bluuebunny/crossref_metadata_2025 huggingface dataset:
vcemway: A one-stop solution for robust inference with multiway clustering
Authors: Gu Ariel , Yoo Hong Il
Published: December 2019

Most Stata commands allow cluster( varname) or vce(cluster clustvar) as an option, popularizing the use of standard errors that are robust to oneway clustering. For adjusting standard errors for multiway clustering, there is no solution that is as widely applicable. While several community-contributed packages support multiway clustering, each package is compatible only with a subset of models that Stata’s ever-expanding library of commands allows the researcher to fit. We introduce a command, vcemway, that provides a one-stop solution for multiway clustering. vcemway works with any estimation command that allows cluster( varname) as an option, and it adjusts standard errors, individual significance statistics, and confidence intervals in output tables for multiway clustering in specified dimensions. The covariance matrix used in making this adjustment is stored in e(V), meaning that any subsequent call to postestimation commands that use e(V) as input (for example, test and margins) will also produce results that are robust to multiway clustering.
Development and Psychometric Properties of a Prostate Cancer Knowledge Scale for African American Men
Authors: Owens Otis L. , Tavakoli Abbas S. , Rose Theda , Wooten Nikki R.
Published: December 2019

African American men have the highest prostate cancer-related mortality nationally. In response to this disparity, targeted interventions are emerging to enhance African American men’s prostate cancer (PrCA) knowledge to ensure they are equipped to make informed decisions about PrCA screening with health-care providers. African American men’s PrCA knowledge has been measured inconsistently over time with limited psychometric evidence. The factor structure of this construct in African American men is relatively unknown. This study describes the development and psychometric evaluation of an 18-item Prostate Cancer Knowledge Scale among 352 African American men. Exploratory factor analysis (EFA) was conducted using weighted least square mean and variance estimation with Geomin rotation. EFA yielded three factors: PrCA Anatomy and Screening (6 items), Risk Factors (5 items), Warning Signs (7 items) with good internal consistency reliability at KR-20 = .80 for the total scale and .64, .66, and .75, respectively, for each subscale. Factor loadings ranged from .31 to .86. The standardized root mean square residual (0.08) indicated that the factor structure explained most of the correlations. The three-factor, 18-item Prostate Cancer Knowledge Scale demonstrates that PrCA knowledge is a multidimensional construct and has utility for reliably measuring PrCA knowledge among African American men. Future research is required to confirm this factor structure among socio-demographically diverse African Americans.
Educational Attainment and Health Behaviors Among Young Adult Men: Racial/Ethnic Disparities
Authors: Lee Jaewon , Seon Jisuk
Published: December 2019

Although promoting health behaviors are important for sustaining physical and mental health, little is known about young adult men’s health behaviors or how they vary across race and ethnicity. This study examines the impact of educational attainment on health behaviors across young adult men, and differences in the association across race/ethnicity. This study used data from the National Longitudinal Survey of Youth 1979 Children and Young Adults. The final sample consists of 3,115 non-Hispanic White males, 1,617 African American males, and 1,144 Hispanic males. The average age of the participants was about 27 years old. Multiple linear regression and logistic regression analyses were conducted. Educational attainment was associated with both food intake and preventive health care visits. Those who received a higher education were less likely to eat fast food than those who did not (β = –.37, p < .001) and were more likely to eat fruits and vegetables (β = .77, OR = 2.15, p < .01; β = 6.44, OR = 1.91, p < .10). Higher education was also positively associated with routine eye exams and health check-ups (β = .50, OR = 1.64, p < .01); β = 1.84, OR = 6.29, p < .01). This study identified interaction effects between educational attainment and African Americans for predicting fast food intake (β = .57, p < .05). Education is one way to improve health behaviors and to lessen racial/ethnic disparities in health behaviors. Specifically, promoting health behaviors in education should target African American men to improve their perception toward the importance of healthy food intake.
Cost Savings of Carpal Tunnel Release Performed In-Clinic Compared to an Ambulatory Surgery Center: Time-Driven Activity-Based-Costing
Authors: White Melissa , Parikh Harsh R. , Wise Kelsey L. , Vang Sandy , Ward Christina M. , Cunningham Brian P.
Published: December 2019

Purpose: The purpose of our study was to investigate carpal tunnel release (CTR) performed in the clinic versus the ambulatory surgery center (ASC) to evaluate for potential cost savings. Methods: Patients who underwent either CTR in clinic under a local anesthetic or CTR in the ASC with sedation and local anesthetic were prospectively enrolled in a registry between 2014 and 2016. All patients completed a Visual Analog Scale (VAS) pain scale for procedural and postprocedure pain. Time-Driven Activity-Based Costing (TDABC) was utilized to quantify cost of both CTR in clinic and CTR in the ASC. Statistical analysis involved parametric comparative tests between patient cohorts for both the TDABC-cost and patient pain. Results: A total of 59 participants completed the postprocedure CTR survey during the study period, 23 (38.9%) in the ASC group and 36 (61.1%) in the clinic group. Overall time for the procedure from patient arrival to discharge was significantly longer for the ASC cases, averaging 215.7 minutes (range: 201-230) compared to 78.6 minutes (range: 59-98) in the clinic group ( P < .01). Both procedural and postoperative VAS pain scores were comparable between clinic and ASC cohorts, procedural pain: 1.8 vs 1.9 ( P = .91) and postoperative pain: 4.8 vs 4.9 ( P = .88). TDABC analysis estimated ASC CTR procedures to cost an average of $557.07 ($522.06-$592.08) and clinic procedures to cost an average of $151.92 ($142.59-$161.25) ( P < .05). Conclusions: CTR in the clinic setting results in significant cost savings compared to CTR in the ASC with no difference in pain scores during the procedure or postoperative period. Level of Evidence: Therapeutic Level II.
Pediatric Hand Transplantation: A Decision Analysis
Authors: Snyder Kaitlyn J. G. , Amaral Sandra , Kessler Sudha , Lefkowitz Debra , Levy Todd J. , Hewlett Jennifer , Levin Scott , Feudtner Chris
Published: December 2019

