bluuebunny/crossref_metadata_2025 huggingface dataset:
Community-based rehabilitation service in Chengdu, Southwest China: a cross-sectional general survey
Authors: Chen Siliang , Lei Yi , Dai Hua , Wu Jia , Yang Ziyu , Liao Xiaoyang
Published: July 2020

Background

World Health Organization initiated community-based rehabilitation (CBR) in 1978, and by now, it has been an essential process of medical services worldwide. China had strengthened primary health care on building more than 35,000 community health centers (CHCs) in cities, and more than 34,000 township health centers (THCs) in the rural area. Nevertheless, it remains unclear that if these primary health centers could provide optional rehabilitation services for disabilities. And this study aims at evaluating the supply capacity of rehabilitation service in primary health centers of Chengdu, a regional center city of southwest China.

Method

We conducted a general investigation of primary health centers in Chengdu, a city located in southwest China with more than 15 million population. Our investigation covered all of Chengdu’s 390 primary health centers from October to November 2016. We researched these primary health centers on basic rehabilitation services, diseases, and rehabilitation equipment quantity and quality, and traditional Chinese medicine (TCM) physiotherapy.

Result

Rehabilitation therapy is available in 88.9% (337 of 379) of all primary health centers. Meanwhile, CHCs slightly surpass THCs with an available rate of 92.2% (106 of 115) and 87.5% (231 of 264), respectively. Traditional Chinese Medicine (TCM) physiotherapy is available in 97.1% (368 of 379) of all primary health centers, 97.3% (112 of 115) of CHCs and 97.0% (256 of 264) of THCs. Quantitative analysis showed that substantial factors which could make an impact on the number of patients per year contain: categories of rehabilitation disease (P < 0.001, 95% confidence interval (CI) [− 1.571, − 0.702]),number of rehabilitation bed (P < 0.001, 95%CI [− 1.249, − 0.290]).

Conclusion

CBR and TCM physiotherapy has become accessible for disabilities in most basic health centers of Chengdu City, whereas, available rate of CBR in THCs is lesser than in CHCs, which suggests an imbalance in primary health service development between rural and urban area. Categories of rehabilitation diseases, and the number of rehabilitation beds constitute co-factors that make an impact on the CBR capacity of basic health centers.
Genome-wide identification of methylated CpG sites in nongenital cutaneous warts
Authors: AL-Eitan Laith N. , Alghamdi Mansour A. , Tarkhan Amneh H. , Al-Qarqaz Firas A.
Published: July 2020

Background

Low-risk HPV infection has not been the subject of epigenetic investigation. The present study was carried out in order to investigate the methylation status of CpG sites in non-genital cutaneous warts.

Methods

Genomic DNA was extracted from 24 paired epidermal samples of warts and normal skin. DNA samples were bisulfite converted and underwent genome-wide methylation profiling using the Infinium MethylationEPIC BeadChip Kit.

Results

From a total of 844,234 CpG sites, 56,960 and 43,040 CpG sites were found to be hypo- and hypermethylated, respectively, in non-genital cutaneous warts. The most differentially methylated CpG sites in warts were located within theC10orf26,FAM83H-AS1,ZNF644,LINC00702,GSAP,STAT5A,HDAC4,NCALD, andEXOC4genes.

Conclusion

Non-genital cutaneous warts exhibit a unique CpG methylation signature.
The IL-17 receptor IL-17RE mediates polyIC-induced exacerbation of experimental allergic asthma
Authors: Vella Giovanna , Lunding Lars , Ritzmann Felix , Honecker Anja , Herr Christian , Wegmann Michael , Bals Robert , Beisswenger Christoph
Published: July 2020

Background

The interleukin 17 receptor E (IL-17RE) is specific for the epithelial cytokine interleukin-17C (IL-17C). Asthma exacerbations are frequently caused by viral infections. Polyinosinic:polycytidylic acid (pIC) mimics viral infections through binding to pattern recognition receptors (e.g. TLR-3). We and others have shown that pIC induces the expression of IL-17C in airway epithelial cells. Using different mouse models, we aimed to investigate the function of IL-17RE in the development of experimental allergic asthma and acute exacerbation thereof.

Methods

Wild-type (WT) and IL-17RE deficient (Il-17re−/−) mice were sensitized and challenged with OVA to induce allergic airway inflammation. pIC or PBS were applied intranasally when allergic airway inflammation had been established. Pulmonary expression of inflammatory mediators, numbers of inflammatory cells, and airway hyperresponsiveness (AHR) were analyzed.

Results

Ablation of IL-17RE did not affect the development of OVA-induced allergic airway inflammation and AHR. pIC induced inflammation independent of IL-17RE in the absence of allergic airway inflammation. Treatment of mice with pIC exacerbated pulmonary inflammation in sensitized and OVA-challenged mice in an IL-17RE-dependent manner. The pIC-induced expression of cytokines (e.g. keratinocyte-derived chemokine (KC), granulocyte-colony stimulating factor (G-CSF)) and recruitment of neutrophils were decreased inIl-17re−/−mice. pIC-exacerbated AHR was partially decreased inIl-17re−/−mice.

