bluuebunny/crossref_metadata_2025 huggingface dataset:
Preferences, Preference Formation and Position Taking in a Eurozone Out: Lessons from the United Kingdom
Authors: Kassim Hussein , James Scott , Warren Thomas , Hargreaves Heap Shaun
Published: April 2020

In the literature on member state position-taking in the eurozone crisis, the debate has mainly centred on whether national preferences are shaped exclusively within the domestic setting or influenced by shared EU-level norms or interaction within EU institutions. This article goes beyond this discussion. Drawing on original data collected by the authors, it uses the UK’s experience to test the claims both of society-centred approaches, including liberal intergovernmentalism, and perspectives that emphasise the importance of shared EU norms or interaction. It argues that while the first overlook the role of institutions as both actors and mediating variables in preference formation, the second have so far focused on the experience of eurozone members, thereby raising the possibility of selection bias. Treating eurozone form as a series of processes rather than a single event, it contests the claim that preference formation is always driven by societal interests, highlights instances where government acts in the absence of or contrary to expressed societal interests, and reveals limitations of the shared norms critique of liberal intergovernmentalism. It shows that the UK government was driven by a scholars concern to protect the UK economy from financial contagion rather than solidarity with its European partners.
Development of a Local Health-Enhancing Physical Activity Policy Analysis Tool in France: CAPLA-Santé
Authors: Noël Racine Antoine , Van Hoye Aurélie , Baron Amandine , Lecomte Flore , Garbarino Jean-Marie , Massiera Bernard , Honta Marina , Vuillemin Anne
Published: April 2020

The promotion of health-enhancing physical activity (HEPA) has become a key objective in public health policy. Therefore, based on the national HEPA Policy Audit Tool Version 2 (HEPA PAT v2) of the World Health Organization, a tool was designed to support local governments in assessing HEPA policies. This study aims to describe the adaptation and testing of the HEPA policy analysis tool (CAPLA-Santé) at the local level in France. The work was conducted in three stages: (1) an intersectoral group of experts was constituted, and the group adapted each item of the HEPA PAT v2 tool to the local level; (2) a testing phase with seven local governments helped to collect data and feedback on the tool; and (3) a final workshop was organized to adjust and finalize the tool. The final version of CAPLA-Santé contains 21 items divided into six major sections: overview of HEPA stakeholders in the local government area, policy documents, policy contents, funding and political engagement, studies and measures relating to physical activity in the local government area, and progress achieved and future challenges. CAPLA-Santé allows the collection and in-depth analysis of local level policies to assess the progress in promoting HEPA and intersectoral collaboration as well as identifying successful policy levers and remaining challenges.
Behavioral Communication Strategies for Global Epidemics: An Innovative Model for Public Health Education and Humanitarian Response
Authors: Dickey Chris , Holzman Emily , Bedford Juliet , Manoncourt Erma , Shirky Clay , Petit Vincent , Guirguis Sherine , Bloch Kiera , Obregon Rafael
Published: April 2020

In response to a number of growing global health challenges, New York University and UNICEF designed a Behavioral Communication Strategies for Global Epidemics course that brings together United Nations professionals, government staff, and MPH (Master of Public Health) students to design innovative social behavior change communication (SBCC) strategies that address disease outbreaks and humanitarian challenges around the world. Applying a systems approach, participants in the course work on interdisciplinary teams to design strategies, develop skills, and engage in global learning. At the culmination of the course, all teams present strategies to UNICEF country offices for implementation. This innovative model for disease outbreak, public health education, and humanitarian response provides professionals with an opportunity to develop a wide range of competencies, including systems thinking, behavior change, and human-centered design and equips them with the necessary tools to develop more novel approaches to SBCC. As the number of outbreaks and humanitarian challenges increase each year, this format for learning can serve as a model for how professionals can effectively address these complex crises.
Aortoduodenal Fistula After Endovascular Abdominal Aortic Aneurysm Repair
Authors: Hosaka Akihiro , Nemoto Masaru , Motoki Manabu , Akai Atsushi , Kato Masaaki
Published: April 2020

Aortoduodenal fistula after endovascular treatment of abdominal aortic aneurysm is a very rare but life-threatening complication. Herein, we describe 4 cases of aortoduodenal fistula diagnosed at 15 to 78 months after the index aortic intervention, all successfully treated by surgery. All patients underwent primary repair of the duodenal wall, creation of tube duodenostomy, stent graft removal, and in situ reconstruction using a rifampicin-soaked prosthesis. Patients received prolonged antibiotic treatment for at least 2 months postoperatively, and all were free of recurrent infection at follow-up. Prompt and appropriate surgical intervention is required to effectively manage this condition.
Male-Dominated Occupations and Substance Use Disorders in Young Adulthood
Authors: Leadbeater Bonnie , Ames Megan E. , Contreras Alejandra
Published: April 2020

