bluuebunny/crossref_metadata_2025 huggingface dataset:
Stroke prevention and control system in China: CSPPC-Stroke Program
Authors: Chao Bao-Hua , Yan Feng , Hua Yang , Liu Jian-Min , Yang Yi , Ji Xun-Ming , Peng Bin , Zhao Guo-Guang , Wang Yong-Jun , Kang De-Zhi , Wang Yi-Long , Zeng Jin-Sheng , Chu Lan , Li Tian-Xiao , Xu Yu-Ming , Liu Ming , He Li , Xu Yun , Wu Jian , Lou Min , Yue Wei , Cao Lei , Tu Wen-Jun , Wang Long-De
Published: March 2020

In China, stroke is a major cause of mortality, and long-term physical and cognitive impairment. To meet this challenge, the Ministry of Health China Stroke Prevention Project Committee (CSPPC) was established in April 2011. This committee actively promotes stroke prevention and control in China. With government financial support of 838.4 million CNY, 8.352 million people from 536 screening points in 31 provinces have received stroke screening and follow-up over the last seven years (2012–2018). In 2016, the CSPPC issued a plan to establish stroke centers. To shorten the pre-hospital period, the CSPPC established a stroke center network, stroke map, and stroke “Green Channel” to create three 1-h gold rescue circles, abbreviated as “1-1-1” (onset to call time <1 h; pre-hospital transfer time < 1 h, and door-to-needle time < 1 h). From 2017 to 2018, the median door-to-needle time dropped by 4.0% (95% confidence interval (CI), 1.4–9.4) from 50 min to 48 min, and the median onset-to-needle time dropped by 2.8% (95% CI, 0.4–5.2) from 180 min to 175 min. As of 31 December 2018, the CSPPC has established 380 stroke centers in mainland China. From 1 November 2018, the CSPPC has monitored the quality of stroke care in stroke center hospitals through the China Stroke Data Center Data Reporting Platform. The CSPPC Stroke program has led to a significant improvement in stroke care. This program needs to be further promoted nationwide.
Mediational role of coping with stress in relationship between personality and effectiveness of performance of soccer players
Authors: Kalinowski Paweł , Bojkowski Łukasz , Śliwowski Robert , Wieczorek Andrzej , Konarski Jan , Tomczak Maciej
Published: March 2020

There is a trend in soccer to ensure comprehensive player preparation including fitness, technical and tactical, as well as mental aspects. It has been emphasized many times that personality traits (neuroticism, conscientiousness, extraversion) are significant for the effectiveness of performance in soccer. The question of why these relations occur has been considered relatively rarely. Therefore, the aim of this study is an attempt to explain these relations through introduction of ways of coping with stress as their significant mediators. It is hence assumed that players with certain personality traits are characterized by specific ways of coping with stress which are related to the effectiveness of their performance. The study group consisted of 122 players, aged 16–19 years. The participants of the study were youth teams at the championship level (medalists of the youth Polish Championships), and the following research tools were used: NEO-FFI Personality Inventory, The Coping Inventory for Competitive Sport (CICS) and Szwarc’s Observation Sheet for effectiveness in soccer. It was demonstrated that task-focused ways of coping with stress (effort expenditure, thought control, and logical analysis) were the most frequent mediators of relations between the studied traits and the effectiveness of performance of soccer players.
Management of hypercapnia in critically ill mechanically ventilated patients—A narrative review of literature
Authors: Tiruvoipati Ravindranath , Gupta Sachin , Pilcher David , Bailey Michael
Published: March 2020

The use of lower tidal volume ventilation was shown to improve survival in mechanically ventilated patients with acute lung injury. In some patients this strategy may cause hypercapnic acidosis. A significant body of recent clinical data suggest that hypercapnic acidosis is associated with adverse clinical outcomes including increased hospital mortality. We aimed to review the available treatment options that may be used to manage acute hypercapnic acidosis that may be seen with low tidal volume ventilation. The databases of MEDLINE and EMBASE were searched. Studies including animals or tissues were excluded. We also searched bibliographic references of relevant studies, irrespective of study design with the intention of finding relevant studies to be included in this review. The possible options to treat hypercapnia included optimising the use of low tidal volume mechanical ventilation to enhance carbon dioxide elimination. These include techniques to reduce dead space ventilation, and physiological dead space, use of buffers, airway pressure release ventilation and prone positon ventilation. In patients where hypercapnic acidosis could not be managed with lung protective mechanical ventilation, extracorporeal techniques may be used. Newer, minimally invasive low volume venovenous extracorporeal devices are currently being investigated for managing hypercapnia associated with low and ultra-low volume mechanical ventilation.
Vitamin D deficiency and total shoulder arthroplasty complications
Authors: Smith J Michael , Cancienne Jourdan M , Brockmeier Stephen F , Werner Brian C
Published: March 2020

Introduction

The primary objective of this study was to examine the relationship between vitamin D deficiency and implant-related and medical complications following total shoulder arthroplasty.

Methods

Using the PearlDiver database, patients who underwent total shoulder arthroplasty from 2005 to 2016 with vitamin D deficiency were identified. These were compared to a 3:1 control group matched by age, sex, and presence of a concomitant osteoporosis diagnosis. Primary outcome measures were implant-related complications (loosening, periprosthetic fracture, periprosthetic joint infection, and revision total shoulder arthroplasty) in addition to medical complications within 90 days of surgery. A multivariable logistic regression analysis was utilized to control for patient demographics and comorbidities.

