bluuebunny/crossref_metadata_2025 huggingface dataset:
The type and scope of physiotherapy is under-utilised in Australian residential aged care facilities: a national, cross-sectional survey of physiotherapists
Authors: Brett Lindsey , Ilhan Emre
Published: July 2022

Background

With an increasingly ageing population in Australia, more older adults who are frail are living in residential aged care facilities (RACFs). The aim of this study was to detail the type, scope, and funding of physiotherapy utilised in Australian RACFs.

Methods

Registered physiotherapists (n = 219, 72% female, mean age (SD) = 38.6 (12.9) years) working in Australian RACFs participated in a nationwide, cross-sectional online survey. The survey was developed iteratively through a review of the literature and clinical guidelines, consensus of final survey items by an expert panel of five senior physiotherapists and aged care managers. Survey questions related to the characteristics of the physiotherapists (e.g., age, gender, employment status), characteristics of the RACFs (e.g., state, remoteness, sector), the type and scope of physiotherapy provided by respondents, and the availability of equipment and certain spaces (e.g., gyms) in the RACFs that respondents worked in. Survey responses were analysed and presented descriptively. Correlation using Spearman’s rho (ρ) and the associated 95% confidence intervals (CI) were used to determine whether the availability of equipment or space at the RACF was associated with the time dedicated to performing non-Aged Care Funding Instrument (ACFI) tasks.

Results

Common reasons for physiotherapy referral were chronic pain management as per the ACFI framework (89.7%), falls (69.2%), and reduced mobility (35.9%). Rehabilitation or short-term restorative care was provided in only 22.2% of the facilities. The ACFI funded 91.4% of all participants, which limited physiotherapists to low-value chronic pain management including massage and electrical stimulation. Respondents spent 64.5% of their time on ACFI tasks, which equated to 19 h per week. More time was spent on non-ACFI tasks particularly when resistance bands (ρ = 0.28, 95%CI 0.14–0.41) and a dedicated therapy space or gym (ρ = 0.19, 95%CI 0.04–0.33) were available.

Conclusions

The expertise of physiotherapists is currently being under-utilised in Australian RACFs, which may be related to the availability of public funding, equipment, and space for therapy. Therefore, public health policy should address the urgent need for high-value, evidence-based physiotherapy that supports the reablement and independence of older adults living in RACFs.
Evidence underscoring immunological and clinical pathological changes associated with Sarcoptes scabiei infection: synthesis and meta-analysis
Authors: Næsborg-Nielsen Christina , Wilkinson Vicky , Mejia-Pacheco Natalia , Carver Scott
Published: July 2022

Background

Sarcoptes scabiei is one of the most impactful mammalian parasites. There has been much research on immunological and clinical pathological changes associated with S. scabiei parasitism across a range of host species. This rich body of literature is complex, and we seek to bring that complexity together in this study. We first (1) synthesise narrative reviews of immunopathological relationships to S. scabiei infection to construct overarching hypotheses; then (2) undertake a systematic meta-analysis of primary literature on immunological and clinical pathological changes; and lastly (3) contrast our findings from the meta-analysis to our synthesis from narrative reviews.

Methods

We synthesised 55 narrative reviews into two overarching hypotheses representing type I and type IV immune responses to S. scabiei infection. We then systematically extracted all literature reporting immunological variables, acute phase proteins, oxidant/antioxidant status, and erythrocytic, hepatological and nephrological changes, calculating 565 effect sizes between controls and sarcoptic mange affected groupings, refining (simplifying) hypotheses from narrative reviews.

Results

Immunological and clinical pathological parameters were most often studied in dogs (n = 12) and humans (n = 14). Combining immunological and clinical pathological information across mammalian species (n = 19) helped yield general insights into observed disease responses. This is evidenced by interspecific consensus in 27 immunological and clinical pathology variables (6/26 type I hypersensitivity, 3/20 type IV hypersensitivity, 6/10 oxidant/antioxidant status, 3/6 acute phase protein, 4/7 erythrocytic, and 5/10 hepatological/nephrological).

