in cerebral ischemia/reperfusion (I/R) injury.

Methods

The I/R injury model was established in vivo by middle cerebral artery occlusion/reperfusion (MCAO/R) in rats and in vitro by oxygen–glucose deprivation and reperfusion (OGD/R) induced SH-SY5Y cells. The expression of miR-19a-3p was determined by reverse transcription quantitative PCR. The infarction volumes, Neurological deficit scores, apoptosis, cell viability, pro-inflammatory cytokines and apoptosis were evaluated using Longa score, Bederson score, TTC, TUNEL staining, CCK-8, ELISA, flow cytometry assays. Luciferase reporter assay was utilized to validate the target gene of miR-19a-3p.

Results

We first found miR-19a-3p was significantly up-regulated in rat I/R brain tissues and OGD/R induced SH-SY5Y cells. Using the in vivo and in vitro I/R injury model, we further demonstrated that miR-19a-3p inhibitor exerted protective role against injury to cerebral I/R, which was reflected by reduced infarct volume, improved neurological outcomes, increased cell viability, inhibited inflammation and apoptosis. Mechanistically, miR-19a-3p binds to 3′UTR region of IGFBP3 mRNA. Inhibition of miR-19a-3p caused the increased expression of IGFBP3 in OGD/R induced SH-SY5Y cells. Furthermore, we showed that IGFBP3 overexpression imitated, while knockdown reversed the protective effects of miR-19a-3p inhibitor against OGD/R-induced injury.

Conclusions

In summary, our findings showed miR-19a-3p regulated I/R-induced inflammation and apoptosis through targeting IGFBP3, which might provide a potential therapeutic target for cerebral I/R injury.
Correction to: Intramural metastasis to the appendix from ascending colon cancer: a case report
Authors: Abe Toshiya , Sakai Hiroshi , Hayashi Masataka , Nakamura So , Takesue Shin , Sada Masafumi , Kozono Shingo , Kitaura Yoshiki , Tanabe Yoshitaka , Nishihara Kazuyoshi , Mine Mari , Tamiya Sadafumi , Nakano Toru
Published: April 2020

In the original publication of this article [1], an author’s name should be changed from Shin Takasue to Shin Takesue.
Porous-coated metaphyseal sleeves and MBT implant for severe bone loss in revision total knee arthroplasty: a mean 2.4-year follow-up
Authors: Wu Yushun , Feng Eryou , Zhang Yiyuan , Lin Feitai , Lin Liqiong , Li Zhanglai , Xiao Lili
Published: April 2020

Background

Porous-coated metaphyseal sleeves are designed to fill bone loss and facilitate osseo-integration when bone loss occurs during revision total knee arthroplasty (TKA). The purpose of this paper was to evaluate the clinical and radiographic outcomes of porous-coated metaphyseal sleeves for severe bone loss in revision TKA.

Methods

Form December 2014 to March 2018, we retrospectively analyzed 36 patients receiving revision TKAs. They had Anderson Orthopaedic Research Institute (AORI) Type II and III tibial bone loss and were treated with metaphyseal sleeve. The patients were followed up for a mean time of 28.5 months. The Knee Society Score (KSS), the Hospital for Special Surgery (HSS) Knee Score, Visual Analog Scale (VAS) score and the range of motion (ROM), radiographic findings of sleeve osteo-integration were also recorded. The paired t test was used to compare the KSS, the HSS knee score and VAS score before and after the revision TKAs. A value of P < 0.05 was considered statistically significant.

Results

Thirty-six patients had complete clinical and radiographic data. At the final follow-up (mean: 28.5 months), significant improvements in knee range of motion, KSS, HSS score and VAS score were observed postoperatively (P < 0.001 for all). No aseptic implant fixation failure occurred. Radiographic reviews at the final follow-up revealed that components were stable without occurrence of component migration or clinically significant osteolysis.

