bluuebunny/crossref_metadata_2025 huggingface dataset:
The association of economic and cultural capital with the NEET rate: differential geographical and temporal patterns
Authors: Ripamonti Enrico , Barberis Stefano
Published: April 2021

Using data from 103 Italian provinces, we investigated the relationship between local/regional development, and NEET. We constructed an indicator of cultural capital and another of economic capital and we studied their relation with the NEET rate. Covariance Structure Analysis with Generalized Least Squares estimation was employed, considering a three time-points retrospective model. Results indicate a consistent protective effect of the economic capital on the NEET rate, both in the short run (2 years) and in the medium run (10 years). However, this effect has been obtained in the Central provinces (at 2 and 10 years) and Southern provinces (at 10 years), but not in the Northern provinces. A mediation analysis indicated that, historically, the cultural capital may partly mediate the effect of the economic capital. We did not detect a significant direct effect of the cultural capital on the NEET rate, which is strongly mediated by the action of the economic capital. Together, these results denote that the economic capital is a strong predictor of NEET, but not in very competitive economic areas.
The prognostic value of an autophagy-related lncRNA signature in hepatocellular carcinoma
Authors: Yang Shiming , Zhou Yaping , Zhang Xiangxin , Wang Lu , Fu Jianfeng , Zhao Xiaotong , Yang Liu
Published: April 2021

Background

lncRNA may be involved in the occurrence, metastasis, and chemical reaction of hepatocellular carcinoma (HCC) through various pathways associated with autophagy. Therefore, it is urgent to reveal more autophagy-related lncRNAs, explore these lncRNAs’ clinical significance, and find new targeted treatment strategies.

Methods

The corresponding data of HCC patients and autophagy genes were obtained from the TCGA database, and the human autophagy database respectively. Based on the co-expression and Cox regression analysis to construct prognostic prediction signature.

Results

Finally, a signature containing seven autophagy-related lncRNAs (PRRT3-AS1, RP11-479G22.8, RP11-73M18.8, LINC01138, CTD-2510F5.4, CTC-297N7.9, RP11-324I22.4) was constructed. Based on the risk score of signature, Overall survival (OS) curves show that the OS of high-risk patients is significantly lower than that of low-risk patients (P = 2.292e−10), and the prognostic prediction accuracy of risk score (AUC = 0.786) is significantly higher than that of ALBI (0.532), child_pugh (0.573), AFP (0.5751), and AJCC_stage (0.631). Moreover, multivariate Cox analysis and Nomogram of risk score are indicated that the 1-year and 3-year survival rates of patients are obviously accuracy by the combined analysis of the risk score, child_pugh, age, M_stage, and Grade (The AUC of 1- and 3-years are 0.87, and 0.855). Remarkably, the 7 autophagy-related lncRNAs may participate in Spliceosome, Cell cycle, RNA transport, DNA replication, and mRNA surveillance pathway and be related to the biological process of RNA splicing and mRNA splicing.

Conclusion

In conclusion, the 7 autophagy-related lncRNAs might be promising prognostic and therapeutic targets for HCC.
Labor epidural analgesia versus without labor epidural analgesia for multiparous women: a retrospective case control study
Authors: Luo Shuzhi , Chen Zhaowen , Wang Xujian , Zhu Changyu , Su Shili
Published: April 2021

Background

Labor epidural analgesia (LEA) effectively relieves the labor pain, but it is still not available consistently for multiparous women in many institutions because of their obviously shortened labor length.

Methods

A total of 811 multiprous women were retrospective enrolled and firstly divided into two groups: LEA group or non-LEA group. And then they were divided into seven subgroups and analyzed according to the use of LEA and cervical dilation. The primary outcomes (time intervals, blood loss and Apgar scores) and secondary outcomes (maternal demographic characteristics and birth weight) were collected by checking electronic medical records.

Results

The prevalence of using LEA in multiprous women was 54.5 %. Using LEA significantly lengthened the duration of labor stage by 56 min (P < 0.001), increased the blood loss (P < 0.001) and lowered Apgar scores (P = 0.001). In the comparison of sub-group analysis, using LEA can obviously prolong the duration of first-second stage in women with 2 cm cervical dilation (P < 0.001) and 3 cm cervical dilation (P = 0.014), while there was no significant difference with 4 cm or more cervical dilation (P = 0.69). Using LEA can significantly increased the blood loss when the initiation of LEA in the women with 2 cm cervical dilation (P < 0.001) and 3 cm cervical dilation (P = 0.035), meanwhile there were no significantly differences in the women with 4 cm or more cervical dilation (P = 0.524). Using LEA can significantly lower the Apgar scores when the initiation of LEA in the women with 2 cm cervical dilation (P = 0.001) and 4 cm or more cervical dilation (P = 0.025), while there were no significantly differences in the women with 3 cm cervical dilation (P = 0.839).

Conclusions

Labor epidural analgesia for the multiparous woman may alter progress of labor, increase postpartum blood loss and lower Apgar scores. Early or late initiation of LEA should be defined as with cervical dilatation of less or more than 3 cm and the different effect should be understand.

Trial registration

ChiCTR2100042746. Registered 27 January 2021-Prospectively registered, http://www.chictr.org.cn.
Association between handgrip strength and bone mineral density of Brazilian children and adolescents stratified by sex: a cross-sectional study
Authors: Saraiva Bruna Thamyres Ciccotti , Agostinete Ricardo Ribeiro , Freitas Júnior Ismael Forte , de Sousa Daniel Eduardo Rodrigues , Gobbo Luis Alberto , Tebar William Rodrigues , Christofaro Diego Giulliano Destro
Published: April 2021

Background

To examine the association of handgrip strength (HGS) and bone mineral density (BMD) of Brazilian children and adolescents.

