bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical service quality, psychological contract, and patient loyalty
Authors: Yu Yanghang , Chen Zhixia , Zhao Yuanyuan , Wang Yanan , Zhang Rong , Zhou Xining
Published: November 2020

The purpose of this study is to examine the mediating effect of psychological contracts (including relational and transactional psychological contracts) on the relationship between medical service quality and patient loyalty.

A cross-sectional survey was conducted between September and December 2017. Questionnaires assessing medical service quality, the psychological contract, and patient loyalty were distributed to a random sample of 600 patients across 6 hospitals. The final sample consisted of 469 participants. Hierarchical regression analyses were conducted to examine the mediating effect of psychological contracts on the relationship between medical service quality and patient loyalty.

The mean scores of medical service quality, psychological contracts, and patient loyalty were 3.497 ± 0.571, 3.699 ± 0.503, and 3.342 ± 0.724, respectively. Medical service quality is positively related to psychological contract (β = 0.612, 95% confidence interval [CI] = 0.476–0.603) and patient loyalty (β = 0.676, 95% CI = 0.773–0.944). Further, psychological contract is positively related to patient loyalty (β = 0.599, 95% CI = 0.757–0.968). Both relational psychological contract and transactional psychological contract mediate the relationship between medical service quality and patient loyalty.

Our findings reveal that medical service quality is associated with patient loyalty and that this association is mediated by relational and transactional psychological contracts. Therefore, in order to improve patient loyalty, psychological contracts should be reinforced, and medical service quality should be improved.
Comparison of perioperative hidden blood loss for intertrochanteric fractures in the elderly by different intramedullary fixations
Authors: Zheng Huayong , Zhang Yang , Wang Hao , Sun Tiansheng , Sun Qicai
Published: November 2020

Background:

Till date only a few studies have reported the clinical outcomes of intraoperative hidden blood loss of intertrochanteric fracture in the old people treated with various intramedullary immobilizations. The aim of the trial is to investigate the best choice for treating intertrochanteric fractures, as well as the hidden blood loss among different intramedullary fixations.

Methods:

This randomized, single-blind, superiority clinical trial was admitted by the Ethics Committee in our hospital (The 7th Medical Center of PLA, 20200602DM). The eligibility criteria were:

Patients who met any of the following conditions would not be able to participate in the test: composite femoral fracture, under 65 years of ages, experience of femoral fractures, surgical contraindications, nonambulatory before the presenting injury, or presence of any other traumatic fractures. 120 participants with unstable intertrochanteric fractures, treated by Gammar nail, (n = 40), Proximal Femoral Nail Antirotation (n = 40) and Intertrochanteric Antegrade Nail (n = 40) instruments were enrolled in this research. The main outcome measures were total blood loss and hidden blood loss, which were evaluated based on the haematocrit change after the operation. The experimental data was analyzed and sorted out with SPSS program (ver.19; SPSS Inc., Chicago, IL).

Results:

This experiment had strict inclusive criteria and exclusive criteria and a well- regulated intervention.

Conclusions:

The results of this trial will provide more evidence on which technique can better treat unstable intertrochanteric fracture.

Trial registration:

This study protocol was registered in Research Registry (researchregistry5788).
Effect of extracorporeal shock wave therapy for rotator cuff tendonitis
Authors: Chen Kewei , Yin Shuai , Wang Xiaodan , Lin Qianqian , Duan Huijie , Zhang Zhenhua , Chang Yiniu , Gu Yujing , Wu Mingli , Wu Nan , Liu Chengmei
Published: November 2020

Background:

Rotator cuff tendinitis is a highly prevalent cause of shoulder pain and leads to decreased patient quality of life. Extracorporeal shock wave therapy (ESWT) and ultrasound-guided needling are considered beneficial for rotator cuff tendinitis. A systematic review and meta-analysis comparing ESWT with sham-ESWT or ultrasound-guided needling in the management of pain and calcification is lacking.

Methods:

We will search the following up database from its inception to August 2020 without language restriction: PubMed, Cochrane Library, Web of Science, EMBASE, China National Knowledge Infrastructure, China Biomedical Literature Database, Chinese Science Journal Database, and WangFang database. All randomized controlled trials compared the effect of ESWT and sham-ESWT or ultrasound-guided needling of rotator cuff tendinitis will be included in pain and calcification. Two researchers will operate literature retrieval, screening, information extraction, quality assessment, and data analysis independently. The analysis will be conducted using Review Manager 5.3 Software.

Results:

The findings will be submitted to a peer-reviewed publication.

Conclusion:

This systematic review and meta-analysis will provide high-quality evidence for the treatment of patients with rotator cuff tendinitis.

INPLASY registration number:

INPLASY202080028
Metastatic site discriminates survival benefit of primary tumor surgery for differentiated thyroid cancer with distant metastases
Authors: Ding Wu , Ruan Guodong , Zhu Jianming , Tu Chuanjian , Li Zhian
Published: November 2020

The role of primary tumor surgery in the management of differentiated thyroid cancer (DTC) with distant metastases (DM) remains controversial. We aimed to explore the survival benefit of primary tumor surgery in patients with different metastatic sites.

A retrospective cohort study based on the SEER database was conducted to identify DTC patients with DM diagnosed between 2010 and 2016. Patients were divided into following 2 groups: surgery and non-surgery group. Propensity score weighting was employed to balance clinicopathologic factors between the 2 groups.

