bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of Suboptimal Antiretroviral Therapy Adherence With Inflammation in Virologically Suppressed Individuals Enrolled in the SMART Study
Authors: Castillo-Mancilla Jose R , Phillips Andrew N , Neaton James D , Neuhaus Jacqueline , Collins Simon , Mannheimer Sharon , Pett Sarah , Touzeau-Römer Veronique , Polizzotto Mark N , Lundgren Jens D , Gardner Edward M ,   INSIGHT SMART Study Group
Published: August 2020

Suboptimal (ie, <100%) antiretroviral therapy (ART) adherence has been associated with heightened inflammation in cohort studies, even among people with virologic suppression. We aimed to evaluate this association among participants in the Strategies for Management of Antiretroviral Therapy (SMART) study who had virologic suppression (HIV-1 VL < 200 copies/mL) at enrollment. Based on self-reported adherence (7-day recall), plasma concentrations of interleukin 6 and D-dimer were 9% (95% confidence interval [CI], 1%–18%; P = .02) and 11% (95% CI, 1%–22%; P = .03) higher in participants who reported suboptimal vs 100% adherence, respectively. These findings confirm previous observations and support the hypothesis that suboptimal ART adherence, even in the context of virologic suppression, may have significant biological consequences.

ClinicalTrials.gov number NCT00027352
What to put on (and what to take off) a wound: treating a chronic neuropathic ulcer with an autologous homologous skin construct, offloading and common sense
Authors: Murphy Grant A , Woelfel Stephanie L , Armstrong David G
Published: August 2020

Closure of chronic lower extremity wounds is important for minimizing the risk of infection and amputation in a very high-risk population. Developments in tissue cultures and matrix therapies have shown promise in enhancing healing. The use of autologous homologous skin constructs in wound treatment may enable the regeneration of functional dermal structures. We present the case of a chronic medial heel ulcer that dehisced following intraoperative debridement, which was subsequently treated using a combination of an autologous homologous skin construct and total contact casting. This case emphasizes the importance of proper offloading for healing and preventing recurrence of lower extremity wounds.
Squamous cell carcinoma in a pregnant woman with recessive dystrophic epidermolysis bullosa
Authors: Lopes Jorge , Baptista Armando , Moreira Ana
Published: August 2020

We report the case of a pregnant woman with recessive dystrophic epidermolysis bullosa. During pregnancy, she presents with a large, rapidly growing, tumor on her right forearm, whose biopsy revealed an invasive squamous cell carcinoma. Amputation by the middle third of the forearm was performed at 21 weeks of pregnancy, without intra- or post-operative complications. The remainder of pregnancy was unremarkable and, at 36 weeks, she gave birth to a healthy baby. One month after delivery, a large lymph node conglomerate was detected in the right axilla, highly suggestive of metastatic disease and complete lymph node dissection was then performed. Despite the prompt institution of chemotherapy, the patient died a few months later due to metastatic disease.
Non-diabetic ketoacidosis associated with a low carbohydrate, high fat diet in a postpartum lactating female
Authors: Marzban Saba , Arbee Mohamed , Vorajee Naseema , Richards Guy A
Published: August 2020

A 31-year old non-diabetic woman presented to our hospital with symptoms of dehydration, drowsiness, fatigue, shortness of breath and vomiting present for two consecutive days prior to admission. She had started a low carbohydrate, high fat (LCHF) diet to induce weight loss while breastfeeding her 4-month-old child 2 weeks prior to admission. The patient was found to have a severely high anion gap metabolic acidosis. It was determined to be due to ketoacidosis, which was as a result of carbohydrate restriction in the presence of increased metabolic demands related with the synthesis and secretion of milk. She denied alcohol use or ingestion of any drugs prior to admission. The patient underwent dialysis and received insulin, 5% dextrose water alongside a well-balanced diet with adequate calories. All abnormal laboratory results normalized and follow-up visits were done. Lactating women are at risk of developing ketoacidosis due to high metabolic demands of the body to produce milk. LCHF diets may exacerbate the body’s demand to meet its milk production requirement and result in ketoacidosis. Health professionals need to be aware of the complications of LCHF diet in this population to prevent mortality associated with this condition.
Limited physiological acclimation to recurrent heatwaves in two boreal tree species
Authors: Gagne Maegan A , Smith Duncan D , McCulloh Katherine A
Published: August 2020

The intensity of extreme heat and drought events has drastically risen in recent decades and will likely continue throughout the century. Northern forests have already seen increases in tree mortality and a lack of new recruitment, which is partially attributed to these extreme events. Boreal species, such as paper birch (Betula papyrifera) and white spruce (Picea glauca), appear to be more sensitive to these changes than lower-latitude species. Our objectives were to investigate the effects of repeated heatwaves and drought on young paper birch and white spruce trees by examining (i) responses in leaf gas exchange and plant growth and (ii) thermal acclimation of photosynthetic and respiratory traits to compare ecophysiological responses of two co-occurring, yet functionally dissimilar species. To address these objectives, we subjected greenhouse-grown seedlings to two consecutive summers of three 8-day long, +10 °C heatwaves in elevated atmospheric CO2 conditions with and without water restriction. The data show that heatwave stress reduced net photosynthesis, stomatal conductance and growth—more severely so when combined with drought. Acclimation of both photosynthesis and respiration did not occur in either species. The combination of heat and drought stress had a similar total effect on both species, but each species adjusted traits differently to the combined stress. Birch experienced greater declines in gas exchange across both years and showed moderate respiratory but not photosynthetic acclimation to heatwaves. In spruce, heatwave stress reduced the increase in basal area in both experimental years and had a minor effect on photosynthetic acclimation. The data suggest these species lack the ability to physiologically adjust to extreme heat events, which may limit their future distributions, thereby altering the composition of boreal forests.
Juniperus communis populations exhibit low variability in hydraulic safety and efficiency
Authors: Unterholzner Lucrezia , Carrer Marco , Bär Andreas , Beikircher Barbara , Dämon Birgit , Losso Adriano , Prendin Angela Luisa , Mayr Stefan
Published: August 2020