Conclusions

Elevated IgE, eosinophils and mast cells in type I hypersensitivity response corresponded to what was described in narrative reviews. Results from type IV hypersensitivity response suggested typical antibody response, however cell-mediated response was less evident. Some consensus of acute phase protein response and shifted oxidant/antioxidant balance and slight evidence of anemia. We highlight the need for mange/scabies studies to more routinely compare immunological and clinical pathological changes against controls, and include collection of a more standardised suite of variables among studies.
Clinical performance of quantitative PCR for the molecular identification of skeletal tuberculosis from formalin-fixed paraffin-embedded tissues
Authors: He Gang , Chen Chun-yu , Zhang Xin , Ding Pei-pei , Hu Chang-zheng , Huang Xiu-fang , Zhang Xian , Gong Xu , Zhen Pei-lin , Zhang Liang
Published: July 2022

Background

At present, skeletal tuberculosis (TB) diagnosis is mostly by histopathology, but the positivity rate is low. There is a need to develop new methods for the molecular identification of this disorder. Therefore, we aimed to investigate the clinical utility of quantitative PCR (qPCR)-based diagnosis of skeletal TB from formalin-fixed paraffin-embedded (FFPE) tissues and its comparative evaluation with acid-fast bacillus staining (AFS).

Methods

We detected Mycobacterium tuberculosis (M. tuberculosis/MTB) DNA using qPCR and AFS in FFPE tissue samples from 129 patients suspected of having skeletal TB. The sensitivity, specificity as well as area under the curve (AUC) of qPCR and AFS were calculated. Meanwhile, some factors potentially affecting qPCR and AFS results were investigated.

Results

Overall, qPCR outperformed AFS in detecting M. tuberculosis. The AUC of qPCR was higher than that of AFS (0.744 vs.0.561, p < 0.001). Furthermore, decalcification of bone tissues did not affect the sensitivity and specificity of qPCR tests. Whereas it impacted the performance of AFS, decalcification increased AFS's specificity and decreased its sensitivity (p < 0.05). Moreover, qPCR had a significantly larger AUC than AFS in decalcified and non-decalcified groups (0.735/0.756 vs. 0.582/0.534, p < 0.001) respectively. Similarly, the AUC of PCR was more extensive than that of AFS regardless of skeletal TB patients with concomitant pulmonary TB or not (0.929 vs. 0.762; 0.688 vs. 0.524, p < 0.01).

Conclusions

Our data demonstrate that qPCR offers superior accuracy for the detection of mycobacteria in FFPE tissues compared to traditional AFS, indicating its clinical value in osteoarticular TB diagnosis.
Influence of overweight and obesity on perinatal outcomes in assisted reproduction: a retrospective cohort study
Authors: Dornelles Victoria Campos , Hentschke Marta Ribeiro , Badalotti Mariangela , Badalotti-Teloken Isadora , Trindade Vanessa Devens , Cunegatto Bibiana , de Vasconcelos Natália Fontoura , Petracco Alvaro , da Costa Bartira Ercília Pinheiro , Padoin Alexandre Vontobel
Published: July 2022

Background

In spontaneous pregnancies, maternal weight and gestational diabetes are independent risk factors for macrosomia and large-for-gestational-age newborns. Furthermore, maternal body mass index (BMI) of ≥25 kg/m2is associated with worse neonatal vitality, classified as an Apgar score of < 7 at the fifth minute of life. However, few studies have evaluated the influence of BMI on perinatal outcomes in pregnancies resulting from assisted reproduction. Therefore, this study aimed to analyze whether the perinatal outcomes of assisted reproduction are influenced by BMI.

Methods

This was a retrospective cohort study performed at a reproductive medicine center. Patients undergoing assisted reproduction (2013–2020) were divided into three groups according to their BMI (kg/m2): group 1, < 25; group 2, 25–29.9, and group 3, ≥30. In total, 1753 in vitro fertilization embryo transfer cycles were analyzed. Data were expressed as mean ± standard deviation or frequency (%). The analysis of variance and chi-square test were performed for comparison. To determine the participants and number of cycles for these analyses, generalized estimating equations were used, consideringp < 0.05.

