bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics and Complications of Operative Acromioclavicular Joint Separations in an Active Population (222)
Authors: Colantonio Donald , Panarello Nicholas , Harrington Colin , Bandarra Tahler , Kilcoyne Kelly , Dickens Jonathan
Published: October 2021

Objectives:

Coracoclavicular ligament reconstruction (CCR) is a commonly performed procedure for surgical management of high-grade acromioclavicular separations however there is a dearth of literature describing complications of this procedure. The purpose of this study was to identify the incidence and characteristics of major complications following CCR in a large cohort of active patients.

Methods:

The Military Data Repository was queried for patients with Current Procedural Terminology (CPT) codes for CCR. Medical records and radiographs were evaluated for major postoperative complications including return to the operating room for surgical site infection (SSI), failure requiring revision, and fracture of the clavicle or coracoid.

Results:

953 CCR were performed between October 2013 and March 2020. There were 44 failures requiring revision,18 post-operative fractures, and 18 SSI. Of the patients who developed SSI, 13 required removal of the graft and/or hardware, and 4 required revision reconstruction. There were 11 coracoid (61.1%) and 7 clavicle (38.9%) fractures. Seven coracoid fractures (63.6%) involved a bone tunnel in the coracoid whereas 4 coracoid fractures (36.4%) did not. Fracture incidence was 3.122 fractures per 1,000 person-years. Eleven of the fractures were treated with open reduction and internal fixation, 4 with revision CCR, and 3 were treated non-operatively. Most patients who had a fracture regained full range of motion.

Conclusions:

This review of a large population who underwent CCR demonstrated an incidence of 1.35 complications per 100 person-years. Clavicle and coracoid fractures after CCR occur in 1.9 out of 100 cases. Fractures occurred after various methods of fixation and most were treated surgically. Coracoid fractures were nearly twice as prevalent as clavicle fractures and occured with and without bone tunnels in the coracoid. This study demonstrates that CCR is a relatively safe procedure in a physically active population. Complications are rare yet typically require surgical management.
Pathology and surgical outcomes of anterior traumatic shoulder instability in gymnasts (235)
Authors: Omodani Toru , Sugaya Hiroyuki , Takahashi Norimasa , Matsuki Keisuke , Tokai Morihito , Morioka Takeshi , Ueda Yusuke , Hoshika Shota , Kamijo Hideki
Published: October 2021

Objectives:

For shoulders of artistic gymnasts, stability against various forces such as weight bearing, torsion, and traction is required as well as wide range of motion. The prevalence of shoulder instability in gymnasts has been reported to be high, particularly in female gymnasts; however, there has been no report on its pathology and the surgical outcomes. The purpose of this study was to retrospectively investigate the pathology and surgical outcomes of anterior traumatic shoulder instability in gymnasts.

Methods:

The subjects of this study were 18 shoulders of 16 gymnasts that underwent arthroscopic surgery for anterior traumatic shoulder instability. They consisted of 4 male and 14 female shoulders with a mean age of 18 years (range, 16-20). The mean follow-up was 30 months (range, 10-66 months). All surgeries were performed arthroscopically, and procedures were determined according to the intraoperative findings. Patients were immobilized with a brace for 3 weeks and started range of motion exercise after the immobilization period. Hand-stand or hanging were normally allowed at 3 month after surgery according to patients’ functional recovery. We investigated injury mechanism, intraoperative findings, surgical procedures, times to start hand-stand or hanging and to start giant swing, time to complete return to gymnastics, and recurrence of instability.

Results:

Three shoulders experienced dislocations that self-reduction was impossible. The remaining 15 shoulders had self-reducible dislocations or subluxations, and 10 of 15 shoulders were injured with the shoulder hyper-flexed: e.g., pulling up hands during somersaults; pushing off the vault (Figure). Bankart lesion was identified during surgery in 14 shoulders including one bony Bankart lesion. Capsular tear was found in 5 shoulders, and only one lesion was concomitant with Bankart lesion. All lesions were arthroscopically repaired. We additionally performed rotator interval closure in 10 shoulders, superior labrum repair in 13, and rotator cuff repair in 2. One patient retired from gymnastics immediately after surgery, and 2 patients were lost to follow-up. The remaining 13 patients returned to gymnastics. The mean time to start hand-stand or hanging was 4 months (range, 3-10 months), and that to start giant swing was 6 months (range, 3-15 months). The mean time to complete return was 9 months (range, 5-17 months). Two shoulders experienced recurrence (1 dislocation and 1 subluxation) after return to gymnastics. Both shoulders underwent revision surgery and returned to gymnastics.

Conclusions:

Capsular tear without Bankart lesion was more common (4 shoulder, 22%) in gymnasts than general population. The sport-related characteristics might be associated with the high incidence of capsular tear. The outcomes of arthroscopic stabilization for gymnasts was good with the high complete return rate.
Outcomes Following the Repair of Isolated Supraspinatus Repairs versus those with Concurrent Subscapularis Repairs (242)
Authors: Whicker Emily , Hughes Jonathan , Puyana Jacob , Patel Neel , Fongod Edna , Kane Gillian , Tublin Joshua , Popchak Adam , Lesniak Bryson , Lin Albert
Published: October 2021

Objectives:

While rotator cuff tears often require repair of the supraspinatus, patients can also have a concurrent tear of the subscapularis requiring repair. Previous smaller studies have shown good clinical outcomes following the repair of the subscapularis and rotator cuff during the same procedure.1 The purpose of this study was to compare clinical outcome measures between patients who had isolated supraspinatus repairs versus those who had a supraspinatus tear with a concurrent subscapularis repair.