Conclusions

This short-term retrospective study illustrated that porous-coated metaphyseal sleeves were useful in revision TKA, with a low rate of intraoperative complications, excellent osteo-integration and stable fixation.
Clinical and Molecular Description of 16 Families With Heterozygous IHH Variants
Authors: Sentchordi-Montané Lucía , Benito-Sanz Sara , Aza-Carmona Miriam , Pereda Arrate , Parrón-Pajares Manuel , de la Torre Carolina , Vasques Gabriela A , Funari Mariana F A , Travessa André M , Dias Patrícia , Suarez-Ortega Larisa , González-Buitrago Jesús , Portillo-Najera Nancy Elizabeth , Llano-Rivas Isabel , Martín-Frías María , Ramírez-Fernández Joaquín , Sánchez del Pozo Jaime , Garzón-Lorenzo Lucía , Martos-Moreno Gabriel A , Alfaro-Iznaola Cristina , Mulero-Collantes Inés , Ruiz-Ocaña Pablo , Casano-Sancho Paula , Portela Ana , Ruiz-Pérez Lorea , del Pozo Angela , Vallespín Elena , Solís Mario , Lerario Antônio M , González-Casado Isabel , Ros-Pérez Purificación , Pérez de Nanclares Guiomar , Jorge Alexander A L , Heath Karen E
Published: April 2020

Context

Heterozygous variants in the Indian hedgehog gene (IHH) have been reported to cause brachydactyly type A1 and mild hand and feet skeletal anomalies with short stature. Genetic screening in individuals with short stature and mild skeletal anomalies has been increasing over recent years, allowing us to broaden the clinical spectrum of skeletal dysplasias.

Objective

The objective of this article is to describe the genotype and phenotype of 16 probands with heterozygous variants in IHH.

Patients and Methods

Targeted next-generation sequencing or Sanger sequencing was performed in patients with short stature and/or brachydactyly for which the genetic cause was unknown.

Results

Fifteen different heterozygous IHH variants were detected, one of which is the first reported complete deletion of IHH. None of the patients showed the classical phenotype of brachydactyly type A1. The most frequently observed clinical characteristics were mild to moderate short stature as well as shortening of the middle phalanx on the fifth finger. The identified IHH variants were demonstrated to cosegregate with the short stature and/or brachydactyly in the 13 probands whose family members were available. However, clinical heterogeneity was observed: Two short-statured probands showed no hand radiological anomalies, whereas another 5 were of normal height but had brachydactyly.

Conclusions

Short stature and/or mild skeletal hand defects can be caused by IHH variants. Defects in this gene should be considered in individuals with these findings, especially when there is an autosomal dominant pattern of inheritance. Although no genotype-phenotype correlation was observed, cosegregation studies should be performed and where possible functional characterization before concluding that a variant is causative.
Sex Steroids as Regulators of Gestural Communication
Authors: Tobiansky Daniel J , Fuxjager Matthew J
Published: April 2020

Gestural communication is ubiquitous throughout the animal kingdom, occurring in species that range from humans to arthropods. Individuals produce gestural signals when their nervous system triggers the production of limb and body movement, which in turn functions to help mediate communication between or among individuals. Like many stereotyped motor patterns, the probability of a gestural display in a given social context can be modulated by sex steroid hormones. Here, we review how steroid hormones mediate the neural mechanisms that underly gestural communication in humans and nonhumans alike. This is a growing area of research, and thus we explore how sex steroids mediate brain areas involved in language production, social behavior, and motor performance. We also examine the way that sex steroids can regulate behavioral output by acting in the periphery via skeletal muscle. Altogether, we outline a new avenue of behavioral endocrinology research that aims to uncover the hormonal basis for one of the most common modes of communication among animals on Earth.
GDF15: A Hormone Conveying Somatic Distress to the Brain
Authors: Lockhart Samuel M , Saudek Vladimir , O’Rahilly Stephen
Published: April 2020

