bluuebunny/crossref_metadata_2025 huggingface dataset:
High-throughput method for detection and quantification of lesions on leaf scale based on trypan blue staining and digital image analysis
Authors: Mulaosmanovic Emina , Lindblom Tobias U. T. , Bengtsson Marie , Windstam Sofia T. , Mogren Lars , Marttila Salla , Stützel Hartmut , Alsanius Beatrix W.
Published: May 2020

Background

Field-grown leafy vegetables can be damaged by biotic and abiotic factors, or mechanically damaged by farming practices. Available methods to evaluate leaf tissue damage mainly rely on colour differentiation between healthy and damaged tissues. Alternatively, sophisticated equipment such as microscopy and hyperspectral cameras can be employed. Depending on the causal factor, colour change in the wounded area is not always induced and, by the time symptoms become visible, a plant can already be severely affected. To accurately detect and quantify damage on leaf scale, including microlesions, reliable differentiation between healthy and damaged tissue is essential. We stained whole leaves with trypan blue dye, which traverses compromised cell membranes but is not absorbed in viable cells, followed by automated quantification of damage on leaf scale.

Results

We present a robust, fast and sensitive method for leaf-scale visualisation, accurate automated extraction and measurement of damaged area on leaves of leafy vegetables. The image analysis pipeline we developed automatically identifies leaf area and individual stained (lesion) areas down to cell level. As proof of principle, we tested the methodology for damage detection and quantification on two field-grown leafy vegetable species, spinach and Swiss chard.

Conclusions

Our novel lesion quantification method can be used for detection of large (macro) or single-cell (micro) lesions on leaf scale, enabling quantification of lesions at any stage and without requiring symptoms to be in the visible spectrum. Quantifying the wounded area on leaf scale is necessary for generating prediction models for economic losses and produce shelf-life. In addition, risk assessments are based on accurate prediction of the relationship between leaf damage and infection rates by opportunistic pathogens and our method helps determine the severity of leaf damage at fine resolution.
How and under what circumstances do quality improvement collaboratives lead to better outcomes? A systematic review
Authors: Zamboni Karen , Baker Ulrika , Tyagi Mukta , Schellenberg Joanna , Hill Zelee , Hanson Claudia
Published: May 2020

Background

Quality improvement collaboratives are widely used to improve health care in both high-income and low and middle-income settings. Teams from multiple health facilities share learning on a given topic and apply a structured cycle of change testing. Previous systematic reviews reported positive effects on target outcomes, but the role of context and mechanism of change is underexplored. This realist-inspired systematic review aims to analyse contextual factors influencing intended outcomes and to identify how quality improvement collaboratives may result in improved adherence to evidence-based practices.

Methods

We built an initial conceptual framework to drive our enquiry, focusing on three context domains: health facility setting; project-specific factors; wider organisational and external factors; and two further domains pertaining to mechanisms: intra-organisational and inter-organisational changes. We systematically searched five databases and grey literature for publications relating to quality improvement collaboratives in a healthcare setting and containing data on context or mechanisms. We analysed and reported findings thematically and refined the programme theory.

Results

We screened 962 abstracts of which 88 met the inclusion criteria, and we retained 32 for analysis. Adequacy and appropriateness of external support, functionality of quality improvement teams, leadership characteristics and alignment with national systems and priorities may influence outcomes of quality improvement collaboratives, but the strength and quality of the evidence is weak. Participation in quality improvement collaborative activities may improve health professionals’ knowledge, problem-solving skills and attitude; teamwork; shared leadership and habits for improvement. Interaction across quality improvement teams may generate normative pressure and opportunities for capacity building and peer recognition.

Conclusion

Our review offers a novel programme theory to unpack the complexity of quality improvement collaboratives by exploring the relationship between context, mechanisms and outcomes. There remains a need for greater use of behaviour change and organisational psychology theory to improve design, adaptation and evaluation of the collaborative quality improvement approach and to test its effectiveness. Further research is needed to determine whether certain contextual factors related to capacity should be a precondition to the quality improvement collaborative approach and to test the emerging programme theory using rigorous research designs.
The distance and median problems in the single-cut-or-join model with single-gene duplications
Authors: Mane Aniket C. , Lafond Manuel , Feijao Pedro C. , Chauve Cedric
Published: May 2020

Background.

In the field of genome rearrangement algorithms, models accounting for gene duplication lead often to hard problems. For example, while computing the pairwise distance is tractable in most duplication-free models, the problem is NP-complete for most extensions of these models accounting for duplicated genes. Moreover, problems involving more than two genomes, such as the genome median and the Small Parsimony problem, are intractable for most duplication-free models, with some exceptions, for example the Single-Cut-or-Join (SCJ) model.

Results.

We introduce a variant of the SCJ distance that accounts for duplicated genes, in the context of directed evolution from an ancestral genome to a descendant genome where orthology relations between ancestral genes and their descendant are known. Our model includes two duplication mechanisms: single-gene tandem duplication and the creation of single-gene circular chromosomes. We prove that in this model, computing the directed distance and a parsimonious evolutionary scenario in terms of SCJ and single-gene duplication events can be done in linear time. We also show that the directed median problem is tractable for this distance, while the rooted median problem, where we assume that one of the given genomes is ancestral to the median, is NP-complete. We also describe an Integer Linear Program for solving this problem. We evaluate the directed distance and rooted median algorithms on simulated data.

Conclusion.

