bluuebunny/crossref_metadata_2025 huggingface dataset:
Antioxidant and Anti-Inflammatory Effects of Diallyl Disulfide on Hepatotoxicity Induced by Cyclophosphamide in Rats
Authors: Hasan Hesham Farouk , Abdel-Hamid Gehan Roushdy , Ebrahim Sahar Ismail
Published: October 2020

Diallyl disulfide (DADS) is a garlic-derived organo-sulfur compound. This study was carried out to investigate the protective potential, antioxidant, and anti-inflammatory effects of this compound against cyclophosphamide (CP)-induced hepatotoxicity in rats. A single intraperitoneal dose of CP (200 mg/kg) resulted in a significant disturbance in hepatic function and oxidative stress, as well as inflammatory biomarkers. In addition, histopathological examination showed distinct changes and increased expression of proliferating cell nuclear antigen in hepatocytes. On the other hand, daily oral preadministration of DADS (200 mg/kg) for 10 days before the CP dose effectively attenuated the hepatotoxicity caused by CP administration as confirmed by significant amelioration of the aforementioned parameters in rat’s liver. It could be concluded that administration of DADS can diminish CP-induced hepatotoxicity through concurrent upregulation of antioxidant and anti-inflammatory responses that denote its possible potential clinical application against side effects of the CP drug.
A Politics of Witnessing: Definitional Ceremony as Social Justice Work in Academia
Authors: Strauven Sarah
Published: October 2020

The work outlined in this article has in part evolved as a response to Mr. Behrouz Boochani’s call to academics to engage with his work. First, I propose academics consider a form of public engagement drawn from narrative practice as social justice work in academia. In the next section, I illustrate my argument with an Australian case by discussing (a) a peaceful resistance undertaken by the refugees on Manus Island through the lens of definitional ceremony, (b) a public witnessing response by Dr. Surma to the written account of Mr. Boochani of the resistance, and (c) his reply to this act of witnessing. I complement this with my own response to both scholars on account of witnessing their exchanges. In the final section of this article, I articulate in more detail how this proposition of conceiving social justice work in academia is based on a politics of witnessing and acknowledgment. I argue that its epistemological and ontological dimensions hold promise for post-qualitative inquiry and that narrative practices more generally, can assist us in performing relationally situated research.
Children’s cancer narratives on YouTube: Agency and entrepreneurship in Brazilian CarecaTV
Authors: Marôpo Lidia , de Carvalho Raiana , Jorge Ana
Published: October 2020

This article looks at the social and cultural contexts of children’s experiences of illness, through a particular focus on the context of the Global South and the role of the social media platform YouTube in children’s culture. It takes a socio-constructivist approach to discuss the case of CarecaTV (BaldTV), a Brazilian YouTube channel with more than one million followers created by Lorena Reginato at the age of 12 when she was recovering from brain cancer. In CarecaTV, cancer subjectivity co-exists with and is expressed through digital commercialization. On the one hand, through this process, Lorena Reginato gains agency as she offers an inspirational and credible first-person testimony about cancer during childhood and becomes an emerging cancer activist. On the other, she uses entrepreneurship strategies associated with the digital influencer model of YouTube to promote herself as a (cancer) micro-celebrity, taking the lead in a youthful and playful culture.
Restoration of Endodontic Ally-Treated Posterior Teeth
Authors: Shelley Andrew
Published: October 2020

A case study provides opportunity to discuss treatment planning and the selection of materials and techniques to provide a replacement restoration of an endodontically-treated molar tooth. The discussion highlights treatment options along with the strengths and weaknesses of the alternative approaches to achieving a successful clinical outcome
Clinical Examination and Recordkeeping: Electronic Records
Authors: Hadden Andy
Published: October 2020

This article is an excerpt from Chapter 8 of FGDP(UK)'s 2016 guidelines on Clinical Examination and Record-Keeping. It covers recommendations which apply specifically to electronic records which are intended to be applied in the context of guidelines for all record types irrespective of format.
Salbutamol-induced severe lactic acidosis in acute asthma
Authors: Najout Hamza , Moutawakil Mohamed , Elkoundi Abdelghafour , Doghmi Nawfal , Bekkali Hicham
Published: October 2020

Selective beta-adrenoceptor agonists are worldwide prescribed to manage bronchial obstruction. However, they expose to a potential risk of hyperlactatemia and lactic acidosis even with normal doses. The mechanism still poorly understood and suggested that salbutamol diverts the metabolism of pyruvate acid from Krebs cycle toward lactate formation. We report the case of a 42-year-old patient, admitted to intensive care unit for acute severe asthma. He presented a transient lactic acidosis over the first 48 h, following an excessive use of salbutamol. The metabolic acidosis caused tachypnea, as a compensatory mechanism, leading to respiratory failure. The diagnosis of salbutamol-induced lactic acidosis must be made by elimination and only accepted after deleting the other causes. The main clinical character is the worsening of dyspnea despite regression of bronchospasm. It is transient and usually normalizes within 24–48 h after stopping or decreasing doses of salbutamol.
No longer aspirational: A case study of young creative workers in Hong Kong who quit
Authors: Wong Yvette Lok Yee , Chow Yiu Fai
Published: October 2020

