bluuebunny/crossref_metadata_2025 huggingface dataset:
Extracellular ATP is a potent signaling molecule in the activation of the Japanese flounder (Paralichthys olivaceus) innate immune responses
Authors: Li Shuo , Chen Xiaoli , Li Jiafang , Li Xuejing , Zhang Tianxu , Hao Gaixiang , Sun Jinsheng
Published: January 2020

Innate immunity is the first line of defense against pathogen infections. Extracellular ATP (eATP) is one of the most studied danger-associated molecular pattern molecules that can activate host innate immune responses through binding with and activating purinergic receptors on the plasma membrane. The detailed actions of eATP on fish innate immunity, however, remain poorly understood. In this study, we investigated bacterial pathogen-induced ATP release in head kidney cells of the Japanese flounder Paralichthys olivaceus. We also examined the actions of eATP on pro-inflammatory cytokine and immune-related gene expression, the activity of induced NO synthase (iNOS), and the production of reactive oxygen species (ROS) and NO in Japanese flounder immune cells. We demonstrate that ATP is dynamically released from Japanese flounder head kidney cells into the extracellular milieu during immune challenge by formalin-inactivated Edwardsiella tarda and Vibrio anguillarum. In addition, we show that eATP administration results in profound up-regulation of pro-inflammatory cytokine gene expression, iNOS activity, and inflammatory mediator production, including ROS and NO, in Japanese flounder immune cells. Altogether, our findings demonstrate that eATP is a potent signaling molecule for the activation of innate immune responses in fish.
Directive Leading Questions and Preparation Technique Effects on Witness Accuracy
Authors: Gous Georgina , Wheatcroft Jacqueline M.
Published: January 2020

The use of leading questions during cross-examination can undermine the accuracy and completeness of evidence presented in court. Furthermore, increasing numbers of general witnesses are arriving in court unprepared for the experience. In this study, 60 mock witnesses from England and Wales were allocated to one of the three preparation conditions: (a) those who received no familiarization with the cross-examination process, (b) those who received a guidance booklet on cross-examination procedures, and (c) those who underwent an alternative rapport-building protocol. The participants observed a hit-and-run scenario video clip before being cross-examined with either (a) non-directive leading questions or (b) directive leading questions. The results showed that directive leading questioning styles were most detrimental to witness accuracy. Neither familiarization with the types of questions typically employed during cross-examination nor the rapport-building protocol were found to be effective as a preparation strategy to increase accurate responses compared against a control group. Consideration of the impact of directive leading question styles on all witnesses in court seems necessary.
Revision decompression with fusion as a treatment for same level restenosis after laminotomy for lumbar spinal stenosis
Authors: Liang Zhuohao Chow , Yim Wing Ngai , Wong Chung Ting Martin , Cheng Hung On , Cheung Ka Kin
Published: January 2020

Background/Purpose:

Laminotomy is an established procedure to relieve symptoms of lumbar spinal stenosis. However, there is a group of patients with symptomatic recurrence. Re-decompression and fusion could be an effective salvage procedure but the results are seldom found in the literature. In this study, we focused on investigating the clinical outcomes and complication rates of revision decompression with fusion in this patient group.

Methods:

A retrospective study including patients who had undergone revision decompression with fusion for recurrent symptoms due to same level restenosis after primary laminotomy for lumbar spinal stenosis was performed. Patients with recurrent symptoms due to prolapsed intervertebral disc, trauma, infection, and neoplasm were excluded. Demographics, clinical outcomes, and complications were retrieved.

Results:

Twenty-eight patients with a total number of 42 levels of revision decompression and fusion were included. With a mean follow-up time of 27 months after revision surgery, there were statistically significant improvement of 63, 49, and 13% in Japanese Orthopaedic Association score, visual analog scale for leg pain, and Roland-Morris disability questionnaire score, respectively. There were 6(21%), 2(7%), 0(0%), and 2(7%) cases of dural tear, infection requiring reoperation, new neurological deficit, and other complications, respectively, in these revision cases.

Conclusion:

Bearing potential complications in mind, re-decompression with fusion is a viable option with reasonable clinical outcomes for patients with recurrent symptoms after laminotomy for lumbar spinal stenosis. As a treatment option for symptomatic lumbar spinal stenosis, primary laminotomy could have the potential benefit of lower complication rates in revision surgery.
Functional Outcomes of Isolated Infrasyndesmotic Fibula Fractures
Authors: Dobbe Ashlee , Beaupre Lauren A. , Almansoori Khaled Ali , Fung Tak-Shing , Scharfenberger Angela V.
Published: January 2020

Background:

Ankle fractures are among the most common injuries encountered by orthopedic surgeons, with an incidence ranging from 71 to 187 per 100 000 people. Few studies have reliably investigated injuries involving isolated fractures of the distal fibula below the level of the ankle syndesmosis. Therefore, this study details on the patient-reported outcomes of nonoperatively managed isolated infrasyndesmotic fibula (ISF) fractures with a minimum 3-year follow-up.

Methods:

A retrospective population-based cohort study was undertaken across all emergency departments serving a major urban population. Among 159 consecutive patients meeting inclusion criteria, 108 agreed to participate. Clinical information, functional outcomes, and radiographic measurements were collected from electronic medical records and 3 validated outcome measures: the American Academy of Orthopaedic Surgeons (AAOS) Foot & Ankle Scale (FAS), the AAOS Shoe-Comfort Scale (SCS), and a general questionnaire.

