bluuebunny/crossref_metadata_2025 huggingface dataset:
Consuming a difficult past unapproved: Chairman Mao as commodity
Authors: Qian Licheng
Published: June 2020

What role does consumption play in remembering a difficult past unacknowledged by the state? By analyzing the consumption of Chairman Mao symbols in contemporary China, this article explores the memory of a difficult past under censorship with ambiguous rules, that is, imposed discursive ambiguity, and puts forward a theory of mnemonic displacement centering on two generational mechanisms: denial and diversion. The “attendant generation” has experienced the past, reads the discursive ambiguity conservatively and consumes the Mao symbol as denial of the difficult past. The “posterior generation” has no autobiographical memory of the past, reads the discursive ambiguity more openly and consumes the Mao symbol as diversion of mnemonic themes. As a result, the difficult past is displaced and forgotten. This article contributes to memory studies not only by theorizing a type of difficult past under discursive ambiguity but also by developing a displacement theory of remembering and forgetting.
Postpartum atypical hemolytic uremic syndrome: Evaluating thrombotic microangiopathy in the pregnant woman
Authors: So S , Fischer E , Gangadharan Komala M , Bose B
Published: June 2020

Acute kidney injury in women during pregnancy and the puerperium is often ascribed to hypertensive complications of pregnancy, especially pre-eclampsia. However, rarer causes, including atypical hemolytic uremic syndrome (aHUS) can be triggered by pregnancy. We present a case of a woman with post-partum acute kidney injury due to aHUS, which was successfully treated with the C5a inhibitor eculizumab. We also present a summary of the evaluation and management of thrombotic microangiopathy in pregnancy.
Temporomandibular joint disorders
Authors: Collins Timothy
Published: June 2020

The temporomandibular joint (TMJ) is prone to a number of disease states involving any one of its anatomical components. The current favoured term for problems associated with the TMJ is ‘temporomandibular disorder’ (TMD). TMD is one of the most common orofacial pain conditions. Patients will present to GPs and general dental practitioners as well as directly to accident and emergency, typically for referral to Oral and maxillofacial surgery, due to either significant acute pain or chronic pain that can no longer be tolerated. Common features of TMD include pain in the face and preauricular area, restricted jaw movement, and noise from the TMJs during jaw movements. TMD can coincide with poor general health, psychological co-morbidities such as depression and often affects quality of life.
Analysis of Scapular Muscle EMG Activity During Elastic Resistance Oscillation Exercises From the Perspective of Different Arm Positions
Authors: Tsuruike Masaaki , Ellenbecker Todd S. , Kagaya Yoshinori , Lemings Luke
Published: June 2020

Background:

Little is known about the optimal exercise intensity and the effects of arm position on elastic resistance exercise. The purpose of this study was to investigate scapular muscle activity in different arm positions utilized during standing elastic resistance exercise.

Hypothesis:

Lower trapezius (LT), serratus anterior (SA), and infraspinatus (IS) muscle activity will vary across arm positions above shoulder level. Also, oscillation resistance exercise will result in increased muscle activity compared with isometric contraction.

Study Design:

Controlled laboratory study.

Level of Evidence:

Level 4.

Methods:

A total of 19 uninjured male collegiate baseball players volunteered to participate in this study. The electromyography (EMG) activity of the LT, upper trapezius (UT), middle deltoid (MD), SA, and IS muscles was determined using surface EMG in 3 arm positions: diagonal pattern 1 (D1), 120° of shoulder abduction (120), and 90° shoulder abduction with external rotation and elbow flexion (90/90) during both isometric contraction and oscillation resistance exercise.

Results:

No difference in EMG activity of the LT muscle was found between the 120 and 90/90 position. However, the 120 position increased UT and MD muscle activity significantly more than those of the 90/90 position. The D1 arm position significantly increased SA muscle activity more than the 120 and 90/90 positions while the LT muscle activity was nearly silent.

Conclusion:

The standing 90/90 position effectively generated both LT and IS muscle EMG activity while minimizing both UT and MD muscle activity.

Clinical Relevance:

The use of oscillation movements under elastic loading can create high muscle activation in the LT muscle without an adverse effect of the humeral head position and scapular rotation.
Barriers to discontinuing antidepressants in patients with depressive and anxiety disorders: a review of the literature and clinical recommendations
Authors: Scholten Willemijn , Batelaan Neeltje , Van Balkom Anton
Published: June 2020

Use of antidepressants has recently increased, mainly caused by the increase of long-term users. Although evidence-based indications for long-term use are lacking, it is assumed that long-term use is unnecessary or undesirable in some patients. Perceived barriers to discontinuing antidepressants contribute to unnecessary or undesirable long-term use. Identifying barriers prior to, during and following discontinuation may enable strategies to overcome them.

This narrative review summarises relevant qualitative and quantitative articles on perceived barriers to discontinuing antidepressants and provides recommendations for clinical practice.

