bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of VERA in 10 micro-arcsecond astrometry
Authors: Nagayama Takumi , Kobayashi Hideyuki , Hirota Tomoya , Honma Mareki , Jike Takaaki , Kim Mi Kyoung , Nakagawa Akiharu , Omodaka Toshihiro , Oyama Tomoaki , Sakai Daisuke , Shibata Katsunori M , Tamura Yoshiaki
Published: April 2020

Very Long Baseline Interferometry (VLBI) astrometry using the phase-referencing technique remains an open issue for the quantitative characterization of the observing conditions to achieve a feasible parallax precision of 10 micro-arcseconds (μas). To address this issue, we evaluated the astrometric performance of the VLBI Exploration of Radio Astrometry (VERA) through the parallax measurements of five distant star-forming regions under good observing conditions of close separations (${0{^{\circ}_{.}}5}$–${1{_{.}^{\circ}}3}$) and high elevations (≥50°). Their parallaxes measured 89–200 μas, corresponding to distances of 5–11 kpc with an error of 11–20 μas. Furthermore, we investigated the contributions to the position error budget and concluded that the tropospheric residual contribution is the dominant error source. We also confirmed that the astrometric error propagation strongly depends on the term $\Delta \sec Z$, which stands for the difference between $\sec Z$ of the target and its reference source, where Z is the zenith angle during the observations. We found that for a source pair with a $\Delta \sec Z$ less than 0.01 (for example, a set of a close separation of $\le {{0{^{\circ}_{.}}5}}$ and a high elevation of ≥50°), we can achieve the parallax precision of 10 μas using a typical monitoring program comprising 10 observing epochs over a span of two years.
Random Tanglegram Partitions (Random TaPas): An Alexandrian Approach to the Cophylogenetic Gordian Knot
Authors: Balbuena Juan Antonio , Pérez-Escobar Óscar Alejandro , Llopis-Belenguer Cristina , Blasco-Costa Isabel
Published: April 2020

Symbiosis is a key driver of evolutionary novelty and ecological diversity, but our understanding of how macroevolutionary processes originate extant symbiotic associations is still very incomplete. Cophylogenetic tools are used to assess the congruence between the phylogenies of two groups of organisms related by extant associations. If phylogenetic congruence is higher than expected by chance, we conclude that there is cophylogenetic signal in the system under study. However, how to quantify cophylogenetic signal is still an open issue. We present a novel approach, Random Tanglegram Partitions (Random TaPas) that applies a given global-fit method to random partial tanglegrams of a fixed size to identify the associations, terminals, and nodes that maximize phylogenetic congruence. By means of simulations, we show that the output value produced is inversely proportional to the number and proportion of cospeciation events employed to build simulated tanglegrams. In addition, with time-calibrated trees, Random TaPas can also distinguish cospeciation from pseudocospeciation. Random TaPas can handle large tanglegrams in affordable computational time and incorporates phylogenetic uncertainty in the analyses. We demonstrate its application with two real examples: passerine birds and their feather mites, and orchids and bee pollinators. In both systems, Random TaPas revealed low cophylogenetic signal, but mapping its variation onto the tanglegram pointed to two different coevolutionary processes. We suggest that the recursive partitioning of the tanglegram buffers the effect of phylogenetic nonindependence occurring in current global-fit methods and therefore Random TaPas is more reliable than regular global-fit methods to identify host–symbiont associations that contribute most to cophylogenetic signal. Random TaPas can be implemented in the public-domain statistical software R with scripts provided herein. A User’s Guide is also available at GitHub.[Codiversification; coevolution; cophylogenetic signal; Symbiosis.]
Outcomes Following Intensive Care Unit Admission in a Pediatric Cohort in Malawi
Authors: Purcell Laura N , Prin Meghan , Sincavage John , Kadyaudzu Clement , Phillips Michael R , Charles Anthony
Published: April 2020

Introduction

The burden of critical illness in low- and middle-income countries (LMICs) is high; however, there is a paucity of data describing pediatric critical care outcomes in this setting.

Methods

We performed a prospective observational study of the pediatric (≤18 years) intensive care population in Malawi, from August 2016 to May 2018. Data collected include patient demographics and clinical data, admission criteria and outcome. A multivariate Poisson regression was performed to determine risk factors for mortality.

Results

Over the study period, 499 patients were admitted to the intensive care unit (ICU) and 105 (21.0%) were children. The average age was 10.6 ± 5.4 years. Primary indications for ICU admission were sepsis (n = 30, 30.3%) and traumatic brain injury (TBI, n = 23, 23.2%). Of those who died, sepsis (n = 18, 32.7%), acute respiratory failure (n = 11, 20.0%) and TBI (n = 11, 20.0%) were the primary admission diagnoses. Overall, ICU mortality was 54.3% (n = 57). Multivariate regression for increased ICU mortality revealed: age ≤5 years [risk ratio (RR) 1.96, 95% CI 1.10–2.26, p < 0.001], hemoglobin < 10 g/dl (RR 1.58, 95% CI 1.08—2.01, p = 0.01) and shock requiring epinephrine support (RR 2.76, 95% CI 1.80–4.23, p < 0.001).