Results:

An incidence of 22 ISF fractures per 100 000 people/year was found with FAS (91.2 ± 12.9) and SCS scores (76.8 ± 27.7), similar to reported population norms. Approximately 40% of patients (n = 43) reported continuing symptoms including pain (81.8%), stiffness (68.1%), and/or instability (39.0%). Less than 13% (n = 14) reported “severe” disabilities, and no patients required operative intervention within the follow-up period. Less-favorable outcomes were reported among work-related injuries, female patients, and “avulsion-type” fractures less than 10 mm in height ( P < .01). No relationships were identified between age, degree of articular-incongruity, fracture-displacement, and self-reported outcomes.

Conclusions:

The majority of patients with nonoperatively managed ISF fractures reported good-to-excellent early functional outcomes. Less-favorable outcomes were reported among work-related injuries, female patients, and “avulsion-type” fractures.

Level of Evidence:

Level III, comparative series.
Projects-as-Practice
Authors: Buchan Linda , Simpson Barbara
Published: January 2020

This article contributes a practice-based approach to project management by opening up to the messiness and unpredictabilities involved in actually doing project work. Drawing on the Pragmatist ideas of John Dewey, we theorize projects-as-practices (noun) and projects-as-practice (verb) as complementary concepts that are built respectively on ontologies of being and becoming. For the purposes of this article, we define the notion of project as an emergent social process of becoming, bounded in time and space, and generative of novel outcomes. We also contribute methodologically by proposing Dewey’s Inquiry as a guide to shadowing the bounded becomingness of projects-as-practice (verb). Using an empirical illustration from a Health and Social Care Partnership in Scotland, we highlight the inherently emergent nature of projects as they bring about transformational change.
Introduction to a review series on treatment of venous thrombotic disorders
Authors: Ortel Thomas L.
Published: January 2020

In this Review Series, introduced by Associate Editor Thomas L. Ortel, experts contribute 6 seminal reviews that focus on the treatment of venous thromboembolism (VTE) in adults and children, the management of VTE developing in unusual locations and in the setting of thrombophilia, and new targets and antithrombotic therapies in development.
PD-1 blockade for diffuse large B-cell lymphoma after autologous stem cell transplantation
Authors: Frigault Matthew J. , Armand Philippe , Redd Robert A. , Jeter Erin , Merryman Reid W. , Coleman Kimberly C. , Herrera Alex F. , Dahi Parastoo , Nieto Yago , LaCasce Ann S. , Fisher David C. , Ng Samuel Y. , Odejide Oreife O. , Freedman Arnold S. , Kim Austin I. , Crombie Jennifer L. , Jacobson Caron A. , Jacobsen Eric D. , Wong Jeffrey L. , Bsat Jad , Patel Sanjay S. , Ritz Jerome , Rodig Scott J. , Shipp Margaret A. , Chen Yi-Bin , Joyce Robin M.
Published: January 2020

Disease relapse remains the leading cause of failure after autologous stem cell transplantation (ASCT) for patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). We conducted a phase 2, multicenter, single-arm study of the anti–PD-1 monoclonal antibody pembrolizumab given after ASCT in patients with chemosensitive DLBCL, hypothesizing that it would improve the progression-free survival (PFS) at 18 months after ASCT (primary endpoint) from 60% to 80%. Pembrolizumab was administered at 200 mg IV every 3 weeks for up to 8 cycles, starting within 21 days of post-ASCT discharge. Twenty-nine patients were treated on this study; 62% completed all 8 cycles. Seventy-nine percent of patients experienced at least one grade 3 or higher adverse event, and 34% experienced at least one grade 2 or higher immune-related adverse event. Overall, 59% of patients were alive and progression free at 18 months, which did not meet the primary endpoint. The 18-month overall survival was 93%. In conclusion, pembrolizumab was successfully administered as post-ASCT consolidation in patients with R/R DLBCL, but the PFS did not meet the protocol-specific primary objective and therefore does not support a larger confirmatory study. This trial was registered at www.clinicaltrials.gov as #NCT02362997.
Dye-doped silica nanoparticles: synthesis, surface chemistry and bioapplications
Authors: Gubala Vladimir , Giovannini Giorgia , Kunc Filip , Monopoli Marco P. , Moore Colin J.
Published: January 2020

Background

Fluorescent silica nanoparticles have been extensively utilised in a broad range of biological applications and are facilitated by their predictable, well-understood, flexible chemistry and apparent biocompatibility. The ability to couple various siloxane precursors with fluorescent dyes and to be subsequently incorporated into silica nanoparticles has made it possible to engineer these fluorophores-doped nanomaterials to specific optical requirements in biological experimentation. Consequently, this class of nanomaterial has been used in applications across immunodiagnostics, drug delivery and human-trial bioimaging in cancer research.

Main body

This review summarises the state-of-the-art of the use of dye-doped silica nanoparticles in bioapplications and firstly accounts for the common nanoparticle synthesis methods, surface modification approaches and different bioconjugation strategies employed to generate biomolecule-coated nanoparticles. The use of dye-doped silica nanoparticles in immunoassays/biosensing, bioimaging and drug delivery is then provided and possible future directions in the field are highlighted. Other non-cancer-related applications involving silica nanoparticles are also briefly discussed. Importantly, the impact of how the protein corona has changed our understanding of NP interactions with biological systems is described, as well as demonstrations of its capacity to be favourably manipulated.

