bluuebunny/crossref_metadata_2025 huggingface dataset:
Soluble guanylyl cyclase stimulation and phosphodiesterase‐5 inhibition improve portal hypertension and reduce liver fibrosis in bile duct–ligated rats
Authors: Brusilovskaya Ksenia , Königshofer Philipp , Lampach Daniel , Szodl Adrian , Supper Paul , Bauer David , Beer Andrea , Stift Judith , Timelthaler Gerald , Oberhuber Georg , Podesser Bruno Karl , Seif Martha , Zinober Kerstin , Rohr‐Udilova Nataliya , Trauner Michael , Reiberger Thomas , Schwabl Philipp
Published: September 2020

Background

In cirrhosis, the nitric oxide‐soluble guanylyl cyclase (sGC)‐cyclic guanosine monophosphate (cGMP) pathway is impaired, which contributes to increased intrahepatic vascular resistance (IHVR) and fibrogenesis. We investigated if sGC stimulation (riociguat (RIO)), sGC activation (cinaciguat (CINA)) or phosphodiesterase (PDE)‐5 inhibition (tadalafil (TADA)) improves portal hypertension (PHT) and liver fibrosis.

Methods

Fifty male Sprague–Dawley rats underwent bile‐duct ligation (BDL) or sham operation. RIO (0.5 mg/kg), CINA (1 mg/kg), TADA (1.5 mg/kg) or vehicle (VEH) was administered from weeks 2 to 4 after BDL. At week 4, invasive haemodynamic measurements were performed, and liver fibrosis was assessed by histology (chromotrope‐aniline blue (CAB), Picro‐Sirius red (PSR)) and hepatic hydroxyproline content.

Results

Cirrhotic bile duct–ligated rats presented with PHT (13.1 ± 1.0 mmHg) and increased IHVR (4.9 ± 0.5 mmHg⋅min/mL). Both RIO (10.0 ± 0.7 mmHg, p  = 0.021) and TADA (10.3 ± 0.9 mmHg, p  = 0.050) decreased portal pressure by reducing IHVR (RIO: –41%, p  = 0.005; TADA: –21%, p  = 0.199) while not impacting heart rate, mean arterial pressure and portosystemic shunting. Hepatic cGMP levels increased upon RIO (+239%, p  = 0.006) and TADA (+32%, p  = 0.073) therapy. In contrast, CINA dosed at 1 mg/kg caused weight loss, arterial hypotension and hyperlactataemia in bile duct–ligated rats. Liver fibrosis area was significantly decreased by RIO (CAB: –48%, p  = 0.011; PSR: –27%, p  = 0.121) and TADA (CAB: –21%, p  = 0.342; PSR: –52%, p  = 0.013) compared to VEH‐treated bile duct–ligated rats. Hepatic hydroxyproline content was reduced by RIO (from 503 ± 20 to 350 ± 30 µg/g, p  = 0.003) and TADA (282 ± 50 µg/g, p = 0.003), in line with a reduction of the hepatic stellate cell activation markers smooth‐muscle actin and phosphorylated moesin. Liver transaminases decreased under RIO (AST: –36%; ALT: –32%) and TADA (AST: –24%; ALT: –27%) treatment. Hepatic interleukin 6 gene expression was reduced in the RIO group (–56%, p  = 0.053).

Conclusion

In a rodent model of biliary cirrhosis, the sGC stimulator RIO and the PDE‐5 inhibitor TADA improved PHT. The decrease of sinusoidal vascular resistance was paralleled by a reduction in liver fibrosis and hepatic inflammation, while systemic haemodynamics were not affected.
The “invisible” wiring technique for displaced fracture patella
Authors: Wong Andrew LY , Wong Kevin KH , Wong Kam Kwong , Wong Wing Cheung
Published: September 2020

Background:

Operative treatment of displaced patella fracture dates back to Lister in 1877. Nowadays, steel wires remain the material of choice in tension band technique despite complications such as wire breakage, suboptimal placement, or skin impingement. We propose using a high-tensile strength braided tape-shaped polyblend suture (FiberTape®, Arthrex, Naples, Florida, USA) as an alternative that could minimize complications related to steel wires.

Method:

Between February 2014 and April 2018, 15 patients with displaced patella fractures (three distal pole, five transverse, and seven comminuted fractures) underwent our proposed method. Open fracture reduction was performed to optimize anatomy before figure-of-eight fixation with FiberTape®. An Ethibond-2 suture was also added as cerclage for stability. Postoperatively, an extension brace was given for wound resting, before progressing to mobilization exercises with a hinge-knee brace. At follow-ups, the knee’s range-of-motion (ROM), along with bone healing status from radiographs, was assessed.

Results:

The mean operation time was 84.5 min, and all surgeries were performed or supervised by the same senior surgeon. Eight patients were discharged from follow-up (mean follow-up of 9.9 months) after achieving good ROM and fracture healing. One patient defaulted, and the remaining is still being followed-up. There was no wound complication or knot impingement in all cases. One patient required manipulation under anesthesia due to stiffness, and one experienced malunion due to poor compliance to rehabilitation protocol.