Methods

The sample included 243 children and adolescents aged from 4 to 15 years (9.3 ± 2.2 years), 171 males and 72 females. The following measurements were performed: weight, height, trunk length, and years to the peak height velocity (PHV). The percentage lean soft tissue (PLST), percentage fat mass (PFM), and BMD were obtained using Dual Energy X-ray Absorptiometry (DXA) and HGS using a dynamometer.

Results

In girls, HGS was positively associated with higher BMD, even after the adjustments, by arms [β = 0.006; p < 0.001], legs [β = 0.014; p < 0.001], pelvis [β = 0.019; p < 0.001], trunk [β = 0.013; p < 0.001], spine [β = 0.013; p = 0.008], and total body [β = 0.009; p < 0.001]. The same occurred in the boys, even after the adjustments a positive relationship was observed, whereas higher HGS was related to greater BMD in arms [β = 0.006; p < 0.001], legs [β = 0.017; p < 0.001], pelvis [β = 0.014; p < 0.001], trunk [β = 0.009; p < 0.001], spine [β = 0.008; p < 0.001], and total body [β = 0.007; p < 0.001].

Conclusion

HGS was positively associated to BMD in boys and girls, regardless of age, PHV, PLST, and PFM.
Effect of COVID-19 on childhood Mycoplasma pneumoniae infection in Chengdu, China
Authors: Zhang Ying , Huang Yijie , Ai Tao , Luo Jun , Liu Hanmin
Published: April 2021

Background

Following the outbreak of the COVID-19 pandemic, a change in the incidence and transmission of respiratory pathogens was observed. Here, we retrospectively analyzed the impact of COVID-19 on the epidemiologic characteristics of Mycoplasma pneumoniae infection among children in Chengdu, one of the largest cities of western China.

Method

M. pneumoniae infection was diagnosed in 33,345 pediatric patients with respiratory symptoms at the Chengdu Women’s & Children’s Central Hospital between January 2017 and December 2020, based on a serum antibody titer of ≥1:160 measured by the passive agglutination assay. Differences in infection rates were examined by sex, age, and temporal distribution.

Results

Two epidemic outbreaks occurred between October-December 2017 and April-December 2019, and two infection peaks were detected in the second and fourth quarters of 2017, 2018, and 2019. Due to the public health response to COVID-19, the number of positive M. pneumoniae cases significantly decreased in the second quarter of 2020. The number of M. pneumoniae infection among children aged 3–6 years was higher than that in other age groups.

Conclusions

Preschool children are more susceptible to M. pneumoniae infection and close contact appears to be the predominant factor favoring pathogen transmission. The public health response to COVID-19 can effectively control the transmission of M. pneumoniae.
Risk factors and prediction model of urosepsis in patients with diabetes after percutaneous nephrolithotomy
Authors: Liu Jun , Yang Qingya , Lan Jiayi , Hong Yang , Huang Xiaobo , Yang Bo
Published: April 2021

Objective

To analyze the risk factors of patients with diabetes mellitus (DM) and urosepsis after percutaneous nephrolithotomy (PCNL) for upper urinary tract stones and to develop a nomogram to predict postoperative urosepsis according to the risk factors.

Methods

The data of patients with type 2 diabetes who underwent one-stage PCNL due to upper urinary tract stones were retrospectively analyzed. The risk factors of patients with postoperative urosepsis were evaluated by univariate and multivariate logistic regression analysis, and the nomogram prediction model was developed according to the regression coefficient.

Results

One-stage PCNL was successfully completed in 241 patients with DM, and urosepsis occurred in 41 (17.0%) patients after PCNL. Based on multivariate logistic regression analysis, the independent risk factors associated with postoperative urosepsis included preoperative leukocyte elevation (OR = 3.973, P = 0.005), positive urine nitrite (OR = 3.697, P = 0.010), and positive urine culture (OR = 3.562, P = 0.002). According to the results of the logistic regression analysis model, staghorn stones (OR = 2.049, P < 0.1) and complete intraoperative stone clearance (OR = 0.431, P < 0.1), were used to develop the nomogram. Internal validation of the nomogram showed that the concordance index (C-index) was 0.725. Additionally, the Hosmer–Lemeshow test was performed, P = 0.938 > 0.05.

Conclusion

Preoperative leukocyte elevation, positive urine nitrite, and positive urine culture are independent risk factors for urosepsis after one-stage PCNL for patients with DM with upper urinary tract stones. The nomogram, which is based on independent risk factors that combine stone morphology and intraoperative stone clearance, can help predict the risk of postoperative urosepsis.
Continuing education interventions about person-centered care targeted for nurses in older people long-term care: a systematic review
Authors: Pakkonen Mari , Stolt Minna , Charalambous Andreas , Suhonen Riitta
Published: April 2021

Background

Person-Centered Care is often seen as an indicator of quality of care. However, it is not known whether and to what extent person-centered care can be enhanced by continuing education interventions in older people’s long-term care settings. This systematic review aimed to analyze and synthesize the existing research literature about person-centered care-based continuing educational interventions for nurses working in long-term care settings for older people.

Methods

Five databases were searched 6/2019 and updated 7/2020; PubMed (Medline), CINAHL, PsycINFO, Cochrane and Eric using the keywords person-centered car* OR person-centred car * OR patient-centered car* OR client-centered car* OR tailored car* OR resident-centered car* OR individualized car* AND older* OR elder* OR old person* AND Long-Term Care OR Nursing home OR 24-h treatment OR long-term treatment. Twenty-seven full texts from 2587 initially retrieved citations were included.