Methods:

A retrospective review of 166 patients who underwent arthroscopic supraspinatus repair with or without a concurrent subscapularis repair between 2013-2018 with a minimum of one-year follow up was performed. Patients were separated into two groups based on their treatment: 100 had an isolated supraspinatus repair (SP) and 66 had both a supraspinatus and subscapularis repair (SB). The primary outcome was revision rotator cuff repair. Secondary outcomes were objective measures such as range of motion (ROM) and strength testing, including flexion (FF), external rotation (ER), and internal rotation (IR), as well as patient-reported outcome measures (PROs) including visual analog pain scale (VAS) and subjective shoulder value (SSV). Outcomes were compared using the Mann- Whitney Test and Fisher’s Exact Test with p<0.05, as the data were not parametric (SPSS, IBM).

Results:

There was no significant difference in the rate of revision surgery required following isolated supraspinatus repair versus those with a subscapularis repair. Additionally, there were no significant differences between groups for all PROs, all ROM parameters, and all strength parameters (all p > 0.05) (Table 1).

Conclusions:

The data from this study demonstrated that patients who require a subscapularis repair at the time of their rotator cuff repair can expect similar short term outcomes to those patients who only required repair of their supraspinatus.
Towards great ethno-civilizations and spiritual empires? How the European New Right imagines a post-liberal world order
Authors: Crone Manni
Published: October 2021

Far-right parties and pundits are often portrayed as parochial nationalists obsessed with the idea of national sovereignty. Opposed to a liberal world order, they prefer a rogue world of nation-states on the loose. This essay seeks to complicate that narrative. It suggests that alongside political parties with a nationalist agenda, an increasing number of voices on the radical Right are now pushing for a re-spiritualized world order in which cultures, civilizations, and empires are to set the scene. This vision of global order echoes Christopher Coker’s recent claim that “we now live in a world in which civilization is fast becoming the currency of international politics.” But, why does this strand of the far-right prefer civilizations to nation-states? To ponder this question, this essay zooms in on the European New Right and more precisely two of its main luminaries, Alain de Benoist and Aleksandr Dugin. It shows how the New Right stretches back to classical geopolitics to imagine a future polycentric world order in which large civilizations are set free from American hegemony. The empires of the future are no longer underpinned by nation-states but by ethnopluralism—a “blossoming variety” of local, ethnic, agrarian polities.
Dentists’ Attitudes Toward Dental Implant Maintenance in Thailand
Authors: Rudeejaraswan A. , Pisarnturakit P.P. , Mattheos N. , Pimkhaokham A. , Subbalekha K.
Published: October 2021

Introduction:

As implant therapy is a widely applied treatment modality, general dentists are in the frontline of maintaining health in patients with implants. It is however unknown to what extent general dentists are competent and feel prepared to deliver maintenance of implants to patients.

Objectives:

The aim of this study was to investigate the attitudes and self-reported and objectively assessed competences of general dentists with maintenance of dental implants in patients.

Methods:

A questionnaire designed and validated for the purpose of the study, including attitudes and self-reported and objectively assessed competences, was distributed by means of an online platform.

Results:

Data from 429 questionnaires were included in the study. Half of the participants were 28 to 33 y old and 78% had been working <10 y. Seventy-eight percent believed that dental implant maintenance should be performed by general dentists, but only 51% were prepared to do this, citing obstacles such as insufficient knowledge and limitations of their working environment. The mean ± SD objectively assessed competence score was 8.97 ± 2.74 of 17. There were significant differences (P < 0.001, 1-way analysis of variance) in the scores among dentists who offered the full range of maintenance and management of complications (10.83 ± 2.45) with those willing to provide comprehensive oral examination and implant maintenance only (9.31 ± 2.73), those offering comprehensive examination but unwilling to conduct maintenance (8.22 ± 2.28), and those who refer all dental implant patients elsewhere (7.2 ± 2.66). Around half of the dentists believed that implants last for life.

Conclusions:

While general dentists appeared to largely acknowledge the importance of providing implant maintenance care and present with positive attitudes, a large portion was unwilling to engage with maintenance of implants in patients and appeared to lack essential competences to this end. The main obstacles for providing implant maintenance care included insufficient knowledge and lack of a properly equipped clinical environment.

Knowledge Transfer Statement:

The results of this study can identify deficiencies in the currently available maintenance competences and schemes for patients with implants. These results can also help dental professionals, scientific bodies, and associations to design appropriate education and professional development strategies that can strengthen the confidence and competences of general dentists, thus offering better service to the public.
The tenacity of trust in petrochemical communities: Reckoning with risk on the Fawley Waterside (1997–2019)
Authors: Brown David , Mah Alice , Walker Gordon
Published: October 2021

Around the world, people living close to polluting industries have different perceptions of the risks of toxic exposure, ranging from anger to acceptance to denial. We draw attention to a case with relatively high levels of social trust, but also relatively high levels of risk perception: the communities living adjacent to the Fawley (UK) oil refinery and petrochemical complex, a site that has been operated by Esso since the early 1950s.

