bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanistic insight into the role of Poly(ADP-ribosyl)ation in DNA topology modulation and response to DNA damage
Authors: Matkarimov Bakhyt T , Zharkov Dmitry O , Saparbaev Murat K
Published: November 2019

Genotoxic stress generates single- and double-strand DNA breaks either through direct damage by reactive oxygen species or as intermediates of DNA repair. Failure to detect and repair DNA strand breaks leads to deleterious consequences such as chromosomal aberrations, genomic instability and cell death. DNA strand breaks disrupt the superhelical state of cellular DNA, which further disturbs the chromatin architecture and gene activity regulation. Proteins from the poly(ADP-ribose) polymerase (PARP) family, such as PARP1 and PARP2, use NAD+ as a substrate to catalyse the synthesis of polymeric chains consisting of ADP-ribose units covalently attached to an acceptor molecule. PARP1 and PARP2 are regarded as DNA damage sensors that, upon activation by strand breaks, poly(ADP-ribosyl)ate themselves and nuclear acceptor proteins. Noteworthy, the regularly branched structure of poly(ADP-ribose) polymer suggests that the mechanism of its synthesis may involve circular movement of PARP1 around the DNA helix, with a branching point in PAR corresponding to one complete 360° turn. We propose that PARP1 stays bound to a DNA strand break end, but rotates around the helix displaced by the growing poly(ADP-ribose) chain, and that this rotation could introduce positive supercoils into damaged chromosomal DNA. This topology modulation would enable nucleosome displacement and chromatin decondensation around the lesion site, facilitating the access of DNA repair proteins or transcription factors. PARP1-mediated DNA supercoiling can be transmitted over long distances, resulting in changes in the high-order chromatin structures. The available structures of PARP1 are consistent with the strand break-induced PAR synthesis as a driving force for PARP1 rotation around the DNA axis.
Effects of valproic acid on histone deacetylase inhibition in vitro and in glioblastoma patient samples
Authors: Berendsen Sharon , Frijlink Elselien , Kroonen Jèrôme , Spliet Wim G M , van Hecke Wim , Seute Tatjana , Snijders Tom J , Robe Pierre A
Published: November 2019

Background

The antiepileptic drug valproic acid (VPA) inhibits histone deacetylase in glioblastoma cells in vitro, which influences several oncogenic pathways and decreases glioma cell proliferation. The clinical relevance of these observations remains unclear, as VPA does not seem to affect glioblastoma patient survival. In this study, we analyzed whether the in vitro effects of VPA treatment on histone acetylation are also observed in tumor tissues of glioblastoma patients.

Methods

The in vitro effects of VPA treatment on histone acetylation were assessed with immunofluorescence and western blotting. On tissue microarrays and in fresh-frozen glioblastoma tissues we investigated the histone acetylation patterns of patients who were either treated with VPA or did not receive antiepileptic drugs at the time of their surgery. We also performed mRNA expression-based and gene set enrichment analyses on these tissues.

Results

VPA increased the expression levels of acetylated histones H3 and H4 in vitro, in agreement with previous reports. In tumor samples obtained from glioblastoma patients, however, VPA treatment affected neither gene (set) expression nor histone acetylation.

Conclusions

The in vitro effects of VPA on histone acetylation status in glioblastoma cells could not be confirmed in clinical tumor samples of glioblastoma patients using antiepileptic doses of VPA, which reflects the lack of effect of VPA on the clinical outcome of glioblastoma patients.
Regulation of the Poly(A) Status of Mitochondrial mRNA by Poly(A)-Specific Ribonuclease Is Conserved among Land Plants
Authors: Kanazawa Mai , Ikeda Yoko , Nishihama Ryuichi , Yamaoka Shohei , Lee Nam-Hee , Yamato Katsuyuki T , Kohchi Takayuki , Hirayama Takashi
Published: November 2019

Regulation of the stability and the quality of mitochondrial RNA is essential for the maintenance of mitochondrial and cellular functions in eukaryotes. We have previously reported that the eukaryotic poly(A)-specific ribonuclease (PARN) and the prokaryotic poly(A) polymerase encoded by AHG2 and AGS1, respectively, coordinately regulate the poly(A) status and the stability of mitochondrial mRNA in Arabidopsis. Mitochondrial function of PARN has not been reported in any other eukaryotes. To know how much this PARN-based mitochondrial mRNA regulation is conserved among plants, we studied the AHG2 and AGS1 counterparts of the liverwort, Marchantia polymorpha, a member of basal land plant lineage. We found that M. polymorpha has one ortholog each for AHG2 and AGS1, named MpAHG2 and MpAGS1, respectively. Their Citrine-fused proteins were detected in mitochondria of the liverwort. Molecular genetic analysis showed that MpAHG2 is essential and functionally interacts with MpAGS1 as observed in Arabidopsis. A recombinant MpAHG2 protein had a deadenylase activity in vitro. Overexpression of MpAGS1 and the reduced expression of MpAHG2 caused an accumulation of polyadenylated Mpcox1 mRNA. Furthermore, MpAHG2 suppressed Arabidopsis ahg2-1 mutant phenotype. These results suggest that the PARN-based mitochondrial mRNA regulatory system is conserved in land plants.
Establishing a student-run free clinic in a major city in Northern Europe: a 1-year experience from Hamburg, Germany
Authors: Drexler Richard , Fröschle Felix , Predel Christopher , Sturm Berit , Ustorf Klara , Lehner Louisa , Janzen Jara , Valentin Lisa , Scheer Tristan , Lehnert Franziska , Tadzic Refmir , Oldhafer Karl Jürgen , Meyer Tobias N
Published: November 2019

Background

Student-Run Free Clinics (SRFCs) have been an integral part of US medical schools since the 1960s and provide health care to underserved populations. In 2018, we established an SRFC in Hamburg, Germany, a major city in Northern Europe. The aim of this study was to describe the central problems and to investigate the usefulness of an SRFC in a country with free access to medical care, such as Germany.