Of 3537 DTC patients with DM, 956 (66.0%) patients underwent primary tumor surgery while 493 (34.0%) patients did not. There were 798 all-cause deaths and 704 DTC-specific deaths over a median follow-up of 22 months. The weighted 3-year overall survival (OS) for the surgery group was 55.2%, compared to 27.8% (P < .001) for the non-surgery group. The magnitude of the survival difference of surgery was significantly correlated with metastatic sites (P
interaction <.001). Significant survival improvements in surgery group compared with non-surgery group were observed in patients with lung-only metastasis (adjusted HR = 0.45, P < .001), bone-only metastasis (adjusted HR = 0.40, P < .001), and liver-only metastasis (adjusted HR = 0.27, P < .001), whereas no survival improvement of surgery was found for patients with brain-only metastasis (adjusted HR = 0.57, P = .059) or multiply organ distant metastases (adjusted HR = 0.81, P = .099).

The survival benefit from primary tumor surgery for DTC patients with DM varies by metastatic sites. Decisions for primary tumor surgery of DTC patients with DM should be tailored according to metastatic sites.
The prognostic value of tumor/lymph node standardized uptake value max ratio and correlation with hematologic parameters in stage III nonsmall cell lung cancer
Authors: Açikgoz Yusuf , Gurler Fatih , Inci Bediz Kurt , Ergun Yakup , Ucar Gokhan , Dirikoc Merve , Esen Selin Akturk , Tekin Berna Okudan , Bal Oznur , Dogan Mutlu , Uncu Dogan
Published: November 2020

Stage III non-small cell lung cancer (NSCLC) is a highly heterogeneous subtype of lung cancer. There are still no widely accepted prognostic parameters for stage III NSCLC. In this study, we evaluated the prognostic value of the standardized uptake value (SUV) max ratio of primary tumor to lymph node (T/N SUV max) and its correlation with various hematological parameters.

Patient data were reviewed from the hospital database retrospectively. The T/N SUV max ratio was calculated by dividing the SUV max of the primary tumor by the maximal SUV max of the lymph node. The cut-off value for T/N SUV max ratio was determined by receiver operating characteristic analysis. Survival analysis was performed by Kaplan–Meier method with the Long-rank test. P value < .05 was considered statistically significant.

A total of 52 patients were included in this study. The optimal cut-off value for T/N SUV max was 1.96 (area under the curve: 0.74; 72.7% sensitivity and 73.7% specificity). Patients with T/N SUV max ≤1.96 were defined as high risk patients and those with >1.96 were defined as low risk patients. The median event (recurrence or progression) free survival was 24.3 months (95% confidence interval: 12.0–36.6) for low risk patients, and 9.2 months (95% confidence interval: 6.1–12.4) for high risk patients (P = .0015). There was an inverse correlation between T/N SUV max and hemoglobin concentration and mean corpuscular volume (rho: −0.349, P = .011; rho: −0.312, P = .025, respectively).

Low risk patients had a more favorable prognosis compared to high risk patients. We demonstrated that T/N SUV max can be of prognostic value in stage III NSCLC. T/N SUV max correlated only with hemoglobin and mean corpuscular volume.
The prognosis of brain magnetic resonance imaging injury pattern for outcomes of hypothermia-treated infants
Authors: Seo Yu-Mi , Im Soo-Ah , Sung In Kyung , Youn Young Ah
Published: November 2020

Magnetic resonance imaging (MRI) can be a tool that allows the observation of structural injury patterns after cooling. The aim of this study was to determine the early pattern of brain injury in the MRIs of infants with hypoxic ischemic encephalopathy (HIE) after cooling and to search for any clinical factors related to abnormal MRI findings.

The study retrospectively recruited 118 infants who were treated with therapeutic hypothermia (TH) between 2013 and 2016.

Forty-three patients had normal brain MRI, and 75 had abnormal brain MRI findings. The TH-treated infants with abnormal brain MRI readings showed significantly more clinical seizures and the use of additional antiepileptic drugs (AEDs) than the normal MRI group. As a long-term outcome, more lesions in the basal ganglia and thalamus, posterior limb of internal capsule, or severe white matter lesions were associated with abnormal neurodevelopmental outcomes at 18 to 24 months of age.

A higher frequency of clinical seizures and AED use were related to abnormal brain injury on MRI. A significant risk for poor long-term outcomes was found in the abnormal brain MRI group.
The role of histogram analysis of grayscale sonograms to differentiate thyroid nodules identified by 18F-FDG PET-CT
Authors: Park Ko Woon , Shin Jung Hee , Hahn Soo Yeon , Kim Jae-Hun , Lim Yaeji , Choi Joon Young
Published: November 2020

The role of histogram based on ultrasound (US) images for thyroid nodules found in fluorine-18 fluorodeoxyglucose (18F-FDG) Positron Emission Tomography/Computed Tomography (PET-CT) is unknown. We aimed to assess whether histogram analysis using gray scale US could differentiate thyroid nodules detected by PET-CT.

In this study, 71 thyroid nodules ≥1 cm were identified in 71 patients by conducting 18F-FDG PET-CT, from January 2010 to June 2013. Subsequently, either grayscale US-guided fine needle aspirations or core needle biopsies were performed on each patient. Each grayscale US feature was categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS). Histogram parameters (skewness, kurtosis, intensity, uniformity, and entropy) were extracted from the grayscale US images followed by statistical analysis using the Chi-Squared or Mann–Whitney U tests.