This article examined associations between male-dominated occupations and substance use disorders in young adulthood, accounting for adolescent experiences of work intensity (more than 15 hr a week at 16 to 17 years of age) and substance use (i.e., smoking, heavy drinking, cannabis, and illicit drug use). The moderating effects of biological sex and coming from a family with a low socioeconomic status (SES) were also assessed. Data were from a 10-year prospective study of community-based youth aged 12–18 in 2003 (T1; N = 662; 48% male; Mage = 15.5, SD = 1.9). Their occupations at ages 22–29 were categorized so that higher scores indicated more male-dominated occupations. Young adults in male-dominated occupations (more than 75% males) had lower education, worked in less prestigious occupations, and earned higher hourly wages than those in the other gendered-occupation groups. Work intensity in high school was associated with substance use at ages 18–25 and substance use was also associated with alcohol- and cannabis-use disorder symptoms and illicit drug use in young adulthood (ages 22–29). Adding to these effects, employment in a male-dominated occupation was associated with more cannabis-use disorder symptoms for the low, but not the high SES group. Public health messages need greater focus on preventing substance use disorders among individuals employed in male-dominated jobs in young adulthood. Efforts to promote self-assessment of problematic substance use and motivation to change may be particularly important for young workers.
Qualitative Examination of International Graduate Students’ Experiences With Campus Recreation Services
Authors: Lee Seonghun , Spencer Tyler , Hums Mary A. , Alagaraja Meera
Published: April 2020

International college students have become an important subgroup in U.S. higher education. However, their campus recreation participation rate is relatively low. Previous studies indicate significant factors preventing international students from campus recreation participation were lack of time, lack of workout partners, and lack of recreation information. Relatively little research has been undertaken on understanding and explaining campus recreation experiences among the international graduate student population. This study utilized semistructured interviews with 14 students who used campus recreation services at a 4-year major U.S. public university. Results indicated three primary constraints emerged: time, transportation, and information. However, these students recognized the benefits of using campus recreation services regularly because it helps improve physical health, personal well-being, and social engagement. The findings of this study will provide campus recreation service administrators with a better understanding of international graduate students’ needs in terms of campus recreation services.
Relationship between hemodialysis patients’ educational level and arteriovenous fistula patency
Authors: Yolgösteren Atıf
Published: April 2020

Objectives

Vascular access is a lifeline for the patients who are in need of long-term hemodialysis. Native arteriovenous fistula is the most intensively preferred vascular access method owing to its longevity and convenience of use. Therefore, in this study, we aimed to determine whether there might be a relationship between hemodialysis patients’ educational levels and arteriovenous fistula patency.

Methods

A total of 349 patients who were attending in a chronic hemodialysis program between June 2018 and September 2018 at Bursa Uludağ University, Faculty of Medicine Dialysis Unit and in a private dialysis center in İstanbul were included in this study. The patients were grouped into two: those who have had arteriovenous fistula primary failure at least once and those who have never had arteriovenous fistula primary failure. Educational levels of the patients were classified according to Turkish National Education system (illiterate, primary school graduate, secondary school graduate, high school graduate, and university graduate). Mann–Whitney U and Chi-square tests were performed for statistical analyses. Risk factors were determined by applying backward binary logistic regression analysis.

Results

A total of 349 patients, 161 (46.1%) females and 188 (53.9%) males, were examined retrospectively. The median age of the patients was 64 years (range: 18–90 years). Educational level comparison revealed statistically significant difference in terms of fistula patency ( p = 0.016). In particular, fistula patency was significantly lower in illiterate, primary, secondary, and high school graduates in comparison with university graduates ( p = 0.001, p = 0.015, p = 0.003, and p = 0.018, respectively). When each group of educational level was analyzed separately in terms of fistula patency, it was observed that the higher the educational level was, the lower arteriovenous fistula primary failure rates were.

Conclusions

In this study, we observed a lower rate of fistula patency in patients with a low level of education. Hence, we are of the opinion that the trainings delivered on arteriovenous fistula care in dialysis centers are required to be shaped in accordance with educational levels of patients.
Bayesian methods for pilot studies
Authors: Willan Andrew R , Thabane Lehana
Published: April 2020

Background/aims:

The use of pilot studies to help inform the design of randomized controlled trials has increased significantly over the last couple of decades. A pilot study can provide estimates of feasibility parameters, such as the recruitment, compliance and follow-up probabilities. The use of frequentist confidence intervals of these estimates fails to provide a meaningful measure of the uncertainty as it pertains to the design of the associated randomized controlled trial. The objective of this article is to introduce Bayesian methods for the analysis of pilot studies for determining the feasibility of an associated randomized controlled trial.

Methods:

An example from the literature is used to illustrate the advantages of a Bayesian approach for accounting for the uncertainty in pilot study results when assessing the feasibility of an associated randomized controlled trial. Vague beta distribution priors for the feasibility parameters are used. Based on the results from a feasibility study, simulation methods are used to determine the expected power of specified recruitment strategies for an associated randomized controlled trial.

Results:

The vague priors used for the feasibility parameters are demonstrated to be considerably robust. Beta distribution posteriors for the feasibility parameters lead to beta-binomial predictive distributions for an associated randomized controlled trial regarding the number of patients randomized, the number of patients who are compliant and the number of patients who complete follow-up. Ignoring the uncertainty in pilot study results can lead to inadequate power for an associated randomized controlled trial.