Background: The first successful bilateral pediatric hand transplant was performed in 2015. Previous hand transplant decision analysis models have focused on the adult population. This model principally aimed to determine whether adverse outcomes associated with immunosuppression outweigh the benefits of performing bilateral hand transplant surgery in a pediatric candidate. The model also conceptualized the valuation of losing years of life and sought to determine the impact of that valuation on the surgical decision. Methods: A decision model compared undergoing bilateral hand transplant surgery with using prosthetics for an 8-year-old patient. The outcome measure used was quality adjusted life years (QALYs), and sensitivity analysis was performed on the immunosuppressive risks associated with the surgical decision, as well as the perceived valuation of aversion to life years lost. Results: The decision to perform surgery was marginally optimal compared to the prosthetic decision (50.11 QALY vs. 47.95 QALY). A Monte Carlo simulation revealed that this difference may be too marginal to detect an optimal decision (50.14 ± 8.28 QALY vs. 47.95 ± 2.12 QALY). Sensitivity analysis identified decision thresholds related to immunosuppression risks ( P = 29% vs. P = 33% modeled), and a trend of increasing risk as a patient is more averse to losing life years. Conclusions: The marginally optimal treatment strategy currently is bilateral hand transplant, compared to prosthetics for pediatric patients. Key determinants of the future optimal strategy will be whether immunosuppressive regimens become safer, with a reduced risk of losing life years due to immunosuppressive complications, and whether prosthetics become more acceptable and enable higher functioning.
Experimental investigation using vibration testing method to optimize feed parameters of color mixing nozzle for fused deposition modeling color 3D printer
Authors: Li Zhiyong , Zhang Dawei , Shao Liangchen , Han Shanling
Published: December 2019

To improve the blockage and printing quality of the color mixing nozzle of fused deposition modeling color 3D printer, the feed parameters of fused deposition modeling color 3D printer were studied by vibration test. The acceleration sensor was fixed up the color mixing nozzle to analyze the vertical vibration of the nozzle. The vibration test of different feed speed, torque, and material were performed under the actual printing condition. Vertical vibration of the nozzle was characterized by an acceleration sensor. The comparative analysis of the actual testing results indicates that the optimum feed parameters are feed torque of triple torque extruder, feed speed of 20 mm/s, and feed material of ABS. Further analysis shows that higher feed torque can be used to improve the printing quality of the color mixing nozzle. The appropriate feed speed of the color 3D printer can not only reduce the accumulation of wire material at a lower speed but also reduce the blockage caused by too-high feed speed. It is proposed that the feed material with smaller flow behavior index and no phase transition in the melting process shows smaller vibration acceleration amplitude.
A deontic perspective on the collaborative, multimodal accomplishment of leadership
Authors: Van De Mieroop Dorien
Published: December 2019

This article makes a case for investigating leadership from a micro-interactional perspective which integrates discursive, sequential and multimodal analytical layers. It thus builds on existing discursive leadership research by demonstrating that leadership is not achieved only through talk, but by means of a complex interplay between verbal and non-verbal resources. Focusing on video-recordings of authentic meetings, I investigate the interactional interplay between the superior, the meeting chair and the other participants by means of a deontic perspective. Drawing on the status–stance distinction and teasing out how proximal and distal deontic rights are enacted and how these relate to leader and follower identities when conceptualized from a social constructionist perspective, I demonstrate that leadership is an essentially collaborative accomplishment in which all participants play a crucial role. Finally, I argue that this can only be uncovered fully when attention is paid to the variety of means – verbal as well as non-verbal – that interlocutors have at their disposal when attempting to influence each other towards achieving organizationally relevant goals.
Semi-automatic measurement of intracranial hemorrhage growth on non-contrast CT
Authors: Chung Kevin J , Kuang Hulin , Federico Alyssa , Choi Hyun Seok , Kasickova Linda , Al Sultan Abdulaziz Sulaiman , Horn MacKenzie , Crowther Mark , Connolly Stuart J , Yue Patrick , Curnutte John T , Demchuk Andrew M , Menon Bijoy K , Qiu Wu
Published: December 2019

Background

Manual segmentations of intracranial hemorrhage on non-contrast CT images are the gold-standard in measuring hematoma growth but are prone to rater variability.

Aims

We demonstrate that a convex optimization-based interactive segmentation approach can accurately and reliably measure intracranial hemorrhage growth.

Methods

Baseline and 16-h follow-up head non-contrast CT images of 46 subjects presenting with intracranial hemorrhage were selected randomly from the ANNEXA-4 trial imaging database. Three users semi-automatically segmented intracranial hemorrhage to measure hematoma volume for each timepoint using our proposed method. Segmentation accuracy was quantitatively evaluated compared to manual segmentations by using Dice similarity coefficient, Pearson correlation, and Bland–Altman analysis. Intra- and inter-rater reliability of the Dice similarity coefficient and intracranial hemorrhage volumes and volume change were assessed by the intraclass correlation coefficient and minimum detectable change.