Results

One thousand and six hundred and seventy-four patients with vitamin D deficiency were identified and compared to 5022 controls. There was a significantly higher rate of revision total shoulder arthroplasty in the vitamin D deficient patients compared to controls (2.3% versus 0.8%, odds ratio 3.3, p < 0.0001). After controlling for confounding variables, there were no significant differences in any of the remaining implant-related or medical complications with the exception of higher rates of urinary tract infections in patients with vitamin D deficiency.

Conclusions

Vitamin D deficiency is associated with a higher rate of all-cause revision total shoulder arthroplasty but not medical complications compared to controls. Level of evidence: Level III case control study
Ideological Conflict and Prejudice: An Adversarial Collaboration Examining Correlates and Ideological (A)Symmetries
Authors: Stern Chadly , Crawford Jarret T.
Published: March 2020

In an adversarial collaboration, we examined associations among factors that could link ideological conflict—perceiving that members of a group do not share one’s ideology—to prejudice and affiliation interest. We also examined whether these factors would possess similar (“symmetrical”) or different (“asymmetrical”) associative strength among liberals and conservatives. Across three samples (666 undergraduate students, 347 Mechanical Turk workers), ideological conflict was associated with perceived dissimilarity on political and nonpolitical topics, as well as negative emotions. Perceived political and nonpolitical dissimilarity were also associated with negative emotions, prejudice, and lower affiliative intentions among both liberals and conservatives. Importantly, however, perceived political dissimilarity was associated with negative emotions, prejudice, and lower affiliative intentions more strongly among liberals. Some inconsistent evidence also suggested that perceived nonpolitical dissimilarity was associated with prejudice and lower affiliative intentions more strongly among conservatives. These findings document nuance in relationships that could link ideological conflict to prejudice.
Metabolism of asymmetric dimethylarginine in hypoxia: from bench to bedside
Authors: Hannemann Juliane , Zummack Julia , Hillig Jonas , Böger Rainer
Published: March 2020

Acute hypoxia and chronic hypoxia induce pulmonary vasoconstriction. While hypoxic pulmonary vasoconstriction is a physiological response if parts of the lung are affected, global exposure to hypoxic conditions may lead to clinical conditions like high‐altitude pulmonary hypertension. Nitric oxide is the major vasodilator released from the vascular endothelium. Nitric oxide‐dependent vasodilation is impaired in hypoxic conditions. Inhibition of nitric oxide synthesis is the most rapid and easily reversible molecular mechanism to regulate nitric oxide‐dependent vascular function in response to physiological and pathophysiological stimuli. Asymmetric dimethylarginine is an endogenous, competitive inhibitor of nitric oxide synthase and a risk marker for major cardiovascular events and mortality. Elevated asymmetric dimethylarginine has been observed in animal models of hypoxia as well as in human cohorts under chronic and chronic intermittent hypoxia at high altitude. In lowlanders, asymmetric dimethylarginine is high in patients with pulmonary hypertension. We have recently shown that high asymmetric dimethylarginine at sea level is a predictor for high‐altitude pulmonary hypertension. Asymmetric dimethylarginine is a highly regulated molecule, both by its biosynthesis and metabolism. Methylation of L‐arginine by protein arginine methyltransferases was shown to be increased in hypoxia. Furthermore, the metabolism of asymmetric dimethylarginine by dimethylarginine dimethylaminohydrolases (DDAH1 and DDAH2) is decreased in animal models of hypoxia. Whether these changes are caused by transcriptional or posttranslational modifications remains to be elucidated. Current data suggest a major role of asymmetric dimethylarginine in regulating pulmonary arterial nitric oxide production in hypoxia. Further studies are needed to decipher the molecular mechanisms regulating asymmetric dimethylarginine in hypoxia and to understand their clinical significance.
Dual role of the L‐arginine–ADMA–NO pathway in systemic hypoxic vasodilation and pulmonary hypoxic vasoconstriction
Authors: Böger Rainer , Hannemann Juliane
Published: March 2020

In healthy vascular endothelium, nitric oxide acts as a vasodilator paracrine mediator on adjacent smooth muscle cells. By activating soluble guanylyl cyclase, nitric oxide stimulates cyclic guanosine monophosphate (cGMP) which causes relaxation of vascular smooth muscle (vasodilation) and inhibition of platelet aggregation. This mechanism is active in both, the systemic and pulmonary circulation. In the systemic circulation, hypoxia results in local vasodilation, which has been shown to be brought about by stabilization of hypoxia‐inducible factor‐1α (HIF1α) and concomitant upregulation of endothelial nitric oxide synthase. By contrast, the physiological response to hypoxia in the pulmonary circulation is vasoconstriction. Hypoxia in the lung primarily results from hypoventilation of circumscript areas of the lung, e.g. by bronchial tree obstruction or inflammatory infiltration. Therefore, hypoxic pulmonary vasoconstriction is a mechanism preventing distribution of blood to hypoventilated areas of the lungs, thereby maintaining maximal oxygenation of blood. The exact molecular mechanism of hypoxic pulmonary vasoconstriction is less well understood than hypoxic vasodilation in the systemic circulation. While alveolar epithelial cells may be key in sensing low oxygen concentration, and pulmonary vascular smooth muscle cells obviously are the effectors of vasoconstriction, the pulmonary vascular endothelium plays a crucial role as an intermediate between these cell types. Indeed, dysfunctional endothelial nitric oxide release was observed in humans exposed to acute hypoxia, and animal studies suggest that hypoxic pulmonary vasoconstriction is enhanced by nitric oxide synthase inhibition. This may be caused, in part, by elevation of asymmetric dimethylarginine, an endogenous inhibitor of nitric oxide synthesis. High asymmetric dimethylarginine levels are associated with endothelial dysfunction, vascular disease, and hypertension.
Rivaroxaban plus aspirin for the prevention of ischaemic events in patients with cardiovascular disease: a cost-effectiveness study
Authors: Petersohn Svenja , Pouwels Xavier , Ramaekers Bram , ten Cate-Hoek Arina , Joore Manuela
Published: March 2020

