bluuebunny/crossref_metadata_2025 huggingface dataset:
Sutureless Valve in Repeated Aortic Valve Replacement: Results from an International Prospective Registry
Authors: Glauber Mattia , Kent William D.T. , Asimakopoulos George , Troise Giovanni , Padrò Josep Maria , Royse Alistair , Marnette Jean-Marc , Noirhomme Philippe , Baghai Max , Lewis Michael , Di Bacco Lorenzo , Solinas Marco , Miceli Antonio
Published: April 2021

Objective

To report early and midterm results registry of patients undergoing repeated aortic valve replacement (RAVR) with sutureless prostheses from an international prospective registry (SURE-AVR).

Methods

Between March 2011 and June 2019, 69 patients underwent RAVR with self-expandable sutureless aortic bioprostheses at 22 international cardiac centers.

Results

Overall mortality was 2.9% with a predicted logistic EuroSCORE II of 10.7%. Indications for RAVR were structural valve dysfunction (84.1%) and infective prosthetic endocarditis (15.9%) and were performed in patients with previously implanted bioprostheses (79.7%), mechanical valves (15.9%), and transcatheter valves (4.3%). Minimally invasive approach was performed in 15.9% of patients. Rate of stroke was 1.4% and rate of early valve-related reintervention was 1.4%. Overall survival rate at 1 and 5 years was 97% and 91%, respectively. No major paravalvular leak occurred. Rate of pacemaker implantation was 5.8% and 0.9% per patient-year early and at follow-up, respectively. The mean transvalvular gradient at 1-year and 5-year follow-up was 10.5 mm Hg and 11.5 mm Hg with a median effective orifice area of 1.8 cm2and 1.8 cm2, respectively.

Conclusions

RAVR with sutureless valves is a safe and effective approach and provides excellent clinical and hemodynamic results up to 5 years.
The application of an information support robot to reduce agitation in an older adult with Alzheimer’s disease living alone in a community dwelling: a case study
Authors: Mizuno Jumpei , Sadohara Ken , Nihei Misato , Onaka Shinichi , Nishiura Yuko , Inoue Takenobu
Published: April 2021

Objective/background:

Agitation is a common behaviour of Alzheimer’s Disease (AD). Although healing robots have previously been used for alleviating agitation for people with dementia in hospitals and other healthcare facilities, its effects remain unclear whether an information-support robot capable of disseminating information with user needs may have similar effects when it is applied in community dwellings. This study was to investigate the effects of information-support robots for reducing agitation in older people with AD residing alone in community-dwellings.

Methods

One participant with AD who lived alone in a community-dwelling was recruited. Participant’s frequencies, durations, and time courses of four patterns of agitation at home at baseline and during intervention were analysed. In this study, agitation was defined as: (a) restlessness going to the corridor (RLtoC), (b) restlessness going to the toilet (RLtoT), (c) restlessness going to the entrance (RLtoE), and (d) restlessness going to multiple places (RLtoMP). In the intervention phase, the information-support robot disseminated daily schedule or date information to the participant.

Results

RLtoC and RLtoMP were significantly reduced in frequency during the intervention. The durations of each episode of RLtoT and RLtoMP in the intervention were slightly reduced than those at the baseline. There were no differences in time courses of episodes of RLtoC and RLtoMP after the intervention.

Conclusion

This case study showed that information-support robot was useful to alleviate agitation of an older adult with AD living alone in a community-dwelling. Further study is warranted.
Diet supplementation with fish broth in early life improves bone development and growth of scarlet ibis (Eudocimus ruber)
Authors: Miranda Stefânia Araújo , Seligmann Igor Chamon Assumpção , de Souza Lima Kedson Raul , Santos Regiane Rodrigues , Domingues Sheyla Farhayldes Souza
Published: April 2021

This study aimed to evaluate the effect of different dietary supplementations (fish or shrimp) on the growth, bone development and beak pigment disappearance in scarlet ibis kept in captivity. One-day-old scarlet ibis ( n = 20) were assigned to one of two diets, where 10 birds were fed a diluted commercial diet supplemented with shrimp broth, and 10 were fed a diluted commercial diet supplemented with fish broth. The feeding trial started at day one until day 35. The diluted commercial diet consisted of a flamingo diet diluted in water (puree). Chicks growth, bone development (radius, tarsus and tibia), and disappearance of beak pigmentation were recorded. No mortality was observed in the groups of the chicks fed supplemented commercial diets. Chicks fed diets supplemented with shrimp or fish broth gained weight from the first to the 35th day of life. However, from day 14 to the end of the trial growth was significantly higher in birds fed fish broth than shrimp broth. Again, the fish broth diet increased ( p < 0.001) the length of radius and tibia in comparison with shrimp one from day 14 and thereafter, while this similar difference in the tarsus was observed starting from day 28. The disappearance of the pigmented portion of the beak was not specifically affected by the diet, and it decreased over time. In conclusion, young scarlet ibis grow better in captivity when fed diets supplemented with fish broth than with shrimp broth.
Walking an Article Into Being Becoming Together
Authors: Reinertsen Anne B. , Blyth Carmen
Published: April 2021

This is an article about a concept. It is an article about walkingtalking a concept. It is about connections with/in a concept. It is about doubs, confusions and uncertainties and about the processes of conceptualization."
Integration of various scales for measurement of insomnia
Authors: Chakrabartty Satyendra Nath
Published: April 2021

Background

Scales for evaluating insomnia differ in number of items, response format, and result in different scores distributions and score ranges and may not facilitate meaningful comparisons.

