bluuebunny/crossref_metadata_2025 huggingface dataset:
Altered redox regulation by Nrf2-Keap1 system in dendritic cells of systemic lupus erythematosus patients
Authors: Gautam Preeti , Kaur Gurjasmine , Tandon Ankit , Sharma Aman , Bhatnagar Archana
Published: August 2020

Systemic lupus erythematosus (SLE) is an autoimmune disorder associated with inflammation and multiple organ involvement. Individually, dendritic cells (DCs) and oxidative stress have been well discussed for their critical involvement in the pathogenesis of disease but the precise impact of oxidative stress on DCs in relation to SLE disease activity is yet to be scrutinized. Nuclear factor (erythroid-derived 2)-like 2 (Nrf2)/Kelch-like ECH-associated protein 1 (Keap1) pathway is the cellular mechanism to combat increased reactive oxygen species (ROS). The current study was framed in order to understand redox regulation in DCs along with an argument in context to disease activity. Here, 23 SLE patients along with 10 healthy controls were enrolled and disease activity was calculated as the recent change in SLEDAI score. We found the percentage of circulating plasmacytoid DCs (pDCs) was increased with an increase in disease activity. Altered DCs functionality along with disease activity was further supported with the differential concentration of Type I IFNs. The disease activity was positively associated with increased levels of ROS. A relevant reason for increased ROS was further explained with the decreased levels of transcription factor Nrf2. Hence, the present study suggests that SLE specific DCs displayed elevation in ROS and this outcome might be due to impaired free radical clearance by Nrf2. Correlation studies further established an association of disease activity with increased ROS, Type I IFNs levels and decreased activity of oxidative stress regulating enzymes.
Use and reporting of risk of bias tools in 825 systematic reviews of acupuncture: a cross-sectional study
Authors: Long Youlin , Wang Xin , Xiao Wenzhe , Chen Rui , Guo Qiong , Liu Jia , Shao Ruochen , Huang Jin , Du Liang
Published: August 2020

Objective:

To assess the use and reporting of risk of bias (RoB) tools in systematic reviews (SRs) of acupuncture.

Study design and setting:

We extracted and analyzed information relating to RoB in acupuncture SRs via Medline, Embase and the Chinese CNKI (Chinese National Knowledge Infrastructure), WanFang and VIP databases from their inception to 24 November 2017. Three subgroup analyses were used to check the influence of language, journal type and impact factor, following which we used descriptive analysis.

Results:

We included 825 acupuncture SRs, of which 48% used the Cochrane RoB tool. Only 36% used the latest version of the Cochrane Handbook (version 5.1.0 at time of writing) with higher proportions among Cochrane SRs (65%) versus non-Cochrane SRs (34%), and high impact factor journals (58%) versus low or no impact factor journals (28% and 38%, respectively). In the last decade, there were notable increases in the use of the Cochrane RoB tool and Cochrane Handbook version 5.1.0, of 43% and 19%, respectively. Chinese-language SRs demonstrated proportionally higher tendencies to report an incorrect Cochrane Handbook version, increasing by 14% in the last 5 years. Additionally, 7% SRs did not report any results, and only 10% reported relatively complete and adequate RoB assessment. Cochrane SRs reported more complete assessments than Chinese-language or non-Cochrane English-language SRs.

Conclusion:

Use and reporting of RoB tools were suboptimal. Proportionally, use of the Cochrane RoB tool and Cochrane Handbook version 5.1.0 was low but rising. Our results highlight the prevalence and concerns of using unsuitable tools and the issue of incomplete RoB reporting. RoB tool application requires further improvement.
Comparison of electroacupuncture and manual acupuncture for patients with plantar heel pain syndrome: a randomized controlled trial
Authors: Wang Weiming , Liu Yan , Jiao Ruimin , Liu Sixing , Zhao Jie , Liu Zhishun
Published: August 2020

Background:

Plantar heel pain syndrome (PHPS), also known as plantar fasciitis, affects millions of people worldwide. Electroacupuncture (EA) and manual acupuncture (MA) are the two acupuncture modalities frequently used for PHPS in the clinical setting. However, which modality is more effective has yet to be determined.

Objective:

To examine whether EA is more effective than MA with regards to pain relief for patients with PHPS.

Methods:

Participants were randomly assigned (1:1) to receive 12 treatment sessions of EA or MA over 4 weeks with 24 weeks of follow-up. The primary outcome was the proportion of treatment responders, defined as patients with at least a 50% reduction from baseline in the worst pain intensity experienced during the first steps in the morning after a 4-week treatment, measured using a visual analogue scale (VAS, 0–100; higher scores signify worse pain). Analysis was by intention-to-treat.

Results:

Ninety-two patients with a clinical diagnosis of PHPS were enrolled from 29 July 2018 through 28 June 2019. Of the patients, 78 (85%) completed the treatment and follow-up. The primary outcome occurred in 54.8% (23/42) of the EA group compared to 50.0% (21/42) of the MA group after the 4-week treatment (difference –4.76, 95% confidence interval, –26.10 to 16.57, P = 0.662). There were no significant between-group differences for any secondary outcomes after 4 weeks of treatment and at 16 weeks and 28 weeks of follow-up. There were no serious treatment-related adverse events in either group.

Conclusion:

Among patients with PHPS, EA did not have a better effect with respect to relieving pain intensity than MA at week 4, although both EA and MA appeared to have positive temporal effects, with decreased heel pain and improved plantar function.