Conclusions

Pediatric ICU mortality is high. Predictors of mortality were age ≤5 years, anemia at ICU admission and the need for epinephrine support. Training of pediatric intensive care specialists and increased blood product availability may attenuate the high mortality for critically ill children in Malawi.
La ratification de la Convention du Cap et de son Protocole ferroviaire : la délicate alchimie du choix des déclarations (ou du bon usage du sur-mesure d’un point de vue français)
Authors: Riffard Jean-François ,   À notre ami Pierre Crocq
Published: April 2020

In order not to lag behind a movement already widely engaged at the international level and to benefit from the advantages of an instrument whose success is well established, France is considering ratifying very soon the Cape Town Convention and its Luxemburg Rail Protocol. While such a decision can be enthusiastically approved, this ratification, which does not rise any major legal difficulties, will nevertheless lead the French authorities to examine the often neglected but very important in practice, issue of declarations. We know that the Convention is not a full “one-size-fits-all” instrument, and that adaptation to national legal contexts and traditions is, in some sensitive areas, necessary. This study proposes to consider the declarations that France might or might not have to make under the CTC and the Rail Protocol and the challenges that are attached to these choices.
Subclinical hypothyroidism
Authors: Simon Chelsea , Weidman-Evans Emily , Allen Sarah
Published: April 2020

Subclinical hypothyroidism affects 4.3% of the US population. Despite this prevalence, whether to treat or to observe patients with subclinical hypothyroidism remains controversial. Guidelines for overt hypothyroidism strongly favor treatment for symptomatic benefits, but the same benefits of levothyroxine treatment have not been proven for patients with subclinical hypothyroidism—most likely due to the asymptomatic nature of the condition. Additionally, a connection between subclinical hypothyroidism and cardiovascular complications has not been definitively established, although the evidence favors a relationship. This article describes the background, presentation, and diagnostics of subclinical hypothyroidism, treatment, and potential cardiovascular complications, so clinicians can decide if initiating treatment is best for their patients with subclinical hypothyroidism.
Substance Use Disorder in Physicians after Completion of Training in Anesthesiology in the United States from 1977 to 2013
Authors: Warner David O. , Berge Keith , Sun Huaping , Harman Ann , Wang Ting
Published: April 2020

Background

Substance use disorder among physicians can expose both physicians and their patients to significant risk. Data regarding the epidemiology and outcomes of physician substance use disorder are scarce but could guide policy formulation and individual treatment decisions. This article describes the incidence and outcomes of substance use disorder that resulted in either a report to a certifying body or death in physicians after the completion of anesthesiology training.

Methods

Physicians who completed training in U.S. anesthesiology residency programs from 1977 to 2013 and maintained at least one active medical license were included in this retrospective cohort study (n = 44,736). Substance use disorder cases were ascertained through records of the American Board of Anesthesiology and the National Death Index.

Results

Six hundred and one physicians had evidence of substance use disorder after completion of training, with an overall incidence of 0.75 per 1,000 physician-years (95% CI, 0.71 to 0.80; 0.84 [0.78 to 0.90] in men, 0.43 [0.35 to 0.52] in women). The highest incidence rate occurred in 1992 (1.79 per 1,000 physician-years [95% CI, 1.12 to 2.59]). The cumulative percentage expected to develop substance use disorder within 30 yr estimated by Kaplan–Meier analysis equaled 1.6% (95% CI, 1.4 to 1.7%). The most common substances used by 353 individuals for whom information was available were opioids (193 [55%]), alcohol (141 [40%]), and anesthetics/hypnotics (69 [20%]). Based on a median of 11.1 (interquartile range, 4.4 to 19.8) yr of follow-up, the cumulative proportion of survivors estimated to experience at least one relapse within 30 yr was 38% (95% CI, 31 to 43%). Of the 601 physicians with substance use disorder, 114 (19%) were dead from a substance use disorder–related cause at last follow-up.

Conclusions

A substantial proportion of anesthesiologists who develop substance use disorder after the completion of training die of this condition, and the risk of relapse is high in those who survive.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Syphilis in Pregnancy
Authors: Adhikari Emily H.
Published: April 2020

Despite a national plan to eliminate syphilis by 2005, recent trends have reversed previously achieved progress in the United States. After a nadir between 2000 and 2013, rates of primary and secondary syphilis among women and congenital syphilis rose by 172% and 185% between 2014 and 2018, respectively. Screening early in pregnancy, repeat screening in the third trimester and at delivery among women at high risk, adherence to recommended treatment regimens, and prompt reporting of newly diagnosed syphilis cases to local public health authorities are strategies that obstetrician–gynecologists can employ to fight the current epidemic. In this report, clinical manifestations and management of syphilis in pregnancy are reviewed, and both traditional and reverse sequence screening algorithms are reviewed in detail in the context of clinical obstetrics.
Mature Follicle Count and Multiple Gestation Risk Based on Patient Age in Intrauterine Insemination Cycles With Ovarian Stimulation
Authors: Evans M. Blake , Stentz Natalie C. , Richter Kevin S. , Schexnayder Brian , Connell Matt , Healy Mae W. , Devine Kate , Widra Eric , Stillman Robert , DeCherney Alan H. , Hill Micah J.
Published: April 2020

OBJECTIVE:

To estimate the risk of a multiple gestation pregnancy in ovarian stimulation intrauterine insemination (IUI) cycles when stratified by patient age and mature follicle number.

