bluuebunny/crossref_metadata_2025 huggingface dataset:
Morphological Characteristics and Transcriptome Comparisons of the Shoot Buds from Flowering and Non-Flowering Pleioblastus pygmaeus
Authors: Yao Wenjing , Li Chuanzhe , Lin Shuyan , Ren Li , Wan Yawen , Zhang Li , Ding Yulong
Published: November 2020

Bamboo plants have a distinctive life cycle with long flowering periodicity. Many species remain in vegetative growth for decades, followed by large-scale flowering and subsequent death. Floral transition is activated while shoot buds are still dormant in bamboo plants. In this study, we performed morphological characterization and transcriptome analysis of the shoot buds at different growth stages from flowering and non-flowering Pleioblastus pygmaeus. The morphological and anatomical structures of the dormant shoot buds were similar in flowering and non-flowering plants, while there was an obvious difference between the flower buds from flowering plants and the leaf buds from non-flowering plants. The transcriptomes of the dormant shoot buds, germinated shoots, and flower buds from flowering P. pygmaeus, and the dormant shoot buds, germinated shoots, and leaf buds from non-flowering P. pygmaeus were profiled and compared by RNA-Seq. The identified sequences were mostly related to metabolic synthesis, signal transmission, translation, and other functions. A total of 2434 unigenes involved in different flowering pathways were screened from transcriptome comparisons. The differentially expressed unigenes associated with the photoperiod pathway were related to circadian rhythm and plant hormone signal transduction. Moreover, the relative expression levels of a few key flowering-related genes such as CO, FT, FLC, and SOC1 were quantified by qRT-PCR, which was in accordance with RNA-Seq. The study revealed morphological differences in the shoot buds at different growth stages and screened flowering-related genes by transcriptome comparisons of the shoot buds from flowering and non-flowering P. pygmaeus, which will enrich the research on reproductive biology of bamboo plants and shed light on the molecular mechanism of the floral transition in bamboo plants.
Stable Allometric Trajectories in Picea abies (L.) Karst. Trees along an Elevational Gradient
Authors: Mura Claudio , Strømme Christian Bianchi , Anfodillo Tommaso
Published: November 2020

The effect of temperature on tree phenology and growth has gained particular attention in relation to climate change. While a number of reports indicate that warming can extend the length of the growing season and enhance tree growth rates, it is still debated whether temperature also affects biomass partitioning. Addressing the question of whether trees grown at different elevations invest similarly in various organs, we established four sites along an elevational gradient (320 to 595 m a.s.l.) in managed Norway spruce (Picea abies (L.) Karts) stands regenerating after clearcuts in central Norway. There, differences in temperature, bud break, tree growth, and allometric scaling were measured in small spruce trees (up to 3 m height). The results showed that bud break and shoot growth are affected by temperature, as lower sites completed the bud break process 5 days earlier than the higher sites did. There was some evidence indicating that the summer drought of 2018 affected tree growth during the season, and the implications of this are discussed. The allometric scaling coefficients did not change for the crown volume (slope value range 2.66–2.84), crown radius (0.77–0.89), and tree diameter (0.89–0.96) against tree height. A slight difference was found in the scaling coefficients of crown length against tree height (slope value range 1.04–1.12), but this did not affect the general scaling of the crown volume with tree height. Our results showed that different local environmental conditions affect both the growth rate and phenology in Norway spruce trees but, on the contrary, that the biomass partitioning among different parts of the tree remains essentially unchanged. This demonstrates that the allometric approach is an important tool for unraveling true vs. apparent plant plasticity, which in turn is an essential awareness for predicting plant responses to environmental changes.
Study on Gene Differential Expression in Tetraploid Populus Leaves
Authors: Zhang Ying , Ren Yongyu , Kang Xiangyang
Published: November 2020

Polyploids exhibit different phenotypes compared to those of diploids in plants, and the important role of polyploids in tree breeding has been widely recognized. The transcriptomes detected by RNA-seq in the Populus triploid by doubling the chromosomes of the female gamete, in the triploid by doubling the chromosomes of somatic cells and the diploid with the parent were compared to reveal the patterns of gene expression of tetraploid leaves and their influence on growth. The results showed that the high expression of GATA and PORA in tetraploid leaves was the reason for the higher chlorophyll content in the leaves than in diploid and triploid leaves. The 11-day-old tetraploid leaves began to enter the aging stage. Compared with that in the diploid, GRF was significantly upregulated, while the amylase genes were downregulated. Compared with those in the triploid, 3 STN7 genes that regulate photosynthetic genes and PGSIP genes which are related to starch synthesis, were significantly downregulated in the tetraploid, and the auxin receptor protein TIR1 was also significantly downregulated. In the tetraploid, auxin-regulating genes such as GH3 and AUX/IAA as well as genes involved in the regulation of leaf senescence, SAG genes and SRG genes were significantly up-regulated, resulting in a decrease in the auxin content. In senescent leaves, CHLD, CHLI1, and CHLM in the early stage of chlorophyll synthesis all began to downregulate their expressions, leading to the downregulation of LHC genes and a decrease in their photosynthetic efficiency, which led to the downregulation of carbon fixation-related genes such as SS genes, thus affecting carbon synthesis and fixation. This finally led to the slow growth of tetraploid plants. These data represent the transcriptome characteristics of tetraploid, and they can be used as a resource for further research on polyploids and provide a reference for further understanding of the function of polyploid vegetative growth-related genes.
Mapping Tree Species Deciduousness of Tropical Dry Forests Combining Reflectance, Spectral Unmixing, and Texture Data from High-Resolution Imagery
Authors: Huechacona-Ruiz Astrid Helena , Dupuy Juan Manuel , Schwartz Naomi B. , Powers Jennifer S. , Reyes-García Casandra , Tun-Dzul Fernando , Hernández-Stefanoni José Luis
Published: November 2020

