bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Effect of Platelet-Rich Fibrin on Wound Healing at Split-Thickness Skin Graft Donor Sites: A Randomized, Placebo-Controlled, Triple-Blind Study
Authors: Vaheb Mojtaba , Karrabi Maryam , Khajeh Mahtab , Asadi Alireza , Shahrestanaki Ehsan , Sahebkar Mohammad
Published: January 2020

Split-thickness skin grafting (STSG) is widely used to heal wounds resulting from trauma, burns, and chronic wounds. This study aimed to determine the true effect of platelet-rich fibrin (PRF) on patients with burn wounds requiring STSG during treatment of donor wounds. This randomized, triple-blind clinical trial was conducted on patients who referred to the burn ward of Vasei Hospital of Sabzevar, Iran, from May 2017 to May 2018. The donor site was randomly divided into 2 groups: PRF and control (Vaseline petrolatum gauze) using Vaseline gauze. In the intervention group, the PRF gel was applied to the wound and covered with Vaseline gauze and wet dressing. Conversely, only Vaseline gauze and wet dressing were applied to the control group. Outcome evaluation was conducted using paired t test and Wilcoxon signed rank-sum test, as appropriate, on days 8 and 15. The mean age of the patients was 33.10 ± 2.60 years, and 51.50% were male. The mean wound healing time in the PRF and control groups was 11.80 ± 3.51 and 16.30 ± 4.32 days, respectively ( P < .001). The PRF group showed significantly higher wound healing rates than the control group at 8 and 15 days dressing ( P < .001 and P < .001, respectively). Moreover, the mean wound healing for all wound healing indices diagnosed by 2 specialists in PRF was higher than control group on days 8 and 15 ( P < .001). We found a statistically significant difference on days 8 and 15 regarding the mean pain levels between the 2 groups ( P < .001). The findings showed that PRF can significantly increase the time and rate of donor wound healing compared with conventional treatment and also reduce the severity of pain.
Low-voltage electricity network monitoring system: Design and production experience
Authors: Stanimirović Aleksandar , Bogdanović Miloš , Frtunić Milena , Stoimenov Leonid
Published: January 2020

This article describes the low-voltage distribution network monitoring system developed for the Electric Power Industry of Serbia electricity distribution company. The implemented system is deployed in two different regional centers of the Electric Power Industry of Serbia and is being used in production for the past 4 years. During this period, it has collected real-life data which was used to analyze and investigate low-voltage distribution network performances as well as to identify and study energy losses in low-voltage distribution networks. The main contribution of this article is represented by the real-life monitoring and control infrastructure implementation insights. Furthermore, the system we describe in this article became a part of company’s enterprise information system, thus becoming integrated with heterogeneous information sources. This integration generated additional values to the company since the collected measurements started to improve the quality of the decision-making system for everyday business processes.
A novel terbium–mercury compound: Preparation, structure, and properties
Authors: Chen Wen-Tong
Published: January 2020

Using a hydrothermal reaction, a novel 4f–5d isonicotinic acid complex {[Tb2(IA)6(H2O)4](Hg3Cl7)} n( nHgCl4)· nCl·4 nH3O (1, HIA = isonicotinic acid) was synthesized and it was characterized by single crystal X-ray diffraction technique. Compound 1 is characterized by a two-dimensional layer-like structure. The photoluminescence measurement using solid-state samples uncovered that it shows four emission peaks at 489, 546, 587, and 622 nm, of which the peak at 546 nm is the strongest. These peaks could be assigned to the 5 D4 → 7 F6, 5 D4 → 7 F5, 5 D4 → 7 F4, and 5 D4 → 7 F3 transitions of the Tb3+ ions, respectively. The energy transfer mechanism of the photoluminescence emission was described by means of the energy level scheme of the Tb3+ ions and the isonicotinic acid ligand. Compound 1 shows remarkable CIE (Commission Internationale de I’Éclairage) chromaticity coordinates of (0.3633, 0.5038) in the yellowish green region. Compound 1 possesses a wide semiconductor band gap of 2.97 eV, as unveiled by the solid-state UV-Vis diffuse reflectance experiment.
Who Goes to Shows? Race-ethnicity and the Visual and Performing Arts
Authors: Patterson Nile DeGray
Published: January 2020

Using data from the 2012 Survey of Public Participation in the Arts, I investigate whether education’s influence on the likelihood of visual and performing arts attendance in the USA varies by race-ethnicity. The results reveal that education increases the odds of attendance for both Whites and non-Whites, but it has a stronger impact upon the former than the latter. Unlike Whites, education’s effect on attending visual and performing arts activities for non-Whites is insignificant for high school diploma recipients when compared to their counterparts with some college education.