The 71 nodules comprised 30 (42.3%) benign nodules, 30 (42.3%) primary thyroid malignancies, and 11 (15.4%) metastatic lesions. Tumor size, US findings, and histogram parameters were significantly different between the benign and malignant thyroid nodules (P = .011, P = .000, and P < .02, respectively). A comparison showed that parallel orientation and an absence of calcifications were found more frequently in metastatic thyroid nodules than in primary thyroid malignancies (P = .04, P < .000, respectively). However, histogram parameters and K-TIRADS were not significantly different between primary thyroid malignancies and metastatic lesions.

There is a limit to replacing cytopathological confirmation with texture analysis for the differentiation of thyroid nodules detected by PET-CT. Therefore, cytopathological confirmation of nodules appearing malignant on US images cannot be avoided for an ultimate diagnosis of metastasis.
Topical use of Jiawei Simiao Yongan Gao to prevent radiodermatitis in patients with head and neck cancer
Authors: Song Fengli , Liao Ziling , Li Tong , Kang Ning , Li Zhiming , Fan Shufang , Liu Fengzhi
Published: November 2020

Radiodermatitis is a common side effect of radiotherapy, but currently there is no standard treatment for its prevention. This study aimed to observe the effect of topical application of a paste based on traditional Chinese medicine, Jiawei Simiao Yongan Gao, on radiodermatitis caused by radiotherapy for patients with head and neck cancer.

This was a retrospective cohort study of 40 patients with head and neck cancer evaluated during their radiotherapy. Of these, 20 patients were treated with Jiawei Simiao Yongan Gao on the irradiated skin from the beginning of radiotherapy (JSY group). The other 20 patients were given standard nursing (standard group). Acute skin reactions were classified according to the radiation-induced skin reaction assessment scale (RISRAS) and American radiation therapy oncology group (RTOG) acute toxicity grading criteria every 2 weeks, and adverse effects were recorded until the end of the radiotherapy.

The two groups showed differences in severity of radiodermatitis. At 0 to 30 Gy, the skin reactions were similar in the two groups, while above 40 Gy the skin reactions were significantly lower grade in the JSY group (P < .05). At 0 to 20 Gy, there was no statistical significance (P > .05); but above 30 Gy they were lower in the JSY group (P < .05).

Jiawei Simiao Yongan Gao effectively alleviated acute radiodermatitis caused by radiotherapy of head and neck cancer patients compared with standard nursing.
Correlation between CYP11B2 polymorphism and the risk of preeclampsia
Authors: Wang Yan , Zhou Minhua , Deng Xun , Ma Yanjiao , Jiang Deqi
Published: November 2020

Background:

Many studies have evaluated the association between aldosterone synthase (CYP11B2) C-344T polymorphism and preeclampsia (PE) susceptibility, however, the results from different studies are inconsistent.

Objective:

The study aimed to derive a more precise estimation of this association.

Methods:

We searched PubMed, Embase, Chinese National Knowledge Infrastructure, China Biological Medicine, and Wanfang Database. The association was evaluated by calculating the odds ratios (ORs) with the corresponding 95% confidence intervals (CIs).

Results:

Seven case-control studies with a total of 720 cases and 766 controls were eligible to be included in this meta-analysis. Overall, there was no significant association between CYP11B2 C-344T polymorphism and PE (for the allele model T vs.C: OR=0.78, 95%CI 0.60-1.01, p=0.06; for the codominant model CT vs. CC: OR=1.08, 95%CI 0.80-1.46, p=0.63; for the dominant model TT + CT vs. CC: OR=0.91, 95%CI 0.68-1.20, p=0.49). Similar results were obtained in sensitivity analysis.

Conclusion:

In summary, the present meta-analysis suggests that CYP11B2 C-344T polymorphism may not be associated with genetic susceptibility of PE, but the association remains indeterminate due to the insufficient evidence.
Damage control surgery for the treatment of perforated acute colonic diverticulitis
Authors: Zizzo Maurizio , Castro Ruiz Carolina , Zanelli Magda , Bassi Maria Chiara , Sanguedolce Francesca , Ascani Stefano , Annessi Valerio
Published: November 2020

Background:

Acute colonic diverticulitis (ACD) complications arise in approximately 8% to 35% patients and the most common ones are represented by phlegmon or abscess, followed by perforation, peritonitis, obstruction, and fistula. In accordance with current guidelines, patients affected by generalized peritonitis should undergo emergency surgery. However, decisions on whether and when to operate ACD patients remain a substantially debated topic while algorithm for the best treatment has not yet been determined. Damage control surgery (DCS) represents a well-established method in treating critically ill patients with traumatic abdomen injuries. At present, such surgical approach is also finding application in non-traumatic emergencies such as perforated ACD. Thanks to a thorough systematic review of the literature, we aimed at achieving deeper knowledge of both indications and short- and long-term outcomes related to DCS in perforated ACD.

Methods:

We performed a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. Pubmed/MEDLINE, Embase, Scopus, Cochrane Library, and Web of Science databases were used to search all related literature.

Results:

The 8 included articles covered an approximately 13 years study period (2006–2018), with a total 359 patient population. At presentation, most patients showed III and IV American Society of Anesthesiologists (ASA) score (81.6%) while having Hinchey III perforated ACD (69.9%). Most patients received a limited resection plus vacuum-assisted closure at first-look while about half entire population underwent primary resection anastomosis (PRA) at a second-look. Overall morbidity rate, 30-day mortality rate and overall mortality rate at follow-up were between 23% and 74%, 0% and 20%, 7% and 33%, respectively. Patients had a 100% definitive abdominal wall closure rate and a definitive stoma rate at follow-up ranging between 0% and 33%.

