bluuebunny/crossref_metadata_2025 huggingface dataset:
Combining sport and conventional military training provides superior improvements in physical test performance
Authors: Havenetidis Konstantinos , Bissas Athanassios , Monastiriotis Nikolaos , Nicholson Gareth , Walker Josh , Bampouras Theodoros M , Dinsdale Alexander J
Published: August 2022

Training for both sporting and military performance is common practice within army trainee populations, although it is currently unknown what effect this combination of training methods may have on the physical attributes required for overall physical preparedness. This study examined the effects of sport-specific training on general fitness in a professional military population. Four hundred and twenty-three Greek male army cadets completed a 12-week training regimen involving standard physical training (callisthenics, strength and endurance running exercises) and either general military training (GMT) or sport military training (SMT). A series of physical tests took place before and after the training period: a mile run, pull-ups, 50 m swim and an obstacle course run. Both the GMT and SMT groups showed significant (p < 0.001) improvements in all physical tests. However, the SMT group produced significantly greater improvements in all four tests (pull-ups [p < 0.001], 50 m swim [p < 0.05], obstacle course [p < 0.01] and mile run [p < 0.01]) compared to the GMT group. Furthermore, different types of SMT (e.g. rock climbing and track sprinting) achieved greater improvements (p < 0.001–0.01) in certain physical tests when compared to other forms of SMT (e.g. Pankration, Fencing). These results indicate that cadets undertaking concurrent participation in general and sport military training are overall better prepared for physical performance than their counterparts who undertake only general military training. Military conditioning personnel should be aware of the positive interplay between general and sports specific training in forming a preparation strategy designed for physical performance.
Are soccer players born later in the year more technically skilled than those born earlier in the year
Authors: Hunter Andrew H , Smith Nicholas M A , Camata Thiago V , Crowther Mathew S , Mather Andrew , Moura Felipe A , Santiago Paulo Roberto Pereira , Wilson Robbie S
Published: August 2022

In many youth sports, selection into elite training academies is dominated by athletes born earlier in the year. Previous research suggests this is partly due to these athletes being more physically developed than their younger peers. How athletes born later in the year survive in elite academies is less understood. Here, we tested the hypothesis that players born later in the year are more technically skilled than their peers born earlier in the same year. Using 150 youth players (10–19 years of age) from an elite Brazilian soccer academy, we measured each player's date of birth, height, and mass; sprinting ability; dribbling ability; and kicking accuracy and speed. We found most players in this academy were born in the first half of the year, and those born earlier in the year (relatively older) tended to be taller and heavier than those born later in the same year (relatively younger). In addition, relatively older players were faster when sprinting and dribbling the ball in a straight line. Conversely, relatively younger players were more accurate when passing the ball with their nondominant foot, providing some evidence these players were more technically skilled than their older peers of the same age. We suggest skill tests with youth players need to consider relative age and physical size in order to best assess a player's potential.
Biomechanical assessment of the central band of the interosseous membrane using shear wave elastography: reliability and reproducibility
Authors: Rougereau Grégoire , Marty-Diloy Thibault , Vigan Marie , Vialle Raphaël , Soubeyrand Marc , Langlais Tristan
Published: August 2022

The interosseous membrane of the forearm is an essential structure for the stability of the forearm skeleton, the most important part being the central band. The purpose of this study was to determine if shear wave elastography, a non-invasive ultrasound technique, can be used to measure shear wave speed in the central band and quantify stiffness. Fifteen healthy adult subjects were included (30 forearms). The participants forearms were positioned on an articulated plate, with their hand in neutral, pronated and then supinated positions of 30°, 60° and 90°. The shear wave speed was highest in 90° pronation (4.4 m/s (SD 0.3)) and 90° supination (4.4 m/s (SD 0.27)) indicating maximum stiffness in these positions. Its minimum value was in the neutral position, and either in 30° pronation or supination (3.5 m/s (SD 0.3)). Intra- and interobserver agreement was excellent, regardless of probe positioning or forearm mobilization. This study presents a reliable shear wave elastography measurement protocol to describe the physiological function of the central band of the interosseous membrane in healthy adults.

Level of evidence: IV
Streptococcus oralis meningitis in pregnancy
Authors: Mohan Naina , O’Connor Lucy , Douglas Hannah , Banerjee Anita , Nelson-Piercy Catherine , Klein John L
Published: August 2022

While pregnancy is a time of relative immunosuppression, infective endocarditis and bacterial meningitis remain rare. We present a case of a pregnant woman with Streptococcus oralis endocarditis and meningitis. This is the first reported case of Streptococcus oralis meningitis in a patient without predisposing risk factors. This case highlights the importance of collecting blood cultures in febrile illness during pregnancy and illustrates that effective management plans can be formulated without performing invasive diagnostic tests such as transesophageal echocardiography.
Unpacking the theory of practice architectures for research in early childhood education
Authors: Gibbs Leanne , Cooke Mandy , Salamon Andi
Published: August 2022