Conclusions

Dye-doped silica nanoparticles have found success in the immunodiagnostics domain and have also shown promise as bioimaging agents in human clinical trials. Their use in cancer delivery has been restricted to murine models, as has been the case for the vast majority of nanomaterials intended for cancer therapy. This is hampered by the need for more human-like disease models and the lack of standardisation towards assessing nanoparticle toxicity. However, developments in the manipulation of the protein corona have improved the understanding of fundamental bio–nano interactions, and will undoubtedly assist in the translation of silica nanoparticles for disease treatment to the clinic.
Association analysis between constructed SNPLDBs and GCA effects of 9 quality-related traits in parents of hybrid rice (Oryza sativa L.)
Authors: Eltahawy Moaz S. , Ali Nour , Zaid Imdad U. , Li Dalu , Abdulmajid Dina , Bux Lal , Wang Hui , Hong Delin
Published: January 2020

Background

The general combining ability (GCA) of parents in hybrid rice affects not only heterotic level of grain yield and other important agronomic traits, but also performance of grain quality traits of F2bulk population which is the commodity consumed by humans. In order to make GCA improvement for quality traits in parents of hybrid rice by molecular marker assisted selection feasible, genome-wide GCA loci for quality traits in parents were detected through association analysis between the effects of GCA and constructed single nucleotide polymorphism linkage disequilibrium blocks (SNPLDBs), by using unhusked rice grains harvested from F1plants of 48 crosses of Indica rice and 78 crosses of Japonica rice. GCA-SNPLDBs association analysis.

Results

Among the 8 CMS and 6 restorer lines ofindicarice subspecies, CMS lines Zhenpin A, Zhenshan97 A, and 257A, and restorers Kanghui98, Minghui63 and Yanhui559 were recognized as good general combiners based on their GCA effect values for the 9 quality traits (brown rice rate, milled rice rate, head rice rate, percentage of chalky grains, chalky area size, chalkiness degree, gelatinization temperature, gel consistency and amylose content). Among the 13 CMS and 6 restorer lines ofjaponicarice subspecies, CMS 863A, 6427A and Xu 2A, and restorers C418, Ninghui8hao and Yunhui4hao showed elite GCA effect values for the 9 traits. GCA-SNPLDB association analysis revealed 39 significant SNPLDB loci associated with the GCA of the 9 quality-related traits, and the numbers of SNPLDB loci located on chromosome 1, 2, 3, 4, 5, 8, 9, 11 and 12 were 1, 4, 3, 9, 6, 5, 5, 4 and 2, respectively. Number of superior GCA alleles for the 9 traits among the 33 parents ranged from 1 to 26.

Conclusions

Thirty-nine significant SNPLDBs loci were identified associated with the GCA of 9 quality-related traits, and the superior SNPLDB alleles could be used to improve the GCA of parents for the traits in the future by molecular marker assisted selection. The genetic basis of trait GCA in parents is different from that of trait itself.
Layer-specific speckle tracking analysis of left ventricular systolic function and synchrony in maintenance hemodialysis patients
Authors: Liu Chang , Yan Zi-Ning , Fan Li , Huang Jun , Shen Dan , Song Xiang-Ting
Published: January 2020

Background

This study investigated the value of layer-specific strain analysis by two-dimensional speckle tracking echocardiography (2D-STE) for evaluating left ventricular (LV) systolic function and synchrony in maintenance hemodialysis (MHD) patients.

Methods

A total of 34 MHD patients and 35 healthy controls were enrolled in this study. Dynamic images were collected at the LV apical long-axis, the four- and two- chamber, and the LV short-axis views at the basal, middle, and apical segments. The layer-specific speckle tracking (LST) technique was used to analyze the longitudinal strain (LS) and circumferential strain (CS) of LV sub-endocardium, mid-myocardium, sub-epicardium, global longitudinal strain (GLS), global circumferential strain (GCS), the LV 17 segment time to peak LS (TTP), and the peak strain dispersion (PSD). The differences in these parameters were compared between control and MHD groups, and the correlation between PSD and each LS parameter was examined. The receiver operator characteristic (ROC) curve was used to evaluate the efficacy of three myocardial layer LS and CS in the assessment of LV systolic dysfunction in MHD patients.

Results

MHD patients had comparable left ventricular ejection fraction (LVEF), but significantly smaller LV GLS, GCS, and three-layer LS and CS compared to the control group. The three myocardial layer LS of the basal segment, middle segment, and apex segment was significantly reduced in the MHD patients compared to the normal subjects, while the three myocardial layer CS of the basal segment, middle segment, and apex segment was significantly reduced in the MHD patients compared to the normal subjects, except for the sub-endocardium of the middle and apex segment. MHD patients had significantly higher TTP of LV 17 segments and PSD compared to controls, and had delayed peak time in most segments. In addition, PSD of MHD patients was positively correlated with sub-endocardial and mid-myocardial LS and GLS, but not with sub-epicardial LS. The area under the curves (AUCs) of sub-endocardial, mid-myocardial, and sub-epicardial LS in MHD patients were 0.894, 0.852, and 0.870, respectively; the AUCs of sub-epicardial, mid-myocardial, and sub-endocardial CS were 0.852, 0.837, and 0.669, respectively.

