bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility of the Oberlin Procedure in Late Presentation Cases of C5-C6 and C5-C7 Brachial Plexus Injuries in Adults
Authors: Cho Álvaro B. , Ferreira Carlos H. V. , Towata Fernando , Almeida Gabriel C. , Sorrenti Luiz , Kiyohara Leandro Y.
Published: June 2020

Background: Oberlin et al presented a new technique for nerve transfer that completely changed the prognosis of patients with brachial plexus injury. Currently, most of the literature addresses cases submitted to early surgical intervention, before 12 months from injury, showing consistent good results. The aim of this study was to evaluate the feasibility of the Oberlin procedure in late presentation cases (≥12 months), comparing the elbow flexion strength with patients operated earlier. Methods: We retrospectively reviewed 49 patients with partial brachial plexus injuries submitted to the Oberlin procedure. They were divided into 2 groups. Group A included 39 patients operated with <12 months of injury. The mean postoperative follow-up was 22.53 months. The interval from injury to surgery varied from 4 to 11 months (±8.45 months). Group B included 10 patients with surgery ≥12 months after injury. The mean postoperative follow-up was 32 months. The interval from injury to surgery ranged from 12 to 19 months (±15.4 months). Patients were evaluated monthly after surgery and the elbow flexion strength was measured using the British Medical Research Council scale. Results: In Group A, 24 patients presented with either good (M3) or excellent (M4) elbow flexion strength. In Group B, 9 patients presented with either good (M3) or excellent (M4) elbow flexion strength. A significant difference was not seen in the postoperative elbow flexion strength among the 2 groups. Conclusion: Biceps reinnervation with the Oberlin procedure is still feasible and should be attempted after more than 12 months of injury in partial brachial plexus injuries.
Role of the signal transducer and activator of transcription 3 protein in the proliferation of vascular smooth muscle cells
Authors: Tang Hong-Xia , Qin Xu-Ping , Li Jie
Published: June 2020

Objectives

Cardiovascular disease (CVD) remains the primary cause of morbidity and mortality worldwide. The abnormal proliferation of vascular smooth muscle cells (VSMCs) is a key event in the pathogenesis of CVD. The functional and phenotypic changes in vascular cells are mediated by complex signaling cascades that initiate and control genetic reprogramming. Many studies have demonstrated that signal transducer and activator of transcription 3 (STAT3) regulates a diverse array of functions relevant to atherosclerosis.

Methods

In this review, we summarize the studies on the STAT3-mediated proliferation of VSMCs and subsequent CVDs such as hypertension, atherosclerosis, stroke, coronary artery disease, and myocardial infarction. Furthermore, we describe the general background of STAT3, its structure, function and regulation as well as the STAT3 signaling pathway. Finally, we highlight some potential issues and propose some solutions to these issues. Results and conclusions: STAT3 activation promotes the proliferation of VSMCs by regulating the transcription of genes. Studying the mechanism of VSMC proliferation induced by the STAT3 pathway is valuable for finding therapeutic targets for CVD.
Dehumanization on Twitter in the Turkish–Kurdish conflict
Authors: Tutkal Serhat
Published: June 2020

This article examines the dissemination of images of mutilated and humiliated dead bodies of ‘others’ and reactions of Twitter users to these images as dehumanizing practices. When the peace negotiations between the Turkish state and Kurdish PKK failed, numerous images of mutilated and humiliated dead bodies of PKK militants were disseminated by Twitter accounts apparently used by members of the Turkish security forces. The author focuses on two controversial cases from 2015 and immediate social media reactions to those images in order to demonstrate how dehumanization of Kurdish militants played out in the case of Turkey.
Unlocking the Power of School Nursing Documentation
Authors: Nicholson Carrie , Johnson Kathleen
Published: June 2020

School nurses may be underestimating the power of their documentation to advance the visibility of their work and the needs of the students they serve. The first step toward unlocking the value of their documentation is recognizing the role that quality documentation plays in advancing these goals. The purpose of this article is to demonstrate the utility of the nursing process for improving the quality of documentation and provide examples of how to use nursing documentation formats.
Intensive fever control using a therapeutic normothermia protocol in patients with febrile early septic shock: A randomized feasibility trial and exploration of the immunomodulatory effects
Authors: Saoraya Jutamas , Musikatavorn Khrongwong , Puttaphaisan Patima , Komindr Atthasit , Srisawat Nattachai
Published: June 2020

Objectives:

Fever control has been shown to reduce short-term mortality in patients with septic shock. This study aimed to explore the feasibility of early intensive fever control in patients with septic shock and to assess the immunomodulatory effects of this intervention.

Methods:

In this single-center, randomized, open-label trial, febrile patients with septic shock presenting to the emergency department were assigned to either a standard fever control or therapeutic normothermia group. Therapeutic normothermia involved intensive fever control in maintaining normothermia below 37°C. The primary outcome was the feasibility of fever control for 24 h. Secondary outcomes included changes in immunomodulatory biomarkers and adverse events.

Results:

Fifteen patients were enrolled and analyzed. Fever control was comparable in both groups, but significantly more patients in the therapeutic normothermia group experienced shivering ( p = 0.007). Both groups demonstrated increased C-reactive protein and unchanged neutrophil chemotaxis and CD11b expression. The therapeutic normothermia group revealed significant decreased IL-6 and IL-10. The standard fever control group significantly expressed increased monocytic human leukocyte antigen. There were no significant differences between the groups in terms of immunomodulation.

