bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary Dermal Melanoma (PDM): Histological and Clinical Interdependence to Guide Therapy
Authors: Zamir Hadas , Feinmesser Meora , Gutman Haim
Published: September 2020

Background/purpose

This study examined clinical and histological parameters of primary dermal melanoma (PDM) to aid in its distinction from dermal metastasis.

Methods

Retrospective analysis of a prospective cohort of PDM patients. Includes patients fulfilling the strict histologic criteria for PDM ( N = 9) and patients who did not, but clinically, unequivocally had an intradermal melanoma—clinical PDM (cPDM; N = 17). Histopathology slides were re-examined. Prognosticators and outcome measures were compared between groups. Sentinel nodes’ retrieval and wide local excision (WLE) were offered to all patients as primary treatment.

Results

26 patients identified, 15 females with a median age of 69 years (range 3.5-85). Mean Breslow was 7.9 ± 5.7 mm (median 5.8, range 1.8-25.0), and the mean mitotic rate was 4.9 ± 3.8/mm2 (median 4.0, range 0-17). Initial treatment and follow-up were as for cutaneous melanoma. One patient in each group with a palpable stage III underwent primary radical dissection. Sentinel nodes were retrieved in all 20 lymphatic mappings performed and found to be metastatic in 5 (25%) patients. Treatment consisted of completion lymph-node dissection. At a median postoperative follow-up of 62 months (range 8-132), 20 patients were disease-free, including 6 of 7 patients with stage III disease at presentation. Six patients died all of cPDM; 5 of 6 patients had primary ulcerated or epidermal-abutting melanomas.

Conclusions

This is the first study to highlight cPDM. Diagnosis requires expert pathology review and a tight correlation to the clinical parameters. Patients seem to benefit from WLE with sentinel node retrieval and complete dissection when appropriate. However, clinical guidelines for dissection have changed since the time period of this retrospective review. Based on this series, complete nodal dissection in these melanomas is associated with better than expected outcome, for stage III disease.
Experimental data interpretation using genetic algorithm for global health assessment of reinforced concrete slabs subjected to cracking
Authors: Daves Michael , Ervin Elizabeth K , Zeng Chuangshuo
Published: September 2020

Bridge deterioration must be monitored to ensure continued safety. Strategic repair can offer asset managers the benefit of saving money and time. However, knowing prime location and appropriate repair can be challenging when relying on visual techniques alone. This work quantitatively measures global damage from progressive cracking in a reinforced concrete slab. A novel combined framework of frequency methods, damage metrics, and genetic algorithm techniques is employed for maximum effectiveness of health evaluation. Through experimental modal analysis, tri-axial accelerometer data is interpreted via genetic algorithm using 24 damage indices based upon mode shapes. Along with easily interpretable visualization, four decision criteria validate the optimized results. Both general location and relative severity are estimated: when one artificial crack was induced by cutting, a relative strength change of 58% was detected. With four to eight cuts, change over 90% was detected.
The impact of adolescent parentification on family relationship and civic engagement
Authors: Wei Hsi-Sheng , Shih An-Ti , Chen Yi-Fu , Hong Jun Sung
Published: September 2020

This study examined the relationships between parentification, family relationship, political interest, and civic beliefs using a large sample of Taiwanese adolescents. Data were collected from 1648 junior and senior high school students in Taichung City, Taiwan. Parentification was hypothesized to positively affect family relationship, which in turn influences adolescents’ political interest and civic beliefs. A series of structural equation models were constructed and tested. Implications of the findings for practice and policy-making are discussed.

Findings

Two dimensions of parentification, instrumental and emotional caregiving, were found to be positively associated with the parent–child relationship while perceived unfairness was negatively associated with the family relations. Family relationship was positively related to youth’s civic beliefs as well as their political interests. Potential gender, age (junior high/senior high), and family (living with/not with both parents) effects were examined through multi-group comparisons. The model was robust with minor differences between gender, age, and family type subgroups.

Applications

Social workers should recognize the developmental benefits of parentification and utilize such experiences when working with adolescents. With cultural sensitivity, a healthy inter-dependence between youth and parents can be appreciated as a source of strength, which facilitates young people’s civic responsibility and concern for public affairs beyond family.
Analysis of oligomeric complexes of the amyloid-forming FYLLYY peptide by collision-induced dissociation with electrospray ionization mass spectrometry
Authors: Choi Ryu Ho , Kim Ho-Tae
Published: September 2020

The monomeric and oligomeric structures of the “FYLLYY” β2 microglobulin (β2m) active sequence, formed in (DMSO/CH3CN) solution, were investigated using electrospray ionization (ESI) mass spectrometry (MS) and tandem mass spectrometry (MS/MS). Dissociation of dimer and trimer ions was investigated by tandem mass spectrometry using collision induced dissociation (CID). The covalent bond fragmentation patterns were observed in the 21+ and 32+ MS/MS spectra (21+ = [dimer+H]1+ and 32+ = [trimer + 2H]2+). A π-π stacking geometry for the FYLLYY 21+ complex and partial parallel β-sheet geometry for the 32+ complex are proposed to be stable structures. The observed covalent bond fragment ions in the MS/MS spectra of the 32+ complex are considered to have originated from the partial parallel β-sheet moiety. The FYLLYY → AALLGY (or FYLLAA) substituted sequence was also investigated by CID-MS/MS. Our MS/MS analysis suggests that the π-π stacking interaction structures are important in dimer binding rather than the structures of a complete parallel or anti-parallel β-sheet 21+ complex.
On a math mission: The time and space compression of professional identity and values in prospective mathematics teachers’ stories
Authors: Mandt Hege Marie , Afdal Geir
Published: September 2020

