bluuebunny/crossref_metadata_2025 huggingface dataset:
A model of integrated remote monitoring and behaviour change for osteoarthritis
Authors: Tack Christopher
Published: August 2021

Background

The National Institute for Health and Care Excellence recommends the use of digital and mobile health technologies to facilitate behaviour change interventions. Due to its high prevalence and dependence upon patient self-management strategies, osteoarthritis is one musculoskeletal condition which may benefit from such approaches. This is particularly pertinent due to the increasing use of remote monitoring technologies to collect patient data and facilitate self-management in individuals outside of hospital clinics. In practice however, application of digital behaviour change interventions is difficult due to insufficient reporting of behaviour change theories in the current literature. When digital technologies are employed to alter behaviour change in osteoarthritis, they often focus on physical activity. Currently, such interventions focus of self-efficacy but do not often explicitly report the behaviour change techniques they use to facilitate these changes.

Methods

This paper proposes a new model of integrating specific behaviour change principles (persuasive design) in an integrated model of remote monitoring and digital behaviour change interventions for osteoarthritis.

Results

There is potential to combine remote monitoring systems of patient data through digital and mobile technologies with behaviour change principles to improve physical activity behaviours in individuals with osteoarthritis. The use of persuasive design principles (e.g. prompts or nudges) through mobile notifications and strategic system design can be directed to enhance behaviour change. A validated measure of behaviour change, such as the patient activation measure, will allow effective evaluation of such systems.

Conclusions

Digital behaviour change interventions should be directed towards the underlying principles of behaviour change they employ, although this is not commonly reported in practice. Such interventions can be integrated within remote monitoring pathways using persuasive design techniques to enhance patient activation. This approach can enhance self-management in individuals with musculoskeletal conditions, such as osteoarthritis.
Protocol for the Weight-bearing in Ankle Fractures (WAX) trial: a multicentre prospective non-inferiority trial of early versus delayed weight-bearing after operatively managed ankle fracture
Authors: Bretherton C. P. , Claireaux H. A. , Achten J. , Athwal A. , Dutton S. J. , Peckham N. , Petrou S. , Kearney R. S. , Appelbe D. , Griffin X. L.
Published: August 2021

Background

Unstable ankle fractures represent a substantial burden of disease, accounting for a mean hospital stay of nine days, a mean cost of £4,491 per patient and 20,000 operations per year. There is variation in UK practice around weight-bearing instructions after operatively managed ankle fracture. Early weight-bearing may reduce reliance on health services, time off work, and improve functional outcomes. However, concerns remain about the potential for complications such as implant failure. This is the protocol of a multicentre randomised non-inferiority clinical trial of weight-bearing following operatively treated ankle fracture.

Methods

Adults aged 18 years and over who have been managed operatively for ankle fracture will be assessed for eligibility. Baseline function (Olerud and Molander Ankle Score [OMAS]), health-related quality of life (EQ-5D-5L), and complications will be collected after informed consent has been obtained. A randomisation sequence has been prepared by a trial statistician to allow for 1:1 allocation to receive either instruction to weight-bear as pain allows from the point of randomisation, two weeks after the time of surgery (‘early weight-bearing’ group) or to not weight-bear for a further four weeks (‘delayed weight -bearing’ group). All other treatment will be as per the guidance of the treating clinician.

Participants will be asked about their weight-bearing status weekly until four weeks post-randomisation. At four weeks post-randomisation complications will be collected. At six weeks, four months, and 12 months post-randomisation, the OMAS, EQ-5D-5L, complications, physiotherapy input, and resource use will be collected. The primary outcome measure is ankle function (OMAS) at four months post-randomisation.

A minimum of 436 participants will be recruited to obtain 80% power to detect a non-inferiority margin of -6 points on the OMAS 4 months post-randomisation. A within-trial health economic evaluation will be conducted to estimate the cost-effectiveness of the treatment options.

Discussion

The results of this study will inform national guidance with regards to the most clinically and cost-effective strategy for weight-bearing after surgery for unstable ankle fractures.

Trial registration

ISRCTN12883981, Registered 02 December 2019.
District health managers perspectives of introducing a new service: a qualitative study of the community-based newborn care programme in Ethiopia
Authors: Berhanu Della , Hashmi Iram , Schellenberg Joanna , Avan Bilal
Published: August 2021

Background

The planning, resourcing, implementation and monitoring of new programmes by district health managers is integral for success and sustainability. Ethiopia introduced the Community-Based Newborn Care programme in 2014 to improve newborn survival: an innovative component allowed community health workers to provide antibiotics for young infants with possible serious bacterial infection when referral was not possible. Informed by the World Health Organization health system building block framework, we aimed to study the capacity and operational challenges of introducing this new health service from the perspective of programme implementers and managers at the district level 20 months after programme initiation.

Methods

This qualitative study was part of a programme evaluation. From November to December of 2015, we conducted 28 semi-structured interviews with staff at district health offices, health centres and implementing Non-Governmental Organisations in 15 districts of four regions of Ethiopia. Verbatim transcripts were analysed using a priori and emerging themes.