Conclusion:

Applying Bayesian methods to pilot studies’ results provides direct inference about the feasibility parameters and quantifies the uncertainty regarding the feasibility of an associated randomized controlled trial in an intuitive and meaningful way. Furthermore, Bayesian methods can identify recruitment strategies that yield the desired power for an associated randomized controlled trial.
CFIUS 2.0: An Instrument of American Economic Statecraft Targeting China
Authors: Khanapurkar Uday
Published: April 2020

On 13 August 2018, the president of the United States signed a bill to strengthen the Committee on Foreign Investment in the United States (CFIUS), an interagency executive body responsible for screening foreign investments made in the United States for national security risks. The move is primarily aimed at preventing Chinese firms from exploiting the US open capital markets to acquire technology. While much commentary exists spelling out the changes made to CFIUS by way of the legislation, their focus is largely on the legal and business ramifications of the policy at the firm level. This analysis assesses what CFIUS strengthening portends for the tech ambitions, examines the Chinese state’s response to the move, and observes its relevance to US–China economic decoupling.
Anti-Aging Effects of Gyrophoric Acid on UVA-Irradiated Normal Human Dermal Fibroblasts
Authors: Shim Joong Hyun
Published: April 2020

This research was conducted to identify the anti-aging effects of gyrophoric acid on the skin, using normal human dermal fibroblasts. The anti-aging effects of gyrophoric acid on dermal fibroblasts were demonstrated through cell viability, verification of collagen, type I, alpha 1 (COL1A1)/COL3A1/matrix metalloproteinases 1 (MMP1) messenger ribonucleic acid (mRNA) expression levels with quantitative real-time reverse-transcription polymerase chain reaction, and protein estimation using type I collagen/MMP1-enzyme-linked immunosorbent assay. Further, the effects of gyrophoric acid on superoxide dismutases (SODs)/catalase were investigated by assessing their mRNA expression. In ultraviolet A (UVA)-treated dermal fibroblasts, gyrophoric acid was observed to increase mRNA levels of COL1A1/COL3A1/SOD2 genes and type I collagen protein levels, consistent with its anti-aging role. Furthermore, gyrophoric acid treatment decreased both MMP1 mRNA and protein expression levels. Therefore, the results of this study demonstrate that gyrophoric acid can be considered as an important natural compound with potent anti-aging effects on the skin. Based on the findings of this study, further research about the mechanism of action of gyrophoric acid should be pursued so as to develop novel anti-aging strategies not only in the field of cosmetics but also for healthcare.
A Proof-of-Concept Investigation of an Energy Management Education Program to Improve Fatigue and Life Participation in Adults on Chronic Dialysis
Authors: Farragher Janine F. , Polatajko Helene J. , McEwen Sara , Jassal Sarbjit V.
Published: April 2020

Background:

Fatigue and its negative impact on life participation are top research priorities of people on chronic dialysis therapy. Energy management education (EME) is a fatigue management approach that teaches people to use practical strategies (eg, prioritizing, using efficient body postures, organizing home environments) to manage their energy expenditure during everyday life.

Objective:

The aim of this study is to explore whether EME is associated with improvements in fatigue and life participation in adults on chronic dialysis.

Design:

Five single-case interrupted time-series AB studies, and follow-up qualitative interviews.

Setting:

The hemodialysis and peritoneal dialysis units at an academic hospital in Toronto, Canada.

Patients:

In total, 5 patients on chronic dialysis therapy were purposively selected to represent diversity in age, gender, and modality.

Measurements:

Brief questionnaires assessing fatigue and life participation were administered weekly during the baseline and intervention periods. Additional validated questionnaires (the Fatigue Impact Scale, 36-Item Short-Form Health Survey [SF-36] Vitality Scale, and Canadian Occupational Performance Measure) were also administered at baseline and post-intervention.

Methods:

All participants underwent “The PEP Program,” a personalized, web-supported EME program designed to meet the needs of people on dialysis. During the program, participants complete 2 brief web modules about energy management, and then use energy management principles and a problem-solving framework to work on 3 life participation goals during sessions with a trained program administrator. Data were analyzed using visual analysis and the Tau- U statistic for the weekly time-series data, and thematic analysis for the qualitative interviews.

Results:

Three of 5 participants displayed a consistently positive response to the Personal Energy Planning (PEP) program across multiple measures of fatigue and life participation. Tau- U effect size estimates ranged from small to moderate, according to the time-series data. All 5 participants expressed that the program had benefited them in qualitative follow-up interviews, with the most common reported benefit being that the program made day-to-day activities easier. The format of the program was also said to be feasible and convenient.

Limitations:

An exploratory, proof-of-concept study that used a small set of participants and lacked an active control comparison.