Our findings are based on a novel comparative analysis of two qualitative studies of local risk perceptions in Fawley conducted more than two decades apart in 1997 and 2019, incorporating focus group and individual interviews with residents, alongside documentary analysis and stakeholder interviews. Perceptions of risk and trust in the local polluting industry have fluctuated over the years, with unease never far from the surface as industrial employment has slowly contracted. Yet overall, the picture in 2019 was not too dissimilar from that in 1997: while community–industry relations were strained amidst periodic risk incidents and a sense of decline, a cautious sense of trust in the polluting enterprise had endured, based on a delicate balance of heritage, risk, and recognition. We draw attention to the residents’ careful reckoning with risks over time and the tenacity of social trust as an act of negotiation that took risk into account but also included other important factors such as recognition and reciprocity. Local risk perceptions in Fawley are closely bound up with the residents’ shared industrial heritage and enduring perceptions of Esso as a ‘good neighbour’. Our longitudinal analysis allowed us to reflect on changes over time in Fawley, providing greater temporal depth to the risk perception literature.
A quick and reliable waiting room checklist for symptoms of disinhibited social engagement disorder
Authors: McMorran-Young Genevieve , Moran Kate , Young David , Batchelor Glyn , Minnis Helen
Published: October 2021

Background: Disinhibited social engagement disorder (DSED) is a psychosocial disorder, associated with child neglect, characterised by indiscriminate friendliness towards strangers. Some behavioural overlap between DSED and autism spectrum disorder (ASD) – a neurodevelopmental condition whose core symptoms include impaired communication – has been observed. Since DSED is associated with a maltreatment history and ASD is not, differential diagnosis is important. We aimed to establish norms and reference ranges for a clinic waiting room checklist (WRO) for the observation of DSED symptoms, and to examine its discrimination between DSED and ASD. Methods: Norms are provided for the WRO based on 56 children aged 5–12 with DSED and 151 typically developing controls, for whom a reference range is also provided. We modified the WRO based on both quantitative examination of discrimination between DSED and ASD ( n = 16) and qualitative observations of typically developing children ( n = 7), children with DSED ( n = 5) and ASD ( n = 6). Results: A WRO score >6 may indicate the need for a multi-informant assessment for DSED. In a waiting room, children from both atypical groups (ASD and DSED) were more likely to approach strangers than controls; however, while children with DSED symptoms appeared to take control of the social aspects of the situation, children with ASD followed a non-social agenda, with the stranger appearing irrelevant. Conclusion: The WRO is an efficient tool that, along with information from parents and teacher, can contribute to clinical decision-making regarding children who have difficulties with social relationships.
Examining Ross’s Community Organisation through the Gramscian Lens
Authors: Agnimitra Neera , Jha Manoj K.
Published: October 2021

Looking through the Gramscian notion of hegemony and counter-hegemony, this article examines some of the fundamental premises of community organisation upheld by Murray G. Ross and his book, Community Organization: Theory, Principles and Practice, which has been acclaimed by social work academia and practitioners ever since the first edition of book appeared in 1955. It has been almost six and a half decades since this book made its appearance; yet despite the temporal traverse, it has continued to enjoy the most exalted status ever accorded to a document in the realm of community organisation and community work in India. The authors contend that the ‘seemingly’ everlasting application of Ross’s text across diverse cultural contexts and vast temporal zones needs a revisit. Beyond attempting to locate the presence of hegemonic discourse in the community and within community work, the article also advocates for the engagement of social work practitioners in the crafting of counter-hegemony strategies, in order to empower the subaltern community of people to shape their lives, following their very own political choices.
Endoscopic ultrasound-guided trans-duodenal fine-needle biopsy of a small renal mass: case report and review of the literature
Authors: Kwong Justin , May Gary , Ordon Michael
Published: October 2021

Background

The incidental detection of small renal masses (SRMs) is increasing and biopsy to obtain pathological diagnosis is increasingly proposed as a diagnostic tool to guide further management. Renal mass biopsies are traditionally performed via a percutaneous approach. However, this is not always feasible due to anatomical limitations. A rarely reported alternative biopsy approach for SRMs is endoscopic ultrasound (EUS)-guided fine-needle biopsy (FNB). Herein, we describe a case of EUS-guided trans-duodenal FNB for a SRM that was not amenable to standard percutaneous biopsy.

Case presentation

A 48-year-old man was incidentally found to have a right-sided SRM measuring 2.9 × 2.2 × 2.4 cm during evaluation for a hernia. It was anterior, interpolar, completely endophytic and near the renal hilum. The tumor was not amenable to traditional percutaneous biopsy due to its anterior location. However, the renal mass was in close proximity to the descending duodenum and so it was felt that an EUS-guided trans-duodenal FNB would be feasible. The procedure was successful without any complications. The specimen adequacy was satisfactory for evaluation and consistent with renal papillary carcinoma with WHO/ISUP grade 3 nuclear changes.