GDF15 has recently gained scientific and translational prominence with the discovery that its receptor is a GFRAL-RET heterodimer of which GFRAL is expressed solely in the hindbrain. Activation of this receptor results in reduced food intake and loss of body weight and is perceived and recalled by animals as aversive. This information encourages a revised interpretation of the large body of previous research on the protein. GDF15 can be secreted by a wide variety of cell types in response to a broad range of stressors. We propose that central sensing of GDF15 via GFRAL-RET activation results in behaviors that facilitate the reduction of exposure to a noxious stimulus. The human trophoblast appears to have hijacked this signal, producing large amounts of GDF15 from early pregnancy. We speculate that this encourages avoidance of potential teratogens in pregnancy. Circulating GDF15 levels are elevated in a range of human disease states, including various forms of cachexia, and GDF15-GFRAL antagonism is emerging as a therapeutic strategy for anorexia/cachexia syndromes. Metformin elevates circulating GDF15 chronically in humans and the weight loss caused by this drug appears to be dependent on the rise in GDF15. This supports the concept that chronic activation of the GDF15-GFRAL axis has efficacy as an antiobesity agent. In this review, we examine the science of GDF15 since its identification in 1997 with our interpretation of this body of work now being assisted by a clear understanding of its highly selective central site of action.
The effect of suture selection in complex anal fistulas on the success of cutting seton placement and patient comfort
Authors: Akıcı Murat , Erşen Ogün
Published: April 2020

Objective: The aim of our study was to compare the success rates of suture selection, recovery times and pain associated with local wound infection and seton placement in patients undergoing cutting seton placement for complex anal fistula.

Methods: The study included a total of 90 patients who were admitted with the diagnosis of complex anal fistula between January 2015 and July 2018.

Results: The first session and other revision appointments demonstrated that the number of patients who required fistulotomy was significantly higher in group-1 as the seton failed to complete the transection (p = 0.001). When the patients were asked to rate pain for 3 different conditions according to numeric rating scale (NRS), the patients in group-2 had significantly higher pain in all 3 cases compared to the patients in group-1 (p = 0.001). The impact of the suture material on local infection was examined and it was determined that the results of cultures for seton material were significantly more positive in group-1 (p = 0.001).

Conclusions: We conclude that a multi-stage tight seton placement with silk material can lead to satisfactory results by aiming to shorten the cutting time of silk seton.

doi: https://doi.org/10.12669/pjms.36.4.1920

How to cite this:Akici M, Ersen O. The effect of suture selection in complex anal fistulas on the success of cutting seton placement and patient comfort. Pak J Med Sci. 2020;36(4):816-820. doi: https://doi.org/10.12669/pjms.36.4.1920

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Physical functioning limitations and physical activity of people experiencing homelessness: A scoping review
Authors: Kiernan Sinéad , Mockler David , Ní Cheallaigh Clíona , Broderick Julie
Published: April 2020

Background: Adults who are experiencing homelessness suffer higher levels of premature mortality and age-related medical conditions compared to the general population, but little is known about physical factors that influence their health experience. This review aimed to evaluate what is known about physical functional limitations and physical activity levels, and how these constructs are measured in adults experiencing homelessness.

Methods: This review was conducted in accordance with the Joanna Briggs Institute’s methodology for scoping reviews. Suitable quantitative and qualitative articles were searched using PubMed, CINAHL, EMBASE, PsychInfo, Web of Science and SCOPUS databases using a combination of keywords and medical subject headings  and a grey literature search was also performed. Two reviewers independently screened articles for inclusion. Inclusion criteria were studies that examined physical functional limitations and/or physical activity among homeless adults (with/without co-occurring mental illness, infectious disease, substance use disorder), as a primary or secondary outcome measure.

