bluuebunny/crossref_metadata_2025 huggingface dataset:
Children with COVID-19 behaving milder may challenge the public policies: a systematic review and meta-analysis
Authors: Liu Chan , He Yu , Liu Lian , Li Fang , Shi Yuan
Published: September 2020

Background

The emerging virus is rampaging globally. A growing number of pediatric infected cases have been reported. Great efforts are needed to cut down the transmission.

Methods

A single-arm meta-analysis was conducted. We searched PubMed, Google Scholar, Web of Science, and several Chinese databases for studies presenting characteristics of children confirmed with Coronavirus Disease 2019 (COVID-19) from December 12, 2019 to May 10, 2020. Quality Appraisal of Case Series Studies Checklist was used to assess quality and publication bias was analyzed by Egger’s test. Random-effect model was used to calculate the pooled incidence rate (IR) or mean difference (MD) with 95% confidence intervals (CI), or a fixed model instead when I2 < 50%. We conducted subgroup analysis according to geographic region. Additionally, we searched United Nations Educational Scientific and Cultural Organization to see how different countries act to the education disruption in COVID-19.

Results

29 studies with 4300 pediatric patients were included. The mean age was 7.04 (95% CI: 5.06–9.08) years old. 18.9% of children were asymptomatic (95% CI: 0.121–0.266), 37.4% (95% CI: 0.280–0.474) had no radiographic abnormalities. Besides, a proportion of 0.1% patients were admitted to intensive care units (0, 95% CI: 0.000–0.013) and four deaths were reported (0, 95% CI: 0.000–0.000). Up to 159 countries have implemented nationwide school closures, affecting over 70% of the world’s students.

Conclusion

Children were also susceptible to SARS-CoV-2, while critical cases or deaths were rare. Characterized by mild presentation, the dilemma that children may become a potential spreader in the pandemic, while strict managements like prolonged school closures, may undermine their well-beings. Thus, the public policies are facing challenge.
Child acceptability of a novel provitamin A carotenoid, iron and zinc-rich complementary food blend prepared from pumpkin and common bean in Uganda: a randomised control trial
Authors: Buzigi Edward , Pillay Kirthee , Siwela Muthulisi
Published: September 2020

Background

Ugandan children are fed homemade complementary foods (CFs) which are usually deficient in vitamin A, iron and zinc. Novel homemade CFs rich in vitamin A, iron and zinc need to be developed, and assessed for their acceptability among target children.

Objective

Homemade provitamin A carotenoids (PVACs), iron and zinc-rich complementary food (CF), common bean pumpkin blend (BPB) formulated from pumpkin (Sweet cream) and common bean (Obwelu) and PVAC-rich pumpkin blend (PB) from Sweet cream were prepared by expert peer mothers. This study compared child acceptability of BPB and PB (control).

Methods

The crossover acceptability study randomly assigned Ugandan children 6 to 24 months old to either receive 100 g of BPB (n = 35) or 100 g of PB (n = 35) on day one. After a washout period of one day, children crossed over to receive either BPB (n = 35) or PB (n = 35). The amount of CF consumed, duration of consumption, and micronutrient intake were assessed. The CF was acceptable if children consumed ≥50 g (50%) of served food (100 g). A paired t-test was used to determine the mean differences within participants between BPB and PB. The level of statistical significant difference was set at a probability value of 5% (p = 0.05).

Results

The mean consumption of BPB and PB was 53.9 g and 54.4 g, respectively. The mean duration for consumption of BPB and PB was 20.6 and 20.3 min, respectively. There was no significant difference in the amounts consumed, and duration of consumption in BPB and PB (p > 0.05). The mean intake of vitamin A was significantly higher (p < 0.00001) in PB (152.5 μgRAE) compared to BPB (100.9 μgRAE). The mean iron intake was significantly higher in BPB (1.1 mg) (p < 0.00001) compared to PB (0.3 mg). Furthermore, zinc intake was significantly higher (p < 0.00001) in BPB (0.58 mg) compared to PB (0.13 mg).

Conclusion

A homemade complementary food, BPB, made from locally available common bean and pumpkin is rich in PVACs, iron and zinc and is acceptable to children in the age range of complementary feeding in Uganda.

Trial registration

Pan African Clinical Trials Registry www.pactr.org as PACTR202002576768667.

Retrospectively registered.

Date of registration: 29/January/2020.
Muscular involvement and tendon contracture in limb-girdle muscular dystrophy 2Y: a mild adult phenotype and literature review
Authors: Feng Xuelin , Wu Jinlang , Xian Wenbiao , Liao Bing , Liao Songjie , Yao Xiaoli , Zhang Weixi
Published: September 2020

Background

Limb girdle muscular dystrophy type 2Y (LGMD2Y) is a rare subgroup of limb girdle muscular dystrophy featuring limb-girdle weakness, tendon contracture and cardiac involvement. It is caused by the mutation of TOR1AIP1, which encodes nuclear membrane protein LAP1 (lamina-associated polypeptide 1) and comprises heterogeneous phenotypes. The present study reported a patient with a novel homozygous TOR1AIP1 mutation that presented with selective muscle weakness, which further expanded the phenotype of LGMD2Y- and TOR1AIP1-associated nuclear envelopathies.

Case presentation

A 40-year-old male presented with Achilles tendon contracture and muscle weakness that bothered him from 8 years old. While the strength of his distal and proximal upper limbs was severely impaired, the function of his lower limbs was relatively spared. Muscle pathology showed dystrophic features, and electron microscopy showed ultrastructural abnormalities of disrupted muscle nuclei envelopes. Whole-exome sequencing showed a frameshift mutation in TOR1AIP1 (c.98dupC).

