bluuebunny/crossref_metadata_2025 huggingface dataset:
Serial casting in early onset scoliosis: syndromic scoliosis is no contraindication
Authors: Ballhause Tobias M. , Moritz Menard , Hättich Annika , Stücker Ralf , Mladenov Kiril
Published: November 2019

Background

Serial casting is a treatment for early onset scoliosis (EOS) in young children to achieve curve correction before bracing or to postpone initial surgical treatment until the patient is older. Good results have been reported for patients with idiopathic early onset scoliosis (IS). However, there are few reports of results in non-idiopathic cases, and the benefits of non-surgical methods in the syndromic-associated early onset scoliosis subgroup are unknown.

Methods

Retrospective single-institution study of patient charts and X-rays of all cases of sustained serial casting for EOS.

Staged correction was obtained by applying three consecutive casts under general anaesthesia. These were changed every 4 weeks, followed by the implementation of a custom-made full-time Chêneau brace. Correction was measured by Cobb angle (CA) and rib-vertebra angle difference (RVAD) on whole spine anterior-posterior radiographs. Statistical analysis was performed via ANOVA.

Results

The study group consisted of 6 patiens with IS and 10 with non-idiopathic scoliosis (NIS) – exclusively syndromic-associated. The mean age at onset of treatment was 35 months (±15). The mean follow up was 21 months (±15). In IS patients average CA/RVAD before treatment was 46°(±8)/20°(±12). In NIS patients average CA/RVAD before treatment was 55°(±15)/24°(±14). After application of the third cast, the CA/RVAD was reduced to 20°(±11)/11°(±10) in IS patients. Whereas in NIS patients average CA/RVAD after the thrid cast was 28°(±12)/18°(±13). At latest follow-up the CA/RVAD was 16°(±7)/9°(±8) in IS patients and 31°(±11)/17° (±15) in NIS patients.

Conclusion

Syndromic etiology is not a contraindication for serial casting in EOS. Our results show a curve correction, measured in CA, of 65% in IS patients and 44% in NIS patients. Significant reduction in the morphologic deformity, measured in RVAD, was achieved in the IS cohort, but not in the NIS cohort. In all cases surgical treatment could be delayed.
Camptocormia as the presenting symptom in sporadic late onset nemaline myopathy: a case report
Authors: Türk Matthias , Nagel Armin M. , Roemer Frank , Schlötzer-Schrehardt Ursula , Thiel Christian T. , Winterholler Martin , Schröder Rolf
Published: November 2019

Background

Camptocormia has been reported in a plethora of diseases comprising disorders of the central nervous system, the peripheral nervous system, and the neuromuscular junction as well as hereditary and acquired myopathies. In sporadic late onset nemaline myopathy concomitant axial myopathy is common, but reports about camptocormia as the only presenting symptom in this condition are very rare. Notably, sporadic late onset nemaline myopathy is a potentially treatable condition in particular when associated with monoclonal gammopathy of unknown significance, HIV or rheumatological disorders.

Case presentation

We report the case of a 62-year-old female patient, who presented with slowly progressive camptocormia. Comprehensive work-up including neurological work-up, laboratory tests, MR-imaging, muscle biopsy and genetic testing led to the diagnosis of sporadic late onset nemaline myopathy.

Conclusions

Our case report highlights that sporadic late onset nemaline myopathy has to be considered in patients presenting with isolated camptocormia and comprehensive work-up of camptocormia is mandatory to ascertain the individual diagnosis, especially in consideration of treatable conditions.
Evaluation of D2-plus radical resection for gastric cancer with pyloric invasion
Authors: Xu Zhi-yuan , Hu Can , Chen Shangqi , Du Yi-an , Huang Ling , Yu Peng-fei , Wang Li-jing , Cheng Xiang-dong
Published: November 2019

Background

The optimal lymphadenectomy for gastric cancer (GC) with pyloric invasion is controversial because the pattern of lymph node metastasis is different from that of distal GC. The rate of lymph node metastasis into the posterior area of the pancreatic head and hepatoduodenal ligament is high. This study evaluated the estimated benefit of radical gastrectomy with D2-plus lymphadenectomy in patients with pyloric invasion.

Methods

All patients with GC invading the pylorus who underwent curative surgical resection with D2-plus lymphadenectomy between February 2013 and September 2015 were enrolled in the study. The index of estimated benefit from lymph node dissection (IEBLD) was calculated by multiplying the incidence of metastasis to each lymph node station by the 3-year overall survival (OS) rate of patients with metastasis to that station.

Results

In total, 128 patients were eligible. The rate of lymph node metastasis and the 3-year OS rate (and IEBLD) of the patients with metastasis to lymph nodes were 14.3 and 44.4% (5.56) for No. 8p, 10.9 and 35.7% (3.89) for No. 12b, 9.5 and 33.3% (3.13) for No. 12p, 18.8 and 54.2% (10.19) for No. 13, and 21.8 and 53.6% (11.68) for No. 14v, respectively.

Conclusions

In radical gastrectomy for GC with pyloric invasion, some survival benefit was observed with dissection of the No. 13 and No. 14 lymph nodes, but there was no survival benefit with dissection of the No. 8p lymph nodes. The No. 12b and No. 12p lymph nodes may be better to dissect in cT3 GC patients with pyloric invasion.

