bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient-derived organoids and high grade serous ovarian cancer: from disease modeling to personalized medicine
Authors: Nero Camilla , Vizzielli Giuseppe , Lorusso Domenica , Cesari Eleonora , Daniele Gennaro , Loverro Matteo , Scambia Giovanni , Sette Claudio
Published: March 2021

Background

High grade serous ovarian cancer (HGSOC) is among the deadliest human cancers and its prognosis remains extremely poor. Tumor heterogeneity and rapid acquisition of resistance to conventional chemotherapeutic approaches strongly contribute to poor outcome of patients. The clinical landscape of HGSOC has been radically transformed since the advent of targeted therapies in the last decade. Nevertheless, the lack of predictive biomarkers informing on the differential clinical benefit in select subgroups, and allowing patient-centric approaches, currently limits the efficacy of these novel therapies. Thus, rational selection of the best possible treatment for each patient represents a clinical priority in order to improve outcome, while limiting undesirable effects.

Main body

In this review, we describe the state of the art and the unmet needs in HGSOC management, illustrate the treatment options that are available and the biomarkers that are currently employed to orient clinical decisions. We also describe the ongoing clinical trials that are testing new therapeutic approaches for HGSOC. Next, we introduce the organoid technology as a promising, expanding strategy to study cancer and to develop personalized therapeutic approaches. In particular, we discuss recent studies that have characterized the translational potential of Patient’s Derived Organoids (PDOs) to inform on drug sensitivity of HGSOC patients.

Conclusions

PDOs can predict the response of patients to treatments and may therefore guide therapeutic decisions. Although preliminary results appear encouraging, organoids still need to be generated and expanded efficiently to enable drug screening in a clinically meaningful time window. A new generation of clinical trials based on the organoid technology should guarantee tailored approaches to ovarian cancer management, as it is now clear that the one-size-fits-all approach cannot lead to efficient and meaningful therapeutic advancements.
The biopsychosocial‐digital continuum of foot orthosis practice and research: the VALUATOR model
Authors: Deschamps Kevin , Nester Chris , Newton Veronica , Gijon‐Nogueron Gabriel , Simsek Engin , Brabants Antoine
Published: March 2021

Foot orthoses have been used for decades despite uncertainty surrunding their therapeutic efficacy. Orthoses have been used exclusively to affect neuro‐biomechanical input and outcome variables, however, there is emerging evidence that therapeutic efficacy may be affected by a psychological stimulus. Critical appraisal of the literature highlights that there is no holistic model upon which foot orthosis practice is taught, practised nor investigated. This paper introduces a conceptual model of foot orthosis practice (Value Based Foot Orthosis Practice (VALUATOR) model) that embraces a broader range of factors that are pertinent to orthosis practice, incorporating contemporary health service behaviours and values into orthosis practice for the first time.

Within the VALUATOR model, foot orthosis design and clinical value is considered along a bio‐psycho‐social‐digital continuum that reflects the reality of foot orthosis practice. The model contextualises the variable outcomes that are observed in research and practice within 6 key areas: 1) value, 2) person‐centered approach, 3) zone of optimal bio‐psycho‐social stress, 4) bio‐psycho‐social assessment, 5) monitoring, 6) primary and secondary clinical strategies.

The VALUATOR model is targeted at students, lecturers, scientists and practitioners and includes carefully chosen terminology to support a robust basis for educational and scientific discussion. It is believed that it provides a contemporary viewpoint and a structured conceptual metaphor that builds on existing evidence from a wide range of sources, invites constructive intellectual debate, and is anchored in the experiences of practitioners too. Stress testing the VALUATOR model will help determine its model and support further developments and evolution of orthotic practice in a evidence based way.
Effect of blastocyst morphology and developmental speed on transfer strategy for grade “C” blastocyst in vitrified‐warmed cycles
Authors: He Yuxia , Chen Shiping , Liu Jianqiao , Kang Xiangjin , Liu Haiying
Published: March 2021

Background

High-quality single blastocyst transfer (SBT) is increasingly recommended to patients because of its acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared to double blastocyst transfer (DBT). However, there is no consensus on whether this transfer strategy is also suitable for poor-quality blastocysts. Moreover, the effect of the development speed of poor-quality blastocysts on pregnancy outcomes has been controversial. Therefore, this study aimed to explore the effects of blastocyst development speed and morphology on pregnancy and neonatal outcomes during the frozen embryo transfer (FET) cycle of poor-quality blastocysts and to ultimately provide references for clinical transfer strategies.

Methods

A total of 2,038 FET cycles of poor-quality blastocysts from patients 40 years old or less were included from January 2014 to December 2019 and divided based on the blastocyst development speed and number of embryos transferred: the D5-SBT (n = 476), D5-DBT (n = 365), D6-SBT (n = 730), and D6-DBT (n = 467) groups. The SBT group was further divided based on embryo morphology: D5-AC/BC (n = 407), D5-CA/CB (n = 69), D6-AC/BC (n = 580), and D6-CA /CB (n = 150).