Conclusion

We reported a novel mild phenotype of LGMD2Y with relatively selective distal upper limb weakness and joint contracture and revealed the heterogeneity of LGDM2Y and the role of the LAP1 isoform by literature review.
Implementing clinical ethics committees as a complex intervention: presentation of a feasibility study in community care
Authors: Magelssen Morten , Karlsen Heidi , Pedersen Reidar , Thoresen Lisbeth
Published: September 2020

Background

How should clinical ethics support services such as clinical ethics committees (CECs) be implemented and evaluated? We argue that both the CEC itself and theimplementationof the CEC should be considered as ‘complex interventions’.

Main text

We present a research project involving the implementation of CECs in community care in four Norwegian municipalities. We show that when both the CEC and its implementation are considered as complex interventions, important consequences follow – both for implementation and the study thereof. Emphasizing four such sets of consequences, we argue, first, that the complexity of the intervention necessitates small-scale testing before larger-scale implementation and testing is attempted; second, that it is necessary to theorize the intervention in sufficient depth; third, that the identification of casual connections charted in so-called logic models allows the identification of factors that are vital for the intervention to succeed and which must therefore be studied; fourth, that an important part of a feasibility study must be to identify and chart as many as possible of the causally important contextual factors.

Conclusion

The conceptualization of the implementation of a CEC as a complex intervention shapes the intervention and the way evaluation research should be performed, in several significant ways. We recommend that researchers consider whether a complex intervention approach is called for when studying CESS implementation and impact.
Ethics parallel research: an approach for (early) ethical guidance of biomedical innovation
Authors: Jongsma Karin R. , Bredenoord Annelien L.
Published: September 2020

Background

Our human societies and certainly also (bio) medicine are more and more permeated with technology. There seems to be an increasing awareness among bioethicists that an effective and comprehensive approach to ethically guide these emerging biomedical innovations into society is needed. Such an approach has not been spelled out yet for bioethics, while there are frequent calls for ethical guidance of biomedical innovation, also by biomedical researchers themselves. New and emerging biotechnologies require anticipation of possible effects and implications, meaning the scope is not evaluative after a technology has been fully developed or about hypothetical technologies, but real-time for a real biotechnology.

Main text

In this paper we aim to substantiate and discuss six ingredients that we increasingly see adopted by ethicists and that together constitute “ethics parallel research”. This approach allows to fulfil two aims: guiding the development process of technologies in biomedicine and providing input for the normative evaluation of such technologies. The six ingredients of ethics parallel research are: (1) disentangling wicked problems, (2) upstream or midstream ethical analysis, (3) ethics from within, (4) inclusion of empirical research, (5) public participation and (6) mapping societal impacts, including hard and soft impacts. We will draw on gene editing, organoid technology and artificial intelligence as examples to illustrate these six ingredients.

Conclusion

Ethics parallel research brings together these ingredients to ethically analyse and proactively or parallel guide technological development. It widens the roles and judgements from the ethicist to a more anticipatory and constructively guiding role. Ethics parallel research is characterised by a constructive, rather than a purely critical perspective, it focusses on developing best-practices rather than outlining worst practice, and draws on insights from social sciences and philosophy of technology.
How can technology support quality improvement? Lessons learned from the adoption of an analytics tool for advanced performance measurement in a hospital unit
Authors: Tolf Sara , Mesterton Johan , Söderberg Daniel , Amer-Wåhlin Isis , Mazzocato Pamela
Published: September 2020

Background

Technology for timely feedback of data has the potential to support quality improvement (QI) in health care. However, such technology may pose difficulties stemming from the complex interaction with the setting in which it is implemented. To enable professionals to use data in QI there is a need to better understand of how to handle this complexity. This study aims to explore factors that influence the adoption of a technology-supported QI programme in an obstetric unit through a complexity informed framework.

Methods

This qualitative study, based on focus group interviews, was conducted at a Swedish university hospital’s obstetric unit, which used an analytics tool for advanced performance measurement that gave timely and case mix adjusted feedback of performance data to support QI. Data was collected through three focus group interviews conducted with 16 managers and staff. The Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework guided the data collection and analysis.

Results

Staff and managers deemed the technology to effectively support ongoing QI efforts by providing timely access to reliable data. The value of the technology was associated with a clear need to make better use of existing data in QI. The data and the methodology in the analytics tool reflected the complexity of the clinical conditions treated but was presented through an interface that was easy to access and user friendly. However, prior understanding of statistics was helpful to be able to fully grasp the presented data. The tool was adapted to the needs and the organizational conditions of the local setting through a collaborative approach between the technology supplier and the adopters.

Conclusions

Technology has the potential to enable systematic QI through motivating professionals by providing timely and adequate feedback of performance. The adoption of such technology is complex and requires openness for gradual learning and improvement.
Severe nausea and vomiting in pregnancy: psychiatric and cognitive problems and brain structure in children
Authors: Wang Hui , Rolls Edmund T. , Du Xiujuan , Du Jingnan , Yang Dexin , Li Jiong , Li Fei , Cheng Wei , Feng Jianfeng
Published: September 2020

Background

Two studies have suggested that severe prolonged nausea and vomiting during pregnancy is associated with emotional and behavioral problems in offspring, with smaller sample size and short-term follow-up. Moreover, little information is available on the role of the brain structure in the associations.

Methods

In a US-based cohort, the association was investigated between severe prolonged nausea and vomiting in pregnancy (extending after the second trimester and termed SNVP), psychiatric and cognitive problems, and brain morphology, from the Adolescent Brain Cognitive Development (ABCD) study, from 10,710 children aged 9–11 years. We validated the emotional including psychiatric findings using the Danish National Cohort Study with 2,092,897 participants.

Results

SNVP was significantly associated with emotional and psychiatric problems (t = 8.89, Cohen’s d = 0.172, p = 6.9 × 10−19) and reduced global cognitive performance (t = − 4.34, d = − 0.085, p = 1.4 × 10−5) in children. SNVP was associated with low cortical area and volume, especially in the cingulate cortex, precuneus, and superior medial prefrontal cortex. These lower cortical areas and volumes significantly mediated the relation between SNVP and the psychiatric and cognitive problems in children. In the Danish National Cohort, severe nausea and vomiting in pregnancy were significantly associated with increased risks of behavioral and emotional disorders in children (hazard ratio, 1.24; 95% confidence interval, 1.16–1.33).

Conclusions

SNVP is strongly associated with psychiatric and cognitive problems in children, with mediation by brain structure. These associations highlight the clinical importance and potential benefits of the treatment of SNVP, which could reduce the risk of psychiatric disorder in the next generation.
Gut microbial characteristics of adult patients with allergy rhinitis
Authors: Zhu Libing , Xu Feng , Wan Wenrong , Yu Bin , Tang Lin , Yang Yimin , Du Yanling , Chen Zhangran , Xu Hongzhi
Published: September 2020

Background

Although recent studies have indicated that intestinal microbiota dweller are involved in the pathogenesis of allergy rhinitis (AR), the influence of gut microbiota on AR adult has not been fully elucidated yet. Hence, we carried out this study to uncover the distinctive bacterial taxa that differentiate allergy rhinitis patients from healthy individuals. Feces samples from thirty three AR patients and thirty one healthy individuals were analyzed by 16S rRNA gene sequencing.

Results

Results showed that the bacterial diversity in AR group was significantly higher than that of the non-AR group. Bacterial communities between AR and non-AR group were significantly differentiated as revealed by Principal coordinates analysis (PCoA) and the variation within non-AR were higher than that of the counterpart. Firmicutes, Fusobacteria, Actinobacteria, Cyanobacteria and Chloroflexi were the significantly differed phyla taxa and the top significantly distinguished bacterial genus included Prevotella_9, Phascolarctobacterium, Roseburia, Megamonas, Alistipes, Lachnoclostridium and Fusobacterium. The higher network complexity in AR group were dominated by taxa belonging to Firmicutes. The predicted function, alpha linolenic acid metabolism and bacterial invasion of epithelial cells pathway were higher in non-AR group while gonadotropin-releasing hormone (GnRH) signaling pathway, Fc γ-R mediated phagocytosis and endocytosis were higher in AR patients. Although the bacterial diversity between moderate and severe AR patients showed no significant difference, the significant correlation between featured genus and total nasal symptom score or rhinoconjunctivitis quality of life questionnaire, such as Butyricicoccus and Eisenbergiella, revealed the potential to intervene the AR status by means of gut microbiota.

Conclusions

In conclusion, patients with allergy rhinitis had distinguished gut microbiota characteritics in comparison with healthy controls. The results suggest that gut microbiota might play crucial roles in influencing the course and different symptoms of AR.

Trial registration ChiCTR, ChiCTR1900028613. Registered 29 December 2019, https://www.chictr.org.cn/showproj.aspx?proj=47650.
Identification of circular RNA hsa_circ_0044556 and its effect on the progression of colorectal cancer
Authors: Jing Liang , Wu Junhui , Tang Xiaocheng , Ma Min , Long Fei , Tian Buning , Lin Changwei
Published: September 2020

Background

Circular RNAs (circRNAs) are a novel class of noncoding RNAs. Increasing evidence indicates that circRNAs play an important role in the occurrence and development of tumors. However, the role of circRNA hsa_circ_0044556 in the progression of colorectal cancer (CRC) remains unclear.

Methods

First, we searched for differentially expressed circRNAs using a circRNA microarray in paired CRC and adjacent normal tissues. The circRNA hsa_circ_0044556 was screened out from the existing CRC circRNA microarray in the Gene Expression Omnibus database and our microarray. The clinical significance of hsa_circ_0044556 expression level in CRC patients was then investigated. Finally, the functions of the targets of this circRNA were determined in CRC cell lines.

Results

Hsa_circ_0044556 was highly expressed in CRC patients and was positively correlated with tumor stage and lymph node metastasis. In CRC cell lines, the proliferation, migration, and invasion of cancer cells were inhibited by knocking down hsa_circ_0044556 expression.

Conclusion

Hsa_circ_0044556 promoted the progression of CRC. It is possible that hsa_circ_0044556 will become a novel biomarker or therapeutic target for CRC.
Validation of Igbo version of the modified falls efficacy scale among community-dwelling older adults: a validation study
Authors: Okoye Emmanuel Chiebuka , Akosile Christopher Olusanjo , Maruf Fatai Adesina , Onwuakagba Ifeoma Uchenna , Urama Sunday Tobias
Published: September 2020

Background

Fear of falling (FOF) is a very pervasive problem among older adults. Consequently, many scales have been developed for its assessment. The Modified Falls Efficacy Scale (MFES) is one of the most popular FOF scales. The MFES was originally developed for use in developed countries, and thus may not be entirely suitable for use in developing countries due to cultural and environmental differences between the two country categories. This study was therefore designed to cross-culturally adapt and validate the MFES to Igbo culture and environment among community-dwelling older adults in Nnewi community using established guidelines.

Methods

The original English version of the MFES (E-MFES) was translated, synthesized, back-translated, subjected to expert panel review, and pretested before producing the final Igbo version of the MFES (I-MFES). The I-MFES and the Short Falls Efficacy Scale International were randomly administered to consecutively recruited 109 consenting older adult residents of Nnewi (43.1% males; mean age = 74.45 ± 8.78 years). Convergent and structural validities and internal consistency of the I-MFES were assessed at 0.05 level of significance.

Results

All the 14 items on the E-MFES were retained on the I-MFES. The I-MFES exhibited the same structure as the E-MFES. The correlation between the total scores on the I-MFES and the Short Falls Efficacy Scale International was excellent (rho = − 0.93) indicating evidence of convergent validity of the I-MFES. The Cronbach’s alpha value of the I-MFES was 0.97 showing evidence of excellent internal consistency of the items on the I-MFES.

Conclusion

This study provides evidence of some aspects of validity and reliability of the I-MFES.
Infant feeding knowledge and practice vary by maternal HIV status: a nested cohort study in rural South Africa
Authors: Yapa H. Manisha , Drayne Róisín , Klein Nigel , De Neve Jan-Walter , Petoumenos Kathy , Jiamsakul Awachana , Herbst Carina , Pillay Deenan , Post Frank A. , Bärnighausen Till
Published: September 2020

Background

We investigate whether correct infant feeding knowledge and practice differ by maternal HIV status in an era of evolving clinical guidelines in rural South Africa.

Methods

This cohort study was nested within the MONARCH stepped-wedge cluster-randomised controlled trial (www.clinicaltrials.gov: NCT02626351) which tested the impact of continuous quality improvement on antenatal care quality at seven primary care clinics in KwaZulu-Natal, from July 2015 to January 2017. Women aged ≥18 years at delivery were followed up to 6 weeks postpartum. Clinical data were sourced from routine medical records at delivery. Structured interviews at early postnatal visits and the 6-week postnatal immunisation visit provided data on infant feeding knowledge and feeding practices respectively. We measured the relationship between maternal HIV status and (i) correct infant feeding knowledge at the early postnatal visit; and (ii) infant feeding practice at 6 weeks, using Poisson and multinomial regression models, respectively.

Results

We analysed data from 1693 women with early postnatal and 471 with 6-week postnatal interviews. HIV prevalence was 47% (95% confidence interval [CI] 42, 52%). Women living with HIV were more knowledgeable than women not living with HIV on correct infant feeding recommendations (adjusted risk ratio, aRR, 1.08, p <  0.001). More women living with HIV (33%; 95% CI 26, 41%) were not breastfeeding than women not living with HIV (15%; 95% CI 11, 21%). However, among women who were currently breastfeeding their infants, fewer women living with HIV (5%; 95% CI 2, 9%) mixed fed their babies than women not living with HIV (21%; 95% CI 14, 32%). In adjusted analyses, women living with HIV were more likely to avoid breastfeeding (adjusted relative risk ratio, aRRR, 2.78, p <  0.001) and less likely to mixed feed (aRRR 0.22, p <  0.001) than women not living with HIV.

Conclusions

Many mothers in rural South Africa still do not practice exclusive breastfeeding. Women living with HIV were more knowledgeable but had lower overall uptake of breastfeeding, compared with women not living with HIV. Women living with HIV were also more likely to practice exclusive breastfeeding over mixed feeding if currently breastfeeding. Improved approaches are needed to increase awareness of correct infant feeding and exclusive breastfeeding uptake.
Evaluation of small bowel motion and feasibility of using the peritoneal space to replace bowel loops for dose constraints during intensity-modulated radiotherapy for rectal cancer
Authors: Li Siyuan , Gong Yanping , Yang Yongqiang , Guo Qi , Qian Jianjun , Tian Ye
Published: September 2020

Background

The goal of this study was to assess small bowel motion and explore the feasibility of using peritoneal space (PS) to replace bowel loops (BL) via the dose constraint method to spare the small bowel during intensity-modulated radiotherapy (IMRT) for rectal cancer.

Methods

A total of 24 patients with rectal cancer who underwent adjuvant or neoadjuvant radiotherapy were selected. Weekly repeat CT scans from pre-treatment to the fourth week of treatment were acquired and defined as Plan, 1 W, 2 W, 3 W, and 4 W. The 4 weekly CT scans were co-registered to the Plan CT, BL and PS contours were delineated in all of the scans, an IMRT plan was designed on Plan CT using PS constraint method, and then copied to the 4 weekly CT scans. The dose-volume, normal tissue complication probability (NTCP) of the small bowel and their variations during treatment were evaluated.

Results

Overall, 109 sets of CT scans from 24 patients were acquired, and 109 plans were designed and copied. The BL and PS volumes were 250.3 cc and 1339.3 cc. The V15 of BL and PS based plan of pre-treatment were 182.6 cc and 919.0 cc, the shift% of them were 28.9 and 11.3% during treatment (p = 0.000), which was less in the prone position than in the supine position (25.2% vs 32.1%, p = 0.000; 9.9% vs 14.9%, p = 0.000). The NTCPC and NTCPA based plan of pre-treatment were 2.0 and 59.2%, the shift% during treatment were 46.1 and 14.0% respectively. Majority of BL’s Dmax and V15 were meet the safety standard during treatment using PS dose limit method except 3 times (3/109) of V15 and 5 times of Dmax (5/109).

Conclusions

This study indicated that small bowel motion may lead to uncertainties in its dose volume and NTCP evaluation during IMRT for rectal cancer. The BL movements were significantly greater than PS, and the prone position was significantly less than the supine position. It is feasibility of using PS to replace BL to spare the small bowel, V15 < 830 cc is the dose constraint standard.
Analysis of key genes and pathways associated with the pathogenesis of intervertebral disc degeneration
Authors: Hu Shiyu , Fu Yucheng , Yan Bin , Shen Zhe , Lan Tao
Published: September 2020

Background

Intervertebral disc degeneration (IDD) is widely known as the main contributor to low back pain which has a negative socioeconomic impact worldwide. However, the underlying mechanism remains unclear. This study aims to analyze the dataset GSE23130 using bioinformatics methods to identify the pivotal genes and pathways associated with IDD.

Material/methods

The gene expression data of GSE23130 was downloaded, and differentially expressed genes (DEGs) were extracted from 8 samples and 15 controls. GO and KEGG pathway enrichment analyses were performed. Also, protein–protein interaction (PPI) network was constructed and visualized, followed by identification of hub genes and key module.

Results

A total of 30 downregulated and 79 upregulated genes were identified. The DEGs were mainly enriched in the regulation of protein catabolic process, extracellular matrix organization, collagen fibril organization, and extracellular structure organization. Meanwhile, we found that most DEGs were primarily enriched in the PI3K-Akt signaling pathway. The top 10 hub genes were FN1, COL1A2, SPARC, COL3A1, CTGF, LUM, TIMP1, THBS2, COL5A2, and TGFB1.

Conclusions

In summary, key candidate genes and pathways were identified by using integrated bioinformatics analysis, which may provide insights into the underlying mechanisms and offer potential target genes for the treatment of IDD.
Valgus knee bracing may have no long-term effect on pain improvement and functional activity in patients with knee osteoarthritis: a meta-analysis of randomized trials
Authors: Fan Yinuo , Li Zhongfeng , Zhang Haitao , Hong Guoju , Wu Zhongshu , Li Weifeng , Chen Lixin , Wu Yunlong , Wei Qiushi , He Wei , Chen Zhenqiu
Published: September 2020

Background

Knee osteoarthritis (KOA), with a high incidence in old-age population, adversely affects their life quality. The valgus knee bracing is an important physical therapy for KOA, but its clinical effects on pain release and functional improvement remained unclear. This meta-analysis is to systematically evaluate the clinical outcomes of valgus knee bracing in patients with KOA.

Methods

A meta-analysis of clinical randomized controlled trials (RCTs) on pain and functional changes in patients with KOA after using valgus knee braces. The search period was ranged from the inception of the database to May 2020. The enrolled research databases included PubMed, Embase, and Web of Science databases. Two investigators independently formulated inclusion criteria and exclusion criteria and screened and determined the final enrolled literature. Then the outcome indicators were extracted and organized from the included literature, and the risk of bias was assessed by Cochrane Handbook 5.0.1.

Results

A total of 10 articles were included in this study, including 739 patients. Eight articles were related to the visual analog scale (VAS) pain score, and the results showed that RR = − 0.29, 95% CI − 0.73, 0.15], P = 0.20; four articles were related to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score, and the results showed that RR = − 0.15, 95% CI [− 0.41, 0.11], P = 0.26; two articles were related to the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the results showed that RR = 0.58, 95% CI [− 4.25, 5.42], P = 0.81; and three articles were related to the KOOS Activities of Daily Living (KOOS-ADL), and the results showed that RR = 0.04, 95% CI [− 0.62, 0.69], P = 0.91. These results indicated that the valgus knee bracing has no statistical significance in pain and functional activity improvement of patients with KOA. The subgroup analysis showed that the follow-up time was the source of the heterogeneity of the VAS pain score.

Conclusion

Our current evidence suggests that valgus knee bracing may not improve pain release and function activates in KOA patients in the long-term period, but only being beneficial to the short-term rehabilitation.
“To die is better for me”, social suffering among Syrian refugees at a noncommunicable disease clinic in Jordan: a qualitative study
Authors: Maconick Lucy , Ansbro Éimhín , Ellithy Sara , Jobanputra Kiran , Tarawneh Mohammad , Roberts Bayard
Published: September 2020

Background

The conflict in Syria has required humanitarian agencies to implement primary-level services for non-communicable diseases (NCDs) in Jordan, given the high NCD burden amongst Syrian refugees; and to integrate mental health and psychosocial support into NCD services given their comorbidity and treatment interactions. However, no studies have explored the mental health needs of Syrian NCD patients. This paper aims to examine the interaction between physical and mental health of patients with NCDs at a Médecins Sans Frontières (MSF) clinic in Irbid, Jordan, in the context of social suffering.

Methods

This qualitative study involved sixteen semi-structured interviews with Syrian refugee and Jordanian patients and two focus groups with Syrian refugees attending MSF’s NCD services in Irbid, and eighteen semi-structured interviews with MSF clinical, managerial and administrative staff. These were conducted by research staff in August 2017 in Irbid, Amman and via Skype. Thematic analysis was used.

Results

Respondents describe immense suffering and clearly perceived the interconnectedness of their physical wellbeing, mental health and social circumstances, in keeping with Kleinman’s theory of social suffering. There was a ‘disconnect’ between staff and patients’ perceptions of the potential role of the NCD and mental health service in alleviating this suffering. Possible explanations identified included respondent’s low expectations of the ability of the service to impact on the root causes of their suffering, normalisation of distress, the prevailing biomedical view of mental ill-health among national clinicians and patients, and humanitarian actors’ own cultural standpoints.

Conclusion

Syrian and Jordanian NCD patients recognise the psychological dimensions of their illness but may not utilize clinic-based humanitarian mental health and psychosocial support services. Humanitarian agencies must engage with NCD patients to elicit their needs and design culturally relevant services.
pipeComp, a general framework for the evaluation of computational pipelines, reveals performant single cell RNA-seq preprocessing tools
Authors: Germain Pierre-Luc , Sonrel Anthony , Robinson Mark D.
Published: September 2020

We present pipeComp (https://github.com/plger/pipeComp), a flexible R framework for pipeline comparison handling interactions between analysis steps and relying on multi-level evaluation metrics. We apply it to the benchmark of single-cell RNA-sequencing analysis pipelines using simulated and real datasets with known cell identities, covering common methods of filtering, doublet detection, normalization, feature selection, denoising, dimensionality reduction, and clustering. pipeComp can easily integrate any other step, tool, or evaluation metric, allowing extensible benchmarks and easy applications to other fields, as we demonstrate through a study of the impact of removal of unwanted variation on differential expression analysis.
A novel antiviral lncRNA, EDAL, shields a T309 O-GlcNAcylation site to promote EZH2 lysosomal degradation
Authors: Sui Baokun , Chen Dong , Liu Wei , Wu Qiong , Tian Bin , Li Yingying , Hou Jing , Liu Shiyong , Xie Juan , Jiang Hao , Luo Zhaochen , Lv Lei , Huang Fei , Li Ruiming , Zhang Chengguang , Tian Yuling , Cui Min , Zhou Ming , Chen Huanchun , Fu Zhen F. , Zhang Yi , Zhao Ling
Published: September 2020

Background

The central nervous system (CNS) is vulnerable to viral infection, yet few host factors in the CNS are known to defend against invasion by neurotropic viruses. Long noncoding RNAs (lncRNAs) have been revealed to play critical roles in a wide variety of biological processes and are highly abundant in the mammalian brain, but their roles in defending against invasion of pathogens into the CNS remain unclear.

Results

We report here that multiple neurotropic viruses, including rabies virus, vesicular stomatitis virus, Semliki Forest virus, and herpes simplex virus 1, elicit the neuronal expression of a host-encoded lncRNA EDAL. EDAL inhibits the replication of these neurotropic viruses in neuronal cells and rabies virus infection in mouse brains. EDAL binds to the conserved histone methyltransferase enhancer of zest homolog 2 (EZH2) and specifically causes EZH2 degradation via lysosomes, reducing the cellular H3K27me3 level. The antiviral function of EDAL resides in a 56-nt antiviral substructure through which its 18-nt helix-loop intimately contacts multiple EZH2 sites surrounding T309, a known O-GlcNAcylation site. EDAL positively regulates the transcription of Pcp4l1 encoding a 10-kDa peptide, which inhibits the replication of multiple neurotropic viruses.

Conclusions

Our findings show that a neuronal lncRNA can exert an effective antiviral function via blocking a specific O-GlcNAcylation that determines EZH2 lysosomal degradation, rather than the traditional interferon-dependent pathway.
Nutritional support for lactating women with or without azithromycin for infants compared to breastfeeding counseling alone in improving the 6-month growth outcomes among infants of peri-urban slums in Karachi, Pakistan—the protocol for a multiarm assessor-blinded randomized controlled trial (Mumta LW trial)
Authors: Muhammad Ameer , Shafiq Yasir , Nisar Muhammad Imran , Baloch Benazir , Yazdani Amna Tanweer , Yazdani Nida , Jehan Fyezah
Published: September 2020

Background

Globally, 45% of under-five deaths are either directly or indirectly attributable to malnutrition, and most of these deaths are in low- and middle-income countries (LMICs). Children are particularly vulnerable in the first 6 months of life. An estimated 4.7 million infants under the age of 6 months are moderately wasted, whereas 3.8 million are severely wasted. Although the children of malnourished women have an increased risk of stunting and wasting, there is little information on this issue.

Methods

This is a community-based, open-label, multiarm randomized controlled trial that will include parallel group assignments with a 1:1:1 allocation ratio in low-income squatter settlements in urban Karachi, Pakistan. The women in the control group (control arm) will receive standard counseling only, whereas the lactating women in the first intervention group (intervention arm 1) will receive two sachets of balanced energy protein (BEP) supplementation per day from enrollment until the infant reaches 6 months of age. The lactating women in the second intervention group (intervention arm 2) will receive the same BEP supplementation as those in intervention arm 1 while their babies will also receive a single stat dose (20 mg/kg orally) of azithromycin at 42 days. The primary outcome will be the relative length velocity from 0 to 6 months by intervention arm. The primary analysis will be intention-to-treat analysis.

Trial registration

ClinicalTrials.gov NCT03564652. Registered on 21 June 2018
National mapping of soil-transmitted helminth and schistosome infections in Ethiopia
Authors: Leta Gemechu Tadesse , Mekete Kalkidan , Wuletaw Yonas , Gebretsadik Abeba , Sime Heven , Mekasha Sindew , Woyessa Adugna , Shafi Oumer , Vercruysse Jozef , Grimes Jack E. T. , Gardiner Iain , French Michael , Levecke Bruno , Drake Lesley , Harrison Wendy , Fenwick Alan
Published: September 2020

Background

An accurate understanding of the geographical distributions of both soil-transmitted helminths (STHs; Ascaris lumbricoides, Trichuris trichiura, and the hookworms Necator americanus and Ancylostoma duodenale) and schistosomes (SCH; Schistosoma mansoni and S. haematobium) is pivotal to be able to effectively design and implement mass drug administration (MDA) programmes. The objective of this study was to provide up-to-date data on the distribution of both STH and SCH in Ethiopia to inform the design of the national control program and to be able to efficiently achieve the 75% MDA coverage target set by the WHO.

Methods

Between 2013 and 2015, we assessed the distributions of STH and SCH infections in a nationwide survey covering 153,238 school-aged children (aged 5–15 years), from 625 woredas (districts), representing all nine Regional States and two City Administrations of Ethiopia. Nationwide disease maps were developed at the woreda level to enable recommendations on the design of the national MDA programme.

Results

The prevalence of any STH infection across the study population was 21.7%, with A. lumbricoides (12.8%) being the most prevalent STH, followed by hookworms (7.6%) and T. trichiura (5.9%). The prevalence for any SCH was 4.0% in areas where both SCH species were evaluated. Schistosoma mansoni was the most prevalent SCH (3.5 vs 0.3%). STHs were more prevalent in southwest Ethiopia, whereas SCH was found mostly in the west and northeast of the country. The prevalence of moderate-to-heavy intensity infections was 2.0% for STHs and 1.6% for SCH. For STH, a total of 251 woredas were classified as moderately (n = 178) or highly endemic (n = 73), and therefore qualify for an annual and biannual MDA program, respectively. For SCH, 67 woredas were classified as endemic and 8 as highly endemic, and hence they require every two years and annual MDA programme, respectively.

Conclusions

The results confirm that Ethiopia is endemic for both STHs and SCH, posing a significant public health problem. Following the WHO recommendations on mass drug administration, 18 and 14 million school-aged children are in need of MDA for STHs and SCH, respectively, based on the number of SACs that live on the eligible geographical areas.
Agreement between nonculprit stenosis follow-up iFR and FFR after STEMI (iSTEMI substudy)
Authors: Thim Troels , Götberg Matthias , Fröbert Ole , Nijveldt Robin , van Royen Niels , Baptista Sergio Bravo , Koul Sasha , Kellerth Thomas , Bøtker Hans Erik , Terkelsen Christian Juhl , Christiansen Evald Høj , Jakobsen Lars , Kristensen Steen Dalby , Maeng Michael
Published: September 2020

Objective

To evaluate agreement between instantaneous wave free ratio (iFR) and fractional flow reserve (FFR) for the functional assessment of nonculprit coronary stenoses at staged follow-up after ST-segment elevation myocardial infarction (STEMI).

Results

We measured iFR and FFR at staged follow-up in 112 STEMI patients with 146 nonculprit stenoses. Median interval between STEMI and follow-up was 16 (interquartile range 5–32) days. Agreement between iFR and FFR was 77% < 5 days after STEMI and 86% after ≥ 5 days (p = 0.19). Among cases with disagreement, the proportion of cases with hemodynamically significant iFR and non-significant FFR were different when assessed < 5 days (5 in 8, 63%) versus ≥ 5 days (3 in 15, 20%) after STEMI (p = 0.04). Overall classification agreement between iFR and FFR was comparable to that observed in stable patients. Time interval between STEMI and follow-up evaluation may impact agreement between iFR and FFR.
GWAS-identified genetic variants associated with medication-assisted treatment outcomes in patients with opioid use disorder: a systematic review and meta-analysis protocol
Authors: Chawar Caroul , Hillmer Alannah , Sanger Stephanie , D’Elia Alessia , Panesar Balpreet , Guan Lucy , Xie Dave Xiaofei , Bansal Nandini , Abdullah Aamna , Kapczinski Flavio , Pare Guillaume , Thabane Lehana , Samaan Zainab
Published: September 2020

Background

The burden of opioid use disorder (OUD) has been increasing in North America. Administration of medication-assisted treatments (MATs) for OUD on an individual-dose basis has been shown to affect patient responses to treatment, proving to be, on occasion, dangerous. A genetic basis has been identified for some MAT responses in a candidate gene context, but consensus has not been reached for any genome-wide significant associations. This systematic review aims to identify and assess any genetic variants associated with MAT patient outcomes at genome-wide significance.

Methods

The databases searched by the authors will be: MEDLINE, Web of Science, EMBASE, CINAHL and Pre-CINAHL, GWAS Catalog, GWAS Central, and NIH Database of Genotypes and Phenotypes. A title and abstract screening, full-text screening, data extraction, and quality assessment will be completed in duplicate for each study via Covidence. Treatment outcomes of interest include continued opioid use or abstinence during treatment or at follow-up, time to relapse, treatment retention rates, opioid overdose, other substance use, comorbid psychiatric disorders, risk taking behaviors, MAT plasma concentrations, and mortality rates. Analysis methods applied, if appropriate, will include random effects meta-analysis with pooled odds ratios for all outcomes. Subgroup analyses will also be implemented, when possible.

Discussion

This systematic review can hopefully inform the direction of future research, aiding in the development of a safer and more patient-centered treatment. It will be able to highlight genome-wide significant variants that are replicable and associated with MAT patient outcomes.