Results

Among the three users, the mean Dice similarity coefficient, Pearson correlation, and mean difference ranged from 76.79% to 79.76%, 0.970 to 0.980 ( p < 0.001), and −1.5 to −0.4 ml, respectively, for all intracranial hemorrhage segmentations. Inter-rater intraclass correlation coefficients between the three users for Dice similarity coefficient and intracranial hemorrhage volume were 0.846 and 0.962, respectively, and the corresponding minimum detectable change was 2.51 ml. Inter-rater intraclass correlation coefficient for intracranial hemorrhage volume change ranged from 0.915 to 0.958 for each user compared to manual measurements, resulting in an minimum detectable change range of 2.14 to 4.26 ml.

Conclusions

We spatially and volumetrically validate a novel interactive segmentation method for delineating intracranial hemorrhage on head non-contrast CT images. Good spatial overlap, excellent volume correlation, and good repeatability suggest its usefulness for measuring intracranial hemorrhage volume and volume change on non-contrast CT images.
Impact of Soong grading on flexor tendon ruptures following palmar plating for distal radial fractures
Authors: Gören Yekta , Sauerbier Michael , Arsalan-Werner Annika
Published: December 2019

The purpose of this study was to evaluate flexor tendon injuries following palmar plating of distal radial fractures relative to the Soong grade. This retrospective cohort study included 113 patients who underwent palmar plate removal after a distal radial fracture between 2010 and 2016. In 13 patients, a greater than 50% injury of the flexor pollicis longus tendon was observed. Of these, nine patients were classified as Soong grade 2, four as Soong grade 1 and none as grade 0. The difference between the Soong groups was statistically significant ( p = 0.006). Flexor tenosynovitis was present in eight patients (7%) and more likely in patients with a higher Soong grade ( p = 0.026). We conclude that higher Soong grades are associated with significantly more flexor tendon complications. Therefore, elective removal of the palmar plate after union of the fracture should be considered in patients with Soong grades 1 and 2.

Level of evidence: IV
Studying policy diffusion at the individual level: Experiments on nationalistic biases in information seeking
Authors: Butler Daniel M. , De Vries Catherine E. , Solaz Hector
Published: December 2019

The foundational assumptions of policy diffusion relate to the behavior of individual policymakers. However, empirical tests of policy diffusion often focus on the behavior of governments as a whole (and not individuals). We provide a template for how to study the behavioral decisions of policymakers related to policy diffusion. Our particular field experiments test whether there is a bias toward seeking out information on the policy experiences of local governments in one’s own country as opposed to governments outside of the country. The experimental evidence shows that local officials do not exhibit this bias. Further, they do not exhibit a bias against information about policies that have received an EU endorsement. Our results are a positive sign that nationalistic forces are not diminishing inter-country, policy diffusion within Europe, and our design provides a template for future experiments on policy diffusion.
Tumor-Induced Osteomalacia and the Importance of Plasma Fibroblast Growth Factor 23 as an Indicator: Diagnostic Delay Leads to a Suicide Attempt
Authors: Seemann LaRae , Padala Sandeep Anand , Mohammed Azeem , Belayneh Nardos
Published: December 2019

Tumor-induced osteomalacia is a rare hypophosphatemic disease caused by unregulated production of fibroblast growth factor 23 by a tumor, thereby inducing renal phosphate wasting and inhibiting appropriate increase of calcitriol production. Symptoms of tumor-induced osteomalacia, including muscle weakness, bone pain, and pathologic fractures, are nonspecific and warrant further workup. We report the case of a 50-year-old African American female with no known psychiatric illness who was admitted after a failed suicide attempt provoked by severe bone pain. She had been treated for fibromyalgia and hypophosphatemic rickets at other facilities with no improvement. The findings of profound renal phosphate wasting initiated further evaluation, which revealed an elevated fibroblast growth factor 23 level and a right proximal fibular mesenchymal tumor on octreotide scintigraphy. Magnetic resonance imaging confirmed the findings of a solid intramuscular tumor corresponding to the octreotide avid lesion. After wide excision of the tumor, serum phosphate and parathyroid hormone levels began to normalize. This case highlights the importance of extensively investigating the cause of bone pain, weakness, and fatigue in patients without a family history of hypophosphatemia or bone disorders. The aforementioned symptoms may precede recurrent pathological fractures, and a thorough workup ensures that a diagnosis of tumor is not delayed or overlooked, as tumor resection confers a favorable prognosis and dramatic increase in the quality of life for patients.
Ultrastructural Assessment of the Anterolateral Ligament
Authors: Redler Andrea , Miglietta Selenia , Monaco Edoardo , Matassa Roberto , Relucenti Michela , Daggett Matthew , Ferretti Andrea , Familiari Giuseppe
Published: December 2019

Background:

The anterolateral ligament (ALL) has been identified as a structure on the lateral side of the knee, but debate exists regarding whether it is a capsular thickening or a ligament.

Hypothesis:

A detailed ultrastructural characterization of the ALL and its ultrastructure collagen arrangement will reveal it more closely resembles ligamentous tissue than joint capsule.

Study Design:

Descriptive laboratory study.