Results

In line with the government's commitment to treat sick newborns close to their homes, participants reported that community health workers had been successfully trained to provide injectable antibiotics. However, the Community-Based Newborn Care programme was scaled up without allowing the health system to adapt to programme needs. There were inadequate processes and standards to ensure consistent availability of (1) trained staff for technical supervision, (2) antibiotics and (3) monitoring data specific to the programme. Furthermore, Non-Governmental Organizations played a central implementing role, which had implications for the long-term district level ownership and thus for the sustainability of the programme.

Conclusion

In settings where sustainable local implementation depends on district-level health teams, new programmes should assess health system preparedness to absorb the service, and plan accordingly. Our findings can inform policy makers and implementers about the pre-conditions for a health system to introduce similar services and maximize long-term success.
A survey of Italian cat owners’ attitudes towards cat vaccination through a web-based questionnaire
Authors: Filipe Joel Fernando Soares , Lauzi Stefania , Pina Lucrezia , Dall’Ara Paola
Published: August 2021

Background

Vaccination plays an important role in feline healthcare as it is the most effective measure for prevention against feline infectious diseases. Therefore, it is important to know owners’ opinion towards cats’ vaccination and current veterinary practices in order to advice owners on the use of the correct vaccination protocol.

This study aimed to investigate the proportion of cats regularly vaccinated and identify the main factors motivating cat owners’ decisions related to vaccination in Italy. A questionnaire was disseminated online (mainly via social networks) to collect data regarding Italian cat owners’ demographics, information about cats, factors regarding cats’ vaccination, and veterinary-owner relationship.

Results

A total of 1264 owners participated in the survey and 1247 questionnaires were completed and statistically analyzed. The majority (91%; n = 1131) of cats were vaccinated and 80% (n = 998) had been vaccinated within the last 3 years. Age of 2–4 years old cats and the acquisition from a breeder or cat shop were significantly associated with vaccination within the last 3 years. Cats vaccinated but not within the last 3 years were significantly associated with cat’s indoor lifestyle, cats’ age ≥ 5 years old and low annual household income. Importance of vaccination cost, low annual household income and owners’ job not related to healthcare was statistically associated with the lack of cat’s vaccination. In addition, 86% of the owners took their cat regularly to veterinary clinics. Veterinarians play a significant role in owners’ decision, and they are considered the most useful source of information about vaccination by 97% of owners.

Conclusions

The high number of recently vaccinated cats suggests owner’s attention towards feline vaccination and cat’s health. The importance of veterinarian’s advice along with the knowledge of factors associated to the unvaccinated status of cats may help veterinarians to grow owner’s confidence and increase prevention of feline infectious diseases.

However further investigations based on a more comprehensive sample of the general population are needed to confirm the results of this survey.
Screening and evaluation of the strong endogenous promoters in Pichia pastoris
Authors: Dou Weiwang , Zhu Quanchao , Zhang Meihua , Jia Zuyuan , Guan Wenjun
Published: August 2021

Background

Due to its ability to perform fast and high-density fermentation, Pichia pastoris is not only used as an excellent host for heterologous protein expression but also exhibits good potential for efficient biosynthesis of small-molecule compounds. However, basic research on P. pastoris lags far behind Saccharomyces cerevisiae, resulting in a lack of available biological elements. Especially, fewer strong endogenous promoter elements available for foreign protein expression or construction of biosynthetic pathways were carefully evaluated in P. pastoris. Thus, it will be necessary to identify more available endogenous promoters from P. pastoris.

Results

Based on RNA-seq and LacZ reporter system, eight strong endogenous promoters contributing to higher transcriptional expression levels and β-galactosidase activities in three frequently-used media were screened out. Among them, the transcriptional expression level contributed by P0019, P0107, P0230, P0392, or P0785 was basically unchanged during the logarithmic phase and stationary phase of growth. And the transcriptional level contributed by P0208 or P0627 exhibited a growth-dependent characteristic (a lower expression level during the logarithmic phase and a higher expression level during the stationary phase). After 60 h growth, the β-galactosidase activity contributed by P0208, P0627, P0019, P0407, P0392, P0230, P0785, or P0107 was relatively lower than PGAP but higher than PACT1. To evaluate the availability of these promoters, several of them were randomly applied to a heterogenous β-carotene biosynthetic pathway in P. pastoris, and the highest yield of β-carotene from these mutants was up to 1.07 mg/g. In addition, simultaneously using the same promoter multiple times could result in a notable competitive effect, which might significantly lower the transcriptional expression level of the target gene.

Conclusions

The novel strong endogenous promoter identified in this study adds to the number of promoter elements available in P. pastoris. And the competitive effect observed here suggests that a careful pre-evaluation is needed when simultaneously and multiply using the same promoter in one yeast strain. This work also provides an effective strategy to identify more novel biological elements for engineering applications in P. pastoris.
WD40 repeat 43 mediates cell survival, proliferation, migration and invasion via vimentin in colorectal cancer
Authors: Li Zijian , Feng Min , Zhang Jie , Wang Xingzhou , Xu En , Wang Chao , Lin Fengcen , Yang Zhi , Yu Heng , Guan Wenxian , Wang Hao
Published: August 2021

Background

WD40 repeat (WDR)43 is an RNA-binding protein that belongs to the WDR domain protein family. Its biological function is largely unclear, particularly in colorectal cancer (CRC).

