bluuebunny/crossref_metadata_2025 huggingface dataset:
Synthesis and properties of a novel silicon-containing phthalonitrile resin and its quartz-fiber-reinforced composites
Authors: Hu Junjie , Hu Yanhong , Deng Shi Feng , Zhou Jia li , Jiang Ning , Zhu Yi , Sun Ming
Published: June 2020

A novel silicon-containing phthalonitrile monomer named bis(4-(4′-(4′-phenoxy)phenyl)phenyl)dimethylsilane phthalonitrile (SiBPPN) was successfully designed and synthesized. The chemical structure was characterized by proton nuclear magnetic resonance and Fourier transform infrared (FTIR) analyses, and its molecular weight was determined by mass spectrometry. Its melting point is lower than that of 4,4′-bis(3,4-dicyanophenoxy)biphenyl (BPPN), which has no silicon atom, and its solubility is also much better than that of BPPN. The curing behavior of SiBPPN was studied by differential scanning calorimetry and FTIR analyses in detail. The thermal and thermomechanical properties of the polymer and laminate were studied by thermogravimetric analysis and dynamic mechanical analysis. The results show that the cured SiBPPN (c-SiBPPN) possesses excellent thermal and mechanical properties. Under nitrogen atmosphere, its residual weight ratio at 800°C is 81.5% and the 5% thermal degradation temperature is 546°C. In addition, quartz-fiber (QF)-reinforced c-SiBPPN composites exhibit mechanical properties superior to those of QF-reinforced cured BPPN composites. The interlaminar shear strength and bending strength of the composite are 30.44 and 389 MPa at room temperature, and the interlaminar shear strength and bending strength of the composite are 22.25 and 339 MPa at 300°C.
Cinnamomum cassia ameliorates Ni-NPs-induced liver and kidney damage in male Sprague Dawley rats
Authors: Iqbal S , Jabeen F , Peng C , Ijaz MU , Chaudhry AS
Published: June 2020

Nickel nanoparticles (Ni-NPs) have been widely used in various industries related to electronics, ceramics, textiles, and nanomedicine. Ambient and occupational exposure to Ni-NPs may bring about potential detrimental effects on animals and humans. Thus, there is a growing effort to identify compounds that can ameliorate NPs-associated pathophysiologies. The present study examined Cinnamomum cassia ( C. cassia) bark extracts (CMBE) for its ameliorative activity against Ni-NPs-induced pathophysiological and histopathological alterations in male Sprague Dawley rats. The biochemical analyses revealed that dosing rats with Ni-NPs at 10 mg/kg/body weight (b.w.) significantly altered the normal structural and biochemical adaptations in the liver and kidney. Conversely, supplementations with CMBE at different doses (225, 200, and 175 mg/kg/b.w. of rat) ameliorated the altered blood biochemistry and reduced the biomarkers of liver and kidney function considerably ( p < 0.05) in a dose-dependent manner. However, the best results were at 225 mg/kg/b.w. of rat. The study provided preliminary information about the protective effect of C. cassia against Ni-NPs indicated liver and kidney damages. Future investigations are needed to explore C. cassia mechanism of action and isolation of single constituents of C. cassia to assess their pharmaceutical importance accordingly.
Aspirations held by young adults with intellectual disabilities and their mothers
Authors: McMahon Mary , Moni Karen , Cuskelly Monica , Lloyd Jan , Jobling Anne
Published: June 2020

This study reports on Australian small-scale exploratory descriptive research into how young people with intellectual disability and their families construct their futures. The aims of this research were to (a) better understand the future aspirations held by young adults with intellectual disability and their parents, (b) identify enablers and barriers to the achievement of these aspirations, and (c) provide insights for career practitioners who support young people with intellectual disability and their parents to achieve their personal and career goals. Participants were four young people with intellectual disabilities aged between 18 and 30 years and their mothers. Data were collected through semi-structured interviews and analysed thematically. Results provide a nuanced understanding of the issues facing young people with intellectual disabilities and their families in constructing their futures. Suggestions are offered that can inform career development practice and policy.
First-Trimester Platelet Count as a Predictive Biomarker for Neonatal Birth Weight Among Pregnant Women at Advanced Maternal Age
Authors: Peng You-Fan , Wei Qiong , Sun Jin-Fang , Li Ling
Published: June 2020

The aim of this study was to investigate the association between first-trimester platelet count and neonatal birth weight in pregnant woman at advanced maternal age. Our study included 148 pregnancy women of advanced maternal age, the clinical and laboratory materials were retrospective obtained from medical record system. The neonatal birth weight was positively correlated with maternal body mass index and fetus gestational age ( r = 0.332, P < .001; r = 0.469, P < .001), even more interestingly, the neonatal birth weight was positively correlated with first-trimester platelet count in pregnant women of advanced maternal age ( r = 0.203, P = .013). Multiple linear regression analysis revealed that neonatal birth weight had an independently association with first-trimester platelet count in pregnant women of advanced maternal age (multiple-adjusted r values 0.167, P = .013). First-trimester platelet count is positively associated with neonatal birth weight, suggesting that first-trimester platelet count may be a predictive biomarker for neonatal birth weight in pregnant women of advanced maternal age.
Serum Lipid Oxidative Stress Products as Risk Factors Are the Candidate Predictive Biomarkers for Human Abdominal Aortic Aneurysms
Authors: Shi Feng , Ma Changcheng , Ji Chao , Li Mu , Liu Xun , Han Yanshuo
Published: June 2020