The performance and distribution of woody species strongly depend on their adjustment to environmental conditions based on genotypic and phenotypic properties. Since more intense and frequent drought events are expected due to climate change, xylem hydraulic traits will play a key role under future conditions, and thus, knowledge of hydraulic variability is of key importance. In this study, we aimed to investigate the variability in hydraulic safety and efficiency of the conifer shrub Juniperus communis based on analyses along an elevational transect and a common garden approach. We studied (i) juniper plants growing between 700 and 2000 m a.s.l. Innsbruck, Austria, and (ii) plants grown in the Innsbruck botanical garden (Austria) from seeds collected at different sites across Europe (France, Austria, Ireland, Germany and Sweden). Due to contrasting environmental conditions at different elevation and provenance sites and the wide geographical study area, pronounced variation in xylem hydraulics was expected. Vulnerability to drought-induced embolisms (hydraulic safety) was assessed via the Cavitron and ultrasonic acoustic emission techniques, and the specific hydraulic conductivity (hydraulic efficiency) via flow measurements. Contrary to our hypothesis, relevant variability in hydraulic safety and efficiency was neither observed across elevations, indicating a low phenotypic variation, nor between provenances, despite expected genotypic differences. Interestingly, the provenance from the most humid and warmest site (Ireland) and the northernmost provenance (Sweden) showed the highest and the lowest embolism resistance, respectively. The hydraulic conductivity was correlated with plant height, which indicates that observed variation in hydraulic traits was mainly related to morphological differences between plants. We encourage future studies to underlie anatomical traits and the role of hydraulics for the broad ecological amplitude of J. communis.
Insect defoliation is linked to a decrease in soil ectomycorrhizal biomass and shifts in needle endophytic communities
Authors: Castaño Carles , Camarero J Julio , Zas Rafael , Sampedro Luis , Bonet José Antonio , Alday Josu G , Oliva Jonàs
Published: August 2020

Insect outbreaks of increasing frequency and severity in forests are predicted due to climate change. Insect herbivory is known to promote physiological changes in forest trees. However, little is known about whether these plant phenotypic adjustments have cascading effects on tree microbial symbionts such as fungi in roots and foliage. We studied the impact of defoliation by the pine processionary moth in two infested Pinus nigra forests through a multilevel sampling of defoliated and non-defoliated trees. We measured tree growth, nutritional status and carbon allocation to chemical defenses. Simultaneously, we analysed the putative impact of defoliation on the needle endophytes and on the soil fungal communities. Higher concentrations of chemical defenses were found in defoliated trees, likely as a response to defoliation; however, no differences in non-structural carbohydrate reserves were found. In parallel to the reductions in tree growth and changes in chemical defenses, we observed shifts in the composition of needle endophytic and soil fungal communities in defoliated trees. Defoliated trees consistently corresponded with a lower biomass of ectomycorrhizal fungi in both sites, and a higher alpha diversity and greater relative abundance of belowground saprotrophs and pathogens. However, ectomycorrhizal alpha diversity was similar between non-defoliated and defoliated trees. Specific needle endophytes in old needles were strongly associated with non-defoliated trees. The potential role of these endophytic fungi in pine resistance should be further investigated. Our study suggests that lower biomass of ectomycorrhizal fungi in defoliated trees might slow down tree recovery since fungal shifts might affect tree-mycorrhizal feedbacks and can potentially influence carbon and nitrogen cycling in forest soils.
Photosynthetic capacity of male and female Hippophae rhamnoides plants along an elevation gradient in eastern Qinghai-Tibetan Plateau, China
Authors: Wu Jiamei , Shi Zuomin , Liu Shun , Centritto Mauro , Cao Xiangwen , Zhang Miaomiao , Zhao Guangdong
Published: August 2020

Elevational variations in the growing environment and sex differences in individuals drive the diversification of photosynthetic capacity of plants. However, photosynthetic response of dioecious plants to elevation gradients and the mechanisms that cause these responses are poorly understood. We measured foliar gas exchange, chlorophyll fluorescence and nitrogen allocations of male and female Seabuckthorn (Hippophae rhamnoides L.) at the elevation of 1900–3700 m above sea level (a.s.l.) on the eastern Qinghai-Tibetan Plateau, China. Male and female plants showed increased leaf photosynthetic capacity at higher elevation generally with no sex-specific difference. Photosynthetic photon flux density-saturated photosynthesis (Asat) was limited mostly by diffusional components (77 ± 1%), whereas biochemical components contributed minor limitations (22 ± 1%). Mesophyll conductance (gm) played an essential role in Asat variation, accounting for 40 ± 2% of the total photosynthetic limitations and had a significant positive correlation with Asat. Leaf nitrogen allocations to Rubisco (PR) and bioenergetics (PB) in the photosynthetic apparatus were major drivers for variations in photosynthetic nitrogen-use efficiency. The increase of these resource uptake capacities enables H. rhamnoides to maintain a high level of carbon assimilation and function efficiently to cope with the harsh conditions and shorter growing season at higher elevation.
End-tidal to Arterial Gradients and Alveolar Deadspace for Anesthetic Agents
Authors: Peyton Philip J. , Hendrickx Jan , Grouls Rene J. E. , Van Zundert Andre , De Wolf Andre
Published: August 2020