Conclusions

Our results indicate that IL-17RE mediates virus-triggered exacerbations but does not have a function in the development of allergic lung disease.
Pregnancy-induced changes in serum concentrations of perfluoroalkyl substances and the influence of kidney function
Authors: Nielsen Christel , Andersson Hall Ulrika , Lindh Christian , Ekström Ulf , Xu Yiyi , Li Ying , Holmäng Agneta , Jakobsson Kristina
Published: July 2020

Background

Epidemiological associations between maternal concentrations of perfluoroalkyl substances (PFAS) and birth weight are inconsistent. There is concern that studies based on samples collected in late pregnancy may be confounded by kidney function but studies of the relation between pregnancy-induced changes in PFAS and kidney function are lacking. Our aims were to investigate changes in serum concentrations of perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) from early to late pregnancy and to explore relations to changes in glomerular filtration rate (GFR) and glomerular pore size.

Methods

We conducted the study in a cohort of 73 pregnancies of normal-weight Swedish women without gestational diabetes and preeclampsia, enrolled 2009–2014. Blood was collected in median weeks 11 and 36, respectively, and analysed PFAS using liquid chromatography-tandem-mass-spectrometry. We estimated GFR based on creatinine and cystatin C and used the ratio eGFRcystatin C/eGFRcreatinine to indicate glomerular pore size. We used Wilcoxon signed-rank test to compare early and late measures and partial Spearman rank correlations to explore relations between changes in PFAS and kidney function.

Results

Median concentrations of PFNA, PFOA and PFOS decreased by 15–21% but changes were uncorrelated to changes in kidney function (partial R = − 0.06–0.11). The observed increase in median PFHxS concentration of 69% was likely an artefact of systematic measurement error caused by coeluting endogenous inferences.

Conclusions

Serum concentrations of PFNA, PFOA and PFOS decrease during pregnancy but the magnitudes of change are unrelated to parallel changes in eGFR and glomerular pore size, suggesting that changes in these indicators of kidney function are not important confounders in studies of PFAS and birth weight in pregnancies without gestational diabetes and preeclampsia.
Online adaptive radiotherapy compared to plan selection for rectal cancer: quantifying the benefit
Authors: de Jong R. , Crama K. F. , Visser J. , van Wieringen N. , Wiersma J. , Geijsen E. D. , Bel A.
Published: July 2020

Background

To compare online adaptive radiation therapy (ART) to a clinically implemented plan selection strategy (PS) with respect to dose to the organs at risk (OAR) for rectal cancer.

Methods

The first 20 patients treated with PS between May–September 2016 were included. This resulted in 10 short (SCRT) and 10 long (LCRT) course radiotherapy treatment schedules with a total of 300 Conebeam CT scans (CBCT). New dual arc VMAT plans were generated using auto-planning for both the online ART and PS strategy.

For each fraction bowel bag, bladder and mesorectum were delineated on daily Conebeam CTs. The dose distribution planned was used to calculate daily DVHs. Coverage of the CTV was calculated, as defined by the dose received by 99% of the CTV volume (D99%). The volume of normal tissue irradiated with 95% of the prescribed fraction dose was calculated by calculating the volume receiving 95% of the prescribed fraction or more dose minus the volume of the CTV. For each fraction the difference between the plan selection and online adaptive strategy of each DVH parameter was calculated, as well as the average difference per patient.

Results

Target coverage remained the same for online ART. The median volume of the normal tissue irradiated with 95% of the prescribed dose dropped from 642 cm3 (PS) to 237 cm3 (online-ART)(p < 0.001). Online ART reduced dose to the OARs for all tested dose levels for SCRT and LCRT (p < 0.001). For V15Gy of the bowel bag the median difference over all fractions of all patients was − 126 cm3 in LCRT, while the average difference per patient ranged from − 206 cm3 to − 40 cm3. For SCRT the median difference was − 62 cm3, while the range of the average difference per patient was − 105 cm3 to − 51 cm3.

For V15Gy of the bladder the median difference over all fractions of all patients was 26% in LCRT, while the average difference per patient ranged from − 34 to 12%. For SCRT the median difference of V95% was − 8%, while the range of the average difference per patient was − 29 to 0%.

Conclusions

Online ART for rectal cancer reduces dose the OARs significantly compared to a clinically implemented plan selection strategy, without compromising target coverage.

Trial registration

Medical Research Involving Human Subjects Act (WMO) does not apply to this study and was retrospectively approved by the Medical Ethics review Committee of the Academic Medical Center (W19_357 # 19.420; Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands).
Challenges of providing healthcare worker education and training in protracted conflict: a focus on non-government controlled areas in north west Syria
Authors: Bdaiwi Yamama , Rayes Diana , Sabouni Ammar , Murad Lina , Fouad Fouad , Zakaria Waseem , Hariri Mahmoud , Ekzayez Abdelkarim , Tarakji Ahmad , Abbara Aula
Published: July 2020

Without healthcare workers (HCWs), health and humanitarian provision in Syria cannot be sustained either now or in the post-conflict phase. The protracted conflict has led to the exodus of more than 70% of the healthcare workforce. Those remaining work in dangerous conditions with insufficient resources and a healthcare system that has been decimated by protracted conflict. For many HCWs, particularly those in non-government-controlled areas (NGCAs) of Syria, undergraduate education and postgraduate training has been interrupted with few opportunities to continue. In this manuscript, we explore initiatives present in north west Syria at both undergraduate and postgraduate level for physician and non-physician HCWs. Conclusion: Challenges to HCW education in north west Syria can be broadly divided into 1. Organisational (local healthcare leadership and governance, coordination and collaboration between stakeholders, competition between stakeholders and insufficient funding.) 2. Programmatic (lack of accreditation or recognition of qualifications, insufficient physical space for teaching, exodus of faculty affecting teaching and training, prioritisation of physicians over non-physicians, informally trained healthcare workers.) 3. Healthcare system related (politicisation of healthcare system, changing healthcare needs of the population, ongoing attacks on healthcare.) Locally implementable strategies including dedicated funding are key to supporting retention of HCWs and return during post-conflict reconstruction.
The pandemic characteristics of 2019-nCoV: case-control study for severity and geographic locations for 2019-nCoV epidemics worldwide
Authors: Ronchetti Roberto , Bianco Pietro Massimiliano
Published: July 2020