Conclusions:

Therapeutic normothermia was feasible in patients with febrile septic shock but was not superior to standard fever control in terms of average body temperature and host defense function. Shivering was more frequent in the therapeutic normothermia group.

Trial registration:

Thai Clinical Trials Registry number: TCTR20160321001
The Relationship Between Student Teachers’ Career Choice Motives and Stress-Inducing Thoughts: A Tentative Cross-Cultural Model
Authors: Tillmann Teresa , Weiß Sabine , Scharfenberg Jonas , Kiel Ewald , Keller-Schneider Manuela , Hellsten Meeri
Published: June 2020

The present study compares student teachers’ career choice motives and their relationship with stress-inducing thoughts across five European countries. A previously established factorial structure for career choice motives embedded within self-determination theory was supported. The factors consist of intrinsic motives, such as interest in educational work with children, and extrinsic motives, such as financial security. Furthermore, differences in the importance of these factors in choosing the teaching profession across countries were found. Results further revealed evidence for a link between extrinsic motives and stress-inducing cognitions. Conclusions and implications for teaching practice are discussed.
When Civilians Deploy With the Military
Authors: Balmer Jennylynn
Published: June 2020

Each year, thousands of civilian workers deploy with active duty service members to support contingency operations, often in harsh environmental conditions. Occupational health nurses aware of these challenges can implement programs to protect the health and safety of this at-risk worker population.
Plasma Technology Reduces Blood Loss in Adolescent Idiopathic Scoliosis Surgery: A Prospective Randomized Clinical Trial
Authors: Piazzolla Andrea , Bizzoca Davide , Solarino Giuseppe , Parato Claudia , Moretti Biagio
Published: June 2020

Study Design:

Prospective randomized clinical trial.

Objectives:

To assess the effectiveness of PEAK Plasmablade (PPB), compared with bipolar sealer and standard electrocautery, in the posterior spinal instrumentation and fusion (PSF) surgery performed for adolescent idiopathic scoliosis (AIS).

Methods:

Ninety-three patients undergoing PSF surgery for AIS were randomized in 2 groups: group-A patients (n = 45) underwent PSF surgery using PPB; group-B patients (n = 48) were treated with bipolar sealer and standard electrocautery. Demographic and surgical data was recorded. All the patients underwent serial blood tests on the day before surgery (T0) and at 24 (T1), 48 (T2), 72 (T3), and 96 (T4) hours postoperatively. Visual analogue scale for pain (VAS) score, the percentage of paracetamol assumption, and the blood transfusion rate were recorded in the time-lapse T1 to T4. Intergroup variability was assessed. Pearson correlation test was performed. A P value <.05 was considered significant.

Results:

In group A, a significantly shorter total operative time ( P = .0087), a significantly lower total intraoperative blood loss (TBL) ( P = .001), and a higher postoperative hemoglobin (Hb) ( P = .01) were recorded. A significant higher mean Hb concentration and mean albumin value was recorded in group A at 24 and 48 hours postoperatively. A significant correlation between TBL and hospital stay was recorded in both groups (group A, P = .00 001; group B, P = .00 006); moreover, in both groups, a significant correlation was observed between TBL and mean VAS at 72 hours postoperatively (group A, P = .0009; group B, P = .0001) and at 96 hours postoperatively (group A, P = .000 044; group B, P = .00 001).

Conclusions:

PPB reduces the intraoperative blood loss in PSF performed for AIS, thus allowing a patient’s faster recovery.
British Colonial Commonality: East Africa and India
Authors: Kumar Ajit
Published: June 2020

This note examines aspects of colonial commonality between British colonised East Africa and India. Community development as a rural development programme, its presence in academic institutions and its use as an expression in development discourse are some of these commonalities. With the passage of time, British East Africa and India have diverged on some of these commonalities. In India, community development began with great developmental hopes in 1952, but it ended miserably and was soon abandoned as a rural development programme. While it vanished from India’s development lexicon, community development still retains a place in the development discourse of Botswana. It also seems to resonate in the mainstream life of some East African countries unlike in India. But one commonality still continues. Community development finds some place in the halls of academe in both Botswana and India today.

To discuss these aspects of colonial commonality, this article moves back-and-forth among Botswana, India and British East Africa. This article needs to be read in the historical context of de-colonisation struggles over developmental ideas in British East Africa and India and the role of the native elites in this process.
Endogenous TCR promotes in vivo persistence of CD19-CAR-T cells compared to a CRISPR/Cas9-mediated TCR knockout CAR
Authors: Stenger Dana , Stief Tanja A. , Kaeuferle Theresa , Willier Semjon , Rataj Felicitas , Schober Kilian , Vick Binje , Lotfi Ramin , Wagner Beate , Grünewald Thomas G. P. , Kobold Sebastian , Busch Dirk H. , Jeremias Irmela , Blaeschke Franziska , Feuchtinger Tobias
Published: June 2020

