bluuebunny/crossref_metadata_2025 huggingface dataset:
Interaction of polymorphisms in APOA4-APOA5-ZPR1-BUD13 gene cluster and sleep duration on 5-year lipid changes in middle aged and older Chinese
Authors: Yang Liangle , Ma Lin , Guo Wenting , Fang Qin , Lai Xuefeng , Zhang Xiaomin
Published: June 2019

Study Objectives

Lipid profiles are influenced by both genetic and environmental factors. Genetic variants in the APOA4-APOA5-ZPR1-BUD13 gene cluster and aberrant sleep duration were independently identified to be associated with lipids in previous studies. We aimed to investigate whether sleep duration modified the genetic associations with longitudinal lipids changes.

Methods

Four single nucleotide polymorphisms (SNPs), rs17119975, rs651821, rs7396835, and rs964184 in the APOA4-APOA5-ZPR1-BUD13 gene cluster were genotyped among 8648 apparently healthy subjects from the Dongfeng-Tongji (DFTJ) cohort. Information on sleep duration was obtained by questionnaires. Changes in total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), were evaluated from baseline to 5-year follow-up.

Results

After multivariate adjustments, we found that rs651821 and weighted genetic risk score (GRS) were significantly associated with increased triglyceride, and the genetic association with triglyceride change consistently strengthened across sleep duration categories. The differences in triglyceride changes per increment of risk allele for rs651821 were 0.028 (SE = 0.017, p = 0.112), 0.051 (SE = 0.009, p < 0.001), and 0.064 (SE = 0.016, p < 0.001) in individuals with sleep duration ≤7, >7–<9, and ≥9 h, respectively (p interaction = 0.031). The GRS also showed a significant interaction with sleep duration categories for triglyceride change (p interaction = 0.010). In addition, all of the four SNPs and GRS were inversely related to HDL-c changes.

Conclusions

Longer sleep duration might exacerbate the adverse effects of SNPs in APOA4-APOA5-ZPR1-BUD13 gene cluster on 5-year triglyceride changes.
Age and autonomic control, but not cerebral oxygenation, are significant determinants of EEG spectral power in children
Authors: Walter Lisa M , Tamanyan Knarik , Weichard Aidan J , Biggs Sarah N , Davey Margot J , Nixon Gillian M , Horne Rosemary S C
Published: June 2019

Study Objectives

Sleep disordered breathing (SDB) in children has significant effects on daytime functioning and cardiovascular control; attributed to sleep fragmentation and repetitive hypoxia. Associations between electroencephalograph (EEG) spectral power, autonomic cardiovascular control and cerebral oxygenation have been identified in adults with SDB. To date, there have been no studies in children. We aimed to assess associations between EEG spectral power and heart rate variability as a measure of autonomic control, with cerebral oxygenation in children with SDB.

Methods

One hundred sixteen children (3–12 years) with SDB and 42 controls underwent overnight polysomnography including measurement of cerebral oxygenation. Power spectral analysis of the EEG derived from C4-M1 and F4-M1, quantified delta, theta, alpha, and beta waveforms during sleep. Multiple regression tested whether age, SDB severity, heart rate (HR), HR variability (HRV), and cerebral oxygenation were determinants of EEG spectral power.

Results

There were no differences in EEG spectral power derived from either central or frontal regions for any frequency between children with different severities of SDB so these were combined. Age, HR, and HRV low frequency power were significant determinants of EEG spectral power depending on brain region and sleep stage.

Conclusion

The significant findings of this study were that age and autonomic control, rather than cerebral oxygenation and SDB severity, were predictive of EEG spectral power in children. Further research is needed to elucidate how the physiology that underlies the relationship between autonomic control and EEG impacts on the cardiovascular sequelae in children with SDB.
Sleep duration and fragmentation in relation to leukocyte DNA methylation in adolescents
Authors: Jansen Erica C , Dolinoy Dana C , O’Brien Louise M , Peterson Karen E , Chervin Ronald D , Banker Margaret , Téllez-Rojo Martha María , Cantoral Alejandra , Mercado-Garcia Adriana , Sanchez Brisa , Goodrich Jaclyn M
Published: June 2019

Study Objectives

Sleep deprivation and low sleep quality are widespread among adolescents, and associate with obesity risk. Plausible mediators include diet and physical activity. Another potential interrelated pathway, as yet unexplored in adolescents, could involve epigenetic modification of metabolism genes.

Methods

In a cohort of 351 Mexico City adolescents (47% male; mean [SD] age = 14 [2] years), 7-day actigraphy was used to assess average sleep duration, sleep fragmentation, and movement index. DNA isolated from blood leukocytes was bisulfite-converted, amplified, and pyrosequenced at four candidate regions. Linear mixed models evaluated sex-stratified associations between sleep characteristics (split into quartiles [Q]) and DNA methylation of each region, adjusted for potential confounders.

Results

Mean sleep duration was 8.5 [0.8] hours for boys and 8.7 [1] hours for girls. There were sex-specific associations between sleep duration and LINE-1 (long interspersed nuclear element) methylation. Boys with longer sleep duration (Q4) had lower LINE-1 methylation than boys in the 3rd quartile reference category, while girls with both longer and shorter sleep duration had higher LINE-1 methylation compared to Q3. Longer sleep duration was associated with higher H19 methylation among girls (comparing highest to third quartile, −0.9% [−2.2, 0.5]; p, trend = 0.047). Sleep fragmentation was inversely associated with peroxisome proliferator-activated receptor alpha (PPARA) methylation among girls (comparing highest to lowest fragmentation quartile, 0.9% [0.1 to 1.8]). Girls also showed an inverse association between sleep fragmentation and hydroxysteroid (11-beta) dehydrogenase 2 (HSD11B2; Q4 to Q1, 0.6% [−1.2%, 0%]).