Objectives

Transform ordinal item-scores of three scales of insomnia to continuous, equidistant, monotonic, normally distributed scores, avoiding limitations of summative scoring of Likert scales.

Methods

Equidistant item-scores by weighted sum using data-driven weights to different levels of different items, considering cell frequencies of Item-Levels matrix, followed by normalization and conversion to [1, 10]. Equivalent test-scores (as sum of transformed item- scores) for a pair of scales were found by Normal Probability curves. Empirical illustration given.

Results

Transformed test-scores are continuous, monotonic and followed Normal distribution with no outliers and tied scores. Such test-scores facilitate ranking, better classification and meaningful comparison of scales of different lengths and formats and finding equivalent score combinations of two scales. For a given value of transformed test-score of a scale, easy alternate method avoiding integration proposed to find equivalent scores of another scales. Equivalent scores of scales help to relate various cut-off scores of different scales and uniformity in interpretations. Integration of various scales of insomnia is achieved by finding one-to-one correspondence among the equivalent score of various scales with correlation over 0.99

Conclusion

Resultant test-scores facilitated undertaking analysis in parametric set up. Considering the theoretical advantages including meaningfulness of operations, better comparison, use of such method of transforming scores of Likert items/test is recommended test and items, Future studies were suggested.
Interspecific sensitivity of European amphibians towards two pesticides and comparison to standard test species
Authors: Adams Elena , Leeb Christoph , Roodt Alexis P. , Brühl Carsten A.
Published: April 2021

Background

Although debates about the assessment of potential effects of pesticides on amphibians are ongoing, amphibians are not yet considered in the current EU environmental risk assessment of pesticides. Instead, the risk assessment of potential effects on aquatic amphibian life stages relies on use of data of surrogate species like the standard temperate fish species rainbow trout (Oncorhynchus mykiss). This assumption is mainly based on the comparison to amphibian species not native to Europe such as the aquatic African clawed frog (Xenopus laevis). It remains unclear whether these surrogate species cover semi-aquatic Central European amphibian sensitivities. Therefore, we assessed the acute sensitivity of aquatic stages of eight European amphibian species native in Germany (Bufo bufo, Bufotes viridis, Epidalea calamita, Hyla arborea, Pelobates fuscus, Pelophylax sp., Rana dalmatina, R. temporaria) towards commercial formulations of the fungicide folpet (Folpan® 500 SC, Adama) and the insecticide indoxacarb (Avaunt® EC, Cheminova). The determined acute sensitivities (median lethal concentration, LC50) were included in species sensitivity distributions and compared to experimentally determined LC50 values of X. laevis and literature values of O. mykiss.

Results

The results showed that native amphibian sensitivities differed between the tested pesticides with a factor of 5 and 11. Depending on the pesticide, X. laevis was five and nine times more tolerant than the most sensitive native amphibian species. Comparing literature values of O. mykiss to the experimentally determined sensitivities of the native amphibian species showed that the O. mykiss sensitivity was in the same range as for the tested amphibians for the formulation Folpan® 500 SC. The comparison of sensitivities towards the formulation Avaunt® EC showed an eight times lower sensitivity of O. mykiss than the most sensitive amphibian species.

Conclusions

A risk assessment using the 96-h LC50 values for fish covers the risk for the assessed aquatic stages of European amphibians after the application of the recommended uncertainty factor of 100 and thus may be adequate for lower tier risk assessment of the studied pesticides. If aquatic amphibian testing will be required for pesticide risk assessment nevertheless, acute tests with the model organism X. laevis and the application of an appropriate uncertainty factor might be a promising approach.
Clinical course, treatment and visual outcome of an outbreak of Burkholderia contaminans endophthalmitis following cataract surgery
Authors: Lind Caroline , Olsen Karina , Angelsen Nina K. , Krefting Einar A. , Fossen Kristian , Gravningen Kirsten , Depoorter Eliza , Vandamme Peter , Bertelsen Geir
Published: April 2021

Background

Postoperative endophthalmitis is a rare but dreaded complication of intraocular surgery and often results in severe visual impairment or blindness. The present study describes the clinical course, treatment and visual outcome of an outbreak of Burkholderia contaminans endophthalmitis following cataract surgery.

Methods

Among 290 patients who underwent uneventful phacoemulsification cataract surgery at one outpatient clinic between January 4th and 28th 2019, 6 cases developed Burkholderia contaminans endophthalmitis. Clinical data were collected by retrospective review of patient records. Microbiological samples from vitreous aspirates, intraocular lenses (IOL) and lens capsules were cultured, and recA and draft whole genome sequences analysed.