Systematic review registration

This systematic review protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) (registration ID CRD42020169121).
Blow-up analysis for parabolic p-Laplacian equations with a gradient source term
Authors: Ding Juntang
Published: September 2020

In this work, we deal with the blow-up solutions of the following parabolic p-Laplacian equations with a gradient source term: $$ \textstyle\begin{cases} (b(u) )_{t} =\nabla \cdot ( \vert \nabla u \vert ^{p-2}\nabla u )+f(x,u, \vert \nabla u \vert ^{2},t) &\text{in } \varOmega \times (0,t^{*}), \\ \frac{\partial u}{\partial n}=0 &\text{on } \partial \varOmega \times (0,t^{*}),\\ u(x,0)=u_{0}(x)\geq 0 & \text{in } \overline{\varOmega }, \end{cases} $$

{

(
b
(
u
)
)

t

=
∇
⋅
(
|
∇
u

|

p
−
2

∇
u
)
+
f
(
x
,
u
,
|
∇
u

|
2

,
t
)

in 
Ω
×
(
0
,

t
∗

)
,

∂
u

∂
n

=
0

on 
∂
Ω
×
(
0
,

t
∗

)
,

u
(
x
,
0
)
=

u
0

(
x
)
≥
0

in 

Ω
‾

,

where $p>2$
p
>
2
, the spatial domain $\varOmega \subset \mathbb{R}^{N}$
Ω
⊂

R
N

($N\geq 2$
N
≥
2
) is bounded, and the boundary ∂Ω is smooth. Our research relies on the creation of some suitable auxiliary functions and the use of the differential inequality techniques and parabolic maximum principles. We give sufficient conditions to ensure that the solution blows up at a finite time $t^{*}$

t
∗

. The upper bounds of the blow-up time $t^{*}$

t
∗

and the upper estimates of the blow-up rate are also obtained.
On locally superquadratic Hamiltonian systems with periodic potential
Authors: Ye Yiwei
Published: September 2020

In this paper, we study the second-order Hamiltonian systems $$ \ddot{u}-L(t)u+\nabla W(t,u)=0, $$

u
¨

−
L
(
t
)
u
+
∇
W
(
t
,
u
)
=
0
,
where $t\in \mathbb{R}$
t
∈
R
, $u\in \mathbb{R}^{N}$
u
∈

R
N

, L and W depend periodically on t, 0 lies in a spectral gap of the operator $-d^{2}/dt^{2}+L(t)$
−

d
2

/
d

t
2

+
L
(
t
)
and $W(t,x)$
W
(
t
,
x
)
is locally superquadratic. Replacing the common superquadratic condition that $\lim_{|x|\rightarrow \infty }\frac{W(t,x)}{|x|^{2}}=+\infty $

lim

|
x
|
→
∞

W
(
t
,
x
)

|
x
|

2

=
+
∞
uniformly in $t\in \mathbb{R}$
t
∈
R
by the local condition that $\lim_{|x|\rightarrow \infty }\frac{W(t,x)}{|x|^{2}}=+\infty $

lim

|
x
|
→
∞

W
(
t
,
x
)

|
x
|

2

=
+
∞
a.e. $t\in J$
t
∈
J
for some open interval $J\subset \mathbb{R}$
J
⊂
R
, we prove the existence of one nontrivial homoclinic soluiton for the above problem.
The relationships of vitamin D, vitamin D receptor gene polymorphisms, and vitamin D supplementation with Parkinson’s disease
Authors: Lv Lingling , Tan Xuling , Peng Xinke , Bai Rongrong , Xiao Qile , Zou Ting , Tan Jieqiong , Zhang Hainan , Wang Chunyu
Published: September 2020

In recent years, many studies have investigated the correlations between Parkinson’s disease (PD) and vitamin D status, but the conclusion remains elusive. The present review focuses on the associations between PD and serum vitamin D levels by reviewing studies on the associations of PD with serum vitamin D levels and vitamin D receptor (VDR) gene polymorphisms from PubMed, Web of Science, Cochrane Library, and Embase databases. We found that PD patients have lower vitamin D levels than healthy controls and that the vitamin D concentrations are negatively correlated with PD risk and severity. Furthermore, higher vitamin D concentrations are linked to better cognitive function and mood in PD patients. Findings on the relationship between VDR gene polymorphisms and the risk of PD are inconsistent, but the FokI (C/T) polymorphism is significantly linked with PD. The occurrence of FokI (C/T) gene polymorphism may influence the risk, severity, and cognitive ability of PD patients, while also possibly influencing the effect of Vitamin D3 supplementation in PD patients. In view of the neuroprotective effects of vitamin D and the close association between vitamin D and dopaminergic neurotransmission, interventional prospective studies on vitamin D supplementation in PD patients should be conducted in the future.
Mindset, Motivation, and Teaching Practice: Psychology Applied to Understanding Teaching and Learning in STEM Disciplines
Authors: Richardson Deborah South , Bledsoe Robert S. , Cortez Zaraly
Published: September 2020

This article reports a study of the relationships among instructor mindset, attitudes about motivation (mastery orientation), and effective teaching practices. Mastery orientation mediates the relationship between mindset and teaching behavior, providing support for Dweck’s model of implicit theories of personality and motivation.
Representing Variability: The Case of Life Cycle Diagrams
Authors: Menendez David , Mathiaparanam Olympia N. , Liu David , Seitz Vienne , Alibali Martha W. , Rosengren Karl S.
Published: September 2020

An examination of life cycle diagrams from books and from an online database of science diagrams is presented. Many diagrams contained many irrelevant details, depicted the life cycle as a closed circle, and did not depict any form of biological variability. How these features might influence student learning and biological reasoning is discussed.