This article analyzes and discusses the professional values of prospective mathematics teachers. Theoretical approaches to the understanding of teachers’ professional values, such as critical mathematics education and relational perspectives, are well developed. Still, there are few empirical contributions to the field. Here, professional values are understood as interwoven with professional identity. The article raises the question of how prospective teachers construct their identity and values in time and space, and the analysis is based on data material from mathematics teacher students at two Norwegian teacher education institutions. The main finding is that the teacher students construct their professional identity and values in a compressed timespace. Their professional responsibility is located in and restricted to themselves and the relation to the individual student, not including concern for, for instance, social justice. The students do not express opposition to ideals of social justice, but it is beyond their constructed professional timespace identity, values and responsibility.
How to deliver bad news to me? Suggestions for preparing Muslim patients before breaking bad news
Authors: Hoseini Akram Sadat Sadat
Published: September 2020

There are several models for delivering bad news, the most important and widely used being the SPIKES protocol. Cultural differences in breaking bad news in different societies with different cultures call for special attention. Muslim societies are examples of communities with special cultural and religious requirements. Then, when collecting information about a person's perception of the illness or the incident, consider his or her view of spirituality and the effect of calamities on human transcendence so as to assess the type and amount of information the patient or the family needs. When preparing a suitable setting for delivering bad news, pay attention to the spiritual needs of Muslims such as the possibility of prostration, recitation of Qur'an, and talking to God in private or even aloud. Be aware of, pay attention to, and respect particular religious views of the patient, and if necessary, correctly exploit such views to deliver bad news. Although some Muslim patients may have no demands for transcendence and human growth at the first stage, but over time and after accepting the condition, they will have demands. Therefore, health care providers must provide the necessary facilities for Muslim patients in terms of the required information, setting, and people present in the setting and provide information appropriate to the culture of these patients so as to give an excellent and comprehensive care.
Disadvantage of Small (<60 kg) Adult Candidates on the Liver Transplantation Waitlist
Authors: van Dijk Anne-Baue R. M. , Sneiders Dimitri , Murad Sarwa Darwish , Polak Wojciech G. , Hartog Hermien
Published: September 2020

Background:

Small adult patients with lower bodyweight wait-listed for liver transplantation may face a shortage of size-matched whole-liver grafts. The objective of this study is to compare time to transplantation in adult patients with a bodyweight of <60 kg to patients with bodyweight ≥60 kg.

Methods:

A matched case–control study was conducted. Patients aged 18 years and older listed for liver transplantation at our transplant center, from 2007 to 2016 with a bodyweight <60 kg were manually matched 1:2 to control patients ≥ 60 kg. Matching was performed based on ABO blood type, model for end-stage liver disease score, (non)-standard exception status, and eligibility for donation after cardiac death. Time to transplantation was assessed with univariable Cox-regression.

Results:

In total, 23 cases with a bodyweight < 60 kg were matched to 46 average-sized control patients. Small adults were significantly disadvantaged for receiving a liver transplantation as compared to their average-sized counterpart (hazard ratio 0.47; 95% confidence interval 0.29-0.75, P = .002). At the end of follow-up, 14/23 (60.9%) of cases versus 35/46 of controls (76.1%) had received a liver transplantation.

Conclusion:

Small adults with a bodyweight below 60 kg are disadvantaged on the waitlist for a size-matched whole liver graft.
Systematic Review and Meta-Analysis of Multitargeted Tyrosine Kinase Inhibitors in Patients With Intractable Metastatic Colorectal Cancer
Authors: Gao Zhenzhen , Cao Chenxi , Bao Yi , Fan Yaohua , Chen Gang , Fu Peng
Published: September 2020

Background:

The treatment options for intractable metastatic colorectal cancer include regorafenib, trifluridine/tipiracil, and fruquintinib. In this study, we aimed to conduct a network meta-analysis for comparing the efficacy of these agents.

Methods:

We searched the PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials databases for relevant literature, up to February 2020. The data were collected from randomized controlled trials on regorafenib, trifluridine/tipiracil, or fruquintinib, administered to patients with metastatic colorectal cancer who failed on treatment with oxaliplatin, irinotecan, or fluoropyrimidine. The primary end points, namely, the overall survival and progression-free survival, were analyzed for subsequent network analysis using the Review Manager and Aggregate Data Drug Information System software for performing direct and indirect comparisons.