Results

The recA sequences of all Burkholderia contaminans isolates and the allelic profile of the isolates were identical. All cases had a similar clinical presentation with rapid development of endophthalmitis symptoms with variable time to onset. The mean time to admission was 34 days (12–112 days). All cases had a seemingly favourable response to intravitreal antibiotics. However, acute recurrences occurred after long time periods (12–71 days). The cases experienced between 0 and 3 recurrences. Due to persistent infection, the cases received between 5 and 15 treatments (mean 7.8) including IOL and lens capsule explantation in 5 of 6 cases. Burkholderia contaminans was detected in all explanted lens capsules. The final corrected distance visual acuity (CDVA, Snellen chart) was between 0.8 and 1.2 and all cases had final CDVA ≥0.8.

Conclusions

A persistent and intensive treatment approach including total lens capsule and IOL explantation is recommended for Burkholderia contaminans endophthalmitis following cataract surgery and may lead to a favourable visual result.
Patient and family views of team functioning in primary healthcare teams with nurse practitioners: a survey of patient-reported experience and outcomes
Authors: Kilpatrick Kelley , Tchouaket Eric , Fernandez Nicolas , Jabbour Mira , Dubois Carl-Ardy , Paquette Lysane , Landry Véronique , Gauthier Nathalie , Beaulieu Marie-Dominique
Published: April 2021

Background

Nurse practitioners (NPs) have been added to primary healthcare teams to improve access to care. Team processes, including communication and decision-making, explicate how patients and families view team functioning. Yet, important gaps exist in our understanding of patient-reported experience and outcomes at the level of the healthcare team. We aimed to examine the influence of individual, team, and organizational characteristics, and role clarity on outcomes of care mediated by team processes in primary healthcare teams that include NPs.

Methods

A cross-sectional survey across six sites representing practices with NPs in Québec, Canada, was conducted between March 2018 and April 2019 as part of a multiple-case study. Patients and families (n = 485; response rate: 53%) completed a validated questionnaire, which included a patient-reported experience measure (PREM) and a patient-reported outcome measure (PROM) of team functioning (Cronbach alpha: 0.771 (PROM) to 0.877 (PREM)). We performed logistic regression and mediation analyses to examine relationships between the individual, team, and organizational characteristics, role clarity, and outcomes of care mediated by team processes.

Results

Patients and families expressed positive perceptions of team functioning (mean 4.97/6 [SD 0.68]) and outcomes of care (5.08/6 [0.74]). Also, high team processes (adjusted odds ratio [AOR] 14.92 [95% CI 8.11 to 27.44]) was a significant predictor of high outcomes of care. Role clarity (indirect effect coefficient ab = 6.48 [95% CI 3.79 to 9.56]), living in an urban area (-1.32 [-2.59 to -0.13]), patient as respondent (-1.43 [-2.80 to -0.14]), and income (1.73 [0.14 to 3.45]) were significant predictors of outcomes of care mediated by team processes.

Conclusions

This study provides key insights on how primary healthcare teams with NPs contribute to team functioning, using a validated instrument consistent with a conceptual framework. Results highlight that high role clarity, living in a non urban area, family as respondent, and adequate income were significant predictors of high outcomes of care mediated by high team processes. Additional research is needed to compare teams with and without NPs in different settings, to further explicate the relationships identified in our study.
Prognostic value of lymphovascular invasion in stage II colorectal cancer patients with an inadequate examination of lymph nodes
Authors: Gao Zhenyan , Cao Huihua , Xu Xiang , Wang Qing , Wu Yugang , Lu Qicheng
Published: April 2021

Background

Lymphovascular invasion (LVI) is defined as the presence of cancer cells in lymphatics or blood vessels. This study aimed to evaluate the prognostic value of LVI in stage II colorectal cancer (CRC) patients with inadequate examination of lymph nodes (ELNs) and further combined LVI with the TNM staging system to determine the predictive efficacy for CRC prognosis. Adjuvant chemotherapy (ACT) was then evaluated for stage II CRC patients with LVI positivity (LVI+).

Methods

In order to avoid the effects of different ACT regimens, among 409 stage II patients, we chose 121 patients who received FOLFOX regimen and the 144 patients who did not receive ACT as the object of study. LVI was examined by hematoxylin-eosin (HE) staining. Kaplan-Meier analysis followed by a log-rank test was used to analyze survival rates. Univariate and multivariate analyses were performed using a Cox proportional hazards model. Harrell’s concordance index (C-index) was used to evaluate the accuracy of different systems in predicting prognosis.

Results

The LVI+ status was significantly associated with pT stage, degree of differentiation, tumor stage, serum CEA and CA19-9 levels, perineural invasion (PNI), tumor budding (TB), and KRAS status. The 5-year overall survival (OS) rate of stage II patients with < 12 ELNs and LVI+ was less than stage IIIA. Multivariate analyses showed that LVI, pT-stage, serum CEA and CA19-9 levels, PNI, TB, and KRAS status were significant prognostic factors for stage II patients with < 12 ELNs. The 8th TNM staging system combined with LVI showed a higher C-index than the 8th TNM staging system alone (C-index, 0.895 vs. 0.833). Among patients with LVI+, the ACT group had a significantly higher 5-year OS and 5-year disease-free survival (DFS) than the surgery alone (SA) group (5-year OS, 66.7% vs. 40.9%, P = 0.004; 5-year DFS, 64.1% vs. 36.3%, P = 0.002).

