bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety of stent-assisted coiling for the treatment of wide-necked ruptured aneurysm: A systematic literature review and meta-analysis of prevalence
Authors: Bsat Shadi , Bsat Ayman , Tamim Hani , Chanbour Hani , Alomari Safwan Omar , Houshiemy Mohamad Nabih El , Moussalem Charbel , Omeis Ibrahim
Published: August 2020

Background

Stent-assisted coil embolization of ruptured wide-necked aneurysms is a controversial treatment modality due to concerns on the peri-procedural safety of anti-platelet therapy in the setting of acute subarachnoid hemorrhage. Our aim was to systematically review the literature on stent-assisted coil embolization of acutely ruptured wide-neck aneurysms to calculate the pooled prevalence of clinical outcome, thromboembolic and hemorrhagic complication rates and overall mortality.

Methods

We searched PubMed and Google Scholar for articles published between 2009 and 2019 and stratified selected articles based on risk of publication bias. Data on thromboembolic and hemorrhagic complications, clinical outcomes and mortality rates were analyzed using quality-effects model and double arcsine transformation.

Results

24 articles were included featuring a total of 1582 patients. Thromboembolic and hemorrhagic complication rates were witnessed in 9.1% [95% CI: 6.0% – 12.7%; I2 = 72.8%] and 8.7% [95% CI: 5.4 – 12.6%; I2 = 77.2%] of patients, respectively. 245 patients received external ventricular drains, of which 33 (13.5%) had EVD-related hemorrhages. Total complication rate was 20.8% [95% CI: 14.2 – 28.1%; I2 = 87.0%]. 57% of aneurysms were completely occluded and a favorable clinical outcome was reported in 74.7% [95% CI: 66.4 – 82.2%; I2 = 86.0] of patients. Overall mortality rate came at 7.8% [95% CI: 4.8 – 11.6%; I2 = 76.9%].

Conclusion

Stent-assisted coiling of ruptured intracranial aneurysm is a technically feasible procedure with controlled thromboembolic complication rate but may be associated with higher hemorrhagic and total complication rates compared to coiling alone. While stent-assisted coiling of ruptured wide-necked aneurysm seems to yield a lower rate of favorable clinical outcome, overall mortality is comparable to that of endovascular coiling alone.
Treatment of iliac atherosclerotic lesions using the balloon-expandable dynamic bare metal stent: One-year outcomes of the BIODYNAMIC single-center retrospective analysis
Authors: Torsello Giovanni F , Doerr Beatrix , Donas Konstantinos , Berekoven Bärbel , Torsello Giovanni B , Beropoulis Efthymios
Published: August 2020

Objectives

Endovascular therapy using balloon expandable stents has become the treatment standard for most iliac atherosclerotic lesions. We aimed to assess the safety and performance of the Dynamic stainless-steel balloon-expanding stent system in this location.

Methods

BIODYNAMIC is a retrospective single center study including consecutive patients with iliac lesions treated with the Dynamic stent system. Not included were implantations inside an endograft. The primary endpoint was freedom from major adverse limb events (MALE) at 12 months, defined as index limb amputation or target lesion revascularization (TLR). Secondary endpoints were procedure success, ankle brachial index (ABI) and Rutherford class change, mortality and freedom from TLR after 12 months.

Results

Within two years, 182 patients with 234 lesions in the common iliac artery were enrolled. Rutherford class 5 and 6 were present in 11.5% of patients, average stent diameter was 8.0 ± 0.5 mm and stented length 40.0 ± 15.3 mm. The primary endpoint was reached in 96.2% (225/234) of the cases, with six TLR (2.6%) and three target limb amputations (1.3%). Procedure success was obtained in all but three patients (98.4%). In paired analysis, ABI improved by 0.25 ± 0.21 from baseline to 0.90 ± 0.16 post-procedure and Rutherford class improved by −1.75 ± 1.53. There were four non-device–related deaths (2.2%). Freedom from TLR was 97%, 95.3%, 94% and 92.7% at 24, 36, 48 and 60 months, respectively.

Conclusion

The Dynamic balloon-expandable stent system proved to be safe and effective in a population with common iliac artery lesions.
Truth and lies in the Caliphate: The use of deception in Islamic State propaganda
Authors: Milton Daniel
Published: August 2020

Deception has a long history in information warfare. Recent technological advances have increased the ability of militants to utilize deception in propaganda, but this subject has not been the focus of much scholarly attention. This study remedies this shortcoming by conducting a case study of the Islamic State’s use of deception in propaganda, and identifies three types of deception: substantive, source, and spread. Additionally, this article discusses the rationales under which the group used these deceptive practices. In doing so, it provides a new framework for understanding deception that can be useful in future academic work. The study of deception can also help those fighting against these groups by providing them with a research-based understanding of how and when deception is likely to be used, which will allow them to better calibrate counter-messaging efforts.
The biomechanical effectiveness of tendon transfers to restore rotation after reverse shoulder arthroplasty: latissimus versus lower trapezius
Authors: Chan Kevin , Langohr G Daniel G , Athwal George S , Johnson James A
Published: August 2020

Background

The purpose of this biomechanical simulator study was primarily to compare latissimus dorsi to lower trapezius tendon transfers for active external rotation and the pectoralis major transfer for internal rotation after reverse shoulder arthroplasty. Secondarily, the role of humeral component lateralization on transfer function was assessed.