Results

The continuing educational interventions found were divided into five themes: person-centered interventions focusing on medication; interaction and caring culture; nurses’ job satisfaction; nursing activities; and older people’s quality of life. The perspective of older people and their next of kin about the influence of continuing education interventions were largely absent. The background theories about interventions, the measurements taken, and the clarity around the building blocks of the continuing-care interventions need further empirical verification. The pedagogical methods used were mainly quite behavioristic mostly lectures and seminars.

Conclusion

Most of person-centered care continuing education interventions are effective. Still more empirical research-based continuing education interventions are needed that include learner-centered pedagogical methods, with measurable outcomes that consider the opinions of older people and their next of kin. Continuing educational interventions for nurses need to be further developed to strengthen nurse’s competence in person-centered care, job satisfaction and for better quality of care.
Maternal methylmercury exposure through rice ingestion and child neurodevelopment in the first three years: a prospective cohort study in rural China
Authors: Rothenberg Sarah E. , Korrick Susan A. , Liu Jihong , Nong Yanfen , Nong Hua , Hong Chuan , Trinh Eva P. , Jiang Xu , Biasini Fred J. , Ouyang Fengxiu
Published: April 2021

Background

Rice is an important dietary source for methylmercury; however, rice does not contain the same beneficial nutrients as fish. Our main objective was to assess associations of prenatal methylmercury exposure through rice ingestion with child neurodevelopment in rural China.

Methods

Eligible peripartum women were enrolled (n = 391), provided peripartum hair samples, and children’s neurodevelopment was assessed at 12 months (n = 264, 68%) and 36 months (n = 190, 48%) using the Bayley Scales of Infant Development, 2nd Edition, including the Mental Developmental Index (MDI) and the Psychomotor Developmental Index (PDI). Associations between prenatal methylmercury exposure during the third trimester [log2 maternal hair total mercury (THg)] and child’s neurodevelopment were assessed using linear mixed models for repeated measures.

Results

In adjusted models, a doubling in maternal hair THg corresponded to a 1.3-point decrement in the MDI score [95% confidence interval (CI): − 2.6, − 0.14], and a 1.2-point decrement in the PDI score (95% CI: − 2.6, 0.14). Overall, adverse associations between maternal hair THg and MDI scores attenuated over time. However, associations were robust and stable over time among children whose primary caregiver was their parent(s). During the study follow-up, an increasing proportion of children were raised by grandparents (12 months: 9% versus 36 months: 27%), a trend associated with rural-to-urban parental migration for work.

Conclusions

For young children living in rural China, a biomarker of prenatal methylmercury exposure was associated with decrements in cognitive function assessed between 12 and 36 months of age. Changes in the family structure over the study follow-up time interval potentially impacted children’s sensitivity to prenatal methylmercury exposure.
Phagocytosis of polymeric nanoparticles aided activation of macrophages to increase atherosclerotic plaques in ApoE−/− mice
Authors: Yin Tieying , Li Yanhong , Ren Yuzhen , Fuad Atik Rohmana Maftuhatul , Hu Fangfang , Du Ruolin , Wang Yang , Wang Guixue , Wang Yazhou
Published: April 2021

The unique physiochemical properties of nanomaterials have been widely used in drug delivery systems and diagnostic contrast agents. The safety issues of biomaterials with exceptional biocompatibility and hemo-compatibility have also received extensive attention at the nanoscale, especially in cardiovascular disease. Therefore, we conducted a study of the effects of poly (lactic-co-glycolic acid) nanoparticles (PLGA NPs) on the development of aortic atherosclerotic plaques in ApoE−/− mice. The particle size of PLGA NPs was 92.69 ± 3.1 nm and the zeta potential were − 31.6 ± 2.8 mV, with good blood compatibility. ApoE−/− mice were continuously injected with PLGA NPs intravenously for 4 and 12 weeks. Examination of oil red O stained aortic sinuses confirmed that the accumulation of PLGA NPs caused a significantly higher extension of atherosclerotic plaques and increasing the expression of associated inflammatory factors, such as TNF-α and IL-6. The combined exposure of ox-LDL and PLGA NPs accelerated the conversion of macrophages to foam cells. Our results highlight further understanding the interaction between PLGA NPs and the atherosclerotic plaques, which we should consider in future nanomaterial design and pay more attention to the process of using nano-medicines on cardiovascular diseases.
The role of Sphingomyelin synthase 2 (SMS2) in platelet activation and its clinical significance
Authors: Guo Yifan , Chang Lin , Zhang Ge , Gao Zhanyan , Lin Hao , Zhang Yuting , Hu Liang , Chen She , Fan Bing , Zhang Si , Xue Ruyi
Published: April 2021

Background

Sphingomyelin (SM) is an essential component of biological lipid rafts, and it plays an indispensable role in maintaining plasma membrane stability and in mediating signal transduction. The ultimate biosynthesis of SM is catalyzed by two sphingomyelin synthases (SMSs) namely SMS1 and SMS2, which are selectively distributed in the trans-Golgi apparatus and the plasma membrane. It has been demonstrated that SMS2 acts as an irreplaceable molecule in the regulation of transmembrane signaling, and loss of SMS2 has been reported to worsen atherosclerosis and liver steatosis. However, the function of SMS2 in platelet activation and its association with the pathological process of thrombosis in acute coronary syndrome (ACS) and portal hypertension (PH) remain unclear.