Results:

A total of 7 trials were analyzed in this study. Trifluridine/tipiracil and regorafenib proved to be superior to the placebo, with respect to the overall survival (odds ratio: 0.38, 95% confidence interval: 0.27-0.52 for trifluridine/tipiracil; odds ratio: 0.47, 95% confidence interval: 0.26-0.84 for regorafenib) and progression-free survival (odds ratio: 0.18, 95% confidence interval: 0.05-0.67 for trifluridine/tipiracil; odds ratio: 0.06, 95% confidence interval: 0.04-0.09 for regorafenib). Regorafenib (80 mg) was superior to the placebo in terms of the overall survival and progression-free survival and inferior to trifluridine/tipiracil and fruquintinib. Network analysis revealed that the efficacy of trifluridine/tipiracil and fruquintinib was fundamentally similar, and both the agents were superior to regorafenib.

Conclusion:

Regorafenib (80 mg) was superior to the placebo, but inferior to 160 mg regorafenib, trifluridine/tipiracil, and fruquintinib. This study further revealed that the efficiency of trifluridine/tipiracil and fruquintinib is identical, but their toxicity profiles are different.
The protective effects of C16 peptide and angiopoietin-1 compound in lipopolysaccharide-induced acute respiratory distress syndrome
Authors: Wu Dingqian , Fu Xiaoxiao , Zhang Yuanyuan , Li Qiang , Ye Ligang , Han Shu , Zhang Mao
Published: September 2020

C16 peptide and angiopoietin-1 (Ang-1) have been found to have anti-inflammatory activity in various inflammation-related diseases. However, their combined role in acute respiratory distress syndrome (ARDS) has not been investigated yet. The objective of this study was to investigate the effects of C16 peptide and Ang-1 in combination with lipopolysaccharide (LPS)-induced inflammatory insult in vitro and in vivo. Human pulmonary microvascular endothelial cells and human pulmonary alveolar epithelial cells were used as cell culture systems, and an ARDS rodent model was used for in vivo studies. Our results demonstrated that C16 and Ang-1 in combination significantly suppressed inflammatory cell transmigration by 33% in comparison with the vehicle alone, and decreased the lung tissue wet-to-dry lung weight ratio to a maximum of 1.53, compared to 3.55 in the vehicle group in ARDS rats. Moreover, C  +  A treatment reduced the histology injury score to 60% of the vehicle control, enhanced arterial oxygen saturation (SO2), decreased arterial carbon dioxide partial pressure (PCO2), and increased oxygen partial pressure (PO2) in ARDS rats, while also improving the survival rate from 47% (7/15) to 80% (12/15) and diminishing fibrosis, necrosis, and apoptosis in lung tissue. Furthermore, when C  +  A therapy was administered 4 h following LPS injection, the treatment showed significant alleviating effects on pulmonary inflammatory cell infiltration 24 h postinsult. In conclusion, our in vitro and in vivo studies show that C16 and Ang-1 exert protective effects against LPS-induced inflammatory insult. C16 and Ang-1 hold promise as a novel agent against LPS-induced ARDS. Further studies are needed to determine the potential for C16 and Ang-1 in combination in treating inflammatory lung diseases.
“Be True to Your School”: A 100-Year Legacy of Music Education Faculty at the Indiana University School of Music
Authors: Ward-Steinman Patrice Madura
Published: September 2020

The 2020 bicentennial year of Indiana University (IU) Bloomington is a fitting time to recognize the 100-year legacy of the faculty members of the IU Music Education Department. This legacy has not been heretofore documented, exposing a gap in the knowledge of historical traditions and influences. The purpose of this study was to create a comprehensive list of the faculty names, and years of service, and to identify publications, leadership roles, curriculum development, and biographical insights. The historical narrative was created through immersion in the following primary sources found in the IU Archives: The annual Indiana University Bulletins, the Trustees Minutes, and miscellaneous clippings files containing photographs, news items, and obituaries. First edition hard copies of books and published articles by the faculty were examined. Greatest detail is provided for those IU professors of the distant past, including Edward Bailey Birge, Samuel T. Burns, Thurber H. Madison, Jack M. Watson, Dorothy G. Kelley, Newell H. Long, Miriam P. Gelvin, Charles R. Hoffer, and Robert H. Klotman. This study illustrates how one-storied Music Education Department is inextricably linked to its past and suggests that other legacy studies are needed for comparison and contrast.
Caveats in the monitoring of fetal growth using ultrasound estimated fetal weight
Authors: Dudley Nicholas John , Varley Helen
Published: September 2020

Introduction

Ultrasound estimated fetal weight is increasingly being used in the monitoring of fetal growth. Differences between estimated fetal weight formulae, curves and measurement methods could lead to significant differences in results. The aim of this study was to investigate the potential impact of these differences on estimated fetal weight and its use in monitoring fetal growth, both by modelling and by analysis of ultrasound scan data.

Methods

Four estimated fetal weight curves were compared in their original form and also normalised to term weight. Estimated fetal weight was calculated from 50th centiles of widely used charts of abdominal and head circumference and femur length and plotted on a widely used estimated fetal weight curve. Fetal measurement data were used to assess the impact of fetal proportions on estimated fetal weight error and on growth trajectory when different estimated fetal weight formulae are used.

Results

Estimated fetal weight curves differ significantly, but after normalisation there is closer agreement. Estimated fetal weight modelled using modern measurement methods differs from the widely used estimated fetal weight growth curve. Errors in estimated fetal weight are correlated with differences in fetal proportions and this can lead to significant changes in estimated fetal weight growth trajectory if different estimated fetal weight formulae are used.