Theory strengthens the methodological and interpretive stance of a research study and is most fruitful when theoretical understandings are shared within collaborative research teams. This paper describes an approach to engaging productively with a theory, specifically the theory of practice architectures. Such engagement enabled the use of the theory for data gathering and analysis within an Australian mixed-methods research study – Exemplary Early Childhood Educators at Work. Within the study, the theory offered a substantive lens for exploring exemplary educator practices and the organisational arrangements within early childhood education (ECE) sites that made those practices possible. The ‘unpacking’ of the theory of practice architectures led to the development of a suite of resource materials. This paper acts as an invitation to interact with and think on a practice theory and provides insight into the positive transformation of educational practices for the benefit of individuals and society.
The dynamic material properties of stabilised rammed earth materials using cement and calcium carbonate residue
Authors: Liu Kewei , Walske Megan , Zhou Mi , Zhang Xihong
Published: August 2022

The use of rammed earth (RE) as a construction material has recently received renewed interest due to its sustainability characteristics and potential for low-cost construction. Modern RE includes the addition of a binder to increase its performance. The mechanical performance of stabilised RE particularly the dynamic material properties is still not well understood. During the design life, a structure could experience dynamic loading. It is necessary to properly understand the dynamic properties of stabilised RE for safe applications. In this study, the quasi-static and dynamic material properties of cement and calcium carbonate residue (CCR) stabilised RE are experimentally investigated. The failure of the stabilised RE under different loading rates is investigated. Dynamic increase effect on cement and CCR stabilised RE are studied. The unconfined uniaxial compressive strength (UCS), Young’s modulus of the two types of stabilised RE at different strain rates are quantified. Empirical formulae of dynamic increase factor are derived for engineering application.
Perinatal intimate partner violence during COVID-19 and its associated factors among postpartum mothers attending newborn immunization in southern Ethiopia, 2021: A cross-sectional study
Authors: Belay Alemayehu Sayih , Kassie Gidafie Aychew , Abera Gudeta Tesfaye
Published: August 2022

Objective:

This study aimed to assess the prevalence of perinatal intimate partner violence during COVID-19 and its associated factors among postpartum mothers attending newborn immunization in southern Ethiopia, 2021.

Method:

A facility-based cross-sectional study was conducted among 657 postpartum mothers from 1 to 30 March 2021 in southern Ethiopia. All postpartum mothers who visited the selected hospitals or health centers for newborn immunization and met the inclusion criteria were included in this study. Data were cleaned, coded, entered into Epidata manager version 4.2 and then exported into SPSS version 26 for analysis. Binary and multivariate logistic regression analysis was used.

Results:

The prevalence of perinatal intimate partner violence was 62.4%. In this study, income loss due to COVID-19 (adjusted odds ratio: 12.00, 95% confidence interval: 5.60, 25.71, p < 0.001) was the strongest factor associated with perinatal intimate partner violence. Young age women (adjusted odds ratio: 5.82, 95% confidence interval: 2.72, 12.46, p < 0.001), partner alcohol use (adjusted odds ratio: 2.21, 95% confidence interval: 1.37, 3.56, p = 0.001), partner substance use (adjusted odds ratio: 2.07, 95% confidence interval: 1.12, 3.83, p = 0.021), and partner relationships (cohabited) (adjusted odds ratio: 1.88, 95% confidence interval: 1.06, 3.34, p = 0.032) were also strongly associated with perinatal intimate partner violence.

Conclusion:

The prevalence of perinatal intimate partner violence was relatively high. The health of the women should be maintained through empowerment of women and provision of health education in order to minimize prevalence of perinatal intimate partner violence associated with low income, young age, substance use, and cohabited marital status. Future qualitative studies are required to identify the underlying multifactorial reasons for intimate partner violence.
Congenital Left Main Coronary Atresia: Rare Cause of Sudden Cardiac Arrest
Authors: Knapp Thomas M , Farias Michael , DeCampli William M
Published: August 2022

A 13-month-old male sustained cardiac arrest under general anesthesia and was found to have left main coronary artery atresia with collateralization from the right coronary artery. After protracted recovery, the patient underwent coronary ostioplasty. Postoperative imaging confirmed patency of the newly established artery without stenosis. At 12 months, no changes in the vessel were noted. Ventricular function remains mildly decreased and stable.
Opioid Use Increases the Rate of Pseudarthrosis and Revision Surgery in Patients Undergoing Anterior Cervical Discectomy and Fusion
Authors: Lambrechts Mark J. , D’Antonio Nicholas D. , Heard Jeremy C. , Toci Gregory R. , Karamian Brian A. , Sherman Matthew , Canseco Jose A. , Kepler Christopher K. , Vaccaro Alexander R. , Hilibrand Alan S. , Schroeder Gregory D.
Published: August 2022

Study Design

Retrospective Cohort

Objectives

To (1) quantify the risk opioids impart on pseudarthrosis development, (2) analyze the effect of pseudarthrosis on clinical outcomes, and (3) identify if the amount of opioids prescribed are predictive of pseudarthrosis revision.

Methods

Patients who underwent ACDF at a single institution between 2017-2019 were retrospectively identified. Postoperative dynamic cervical spine radiographs were reviewed to assess fusion status. Logistic regression models measured the effect of morphine milligram equivalents (MME) prescribed on the likelihood of pseudarthrosis development. Receiver operating characteristic (ROC) curves were generated to predict the probability of surgical revision based on MME prescribed.