Conclusions

LVI is an independent prognostic risk factor for stage II CRC patients. Combining LVI with the 8th TNM staging system improved the predictive accuracy for CRC prognosis. ACT in stage II CRC patients with LVI+ is beneficial for survival.
Vascular resection for locally advanced pancreatic ductal adenocarcinoma: analysis of long-term outcomes from a single-centre series
Authors: Feo Claudio F. , Deiana Giulia , Ninniri Chiara , Cherchi Giuseppe , Crivelli Paola , Fancellu Alessandro , Ginesu Giorgio C. , Porcu Alberto
Published: April 2021

Background

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with poor prognosis. Radical surgery is the best option for cure and, nowadays, it is performed by many surgeons also in cases of vascular infiltration. Whether this aggressive approach to a locally advanced PDAC produces a survival benefit is under debate. Most data in the literature come from retrospective comparative studies; therefore, it is still unclear if such an extensive surgery for an advanced cancer is justified.

Methods

A retrospective review of patients with PDAC treated at our institution over a 12-year period was performed. Data concerning patients’ characteristics, operative details, postoperative course, and long-term survival were retrieved from prospective databases and analysed. Factors associated with poor survival were assessed via Cox regression analysis.

Results

A total of 173 patients with PDAC were included in the analysis, 41 subjects underwent pancreatectomy with vascular resection for locally advanced disease, and in 132 patients, only a pancreatic resection was undertaken. Demographics, major comorbidities, and tumour characteristics were similar between the two groups. Length of surgery (P=0.0006), intraoperative blood transfusions (P<0.0001), and overall complications (P<0.0001) were significantly higher in the vascular resection group. Length of hospital stay (P=0.684) and 90-day mortality (P=0.575) were comparable between groups. Overall median survival (P= 0.717) and survival rates at 1, 3, and 5 years (P=0.964, P=0.500, and P=0.445, respectively) did not differ significantly between groups. Age ≥70 years and postoperative complications were independent predictors of lower survival.

Conclusions

Our study confirms that pancreatectomy with vascular resection for a locally advanced PDAC is a complex operation associated with a significant longer operating time that may increase morbidity; however, in selected patients, R0 margins can be obtained with an acceptable long-term survival rate. Older patients are less likely to benefit from surgery.
Classic Kaposi sarcoma in a patient of Miao ethnicity followed up for 7 years: a case report
Authors: Zhou Jing , Shen Xiaoping , Wang Xiaodong , Xiao Kun , Cao Yu , Jiang Yanping
Published: April 2021

Background

Classic Kaposi sarcoma (CKS) is a vascular sarcoma associated with human herpesvirus 8 (HHV-8), which is known to be more common in Mediterranean elderly men and is characterized by indolent clinical behavior. Xinjiang province in China is considered an endemic region for Kaposi’s sarcoma-associated herpesvirus (KSHV), with higher incidence among adults of Kazak and Uyghur ethnicities. Cases of CKS are rarely reported in inland China. Here, we followed a case of CKS for 7 years in a patient of Miao ethnic background in southwestern China.

Case presentation

A 63-year-old Miao (southwestern China) man was initially diagnosed with CKS in 2010, having a history of limb lesions for 37 years, with left eyelid and binaural lesions for 9 years. He did not have sexual contact with men and was human immunodeficiency virus (HIV)-negative. Due to his lumbago and fever, spinal tuberculosis in the lumbar vertebra was highly suspected after computed tomography (CT) scan. However, diagnostic antituberculosis treatment for 4 weeks failed. The patient was followed up in 2016, when the rash was recovering as the systemic symptoms improved. A new CT was performed, which showed a partial response despite the absence of any medical treatment. The open reading frame (ORF)-K1 of KSHV from skin tissue of the foot was amplified and sequenced, and K1 belonged to subtype A. This genotype is consistent with the typical subtype present in Xinjiang.

Conclusions

We describe spontaneous partial regression of CKS in a patient of Miao ethnicity in inland China. Our sample may represent an unknown, novel genotype. Surveillance and regulating the immune state may represent a valuable approach for this rare disease.
Health behaviors of medical students decline towards residency: how could we maintain and enhance these behaviors throughout their training
Authors: Wilf-Miron Rachel , Kagan Ilya , Saban Mor
Published: April 2021

Background

We examined health behaviors and perceptions among medical students and compared them with the results of a previous survey among residents and senior physicians.

Methods

This cross–sectional study was performed among second-year medical students (2015–2018) and among physicians (2015) using an online questionnaire. Univariate and multivariate analyses were performed.

Results

Significantly more physicians perceived their health as bad, compared with students. Half of the residents, compared with one-third of senior physicians and one-fifth of students, reported high emotional stress. Residents reported the worst, and students - the best, eating habits. Logistic regression models demonstrated that lower emotional stress, healthy eating habits, adequate sleep, lower body mass index and not having a regular physician, explained good perceived health. Female gender, being a resident, bad perceived health, unhealthy eating habits, less sleep and not having a regular physician, were correlated with high emotional stress.