While many young creative workers are braving precaritization presumably with the drive of aspiration, this article focuses on the other end of their career path: disillusionment. Informed by the experiences of five self-proclaimed wenyi qingnian – loosely translated as cultural youth – in Hong Kong, this article tracks their aspirations which kept them hoping and going till they were disillusioned and decided to quit. Drawing together two lines of research – on precarity and on failure – our study fills in a gap of the scholarship on creative work and workers that is dominated by concerns with precarity and related abuses. We attend not only to the abuse, exploitation and precarity of creative work, but to a more open understanding of how and why young creative practitioners leave. We do so with an unusual deployment of longitudinal inquiry that does not only concern itself with struggles of creative workers but also with the termination of such struggles. We observe four dimensions of failure: their increasingly precarious way of life; their disillusionment with creativity; the urgency posed by their ‘ageing’; and the specific local political situation. As transpired, only one factor is immediately related to precarity. This article argues to include ‘failure’ as a significant phase of creative work, that warrants further investigation and may open up more understanding on precarity, or in general, creative work and workers. While precarity is dominantly defined in economic and market-related terms – with good reasons – we see the need to loosen it up to acknowledge more aspects of precarity and experiences of creative work. This article is part of the Special Issue Creative Labour in East Asia.
Gait Training Using a Wearable Robotic Device for Non-Traumatic Spinal Cord Injury: A Case Report
Authors: Yoshikawa Kenichi , Mutsuzaki Hirotaka , Koseki Kazunori , Endo Yusuke , Hashizume Yuko , Nakazawa Ryo , Aoyama Toshiyuki , Yozu Arito , Kohno Yutaka
Published: October 2020

Introduction:

We aimed to report the clinical evaluation results of gait training with the Honda Walking Assist Device® (HWAT) in a patient with spinal cord injury (SCI).

Patients and Methods:

A 63-year-old male with SCI (grade D on the American Spinal Injury Association Impairment Scale) underwent 20 HWAT sessions over 4 weeks. The self-selected walking speed (SWS), mean step length, cadence, 6-minute walking test (6MWT), Walking Index for SCI score, SCI Functional Ambulation Inventory gait score, American Spinal Injury Association Impairment Scale grade, neurological level, upper and lower extremity motor scores, modified Ashworth Scale, Penn Spasm Frequency Scale, and Spinal Cord Independence Measure version III were measured on admission, at the start of HWAT, at 2 and 4 weeks post-HWAT, and at discharge. Three-dimensional kinematic gait analysis and electromyographic assessments were performed before and after HWAT.

Results:

The patient safely completed 20 HWAT sessions. We found improvements above the clinically meaningful difference in SWS and 6MWT as well as increased hip extension, ankle plantar- and dorsi-flexion range of motion and increased hip extensor, abductor, adductor, and ankle plantar flexor muscle activity.

Discussion:

The SWS improved more markedly during the HWAT intervention, exceeding the minimal clinically important difference (0.10 to 0.15 m/s) in walking speed for people with SCI until discharge. Moreover, the 6MWT results at 2 weeks after the start of HWAT exceeded the cutoff value (472.5 m) for community ambulation and remained at a similar value at discharge.

Conclusion:

The walking distance (6MWT) and the walking speed (SWS) both demonstrated clinically important improvements following 20 treatment sessions which included HWAT.
What Comprises Well-being at Workplace? A Qualitative Inquiry Among Service Sector Employees in India
Authors: Jaiswal Akanksha , C. Joe Arun, S J
Published: October 2020

The notion of well-being has been evolving as research continues to unfurl its multidimensional nature. The importance of well-being in the organizational context is becoming a valuable line of inquiry, and employee well-being has emerged as a pivotal focus in positive psychology. Despite this, employees report high levels of disengagement and stress at work. Thus, we conducted 15 in-depth interviews with middle- and senior-level managers in the service sector in India to understand the factors that impact an employee’s well-being.

Research question: What comprises an individual’s well-being at the workplace?

Theory: Conservation-of-resources theory, broaden-and-build theory.

Type of the case: Applied problem-solving.

Basis of the Case: Phenomenon.

Protagonist: Not needed.

Findings: Data was analysed using grounded theory. We synthesized the factors contributing to employee well-being into the following themes: encouraging organizational culture, providing social support, demonstrating positive leadership, integrating work and life, finding meaning in work, providing autonomy and ensuring good working conditions.

Discussion: Study findings extend the conservation-of-resources and broaden-and-build theories by emphasizing on gain spirals; that is, individuals use a positive effect to conserve, replenish, broaden, and build their inner resources and well-being. While leaders in an organization invest in enhancing employees’ well-being, they need to be cognizant of the several factors at interplay. An overall positive environment, autonomy, safety and meaningfulness contribute holistically towards the well-being of employees.
A Multidisciplinary Hand Clinic Using Physiatrists for the Evaluation of Non-Operative Pathologies
Authors: Mardinger Cynthia , Steve Anna K. , Yeung Justin K.
Published: October 2020

Purpose:

The purpose of this study was to describe the impact of using a multidisciplinary hand clinic on (1) hand clinic waitlists for urgent operative pathologies and (2) the volume of urgent operative referrals seen by plastic surgery.

Methods:

A retrospective data analysis of all new referrals to the Peter Lougheed Centre hand clinic in Calgary, Alberta, was performed. Data were collected from 6 months before and after the introduction of the multidisciplinary model (ie, between January 2017 and January 2018). Demographics for all new referrals were collected from the clinic database, including wait times, triage type, and volume of referrals triaged to each discipline.