Using available official data we found 248 epidemics curves caused worldwide by the 2019-nCoV in the period December 2019–March 31st 2020. The analysis of this material allowed two main observations: 1) it is possible to describe the main geographical pathway of the diffusion of the virus in different directions. This strongly suggests a unique point of origin of the pandemics in Wuhan, China, from where it spread in many different directions. 2) of the 74 epidemics which were characterized by at least 1000 cases, 65 (90%) were located in the geographic region of the world delimitated by 52–30 degrees latitude North. Viceversa 110 (60%) of the 176 epidemics with less than 1000 cases were located outside the cited geographical world region. These results suggest considerations on the pandemic characteristics of 2019-nCoV.
Sierra: discovery of differential transcript usage from polyA-captured single-cell RNA-seq data
Authors: Patrick Ralph , Humphreys David T. , Janbandhu Vaibhao , Oshlack Alicia , Ho Joshua W.K. , Harvey Richard P. , Lo Kitty K.
Published: July 2020

High-throughput single-cell RNA-seq (scRNA-seq) is a powerful tool for studying gene expression in single cells. Most current scRNA-seq bioinformatics tools focus on analysing overall expression levels, largely ignoring alternative mRNA isoform expression. We present a computational pipeline, Sierra, that readily detects differential transcript usage from data generated by commonly used polyA-captured scRNA-seq technology. We validate Sierra by comparing cardiac scRNA-seq cell types to bulk RNA-seq of matched populations, finding significant overlap in differential transcripts. Sierra detects differential transcript usage across human peripheral blood mononuclear cells and the Tabula Muris, and 3 ′UTR shortening in cardiac fibroblasts. Sierra is available at https://github.com/VCCRI/Sierra.
Description of Cryptosporidium ornithophilus n. sp. (Apicomplexa: Cryptosporidiidae) in farmed ostriches
Authors: Holubová Nikola , Tůmová Lenka , Sak Bohumil , Hejzlarová Adéla , Konečný Roman , McEvoy John , Kváč Martin
Published: July 2020

Background

Avian cryptosporidiosis is a common parasitic disease that is caused by five species, which are well characterised at the molecular and biological level, and more than 18 genotypes for which we have limited information. In this study, we determined the occurrence and molecular characteristics of Cryptosporidium spp. in farmed ostriches in the Czech Republic.

Methods

The occurrence and genetic identity of Cryptosporidium spp. were analysed by microscopy and PCR/sequencing of the small subunit rRNA, actin, HSP70 and gp60 genes. Cryptosporidium avian genotype II was examined from naturally and experimentally infected hosts and measured using differential interference contrast. The localisation of the life-cycle stages was studied by electron microscopy and histologically. Infectivity of Cryptosporidium avian genotype II for cockatiels (Nymphicus hollandicus (Kerr)), chickens (Gallus gallus f. domestica (L.)), geese (Anser anser f. domestica (L.)), SCID and BALB/c mice (Mus musculus L.) was verified.

Results

A total of 204 individual faecal samples were examined for Cryptosporidium spp. using differential staining and PCR/sequencing. Phylogenetic analysis of small subunit rRNA, actin, HSP70 and gp60 gene sequences showed the presence of Cryptosporidium avian genotype II (n = 7) and C. ubiquitum Fayer, Santín & Macarisin, 2010 IXa (n = 5). Only ostriches infected with Cryptosporidium avian genotype II shed oocysts that were detectable by microscopy. Oocysts were purified from a pooled sample of four birds, characterised morphometrically and used in experimental infections to determine biological characteristics. Oocysts of Cryptosporidium avian genotype II measure on average 6.13 × 5.15 μm, and are indistinguishable by size from C. baileyi Current, Upton & Haynes, 1986 and C. avium Holubová, Sak, Horčičková, Hlásková, Květoňová, Menchaca, McEvoy & Kváč, 2016. Cryptosporidium avian genotype II was experimentally infectious for geese, chickens and cockatiels, with a prepatent period of four, seven and eight days post-infection, respectively. The infection intensity ranged from 1000 to 16,000 oocysts per gram. None of the naturally or experimentally infected birds developed clinical signs in the present study.

Conclusions

The molecular and biological characteristics of Cryptosporidium avian genotype II, described here, support the establishment of a new species, Cryptosporidium ornithophilus n. sp.
Evaluation of a sitting light volleyball intervention to adults with physical impairments: qualitative study using social–ecological model
Authors: Leung Ka-Man , Chung Pak-Kwong , Chu William
Published: July 2020

Background

This study was a part of 16-week sitting light volleyball (SLVB) intervention program which examined the effects of the intervention on the physical and psychological attributes of adults with physical impairments (PWPI) in Hong Kong. Gaining a deeper understanding of the perceptions and experiences of PWPI in the SLVB intervention is critical to the development of SLVB as a physical activity and a sport. The aims of this study were (a) to assess participants’ experiences of the intervention and (b) to examine the suitability and feasibility of SLVB intervention for PWPI.