Background

According to the “three-compartment” model of ventilation-perfusion (

JOURNAL/anet/04.03/00000542-202009000-00015/inline-graphic1/v/2024-12-04T190757Z/r/image-png

) inequality, increased

JOURNAL/anet/04.03/00000542-202009000-00015/inline-graphic2/v/2024-12-04T190757Z/r/image-png

scatter in the lung under general anesthesia is reflected in increased alveolar deadspace fraction (Vda/Va) customarily measured using end-tidal to arterial (a-a) partial pressure gradients for carbon dioxide. a-a gradients for anesthetic agents such as isoflurane are also significant but have been shown to be inconsistent with those for carbon dioxide under the three-compartment theory. The authors hypothesized that three-compartment Vda/Va calculated using partial pressures of four inhalational agents (Vda/Va

g
) is different from that calculated using carbon dioxide (Vda/Vaco
2) measurements, but similar to predictions from multicompartment models of physiologically realistic “log-normal”

JOURNAL/anet/04.03/00000542-202009000-00015/inline-graphic3/v/2024-12-04T190757Z/r/image-png

distributions.

Methods

In an observational study, inspired, end-tidal, arterial, and mixed venous partial pressures of halothane, isoflurane, sevoflurane, or desflurane were measured simultaneously with carbon dioxide in 52 cardiac surgery patients at two centers. Vda/Va was calculated from three-compartment model theory and compared for all gases. Ideal alveolar (Pag
) and end-capillary partial pressure (Pc’
g
) of each agent, theoretically identical, were also calculated from end-tidal and arterial partial pressures adjusted for deadspace and venous admixture.

Results

Calculated Vda/Va

g
was larger (mean ± SD) for halothane (0.47 ± 0.08), isoflurane (0.55 ± 0.09), sevoflurane (0.61 ± 0.10), and desflurane (0.65 ± 0.07) than Vda/Va
co
2 (0.23 ± 0.07 overall), increasing with lower blood solubility (slope [Cis], –0.096 [–0.133 to –0.059], P < 0.001). There was a significant difference between calculated ideal Pag
and Pc’
g
median [interquartile range], Pa

g
5.1 [3.7, 8.9] versus Pc’
g
4.0[2.5, 6.2], P = 0.011, for all agents combined. The slope of the relationship to solubility was predicted by the log-normal lung model, but with a lower magnitude relative to calculated Vda/Vag
.

Conclusions

Alveolar deadspace for anesthetic agents is much larger than for carbon dioxide and related to blood solubility. Unlike the three-compartment model, multicompartment

JOURNAL/anet/04.03/00000542-202009000-00015/inline-graphic4/v/2024-12-04T190757Z/r/image-png

scatter models explain this from physiologically realistic gas uptake distributions, but suggest a residual factor other than solubility, potentially diffusion limitation, contributes to deadspace.

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Mitochondrial Complex I Mutations Predispose Drosophila to Isoflurane Neurotoxicity
Authors: Olufs Zachariah P. G. , Ganetzky Barry , Wassarman David A. , Perouansky Misha
Published: August 2020

Background

General anesthetics influence mitochondrial homeostasis, placing individuals with mitochondrial disorders and possibly carriers of recessive mitochondrial mutations at increased risk of perioperative complications. In Drosophila, mutations in the ND23 subunit of complex I of the mitochondrial electron transport chain–analogous to mammalian NDUFS8–replicate key characteristics of Leigh syndrome, an inherited mitochondrial disorder. The authors used the ND23 mutant for testing the hypothesis that anesthetics have toxic potential in carriers of mitochondrial mutations.

Methods

The authors exposed wild-type flies and ND23 mutant flies to behaviorally equivalent doses of isoflurane or sevoflurane in 5%, 21%, or 75% oxygen. The authors used percent mortality (mean ± SD, n ≥ 3) at 24 h after exposure as a readout of toxicity and changes in gene expression to investigate toxicity mechanisms.

Results

Exposure of 10- to 13-day-old male ND23 flies to isoflurane in 5%, 21%, or 75% oxygen resulted in 16.0 ± 14.9% (n = 10), 48.2 ± 16.1% (n = 9), and 99.2 ± 2.0% (n = 10) mortality, respectively. Comparable mortality was observed in females. In contrast, under the same conditions, mortality was less than 5% for all male and female groups exposed to sevoflurane, except 10- to 13-day-old male ND23 flies with 9.6 ± 8.9% (n = 16) mortality. The mortality of 10- to 13-day-old ND23 flies exposed to isoflurane was rescued by neuron- or glia-specific expression of wild-type ND23. Isoflurane and sevoflurane differentially affected expression of antioxidant genes in 10- to 13-day-old ND23 flies. ND23 flies had elevated mortality from paraquat-induced oxidative stress compared with wild-type flies. The mortality of heterozygous ND23 flies exposed to isoflurane in 75% oxygen increased with age, resulting in 54.0 ± 19.6% (n = 4) mortality at 33 to 39 days old, and the percent mortality varied in different genetic backgrounds.