These findings suggest a racial-ethnic bias in visual and performing arts attendance net of education that connects to the European roots of “legitimate” art in modern western society and the history of US racial discrimination. European Americans have dominated the USA’s social institutions for centuries and have held prejudices against minorities’ artistic capabilities since the colonial era. Consequentially, they could determine which arts genres provide valuable cultural capital. Conversely, minority art communities have only recently acquired the resources for self-sustainability. This likely limited their ability to develop formal institutions within their own communities to support the arts.
The effect of surgery for basal osteoarthritis of the thumb on dart thrower’s motion
Authors: Elajnaf Mohamed , Rust Philippa A. , Wallace Robert
Published: January 2020

This study aimed to identify the effects of basal thumb surgery on the range of dart thrower’s motion. Thirteen fresh-frozen cadaveric specimens were placed in a customized jig. Simulated scaphotrapeziotrapezoid joint fusion was carried out on all specimens. Half the specimens then underwent trapeziectomy and the rest had excision of the distal pole of the scaphoid. Simulated scaphotrapeziotrapezoid fusion reduced the range of dart thrower’s motion to 89% of the range in the intact wrists, from a mean of 117° to 104°. Although this reduction is not large, it was statistically significant. Simulated trapeziectomy caused a very small increase in dart thrower’s motion range compared with the range in the intact wrists. Simulated distal pole of scaphoid excision did not change the range of dart thrower’s motion. These results may inform preoperative decisions for surgical management of basal osteoarthritis of the thumb.
Toward a model to apprehend the complexity of manufacturing firm’s overall performance
Authors: Lamjahdi Aicha , Bouloiz Hafida , Gallab Maryam
Published: January 2020

Recently, the company’s overall performance (OP) has become a major concern of our modern society, as a key factor that can potentially increase firm’s competitive advantage and ensure its sustainable development. However, OP is increasingly being considered as highly complex because of the complex interrelationships within industrial systems. This article presents a contribution to modeling of OP in order to apprehend its complexity and take into account the interactions between all its aspects. The proposed model is based on a combination of the value chain concept and System Modeling Language modeling. The main study established an OP indicators system to better present the firm sustainability behavior, and thus provide a comprehensive view that facilitates an in-depth understanding of its complexity. Besides, a case study from the dairy industry is presented to illustrate the model. This model can identify different activities’ interactions in the firm and understand interrelationships between OP dimensions and firm’s activities. Moreover, the proposed indicators system helps to define OP problems in the firm. Such knowledge enables managers to identify OP problems’ drivers, the related activities and set up the optimal solutions to improve the most critical activities whose performance affect the whole value chain.
China’s “Belt and Road” Economic Diplomacy in the Persian Gulf: Strategic Hedging amidst Saudi–Iranian Regional Rivalry
Authors: Garlick Jeremy , Havlová Radka
Published: January 2020

Drawing on the literature on strategic hedging and adapting it to China’s use of economic diplomacy in the service of comprehensive national security goals within the regionalised foreign policy approach of the Belt and Road Initiative (BRI), we examine China’s approach to securing and expanding its interests in the Persian Gulf. To implement the trade and infrastructure connectivity goals of the BRI and to secure the continued flow of diversified energy supplies, China needs to boost relations with both regional powerhouses, Iran and Saudi Arabia, without alienating either of them or the regional hegemon, the United States. The resulting strategy of strategic hedging is based in the Chinese approach to economic diplomacy, which utilises Chinese commercial actors in the service of national strategic objectives. Relations require careful and ongoing management if China is to achieve outcomes which benefit all sides while avoiding becoming entangled in the region’s intractable geopolitical problems.
Homicidal Paraquat Poisoning Following Ligature Strangulation
Authors: Ruwanpura Rohan , Nandasiri Chathura
Published: January 2020

We report a case of homicidal paraquat poisoning preceded by attempted manual strangulation. The poison had been forcibly ingested when the victim was unconscious due to pressure on the neck. The victim survived for ten days and died due to development of fibrosing alveolitis. The autopsy showed classic features of proliferative stages of paraquat poisoning and healing signs of ligature strangulation.
A Two-Year Experience of Gender-Based Violence at a Pioneer One Stop Crisis Center: Sukoon
Authors: Gambhir Sunil , Aggarwal Akash Deep , Mahajan Aatika , Setiya Ritu
Published: January 2020

This paper examines violence against women, with a special focus on domestic violence, along with sexual violence and sexual assault, in multidimensional perspective for the period of two years so as to understand its magnitude and its impact on the rights of women in the northern part of India. Among all such cases, there were 57.2% cases of domestic violence, 20.3% cases of sexual violence and sexual assault, 17.8% cases of attempted poisoning, 1.5% cases of homicidal burns, and 1.2% cases of attempted suicide. The greatest number of cases was recorded during the spring, followed by summer. It was observed that the greatest number of cases (60.24%) was recorded under the homemaker (housewife) category of women followed by the working category (26.80%). The greatest number of cases is seen in the age group of 20 to 30 years (42.77%), followed by the age group of 30 to 40 years (23.49%). A slightly higher number of cases (51.20%) was reported from rural areas. The greatest number of cases was recorded under the domestic violence category. The second highest percentage of cases reported involved sexual violence and sexual assault. The greatest number of married cases had a duration of zero to ten years (43.37%), followed by the unmarried category (19.87%). With reference to duration of violence, the greatest number of cases is seen in the age group of zero to six months (32.53%). The greatest number of cases is seen under the no child category (40.96%). Regarding the alleged perpetrator, the greatest number of cases is seen under the husband category (23.79%), followed by unknown category (22.28%).
“I Struggled But I Made It”: Black Gifted Underachievers on Transitioning to College
Authors: Sewell Christopher J. P. , Goings Ramon B.
Published: January 2020