Methods:

Eight paired knee samples from 4 fresh-frozen male cadavers were used for this study. Samples were harvested from the ALL, the joint capsule, and the medial collateral ligament (MCL). All samples were evaluated with light microscopy (LM), transmission electron microscopy (TEM), and variable pressure scanning electron microscopy (VP-SEM). With LM, the 3 tissues were analyzed and their morphology described. With TEM, the ultrastructure and collagen characteristics were quantified and compared among specimens. Then, the 3-dimensional characteristics were compared with VP-SEM.

Results:

Ultrastructure analysis demonstrated similar morphology between the ALL and MCL, with significant differences in these 2 structures as compared with the joint capsule. On LM, the ALL and MCL were characterized by the presence of a dense collagen fiber oriented in the longitudinal and transversal directions of the fiber bundles, while the joint capsule was found to have a more disorganized architecture. On TEM, the collagen fibers of the ALL and MCL demonstrated similar ultrastructural morphology, with both having collagen fibers in parallel, longitudinal alignment. A quantitative analysis was also performed, with the mean (± SD) diameter of fibrils in the ALL and MCL being 80 ± 2.66 nm and 150 ± 3.35 nm, respectively (all P < .001). The VP-SEM highlighted that ALL and MCL morphology demonstrated arrangements of fiber bundles that are densely packed and organized, in contrast to the disorganized fibers of the joint capsule.

Conclusion:

The ALL and MCL have comparable ultrastructures that are distinctly different from the joint capsule, as visualized on LM, TEM, and VP-SEM.

Clinical Relevance:

The ALL should be considered a distinctive structure of the knee, although strictly connected to the surrounding capsule.
Early cold stress responses in post-meiotic anthers from tolerant and sensitive rice cultivars
Authors: González-Schain Nahuel , Roig-Villanova Irma , Kater Martin M.
Published: December 2019

Background

Rice grain production is susceptible to a changing environment that imposes both biotic and abiotic stress conditions. Cold episodes are becoming more frequent in the last years and directly affect rice yield in areas with a temperate climate. Rice is particularly susceptible to cold stress during the reproductive phase, especially in anthers during post-meiotic stages which, in turn, affect pollen production. However, a number of rice cultivars with a certain degree of tolerance to cold have been described, which may represent a good breeding resource for improvement of susceptible commercial varieties. Plants experiencing cold stress activate a molecular response in order to reprogram many metabolic pathways to face these hostile conditions.

Results

Here we performed RNA-seq analysis using cold-stressed post-meiotic anther samples from a cold-tolerant, Erythroceros Hokkaido (ERY), and a cold-susceptible commercial cultivar Sant’Andrea (S.AND). Both cultivars displayed an early common molecular response to cold, although the changes in expression levels are much more drastic in the tolerant one. Comparing our datasets, obtained after one-night cold stress, with other similar genome-wide studies showed very few common deregulated genes, suggesting that molecular responses in cold-stressed anthers strongly depend on conditions and the duration of the cold treatments. Cold-tolerant ERY exhibits specific molecular responses related to ethylene metabolism, which appears to be activated after cold stress. On the other hand, S.AND cold-treated plants showed a general downregulation of photosystem I and II genes, supporting a role of photosynthesis and chloroplasts in cold responses in anthers, which has remained elusive.

Conclusions

Our study revealed that a number of ethylene-related transcription factors, as putative master regulators of cold responses, were upregulated in ERY providing promising candidates to confer tolerance to susceptible cultivars. Our results also suggest that the photosynthesis machinery might be a good target to improve cold tolerance in anthers. In summary, our study provides valuable candidates for further analysis and molecular breeding for cold-tolerant rice cultivars.
CRISPR/Cas9-mediated targeted mutagenesis of GmLHY genes alters plant height and internode length in soybean
Authors: Cheng Qun , Dong Lidong , Su Tong , Li Tingyu , Gan Zhuoran , Nan Haiyang , Lu Sijia , Fang Chao , Kong Lingping , Li Haiyang , Hou Zhihong , Kou Kun , Tang Yang , Lin Xiaoya , Zhao Xiaohui , Chen Liyu , Liu Baohui , Kong Fanjiang
Published: December 2019

Background

Soybean (Glycine max) is an economically important oil and protein crop. Plant height is a key trait that significantly impacts the yield of soybean; however, research on the molecular mechanisms associated with soybean plant height is lacking. The CRISPR (clustered regularly interspaced short palindromic repeat)/Cas9 (CRISPR-associated system 9) system is a recently developed technology for gene editing that has been utilized to edit the genomes of crop plants.

Results

Here, we designed four gRNAs to mutate four LATE ELONGATED HYPOCOTYL(LHY) genes in soybean. In order to test whether the gRNAs could perform properly in transgenic soybean plants, we first tested the CRISPR construct in transgenic soybean hairy roots using Agrobacterium rhizogenes strain K599. Once confirmed, we performed stable soybean transformation and obtained 19 independent transgenic soybean plants. Subsequently, we obtained one T1 transgene-free homozygous quadruple mutant of GmLHY by self-crossing. The phenotypes of the T2-generation transgene-free quadruple mutant plants were observed, and the results showed that the quadruple mutant of GmLHY displayed reduced plant height and shortened internodes. The levels of endogenous gibberellic acid (GA3) in Gmlhy1a1b2a2b was lower than in the wild type (WT), and the shortened internode phenotype could be rescued by treatment with exogenous GA3. In addition, the relative expression levels of GA metabolic pathway genes in the quadruple mutant of GmLHY were significantly decreased in comparison to the WT. These results suggest that GmLHY encodes an MYB transcription factor that affects plant height through mediating the GA pathway in soybean. We also developed genetic markers for identifying mutants for application in breeding studies.