This research was designed to determine the association of serum lipid peroxidation products with disease severity in patients with abdominal aortic aneurysm (AAA). In total, 76 pairs of AAA cases as well as matched controls were enrolled in our research using propensity score matching (PSM). And their malondialdehyde (MDA), lipid hydroperoxide (LPO), and glutathione peroxidase (GSH-Px) levels were also detected through enzyme-linked immunosorbent assay (ELISA). Additionally, the relative clinical data of enrolled participants were extracted. The serum biomarker concentrations were measured in 76 patients with AAAs (diameter between 30 and 54 mm, n = 54; diameter ≥55 mm, n = 22) and 76 control patients from observational cohort study. After PSM adjustment for clinical variables, including age, gender, heart ratio, body mass index, smoking, hypertension, diabetes mellitus, coronary heart disease, and stroke, the serum MDA and LPO among AAA cases were remarkably increased compared with those from the normal patients. Inversely, serum GSH-Px was significantly decreased in patients with AAA compared to the control group. Besides, the serum levels of MDA and LPO were independently associated with AAA risk. Typically, there was significantly positive correlation between MDA level and LPO level (R = 0.358) but negative correlation of MDA level with GSH-Px (R = -0.203) level in patients with AAA. Meanwhile, the area under the receiver operating characteristic curve was 0.965 when MDA was used to diagnose AAA, and the optimal threshold value was 0.242 nmol/mL. Moreover, serum MDA level was significantly increased in cases with rupture AAA compared to those in selective AAA cases. Logistic regression analysis suggested that a higher serum MDA level indicated an elevated risk of AAA rupture (odds ratio = 2.536; 95% CI: 1.037-6.203; P =0.041). Our present findings suggest that serum peroxidation contents were evidently changed among AAA cases. Serum MDA and LPO concentrations could be used to predict disease severity in patients with AAA. Moreover, serum MDA may serve as the candidate biomarker for diagnosis of AAA and accurate identification of increased risks of AAA rupture.
Factors affecting operative time during ureteroscopy and stone treatment and its effect on outcomes: retrospective results over 6.5 years
Authors: Whitehurst Lily , Pietropaolo Amelia , Geraghty Robert , Kyriakides Rena , Somani Bhaskar K.
Published: June 2020

Background:

We aimed to evaluate operative time with the outcomes of ureteroscopy (URS) and investigate the relationship between these factors, and assess if longer operative times were associated with a higher risk of complications.

Methods:

We retrospectively audited consecutive cases of URS done between March 2012 and June 2018. Data were collected for operative times, patient demographics, stone parameters, stent insertions, use of ureteric access sheath, length of stay, stone-free rate (SFR) and complications. Statistical analysis was performed using IBM SPSS version 24.

Results:

Over 6.5 years, 736 patients with a male:female ratio of 1.8:1 and a mean age of 54.7 years (range: 2–91 years), underwent 860 URS and stone treatment procedures. The mean operative time was 43.5 min (range: 8–160 min), with a stone size of 12.3 mm (range: 3–100 mm) and access sheath was used in 35.8%. The initial and final SFR was 86% and 92.5%, respectively, and 85.6% ( n = 736) patients were discharged the same day of procedure. Treatment of multiple renal stones, ureteric and renal stones, large stones, use of access sheath and post-operative stent were all associated with longer operative times ( p <0.001). Patients who were stone free and those having day-case procedures had shorter operative times ( p <0.001). There were 27 (3.2%) Clavien I/II complications and 8 (0.9%) Clavien ⩾III complications. Clavien score ⩾III ( p = 0.028) and infectious complications ( p <0.001) had significantly longer operative times.

Conclusion:

Patients with shorter operative times have a higher chance of being discharged home the same day without a post-operative stent. Higher operative times are associated with high-grade, especially infection-related, complications.
The good citizen: Revisiting moral motivations for introducing historical consciousness in history education drawing on the writings of Gadamer
Authors: Edling Silvia , Sharp Heather , Löfström Jan , Ammert Niklas
Published: June 2020

Historical consciousness is regarded as an important means to stimulate moral citizens through history education. This article conceptually examines the moral dimension associated with historical consciousness by revisiting the paradigm wars between natural science based on positivism and human and social sciences during the 1960s–1990s as expressed through the voice of Gadamer. More specifically, the article explores: (1) the moral arguments that Gadamer put forward for introducing historical consciousness and (2) the epistemological and ontological building blocks for approaching morality in history education that his arguments brought to the fore. In general, moral consciousness in relation to historical consciousness draws attention to: (a) people’s life conditions, (b) that moral reasoning and practice are influenced by feelings and reason, (c) that reflections on past events can help to interpret our ways of being towards others in the present and future, (d) that a plurality of people, thoughts and history are important to acknowledge and (e) that every person is part of creating history and responsible for weaving the past/present/future web in ways that acknowledge others.
A progressive stage IIIB melanoma treated with oncolytic ECHO-7 virus: A case report
Authors: Sorokins Vladimirs , Tilgase Andra , Olmane Evija , Isajevs Sergejs , Zablocka Tatjana , Rasa Agnija , Alberts Pēteris
Published: June 2020