Methods

Eight rotator cuff deficient cadavers underwent reverse shoulder arthroplasty with an adjustable lateralization humeral component. Latissimus dorsi and lower trapezius transfers were compared for active external rotation restoration and pectoralis major transfer for internal rotation restoration. Internal rotation/external rotation torques were measured for each lateralization at varying abduction and internal rotation/external rotation ranges-of-motion.

Results

The lower trapezius transfer generated, on average, 1.6 ± 0.2 nm more torque than the latissimus dorsi transfer (p < 0.001). The internal rotation/external rotation torques of all tendon transfers decreased as abduction increased (p < 0.01). At 0° elevation, reverse shoulder arthroplasty humeral component lateralization had a significant positive effect on tendon transfer torque at 60° internal rotation and external rotation (p < 0.01).

Discussion

Both the lower trapezius and the latissimus dorsi tendon transfers were effective in restoring active external rotation after reverse shoulder arthroplasty; however, the lower trapezius generated significantly more torque. Additionally, the pectoralis major transfer was effective in restoring active internal rotation. All tendon transfers were optimized with greater humeral component lateralization.
Respiratory syntycial virus: Current treatment strategies and vaccine approaches
Authors: Thornhill Elena Margret , Salpor Jessica , Verhoeven David
Published: August 2020

Respiratory Syncytial Virus is a yearly respiratory virus that causes significant frequencies of morbidities, particularly in the young and elderly populations. However, preventive vaccines and/or treatment therapies are generally lacking, although much attention is now being placed on this virus. Moreover, there are now multiple strategies currently being explored in a race to the first licensed vaccine. While vaccines are being developed, multiple treatment strategies are being explored to attenuate the severity of infection and thus reduce hospitalization rates in vulnerable populations. This review outlines current strategies to prevent or treat this virus in the hopes of reducing significant human morbidity and mortality that occurs yearly with this seasonal virus.
A brief report on the effects of vasoactive agents on peripheral venous waveforms in a porcine model
Authors: Polcz Monica , Hocking Kyle M , Chang Devin , Leisy Philip , Sobey Jenna H , Huston Jessica , Eagle Susan , Brophy Colleen , Alvis Bret D
Published: August 2020

Objectives

Non-invasive venous waveform analysis (NIVA) is a recently described, novel technique to assess intravascular volume status. Waveforms are captured with a piezoelectric sensor; analysis in the frequency domain allows for calculation of a “NIVA value” that represents volume status. The aim of this report was to determine the effects of vasoactive agents on the venous waveform and calculated NIVA values.

Design

Porcine experimental model.

Setting

Operating theatre.

Participants

A piezoelectric sensor was secured over the surgically exposed saphenous vein in eight anesthetized pigs.

Main outcome measures

NIVA value, pulmonary capillary wedge pressure (PCWP), and mean arterial pressure prior to and post intravenous administration of 150–180 µg of phenylephrine or 100 µg of sodium nitroprusside.

Results

Phenylephrine led to a decrease in NIVA value (mean 9.2 vs. 4.6, p < 0.05), while sodium nitroprusside led to an increase in NIVA value (mean 9.5 vs. 11.9, p < 0.05). Mean arterial pressure increased after phenylephrine ( p < 0.05) and decreased after sodium nitroprusside ( p < 0.05). PCWP did not change significantly after phenylephrine ( p = 0.25) or sodium nitroprusside ( p = 0.06).

Conclusions

Vasoactive agents lead to changes in non-invasively obtained venous waveforms in euvolemic pigs, highlighting a potential limitation in the ability to NIVA to estimate static volume in this setting. Further studies are indicated to understand the effects of vasoactive agents in the setting of hypovolemia and hypervolemia.
Panenteric capsule endoscopy identifies proximal small bowel disease guiding upstaging and treatment intensification in Crohn's disease: A European multicentre observational cohort study
Authors: Tai Foong Way D. , Ellul Pierre , Elosua Alfonso , Fernandez‐Urien Ignacio , Tontini Gian E. , Elli Luca , Eliakim Rami , Kopylov Uri , Koo Sara , Parker Clare , Panter Simon , Sidhu Reena , McAlindon Mark
Published: August 2020

Background

Endoscopically defined mucosal healing in Crohn's disease is associated with improved outcomes. Panenteric capsule endoscopy enables a single non‐invasive assessment of small and large bowel mucosal inflammation.

Aims and Methods

This multicentre observational study of patients with suspected and established Crohn's disease examined the feasibility, safety and impact on patient outcomes of panenteric capsule endoscopy in routine clinical practice. The potential role in assessment of disease severity and extent by a comparison with existing clinical and biochemical markers is examined.