Research on Black student presence in gifted and talented programs consistently illuminates issues with recruitment and underrepresentation. While enrolled, gifted Black students face a series of issues that affect their ability to persist and achieve, especially in nondiverse environments. This work examines the reflections of four Black adults who attended gifted schools in New York City and encountered significant hurdles during their K–12 schooling. These findings are excerpted from a larger qualitative study that investigated how Black adults, who were identified as gifted in New York City Public Schools, reflected on their experiences as gifted students and how they leveraged those experiences to persist to and through college. Using Schlossberg’s model for adapting to transitions as the theoretical frame, findings suggest that participants received limited guidance as they transitioned to college but learned many lessons that led to become productive in college.
CEO Overconfidence and Firm Performance: The Moderating Effect of Restaurant Franchising
Authors: Kim Hong Soon , Jang SooCheong (Shawn)
Published: January 2020

This study examined the effect of CEO overconfidence on restaurant performance and how franchising, a key business format in the restaurant industry, affects the relationship. Based on the notion that overconfident individuals take more risks than non-overconfident people, this study hypothesized that CEO overconfidence positively (negatively) influences restaurant growth (profitability). Furthermore, since franchising reduces operational and financial risk, this study hypothesized that franchising moderates the relationship between CEO overconfidence and firm performance. The results of this study confirmed that CEO overconfidence positively influences firm growth but negatively affects firm profitability in the restaurant industry. This study also found that franchising negatively (positively) influences the effect of CEO overconfidence on restaurant firm growth (profitability). The results suggest that overconfident CEOs are more suitable for growth-seeking restaurant firms but less desirable for profit-seeking firms. The results also highlight that franchising mitigates the risk associated with CEO overconfidence. More detailed results and implications are discussed in this article.
Acute respiratory failure and inflammatory response after out-of-hospital cardiac arrest: results of the Post-Cardiac Arrest Syndrome (PCAS) pilot study
Authors: Czerwińska-Jelonkiewicz Katarzyna , Grand Johannes , Tavazzi Guido , Sans-Rosello Jordi , Wood Alice , Oleksiak Anna , Buszman Piotr , Krysiński Mateusz , Sionis Alessandro , Hassager Christian , Stępińska Janina
Published: January 2020

Background:

Although the lungs are potentially highly susceptible to post-cardiac arrest syndrome injury, the issue of acute respiratory failure after out-of-hospital cardiac arrest has not been investigated. The objectives of this analysis were to determine the prevalence of acute respiratory failure after out-of-hospital cardiac arrest, its association with post-cardiac arrest syndrome inflammatory response and to clarify its importance for early mortality.

Methods:

The Post-Cardiac Arrest Syndrome (PCAS) pilot study was a prospective, observational, six-centre project (Poland 2, Denmark 1, Spain 1, Italy 1, UK 1), studying patients resuscitated after out-of-hospital cardiac arrest of cardiac origin. Primary outcomes were: (a) the profile of organ failure within the first 72 hours after out-of-hospital cardiac arrest; (b) in-hospital and short-term mortality, up to 30 days of follow-up. Respiratory failure was defined using a modified version of the Berlin acute respiratory distress syndrome definition. Inflammatory response was defined using leukocytes (white blood cells), platelet count and C-reactive protein concentration. All parameters were assessed every 24 hours, from admission until 72 hours of stay.

Results:

Overall, 148 patients (age 62.9±15.27 years; 27.7% women) were included. Acute respiratory failure was noted in between 50 (33.8%) and 75 (50.7%) patients over the first 72 hours. In-hospital and short-term mortality was 68 (46.9%) and 72 (48.6%), respectively. Inflammation was significantly associated with the risk of acute respiratory failure, with the highest cumulative odds ratio of 748 at 72 hours (C-reactive protein 1.035 (1.001–1.070); 0.043, white blood cells 1.086 (1.039–1.136); 0.001, platelets 1.004 (1.001–1.007); <0.005). Early acute respiratory failure was related to in-hospital mortality (3.172, 95% confidence interval 1.496–6.725; 0.002) and to short-term mortality (3.335 (1.815–6.129); 0.0001).

Conclusions:

An inflammatory response is significantly associated with acute respiratory failure early after out-of-hospital cardiac arrest. Acute respiratory failure is associated with a worse early prognosis after out-of-hospital cardiac arrest.
Hidden Long Head of the Biceps Tendon Instability and Concealed Intratendinous Subscapularis Tears
Authors: Chae Sang Hoon , Jung Tae Wan , Lee Sang Hyeon , Kim Myo Jong , Park Seung Min , Jung Jeung Yeol , Yoo Jae Chul
Published: January 2020

Background:

Few studies have described the characteristics of a concealed intratendinous subscapularis tear (CIST), and there is a lack of research on the preoperative predictability of such lesions.

Purpose:

To describe the characteristics of a CIST as seen on magnetic resonance imaging (MRI) and intraoperatively and to develop a scoring system for predicting such lesions.

Study Design:

Case series; Level of evidence, 4.