Trial registration

http://ClinicalTrials.gov Identifier: NCT01836991. Date of registration: April 17, 2013.
Multidisciplinary management of a large pheochromocytoma presenting with cardiogenic shock: a case report
Authors: Maestroni Umberto , Ziglioli Francesco , Baciarello Marco , Bellini Valentina , Dalla Valle Raffaele , Cataldo Simona , Maspero Giada , Bignami Elena
Published: November 2019

Background

Pheochromocytoma is well-known for sudden initial presentations, particularly in younger patients. Hemodynamic instability may cause serious complications and delay a patient’s ability to undergo surgical resection. Larger tumors present a further challenge because of the risk of catecholamine release during manipulations. In the case we present, increases in systemic vascular resistance caused cardiogenic shock, and the size of the lesion prompted surgeons to veer off from their usual approach.

Case presentation

A 38-year-old female patient was admitted to our intensive care unit with hypertension and later cardiogenic shock. Profound systolic dysfunction (left ventricular ejection fraction of 0.12) was noted together with severely increased systemic vascular resistance, and gradually responded to vasodilator infusion. A left-sided 11-cm adrenal mass was found with computed tomography and confirmed a pheochromocytoma with a meta-iodo-benzyl-guanidine scintigraphy. Surgical treatment was carefully planned by the endocrinologist, anesthesiologist and surgeon, and was ultimately successful. After prolonged hemodynamic stabilization, open adrenalectomy and nephrectomy were deemed safer because of lesion size and the apparent invasion of the kidney. Surgery was successful and the patient was discharged home 5 days after surgery. She is free from disease at almost 2 years from the initial event.

Conclusions

Large, invasive pheochromocytoma can be safely and effectively managed with open resection in experienced hands, provided all efforts are made to achieve hemodynamic stabilization and to minimize. Catecholamine release before and during surgery.
Identification and characterization of the GmRD26 soybean promoter in response to abiotic stresses: potential tool for biotechnological application
Authors: Freitas Elinea O. , Melo Bruno P. , Lourenço-Tessutti Isabela T. , Arraes Fabrício B. M. , Amorim Regina M. , Lisei-de-Sá Maria E. , Costa Julia A. , Leite Ana G. B. , Faheem Muhammad , Ferreira Márcio A. , Morgante Carolina V. , Fontes Elizabeth P. B. , Grossi-de-Sa Maria F.
Published: November 2019

Background

Drought is one of the most harmful abiotic stresses for plants, leading to reduced productivity of several economically important crops and, consequently, considerable losses in the agricultural sector. When plants are exposed to stressful conditions, such as drought and high salinity, they modulate the expression of genes that lead to developmental, biochemical, and physiological changes, which help to overcome the deleterious effects of adverse circumstances. Thus, the search for new specific gene promoter sequences has proved to be a powerful biotechnological strategy to control the expression of key genes involved in water deprivation or multiple stress responses.

Results

This study aimed to identify and characterize theGmRD26promoter (pGmRD26), which is involved in the regulation of plant responses to drought stress. The expression profile of theGmRD26gene was investigated by qRT-PCR under normal and stress conditions in Williams 82, BR16 and Embrapa48 soybean-cultivars. Our data confirm thatGmRD26is induced under water deficit with different induction folds between analyzed cultivars, which display different genetic background and physiological behaviour under drought. The characterization of theGmRD26promoter was performed under simulated stress conditions with abscisic acid (ABA), polyethylene glycol (PEG) and drought (air dry) onA. thalianaplants containing the complete construct of pGmRD26::GUS(2.054 bp) and two promoter modules, pGmRD26A::GUS(909 pb) and pGmRD26B::GUS(435 bp), controlling the expression of the β-glucuronidase (uidA) gene. Analysis of GUS activity has demonstrated that pGmRD26and pGmRD26Ainduce strong reporter gene expression, as the pAtRD29positive control promoter under ABA and PEG treatment.

Conclusions

The full-length promoter pGmRD26and the pGmRD26Amodule provides an improveduidAtranscription capacity when compared with the other promoter module, especially in response to polyethylene glycol and drought treatments. These data indicate that pGmRD26Amay become a promising biotechnological asset with potential use in the development of modified drought-tolerant plants or other plants designed for stress responses.
Inhibitory effects of ChondroT and its constituent herbs on RANKL-induced osteoclastogenesis
Authors: Guo Rui Hong , Kim Seon-Jong , Choi Chan-hun , Na Chang-su , Kang Bok Yun , Kim Young Ran
Published: November 2019

Background

ChondroT is a complex herbal medicine consisting of water extracts of Ostericum koreanum (Maxim.) Kitag., Lonicera japonica Thunb., Angelica gigas Nakai, Clematis manshurica Rupr., and Phellodendron amurense Rupr. (6:4:4:4:3). Previous studies have reported that ChondroT possesses chondroprotective and anti-inflammatory, anti-osteoarthritic, and anti-hyperuricemic activities. The study is aim to demonstrate the effects of ChondroT and its five constituent herbs on receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and the underlying mechanisms.