Conclusion:

DCS application to ACD patients seems to offer good outcomes with a lower percentage of patients with definitive ostomy, if compared to Hartmann's procedure. However, correct definition of DCS eligible patients is paramount in avoiding overtreatment. In accordance to 2016 WSES (World Society of Emergency Surgery) Guidelines, DCS remains an effective surgical strategy in critically ill patients affected by sepsis/septic shock and hemodynamical unstability.
Effect of perioperative intravenous lidocaine for patients undergoing spine surgery
Authors: Bi Yaodan , Ye Yu , Ma Jun , Tian Zerong , Zhang Xiuqian , Liu Bin
Published: November 2020

Background:

Perioperative intravenous lidocaine has been reported to have analgesic and opioid-sparing effects in many kinds of surgery. Several studies have evaluated its use in the settings of spine surgery. The aim of the study is to examine the effect of intravenous lidocaine in patients undergoing spine surgery.

Methods:

We performed a quantitative systematic review. Databases of PubMed, Medline, Embase database and Cochrane library were investigated for eligible literatures from their establishments to June, 2019. Articles of randomized controlled trials that compared intravenous lidocaine to a control group in patients undergoing spine surgery were included. The primary outcome was postoperative pain intensity. Secondary outcomes included postoperative opioid consumption and the length of hospital stay.

Result:

Four randomized controlled trials with 275 patients were included in the study. postoperative pain compared with control was reduced at 6 hours after surgery (WMD −0.50, 95%CI, −0.76 to −0.25, P < .001), at 24 hours after surgery (WMD −0.50, 95%CI, −0.70 to −0.29, P < .001) and at 48 hours after surgery (WMD −0.57, 95%CI, −0.96 to −0.17, P = .005). The effect of intravenous lidocaine on postoperative opioid consumption compared with control revealed a significant effect (WMD −15.36, 95%CI, −21.40 to −9.33 mg intravenous morphine equivalents, P < .001).

Conclusion:

This quantitative analysis of randomized controlled trials demonstrated that the perioperative intravenous lidocaine was effective for reducing postoperative opioid consumption and pain in patients undergoing spine surgery. The intravenous lidocaine should be considered as an effective adjunct to improve analgesic outcomes in patients undergoing spine surgery. However, the quantity of the studies was very low, more research is needed.
Use of the GlideScope does not lower the hemodynamic response to tracheal intubation more than the Macintosh laryngoscope: a systematic review and meta-analysis
Authors: Hoshijima Hiroshi , Maruyama Koichi , Mihara Takahiro , Boku Aiji Sato , Shiga Toshiya , Nagasaka Hiroshi
Published: November 2020

Background:

It is presently unclear whether the hemodynamic response to intubation is less marked with indirect laryngoscopy using the GlideScope (GlideScope) than with direct laryngoscopy using the Macintosh laryngoscope. Thus, the aim of this study was to determine whether using the GlideScope lowers the hemodynamic response to tracheal intubation more than using the Macintosh laryngoscope.

Methods:

We performed a comprehensive literature search of electronic databases for clinical trials comparing hemodynamic response to tracheal intubation. The primary aim was to determine whether the heart rate (HR) and mean blood pressure (MBP) 60 s after tracheal intubation with the GlideScope were lower than after intubation with the Macintosh laryngoscope. We expressed pooled differences in HR and MBP between the devices as the weighted mean difference with 95% confidence interval and also performed trial sequential analysis (TSA). Second, we examined whether use of the GlideScope resulted in lower post-intubation hemodynamic responses at 120, 180, and 300 s compared with use of the Macintosh laryngoscope. For sensitivity analysis, we used a multivariate random effects model that accounted for within-study correlation of the longitudinal data.

Results:

The literature search identified 13 articles. HR and MBP at 60 seconds post-intubation was not significantly lower with the GlideScope than with the Macintosh (HR vs MBP: weighted mean difference = 0.22 vs 2.56; 95% confidence interval −3.43 to 3.88 vs −0.82 to 5.93; P = .90 vs 0.14; I
2 = 77% vs 63%: Cochran Q, 52.7 vs 27.2). Use of the GlideScope was not associated with a significantly lower HR or MBP at 120, 180, or 300 s post-intubation. TSA indicated that the total sample size was over the futility boundary for HR and MBP. Sensitivity analysis indicated no significant association between use of the GlideScope and a lower HR or MBP at any measurement point.

Conclusions:

Compared with the Macintosh laryngoscope, the GlideScope did not lower the hemodynamic response after tracheal intubation. Sensitivity analysis results supported this finding, and the results of TSA suggest that the total sample size exceeded the TSA monitoring boundary for HR and MBP.
Influence of rosuvastatin dose on total fatty acids and free fatty acids in plasma
Authors: Ciucanu Cristian I. , Olariu Sonia , Vlad Daliborca C. , Dumitraşcu Victor
Published: November 2020

This study investigates for the first time the influence of four doses of rosuvastatin on total fatty acids (TFA) and free fatty acids (FFA) in human plasma and correlates their changes in concentration with changes in the concentration of other lipids involved in cholesterol homeostasis.

This study was a placebo-controlled, randomized, double-blind, crossover experiment. The study used a single group of 16 men and consisted of 5 treatment periods lasting 4 weeks each with placebo and 4 doses of rosuvastatin (5, 10, 20, and 40 mg). Each subject changed 5 medical treatments and received in each new treatment different tablets of rosuvastatin or placebo compared to those taken in previous treatments, in a random order. Between treatment periods there was a wash-out period of 2 weeks, without treatment.