We can conclude that implications for clinical practice are diverse and the most important barriers experienced by patients and physicians include the fear of relapse or recurrence, insufficient evaluation and monitoring, withdrawal symptoms, and actual relapse or recurrence.
Use of the orbital atherectomy system backed up with the guide-extension catheter for a severely tortuous calcified coronary lesion
Authors: Kobayashi Norihiro , Yamawaki Masahiro , Hirano Keisuke , Araki Motoharu , Sakai Tsuyoshi , Sakamoto Yasunari , Mori Shinsuke , Tsutsumi Masakazu , Nauchi Masahiro , Sahara Naohiko , Honda Yohsuke , Makino Kenji , Shirai Shigemitsu , Mizusawa Masafumi , Sugizaki Yuta , Nakano Takahide , Fukagawa Tomoya , Kishida Toshihiko , Kozai Yuki , Setonaga Yusuke , Goda Shutaro , Ito Yoshiaki
Published: June 2020

A 68-year-old man was scheduled to undergo percutaneous coronary intervention for in-stent total occlusion of the severely tortuous right coronary artery. Intravascular ultrasound revealed heavy in-stent calcification. Lesion atherectomy was required; however, severe proximal vessel tortuosity was detected. We introduced a 7-Fr guide-extension catheter beyond the severely tortuous part and performed rotational atherectomy with a 1.5 mm burr. However, the balloon could not expand; therefore, we changed to an orbital atherectomy system. Subsequently, the balloon successfully expanded, and intravascular ultrasound revealed an enlarged lumen. Severe proximal vessel tortuosity limits the use of atherectomy devices; however, a guide-extension catheter delivers the atherectomy device beyond the tortuosity. The delivery of the orbital atherectomy system inside the guide-extension catheter is easy due to its low profile; the debulking effect increases with the number of passes and rotational speed. This strategy is a useful option for treating severe calcified lesions with proximal vessel tortuosity.
Successful advancement of endotracheal tube with combined fiberoptic bronchoscopy and videolaryngoscopy in a patient with a huge goiter
Authors: Kim Sung Mi , Kim Hyun Joo
Published: June 2020

If the presence of a goiter causes airway deformities in the supraglottic and infraglottic areas, difficult airway should be considered and airway evaluation including physical examination, radiologic studies, and indirect laryngoscopy should be preoperatively performed to determine the airway management plan. Various methods such as direct laryngoscopy, videolaryngoscopy, awake fiberoptic intubation, tracheostomy, and extracorporeal membrane oxygenation support have been reported to secure the airway. In most previously reported goiter cases, the upper airway patency was well maintained and the endotracheal tube was easily passed even when there was severe tracheal narrowing and deviation. We describe a case of successful combined use of videolaryngoscopy and fiberoptic bronchoscopy for advancement of an endotracheal tube through a narrow trachea due to the presence of a huge goiter.
Decades of cough: delayed recognition of atypical cystic fibrosis in an adult patient
Authors: Chandel Abhimanyu , Pak Kevin , Dooley Sean , Salazar Krystle
Published: June 2020

We present a case of a 30-year-old male diagnosed with atypical cystic fibrosis. This report demonstrates the heterogeneity of the presentation of this common genetic disease.
“Lock, Load, n’ Thank the Driver”: The Positive Influence of Prosocial Activity on Language in Online Social Groups
Authors: Ryan Seamus , McDonnell Dean , Meade Sinéad
Published: June 2020

Social-psychological research aims to understand and improve human functioning in a wide variety of contexts. With research showing that trust, joy, and anticipation are among the most influential positive emotions in aspects of online communication, determining the environmental factors that may influence communication and interaction is of significant interest. This research aims to identify the ways prosocial actions influence language within an online social community. Using a longitudinal observational analysis of linguistic markers, an analysis was done on an online community, surrounding the game “Fortnite.” At different time intervals, the written dialogue was analyzed for psycholinguistic markers through LIWC to detect variance in tone within the community. Users were queried ( n = 9,037), filtered to meet the inclusion criteria (n = 7,221) and having their posts (n = 1,232,741) assigned to three cohorts, those of pre-prosocial, post-prosocial, and post-reciprocity, depending on the posting date. A statistically significant ( R2 = .572) increase in positive emotion linguistic markers was detected in the data set after the prosocial action was added. A change in motivation did not reduce the use of positive emotion linguistic markers, contrary to what was expected. This research observes how individuals within online communities treat each other and that interaction can be influenced to improve the participant’s experience and the quality of dialogue. This research addresses how game design and human–computer interaction influence human communication and behavior. It supports that small changes to the real world have ripple effects in online communities for the better.
“They Got Filters”: Indigenous Social Media, the Settler Gaze, and a Politics of Hope
Authors: Carlson Bronwyn , Frazer Ryan
Published: June 2020

Social media technologies have had ambivalent political implications for Indigenous peoples and communities. On one hand, they constitute new horizons toward which settler colonial forces of marginalization, disenfranchisement, and elimination can extend and strengthen their power. On the other hand, social media have also offered opportunities to resist and reject the violence of colonization and its ideological counterparts of domination and racial superiority, and work toward imagining and realizing alternative futures. In this article, we draw on insights from settler colonial studies and affect theory to chart the politics of “affect” through the stories of Indigenous Australian social media users. We first argue that the online practices of Indigenous social media users are often mediated by an awareness of the ‘settler gaze’—that is, a latent audience of non-Indigenous others observing in bad faith. We then outline two responses to this presence described by participants: policing the online behaviors of friends and family, and circulating hopeful, inspiring, and positive content. If “policing” is about delimiting the things of which online bodies are capable, then an affective politics of hope is about expanding a body’s capacity to act and imagining other possible futures for Indigenous people.
Political Identity Ownership: Symbolic Contests to Represent Members of the Public
Authors: Kreiss Daniel , Lawrence Regina G , McGregor Shannon C
Published: June 2020