Results

Panenteric capsule endoscopy was performed on 93 patients (71 with established and 22 with suspected Crohn's disease). A complete examination occurred in 85% (79/93). Two cases (2.8%) of capsule retention occurred in patients with established Crohn's disease. Panenteric capsule resulted in management change in 38.7% (36/93) patients, including 64.6% (32/48) of those with an established diagnosis whose disease was active, and all three patients with newly diagnosed Crohn's disease. Montreal classification was upstaged in 33.8% of patients with established Crohn's disease and mucosal healing was demonstrated in 15.5%. Proximal small bowel disease upstaged disease in 12.7% and predicted escalation of therapy (odds ratio 40.3, 95% confidence interval 3.6–450.2). Raised C‐reactive protein and faecal calprotectin were poorly sensitive in detecting active disease (0.48 and 0.59 respectively).

Conclusions

Panenteric capsule endoscopy was feasible in routine practice and the ability to detect proximal small bowel disease may allow better estimation of prognosis and guide treatment intensification. Panenteric capsule endoscopy may be a suitable non‐invasive endoscopic investigation in determining disease activity and supporting management decisions.
Alpha‐fetoprotein‐adjusted‐to‐HCC‐size criteria are associated with favourable survival after liver transplantation for hepatocellular carcinoma
Authors: Meischl Tobias , Rasoul‐Rockenschaub Susanne , Győri Georg , Scheiner Bernhard , Trauner Michael , Soliman Thomas , Berlakovich Gabriela , Pinter Matthias
Published: August 2020

Background

The Milan criteria are recommended to select hepatocellular carcinoma (HCC) patients for liver transplantation (LT). The utility of other selection criteria, such as the alpha‐fetoprotein‐adjusted‐to‐HCC‐size (AFP‐UTS) criteria, is still unclear.

Objective

We investigated, in HCC patients who underwent LT, the survival and the recurrence after LT according to AFP‐UTS and Milan criteria, the impact of early recurrence and the correlation between radiological and pathological staging.

Methods

Adult HCC patients undergoing deceased donor LT at the Medical University of Vienna between 1997 and 2014 were retrospectively analysed.

Results

Among 166 patients included, the number of patients who fulfilled Milan or AFP‐UTS criteria was the same (139 [84%] each), although not all of them were the same individuals; 127 patients (77%) fulfilled both Milan and AFP‐UTS criteria. Median overall survival of patients within AFP‐UTS was 126.9 versus 34.2 months outside AFP‐UTS (5‐year survival rate 71% vs. 43%; p = 0.104). The 5‐year recurrence rate was significantly lower in patients fulfilling the AFP‐UTS criteria (18%) than in those exceeding AFP‐UTS (64%; p < 0.001). Of the 139 patients within Milan criteria on imaging, 24 (17%) had microvascular invasion and 47 (34%) were outside Milan according to explant histology. Early recurrence correlated with AFP‐UTS and was associated with dismal survival (median overall survival 17.2 vs. 122.1 months, p = 0.002).

Conclusions

The overall survival of patients within AFP‐UTS criteria was favourable with a 5‐year survival rate above 70%. Early recurrence is associated with worse survival after LT. The AFP‐UTS criteria may be more suitable to exclude patients at high risk of (early) recurrence than Milan criteria.
Low Voltage Operating 2D MoS2 Ferroelectric Memory Transistor with Hf1-xZrxO2 Gate Structure
Authors: Zhang Siqing , Liu Yan , Zhou Jiuren , Ma Meng , Gao Anyuan , Zheng Binjie , Li Lingfei , Su Xin , Han Genquan , Zhang Jincheng , Shi Yi , Wang Xiaomu , Hao Yue
Published: August 2020

Ferroelectric field effect transistor (FeFET) emerges as an intriguing non-volatile memory technology due to its promising operating speed and endurance. However, flipping the polarization requires a high voltage compared with that of reading, impinging the power consumption of writing a cell. Here, we report a CMOS compatible FeFET cell with low operating voltage. We engineer the ferroelectric Hf1-xZrxO2 (HZO) thin film to form negative capacitance (NC) gate dielectrics, which generates a counterclock hysteresis loop of polarization domain in the few-layered molybdenum disulfide (MoS2) FeFET. The unstabilized negative capacitor inherently supports subthermionic swing rate and thus enables switching the ferroelectric polarization with the hysteresis window much less than half of the operating voltage. The FeFET shows a high on/off current ratio of more than 107 and a counterclockwise memory window (MW) of 0.1 V at a miminum program (P)/erase (E) voltage of 3 V. Robust endurance (103 cycles) and retention (104 s) properties are also demonstrated. Our results demonstrate that the HZO/MoS2 ferroelectric memory transistor can achieve new opportunities in size- and voltage-scalable non-volatile memory applications.
Neural defects caused by total and Wnt1-Cre mediated ablation of p120ctn in mice
Authors: Pieters Tim , Sanders Ellen , Tian Huiyu , van Hengel Jolanda , van Roy Frans
Published: August 2020

Background

p120 catenin (p120ctn) is an important component in the cadherin-catenin cell adhesion complex because it stabilizes cadherin-mediated intercellular junctions. Outside these junctions, p120ctn is actively involved in the regulation of small GTPases of the Rho family, in actomyosin dynamics and in transcription regulation. We and others reported that loss of p120ctn in mouse embryos results in an embryonic lethal phenotype, but the exact developmental role of p120ctn during brain formation has not been reported.