Conclusions

LST may detect early changes of all three-layer LS and CS and PSD in MHD patients, and is therefore a valuable tool to diagnose LV systolic dysfunction in MHD patients.
Complexities in consultations in case of euthanasia or physician-assisted suicide: a survey among SCEN physicians
Authors: Bergman Tessa D. , Pasman H. Roeline W. , Onwuteaka-Philipsen Bregje D.
Published: January 2020

Background

In the Netherlands, euthanasia or physician-assisted suicide (EAS) is allowed if due care criteria are met. One criterion is consultation of a second independent physician, often SCEN physicians. The public debate about EAS focuses on patients with psychiatric disorders, dementia, and tired of living, as complex cases. What complexities SCEN physicians perceive during consultation is unknown. This study aims to assess the frequency of EAS consultations that are perceived difficult by SCEN physicians, to explore what complexities are perceived by SCEN physicians during consultation, and to assess what characteristics are associated with difficult consultations.

Methods

Data from 2015 to 2017 from an annual cross-sectional survey among SCEN physicians was used. In 2015, the survey focused on the most difficult consultation that year and in 2016/2017 on the most recent consultation. Frequencies of coded answers to an open-ended question were done to explore what complexities SCEN physicians perceived during their most difficult consultation. Univariable and multivariable logistic regression analyses were used to assess what characteristics were associated with difficult consultations.

Results

21.6% of cases consulted by SCEN physicians is perceived difficult. Complexities that SCEN physicians perceive were mainly in contact with patients (79.7%) and in the assessment of due care criteria (41.0%). Characteristics that were associated with a higher likelihood of a consultation being difficult are the attending physician being less certain to perform the EAS, patients staying in the hospital, main diagnosis heart failure/CVA, and accumulation of age-related health problems/psychiatry/dementia, and the presence of a psychiatric disorder, or psychosocial or existential problems besides the main diagnosis. Characteristics that were associated with a lower likelihood of a consultation being difficult are high patient’s age and physical suffering as reason to request EAS.

Conclusion

Complexities perceived by SCEN physicians in EAS consultations are not limited to the ‘complex’ cases present in the current public debate about EAS, e.g. patients with psychiatric disorders, dementia, and tired of living. Attention for these complexities in intervision could indicate if there is a need among SCEN physicians to enhance knowledge and skills in training and to receive specific support in intervision on these complexities.
Risk factors for spontaneous miscarriage above 12 weeks or premature delivery in patients undergoing cervical polypectomy during pregnancy
Authors: Fukuta Kaori , Yoneda Satoshi , Yoneda Noriko , Shiozaki Arihiro , Nakashima Akitoshi , Minamisaka Takashi , Imura Johji , Saito Shigeru
Published: January 2020

Background

It currently remains unknown whether the resection of cervical polyps during pregnancy leads to miscarriage and/or preterm birth. This study evaluated the risk of spontaneous PTB below 34 or 37 weeks and miscarriage above 12 weeks in patients undergoing cervical polypectomy during pregnancy.

Methods

This was a retrospective monocentric cohort study of patients undergoing cervical polypectomy for clinical indication. Seventy-three pregnant women who underwent polypectomy were selected, and risk factors associated with miscarriage above 12 weeks or premature delivery below 34 or 37 weeks were investigated. A multivariable regression looking for predictors of spontaneous miscarriage > 12 weeks and PTB < 34 or 37 weeks were performed.

Results

Sixteen patients (21.9%, 16/73) had spontaneous delivery at < 34 weeks or miscarriage above 12 weeks. A univariate analysis showed that bleeding before polypectomy [odds ratio (OR) 7.7, 95% confidence interval (CI) 1.6–37.3, p = 0.004], polyp width ≥ 12 mm (OR 4.0, 95% CI 1.2–13.1, p = 0.005), the proportion of decidual polyps (OR 8.1, 95% CI 1.00–65.9, p = 0.024), and polypectomy at ≤10 weeks (OR 5.2, 95% CI 1.3–20.3, p = 0.01) were significantly higher in delivery at < 34 weeks than at ≥34 weeks. A logistic regression analysis identified polyp width ≥ 12 mm (OR 11.8, 95% CI 2.8–77.5, p = 0.001), genital bleeding before polypectomy (OR 6.5, 95% CI 1.2–55.7, p = 0.025), and polypectomy at ≤10 weeks (OR 5.9, 95% CI 1.2–45.0, p = 0.028) as independent risk factors for predicting delivery at < 34 weeks. Polyp width ≥ 12 mm and bleeding before polypectomy are risk factors for PTB < 37 wks.

Conclusions

Our cohort of patients undergoing polypectomy in pregnancy have high risks of miscarriage or spontaneous premature delivery. It is unclear whether these risks are given by the underlying disease, by surgical treatment or both. This study establishes clinically relevant predictors of PTB are polyp size> 12 mm, bleeding and first trimester polypectomy. PTB risks should be exposed to patients and extensively discussed with balancing against the benefits of intervention in pregnancy.
Are quantity and content of psychiatric interventions associated with suicide? A case-control study of a Swedish sample
Authors: Holländare Fredrik , Tillfors Maria , Nordenskjöld Axel , Sellin Tabita
Published: January 2020

Background

Research is required to identify those psychiatric interventions with a protective effect against suicide. The overarching aim of the current study was to examine whether completed suicide in psychiatric patients in a Swedish population was associated with the quantity and nature of previous medical and psychosocial treatment interventions.

Methods

This retrospective case-control study (n = 308) compared a group of deceased psychiatric patients with matched controls. For every case of suicide, a control was found within psychiatry that matched according to sex, age, and primary psychiatric diagnosis. A stepwise forward logistic regression model with suicide as the dependent outcome variable was used.