Methods

All consecutive patients treated at the SRFC Hamburg between February 2018 and March 2019 that consented to this study were analyzed regarding clinical characteristics, diagnosis, readmission rate and country of origin.

Results

Between February 2018 and March 2019, 229 patients were treated at the SRFC in Hamburg. The patients came from 33 different countries with a majority (n = 206, 90%) from countries inside the European Union. The most common reasons for visiting the SRFC were infections (23.2%), acute or chronic wounds (13.5%) and fractures (6.3%).

Conclusion

Our multicultural patients suffer mainly from infections and traumatological and dermatological diseases. We find similarities to published Canadian SRFC patient cohorts but differences in diseases and treatment modalities compared to US SRFCs. Importantly, we demonstrate the relevance and necessity of the SRFC in a major city in Northern Europe.
A comparative study of two porous sponge scaffolds prepared by collagen derived from porcine skin and fish scales as burn wound dressings in a rabbit model
Authors: Shi Yufei , Zhang Hongjian , Zhang Xin , Chen Zhan , Zhao Dan , Ma Jun
Published: November 2019

Collagen is widely used in biomedical applications due to its outstanding properties. In this study, highly porous sponge scaffolds were developed by using porcine skin-derived collagen (PSC) and fish scale-derived collagen (FSC), respectively. The morphology and composition of these PSC and FSC scaffolds were compared. The water uptake ratio of FSC scaffolds reached 47.8, which is 1.7 times of PSC scaffolds. The water vapour transmission rates (WVTR) of PSC and FSC scaffolds were 952.6 ± 55.5 and 1090.9 ± 77.1 g/m2/day, which could produce a moist healing environment for wounds. Both scaffolds show non-toxicity to L929 fibroblast cells. The burn wound healing efficiency of these two scaffolds was examined in vivo using rabbits. No scars around the wounds were observed after applying PSC and SFC scaffolds. Histopathological studies reveal that the wound treated with PSC and FSC scaffolds showed much better wound recovery than gauze and vaseline gauze groups. It was suggested that FSC scaffolds have great potential as same as PSC to be used as burn wound dressing materials.
Higher Social Rejection Sensitivity in Opioid-Dependent Patients Is Related to Smaller Insula Gray Matter Volume: A Voxel-Based Morphometric Study
Authors: Bach Patrick , Frischknecht Ulrich , Klinkowski Svenja , Bungert Melanie , Karl Damian , Vollmert Christian , Vollstädt-Klein Sabine , Lis Stefanie , Kiefer Falk , Hermann Derik
Published: November 2019

Opioid-dependent patients are highly sensitized to negative social feedback, and increased social rejection sensitivity was linked to adverse treatment outcome, but its neurobiological underpinnings have not been understood yet. The present study investigated gray matter (GM) volume differences between 19 opioid maintenance treatment (OMT) patients and 20 healthy controls using magnetic resonance imaging and voxel-based morphometry. Associations of GM volumes with subjective feelings of exclusion and inclusion during a social ostracism (Cyberball) paradigm, with rejection sensitivity, social interaction anxiety and social phobia were explored. OMT patients displayed smaller GM volume in the bilateral insula and inferior frontal gyri. Psychometric and task data showed that patients reported significantly higher rejection sensitivity, social anxiety and social phobia scores and felt more excluded and less included during the social ostracism paradigm. Smaller GM volume in the insula was associated with higher subjective exclusion, lower subjective inclusion and higher rejection sensitivity, social anxiety and social phobia scores. Findings indicate that structural deficits in emotion- and anxiety-processing brain regions in OMT patients are associated with increased social rejection sensitivity. As social rejection is a potential trigger for relapse, patients might benefit from therapeutic strategies that promote social integration.
Differences in Functional Connectivity Networks Related to the Midbrain Dopaminergic System-Related Area in Various Psychiatric Disorders
Authors: Nakamura Yuko , Okada Naohiro , Koshiyama Daisuke , Kamiya Kouhei , Abe Osamu , Kunimatsu Akira , Okanoya Kazuo , Kasai Kiyoto , Koike Shinsuke
Published: November 2019

Objective

Disruptions in the dopamine system have been observed in psychiatric disorders. Since dopamine is mainly produced in the ventral tegmental area (VTA), elucidating the differences in the VTA neural network across psychiatric disorders would facilitate a greater understanding of the pathophysiological mechanisms underlying these disorders. However, no study has compared VTA-seed-based functional connectivity across psychiatric disorders. Therefore, we conducted a resting-state functional magnetic resonance imaging (rs-fMRI) study to perform a seed-based fMRI analysis, using the VTA as a seed.

Methods

We included participants with major depressive disorder (MDD; n = 45), schizophrenia (n = 32), and bipolar disorder (BPD; n = 30), along with healthy control participants (n = 46) who were matched for age, gender, and handedness.