Changes in TFA and FFA were significant compared to placebo and between different doses of rosuvastatin. We found a continuous logarithmic decrease in levels of TFA, FFA, low-density lipoprotein (LDL)-cholesterol, total cholesterol, triglycerides, phospholipids, and apolipoprotein B-100, and a continuous increase in levels of high-density lipoprotein (HDL)-cholesterol and apolipoprotein A-1 by increases the dose of rosuvastatin. Analysis of the correlation of TFA and FFA with the main lipids and lipoproteins in cholesterol homeostasis indicated a linear regression with high correlation coefficients and all P-values were less than .05 level.

The concentrations of TFA and FFA are significantly influenced by the dose of rosuvastatin. They are strongly correlated with those of other lipids and lipoproteins involved in cholesterol homeostasis. The mechanisms of cholesterol homeostasis regulation are involved in changing the concentrations of TFA and FFA.
Acupuncture in the treatment of fatigue in Parkinson's disease
Authors: Zhi Yingpeng , Gao Chen
Published: November 2020

Background:

Fatigue is a commonly occurring nonmotor symptom among individuals of Parkinson's disease (PD). Little is known about how to measure fatigue in PD. This study is aiming to investigate the safety and efficacy of acupuncture for PD-related fatigue.

Methods:

RCTs of acupuncture for PD-related fatigue will be retrieved from inception to July 2020 in 9 different databases such as Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and so on. Search words will be used for the BC and acupuncture. The analysis would include randomised, controlled, clinical trials of PD patients with fatigue that were published in either Chinese or English. The primary outcome is the fatigue condition. Two or three reviewers should be in charge of study selection, data extraction and evaluating the risk of bias. RevMan software (V.5.3) will be used to perform the assessment of the risk of bias and data synthesis.

Results:

To provide evidence for the efficacy and safety of acupuncture treating PD-related fatigue.

Conclusion:

This study will be helpful for understanding the effect and safety of acupuncture for PD-related fatigue.

Trial registration number:

CRD42020160823
Efficacy of autologous platelet-rich plasma use for arthroscopic meniscal repair
Authors: Yu Hongchang , Tan Rongrong , Lou Baozhen , Xue Dingshan
Published: November 2020

Background:

Meniscus tear is one of the most familiar orthopedic injury, and it is also the leading cause of the dysfunction of knee joint. Recent efforts to improve the success rate of the meniscus repair surgery involve the addition of platelet-rich plasma (PRP). The aim of our experiment is to assess the clinical effects of arthroscopic repair of meniscal tears without or with PRP.

Methods:

This is a randomized and parallel-group superiority study. The study protocol is approved through the review committee of the corresponding institutions in PLA Army 80th Group Military Hospital. All patients will provide written informed consent to participate in the study. We implement our investigation on the basis of the ethical standards outlined in the Helsinki Declaration of 1964 and then report our outcomes according to the CONSORT statement of 2010. All the patients follow a same rehabilitation program. Patients are assessed at baseline (day before operation), 12 months and 24 months after the last time of injection; outcome assessments involve Ikeuchi score, Lysholm score, and the visual analogue scales for failure and pain rate. P value less than .05 indicates that there is statistical significance.

Results:

We suppose that arthroscopic PRP repair of meniscus tears results in improved pain and functional results owing to the release of bioactive molecules that may affect the healing of meniscus.

Trial registration:

This study protocol was registered in Research Registry (researchregistry6175).
Clinical significance of serum human epididymis protein 4 in liver fibrosis
Authors: Hou Yulei , Li Fengzeng , Chen Juanjuan , Zhao Jinqiu , Li Detao , Chen Hui
Published: November 2020

Background:

Human epididymis protein 4 (HE4) has been identified as marker for renal fibrosis. Present study aimed to investigate the clinical significance of serum HE4 in liver fibrosis.

Methods:

Serum from 65 liver fibrosis patients, 68 hepatic patients without fibrosis, and 50 controls was collected respectively. Serum HE4 levels were measured by chemiluminescence immunoassay and compared among the groups. The relationships between serum HE4 levels and the clinical characteristics of liver fibrosis were also analyzed. A receiver operator characteristic curve was plotted to investigate the diagnostic efficacy of serum HE4 for liver fibrosis. Child–Pugh (C–P) score and liver fibrosis score were also evaluated. Data were analyzed by statistical software 13.0.

Results:

Serum HE4 levels were significantly higher in liver fibrosis than that of controls [105.35 (82.64, 164.18) vs 46.2 (39.9, 58.9) pmol L−1, P = .00] and hepatic patients without liver fibrosis [105.35 (82.64, 164.18) vs 51.00 (44.02, 65.65) pmol L−1, P < .01]; Serum HE4 levels in liver fibrosis patients with C–P class C were significantly higher than those with C–P class A [143.75 (106.50, 186.08) vs 81.42 (69.73, 99.26) pmol L−1, P = .005] and C–P class B [143.75 (106.50, 186.08) vs 113.10 (88.92, 169.50) pmol L−1, P = .01]; the diagnostic sensitivity and specificity of serum HE4 levels for liver fibrosis detection were 87.5% and 81.1%, at a cutoff value of 69 pmol L−1; Serum HE4 levels in alcoholic liver fibrosis were higher than that of liver fibrosis with hepatitis B virus infection [131.30 (100.67, 228.35) vs 89.46 (73.74, 116.45) pmol L−1, P < .01].