Conclusions

The healthy lifestyle of medical students declines towards residency. Given the workload and emotional stress of their chosen profession, it is advised that medical school curriculum provide students with measures to help them to adopt healthier lifestyles, allowing students and physicians to be better role models and the healthcare system to perform better.
A systematic review of the factors associated with the course of borderline personality disorder symptoms in adolescence
Authors: Skabeikyte Gabriele , Barkauskiene Rasa
Published: April 2021

Background

Research on personality pathology in adolescence has accelerated during the last decade. Among all of the personality disorders, there is strong support for the validity of borderline personality disorder (BPD) diagnosis in adolescence with comparable stability as seen in adulthood. Researchers have put much effort in the analysis of the developmental pathways and etiology of the disorder and currently are relocating their attention to the identification of the possible risk factors associated with the course of BPD symptoms during adolescence. The risk profile provided in previous systematic reviews did not address the possible development and course of BPD features across time. Having this in mind, the purpose of this systematic review is to identify the factors that are associated with the course of BPD symptoms during adolescence.

Methods

Electronic databases were systematically searched for prospective longitudinal studies with at least two assessments of BPD as an outcome of the examined risk factors. A total number of 14 articles from the period of almost 40 years were identified as fitting the eligibility criteria.

Conclusions

Factors associated with the course of BPD symptoms include childhood temperament, comorbid psychopathology, and current interpersonal experiences. The current review adds up to the knowledge base about factors that are associated with the persistence or worsening of BPD symptoms in adolescence, describing the factors congruent to different developmental periods.
Interrupted time series design to evaluate ICD-9-CM to ICD-10-CM coding changes on trends in Colorado emergency department visits related to traumatic brain injury
Authors: De Crescenzo Lauren Alexis , Gabella Barbara Alison , Johnson Jewell
Published: April 2021

Background

The transition in 2015 to the Tenth Revision of the International Classification of Disease, Clinical Modification (ICD-10-CM) in the US led the Centers for Disease Control and Prevention (CDC) to propose a surveillance definition of traumatic brain injury (TBI) utilizing ICD-10-CM codes. The CDC’s proposed surveillance definition excludes “unspecified injury of the head,” previously included in the ICD-9-CM TBI surveillance definition. The study purpose was to evaluate the impact of the TBI surveillance definition change on monthly rates of TBI-related emergency department (ED) visits in Colorado from 2012 to 2017.

Results

The monthly rate of TBI-related ED visits was 55.6 visits per 100,000 persons in January 2012. This rate in the transition month to ICD-10-CM (October 2015) decreased by 41 visits per 100,000 persons (p-value < 0.0001), compared to September 2015, and remained low through December 2017, due to the exclusion of “unspecified injury of head” (ICD-10-CM code S09.90) in the proposed TBI definition. The average increase in the rate was 0.33 visits per month (p < 0.01) prior to October 2015, and 0.04 visits after. When S09.90 was included in the model, the monthly TBI rate in Colorado remained smooth from ICD-9-CM to ICD-10-CM and the transition was no longer significant (p = 0.97).

Conclusion

The reduction in the monthly TBI-related ED visit rate resulted from the CDC TBI surveillance definition excluding unspecified head injury, not necessarily the coding transition itself. Public health practitioners should be aware that the definition change could lead to a drastic reduction in the magnitude and trend of TBI-related ED visits, which could affect decisions regarding the allocation of TBI resources. This study highlights a challenge in creating a standardized set of TBI ICD-10-CM codes for public health surveillance that provides comparable yet clinically relevant estimates that span the ICD transition.
Treatment with senicapoc in a porcine model of acute respiratory distress syndrome
Authors: Petersen Asbjørn G. , Lind Peter C. , Jensen Anne-Sophie B. , Eggertsen Mark A. , Granfeldt Asger , Simonsen Ulf
Published: April 2021

Background

Senicapoc is a potent and selective blocker of KCa3.1, a calcium-activated potassium channel of intermediate conductance. In the present study, we investigated whether there is a beneficial effect of senicapoc in a large animal model of acute respiratory distress syndrome (ARDS). The primary end point was the PaO2/FiO2 ratio.

Methods

ARDS was induced in female pigs (42–49 kg) by repeated lung lavages followed by injurious mechanical ventilation. Animals were then randomly assigned to vehicle (n = 9) or intravenous senicapoc (10 mg, n = 9) and received lung-protective ventilation for 6 h.

Results

Final senicapoc plasma concentrations were 67 ± 18 nM (n = 9). Senicapoc failed to change the primary endpoint PaO2/FiO2 ratio (senicapoc, 133 ± 23 mmHg; vehicle, 149 ± 68 mmHg). Lung compliance remained similar in the two groups. Senicapoc reduced the level of white blood cells and neutrophils, while the proinflammatory cytokines TNFα, IL-1β, and IL-6 in the bronchoalveolar lavage fluid were unaltered 6 h after induction of the lung injury. Senicapoc-treatment reduced the level of neutrophils in the alveolar space but with no difference between groups in the cumulative lung injury score. Histological analysis of pulmonary hemorrhage indicated a positive effect of senicapoc on alveolar–capillary barrier function, but this was not supported by measurements of albumin content and total protein in the bronchoalveolar lavage fluid.