Results

When blastocysts reach the same development speed, the live birth and multiple pregnancy rates of DBT were significantly higher than those of SBT. Moreover, there was no statistical difference in the rates of early miscarriage and live birth between the AC/BC and CA/CB groups. When patients in the SBT group were stratified by blastocyst development speed, the rates of clinical pregnancy (42.44 % vs. 20.82 %) and live birth (32.35 % vs. 14.25 %) of D5-SBT group were significantly higher than those of D6-SBT group. Furthermore, for blastocysts in the same morphology group (AC/BC or CA/CA group), the rates of clinical pregnancy and live birth in the D5 group were also significantly higher than those of D6 group.

Conclusions

For poor-quality D5 blastocysts, SBT can be recommended to patients because of acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared with DBT. For poor-quality D6, the DBT strategy is recommended to patients to improve pregnancy outcomes. When blastocysts reach the same development speed, the transfer strategy of selecting blastocyst with inner cell mass “C” or blastocyst with trophectoderm “C” does not affect the pregnancy and neonatal outcomes.
Two solutions to Kirchhoff-type fourth-order implusive elastic beam equations
Authors: Liu Jian , Yu Wenguang
Published: March 2021

In this paper, the existence of two solutions for superlinear fourth-order impulsive elastic beam equations is obtained. We get two theorems via variational methods and corresponding two-critical-point theorems. Combining with the Newton-iterative method, an example is presented to illustrate the value of the obtained theorems.
The role of prophylactic antibiotics in hepatitis B virus-related acute-on-chronic liver failure patients at risk of bacterial infection: a retrospective study
Authors: Liu Xiao-Qin , Zhang Xue-Yun , Ying Yue , Zheng Jian-Ming , Sun Jian , Zhang Wen-Hong , Zhang Ji-Ming , Huang Yu-Xian
Published: March 2021

Background

Acute-on-chronic liver failure (ACLF) is characterized by an excessive systemic inflammatory response and organ failure and has high mortality. Bacterial infections (BIs) worsen the clinical course of ACLF and carry a poor prognosis in ACLF patients. The efficacy of third-generation cephalosporins has been challenged in recent years. The aim of this study was to characterize the difference between ACLF patients with and without BIs and to provide a reference for medical intervention.

Methods

A total of 140 patients with hepatitis B virus-related ACLF (HBV-ACLF) hospitalized at the Department of Infectious Diseases, Huashan Hospital, Fudan University (Shanghai, China) between May 2013 and January 2020 were enrolled. Mann-Whitney U test was used to compare the baseline characteristics of HBV-ACLF patients with and without BIs. Univariate and multivariate analyses were performed to find predictors of BIs. The characteristics of BIs and the role of prophylactic antibiotics were profiled.

Results

A total of 97 episodes of BIs occurred in patients during the course of HBV-ACLF. Patients with and without BIs differed in clinical characteristics. The incidence of BIs showed a positive correlation with the ACLF grade (P = 0.003) and the clinical course (P = 0.003). The 90-day transplant-free survival of patients with BIs was lower than those without BIs (P < 0.0001). Patients administered prophylactic antibiotics showed a lower incidence of BIs and had a higher transplant-free survival probability than those who did not (P = 0.046). No statistical differences in antibiotic efficacy between third-generation and other antibiotics were observed (P = 0.108).

Conclusions

BIs affected the clinical course and prognosis of patients with HBV-ACLF. Prophylactic antibiotics were of potential clinical importance in the prevention of BIs and improving the clinical course and prognosis in HBV-ACLF patients. Third-generation cephalosporins were qualified for use in antibiotic prophylaxis.
The role of exosomes in tumour immunity under radiotherapy: eliciting abscopal effects?
Authors: Yin Tianwen , Xin Huixian , Yu Jinming , Teng Feifei
Published: March 2021

As a curative treatment of localized tumours or as palliative control, radiotherapy (RT) has long been known to kill tumour cells and trigger the release of proinflammatory factors and immune cells to elicit an immunological response to cancer. As a crucial part of the tumour microenvironment (TME), exosomes, which are double-layered nanometre-sized vesicles, can convey molecules, present antigens, and mediate cell signalling to regulate tumour immunity via their contents. Different contents result in different effects of exosomes. The abscopal effect is a systemic antitumour effect that occurs outside of the irradiated field and is associated with tumour regression. This effect is mediated through the immune system, mainly via cell-mediated immunity, and results from a combination of inflammatory cytokine cascades and immune effector cell activation. Although the abscopal effect has been observed in various malignancies for many years, it is still a rarely identified clinical event. Researchers have indicated that exosomes can potentiate abscopal effects to enhance the effects of radiation, but the specific mechanisms are still unclear. In addition, radiation can affect exosome release and composition, and irradiated cells release exosomes with specific contents that change the cellular immune status. Hence, fully understanding how radiation affects tumour immunity and the interaction between specific exosomal contents and radiation may be a potential strategy to maximize the efficacy of cancer therapy. The optimal application of exosomes as novel immune stimulators is under active investigation and is described in this review.
Linking experiences of child sexual abuse to adult sexual intimate partner violence: the role of borderline personality features, maladaptive cognitive emotion regulation, and dissociation
Authors: Krause-Utz Annegret , Dierick Tara , Josef Tobias , Chatzaki Elianne , Willem Andries , Hoogenboom Jan , Elzinga Bernet
Published: March 2021

Background

Child sexual abuse (CSA) has been linked to a higher risk of sexual re-victimization, including sexual intimate partner violence (IPV). The aim of this study was to investigate whether borderline personality disorder (BPD) features, dissociation, and maladaptive cognitive emotion regulation mediate the link between self-reported CSA severity and sexual IPV. Specifically, we were interested in the unique effect of each mediator variable, when accounting for the effect of the other variables.