Conclusion:

Fixation using a high-tensile strength braided suture may be an equally effective method in the management of displaced patella fracture. However, larger sample size is useful to provide a more definitive conclusion.
Long-term prognosis after intracerebral haemorrhage
Authors: van Nieuwenhuizen Koen M , Vaartjes Ilonca , Verhoeven Jamie I , Rinkel Gabriel JE , Kappelle L Jaap , Schreuder Floris HBM , Klijn Catharina JM
Published: September 2020

Introduction

The aim of this study was to determine the risk of recurrent intracerebral haemorrhage (ICH), ischaemic stroke, all stroke, any vascular event and all-cause mortality in 30-day survivors of ICH, according to age and sex.

Patients and methods

We linked national hospital discharge, population and cause of death registers to obtain a cohort of Dutch 30-day survivors of ICH from 1998 to 2010. We calculated cumulative incidences of recurrent ICH, ischaemic stroke, all stroke and composite vascular outcome, adjusted for competing risk of death and all-cause mortality. Additionally, we compared survival with the general population.

Results

We included 19,444 ICH-survivors (52% male; median age 72 years, interquartile range 61–79; 78,654 patient-years of follow-up). First-year cumulative incidence of recurrent ICH ranged from 1.5% (95% confidence interval 0.9–2.3; men 35–54 years) to 2.4% (2.0–2.9; women 75–94 years). Depending on age and sex, 10-year risk of recurrent ICH ranged from 3.7% (2.6–5.1; men 35–54 years) to 8.1% (6.9–9.4; women 55–74 years); ischaemic stroke 2.6% to 7.0%, of all stroke 9.9% to 26.2% and of any vascular event 15.0% to 40.4%. Ten-year mortality ranged from 16.7% (35–54 years) to 90.0% (75–94 years). Relative survival was lower in all age-groups of both sexes, ranging from 0.83 (0.80–0.87) in 35- to 54-year-old men to 0.28 (0.24–0.32) in 75- to 94-year-old women.

Discussion

ICH-survivors are at high risk of recurrent ICH, of ischaemic stroke and other vascular events, and have a sustained reduced survival rate compared to the general population.

Conclusion

The high risk of recurrent ICH, other vascular events and prolonged reduced survival-rates warrant clinical trials to determine optimal secondary prevention treatment after ICH.
The revenge of the village? The geography of right-wing populist electoral success, anti-politics, and austerity in Germany
Authors: Förtner Maximilian , Belina Bernd , Naumann Matthias
Published: September 2020

This paper discusses the geography of the electoral successes of the right-wing populist party Alternative for Germany (AfD) in the national election to the German parliament in September 2017. Unlike other studies that reduce the electoral pattern to differences between “the city” and “the country,” we do not accept the empirical observation of an urban-rural divide as a sufficient explanation. By doing so, this paper proposes a theorization of the urban and the rural as social relationships that can be dialectically differentiated through the all-encompassing urbanization process and which materialize through space. This approach draws on Henri Lefebvre’s work on urbanization and his understanding of “the urban” and “the rural” and integrates it with Theodor W. Adorno’s notion of “the provincial” to better characterize “the rural” as a form of social relationship in which the culturally familiar, authenticity, and a lack of difference and reflection dominate. Recent theoretical discussions of anti-politics—understood as both a mode of making political claims and a political strategy that negates arguments, negotiations, and compromise, starting instead with absolute, non-negotiable positions— inform this paper as well. Based on this theoretical foundation, we argue that the rural is the breeding ground for anti-politics and AfD votes. A discussion of three places where the AfD was particularly successful supports our argument: the more peripheral, small-town administrative district of Western Pomerania-Greifswald and the two large-city districts of Mannheim-Schönau and Pforzheim-Haidach.
Influence of assemble patterns on bonding strength of glued bamboo
Authors: Zheng Yu , Yi Bao-long , Tong Ya-qi , Peng Zhen-zhen
Published: September 2020

As a kind of natural composite material, the outer side of bamboo was quite different from its inner side in microscopic structure and mechanical properties. In order to research the effect of these differences on bonding strength of glued bamboo, bamboo strips were bonded by three different forms: outer side to outer side, outer side to inner side and inner side to inner side. Shear strength results indicated that the bamboo sample glued by inner side to inner side has the greatest shear strength value, which is 18.35 MPa, and the other two types have similar shear strength values (approximately 14 MPa). In particular, for the sample glued by outer side to inner side, the broken part is always the outer side. The scanning electron microscope (SEM) images indicated that bamboo fiber cells and parenchyma cells have different failure patterns in compression shear test. For bamboo fiber cells, dominant destruction occurred at the interface between the fibers. And for parenchyma cell, fracture occurred on cell wall and broken the parenchyma cell itself. The interface between bamboo fiber cells was very weak, thus parenchyma cell was the major contributor to shear strength of bamboo. The inner side had higher shear strength because it had higher content of parenchyma cells. The SEM image and shear strength curve also indicated that in the early period of shearing process, the deformed parenchyma cells are in a relax status, and until the later period of shearing process, the parenchyma cells begin to contribute to shear strength.
Integrating transcriptomic and metabolomic analysis of hormone pathways in Acer rubrum during developmental leaf senescence
Authors: Zhu Chen , Xiaoyu Lu , Junlan Gao , Yun Xuan , Jie Ren
Published: September 2020

Background

To fully elucidate the roles and mechanisms of plant hormones in leaf senescence, we adopted an integrated analysis of both non-senescing and senescing leaves from red maple with transcriptome and metabolome data.