Conclusion

Our case report demonstrated that EUS-guided trans-duodenal FNB was a safe and feasible approach to obtaining biopsy tissue diagnosis of a SRM that was not amenable to percutaneous biopsy.
Travellers’ preferences towards existing and emerging means of first/last mile transport: a case study for the Almere centrum railway station in the Netherlands
Authors: Stam Bas , van Oort Niels , van Strijp-Harms Hilke J. , van der Spek Stefan C. , Hoogendoorn Serge P.
Published: October 2021

First/last mile transport is essential for transit but is often found to be the weakest link in a trip. Moreover, as a result of multiple developments (e.g. demographic shifts, urbanization, climate change, technology advancement) first/last mile transport will likely change rapidly. The literature review of this study shows six different categories of factors affecting first/last mile mode choice: (1) traveller, (2) psychological, (3) first/last mile trip, (4) first/last mile modes, (5) built environment, and (6) main stage. We used this framework to understand and predict the complex process of mode choice, specifically given the emerge of new modes. The performed mode choice experiment shows varying results regarding the preferences of travellers for existing and new means of first/last mile transport. Four future scenarios (varying in level of sharing and flexibility of rides) are investigated. Traditional means of transport such as private vehicles and traditional ride services remain preferred over shared vehicles and on-demand ride services. For instance, 21% of the travellers chooses a private but no shared vehicle, and 12% chooses a traditional but no on-demand ride service. On the other hand, 21% of the travellers prefer a shared vehicle and 23% prefer an on-demand ride service whenever these vehicles/services are available. These results illustrate that when mode choice factors are absent and there are no restrictions taken into account (for example the possession of a car and driving license when choosing car), the actual chosen means of transport in the current situation differs from the preferred means of transport in the future. The results also show potential for new, emerging, means of first/last mile transport. According to the ‘preferred situation’ by travellers, transit nodes and first/last mile systems require a different design regarding first/last mile facilities, dependent on the scenario(s) that will develop. The challenge for decision makers and planners is to steer mode choice decisions in the direction according to their policy objectives, where our insights support the corresponding design choices and policy interventions.
Distinct patterns of whole blood transcriptional responses are induced in mice following immunisation with adenoviral and poxviral vector vaccines encoding the same antigen
Authors: Sheerin Dylan , Dold Christina , O’Connor Daniel , Pollard Andrew J. , Rollier Christine S.
Published: October 2021

Background

Viral vectors, including adenovirus (Ad) and modified vaccinia Ankara (MVA), have gained increasing attention as vaccine platforms in recent years due to their capacity to express antigens from a wide array of pathogens, their rapid induction of humoral and cellular protective immune responses, and their relatively low production costs. In particular, the chimpanzee Ad vector, ChAdOx1, has taken centre stage as a leading COVID-19 vaccine candidate. However, despite mounting data, both clinical and pre-clinical, demonstrating effective induction of adaptive immune responses, the innate immune signals that precede the protective responses that make these vectors attractive vaccine platforms remain poorly understood.

Results

In this study, a mouse immunisation model was used to evaluate whole blood gene expression changes 24 h after either a single dose or heterologous prime-boost regimen of an Ad and/or MVA vaccine. We demonstrate through comparative analysis of Ad vectors encoding different antigens that a transgene product-specific gene signature can be discerned from the vector-induced transcriptional response. Expression of genes involved in TLR2 stimulation and γδ T cell and natural killer cell activation were induced after a single dose of Ad, while MVA led to greater expression of type I interferon genes. The order of prime-boost combinations was found to influence the magnitude of the gene expression changes, with MVA/Ad eliciting greater transcriptional perturbation than Ad/MVA. Contrasting the two regimens revealed significant enrichment of epigenetic regulation pathways and augmented expression of MHC class I and II molecules associated with MVA/Ad.

Conclusion

These data demonstrate that the order in which vaccines from heterologous prime-boost regimens are administered leads to distinct transcriptional responses and may shape the immune response induced by such combinations. The characterisation of early vaccine-induce responses strengthens our understanding of viral vector vaccine mechanisms of action ahead of their characterisation in human clinical trials and are a valuable resource to inform the pre-clinical design of appropriate vaccine constructs for emerging infectious diseases.
Maternal methionine supplementation during gestation alters alternative splicing and DNA methylation in bovine skeletal muscle
Authors: Liu Lihe , Amorín Rocío , Moriel Philipe , DiLorenzo Nicolás , Lancaster Phillip A. , Peñagaricano Francisco
Published: October 2021

Background

The evaluation of alternative splicing, including differential isoform expression and differential exon usage, can provide some insights on the transcriptional changes that occur in response to environmental perturbations. Maternal nutrition is considered a major intrauterine regulator of fetal developmental programming. The objective of this study was to assess potential changes in splicing events in the longissimus dorsi muscle of beef calves gestated under control or methionine-rich diets. RNA sequencing and whole-genome bisulfite sequencing were used to evaluate muscle transcriptome and methylome, respectively.