Methods:

Retrospectively, we identified 43 patients with CISTs among 442 consecutive patients who had undergone rotator cuff repair from July 2014 to June 2016. Range of motion, visual analog scale results for pain and function, and patient-reported outcome scores were evaluated preoperatively and at 1 and 2 years postoperatively. CISTs were classified arthroscopically as small (<5 mm), medium (5-10 mm), and large (>10 mm). We performed repair (≥50%) or debridement (<50%) depending on the total subscapularis tendon tear size including the CIST. Preoperative MRI findings were analyzed by 2 observers and were correlated with the arthroscopic findings. A 10-point scoring system was developed based on characteristics during the physical examination (anterior tenderness, bear hug sign), MRI (biceps tendon displacement and subluxation, subscapularis signal change just lateral to the lesser tuberosity), and arthroscopic surgery (medial biceps tendon lesion, combined subscapularis tendon tear), with a cutoff value of ≥7 predicting a CIST. After the retrospective study, we prospectively enrolled 95 patients to validate the 10-point CIST scoring system.

Results:

All 43 patients diagnosed with a CIST during the retrospective study improved both range of motion and functional scores at 1 year postoperatively. The interrater agreement of the 2 observers was substantial for the evaluation of all parameters except for subscapularis tear classification, which was moderate. On arthroscopic surgery, 11 small, 19 medium, and 13 large CISTs were detected. The preliminary prospective study showed a sensitivity of 61.9%, specificity of 94.3%, positive predictive value of 89.0%, negative predictive value of 75.7%, and accuracy of 80.0% when the cutoff value was set at ≥7 on the CIST scoring system.

Conclusion:

A CIST can be suspected using a combination of preoperative MRI and intra-articular diagnostic arthroscopic findings, but a definitive diagnosis requires an arthroscopic view. On the 10-point CIST scoring system, a score of ≥5 can be suggestive of a CIST, and a score of ≥7 is most likely to predict a CIST.
Historical Appropriation of Epistemological Values: A Goal Ahead for Higher Education
Authors: Prabakaran Madhu
Published: January 2020

The historical appropriation of epistemological values is the theme of the article. Bachelard, one of the pioneering thinkers on epistemological evolution, presupposed that historical epistemology will culminate in the end of its history. Scientific imagination should be decluttered from human sentimentalities, Bachelard observed. For that, it is necessary that academics has to psychoanalytically purge himself/herself from his/her path dependencies, originary misperceptions and methodological inappropriateness. Thinking along with Bachelard, I explore whether higher education can be channelized towards evolutionary ascendance of epistemological values.
The electronic nose: emerging biomarkers in lung cancer diagnostics
Authors: van Geffen Wouter H. , Lamote Kevin , Costantini Adrien , Hendriks Lizza E.L. , Rahman Najib M. , Blum Torsten G. , van Meerbeeck Jan
Published: January 2020

Lung cancer is very common and the most common cause of cancer death worldwide. Despite recent progress in the systemic treatment of lung cancer (checkpoint inhibitors and tyrosine kinase inhibitors), each year, >1.5 million people die due to this disease. Most lung cancer patients already have advanced disease at the time of diagnosis. Computed tomography screening of high-risk individuals can detect lung cancer at an earlier stage but at a cost of false-positive findings. Biomarkers could lead towards a reduction of these false-positive findings and earlier lung cancer diagnosis, and have the potential to improve outcomes and treatment monitoring. To date, there is a lack of such biomarkers for lung cancer and other thoracic malignancies, although electronic nose (e-nose)-derived biomarkers are of interest.

E-nose techniques using exhaled breath component measurements can detect lung cancer with a sensitivity ranging from 71% to 96% and specificity from 33 to 100%. In some case series, such results have been validated but this is mostly using internal validation and hence, more work is needed. Furthermore, standardised sampling and analysis methods are lacking, impeding interstudy comparison and clinical implementation. In this narrative review, we provide an overview of the currently available data on E-nose technology for lung cancer detection.
Burden of migraine in Finland: multimorbidity and phenotypic disease networks in occupational healthcare
Authors: Korolainen Minna A. , Tuominen Samuli , Kurki Samu , Lassenius Mariann I. , Toppila Iiro , Purmonen Timo , Santaholma Jaana , Nissilä Markku
Published: January 2020

Background

Migraine is a complex neurological disorder with high co-existing morbidity burden. The aim of our study was to examine the overall morbidity and phenotypic diseasome for migraine among people of working age using real world data collected as a part of routine clinical practice.

Methods

Electronic medical records (EMR) of patients with migraine (n = 17,623) and age- and gender matched controls (n = 17,623) were included in this retrospective analysis. EMRs were assessed for the prevalence of ICD-10 codes, those with at least two significant phi correlations, and a prevalence >2.5% in migraine patients were included to phenotypic disease networks (PDN) for further analysis. An automatic subnetwork detection algorithm was applied in order to cluster the diagnoses within the PDNs. The diagnosis-wise connectivity based on the PDNs was compared between migraine patients and controls to assess differences in morbidity patterns.

Results

The mean number of diagnoses per patient was increased 1.7-fold in migraine compared to controls. Altogether 1337 different ICD-10 codes were detected in EMRs of migraine patients. Monodiagnosis was present in 1% and 13%, and the median number of diagnoses was 12 and 6 in migraine patients and controls. The number of significant phi-correlations was 2.3-fold increased, and cluster analysis showed more clusters in those with migraine vs. controls (9 vs. 6). For migraine, the PDN was larger and denser and exhibited one large cluster containing fatigue, respiratory, sympathetic nervous system, gastrointestinal, infection, mental and mood disorder diagnoses. Migraine patients were more likely affected by multiple conditions compared to controls, even if no notable differences in morbidity patterns were identified through connectivity measures. Frequencies of ICD-10 codes on a three character and block level were increased across the whole diagnostic spectrum in migraine.