Methods

In this study, we tested the role of SMS2 in platelet activation and thrombosis using SMS2 knockout (SMS2 –/–) mice and SMS2-specific inhibitor, D609. Furthermore, we detected SMS2 expression in patients with ACS and PH.

Results

SMS2 –/– platelets showed significant reduction in platelet aggregation, spreading, clot retraction and in vivo thrombosis. Similar inhibitory effects on platelet activation were detected in D609-treated wild-type platelets. PLCγ/PI3K/Akt signaling pathway was inhibited in SMS2 –/– platelets and D609-treated wild-type platelets. In addition, we discovered that platelet SMS2 expression was remarkably increased in patients with ACS and PH, compared with healthy subjects.

Conclusions

Our study indicates that SMS2 acts as a positive regulator of platelet activation and thrombosis, and provides a theoretical basis for the potential use of D609 in anti-thrombosis treatment.
Texture analysis to differentiate anterior cruciate ligament in patients after surgery with platelet-rich plasma
Authors: Alves Allan Felipe Fattori , de Arruda Miranda José Ricardo , de Souza Sérgio Augusto Santana , Pereira Ricardo Violante , de Almeida Silvares Paulo Roberto , Yamashita Seizo , Deffune Elenice , de Pina Diana Rodrigues
Published: April 2021

Background

Platelet-rich plasma (PRP) has been used to favor anterior cruciate ligament (ACL) healing after reconstruction surgeries. However, clinical data are still inconclusive and subjective about PRP. Thus, we propose a quantitative method to demonstrate that PRP produced morphological structure changes.

Methods

Thirty-four patients undergoing ACL reconstruction surgery were evaluated and divided into control group (sixteen patients) without PRP application and experiment group (eighteen patients) with intraoperative application of PRP. Magnetic resonance imaging (MRI) scans were performed 3 months after surgery. We used Matlab® and machine learning (ML) in Orange Canvas® to texture analysis (TA) features extraction. Experienced radiologists delimited the regions of interest (RoIs) in the T2-weighted images. Sixty-two texture parameters were extracted, including gray-level co-occurrence matrix and gray level run length. We used the algorithms logistic regression (LR), naive Bayes (NB), and stochastic gradient descent (SGD).

Results

The accuracy of the classification with NB, LR, and SGD was 83.3%, 75%, 75%, respectively. For the area under the curve, NB, LR, and SGD presented values of 91.7%, 94.4%, 75%, respectively. In clinical evaluations, the groups show similar responses in terms of improvement in pain and increase in the IKDC index (International Knee Documentation Committee) and Lysholm score indices differing only in the assessment of flexion, which presents a significant difference for the group treated with PRP.

Conclusions

Here, we demonstrated quantitatively that patients who received PRP presented texture changes when compared to the control group. Thus, our findings suggest that PRP interferes with morphological parameters of the ACL.

Trial registration

Protocol no. CAAE 56164316.6.0000.5411.
Comprehensive characterization of the chemical constituents in Yiganmingmu oral liquid and the absorbed prototypes in cynomolgus monkey plasma after oral administration by UPLC-Q-TOF-MS based on the self built components database
Authors: Wei Wei , Li Siwei , Cheng Linyou , Hao Erwei , Hou Xiaotao , Zhou Hua , Deng Jiagang , Yao Xinsheng
Published: April 2021

Background

Yiganmingmu oral liquid (YGMM), a well known over-the-counter (OTC) drug in China, is composed of 12 types of valuable herbal medicines and has been widely used in clinical for the treatment of soreness and weakness of waist and knees, dizziness, memory loss, and fatigue. However, the chemical compositions of YGMM and its absorbed compounds in plasma remain unclear.

Methods

Since chemical investigation is the first important step to reveal effects and action mechanisms of traditional Chinese medicine (TCM), in this study, based on the self built components database, systematic characterization of the chemical profile of YGMM in vitro was carried out by using a reliable UPLC-Q-TOF-MS method. Moreover, to obtain better understanding of the absorbed prototypes in plasma, serum pharmacochemistry analysis of YGMM after oral administration was conducted by using cynomolgus monkeys as animal model.

Results

A total of 667 constituents from the 12 single herbal medicines were collected in the self built components database by searching the reported literatures, and 415 of them were initially screened as candidate compounds in YGMM by comparison of their experimental accurate mass measurements with those theoretical values. After that, 117 compounds including 17 phenolic acids, 25 flavonoids, 4 alkaloids, 10 phthalides, 5 monoterpenes, 8 triterpenoid saponins, 9 anthraquinones, and 39 other compounds, were unambiguously identified or tentatively characterized by analysing their MS/MS fragmentation patterns, and also by comparison with reference standards and those data reported in the literatures. 61 prototypes absorbed in plasma of cynomolgus monkey, including 13 phenolic acids, 21 flavonoids, 8 phthalides, 3 monoterpenes, 4 triterpenoid saponins, and 12 other compounds were tentatively assigned by serum pharmacochemistry analysis after oral administration.

Conclusion

It was the first comprehensive analysis of chemical constituents of YGMM and prototypes in plasma, and the data analysis strategy developed in this study showed high efficiency in the structural elucidations. The results might provide scientific evidence for further research on material basis of YGMM.
Optimizing language for effective communication of gene therapy concepts with hemophilia patients: a qualitative study
Authors: Hart Daniel P. , Branchford Brian R. , Hendry Sarah , Ledniczky Robert , Sidonio Robert F. , Négrier Claude , Kim Michelle , Rice Michelle , Minshall Matthew , Arcé Claire , Prince Steve , Kelleher Maria , Lee Sharon
Published: April 2021

Background

For communities of people living with hemophilia and other genetic conditions, gene therapy could represent a paradigm shift in treatment strategies. As investigational therapeutic modalities such as gene therapy become more widely used and discussed, there is a critical need for all stakeholders to communicate using a lexicon that is intelligible, accurate, consistent, and representative of novel treatments. In doing so, expectations can be more carefully managed and potential risks, benefits, and limitations better understood. In recognition of this need, a first-ever study of gene therapy lexicon was conducted using established methods of market research and linguistic analysis.

