bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors affecting recurrence and management of recurrent cerebral aneurysms after initial coiling
Authors: Han Yongfeng , Liu Jian , Tian Zhongbin , Lv Ming , Yang Xinjian , Wu Zhongxue , Gao Bu-Lang
Published: January 2020

Objective

To investigate factors affecting recurrence and effects and safety of endovascular retreatment for aneurysms recurrent after embolization.

Methods

Among 815 aneurysms treated with embolization, recurrence was in 114 aneurysms (14.0%). Forty-three recurrent aneurysms were managed with re-embolization. Procedural complications, angiographic, and clinical results of retreatment were analyzed.

Results

Patients with recurrent aneurysms were significantly ( P < 0.01) younger than without recurrence (51.09 ± 10.46 vs. 53.88 ± 9.61 years). Recurrent aneurysms ( n = 114) were significantly ( P = 0.00) greater (11.12 ± 8.35 vs. 5.81 ± 3.44 mm) with a significantly ( P = 0.00) greater neck (4.34 ± 2.26 vs. 2.90 ± 1.44 mm) than without recurrence. The rupture status of aneurysms significantly ( P = 0.00) affected recurrence at follow-up. Significantly ( P = 0.00) more aneurysms without recurrence were treated with advanced embolization techniques (81.0% vs. 62.3%) and got complete occlusion at the first embolization than those with recurrence (93.7% vs. 36.8%). In treating 43 recurrent aneurysms, stent-assisted recoiling was used in 48.8% in the first retreatment and 50% in the second and third retreatment procedures. Angiographic follow-up in 38 (88.4%) cases showed complete or near complete occlusion in 30 aneurysms, with the rest eight aneurysms experiencing a second recurrence (21.1%). Of the eight aneurysms with the second recurrence, five underwent the second endovascular retreatment, with complete aneurysm occlusion achieved in three cases (60%), near-complete occlusion in one (20%), and incomplete occlusion in one case at immediate angiography and six-month follow-up. Procedure-related complications occurred in three patients.

Conclusions

Endovascular retreatment of recurrent previously coiled aneurysms is safe and effective even though advanced embolization techniques are frequently involved especially for large and giant aneurysms.
Photophysical properties and energy transfer mechanism of a praseodymium compound with a two-dimensional layer
Authors: Chen Wen-Tong
Published: January 2020

A hydrothermal reaction results in the formation of a novel [Pr2(2,5-PA)2(2,5-HPA)2(H2O)4] n·2 nH2O complex (2,5-H2PA = 2,5-pyridinedicarboxylic acid). The complex is structurally characterized by single-crystal X-ray diffraction and crystallizes in the space group P21 of the monoclinic system with two formula units in one cell. This praseodymium complex is characterized by a two-dimensional layered structure. A solid-state photoluminescence experiment reveals that the praseodymium complex shows an emission in the red region. The complex has Commission Internationale de I’Éclairage chromaticity coordinates of 0.5495 and 0.4492. The photoluminescence emission bands could be assigned to the characteristic emission of the 4 f electron intrashell transition of the 3 P0 → 3 H5, 1 D2 → 3 H4, 3 P0 → 3 H6, 3 P0 → 3 F2, and 3 P1 → 3 F3 of the Pr3+ ions. The energy transfer mechanism is explained by the energy level diagrams of the praseodymium ions and the 2,5-H2PA ligand. A solid-state diffuse reflectance measurement shows that the complex possesses a wide optical band gap of 3.48 eV.
Alterations of connectivity patterns in functional brain networks in patients with mild traumatic brain injury: A longitudinal resting-state functional magnetic resonance imaging study
Authors: D’Souza Maria M , Kumar Mukesh , Choudhary Ajay , Kaur Prabhjot , Kumar Pawan , Rana Poonam , Trivedi Richa , Sekhri Tarun , Singh Ajay K
Published: January 2020

Aim

In the present study, we aimed to characterise changes in functional brain networks in individuals who had sustained uncomplicated mild traumatic brain injury (mTBI). We assessed the progression of these changes into the chronic phase. We also attempted to explore how these changes influenced the severity of post-concussion symptoms as well as the cognitive profile of the patients.

Methods

A total of 65 patients were prospectively recruited for an advanced magnetic resonance imaging (MRI) scan within 7 days of sustaining mTBI. Of these, 25 were reassessed at 6 months post injury. Differences in functional brain networks were analysed between cases and age- and sex-matched healthy controls using independent component analysis of resting-state functional MRI.

Results

Our study revealed reduced functional connectivity in multiple networks, including the anterior default mode network, central executive network, somato-motor and auditory network in patients who had sustained mTBI. A negative correlation between network connectivity and severity of post-concussive symptoms was observed. Follow-up studies performed 6 months after injury revealed an increase in network connectivity, along with an improvement in the severity of post-concussion symptoms. Neurocognitive tests performed at this time point revealed a positive correlation between the functional connectivity and the test scores, along with a persistence of negative correlation between network connectivity and post-concussive symptom severity.