Methods

Osteoclastogenesis was identified in bone marrow-derived macrophages (BMDMs) by tartrate-resistant acid phosphatase (TRAP) staining assay, actin ring formation assay and the bone resorption assay. For the molecular mechanisms, activation of RANKL-induced NF-κB and MAPK signaling pathways and the expression levels of osteoclast-specific proteins were investigated by Western blotting. Cell viability was assessed by MTT assay. Actin ring formation and NF-κB translocation were evaluated by immunostaining.

Results

ChondroT and each of its constituent herbs significantly suppressed osteoclast differentiation dose dependently, and decreased actin ring formation as well as bone-resorbing capacity. Mechanistically, ChondroT and its constituent herbs downregulated the expressional levels of osteoclast-specific proteins such as NFATc1, c-Fos, Cathepsin K, and matrix metalloproteinase 9 (MMP9) by suppressing NF-κB translocation to nucleus and MAPKs phosphorylation at different levels. Compared to its five constituent herbs, ChondroT exhibited the best inhibitory efficiency against osteoclastogenesis.

Conclusions

Taken together, ChondroT has anti-osteoclastogenesis properties by inhibiting NF-κB and MAPKs pathways. It could be considered as a potential therapeutic candidate for the treatment of osteoclast-related bone diseases.
The association between health professionals’ international experience and the academic output of their students in Harbin, China
Authors: Liu Tingjiao , Zhang Liming , Zhao Tingting , Chen Nan
Published: November 2019

Background

It is common practice for health professionals in China to have international experience. However, the association between such experience and these professionals’ students’ scientific research ability has not previously been evaluated. Our study aimed to quantify this association among the students of health professionals in China.

Methods

We constructed a self-administered questionnaire and distributed it to all students at Harbin Medical University and its affiliated hospitals, including 257 students (Group A) of health professionals who had studied overseas (“returning” professionals) and 257 age-, enrollment year-, and specialty-matched students (Group B) of health professionals who had not studied overseas (“resident” professionals). SPSS software was used for the data entry and analysis.

Results

The total impact factor (IF) for articles published during their PhD study was 1031.68 in Group A and 727.65 in Group B (P = 0.001), and the number of articles was 297 in Group A and 228 in Group B (P = 0.040). The total IF for articles published by the 151 clinical medicine students of returning professionals during their PhD study was positively correlated with their advisor’s total IF for articles published while abroad (P = 0.019).

Conclusions

This study indicates that medical students may benefit from their advisors’ international experience. Medical education administrators and the government could encourage clinical professionals to study overseas and to prolong the duration of their study abroad. Medical students should consider potential advisors’ overseas experience when choosing a mentor.
Primary health institutions preference by hypertensive patients: effect of distance, trust and quality of management in the rural Heilongjiang province of China
Authors: Liu Jingjing , Yin Hui , Zheng Tong , Ilia Bykov , Wang Xing , Chen Ruohui , Hao Yanhua , Sun Hong , Jiao Mingli , Kang Zheng , Gao Lijun , Wu Qunhong
Published: November 2019

Background

Traditional “inverted triangle” healthcare resources allocation model in China has wasted a lot of health resources. The Chinese health reform began to strengthens the role of the primary health institutions in delivering primary health care especially in rural areas in the background of large development gap between urban-rural health and rapid growth in the incidence of chronic diseases in rural. We take hypertensive patients as an example, to verify the effect of policy implementation through distribution characteristics of rural primary health institutions preference of hypertensive patients and explore the influencing factor that promoting rationalized use of medical care for patients with chronic disease as well as rational allocation of health resources in rural areas.

Methods

A cross-sectional survey was conducted in Heilongjiang, a province in northeastern China by using a self-designed questionnaire. Stratified cluster sampling was used to choose 484 hypertensive patients from two villages in Heilongjiang province in 2010.

Results

About 88.4% of respondents reported preferred primary health institutions (83.5% preferred village clinics and 4.9% preferred township hospitals), 49.4% of respondents knew hypertension management administered by primary health institutions, 53.5% received hypertension education from primary care physicians, more than half of respondents reported that they didn’t receive telephone interviews and family visits from primary care physicians over the past 6 months. Residence closer to the primary health institutions (OR = 10.360), trust in village doctors (OR = 7.323), elders (OR = 3.001), and asked for return visits by primary health physicians (OR = 2.073) promote preferences for primary health institutions.

Conclusions: Accessibility to primary healthcare and doctor-patient trust stimulate patients to choose the primary health institutions. Primary health institutions should improve general approach to hypertension management and enhance the ability of providing basic public health services.
Access to public health services and integral care for women during the puerperal gravid period period in Ceará, Brazil
Authors: de Fátima Vasques Monteiro Maria , Barbosa Caio Parente , Vertamatti Maria Auxiliadora Figueredo , Tavares Maria Nizete Alves , de Oliveira Carvalho Amanda Cordeiro , Alencar Ana Paula Agostinho
Published: November 2019

Background

Over time, the Brazilian health system, a growing country, has been developing to ensure good accessibility to health goods and services. This development is focusing on the principle of universality of access and completeness of health care. In this context, we aimed to evaluate the completeness of care and universality of access for women in their pregnancy and puerperal period in Ceará, Brazil.

Methods

A descriptive, cross-sectional study based on a quantitative approach, using information collected from the database of the regulation system of the state of Ceará and data from the Prenatal Monitoring System. The research population comprised of 1701 women who delivered a baby in an obstetric reference unit in the Health Macro-Region of Cariri, Ceará, Brazil from January to December 2015.