Methods

Twenty participants (mean age = 53.52 years, standard deviation 9.02 years; 60% female; 25% with at least a college degree) participated in semi-structured interviews.

Results

Content analysis revealed features of their experiences at theindividualorintrapersonallevel (physical and psychological health, enjoyment, novelty, competence, autonomy),interpersonallevel (socialization and teamwork, social support),organizationalandcommunitylevels (perceived sport venue environment, venue accessibility, safety, dissemination of information), andpolicylevel (resources allocation by the government). The participants also commented on the suitability and feasibility of the SLVB intervention for PWPI, its content and coaching, the modified rules, the duration of sessions, scheduling, and the number of participants and coaches.

Conclusions

This study identified several themes relevant to the promotion of PWPI engagement with SLVB and demonstrated that adopting a multilevel approach to the intervention resulted in positive outcomes for participants. Playing SLVB is suitable and feasible for PWPI. The findings contribute to the understanding of the experiences PWPI had of the SLVB intervention, which is critical to the further development of SLVB as a physical activity and a sport.
The current crisis of academia-led research: a threat to the common good? Preliminary data from Europe and the United States
Authors: Carta Mauro Giovanni , Moro Maria Francesca , Kirilov Iskren , Romano Ferdinando , Tagliagambe Silvano
Published: July 2020

Objective

This research note aimed to analyze the scientific productivity trends 2015–2019, focusing on the top 30 universities in Europe and United States and on the top 30 private companies—as classified in the SCImago Institutions Ranking. Our hypothesis is that private companies are gaining an increasingly prominent role in the research field, while academia is losing its predominance.

Results

From 2015 to 2019, all universities in Europe and the United States lost positions in the scientific production ranking, while private companies gained positions. These trends seem to be driven mainly by the scientific productivity sub-indicator “Innovation”. These data suggest that the role private companies will play in the future will not be limited to support research economically or influence it from “outside”. Private companies have taken a path that may lead them to directly control all stages of production/communication of knowledge, including research—a role once bestowed on universities. Our data, although preliminary, seem to suggest that, at present, academia risks losing its predominance in the research field. This scenario deserves attention because of the threats it may pose to the independence of research and its role in supporting human equity and sustainable health for all.
Protective effect of miRNA-containing extracellular vesicles derived from mesenchymal stromal cells of old rats on renal function in chronic kidney disease
Authors: Wang Yan , Guo Yi Fang , Fu Guang Ping , Guan Chang , Zhang Xin , Yang Dong Gang , Shi Yun Cong
Published: July 2020

Introduction

Mesenchymal stromal cells (MSCs) play an important role in the prevention of cell and tissue fibrosis. Senescence may decrease the function of MSCs during recovery from tissue and organ damage. Extracellular vesicles (EVs) released from MSCs contribute to the repair of kidney injury. We explored the influence of senescence on EVs derived from MSCs (MSC-EVs) and detected the protective effects of MSC-EVs expressing low levels of miR-294/miR-133 derived from old rats against chronic kidney disease (CKD).

Methods

The effects of MSC-EVs derived from 3-month-old and 18-month-old male Fisher 344 rats on renal fibrosis were explored in a unilateral ureteral obstruction (UUO) model. pLV-miR-294/pLV-miR-133 mimic/inhibitor were injected into young and old rats before UUO to detect the effects of miR-294/miR-133, which were decreased in MSC-EVs and sera from old rats, on renal function in CKD. Transforming growth factor-β1 (TGF-β1)-induced human renal proximal tubular epithelial (HK2) cells were used to imitate the pathological process of renal fibrosis in vitro. Western blotting was used to assess the expression of epithelial/mesenchymal markers and phosphorylation of proteins in HK2 cells.

Results

The inhibition of UUO-induced CKD by MSC-EVs was weaker in old rats than in young rats. Downregulation of miRNAs (miR-294 and miR-133) in both MSC-EVs and sera from old rats obviously attenuated UUO-induced renal injury in old rats. miR-294 and miR-133 overexpression mitigated TGF-β1-mediated epithelial-mesenchymal transition (EMT) in HK2 cells, and the obvious increase in the phosphorylation of both SMAD2/3 and ERK1/2 induced by TGF-β1 was prevented in miR-294- and miR-133-overexpressing HK2 cells.

Conclusions

The ability of MSC-EVs to inhibit renal fibrosis decreased with age. miR-294/miR-133 in MSC-EVs and sera had an important effect on renal fibrosis in old rats and on EMT in HK2 cells. Furthermore, miR-294/miR-133 overexpression prevented SMAD2/3 and ERK1/2 phosphorylation in HK2 cells during TGF-β1-mediated EMT. These findings show that miR-294/miR-133 may be therapeutic in renal fibrosis and related renal dysfunction in elderly individuals.
Application of big data analytics and organizational performance: the mediating role of knowledge management practices
Authors: Shabbir Muhammad Qasim , Gardezi Syed Babar Waheed
Published: July 2020

Drawing from tenets of the resource-based theory, we propose and test a model that examines the relationship between the application of big data analytics (ABDA) and organizational performance (OP) in small and medium enterprises (SMEs). Further, this study examines the mediating role of knowledge management practices (KMP) in relation to the ABDA and OP. Data were collected from respondents working in SMEs through an adapted instrument. This research study adopts the Baron–Kenny approach to test the mediation. The results indicated that the ABDA had a positive and significant impact on OP. Also, KMP had partially mediated the relationship between ABDA and OP in SMEs. The dataset was solely comprised of SMEs from Pakistan administered Kashmir and may not reflect the insights from other regions. Hence limits the generalizability of the results. Findings highlight both strategic and practical implications related to decision making in organizations for top management, particularly in developing countries. This study attempts to contribute to the literature through novel findings and recommendations. These fallouts will help the top management during the key decision-making process and encourage practitioners who seek competitive advantage through enhanced organizational performance in SMEs.
A CT-based radiomics nomogram for prediction of lung adenocarcinomas and granulomatous lesions in patient with solitary sub-centimeter solid nodules
Authors: Chen Xiangmeng , Feng Bao , Chen Yehang , Liu Kunfeng , Li Kunwei , Duan Xiaobei , Hao Yixiu , Cui Enming , Liu Zhuangsheng , Zhang Chaotong , Long Wansheng , Liu Xueguo
Published: July 2020

Purpose

To develop a radiomics nomogram based on computed tomography (CT) images that can help differentiate lung adenocarcinomas and granulomatous lesions appearing as sub-centimeter solid nodules (SCSNs).

Materials and methods

The records of 214 consecutive patients with SCSNs that were surgically resected and histologically confirmed as lung adenocarcinomas (n = 112) and granulomatous lesions (n = 102) from 2 medical institutions between October 2011 and June 2019 were retrospectively analyzed. Patients from center 1 ware enrolled as training cohort (n = 150) and patients from center 2 were included as external validation cohort (n = 64), respectively. Radiomics features were extracted from non-contrast chest CT images preoperatively. The least absolute shrinkage and selection operator (LASSO) regression model was used for radiomics feature extraction and radiomics signature construction. Clinical characteristics, subjective CT findings, and radiomics signature were used to develop a predictive radiomics nomogram. The performance was examined by assessment of the area under the receiver operating characteristic curve (AUC).

Results

Lung adenocarcinoma was significantly associated with an irregular margin and lobulated shape in the training set (p = 0.001, < 0.001) and external validation set (p = 0.016, = 0.018), respectively. The radiomics signature consisting of 22 features was significantly associated with lung adenocarcinomas of SCSNs (p < 0.001). The radiomics nomogram incorporated the radiomics signature, gender and lobulated shape. The AUCs of combined model in the training and external validation dataset were 0.885 (95% confidence interval [CI]: 0.823–0.931), 0.808 (95% CI: 0.690–0.896), respectively. Decision curve analysis (DCA) demonstrated that the radiomics nomogram was clinically useful.

Conclusion

A radiomics signature based on non-enhanced CT has the potential to differentiate between lung adenocarcinomas and granulomatous lesions. The radiomics nomogram incorporating the radiomics signature and subjective findings may facilitate the individualized, preoperative treatment in patients with SCSNs.
Gender role attitudes and male-female income differences in China
Authors: Qing Shisong
Published: July 2020

By investigating deep-rooted cultural norms, this paper explores whether and how traditional gender role attitudes impact income gaps between men and women and identifies causal effects via instrumental variable and other causal inference methods. Based on data from the Chinese General Social Survey in 2013, the results show that traditional gender role attitudes have a strong negative effect to the earnings of women but have no significant effect on men’s incomes. Through Oaxaca-Blinder decomposition, this research finds that the different effects of gender role attitudes on the incomes of men and women appear to play a prominent role in causing the gender gap in earnings. In addition, gender role attitudes have an indirect and broad effect on gender income inequality through educational attainment, labor force participation, working hours, and occupational status. These results provide us with a new perspective for understanding the persistence and mechanisms of gender income stratification under educational equalization and have implications for gender equality policies.
Nematicidal activity of native Bacillus thuringiensis against the root knot nematode, Meloidogyne incognita (Kofoid and White)
Authors: Ramalakshmi A. , Sharmila R. , Iniyakumar M. , Gomathi V.
Published: July 2020

In this study, potential of the native Bacillus thuringiensis Berliner was investigated against the root knot nematode, Meloidogyne incognita (Kofoid and White) under laboratory and greenhouse conditions. Fourteen out of 50 Bt isolates obtained from root zone of vegetable crops of north western zone of Tamil Nadu, India, were found to be encoded with nematicidal cry genes, confirmed by gene-specific PCR. Nine different Cry protein profiles were obtained from native Bt. Spore-crystal mixtures of 6 isolates out of 14 (at 0.5%) showed 100% inhibition to J2 juveniles emergence from egg masses of M. incognita within 72 h of treatment. Analysis by SEM revealed that fluffy egg masses were observed in untreated samples due to hatching, whereas egg masses were covered by gelatinous matrix, when treated with spore-crystal mixture of nematicidal Bt. Two (BC and BD) of the 6 isolates were selected based on their highest nematicidal activity against J2 of M. incognita with LC50 values of 0.12 and 0.23 μg/ml of protein. The spore-crystal mixtures of isolates BC and BD when applied to tomato plants under greenhouse conditions exhibited the enhanced biocontrol potential by suppressing number of egg masses, reduction of female population and decreased root gall index, when compared to control and chemical treatments.
A comparative study on outcome of Type I Tympanoplasty using sliced 1-mm Conchal cartilage and full-thickness Conchal cartilage for grafting
Authors: Ramalingam Vijay , Kamindan Kandasamy , Murugan Ram Karthik , Rajeswari Velumani
Published: July 2020

Background

This study aims at comparing the pure tone audiogram and tympanogram results of a measured thickness (1 mm) conchal cartilage graft material (1.0-mm CC) with full-thickness conchal cartilage (FTCC) used for inactive chronic suppurative otitis media (CSOM) mucosal disease with moderate size perforation.