Conclusions

In summary, senicapoc failed to improve the primary endpoint PaO2/FiO2 ratio, but reduced pulmonary hemorrhage and the influx of neutrophils into the lung. These findings open the perspective that blocking KCa3.1 channels is a potential treatment to reduce alveolar neutrophil accumulation and improve long-term outcome in ARDS.
Multivariate analysis of causal factors influencing accuracy of guided implant surgery for partial edentulism: a retrospective clinical study
Authors: Matsumura Atsushi , Nakano Tamaki , Ono Shinji , Kaminaka Akihiro , Yatani Hirofumi , Kabata Daijiro
Published: April 2021

Background

In dental implant treatment, the placement position of the implant body is important. The hypothesis is that there are factors that have a greater impact than the factors that have been studied so far.

Material and Methods

The deviation between planned and actually placed implants was measured three-dimensionally by modified treatment evaluation method in 110 patients who underwent implant placement with guided surgery for partial edentulism. Ten factors that seemed to affect errors in placement were selected: the type of tooth, type of edentulism, distance from the remaining teeth, the type of implant, implant length, number of implants, method of guidance, the number of teeth supporting the surgical guide, number of anchor pins, and presence or absence of a reinforcement structure. The effect of each factor that corrected each confounding was calculated using multivariate analysis.

Results

In this study, 188 implant bodies were set to target, and the errors measurement data of the implant position were as follows: average Angle, 2.5 ± 1.6° (95% CI 2.25–2.69); Base, 0.67 ± 0.37 mm (95% CI 0.62–0.72); and Apex, 0.92 ± 0.47 mm (95% CI 0.86–0.98). As the result of multivariate analysis, larger errors were present in the partially guided group than the fully guided group. The number of teeth supporting the surgical guide significantly influenced the error in placement position. The error caused by the number of anchor pins was significantly different for the Angle. Similarly, the presence of the reinforcement structure influenced the error significantly for the Angle.

Conclusions

It was suggested that the smaller errors could be present by performing guided surgery with full guidance and devising the design of the guide such as the number of teeth supporting the surgical guide, the setting of the anchor pin, and the reinforcement structure.
B-natriuretic peptide serum levels in neonates with persistent pulmonary hypertension
Authors: Abdel Hamid Tamer A. , Eldin Zahraa Mohamed Ezz , Hegazy Ranya Aly , Esmail Reem Ibrahim , El-sholkamy Lamis Mohsen Ahmed
Published: April 2021

Background

Better management of persistent pulmonary hypertension of neonates (PPHN) required new markers that can predict the response of patient to treatment and thus influence the medical decision to avoid short-term and long-term adverse effects. Hence, we aimed to evaluate B-natriuretic peptide (BNP) serum levels in neonates with PPHN and to correlate its levels with disease severity and response to treatment.

Patients and methods

The study included 60 neonates (30 PPHN patients and 30 healthy subjects). BNP was assessed, using the ELISA technique, at admission and after 4 days of treatment.

Results

Initial serum BNP levels were significantly higher in patients compared to controls (p< 0.001). Patients with mild severity showed lower BNP levels compared to patients with moderate severity, while patients with moderate severity showed decreased levels in comparison to severe cases (p< 0.001). The group of patients who showed remission after 4 days of treatment had lower pre-treatment and post-treatment BNP levels, compared to patients who showed incomplete remission. Initial levels of BNP showed strong positive correlations with pulmonary artery pressure (PAP) and oxygenation index (OI) before treatment (r= 0.9,p< 0.001 andr= 0.85,p= 0.001), while BNP after treatment showed moderate positive correlations with PAP before treatment (r= 0.6,p= 0.001) and OI before treatment (r= 0.6,p= 0.001). Analysis of the ROC curve revealed an AUC of 0.83with CI = 0.7–0.98 andp= 0.003.

Conclusions

BNP may play a role in the pathogenesis of PPHN, and BNP serum level can be used as a marker to detect disease severity and predict response to treatment.
The Formation of Haemoglobin during the Development of the Erythrocytes
Authors: Thorell Bo
Published: April 2021

From the functional point of view the processes of differentiation during the formation of the red blood-cells are characterized by the synthesis of haemoglobin.
Cellular Interactions in Cell Differentiation
Authors: Amprino Rodolfo
Published: April 2021

It is of some interest, in connexion with the problem of cellular interactions, to view the affinities between different tissues in various stages of development.
Isolation of a chick cytokeratin cDNA clone indicative of regional specialization in early embryonic ectoderm
Authors: Charlebois Timothy S. , Spencer Deborah H. , Tarkington Sharon K. , Henry Jonathan J. , Grainger Robert M.
Published: April 2021