Melanoma is an aggressive skin cancer form with a grave prognosis. Current results suggest that oncolytic virus treatment of melanoma has a high therapeutic potential. ECHO-7 (Rigvir) is the first oncolytic virus registered in Latvia. A female patient was diagnosed with stage IIIB melanoma in December 2012, over 9.4 years ago. After the first excision and re-excision, the patient had several recurrences and disease progressions. After the patient had received surgical treatment in 2014, ECHO-7 virus oncolytic virotherapy was started. Since then, the patient has experienced only one more disease progression episode in May 2015 and has been stable for over 60 months. The patient has not received any other treatment than surgery and oncolytic virotherapy. No severe adverse events have been reported during virotherapy. The present case suggests that ECHO-7 virotherapy is an effective treatment of skin melanoma.
Community health alliances as social enterprises that digitally engage citizens and integrate services: A case study in Southwestern Sydney (protocol)
Authors: Godinho Myron Anthony , Ashraf Md Mahfuz , Narasimhan Padmanesan , Liaw Siaw-Teng
Published: June 2020

South Western Sydney (SWS) is one of the fastest growing regions in the state of New South Wales (Australia). Much of the population live in local government areas (LGAs) with levels of disadvantage higher than the state average, with a predominance of non-communicable and chronic diseases that are typically associated with age-related and behavioural factors. This necessitates the management of social determinants of health through the integrated provision of primary and social care. The SWS Local Health District and Primary Health Network is exploring the potential of community health alliances (CHAs) as an innovative approach to support the provision of integrated health services. CHAs are a population health approach for addressing health challenges faced by people who share a common area of residence, sociocultural characteristic or health need, and are characterised by a shared mission, shared resource needs and acquiring/developing necessary organisational knowledge and skills. We explore how CHAs operate as social enterprises that utilise digital health and citizen engagement to deliver integrated people-centred health services (IPCHS) by conducting two case studies of CHAs operating in SWS: in Wollondilly and Fairfield LGAs. Using this approach, we aim to unpack the conceptual convergence that enables social enterprises to utilise digital health interventions and citizen engagement strategies to co-produce IPCHS with a view to developing theory and a framework for engaging digital citizens in integrated primary health care via social enterprise.
Listening to Women’s Voices: Using an Adapted Photovoice Methodology to Access Their Emotional Responses to Diagnosis and Treatment of Breast Cancer
Authors: Capewell Carmel , Ralph Sue , Symonds Melissa
Published: June 2020

Introduction:

The emotional impact of a diagnosis of breast cancer in women and listening to their affective needs is not widely reported in the literature. Recent policies globally emphasize the importance of incorporating patients’ views in treatment. The aim of the study was to provide insights for health care professionals and make recommendations based on patients’ experiences. Breast cancer survivorship is increasing, but the long-term support needs of such women are less understood.

Method:

This exploratory study asked 20 white women from 2 urban centers in the UK about their experience of diagnosis and treatment for breast cancer. It used an adaptation of the photovoice methodology to examine a health issue and identify issues of importance and relevance to patients. It recognizes their expertise in their situation.

Results:

The themes identified were: Fear/Shock; Waiting; Lack of Control; Communication/Practicalities; Body image changes; Specialist versus nonspecialist Centers/Staff; and Ongoing Support.

Discussion:

The women provided images, with a written summary of their meaning, and discussed them in groups. They identified good practice and suggestions for how to improve the experience of diagnosis and treatment of breast cancer.

Conclusion:

The photovoice methodology provides a low-cost, easy to implement a way for patients to provide insight into their experience and contribute their knowledge to improve clinical practice. Visual images and patients’ words allow clinicians to have greater insight into the environment and priorities of patients which could have implications for their response to treatment and long-term care.
Direct oral anticoagulants and cancer-associated VTE: good for all, or just some?
Authors: Carrier Marc , Wang Tzu-Fei
Published: June 2020

Venous thromboembolism (VTE) is associated with significant mortality and morbidity in patients with cancer. Therefore, tailoring anticoagulation is of utmost importance to decrease the risk of recurrent VTE while minimizing the risk of bleeding. Direct oral anticoagulants have been recently compared with low-molecular-weight heparin for the management of acute cancer-associated thrombosis. Although direct oral anticoagulants are a welcome addition, clinicians need to incorporate clinical characteristics, drug–drug interactions, and patient preference in decision making.
Metabolic engineering against the arginine microenvironment enhances CAR-T cell proliferation and therapeutic activity
Authors: Fultang Livingstone , Booth Sarah , Yogev Orli , Martins da Costa Barbara , Tubb Vanessa , Panetti Silvia , Stavrou Victoria , Scarpa Ugo , Jankevics Andris , Lloyd Gavin , Southam Andrew , Lee Steven P. , Dunn Warwick B. , Chesler Louis , Mussai Francis , De Santo Carmela
Published: June 2020