Results

Alternative splicing patterns were significantly altered by maternal methionine supplementation. Most of the altered genes were directly implicated in muscle development, muscle physiology, ATP activities, RNA splicing and DNA methylation, among other functions. Interestingly, there was a significant association between DNA methylation and differential exon usage. Indeed, among the set of genes that showed differential exon usage, significant differences in methylation level were detected between significant and non-significant exons, and between contiguous and non-contiguous introns to significant exons.

Conclusions

Overall, our findings provide evidence that a prenatal diet rich in methyl donors can significantly alter the offspring transcriptome, including changes in isoform expression and exon usage, and some of these changes are mediated by changes in DNA methylation.
Whole transcriptome sequencing identifies key circRNAs, lncRNAs, and miRNAs regulating neurogenesis in developing mouse retina
Authors: Chen Gang , Qian Hong-Mei , Chen Jing , Wang Jie , Guan Ji-Tian , Chi Zai-Long
Published: October 2021

Background

The molecular complexity of neural retina development remains poorly studied. Knowledge of retinal neurogenesis regulation sheds light on retinal degeneration therapy exploration. Therefore, we integrated the time-series circRNA, lncRNA, miRNA, and mRNA expression profiles of the developing retina through whole-transcriptome sequencing. The key functional ncRNAs and the ceRNA network regulating retinal neurogenesis were identified.

Results

Transcriptomic analysis identified circRNA as the most variable ncRNA subtype. We screened a series of neurogenesis-related circRNAs, lncRNAs, and miRNAs using different strategies based on their diversified molecular functions. The expression of circCDYL, circATXN1, circDYM, circPRGRIP, lncRNA Meg3, and lncRNA Vax2os was validated by quantitative real-time PCR. These circRNAs and lncRNAs participate in neurotransmitter transport and multicellular organism growth through the intricate circRNA/lncRNA-miRNA-mRNA network.

Conclusion

Whole-transcriptome sequencing and bioinformatics analysis systematically screened key ncRNAs in retinal neurogenesis. The validated ncRNAs and their circRNA/lncRNA-miRNA-mRNA network involve neurotransmitter transport and multicellular organism growth during retinal development.
Seed priming with proline improved photosystem II efficiency and growth of wheat (Triticum aestivum L.)
Authors: Ambreen Sarah , Athar Habib-ur-Rehman , Khan Ameer , Zafar Zafar Ullah , Ayyaz Ahsan , Kalaji Hazem M.
Published: October 2021

Background

Proline can promote growth of plants by increasing photosynthetic activity under both non-stress and abiotic stress conditions. However, its role in non-stressed conditions is least studied. An experiment was conducted to assess as to whether increase in growth of wheat due to seed priming with proline under non-stress condition was associated with proline-induced changes in photosystem II (PSII) activity. Seeds of four wheat varieties (S-24, Sehar-06, Galaxy-13, and Pasban-90) were primed with different concentrations of proline (0, 5, 15 and 25 mM) for 12 h and allowed to grow under normal conditions. Biomass accumulation and photosynthetic performance, being two most sensitive features/indicators of plant growth, were selected to monitor proline modulated changes.

Results

Seed priming with proline increased the fresh and dry weights of shoots and roots, and plant height of all four wheat varieties. Maximum increase in growth attributes was observed in all four wheat varieties at 15 mM proline. Maximum growth improvement due to proline was found in var. Galaxy-13, whereas the reverse was true for S-24. Moreover, proline treatment changed the Fo, Fm, Fv/Fo, PIABS, PITot in wheat varieties indicating changes in PSII activity. Proline induced changes in energy fluxes for absorption, trapping, electron transport and heat dissipation per reaction center indicated that var. Galaxy-13 had better ability to process absorbed light energy through photosynthetic machinery. Moreover, lesser PSII efficiency in var. S-24 was due to lower energy flux for electron transport and greater energy flux for heat dissipation. This was further supported by the fact that var. S-24 had disturbance at acceptor side of PSI as reflected by reduction in ΔVIP, probability and energy flux for electron transport at the PSI end electron acceptors.

Conclusion

Seed priming with proline improved the growth of wheat varieties, which depends on type of variety and concentration of proline applied. Seed priming with proline significantly changed the PSII activity in wheat varieties, however, its translation in growth improvement depends on potential of processing of absorbed light energy by electron acceptors of electron transport chain, particularly those present at PSI end.
Genome-wide identification of the tobacco GDSL family and apical meristem-specific expression conferred by the GDSL promoter
Authors: Lv Jing , Dai Chang-Bo , Wang Wei-Feng , Sun Yu-He
Published: October 2021

Background

GDSL esterases/lipases are a large protein subfamily defined by the distinct GDSL motif, and play important roles in plant development and stress responses. However, few studies have reported on the role of GDSLs in the growth and development of axillary buds. This work aims to identify the GDSL family members in tobacco and explore whether the NtGDSL gene contributes to development of the axillary bud in tobacco.