In tropical dry forests, deciduousness (i.e., leaf shedding during the dry season) is an important adaptation of plants to cope with water limitation, which helps trees adjust to seasonal drought. Deciduousness is also a critical factor determining the timing and duration of carbon fixation rates, and affecting energy, water, and carbon balance. Therefore, quantifying deciduousness is vital to understand important ecosystem processes in tropical dry forests. The aim of this study was to map tree species deciduousness in three types of tropical dry forests along a precipitation gradient in the Yucatan Peninsula using Sentinel-2 imagery. We propose an approach that combines reflectance of visible and near-infrared bands, normalized difference vegetation index (NDVI), spectral unmixing deciduous fraction, and several texture metrics to estimate the spatial distribution of tree species deciduousness. Deciduousness in the study area was highly variable and decreased along the precipitation gradient, while the spatial variation in deciduousness among sites followed an inverse pattern, ranging from 91.5 to 43.3% and from 3.4 to 9.4% respectively from the northwest to the southeast of the peninsula. Most of the variation in deciduousness was predicted jointly by spectral variables and texture metrics, but texture metrics had a higher exclusive contribution. Moreover, including texture metrics as independent variables increased the variance of deciduousness explained by the models from R2 = 0.56 to R2 = 0.60 and the root mean square error (RMSE) was reduced from 16.9% to 16.2%. We present the first spatially continuous deciduousness map of the three most important vegetation types in the Yucatan Peninsula using high-resolution imagery.
Lactic Acid Bacterial Production of Exopolysaccharides from Fruit and Vegetables and Associated Benefits
Authors: Guérin Marie , Silva Christine Robert-Da , Garcia Cyrielle , Remize Fabienne
Published: November 2020

Microbial polysaccharides have interesting and attractive characteristics for the food industry, especially when produced by food grade bacteria. Polysaccharides produced by lactic acid bacteria (LAB) during fermentation are extracellular macromolecules of either homo or hetero polysaccharidic nature, and can be classified according to their chemical composition and structure. The most prominent exopolysaccharide (EPS) producing lactic acid bacteria are Lactobacillus, Leuconostoc, Weissella, Lactococcus, Streptococcus, Pediococcus and Bifidobacterium sp. The EPS biosynthesis and regulation pathways are under the dependence of numerous factors as producing-species or strain, nutrient availability, and environmental conditions, resulting in varied carbohydrate compositions and beneficial properties. The interest is growing for fruits and vegetables fermented products, as new functional foods, and the present review is focused on exploring the EPS that could derive from lactic fermented fruit and vegetables. The chemical composition, biosynthetic pathways of EPS and their regulation mode is reported. The consequences of EPS on food quality, especially texture, are explored in relation to producing species. Attention is given to the scientific investigations on health benefits attributed to EPS such as prebiotic, antioxidant, anti-inflammatory and cholesterol lowering activities.
Numerical Investigation of the Cavitation Effects on the Vortex Shedding from a Hydrofoil with Blunt Trailing Edge
Authors: Chen Jian , Geng Linlin , Escaler Xavier
Published: November 2020

Vortex cavitation can appear in the wake flow of hydrofoils, inducing unwanted consequences such as vibrations or unstable behaviors in hydraulic machinery and systems. To investigate the cavitation effects on hydrofoil vortex shedding, a numerical investigation of the flow around a 2D NACA0009 with a blunt trailing edge at free caviation conditions and at two degrees of cavitation developments has been carried out by means of the Zwart cavitation model and the LES WALE turbulence model which permits predicting the laminar to turbulent transition of the boundary layers. To analyze the dynamic behavior of the vortex shedding process and the coherent structures, two identification methods based on the Eulerian and Lagrangian reference frames have been applied to the simulated unsteady flow field. It is found that the cavitation occurrence in the wake significantly changes the main vortex shedding characteristics including the morphology of the vortices, the vortex formation length, the effective height of the near wake flow and the shedding frequency. The numerical results predict that the circular shape of the vortices changes to an elliptical one and that the vortex shedding frequency is significantly increased under cavitation conditions. The main reason for the frequency increase seems to be the reduction in the transverse separation between the upper and lower rows of vortices induced by the increase in the vortex formation length.
Biochemical, Physicochemical and Sensory Properties of Yoghurts Made from Mixing Milks of Different Mammalian Species
Authors: Boukria Oumayma , El Hadrami El Mestafa , Sameen Aysha , Sahar Amna , Khan Sipper , Safarov Jasur , Sultanova Shakhnoza , Leriche Françoise , Aït-Kaddour Abderrahmane
Published: November 2020