Our results provide a simple genome rearrangement model, extending the SCJ model to account for single-gene duplications, for which we prove a mix of tractability and hardness results. For the NP-complete rooted median problem, we design a simple Integer Linear Program. Our publicly available implementation of these algorithms for the directed distance and median problems allow to solve efficiently these problems on large instances.
Three-year follow-up of changes of cortical bone thickness after implantation of Endo-Exo-Prosthesis (EEP) for transfemoral amputees
Authors: Örgel Marcus , Liodakis Emmanouil , Jaratjitwilai Pratya , Harb Afif , Wirries Nils , Omar Mohamed , Krettek Christian , Aschoff Horst-Heinrich
Published: May 2020

Introduction

Transcutaneous Osseointegrated Prosthetic Systems (TOPS) offer a good alternative for patients who cannot be satisfactorily rehabilitated by conventional suspension sockets. The Endo-Exo-Prothesis (EEP, ESKA Orthopaedic Handels GmbH®, Deutschland) is the most implanted TOPS in Germany. Previous studies have shown that cortical thickness increases after implantation of TOPS. The aim of this study is to determine changes of cortical thickness in relation to the time after implantation of the Endo-Fix-Stem.

Patients and methods

All transfemoral amputees treated by EEP from 2007 to 2013 were operated by the last author of this study. X-ray images of 4 follow-up intervals (postoperative, 3 months, 12 months, 3 years) were analyzed retrospectively. The femoral residuum was divided into 3 sections (proximal, middle, distal) with 2 measuring points in each section: medial and lateral. Cortical thickness was measured at these 6 points and compared at regular intervals using the Friedman test for non-parametric dependent variables.

Results

Thirty-seven patients with 40 implants were included. The average age was 52.2 years (30–79 years). 83.7% of the patients were male. No statistical significance could be shown for any of the measuring points of the femoral residual (proximal medial, proximal lateral, middle medial, middle lateral, distal medial, distal lateral) among the mean values of the cortical thickness at the different follow-up times (p > 0.05 for all measuring points). Cortical remodeling processes (> 1 millimeter (mm)) occurred in all implants despite a missing statistical significance. Hypertrophy could be confirmed for 42.5% and atrophy for 37.5%. Twenty percent of the cases showed a parallel occurrence of both entities. Cortical changes greater than 5 mm were only observed at the distal end of the femur.

Conclusion

Even if our results did not show any significant difference, it can be deduced that the osseointegration process leads to a remodeling of the bone structure, both in terms of increased bone formation and bone resorption. However, it has not yet been conclusively clarified which processes lead to hyper- or atrophy. The force transmission between prosthesis and bone and the facultative bacterial colonization of the stoma are still the main factors which may be responsible for the bone remodeling processes.
Plasma volume expansion and capillary leakage of 20% albumin in burned patients and volunteers
Authors: Zdolsek Markus , Hahn Robert G. , Sjöberg Folke , Zdolsek Joachim H.
Published: May 2020

Background

Burn injury is associated with a long-standing inflammatory reaction. The use of albumin solutions for plasma volume support is controversial because of concerns of increased capillary leakage, which could aggravate the commonly seen interstitial oedema.

Methods

In the present open controlled clinical trial, an intravenous infusion of 20% albumin at 3 mL/kg was given over 30 min to 15 burn patients and 15 healthy volunteers. Blood samples and urine were collected for 5 h. Plasma dilution, plasma albumin and colloid osmotic pressure were compared. Mass balance calculations were used to estimate plasma volume expansion and capillary leakage of fluid and albumin.

Results

The patients were studied between 4 and 14 (median, 7) days after the burn injury, which spread over 7–48% (median, 15%) of the total body surface area. The albumin solution expanded the plasma volume by almost 15%, equivalent to twice the infused volume, in both groups. The urinary excretion exceeded the infused volume by a factor of 2.5. Capillary leakage of albumin occurred at a rate of 3.4 ± 1.5 g/h in burn patients and 3.7 ± 1.6 g/h in the volunteers (P = 0.61), which corresponded to 2.4 ± 1.0% and 2.5 ± 1.2% per hour of the intravascular pool (P = 0.85). The median half-life of the plasma volume expansion was 5.9 (25th–75th percentiles 2.7–11.7) h in the burn patients and 6.9 (3.4–8.5) h in the volunteers (P = 0.56).

Conclusions

Albumin 20% was an effective volume expander in patients at 1 week post-burn. No relevant differences were found between burn patients and healthy volunteers.

Trial registration

EudraCT 2016-000996-26on May 31, 2016.
The role of baseline BLyS levels and type 1 interferon-inducible gene signature status in determining belimumab response in systemic lupus erythematosus: a post hoc meta-analysis
Authors: Wilkinson Christel , Henderson Robert B. , Jones-Leone Angela R. , Flint Shaun M. , Lennon Mark , Levy Roger A. , Ji Beulah , Bass Damon L. , Roth David
Published: May 2020

Background

Elevated B lymphocyte stimulator (BLyS) levels in patients with systemic lupus erythematosus (SLE) correlate positively with disease activity; BLyS expression is directly linked to interferon (IFN) pathway activation. This post hoc meta-analysis of BLISS-52 and BLISS-76 explored the relationship between baseline BLyS mRNA/protein levels and/or type 1 IFN-inducible gene signature (IFN-1) and responses to the BLyS-targeting monoclonal antibody belimumab in SLE.