This study develops the concept of identity ownership to explain how, in the course of electioneering, candidates perform their own identities to align with groups whose support they seek. We frame this from a communication perspective—media are increasingly central sites for constructing and conveying the identity of candidates and the groups of constituents they seek to represent. In developing this model, we seek to bring this identity-based framework more to the fore in communication research, as well as place communication at the center of studies of social identity. We argue that seeing political identities as dynamic and actively performed provides an opportunity to analyze communications based not only on their informational value but also on their identity value.
Discovering the digital Stephen Chow: The transborder influence of Chow’s films on the Chinese Internet in the 2010s
Authors: Chew Matthew Ming-tak
Published: June 2020

This study uncovers and analyzes the transborder influence of Stephen Chow’s films in China in the 2010s. This influence takes a form that is new and different from that of the first three fan cultures of Chow’s films. It operates through various online carnivalesque items co-created by Chinese netizens and cultural producers. I document this with an investigation of the online catchphrases, visual memes, and web novels inspired by Chow’s films. One can interpret this new wave of influence as the fourth fan culture of Chow’s films or as a merger between Hong Kong nonsensical culture with the Chinese online carnival. This study’s data come from primary sources including memes and web novels and secondary sources including relevant news reports, online commentaries, and Chinese-language scholarship.
Identifying Frequency of Mild Traumatic Brain Injury in Firefighters
Authors: Torres Victoria A. , Strack Jordan E. , Dolan Sara , Kruse Marc I. , Pennington Michelle L. , Synett Samantha J. , Kimbrel Nathan , Gulliver Suzy B.
Published: June 2020

Background: Mild traumatic brain injury (mTBI) is a nationwide problem; yet, no firefighter mTBI data are available. Methods: In this cross-sectional study, we assessed retrospective head injuries using WHO guidelines. We captured mTBI frequency and examined firefighters’ symptoms (e.g., using Ohio State University Traumatic Brain Injury Identification method, Brief Traumatic Brain Injury Screen, Warrior Administered Retrospective Causality Assessment Tool). Findings: Of 1,112 firefighters contacted, 60 responses were included. Most participants were White (80%), male (90%), former athletes (75%). 62% met mTBI symptom criteria. 75% reported at least one lifetime head injury. Number of head injuries and depression symptoms were associated (r = .36, p < .05). Conclusion/application to practice: Overall, it appears most firefighters have sustained at least one lifetime mTBI. Those with multiple head injuries may be at increased risk of depression. Occupational health professionals should be aware of firefighters’ mTBI risk. Further research is warranted given findings.
Determinants of Image and Image Fit: A Study of Four Sports and Their Domestic and International Governing Organizations
Authors: Hallmann Kirstin , Dickson Geoff , Giesen Nadja
Published: June 2020

This study examined the determinants of image and image fit between a sport and its domestic and international governing bodies. Data were collected using eight online surveys ( n = 1,862). Each of the eight surveys focused on a single sport and either its national or international governing organization (e.g., athletics and the International Association of Athletics Federations (IAAF) or athletics and the German Athletics Federation). Regression analyses revealed that sport interest, trust, age, and gender significantly influenced the overall image fit of the sport with the organization. Trust was significantly associated with both sport image and organization image. Sport organizations should become more adept at leveraging their association with their (positively viewed) athletes and their sport. To leverage the link with their sport, sport organizations should associate themselves with “feel good” dimensions of their sport. This study is the first to examine image fit between a sport and its domestic and international governing organization.
Divided Eyelid Nevus: Surgical Repair Discussion and Case Reports From Northwestern China
Authors: Zhang Xianying , Tang Wen , Yi Liu , Xu Liwei , Xu Chengxin , Liu Yan
Published: June 2020

Currently, due to the lack of long-term postoperative follow-up outcomes of the congenital divided eyelid nevus, we described our surgical approaches and presented the functional and cosmetic results of 13 patients with an average of 5-year follow-up. Based on the surgical treatments and the follow-ups, the selection of total or subtotal excision depends on the lesion location and the use of blepharoplasty approaches is determined by defect size. The CO2 laser may be a useful second-stage procedure to ablate remnant lesions, but long-term monitoring is required.
A Case Series of Patients Coinfected With Influenza and COVID-19
Authors: Konala Venu Madhav , Adapa Sreedhar , Naramala Srikanth , Chenna Avantika , Lamichhane Shristi , Garlapati Pavani Reddy , Balla Mamtha , Gayam Vijay
Published: June 2020

Coronavirus disease 2019, also called COVID-19, is a global pandemic resulting in significant morbidity and mortality worldwide. In the United States, influenza infection occurs mainly during winter and several factors influence the burden of the disease, including circulating virus characteristics, vaccine effectiveness that season, and the duration of the season. We present a case series of 3 patients with coinfection of COVID-19 and influenza, with 2 of them treated successfully and discharged home. We reviewed the literature of patients coinfected with both viruses and discussed the characteristics, as well as treatment options.
Impact of Standardized Patients on First Semester Nursing Students Self-Confidence, Satisfaction, and Communication in a Simulated Clinical Case
Authors: Johnson Kelly V. , Scott Allison L. , Franks Lisa
Published: June 2020

Background

Utilizing standardized patients (SPs) as a strategy to potentially improve beginning level nursing students’ confidence, satisfaction, and communication after simulated clinical cases is an innovative approach in nursing education.