Among developed countries, bovine milk production makes a major contribution towards the economy. Elevating consumer demand for functional foods has triggered a niche for non-bovine milk-based products. Mixing milks from different species can be a strategy to increase the consumption of non-bovine milk and enable consumers and dairy companies to benefit from their nutritional and technological advantages. Thus, this review aimed to gather the most important research on yoghurts derived from processing mixtures of milks of different species. We discuss the impact of milk mixtures (i.e., species and milk ratio) on nutritional, physicochemical, sensory, rheological and microbiological properties of yoghurts. More specifically, this paper only highlights studies that have provided a clear comparison between yoghurts processed from a mixture of two milk species and yoghurts processed from a single species of milk. Finally, certain limitations and future trends are discussed, and some recommendations are suggested for future research.
Hyaluronic Acid-Poly(N-acryloyl glycinamide) Copolymers as Sources of Degradable Thermoresponsive Hydrogels for Therapy
Authors: Boustta Mahfoud , Vert Michel
Published: November 2020

One-pot free-radical polymerization of N-acryloyl glycinamide in the presence of hyaluronic acid as transfer-termination agent led to new copolymers in high yields without any chemical activation of hyaluronic acid before. All the copolymers formed thermoresponsive hydrogels of the Upper Critical Solution Temperature-type in aqueous media. Gel properties and the temperature of the reversible gel ↔ sol transition depended on feed composition and copolymer concentration. Comparison with mixtures of hyaluronic acid-poly(N-acryloyl glycinamide) failed in showing the expected formation of graft copolymers conclusively because poly(N-acryloyl glycinamide) homopolymers are also thermoresponsive. Grafting and formation of comb-like copolymers were proved after degradation of inter-graft hyaluronic acid segments by hyaluronidase. Enzymatic degradation yielded poly(N-acryloyl glycinamide) with sugar residues end groups as shown by NMR. In agreement with the radical transfer mechanism, the molar mass of these released poly(N-acryloyl glycinamide) grafts depended on the feed composition. The higher the proportion of hyaluronic acid in the feed, the lower the molar mass of poly(N-acryloyl glycinamide) grafts was. Whether molar mass can be made low enough to allow kidney filtration remains to be proved in vivo. Last but not least, Prednisolone was used as model drug to show the ability of the new enzymatically degradable hydrogels to sustain progressive delivery for rather long periods of time in vitro.
Graphene Oxide Increases Corneal Permeation of Ciprofloxacin Hydrochloride from Oleogels: A Study with Cocoa Butter-Based Oleogels
Authors: Qureshi Dilshad , Choudhary Barbiee , Mohanty Biswaranjan , Sarkar Preetam , Anis Arfat , Cerqueira Miguel A. , Banerjee Indranil , Maji Samarendra , Pal Kunal
Published: November 2020

In this work, oleogels of cocoa butter (CB), rice bran oil (RBO), and graphene oxide (GO) were prepared. The prepared oleogels were subjected to various characterization techniques such as bright-field microscopy, X-ray diffraction (XRD), crystallization kinetics, differential scanning calorimetry (DSC), and mechanical studies. The influence of increasing GO content on the in vitro drug release and ex vivo corneal permeation of the model drug (ciprofloxacin HCl—CPH) from the oleogels was also investigated. Bright-field micrographs showed that increment in GO content reduced the size of the globular particles of CB. XRD analysis revealed that CB was crystallized in its β’ and β polymorphic forms in the oleogels, which was in agreement with thermal studies. The mechanical characterization demonstrated that the presence of GO improved the elastic nature and stress-bearing properties of the oleogels. Moreover, GO altered the crystallization kinetics of CB in the oleogels in a composition-dependent manner. The in vitro release of CPH from the oleogels occurred through either Fickian diffusion or fat network relaxation or a combination thereof. Furthermore, the inclusion of GO enhanced the ex vivo permeation of CPH molecules across the caprine cornea. Hence, we concluded that the prepared oleogels could be explored as potential delivery systems for ophthalmic applications.
Metagenomic Information Recovery from Human Stool Samples Is Influenced by Sequencing Depth and Profiling Method
Authors: Santiago-Rodriguez Tasha M. , Garoutte Aaron , Adams Emmase , Nasser Waleed , Ross Matthew C. , La Reau Alex , Henseler Zachariah , Ward Tonya , Knights Dan , Petrosino Joseph F. , Hollister Emily B.
Published: November 2020

Sequencing of the 16S rRNA gene (16S) has long been a go-to method for microbiome characterization due to its accessibility and lower cost compared to shotgun metagenomic sequencing (SMS). However, 16S sequencing rarely provides species-level resolution and cannot provide direct assessment of other taxa (e.g., viruses and fungi) or functional gene content. Shallow shotgun metagenomic sequencing (SSMS) has emerged as an approach to bridge the gap between 16S sequencing and deep metagenomic sequencing. SSMS is cost-competitive with 16S sequencing, while also providing species-level resolution and functional gene content insights. In the present study, we evaluated the effects of sequencing depth on marker gene-mapping- and alignment-based annotation of bacteria in healthy human stool samples. The number of identified taxa decreased with lower sequencing depths, particularly with the marker gene-mapping-based approach. Other annotations, including viruses and pathways, also showed a depth-dependent effect on feature recovery. These results refine the understanding of the suitability and shortcomings of SSMS, as well as annotation tools for metagenomic analyses in human stool samples. Results may also translate to other sample types and may open the opportunity to explore the effect of sequencing depth and annotation method.
Differential Gene Expression in Longissimus Dorsi Muscle of Hanwoo Steers—New Insight in Genes Involved in Marbling Development at Younger Ages
Authors: de las Heras-Saldana Sara , Chung Ki Yong , Kim Hyounju , Lim Dajeong , Gondro Cedric , van der Werf Julius H. J.
Published: November 2020

