bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinician Experiences in Treatment Decision-Making for Patients with Spinal Metastases
Authors: Barton Lauren B. , Arant Kaetlyn R. , Blucher Justin A. , Sarno Danielle L. , Redmond Kristin J. , Balboni Tracy A. , Colman Matthew , Goodwin C. Rory , Laufer Ilya , Placide Rick , Shin John H. , Sciubba Daniel M. , Losina Elena , Katz Jeffrey N. , Schoenfeld Andrew J.
Published: January 2021

Background:

Effective management of metastatic disease requires multidisciplinary input and entails high risk of disease-related and treatment-related morbidity and mortality. The factors that influence clinician decision-making around spinal metastases are not well understood. We conducted a qualitative study that included a multidisciplinary cohort of physicians to evaluate the decision-making process for treatment of spinal metastases from the clinician’s perspective.

Methods:

We recruited operative and nonoperative clinicians, including orthopaedic spine surgeons, neurosurgeons, radiation oncologists, and physiatrists, from across North America to participate in either a focus group or a semistructured interview. All interviews were audiorecorded and transcribed verbatim. We then performed a thematic analysis using all of the available transcript data. Investigators sequentially coded transcripts and identified recurring themes that encompass overarching patterns in the data and directly bear on the guiding study question. This was followed by the development of a thematic map that visually portrays the themes, the subthemes, and their interrelatedness, as well as their influence on treatment decision-making.

Results:

The thematic analysis revealed that numerous factors influence provider-based decision-making for patients with spinal metastases, including clinical elements of the disease process, treatment guidelines, patient preferences, and the dynamics of the multidisciplinary care team. The most prominent feature that resonated across all of the interviews was the importance of multidisciplinary care and the necessity of cohesion among a team of diverse health-care providers. Respondents emphasized aspects of care-team dynamics, including effective communication and intimate knowledge of team-member preferences, as necessary for the development of appropriate treatment strategies. Participants maintained that the primary role in decision-making should remain with the patient.

Conclusions:

Numerous factors influence provider-based decision-making for patients with spinal metastases, including multidisciplinary team dynamics, business pressure, and clinician experience. Participants maintained a focus on shared decision-making with patients, which contrasts with patient preferences to defer decisions to the physician, as described in prior work.

Clinical Relevance:

The results of this thematic analysis document the numerous factors that influence provider-based decision-making for patients with spinal metastases. Our results indicate that provider decisions regarding treatment are influenced by a combination of clinical characteristics, perceptions of patient quality of life, and the patient’s preferences for care.
Contextualizing Mine-Community Relations in Treaty No. 9 Territory
Authors: Reid Brady
Published: January 2021

This paper presents a rigorous literature review identifying and critically examining the characteristics of decision-making processes in the mining sector that empower or disempower Indigenous communities in north-eastern Ontario, specifically Treaty no. 9 territory. The conclusions drawn from this review aim to inform future research throughout my doctoral program and other researchers and practitioners within the mining sector. The Ring of Fire is a controversial but lucrative mineral cache in north-eastern Ontario worth an estimated $60 billion that may position nearby rural and remote communities for economic growth. However, critics caution that proposed mineral exploration and extraction in the region may threaten the sustainability of First Nations communities. Fifty secondary sources, academic and grey literature produced by both Indigenous and non-Indigenous authors, were reviewed and I propose three “myths” surrounding relations between the mining sector and Indigenous communities in Ontario. I position the synthesis of literature in response to these myths to provide insight into false assumptions that may form the basis of community-mine relations. First, critical examination of the signing of Treaty 9 in the early twentieth century shows that Indigenous communities in northern Ontario did not unilaterally cede and surrender title rights to their traditional territories. Second, the literature falsifies the notion that Indigenous communities are inherently anti-development and show that Indigenous communities do not always unilaterally refute opportunities for resource development. Third, the literature debunks the idea that the duty to consult and accommodate is always triggered before proponents infringe on Indigenous and treaty rights on traditional territory. The duty to consult and accommodate, triggered by the fiduciary duty of the Crown to protect aboriginal and treaty rights outlined in the Constitution Act of 1982, attempts to address the exclusion of Indigenous perspectives in decision-making processes within the mining sector. However, current consultation standards do not ensure an “effective” or “meaningful” decision-making process. Narrowing in on some false assumptions surrounding relations built between mining operations and Indigenous communities, this rigorous literature review can support researchers and practitioners working with Indigenous communities in the mining sector to generate novel approaches to community-mine relations in the future.
Diagnostic Accuracy of a Liquid Chromatography-Tandem Mass Spectrometry Assay for Rifampin-resistant Tuberculosis Drug Concentrations in a Routine Care Setting
Authors: Metcalfe John , Bacchetti Peter , Esmail Ali , Reckers Andrew , Aguilar David , Wen Anita , Huo Shu , Muyindike Winnie R. , Hahn Judith A. , Dheda Keertan , Gandhi Monica , Gerona Roy
Published: January 2021