METHODS:

We conducted a retrospective cohort study at a single private practice fertility center of IUI cycles performed from 2004 to 2017. Intervention(s) were ovarian stimulation and IUI if postwash total motile sperm count was more than 8 million. Mature follicles were defined as 14 mm or more as measured on the day of ovulation trigger. Main outcomes and measures were rates of clinical pregnancy and multiple gestation.

RESULTS:

We identified 24,649 women who underwent a total of 50,473 IUI cycles. Increasing the number of mature follicles from one to five at the time of IUI in women younger than age 38 years increased the clinical pregnancy rate from 14.6% to 21.9% (adjusted odds ratio [aOR] 1.6, 95% CI 1.4–1.9), almost entirely from a marked increase in multiple gestations per cycle from 0.6% to 6.5% (aOR 9.9, 95% CI 6.9–14.2). There was little increase in singleton pregnancies per IUI (14.1–16.4%) regardless of mature follicle number. The per-pregnancy twin and higher-order multiple gestation risk significantly increased (3.9–23.3%, P<.01 and 0.2–10.6%, P<.01, respectively) when comparing one with five mature follicles present at the time of IUI (P<.01). In women younger than age 38 years with more than three follicles present, more than one quarter of all pregnancies were multiples. Similar findings occurred in women aged 38–40 years. In women older than age 40 years, up to four follicles tripled the odds of pregnancy (aOR 3.1, 95% CI 2.1–4.5) while maintaining a less than 12% risk of multiple gestation per pregnancy and a 1.0% absolute risk of multiples.

CONCLUSION:

Caution should be used in proceeding with IUI after ovarian stimulation when there are more than two mature follicles in women younger than age 40 years owing to the substantially increased risk of multiple gestation without an improved chance of singleton clinical pregnancy.
Uterine Exteriorization Compared With In Situ Repair of Hysterotomy After Cesarean Delivery
Authors: Mireault Danny , Loubert Christian , Drolet Pierre , Tordjman Laurent , Godin Nadia , Richebé Philippe , Zaphiratos Valerie
Published: April 2020

OBJECTIVE:

To compare the effect of exteriorized with in situ uterine repair on intraoperative nausea and vomiting during elective cesarean delivery under spinal anesthesia using a phenylephrine infusion.

METHODS:

This study was a randomized double-blinded controlled trial of 180 women undergoing elective cesarean delivery using a standardized anesthetic protocol. Patients were randomized to exteriorization (n=90) or in situ uterine repair (n=90). The spinal anesthetic, phenylephrine infusion, and blood pressure management were all standardized. The primary outcome was postdelivery intraoperative nausea and vomiting using a 4-point scale (0–3). A sample size of 80 patients per group was needed to demonstrate a 50% reduction in intraoperative nausea and vomiting with in situ repair.

RESULTS:

From November 2015 through July 2018, 180 patients were enrolled. Incidence of postdelivery intraoperative nausea and vomiting was 39% in the exteriorization group compared with 22% in the in situ group (P=.01). Incidence of hypotension (80% vs 50%; P<.001) and tachycardia (33% vs 17%; P=.02) was significantly higher in the exteriorization group, and more phenylephrine boluses were administered to this group (median 4 boluses [first and third quartiles 1.25–7] vs 2 [0–4]; P<.001). The duration of surgery, blood loss, and postoperative hemoglobin decline were similar between groups.

CONCLUSION:

In situ uterine repair for elective cesarean delivery under spinal anesthesia with a phenylephrine infusion is associated with less postdelivery intraoperative nausea and vomiting.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT02587013.
Tracking Cognitive Spare Capacity During Speech Perception With EEG/ERP: Effects of Cognitive Load and Sentence Predictability
Authors: Hunter Cynthia R.
Published: April 2020

Objectives:

Listening to speech in adverse listening conditions is effortful. Objective assessment of cognitive spare capacity during listening can serve as an index of the effort needed to understand speech. Cognitive spare capacity is influenced both by signal-driven demands posed by listening conditions and top-down demands intrinsic to spoken language processing, such as memory use and semantic processing. Previous research indicates that electrophysiological responses, particularly alpha oscillatory power, may index listening effort. However, it is not known how these indices respond to memory and semantic processing demands during spoken language processing in adverse listening conditions. The aim of the present study was twofold: first, to assess the impact of memory demands on electrophysiological responses during recognition of degraded, spoken sentences, and second, to examine whether predictable sentence contexts increase or decrease cognitive spare capacity during listening.

Design:

Cognitive demand was varied in a memory load task in which young adult participants (n = 20) viewed either low-load (one digit) or high-load (seven digits) sequences of digits, then listened to noise-vocoded spoken sentences that were either predictable or unpredictable, and then reported the final word of the sentence and the digits. Alpha oscillations in the frequency domain and event-related potentials in the time domain of the electrophysiological data were analyzed, as was behavioral accuracy for both words and digits.

Results:

Measured during sentence processing, event-related desynchronization of alpha power was greater (more negative) under high load than low load and was also greater for unpredictable than predictable sentences. A complementary pattern was observed for the P300/late positive complex (LPC) to sentence-final words, such that P300/LPC amplitude was reduced under high load compared with low load and for unpredictable compared with predictable sentences. Both words and digits were identified more quickly and accurately on trials in which spoken sentences were predictable.