Conclusions

Mutations in the mitochondrial complex I subunit ND23 increase susceptibility to isoflurane-induced toxicity and to oxidative stress in Drosophila. Asymptomatic flies that carry ND23 mutations are sensitized to hyperoxic isoflurane toxicity by age and genetic background.

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Application of a Blended Assessment Strategy to Enhance Student Interest and Effectiveness in Learning
Authors: Lin Kai-Yin
Published: August 2020

In the Internet era, information security literacy is a global imperative for nursing students. This study combined an audience response system and an online system to formulate an assessment strategy based on the concept of blended learning. The participants of this study comprised two college nursing classes of an introductory computer science course in Taiwan. With information security as the teaching content, we adopted a quasi-experimental approach to conduct a 5-week teaching experiment. A blended assessment model was adopted for the experiment group, while slide presentation and verbal assessment were used for the control group. Pretests and posttests were administered for information security literacy and learning environment stimulation. The study results indicate the following: (1) the experimental group performed significantly better than the control group in information security literacy, with statistically significant differences in scores regarding information security knowledge and information security skills; (2) the experimental group also presented higher learning motivation than the control group, with statistically significant differences in scores regarding self-efficacy, achievement goals, and learning environment stimulation.
A Conceptual Model of Rural Household Food Insecurity
Authors: Piaskoski Angela , Reilly Kristen , Gilliland Jason
Published: August 2020

This systematic review explores experiences of household food insecurity in rural areas of developed countries. A search of 5 databases resulted in 32 peer-reviewed articles for inclusion. Data were analyzed using directed content analysis to broaden the understanding of rural household food insecurity. Elements of food security (ie, availability, accessibility, acceptability, adequacy, and agency) were exemplified across the literature. In addition, 4 key themes were found: exercising human capital, realizing social capital, coping with compounding stressors, and navigating complex systems. This review demonstrates the need for interventions that improve social connectedness, individual coping skills, and system navigation.
Differences in patient and physician perspectives on pharmaceutical therapy and renal denervation for the management of hypertension
Authors: Schmieder Roland E. , Kandzari David E. , Wang Tzung-Dau , Lee Ying-Hsiang , Lazarus Gabriel , Pathak Atul
Published: August 2020

Objective:

To study patient and physician attitudes to pharmaceutical therapy and renal denervation for the management of hypertension.

Methods:

Data were analyzed from 19 market research studies in Western Europe and the United States conducted between 2010 and 2019 to obtain quantitative and qualitative perspectives. The analysis incorporated insights from 2768 patients and the experiences of 1902 physicians either actively performing or interested to perform device procedures, or hypertension specialists who would refer patients for a device-based intervention.

Results:

Referring cardiologists and proceduralists were more likely to recommend the renal denervation procedure to patients with higher BP levels and a greater number of antihypertensive medications. Physicians perceived patient reluctance towards a procedure as an important obstacle to recommending renal denervation as a treatment option for uncontrolled hypertension. Patient interest in the renal denervation procedure did not correlate with BP severity (P = NS), and the highest preference for the procedure was in patients diagnosed with hypertension but not receiving treatment (P < 0.001). Patients who perceived high BP as a major problem (P = 0.029) and those who experienced side effects attributed to their BP medications (P = 0.006) had a higher preference for renal denervation.

Conclusion:

Patients with hypertension often regard the choice of renal denervation to lower BP differently from physicians. A considerable proportion of hypertensive patients, especially those not taking medications, may prefer a device-based approach to reduce their BP.
Impact of Nutritional Status on the Severity of Dengue Infection Among Pediatric Patients in Southern Thailand
Authors: Maneerattanasak Sarunya , Suwanbamrung Charuai
Published: August 2020

Background:

Given the lack of specific antiviral drugs and effective vaccine for dengue infection, factors such as host nutritional status that may alter disease progression require investigation. This study examined the relationship between baseline nutritional status and severity of dengue infection in pediatric patients.

Methods:

Data from dengue patients 1–14 years of age treated at four hospitals in southern Thailand (2017–2018) were reviewed. Dengue infection was classified as dengue fever, dengue hemorrhagic fever and dengue shock syndrome. Children’s nutritional status was assessed based on international and national growth charts. Binary logistic regression was used to identify factors associated with dengue severity and malnutrition.

Results:

Overall, 248, 281 and 43 patients had dengue fever, dengue hemorrhagic fever and dengue shock syndrome, respectively. Overweight was associated with increased risk of dengue severity [odds ratio (OR) = 1.76, 95% confidence interval (CI): 1.13–2.75, P = 0.012; OR = 1.84, 95% CI: 1.09–3.09, P = 0.022, per international and national growth criteria, respectively). Stunting was associated with decreased risk of dengue severity (OR = 0.54, 95% CI: 0.33–0.88, P = 0.013; OR = 0.61, 95% CI: 0.39–0.95, P = 0.030, per international and national growth criteria, respectively). Being overweight was significantly and positively associated with levels of hemoglobin >14 g/dL, hematocrit >42%, hemoconcentration ≥20% and platelet count ≤50,000/mm3, whereas being stunted was significantly and negatively associated with levels of hemoglobin >14 g/dL and hematocrit >42%.