Results

We combined floxed p120ctn mice with Del-Cre or Wnt1-Cre mice to deplete p120ctn from either all cells or specific brain and neural crest cells. Complete loss of p120ctn in mid-gestation embryos resulted in an aberrant morphology, including growth retardation, failure to switch from lordotic to fetal posture, and defective neural tube formation and neurogenesis. By expressing a wild-type p120ctn from the ROSA26 locus in p120ctn-null mouse embryonic stem cells, we could partially rescue neurogenesis. To further investigate the developmental role of p120ctn in neural tube formation, we generated conditional p120ctnfl/fl;Wnt1Cre knockout mice. p120ctn deletion in Wnt1-expressing cells resulted in neural tube closure defects (NTDs) and craniofacial abnormalities. These defects could not be correlated with misregulation of brain marker genes or cell proliferation. In contrast, we found that p120ctn is required for proper expression of the cell adhesion components N-cadherin, E-cadherin and β-catenin, and of actin-binding proteins cortactin and Shroom3 at the apical side of neural folds. This region is of critical importance for closure of neural folds. Surprisingly, the lateral side of mutant neural folds showed loss of p120ctn, but not of N-cadherin, β-catenin or cortactin.

Conclusions

These results indicate that p120ctn is required for neurogenesis and neurulation. Elimination of p120ctn in cells expressing Wnt1 affects neural tube closure by hampering correct formation of specific adhesion and actomyosin complexes at the apical side of neural folds. Collectively, our results demonstrate the crucial role of p120ctn during brain morphogenesis.
Comparative transcriptome analysis reveals ecological adaption of cold tolerance in northward invasion of Alternanthera philoxeroides
Authors: Luo Landi , Kong Xiangxiang , Gao Zean , Zheng Yan , Yang Yunqiang , Li Xiong , Yang Danni , Geng Yupeng , Yang Yongping
Published: August 2020

Background

Alternanthera philoxeroides (alligator weed) is a highly invasive alien plant that has continuously and successfully expanded from the tropical to the temperate regions of China via asexual reproduction. During this process, the continuous decrease in temperature has been a key limiting environmental factor.

Results

In this study, we provide a comprehensive analysis of the cold tolerance of alligator weed via transcriptomics. The transcriptomic differences between the southernmost population and the northernmost population of China were compared at different time points of cold treatments. GO enrichment and KEGG pathway analyses showed that the alligator weed transcriptional response to cold stress is associated with genes encoding protein kinases, transcription factors, plant-pathogen interactions, plant hormone signal transduction and metabolic processes. Although members of the same gene family were often expressed in both populations, the levels of gene expression between them varied. Further ChIP experiments indicated that histone epigenetic modification changes at the candidate transcription factor gene loci are accompanied by differences in gene expression in response to cold, without variation in the coding sequences of these genes in these two populations. These results suggest that histone changes may contribute to the cold-responsive gene expression divergence between these two populations to provide the most beneficial response to chilling stimuli.

Conclusion

We demonstrated that the major alterations in gene expression levels belonging to the main cold-resistance response processes may be responsible for the divergence in the cold resistance of these two populations. During this process, histone modifications in cold-responsive genes have the potential to drive the major alterations in cold adaption necessary for the northward expansion of alligator weed.
An examination of trends in antibiotic prescribing in primary care and the association with area-level deprivation in England
Authors: Thomson Katie , Berry Rachel , Robinson Tomos , Brown Heather , Bambra Clare , Todd Adam
Published: August 2020

Background

Internationally, there are growing concerns about antimicrobial resistance. This has resulted in increased scrutiny of antibiotic prescribing trends – particularly in primary care where the majority of prescribing occurs. In England, antibiotic prescribing targets are set nationally but little is known about the local context of antibiotic prescribing. This study aimed to examine trends in antibiotic prescribing (including broad-spectrum), and the association with area-level deprivation and region in England.

Methods

Antibiotic prescribing data by GP surgery in England were obtained from NHS Business Service Authority for the years 2014–2018. These data were matched with the Index of Multiple Deprivation (IMD) 2015 at the Lower Layer Super Output Area level Lower Layer Super Output Area (LSOA) level. Linear regression methods were employed to explore the relationship between antibiotic use and area-level deprivation as well as region, after controlling for a range of other confounding variables, including health need, rurality, and ethnicity.

Results

Over time, the amount of antibiotic prescribing significantly reduced from 1.11 items per STAR-PU to 0.96 items per STAR-PU – a reduction of 13.6%. The adjusted models found that, at LSOA level, the most deprived areas of England had the highest levels of antibiotic prescribing (0.03 items per STAR-PU higher). However, broad spectrum antibiotic prescribing exceeding 10% of all antibiotic prescribing within a GP practice was higher in more affluent areas. There were also significant regional differences – with the North East and the East of England having the highest levels of antibiotic prescribing (by 0.16 items per STAR-PU).

Conclusion

Although antibiotic prescribing has reduced over time, there remains significant variation in by area-level deprivation and region in England – with higher antibiotic prescribing in more deprived areas. Future prescribing targets should account for local factors to ensure the most deprived communities are not inappropriately penalised.
Weight control in older adults with knee osteoarthritis: a qualitative study
Authors: Yeh Wen-Ling , Tsai Yun-Fang , Hsu Kuo-Yao , Chen Dave Weichih , Wang Jong-Shyan , Chen Ching-Yen
Published: August 2020

Background

Knee osteoarthritis (OA) affects mostly older adults and its primary risk factor is obesity. This study sought to understand weight-control strategies, facilitators of and barriers toward weight control in older adults with knee OA who preferred not to undergo physician-recommended total knee arthroplasty.

Methods

For this qualitative descriptive study, older outpatients (N = 118) were recruited from orthopedic clinics at three hospitals. Data were collected through face-to face, individual in-depth interviews using a semi-structured interview guide and analyzed using content analysis.

Results

Among participants, only 25.4% had body weight in the normal range and 55.9% reported having controlled their weight. Their most common weight-control strategies were to control diet and to exercise and control diet together. Weight control was facilitated by desiring good health, wanting to improve walking or movement, perceiving that they had gained weight, wanting to look good, and advice from healthcare providers. Common barriers to participants’ weight control were perceiving that dietary control was not needed, controlling appetite was difficult, dietary control was difficult, and not eating was physically uncomfortable.

Conclusions

Our findings help healthcare providers understand how older adults with knee OA perceive weight control and serve as a reference for developing weight-control programs. Health care providers can integrate these identified facilitators and barriers into a weight-control intervention program. The importance of weighing oneself every day, the meaning of body mass index, consulting with a dietician regularly to control weight, and providing appropriate knowledge about aging and weight control should also be included in any weight-control intervention program.
The use of PEEK in digital prosthodontics: A narrative review
Authors: Papathanasiou Ioannis , Kamposiora Phophi , Papavasiliou George , Ferrari Marco
Published: August 2020

Background

Advanced computer-aided design and computer-aided manufacturing (CAD-CAM) technology led to the introduction of an increasing number of machinable materials suitable for dental prostheses. One of these materials is polyetheretherketone (PEEK), a high performance polymer recently used in dentistry with favorable physical, mechanical and chemical properties. The purpose of this study was to review the current published literature on the use of PEEK for the fabrication of dental prostheses with CAD-CAM techniques.

Methods

Electronic database searches were performed using the terms “PEEK”, “CAD-CAM”, “dental”, “dentistry” to identify studies related to the use of PEEK for the fabrication of CAD-CAM prostheses. The search period spanned from January 1990 through February 2020. Both in vivo and in vitro studies in English were eligible. Review articles and the references of the included publications were searched to identify relevant articles.

Results

A great number of in vitro studies are available in the current literature pointing out the noticeable properties of PEEK. The use of PEEK has been recommended for a wide range of CAD-CAM fabricated fixed and removable dental prostheses. PEEK was additionally recommended for occlusal splints, intra-radicular posts, implant abutments, customized healing abutments and provisional restorations. However, only a few clinical studies were identified.

Conclusions

PEEK could be considered as a viable alternative for CAD-CAM fixed and removable dental prostheses to well-established dental materials. Due to the scarcity of clinical data, clinical trials are needed to assess the long-term performance of PEEK prostheses.
Current situation and challenges for mental health focused on treatment and care in Japan and the Philippines - highlights of the training program by the National Center for Global Health and Medicine
Authors: Estrada Crystal Amiel , Usami Masahide , Satake Naoko , Gregorio Ernesto , Leynes Cynthia , Balderrama Norieta , Fernandez de Leon Japhet , Concepcion Rhodora Andrea , Tuazon Timbalopez Cecile , Tsujii Noa , Harada Ikuhiro , Masuya Jiro , Kihara Hiroaki , Kawahara Kazuhiro , Yoshimura Yuta , Hakoshima Yuuki , Kobayashi Jun
Published: August 2020

Background and purpose

Mental health has emerged as an important public health concern in recent years. With a high proportion of children and adolescents affected by mental disorders, it is important to ensure that they are provided with proper care and treatment. With the goal of sharing the activities and good practices on child and adolescent mental health promotion, care, and treatment in Japan and the Philippines, the National Center for Global Health and Medicine conducted a training program on the promotion of mental health focused on treatment and care in Japan and the Philippines in September and November 2019.

Key highlights

The training program comprised of a series of lectures, site visits, and round table discussions in Japan and the Philippines. The lectures and site visits focused on the current situation of child and adolescent psychiatry, diagnosis of childhood mental disorders, abuse, health financing for mental disorders, pharmacotherapy, psychotherapy, and disaster child psychiatry in both countries. Round table discussions provided an opportunity to explore the similarities and differences between the two countries in terms of the themes discussed during the lectures.

The training program identified the need to collaborate with other professionals to improve the diagnosis of mental disorders in children and adolescents and to increase the workforce capable of addressing mental health issues among children and adolescents. It also emphasized the importance of cooperation between government efforts during and after disasters to ensure that affected children and their families are provided with the care and support that they need.
Rat models of human diseases and related phenotypes: a systematic inventory of the causative genes
Authors: Szpirer Claude
Published: August 2020

The laboratory rat has been used for a long time as the model of choice in several biomedical disciplines. Numerous inbred strains have been isolated, displaying a wide range of phenotypes and providing many models of human traits and diseases. Rat genome mapping and genomics was considerably developed in the last decades. The availability of these resources has stimulated numerous studies aimed at discovering causal disease genes by positional identification. Numerous rat genes have now been identified that underlie monogenic or complex diseases and remarkably, these results have been translated to the human in a significant proportion of cases, leading to the identification of novel human disease susceptibility genes, helping in studying the mechanisms underlying the pathological abnormalities and also suggesting new therapeutic approaches. In addition, reverse genetic tools have been developed. Several genome-editing methods were introduced to generate targeted mutations in genes the function of which could be clarified in this manner [generally these are knockout mutations]. Furthermore, even when the human gene causing a disease had been identified without resorting to a rat model, mutated rat strains (in particular KO strains) were created to analyze the gene function and the disease pathogenesis. Today, over 350 rat genes have been identified as underlying diseases or playing a key role in critical biological processes that are altered in diseases, thereby providing a rich resource of disease models. This article is an update of the progress made in this research and provides the reader with an inventory of these disease genes, a significant number of which have similar effects in rat and humans.
Therapeutic duplication of anticoagulants: a retrospective study of frequency and consequences in a tertiary referral hospital
Authors: Rahmanzade Ramin , Cabrera Diaz Francisco , Zaugg Claudia , Schuetz Philipp , Salili Ali Reza
Published: August 2020

Background

Anticoagulants are commonly prescribed in medical practices and could be of significant harm in the case of medication errors. We conducted a retrospective observational study to determine the frequency and consequences of the therapeutic duplication of anticoagulants (TDA). As a secondary objective, we aimed to determine the characteristics of the population in which TDA occurs.

Methods

We conducted a retrospective observational study among admitted patients who concomitantly received at least two anticoagulants from August 2017 to August 2018.

Results

A total of 107 patients with TDA are included in the research. The patients with TDA have a mean age of 73. The TDA population has a high rate of associated comorbidities with 69% of patients having arterial hypertonia, 40% with chronic kidney disease, 26% with a history of malignancy, and 20.5% with a history of stroke. More than 65% of patients were under anticoagulation before admission, mostly due to atrial fibrillation. The TDA occurred in more than 95% of cases in the first week or the last week of hospitalization. Patients had a high risk of bleeding prior to the TDA-event with about 62.5% of TDA patients having a HAS-BLED score at least 3. A total of 8 patients showed a significant Hemoglobin (Hb)-drop of at least 10 g/L within 24 h after TDA-event. Two patients had a new or worsened hematuria following TDA-event.

Conclusion

TDA occurred in 0.8% of patients who were under anticoagulation and in 6.7% of patients who received direct oral anticoagulants (DOACs). TDA led in about 7.4% of cases to hemoglobin-relevant bleeding. The old patients with significant comorbidities and a high HAS-BLED score were mainly affected. The female gender and presence of anemia independently predicted the occurrence of bleeding following TDA.
Barriers and facilitators to the effective de-escalation of conflict behaviours in forensic high-secure settings: a qualitative study
Authors: Goodman Helena , Papastavrou Brooks Cat , Price Owen , Barley Elizabeth Alexandra
Published: August 2020

Background

Violent and aggressive incidents are common within mental health settings and are often managed using high-risk physical interventions such as restraint and seclusion. De-escalation is a first-line technique to manage conflict behaviours and prevent violence and aggression. There is limited research into the use of de-escalation in high-secure settings. This study investigated staff, patient and carer perspectives on the barriers and facilitators to using de-escalation for conflict behaviours.

Methods

Semi-structured individual interviews (n = 12) and focus groups (n = 3) were conducted with eight patients, four carers and 25 staff members in a high-secure hospital in England. Interviews and focus groups were informed by the theoretical domains framework and were digitally recorded, transcribed verbatim and analysed using framework analysis and the COM-B behaviour change model.

Results

Four themes and 15 sub-themes (barriers and facilitators) were identified. Themes related to capabilities (building relationships: knowing the patient and knowing yourself), opportunities (filling the void: challenges within the high-security environment; dynamic relationships) and motivation (keeping everyone safe). Strong staff–patient therapeutic relationships underpinned by trust, fairness, consistency and an awareness of the trauma-aggression link were considered key to successful de-escalation. Specific psychological and interpersonal skills including empathy, respect, reassurance, sincerity, genuine concern and validation of the patient perspective are needed to achieve this. Barriers related to the physical environment; organisational resources, practices and systems; staff traumatisation; hierarchical and punitive attitudes towards patient care, and an insufficient understanding of psychiatric diagnoses, especially personality disorder. It was apparent across themes that fear, which was experienced by both staff and patients, was a driver for many behaviours.