Results

Receiving pharmacotherapy combined with psychotherapy [OR: 0.44 (95% CI: 0.226–0.876),p = 0.019] and a higher number of outpatient visits in psychiatry [OR: 0.99 (95% CI: 0.982–0.999),p = 0.028] were negatively associated with suicide. These associations were still significant after controlling for previous serious suicide attempts and somatic comorbidity.

Conclusions

Frequent visits and pharmacotherapy combined with psychotherapy seem to be important for preventing suicide in psychiatric patients. The reasons for not receiving such therapy are important issues for further study.
Using EMDR therapy with patients in an acute mental health crisis
Authors: Proudlock Simon , Peris Jasmine
Published: January 2020

Background

Death by suicide continues to be a global public health concern with little research demonstrating the effectiveness of treatment options. This exploratory study exams the efficacy of Eye Movement Desensitisation and Reprocessing (EMDR) Therapy delivered to patients experiencing an acute mental health crisis to explore if by treating their background trauma, improvements could be seen in their general psychopathology and if there was a resulting decrease in their desire for suicide.

Methods

A practice-based service development project was conducted within a mental health hospital. A non-randomised, exploratory pre-test post-test design was utilised. Participants were identified from adult patients currently receiving care from either an inpatient mental health ward or the Crisis Resolution and Home Treatment Team (CRHTT). Those who had reported experiencing at least one event that they considered to be traumatic were offered EMDR Therapy. Notes from the electronic database were analysed to assess contact with services 12 months prior to treatment and following treatment.

Results

72 patients were offered treatment in the study with 57 completing treatment. Patients made significant improvements across all the psychometrics, including a reduction in suicidal ideation. The majority needed less than 10 sessions and needed no onward referral for further psychological therapy. Cost savings were realised by retracting referrals for further therapy and in early discharge from CRHTT and acute wards, and by preventing admissions. Contact with services post treatment also reduced.

Conclusions

EMDR Therapy can be an effective treatment for patients experiencing a mental health crisis who have a trauma picture, resulting in significant improvements in their mental well-being and substantial cost savings for the National Health Service (NHS).
Correction to: The Japanese version of the questionnaire about the process of recovery: development and validity and reliability testing
Authors: Kanehara Akiko , Kotake Risa , Miyamoto Yuki , Kumakura Yousuke , Morita Kentaro , Ishiura Tomoko , Shimizu Kimiko , Fujieda Yumiko , Ando Shuntaro , Kondo Shinsuke , Kasai Kiyoto
Published: January 2020

After publication of our article [1] we were notified that the 5-point Likert-type scale in Additional file 1 needs to change from “1 to 5” to “0 to 4”. The updated Additional file 1 is included in this correction.
Trends of online news media reported suicides in Ghana (1997–2019)
Authors: Abdulai Tanko
Published: January 2020

Background

Suicides have become headline news in most developing countries and often feature on front pages with accompanying graphic pictures on prominent news portals. There has been an increased reportage of suicides by the Ghanaian news media. This study aims to shed light on the trend of online news media reporting of suicides, and the epidemiology of media reported suicides in Ghana.

Methods

An online search was conducted for news media reports of suicides committed in Ghana. One hundred and forty-two (142) news media reported suicides spanning 1997 to 31st July 2019 were retrieved and included in the analyses.

Results

The victims of suicides were predominantly male (85.92%), young (mean age = 34.81 ± 15.71 years; range 10-86 years). Suicide by hanging (67.94%), the use of firearms (18.32%), and self-poisoning (8.93%) were the common methods used by the victims. There has been increased online news media reportage of suicides in Ghana in the last 3 years; 2017 witnessed the highest reportage of 30 (21%) cases. Marital or relationships and family problems were commonly cited as the reasons for the commission of suicides; mental disorders, and financial problems were also cited as immediate triggers of the suicides by close relations of the victims.

Conclusion

There is an increased media reportage of suicides in Ghana, although this cannot be linked to a corresponding increase in suicide incidence. Interventions to decrease the risk of suicide among vulnerable populations (young adults) such as the identification of suicidal behavior, making mental healthcare services more accessible by integrating into the general healthcare service, public education, establishing a suicide hotline will be critical programs to help reduce suicide incidence in Ghana.
A multicentre prospective observational study comparing arterial blood gas values to those obtained by pulse oximeters used in adult patients attending Australian and New Zealand hospitals
Authors: Pilcher Janine , Ploen Laura , McKinstry Steve , Bardsley George , Chien Jimmy , Howard Lesley , Lee Sharon , Beckert Lutz , Swanney Maureen , Weatherall Mark , Beasley Richard
Published: January 2020

Background

Pulse oximetry is widely used in the clinical setting. The purpose of this validation study was to investigate the level of agreement between oxygen saturations measured by pulse oximeter (SpO2) and arterial blood gas (SaO2) in a range of oximeters in clinical use in Australia and New Zealand.

Methods

Paired SpO2 and SaO2 measurements were collected from 400 patients in one Australian and two New Zealand hospitals. The ages of the patients ranged from 18 to 95 years. Bias and limits of agreement were estimated. Sensitivity and specificity for detecting hypoxaemia, defined as SaO2 < 90%, were also estimated.

