bluuebunny/crossref_metadata_2025 huggingface dataset:
Separating Fact From Fiction: A Nationwide Longitudinal Examination of Complex Regional Pain Syndrome Following Treatment of Dupuytren Contracture
Authors: Rochlin Danielle H. , Sheckter Clifford C. , Satteson Ellen S. , Swan Courtney C. , Fox Paige M. , Curtin Catherine
Published: October 2020

Background:

One of the most feared complications following treatment of Dupuytren contracture is complex regional pain syndrome (CRPS). This study aims to provide a national perspective on the incidence of CRPS following treatment of Dupuytren contracture and identify patient factors to target for risk reduction.

Methods:

Using the Truven MarketScan databases from 2007 to 2016, individuals aged ≥18 years who developed CRPS within 1 year of treatment of Dupuytren contracture were identified using the International Classification of Disease diagnosis code for CRPS. Predictor variables included: age, sex, employment status, region, type of procedure, and concurrent carpal tunnel surgery. Multivariable logistic regression was used to analyze outcomes.

Results:

In all, 48 327 patients received treatment for Dupuytren contracture, including collagenase injection (13.6%); percutaneous palmar fasciotomy (10.3%); open palmar fasciotomy (3.9%); palmar fasciectomy with 0 (10.8%), 1 (29.2%), or multiple (19.6%) digit releases; or a combination of these procedures (12.8%). One hundred forty-five patients (0.31%) were diagnosed with CRPS at a mean of 3.4 months (standard deviation, 2.3) following treatment. Significant predictors of CRPS included female sex (odds ratio [OR], 2.02; P < .001), Southern region (OR, 1.80; P = .022), long-term disability status (OR, 4.73; P = .035), palmar fasciectomy with release of 1 (OR, 5.91; P = .003) or >1 digit (OR, 13.32; P < .001), or multiple concurrent procedures for Dupuytren contracture (OR, 8.23; P = .001).

Conclusions:

Based on national commercial claims data, there is a lower incidence of CRPS following treatment of Dupuytren contracture than previously reported. Risk factors identified should help with preoperative counseling and assist clinicians in targeting risk reduction measures.
Understanding and attitudes of the Jordanian public about clinical research ethics
Authors: Ababneh Mera A , Al-Azzam Sayer I , Alzoubi Karem , Rababa’h Abeer , Al Demour Saddam
Published: October 2020

In Jordan, research ethics committees exist in most health settings. However, little is known about Jordanian public views regarding the ethics of clinical research. This study aimed to evaluate Jordanian public understanding and attitudes about ethics in clinical research. A questionnaire was used to collect information that included demographics, public knowledge, and attitudes towards ethics in clinical research. It was administered via face-to-face interviews in two major cities in Jordan from 1st June to 15th August 2017. Of the 2315 respondents, 2.33% were found to have poor knowledge, 22.16% had fair knowledge, and 75.51% had good knowledge of ethics in clinical research. Furthermore, 75.81% of respondents had positive attitudes towards ethics in research. However, only 45.23% reported that they trust clinical researchers in Jordan. Even though a large majority of respondents were aware of key features of research ethics, efforts are needed to address negative perceptions and knowledge deficits.
Do primates flexibly use spatio-temporal cues when foraging?
Authors: Trapanese Cinzia , Meunier Hélène , Masi Shelly
Published: October 2020

Foraging in seasonal environments can be cognitively demanding. Comparative studies have associated large brain size with a frugivorous diet. We investigated the ability of three semi-free-ranging primate species with different degrees of frugivory ( Ntrials: Macaca tonkeana = 419, Macaca fascicularis = 197, Sapajus apella = 346) in developing a mental representation of the spatio-temporal distribution of food using foraging experiments. Forty-two boxes were fixed on trees, and each week (“season”), some of them were filled with fruits which were either highly preferred, or less preferred. Spatial (geometrical panels) and temporal (peel skin of the available fruit) cues were present at each season to indicate where (food location), what (which food) was available, and when. To test the flexible use of the cues in primate foraging behaviour, we first removed the spatial and temporal cues one at a time, and then, we manipulated the “seasonal” order of the available fruit. We compared the foraging performances in the absence and the presence of the cues and during the usual and unusual seasonal order. The average proportion of baited boxes chosen by the subjects in presence of both cues was high (between 73% and 98%) for all species. The primates seemed to remember the spatio-temporal food availability (or used other cues) because no difference was found between trials with or without our spatial and temporal cues. When the usual seasonal pattern was changed, they flexibly adjusted the feeding choice by using the provided temporal cues. We discuss these results also in view of a possible experimental bias.
Noninvasive Blood and Tissue Analysis: Raman Spectroscopy, One Perspective for Monitoring of Glucose and Beyond
Authors: Chaiken Joseph , Peterson Charles M.
Published: October 2020

Noninvasive in vivo blood and tissue analysis remains a challenge to medical technology epitomized by the ongoing quest to replace fingerstick self-monitoring of blood glucose. Recent developments warrant comment on near-term prospects for using Raman spectroscopy to meet that challenge. These developments combined with 20 years of experimentation with noninvasive blood and tissue analysis suggest that it may be possible and practical to perform noninvasive in vivo glucose analysis with improvements in (1) the enabling technologies for making Raman measurements and (2) an underlying anatomical–physiological model of how in vivo spectroscopic measurements are made and interpreted. We review the substantial progress made toward meeting the challenge and the personal, public health, and economic implications of these ongoing efforts.
Analysis of “Accuracy of a 14-Day Factory Calibrated Continuous Glucose Monitoring System With Advanced Algorithm in Pediatric and Adult Population With Diabetes”
Authors: Kompala Tejaswi , Neinstein Aaron B.
Published: October 2020