Methods

In BLISS-52 and BLISS-76, patients with autoantibody-positive SLE and a SELENA-SLEDAI score ≥ 6 and receiving stable standard SLE therapy were randomised to intravenous belimumab 10 mg/kg or placebo, plus standard of care (SoC), for 52 or 76 weeks. For this post hoc meta-analysis, patients with an appropriate mRNA sample were stratified by BLyS mRNA expression (tertiles: high/medium/low; revised quantiles: high/low), IFN-1 mRNA expression (high/low) and BLyS protein level (high/low). Co-primary endpoints were correlation between baseline BLyS and IFN-1 mRNA levels and SLE Responder Index (SRI)4 response at week 52 within BLyS/IFN-1 subgroups. Secondary endpoints included time to first severe SELENA-SLEDAI Flare Index (SFI) flare.

Results

Of 554 patients included in this analysis, 281 had received belimumab and 273 had received placebo. Baseline BLyS and IFN-1 mRNA levels were highly correlated (Spearman’s rank correlation coefficient 0.7799; 95% confidence interval [CI] 0.7451, 0.8106; p < 0.0001). The proportion of SRI4 responders was higher with belimumab versus placebo in all subgroups, but the difference reached statistical significance in the medium BLyS mRNA tertile (odds ratio [OR] 2.17; 95% CI 1.16, 4.04; p = 0.0153), high BLyS mRNA quantile (OR 1.58; 95% CI 1.02, 2.44; p = 0.0402), high IFN-1 mRNA (OR 1.58; 95% CI: 1.08, 2.31; p = 0.0186) and high BLyS protein (OR 3.57; 95% CI 1.63, 7.83; p = 0.0015) subgroups only. The risk of severe SFI flare was significantly lower with belimumab than placebo in the high BLyS mRNA quantile (hazard ratio [HR] 0.59; 95% CI 0.36, 0.97; p = 0.0371) and high BLyS protein (HR 0.39; 95% CI 0.19, 0.79; p = 0.0090) subgroups.

Conclusions

This post hoc meta-analysis demonstrated a tendency towards improved response to add-on intravenous belimumab 10 mg/kg versus SoC alone in patients with high baseline BLyS protein and IFN-1 mRNA levels and medium/high BLyS mRNA levels.
Fear-avoidance beliefs are associated with exercise adherence: secondary analysis of a randomised controlled trial (RCT) among female healthcare workers with recurrent low back pain
Authors: Taulaniemi Annika , Kankaanpää Markku , Rinne Marjo , Tokola Kari , Parkkari Jari , Suni Jaana H.
Published: May 2020

Background

Exercise is recommended for the treatment and management of low back pain (LBP) and the prevention of chronicity. Exercise adherence has been only modest in intervention studies among people with musculoskeletal pain. Fear-avoidance beliefs (FABs) are known to affect exercise adherence.

The purpose was twofold: to examine which bio-psycho-social factors contributed to exercise adherence during a 6-month neuromuscular exercise intervention among female healthcare workers with recurrent LBP, and to investigate how exercising affects FABs at 6 and 12 months’ follow-up.

Methods

Some 219 healthcare workers aged 30–55 years with mild-to-moderate re-current non-specific LBP were originally allocated into: 1) exercise, 2) counselling, 3) combined exercise and counselling, and 4) control groups. In the present secondary analysis, groups 1 and 3 (exercise only and exercise+counselling) were merged to be exercisers and groups 2 and 4 were merged to be non-exercisers. Baseline variables of the exercise compliers (≥24 times over 24 weeks; n = 58) were compared to those of the non-compliers (< 1 time/week, 0–23 times; n = 52). The effects of the exercise programme on FABs were analysed by a generalised linear mixed model according to the intention-to-treat principle (exercisers; n = 110 vs non-exercisers; n = 109) at three measurement points (baseline, 6, and 12 months). A per-protocol analysis compared the more exercised to the less exercised and non-exercisers.

Results

A low education level (p = 0.026), shift work (p = 0.023), low aerobic (p = 0.048) and musculoskeletal (p = 0.043) fitness, and high baseline physical activity-related FABs (p = 0.019) were related to low exercise adherence. The exercise programme reduced levels of both physical activity- and work-related FABs, and there was a dose response: FABs reduced more in persons who exercised ≥24 times compared to those who exercised 0–23 times.

Conclusion

Healthcare workers who had lower education and fitness levels, worked shifts, and had high physical activity-related FABs had a lower adherence to the 6-month neuromuscular exercise programme. Exercising with good adherence reduced levels of FABs, which have been shown to be linked with prolonged LBP. Motivational strategies should be targeted at persons with low education and fitness levels and high FABs in order to achieve better exercise adherence.
Abundance, diversity, and distribution patterns along with the salinity of four nitrogen transformation-related microbes in the Yangtze Estuary
Authors: Zheng Lei , Liu Tingting , Yuan Dongdan , Wang Huipeng , Zhang Shurong , Ding Aizhong , Xie En
Published: May 2020

Purpose

The abundance and composition of nitrogen transformation-related microbes with certain environmental parameters for living conditions provide information about the nitrogen cycle in the Yangtze Estuary. The aim of this study was to explore the impacts of salinity on four N-related microbes and reveal the phylogenetic characteristics of microorganisms in the Yangtze Estuary ecosystem. A molecular biology method was used for the quantitation and identification of four microbes in the Yangtze River: ammonia-oxidizing bacteria (AOB), ammonia-oxidizing archaea (AOA), denitrifying microbes (nirS-type), and anaerobic ammonia-oxidizing (anammox) bacteria. Sequence identification was performed on the levels of phylum, class, order, family, and genus, and the sequences were then matched to species.