Results

In groups 1, 2, and 3, the rates of live birth were 33.5, 32.3, and 29.9% (p = 0.668); preeclampsia were 2.9, 6.1, and 6.3% (p = 0.268); small-for-gestational-age newborns were 23, 23.2, and 21.7% (p = 0.965); macrosomia were 1.9, 0.9, and 2.7% (p = 0.708); Apgar score > 7 at the fifth minute were 97.6, 98.2, and 100% (p = 0.616); and preterm birth were 29.6, 30.1, and 35.1% (p = 0.970), respectively.

Conclusions

In conclusion, although the three groups had similar perinatal outcomes in this study, the study population was too small for conclusive results. The higher the BMI, the lower the chances of clinically relevant LBR and the higher the chances of premature labor and preeclampsia.
Systematic literature review on surgical site preparation in paediatric surgery
Authors: Bielicki Isabella , Subotic Ulrike , Bielicki Julia Anna
Published: July 2022

Background

Surgical site infections (SSIs) in children represent a common and serious postoperative complication. Surgical skin preparation is an essential preventive measure in every surgical procedure. The most commonly used antiseptic agents for surgical skin preparation are chlorhexidine gluconate and iodophors in alcohol-based solutions. In adult patients the use of chlorhexidine-containing antiseptic solutions for preoperative skin preparation has been advocated to reduce SSI rates. Our objective was to conduct a systematic literature review on use of antiseptic agents for surgical skin preparation in children less than 16 years of age.

Methods

A systematic review of MEDLINE, EMBASE, CINAHL and CENTRAL was performed using both MeSH and free text terms and using the relevant Cochrane filter to identify full text randomized trials (RCTs) and comparative observational studies. Interventions of interest were the choice of main agent in antiseptic solutions (chlorhexidine/povidone-iodine/alcohol) compared with each other or with other antiseptic agents. Primary outcome was the reported rate of surgical site infections.

Results

In total 8 studies were included in the review; 2 RCTs and 6 observational studies. Observational studies generally did not primarily investigate the association of different antiseptics with subsequent SSI. The identified randomised controlled trials included only 61 children in total, and were of low quality. Consequently, we did not conduct a formal meta-analysis. Since the publication of a comprehensive systematic review of perioperative measures for the prevention of SSI in 2016, no randomized controlled trials comparing antiseptic agents for surgical skin preparation in paediatric surgery have been conducted.

Conclusion

Robust evidence on the optimal skin antisepsis to reduce SSIs in children is lacking. Direct extrapolation of effects from trials involving adults is not appropriate as physiologic characteristics and risk factors for SSIs differ between adults and children. It is therefore essential to conduct high quality RCT investigating interventions to identify optimal measures to reduce SSI rates in children.

Trial registration

Prospero registration (CRD42020166193).
Psychometric evaluation of the Positive Mental Health (PMH) scale using item response theory
Authors: Vaganian Lusine , Boecker Maren , Bussmann Sonja , Kusch Michael , Labouvie Hildegard , Margraf Jürgen , Gerlach Alexander L. , Cwik Jan C.
Published: July 2022

Background

The investigation of patient-reported outcomes and psycho-oncological interventions mainly focuses on psychological distress or psychopathology. However, the recognition of the equal importance of positive mental health (PMH) has increased lately. The PMH-scale is a brief questionnaire allowing to assess well-being in individuals in the general population and in patients. Previous studies evaluated the psychometric properties of the PMH-scale using classical test theory (CTT). This study is the first to investigate the PMH-scale in patients with cancer using item analysis according to the Rasch model.

Methods

In total, N = 357 cancer patients participated in the study. A Rasch analysis of the PMH-scale was conducted including testing of unidimensionality, local independence, homogeneity and differential item functioning (DIF) with regard to age, gender, type of cancer, the presence of metastases, psycho-oncological support, and duration of disease. Additionally, the ordering of the item thresholds as well as the targeting of the scale were investigated.