Aim

The aim of this study was to examine to what extent an SP affected first semester nursing students’ self-confidence, satisfaction, and communication using a simulated clinical case.

Methods

First semester undergraduate students in a bachelors of nursing program at a large university in the South-Central region of the United States ( N =  100), were randomly assigned to one of the two groups. Each group was assigned the same case using either an SP or high-fidelity manikin. Students completed postsurveys immediately following completion of the simulation. Student’s self-confidence, satisfaction, and communication were measured using the National League for Nursing Student Satisfaction and Self-Confidence in Learning for Nursing Education Research and an SP/Faculty Communication Checklist.

Results

An independent sample t test comparing the two student groups on each of the outcome variables was conducted for each of the research questions. Students who completed the simulation with an SP, reported greater satisfaction, and improved communication. Student reflective comments were significantly more positive in the SP group. There was no statistical difference between the two groups in self-confidence.

Conclusion

Further research is needed to determine whether the use of SPs versus high-fidelity manikins in simulated cases results in increased self-confidence in beginning level nursing students. Student satisfaction and communication are key components for nursing student success. The impact of SPs and the effect on student outcomes could have long-term benefits for undergraduate nursing programs.
Return to Normalcy? Principles on Resuming Surgical Services in the COVID‐19 Era
Authors: Valika Taher S. , Billings Kathleen R.
Published: June 2020

The rapidly changing health care climate related to coronavirus disease 2019 (COVID‐19) has resulted in numerous changes to health care systems and in practices that protect both the public and the workers who serve in hospitals around the country. As a result, these past few months have seen a drastic reduction in outpatient visits and surgical volumes. With phased reopening and appropriate guidance, health care systems are attempting to return to normal. Our institution has had the unique opportunity to already return operations back to full capacity. The experiences and lessons learned are described, and we provide guiding principles to allow for a safe and effective return to patient care.
Crud (Re)Defined
Authors: Orben Amy , Lakens Daniël
Published: June 2020

The idea that in behavioral research everything correlates with everything else was a niche area of the scientific literature for more than half a century. With the increasing availability of large data sets in psychology, the “crud” factor has, however, become more relevant than ever before. When referenced in empirical work, it is often used by researchers to discount minute—but statistically significant—effects that are deemed too small to be considered meaningful. This review tracks the history of the crud factor and examines how its use in the psychological- and behavioral-science literature has developed to this day. We highlight a common and deep-seated lack of understanding about what the crud factor is and discuss whether it can be proven to exist or estimated and how it should be interpreted. This lack of understanding makes the crud factor a convenient tool for psychologists to use to disregard unwanted results, even though the presence of a crud factor should be a large inconvenience for the discipline. To inspire a concerted effort to take the crud factor more seriously, we clarify the definitions of important concepts, highlight current pitfalls, and pose questions that need to be addressed to ultimately improve understanding of the crud factor. Such work will be necessary to develop the crud factor into a useful concept encouraging improved psychological research.
Neck treatment compared to aerobic exercise in migraine: A preference-based clinical trial
Authors: Luedtke Kerstin , Starke Wiebke , Korn Karolin von , Szikszay Tibor Maximillian , Schwarz Annika , May Arne
Published: June 2020

Objectives:

The main objective of this study was to compare the effectiveness of aerobic exercise with physiotherapy. A second objective was to evaluate whether patients with pain referred to the head during manual palpation will benefit more from physiotherapy than patients with local or no pain.

Methods:

A total of 103 patients with migraine received physiotherapy ( n = 79) or supervised aerobic exercise ( n = 24) according to their preference as an add-on treatment. Both groups had the same contact time with a specialized physiotherapist. The primary outcome measure was headache frequency during the 4 weeks after the intervention. Eighty-seven patients were analyzed at the primary end point ( n = 69 in the physiotherapy group; n = 18 in the aerobic exercise group). A follow-up assessment was conducted 3 months after the final intervention.

Results:

During the initial assessment of the upper cervical spine, 17 patients reported no pain, 45 local pain, and 25 referred pain to the head. Patients in the physiotherapy group had a mean reduction of 1.8 days (standard deviation (SD) 6.07), while patients in the aerobic exercise group had a mean reduction of 1.2 days (SD 4.27) at the primary end point. This difference was not statistically significant ( p = 0.8). The largest improvement was noted in the group that showed referred pain to the head and received physiotherapy (2.13 days (SD 7.82)). Only patients in the physiotherapy group reported a subjectively perceived general improvement.