In this study by Alva et al, accuracy of a second-generation factory calibrated continuous glucose monitoring system is evaluated. Compared to the first-generation FreeStyle Libre 14-day system (FSL), accuracy was improved throughout the 14-day wear period, including improved accuracy in hypoglycemia for adults and youth. The addition of optional real-time alerts for hypoglycemia and hyperglycemia as well as an integrated continuous glucose monitor (iCGM) designation by the FDA may further enable users to benefit from using CGM in real time, including in future automated insulin delivery systems. As CGM accuracy, affordability, and accessibility improve, we anticipate increased uptake of CGM by people on intensive insulin therapy, and also potential benefits and expansion into a broader patient population. There are growing opportunities to leverage cloud-connected CGM devices in the increasingly virtual, continuous telehealth-driven diabetes care model, which will require more focus on development and use of data interoperability standards.
Right-Wing YouTube: A Supply and Demand Perspective
Authors: Munger Kevin , Phillips Joseph
Published: October 2020

YouTube is the most used social network in the United States and the only major platform that is more popular among right-leaning users. We propose the “Supply and Demand” framework for analyzing politics on YouTube, with an eye toward understanding dynamics among right-wing video producers and consumers. We discuss a number of novel technological affordances of YouTube as a platform and as a collection of videos, and how each might drive supply of or demand for extreme content. We then provide large-scale longitudinal descriptive information about the supply of and demand for conservative political content on YouTube. We demonstrate that viewership of far-right videos peaked in 2017.
A review of current guidelines and research on the management of sexually transmitted infections in adolescents and young adults
Authors: Gannon-Loew Kathryn E. , Holland-Hall Cynthia
Published: October 2020

Adolescents and young adults are at high risk for sexually transmitted infections (STIs). Providers have the responsibility to accurately manage these infections to prevent medical complications and the spread of STIs. This article will review the epidemiology, screening recommendations, diagnostic tests, and treatment guidelines for STIs most commonly encountered in this population: Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex virus, and Trichomonas vaginalis, as well as the sexually associated infection bacterial vaginosis. This review will discuss ongoing research that explores ways to improve the management of STIs in adolescents and young adults.
A unique case of bilateral lower extremity post-endovascular aneurysm repair claudication
Authors: Loo Rory J , Srinivasan Arvind , Alizadegan Shahriar
Published: October 2020

The majority of abdominal aortic aneurysms have been treated by endovascular aneurysm repair in the past decade. Common perioperative complications after this procedure are mostly related to vascular access and improper stent-graft placement. We present the first case of bilateral lower extremity claudication due to severe angulation of the graft–aorta interface, which may have been prevented by a more critical consideration of the patient’s anatomy. Treatment required open explantation and repair of the abdominal aortic aneurysms which led to complete resolution of claudication. The results of this case highlight the importance of adherence to instructions for use guidelines.
A post-truth pandemic?
Authors: Shelton Taylor
Published: October 2020

As the coronavirus pandemic continues apace in the United States, the dizzying amount of data being generated, analyzed and consumed about the virus has led to calls to proclaim this the first ‘data-driven pandemic’. But at the same time, it seems that this plethora of data has not meant a better grasp on the reality of the pandemic and its effects. Even as we have the potential to digitally track and trace nearly every single individual who has contracted the virus, we have no idea exactly how many people have had the virus, been hospitalized, or died because of it, largely due to a confluence of factors, particularly active obfuscation and mismanagement by public authorities and misinformation spread through social media and right-wing media channels. But beyond these dynamics, there also lies the less nefarious ways that the everyday, subjective practices of data collection, analysis and visualization have the potential to themselves (re)produce these very same dynamics where data is at once valorized and ignored, preeminent and completely useless. That is, the pandemic has revealed only the general inadequacy of our data infrastructures and assemblages to solving pressing social issues, but also the more general shift towards a ‘post-truth’ disposition in contemporary social life. But, as this paper argues, it would be a mistake to see the centrality of data as being somehow the opposite from the larger post-truth apparatus, as the two are instead fundamentally intertwined and co-produced.
Dialectics of Complexity: A Five-Country Examination of Lived Experiences on Social Media
Authors: Masullo Gina M. , Riedl Martin J. , Tenenboim Ori
Published: October 2020

This study examined people’s lived experiences with social media through 10 focus groups with 82 total participants across five countries: Brazil, Germany, Malaysia, South Africa, and the United States. Findings demonstrate that social media make people’s lives less complex, but this belies heightened complexity as they negotiate three paradoxes when using social media. We describe these as dialectics between: convenience versus privacy, trust versus distrust, and meaningful versus wasted time. These dialectics fit into one over-arching theme that social media make people feel better but also worse, sometimes at the same time. We characterize these experiences as negative—and likely unintended—side effects of reflexive modernization. According to our participants, these tensions leave people in a sort of existential limbo—knowing social media can distress them but not always having the will to leave.
Surgical Fixation of Sacral Fractures in the Elderly Population: Are There Predictors of Outcome? An Analysis of Return to Ambulation and Residential Living Status
Authors: Ferry Chris , Kim Victoria , Ostrander James , Gaughan John , Mashru Rakesh P. , Graf Kenneth W.
Published: October 2020

Introduction:

Recent literature suggests that surgical fixation of elderly sacral fractures may reduce time to mobilization and ultimately self-sufficiency. However, it is unclear if predictors of success exist in this subpopulation. The objective of this study was to characterize relative change in ambulation and residential living statuses (pre-injury vs. post-surgery) of elderly patients who received surgical fixation of sacral fractures, as well as determine whether or not demographics and injury characteristics influence these findings.