Conclusions

Our results indicate that CRISPR/Cas9-mediated targeted mutagenesis of four GmLHY genes reduces soybean plant height and shortens internodes from 20 to 35 days after emergence (DAE). These findings provide insight into the mechanisms underlying plant height regulatory networks in soybean.
Comparative study between intrathecal dexmedetomidine and intrathecal magnesium sulfate for the prevention of post-spinal anaesthesia shivering in uroscopic surgery; (RCT)
Authors: Omar Heba , Aboella Wessam Adel , Hassan Mohammed Mahmoud , Hassan Amany , Hassan Passaint , Elshall Ahmed , Khaled Dalia , Mostafa Maha , Tawadros Pierre Zarif , Hossam Eldin Mona , Wedad Mai , Abdelhamid Bassant Mohamed
Published: December 2019

Background

Hypothermia and shivering are common complications after spinal anaesthesia, especially after uroscopic procedures in which large amounts of cold intraluminal irrigation fluids are used. Magnesium sulfate and dexmedetomidine are the most effective adjuvants with the least side effects. The aim of this study was to compare the effects of intrathecal dexmedetomidine versus intrathecal magnesium sulfate on the prevention of post-spinal anaesthesia shivering.

Methods

This prospective randomized, double-blinded controlled study included 105 patients who were scheduled for uroscopic surgery at the Kasr El-Aini Hospital. The patients were randomly allocated into three groups.Group C (n = 35) received2.5 ml of hyperbaric bupivacaine 0.5% (12.5 mg) + 0.5 ml of normal saline,Group M (n = 35)received 2.5 ml of hyperbaric bupivacaine 0.5% (12.5 mg) + 25 mg of magnesium sulfate in 0.5 ml saline, andGroup D (n = 35)received 2.5 ml of hyperbaric bupivacaine 0.5% (12.5 mg) + 5 μg of dexmedetomidine in 0.5 ml saline. The primary outcomes were the incidence and intensity of shivering. The secondary outcomes were the incidence of hypothermia, sedation, the use of meperidine to control shivering and complications.

Results

Group C had significantly higher proportions of patients who developed shivering (21), developed grade IV shivering (20) and required meperidine (21) to treat shivering than group M (8,5,5) and group D (5,3,6), which were comparable to each other.

The time between block administration and meperidine administration was similar among the three groups. Hypothermia did not occur in any of the patients.

The three groups were comparable regarding the occurrence of nausea, vomiting, bradycardia and hypotension. All the patients in group C, 32 patients in group M and 33 patients in group D had a sedation score of 2. Three patients in group M and 2 patients in group D had a sedation score of 3.

Conclusions

Intrathecal injections of both dexmedetomidine and magnesium sulfate were effective in reducing the incidence of post-spinal anaesthesia shivering. Therefore, we encourage the use of magnesium sulfate, as it is more physiologically available, more readily available in most operating theatres and much less expensive than dexmedetomidine.

Trial registration

Clinical trial registration ID: Pan African Clinical Trial Registry (PACTR) Trial NumberPACTR201801003001727; January 2018, “retrospectively registered”.
Modified technique for thermal radiofrequency ablation of Thoracic dorsal root ganglia under combined fluoroscopy and CT guidance: a randomized clinical trial
Authors: Reyad Raafat M. , Ghobrial Hossam Z. , Shaker Ehab H. , Reyad Ehab M. , Shaaban Mohammed H. , Hashem Rania H. , Darwish Wael M.
Published: December 2019

Background

This study is comparing thermal radiofrequency ablation (TRFA) of the thoracic dorsal root ganglia (TDRG) guided by Xper CT and fluoroscopy with the standard fluoroscopy.

Methods

This randomized clinical trial included 78 patients suffering from chronic refractory pain due to chest malignancies randomly allocated into one of two groups according to guidance of TRFA of TDRG. In CT guided group (n = 40) TRFA was done under integrated Xper CT-scan and fluoroscopy guidance, while it was done under fluoroscopy guidance only in standard group (n = 38). The primary outcome was pain intensity measured by visual analog scale (VAS) score, functional improvement and consumption of analgesics. The secondary outcome measures were patient global impression of changes (PGIC) and adverse effects.

Results

VAS scores decreased in the two groups compared to baseline values (p < 0.001) and were lower in CT guided group up to 12 weeks. Pregabalin and oxycodone consumption was higher in the standard group at 1, 4 and 12 weeks (p < 0.001). Functional improvement showed near significant difference between the two groups (P = 0.06 at week 1, 0.07 at week 4 respectively) while the difference was statistically significant at week 12 (P = 0.04). PGIC showed near significant difference only at week 1 (P = 0.07) while the per-patient adverse events were lower in CT guided group (p = 0.027).

Conclusions

Integrated modality guidance with Xper CT-scan and fluoroscopy together with suprapedicular inferior transforaminal approach may improve efficacy and safety of TRFA of TDRG for the treatment of intractable chest pain in cancer patients.