Methods

In the present study, we searched the TCGA database and found the correlation between WDR43 and CRC. Subsequently, the high expression of WDR43 in human clinical samples of CRC was validated and we further examined the biological functions of it in CRC cells. Finally, we explored potential downstream proteins or pathways and established subcutaneous xenograft model to verify our findings.

Results

Immunohistochemistry of 16 patient specimens confirmed that the expression of WDR43 was elevated in CRC. WDR43 knockdown was shown to increase apoptosis and inhibit the proliferation, migration and invasion of CRC cells in vitro and reduce tumorigenesis in animal models. In addition, it was found that WDR43 knockdown inhibited vimentin (VIM) expression in CRC cells and overexpression of VIM can partially reverse the effects of WDR43 both in vitro and in vivo.

Conclusion

In conclusion, the role of WDR43 in the occurrence and development of CRC was investigated in the present study. WDR43 may serve as a valuable biomarker and provide new options for the diagnosis and treatment of colorectal cancer.
Trajectories of objectively measured physical activity and childhood overweight: longitudinal analysis of the IDEFICS/I.Family cohort
Authors: Sprengeler Ole , Pohlabeln Hermann , Bammann Karin , Buck Christoph , Lauria Fabio , Verbestel Vera , Eiben Gabriele , Konstabel Kenn , Molnár Dénes , Moreno Luis A. , Pitsiladis Yannis , Page Angie , Reisch Lucia , Tornaritis Michael , Ahrens Wolfgang
Published: August 2021

Background

Since only few longitudinal studies with appropriate study designs investigated the relationship between objectively measured physical activity (PA) and overweight, the degree PA can prevent excess weight gain in children, remains unclear. Moreover, evidence is limited on how childhood overweight determines PA during childhood. Therefore, we analyzed longitudinal trajectories of objectively measured PA and their bi-directional association with weight trajectories of children at 2- and 6-year follow-ups.

Methods

Longitudinal data of three subsequent measurements from the IDEFICS/I.Family cohort study were used to analyze the bi-directional association between moderate-to-vigorous PA (MVPA) and weight status by means of multilevel regression models. Analyses comprised 3393 (2-year follow-up) and 1899 (6-year follow-up) children aged 2–15.9 years from eight European countries with valid accelerometer data and body mass index (BMI) measurements. For categorized analyses, children’s weight status was categorized as normal weight or overweight (cutoff: 90th percentile of BMI) and children’s PA as (in-) sufficiently active (cutoffs: 30, 45 and 60 min of MVPA per day).

Results

Children engaging in at least 60 min MVPA daily at baseline and follow-ups had a lower odds of becoming overweight (odds ratio [OR] at 2-year follow-up: 0.546, 95% CI: 0.378, 0.789 and 6-year follow-up: 0.393, 95% CI: 0.242, 0.638), compared to less active children. Similar associations were found for 45 min MVPA daily. On the other side, children who became overweight had the lowest odds to achieve 45 or 60 min MVPA daily (ORs: 0.459 to 0.634), compared to normal weight children.

Conclusions

Bi-directional associations between MVPA and weight status were observed. In summary, at least 60 min MVPA are still recommended for the prevention of childhood overweight. To prevent excess weight gain, 45 min MVPA per day also showed preventive effects.
Fe3O4 magnetic nanoparticle-enhanced radiotherapy for lung adenocarcinoma via delivery of siBIRC5 and AS-ODN
Authors: Chen Shuzhen , Han Fushi , Huang Dongdong , Meng Jinqian , Chu Jiapeng , Wang Meng , Wang Peijun
Published: August 2021

Background

Radiotherapy is the mainstay treatment for lung adenocarcinoma, yet remains highly susceptible to resistance. Fe3O4 magnetic nanoparticles (MNPs) possess the ability to induce biological therapeutic effects. Herein, the current study set out to explore the effects of Fe3O4 MNPs on radiosensitivity of lung adenocarcinoma cells.

Methods

Fe3O4 MNPs loaded with both negatively-charged small interfering RNA against baculoviral IAP repeat containing 5 (siBIRC5) and oligodeoxynucleotide antisense (AS-ODN) to generate co-delivery NPs, followed by evaluation. Gel retardation assay was further performed to determine the binding ability of Fe3O4 MNPs to AS-ODN/siBIRC5. The radiosensitizing effect of NPs on lung adenocarcinoma cells was determined in the absence or the presence of NPs or radiotherapy. A549 and H460 tumor-bearing mice were established, where tumor tissues were subjected to immunohistochemistry.

Results

NPs were successfully prepared and characterized. BIRC5 expression levels were augmented in tissues of lung cancer patients. Fe3O4 MNPs enhanced the uptake of siBIRC5 and AS-ODN by lung adenocarcinoma cells. The presence of NPs under magnetic field reduced the BIRC5 expression and elevated the DR5 expression in lung adenocarcinoma cells. Lung adenocarcinoma cells treated with NPs exhibited inhibited tumor cell migration and increased DNA damage. After magnetic field treatment, tumors were better suppressed in the tumor-bearing mice treated with NPs, followed by radiotherapy.