Results

The results showed that patients with MDD and BPD had altered VTA-related connectivity in the superior frontal gyrus, frontal pole regions, hippocampus, cerebellum, and posterior cingulate cortex. Some of these differences in connectivity were also found between affective disorders and schizophrenia; however, there were no differences between the schizophrenia and control groups. Connectivity between the VTA and the hippocampus was correlated with positive symptoms in the schizophrenia group. The connectivity was not associated with medication dose, and the results remained significant after controlling for dose.

Conclusions

The results suggest that altered brain functional connectivity related to VTA networks could be associated with the distinctive pathophysiologies of psychiatric disorders, especially affective disorders.
The Wall Around EU Fundamental Freedoms: the Purely Internal Rule at the Forty-Year Mark
Authors: Arena Amedeo
Published: November 2019

‘Purely internal situations’ are sets of facts entirely confined within a single Member State. According to the ‘purely internal rule’, introduced by the European Court of Justice (ECJ) in 1979, purely internal situations lie outside the scope of the internal market fundamental freedoms and of other EU provisions having a cross-border scope. On the fortieth anniversary of the jurisprudential genesis of the purely internal rule, this article seeks to examine its origins, rationale, and evolution, by analyzing the most relevant patterns in the over 250 preliminary rulings handed down in disputes involving purely internal situations. This survey will enable an assessment of the systemic significance of the purely internal rule and of the consequences that abolishing that rule would have for the European integration process.
Burmese amber reveals a new stem lineage of whirligig beetle (Coleoptera: Gyrinidae) based on the larval stage
Authors: Gustafson Grey T , Michat Mariano C , Balke Michael
Published: November 2019

Burmese amber is well known for preserving unique extinct lineages of insects. Here, we describe a new fossil beetle in its larval stage from Burmese amber. Bayesian and parsimony phylogenetic analysis of 50 morphological characters support this fossil as being sister to both the tribes Dineutini and Orectochilini, representing an extinct stem lineage in Gyrininae. It is described here as a new genus and species of whirligig beetle, Chimerogyrus gigagalea gen. & sp. nov., a taxon that preserves remarkable intermediate features between the whirligig beetle tribe Gyrinini and the crown Orectochilini and Dineutini. This new taxon preserves key features for studying the evolution of characters within the larval stage of the Gyrinidae and highlights the importance of Burmese amber for preserving both stem and crown lineages present during the mid-Cretaceous, before the end-Cretaceous mass extinction event.
Anthracnose in U.S. Tea: Pathogen Characterization and Susceptibility Among Six Tea Accessions
Authors: Orrock James M. , Rathinasabapathi Bala , Spakes Richter Brantlee
Published: November 2019

Tea (Camellia sinensis [L.] O. Kuntze) is under investigation as a specialty crop in the United States. Anthracnose is a serious disease in global tea production, but there is no literature on the susceptibility of U.S. planting materials to this disease. We isolated a Colletotrichum species from symptomatic plants in a field trial and identified the pathogen as Colletotrichum camelliae based on morphology and sequencing of the ITS, GS, GAPDH, TUB2, and ApMat domains. A phylogenetic analysis showed that local field isolates were genetically similar to one another and grouped with isolates from C. sinensis in China, whereas a local isolate from an ornamental camellia (C. japonica) was more closely related to C. camelliae isolated from other Camellia spp. Six commercially available tea accessions were evaluated in detached leaf assays for susceptibility to this anthracnose pathogen. All accessions were susceptible to infection, with Fairhope and Small Leaf having the largest lesion sizes. In field observations, Fairhope, Big Leaf, and Small Leaf consistently had lower disease severity than Georgian over two growing seasons. This work documents the impact of anthracnose on U.S. tea varieties and may help shape future directions of tea research, breeding, and recommendations for growers in establishing a novel industry.
The Benefit of Dexmedetomidine on Postoperative Cognitive Function Is Unrelated to the Modulation on Peripheral Inflammation
Authors: Mei Bin , Xu Guanghong , Han Wei , Lu Xiaolong , Liu Ruihong , Cheng Xinqi , Chen Shishou , Gu Erwei , Liu Xuesheng , Zhang Ye
Published: November 2019

Background:

Dexmedetomidine potentially confers an advantage to reduce the incidence of postoperative delirium (POD) in surgical patients. Anti-inflammation is important effect of this sedative drug. In this study, we aimed to investigate whether the effect of dexmedetomidine on the postoperative cognitive function is via inhibiting peripheral inflammation.

Methods:

A prospective, randomized, controlled study was conducted with patients 65 years of age or above who received total knee arthroplasty from January 2019 to May 2019. The patients were randomly assigned to receive spinal anesthesia supplemented with propofol or dexmedetomidine for sedation. The incidence of POD was the primary endpoint and was evaluated with the Confusion Assessment Method, and incidence of postoperative cognitive dysfunction was assessed with the Mini-Mental State Examination. Blood samples were collected postoperatively to test the plasma concentrations of interleukin-6, tumor necrosis factor-α, and S100β.

Results:

A total of 366 patients were randomly assigned to 2 groups. Patients who received dexmedetomidine sedation had lower incidences of POD and better postoperative cognitive function than patients sedated with propofol. There was no difference in postoperative plasma concentrations of tumor necrosis factor-α and interleukin-6 between the 2 groups. The concentration of S100β 48 hours after surgery was higher in patients sedated with propofol than in patients who received dexmedetomidine sedation.