Conclusion

Our results suggest that uncomplicated mTBI is associated with specific abnormalities in functional brain networks that evolve over time and may contribute to the severity of post-concussive symptoms and cognitive deficits.
Ballistic performance of multi-metal systems
Authors: Ranaweera Prabhani , Weerasinghe Dakshitha , Fernando PLN , Raman Sudharshan N , Mohotti Damith
Published: January 2020

Ballistic resistance enhancement of armours and structures has been a prominent area of research over the years. Monolithic metallic plates have been the preferred choice for armours against high-velocity projectiles. High-strength steel is a popular choice for such systems. However, the high areal density deters in accommodating such systems in practical applications which require lightweight products. On the contrary, multi-metallic systems produced by the combination of low-density materials with similar or superior ballistic resistance as their monolithic counterparts have become attractive candidates in defence applications. However, only a limited number of comprehensive studies on the ballistic performance of multi-metal multi-layered targets are available in the literature. Moreover, these studies have drawn contradictory conclusions on the optimum arrangement of different layers and materials within the systems. In addition, existing knowledge in this area is scattered in the literature and there is a need to collate them to enhance the development of multi-metal multi-layered ballistic-resistant plate systems in order to be optimised for ballistic-related armour. This article aims to provide a comprehensive review of the effect of different metals, thickness, fracture mechanisms, feasibility of the connection types and the order of the metallic plates within targets on the ballistic performance.
Reshaping home–school connections in the digital age: Challenges for teachers and parents
Authors: Hutchison Kirsten , Paatsch Louise , Cloonan Anne
Published: January 2020

Imperatives to connect the worlds of home and school, evident in global policies of family engagement and partnership initiatives between teachers and parents to support children’s education are viewed as key dimensions of academic success. However, developing ways to meaningfully connect and engage teachers, parents and students in learning ecologies remains elusive, contested and increasingly complex in the digital age. Teachers are encouraged to draw on their students’ digital ‘funds of knowledge’ to create innovative learning opportunities and develop capacities for creativity and critical thinking. Despite significant research into creativity pedagogies and the inclusion of parents in policy documents urging for increased innovation in schooling, which often implies the use of digital technologies, parents are largely invisible in research into creative pedagogies. The data explored in this article are drawn from a larger project which adopted a teacher-as-inquirer approach to investigate teacher, student and parent experiences and understandings of innovative teaching designed to integrate creative and critical thinking with digital literacy practices. The analysis mobilises the key features of creative and innovative learning environments identified in the research literature to explore teachers’ initiatives to develop reflexive and innovative pedagogies and foregrounds the ways in which incorporation of digital media impacted on parental engagement in their children’s learning. Findings highlight significant challenges for schools and teachers to meaningfully and sustainably connect home and school learning which positions children, teachers and parents as agentic and creative.
Spironolactone in pulmonary arterial hypertension: results of a cross‐over study
Authors: Safdar Zeenat , Frost Adaani , Basant Arya , Deswal Anita , O’Brian Smith E. , Entman Mark
Published: January 2020

The renin–angiotensin–aldosterone system is implicated in the pathophysiology of pulmonary arterial hypertension. We undertook this study to determine the effects of spironolactone, a mineralocorticoid receptor blocker, on collagen metabolism in pulmonary arterial hypertension patients. After obtaining institutional review board approval and informed consent, 42 pulmonary arterial hypertension patients were prospectively enrolled and 35 patients completed the 16‐week randomized double‐blinded crossover clinical trial. Subjects received 50 mg spironolactone or placebo and at the end of week 8, treatment arm was switched. Circulating levels of collagen biomarkers, brain natriuretic peptide, and aldosterone levels were measured, and six‐minute walk distance, liver function tests, and echocardiogram data were collected at weeks 0, 8, and 16. Mean age was 45 ± 15 years and 87% were females. At baseline, brain natriuretic peptide and aldosterone levels were 74 ± 95 pg/ml and 7 ± 8 pg/ml, respectively. There was no change in the levels of amino‐terminal propeptide of procollagen type III (PIIINP), MMP‐9, TIMP‐1, and MMP‐9/TIMP‐1 ratio at weeks 8 and 16 compared to baseline values in placebo arm and treatment arm. The baseline six‐min walk distance was 436 ± 115 meters at baseline and no change in walk distance was noted at weeks 8 and 16 (P = 0.372). None of the patients developed hyperkalemia or liver function test abnormalities at weeks 8 and 16 requiring discontinuation of study drug. Our study showed no change in collagen metabolite levels in pulmonary arterial hypertension patients treated with spironolactone. Spironolactone was safe and well tolerated by pulmonary arterial hypertension patients with no increased hyperkalemia or liver function test abnormalities.
Depicting Students’ Social Presence on Social Networking Site in Course-Related Interaction
Authors: Al-Dheleai Yahya M. , Tasir Zaidatun , Jumaat Nurul Farhana
Published: January 2020