Conclusions

Migraine was associated with an increased multimorbidity, evidenced by multiple different approaches in the study. A systematic increase in the morbidity across the whole spectrum of ICD-10 coded diagnoses, and when interpreting PDNs, were detected in migraine patients. However, no specific diagnoses explained the morbidity. The results reflect clinical praxis, but also undoubtedly, the pathophysiological phenotypes related to migraine, and emphasize the importance of better understanding migraine-related morbidity.
One-step, Rapid and Green Synthesis of Multifunctional Gold Nanoparticles for Tumor-Targeted Imaging and Therapy
Authors: Yin Hua Qin , Shao Guang , Gan Feng , Ye Gang
Published: January 2020

Gold nanoparticles (GNPs) have always been used as doxorubicin (DOX) transport vectors for tumor diagnosis and therapy; however, the synthesis process of these vectors is to prepare GNPs via chemical reduction method firstly, followed by conjugation with DOX or specific peptides, so these meth•ods faced some common problems including multiple steps, high cost, time consuming, complicated preparation, and post-processing. Here, we present a one-step strategy to prepare the DOX-conjugated GNPs on the basis of DOX’s chemical constitution for the first time. Moreover, we prepare a multifunctional GNPs (DRN-GNPs) with a one-step method by the aid of the reductive functional groups possessed by DOX, RGD peptides, and nuclear localization peptides (NLS), which only needs 30 min. The results of scattering images and cell TEM studies indicated that the DRN-GNPs could target the Hela cells’ nucleus. The tumor inhibition rates of DRN-GNPs via tumor and tail vein injection of nude mice were 66.7% and 57.7%, respectively, which were significantly enhanced compared to control groups. One step synthesis of multifunctional GNPs not only saves time, materials, but also it is in line with the development direction of green chemistry, and it would lay the foundation for large-scale applications within the near future. Our results suggested that the fabrication strategy is efficient, and our prepared DRN-GNPs possess good colloidal stability in the physiological system; they are a potentially contrast agent and an efficient DOX transport vector for cervical cancer diagnosis and therapy.
Severe visual impairment due to an optic neuropathy and central retinal vein occlusion in a sarcoidosis patient
Authors: Hiraoka Miki
Published: January 2020

Background

The ophthalmic manifestation of neurosarcoidosis is varied. The complication of optic neuropathy and central retinal vein occlusion (CRVO) is rare in sarcoidosis.

Case report

The patient was a 55-year-old female with systemic sarcoidosis suffering from visual loss as hand motion in her left eye. A fundus examination showed severe optic disc head edema and hyperemia, and a central retinal vein occlusion phenotype including engorgement of all branches of the central retinal vein, dot, and flame-shaped hemorrhages. Brain magnetic resonance imaging (MRI) revealed irregular hypertrophy of the left retrobulbar optic nerve. She received several sets of pulse therapy with intravenous methylprednisolone. Although fundus findings of her left eye and the legion around the left retrobulbar optic nerve showed improvement, the final visual outcome was light perception due to optic nerve atrophy.

Conclusions

Our findings suggest neurosarcoidosis of the unilateral retrobulbar optic nerve can cause compressive optic disc edema and resembles the central retinal vein occlusion (CRVO) phenotype.
BigTop: a three-dimensional virtual reality tool for GWAS visualization
Authors: Westreich Samuel T. , Nattestad Maria , Meyer Christopher
Published: January 2020

Background

Genome-wide association studies (GWAS) are typically visualized using a two-dimensional Manhattan plot, displaying chromosomal location of SNPs along the x-axis and the negative log-10 of their p-value on the y-axis. This traditional plot provides a broad overview of the results, but offers little opportunity for interaction or expansion of specific regions, and is unable to show additional dimensions of the dataset.

Results

We created BigTop, a visualization framework in virtual reality (VR), designed to render a Manhattan plot in three dimensions, wrapping the graph around the user in a simulated cylindrical room. BigTop uses the z-axis to display minor allele frequency of each SNP, allowing for the identification of allelic variants of genes. BigTop also offers additional interactivity, allowing users to select any individual SNP and receive expanded information, including SNP name, exact values, and gene location, if applicable. BigTop is built in JavaScript using the React and A-Frame frameworks, and can be rendered using commercially available VR headsets or in a two-dimensional web browser such as Google Chrome. Data is read into BigTop in JSON format, and can be provided as either JSON or a tab-separated text file.

Conclusions

Using additional dimensions and interactivity options offered through VR, we provide a new, interactive, three-dimensional representation of the traditional Manhattan plot for displaying and exploring GWAS data.
A systemic approach to screening high-throughput RT-qPCR data for a suitable set of reference circulating miRNAs
Authors: Pagacz Konrad , Kucharski Przemyslaw , Smyczynska Urszula , Grabia Szymon , Chowdhury Dipanjan , Fendler Wojciech
Published: January 2020

Background

The consensus on how to choose a reference gene for serum or plasma miRNA expression qPCR studies has not been reached and none of the potential candidates have yet been convincingly validated. We proposed a new in silico approach of finding a suitable reference for human, circulating miRNAs and identified a new set of endogenous reference miRNA based on miRNA profiling experiments from Gene Expression Omnibus. We used 3 known normalization algorithms (NormFinder, BestKeeper, GeNorm) to calculate a new normalization score. We searched for a universal set of endogenous miRNAs and validated our findings on 2 new datasets using our approach.