Results

Of 298 included patients, an average of 2.01 ± 0.82 levels were included in the construct and 121 (40.9%) patients were diagnosed with a pseudarthrosis. However, only 14 (4.7%) required a pseudarthrosis revision. Patients requiring pseudarthrosis revision had worse one-year postoperative Δ PCS-12 (−1.70 vs. 7.58, P = 0.004), Δ NDI (3.33 vs. −15.26, P = 0.002), and Δ VAS Arm (2.33 vs. −2.48, P = .047). Multivariate logistic regression analyses found the three-month postoperative (OR=1.00, P = .010), one-year postoperative (OR=1.001, P = 0.025), and combined pre- and postoperative MME (OR=1.000, P = .035) increased the risk of pseudarthrosis. ROC analysis identified cutoff values to predict pseudarthrosis revision at 90.00 (area under the curve (AUC): 0.693, confidence interval (CI): 0.554-0.832), 132.86 (0.710, CI: 0.589-0.840), 224.76 (0.687, CI: 0.558-0.817) and 285.00 (0.711, CI: 0.585-0.837) MME in the preoperative, three-month postoperative, one-year postoperative, and combined pre-and postoperative period.

Conclusion

Increased prescription of opioid medications following ACDF procedures may increase the risk of pseudarthrosis development and revision surgery.

Level of Evidence

Therapeutic Level III
Involvement of Bacteria in the Pathological Changes Before Achilles Tendon Rupture: A Case Series Investigating 16S rDNA in 20 Consecutive Ruptures
Authors: Cramer Allan , Moser Claus , Fritz Blaine Gabriel , Hölmich Per , Barfod Kristoffer Weisskirchner
Published: August 2022

Background:

The source of the pathological changes that occur before an acute Achilles tendon rupture (ATR) is not fully understood. Bacterial DNA has previously been detected in samples from ruptured Achilles tendons, suggesting a pathogenic role of bacteria in ATR.

Purpose/Hypothesis:

The purpose of this study was to investigate if DNA from bacteria was present in acutely ruptured Achilles tendons. We hypothesized that 20% to 30% of the samples from the rupture site and no samples from healthy tissue would be positive for bacterial DNA.

Study Design:

Case series; Level of evidence, 4.

Methods:

This study included 20 consecutive patients scheduled for surgical repair of an acute ATR. Tendon biopsy specimens were taken from the rupture site and from the healthy tendon tissue proximal to the rupture to act as a control. Samples were blinded to the technician and analyzed using polymerase chain reaction targeted to the bacterial 16S rDNA gene and Sanger sequencing to identify the bacterial species present. McNemar test for paired proportions was performed to test for statistically significant differences in the number of samples positive for bacterial DNA between the ruptured and control regions of the Achilles tendon.

Results:

Of the 20 patients, 1 (5%) had a positive sample with bacterial DNA from the ruptured part of the Achilles tendon. The same patient also had a positive control sample, although with different bacterial DNA. An additional patient had a positive control sample. There was no statistically significant difference in the number of bacterial DNA–positive samples between the ruptured and control regions of the Achilles tendon. The bacteria found ( Staphylococcus sp, Micrococcus sp, and Staphylococcus epidermidis) were normal commensal organisms on the human skin.

Conclusion:

Bacterial DNA was infrequent in tissue from ruptured Achilles tendons and, if identified, likely was a result of contamination. This suggests that bacteria are not involved in the pathological changes occurring before rupture of the Achilles tendon.
Human-bottlenose dolphin interactions within wildlife tourism, ocean recreation and fisheries
Authors: Barnhill Kelsey Archer , Scott Jennifer , Clark H Poppy , Smith Alycia Jane
Published: August 2022

Bottlenose dolphins ( Tursiops truncatus and Tursiops aduncus; BND) live in coastal waters, prompting frequent contact with humans. Interaction with BND can be either planned (e.g. swim-with-dolphin experiences) or chance (e.g. BND surfing on boat wakes). These charismatic cetaceans are common in many forms of wildlife tourism, including marine wildlife tours, swim-with-dolphin experiences and hand feeding. BND also interact with humans by chance during ocean recreation activities, such as surfing, swimming and boating. Within fisheries, there is both cooperation and conflict between humans and BND. Through a literature review, this paper highlights the effects such interactions cause to both BND and humans with a focus on wildlife tourism, ocean recreation and fisheries.
Molecular basis of high temperature-induced bolting in lettuce revealed by multi-omics analysis
Authors: Hao Jinghong , Yang Junwei , Liu Xiaofeng , Pan Gaoyang , Li Yunfeng , Zhang Xiaolan , Han Yingyan , Fan Shuangxi , Zhou Zhaoyang
Published: August 2022

Background

High temperature induces early bolting in lettuce (Lactuca sativa L.), which affects both quality and production. However, the molecular mechanism underlying high temperature-induced bolting is still limited.

Results

We performed systematical analysis of morphology, transcriptome, miRNAs and methylome in lettuce under high temperature treatment. Through a comparison of RNA-Seq data between the control and the high temperature treated lettuces at different time points totally identified 2944 up-regulated genes and 2203 down-regulated genes, which cover three floral pathways including photoperiod, age and gibberellin (GA) pathways. Genome wide analysis of miRNAs and methylome during high temperature treatment indicated miRNAs and DNA methylation might play a role controlling gene expression during high temperature-induced bolting. miRNA targets included some protein kinase family proteins, which potentially play crucial roles in this process.