Results

Transcription and metabolite profiles were generated through a combination of deep sequencing, third-generation sequencing data analysis, and ultrahigh-performance liquid chromatograph Q extractive mass spectrometry (UHPLC-QE-MS), respectively. We investigated the accumulation of compounds and the expression of biosynthesis and signaling genes for eight hormones. The results revealed that ethylene and abscisic acid concentrations increased during the leaf senescence process, while the contents of cytokinin, auxin, jasmonic acid, and salicylic acid continued to decrease. Correlation tests between the hormone content and transcriptional changes were analyzed, and in six pathways, genes closely linked with leaf senescence were identified.

Conclusions

These results will enrich our understanding of the mechanisms of plant hormones that regulate leaf senescence in red maple, while establishing a foundation for the genetic modification ofAcerin the future.
Increased incidence of Susac syndrome: a case series study
Authors: Wilf-Yarkoni A. , Elkayam O. , Aizenstein O. , Oron Y. , Furer V. , Zur D. , Goldstein M. , Barequet D. , Hallevi H. , Karni A. , Habot-Wilner Z. , Regev K.
Published: September 2020

Background

Susac syndrome (SuS) is a rare condition characterized by a clinical triad of sensorineural hearing loss, branch artery occlusion and encephalopathy. This study reports an increased incidence of SuS in Israel. We describe the clinical characteristics of these patients, diagnostic procedures and the use and subsequent outcomes of newly published treatment guidelines.

Methods

This is a single center retrospective study. Patients who were diagnosed with SuS between July 2017 and August 2018 were enrolled in this study.

Results

Seven patients were diagnosed with SuS according to the diagnostic criteria in a time period of 13 months. The annual incidence was recently evaluated in Austria to be 0.024/100000, therefore, our case series represent at least a 5.4- fold increase in the annual incidence of SuS expected in Israel and a 7-fold increase in the annual incidence expected in our medical center. Mean time from the onset of the symptoms to diagnosis was three weeks and follow-up time was twenty four months.

Recent exposure to cytomegalovirus was serologically evident in three patients and one patient had high titer of anti-streptolysin antibody. All patients underwent brain MRI, fluorescein angiography and audiometry.

All patients were treated according to the newly recommended guidelines. All patients achieved clinical and radiological stability.

Conclusions

We report of an increased incidence of SuS in Israel. Infectious serological findings may imply a post infectious mechanism. The use of the recommended diagnostic procedures reduced the time to diagnosis. Newly published treatment guidelines led to favorable clinical outcomes.
Competing priorities: a qualitative study of how women make and enact decisions about weight gain in pregnancy
Authors: Vanstone Meredith , Sadik Marina , Van Blyderveen Sherry , Biringer Anne , Sword Wendy , Schmidt Louis , Mcdonald Sarah D.
Published: September 2020

Background

Despite ample clinical evidence that gaining excess weight in pregnancy results in negative health outcomes for women and infants, more than half of women in Western industrialized nations gain in excess of national guidelines. The influence of socio-demographic factors and weight gain is well-established but not causal; the influence of psychological factors may explain some of this variation.

Methods

This is the qualitative portion of an explanatory sequential mixed-methods study designed to identify predictive psychological factors of excess gestational weight gain (QUAN) and then explain the relevance of those factors (qual). For this portion of the study, we used a qualitative descriptive approach to elicit 39 pregnant women’s perspectives of gestational weight gain, specifically inquiring about factors determined as relevant to excess gestational weight gain by our previous predictive study. Women were interviewed in the latter half of their third trimester. Data were analyzed using a combination of unconstrained deductive content analysis to describe the findings relevant to the predictive factors and a staged inductive content analytic approach to examine the data without a focus on the predictive factors.

Results

Very few participants consistently made deliberate choices relevant to weight gain; most behaviour relevant to weight gain happened with in-the-moment decisions. These in-the-moment decisions were influenced by priorities, hunger, a consideration of the consequence of the decision, and accommodation of pregnancy-related discomfort. They were informed by the foundational information a woman had available to her, including previous experience and interactions with health care providers. The foundational information women used to make these decisions was often incomplete. While women were aware of the guidelines related to gestational weight gain, they consistently mis-applied them due to incorrect understanding of their own BMI. Only one woman was aware that weight gain was linked to maternal and infant health outcomes.

Conclusions

There is an important role for prenatal providers to provide the foundational information to positively influence in-the-moment decisions. Understanding how weight gain guidelines apply to one’s own pre-pregnancy BMI and comprehending the well-established link between gestational weight gain and health outcomes may help women prioritize healthy weight gain amongst many competing factors.
Promotion of the occurrence of endometrioid carcinoma by S100 calcium binding protein P
Authors: Zhang Dan , Chen Xiuying , Xia Hexia , Wang Lu , Zhao Hongbo , Xu Bufang , Zhang Aijun , Zhang Wei
Published: September 2020

Background

Endometrial cancer, one of the most common malignant tumors, is a serious threat to women’s health. Endometrial hyperplasia is a precursor of endometrial cancer. S100 calcium binding protein P (S100P) has been found to play important roles in many types of cancer. The present study aimed to investigate the expression of S100P in endometrial cancer and its precursor lesions, and to explore the possible mechanisms.