BackgroundTreatment monitoring of drug-resistant tuberculosis (DR-TB) in resource-limited settings is challenging. We developed a multi-analyte assay for eleven anti-TB drugs in small hair samples as an objective metric of drug exposure. MethodsSmall hair samples were collected from participants at various timepoints during directly observed RR-TB treatment at an inpatient tertiary referral facility in South Africa (DR-TB cohort). We assessed qualitative determination (i.e., detection above limit of detection) of bedaquiline, linezolid, clofazimine, pretomanid, levofloxacin, moxifloxacin, pyrazinamide, isoniazid, ethambutol, ethionamide, and prothionamide in an LC-MS/MS index panel assay against a reference standard of inpatient treatment records. Because treatment regimens prior to hospitalization were not available, we also analyzed specificity (for all drugs except isoniazid) using an external cohort of HIV-positive patients treated for latent TB infection with daily isoniazid (HIV/LTBI cohort) in Uganda.ResultsAmong the 57 DR-TB patients (58% with pre-XDR/XDR-TB; 70% HIV-positive) contributing analyzable hair samples, the sensitivity of the investigational assay was 94% or higher for all drugs except ethionamide (58.5%, 95% confidence interval [CI], 40.7-99.9). Assay specificity was low across all tested analytes within the DR-TB cohort; conversely, assay specificity was 100% for all drugs in the HIV/LTBI cohort. ConclusionsHair drug concentrations reflect long-term exposure, and multiple successive regimens commonly employed in DR-TB treatment may result in apparent false-positive qualitative and falsely elevated quantitative hair drug levels when prior treatment histories within the hair growth window are not known.
T-cell tailored single-cell RNA barcoding and sequencing (tSCRB-seq)
Authors: Kanev Kristiyan , Roelli Patrick , Wu Ming , Wurmser Christine , Delorenzi Mauro , Pfaffl Michael W. , Zehn Dietmar
Published: January 2021

tSCBR-seq is a T-cell tailored plate-based single-cell RNA sequencing protocol with superior mRNA capturing efficacy and dynamic range of gene detection. This was achieved through a series of chemical modifications of the original SCBR-seq protocol published by Soumilon and colleagues [1]. The performance of the protocol was also demonstrated in the article “Proliferation-competent Tcf1+ CD8 T cells in dysfunctional populations are CD4 T cell help independent” [2].
Cryo-EM reveals the architecture of placental malaria VAR2CSA and provides molecular insight into chondroitin sulfate binding
Authors: Wang Kaituo , Dagil Robert , Lavstsen Thomas , Misra Sandeep , Spliid Charlotte , Wang Yong , Gustavsson Tobias , Sandoval Daniel , Vidal-Calvo Elena , Choudhary Swati , Agerbæk Mette , Lindorff-Larsen Kresten , Nielsen Morten , Theander Thor , Sharp Joshua , Clausen Thomas , Gourdon Pontus , Salanti Ali
Published: January 2021

Malaria during pregnancy remains a major health problem in Plasmodium falciparum endemic areas. Parasite-infected red blood cells sequester in the placenta through interaction between parasite-expressed protein VAR2CSA and the glycosaminoglycan chondroitin sulfate A (CS) abundantly present in the intervillous space. Placental malaria can have severe consequences for both mother and child by causing maternal anemia, low birth weight and stillbirth. Several VAR2CSA-based vaccines have been developed and clinically tested but they have failed to induce an antibody response that effectively inhibits placental adhesion of different genetic variants of VAR2CSA. The interaction between VAR2CSA and CS represents a unique case of an evolution-driven high-affinity interaction between a protein and an oncofetal carbohydrate. Here, we report cryo-EM structures of the VAR2CSA ectodomain up to 3.1 Å resolution revealing an overall V-shaped architecture and a complex domain organization. Notably, the surface displays a single significantly electropositive patch, compatible with binding of negatively charged CS. Using molecular docking and molecular dynamics simulations as well as comparative hydroxyl radical protein foot-printing of VAR2CSA in complex with placental CS, we identify the CS-binding groove, intersecting with the positively charged patch of the central VAR2CSA structure. We identify distinctive conserved structural features upholding the macro-molecular domain complex and CS binding capacity of VAR2CSA as well as divergent elements possibly allowing immune escape at or near the CS binding site. These observations enable rational design of second-generation placental malaria vaccines eliciting broadly VAR2CSA-reactive antibodies and novel cancer therapies.
The Socioecological Model as a Framework for Exploring Factors Influencing Childhood Immunization Uptake in Lagos State, Nigeria
Authors: Olaniyan Abisola , Isiguzo Chinwoke , Hawk Mary
Published: January 2021

Background

Nigeria is one of the ten countries globally that accounts for 62% of under- and unvaccinated children worldwide. Despite several governmental and non-governmental agencies' interventions, Nigeria has yet to achieve significant gains in childhood immunization coverage. This study identifies intrapersonal, interpersonal, organizational, community, and policy-level factors that influence childhood immunization uptake from various stakeholders' perspectives using the Socioecological Model (SEM).
Methods

Using the Socioecological Model as a guiding framework, we conducted ten focus group sessions with mothers/caregivers and community leaders residing in Lagos state and nine semi-structured interviews with healthcare workers who provide routine immunization services in Lagos state primary healthcare facilities. We performed a qualitative analysis of focus groups and semi-structured interviews using deductive coding methods.
Results

The study sample included 44 mothers/caregivers and 24 community leaders residing in Lagos State, Nigeria, and 18 healthcare workers (routine immunization focal persons) working in the primary healthcare setting in Lagos state. Study participants discussed factors at the each level of the SEM that influence childhood immunization uptake, including intrapersonal (caregivers’ immunization knowledge, caregivers’ welfare and love of child/ren), interpersonal (role of individual relationships and social networks), organizational (geographical and financial access to health facilities, health facilities attributes, staff coverage, and healthcare worker attributes), community (community outreaches and community resources), and policy-level (free immunization services and provision of child immunization cards) that influence childhood immunization uptake. Several factors were intertwined, such as healthcare workers’ education of caregivers on immunization and caregivers' knowledge of vaccination.
Conclusions