Result

The results showed that the dominant species of AOA were crenarchaeote enrichment cultures, thaumarchaeote enrichment cultures, and Nitrosopumilus maritimus cultures, and the dominant AOB species were betaproteobacterium enrichment cultures and Nitrosomona sp. The denitrifying microbes were identified as the phylum Proteobacteria, classes Alphaproteobacteria, Betaproteobacteria, and Gammaproteobacteria, and the species Thauera selenatis. The dominant species of the anammox bacteria was Candidatus Brocadia sp. In the estuarine sediments of the Yangtze River, the nirS gene abundance (1.31 × 107–9.50 × 108 copies g−1 sediments) was the highest among all the detected genes, and the abundance of bacterial amoA, archaeal amoA, and nirS was significantly correlated. Closely correlated with the abundance of the bacterial amoA gene, salinity was an important factor in promoting the abundance and restraining the community diversity of AOB. Moreover, the distribution of the AOB species exhibited regional patterns in the estuarine zone.

Conclusions

The results indicated that salinity might promote abundance while limiting the diversity of AOB and that salinity might have reverse impacts on AOA. Denitrifying microbes, which showed a significant correlation with the other genes, were thought to interact with the other genes during nitrogen migration. The results also implied that AOA has a lower potential nitrification rate than AOB and that both the anammox and denitrification processes (defined by nirS gene) account for N2 production.
Attitudes, knowledge, and preferences of the Israeli public regarding the allocation of donor organs for transplantation
Authors: Elalouf Amir , Pliskin Joseph S. , Kogut Tehila
Published: May 2020

Background

There is a stark disparity between the number of patients awaiting deceased-donor organ transplants and the rate at which organs become available. Though organs for transplantation are assumed to be a community resource, and the organ supply depends on public willingness to donate, current allocation schemes do not explicitly incorporate public priorities and preferences. This paper seeks to provide insights regarding the Israeli public’s preferences regarding criteria for organ (specifically, kidney) allocation, and to determine whether these preferences are in line with current allocation policies.

Methods

A market research company administered a telephone survey to 604 adult participants representing the Jewish-Israeli public (age range: 18–95; 50% male). The questionnaire comprised 39 questions addressing participants’ knowledge, attitudes, and preferences regarding organ donation and criteria for organ allocation, including willingness to donate.

Results

The criteria that respondents marked as most important in prioritizing waitlist candidates were maximum medical benefit (51.3% of respondents) and waiting time (21%). Donor status (i.e., whether the candidate is registered as an organ donor) was ranked by 43% as the least significant criterion. Most participants expressed willingness to donate the organs of a deceased relative; notably, they indicated that they would be significantly more willing to donate if organ allocation policies took their preferences regarding allocation criteria into account. Unlike individuals in other countries (e.g., the UK, the US, and Australia) who responded to similar surveys, Israeli survey respondents did not assign high importance to the candidate’s age (24% ranked it as the least important factor). Interestingly, in some cases, participants’ declared preferences regarding the importance of various allocation criteria diverged from their actual choices in hypothetical organ allocation scenarios.

Conclusions

The findings of this survey indicate that Israel’s citizens are willing to take part in decisions about organ allocation. Respondents did not seem to have a strict definition or concept of what they deem to be just; yet, in general, their preferences are compatible with current policy. Importantly, participants noted that they would be more willing to donate organs if their preferences were integrated into the allocation policy. Accordingly, we propose that allocation systems must strive to respect community values and perceptions while maintaining continued clinical effectiveness.
Functional performance and 30-day postoperative mortality after emergency laparotomy—a retrospective, multicenter, observational cohort study of 1084 patients
Authors: Cihoric Mirjana , Tengberg Line Toft , Foss Nicolai Bang , Gögenur Ismail , Tolstrup Mai-Britt , Bay-Nielsen Morten
Published: May 2020

Background

Despite the importance of predicting adverse postoperative outcomes, functional performance status as a proxy for frailty has not been systematically evaluated in emergency abdominal surgery. Our aim was to evaluate if the Eastern Cooperative Oncology Group (ECOG) performance score was independently associated with mortality following high-risk emergency abdominal surgery, in a multicentre, retrospective, observational study of a consecutive cohort.

Methods

All patients aged 18 or above undergoing high-risk emergency laparotomy or laparoscopy from four emergency surgical centres in the Capitol Region of Denmark, from January 1 to December 31, 2012, were included. Demographics, preoperative status, ECOG performance score, mortality, and surgical characteristics were registered. The association of frailty with postoperative mortality was evaluated using multiple regression models. Likelihood ratio test was applied for goodness of fit.

Results

In total, 1084 patients were included in the cohort; unadjusted 30-day mortality was 20.2%. ECOG performance score was independently associated with 30-day mortality. Odds ratio for mortality was 1.70 (95% CI (1.0, 2.9)) in patients with ECOG performance score of 1, compared with 5.90 (95% CI (1.8, 19.0)) in patients with ECOG performance score of 4 (p < 0.01). Likelihood ratio test suggests improvement in fit of logistic regression modelling of 30-day postoperative mortality when including ECOG performance score as an explanatory variable.