Social networking sites (SNS) are widely used among students, where its integration in higher education is increasing across years. Therefore, this study aimed to analyze students’ use of social presence (SP) expressions in blended learning environment using Facebook group as a medium of online discussion. A total of 11 students and one instructor were involved in 7-week multimedia learning course in one of the Malaysian universities. The content of students’ online discussion on Facebook group was the source of the data in this study. The discussion content was transcribed, coded, and analyzed, and the frequencies of categories were calculated to determine students’ use of SP expressions. The findings of the study revealed that students focus on delivering more interactive response (IR) posts across all learning topics. Interestingly, although SNS are social in nature, this study revealed that students’ use of SP expressions on SNS was intended to improve course discussion interactivity rather than for pure socializing purpose. However, more theoretical topics triggered higher number of SP posts compared with technical focused topics. More importantly, the way students used SP expressions during course-related interaction through Facebook may contribute to improved performance in test.
Using antibiotic cement nail with multiple screws fixation as a single-stage salvage procedure for patient with infected tibiotalocalcaneal arthrodesis: A case report
Authors: Chiu Yen-Chun , Chen I-Chien , Yang Shih-Chieh , Kuo Shyh-Ming , Kao Yu-Hsien , Jou I-Ming , Tu Yuan-Kun
Published: January 2020

Tibiotalocalcaneal (TTC) arthrodesis with retrograde nail is a widely used treatment option for severe ankle arthropathy. With inherent biomechanical benefits in axial loading and strong bending stiffness, high union rate and good clinical outcomes have been reported in the literature. However, some undesired complications, such as osteomyelitis or implant failure, can develop after this procedure. Herein, we report the case of an 86-year-old man with right ankle osteomyelitis after TTC arthrodesis with retrograde nail. After removing the previous implants and extensive debridement, we used an antibiotic cement nail with multiple screws fixation as a salvage procedure in the same operation. The patient fully recovered without further surgical treatment.
Neural Representation of Loudness: Cortical Evoked Potentials in an Induced Loudness Reduction Experiment
Authors: Schmidt Florian H. , Mauermann Manfred , Kollmeier Birger
Published: January 2020

Loudness context effects comprise differences in judgments of the loudness of a target stimulus depending on the presence of a preceding inducer tone. Interstimulus intervals (ISIs) between inducer tone and target tone of about 200 ms and above cause an induced loudness reduction (ILR) of the target tone. As the ILR increases, respectively, the perceived loudness of the target stimuli decreases with increasing ISI. This in turn means that identical stimuli in a different context have a differently perceived loudness. A correlation between specific characteristics in the electroencephalography responses and perceived loudness in an ILR experiment would therefore provide a neurophysiological indication of loudness processing beyond a neural representation of stimulus intensity only. To examine if such a correlation exists, we investigated cortical electroencephalography responses in a latency range from 75 to 510 ms during a psychoacoustical ILR experiment with different ISIs. With increasing ISI, the strength of the N1-P2 deflection of the respective electroencephalography response decreases similarly to the loudness perception of the target tone pulse. This indicates a representation based on loudness rather than on intensity at the corresponding processing stage.
Bleeding and recurrent VTE with apixaban vs warfarin as outpatient treatment: time-course and subgroup analyses
Authors: Weycker Derek , Wygant Gail DeVecchis , Guo Jennifer D. , Lee Theodore , Luo Xuemei , Rosenblatt Lisa , Mardekian Jack , Atwood Mark , Hanau Ahuva , Cohen Alexander T.
Published: January 2020

In the phase 3 trial Apixaban for the Initial Management of Pulmonary Embolism and Deep-Vein Thrombosis as First-Line Therapy, apixaban was noninferior to enoxaparin, overlapped and followed by warfarin, in the treatment of venous thromboembolism (VTE) with significantly less bleeding; in a real-world evaluation, risks for bleeding and recurrent VTE were lower with apixaban vs warfarin plus parenteral anticoagulant (PAC) bridge therapy. The present study extends this research by comparing outcomes over time and within selected subgroups. A retrospective observational cohort design and 4 US private health care claims databases were used. Study population included patients who initiated outpatient treatment with apixaban or warfarin (plus PAC bridge therapy) for VTE. Major bleeding, clinically relevant nonmajor (CRNM) bleeding, and recurrent VTE were compared during the 180-day follow-up period, at selected follow-up time points (days 21, 90, 180), and within subgroups (pulmonary embolism [PE] with or without deep vein thrombosis [DVT], DVT only, provoked VTE, unprovoked VTE) using multivariable shared frailty models. Study population consisted of 20 561 apixaban patients and 35 080 warfarin patients; baseline characteristics were comparable. Overall, at selected follow-up time points, and within the aforementioned subgroups, adjusted risks were lower among apixaban vs warfarin patients: major bleeding, by 27% to 39%, CRNM bleeding, by 17% to 28%, and recurrent VTE, by 25% to 39% (all P ≤ .01). In this real-world study of VTE patients, risks of bleeding and recurrent VTE were lower among apixaban (vs warfarin) patients during the 180-day follow-up period, at selected follow-up time points, and within subgroups defined by index VTE episode.
The effects of pharmacological interventions on quality of life and fatigue in sarcoidosis: a systematic review
Authors: Vis Roeland , van de Garde Ewoudt M.W. , Grutters Jan C. , Korenromp Ingrid H.E.
Published: January 2020

Aims

Many sarcoidosis patients experience a reduction in health-related quality of life (HRQoL) and a majority of patients report fatigue. Historically, drug trials in sarcoidosis have focused on changes in chest radiographs, lung function parameters and biomarkers, while HRQoL and fatigue have not been the main outcomes examined. We performed a systematic review of the literature to evaluate the existing evidence on the effects of pharmacological interventions on HRQoL and fatigue outcomes.