Conclusions

This work has identified organizational and behaviour change targets for interventions seeking to reduce violence and restrictive practices through the use of de-escalation in high-secure hospitals. The potential for, and occurrence of, violence in such settings is high and leads to fear in patients and staff. The factors which promote fear in each group should be addressed in de-escalation training.
RETRACTED ARTICLE: Genipin suppression of growth and metastasis in hepatocellular carcinoma through blocking activation of STAT-3
Authors: Hong Ming , Lee Selena , Clayton Jacob , Yake Wildman , Li Jinke
Published: August 2020

Background

The signal transducer and activator of transcription-3 (STAT-3) can facilitate cancer progression and metastasis by being constitutively active via various signaling. Abundant evidence has indicated that STAT-3 may be a promising molecular target for cancer treatment.

Methods

In this study, a dual-luciferase assay-based screening of 537 compounds for STAT-3 inhibitors of hepatocellular carcinoma (HCC) cells was conducted, leading to the identification of genipin. Effects of genipin on HCC were assessed in a patient-derived xenograft nude mice model. Western blotting assay, chromatin immunoprecipitation (ChIP) assay, molecular docking study, tube formation assay, three-dimensional top culture assay, histological examination, and immunofluorescence were utilized to evaluate the regulatory signaling pathway.

Results

Our research demonstrated that genipin suppresses STAT-3 phosphorylation and nuclear translocation, which may be attributed to the binding capacity of this compound to the Src homology-2 (SH2) domain of STAT-3. In addition, the therapeutic effects of genipin in a patient-derived HCC xenograft nude mice model were also demonstrated.

Conclusions

In conclusion, genipin showed therapeutic potential for HCC treatment by interacting with the SH2-STAT-3 domain and suppressing the activity of STAT-3. In the future, further research is planned to explore the potential role of genipin in combination with chemotherapy or radiotherapy for HCC.
HAPPi Kneecaps! Protocol for a participant‐ and assessor‐blinded, randomised, parallel group feasibility trial of foot orthoses for adolescents with patellofemoral pain
Authors: O'Sullivan Isobel C. , Crossley Kay M. , Kamper Steven J. , van Middelkoop Marienke , Vicenzino Bill , Franettovich Smith Melinda M. , Menz Hylton B. , Smith Anne J. , Tucker Kylie , O'Leary Karina T. , Collins Natalie J.
Published: August 2020

Background

Patellofemoral pain (PFP) is a common cause of knee pain in adolescents, but there are limited evidence‐based treatment options for this population. Foot orthoses can improve pain and function in adults with PFP, and may be effective for adolescents. The primary aim of this study is to determine the feasibility of conducting a full‐scale randomised controlled trial (RCT) evaluating the effects of contoured foot orthoses on knee pain severity and patient‐perceived global change, compared to flat shoe insoles, in adolescents with PFP. The secondary aim is to provide an estimate of treatment effects for foot orthoses, compared to flat insoles, in adolescents with PFP.

Methods

This randomised, controlled, participant‐ and assessor‐blinded, feasibility trial has two parallel groups. Forty adolescents (aged 12–18 years) with clinical symptoms of PFP will be recruited from Queensland, Australia. Participants will be randomised to receive either prefabricated contoured foot orthoses or flat shoe insoles. Both interventions will be fit by a physiotherapist, and worn for 3 months. Feasibility will be evaluated through assessing willingness of volunteers to enrol, number of eligible participants, recruitment rate, adherence with the study protocol, adverse effects, success of blinding, and drop‐out rate. Secondary outcomes will evaluate knee‐related pain, symptoms, function, quality of life, global rating of change, patient acceptable symptom state, and use of co‐interventions, at 6 weeks and 3 months. Primary outcomes will be reported descriptively, while estimates of standard deviation and between‐group differences (with 95% confidence intervals) will be reported for secondary outcomes.

Discussion

Findings of this study will inform the feasibility of a full‐scale RCT investigating the efficacy of contoured foot orthoses in adolescents with PFP. This full‐scale study is necessary to improve the evidence base for management of adolescent PFP, and enhance outcomes for this population.

Trial registration

ACTRN12619000957190.
Listeria meningitis complicated by hydrocephalus in an immunocompetent child: case report and review of the literature
Authors: Brisca Giacomo , La Valle Alberto , Campanello Claudia , Pacetti Mattia , Severino Mariasavina , Losurdo Giuseppe , Palmieri Antonella , Buffoni Isabella , Renna Salvatore
Published: August 2020

Background

Listeria monocytogenes is a Gram-positive bacteria transmitted to human by animal stools, contaminated water and food.

In children, Listeria monocytogenes typically affects newborns and immunocompromised patients often leading to invasive syndromes including sepsis, brain abscesses, meningitis, meningoencephalitis and rhombencephalitis.

In healthy and immunocompetent children, Listeria meningitis is rare, but can progress rapidly and may be associated with severe complications (hydrocephalus, ventriculitis, cranial nerves palsy and cerebrospinal abscesses) and high mortality rate.

Case presentation

We describe a very uncommon case of meningoencephalitis due to Listeria monocytogenes in a 11-month-old immunocompetent girl. Cerebrospinal fluid (CSF) culture was positive on the second day. Antibiotic therapy was promptly started but the disease was complicated by neurological deterioration and decompensated hydrocephalus. The child required a very demanding pediatric and neurosurgical management and was discharged after 40 days without major sequelae.