Conclusions

Sleep duration and fragmentation in adolescents show sex-specific associations with leukocyte DNA methylation patterns of metabolism genes.
Old and Dangerous: Bordering Older Migrants’ Mobilities, Rejuvenating the Post-Welfare State
Authors: Braedley Susan , Côté-Boucher Karine , Przednowek Anna
Published: June 2019

Caught in the cross-hairs of perceived crises of aging populations, increasing migration flows, and social welfare sustainability, older migrants are often not welcome in post-welfare states. Employing a feminist border analysis, Canada’s relatively generous immigration policies on parent and grandparent entry are analyzed to show the ways in which older people’s mobilities are bordered, who is most affected, and why this bordering is worthy of attention. We show links between these policies and Canada’s national rejuvenation project that aims to externalize and privatize both the costs and labor of social reproduction, limiting state contributions.
Using the Practical, Robust Implementation and Sustainability Model (PRISM) to qualitatively assess multilevel contextual factors to help plan, implement, evaluate, and disseminate health services programs
Authors: McCreight Marina S , Rabin Borsika A , Glasgow Russell E , Ayele Roman A , Leonard Chelsea A , Gilmartin Heather M , Frank Joseph W , Hess Paul L , Burke Robert E , Battaglia Catherine T
Published: June 2019

PRISM is useful to identify contextual factors that influence implementation, modification, uptake, and evaluation of health services programs.
Adaptation of the Systematic Review Framework to the Assessment of Toxicological Test Methods: Challenges and Lessons Learned With the Zebrafish Embryotoxicity Test
Authors: Stephens Martin L , Akgün-Ölmez Sevcan Gül , Hoffmann Sebastian , de Vries Rob , Flick Burkhard , Hartung Thomas , Lalu Manoj , Maertens Alexandra , Witters Hilda , Wright Robert , Tsaioun Katya
Published: June 2019

Systematic review methodology is a means of addressing specific questions through structured, consistent, and transparent examinations of the relevant scientific evidence. This methodology has been used to advantage in clinical medicine, and is being adapted for use in other disciplines. Although some applications to toxicology have been explored, especially for hazard identification, the present preparatory study is, to our knowledge, the first attempt to adapt it to the assessment of toxicological test methods. As our test case, we chose the zebrafish embryotoxicity test (ZET) for developmental toxicity and its mammalian counterpart, the standard mammalian prenatal development toxicity study, focusing the review on how well the ZET predicts the presence or absence of chemical-induced prenatal developmental toxicity observed in mammalian studies. An interdisciplinary team prepared a systematic review protocol and adjusted it throughout this piloting phase, where needed. The final protocol was registered and will guide the main study (systematic review), which will execute the protocol to comprehensively answer the review question. The goal of this preparatory study was to translate systematic review methodology to the assessment of toxicological test method performance. Consequently, it focused on the methodological issues encountered, whereas the main study will report substantive findings. These relate to numerous systematic review steps, but primarily to searching and selecting the evidence. Applying the lessons learned to these challenges can improve not only our main study, but may also be helpful to others seeking to use systematic review methodology to compare toxicological test methods. We conclude with a series of recommendations that, if adopted, would help improve the quality of the published literature, and make conducting systematic reviews of toxicological studies faster and easier over time.
Using a Global Health Media Project Video to Increase Knowledge and Confidence in the Mothers of Admitted Neonates in Rwanda: A Prospective Interventional Study
Authors: Arinitwe Richard , Willson Alice , Batenhorst Sean , Cartledge Peter T
Published: June 2019

Introduction

In resource-limited settings, the ratio of trained health care professionals to admitted neonates is low. Parents therefore, frequently need to provide primary neonatal care. In order to do so safely, they require effective education and confidence. The evolution and availability of technology mean that video education is becoming more readily available in this setting.

Aim

This study aimed to investigate whether showing a short video on a specific neonatal topic could change the knowledge and confidence of mothers of admitted neonates.

Methods

A prospective interventional study was conducted in two hospitals in Kigali, Rwanda. Mothers of admitted neonates at a teaching hospital and a district hospital were invited to participate. Fifty-nine mothers met the inclusion criteria. Participants were shown ‘Increasing Your Milk Supply, for mothers’ a seven-minute Global Health Media Project video in the local language (Kinyarwanda). Before and after watching the video, mothers completed a Likert-based questionnaire which assessed confidence and knowledge on the subject.

Results

Composite Likert scores showed a statistically significant increase in knowledge (pre = 27.2, post = 33.2, p < 0.001) and confidence (pre = 5.9, post = 14.2, p < 0.001). Satisfaction levels were high regarding the video content, language and quality. However, only 10% of mothers owned a smartphone.