Conclusions:

These findings support a hypothesis that malnutrition might influence the severity of dengue infection through host immune response. Overweight children with dengue infections should be closely observed for early signs of severe dengue infection.
Postnatal Exposure to Herpes Simplex Virus
Authors: Pittet Laure F. , Curtis Nigel
Published: August 2020

Neonatal herpes simplex virus (HSV) infection carries significant morbidity and mortality. In contrast to perinatal exposure, there are no clear guidelines for the management of postnatal HSV exposure. This review focuses on the risk of HSV infection following postnatal exposure and suggests an approach to management. While many infants are protected by transplacentally transferred maternal anti-HSV antibodies, infants of seronegative mothers with significant postnatal HSV exposure may be at risk of severe disease. Individual risk assessment, appropriate investigations, and empiric acyclovir treatment should be considered in postnatally exposed newborns, even if asymptomatic. In all cases, close clinical follow-up is indicated, as well as education of families on the symptoms of neonatal HSV disease. Finally, measures to reduce the risk of postnatal HSV infection should be considered, such as discouraging individuals, particularly those with a history of recurrent cold sores, from kissing newborns.
Evidence of Dose Variability and Dosing Below the FDA and EMA Recommendations for Intravenous Colistin (Polymyxin E) Use in Children and Neonates
Authors: Chin Maxx King Yau , Hsia Yingfen , Goossens Herman , Versporten Ann , Bielicki Julia , Sharland Mike , Donà Daniele
Published: August 2020

Intravenous colistin (polymyxin E) has renewed interest as a last-line treatment against antimicrobial-resistant Gram-negative bacterial infections, despite limited literature on pediatric prescribing practices. Point-prevalence surveys were used to obtain intravenous colistin prescribing data from 78 children and neonates, showing high variability, and 60.3% received doses below the Food and Drug Administration and the European Medicines Agency recommendations.
Trends of Pediatric Bloodstream Infections in Stockholm, Sweden: A 20-year Retrospective Study
Authors: Luthander Joachim , Bennet Rutger , Giske Christian G. , Eriksson Margareta , Nilsson Anna
Published: August 2020

Background:

The etiology of bloodstream infections (BSIs) changes over time due to updated immunization programs, new antibiotic-use strategies, changes in patient mix and travel. Continuous surveillance can guide empiric therapy and identify targets for prevention.

Method:

We conducted a descriptive retrospective analysis among children <18 years of age who were detected with BSI between July 1998 and June 2018 for changes in the incidence, risk factors, and etiology of BSI in a Swedish tertiary hospital (Karolinska University Hospital).

Results:

We evaluated 2079 episodes of BSI. During the study period, the incidence of BSI in children 0–17 years of age decreased (τ = −0.45, P = 0.016), which was most evident among children 3 months to 2 years of age (τ = −0.59, P = 0.0006) and in early neonatal period (0–7 days; τ = −0.44, P = 0.0069). These were explained by the reduced occurrence of Streptococcus pneumoniae in children 3 months to 2 years of age and Streptococcus agalactiae and Candida spp. in neonates. Staphylococcus aureus was the commonest pathogen, accounting for 31.6% of episodes. The proportion of hospital-acquired infection was higher in patients with underlying risk factors (47.6% vs. 2.6%). The etiology of hospital-acquired infection BSI was more diverse than that of community-acquired infections and was related to underlying risk factors. The crude mortality rate was 5.7%. For children admitted to the neonatal ward, the mortality was 17.6%, but declined (τ = −0.469, P = 0.004) over the study period.

Conclusions:

There was a decreasing trend of pediatric BSI and mortality over last 20 years, which was associated with pneumococcal immunization and antimicrobial prophylaxis for high-risk patients.
Assessment of Tactile Sensitivity Threshold Using Cochet-Bonnet Esthesiometer and Semmes-Weinstein Monofilaments and Their Use in Corneal Neurotization
Authors: Vinee Frédéric , Grobnicu Oana , Errera Charlotte , Gomart Gabrielle , Tuzin Nicolas , Heitz Antoine , Liverneaux Philippe , Bourcier Tristan
Published: August 2020

Purpose:

Although the Cochet-Bonnet esthesiometer (CBE) measures corneal sensitivity, it has heretofore only been tested on the index pulp. Tactile skin sensitivity thresholds are measured with Semmes-Weinstein monofilaments (SWM). This study measured skin sensitivity thresholds in healthy individuals using CBE and SWM, and compared both instruments in territories involved in corneal neurotization.

Methods:

Overall, 27 healthy individuals were tested by a single examiner at 9 territories on the face, neck, forearm, and leg, using 20-thread SWM and CBE with a diameter of 0.12 mm. Both sides were tested. Thresholds were compared for both instruments and between the different territories using Bayesian methods.

Results:

Mean sensitivity levels for SWM ranged from 0.010 to 1.128 g, while mean sensitivity levels for CBE ranged from 0.006 to 0.122 g. Thresholds measured with SWM were significantly higher than with CBE. Both instruments demonstrated higher thresholds in the leg territory than the forearm. However, the forearm presented higher thresholds than the head territories. No significant differences were found between the head territories themselves. Overall, right-side territories exhibited lower thresholds than left-side territories.