Results

We discovered and validated a set of 13 miRNAs (miR-222, miR-92a, miR-27a, miR-17, miR-24, miR-320a, miR-25, miR-126, miR-19b, miR-199a-3p, miR-30b, miR-30c, miR-374a) that can be used to create a reliable reference combination of 3 miRNAs. We showed that on average the mean of 3 miRNAs (p = 0.0002) and 2 miRNAs (p = 0.0031) were a better reference than single miRNA. The arithmetic means of 3 miRNAs: miR-24, miR-222 and miR-27a was shown to be the most stable combination of 3 miRNAs in validation sets.

Conclusions

No single miRNA was suitable as a universal reference in serum miRNA qPCR profiling, but it was possible to designate a set of miRNAs, which consistently contributed to most stable combinations.
Correction to: Piphillin predicts metagenomic composition and dynamics from DADA2- corrected 16S rDNA sequences
Authors: Narayan Nicole R. , Weinmaier Thomas , Laserna-Mendieta Emilio J. , Claesson Marcus J. , Shanahan Fergus , Dabbagh Karim , Iwai Shoko , DeSantis Todd Z.
Published: January 2020

Following the publication of this article [1], the authors reported errors in Figs. 1, 2 and 5. Due to a typesetting error the asterisks denoting significance were missing from the published figures.
Reliable reference genes for the quantification of mRNA in human T-cells and PBMCs stimulated with live influenza virus
Authors: Roy Justin G. , McElhaney Janet E. , Verschoor Chris P.
Published: January 2020

Background

Quantitative PCR (qPCR) is a powerful tool that is particularly well-suited to measure mRNA levels in clinical samples, especially those with relatively low cell counts. However, a caveat of this approach is that reliable, stably expressed reference (housekeeping) genes are vital in order to ensure reproducibility and appropriate biological inference. In this study, we evaluated the expression stability of six reference genes in peripheral blood mononuclear cells (PBMCs) and isolated CD3+ T-cells from young and old adults (n = 10), following ex vivo stimulation with mock (unstimulated) or live influenza virus. Our genes included: β-actin (ACTB), glyercaldehyde-3-phostphate dehydrogenase (GAPDH), ribosomal protein L13a (RPL13a), ribosomal protein S18 (RPS18), succinate dehydrogenase complex flavoprotein subunit A (SDHA), and ubiquitin-conjugating enzyme E2D2 (UBE2D2).

Results

Reference gene expression varied significantly depending on cell type and stimulation conditions, but not age. Using the comparative ΔCt method, and the previously published software BestKeeper, NormFinder, and geNorm, we show that in PBMCs and T-cells, UBE2D2 and RPS18 were the most stable reference genes, followed by ACTB; however, the expression of UBE2D2 and RPS18 was found to increase with viral stimulation in isolated T-cells, while ACTB expression did not change significantly. No age-related differences in stability were observed for any gene

Conclusions

This study suggests the use of a combination of UBE2D2, RPS18, and ACTB for the study of influenza responses in PBMCs and T-cells, although ACTB alone may be the most optimal choice if choosing to compare target gene expression before and after viral stimulation. Both GAPDH and RPL13a were found to be poor reference genes and should be avoided for studies of this nature.
Translating facilitated multimodal online learning into effective person-centred practice for the person living with dementia among health care staff in Australia: an observational study
Authors: DeSouza K. , Pit S. W. , Moehead A.
Published: January 2020

Background

This paper aims to identify whether health care staff perceive a 12-week online facilitated, multimodal, person-centred care, dementia education program influences their knowledge, skills, behaviour and practice improvement activities in dementia care. In particular it will examine a dementia education program ‘Positive Approach to Care of the Older Person with Dementia’ (The Program).

Methods

Three clusters of online questions were developed. Participants completed the first cluster at course completion (N = 1455;2013–2016). The second cluster was added into the 2015–2016 exit-surveys to measure clinical practice improvement (CPI) activities implementation (N = 520). Thirdly, all participants were invited to a 2018 follow-up survey (N = 343). The Program was also matched with key factors that are likely to result in effective online dementia education programs.

Results

The Program had a 78% completion rate. At course completion (2013–2016,N = 1455), 62% felt that the online forums generated useful discussion and 92% thought their work would support implementing their new knowledge and skills. In 2015–16, participants (N = 520) reported that The Program had influenced their practice in terms of new knowledge (87%), understanding (87%), awareness (88%), and new ideas about delivering dementia care (80%). Almost all (95%) participants indicated they had changed ‘an aspect of their own professional practice’. Sixty-three percent had planned to develop a CPI activity. Of those (N = 310), 40% developed a new or improved tool and 21% planned to deliver education or create new resources. The most common CPI activities reported in the 2018 follow-up survey (N = 343) included education (49%) and role modelling of new behaviour (47%). Additionally, 75% indicated their CPI influenced their practice and had influenced patients (53%) and colleagues (53%). Fifty-seven percent reported their projects were sustained for 12 months or more.