Results

A total of 40 successful cartilage tympanoplasty procedures were included in the prospective quasi-randomised study. Patients aged between 15 and 55 years with inactive CSOM—moderate size perforation in the tympanic membrane were included. The patients were assessed at the end of 12 weeks with a pure tone audiogram and a tympanogram. The results were compared to know the compliance of the tympanic membrane (TM) between the two groups and the difference in audiometric gain (air-bone gap closure). The air-bone gap gain was better in the 1.0-mm CC group of patients (12) compared to the FTCC group of patients (7). The difference was statistically significant (p = 0.04). The 1.0-mm CC group of patients showed better compliance (0.43) compared to FTCC group of patients (0.73). The air volume and compliance were significantly better in the 1-mm CC group compared to the FTCC group (p = 0.031 and 0.01 respectively).

Conclusion

The use of sliced cartilage seems to have a better role in reconstructing the TM when compared to full-thickness cartilage as graft material. It is indeed beneficial to have a compliant TM. Though the results cannot be compared with temporalis fascia grafts, the use of 1.0-mm CC has its advantage in producing an audio logically acceptable outcome in tympanoplasty surgery.
Vocal cordopathy consequent to bronchial asthma inhalation therapy
Authors: Abumossalam Ahmed Mohammed , Ahmed Hanan Abdelsattar , Ibrahim Omar Mohamed , Algreisy Talal Mohamad Saad , Al-Shenqiti Abdullah Mohmad
Published: July 2020

Background

Vocal cords signify an imperative lane for air flow in and out of the respiratory tract along with a phonetic role. So, the aim of this work is to assess the impact of habitual versus occasional utilization of inhalation therapy of patients with bronchial asthma on their vocal cords regarding visual endoscopic pathological changes in addition to phonetic dysfunction. This study was conducted on 112 diagnosed bronchial asthma patients (66 male and 46 females). They were classified into the following: group A (habitual user), 65 patients with severe persistent asthma with regular frequent intake of inhalation therapy, and group B (occasional user), 47 patients with intermittent asthma with alternating intake of inhalation therapy. They were submitted to clinical, vocal assessment plus laryngoscopic examination.

Results

The habitual users group demonstrated that laryngeal edema and hyperemia attained the higher percentage in the adult than children age group (60%, 40–67.3%, 50%) respectively together after 6 and 9 months of study followed by laryngeal nodules (5.4%, 0–9%, 10%). Occasional users presented the same findings comparable to the habitual group (27%, 10–32.4%, 20%). Cord paresis, cord dysfunction, and fungal plaques were in the second frequencies in both age groups with the same percentage (3.6%) at the end of the study; however, in occasional users, fungal plaques illustrated low percentage (2.7%, 5.4–0, 10%, respectively).

Conclusion

Inhalation therapy as a form of asthma medication correlated with major counter effects on vocal cords with well-recorded laryngeal hyperemia, edema, and vocal nodules in addition to fungal plaques moreover phonetic dysfunction.
Influence of Surgical Excision on the Survival of Patients With Stage 4 High-Risk Neuroblastoma: A Report From the HR-NBL1/SIOPEN Study
Authors: Holmes Keith , Pötschger Ulrike , Pearson Andrew D. J. , Sarnacki Sabine , Cecchetto Giovanni , Gomez-Chacon Javier , Squire Roly , Freud Enrique , Bysiek Adam , Matthyssens Lucas E. , Metzelder Martin , Monclair Tom , Stenman Jakob , Rygl Michal , Rasmussen Lars , Joseph Jean-Marc , Irtan Sabine , Avanzini Stefano , Godzinski Jan , Björnland Kristin , Elliott Martin , Luksch Roberto , Castel Victoria , Ash Shifra , Balwierz Walentyna , Laureys Geneviève , Ruud Ellen , Papadakis Vassilios , Malis Josef , Owens Cormac , Schroeder Henrik , Beck-Popovic Maja , Trahair Toby , Forjaz de Lacerda Ana , Ambros Peter F. , Gaze Mark N. , McHugh Kieran , Valteau-Couanet Dominique , Ladenstein Ruth Lydia ,   for the International Society of Paediatric Oncology Europe Neuroblastoma Group (SIOPEN)
Published: July 2020

PURPOSE

To evaluate the impact of surgeon-assessed extent of primary tumor resection on local progression and survival in patients in the International Society of Pediatric Oncology Europe Neuroblastoma Group High-Risk Neuroblastoma 1 trial.

PATIENTS AND METHODS

Patients recruited between 2002 and 2015 with stage 4 disease > 1 year or stage 4/4S with MYCN amplification < 1 year who had completed induction without progression, achieved response criteria for high-dose therapy (HDT), and had no resection before induction were included. Data were collected on the extent of primary tumor excision, severe operative complications, and outcome.