Methods:

Fifty-four elderly patients (≥60 years old) receiving percutaneous screw fixation of sacral fractures were retrospectively reviewed. All fractures were traumatic in nature; insufficiency fractures were excluded. Patient and surgical demographic data, as well as 1-year mortality status, was reported. Primary study endpoints included relative change in patient ambulation and residential living statuses (pre-injury to post-surgery). Statistical analyses were performed to assess relative change in ambulation/living status from pre-injury to post-surgery and to determine if predictors of outcome existed.

Results:

Of the 54 patients who met inclusion criteria, 4 expired prior to discharge, 2 expired post-discharge, and 4 were lost to follow-up. Of those patients discharged, 95.7% regained some form of ambulation at last follow-up (mean: 22.4 ± 18.9 weeks). Of patients living independent pre-injury, 94.9% would eventually return to independent home living. Neither time-to-surgery, concomitant orthopaedic injury, Charlson Comorbidity Index, or injury mechanism were predictors of final ambulation or residential status (p ≥ 0.07). Mortality at 1-year was 11.1%.

Discussion:

Operative fixation supported a high rate of return to pre-injury ambulation and residential living status. However, there did not appear to be measures predictive of final functional status. Further efforts with larger, prospective cohorts are warranted.
Investigating Press Coverage of Protest Songs During the 2003 Iraq War
Authors: Esteve-Faubel José María , Martin Tania Josephine , Esteve-Faubel Rosa Pilar
Published: October 2020

The 2003 Iraq War was a landmark for real-time news dissemination, with news broadcast by journalists embedded with U.S. troops. The literature indicates that mainstream media reflected the viewpoints of those in power, giving little coverage to anti-war sentiment. This study focuses on press coverage relating to a specific aspect of dissent—protest songs against the 2003 Iraq War. After analyzing the content of articles sourced from mainstream newspapers from both sides of the Atlantic, namely, The New York Times, The Wall Street Journal, The Guardian, and the Telegraph, the results indicate that from the beginning of this war, anti-war songs were perceived by journalists to be in decline for reasons that were reported to have been linked to the period’s sociopolitical and economic context. The conclusions of the study underscore the value of analyzing news type articles and opinion pieces from newspapers of record.
A Case of Arteriovenous Fistula After Kidney Trauma Mimicking Tumor
Authors: Hoang Van Trung , Pham Ngoc Trinh Thi , Nguyen Hoang Quan , Van Hoang Anh Thi , Vo Minh Tri Thi , Nguyen Thanh Tam Thi , Chansomphou Vichit , Trinh Cong Thao
Published: October 2020

Renal arteriovenous fistulas are rare complications of kidney injury that are usually caused by penetrating or blunt abdominal trauma, percutaneous or open biopsy, or surgery. We report a case of renal arteriovenous fistula after blunt abdominal trauma of a male patient who had traffic accidents. Computed tomography images show arteriovenous fistula lesion mimicking the tumor of the renal pelvis. Through this case, we present how to identify and avoid being confused in diagnosis as well as introduce its clinical manifestations, imaging, and treatment.
Concussions in Soccer: An Epidemiological Analysis in the Pediatric Population
Authors: Chatha Kiran , Pruis Taylor , Peaguda Carlos Fernandez , Guo Eric , Koen Sandra , Malone Danielle , Sabesan Vani
Published: October 2020

Background:

As the popularity of youth soccer has increased in the United States, more attention has been focused on the effect of concussion injuries, with recent debate on whether heading should be disallowed. There is little evidence examining the epidemiology of these injuries.

Purpose/Hypothesis:

The purpose of this study was to examine the prevalence and incidence of youth soccer-related concussions. We hypothesized that concussion rates will correlate with increased participation in youth soccer.

Study Design:

Descriptive epidemiology study.

Methods:

The National Electronic Injury Surveillance System was used to collect data on concussion injuries that occurred during soccer in pediatric patients from 2008 through 2016. Soccer-related concussion injuries were identified using specific codes and were analyzed for variation in disposition. The types of contact were categorized into player-to-player, head-to-ball, player-to-post, and player-to-ground contacts. Contact types related to hospitalization were subanalyzed.

Results:

A weighted total of 3285 concussion injuries were identified during the study period, with an average of 386 concussions each year. The average age was 13.5 years, and there were no differences seen in incidence between the sexes. The overall incidence of concussion injuries increased ( r = 0.789), while hospitalizations decreased ( r = –0.574). The most common cause of concussion was found to be player-to-player contact, followed by head-to-ground contact and then head-to-ball contact. Subanalysis showed that 13% of hospitalizations were due to head-to-ball contact, compared with 39% and 44% due to player-to-player contact and head-to-ground contact, respectively. The relative risk of hospitalization from a concussion due to head-to-ball contact was 7.06 compared with 22.60 due to head-to-ground contact.