Background

Dual pathway inhibition with 2.5 mg rivaroxaban twice daily plus 100 mg aspirin once daily may be a promising alternative to 100 mg aspirin antiplatelet therapy for the prevention of cardiovascular events in patients with coronary artery disease and/or peripheral arterial disease. However, treatment costs and bleeding risks are higher, and there is another treatment option for peripheral arterial disease, 75 mg clopidogrel. A comprehensive assessment of benefits, risks and costs of dual pathway inhibition versus standard of care is needed.

Methods

We used a state transition model including cardiovascular, ischaemic limb and bleeding events to compare dual pathway inhibition to aspirin antiplatelet therapy in coronary artery disease, and additionally to clopidogrel antiplatelet therapy in peripheral arterial disease patients. We calculated the incremental cost-effectiveness ratio from costs and quality-adjusted life-years of lifelong treatment, and the cost-effectiveness probability at a €50,000/quality-adjusted life-year threshold.

Results

Quality-adjusted life-years and costs of dual pathway inhibition were highest, the incremental cost-effectiveness ratios versus aspirin were €32,109 in coronary artery disease and €26,381 in peripheral arterial disease patients, with 92% and 56% cost-effectiveness probability, respectively (clopidogrel was extendedly dominated). Incremental cost-effectiveness ratios were below €20,000 in comorbid peripheral arterial disease patients and coronary artery disease patients younger than 65 years, incremental cost-effectiveness ratios were above €50,000 in carotid artery disease patients and coronary artery disease patients older than 75 years.

Conclusion

Lifelong preventive treatment of coronary artery disease and peripheral arterial disease patients at risk of cardiovascular events with dual pathway inhibition improves health outcomes and seems overall cost-effective relative to aspirin antiplatelet therapy and also to clopidogrel antiplatelet therapy for peripheral arterial disease, particularly in comorbid patients, but not in older patients and in carotid artery disease patients. These findings may warrant a targeted approach.
Authorship growth in contemporary medical literature
Authors: An Julie Y , Marchalik Rachel J , Sherrer Rachael L , Baiocco Joseph A , Rais-Bahrami Soroush
Published: March 2020

Objectives:

The aims of this study were to investigate authorship trends among publications in high-impact, peer-reviewed specialty journals published within the last decade and to assess how publication practices differ among medical specialties.

Methods:

The National Institutes of Health’s Portfolio Analysis platform, iCite, was queried for PubMed-indexed case reports, review articles, and original research articles published between 2005 and 2017 in 69 high-impact, clinical journals encompassing 23 medical specialties. Overall, 121,397 peer-reviewed publications were evaluated—of which, 45.1% were original research, 28.7% were review articles, and 26.3% were case reports. Multivariable regression was used to evaluate the magnitude of association of publication year on the number of authors per article by specialty and article type.

Results:

Original research articles have the greatest increase in authorship (0.23 more authors per article per year), as compared with review articles (0.18 authors per article per year) and case reports (0.01 authors per article per year). Twenty-two of the 23 specialties evaluated had increase in authorship in high-impact specialty journals. Specialty growth rates ranged from 0.42 authors/year (Neurology), Psychiatry (0.35 authors/year), General Surgery (0.29 authors/year), Urology (0.27 authors/year), and Pathology (0.27 authors/year). Specialties with a greater percentage of graduates entering academics had more authors per article; surgical specialties and length of residency were not found to be predictive factors.

Conclusion:

There has been substantial growth in the authorship bylines of contemporary medical literature, much of which cannot be explained by increased complexity or collaboration alone.
How do family members of individuals with spinal cord and acquired brain injuries make sense of their experiences: A qualitative study of meaning making processes
Authors: Geard Anne , Kirkevold Marit , Løvstad Marianne , Schanke Anne-Kristine
Published: March 2020

This study explores the processes that promote coping with abruptive life changes, often experienced as life before and after injury. The consept of meaning making, was used as theoretical framework for analysisthr. Family members of individuals with spinal cord and acquired brain injury participated in two focus groups three to twenty years post-injury. Data was analysed using thematic analyses. Two main themes were identified: drawing upon different coping strategies and balancing family needs against personal autonomy. Making sense of an altered situation was by keeping a positive outlook, making comparisons to worst cases, engagement in activities and making room for own needs. Thus, the study illistrates that life can continue in a good manner after adversities, but requires flexibility and adjustments.
Spinal Surgery in Patients Aged 80 Years and Older: Risk Stratification Using the Modified Frailty Index
Authors: Kweh Barry , Lee Hui , Tan Terence , O’Donohoe Tom , Mathew Joseph , Fitzgerald Mark , Gantner Dashiell , Kambourakis Tony , Tew Kim , Hunn Martin , Rosenfeld Jeffrey , Tee Jin
Published: March 2020

Study Design:

This was an ambispective clinical quality registry study.

Objective:

To evaluate utility of 11-variable modified Frailty Index (mFI) in predicting postoperative outcomes among patients ≥80 years undergoing spinal surgery.