Conclusion

Findings obtained in our study indicated that Fe3O4 MNPs-targeted delivery of siBIRC5 and AS-ODN enhances radiosensitivity, providing an innovative solution for the current clinically existing lung adenocarcinoma patients with radiotherapy resistance with a low risk of toxicity.
Bcl-2-associated transcription factor 1 Ser290 phosphorylation mediates DNA damage response and regulates radiosensitivity in gastric cancer
Authors: Liu Jia , Li Jingyi , Sun Zhao , Duan Yangmiao , Wang Fengqin , Wei Guangwei , Yang Jing-Hua
Published: August 2021

Background

DNA damage response plays critical roles in tumor pathogenesis and radiotherapy resistance. Protein phosphorylation is a critical mechanism in regulation of DNA damage response; however, the key mediators for radiosensitivity in gastric cancer still needs further exploration.

Methods

A quick label-free phosphoproteomics using high-resolution mass spectrometry and an open search approach was applied to paired tumor and adjacent tissues from five patients with gastric cancer. The dysregulated phosphoproteins were identified and their associated-pathways analyzed using Gene Set Enrichment Analysis (GSEA). The mostly regulated phosphoproteins and their potential functions were validated by the specific antibodies against the phosphorylation sites. Specific protein phosphorylation was further analyzed by functional and clinical approaches.

Results

832 gastric cancer-associated unique phosphorylated sites were identified, among which 25 were up- and 52 down-regulated. Markedly, the dysregulated phosphoproteins were primarily enriched in DNA-damage-response-associated pathways. Particularly, the phosphorylation of Bcl-2-associated transcription factor 1 (BCLAF1) at Ser290 was significantly upregulated in tumor. The upregulation of BCLAF1 Ser290 phosphorylation (pBCLAF1 (Ser290)) in tumor was confirmed by tissue microarray studies and further indicated in association with poor prognosis of gastric cancer patients. Eliminating the phosphorylation of BCLAF1 at Ser290 suppressed gastric cancer (GC) cell proliferation. Upregulation of pBCLAF1 (Ser290) was found in association with irradiation-induced γ-H2AX expression in the nucleus, leading to an increased DNA damage repair response, and a marked inhibition of irradiation-induced cancer cell apoptosis.

Conclusions

The phosphorylation of BCLAF1 at Ser290 is involved in the regulation of DNA damage response, indicating an important target for the resistance of radiotherapy.
Ginsenoside Rb1 induces a pro-neurogenic microglial phenotype via PPARγ activation in male mice exposed to chronic mild stress
Authors: Zhang Lijuan , Tang Minmin , Xie Xiaofang , Zhao Qiuying , Hu Nan , He Hui , Liu Gangcai , Huang Shiqi , Peng Cheng , Xiao Ying , You Zili
Published: August 2021

Background

Anti-inflammatory approaches are emerging as a new strategy for the treatment of depressive disorders. Ginsenoside Rb1 (GRb1), a major component of Panax ginseng, can inhibit inflammatory cascade and alleviate depressive-like behaviors. Microglia can promote or inhibit adult hippocampal neurogenesis according to their functional phenotypes. Here, we examine whether GRb1 may exert antidepressant effects by promoting a pro-neurogenic phenotype of microglia and thereby increasing neurogenesis.

Methods

The antidepressant effects of GRb1 or the licensed antidepressant imipramine (IMI) were assessed in chronic mild stress (CMS)-exposed male mice. The depressive-like behaviors of mice were evaluated by sucrose preference test, forced swimming test (FST), and tail suspension test (TST). The microglial phenotypes were identified by pro- and anti-inflammatory cytokine expression and morphological properties, analyzed by RT-qPCR, western blotting, and immunofluorescence staining. The effect of GRb1-treated microglia on adult hippocampal neurogenesis in vivo and in vitro was detected using immunofluorescence staining.

Results

Behavioral assessment indicated that GRb1 or IMI treatment alleviated depressive-like behaviors in CMS-exposed mice. Immunofluorescence examination demonstrated that GRb1 induced a pro-neurogenic phenotype of microglia via activating PPARγ in vivo and in vitro, which were effectively reversed by the PPARγ inhibitor GW9662. In addition, GRb1-treated microglia increased the proliferation and differentiation of neural precursor cells.

Conclusions

These findings demonstrated that GRb1 alleviated depressive-like behaviors of CMS-exposed male mice mainly through PPARγ-mediated microglial activation and improvement of adult hippocampus neurogenesis.
A critical cartography of domestic violence policies in Mozambique
Authors: Jethá Eunice , Keygnaert Ines , Seedat Mohamed , Nhampoca Joaquim , Sidat Mohsin , Roelens Kristien
Published: August 2021

Background

Domestic violence (DV) affects millions of people worldwide, especially women impacting their health status and livelihoods. To prevent DV and to improve the quality of victims’ lives, Mozambican governmental and non-governmental entities are making efforts to develop adequate policies and legislation and to improve the accessibility of services for victims of DV.

However, a critical review of whether or not current policies and legislation concerning DV in Mozambique are in agreement with international guidelines has yet to be examined. Therefore, this paper aims to map the Mozambican legislative and policy responses to DV. It also strives to analyse their alignment with international treaties and conventions and with each other.

Methods

Through a critical cartography, documents were selected and their content analysed. Some of these documents were not available online, printed versions were not available on the field and some were not up to date. Therefore, we had to search for them via physical office visits at governmental institutions with a responsibility to deal with DV aspects. These documents were listed and analysed for key content applying a framework inquiring on recommendations of international agencies such as World Health Organization. Subsequently, we compared these policies with international conventions and treaties of which Mozambique is signatory and with each other to identify discrepancies.