Conclusions:

Patients had a strong preference for physiotherapy. Both groups showed small reductions in headache frequency. Effects were superior after physiotherapy but not statistically significant. Patients with pain referred to the head responded best to a physiotherapy intervention.
The role of risk measures in making seismic upgrading decisions
Authors: Bodenmann Lukas , Galanis Panagiotis , Broccardo Marco , Stojadinović Božidar
Published: June 2020

Risk measures are tools that enable consistent measurement of financial risk and quantify the risk exposure to an associated hazard. In finance, there is a broad spectrum of risk measures which reflect different asset performance goals and the risk appetite of the decision-maker. In this study, the authors leverage advancements in financial risk management to examine the role of risk measures to quantify the seismically induced financial risk, measure the benefit of seismic upgrading, and relate the benefit of seismic risk reduction to a degree of the implemented seismic upgrade. The findings demonstrate that the relation between the financial benefits of a seismic upgrade, quantified using risk measures that consider the full range of earthquake events, and the degree of the seismic upgrade are concave, that is, the incremental financial benefit reduces gradually with increasing degree of seismic upgrading. The opposite holds if the risk measures consider only the high-severity low-likelihood events. Therefore, the study shows that the selection of the risk measure plays a crucial role in determining the target degree of seismic upgrading. Equivalently, quantifying the financial benefits of seismic risk mitigation using different risk measures might lead to different seismic upgrading decisions for the same structure.
Cellular therapies for graft-versus-host disease: a tale of tissue repair and tolerance
Authors: Voermans Carlijn , Hazenberg Mette D.
Published: June 2020

The success of allogeneic hematopoietic cell transplantation depends heavily on the delicate balance between the activity of the donor immune system against malignant and nonmalignant cells of the recipient. Abrogation of alloreactivity will lead to disease relapse, whereas untamed allo-immune responses will lead to lethal graft-versus-host disease (GVHD). A number of cell types have been identified that can be used to suppress alloreactive immune cells and prevent lethal GVHD in mice. Of those, mesenchymal stromal cells and, to a lesser extent, regulatory T cells have demonstrated efficacy in humans. Ideally, cellular therapy for GVHD will not affect alloreactive immune responses against tumor cells. The importance of tissue damage in the pathophysiology of GVHD rationalizes the development of cells that support tissue homeostasis and repair, such as innate lymphoid cells. We discuss recent developments in the field of cellular therapy to prevent and treat acute and chronic GVHD, in the context of GVHD pathophysiology.
Introduction to a review series on pathophysiology and treatment of acute GVHD
Authors: Zeiser Robert
Published: June 2020

Edited by Associate Editor Robert Zeiser, this Review Series presents the current understanding of the pathophysiology of and therapeutic approaches to acute graft-versus-host disease (aGVHD). The articles discuss the role of the microbiome in contributing to aGVHD and review how novel cellular therapies, biologicals, and small-molecule inhibitors may advance its treatment.
Deep-learning algorithm helps to standardise ATS/ERS spirometric acceptability and usability criteria
Authors: Das Nilakash , Verstraete Kenneth , Stanojevic Sanja , Topalovic Marko , Aerts Jean-Marie , Janssens Wim
Published: June 2020

Rationale

While American Thoracic Society (ATS)/European Respiratory Society (ERS) quality control criteria for spirometry include several quantitative limits, it also requires manual visual inspection. The current approach is time consuming and leads to high intertechnician variability. We propose a deep-learning approach called convolutional neural network (CNN), to standardise spirometric manoeuvre acceptability and usability.

Methods and methods

In 36 873 curves from the National Health and Nutritional Examination Survey USA 2011–2012, technicians labelled 54% of curves as meeting ATS/ERS 2005 acceptability criteria with satisfactory start and end of test, but identified 93% of curves with a usable forced expiratory volume in 1 s. We processed raw data into images of maximal expiratory flow–volume curve (MEFVC), calculated ATS/ERS quantifiable criteria and developed CNNs to determine manoeuvre acceptability and usability on 90% of the curves. The models were tested on the remaining 10% of curves. We calculated Shapley values to interpret the models.

Results

In the test set (n=3738), CNN showed an accuracy of 87% for acceptability and 92% for usability, with the latter demonstrating a high sensitivity (92%) and specificity (96%). They were significantly superior (p<0.0001) to ATS/ERS quantifiable rule-based models. Shapley interpretation revealed MEFVC<1 s (MEFVC pattern within first second of exhalation) and plateau in volume–time were most important in determining acceptability, while MEFVC<1 s entirely determined usability.

Conclusion

The CNNs identified relevant attributes in spirometric curves to standardise ATS/ERS manoeuvre acceptability and usability recommendations, and further provides individual manoeuvre feedback. Our algorithm combines the visual experience of skilled technicians and ATS/ERS quantitative rules in automating the critical phase of spirometry quality control.
Oseltamivir and influenza-related complications in children: a retrospective cohort in primary care
Authors: Lee Joseph Jonathan , Smith Margaret , Bankhead Clare , Perera Salazar Rafael , Kousoulis Antonis A. , Butler Christopher C. , Wang Kay
Published: June 2020

Background

Influenza and influenza-like illness (ILI) place considerable burden on healthcare systems, especially during influenza epidemics and pandemics. During the 2009/10 H1N1 influenza pandemic, UK national guidelines recommended antiviral medications for patients presenting within 72 h of ILI onset. However, it is not clear whether antiviral treatment was associated with reductions in influenza-related complications.

