bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimally invasive reduction of thoracolumbar burst fracture using monoaxial percutaneous pedicle screws: Surgical technique and report of radiological outcome
Authors: Chung Weng Hong , Eu Wei Cheong , Chiu Chee Kidd , Chan Chris Yin Wei , Kwan Mun Keong
Published: December 2019

Purpose:

To describe the reduction technique of thoracolumbar burst fracture using percutaneous monoaxial screws and its radiological outcomes compared to polyaxial screws.

Methods:

All surgeries were performed by minimally invasive technique with either percutaneous monoaxial or percutaneous polyaxial screws inserted at adjacent fracture levels perpendicular to both superior end plates. Fracture reduction is achieved with adequate rod contouring and distraction maneuver. Radiological parameters were measured during preoperation, postoperation, and follow-up.

Results:

A total of 21 patients were included. Eleven patients were performed with monoaxial pedicle screws and 10 patients performed with polyaxial pedicle screws. Based on AO thoracolumbar classification system, 10 patients in the monoaxial group had A3 fracture type and 1 had A4. In the polyaxial group, six patients had A3 and four patients had A4. Total correction of anterior vertebral height (AVH) ratio was 0.30 ± 0.10 and 0.08 ± 0.07 in monoaxial and polyaxial groups, respectively ( p < 0.001). Total correction of posterior vertebral height (PVH) ratio was 0.11 ± 0.05 and 0.02 ± 0.02 in monoaxial and polyaxial groups, respectively ( p < 0.001). Monoaxial group achieved more correction of 13° (62.6%) in local kyphotic angle compared to 8.2° (48.0%) in polyaxial group. Similarly, in regional kyphotic angle, 16.5° (103.1%) in the monoaxial group and 8.1° (76.4%) in the polyaxial group were achieved.

Conclusions:

Monoaxial percutaneous pedicle screws inserted at adjacent fracture levels provided significantly better fracture reduction compared to polyaxial screws in thoracolumbar fractures.
Spontaneous decrease in gastrocnemius spasticity after correction of knee flexion gait in children with cerebral palsy
Authors: Low Winson Min-Teng , Wang Sue-Mei , Yeh Kuo-Kuang , Chang Chia-Hsieh
Published: December 2019

Purpose:

Synergistic neuro-excitability in the lower extremities may be related to gait disorders. This study aimed to report spontaneous changes after correcting knee flexion gait and discuss the underlying mechanisms.

Methods:

A prospective study of 23 children with cerebral palsy was conducted to assess postoperative changes in gross motor function, joint range of motion (ROM), and spasticity. Characteristics of children/limbs with spontaneous decrease in gastrocnemius spasticity were assessed.

Results:

In 10 patients (19 limbs) without gastrocnemius release, the Modified Ashworth scores in the gastrocnemius decreased in 6 limbs after 3 months and in 10 limbs after 6 months. Those limbs with spontaneous changes had worse preoperative knee flexion contracture than the limbs without spasticity changes (knee ROM limitation score 5.4 vs. 3.7, p = 0.026).

Conclusions:

Patients with knee flexion contracture recruited greater plantar flexion–knee extension couple to balance knee flexion gait, and synergistic neuro-excitability of the gastrocnemius was enhanced. Our early results suggest preservation of the gastrocnemius in treating knee flexion gait, especially for patients with knee flexion contracture.
Arthroscopy-assisted surgery: The management of posterolateral tibial plateau depression fracture accompanying ligament injury: A case series and review of the literature
Authors: Wang Zhangfu , Zheng Binbin , Jin Yanjun , Yang Guangyong , Chen Guofu , Liang Junbo , Zhou Xiaobo , Yang Xiangdong
Published: December 2019

Tibial plateau fractures are multiple fracture patterns associated with soft-tissue injuries. Among which, the combined existence of posterolateral tibial plateau depression fracture with anterior cruciate ligament (ACL) rupture has been reported rarely. Meanwhile, surgical method for the treatment of depression fracture is fairly complex. The aim of this article is to show a case series of this unusual injury pattern and the therapy of posterolateral tibial plateau depression fracture accompanying ACL rupture. In our treatment, arthroscopy assisted reduction of depression fracture and ACL reconstruction reduces surgical trauma and leads to good functional recovery. We also review the current literature.
Comparison of muscle activity, strength, and balance, before and after a 6-month training using the FIFA11+ program (part 2)
Authors: Oshima Takeshi , Nakase Junsuke , Inaki Anri , Mochizuki Takafumi , Takata Yasushi , Shimozaki Kengo , Kinuya Seigo , Tsuchiya Hiroyuki
Published: December 2019

Background:

Sports injury prevention training programs have been reported to be effective in decreasing the incidence of injuries. The aim of this study was to evaluate the effects of a 6-month training period, using part 2 of the FIFA11+ program (the Fédération Internationale de Football), on the activation and strength of core and lower limb muscles and on static and dynamic balance performance.

Study Design:

Case series; level of evidence, 4.

Methods:

Eight college male soccer players, aged mean 20.4 ± 0.5 years old, completed the FIFA11+ program at least three times per week for 6 months. The following variables were measured both before and after the 6-month training program: activities of more than 30 muscles (core and lower limb muscles), measured using the standardized uptake values of 18F-fluorodeoxyglucose on positron emission tomography; isokinetic strength of the knee flexor and extensor and hip abductor muscles, measured at 60° s−1; static balance over a 60-s period, measured using a gravicorder; and dynamic balance, measured using the star excursion balance test.