Anti-CD19 chimeric antigen receptor (CAR) T cells showed significant antileukemic activity in B-precursor acute lymphoblastic leukemia (ALL). Allogeneic, HLA-mismatched off-the-shelf third-party donors may offer ideal fitness of the effector cells, but carry the risk of graft-versus-host disease. Knockout (KO) of the endogenous T-cell receptor (TCR) in CD19-CAR-T cells may be a promising solution. Here, we induced a CRISPR/Cas9-mediated KO of the TCRβ chain in combination with a second-generation retroviral CAR transduction including a 4-1BB costimulatory domain in primary T cells. This tandem engineering led to a highly functional population of TCR-KO-CAR-T cells with strong activation (CD25, interferon γ), proliferation, and specific killing upon CD19 target recognition. TCR-KO-CAR-T cells had a balanced phenotype of central memory and effector memory T cells. KO of the endogenous TCR in T cells strongly ablated alloreactivity in comparison with TCR-expressing T cells. In a patient-derived xenograft model of childhood ALL, TCR-KO-CAR-T cells clearly controlled CD19+ leukemia burden and improved survival in vivo. However, coexpression of endogenous TCR plus CAR led to superior persistence of T cells and significantly prolonged leukemia control in vivo, confirmed by a second in vivo model using the leukemia cell line NALM6. These results point toward an essential role of the endogenous TCR for longevity of the response at the price of alloreactivity. In conclusion, anti-CD19 CAR T cells with a CRISPR/Cas9-mediated TCR-KO are promising candidates for nonmatched third-party adoptive T-cell transfer with high antileukemic functionality in the absence of alloreactivity, but long-term persistence in vivo is better in the presence of the endogenous TCR.
Efficacy, tolerability, and safety of erenumab for the preventive treatment of persistent post-traumatic headache attributed to mild traumatic brain injury: an open-label study
Authors: Ashina Håkan , Iljazi Afrim , Al-Khazali Haidar Muhsen , Eigenbrodt Anna Kristina , Larsen Eigil Lindekilde , Andersen Amalie Middelboe , Hansen Kevin John , Bräuner Karoline Bendix , Mørch-Jessen Thomas , Chaudhry Basit , Antic Sonja , Christensen Casper Emil , Ashina Messoud , Amin Faisal Mohammad , Schytz Henrik Winther
Published: June 2020

Background

Calcitonin gene-related peptide (CGRP) has recently been implicated in the pathogenesis of post-traumatic headache (PTH), which raises the prospect for therapeutic use of monoclonal antibodies targeting CGRP or its receptor. Therefore, we decided to assess the efficacy, tolerability, and safety of erenumab for prevention of persistent PTH attributed to mild traumatic brain injury.

Methods

A single-center, non-randomized, single-arm, open-label study of erenumab for adults aged 18–65 years with persistent PTH. Patients were assigned to receive 140-mg erenumab monthly by two subcutaneous 1-mL injections, given every 4 weeks for 12 weeks. The primary outcome measure was the mean change in number of monthly headache days of moderate to severe intensity from baseline (4-week pretreatment period) to week 9 through 12. Tolerability and safety endpoints were adverse events (i.e. number and type).

Results

Eighty-nine of 100 patients completed the open-label trial. At baseline, the mean monthly number of headache days of moderate to severe intensity was 15.7. By week 9 through 12, the number was reduced by 2.8 days. The most common adverse events were constipation (n = 30) and injection-site reactions (n = 15). Of 100 patients who received at least one dose of erenumab, two patients discontinued the treatment regimen due to adverse events.

Conclusions

Among patients with persistent PTH, erenumab resulted in a lower frequency of moderate to severe headache days in this 12-week open-label trial. In addition, erenumab was well-tolerated as discontinuations due to adverse events were low. Placebo-controlled randomized clinical trials are needed to adequately evaluate the efficacy and safety of erenumab in patients with persistent PTH.

Trial registration

ClinicalTrials.Gov, NCT03974360. Registered on April 17, 2019 - Retrospectively registered
Production Assessment and Genome Comparison Revealed High Yield Potential and Novel Specific Alleles Associated with Fertility and Yield in Neo-Tetraploid Rice
Authors: Yu Hang , Shahid Muhammad Qasim , Li Qihang , Li Yudi , Li Cong , Lu Zijun , Wu Jinwen , Zhang Zemin , Liu Xiangdong
Published: June 2020

Background

Neo-tetraploid rice (NTR) is a new tetraploid rice germplasm that developed from the crossing and directional selection of different autotetraploid rice lines, which showed high fertility and promising yield potential. However, systematic yield assessment, genome composition and functional variations associated with fertility and yield remain elusive.

Results

Two season’s field trials of 15 NTRs and 27 autotetraploid rice (ATR) lines revealed that the improvement of YPP (yield per plant, 4.45 g increase) were significantly associated with the increase of SS (seed setting, 29.44% increase), and yield and seed setting of NTRs improved significantly compared to parental lines. Whole genome resequencing of 13 NTR sister lines and their parents at about 48.63 depth were conducted and genome compositions were illustrated using inherited chromosomal blocks. Interestingly, 222 non-parental genes were detected between NTRs and their low fertility parental lines, which were conserved in 13 NTRs. These genes were overlapped with yield and fertility QTLs, and RNA-Seq analysis revealed that 81 of them were enriched in reproductive tissues. CRISPR/Cas9 gene knockout was conducted for 9 non-parental genes to validate their function. Knockout mutants showed on an average 25.63% and 4.88 g decrease in SS and YPP, respectively. Notably, some mutants showed interesting phenotypes, e.g., kin7l (kinesin motor gene) and kin14m (kinesin motor gene), bzr3 (BES1/BZR1 homolog) and nrfg4 (neo-tetraploid rice fertility related gene) exhibited 44.65%, 24.30%, 24.42% and 28.33% decrease in SS and 8.81 g, 4.71 g, 5.90 g, 6.22 g reduction in YPP, respectively.