Conclusion:

The incidence of concussion in youth soccer has been increasing over the past decade as predicted, given the growing participation rates in both male and female soccer players. The most common cause of concussion was player-to-player contact, and the majority of concussions resulting in hospitalization occurred because of head-to-ground contact.
The COVID-19 Pandemic and Italian Public Mental Health Services: Experience and Future Directions
Authors: Pelizza Lorenzo , Pupo Simona
Published: October 2020

The COVID-19 pandemic has crosses every health care area (from primary care to specialist ones), leading to a review of all public health policies. The use of smart working allows important technological innovations, but it must be accompanied by a review of hospital and residential programs and locations. Since many institution are talking about economic investments for mental health (a crucial area for a full recovery of the society), specific funds are needed in mental health professionals (eg, psychologists), skills, and innovation of locations and technology, such as the conversion of psychiatric wards to community services that carefully must consider the patient experience and clinician’s point of view. Some considerations on the COVID-19 experience in Italy are reported, and suggestions on future directions for public mental health service organization are hypothesized.
Is anyone home? Appropriating and re-narrativisating the post-criminalisation squatting scene in England and Wales
Authors: Nowicki Mel
Published: October 2020

This paper explores the political significance of narratives of home. Using the aftermath of the 2012 criminalisation of squatting in England and Wales as a case study, the paper traces the ways in which the concept of ‘home’ is deployed to both reinforce neoliberal ideals, and is utilised as a tool of resistance by squatters. This paper focuses on the ways in which particular narratives of home are utilised to shape and legitimise housing policy and legislation such as the criminalisation of squatting through moralising language that delegitimise anti-capitalist homes as ‘nonhomes’. Following this, the paper goes on to explore how tropes and aesthetics of squatting are appropriated, re-narrativised and commercialised by neoliberal stakeholders. The remainder of the paper focuses on the methods by which squatters and other housing activists, too, utilise re-narrativisation tactics. Firstly, I highlight instances in which squatters have subverted assumptions of squats as ‘non-homes’ in order to make themselves invisible, and thus safe, in the urban landscape. Secondly, I explore linguistic methods utilised by squatters as a means of disassociating themselves from negative connotations through re-framing elements of the practice as ‘occupation’. The paper concludes by calling for closer attention to be paid to the political potency of the homespace, and the ways in which narratives of home can be utilised in the pursuit of social justice and anti-capitalist housing models.
Effect of Opioid Limiting Legislation on Postoperative Opioid Utilization in Patients Treated for Ankle Fractures
Authors: Hoge Connor G. , Matar Robert N. , Cotton Colin D. F. , Rubeiz Michael G. , Dixon Tonya L. , Laughlin Richard T.
Published: October 2020

Background:

The state of Ohio implemented legislation in August of 2017 limiting the quantity of opioids a provider could prescribe. The purpose of this study was to identify if implementation of legislation affected opioid and nonopioid utilization in patients operatively treated for ankle fractures in the initial 90-day postoperative period after controlling for injury severity and preoperative narcotic usage.

Methods:

A retrospective review of 144 patients treated for isolated ankle fractures in a pre-law group (January 2017–July 2017; n = 73) and post-law group (January 2018–July 2018; n = 71) was completed using electronic medical records and a legal prescriber database. Total number of opioid prescriptions, pills, milligrams of morphine equivalents (MMEs), and nonopioid prescriptions were recorded. Multiple regression analysis was run to identify predictors of opioid prescribing after controlling for law group, demographic, preoperative narcotic use, and injury severity characteristics.

Results:

Mean MME prescribed per patient significantly decreased from 817.2 MME pre-law to 380.9 post-law ( P < .01). Mean number of opioid pills prescribed per patient decreased from 99.1 in the pre-law group and 55.3 in the post law group ( P < .001), respectively. Multiple linear regression analysis to predict the mean number of opioid pills prescribed was statistically significant ( R 2 = 0.33; P < .001), with law group adding significantly to the prediction ( P < .001). The multiple linear regression analysis to predict MME per patient was found to be statistically significant ( R 2 = 0.31; P < .001), with the law group contributing significantly ( P < .001).

Conclusion:

The Ohio prescriber law successfully contributed to the decreased number of opioid pills and MME prescribed in the initial 90-day postoperative period after controlling for injury severity and preoperative narcotic usage. Policies on opioid prescriptions may serve as an important public health tool in the fight against the opioid epidemic.

Level of Evidence:

Level III, retrospective comparative series.
A proof-of-concept study on CGRP plasma levels of migraineurs during a 6-month treatment with ERENUMAB
Authors: Tringali Giuseppe , Vollono Catello , Calabresi Paolo , Navarra Pierluigi
Published: October 2020

The introduction of monoclonal antibodies (mAbs) against calcitonin-gene related peptide (CGRP) or CGRP receptors in the treatment of migraine raised concerns on the possible risks associated to the long-term inhibition of CGRP physiological functions. In this proof-of-concept study, we have measured the circulating levels of CGRP in 7 patients with high-frequency episodic migraine receiving the anti-CGRP receptor mAb erenumab for at least 6 months, to test the hypothesis that long-term blockade of CGRP receptors induces an increase in systemic CGRP levels via a classical up-regulation mechanism.