Conclusion:

Serum HE4 was closely correlated with C–P class and might be a potential marker for liver fibrosis.
Endovascular treatment with stenting of celiac artery aneurysms
Authors: Yuan Fu-Kang , Xi Hai-Lin , Qin Rui-Hao , Tian Zhi-Long , Li Cui , Lu Fei
Published: November 2020

This study aimed to detail the clinical outcomes of patients suffering from celiac arterial aneurysm (CAA) that underwent treatment via stent occlusion.

This is a single-center, retrospective study. A total of 8 consecutive CAA patients were treated via stent occlusion from March 2014 to September 2018 at our hospital. Follow-up computed tomography was conducted after stenting at 1, 3, 6, and 12-month time points and every year thereafter. Both short- and long-term outcomes were assessed.

In total, 8 stents were inserted into these 8 patients, with 2 being uncovered and 6 being covered stents. In 2 patients, stents were positioned in the celiac artery, while in the remaining 6 patients they were placed in the celiac and common hepatic arteries. The median operative duration was 66 minutes. No patients exhibited procedure-associated complications, and the median follow-up duration was 39 months (range: 18–72). Abdominal contrast-enhanced CT analyses of these patients exhibited stent and distal artery patency in 100% of patients, together with CAA obliteration. Visceral necrosis did not occur in any patients over the follow-up period.

Stent occlusion can be safely and effectively used to treat CAA patients.
Treatment of purely ligamentous dorsoulnar radiocarpal dislocation with ulnar translation of the carpus
Authors: Park Il-Jung , Kim Jongmin , Baek Jong Won , Kang Soo Hwan
Published: November 2020

Rationale:

Radiocarpal fracture-dislocations are extremely infrequent injuries caused by high-energy trauma and involve significant osseous and ligamentous injuries. If not treated properly, it can lead to serious complications such as ulnar translation of the carpus, multidirectional instability, loss of motion, and post-traumatic arthritis. Purely ligamentous injuries are rarer than fracture-dislocation injuries. Because previous studies have reported small patient cohorts, there has been no standardized treatment strategy for purely ligamentous radiocarpal dislocation.

Patient concerns:

A 24-year-old man suffered a left wrist injury in a motorcycle accident. Plain radiographs revealed dorso-ulnar radiocarpal dislocation without radial fracture and Carpal-ulnar distance ratio (CUDR) was 0.16. MRI scans showed the disruption of the dorsal ligaments and capsules and avulsed from the proximal insertion of the volar radiocarpal ligaments.

Diagnosis:

Dorsoulnar radiocarpal dislocation with purely ligamentous injury.

Intervention:

We removed the interposing chondral fragment from the radiocarpal joint and repaired the radioscaphocapitate (RSC) and radiolunate (RL) ligaments with the Jugger Knot Soft Anchor Suture (Biomet, Inc, Warsaw, IN) and applied additional radiocarpal K-wires and an external fixator to maintain reduction and optimal ligament tension.

Outcomes:

The patient showed good clinical results although ulnar translation of the carpus recurred in radiological follow-up.

Lessons:

Aggressive surgical management is needed earlier in the treatment of purely ligamentous radiocarpal dislocation, especially if the ulnar translation of the carpus was observed in the initial radiographs.
Acupuncture combined with Tongxieyaofang for diarrhea-type irritable bowel syndrome
Authors: Li Yi-Lin , Yao Cheng-Jiao , Lei Rong , Xie Fengjiao , Xiong Qin , Luo Li-Hong , Feng Pei-Min
Published: November 2020

Background:

As a traditional Chinese medicine external treatment method, acupuncture is characterized by simple operation, significant treatment effect and few side effects. Tong-Xie-Yao-Fang (TXYF), a Chinese patent medicine, combined with acupuncture has been widely used on treating Diarrhea Predominant Irritable Bowel Syndrome (IBS-D). However, the efficacy and safety of TXYF combined with acupuncture for the treatment of IBS-D are unclear. This study aims to investigate verify the efficacy and safety of TXYF combined with acupuncture for IBS-D.

Methods and analysis:

Randomized controlled trials of TXYF combined with acupuncture for all IBS-D will be searched in PubMed, the Cochrane Library, Embase, Web of Science, the China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Periodical Database, and Chinese Biomedical Literature Database from inception to October 20, 2020. And Baidu Scholar, Google Scholar, International Clinical Trials Registry Platform, and Chinese Clinical Trials Registry will be searched to obtain more relevant studies comprehensively. The methodological qualities, including the risk of bias, will be evaluated using the Cochrane risk of bias assessment tool, while confidence in the cumulative evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Two researchers will perform data extraction and risk of bias assessment independently. Statistical analysis will be conducted in RevMan 5.3.

Results:

Based on the current evidence, the potential rank of the efficacy and safety of TXYF plus acupuncture for IBS-D will be assessed.

Conclusion:

The findings of the study will provide helpful evidence for the efficacy and safety of TXYF combined with acupuncture in the treatment of IBS-D, facilitating clinical practice and further scientific studies.
Is the Moon the future of infrared astronomy?
Authors: Maillard Jean-Pierre
Published: November 2020

Infrared astronomy, particularly in spectroscopy, could benefit in a decisive way from an implementation of telescopes on the Moon since the largest telescopes on Earth are practically limited to 40 m and in space to 10 m. On the Moon, a collector larger than on Earth becomes conceivable, thanks to the low gravity and the absence of wind, in having the advantages of space. Passively cooled in the bottom of a permanently shadowed crater at the northern or the southern pole, it could reach unprecedented spectral sensitivity on a large part of the infrared domain, making possible spectral analysis of the most primitive galaxies and of the terrestrial exoplanet atmospheres. A project aiming at the detection of the weak cosmic microwave background spectral distortions is also presented. Several identical 1.5 m cryo-cooled telescopes at 2.5 K to fit in a launcher, with an imaging Fourier transform spectrometer in each unit, deposited in a cold crater and pointing in the same direction in lunar survey mode, would build for this fundamental goal the equivalent of a large telescope at an extremely low temperature. Last, the feasibility of these projects is discussed.

