bluuebunny/crossref_metadata_2025 huggingface dataset:
The mononuclear phagocyte system contributes to fibrosis in post-transplant obliterans bronchiolitis
Authors: Di Campli Maria-Pia , Azouz Abdulkader , Assabban Assiya , Scaillet Jessika , Splittgerber Marion , Van Keymeulen Alexandra , Libert Frederick , Remmelink Myriam , Le Moine Alain , Lemaitre Philippe , Goriely Stanislas
Published: October 2020

Bronchiolitis obliterans syndrome (BOS) is a fibrotic disease that is heavily responsible for the high mortality rates after lung transplantation. Myofibroblasts are primary effectors of this fibrotic process, but their origin is still debated. The purpose of this work was to identify the precursors of mesenchymal cells responsible for post-transplant airway fibro-obliteration.

Lineage-tracing tools were used to track or deplete potential sources of myofibroblasts in the heterotopic tracheal transplantation model. Allografts were analysed by histology, confocal microscopy, flow cytometry or single-cell transcriptomic analysis. BOS explants were evaluated by histology and confocal microscopy.

Myofibroblasts in the allografts were recipient-derived. When recipient mice were treated with tacrolimus, we observed rare epithelial-to-mesenchymal transition phenomena and an overall increase in donor-derived myofibroblasts (p=0.0467), but the proportion of these cells remained low (7%). Haematopoietic cells, and specifically the mononuclear phagocyte system, gave rise to the majority of myofibroblasts found in occluded airways. Ablation of Cx3cR1+cells decreased fibro-obliteration (p=0.0151) and myofibroblast accumulation (p=0.0020). Single-cell RNA sequencing revealed similarities between myeloid-derived cells from allografts and both murine and human samples of lung fibrosis. Finally, myofibroblasts expressing the macrophage marker CD68 were increased in BOS explants when compared to controls (14.4%versus8.5%, p=0.0249).

Recipient-derived myeloid progenitors represent a clinically relevant source of mesenchymal cells infiltrating the airways after allogeneic transplantation. Therapies targeting the mononuclear phagocyte system could improve long-term outcomes after lung transplantation.
Idiopathic pulmonary fibrosis in the UK: analysis of the British Thoracic Society electronic registry between 2013 and 2019
Authors: Spencer Lisa G. , Loughenbury Maria , Chaudhuri Nazia , Spiteri Monica , Parfrey Helen
Published: October 2020

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and terminal interstitial lung disease (ILD) with a median survival of 3–5 years. The British Thoracic Society (BTS) established the UK IPF Registry in 2013 as a platform to collect data on clinical characteristics, treatments and outcomes for this cohort in the UK.

Between 1 January 2013 and 31 October 2019, 2474 cases were registered. Most patients were male (79%) with a mean±sdage of 74±8.3 years and 66% were ex-smokers. Over time we observed an increase in the number of patients aged over 70 years. However, we have not seen a trend towards earlier presentation as symptoms of breathless and/or cough were present for >12 months in 63% of the cohort. At presentation, mean±sd% predicted forced vital capacity (FVC) was 78.2±18.3%, median 76.2% (interquartile range (IQR) 22.4%) and transfer factor of the lung for carbon monoxide (TLCO) 48.4±16.0, median 47.5 (IQR 20.1). Most cases were discussed at an ILD multidisciplinary meeting, with an increase over this time in the number of cases reported as having possible usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography (HRCT) thorax. We noted a reduction in the number of patients undergoing surgical lung biopsy or bronchoalveolar lavage. Although more patients were prescribed anti-fibrotic therapies from 2013 to 2019, 43% were ineligible for treatment based upon National Institute for Health and Care Excellence (NICE) prescribing criteria. Hypertension, ischaemic heart disease, diabetes mellitus and gastro-oesophageal reflux were the most common comorbidities.

In conclusion, we have presented baseline demographics as well as diagnostic and treatment strategies from the largest single-country IPF registry, reflecting changes in UK practices over this period.
Blood eosinophil count predicts treatment failure and hospital readmission for COPD
Authors: Kerkhof Marjan , Chaudhry Isha , Pavord Ian D. , Miravitlles Marc , Kook Rhee Chin , Halpin David M.G. , Usmani Omar S. , Jones Rupert , Kocks Janwillem , Alacqua Marianna , Morris Tamsin , Kaplan Alan , Price David B.
Published: October 2020

We examined associations between blood eosinophil counts (BEC) and risk of treatment failure or hospital readmission following acute oral corticosteroid (OCS)-treated COPD exacerbations.

We conducted studies from the Optimum Patient Care Research Database (OPCRD) (www.optimumpatientcare.org/opcrd) and Clinical Practice Research Datalink (CPRD) (www.cprd.com/home/), validated databases for medical research, with linked Hospital Episode Statistics (HES) data for ∼20 000 COPD patients aged ≥40 years. For patients with OCS-treated COPD exacerbations treated in primary care, with BECs recorded on first day of OCS treatment (Cohort 1), we assessed treatment failure (COPD-related hospitalisations and OCS prescriptions beyond index OCS course). For patients hospitalised for COPD exacerbations, with BEC measured over an exacerbation-free period during the year prior to admission (Cohort 2), we assessed readmission rate. Cox proportional hazards regression analysis was adjusted for confounders to estimate the association between BEC and treatment outcomes.