Conclusions

Together, our results propose a possible regulation network involved in high temperature-induced bolting.
Evaluating the impact of calibration of patient-reported outcomes measures on results from randomized clinical trials: a simulation study based on Rasch measurement theory
Authors: Loubert Angély , Regnault Antoine , Sébille Véronique , Hardouin Jean-Benoit
Published: August 2022

Background

Meaningfully interpreting patient-reported outcomes (PRO) results from randomized clinical trials requires that the PRO scores obtained in the trial have the same meaning across patients and previous applications of the PRO instrument. Calibration of PRO instruments warrants this property. In the Rasch measurement theory (RMT) framework, calibration is performed by fixing the item parameter estimates when measuring the targeted concept for each individual of the trial. The item parameter estimates used for this purpose are typically obtained from a previous “calibration” study. But imposing this constraint on item parameters, instead of freely estimating them directly in the specific sample of the trial, may hamper the ability to detect a treatment effect. The objective of this simulation study was to explore the potential negative impact of calibration of PRO instruments that were developed using RMT on the comparison of results between treatment groups, using different analysis methods.

Methods

PRO results were simulated following a polytomous Rasch model, for a calibration and a trial sample. Scenarios included varying sample sizes, with instrument of varying number of items and modalities, and varying item parameters distributions. Different treatment effect sizes and distributions of the two patient samples were also explored. Cross-sectional comparison of treatment groups was performed using different methods based on a random effect Rasch model. Calibrated and non-calibrated approaches were compared based on type-I error, power, bias, and variance of the estimates for the difference between groups.

Results

There was no impact of the calibration approach on type-I error, power, bias, and dispersion of the estimates. Among other findings, mistargeting between the PRO instrument and patients from the trial sample (regarding the level of measured concept) resulted in a lower power and higher position bias than appropriate targeting.

Conclusions

Calibration does not compromise the ability to accurately assess a treatment effect using a PRO instrument developed within the RMT paradigm in randomized clinical trials. Thus, given its essential role in producing interpretable results, calibration should always be performed when using a PRO instrument developed using RMT as an endpoint in a randomized clinical trial.
Fertility intentions among young people in the era of China’s three–child policy: a national survey of university students
Authors: Zhang Chenyun , Wei Lingling , Zhu Yinyan , Teng Li , Zhang Wenchang , Xu Jia , Qin Mengqi , Jiang Na , Alias Haridah , Wong Li Ping
Published: August 2022

Background

This study aimed to assess the fertility intentions of young people after the announcement of the three–child policy in China and to determine whether knowledge about reproductive, maternal, newborn, and child health (RMNCH) services or support, childbearing- and childbirth-related anxiety, and parenthood–related anxiety influence fertility intentions.

Methods

A cross-sectional Internet-based survey was conducted on a nationwide sample of young people aged 18 to 28 years old in education institutions. Factors associated with fertility intentions were analysed using partial least squares structural equation modelling (PLS-SEM).

Results

Only 4.2% of males and 1.7% of females intended to have three children or more. On the whole, the majority (40.3%) reported the intention to have two children. The mean and standard deviation (SD) for the total knowledge RMNCH support and/or services knowledge score was 9.5 (SD ± 8.9), out of a possible score of 39. The median and interquartile range (IQR) of childbearing– and childbirth-related anxiety score was 8.0 (IQR = 6.0–9.0), out of a possible score of 10. The median and IQR of parenthood–related anxiety score among the males was 6.0 (IQR = 4.0–9.0) and for females was 7.0 (IQR = 5.0–9.0). Results from PLS-SEM revealed that a higher level of knowledge of RMNCH support and/or services is significantly associated with higher fertility intentions. Both childbearing- and childbirth-related anxiety and parenthood–related anxiety were inversely associated with fertility intentions.

Conclusion

Raising awareness about RMNCH supportive measures and easing birth- and parenting anxiety are imperative to enhance birth rates. Future policies should pay more attention to these determinants to achieve their intended goal of boosting population growth.
GPX4 suppresses ferroptosis to promote malignant progression of endometrial carcinoma via transcriptional activation by ELK1
Authors: Wei Sitian , Yu Zhicheng , Shi Rui , An Lanfen , Zhang Qi , Zhang Qian , Zhang Tangansu , Zhang Jun , Wang Hongbo
Published: August 2022

Background

Glutathione Peroxidase 4 (GPX4) is a key protein that inhibits ferroptosis. However, its biological regulation and mechanism in endometrial cancer (EC) have not been reported in detail.

Methods

The expression of GPX4 in EC tissues was determined by TCGA databases, qRT-PCR, Western blot, and immunohistochemistry (IHC). The effects of GPX4 on EC cell proliferation, migration, apoptosis, and tumorigenesis were studied in vivo and in vitro. In addition, ETS Transcription Factor ELK1 (ELK1) was identified by bioinformatics methods, dual-luciferase reporter assay, and chromatin immunoprecipitation (ChIP). Pearson correlation analysis was used to evaluate the association between ELK1 and GPX4 expression.

Results

The expression of GPX4 was significantly up-regulated in EC tissues and cell lines. Silencing GPX4 significantly inhibited the proliferation, migration ability, induced apoptosis, and arrested the cell cycle of Ishikawa and KLE cells. Knockdown of GPX4 accumulated intracellular ferrous iron and ROS, disrupted MMP, and increased MDA levels. The xenograft tumor model also showed that GPX4 knockdown markedly reduced tumor growth in mice. Mechanically, ELK1 could bind to the promoter of GPX4 to promote its transcription. In addition, the expression of ELK1 in EC was positively correlated with GPX4. Rescue experiments confirmed that GPX4 knockdown could reverse the strengthens of cell proliferation and migration ability and the lower level of Fe2+ and MDA caused by upregulating ELK1.