Trial registration

The study was retrospectively registered atclinicaltrials.govon 04/22/2018 (Registration No.: NCT03533413).
Impact of a semi-structured briefing on the management of adverse events in anesthesiology: a randomized pilot study
Authors: Neuhaus Christopher , Schäfer Johannes , Weigand Markus A. , Lichtenstern Christoph
Published: December 2019

Background

Human factors research has identified mental models as a key component for the effective sharing and organization of knowledge. The challenge lies in the development and application of tools that help team members to arrive at a shared understanding of a situation. The aim of this study was to assess the influence of a semi-structured briefing on the management of a simulated airway emergency.

Methods

37 interprofessional teams were asked to perform a simulated rapid-sequence induction in the simulator. Teams were presented with a “cannot ventilate, cannot oxygenate” scenario that ultimately required a cricothyroidotomy. Study group (SG) teams were asked to perform a briefing prior to induction, while controls (CG) were asked to perform their usual routine.

Results

We observed no difference in the mean time until cricothyroidotomy (SG 8:31 CG 8:16,p = 0.36). There was a significant difference in groups’ choice of alternative means of oxygenation: While SG teams primarily chose supraglottic airway devices, controls initially reverted to mask ventilation (p = 0.005). SG teams spent significantly less time with this alternative airway device and were quicker to advance in the airway algorithm.

Conclusions

Our study addresses effects on team coordination through a shared mental model as effected by a briefing prior to anesthesia induction. We found measurable improvements in airway management during those stages of the difficult airway algorithm explicitly discussed in the briefing. For those, time spent was shorter and participants were quicker to advance in the airway algorithm.
Effectiveness and cost-effectiveness of home-based postpartum care on neonatal mortality and exclusive breastfeeding practice in low-and-middle-income countries: a systematic review and meta-analysis
Authors: Tiruneh Gizachew Tadele , Shiferaw Chalachew Bekele , Worku Alemayehu
Published: December 2019

Background

Early postpartum facility discharge negatively impacts mothers’ proper and effective use postnatal care. Cognizant of these facts, home-based postnatal care practices have been promoted to complement facility-based care to reduce neonatal mortality. This systematic review evaluated the effectiveness and cost-effectiveness of home-based postnatal care on exclusive breastfeeding practice and neonatal mortality in low-and-middle-income countries.

Methods

Randomized trials and quasi-experimental studies were searched from electronic databases including PubMed, Popline, Cochrane Central Register of Controlled Trials and National Health Service Economic Evaluation databases. Random-effects meta-analysis model was used to pool the estimates of the outcomes accounting for the variability among studies.

Results

We identified 14 trials implementing intervention packages that included preventive and promotive newborn care services, home-based treatment for sick neonates, and community mobilization activities. The pooled analysis indicates that home-based postpartum care reduced neonatal mortally by 24% (risk ratio 0.76; 95% confidence interval 0.62–0.92; 9 trials; n = 93,083; heterogeneity p < .01) with no evidence of publication bias (Egger’s test: Coef. = − 1.263; p = .130). The subgroup analysis suggested that frequent home visits, home visits by community health workers, and community mobilization efforts with home visits, to had better neonatal survival. Likewise, the odds of mothers who exclusively breastfed from the home visit group were about three times higher than the mothers who were in the routine care group (odds ratio: 2.88; 95% confidence interval: 1.57–5.29; 6 trials; n = 20,624 mothers; heterogeneity p < .01), with low possibility of publication bias (Coef. = − 7.870; p = .164).

According to the World Health Organization’s Choosing Interventions that are Cost-Effective project recommendations, home-based neonatal care strategy was found to be cost-effective.

Conclusions

Home visits and community mobilization activities to promote neonatal care practices by community health workers is associated with reduced neonatal mortality, increased practice of exclusive breastfeeding, and cost-effective in improving newborn health outcomes for low-and-middle-income countries. However, a well-designed evaluation study is required to formulate the optimal package and optimal timing of home visits to standardize home-based postnatal interventions.
The host fruit amplifies mutualistic interaction between Ceratitis capitata larvae and associated bacteria
Authors: Zaada Doron Shalom Yishai , Ben-Yosef Michael , Yuval Boaz , Jurkevitch Edouard
Published: December 2019

Background

The Mediterranean fruit fly Ceratitis capitata is a major pest in horticulture. The development of fly larvae is mediated by bacterial decay in the fruit tissue. Despite the importance of bacteria on larval development, very little is known about the interaction between bacteria and larvae in their true ecological context. Understanding their relationship and inter-dependence in the host fruit is important for the development of new pest control interfaces to deal with this pest.

Results

We find no negative effects on egg hatch or larval development brought about by the bacterial isolates tested. The various symbionts inhabiting the fly’s digestive system differ in their degree of contribution to the development of fly larvae depending on the given host and their sensitivity to induced inhibition caused by female produced antimicrobial peptides. These differences were observed not only at the genus or species level but also between isolates of the same species. We demonstrate how the microbiota from the mother’s gut supports the development of larvae in the fruit host and show that larvae play a major role in spreading the bacterial contagion in the infected fruit itself. In addition, we present (for the first time) evidence for horizontal transfer of bacteria between larvae of different maternal origin that develop together in the same fruit.