Of patients treated with OCS for COPD exacerbations in primary care (Cohort 1), 44% experienced treatment failure following single OCS courses, and 10% (255/2482) were hospitalised for ≤6 weeks. Greater BEC was associated with reduced hospital-admission risk (hazard ratio [HR]=0.26; 95% CI: 0.12–0.56, per 100 cells·µL−1increase). BEC increases of ≥200 cells·µL−1from exacerbation-free periods to exacerbations were associated with least hospitalisation risk (HR=0.32; 95% CI: 0.15–0.71)versusno BEC change. For patients hospitalised for COPD exacerbations (Cohort 2), 4-week hospital readmission was 12% (1189/10 245). BEC increases during an exacerbation-free period within the past year were associated with reduced risk of short-term readmission (HR=0.78; 95% CI: 0.63–0.96).

Greater BEC predicted better outcomes for patients with OCS-treated COPD exacerbations, whether community or hospital managed. Eosinopenia predicted worse outcomes.
Whole-exome sequencing accuracy in the diagnosis of primary ciliary dyskinesia
Authors: Gileles-Hillel Alex , Mor-Shaked Hagar , Shoseyov David , Reiter Joel , Tsabari Reuven , Hevroni Avigdor , Cohen-Cymberknoh Malena , Amirav Israel , Brammli-Greenberg Shuli , Horani Amjad , Kerem Eitan , Breuer Oded
Published: October 2020

The diagnosis of primary ciliary dyskinesia (PCD) relies on clinical features and sophisticated studies. The detection of bi-allelic disease-causing variants confirms the diagnosis. However, a standardised genetic panel is not widely available and new disease-causing genes are continuously identified.

To assess the accuracy of untargeted whole-exome sequencing (WES) as a diagnostic tool for PCD, patients with symptoms highly suggestive of PCD were consecutively included. Patients underwent measurement of nasal nitric oxide (nNO) levels, ciliary transmission electron microscopy analysis (TEM) and WES. A confirmed PCD diagnosis in symptomatic patients was defined as a recognised ciliary ultrastructural defect on TEM and/or two pathogenic variants in a known PCD-causing gene.

Forty-eight patients (46% male) were enrolled, with a median age of 10.0 years (range 1.0–37 years). In 36 patients (75%) a diagnosis of PCD was confirmed, of which 14 (39%) patients had normal TEM. A standalone untargeted WES had a diagnostic yield of 94%, identifying bi-allelic variants in 11 known PCD-causing genes in 34 subjects. A nNO<77 nL·min was nonspecific when including patients younger than 5 years (area under the receiver operating characteristic curve (AUC) 0.75, 95% CI 0.60–0.90). Consecutive WES considerably improved the diagnostic accuracy of nNO in young children (AUC 0.97, 95% CI 0.93–1). Finally, WES established an alternative diagnosis in four patients.

In patients with clinically suspected PCD and low nNO levels, WES is a simple, beneficial and accurate next step to confirm the diagnosis of PCD or suggest an alternative diagnosis, especially in preschool-aged children in whom nNO is less specific.
Non-interventional monitoring of expiratory flow limitation during experimental mechanical ventilation
Authors: Marinakis Giorgos , Paraschos Michael , Patrani Maria , Tsoutsouras Theodoros , Vassiliou Miltos
Published: October 2020

Background

Expiratory flow limitation (EFL) is common among patients in the intensive care unit under mechanical ventilation (MV) and may have significant clinical consequences. In the present study, we examine the possibility of non-interventional detection of EFL during experimental MV.

Methods

Eight artificially ventilated New Zealand rabbits were included in the experiments. EFL was induced during MV by application of negative expiratory pressure (−5, −8 and −10 hPa) and detected by the negative expiratory pressure technique. Airway pressure (Paw) and gas flow (V′) were digitally recorded and processed off-line for the evaluation of respiratory mechanics. The method is based on the computation and monitoring of instantaneous respiratory resistanceRrs(t). The resistive pressure (Paw,res(t)) is calculated by subtracting fromPawits elastic component and the end-expiratory pressure, as assessed by linear regression. Then,Rrs(t) is computed as the instant ratioPaw,res(t)/V′(t).

Results

Two completely different patterns of expiratoryRrs(t) separate the cases with EFL from those without EFL. Small and random fluctuations are noticed when EFL is absent, whereas the onset of EFL is accompanied by an abrupt and continuous rise inRrs(t), towards the end of expiration. Thus, EFL is not only detected but may also be quantified from the volume still to be expired at the time EFL occurs.

Conclusion

The proposed technique is a simple, accurate and non-interventional tool for EFL monitoring during MV.
Effect of maternal asthma exacerbations on perinatal outcomes: a population-based study
Authors: Robijn Annelies L. , Brew Bronwyn K. , Jensen Megan E. , Rejn� Gustaf , Lundholm Cecilia , Murphy Vanessa E. , Almqvist Catarina
Published: October 2020

Background

Although there is a growing body of literature about the impact of asthma exacerbations during pregnancy on adverse perinatal outcomes, it is still unclear whether asthma exacerbations themselves or asthma severity are the driving factor for negative outcomes. This study aimed to estimate the associations between maternal asthma exacerbations and perinatal outcomes, and whether this differed by asthma treatment regime as a proxy for severity.

Methods

We included births of women with asthma in Sweden from July 2006 to November 2013 (n=33 829). Asthma exacerbations were defined as unplanned emergency visits/hospitalisations or a short course of oral corticosteroids. Adjusted odds ratios (aOR) were estimated for the associations between exacerbations during pregnancy and perinatal outcomes (small for gestational age (SGA), preterm birth, birthweight and mode of delivery), stratified by preconception treatment regime.