RESULTS

A total of 1,531 patients were included (median observation time, 6.1 years). Surgeon-assessed extent of resection included complete macroscopic excision (CME) in 1,172 patients (77%) and incomplete macroscopic resection (IME) in 359 (23%). Surgical mortality was 7 (0.46%) of 1,531. Severe operative complications occurred in 142 patients (9.7%), and nephrectomy was performed in 124 (8.8%). Five-year event-free survival (EFS) ± SE (0.40 ± 0.01) and overall survival (OS; 0.45 ± 0.02) were significantly higher with CME compared with IME (5-year EFS, 0.33 ± 0.03; 5-year OS, 0.37 ± 0.03; P < .001 and P = .004). The cumulative incidence of local progression (CILP) was significantly lower after CME (0.17 ± 0.01) compared with IME (0.30 ± 0.02; P < .001). With immunotherapy, outcomes were still superior with CME versus IME (5-year EFS, 0.47 ± 0.02 v 0.39 ± 0.04; P = .038); CILP was 0.14 ± 0.01 after CME and 0.27 ± 0.03 after IME ( P < .002). A hazard ratio of 1.3 for EFS associated with IME compared with CME was observed before and after the introduction of immunotherapy ( P = .030 and P = .038).

CONCLUSION

In patients with stage 4 high-risk neuroblastoma who have responded to induction therapy, CME of the primary tumor is associated with improved survival and local control after HDT, local radiotherapy (21 Gy), and immunotherapy.
Improving Timeliness of Lung Cancer Diagnosis and Staging Investigations Through Implementation of Standardized Triage Pathways
Authors: Mullin Monica L.L. , Tran Audrey , Golemiec Breanne , Stone Christopher J.L. , Noseworthy Christine , O’Callaghan Nicole , Parker Christopher M , Digby Geneviève C
Published: July 2020

PURPOSE:

Timely care for patients with lung cancer (LC) is associated with improved clinical outcomes. In Southeastern Ontario, Canada, we identified delays in the diagnostic process for patients undergoing evaluation for suspected LC through a rapid assessment clinic. We developed improvement initiatives with an aim of reducing the time from referral to diagnosis.

METHODS:

A Standardized Triage Process (STP) was implemented for patients referred with suspected LC, including routine interdisciplinary triage, standardized pathways with preordered staging tests, and a new Small Nodule Clinic. We retrospectively analyzed all patients referred pre-STP (January to April 2018) and prospectively for improvement (May 2018 to March 2019). Process measures included STP compliance and time to completion of staging investigations (positron emission tomography [PET] and computed tomography/magnetic resonance imaging of brain). Data are reported as means; significance was determined by special-cause variation using Statistical Process Control charts; unpaired t tests were compared between groups.

RESULTS:

We reviewed 833 referrals (207 baseline and 626 post-STP). STP compliance improved monthly to 99.4%. Post-STP, time from referral to PET decreased (from 38.5 to 15.7 days), time from referral to brain imaging decreased (from 33.4 to 13.1 days), and time from referral to diagnosis decreased (from 38.0 to 22.7 days), all demonstrating special-cause variation. Patients completing preordered staging tests experienced significantly faster care than those without preordered tests, including time to PET (23.0 v 35.9 days), computed tomography/magnetic resonance imaging of brain (16.2 v 29.9 days), and diagnosis (39.9 v 28.1 days), all P < .001.

CONCLUSION:

An STP significantly improved timeliness of diagnosis and staging for patients with suspected LC undergoing evaluation in a rapid assessment clinic.
Effects of State Law Limiting Postoperative Opioid Prescription in Patients After Cesarean Delivery
Authors: Potnuru Paul P. , Patel Selina D. , Birnbach David J. , Epstein Richard H. , Dudaryk Roman
Published: July 2020

BACKGROUND:

The impact of the Florida State law House Bill 21 (HB 21) restricting the duration of opioid prescriptions for acute pain in patients after cesarean delivery is unknown. Our objective was to assess the association of the passage of Florida State law HB 21 with trends in discharge opioid prescription practices following cesarean delivery, necessity for additional opioid prescriptions, and emergency department visits at a large tertiary care center.

METHODS:

This was a retrospective cohort study conducted at a large, public hospital. The 2 cohorts represented the period before and after implementation of the law. Using a confounder-adjusted segmented regression analysis of an interrupted time series, we evaluated the association between HB 21 and trends in the proportions of patients receiving opioids on discharge, duration of opioid prescriptions, total opioid dose prescribed, and daily opioid dose prescribed. We also compared the need for additional opioid prescriptions within 30 days of discharge and the prevalence of emergency department visits within 7 days after discharge.

RESULTS:

Eight months after implementation of HB 21, the mean duration of opioid prescriptions decreased by 2.9 days (95% confidence interval [CI], 5.2–0.5) and the mean total opioid dose decreased by 20.1 morphine milligram equivalents (MME; 95% CI, 4–36.3). However, there was no change in the proportion of patients receiving discharge opioids (95% CI of difference, −0.1 to 0.16) or in the mean daily opioid dose (mean difference, 5.3 MME; 95% CI, −13 to 2.4). After implementation of the law, there were no changes in the proportion of patients who required additional opioid prescriptions (2.1% vs 2.3%; 95% CI of difference, −1.2 to 1.5) or in the prevalence of emergency department visits (2.4% vs 2.2%; 95% CI of difference, −1.6 to 1.1).

CONCLUSIONS:

Implementation of Florida Law HB 21 was associated with a lower total prescribed opioid dose and a shorter duration of therapy at the time of hospital discharge following cesarean delivery. These reductions were not associated with the need for additional opioid prescriptions or emergency department visits.
Effects of an Intraoperative Intravenous Bolus Dose of Dexmedetomidine on Remifentanil-Induced Postinfusion Hyperalgesia in Patients Undergoing Thyroidectomy: A Double-Blind Randomized Controlled Trial
Authors: Wu Zhijie , Yu Junjie , Lin Qihua , Li Huiting , Zhang Tianhua , Tan Hongying , Lin Wenqian , Cao Longhui
Published: July 2020

BACKGROUND:

Consecutive exposure to high-dose remifentanil during anesthesia may induce remifentanil-induced postinfusion hyperalgesia (RPH). Dexmedetomidine, a highly selective α2-adrenergic receptor agonist, may have synergistic effects with opioids and aid in perioperative pain management. In this study, we hypothesized that an intraoperative bolus dose of intravenous dexmedetomidine could alleviate RPH in patients undergoing thyroidectomy under general anesthesia.