Results:

Prior to using a multidisciplinary model, 81% (n = 591) of new patient referrals were triaged directly to plastic surgery, 4% (n = 28) to physiotherapy, and 6% (n = 43) to minor surgery (N = 728). However, following the addition of physiatry to the clinic, 62% (n = 451) of new patient referrals were triaged directly to plastic surgery, 24% (n = 173) to physiatry, 2% (n = 17) to physiotherapy, and 4% (n = 31) to minor surgery (N = 730). Overall, the number of urgent operative referrals triaged to plastic surgery proportionally increased by 7%, from 67% to 74%. Mean wait times for urgent referrals to plastic surgery decreased by 1.7 ± 1.0 months ( P = .09).

Conclusion:

Applying a multidisciplinary model to a hand clinic can allow non-operative cases to be triaged directly to physiotherapy and physiatry, allowing plastic surgeons to manage a higher volume of urgent and operative referrals. Implementing a multidisciplinary hand clinic can, therefore, decrease waitlist volumes and shorten the time to assessment by a plastic surgeon.

Type of Study:

Level II Prognostic Study.
Epidemiology of Hip Injuries in Professional Rodeo: A 4-Year Analysis
Authors: Sinclair Elder Amanda J. , Tincknell Rachel
Published: October 2020

Background:

Professional rodeo is a sport with a high risk of injuries for which research is needed to support interventions. To date, there have been no epidemiological studies performed specifically on hip conditions sustained during rodeo.

Purpose:

To describe the epidemiology of hip conditions in professional rodeo.

Study Design:

Case series; Level of evidence, 4.

Methods:

Deidentified hip injury data from electronic medical records of the Justin Sportsmedicine Team from 2011 to 2014 were analyzed for risk, frequency, type, location, and mechanism, as well as activity phase, of hip injuries.

Results:

A total of 84 hip injuries among 82 adult male and female athletes were reported, resulting in an overall hip injury density of 0.41 injuries per 1000 competitor-exposures (95% CI, 0.0003-0.0005) and a risk probability of 0.04%. Rough stock athletes sustained 83.3% of hip injuries, with bull riders sustaining 50.0% of the injuries. Contusions (45.2%), impingement (15.5%), and hip strains (13.1%) were the most common injuries. Athletes were most likely to be injured during the dismount (36.1%), and 36.9% of injuries were due to contact with the ground.

Conclusion:

Rough stock athletes have the greatest risk for hip injury in professional rodeo, with bull riders sustaining the most hip injuries. Athletes are most likely to be injured during the dismount. Common hip injuries in professional rodeo are contusions, impingement, and strains. The majority of contusions result from collision with the ground. Applicable measures to prevent or reduce the severity of injuries to the hip, such as protective padding, proprioceptive training, and eccentric strength training, should be implemented.
Osteochondral Allograft Transplant of the Patella Using Femoral Condylar Allografts: Magnetic Resonance Imaging and Clinical Outcomes at Minimum 2-Year Follow-up
Authors: Lin Kenneth M. , Wang Dean , Burge Alissa J. , Warner Tyler , Jones Kristofer J. , Williams Riley J.
Published: October 2020

Background:

Fresh osteochondral allograft transplant (OCA) has good outcomes in the knee. However, donor tissue for patellar OCA is limited. Outcomes after nonorthotopic OCA of the patella using more readily available femoral condylar allograft (FCA) tissue have not been previously reported.

Purpose:

To assess short-term magnetic resonance imaging (MRI) and minimum 2-year clinical outcomes of nonorthotopic patellar OCA using an FCA donor.

Study Design:

Case series; Level of evidence, 4.

Methods:

A prospective institutional cartilage registry was reviewed to identify patients treated with patellar OCA using an FCA donor between August 2009 and June 2016. OCA plugs were obtained from the FCA at its trochlear-condylar junction and implanted into the recipient patellar lesion. Early postoperative MRI scans were graded by a blinded musculoskeletal radiologist using the Osteochondral Allograft MRI Scoring System (OCAMRISS). International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), Knee Outcomes Survey–Activities of Daily Living (KOS-ADL), and pain visual analog scale (VAS) scores were collected preoperatively and at minimum 2 years postoperatively, and outcomes were compared using the paired t test.

Results:

A total of 25 patients were included for clinical outcome analysis and 20 patients for MRI analysis. MRI scans obtained at a mean of 11.4 months (range, 6-22 months) postoperatively showed a mean total OCAMRISS score of 9.0 (range, 7-11); mean bone, cartilage, and ancillary subscores were 2.6, 3.7, and 2.6, respectively. At the latest follow-up (mean, 46.5 months; range, 24-85 months), postoperative improvements were noted in IKDC (from 45.0 to 66.2; P = .0002), KOS-ADL (from 64.3 to 80.4; P = .0012), and VAS (from 5.1 to 3.4; P = .001) scores, with IKDC and KOS-ADL scores above the corresponding previously reported minimal clinically important difference.