Results:

Training improved the activity levels of core (obliquus externus abdominis and erector spinae) and lower limb (tibialis anterior) muscles ( p ≤ 0.03), corrected the between-limb difference in the activation of the semimembranosus and improved dynamic balance, with a greater training effect on the nondominant limb ( p ≤ 0.02). Training also improved the knee flexor force of the nondominant lower limb ( p = 0.02).

Conclusion:

Routine performance of the FIFA11+ program can improve the activation of core and lower limb muscles, with a concomitant improvement in dynamic balance. These improvements could be beneficial in lowering the risk of sports-related injuries.
Acute progressive bilateral carpal tunnel syndrome associated with remitting seronegative symmetrical synovitis with pitting edema syndrome: A case report
Authors: Okuma Kentaro , Furuhata Ryogo , Kiyota Yasuhiro , Kono Aki , Hayashi Teppei , Kamata Yusaku , Morioka Hideo
Published: December 2019

The association between carpal tunnel syndrome (CTS) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome, an elderly onset rheumatic disease, is not fully understood. Here, we describe a case of acute CTS caused by RS3PE syndrome. An 84-year-old man visited the hospital with sudden onset of severe neuralgia in the median nerve and pitting edema in both hands. Computed tomography showed low-density areas around the flexor tendons and median nerve compression in the carpal tunnel. Rapidly progressing intolerable neuralgia and paralysis required urgent carpal tunnel release in the left hand. After surgery, we considered the possibility of RS3PE syndrome and started the administration of prednisolone. The pitting edema and neuralgia improved. In this case, imaging and intraoperative findings suggest that the effusion generated from flexor tenosynovitis associated with RS3PE syndrome increased the internal pressure in the carpal tunnel rapidly, which led to acute CTS and urgent surgery.
Similar outcomes between ultracongruent and posterior-stabilized insert in total knee arthroplasty: A propensity score-matched analysis
Authors: Lee Sung-Sahn , Yeom Jaewoo , Lee Dae-Hee , Moon Young-Wan
Published: December 2019

Purpose:

(1) To compare postoperative range of motion (ROM), stability, and clinical outcomes between fixed-bearing posterior-stabilized (PS) and ultracongruent (UC). (2) The effect of postoperative stability on ROM and clinical outcomes was also evaluated in both designs.

Materials and methods:

Propensity score matching was conducted for age, gender, body mass index, preoperative ROM, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, Knee Society (KS) scores, hip–knee–ankle (HKA) alignment, and follow-up period. Two hundred patients (100 PS and 100 UC) were enrolled. Preoperative and final follow-up outcomes including postoperative ROM, anteroposterior (AP) stability (good, fair, and poor), WOMAC index, and KS scores were compared. Then, postoperative outcomes compared between the PS and UC. We also analyzed if AP stability was associated with the postoperative outcomes in both implant designs.

Results:

In both groups, ROM and clinical outcomes of final follow-up showed improvement than preoperation. Statistical significance was not determined between the PS and UC groups in terms of postoperative ROM (PS vs. UC, 134.6° vs. 133.4°, p = 0.13), stability (good/fair/poor, 91/9/0 vs. 84/14/0, p = 0.376), WOMAC index, KS scores, and outliers of HKA alignment (15% vs. 10%, p = 0.393). “Fair” stability showed inferior KS scores but greater ROM than “good” stability in both designs.

Conclusion:

TKA with UC insert provided similar ROM, AP stability, and clinical outcomes when compared to PS insert. In both designs, greater postoperative ROM was found but inferior clinical outcomes were found when TKA resulted in fair stability instead of good stability.

Level of evidence III:

Retrospective comparative study.
Effect of Fatigue Protocols on Upper Extremity Neuromuscular Function and Implications for Ulnar Collateral Ligament Injury Prevention
Authors: Jildeh Toufic R. , Okoroha Kelechi R. , Tramer Joseph S. , Chahla Jorge , Nwachukwu Benedict U. , Annin Shawn , Moutzouros Vasilios , Bush-Joseph Charles , Verma Nikhil
Published: December 2019

Background:

As the incidence of overuse injuries to the medial elbow in overhead athletes continues to rise, recent evidence suggests a link between these injuries and alterations in biomechanics produced by athlete fatigue. Previous studies have evaluated the effect of fatigue on elbow injuries using a wide array of fatigue protocols/athletic tasks, and, as a consequence, the results have been heterogeneous.

Purpose:

To determine whether there is a uniform alteration in neuromuscular function or biomechanics as the overhead athlete fatigues. Furthermore, this study sought to determine whether player fatigue should be accounted for in ulnar collateral ligament (UCL) injury prevention programs.

Study Design:

Systematic review.

Methods:

A systematic review of the literature using PubMed and MEDLINE databases was performed. Keywords included fatigue, upper extremity, baseball, pitcher, throwing, and muscle activity. Inclusion criteria consisted of original research articles in the English language involving healthy athletes, use of fatigue protocols, and the evaluation of at least 1 upper limb biomechanical variable.