Conclusion

The results of the present study suggest that ELK1 / GPX4 axis plays an important role in the progress of EC by promoting the malignant biological behavior and inducing ferroptosis of EC cells, which provides evidence for investigating the potential therapeutic strategies of endometrial cancer.
Barriers to the management of sexual dysfunction among people with psychosis: analysis of qualitative data from the REMEDY trial
Authors: Thana Lavanya J. , O’Connell Lesley , Carne-Watson Alexandra , Shastri Abhishek , Saravanamuthu Arunan , Budhwani Natasha , Jayacodi Sandra , Leeson Verity C. , Munjiza Jasna , Pappa Sofia , Hughes Elizabeth , Reilly Joe , Crawford Mike J.
Published: August 2022

Background

More than half of people who use antipsychotic medication for psychosis report having sexual dysfunction. The REMEDY trial aimed to find out if switching antipsychotic medication provides an effective way to reduce sexual dysfunction among people with psychosis. We set out to recruit 216 participants over a two-year period, but recruitment was stopped after an extended 12-month pilot phase, during which we recruited only 10 participants. As part of a nested process evaluation, we conducted qualitative interviews with front-line clinicians to examine barriers to recruitment to the trial.

Methods

We developed a semi-structured interview schedule to explore staff views on factors that influenced whether they referred potential participants to the study. We interviewed a purposive sample of 51 staff from four National Health Service (NHS) Trusts in England, ensuring a range of different backgrounds, seniority, and levels of involvement in the trial. Audio recordings of interviews were transcribed for verbatim, and data were analysed using an inductive approach to thematic analysis.

Results

Nine interconnected themes were generated. Six themes concerned barriers to recruitment; including; prioritising patients’ mental stability, mutual discomfort and embarrassment about discussing a “taboo” subject, and concerns about unintended consequences of asking people with psychosis about their sexual functioning. Three themes, including the quality of treatment relationships and strategies for opening dialogue suggested ways to improve recognition of these “hidden” side effects.

Conclusion

The identification and management of sexual dysfunction among people with psychosis are not priorities for mental health services in England at this time. Many staff working in front-line services feel unprepared and uncomfortable asking people with psychosis about these problems. While greater use of screening tools may improve the identification of sexual dysfunction among people with psychosis, the evaluation and implementation of interventions to manage them will continue to be challenging unless NHS leaders and senior clinicians demonstrate greater commitment to changing current clinical practice.

Trial registration

Current Controlled Trials ISRCTN12307891.
Towards an integrated surveillance of zoonotic diseases in Burkina Faso: the case of anthrax
Authors: Nana Sougrenoma Désiré , Caffin Jean-Hugues , Duboz Raphaël , Antoine-Moussiaux Nicolas , Binot Aurélie , Diagbouga Potiandi Serge , Hendrikx Pascal , Bordier Marion
Published: August 2022

Background

Anthrax is a zoonotic disease that causes frequent outbreaks in livestock and fatal human cases in Burkina Faso. Effective surveillance of this disease calls for the establishment of an integrated surveillance system, in line with the One Health concept. However, despite a strong technical and financial support from international partners, surveillance is still poorly conducted within an integrated approach. Based on stakeholder perspectives, the study has for objective to deepen our understanding of the anthrax surveillance system and to identify the obstacles and levers towards a more integrated approach to anthrax surveillance in Burkina Faso.

Methods

The data was collected from a literature review and interviews with surveillance stakeholders. We first conducted a qualitative descriptive analysis of the data to characterize the surveillance system (programmes, actors, collaboration). In a second step, we conducted a thematic analysis of the informants' discourse in order to identify what represents an obstacle or, conversely, a lever for a more integrated approach to anthrax surveillance.

Results

The surveillance system of anthrax in Burkina Faso includes three programmes (in the livestock, wildlife and human sectors), which involves 30 actors. These sectoral programmes operate almost independently from one another, although some collaborations are existing for the governance and implementation of surveillance activities. Analysis of the discourse of key stakeholders led to the identification of four categories of factors that may influence the implementation of an integrated surveillance system in the country: knowledge; technical, organizational and social capacities; motivation; intersectoral governance.

Conclusions

This study highlights the difficulty of translating One Health governance to the national level and the need to better articulate the visions of all categories of stakeholders. This study also reveals the need to develop specific evaluation systems for integrated policies in order to provide credible evidence of their added value for a better management of zoonotic diseases. Finally, our study underlines the need to act upstream the emergence of zoonoses and allocate more resources to the prevention of zoonoses than to their control.
Women’s experience and perspectives toward genital cosmetic surgery in Erbil city/Iraq: a qualitative study
Authors: Piro Tiran Jamil , Saeed Awaz Aziz , Abdulla Warda Hassan , Safari Kolsoom
Published: August 2022

Background

Nowadays, Female Genital Cosmetic Surgery is quite prevalent, resulting in a wide range of medical and cultural implications. The majority of women who undergo this operation suffer from anxiety, depression, and other emotional symptoms. The present study was carried out in order to explore women’s perspective on and experience of genital cosmetic surgery given their special context and cultural aspects.