Conclusions:

We have reported the first mapping of skin sensitivity thresholds using CBE. Thresholds measured with CBE and SWM were coherent. The use of CBE on the skin is particularly relevant to the field of corneal neurotization.
New COVID-19 saliva-based test: How good is it compared with the current nasopharyngeal or throat swab test?
Authors: Hung Kai-Feng , Sun Yi-Chen , Chen Bing-Hong , Lo Jeng-Fan , Cheng Chao-Min , Chen Cho-Yi , Wu Cheng-Hsien , Kao Shou-Yen
Published: August 2020

As of April 15, 2020, the US Food and Drug Administration has granted emergency use authorization to a first saliva test for diagnosis of severe acute respiratory syndrome coronavirus 2 infection, the device developed by RUCDR Infinite Biologics laboratory, Rutgers University. A key feature that distinguishes the saliva-based test from nasopharyngeal or oropharyngeal (throat) swabs is that this kit allows self-collection and can spare healthcare professionals to be at risk during collecting nasopharyngeal or oropharyngeal samples, thereby preserving personal protective equipment for use in patient care rather than sampling and testing. Consequently, broader testing than the current methods of nasal or throat swabs will significantly increase the number of people screening, leading to more effective control of the spread of COVID-19. Nonetheless, a comparison of saliva-based assay with current swab test is needed to understand what and how we can benefit from this newly developed assay. Therefore, in this mini-review article, we aimed to summarize the current and emerging tools, focusing on diagnostic power of different clinical sampling and specimens.
Using multiple-steps bioinformatic analysis to predict the potential microRNA targets by cardiogenic HoxA11
Authors: Wang Chien-Ying , Liu Szu-Yuan , Kuo Fu-Hsuan , Lin Heng-Fu , Liu Chao-Yu , Yang Yi-Ping , Tsai Fu-Ting , Huang Wei-Chun , Tarng Yih-Wen , Lin Hsin-Chi , Lu Kai-Hsi , Yu Wen-Chung , Yang Meng-Yin
Published: August 2020

Background:

In this study, our major aim is to using multiple-steps bioinformatic analysis to predict cardiogenic genes with targeting mRNA profiling for predicting cardiogenic HoxA11 gene.

Methods:

We first analyzed the microarray data with bioinformatic measurement, including combining with panel module 1 (mouse embryonic stem cells), panel module 2 (mouse induced pluripotent stem cells), and panel module 3 (gene list form literature of heart development). A literature-based comparison of the two microarrays and a software-based (Targetscan program, www.targetscan.org) comparative analysis of the two datasets. Furthermore, we select the common central pathways and potential candidate genes involved in the cardiomyocyte-lineaged differentiation and development.

Results:

Schematic presentation of a putative miR181a target site in Hox-A11 3′UTR. The bioinformatic result showed that potential interacted cardiogenic targets of Tbx5, Tbx20, Mal2c, Nkx2.5, cTNT, Cx43, MHC, and MCK in different treatment groups of pluripotent stem cells by using a literature-based comparison of the two microarrays and a software-based gene-lineage system.

Conclusion:

Our findings support that mir181a is an up-stream regulating microRNA to target the 3′UTR of HoxA11 mRNA during the process of cardiomyocyte differentiation.
The effect of aspirin on preeclampsia, intrauterine growth restriction and preterm delivery among healthy pregnancies with a history of preeclampsia
Authors: Abdi Nazanin , Rozrokh Afsane , Alavi Azin , Zare Shahram , Vafaei Homeira , Asadi Nasrin , Kasraeian Maryam , Hessami Kamran
Published: August 2020

Background:

Due to the significance of preeclampsia (PE) and its adverse outcomes in the health of both mother and newborn, the present study was carried out to investigate the effect of aspirin on preventing the occurrence of PE, intrauterine growth restriction (IUGR), and preterm delivery in women with a previous history of PE.

Methods:

The present clinical trial was conducted on 90 pregnant women with a previous history of PE referred to the Khalij Fars Hospital in Bandar Abbas, Hormozgan Province Iran from April 2017 to August 2018. The subjects of the study were randomly assigned into two groups of intervention and control to receive either 80 mg of aspirin or placebo daily during the pregnancy. Patients’ information was obtained and recorded upon entering the study, follow-up visits, and childbirth.

Results:

Among participants who entered the clinical trial, 86 patients (95.6%) completed the study. During the pregnancy, systolic blood pressure increased by 8.25 ± 14.83 and 19.06 ± 18.33 mmHg in aspirin and placebo groups, respectively (p = 0.001). Also, the same happened with diastolic blood pressure (6.12 ± 11.46 vs 13.48 ± 13.95 mmHg, p = 0.010). The rate of PE was equal to 27 (62.8%) and 38 (88.4%) in the aspirin and placebo groups, respectively (aOR = 0.23, p = 0.013). In the aspirin group, the rate of IUGR was equal to 27.9% compared with 25.6% of newborns in the control group (aOR = 1.18, p = 0.750). Similarly, there was no significant difference in the rate of preterm delivery between the two groups (p = 0.061).

Conclusion:

The findings of the present study conducted exclusively on women with previous documented PE revealed that taking aspirin may have a preventive effect on PE in the current pregnancy.
Relationship between platelet/lymphocyte ratio and prognosis of patients with septic acute kidney injury: A pilot study
Authors: Chen Yu , Feng Fang , Li Min , Yuan Jiao-Jiao , Chang Xue-Ni , Wei Bao-Hua , Du Hang , Dong Chen-Ming
Published: August 2020

Background:

To explore the potential role of the platelet/lymphocyte ratio (PLR) as a prognostic marker in septic patients with acute kidney injury (AKI) and to provide theoretical evidence for the epidemiological study of the prognosis of patients with septic AKI in its early stage.

Methods:

A pilot study was conducted. A logistic regression analysis was conducted to screen the risk factors, and the selected factors were performed using multiple logistic regression analysis; a Receiver Operating Characteristic curve was used to determine the optimal cutoff value of the PLR and then to calculate the sensitivity and specificity of the PLR ratio.

Results:

Mechanical ventilation, platelet count, PLR, and arterial blood lactate concentration have a correlation with sepsis (p < 0.05). An elevated PLR is significantly associated with a worse prognosis of sepsis-induced AKI (higher mortality).

Conclusion:

The PLR might be an effective factor in predicting a worse prognosis of septic AKI patients.
Long-term imaging follow-up to evaluate restenosis in patients with carotid stenosis after angioplasty and stenting
Authors: Chen Jung-Hsuan , Wu Mei-Han , Luo Chao-Bao , Lirng Jiing-Feng , Chen Shu-Ting , Wu Chia-Hung , Guo Wan-Yuo , Chang Feng-Chi
Published: August 2020

Background:

Stent patency after carotid angioplasty and stenting (CAS) correlates not only with stroke prevention but also with improvements in cognition and quality of life by positively influencing cerebral perfusion. The long-term outcomes of CAS after more than 5 years have still not been well described. This retrospective study was designed to evaluate the stent patency and significant restenosis (SR) after CAS with more than 5 years of follow-up.

Methods:

Between 2006 and 2012, 118 patients with carotid stenosis who underwent 131 CAS procedures with regular annual imaging follow-up for more than 5 years were enrolled. We evaluated their demographic characteristics and the risk factors related to stent restenosis. Patients with SR (restenosis ≥ 50%) were compared with those with no significant restenosis (NSR, patency or restenosis < 50%) to identify the restenosis predictors and restenosis-free survival.

Results:

Of the 131 CAS procedures, 16.0% (21/131) had SR. A history of head and neck radiotherapy (HNRT) was a predictor for SR (HR, 6.352; 95% CI, 2.504–16.112; p < 0.001) and was associated with shorter restenosis-free survival (log-rank test p value < 0.001, median time of restenosis-free survival was 38 months). Left-sided stenting was an associated factor for SR (HR, 3.007; 95% CI, 1.068–8.467; p = 0.037) with a trend of less restenosis-free survival (log-rank test p value 0.067).

Conclusion:

Both HNRT and left-sided carotid stenosis were predictors of SR after CAS in more than 5 years of long-term follow-up. Restenosis-free survival was significantly shorter in patients with prior HNRT than in patients without previous irradiation treatment. We suggest close follow-up and aggressive medical treatment for patients with prior HNRT and left-sided carotid stenosis undergoing CAS.
Nonintubated video-assisted thoracic surgery with high-flow oxygen therapy shorten hospital stay
Authors: Ke Hui-Hsuan , Hsu Po-Kuei , Tsou Mei-Yung , Ting Chien-Kun
Published: August 2020

Background:

Nonintubated video-assisted thoracic surgery (VATS) is widely used due to its acceptable postoperative outcomes. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) has been successfully applied in cases of prolonged difficult intubation and intensive respiratory care in patients receiving VATS lobectomy. Thopaz Digital Chest Drainage System (THOPAZ) provides regulated negative pressure close to the patient’s chest, optimizing drainage of the pleural and mediastinum. We explored the surgical outcomes of nonintubated VATS lung wedge resection and traditional wedge resection with a double-lumen endotracheal tube.

Methods:

Patients who received nonintubated VATS lung wedge resection (group A, n = 81) and traditional wedge resection with double-lumen endotracheal tube (group B, n = 79) during the period of November 2015 to April 2018 were enrolled in the study. Demographic data and operation outcomes were obtained and analyzed from review of patient medical charts.

Results:

Group B had significantly longer mean induction and operative times than group A. Similarly, group B suffered greater intraoperative blood loss, longer postoperative hospital stays, and increased chest tube retention times than group A. Group A had higher partial pressure of carbon dioxide levels in both the pre-one-lung and during one-lung ventilation periods than group B. Furthermore, group A showed lower serum pH levels during one-lung ventilation period. However; group A had significantly higher partial pressure of oxygen levels during one-lung ventilation than group B, although the differences in peripheral oxygen saturation were not statistically significant.

Conclusion:

Our study demonstrated that nonintubated VATS using THRIVE and THOPAZ in lung wedge resection provides measurable benefits to patients.
Efficacy of endoscopic triage during the Covid-19 outbreak and infective risk
Authors: Elli Luca , Tontini Gian Eugenio , Filippi Elisabetta , Scaramella Lucia , Cantù Paolo , Vecchi Maurizio , Bertè Roberto , Baldassarri Annarita , Penagini Roberto
Published: August 2020

Objective

SARS-CoV-2 outbreak is spreading worldwide. As a consequence of the new circumstances, almost all endoscopic units underwent in-depth reorganization involving patients’ selection. We analyzed the efficacy of the newly adopted endoscopic triage.

Methods

In March 2020, we monitored endoscopies to evaluate the effects of the novel selective triage aimed to reduce the number of investigations and viral spread/contagions. Clinical-demographic data of the patients, indications, type of endoscopy, endoscopic findings (subtyped in major and minor), finding rates (major and minor) and diagnostic yields (major findings) have been analyzed and compared to the endoscopic procedures performed in March 2019. Furthermore, patients were called at least 21 days after the endoscopy to evaluate the possibility of a Covid-19 onset.

Results

Accordingly to the novel triage, the number of procedures dropped from 530 to 91 (−84%). The finding rates and diagnostic yields were 83% (74–89) vs 71% (66–73) (P 0.015) and 56% (46–65) vs 43% (38–47) (P 0.03) on March 2020 and March 2019, respectively. A significant increase of operative procedures has been reported in 2020, 34% vs 22% in March 2019. All the patients were recalled and neither cases of onset of Covid-19 like symptoms nor positive nasopharyngeal swabs PCR have been evidenced.