This article is part of a discussion meeting issue ‘Astronomy from the Moon: the next decades (part 1)'.
The effects of feeding ferric citrate on ruminal bacteria, methanogenic archaea and methane production in growing beef steers
Authors: Clemmons Brooke A. , Schneider Liesel G. , Melchior Emily A. , Lindholm-Perry Amanda K. , Hales Kristin E. , Wells James E. , Freetly Harvey C. , Hansen Stephanie L. , Drewnoski Mary E. , Hartman Sarah J. , Myer Phillip R.
Published: November 2020

Methane produced by cattle is one of the contributors of anthropogenic greenhouse gas. Methods to lessen methane emissions from cattle have been met with varying success; thus establishing consistent methods for decreasing methane production are imperative. Ferric iron may possibly act to decrease methane by acting as an alternative electron acceptor. The objective of this study was to assess the effect of ferric citrate on the rumen bacterial and archaeal communities and its impact on methane production. In this study, eight steers were used in a repeated Latin square design with 0, 250, 500 or 750 mg Fe/kg DM of ferric iron (as ferric citrate) in four different periods. Each period consisted of a 16 day adaptation period and 5 day sampling period. During each sampling period, methane production was measured, and rumen content was collected for bacterial and archaeal community analyses. Normally distributed data were analysed using a mixed model ANOVA using the GLIMMIX procedure of SAS, and non-normally distributed data were analysed in the same manner following ranking. Ferric citrate did not have any effect on bacterial community composition, methanogenic archaea nor methane production (P>0.05). Ferric citrate may not be a viable option to observe a ruminal response for decreases in enteric methane production.
Antibiotic resistance levels in soils from urban and rural land uses in Great Britain
Authors: Osbiston Kieran , Oxbrough Anne , Fernández-Martínez Lorena Teresa
Published: November 2020

Although soil is one of the largest microbial diversity reservoirs, the processes that define its microbial community dynamics are not fully understood. Improving our understanding of the levels of antibiotic resistance in soils with different land uses in Great Britain is not only important for the protection of animal health (including humans), but also for gaining an insight into gene transfer levels in microbial communities. This study looked at the levels of antibiotic-resistant bacteria (ARB) able to survive inhibitory concentrations of chloramphenicol, erythromycin and vancomycin, as well as subinhibitory (10 µg ml−1) erythromycin concentrations. Soils from nine different sites across Great Britain with three distinct land uses (agricultural, urban and semi-natural) were sampled and the percentage of ARB was calculated for each site. Statistical analyses confirmed a significant difference in the level of ARB found in agricultural land compared to urban or semi-natural sites. The results also showed that resistance levels to vancomycin and chloramphenicol in the agricultural and urban sites sampled were significantly higher than those for erythromycin, whilst in semi-natural sites all three antibiotics show similar resistance levels. Finally, although the levels of resistance to a subinhibitory (10 µg ml−1) erythromycin concentration were significantly higher across land use types when compared to the levels of resistance to an inhibitory (20 µg ml−1) concentration, these were much less marked in soil from agricultural land compared to that from urban or semi-natural land use soil.
Five novel bifidobacterial species isolated from faeces of primates in two Czech zoos: Bifidobacterium erythrocebi sp. nov., Bifidobacterium moraviense sp. nov., Bifidobacterium oedipodis sp. nov., Bifidobacterium olomucense sp. nov. and Bifidobacterium panos sp. nov.
Authors: Neuzil-Bunesova Vera , Lugli Gabriele Andrea , Modrackova Nikol , Vlkova Eva , Bolechova Petra , Burtscher Johanna , Longhi Giulia , Mancabelli Leonardo , Killer Jiri , Domig Konrad , Ventura Marco
Published: November 2020

Five

Bifidobacterium

strains, VB23T, VB24T, VB25T, VB26T and VB31T, were isolated from chimpanzee (Pan troglodytes), cotton-top tamarin (Saguinus oedipus), Goeldi’s marmoset (Callimico goeldii), moustached tamarin (Saguinus mystax) and patas monkey (Erythrocebus patas), respectively, which were kept in two Czech zoos. These strains were isolated from faecal samples and were Gram-positive, non-motile, non-sporulating, anaerobic and fructose-6-phosphate phosphoketolase-positive. Phylogenetic analyses based on 16S rRNA revealed close relatedness between VB23T and

Bifidobacterium angulatum

LMG 11039T (96.0 %), VB24T and

Bifidobacterium pullorum

subsp.

pullorum

DSM 20433T (96.1 %), VB25T and

Bifidobacterium goeldii

LMG 30939T (96.5 %), VB26T and

Bifidobacterium imperatoris

LMG 30297T (98.1 %), and VB31T and

B

.

angulatum

LMG 11039T (99.40 %). Internal transcribed spacer profiling revealed that VB23T, VB24T, VB25T, VB26T and VB31T had highest similarity to

Bifidobacterium breve

LMG 13208T (77.2 %),

Bifidobacterium longum

subsp.