Conclusion

ThePositive Approach to Care of the Older Person with Dementiaeducation program can potentially improve training the dementia workforce. Participants perceived that a multimodal online platform facilitated by clinical champions influences knowledge transfer, skills and behaviour, encourages workplace CPI activities. Further effort could be directed towards empowering and supporting care staff on system, procedure and practice change and engaging management to translate training activities into practice.
Modifiable factors related to life-space mobility in community-dwelling older adults: results from the Canadian Longitudinal Study on Aging
Authors: Kuspinar A. , Verschoor CP , Beauchamp MK , Dushoff J. , Ma J. , Amster E. , Bassim C. , Dal Bello-Haas V. , Gregory M. A. , Harris JE , Letts L. , Neil-Sztramko S. E. , Richardson J. , Valaitis R. , Vrkljan B.
Published: January 2020

Background

The most common methods for measuring mobility in older adulthood include performance-based tests, such as the Timed-Up-and-Go and gait speed. While these measures have strong predictive validity for adverse outcomes, they are limited to assessing what older adults do in standardized settings, rather than what they do in their daily life. Life-space mobility, which is the ability to move within environments that expand from one’s home to the greater community, has been proposed as a more comprehensive measure of mobility. The aim of this study was to determine the association between modifiable factors and life-space mobility in older adults enrolled in the Canadian Longitudinal Study on Aging (CLSA).

Methods

Life-space mobility was measured using the Life Space Index (LSI). Explanatory factors included physical, psychosocial and cognitive determinants, as well as pain, fatigue, driving status, nutrition, body mass index, smoking status, and vision. To estimate the association between the LSI and explanatory variables, univariate and multivariable ordinary least squares regression analyses were performed.

Results

All adults 65 years and older (n = 12,646) were included in the analysis. Fifty percent were women and the mean age was 73.0 (SD5.7). The mean LSI score was 80.5, indicating that, on average, the sample was able to move outside of their neighborhood independently. All explanatory variables were significantly associated with the LSI except for balance and memory. The top 3 variables that explained the most variation in the LSI were driving, social support and walking speed.

Conclusion

To our knowledge, this was the first study to examine the association between life-space mobility and a comprehensive set of modifiable factors that were selected based on a theoretical framework and existing research evidence. This study had two important messages. First, driving, social support and walking speed emerged as the most significant correlates of life-space mobility in older adults. Second, life-space mobility is multifactorial and interventions that are pragmatic in their design and testing are needed that consider the complexity involved. A multi-disciplinary approach to examining life-space mobility in older adults is needed to optimize opportunities for healthy aging and develop strategies that support mobility in older adulthood.
A mycotic aneurysm related to Salmonella Rissen infection: a case report
Authors: Nagrodzki Jakub , Sharrocks Katherine E. , Wong Vanessa K. , Carmichael Andrew J.
Published: January 2020

Background

Salmonella species commonly causes infection in humans and on occasion leads to serious complications, such as mycotic aneurysms. Here, we present the first case reported of a patient with a mycotic aneurysm likely secondary to Salmonella Rissen infection.

Case presentation

The patient presented with 4 weeks of lower back pain, chills and a single episode of diarrhoea 2 months prior during a 14-day trip to Hong Kong and Taiwan. Magnetic resonance imaging revealed an aneurysmal left internal iliac artery with adjacent left iliacus rim-enhancing collection. A stool culture was positive for Salmonella Rissen ST 469 EBG 66 on whole genome sequencing. The patient underwent an emergency bifurcated graft of his internal iliac aneurysm and was successfully treated with appropriate antibiotics.

Conclusions

This case highlights the importance of considering the diagnosis of a mycotic aneurysm in an unusual presentation of back pain with features of infection.
DSP p.(Thr2104Glnfs*12) variant presents variably with early onset severe arrhythmias and left ventricular cardiomyopathy
Authors: Heliö Krista , Kangas-Kontio Tiia , Weckström Sini , Vanninen Sari U. M. , Aalto-Setälä Katriina , Alastalo Tero-Pekka , Myllykangas Samuel , Heliö Tiina M. , Koskenvuo Juha W.
Published: January 2020

Background

Dilated cardiomyopathy (DCM) is a condition characterized by dilatation and systolic dysfunction of the left ventricle in the absence of severe coronary artery disease or abnormal loading conditions. Mutations in the titin (TTN) and lamin A/C (LMNA) genes are the two most significant contributors in familial DCM. Previously mutations in the desmoplakin (DSP) gene have been associated with arrhythmogenic right ventricular cardiomyopathy (ARVC) and more recently with DCM.

Methods

We describe the cardiac phenotype related to a DSP mutation which was identified in ten unrelated Finnish index patients using next-generation sequencing. Sanger sequencing was used to verify the presence of this DSP variant in the probands’ relatives. Medical records were obtained, and clinical evaluation was performed.

Results

We identified DSP c.6310delA, p.(Thr2104Glnfs*12) variant in 17 individuals of which 11 (65%) fulfilled the DCM diagnostic criteria. This pathogenic variant presented with left ventricular dilatation, dysfunction and major ventricular arrhythmias. Two patients showed late gadolinium enhancement (LGE) and myocardial edema on cardiac magnetic resonance imaging (MRI) that may suggest inflammatory process at myocardium.