Results: We identified 15 studies for inclusion including 2,018 participants. Studies were primarily quantitative (n=11) and there were 4 qualitative studies. The following physical focused measures were evaluated across studies; mobility levels (n=2), frailty (n=1), flexibility (n=2), strength (n=1), physical symptom burden (n=3), physical activity levels (n=6) and exercise capacity (n=3). The majority of studies reported high levels of functional limitations among participants and low physical activity levels although a spectrum of abilities was noted.

Conclusion: This review showed that many adults who are homeless appear to show a high burden of physical functional limitations and low physical activity levels but more objective and consistent measures should be applied to examine these factors in future studies. This will help address and plan future care, physical rehabilitation and housing needs for this vulnerable cohort. This scoping review will help direct research and future systematic reviews in this emerging area.
An international focus on cardiac surgery nursing: advanced practice
Authors: Fredericks Suzanne , Martorella Geraldine , Wynne Rochelle , Sanders Julie
Published: April 2020

This six-paper series in the International Year of the Nurse and Midwife aims to draw together two important themes: celebrating the role of nursing in advancing care in cardiac surgery and providing an international perspective of cardiac surgery nursing.
Lightweight Messaging for Efficient Service Discovery in Mobile IoT Environments Using Hierarchical Bloom Filters
Authors: Kim Minhyeop , Kwon Jung-Hyun , Jo Hyeon-Jun , Ko In-Young
Published: April 2020

In highly dynamic IoT environments, the connection statuses of IoT resources and the availability of IoT-based services change frequently. Therefore, to successfully build distributed service registries for managing and finding the information about available services in an effective manner, it is crucial to minimize the overhead of message exchanges between registries and to reduce the time overhead for identifying the capabilities of available IoT resources and the services that can be provided by utilizing these capabilities. In this paper, we propose a lightweight messaging approach that uses hierarchical Bloom filters to efficiently represent service information to be exchanged and managed by distributed service registries for IoT environments with high mobility. We also propose a method for serializing the dimensions of a Bloom-filter-encoded search space. We conducted experiments to demonstrate the improvement in the service discovery performance, the reduction in message traffic among service registries, and the decrease in the latency when synchronizing distributed service registries.
Adult cavernous haemangioma of the vocal cords with a unique presentation of acute respiratory distress: a case report
Authors: Rafie A , Jolly K , Darr A , Thompson S
Published: April 2020

Laryngeal haemangiomas can commonly be seen in children, and first-line treatment is usually propranolol. However, in adults, cavernous haemangioma of the vocal cord(s) is an extremely rare condition – with this being the only published adult case presenting with acute respiratory distress – the mainstay of treatment is surgical excision under microlaryngoscopy. Presentation in adults can be unpredictable, but primarily consists of hoarseness which can be associated with, dyspnoea, dysphagia, and haemoptysis – and in one documented case stenosis of the aero-digestive tract led to death. Due to these airway difficulties, surgery can often prove challenging. In this study, we explore the unusual case of a previously well 71-year-old gentleman presenting to the Emergency Department, with worsening shortness of breath as his primary complaint. Uniquely, in this case, an awake fibre-optic intubation was undertaken to manage the difficult airway and a microlaryngoscopy was performed. A 20x10x15mm lesion was excised, which had characteristics in keeping with a cavernous haemangioma on microscopic examination.
Subsuns and rainbows during solar eclipses
Authors: Können Gunther P. , Schneider Glenn , Zucker Evan H. , Lahtinen Panu
Published: April 2020

A photographic observation sequence was obtained of a subsun before, during, and after the total phase of the 2016 solar eclipse. The time-resolved images were obtained from a high-altitude jet aircraft. The image sequence was searched for the possible presence of a solar corona-generated subsun during totality. Although the subsun-creating conditions apparently persisted during totality, the drop in signal intensity compared to the local background prevented its detection. Separately, we document a visual observation from the 1977 total solar eclipse of a rainbow that faded, in the last a few seconds before totality, from being normally multicolored to monochromatic red from water drops then predominantly illuminated by light from the solar chromosphere. A similar transition in the final seconds before, and after, totality is expected to occur for parhelia. The posited short-living monochromatic red parhelion resulting from the momentary illumination of ice crystals by the solar chromosphere is still waiting to be observed.
Optical properties of molybdenum in the ultraviolet and extreme ultraviolet by reflection electron energy loss spectroscopy
Authors: Pauly N. , Yubero F. , Tougaard S.
Published: April 2020