Methods

Our study population consisted of a retrospective cohort of children aged ≤17 years who presented with influenza/ILI at UK primary care practices contributing to the Clinical Practice Research Datalink during the 2009/10 pandemic. We used doubly robust inverse-probability weighted propensity scores and physician prior prescribing instrumental variable methods to estimate the causal effect of oseltamivir prescribing on influenza-related complications. Secondary outcomes were complications requiring intervention, pneumonia, pneumonia or hospitalisation, influenza-related hospitalisation and all-cause hospitalisation.

Results

We included 16 162 children, of whom 4028 (24.9%) were prescribed oseltamivir, and 753 (4.7%) had recorded complications. Under propensity score analyses oseltamivir prescriptions were associated with reduced influenza-related complications (risk difference (RD) −0.015, 95% CI −0.022–−0.008), complications requiring further intervention, pneumonia, pneumonia or hospitalisation and influenza-related hospitalisation, but not all-cause hospitalisation. Adjusted instrumental variable analyses estimated reduced influenza-related complications (RD −0.032, 95% CI −0.051–−0.013), pneumonia or hospitalisation, all-cause and influenza-related hospitalisations.

Conclusions

Based on causal inference analyses of observational data, oseltamivir treatment in children with influenza/ILI was associated with a small but statistically significant reduction in influenza-related complications during an influenza pandemic.
Homeostatic and early-recruited CD101−eosinophils suppress endotoxin-induced acute lung injury
Authors: Zhu Chen , Weng Qing-Yu , Zhou Ling-Ren , Cao Chao , Li Fei , Wu Yin-Fang , Wu Yan-Ping , Li Miao , Hu Yue , Shen Jia-Xin , Xiong Xue-Fang , Lan Fen , Xia Li-Xia , Zhang Bin , Zhang Hao , Huang Man , Ying Song-Min , Shen Hua-Hao , Chen Zhi-Hua , Li Wen
Published: June 2020

Introduction

Acute lung injury (ALI) is a fatal but undertreated condition with severe neutrophilic inflammation, although little is known about the functions of eosinophils in the pathogenesis of ALI. Our objectives were to investigate the roles and molecular mechanisms of eosinophils in ALI.

Methods

Pulmonary eosinophils were identified by flow cytometry. Mice with abundant or deficient eosinophils were used. Cellularity of eosinophils and neutrophils in bronchoalveolar lavage fluid, inflammatory assessment, and survival rate were determined. Human samples were also used for validating experimental results.

Results

Blood eosinophils were increased in surviving patients with acute respiratory distress syndrome (ARDS) independent of corticosteroid usage. There existed homeostatic eosinophils in lung parenchyma in mice and these homeostatic eosinophils, originating from the bone marrow, were predominantly CD101−. More CD101−eosinophils could be recruited earlier than lipopolysaccharide (LPS)-initiated neutrophilic inflammation. Loss of eosinophils augmented LPS-induced pulmonary injury. Homeostatic CD101−eosinophils ameliorated, while allergic CD101+eosinophils exacerbated, the neutrophilic inflammation induced by LPS. Likewise, CD101 expression in eosinophils from ARDS patients did not differ from healthy subjects. Mechanistically, CD101−eosinophils exhibited higher levels of Alox15 and Protectin D1. Administration of Protectin D1 isomer attenuated the neutrophilic inflammation.

Conclusions

Collectively, our findings identify an uncovered function of native CD101−eosinophils in suppressing neutrophilic lung inflammation and suggest a potential therapeutic target for ALI.
Effect of genomic selection and genotyping strategy on estimation of variance components in animal models using different relationship matrices
Authors: Wang Lei , Janss Luc L. , Madsen Per , Henshall John , Huang Chyong-Huoy , Marois Danye , Alemu Setegn , Sørensen AC , Jensen Just
Published: June 2020

Background

The traditional way to estimate variance components (VC) is based on the animal model using a pedigree-based relationship matrix (A) (A-AM). After genomic selection was introduced into breeding programs, it was anticipated that VC estimates from A-AM would be biased because the effect of selection based on genomic information is not captured. The single-step method (H-AM), which uses an H matrix as (co)variance matrix, can be used as an alternative to estimate VC. Here, we compared VC estimates from A-AM and H-AM and investigated the effect of genomic selection, genotyping strategy and genotyping proportion on the estimation of VC from the two methods, by analyzing a dataset from a commercial broiler line and a simulated dataset that mimicked the broiler population.

Results

VC estimates from H-AM were severely overestimated with a high proportion of selective genotyping, and overestimation increased as proportion of genotyping increased in the analysis of both commercial and simulated data. This bias in H-AM estimates arises when selective genotyping is used to construct the H-matrix, regardless of whether selective genotyping is applied or not in the selection process. For simulated populations under genomic selection, estimates of genetic variance from A-AM were also significantly overestimated when the effect of genomic selection was strong. Our results suggest that VC estimates from H-AM under random genotyping have the expected values. Predicted breeding values from H-AM were inflated when VC estimates were biased, and inflation differed between genotyped and ungenotyped animals, which can lead to suboptimal selection decisions.