Results:

A total of 35 studies involving 644 athletes (90 females, 554 males; mean age, 20.2 years) met the inclusion criteria. General fatigue protocols were used in 2 investigations, peripheral protocols were used in all 35 studies, and 5 different athletic tasks were studied (simulated baseball game, overhead throwing, high-effort swimming, simulated tennis game, and overhead serving). There was a uniform decrease in muscle force production and proprioception in athletes after completing a fatigue protocol. However, there was no consistency among studies when evaluating other important upper limb biomechanical factors. The fatigue protocols did not consistently produce statistically significant changes in elbow torque, pitching biomechanics, or ball velocity.

Conclusion:

A uniform decrease in muscle force production and proprioception was found after fatigue protocols; however, a majority of fatigue protocols published in the current literature are inconsistently measured and produce heterogeneous results. Therefore, currently, no recommendations can be made for changes in UCL injury prevention training programs to account for potential effects of fatigue. The effect of muscle force production and proprioception on upper extremity injuries should be evaluated in future studies.
Severity of Postoperative Complications From the Perspective of the Patient
Authors: Rendell Victoria R , Siy Alexander B , Stafford Linda M Cherney , Schmocker Ryan K , Leverson Glen E , Winslow Emily R
Published: December 2019

Background:

Although provider-derived surgical complication severity grading systems exist, little is known about the patient perspective.

Objective:

To assess patient-rated complication severity and determine concordance with existing grading systems.

Methods:

A survey asked general surgery patients to rate the severity of 21 hypothetical postoperative events representing grades 1 to 5 complications from the Accordion Severity Grading System. Concordance with the Accordion scale was examined. Separately, descriptive ratings of 18 brief postoperative events were ranked.

Results:

One hundred sixty-eight patients returned a mailed survey following their discharge from a general surgery service. Patients rated grade 4 complications highest. Grade 1 complications were rated similarly to grade 5 and higher than grades 2 and 3 ( P ≤ .01). Patients rated one event not considered an Accordion scale complication higher than all but grade 4 complications ( P < .001). The brief events also did not follow the Accordion scale, other than the grade 6 complication ranking highest.

Conclusion:

Patient-rated complication severity is discordant with provider-derived grading systems, suggesting the need to explore important differences between patient and provider perspectives.
Patient Information Leaflets for Lumbar Spine Surgery: A Missed Opportunity
Authors: Low Matthew , Burgess Louise C , Wainwright Thomas W
Published: December 2019

Background:

High-quality patient information is recommended to help reduce procedure-related anxiety and encourage patients to become active participants in their recovery. The objective of this study was to analyze the quality of patient information leaflets (PILs) given to National Health Service (NHS) patients ahead of lumbar spine surgery.

Methods:

The DISCERN tool was used to evaluate the quality of PILs, sourced from NHS websites.

Results:

Thirty-two PILs on lumbar surgery were included. Two (6%) leaflets were considered poor, 13 (41%) were marked as fair, 14 (44%) were of good quality, and 3 (9%) were scored as excellent. The total mean score was 55 (30-74), which corresponds to good quality. The lowest scoring questions were sources of information (Q4), balanced/unbiased content (Q6), and explanation of no treatment (Q12).

Conclusions:

There is considerable variation in the quality of PILs provided ahead of lumbar spine surgery. The scope for improvement is clear, and as the move toward patient-centered, evidence-based care continues, it is important that hospital resources provide recommendations based upon evidence of clinical effectiveness.
RETRACTED ARTICLE: The novel circular RNA circ-CAMK2A enhances lung adenocarcinoma metastasis by regulating the miR-615-5p/fibronectin 1 pathway
Authors: Du Jiahui , Zhang Guangzhao , Qiu Hongli , Yu Haifeng , Yuan Wuying
Published: December 2019

Background

Circular RNA (circRNA) has recently been considered as a key regulator in carcinogenesis. In this study, we investigated the functional significance and regulatory role of circ-CAMK2A (hsa_circ_0128332) in lung adenocarcinoma (LUAD).

Methods

GSE101586 was employed to screen differentially expressed circRNAs. = Relative expression levels of circ-CAMK2A, miR-615-5p, fibronectin 1 (FN1), MMP2, and MMP9 were tested by quantitative reverse transcription PCR (qRT-PCR) or western blotting. Functional experiments were performed by CCK-8, wound healing, and transwell assays. Luciferase reporter and biotin-labeled RNA pull-down assays were carried out to evaluate the interaction between circ-CAMK2A, miR-615-5p, and fibronectin 1. In addition, a lung metastasis model was constructed to determine the metastasis-promoting role of circ-CAMK2A in vivo.

Results

Circ-CAMK2A overexpression was observed in LUAD and was closely associated with lymph node metastasis, distant metastasis, advanced clinical stage, and poor prognosis. Circ-CAMK2A silencing evidently inhibited LUAD cell migration and invasion, whereas circ-CAMK2A overexpression had an opposite effect. Importantly, overexpression of circ-CAMK2A also enhanced LUAD metastasis in vivo. Mechanistically, miR-615-5p was identified as a direct target of circ-CAMK2A. Circ-CAMK2A up-regulates the expression level of fibronectin 1 by sponging miR-615-5p, thereby increasing MMP2 and MMP9 expression to promote the metastasis of LUAD.