Conclusions

The patients diagnosed with DCM showed an arrhythmogenic phenotype as well as SCD at young age supporting the recently proposed concept of arrhythmogenic cardiomyopathy. This study also demonstrates relatively low penetrance of truncating DSP variant in the probands’ family members by the age of 40. Further studies are needed to elucidate the possible relations between myocardial inflammation and pathogenic DSP variants.
Diagnostic and treatment challenge of unrecognized subacute bacterial endocarditis associated with ANCA-PR3 positive immunocomplex glomerulonephritis: a case report and literature review
Authors: Bele D. , Kojc N. , Perše M. , Černe Čerček A. , Lindič J. , Aleš Rigler A. , Večerić-Haler Ž.
Published: January 2020

Background

Diagnosis and treatment of either ANCA disease or silent infection-related glomerulonephritis is complicated and is a huge treatment challenge when overlapping clinical manifestations occur. We report a case of ANCA-PR3 glomerulonephritis, nervous system involvement, hepatosplenomegaly and clinically silent subacute infectious endocarditis.

Case presentation

A 57-year-old man with known mitral valve prolaps was admitted for unexplained renal failure with signs of nephritic syndrome, hepatosplenomegaly, sudden unilateral hearing loss, vertigo, malaise, new onset hemolytic anemia and thrombocytopenia. Immunoserology revealed positive c-anti-neutrophil cytoplasm antibody (ANCA)/anti-proteinase 3 (anti-PR3), mixed type crioglobulinemia and lowered complement fraction C3. Head MRI showed many microscopic hemorrhages. Common site of infection, as well as solid malignoma were ruled out. In accordance with clinical and laboratory findings, systemic vasculitis was assumed, although the etiology remained uncertain (ANCA-associated, cryoglobulinemic or related to unrecognized infection). After kidney biopsy, clinical signs of sepsis appeared. Blood cultures revealed Streptococcus cristatus. Echocardiography showed mitral valve endocarditis. Kidney biopsy revealed proliferative, necrotizing immunocomplex glomerulonephritis. Half a year later, following intravenous immunoglobulins, glucocorticoids, antibiotic therapy and surgical valve repair, the creatinine level decreased and c-ANCA and cryoglobulins disappeared. A second kidney biopsy revealed no residual kidney disease. Four years after treatment, the patient is stable with no symptoms or signs of vasculitis recurrence.

Conclusions

Here we describe the diagnostic and treatment challenge in a patient with unrecognized subacute bacterial endocarditis associated with ANCA-PR3 immunocomplex proliferative and crescentic glomerulonephritis. In patients with ANCA-PR3 immunocomplex glomerulonephritis and other overlapping manifestations suggesting systemic disease, it is important to recognize and aggressively treat any possible coexisting bacterial endocarditis, This is the most important step for a favorable patient outcome, including complete clinical and pathohistological resolution of the glomerulonephritis.
Sexual dysfunction and mental health in patients with multiple sclerosis and epilepsy
Authors: Petersen Marian , Kristensen Ellids , Giraldi Laura , Giraldi Annamaria
Published: January 2020

Background

Epilepsy and multiple sclerosis (MS) are two neurological diseases known to greatly influence a patient’s life. The primary aim of this study was to describe the prevalence of sexual dysfunction in patients with epilepsy and MS and investigate whether there is an association between disease, sexual function, and physical and mental health. A secondary aim was to investigate whether there is a difference in sexual function between patients with MS and epilepsy.

Methods

A total of 414 patients were included in this descriptive cross-sectional study. Three patient report questionnaires were used for measurements: the Changes in Sexual Function Questionnaire (CSFQ) cut-off score; the Short Form 36 Health Survey (SF-36) divided into the Physical Component Summary (PCS) and Mental Component Summary (MCS), and the Life Satisfaction—11 (LiSat-11).

Results

Patients with MS constituted 62% (n = 258) of the participants and patients with epilepsy 38% (n = 156). The prevalence of sexual dysfunction was 68% in women and 77% in men. No differences were found between patients with MS and epilepsy (p = 0.184), except for the CSFQ desire domain, as patients with epilepsy more often had a desire problem (p = 0.029). On the SF-36, patients with MS scored significantly worse on the PCS (p = 0.000). Patients with epilepsy scored significantly worse on the MCS (p = 0.002). No significant differences were found on the LiSat-11. Regression analysis with CSFQ as the dependent variable showed an association with the PCS in men and an association with both PCS and MCS in women.

Conclusions

In this study, the cohort of patients with MS and epilepsy had negatively affected sexual function. The only significant difference between patients with MS and epilepsy in sexual function measured by the CSFQ-14, was found in the frequency of desire, in which a larger number of patients with epilepsy reported sexual dysfunction. In the studied cohort, sexual function in women is associated with both physical and mental health, and in men with physical health. These results should be considered when caring for patients with epilepsy and MS.
Correction to: Decision-making at the limit of viability: differing perceptions and opinions between neonatal physicians and nurses
Authors:   on behalf of the Swiss Neonatal End-of-Life Study Group, Bucher Hans Ulrich , Klein Sabine D. , Hendriks Manya J. , Baumann-Hölzle Ruth , Berger Thomas M. , Streuli Jürg C. , Fauchère Jean-Claude
Published: January 2020

After publication of our article [1] it was brought to our attention that we did not have permission to reproduce the questionnaire in Additional File 1.