Trial registration number:

ChiCTR1800016531 (Chinese Clinical Trial Registry).
Improving the Quality of Visualization Dashboards in Critical Care
Authors: Williams Asia A. , Jallo Jack , Yoo Erika J.
Published: August 2020

Intensive care units (ICUs) lack both standardized performance indicators to better understand the effectiveness of interventions and uniform platforms to present these indicators. The goal of this study was to identify ICU metrics meaningful to stakeholders to help guide the development of a local visualization dashboard. Individual ICU directors were interviewed to collate their input on metrics important to their units. These qualitative data were used to develop a dashboard draft, after which the authors surveyed 20 stakeholders from different hospital departments for feedback on its content and structure. The varied survey results reinforced the inherent difficulties of adapting previously developed measurement tools while also selecting ICU performance measures that are simultaneously widely accepted yet relevant to local practice. These results also call attention to the importance of interdisciplinary input in quality dashboard development, thereby enabling more successful implementation and utilization for ICU quality improvement.
Estimation and interrater reliability of pupillography by digital mobile app: Digital movil pupillography app validity
Authors: Hernández-Sierra Juan Francisco , Tellez-Quijada Fernanda , Hernández Gómez Carlos Alejandro , Hernández-Gómez Juan Francisco , Fonseca Leal Pilar
Published: August 2020

Objective:

The examination of pupillary light reflexes is widely employed to evaluate the autonomic system’s balance, ocular, and neurological conditions, typically evaluated by qualitative observation. To describe and evaluate the inter-rater reliability and agreement of pupillometric values obtained with a novel semi-automatic mobile pupillography app.

Methods:

Two examiners and two graders perform the measurements with an android app which corrects the device-face distance, measure the maximum contraction of the pupil, and calculates its slope, in a hospital room setting with three levels of environmental light intensity: <100, 101 to 200, and 201 to 300 lux, at 200, 400, 600, 900, 1200, and 1500 milliseconds.

Results:

Sixty healthy individuals, aged 18 to 45, were included; 85% had brown eyes. The reliability of the pupil/iris ratio had Ri = 70% to 88%, and bland Altman graphics show a uniform agreement. The pupillography curves show a similar slope at different light intensities, during the contraction phase.

Conclusion:

There were very good repeatability and inter-rater reproducibility of the measurements at average levels of illumination in examination rooms, even in dark-eyed people. This app provides a highly promising approach to pupillary measurements in clinical practice.
XEN 63 gel stent device in glaucoma surgery: A 5-years follow-up prospective study
Authors: Lavin-Dapena Cosme , Cordero-Ros Rosa , D’Anna Oriana , Mogollón Isabel
Published: August 2020

Purpose:

To evaluate the efficacy and safety of the XEN63 Gel Stent in patients with open-angle glaucoma (OAG).

Methods:

Prospective, nonrandomized, open-label, not-controlled, and single center study conducted on OAG patients who underwent glaucoma surgery with the XEN63 gel stent. The main outcome measure was intraocular pressure (IOP). Secondary end-points were number of topical ocular hypotensive drugs, percentage of patients achieving an IOP reduction ⩾20%, and treatment-related adverse events.

Results:

Eleven eyes from 11 patients were treated with XEN 63. Mean (95% confidence interval, CI) age was 78.8 (73.7–85.9). Two eyes (18.2%) underwent XEN alone, while nine eyes (81.8%) underwent combined XEN + cataract extraction (phacoemulsification). The median (95% CI) IOP reduction was 17.7% (−13.3% to 34.9%). At the end of the study 9 (81.8%) eyes had an IOP ⩽ 18 mm Hg, six of them without treatment. Six (54.6%) eyes obtained an IOP reduction ⩾20%. Compared to baseline, there was a significant reduction in the number of ocular hypotensive drugs ( p = 0.0039). There were no treatment-related serious adverse events. Early postoperative complications included diplopia (1), blood in endothelium (2), ocular hypertension (1), corneal edema (1), folds in Descemet’s membrane (1), and contact between the implant and the iris (1). All the adverse events were successfully solved without sequalae. One eye required bleb needling.

Conclusion:

The XEN63 implant significantly reduced both IOP and the amount of ocular hypotensive medications while maintaining a good safety profile.
Silicone oil-induced displacement of subretinal hemorrhage in age-related macular degeneration
Authors: Corbelli Eleonora , Iuliano Lorenzo , Fogliato Giovanni , Bandello Francesco , Codenotti Marco
Published: August 2020

Purpose:

To describe the use of silicone oil (SO) in combination with subretinal recombinant tissue plasminogen activator (rtPA) to achieve dislocation of large subretinal hemorrhage secondary to exudative age-related macular degeneration (AMD).

Methods:

A single-eye 81-year-old woman, known for exudative AMD, presented for a profound vision loss in her left eye since 7 days due to a massive subretinal hemorrhage. She promptly underwent standard three-port pars plana vitrectomy with subretinal injection of rtPA and SO tamponade.

Results:

The surgical technique showed favorable anatomical and functional outcomes, achieving a substantial peripheral displacement of blood and visual improvement.