Conclusions

We conclude that VC estimates from H-AM are biased with selective genotyping, but are close to expected values with random genotyping.VC estimates from A-AM in populations under genomic selection are also biased but to a much lesser degree. Therefore, we recommend the use of H-AM with random genotyping to estimate VC for populations under genomic selection. Our results indicate that it is still possible to use selective genotyping in selection, but then VC estimation should avoid the use of genotypes from one side only of the distribution of phenotypes. Hence, a dual genotyping strategy may be needed to address both selection and VC estimation.
Identification and genetic analysis of qCL1.2, a novel allele of the “green revolution” gene SD1 from wild rice (Oryza rufipogon) that enhances plant height
Authors: Zhang Lizhen , Huang Jingfen , Wang Yanyan , Xu Rui , Yang Ziyi , Zhao Zhigang , Liu Shijia , Tian Yunlu , Zheng Xiaoming , Li Fei , Wang Junrui , Song Yue , Li Jiaqi , Cui Yongxia , Zhang Li-Fang , Cheng Yunlian , Lan Jinhao , Qiao Weihua , Yang Qingwen
Published: June 2020

Background

The exploitation of novel alleles from wild rice that were lost during rice cultivation could be very important for rice breeding and evolutionary studies. Plant height (PH) was a target of artificial selection during rice domestication and is still a target of modern breeding. The “green revolution” gene semi-dwarf 1 (SD1) were well documented and used in the past decades, allele from wild rice could provide new insights into the functions and evolution of this gene.

Results

We identified a PH-related quantitative trait locus, qCL1.2,from wild riceusing a set of chromosome segment substitution lines. qCL1.2encodesa novel allele of SD1 gene. The wild allele of SD1 is a dominant locus that can significantly promote rice internode length by regulating the expression levels of genes involved in gibberellin biosynthesis and signal transduction. Nucleotide diversity and haplotype network analyses of the SD1 gene were performed using 2822 rice landraces. Two previously reported functional nucleotide polymorphisms clearly differentiated japonica and indica rice; however, they were not associated with PH selection. Other new functional nucleotide polymorphisms in the coding, but not promoter, regions were involved in PH selection during rice domestication. Our study increasesunderstanding of the rice SD1 gene and provides additional evidence of this gene’s selection during rice domestication.

Conclusions

Our findings provide evidence thatSD1 gene from wild rice enhances plant height and new functional nucleotide polymorphisms of this gene were artificially selected during cultivated rice differentiation.
Effect of subinhibitory exposure to quaternary ammonium compounds on the ciprofloxacin susceptibility of Escherichia coli strains in animal husbandry
Authors: Maertens H. , Demeyere K. , De Reu K. , Dewulf J. , Vanhauteghem D. , Van Coillie E. , Meyer E.
Published: June 2020

Background

Quaternary ammonium compound based disinfectants are commonly used in pig and poultry husbandry to maintain farm hygiene. However, studies have shown that subinhibitory concentrations of these disinfectants may increase antibiotic resistance. Investigation of antibiotic susceptibility is usually assessed via the microbroth dilution method, although this conventional culture-based technique only provides information on the bacteriostatic activity of an antimicrobial agent. Therefore, experiments were performed to investigate the effect of prior benzalkonium chloride (BKC) exposure on the viability of subsequent ciprofloxacin (CIP) treated Escherichia coli.

Results

Following CIP treatment, bacterial cell counts were significantly higher after exposure to a subinhibitory BKC concentration than without BKC exposure. The flow cytometric results suggested a BKC-dependent onset of membrane damage and loss of membrane potential.

Conclusion

Our results indicate a lower bactericidal effect of CIP treatment on BKC-exposed E. coli isolates compared to unexposed E. coli isolates.
Correction to: Antimicrobial sensitivity profile and bacterial isolates among suspected pyogenic meningitis patients attending at Hawassa University Hospital: Cross-sectional study
Authors: Assegu Fenta Demissie , Lemma Kinfe , Tadele Henok , Tadesse Birkneh Tilahun , Derese Birrie
Published: June 2020

An amendment to this paper has been published and can be accessed via the original article.
Laparoscopic based renal denervation in a canine neurogenic hypertension model
Authors: Shao Chunlai , Zhou Yan , You Tao , Xue Boxin , Stella Pieter R. , Jiang Ting Bo , Miao Zhigang , Xu Longjiang , Yin  , Lan Longsheng , Rong Guang
Published: June 2020

Background

Previous renal denervation (RDN) studies showed controversial results in reducing blood pressure. The aim of this study was to provide evidence supporting the effectiveness of laparoscopic-based renal denervation (L-RDN) in treating hypertension.

Methods

Sixteen Beagle dogs were randomly divided into RDN group (n = 12) and sham group (n = 4). Neurogenic hypertension was generated in all dogs via carotid artery route. L-RDN was performed in the RDN group, with sham operation performed as a control. Blood pressure (BP) changes were recorded at 2, 4, 6, and 8 weeks after the procedure. Changes in serum creatinine (sCr), blood urea nitrogen (BUN) and level of norepinephrine (NE) were analyzed. Histological changes of kidney and renal arteries were also evaluated.