Results

After excluding one misfitting item and accounting for local dependence by forming superitems, a satisfactory overall fit to the Rasch model was established (χ2 = 30.34, p = 0.21). The new PMH-8 scale proved to be unidimensional, and homogeneity of the scale could be inferred. All items showed ordered thresholds, there was no further item misfit. DIF was found for age, but as the impact of DIF was not substantial, no adjustment related to the age-DIF had to be made. The Person Separation Index (PSI = 0.89) was excellent, indicating excellent discriminatory power between different levels of positive mental health. Overall, the targeting of the PMH-8 was good for the majority of the present sample. However, at both ends of the scale item thresholds are missing as indicated by a slight floor effect (1.4%) and a considerable ceiling effect (9.8%).

Conclusions

Overall, the results of the analysis according to the Rasch model support the use of the revised PMH-scale in a psycho-oncological context.
Factors contributing to the sharing of COVID-19 health information amongst refugee communities in a regional area of Australia: a qualitative study
Authors: Healey Sunita Joann Rebecca , Ghafournia Nafiseh , Massey Peter D. , Andrich Karinne , Harrison Joy , Taylor Kathryn , Bolsewicz Katarzyna
Published: July 2022

Background

The COVID-19 pandemic has had a disproportionate impact on culturally and linguistically diverse (CALD) groups worldwide. Newly emerging CALD populations formed by recently arrived refugees are predisposed to even greater health disadvantages due to complexities of the refugee experience. The aim of this study was to explore how culture, refugee experiences and existing relationships shaped what COVID-19 messages were listened to and shared during the early-mid phases of the pandemic. The work focused on three newly emerging refugee groups in the Hunter New England region, Australia: Afghan, Congolese and Syrian communities.

Methods

Qualitative, semi-structured interviews were conducted to explore the experiences and stories of 15 adult community members, nine influential members and six service providers. All community members arrived in Australia on or after January 2014. Interpreter-assisted interviews were conducted with small groups or individuals, audio-recorded and transcribed verbatim in English. Three levels of thematic data analysis were employed to uncover the important issues and experiences of the participants.

Results

Three key themes and several subthemes were identified. The themes were: 1) Experience as a refugee uniquely influences COVID-19 message communication; 2) Refugee groups use diverse practices when accessing and sharing COVID-19 messages; and 3) Official government messages could be improved by listening and tailoring to community needs.

Conclusions

Effective health messaging relies on reaching communities in a culturally acceptable and meaningful way. Official COVID-19 messages can be tailored to engage newly emerging communities by improving the quality of the content, delivery and format whilst working collaboratively with communities and trusted service providers. Further mutual research is needed to understand emerging communities’ viewpoints. The use of culturally informed approaches is recommended.
In response to letter to the editor: calcar fracture gapping: a reliable predictor of anteromedial cortical support failure after cephalomedullary nailing for pertrochanteric femur fractures
Authors: Chang Shi-Min , Mao Wei , Li Shi-Jie , Song Hui
Published: July 2022

We appreciate the interest by Drs. Hagiyama and coauthors in our work entitled “Calcar fracture gapping: a reliable predictor of anteromedial cortical support failure after cephalomedullary nailing for pertrochanteric femur fractures”. They discussed several pertinent points and it is our pleasure to respond their concerns in order. Firstly, we agree that calcar fracture gap and anteromedial cortical support are different concepts, though both of them were used to evaluate the displacement of fracture reduction quality. Secondly, our primary outcome parameter was the threshold distance of calcar fracture gapping in anteroposterior and lateral fluoroscopies, which was calculated based on sensitivity and specificity by receiver operating characteristic curves. Thirdly, we took immediate post-operative fluoroscopic images in 3 views to describe the initial reduction quality as baseline to compare and calculate the changes with three-dimensional computed tomography, which was taken about one week after operation for confirming secondary stability after head-neck sliding and impaction. Lastly, the parameters selected in multivariable analysis. Future work with better study-design is needed to improve the prediction of patient outcomes.
Useful vertical latissimus dorsi flap for partial breast reconstruction in every tumor location
Authors: Lee Jong Ho , Ryu Jeong Yeop , Choi Kang Young , Yang Jung Dug , Chung Ho Yun , Cho Byung Chae , Kang Byungju , Lee Jeeyeon , Park Ho Yong , Lee Joon Seok
Published: July 2022

Background

We conducted a prospective cohort study to evaluate effective techniques for breast reconstruction after partial mastectomy due to breast cancer. Determining the method of reconstruction is often difficult as it depends on the location of the cancer and the amount of tissue excised.. Here, we present a new technique, using the vertical latissimus dorsi (LD) flap, that can be used in all partial mastectomies and can almost conceal scarring. We also compared these results to those of the mini LD flap.