Conclusion

Circ-CAMK2A plays a crucial role in the metastasis of LUAD, at least partially, by regulating the miR-615-5p/fibronectin 1 axis.
Can the SCD test and terminal uridine nick-end labeling by flow cytometry technique (TUNEL/FCM) be used interchangeably to measure sperm DNA damage in routine laboratory practice?
Authors: Grèze Cécile , Guttmann Aline , Pons-Rejraji Hanae , Vasson Marie-Paule , Lornage Jacqueline , Ouchchane Lemlih , Brugnon Florence
Published: December 2019

Background

Numerous tests have been proposed to evaluate sperm DNA integrity. To assess the sperm chromatin dispersion (SCD) test in an andrology laboratory, twenty-five men attending Clermont-Ferrand (France) University Hospital’s Center for Reproductive Medicine were recruited. Sperm DNA damage was measured in the same semen samples using the SCD test and the Terminal Uridine Nick-end Labeling by flow cytometry technique (TUNEL/FCM) after density gradient centrifugation.

Results

SCD test reliability between readings, readers or slides was clearly established with very high agreement between measurements (Intraclass correlation coefficient (ICC) at 0.97, 0.95 and 0.98 respectively). Despite very good agreement between the SCD test and TUNEL/FCM (ICC at 0.94), the SCD test tended to slightly but significantly underestimate DNA damage compared with TUNEL (p = 0.0127). This systematic difference between the two techniques was − 3.39 ± 1.45% (mean ± SE).

Conclusions

Andrology laboratories using the SCD test to measure sperm DNA damage need to know that it appears to give slightly underestimated measurements compared to TUNEL/FCM. However, this systematic underestimation is very small in amplitude. Both techniques give almost perfectly congruent results. Our study underlines the importance for each laboratory to validate its method to assess sperm DNA damage before implementing it in routine andrology lab practice.
A multi-breed reference panel and additional rare variants maximize imputation accuracy in cattle
Authors: Rowan Troy N. , Hoff Jesse L. , Crum Tamar E. , Taylor Jeremy F. , Schnabel Robert D. , Decker Jared E.
Published: December 2019

Background

During the last decade, the use of common-variant array-based single nucleotide polymorphism (SNP) genotyping in the beef and dairy industries has produced an astounding amount of medium-to-low density genomic data. Although low-density assays work well in the context of genomic prediction, they are less useful for detecting and mapping causal variants and the effects of rare variants are not captured. The objective of this project was to maximize the accuracies of genotype imputation from medium- and low-density assays to the marker set obtained by combining two high-density research assays (~ 850,000 SNPs), the Illumina BovineHD and the GGP-F250 assays, which contains a large proportion of rare and potentially functional variants and for which the assay design is described here. This 850 K SNP set is useful for both imputation to sequence-level genotypes and direct downstream analysis.

Results

We found that a large multi-breed composite imputation reference panel that includes 36,131 samples with either BovineHD and/or GGP-F250 genotypes significantly increased imputation accuracy compared with a within-breed reference panel, particularly at variants with low minor allele frequencies. Individual animal imputation accuracies were maximized when more genetically similar animals were represented in the composite reference panel, particularly with complete 850 K genotypes. The addition of rare variants from the GGP-F250 assay to our composite reference panel significantly increased the imputation accuracy of rare variants that are exclusively present on the BovineHD assay. In addition, we show that an assay marker density of 50 K SNPs balances cost and accuracy for imputation to 850 K.

Conclusions

Using high-density genotypes on all available individuals in a multi-breed reference panel maximized imputation accuracy for tested cattle populations. Admixed animals or those from breeds with a limited representation in the composite reference panel were still imputed at high accuracy, which is expected to further increase as the reference panel expands. We anticipate that the addition of rare variants from the GGP-F250 assay will increase the accuracy of imputation to sequence level.
Different transcriptional response between susceptible and resistant common carp (Cyprinus carpio) fish hints on the mechanism of CyHV-3 disease resistance
Authors: Tadmor-Levi Roni , Doron-Faigenboim Adi , Marcos-Hadad Evgeniya , Petit Jules , Hulata Gideon , Forlenza Maria , Wiegertjes Geert F. , David Lior
Published: December 2019

Background

Infectious disease outbreaks form major setbacks to aquaculture production and to further development of this important sector. Cyprinid herpes virus-3 (CyHV-3) is a dsDNA virus widely hampering production of common carp (Cyprinus carpio), one of the most farmed fish species worldwide. Genetically disease resistant strains are highly sought after as a sustainable solution to this problem. To study the genetic basis and cellular pathways underlying disease resistance, RNA-Seq was used to characterize transcriptional responses of susceptible and resistant fish at day 4 after CyHV-3 infection.

Results

In susceptible fish, over four times more differentially expressed genes were up-regulated between day 0 and 4 compared to resistant fish. Susceptible and resistant fish responded distinctively to infection as only 55 (9%) of the up-regulated genes were shared by these two fish types. Susceptible fish elicited a typical anti-viral response, involving interferon and interferon responsive genes, earlier than resistant fish did. Furthermore, chemokine profiles indicated that the two fish types elicited different cellular immunity responses. A comparative phylogenetic approach assisted in chemokine copies annotation pointing to different orthologous copies common to bony-fishes and even carp-specific paralogs that were differentially regulated and contributed to the different response of these two fish types. Susceptible fish up-regulated moreccl19chemokines, which attract T-cells and macrophages, the anti-viral role of which is established, whereas resistant fish up-regulated morecxcl8/il8chemokines, which attract neutrophils, the antiviral role of which is unfamiliar.