Conclusion:

This report favorably supports the use of SO in adjunction to subretinal rtPA in selected cases of subretinal hemorrhage secondary to wet AMD.
Parent utilization of ImPACT intervention strategies is a mediator of proximal then distal social communication outcomes in younger siblings of children with ASD
Authors: Yoder Paul J , Stone Wendy L , Edmunds Sarah R
Published: August 2020

Younger siblings of children with autism spectrum disorders (HR-Sibs) are at elevated risk for social communication deficits and language delays. One way to mitigate this risk early, before these deficits and delays become clear or impairing, may be to equip parents to use the strategies taught through the Improving Parents as Communication Teachers (ImPACT) intervention. In this randomized control trial, 97 HR-Sibs (mean age 14 months) and their primary caregiver were randomized to either ImPACT or a business-as-usual control group. Our a priori, preregistered hypothesis was that parents’ participation in ImPACT training would indirectly attenuate younger siblings’ social communication challenges 9 months later by sequentially increasing parents’ use of ImPACT strategies immediately after the intervention phase and by improving children’s midpoint proximal skills (e.g. motor imitation or intentional communication). Results supported this prediction.

Lay abstract

Later born siblings of children with autism spectrum disorders (ASD) are at elevated risk for language delay or ASD. One way to manage this risk may be for parents to use techniques taught in Improving Parents as Communication Teachers (ImPACT) with the younger siblings during the period in which language delay and ASD may be too subtle to be diagnosed. ImPACT targets children’s play, imitation, and communication skills. Improvement in these skills may reduce the severity of language delays and social communication deficits associated with ASD. In this study, 97 younger siblings of children with ASD and their primary parents were randomly assigned to ImPACT or a control group. We measured whether parents used ImPACT teaching strategies and whether children used the skills that ImPACT targets. We also measured children’s later language ability and social communication skills. The results confirmed our predictions that parents’ use of ImPACT strategies improves language ability by improving children’s motor imitation and communication skills. Use of ImPACT also had a positive effect on children’s language delay and ASD symptoms, supporting the clinical value of the findings. The study’s methodological strengths make this one of the most rigorous tests of ImPACT and supports one way to manage the risk of language delay and ASD in younger siblings of children with ASD.
A Novel Angiographic Risk Score for Femoropopliteal Interventions
Authors: Iida Osamu , Takahara Mitsuyoshi , Soga Yoshimitsu , Fujihara Masahiko , Kawasaki Daizo , Hirano Keisuke , Choi Donghoon , Mano Toshiaki
Published: August 2020

Purpose

To present a novel angiographic scoring system that stratifies the risk of restenosis after endovascular therapy (EVT) to inform the decision to use paclitaxel-eluting devices in the femoropopliteal segment.

Materials and Methods

A prospective, multicenter registry including 1799 limbs of 1578 patients (mean age 74±9 years; 1090 men) with symptomatic peripheral artery disease undergoing intravascular ultrasound–supported femoropopliteal EVT was used as the basis for developing the angiographic score. Multivariable analysis identified baseline patient and limb characteristics associated with restenosis at 12 months. These risk factors for 12-month restenosis were explored using a generalized linear mixed model with a logit-link function in which the inter-institutional and inter-subject variability were treated as random effects. The multiple imputation method was adopted to address missing data. Results of the regression analysis are presented as the odds ratio (OR) with 95% confidence interval (CI).

Results

Twelve-month primary patency was estimated to be 65.1% (95% CI 62.7% to 67.5%). After multivariable analysis, distal reference vessel diameter per 1 mm (OR 0.71, 95% CI 0.62 to 0.81, p<0.001), lesion length per 10 cm (OR 1.39, 95% CI 1.19 to 1.62, p<0.001), and chronic total occlusion (OR 1.56, 95% CI 1.15 to 2.10, p=0.004) were independently associated with the 12-month restenosis risk, whereas baseline patient risk factors were not. Compared to bare nitinol stent implantation, plain angioplasty (OR 2.31, 95% CI 1.67 to 3.18, p<0.001) was independently associated with a higher risk of 12-month restenosis, while drug-eluting stents (OR 0.65, 95% CI 0.43 to 0.99, p=0.045) and stent-grafts (OR 0.24, 95% CI 0.12 to 0.50, p<0.001) were independently associated with a lower risk of 12-month restenosis. The angiographic score, which was developed by using the 3 angiographic factors but not the TransAtlantic Society Consensus II (TASC) class, was significantly and independently associated with 12-month restenosis.

Conclusion

The current study demonstrated a novel angiographic score for 12-month restenosis after femoropopliteal EVT in a real-world clinical practice. The developed score was significantly and independently associated with the 12-month restenosis risk, but the TASC class was not.
Long Noncoding RNA LUCAT1 Promotes Multiple Myeloma Cell Growth by Regulating the TGF-β Signaling Pathway
Authors: Liu Zhaoyu , Gao Hong , Peng Qing , Yang Yongheng
Published: August 2020

Objective:

Long noncoding RNAs (lncRNAs) are potential biomarkers for cancers. Nevertheless, the ability of long noncoding RNA lung cancer-associated transcript 1 in patients with multiple myeloma remains unknown. The purpose of this current study was to figure out its function in multiple myeloma.

Methods:

Firstly, the expression of long noncoding RNA lung cancer-associated transcript 1 in cancer or normal tissues and serum from patients with multiple myeloma and normal donors was detected. Secondly, the expression of long noncoding RNA lung cancer-associated transcript 1 was overexpressed or silenced in U266 and H929 cells, respectively to detect changes of proliferation and apoptosis in multiple myeloma in vitro. Subsequently, the expression of transforming growth factor-β signaling pathway-related proteins was detected by western blot analysis. Finally, the effect of long noncoding RNA lung cancer-associated transcript 1 on the growth of multiple myeloma cells in vivo was evaluated by tumor xenograft in nude mice.