Conclusion

Comparative genomics provides insights into genome composition of neo-tetraploid rice and the genes associated with fertility and yield will play important role to reveal molecular mechanisms for the improvement of tetraploid rice.
Agrobacterium-Mediated Genetic Transformation of Wild Oryza Species Using Immature Embryos
Authors: Shimizu-Sato Sae , Tsuda Katsutoshi , Nosaka-Takahashi Misuzu , Suzuki Toshiya , Ono Seijiro , Ta Kim Nhung , Yoshida Yuri , Nonomura Ken-Ichi , Sato Yutaka
Published: June 2020

Genetic transformation is one of the most important technologies for revealing or modulating gene function. It is used widely in both functional genomics and molecular breeding of rice. Demands on its use in wild Oryza species is increasing because of their high genetic diversity. Given the difficulties in genetic crosses between distantly related species, genetic transformation offers a way to alter or transfer genetic traits in wild rice accessions. However, transformation of wild Oryza accessions by conventional methods using calli induced from scutellum tissue of embryos in mature seeds often fails. Here, we report methods using immature embryos for the genetic transformation of a broad range of Oryza species. First, we investigated the ability of callus induction and regeneration from immature embryos of 192 accessions in 20 species under several culture conditions. We regenerated plants from immature embryos of 90 accessions in 16 species. Next, we optimized the conditions of Agrobacterium infection using a vector carrying the GFP gene driven by the maize ubiquitin promoter. GFP signals were observed in 51 accessions in 11 species. We analyzed the growth and seed set of transgenic plants of O. barthii, O. glumaepatula, O. rufipogon, and O. brachyantha. The plants grew to maturity and set seeds normally. Southern blot analyses using DNA from T0 plants showed that all GFP plants were derived from independent transformation events. We confirmed that the T-DNAs were transmitted to the next generation through the segregation of GFP signals in the T1 generation. These results show that many Oryza species can be transformed by using modified immature-embryo methods. This will accelerate the use of wild Oryza accessions in molecular genetic analyses and molecular breeding.
The nuclear and mitochondrial genomes of Frieseomelitta varia – a highly eusocial stingless bee (Meliponini) with a permanently sterile worker caste
Authors: de Paula Freitas Flávia C. , Lourenço Anete P. , Nunes Francis M. F. , Paschoal Alexandre R. , Abreu Fabiano C. P. , Barbin Fábio O. , Bataglia Luana , Cardoso-Júnior Carlos A. M. , Cervoni Mário S. , Silva Saura R. , Dalarmi Fernanda , Del Lama Marco A. , Depintor Thiago S. , Ferreira Kátia M. , Gória Paula S. , Jaskot Michael C. , Lago Denyse C. , Luna-Lucena Danielle , Moda Livia M. , Nascimento Leonardo , Pedrino Matheus , Oliveira Franciene Rabiço , Sanches Fernanda C. , Santos Douglas E. , Santos Carolina G. , Vieira Joseana , Barchuk Angel R. , Hartfelder Klaus , Simões Zilá L. P. , Bitondi Márcia M. G. , Pinheiro Daniel G.
Published: June 2020

Background

Most of our understanding on the social behavior and genomics of bees and other social insects is centered on the Western honey bee,Apis mellifera.The genusApis,however, is a highly derived branch comprising less than a dozen species, four of which genomically characterized. In contrast, for the equally highly eusocial, yet taxonomically and biologically more diverse Meliponini, a full genome sequence was so far available for a singleMeliponaspecies only. We present here the genome sequence ofFrieseomelitta varia, a stingless bee that has, as a peculiarity, a completely sterile worker caste.

Results

The assembly of 243,974,526 high quality Illumina reads resulted in a predicted assembled genome size of 275 Mb composed of 2173 scaffolds. A BUSCO analysis for the 10,526 predicted genes showed that these represent 96.6% of the expected hymenopteran orthologs. We also predicted 169,371 repetitive genomic components, 2083 putative transposable elements, and 1946 genes for non-coding RNAs, largely long non-coding RNAs. The mitochondrial genome comprises 15,144 bp, encoding 13 proteins, 22 tRNAs and 2 rRNAs. We observed considerable rearrangement in the mitochondrial gene order compared to other bees. For an in-depth analysis of genes related to social biology, we manually checked the annotations for 533 automatically predicted gene models, including 127 genes related to reproductive processes, 104 to development, and 174 immunity-related genes. We also performed specific searches for genes containing transcription factor domains and genes related to neurogenesis and chemosensory communication.