Hematological and solid cancers catabolize the semiessential amino acid arginine to drive cell proliferation. However, the resulting low arginine microenvironment also impairs chimeric antigen receptor T cells (CAR-T) cell proliferation, limiting their efficacy in clinical trials against hematological and solid malignancies. T cells are susceptible to the low arginine microenvironment because of the low expression of the arginine resynthesis enzymes argininosuccinate synthase (ASS) and ornithine transcarbamylase (OTC). We demonstrate that T cells can be reengineered to express functional ASS or OTC enzymes, in concert with different chimeric antigen receptors. Enzyme modifications increase CAR-T cell proliferation, with no loss of CAR cytotoxicity or increased exhaustion. In vivo, enzyme-modified CAR-T cells lead to enhanced clearance of leukemia or solid tumor burden, providing the first metabolic modification to enhance CAR-T cell therapies.
De novo transcriptome sequencing and analysis of salt-, alkali-, and drought-responsive genes in Sophora alopecuroides
Authors: Yan Fan , Zhu Youcheng , Zhao Yanan , Wang Ying , Li Jingwen , Wang Qingyu , Liu Yajing
Published: June 2020

Background

Salinity, alkalinity, and drought stress are the main abiotic stress factors affecting plant growth and development. Sophora alopecuroides L., a perennial leguminous herb in the genus Sophora, is a highly salt-tolerant sand-fixing pioneer species distributed mostly in Western Asia and northwestern China. Few studies have assessed responses to abiotic stress in S. alopecuroides. The transcriptome of the genes that confer stress-tolerance in this species has not previously been sequenced. Our objective was to sequence and analyze this transcriptome.

Results

Twelve cDNA libraries were constructed in triplicate from mRNA obtained from Sophora alopecuroides for the control and salt, alkali, and drought treatments. Using de novo assembly, 902,812 assembled unigenes were generated, with an average length of 294 bp. Based on similarity searches, 545,615 (60.43%) had at least one significant match in the Nr, Nt, Pfam, KOG/COG, Swiss-Prot, and GO databases. In addition, 1673 differentially expressed genes (DEGs) were obtained from the salt treatment, 8142 from the alkali treatment, and 17,479 from the drought treatment. A total of 11,936 transcription factor genes from 82 transcription factor families were functionally annotated under salt, alkali, and drought stress, these include MYB, bZIP, NAC and WRKY family members. DEGs were involved in the hormone signal transduction pathway, biosynthesis of secondary metabolites and antioxidant enzymes; this suggests that these pathways or processes may be involved in tolerance towards salt, alkali, and drought stress in S. alopecuroides.

Conclusion

Our study first reported transcriptome reference sequence data in Sophora alopecuroides, a non-model plant without a reference genome. We determined digital expression profile and discovered a broad survey of unigenes associated with salt, alkali, and drought stress which provide genomic resources available for Sophora alopecuroides.
Development of a DNA microarray assay for rapid detection of fifteen bacterial pathogens in pneumonia
Authors: Ma Xiuqing , Li Yanqin , Liang Yuan , Liu Yang , Yu Ling , Li Chunsun , Liu Qiqi , Chen Liangan
Published: June 2020

Background

The rapid identification of pathogenic bacteria is important for determining an appropriate antimicrobial therapy for pneumonia, but traditional bacterial culture is time-consuming and labourious. The aim of this study was to develop and evaluate a DNA microarray assay for the simultaneous detection of fifteen bacterial species directly from respiratory tract specimens in patients with pneumonia. These species included Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Mycoplasma pneumoniae, Enterococcus faecalis, Enterococcus faecium, Enterobacter cloacae, Stenotrophomonas maltophilia, Burkholderia cepacia, Legionella pneumophila and Chlamydia pneumoniae. The 16S rDNA genes and other specific genes of each pathogen were chosen as the amplification targets, amplified via multiplex polymerase chain reaction (PCR), and hybridized to oligonucleotide probes in a microarray.

Results

The DNA microarray detection limit was 103 copies/μL. Nineteen standard strains and 119 clinical isolates were correctly detected with our microarray, and 3 nontarget species from 4 clinical isolates were not detected. Additionally, bacterial pathogens were accurately identified when two or three bacterial targets were mixed together. Furthermore, the results for 99.4% (156/157) of clinical specimens were the same as those from a conventional assay.

Conclusions

We developed a DNA microarray that could simultaneously detect various bacterial pathogens in pneumonia. The method described here has the potential to provide considerable labour and time savings due to its ability to screen for 15 bacterial pathogens simultaneously.
Development of a droplet digital PCR method for detection of Streptococcus agalactiae
Authors: Zeng Yi-Fan , Chen Chu-Mao , Li Xiao-Yan , Chen Jun-Jiang , Wang Yan-Ge , Ouyang Shi , Ji Tian-Xing , Xia Yong , Guo Xu-Guang
Published: June 2020

Background

Streptococcus agalactiae (GBS) is the causative pathogen of puerperal sepsis in pregnant women and pneumonia, sepsis and meningitis in infants. Infection of GBS is responsible for the increased morbidity in pregnant women and the elderly, and bring challenges to clinical diagnosis and treatment. However, culture-based approaches to detect S.agalactiae is time-consuming with limited sensitivity. Besides, real-time quantitative PCR demands expensive instruments with tedious steps. Thus, we aim to establish a new detection method for more accurate and rapid detection of S.agalactiae.

Results

The ddPCR primer targeted the CpsE gene showed better amplified efficiency in the reaction. The limit of detection for GBS DNA with ddPCR was able to reach 5 pg/μL. Moreover, no positive amplified signals could be detected in the reactions which served 11 non-GBS strains DNA as templates. Furthermore, the coefficient of variation of this method was 4.5%, indicating excellent repeatability of ddPCR assay.