Conclusion:

In this study, patellar OCA using nonorthotopic FCA led to significant short-term improvements in pain and patient-reported outcomes. The majority of nonorthotopic patellar grafts demonstrated full osseous incorporation and good restoration of the articular surface on MRI at short-term follow-up.
Why Me?: A Qualitative Study on the Experiences of Young Stroke Survivors in the Accra Metropolis of Ghana, West Africa
Authors: Opoku Sussana , Eliason Cecilia , Akpalu Albert
Published: October 2020

Young stroke survivors are affected gravely when diagnosed with stroke between the ages of 18 to 45 years. The psychological and social effects of young stroke require stringent coping factors geared toward recovery and regeneration of self. A qualitative exploratory design was used to explore coping experiences and purposive sampling technique was employed to recruit 10 participants. Data were collected using tape recorded interviews which lasted between 45 minutes to 1 hour 30 minutes and guided by a semistructured interview guide which was informed by the research objectives and literature review. Thematic content analysis was used to analyze the transcribed data and 6 themes namely: psychological disruption, disruption to social identity, spiritual practices and beliefs, self-determination, support, and herbal medicine were derived. These themes gave insight into how these young stroke victims experienced and coped with physical signs and symptoms which negatively impacted their activities of daily living and resulted in social isolation, fear, anxiety, depression, guilt, and suicidal ideations. Provision of continuity of care for young adults living with stroke is highly recommended.
Positive and negative work reflection, engagement and exhaustion in dual-earner couples: Exploring living with children and work-linkage as moderators
Authors: Walter Johanna , Haun Verena C
Published: October 2020

Many employees think about their work during off-job time. Scholars have suggested that whether work-related thoughts during off-job time have detrimental or beneficial effects on employees’ well-being and performance depends on the nature of these thoughts. In this study with dual-earner couples we examined whether employees’ positive and negative work reflection during off-job time are associated with their own and with their partners’ work engagement and exhaustion. Furthermore, we investigated whether (a) living with children and (b) being work-linked (i.e. working in the same organisation and/or working in the same profession) moderated these relations. Both partners of 130 German heterosexual dual-earner couples responded to online questionnaires. We estimated multilevel analyses using the actor–partner interdependence model to analyse our dyadic data. We found positive associations between employees’ positive work reflection and both their own and their partners’ work engagement. Employees’ positive work reflection was also associated with their decreased exhaustion. Employees’ negative work reflection was negatively associated with their own work engagement and positively associated with their own exhaustion but unrelated to their partners’ outcomes. Moderator analyses revealed that living with children weakened the link between employees’ positive work reflection and their own work engagement and strengthened the link between their negative work reflection and exhaustion. The presence of couples’ work-linkage did not moderate any of these relations. This study builds on previous research by showing that employees’ positive work-related thinking is not only beneficial to themselves but also to their partners. Furthermore, the results suggest that living with children constitutes an additional demand that reduces the motivational effects of positive work reflection and amplifies the detrimental effects of employees’ negative work reflection.
Personalmanagement in Italien
Authors: Hinterhuber Hans H. , Stumpf Monika , Kneisl Patricia
Published: October 2020

Im vorliegenden Beitrag wird nach einer Einordnung des Personalmanagements in den spezifischen gesellschaftlichen Kontext zunächst die Entwicklung von Forschung und Lehre skizziert. Danach werden vier Schwerpunkte der italienischen Führungslehre herausgearbeitet. Im vierten Teil werden die neueren Entwicklungen im Personalmanagement anhand von vier Praxisbeispielen (Fiat, Procter & Gamble, Pirelli und Benetton) erläutert. In der abschließenden Einschätzung äußern die Autoren die Ansicht, daß trotz oder gerade wegen der ungünstigen politischen Rahmenbedingungen die “lernende Organisation” in Italien aufgrund vorhandener Kreativität, Phantasie und Flexilibität gute Verwirklichungschancen hat.
Arbeitsengagement aus freien Stücken - psychologische Aspekte eines sensiblen Phänomens
Authors: Müller Günter F. , Bierhoff Hans Werner
Published: October 2020

Die Bedeutung freiwilligen Arbeitsengagements in Organisationen wird begründet. Äußerungsformen und psychisch relevante Faktoren eines entsprechenden Verhaltens werden beschrieben. Es wird ein Modell freiwilligen Arbeitsenagagements skizziert und dargestellt, welche Effekte empirisch gesichert sind. Eine Diskussion von Ansatzpunkten für personalpsychologische Maßnahmen schließt sich an. Durch Besonderheiten der Kernvariablen positive Stimmung bedingt wird für Kontextkontrolle und indirekte Einflußnahme plädiert.
Persönlichkeitsmerkmale in Stellenanzeigen für qualifizierte Fach- und Führungskräfte. Eine Überprüfung ihrer Verwendung sowie der Selektions- und Akquisitions effektivität
Authors: Klinkenberg Ulrich
Published: October 2020