Plasma CGRP levels were measured by a validated radioimmunoassay at baseline, and after 1 and 6 months of treatment with erenumab, 70 mg given sc every 4 weeks.

We found (data expressed as the means ± SD): 38.34 ± 30.74 pg CGRP/ml of plasma at baseline, 38.19 ± 29.23 pg/ml after 1 month and 53.89 ± 28.03 pg/ml after 6 months of treatment. Thus, the average increase in plasma CGRP levels after 6 months of treatment was about + 40% compared to both baseline and 1-month treatments; such difference was not statistically significant because of high SD values in all groups.

These preliminary findings need to be confirmed in larger, sufficiently powered experiments.
Development of a genetic evaluation for hair shedding in American Angus cattle to improve thermotolerance
Authors: Durbin Harly J. , Lu Duc , Yampara-Iquise Helen , Miller Stephen P. , Decker Jared E.
Published: October 2020

Background

Heat stress and fescue toxicosis caused by ingesting tall fescue infected with the endophytic fungusEpichloë coenophialarepresent two of the most prevalent stressors to beef cattle in the United States and cost the beef industry millions of dollars each year. The rate at which a beef cow sheds her winter coat early in the summer is an indicator of adaptation to heat and an economically relevant trait in temperate or subtropical parts of the world. Furthermore, research suggests that early-summer hair shedding may reflect tolerance to fescue toxicosis, since vasoconstriction induced by fescue toxicosis limits the ability of an animal to shed its winter coat. Both heat stress and fescue toxicosis reduce profitability partly via indirect maternal effects on calf weaning weight. Here, we developed parameters for routine genetic evaluation of hair shedding score in American Angus cattle, and identified genomic loci associated with variation in hair shedding score via genome-wide association analysis (GWAA).

Results

Hair shedding score was moderately heritable (h2 = 0.34 to 0.40), with different repeatability estimates between cattle grazing versus not grazing endophyte-infected tall fescue. Our results suggest modestly negative genetic and phenotypic correlations between a dam’s hair shedding score (lower score is earlier shedding) and the weaning weight of her calf, which is one metric of performance. Together, these results indicate that economic gains can be made by using hair shedding score breeding values to select for heat-tolerant cattle. GWAA identified 176 variants significant at FDR < 0.05. Functional enrichment analyses using genes that were located within 50 kb of these variants identified pathways involved in keratin formation, prolactin signalling, host-virus interaction, and other biological processes.

Conclusions

This work contributes to a continuing trend in the development of genetic evaluations for environmental adaptation. Our results will aid beef cattle producers in selecting more sustainable and climate-adapted cattle, as well as enable the development of similar routine genetic evaluations in other breeds.
Correction to: Matrix metalloproteinase 9 induces endothelial-mesenchymal transition via Notch activation in human kidney glomerular endothelial cells
Authors: Zhao Ye , Qiao Xi , Wang Lihua , Tan Tian Kui , Zhao Hong , Zhang Yun , Zhang Jianlin , Rao Padmashree , Cao Qi , Wang Yiping , Wang Ya , Wang Yuan Min , Lee Vincent W. S. , Alexander Stephen I. , Harris David C. H. , Zheng Guoping
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
Assaying the effect of yeasts on growth of fungi associated with disease
Authors: Horváth Enikő , Sipiczki Matthias , Csoma Hajnalka , Miklós Ida
Published: October 2020

Background

Pathogenic fungi often cause serious infections mainly in immunocompromised persons. The number of infections caused by the non-albicans Candidaor other species has significantly increased over the last years. These infections present a major challenge in the health sector because these pathogenic fungi have strong virulence and often show resistance to the commonly used antifungal treatments. To solve the problems caused by the drug resistant pathogenic fungi, it is necessary to find new antifungal agents and their sources. The aim of this study was to give evidence that yeasts can effectively fight against strains which belong to pathogenic fungi and reveal those yeasts which are able to inhibit growth ofKodamaea ohmeri, Pichia kudriavzevii, Naganishia albidaorCandida tropicalis.Furthermore, we wanted to determine the effects of certain culturing factors on the growth inhibition.

Results

Our screening revealed that although the strains belonging to pathogenic species were much more tolerant to the yeast-produced bioactive agents than the non-disease-associated yeasts, growth ofKodamaea ohmeriandCandida tropicaliscould be inhibited byMetschnikowia andauensis, whileNaganishia albidacould be controlled byPichia anomalaorCandida tropicalis.Our data proved that the experimental circumstances could have a serious impact on the inhibitory capacity of the yeasts. Appearance of inhibition strongly depended on media, pH and temperature. Our data also shed some light on the fact thatPichia kudriavzeviimust have high natural resistance to the yeast-produced agents, while other species, such asSaccharomycopsis crataegensisbelonged to the easily inhibitable species.

Conclusions

Our study suggests that yeast-produced bioactive agents could be potential growth inhibitory agents against the disease-associated fungi and yeasts can also contribute to alternative approaches to combat against pathogenic fungi. Our data revealed an important role of the culturing factors in inhibition and pointed to the complex nature of antagonism.
Physiological effects of different recruitment maneuvers in a pig model of ARDS
Authors: Xia Feiping , Pan Chun , Wang Lihui , Liu Ling , Liu Songqiao , Guo Fengmei , Yang Yi , Huang Yingzi
Published: October 2020

Background

In acute respiratory distress syndrome (ARDS), lung recruitment maneuvers can recruit collapsed alveoli in gravity-dependent lung regions, improving the homogeneity of ventilation distribution. This study used electrical impedance tomography to investigate the physiological effects of different recruitment maneuvers for alveolar recruitment in a pig model of ARDS.