The Korean Hanwoo breed possesses a high capacity to accumulate intramuscular fat, which is measured as a marbling score in the beef industry. Unfortunately, the development of marbling is not completely understood and the identification of differentially expressed genes at an early age is required to better understand this trait. In this study, we took muscle samples from 12 Hanwoo steers at the age of 18 and 30 months. From the contrast between age and marbling score, we identified in total 1883 differentially expressed genes (FDR < 0.05 and logarithm fold change ≥ 1.5) with 782 genes up-regulated and 1101 down-regulated. Differences in gene expression were higher between the ages x marbling groups rather than between high and low marbling groups. At 18 months of age, the genes SLC38A4, ABCA10, APOL6, and two novel genes (ENSBTAG00000015330 and ENSBTAG00000046041) were up-regulated in the high marbling group. From the protein–protein interaction network analysis, we identified unique networks when comparing marbling scores between different ages. Nineteen genes (AGT, SERPINE1, ADORA1, FOS, LEP, FOXO1, FOXO3, ADIPOQ, ITGA1, SDC1, SDC4, ITGB3, ITGB4, CXCL10, ACTG2, MX1, EDN1, ACTA2, and ESPL1) were identified to have an important role in marbling development. Further analyses are needed to better understand the role of these genes.
Multi-Omics Database Analysis of Aminoacyl-tRNA Synthetases in Cancer
Authors: Wang Justin , Vallee Ingrid , Dutta Aditi , Wang Yu , Mo Zhongying , Liu Ze , Cui Haissi , Su Andrew I. , Yang Xiang-Lei
Published: November 2020

Aminoacyl-tRNA synthetases (aaRSs) are key enzymes in the mRNA translation machinery, yet they possess numerous non-canonical functions developed during the evolution of complex organisms. The aaRSs and aaRS-interacting multi-functional proteins (AIMPs) are continually being implicated in tumorigenesis, but these connections are often limited in scope, focusing on specific aaRSs in distinct cancer subtypes. Here, we analyze publicly available genomic and transcriptomic data on human cytoplasmic and mitochondrial aaRSs across many cancer types. As high-throughput technologies have improved exponentially, large-scale projects have systematically quantified genetic alteration and expression from thousands of cancer patient samples. One such project is the Cancer Genome Atlas (TCGA), which processed over 20,000 primary cancer and matched normal samples from 33 cancer types. The wealth of knowledge provided from this undertaking has streamlined the identification of cancer drivers and suppressors. We examined aaRS expression data produced by the TCGA project and combined this with patient survival data to recognize trends in aaRSs’ impact on cancer both molecularly and prognostically. We further compared these trends to an established tumor suppressor and a proto-oncogene. We observed apparent upregulation of many tRNA synthetase genes with aggressive cancer types, yet, at the individual gene level, some aaRSs resemble a tumor suppressor while others show similarities to an oncogene. This study provides an unbiased, overarching perspective on the relationship of aaRSs with cancers and identifies certain aaRS family members as promising therapeutic targets or potential leads for developing biological therapy for cancer.
Genomic Identification, Evolution and Sequence Analysis of the Heat-Shock Protein Gene Family in Buffalo
Authors: Rehman Saif ur , Nadeem Asif , Javed Maryam , Hassan Faiz-ul , Luo Xier , Khalid Ruqayya Bint , Liu Qingyou
Published: November 2020

Heat-shock proteins (HSP) are conserved chaperones crucial for protein degradation, maturation, and refolding. These adenosine triphosphate dependent chaperones were classified based on their molecular mass that ranges between 10–100 kDA, including; HSP10, HSP40, HSP70, HSP90, HSPB1, HSPD, and HSPH1 family. HSPs are essential for cellular responses and imperative for protein homeostasis and survival under stress conditions. This study performed a computational analysis of the HSP protein family to better understand these proteins at the molecular level. Physiochemical properties, multiple sequence alignment, and phylogenetic analysis were performed for 64 HSP genes in the Bubalus bubalis genome. Four genes were identified as belonging to the HSP90 family, 10 to HSP70, 39 to HSP40, 8 to HSPB, one for each HSPD, HSPH1, and HSP10, respectively. The aliphatic index was higher for HSP90 and HSP70 as compared to the HSP40 family, indicating their greater thermostability. Grand Average of hydropathicity Index values indicated the hydrophilic nature of HSP90, HSP70, and HSP40. Multiple sequence alignment indicated the presence of highly conserved consensus sequences that are plausibly significant for the preservation of structural integrity of proteins. In addition, this study has expanded our current knowledge concerning the genetic diversity and phylogenetic relatedness of HSPs of buffalo with other mammalian species. The phylogenetic tree revealed that buffalo is more closely related to Capra hircus and distantly associated with Danio rerio. Our findings provide an understanding of HSPs in buffalo at the molecular level for the first time. This study highlights functionally important HSPs and indicates the need for further investigations to better understand the role and mechanism of HSPs.
Genome-Wide Identification and Expression Profiling Analysis of the Trihelix Gene Family Under Abiotic Stresses in Medicago truncatula
Authors: Liu Xiqiang , Zhang Han , Ma Lin , Wang Zan , Wang Kun
Published: November 2020