Conclusions

The total genome size forF. variais similar to the sequenced genomes of other bees. Using specific prediction methods, we identified a large number of repetitive genome components and long non-coding RNAs, which could provide the molecular basis for gene regulatory plasticity, including worker reproduction. The remarkable reshuffling in gene order in the mitochondrial genome suggests that stingless bees may be a hotspot for mtDNA evolution. Hence, while being just the second stingless bee genome sequenced, we expect that subsequent targeting of a selected set of species from this diverse clade of highly eusocial bees will reveal relevant evolutionary signals and trends related to eusociality in these important pollinators.
Identification of genetic loci associated with higher resistance to pancreas disease (PD) in Atlantic salmon (Salmo salar L.)
Authors: Hillestad Borghild , Makvandi-Nejad Shokouh , Krasnov Aleksei , Moghadam Hooman K.
Published: June 2020

Background

Pancreas disease (PD) is a contagious disease caused by salmonid alphavirus (SAV) with significant economic and welfare impacts on salmon farming. Previous work has shown that higher resistance against PD has underlying additive genetic components and can potentially be improved through selective breeding. To better understand the genetic basis of PD resistance in Atlantic salmon, we challenged 4506 smolts from 296 families of the SalmoBreed strain. Fish were challenged through intraperitoneal injection with the most virulent form of the virus found in Norway (i.e., SAV3). Mortalities were recorded, and more than 900 fish were further genotyped on a 55 K SNP array.

Results

The estimated heritability for PD resistance was 0.41 ± 0.017. The genetic markers on two chromosomes, ssa03 and ssa07, showed significant associations with higher disease resistance. Collectively, markers on these two QTL regions explained about 60% of the additive genetic variance. We also sequenced and compared the cardiac transcriptomics of moribund fish and animals that survived the challenge with a focus on candidate genes within the chromosomal segments harbouring QTL. Approximately 200 genes, within the QTL regions, were found to be differentially expressed. Of particular interest, we identified various components of immunoglobulin-heavy-chain locus B (IGH-B) on ssa03 and immunoglobulin-light-chain on ssa07 with markedly higher levels of transcription in the resistant animals. These genes are closely linked to the most strongly QTL associated SNPs, making them likely candidates for further investigation.

Conclusions

The findings presented here provide supporting evidence that breeding is an efficient tool for increasing PD resistance in Atlantic salmon populations. The estimated heritability is one of the largest reported for any disease resistance in this species, where the majority of the genetic variation is explained by two major QTL. The transcriptomic analysis has revealed the activation of essential components of the innate and the adaptive immune responses following infection with SAV3. Furthermore, the complementation of the genomic with the transcriptomic data has highlighted the possible critical role of the immunoglobulin loci in combating PD virus.
Distinctions between sex and time in patterns of DNA methylation across puberty
Authors: Moore Sarah Rose , Humphreys Kathryn Leigh , Colich Natalie Lisanne , Davis Elena Goetz , Lin David Tse Shen , MacIsaac Julia Lynn , Kobor Michael Steffen , Gotlib Ian Henry
Published: June 2020

Background

There are significant sex differences in human physiology and disease; the genomic sources of these differences, however, are not well understood. During puberty, a drastic neuroendocrine shift signals physical changes resulting in robust sex differences in human physiology. Here, we explore how shifting patterns of DNA methylation may inform these pathways of biological plasticity during the pubertal transition. In this study we analyzed DNA methylation (DNAm) in saliva at two time points across the pubertal transition within the same individuals. Our purpose was to compare two domains of DNAm patterns that may inform processes of sexual differentiation 1) sex related sites, which demonstrated differences between males from females and 2) time related sites in which DNAm shifted significantly between timepoints. We further explored the correlated network structure sex and time related DNAm networks and linked these patterns to pubertal stage, assays of salivary testosterone, a reliable diagnostic of free, unbound hormone that is available to act on target tissues, and overlap with androgen response elements.

Results

Sites that differed by biological sex were largely independent of sites that underwent change across puberty. Time-related DNAm sites, but not sex-related sites, formed correlated networks that were associated with pubertal stage. Both time and sex DNAm networks reflected salivary testosterone levels that were enriched for androgen response elements, with sex-related DNAm networks being informative of testosterone levels above and beyond biological sex later in the pubertal transition.

Conclusions

These results inform our understanding of the distinction between sex- and time-related differences in DNAm during the critical period of puberty and highlight a novel linkage between correlated patterns of sex-related DNAm and levels of salivary testosterone.
PCR-based screening, isolation, and partial characterization of motile lactobacilli from various animal feces
Authors: Suzuki Shunya , Fujita Koki , Maeno Shintaro , Shiwa Yuh , Endo Akihito , Yokota Kenji , Igimi Shizunobu , Kajikawa Akinobu
Published: June 2020

Background

Most lactobacilli found in animal intestines are generally non-motile, but there are few exceptions. Our previous work showed that Lactobacillus agilis BKN88, which is a highly motile strain originating from a chicken, takes advantage of motility in gut colonization in murine models, and thus motile lactobacilli likely have unique ecological characteristics conferred by motility. However, the ecology and habitat of gut-derived motile lactobacilli are still rarely understood. In addition, the limited availability of motile Lactobacillus isolates is one of the major obstacles for further studies. To gain insight into the ecology and habitat of the motile lactobacilli, we established a routinely applicable detection method for motile lactobacilli using PCR and subsequent selective isolation in semi-solid MRS medium for the collection of additional motile lactobacilli from animal feces.