Results

The majority of participants were recruited from the Outpatient, Ward or High Dependency Unit setting. Bias, oximeter-measured minus arterial blood gas-measured oxygen saturation, was − 1.2%, with limits of agreement − 4.4 to 2.0%. SpO2 was at least 4% lower than SaO2 for 10 (2.5%) of the participants and SpO2 was at least 4% higher than the SaO2 in 3 (0.8%) of the participants. None of the participants with a SpO2 ≥ 92% were hypoxaemic, defined as SaO2 < 90%. There were no clinically significant differences in oximetry accuracy in relation to clinical characteristics or oximeter brand.

Conclusions

In the majority of the participants, pulse oximetry was an accurate method to assess SaO2 and had good performance in detecting hypoxaemia. However, in a small proportion of participants, differences between SaO2 and SpO2 could have clinical relevance in terms of patient monitoring and management. A SpO2 ≥ 92% indicates that hypoxaemia, defined as a SaO2 < 90%, is not present.

Trial registration

Australian and New Zealand Clinical Trials Registry (ACTRN12614001257651). Date of registration: 2/12/2014.
Intein-mediated recombinant expression of monomeric B22Asp desB30 insulin
Authors: Zhang Minmin , Zhang Yunlong , Wu Bingnan , Peng Yanhao , Simair Altaf Ahmed , Siegel Geoffery W. , Lu Changrui , Chen Ting
Published: January 2020

Background

Insulin controls hyperglycemia caused by diabetes, and virtually all treatments require exogenous insulin. However, the product’s extensive post-translational modifications have hindered the manufacture of recombinant insulin.

Result

Here we report a novel production method for a monomeric B22Asp desB30 insulin analog (B22D desB30 insulin). Its precursor, DPIP, is fused to an N-terminal chitin-binding domain and intein self-cleavage tag. The fusion protein is expressed and purified from E. coli and immobilized on chitin resins. DPIP is then released using an optimized pH shift and converted to mature insulin via trypsin digest. The resulting product appears monomeric, > 90% pure and devoid of any exogenous enzyme.

Conclusion

Thus, biologically active insulin analog can be efficiently produced in bacteria and potentially applicable in the treatment of human diabetes.
Associations between diet and mental health using the 12-item General Health Questionnaire: cross-sectional and prospective analyses from the Japan Multi-Institutional Collaborative Cohort Study
Authors: Choda Naoki , Wakai Kenji , Naito Mariko , Imaeda Nahomi , Goto Chiho , Maruyama Kenta , Kadomatsu Yuka , Tsukamoto Mineko , Sasakabe Tae , Kubo Yoko , Okada Rieko , Kawai Sayo , Tamura Takashi , Hishida Asahi , Takeuchi Kenji , Mori Atsuyoshi , Hamajima Nobuyuki
Published: January 2020

Background

Mental health has become a major public health issue worldwide. Biological and epidemiological studies suggest diet has a role in the prevention or cure of mental disorders. However, further research is required to elucidate the relationship between diet and mental health. This study aimed to investigate associations between dietary intake of nutrients (macronutrients, vitamins, calcium, and fatty acids) and food groups (fish, meat and chicken, dairy products, and vegetables) and mental health among middle-aged Japanese in cross-sectional and prospective studies.

Methods

In total, 9298 men and women that participated in two areas of the Japan Multi-Institutional Collaborative Cohort Study were eligible for analysis at the baseline (cross-sectional) survey. Of these, 4701 participants were followed for about 5 years and included in the follow-up (prospective) analysis. The 12-item General Health Questionnaire (GHQ) was used to assess participants’ general mental health status over the past several weeks. The average intake of 46 foods over the past year was assessed by a validated food frequency questionnaire. We also evaluated lifestyle and medical factors using a self-administered questionnaire. A cross-sectional logistic regression analysis was performed to estimate odds ratios for a GHQ score ≥ 4 (poor mental health) according to dietary intake of foods/nutrients at baseline. The prospective study used baseline dietary and lifestyle factors and GHQ scores at follow-up.

Results

The cross-sectional logistic regression analysis showed vegetables, protein, calcium, vitamin D, carotene and n-3 highly-polyunsaturated fatty acids were inversely associated with a GHQ score ≥ 4. On the other hand, mono-unsaturated fatty acids showed a positive association with higher GHQ score. The prospective logistic regression analysis found dairy products, calcium, vitamin B2, and saturated fatty acids were inversely correlated with a GHQ score ≥ 4. Calcium was associated with GHQ scores in both the cross-sectional and follow-up studies. In the follow-up study, the multivariable-adjusted odds ratio for a GHQ score ≥ 4 was 0.71 (95% confidence interval, 0.55–0.92) for the highest versus lowest quartiles of calorie-adjusted dietary calcium intake.

Conclusion

Consuming particular nutrients and foods, especially calcium and dairy products, may lead to better mental health in Japanese adults.
Preventing opioid overdose with peer-administered naloxone: findings from a rural state
Authors: Hanson Bridget L. , Porter Rebecca R. , Zöld Amanda L. , Terhorst-Miller Heather
Published: January 2020

Background

In response to the opioid epidemic, naloxone distribution programs aim to prevent overdose death by making naloxone available and training people to use it. Peers of individuals at risk of opioid overdose are well-positioned to administer naloxone and prevent overdose death.

Methods

We conducted key informant interviews with 18 individuals with past or current opioid and heroin drug use who had administered naloxone to a peer during an overdose emergency. Interviews explored individuals’ experiences with administration and their recommendations for program and policy improvement. Data were systematically coded and analyzed for themes.