Results

Exacerbations occurred in 1430 (4.2%) pregnancies. Exacerbations were associated with reduced birthweight (aOR 1.45, 95% CI 1.24�1.70), and elective (aOR 1.50, 95% CI 1.25�1.79) and emergency caesarean section (aOR 1.35, 95% CI 1.13�1.61). Multiple exacerbations were associated with a 2.6-fold increased odds of SGA (95% CI 1.38�4.82). Amongst women treated prepregnancy with combination therapy (proxy for moderate�severe asthma), exacerbators were at increased odds of elective (aOR 1.69, 95% CI 1.30�2.2) and emergency (aOR 1.62, 95% CI 1.26�2.08) caesarean section, and SGA (aOR 1.74, 95% CI 1.18�2.57)
versus
non-exacerbators.

Conclusion

Maternal asthma exacerbations increase the risk of SGA and caesarean sections, particularly in women with multiple exacerbations or moderate�severe asthma. Adequate antenatal asthma care is needed to reduce exacerbations and reduce risks of poor outcomes.
The impact of changing to the Global Lung Function Initiative reference equations for transfer factor in paediatrics
Authors: Burns Paul D. , Paton James Y.
Published: October 2020

The Global Lung Function Initiative (GLI) all-age reference equations for carbon monoxide transfer factor were published in 2017 and endorsed by the European Respiratory Society and American Thoracic Society. In order to understand the impact of these new reference equations on the interpretation of results in children referred from haematology and oncology paediatric services, we retrospectively analysed transfer factor results from any paediatric patient referred from haematology/oncology in the period 2010–2018. We examined transfer factor of the lung for carbon monoxide (TLCO), transfer coefficient of the lung for carbon monoxide (KCO) and alveolar volume (VA) from 241 children (age range 7–18 years, 130 male). The predicted values from Rosenthal and GLI were plotted against height. The difference in interpretation of results was analysed by looking at the percentage of patients below the lower limit of normal for each parameter. Overall, the Rosenthal predicted values forTLCOwere higher than those predicted by GLI. PredictedKCOusing Rosenthal was higher in all observations. In contrast, the Rosenthal predictedVAwas generally lower than the GLI value. The GLI predicted values for transfer factor show considerable differences compared with currently used paediatric UK reference values, differences that will have a significant impact on interpretation of results.
Which functional outcome measures can we use as a surrogate for exercise capacity during remote cardiopulmonary rehabilitation assessments? A rapid narrative review
Authors: Houchen-Wolloff Linzy , Daynes Enya , Watt Amye , Chaplin Emma , Gardiner Nikki , Singh Sally
Published: October 2020

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has seen many cardiopulmonary rehabilitation services delivering programmes remotely. One area of concern is how to assess exercise capacity when a supervised exercise test is not possible. The aim of this review was to examine the relationship between functional exercise tests and recommended exercise tests for cardiopulmonary rehabilitation.

Methods

A rapid narrative review was carried out. Searches were conducted by two of the study authors. The study had the following features.Participants:adults, all with long-term conditions;intervention:any/none;outcome:Duke activity status index (DASI), sit to stand (STS, 30 s, 1 min and 5 repetitions), short physical performance battery (SPPB), 4-metre gait speed (4MGS) or step test (Chester/others) AND directly compared to one of the recommended exercise tests for cardiopulmonary rehabilitation: 6-min walk test (6MWT), incremental shuttle walk test (ISWT) or cardiopulmonary exercise test (CPET) in terms of reporting agreement/correlation;Study design:primary research only, controlled trials or observational studies.

Results

Sixteen articles out of 249 screened were included (n=2271 patients). Overall, there were weak–strong correlations for the included tests with a recommended exercise test (r=0.38–0.85). There were few reported issues with feasibility or safety of the tests. However, all tests were supervised in a clinical setting. The test that had the highest correlation with the field walking test was the 4MGS with the ISWT (r=0.78) and with the 6MWT (r=0.85).

Discussion

The 4MGS has the highest correlation with routine measures of exercise tolerance. However, it may be difficult to standardise in a remote assessment or to prescribe exercise from. Clinicians should strive for face-to-face standardised exercise tests where possible to be able to guide exercise prescription.
Brain antibody sequence evaluation (BASE): an easy-to-use software for complete data analysis in single cell immunoglobulin cloning
Authors: Reincke S. Momsen , Prüss Harald , Kreye Jakob
Published: October 2020

Background

Repertoire analysis of patient-derived recombinant monoclonal antibodies is an important tool to study the role of B cells in autoimmune diseases of the human brain and beyond. Current protocols for generation of patient-derived recombinant monoclonal antibody libraries are time-consuming and contain repetitive steps, some of which can be assisted with the help of software automation.

Results

We developed BASE, an easy-to-use software for complete data analysis in single cell immunoglobulin cloning. BASE consists of two modules: aBASE for immunological annotations and cloning primer lookup, and cBASE for plasmid sequence identity confirmation before expression. Comparing automated BASE analysis with manual analysis we confirmed the validity of BASE output: identity between manual and automated aBASE analysis was 100% for all outputs, except for immunoglobulin isotype determination. In this case, aBASE yielded correct results in 96% of cases, whereas 4% of cases required manual confirmation. cBASE automatically concluded expression recommendations in 89.8% of cases, 91.8% of which were identical to manually derived results and none of them were false-positive.