Methods

Ninety-four participants representing hematologists, nurses, caregivers, and people with hemophilia A, in six countries (US, UK, Spain, Germany, France, Italy) took part in a series of in-depth interviews, face-to-face focus groups, an advisory board meeting, and online group interviews to develop, refine, and test verbal, written, and pictorial language concepts through a three-phase iterative process. Sessions were conducted in local languages using detailed discussion guides. Feedback from participants was captured using real-time instant-response dial testing to measure moment-by-moment emotional responses to language stimuli. Semiquantitative analysis of the responses informed selection of preferred language concepts for final testing, and qualitative discussion explored preference rationale. Participants also completed polling and forced rank and choice written exercises.

Results

Study feedback showed that the hemophilia community has preferences around consistent lexicon to describe hemophilia and its management. Expert linguistic analysis of feedback from the three phases enabled agreement of a consensus lexicon of vocabulary and an optimized summary narrative for talking about gene therapy amongst people affected by hemophilia A. Preferences were largely consistent across audiences and countries, although some country-specific recommendations were made. A representative summary phrase was agreed: “Gene therapy is being studied in clinical trials with the aim to allow the body to produce factor VIII protein on its own”.

Conclusions

The use of preferred language across different stakeholders increases understanding and comfort during discussions of novel and complex therapeutic modalities such as gene therapy. Consistent use of community-informed lexicon minimizes miscommunication and facilitates informed decision-making regarding potential future treatment opportunities.
Neonatal hyperinsulinism in transient and classical forms of tyrosinemia
Authors: Sethuram Swathi , Sperling Mark A. , Gujral Jasmine , Romero Christopher J.
Published: April 2021

Background

The spectrum of disorders associated with hyperinsulinemic hypoglycemia (HHI) has vastly increased over the past 20 years with identification of molecular, metabolic and cellular pathways involved in the regulation of insulin secretion and its actions. Hereditary tyrosinemia (HT1) is a rare metabolic disorder associated with accumulation of toxic metabolites of the tyrosine pathway due to a genetically mediated enzyme defect of fumarylacetoacetate hydrolase. Transient tyrosinemia of the newborn (TTN) is a benign condition with a maturational defect of the enzymes associated with tyrosine metabolism without any genetic abnormalities.

Results

We describe two rare cases of HHI, one in a patient with HT1 and for the first time, in a patient with TTN. Each of our patients presented in the neonatal period with persistent hypoglycemia that on biochemical evaluation was consistent with HHI. Each patient received diazoxide therapy for 3.5 months and 17 months of life, respectively and HHI resolved thereafter.

Conclusion

Despite the fact that HHI has been described in HT1 for several decades, no specific mechanism has been delineated. Although we considered the common embryonal origin of the liver and pancreas with the hepatotoxic effect in HT1 also impacting the latter, this was not a possible explanation for TTN. The commonality between our two patients is the accumulation of certain amino acids which are known to be insulinotropic. We therefore hypothesize that the excess of amino acids such as leucine, lysine, valine and isoleucine in our patients resulted in HHI, which was transient. Both patients responded to diazoxide. This novel presentation in TTN and the reassuring response in both HT1 and TTN to diazoxide will be useful to inform physicians about managing HHI in these patients. Further studies are required to delineate the mechanism of HHI in these infants.
Shifted phase of EEG cross-frequency coupling in individuals with Phelan-McDermid syndrome
Authors:   the Developmental Synaptopathies Consortium, Mariscal Michael. G. , Berry-Kravis Elizabeth , Buxbaum Joseph D. , Ethridge Lauren E. , Filip-Dhima Rajna , Foss-Feig Jennifer H. , Kolevzon Alexander , Modi Meera. E. , Mosconi Matthew W. , Nelson Charles A. , Powell Craig M. , Siper Paige M. , Soorya Latha , Thaliath Andrew , Thurm Audrey , Zhang Bo , Sahin Mustafa , Levin April R.
Published: April 2021

Background

Phelan-McDermid Syndrome (PMS) is a rare condition caused by deletion or mutation of the SHANK3 gene. Individuals with PMS frequently present with intellectual disability, autism spectrum disorder, and other neurodevelopmental challenges. Electroencephalography (EEG) can provide a window into network-level function in PMS.

Methods

Here, we analyze EEG data collected across multiple sites in individuals with PMS (n = 26) and typically developing individuals (n = 15). We quantify oscillatory power, alpha-gamma phase-amplitude coupling strength, and phase bias, a measure of the phase of cross frequency coupling thought to reflect the balance of feedforward (bottom-up) and feedback (top-down) activity.

Results

We find individuals with PMS display increased alpha-gamma phase bias (U = 3.841, p < 0.0005), predominantly over posterior electrodes. Most individuals with PMS demonstrate positive overall phase bias while most typically developing individuals demonstrate negative overall phase bias. Among individuals with PMS, strength of alpha-gamma phase-amplitude coupling was associated with Sameness, Ritualistic, and Compulsive behaviors as measured by the Repetitive Behavior Scales-Revised (Beta = 0.545, p = 0.011).