Results

One hundred fifty-nine GDSL esterase/lipase genes from cultivated tobacco (Nicotiana tabacum) were identified, and the dynamic changes in the expression levels of 93 of these genes in response to topping, as assessed using transcriptome data of topping-induced axillary shoots, were analysed. In total, 13 GDSL esterase/lipase genes responded with changes in expression level. To identify genes and promoters that drive the tissue-specific expression in tobacco apical and axillary buds, the expression patterns of these 13 genes were verified using qRT-PCR. GUS activity and a lethal gene expression pattern driven by the NtGDSL127 promoter in transgenic tobacco demonstrated that NtGDSL127 is specifically expressed in apical buds, axillary buds, and flowers. Three separate deletions in the NtGDSL127 promoter demonstrated that a minimum upstream segment of 235 bp from the translation start site can drive the tissue-specific expression in the apical meristem. Additionally, NtGDSL127 responded to phytohormones, providing strategies for improving tobacco breeding and growth.

Conclusion

We propose that in tobacco, the NtGDSL127 promoter directs expression specifically in the apical meristem and that expression is closely correlated with axillary bud development.
“The PLCP gene family of grapevine (Vitis vinifera L.): characterization and differential expression in response to Plasmopara Viticola”
Authors: Kang Jun , Gong Peijie , Ge Mengqing , Sadeghnezhad Ehsan , Liu Zhongjie , Zhang Mengwei , Shangguan Lingfei , Fang Jinggui
Published: October 2021

Background

Papain-like cysteine proteases (PLCPs), a large group of cysteine proteases, are structurally related to papain. The members belonging to PLCPs family contribute to plant immunity, senescence, and defense responses in plants. ThePLCPgene family has been identified in Arabidopsis, rice, soybean, and cotton. However, no systematic analysis ofPLCPgenes has been undertaken in grapevine. SincePlasmopara viticolaas a destructive pathogen could affect immunity of grapes in the field, we considered that the members belonged to PLCPs family could play a crucial role in defensive mechanisms or programmed cell death. We aimed to evaluate the role ofPLCPsin 2 different varieties of grapevines and compared the changes of their expressions with the transcriptional data in response toP. viticola.

Results

In this study, 23 grapevinePLCP(VvPLCP) genes were identified by comprehensive bioinformatics analysis. Subsequently, the chromosomal localizations, gene structure, conserved domains, phylogenetic relationship, gene duplication, and cis-acting elements were analyzed. Numerous cis-acting elements related to plant development, hormone, and stress responses were identified in the promoter of theVvPLCPgenes. Phylogenetic analysis grouped theVvPLCPgenes into nine subgroups. The transcription ofVvPLCPin different inoculation time points and varieties indicated thatVvPLCPmay have vital functions in grapevine defense againstPlasmopara viticola. According to transcriptome data and qPCR analysis, we observed the increasing expression levels ofVvRD21–1at 72 h after inoculation in resistant variety, inferring that it was related to grape downy mildew resistance. Meanwhile, 3 genes includingVvXBCP1,VvSAG12–1,andVvALP1showed higher expression at 24 h after pathogen inoculation in the susceptible variety and might be related to the downy mildew phenotype. We nominated these four genes to function during hypersensitive response (HR) process, inferring that these genes could be associated with downy mildew resistance in grapes.

Conclusions

Our results provide the reference for functional studies ofPLCPgene family, and highlight its functions in grapevine defense againstP. viticola. The results help us to better understand the complexity of thePLCPgene family in plant immunity and provide valuable information for future functional characterization of specific genes in grapevine.
Predictors of treatment failure among patients with gunshot wounds and post-traumatic stress disorder
Authors: Kuchyn Iurii Leonidovych , Horoshko Vasyl’ Romanovych
Published: October 2021

Background

The 82.1% treatment failure of post-traumatic stress disorder (PTSD), associated with gunshot wounds, is related to high incidence of chronic pain syndrome as well as resistance to the PTSD treatment. Defining treatment failure predictors among the PTSD patients with gunshot extremity wounds and the following therapy would improve treatment outcomes.

Methods

A total of 218 patients completed the study. The Mississippi Scale for Combat-Related PTSD (M-PTSD) was used for assessment of the treatment outcome rate. The risk relation between treatment failure and factors was assessed by a univariate or multivariate logistic regression method, with the model accuracy measured by the AUC – Area under the ROC curve. The odds ratio (OR) was considered for the qualitative factor assessment.

Results

The predictors of the PTSD treatment failure among the patients with gunshot wounds to the extremities are: 1) anesthesia type: the risk of failure is higher with the general anesthesia compared to the regional (p = 0.002), OR = 0.30 (95% CI 0.13-0.69) and the regional one with sedation (p = 0.004), OR = 0.30 (95% CI 0,14-0.65); 2) severe postoperative pain: the risk of treatment failure rises with increased pain intensity assessed by the visual analogue scale (p = 0.02), OR = 3.2 (95% CI 1.2-8.3).

Conclusions

The analysis showed that administration of general anesthesia compared to the regional one (regardless of the sedation) and high postoperative pain intensity are associated with higher risk of the PTSD treatment failure among patients with gunshot wounds to the extremities. The preference of regional anesthesia and postoperative pain control may potentially improve the treatment outcomes.