Methods

Data was assessed in a cross-sectional anonymous online survey, posted on platforms for people affected by domestic violence, and research platforms of Leiden University. Overall,n = 633 participants completed the survey (includingn = 100 participants with CSA andn = 345 reporting at least one incidence of sexual IPV). Multivariate regression analyses and path-analytical modelling were performed for hypothesis testing.

Results

Adult sexual IPV was predicted by more severe CSA, more severe BPD features, higher dissociation, and more maladaptive emotion regulation. Each mediator variable showed a significant effect in the separate mediation models. In the overall model, only dissociation and maladaptive emotion regulation, but not BPD features, mediated the association between CSA and sexual IPV.

Conclusions

Findings add to the existing literature, suggesting that CSA severity, BPD features, dissociation, and maladaptive emotion regulation are important risk factors for sexual IPV. Given the cross-sectional correlational design of our study, prospective studies are needed to corroborate our findings regarding potential psychological mechanisms underlying sexual re-victimization. Ultimately, this can help developing interventions aimed at breaking the cycle of abuse.
Review of deep learning: concepts, CNN architectures, challenges, applications, future directions
Authors: Alzubaidi Laith , Zhang Jinglan , Humaidi Amjad J. , Al-Dujaili Ayad , Duan Ye , Al-Shamma Omran , Santamaría J. , Fadhel Mohammed A. , Al-Amidie Muthana , Farhan Laith
Published: March 2021

In the last few years, the deep learning (DL) computing paradigm has been deemed the Gold Standard in the machine learning (ML) community. Moreover, it has gradually become the most widely used computational approach in the field of ML, thus achieving outstanding results on several complex cognitive tasks, matching or even beating those provided by human performance. One of the benefits of DL is the ability to learn massive amounts of data. The DL field has grown fast in the last few years and it has been extensively used to successfully address a wide range of traditional applications. More importantly, DL has outperformed well-known ML techniques in many domains, e.g., cybersecurity, natural language processing, bioinformatics, robotics and control, and medical information processing, among many others. Despite it has been contributed several works reviewing the State-of-the-Art on DL, all of them only tackled one aspect of the DL, which leads to an overall lack of knowledge about it. Therefore, in this contribution, we propose using a more holistic approach in order to provide a more suitable starting point from which to develop a full understanding of DL. Specifically, this review attempts to provide a more comprehensive survey of the most important aspects of DL and including those enhancements recently added to the field. In particular, this paper outlines the importance of DL, presents the types of DL techniques and networks. It then presents convolutional neural networks (CNNs) which the most utilized DL network type and describes the development of CNNs architectures together with their main features, e.g., starting with the AlexNet network and closing with the High-Resolution network (HR.Net). Finally, we further present the challenges and suggested solutions to help researchers understand the existing research gaps. It is followed by a list of the major DL applications. Computational tools including FPGA, GPU, and CPU are summarized along with a description of their influence on DL. The paper ends with the evolution matrix, benchmark datasets, and summary and conclusion.
Designing and implementing a STEM career maturity program for prospective counselors
Authors: Karahan Engin , Kara Ahmet , Akçay Ahmet Oğuz
Published: March 2021

Background

Although the importance of directing students to career options in Science, Technology, Engineering, and Mathematics (STEM) fields at early ages has been emphasized in the literature, it has not been clearly stated just who will play a role in this process and what kind of consultancy process will be followed. It is of great importance for prospective counselors, who are studying in the field of counseling, to master the career selection process, specifically for STEM, towards achieving the national goals. Therefore, the purpose of this study was to investigate the career counseling competencies of prospective counselors who were participating in a STEM career maturity program.

Findings

The current study employed the mixed-methods sequential explanatory design. In this design, after collecting and analyzing the quantitative and qualitative data, both datasets were then interpreted together. The quantitative data analysis revealed a significant difference between the post-test mean career counseling and performance indicator scores of the experimental and the control groups (u = 49.00; P < 0.05). The career counseling and performance indicator mean rank and sum of mean scores of the students in the experimental group were higher than those of the students in the control group. The mean career counseling and performance indicator scores of the students in the experimental group increased after the experimental application (Z = – 3.07; P < 0.01). Moreover, the effect size was also calculated and determined to be 0.58. As a result of the analysis of qualitative data, 4 themes were established, comprising (1) personal and professional development, (2) awareness of the STEM majors and careers, (3) STEM-focused career counseling, and (4) feedback about the program.