Obwohl wissenschaftlich obsolet, erfreut sich der Eigenschaftsansatz der Führung in der Unternehmungspraxis einer großen Popularität. Ein Indiz hierfür ist die weite Verbreitung stereotyper Persönlichkeitsmerkmale in Stellenanzeigen für Führungs(nachwuchs)kräfte. Hauptbestandteil des vorliegenden Beitrags ist die Darstellung und Interpretation einer vom Verfasser durchgeführten empirischen Studie. Neben einer Auswertung von rd. 1.700 Stellenanzeigen, durch die die hohe Verbreitung von Persönlichkeitsmerkmalen sowie der eher geringe stellen- und unternehmungsspezifische Differenzierungsgrad bei der Merkmalsverwendung nachgewiesen werden soll, beinhaltet die Studie eine strukturierte Befragung von 44 Zielpersonen zur Überprüfung der Akquisitions- und Vorauswahlwirkung solcher Merkmale.
Tumor and microenvironment response but no cytotoxic T-cell activation in classic Hodgkin lymphoma treated with anti-PD1
Authors: Reinke Sarah , Bröckelmann Paul J. , Iaccarino Ingram , Garcia-Marquez Maria , Borchmann Sven , Jochims Franziska , Kotrova Michaela , Pal Karol , Brüggemann Monika , Hartmann Elena , Sasse Stephanie , Kobe Carsten , Mathas Stephan , Soekler Martin , Keller Ulrich , Bormann Matthias , Zimmermann Andreas , Richter Julia , Fuchs Michael , von Tresckow Bastian , Borchmann Peter , Schlößer Hans , von Bergwelt-Baildon Michael , Rosenwald Andreas , Engert Andreas , Klapper Wolfram
Published: October 2020

Classic Hodgkin lymphoma (cHL) is the cancer type most susceptible to antibodies targeting programmed cell death protein 1 (PD1) and is characterized by scarce Hodgkin and Reed-Sternberg cells (HRSCs), perpetuating a unique tumor microenvironment (TME). Although anti-PD1 effects appear to be largely mediated by cytotoxic CD8+ T cells in solid tumors, HRSCs frequently lack major histocompatibility complex expression, and the mechanism of anti-PD1 efficacy in cHL is unclear. Rapid clinical responses and high interim complete response rates to anti-PD1 based first-line treatment were recently reported for patients with early-stage unfavorable cHL treated in the German Hodgkin Study Group phase 2 NIVAHL trial. To investigate the mechanisms underlying this very early response to anti-PD1 treatment, we analyzed paired biopsies and blood samples obtained from NIVAHL patients before and during the first days of nivolumab first-line cHL therapy. Mirroring the rapid clinical response, HRSCs had disappeared from the tissue within days after the first nivolumab application. The TME already shows a reduction in type 1 regulatory T cells and PD-L1+ tumor-associated macrophages at this early time point of treatment. Interestingly, a cytotoxic immune response and a clonal T-cell expansion were not observed in the tumors or peripheral blood. These early changes in the TME were distinct from alterations found in a separate set of cHL biopsies at relapse during anti-PD1 therapy. We identify a unique very early histologic response pattern to anti-PD1 therapy in cHL that is suggestive of withdrawal of prosurvival factors, rather than induction of an adaptive antitumor immune response, as the main mechanism of action.
Multi-tissue transcriptome analysis using hybrid-sequencing reveals potential genes and biological pathways associated with azadirachtin A biosynthesis in neem (azadirachta indica)
Authors: Wang Huiyan , Wang Ning , Huo Yixin
Published: October 2020

Background

Azadirachtin A is a triterpenoid from neem tree exhibiting excellent activities against over 600 insect species in agriculture. The production of azadirachtin A depends on extraction from neem tissues, which is not an eco-friendly and sustainable process. The low yield and discontinuous supply of azadirachtin A impedes further applications. The biosynthetic pathway of azadirachtin A is still unknown and is the focus of our study.

Results

We attempted to explore azadirachtin A biosynthetic pathway and identified the key genes involved by analyzing transcriptome data from five neem tissues through the hybrid-sequencing (Illumina HiSeq and Pacific Biosciences Single Molecule Real-Time (SMRT)) approach. Candidates were first screened by comparing the expression levels between the five tissues. After phylogenetic analysis, domain prediction, and molecular docking studies, 22 candidates encoding 2,3-oxidosqualene cyclase (OSC), alcohol dehydrogenase, cytochrome P450 (CYP450), acyltransferase, and esterase were proposed to be potential genes involved in azadirachtin A biosynthesis. Among them, two unigenes encoding homologs of MaOSC1 and MaCYP71CD2 were identified. A unigene encoding the complete homolog of MaCYP71BQ5 was reported. Accuracy of the assembly was verified by quantitative real-time PCR (qRT-PCR) and full-length PCR cloning.

Conclusions

By integrating and analyzing transcriptome data from hybrid-seq technology, 22 differentially expressed genes (DEGs) were finally selected as candidates involved in azadirachtin A pathway. The obtained reliable and accurate sequencing data provided important novel information for understanding neem genome. Our data shed new light on understanding the biosynthesis of other triterpenoids in neem trees and provides a reference for exploring other valuable natural product biosynthesis in plants.
Phenotypic and proteomic approaches of the response to iron-limited condition in Staphylococcus lugdunensis
Authors: Aubourg Marion , Dhalluin Anne , Gravey François , Pottier Marine , Thomy Nicolas , Bernay Benoit , Goux Didier , Martineau Matthieu , Giard Jean-Christophe
Published: October 2020

Background

Staphylococcus lugdunensis is a coagulase-negative Staphylococcus part of the commensal skin flora but emerge as an important opportunistic pathogen. Because iron limitation is a crucial stress during infectious process, we performed phenotypic study and compared proteomic profiles of this species incubated in absence and in presence of the iron chelator 2,2′-dipyridyl (DIP).