Methods

The qualitative study applying content analysis examined the experiences of nine women who received genital cosmetic surgery in Erbil, Kurdistan-Iraq, between 2021 and 2022. Each of the semi-in-depth face-to-face interviews lasted between 40 and 60 min and was conducted at the physician's clinics.

Results

Semi-structured interviews led to emergence of two main themes, namely “husband satisfaction” and “self-confidence”. Interpreting the participants’ stories resulted in some relevant subthemes and meaning units like “ugly appearance”, “anxiety related to husband undesirable intercourse”, and “dyspareunia”. Finally, the related conclusions of each theme were explored.

Conclusion

As suggested by the study findings, female genital cosmetic surgery improves the women’s body image and sexual function and the couples’ sexual satisfaction, especially that of husbands. Because of the people’s sociocultural aspects in Kurdistan region, their awareness of female sexual needs and marital relationship needs to be raised.
The effects of romosozumab combined with active vitamin D3 on fracture healing in ovariectomized rats
Authors: Takase Ryota , Tsubouchi Yuta , Otsu Takefumi , Kataoka Takashi , Iwasaki Tatsuya , Kataoka Masashi , Tsumura Hiroshi
Published: August 2022

Background

In this study, we investigated the potential acceleration of fracture healing and bone mineral density-increasing effects of romosozumab and active vitamin D3 combination therapy for fractures in ovariectomized rats.

Methods

Ovariectomy was performed on 40 24-week-old female Sprague–Dawley rats. After 8 weeks, the rats were subjected to periosteum removal and osteotomy of the femoral shaft followed by osteosynthesis with intramedullary nailing to create fracture models. The rats were then divided into four groups: C group (control), R group (receiving romosozumab at 25 mg/kg once a month via subcutaneous injection), VD group (receiving active vitamin D3 at 0.2 µg/kg twice a week via subcutaneous injection), and R + VD group. Further, 10 rats were included in a sham group. At 10 weeks after the intervention, both femurs were removed and blood samples were collected from all rats. Soft X-ray imaging was used to evaluate bone union, and microcomputed tomography (micro-CT) was used for bone morphometric evaluation. Toluidine blue staining was used for the histopathological evaluation of the undecalcified specimens, and bone turnover marker levels were measured using enzyme-linked immunosorbent assay.

Results

Bone morphometry analysis via micro-CT revealed increased mineral density of the trabecular bone in the R + VD group femurs, demonstrating the effectiveness of romosozumab plus active vitamin D3 combination therapy. However, there were no differences in bone union evaluated using soft X-ray imaging, indicating no acceleration of fracture healing.

Conclusions

Although romosozumab and active vitamin D3 combination therapy increased trabecular bone volume, there was no evidence on its ability to accelerate fracture healing.

Graphical abstract
Lysophosphatidic acid acyltransferase 2 and 5 commonly, but differently, promote seed oil accumulation in Brassica napus
Authors: Zhang Kai , He Jianjie , Yin Yongtai , Chen Kang , Deng Xiao , Yu Peng , Li Huaixin , Zhao Weiguo , Yan Shuxiang , Li Maoteng
Published: August 2022

Background

Increasing seed oil content (SOC) of Brassica napus has become one of the main plant breeding goals over the past decades. Lysophosphatidic acid acyltransferase (LPAT) performs an important molecular function by regulating the production of phosphatidic acid (PA), a key intermediate in the synthesis of membrane and storage lipids. However, the mechanism underlying the effect of LPAT on the SOC of B. napus remains unclear.

Results

In the present study, significant elevation of SOC was achieved by overexpressing BnLPAT2 and BnLPAT5 in B. napus. RNAi and CRISPR–Cas9 were also successfully used to knock down and knock out these two genes in B. napus where SOC significantly decreased. Meanwhile, we found an accumulation of lipid droplets and oil bodies in seeds of BnLPAT2 and BnLPAT5 overexpression lines, whereas an increase of sugar and protein in Bnlpat2 and Bnlpat5 mutant seeds. Sequential transcriptome analysis was further performed on the developing seeds of the BnLPAT2 and BnLPAT5 overexpression, knockdown, and knockout rapeseed lines. Most differentially expressed genes (DEGs) that were expressed in the middle and late stages of seed development were enriched in photosynthesis and lipid metabolism, respectively. The DEGs involved in fatty acid and lipid biosynthesis were active in the overexpression lines but were relatively inactive in the knockdown and knockout lines. Further analysis revealed that the biological pathways related to fatty acid/lipid anabolism and carbohydrate metabolism were specifically enriched in the BnLPAT2 overexpression lines.

Conclusions

BnLPAT2 and BnLPAT5 are essential for seed oil accumulation. BnLPAT2 preferentially promoted diacylglycerol synthesis to increase SOC, whereas BnLPAT5 tended to boost PA synthesis for membrane lipid generation. Taken together, BnLPAT2 and BnLPAT5 can jointly but differently promote seed oil accumulation in B. napus. This study provides new insights into the potential mechanisms governing the promotion of SOC by BnLPAT2 and BnLPAT5 in the seeds of B. napus.
Infusion of two-dose mesenchymal stem cells is more effective than a single dose in a dilated cardiomyopathy rat model by upregulating indoleamine 2,3-dioxygenase expression
Authors: Gong Chenyi , Chang Lei , Sun Xuan , Qi Yu , Huang Rong , Chen Ke , Wang Bin , Kang Lina , Wang Lian , Xu Biao
Published: August 2022

Background and aims

The therapeutic efficacy of single-dose mesenchymal stromal cell (MSC) therapy for heart failure (HF) remains inconsistent. This study aimed to investigate whether infusion with two-dose human umbilical cord MSC (hUCMSCs) could be therapeutically superior to single-dose therapy in a rat model of dilated cardiomyopathy (DCM) and explored the underlying mechanisms.