Conclusions

This study found that the STEM career maturity program that was designed and implemented herein resulted in positive impacts on the career counseling competencies and performance indicators of the participants, as well as their knowledge and awareness of professional STEM areas. Considering the role of school counselors in supporting students in choosing STEM careers, this newly proposed STEM career maturity program will provide a strong model for supporting pre-service and in-service school counselors in directing students towards STEM fields, so as to develop a qualified workforce in STEM fields, which is one of the main objectives of the STEM education reform.
Voluntary tax compliance behavior of individual taxpayers in Pakistan
Authors: e Hassan Ibn , Naeem Ahmed , Gulzar Sidra
Published: March 2021

Governments settle their financial obligations and pay for the public expenditures largely through finances generated from taxes. For many developing countries like Pakistan, the state authorities are still having difficulty to achieve tax compliance. Existing literature has yet to traverse individual's tax compliance behavior on developing countries. The current study, however, explores the relationships among voluntary tax compliance behavior of individual taxpayers with selected economic, social, behavioral and institutional factors. This individual tax compliance behavior is studied through the multi-perspective lenses of the theory of attribution, equity theory, expected utility theory, and social exchange theory. Quantitative design using the survey method was employed to collect data from 435 individual taxpayers through questionnaire. For testing linkage between constructs, through mediation and moderation tests, structural equation modeling technique was used. The results suggest that tax compliance simplicity has a larger impact on tax filing than perception about Government Spending and tax morale. Furthermore, perception of fairness significantly mediates the strengths between morale, simplicity, government spending and compliance behavior.
Depression facilitators from the perspective of Iranian patients with major depressive disorder: a qualitative research
Authors: Rezaiye Milad , Radfar Moloud , Hemmati MaslakPak Masumeh
Published: March 2021

Background

Major depressive disorder is the most common psychological disorder and affects many people worldwide. Therefore, it is important to identify the factors that cause or facilitate this disorder.

Objectives

The aim of this qualitative study was to identify the facilitating factors of depression from the perspective of Iranian patients with major depressive disorder.

Methods

This qualitative study was conducted by content analysis method. Data were collected via purposeful sampling (maximum variation sampling) by conducting semi-structured interviews until reaching data saturation. In-depth interviews were conducted with 12 participants, including patients with major depressive disorder and their families in Razi Psychiatric Training and Treatment Center in Urmia (RPsTT) from November 2018 to February 2020. The process of data analysis was based on the Landman and Grenheim method. The accuracy and trustworthiness of the data were obtained through the Lincoln and Guba criteria.

Results

The analysis of interviews with the participants indicated four major categories: a. Environmental factors (approved by 8 participants), b. Attitudinal factors (approved by 12 participants), c. Economic factors (approved by 9 participants) and d. Situational factors (approved by 10 participants).

Conclusion

In order to prevent major depressive disorder or to reduce the signs of this disorder and improve these patients quality of life, paying attention to the facilitating factors from patient’s perspective based on their community culture can be effective. Among facilitating factors, attitudinal factors have the most impact on the incidence and exacerbation of this disorder from the perspective of patients.
Impact of gender, depression severity and type of depressive episode on efficacy and safety of escitalopram: an observational study on major depressive disorder patients in southern India
Authors: Mandal Tatiyana , Bairy Laxminarayana Kurady , Sharma Podila Satya Venkata Narasimha , Valaparla Vijaya Lakshmi
Published: March 2021

Background

Antidepressant response is a complex trait influenced by clinical, demographic and genetic factors.

Objectives

To explore the influences of baseline depression severity, gender and type of depressive episode on efficacy and safety of escitalopram (10–20 mg/day) in South Indian patients with major depressive disorder (MDD).

Methods

The study was conducted on 18–65-year-old patients (n = 151) suffering from a first or recurrent episode of MDD with a 17-item Hamilton Depression Rating Scale (HDRS-17) score of ≥ 18 at baseline. Efficacy assessments were done using HDRS-17, Montgomery-Asberg Depression Rating Scale (MADRS), and Clinical Global Impression (CGI) at baseline and weeks 4, 8 and 12. Patients were monitored for adverse drug reactions (ADRs). Clinical outcomes were compared among various groups based on gender, type of depressive episode (first or recurrent episode) and baseline HDRS-17 scores (moderate depression—score between 17 and 23; severe depression—score ≥ 24).

Results

Among the 148 subjects who completed the 12-week study, 43.9% and 42.6% achieved response and remission, respectively. The decline in HDRS-17 and MADRS scores from baseline was significant (p value < 0.05) at all follow-up visits and a similar pattern was seen with CGI. Efficacy outcomes were better in the moderate baseline depression group compared with severe depression. There were no associations of efficacy with gender and type of depressive episode. A total of 247 adverse drug reactions (ADR) were reported and 119 (80.41%) subjects experienced at least one ADR during the study period. No serious ADR was reported. Male patients experienced more ADRs compared with females. The safety profile of escitalopram was similar across various groups based on baseline depression severity and type of depressive episode.