Conclusions

BASE offers an easy-to-use software solution suitable for complete Ig sequence data analysis and tracking during recombinant mAb cloning from single cells. Plasmid sequence identity confirmation by cBASE offers functionality not provided by existing software solutions in the field and will help to reduce time-consuming steps of the monoclonal antibody generation workflow. BASE can be installed locally or accessed online at Code Ocean.
Correction to: Cardiac rupture complicating acute myocardial infarction: the clinical features from an observational study and animal experiment
Authors: Lu Qun , Liu Ping , Huo Jian-Hua , Wang Yan-Ni , Ma Ai-Qun , Yuan Zu-Yi , Du Xiao-Jun , Bai Ling
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
Medical treatment for an isolated renal multilocular hydatid cyst in an elderly: a case report
Authors: Moghtadaie Atie , Yazdi Seyed Amir Miratashi , Mohraz Minoo , Asefi Hoda , Razeghi Effat
Published: October 2020

Background

Almost all cases of renal hydatid cysts need surgical intervention for treatment. We report a case of isolated renal hydatid cyst treated successfully only with medical therapy.

Case presentation

This case is a 79-year-old veterinarian presented with right flank pain, hydatiduria and positive echinococcus granulosus serology. A 70*50 mm cyst with daughter cysts in mid-portion of right kidney on presentation was changed into a 60*40 mm cyst without daughter cysts at last follow-up. Due to patient’s refusal of surgery, our patient received medical treatment including praziquantel and albendazole. After completion of first round of treatment, recurrence occurred and the same treatment was repeated. At last, the cyst became inactive and calcified with negative serology and no clinical symptoms under medical treatment.

Conclusion

The treatment of choice in renal hydatid cyst is surgery; although there are some reports about the efficacy of medical treatments for hydatid cysts but lower rates of recurrence and higher efficacy put surgery in a superior position compared to medical approaches. Our case showed relative success of medical treatment, despite the presence of a large multilocular renal involvement. Thus, medical therapy without surgery can be considered in very particular cases with isolated renal hydatid cysts.
Does prolonged labor affect the birth experience and subsequent wish for cesarean section among first-time mothers? A quantitative and qualitative analysis of a survey from Norway
Authors: Gaudernack L. C. , Michelsen T. M. , Egeland T. , Voldner N. , Lukasse M.
Published: October 2020

Background

Prolonged labor might contribute to a negative birth experience and influence first-time mothers’ attitudes towards future pregnancies. Previous studies have not adjusted for possible confounding factors, such as operative delivery, induction and postpartum hemorrhage. We aimed to determine the impact of prolonged labor on birth experience and a wish for cesarean section in subsequent pregnancies.

Methods

A survey including the validated “Childbirth Experience Questionnaire”. First-time mothers giving birth between 2012 and 2014 at a Norwegian university hospital participated. Data from deliveries were collected. Regression analysis and thematic content analysis were performed.

Results

459 (71%) women responded. Women with labor duration > 12 h had significantly lower scores on two out of four sub-items of the questionnaire: own capacity (p = 0.040) and perceived safety (p = 0.023).

Other factors contributing to a negative experience were:

Cesarean section vs vaginal birth: own capacity (p = 0.001) and perceived safety (p = 0.007). Operative vaginal vs spontaneous birth: own capacity (p = 0.001), perceived safety (p < 0.001) and participation (p = 0.047).

Induced vs spontaneous start: own capacity (p = 0.039) and participation (p = 0.050). Postpartum hemorrhage ≥500 ml vs < 500 ml: perceived safety (p = 0.002) and participation (p = 0.031).

In the unadjusted analysis, prolonged labor more than doubled the risk (odds ratio (OR) 2.66, 95%CI 1.42–4.99) of a subsequent wish for cesarean delivery. However, when adjustments were made for mode of delivery and induction, emergency cesarean section (OR 8.86,95%CI 3.85–20.41) and operative vaginal delivery (OR 3.05, 95%CI 1.46–6.38) remained the only factors significantly increasing the probability of wanting a cesarean section in subsequent pregnancies.

The written comments on prolonged labor (n = 46) indicated four main themes:

Difficulties gaining access to the labor ward.

Being left alone during the unexpectedly long, painful early stage of labor.

Stressful operative deliveries and worse pain than imagined.

Lack of support and too little or contradictory information from the staff.

Conclusions

Women with prolonged labors are at risk of a negative birth experience. Prolonged labor per se did not predict a wish for a cesarean section in a subsequent pregnancy. However, women with long labors more often experience operative delivery, which is a risk factor of a later wish for a cesarean section.
Risk score for predicting primary cesarean delivery in women with gestational diabetes mellitus
Authors: Phaloprakarn Chadakarn , Tangjitgamol Siriwan
Published: October 2020

Background

Women with gestational diabetes mellitus (GDM) have a higher risk of cesarean delivery (CD) than glucose-tolerant women. The aim of this study was to develop and validate a risk score for predicting primary CD in women with GDM.

Methods

A risk score for predicting primary CD was developed using significant clinical features of 385 women who had a diagnosis of GDM and delivered at our institution between January 2011 and December 2014. The score was then tested for validity in another cohort of 448 individuals with GDM who delivered between January 2015 and December 2018.

Results

The risk score was developed using the features nulliparity, excess gestational weight gain, and insulin use. The scores that classified the pregnant women as low risk (0 points), intermediate risk (1–3 points), and high risk (≥ 4 points) were directly associated with the primary CD rates of the women in the development cohort: 14.7, 38.2 and 62.3%, respectively (P <  0.001). The model showed good calibration and acceptable discriminative power with a C statistic of 0.724 (95% confidence interval, 0.670–0.777). Similar results were observed in the validation cohort.