Conclusions:

Results indicate that during a sentence-recognition task, both cognitive load and sentence predictability modulate electrophysiological indices of cognitive spare capacity, namely alpha oscillatory power and P300/LPC amplitude. Both electrophysiological and behavioral results indicate that a predictive sentence context reduces cognitive demands during listening. Findings contribute to a growing literature on objective measures of cognitive demand during listening and indicate predictable sentence context as a top-down factor that can support ease of listening.
miR-203a suppresses cell proliferation by targeting RING-finger protein 6 in colorectal cancer
Authors: Miao Jiyu , Hou Ni , Yang Wanwan , Jiang Qiuyu , Xue Wanjuan , Wang Xiaofei , Zhang Huahua , Xiong Xiaofan , Wang Lumin , Zhao Lingyu , Huang Chen
Published: April 2020

Colorectal cancer (CRC) is one of most common cancers worldwide. Although miR-203a is reported as a tumor suppressor involved in cell progression in some cancers, the role of miR-203a in CRC is still controversial and the underling mechanism of miR-203a in CRC remains unclear. Here, we demonstrated that low expression of miR-203a had poorer survival in CRC patients. miR-203a was down-regulated in most human colon cancer cells. Overexpression of miR-203a could inhibit colon cancer cell proliferation and arrest cell cycle in G1 phase. Bioinformatics and dual luciferase reporter assay confirmed that RING-finger protein 6 (RNF6) was a target gene of miR-203a. Silencing RNF6 inhibited cell proliferation and arrest cell cycle in G1 phase. RNF6 overexpression reversed the effects of miR-203a overexpression in colon cancer cells. Taken together, our data indicate that miR-203a inhibits colon cancer cell proliferation by targeting RNF6, offer novel insights into the regulatory network of miR-203a-modulated cell cycle and proliferation, and suggest that miR-203a a potential therapeutic target in CRC treatment.
Trichostatin A augments esophageal squamous cell carcinoma cells migration by inducing acetylation of RelA at K310 leading epithelia–mesenchymal transition
Authors: Huang Keke , Liu Yuzhen , Gu Chengwei , Liu Danhui , Zhao Baosheng
Published: April 2020

Protein acetylation modification controlled by acetyltransferases (HATs) and histone deacetylases (HDACs) regulates multiple biologic processes including cell proliferation and migration. HDAC inhibitors (HDACi) are currently used as a promising epigenetic-based therapy for cancer treatment. Of the anticancer activity, accumulating evidence has shown that HDACi can enhance cell migration in subset of cancer cells. Thus, there is a critical need to identify such counter anticancer activity to HDACi in different cancer cell types and elucidate the rational in order to develop appropriate combination therapies in cancer treatment. In seeking to address the effect of HDACi on esophageal squamous cell carcinoma (ESCC) cells migration, trichostatin A (TSA), a canonical HDACi targeting class I and class II HDACs, was used. Here, we report the discovery that TSA augmented ESCC cells migration by increasing the acetylation of nuclear factor-κB/RelA at lysine 310 (K310). To elucidate the mechanism by which TSA promotes the migration of ESCC cells, plasmid of RelA K310R, a mutant precluding acetylation at K310, was transfected into ESCC cells. Blocking acetylation of RelA at K310 significantly arrogated TSA-induced cell migration. Mechanistic investigations revealed that TSA increased the level of acetylated RelA at K310 (RelA K310ac), thereby increasing the level of epithelia–mesenchymal transition (EMT) transcription factor slug mRNA, which in turn induced EMT. Overall, this study indicates that TSA promotes ESCC cells migration by RelA K310ac-slug-EMT pathway. Our findings provide a strategy to eradicate HDACi-induced ESCC cells migration by targeting RelA as a combination therapy with nonspecific HDACi in ESCC treatment.
In-vitro and in-vivo investigations into the carbene-gold anticancer drug candidates NHC*-Au-SCSNMe2 and NHC*-Au-S-GLUC against advanced prostate cancer PC3
Authors: Walther Wolfgang , Althagafi Dhiyaa , Curran Danielle , O’Beirne Cillian , Mc Carthy Cian , Ott Ingo , Basu Uttara , Büttner Britta , Sterner-Kock Anja , Müller-Bunz Helge , Sánchez-Sanz Goar , Zhu Xiangming , Tacke Matthias
Published: April 2020