Conclusion

The study revealed that escitalopram is efficacious in south Indian MDD patients with a favourable safety profile. The efficacy was influenced by baseline depression severity whereas more ADRs were reported by male patients.
The impact of molded pulp product process on the mechanical properties of molded Bleached Chemi-Thermo-Mechanical Pulp
Authors: Dislaire Claire , Grohens Yves , Seantier Bastien , Muzy Marion
Published: March 2021

This study was carried out using bleached softwood Chemi-Thermo-Mechanical Pulp to evaluate the influence of Molded Pulp Products’ manufacturing process parameters on the finished products’ mechanical and hygroscopic properties. A Taguchi table was done to make 8 tests with specific process parameters such as moulds temperature, pulping time, drying time, and pressing time. The results of these tests were used to obtain an optimized manufacturing process with improved mechanical properties and a lower water uptake after sorption analysis and water immersion. The optimized process parameters allowed us to improve the Young’ Modulus after 30h immersion of 58% and a water uptake reduction of 78% with the first 8 tests done.
Acute ischemic stroke care in Germany – further progress from 2016 to 2019
Authors: Richter Daniel , Weber Ralph , Eyding Jens , Bartig Dirk , Misselwitz Björn , Grau Armin , Hacke Werner , Krogias Christos
Published: March 2021

Background

Stroke Unit Care (SUC), intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are evidence-based treatment options for acute ischemic stroke (AIS). Using nationwide comprehensive administrative data from Germany, we recently reported nationwide development of AIS admissions, SUC rates, IVT rates and MT rates in Germany between 2010 and 2016. In this update paper, we analyze data on the further development of these data to 2019 after publication of time window extensions for recanalization therapies.

Methods

We considered all hospitalized cases with the main diagnosis of the ICD-10-GM code I63 (AIS) for the year 2019. We identified stroke therapies by using the corresponding Operating and Procedure Keys for IVT, MT and SUC out of the DRG statistics. Regional analyses are based on data from the 412 German administrative districts and cities. We compared the results with those from 2016.

Results

Number of hospitalized AIS patients showed a mild decrease in 2019 (n = 225,531) compared with 2016 (n = 227,687), with significant more AIS patients treated on a stroke unit in 2019 (n = 167,799; 74.4% vs. n = 164,270; 72.1%, p < 0.001). The rate of IVT further increased from 14.9% (n = 33,916) in 2016 to 16.3% (n = 36,745) in 2019 (p < 0.001). Similarly, the MT rate increased from 4.3% (n = 9795) in 2016 to 7.2% (n = 16,135) in 2019 (p < 0.001). There was still a high regional variability for MT (1.4 to 15.2%) according to the place of residence of the AIS patients.

Conclusions

In Germany, the rates of recanalization therapies in patients with AIS continued to increase from 2016 to 2019. Compared to IVT-rates and numbers, the respective data for MT procedures showed an even more pronounced increase.
Epidemiologic Pattern of Cancer in Kathmandu Valley, Nepal: Findings of Population-Based Cancer Registry, 2018
Authors: Subedi Ranjeeta , Dhimal Meghnath , Budukh Atul , Chapagain Sandhya , Gyanwali Pradip , Gyawali Bishal , Dahal Uma , Dikshit Rajesh , Jha Anjani Kumar
Published: March 2021

PURPOSE

Although cancer is an important and growing public health issue in Nepal, the country lacked any population-based cancer registry (PBCR) until 2018. In this study, we describe the establishment of the PBCR for the first time in Nepal and use the registry data to understand incidence, mortality, and patterns of cancer in the Kathmandu Valley (consisting of Kathmandu, Lalitpur, and Bhaktapur districts), which comprises 10.5% of the estimated 29 million population of Nepal in 2018.

MATERIALS AND METHODS

The PBCR collects information from facilities and communities through the active process. The facilities include cancer or general hospitals, pathology laboratories, hospice, and Ayurvedic centers. In the communities, the field enumerators or female community health volunteers collected the data from the households. In addition, the Social Security and Nursing Division under the Department of Health Services, which provides subsidy for cancer treatment of underprivileged patients, was another major source of data. The collected data were verified for residence, accuracy, and completeness and then entered and analyzed using CanReg5 software.

RESULTS

In the Kathmandu Valley, the PBCR registered 2,156 new cancer cases with overall age-adjusted incidence rate for all cancers of 95.7 per 100,000 population (95.3 for males and 98.1 for females). The age-adjusted mortality rate for males was 36.3 (n = 365) and for females 27.0 (n = 305) per 100,000 population. We found that the commonest cancers in males were lung and stomach, whereas in females, they were breast and lung cancer. Gallbladder cancer was among the top five common cancers in both sex.

CONCLUSION

These findings provide a milestone to understand the cancer burden in the country for the first time using the PBCR and will be helpful to develop and prioritize cancer control strategies.
Exceptionality of Distant Metastasis in Node-Negative Hereditary and Sporadic Medullary Thyroid Cancer: Lessons Learned
Authors: Machens Andreas , Lorenz Kerstin , Weber Frank , Dralle Henning
Published: March 2021

Context

Risk factors of lymph node and distant metastases have rarely been analyzed in hereditary and sporadic medullary thyroid cancer (MTC) using large genetic-clinical data sets.

Objective

This comprehensive investigation aimed to explore risk factors of lymph node and distant metastases and interdependencies between age at thyroidectomy, primary tumor size, lymph node metastasis, and distant metastasis in patients with hereditary and sporadic MTC.