Methods

ARDS was induced in ten healthy male pigs with repeated bronchoalveolar lavage until the ratio of arterial partial pressure of oxygen (PaO2) of fraction of inspired oxygen (P/F) was < 100 mmHg and remained stable for 30 min (TARDS). ARDS pigs underwent three sequential recruitment maneuvers, including sustained inflation, increments of positive end-expiratory pressure (PEEP), and pressure-controlled ventilation (PCV) applied in random order, with 30 mins at a PEEP of 5 cmH2O between maneuvers. Respiratory mechanics, hemodynamics, arterial blood gas, and electrical impedance tomography were recorded at baseline, TARDS, and before and after each recruitment maneuver.

Results

In all ten pigs, ARDS was successfully induced with a mean 2.8 ± 1.03 L bronchoalveolar lavages. PaO2, P/F, and compliance were significantly improved after recruitment with sustained inflation, increments of PEEP or PCV (allp < 0.05), and there were no significant differences between maneuvers. Global inhomogeneity index significantly decreased after recruitment with sustained inflation, increments of PEEP, or PCV. There were no significant differences in global inhomogeneity before or after recruitment with the different maneuvers. The decrease in global inhomogeneity index (ΔGI) was significantly greater after recruitment with increments of PEEP compared to sustained inflation (p = 0.023), but there was no significant difference in ΔGI between increments of PEEP and PCV or between sustained inflation and PCV.

Conclusion

Sustained inflation, increments of PEEP, and PCV increased oxygenation, and regional and global compliance of the respiratory system, and decreased inhomogeneous gas distribution in ARDS pigs. Increments of PEEP significantly improved inhomogeneity of the lung compared to sustained inflation, while there was no difference between increments of PEEP and PCV or between sustained inflation and PCV.
HIV infection, seasonality and younger age predicting incident Bell’s palsy among black South Africans
Authors: Magazi Dali , Longombenza Benjamin , Mda Siyazi , Van der Meyden Kees , Motshwane Marcus , Nanjoh Mirabel , Towobola Olakunle
Published: October 2020

Background

Although South Africa (SA) is facing a high prevalence of HIV infection, there is no literature from this region on a link between Bell’s palsy and HIV. The aim of this study was to identify the occurrence of Bell’s palsy in relation to demographics, seasons and HIV status among black South Africans.

Methods

This retrospective cohort was conducted among adult black patients, without Bell’s palsy in 2003, presenting to the neurology outpatients department at Dr. George Mukhari Academic hospital, Pretoria, South Africa, between 2004 (study baseline) and 2012 (end test). Gender, age, HIV status, and seasons were potential predictors of Bell’s palsy using Cox regression model and Kaplan Meier curves.

Results

From the baseline of 1487 patients, 20.9% (n = 311) experienced Bell’s palsy onset by the end of the study. In univariate analysis, male gender (RR = 2.1 95% CI 1.7–2.5; P <  0.0001), age less than 30 years (RR = 2.9 95% CI 2.4–3.6; P <  0.0001), HIV seropositivity (RR =2.9 95% CI 2.3–4.9; P < 0.0001).

The highest incidence in winter (30.3% n = 136/450) vs. incidences during other seasons with Intermediate values during Summer (25.3% n = 136/450) and Autumn (20.7% n = 64/308) and the lowest incidence in Spring (23.7% n = 16/353) P < 0.0001) were predictors of Bell’s palsy. In multivariate analysis at adjusting for gender, the most significant and independent predictors of incident Bell’s palsy were HIV seropositivity (HR = 6.3 95% CI 4.8–8.3; P < 0.0001), winter (HR = 1.6 95% CI 1.2–2.1; P < 0.0001) vs. other seasons, and younger age < 30 years (HR = 7.1 95% CI 5.6–9.1; P < 0.0001) vs. older age groups.

Conclusion

Seasonality, younger age and HIV positivity are important and independent risk factors of Bell’s palsy. Education and awareness programs on the possible effects of HIV and seasons on the development of Bell’s palsy are necessary. This would lead to a better understanding and even a possible development of avoidance measures for this condition amongst young black South Africans.
Clot composition of embolic strokes of undetermined source: a feasibility study
Authors: Nouh Amre , Mehta Tapan , Hussain Mohamed , Song Xianyuan , Ollenschleger Martin
Published: October 2020

Background

A number of emerging studies have evaluated clot composition in acute ischemic stroke. Studies of clot composition of embolic strokes of undetermined strokes are lacking.

Objectives

We sought to analyze the RBC to platelet ratios in clots and correlated our findings with stroke etiology.

Methods

This was a prospective study analyzing clots retrieved by mechanical thrombectomy in acute ischemic stroke patients at our institution. All clots were stained and scanned at 200x magnification by using a Scanscope XT digital scanner (Apergio, Vista, California). Image-J software (National Institutes of Health, Bethesda, Maryland) was used for semi quantitative analysis of percentage RBC’s and platelets. Unpaired t-test was used to compare means of RBC to Platelet ratios. Correlation of RBC to Platelet ratios with stroke etiology was performed.