Methods

We analyzed the data of a total of 50 and 47 patients, who underwent breast reconstruction with the mini LD flap and the vertical LD flap, respectively. Immediately after tumor excision, breast reconstruction was initiated. The skin flap for vertical LD was designed in a planarian shape, such that it may be hidden as much as possible and minimize bulging during closure, and the LD muscle flap was designed with a sufficient distance in the inferior direction.

Results

Our finding showed that the vertical LD flap group required significantly less total operation time than the mini LD flap group. While the mini-LD flap resulted in a scar that was difficult to conceal, the donor site scar of the vertical LD flap could not be seen easily, and no scar was visible on the back.

Conclusions

The vertical LD flap is useful for partial breast reconstruction, in all breast regions requires a rather small volume of the flap. Moreover, recovery was relatively fast with high patient satisfaction.
Relationship of BMI with the diet, physical activity and oral hygiene practices amongst the dental students
Authors: Alam Beenish Fatima , Abbasi Nabeela , Hussain Talib , Khan Malik Arshman , Chaudhary Muhammad Aamir Ghafoor , Ijaz Faiza
Published: July 2022

Background

Regardless of attaining adequate knowledge regarding oral hygiene, physical activity, and healthy eating habits, dental students still face oral health problems. This study was aimed to assess the association of oral hygiene habits, physical activity, and eating habits with the BMI in the dental students.

Method

This multi centric cross-sectional study was conducted from January to May 2021 in Pakistan. Three hundred and eighty-six study participants enrolled as undergraduate dental students, both males and females, were included in the study. A questionnaire used to gather data, was modified from a study conducted by Jouhar et al. Chi-square testing was used in order to assess the relationship between two categorical variables. Linear regression was performed to assess the association with putative confounders. Statistical significance was considered for p value < 0.05.

Results

Regarding brushing teeth, 57% of the underweight individuals brushed once daily, 69.8% of the healthy, 79.2% of overweight, and 48% of obese participants brushed twice. Horizontal brushing technique was performed by 50% of the underweight participants, followed by scrub technique. A soft bristled brush was frequently used by underweight (42.9%) and healthy (66%) individuals, while a medium textured bristle brush was used by overweight (62.3%) and obese (54.2%) participants. Majority of the underweight (64.3%), overweight (48.1%), and 45.8% of obese individuals had meals thrice a day, while healthy (62.3%) individuals had meals twice a day.

Conclusion

This study further intensified the contributing role of having an excessive dietary intake and sugar consumption in causing obesity and dental caries. Findings from the current study, identify a statistically significant relationship that exists between BMI levels with oral hygiene, eating habits and the physical activity.
The epidemiological survey of Coxiella burnetii in small ruminants and their ticks in western Iran
Authors: Rahravani Maryam , Moravedji Meysam , Mostafavi Ehsan , Mohammadi Mehrdad , Seyfi Hamid , Baseri Neda , Mozoun Mohammad Mahdi , Latifian Mina , Esmaeili Saber
Published: July 2022

Background

Q fever is one of the most important zoonotic diseases caused by Coxiella burnetii. Although Q fever is an endemic disease in Iran, epidemiological data on C. burnetii infection are not yet complete in reservoirs and vectors in some parts of Iran. This survey investigated C. burnetii infection in small ruminants (sheep and goat blood samples) and their ticks in western Iran (Kurdistan province) in 2020. The presence of C. burnetii DNA was identified in these samples by targeting the IS1111 gene using the quantitative PCR (qPCR) method.