Results

Overall, six institutions were visited assuring identification of all available information and policy documents on DV. We identified a total of fifteen national DV documents of which five were on laws, one on policy and nine institutional strategic/action plans. Most of the national DV documents focused on strategies for assistance/care of victims and prevention of DV. Little focus was found on advocacy, monitoring and evaluation.

Conclusions

Mozambique has demonstrated its commitment by signing several international and regional treaties and conventions on DV. Despite this, the lack of consistency in the alignment of international treaties and conventions with national policies and laws is remarkable. However, a gap in the reliable translation of national policies and laws into strategic plans is to be found particularly in relation to naming type, beneficiaries, main strategies and multi-sectorial approach.
Virome analysis of ticks in a forest region of Liaoning, China: characterization of a novel hepe-like virus sequence
Authors: Yang Zijun , Zhang Ju , Yang Shixing , Wang Xiaochun , Shen Quan , Sun Guangming , Wang Hao , Zhang Wen
Published: August 2021

Background

Ticks (class Arachnida, subclass Acari) are vectors of transmitting a broad range of pathogenic microorganisms, protozoa, and viruses affecting humans and animals. Liaoning Province is rich in forests where different animals and, abundant Haemaphysalis longicornis ticks exist.

Methods

Using viral metagenomics, we analyzed the virome in 300 Haemaphysalis longicornis ticks collected from June to August 2015 in the forested region of Liaoning Province, China.

Results

From the 300 ticks, 1,218,388 high-quality reads were generated, of which 5643 (0.463%) reads showed significant sequence identity to known viruses. Sequence and phylogenetic analysis revealed that viral sequences showing a close relationship with Dabieshan tick virus, Aleutian mink disease virus, adeno-associated virus, Gokushovirus, avian gyrovirus 2 were present in the virome of these ticks. However, the significance of these viruses to human and animal health requires further investigation. Notably, an hepe-like virus, named tick-borne hepe-like virus sequence, was obtained and was highly prevalent in these ticks with a rate of 50%. Nevertheless, one constraint of our study was the limited geographical distribution of the sampled ticks.

Conclusion

Our study offers an overview of the virome in ticks from a forest region of Liaoning Province and provides further awareness of the viral diversity of ticks.
Gut micobiota alteration by Lactobacillus rhamnosus reduces pro-inflammatory cytokines and glucose level in the adult model of Zebrafish
Authors: Bootorabi Fatemeh , Saadat Farshid , Falak Reza , Manouchehri Hamed , Changizi Reza , Mohammadi Hasan , Safavifar Farnaz , Khorramizadeh Mohammad Reza
Published: August 2021

Objective

Type 2 diabetes mellitus (T2DM) is still a challenge for physicians to manage patient’s circumstances. It is assumed that alterations in the normal flora may be involved in the pathogenesis of T2DM through inducing chronic inflammation. To investigate the effect of Lactobacillus rhamnosus as a common probiotic on T2DM, we induced an experimental model of T2DM in adult male Zebrafish by gradient hyper-glucose accumulation methodology.

Results

In this trial 3-month old male adult Zebrafish were divided in to four groups including two control groups and T2DM induced groups with or without probiotic treatment. After 5 days of acclimation, T2DM was induced by a gradient hyper-glucose accumulation methodology. Diabetic fishes had statistically abnormal blood glucose and pro-inflammatory cytokine levels compared to control group (p = 0.0001). These results suggest that probiotic intervention decreased the blood glucose level in the T2DM-P group by decreasing pro-inflammatory cytokines responsible for signaling in T2DM therapeutic modalities.
Re-staging and follow-up of rectal cancer patients with MR imaging when “Watch-and-Wait” is an option: a practical guide
Authors: Santiago Inês , Rodrigues Bernardete , Barata Maria , Figueiredo Nuno , Fernandez Laura , Galzerano Antonio , Parés Oriol , Matos Celso
Published: August 2021

In the past nearly 20 years, organ-sparing when no apparent viable tumour is present after neoadjuvant therapy has taken an increasingly relevant role in the therapeutic management of locally-advanced rectal cancer patients. The decision to include a patient or not in a “Watch-and-Wait” program relies mainly on endoscopic assessment by skilled surgeons, and MR imaging by experienced radiologists. Strict surveillance using the same modalities is required, given the chance of a local regrowth is of approximately 25–30%, almost always surgically salvageable if caught early. Local regrowths occur at the endoluminal aspect of the primary tumour bed in almost 90% of patients, but the rest are deep within it or outside the rectal wall, in which case detection relies solely on MR Imaging. In this educational review, we provide a practical guide for radiologists who are, or intend to be, involved in the re-staging and follow-up of rectal cancer patients in institutions with an established “Watch-and-Wait” program. First, we discuss patient preparation and MR imaging acquisition technique. Second, we focus on the re-staging MR imaging examination and review the imaging findings that allow us to assess response. Third, we focus on follow-up assessments of patients who defer surgery and confer about the early signs that may indicate a sustained/non-sustained complete response, a rectal/extra-rectal regrowth, and the particular prognosis of the “near-complete” responders. Finally, we discuss our proposed report template.
Improving workflow in prostate MRI: AI-based decision-making on biparametric or multiparametric MRI
Authors: Hötker Andreas M. , Da Mutten Raffaele , Tiessen Anja , Konukoglu Ender , Donati Olivio F.
Published: August 2021

Objectives

To develop and validate an artificial intelligence algorithm to decide on the necessity of dynamic contrast-enhanced sequences (DCE) in prostate MRI.