Methods

The systematic search was performed in Medline and Embase and yielded 15 records covering seven randomised controlled trials and seven single-arm open label studies, which were included in a qualitative synthesis (the results of one study were included in two publications). 12 studies evaluated immunosuppressive and/or immunomodulatory therapies and two studies evaluated stimulants.

Results

Nine out of the 14 studies observed positive treatment effects from the interventions on HRQoL and/or fatigue, exceeding the minimal important difference. The risk of bias was generally high with only three studies rated as having a low risk of bias. The results suggest a potential for improvement in HRQoL and/or fatigue in patients with active disease who are either untreated or treated but not yet fully stabilised or therapy refractory.

Conclusion

More randomised, double-blind and placebo-controlled trials are needed to expand the evidence base on these important outcome parameters.
Simulated solar light-driven photocatalytic degradation of trichloroethylene in water using BiOBr promoted by sulfite addition
Authors: Jung Bahngmi , Deng Wei , Li Ying , Batchelor Bill , Abdel-Wahab Ahmed
Published: January 2020

Background

Photodegradation of trichloroethylene (TCE) in aqueous solution under simulated solar light irradiation was studied under different experimental conditions to determine the reaction mechanism and kinetics that control TCE degradation using bismuth oxybromide (BiOBr) in the presence of sulfite. Photocatalysts were synthesized to be more responsive to visible light under simulated solar light and particular attention was focused on the reactive specie formed by reaction of the sulfite on the surface of BiOBr under simulated sunlight.

Result

Degradation rate of TCE was greatly enhanced by the presence of sulfite, and the enhancement increased with sulfite dose to a maximum that was retained at higher sulfite doses. Degradation rate of TCE was also affected by other factors, such as initial TCE concentration, BiOBr dose, and solution pH. In addition, the cycling performance of BiOBr was examined, and the amount of TCE degraded was almost constant over increasing cycle numbers when initial sulfite concentration was high enough to maintain a suitable sulfite concentration throughout the experiment. When TCE was degraded by BiOBr in the presence of sulfite under simulated sunlight irradiation, the major by-product measured was the non-hazardous chloride ion, and dechlorination efficiency was about 58%.

Conclusion

This study extended the use of a potential effective photocatalyst (BiOBr) to a semi-volatile organic contaminant (TCE), not limited to mainly focus on organic dyes, and evaluated the use of sulfite as a hole scavenger in order to enhance the degradation of TCE without needing to manipulate the structure of BiOBr. The active species being responsible for TCE degradation in BiOBr/TCE/sulfite system under simulated solar light was the sulfite radical (SO3·−), and the photocatalytic activity of BiOBr did not decrease over a number of treatment cycles when SIV dose was sufficient.
Genome-wide analyses of cassava Pathogenesis-related (PR) gene families reveal core transcriptome responses to whitefly infestation, salicylic acid and jasmonic acid
Authors: Irigoyen Maria L. , Garceau Danielle C. , Bohorquez-Chaux Adriana , Lopez-Lavalle Luis Augusto Becerra , Perez-Fons Laura , Fraser Paul D. , Walling Linda L.
Published: January 2020

Background

Whiteflies are a threat to cassava (Manihot esculenta), an important staple food in many tropical/subtropical regions. Understanding the molecular mechanisms regulating cassava’s responses against this pest is crucial for developing control strategies. Pathogenesis-related (PR) protein families are an integral part of plant immunity. With the availability of whole genome sequences, the annotation and expression programs of the full complement of PR genes in an organism can now be achieved. An understanding of the responses of the entire complement of PR genes during biotic stress and to the defense hormones, salicylic acid (SA) and jasmonic acid (JA), is lacking. Here, we analyze the responses of cassava PR genes to whiteflies, SA, JA, and other biotic aggressors.

Results

The cassava genome possesses 14 of the 17 plant PR families, with a total of 447 PR genes. A cassava PR gene nomenclature is proposed. Phylogenetic relatedness of cassava PR proteins to each other and to homologs in poplar, rice and Arabidopsis identified cassava-specific PR gene family expansions. The temporal programs of PR gene expression in response to the whitefly (Aleurotrachelus socialis) in four whitefly-susceptible cassava genotypes showed that 167 of the 447 PR genes were regulated after whitefly infestation. While the timing of PR gene expression varied, over 37% of whitefly-regulated PR genes were downregulated in all four genotypes. Notably, whitefly-responsive PR genes were largely coordinately regulated by SA and JA. The analysis of cassava PR gene expression in response to five other biotic stresses revealed a strong positive correlation between whitefly and Xanthomonas axonopodis and Cassava Brown Streak Virus responses and negative correlations between whitefly and Cassava Mosaic Virus responses. Finally, certain associations between PR genes in cassava expansions and response to biotic stresses were observed among PR families.

Conclusions

This study represents the first genome-wide characterization of PR genes in cassava. PR gene responses to six biotic stresses and to SA and JA are demonstrably different to other angiosperms. We propose that our approach could be applied in other species to fully understand PR gene regulation by pathogens, pests and the canonical defense hormones SA and JA.
Fluorescent amplification for next generation sequencing (FA-NGS) library preparation
Authors: Chiniquy Jennifer , Garber Megan E. , Mukhopadhyay Aindrila , Hillson Nathan J.
Published: January 2020

Background

Next generation sequencing (NGS) has become a universal practice in modern molecular biology. As the throughput of sequencing experiments increases, the preparation of conventional multiplexed libraries becomes more labor intensive. Conventional library preparation typically requires quality control (QC) testing for individual libraries such as amplification success evaluation and quantification, none of which occur until the end of the library preparation process.

Results

In this study, we address the need for a more streamlined high-throughput NGS workflow by tethering real-time quantitative PCR (qPCR) to conventional workflows to save time and implement single tube and single reagent QC. We modified two distinct library preparation workflows by replacing PCR and quantification with qPCR using SYBR Green I. qPCR enabled individual library quantification for pooling in a single tube without the need for additional reagents. Additionally, a melting curve analysis was implemented as an intermediate QC test to confirm successful amplification. Sequencing analysis showed comparable percent reads for each indexed library, demonstrating that pooling calculations based on qPCR allow for an even representation of sequencing reads. To aid the modified workflow, a software toolkit was developed and used to generate pooling instructions and analyze qPCR and melting curve data.

Conclusions

We successfully applied fluorescent amplification for next generation sequencing (FA-NGS) library preparation to both plasmids and bacterial genomes. As a result of using qPCR for quantification and proceeding directly to library pooling, the modified library preparation workflow has fewer overall steps. Therefore, we speculate that the FA-NGS workflow has less risk of user error. The melting curve analysis provides the necessary QC test to identify and troubleshoot library failures prior to sequencing. While this study demonstrates the value of FA-NGS for plasmid or gDNA libraries, we speculate that its versatility could lead to successful application across other library types.
Identifying critical state of complex diseases by single-sample Kullback–Leibler divergence
Authors: Zhong Jiayuan , Liu Rui , Chen Pei
Published: January 2020

Background

Developing effective strategies for signaling the pre-disease state of complex diseases, a state with high susceptibility before the disease onset or deterioration, is urgently needed because such state usually followed by a catastrophic transition into a worse stage of disease. However, it is a challenging task to identify such pre-disease state or tipping point in clinics, where only one single sample is available and thus results in the failure of most statistic approaches.

Methods

In this study, we presented a single-sample-based computational method to detect the early-warning signal of critical transition during the progression of complex diseases. Specifically, given a set of reference samples which were regarded as background, a novel index called single-sample Kullback–Leibler divergence (sKLD), was proposed to explore and quantify the disturbance on the background caused by a case sample. The pre-disease state is then signaled by the significant change of sKLD.

Results

The novel algorithm was developed and applied to both numerical simulation and real datasets, including lung squamous cell carcinoma, lung adenocarcinoma, stomach adenocarcinoma, thyroid carcinoma, colon adenocarcinoma, and acute lung injury. The successful identification of pre-disease states and the corresponding dynamical network biomarkers for all six datasets validated the effectiveness and accuracy of our method.

Conclusions

The proposed method effectively explores and quantifies the disturbance on the background caused by a case sample, and thus characterizes the criticality of a biological system. Our method not only identifies the critical state or tipping point at a single sample level, but also provides the sKLD-signaling markers for further practical application. It is therefore of great potential in personalized pre-disease diagnosis.
Characterising avenin-like proteins (ALPs) from albumin/globulin fraction of wheat grains by RP-HPLC, SDS-PAGE, and MS/MS peptides sequencing
Authors: Zhang Yujuan , Hu Xin , Juhasz Angela , Islam Shahidul , Yu Zitong , Zhao Yun , Li Gang , Ding Wenli , Ma Wujun
Published: January 2020

Background

Wheat grain avenin-like proteins (ALPs) belong to a recently discovered class of wheat grain storage protein. ALPs in wheat grains not only have beneficial effects on dough quality but also display antifungal activities, which is a novel observation for wheat storage proteins. Previous studies have shown that ALPs are likely present in the albumin/globulin fractions of total protein extract from wheat flour. However, the accumulation characteristics of these ALPs in the mature wheat grain remains unknown.

Results

In the present study, a total of 13 ALPs homologs were isolated and characterized in the albumin/globulin fractions of the wheat protein extract. A combination of multiple techniques including RP-HPLC, SDS-PAGE, MALDI-TOF and peptide sequencing were used for accurate separation and identification of individual ALP homolog. The C-terminal TaALP-by-4AL/7DS, TaALP-by-4AL/7AS/7DS, TaALP-bx/4AL/7AS/7DS, TaALP-ay-7DS, TaALP-ay-4AL, TaALP-ax-4AL, TaALP-ax-7AS, and TaALP-ax-7DS, were separated as individual protein bands from wheat flour for the first time. These unique ALPs peptides were mapped to the latest wheat genome assembly in the IWGSC database. The characteristic defence related proteins present in albumin and globulin fractions, such as protein disulfide-isomerase (PDI), grain softness protein (GSP), alpha-amylase inhibitors (AAIs) and endogenous alpha-amylase/subtilisin inhibitor were also found to co-segregate with these identified ALPs, avenin-3 and α-gliadins. The molecular weight range and the electrophoresis segregation properties of ALPs were characterised in comparison with the proteins containing the tryp_alpha_amyl domain (PF00234) and the gliadin domain (PF13016), which play a role in plant immunity and grain quality. We examined the phylogenetic relationships of the AAIs, GSP, avenin-3, α-gliadins and ALPs, based on the alignment of their functional domains. MALDI-TOF profiling indicated the occurrence of certain post-translations modifications (PTMs) in some ALP subunits.

Conclusions

We reported for the first time the complete profiling of ALPs present in the albumin/globulin fractions of wheat grain protein extracts. We concluded that majority of the ALPs homologs are expressed in wheat grains. We found clear evidence of PTMs in several ALPs peptides. The identification of both gliadin domain (PF13016) and Tryp_alpha_amyl domain (PF00234) in the mature forms of ALPs highlighted the multiple functional properties of ALPs in grain quality and disease resistance.
Effect of postoperative Trendelenburg position on shoulder pain after gynecological laparoscopic procedures: a randomized clinical trial
Authors: Zeeni Carine , Chamsy Dina , Khalil Ali , Abu Musa Antoine , Al Hassanieh Majed , Shebbo Fadia , Nassif Joseph
Published: January 2020

Background

Laparoscopic surgery has become a standard of care for many gynecological surgeries due to its lower morbidity, pain and cost compared to open techniques. Unfortunately, the use of carbon dioxide (CO2) to insufflate the abdomen is the main contributor to post-operative shoulder pain.

Methods

We aim to assess the effect of postoperative Trendelenburg position on shoulder pain after gynecological laparoscopic procedures. We hypothesize that maintaining the patient in Trendelenburg for 24 h postoperatively will significantly decrease postoperative shoulder pain and analgesic consumption. After obtaining written informed consent, 108 patients were prospectively randomized into two groups. In the control group, patients underwent standard gynecologic laparoscopic procedures; then after passive deflation of the pneumoperitoneum at the end of the surgery, the patients were placed in supine head up position in the post anesthesia care unit (PACU) and received our institution’s common postoperative care. Patients in the intervention group were subjected to the same maneuver but were positioned in a Trendelenburg position (20 °) once fully awake and cooperative in the PACU and retained this position for the first 24 h. Numerical rating scale (NRS) was used to assess shoulder pain and nausea upon patient arrival to the PACU, at 4, 6, 12 (primary outcome) and 24 h postoperatively. Time to first rescue pain medication, total rescue pain medications and overall satisfaction with pain control were recorded. 101 patients were included in the final data analysis.

Results

Both groups were comparable in terms of baseline characteristics. NRS pain scores were significantly lower in the intervention group at 12 h compared to the control group (0 [0–1] versus 5 [1–4], p < 0.001), furthermore improvement in postoperative shoulder pain between time of arrival to PACU (time zero) and 12 h postoperatively was significantly higher in patients allocated to the experimental group compared to the control group. Pain scores were significantly lower in patients allocated to the experimental group versus the control group (0 [0–1] versus 5 [1–4], p < 0.001).

Conclusion

In conclusion, Trendelenburg position is an easy non-pharmacologic intervention that is beneficial in reducing postoperative shoulder pain following gynecologic laparoscopic surgery.

Trial registration

Retrospectively registered at Clinicaltrials.gov, registration number NCT04129385,  date of registration: June 28, 2019
The utility of the brain trauma evidence to inform paramedic rapid sequence intubation in out-of-hospital stroke
Authors: Fouche Pieter Francsois , Jennings Paul Andrew , Boyle Malcolm , Bernard Stephen , Smith Karen
Published: January 2020

Background

Rapid sequence intubation (RSI) is used to secure the airway of stroke patients. Randomized controlled trial evidence exists to support the use of paramedic RSI for traumatic brain injury (TBI), but cannot necessarily be applied to stroke RSI because of differences between the stroke and TBI patient. To understand if the TBI evidence can be used for stroke RSI, we analysed a retrospective cohort of TBI and strokes to compare how survival is impacted differently by RSI when comparing strokes and TBI.

Methods

This study was a retrospective analysis of 10 years of in-hospital and out-of-hospital data for all stroke and TBI patients attended by Ambulance Victoria, Australia. Logistic regression predicted the survival for ischemic and haemorrhagic strokes as well as TBI. The constituents of RSI, such a medications, intubation success and time intervals were analysed against survival using interactions to asses if RSI impacts survival differently for strokes compared to TBI.

Results

This analysis found significant interactions in the RSI-only group for age, number of intubation attempts, atropine, fentanyl, pulse rate and perhaps scene time and time- to-RSI. Such interactions imply that RSI impact survival differently for TBI versus strokes. Additionally, no significant difference in survival for TBI was found, with a − 0.7% lesser survival for RSI compared to no-RSI; OR 0.86 (95% CI 0.67 to 1.11; p = 0.25). Survival for haemorrhagic stroke was − 14.1% less for RSI versus no-RSI; OR 0.44 (95% CI 0.33 to 0.58; p = 0.01) and was − 4.3%; OR 0.67 (95% CI 0.49 to 0.91; p = 0.01) lesser for ischemic strokes.

Conclusions

Rapid sequence intubation and related factors interact with stroke and TBI, which suggests that RSI effects stroke survival in a different way from TBI. If RSI impact survival differently for strokes compared to TBI, then perhaps the TBI evidence cannot be used for stroke RSI.
Sample size issues in time series regressions of counts on environmental exposures
Authors: Armstrong Ben G. , Gasparrini Antonio , Tobias Aurelio , Sera Francesco
Published: January 2020

Background

Regression analyses of time series of disease counts on environmental determinants are a prominent component of environmental epidemiology. For planning such studies, it can be useful to predict the precision of estimated coefficients and power to detect associations of given magnitude. Existing generic approaches for this have been found somewhat complex to apply and do not easily extend to multiple series studies analysed in two stages. We have sought a simpler approximate approach which can easily extend to multiple series and give insight into factors determining precision.

Methods

We derive approximate expressions for precision and hence power in single and multiple time series studies of counts from basic statistical theory, compare the precision predicted by these with that estimated by analysis in real data from 51 cities of varying size, and illustrate the use of these estimators in a realistic planning scenario.

Results

In single series studies with Poisson outcome distribution, precision and power depend only on the usable variation of exposure (i.e. that conditional on covariates) and the total number of disease events, regardless of how many days those are spread over. In multiple time series (eg multi-city) studies focusing on the meta-analytic mean coefficient, the usable exposure variation and the total number of events (in all series) are again the sole determinants if there is no between-series heterogeneity or within-series overdispersion. With heterogeneity, its extent and the number of series becomes important. For all but the crudest approximation the estimates of standard errors were on average within + 20% of those estimated in full analysis of actual data.

Conclusions

Predicting precision in coefficients from a planned time series study is possible simply and given limited information. The total number of disease events and usable exposure variation are the dominant factors when overdispersion and between-series heterogeneity are low.
Evaluation of ultrasound-guided Freka-Trelumina enteral nutrition tube placement in the treatment of acute pancreatitis
Authors: Liu Zhijun , Guo Jintao , Ren Weidong , Tang Shaoshan , Huang Ying , Huang Liping , Sun Siyu , Lin Lianjie
Published: January 2020

Background

Enteral nutrition should be implemented as early as possible in patients with moderate or severe acute pancreatitis. This study was designed to evaluate the feasibility and Deffectiveness of ultrasound-guided Freka-Trelumina tube placement for enteral nutrition in acute pancreatitis.

Methods

Patients with severe acute pancreatitis admitted to Shengjing Hospital of China Medical University who needed Freka-Trelumina tube placement for enteral nutrition and gastrointestinal decompression were included in the current study. The relevant evaluation indicators of tube placement included the success rate of tube placement, tube placement time, tube shift rate, and blocking rate. In addition, the evaluation indicators of ultrasound-guided tube placement (from 1 January 2018 to 31 July 2019) were compared with those of previous endoscope-guided placement (from 1 January 2015 to 31 December 2017) by analysing the data from the electronic medical record system.

Results

The success rate of ultrasound-guided tube placement was 90.7% (49/54). All 49 patients tolerated the Freka-Trelumina feeding tube. The average ultrasound-guided tube placement time for the 49 patients was 18.4 ± 12.8 min (range, 5–36 min). The Freka-Trelumina feeding tube had a shift rate of 10.2% (5/49). The blocking rate of the Freka-Trelumina feeding tube was 12.2% (6/49). The success rate of tube placement, tube shift rate and blocking rate for endoscope-guided tube placement were 100% (62/62), 11.3% (7/62), and 12.9% (8/62), respectively. The average endoscope-guided tube placement time for the 62 patients was 16.5 ± 5.7 min (range, 12–31 min). The comparison between the ultrasound-guided group and the endoscope-guided group showed that the success rate of tube placement, tube placement time, tube shift rate and blocking rate were similar.

Conclusion

The ultrasound-guided method can be done non-invasively at the bedside, which is safe and convenient, and the Freka-Trelumina feeding tube can be placed in time to achieve the goal of early enteral nutrition and gastrointestinal decompression.
Association of cognitive impairment and elderly mortality: differences between two cohorts ascertained 6-years apart in China
Authors: Duan Jun , Lv Yue-Bin , Gao Xiang , Zhou Jin-Hui , Kraus Virginia Byers , Zeng Yi , Su Hong , Shi Xiao-Ming
Published: January 2020

Background

Cognitive impairment is a major contributor to mortality among the elderly. However, the relationship between cognitive impairment evaluated by educational levels and mortality and the trend between cognitive impairment and mortality with time are unclear. We aim to evaluate the differences in associations of cognitive impairment, taking the stratification by educational levels into account, with all-cause mortality and further explore the relationship of cognitive impairment with mortality in different age and sex groups in two cohorts ascertained 6 years apart in China.

Methods

A total of 13,906 and 13,873 Chinese elderly aged 65 years and older were included in the 2002–2008 and 2008–2014 cohorts from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Mortality data was ascertained from interviews with family members or relatives of participants. Cognitive function, evaluated by the Mini-Mental State Examination (MMSE), were defined by different cut-offs taking educational background into account. Cox models were used to explore the relationship of cognitive impairment with mortality.

Results

For the 2002–2008 and 2008–2014 cohorts, 55,277 and 53,267 person-years were followed up, and the mean (SD) age were 86.5 (11.6) and 87.2 (11.3) years, respectively. Compared to normal cognition, cognitive impairment was independently associated with higher mortality risk after controlling for potential confounders, with hazard ratios (HRs) of 1.32 (95% confidence interval [CI], 1.25–1.39) in 2002–2008 cohort and 1.26 (95% CI, 1.19–1.32) in 2008–2014 cohort, stratified by educational levels. The trend of cognitive impairment with all-cause mortality risk decreased from 2002 to 2008 to 2008–2014 cohort, while no significant interaction of cognitive impairment with cohort for all-cause mortality was observed. The associations of cognitive impairment and mortality were decreased with age in the two cohorts.

Conclusions

Cognitive impairment evaluated by different cut-offs were associated with increased risk of mortality, especially among those aged 65–79 years in the two cohorts; this advocates that periodic screening for cognitive impairment among the elderly is warranted.
Different macrophage polarization between drug-susceptible and multidrug-resistant pulmonary tuberculosis
Authors: Cho Hyun Jin , Lim Yun-Ji , Kim Jhingook , Koh Won-Jung , Song Chang-Hwa , Kang Min-Woong
Published: January 2020

Background

Macrophages play a key role in the infection process, and alternatively activated macrophages (M2 polarization) play important roles in persistent infection via the immune escape of pathogens. This suggests that immune escape of pathogens from host immunity is an important factor to consider in treatment failure and multidrug-resistant tuberculosis (MDR-TB)/extensively drug-resistant tuberculosis (XDR-TB). In this study, we investigated the association between macrophage polarization and MDR-TB/XDR-TB and the association between macrophage polarization and the anti-TB drugs used.

Methods

iNOS and arginase-1, a surface marker of polarized macrophages, were quantified by immunohistochemical staining and imaging analysis of lung tissues of patients who underwent surgical treatment for pulmonary TB. Drug susceptibility/resistance and the type and timing of anti-tuberculosis drugs used were investigated.

Results

The M2-like polarization rate and the ratio of the M2-like polarization rate to the M1-like polarization rate were significantly higher in the MDR-TB/XDR-TB group than in the DS-TB group. The association between a high M2-like polarization rate and MDR-TB/XDR-TB was more pronounced in patients with a low M1-like polarization rate. Younger age and a higher M2-like polarization rate were independent associated factors for MDR-TB/XDR-TB. The M2-like polarization rate was significantly higher in patients who received anti-TB drugs containing pyrazinamide continuously for 4 or 6 weeks than in those who received anti-TB drugs not containing pyrazinamide.

Conclusions

The M2-like polarization of macrophages is associated with MDR-TB/XDR-TB and anti-TB drug regimens including pyrazinamide or a combination of pyrazinamide, prothionamide and cycloserine.
Patient-adapted organ absorbed dose and effective dose estimates in pediatric 18F-FDG positron emission tomography/computed tomography studies
Authors: Quinn Brian M. , Gao Yiming , Mahmood Usman , Pandit-Taskar Neeta , Behr Gerald , Zanzonico Pat , Dauer Lawrence T.
Published: January 2020

Background

Organ absorbed doses and effective doses can be used to compare radiation exposure among medical imaging procedures, compare alternative imaging options, and guide dose optimization efforts. Individual dose estimates are important for relatively radiosensitive patient populations such as children and for radiosensitive organs such as the eye lens. Software-based dose calculation methods conveniently calculate organ dose using patient-adjusted and examination-specific inputs.

Methods

Organ absorbed doses and effective doses were calculated for 429 pediatric 18F-FDG PET-CT patients. Patient-adjusted and scan-specific information was extracted from the electronic medical record and scanner dose-monitoring software. The VirtualDose and OLINDA/EXM (version 2.0) programs, respectively, were used to calculate the CT and the radiopharmaceutical organ absorbed doses and effective doses. Patients were grouped according to age at the time of the scan as follows: less than 1 year old, 1 to 5 years old, 6 to 10 years old, 11 to 15 years old, and 16 to 17 years old.

Results

The mean (+/− standard deviation, range) total PET plus CT effective dose was 14.5 (1.9, 11.2–22.3) mSv. The mean (+/− standard deviation, range) PET effective dose was 8.1 (1.2, 5.7–16.5) mSv. The mean (+/− standard deviation, range) CT effective dose was 6.4 (1.8, 2.9–14.7) mSv. The five organs with highest PET dose were: Urinary bladder, heart, liver, lungs, and brain. The five organs with highest CT dose were: Thymus, thyroid, kidneys, eye lens, and gonads.

Conclusions

Organ and effective dose for both the CT and PET components can be estimated with actual patient and scan data using commercial software. Doses calculated using software generally agree with those calculated using dose conversion factors, although some organ doses were found to be appreciably different. Software-based dose calculation methods allow patient-adjusted dose factors. The effort to gather the needed patient data is justified by the resulting value of the characterization of patient-adjusted dosimetry.