Results

BP and NE levels were significantly elevated after hypertension induction (p < 0.01). Systolic and diastolic BP of RDN group were decreased by 15.5 mmHg and 7.3 mmHg (p < 0.0001 and p = 0.0021, respectively) at the eighth week after L-RDN. Invasive systolic and diastolic BP of RDN group were significantly decreased by 14.5 mmHg and 15.3 mmHg (p < 0.0001). In contrast, there was no significant decrease in blood pressure in the sham group. In addition, RDN group but not the sham group showed a significant decrease in NE levels (p < 0.001), while no significant changes in sCr and BUN were observed in both groups. Pathological examinations showed no discernible damage, tear, or dissection to the renal arteries in RND group.

Conclusions

L-RDN lowered BP and NE levels in hypertensive dogs without affecting renal artery morphology and kidney function.
Person-centred and efficient care delivery for high-need, high-cost patients: primary care professionals’ experiences
Authors: Smeets Rowan G. M. , Kroese Mariëlle E. A. L. , Ruwaard Dirk , Hameleers Niels , Elissen Arianne M. J.
Published: June 2020

Background

High-need, high-cost (HNHC) patients, who typically have complex and long-term care demands, contribute considerably to the high work pressure of primary care professionals (PCPs). To improve patient as well as provider experiences, it is crucial to take into account the PCPs’ perspective in designing health care strategies for HNHC patients. Therefore, this study aimed to create insight into PCPs’ experienced barriers and possible solutions with regards to person-centred, efficient care delivery to HNHC patients.

Methods

We conducted a qualitative study using focus group interviews with PCPs at a Dutch primary care group. A semi-structured interview guide was developed for the interviews. Qualitative content analysis was employed deductively by means of a categorisation matrix. The matrix was based on the components retrieved from the SELFIE framework for integrated care for multi-morbidity.

Results

Forty-two PCPs participated in five focus group interviews. Discussed barriers and solutions were related to the core of the SELFIE framework (i.e. the individual and environment), and particularly four of the six health system components in the framework: service delivery, leadership & governance, workforce, and technologies & medical products. Many discussed barriers revolved around the complex biopsychosocial needs of HNHC patients: PCPs reported a lack of time (service delivery), insufficiently skilled PCPs (workforce), and inefficient patient information retrieval and sharing (technologies & medical products) as barriers to adequately meet the biopsychosocial needs of HNHC patients.

Conclusions

This qualitative study suggests that primary care is currently insufficiently equipped to accommodate the complex biopsychosocial needs of HNHC patients. Therefore, it is firstly important to strengthen primary care internally, taking into account the experienced lack of time, the insufficient number of equipped PCPs and lack of inter-professional information retrieval and sharing. Secondly, PCPs should be supported in cooperating and communicating more efficiently with health services outside primary care to adequately deliver person-centred, efficient care. As a prerequisite, it is crucial to direct policy efforts at the design of a strong system of social and community services. In terms of future research, it is important to assess the feasibility and effects of re-designing primary care based on the provided recommendations.
Patients’ preferences in selecting family physician in primary health centers: a qualitative-quantitative approach
Authors: Khatami Farnaz , Shariati Mohammad , Khedmat Leila , Bahmani Maryam
Published: June 2020

Background

The role of family physicians (FPs) in the metropolitan area is critical in identifying risk factors for disease prevention/control and health promotion in various age groups. Understanding patients’ preferences and interests in choosing a FP can be an effective and fundamental step in the success of this program. In this study factors affecting the FP selection by Iranian patients referred to health centers in the most populous areas in the south of Tehran were assessed and ranked.

Methods

A sequential mixed-method (qualitative-quantitative) triangulation approach was designed with three subject groups of patients, physicians, and health officials. The Framework method was used to analyze interviews transcribed verbatim. After implementing an iterative thematic process, a 26-item quantitative questionnaire with high validity and reliability was drafted to evaluate the different factors. A convenient sampling method was used to select 400 subjects on a population-based scale to quantitatively rank the most critical selection factors as a mean score of items.

Results

The selection factors were divided into six centralized codes, including FPs’ ethics, individual, professional and performance factors; patients’ underlying disease and individual health, and disease-related factors, office’s location and management factors, democracy factors, economic factors, and social factors. After filling out the questionnaires, the most important factors in selecting FP were a specialist degree in family medicine (FM) (4.49 ± 0.70), performing accurate examinations with receiving a detailed medical history (4.43 ± 0.68), and spending enough time to visit patients (4.28 ± 0.75), respectively. However, the parameters such as being a fellow-citizen, being the same gender, and physician’s appearance were of the least importance.

Conclusion

There is a possibility to screen the most important factors affecting the FP choice through the combination of qualitative and quantitative studies. The first and last patients’ priority was physicians’ specialty in FM and being a fellow-citizen with them, respectively. The clinical and administrative healthcare systems should schedule the entire implementation process to oversee the doctor’s professional commitment and setting the visit times of FP.