Conclusion

The novel endoscopic triage significantly reduced the number of procedures and increased finding rates and diagnostic yields. However, a careful schedule of canceled procedures should be applied to avoid to miss relevant pathologies. No Covid-19 onset or infection has been noted after endoscopies.
Relationship between atrophic gastritis, serum ghrelin and body mass index
Authors: Panarese Alba , Romiti Alessandra , Iacovazzi Palma Aurelia , Leone Carla Maria , Pesole Pasqua Letizia , Correale Mario , Vestito Amanda , Bazzoli Franco , Zagari Rocco Maurizio
Published: August 2020

Objective

Atrophic gastritis may affect circulating ghrelin levels and, indirectly, body mass index. The aim of this study was to investigate the relationship between atrophic gastritis, focusing on autoimmune atrophic gastritis and advanced stages of atrophic gastritis, serum ghrelin levels and BMI.

Methods

Sixty-three patients, of whom 18 had autoimmune atrophic gastritis, 27 non-autoimmune antrum and corpus atrophic gastritis, and 18 non-atrophic gastritis or antrum-limited atrophic gastritis (control group) were assessed. All participants underwent endoscopy with multiple gastric biopsies. Atrophic gastritis was diagnosed by histology, classified according to the Updated Sydney System and staged by the Operative Link on Gastritis Assessment (OLGA) Classification. Total serum ghrelin, body weight and height were measured.

Results

Compared with control patients (144.6 ± 111 pg/ml), mean serum level of total ghrelin was higher in patients with autoimmune atrophic gastritis (226.08 ± 243.03 pg/ml, P = 0.65) and lower in those with both antrum and corpus atrophic gastritis (74.51 ± 37.38 pg/ml, P = 0.12), although differences were not statistically significant. Serum ghrelin decreased in patients with advanced OLGA stages of atrophic gastritis. In non-obese patients BMI was significantly lower in those with both antrum and corpus atrophic gastritis than in control patients (23.1 ± 1.8 vs. 24.5 ± 1.6, P = 0.01), also after adjustment for age and sex (P = 0.02); BMI was positively correlated with serum total ghrelin (r = 0.51, P < 0.001).

Conclusion

Advanced stages of atrophic gastritis, but not autoimmune atrophic gastritis, seem to be associated with lower serum levels of ghrelin and lower BMI. In non-obese patients, BMI was positively correlated with total serum ghrelin.
Atherosclerosis: cell biology and lipoproteins
Authors: Getz Godfrey S. , Reardon Catherine A.
Published: August 2020

Purpose of review

Lipoproteins have significant role in both the promotion and prevention of atherosclerosis. This brief review will focus on recent reports on relationship between HDL and HDL subclasses and their composition and function, the role of apoC-III in metabolism of triglyceride-rich lipoproteins, the impact of Lipoprotein (a) (Lp(a)) on endothelial cells, and the mechanism of uptake of aggregated LDL by macrophages.

Recent findings

The complexity of the protein and lipid content of murine and human HDL and their relationship to its cholesterol efflux capacity have been examined. HDL has also been shown to have both antiatherogenic and proatherogenic properties. The relationship between apoC-III and LPL activity, apoprotein E mediated clearance of triglyceride-rich lipoproteins and the potential importance of apoC-III in the increased risk of cardiovascular disease in type 1 diabetics has been investigated. Oxidized phospholipid in Lp(a) promotes endothelial cells inflammatory and glycolytic responses. TLR4 participates in the uptake of aggregated LDL to contribute to foam cell formation.

These studies contribute to our mechanistic understanding of how lipoproteins contribute to atherogenesis and identify potential therapeutic targets.
Measurement of carotid plaque burden
Authors: Spence J. David
Published: August 2020

Purpose of review

To describe the uses of measurement of carotid plaque burden, as total plaque area (TPA), total plaque volume (TPV), and vessel wall volume (VWV), which includes plaque burden and wall volume.

Recent findings

Measurement of plaque burden is useful for risk stratification, research into the genetics and biology of atherosclerosis, for measuring effects of new therapies for atherosclerosis, and for treatment of high-risk patients with severe atherosclerosis.

Measurement of plaque burden is far superior to measurement of carotid intima-media thickness (IMT) in many ways, and should replace it. Vessel wall volume can be measured in persons with no plaque as an alternative to IMT.
Skin xenotransplantation: technological advances and future directions
Authors: Kalsi Richa , Messner Franka , Brandacher Gerald
Published: August 2020

Purpose of review

To summarize the evolution of skin xenotransplantation and contextualize technological advances and the status of clinically applicable large animal research as well as prospects for translation of this work as a viable future treatment option.

Recent findings

Porcine xenografts at the start of the millennium were merely biologic dressings subject to rapid rejection. Since then, numerous important advances in swine to nonhuman primate models have yielded xenotransplant products at the point of clinical translation. Critical genetic modifications in swine from a designated pathogen-free donor herd have allowed xenograft survival reaching 30 days without preconditioning or maintenance immunosuppression. Further, xenograft coverage appears not to sensitize the recipient to subsequent allograft placement and vice versa, allowing for temporary coverage times to be doubled using both xeno and allografts.

Studies in large animal models have led to significant progress in the creation of living, functional skin xenotransplants with clinically relevant shelf-lives to improve the management of patients with extensive burns.