Conclusions

In our study, ddPCR was performed as a rapid detection of S.agalactiae with high sensitivity and specificity. This technique can promote the accuracy of the diagnosis of GBS infection and provide a scientific basis for clinical treatment.
Impact of foliar application of some metal nanoparticles on antioxidant system in oakleaf lettuce seedlings
Authors: Jurkow Rita , Pokluda Robert , Sękara Agnieszka , Kalisz Andrzej
Published: June 2020

Background

Nanoparticles (NPs) serve various industrial and household purposes, and their increasing use creates an environmental hazard because of their uncontrolled release into ecosystems. An important aspect of the risk assessment of NPs is to understand their interactions with plants. The aim of this study was to examine the effect of Au (10 and 20 ppm), Ag, and Pt (20 and 40 ppm) NPs on oakleaf lettuce, with particular emphasis on plant antioxidative mechanisms. Nanoparticles were applied once on the leaves of 2-week-old lettuce seedlings, after next week laboratory analyses were performed.

Results

The antioxidant potential of oakleaf lettuce seedlings sprayed with metal NPs at different concentrations was investigated. Chlorophylls, fresh and dry weight were also determined. Foliar exposure of the seedlings to metal NPs did not affect ascorbate peroxidase activity, total peroxidase activity increased after Au-NPs treatment, but decreased after applying Ag-NPs and Pt-NPs. Both concentrations of Au-NPs and Pt-NPs tested caused an increase in glutathione (GSH) content, while no NPs affected L-ascorbic acid content in the plants. Ag-NPs and Pt-NPs applied as 40 ppm solution increased total phenolics content by 17 and 15%, respectively, compared to the control. Carotenoids content increased when Ag-NPs and Au-NPs (20 and 40 ppm) and Pt-NPs (20 ppm) were applied. Plants treated with 40 ppm of Ag-NPs and Pt-NPs showed significantly higher total antioxidant capacity and higher concentration of chlorophyll a (only for Ag-NPs) than control. Pt-NPs applied as 40 ppm increased fresh weight and total dry weight of lettuce shoot.

Conclusions

Results showed that the concentrations of NPs applied and various types of metal NPs had varying impact on the antioxidant status of oakleaf lettuce. Alteration of POX activity and in biosynthesis of glutathione, total phenolics, and carotenoids due to metal NPs showed that tested nanoparticles can act as stress stimuli. However, judging by the slight changes in chlorophyll concentrations and in the fresh and dry weight of the plants, and even based on the some increases in these traits after M-NPs treatment, the stress intensity was relatively low, and the plants were able to cope with its negative effects.
Usefulness of ECG to differentiate apical hypertrophic cardiomyopathy from non-ST elevation acute coronary syndrome
Authors: Tao Yirao , Xu Jing , Bako Samira Yerima , Yao Xiaobo , Yang Donghui
Published: June 2020

Background

Apical hypertrophic cardiomyopathy (ApHCM) is a phenotypic variant of nonobstructive HCM. ApHCM is characterized by left ventricular hypertrophy involve the distal apex. The electrocardiographic character of ApHCM can mimic non-ST elevation acute coronary syndrome (NSTEACS), triggering a series of studies and treatments that may be unnecessary. This study aimed to clarify the electrocardiogram (ECG) differences between the two diseases.

Methods

Initial ECG recordings of 41 patients with ApHCM and 72 patients with NSTEACS were analyzed retrospectively. We analyzed the voltage of negative T (neg T) and R wave, the change of ST-segment as well as the number of leads with neg T wave in the 12-lead ECGs.

Results

Across the 12-lead ECGs, the magnitude of R wave significantly differed between ApHCM and NSTEACS in 10 leads excluding leads aVR and V1. ApHCM was associated with a greater maximal amplitude of R wave in lead V5 (3.13 ± 1.08 vs. 1.38 ± 0.73 mV, P <  0.001). The magnitude of T wave significantly differed between ApHCM and NSTEACS in 10 leads excluding leads II and V1. ApHCM was associated with a greater maximal amplitude of neg T wave in lead V4 (0.85 ± 0.69 vs. 0.35 ± 0.23 mV, P <  0.001). The frequency of giant neg T (1mv or more) wave was higher in ApHCM (36.5% vs. 0%, P <  0.001). The magnitude of ST-segment deviation significantly differed between ApHCM and NSTEACS in 10 leads excluding leads aVF and V2. ApHCM was associated with a greater maximal amplitude of ST-segment depression in lead V5 (0.19 ± 0.07 vs. 0.03 ± 0.06 mV, P <  0.001). The number of leads with neg T wave also differed between ApHCM and NSTEACS (6.75 ± 1.42 vs. 6.08 ± 1.51, P = 0.046). The sum of R wave in lead V5, neg T wave in lead V6 and ST-segment depression in lead V4 > 2.585 mV identified ApHCM with 90.2% sensibility and 87.5% specificity, representing the highest diagnostic accuracy.