Results

Participants sought naloxone rescue kits because they perceived high risk of overdose. They described high satisfaction with training and felt prepared to administer naloxone during overdose incidents. Overwhelmingly, participants perceived naloxone to be effective and emphasized the need to make it widely available. Findings suggest that engagement in overdose prevention strategies other than naloxone differs by gender, with females more likely than males to use multiple different strategies. Participants described that overdose experiences do not have a lasting impact on drug use behaviors.

Conclusions

Findings support the feasibility of naloxone distribution to peer opioid and heroin users and provide recommendations for policy improvement, including effective and well-advertised Good Samaritan laws and links to treatment for opioid use disorder.
FOXE1 represses cell proliferation and Warburg effect by inhibiting HK2 in colorectal cancer
Authors: Dai Weixing , Meng Xianke , Mo Shaobo , Xiang Wenqiang , Xu Ye , Zhang Long , Wang Renjie , Li Qingguo , Cai Guoxiang
Published: January 2020

Background

Low expression of FOXE1, a member of Forkhead box (FOX) transcription factor family that plays vital roles in cancers, contributes to poor prognosis of colorectal cancer (CRC) patients. However, the underlying mechanism remains unclear.

Materials and methods

The effects of FOXE1 on the growth of colon cancer cells and the expression of glycolytic enzymes were investigated in vitro and in vivo. Molecular biological experiments were used to reveal the underlying mechanisms of altered aerobic glycolysis. CRC tissue specimens were used to determine the clinical association of ectopic metabolism caused by dysregulated FOXE1.

Results

FOXE1 is highly expressed in normal colon tissues compared with cancer tissues and low expression of FOXE1 is significantly associated with poor prognosis of CRC patients. Silencing FOXE1 in CRC cell lines dramatically enhanced cell proliferation and colony formation and promoted glucose consumption and lactate production, while enforced expression of FOXE1 manifested the opposite effects. Mechanistically, FOXE1 bound directly to the promoter region of HK2 and negatively regulated its transcription. Furthermore, the expression of FOXE1 in CRC tissues was negatively correlated with that of HK2.

Conclusion

FOXE1 functions as a critical tumor suppressor in regulating tumor growth and glycolysis via suppressing HK2 in CRC.
Can prospective systematic reviews of animal studies improve clinical translation?
Authors: Pound Pandora , Ritskes-Hoitinga Merel
Published: January 2020

Systematic reviews are powerful tools with the potential to generate high quality evidence. Their application to animal studies has been instrumental in exposing the poor quality of these studies, as well as a catalyst for improvements in study design, conduct and reporting. It has been suggested that prospective systematic reviews of animal studies (i.e. systematic reviews conducted prior to clinical trials) would allow scrutiny of the preclinical evidence, providing valuable information on safety and efficacy, and helping to determine whether clinical trials should proceed. However, while prospective systematic reviews allow valuable scrutiny of the preclinical animal data, they are not necessarily able to reliably predict the safety and efficacy of an intervention when trialled in humans. Consequently, they may not reliably safeguard humans participating in clinical trials and might potentially result in lost opportunities for beneficial clinical treatments. Furthermore, animal and human studies are often conducted concurrently, which not only makes prospective systematic reviews of animal studies impossible, but suggests that animal studies do not inform human studies in the manner presumed. We suggest that this points to a confused attitude regarding animal studies, whereby tradition demands that they precede human studies but practice indicates that their findings are often ignored. We argue that it is time to assess the relative contributions of animal and human research in order to better understand how clinical knowledge is actually produced.
Trends and factors associated to early initiation of breastfeeding, exclusive breastfeeding and duration of breastfeeding in Ethiopia: evidence from the Ethiopia Demographic and Health Survey 2016
Authors: Woldeamanuel Berhanu Teshome
Published: January 2020

Background

Initiation of breastfeeding immediately after birth, exclusive breastfeeding, and continuous breastfeeding for at least 2 years lower the risk of newborn deaths. This study was conducted to examine the trends and factors associated with early initiation of breastfeeding, exclusive breastfeeding and duration of breastfeeding in Ethiopia.

Methods

Data for this study were extracted from the Ethiopian Demographic and Health Survey 2016. A total of 5122 children were included in the analysis. Multivariate logistic regression analysis, and Cox proportional hazards model were fitted to find the factors associated with breastfeeding practices. Reportedp- values < 0.05 or a 95% Confidence Interval of Odds Ratio/Hazard Ratio excluding one was considered as significant association with early initiation of breastfeeding, exclusive breastfeeding, duration of breastfeeding and independent variables.

Results

About 81.8% of the children initiated breastfeeding within 1 h of birth and during the day before an interview, 47% were exclusively breastfed during the first 6 months. The median duration of breastfeeding was 22 months (22 ± 0.50 months 95% Confidence Interval [CI] 21.01–22.99). Rural residents (Odds Ratio [OR] 0.71, 95% CI 0.51, 0.99), mothers with no antenatal follow up (OR 0.75, 95% CI 0.57, 0.99), caesarean birth (OR 0.80, 95% CI 0.66, 0.96) and home delivery were associated with low initiation of breastfeeding within 1 h of birth. Mothers with no/primary education (OR 0.62, 95% CI 0.40, 0.96), no baby postnatal checkup (OR 0.53, 95% CI 0.39, 0.73), average/larger size of a child at birth (OR 0.80, 95% CI 0.65, 0.99) and deliveries outside of health centers were significantly associated with non-exclusive breastfeeding at the time of the interview. Further, mothers living in Amhara (Hazard Ratio [HR] 1.31, 95% CI 1.05, 1.64), Oromia (HR 1.27, 95% CI 1.04, 1.54), and Benishangul-Gumuz (HR 1.34, 95% CI 1.09, 1.65) regions had a longer duration of breastfeeding while Muslims, employed mothers, multiple births and poor economic level of households were associated with shorter durations of breastfeeding.