Results

There was a high rate of cesarean delivery (49.7%) and a high waiting time for access to high-risk delivery (32.6%) and neonatal intensive care unit (72.9%). There was also a low percentage (41.1%) of pregnant women undergoing an adequate number of prenatal consultations, dental care (20%), educational activities (15%), visits to the maternity ward (0.1%), laboratory tests of the third trimester (29.2%) and puerperal consultation (37.9%).

Conclusions

It was concluded that the Maternal and Child Health Policy, especially the Rede Cegonha, which is still under development, does not ensure access and completeness of care for women during the prenatal, delivery, and puerperal periods, thus violating their reproductive rights. The results of this study allow a critical analysis by the academia and health managers in search of strategies to improve the services of Rede Cegonha in Brazil.
Comparative iTRAQ proteomics revealed proteins associated with lobed fin regeneration in Bichirs
Authors: Lu Suxiang , Xiong Qian , Du Kang , Gan Xiaoni , Wang Xuzhen , Yang Liandong , Wang Ying , Ge Feng , He Shunping
Published: November 2019

Background

Polypterus senegalus can fully regenerate its pectoral lobed fins, including a complex endoskeleton, with remarkable precision. However, despite the enormous potential of this species for use in medical research, its regeneration mechanisms remain largely unknown.

Methods

To identify the differentially expressed proteins (DEPs) during the early stages of lobed fin regeneration in P. senegalus, we performed a differential proteomic analysis using isobaric tag for relative and absolute quantitation (iTRAQ) approach based quantitative proteome from the pectoral lobed fins at 3 time points. Furthermore, we validated the changes in protein expression with multiple-reaction monitoring (MRM) analysis.

Results

The experiment yielded a total of 3177 proteins and 15,091 unique peptides including 1006 non-redundant (nr) DEPs. Of these, 592 were upregulated while 349 were downregulated after lobed fin amputation when compared to the original tissue. Bioinformatics analyses showed that the DEPs were mainly associated with Ribosome and RNA transport, metabolic, ECM-receptor interaction, Golgi and endoplasmic reticulum, DNA replication, and Regulation of actin cytoskeleton.

Conclusions

To our knowledge, this is the first proteomic research to investigate alterations in protein levels and affected pathways in bichirs’ lobe-fin/limb regeneration. In addition, our study demonstrated a highly dynamic regulation during lobed fin regeneration in P. senegalus. These results not only provide a comprehensive dataset on differentially expressed proteins during the early stages of lobe-fin/limb regeneration but also advance our understanding of the molecular mechanisms underlying lobe-fin/limb regeneration.
An academic perspective of participation in healthcare redesign
Authors: Prior Sarah Jane , Mather Carey , Miller Andrea , Campbell Steven
Published: November 2019

Healthcare redesign, based on building collaborative capacity between academic and clinical partners, should create a method to facilitate flow between the key elements of health service improvement. However, utilising the skills and resources of an organisation outside of the health facility may not always have the desired effect. Accountability and mutually respectful relationships are fundamental for collaborative, sustainable and successful completion of clinical research projects. This paper provides an academic perspective of both the benefits of academic involvement in facilitating healthcare redesign processes as well as the potential pitfalls of involving external partner institutions in internal healthcare redesign projects.
A novel epigenetic signature for overall survival prediction in patients with breast cancer
Authors: Bao Xuanwen , Anastasov Natasa , Wang Yanfang , Rosemann Michael
Published: November 2019

Background

Breast cancer is the most common malignancy in female patients worldwide. Because of its heterogeneity in terms of prognosis and therapeutic response, biomarkers with the potential to predict survival or assist in making treatment decisions in breast cancer patients are essential for an individualised therapy. Epigenetic alterations in the genome of the cancer cells, such as changes in DNA methylation pattern, could be a novel marker with an important role in the initiation and progression of breast cancer.

Method

DNA methylation and RNA-seq datasets from The Cancer Genome Atlas (TCGA) were analysed using the Least Absolute Shrinkage and Selection Operator (LASSO) Cox model. Applying gene ontology (GO) and single sample gene set enrichment analysis (ssGSEA) an epigenetic signature associated with the survival of breast cancer patients was constructed that yields the best discrimination between tumour and normal breast tissue. A predictive nomogram was built for the optimal strategy to distinguish between high- and low-risk cases.

Results

The combination of mRNA-expression and of DNA methylation datasets yielded a 13-gene epigenetic signature that identified subset of breast cancer patients with low overall survival. This high-risk group of tumor cases was marked by upregulation of known cancer-related pathways (e.g. mTOR signalling). Subgroup analysis indicated that this epigenetic signature could distinguish high and low-risk patients also in different molecular or histological tumour subtypes (by Her2-, EGFR- or ER expression or different tumour grades). Using Gene Expression Omnibus (GEO) the 13-gene signature was confirmed in four external breast cancer cohorts.