Results:

Long noncoding RNA lung cancer-associated transcript 1 was increased in cancer tissues and serum of patients with multiple myeloma as well as multiple myeloma cells, which was correlated with dismal prognosis of patients with multiple myeloma. Overexpression of long noncoding RNA lung cancer-associated transcript 1 promoted the activity of U266 and H929 cells, while inhibition of long noncoding RNA lung cancer-associated transcript 1 suppressed the activity of U266 and H929 cells. In addition, long noncoding RNA lung cancer-associated transcript 1 was found to promote activation of the transforming growth factor-β signaling pathway. Furthermore, long noncoding RNA lung cancer-associated transcript 1 knockdown restricted the growth of multiple myeloma cells in vivo.

Conclusion:

This study suggests that suppression of long noncoding RNA lung cancer-associated transcript 1 inhibits the activation of transforming growth factor-β signaling pathway, thereby inhibiting the growth of multiple myeloma cells.
Men’s Vasectomy Knowledge, Attitudes, and Information-Seeking Behaviors in the Southern United States: Results From an Exploratory Survey
Authors: White Ashley L. , Davis Rachel E. , Billings Deborah L. , Mann Emily S.
Published: August 2020

Vasectomy is one of the few options men have to manage their reproductive capacity and take on a more equitable role in pregnancy prevention. While the method is underused throughout the United States, the southern states have a lower prevalence rate compared to the rest of the country. Existing survey research does not assess what men know or think about the procedure as a means of understanding why this is the case. We created and conducted an exploratory survey to assess men’s knowledge, attitudes, and information-seeking behaviors about vasectomy in the Southern United States. We used targeted Facebook advertising to recruit men ages 25–70 years living in 7 southern states to complete an online survey ( n = 397). Using regression analyses, we identify that participants who had a vasectomy knew more about the procedure than participants who had not. Participants who had not had a vasectomy had less positive attitudes about the procedure across all six attitude subscales compared to participants with vasectomies. We highlight potential avenues for future research to understand why this may be the case. Finally, the majority of participants knew someone who had had a vasectomy. This suggests that men disclose having a vasectomy to others. The interpersonal dynamics around vasectomy decision-making and disclosure remain unknown and a viable area for future research. Findings from this exploratory survey may be used by public health officials interested in implementing campaigns to increase knowledge about vasectomy and reduce stigma, which may encourage more positive attitudes about the procedure.
Cavernous carotid artery large aneurysm treated with a new flow diverter – Xcalibur aneurysm occlusion device (AOD)
Authors: Chauhan Richa Singh , Kathrani Nihar Vijay , Kulanthaivelu Karthik , Prasad Chandrajit , Gupta Arun Kumar
Published: August 2020

We report a case of an unruptured, symptomatic, large right cavernous internal carotid artery aneurysm successfully treated with a new balloon-expandable flow diverter – Xcalibur Aneurysm Occlusion Device (AOD). Follow up imaging performed at six months demonstrated complete exclusion of the aneurysm and regression in dimensions, resulting in resolution of mass effect and clinical improvement.
Are electoral autocracies better for the poor? Evidence from social assistance programs
Authors: Fails Matthew D.
Published: August 2020

Autocratic elections occur on uneven playing fields, yet their regular contestation compels ruling parties to pay attention to citizens’ demands. This claim is at the heart of research linking multiparty elections in autocracies to improvements in human development. Recent work, however, casts doubt on the theoretical and empirical basis of such claims. This paper addresses this debate by focusing specifically on the adoption of social assistance programs, an often theorized but seldom examined link in the chain connecting electoral autocracy with improvements in human development. I demonstrate that electoral autocracies are more likely to adopt these programs than closed autocracies and that the impact largely works through within-country changes in the presence of electoral authoritarianism. The results are consistent with the argument that such regimes are more responsive to citizens’ demands. However, they also remind researchers that the goal of such regimes is to win elections; there is little preventing them from crafting targeted social policies that secure the loyalty of the voting public but without the attendant improvements in broad measures of human development. I conclude with suggestions for how future research can better understand how authoritarian governance shapes development outcomes.
Painful conversations: Therapeutic chatbots and public capacities
Authors: Yang Misti
Published: August 2020

Today, conversations automated by algorithms and delivered via screens seek to heal wounds such as substance use disorders, wartime traumas, and a global pandemic. This article explores the relationship between painful conversations, automated discourse, and public action. By articulating what is lost when therapeutic conversations are had with artificial intelligence, I illustrate that painful, human conversations expand capacities—contextualizing, norm-building, and caring—that are necessary for the public reparation of wounds.
Exploring the Distressing Events and Perceptions of Support Experienced by Rural and Remote Nurses: A Thematic Analysis of National Survey Data
Authors: Jahner Sharleen , Penz Kelly , Stewart Norma J. , MacLeod Martha L. P.
Published: August 2020

Background:

Exposure to traumatic events is an occupational hazard with potential adverse psychological consequences. Previous research has focused mainly on urban practice settings; therefore, this study explored the distressing experiences encountered by rural/remote nurses and their perception of organizational support.