Conclusions

Increased phase bias suggests potential circuit-level mechanisms underlying phenotype in PMS, offering opportunities for back-translation of findings into animal models and targeting in clinical trials.
Comparison of the CO-RADS and the RSNA chest CT classification system concerning sensitivity and reliability for the diagnosis of COVID-19 pneumonia
Authors: Abdel-Tawab Mohamed , Basha Mohammad Abd Alkhalik , Mohamed Ibrahim A. I. , Ibrahim Hamdy M. , Zaitoun Mohamed M. A. , Elsayed Saeed Bakry , Mahmoud Nader E. M. , El Sammak Ahmed A. , Yousef Hala Y. , Aly Sameh Abdelaziz , Khater Hamada M. , Mosallam Walid , Abo Shanab Waleed S. , Hendi Ali M. , Hassan Sayed
Published: April 2021

Background

The Radiological Society of North America (RSNA) recently published a chest CT classification system and Dutch Association for Radiology has announced Coronavirus disease 2019 (COVID-19) reporting and data system (CO-RADS) to provide guidelines to radiologists who interpret chest CT images of patients with suspected COVID-19 pneumonia. This study aimed to compare CO-RADS and RSNA classification with respect to their sensitivity and reliability for diagnosis of COVID-19 pneumonia.

Results

A retrospective study assessed consecutive CT chest imaging of 359 COVID-19-positive patients. Three experienced radiologists who were aware of the final diagnosis of all patients, independently categorized each patient according to CO-RADS and RSNA classification. RT-PCR test performed within one week of chest CT scan was used as a reference standard for calculating sensitivity of each system. Kappa statistics and intraclass correlation coefficient were used to assess reliability of each system. The study group included 359 patients (180 men, 179 women; mean age, 45 ± 16.9 years). Considering combination of CO-RADS 3, 4 and 5 and combination of typical and indeterminate RSNA categories as positive predictors for COVID-19 diagnosis, the overall sensitivity was the same for both classification systems (72.7%). Applying both systems in moderate and severe/critically ill patients resulted in a significant increase in sensitivity (94.7% and 97.8%, respectively). The overall inter-reviewer agreement was excellent for CO-RADS (κ = 0.801), and good for RSNA classification (κ = 0.781).

Conclusion

CO-RADS and RSNA chest CT classification systems are comparable in diagnosis of COVID-19 pneumonia with similar sensitivity and reliability.
Dual treatment of acromegaly and hormone-receptor-positive breast cancer with tamoxifen: a case report
Authors: Mirfakhraee Sasan , Chan Alberto V. Cabo , Ganji Niloofar , Abramowitz Jessica
Published: April 2021

Background

Adjuvant endocrine therapy is recommended for the treatment of hormone-receptor-positive breast cancer. Aromatase inhibitors are associated with significant musculoskeletal adverse effects, likely through growth hormone/insulin-like growth factor 1 modulation, while tamoxifen reduces insulin-like growth factor 1 production. We describe the case of a patient who was treated successfully with tamoxifen for her hormone-receptor-positive breast cancer and acromegaly.

Case presentation

A 57-year old White female with hormone-receptor-positive breast cancer was diagnosed with acromegaly. She received adjuvant endocrine therapy with anastrozole but could not tolerate this medication because of severe arthralgia, so she was switched to tamoxifen. Shortly after starting tamoxifen, the patient’s musculoskeletal symptoms resolved and her insulin-like growth factor 1 levels normalized. She has remained in remission of her acromegaly and breast cancer since initiating tamoxifen.

Conclusion

This case highlights the dual benefit of tamoxifen therapy in the treatment of hormone-receptor-positive breast cancer and acromegaly. Unlike anastrozole, tamoxifen has the benefit of lowering insulin-like growth factor 1 levels, which underscores its advantage in reducing adverse musculoskeletal symptoms during the treatment of hormone-receptor-positive breast cancer. We offer the first reported use of tamoxifen monotherapy for the successful treatment of acromegaly and hormone-receptor-positive breast cancer. While tamoxifen may offer an additional, oral option for acromegaly patients who do not respond to or tolerate conventional growth-hormone-lowering therapy, additional studies are necessary.
Traffic analysis for 5G network slice based on machine learning
Authors: Xie Feng , Wei Dongxue , Wang Zhencheng
Published: April 2021

With the rise of 5G and Internet of things, especially the key technology of 5G, network slice cuts a physical network into multiple virtual end-to-end networks, each of them can obtain logically independent network resources to support richer services. 5G mobile data and sensor data converge to form a growing network traffic. Traffic explosion evolved into a mixed network type, and network viruses, worms, network theft and malicious attacks are also involved. How to distinguish traffic types, block malicious traffic and make effective use of sensor data under the background of 5G network slice, and also the significance of this study.
Matrix iteration algorithms for solving the generalized Lyapunov matrix equation
Authors: Zhang Juan , Kang Huihui , Li Shifeng
Published: April 2021

In this paper, we first recall some well-known results on the solvability of the generalized Lyapunov equation and rewrite this equation into the generalized Stein equation by using Cayley transformation. Then we introduce the matrix versions of biconjugate residual (BICR), biconjugate gradients stabilized (Bi-CGSTAB), and conjugate residual squared (CRS) algorithms. This study’s primary motivation is to avoid the increase of computational complexity by using the Kronecker product and vectorization operation. Finally, we offer several numerical examples to show the effectiveness of the derived algorithms.
The validity and reliability of a digital Ruff Figural Fluency Test (RFFT)
Authors: Vrijsen J. , van Erpecum C. L. , de Rooij S. E. , Niebuur J. , Smidt N.
Published: April 2021

Background

The Ruff Figural Fluency Test (RFFT) is a valid but time-consuming and labour-intensive cognitive paper-and-pencil test. A digital RFFT was developed that can be conducted independently using an iPad and Apple Pencil and RFFT scores are computed automatically. We investigated the validity and reliability of this digital RFFT.