Conclusion:

Intraoperative sedation with dexmedetomidine conferred better postoperative neurocognitive function for elderly patients who received total knee arthroplasty. This effect was unrelated to the modulation of dexmedetomidine on peripheral inflammation.
Anesthetic Management Using Multiple Closed-loop Systems and Delayed Neurocognitive Recovery
Authors: Joosten Alexandre , Rinehart Joseph , Bardaji Aurélie , Van der Linden Philippe , Jame Vincent , Van Obbergh Luc , Alexander Brenton , Cannesson Maxime , Vacas Susana , Liu Ngai , Slama Hichem , Barvais Luc
Published: November 2019

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

Cognitive changes after anesthesia and surgery represent a significant public health concern. We tested the hypothesis that, in patients 60 yr or older scheduled for noncardiac surgery, automated management of anesthetic depth, cardiac blood flow, and protective lung ventilation using three independent controllers would outperform manual control of these variables. Additionally, as a result of the improved management, patients in the automated group would experience less postoperative neurocognitive impairment compared to patients having standard, manually adjusted anesthesia.

Methods

In this single-center, patient-and-evaluator-blinded, two-arm, parallel, randomized controlled, superiority study, 90 patients having noncardiac surgery under general anesthesia were randomly assigned to one of two groups. In the control group, anesthesia management was performed manually while in the closed-loop group, the titration of anesthesia, analgesia, fluids, and ventilation was performed by three independent controllers. The primary outcome was a change in a cognition score (the 30-item Montreal Cognitive Assessment) from preoperative values to those measures 1 week postsurgery. Secondary outcomes included a battery of neurocognitive tests completed at both 1 week and 3 months postsurgery as well as 30-day postsurgical outcomes.

Results

Forty-three controls and 44 closed-loop patients were assessed for the primary outcome. There was a difference in the cognition score compared to baseline in the control group versus the closed-loop group 1 week postsurgery (–1 [–2 to 0] vs. 0 [–1 to 1]; difference 1 [95% CI, 0 to 3], P = 0.033). Patients in the closed-loop group spent less time during surgery with a Bispectral Index less than 40, had less end-tidal hypocapnia, and had a lower fluid balance compared to the control group.

Conclusions

Automated anesthetic management using the combination of three controllers outperforms manual control and may have an impact on delayed neurocognitive recovery. However, given the study design, it is not possible to determine the relative contribution of each controller on the cognition score.
Patients With Poor Baseline Mental Health May Experience Significant Improvements in Pain and Disability After Minimally Invasive Transforaminal Lumbar Interbody Fusion
Authors: Goh Graham Seow-Hng , Liow Ming Han Lincoln , Yeo William , Ling Zhixing Marcus , Yue Wai-Mun , Guo Chang-Ming , Tan Seang-Beng , Chen John Li-Tat
Published: November 2019

Study Design:

A retrospective study using prospectively collected registry data.

Objective:

Examine the influence of preoperative mental health on outcomes after Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF).

Summary of Background Data:

Prior studies investigating the relationship between mental health and outcomes after lumbar spine surgery included small cohorts with short follow-up and heterogenous fusion techniques. The effect of MIS-TLIF on mental health also remains unclear.

Methods:

Prospectively collected registry data of 226 patients who underwent single-level MIS-TLIF at a single institution were reviewed. Patients had completed 5-year follow-up data and were assigned into propensity score-matched groups: poor baseline mental health, that is, low Mental Component Summary (MCS) (<50, n=113) and normal baseline mental health, that is, high MCS (≥50, n=113). Outcomes assessed were visual analog scale for back pain (BP), leg pain (LP), Oswestry Disability Index (ODI), Short-Form 36, North American Spine Society-Neurogenic Symptoms (NS), return to work, return to function, satisfaction, and expectation fulfillment. Length of operation and length of stay were recorded.

Results:

Preoperative MCS was 40.6±8.2 and 58.5±5.4 in the low and high MCS groups, respectively, after propensity score matching (P<0.001). At 5 years, the high MCS group had significantly lower LP (P=0.020) and NS (P=0.009). Despite a significantly poorer baseline (44.3 vs. 38.7, P=0.007) and 6-month ODI (20.3 vs. 15.7, P=0.018) in the low MCS group, both groups achieved a comparable ODI at 5 years (P=0.084). There was no significant difference in proportion that achieved minimal clinically important difference for ODI, PCS, BP, and LP (P>0.05). Both groups reported similar proportions that return to work. However, the low MCS group had a smaller proportion of patients that return to function at 5 years (P=0.025).

Conclusions:

Although patients with poorer baseline mental health had greater pain and worse NS preoperatively and up to 5 years postoperatively, a similar proportion experienced a clinically significant improvement in all outcomes.

Level of Evidence:

Level III—nonrandomized cohort study.
Physiological Responses to the 6-min Step Test in Patients With Chronic Obstructive Pulmonary Disease
Authors: Munari Anelise B. , Venâncio Raysa S. , Klein Suelen R. , Gulart Aline A. , Silva Isabela J. C. S. , Sonza Anelise , Dal Lago Pedro , Mayer Anamaria F.
Published: November 2019

Purpose:

To describe physiological responses during the 6-min step test (6MST) in patients with chronic obstructive pulmonary disease (COPD), to investigate whether COPD severity and test interruptions could determine different physiological responses, and to test the reproducibility of 6MST performance.

Methods:

Cross-sectional study. Patients with moderate to very severe COPD underwent lung function assessment and 2 6MSTs, with physiological responses measurement by a gas analyzer and a near-infrared spectroscopy device.