Methods:

Thematic analyses were conducted on open-ended data from a pan-Canadian survey of 3,822 regulated nurses, where 1,222 nurses (32%) reported experiencing an extremely distressing health care incident within the past 2 years. Among the respondents, 804 nurses (65%) reported that they did not receive psychological support from the organizations leadership following incidents.

Findings:

Three main themes regarding distressing events were: (a) involvement in profound events of death/dying, traumatic injury and loss, (b) experiencing or witnessing severe violence and/or aggression, and (c) failure to rescue or protect patients/clients. Three themes were identified regarding perceptions of organizational support including: (a) feeling well supported in the work setting with debriefing and reliance on informal peer support, (b) lack of acknowledgement and support from leaders on the nature and impact of distressing events, and (c) barriers influencing access to adequate mental health services in rural/remote settings.

Conclusion/Application to Practice:

Findings suggest that rural/remote nurses rely on informal, peer supports; there is a lack of organizational understanding of the potential risks to their psychosocial health and safety. They require more accessible, structured, appropriate, and timely supports within these settings. Increased understanding of the psychological hazards will assist organizations to establish workplace policies and practices designed to protect and support rural/remote nurses.
Ambulatory Blood Pressure Monitoring in HIV-Infected Patients: Usefulness for Cardiovascular Risk Assessment
Authors: Gómez-Berrocal Ana , De los Santos-Gil Ignacio , Abad-Pérez Daniel , Gutiérrez-Liarte Ángela , Ibáñez-Sanz Patricia , Sanz-Sanz Jesús , Suárez Carmen
Published: August 2020

Background:

There is a lack of consensus regarding the risk of hypertension in HIV-infected patients compared to the general population. Ambulatory blood pressure monitoring (ABPM) is the most accurate method for the hypertension diagnosis. Nevertheless, it is rarely used in HIV clinical care.

Materials and Methods:

All HIV-infected patients who underwent 24 hours ABPM were included. The agreement between office blood pressure (BP) readings and ABPM was analyzed. The rate of patients with masked hypertension (MH), isolated clinical hypertension, and nocturnal hypertension was obtained. Furthermore, it was analyzed if the differences between both methods may affect the cardiovascular risk (CVR) assessment.

Results:

A total of 116 patients were included. The κ coefficient between office BP and ABPM was 0.248. Over a quarter of the cohort was diagnosed with MH—25.8% (CI 95% 17.7%-34.0%), and 12% (CI 95%: 6.1%-16.1%) was diagnosed with ICH. Moreover, 19% of patients had hypertension exclusively during the night. The patients classified as low risk according to the CVR scores had a different diagnosis with ABPM than with office BP ( P < .001).

Conclusions:

The agreement between office BP and ABPM was low in HIV-infected patients. Ambulatory BP monitoring is useful in HIV-infected patients as a hypertension diagnosis method, especially among patients classified as low risk.
Management of Penetrating Maxillofacial Trauma as a Result of Industrial Accident: Report of an Unusual Case
Authors: Payami Ali , Montazem Andre H.
Published: August 2020

Facial injury as a result of an industrial accident from a stationary saw is rather uncommon; however, such an injury can result in significant damage to vital structures in the maxillofacial region and can even be life-threatening. Expeditious and prompt treatment at the time of such penetrating facial injury results in a favorable outcome. Appropriate care and proper treatment of a patient with penetrating facial injury includes immediate clinical assessment, diagnostic imaging, early wound exploration, removal of the foreign body, wound debridement, repair of hard and soft tissue, and adjunctive antimicrobial therapy.
A Case Report of a Buried Needle in an Oculofacial Trauma
Authors: Parulan Mariel Angelou A. , Sundar Gangadhara
Published: August 2020

We report a case of a 40-year-old East Asian male who presented with multiple facial lacerations and was referred to oculoplastics for periorbital assessment and wound repair. On wound closure, the needle of a 6-0 vicryl suture accidentally detached, and a mobile image intensifier was used which did not detect a foreign body. Surgical closure was done, but upon computed tomography scan of the face, an embedded foreign material was seen. Difficult secondary wound exploration was performed but with the aid of an intraoperative magnetic probe, the 11-mm needle was identified in entirety.
The Missing Link in Project Governance: Permeability and Influence of Governance Precepts on Decision Making in the Project Domain
Authors: Ferrer Paulo Sergio Scoleze , Araújo Galvão Graziela Darla , Monteiro de Carvalho Marly
Published: August 2020

This study aims to understand how the information about corporate governance precepts permeates the organization within the project environment and influences decision making. After analyzing 157 decisions, we concluded that there is a lack of robustness in the governance mechanisms to convey this information consistently. However, when there is strength to break the gap and reach the agent, the decisions made in the projects are 16.5 times more likely to be aligned with corporate governance. This finding reveals the importance of effective and consistent project governance mechanisms.
Germline genetic factors influence the outcome of interferon-α therapy in polycythemia vera
Authors: Jäger Roland , Gisslinger Heinz , Fuchs Elisabeth , Bogner Edith , Milosevic Feenstra Jelena D. , Weinzierl Jakob , Schischlik Fiorella , Gisslinger Bettina , Schalling Martin , Zörer Michael , Krejcy Kurt , Klade Christoph , Kralovics Robert
Published: August 2020