The anticancer drug candidates 1,3-dibenzyl-4,5-diphenyl-imidazol-2-ylidene gold(I) dimethylamino dithiocarbamate and 2,3,4,6-tetra-O-acetyl-α-D-glucopyranosyl-1-thiolate derivative exhibited nanomolar in-vitro activity against prostate cancer cells advanced prostate cancer (PC3) and micromolar inhibition of mammalian thioredoxin reductase. Encouraging maximum tolerable dose experiments led to human prostate cancer subcutaneous xenograft experiments; 1,3-dibenzyl-4,5-diphenyl-imidazol-2-ylidene gold(I) dimethylamino dithiocarbamate and 2,3,4,6-tetra-O-acetyl-α-D-glucopyranosyl-1-thiolate derivative were applied twelve times at two doses in groups of n = 5 PC3 to tumor-bearing NMRI:nu/nu mice. 1,3-dibenzyl-4,5-diphenyl-imidazol-2-ylidene gold(I) dimethylamino dithiocarbamate and 2,3,4,6-tetra-O-acetyl-α-D-glucopyranosyl-1-thiolate derivative at the dose of 10 and 20 mg/kg showed good tolerability, while no significant body weight loss was seen in both groups. In particular, for the drug 1,3-dibenzyl-4,5-diphenyl-imidazol-2-ylidene gold(I) dimethylamino dithiocarbamate the tumor growth inhibition suggested to be dose dependent, reflected by the respective optimal T/C values of 0.45 at the dose of 10 mg/kg and of 0.31 at the dose of 20 mg/kg. By contrast, the 2,3,4,6-tetra-O-acetyl-α-D-glucopyranosyl-1-thiolate derivative treated groups showed no indication for dose-dependent antitumoral activity, as reflected by the optimal T/C values of 0.44 for the 10 mg/kg and for the 20 mg/kg treated mice. Immunohistochemical experiments involving Ki67 staining of tumor tissue showed that both compounds reduced PC3 cell proliferation against the difficult to treat advanced human prostate tumors derived from PC3.
Key Components of ICU Recovery Programs: What Did Patients Report Provided Benefit?
Authors: McPeake Joanne , Boehm Leanne M. , Hibbert Elizabeth , Bakhru Rita N. , Bastin Anthony J. , Butcher Brad W. , Eaton Tammy L. , Harris Wendy , Hope Aluko A. , Jackson James , Johnson Annie , Kloos Janet A. , Korzick Karen A. , MacTavish Pamela , Meyer Joel , Montgomery-Yates Ashley , Quasim Tara , Slack Andrew , Wade Dorothy , Still Mary , Netzer Giora , Hopkins Ramona O. , Mikkelsen Mark E. , Iwashyna Theodore J. , Haines Kimberley J. , Sevin Carla M.
Published: April 2020

Objectives:

To understand from the perspective of patients who did, and did not attend ICU recovery programs, what were the most important components of successful programs and how should they be organized.

Design:

International, qualitative study.

Setting:

Fourteen hospitals in the United States, United Kingdom, and Australia.

Patients:

We conducted 66 semi-structured interviews with a diverse group of patients, 52 of whom had used an ICU recovery program and 14 whom had not.

Interventions:

None.

Measurements and Main Results:

Using content analysis, prevalent themes were documented to understand what improved their outcomes. Contrasting quotes from patients who had not received certain aspects of care were used to identify perceived differential effectiveness. Successful ICU recovery programs had five key components: 1) Continuity of care; 2) Improving symptom status; 3) Normalization and expectation management; 4) Internal and external validation of progress; and 5) Reducing feelings of guilt and helplessness. The delivery of care which achieved these goals was facilitated by early involvement (even before hospital discharge), direct involvement of ICU staff, and a focus on integration across traditional disease, symptom, and social welfare needs.

Conclusions:

In this multicenter study, conducted across three continents, patients identified specific and reproducible modes of benefit derived from ICU recovery programs, which could be the target of future intervention refinement.
Cardiovascular Considerations in Treating Patients With Coronavirus Disease 2019 (COVID-19)
Authors: Dixon Dave L. , Van Tassell Benjamin W. , Vecchié Alessandra , Bonaventura Aldo , Talasaz Azita H. , Kakavand Hessam , D'Ascenzo Fabrizio , Perciaccante Antonio , Castagno Davide , Ammirati Enrico , Biondi-Zoccai Giuseppe , Stevens Michael P. , Abbate Antonio
Published: April 2020

A novel betacoronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread rapidly across the globe since December 2019. Coronavirus disease 2019 (COVID-19) has a significantly higher mortality rate than seasonal influenza and has disproportionately affected older adults, especially those with cardiovascular disease and related risk factors. Adverse cardiovascular sequelae, such as myocarditis, acute myocardial infarction, and heart failure, have been reported in patients with COVID-19. No established treatment is currently available; however, several therapies, including remdesivir, hydroxychloroquine and chloroquine, and interleukin (IL)-6 inhibitors, are being used off-label and evaluated in ongoing clinical trials. Considering these therapies are not familiar to cardiovascular clinicians managing these patients, this review describes the pharmacology of these therapies in the context of their use in patients with cardiovascular-related conditions.
The Effect of an Empowerment Program on the Perceived Risk and Physical Health of Patients With Coronary Artery Disease
Authors: Kuchi Zeinab Ghasemzadeh , Zakerimoghadam Masoomeh , Esmaeili Maryam , Geraiely Babak
Published: April 2020

This study was conducted to assess the effect of an empowerment program on the perceived risk and physical health of patients with coronary artery disease. This randomized clinical trial recruited 84 patients with coronary artery disease admitted to post-cardiac care unit (CCU) wards in Tehran Heart Center in 2017. The study subjects were selected and assessed according to inclusion criteria and assigned to intervention and control groups by block randomization. Both groups completed questionnaires for demographic details and disease history, perceived risk in cardiac patients, and physical health. The Magic Empowerment Program was performed for the intervention group as 3 workshops on 3 successive days. Intervention continued after patients' discharge from the hospital through phone calls once a week for 8 weeks. The perceived risk in cardiac patients and physical health questionnaires were completed for both groups. Postintervention results showed significant differences between the 2 groups in total score of perceived risk (P = .001) and its subscales. The Empowerment Program changed patients' attitudes toward risk-motivating behavior change and improving physical health.
A Qualitative Study of the Experiences of Complementary and Alternative Medicine Use in Patients With IBS-C
Authors: Parlar Kılıc Serap , Kılıç Nermin , Sevinç Sibel , Demirel Cihat
Published: April 2020