Conclusion

A risk score using the features nulliparity, excess gestational weight gain, and insulin use can estimate the risk for primary CD in women with GDM.
Mortality among persons experiencing musculoskeletal pain: a prospective study among Danish men and women
Authors: Holmberg Teresa , Davidsen Michael , Thygesen Lau Caspar , Krøll Mikala Josefine , Tolstrup Janne Schurmann
Published: October 2020

Background

Musculoskeletal (MSK) pain affects many people worldwide and has a great impact on general health and quality of life. However, the relationship between MSK pain and mortality is not clear. This study aimed to investigate all-cause and cause-specific mortality in relation to self-reported MSK pain within the last 14 days, including spread of pain and pain intensity.

Methods

This prospective cohort study included a representative cohort of 4806 men and women aged 16+ years, who participated in a Danish MSK survey 1990–1991. The survey comprised questions on MSK pain, including spread of pain and pain intensity. These data were linked with the Danish Register of Causes of Death to obtain information on cause of death. Mean follow-up was 19.1 years. Cox regression analyses were performed with adjustment for potential confounders.

Results

In the study population (mean age 44.5 years; 47.9% men), 41.0% had experienced MSK pain within the last 14 days and 1372 persons died during follow-up. For both sexes, increased all-cause mortality with higher spread and intensity of MSK pain was observed; a high risk was observed especially for men with strong pain (HR = 1.66; 95% CI:1.09–2.53) and women with widespread pain (HR = 1.49; 95% CI:1.16–1.92). MSK pain within last 14 days yielded c-statistics of 0.544 and 0.887 with age added. Moreover, persons with strong MSK pain had an increased cardiovascular mortality, persons with moderate pain and pain in two areas had an increased risk of cancer mortality, and persons with widespread pain had an increased risk of respiratory mortality.

Conclusions

Overall, persons experiencing MSK pain had a higher risk of mortality. The increased mortality was not accounted for by potential confounders. However, when evaluating these results, it is important to take the possibility of unmeasured confounders into account as we had no information on e.g. BMI etc.

Significance

The present study provides new insights into the long-term consequences of MSK pain. However, the discriminatory accuracy of MSK pain was low, which indicates that this information cannot stand alone when predicting mortality risk.
Ellipse method for measuring Liaw’s anteversion of the acetabular component after total hip arthroplasty
Authors: Yeh Kuei-Lin , Wu Tai-Yin , Ma Hsuan-Hsiao , Hou Sheng-Mou , Liaw Chen-Kun
Published: October 2020

Background

Several cup anteversion measurements for post-operative total hip arthroplasty (THA) surgery have been described. We developed the standardized Liaw’s trigonometric method to eliminate the influence of patient position, which is the most accurate method for cup anteversion measurement. We then developed an ellipse method using the Elliversion software and reported an interobserver error reduction in 2013. In this study, we attempted to apply this ellipse method in the clinic and compared its accuracy with the standard trigonometric version.

Methods

In the present study, we attempted to incorporate the ellipse method with Liaw’s standardized anteversion in the simulated cup position. We measured standardized Liaw’s anteversion for 434 radiographs in the clinic using the ellipse method. Repeated standard deviation (RSD) was calculated for accuracy evaluation. Furthermore, paired t-test was used for comparison with the interobserver and intraobserver errors.

Results

We found that the standardized Liaw’s anteversion measured using the ellipse method showed lower RSD than the radiographic version. RSD was 0.795 in the standardized Liaw’s anteversion with ellipse method group. The p-values of the paired t-test were all higher than 0.05 when measuring the interobserver and intraobserver errors. It indicated that the ellipse method was a precise and simple tool for cup anteversion measurement.

Conclusion

We believe that this ellipse measurement can assist surgeons while placing the acetabulum cup into the precise position and enable early diagnosis of acetabulum loosening.
Clinical efficacy of short-term pre-operative halo-pelvic traction in the treatment of severe spinal deformities complicated with respiratory dysfunction
Authors: Qi Longtao , Xu Beiyu , Li Chunde , Wang Yu
Published: October 2020

Background

Halo traction has been used as an adjunctive method in the treatment of severe spinal deformities. But there are few reports on the clinical efficacy of halo-pelvic traction (HPT) in the treatment of severe spinal deformities complicated with respiratory dysfunction. This study was to evaluate the clinical efficacy and complications associated with pre-operative HPT in the treatment of severe spinal deformities with respiratory dysfunction.

Methods

Thirty patients with severe spinal deformities complicated with respiratory dysfunction treated with short-term pre-operative HPT were retrospectively reviewed. Inclusion criteria were: (1) patients with severe kyphoscoliosis (coronal Cobb angle or kyphosis angle ≥100°) and respiratory failure, (2) patients undergoing HPT until posterior fusion surgery. All patients underwent general anesthesia for HPT application, which the pelvic ring used in this study was a half-ring, and the rods were all placed on the anterolateral side of the truck.

Results

The major coronal curve scoliosis averaged 116.00 ± 16.70° and was reduced to 63.23 ± 14.00° after HPT, 46.33 ± 10.70° after surgery. The major kyphosis was 102.40 ± 27.67° and was reduced to 52.23 ± 14.16° after HPT, 42.0 ± 11.92° after surgery. A significantly increased FVC was observed after HPT (p < 0.001), with a significantly improved FVC% (p < 0.001). Similarly, a significantly increased FEV1 was also observed (p < 0.001), with a significantly improved FEV1% (p < 0.001).