During early vertebrate development, a series of inductive tissue interactions appear to be involved in establishing regional specializations that are eventually elaborated in the basic body plan of the embryo. These early inductive interactions are particularly difficult to study because they often occur in the absence of any associated morphological changes. In the chick embryo, the regional subdivision of the early ectoderm is evidenced by a marked lens-forming bias in the head ectoderm, which is absent from the presumptive dorsal epidermis of the trunk region. This striking divergence in developmental state is present long before any differentiation into lens or epidermal phenotypes can be detected. As a strategy for isolating genes whose differential expression might be a reflection of this regional subdivision, a cDNA library was prepared from early embryos and screened for differential hybridization to radiolabelled probes prepared from head ectoderm and trunk ectoderm. Two related cDNA clones were isolated that hybridize to transcripts present at much higher levels in trunk ectoderm than in head ectoderm. Sequence analysis of one of these clones revealed a high degree of similarity to members of the type II subfamily of intermediate filament cytokeratins. This clone (pCKsel) was used to examine cytokeratin gene expression in ectodermal tissues. A large increase in the level of CKsel transcripts was found to take place in trunk ectoderm, approximately coordinate with neurulation, contrasting sharply with the much lower levels detected in head ectoderm and neural ectoderm at all stages tested. These results indicate that differential cytokeratin gene expression can occur within a contiguous layer of simple embryonic epithelia, and that this expression pattern coincides closely to the subdivision of the early ectoderm into regions with distinct developmental potencies. This type of regulation has not been described previously for members of the cytokeratin gene family.
Region-specific expression in early chick and mouse embryos of Ghox-lab and Hox 1.6, vertebrate homeobox-containing genes related to Drosophila labial
Authors: Sundin Olof H. , Busse Heinz G. , Rogers Melissa B. , Gudas Lorraine J. , Eichele Gregor
Published: April 2021

A chick gene homologous to the Drosophila homeobox gene labial has been cloned and sequenced. Regions of additional sequence identity outside of the homeobox reveal a close relationship to the mouse gene Hox 1.6. Northern blot analysis demonstrates that Ghox-lab and Hox 1 .6 transcripts are both present at high levels during early stages of chick and mouse development, with a subsequent decline in abundance to very low levels by the time limb mesenchyme begins to differen tiate. In situ hybridization analysis of chick embryos shows intense expression of Ghox-lab mRNA by Ham burger and Hamilton stage 4 (avian ‘mid gastrula’) and by stage 6 (pre-somitic neural plate) with expression decreasing shortly thereafter. The pattern of Ghox-lab RNA expression in these early embryos divides the embryo into an anterior and a posterior compartment. At stage 6, considerable signal is observed in the posterior two thirds of the embryo, while none is detected in the anterior third which is fated to become the head. This pattern is purely regional in nature, and does not follow boundaries defined by known tissue types. In situ hybridization of Hox 1.6 probes to mouse embryos of day 7.S or 8.0 indicate that the Hox I .6 transcript has a temporal and spatial distribution very similar to that of Ghox-lab in the chick embryo.
Inhibition by α-methyl-norvaline of the uptake of valine and leucine into haemoglobin of the chick embryo
Authors: Deuchar E. M. , Dryland A. M. L.
Published: April 2021

We reported recently (Deuchar & Dryland, 1965) that a-methyl-norvaline, an amino acid whose structure resembles both valine and leucine, inhibits the uptake of these two normal amino-acids into protein in explanted chick embryos and is also itself incorporated into embryonic proteins.
Rate of Movement and Rheotaxis in Planaria Alpina
Authors: Beauchamp R. S. A.
Published: April 2021

In an earlier paper (Beauchamp, 1933) the migrations of Planaria alpina up and downstream were described; these migrations were shown to be associated with feeding and sexual development. In a later paper (Beauchamp, 1935) the influence of temperature on the rate of movement of immature individuals was described, and also the effect of certain stimuli which cause an increase in rate of movement.
Adaptation to Changes of Salinity in the Polychaetes
Authors: Beadle L. C.
Published: April 2021

Nereis diversicolor collected from the same locality at different times showed smaller weight increases in dilute sea water (25 per cent) during the winter than during the summer months. In spite of great variations in the weight curve, the body fluid concentration curve was very constant. The maintenance of hypertonic body fluids and the regulation of body volume are largely unconnected. The lowering of the weight curve below that theoretically expected from the concentration curve cannot be attributed to passive salt loss through the body surface. It is suggested that this is due to the removal of fluid through the nephridia under the hydrostatic pressure produced by the contraction of the body wall muscles. Animals previously subjected to dilute sea water, when placed in water isotonic with the body fluids, will increase the concentration of the latter. This result is more marked when the internal hydrostatic pressure is high. The results suggest that the osmotic regulatory mechanism involves the removal by the nephridia of fluid hypotonic to the body fluids. But no direct evidence for this is available. Calcium deficiency and cyanide in dilute sea water cause an increase of weight and ultimately inhibit the maintenance of hypertonic body fluids. Both these effects are reversible. The mechanism by which body fluids are maintained hypertonic to the external medium is not sufficiently developed to be of survival value in the locality in which the animals were found. The control of body volume is probably of greater importance. The majority of the extra oxygen consumption in dilute sea water is not the result of osmotic work. It is suggested that it may be due to work done by the body wall muscles in resisting swelling.
Studies on the Excreta of A Grasshopper (Melanoplus BivittatusSay)
Authors: Brown A. W. A.
Published: April 2021