Conclusions

This study found ECOG performance score to be independently associated with the postoperative 30-day mortality among patients undergoing high-risk emergency laparotomy. The utility of including functional performance in a preoperative risk assessment model of emergency laparotomy should be evaluated.
Determination of the available energy values and amino acid digestibility of Flammulina velutipes stem waste and its effects on carcass trait and meat quality fed to growing-finishing pigs
Authors: Liu Xuzhou , Zhang Bo , Liu Hansuo , Zhang Gang , Zhao Jinbiao , Liu Ling , Piao Xiangshu , Song Hui , Zhang Shuai , Li Yu
Published: May 2020

Background

Flammulina velutipes stem waste (FVS) is the by-product of mushroom industry. The objectives of this study were to determine the available energy and amino acid digestibility of FVS fed to pigs, and to evaluate the effects of dietary FVS inclusion on growth performance, biochemical profile of serum, fecal short chain fatty acid (SCFA) concentration, carcass traits, meat quality, intestinal morphology and microflora of pigs. In Exp. 1, twelve crossbred barrows with initial body weight (IBW) of 37.48 ± 4.31 kg were randomly allotted to 2 dietary treatments, including a corn basal diet and an experimental diet containing 24.35% FVS. In Exp. 2, twelve barrows fitted with an ileal T-cannula (IBW: 32.56 ± 1.67 kg) were randomly allotted to 2 dietary treatments, which included a N-free diet and an experimental diet containing 40.0% FVS. In Exp. 3, ninety growing pigs (IBW: 63.98 ± 6.89 kg) were allotted to 1 of 3 treatment diets for 63 d, including a basal diet and 2 experimental diets with 2.5% and 5% FVS, respectively.

Results

The digestible energy (DE) and metabolizable energy (ME) of FVS were 4.58 and 4.06 MJ/kg on dry matter basis, respectively, and the standardized ileal digestibility (SID) of indispensable AAs ranged from 17.50% to 59.47%. Pigs fed diets with 2.5% FVS showed no difference on average daily gain (ADG) and gain to feed ratio (G/F). Although dietary 5% FVS inclusion impaired apparent total tract digestibility (ATTD) of organic matter and gross energy, it elevated the SCFA concentration (P ≤ 0.04) in gut and antioxidant capacity in serum. In addition, dietary FVS inclusion depressed the backfat thickness (P = 0.03) in pigs. The longissimus dorsi muscle of pigs fed FVS revealed higher n-3 polyunsaturated fatty acid concentration and optimized fatty acid composition. Dietary 2.5% FVS inclusion also improved the intestinal development and health by increasing the villius height to crypt depth ratio (V/C) in jejunum (P < 0.01), and promoting microbial diversity and beneficial microbiota proliferation.

Conclusions

It is feasible to include moderate content of FVS as an unconventional fiber ingredient in diet of growing-finishing pigs.
Space use and habitat selection of an invasive mesopredator and sympatric, native apex predator
Authors: Wysong Michael L. , Hradsky Bronwyn A. , Iacona Gwenllian D. , Valentine Leonie E. , Morris Keith , Ritchie Euan G.
Published: May 2020

Background

Where mesopredators co-exist with dominant apex predators, an understanding of the factors that influence their habitat and space use can provide insights that help guide wildlife conservation and pest management actions. A predator’s habitat use is defined by its home range, which is influenced by its selection or avoidance of habitat features and intra- and inter-specific interactions within the landscape. These are driven by both innate and learned behaviour, operating at different spatial scales. We examined the seasonal home ranges and habitat selection of actively-managed populations of a native apex predator (dingo Canis dingo) and invasive mesopredator (feral cat Felis catus) in semi-arid Western Australia to better understanding their sympatric landscape use, potential interactions, and to help guide their management.

Methods

We used kernel density estimates to characterise the seasonal space use of dingoes and feral cats, investigate inter- and intra-species variation in their home range extent and composition, and examine second-order habitat selection for each predator. Further, we used discrete choice modelling and step selection functions to examine the difference in third-order habitat selection across several habitat features.

Results

The seasonal home ranges of dingoes were on average 19.5 times larger than feral cats. Feral cat seasonal home ranges typically included a larger proportion of grasslands than expected relative to availability in the study site, indicating second-order habitat selection for grasslands. In their fine-scale movements (third-order habitat selection), both predators selected for roads, hydrological features (seasonal intermittent streams, seasonal lakes and wetlands), and high vegetation cover. Dingoes also selected strongly for open woodlands, whereas feral cats used open woodlands and grasslands in proportion to availability.

Management recommendations

Based on these results, and in order to avoid unintended negative ecological consequences (e.g. mesopredator release) that may stem from non-selective predator management, we recommend that feral cat control focuses on techniques such as trapping and shooting that are specific to feral cats in areas where they overlap with apex predators (dingoes), and more general techniques such as poison baiting where they are segregated.
Low-chloride- versus high-chloride-containing hypertonic solution for the treatment of subarachnoid hemorrhage–related complications: The ACETatE (A low ChloriE hyperTonic solution for brain Edema) randomized trial
Authors: Sadan Ofer , Singbartl Kai , Kraft Jacqueline , Plancher Joao McONeil , Greven Alexander C. M. , Kandiah Prem , Pimentel Cederic , Hall C. L. , Papangelou Alexander , Asbury William H. , Hanfelt John J. , Samuels Owen
Published: May 2020

Background

Recent reports have demonstrated that among patients with subarachnoid hemorrhage (SAH) treated with hypertonic NaCl, resultant hyperchloremia has been associated with the development of acute kidney injury (AKI). We report a trial comparing the effect of two hypertonic solutions with different chloride contents on the resultant serum chloride concentrations in SAH patients, with a primary outcome aimed at limiting chloride elevation.

Methods

A low ChloridE hyperTonic solution for brain Edema (ACETatE) trial is a single-center, double-blinded, double-dummy, randomized pilot trial comparing bolus infusions of 23.4% NaCl and 16.4% NaCl/Na-acetate for the treatment of cerebral edema in patients with SAH. Randomization occurred when patients developed hyperchloremia (serum Cl− ≥ 109 mmol/L) and required hyperosmolar treatment.