Results

We applied the PCR detection using motile lactobacilli-specific primers, based on the motor switch protein gene (fliG) of flagella, to 120 animal feces, followed by selective isolation performed using 45 animal feces. As a result, motile lactobacilli were detected in 44 animal feces. In the selective isolation, 29 isolates of L. agilis and 2 isolates of L. ruminis were obtained from 8 animal species.

Conclusions

These results indicated that motile lactobacilli are distributed in different animal species. Moreover, phylogenetic analysis of the L. agilis isolates suggests co-evolution with the host, and adaptation to a particular environmental niche.
Acute kidney injury risk prediction score for critically-ill surgical patients
Authors: Trongtrakul Konlawij , Patumanond Jayanton , Kongsayreepong Suneerat , Morakul Sunthiti , Pipanmekaporn Tanyong , Akaraborworn Osaree , Poopipatpab Sujaree
Published: June 2020

Background

There has been a global increase in the incidence of acute kidney injury (AKI), including among critically-ill surgical patients. AKI prediction score provides an opportunity for early detection of patients who are at risk of AKI; however, most of the AKI prediction scores were derived from cardiothoracic surgery. Therefore, we aimed to develop an AKI prediction score for major non-cardiothoracic surgery patients who were admitted to the intensive care unit (ICU).

Methods

The data of critically-ill patients from non-cardiothoracic operations in the Thai Surgical Intensive Care Unit (THAI-SICU) study were used to develop an AKI prediction score. Independent prognostic factors from regression analysis were included as predictors in the model. The outcome of interest was AKI within 7 days after the ICU admission. The AKI diagnosis was made according to the Kidney Disease Improving Global Outcomes (KDIGO)-2012 serum creatinine criteria. Diagnostic function of the model was determined by area under the Receiver Operating Curve (AuROC). Risk scores were categorized into four risk probability levels: low (0–2.5), moderate (3.0–8.5), high (9.0–11.5), and very high (12.0–16.5) risk. Risk of AKI was presented as likelihood ratios of positive (LH+).

Results

A total of 3474 critically-ill surgical patients were included in the model; 333 (9.6%) developed AKI. Using multivariable logistic regression analysis, older age, high Sequential Organ Failure Assessment (SOFA) non-renal score, emergency surgery, large volume of perioperative blood loss, less urine output, and sepsis were identified as independent predictors for AKI. Then AKI prediction score was created from these predictors. The summation of the score was 16.5 and had a discriminative ability for predicting AKI at AuROC = 0.839 (95% CI 0.825–0.852). LH+ for AKI were: low risk = 0.117 (0.063–0.200); moderate risk = 0.927 (0.745–1.148); high risk = 5.190 (3.881–6.910); and very high risk = 9.892 (6.230–15.695), respectively.

Conclusions

The function of AKI prediction score to predict AKI among critically ill patients who underwent non-cardiothoracic surgery was good. It can aid in early recognition of critically-ill surgical patients who are at risk from ICU admission. The scores could guide decision making for aggressive strategies to prevent AKI during the perioperative period or at ICU admission.

Trial registration

TCTR20190408004, registered on April 4, 2019.
Comparison of intrathecal morphine with continuous patient-controlled epidural anesthesia versus intrathecal morphine alone for post-cesarean section analgesia: a randomized controlled trial
Authors: Sato Izumi , Iwasaki Hajime , Luthe Sarah Kyuragi , Iida Takafumi , Kanda Hirotsugu
Published: June 2020

Background

Several neuraxial techniques have demonstrated effective post-cesarean section analgesia. According to previous reports, it is likely that patient-controlled epidural analgesia (PCEA) without opioids is inferior to intrathecal morphine (IM) alone for post-cesarean section analgesia. However, little is known whether adding PCEA to IM is effective or not. The aim of this study was to compare post-cesarean section analgesia between IM with PCEA and IM alone.

Methods

Fifty patients undergoing elective cesarean section were enrolled in this prospective randomized study. Patients were randomized to one of two groups: IM group and IM + PCEA group. All patients received spinal anesthesia with 12 mg of 0.5% hyperbaric bupivacaine, 10 μg of fentanyl, and 150 μg of morphine. Patients in IM + PCEA group received epidural catheterization through Th11–12 or Th12-L1 before spinal anesthesia and PCEA (basal 0.167% levobupivacaine infusion rate of 6 mL/h, bolus dose of 3 mL in lockout interval of 30 min) was commenced at the end of surgery. A numerical rating scale (NRS) at rest and on movement at 4,8,12,24,48 h after the intrathecal administration of morphine were recorded. In addition, we recorded the incidence of delayed ambulation and the number of patients who requested rescue analgesics. We examined NRS using Bonferroni’s multiple comparison test following repeated measures analysis of variance;p < 0.05was considered as statistically significant.