Interferon-α (IFN-α)–based treatments can induce hematologic and molecular responses (HRs and MRs, respectively) in polycythemia vera (PV); however, patients do not respond equally. Germline genetic factors have been implicated in differential drug responses. We addressed the effect of common germline polymorphisms on HR and MR after treatment of PV in the PROUD-PV and CONTINUATION-PV studies in a total of 122 patients who received ropeginterferon alfa-2b. Genome-wide association studies using longitudinal data on HR and MR over a 36-month follow-up did not reveal any associations at the level of genome-wide statistical significance. Furthermore, we performed targeted association analyses at the interferon lambda 4 (IFNL4) locus, well known for its role in hepatitis C viral clearance and recently reported to influence HR during treatment of myeloproliferative neoplasms. We did not observe any association of IFNL4 polymorphisms with HR in our study cohort; however, we demonstrated a statistically significant effect of the functionally causative IFNL4 diplotype (haplotype pair, including the protein-coding variants rs368234815/rs117648444) on MR (P = 3.91 × 10−4; odds ratio, 10.80; 95% confidence interval, 2.39-69.97) as reflected in differential JAK2V617F mutational burden changes according to IFNL4 diplotype status. Stratification of patients with PV based on IFNL4 functionality may allow for optimizing patient management during IFN-α–based therapy.
Complement C3 and allergic asthma: a cohort study of the general population
Authors: Vedel-Krogh Signe , Rasmussen Katrine L. , Nordestgaard Børge G. , Nielsen Sune F.
Published: August 2020

Complement C3 plays a role in asthma development and severity. We tested the hypothesis that high plasma complement C3 concentration is associated with high risks of asthma hospitalisation and exacerbation.

We prospectively assessed the risk of asthma hospitalisation in 101 029 individuals from the Copenhagen General Population Study with baseline measurements of plasma complement C3, and genotyped for rs1065489, rs429608 and rs448260 determining levels of complement C3. Risk of asthma exacerbation was further assessed in 2248 individuals with allergic asthma.

The multivariable adjusted hazard ratio of asthma hospitalisation was 1.23 (95% CI 1.04–1.45) for individuals in the highest tertile (>1.19 g·L−1) of plasma complement C3 compared with those in the lowest tertile (<1.03 g·L−1). TheC3rs448260 genotype was associated with risk of asthma hospitalisation with an observed hazard ratio of 1.17 (95% CI 1.06–1.28) for the CC genotype compared with the AA genotype. High plasma complement C3 was associated with high levels of blood eosinophils and IgE (p for trends ≤6×10−9), but only theSKIV2Lrs429608 genotype was positively associated with blood eosinophil count (p=3×10−4) and IgE level (p=3×10−4). In allergic asthma, the multivariable adjusted incidence rate ratio for risk of exacerbation was 1.69 (95% CI 1.06–2.72) for individuals in the highest plasma complement C3 tertile (>1.24 g·L−1)versusthe lowest (<1.06 g·L−1).

In conclusion, a high concentration of plasma complement C3 was associated with a high risk of asthma hospitalisation in the general population and with a high risk of asthma exacerbation in individuals with allergic asthma. Our findings support a causal role of the complement system in asthma severity.
Transbronchial cryobiopsy increases diagnostic confidence in interstitial lung disease: a prospective multicentre trial
Authors: Hetzel Jürgen , Wells Athol U. , Costabel Ulrich , Colby Thomas V. , Walsh Simon L.F. , Verschakelen Johny , Cavazza Alberto , Tomassetti Sara , Ravaglia Claudia , Böckeler Michael , Spengler Werner , Kreuter Michael , Eberhardt Ralf , Darwiche Kaid , Torrego Alfons , Pajares Virginia , Muche Rainer , Musterle Regina , Horger Marius , Fend Falko , Warth Arne , Heußel Claus Peter , Piciucchi Sara , Dubini Alessandra , Theegarten Dirk , Franquet Tomas , Lerma Enrique , Poletti Venerino , Häntschel Maik
Published: August 2020

Introduction

The accurate diagnosis of individual interstitial lung diseases (ILD) is often challenging, but is a critical determinant of appropriate management. If a diagnosis cannot be made after multidisciplinary team discussion (MDTD), surgical lung biopsy is the current recommended tissue sampling technique according to the most recent guidelines. Transbronchial lung cryobiopsy (TBLC) has been proposed as an alternative to surgical lung biopsy.

Methods

This prospective, multicentre, international study analysed the impact of TBLC on the diagnostic assessment of 128 patients with suspected idiopathic interstitial pneumonia by a central MDTD board (two clinicians, two radiologists, two pathologists). The level of confidence for the first-choice diagnoses were evaluated in four steps, as follows: 1) clinicoradiological data alone; 2) addition of bronchoalveolar lavage (BAL) findings; 3) addition of TBLC interpretation; and 4) surgical lung biopsy findings (if available). We evaluated the contribution of TBLC to the formulation of a confident first-choice MDTD diagnosis.

Results

TBLC led to a significant increase in the percentage of cases with confident diagnoses or provisional diagnoses with high confidence (likelihood ≥70%) from 60.2% to 81.2%. In 32 out of 52 patients nondiagnostic after BAL, TBLC provided a diagnosis with a likelihood ≥70%. The percentage of confident diagnoses (likelihood ≥90%) increased from 22.7% after BAL to 53.9% after TBLC. Pneumothoraces occurred in 16.4% of patients, and moderate or severe bleeding in 15.7% of patients. No deaths were observed within 30 days.