Discussion

We have shown that maternal confidence and knowledge on a specific neonatal topic can be increased through the use of a short video and these videos have the potential to improve the quality of care provided to admitted neonates by their parents in low-resource settings.
Fostering sexual and gender minority status disclosure in patients
Authors: Cottrell Damon B.
Published: June 2019

Members of the sexual and gender minority (SGM) community face complex barriers to accessing quality healthcare. NPs have a responsibility to create welcoming care settings where patients can share a trusting provider–patient relationship to disclose their SGM status, an event shown to improve patient outcomes.
Clinical Anatomy and Possible Clinical Significance of the Postcentral Branches of Spinal Arteries in the L1–L5 Levels
Authors: Zhao Qinghao , Zhong Enyi , Shi Benchao , Ding Zihai , Jin Dadi , Li Qingchu
Published: June 2019

Study Design:

This was a dissection-based study of 10 embalmed human cadavers.

Objective:

The objective of this study was to identify and describe the postcentral branches in the L1–L5 intervertebral foramina (IVF) and to determine their possible clinical significance.

Summary of Background Data:

The lower lumbar segmental arteries have been well studied. However, there are few articles with regard to the postcentral branches in the L1–L5 IVF.

Materials and Methods:

Eighty L1–L5 IVF from 10 embalmed cadavers were studied with a surgical microscope, and the postcentral branches were identified. The branches, origin, insertion, and spatial orientation of the postcentral branches in the L1–L5 IVF were examined. The diameter of the arteries was measured using a Vernier caliper.

Results:

In our study, the occurrence rate of a postcentral branch was 100.00% in the 80 IVFs. The postcentral branch was routinely divided into the following 2 types: type 1, postcentral branch main trunks (65.00%), which branch from the spinal arteries or lumbar arteries and then divide into 2 branches (superior and inferior branches), and type 2, superior and inferior branches, which branch straight from the spinal arteries (35.00%). The initial portion of the postcentral branches traveled around the anterolateral edge of the disk to the dorsum.

Conclusions:

Postcentral branches of spinal arteries are common structures in IVF; there are 2 types of postcentral branches. Thorough understanding of the spinal arteries before percutaneous endoscopic lumbar discectomy may be an important step in reducing intraoperative bleeding and ensuring clear visualization, which may result in significant benefits for patients.
Multicultural approaches of cancer pain
Authors: Crombez Patrick , Bron Dominique , Michiels Sandra
Published: June 2019

Purpose of review

Pain continues to be a prevalent symptom in cancer patients. Patient's ethnicity may influence the experience of pain with variations in pain outcomes among different ethnic groups. The objective of this thematic review is to investigate the relationship between ethnicity and cancer pain experience, assessment and management.

Recent findings

Cancer pain is not only a biophysiological construct but is rather a multidimensional concept of physiological and psychosocial responses, including the biocultural dimension. Culture can significantly affect patients’ cancer pain-related beliefs and behaviors and patient's ethnicity may influence the experience of pain.

We found a scarcity of data and an inconsistent literature that highlights gaps in knowledge, research and clinical practice concerning effective cancer pain management in a multicultural context.

To face disparities among ethnic minorities in cancer pain management, well-designed randomized controlled trials and robust qualitative research on cancer pain-related issues should inform good clinical practice. A close worldwide collaboration between researchers and clinicians and professional organizations is warranted.
Interactive Effect of Diurnal Temperature Range and Temperature on Mortality, Northeast Asia
Authors: Lee Whanhee , Chung Yeonseung , Michelle Choi Hayon , Kim Dahye , Honda Yasushi , Leon Guo Yue-Liang , Kim Ho
Published: June 2019

Background:

The diurnal temperature range (DTR) represents temperature variability within a day and has been reported as a potential risk factor for mortality. Previous studies attempted to identify the role of temperature in the DTR–mortality association, but results are inconclusive. The aim of this study was to investigate the interactive effect of temperature and DTR on mortality using a multicountry time series analysis.

Methods:

We collected time series data for mortality and weather variables for 57 communities of three countries (Taiwan, Korea, and Japan) in Northeast Asia (1972–2012). Two-stage time series regression with a distributed lag nonlinear model and meta-analysis was used to estimate the DTR–mortality association changing over temperature strata (six strata were defined based on community-specific temperature percentiles). We first investigated the whole population and then, the subpopulations defined by temperature distribution (cold and warm regions), sex, and age group (people <65 and ≥65 years of age), separately.

Results:

The DTR–mortality association changed over temperature strata. The relative risk (RR) of mortality for 10°C increase in DTR was larger for high-temperature strata compared with cold-temperature strata (e.g., = 1.050; 95% confidence interval [CI] = 1.040, 1.060 at extreme-hot stratum and RR = 1.040; 95% CI = 1.031, 1.050 at extreme-cold stratum); extreme-hot and -cold strata were defined as the days with daily mean temperature above 90th and below 10th percentiles each community’s temperature distribution. Such increasing pattern was more pronounced in cold region and in people who were 65 years or older.

Conclusions:

We found evidence that the DTR–related mortality may increase as temperature increases.
Polybrominated Biphenyl Exposure and Menstrual Cycle Function
Authors: Howards Penelope P. , Terrell Metrecia L. , Jacobson Melanie H. , Taylor Kira C. , Kesner James S. , Meadows Juliana W. , Spencer Jessica B. , Manatunga Amita K. , Marcus Michele
Published: June 2019

Background:

Brominated flame retardants, including polybrominated biphenyls (PBB), are persistent compounds reported to affect sex hormones in animals; less is known about potential effects in humans. An industrial accident in 1973–1974 exposed Michigan residents to PBB through contaminated food. We examined whether this exposure to PBB had long-term effects on menstrual cycle function.