Methods

We performed comparative analyses of risk factors of metastasis, stratified by hereditary MTC (4 mutational risk categories) and sporadic MTC.

Results

There were 1115 patients with hereditary MTC (307 patients) or sporadic MTC (808 patients). Age at thyroidectomy increased proportionately from 12.2, 22.7, 34.3, and 49.8 years for patients with decreasing mutational risk, compared with 52.1 years for patients with sporadic MTC. Metastatic primary tumors overall were 10.7 to 19.4 mm larger in node-positive patients and 15.9 to 19.3 mm larger in distant metastatic patients at thyroidectomy than nonmetastatic tumors. Distant metastases were noted in 13% to 50% of node-positive vs 0% of node-negative hereditary MTC, and in 23.5% of node-positive vs 1.7% of node-negative sporadic MTC. In multivariable logistic regression analysis for sporadic MTC, lymph node metastasis contributed to distant metastasis (odds ratio 12.4) more than primary tumor size (odds ratios of 7.8, 5.5, and 2.4 for tumors measuring >60, 41-60, and 21-40 mm, respectively).

Conclusion

When thyroidectomy is performed before lymph node metastases have developed, distant metastases are exceptional, both in patients with hereditary MTC (irrespective of mutational risk level) and patients with sporadic MTC.
The origin and mechanisms of smooth muscle cell development in vertebrates
Authors: Donadon Michael , Santoro Massimo M.
Published: March 2021

Smooth muscle cells (SMCs) represent a major structural and functional component of many organs during embryonic development and adulthood. These cells are a crucial component of vertebrate structure and physiology, and an updated overview of the developmental and functional process of smooth muscle during organogenesis is desirable. Here, we describe the developmental origin of SMCs within different tissues by comparing their specification and differentiation with other organs, including the cardiovascular, respiratory and intestinal systems. We then discuss the instructive roles of smooth muscle in the development of such organs through signaling and mechanical feedback mechanisms. By understanding SMC development, we hope to advance therapeutic approaches related to tissue regeneration and other smooth muscle-related diseases.
Implication of backward contact tracing in the presence of overdispersed transmission in COVID-19 outbreaks
Authors: Endo Akira ,   Centre for the Mathematical Modelling of Infectious Diseases COVID-19 Working Group, Leclerc Quentin J. , Knight Gwenan M. , Medley Graham F. , Atkins Katherine E. , Funk Sebastian , Kucharski Adam J.
Published: March 2021

Introduction: Contact tracing has the potential to control outbreaks without the need for stringent physical distancing policies, e.g. civil lockdowns. Unlike forward contact tracing, backward contact tracing identifies the source of newly detected cases. This approach is particularly valuable when there is high individual-level variation in the number of secondary transmissions (overdispersion).

Methods: By using a simple branching process model, we explored the potential of combining backward contact tracing with more conventional forward contact tracing for control of COVID-19. We estimated the typical size of clusters that can be reached by backward tracing and simulated the incremental effectiveness of combining backward tracing with conventional forward tracing.

Results: Across ranges of parameter values consistent with dynamics of SARS-CoV-2, backward tracing is expected to identify a primary case generating 3-10 times more infections than a randomly chosen case, typically increasing the proportion of subsequent cases averted by a factor of 2-3. The estimated number of cases averted by backward tracing became greater with a higher degree of overdispersion.

Conclusion: Backward contact tracing can be an effective tool for outbreak control, especially in the presence of overdispersion as is observed with SARS-CoV-2.
Monitoring of the Main Reactor Joint by Automated System
Authors: Povarov Vladimir
Published: March 2021

Traditionally, on reactors of the VVER type, a manual measuring tool is used to inspect the sealing surfaces of the main joint. To automate testing, a PGR-59 system was developed, which was successfully applied to three new power units of type VVER-1200.

The purpose of the application is to measure the geometric characteristics of the main joint and determine the filling factor of the sealing grooves with nickel wire. Measurement is performed by laser scanning. Additionally, the article has a television camera for searching for defects with the possibility of measuring their dimensions.

The result of the work was the obtaining of actual profiles of seating surfaces of the main joint of the reactor. The use of the PGR-59 system allows you to monitor the change in the profile of the seating surfaces, which constantly changes due to mechanical impact on the seating surfaces, predict its condition and plan the necessary repairs in advance. Based on the measurement results, new data were found on the nature of the main connector seal.

The information obtained during the actual measurements made it possible to improve the operational and ergonomic characteristics of the system.
Procedural Competency Among Hospitalists: A Literature Review and Future Considerations
Authors: Cool Joséphine A , Huang Grace C
Published: March 2021

BACKGROUND

As general internists practicing in the inpatient setting, hospitalists at many institutions are expected to perform invasive bedside procedures, as defined by professional standards. In reality, hospitalists are doing fewer procedures and increasingly are referring to specialists, which threatens their ability to maintain procedural skills. The discrepancy between expectations and reality, especially when hospitalists may be fully credentialed to perform procedures, poses significant risks to patients because of morbidity and mortality associated with complications, some of which derive from practitioner inexperience.

METHODS

We performed a structured search of the peer‐reviewed literature to identify articles focused on hospitalists performing procedures.