Results

No modification of cell morphology nor cell wall thickness were observed in presence of DIP. However iron-limitation condition promoted biofilm formation and reduced the ability to cope with oxidative stress (1 mM H2O2). In addition, S. lugdunensis N920143 cultured with DIP was significantly less virulent in the larvae of Galleria mellonella model of infection than that grown under standard conditions. We verified that these phenotypes were due to an iron limitation by complementation experiments with FeSO4. By mass spectrometry after trypsin digestion, we characterized the first iron-limitation stress proteome in S. lugdunensis. Among 1426 proteins identified, 349 polypeptides were differentially expressed. 222 were more and 127 less abundant in S. lugdunensis incubated in iron-limitation condition, and by RT-qPCR, some of the corresponding genes have been shown to be transcriptionally regulated. Our data revealed that proteins involved in iron metabolism and carriers were over-expressed, as well as several ABC transporters and polypeptides linked to cell wall metabolism. Conversely, enzymes playing a role in the oxidative stress response (especially catalase) were repressed.

Conclusions

This phenotypic and global proteomic study allowed characterization of the response of S. lugdunensis to iron-limitation. We showed that iron-limitation promoted biofilm formation, but decrease the oxidative stress resistance that may, at least in part, explained the reduced virulence of S. lugdunensis observed under low iron condition.
Differential leukocyte counts and cardiovascular mortality in very old patients with acute myocardial infarction: a Chinese cohort study
Authors: Yan Xiao-Ni , Jin Jing-Lu , Zhang Meng , Hong Li-Feng , Guo Yuan-Lin , Wu Na-Qiong , Zhu Cheng-Gang , Dong Qian , Li Jian-Jun
Published: October 2020

Background

Total leukocyte and differential Leukocyte counts are prognostic indictors in patients with coronary artery disease (CAD). However, there is no data available regarding their prognostic utility in very old patients with acute myocardial infarction (AMI). The aim of this study is to investigate the potential role of different leukocyte parameters in predicting the mortality among very old patients with AMI.

Methods

A total of 523 patients aged over 80 years with AMI were consecutively enrolled into this study. Leukocyte and its subtypes were obtained at admission in each patient. The primary study endpoint was cardiovascular mortality. Patients were followed up for an average of 2.2 years and 153 patients died. The associations of leukocyte parameters with mortality were assessed using Cox regression analyses. The concordance index was calculated to test the model efficiency.

Results

In multivariable regression analysis, neutrophils-plus-monocytes-to-lymphocytes ratio (NMLR) and neutrophils-to-lymphocytes ratio (NLR) were two most significant predictors of mortality among all the leukocyte parameters (HR = 3.21, 95% CI 1.75–5.35; HR = 2.79, 95% CI 1.59–4.88, respectively, all p < 0.001, adjusted for age, male gender, body mass index, family history of CAD, smoking, hypertension, diabetes mellitus, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, high sensitivity C-reactive protein, creatinine, left ventricular ejection fraction, troponin I, use of statin, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and percutaneous coronary intervention). Furthermore, adding NMLR and NLR into the Cox model increased the C-statistic by 0.038 and 0.037 respectively, which were more significant than that of other leukocyte parameters. Besides, addition of NMLR and NLR to the Canada Acute Coronary Syndrome Risk Score model also increased the C-statistic by 0.079 and 0.077 respectively.

Conclusion

Our data firstly indicated that most leukocyte subtypes were independent markers for the mortality in very old patients with AMI, while NMLR and NLR appeared to be more effective.
Predictive ability of EuroSCORE II integrating cardiactroponin T in patients undergoing OPCABG
Authors: Li Xiang , Shan Lingtong , Lv Mengwei , Li Zhi , Han Chunyan , Liu Ban , Ge Wen , Zhang Yangyang
Published: October 2020

Background

Preoperative risk evaluation systems are significant and important to the allocation of medical resources and the communication between doctors and patients. The European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) is widely used in clinical practice. Cardiac troponin T (cTnT) can specifically and accurately reflect myocardial injury. Whether EuroSCORE II can improve the predictive power after integrating with cTnT is still unclear. This study was a retrospective single center study designed to assess the predictive ability of EuroSCORE II integrated with cTnT for patients undergoing isolated off-pump coronary artery bypass grafting (OPCABG).

Methods

This retrospective and observational cohort study included 1887 patients who underwent first isolated OPCABG. cTnT was detected within 48 h before operation in each patient. According to myocardial injury, patients were divided by cTnT into 4 stages. A new risk evaluation system was created through logistic regression with EuroSCORE II and myocardial injury classification as covariates. Then the two risk evaluation systems were comparatively assessed by regression analysis, receiver operator characteristic curves, net reclassification index, Bland–Altman plots and decision curve analysis.

Results

There were 43 in-hospital deaths, with a mortality of 2.30% (43/1887). The logistic regression analysis showed that preoperative myocardial injury classification was a significant risk factor for in-hospital mortality in both total cohort (OR 1.491, 95%CI 1.049–2.119) and subsets (OR 1.761, 95%CI 1.102–2.814). The new risk evaluation system has higher calibration and discrimination power than EuroSCORE II, both for overall cohort and subsets. Especially, the new system has obvious advantages in discrimination power in the subset of acute myocardial infarction (AUC 0.813 vs. 0.772, 0.906 vs. 0.841, and 0.715 vs. 0.646, respectively).