Conclusion

An epigenetic signature was discovered that effectively stratifies breast cancer patients into low and high-risk groups. Since its efficiency appears independent of other known classifiers (such as staging, histology, metastasis status, receptor status), it has a high potential to further improve likely individualised therapy in breast cancer.
Correction to: A novel generation 1928zT2 CAR T cells induce remission in extramedullary relapse of acute lymphoblastic leukemia
Authors: Weng Jianyu , Lai Peilong , Qin Le , Lai Yunxin , Jiang Zhiwu , Luo Chenwei , Huang Xin , Wu Suijing , Shao Dan , Deng Chengxin , Huang Lisi , Lu Zesheng , Zhou Maohua , Zeng Lingji , Chen Dongmei , Wang Yulian , Chen Xiaomei , Geng Suxia , Weinkove Robert , Tang Zhaoyang , He Chang , Li Peng , Du Xin
Published: November 2019

The original article [1] contains an error in authorship whereby author, Robert Weinkove’s name is mistakenly inverted. The configuration noted in this Correction article should be considered instead along with author’s updated affiliation.
Beneficial effects of early empirical administration of appropriate antimicrobials on survival and defervescence in adults with community-onset bacteremia
Authors: Lee Ching-Chi , Lee Chung-Hsun , Yang Chao-Yung , Hsieh Chih-Chia , Tang Hung-Jen , Ko Wen-Chien
Published: November 2019

Background

Bloodstream infections are associated with high morbidity and mortality, both of which contribute substantially to healthcare costs. The effects of early administration of appropriate antimicrobials on the prognosis and timing of defervescence of bacteremic patients remain under debate.

Methods

In a 6-year retrospective, multicenter cohort, adults with community-onset bacteremia at the emergency departments (EDs) were analyzed. The period from ED arrival to appropriate antimicrobial administration and that from appropriate antimicrobial administration to defervescence was regarded as the time-to-appropriate antibiotic (TtAa) and time-to-defervescence (TtD), respectively. The primary study outcome was 30-day mortality after ED arrival. The effects of TtAa on 30-day mortality and delayed defervescence were examined after adjustment for independent predictors of mortality, which were recognized by a multivariate regression analysis.

Results

Of the total 3194 patients, a TtAa-related trend in the 30-day crude (γ = 0.919, P = 0.01) and sepsis-related (γ = 0.909, P = 0.01) mortality rate was evidenced. Each hour of TtAa delay was associated with an average increase in the 30-day crude mortality rate of 0.3% (adjusted odds ratio [AOR], 1.003; P < 0.001) in the entire cohort and 0.4% (AOR, 1.004; P < 0.001) in critically ill patients, respectively, after adjustment of independent predictors of 30-day crude mortality. Of 2469 febrile patients, a TtAa-related trend in the TtD (γ = 0.965, P = 0.002) was exhibited. Each hour of TtAa delay was associated with an average 0.7% increase (AOR, 1.007; P < 0.001) in delayed defervescence (TtD of ≥ 7 days) after adjustment of independent determinants of delayed defervescence. Notably, the adverse impact of the inappropriateness of empirical antimicrobial therapy (TtAa > 24 h) on the TtD was noted, regardless of bacteremia severity, bacteremia sources, or causative microorganisms.

Conclusions

The delay in the TtAa was associated with an increasing risk of delayed defervescence and 30-day mortality for adults with community-onset bacteremia, especially for critically ill patients. Thus, for severe bacteremia episodes, early administration of appropriate empirical antimicrobials should be recommended.
Epigenetic modifications of histones in cancer
Authors: Zhao Zibo , Shilatifard Ali
Published: November 2019

The epigenetic modifications of histones are versatile marks that are intimately connected to development and disease pathogenesis including human cancers. In this review, we will discuss the many different types of histone modifications and the biological processes with which they are involved. Specifically, we review the enzymatic machineries and modifications that are involved in cancer development and progression, and how to apply currently available small molecule inhibitors for histone modifiers as tool compounds to study the functional significance of histone modifications and their clinical implications.
A mobile device app to reduce prehospital medication errors and time to drug preparation and delivery by emergency medical services during simulated pediatric cardiopulmonary resuscitation: study protocol of a multicenter, prospective, randomized controlled trial
Authors: Siebert Johan N. , Bloudeau Laurie , Ehrler Frédéric , Combescure Christophe , Haddad Kevin , Hugon Florence , Suppan Laurent , Rodieux Frédérique , Lovis Christian , Gervaix Alain , Manzano Sergio
Published: November 2019

Background

Emergency drug preparation and administration in children is both complex and time-consuming and places this population at a higher risk than adults for medication errors. Moreover, survival and a favorable neurological outcome from cardiopulmonary resuscitation are inversely correlated to drug preparation time. We developed a mobile device application (the pediatric Accurate Medication IN Emergency Situations (PedAMINES) app) as a step-by-step guide for the preparation to delivery of drugs requiring intravenous injection. In a previous multicenter randomized trial, we reported the ability of this app to significantly reduce in-hospital continuous infusion medication error rates and drug preparation time compared to conventional preparation methods during simulation-based pediatric resuscitations. This trial aims to evaluate the effectiveness of this app during pediatric out-of-hospital cardiopulmonary resuscitation.