Results:

Thirty-six patients (29 men; forced expiratory volume in the first second of expiration [FEV1] = 51.1 ± 13.6%pred) participated in the study. Most of the physiological variables stabilized between the second and fourth minutes of the 6MST, except the respiratory rate and heart rate (HR), which stabilized after the fifth minute. The patients who interrupted the 6MST showed higher minute ventilation to maximal voluntary ventilation ratio (

JOURNAL/jcprh/04.03/01273116-202001000-00010/10FSM1/v/2023-09-11T232142Z/r/image-gif

e/mvv; all test minutes) and HR (first and second minutes) (P < .05) and worse pulmonary function (FEV1 = 1.37 ± 0.37 L vs 1.82 ± 0.41 L, P = .002, and 47.2 ± 13.2%pred vs 56.6 ± 12.4%pred, P = .04, respectively) than those who did not interrupt the 6MST. However, their performance was similar (P = .11). 6MST performance and physiological variables were reproducible, and there was a learning effect of 6.28%.

Conclusions:

The 6MST showed a stabilization of the most physiological variables. In addition, interruptions were usually made by patients with a greater impairment of lung function and they presented greater increased ventilatory demand during the 6MST. However, these interruptions do not interfere with 6MST physiological responses. Moreover, the 6MST is a reliable test to evaluate the functional capacity of patients with COPD.
Coexistence of Congenital Hereditary Endothelial Dystrophy and Fuchs Endothelial Corneal Dystrophy Associated With SLC4A11 Mutations in Affected Families
Authors: Chaurasia Sunita , Ramappa Muralidhar , Annapurna Mohini , Kannabiran Chitra
Published: November 2019

Purpose:

To evaluate parents of probands affected with autosomal recessive congenital hereditary endothelial dystrophy (CHED) for clinical signs of Fuchs endothelial corneal dystrophy (FECD) and to determine the genotypes of the SLC4A11 gene in the probands and their parents.

Methods:

This study involved 9 patients affected with CHED from 8 families. The parents of such probands were examined to investigate for possible signs of FECD although they did not present with any visual complaints. Blood samples were collected after obtaining consent, from all 9 cases and the parents of each proband, for genetic analysis. Genomic DNA isolated from blood leukocytes was used for genetic analysis. Screening of the coding regions of the SLC4A11 gene for mutations was carried out by standard procedures using polymerase chain reaction (PCR) amplification and sequencing. Sequences were checked against the human SLC4A11 reference sequence to detect alterations and in normal control samples available in the laboratory.

Results:

The probands had characteristic signs of CHED, whereas one of the parents of each of the probands showed early signs of FECD, characterized by the presence of guttae in the central cornea corroborative with the diagnosis of FECD, and were otherwise asymptomatic at that time. The CHED-affected probands were homozygous for various SLC4A11 mutations, and their parents were heterozygous for the same. The mutations included missense mutations in 6 probands and nonsense mutations in 2 cases.

Conclusions:

Heterozygosity for SLC4A11 mutations in the parents of children with autosomal recessive CHED appears to be a risk factor for the development of FECD in these cases.
Eyeliner Induces Tear Film Instability and Meibomian Gland Dysfunction
Authors: Prabhasawat Pinnita , Chirapapaisan Chareenun , Chitkornkijsin Chayachit , Pinitpuwadol Warinyupa , Saiman Manutsawin , Veeraburinon Anupong
Published: November 2019

Purpose:

To compare the degree of tear film instability and severity of meibomian gland dysfunction between subjects who use eyeliner and those who do not use eyeliner.

Methods:

This cross-sectional study included 42 healthy volunteer women who had no dry eye symptoms (Ocular Surface Disease Index score < 13) and aged between 18 and 40 years. The subjects were classified into 2 groups: an eyeliner-use group (EL: regularly used eyeliner ≥3 d/wk and continuously used ≥6 mo) and a noneyeliner-use group as controls. A questionnaire for ocular surface symptoms using a visual analog scale was administered. Then, a number of eye tests were performed [grading of conjunctival inflammation, fluorescein tear breakup time, ocular surface fluorescein staining, Schirmer I, evaluation of meibomian gland (MG) function, detection of eyelid margin abnormalities, and Demodex detection].

Results:

Tear breakup time was significantly lower in the EL group compared with controls (3.0 ± 1.9 vs. 5.8 ± 2.1 s, P < 0.001). MG grading was significantly higher in the EL group than in controls (P = 0.004); higher grade (grades 2–3) was found in 85.7% of EL and 47.6% of controls. Meiboscore was also higher in EL than in controls (P = 0.001). Regarding the morphological changes in lid margin, only telangiectasia was detected significantly more in EL (28.6%) compared with controls (4.8%) (P = 0.041). Conjunctival inflammation was observed 4 times more in EL (66.7%) than in controls (14.3%), P = 0.001. Other outcomes included ocular surface symptoms and fluorescein staining scores, and Schirmer I and Demodex detection were not significantly different between both groups.

Conclusions:

The regular use of eyeliner induces tear film instability and MG dysfunction.
Learning Descemet Membrane Endothelial Keratoplasty: A Survey of U.S. Corneal Surgeons
Authors: Koo Ellen H. , Pineda Roberto , Afshari Natalie , Eghrari Allen
Published: November 2019

Purpose:

The transition to Descemet membrane endothelial keratoplasty (DMEK) is frequently challenging, requiring the adoption of new techniques, skills, and methods. We sought to draw on surgeons' initial experiences with DMEK to characterize the learning curve associated with this procedure and identify factors that could be linked to the frequency of primary graft failure (PGF) in the first 10 cases.

Methods:

We invited corneal surgeons based in the United States who started performing the DMEK procedure within the past 2 years to answer a 12-question survey using an online survey platform. We analyzed quantitative and qualitative data. A Fisher exact test was used to determine whether preoperative approaches to preparation were associated with decreased PGF rates.

Results:

A total of 100 US-based corneal surgeons replied from 34 of 50 states. Of these, 68% reported that DMEK comprised a majority of their endothelial keratoplasty cases. Approximately half of surgeons (52%) had performed more than 20 DMEK cases by the time of the survey, and 51% felt equally comfortable performing DMEK relative to Descemet stripping endothelial keratoplasty. Among the respondents, 37% answered that they had experienced PGF in the first 10 cases. Scrubbing in with an experienced colleague before surgery was associated with a decreased likelihood of at least one case of PGF (31%, P = 0.049), but not participation in a wet lab with an experienced instructor or mentor (38%, P = 0.50), nor having an eye bank representative present in the operating room (43%, P = 0.886).

Conclusions:

The collective experience of 100 surgeons beginning DMEK confirms the importance of mentorship and that the accompaniment of an experienced colleague during the learning curve is associated with lower rates of PGF.
Partial Schlemm Canal, Trabecular Meshwork, and Descemet Membrane Separation During Gonioscopy-assisted Transluminal Trabeculotomy: A Case Report
Authors: Dönmez Gün Raziye , Kuğu Süleyman , Erkan Murat , Şimşek Şaban
Published: November 2019

Gonioscopy-assisted transluminal trabeculotomy (GATT) is a surgery that opens the trabecular meshwork (TM) circumferentially after cannulation of the Schlemm canal (SC) with a flexible illuminated microcatheter or suture. The main purpose of this case report was to describe a new complication of GATT. Herein, we report a case of partial SC, TM, and Descemet membrane (DM) separation during GATT. The patient was a 60-year-old man with a history of glaucoma who underwent GATT. SC, TM, and DM separation occurred intraoperatively during 360 degrees trabeculotomy. The separated tissue fragment was removed from the anterior chamber and later confirmed to be a part of the SC, TM, and DM by histopathologic examination. In our patient, this complication did not cause surgical failure. Various complications associated with GATT have been reported previously. Partial SC, TM, and DM separation may occur during this surgery.
Association between maternal anemia at admission for delivery and adverse perinatal outcomes
Authors: Chu Fu-Chieh , Shen-Wen Shao Steven , Lo Liang-Ming , Hsieh T’sang-T’ang , Hung Tai-Ho
Published: November 2019

Background:

Maternal anemia is a risk factor for poor pregnancy outcomes and threatens maternal or fetal life. Anemia increases the risk of low birth weight and preterm birth. We aimed to determine the cutoff level of hemoglobin and risk factors for maternal anemia at admission for delivery and investigate the association between maternal anemia and adverse perinatal outcomes in contemporary Taiwanese women.

Methods:

About 32,234 women admitted to the Taipei Chang Gung Memorial Hospital from 2001 to 2016 were enrolled in this retrospective observational cohort study. The prevalence of pre-delivery maternal anemia in Taiwan and the maternal demographic and perinatal outcomes associated with maternal anemia was assessed.

Results:

The 10th and 5th percentile hemoglobin levels of the test cohort (2001–2008, n = 15,602) were 10.8 g/dL and 9.9 g/dL, respectively. In the study cohort (2009–2016, n = 13,026), women who were multiparous, who were aged >34 years, with history of cesarean delivery, and with history of uterine fibroids had higher prevalence of anemia. Anemic women were at increased risk of cesarean delivery, primary cesarean delivery, premature rupture of membranes, early preterm birth <34 weeks, having very low birth weight infants (<1,500 g), having large for gestational age infants, and neonatal intensive care center transfer, but at lower risk of having small for gestational age infants.

Conclusion:

Maternal anemia at delivery is a risk factor for primary cesarean delivery and adverse maternal and neonatal outcomes. Furthermore, we hypothesize that maternal anemia might increase fetoplacental vasculogenesis and angiogenesis as an adaptive response.
Effects of psychological intervention and relevant influence factors on pregnant women undergoing interventional prenatal diagnosis
Authors: Kang Chun-Mei
Published: November 2019

Background:

This study aims to explore the effects of psychological intervention on eliminating anxiety and fear in pregnant women caused by interventional prenatal diagnosis, and the success rate of surgery.

Methods:

A total of 100 pregnant women who scheduled for interventional prenatal diagnosis were included in this study, and were randomly divided into two groups: control group and intervention group. Women in the control group were given routine nursing care, and women in the intervention group were given psychological intervention in different stages of the operation. Psychological status were assessed by the symptom checklist-90 (SCL-90), self-rating anxiety scale (SAS), self-rating depression scale (SDS), and visual analogue scale (VAS). Furthermore, the success rate of surgery and the incidence of postoperative complications were tracked.

Results:

Compared with the control group, the SCL-90 test scores of pregnant women in the intervention group were significantly lower in the following five factors: somatization, interpersonal sensitivity, depression, anxiety, and fear (p < 0.05). Furthermore, postoperative SAS, SDS, and VAS scores in the intervention group were significantly lower than in the control group; and the differences were statistically significant (p < 0.01).

Conclusion:

Before pregnant women undergo interventional prenatal diagnosis, nurses should understand their psychological status and give psychological guidance in time, calm their anxiety, tension and fear, and help them build confidence to weather the pregnancy stages before and after the operation. This would improve the success rate of puncture and reduce the incidence of complications.
RAMPED-UP: The Development and Testing of an Interprofessional Collaboration Model
Authors: Akuamoah-Boateng Kwame Asante , Wiencek Clareen , Esquivel Jill H. , DeGennaro Gina , Torres Beth , Whelan James F.
Published: November 2019

Interprofessional collaboration (IPC) is an essential component of care delivery needed to achieve optimal patient- and system-level outcomes. The purpose of this project was to measure the impact of a structured IPC model, RAMPED-UP, on hospital length of stay (LOS) in a surgical trauma population. The study design was a prospective cohort with a historical comparison group. The project was conducted at a Level 1 trauma center. The RAMPED-UP group constituted trauma patients admitted from October to December 2017 (n = 96). Trauma patients admitted from October to December 2016 constituted the pre-RAMPED-UP group (n = 98). The 2 groups were similar in demographics. Hospital LOS was not statistically significant between groups. Median RAMPED-UP LOS, defined as the number of days the patient received RAMPED-UP rounds, was 3 days. Patients in the RAMPED-UP group were more likely to be discharged home, with higher discharge-by-noon (DBN) rates of 18.2% (p = .005). A statistically significant correlation was found between incentive spirometry (I/S) values and hospital LOS and RAMPED-UP LOS in the RAMPED-UP group (95% CI: rs −0.301, p = .008; 95% CI: rs −0.270, p = .018, respectively). Although the RAMPED-UP model did not decrease hospital LOS, the model did significantly improve DBN and RAMPED-UP LOS. Further exploration of I/S values as a predictor of LOS is warranted. The use of a structured IPC model that includes essential members of the IPC team can aid in improving patient outcomes such as DBN.
Factors Affecting Interprofessional Teamwork in Emergency Department Care of Polytrauma Patients: Results of an Exploratory Study
Authors: Lapierre Alexandra , Lefebvre Hélène , Gauvin-Lepage Jérôme
Published: November 2019

Considering that traumatic injuries are the leading cause of death among young adults across the globe, emergency department care of polytrauma patients is a crucial aspect of optimized care and premature death prevention. Unfortunately, many studies have highlighted important gaps in collaboration among different trauma team professionals, posing a major quality-of-care challenge. Using the conceptual framework for interprofessional teamwork (IPT) of Reeves, Lewin, Espin, and Zwarenstein (2010), the aim of this qualitative descriptive exploratory study was to better understand IPT from the perspective of health professionals in emergency department care of polytrauma patients, specifically by identifying factors that facilitate and impede IPT. Data were collected from a sample of 7 health professionals involved in the care of polytrauma patients through individual interviews and a focus group. In the second phase, 2 structured observations of polytrauma patient care were conducted. Following a thematic analysis, results revealed multiple factors affecting IPT, which can be divided into 5 broad categories: individual, relational, processual, organizational, and contextual. Individual factors, a category that is not part of the conceptual framework of Reeves et al. (2010), also emerged as playing a major part in IPT.
Epidemiology of Maxillofacial Trauma in a Prehospital Service in Brazil
Authors: Avansini Marsicano Juliane , Zanelato Cavalleri Nathália , Cordeiro Denis Maurício , Mori Graziela Garrido , Gurgel Calvet da Silveira João Luiz , Leal do Prado Rosana
Published: November 2019

Understanding facial trauma behaviors in different populations can help enhance effective prevention and efficient management of public resources in order to offer better treatment in large health systems. The aim of this study was to assess the epidemiology of maxillofacial trauma treated by a public health emergency care service. A cross-sectional study was conducted to assess maxillofacial trauma in patients treated by a public health service of emergency care at a midsize city in southern Brazil. Facial trauma records were retrieved directly from medical records from January 2010 to April 2014. The following variables were collected: patient age, sex, destination of patient after initial treatment, cause of trauma, and type of injury. Statistical analyses were performed using G tests with Williams' corrections (p < .05). The most frequent cause was road traffic collision (39.6%), followed by falls (33.6%) and interpersonal violence (22.0%). The prevalence of falls was higher in older adults. A statistically significant association was observed between age and causes (p < .05). After the initial care provided by the prehospital service, 44.1% of the patients were referred to secondary care centers and 40.1% to hospitals. Traffic accidents were the most common cause of facial trauma in Brazil, with a higher prevalence in young men. Falls were also a big concern for facial injuries, especially among older adults. Although most lesions could be classified as minor trauma, many patients are being treated at hospitals, which may increase the costs to the public health system.
Human papillomavirus Posttreatment Clearance Time in Cervical Intraepithelial Neoplasia and Invasive Cervical Cancer
Authors: Abudurexiti Guligeina , Tuerxun Gulixian , Abulizi Guzhalinuer , Mijiti Patiman , Aierken Kailibinuer , Maimaiti Anaerguli , Li Hua
Published: November 2019

Objective

The aim of the study was to determine an appropriate follow-up schedule for human papillomavirus (HPV) detection by evaluating the clearance time of HPV after treatment.

Materials and Methods

A retrospective study was conducted on 97 high-grade squamous intraepithelial lesion (HSIL) (cervical intraepithelial neoplasia 2–3) patients and 437 early invasive cervical cancer (CC) (stages Ia–IIa) patients who received radical surgery at the Affiliated Tumor Hospital of Xinjiang Medical University. Patient medical information, including personal information, pathological diagnosis, HPV infection status, and therapeutic methods, was obtained through the hospital's historical medical records management system. The clearance time of HPV was determined using Kaplan-Meier method analysis, and clearance time of HPV among different age groups, different grades, and different clinical stages were compared using the log-rank test.

Results

The median clearance time of all patients was 10.4 months. The median clearance time was longer in HSIL patients than in early invasive CC patients (p < .05). No statistical significance was found among different HSIL grades, CC stages, or patient age groups (P > 0.05).

Conclusions

Delaying first posttreatment follow-up to 9 months in patients at high risk of noncompliance could potentially reduce burden of cost and repeated clinical visits. This follow-up approach could be consistently applied to all women regardless of age, severity, and extent of disease.
Inter-arm difference of systolic blood pressure measured by automated double-cuff device is associated with arterial stiffness in patients with hypertension
Authors: Iida Masato , Ishiguro Yuko , Ueda Norihiro , Honjo Haruo
Published: November 2019

Purpose

Inter-arm differences of SBP ≧5 mmHg have been associated with all-cause and cardiovascular mortalities in hypertensive subjects. Inter-arm differences of SBP appears to be mediated by arterial stiffness. We hypothesized inter-arm differences of SBP ≧5 mmHg may be related to higher pulse pressure/stroke volume index, a surrogate marker of arterial stiffness.

Materials and methods

To obtain inter-arm differences of SBP (the absolute difference of right and left arm) and ankle-brachial index, bilateral blood pressures were measured simultaneously at the four limbs using an automated oscillometric device in patients with treated hypertension (n = 234) and in normotensive subjects (n = 40). Pulse pressure was calculated as SBP–DBP. Stroke volume was obtained by time-velocity integral method using echocardiography. Left ventricular mass and relative wall thickness were calculated by the conventional methods.

Results

All hypertensive patients were medically treated and had average blood pressure levels of 135/85 mmHg. Inter-arm differences of SBP ≧5 mmHg was detected in 26.5% of hypertensive patients. Hypertensive patients with inter-arm differences of SBP ≧5 mmHg had higher pulse pressure/stroke volume index, lower ankle-brachial index, higher BMI, and higher relative wall thickness, higher prevalence of female than those with inter-arm differences of SBP <5 mmHg. Multiple linear regression analysis confirmed inter-arm differences of SBP ≧5 mmHg was associated with higher pulse pressure/stroke volume index, higher relative wall thickness, and lower ankle-brachial index.

Conclusion

Inter-arm difference of SBP measured by automated double-cuff device was related to large artery stiffness in patients with hypertension.
The role of genomic profiling in identifying molecular phenotypes in obstructive lung diseases
Authors: Christenson Stephanie A.
Published: November 2019

Purpose of review

The biology underlying asthma and chronic obstructive pulmonary disease (COPD) is heterogeneous. Targeting therapies to patient subgroups, or ‘molecular phenotypes’, based on their underlying biology is emerging as an efficacious treatment strategy. This review summarizes the role of airway sample gene expression profiling in understanding molecular phenotypes in obstructive lung disease.

Recent findings

Recent gene expression studies have reinforced the importance of Type two (T2) inflammation in asthma and COPD subgroups. Studies in asthma also suggest that the molecular phenotype with enhanced T2 inflammation is itself heterogeneous with a subgroup that has steroid-refractory inflammation. Other inflammatory pathways are also emerging as implicated in asthma and COPD molecular phenotypes, including Type one and Type 17 adaptive immune responses and proinflammatory cytokines, such as interleukin-6.

Genomic profiling studies are advancing our understanding of the complex biology contributing to asthma and COPD molecular phenotypes. Recent studies suggest that asthma and COPD subgroups may benefit from different treatment strategies than those currently in practice.
Neurological outcomes after an out-of-hospital cardiac arrest among people living in high-rise buildings in South Korea
Authors: Sohn Youdong , Cho Youngsuk , Cho Gyuchong
Published: November 2019

Objective

Living in high-rise buildings may cause delays in reaching a hospital after an out-of-hospital cardiac arrest. This study aimed to compare neurological outcomes in people who had had an out-of-hospital cardiac arrest, according to their floor of residence.

Methods

We conducted a retrospective study of 1541 patients aged ≥20 years who had out-of-hospital cardiac arrest between 1 October 2015 and 30 June 2018, using data from a central registry. We compared the outcomes of patients living on the first (ground) or second floor and those living on the third floor or above, using multiple logistic regression.

Results

Those living on higher floors were more likely to have been at home (88.1% vs. 58.0%); to have had bystander cardiopulmonary resuscitation (57.9% vs. 45.2%); and experienced a significantly longer emergency medical service response time [median interquartile range (IQR): 7 min (6–10 min) vs. 7 min (5–9 min), P = 0.001] and on-scene time [median (IQR): 16 min (11–23 min) vs. 12 min (8–19 min), P < 0.001]. The strongest predictors of a good neurological outcome were younger age [odds ratio (OR): 0.96, 95% confidence interval (CI): 0.94–0.97], being on a lower floor at the time of the cardiac arrest (OR: 1.82, 95% CI: 1.09–3.12) and having a shockable rhythm (OR: 21.97, 95% CI: 12.81–39.47).

Conclusion

People living on higher floors have poorer outcomes after an out-of-hospital cardiac arrest. Further studies are required to assess factors causing a delay in the emergency medical service response time, and placement of automated external defibrillators in high-rise buildings.