Methods

Male Sprague–Dawley rats were intraperitoneally injected with doxorubicin (DOX) to establish a DCM model and randomized to intravenously receive single-dose or two-dose hUCMSCs at an interval of 14 days. Their left ventricular (LV) systolic and diastolic functions were analyzed by echocardiography. The percentages of Th1, Th2, Th17, and Treg cells in the heart, spleen, lymph nodes, and peripheral blood and the levels of serum cytokines in individual rats were analyzed by flow cytometry and cytometric bead assay, respectively. The degrees of cardiac fibrosis and cardiomyocyte apoptosis were examined by histology. The importance of indoleamine 2,3-dioxygenase (IDO), an activator of Treg differentiation, in the therapeutic effect of hUCMSCs on inflammation and heart function of rats was determined after induction of IDO over-expression (IDO-OE) using IFN-γ (1 ng/ml) and TNF-α (10 ng/ml) stimulation or silencing (IDO-KD) using small interfering RNA (siRNA) technology.

Results

Compared with the single dose, two-dose hUCMSCs were more effective in improving LV performance, attenuating cardiac dilation, reducing cardiomyocyte apoptosis and cardiac fibrosis. Two-dose hUCMSC therapy significantly increased Treg number in the heart and peripheral blood, accompanied by increased cardiac IDO expression. Compared with the control hUCMSCs, IDO-OE hUCMSCs significantly enhanced Treg and Th2 cell responses and decreased systemic Th17 cell responses and Th1 cell numbers in the mediastinal lymph nodes. Treatment with IDO-OE hUCMSCs significantly improved LV remodeling and dysfunction. However, treatment with IDO-KD hUCMSCs had opposite effects in rats.

Conclusions

Administration of two-dose hUCMSCs has better therapeutic effects than single-dose therapy for inhibiting myocardial inflammation to improve LV function in DCM rats. These effects are associated with upregulating IDO expression and its systemic anti-inflammatory activities.
Detection of circulating tumor cells: opportunities and challenges
Authors: Ju Siwei , Chen Cong , Zhang Jiahang , Xu Lin , Zhang Xun , Li Zhaoqing , Chen Yongxia , Zhou Jichun , Ji Feiyang , Wang Linbo
Published: August 2022

Circulating tumor cells (CTCs) are cells that shed from a primary tumor and travel through the bloodstream. Studying the functional and molecular characteristics of CTCs may provide in-depth knowledge regarding highly lethal tumor diseases. Researchers are working to design devices and develop analytical methods that can capture and detect CTCs in whole blood from cancer patients with improved sensitivity and specificity. Techniques using whole blood samples utilize physical prosperity, immunoaffinity or a combination of the above methods and positive and negative enrichment during separation. Further analysis of CTCs is helpful in cancer monitoring, efficacy evaluation and designing of targeted cancer treatment methods. Although many advances have been achieved in the detection and molecular characterization of CTCs, several challenges still exist that limit the current use of this burgeoning diagnostic approach. In this review, a brief summary of the biological characterization of CTCs is presented. We focus on the current existing CTC detection methods and the potential clinical implications and challenges of CTCs. We also put forward our own views regarding the future development direction of CTCs.
Prediction of high infiltration levels in pituitary adenoma using MRI-based radiomics and machine learning
Authors: Zhang Chao , Heng Xueyuan , Neng Wenpeng , Chen Haixin , Sun Aigang , Li Jinxing , Wang Mingguang
Published: August 2022

Background

Infiltration is important for the surgical planning and prognosis of pituitary adenomas. Differences in preoperative diagnosis have been noted. The aim of this article is to assess the accuracy of machine learning analysis of texture-derived parameters of pituitary adenoma obtained from preoperative MRI for the prediction of high infiltration.

Methods

A total of 196 pituitary adenoma patients (training set: n = 176; validation set: n = 20) were enrolled in this retrospective study. In total, 4120 quantitative imaging features were extracted from CE-T1 MR images. To select the most informative features, the least absolute shrinkage and selection operator (LASSO) and variance threshold method were performed. The linear support vector machine (SVM) was used to fit the predictive model based on infiltration features. Furthermore, the receiver operating characteristic curve (ROC) was generated, and the diagnostic performance of the model was evaluated by calculating the area under the curve (AUC), accuracy, precision, recall, and F1 value.

Results

A variance threshold of 0.85 was used to exclude 16 features with small differences using the LASSO algorithm, and 19 optimal features were finally selected. The SVM models for predicting high infiltration yielded an AUC of 0.86 (sensitivity: 0.81, specificity 0.79) in the training set and 0.73 (sensitivity: 0.87, specificity: 0.80) in the validation set. The four evaluation indicators of the predictive model achieved good diagnostic capabilities in the training set (accuracy: 0.80, precision: 0.82, recall: 0.81, F1 score: 0.81) and independent verification set (accuracy: 0.85, precision: 0.93, recall: 0.87, F1 score: 0.90).

Conclusions

The radiomics model developed in this study demonstrates efficacy for the prediction of pituitary adenoma infiltration. This model could potentially aid neurosurgeons in the preoperative prediction of infiltration in PAs and contribute to the selection of ideal surgical strategies.
Evaluation of the role of hydrocortisone either alone or combined with fludrocortisone in the outcome of septic shock in adults
Authors: Labib Heba A. , Hassan Ali I. , Kamaly Ayman M. , Wahba Sherif S. , Ammar Mona A.
Published: August 2022

Background

Management of sepsis is a time critical procedure; the consequences of improperly managed sepsis and septic shock can cause multiple organ dysfunction and death. The aim of this study was to evaluate of the role of hydrocortisone either alone or with fludrocortisone on the outcome septic shock in adults. This study was conducted on 66 patients who were assigned randomly to 3 groups each containing 22 patients. Control group had received standard therapy for sepsis, and H group had received standard therapy for sepsis plus hydrocortisone. HF group had received standard therapy for sepsis plus hydrocortisone and fludrocortisone.

Results

It showed that the use of corticosteroids (the hydrocortisone or the hydrocortisone plus fludrocortisone) in septic patients was associated with significant reduction in the time to wean from vasopressors and length of intensive care unit stay. Meanwhile, there were no significant effect of the mortality rate, Sepsis-Related Organ Failure Assessment (SOFA) score reduction, gastrointestinal bleeding, and superinfection as corticosteroids adverse effects between the three groups.

Conclusions

The corticosteroids in septic shock have significant positive impacts on some aspects in treatment of septic shock but it does not affect the mortality rate of the patients.
Role of 18F-FDG PET/CT in evaluation of recently diagnosed breast cancer patients
Authors: Kamal Ayat Mahmoud , Kamal Omnia Ahmed , Sakr Hossam Moussa , Ali Susan Adil
Published: August 2022

Background

Breast cancer is the most frequent malignant disease in women and usually affects people of all ages, races, socioeconomic classes, and geographic locations. Once breast cancer is diagnosed, tumor staging should be assessed precisely before treatment and prognosis could be determined. The purpose of this study was to determine the diagnostic usefulness of PET/CT in the initial assessment of patients with newly diagnosed breast cancer who were referred for tumor staging, pre-therapeutic or preoperative evaluation.

Results

In the examined 50 patients, PET/CT has higher sensitivity and accuracy compared to CT alone (reaching 100% for PET/CT and 96% for CT) in detecting malignant breast lesions, regional and distant nodal deposits as well as distant deposits, with subsequent upstaging in two patients.

Conclusions

18F-FDG PET/CT is a single valuable technique that detects metastatic illness in newly diagnosed breast cancer patients in an efficient, accurate, and noninvasive manner, resulting in modification of the initial staging, which in turn reflected on the patients' therapeutic plans.
RUBY: Natural Language Processing of French Electronic Medical Records for Breast Cancer Research
Authors: Schiappa Renaud , Contu Sara , Culie Dorian , Thamphya Brice , Chateau Yann , Gal Jocelyn , Bailleux Caroline , Haudebourg Juliette , Ferrero Jean-Marc , Barranger Emmanuel , Chamorey Emmanuel
Published: August 2022

PURPOSE

Electronic medical records are a valuable source of information about patients' clinical status but are often free-text documents that require laborious manual review to be exploited. Techniques from computer science have been investigated, but the literature has marginally focused on non-English language texts. We developed RUBY, a tool designed in collaboration with IBM—France to automatically structure clinical information from French medical records of patients with breast cancer.

MATERIALS AND METHODS

RUBY, which exploits state-of-the-art Named Entity Recognition models combined with keyword extraction and postprocessing rules, was applied on clinical texts. We investigated the precision of RUBY in extracting the target information.

RESULTS

RUBY has an average precision of 92.8% for the Surgery report, 92.7% for the Pathology report, 98.1% for the Biopsy report, and 81.8% for the Consultation report.

CONCLUSION

These results show that the automatic approach has the potential to effectively extract clinical knowledge from an extensive set of electronic medical records, reducing the manual effort required and saving a significant amount of time. A deeper semantic analysis and further understanding of the context in the text, as well as training on a larger and more recent set of reports, including those containing highly variable entities and the use of ontologies, could further improve the results.
Early-Phase Oncology Trials: Why So Many Designs?
Authors: Clertant Matthieu
Published: August 2022

The past 30 years have seen a considerable effort on the part of statisticians to improve the design and accuracy of early-phase oncology trials. Some of this effort has been rewarded via successful implementation in actual trials, yet it would be fair to say that among clinicians, there remains some reluctance to fully embrace more efficient model-based approaches. One reason for such reticence is the difficulty in understanding exactly what is being offered by more modern designs. Although it is generally accepted that these designs offer improvements over the old standard 3 + 3 design, a new question has then to be addressed: How should we decide among the new proposals which one is the best for our purpose? In this study, we recall 15 designs that are currently proposed and in use. We show that among these 15 designs, many are operationally identical. These 15 designs reduce to three broad classes of designs. This review helps summarize their properties and differences and highlights that certain designs require ad hoc modifications to ensure satisfactory performance.