Methods/design

We will conduct a multicenter, prospective, randomized controlled trial to compare the PedAMINES app with conventional calculation methods for the preparation of direct intravenously administered emergency medications during standardized, simulation-based, pediatric out-of-hospital cardiac arrest scenarios using a high-fidelity manikin. One hundred and twenty paramedics will be randomized (1:1) in several emergency medical services located in different regions of Switzerland. Each paramedic will be asked to prepare, sequentially, four intravenously administered emergency medications using either the app or conventional methods. The primary endpoint is the medication error rates. Enrollment will start in mid-2019 and data analysis in late 2019. We anticipate that the intervention will be completed in early 2020 and study results will be submitted in late 2020 for publication (expected in early 2021).

Discussion

This clinical trial will assess the impact of an evidence-based mobile device app to reduce the rate of medication errors, time to drug preparation and time to drug delivery during prehospital pediatric resuscitation. As research in this area is scarce, the results generated from this study will be of great importance and may be sufficient to change and improve prehospital pediatric emergency care practice.

Trial registration

ClinicalTrials.gov, ID:NCT03921346. Registered on 18 April 2019.
Common metabolic networks contribute to carbon sink strength of sorghum internodes: implications for bioenergy improvement
Authors: Li Yin , Tu Min , Feng Yaping , Wang Wenqin , Messing Joachim
Published: November 2019

Background

Sorghum bicolor(L.) is an important bioenergy source. The stems of sweet sorghum function as carbon sinks and accumulate large amounts of sugars and lignocellulosic biomass and considerable amounts of starch, therefore providing a model of carbon allocation and accumulation for other bioenergy crops. While omics data sets for sugar accumulation have been reported in different genotypes, the common features of primary metabolism in sweet genotypes remain unclear. To obtain a cohesive and comparative picture of carbohydrate metabolism between sorghum genotypes, we compared the phenotypes and transcriptome dynamics of sugar-accumulating internodes among three different sweet genotypes (Della, Rio, and SIL-05) and two non-sweet genotypes (BTx406 and R9188).

Results

Field experiments showed that Della and Rio had similar dynamics and internode patterns of sugar concentration, albeit distinct other phenotypes. Interestingly, cellulose synthases for primary cell wall and key genes in starch synthesis and degradation were coordinately upregulated in sweet genotypes. Sweet sorghums maintained active monolignol biosynthesis compared to the non-sweet genotypes. Comparative RNA-seq results support the role of candidateTonoplast Sugar Transportergene (TST), but not theSugars Will Eventually be Exported Transportergenes (SWEETs) in the different sugar accumulations between sweet and non-sweet genotypes.

Conclusions

Comparisons of the expression dynamics of carbon metabolic genes across the RNA-seq data sets identify several candidate genes with contrasting expression patterns between sweet and non-sweet sorghum lines, including genes required for cellulose and monolignol synthesis (CesA,PTAL,andCCR), starch metabolism (AGPase,SS,SBE,and G6P-translocatorSbGPT2), and sucrose metabolism and transport (TPPandTST2). The common transcriptome features of primary metabolism identified here suggest the metabolic networks contributing to carbon sink strength in sorghum internodes, prioritize the candidate genes for manipulating carbon allocation with bioenergy purposes, and provide a comparative and cohesive picture of the complexity of carbon sink strength in sorghum stem.
Genetic resistance and specificity in sister taxa of Daphnia: insights from the range of host susceptibilities
Authors: Orlansky Sigal , Ben-Ami Frida
Published: November 2019

Background

Host genetic diversity can affect various aspects of host-parasite interactions, including individual-level effects on parasite infectivity, production of transmission stages and virulence, as well as population-level effects that reduce disease spread and prevalence, and buffer against widespread epidemics. However, a key aspect of this diversity, the genetic variation in host susceptibility, has often been neglected in interpreting empirical data and in theoretical studies.Daphnia similisnaturally coexists with its competitorDaphnia magnaand is more resistant to the endoparasitic microsporidiumHamiltosporidium tvaerminnensis, as suggested by a previous survey of waterbodies, which detected this parasite inD. magna, but not inD. similis. However, under laboratory conditionsD. similiswas sometimes found to be susceptible. We therefore asked if there is genetic variation for disease trait expression, and if the genetic variation in disease traits inD. similisis different from that ofD. magna.

Methods

We exposed ten clones ofD. similisand ten clones ofD. magnato three isolates ofH. tvaerminnensis, and measured infection rates, parasite-induced host mortality and parasite spore production.

Results

The twoDaphniaspecies differ in the range and variation of their susceptibilities. The parasite produced on average two-fold more spores when growing inD. magnaclones than inD. similisclones.

Conclusions

We confirm thatD. similisis indeed much more resistant thanD. magnaand suggest that this could create a dilution effect in habitats where both species coexist.
Noninvasive imaging diagnosis of sinusoidal obstruction syndrome: a pictorial review
Authors: Zhang Yun , Yan Yuling , Song Bin
Published: November 2019

Sinusoidal obstruction syndrome (SOS) is a rare liver disorder due to hepatic vascular injury. Its rapid and accurate diagnosis is crucial for patient survival. SOS is often established clinically, based on Baltimore, modified Seattle, or European Society for Blood and Marrow Transplantation (EBMT) criteria. Unfortunately, such criteria are not highly specificity and fail to provide a timely, reliable differential diagnosis. The use of noninvasive imaging techniques, such as ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), has recently grown in this setting, some key imaging features offering diagnostic improvement. This review provides a synopsis of current noninvasive imaging techniques used for this purpose, summarizing accurate and reliable diagnostic features of SOS.
Treatment with adipose tissue-derived mesenchymal stem cells exerts anti-diabetic effects, improves long-term complications, and attenuates inflammation in type 2 diabetic rats
Authors: Yu Songyan , Cheng Yu , Zhang Linxi , Yin Yaqi , Xue Jing , Li Bing , Gong Zhengyuan , Gao Jieqing , Mu Yiming
Published: November 2019

Background

Long-term diabetes-associated complications are the major causes of morbidity and mortality in individuals with diabetes. These diabetic complications are closely linked to immune system activation along with chronic, non-resolving inflammation, but therapies to directly reverse these complications are still not available. Our previous study demonstrated that mesenchymal stem cells (MSCs) attenuated chronic inflammation in type 2 diabetes mellitus (T2DM), resulting in improved insulin sensitivity and islet function. Therefore, we speculated that MSCs might exert anti-inflammatory effects and promote the reversal of diabetes-induced kidney, liver, lung, heart, and lens diseases in T2DM rats.

Methods

We induced a long-term T2DM complication rat model by using a combination of a low dose of streptozotocin (STZ) with a high-fat diet (HFD) for 32 weeks. Adipose-derived mesenchymal stem cells (ADSCs) were systemically administered once a week for 24 weeks. Then, we investigated the role of ADSCs in modulating the progress of long-term diabetic complications.

Results

Multiple infusions of ADSCs attenuated chronic kidney disease (CKD), nonalcoholic steatohepatitis (NASH), lung fibrosis, and cataracts; improved cardiac function; and lowered serum lipid levels in T2DM rats. Moreover, the levels of inflammatory cytokines in the serum of each animal group revealed that ADSC infusions were able to not only inhibit pro-inflammatory cytokines IL-6, IL-1β, and TNF-α expression but also increase anti-inflammatory cytokine IL-10 systematically. Additionally, MSCs reduced the number of iNOS(+) M1 macrophages and restored the number of CD163(+) M2 macrophages.

Conclusions

Multiple intravenous infusions of ADSCs produced significant protective effects against long-term T2DM complications by alleviating inflammation and promoting tissue repair. The present study suggests ADSCs may be a novel, alternative cell therapy for long-term diabetic complications.
A simulation method of three-dimensional cloud over WRF big data
Authors: Xie Yonghua , Kou Xiaoyong , Li Ping
Published: November 2019

Nowadays, due to the expansion of people’s living ranges and the impact of human life on the natural environment, climate changes fiercely than before. In order to observe the changing climate environment accurately, multi-modal sensors are used to collect the various data around us, and we could analyze and predict the weather based on these collected data. One of the applications is 3D visualization simulation, and the 3D visualization simulation of cloud data has always been the research hotspot in the field of computer graphics and meteorology. Currently, it is a key challenge to resolve the problems of 3D cloud simulation, such as reducing complexity of modeling and computation and improving the real-time performance. Technically, a method for data modeling and optimizing based on Weather Research and Forecasting (WRF) is proposed in this paper, aiming to solve the problems of the existing 3D cloud simulation and realize 3D virtual simulation of real-world cloud data. According to the characteristics (e.g., color, size, shape) of the cloud, the spherical particle system is designed to model, and the initial color, size, shape, and other attributes are given to these spherical particles to realize the modeling of WRF cloud data. From the perspective of new particles’ generation, the level of detail (LOD) technique, based on the relationship between the quantity of new generated spherical particles and the distance of the viewpoint, is used to change the quantity of new particles generated in real time according to the distance of the simulated scene distance. Finally, illumination model is introduced to render and simulate the modeling particles. Experimental simulation results verify the effectiveness of this method in improving the modeling and rendering speed of cloud data as well as the fidelity of the 3D virtualization model.
Existence and Ulam stability for implicit fractional q-difference equations
Authors: Abbas Saïd , Benchohra Mouffak , Laledj Nadjet , Zhou Yong
Published: November 2019

This paper deals with some existence, uniqueness and Ulam–Hyers–Rassias stability results for a class of implicit fractional q-difference equations. Some applications are made of some fixed point theorems in Banach spaces for the existence and uniqueness of solutions, next we prove that our problem is generalized Ulam–Hyers–Rassias stable. Two illustrative examples are given in the last section.
Environmental determinants of distribution of freshwater snails and trematode infection in the Omo Gibe River Basin, southwest Ethiopia
Authors: Mereta Seid Tiku , Bedewi Jemal , Yewhalaw Delenasaw , Mandefro Belayhun , Abdie Yihun , Tegegne Dechassa , Birke Wondwosen , Mulat Worku Legesse , Kloos Helmut
Published: November 2019

Background

Determination of infection rates of snail populations is one of the basic tools for epidemiological studies of snail borne diseases. In this study, we opted to determine the trematode infection of freshwater snails in the Omo-Gibe River Basin, southwest Ethiopia.

Methods

We collected snail samples from 130 observation sites in lakes, wetlands, rivers, reservoirs and irrigation canals surveyed during the dry season (March to May) in 2016. The snail samples were examined for trematode infections by cercarial shedding immediately after collection. Habitat conditions, water quality, human water contact practices and other human activities were assessed at each survey site. A redundancy analysis (RDA) was used to examine the relationship between cercarial infection and environmental variables. The statistical significance of eigenvalues and cercariae-environment correlations generated by the RDA were tested using Monte Carlo permutations at 499 permutations.