Optical properties of polycrystalline molybdenum are determined from ultraviolet up to extreme ultraviolet by reflection electron energy loss spectroscopy (REELS). Calculations are performed within the dielectric response theory by means of the quantitative analysis of electron energy losses at surfaces QUEELS-

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-REELS software [Surf. Interface Anal. 36, 824 (2004)SIANDQ0142-242110.1002/sia.1774] that allows the simulation of inelastic scattering cross sections, using a parametric energy loss function describing the optical response of the material. From this energy loss function, the real and imaginary parts of the dielectric function, the refractive index, and the extinction coefficient are deduced and compared with previously published results.
Non-invasive investigation of adipose tissue by time domain diffuse optical spectroscopy
Authors: Lanka Pranav , Segala Agnese , Farina Andrea , Konugolu Venkata Sekar Sanathana , Nisoli Enzo , Valerio Alessandra , Taroni Paola , Cubeddu Rinaldo , Pifferi Antonio
Published: April 2020

The human abdominal region is very heterogeneous and stratified with subcutaneous adipose tissue (SAT) being one of the primary layers. Monitoring this tissue is crucial for diagnostic purposes and to estimate the effects of interventions like caloric restriction or bariatric surgery. However, the layered nature of the abdomen poses a major problem in monitoring the SAT in a non-invasive way by diffuse optics. In this work, we examine the possibility of using multi-distance broadband time domain diffuse optical spectroscopy to assess the human abdomen non-invasively. Broadband absorption and reduced scattering spectra from 600 to 1100 nm were acquired at 1, 2 and 3 cm source-detector distances on ten healthy adult male volunteers, and then analyzed using a homogeneous model as an initial step to understand the origin of the detected signal and how tissue should be modeled to derive quantitative information. The results exhibit a clear influence of the layered nature on the estimated optical properties. Clearly, the underlying muscle makes a relevant contribution in the spectra measured at the largest source-detector distance for thinner subjects related to blood and water absorption. More unexpectedly, also the thin superficial skin layer yields a direct contamination, leading to higher water content and steeper reduced scattering spectra at the shortest distance, as confirmed also by simulations. In conclusion, provided that data analysis properly accounts for the complex tissue structure, diffuse optics may offer great potential for the continuous non-invasive monitoring of abdominal fat.
Compact mid-infrared dual-comb spectrometer for outdoor spectroscopy
Authors: Ycas Gabriel , Giorgetta Fabrizio R. , Friedlein Jacob T. , Herman Daniel , Cossel Kevin C. , Baumann Esther , Newbury Nathan R. , Coddington Ian
Published: April 2020

This manuscript describes the design of a robust, mid-infrared dual-comb spectrometer operating in the 3.1-µm to 4-µm spectral window for future field applications. The design represents an improvement in system size, power consumption, and robustness relative to previous work while also providing a high spectral signal-to-noise ratio. We demonstrate a system quality factor of 2×106 and 30 hours of continuous operation over a 120-meter outdoor air path.
Minimalist Mie coefficient model
Authors: Rahimzadegan Aso , Alaee Rasoul , Rockstuhl Carsten , Boyd Robert W.
Published: April 2020