Results

We enrolled 59 patients, of which 32 developed hyperchloremia and required hyperosmolar treatment. 15 patients were randomized to the 23.4% NaCl group, and 17 patients were randomized to the 16.4% NaCl/Na-acetate group. Although serum chloride levels increased similarly in both groups, the NaCl/Acetate group showed a significantly lower Cl− load at the end of the study period (978mEq vs. 2,464mEq, p < 0.01). Secondary outcome analysis revealed a reduced rate of AKI in the Na-acetate group (53.3% in the NaCl group vs. 11.8% in the Na-acetate group, p = 0.01). Both solutions had similar effects on ICP reduction, but NaCl/Acetate treatment had a more prominent effect on immediate post-infusion Na+ concentrations (increase of 2.2 ± 2.8 vs. 1.4 ± 2.6, (p < 0.01)). Proximal tubule renal biomarkers differed in concentration between the two groups.

Conclusions

Our pilot trial showed the feasibility and safety of replacing 23.4% NaCl infusions with 16.4% NaCl/Na-acetate infusions to treat cerebral edema in patients with SAH. The degree of hyperchloremia was similar in the two groups. 16.4% NaCl/Na-acetate infusions led to lower Cl− load and AKI rates than 23.4% NaCl infusions. Further multi-center studies are needed to corroborate these results.

Trial registration

clinicaltrials.gov # NCT03204955, registered on 6/28/2017
Nanosheet composed of gold nanoparticle/graphene/epoxy resin based on ultrasonic fabrication for flexible dopamine biosensor using surface-enhanced Raman spectroscopy
Authors: Hussein Mahmoud A. , El-Said Waleed A. , Abu-Zied Bahaa M. , Choi Jeong-Woo
Published: May 2020

Construction of a fast, easy and sensitive neurotransmitters-based sensor could provide a promising way for the diagnosis of neurological diseases, leading to the discovery of more effective treatment methods. The current work is directed to develop for the first time a flexible Surface-Enhanced Raman Spectroscopy (SERS) based neurotransmitters sensor by using the ultrasonic-assisted fabrication of a new set of epoxy resin (EPR) nanocomposites based on graphene nanosheets (GNS) using the casting technique. The perspicuous epoxy resin was reinforced by the variable loading of GNS giving the general formula GNS/EPR1–5. The designed products have been fabricated in situ while the perspicuous epoxy resin was formed. The expected nanocomposites have been fabricated using 3%, 5%, 10%, 15% and 20% GNS loading was applied for such fabrication process. The chemical, physical and morphological properties of the prepared nanocomposites were investigated by using Fourier transforms infrared spectroscopy, X-ray diffraction, Thermogravimetric analysis, Differential Thermal gravimetry, and field emission scanning electron microscopy methods. The GNS/EPR1–5 nanocomposites were decorated with a layer of gold nanoparticles (Au NPs/GNS/EPR) to create surface-enhanced Raman scattering hot points. The wettability of the Au NPs/GNS/EPR was investigated in comparison with the different nanocomposites and the bare epoxy. Au NPs/GNS/EPR was used as a SERS-active surface for detecting different concentrations of dopamine with a limit of detection of 3.3 µM. Our sensor showed the capability to detect low concentrations of dopamine either in a buffer system or in human serum as a real sample.
A case of reactive lymphoid hyperplasia of the liver in a patient with autoimmune hepatitis
Authors: Kanno Hiroki , Sakai Hisamune , Hisaka Toru , Kojima Satoki , Midorikawa Ryuta , Fukutomi Shogo , Nomura Yoriko , Goto Yuichi , Sato Toshihiro , Yoshitomi Munehiro , Kawahara Ryuichi , Okuda Koji
Published: May 2020

Background

Reactive lymphoid hyperplasia (RLH) of the liver is a benign disorder. It is usually observed in the skin, orbit, thyroid, lung, breast, or gastrointestinal tract, but rarely in the liver. Since the first report of RLH of the liver in 1981, only 75 cases have been described in the past literature. Herein, we report a case of RLH of the liver in a patient with autoimmune hepatitis (AIH), which was misdiagnosed as hepatocellular carcinoma (HCC) preoperatively and resected laparoscopically.

Case presentation

A 43-year-old Japanese woman with autoimmune hepatitis was followed up for 5 years. During her medical checkup, a hypoechoic nodule in segment 6 of the liver was detected. The nodule had been gradually increasing in size for 4 years. Abdominal ultrasound (US) revealed a round, hypoechoic nodule, 12 mm in diameter. Contrast-enhanced computed tomography (CT) demonstrated that the nodule was slightly enhanced in the arterial dominant phase, followed by perinodular enhancement in the portal and late phases. A magnetic resonance imaging (MRI) scan showed low signal intensity on the T1-weighted image (T1WI) and slightly high signal intensity on the T2-weighted image (T2WI). The findings of the Gd-EOB-DTPA-enhanced MRI were similar to those of contrast-enhanced CT. Tumor markers were all within the normal range. The preoperative diagnosis was HCC and a laparoscopic right posterior sectionectomy was performed. Pathological examination revealed that the nodular lesion was infiltrated by small lymphocytes and plasma cells, and germinal centers were present. Immunohistochemistry was positive for B celland T cell markers, indicating polyclonality.The final diagnosis was RLH of the liver.

