bluuebunny/crossref_metadata_2025 huggingface dataset:
Dietary trans-fatty acid intake in relation to cancer risk: a systematic review and meta-analysis
Authors: Michels Nathalie , Specht Ina Olmer , Heitmann Berit L , Chajès Veronique , Huybrechts Inge
Published: May 2020

Context

Apart from ruminant fat, trans-fatty acids are produced during the partial hydrogenation of vegetable oils, (eg, in the production of ultraprocessed foods). Harmful cardiovascular effects of trans-fatty acids are already proven, but the link with cancer risk has not yet been summarized.

Objective

A systematic review (following PRISMA guidelines) – including observational studies on the association of trans-fatty acid intake with any cancer risk – was conducted, with no limitations on population types.

Data Sources

The electronic databases PubMed and Embase were searched to identify relevant studies.

Data Extraction

This systematic review included 46 articles. Quality was assessed via the Newcastle-Ottawa scale. Meta-analyses were conducted if at least 4 articles exploring the same transfat-cancer pairings were found.

Data analysis

Nineteen cancer types have been researched in cohort and case-control studies on trans-fatty acids, with breast cancer (n = 17), prostate cancer (n = 11), and colorectal cancer (n = 9) as the most researched. The meta-analyses on total trans-fat showed a significant positive association for prostate cancer (odds ratio [OR] 1.49; 95%CI, 1.13–1.95) and colorectal cancer (OR 1.26; 95%CI, 1.08–1.46) but not for breast cancer (OR 1.12; 95%CI, 0.99–1.26), ovarian cancer (OR 1.10; 95%CI, 0.94–1.28), or non-Hodgkin lymphoma (OR 1.32; 95%CI, 0.99–1.76). Results were dependent on the fatty acid subtype, with even cancer-protective associations for some partially hydrogenated vegetable oils. Enhancing moderators in the positive transfat-cancer relation were gender (direction was cancer-site specific), European ancestry, menopause, older age, and overweight.

Conclusion

Despite heterogeneity, higher risk of prostate and colorectal cancer by high consumption of trans-fatty acids was found. Future studies need methodological improvements (eg, using long-term follow-up cancer data and intake biomarkers). Owing to the lack of studies testing trans-fatty acid subtypes in standardized ways, it is not clear which subtypes (eg, ruminant sources) are more carcinogenic.

Systematic Review Registration

PROSPERO registration no. CRD42018105899
Sequence Capture Phylogenomics of True Spiders Reveals Convergent Evolution of Respiratory Systems
Authors: Ramírez Martín J , Magalhaes Ivan L F , Derkarabetian Shahan , Ledford Joel , Griswold Charles E , Wood Hannah M , Hedin Marshal
Published: May 2020

The common ancestor of spiders likely used silk to line burrows or make simple webs, with specialized spinning organs and aerial webs originating with the evolution of the megadiverse “true spiders” (Araneomorphae). The base of the araneomorph tree also concentrates the greatest number of changes in respiratory structures, a character system whose evolution is still poorly understood, and that might be related to the evolution of silk glands. Emphasizing a dense sampling of multiple araneomorph lineages where tracheal systems likely originated, we gathered genomic-scale data and reconstructed a phylogeny of true spiders. This robust phylogenomic framework was used to conduct maximum likelihood and Bayesian character evolution analyses for respiratory systems, silk glands, and aerial webs, based on a combination of original and published data. Our results indicate that in true spiders, posterior book lungs were transformed into morphologically similar tracheal systems six times independently, after the evolution of novel silk gland systems and the origin of aerial webs. From these comparative data, we put forth a novel hypothesis that early-diverging web-building spiders were faced with new energetic demands for spinning, which prompted the evolution of similar tracheal systems via convergence; we also propose tests of predictions derived from this hypothesis.[Book lungs; discrete character evolution; respiratory systems; silk; spider web evolution; ultraconserved elements.]
Evaluation of 5-day In Vivo Rat Liver and Kidney With High-throughput Transcriptomics for Estimating Benchmark Doses of Apical Outcomes
Authors: Gwinn William M , Auerbach Scott S , Parham Fred , Stout Matthew D , Waidyanatha Suramya , Mutlu Esra , Collins Brad , Paules Richard S , Merrick Bruce Alex , Ferguson Stephen , Ramaiahgari Sreenivasa , Bucher John R , Sparrow Barney , Toy Heather , Gorospe Jenni , Machesky Nick , Shah Ruchir R , Balik-Meisner Michele R , Mav Deepak , Phadke Dhiral P , Roberts Georgia , DeVito Michael J
Published: May 2020