Conclusions

Larvae play a major role in the spread and shaping of the microbial population in the fruit. The transfer of bacteria between different individuals developing in the same fruit suggests that the infested fruit serves as a microbial hub for the amplification and spread of bacterial strains between individuals.
Horizontal transfer and finalization of a reliable detection method for the olive fruit fly endosymbiont, Candidatus Erwinia dacicola
Authors: Bigiotti Gaia , Pastorelli Roberta , Guidi Roberto , Belcari Antonio , Sacchetti Patrizia
Published: December 2019

Background

The olive fly,Bactrocera oleae,is the most important insect pest in olive production, causing economic damage to olive crops worldwide. In addition to extensive research onB. oleaecontrol methods, scientists have devoted much effort in the last century to understanding olive fly endosymbiosis with a bacterium eventually identified asCandidatusErwinia dacicola. This bacterium plays a relevant role in olive fly fitness. It is vertically transmitted, and it benefits both larvae and adults in wild populations; however, the endosymbiont is not present in lab colonies, probably due to the antibiotics and preservatives required for the preparation of artificial diets. Endosymbiont transfer from wildB. oleaepopulations to laboratory-reared ones allows olive fly mass-rearing, thus producing more competitive flies for future Sterile Insect Technique (SIT) applications.

Results

We tested the hypothesis thatCa. E. dacicola might be transmitted from wild, naturally symbiotic adults to laboratory-reared flies. Several trials have been performed with different contamination sources ofCa. E. dacicola, such as ripe olives and gelled water contaminated by wild flies, wax domes containing eggs laid by wild females, cages dirtied by faeces dropped by wild flies and matings between lab and wild adults. PCR-DGGE, performed with the primer set 63F-GC/518R, demonstrated that the transfer of the endosymbiont from wild flies to lab-reared ones occurred only in the case of cohabitation.

Conclusions

Cohabitation of symbiotic wild flies and non-symbiotic lab flies allows the transfer ofCa. E. dacicola through adults. Moreover, PCR-DGGE performed with the primer set 63F-GC/518R was shown to be a consistent method for screeningCa. E. dacicola, also showing the potential to distinguish between the two haplotypes (htA and htB). This study represents the first successful attempt at horizontal transfer ofCa. E. dacicola and the first step in acquiring a better understanding of the endosymbiont physiology and its relationship with the olive fly. Our research also represents a starting point for the development of a laboratory symbiotic olive fly colony, improving perspectives for future applications of the Sterile Insect Technique.
Effect of core materials for core fabrication for dental implants on in-vitro cytocompatibility of MC3T3-E1 cells
Authors: Park Jung-Hyun , Lee Hyun , Kang Seen-Young , Kim Junesun , Kim Ji-Hwan
Published: December 2019

Background

Despite the wide use of dental materials for CAD/CAM system in prosthetic treatment, the effect of the materials, which are used as dental implants core fabricated, on cells involved in dental implant osseointegration is uncertain. This study aimed to investigate and compare the effect of single core materials used for dental implants fabricated by the dental prostheses fabrication process and the CAD/CAM milling method on MC3T3-E1 cells.

Methods

The materials used for prostheses restoration in this experiment were Porcelain Fused Gold (P.F.G), Lithium disilicate glass ceramic (LiSi2), Zirconia (ZrO2), Nickel-Chromium (Ni-Cr) and Cobalt-Chromium (Co-Cr). MC3T3-E1 cells were cultured and used, the cell adhesion and morphology were observed and analyzed using confocal laser scanning microscopy (CLSM). Methoxyphenyl tetrazolium salt (MTS) and alkaline phosphatase (ALP) assay were used to observe the cell proliferation and differentiation.

Results

CLSM revealed irregular cell adhesion and morphology and the filopodia did not spread in the Ni-Cr specimen group. Significantly high cell proliferation was observed in the ZrO2 specimen group. The LiSi2 specimen group presented significantly high cell differentiation. Intergroup comparison of cell proliferation and differentiation between the Ni-Cr specimen group and all other specimen groups showed significant differences (p < .05).

Conclusion

Cell proliferation and differentiation were observed from the cores, which were fabricated with all specimen groups on cytocompatibility except the Ni-Cr specimen group.
Prognostic differences among patients with idiopathic interstitial pneumonias with acute exacerbation of varying pathogenesis: a retrospective study
Authors: Kato Motoyasu , Yamada Tomoko , Kataoka Shunichi , Arai Yuta , Miura Keita , Ochi Yusuke , Ihara Hiroaki , Koyama Ryo , Sasaki Shinichi , Takahashi Kazuhisa
Published: December 2019

Background

Acute exacerbation of chronic fibrosing idiopathic interstitial pneumonias (AE-IIPs) is associated with a high mortality rate. In 2016, an international working group proposed a revised diagnostic criteria for AE-IIPs, suggesting that it be classified as idiopathic or triggered. Many factors are known to trigger AE-IIPs, including surgery, infection, and drugs. However, it is unknown which AE-IIPs triggers have a worse prognosis. We aimed to investigate the prognosis of patients with various clinical types of AE-IIPs, particularly infection-triggered, non-infection triggered, and idiopathic AE-IIPs.

Methods

We retrospectively collected data from 128 chronic fibrosing IIPs (CF-IIPs) patients who were hospitalized by respiratory failure between April 2009 and March 2019 at Juntendo University Hospital. Among these patients, we evaluated 79 patients who developed AE-IIPs and 21 who developed pneumonia superimposed on CF-IIPs. Patients with AE-IIPs were classified into three types: idiopathic, infection-triggered, and non-infection-triggered AE-IIPs. We analyzed differences in patient characteristics, examination findings; level of serum markers, results of pulmonary function, and radiological findings, prior treatment for baseline CF-IIPs, and prognosis. We then evaluated the risk factor for early death (death within 30 days from the onset of AE-IIPs) associated with AE-IIPs.