Conclusions

Choice of measurement methods, estimated fetal weight formulae and growth curves have a significant effect on estimated fetal weight growth trajectories relative to normal ranges. It is important to understand these caveats when using estimated fetal weight to monitor fetal growth.
Training and Support for Hybrid Closed-Loop Therapy
Authors: Boughton Charlotte K. , Hartnell Sara , Allen Janet M. , Fuchs Julia , Hovorka Roman
Published: September 2020

Hybrid closed-loop therapy is an emerging technology transforming the management of type 1 diabetes (T1D). Research studies demonstrate glycemic and quality of life benefits of hybrid closed-loop therapy for people with T1D. Translating these outcomes into standard clinical practice is critical for reimbursement and improving access to this technology.

High-quality training is essential for achieving optimal outcomes with hybrid closed-loop therapy. Basic diabetes skills and tasks are as important, or even more important, with closed-loop therapy than with standard insulin therapy and need to be reiterated. Establishing expectations of hybrid closed-loop therapy clearly at the outset promotes long-term usage and optimal outcomes.

We share key aspects of training and support for users of commercially available hybrid closed-loop systems and consider who may benefit from this technology.
A Systematic Review of the Neuropathologic Findings of Post-Viral Olfactory Dysfunction: Implications and Novel Insight for the COVID-19 Pandemic
Authors: Lee Jason C. , Nallani Rohit , Cass Lauren , Bhalla Vidur , Chiu Alexander G. , Villwock Jennifer A.
Published: September 2020

Background

Post-viral olfactory dysfunction is a common cause of both short- and long-term smell alteration. The coronavirus pandemic further highlights the importance of post-viral olfactory dysfunction. Currently, a comprehensive review of the neural mechanism underpinning post-viral olfactory dysfunction is lacking.

Objectives

To synthesize the existing primary literature related to olfactory dysfunction secondary to viral infection, detail the underlying pathophysiological mechanisms, highlight relevance for the current COVID-19 pandemic, and identify high impact areas of future research.

Methods

PubMed and Embase were searched to identify studies reporting primary scientific data on post-viral olfactory dysfunction. Results were supplemented by manual searches. Studies were categorized into animal and human studies for final analysis and summary.

Results

A total of 38 animal studies and 7 human studies met inclusion criteria and were analyzed. There was significant variability in study design, experimental model, and outcome measured. Viral effects on the olfactory system varies significantly based on viral substrain but generally include damage or alteration in components of the olfactory epithelium and/or the olfactory bulb.

Conclusions

The mechanism of post-viral olfactory dysfunction is highly complex, virus-dependent, and involves a combination of insults at multiple levels of the olfactory pathway. This will have important implications for future diagnostic and therapeutic developments for patients infected with COVID-19.
Microfracture for the Treatment of Symptomatic Cartilage Lesions of the Knee: A Survey of International Cartilage Regeneration & Joint Preservation Society
Authors: Medina Jesus , Garcia-Mansilla Ignacio , Fabricant Peter D. , Kremen Thomas J. , Sherman Seth L. , Jones Kristofer
Published: September 2020

Objective

The purpose of this study was to describe the current practice trends for managing symptomatic cartilage lesions of the knee with microfracture among ICRS (International Cartilage Regeneration & Joint Repair Society) members.

Design

A 42-item electronic questionnaire was sent to all ICRS members, which explored indications, surgical technique, postoperative management, and outcomes of the microfracture procedure for the treatment of symptomatic, full thickness chondral and osteochondral defects of the knee. Responses were compared between surgeons from different regions and years of practice.

Results

A total of 385 surgeons answered the questionnaire. There was a significant difference noted in the use of microfracture among surgeons by region ( P < 0.001). There was no association between the number of years in practice and the self-reported proportion of microfracture cases performed ( P = 0.37). Fifty-eight subjects (15%) indicated that they do not perform microfracture at all. Regarding indication for surgery, 56% of surgeons would limit their indication of microfracture to lesions measuring 2 cm2 or less. Half of the surgeons reported no upper age or body mass index limit. Regarding surgical technique, 90% of surgeons would recommend a formal debridement of the calcified layer and 91% believe it is important to create stable vertical walls. Overall, 47% of surgeons use biologic augmentation, with no significant difference between regions ( P = 0.35) or years of practice ( P = 0.67). Rehabilitation protocols varied widely among surgeons.

Conclusions

Indications, operative technique, and rehabilitation protocols utilized for patients undergoing microfracture procedures vary widely among ICRS members. Regional differences and resources likely contribute to these practice pattern variations.
Extracellular HMGB-1 activates inflammatory signaling in tendon cells and tissues
Authors: Zhang Chuanxin , Gu Xinfeng , Zhao Guangyi , Wang Wang , Shao Jiahua , Zhu Jun , Yuan Ting , Sun Jiuyi , Nie Daibang , Zhou Yiqin
Published: September 2020

Background:

Increasing evidence indicates that secretion of high mobility group box 1 protein (HMGB-1) is functionally associated with tendinopathy development. However, the underlying effect and mechanism of extracellular HMGB-1 on tendon cells are unclear.