Methods

We collected paraffin sections of normal endometrium, simple and complex non-atypical hyperplasia, atypical hyperplasia, and endometrioid carcinoma. The expression of S100P in endometrial cancer and its precancerous lesions was observed using immunohistochemistry. We also cultured primary endometrial cells and endometrial cancer cell lines (Ishikawa and RL95–2), and observed the expression of S100P in these cells. Laser confocal microscopy was used to observe the co-localization of S100P and its interacting protein Ezrin in RL95–2 cells. We employed lentiviruses to knockdown and overexpress S100P and then detected the F-actin distribution and cell invasion using phalloidin staining and Transwell assays.

Results

There was a gradual increase in the S100P signal as the disease progressed from normal endometrium and simple non-atypical hyperplasia, to complex non-atypical hyperplasia, atypical hyperplasia, and then to endometrial cancer. S100P was mainly distributed in the cytoplasm and co-localized with Ezrin in endometrial cancer cells. After knocking down S100P, F-actin aggregated in the nucleus or to the local cell membrane. Furthermore, knockdown of S100P in Ishikawa cells decreased their cell invasion capability. Meanwhile, S100P overexpression in endometrial stromal cells increased cell invasion.

Conclusions

These data suggested that S100P might be involved in the occurrence and development of endometrial cancer via interaction with Ezrin and re-organization of F-actin to promote cell invasion.
The mutation spectrum in familial versus sporadic congenital cataract based on next-generation sequencing
Authors: Fan Fan , Luo Yi , Wu Jihong , Gao Chao , Liu Xin , Mei Hengjun , Zhou Xiyue
Published: September 2020

Background

Congenital cataract (CC) is a significant cause of lifelong visual loss, and its genetic diagnosis is challenging due to marked genetic heterogeneity. The purpose of this article is to report the genetic findings in sporadic and familial CC patients.

Methods

Patients (n = 53) who were clinically diagnosed with CC and their parents were recruited. Blood samples were collected in our hospital. Mutations were detected by panel-based next-generation DNA sequencing (NGS) targeting 792 genes frequently involved in common inherited eye diseases.

Results

We identified variants in 10/37 cases (27.02%) of sporadic CC and 14/16 cases (87.5%) of familial CC, which indicated a significant difference (P = 0.000). Of the 13 variants identified in sporadic cases, nine were previously reported mutations, and three were novel mutations, including one de novo mutation (CRYBB2 c.487C > T). The most frequent variants in our cohort were in crystallins and cytoskeletal genes (5/27, 18.52%), followed by proteins associated with X-linked syndromic conditions (14.81%) and transcriptional factors (11.11%). Additional information on the possibility of complications with inherited ocular or systemic diseases other than CC was provided in 17/27 (62.96%) variants.

Conclusions

These results contribute to expanding the mutation spectrum and frequency of genes responsible for CC. Targeted NGS in CC provided significant diagnostic information and enabled more accurate genetic counselling. This study reports the different distributions of mutation genes in familial and sporadic CC cases.
Improving assessment of child growth in a pediatric hospital setting
Authors: Gupta Priya M. , Wieck Emily , Conkle Joel , Betters Kristina A. , Cooley Anthony , Yamasaki Selena , Laibhen-Parkes Natasha , Suchdev Parminder S.
Published: September 2020

Background

Accurate anthropometric measurements are essential for assessing nutritional status, monitoring child growth, and informing clinical care. We aimed to improve height measurements of hospitalized pediatrics patients through implementation of gold standard measurement techniques.

Methods

A quality improvement project implemented computerized training modules on anthropometry and standardized wooden boards for height measurements in a tertiary children’s hospital. Heights were collected pre- and post-intervention on general pediatric inpatients under 5 years of age. Accuracy of height measurements was determined by analyzing the variance and by comparing to World Health Organization’s defined biologically plausible height-for-age z-scores. Qualitative interviews assessed staff attitudes.

Results

Ninety-six hospital staff completed the anthropometry training. Data were available on 632 children pre- and 933 post-intervention. Training did not increase the proportion of patients measured for height (78.6% pre-intervention vs. 75.8% post-intervention, p = 0.19). Post-intervention, wooden height boards were used to measure height of 34.8% patients, while tape measures and wingspan accounted for 42.0% and 3.5% of measurements, respectively. There was no improvement in the quality of height measurements based on plausibility (approximately 3% height-for-age z-scores measurements flagged out of range pre- and post-intervention), digit preference (13.4% of digits pre- and 12.3% post-intervention requiring reclassification), or dispersion of measurements (height-for-age z-scores standard deviation 1.9 pre- and post-intervention). Staff reported that using the wooden board was too labor consuming and cumbersome.

Conclusions

Our findings suggest that efforts to improve anthropometric measurements of hospitalized children have multiple obstacles, and further investigation of less cumbersome methods of measurements may be warranted.
Concurrent OPA1 mutation and chromosome 3q deletion leading to Behr syndrome: a case report
Authors: Zeng Ting , Liao Linyan , Guo Yi , Liu Xuxu , Xiong Xiaobo , Zhang Yu , Cen Shi , Li Honghui , Wei Shuzhang
Published: September 2020

Background

Optic atrophy 1 (OPA1) gene mutations are associated with dominantly inherited optic neuropathy resulting in a progressive loss of visual acuity. Compound heterozygous or homozygous variants that lead to severe phenotypes, including Behr syndrome, have been reported rarely.