Conclusions

Compared with NSTEACS patients, ApHCM patients presented higher R and neg T wave voltage as well as a greater ST-segment depression in the 12-lead ECG. The ECG characteristics can help to differentiate ApHCM from NSTEACS in clinical setting.
Sharing reports about domestic violence and abuse with general practitioners: a qualitative interview study
Authors: Pitt Katherine , Dheensa Sandi , Feder Gene , Johnson Emma , Man Mei-See , Roy Jessica , Williamson Emma , Szilassy Eszter
Published: June 2020

Background

Domestic violence and abuse (DVA) is common and damaging to health. UK national guidance advocates a multi-agency response to DVA, and domestic homicide reviews consistently recommend improved information-sharing between agencies. Identification of patients experiencing DVA in general practice may come from external information shared with the practice, such as police incident reports and multi-agency risk assessment conference (MARAC) reports. The aim of this study was to explore the views of general practitioners (GPs) and the police about sharing reports about DVA with GPs.

Methods

Qualitative semi-structured interviews were conducted with GPs, police staff and a partnership manager. Participants were located across England and Wales. Thematic analysis was undertaken.

Results

Interviews were conducted with 23 GPs, six police staff and one former partnership manager. Experiences of information-sharing with GPs about DVA varied. Participants described the relevance and value of external reports to GPs to help address the health consequences of DVA and safeguard patients. They balanced competing priorities when managing this information in the electronic medical record, namely visibility to GPs versus the risk of unintended disclosure to patients. GPs also spoke of the judgements they made about exploring DVA with patients based on external reports, which varied between abusive and non-abusive adults and children. Some felt constrained by short general practice consultations. Some police and GPs reflected on a loss of control when information about DVA was shared between agencies, and the risk of unintended consequences. Both police and GPs highlighted the importance of clear information and a shared understanding about responsibility for action.

Conclusion

GPs regarded external reports about DVA as relevant to their role, but safely recording this information in the electronic medical record and using it to support patients required complex judgements. Both GPs and police staff emphasised the importance of clarity of information and responsibility for action when information was shared between agencies about patients affected by DVA.
The impact of albumin infusion on the risk of rebleeding and in-hospital mortality in cirrhotic patients admitted for acute gastrointestinal bleeding: a retrospective study of a single institute
Authors: Wang Zhu , Xie Ya-Wen , Lu Qing , Yan Hai-Lin , Liu Xin-Bin , Long Yi , Zhang Xian , Yang Jin-Lin
Published: June 2020

Background

To investigate the effect of albumin infusion on cirrhotic patients admitted for acute gastrointestinal bleeding.

Methods

Medical records of cirrhotic patients who admitted due to acute gastrointestinal bleeding through January 2009 to December 2018 were reviewed. Clinical data and the total amount of albumin and red blood cell used during hospitalization were recorded. For patients with rebleeding, the amount of albumin and red blood cell used before rebleeding was also documented. The primary outcome was the occurrence of rebleeding, and the second outcome was in-hospital mortality. Univariate and multivariate logistic analysis was performed to identify risk factors associated with rebleeding and in-hospital mortality.

Results

A total of 1503 cirrhotic patients were included in the analysis. There were 146 episodes of in-patient rebleeding occurred, while 81 patients died. Overall, more red blood cells and albumin were prescribed to patients who suffered rebleeding. In terms of the amount before rebleeding, the red blood cell was higher in patients with rebleeding, but the albumin infusion was similar. In the multivariate model, the albumin infusion before rebleeding was an independent risk factor associated with rebleeding (adjusted OR for ≤40 g vs 0 g, 0.469 [0.269–0.793], p = 0.006; adjusted OR for > 40 g vs 0 g, 0.272 [0.115–0.576], p = 0.001). In Child-Pugh C class patients, the use of albumin more than 40 g during hospitalization associated with a lower risk of in-patient mortality (adjusted OR for > 40 g vs 0 g, 0.136 [0.019–0.741], p = 0.031).

Conclusions

Albumin infusion was associated with a lower risk of rebleeding and in-hospital deaths in cirrhosis admitted for acute gastrointestinal bleeding.
Association of cerebral malaria and TNF-α levels: a systematic review
Authors: Leão Luana , Puty Bruna , Dolabela Maria Fâni , Povoa Marinete Marins , Né Yago Gecy De Sousa , Eiró Luciana Guimarães , Fagundes Nathália Carolina Fernandes , Maia Lucianne Cople , Lima Rafael Rodrigues
Published: June 2020

Background

Cerebral malaria is the most severe form of infection with Plasmodium falciparum characterized by a highly inflammatory response. This systematic review aimed to investigate the association between TNF-α levels and cerebral malaria.

Methods

This review followed the Preferred Reporting of Systematic Review and Meta-analyses (PRISMA) guidelines. The search was performed at PubMed, LILACS, Scopus, Web of Science, The Cochrane Library, OpenGrey and Google Scholar. We have included studies of P. falciparum-infected humans with or without cerebral malaria and TNF-α dosage level. All studies were evaluated using a risk of bias tool and the GRADE approach.

Results

Our results have identified 2338 studies, and 8 articles were eligible according to this systematic review inclusion criteria. Among the eight articles, five have evaluated TNF- α plasma dosage, while two have evaluated at the blood and one at the brain (post-Morten). Among them, only five studies showed higher TNF-α levels in the cerebral malaria group compared to the severe malaria group. Methodological problems were identified regarding sample size, randomization and blindness, but no risk of bias was detected.