Conclusions

Taken together, by pointing out transcriptional differences between susceptible and resistant fish in response to CyHV-3 infection, this study unraveled possible genes and pathways that take part in disease resistance mechanisms in fish and thus, enhances our understanding of fish immunogenetics and supports the development of sustainable and safe aquaculture.
Metabolite profile comparison of a graft chimera ‘Hongrou Huyou’ (Citrus changshan-huyou + Citrus unshiu) and its two donor plants
Authors: Zhang Min , Jing Luyang , Wu Qun , Zhu Kaijie , Ke Fuzhi , Xu Jianguo , Zhao Siqing , Wang Gang , Zhang Chi
Published: December 2019

Background

Chimeras synthesized artificially by grafting are crucial to the breeding of perennial woody plants. ‘Hongrou Huyou’ (Citrus changshan-huyou + Citrus unshiu) is a new graft chimera originating from the junction where aCitrus changshan-huyou(“C”) scion was top-grafted onto a stock Satsuma mandarin ‘Owari’ (C. unshiu, “O”). The chimera was named OCC because the cell layer constitutions were O for Layer 1(L1) and C for L2 and L3. In this study, profiles of primary metabolites, volatiles and carotenoids derived from different tissues in OCC and the two donors were investigated, with the aim of determining the relationship between the layer donors and metabolites.

Results

The comparison of the metabolite profiles showed that the amount and composition of metabolites were different between the peels and the juice sacs, as well as between OCC and each of the two donors. The absence or presence of specific metabolites (such as the carotenoids violaxanthin andβ-cryptoxanthin, the volatile hydrocarbon germacrene D, and the primary metabolites citric acid and sorbose) in each tissue was identified in the three phenotypes. According to principal component analysis (PCA), overall, the metabolites in the peel of the chimera were derived from donor C, whereas those in the juice sac of the chimera came from donor O.

Conclusion

The profiles of primary metabolites, volatiles and carotenoids derived from the peels and juice sacs of OCC and the two donors were systematically compared. The content and composition of metabolites were different between the tissues and between OCC and the each of the two donors. A clear donor dominant pattern of metabolite inheritance was observed in the different tissues of OCC and was basically consistent with the layer origin; the peel of the chimera was derived from C, and the juice sacs of the chimera came from O. These profiles provide potential chemical markers for genotype differentiation, citrus breeding assessment, and donor selection during artificial chimera synthesis.
Genome-scale mining of root-preferential genes from maize and characterization of their promoter activity
Authors: Li Ye , Liu Xiaoqing , Chen Rumei , Tian Jian , Fan Yunliu , Zhou Xiaojin
Published: December 2019

Background

Modification of root architecture and improvement of root resistance to stresses can increase crop productivity. Functional analyses of root-specific genes are necessary for root system improvement, and root-specific promoters enable research into the regulation of root development and genetic manipulation of root traits. Maize is an important crop species; however, little systematic mining of root-specific genes and promoters has been performed to date.

Results

Genomic-scale mining based on microarray data sets followed by transcript detection resulted in the identification of 222 root-specific genes. Gene Ontology enrichment analyses revealed that these 222 root-specific genes were mainly involved in responses to chemical, biotic, and abiotic stresses. Of the 222 genes, 33 were verified by quantitative reverse transcription polymerase chain reaction, and 31 showed root-preferential activity. About 2 kb upstream 5 of the 31 identified root-preferential genes were cloned from the maize genome as putative promoters and named p8463, p5023, p1534, p8531 and p6629. GUS staining of transgenic maize-derived promoter-GUS constructs revealed that the five promoters drove GUS expression in a root-preferential manner.

Conclusions

We mined root-preferential genes and their promoters in maize and verified p8463, p5023, p1534, p8531 and p6629 as root-preferential promoters. Our research enables the identification of other tissue-specific genes and promoters in maize and other species. In addition, the five promoters may enable enhancement of target gene(s) of maize in a root-preferential manner to generate novel maize cultivars with resistance to water, fertilizer constraints, or biotic stresses.
Severe acute respiratory infection risk following glucocorticosteroid treatment in uncomplicated influenza-like illness resulting from pH1N1 influenza infection: a case control study
Authors: Xing Xuesen , Hu Shixiong , Chen Meihua , Zhan Faxian , Liu Huihui , Chen Zhang , Zhang Hengjiao , Zeng Ge , Xu Qiaohua , Zhang Hong , Liu Man , Liu Honghui , Gao Lidong , Zhang Lijie
Published: December 2019

Background

Current studies regarding glucocorticosteroid treatment of influenza have only estimated risk of critical illness or death which can be easily confounded by timing of treatment administration. We used severe acute respiratory infection (sARI) as an endpoint and investigated risk associated with receiving glucocorticosteroids before sARI onset.

Methods

sARI cases were defined as influenza-like illness (ILI) with pH1N1 infection and respiratory distress. Controls were defined as pH1N1 cases other than sARI and randomly selected from the community. We compared glucocorticosteroids and other medications used before sARI onset using a matched case control study adjusted for age group as well as underlying disease. Time-dependent risk and dose responses at different time periods over the course of sARI cases were also examined.