Case presentation

Here, we present a 14-month-old boy with early onset optic atrophy, congenital cataracts, neuromuscular disorders, mental retardation, and developmental delay. Combined genetic testing, including whole exome sequencing (WES) and chromosomal microarray analysis, revealed a concurrent OPA1 variant (c.2189 T > C p.Leu730Ser) and de novo chromosome 3q deletion as pathogenic variants leading to the severe phenotype.

Conclusions

Our case is the first reporting a novel missense OPA1 variant co-occurring with a chromosomal microdeletion leading to a severe phenotype reminiscent of Behr syndrome. This expands the mutation spectrum of OPA1 and inheritance patterns of this disease.
Free large sized intra-abdominal endometrioma in a postmenopausal woman: a case report
Authors: Naem Antoine , Shamandi Anwar , Al-Shiekh Ali , Alsaid Bayan
Published: September 2020

Background

Endometriosis is an estrogen-dependent disease defined by the presence of endometrial glands and stroma out of the uterine cavity. Its prevalence is estimated to be 2–10% in reproductive aged women. Endometriosis occurrence is estimated to be 2.55% in postmenopausal patients due to the decreased levels of estrogen. Endometriosis can present in three different forms: superficial peritoneal implants, ovarian endometriomas, and deep infiltrating endometriosis. Ovarian endometriomas are the most common form of endometriosis. Even though endometriomas have been encountered in various localizations, a free abdominal endometrioma was only reported once in a premenopausal patient. Here, we are reporting the first case of a free large endometrioma in a postmenopausal patient.

Case presentation

A 67-year-old woman presented to the emergency department at our university hospital complaining of constipation and right flank pain. She suffered from uncontrolled primary hypertension and type 2 diabetes mellitus. On presentation, she was afebrile, hypertensive, and tachycardic. An abdominal CT scan revealed a large cystic mass measuring 17 × 26 cm in the anterior-posterior and transverse diameters respectively. The cyst caused bowel obstruction and right sided hydronephrosis. The patient underwent laparotomy and during the surgical exploration a large abdominal cyst adhered to the greater omentum was found. The cyst received plenteous blood supply from the greater omentum. The uterus and both ovaries were completely normal and didn’t have any connection to the cyst. An en-bloc cystectomy was performed successfully. The final histopathology report confirmed an abdominal endometrioma. The patient had an uneventful postoperative recovery.

Conclusions

Endometriomas might reach large sizes regardless of their location or the patient’s age. The close relation of free abdominal endometriomas with the greater omentum suggests that these were developed from endometriotic omental implants. Endometrioma is rare in postmenopausal women. However, it should be considered as a possible differential diagnosis at any age.
White lie during patient care: a qualitative study of nurses’ perspectives
Authors: Nasrabadi A. Nikbakht , Joolaee S. , Navab E. , Esmaeili M. , Shali M.
Published: September 2020

Background

Keeping the patients well and fully informed about diagnosis, prognosis, and treatments is one of the patient’s rights in any healthcare system. Although all healthcare providers have the same viewpoint about rendering the truth in treatment process, sometimes the truth is not told to the patients; that is why the healthcare staff tell “white lie” instead. This study aimed to explore the nurses’ experience of white lies during patient care.

Methods

This qualitative study was conducted from June to December 2018. Eighteen hospital nurses were recruited with maximum variation from ten state-run educational hospitals affiliated to Tehran University of Medical Sciences. Purposeful sampling was used and data were collected by semi-structured interviews that were continued until data saturation. Data were classified and analyzed by content analysis approach.

Results

The data analysis in this study resulted in four main categories and 11 subcategories. The main categories included hope crisis, bad news, cultural diversity, and nurses’ limited professional competences.

Conclusion

Results of the present study showed that, white lie told by nurses during patient care may be due to a wide range of patient, nurse and/or organizational related factors. Communication was the main factor that influenced information rendering. Nurses’ communication with patients should be based on mutual respect, trust and adequate cultural knowledge, and also nurses should provide precise information to patients, so that they can make accurate decisions regarding their health care.
Individual, institutional, and scientific environment factors associated with questionable research practices in the reporting of messages and conclusions in scientific health services research publications
Authors: Gerrits Reinie G. , Mulyanto Joko , Wammes Joost D. , van den Berg Michael J. , Klazinga Niek S. , Kringos Dionne S.
Published: September 2020

Background

Health Services Research findings (HSR) reported in scientific publications may become part of the decision-making process on healthcare. This study aimed to explore associations between researcher’s individual, institutional, and scientific environment factors and the occurrence of questionable research practices (QRPs) in the reporting of messages and conclusions in scientific HSR publications.

Methods

We employed a mixed-methods study design. We identified factors possibly contributing to QRPs in the reporting of messages and conclusions through a literature review, 14 semi-structured interviews with HSR institutional leaders, and 13 focus-groups amongst researchers. A survey corresponding with these factors was developed and shared with 172 authors of 116 scientific HSR publications produced by Dutch research institutes in 2016. We assessed the included publications for the occurrence of QRPs. An exploratory factor analysis was conducted to identify factors within individual, institutional, and environmental domains. Next, we conducted bivariate analyses using simple Poisson regression to explore factors’ association with the number of QRPs in the assessed HSR publications. Factors related to QRPs with a p-value < .30 were included in four multivariate models tested through a multiple Poisson regression.