Methods

This study was approved by the institutional review board and requirement for study-specific informed consent was waived. A convolutional neural network (CNN) was developed on 300 prostate MRI examinations. Consensus of two expert readers on the necessity of DCE acted as reference standard. The CNN was validated in a separate cohort of 100 prostate MRI examinations from the same vendor and 31 examinations from a different vendor. Sensitivity/specificity were calculated using ROC curve analysis and results were compared to decisions made by a radiology technician.

Results

The CNN reached a sensitivity of 94.4% and specificity of 68.8% (AUC: 0.88) for the necessity of DCE, correctly assigning 44%/34% of patients to a biparametric/multiparametric protocol. In 2% of all patients, the CNN incorrectly decided on omitting DCE. With a technician reaching a sensitivity of 63.9% and specificity of 89.1%, the use of the CNN would allow for an increase in sensitivity of 30.5%. The CNN achieved an AUC of 0.73 in a set of examinations from a different vendor.

Conclusions

The CNN would have correctly assigned 78% of patients to a biparametric or multiparametric protocol, with only 2% of all patients requiring re-examination to add DCE sequences. Integrating this CNN in clinical routine could render the requirement for on-table monitoring obsolete by performing contrast-enhanced MRI only when needed.
Toward a systematic conflict resolution framework for ontologies
Authors: Keet C. Maria , Grütter Rolf
Published: August 2021

Background

The ontology authoring step in ontology development involves having to make choices about what subject domain knowledge to include. This may concern sorting out ontological differences and making choices between conflicting axioms due to limitations in the logic or the subject domain semantics. Examples are dealing with different foundational ontologies in ontology alignment and OWL 2 DL’s transitive object property versus a qualified cardinality constraint. Such conflicts have to be resolved somehow. However, only isolated and fragmented guidance for doing so is available, which therefore results in ad hoc decision-making that may not be the best choice or forgotten about later.

Results

This work aims to address this by taking steps towards a framework to deal with the various types of modeling conflicts through meaning negotiation and conflict resolution in a systematic way. It proposes an initial library of common conflicts, a conflict set, typical steps toward resolution, and the software availability and requirements needed for it. The approach was evaluated with an actual case of domain knowledge usage in the context of epizootic disease outbreak, being avian influenza, and running examples with COVID-19 ontologies.

Conclusions

The evaluation demonstrated the potential and feasibility of a conflict resolution framework for ontologies.
Characterisation of smallholders’ goat production systems in the Fatick area, Senegal
Authors: Sow Fafa , Camara Younouss , Traore El Hadji , Cabaraux Jean-François , Missohou Ayao , Antoine-Moussiaux Nicolas , Hornick Jean-Luc , Moula Nassim
Published: August 2021

Senegal, like the other Sahelian countries, remains an important livestock area, particularly for ruminants, with almost 36% of its livestock population was goat in 2016. The national herd increased from 2010 to 2016, from 3.32 to 3.54 million head of cattle, 5.6 to 6.68 million sheep and 4.8 to 5.7 million goats, i.e. annual growth rates of 1.1%, 3.2% and 3.13% respectively. Thus, due to diversification of local agricultural resources and the strengthening of goat breeding techniques in the Fatick area, a programme aiming to develop the local goat sector was set up in 2010. The programme focused on improving animal husbandry, providing new added values to goat products and structuring the goat sector. This study’s aim is to better understand goat rearing systems in the area, in order to propose, together with the herders, ways of improving these systems, taking into account family and socio-cultural considerations. To better evaluate the diversity in different production systems, a survey of animal rearing practices was carried out. The survey involved 45 farmers in four localities. It revealed that the farmers were all agro-pastoralists practising a mixed farming system. The majority (93%) supplemented their animals with agricultural by-products, agro-forestry and kitchen leftovers. A multiple correspondence analysis identified three groups: cluster 1 (milk producers and processors into traditional curdled milk, selling animals for household needs), cluster 2 (milk processors into yoghurt and cheese) and cluster 3 (goat vendors in pastoral and the agro-pastoral system).

The study of the objectives and contexts of goat farming in the Fatick will enable policy-makers to design strategies for the sustainable development of family goat farming in the area.
On two kinds of the reverse half-discrete Mulholland-type inequalities involving higher-order derivative function
Authors: Chen Qiang , Yang Bicheng
Published: August 2021

By means of the weight functions, Hermite–Hadamard’s inequality, and the techniques of real analysis, a new more accurate reverse half-discrete Mulholland-type inequality involving one higher-order derivative function is given. The equivalent statements of the best possible constant factor related to a few parameters, the equivalent forms, and several particular inequalities are provided. Another kind of the reverses is also considered.
Solvability for generalized nonlinear two dimensional functional integral equations via measure of noncompactness
Authors: Singh Soniya , Singh Bhupander , Nisar Kottakkaran Sooppy , Hyder Abd-Allah , Zakarya M.
Published: August 2021

In this article, we provide the existence result for functional integral equations by using Petryshyn’s fixed point theorem connecting the measure of noncompactness in a Banach space. The results enlarge the corresponding results of several authors. We present fascinating examples of equations.
The influence of fasting and carbohydrate-enriched drink administration on body water amount and distribution: a volunteer randomized study
Authors: Kukliński Jakub , Steckiewicz Karol P. , Sekuła Bartosz , Aszkiełowicz Aleksander , Owczuk Radosław
Published: August 2021

Background

Fasting prior to anesthesia is considered aspiration prophylaxis. However, prolonged food and drink restrictions may increase the risk of other complications. The aim of this study was to assess whether a carbohydrate-enriched drink (Nutricia™ preOp®), recommended by the enhanced recovery after surgery (ERAS) protocol, can improve body hydration in fasting healthy individuals.

Methods

Measurements were done with the bioelectric impedance analysis with a Fresenius body composition monitor. Body composition, total body water, water distribution, and hemodynamic parameters were measured at the beginning of the study and after 10 h and 12 h of fasting. Patients fasted for 10 h and then were divided into two groups: the control (n = 40) and the pre-op group (n = 41). The pre-op group received 400 mL of Nutricia™ preOp®, as suggested in the ERAS guidance. The two-tailed Student’s t test was used to compare two groups with normally distributed data and homogenous variances; if variances were heterogeneous, Welch’s test was used. The Mann-Whitney U test was used to compare two groups with non-normal data distribution. p < 0.05 was considered statistically significant.

Results

We found no significant differences between the control and pre-op groups regarding body water distribution and body composition. We did not observe significant losses in the total body water after fasting. Also, blood pressure was not affected by fasting.

Conclusion

We have proven that pre-op did not impact either body composition or body water.

Trial registration

ClinicalTrials.gov, NCT04665349. Registered on 11 December 2020—retrospectively registered.
Evidence of effect of riparian attributes on listed freshwater fishes and mussels and their aquatic critical habitat: a systematic map protocol
Authors: Caskenette Amanda , Durhack Travis , Hnytka Sarah , Kovachik Colin , Enders Eva
Published: August 2021

Background

Habitat that is necessary for the survival and recovery of a species listed as threatened, endangered or extirpated (i.e., Critical Habitat) is protected in Canada. For freshwater aquatic species, Critical Habitat may include the riparian zone, however, it is unclear how much of this riparian habitat needs to be protected to support the survival and recovery of a listed species. The riparian zone mainly affects aquatic species through its indirect effect on aquatic habitat according to five main processes: erosion, filtration, infiltration, shading, and subsidization. To provide quantitative evidence to support the delineation of riparian Critical Habitat, a systematic map will be used to create a searchable database containing the current state of knowledge regarding the relationships between the riparian zone attributes (e.g., size, vegetation) and fishes and mussels, aquatic features, and riparian processes.

Methods

We will search for primary research articles in bibliographic databases and relevant organizational websites for primary literature, theses, preprints, and grey literature including reports, along with models using a search string specific to riparian habitat. The results will be screened at title and abstract, and full text levels against predefined inclusion criteria and consistency checking will be performed to ensure the inclusion criteria are consistent across multiple reviewers. Quantitative and qualitative data including study details and methods, the riparian habitat, and the waterbody and upland habitat use will be extracted. The findings of the systematic map will be provided in a manuscript and a searchable database accompanied by a decision tree to support biologists in providing scientifically defensible delineation of riparian Critical Habitat for aquatic species at risk in Canada.
A case report of primary pulmonary artery intimal sarcoma
Authors: Bai Xiaofang , Ruan Litao
Published: August 2021

Background

Pulmonary artery intimal sarcoma (PAS) is a very rare disease, its prevalence is about 0.001–0.003%. PAS is often misdiagnosed as acute or chronic pulmonary thromboembolism due to its clinical presentation and radiological findings. Thus, early diagnosis is very crucial and may improve patient outcome.

Case presentation

Here, we report a case in a Chinese male where the symptom presentation was episodes of shortness of breath. Transthoracic echocardiography showed a solid mass in the pulmonary valve orifice, which was demonstrated to be a pulmonary artery intimal sarcoma diagnosed by histopathology. In this case, the initial differential diagnosis included pulmonary embolism. Because the initial symptom of primary pulmonary artery sarcoma is extremely similar to the pulmonary embolism, half of them may be misdiagnosed as pulmonary embolism. Imaging studies are very helpful. Ultrasound and CT are the best due to their resolution and ability to assess the relationship of the mass with the surrounding structures. The final diagnosis is mostly made after surgical excision and this is the most effective treatment. At the same time, radiotherapy and chemotherapy after surgery is also an adjuvant treatment.