infantis

ATCC 15697T (85.8 %),

Bifidobacterium biavatii

DSM 23969T (76.9 %),

B. breve

LMG 13208T (81.2 %) and

B. angulatum

LMG 11039T (88.2 %), respectively. Average nucleotide identity (ANI) and digital DNA–DNA hybridization (dDDH) analyses with their closest neighbours supported the independent phylogenetic positions of the strains with values between 86.3 and 94.3 % for ANI and 25.8 and 54.9 % for dDDH. These genomic and phylogenetic analyses suggested that the evaluated strains were novel

Bifidobacterium

species named Bifidobacterium erythrocebi sp. nov. (VB31T=DSM 109960T=CCUG 73843T), Bifidobacterium moraviense sp. nov. (VB25T=DSM 109958T=CCUG 73842T), Bifidobacterium oedipodis sp. nov. (VB24T=DSM 109957T=CCUG 73932T), Bifidobacterium olomucense sp. nov. (VB26T=DSM 109959T=CCUG 73845T) and Bifidobacterium panos sp. nov. (VB23T=DSM 109963T=CCUG 73840T).
EMBEDR: Distinguishing Signal from Noise in Single-Cell Omics Data
Authors: Johnson Eric , Kath William , Mani Madhav
Published: November 2020

While single-cell “omics” based measurements hold the promise of unparalleled biological insight they remain a challenge to analyze owing to their high-dimensional nature. As a result, Dimensionality Reduction (DR) algorithms are necessary for data visualization and for downstream quantitative analysis. The lack of a principled methodology for separating signal from noise in DR algorithmic outputs has limited the confident application of these methods in unsupervised analyses of single-cell data, greatly hampering researchers’ ability to make data-driven discoveries. In this work we present an approach to quality assessment,EMBEDR, that works in conjunction with any DR algorithm to distinguish signal from noise in dimensionally-reduced representations of high-dimensional data. We apply EMBEDR to t-SNE- and UMAP-generated representations of published scRNA-seq data, revealing where lower-dimensional representations of the data are faithful renditions of biological signal in the data, and where they are more consistent with noise. EMBEDR produces easily interpreted p-values for each cell in a data set, facilitating the comparison of different DR methods and allowing optimization of their global hyperparameters. Most compellingly, EMBEDR allows for the analysis of single-cell data at a single-cell resolution, allowing DR methods to be used in a cell-wise optimal manner. Applying this technique to real data results in a biologically interpretable view of the data with no user supervision. We demonstrate the utility of EMBEDR in the context of several data sets and DR algorithms, illustrating its robustness and flexibility as well as its potential for making rigorous, quantitative analyses of single-cell omics data. EMBEDR is available as a Python package for immediate use.
Community Transmission of SARS-CoV-2 by Fomites: Risks and Risk Reduction Strategies
Authors: Pitol Ana K. , Julian Timothy R.
Published: November 2020

SARS-CoV-2, the virus responsible for the COVID-19 pandemic, is perceived to be primarily transmitted via person-to-person contact, through droplets produced while talking, coughing, and sneezing. Transmission may also occur through other routes, including contaminated surfaces; nevertheless, the role that surfaces have on the spread of the disease remains contested. Here we use the Quantitative Microbial Risk Assessment framework to examine the risks of community transmission of SARS-CoV-2 through contaminated surfaces and to evaluate the effectiveness of hand and surface disinfection as potential interventions. The risks posed by contacting surfaces in communities are low (average of the median risks 1.6×10−4- 5.6×10−9) for community infection prevalence rates ranging from 0.2-5%. Hand disinfection substantially reduces relative risks of transmission independently of the disease’s prevalence and the frequency of contact, even with low (25% of people) or moderate (50% of people) compliance. In contrast, the effectiveness of surface disinfection is highly dependent on the prevalence and the frequency of contacts. The work supports the current perception that contaminated surfaces are not a primary mode of transmission of SARS-CoV-2 and affirms the benefits of making hand disinfectants widely available.
Single cell profiling of COVID-19 patients: an international data resource from multiple tissues
Authors:   Chan Zuckerberg Initiative Single-Cell COVID-19 Consortia, Ballestar Esteban , Farber Donna L. , Glover Sarah , Horwitz Bruce , Meyer Kerstin , Nikolić Marko , Ordovas-Montanes Jose , Sims Peter , Shalek Alex , Vandamme Niels , Vandekerckhove Linos , Vento-Tormo Roser , Villani Alexandra Chloe
Published: November 2020

[Abstract]

In late 2019 and through 2020, the COVID-19 pandemic swept the world, presenting both scientific and medical challenges associated with understanding and treating a previously unknown disease. To help address the need for great understanding of COVID-19, the scientific community mobilized and banded together rapidly to characterize SARS-CoV-2 infection, pathogenesis and its distinct disease trajectories. The urgency of COVID-19 provided a pressing use-case for leveraging relatively new tools, technologies, and nascent collaborative networks. Single-cell biology is one such example that has emerged over the last decade as a powerful approach that provides unprecedented resolution to the cellular and molecular underpinnings of biological processes. Early foundational work within the single-cell community, including the Human Cell Atlas, utilized published and unpublished data to characterize the putative target cells of SARS-CoV-2 sampled from diverse organs based on expression of the viral receptor ACE2 and associated entry factors TMPRSS2 and CTSL (Muus et al., 2020; Sungnak et al., 2020; Ziegler et al., 2020). This initial characterization of reference data provided an important foundation for framing infection and pathology in the airway as well as other organs. However, initial community analysis was limited to samples derived from uninfected donors and other previously-sampled disease indications. This report provides an overview of a single-cell data resource derived from samples from COVID-19 patients along with initial observations and guidance on data reuse and exploration.