Results

In total, 78 (45%) participants completed the survey (51.3% first authors and 48.7% last authors). Twelve factors were included in the multivariate analyses. In all four multivariate models, a higher score of “pressure to create societal impact” (Exp B = 1.28, 95% CI [1.11, 1.47]), was associated with higher number of QRPs. Higher scores on “specific training” (Exp B = 0.85, 95% CI [0.77–0.94]) and “co-author conflict of interest” (Exp B = 0.85, 95% CI [0.75–0.97]) factors were associated with a lower number of QRPs. Stratification between first and last authors indicated different factors were related to the occurrence of QRPs for these groups.

Conclusion

Experienced pressure to create societal impact is associated with more QRPs in the reporting of messages and conclusions in HSR publications. Specific training in reporting messages and conclusions and awareness of co-author conflict of interests are related to fewer QRPs. Our results should stimulate awareness within the field of HSR internationally on opportunities to better support reporting in scientific HSR publications.
Antimicrobial susceptibility profiles of porcine mycoplasmas isolated from samples collected in southern Europe
Authors: Rosales Rubén S. , Ramírez Ana S. , Tavío María M. , Poveda Carlos , Poveda José B.
Published: September 2020

Background

Mycoplasma(M.)hyopneumoniae,M. hyorhinisandM. hyosynoviaeare significant pathogens for the porcine industry worldwide. The aim of the present study was to determine the antimicrobial susceptibility of six key antimicrobials (tylosin, tilmicosin, tylvalosin, lincomycin, tiamulin and valnemulin) routinely used for treating infections caused by these pathogens. Twenty-sevenM. hyopneumoniae, 48 M. hyorhinisand 40 M. hyosynoviaefield strains isolated from clinical samples from different Southern European countries between 2013 and 2018 using broth microdilution method were evaluated.

Results

Tylvalosin exhibited the highest in vitro activity among the macrolides assayed, with MIC90values 4 to 5 two-fold dilutions lower than those of tylosin and tilmicosin. The pleuromutilin valnemulin showed one of the highest in vitro activities against the three mycoplasma species. On the contrary, lincomycin exhibited the highest MIC values of the antimicrobials tested.

Conclusions

The data obtained in the present study supports the use of pleuromutilins and macrolides for the control of infections caused by porcine mycoplasmas. The use of lincomycin for the treatment of porcine mycoplasma infections should be carefully evaluated due to the presence of circulating field isolates with decreased susceptibility to this antimicrobial.
Majocchi’s granuloma on the forearm caused by Trichophyton tonsurans in an immunocompetent patient
Authors: Zheng Yun-yan , Li Yue , Chen Ming-yan , Mei Qian-yun , Zhang Ru-zhi
Published: September 2020

Majocchi's granuloma is an uncommon fungal infection of the dermis and subcutaneous tissue. The most frequently identified cause of Majocchi’s granuloma is anthropophilic Trichophyton rubrum, and it is most commonly located on the anterior aspect of the lower limbs in women. Here, we report a case of Majocchi’s granuloma on the forearm, a site that is rarely involved, in a 62-year-old woman who had been bitten by a dog. Histological examination revealed a dense dermal infiltrate composed of lymphoplasmacytic cells and neutrophils, with hyphae in the dermis. The presence of the fungus, Trichophyton tonsurans, was confirmed by mycological examination and molecular methods. Therefore, histological and mycological examination confirmed the diagnosis of Majocchi’s granuloma. The patient was treated with local moxibustion and itraconazole, 200 mg/day, for 60 days, which facilitated a complete resolution of the lesions.
No differences in hemostatic and endothelial activations between haploidentical and matched-donor hematopoietic stem cell transplantation in thalassemia disease
Authors: Lertthammakiat Surapong , Sitthirat Peerasit , Anurathapan Usanarat , Songdej Duantida , Pakakasama Samart , Chuansumrit Ampaiwan , Putawornsub Nattaphat , Sirasittikarn Sawitt , Wantanawijarn Sataporn , Kadegasem Praguywan , Hongeng Suradej , Sirachainan Nongnuch
Published: September 2020

Hemostatic changes and endothelial activations have been recognized in β-thalassemic patients after matched-donor hematopoietic stem cell transplantation (HSCT) but there are limited studies for haploidentical HSCT. This report demonstrates that the levels of hemostatic and endothelial markers, including thrombin antithrombin complex, prothrombin fragment, D-dimer, von Willebrand factor antigen and thrombomodulin levels, were not significantly different between haploidentical and matched-donor HSCT patients.
Plan, recruit, retain: a framework for local healthcare organizations to achieve a stable remote rural workforce
Authors: Abelsen Birgit , Strasser Roger , Heaney David , Berggren Peter , Sigurðsson Sigurður , Brandstorp Helen , Wakegijig Jennifer , Forsling Niclas , Moody-Corbett Penny , Akearok Gwen Healey , Mason Anne , Savage Claire , Nicoll Pam
Published: September 2020

Background

Recruiting and retaining a skilled health workforce is a common challenge for remote and rural communities worldwide, negatively impacting access to services, and in turn peoples’ health. The research literature highlights different factors facilitating or hindering recruitment and retention of healthcare workers to remote and rural areas; however, there are few practical tools to guide local healthcare organizations in their recruitment and retention struggles.

The purpose of this paper is to describe the development process, the contents, and the suggested use of The Framework for Remote Rural Workforce Stability. The Framework is a strategy designed for rural and remote healthcare organizations to ensure the recruitment and retention of vital healthcare personnel.