Conclusion

Listeria is difficult to isolate and it is not susceptible to first-line treatment for bacterial meningitis with extended-spectrum cephalosporins. Early recognition is therefore crucial for a positive outcome. Pediatricians have to perform close clinical monitoring of these children and be aware of possible complications.

A review of all cases of Listeria meningitis complicated by hydrocephalus in healthy children has been performed, to provide an overview on clinical features, treatment options and outcome.
Synapse development and maturation at the drosophila neuromuscular junction
Authors: Chou Vivian T. , Johnson Seth A. , Van Vactor David
Published: August 2020

Synapses are the sites of neuron-to-neuron communication and form the basis of the neural circuits that underlie all animal cognition and behavior. Chemical synapses are specialized asymmetric junctions between a presynaptic neuron and a postsynaptic target that form through a series of diverse cellular and subcellular events under the control of complex signaling networks. Once established, the synapse facilitates neurotransmission by mediating the organization and fusion of synaptic vesicles and must also retain the ability to undergo plastic changes. In recent years, synaptic genes have been implicated in a wide array of neurodevelopmental disorders; the individual and societal burdens imposed by these disorders, as well as the lack of effective therapies, motivates continued work on fundamental synapse biology. The properties and functions of the nervous system are remarkably conserved across animal phyla, and many insights into the synapses of the vertebrate central nervous system have been derived from studies of invertebrate models. A prominent model synapse is the Drosophila melanogaster larval neuromuscular junction, which bears striking similarities to the glutamatergic synapses of the vertebrate brain and spine; further advantages include the simplicity and experimental versatility of the fly, as well as its century-long history as a model organism. Here, we survey findings on the major events in synaptogenesis, including target specification, morphogenesis, and the assembly and maturation of synaptic specializations, with a emphasis on work conducted at the Drosophila neuromuscular junction.
Characteristics and outcome of elderly patients admitted for acute Cholecystitis to medical or surgical wards
Authors: Feldman Itamar , Feldman Lena , Shapiro Dvorah S. , Munter Gabriel , Yinnon Amos M. , Friedman Reuven
Published: August 2020

Background

Elderly patients admitted because of acute cholecystitis are usually not operated during their initial admission and receive conservative treatment. To help formulate a new admission policy regarding elderly patients with acute cholecystitis we compared the demographic and clinical characteristics and outcome of patients > 65 with acute cholecystitis admitted to medical or surgical wards.

Methods

This retrospective study included all patients > 65 years admitted for acute cholecystitis between January, 2009 and September, 2016. Data were retrieved from the electronic health records.

Results

A total of 187 patients were detected, 54 (29%) in medical departments and 133 (71%) in surgical wards. The mean age (±SD) was 80 ± 7.5 and was higher among those in medical than surgical wards (84 ± 7 versus 79 ± 7, p <  0.05). Patients hospitalized in medical departments had more comorbidity, disability and mental impairment. However, there was no difference in mortality between the two groups, 1 (2%) and 6 (4%) respectively. Independent predictors for hospitalization in medical departments were chronic obstructive pulmonary disease (OR = 9.8, 95% C. I 1.6–59) and the Norton Scale score (NSS)(OR = 0.7, 95% C. I 0.7–0.8). Impaired mental condition was the only predictor for hospitalization > 1 week. The strongest predictor for having cholecystostomy was admission to the surgical department (OR = 14.7, 95% C. I 3.9–56.7). Linear regression showed a negative correlation between NSS and length of hospitalization (LOH; Beta = − 0.5).

Conclusion

Elderly patients with acute cholecystitis who require conservative management, especially those with severe functional and mental impairment can be safely hospitalized in medical departments. Outcome was not inferior in terms of mortality and LOH. These results have practical policy implications for the placement of elderly patients with acute cholecystitis in medical rather than surgical departments.
Tuberculosis treatment outcomes of non-citizen migrants: Israel compared to other high-income countries
Authors: Chemtob D. , Ogum E.
Published: August 2020

Background: In TB low incidence countries, the outcome of TB treatment among non-citizen migrants from endemic countries affects ability to eliminate TB. This study compares TB treatment outcomes among non-citizen migrants in select pre-elimination country based on their policies for non-citizen migrant TB patients in order to determine how policy affects TB outcomes.

Methods

A literature review was conducted via PUBMED, MEDLINE (2000–2017) on TB policy among non-citizen migrants and treatment outcome. Treatment outcome among migrants diagnosed in Israel during 2000–2014 was analysed.

Results

In total, 18 publications met the inclusion criteria. All the countries reviewed except the United States offered free TB treatment to undocumented migrants. Successful TB treatment outcome for non-citizen migrants in Israel was 87%, the Netherlands was 90.7%, the UK was 82.1%, and outcomes in the US and Australia were not published.

Conclusions

There is a need to standardize results based on international definitions of migrants, asylum seekers, and refugees in order to determine status-specific barriers and to facilitate international comparisons. Policies insuring free access to TB care for non-citizen migrants are an important element for TB elimination in low incidence countries.