Methods

We randomly allocated participants to the digital or paper-and-pencil RFFT. After the first test, the other test was performed immediately (cross-over). Participants were invited for a second digital RFFT 1 week later. For the digital RFFT, an (automatic) algorithm and two independent raters (criterion standard) assessed the number of unique designs (UD) and perseverative errors (PE). These raters also assessed the paper-and-pencil RFFT. We used Intraclass correlation coefficients (ICC), sensitivity, specificity, %-agreement, Kappa, and Bland–Altman plots.

Results

We included 94 participants (mean (SD) age 39.9 (14.8), 73.4% follow-up). Mean (SD) UD and median (IQR) PE of the digital RFFT were 84.2 (26.0) and 4 (2–7.3), respectively. Agreement between manual and automatic scoring of the digital RFFT was high for UD (ICC = 0.99, 95% CI 0.98, 0.99, sensitivity = 0.98; specificity = 0.96) and PE (ICC = 0.99, 95% CI 0.98, 0.99; sensitivity = 0.90, specificity = 1.00), indicating excellent criterion validity. Small but significant differences in UD were found between the automatic and manual scoring (mean difference: − 1.12, 95% CI − 1.92, − 0.33). Digital and paper-and-pencil RFFT had moderate agreement for UD (ICC = 0.73, 95% CI 0.34, 0.87) and poor agreement for PE (ICC = 0.47, 95% CI 0.30, 0.62). Participants had fewer UD on the digital than paper-and-pencil RFFT (mean difference: − 7.09, 95% CI − 11.80, − 2.38). The number of UD on the digital RFFT was associated with higher education (Spearman’s r = 0.43, p < 0.001), and younger age (Pearson’s r = − 0.36, p < 0.001), showing its ability to discriminate between different age categories and levels of education. Test–retest reliability was moderate (ICC = 0.74, 95% CI 0.61, 0.83).

Conclusions

The automatic scoring of the digital RFFT has good criterion and convergent validity. There was low agreement between the digital RFFT and paper-and-pencil RFFT and moderate test–retest reliability, which can be explained by learning effects. The digital RFFT is a valid and reliable instrument to measure executive cognitive function among the general population and is a feasible alternative to the paper-and-pencil RFFT in large-scale studies. However, its scores cannot be used interchangeably with the paper-and-pencil RFFT scores.
Impact of structured physical therapy intervention on functional recovery in a patient with CAPOS syndrome: a case report
Authors: Gardas Shailesh , Mahajan Aishwarya
Published: April 2021

Background

CAPOS syndrome (cerebellar ataxia, areflexia, pescavus, optic atrophy, and sensorineural hearing loss) is a rare congenital autosomal dominant disorder. The resulting neurological sequelae of impairments are progressive in nature and may interfere with functional independence, performing activities of daily living (ADL’s), and subsequently, affecting the quality of life (QOL). Since it is an extremely rare disorder, there is a severe dearth in the literature about how specific physiotherapy interventions may affect their functional status. Therefore, our objective was to investigate the effects of proprioceptive neuromuscular facilitation (PNF) and Frenkel’s coordination exercises on functional recovery in a patient with CAPOS syndrome.

Case presentation

We herein present a case of a 25-year-old Indian male with complaints of generalized body weakness, difficulty visualizing distant objects, nystagmus, progressive sensorineural deafness, and ataxia. He was rehabilitated with a structured/customized physiotherapy protocol consisting of PNF approach and coordination exercises for 4 weeks, 6 days/week, 60 min daily. An improvement in overall functional performance of patient as per post-intervention scores of manual muscle testing, trunk control measurement scale, functional independence measure (components of self-care, transfers, and locomotion), and decline in severity of ataxia on scale for assessment and rating of ataxia scale was observed.

Conclusion

PNF and Frenkel’s exercises resulted in an improvement in overall functional performance of the patient. Improvement was observed in post-test scores of Manual Muscle Testing (MMT), Trunk Control Measurement Scale (TCMS), and Functional Independence Measure (FIM) for the components of self-care, transfers, and locomotion. Additionally, results also showed a decline in severity of ataxia on post-test scores of scale for the assessment and rating of ataxia (SARA) scale (i.e., from severe to moderate).
Contributions to the American Society of Hematology Meeting From Low- and Middle-Income Countries: An In-Depth Analysis and Call to Action
Authors: Gómez-De León Andrés , Colunga-Pedraza Perla R. , Tarín-Arzaga Luz , Bugarín-Estrada Emmanuel , Sung Lilian , Cantú-Martínez Omar , Jaime-Pérez José C. , Gómez-Almaguer David
Published: April 2021

PURPOSE:

Establishing research capacity in low- and middle-income countries (LMICs) is key for improving the outcomes of patients with hematologic diseases globally. Few studies have analyzed the contributions of LMICs to global hematology. The American Society of Hematology Meeting (ASH) is the largest international academic event where peer-reviewed contributions in our field are presented.

METHODS:

In this cross-sectional analysis, all abstracts accepted to ASH 2018 selected for a poster or oral presentation were reviewed. Those that had a contributing author from an LMIC were identified. The proportion of LMIC abstracts across categories was analyzed. Country of origin, high-income country participation, the presence of a conflict of interest (COI), and sponsorship were determined.