Conclusion

This study indicated that the modified HPT could be used to help patients with severe spinal deformities complicated with respiratory dysfunction achieve significant correction in both the coronal and sagittal deformities during the pre-operative treatment period along with improved respiratory function and in the absence of severe complications.
The effectiveness of Baduanjin exercise for hypertension: a systematic review and meta-analysis of randomized controlled trials
Authors: Shao Bao-yi , Zhang Xia-tian , Vernooij Robin W. M. , Lv Qiu-yi , Hou Yao-yang , Bao Qi , Lao Li-xing , Liu Jian-ping , Zhang Ying , Guyatt Gordon H.
Published: October 2020

Background

Hypertension, a major risk factor of cardiovascular mortality, is a critical issue for public health. Although Baduanjin (Eight Brocades, EB), a traditional Chinese exercise, might influence blood pressure, glucose, and lipid status, the magnitude of true effects and subgroup differences remains unclear. Therefore, we performed a systematic review of relevant randomized controlled trials (RCTs) to evaluate the effect of EB on patient-important outcomes.

Methods

We systematically searched PubMed, the Cochrane Library, Web of Science, and Chinese databases since inception until March 30, 2020. Meta-analysis was carried out using “meta” package in R 3.4.3 software. A prespecified subgroup analysis was done according to the type of comparisons between groups, and the credibility of significant subgroup effects (P < 0.05) were accessed using a five-criteria list. A GRADE evidence profile was constructed to illustrate the certainty of evidence.

Results

Our meta-analysis, including 14 eligible trials with 1058 patients, showed that compared with routine treatment or health education as control groups, the mean difference (MD) in systolic blood pressure (SBP) of the EB groups was − 8.52 mmHg (95%CI:[− 10.65, − 6.40], P < 0.01) and diastolic blood pressure (DBP) was − 4.65 mmHg (95%CI: [− 6.55, − 2.74], P < 0.01). For blood pressure, the evidence was, however, of low certainty because of risk of bias and inconsistency, and for the outcomes of most interest to patients (cardiovascular morbidity and mortality directly), of very low certainty (measurement of surrogate only). Subgroup analysis showed there was no significant interaction effect between different type of comparisons (SBP P = 0.15; DBP P = 0.37), so it could be easily attributed to chance.

Conclusion

Regularly EB exercising may be helpful to control blood pressure, but the evidence is only low certainty for blood pressure and very low certainty for cardiovascular morbidity and mortality. Rigorously designed RCTs that carry out longer follow-up and address patient-important outcomes remain warranted.

Trial registration

PROSPERO Registration number: CRD42018095854.
The effect of curcumin ointment on knee pain in older adults with osteoarthritis: a randomized placebo trial
Authors: Jamali Neda , Adib-Hajbaghery Mohsen , Soleimani Alireza
Published: October 2020

Background

Some studies have shown the effect of oral administration of curcumin on knee pain. However, limited studies are available on the effect of topical curcumin. This study aimed to investigate the effect of curcumin ointment on knee pain in older adults with osteoarthritis.

Methods

This double-blind randomized placebo trial was conducted on 72 older adults with knee pain associated with osteoarthritis. The subjects were randomly assigned into an intervention and a placebo group to apply either curcumin 5% ointment or Vaseline ointment twice daily for 6 weeks. Using a Visual Analog Scale, the severity of knee pain was measured at the beginning of the study, at the end of the fourth and sixth week. Data were analyzed using descriptive and inferential methods.

Results

The mean baseline knee pain intensity was not significantly different between the two groups (P = 0.15). The mean pain intensity was significantly lower in the intervention group than in the placebo group at the third measurement (P = 0.02). The repeated-measures analysis showed that over time, the curcumin significantly decreased the mean pain intensity in the intervention group (P = 0.001). The mixed model showed an absolute difference of 1.133 (i.e. 11.33 mm) score which signifies a medium effect size and that the patient in the intervention group achieved the minimal clinically important difference.

Conclusion

Topical administration of curcumin 5% ointment can significantly reduce knee pain in older adults with knee osteoarthritis. Curcumin ointment can be used as an alternative treatment in older adults with knee pain associated with osteoarthritis.

Trial registration

Retrospectively registered in the Iranian Registry of Clinical Trials (IRCT) (IRCT20100403003618N6, 2019-03-08), https://en.irct.ir/trial/37155
Complexity in psychological self-ratings: implications for research and practice
Authors: Olthof Merlijn , Hasselman Fred , Lichtwarck-Aschoff Anna
Published: October 2020

Background

Psychopathology research is changing focus from group-based “disease models” to a personalized approach inspired by complex systems theories. This approach, which has already produced novel and valuable insights into the complex nature of psychopathology, often relies on repeated self-ratings of individual patients. So far, it has been unknown whether such self-ratings, the presumed observables of the individual patient as a complex system, actually displaycomplexdynamics. We examine this basic assumption of a complex systems approach to psychopathology by testing repeated self-ratings for three markers of complexity:memory, the presence of (time-varying) short- and long-range temporal correlations;regime shifts, transitions between different dynamic regimes; andsensitive dependence on initial conditions, also known as the “butterfly effect,” the divergence of initially similar trajectories.

Methods

We analyzed repeated self-ratings (1476 time points) from a single patient for the three markers of complexity using Bartels rank test, (partial) autocorrelation functions, time-varying autoregression, a non-stationarity test, change point analysis, and the Sugihara-May algorithm.