Results

Out of 250 blood samples (232 sheep and 18 goats), C. burnetii was detected in two samples (0.8%) belonging to the sheep (0.9%). In addition, 34 of 244 collected ticks (13.9%) from infested animals (244) were positive for C. burnetii infection. The highest prevalence of infection was found in Dermacentor marginatus (18.3%) and Haemaphysalis concinna (12.5%).

Conclusions

The present study showed that ticks could have a possible role in the epidemiology of Q fever in Iran.
Multiplex Epstein-Barr virus BALF2 genotyping detects high-risk variants in plasma for population screening of nasopharyngeal carcinoma
Authors: Miller Jacob A. , Sahoo Malaya K. , Yamamoto Fumiko , Huang ChunHong , Wang Hannah , Zehnder James L. , Le Quynh-Thu , Pinsky Benjamin A.
Published: July 2022

Background

Epstein-Barr Virus (EBV)-associated nasopharyngeal carcinoma (NPC) exhibits unusual geographic restriction despite ubiquitous lifelong infection. Screening programs can detect most NPC cases at an early stage, but existing EBV diagnostics are limited by false positives and low positive predictive value (PPV), leading to excess screening endoscopies, MRIs, and repeated testing. Recent EBV genome-wide association studies (GWAS) suggest that EBV BALF2 variants account for more than 80% of attributable NPC risk. We therefore hypothesized that high-risk BALF2 variants could be readily detected in plasma for once-lifetime screening triage.

Methods

We designed and validated a multiplex genotyping assay to detect EBV BALF2 polymorphisms in human plasma. Targeted next-generation sequencing was used to validate this assay, conduct association studies with clinical phenotype, and longitudinally genotype plasma to assess within-host haplotype stability. We examined the association between NPC and BALF2 haplotypes in a large non-endemic population and three prior EBV GWAS. Finally, we estimated NPC mortality reduction, resource utilization, and cost-effectiveness of BALF2 variant-informed screening using a previously-validated cohort model.

Results

Following analytical validation, the BALF2 genotyping assay had 99.3% concordance with sequencing in a cohort of 24 NPC cases and 155 non-NPC controls. BALF2 haplotype was highly associated with NPC in this non-endemic population (I613V: odds ratio [OR] 7.9; V317M: OR 178.8). No other candidate BALF2 polymorphisms were significantly associated with NPC or hematologic disorders.

Longitudinal genotyping revealed 97.8% within-host haplotype concordance, indicative of lifelong latent infection. In a meta-analysis of 755 NPC cases and 981 non-NPC controls, BALF2 I613V and V317M were significantly associated with NPC in both endemic and non-endemic populations.

Modeled variant-informed screening strategies achieved a 46% relative increase in PPV with 7% decrease in effective screening sensitivity, thereby averting nearly half of screening endoscopies/MRIs among endemic populations in east/southeast Asia.

Conclusions

EBV BALF2 haplotypes are temporally stable within hosts and can be readily detected in plasma via an inexpensive multiplex genotyping assay that offers near-perfect sequencing concordance. In endemic and non-endemic populations, I613V and V317M were highly associated with NPC and could be leveraged to develop variant-informed screening programs that mitigate false positives with small reductions in screening sensitivity.
Posterior intercostal flap: an anatomical study and best flap design
Authors: Elzawawy Ehab M. , Kelada Melad N.
Published: July 2022

Background

Posterior intercostal arteries perforators (PICAPs) and lateral intercostal arteries perforators (LICAPs) are great vascular pedicles. Between the 4th and 11th spaces, they arise from the thoracic aorta. These are large perforators that can be the basis of many flaps. Yet, these perforators are underrated as they are poorly studied and scarcely utilized in plastic reconstructions.

Methods

Twenty (ten males and ten females) adult cadaveric dissections were done on both sides to study the types, locations, and sizes of posterior intercostal perforators to help design flaps based on them in the best possible way. Perforators were assigned into one of 3 topographical zones of the back (medial, intermediate, and lateral).