The reciprocity of the findings from the different Socioecological Model levels emphasizes the importance of developing multi-pronged interventions that operate at multiple levels of the SEM. Our results can inform the design of culturally appropriate and effective interventions to address Nigeria's suboptimal immunization coverage.
Maternal Periconceptional Folic Acid Supplementation and the Risk of Non-Syndromic Oral Clefts in Offspring: A Population-Based Case-Control Study in Chengdu, China
Authors: Xu Wenli , Yi Ling , Deng Changfei , Zhao Ziling , Zhou Tianjin , Zhang Gang , Ran Longrong , Ren Zhihong , Zhao Shunxia , Liu Hanmin , Dai Li
Published: January 2021

Maternal periconceptional folic acid supplementation (FAS) has been documented to be associated with decreased risk of nonsyndromic oral clefts (NsOC). However, the results remain inconclusive. In this population-based case-control study of 807 singletons affected by NsOC and 8070 healthy neonates who were born between October 2010 and September 2015 in Chengdu, China, we examined the association of maternal FAS with the risk of nonsyndromic cleft lip with or without cleft palate (NsCL/P), and cleft palate (NsCP). Unconditional logistic regression analysis was used to estimate the crude and adjusted odds ratios (ORs) and 95% confidential intervals (CI). Significant associations were found between maternal periconceptional FAS and decreased risk of NsCL/P (aOR = 0.41, 95% CI: 0.33–0.51). This protective effect was also detected for NsCL (aOR = 0.42, 95% CI: 0.30–0.58) and NsCLP (aOR = 0.41, 95% CI: 0.31–0.54). Both maternal FAS started before and after the last menstrual period (LMP) were negatively associated with NsCL/P (before LMP, aOR = 0.43, 95% CI: 0.33–0.56; after LMP, aOR = 0.41, 95% CI: 0.33–0.51). The association between NsCP and maternal FAS initiating before LMP was significant (aOR = 0.52, 95% CI: 0.30–0.90), but the statistical power seemed weak due to limited number of NsCP cases. The findings suggest that maternal periconceptional FAS can reduce the risk of each subtype of NsCL/P in offspring, while the potential effect on NsCP needs further investigations.
Hyperbaric Oxygen Suppressed Tumor Progression through Improvement of Tumor Hypoxia and Induction of Tumor Apoptosis in Lung Cancer
Authors: Chen Shao-Yuan , Tsuneyama Koichi , Yen Mao-Hsiung , Lee Jiunn-Tay , Chen Jiun-Liang , Huang Shih-Ming
Published: January 2021

Tumor cells have long term been recognized as a relative contraindication to hyperbaric oxygen treatment (HBOT) since HBOT might enhance progressive cancer growth. However, in an oxygen deficit condition, tumor cells are more progressive and have the potentials to be metastatic. HBOT increasing in oxygen partial pressure may benefit tumor suppression. In this study, we investigated the effects of HBOT on solid tumors, such as lung cancer. Non-small cell human lung carcinoma A549-cell-transferred severe combined immunodeficiency mice (SCID) mice were selected as an in vivo model to detect the potential mechanism of HBOT in lung tumors. HBOT not only improved tumor hypoxia but also suppressed tumor growth in murine xenograft tumor models. In vitro, HBOT suppressed the growth of A549 cells in a time-dependent manner and immediately downregulated the expression of p53 protein after HBOT in A549 cells. Our results demonstrated that HBOT improved tissue vasculogenesis, tumor hypoxia and potentially target apoptosis to lung cancer cells in murine xenograft tumor models. HBOT will merit further cancer therapy as an adjuvant treatment for lung cancer.
Flavor Disorder Is Associated with Obstructive Sleep Apnea: A Nationwide Population-Based Cohort Study
Authors: Tsao Chien-Han , Huang Hsin-Hsin , Hung Yao-Min , Hung  , Wei James Cheng-Chung , Wen Wei-Sheng , Wang Yu-Hsun , Huang Kuo-Shu
Published: January 2021

Background: Flavor sensation was the joint perception of smell and taste sensation was associated with the pleasure of life. Obstructive sleep apnea (OSA) had been demonstrated the presence of upper airway remodeling which altered sensory and motor function due to hypoxia or snore vibration. This study aims to investigate whether OSA is associated with the risk of flavor disorder (FD). Methods: We conducted a nationwide cohort study using the Taiwan National Health Insurance Research Database, one million subjects were sampled with data collected from 1999 to 2013 and 9,191 identified diagnosed OSA patients were included. Each patient was matched with non-OSA controls from the general population by propensity score matching (1:1) based on age, gender, hypertension, hyperlipidemia, ankylosing spondylitis, and Charlson comorbidity index, 8,037 OSA and an equal number of non-OSA subjects were used to compared in this study. The incidence of FD was assessed at the end of 2013 and cumulative incidences, hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Results: The adjusted HR (aHR)of FD for the OSA group was 2.082-fold (95% CI = 1.149–3.773, p=0.0155) higher than non-OSA group. The stratified analyses revealed aHR of FD for the hyperlipidemia group was 2.264-fold (95% CI = 1.061–4.832, p=0.035). Subgroup analysis showed the subjected of female OSA had more risk to develop FD (aHR:2.345, 95% CI = 1.026–5.357, p=0.043). Conclusion: A higher risk of developing FD was found among the newly diagnosed OSA cohort during the longer than 10-year follow-up period
Prevalence of Orthodontic Malocclusion in School Children in the North East of Slovenia: Retrospective Epidemiology Study
Authors: Egic Boris
Published: January 2021