Method

The Framework is the result of a 7-year, five-country (Sweden, Norway, Canada, Iceland, and Scotland) international collaboration combining literature reviews, practical experience, and national case studies in two different projects.

Result

The Framework consists of nine key strategic elements, grouped into three main tasks (plan, recruit, retain). Plan: activities to ensure that the population’s needs are periodically assessed, that the right service model is in place, and that the right recruits are targeted. Recruit: activities to ensure that the right recruits and their families have the information and support needed to relocate and integrate in the local community. Retain: activities to support team cohesion, train current and future professionals for rural and remote health careers, and assure the attractiveness of these careers.

Five conditions for success are recognition of unique issues; targeted investment; a regular cycle of activities involving key agencies; monitoring, evaluating, and adjusting; and active community participation.

Conclusion

The Framework can be implemented in any local context as a holistic, integrated set of interventions. It is also possible to implement selected components among the nine strategic elements in order to gain recruitment and/or retention improvements.
Worldwide surveillance of self-reported sitting time: a scoping review
Authors: Mclaughlin M. , Atkin A. J. , Starr L. , Hall A. , Wolfenden L. , Sutherland R. , Wiggers J. , Ramirez A. , Hallal P. , Pratt M. , Lynch B. M. , Wijndaele K. ,   on behalf of the Sedentary Behaviour Council Global Monitoring Initiative Working Group, Adli Saiful , Gardiner Paul A. , Doyle Ciaran B. , Meadows Angela , Mabry Ruth M. , Pregonero Alberto Florez , Sadarangani Kabir P. , Hadgraft Nyssa T. , Boyle Terry , Farias Nicolas Aguilar , Mair Jacqueline L. , Hafoka Siosaia F. , Mielke Gregore Iven , Lin Selina Khoo Phaik , McLeod Vienna R. , Ranasinghe Chathuranga , Storning Paul C. , Dohrn Ing-Mari , Müller-Riemenschnieder Falk , Al Subhi Lyutha , Yee Anne Chu Hin , Gad Mayuri , Marques Adilson , Kontostoli Elli
Published: September 2020

Background

Prolonged sitting time is a risk factor for chronic disease, yet recent global surveillance is not well described. The aims were to clarify: (i) the countries that have collected country-level data on self-reported sitting time; (ii) the single-item tools used to collect these data; and (iii) the duration of sitting time reported across low- to high-income countries.

Methods

Country-level data collected within the last 10 years using single-item self-report were included. The six-stage methodology: (1) reviewing Global Observatory for Physical Activity! Country Cards; (2–4) country-specific searches of PubMed, the Demographic and Health Survey website and Google; (5) analysing the Eurobarometer 88.4; and (6) country-specific searches for World Health Organization STEPwise reports.

Results

A total of 7641 records were identified and screened for eligibility. Sixty-two countries (29%) reported sitting time representing 47% of the global adult population. The majority of data were from high-income (61%) and middle income (29%) countries. The tools used were the International Physical Activity Questionnaire (IPAQ; n = 34), a modified IPAQ (n = 1) or the Global Physical Activity Questionnaire (GPAQ; n = 27). The median of mean daily sitting times was 4.7 (IQR: 3.5–5.1) hours across all countries. Higher-income countries recorded a longer duration of sitting time than lower-income countries (4.9 vs 2.7 h).

Conclusions

This study provides an updated collation of countries collecting self-reported sitting time data. The daily sitting time findings should be interpreted cautiously. Current surveillance of sitting time is limited by a lack of coverage. Measures of population sitting time that are valid, feasible and sensitive to change should be embedded within global surveillance systems, to help guide future policy, research and practice.

Trial registration

Not applicable.
Impact of lockdown on Covid-19 case fatality rate and viral mutations spread in 7 countries in Europe and North America
Authors: Pachetti Maria , Marini Bruna , Giudici Fabiola , Benedetti Francesca , Angeletti Silvia , Ciccozzi Massimo , Masciovecchio Claudio , Ippodrino Rudy , Zella Davide
Published: September 2020

Background

Severe acute respiratory syndrome CoV-2 (SARS-CoV-2) caused the first coronavirus disease 2019 (COVID-19) outbreak in China and has become a public health emergency of international concern. SARS-CoV-2 outbreak has been declared a pandemic by WHO on March 11th, 2020 and the same month several Countries put in place different lockdown restrictions and testing strategies in order to contain the spread of the virus.

Methods

The calculation of the Case Fatality Rate of SARS-CoV-2 in the Countries selected was made by using the data available at https://github.com/owid/covi-19-data/tree/master/public/data. Case fatality rate was calculated as the ratio between the death cases due to COVID-19, over the total number of SARS-CoV-2 reported cases 14 days before. Standard Case Fatality Rate values were normalized by the Country-specific ρ factor, i.e. the number of PCR tests/1 million inhabitants over the number of reported cases/1 million inhabitants. Case-fatality rates between Countries were compared using proportion test. Post-hoc analysis in the case of more than two groups was performed using pairwise comparison of proportions and p value was adjusted using Holm method. We also analyzed 487 genomic sequences from the GISAID database derived from patients infected by SARS-CoV-2 from January 2020 to April 2020 in Italy, Spain, Germany, France, Sweden, UK and USA. SARS-CoV-2 reference genome was obtained from the GenBank database (NC_045512.2). Genomes alignment was performed using Muscle and Jalview software. We, then, calculated the Case Fatality Rate of SARS-CoV-2 in the Countries selected.