Methods:

We tested the effect of exogenous HMGB-1 on cell growth, migration, and inflammatory signaling responses with isolated rat Achilles tendon cells. Also, we studied the role of extracellular HMGB-1, when administrated alone or in combination with mechanical overloading induced by intensive treadmill running (ITR), in stimulating inflammatory effects in tendon tissues.

Results:

By using in vitro and in vivo models, we show for the first time that exogenous HMGB-1 dose-dependently induces inflammatory reactions in tendon cells and tendon tissue. Extracellular HMGB-1 promoted redistribution of HMGB-1 from the nucleus to the cytoplasm, and activated canonical nuclear factor kappa B (NF-κB) signaling and mitogen-activated protein kinase (MAPK) signaling. Short-term administration of HMGB-1 induced hyper-cellularity of rat Achilles tendon tissues, accompanied with enhanced immune cell infiltration. Additional ITR to HMGB-1 treatment worsens these responses, and application of HMGB-1 specific inhibitor glycyrrhizin (GL) completely abolishes such inflammatory effects in tendon tissues.

Conclusion:

Collectively, these results confirm that HMGB-1 plays key roles in the induction of tendinopathy. Our findings improve the understanding of the molecular and cellular mechanisms during tendinopathy development, and provide essential information for potential targeted treatments of tendinopathy.
How do politicians respond to opinion polls? An experiment with Swedish politicians
Authors: Schumacher Gijs , Öhberg Patrik
Published: September 2020

Do politicians demand change if party support is slipping in opinion polls? If so, should a party change its program or just the way it communicates with voters? To investigate this, we conducted a survey experiment with 1236 Swedish politicians. We exposed them to a frame in which their party was losing in the polls, or a frame in which their party was gaining in the polls without using deception. Our results demonstrate that losing politicians seek change, both in terms of program and communication. However, the effects of the most recent polls are typically stronger than our experimental treatment. Along those lines we also find that politicians who are losing in recent polls, but not in our experimental treatment, favor ideological radicalization more than moderation or staying put. With these results our study paper speaks to the discussion on how representation is achieved and whether opinion polls are good or bad for democracy.
Symbolic politics and self-interest in post-Affordable Care Act health Insurance coverage
Authors: Reny Tyler T. , Sears David O.
Published: September 2020

Social scientists have long shown that self-interest rarely has a large effect on citizens’ sociopolitical attitudes. Instead, Americans’ opinions about public policy are driven more by symbolic predispositions. Yet those opinions about policy may just be cheap talk. When Americans are faced with costly behaviors that pit their interests against their values, perhaps self-interest will play a larger role. Post-Affordable Care Act (ACA) health insurance coverage provides an important test for self-interest and symbolic politics. Faced with costly decisions to pay fines or purchase insurance, did Americans put symbolic politics over material self-interests? Using a monthly tracking poll, we first show that symbolic attitudes overwhelm self-interest in shaping public opinion about health policy. Marshaling data from over one million respondents from Gallup’s Tracking Poll, however, we show that both self-interest and symbolic predispositions are associated with decisions to purchase health insurance under the ACA.
Diabetes assistance before, during and after Covid-19 in Ferrara, Italy
Authors: Pelizzola Dario
Published: September 2020

The COVID-19 pandemic has profoundly changed people's habits and social organization, including the care models of people with chronic diseases. Diabetes care in Ferrara is based on Integrated Care Protocols (ICP) in collaboration with General Practitioners (GPs). The sudden arrival of the Covid-19 pandemic has resulted in the suspension of most of the planned health activities. The Diabetes Services have mainly dedicated themselves to communicating by telephone with their clients to suspend appointments and monitor their health conditions, accepting only urgent situations that could not be managed by telephone. The psychosocial aspects of people with diabetes have led to the fear of contagion taking into account the greater risks related to age and comorbidity and the aspects of loneliness and reduction of social contacts. After the lockdown, the health systems are reactivating the suspended treatment paths even if with all the measures to avoid spreading the infection. Consequently, the assistance activities will be quantitatively less numerous to apply the safety criteria. E-health gives the opportunity to customize monitoring and assistance and to configure a profile of the monitored parameters aimed at revaluations of care in the clinic only when necessary, rather than at predetermined deadlines.
The value of sharing: Branding and behaviour in a life and health insurance company
Authors: Jeanningros Hugo , McFall Liz
Published: September 2020

As Big Data, the Internet of Things and insurance collide, so too, do the best and the worst of our futures. Insurance is summoned as an example of the interference in our private lives that is already underway everywhere. In this paper, we pause to reflect on this argument. Can changes in the way insurance measures the value of behaviour really serve as an example of the individual and social harms of datafication? How do we know? Insurance is a mathematical relationship staged between individuals and groups, between risk and uncertainty, between distribution and assessment, between the value of sharing and the sharing of value. We use the case study of Discovery International, owner of Vitality, the market leading brand in behavioural insurance to consider how behaviour is being branded and how the brand behaves.
Low Rates of Colonoscopy Follow-up After a Positive Fecal Immunochemical Test in a Medicaid Health Plan Delivered Mailed Colorectal Cancer Screening Program
Authors: Green Beverly B. , Baldwin Laura-Mae , West Imara I. , Schwartz Malaika , Coronado Gloria D.
Published: September 2020

Background

Follow-up colonoscopy after a positive fecal immunochemical test (FIT) is necessary for colorectal cancer (CRC) screening to be effective. We report colonoscopy follow-up rates after a positive FIT overall and by population characteristics in the BeneFIT demonstration pilot, a Medicaid health insurance plan-delivered mailed FIT outreach program.