A 5-day in vivo rat model was evaluated as an approach to estimate chemical exposures that may pose minimal risk by comparing benchmark dose (BMD) values for transcriptional changes in the liver and kidney to BMD values for toxicological endpoints from traditional toxicity studies. Eighteen chemicals, most having been tested by the National Toxicology Program in 2-year bioassays, were evaluated. Some of these chemicals are potent hepatotoxicants (eg, DE71, PFOA, and furan) in rodents, some exhibit toxicity but have minimal hepatic effects (eg, acrylamide and α,β-thujone), and some exhibit little overt toxicity (eg, ginseng and milk thistle extract) based on traditional toxicological evaluations. Male Sprague Dawley rats were exposed once daily for 5 consecutive days by oral gavage to 8–10 dose levels for each chemical. Liver and kidney were collected 24 h after the final exposure and total RNA was assayed using high-throughput transcriptomics (HTT) with the rat S1500+ platform. HTT data were analyzed using BMD Express 2 to determine transcriptional gene set BMD values. BMDS was used to determine BMD values for histopathological effects from chronic or subchronic toxicity studies. For many of the chemicals, the lowest transcriptional BMDs from the 5-day assays were within a factor of 5 of the lowest histopathological BMDs from the toxicity studies. These data suggest that using HTT in a 5-day in vivo rat model provides reasonable estimates of BMD values for traditional apical endpoints. This approach may be useful to prioritize chemicals for further testing while providing actionable data in a timely and cost-effective manner.
Early Immersion Clinical for an Accelerated BSN Nursing Program
Authors: McElwain Sharon D. , Rhodes Kathleen A. , Carr Kayla L. , Lawrence Marlie C.
Published: May 2020

Ensuring clinical competency and judgment in nursing students is critical. Developing ways for students to obtain this goal in a second-degree bachelor of science in nursing (BSN) program is challenging. One method described here is the early immersion clinical (EIC). Occurring concurrently with health assessment and fundamentals courses, EIC allowed for quick application of skills in the context of clinical care. Weekly clinical objectives were aligned with objectives for both courses. This article describes how EIC was implemented in a 12-month second-degree accelerated BSN program.
A Telemedicine Approach to Increase Treatment of Alcohol Use Disorder in Primary Care: A Pilot Feasibility Study
Authors: Leibowitz Amy , Satre Derek D. , Lu Wendy , Weisner Constance , Corriveau Caroline , Gizzi Elio , Sterling Stacy
Published: May 2020

Background and Aims:

Unhealthy drinking is a leading threat to health, yet few people with alcohol use disorder (AUD) receive treatment. This pilot tested the feasibility of addiction medicine video consultations in primary care for improving AUD medication adoption and specialty treatment initiation.

Methods:

Primary care providers (PCPs) received training and access to on-call addiction medicine consultations. Feasibility measures were training attendance, intention to use the service and/or AUD pharmacotherapy, and user feedback. Secondary outcomes were utilization, prescription and treatment initiation rates, and case reports. χ2 tests were used to compare prescription and treatment initiation rates for consult recipients and non-recipients.

Results:

Ninety-one PCPs (71.1%) attended a training, and 60 (65.9%) provided feedback. Of those, 37 (64.9%) mentioned pharmacotherapy and 41 (71.9%) intended to use the video consult service. Of 27 users, 19 provided feedback; 12 (63.1%) rated its value at 8 or above, on a scale of 1 to 10 (average 6.9). The most useful aspect was immediacy, and users wanted an easier workflow and increased consultant availability. Of 32 patients who received a consult, 11 (34.4%) were prescribed naltrexone, versus 43 (6.4%) of non-recipients (P < 0.0001); 11 (34.4%) initiated specialty treatment, versus 105 (19.7%) of non-recipients (P < 0.05).

Conclusions:

PCP training attendance and feedback suggest that an addiction telemedicine consult service would be valuable to PCPs and might increase AUD medication uptake and specialty addiction treatment initiation. However, future research should include significant modifications to the piloted telemedicine model: robust staffing and simpler, more flexible methods for PCPs to obtain consults.
Characterizing Use of Growth-friendly Implants for Early-onset Scoliosis: A 10-Year Update
Authors: Klyce Walter , Mitchell Stuart L. , Pawelek Jeff , Skaggs David L. , Sanders James O. , Shah Suken A. , McCarthy Richard E. , Luhmann Scott J. , Sturm Peter F. , Flynn John M. , Smith John T. , Akbarnia Behrooz A. , Sponseller Paul D.
Published: May 2020

Background:

Growth-friendly treatment of early-onset scoliosis (EOS) has changed with the development and evolution of multiple devices. This study was designed to characterize changes in the use of growth-friendly implants for EOS from 2007 to 2017.

Methods:

We queried the Pediatric Spine Study Group database for patients who underwent index surgery with growth-friendly implants from July 2007 to June 2017. In 1298 patients, we assessed causes of EOS; preoperative curve magnitude; age at first surgery; patient sex; construct type; lengthening interval; incidence of “final” fusion for definitive treatment; and age at definitive treatment. α=0.05.

Results:

From 2007 to 2017, the annual proportion of patients with idiopathic EOS increased from 12% to 33% (R
2=0.58, P=0.006). Neuromuscular EOS was the most common type at all time points (range, 33% to 44%). By year, mean preoperative curve magnitude ranged from 67 to 77 degrees, with no significant temporal changes. Mean (±SD) age at first surgery increased from 6.1±2.9 years in 2007 to 7.8±2.5 years in 2017 (R
2=0.78, P<0.001). As a proportion of new implants, magnetically controlled growing rods increased from <5% during the first 2 years to 83% in the last 2 years of the study. Vertically expandable prosthetic titanium ribs decreased from a peak of 48% to 6%; growth-guidance devices decreased from 10% to 3%. No change was seen in mean surgical lengthening intervals (range, 6 to 9 mo) for the 614 patients with recorded lengthenings. Final fusion was performed in 88% of patients who had undergone definitive treatment, occurring at a mean age of 13.4±2.4 years.