When considering light scattering from a sphere, the ratios between the expansion coefficients of the scattered and the incident field in a spherical basis are known as the Mie coefficients. Generally, Mie coefficients depend on many degrees of freedom, including the dimensions and electromagnetic properties of the spherical object. However, for fundamental research, it is important to have easy expressions for all possible values of Mie coefficients within the existing physical constraints and which depend on the least number of degrees of freedom. While such expressions are known for spheres made from non-absorbing materials, we present here, for the first time to our knowledge, corresponding expressions for spheres made from absorbing materials. To illustrate the usefulness of these expressions, we investigate the upper bound for the absorption cross section of a trimer made from electric dipolar spheres. Given the results, we have designed a dipolar ITO trimer that offers a maximal absorption cross section. Our approach is not limited to dipolar terms, but indeed, as demonstrated in the manuscript, can be applied to higher order terms as well. Using our model, one can scan the entire accessible parameter space of spheres for specific functionalities in systems made from spherical scatterers.
Sensing within the OTDR dead-zone using a two-mode fiber
Authors: Mao Yuan , Ashry Islam , Wang Biwei , Hveding Frode , Bukhamseen Ahmed Y. , Ng Khee Tien , Ooi Boon S.
Published: April 2020

An optical time-domain reflectometer (OTDR) is incapable of providing sensing or diagnostic information within dead-zones. We use a two-mode fiber (TMF) and a photonic lantern to completely overcome the main OTDR’s dead-zone originating from the front facet of optical fiber. This is achieved by injecting the optical pulses of the OTDR in the form of the fundamental mode and meanwhile collecting the Rayleigh signals associated with the higher-order modes. Using the reported TMF-based OTDR, we accurately sense the position and frequency of a vibration event located within the dead-zone as a proof-of-concept demonstration.
Basket-work, well-being and recovery: The story from Scotland
Authors: Bunn Stephanie
Published: April 2020

This chapter explores the relationship between craft and well-being through a close examination of the relationship between craftwork, specifically basketry, and cognition. The author argues that the exploratory, gestural and embodied skills manifest in basketry-in-action enhance creative thinking and spatial understanding of a person's environment. This enhanced understanding arises through the physical and neurological developments which grow during becoming skilful. This attribute of crafts such as basketwork to enhance cognition is equally valuable for people with memory loss, and also for those who have experience acquired bran injury or stroke. Here, new learning can both provide resonance with former skills, and also enable new neural pathways to become established, often enabling a degree of recovery to take place.
A grounded theory approach to studying craft: The serious work and leisure of knitting
Authors: Court Kate
Published: April 2020

The primary aim of this article is to exemplify and evaluate the application of a grounded theory approach to studying craft participants, including the introduction of social theory in the analysis process. This is done by describing a qualitative research project that explored why women today knit. An increased interest in knitting and other crafts has been noted, particularly amongst women participants. The article sets out how a grounded theory approach was employed to offer new ways to understand this topic. The secondary aim of this article is to share the findings of this research. It is suggested that what participants said about their relationship with knitting could be understood in terms of Stebbins' notions of creating routines for engaging in this leisure activity, fulfilling a sense of obligation to undertake the activity, and a sense of pride and autonomy. This helped frame knitting as an activity that requires hard work and perseverance but results in fulfilment. Furthermore, it was found that knitting deviates from Stebbins' conception of serious leisure activities as the categories of hobbyists, amateurs and professionals may need reworking, given that knitters (classed by Stebbins' as hobbyists without professional counterparts) are partly professionalized and therefore seem more appropriately classed as amateurs.
Mattering and making ethics: On craft, embodiment and vulnerable materialities
Authors: Gilmour Ruth Elvira
Published: April 2020

Unearthing the development of my craft practice and my physicality, this critical self-portrait exposes my embodied experiences, material processes and the humanistic and scientific research entangled within my artistic investigations. By examining linkages between body, material and language, my practice concerns itself with vulnerability and the interrelations of the self and other. Initially using porcelain to explore ecocritical matters, the responsive material soon revealed potential for personal and physiological abstraction; exposing this journey, I later develop correlations with silk. Throughout this article I explain how close material relationships open space for the training and moulding of my body, ethically and for reasons of recovery and resistance.