RESULTS

Our synthesis of the literature characterizes contributors to hospitalists' procedural competency and discusses: (1) temporal trends for procedures performed by hospitalists and their associated referral patterns, (2) data comparing use and clinical outcomes of procedures performed by hospitalists compared with specialists, (3) the lack of nationwide standardization of hospitalist procedural training and credentialing, and (4) the role of medical procedure services, although limited in supportive evidence, in concentrating procedural skill and mitigating risk in the hands of a few well‐trained hospitalists.

CONCLUSION

We conclude with recommendations for hospital medicine groups to ensure the safety of hospitalized patients undergoing bedside procedures.
Dynamic, Multidimensional, and Skillset-Specific Reputation Systems for Online Work
Authors: Kokkodis Marios
Published: March 2021

Current reputation systems in online (labor) markets are overly positive and unidimensional. This article presents a new reputation framework that combines human input with machine learning to provide dynamic, multidimensional, and skill-set-specific quality assessments. The framework significantly outperforms current reputation systems. By providing more representative reputation scores, the framework helps workers to differentiate, employers to make informed decisions, and the market to improve its recommendation algorithms and understand the supply distributions across different dimensions. The framework generalizes in other contexts where reputation systems are overly positive and unidimensional. The framework highlights how combining human input with advanced machine learning techniques can augment intelligence by creating the necessary conditions for humans to make informed decisions. Such systems have the potential to increase efficiency and outcome quality precisely because they intelligently differentiate workers. The deployment of the proposed intelligence augmentation framework in different types of online platforms could have implications for workers, employers, businesses, and the future of work.
U-bent Plastic Optical Fiber for Lard Adulteration Sensor in Edible Oil
Authors: Puspita Ika , Kurniawan Fredy , Hatta Agus Muhamad , Koentjoro Sekartedjo
Published: March 2021

A plastic optical fiber with the structure of U-bent was utilized as a sensor to detect lard adulterants in olive oil. The macro bending was formed on the plastic optical fiber with a bending radius of 10 mm, 12.5 mm, and 15 mm. The output spectra and intensity were measured to detect the existence of lard substance in olive oil. The U-bent plastic optical fiber sensor with a bending radius of 12.5 mm has the optimum performance to detect the lard adulterant substance in olive oil. It has a sensitivity of 4.6 a.u/% with 855 nm LED source and 10.07 a.u/% with 940 nm LED source in intensity-based measurement and 0.50 nm/% in spectrum-based measurement. The proposed sensor is the potential to give rapid detection on lard adulterant in edible oil.
Life beyond dental nursing
Authors: Frisby Claire
Published: March 2021

Claire Frisby shares her career move – and her new home in warmer climes
Inflammatory bowel disease advice lines during the COVID-19 pandemic: a retrospective service evaluation
Authors: Avery Pearl , Younge Lisa , Dibley Lesley , Segal Jonathan
Published: March 2021

Background:

The COVID-19 pandemic significantly impacted on healthcare delivery worldwide, affecting many services, including those for inflammatory bowel disease (IBD).

Aims:

To evaluate the impact of COVID-19 on worldwide IBD telephone advice-line services.

Methods:

A mixed-methods 25-item online survey was distributed to IBD specialist nurses globally using IBD professional networks, email and social media. Data were analysed using descriptive statistics (quantitative data) and content and thematic analysis (qualitative data).

Findings:

Across 21 countries, 182 IBD specialists participated. With adjustments, all advice lines remained functional. Call content changed, and call volume increased exponentially. Strategies were recommended to maintain services. IBD specialist nurses faced considerable challenges, including overwhelming workload, disrupted referral pathways, fragmented IBD clinical team support, isolation and greatly lowered morale.

Conclusions:

To cope with similar future crises, advice-line training, resilience coaching and ringfencing of the IBD clinical team are essential. Development of global guidelines for maintaining advice-line functionality in any scenario is recommended.
The assessment and management of globus pharyngeus
Authors: Siau Richard , Kinshuck Andrew , Houghton Lisa
Published: March 2021

Globus is the sensation of a foreign body in the throat. Investigation and management of patients with globus is widely variable. Most investigations yield negative results yet incur varying patient morbidity and healthcare costs, while malignancy is vanishingly rare in the absence of red flag symptoms and ear, nose and throat examination findings. History taking is key and can help to identify possible causative pathology, directing further investigations and management if necessary. Treatment of globus mainly centres on patient reassurance and counselling, and may include reflux management, neuromodulation, or speech therapy in selected cases, and treatment of any identified cause.
Activities for resident wellbeing
Authors: Hong Chia Swee
Published: March 2021

Keeping residents active is critical to overall health, especially in times where their freedom of movement might be restricted. Chia Swee Hong provides the ninth instalment of his series on resident engagement.
Relieving the pressure of venous leg ulcers
Authors: Greener Mark
Published: March 2021

Venous leg ulcers are common among older people in nursing and residential homes and can cause considerable pain, distress and even psychological problems. Improved awareness of guidance, greater referral to specialist vascular services and a multidisciplinary approach to management are important to deal appropriately with this frequently underprioritised condition. Mark Greener reports.
Flea infestation: a snapshot on the common products and the reasons for treatment failure
Authors: Elsheikha Hany , Wong Serena , Wright Ian
Published: March 2021