METHODS:

Ninety patients undergoing thyroidectomy were randomly assigned to 1 of 3 groups: placebo, normal saline (group P); low-dose dexmedetomidine 0.2 μg·kg−1 (group LD); or high-dose dexmedetomidine 0.5 μg·kg−1 (group HD). Remifentanil was infused at a rate of 0.30 μg·kg−1·minute−1. Mechanical pain thresholds were measured using an Electronic von Frey device preoperatively and at 30 minutes, 6 hours, 24 hours, and 48 hours after surgery and were analyzed with 2-way repeated-measures analysis of variance (ANOVA) followed by Bonferroni post hoc comparison. We also recorded postoperative pain scores, the incidence of receiving rescue analgesics, and side effects up to 48 hours after surgery.

RESULTS:

The mechanical pain thresholds around the skin incision were significantly higher in group LD compared to group P 30 minutes and 6 hours after surgery (mean ± standard deviation: [65.0 ± 25.2] vs [49.6 ± 24.4] g, mean difference [95% confidence interval]: 15.4 [0.3–30.5] g, P = .045 at 30 minutes; [65.9 ± 24.5] vs [49.3 ± 26.1] g, 16.6 [1.1–32.1] g, P = .032 at 6 hours). The pain thresholds around the skin incision were significantly higher in group HD compared to group P 30 minutes and 6 hours after surgery ([67.8 ± 21.7] vs [49.6 ± 24.4] g, 18.2 [3.1–33.3] g, P = .013 at 30 minutes; [68.3 ± 22.5] vs [49.3 ± 26.1] g, 19.0 [3.5–34.5] g, P = .011 at 6 hours). The incidence of hyperalgesia around the skin incision was lower in group HD than in group P 30 minutes and 6 hours after surgery (4 [13%] vs 14 [48%], P = .012 at 30 minutes, 4 [13%] vs 12 [41%], P = .045 at 6 hours), although no significant difference was observed between group LD and group P. Postoperative pain scores, the incidence of rescue analgesic demand, and postoperative side effects were not significantly different between the groups.

CONCLUSIONS:

An intraoperative intravenous bolus dose of dexmedetomidine 0.5 μg·kg−1 alleviates remifentanil-induced hyperalgesia in patients undergoing thyroidectomy without a significant difference in side effects.
Femme Migritude
Authors: Reddy Vanita
Published: July 2020

This article examines the queer feminist Afro-Asian poetics and politics of spoken word and performance artist Shailja Patel’s 2006 onewoman show and 2010 prose poem, both titled Migritude. Patel’s migritude poetics resonates with and departs from much contemporary migritude writing, particularly with respect to the genre’s focus on a global-North-based, black Atlantic African diaspora. The article draws attention to a “brown Atlantic,” in which Africa is the site both of diaspora and of homeland. More important, it shows that Patel’s queer femininity unsettles a diasporic logic of racial exceptionalism. This logic aids and abets a (black) native/(South Asian) migrant divide in colonial and postcolonial Kenya. Patel’s femme migritude, as I call it, draws on nonequivalent histories of black and Asian racialized dispossession to construct a mode of global-South, cross-racial political relationality.
Mobility in the City
Authors: Siddiqi Yumna
Published: July 2020

In his novels Cockroach and Carnival, Rawi Hage explores the varied experiences of postcolonial migrants to the northern city. His protagonists are antiheroes, hustlers who reject the demands of good immigrant citizenship. Theorists of urban life applaud the city as a space that is hospitable to encounters with difference; they fail to consider the ways in which processes of bordering and differentiation are part of economies that exploit migrants. This article focuses on Hage’s portrayal of migrant mobility in the city. By bringing together a critique of these theorists of urban experience with Sandro Mezzadra’s arguments about the autonomy of postcolonial migrants, who are subjects and agents despite and because of the determinations of the political field, this article probes the subjection of postcolonial migrants in the city. The “politics of mobility” also determines migrants’ modes of conviviality and labor. Hage’s protagonists survive by maneuvering underground, in the interstices of the city, or in a cab, their space of work and mobility in the city, and using a rich verbal medley to tell its myriad stories. Thus Hage presents counterhegemonic narratives and visions of postcolonial migrants in the city.
Wanting More
Authors: Hayes Shannan L.
Published: July 2020

This essay interrogates the forms of feminist political desire and subject formation being reproduced under the heading of contemporary feminist art. The author considers two recent exhibitions, similarly organized around the theme of intersectionality, that took place over two consecutive summers in New York City: Simone Leigh’s The Waiting Room at the New Museum (2016), and the group exhibit We Wanted a Revolution at the Brooklyn Museum (2017). While both exhibitions promote the work of black women artists at the center of their institutional program-building initiatives, each exhibition forwards a notably distinct version of what counts as “revolutionary” feminist politics. Hayes argues ultimately for an interpretation of Leigh’s work as a prefigurative, utopian feminism that demands more—for example, than mere inclusion—from progressive institutions and feminist art.