The aim of this study was to explore the experiences of complementary and alternative medicine (CAM) among patients with constipation irritable bowel syndrome (IBS-C). This qualitative study consisted of a total of 30 patients who were admitted to a university hospital in Turkey. Data were collected using a descriptive questionnaire and a semistructured interview. Data analysis identified 5 main themes: (1) the constipation-associated difficulties experienced because of IBS; (2) the feeling that CAM is natural and useful; (3) the effect of environmental stimuli in preferring the use of CAM; (4) the feeling that CAM is not negative and relieves symptoms; and (5) suggesting the use of CAM. In conclusion, it was determined that all the patients with IBS-C used various CAM methods. It may be recommended that health care professionals should raise awareness among patients about CAM methods that may be useful.
The Effect of Aromatherapy on Sleep Quality and Fatigue Level of the Elderly
Authors: Genç Fatma , Karadağ Songül , Kılıç Akça Nazan , Tan Mehtap , Cerit Derya
Published: April 2020

This randomized controlled experimental study was conducted to determine the effect of inhaled aromatherapy on the sleep quality and fatigue level of the institutionalized elderly. The sample of the study consisted of a total of 59 elderly individuals (30 in the intervention group and 29 in the control group) who met the inclusion criteria and agreed to participate in the study. Aromatherapy (lavender oil) inhalation was administered to individuals in the intervention group half hour before their sleep every day for a month in accordance with aromatherapy protocol. No administration was applied to the control group. The data were collected using the Elderly Description Form, Pittsburgh Sleep Quality Index, and Fatigue Severity Scale. Forms were completed in the beginning of administration and in the follow-up at the end of 4 weeks (baseline and last follow-up). In the study, it was determined that aromatherapy administration improved sleep quality (P < .001) and decreased fatigue severity in the elderly (P < .05). The study should be replicated in a different group.
Perinatal HIV-1 Infection in an Extremely Low Birth Weight Infant
Authors: Al Hammoud Roukaya , Aneji Chiamaka , Heresi Gloria , Murphy James R. , Pérez Norma
Published: April 2020

There is limited guidance on how to treat extremely premature infants with HIV infection. This can lead to delay of antiretroviral therapy initiation adversely affecting magnitude of HIV reservoir and disease progression. We report perinatal HIV-1 infection in an extremely low birth weight infant born at 24 5/7 weeks of gestation. Treatment challenges, viral dynamics and clinical outcomes are described.
Rehospitalization of a Recovered Coronavirus Disease 19 (COVID-19) Child With Positive Nucleic Acid Detection
Authors: Wang Haizhou , Li Ying , Wang Fan , Du Hui , Lu Xiaoxia
Published: April 2020

Since December 2019, novel coronavirus-infected pneumonia (coronavirus disease 19) occurred in Wuhan and rapidly spread throughout China and beyond. During this period, increasing of reports found that several recovered patients from different hospitals showed positive results of nucleic acid test again soon after discharge. However, little attention has been paid to recovered children. Herein, we reported a case of 8-year-old recovered child, who was rehospitalized again because of unexplained fever.
Isolated Ophthalmoplegia Following Filler Injections to the Upper Face
Authors: Downie Elaine M. , Chen Yanjun , Lucarelli Mark J. , Burkat Cat N.
Published: April 2020

Ophthalmoplegia following cosmetic facial filler injections is a rare but serious complication. The authors report 2 cases of ophthalmoplegia following filler injection. In the first case, a 54-year-old female presented with acute onset headache, vomiting, and diplopia during malar and temporal injection of hyaluronic acid. In the second case, a 37-year-old female presented with binocular diplopia that developed following injection of an unknown filler to the upper face. Neither of the 2 patients had skin necrosis or ocular abnormalities other than motility deficits. To the authors' knowledge, there have been no other cases of isolated ophthalmoplegia without evidence of other ocular injuries following facial filler.
Guillain–Barré syndrome in a heart transplantation recipient
Authors: Wei Ching-Wen , Liu Chin-Yu , Chang Chung-Yi , Liu Wei-Chun , Cheng Hao-Chun , Tung Heng-Hsin , Chiang Nian-Chen , Chang Hsin-Huei
Published: April 2020

A rare case of a heart transplantation recipient with Guillain–Barré syndrome occurred, which was associated with peripheral nervous system damage. Based on a review of epidemiological research, the symptom development process, and diagnostic tools, the authors highlight the extreme rarity of this postinfectious immune disease. After diagnosis, plasma exchange and immunoregulatory therapy should be performed because they result in rapid recovery. If there is delayed diagnosis and treatment, there is a high risk of disability or death. When patients experience acute limb paralysis as the main symptom, nurse practitioners (NPs) should focus on the patient's history, particularly with regard to infectious agents. Closely monitoring the patient to detect respiratory failure and the need for early respiratory intervention can help the patient to avoid the severe complication of permanent brain injury. For NPs, performance of early differential diagnosis is important, especially among patients who have immunosuppressive dependence after transplantation.
Raynaud's phenomenon of the nipple: Ensuring timely diagnosis
Authors: Pereira Marina , Thable Angela
Published: April 2020