The methods hitherto employed in the study of the gross metabolism of insects have been based mainly on the changes in their content of physiologically important substances during development, and on the ability of the organism to grow on selected diets of known composition. There is a third method, extensively employed by mammalian physiologists, namely analysis of excreta; this, as Uvarov (1928) has pointed out, necessarily involves its correlation with the constitution of the food. Very few analyses of insect excreta, however, have been made, and those of any completeness are confined to species of unusually specialized food habits, i.e. the clothes moth (Babcock, 1912), (Hollande&Cordebard, 1926), and Rhodnius prolixus (Wigglesworth, 1931).
Phasic Action of the Tensor Muscle Modulates the Calling Song in Cicadas
Authors: Fonseca P. J. , Hennig R. M.
Published: April 2021

The effect of tensor muscle contraction on sound production by the tymbal was investigated in three species of cicadas (Tettigetta josei, Tettigetta argentata and Tympanistalna gastrica). All species showed a strict time correlation between the activity of the tymbal motoneurone and the discharge of motor units in the tensor nerve during the calling song. Lesion of the tensor nerve abolished the amplitude modulation of the calling song, but this modulation was restored by electrical stimulation of the tensor nerve or by mechanically pushing the tensor sclerite. Electrical stimulation of the tensor nerve at frequencies higher than 30–40 Hz changed the sound amplitude. In Tett. josei and Tett. argentata there was a gradual increase in sound amplitude with increasing frequency of tensor nerve stimulation, while in Tymp. gastrica there was a sudden reduction in sound amplitude at stimulation frequencies higher than 30 Hz. This contrasting effect in Tymp. gastrica was due to a bistable tymbal frame. Changes in sound pulse amplitude were positively correlated with changes in the time lag measured from tymbal motoneurone stimulation to the sound pulse. The tensor muscle acted phasically because electrical stimulation of the tensor nerve during a time window (0–10 ms) before electrical stimulation of the tymbal motoneurone was most effective in eliciting amplitude modulations.

In all species, the tensor muscle action visibly changed the shape of the tymbal. Despite the opposite effects of the tensor muscle on sound pulse amplitude observed between Tettigetta and Tympanistalna species, the tensor muscle of both acts by modulating the shape of the tymbal, which changes the force required for the tymbal muscle to buckle the tymbal.
Design of the Oxygen and Substrate Pathways: IV. Partitioning Energy Provision From Fatty Acids
Authors: Weber Jean-Michel , Brichon Gérard , Zwingelstein Georges , Mcclelland Grant , Saucedo Christopher , Weibel Ewald R. , Taylor C. Richard
Published: April 2021

This paper quantifies the fluxes of fatty acids through the pathways supplying muscle mitochondria with oxidative fuel in exercising dogs and goats. We used continuous infusions of 1-[14C]palmitate and indirect calorimetry to measure fatty acid supply from two sources: the circulation and the triglyceride stores within the muscle cells. Our goal was to determine maximal flux through these two branches of the lipid pathway as key functional parameters for testing the principle of symmorphosis, i.e. that structural capacity is quantitatively matched to functional demand in the oxidative substrate pathways. It is under these rate-limiting conditions that we predict that all of the structural capacity will be used. Maximal rates of fatty acid oxidation were reached at low exercise intensities of 40 % . Fatty acids from the circulation supplied only a small fraction (15–25 %) of the total fat oxidized under these conditions. Although dogs were able to oxidize circulatory fatty acids faster than goats, maximal rates were not in proportion to the 2.2-fold difference in aerobic capacity between the two species. Dogs compensated for their relatively lower use of circulatory fatty acids by oxidizing more triglycerides from lipid droplets in their muscle cells. We conclude that fatty acids from intramuscular triglyceride stores are a major source of fuel during maximal rates of lipid oxidation. Furthermore, it is this branch of the fatty acid pathway that is adapted to the large difference in aerobic capacity between dogs and goats.
Design of the Oxygen and Substrate Pathways: VI. Structural Basis of Intracellular Substrate Supply to Mitochondria in Muscle Cells
Authors: Vock Ruth , Hoppeler Hans , Claassen Helgard , Wu David X. Y. , Billeter Rudolf , Weber Jean-Michel , Taylor C. Richard , Weibel Ewald R.
Published: April 2021

This paper quantifies the structures involved in the transport and oxidation of carbohydrates and fatty acids within the muscle cell. The structural capacity is measured on whole-body random samples of the musculature of dogs and pygmy goats and compared with maximal rates of oxygen consumption and substrate oxidation. Comparing dogs and goats of the same body size provided a 1.55-fold difference in the maximal rate of oxidation when related to muscle mass. As in previous studies, we found that the volume of mitochondria was approximately proportional to aerobic capacity. The maximal glucose flux from intracellular stores to mitochondria is 1.6 times greater in the dog than in the goat; we find that the amount of glycogen stored in the muscle cells is 4.2 times as great in the dog, but part of the intracellular glycogen pool is used for anaerobic rather than for oxidative metabolism. The maximal fatty acid flux from intracellular stores to mitochondria is 1.5 times larger in the dog, and the amount of lipid stored is 2.3 times as great in the dog. Every lipid droplet is in direct contact with the outer membrane of a mitochondrion and the contact surface area is 3.6 times greater in the dog than in the goat. Additional measurements are needed to investigate the role of structural limitation at this step. The amount of substrates stored intracellularly in the muscle cells of the dog is about twice as much as would match the differences in the maximal rates of utilization. This allows the endurance-specialized dogs to run for longer periods at higher rates of oxidation.