Results

Self-ratings concerning psychological states (e.g., the item “I feel down”) exhibited all complexity markers: time-varying short- and long-term memory, multiple regime shifts, and sensitive dependence on initial conditions. Unexpectedly, self-ratings concerning physical sensations (e.g., the item “I am hungry”) exhibited less complex dynamics and their behavior was more similar to random variables.

Conclusions

Psychological self-ratings display complex dynamics. The presence of complexity in repeated self-ratings means that we have to acknowledge that (1) repeated self-ratings yield a complex pattern of data and not a set of (nearly) independent data points, (2) humans are “moving targets” whose self-ratings display non-stationary change processes including regime shifts, and (3) long-term prediction of individual trajectories may be fundamentally impossible. These findings point to a limitation of popular statistical time series models whose assumptions are violated by the presence of these complexity markers. We conclude that a complex systems approach to mental health should appreciate complexity as a fundamental aspect of psychopathology research by adopting the models and methods of complexity science. Promising first steps in this direction, such as research on real-time process monitoring, short-term prediction, and just-in-time interventions, are discussed.
Serological prevalence of six vector-borne pathogens in dogs presented for elective ovariohysterectomy or castration in the South central region of Texas
Authors: Fudge J. Mack , Boyanowski Bailey , Page Bernie , Liu Shuling , Rogovskyy Artem S.
Published: October 2020

Background

Most vector-borne pathogens cause zoonotic diseases. These zoonoses often have wild animal reservoirs that play a significant role in disease epidemiology. However, pet animals have also been implicated in transmission of zoonotic agents to humans. To exemplify, dogs are competent reservoir hosts for several zoonotic vector-borne bacteria and protozoa. Despite that vector-borne diseases can be life-threatening for both pets and humans, studies on pathogen seroprevalence are very limited. Therefore, the objective of this study was to determine the serological prevalence of six zoonotic vector-borne agents in dogs from the South Central region of Texas (US).

Electronic medical records of dogs, presenting over 2014–2019 for elective ovariohysterectomy or castration at a high volume spay and neuter clinic, were reviewed for serological testing. Sera from 418 dogs were tested for theDirofilaria immitisantigen, and antibodies toAnaplasma phagocytophilum, Anaplasma platys,Borrelia burgdorferi, Ehrlichia canis,andEhrlichia ewingi,using a commonly available commercial test kit. Descriptive statistics were computed to characterize the respective seroprevalence rates of the dog population. The study involved 192 (46%) male and 226 (54%) female dogs.

Results

Overall, 85 (20%) dogs tested positive for at least one of the 6 pathogens investigated. The highest seroprevalence rate averaged over the 6-year period was 11.7% forD. immitisfollowed by 8.4% forE. canisand/orE. ewingii, 4.3% forA. phagocytophilumand/orA. platys, and 0.2% forB. burgdorferi. The co-exposure or co-infection was only detected in 3.8% of the dog population.

Conclusions

Together, opportunistic testing of dogs presenting for elective surgical procedures may provide an effective way of assessing seroprevalence and/or risk factors for common vector-borne diseases within a geographic region of concern.
Dexamethasone rescues TGF-β1-mediated β2-adrenergic receptor dysfunction and attenuates phosphodiesterase 4D expression in human airway smooth muscle cells
Authors: Chung Elena , Ojiaku Christie A. , Cao Gaoyuan , Parikh Vishal , Deeney Brian , Xu Shengjie , Wang Serena , Panettieri Reynold A. , Koziol-White Cynthia
Published: October 2020

Glucocorticoids (GCs) and β2-adrenergic receptor (β2AR) agonists improve asthma outcomes in most patients. GCs also modulate gene expression in human airway smooth muscle (HASM), thereby attenuating airway inflammation and airway hyperresponsiveness that define asthma. Our previous studies showed that the pro-fibrotic cytokine, transforming growth factor- β1 (TGF-β1) increases phosphodiesterase 4D (PDE4D) expression that attenuates agonist-induced levels of intracellular cAMP. Decreased cAMP levels then diminishes β2 agonist-induced airway relaxation. In the current study, we investigated whether glucocorticoids reverse TGF-β1-effects on β2-agonist-induced bronchodilation and modulate pde4d gene expression in HASM. Dexamethasone (DEX) reversed TGF-β1 effects on cAMP levels induced by isoproterenol (ISO). TGF-β1 also attenuated G protein-dependent responses to cholera toxin (CTX), a Gαs stimulator downstream from the β2AR receptor. Previously, we demonstrated that TGF-β1 treatment increased β2AR phosphorylation to induce hyporesponsiveness to a β2 agonist. Our current data shows that expression of grk2/3, kinases associated with attenuation of β2AR function, are not altered with TGF-β1 stimulation. Interestingly, DEX also attenuated TGF-β1-induced pde4d gene expression. These data suggest that steroids may be an effective therapy for treatment of asthma patients whose disease is primarily driven by elevated TGF-β1 levels.
MiR-924 as a tumor suppressor inhibits non-small cell lung cancer by inhibiting RHBDD1/Wnt/β-catenin signaling pathway
Authors: Wang Huaishi , Chen Xi , Yang Baishuang , Xia Zhi , Chen Qiong
Published: October 2020

Background

MiR-924 has been reported to be a tumor suppressor in hepatocellular carcinoma. However, the functions and mechanisms of miR-924 in non-small cell lung cancer (NSCLC) remain unclear.