Breast milk is the perfect first food for infants, yet many women face challenges that prematurely discontinue their breastfeeding. Nipple pain is the second most common reason women stop breastfeeding. As primary care providers, nurse practitioners (NPs) are in the ideal position to support women both prenatally and postpartum. To help these patients, the NP must recognize conditions affecting nursing mothers early, as well as provide interventions and referrals in a timely fashion. A common but frequently overlooked condition is Raynaud's phenomenon of the nipple (RPN), a vasospastic disorder that causes moderate to severe nipple pain and is often misdiagnosed. The purpose of this article is to address a gap in the literature regarding this phenomenon, prevent missed diagnoses of RPN, and to promote higher rates of successful breastfeeding.
Facilitators, barriers, benefits, and funding to implement postgraduate nurse practitioner residency/fellowship programs
Authors: Kesten Karen S. , El-Banna Majeda M.
Published: April 2020

Background:

A current trend to address the increasing numbers of new graduate nurse practitioners (NPs) and the expanding scope of practice of NPs is the emergence of employer-based postgraduate NP residency/fellowship programs.

Purpose:

The purpose of this study was to conduct a comprehensive examination of postgraduate NP residency/fellowship programs in the United States, to gain an understanding of the facilitators, barriers, benefits, and funding of these programs, from the perspective of the program directors.

Methods:

This exploratory study used a quantitative design to conduct an online survey, developed by the researchers, of program directors of postgraduate NP residency/fellowship programs. Descriptive statistics were generated for continuous variables: the mean, SD, and minimum, and maximum values, and for categorical variables, frequency and percentage were reported.

Results:

More than 90% of program directors indicated that NP recruitment and retention were benefits to organizations implementing NP residency/fellowship programs. Decision makers in organizations support postgraduate NP residency/fellowship programs and few barriers exist to implement programs. More than 84% indicated that physician and administrative support were facilitators to program implementation. Less than 50% of program directors identified barriers to implementation. Less than half of programs received funding sources for program implementation.

Implications for practice:

This study provides data and insight into the emerging industry of postgraduate NP residency/training programs and informs regulators, educators, and employers about how to maximize the facilitators, reduce and decrease barriers, identify sources of funding, and appreciate the benefits of implementing programs.
Significant association between long non-coding RNA H19 polymorphisms and cancer susceptibility
Authors: Li Wei , Jiang Xia , Jin Xiaojing , Yan Weitao , Liu Ying , Li Dongyun , Zhao Zengren
Published: April 2020

Background:

H19, a well-known long non-coding RNA, is involved in carcinogenesis and progression of multiple cancers. Molecular epidemiological research suggests that polymorphisms in H19 are associated with an increased risk of cancer, but the results are inconsistent. Thus, we performed a meta-analysis to estimate the associations between H19 polymorphisms and cancer susceptibility.

Methods:

PubMed, Embase, and Web of Science databases were searched. Odds ratios with 95% confidence interval were applied to assess the association between H19 rs2107425, rs217727, rs2839698, rs2735971, rs3024270, and rs3741219 polymorphisms and cancer susceptibility in all 5 models. We also predicted the H19 secondary structure, as well as the generation and abolishment of miRNA binding sites on H19 through the selected SNPs.

Results:

Eighteen related studies, involving 17,090 patients and 23,532 control samples, were analyzed. The pooled data showed that rs2839698 polymorphism was significantly associated with an increased cancer susceptibility. As for rs217727 and rs3024270 polymorphisms, similarly increased risks were found in specific genetic models and stratified groups. However, significant decreases in cancer risk were observed for rs2107425 and rs2735971 in the total population, as well as in subgroup analyses. In addition, no significant associations were found in all 5 models for rs3741219 polymorphism. Furthermore, RNAfold prediction revealed that the centroid secondary structure was markedly altered in rs217727 and rs2735971. We also identified that rs217727 G>A and rs2839689 G>A alleles could create and destroy miRNA binding sites on H19.

Conclusion:

The results of our meta-analyses suggest that H19 polymorphisms may be associated with the risk of cancer development.
Hemorrhoidal artery ligation with Doppler guidance vs digital guidance for grade II-III hemorrhoidal disease treatment
Authors: Markaryan Daniil , Tulina Inna , Garmanova Tatiana , Bredikhin Mikhail , Alikperzade Aftandil , Tsarkov Petr
Published: April 2020

Introduction:

Hemorrhoidal artery ligation (HAL) with Doppler guidance and suture fixation of hemorrhoidal nodes (RAR) is a popular minimally invasive technique for hemorrhoidal disease (HD) treatment which uses an ultrasound probe to detect hemorrhoidal arteries for further ligation. We hypothesized that ultrasound guidance has no advantages over manual hemorrhoidal arteries detection for HD treatment.

The aim is to compare the results of HAL-RAR procedure in patients with stage II-III HD with Doppler and manual HA detection.

In this ongoing randomized, controlled, single center clinical study 204 patients randomly divides into group A (HAL-RAR with Doppler US navigation) and group B (HAL with manual HA detection and mucopexy) are planned to be included. The primary endpoint was recurrence of any symptoms of HD; secondary endpoints were pain syndrome severity, treatment satisfaction (1 to 5 points), and need for the drug therapy in 30 days and 8 weeks after surgery.