Interpretation

TBLC increases diagnostic confidence in the majority of ILD patients with an uncertain noninvasive diagnosis, with manageable side-effects. These data support the integration of TBLC into the diagnostic algorithm for ILD.
IMPARO: inferring microbial interactions through parameter optimisation
Authors: Vidanaarachchi Rajith , Shaw Marnie , Tang Sen-Lin , Halgamuge Saman
Published: August 2020

Background

Microbial Interaction Networks (MINs) provide important information for understanding bacterial communities. MINs can be inferred by examining microbial abundance profiles. Abundance profiles are often interpreted with the Lotka Volterra model in research. However existing research fails to consider a biologically meaningful underlying mathematical model for MINs or to address the possibility of multiple solutions.

Results

In this paper we present IMPARO, a method for inferring microbial interactions through parameter optimisation. We use biologically meaningful models for both the abundance profile, as well as the MIN. We show how multiple MINs could be inferred with similar reconstructed abundance profile accuracy, and argue that a unique solution is not always satisfactory. Using our method, we successfully inferred clear interactions in the gut microbiome which have been previously observed in in-vitro experiments.

Conclusions

IMPARO was used to successfully infer microbial interactions in human microbiome samples as well as in a varied set of simulated data. The work also highlights the importance of considering multiple solutions for MINs.
Correction to: A 2-Cys peroxiredoxin gene from Tamarix hispida improved salt stress tolerance in plants
Authors: Wang Yuanyuan , Liu Zhongyuan , Wang Peilong , Jiang Bo , Lei Xiaojin , Wu Jing , Dong Wenfang , Gao Caiqiu
Published: August 2020

An amendment to this paper has been published and can be accessed via the original article.
Intrathecal morphine is associated with reduction in postoperative opioid requirements and improvement in postoperative analgesia in patients undergoing open liver resection
Authors: Tang Jefferson , Churilov Leonid , Tan Chong Oon , Hu Raymond , Pearce Brett , Cosic Luka , Christophi Christopher , Weinberg Laurence
Published: August 2020

Background

Our study aimed to test the hypothesis that the addition of intrathecal morphine (ITM) results in reduced postoperative opioid use and enhanced postoperative analgesia in patients undergoing open liver resection using a standardized enhanced recovery after surgery (ERAS) protocol with multimodal analgesia.

Methods

A retrospective analysis of 216 adult patients undergoing open liver resection between June 2010 and July 2017 at a university teaching hospital was conducted. The primary outcome was the cumulative oral morphine equivalent daily dose (oMEDD) on postoperative day (POD) 1. Secondary outcomes included postoperative pain scores, opioid related complications, and length of hospital stay. We also performed a cost analysis evaluating the economic benefits of ITM.

Results

One hundred twenty-five patients received ITM (ITM group) and 91 patients received usual care (UC group). Patient characteristics were similar between the groups. The primary outcome - cumulative oMEDD on POD1 - was significantly reduced in the ITM group. Postoperative pain scores up to 24 h post-surgery were significantly reduced in the ITM group. There was no statistically significant difference in complications or hospital stay between the two study groups. Total hospital costs were significantly higher in the ITM group.

Conclusion

In patients undergoing open liver resection, ITM in addition to conventional multimodal analgesic strategies reduced postoperative opioid requirements and improved analgesia for 24 h after surgery, without any statistically significant differences in opioid-related complications, and length of hospital stay. Hospital costs were significantly higher in patients receiving ITM, reflective of a longer mandatory stay in intensive care.

Trial registration

Registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) under ACTRN12620000001998.
Safety and bactericidal efficacy of cold atmospheric plasma generated by a flexible surface Dielectric Barrier Discharge device against Pseudomonas aeruginosa in vitro and in vivo
Authors: Dijksteel Gabrielle S. , Ulrich Magda M. W. , Vlig Marcel , Sobota Ana , Middelkoop Esther , Boekema Bouke K. H. L.
Published: August 2020

Background

Cold atmospheric plasma (CAP), which is ionized gas produced at atmospheric pressure, could be a novel and potent antimicrobial therapy for the treatment of infected wounds. Previously we have shown that CAP generated with a flexible surface Dielectric Barrier Discharge (sDBD) is highly effective against bacteria in vitro and in ex vivo burn wound models. In the current paper, we determined the in vitro and in vivo safety and efficacy of CAP generated by this sDBD device.

Methods

The effect of CAP on DNA mutations of V79 fibroblasts was measured using a hypoxanthine–guanine-phosphoribosyltransferase (HPRT) assay. Furthermore, effects on cell proliferation, apoptosis and DNA damage in ex vivo burn wound models (BWMs) were assessed using immunohistochemistry. Next, 105 colony forming units (CFU) P. aeruginosa strain PAO1 were exposed to CAP in a 3D collagen-elastin matrix environment to determine the number of surviving bacteria in vitro. Finally, rat excision wounds were inoculated with 107 CFU PAO1 for 24 h. The wounds received a single CAP treatment, repeated treatments on 4 consecutive days with CAP, 100 µL of 1% (wt/wt) silver sulfadiazine or no treatment. Wound swabs and punch biopsies were taken to determine the number of surviving bacteria.