The reasons why flea infestations remain frequent in companion animals despite the considerable number of anti-flea products is of interest. Successful flea control relies mainly on the use of effective anti-flea products and pet owners adhering to treatment recommendations. When flea infestations continue to persist despite the application of a potent anti-flea product, lack of efficacy may be suspected. In this article, the basics of flea biology and impact of flea infestation on the host are summarised. In addition, the factors that can result in ineffective treatment and control of flea infestation are discussed. Better understanding of the possible reasons can help to inform clinical practice and avoid treatment failures.
Canine developmental elbow disease part 1: aetiopathogenesis and diagnosis
Authors: Fernee-Hall Rosanne , Janovec Jan
Published: March 2021

Elbow dysplasia or ‘developmental elbow disease’ as it is now known, is an umbrella term encompassing multiple abnormalities of the elbow joint. These include elbow incongruity, fragmented medial coronoid process, osteochondritis dissecans and ununited anconeal process. These problems may occur individually or in combination with each other and all may cause lameness, pain, reluctance to exercise and restricted movement as the disease progresses. The advanced stage of osteoarthritis associated with medial coronoid disease involving extensive damage to or loss of cartilage is known as medial compartment disease. There are multiple modalities available for imaging the elbow joint: radiography which is widely available in general practice can detect some changes but may miss others; computed tomography in conjunction with arthroscopic examination is considered the ‘gold standard’ in elbow imaging. Part 1 of this two part series of articles introduces the aetiopathogenesis of canine developmental elbow disease, and part 2 will cover the surgical and nonsurgical management.
Population Genetic Structure and Breeding Pattern of Higher Group Termite Globitermes sulphureus (Haviland) (Blattodea:Termitidae)
Authors: Khizam Nur Aizatul Nathasha , Ab Majid Abdul Hafiz
Published: March 2021

The subterranean termite Globitermes sulphureus (Blattodea: Termitidae) can be found in tropical regions. We chose seven novel species-specific microsatellite markers to infer the breeding pattern of G. sulphureus based on its colony and population genetic structure in eight selected populations (natural-n = 4 and metropolitan-n = 4) in Kedah and Penang, Malaysia. A strong correlation with their geographical location is shown by the acquired genetic gap for all studied populations from this study. The breeding pattern of family structure and comparisons of estimated F-statistics among G. sulphureus workers suggests 60% of all colonies are mixed families, whereas the remaining are simple families. Average relatedness values within simple and mixed family colonies are similar (r = 0.121). Positive fixation index FST values (FST = 0.086) indicate all eight populations (>500 m apart) have a significantly moderate genetic differentiation and low levels of inbreeding based on the low overall inbreeding coefficient FIT value of 0.391. Furthermore, four populations; Palapes USM (PU), Tmn Astana (TA), Kg Teluk (KT), and Penang National Park (NP), deviate from Hardy–Weinberg equilibrium (HWE, all p = 0.000) and five studied polymorphic loci (GS1, GS10, GS15, GS27 and GS29) are possibly under selection. The findings also reveal signs of a bottleneck effect in two populations: Tikam Batu (TB) and Penang National Park (NP), indicating genetic drift.
Identification of Mesophylic Bacterial Flora in Deceased Worker Adults of Apis mellifera caucasia (Pollmann, 1889)
Authors: Çil Elif , Ertürk Ömer , Işik Kamil
Published: March 2021

Apis mellifera, widely farmed around the world, is the most economically important species within the genus Apis. While the microbiota of live honey bees have been extensively examined, bacteria found in deceased honey bees (which might indicate infection or opportunistic pathogens) is in contrast poorly studied. Therefore, we decided to investigate the mesophilic bacterial flora of dead honey bees. So, in September 2013, dead adult worker honey bees were collected from 12 different cities, most of which were in the border provinces of Turkey. We identified bacterial isolates at the species level by using different morphological, biochemical, physical and molecular methods, in conjunction with molecular phylogenetic analysis. We constructed phylogenetic trees for isolated bacteria with the MEGA 6.0 program and neighbor-joining trees were reconstructed based on 16S rDNA gene sequences. The phylogenetic trees indicated that isolates DE003, DE007, DE011, DE001, DE019 and DE016, DE029 could be new members of the genera Erwinia, Acidovorax, Hydrogenophaga and Bacillus genus, respectively. In the bioassay study results, we observed that DE019 Hydrogenophaga sp. (64.7%) and DE004 Klebsiella grimontii (73.3%) had lethal effects on the honey bees. The other mortalities ranged from 10% to 25% (p>0.05), and according to a One-Way ANOVA analysis DE004 and DE019 significantly affect the A. mellifera caucasia in adult worker honey bees. This study is the first report of Hydrogenophaga as honey bee pathogen.
Erratum: Amniotic membrane transplantation for infectious corneal ulcer treatment: a cohort retrospective study
Authors: Casalita Vega , Nora Rina La Distia , Edwar Lukman , Susiyanti Made , Sitompul Ratna
Published: March 2021

[This corrects the article DOI: 10.13181/mji.oa.203849]