Methods

In 2016, 2 health insurance plans in Oregon and in Washington state mailed FIT kits to Medicaid patients who, based on claims data, were overdue for CRC screening. We report follow-up colonoscopy completion rates after positive FIT, and differences in completion rates by age, sex, race, ethnicity, preferred language, and number of primary care visits in the prior year. This research was human subjects approved with a waiver of consent for data collection.

Results

The FIT positivity rates in Health Plan Oregon and Health Plan Washington were 7.9% (39/488) and 14.6% (125/857), respectively. Colonoscopy completion rates within 12 months of the positive test were 35.9% (14/41) in Health Plan Oregon and 32.8% (41/125) in Health Plan Washington. Colonoscopy completion rates were higher among individuals who preferred a language other than English (Non-English speakers 70.0%, English speakers 31.3%, P = .04).

Conclusion

In a health plan-delivered mailed FIT outreach program, follow-up colonoscopy rates after a positive test were low. Additional interventions are needed to assure colonoscopy after a positive FIT test and to reap the benefits of screening.
When the Lawyer Becomes Traumatized: A Scoping Review
Authors: Léonard Marie-Jeanne , Saumier Daniel , Brunet Alain
Published: September 2020

Lawyers can be exposed to cases involving traumatic elements of crimes. Such exposure may result in symptoms of posttraumatic stress disorder (PTSD) and have adverse effects on the lawyers’ capacities to work. A scoping review was conducted to summarize original investigations of work-related PTSD among lawyers in terms of (a) trauma exposure conceptualization and operationalization, (b) symptom severity, (c) prevalence, and (d) risk factors. The scoping review also aimed to highlight potential directions for future studies and clinical implications. Literature searches were conducted in PsycINFO, Embase, Pubmed, MEDLINE, PILOTS, and Google Scholar. Of 341 initial publications, 9 were included. A majority conceptualized the impact of work-related trauma exposure as secondary traumatic stress and operationalized work-related trauma exposure as the number of cases or clients involving traumatic material. Levels of PTSD symptoms reported by lawyers were positively related to levels of work-related trauma exposure.
Local Autograft Versus Iliac Crest Bone Graft PSF-Augmented TLIF in Low-Grade Isthmic and Degenerative Lumbar Spondylolisthesis
Authors: Abou-Madawi Ali M. , Ali Sherif H. , Abdelmonem Ahmed M.
Published: September 2020

Study Design:

Prospective randomized controlled cohort study.

Objective:

To compare the outcome of local autograft versus iliac crest bone graft (ICBG) stand-alone transforaminal lumbar interbody fusion (TLIF) in lumbar spondylolisthesis.

Methods:

One hundred eight patients with low-grade single-level spondylolisthesis underwent operation with pedicular screw fixation (PSF)-augmented stand-alone TLIF. Patients were randomly divided into groups according to bone graft: group I, autograft group; and group II, ICBG group, with 54 patients each. Fifty-nine patients had isthmic spondylolisthesis and 49 had degenerative spondylolisthesis. Clinical outcome parameters included Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and patient’s satisfaction, while the radiological parameters included fusion rate, slip reduction, segmental angle, and disc height. The mean follow-up period was 38 ± 19 months, with a minimum 24 of months.

Results:

The preoperative VAS of back pain improved from 8 ± 3.1 to 3.4 ± 2.9 and from 8 ± 3.2 to3.6 ± 2.6 in group I and group II, respectively. The preoperative ODI improved from 41.4 ± 8 to 12.3 ± 7 and from 39 ± 9 to 13 ± 8 in group I and group II, respectively. The fusion rate was 93% in group I and 94.5% in group II. The percentage of slip was reduced from 26.7 ± 7.1% to 16.5 ± 6.1% in group I and from 27.4 ± 8.25 to 15.8 ± 5.2% in group II. Intervertebral disc height increased from 25.27 ± 14.62 to 46.38 ± 15.41 in group I and from 22.29 ± 13.72 to 45.15 ± 16.77 in group II. Segmental angle improved from 10.5 ± 8.1° to 16.7 ± 5.4° in group I and from 11.6 ± 5.3° to 15.9 ± 6.2° in group II. There was no significant difference of the above-mentioned parameters between the 2 groups.

Conclusion:

Patients with single-level low-grade spondylolisthesis can be effectively treated with PSF-augmented stand-alone TLIF using either local autograft or ICBG with no outcome differences between the 2 groups.
Accurate prediction of DNA N4-methylcytosine sites via boost-learning various types of sequence features
Authors: Zhao Zhixun , Zhang Xiaocai , Chen Fang , Fang Liang , Li Jinyan
Published: September 2020

Background

DNA N4-methylcytosine (4mC) is a critical epigenetic modification and has various roles in the restriction-modification system. Due to the high cost of experimental laboratory detection, computational methods using sequence characteristics and machine learning algorithms have been explored to identify 4mC sites from DNA sequences. However, state-of-the-art methods have limited performance because of the lack of effective sequence features and the ad hoc choice of learning algorithms to cope with this problem. This paper is aimed to propose new sequence feature space and a machine learning algorithm with feature selection scheme to address the problem.