Results

In this study we analyse how different lockdown strategies and PCR testing capability adopted by Italy, France, Germany, Spain, Sweden, UK and USA have influenced the Case Fatality Rate and the viral mutations spread. We calculated case fatality rates by dividing the death number of a specific day by the number of patients with confirmed COVID-19 infection observed 14 days before and normalized by a ρ factor which takes into account the diagnostic PCR testing capability of each Country and the number of positive cases detected. We notice the stabilization of a clear pattern of mutations at sites nt241, nt3037, nt14408 and nt23403. A novel nonsynonymous SARS-CoV-2 mutation in the spike protein (nt24368) has been found in genomes sequenced in Sweden, which enacted a soft lockdown strategy.

Conclusions

Strict lockdown strategies together with a wide diagnostic PCR testing of the population were correlated with a relevant decline of the case fatality rate in different Countries. The emergence of specific patterns of mutations concomitant with the decline in case fatality rate needs further confirmation and their biological significance remains unclear.
Educating, training, and exercising for infectious disease control with emphasis on cross-border settings: an integrative review
Authors: de Rooij Doret , Belfroid Evelien , Hadjichristodoulou Christos , Mouchtouri Varvara A. , Raab Jörg , Timen Aura ,   for the EU HEALTHY GATEWAYS Joint Action consortium
Published: September 2020

Introduction

Points of entry and other border regions educate, train, and exercise (ETEs) their staff to improve preparedness and response to cross-border health threats. However, no conclusive knowledge of these ETEs’ effectiveness exists. This study aimed to review the literature on ETEs in infectious disease control concerning their methods and effect, with an emphasis on cross-border settings and methods that enlarge ETEs’ reach.

Methodology

We systematically searched for studies in the databases Embase, Medline, Web of Science, PsycInfo, ERIC, and Cinahl. After successively screening titles and abstracts, full-texts, and citations, 62 studies were included using in- and exclusion criteria. Data were extracted using a data-extraction form. Quality assessment was performed. We developed a theoretical framework based on which we analyzed the ETE context (target group, recruitment, autonomy, training needs), input (topic, trainers, development and quality of materials), process (design, duration, interval, goals), evaluation (pre-, post- follow-up tests), and outcome (reaction, learning, behavior, and system).

Results

We found a limited number of published evaluations of ETEs in general (n = 62) and of cross-border settings (n = 5) in particular. The quality assessment resulted in seven ETE methodologies and 23 evaluations with a ‘good’ score. Both general studies and those in a cross-border setting contain a low-moderate detail level on context, input, and process. The evaluations were performed on reaction (n = 45), learning (n = 45), behavior (n = 9) and system (n = 4), mainly using pre- and post-tests (n = 22). Online learning methods have a high potential in enlarging the reach and are effective, particularly in combination with offline training. Training-of-trainer approaches are effective for learning; new ETEs were developed by 20–44% of participants until six months after the initial training.

Conclusion

Our study reveals a limited number of publications on ETEs in infectious disease control. Studies provide few details on methodology, and use mainly short-term evaluations and low level outcomes. We call for more extensive, higher-level evaluation standards of ETEs, and an easy and sustainable way to exchange evaluations within the workforce of infectious disease control in cross-border settings. The theoretical framework developed in this study could guide future development and evaluation of ETEs in infectious disease control.
Effects of proximal fibular osteotomy on stress changes in mild knee osteoarthritis with varus deformity: a finite element analysis
Authors: Pan Deng , TianYe Lin , Peng Yang , JingLi Xu , HongZhu Li , HeRan Zhao , QingWen Zhang , LeiLei Chen , ZhenQiu Chen , QiuShi Wei , Wei He
Published: September 2020

Background

Many previous studies lack sufficient quantitative evidences about changes in biomechanical properties of the knee in response to proximal fibular osteotomy (PFO). Therefore, the aim of this study was to compare the preoperative and postoperative effects of PFO on mechanical stresses in the knee joint and provide with a biomechanical basis for PFO in the treatment of mild knee osteoarthritis (KOA) with varus deformity.

Methods

A total of 10 patients suffering mild KOA with varus deformity were enrolled in this study. Their image data from computerized tomography (CT) and magnetic resonance imaging (MRI) were used for finite element models, and PFO models were established. Static structural analysis was carried out using ABAQUS to compare the von Mises stress distribution and values of the maximal von Mises stress of femoral cartilage, meniscuses, tibial cartilages, and tibial plateau before and after surgery.

Results

The stress distribution in the cortical bone of the tibial plateau showed that stresses were transferred from the anterior medial area to the posterior medial area after PFO. Values of the maximal von Mises stress in femoral cartilage, medial meniscus, medial tibial cartilage, and tibial plateau after surgery were significantly lower than the preoperative values, with statistically significant differences (P < 0.05). Postoperative values of the maximal von Mises stress of lateral meniscus and lateral tibial cartilage were significantly higher than the preoperative ones, with statistically significant differences (P < 0.05).

Conclusion

PFO could reduce the stresses in the medial compartment of the knee joint with stress pathways transferring from the anterior medial area to the posterior medial area of the tibial plateau. Therefore, PFO is recommended for the treatment of mild KOA with varus deformity featuring favorably pain-relieving effects.

Graphical abstract