Conclusions:

The PEP program might have potential for improving fatigue-related outcomes in people on chronic dialysis. Larger, controlled studies of the program are warranted.
The Relative Effect of Growth of Economy, Industry Expansion, and Firm-Specific Factors on Corporate Hotel Performance in Sri Lanka
Authors: Weerathunga P. R. , Xiaofang Cheng , Samarathunga W. H. M.S. , Jayathilake P. M. B.
Published: April 2020

This study evaluates the relative effects of economic growth, industrial expansion, and firm-specific and contextual factors on corporate hotel performance in Sri Lanka. We use data from a sample of 29 listed hotels for 7 years from 2012 to 2018 and employ panel regression to uncover the relationship that exists between these variables. The findings suggest that the macroeconomic factors alone can account for a small part of the variance in return on assets and return on equity, and yet that these macroeconomic factors are the key drivers of the overall financial performance. Moreover, the selected macroeconomic factors, together with firm-specific and contextual factors, appear to have a profound impact on hotel performance. More specifically, growth in the number of tourist arrivals and growth in inflation are found to have a positive and significant impact on corporate hotel performance, while the interest rate has a significantly negative effect. Our findings with regard to the impact of growth in gross domestic product (GDP) on hotel performance are inconclusive. Furthermore, our findings reveal that the profitability of Sri Lankan hotels is driven by managerial efficiency, location factors, geographical diversification, and connection to a wider business network.
The bone-mimicking effect of calcium phosphate on composite chitosan scaffolds in maxillofacial bone tissue engineering
Authors: Sangkert Supaporn , Kamolmatyakul Suttatip , Meesane Jirut
Published: April 2020

This research explored a new trend in biomaterials science. The bone-mimicking effect of calcium phosphate on chitosan composite scaffolds was evaluated. Chitosan with 2% calcium phosphate was found to have suitable bone-mimicking performance for maxillofacial bone tissue engineering.
A Review and Clinical Understanding of Tenofovir: Tenofovir Disoproxil Fumarate versus Tenofovir Alafenamide
Authors: Wassner Chanie , Bradley Nicole , Lee Yuman
Published: April 2020

HIV is a serious chronic medical condition. Significant improvements in antiretroviral therapy have led to a transformation in its management. No curative treatment is available for HIV, and lifelong therapy is required with a combination of agents to control viral replication and prevent complications. Some of the older agents are notorious for many side effects, making patient compliance difficult, which is critical to preventing HIV resistance. Tenofovir is one of the newer, more tolerable, nucleotide reverse transcriptase inhibitors on the market; is a mainstay of many antiretroviral therapy combinations; and is now available in 2 different formulations, tenofovir disoproxil fumarate (TDF) and, the more recent, tenofovir alafenamide (TAF). These 2 formulations have very different pharmacokinetics, which seem to affect their efficacy and safety. This manuscript provides insight into the history of TDF and TAF development, their unique pharmacokinetics and pharmacology, clinically important adverse effects, monitoring, interactions, resistance, review of clinical studies, and guideline recommendations and clinical applications for tenofovir’s various indications.
Isovist indicators as a means to relieve pedestrian psycho-physiological stress in Hong Kong
Authors: Xiang Luyao , Papastefanou Georgios , Ng Edward
Published: April 2020

The creation of a psychologically friendly outdoor environment has important quality-of-life implications for urban residents who live in cities with extremely high population density, such as Hong Kong. Prospect Refuge Theory is the most widely recognized theory that explains environmental emotional influence by referring to urban planning and architecture, and it can be quantified by applying isovist indicators. We aim to (a) conduct field measurements that record dynamic psycho-physiological stress, (b) calculate isovist indicators by introducing a new indicator-isovist time difference and then analyse their effects on stress, and (c) draw on findings to provide recommendations for urban planning and design. The experiment is conducted for the first time in a high-density city where 30 participants are asked to walk a predefined route. Each participant wears a portable smart band that records skin conductance response and a global positioning system (GPS) that records geographic coordinates. The results demonstrate that (1) an open space with a visual target set at a distance is the dominant factor that creates positive emotions in Hong Kong; (2) the new indicator-isovist time difference (D1) is valuable, as it is more significantly related to stress than the isovist level; (3) the living environment and cultural differences play an important role in the final result, i.e. people in Europe prefer relatively closed spaces while people in Hong Kong feel stress when the space is highly enclosed.
How to think like an emergency care provider: a conceptual mental model for decision making in emergency care
Authors: Al-Azri Nasser Hammad
Published: April 2020

Background

General medicine commonly adopts a strategy based on the analytic approach utilizing the hypothetico-deductive method. Medical emergency care and education have been following similarly the same approach. However, the unique milieu and task complexity in emergency care settings pose a challenge to the analytic approach, particularly when confronted with a critically ill patient who requires immediate action. Despite having discussions in the literature addressing the unique characteristics of medical emergency care settings, there has been hardly any alternative structured mental model proposed to overcome those challenges.

Methods

This paper attempts to address a conceptual mental model for emergency care that combines both analytic as well as non-analytic methods in decision making.

Results

The proposed model is organized in an alphabetical mnemonic, A–H. The proposed model includes eight steps for approaching emergency cases, viz., awareness, basic supportive measures, control of potential threats, diagnostics, emergency care, follow-up, groups of particular interest, and highlights. These steps might be utilized to organize and prioritize the management of emergency patients.

Discussion

Metacognition is very important to develop practicable mental models in practice. The proposed model is flexible and takes into consideration the dynamicity of emergency cases. It also combines both analytic and non-analytic skills in medical education and practice.