Conclusions:

From 2007 to 2017, neuromuscular EOS was the most common diagnosis for patients treated with growth-friendly implants. Patient age at first surgery and the use of magnetically controlled growing rods increased during this time. Preoperative curve magnitude, traditional growing rod lengthening intervals, and rates of final fusion did not change.

Level of Evidence:

Level II.
Normative Exophthalmometry Measurements Vary Among Ethiopian Adults and the Major Ethiopian Ethnic Groups
Authors: Heisel Curtis J. , Garza Philip S. , Fashe Cherinet M. , Sime Asrat , Nelson Christine
Published: May 2020

Purpose:

Periocular and orbital anthropometric values vary among races. No studies have established normative exophthalmometry values for Ethiopians or the many Ethiopian ethnic groups. This study established a set of normative anthropometric values for exophthalmometry, and further evaluated whether these measurements differed based on sex or ethnic group.

Methods:

A cross-sectional study was performed in the ophthalmology department at St. Paul’s Hospital in Addis Ababa, Ethiopia. Two hundred ninety-six participants were recruited for the study. Sex, primary Ethiopian ethnic subgroup, and exophthalmometry measurements were recorded. Differences between ethnicities and sexes were evaluated using independent samples t test.

Results:

Average proptosis for the total cohort was 15.88 ± 2.49 mm, with 582 eyes measured. Females (15.87 ± 2.53, n = 286) and males (15.89 ± 2.49, n = 296) were not significantly different in their proptosis measurements. Within the 3 largest ethnic groups measured, Amhara (16.12 ± 2.67, n = 204), Oromo (15.43 ± 2.51, n = 172), and Gurage (16.23 ± 2.59, n = 98), the difference in proptosis measurement was significant between the Amhara and Oromo groups (p = 0.01), and the Oromo and Gurage groups (p = 0.01). The only ethnic group that was significantly different between sexes was Gurage, of which average female proptosis was 15.51 ± 2.74 (n = 54), while male proptosis was 17.13 ± 2.11 (n = 44) (p < 0.01).

Conclusions:

Mean Ethiopian proptosis values vary across ethnicities, are similar to those measured in other African populations, but are lower than those established in African-American populations. This study provides an important resource that Ethiopian ophthalmologists can use when evaluating patients with suspected ophthalmic and orbital disease.
Treatment of Congenital Ptosis in Infants With Associated Amblyopia Using a Frontalis Muscle Flap Eyelid Reanimation Technique
Authors: Eton Emily A. , Carniciu Anaïs L. , Prabhu Shreya S. , Wang Grace M. , Kahana Alon
Published: May 2020

Purpose:

To determine the efficacy of a frontalis muscle flap eyelid reanimation technique for correction of severe congenital ptosis and associated amblyopia in infants.

Methods:

The authors performed a retrospective chart review of patients 12 months of age or younger with unilateral or bilateral congenital ptosis and associated amblyopia or deemed at high risk for amblyopia due to visual deprivation. Following ptosis repair via a frontalis muscle flap technique, primary outcomes of postoperative eyelid position and amblyopia reversal were assessed.

Results:

Seventeen eyes of 12 participants were included for study. Seven of these patients had simple congenital ptosis, and the remainder had ptosis as part of a syndrome. Nine were diagnosed with amblyopia preoperatively, and the remaining 3 were too young for acuity testing but had occlusion of the visual axis by the ptotic eyelid in primary gaze. Postoperatively, the mean margin-to-reflex distance 1 was 2.4 mm (range: 0.0–4.0), and 9 patients (75%) demonstrated no evidence of amblyopia. Only 2 patients had eyelid asymmetry greater than 2 mm, which in both cases was due to lack of frontalis activation by the patient secondary to ongoing visual impairment. The most common complication was lagophthalmos in 6 eyes (35.3%), with no significant associated surface keratopathy.

Conclusions:

The frontalis muscle flap technique may offer a new and effective approach to treating infants with severe congenital ptosis causing poor eyelid excursion and associated amblyopia while avoiding use of an implant.
Pain Score Assessment Using Single-Dose IV Ketorolac Only, After External Dacryocystorhinostomy: A Randomized Double/Triple-Blind Placebo-Controlled Trial
Authors: Agarwal Abhishek , Patidar Narendra , Gabba Harshdeep Singh , Sood Devindra , Piush Parimal
Published: May 2020

Purpose:

To assess efficacy of intravenous (IV) ketorolac for postoperative pain control after external dacryocystorhinostomy.

Method:

Fifty-five patients from January to April 2019 were randomized, to a double-blind prospective interventional study. Intervention arm received IV ketorolac (60 mg/2 ml) immediately post-op, control received IV saline bolus. Pain assessment was done with numerical rating scale pre- and postinjection (day 0) and on day 1. Requirement for analgesics and antiemetics was recorded.

Results:

Total 55 patients (11 men and 44 women) with mean age 49.93 ± 16.29 years were included in the study. Twenty-four (43.6%) patients received IV ketorolac and 31 (56.4%) received placebo. Mann-Whitney U test showed mean rank score for pain scale was significantly lower in intervention arm versus control arm, assessed postinjection (16.69 vs. 36.76 respectively, p = .000) and at day 1 (21.08 vs. 33.35 respectively, p = .003).

Conclusion:

IV ketorolac significantly lowers self-reported pain score following external dacryocystorhinostomy with reduced requirement of analgesic and antiemetic medications.
The Role of Employee Self-Efficacy in Top-Down Burnout Crossover
Authors: Parent-Lamarche Annick , Fernet Claude
Published: May 2020

Burnout has been a prominent topic in the management research for over 30 years. Yet few studies have explored the conditions that foster burnout from managers to employees (indirect crossover). Based on the principle of behavioral plasticity, we propose that self-efficacy is an adaptive resource that enables employees to counter the potentially crossover effects of burnout (ie, emotional exhaustion and cynicism). This proposal is partially supported by the results of a longitudinal analysis of educators (principals and teachers): a moderating effect of employee self-efficacy was found, but only for emotional exhaustion, which is considered the basic individual stress dimension of burnout. More specifically, managerial emotional exhaustion was associated with lower emotional exhaustion over time in employees who reported higher self-efficacy, with the inverse association for employees with lower self-efficacy. This suggests that managers’ emotional exhaustion can indirectly affect the experience of a congruent emotional state in their subordinates. Theoretical and practical implications are discussed.
Percutaneous pedicle screw fixation combined with transforaminal endoscopic spinal canal decompression for the treatment of thoracolumbar burst fracture with severe neurologic deficit
Authors: Huang Zhangheng , Hu Chuan , Tong Yuexin , Fan Zhiyi , Liu Kewen , Yang Binbin , Zhao Chengliang
Published: May 2020

Rationale:

The most common fractures of the spine are associated with the thoracolumbar junction (T10–L2). And burst fractures make up 15% of all traumatic thoracolumbar fractures, which are often accompanied by neurological deficits and require open surgeries. Common surgeries include either anterior, posterior or a combination of these approaches. Here, we report the first attempt to treat thoracolumbar burst fracture (TLBF) with severe neurologic deficits by percutaneous pedicle screw fixation (PPSF) and transforaminal endoscopic spinal canal decompression (TESCD).

Patient concerns:

A 46-year-old Chinese woman suffered from severe lower back pain with grade 0 muscle strength of lower limbs, without any sensory function below the injury level, with an inability to urinate or defecate after a motor vehicle accident. Imaging studies confirmed that she had Magerl type A 3.2 L1 burst fracture.

Diagnoses:

Burst fracture at L1.

Interventions:

The patient underwent PPSF at the level of T12 to L2, but her neurological function did not fully recover after the operation. One week after the injury, we performed TESCD on her.

Outcomes:

There was an immediate improvement in her neurological function in just 1 day after 2-stage operation. During the 6-month follow-up period, her neurological functions gradually recovered, and she was able to defecate and urinate. At the last follow-up visit, her spinal cord function was assessed to be at Frankel grade D.

Lessons:

PPSF plus TESCD can achieve complete spinal cord decompression, promote neurological recovery, and is therefore an effective method for the treating lumbar burst fractures with severe neurologic deficits.
Understanding Preferences for Addressing Spirituality Among Adults Seeking Outpatient Mental Health Care
Authors: Currier Joseph M. , Stevens Laura T. , Isaak Steven L. , Smith Tracey , Zlomke Kimberly
Published: May 2020

Focusing on 472 religiously heterogenous adult patients seeking psychotherapy at a university-based outpatient clinic, this brief report examined (1) these patients' preferences about clinicians appreciating their religion and/or spirituality (R/S) backgrounds (spiritually affirming) and addressing spiritual concerns in treatment (spiritually integrated) and (2) role of demographic factors and psychological functioning in predicting preferences for R/S integration. Analyses revealed that more than half of patients reported moderate or greater importance for spiritually affirming care and one-third hoped to address spiritual issues. Furthermore, these factors emerged as indicators of stronger preferences for R/S integration: female sex, racial minority status (African American, Native American), history of marriage (past and present), affiliation to organized religion (Christianity, Islam), and importance placed on R/S. In general, findings suggest that most patients seeking psychotherapy in a university-based clinic in southern Alabama might desire a spiritually affirming approach, and a smaller subset prefer an approach in which R/S is integrated into treatment.
Sugammadex
Authors: Chen Betty
Published: May 2020

Sugammadex reverses neuromuscular blockade by the steroidal nondepolarizing neuromuscular blocking agents rocuronium and vecuronium. In 2015, it was approved in the United States by the Food and Drug Administration for adult use. However, there are ongoing clinical trials investigating its use in the pediatric population. Before approval in adult use in the United States, several adverse effects were noted to occur in patients receiving sugammadex in clinical trials including prolonged QT interval, bradycardia, hypersensitivity reactions, and prolongation of coagulation parameters. Additional investigations further elucidated the risks of these adverse events. Sugammadex is approved for use in children older than 2 years in other countries in Europe and Asia. Investigations suggest that the efficacy, safety, and pharmacokinetic profile is similar in children when compared with adults. Published pediatric data favor the use of sugammadex in children older than 2 years, but there are some data in young children younger than 2 years. Case reports discuss the use of sugammadex in pediatric patients with neuromuscular diseases. Although sugammadex is typically used in the operating room for reversing neuromuscular blockade for surgical procedures, there is a small but important role for sugammadex use in the emergency department. In cases where rapid neurological examination is required after neuromuscular blockage with rocuronium or vecuronium, sugammadex can assist in facilitating a timely comprehensive neurological examination where pharmacologic or surgical management may depend on examination findings such as in the case of cerebral vascular accident, status epilepticus, or traumatic brain injury. Some clinicians have advocated for the use of sugammadex in the cannot intubate, cannot ventilate scenario. However, caution should be exercised in this situation as reversal of paralysis can take up to 22 minutes to occur.
A Root Cause Analysis of Barriers to Timely Colonoscopy in California Safety-Net Health Systems
Authors: Sharma Anjana E. , Lyson Helena C. , Cherian Roy , Somsouk Ma , Schillinger Dean , Sarkar Urmimala
Published: May 2020

Objectives

Safety-net health care systems, serving vulnerable populations, see longer delays to timely colonoscopy after a positive fecal occult blood test (FOBT), which may contribute to existing disparities. We sought to identify root causes of colonoscopy delay after positive FOBT result in the primary care safety net.

Methods

We conducted a multisite root cause analysis of cases of delayed colonoscopy, identifying cases where there was a delay of greater than 6 months in completing or scheduling a follow-up colonoscopy after a positive FOBT. We identified cases across 5 California health systems serving low-income, vulnerable populations. We developed a semistructured interview guide based on precedent work. We conducted telephone individual interviews with primary care providers (PCPs) and patients. We then performed qualitative content analysis of the interviews, using an integrated inductive-deductive analytic approach, to identify themes related to recurrent root causes of colonoscopy delay.

Results

We identified 12 unique cases, comprising 5 patient and 11 PCP interviews. Eight patients completed colonoscopy; median time to colonoscopy was 11.0 months (interquartile range, 6.3 months). Three patients had advanced adenomatous findings. Primary care providers highlighted system-level root causes, including inability to track referrals between primary care and gastroenterology, lack of protocols to follow up with patients, lack of electronic medical record interoperability, and lack of time or staffing resources, compelling tremendous additional effort by staff. In contrast, patients’ highlighted individual-level root causes included comorbidities, social needs, and misunderstanding the importance of the FOBT. There was a little overlap between PCP and patient-elicited root causes.

Conclusions

Current protocols do not accommodate communication between primary care and gastroenterology. Interventions to address specific barriers identified include improved interoperability between PCP and gastroenterology scheduling systems, protocols to follow-up on incomplete colonoscopies, accommodation for support and transport needs, and patient-friendly education. Interviewing both patients and PCPs leads to richer analysis of the root causes leading to delayed diagnosis of colorectal cancer.
The Lived Experience of Inpatients With Acute Recurrent Pancreatitis
Authors: Liu Jie , Zhang Bingqiang
Published: May 2020

The incidence of acute pancreatitis (AP) has increased year by year. Approximately 20%–30% of these patients will have further subsequent attacks, described as acute recurrent pancreatitis (ARP). Patients who are repeatedly admitted to hospitals suffer significant psychological problems and mental hardships. In the current study, we aimed to illuminate the lived experience of inpatients with ARP from Chongqing, China. A purposive sample of 13 ARP patients was recruited from the First Affiliated Hospital of Chongqing Medical University. Semistructured and in-depth qualitative interviews were adopted in this phenomenological research. Data were analyzed by Colaizzi's Method of descriptive phenomenology and feedback on early findings from the participants. All interviews were audio-recorded and transcribed with the permission of the participants. Five themes presented in the study: anxiety and fear, lack of related knowledge, inevitability and helplessness, guilt and shame, hope, and perseverance. Overall, the ARP inpatients showed complexed experience, both active and positive. They also performed poor compliance during their hospitalization but wished for professional knowledge. Nurses should pay attention to their psychological changes to take effective interventions for them.
The current status of disaster preparedness in Canadian trauma centers
Authors: Nantais Jordan , Gabbe Belinda J. , Nathens Avery , Gomez David
Published: May 2020

Mass casualty incidents (MCIs) put substantial stress on loco-regional resources, and trauma centers are critical to responding to these events. Our previous evaluation of Canadian centers helped to identify several weaknesses in disaster responsiveness. In this analysis, we determined the current state of MCI readiness across Canada and how this has changed over time. A multinational cross-sectional survey-based study on MCI preparedness was performed, including 24 Canadian trauma centers. Surveys were completed anonymously online by representatives of each facility. Responses from Canadian centers were examined and compared to previous findings to assess temporal changes in institutional capacity. Fifteen (63%) trauma centers responded, 100% of which had a disaster committee. Sixty percent had a single all-hazards emergency plan, and 71% performed a practice drill in the last two years. Sixty-two percent had communications systems designed to function during an MCI. Ninety-two percent had a triage system in place, and 54% of centers could monitor surge capacity. Half (54%) reported back-up systems for survival essentials, but the capability for prolonged operation during a disaster was limited. A minority (15%) had a database denoting staff with emergency training, although half (54%) had disaster training programs. Comparison to past data showed an increased prevalence of committees dedicated to disaster preparedness and disaster drills but worsened external stakeholder representation and poor ability to provide a prolonged response to crises. Our results demonstrate that MCI preparedness is a growing focus of Canadian trauma centers, but that there are deficiencies that remain unaddressed. Future efforts should focus on these vulnerabilities to ensure the provision of a robust disaster response.

LEVEL OF EVIDENCE

Level 3b (prevalence study, limited population).
How repetitive traumatic injury alters long-term brain function
Authors: Dhillon Navpreet K. , Linaval Nikhil T. , O'Rourke Jacqueline , Barmparas Galinos , Yang Audrey , Cho Noell , Shelest Oksana , Ley Eric J.
Published: May 2020

BACKGROUND

How recurrent traumatic brain injury (rTBI) alters brain function years after insult is largely unknown. This study aims to characterize the mechanistic cause for long-term brain deterioration following rTBI using a rat model.

METHODS

Eighteen Sprague-Dawley wild-type rats underwent bilateral rTBI using a direct skull impact device or sham treatment, once per week for 5 weeks, and were euthanized 56 weeks after the first injury. Weekly rotarod performance measured motor deficits. Beam walk and grip strength were also assessed. Brain tissue were stained and volume was computed using Stereo Investigator's Cavalieri Estimator. The L5 cortical layer proximal to the injury site was microdissected and submitted for sequencing with count analyzed using R “DESeq2” and “GOStats.” Brain-derived neurotrophic factor (BDNF) levels were determined using enzyme-linked immunosorbent assay.

RESULTS

Rotarod data demonstrated permanent deficits 1 year after rTBI. Decreased beam walk performance and grip strength was noted among rTBI rodents. Recurrent traumatic brain injury led to thinner cortex and thinner corpus callosum, enlarged ventricles, and differential expression of 72 genes (25 upregulated, 47 downregulated) including dysregulation of those associated with TBI (BDNF, NR4A1/2/3, Arc, and Egr) and downregulation in pathways associated with neuroprotection and neuroplasticity. Over the course of the study, BDNF levels decreased in both rTBI and sham rodents, and at each time point, the decrease in BDNF was more pronounced after rTBI.

CONCLUSION

Recurrent traumatic brain injury causes significant long-term alteration in brain health leading to permanent motor deficits, cortical and corpus callosum thinning, and expansion of the lateral ventricles. Gene expression and BDNF analysis suggest a significant drop in pathways associated with neuroplasticity and neuroprotection. Although rTBI may not cause immediate neurological abnormalities, continued brain deterioration occurs after the initial trauma in part due to a decline in genes associated with neuroplasticity and neuroprotection.
Physical and Vestibular Physical Therapy Referrals in People With Alzheimer Disease
Authors: Gandhi Priyal , Klatt Brooke N. , Agrawal Yuri
Published: May 2020

People with Alzheimer disease (AD) are at increased risk of falls and disproportionately burdened with vestibular impairment compared with healthy older adults. Although physical therapy (PT) and vestibular physical therapy (VPT) are effective rehabilitation interventions in improving balance and fall risk, referral patterns for these services in the AD population are understudied. A retrospective chart review was conducted of patients seen for primary AD care at a tertiary AD referral center to investigate the frequency of rehabilitation referrals. Of the 801 people with AD seen for AD care in 1 year, 48 individuals (6.0%) were referred to PT and 5 individuals (0.6%) to VPT. People with AD appear to receive very infrequent PT and VPT referrals, despite the potentially large number of people with AD who could benefit from PT and VPT services to improve their balance and vestibular function.
A Scope of the Social Brain in Multiple Sclerosis: Insights From Neuroimaging Studies
Authors: Chalah Moussa A. , Ayache Samar S.
Published: May 2020

Multiple sclerosis (MS) is the most common inflammatory neurologic disease in young adults. Its pathological mechanisms include demyelination, neurodegeneration, and synaptopathy. Cognitive deficits occur in up to 65% of individuals with MS and affect both nonsocial (eg, information processing speed, memory, and executive functions) and social (ie, emotion recognition, theory of mind, and empathy) cognitive domains. In the last 3 decades, there has been a growing interest in social cognition and its relationship with neuropsychological, sociodemographic, and disease characteristics in individuals with MS. Uncovering the neuropathological correlates of social cognitive deficits is now a crucial aim that would also help us better understand the underlying mechanisms of social cognition. We reviewed 11 neuroimaging studies to investigate social cognition in MS. These studies focused mainly on facial emotion recognition and theory of mind, with the findings suggesting that a disrupted cortico-subcortical network forms the basis of social deficits involving both domains. We then interpreted these results in the context of multiple disconnection syndrome, which occurs as a result of axonal demyelination and degeneration within the connexome of several neural hubs devoted to social cognition. Heterogeneity in social cognitive performance, observed among our study participants, is discussed with reference to the cognitive reserve and brain reserve hypotheses. These reserves may explain why individuals with comparable clinical characteristics of MS may exhibit different cognitive profiles. Further research is required to generalize these findings to the MS population and to inform the development of effective interventions to improve psychosocial functioning in individuals with MS.
Clinical Features of Late-onset Semantic Dementia
Authors: Mendez Mario F. , Chavez Diana , Desarzant Randy E. , Yerstein Oleg
Published: May 2020

Background:

Semantic dementia (SD) is characterized by progressive semantic anomia extending to a multimodal loss of semantic knowledge. Although often considered an early-onset dementia, SD also occurs in later life, when it may be misdiagnosed as Alzheimer disease (AD).

Objective:

To evaluate late-onset SD in comparison to early-onset SD and to AD.

Methods:

We identified 74 individuals with SD and then compared those with late-onset SD (≥65 years of age) to those with early-onset SD (<65) on demographic and clinical features. We also compared a subgroup of 23 of the late-onset SD individuals with an equal number of individuals with clinically probable AD.

Results:

Twenty-six (35.1%) of the SD individuals were late onset, and 48 (64.9%) were early onset. There were no differences between the two groups on clinical measures, although greater asymmetry of temporal involvement trended to significance in the late-onset SD group. Compared to the 23 AD individuals, the subgroup of 23 late-onset SD individuals had worse performance on confrontational naming, irregular word reading, and face recognition; however, this subgroup displayed better verbal delayed recall and constructions. The late-onset SD individuals also experienced early personality changes at a time when most individuals with AD had not yet developed behavioral changes.

Conclusions:

Approximately one-third of SD individuals may be late onset, and the differentiation of late-onset SD from AD can lead to better disease management, education, and prognosis. SD may be distinguished by screening for disproportionate changes in reading, face recognition, and personality.
Uncertainty quantification and sensitivity analysis of left ventricular function during the full cardiac cycle
Authors: Campos J. O. , Sundnes J. , dos Santos R. W. , Rocha B. M.
Published: May 2020

Patient-specific computer simulations can be a powerful tool in clinical applications, helping in diagnostics and the development of new treatments. However, its practical use depends on the reliability of the models. The construction of cardiac simulations involves several steps with inherent uncertainties, including model parameters, the generation of personalized geometry and fibre orientation assignment, which are semi-manual processes subject to errors. Thus, it is important to quantify how these uncertainties impact model predictions. The present work performs uncertainty quantification and sensitivity analyses to assess the variability in important quantities of interest (QoI). Clinical quantities are analysed in terms of overall variability and to identify which parameters are the major contributors. The analyses are performed for simulations of the left ventricle function during the entire cardiac cycle. Uncertainties are incorporated in several model parameters, including regional wall thickness, fibre orientation, passive material parameters, active stress and the circulatory model. The results show that the QoI are very sensitive to active stress, wall thickness and fibre direction, where ejection fraction and ventricular torsion are the most impacted outputs. Thus, to improve the precision of models of cardiac mechanics, new methods should be considered to decrease uncertainties associated with geometrical reconstruction, estimation of active stress and of fibre orientation.

This article is part of the theme issue ‘Uncertainty quantification in cardiac and cardiovascular modelling and simulation’.
Discovery and characterization of a novel insect-specific reovirus isolated from Psammotettix alienus
Authors: Fu Yumei , Cao Mengji , Wang Hui , Du Zhenzhen , Liu Yan , Wang Xifeng
Published: May 2020

A novel double-stranded RNA (dsRNA) virus designated Psammotettix alienus reovirus (PARV) was found in the leafhopper Psammotettix alienus in China. Spherical particles approximately 70 nm in diameter arranged in a crystalline array were observed in the salivary gland tissues of infected leafhoppers by transmission electron microscopy. Some viral particles were also encased in tubules, similar to those of previously described reoviruses. Whole-genome sequencing revealed that the dsRNA genome of PARV consists of 29 569 nucleotides (nt) divided into 10 segments ranging from 4403 to 1476 nt, with low G+C content (29.5–36.5 %). All segments contained conserved terminal sequences (5′AAC…GUCA3′) and specific panhandle structures formed by inverted terminal repeats in the noncoding regions. Phylogenetic analysis based on the deduced RNA-dependent RNA polymerase (RdRp) revealed that PARV was in the fijivirus clade, but in a monophyletic lineage with an unassigned insect reovirus (Hubei insect virus 2, HBIV-2), although PARV and HBIV-2 are distinct enough to represent a new group within the genus Fijivirus. Biological assays showed that PARV infects P. alienus but not wheat plants, implying that it is a new insect-specific reovirus in the leafhopper. Given these features, PARV should be considered as a new species in the genus Fijivirus, family Reoviridae.
Combinatorial Polyacrylamide Hydrogels for Preventing Biofouling on Implantable Biosensors
Authors: Chan Doreen , Chien Jun-Chau , Axpe Eneko , Blankemeier Louis , Baker Samuel W. , Swaminathan Sarath , Piunova Victoria A. , Zubarev Dmitry Yu. , Maikawa Caitlin L. , Grosskopf Abigail K. , Mann Joseph L. , Soh H. Tom , Appel Eric A.
Published: May 2020

Biofouling on the surface of implanted medical devices severely hinders device functionality and drastically shortens device lifetime. Poly(ethylene glycol) and zwitterionic polymers are currently considered “gold standard” device coatings to reduce biofouling. To discover novel anti-biofouling materials, we created a combinatorial library of polyacrylamide-based copolymer hydrogels and screened their ability to prevent fouling from serum and platelet-rich plasma in a high-throughput parallel assay. We found certain non-intuitive copolymer compositions exhibit superior antibiofouling properties over current gold standard materials, and employed machine learning to identify key molecular features underpinning their performance. For validation, we coated the surfaces of electrochemical biosensors with our hydrogels and evaluated their anti-biofouling performancein vitroandin vivoin rodent models. Our copolymer hydrogels preserved device function and enabled continuous measurements of a small-molecule drugin vivobetter than gold standard coatings. The novel methodology we describe enables the discovery of anti-biofouling materials that can extend the lifetime of real-timein vivosensing devices.
A Critical Interpretive Synthesis to Develop Quality Assessment Tools for E-Cigarette Reviews: Scope and Protocol
Authors: O’Leary R. , Costanzo F.
Published: May 2020

One component of a systematic review is the quality assessment of studies to determine their inclusion or exclusion. Studies on e-cigarettes are conducted in the contentious atmosphere surrounding tobacco harm reduction, which has resulted at times in research bias. Therefore, the quality assessment of studies on e-cigarettes requires more scrutiny than what is provided by generic tools on study design. This topic-specific quality assessment must examine the tests, measurements, and analysis methods used for their adherence to research standards. Furthermore, the studies need to be carefully screened for bias. Because standard quality assessment tools do not provide this topic-specific guidance, we propose to develop quality assessment tools specifically for reviews on e-cigarettes, and for our living systematic reviews on e-cigarettes for tobacco harm reduction.
BtToxin_Digger: a comprehensive and high-throughput pipeline for mining toxin protein genes fromBacillus thuringiensis
Authors: Liu Hualin , Zheng Jinshui , Bo Dexin , Yu Yun , Ye Weixing , Peng Donghai , Sun Ming
Published: May 2020

Bacillus thuringiensis(Bt) which is a spore-forming gram-positive bacterium, has been used as the most successful microbial pesticide for decades. Its toxin genes (cry) have been successfully used for the development of GM crops against pests. We have previously developed a web-based insecticidal gene mining tool BtToxin_scanner, which has been proved to be the most important method for miningcrygenes from Bt genome sequences. To facilitate efficiently mining major toxin genes and novel virulence factors from large-scale Bt genomic data, we re-design this tool with a new workflow. Here we present BtToxin_Digger, a comprehensive, high-throughput, and easy-to-use Bt toxin mining tool. It runs fast and can get rich, accurate, and useful results for downstream analysis and experiment designs. Moreover, it can also be used to mine other targeting genes from large-scale genome and metagenome data with the addition of other query sequences.

Availability and Implementation

The BtToxin_Digger codes and instructions are freely available athttps://github.com/BMBGenomics/BtToxin_Digger. A web server of BtToxin_Digger can be found athttp://bcam.hzau.edu.cn/BtToxin_Digger.

Contact

jszheng@mail.hzau.edu.cn;m98sun@mail.hzau.edu.cn.
Sex-biased migration and admixture in macaque species revealed by comparison between autosomal and X-chromosomal genomic sequences
Authors: Osada Naoki , Matsudaira Kazunari , Hamada Yuzuru , Malaivijitnond Suchinda
Published: May 2020

The role of sex-specific demography in hybridization and admixture of genetically diverged species and populations is essential to understand the mechanisms forming the genomic diversity of sexually reproducing organisms. In order to infer how sex-linked genetic loci have been differentiated undergoing frequent hybridization and admixture, we examined 17 whole-genome sequences of seven species of the genusMacaca, which shows frequent inter-specific hybridization and predominantly female philopatry. We found that hybridization and admixture were prevalent within these species. For three cases of suggested hybrid origin of species/subspecies,M. arctoides,M. fascicularis ssp. aurea, and ChineseM. mulatta, we examined the level of admixture of X chromosomes, which is less affected by male-biased migration than that of autosomes. In one case, we were able to determine thatM. cyclopisandM. fuscatawas genetically closer to ChineseM. mulattathan to the IndianM. mulatta, and the admixture level of ChineseM. mulattaandM. fuscata/cyclopiswas more pronounced on the X chromosome than on autosomes. Since the mitochondrial genomes of ChineseM. mulatta,M. cyclopis, andM. fuscatawere found to cluster together, and the mitochondrial genome of IndianM. mulattais more distantly related, the observed pattern of genetic differentiation on X-chromosomal loci is consistent with the nuclear swamping hypothesis, in which strong, continuous male-biased introgression from the ancestral ChineseM. mulattapopulation to a population related toM. fuscataandM. cyclopisgenerated incongruencies between the genealogies of the mitochondrial and autosomal genomes.
Exposure to hypergravity during zebrafish development alters cartilage material properties and strain distribution
Authors: Lawrence Elizabeth A , Aggleton Jessye A , Loon Jack J. W. A. van , Godivier Josepha , Harniman Robert L. , Pei Jiaxin , Nowlan N. C. , Hammond Chrissy L
Published: May 2020

Terrestrial vertebrates have adapted to life on Earth and its constant gravitational field, which exerts load on the body and influences the structure and function of tissues. While the effects of microgravity on muscle and bone homeostasis are well described, the effects of shorter exposures to increased gravitational fields are less well characterized. Here, we exposed zebrafish to 3 and 6g hypergravity from 3-5 days post fertilisation, when key events in jaw cartilage morphogenesis occur. We did not observe changes to growth, or morphology of cartilage or muscle. However, we observed altered mechanical properties of jaw cartilages. We model the impact of these material property changes using Finite Element Analysis and show strain distribution in the jaw is altered following hypergravity. In regions of predicted altered strain we observed local changes to chondrocyte morphology, suggesting altered gravity affects chondrocyte maturation, ultimately leading to changes to cartilage structure and function.