The trihelix transcription factor (GT) family is widely involved in regulating plant growth and development, and most importantly, responding to various abiotic stresses. Our study first reported the genome-wide identification and analysis of GT family genes in Medicago truncatula. Overall, 38 trihelix genes were identified in the M. truncatula genome and were classified into five subfamilies (GT-1, GT-2, SH4, GTγ and SIP1). We systematically analyzed the phylogenetic relationship, chromosomal distribution, tandem and segmental duplication events, gene structures and conserved motifs of MtGTs. Syntenic analysis revealed that trihelix family genes in M. truncatula had the most collinearity relationship with those in soybean followed by alfalfa, but very little collinearity with those in the maize and rice. Additionally, tissue-specific expression analysis of trihelix family genes suggested that they played various roles in the growth and development of specific tissues in M. truncatula. Moreover, the expression of some MtGT genes, such as MtGT19, MtGT20, MtGT22, and MtGT33, was dramatically induced by drought, salt, and ABA treatments, illustrating their vital roles in response to abiotic stresses. These findings are helpful for improving the comprehensive understanding of trihelix family; additionally, the study provides candidate genes for achieving the genetic improvement of stress resistance in legumes.
Barriers to and Facilitators of School Health Care for Students with Chronic Disease as Perceived by Their Parents: A Mixed Systematic Review
Authors: Uhm Ju-Yeon , Choi Mi-Young
Published: November 2020

Understanding parental perspectives through mixed systematic reviews is imperative for developing effective school health care for children and adolescents with chronic disease. A mixed systematic review was conducted to explore barriers to and facilitators of school health care for students with chronic disease as perceived by their parents. Four databases (2010–2020) were searched, following which critical appraisals were conducted to determine the validity of the selected studies using the Mixed Method Appraisal Tool, version 2018. Twenty articles were synthesized using the convergent integrated approach from the Joanna Briggs Institute’s mixed method systematic review methodology. We examined 20 articles regarding parents’ perceived barriers and facilitators and found views across four levels: intrapersonal, interpersonal, institutional, and public and policy. Parents perceived more barriers than facilitators. Barriers on the institutional level were the most frequently reported of all levels of barriers. These results suggest that multi-level school health interventions could be a valuable resource to facilitate effective school guidelines and public policies for students with chronic diseases.
Exploring the Relationship between Innovative Work Behavior, Job Anxiety, Workplace Ostracism, and Workplace Incivility: Empirical Evidence from Small and Medium Sized Enterprises (SMEs)
Authors: Samma Madeeha , Zhao Yan , Rasool Samma Faiz , Han Xiao , Ali Shahzad
Published: November 2020

The aim of this study is to explore the relationship between workplace ostracism (WO), workplace incivility (WI), and innovative work behavior (IWB), using job anxiety as a mediating variable. Building on the conservation of resource (COR) theory, this study proposes a theoretical framework. In this framework, workplace ostracism and workplace incivility are theorized to strengthen innovative work behavior, directly and indirectly, through job anxiety. Data were collected from the workers of small and medium sized enterprise (SME) entrepreneurs located in Pakistan. To estimate the proposed relationships in the conceptual model, we used structural equation modeling (SEM) through AMOS-21. The outcomes of this study confirmed that workplace ostracism and workplace incivility had a negative impact on innovative work behavior. It was also confirmed that job anxiety mediates in the relationship between workplace ostracism, workplace incivility, job anxiety, and innovative work behavior. At the end of the study, we thoroughly discussed the conclusions, practical implications, limitations, and future research directions of the study.
Atypical Streptococcal Meningitis with Fatal Cerebrovascular Complications: A Case Report
Authors: Pinilla-Monsalve Gabriel D. , Torres-Cutiva Daniel F. , Fernández-Cubillos Juan P.
Published: November 2020

Bacterial meningitis is an infectious pathology that remains a public health challenge. The most frequent etiological agent is Streptococcus pneumoniae, which is also associated with higher rates of mortality and sequels. However, less is known about the clinical presentation of atypical non-pneumoniae streptococcal meningitis. Here, we studied a 23-year-old man with no medical background who presented with projectile vomiting, states of consciousness alteration, unilateral cranial nerve palsy, and meningeal signs. Neuroimaging showed tonsillar herniation, regions of empyema, right transverse and sigmoid sinuses thrombosis, and multiple arterial subcortical infarcts. Cerebrospinal fluid suggested bacterial infection; blood and abscess cultures were positive for Streptococcus constellatus. The patient received antibiotics with no clinical improvement. He deteriorated over the following days, the abolishment of brainstem reflexes was observed, and brain death was declared. Streptococcal meningitis produced by atypical species is a potential cause of lethal cerebrovascular complications, even in immunocompetent patients.
Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews
Authors: Latina Roberto , Salomone Katia , D’Angelo Daniela , Coclite Daniela , Castellini Greta , Gianola Silvia , Fauci Alice , Napoletano Antonello , Iacorossi Laura , Iannone Primiano
Published: November 2020