Background: Dental malocclusions exhibit the third-highest prevalence among oral pathologies. The occlusion is evaluated in primary, mixed and permanent dentition. Most orthodontic patients were treated in the early permanent dentition. Early detection of dental anomalies is important to prevent complications and can have short-term and long-term benefits. The epidemiological data on the prevalence of malocclusion is an important determinant in planning appropriate levels of orthodontic services. Dentists have the responsibility to recognize, diagnose, and manage or refer to abnormalities. Data from researches showed that is the incidence of malocclusions from 11% to 93%. The study aim is to find out, the prevalence and species of malocclusion of school children in 4 school years, how they are registered by general dentists.Results: The research was conducted in 4 consecutive school years on schoolchildren from 1. to 9. class. Dentists have registered the presence and type of malocclusion. They are made statistical data percentage of children with malocclusion and percentage of representation malocclusion and statistical difference between genders. The percentage of malocclusion was the lowest in the 1. class. The highest percentage of malocclusion was in 7. class. The most common types of malocclusion were deep bite, crowding cross bite and II class of Angle's. The upper lateral incisive was the most common missing tooth (aplasia).Conclusion: The high percentage of malocclusion at the end of school (15-year-old) about 50% and the low number of children in orthodontic therapy.
Mechanism of Cellular Production and in Vivo Seeding Effects of Hexameric β-Amyloid Assemblies
Authors: Vrancx Céline , Vadukul Devkee M , Contino Sabrina , Suelves Nuria , D'Auria Ludovic , Perrin Florian , Pesch Vincent van , Hanseeuw Bernard , Quinton Loïc , Kienlen-Campard Pascal
Published: January 2021

BackgroundThe β-amyloid peptide (Aβ) plays a key role in Alzheimer’s disease. After its production by catabolism of the amyloid precursor protein (APP) through the action of presenilin 1 (PS1)- or presenilin 2 (PS2)-dependent γ-secretases, monomeric Aβ can assemble in oligomers. In a pathological context, this eventually leads to the formation of fibrils, which deposit in senile plaques. Many studies suggest that Aβ toxicity is related to its soluble oligomeric intermediates. Among these, our interest focuses on hexameric Aβ, which acts as a nucleus for Aβ self-assembly.MethodsBiochemical analyses were used to identify hexameric Aβ in a wide range of models; cell lines, cerebrospinal fluid from cognitively impaired patients and transgenic mice exhibiting human Aβ pathology (5xFAD). We isolated this assembly and assessed both its effect on primary neuron viability in vitro, and its contribution to amyloid deposition in vivo following intracerebral injection. In both cases, we used wild-type mice (C57BL/6) to mimic an environment where hexameric Aβ is present alone and 5xFAD mice to incubate hexameric Aβ in a context where human Aβ species are pre-existing. Using CRISPR-Cas9, we produced stable knockdown human cell lines for either PS1 or PS2 to elucidate their contribution to the formation of hexameric Aβ.ResultsIn WT mice, we found that neither in vitro or in vivo exposure to hexameric Aβ was sufficient to induce cytotoxic effects or amyloid deposition. In 5xFAD mice, we observed a significant increase in neuronal death in vitro following exposure to 5μM hexameric Aβ, as well as a 1.47-fold aggravation of amyloid deposition in vivo. At the cellular level, we found hexameric Aβ in extracellular vesicles and observed a strong decrease in its excretion when PS2 was knocked down by 60%.ConclusionsOur results indicate the absence of cytotoxic effects of cell-derived hexameric Aβ by itself, but its capacity to aggravate amyloid deposition by seeding other Aβ species. We propose an important role for PS2 in the formation of this particular assembly in vesicular entities, in line with previous reports linking the restricted location of PS2 in acidic compartments to the production of more aggregation-prone Aβ.
Debridement and Bone Graft Fusion via the Lateral Extracavitary Approach Combined with Lateral and Posterior Screw-Rod Fixation in Treatment of Thoracic Spinal Tuberculosis: A Retrospective Study of 38 Cases
Authors: Zhou Jianwei , Li Shaoping , Guan Xiaoli , Lei Shuanhu , Wang Yuliang
Published: January 2021

BackgroundThoracic spinal tuberculosis is still common, and surgical treatment can rapidly relieve pain, correct deformity, reduce bone loss and prevent further damage to neurological function. We have practiced an efficient and safe surgical method.MethodsFrom January 2013 to April 2019, 38 patients with thoracic spinal TB were included in our study. Debridement and bone grafting were performed via the lateral extracavitary approach, combined with two different fixation method. Data from these cases were analyzed retrospectively.ResultsThe average surgical duration was 297.0±68.4 min, average intraoperative blood loss was 702.6±252.0 ml, postoperative hospital stay was 11.1±3.6 d, and C-reaction protein (CRP) and erythrocyte sedimentation rate (ESR) of all the patients decreased to normal levels at the last follow-up. The average Visual Analog Scale (VAS) score was 7.5±1.6 preoperatively and 0.6±0.8 at the last follow-up, which was significantly reduced compared with that before surgery. The average kyphosis correction was 6.3±4.7° and the angle loss was 1.4±1.6°. Neurological functions of all cases were significantly improved According to the American Spinal Injury Association (ASIA) classification. Solid fusion was observed in all cases at the last follow-up. One patient presented sinus tract formation at the incision site and the other two patients had rupture of the parietal pleura intraoperatively. No severe complications such as spinal cord injury or great vessel injury were found in all patients.ConclusionsDebridement and bone graft fusion via the posterolateral extracavitary approach combined with two fixation methods can both achieve high efficacy in the treatment of thoracic spinal TB. Lateral single screw-rod fixation is more suitable for patients with single-segment lower thoracic lesions and high stability, with less blood loss and shorter surgical duration. Posterior pedicle screw fixation has higher strength, and is more suitable for patients with multi-segment lesions, poor stability and complex conditions.
A Systematic Review and Meta-analysis of Direct Anterior Approach Versus Posterolateral Approach in Total Hip Arthroplasty
Authors: Xie Honghua , Long Junyangxi , Li Shuzhen
Published: January 2021

Background: To evaluate the difference of clinical results between DAA and PLA in primary THA.Methods: The PubMed , Embase and the Cochrane Library were searched by computer to collect and compare clinical randomized controlled trials of primary THA through DAA and PLA. The clinical outcome measures include operation time, total blood loss, acetabular abduction angle, acetabular anteversion angle, Harris hip score and postoperative dislocation rate. The Revman 5.3 software provided by the Cochrane Collaborat Network was used for Meta analysis of the data.Results: A total of 654 patients were included in 8 studies, including 328 patients in DAA group and 326 patients in PLA group. Meta-combined results, The number of acetabular abduction angle in DAA group is smaller than that in PLA group [MD =-0.87, 95%CI(-1.69 ~-0.04), p = 0.04], and the number of acetabular anteversion angle in DAA group is also smaller than that in PLA group [MD =-4.25, 95%CI(-4.96 ~-3.54), p < 0.00001], the differences are statistically significant. 6 weeks after operation, the Harris hip score of DAA was higher than that of PLA [MD = 5.35, 95%CI(2.38 ~ 8.32), P = 0.0004], and the difference was statistically significant. For the total Harris hip score , DAA is higher than PLA, and the difference is statistically significant [MD = 2.3, 95%CI (0.19 ~ 4.41), P = 0.03]; However, other results were not statistically significant.Conclusion: Compared with PLA, DAA can accelerate postoperative rehabilitation of patients, and at the same time can obtain better acetabular prosthesis location.
Cytotoxicity of Insects (T. Molitor, G. Bimaculatis, S. Gregaria and A. Domesticus) in A Simulated Gastrointestinal Digestion/Human Intestinal Cell Model
Authors: Dobermann Darja , Scheers Nathalie
Published: January 2021

Insects as an alternative nutritional source for protein and other nutrients has gained increasing attention in the last decade. On the other hand, insects produce several compounds toxic to human cells associated with e.g. antitumoral activity and as such has been proposed as tentative anti-cancer agents. In this work, we used a combined simulated gastrointestinal digestion and human absorptive cell model, Caco-2, common in nutritional studies but also in cancer research, to investigate cytotoxicity of common insect species in a simulated oral intake setting. Caco-2 cells were exposed to various concentrations of digested insects (Gryllus bimaculatus, Schistocerca gregaria, Tenebrio molitor, Acheta domesticus) which showed a significant decrease in survival and viability in response to the digests. T. molitor affected the viability of Caco-2 cells the most, compared to the other species. Notable effects on protein expression of several calcium homeostasis and cell response related proteins, FOSB, BANK1 and EGFL7, a metabolic homeostasis oxidative stress response related protein, FOXO1, and an apoptosis related protein, H0-1/HM0X/HSP32 was identified. We conclude that these insect species were cytotoxic to the intestinal cells in a simulated oral intake setting.
A Deep Learning Method for ECG Signal Prediction Based on VMD, Cao Method, and LSTM Neural Network
Authors: Huang Fuying , Qin Tuanfa , Wang Limei , Wan Haibin
Published: January 2021

Background: In body area network (BAN), accurate prediction of ECG signal can not only let doctors know the patient's condition in advance, but also help to reduce the energy consumption of sensors. In order to improve the accuracy of ECG signal prediction, this paper proposes a deep learning method for ECG signal prediction. Methods: The proposed prediction method combines variational mode decomposition (VMD), Cao method and a long short-term memory (LSTM) neural network. In the method, VMD decomposes ECG data into a series of intrinsic mode functions (IMFs), which reduces the non-stationary character of ECG signals and helps to improve the prediction accuracy. Cao method is used to determine the input dimension of LSTM input layer, namely, the minimum embedding dimension of each IMF is the input dimension of LSTM input layer. Each IMF is predicted by a LSTM neural network which adopts Adam optimizer. All IMFs predictions are aggregated to get the final prediction result. Results: To evaluate the prediction accuracy of the proposed method, simulation experiments are carried out on ECG data from the MIT-BIH Arrhythmia Database. Experimental results show that the RMSE (root mean square error) and MAE (mean absolute error) of the proposed model are 0.001326 and 0.001044 respectively, which are more than 10 percent lower than the traditional prediction methods.Conclusions: Compared with some traditional prediction methods, the proposed prediction method improves the prediction accuracy obviously.
Attitudes Towards Cardiopulmonary Resuscitation Situations and the Associations of Possible Affecting Factors – a Survey Among 3,602 in-hospital Healthcare Professionals
Authors: Silverplats Jennie , STRÖMSÖE Anneli , ÄNG Björn , Källestedt Marie-Louise Södersved
Published: January 2021

BackgroundAttitudes among in-hospital healthcare professionals (HCPs) towards cardiopulmonary resuscitation (CPR) are poorly understood. The aim of this study was therefore to evaluate attitudes among in-hospital HCPs towards CPR and furthermore to assess the associations of possible affecting factors.MethodsA questionnaire was distributed to n=6,055 HCPs. The associations of affecting factors were analysed using binary logistic regression.ResultsThe response rate was 59% (n=3,602). Fifty three percent of HCPs felt confident in their CPR knowledge, 80% would know what to do, and 52% would be able to take command if necessary in a cardiac arrest situation. A third of HCPs were worried about making mistakes/cause complications, 57% felt stressed, and 27% felt anxious in connection to the latest real-life CPR situation. A short time since the last real-life CPR performance and a high number of previous real-life CPR performances were associated with lower odds of a worry about making mistakes/cause complications, lower odds of feeling stressed or anxious, and higher odds of feeling calm. Despite previous real-life CPR experience, there were differences in attitudes between groups of profession, and between monitored and non-monitored wards. Time since last CPR training course was associated with anxiety.ConclusionsDespite overall positive attitudes towards performing CPR, feelings of stress and anxiety were common which could reflect possible stress overload. Many HCPs work in low-risk areas of cardiac arrest, therefore regular CPR training is important to maintain competence and reduce anxiety. The possible effect of attitudes on performing CPR needs to be studied further.
A Hazardous Foreign Body Perforating the Cervical Esophagus With Extra-Esophageal Impact
Authors: Sahin Mehmet Furkan , Beyoglu Muhammet Ali , Yazicioglu Alkin , Yekeler Erdal
Published: January 2021

BackgroundEsophageal perforation due to foreign body is a fatal complication when not diagnosed on time and not managed properly. Although admissions to the emergency department after foreign body ingestion are frequently observed, perforating the esophagus after ingestion of sharp-edged objects and being observed in the soft tissue in the extraesophageal area is a very rare condition. MethodsThe patient, who admitted to the emergency department with dysphgia after swallowing a sharp-pointed foreign body, was retrospectively analyzed. ResultsWe present our patient who developed esophageal perforation as a result of accidentally swallowing a sharp-edged glass object which we diagnosed immediately, approached with a lateral cervical incision within 24 hours and removed from the location very close to the carotid artery in the extraesophageal area. ConclusionsPerforating esophageal foreign bodies are urgent problems that require early diagnosis and intervention. Delayed surgery can lead to fatal consequences. Trial RegistirationThis case report was retrospectively registered by Institutional Thoracic Surgery Education and Research Committe. (Number:2020-12-15/01, Date: 18/12/2020)
Efficacy of Early Antifibrotic Treatment for Idiopathic Pulmonary Fibrosis
Authors: Sugino Keishi , Ono Hirotaka , Watanabe Natsumi , Shimizu Shigeru , Ando Masahiro , Tsuboi Eiyasu , Homma Sakae , Kishi Kazuma
Published: January 2021

The present study aimed to clarify the efficacy of nintedanib and pirfenidone in patients with early-stage IPF. We compared survival, disease progression, and efficacy of antifibrotics between patients with IPF with Japanese Respiratory Society (JRS) disease severity system stage I with and without oxygen desaturation on the 6-minute walk test (6MWT) and increased the gender–age–physiology (GAP) staging. The severity of stage I IPF (n = 179) according to the JRS criteria consisted of the following GAP staging criteria: stage I, 111 cases; stage II, 58 cases; stage III, 10 cases. The duration from the initial visit to disease progression and survival time was significantly shorter in JRS stage I patients with oxygen desaturation on the 6MWT or with increased GAP staging (unfavorable group) compared with patients without those factors. In the unfavorable group, the forced vital capacity (FVC) decline and relative decline in percentage predicted FVC over 6 months was significantly lower in patients undergoing antifibrotic treatment compared with non-treated patients. Antifibrotics have a beneficial effect on the decline in FVC in Japanese patients with early-stage IPF who have oxygen desaturation on the 6MWT or increased GAP staging.
The Deubiquitinase OTUD3 Stabilizes ACTN4 to Activate NF-κB Signaling Pathway in Hepatocellular Carcinoma
Authors: Xie Peiyi , Chen Yanglin , Zhang Hongfei , Zhou Guichao , Chao Qing , Wang Jiangwen , Wang Zhiyuan , Hao Liang , Huang Da
Published: January 2021

Background: OTUD3, a deubiquitinating enzyme, has emerged as important role in some cancer. It showed that OTUD3 plays suppressive role in breast cancer whereas oncogenic role in lung cancer. However, the function and mechanism of OTUD3 in hepatocellular carcinoma (HCC) progression remain elusive. Methods: Gene and protein expression of OTUD3 in HCC tissues were determined by qRT-PCR, western blot and immunohistochemistry. A series of gain- and loss-of-function assays were used to investigated the role of OTUD3 in HCC cells progression. Moreover, mass spectroscopic analysis and RNA-seq were used to identify the downstream targets of OTUD3 in HCC cells. The interaction between OTUD3 and ACTN4 was examined through co-IP experiment and in vitro ubiquitination assay.Results: In our research, OTUD3 was significantly overexpressed in HCC tissues and higher OTUD3 expression was correlated with bigger tumor size, more distant metastasis, and worse TNM stage. Additionally, OTUD3 promoted HCC cells growth and metastasis in vitro and in vivo. Furthermore, ACTN4 was identified as a downstream target of OTUD3 and ACTN4 protein level was significantly related to OTUD3 expression. Rescue experiments indicated that ACTN4 was essential for OTUD3-mediated HCC proliferation and metastasis in vitro and in vivo. Moreover, we identified that NF-κB signaling pathway was activated by OTUD3 through ACTN4 to promote HCC cells progression. Importantly, OTUD3 protein level was correlated with ACTN4 protein level and activity of NF-κB signaling pathway in HCC tissues. Conclusion: Our findings identify the oncogenic role of OTUD3 in HCC and suggest that OTUD3 can be considered as a pivotal prognostic biomarker and a potential therapeutic target.
Co-treatment With the Herbal Medicine SIP3 and Donepezil Improves Memory and Depression in the Mouse Model of Alzheimer’s Disease
Authors: Liu Quan Feng , Choi Hoon , Son Taekwon , Kim Young-Mi , Kanmani Suganya , Chin Young-Won , Kim Seung-Nam , Kim Kwang-Ki , Kim Kyu-Won , Koo Byung-Soo
Published: January 2021

Background: Alzheimer’s disease (AD) is a lethal progressive neurodegenerative disorder. Currently, many acetylcholinesterase inhibitors, such as donepezil, is widely used for the treatment of AD. However, the efficacy of long-term donepezil use is limited. SIP3, a mixture of Santalum album, Illicium verum, and Polygala tenuifolia, a new formula derived from traditional Korean herbal medicine. In this study, SIP3 were assessed the survival of Drosophila AD model and synergistic effect of SIP3, donepezil co-treatment of AD using APP/PS1 transgenic mice. Methods: In Drosophila AD models, we analyzed the survival, climbing ability and acridine orange (AO) staining. In APP/PS1 mice, at six months of age were randomized into four groups. Then, these groups were orally administered vehicle (for the control), donepezil, low and high doses SIP3 plus Donepezil respectively for six months. The passive avoidance test (PAT) and the Morris water maze (MWM) were analyzed cognitive behavioral changes. In addition, the forced swimming test (FST) and the tail suspension test (TST) were assessed depression-like behavior. To investigate the molecular and cellular mechanisms underlying positive effects of SIP3 on AD, the cerebral cortex transcriptomes were analyzed by RNA sequencing.Results: Using the passive avoidance test (PAT), we analyzed the combination of SIP3 and donepezil improved the learning capabilities and memory of APP/PS1 mice, compared with the group treated with donepezil only, in late stage of AD. In addition, using the Morris water maze (MWM) test, co-treatment with donepezil and a low concentration of SIP3 significantly ameliorated cognitive impairment. Co-administration of SIP3 and donepezil effectively reduced depression-like behavior in the forced swimming and tail suspension tests. Furthermore, RNA sequencing of cerebral cortex transcriptome revealed that gene expression profiles after low dose of SIP3 co-treatment are slightly similar to those of normal phenotype mice than those obtained after donepezil treatment alone. Gene ontology (GO) along with Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway have demonstrated that differentially expressed genes were involved in locomotor behavior and neuroactive ligand-receptor interactions. Collectively: our results suggest that co-treatment of low dose of SIP3 and donepezil improves impaired learning, memory, and depression in late stage of AD in mice.
Glial Associated Impairment of the Glymphatic System in Experimental Neonatal Hydrocephalus
Authors: Vasas Joseph Tyler , McAllister James Pat , Eskandari Ramin
Published: January 2021

Background

Changes in aquaporin-4 (AQP4) and glial fibrillary acid protein (GFAP) expression by astrocytes have been observed in several pathologies. It is hypothesized that prolonged exposure to pathologically elevated intracranial pressure (ICP) may be linked to impaired glymphatic pathways. In this study we explore histological consequences of prolonged pressure-induced injury in a feline model of neonatal hydrocephalus through changes in AQP4 and GFAP expression. We discuss the implications this may have in gaining a better understanding of the underlying mechanisms of hydrocephalus (HCP).
Methods

Using a neonatal feline model, obstructive HCP was induced through kaolin injection into the cisterna magna. Time between injection and intervention via ventricular reservoir placement was used to divide groups into early and late treatment groups. Early and late animals received reservoirs at 1- and 2-weeks post kaolin injection, respectively. Controls underwent sham operations (saline injection instead of kaolin). Animals were sacrificed at 4 months allowing for a chronic treated hydrocephalic model at time of brain harvest. Immunofluorescent staining for GFAP, AQP4 and DAPI was performed on histological brain sections from each group, and densitometry was used to quantify the relative signal of protein expression.
Results

Hydrocephalus was seen in all animals receiving kaolin injection as demonstrated by magnetic resonance imaging, clinical examination and neurological sequelae. Hydrocephalic animals demonstrated lower levels of perivascular AQP4 expression, increased diffuse AQP4 expression and increased glial scarring of perivascular, ependymal and subependymal spaces. Cerebral microvasculature of early treatment groups demonstrated increased astrocytic processes in the perivascular spaces, while late treatment groups demonstrated increased glial scar formation. Overall, the glymphatic system was severely disrupted in chronic treated hydrocephalus compared to controls.
Conclusions

Reactive astrogliosis and AQP4 mislocation are evident in early and late reservoir-treated HCP. Glial scarring in the perivascular, ependymal and subependymal spaces concurrent with AQP4 internalization from the perivascular region are prominent in HCP conditions present within the neonatal period. Delay in treatment by 1 week demonstrates quantifiable increases in perivascular and ependymal glial scarring at 4 months of age. Further investigation is needed to correlate glymphatic disruption with impaired CSF absorption and its role in promoting progressive hydrocephalus.
Rosiglitazone Protects Blood-Brain Barrier Integrity Following Ischemic Stroke by Reducing MMP-9 Expression Through a Caveolin-1-Dependent Pathway
Authors: Huang Qianyi , Zhong Wei , Yi Xia , Qin Zhen , Tang Xiangqi
Published: January 2021

Background

Rosiglitazone (RSG) is a widely used antidiabetic drug which activates peroxisome proliferator-activated receptor-γ. Recent work have shown that RSG can up-regulate caveolin-1 levels and ameliorate both chronic and acute brain injury. However, whether rosiglitazone can ameliorate ischemic injury in the brain via a caveolin-1-dependent pathway remains unknown.
Methods

Adult male sprague-dawley rats were randomly divided into sham operation group, model group, rosiglitazone group and rosiglitazone + daidzein group. The rat models of middle cerebral artery occlusion (MCAO) was established using the suture method, with ischemia for 2 hours and reperfusion for 22 hours. Neurological deficits were evaluated by the methods of Longa’s standard scoring. Cerebral infarction volume was observed by staining with 2, 3, 5-triphenyltetrazolium chloride. Evans blue content reflects BBB permeability. The expressions of caveolin-1, matrix metalloproteinase-9(MMP-9) and occludin were detected by immunofluorescent staining and western blot.
Results

In this study, we found that the expression of caveolin-1 was increased in a rat model of stroke, and treatment with RSG significantly increased the levels of caveolin-1, reduced the release of MMP-9, and increased the expression of occludin. On the other hand, a caveolin-1 inhibitor daidzein canceled the protective roles of RSG in the MCAO model.
Conclusions

These data unveil that RSG might protect blood-brain barrier integrity by down-regulating the levels of MMP-9 via a caveolin-1-dependent pathway.
Dietary Habits, BMI, and demographic characteristics affect the Academic Performance of University Students in Saudi Arabia: A cross-sectional study
Authors: Jalloun Rola A. , Shikieri Ahlam Badreldin El
Published: January 2021

Background

Students' academic performance remains one of the ongoing topics of debate among educators, academicians, and policy-makers. We aimed to assess the effect of dietary habits, demographic characteristics, and body mass index (BMI) on academic performance.
Method

: An epidemiological, cross-sectional, retrospective study design was conducted. Data were collected from 385 full-time, Saudi undergraduate students at Taibah University aged between 18–24 years old. Students were asked about their breakfast, fast food, and soft drink consumption, and their daily number of meals. Information about their gender, residence in hostels, and smoking status were obtained. Grade point average (GPA) was used to assess academic performance. BMI was also calculated. All statistical analyses were performed using the SPSS software program version 20.
Results

More females (n = 290; 75.3%) than males were included. High academic performers were non-smokers (P < 0.0005) and didn't stay in hostels (P = 0.026). BMI associated negatively with academic performance. Females had better academic performance (95%) compared to males (58%, P < 0.0005), GPA (2.72 vs 3.53, P < 0.0005 respectively), lower number of meals (Mean: 2.31 vs 1.99), and low prevalence of overweight/obesity (43% vs 30%).
Conclusion

Nutrition education programs targeting Taibah University students are to be developed to raise awareness about the importance of healthy eating and normal body weight.
Fabrication of perfect plasmonic absorbers for blue and near-ultraviolet lights using double-layer wire-grid structures
Authors: Motogaito Atsushi , Tanaka Ryoga , Hiramatsu Kazumasa
Published: January 2021

This study proposes using double-layer wire-grid structures to create narrow-band, perfect plasmonic absorbers, which depend on polarization, for the short-wavelength visible and near-ultraviolet regions of the electromagnetic spectrum. A rigorous coupled-wave analysis reveals that the maximum absorption attained using Ag and Al is ~90% at 450 nm and 375 nm. Experiments using Ag yielded results similar to those predicted by simulations. These results demonstrate that narrow-band perfect plasmonic absorbers, which depend on the polarization, can be realized at 450 nm and 375 nm using Ag or Al.
Assessment of Modern Contraceptive Utilization and Associated Factors Among Women Living With HIV/AIDS In Debre Tabor Referral Hospital In Debre Tabor Town, South Gondar Zone, North Central Ethiopia
Authors: Abebe Endeshaw Chekol , Mengie Teklie , Dejenie Tadesse Asmamaw , Muchie Zelalem Tilahun
Published: January 2021

Introduction: Preventing unintended pregnancy among HIV-positive women constitutes a critical global public health priority for addressing the desperate state of maternal and child health in HIV hyper endemic settings, yet few data exist on contraceptive use among women entering ART follow up in Debre Tabor Referral Hospital. Objective: The main objective of this study was to assess contraceptive utilization and associated factors among women aged 15-49 years living with HIV/AIDS in Debre Tabor Referral Hospital.Methods: Institution based cross-sectional study was conducted from January 02 to February 03, 2020 on women aged 15-49 years living with HIV/AIDS in Debre Tabor Referral Hospital. A total of 415 reproductive women living with HIV/AIDS were selected for the study using simple random sampling technique. Data was collected using a Structured questionnaires through face to face interview by two trained nurses assigned at ART clinic of DTH during data collection period. The data was presented using descriptive statistics of frequency and percentage and the association between dependent and selected independent variables was determined by inferential statistics of chi-square test.Result: The study analysis shows that there is significant association (p-value<0.05) between educational status (p-value=0.000), knowledge about modern contraceptive (p-value=0.000), spouse approval (p-value=0.000) and receive counseling about modern contraceptive (p-value=0.000) with their modern contraceptive use.Conclusion: This study in generally showed lower utilization of modern contraceptive in the study area.