Results

The feature importance score distributions in datasets of six species are firstly reported and analyzed. Then the impact of the feature selection on model performance is evaluated by independent testing on benchmark datasets, where ACC and MCC measurements on the performance after feature selection increase by 2.3% to 9.7% and 0.05 to 0.19, respectively. The proposed method is compared with three state-of-the-art predictors using independent test and 10-fold cross-validations, and our method outperforms in all datasets, especially improving the ACC by 3.02% to 7.89% and MCC by 0.06 to 0.15 in the independent test. Two detailed case studies by the proposed method have confirmed the excellent overall performance and correctly identified 24 of 26 4mC sites from the C.elegans gene, and 126 out of 137 4mC sites from the D.melanogaster gene.

Conclusions

The results show that the proposed feature space and learning algorithm with feature selection can improve the performance of DNA 4mC prediction on the benchmark datasets. The two case studies prove the effectiveness of our method in practical situations.
Genome-wide identification, phylogeny and expression analysis of the SPL gene family in wheat
Authors: Zhu Ting , Liu Yue , Ma Liting , Wang Xiaoying , Zhang Dazhong , Han Yucui , Ding Qin , Ma Lingjian
Published: September 2020

Background

Members of the plant-specific SPL gene family (squamosa promoter-binding protein -like) contain the SBP conserved domain and are involved in the regulation of plant growth and development, including the development of plant flowers and plant epidermal hair, the plant stress response, and the synthesis of secondary metabolites. This family has been identified in various plants. However, there is no systematic analysis of the SPL gene family at the genome-wide level of wheat.

Results

In this study, 56 putative TaSPL genes were identified using the comparative genomics method; we renamed them TaSPL001 - TaSPL056 on their chromosomal distribution. According to the un-rooted neighbor joining phylogenetic tree, gene structure and motif analyses, the 56 TaSPL genes were divided into 8 subgroups. A total of 81 TaSPL gene pairs were designated as arising from duplication events and 64 interacting protein branches were identified as involve in the protein interaction network. The expression patterns of 21 randomly selected TaSPL genes in different tissues (roots, stems, leaves and inflorescence) and under 4 treatments (abscisic acid, gibberellin, drought and salt) were detected by quantitative real-time polymerase chain reaction (qRT-PCR).

Conclusions

The wheat genome contains 56 TaSPL genes and those in same subfamily share similar gene structure and motifs. TaSPL gene expansion occurred through segmental duplication events. Combining the results of transcriptional and qRT-PCR analyses, most of these TaSPL genes were found to regulate inflorescence and spike development. Additionally, we found that 13 TaSPLs were upregulated by abscisic acid, indicating that TaSPL genes play a positive role in the abscisic acid-mediated pathway of the seedling stage. This study provides comprehensive information on the SPL gene family of wheat and lays a solid foundation for elucidating the biological functions of TaSPLs and improvement of wheat yield.
Prevalences and associated factors of electrocardiographic abnormalities in Chinese adults: a cross-sectional study
Authors: Yu Liping , Ye Xiaojun , Yang Zhaojun , Yang Wenying , Zhang Bo ,   on behalf of the China National Diabetes and Metabolic Disorders Study Group
Published: September 2020

Background

Electrocardiogram (ECG) is widely used to screen cardiac diseases. To date, no large population study has provided estimates of the prevalences of ECG findings in China. We aim to investigate the prevalences and associated factors of ECG abnormalities in a general population of Chinese adults.

Methods

ECG data were obtained from 34,965 participants in the 2007–2008 China National Diabetes and Metabolic Disorders Study. ECG abnormalities were classified according to the Minnesota coding (MC) criteria. Prevalences of variant ECG abnormalities were calculated. The associations between ECG abnormalities and gender, age and other risk factors for cardiovascular diseases (CVD) were analyzed by multivariate logistic regression test.

Results

The prevalences of major arrhythmias were 1.70, 2.37 and 1.04% in the whole population, men and women, respectively. Atrial fibrillation/flutter was found in 0.35% of men and 0.20% of women. ST depression and T abnormalities accounted for 10.96, 7.54 and 14.32% in the whole population, men and women, respectively. Independent of gender and other CVD risk factors, older age significantly increased the odds of having atrial fibrillation/flutter, complete left bundle branch block, complete right bundle branch block, sinus tachycardia, atrial/junctional/ventricular premature beats, ST depression and T abnormalities, tall R wave left, left/right atrial hypertrophy, left axis deviation and low voltage. Hypertension, overweight, obesity and hypercholesterolemia all independently increased the odds of having ST depression and T abnormalities. History of cardiovascular/cerebrovascular diseases was positively associated with major arrhythmias, ST depression and T abnormalities and tall R wave left.