Methods:

In 2004–2006, we recruited reproductive-aged women in the Michigan PBB Registry who were not pregnant, lactating, or taking hormonal medications. Participants kept daily diaries and provided daily urine samples for up to 6 months. We assayed the urine samples for estrone 3-glucuronide (E13G), pregnanediol 3-glucuronide (Pd3G), and follicle stimulating hormone (FSH). We fit linear mixed models among women aged 35–42 years to describe the relation between serum PBB levels and log-transformed, creatinine-adjusted daily endocrine levels among women who were premenarchal during the exposure incident in 1973–1974 (n = 70).

Results:

We observed that high (>3.0 parts per billion [ppb]) and medium (>1.0–3.0 ppb) PBB exposure were associated with lower E13G levels across the menstrual cycle and lower FSH levels during the follicular phase, compared with low PBB exposure (≤1.0 ppb). High PBB exposure was also associated with lower Pd3G levels across the cycle compared with low PBB exposure, whereas Pd3G levels were similar in women with medium and low PBB exposure.

Conclusion:

Our results are consistent with a hypothesized effect of exposure to an exogenous estrogen agonist but the modest sample size of the study requires cautious interpretation.
Reconstruction of the Congenital Divided Nevus of the Eyelids and Proposal of New Classification
Authors: Suzuki Akiyo , Yotsuyanagi Takatoshi , Yamashita Ken , Yoshimatsu Hidehiko
Published: June 2019

Background:

Divided nevus is a rare form of congenital nevus that usually occurs on both upper and lower eyelids of one eye, forming one large nevus when the eyelids are closed. Typically, congenital melanocytic nevi of the body are classified according to their size (small < 1.5 cm, medium 1.5–20 cm, and large > 20 cm). However, because divided nevus of the eyelids is usually relatively small, this classification may be too coarse and not adequate. Furthermore, there is no practical classification for divided nevus of eyelids yet.

Methods:

We treated 3 cases of medium and large congenital divided nevus of the eyelids using local flaps based on the idea of esthetic subunits. Also, we proposed a new classification especially for congenital divided nevus of the eyelids based on the idea of esthetic subunits.

Results:

All patients were treated successfully with the reconstructive idea of esthetic subunits for the eyelids. Case 1 (medium size) was reconstructed by orbicularis musculocutaneous flap and case 2 (large size) was reconstructed by expanded flap, and case 3 (medium size) was treated by modified V-Y orbicularis oculi musculocutaneous flap. In all cases, the flap color and texture were well matched and satisfactory results were obtained. Also, by using the new classification, we were able to plan practical scheme for divided nevus reconstruction.

Conclusions:

The use of our proposed classification and esthetic subunits for the divided nevus of the eyelids allows systematic surgical planning, leading to improved reconstructive outcomes.
Women at the helm: Chief executive officer gender and patient experience in the hospital industry
Authors: Silvera Geoffrey A. , Clark Jonathan R.
Published: June 2019

Background

Health care scholars have recognized the important role leaders play in the improvement of health care delivery systems, yet few have explored the kind of leaders who make a difference or the conditions under which certain health care executives thrive. Recent work in the hospital industry suggests that the role of chief executive officer (CEO) gender may be particularly salient in the context of patient experience (Galstian, Hearld, O’Connor, & Borkowski, 2018).

Purpose

In this article, we bring an explicit theoretical and empirical lens to the issue of CEO gender in the context of patient experience. Our framework provides an explanation of both why (differences between men and women in their tendency for relational orientation) and under what circumstances (the degree of complexity in the executive job environment) CEO gender is most influential.

Methodology/Approach

We test these relationships using data on patient experience in 391 nonrural U.S. hospitals between 2007 and 2011. Our study relies on both archival (e.g., Hospital Consumer Assessment of Healthcare Providers and Systems survey) and collected (e.g., CEO characteristics) data. Fixed-effects regression models are used to estimate the relationship between CEO gender and the interpersonal care experience.

Results

We find evidence that female CEOs improve the interpersonal care experience faster than male CEOs, particularly in the most complex executive job environments, that is, in the most populous urban environments, and in the largest hospital facilities.

Conclusion

Our results not only support the notion that executives tend to rely on personal values and preferences but also that women have an apparent propensity for transforming health care organizations in the direction of patient centeredness, particularly in the most demanding circumstances.

Practice Implications

Hospital boards seeking to improve the patient experience should give careful attention to promoting women to the role of CEO and consider how their own policies may be constraining both the promotion of female executives and the creation of more patient-centered health care organizations.
Changes in Corneal Biomechanical Properties After Descemet Membrane Endothelial Keratoplasty
Authors: Siggel Robert , Christofi Eleftheria , Giasoumi Fanouria , Adler Werner , Siebelmann Sebastian , Bachmann Björn , Cursiefen Claus , Heindl Ludwig M.
Published: June 2019

Purpose:

To evaluate the course of corneal biomechanical properties (corneal hysteresis and corneal resistance factor) after Descemet membrane endothelial keratoplasty (DMEK) in patients with Fuchs endothelial dystrophy (FECD).

Methods:

In this prospective study, we consecutively included 49 patients with FECD with an indication for DMEK. Central corneal thickness, measured using the Oculus Pentacam, and corneal hysteresis (CH) and corneal resistance factor (CRF), both measured using the Reichert Ocular Response Analyzer, were examined preoperatively, 3 months, and 6 months after DMEK.