Results

The skin of the back was divided into 3 vertical zones: medial, intermediate, and lateral. Posterior intercostal arteries perforators (PICAPs) were found in the medial and intermediate zones. Medial zone PICAPs were large and appeared at the medial border of erector spinae (Es). Intermediate zone PICAPs appeared at the lateral border of Es and passed through latissimus dorsi (Ld) before reaching the skin. Lateral zone perforators were branches of lateral intercostal arteries and were divided into 2 types: (1) posterior branches of lateral intercostal perforators: simply named posterior lateral perforators (PLs); they were small and present in most of the spaces, and (2) anterior branches of lateral intercostal perforators (LICAPs): they were large, dominant pedicles and were found mainly in the 4th to the 7th spaces.

Conclusion

PICAPs and LICAPs are constant and of enormous size and run for a great distance in the skin. They can be utilized as any type of flap.
Earbox, an open tool for high-throughput measurement of the spatial organization of maize ears and inference of novel traits
Authors: Oury V. , Leroux T. , Turc O. , Chapuis R. , Palaffre C. , Tardieu F. , Prado S. Alvarez , Welcker C. , Lacube S.
Published: July 2022

Background

Characterizing plant genetic resources and their response to the environment through accurate measurement of relevant traits is crucial to genetics and breeding. Spatial organization of the maize ear provides insights into the response of grain yield to environmental conditions. Current automated methods for phenotyping the maize ear do not capture these spatial features.

Results

We developed EARBOX, a low-cost, open-source system for automated phenotyping of maize ears. EARBOX integrates open-source technologies for both software and hardware that facilitate its deployment and improvement for specific research questions. The imaging platform consists of a customized box in which ears are repeatedly imaged as they rotate via motorized rollers. With deep learning based on convolutional neural networks, the image analysis algorithm uses a two-step procedure: ear-specific grain masks are first created and subsequently used to extract a range of trait data per ear, including ear shape and dimensions, the number of grains and their spatial organisation, and the distribution of grain dimensions along the ear. The reliability of each trait was validated against ground-truth data from manual measurements. Moreover, EARBOX derives novel traits, inaccessible through conventional methods, especially the distribution of grain dimensions along grain cohorts, relevant for ear morphogenesis, and the distribution of abortion frequency along the ear, relevant for plant response to stress, especially soil water deficit.

Conclusions

The proposed system provides robust and accurate measurements of maize ear traits including spatial features. Future developments include grain type and colour categorisation. This method opens avenues for high-throughput genetic or functional studies in the context of plant adaptation to a changing environment.
How a compensated kidney donation program facilitates the sale of human organs in a regulated market: the implications of Islam on organ donation and sale
Authors: Siraj Md. Sanwar
Published: July 2022

Background

Advocates for a regulated system to facilitate kidney donation between unrelated donor-recipient pairs argue that monetary compensation encourages people to donate vital organs that save the lives of patients with end-stage organ failure. Scholars support compensating donors as a form of reciprocity. This study aims to assess the compensation system for the unrelated kidney donation program in the Islamic Republic of Iran, with a particular focus on the implications of Islam on organ donation and organ sales.

Methods

This study reviews secondary documents for philosophical argumentation and ethical analysis of human organ donation and sale for transplantation.

Results and discussion

According to Islamic law, organ donation is an act ofsadaqatul jariyah,and individuals are permitted to donate organs with the intention of saving lives. The commercialization of humans as organ sellers and buyers is contrary to the Islamic legal maximeethaar, undermining donors of ‘selfless’ or ‘altruistic’ motivations. Such an act should be considered immoral, and the practice should not be introduced into other countries for the sake of protecting human dignity, integrity, solidarity, and respect. I, therefore, argue that Iran’s unrelated kidney donation program not only disregards the position of the Islamic religion with respect to the provision or receipt of monetary benefits for human kidneys for transplantation but that it also misinterprets the Islamic legal proscription of the sale of human organs. I also argue that the implementation of Iran’s unrelated kidney donor transplantation program is unethical and immoral in that potential donors and recipients engage in a bargaining process akin to that which sellers and buyers regularly face in regulated commodity exchange markets. Conversely, I suggest that a modest fixed monetary remuneration as a gift be provided to a donor as a reward for their altruistic organ donation, which is permissible by Islamic scholars. This may remove the need to bargain for increased or decreased values of payment in exchange for the organ, as well as the transactional nature of ‘buyer and seller’, ensuring the philosophy of ‘donor and recipient’ is maintained.