Conclusions

This study provides estimates of the prevalences of ECG findings in a large population of Chinese adults. Gender, age, CVD risk factors and history of cardiovascular/cerebrovascular diseases were significantly associated with ECG abnormalities.
Antibiotic prescribing and non-prescribing in nursing home residents with signs and symptoms ascribed to urinary tract infection (ANNA): study protocol for a cluster randomized controlled trial
Authors: Rutten Jeanine J. S. , van Buul Laura W. , Smalbrugge Martin , Geerlings Suzanne E. , Gerritsen Debby L. , Natsch Stephanie , Sloane Philip D. , Veenhuizen Ruth B. , van der Wouden Johannes C. , Hertogh Cees M. P. M.
Published: September 2020

Background

Antibiotic overprescribing for suspected urinary tract infection (UTI) in nursing homes (NHs) is common. Typical clinical scenarios in which antibiotics are inappropriately prescribed include response to nonspecific signs and symptoms and/or a positive urine test in the absence of symptoms referable to the urinary tract. These and other scenarios for inappropriate antibiotic prescribing were addressed in a recent international Delphi study which resulted in the development of a decision tool for the empiric treatment of UTI in frail older adults. The aim of the current study is to implement this decision tool, by integrating it into the electronic health record (EHR) and providing education on its content and use, and to evaluate its effect on appropriate antibiotic prescribing. An additional aim is to evaluate the quality of the intervention and the implementation process.

Methods

A cluster Randomized Controlled Trial (cRCT) is conducted in sixteen NHs and aims to include 897 residents diagnosed with suspected UTI. NHs in the intervention group use the EHR-integrated decision tool, and receive education for physicians and nursing staff; in the control group care as usual is provided. Data is collected through case report forms within the EHR at the day of diagnosis and at 3, 7, and 21 days thereafter. The primary outcome is appropriate antibiotic prescribing for suspected UTI at the day of diagnosis. Secondary outcomes include the course of symptoms, alternative diagnoses, treatment changes, complications, hospitalization, and mortality. Data on total antibiotic prescribing are additionally collected in the participating NHs 12 months before and during the study. Finally, the process evaluation combines cRCT data with questionnaires and qualitative interviews with NH professionals.

Discussion

This is the first cRCT to evaluate the recently developed, international decision tool for empiric treatment of suspected UTI in NH residents. Study findings will elucidate the effect of the intervention on appropriate antibiotic prescribing for suspected UTI, and provide insight into the applicability of the decision tool in NHs in general and in specific subgroups of NH residents. With this study we aim to contribute to antibiotic stewardship efforts in long-term care.

Trial registration

The ANNA study was registered at the Netherlands Trial Register on 26 February 2019, with identification number NTRNL7555.
Effect of renal replacement therapy on selected arachidonic acid derivatives concentration
Authors: Cecerska-Heryć Elżbieta , Heryć Rafał , Wiśniewska Magda , Serwin Natalia , Grygorcewicz Bartłomiej , Dołęgowska Barbara
Published: September 2020

Background

Platelet activation is an important side effect of dialysis, resulted in a subsequent release of arachidonic acid (AA) from activated platelets. AA is involved in many pathologic conditions, such as inflammation, asthma, cancer, diabetes, hypertension, and the pathogenesis of kidney disease. The aim of this study was to define whether the dialysis type affects the concentration of AA derivatives in patients with chronic kidney disease.

Methods

117 patients were qualified to the study group. Based on the type of renal replacement therapy, patients were divided into the following groups: hemodialysis (HD A – before/HD B - after hemodialysis), peritoneal dialysis (PD), kidney transplant patients (TE - before/TE A – after transplantation) and conservative treatment (CT) (30; 30; 27; 30 patients, respectively). The control group consisted of 30 healthy volunteers (NK). The ELISA methods were used to measure the concentrations of TXB2, 5-HETE, 12-HETE, and 15-HETE in the blood serum.

Results

Renal replacement therapy significantly influences the concentration of TXB2 (mean ± SD [ng/mL]: HD A- 34.6 ± 9; HD B- 28.3 ± 15.2; PD- 28.3 ± 15.2; CT- 34.2 ± 8.0; TE- 36.7 ± 42.9; TE A- 27.9 ± 8.8; NK– 19.6 ± 15; p = 0.010), 5-HETE (mean ± SD [ng/mL]: HD A- 284.2 ± 428.4; HD B- 304.8 ± 516.2; PD – 530.0 ± 553.3; CT- 318.7 ± 366.0; TE- 525.6 ± 358.0; TE A – 409.8 ± 377.1; NK 838.1 ± 497.8; p < 0.001) and 15-HETE (HD A—18.1 ± 8.7; HD B- 42.2 ± 14; PD – 36.3 ± 13.8; CT- 33.7 ± 14.0; TE- 19.5 ± 10.2; TE A – 34.4 ± 16.3; NK 22.2 ± 17.8; p < 0,001). There was a significant relationship between the type of renal replacement therapy and the duration of dialysis, and the concentration of TXB2, 12-HETE acid, and 15-HETE.

Conclusions

The type of renal replacement therapy significantly affects the concentration of AA derivatives. Peritoneal dialysis is the best method of dialysis, taking into account the concentration of arachidonic acid derivatives.