Results

Twenty-three patients in each group were finally analyzed. Mean NRS at rest was significantly higher in IM group than in IM + PCEA group at 4 (2.7 vs 0.6), 8 (2.2 vs 0.6), and 12 h (2.5 vs 0.7), and NRS during mobilization was significantly higher in IM group than in IM + PCEA group at 4 (4.9 vs 1.5), 8 (4.8 vs 1.9), 12 (4.9 vs 2), and 24 h (5.7 vs 3.5). The number of patients who required rescue analgesics during the first 24 h was significantly higher in IM group compared to IM + PCEA group. No significant difference was observed between the groups in incidence of delayed ambulation.

Conclusions

The combined use of PCEA with IM provided better post-cesarean section analgesia compared to IM alone.

Trial registration

UMIN-CTR (Registration No.UMIN000032475). Registered 6 May 2018 – Retrospectively registered.
The effect of intraoperative lidocaine infusion on opioid consumption and pain after totally extraperitoneal laparoscopic inguinal hernioplasty: a randomized controlled trial
Authors: Ghimire Anup , Subedi Asish , Bhattarai Balkrishna , Sah Birendra Prasad
Published: June 2020

Background

As a component of multimodal analgesia, the administration of systemic lidocaine is a well-known technique. We aimed to evaluate the efficacy of lidocaine infusion on postoperative pain-related outcomes in patients undergoing totally extraperitoneal (TEP) laparoscopies inguinal hernioplasty.

Methods

In this randomized controlled double-blind study, we recruited 64 patients to receive either lidocaine 2% (intravenous bolus 1.5 mg. kg − 1 followed by an infusion of 2 mg. kg− 1. h− 1), or an equal volume of normal saline. The infusion was initiated just before the induction of anesthesia and discontinued after tracheal extubation. The primary outcome of the study was postoperative morphine equivalent consumption up to 24 h after surgery. Secondary outcomes included postoperative pain scores, nausea/vomiting (PONV), sedation, quality of recovery (scores based on QoR-40 questionnaire), patient satisfaction, and the incidence of chronic pain.

Results

The median (IQR) cumulative postoperative morphine equivalent consumption in the first 24 h was 0 (0–1) mg in the lidocaine group and 4 [1–8] mg in the saline group (p < 0.001). Postoperative pain intensity at rest and during movement at various time points in the first 24 h were significantly lower in the lidocaine group compared with the saline group (p < 0.05). Fewer patients reported PONV in the lidocaine group than in the saline group (p < 0.05). Median QoR scores at 24 h after surgery were significantly better in the lidocaine group (194 (194–196) than saline group 184 (183–186) (p < 0.001). Patients receiving lidocaine were more satisfied with postoperative analgesia than those receiving saline (p = 0.02). No difference was detected in terms of postoperative sedation and chronic pain after surgery.

Conclusions

Intraoperative lidocaine infusion for laparoscopic TEP inguinal hernioplasty reduces opioid consumption, pain intensity, PONV and improves the quality of recovery and patient satisfaction.

Trial registration

ClinicalTrials.gov- NCT02601651. Date of registration: November 10, 2015.
Cardiotoxicity evaluation using magnetic resonance imaging in breast Cancer patients (CareBest): study protocol for a prospective trial
Authors: Hong Yoo Jin , Kim Gun Min , Han Kyunghwa , Kim Pan Ki , Lee Su An , An Eunkyung , Lee Ji Yeon , Lee Hye-Jeong , Hur Jin , Kim Young Jin , Kim Min Jung , Choi Byoung Wook
Published: June 2020

Background

Cardiovascular disease is second only to cancer recurrence as a determinant of lifespan in cancer survivors, and cancer therapy-related cardiac dysfunction is a clinically important risk factor. We aim to investigate the use of cardiac magnetic resonance imaging (MRI) to evaluate early tissue changes and perform functional assessment of chemo- and radiation-induced cardiotoxicity and to identify MRI prognostic indicators of cardiotoxicity in breast cancer patients.

Methods

A 3-min cardiac imaging protocol will be added to the breast MRI examination to diagnose cardiotoxicity in breast cancer patients. Standardized MRI-based evaluation of breast cancer and the left ventricular myocardium will be performed at baseline and at 3, 6, and 12 months and 2 years or more after cancer treatment. We will analyze both ventricular volume and ejection fraction (EF), strain of left ventricle (LV), native T1, extracellular volume fraction (ECV), and T2 values acquired in the mid LV.

Discussion

The primary result of this study will be the comparison of the prognostic value of MRI parameters (native T1, ECV, both ventricular systolic function and LV strain) for cardiotoxicity. The endpoint is defined as the occurrence of a major adverse cardiac event (MACE). The secondary outcome will be an assessment of the temporal relationships between contractile dysfunction and microstructural injury over 4 years using MRI. This study will assess the usefulness of quantitative MRI to diagnose cardiotoxicity and will clarify the temporal relationships between contractile dysfunction and microstructural injury of the LV myocardium using MRI during breast cancer treatment.

Trial registration

The protocol was registered at clinicaltrials.gov (Clinical trial no. NCT03301389) on October 4, 2017.
Publication and related biases in health services research: a systematic review of empirical evidence
Authors: Ayorinde Abimbola A. , Williams Iestyn , Mannion Russell , Song Fujian , Skrybant Magdalena , Lilford Richard J. , Chen Yen-Fu
Published: June 2020

Background

Publication and related biases (including publication bias, time-lag bias, outcome reporting bias and p-hacking) have been well documented in clinical research, but relatively little is known about their presence and extent in health services research (HSR). This paper aims to systematically review evidence concerning publication and related bias in quantitative HSR.