Methods:

Consecutive patients ≥80 years who underwent spinal surgery between January 1, 2013, and June 30, 2018, were included. Primary outcome measure was rate of major complication. Secondary outcome measures were (1) overall complication rate, (2) surgical site infection, and (3) 6-month mortality.

Results:

A total of 121 operations were performed. Demographic metrics were (1) age (mean ± SD) = 83.1 ± 2.8 years and (2) mFI (mean ± SD) = 2.1 ± 1.4 variables. As mFI increased from 0 to ≥4 variables, risk of major complication increased from 18.2% to 40.0% ( P = .014); overall complication increased from 45.5% to 70.0% ( P = .032); surgical site infection increased from 0.0% to 25.0% ( P = .007). There were no significant changes in risk of 6-month mortality across mFIs ( P = .115). Multivariate analysis showed that a higher mFI score of ≥3 variables was associated with a significantly higher risk of (1) major complication ( P = .025); (2) overall complication ( P = .015); (3) surgical site infection ( P = .007); and (4) mortality ( P = .044).

Conclusions:

mFI scores of ≥3/11 variables were associated with a higher risk of postoperative morbidity in patients aged ≥80 years undergoing spinal surgery. The mFI-associated risk stratification provides a valuable adjunct in surgical decision making for this rapidly growing subpopulation of patients.
Effects of malalignment and disease activity on osteophyte formation in knees of rheumatoid arthritis patients
Authors: Okumura Noriaki , Kawasaki Taku , Kubo Mitsuhiko , Yayama Takafumi , Mimura Tomohiro , Kumagai Kosuke , Maeda Tsutomu , Imai Shinji
Published: March 2020

Purpose:

Rheumatoid arthritis (RA) patients with secondary osteoarthritis (OA) in a knee joint following a total knee arthroplasty (TKA) procedure have been increasing. Here, we investigated osteophyte formation in knee joints of RA patients and associated factors.

Methods:

We retrospectively examined findings of 35 knees in 30 RA patients (26 females, 4 males; mean age: 63.0 years; median disease duration: 15 years) who underwent TKA, including preoperative anteroposterior view radiographs of the knee joint. Using the ImageJ software package, osteophyte size in the medial femur (MF), medial tibia (MT), lateral femur (LF), and lateral tibia (LT) regions was also determined.

Results:

The mean femorotibial angle was 179°, while Larsen grade was 2 in 1, 3 in 12, 4 in 18, and 5 in 2 patients. Osteophyte sizes in the MF, MT, LF, and LT regions were 37.2, 17.0, 27.2, and 4.57 mm2, respectively, and significantly greater in the medial compartment (MC; MF+MT) than the lateral compartment (LC; LF+LT) ( p < 0.001). In varus cases, osteophyte size in the MC was significantly larger than normal and valgus cases ( p = 0.0016). Furthermore, osteophyte size in the MC was negatively correlated with the inflammatory markers C-reactive protein ( r = −0.492, p = 0.0027) and erythrocyte sedimentation rate ( r = −0.529, p = 0.0016), whereas that in the LC was negatively correlated with disease activity ( r = −0.589, p = 0.0023).

Conclusion:

Our results suggest that alignment and disease activity influence osteophyte formation in RA patients, with secondary OA a more prominent symptom in RA patients with controlled inflammation.
Diagnosis of deep vein thrombosis of the lower extremity: a systematic review and meta-analysis of test accuracy
Authors: Bhatt Meha , Braun Cody , Patel Payal , Patel Parth , Begum Housne , Wiercioch Wojtek , Varghese Jamie , Wooldridge David , Alturkmani Hani J. , Thomas Merrill , Baig Mariam , Bahaj Waled , Khatib Rasha , Kehar Rohan , Ponnapureddy Rakesh , Sethi Anchal , Mustafa Ahmad , Nieuwlaat Robby , Lim Wendy , Bates Shannon M. , Lang Eddy , Le Gal Grégoire , Righini Marc , Husainat Nedaa M. , Kalot Mohamad A. , Al Jabiri Yazan Nayif , Schünemann Holger J. , Mustafa Reem A.
Published: March 2020

Deep vein thrombosis (DVT) of the lower extremities can be associated with significant morbidity and may progress to pulmonary embolism and postthrombotic syndrome. Early diagnosis and treatment are important to minimize the risk of these complications. We systematically reviewed the accuracy of diagnostic tests for first-episode and recurrent DVT of the lower extremities, including proximal compression ultrasonography (US), whole leg US, serial US, and high-sensitivity quantitative D-dimer assays. We searched Cochrane Central, MEDLINE, and EMBASE for eligible studies, reference lists of relevant reviews, registered trials, and relevant conference proceedings. Two investigators screened and abstracted data. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework. We pooled estimates of sensitivity and specificity. The review included 43 studies. For any suspected DVT, the pooled estimates for sensitivity and specificity of proximal compression US were 90.1% (95% confidence interval [CI], 86.5-92.8) and 98.5% (95% CI, 97.6-99.1), respectively. For whole-leg US, pooled estimates were 94.0% (95% CI, 91.3-95.9) and 97.3% (95% CI, 94.8-98.6); for serial US pooled estimates were 97.9% (95% CI, 96.0-98.9) and 99.8% (95% CI, 99.3-99.9). For D-dimer, pooled estimates were 96.1% (95% CI, 92.6-98.0) and 35.7% (95% CI, 29.5-42.4). Recurrent DVT studies were not pooled. Certainty of evidence varied from low to high. This systematic review of current diagnostic tests for DVT of the lower extremities provides accuracy estimates. The tests are evaluated when performed in a stand-alone fashion, and in a diagnostic pathway. The pretest probability of DVT often assessed by a clinical decision rule will influence how, together with sensitivity and specificity estimates, patients will be managed.
Organic Phosphorous and Calcium Source Induce the Synthesis of Yolk-Shell Structured Microspheres of Calcium Phosphate with High-Specific Surface Area: Application in HEL Adsorption
Authors: Cao Xianshuo , Wang Guizhen , Wang Kai , Guo Lan , Cao Yang , Cao Xianying , Yang Yong
Published: March 2020