Conclusion

We report a very rare case of pulmonary artery intimal sarcoma. Due to late diagnosis and delayed treatment in this case, the patient displayed a poor prognostic. Early diagnosis and right treatment can improve the prognosis of PAS and optimize overall health.
The Gold Coast criteria increases the diagnostic sensitivity for amyotrophic lateral sclerosis in a Chinese population
Authors: Shen Dongchao , Yang Xunzhe , Wang Yanying , He Di , Sun Xiaohan , Cai Zhengyi , Li Jinyue , Liu Mingsheng , Cui Liying
Published: August 2021

Objectives

The aim of this study was to assess and compare the diagnostic utility of a new diagnostic criteria for amyotrophic lateral sclerosis (ALS), abbreviated as the ‘Gold Coast Criteria’, with the revised El Escorial (rEEC) and Awaji criteria.

Methods

Clinical and electrophysiological data of 1185 patients from January 2014 to December 2019 in the Peking Union Medical College Hospital ALS database were reviewed. The sensitivity of the Gold Coast criteria was compared to that of the possible rEEC and Awaji criteria (defined by the proportion of patients categorized as definite, probable, or possible ALS).

Results

A final diagnosis of ALS was recorded in 1162 patients. The sensitivity of the Gold Coast criteria (96.6%, 95% confidence interval [CI] = 95.3%–97.5%) was greater than that of the rEEC (85.1%, 95%CI = 82.9%–87.1%) and Awaji (85.3%, 95%CI = 83.2%–87.3%). In addition, the sensitivity of the novel criteria maintained robust across subgroups, and the advantage was more prominent in limb-onset ALS patients and those who completed electromyographic tests. In those who did not achieve any of the rEEC diagnostic categories, the sensitivity of Gold Coast criteria was 84.4%.

Conclusions

The current study demonstrated that the Gold Coast criteria exhibited greater diagnostic sensitivity than the rEEC and Awaji criteria in a Chinese ALS population. The application of the Gold Coast criteria should be considered in clinical practice and future therapeutic trials.
Role of the Global Fund in national HIV/AIDS response in Myanmar: a qualitative study
Authors: Htun Zarni , Zhao Yingxi , Gilbert Hannah , Lu Chunling
Published: August 2021

Background

The Global Fund has been a major funding source for HIV/AIDS programs in Myanmar. In this qualitative study, we aim to understand the impact of Global Fund on national HIV/AIDS response in Myanmar during the era of Millennium Development Goals (MDGs).

Methods

We conducted individual in-depth interviews by recruiting key informants through purposive snowball sampling. The respondents were engaged in the national/subnational response to HIV/AIDS in Myanmar and worked for the United Nations agencies, non-governmental organizations (NGOs), and civil society. Interview questions were organized around the role of Global Fund in strengthening national response to HIV/AIDS in the six building blocks of the Myanmar’s health system. Transcripts from the key informants were synthesized into specific themes through a deductive approach.

Results

We found that the Global Fund has provided substantial support to (1) finance the national HIV/AIDS response in Myanmar, and (2) strengthen leadership and governance at the central level through improving coordination and collaboration, including more stakeholders (e.g. civil society, NGOs) in decision making process, and catalyzing policy changes on scaling-up key interventions. Yet, its role remains limited in addressing new demands at the township level in terms of capacity building, staffing, and medical supply resulting from rapid scale-up of HIV interventions and decentralization of service delivery in the public sector.

Conclusion

There was a missed opportunity for Myanmar to capitalize on the use of the Global Fund’s funding to strengthen the health system. Deliberate planning is required to optimize the use of those scarce resources to provide universal coverage for HIV/AIDS.
Simplified intravoxel incoherent motion diffusion-weighted MRI of liver lesions: feasibility of combined two-colour index maps
Authors: Mürtz Petra , Mesropyan Narine , Sprinkart Alois M. , Block Wolfgang , Luetkens Julian A. , Attenberger Ulrike , Pieper Claus C.
Published: August 2021

Background

To evaluate the feasibility of two-colour index maps containing combined diffusion and perfusion information from simplified intravoxel incoherent motion (IVIM) for liver lesion malignancy assessment.

Methods

Diffusion-weighted data from a respiratory-gated 1.5-T magnetic resonance sequence were analysed in 109 patients with liver lesions. With three b values (0, 50, 800 s/mm2) estimated diffusion coefficient D′, perfusion fraction f′, and apparent diffusion coefficient (ADC) maps were calculated and analysed for regions of interest (ROIs). D′ and f′ cutoff values were determined by differentiating haemangiomas from other lesions and focal nodular hyperplasias from other lesions, respectively. Combined IDf index maps were generated with a voxel value set to 100, if both D′ and f′ voxel values were lower than their cutoff values (1,529.4 × 10-6 mm2/s and 114.4 × 10-3, respectively), otherwise to 0. Moreover, IADC index maps were generated from ADC cutoff value (1,338.5 × 10-6 mm2/s) obtained by differentiating benign from malignant lesions. Discriminatory power was assessed for both IDf and IADC. Index maps were displayed as two-colour overlays to b-800 images and visually assessed within the translucent hyperintense areas.

Results

For IDf, the same diagnostic accuracy was achieved as for the combined use of parameters D′ and f′ (93.6%). Compared to IADC, IDf showed a higher diagnostic accuracy. Visual judgment of IDf yielded an accuracy (95.4%) similar to that of quantitative analysis (93.6%).

Conclusion

Voxel-wise combined two-colour index maps IDf provide similar diagnostic accuracy as ROI-based combination of estimated IVIM parameters D′ and f′ and are suitable for visual assessment of liver lesion malignancy.