Results

A total of 33 clots from 33 patients were analyzed. Stroke etiology was undetermined in 6 patients, cardioembolic in 14, large vessel atherosclerosis (LVA) in 9, and carotid dissection in 4. The mean RBC to platelet ratio was 0.78:1 (+/− 0.65) in cardioembolic clots, 1.73:1 (+/− 2.38) in LVA and 1.4:1(+/− 0.70) in carotid dissections. Although patients with undetermined etiology had a similar clot composition to cardioembolic stroke (0.36:1+/− 0.33), (p = 0.19), it differed significantly from LVA and dissections respectively (p = 0.037, p = 0.01).

Conclusion

In our study, a low RBC to Platelet ratio was found among patients with embolic strokes of undetermined source, however shared similar characteristics with cardioembolic thrombi. Ongoing collection and analysis is needed to confirm these findings and its significance in evaluating stroke etiology.
Tumor infiltrating immune cells (TIICs) as a biomarker for prognosis benefits in patients with osteosarcoma
Authors: Chen Ying , Zhao Bo , Wang Xiaohu
Published: October 2020

Background

Osteosarcoma is a rare malignant bone tumor in adolescents and children. Poor prognosis has always been a difficult problem for patients with osteosarcoma. Recent studies have shown that tumor infiltrating immune cells (TIICs) are associated with the clinical outcome of osteosarcoma patients. The aim of our research was to construct a risk score model based on TIICs to predict the prognosis of patients with osteosarcoma.

Methods

CIBERSORTX algorithm was used to calculate the proportion of 22 TIIC types in osteosarcoma samples. Kaplan-Meier curves were drawn to investigate the prognostic value of 22 TIIC types. Forward stepwise approach was used to screen a minimal set of immune cell types. Multivariate Cox PHR analysis was performed to construct an immune risk score model.

Results

Osteosarcoma samples with CIBERSORTX output p value less than 0.05 were selected for research. Kaplan-Meier curves indicated that naive B cells (p = 0.047) and Monocytes (p = 0.03) in osteosarcoma are associated with poor prognosis. An immune risk score model was constructed base on eight immune cell types, and the ROC curve showed that the immune risk score model is reliable in predicting the prognosis of patients with osteosarcoma (AUC = 0.724). Besides, a nomogram model base on eight immune cell types was constructed to predict the survival rate of patients with osteosarcoma.

Conclusions

TIICs are closely related to the prognosis of osteosarcoma. The immune risk score model based on TIICs is reliable in predicting the prognosis of osteosarcoma.
The impact of the Maritime Labor Convention on seafarers’ working and living conditions: an analysis of port state control statistics
Authors: Fotteler Marina Liselotte , Andrioti Bygvraa Despena , Jensen Olaf Chresten
Published: October 2020

Background

The Maritime Labour Convention, 2006 (MLC2006) entered into force in August 2013 and is a milestone for better working and living conditions (WLC) for seafarers. As of March 2020, 96 countries have ratified the MLC2006, covering more than 90% of the world’s shipping fleet. A system of port state control (PSC) allows ratifying countries to inspect any foreign ship arriving in their ports for compliance with the convention. It is intended as a second safety measure for the identification of substandard ships that sail all over the world. Nine regional agreements, so-called Memoranda of Understanding (MoU), have been signed to coordinate and standardize PSC inspections and to increase efficiency by sharing inspections and information. This paper uses public PSC statistics to evaluate the impact of the MLC2006.

Methods

A preliminary analysis using registered tonnage and MLC2006 ratification was conducted and seven MoU were selected for the analysis. The annual reports of these MoU have been viewed in September 2019. Numbers on annual inspections, deficiencies and detentions and in particular data for deficiencies related to living and working conditions and certificates and documents, have been extracted and analyzed for the years 2010 to 2017.

Results

Across the eight-year period analyzed, inspection numbers remained stable among all MoU authorities. Deficiencies overall and deficiencies related to WLC declined, indicating an improvement in conditions overall and an increased focus on seafarers’ conditions on board. After the MLC2006 entered into force, three MoU reported WLC-ratios above 14%, while the numbers didn’t rise above 10% in the other four authorities. Deficiencies related to certificates and documents did not rise significantly between 2010 and 2017. Two European MoU showed the highest ratios for deficiencies in both categories analyzed.

Conclusion

The analysis confirmed that an increasing attention is being paid to the inspection of working and living conditions, especially in European countries. However, a clear positive impact of the MLC2006 could not be determined from the PSC statistics in this analysis. A large variation still exists among the MoU, a fact that demands increased efforts for harmonization of PSC procedures.
The effects of financial incentives on diabetes prevention program attendance and weight loss among low-income patients: the We Can Prevent Diabetes cluster-randomized controlled trial
Authors: Desai Jay R. , Vazquez-Benitez Gabriela , Taylor Gretchen , Johnson Sara , Anderson Julie , Garrett Joyce E. , Gilmer Todd , Vue-Her Houa , Rinn Sarah , Engel Katelyn , Schiff Jeff , O’Connor Patrick J.
Published: October 2020

Background

Penetration and participation of real life implementation of lifestyle change programs to prevent type 2 diabetes has been challenging. This is particularly so among low income individuals in the United States. The purpose of this study is to examine the effectiveness of financial incentives on attendance and weight loss among Medicaid beneficiaries participating in the 12-month Diabetes Prevention Program (DPP).