Conclusions

The pathogenesis of RLH of the liver remains unknown, and a definitive diagnosis based on imaging findings is extremely difficult. If a small, solitary nodule is found in female patients with AIH, the possibility of RLH of the liver should be considered.
Signs, meanings and practices of people living with human t-cell lymphotropic virus type 1 or tropical spastic myelopathy
Authors: Santana Genildes Oliveira , Libório Ana Mary , Galvão Ana Verena , Pondé Milena Pereira , Sá Katia Nunes
Published: May 2020

Background

Human T-cell lymphotropic virus type 1 (HTLV-1) spreads silently in the world’s population and causes several syndromes. Among these, HTLV-1 associated myelopathy, also called tropical spastic paraparesis (HAM/TSP), affects the nervous system. It causes sensorimotor losses, spasticity, muscle weakness, voiding and sexual dysfunction, pain, and balance disorders. There is limited knowledge of the feelings, experiences, and coping mechanisms associated with this neglected disease. The objective of the present qualitative study was to investigate the signs, meanings, and practices of people with HAM/TSP, through narratives obtained from focus groups and individual semi-structured face-to-face interviews.

Results

Thirty-eight individuals diagnosed with HAM/TSP participated in the study. The following categories and subcategories emerged from the participants: Signs—physical signs, symptoms, and discovery of the disease; Meanings—reaction to diagnosis and knowledge of disease, fears, and expectations; Practices—daily life, leisure, religious, and treatment activities.

Conclusions

People with HAM/TSP suffer from symptoms that limit their social participation, and they are affected by complex and multidimensional feelings. This awareness can contribute to the implementation of public policies—focused on the real perspective of these patients—that provide more directed, empathic, and harmonious care for these individuals.
General-type proximal point algorithm for solving inclusion and fixed point problems with composite operators
Authors: Sow T. M. M.
Published: May 2020

The main purpose of this paper is to introduce a new general-type proximal point algorithm for finding a common element of the set of solutions of monotone inclusion problem, the set of minimizers of a convex function, and the set of solutions of fixed point problem with composite operators: the composition of quasi-nonexpansive and firmly nonexpansive mappings in real Hilbert spaces. We prove that the sequence xn which is generated by the proposed iterative algorithm converges strongly to a common element of the three sets above without commuting assumption on the mappings. Finally, applications of our theorems to find a common solution of some nonlinear problems, namely, composite minimization problems, convex optimization problems, and fixed point problems, are given to validate our new findings.
The prevalence of depression among Iranian infertile couples: an update systematic review and meta-analysis
Authors: Alimohamadi Yousef , Mehri Ahmad , Sepandi Mojtaba , Esmaeilzadeh Firooz , Rashti Roya
Published: May 2020

Background

Depression is a common mental disorder. Infertility can lead to depression. The current systematic review and meta-analysis were conducted to estimate the pooled prevalence of depression among Iranian infertile couples. Seven electronic databases (Google Scholar, MagIran, SID, Science Direct, PubMed, Scopus, Web of Science) were searched, up to August 2019, for relevant published studies. The pooled prevalence of depression also pooled mean of depression score was determined using a random-effects model with a 95% confidence interval (95% CI). All analyses performed using Stata ver11 (Stata Corporation, College Station, TX, USA). The 0.05 was considered a significant level.

The main body

Totally, 230 studies were retrieved and 31 studies included in the meta-analysis. The pooled prevalence of depression among infertile couples was about 35.3% (95 % CI 24.1–46.5), and the prevalence of depression among females and males was 48.7% (95% CI 24.0–73.3) and 9% (95% CI 0% to 23.7%), respectively.

Conclusions

Our findings suggest a high prevalence of depression in infertile couples. The results can highlight an important and growing mental disorder among infertile couples that may be overlooked.
Diffusion-weighted imaging in the evaluation of perianal fistula and abscess
Authors: Mohsen Laila Adel , Osman Nasr Mohamed
Published: May 2020

Background

Perianal fistulas are a common inflammatory condition of the anal canal and perianal tissue. The introduction of MRI in the evaluation of suspected perianal inflammation has greatly improved the surgical outcome of these patients as it allowed the direct visualization of anal sphincters, levator ani muscle, and the extent of the disease in relation to these vital structures. Diffusion-weighted imaging (DWI) has been under extensive research to evaluate whether it adds any value in the setting of perianal inflammation.

The aim of our study was to evaluate the visibility of perianal inflammation on DWI and evaluate the diffusion characteristics of perianal fistulas and abscesses and how accurately can DWI classify perianal disease.

Results

Mean age of patients was 37 ± 8.9 years old. The study included 30 fistulas and 15 abscesses. Seven patients had more than 1 fistula or fistula and abscess. Perianal abscesses were well visualized equally on DWI and T2W images and correctly classified by DWI, when compared to post-contrast images. Perianal fistulas without abscesses, on the other hand, had variable visibility scores. Although the visibility of these fistulas on DWI was generally less than T2W and combined DWI and T2W, yet this did not reach a significant level and it was not significantly different between positive and negative inflammatory groups. Combined DWI and T2W evaluation had the highest performance and accurately classified 97.8 % of perianal fistulas and abscesses, and only 1 case was misclassified (2.3%).