Results

Of the sARI cases, 34% received glucocorticosteroids before sARI onset compared to 3.8% of controls during equivalent days (ORM-H = 17,95%CI = 2.1–135). Receiving glucocorticosteroids before sARI onset increased risk of developing subsequent critical illness or death (ORM-H = 5.7,95%CI = 1.6–20.2), and the ORM-H increased from 5.7 to 8.5 for continued glucocorticosteroid use after sARI onset. However, only receiving glucocorticosteroids after sARI onset did not increase risk of severe illness (ORM-H = 1.1,95%CI = 0.3–4.6). Each increase in glucocorticosteroids dose of 1 mg/kg/day before sARI onset resulted in an increase of 0.62 (R2 = 0.87) in the pMEWS score at the time of sARI onset.

Conclusions

Early glucocorticosteroid treatment increased risk of sARI and subsequent critical illness or death; however, only receiving glucocorticosteroids after sARI onset did not increase risk of severe illness.
Association between vitamin D receptor (VDR) polymorphisms and the risk of multiple sclerosis (MS): an updated meta-analysis
Authors: Imani Danyal , Razi Bahman , Motallebnezhad Morteza , Rezaei Ramazan
Published: December 2019

Background

The association between theVitamin D Receptor(VDR) gene polymorphism and the risk of Multiple sclerosis (MS) has been evaluated in several researches. However, the findings were inconsistent and inconclusive. Therefore, we set out a meta-analysis of all eligible published case-control studies to obtain an exact evaluation of the association betweenVDRgene polymorphisms and MS.

Method

All relevant studies reporting the association between theVDRgene FokI (rs2228570), or/and TaqI (rs731236) or/and BsmI (rs1544410) or/and ApaI (rs7975232) polymorphisms and susceptibility to MS published up to May, 2019 were identified by comprehensive systematic search in the electronic database of web of science, Scopus, and PubMed. After that, the strength of association betweenVDRgene polymorphisms and susceptibility to MS was evaluated by odds ratio (OR) and 95% confidence interval (CI).

Results

A total of 30 case–control studies were included in the meta-analysis. The overall results suggested a significant association between TaqI polymorphism and MS risk under heterozygote genetic model (OR = 1.27, 95%CI = 1.01–1.59, random effect). Moreover, the pooled results of subgroup analysis declined presence of significant association under all defined genetic model. In subgroup analysis, BsmI polymorphisms was associated with increased risk of MS under recessive model in Asian populations. On the other hand, ApaI polymorphism was associated with decreased risk of MS under recessive and aa vs. AA model in Asian populations.

Conclusion

This meta-analysis suggested a significant association between TaqI polymorphism and MS susceptibility. Furthermore, BsmI polymorphism was associated with increased risk of MS in Asian populations. In contrast, ApaI polymorphism was associated with decreased risk of MS in Asian populations. Future large-scale studies on gene–environment and gene–gene interactions are required to estimate risk factors and assist early diagnosis of patients at high risk for MS.
Correction to: Exploration for novel inhibitors showing back-to-front approach against VEGFR-2 kinase domain (4AG8) employing molecular docking mechanism and molecular dynamics simulations
Authors: Rampogu Shailima , Baek Ayoung , Zeb Amir , Lee Keun Woo
Published: December 2019

Following publication of the original article [1], the authors reported errors in Figure 3, Figure 14a, Figure 18, Figure 19b, Additional file 3 and Additional file 7.
Sustained adherence to a Mediterranean diet and physical activity on all-cause mortality in the Melbourne Collaborative Cohort Study: application of the g-formula
Authors: Williamson Elizabeth J. , Polak Julia , Simpson Julie A. , Giles Graham G. , English Dallas R. , Hodge Allison , Gurrin Lyle , Forbes Andrew B.
Published: December 2019

Background

Adherence to a traditional Mediterranean diet has been associated with lower mortality and cardiovascular disease risk. The relative importance of diet compared to other lifestyle factors and effects of dietary patterns over time remains unknown.

Methods

We used the parametric G-formula to account for time-dependent confounding, in order to assess the relative importance of diet compared to other lifestyle factors and effects of dietary patterns over time. We included healthy Melbourne Collaborative Cohort Study participants attending a visit during 1995–1999. Questionnaires assessed diet and physical activity at each of three study waves. Deaths were identified by linkage to national registries. We estimated mortality risk over approximately 14 years (1995–2011).

Results

Of 22,213 participants, 2163 (9.7%) died during 13.6 years median follow-up. Sustained high physical activity and adherence to a Mediterranean-style diet resulted in an estimated reduction in all-cause mortality of 1.82 per 100 people (95% confidence interval (CI): 0.03, 3.6). The population attributable fraction was 13% (95% CI: 4, 23%) for sustained high physical activity, 7% (95% CI: − 3, 17%) for sustained adherence to a Mediterranean-style diet and 18% (95% CI: 0, 36%) for their combination.

Conclusions

A small reduction in mortality may be achieved by sustained elevated physical activity levels in healthy middle-aged adults, but there may be comparatively little gain from increasing adherence to a Mediterranean-style diet.
Circulating tumor cells prior to initial treatment is an important prognostic factor of survival in non-small cell lung cancer: a meta-analysis and system review
Authors: Jiang Sha-Sha , Deng Bo , Feng Yong-Geng , Qian Kai , Tan Qun-You , Wang Ru-Wen
Published: December 2019

Background

Our study aimed to verify the prognostic value of circulating tumor cells (CTCs) prior to initial treatment on survival of non-small cell lung cancer (NSCLC) by using meta-analysis and system review of published studies.