Results:

CH was significantly increased 6 months postoperatively (8.66 ± 2.50 mm Hg) compared with preoperative baseline (7.43 ± 1.56 mm Hg). Preoperative CRF (7.89 ± 1.68 mm Hg) increased significantly 6 months after DMEK (8.49 ± 1.71 mm Hg). Preoperative central corneal thickness showed a significant decrease from 629 ± 58 μm to 550 ± 40 μm after 3 months and 535 ± 40 μm after 6 months postoperatively.

Conclusions:

DMEK affects both measured corneal biomechanical properties in patients with FECD: CH and CRF. This has to be taken into account for the accuracy of intraocular pressure measurements.
Pasero Opioid-Induced Sedation Scale in a Pediatric Surgical Ward: A Quality Improvement Project
Authors: Garcia Mayra G. , McMullan Taralyn W.
Published: June 2019

Pediatric patients are at risk for adverse events associated with opioid medication. Sedation scales enable nurses to reach knowledgeable decisions maximizing patient safety during opioid administration. Adult literature has focused on the Pasero Opioid-Induced Sedation Scale (POSS) to address this risk in the adult population; however, literature in the pediatric setting is limited.

Purpose

The purpose of this quality improvement project was to implement the POSS tool in a pediatric setting and reduce adverse outcomes because of opioid oversedation and respiratory depression.

Methods

Two patient cohorts were recruited and evaluated to compare the number of medical emergency team calls, supplemental oxygen use, and length of stay. Bedside nurses received education on opioid-induced sedation and use of the POSS tool. Pretest and posttest surveys were conducted to acquire nurse perceptions of the POSS tool in pediatric postsurgical patients.

Results

No medical emergency team calls occurred in the preintervention and postintervention patient cohorts. Eight percent of the preintervention patient cohort required supplemental oxygen in comparison with no oxygen need in the postintervention group. In the postintervention patient cohort, length of stay averages were 185.85 hours (SD = 325.6) in comparison with 89.09 hours (SD = 76.6) in the preintervention group. Nursing survey results improved in nurses' confidence, usage, and assessment using the POSS tool. This project led to widespread use of POSS in the facility.

Conclusions

POSS is an appropriate tool to assess pediatric patients in acute care units. The POSS tool assists nurses in accurate assessments and reduces adverse events related to opioid-induced sedation.
Anatomical distribution and number of parathyroid glands, and parathyroid function, after total parathyroidectomy and bilateral cervical thymectomy
Authors: Uslu Adam , Okut Gokalp , Tercan Ismail Can , Erkul Zehra , Aykas Ahmet , Karatas Murat , Simsek Cenk , Tatar Erhan
Published: June 2019

The normal distribution of parathyroid glands is well documented. However, this study aims to evaluate the efficacy of total parathyroidectomy (TPTx) and bilateral cervical thymectomy (BCTx) for the treatment of secondary hyperparathyroidism (SHPT) through identifying the location of parathyroid glands with attention to the pattern and frequency of orthotopic and ectopic glands.

Between 2013 and 2018, sixty chronic hemodialysis patients with medically refractory SHPT underwent TPTx & BCTx. The adequacy of the operation was defined by the pathological confirmation of at least 4 parathyroid glands, accompanied by an intact parathormone (iPTH) value of <60 pg/mL on postoperative day 1(POD1). Based on their anatomical localizations, four distinct sites were identified for both the upper (Zone I–IV) and lower parathyroid glands (Zone V–VIII).

The mean follow-up was 15.2 ± 14.6 months. The mean iPTH values on POD1 were normal in 50 patients, with an average of 11.7 ± 14.4 pg/mL. Ten patients (16.6%) had persistent HPT after the operation, three of whom underwent complementary parathyroidectomy. The surgical success rates after first and second operations were both 83.3%. A total of 235 parathyroid glands were detected. Ninety-two percent of the upper parathyroids were located in Zones I and II. However, almost 28% of the lower parathyroids were ectopic and located in Zones VII and VIII.

At least one fourth of the lower parathyroids are ectopic; for this reason, Zones VII and VIII require careful investigation during surgery. For upper parathyroids not found in Zone I–III, total thyroidectomy on the same side is recommended.
IP-10 for the diagnosis of tuberculosis in children
Authors: Zhang Weijun
Published: June 2019

Background:

Tuberculosis (TB) is a highly contagious and chronic disease. The microbiological examination to confirm children TB disease are limited due to paucibacillary Mycobacterium, specimens and detecting facilities. Considering these limitations in diagnosing children TB, new and reliable methods that detect children TB should be developed. Recently, Interferon gamma-induced protein 10 (IP-10) has been identified as a sensitive parameter in detecting children TB. The present study aims to synthesis and analysis the diagnostic value of IP-10 for children TB.

Methods:

We will search PubMed, Embase, the Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, and Chinese Biological Medical Databases. We will search relevant citations up to May 2019. The quality of individual study will be assessed using the Quality Assessment of Diagnostic Accuracy Studies tool-2 (QUADAS-2). Stata 14.0 software will be used to calculate the pooled sensitivity, pooled specificity, pooled positive likelihood ratio (PLR), pooled negative likelihood ratio (NLR), pooled diagnostic odds ratio (DOR), pre-test probability, post-test probability and the hierarchical summary receiver operating characteristic (HSROC) curve.