Conclusion

Combining various clinical reasoning provides better opportunity, particularly for trainees and novices, to develop their experience and learn new skills. This mental model could be also of help for seasoned practitioners in their teaching, audits, and review of emergency cases.
Manual ventilation quality is improved with a real-time visual feedback system during simulated resuscitation
Authors: Gould Jeffrey R. , Campana Lisa , Rabickow Danielle , Raymond Richard , Partridge Robert
Published: April 2020

Introduction

Manual ventilations during cardiac arrest are frequently performed outside of recommended guidelines. Real-time feedback has been shown to improve chest compression quality, but the use of feedback to guide ventilation volume and rate has not been studied. The purpose of this study was to determine whether the use of a real-time visual feedback system for ventilation volume and rate improves manual ventilation quality during simulated cardiac arrest.

Methods

Teams of 2 emergency medical technicians (EMTs) performed two 8-min rounds of cardiopulmonary resuscitation (CPR) on a manikin during a simulated cardiac arrest scenario with one EMT performing ventilations while the other performed compressions. The EMTs switched roles every 2 min. During the first round of CPR, ventilation and chest compression feedback was disabled on a monitor/defibrillator. Following a 20-min rest period and a brief session to familiarize the EMTs with the feedback technology, the trial was repeated with feedback enabled. The primary outcome variables for the study were ventilations and chest compressions within target. Ventilation rate (target, 8–10 breaths/minute) and tidal volume (target, 425–575 ml) were measured using a novel differential pressure-based flow sensor. Data were analyzed using paired t tests.

Results

Ten teams of 2 EMTs completed the study. Mean percentages of ventilations performed in target for rate (41% vs. 71%, p < 0.01), for volume (31% vs. 79%, p < 0.01), and for rate and volume together (10% vs. 63%, p < 0.01) were significantly greater with feedback.

Conclusion

The use of a novel visual feedback system for ventilation quality increased the percentage of ventilations in target for rate and volume during simulated CPR. Real-time feedback to perform ventilations within recommended guidelines during cardiac arrest should be further investigated in human resuscitation.
Host-parasite interactions in non-native invasive species are dependent on the levels of standing genetic variation at the immune locus
Authors: Biedrzycka Aleksandra , Popiołek Marcin , Zalewski Andrzej
Published: April 2020

Background

Parasites may mediate the success of biological invasions through their effect on host fitness and thus, on host population growth and stability. However, a release from the pressure of parasites is strongly related to the genetic differentiation of the host. In invasive host populations, the number of available genetic variants, allowing them to ‘fight’ the infection, are likely to be influenced by founder events and genetic drift. The level standing genetic variation of invasive populations may be crucial in successfully adapting to new environments and resisting diseases. We studied invasive populations of raccoon that experienced a random reduction in genetic diversity during the establishment and evaluated the relationship between host immune genetic diversity and intestinal parasites infection.

Results

We distinguished two different genetic clusters that are characterized by different sets of functionally relevant MHC-DRB alleles. Both clusters were characterized by considerably different allele-parasite associations and different levels of parasite infection. The specific resistance MHC-DRB alleles explained the lower prevalence of Digenea parasites. An increased infection intensity was related to the presence of two MHC-DRB alleles. One of these alleles significantly decreased in frequency over time, causing a decrease of Digenea abundance in raccoons in consecutive years.

Conclusions

Our findings suggest that intestinal parasites can exert selective pressure on an invasive host with lowered levels of immune genetic diversity and contribute to promoting local adaptation over time. The random genetic drift that created the two different genetic clusters in the invasive raccoon range imposed completely different MHC-parasite associations, strongly associated with the infection status of populations. Our findings underline the role of standing genetic variation in shaping host-parasite relationships and provide empirical support that functional genetic variation may be, at least partly, responsible for differences in the success of invasive populations.
Unblended disjoint tree merging using GTM improves species tree estimation
Authors: Smirnov Vladimir , Warnow Tandy
Published: April 2020

Background

Phylogeny estimation is an important part of much biological research, but large-scale tree estimation is infeasible using standard methods due to computational issues. Recently, an approach to large-scale phylogeny has been proposed that divides a set of species into disjoint subsets, computes trees on the subsets, and then merges the trees together using a computed matrix of pairwise distances between the species. The novel component of these approaches is the last step: Disjoint Tree Merger (DTM) methods.

Results

We present GTM (Guide Tree Merger), a polynomial time DTM method that adds edges to connect the subset trees, so as to provably minimize the topological distance to a computed guide tree. Thus, GTM performs unblended mergers, unlike the previous DTM methods. Yet, despite the potential limitation, our study shows that GTM has excellent accuracy, generally matching or improving on two previous DTMs, and is much faster than both.

Conclusions

The proposed GTM approach to the DTM problem is a useful new tool for large-scale phylogenomic analysis, and shows the surprising potential for unblended DTM methods.
Analysis of local genome rearrangement improves resolution of ancestral genomic maps in plants
Authors: Rubert Diego P. , Martinez Fábio V. , Stoye Jens , Doerr Daniel
Published: April 2020

Background

Computationally inferred ancestral genomes play an important role in many areas of genome research. We present an improved workflow for the reconstruction from highly diverged genomes such as those of plants.