Materials and methods

The PubMed, EMBASE and Cochrane Library were searched, respectively, to identify all studies that addressed the issues of CTCs prior to initial treatment and progression-free survival (PFS) and overall survival (OS). Finally, ten citations were included for analysis and assessment of publication bias by using review manager 5.3 statistical software and STATA 15.0.

Results

Randomized model analyzing multivariate Cox Proportional Hazards Regression indicated that higher abundance of CTCs significantly predicts poorer prognosis of lung cancer cases basing both on PFS (Z = 2.31, P = 0.02) and OS of advanced cases (Z = 2.44, P = 0.01), and systematic study aslo indicated the similar results.

Conclusion

High CTCs prior to initial treatment can predict shorter PFS and OS in NSCLC, and further studies are warranted in the future.
Is radiographic lumbar spondylolisthesis associated with occupational exposures? Findings from a nested case control study within the Wakayama spine study
Authors: Ishimoto Yuyu , Cooper Cyrus , Ntani Georgia , Yamada Hiroshi , Hashizume Hiroshi , Nagata Keiji , Muraki Shigeyuki , Tanaka Sakae , Yoshida Munehito , Yoshimura Noriko , Walker-Bone Karen
Published: December 2019

Background

To explore the relationship between radiographic spondylolisthesis and occupational factors in a case-control study nested within the Wakayama Spine Study (WSS).

Methods

The WSS is a cross-sectional observational study amongst Japanese adults. All participants completed a lifetime occupational history and underwent X-rays of the lumbar spine (L1-S1) according to a pre-defined protocol. One trained surgeon graded the presence of a spondylolisthesis based upon ≥5% anterior or posterior slip at one or more levels. Cases, with lumbar spondylolisthesis, were compared with controls without, for their principal occupation and occupational exposures.

Results

In total, data were available for 722 adults (245 men and 477 women), mean age 70.1 (range 53–93) years. According to the pre-defined radiographic criteria, 117 were defined with spondylolisthesis (cases), leaving 605 controls. Cases were not significantly different from controls for age, gender, BMI, smoking or alcohol intake. However, cases were more than twice as likely to report occupational driving ≥4 h/day (OR 2.39, 95% CI 1.08–5.27) after adjustment for age, gender and BMI. Additionally, after stratification by age using 75 years as a cut-point, cases were more than 3-fold more likely to report having worked in the agricultural/ fishing industries (OR 3.47, 95% CI 1.29–9.29) among those aged < 75 years. A reduced risk of being a case was associated with climbing slopes/steps and walking.

Conclusions

A history of occupational driving and working in the agricultural/fishing industry were associated with radiographic spondylolisthesis in this cross-sectional population study. This finding requires further evaluation in longitudinal studies.
The impact of care process development and comorbidity on time to surgery, mortality rate and functional outcome for hip fracture patients: a retrospective analysis over 19 years with data from the Swedish National Registry for hip fracture patients, RIKSHÖFT
Authors: Turesson Emma , Ivarsson Kjell , Thorngren Karl-Göran , Hommel Ami
Published: December 2019

For a long time the attention given to the hip fracture patient group was minor and without any certain consideration to their frailty. To improve the care for these patients Skane University Hospital in Lund has during the past 19 years worked actively with developing the care. This paper aims to describe what impact the care process development has had on functional outcome and mortality, as well as to analyze the impact of comorbidity and fracture type.

Methods

Patients older than 50 years with non-pathological cervical and trochanteric hip fracture admitted between Jan 1st 1999 and Dec 31st 2017 were included and data was retrieved from the National Quality Register for hip fracture patients, RIKSHÖFT. Variables regarding patient characteristics, fracture type, operation method, lead-times and outcome were analyzed. For comparison Fischer’s exact test and Spearman’s rank correlation coefficient was used for the categorical data and Pearson correlation coefficient for the continuous. To further analyze the effect over time a linear regression model was used.

Results

A total of 7827 patients were included. A significant shift in the overall morbidity was seen, with an increase in patients of higher ASA grade. No correlation was seen between outcome and the care process development. The mortality rate for the group as a whole the mortality rate had decreased over time. The total length of stay had decreased significantly over time. There was no statistically significant change in mortality rate over time when relating it to time-to-surgery.

Conclusions

Although the patients display a higher morbidity over time, the mortality rate has not changed significantly, which might indicate an effect of the care process development.

The care process development does not seem to impact on outcome as much as other factors.

This study supports the possibility to create a more specific algorithm for hip fracture patients, taking specific subgroups into consideration.
Culture and personal influences on cardiopulmonary resuscitation- results of international survey
Authors: Ozer Janet , Alon Gadi , Leykin Dmitry , Varon Joseph , Aharonson-Daniel Limor , Einav Sharon
Published: December 2019

Background

The ethical principle of justice demands that resources be distributed equally and based on evidence. Guidelines regarding forgoing of CPR are unavailable and there is large variance in the reported rates of attempted CPR in in-hospital cardiac arrest. The main objective of this work was to study whether local culture and physician preferences may affect spur-of-the-moment decisions in unexpected in-hospital cardiac arrest.

Methods

Cross sectional questionnaire survey conducted among a convenience sample of physicians that likely comprise code team members in their country (Indonesia, Israel and Mexico). The questionnaire included details regarding respondent demographics and training, personal value judgments and preferences as well as professional experience regarding CPR and forgoing of resuscitation.