Results:

The results of this study will be published in a peer-reviewed journal.

Discussion:

The evidence will indicate that IP-10 test is an alternative immunological test in detecting children TB. This is a protocol of systematic review and meta-analysis, so the ethical approval and patient consent are not required.

Protocol registration number:

CRD42019129743.
Management and outcomes of hepatorenal syndrome at an urban academic medical center: a retrospective study
Authors: Bashir Muhammad H. , Iqbal Sadat , Miller Regina , Singh Joie , Mubarak Ghassan , Likhtshteyn Michelle , Bigajer Elliot , Gallagher Bridget , Hurairah Abu , Stefanov Dimitre , McFarlane Samy I. , Ferstenberg Richard
Published: June 2019

Objectives

This study is aimed to evaluate the management of acute kidney injury (AKI) in our inner city, American hospital. We intended to ascertain whether or not there is prompt recognition of AKI in cirrhosis according to International Club of Ascites and acute kidney injury network criteria as well how effective we are at distinguishing among different causes of AKI. We aimed to calculated the mortality of hepatorenal syndrome (HRS) in our hospital, and to evaluate the adequacy of the established treatment of AKI at each stage of its algorithm.

Patients and methods

ICD diagnostic codes were used to identify patients with liver cirrhosis and acute renal failure. A total of 725 patients met the search criteria. We excluded the patients without clinical or imaging evidence of ascites, heart failure, on hemodialysis, baseline creatinine more than 1.5 mg/dl and patients who died within 48 h of developing acute renal failure. 291 patients met the inclusion criteria. All statistical analyses were performed using SPSS version 23.0 software with a two-sided significance level set at P value less than 0.05.

Results

Mean age was 55.7 ± 0.61 and baseline serum creatinine was 0.94 ± 0.14. 66.5% of patients were African American, 27.3%, Hispanic, and 4.3% White. The average rise in creatinine from baseline was 1.36 ± 0.08 mg/dl. 27.2% of patients met the diagnostic criteria of HRS. 92.3% of patients with HRS received intravenous fluids and 75.4% received intravenous albumin within 48 h of acute creatinine rise. The in-hospital mortality rate was 14.1, 23.3, and 41.5% for patients with pre-renal azotemia, ARF, and HRS, respectively (P < 0.01).

Conclusion

This study demonstrates that with present tools, there is significantly higher mortality in HRS despite guideline-based treatment. Biomarkers for early diagnosis of HRS are necessary to avoid delays in initiation of HRS treatment while establishing the diagnosis. As well, worldwide standardization of the treatment of HRS will be important if the outcome is to be improved.
Comparisons of Outcomes of Real-World Patients With Advanced Pancreatic Cancer Treated With FOLFIRINOX Versus Gemcitabine and Nab-Paclitaxel
Authors: Papneja Neha , Zaidi Adnan , Chalchal Haji , Moser Michael , Tan Kiat , Olson Colleen , Haider Kamal , Shaw John , Ahmed Shahid
Published: June 2019

Objectives

The aim of this study was to compare the efficacy and safety of FOLFIRINOX (5-FU/leucovorin, irinotecan, and oxaliplatin) and gemcitabine/nab-paclitaxel (GnP) in patients with advanced pancreatic cancer.

Methods

Patients with newly diagnosed advanced pancreatic cancer in Saskatchewan, Canada, from 2011 to 2016, who received FOLFIRINOX or GnP were assessed. A Cox proportional multivariate analysis was performed to evaluate prognostic variables.

Results

One hundred nineteen eligible patients with median age of 61 years and male/female ratio of 70:49 were identified. Seventy-seven percent had metastatic disease. Of 119 patients, 86 (72%) received FOLFIRINOX and 33 (28%) were treated with GnP. Median progression-free survival of the FOLFIRINOX group was 6.0 months [95% confidence interval (CI), 4.5–7.5] versus 4.0 months (95% CI, 2.9–5.1) with GnP (P = 0.39). The median overall survival of the FOLFIRINOX group was 9.0 months (95% CI, 7–11) compared with 9.0 months (95% CI, 4.2–13.8) with GnP (P = 0.88). On multivariate analysis, albumin [hazard ratio (HR), 0.63; 95% CI, 0.41–0.97], male sex (HR, 0.65; 95% CI, 0.43–0.97), and second-line therapy (HR, 0.50; 95% CI, 0.28–0.86) were correlated with survival.

Conclusions

Our results showed that real-world patients with advanced pancreatic cancer treated with FOLFIIRNOX or GnP had comparable survival with different safety profile.
Cold Vibration (Buzzy) Versus Anesthetic Patch (EMLA) for Pain Prevention During Cannulation in Children
Authors: Bourdier Stéphanie , Khelif Nedjoua , Velasquez Maria , Usclade Alexandra , Rochette Emmanuelle , Pereira Bruno , Favard Brigitte , Merlin Etienne , Labbé André , Sarret Catherine , Michaud Elodie
Published: June 2019

Introduction

The purpose of this study was to assess differences in observed pain-related behaviors during cannulation between a device combining cold and vibration (Buzzy) and the standard care (EMLA patch).