Clinical or care pathways are developed by a multidisciplinary team of healthcare practitioners, based on clinical evidence, and standardized processes. The evaluation of their framework/content quality is unclear. The aim of this study was to describe which tools and domains are able to critically evaluate the quality of clinical/care pathways. An overview of systematic reviews was conducted, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses, using Medline, Embase, Science Citation Index, PsychInfo, CINAHL, and Cochrane Library, from 2015 to 2020, and with snowballing methods. The quality of the reviews was assessed with Assessment the Methodology of Systematic Review (AMSTAR-2) and categorized with The Leuven Clinical Pathway Compass for the definition of the five domains: processes, service, clinical, team, and financial. We found nine reviews. Three achieved a high level of quality with AMSTAR-2. The areas classified according to The Leuven Clinical Pathway Compass were: 9.7% team multidisciplinary involvement, 13.2% clinical (morbidity/mortality), 44.3% process (continuity-clinical integration, transitional), 5.6% financial (length of stay), and 27.0% service (patient-/family-centered care). Overall, none of the 300 instruments retrieved could be considered a gold standard mainly because they did not cover all the critical pathway domains outlined by Leuven and Health Technology Assessment. This overview shows important insights for the definition of a multiprinciple framework of core domains for assessing the quality of pathways. The core domains should consider general critical aspects common to all pathways, but it is necessary to define specific domains for specific diseases, fast pathways, and adapting the tool to the cultural and organizational characteristics of the health system of each country.
Decompressive Craniectomy Improves QTc Interval in Traumatic Brain Injury Patients
Authors: Dabrowski Wojciech , Siwicka-Gieroba Dorota , Robba Chiara , Badenes Rafael , Kotfis Katarzyna , Schlegel Todd T. , Jaroszynski Andrzej
Published: November 2020

Background: Traumatic brain injury (TBI) is commonly associated with cardiac dysfunction, which may be reflected by abnormal electrocardiograms (ECG) and/or contractility. TBI-related cardiac disorders depend on the type of cerebral injury, the region of brain damage and the severity of the intracranial hypertension. Decompressive craniectomy (DC) is commonly used to reduce intra-cranial hypertension (ICH). Although DC decreases ICH rapidly, its effect on ECG has not been systematically studied. The aim of this study was to analyze the changes in ECG in patients undergoing DC. Methods: Adult patients without previously known cardiac diseases treated for isolated TBI with DC were studied. ECG variables, such as: spatial QRS-T angle (spQRS-T), corrected QT interval (QTc), QRS and T axes (QRSax and Tax, respectively), STJ segment and the index of cardio-electrophysiological balance (iCEB) were analyzed before DC and at 12–24 h after DC. Changes in ECG were analyzed according to the occurrence of cardiac arrhythmias and 28-day mortality. Results: 48 patients (17 female and 31 male) aged 18–64 were studied. Intra-cranial pressure correlated with QTc before DC (p < 0.01, r = 0.49). DC reduced spQRS-T (p < 0.001) and QTc interval (p < 0.01), increased Tax (p < 0.01) and changed STJ in a majority of leads but did not affect QRSax and iCEB. The iCEB was relatively increased before DC in patients who eventually experienced cardiac arrhythmias after DC (p < 0.05). Higher post-DC iCEB was also noted in non-survivors (p < 0.05), although iCEB values were notably heart rate-dependent. Conclusions: ICP positively correlates with QTc interval in patients with isolated TBI, and DC for relief of ICH reduces QTc and spQRS-T. However, DC might also increase risk for life-threatening cardiac arrhythmias, especially in ICH patients with notably prolonged QTc before and increased iCEB after DC.
Determinants of Multidimensional and Physical Frailty and Their Individual Components: Interactions between Frailty Deficits
Authors: Sacha Magdalena , Sacha Jerzy , Wieczorowska-Tobis Katarzyna
Published: November 2020

Purpose: To identify the interrelations among determinants of multidimensional frailty, physical frailty, and their individual components. Methods: A group of 1024 community-dwelling people older than 65 years completed questionnaires regarding: multidimensional frailty (Tilburg Frailty Indicator, TFI) and physical frailty (FRAIL scale), and common frailty risk factors. Results: Multidimensional frailty was recognized in 559 subjects (54.6%) and determined by 13 factors (R2 = 0.21 in logistic regression). After incorporating TFI components to the models, the majority of previous risk factors became non-essential, and the frailty deficits mainly determined each other with R2 ranging between 0.07–0.67. Physical frailty and non-robust status (i.e., either physical frailty or pre-frailty) were recognized in 64 (6.3%) and 542 (52.9%) participants, and were determined by 5 factors (R2 = 0.33) and 11 factors (R2 = 0.34), respectively. Associations between the frailty deficits were detected within and between different dimensions (i.e., physical, psychological and social); the physical domain was mainly related to the psychological one which in turn was additionally associated with the social one. Conclusion: Frailty is the accumulation of deficits and is determined by factors other than the determinants of the individual deficits. The associations between deficits coming from various dimensions of human functioning presumably amplify their effects and accelerate frailty development.
Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant Outcomes
Authors: Leifheit Kathryn M. , Schwartz Gabriel L. , Pollack Craig E. , Edin Kathryn J. , Black Maureen M. , Jennings Jacky M. , Althoff Keri N.
Published: November 2020