Trial registration

ClinicalTrials.gov: Retrospectively registered on December 30, 2020, NCT04689022.
Comparison of the hemodynamic response of dexmedetomidine versus additional intravenous lidocaine with propofol during tracheal intubation: a randomized controlled study
Authors: Seangrung Rattaphol , Pasutharnchat Koravee , Injampa Subundit , Kumdang Sirima , Komonhirun Rojnarin
Published: October 2021

Background

Laryngoscopy and tracheal intubation are strong stimuli that cause a reflex increase in blood pressure (BP), heart rate (HR), and serum catecholamine level. These can lead to myocardial infarction or cerebrovascular accidents. The purpose of this study is to compare the efficacy of dexmedetomidine and lidocaine combined with propofol in attenuating the hemodynamic response following laryngoscopy and endotracheal intubation.

Methods

This study was a randomized controlled study and adhered to the CONSORT guidelines. One-hundred and six patients undergoing elective general anesthesia with endotracheal intubation were divided randomly into two groups. Group D received dexmedetomidine (1 μg kg− 1) before induction. Group LP received lidocaine (1.5 mg kg− 1) before induction with additional propofol (0.5 mg kg− 1) before laryngoscopy. The primary endpoint was hemodynamic including systolic (S) BP, diastolic (D) BP, mean arterial blood pressure (MAP) and HR measured before and after induction and ≤ 10 min after intubation. Secondary outcome was complications/adverse effects.

Results

After induction, the mean SBP, DBP, MAP and HR decreased significantly from baseline in both groups except for mean HR in group LP at 1 min. Differences in mean values of SBP, DBP, and MAP were significantly lower in group D after intubation at 4–10 min (P <  0.05). Group LP had a non-inferior effect in blunting BP at all time points except 1 and 2 min after induction, and 2 min after intubation. The mean difference in HR in group D was significantly lower than that in group LP at all time points (P <  0.001). Group D had significantly more episodes of bradycardia (18.87% vs. 0%,P = 0.001) and hypotension (52.83% vs. 15.09%,P < 0.001) than did group LP.

Conclusion

Lidocaine (1.5 mg kg− 1) with additional propofol (0.5 mg kg− 1) had a non-inferior effect compared with dexmedetomidine (1 μg kg− 1) in attenuating the hemodynamic response following laryngoscopy and endotracheal intubation, and had fewer adverse effects.

Trial registration

Thai Clinical Trial Registry, (TRTC20190206002). Retrospectively registered 4 February 2019.
Using the South African Triage Scale for prehospital triage: a qualitative study
Authors: Dixon Julia , Burkholder Taylor , Pigoga Jennifer , Lee Michael , Moodley Kubendhren , de Vries Shaheem , Wallis Lee , Mould-Millman Nee-Kofi
Published: October 2021

Background

Triage is a critical component of prehospital emergency care. Effective triage of patients allows them to receive appropriate care and to judiciously use personnel and hospital resources. In many low-resource settings prehospital triage serves an additional role of determining the level of destination facility. In South Africa, the Western Cape Government innovatively implemented the South African Triage Scale (SATS) in the public Emergency Medical Services (EMS) service in 2012. The prehospital provider perspectives and experiences of using SATS in the field have not been previously studied.

Methods

In this qualitative study, focus group discussions with cohorts of basic, intermediate and advanced life support prehospital providers were conducted and transcribed. A content analysis using an inductive approach was used to code transcripts and identify themes.

Results

15 EMS providers participated in three focus group discussions. Data saturation was reached and four major themes emerged from the qualitative analysis: Implementation and use of SATS; Effectiveness of SATS; Limitations of the discriminator; and Special EMS considerations. Participants overall felt that SATS was easy to use and allowed improved communication with hospital providers during patient handover. Participants, however, described many clinical cases when their clinical gestalt triaged the patient to a different clinical acuity than generated by SATS. Additionally, they stated many clinical discriminators were too subjective to effectively apply or covered too broad a range of clinical severity (e.g., ingestions). Participants provided examples of how the prehospital environment presents additional challenges to using SATS such as changing patient clinical conditions, transport times and social needs of patients.

Conclusions

Overall, participants felt that SATS was an effective tool in prehospital emergency care. However, they described many clinical scenarios where SATS was in conflict with their own assessment, the clinical care needs of the patient or the available prehospital and hospital resources. Many of the identified challenges to using SATS in the prehospital environment could be improved with small changes to SATS and provider re-training.
Pharmacist’s recommendations of over-the-counter treatments for the common cold - analysis of prospective cases in Poland
Authors: Pietrusiewicz Malgorzata , Kopa-Stojak Paulina Natalia , Pawliczak Rafal
Published: October 2021

Background

Common cold is a frequent illness in northern hemisphere between late autumn and early spring. Patients suffering from it frequently turn to pharmacists instead of physicians in order to receive medical advice and treatment. We studied its treatment advised by pharmacists in Poland, as well as evidence for the efficacy of their recommendations by utilizing a self-developed questionnaire and a study of existing literature.

Methods

The data were collected by 27 pharmacists who worked in four large network community pharmacies in Lodz, Poland. The study took place from December 2019 to February 2020. Data were recorded only if the patient asked for pharmacy counselling for over-the counter (OTC) products due to common cold self-diagnosis and a product was sold. Pharmacists’ recommendations were compared with the results of a literature review of best evidence to determine appropriateness of the pharmacists’ decisions.