Methods

Patients 18 months to 6 years old, requiring venous access in a pediatric emergency department, received either the Buzzy device or the EMLA patch. Predefined week randomization ensured equal allocation to the 2 intervention groups. Pain during cannulation was measured using the Children's Hospital of Eastern Ontario Pain Scale. Parent and nurse reports, cannulation success, and venous access times were also assessed.

Results

In total, 607 included patients were randomized into the Buzzy group (n = 302) or the EMLA group (n = 305). Observed pain-related behaviors scores, parent-assessed pain scores, and nurse-reported pain ratings were higher with Buzzy.

Conclusions

Pain relief by a combination of cold and vibration during cannulation is not as effective as the standard-care method in children 18 months to 6 years old.
Adipose Stem Cells from Lipedema and Control Adipose Tissue Respond Differently to Adipogenic Stimulation In Vitro
Authors: Bauer Anna-Theresa , von Lukowicz Dominik , Lossagk Katrin , Hopfner Ursula , Kirsch Manuela , Moog Philipp , Bauer Hannelore , Machens Hans-Guenther , Schmauss Daniel
Published: June 2019

Background:

Lipedema is characterized by localized accumulation of fat in the extremities, which is typically unresponsive to dietary regimens or physical activity. Although the disease is well described and has a high incidence, little is known regarding the molecular and cellular mechanisms underlying its pathogenesis. The aim of this study was to investigate the pathophysiology of lipedema adipose cells in vitro.

Methods:

Adipose-derived stem cells were isolated from lipoaspirates derived from lipedema and nonlipedema patients undergoing tumescent liposuction. In vitro differentiation studies were performed for up to 14 days using adipogenic or regular culture medium. Supernatants and cell lysates were tested for adiponectin, leptin, insulin-like growth factor-1, aromatase (CYP19A1), and interleukin-8 content at days 7 and 14, using enzyme-linked immunosorbent assays. Adipogenesis was evaluated by visualizing and measuring cytoplasmic lipid accumulation.

Results:

Lipedema adipose-derived stem cells showed impeded adipogenesis already at early stages of in vitro differentiation. Concomitant with a strongly reduced cytoplasmic lipid accumulation, significantly lower amounts of adiponectin and leptin were detectable in supernatants from lipedema adipose-derived stem cells and adipocytes compared with control cells. In addition, lipedema and nonlipedema cells differed in their expression of insulin-like growth factor-1, aromatase (CYP19A1), and interleukin-8 and in their proliferative activity.

Conclusions:

The authors’ findings indicate that in vitro adipogenesis of lipedema adipose-derived stem cells is severely hampered compared with nonlipedema adipose-derived stem cells. Lipedema adipose cells differ not only in their lipid storage capacity but also in their adipokine expression pattern. This might serve as a valuable marker for diagnosis of lipedema, probably from an early stage on.
Air retaining grids—a novel technology to maintain stable air layers under water for drag reduction
Authors: Mail M. , Moosmann M. , Häger P. , Barthlott W.
Published: June 2019

Extreme water repellent ‘superhydrophobic’ surfaces evolved in plants and animals about 450 Ma: a combination of hydrophobic chemistry and hierarchical structuring causes contact angles of greater than 150°. Technical biomimetic applications and technologies for water repellency, self-cleaning (Lotus Effect) and drag reduction (Salvinia Effect) have become increasingly important in the last two decades. Drag reduction (e.g. for ship hulls) requires the presence of a rather thick and persistent air layer under water. All existing technical solutions are based on fragile elastic hairs, micro-pillars or other solitary structures, preferably with undercuts (Salvinia Effect). We propose and provide experimental data for a novel alternative technology to trap persistent air layers by superhydrophobic grids or meshes superimposed to the solid surface: AirGrids. AirGrids provide a simple and stable solution to generate air trapping surfaces for drag reduction under water as demonstrated by first prototypes. Different architectural solutions, including possible recovery techniques for the air layer under hydrodynamic conditions, are discussed. The most promising target backed by first results is the combination of Air Retaining Grids with the existing microbubble technology.

This article is part of the theme issue ‘Bioinspired materials and surfaces for green science and technology (part 2)’.
Bioinspired synthesis of SnO crosses as backbone in artificial sponges
Authors: Jahnke Timotheus , Kilper Stefan , Knöller Andrea , Brümmer Franz , Widenmeyer Marc , Rothenstein Dirk , Burghard Zaklina , Bill Joachim
Published: June 2019

The distinct electronic properties, including p-type semiconducting and a wide optical band gap, renders SnO suitable for applications such as microelectronic devices, gas sensors and electrodes. However, the synthesis of SnO is rather challenging due to the instability of the oxide, which is usually obtained as a by-product of SnO
2
fabrication. In this work, we developed a bioinspired synthesis, based on a hydrothermal approach, for the direct production of SnO nanoparticles. The amount of mineralizer, inducing the precipitation, was identified, which supports a template-free formation of the nanosized SnO particles at low temperature and mild chemical conditions. Moreover, the SnO nanoparticles exhibit a shape of unique three-dimensional crosses similar to the calcite crosses present in the calcareous sponges. We demonstrated that SnO crosses are evenly distributed and embedded in an organic scaffold by an ice-templating approach, in this way closely mimicking the structure of calcareous sponges. Such scaffolds, reinforced by an active material, here SnO, could be used as filters, sensors or electrodes, where a high surface area and good accessibility are essential.