Methods

This is a cluster-randomized controlled trial with two financial incentive study arms and an attention control study arm. Medicaid beneficiaries with prediabetes from 13 primary care clinics were randomly assigned to individually earned incentives (IND; 33 groups; n = 309), a hybrid of individual- and group-earned incentives (GRP; 30 groups; n = 259), and an attention control (AC; 30 groups; n = 279). Up to $520 in incentives could be earned for attaining attendance and weight loss goals over 12 months. Outcomes are percent weight loss from baseline, achieving 5% weight loss from baseline, and attending 75% of core and 75% of maintenance DPP sessions. Linear mixed models were used to examine weight change and attendance rates over the 16 weeks and 12 months.

Results

The percent weight change at 16 weeks for the IND, GRP, and AC participants were similar, at − 2.6, − 3.1%, and − 3.4%, respectively. However, participants achieving 5% weight loss in the IND, GRP, and AC groups was 21.5, 24.0% (GRP vs AC, P < 0.05), and 15.2%. Attendance at 75% of the DPP core sessions was significantly higher among IND (60.8%, P < 0.001) and GRP (64.0%, P < 0.001) participants than among AC (38.6%) participants. Despite substantial attrition over time, attendance at 75% of the DPP maintenance sessions was also significantly higher among IND (23.0%, P < 0.001) and GRP (26.1%, P < 0.001) participants than among AC (11.0%) participants.

Conclusions

Financial incentives can improve the proportion of Medicaid beneficiaries attending the 12-month DPP and achieving at least 5% weight loss.

Trial registration

ClinicalTrials.govNCT02422420; retrospectively registered April 21, 2015.
Pseudoaneurysm following hamstring tendon harvest in arthroscopic anterior cruciate ligament reconstruction: a case report
Authors: Ho Chung-Wei , Lee Shih-Han , Wu Shen-Han , Lin Chun-Yu , Lee Chian-Her , Wu Jia-Lin
Published: October 2020

Background

Vascular injury is a very rare complication following arthroscopic knee surgery. This is the first report of pseudoaneurysm at the saphenous branch of the descending genicular artery complicating semitendinosus tendon harvest in arthroscopic anterior cruciate ligament reconstruction.

Case presentation

A 19-year-old male had developed large ecchymosis, focal swelling and tenderness around his posteromedial knee after an arthroscopic anterior cruciate ligament reconstruction. Compartment syndrome of the lower leg and deep vein thrombosis were ruled out. A pseudoaneurysm formation was confirmed through an angiography and coil embolization was performed. At one year follow up, the patient reported improved functional outcome with good stability of the knee. However, mild paresthesia over the posteromedial calf was noted due to the compression injury of the saphenous nerve by the hematoma.

Conclusions

The pseudoaneurysm was presumed to result from accidental vascular injury while dissecting the accessory bands of the semitendinosus and was successfully treated by coil embolization. Care must be taken to section the expansions of the hamstring tendon, especially when the patient presents with underlying coagulopathy or vascular disease.
Intravesical prostatic protrusion may affect early postoperative continence undergoing robot-assisted radical prostatectomy
Authors: Hikita Katsuya , Honda Masashi , Teraoka Shogo , Nishikawa Ryoma , Kimura Yuske , Tsounapi Panagiota , Iwamoto Hideto , Morizane Shuichi , Takenaka Atsushi
Published: October 2020

Background

In this study, we investigated the effect of preoperative prostate morphology, especially intravesical prostatic protrusion (IPP), on continence after robot-assisted radical prostatectomy (RARP).

Methods

Retrospective analysis was applied to patients who underwent RARP between October 2010 and July 2014. The following parameters were assessed in all patients: age, body mass index (BMI), prostate-specific antigen, magnetic resonance imaging and pressure-flow studies findings. The impact of preoperative and intraoperative factors on postoperative urinary incontinence (UI) was assessed using multivariate logistic regression analysis. To evaluate the effects of IPP, the patients were divided into groups according to the IPP length: Group 1, < 5 mm and Group 2, ≥ 5 mm. The International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score, Quality of Life index and the number of pads used were assessed.

Results

A total of 119 patients were eligible for this study. Multivariate analyses showed that IPP (odds ratio (OR) 1.14, 95% confidence interval (CI) 1.02–1.28, p < 0.05) and nerve-sparing (NS) (OR 0.23, 95% CI 0.18–0.61, p < 0.01) were significant factors related to UI in the first month after RARP. Twelve months after RARP, multivariate analyses revealed that only NS is a factor related to postoperative UI (OR 0.23, 95% CI 0.18–0.61, p < 0.01). The comparison of Groups 1 and 2 indicated significant differences in age (p < 0.01), prostate volume (p < 0.01), total IPSS and voiding symptom score (p < 0.05), compliance (p < 0.01), and detrusor pressure at maximum flow (p < 0.01). Group 1 had a higher continence rate (38.0%) than Group 2 (20.8%) in the first month after RARP (p < 0.05), but the difference was no longer significant from the third month after RARP. The total IPSS and voiding symptom scores were significantly different between the two groups before RARP, however, the significant difference disappeared from the first month after RARP.

Conclusions

The data suggest that IPP affects early postoperative UI. Although NS was strongly involved in UI in the early and later stages after RARP, IPP had no effect on UI in the later stages.