Results

In four out of five cases the pharmacists recommended products contained paracetamol. In addition, in one out of three patient encounters they advised nasal decongestant, inosines and/or OTC mucolytics. There was a significant relationship between fever and recommendation frequency of some analgesics, inosines, mucolytics and sore throat products (OR > 1, p < 0.05); rhinorrhea and recommendation frequency of paracetamol, inosines, anti-histamines and alpha-mimetics (OR > 1, p < 0.05); cough and recommendation frequency of paracetamol, inosines, mucolytics and sore throat products (OR > 1, p < 0.05); and fatigue and recommendation frequency of paracetamol, acetylsalicylic acid, inosines and sore throat products (OR > 1, p < 0.05). The pharmacist recommendations were based on patients’ symptoms, product price, pharmaceutical company promotion and the financial incentive. In many cases their recommendations were not in line with current best practice recommendations.

Conclusions

Our study suggests that the most common rationale for pharmacist recommendation on anti-common cold treatment was to take a “shotgun” approach. Pharmacists commonly made recommendations for products that lack strong evidence for efficacy (i.e. anti-viral agents) and are potentially unnecessary, based on presentation of the symptom. Reasons for this situation include lack of training, lack of time to evaluate the patient, lack of awareness of evidence as well as drug company marketing and financial incentives (i.e. fulfilling sale plans and target sale bonuses).

Trial registration

The study was a non-interventional, observational research trial. The study registration was not required.
Screening of characteristic genes in ulcerative colitis by integrating gene expression profiles
Authors: Han Yingbo , Liu Xiumin , Dong Hongmei , Wen Dacheng
Published: October 2021

Background

This study aimed to screen the feature modules and characteristic genes related to ulcerative colitis (UC) and construct a support vector machine (SVM) classifier to distinguish UC patients.

Methods

Four datasets that contained UC and control samples were obtained from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) with consistency were screened via the MetaDE method. The weighted gene coexpression network (WGCNA) was used to distinguish significant modules based on the four datasets. The protein–protein interaction network was established based on intersection genes. Enrichment analysis of Gene Ontology (GO) biological processes (BPs) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were established based on DAVID. An SVM combined with recursive feature elimination was also applied to construct a disease classifier for the disease diagnosis of UC patients. The efficacy of the SVM classifier was evaluated through receiver operating characteristic curves.

Results

Twelve highly preserved modules were obtained using the WGCNA, and 2009 DEGs with significant consistency were selected using the MetaDE method. Sixteen significantly related GO BPs and 12 KEGG pathways were obtained, such as cytokine-cytokine receptor interaction, cell adhesion molecules, and leukocyte transendothelial migration. Subsequently, 41 genes were used to construct an SVM classifier, such as CXCL1, CCR2, IL1B, and IL1A. The area under the curve (AUC) was 0.999 in the training dataset, whereas the AUC was 0.886, 0.790, and 0.819 in the validation set (GSE65114, GSE37283, and GSE36807, respectively).

Conclusions

An SVM classifier based on feature genes might correctly identify healthy people or UC patients.
Development of a Parkinson’s disease specific falls questionnaire
Authors: Harris Dale M. , Duckham Rachel L. , Daly Robin M. , Abbott Gavin , Johnson Liam , Rantalainen Timo , Teo Wei-Peng
Published: October 2021

Background

Falls are a major health burden for older adults with Parkinson’s disease (PD), but there is currently no reliable questionnaire to capture the circumstances and consequences of falls in older adults with PD. This study aimed to develop a PD-specific falls questionnaire and to evaluate its test-retest reliability in older adults with PD.

Methods

A novel PD-specific falls questionnaire (PDF-Q) was developed in two modes (online and paper-based version) and used to assess falls and near-falls events over the past 12-months. Questions were agreed upon by an expert group, with the domains based on previous falls-related questionnaires. The questions included the number and circumstances (activities, location and direction) of falls and near-falls, and consequences (injuries and medical treatment) of falls. The PDF-Q was distributed to 46 older adults with PD (onlinen = 30, papern = 16), who completed the questionnaire twice, 4 weeks apart. Kappa (κ) statistics were used to establish test-retest reliability of the questionnaire items.

Results

Pooled results from both questionnaires for all participants were used to assess the overall test-retest reliability of the questionnaire. Questions assessing the number of falls (κ = 0.41) and the number of near-falls (κ = 0.51) in the previous 12-months demonstrated weak agreement, while questions on the location of falls (κ = 0.89) and near-falls (κ = 1.0) demonstrated strong to almost perfect agreement. Questions on the number of indoor (κ = 0.86) and outdoor (κ = 0.75) falls demonstrated moderate to strong agreement, though questions related to the number of indoor (κ = 0.47) and outdoor (κ = 0.56) near-falls demonstrated weak agreement. Moderate to strong agreement scores were observed for the most recent fall and near-fall in terms of the direction (indoor fallκ = 0.80; outdoor fallκ = 0.81; near-fallκ = 0.54), activity (indoor fallκ = 0.70; outdoor fallκ = 0.82; near-fallκ = 0.65) and cause (indoor fallκ = 0.75; outdoor fallκ = 0.62; near-fallκ = 0.56).

Conclusions

The new PDF-Q developed in this study was found to be reliable for capturing the circumstances and consequences of recent falls and near-falls in older adults with PD.