Results

Among the patients who developed AE-IIPs, 34 were characterized as having idiopathic, 25 were characterized as having infection-triggered, and 20 were categorized as having non-infection-triggered AE-IIPs. Survival time for pneumonia superimposed on IIPs was significantly longer than that for any AE-IIPs. Survival time for bacterial pneumonia superimposed on CF-IIPs was significantly longer than that for AE-IIPs (for each idiopathic and all triggered IIPs). Thereafter, survival time for infection-triggered was significantly longer than for idiopathic or non-infection-triggered AE-IIPs. The mortality rate was significantly lower in infection-triggered AE-IIPs than in other types of AE-IIPs. Furthermore, the incidence of infection-triggered AE-IIPs in winter was significantly higher than that in other seasons. Moreover, the clinical AE-IIPs types and radiological findings at AE-IIP onset were significant risk factors for AE-IIPs-induced early death.

Conclusions

Our findings suggest that patients with infection-triggered AE-IIPs can expect a better prognosis than can patients with other clinical types of AE-IIPs.
Clinical characteristics and treatment outcomes of patients with macrolide-resistant Mycobacterium avium complex pulmonary disease: a systematic review and meta-analysis
Authors: Park Youngmok , Lee Eun Hye , Jung Inkyung , Park Goeun , Kang Young Ae
Published: December 2019

Background

Macrolide is a key drug in the treatment of Mycobacterium avium complex pulmonary disease (MAC-PD). Macrolide-resistant MAC is gaining importance, but there are little data in clinical characteristics and treatment outcomes of macrolide-resistant MAC-PD (MR-MAC-PD).

Methods

We performed a systematic review and meta-analysis of published studies reporting clinical characteristics and treatment outcomes of patients with MR-MAC-PD. Risk of bias was assessed using the modified Newcastle-Ottawa Scale.

Results

Nine studies (seven retrospective and two prospective) comprising 319 patients were identified through a database search. Around 73% were women, and 52% had the fibrocavitary form. Pooled sputum culture conversion rate after combined multiple antibiotics or surgical resection was 21% (95% confidence interval [CI], 14–30%), and the one-year all-cause mortality was 10% (95% CI, 5–20%). There was no significant difference in treatment outcomes between nodular bronchiectatic and fibrocavitary types.

Conclusions

Even combination therapy with fluoroquinolone, aminoglycoside, and surgical resection, the treatment outcomes of MR-MAC-PD were poor. The investigation of new treatment modalities is urgent.
Exchange protein directly activated by cAMP (Epac) protects against airway inflammation and airway remodeling in asthmatic mice
Authors: Chen Yi-fei , Huang Ge , Wang Yi-min , Cheng Ming , Zhu Fang-fang , Zhong Jin-nan , Gao Ya-dong
Published: December 2019

Background

β2 receptor agonists induce airway smooth muscle relaxation by increasing intracellular cAMP production. PKA is the traditional downstream signaling pathway of cAMP. Exchange protein directly activated by cAMP (Epac) was identified as another important signaling molecule of cAMP recently. The role of Epac in asthmatic airway inflammation and airway remodeling is unclear.

Methods

We established OVA-sensitized and -challenged acute and chronic asthma mice models to explore the expression of Epac at first. Then, airway inflammation and airway hyperresponsiveness in acute asthma mice model and airway remodeling in chronic asthma mice model were observed respectively after treatment with Epac-selective cAMP analogue 8-pCPT-2′-O-Me-cAMP (8pCPT) and Epac inhibitor ESI-09. Next, the effects of 8pCPT and ESI-09 on the proliferation and apoptosis of in vitro cultured mouse airway smooth muscle cells (ASMCs) were detected with CCK-8 assays and Annexin-V staining. Lastly, the effects of 8pCPT and ESI-09 on store-operated Ca2+ entry (SOCE) of ASMCs were examined by confocal Ca2+ fluorescence measurement.

Results

We found that in lung tissues of acute and chronic asthma mice models, both mRNA and protein expression of Epac1 and Epac2, two isoforms of Epac, were lower than that of control mice. In acute asthma mice model, the airway inflammatory cell infiltration, Th2 cytokines secretion and airway hyperresponsiveness were significantly attenuated by 8pCPT and aggravated by ESI-09. In chronic asthma mice model, 8pCPT decreased airway inflammatory cell infiltration and airway remodeling indexes such as collagen deposition and airway smooth muscle cell proliferation, while ESI-09 increased airway inflammation and airway remodeling. In vitro cultured mice ASMCs, 8pCPT dose-dependently inhibited, whereas ESI-09 promoted ASMCs proliferation. Interestingly, 8pCPT promoted the apoptosis of ASMCs, whereas ESI-09 had no effect on ASMCs apoptosis. Lastly, confocal Ca2+ fluorescence examination found that 8pCPT could inhibit SOCE in ASMCs at 100 μM, and ESI-09 promoted SOCE of ASMCs at 10 μM and 100 μM. In addition, the promoting effect of ESI-09 on ASMCs proliferation was inhibited by store-operated Ca2+ channel blocker, SKF-96365.

Conclusions

Our results suggest that Epac has a protecting effect on asthmatic airway inflammation and airway remodeling, and Epac reduces ASMCs proliferation by inhibiting SOCE in part.