Conclusions

Both myocardial injury classification and EuroSCORE II are independent risk factors of in-hospital mortality in OPCABG patients. The new risk evaluation system has higher predictive ability than EuroSCORE II, especially in patients with a recent history of AMI.
Multipolar mapping for catheter ablation of premature ventricular complexes originating from papillary muscles in the structurally normal heart: a case series
Authors: Cai Chi , Wang Jing , Niu Hongxia , Hua Wei , Chu Jianmin , Zhang Shu
Published: October 2020

Background

Previous studies on radiofrequency catheter ablation of premature ventricular complexes (PVCs) arising from the left ventricle (LV) papillary muscles (PM) show a modest procedural success rate with higher recurrence rate. Our study sought to explore the utility of using a multipolar mapping with a steerable linear duodecapolar catheter for ablating the PM PVCs.

Methods

Detailed endocardial multipolar mapping was performed using a steerable linear duodecapolar catheter in 6 consecutive PM PVCs patients with structurally normal heart. The clinical features and procedural data as well as success rate were analysed.

Results

LV endocardial electroanatomic mapping was performed in all patients via a retrograde aortic approach using a duodecapolar mapping catheter. All patients displayed a PVC burden with 16.2 ± 5.4%. Duodecapolar catheter mapping demonstrated highly efficiency with an average procedure time (95.8 ± 7.4 min) and fluoroscopy time (14.2 ± 1.5 min). The mean number of ablation applications points was 6.8 ± 1.9 with an average overall ablation duration of 6.1 ± 3.0 min. The values of earliest activation time during mapping using duodecapolar catheter were 37.8 ± 7.2 ms. All patients demonstrated acute successful ablation, and the PVC burden in all patients after an average follow-up of 8.5 ± 2.0 months was only 0.7%. There were no complications during the procedures and after follow-up.

Conclusions

Mapping and ablation of PM PVCs using a duodecapolar catheter facilitated the identification of earliest activation potentials and pace mapping, and demonstrated a high success rate during follow-up.
Accuracy of reporting of Aboriginality on administrative health data collections using linked data in NSW, Australia
Authors: Nelson Michael A. , Lim Kim , Boyd Jason , Cordery Damien , Went Allan , Meharg David , Jackson-Pulver Lisa , Winch Scott , Taylor Lee K.
Published: October 2020

Background

Aboriginal people are under-reported on administrative health data in Australia. Various approaches have been used or proposed to improve reporting of Aboriginal people using linked records. This cross-sectional study used self-reported Aboriginality from the NSW Patient Survey Program (PSP) as a reference standard to assess the accuracy of reporting of Aboriginal people on NSW Admitted Patient (APDC) and Emergency Department Data Collections (EDDC), and compare the accuracy of selected approaches to enhance reporting Aboriginality using linked data.

Methods

Ten PSP surveys were linked to five administrative health data collections, including APDC, EDDC, perinatal, and birth and death registration records. Accuracy of reporting of Aboriginality was assessed using sensitivity, specificity, and positive and negative predictive values (PPVs and NPVs) and F score for the EDDC and APDC as baseline and four enhancement approaches using linked records: “Most recent linked record”, “Ever reported as Aboriginal”, and two approaches using a weight of evidence, “Enhanced Reporting of Aboriginality (ERA) algorithm” and “Multi-stage median (MSM)”.

Results

There was substantial under-reporting of Aboriginality on APDC and EDDC records (sensitivities 84 and 77% respectively) with PPVs of 95% on both data collections. Overall, specificities and NPVs were above 98%. Of people who were reported as Aboriginal on the PSP, 16% were not reported as Aboriginal on any of their linked records. Record linkage approaches generally increased sensitivity, accompanied by decrease in PPV with little change in overall F score for the APDC and an increase in F score for the EDDC. The “ERA algorithm” and “MSM” approaches provided the best overall accuracy.

Conclusions

Weight of evidence approaches are preferred when record linkage is used to improve reporting of Aboriginality on administrative health data collections. However, as a substantial number of Aboriginal people are not reported as Aboriginal on any of their linked records, improvements in reporting are incomplete and should be taken into account when interpreting results of any analyses. Enhancement of reporting of Aboriginality using record linkage should not replace efforts to improve recording of Aboriginal people at the point of data collection and addressing barriers to self-identification for Aboriginal people.
Deriving and validating a brief measure of treatment burden to assess person-centered healthcare quality in primary care: a multi-method study
Authors: Eton David T. , Linzer Mark , Boehm Deborah H. , Vanderboom Catherine E. , Rogers Elizabeth A. , Frost Marlene H. , Wambua Mike , Vang Miamoua , Poplau Sara , Lee Minji K. , Anderson Roger T.
Published: October 2020

Background

In primary care there is a need for more quality measures of person-centered outcomes, especially ones applicable to patients with multiple chronic conditions (MCCs). The aim of this study was to derive and validate a short-form version of the Patient Experience with Treatment and Self-management (PETS), an established measure of treatment burden, to help fill the gap in quality measurement.