Conclusion

Although the results suggested that that TNF-α level is associated with cerebral malaria, the evidence is inconsistent and imprecise. More observational studies evaluating the average TNF-alpha are needed.
Investigation of syphilis immunology and Treponema pallidum subsp. pallidum biology to improve clinical management and design a broadly protective vaccine: study protocol
Authors: Osias Ethan , Hung Phoebe , Giacani Lorenzo , Stafylis Chrysovalantis , Konda Kelika A. , Vargas Silver K. , Reyes-Díaz E. Michael , Comulada W. Scott , Haake David A. , Haynes Austin M. , Caceres Carlos F. , Klausner Jeffrey D.
Published: June 2020

Background

The syphilis epidemic continues to cause substantial morbidity and mortality worldwide, particularly in low- and middle-income countries, despite several recent disease control initiatives. Though our understanding of the pathogenesis of this disease and the biology of the syphilis agent,Treponema pallidumsubsp.pallidumhas improved over the last two decades, further research is necessary to improve clinical diagnosis and disease management protocols. Additionally, such research efforts could contribute to the identification of possible targets for the development of an effective vaccine to stem syphilis spread.

Methods

This study will recruit two cohorts of participants with active syphilis infection, one with de novo infection, one with repeat infection. Whole blood specimens will be collected from each study participant at baseline, 4, 12, 24, 36, and 48 weeks, to track specific markers of their immunological response, as well as to compare humoral reactivity toTreponema pallidumantigens between the two groups. Additionally, we will use serum specimens to look for unique cytokine patterns in participants with early syphilis. Oral and blood samples, as well as samples from any syphilitic lesions present, will also be collected to sequence anyTreponema pallidumDNA found.

Discussion

By furthering our understanding of syphilis pathogenesis and human host immune response toTreponema pallidum, we will provide important data that will help in development of new point-of-care tests that could better identify active infection, leading to improved syphilis diagnosis and management. Findings could also contribute to vaccine development efforts.
Stanford type a aortic dissection with cerebral infarction: a rare case report
Authors: Wang Jie , Wu Li-Rong , Xie Xin
Published: June 2020

Background

Aortic dissection (AoD) is a disease with a high mortality rate. Its clinical manifestations are diverse and covert, which makes diagnosis and treatment challenging. Here, we report a very rare case of aortic dissection leading to bilateral cerebral cortex ischaemia and epilepsy.

Case presentation

A 54-year-old man was admitted to the hospital with acute onset of right limb weakness accompanied by slurred speech. He had a history of hypertension as well as tobacco and alcohol use. The patient was found to have aphasia and right hemiplegia on physical examination. No bleeding was seen on the skull CT. Acute cerebral infarction was considered after admission, and rt-PA was administered for intravenous thrombolysis. During intravenous thrombolysis, the patient suddenly developed epilepsy, and diazepam was given immediately by intravenous injection to control the symptoms. Emergency skull diffusion-weighted imaging (DWI) was performed, and the results showed a small, patchy, high signal that was scattered throughout the left brain hemisphere, right frontal parietal lobe and centrum semiovale. Head and neck CT angiography (CTA) was performed; dissection was found in the ascending aorta, aortic arch, bilateral common carotid artery, proximal part of the internal carotid artery, and initial segment of the left external carotid artery. The laceration was located in the upper part of the ascending aorta. AoD complicated by acute cerebral infarction and epilepsy was considered, and the patient was immediately transferred to the cardiovascular surgery specialist hospital for surgical treatment.

Conclusions

Some aortic dissections have no typical manifestations of chest pain, and the onset is covert. Atypical clinical manifestations of epilepsy secondary to bilateral cerebral hemisphere infarction may appear. AoD with cerebral infarction is a contraindication for intravenous thrombolysis; surgical treatment is the best way to reduce mortality.
Health information needs regarding diabetes mellitus in China: an internet-based analysis
Authors: Wang Tian-Hao , Zhou Xiao-Feng , Ni Yuan , Pan Zhi-Gang
Published: June 2020

Background

Today,. most people use the Internet to seek online health-related information from general public health-related websites and discussion groups. However, there are no Internet-based analyses of health information needs pertaining to diabetes in China until now. With the development of artificial intelligence,we can analyzed these online health-related information and provide references for health providers to improve their health service.

Methods

We have done a study of statistically analyzing the questions about diabetes collected from 39 health website, the number of which is 151,589. We have divided these questions into 9 categories using a convolutional neural network.

Results

The diabetes problems of consumer are presented as follows, diagnosis: 34.95%, treatment: 25.17%, lifestyle: 21.09%, complication: 8.00%, maternity-related:5.00%, prognosis: 2.59%, health provider choosing: 1.40%, prevention: 1.23%, others: 0.58%, The elderly are more concerned about the treatment and complications of diabetes, while the young are more concerned about the maternity-related and prognosis of diabetes. The diabetes drugs most frequently mentioned by consumers are insulin, metformin and Xiaoke pills, The most concerned complication is caidiovascular disease and diabetic eye disease.

Conclusion

Diabetes health education should focus on how to prevent diabetes and the contents of health education should be different for differernt age groups;on diabetes treatment, the use of insulin and oral hypoglycemic drugs education should be strengthened.
Minimal important differences for the WOMAC osteoarthritis index and the Forgotten Joint Score-12 in total knee arthroplasty patients
Authors: Holtz N. , Hamilton D. F. , Giesinger J. M. , Jost B. , Giesinger K.
Published: June 2020

Background

Total knee arthroplasty (TKA) is an effective treatment for end-stage osteoarthritis. Patient reported-outcome measures (PROMs) capture the patients’ perception of the success of an intervention. The minimal important difference (MID) is an important characteristic of the PROM, which helps to interpret results. The aim of this study was to identify the MID for the Forgotten Joint Score-12 (FJS-12) and Western Ontario and McMaster Universities (WOMAC) osteoarthritis index.