This article is part of the theme issue ‘Bioinspired materials and surfaces for green science and technology (part 2)’.
A Generalized Similarity Metric for Predicting Peptide Binding Affinity
Authors: Rodriguez Jacob , Rath Siddharth , Francis-Landau Jonathan , Demirci Yekta , Üstündağ Burak Berk , Sarikaya Mehmet
Published: June 2019

The ability to capture the relationship between similarity and functionality would enable the predictive design of peptide sequences for a wide range of implementations from developing new drugs to molecular scaffolds in tissue engineering and biomolecular building blocks in nanobiotechnology. Similarity matrices are widely used for detecting sequence homology but depend on the assumption that amino acid mutational frequencies reflected by each matrix are relevant to the system in which they are applied. Increasingly, neural networks and other statistical learning models solve problems related to functional prediction but avoid using known features to circumvent unconscious bias. We demonstrated an iterative alignment method that enhances predictive power of similarity matrices based on a similarity metric, the Total Similarity Score. A generalized method is provided for application to amino acid sequences from inorganic and organic systems by benchmarking it on the debut quartz-binder set and 3 peptide-protein sets from the Immune Epitope Database. Pearson and Spearman Rank Correlations show that by treating the gapless Total Similarity Score as a predictor of relative binding affinity, prediction of test data has a 0.5-0.7 Pearson and Spearman Rank correlation. with respect to size of the dataset. Since the benchmarks used herein are from a solid-binding peptide and a protein-peptide system, our proposed method could prove to be a highly effective general approach for establishing the predictive sequence-function relationships of among the peptides with different sequences and lengths in a wide range of biotechnology, nanomedicine and bioinformatics applications.

Author Summary

The significance of this work is to expand the applicability of a known metric for describing the function of tiny proteins also called peptides. The Total Similarity Score (TSS) can describe how ‘similar’ a peptide, or a group of peptides are to another group of sequences with a known or suspected function. A peptide/group of peptides will always have a high TSS if it contains the same or ‘similar’ amino acids in the same positions. This metric can therefore be used to select peptides for useful functions based purely on conserved amino acids in unknown positions. The greedy search algorithm used to learn how similar amino acids are to each other has been shown to be marginally effective in this larger dataset. Therefore, we argue that the TSS metric is a highly useful one for predicting peptide affinity but a different machine learning algorithm should be applied to make full use of it.
Constructing a high-density linkage map to infer the genomic landscape of recombination rate variation in European Aspen(Populus tremula)
Authors: Apuli Rami-Petteri , Bernhardsson Carolina , Schiffthaler Bastian , Robinson Kathryn M. , Jansson Stefan , Street Nathaniel R. , Ingvarsson Pär K.
Published: June 2019

The rate of meiotic recombination is one of the central factors determining levels of linkage disequilibrium and the efficiency of natural selection, and many organisms show a positive correlation between local rates of recombination and levels of nucleotide diversity indicating that linked selection is an important factor determining genome-wide levels of nucleotide diversity. Several methods for estimating recombination rates from segregating polymorphisms in natural populations have recently been developed. These methods have been extensively used in part because they are relatively simple to implement even in many non-model organisms, but also because they potentially offer higher resolution than traditional map-based methods. However, thorough comparisons of LD and map-based estimates of recombination are not readily available in plants. Here we present a new, high-resolution linkage map forPopulus tremulaand use this to estimate variation in recombination rates across theP. tremulagenome. We compare these results to recombination rates estimated based on linkage disequilibrium in a large number of unrelated individuals. We also assess how variation in recombination rates is associated with genomic features, such as gene density, repeat density and methylation levels. We find that recombination rates obtained from the two methods largely agree, although the LD-based method identify a number of genomic regions with very high recombination rates that the map-based method fail to detect. Linkage map and LD-based estimates of recombination rates are positively correlated and show similar correlations with other genomic features, showing that both methods can accurately infer recombination rate variation across the genome.
Decoding commensal-host communication through genetic engineering ofStaphylococcus epidermidis
Authors: Chen Y. Erin , Bouladoux Nicolas , Hurabielle Charlotte , Mattke Aiden M. , Belkaid Yasmine , Fischbach Michael A.
Published: June 2019

Commensal skin bacteria elicit potent, antigen-specific immune responses in the skin without barrier breach or visible inflammation. While microbial modulation of immune homeostasis has profound consequences for epithelial health and inflammatory skin diseases, the mechanisms of microbe-immune crosstalk in the skin are largely unknown. A key barrier to mechanistic work has been genetic intractability of one of the most prevalent skin colonists,Staphylococcus epidermidis(S. epidermidis). Here, we develop a novel method to create a library of mutants with defined cell envelope alterations in primary humanS. epidermidisisolates. By colonizing mice with these mutants, we uncover bacterial molecules involved in the induction of defined immune signatures. Notably, we show that under conditions of physiologic colonization,S. epidermidiscell envelope glycolipids are sensed by C-type lectin receptors, likely in non-myeloid cells, in conjunction with Toll-like receptors. This combinatorial signaling determines the quality of T cell responses and results in the potential for greater specificity toward commensal microbiota than previously appreciated. Additionally, the microbial molecules required for the colonization-induced immune response are dispensable for T cells responses in a model ofS. epidermidisinfection, but differentially modulate innate inflammatory responses. Thus, the same microbe uses distinct sets of molecules to signal to the immune system commensal versus pathogenic behavior, and differential sensing of these microbial signals depends on host context.