Results

Our work relies on an established workflow in the reconstruction of ancestral plants, but improves several steps of this process. Instead of using gene annotations for inferring the genome content of the ancestral sequence, we identify genomic markers through a process called genome segmentation. This enables us to reconstruct the ancestral genome from hundreds of thousands of markers rather than the tens of thousands of annotated genes. We also introduce the concept of local genome rearrangement, through which we refine syntenic blocks before they are used in the reconstruction of contiguous ancestral regions. With the enhanced workflow at hand, we reconstruct the ancestral genome of eudicots, a major sub-clade of flowering plants, using whole genome sequences of five modern plants.

Conclusions

Our reconstructed genome is highly detailed, yet its layout agrees well with that reported in Badouin et al. (2017). Using local genome rearrangement, not only the marker-based, but also the gene-based reconstruction of the eudicot ancestor exhibited increased genome content, evidencing the power of this novel concept.
High-throughput sequencing study of the effect of transabdominal hysterectomy on intestinal flora in patients with uterine fibroids
Authors: Wang Wantong , Li Yibing , Wu Qijun , Pan Xin , He Xinhui , Ma Xiaoxin
Published: April 2020

Background

To investigate the effect of transabdominal hysterectomy on the diversity of the intestinal flora in patients with uterine fibroids. Patients with uterine fibroids were selected from September 2018 to December 2018, in the Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, and stool specimens were collected from patients before and after surgery.

Results

High-throughput sequencing of the 16S rRNA gene was used to detect the changes in microbial community structure and diversity, and the effects of total hysterectomy on the intestinal flora were further analyzed. Estrogen levels decreased after trans-abdominal hysterectomy. High-throughput sequencing showed that after abdominal hysterectomy, the abundance and diversity of the intestinal flora decreased. The abundance changes were mainly due to Proteobacteria, where their abundance increased.

Conclusions

Trans-abdominal hysterectomy changes the intestinal flora of the body by lowering the level of estrogen in the body, which reduces the diversity and abundance of the intestinal flora.
Predictive value of circulating plasma mitochondrial DNA for Sepsis in the emergency department: observational study based on the Sepsis-3 definition
Authors: Wang Lifeng , Zhou Wei , Wang Kaiwen , He Shuangjun , Chen Yi
Published: April 2020

Background

The definition of sepsis is regularly updated; however, there is no standard diagnostic test. To improve diagnosis and prognostic prediction, the aim of this study was to determine the predictive value of circulating plasma mitochondrial DNA (mtDNA) levels in patients admitted to the emergency department (ED) with sepsis.

Methods

A total of 107 patients hospitalized from June 2018 to January 2019 were divided into the sepsis (n = 72) and septic shock (n = 35) groups based on the sepsis-3 definition. Clinical and laboratory data were measured within 24 h of admission. The mtDNA concentrations in clarified plasma were estimated by quantitative polymerase chain reaction. Binary logistic regression analysis and the receiver operating characteristic (ROC) curve were used to determine predictive value of mtDNA and other markers for sepsis outcome (28-day mortality).

Results

The median plasma mtDNA levels on admission were significantly higher in the septic shock patients than in the sepsis patients (134,252(IQR 70215–203,184) vs. 59,945(IQR 13274–95,319) copies/μL, P < 0.01), and were also higher in non-survivors than in survivors within 28 days (165,291(IQR 89919–272,228)vs. 63,025(IQR 17031–98,401)copies/μL, P < 0.01). Binary logistic regression showed that plasma lactate and mtDNA levels were independent risk factors for 28-day mortality [odds ratio (OR) 1.341, 95% confidence interval (CI) 1.035–1.736, P = 0.026 and OR 13.299, 95%CI 2.765–63.956, P = 0.001, respectively). The area under the ROC curve values for plasma mtDNA levels, lactate concentration, and their combined were 0.781 (p < 0.001, 95%CI 0.671–0.891), 0.733 (p < 0.001, 95%CI 0.635–0.832), and 0.799 (p < 0.001, 95%CI 0.698–0.901), respectively. The calibration test for the combined variable showed X2 of 2.559 and P = 0.923.

Conclusion

A higher plasma mtDNA level was associated with a poor prognosis of sepsis in the emergency room, and could serve as a predictor of sepsis for 28-day mortality.
The impact of early administration of vasopressor agents for the resuscitation of severe hemorrhagic shock following blunt trauma
Authors: Uchida Kenichiro , Nishimura Tetsuro , Hagawa Naohiro , Kaga Shinichiro , Noda Tomohiro , Shinyama Naoki , Yamamoto Hiromasa , Mizobata Yasumitsu
Published: April 2020

Background

When resuscitating patients with hemorrhagic shock following trauma, fluid volume restriction and permissive hypotension prior to bleeding control are emphasized along with the good outcome especially for penetrating trauma patients. However, evidence that these concepts apply well to the management of blunt trauma is lacking, and their use in blunt trauma remains controversial. This study aimed to assess the impact of vasopressor use in patients with blunt trauma in severe hemorrhagic shock.