Results

Exposure of V79 fibroblasts to CAP did not increase the numbers of mutated colonies. Additionally, the number of proliferative, apoptotic and DNA damaged cells in the BWMs was comparable to that of the unexposed control. Exposure of PAO1 to CAP for 2 min resulted in the complete elimination of bacteria in vitro. Contrarily, CAP treatment for 6 min of rat wounds colonized with PAO1 did not effectively reduce the in vivo bacterial count.

Conclusions

CAP treatment was safe but showed limited efficacy against PAO1 in our rat wound infection model.
A new method for the inoculation of Phytophthora palmivora (Butler) into cacao seedlings under greenhouse conditions
Authors: Delgadillo-Durán Paola , Soto-Suárez Mauricio , Rodriguez-Polanco Leonora , Carrero-Gutierrez Martha , Torres-Rojas Esperanza , Yockteng Roxana
Published: August 2020

Background

The black pod disease affects cacao plantations worldwide; it is caused by the oomycete species of the genusPhytophthora. The resistance of cacao plants to the black pod is commonly evaluated by artificial inoculation of the pathogen and the monitoring of the disease symptoms. However, it is difficult to identify resistant plants because the commonly used methods for the inoculation of the pathogens produce inconsistent results. Therefore, this study aimed to develop an efficient and reliable method to evaluate the resistance ofTheobroma cacaoseedlings to the infection byPhytophthora palmivora.

Results

Seedlings of different cacao genotypes were inoculated withP. palmivoraunder greenhouse conditions using the previously reported inoculation methods and a newly proposed method, the agar–water solution method. While none of the previously reported methods was effective, the agar–water solution method ensured a 100% seedling infection under greenhouse conditions. The proposed agar–water methodology is fast, simple and reproducible. Furthermore, the evaluation of this method in susceptible (CCN-51) and tolerant (SCA-6)T. cacaogenotypes produced the expected contrasting results.

Conclusions

The agar–water solution method presented in this study is an efficient alternative inoculation protocol for the identification of cacao genotypes that are resistant to black pod under greenhouse conditions.
Coexistence of recurrent chromosomal abnormalities and the Philadelphia chromosome in acute and chronic myeloid leukemias: report of five cases and review of literature
Authors: Gong Jin-Ying , Zhang Zhen-Hao , Zhang Wei , Wang Hui-Jun , Feng Xiao-Fang , Zhou Ji , Zhu Guo-Qing
Published: August 2020

Progression of chronic myelogenous leukemia (CML) is frequently accompanied by cytogenetic evolution. Additional genetic abnormalities are seen in 10–20% of CML cases at the time of diagnosis, and in 60–80% of cases of advanced disease. Unbalanced chromosomal changes such as an extra copy of the Philadelphia chromosome (Ph), trisomy 8, and i(17)(q10) are common. Balanced chromosomal translocations, such as t(3;3), t(8;21), t(15;17), and inv(16) are typically found in acute myeloid leukemia, but rarely occur in CML. Translocations involving 11q23, t(8;21), and inv(16) are relatively common genetic abnormalities in acute leukemia, but are extremely rare in CML. In the literature to date, there are at least 76 Ph+ cases with t(3;21), 47 Ph+ cases with inv(16), 16 Ph+ cases with t(8;21), and 9 Ph+ cases with t(9;11). But most of what has been published is now over 30 years old, without the benefit of modern immunophenotyping to confirm diagnosis, and before the introduction of treatment regimes such as TKI. In this study, we explored the rare concomitant occurrence of coexistence current chromosomal translocation and t(9;22) in CML or acute myeloid leukemia (AML).
Comparison of freshly cultured versus freshly thawed (cryopreserved) mesenchymal stem cells in preclinical in vivo models of inflammation: a protocol for a preclinical systematic review and meta-analysis
Authors: Dave Chintan , McRae Andrea , Doxtator Emily , Mei Shirley H. J. , Sullivan Katrina , Wolfe Dianna , Champagne Josee , McIntyre Lauralyn
Published: August 2020

Background

Mesenchymal stem cells (MSCs) are multipotent cells that demonstrate therapeutic potential for the treatment of acute and chronic inflammatory-mediated conditions. Especially for acute conditions, it is critical to have a readily available freshly thawed (cryopreserved) MSC product for rapid administration. Although controversial, some studies suggest that MSCs may lose their functionality with cryopreservation which in turn could render them non-efficacious.

Objective

In controlled preclinical in vivo models of inflammation, to determine if there are differences in surrogate measures of preclinical efficacy between freshly cultured and freshly thawed MSCs

Methods/design

A systematic search for pre-clinical in vivo inflammatory model studies will compare freshly cultured to freshly thawed MSCs from any source. The primary outcomes will include measures of in vivo preclinical efficacy; secondary outcomes will include measures of in vitro MSC potency. Electronic searches for MEDLINE and EMBASE will be constructed and reviewed by the Peer Review of Electronic Search Strategies (PRESS) process. If applicable, study outcomes will be meta-analyzed using a random effects model. Risk of bias will be assessed by the SYRCLE “Risk of Bias” assessment tool for preclinical in vivo studies.

Discussion

The results of this systematic review will provide translational scientists, clinical trialists, health regulators, and the clinical and public community with the current pre-clinical evidence base related to the efficacy and potency of freshly cultured versus freshly thawed MSCs, help identify evidence gaps, and guide future related research.

Systematic review registration

Protocol is submitted to PROSPERO for registration (pending confirmation) and will be submitted to Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies (CAMARADES) for public posting.