Yolk-shell-structured calcium phosphate microspheres have a great potential for medical applications due to their excellent physicochemical properties and biocompatibility. However, developing a yolk-shell-structured calcium phosphate with high adsorption capability remains a challenge. Herein, a porous yolk-shell-structured microsphere (ATP-CG) of calcium phosphate with high-specific surface area [SBET = 143 m2 g−1, which is approximately three times as high as that of ATP-CL microspheres synthesized by replacing calcium source with calcium l-lactate pentahydrate (CL)] was successfully synthesized by using adenosine 5'-triphosphate disodium salt (ATP) as the phosphorous source and calcium gluconate monohydrate (CG) as calcium source through a self-templating approache. The influences of molar ratio of Ca to P (Ca/P), hydrothermal temperature, and time on the morphology of ATP-CG microspheres were also investigated. It is found that the organic calcium source and organic phosphorous source play a vital role in the formation of yolk-shell structure. Furthermore, a batch of adsorption experiments were investigated to illuminate the adsorption mechanism of two kinds of yolk-shell-structured microspheres synthesized with different calcium sources. The results show that the adsorption capacity of ATP-CG microspheres (332 ± 36 mg/g) is about twice higher than that of ATP-CL microspheres (176 ± 33 mg/g). Moreover, the higher-specific surface area caused by the calcium source and unique surface chemical properties for ATP-CG microspheres play an important role in the improvement of HEL adsorption capability. The study indicates that the as-prepared yolk-shell-structured microsphere is promising for application in drug delivery fields and provides an effective approach for improving drug adsorption capability.
Antimicrobial peptide and sequence variation along a latitudinal gradient in two anurans
Authors: Cortázar-Chinarro Maria , Meyer-Lucht Yvonne , Van der Valk Tom , Richter-Boix Alex , Laurila Anssi , Höglund Jacob
Published: March 2020

Background

While there is evidence of both purifying and balancing selection in immune defense genes, large-scale genetic diversity in antimicrobial peptides (AMPs), an important part of the innate immune system released from dermal glands in the skin, has remained uninvestigated. Here we describe genetic diversity at three AMP loci (Temporin, Brevinin and Palustrin) in two ranid frogs (Rana arvalisandR. temporaria) along a 2000 km latitudinal gradient. We amplified and sequenced part of the Acidic Propiece domain and the hypervariable Mature Peptide domain (~ 150-200 bp) in the three genes using Illumina Miseq and expected to find decreased AMP genetic variation towards the northern distribution limit of the species similarly to studies on MHC genetic patterns.

Results

We found multiple loci for each AMP and relatively high gene diversity, but no clear pattern of geographic genetic structure along the latitudinal gradient. We found evidence of trans-specific polymorphism in the two species, indicating a common evolutionary origin of the alleles. Temporin and Brevinin did not form monophyletic clades suggesting that they belong to the same gene family. By implementing codon evolution models we found evidence of strong positive selection acting on the Mature Peptide. We also found evidence of diversifying selection as indicated by divergent allele frequencies among populations and high Theta k values.

Conclusion

Our results suggest that AMPs are an important source of adaptive diversity, minimizing the chance of microorganisms developing resistance to individual peptides.
Characterization of TMC-1 in C. elegans sodium chemotaxis and sodium conditioned aversion
Authors: Dao Joseph , Lee Aileen , Drecksel Dana K. , Bittlingmaier Nicole M. , Nelson Theodore M.
Published: March 2020

Background

While sodium is attractive at low and aversive at high concentrations in most studied species, includingCaenorhabditis elegans, the molecular mechanisms behind transduction remain poorly understood. Additionally, past studies withC. elegansprovide evidence that the nematode’s innate behavior can be altered by previous experiences. Here we investigated the molecular aspects of both innate and conditioned responses to salts. Transmembrane channel-like 1 (tmc-1) has been suggested to encode a sodium-sensitive channel required for sodium chemosensation inC. elegans, but its specific role remains unclear.

Results

We report that TMC-1 is necessary for sodium attraction, but not aversion in the nematode. We show that TMC-1 contributes to the nematode’s lithium induced attraction behavior, but not potassium or magnesium attraction thus clarifying the specificity of the response. In addition, we show that sodium conditioned aversion is dependent on TMC-1 and disrupts not only sodium induced attraction, but also lithium.

Conclusions

These findings represent the first time a role for TMC-1 has been described in sodium and lithium attraction in vivo, as well as in sodium conditioned aversion. Together this clarifies TMC-1’s importance in sodium hedonics and offer molecular insight into salt chemotaxis learning.
The molecular characters and antibiotic resistance of Clostridioides difficile from economic animals in China
Authors: Zhang Wen-Zhu , Li Wen-Ge , Liu Yu-Qing , Gu Wen-Peng , Zhang Qing , Li Hu , Liu Zheng-Jie , Zhang Xin , Wu Yuan , Lu Jin-Xing
Published: March 2020

Background

It has been performed worldwidely to explore the potential of animals that might be a reservoir for community associated human infections of Clostridioides difficile. Several genetically undistinguished PCR ribotypes of C. difficile from animals and human have been reported, illustrating potential transmission of C. difficile between them. Pig and calf were considered as the main origins of C. difficile with predominant RT078 and RT033, respectively. As more investigations involved, great diversity of molecular types from pig and calf were reported in Europe, North American and Australia. However, there were quite limited research on C. difficile isolates from meat animals in China, leading to non-comprehensive understanding of molecular epidemiology of C. difficile in China.

Results

A total of 55 C. difficile were isolated from 953 animal stool samples, within which 51 strains were from newborn dairy calf less than 7 days in Shandong Province. These isolates were divided into 3 STs and 6 RTs, of which ST11/RT126 was predominant type, and responsible for majority antibiotic resistance isolates. All the isolates were resistant to at least one tested antibiotics, however, only two multidrug resistant (MDR) isolates were identified. Furthermore, erythromycin (ERY) and clindamycin (CLI) were the two main resistant antibiotics. None of the isolates were resistant to vancomycin (VAN), metronidazole (MTZ), tetracycline (TET), and rifampin (RIF).

Conclusions

In this study, we analyzed the prevalence, molecular characters and antibiotic resistance of C. difficile from calf, sheep, chicken, and pig in China. Some unique features were found here: first, RT126 not RT078 were the dominant type from baby calf, and none isolates were got from pig; second, on the whole, isolates from animals display relative lower resistant rate to these 11 tested antibiotics, compared with isolates from human in China in our previous report. Our study helps to deep understanding the situation of C. difficile from economic animals in China, and to further study the potential transmission of C. difficile between meat animals and human.
Factors associated with smoking cessation in patients with coronary heart disease: a cohort analysis of the German subset of EuroAspire IV survey
Authors:   on behalf of the German EUROASPIRE IV collaborators, Goettler D. , Wagner M. , Faller H. , Kotseva K. , Wood D. , Leyh R. , Ertl G. , Karmann W. , Heuschmann P. U. , Störk S.
Published: March 2020

Background

Tobacco smoking is one of the most important risk factors of coronary heart disease (CHD). Hence, smoking cessation is considered pivotal in the prevention of CHD. The current study aimed to evaluate smoking cessation patterns and determine factors associated with smoking cessation in patients with established CHD.

Methods

The fourth European Survey of Cardiovascular Disease Prevention and Diabetes investigated quality of CHD care in 24 countries across Europe in 2012/13. In the German subset, smoking cessation patterns and clinical characteristics were repetitively assessed a) during index event due to CHD by medical record abstraction, b) as part of a face-to-face interview 6 to 36 months after the index event (i.e. baseline visit), and c) by telephone-based follow-up interview two years after the baseline visit. Logistic regression analysis was performed to search for factors determining smoking status at the time of the telephone interview.

Results

Out of 469 participants available for follow-up, 104 (22.2%) had been classified as current smokers at the index event. Of those, 65 patients (62.5%) had quit smoking at the time of the telephone interview, i.e., after a median observation period of 3.5 years (quartiles 3.0, 4.1). Depressed mood at baseline visit and higher education level were less prevalent amongst quitters vs non-quitters (17.2% vs 35.9%, p = 0.03 and 15.4% vs 33.3%, p = 0.03), cardiac rehabilitation programs were more frequently attended by quitters (83.1% vs 48.7%, p < 0.001), and there was a trend for a higher prevalence of diabetes at baseline visit in quitters (37.5% vs 20.5%, p = 0.07). In the final multivariable model, cardiac rehabilitation was associated with smoking cessation (OR 5.19; 95%CI 1.87 to 14.46; p = 0.002).

Discussion

Attending a cardiac rehabilitation program after a cardiovascular event was associated with smoking cessation supporting its use as a platform for smoking cessation counseling and relapse prevention.
Effects of a vocational rehabilitation programme on return to work among sick-listed primary health care patients: a population-based matched, case-control study
Authors: von Celsing Anna-Sophia , Kristiansson Per , Svärdsudd Kurt , Wallman Thorne
Published: March 2020

Background

To evaluate the efficacy of a multidisciplinary vocational programme in sick-listed, primary health care patients as compared to matched non-programme patients.

Methods

The design was a 3-year prospective population-based, matched case-control study. It was set in a large primary healthcare centre in the city of Eskilstuna, Sweden. The subjects were 943 sickness-certified patients (482 women and 461 men). 170 high-risk patients and a matched control group (n = 340) with similar risk for not returning to work within expected time, based on propensity score was created. The intervention group passed a multidisciplinary medical assessment and a coordinated vocational programme, while the control group received usual care by their general practitioner. Main outcome was sick leave conclusion and the day when it occurred.

Results

The follow-up time was subdivided into four periods. During the first two periods, days 1–14 and days 15–112 after baseline, the intervention group had a significantly lower sick leave conclusion rate than the control group (hazard ratios, (HR) 0.32, 95% CI 0.20–0.51, p <  0.0001 and 0.47, 95% CI 0.35–0.64). During the third period, days 113–365, the intervention group had an insignificantly lower conclusion rate (HR 0.70, 95% CI 0.46–1.08, p = 0.10), and during the fourth follow-up period, days 366–1096, the intervention group had an insignificantly higher conclusion rate than the control group (HR 1.16, 95% CI 0.69–1.96, p = 0.58). Across the total follow-up period, the intervention group had a lower conclusion rate than the control group (HR 0.55, 95% CI 0.45–0.66, p <  0.0001).

Conclusions

No positive significant effects of the rehabilitation programme on time to sick leave conclusion were found.
Self-rated health and objective health status as predictors of all-cause mortality among older people: a prospective study with a 5-, 10-, and 27-year follow-up
Authors: Wuorela Maarit , Lavonius Sirkku , Salminen Marika , Vahlberg Tero , Viitanen Matti , Viikari Laura
Published: March 2020

Background

Despite a non-specific nature of self-rated health (SRH), it seems to be a strong predictor of mortality. The aim of this study is to assess the association of SRH and objective health status (OH) with all-cause mortality in 70-year-old community-dwelling older people in Finland.

Methods

A prospective study with 5-, 10- and 27-year follow-ups. SRH (n = 1008) was assessed with a single question and OH (n = 962) by the Rockwood’s Frailty Index (FI). To assess the association of SRH and OH with mortality, Cox regression model was used.

Results

Of the 1008 participants, 138 (13.7%), 319 (31.6%), and 932 deceased (86.3%) during the 5-, 10- and 27-year follow-ups, respectively. In unadjusted models, subjects with poor SRH had almost eightfold risk for mortality compared to those with good SRH during the 5-year follow-up; among those with poor OH, the risk was fourfold compared to those with good OH. In the 10-year-follow up, both poor SRH and poor OH predicted about fourfold risk for mortality compared to those with good health. During the 27-year follow-up, OH was a stronger predictor of mortality than SRH. Poor SRH, compared to good SRH, showed 95% sensitivity and 34% specificity for 5-year mortality; corresponding figures for OH were 54 and 80%, respectively.

Conclusions

Single-item SRH seems to be able to capture almost the same as OH in predicting a short-term (less than 10 years) mortality risk among older adults in clinical settings. The use of SHR may also enhance the focus on patient-centered care.
A cross-sectional study of the relationships between different components of sarcopenia and brachial ankle pulse wave velocity in community-dwelling elderly
Authors: Rong Yu-Dong , Bian Ai-Lin , Hu Hui-Ying , Ma Yue , Zhou Xin-Zi
Published: March 2020

Background

Previous studies have just found skeletal muscle mass decline is associated with arterial stiffness, but it is unclear whether muscle strength and physical performance as important compositions of sarcopenia are associated with arterial stiffness. The aim of this study was to investigate the relationship between sarcopenia, the components of sarcopenia and arterial stiffness among elderly in the community.

Methods

This study enrolled 450 elderly people who received general medical examinations in Tianjin First Center Hospital. Each of the subjects was greater than 65 years old, including 266 male and 184 female subjects. Based on the diagnostic criteria for sarcopenia in older people developed by the Asian Working Group for Sarcopenia (AWGS), 89 subjects were separated into the sarcopenia group. The living habits, disease status, general status and laboratory examinations of all subjects were collected. The body composition (including appendicular skeletal muscle mass and visceral fat area (VFA) of each participant) was measured by bioimpedance analysis. HS, usual gait speed (GS), and brachial ankle pulse wave velocity (baPWV) were measured.

Results

Sarcopenia subjects had higher baPWV, nutrition risk and lower appendicular skeletal muscle index (ASMI), Handgrip strength (HS), GS, body mass index (BMI), triacylglycerol (TG), serum albumin (ALB) and creatinine (Cr) than did non-sarcopenia subjects; Sarcopenia subjects also had higher visceral fat area (VFA) than did non-sarcopenia subjects (p < 0.05). ASMI and HS were negatively associated with baPWV (t = − 5.807,p = 0.000 and t = − 3.085,p = 0.002), but the relationship between baPWV and GS was not statistically significant (t = − 0.862,p = 0.389) by multivariable linear regression. After adjusting for confounders, a multivariate logistic regression analysis revealed that sarcopenia was related with age, BMI, sports and baPWV in community dwelling elderly.

Conclusions

ASMI and HS were negatively associated with baPWV in community dwelling elderly in China; and baPWV was a risk factor of sarcopenia.
Prevalence of medication-related falls in 200 consecutive elderly patients with hip fractures: a cross-sectional study
Authors: Andersen Charlotte Uggerhøj , Lassen Pernille Overgaard , Usman Hussain Qassim , Albertsen Nadja , Nielsen Lars Peter , Andersen Stig
Published: March 2020

Background

Hip fractures constitute a major health problem in elderly people and are often fall-related. Several factors can contribute to a fall episode leading to hip fracture, including fall-risk-increasing drugs (FRIDs), which are often used by elderly people.

We aimed to investigate the prevalence of medication-related falls and to assess the role of FRIDs and potentially inappropriate medications (PIMs) in a population of elderly patients hospitalized for a hip fracture.

Methods

We reviewed the patient records of 200 consecutive patients, aged ≥65 years, who were admitted for a hip fracture and evaluated whether medications were likely to have contributed to the fall episode. PIMs were identified using the Screening Tool of Older Persons’ Prescriptions version 2 (STOPP) and by evaluating indications, contra-indications and interactions of the prescribed medications for each patient.

Results

FRIDs were used by 175 patients (87.5%). Medications were considered a likely contributor to the fall in 82 patients (41%). These were most often psychotropic medications alone or in combination with antihypertensives and/or diuretics. The 82 patients with suspected medication-related falls used more medications, FRIDs and PIMs than the rest of the patients, and in 74 (90%) of the 82 patients, at least one medication considered to be a contributor to the fall was also a PIM.

Conclusions

The prevalence of suspected medication-related falls was 41%. It seems likely that a medication review could have reduced, though not eliminated, the risk of falling in this group of patients.
Post-mortem histology in transient receptor potential cation channel subfamily V member 6 (TRPV6) under-mineralising skeletal dysplasia suggests postnatal skeletal recovery: a case report
Authors: Mason Anna E. , Grier David , Smithson Sarah F. , Burren Christine P. , Gradhand Elise
Published: March 2020

Background

The calcium-selective channel TRPV6 (transient receptor potential cation channel subfamily V member 6) is crucial for maternal-fetal calcium transport across the placenta. TRPV6 mutations have recently been associated with an antenatally severe under-mineralising skeletal dysplasia accompanied by postnatal biochemical abnormalities. This is the first post-mortem report in a patient with TRPV6 skeletal dysplasia.

Case presentation

The female infant had severe antenatal and postnatal skeletal abnormalities by 20 weeks gestation and was ventilator-dependent from birth. These skeletal abnormalities were apparent at an earlier gestational age than in previous reported cases and a more severe clinical course ensued. Biochemical and skeletal abnormalities, including bone density, improved postnatally but cardiac arrest at 4 months of age led to withdrawal of intensive care. Compound heterozygous TRPV6 variants (c.1978G > C p.(Gly660Arg) and c.1528C > T p.(Arg510Ter)) were identified on exome sequencing. Post-mortem identified skeletal abnormalities but no specific abnormalities in other organ systems. No placental pathology was found, multi-organ histological features reflected prolonged intensive care only. Post-mortem macroscopic examination indicated reduced thoracic size and short, pale and pliable ribs. Histological examination identified reduced number of trabeculae in the diaphyses (away from the growth plates), whereas metaphyses showed adequate mineralisation and normal number of trabeculae, but with slightly enlarged reactive chondrocytes, indicating post-natal skeletal growth recovery. Post-mortem radiological findings demonstrated improved bone density, improved rib width, healed fractures, although ribs were still shorter than normal. Long bones (especially humerus and femur) had improved from initial poorly defined metaphyses and reduced bone density to sharply defined metaphyses, prominent growth restart lines in distal diaphyses and bone-in-bone appearance along diaphyses.

Conclusions

This case provide bone histological confirmation that human skeletal development is compromised in the presence of TRPV6 pathogenic variants. Post-mortem findings were consistent with abnormal in utero skeletal mineralisation due to severe calcium deficit from compromised placental calcium transfer, followed by subsequent phenotypic improvement with adequate postnatal calcium availability. Significant skeletal recovery occurs in the early weeks of postnatal life in TRPV6 skeletal dysplasia.
HLA-G14bp ins/del polymorphism and post-transplant weight gain in kidney transplantation: potential implications beyond tolerance
Authors: Piancatelli Daniela , Maccarone Daniela , Colanardi Alessia , Sebastiani Pierluigi , Clemente Katia , Iesari Samuele , Lai Quirino , Pisani Francesco
Published: March 2020

Background

Human leukocyte antigen (HLA)-G is a non-classical HLA molecule with immunomodulant and immunosuppressive functions, involved in transplantation tolerance. HLA-G14bp ins/del polymorphism in exon 8 has been associated with allograft rejection and kidney transplant outcome, with controversial results. We investigated associations of HLA-G14bp ins/del polymorphism on onset of some of the main post-transplant risk factors, like excess body weight, lipid abnormalities, increased fasting plasma glucose. Polymorphisms of cytokines with both immunosuppressive and metabolic effects were also assessed for comparisons and associated analysis.

Methods

The present study involved kidney transplant recipients (n = 173) in which body mass index, cholesterol, triglycerides, fasting plasma glucose were registered in the first years after transplantation and analyzed in association with genotypes. Presence of hypertension and smoking habits, demographic, transplant-related and therapeutic data of patients were also recorded. Polymerase chain reaction, sequence-specific primer amplification and Taqman allelic discrimination techniques were used for genotyping of HLA-G14bp ins/del, interleukin (IL)-10(−1082G > A,-819 T > C,–592A > C), transforming growth factor-β(+ 869 T > C,+915C > G), IL-6(−174G > C), tumor necrosis factor-α(−308G > A) and IL-18(−137G > C,-607C > A). Effects of genotypes on clinical markers at each time point (pre-transplant and 1 to 5 years after transplant) were analyzed using a repeated-measures general linear model analysis; adjustment for potential confounders was performed.

Results

Results showed that HLA-G14bp ins/ins was significantly associated with obesity, in particular after transplantation (3 years,p = 0.002, OR = 4.48, 95% CI:1.76–11.41). Post-transplant body mass index was significantly increased in HLA-G14bp ins/ins carriers (3 and 4 years,p = 0.033 andp = 0.044); effects of HLA-G14bp genotypes on post-transplant BMI were confirmed by using repeated-measures analysis and after controlling for confounding variables. Cytokine genotypes did not associate with the examined factors.

Conclusions

The study of transplanted patients allowed to evidence a potential relationship between post-transplant weight gain and HLA-G14bp ins/del polymorphism, previously involved in rejection for its immunosuppressive/tolerogenic activity. This novel association could widen the knowledge of the role and functions of HLA-G molecules in diseases and transplantation.