Methods

In this single-center retrospective study, we reviewed records of blunt trauma patients with hemorrhagic shock and included patients with a probability of survival < 0.6. Vital signs on arrival, characteristics, examinations, concomitant injuries and severity, vasopressor use and dose, and volumes of crystalloids and blood infused were compared between survivors and non-survivors. Data are described as median (25–75% interquartile range) or number.

Results

Forty patients admitted from April 2014 to September 2019 were included. Median Injury Severity Score in survivors vs non-survivors was 41 (36–48) vs 45 (34–51) (p = 0.48), with no significant difference in probability of survival between the two groups (0.22 [0.12–0.48] vs 0.21 [0.08–0.46]; p = 0.93). Despite no significant difference in patient characteristics and injury severity, non-survivors were administered vasopressors significantly earlier after admission and at significantly higher doses. Total blood transfusion amount administered within 24 h after admission was significantly higher in survivors (8430 [5680–9320] vs 6540 [4550–7880] mL; p = 0.03). Max catecholamine index was significantly higher in non-survivors (2 [0–4] vs 14 [10–18]; p = 0.008), and administered vasopressors were terminated significantly earlier (12 [4–26] vs 34 [10–74] hours; p = 0.026) in survivors.

Although the variables of severity of the patients had no significant differences, vasopressor use (Odds ratio [OR] = 21.32, 95% confident interval [CI]: 3.71–121.6; p = 0.0001) and its early administration (OR = 10.56, 95%CI: 1.90–58.5; p = 0.005) indicated significant higher risk of death in this study.

Conclusion

Vasopressor administration and high-dose use for resuscitation of hemorrhagic shock following severe blunt trauma are potentially associated with increased mortality. Although the transfused volume of blood products tends to be increased when resuscitating these patients, early termination of vasopressor had better to be considered.
Data sources and methods used to determine pretest probabilities in a cohort of Cochrane diagnostic test accuracy reviews
Authors: Oerbekke Michiel S. , Jenniskens Kevin , Scholten Rob J. P. M. , Hooft Lotty
Published: April 2020

Background

A pretest probability must be selected to calculate data to help clinicians, guideline boards and policy makers interpret diagnostic accuracy parameters. When multiple analyses for the same target condition are compared, identical pretest probabilities might be selected to facilitate the comparison. Some pretest probabilities may lead to exaggerations of the patient harms or benefits, and guidance on how and why to select a specific pretest probability is minimally described. Therefore, the aim of this study was to assess the data sources and methods used in Cochrane diagnostic test accuracy (DTA) reviews for determining pretest probabilities to facilitate the interpretation of DTA parameters. A secondary aim was to assess the use of identical pretest probabilities to compare multiple meta-analyses within the same target condition.

Methods

Cochrane DTA reviews presenting at least one meta-analytic estimate of the sensitivity and/or specificity as a primary analysis published between 2008 and January 2018 were included. Study selection and data extraction were performed by one author and checked by other authors. Observed data sources (e.g. studies in the review, or external sources) and methods to select pretest probabilities (e.g. median) were categorized.

Results

Fifty-nine DTA reviews were included, comprising of 308 meta-analyses. A pretest probability was used in 148 analyses. Authors used included studies in the DTA review, external sources, and author consensus as data sources for the pretest probability. Measures of central tendency with or without a measure of dispersion were used to determine the pretest probabilities, with the median most commonly used. Thirty-two target conditions had at least one identical pretest probability for all of the meta-analyses within their target condition. About half of the used identical pretest probabilities were inside the prevalence ranges from all analyses within a target condition.

Conclusions

Multiple sources and methods were used to determine (identical) pretest probabilities in Cochrane DTA reviews. Indirectness and severity of downstream consequences may influence the acceptability of the certainty in calculated data with pretest probabilities. Consider: whether to present normalized frequencies, the influence of pretest probabilities on normalized frequencies, and whether to use identical pretest probabilities for meta-analyses in a target condition.
Prognostic value of TP53 concurrent mutations for EGFR- TKIs and ALK-TKIs based targeted therapy in advanced non-small cell lung cancer: a meta-analysis
Authors: Qin Kang , Hou Helei , Liang Yu , Zhang Xiaochun
Published: April 2020

Background

The prognostic significance of TP53 concurrent mutations in patients with epidermal growth factor receptor (EGFR)- or anaplastic lymphoma kinase (ALK)- mutated advanced non–small-cell lung cancer (NSCLC) who received EGFR-tyrosine kinase inhibitors (TKIs) or ALK-TKIs based targeted therapy remains controversial. Therefore, the present meta-analysis was performed to investigate the association between TP53 concurrent mutations and prognosis of patients with advanced NSCLC undergoing EGFR-TKIs or ALK-TKIs treatments.