Conclusion

DWI had a good performance in the evaluation of perianal inflammatory disease. However, combined DWI and T2W evaluation had better performance which was not significantly different from combined T2W and post-contrast images.
PD-1 Blockade in Anaplastic Thyroid Carcinoma
Authors: Capdevila Jaume , Wirth Lori J. , Ernst Thomas , Ponce Aix Santiago , Lin Chia-Chi , Ramlau Rodryg , Butler Marcus O. , Delord Jean-Pierre , Gelderblom Hans , Ascierto Paolo A. , Fasolo Angelica , Führer Dagmar , Hütter-Krönke Marie Luise , Forde Patrick M. , Wrona Anna , Santoro Armando , Sadow Peter M. , Szpakowski Sebastian , Wu Hongqian , Bostel Geraldine , Faris Jason , Cameron Scott , Varga Andreea , Taylor Matthew
Published: May 2020

PURPOSE

Anaplastic thyroid carcinoma is an aggressive malignancy that is almost always fatal and lacks effective systemic treatment options for patients with BRAF-wild type disease. As part of a phase I/II study in patients with advanced/metastatic solid tumors, patients with anaplastic thyroid carcinoma were treated with spartalizumab, a humanized monoclonal antibody against the programmed death-1 (PD-1) receptor.

METHODS

We enrolled patients with locally advanced and/or metastatic anaplastic thyroid carcinoma in a phase II cohort of the study. Patients received 400 mg spartalizumab intravenously, once every 4 weeks. The overall response rate was determined according to RECIST v1.1.

RESULTS

Forty-two patients were enrolled. Adverse events were consistent with those previously observed with PD-1 blockade. Most common treatment-related adverse events were diarrhea (12%), pruritus (12%), fatigue (7%), and pyrexia (7%). The overall response rate was 19%, including three patients with a complete response and five with a partial response. Most patients had baseline tumor biopsies positive for PD-L1 expression (n = 28/40 evaluable), and response rates were higher in PD-L1–positive (8/28; 29%) versus PD-L1–negative (0/12; 0%) patients. The highest rate of response was observed in the subset of patients with PD-L1 ≥ 50% (6/17; 35%). Responses were seen in both BRAF-nonmutant and BRAF-mutant patients and were durable, with a 1-year survival of 52.1% in the PD-L1–positive population.

CONCLUSION

To our knowledge, this is the first clinical trial to show responsiveness of anaplastic thyroid carcinoma to PD-1 blockade.
Routine Intraoperative Inhaled Milrinone and Iloprost Reduces Inotrope Use in Patients Undergoing Cardiac Surgery: A Retrospective Cohort Pilot Study
Authors: Hu Xiaobo , Li Xiaoqiang , Boggett Stuart , Yang Yang , Chun-Ting Wang , Anstey James , Royse Alistair , Royse Colin
Published: May 2020

BACKGROUND:

Catecholamine inotropes are frequently used after cardiopulmonary bypass (CPB) but may have undesirable effects. The aim was to identify whether the routine use of inhaled pulmonary vasodilators might reduce the requirement for inotrope drugs after cardiac surgery.

METHODS:

Retrospective cohort study of sequential patients undergoing cardiac surgery at the Royal Melbourne Hospital performed by a single surgeon and anesthesia care team, within 14 months before and after routine implementation of inhaled pulmonary vasodilators, August 2017. Milrinone 4 mg and iloprost 20 µg were inhaled using a vibrating mesh nebulizer (Aerogen) before initiation of CPB and at chest closure. Other aspects of clinical management were unaltered over the time period. Two investigators blinded to each other extracted data from electronic and written medical records. The primary outcome was any use of inotropes in the perioperative period; a Fisher exact test was used to analyze any differences between the 2 groups. Demographic data, hemodynamic data, and use of inotropes and vasopressors were collected from induction of anesthesia to 36 hours postoperative in the intensive care unit (ICU). Hospital and ICU length of stay, cost, and complications were collected.

RESULTS:

Any use of inotropes was significantly lower with inhaled pulmonary dilators (62.5% vs 86.8%, odds ratio [95% confidence interval {CI}], 0.253 (0.083–0.764); P = .011), including intraoperative inotrope use (37.5% vs 86.8%, odds ratio [95% CI], 0.091 (0.03–0.275); P < .001). ICU length of stay was significantly lower with inhaled pulmonary dilators (45 hours, interquartile range [IQR], 27–65 vs 50 hours, IQR, 45–74; P = .026). There were no significant differences among major postoperative complications or costs between groups.

CONCLUSIONS:

Routine use of inhaled milrinone 4 mg and iloprost 20 µg before and after CPB is associated with reduced postoperative inotrope use.
A Guide to Understanding “State-of-the-Art” Basic Research Techniques in Anesthesiology
Authors: Obal Detlef , Wu Shaogen , McKinstry-Wu Andrew , Tawfik Vivianne L.
Published: May 2020

Perioperative medicine is changing from a “protocol-based” approach to a progressively personalized care model. New molecular techniques and comprehensive perioperative medical records allow for detection of patient-specific phenotypes that may better explain, or even predict, a patient’s response to perioperative stress and anesthetic care. Basic science technology has significantly evolved in recent years with the advent of powerful approaches that have translational relevance. It is incumbent on us as a primarily clinical specialty to have an in-depth understanding of rapidly evolving underlying basic science techniques to incorporate such approaches into our own research, critically interpret the literature, and improve future anesthesia patient care. This review focuses on 3 important and most likely practice-changing basic science techniques: next-generation sequencing (NGS), clustered regularly interspaced short palindromic repeat (CRISPR) modulations, and inducible pluripotent stem cells (iPSCs). Each technique will be described, potential advantages and limitations discussed, open questions and challenges addressed, and future developments outlined. We hope to provide insight for practicing physicians when confronted with basic science articles and encourage investigators to apply “state-of-the-art” technology to their future experiments.