RESULTS:

From 4,871 abstracts reviewed, 506 had a contributing author from an LMIC (10.4%), with 277 (54.7%) contributions in partnership with a high-income country. LMIC-independent contributions corresponded to 19 of 1,026 oral abstracts (1.9%) and 209 of 3,845 posters (5.4%). Most abstracts from LMICs were clinical (n = 311; 61.5%) and multicentric in nature (n = 353; 69.8%). COI statements with the pharmaceutical industry were common (n = 214; 42.3%). Collaboration between LMICs was infrequent (n = 33; 6.5%). Upper-middle–income countries had 466 participations (81.5%), in comparison with 96 (16.8%) in low-middle–income and 10 (1.7%) in low-income countries.

CONCLUSION:

LMICs were responsible for a small fraction of abstracts at ASH18; low-income countries were practically absent. Almost half of accepted works represented a form of international collaboration, with clinical, multicenter studies predominating and COI disclosures a frequent and unexpected feature, reflecting the instrumental nature of LMIC participation and a lack of independent, robust, locally developed hematology research.
Testicular germ cell tumors arise in the absence of sex-specific differentiation
Authors: Webster Nicholas J. , Maywald Rebecca L. , Benton Susan M. , Dawson Emily P. , Murillo Oscar D. , LaPlante Emily L. , Milosavljevic Aleksandar , Lanza Denise G. , Heaney Jason D.
Published: April 2021

In response to signals from the embryonic testis, the germ cell intrinsic factor NANOS2 coordinates a transcriptional program necessary for the differentiation of pluripotent-like primordial germ cells toward a unipotent spermatogonial stem cell fate. Emerging evidence indicates that genetic risk factors contribute to testicular germ cell tumor initiation by disrupting sex-specific differentiation. Here, using the 129.MOLF-Chr19 mouse model of testicular teratomas and a NANOS2 reporter allele, we report that the developmental phenotypes required for tumorigenesis, including failure to enter mitotic arrest, retention of pluripotency and delayed sex-specific differentiation, were exclusive to a subpopulation of germ cells failing to express NANOS2. Single-cell RNA sequencing revealed that embryonic day 15.5 NANOS2-deficient germ cells and embryonal carcinoma cells developed a transcriptional profile enriched for MYC signaling, NODAL signaling and primed pluripotency. Moreover, lineage-tracing experiments demonstrated that embryonal carcinoma cells arose exclusively from germ cells failing to express NANOS2. Our results indicate that NANOS2 is the nexus through which several genetic risk factors influence tumor susceptibility. We propose that, in the absence of sex specification, signals native to the developing testis drive germ cell transformation.
An Update on Simple Elbow Dislocations: A Protocol for Early Return to Sport in High School Wrestlers
Authors: Barton Dane , DeSilva Gregory
Published: April 2021

The principles and management of simple elbow dislocations have evolved over time. In the past, a conservative approach of immobilization and slow rehabilitation were used. More modern treatments emphasize an understanding of the soft tissues about the elbow joint and prescribe an aggressive approach to regaining motion. Elbow stiffness is a common effect of the injury. We outline our treatment principles in a series of high school wrestlers with simple elbow dislocation. The ultimate goal is to return to sport in a safe but early timeframe. We recommend a brief period of immobilization with close follow-up and no motion restrictions after immobilization is removed. This review and case series emphasize the importance of aggressive but safe return to sport in high school wrestlers with an elbow dislocation.
Measuring the Feasibility and Effectiveness of an Individualized Exercise Program Delivered Virtually to Cancer Survivors
Authors: Wonders Karen Y. , Gnau Kara , Schmitz Kathryn H.
Published: April 2021

In the spring of 2020, we faced a global pandemic that resulted in social distancing limitations not previously experienced, forcing practitioners to adapt exercise programming to a virtual model. The purpose of this investigation was to measure the effectiveness of a virtual exercise oncology program in 491 participants undergoing antineoplastic therapy between March and June 2020. Each session was completed virtually with a certified exercise oncology trainer. Fitness and psychological parameters were measured preexercise and postexercise intervention. Overall, participants completed 4949 of 5892 prescribed exercise sessions. Patients saw increases in cardiovascular endurance (15.2%, P < 0.05), muscular endurance (18.2%, P < 0.05), flexibility (31.9%, P < 0.05), feelings of support (58.7%, P < 0.05), and quality of life (32.2%, P < 0.05), as well as decreases in loneliness (54%, P < 0.05) and fatigue (48.7%, P < 0.05). In light of our findings, we assert that virtual exercise training is a viable option in circumstances where in-person, individualized exercise training is not possible.
Efficiency and Equity Impacts of Energy Subsidies
Authors: Hahn Robert W. , Metcalfe Robert D.
Published: April 2021

Economic theory suggests that energy subsidies can lead to excessive consumption and environmental degradation. However, the precise impact of energy subsidies is not well understood. We analyze a large energy subsidy: the California Alternate Rates for Energy (CARE). CARE provides a price reduction for low-income consumers of natural gas and electricity. Using a natural field experiment, we estimate the price elasticity of demand for natural gas to be about −0.35 for CARE customers. An economic model of this subsidy yields three results. First, the natural gas subsidy appears to reduce welfare. Second, the economic impact of various policies, such as cap-and-trade, depends on whether prices for various customers move closer to the marginal social cost. Third, benefits to CARE customers need to increase by 6 percent to offset the costs of the program. (JEL C93, D61, H24, L94, L95, L98, Q48)