Methods

Eligible studies were identified by searching the online databases PubMed, Embase, Medline, The Cochrane library and Web of Science. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to clarify the correlation between TP53 mutation status and prognosis of patients. This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Results

In total, 15 studies with 1342 patients were included for final analysis. Overall, concurrent TP53 mutation was associated with unfavorable progression-free survival (PFS) (HR = 1.88, 95%CI: 1.59–2.23, p < 0.001, I2 = 0.0%, P = 0.792) and overall survival (OS) (HR = 1.92, 95%CI: 1.55–2.38, p < 0.001, I2 = 0.0%, P = 0.515). Subgroup analysis based on type of targeted therapy (EGFR-TKIs or ALK-TKIs, pathological type of cancer (adenocarcinoma only or all NSCLC subtypes) and line of treatment (first-line only or all lines) all showed that TP53 mutations was associated with shorter survivals of patients with EGFR-TKIs or ALK-TKIs treatments. Particularly, in patients with first-line EGFR-TKIs treatment, significantly poorer prognosis was observed in patients with TP53 concurrent mutations (pooled HR for PFS: 1.69, 95% CI 1.25–2.27, P < 0.001, I2 = 0.0%, P = 0.473; pooled HR for OS: 1.94, 95% CI 1.36–2.76, P < 0.001, I2 = 0.0%, P = 0.484). Begg’s funnel plots and Egger’s tests indicated no significant publication bias in this study.

Conclusions

This meta-analysis indicated that concurrent TP53 mutations was a negative prognostic factor and associated with poorer outcomes of patients with EGFR-TKIs or ALK-TKIs treatments in advanced NSCLC. In addition, our study provided evidence that TP53 mutations might be involved in primary resistance to EGFR-TKIs treatments in patients with sensitive EGFR mutations in advanced NSCLC.
Taxane-induced sensory peripheral neuropathy is associated with an SCN9A single nucleotide polymorphism in Japanese patients
Authors: Tanabe Yuko , Shiraishi Seiji , Hashimoto Kenji , Ikeda Kazutaka , Nishizawa Daisuke , Hasegawa Junko , Shimomura Akihiko , Ozaki Yukinori , Tamura Nobuko , Yunokawa Mayu , Yonemori Kan , Takano Toshimi , Kawabata Hidetaka , Tamura Kenji , Fujiwara Yasuhiro , Shimizu Chikako
Published: April 2020

Background

Sodium channels located in the dorsal root ganglion, particularly Nav1.7 and Nav1.8, encoded by SCN9A and SCN10A, respectively, act as molecular gatekeepers for pain detection. Our aim was to determine the association between TIPN and SCN9A and SCN10A polymorphisms.

Methods

Three single nucleotide polymorphisms (SNPs) in SCN9A and two in SCN10A were investigated using whole-genome genotyping data from 186 Japanese breast or ovarian cancer patients classified into two groups as follows: cases that developed taxane-induced grade 2–3 neuropathy (N = 108) and controls (N = 78) with grade 0–1 neuropathy. Multiple logistic regression analyses were conducted to evaluate associations between TIPN and SNP genotypes.

Results

SCN9A-rs13017637 was a significant predictor of grade 2 or higher TIPN (odds ratio (OR) = 3.463; P = 0.0050) after correction for multiple comparisons, and precision was improved when only breast cancer patients were included (OR 5.053, P = 0.0029). Moreover, rs13017637 was a significant predictor of grade 2 or higher TIPN 1 year after treatment (OR 3.906, P = 0.037), indicating its contribution to TIPN duration.

Conclusion

SCN9A rs13017637 was associated with the severity and duration of TIPN. These findings are highly exploratory and require replication and validation prior to any consideration of clinical use.
Effect of climatic factors on the seasonal fluctuation of human brucellosis in Yulin, northern China
Authors: Liu Kun , Yang Zurong , Liang Weifeng , Guo Tianci , Long Yong , Shao Zhongjun
Published: April 2020

Background

Brucellosis is a serious public health problem primarily affecting livestock workers. The strong seasonality of the disease indicates that climatic factors may play important roles in the transmission of the disease. However, the associations between climatic variability and human brucellosis are still poorly understood.

Methods

Data for a 14-year series of human brucellosis cases and seven climatic factors were collected in Yulin City from 2005 to 2018, one of the most endemic areas in northern China. Using cross-correlation analysis, the Granger causality test, and a distributed lag non-linear model (DLNM), we assessed the quantitative relationships and exposure-lag-response effects between monthly climatic factors and human brucellosis.

Results

A total of 7103 cases of human brucellosis were reported from 2005 to 2018 in Yulin City with a distinct peak between April and July each year. Seasonal fluctuations in the transmission of human brucellosis were significantly affected by temperature, sunshine duration, and evaporation. The effects of climatic factors were non-linear over the 6-month period, and higher values of these factors usually increased disease incidence. The maximum separate relative risk (RR) was 1.36 (95% confidence interval [CI], 1.03–1.81) at a temperature of 17.4 °C, 1.12 (95% CI, 1.03–1.22) with 311 h of sunshine, and 1.18 (95% CI, 0.94–1.48) with 314 mm of evaporation. In addition, the effects of these three climatic factors were cumulative, with the highest RRs of 2.27 (95% CI, 1.09–4.57), 1.54 (95% CI, 1.10–2.18), and 1.27 (95% CI, 0.73–2.14), respectively.

Conclusions

In Yulin, northern China, variations in climatic factors, especially temperature, sunshine duration, and evaporation, contributed significantly to seasonal fluctuations of human brucellosis within 6 months. The key determinants of brucellosis transmission and the identified complex associations are useful references for developing strategies to reduce the disease burden.