Conclusion:

Ultrasound guidance technology of HAL with mucopexy could have the same efficacy the manual HA detection regarding the HD treatment effectiveness and patient satisfaction.
Association of clopidogrel high on-treatment reactivity with clinical outcomes and gene polymorphism in acute ischemic stroke patients
Authors: Fu Hefei , Hu Pan , Ma Chunmei , Peng Fei , He Zhiyi
Published: April 2020

High on-treatment platelet reactivity (HTPR) was suggested to be better correlated with recurrent ischemic events as compared with gene polymorphism, whereas most of the results were from white populations with acute coronary disease. The evidence is relatively limited regarding HTPR and its genetic determinants in predicting clinical outcomes of stroke among Chinese-Han patients.

A prospective study including 131 Chinese-Han stroke patients treated with clopidogrel was analyzed. Platelet function was assessed by light transmission aggregometry (LTA)- adenosine diphosphate (ADP) method. HTPR was defined as 5 μM ADP induced platelet aggregation > 46%. CYP2C19 and P2Y12 genotype were detected using the PCR-RFLP method. The difference in the occurrence of the primary endpoint was analyzed according to platelet function and genetic status.

Sixty-three (48.1%) subjects displayed HTPR after administering clopidogrel for 1 week. The prevalence of HTPR was significantly higher in CYP2C19 loss-of-function (LOF) alleles (∗2, ∗3) carriers vs wild-type homozygotes (71.7% vs 32.1%, P < .01), and logistic regression analysis showed that carriers of CYP2C19 LOF alleles were an independent risk factor of HTPR. Survival analysis indicated that patients with HTPR had an increased risk of primary endpoints (20.6% vs 7.3%, P = .04), whereas the presence of CYP2C19 LOF alleles or P2Y12 H2 haplotype did not increase the incidence of ischemic events. Cox regression analysis demonstrated that HTPR was an independent predictor of the primary composite endpoint (HR, 3.1; 95% CI, 1.07–8.99; P = .04).

We identified a high prevalence of clopidogrel-HTPR in a cohort of Chinese-Han patients with acute ischemic stroke, and patients with HTPR may have an increased risk of recurrent ischemic stroke events. CYP2C19 LOF alleles are associated with HTPR but not with stroke prognosis. Further clinical trials with large samples are needed to confirm these findings.
Transcatheter arterial embolization for advanced gastric cancer bleeding
Authors: Cho Soo Buem , Hur Saebeom , Kim Hyo-Cheol , Jae Hwan Jun , Lee Myungsu , Kim Minuk , Kim Jeong-Eun , Lee Jae Hwan , Chung Jin Wook
Published: April 2020

To investigate computed tomography and angiography findings and clinical outcomes after transcatheter arterial embolization for acute upper gastrointestinal bleeding from advanced gastric cancers.

From January 2005 to December 2014, 58 patients with pathologically proven gastric cancer were treated at our institution with transcatheter arterial embolization due to acute upper gastrointestinal bleeding recalcitrant to endoscopic treatment. The electronic medical records for each patient were reviewed for clinical presentation, endoscopy history, computed tomography and angiographic findings, blood transfusion requirements, and follow-up results.

Angiography findings were positive in 13 patients (22.4%): contrast extravasation was found in 9 patients and pseudoaneurysm in 4 patients. All patients with positive angiograms underwent selective embolization treatment. Those with negative angiography findings underwent empirical embolization. Gelfoam, n-butyl cyanoacrylate, coils, or a combination of these were used as embolic agents. The overall clinical success rate was 72.4% (42/58), and the success rate for patients with positive angiography was 53.8% (7/13). The median survival was 97.5 days (range, 7–1415 days), and the 1-month survival rate was 89.6% (52/58). The 1-month survival rate of the clinical success group was 95.2% (40/42), which was significantly higher than that of the clinical failure group (P = .04). The clinical success group also required significantly fewer transfusions (2.43 units, range 0–24 units) (P = .02).

Transcatheter arterial embolization is a highly effective treatment for advanced gastric cancer with active bleeding. It should be considered as an additional treatment, especially when endoscopic or surgical treatment fails or when these approaches are difficult.
Sex differences in uric acid and NT-pro BNP assessments during coronary severity
Authors: Guo Guofeng , Huang Zhaoqi , Wang Shixiang , Chen Ximing
Published: April 2020

To investigate the correlation between uric acid (UA) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and coronary artery severity in acute coronary syndrome patients of different sexes.

A total of 134 patients with acute coronary syndrome (ACS) were investigated. According to sex, there were 96 cases in male group and 38 cases in female group. According to the number of diseased vessels, the degree of coronary artery lesion was determined and divided into negative group (n = 21), single vessel lesion group (n = 43), double vessel lesion group (n = 38), and 3 vessel lesion group (n = 32).

Univariate analysis showed that UA, NT-proBNP was correlated with the severity of ACS (P < .05). UA was an independent risk factor for the severity of coronary artery disease in female group (P < .05), but not in male group (P > .05). There was no significant correlation between NT-proBNP and severity of coronary artery disease in different sex (P > .05).

UA was significantly correlated with the severity of coronary heart disease, especially in women, but not in men. The level of NT-proBNP was positively correlated with the severity of coronary artery, but no significant difference was found in different sexes.