Results

A total of 3107 snails belonging to five species were collected. The most abundant species was Biomphalaria pfeifferi, representing 66% of the total collection. Overall, 109 (3.6%) of the snails were found infected with trematodes (cercariae). Biomphalaria pfeifferi was found to be the most highly infected, accounting 85% of all infected snails. A total of eight morphologically different types of cercariae were recorded, which included: Echinostoma cercariae, brevifurcate apharyngeate distome cercariae, amphistome cercariae, brevifurcate apharyngeate monostome cercariae, xiphidiocercariae, longifurcate pharyngeate distome cercariae, strigea cercariae and unidentified cercariae. Brevifurcate apharyngeate distome cercariae, and Echinostoma cercariae were the most abundant cercariae, accounting for 36 and 34% of all infection, respectively. The mean concentration of water conductivity and 5 days biological oxygen demand were higher in irrigation canals and lake sampling points. Human activities such as open field defecation, urination, livestock grazing, farming, and swimming were highly correlated with trematode infection.

Conclusions

The abundance, occurrence and infection rates of snail species were largely influenced by water physicochemical quality, sanitation and water contact behaviour of the inhabitants. Human activities, such as open field defecation and urination, livestock grazing, farming, and swimming were important predictors of the abundance of cercariae. Therefore, awareness creation should be implemented for proper containment of excreta (urine and faeces) and reducing human and animal contacts with surface waters to reduce snail-borne disease transmission.
Influence of the cloud-level neutral layer on the vertical propagation of topographically generated gravity waves on Venus
Authors: Yamada Takeru , Imamura Takeshi , Fukuhara Tetsuya , Taguchi Makoto
Published: November 2019

The reason for stationary gravity waves at Venus’ cloud top to appear mostly at low latitudes in the afternoon is not understood. Since a neutral layer exists in the lower part of the cloud layer, the waves should be affected by the neutral layer before reaching the cloud top. To what extent gravity waves can propagate vertically through the neutral layer has been unclear. To examine the possibility that the variation of the neutral layer thickness is responsible for the dependence of the gravity wave activity on the latitude and the local time, we investigated the sensitivity of the vertical propagation of gravity waves on the neutral layer thickness using a numerical model. The results showed that stationary gravity waves with zonal wavelengths longer than 1000 km can propagate to the cloud-top level without notable attenuation in the neutral layer with realistic thicknesses of 5–15 km. This suggests that the observed latitudinal and local time variation of the gravity wave activity should be attributed to processes below the cloud. An analytical approach also showed that gravity waves with horizontal wavelengths shorter than tens of kilometers would be strongly attenuated in the neutral layer; such waves should originate in the altitude region above the neutral layer.
Prevalence and antimicrobial susceptibility patterns of Salmonella and Shigella isolates among children aged below five years with diarrhea attending Robe General Hospital and Goba Referral Hospital, South East Ethiopia
Authors: Assefa Addisu , Girma Mengistu
Published: November 2019

Background

Diarrheal diseases are responsible for high level of morbidity and mortality, particularly in children below 5 years.SalmonellaandShigellaspp. are pathogenic microbes responsible for the major diarrheal associated mortality. The purpose of this study was to determine the prevalence, factors associated withSalmonellaandShigellaisolates infections and their antimicrobial susceptibility patterns among diarrheic children aged below 5 years attending BRGH and GRH, Ethiopia.

Methods

A health institution based cross-sectional study was conducted from April to July 2016. One stool samples was collected from 422 diarrheic children under the ages of five and were cultured on to Hektoen Enteric (HE) and Salmonella-Shigella agar. Isolation identification of theSalmonellaandShigellaisolates were conducted using standard bacteriological methods. Antibiotic susceptibility was done by Kirby–Bauer disk diffusion method. The isolates were defined as multidrug resistant if it was resistant to two or more antimicrobial agents. Descriptive statistics were employed and logistic regression models were constructed to determine factors associated withShigella/Salmonellaprevalence.

Results

The prevalence ofSalmonellaandShigellaisolates were 6.9 and 4.3%, respectively. Children aged between 1 to 3 years were significantly associated withSalmonellainfection [AOR = 19.08, 95% CI (2.68–135.86)]. The odd of prevalence ofSalmonella/Shigellaisolates was significantly associated with absence of latrine, absence of hand washing after latrine, and in unimmunized children in adjusted odd ratio. Unimproved water sources and hand washing before meal had also higher odd of prevalence although the difference was not significant. AllSalmonellaandShigellaisolates were resistant to amoxicillin (100%). In addition, allShigellaisolates were completely resistant to chloramphenicol, and tetracycline, and were multidrug resistant. However, allSalmonellaandShigella isolates were susceptible to ciprofloxacin and ceftriaxone.

Conclusion

There was a relatively low prevalence ofSalmonellaandShigellaspecies in the study areas and were significantly associated with lack of personal hygiene and environmental sanitation. There were also higher drug resistance and multidrug resistant pattern. Personal hygiene and environmental sanitation, including access to latrine and supply of safe drinking water are suggested. Checking susceptibilities ofShigellaandSalmonellaisolates causing diarrhea is also suggested.