Conclusions

Rural residence, female sex, home delivery, caesarean birth, small birthweight baby and large family size were associated with late initiation of breastfeeding. Living in Affar, Somali, and Harari, primary education level of mothers, giving birth outside of health facilities, no antenatal care follow up, and no postnatal check-up were associated with non-exclusive breastfeeding, while younger age mothers, Muslims, giving birth outside of health facilities, and employed mothers were associated with shorter time to cessation of breastfeeding. Providing health education and counseling for mothers during and after pregnancy should be encouraged.
Repeated CyberKnife stereotactic body radiation therapy in hepatocellular carcinoma
Authors: Sun Jing , Ouyang Can , Chang Xiaoyun , Zhang Aimin , Wang Quan , Li Wengang , Zhang Dan , Wang Jia , Li Dong , Duan Xuezhang
Published: January 2020

Background

To explore the survival and side effects of repeated CyberKnife stereotactic body radiation therapy (CK-SBRT) on hepatocellular carcinoma patients.

Methods

24 HCC patients were collected at The Fifth Medical Center of PLA General Hospital from November 2011 to July 2016. They received second-course CK-SBRT with a prescribed dose of 50(48–55) Gy/5-8fx, and a single dose of 10 (7–11) Gy/fx. Cumulative overall survival rates (OS), progression-free survival rates (PFS) and local control rates (LC) were calculated by Kaplan-Meier method.

Results

All patients finished their radiotherapy plans. The 1-,2- and 3-year cumulative OS rate were 95.8,81.1 and 60.8%. The 1-,2- and 3-year LC rate were 95.5,90.7 and 90.7%, respectively. The 1-, 2- and 3-year PFS were 74.8, 49.2 and 39.4%, respectively. 16 patients complained of fatigue during second-course therapy, 2 patients showed Grade 2 gastrointestinal reaction, 1 patient was diagnosed radiation-induced liver disease and none died. PFS was significantly higher in the interval time < 12 months group than in the interval time ≥ 12 months group (p = 0.030).

Conclusions

It is preliminarily believed that re-CK-SBRT is an effective and safe treatment for HCC patients, but the treatment criteria should be strictly controlled.
Evaluating the effectiveness of anti-Nogo treatment in spinal cord injuries
Authors: Mohammed Raihan , Opara Kaesi , Lall Rahul , Ojha Utkarsh , Xiang Jinpo
Published: January 2020

As humans, we cannot regenerate axons within the central nervous system (CNS), therefore, making any damage to it permanent. This leads to the loss of sensory and motor function below the site of injury and can be crippling to a person’s health. Spontaneous recovery can occur from plastic changes, but it is minimal. The absence of regeneration is due to the inhibitory environment of the CNS as well as the inherent inability of CNS axons to form growth cones. Amongst many factors, one of the major inhibitory signals of the CNS environment is the myelin-associated Nogo pathway. Nogo-A, Nogo-B and Nogo-C (Nogo), stimulate the Nogo receptor, inhibiting neurite outgrowth by causing growth cones to collapse through activation of Rho Kinase (ROCK). Antibodies can be used to target this signalling pathway by binding to Nogo and thus promote the outgrowth of neuronal axons in the CNS. This use of anti-Nogo antibodies has been shown to upregulate CNS regeneration as well as drastically improve sensory and motor function in both rats and primates when coupled with adequate training. Here, we evaluate whether the experimental success of anti-Nogo at improving CNS regeneration can be carried over into the clinical setting to treat spinal cord injuries (SCI) and their symptoms successfully. Furthermore, we also discuss potential methods to improve the current treatment and any developmental obstacles.
Correction to: Management of adult-onset Still’s disease with interleukin-1 inhibitors: evidence- and consensus-based statements by a panel of Italian experts
Authors:   AOSD Consensus Group, Colafrancesco Serena , Manara Maria , Bortoluzzi Alessandra , Serban Teodora , Bianchi Gerolamo , Cantarini Luca , Ciccia Francesco , Dagna Lorenzo , Govoni Marcello , Montecucco Carlomaurizio , Priori Roberta , Ravelli Angelo , Sfriso Paolo , Sinigaglia Luigi
Published: January 2020

Following publication of the original article [1], it was brought to our attention that the AOSD Consensus Group was incorrectly tagged and therefore not searchable. The publishers apologize for this error.
Correction to: Chronic toxicity of low dose monosodium glutamate in albino Wistar rats
Authors: Nnadozie Josiah Okwudili , Chijioke Udunma Olive , Okafor Okechukwu Charles , Olusina Daniel Bankole , Oli Angus Nnamdi , Nwonu Patience Chiebonam , Mbagwu Herbert Orji , Chijioke Chioli Pascal
Published: January 2020

The original article [1] mistakenly omits mention of grant funding which partially funded the work undertaken in this article. The authors sincerely apologise for this omission and would like to acknowledge this funding source in this correction article as per the below information: