bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization and whole genome sequencing of a novel strain of Bergeyella cardium related to infective endocarditis
Authors: Pan Hongwei , Li Wei , Sun Enhua , Zhang Yi
Published: February 2020

Background

Bergeyella cardiuminfection is becoming increasingly prevalent in patients with infective endocarditis, suggesting its significance in disease pathogenesis. However, few studies have fully characterized this species.

Results

Herein, we report the morphological and physiological characteristics, as well as whole genome sequencing of a newly identifiedB. cardiumHPQL strain isolated from a patient with infective endocarditis. Results from the cellular morphology and biochemical analysis provide basic knowledge on the new pathogen. The whole genome sequencing ofB. cardiumHPQL consists of a circular chromosome with a total length of 2,036,890 bp. No plasmid was detected. Comparative genomics were carried out then. Antibiotics resistance related genes, pathogenesis related genes, predicted insertion sequences, genome islands and predicted CRISPRs sequences were demonstrated. To our knowledge, this is the first study to provide a complete genome sequence forBergeyellaspp.

Conclusions

This study provides fundamental phenotypic and genomic information for the newly identified fastidious infective endocarditis causative bacteria,B. cardium. Our results provide insights into effective clinical diagnosis and treatment of this pathogen.
Development and validation of a brief self-assessed wisdom scale
Authors: Fung Sai-fu , Chow Esther Oi-wah , Cheung Chau-kiu
Published: February 2020

Background

This longitudinal study aimed to develop a nine-item Brief Self-Assessed Wisdom Scale (BSAWS) derived from the original 40-item Self-Assessed Wisdom Scale (SAWS).

Methods

The psychometric properties of the shortened scale were evaluated based on a sample of 157 older adults. The factor structure and dimensionality of the original SAWS were examined using confirmatory factor analysis. Subsequent explorative factor analysis of the BSAWS supported the construct validity of the shortened scale.

Results

The internal consistency, convergent validity and construct validity of the shortened scale were also evaluated and the results indicated that the BSAWS possesses good psychometric properties and is comparable with the full version.

Conclusions

This scale refinement may help researchers and practitioners conduct epistemological surveys or clinical research related to wisdom.
Elderly patients’ decision-making embedded in the social context: a mixed-method analysis of subjective norms and social support
Authors: Doekhie Kirti D. , Buljac-Samardzic Martina , Strating Mathilde M. H. , Paauwe Jaap
Published: February 2020

Background

Older patients are increasingly encouraged to be actively involved but how they perceive their role in the decision-making process varies according to their health care providers and their health situation. Their role could be influenced by their social context but more specifically by subjective norms (i.e. patients’ view of the role that significant others expect them to play in the decision-making process) and perceived social support. We explore how social context (i.e. subjective norms and social support) relates to how the patient perceives their role in the decision-making process. Also, we explore the level of alignment on subjective norms between patients and their informal caregivers and nurses.

Methods

Mixed-method study among older patients, informal caregivers and nurses. For the quantitative questionnaire, a home care organisation randomly selected patients. The patients were asked to identify their informal caregiver and the home care organisation was asked to identify the nurse who was most involved in their care. In total 133 patients, 64 informal caregivers and 72 nurses were questioned. Participants for the qualitative interviews were selected using convenience sampling, resulting in the inclusion of ten patients, five informal caregivers and six nurses. Subjective norms were based on a previous study. Social support was measured with the ‘social support for health scale’ of the Health Literacy Questionnaire. The Control Preference Scale was used as outcome variable. The interviews focused on subjective norms, social support and how the patient perceived their role. Quantitative analysis included the calculation of subjective norm difference scores between respondent groups, one-way analysis of variance and multinomial logistic regression analysis. Directed content analysis was applied to the interviews using Atlas TI.

Results

Lower difference scores were found for patient-informal caregiver dyads (mean = 0.95), implying more alignment than in patient-nurse dyads (mean = 2.12). Patients perceiving themselves to have a shared or passive role tend to believe that they are expected to leave decision-making to the health care provider. Higher social support scores related more to a shared role. Alignment relates to: familiarity with the patient’s preferences, overprotectiveness or valuing the care provider’s opinion and the severity of the patient’s medical history.

Conclusion

Patients and informal caregivers align on whether the patient should make decisions. The more patients believe that they are expected to leave decision-making to the health care provider, the more they perceive themselves as having a passive role. The more patients who feel they have support, the more they perceive themselves as having a shared role. Patients and caregivers could be facilitated to make role expectations explicit. Examining support resources in the social network is desirable.
Novel PAK3 gene missense variant associated with two Chinese siblings with intellectual disability: a case report
Authors: Qian Yanyan , Wu Bingbing , Lu Yulan , Zhou Wenhao , Wang Sujuan , Wang Huijun
Published: February 2020

Background

Intellectual disability (ID) constitutes the most common group of neurodevelopmental disorders. Exome sequencing has enabled the discovery of genetic mutations responsible for a wide range of ID disorders.

Case presentation

In this study, we reported on two male siblings, aged 4 and 2 years, with motor and mental developmental delays and mild dysmorphic facial features. To identify the genetic causes of these symptoms, we employed trio-whole exome sequencing for the proband. We found a novel hemizygous missense variant in the PAK3 gene (c.1112G > A, p.Cys371Tyr), which encodes the p21-activated kinase 3, in the proband, which inherited from mother. The younger brother also has the hemizygous variant, which was confirmed by Sanger sequencing. The variant is located in the kinase domain and was regarded as a likely pathogenic variant in this family.

Conclusion

We diagnosed two male siblings with developmental delays as having a PAK3 likely pathogenic variant. This finding expands the list of PAK3 gene mutations associated with neurodevelopmental disorders and provides further details on its clinical features.
Association of IL-10 gene promoter polymorphisms with susceptibility to pseudoexfoliation syndrome, pseudoexfoliative and primary open-angle glaucoma
Authors: Fakhraie Ghasem , Parvini Farshid , Ghanavi Jalaledin , Saif Shima , Farnia Poopak
Published: February 2020

Background

The involvement of cytokines in pathogenesis of pseudoexfoliation syndrome and glaucoma has been demonstrated in several studies. The aim of the present study was to explore the association between three promoter polymorphisms −592C/A (rs1800872), − 819C/T (rs1800871) and -1082A/G (rs1800896) of interleukin 10 (IL-10) gene with susceptibility to pseudoexfoliation syndrome (PEX), pseudoexfoliative glaucoma (PEXG), and primary open-angle glaucoma (POAG).

Methods

In this study, 114 PEX, 118 PEXG, 114 POAG patients and 126 healthy individuals from Iranian population were participated. Detailed ophthalmic examinations by an ophthalmologist including slit-lamp bio-microscopic examination, dilated examination of the lens, gonioscopy, and funduscopy were carried out on patients and controls. Genomic DNA was extracted from the blood samples and ARMS–PCR was performed to detect promoter polymorphisms of IL-10.

Results

In all three SNPs studied, there was a significant difference in the genotype distribution between patients and control subjects. Results revealed that the AA genotype of IL-10 -592C/A SNP is associated with PEX. However, TT genotype of −819C/T and AA genotype of -1082A/G SNP are significantly associated with susceptibility to either PEX or PEXG and POAG disorders. Furthermore, the ACC haplotype containing the IL-10 -1082A allele was associated with PEX (P = 0.02, OR = 5.76, 95% CI = 5.17–24.49), PEXG (P = 0.006, OR = 7.54, 95% CI = 6.62–30.76) and POAG (P = 0.003, OR = 8.11, 95% CI = 7.13–33.15).

Conclusions

Our results demonstrated that IL-10 gene promoter polymorphisms are associated with susceptibility to PEX, PEXG and POAG in Iranian population. Considering the fact that IL-10 polymorphisms are associated with various IL-10 expressions, further research is needed to explain its involvement in these disorders and the formation of extracellular fibrillar amyloid deposits in PEX and PEXG.
Factors influencing adoption of facility-assisted delivery - a qualitative study of women and other stakeholders in a Maasai community in Ngorongoro District, Tanzania
Authors: Mosley Paul D. , Saruni Kisiaya , Lenga Bernadetha
Published: February 2020

Background

Tanzania’s One Plan II health sector program aims to increase facility deliveries from 50 to 80% from 2015 to 2020. Success is uneven among certain Maasai pastoralist women in Northern Tanzania who robustly prefer home births to facility births even after completing 4+ ANC visits. Ebiotishu Oondomonok Ongera (EbOO) is a program in Nainokanoka ward to promote facility births through a care-group model using trained traditional birth attendants (TBAs) as facilitators. Results to date are promising but show a consistent gap between women completing ANC and those going to a facility for delivery. A qualitative study was conducted to understand psychosocial preferences, agency for decision-making, and access barriers that influence where a woman in the ward will deliver.

Methods

In-depth interviews, focus group discussions and key-informant interviews were conducted with 24 pregnant and/or parous women, 24 TBAs, 3 nurse midwives at 3 health facilities, and 24 married men, living in Nainokanoka ward. Interviews and discussions were transcribed, translated, and analyzed thematically using a grounded theory approach.

Results

Most women interviewed expressed preference for a home birth with a TBA and even those who expressed agency and preference for a facility birth usually had their last delivery at home attributed to unexpected labor. TBAs are engaged by husbands and play a significant influential role in deciding place of delivery. TBAs report support for facility deliveries but in practice use them as a last resort, and a significant trust gap was documented based on a bad experience at a facility where women in labor were turned away.

Conclusions

EbOO project data and study results show a slow but steady change in norms around delivery preference in Nainokanoka ward. Gaps between expressed intention and practice, especially around ‘unexpected labor’ present opportunities to accelerate this process by promoting birth plans and perhaps constructing a maternity waiting house in the ward. Rebuilding trust between facility midwives, TBAs, and the community on the availability of health facility services, and increased sensitivity to women’s cultural preferences, could also close the gap between the number of women who are currently using facilities for ANC and those returning for delivery.
Socio-ecological determinants of lifestyle behavior of women with overweight or obesity before, during and after pregnancy: qualitative interview analysis in the Netherlands
Authors: Timmermans Y. E. G. , van de Kant K. D. G. , Krumeich J. S. M. , Zimmermann L. J. I. , Dompeling E. , Kramer B. W. , Maassen L. L. J. , Spaanderman M. A. E. , Vreugdenhil A. C. E.
Published: February 2020

Background

Maternal overweight and obesity are related to several health risks in the periods before, during and after pregnancy including a higher risk of gestational diabetes mellitus, preeclampsia and preterm birth. At the same time, women’s daily life quickly changes in these periods. Therefore, we hypothesize that the value of determinants of lifestyle behavior within different levels of the socio-ecological model differ accordingly and influence lifestyle behavior. These dynamics of determinants of lifestyle behavior in the periods before, during and after pregnancy are unexplored and therefore evaluated in this study. These insights are needed to offer appropriate guidance to improve lifestyle in women of childbearing age.

Methods

Individual semi-structured interviews were conducted before, during or after pregnancy in 26 women with overweight or obesity living in the Netherlands. Questions covered all levels of the socio-ecological model, i.e. intrapersonal, interpersonal, institutional and environmental/societal. All interviews were transcribed and coded.

Results

Determinants at all levels of the socio-ecological model were perceived as relevant by women of childbearing age. Various determinants were mentioned including knowledge of a healthy lifestyle, social support, access to customized lifestyle guidance, and distance to healthy lifestyle supporting activities. The importance women attributed to determinants differed between the periods before, during and after pregnancy. Before pregnancy, child’s wellbeing as motivator for adopting a healthy lifestyle was mentioned less frequently than during and after pregnancy. Women described that the interplay and balance between determinants varied on a daily basis, and not merely per period. This was often expressed as fluctuation in energy level per day which influences their willingness to put effort in making healthy choices.

Conclusions

Findings of this study confirm the importance of determinants at multiple socio-ecological levels for shaping lifestyle behavior in women of childbearing age. The findings add to current insights that the perceived importance of determinants and their interplay differ before, during and after pregnancy. They influence lifestyle behavior decisions, not only per period but even on a daily basis, in particular in this phase of life. This perspective can be helpful in optimizing lifestyle guidance for women of childbearing age in order to prevent perinatal complications.
First-trimester maternal serum alpha-fetoprotein is not a good predictor for adverse pregnancy outcomes: a retrospective study of 3325 cases
Authors: Hu Jilin , Zhang Jinman , He Guilin , Zhu Shu , Tang Xinhua , Su Jie , Li Qian , Kong Yamin , Zhu Baosheng
Published: February 2020

Background

It is well known that second-trimester maternal serum alpha-fetoprotein (MS-AFP) is a predictor for adverse pregnancy outcomes (APOs), such as preterm birth, stillbirth, preeclampsia and small for gestational age (SGA). However, it is unknown whether first-trimester MS-AFP is also predictive of APOs.

Methods

We retrospectively reviewed the data on the first-trimester MS-AFP levels and pregnancy outcomes of 3325 singleton pregnant women. The cutoff value of 2.5 multiple of the median (MoM) was used to evaluate the risks of APOs regarding MS-AFP. The receiver operating characteristic (ROC) curves were used to evaluate the predictive efficiencies of MS-AFP to these disorders.

Results

A total of 181 pregnancies resulted in preterm birth, 32 in stillbirth, 81 in preeclampsia, and 362 in SGA. Compared to women with MS-AFP < 2.5MoM, those with MS-AFP ≥ 2.5MoM had increased risks (odds ratio, 95% confidence interval) of preterm birth (2.53, 1.65~3.88), preeclampsia (3.05, 1.71~5.43) and SGA (1.90, 1.34~2.69), and had an earlier distribution of gestational weeks at delivery (P = 0.004) and a lower distribution of neonatal birth weights (P = 0.000), but the actual between-group differences were minuscule. The areas under ROC curves were 0.572 (P = 0.001), 0.579 (P = 0.015) and 0.565 (P = 0.000) for preterm birth, preeclampsia and SGA, respectively. Subdivisions for the disorders did not obviously improve the performances of MS-AFP.

Conclusions

Elevated first-trimester MS-AFP is associated with increased risk of preterm birth, preeclampsia and SGA. However, the predictive efficiencies were low and it is not a good predictor for these APOs.
Gestational weight gain counselling practices among different antenatal health care providers: a qualitative grounded theory study
Authors:   for DOH-NET (Diabetes, Obesity and Hypertension in Pregnancy Research Network) and SOON (Southern Ontario Obstetrical Network) Investigators™, Murray-Davis Beth , Berger Howard , Melamed Nir , Mawjee Karizma , Syed Maisah , Barrett Jon , Ray Joel G. , Geary Michael , McDonald Sarah D.
Published: February 2020

Background

Inappropriate gestational weight gain in pregnancy may negatively impact health outcomes for mothers and babies. While optimal gestational weight gain is often not acheived, effective counselling by antenatal health care providers is recommended. It is not known if gestational weight gain counselling practices differ by type of antenatal health care provider, namely, family physicians, midwives and obstetricians, and what barriers impede the delivery of such counselling. The objective of this study was to understand the counselling of family physicians, midwives and obstetricians in Ontario and what factors act as barriers and enablers to the provision of counselling about GWG.

Methods

Semi-structured interviews were conducted with seven family physicians, six midwives and five obstetricians in Ontario, Canada, where pregnancy care is universally covered. Convenience and purposive sampling techniques were employed. A grounded theory approach was used for data analysis. Codes, categories and themes were generated using NVIVO software.

Results

Providers reported that they offered gestational weight gain counselling to all patients early in pregnancy. Counselling topics included gestational weight gain targets, nutrition & exercise, gestational diabetes prevention, while dispelling misconceptions about gestational weight gain. Most do not routinely address the adverse outcomes linked to gestational weight gain, or daily caloric intake goals for pregnancy. The health care providers all faced similar barriers to counselling including patient attitudes, social and cultural issues, and accessibility of resources. Patient enthusiasm and access to a dietician motivated health care providers to provide more in-depth gestational weight gain counselling.

Conclusion

Reported gestational weight gain counselling practices were similar between midwives, obstetricians and family physicians. Antenatal knowledge translation tools for patients and health care providers are needed, and would seem to be suitable for use across all three types of health care provider specialties.
Birth order is associated with caries development in young children: a register-based cohort study
Authors: Julihn A. , Soares F. C. , Hammarfjord U. , Hjern A. , Dahllöf G.
Published: February 2020

Background

Birth order has been shown to affect the health of the child; less is known, however, about how birth order affects caries development in children. Thus, the present study investigated the association between birth order and dental caries development in young children.

Methods

This retrospective registry-based cohort study included all children born in 2000–2003 who were residing in Stockholm County, Sweden, at age 3 years (n = 83,147). The study followed the cohort until subjects reached 7 years of age. Children with registry data on dental examinations and sociodemographic characteristics at ages 3- and 7 years constituted the final study cohort (n = 65,259). The outcome variable was “caries increment from age 3- to 7 years” (Δdeft > 0) and the key exposure, “birth order”, was divided into five groups. A forward stepwise logistic binary regression was done for the multivariate analysis with adjustments for sociodemographic factors.

Results

At age 3 years, 94% had no fillings or manifest caries lesions. During the study period, 22.5% (n = 14,711) developed dental caries. The final logistic regression analysis found a statistically significant positive association between birth order and caries increment. Further, excess risk increased with higher birth order; with the mother’s first-born child as reference, risk for the second-born child was OR 1.17, 95% CI = 1.12–1.23; for the third-born child, OR 1.47, 95% CI = 1.38–1.56; for the fourth-born child, OR 1.69, 95% CI = 1.52–1.88; and for the fifth-born or higher birth-order child, OR 1.84, 95% CI = 1.58–2.14.

Conclusions

These findings show that birth order influences caries development in siblings, suggesting that birth order can be regarded as a predictor for caries development in young children. This factor may be helpful in assessing caries risk in preschool children and should be considered in caries prevention work in young children with older siblings.
Non-participation in mammographic screening – experiences of women from a region in Sweden
Authors: Norfjord van Zyl Maria , Akhavan Sharareh , Tillgren Per , Asp Margareta
Published: February 2020

Background

Understanding women’s life conditions regarding their non-participation in different health-promoting and disease-preventing activities is important as it may draw attention to potential areas for improvement in the healthcare sector. Mammographic screening, a disease-preventing service, facilitates early detection of any potential malignancies and consequently prompts initiation of treatment. The reasons for non-participation in mammographic screening can be understood from different perspectives, such as socioeconomic and lifestyle-related determinants of health. This study aims to gain a deeper understanding of women’s experiences and perceptions about non-participation in mammographic screening in a Swedish region with a single mammographic facility.

Methods

Data from individual semi-structured interviews, conducted in 2018 with eleven women between the ages of 48 and 73, were analysed by a qualitative content analysis.

Results

The findings reveal three main categories: 1) doubts regarding mammographic screening and its organisation, 2) sense and sensibility in the decision to refrain from mammographic screening, and 3) dependency and options. These three categories indicate aspects, such as the individual’s life situation, accessibility to the offered service, and the flexibility of the healthcare system, that need to be considered to improve the organisation of mammographic screening.

Conclusion

Listening to the women’s voices regarding their experiences and perceptions about mammographic screening is important as individual characteristics and social circumstances interact with healthcare and affect the degree of participation.
Show cards of the Global Physical Activity Questionnaire (GPAQ) – do they impact validity? A crossover study
Authors: Rudolf Kevin , Lammer Florian , Stassen Gerrit , Froböse Ingo , Schaller Andrea
Published: February 2020

Background

The Global Physical Activity Questionnaire (GPAQ) is applied internationally as a tool to assess the level of physical activity. The GPAQ was designed as an interview, including the use of show cards, which visualise activities of moderate and intensive physical activity and support the distinction between these intensities. The self-administered version of the GPAQ is used in the application-oriented research for reasons of economy and practicality. However, the use of show cards often remains unknown.

The aim of the present study was to examine differences in validity between two self-administered versions of the GPAQ with and without show cards.

Methods

In this crossover study, two groups (n = 54; 57.4% female; 28.3 ± 12.2 years) received the GPAQ with or without show cards after 7 days and the respective other version after additional 7 days. For validation, all participants wore an accelerometer (ActiGraph GT3X+) on all 14 days.

Differences between GPAQ versions and accelerometer data were compared by Wilcoxon signed rank test. Additionally, Spearman analyses and Bland-Altman plots were calculated.

Results

No statistically significant difference between the GPAQ versions could be found in regard to the accuracy of physical activity assessment (p > 0.05).

Both GPAQ versions show similar correlation coefficients for vigorous physical activity (rho = 0.31–0.42) and sedentary behaviour (rho = 0.29–0.32). No statistically significant correlation was found for physical activity of moderate intensity. The Bland-Altman plots support these results, as both GPAQ versions have the same trends in terms of overestimation and underestimation of physical activity.

Conclusion

The use of show cards had no significant impact on questionnaire validity. Therefore, both GPAQ versions can be applied interchangeably. Nevertheless the exact description of application of the GPAQ is desirable in terms of reproducibility and transparent scientific research.
Violence typologies and sociodemographic correlates in South African adolescents: a three-wave cross-sectional study
Authors: Sui Xincheng , Massar Karlijn , Ruiter Robert A. C. , Reddy Priscilla S.
Published: February 2020

Background

Violence victimisation and violence perpetration may co-occur in adolescents. Understanding the sociodemographic correlates of the independent and joint profiles of victimisation and perpetration may inform preventive interventions. This study examined the associations of sociodemographic factors with four violence typologies, namely, 1) non-involvement in both victimisation and perpetration, 2) victims only, 3) perpetrators only, and 4) victim-perpetrators. Trends in the prevalence of the four violence typologies over the three survey years were also examined.

Methods

We used data from the three nationally representative South African Youth Risk Behaviour Surveys conducted in 2002, 2008, and 2011 and included a multi-ethnic sample of adolescents (n = 30,007; boy: 46.9%, girls: 53.1%; M age = 16 years, SD = .06).

Results

The sample consisted of 8030 (30.8%) adolescents who had non-involvement in both victimisation and perpetration, 8217 were victims only (29.8%), 2504 were perpetrators only (9.0%), and 7776 were victim-perpetrators (24.6%). Logistic regression analyses showed that being a girl increased the odds of non-involvement (OR: 1.47, 99% CI: 1.36–1.58) and being victims only (OR: 1.90, 99% CI: 1.76–2.05). Being a boy increased the odds of being perpetrators only (OR: 0.42, 99% CI: 0.37–0.47) and victim-perpetrators (OR: 0.51, 99% CI: 0.47–0.55). Adolescents who did not have an absent mother had higher odds of non-involvement (OR: 0.78, 99% CI: 0.62–0.97). Lower monthly allowance increased the odds of victimisation only (OR: 0.99, 99% CI: 0.97–1.00), whereas higher monthly allowance increased the odds of perpetration only (OR: 1.05, 99% CI: 1.03–1.08). Trend analysis showed that between 2002 to 2011, there was an increase in the prevalence of non-involvement in adolescents (p < .001), a decrease in the prevalence of victims only (p < .05) and victim-perpetrators (p < .001), and no changes in the prevalence of perpetrators only (p > .05).

Conclusions

Sociodemographic factors are uniquely associated with different violence typologies suggesting the need for tailored interventions to target adolescents with differed risks to violence victimisation and perpetration. Strengthening family relations, particularly between mother and child, may protect adolescents from the experiences of victimisation and perpetration.
Venous thromboembolism rates after hip and knee arthroplasty and hip fractures
Authors: Mula Viswanath , Parikh Sunny , Suresh Sivakolundu , Bottle Alex , Loeffler Mark , Alam Mahbub
Published: February 2020

Background

The ideal thromboprophylaxis regime following lower limb arthroplasty and proximal femur fractures remains controversial. Guidelines disagree on the type of chemical prophylaxis, its dose or duration. This article describes a method of monitoring venous thromboembolism (VTE) rates following Total Hip (THA), Total Knee Arthroplasty (TKA) and surgery for hip fractures (NOF#).

Methods

Over 3 years, all patients investigated for VTE were analysed using Picture Archiving Communications System (PACS). All positive scans were then cross-referenced using PACS and local registry data to see if they had undergone THA, TKA or NOF# in the preceding 90 days. Mortality data were obtained from the national administrative database, Hospital Episode Statistics.

Results

Five thousand seven hundred eighty-eight patients underwent investigation for VTE and there were 29 diagnoses of PE and 24 of DVT. There was a 0.77% rate of symptomatic DVT after THA, 0.05% after TKA and 0.55% after NOF #. The rate of confirmed symptomatic PE for THA was 0.46, 0.27% for TKA and 0.96% for NOF #. Mortality at one-year post-THA was 0.6, 0.6% for TKA and 25.9% after NOF#. All patients contacted either remained within the catchment area for the minimum 90 postoperative days or died within the catchment area.

Conclusions

The 90 day post-operative prevalence of symptomatic VTE of 1.2, 0.3 and 1.5% in THA, TKA and NOF # respectively are similar to other studies using symptomatic and imaging positive VTE as their endpoint. The study uses a method of collecting data which can be utilised in centres where PACS is available.
Markers of liver regeneration—the role of growth factors and cytokines: a systematic review
Authors: Hoffmann Katrin , Nagel Alexander Johannes , Tanabe Kazukata , Fuchs Juri , Dehlke Karolin , Ghamarnejad Omid , Lemekhova Anastasia , Mehrabi Arianeb
Published: February 2020

Background

Post-hepatectomy liver failure contributes significantly to postoperative mortality after liver resection. The prediction of the individual risk for liver failure is challenging. This review aimed to provide an overview of cytokine and growth factor triggered signaling pathways involved in liver regeneration after resection.

Methods

MEDLINE and Cochrane databases were searched without language restrictions for articles from the time of inception of the databases till March 2019. All studies with comparative data on the effect of cytokines and growth factors on liver regeneration in animals and humans were included.

Results

Overall 3.353 articles comprising 40 studies involving 1.498 patients and 101 animal studies were identified and met the inclusion criteria. All included trials on humans were retrospective cohort/observational studies. There was substantial heterogeneity across all included studies with respect to the analyzed cytokines and growth factors and the described endpoints.

Conclusion

High-level evidence on serial measurements of growth factors and cytokines in blood samples used to predict liver regeneration after resection is still lacking. To address the heterogeneity of patients and potential markers, high throughput serial analyses may offer a method to predict an individual’s regenerative potential in the future.
Effects of ERK/p38 MAPKs signaling pathways on MTA-mediated osteo/odontogenic differentiation of stem cells from apical papilla: a vitro study
Authors: Du Jing , Lu Yating , Song Mengxiao , Yang Lin , Liu Junqing , Chen Xinyu , Ma Yue , Wang Yan
Published: February 2020

Background

Stem cells from apical papilla (SCAP) located in the root apex of immature permanent teeth are a reliable cell source for pulp-dentine complex regeneration. Mineral trioxide aggregate (MTA) is a biocompatible material which has been widely used in endodontic treatments. The aim of this study was to elucidate the regulatory role of MTA in the proliferation and differentiation of SCAP.

Methods

Cell viability was detected by Cell counting kit-8. Characteristics of SCAP were confirmed by Flow cytometric (FCM) analysis and alizarin red staining. Then, MTA-mediated osteo/odontogenic differentiation of SCAP was investigated by reverse transcription polymerase chain reaction. The effect of MAPKs on MTA-mediated osteo/odontogenic differentiation was evaluated by western blot analysis.

Results

There was no significant difference in cell viability between the control group and the group with lower concentrations of MTA. However, higher concentrations of MTA could inhibit proliferation of SCAP. It is demonstrated that the ALP activity were enhanced, the mRNA and protein expression of BSP, OCN, DSPP, Runx2 were up-regulated. In addition, phosphorylation proteins of ERK, p38 were activated through western blot analysis.

Conclusions

MTA at appropriate concentration could enhance osteo/odontogenic differentiation of SCAP by activating p38 and ERK signaling pathways. This study provides a new idea for the clinical application of MTA and the treatment of endodontic diseases.
Clinical, economic and organizational impact of pharmacist interventions on injectable antineoplastic prescriptions: a prospective observational study
Authors: Zecchini Céline , Vo Thi-Ha , Chanoine Sébastien , Lepelley Marion , Laramas Mathieu , Lemoigne Aude , Allenet Benoît , Federspiel Isabelle , Bedouch Pierrick
Published: February 2020

Background

Pharmacists play a key role in ensuring the safe use of injectable antineoplastics, which are considered as high-alert medications. Pharmaceutical analysis of injectable antineoplastic prescriptions aims to detect and prevent drug related problems by proposing pharmacist interventions (PI). The impact of this activity for patients, healthcare facilities and other health professionals is not completely known. This study aimed at describing the clinical, economic, and organizational impacts of PIs performed by pharmacists in a chemotherapy preparation unit.

Methods

A prospective 10-week study was conducted on PIs involving injectable antineoplastic prescriptions. Each PI was assessed by one of the four multidisciplinary expert committees using a multidimensional tool with three independent dimensions: clinical, economic and organizational. An ancillary quantitative evaluation of drug cost savings was conducted.

Results

Overall, 185 patients were included (mean age: 63.5 ± 13.7 years; 54.1% were male) and 237 PIs concerning 10.1% prescriptions were recorded. Twenty one PIs (8.9%) had major clinical impact (ie: prevented hospitalization or permanent disability), 49 PIs (20.7%) had moderate clinical impact (ie: prevented harm that would have required further monitoring/treatment), 62 PIs (26.2%) had minor clinical impact, 95 PIs (40.0%) had no clinical impact, and 9 PIs (3.8%) had a negative clinical impact. For one PI (0.4%) the clinical impact was not determined due to insufficient information. Regarding organizational impact, 67.5% PIs had a positive impact on patient management from the healthcare providers’ perspective. A positive economic impact was observed for 105 PIs (44.3%), leading to a saving in direct drug costs of 15,096 €; 38 PIs (16.0%) had a negative economic impact, increasing the direct drug cost by 11,878 €. Overall cost saving was 3218€.

Conclusions

PIs are associated with positive clinical, economic and organizational impacts. This study confirms the benefit of pharmacist analysis of injectable antineoplastic prescriptions for patient safety with an overall benefit to the healthcare system.
How does the WHO Surgical Safety Checklist fit with existing perioperative risk management strategies? An ethnographic study across surgical specialties
Authors: Wæhle Hilde Valen , Haugen Arvid Steinar , Wiig Siri , Søfteland Eirik , Sevdalis Nick , Harthug Stig
Published: February 2020

Background

The World Health Organization (WHO) Surgical Safety Checklist (SSC) has demonstrated beneficial impacts on a range of patient- and team outcomes, though variation in SSC implementation and staffʼs perception of it remain challenging. Precisely how frontline personnel integrate the SSC with pre-existing perioperative clinical risk management remains underexplored – yet likely an impactful factor on how SSC is being used and its potential to improve clinical safety. This study aimed to explore how members of the multidisciplinary perioperative team integrate the SSC within their risk management strategies.

Methods

An ethnographic case study including observations (40 h) in operating theatres and in-depth interviews of 17 perioperative team members was carried out at two hospitals in 2016. Data were analysed using content analysis.

Results

We identified three themes reflecting the integration of the SSC in daily surgical practice: 1) Perceived usefullness; implying an intuitive advantage assessment of the SSCʼs practical utility in relation to relevant work; 2) Modification of implementation; reflecting performance variability of SSC on confirmation of items due to precence of team members; barriers of performance; and definition of SSC as performance indicator, and 3) Communication outside of the checklist; including formal- and informal micro-team formations where detailed, specific risk communication unfolded.

Conclusion

When the SSC is not integrated within existing risk management strategies, but perceived as an “add on”, its fidelity is compromised, hence limiting its potential clinical effectiveness. Implementation strategies for the SSC should thus integrate it as a risk-management tool and include it as part of risk-management education and training. This can improve team learning around risk comunication, foster mutual understanding of safety perspectives and enhance SSC implementation.
Amniotic fluid cell-free transcriptome: a glimpse into fetal development and placental cellular dynamics during normal pregnancy
Authors: Tarca Adi L. , Romero Roberto , Pique-Regi Roger , Pacora Percy , Done Bogdan , Kacerovsky Marian , Bhatti Gaurav , Jaiman Sunil , Hassan Sonia S. , Hsu Chaur-Dong , Gomez-Lopez Nardhy
Published: February 2020

Background

The amniotic fluid (AF) cell-free transcriptome is modulated by physiologic and pathologic processes during pregnancy. AF gene expression changes with advancing gestation reflect fetal development and organ maturation; yet, defining normal expression and splicing patterns for biomarker discovery in obstetrics requires larger heterogeneous cohorts, evaluation of potential confounding factors, and novel analytical approaches.

Methods

Women with a normal pregnancy who had an AF sample collected during midtrimester (n = 30) or at term gestation (n = 68) were included. Expression profiling at exon level resolution was performed using Human Transcriptome Arrays. Differential expression was based on moderated t-test adjusted p < 0.05 and fold change > 1.25; for differential splicing, a splicing index > 2 and adjusted p < 0.05 were required. Functional profiling was used to interpret differentially expressed or spliced genes. The expression of tissue-specific and cell-type specific signatures defined by single-cell genomics was quantified and correlated with covariates. In-silico validation studies were performed using publicly available datasets.

Results

1) 64,071 genes were detected in AF, with 11% of the coding and 6% of the non-coding genes being differentially expressed between midtrimester and term gestation. Expression changes were highly correlated with those previously reported (R > 0.79, p < 0.001) and featured increased expression of genes specific to the trachea, salivary glands, and lung and decreased expression of genes specific to the cardiac myocytes, uterus, and fetal liver, among others. 2) Single-cell RNA-seq signatures of the cytotrophoblast, Hofbauer cells, erythrocytes, monocytes, T and B cells, among others, showed complex patterns of modulation with gestation (adjusted p < 0.05). 3) In 17% of the genes detected, we found differential splicing with advancing gestation in genes related to brain development processes and immunity pathways, including some that were missed based on differential expression analysis alone.

Conclusions

This represents the largest AF transcriptomics study in normal pregnancy, reporting for the first time that single-cell genomic signatures can be tracked in the AF and display complex patterns of expression during gestation. We also demonstrate a role for alternative splicing in tissue-identity acquisition, organ development, and immune processes. The results herein may have implications for the development of fetal testing to assess placental function and fetal organ maturity.
Haemosporidioses in wild Eurasian blackbirds (Turdus merula) and song thrushes (T. philomelos): an in situ hybridization study with emphasis on exo-erythrocytic parasite burden
Authors: Himmel Tanja , Harl Josef , Pfanner Simone , Nedorost Nora , Nowotny Norbert , Weissenböck Herbert
Published: February 2020

Background

Passerine birds are frequently infected with diverse haemosporidian parasites. While infections are traditionally considered benign in wild birds, recent studies demonstrated mortalities of passerine species due to exo-erythrocytic development of the parasites, which can damage organs in affected hosts. However, exo-erythrocytic development remains insufficiently investigated for most haemosporidian species and thus little is known about the virulence of tissue stages in wild passerine birds. The aim of the present study was to investigate natural haemosporidian infections in deceased Eurasian blackbirds (Turdus merula) and song thrushes (Turdus philomelos) and to determine parasite burden and associated histological effects.

Methods

For molecular analysis, blood and tissue samples from 306 thrushes were screened for Plasmodium, Haemoproteus and Leucocytozoon parasites by nested PCR. For the detection of parasite stages in organ samples, tissue sections were subjected to chromogenic in situ hybridization (CISH) using genus- and species-specific probes targeting the rRNAs of parasites. Exo-erythrocytic parasite burden was semi-quantitatively assessed and histological lesions were evaluated in haematoxylin–eosin-stained sections.

Results

By PCR, 179 of 277 Eurasian blackbirds and 15 of 29 song thrushes were positive for haemosporidians. Parasites of all three genera were detected, with Plasmodium matutinum LINN1 and Plasmodium vaughani SYAT05 showing the highest prevalence. CISH revealed significant differences in exo-erythrocytic parasite burden between lineages in Eurasian blackbirds, with P. matutinum LINN1 frequently causing high exo-erythrocytic parasite burdens in various organs that were associated with histological alterations. Song thrushes infected with P. matutinum LINN1 and birds infected with other haemosporidian lineages showed mostly low exo-erythrocytic parasite burdens. Two Eurasian blackbirds infected with Leucocytozoon sp. TUMER01 showed megalomeronts in various organs that were associated with inflammatory reactions and necroses.

Conclusion

This study suggests that P. matutinum LINN1, a common lineage among native thrushes, regularly causes high exo-erythrocytic parasite burdens in Eurasian blackbirds, which may result in disease and mortalities, indicating its high pathogenic potential. The findings further illustrate that the same parasite lineage may show different levels of virulence in related bird species which should be considered when assessing the pathogenicity of haemosporidian parasite species. Finally, the study provides evidence of virulent Leucocytozoon sp. TUMER01 infections in two Eurasian blackbirds caused by megalomeront formation.
Angiotensin II blockade had no effect on range of motion after total knee arthroplasty: a retrospective review
Authors: Langston Joseph R. , Ramsey Duncan C. , Skoglund Kathryn , Schabel Kathryn
Published: February 2020

Background

Stiffness and pain from arthrofibrosis following total knee arthroplasty (TKA) is a challenging problem, and investigating methods to prevent or reduce the incidence of postoperative arthrofibrosis is critical. Studies have shown that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are efficacious at preventing fibrotic disorders in the lungs, liver, kidneys, and eyes. Our aim was to determine if ACEI or ARB use postoperatively reduces the incidence of arthrofibrosis in TKA patients.

Methods

In a retrospective review, we analyzed 141 consecutive TKAs performed at a single institution by a single surgeon from December 2010 to December 2014. Range of motion (ROM) in patients already taking ACEI, ARB, or neither medication was compared. Independent variables recorded were gender, age, BMI, presence of diabetes or preoperative opioid or statin use, preoperative ROM, and use of ACEIs or ARBs. Dependent variables recorded were postoperative knee flexion, extension, and total arc of motion. The primary outcome variable was success or failure of achieving 118o total arc of motion postoperatively, based on a study that found significant compromise of function in TKA patients who failed to obtain this goal. Secondary endpoints were postoperative knee flexion, extension, and total arc of motion.

Results

The use of neither ACEIs nor ARBs showed a significant difference in attaining greater than 118° of motion postoperatively compared to controls at 6 months. Significant predictors of obtaining > 118° motion were BMI (p < 0.05), preoperative flexion (p < 0.001), and preoperative total arc of motion (p < 0.002). Significant predictors of secondary ROM outcomes were preoperative ROM and BMI.

Conclusions

Our study demonstrated that the principle predictor of postoperative ROM is BMI and preoperative ROM. The use of ACEIs or ARBs did not result in a greater likelihood of obtaining satisfactory ROM postoperatively.
Is supported self-management for depression effective for adults in community-based settings in Vietnam?: a modified stepped-wedge cluster randomized controlled trial
Authors: Murphy Jill K. , Xie Hui , Nguyen Vu Cong , Chau Leena W. , Oanh Pham Thi , Nhu Tran Kieu , O’Neil John , Goldsmith Charles H. , Van Hoi Nguyen , Ma Yue , Lou Hayami , Jones Wayne , Minas Harry
Published: February 2020

Background

This study tested the effectiveness of a supported self-management (SSM) intervention to reduce symptoms of depression among adults compared with enhanced treatment as usual in community-based and primary care settings in Vietnam.

Methods

The cluster randomized trial included 376 adults in 32 communes in eight provinces. Eligible participants scored > 7 on the SRQ-20 depression scale. Patients with severe symptoms were excluded and referred to tertiary care. Randomization took place at the commune level. The immediate intervention group included 16 communes with 190 participants and the delayed group included 16 communes with 186 participants. Participants in communes randomized to the immediate intervention group received a two-month course of SSM, consisting of a workbook and supportive coaching. Those in communes randomized to the delayed group received enhanced treatment as usual and, for ethical purposes, received the SSM intervention after 4 months. The primary outcome is the effect of SSM on reduction in depression scores as indicated by a reduced proportion of participants with SRQ-20 scores > 7 at 2 months after commencement of SSM intervention. Blinding was not possible during intervention delivery but outcome assessors were blinded. Analysis was intention-to-treat.

Results

At 2 months, 26.4% of the intervention group and 42.3% of the delayed group had SRQ-20 scores > 7. The adjusted odds ratio of having depression between the intervention and control was 0.42 (p < 0.0001), 95% CI (0.28, 0.63). Receiving the intervention thus reduces the odds of having depression by 58%, compared with receiving the control after 2 months of treatment. No adverse events were reported.

Conclusions

Results suggest that SSM is effective for decreasing depression symptoms among adults in community-based settings in Vietnam.

Trial RegistrationThis trial is registered at ClinicalTrials.gov, number NCT03001063.