Introduction: Housing insecurity is increasingly commonplace among disadvantaged women and children. We measured the individual- and population-level impact of severe housing insecurity during pregnancy on adverse birth and infant outcomes. Methods: We analyzed data from 3428 mother–infant dyads enrolled in the Fragile Families and Child Wellbeing Study, a prospective cohort study representing births in 20 large U.S. cities from 1998 to 2000. Severe housing insecurity was defined as threatened eviction or homelessness during pregnancy. Outcomes included low birth weight and/or preterm birth, admission to a neonatal intensive care unit (NICU) or stepdown facility, extended hospitalization after delivery, and infant health and temperament. We estimated exposure–outcome associations with risk ratios adjusted for pre-pregnancy maternal sociodemographic and heath factors and calculated a population attributable fraction (PAF) of outcomes attributable to severe housing insecurity. Results: We found statistically significant associations between severe housing insecurity during pregnancy and low birth weight and/or preterm birth (risk ratio (RR] 1.73, 95% confidence interval (CI) 1.28, 2.32), NICU or stepdown stay (RR 1.64, CI 1.17, 2.31), and extended hospitalization (RR 1.66, CI 1.28, 2.16). Associations between housing insecurity and infant fair or poor health (RR 2.62, CI 0.91, 7.48) and poor temperament (RR 1.52, CI 0.98, 2.34) were not statistically significant. PAF estimates ranged from 0.9–2.7%, suggesting that up to three percent of adverse birth and infant outcomes could be avoided by eliminating severe housing insecurity among low-income, pregnant women in US cities. Conclusions: Results suggest that housing insecurity during pregnancy shapes neonatal and infant health in disadvantaged urban families.
How Molecular Typing Can Support Legionella Environmental Surveillance in Hot Water Distribution Systems: A Hospital Experience
Authors: Girolamini Luna , Salaris Silvano , Lizzadro Jessica , Mazzotta Marta , Pascale Maria Rosaria , Pellati Tiziana , Cristino Sandra
Published: November 2020

In this study, we aimed to associate the molecular typing of Legionella isolates with a culture technique during routine Legionella hospital environmental surveillance in hot water distribution systems (HWDSs) to develop a risk map able to be used to prevent nosocomial infections and formulate appropriate preventive measures. Hot water samples were cultured according to ISO 11731:2017. The isolates were serotyped using an agglutination test and genotyped by sequence-based typing (SBT) for Legionella pneumophila or macrophage infectivity potentiator (mip) gene sequencing for non-pneumophila Legionella species. The isolates’ relationship was phylogenetically analyzed. The Legionella distribution and level of contamination were studied in relation to temperature and disinfectant residues. The culture technique detected 62.21% of Legionella positive samples, characterized by L. pneumophila serogroup 1, Legionella non-pneumophila, or both simultaneously. The SBT assigned two sequence types (STs): ST1, the most prevalent in Italy, and ST104, which had never been isolated before. The mip gene sequencing detected L. anisa and L. rubrilucens. The phylogenetic analysis showed distinct clusters for each species. The distribution of Legionella isolates showed significant differences between buildings, with a negative correlation between the measured level of contamination, disinfectant, and temperature. The Legionella molecular approach introduced in HWDSs environmental surveillance permits (i) a risk map to be outlined that can help formulate appropriate disinfection strategies and (ii) rapid epidemiological investigations to quickly identify the source of Legionella infections.
Parenting Behavior at 18 Months Predicts Internalizing and Externalizing Problems at 6 Years in Moderately Preterm and Full Term Children
Authors: Oosterom Lisa , Bogičević Lilly , Verhoeven Marjolein , van Baar Anneloes L.
Published: November 2020

Moderately preterm born children (MPT) are at increased risk for behavior problems compared to full term born (FT) children. MPT children may receive less optimal parenting, and in response, may develop behavior problems. Our aims were to examine whether parenting behavior and mother–child interaction quality mediate the association between birth status and child behavior problems. Participants were 120 MPT children and 100 FT children. At 18 months of age, mothers reported on their parenting behavior (support and structure), and mother–child interaction (sensitivity and limit-setting) was observed. At 6 years of age, mothers reported on children’s behavior problems. Using structural equation modeling, birth status was found to predict attention problems, but not internalizing and externalizing problems. Mothers of MPT children set less appropriate limits than mothers of FT children at 18 months of age. More maternal structure at 18 months predicted fewer internalizing and externalizing problems, but not attention problems, at 6 years. These associations between parenting behavior, mother–child interaction quality, and child behavior problems were similar for MPT and FT children. Our findings indicate that maternal structure in toddlerhood is an important predictor of later internalizing and externalizing problems for both MPT and FT children.
Follow-Up of Elevated Blood Lead Levels and Sources in a Cohort of Children in Benin
Authors: Ahmadi Shukrullah , Le Bot Barbara , Zoumenou Roméo , Durand Séverine , Fiévet Nadine , Ayotte Pierre , Massougbodji Achille , Alao Maroufou Jules , Cot Michel , Glorennec Philippe , Bodeau-Livinec Florence
Published: November 2020