Methods

Patient interviews (30) and provider surveys (30) were used to winnow items from the PETS (60 items) to a subset targeting person-centered care quality. Results were reviewed by a panel of healthcare providers and health-services researchers who finalized a pilot version. The Brief PETS was tested in surveys of 200 clinic and 200 community-dwelling MCC patients. Surveys containing the Brief PETS and additional measures (e.g., health status, medication adherence, quality of care, demographics) were administered at baseline and follow-up. Correlations and t-tests were used to assess validity, including responsiveness to change of the Brief PETS. Effect sizes (ES) were calculated on mean differences.

Results

Winnowing and panel review resulted in a 34-item Brief PETS pilot measure that was tested in the combined sample of 400 (mean age = 57.9 years, 50% female, 48% white, median number of conditions = 5). Reliability of most scales was acceptable (alpha > 0.70). Brief PETS scores were associated with age, income, health status, and quality of chronic illness care at baseline (P < .05; rho magnitude range: 0.16–0.66). Furthermore, Brief PETS scores differentiated groups based on marital and education status, presence/absence of a self-management routine, and optimal/suboptimal medication adherence (P < .05; ES range: 0.25–1.00). Declines in patient-reported physical or mental health status over time were associated with worsening PETS burden scores, while improvements were associated with improving PETS burden scores (P < .05; ES range: 0.04–0.44). Among clinic patients, 91% were willing to complete the Brief PETS as part of their clinic visits.

Conclusions

The Brief PETS (final version: 32 items) is a reliable and valid tool for assessing person-centered care quality related to treatment burden. It holds promise as a means of giving voice to patient concerns about the complexity of disease management.
Longitudinal trajectory of disability in community-dwelling older adults: An observational cohort study in South Korea
Authors: Kim Hae Reong , Lee Heayon , Seong Yoonje , Lee Eunju , Jung Hee-Won , Park Yu Rang , Jang Il-Young
Published: October 2020

Background

Disability, which is considered a health-related condition, increases care demands and socioeconomic burdens for both families and communities. To confirm the trend of dynamic longitudinal changes in disability, this study aims to explore how disability is divided by the trajectory method, which deals with time-sequenced data. Additionally, this study examines the differences in demographics, geriatric conditions, and time spent at home among the trajectory groups in community-dwelling older adults. Home time is defined as the period during which the patient was not in a hospital or health care facility during their lifetime.

Methods

Records of 786 community-dwelling older participants were analyzed from the Aging Study of PyeongChang Rural Area, a population-based cohort study that took place over three years. Using 7 domains of activities of daily living and 10 domains of instrumental activities of daily living, participants were grouped into no dependency (0 disabled domain), mild (1 disabled domain), and severe (2 or more disabled domains) disability groups. The longitudinal trajectory group of disability was calculated as a trajectory method. Three distinct trajectory groups were calculated over time: a relatively-stable group (78.5%;n = 617), a gradually-aggravated group (16.0%;n = 126), and a rapidly-deteriorated group (5.5%;n = 43).

Results

The average age of 786 participants was 73.3 years (SD: 5.8), and the percentage of female was 52.7%. It was found that 78.5% of patients showed relatively no dependence and 5.5% of older adults in a rural area showed severe dependence. Through applying the trajectory method, it was shown that the Short Physical Performance Battery (SPPB) score was 10.2 points in the relatively-stable group and 3.1 points in the rapidly-deteriorating group by the 3rd year. Additionally, by the trajectory method, the rate of decrease in home time was 3.33% in the rapidly-deteriorated group compared to the relatively-stable group.

Conclusions

This study shows the difference in demographics and geriatric conditions (such as SPPB) through the examination of longitudinal trajectory groups of disability in community-dwelling older adults. Significant differences were also found in the amount of home time among the trajectory groups.
Comparing intervention strategies for reducing Clostridioides difficile transmission in acute healthcare settings: an agent-based modeling study
Authors: Stephenson Brittany , Lanzas Cristina , Lenhart Suzanne , Ponce Eduardo , Bintz Jason , Dubberke Erik R. , Day Judy
Published: October 2020

Background

Clostridioides difficile infection (CDI) is one of the most common healthcare infections. Common strategies aiming at controlling CDI include antibiotic stewardship, environmental decontamination, and improved hand hygiene and contact precautions. Mathematical models provide a framework to evaluate control strategies. Our objective is to evaluate the effectiveness of control strategies in decreasing C. difficile colonization and infection using an agent-based model in an acute healthcare setting.

Methods

We developed an agent-based model that simulates the transmission of C. difficile in medical wards. This model explicitly incorporates healthcare workers (HCWs) as vectors of transmission, tracks individual patient antibiotic histories, incorporates varying risk levels of antibiotics with respect to CDI susceptibility, and tracks contamination levels of ward rooms by C. difficile. Interventions include two forms of antimicrobial stewardship, increased environmental decontamination through room cleaning, improved HCW compliance, and a preliminary assessment of vaccination.

Results

Increased HCW compliance with CDI patients was ranked as the most effective intervention in decreasing colonizations, with reductions up to 56%. Antibiotic stewardship practices were highly ranked after contact precaution compliance. Vaccination and reduction of high-risk antibiotics were the most effective intervention in decreasing CDI. Vaccination reduced CDI cases to up to 90%, and the reduction of high-risk antibiotics decreased CDI cases up to 23%.

Conclusions

Overall, interventions that decrease patient susceptibility to colonization by C. difficile, such as antibiotic stewardship, were the most effective interventions in reducing both colonizations and CDI cases.