Methods

The expression of miR-924 was determined in NSCLC tissues and cell lines using quantitative real time PCR. The Chi-squared test was used to evaluate the correlation between miR-924 levels and clinicopathological parameters in patients with NSCLC. Cell proliferation was assessed by CCK-8 assay. Cell migration and invasion were detected by transwell assay. The combination of miR-924 and RHBDD1 was analyzed via the luciferase reporter assay. The expression level of RHBDD1 was evaluated in lung cancer tissues using public microarray datasets form Oncomine and its prognostic value was assessed by Kaplan–Meier Plotter databases. A tumor xenograft mouse model was established to illustrate the effects of miR-924 on the tumorigenesis of NSCLC in vivo.

Results

In this study, we found miR-924 was strikingly decreased in NSCLC tissues and cell lines. Decreased miR-924 was closely correlated with advanced tumor-node-metastasis (TNM) stage and lymphatic metastasis in NSCLC patients. Noticeably, rhomboid domain-containing protein 1 (RHBDD1) was predicted and confirmed as a direct target of miR-924. Moreover, the expression level of RHBDD1 was significantly increased and inversely associated with prognosis using public microarray datasets form Oncomine and Kaplan–Meier Plotter databases. MiR-924 overexpression suppressed cell proliferation, migration and invasion. The in vivo experiments further demonstrated that miR-924 overexpression reduced NSCLC xenograft growth through inhibiting RHBDD1/Wnt/β-catenin signaling pathway.

Conclusions

In summary, these findings demonstrated that miR-924 blocked the progression of NSCLC by targeting RHBDD1 and miR-924/RHBDD1 axis might provide a novel therapeutic target for the treatment of NSCLC.
Acute exercise in mice transiently remodels the hepatic lipidome in an intensity-dependent manner
Authors: Henderson Gregory C. , Martinez Tenorio Valeria , Tuazon Marc A.
Published: October 2020

Background

The content of triacylglycerol (TAG) in the liver is known to rapidly increase after a single bout of exercise followed by recovery to sedentary levels. The response of other hepatic lipids, and acyl chain composition of lipid classes, would provide a deeper understanding of the response of hepatic lipid metabolism to acute exercise.

Methods

Female mice performed a single bout of continuous exercise (CE), high-intensity interval exercise (HIIE), or no exercise (CON). The total content of various lipids in the liver, and fatty acids within lipid classes, were measured in tissues collected 3 h after exercise (Day 1) and the day following exercise (Day 2).

Results

The total concentration of TAG rose on Day 1 after exercise (P < 0.05), with a greater elevation in HIIE than CE (P < 0.05), followed by a decline toward CON levels on Day 2. The total concentration of other measured lipid classes was not significantly altered by exercise. However, n-6 polyunsaturated fatty acid relative abundance in diacylglycerol (DAG) was increased by HIIE (P < 0.05). In CON liver, TAG content was positively correlated with DAG and phosphatidylethanolamine (P < 0.05), while these statistical associations were disrupted in exercised mice on Day 1.

Conclusions

The response of lipid metabolism to exercise involves the coordination of metabolism between various tissues, and the lipid metabolism response to acute exercise places a metabolic burden upon the liver. The present findings describe how the liver copes with this metabolic challenge. The flexibility of the TAG pool size in the liver, and other remodeling of the hepatic lipidome, may be fundamental components of the physiological response to intense exercise.
Factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Australia
Authors: Rahman Muhammad Aziz , Hoque Nazmul , Alif Sheikh M. , Salehin Masudus , Islam Sheikh Mohammed Shariful , Banik Biswajit , Sharif Ahmed , Nazim Nashrin Binte , Sultana Farhana , Cross Wendy
Published: October 2020

Background

The COVID-19 pandemic disrupted the personal, professional and social life of Australians with some people more impacted than others.

Objectives

This study aimed to identify factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Australia.

Methods

A cross-sectional online survey was conducted among residents in Australia, including patients, frontline health and other essential service workers, and community members during June 2020. Psychological distress was assessed using the Kessler Psychological Distress Scale (K10); level of fear was assessed using the Fear of COVID-19 Scale (FCV-19S); and coping strategies were assessed using the Brief Resilient Coping Scale (BRCS). Logistic regression was used to identify factors associated with the extent of psychological distress, level of fear and coping strategies while adjusting for potential confounders.

Results

Among 587 participants, the majority (391, 73.2%) were 30–59 years old and female (363, 61.8%). More than half (349, 59.5%) were born outside Australia and two-third (418, 71.5%) completed at least a Bachelor’s degree. The majority (401, 71.5%) had a source of income, 243 (42.3%) self-identified as a frontline worker, and 335 (58.9%) reported financial impact due to COVID-19. Comorbidities such as pre-existing mental health conditions (AOR 3.13, 95% CIs 1.12–8.75), increased smoking (8.66, 1.08–69.1) and alcohol drinking (2.39, 1.05–5.47) over the last four weeks, high levels of fear (2.93, 1.83–4.67) and being female (1.74, 1.15–2.65) were associated with higher levels of psychological distress. Perceived distress due to change of employment status (4.14, 1.39–12.4), alcohol drinking (3.64, 1.54–8.58), providing care to known or suspected cases (3.64, 1.54–8.58), being female (1.56, 1.00–2.45), being 30–59 years old (2.29, 1.21–4.35) and having medium to high levels of psychological distress (2.90, 1.82–5.62) were associated with a higher level of fear; while healthcare service use in the last four weeks was associated with medium to high resilience.

Conclusions

This study identified individuals who were at higher risk of distress and fear during the COVID-19 pandemic specifically in the State of Victoria, Australia. Specific interventions to support the mental wellbeing of these individuals should be considered in addition to the existing resources within primary healthcare settings.