Methods

Data were collected in a prospective cohort study. Patients were asked to complete the FJS-12, WOMAC osteoarthritis index and transition items evaluating change over time to determine the MID. We employed an anchor-based methodology relating score change to the response categories of the transition items using both binary logistic regression and receiver operating characteristic (ROC) analysis.

Results

Data from 199 patients were analysed. Mean age was 72.3 years, 58% were women. Employing binary logistic regression the MID for the FJS-12 was 10.8 points, for the WOMAC pain score 7.5 points and for the WOMAC function score 7.2 points. ROC analyses found a MID of 13.0 points for the FJS-12, 12.5 points for WOMAC pain and 14.7 points for WOMAC function.

Conclusion

We report MIDs for the FJS-12 and the WOMAC Pain and Function scales in a TKA patient cohort, which can be used to interpret meaningful differences in score. In line with previous research, we found more advanced statistical methods to result in smaller MID estimates for both scores.

Trial registration

Written consent for this study was obtained from all participants and ethical approval was granted by the local ethics committee (Ethikkommission St. Gallen; EKSG 14/973; Registered 03 July 2014;http://www.sg.ch/home/gesundheit/ethikkommission.html).
Return to play after hip arthroscopy among tennis players: outcomes with minimum five-year follow-up
Authors: Maldonado David R. , Yelton Mitchell J. , Rosinsky Philip J. , Shapira Jacob , Meghpara Mitchell B. , Lall Ajay C. , Domb Benjamin G.
Published: June 2020

Background

Playing tennis is associated with various movements that can lead to labral injuries and may require arthroscopic surgery. While hip arthroscopies have demonstrated good outcomes in athletes, there is limited literature reporting patient reported outcomes (PROs) and return to sport (RTS) in competitive or recreational tennis players after arthroscopic hip surgery. Therefore, the purpose of the present study was to (1) report minimum five-year PROs and RTS in tennis players who underwent arthroscopic hip surgery and (2) compare outcomes between recreational and competitive tennis players.

Methods

Data for patients who underwent hip arthroscopy surgery in the setting of femoroacetabular impingement and labral tears between March 2009 and January 2014 and who played tennis within one-year of surgery were retrospectively reviewed. Patients with preoperative and minimum five-year postoperative scores for the following PROs were included: modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Patient Acceptable Symptomatic State (PASS) and Minimal Clinically Important Difference (MCID) for mHHS and HOS-SSS were calculated.

Results

Of 28 patients, 31 hips met all inclusion and exclusion criteria of which 28 (90.3%) had minimum 5-year follow-up (mean: 72.8 ± 13.9 months). There were 3 professional, 3 collegiate, 2 high school, 2 organized amateur, and 18 recreational level tennis players. All PROs significantly improved at latest follow-up: mHHS from 67.0 to 86.7 (P <  0.001), NAHS from 65.9 to 87.2 (P <  0.001), HOS-SSS from 50.0 to 77.9 (P = 0.009), and VAS from 5.4 to 1.8 (P <  0.001). There was a 75.0% RTS rate. Additionally, 66.7% of patients achieved MCID and 83.3% achieved PASS for mHHS, and 63.6% achieved MCID and 58.3% achieved PASS for HOS-SSS.

Conclusion

Regardless of the level of participation, tennis players who underwent arthroscopic hip surgery reported statistically significant PRO improvements. A favorable rate of RTS was also achieved by players with a continued interest in playing. The data here may be useful in counseling tennis players of various levels who are considering arthroscopic treatment of a hip injury.

Level of evidence

IV
The value of the atherogenic index of plasma in non-obese people with non-alcoholic fatty liver disease: a secondary analysis based on a cross-sectional study
Authors: Dong Bu-yuan , Mao Yu-qing , Li Zheng-yang , Yu Fu-jun
Published: June 2020

Background and objectives

The atherogenic index of plasma (AIP) is elevated in fatty liver disease, but its value in non-obese people with non-alcoholic fatty liver disease (NAFLD) is unclear. This study aimed to investigate the relationship between AIP and NAFLD as well as to determine whether AIP might be used as an indicator of NAFLD in non-obese individuals.

Methods

The present study involved non-obese Chinese and Japanese participants. Risk factors are evaluated using univariate and multivariate analysis. The performance of risk factors was compared according to the area under the receiver operating characteristic curve.

Results

In the unadjusted model, the odds ratio (OR) for every 1 standard deviation (SD) increase in AIP was 52.30. In adjusted models I and II, the OR for every 1 SD increase in AIP was 36.57 and 50.84, respectively. The area under the receiver operating characteristic curve for AIP was 0.803 and 0.802 in the development and validation groups, respectively. The best cut-off value of AIP for discrimination between NAFLD and non-NAFLD was 0.005 in the Chinese group and − 0.220 in the Japanese group.

Conclusions

AIP and NAFLD are positively correlated in Chinese and Japanese populations. Therefore, AIP can be used as a new screening indicator for non-obese people with NAFLD in different nations.