Lead exposure is associated with poor cognitive development in children. Very few studies in sub-Saharan Africa (SSA) have studied blood lead levels (BLLs) and non-gasoline sources of exposure in children. Data from a birth cohort in Benin (2011–2013) suggested that 58% of 1-year-old children had BLLs > 50 ug/L. We aimed to investigate the prevalence of elevated BLLs (>50 µg/L and >100 µg /L) among 425 of these children at 6 years of age in 2016–2018 and to compare BLLs between age 1 and 6 years, and study sources of lead at age 6 years. BLLs were analysed by inductively coupled plasma mass spectrometry. Multiple linear regression and quantile regressions were used to study potential sources of lead. The prevalence of BLLs > 50 µg/L in children was 59.5% (Geometric Mean (GM) 56.4 µg/L, 95% CI: 54.1–58.7) at 6 years of age compared to 54.8% (GM 56.5 µg/L, 95% CI: 53.4–59.6) at 1 year of age. The prevalence of children with BLLs > 100 µg/L decreased from 14.4% at 1 year of age to 8.2% at 6 years of age. After adjustment for all other covariates, consumption of peanuts more than once per month was significantly associated with a 22.0% (95% CI: 4.6, 42.5) increment in BLLs at age 6 years compared with no consumption. Consumption of bushmeat killed by lead bullets at age 6 years was associated with an increase in the higher percentiles of BLLs (P75) compared with the absence of this source. Other potential sources of lead associated with BLLs with marginal significance were consumption of rice, paternal occupational exposure, and the presence of activity with the potential use of lead. This prospective cohort confirms the persistently high prevalence of elevated BLLs in children residing in a rural region in the south of Benin, as well as the presence of multiple and continuous sources of lead. These results highlight the need for prevention programs to reduce and eliminate lead exposure in children.
Investigating a Potential Map of PM2.5 Air Pollution and Risk for Tourist Attractions in Hsinchu County, Taiwan
Authors: Lin Yuan-Chien , Shih Hua-San , Lai Chun-Yeh , Tai Jen-Kuo
Published: November 2020

In the past few years, human health risks caused by fine particulate matters (PM2.5) and other air pollutants have gradually received attention. According to the Disaster Prevention and Protection Act of Taiwan’s Government enforced in 2017, “suspended particulate matter” has officially been acknowledged as a disaster-causing hazard. The long-term exposure to high concentrations of air pollutants negatively affects the health of citizens. Therefore, the precise determination of the spatial long-term distribution of hazardous high-level air pollutants can help protect the health and safety of residents. The analysis of spatial information of disaster potentials is an important measure for assessing the risks of possible hazards. However, the spatial disaster-potential characteristics of air pollution have not been comprehensively studied. In addition, the development of air pollution potential maps of various regions would provide valuable information. In this study, Hsinchu County was chosen as an example. In the spatial data analysis, historical PM2.5 concentration data from the Taiwan Environmental Protection Administration (TWEPA) were used to analyze and estimate spatially the air pollution risk potential of PM2.5 in Hsinchu based on a geographic information system (GIS)-based radial basis function (RBF) spatial interpolation method. The probability that PM2.5 concentrations exceed a standard value was analyzed with the exceedance probability method; in addition, the air pollution risk levels of tourist attractions in Hsinchu County were determined. The results show that the air pollution risk levels of the different seasons are quite different. The most severe air pollution levels usually occur in spring and winter, whereas summer exhibits the best air quality. Xinfeng and Hukou Townships have the highest potential for air pollution episodes in Hsinchu County (approximately 18%). Hukou Old Street, which is one of the most important tourist attractions, has a relatively high air pollution risk. The analysis results of this study can be directly applied to other countries worldwide to provide references for tourists, tourism resource management, and air quality management; in addition, the results provide important information on the long-term health risks for local residents in the study area.
Abdominal Cutaneous Thermography and Perfusion Mapping after Caesarean Section: A Scoping Review
Authors: Childs Charmaine , Soltani Hora
Published: November 2020

Introduction: Caesarean section (CS) is the most prevalent surgical procedure in women. The incidence of surgical site infection (SSI) after CS remains high but recent observations of CS wounds using infrared thermography has shown promise for the technique in SSI prognosis. Although thermography is recognised as a ‘surrogate’ of skin perfusion, little is known of the relationship between skin temperature and skin perfusion in the context of wound healing. Aim: To assess the extent of literature regarding the application of infrared thermography and mapping of abdominal cutaneous perfusion after CS. Methods: Wide eligibility criteria were used to capture all relevant studies of any design, published in English, and addressing thermal imaging or skin perfusion mapping of the abdominal wall. The CINAHL and MEDLINE databases were searched, with two independent reviewers screening the title and abstracts of all identified citations, followed by full-text screening of relevant studies. Data extraction from included studies was undertaken using a pre-specified data extraction chart. Data were tabulated and synthesised in narrative format. Results: From 83 citations identified, 18 studies were considered relevant. With three additional studies identified from the reference lists, 21 studies were screened via full text. None of the studies reported thermal imaging and cutaneous perfusion patterns of the anterior abdominal wall. However, two observational studies partially met the inclusion criteria. The first explored analysis methodologies to ‘interrogate’ the abdominal thermal map. A specific thermal signature (‘cold spots’) was identified as an early ‘flag’ for SSI risk. A second study, by the same authors, focusing on obesity (a known risk factor for SSI after CS) showed that a 1 °C lower abdominal skin temperature led to a 3-fold odds of SSI. Conclusion: There is a significant gap in knowledge on how to forewarn of wound complications after CS. By utilising the known association between skin temperature and blood flow, thermographic assessment of the wound and adjacent thermal territories has potential as a non-invasive, independent, imaging option with which to identify tissue ‘at risk’. By identifying skin ‘hot’ or ‘cold’ spots, commensurate with high or low blood flow regions, there is potential to shed light on the underlying mechanisms leading to infective and non-infective wound complications.