Methods

Databases including MEDLINE, EMBASE, HMIC, CINAHL, Web of Science, Health Systems Evidence, Cochrane EPOC Review Group and several websites were searched to July 2018. Information was obtained from: (1) Methodological studies that set out to investigate publication and related biases in HSR; (2) Systematic reviews of HSR topics which examined such biases as part of the review process. Relevant information was extracted from included studies by one reviewer and checked by another. Studies were appraised according to commonly accepted scientific principles due to lack of suitable checklists. Data were synthesised narratively.

Results

After screening 6155 citations, four methodological studies investigating publication bias in HSR and 184 systematic reviews of HSR topics (including three comparing published with unpublished evidence) were examined. Evidence suggestive of publication bias was reported in some of the methodological studies, but evidence presented was very weak, limited in both quality and scope. Reliable data on outcome reporting bias and p-hacking were scant. HSR systematic reviews in which published literature was compared with unpublished evidence found significant differences in the estimated intervention effects or association in some but not all cases.

Conclusions

Methodological research on publication and related biases in HSR is sparse. Evidence from available literature suggests that such biases may exist in HSR but their scale and impact are difficult to estimate for various reasons discussed in this paper.

Systematic review registration

PROSPERO 2016 CRD42016052333.
Productivity costs from a dengue episode in Asia: a systematic literature review
Authors: Hung Trinh Manh , Shepard Donald S. , Bettis Alison A. , Nguyen Huyen Anh , McBride Angela , Clapham Hannah E. , Turner Hugo C.
Published: June 2020

Background

Dengue is a mosquito-borne viral infection which has been estimated to cause a global economic burden of US$8.9 billion per year. 40% of this estimate was due to what are known as productivity costs (the costs associated with productivity loss from both paid and unpaid work that results from illness, treatment or premature death). Although productivity costs account for a significant proportion of the estimated economic burden of dengue, the methods used to calculate them are often very variable within health economic studies. The aim of this review was to systematically examine the current estimates of the productivity costs associated with dengue episodes in Asia and to increase awareness surrounding how productivity costs are estimated.

Method

We searched PubMed and Web of Knowledge without date and language restrictions using terms related to dengue and cost and economics burden. The titles and abstracts of publications related to Asia were screened to identify relevant studies. The reported productivity losses and costs of non-fatal and fatal dengue episodes were then described and compared. Costs were adjusted for inflation to 2017 prices.

Results

We reviewed 33 relevant articles, of which 20 studies reported the productivity losses, and 31 studies reported productivity costs. The productivity costs varied between US$6.7–1445.9 and US$3.8–1332 for hospitalized and outpatient non-fatal episodes, respectively. The productivity cost associated with fatal dengue episodes varied between US$12,035-1,453,237. A large degree of this variation was due to the range of different countries being investigated and their corresponding economic status. However, estimates for a given country still showed notable variation.

Conclusion

We found that the estimated productivity costs associated with dengue episodes in Asia are notable. However, owing to the significant variation in methodology and approaches applied, the reported productivity costs of dengue episodes were often not directly comparable across studies. More consistent and transparent methodology regarding the estimation of productivity costs would help the estimates of the economic burden of dengue be more accurate and comparable across studies.
A novel SPAST gene mutation identified in a Chinese family with hereditary spastic paraplegia
Authors: Yu Weiwei , Jin Haiqiang , Deng Jianwen , Nan Ding , Huang Yining
Published: June 2020

Background

Hereditary spastic paraplegia is a heterogeneous group of clinically and genetically neurodegenerative diseases characterized by progressive gait disorder. Hereditary spastic paraplegia can be inherited in various ways, and all modes of inheritance are associated with multiple genes or loci. At present, more than 76 disease-causing loci have been identified in hereditary spastic paraplegia patients. Here, we report a novel mutation in SPAST gene associated with hereditary spastic paraplegia in a Chinese family, further enriching the hereditary spastic paraplegia spectrum.

Methods

Whole genomic DNA was extracted from peripheral blood of the 15 subjects from a Chinese family using DNA Isolation Kit. The Whole Exome Sequencing of the proband was analyzed and the result was identified in the rest individuals. RaptorX prediction tool and Protein Variation Effect Analyzer were used to predict the effects of the mutation on protein tertiary structure and function.

Results

Spastic paraplegia has been inherited across at least four generations in this family, during which only four HSP patients were alive. The results obtained by analyzing the Whole Exome Sequencing of the proband exhibited a novel disease-associated in-frame deletion in the SPAST gene, and this mutation also existed in the rest three HSP patients in this family. This in-frame deletion consists of three nucleotides deletion (c.1710_1712delGAA) within the exon 16, resulting in lysine deficiency at the position 570 of the protein (p.K570del). This novel mutation was also predicted to result in the synthesis of misfolded SPAST protein and have the deleterious effect on the function of SPAST protein.

Conclusion

In this case, we reported a novel mutation in the known SPAST gene that segregated with HSP disease, which can be inherited in each generation. Simultaneously, this novel discovery significantly enriches the mutation spectrum, which provides an opportunity for further investigation of genetic pathogenesis of HSP.