Results

Of the 675 questionnaires distributed, 617 (91.4%) were completed and returned. Country of practice and level of knowledge about resuscitation were strongly associated with avoiding CPR performance. Mexican physicians were almost twicemore likely to forgo CPR than their Israeli and Indonesian/Malaysian counterparts [OR1.84 (95% CI 1.03, 3.26), p = 0.038]. Mexican responders also placed greater emphasison personal and patient quality of life (p <  0.001). In multivariate analysis, degree of religiosity was most strongly associated with willingness to forgo CPR; orthodox respondents were more than twice more likely to report having forgone CPR for apatient they do not know than secular and observant respondents, regardless of the country of practice [OR 2.12 (95%CI 1.30, 3.46), p = 0.003].

Conclusions

In unexpected in-hospital cardiac arrest the decision to perform or withhold CPR may be affected by physician knowledge and local culture as well as personal preferences. Physician CPR training should include information regarding predictors of patient outcome at as well as emphasis on differentiating between patient and personal preferences in an emergency.
A case of misalignment: the perspectives of local and national decision-makers on the implementation of psychological treatment by telephone in the Improving Access to Psychological Therapies Service
Authors: Rushton Kelly , Fraser Claire , Gellatly Judith , Brooks Helen , Bower Peter , Armitage Christopher J. , Faija Cintia , Welsh Charlotte , Bee Penny
Published: December 2019

Background

Psychological treatment delivered by telephone is recommended by the National Institute for Health and Care Excellence (NICE) for mild to moderate depression and anxiety, and forms a key part of the Improving Access to Psychological Therapy (IAPT) programme in the UK. Despite evidence of clinical effectiveness, patient engagement is often not maintained and psychological wellbeing practitioners (PWPs) report lacking confidence and training to deliver treatment by telephone. This study aimed to explore the perspectives of professional decision makers (both local and national) on the barriers and facilitators to the implementation of telephone treatment in IAPT.

Methods

Sixteen semi-structured qualitative telephone interviews and one focus group were carried out with decision makers (n = 21) who were involved locally and nationally in policy, practice and research. The interviews and focus group were coded thematically, and then mapped onto the four core constructs of Normalisation Process Theory (NPT).

Results

The use of telephone for psychological treatment was universally recognised amongst participants as beneficial for improving patient choice and access to treatment. However, at service level, motives for the implementation of telephone treatments are often misaligned with national objectives. Pressure to meet performance targets has become a key driver for the use of telephone treatment, with promises of increased efficiency and cost savings. These service-focussed objectives challenge the integration of telephone treatments, and PWP acceptance of telephone treatments as non-inferior to face-to-face. Ambivalence among a workforce often lacking the confidence to deliver telephone treatments leads to reluctance among PWPs to ‘sell’ treatments to a patient population who are not generally expecting treatment in this form.

Conclusions

Perceptions of a need to ‘sell’ telephone treatment in IAPT persist from top-level decision makers down to frontline practitioners, despite their conflicting motives for the use of telephone. The need for advocacy to highlight the clinical benefit of telephone treatment, along with adequate workforce support and guidance on best practice for implementation is critical to the ongoing success and sustainability of telephone treatment in primary care mental health programmes.
Establishing a hospital transfusion management system promotes appropriate clinical use of human albumin in Japan: a nationwide retrospective study
Authors: Yano Yoshiteru , Sakata Nobuo , Fushimi Kiyohide
Published: December 2019

Background

Despite international recommendations to establish hospital transfusion management systems to promote appropriate use of blood products, the general efficacy of establishing such systems has not been proven. This study aimed to validate the effect of establishing such systems for promoting the appropriate use of human albumin.

Methods

In this retrospective observational study, we used a Japanese Diagnosis Procedure Combination (DPC) database from fiscal year 2012 to 2016, which included inpatient records from approximately 1200 hospitals for payment processes in the national medical insurance system. From this existing database, containing approximately 8 million inpatient records per year, we selected patients with emergency due to “bleeding,” “sepsis,” and “burn injury,” by using the International Classification of Diseases and Injuries 10th revision (ICD-10) codes, and hospitals that had one or more patients for each disease group in each fiscal year. We conducted multivariable logistic regression analysis to estimate the relationship between human albumin administration and the state of the hospital transfusion management system. We evaluated temporal trends of mortality rate and length of stay as an indicator of care quality.

Results

Overall, 139,853 eligible patients admitted to 682 hospitals were selected. The results of the multivariable logistic regression analysis show that patients who were admitted to hospitals with an established hospital transfusion department introducing good practice criteria of blood products were less likely to be administered human albumin compared with those who were admitted to hospitals not introducing it, by approximately 30% for each of the three disease groups; adjusted odds ratios (95% confidential intervals) were 0.70 (0.59–0.83), 0.75 (0.69–0.81), and 0.71 (0.58–0.87) in the “bleeding,” “sepsis,” and “burn injury” groups, respectively. The temporal trends evaluation shows that there were no increasing trends of mortality rate and average length of stay against decreasing trends of human albumin administration in any disease groups.

Conclusions

Establishing a hospital transfusion department responsible for promoting appropriate clinical use of blood products could reduce human albumin administration for critically ill patients without loss of care quality. These findings provide support for policy makers and hospital managers to consider establishing such systems.