Conclusions

Offering a fixed modest monetary incentive to organ donors would serve to increase organ supply while protecting donors’ health and reducing human suffering without legalizing the human organ trade.
Identification of fatty acid metabolism-related lncRNAs in the prognosis and immune microenvironment of colon adenocarcinoma
Authors: Wu Shuang , Gong Yuzhu , Chen Jianfang , Zhao Xiang , Qing Huimin , Dong Yan , Li Sisi , Li Jianjun , Wang Zhe
Published: July 2022

Background

Cancer metabolism is largely altered compared to normal cells. This study aims to explore critical metabolism pathways in colon adenocarcinoma (COAD), and reveal the possible mechanism of their role in cancer progression.

Methods

Expression data and sequencing data of COAD samples were obtained from The Cancer Genome Atlas and Gene Expression Omnibus databases. The expression profiles between tumor and normal samples were compared to identify differential metabolism pathways through single sample gene set enrichment analysis.

Results

Fatty acid synthesis was identified as a key metabolism pathway in COAD. Based on fatty acid-related lncRNAs, two molecular subtypes (C1 and C2) were defined. C2 subtype with worse prognosis had higher immune infiltration and higher expression of immune checkpoints. Five transcription factors (TFs) including FOS, JUN, HIF1A, STAT3 and STAT2 were highly expressed in C2 subtype. Five fatty acid-related lncRNAs were identified to be biomarkers for predicting COAD prognosis. Finally, further experients showed that knockdown of lncRNA PAXIP1-AS1 decreased the triglyceride content and the fatty acid synthase and acetyl-CoA carboxylase 1 expressions, which suggested that lncRNA PAXIP1-AS1 plays an important role in fatty acid metabolism of COAD.

Conclusions

This study demonstrated that fatty acid synthesis was greatly altered in COAD. Fatty acid-related lncRNAs were speculated to be involved in cancer progression through associating with TFs. The five screened TFs may serve as new drug targets for treating COAD.
Protocol for a multi-center randomized controlled trial to evaluate the benefits of exercise incentives and corticosteroid injections in osteoarthritis of the knee (MOVE-OK)
Authors: Leach William , Doherty Caleigh , Olave Marianna , England Bryant R. , Wysham Katherine , Kerr Gail , Quinones Mercedes , Ogdie Alexis , White Dan , Neogi Tuhina , Scanzello Carla R. , Baker Joshua F.
Published: July 2022

Background

Knee osteoarthritis (KOA) is a high-priority problem among the aging population. While exercise has been shown to be beneficial in management of the disease, scalable and low-cost interventions to improve exercise in this population are lacking. Recent controversy over the value of corticosteroid injections for palliation has also arisen. Therefore, we designed a randomized, double-blind, placebo-controlled clinical trial with a 2-period crossover design to study (1) behavioral incentives to promote exercise and (2) corticosteroid injections to reduce pain and improve function in patients with KOA when compared to lidocaine only.

Methods

The study design is a pragmatic factorial and crossover randomized clinical trial. Patients with KOA who are deemed eligible by their provider to receive knee injections and are able to walk without assistive devices will be recruited from clinical practices at four sites within the Veterans Affairs (VA) Health System in the USA. In total, 220 participants will be randomized to receive social incentives with gamification (i.e., incorporation of game elements) to promote exercise and compared to controls that receive a Fitbit but no incentive. Each patient will also be assigned to receive a blinded corticosteroid injection and a lidocaine-only injection in random order. The primary outcomes are the change in average daily step counts from baseline and the change in Knee Osteoarthritis Outcome Score (KOOS) from baseline. The study team will continuously collect step count, heart rate, and sleep data using activity monitors and patient-reported outcomes using the Way to Health (WTH) platform at two four-week intervals over eight months of follow-up. Mixed effects regression incorporating all available data points will be used for analysis.

Discussion

The “Marching on for Veterans with Osteoarthritis of the Knee” (MOVE-OK) trial will take a pragmatic approach to evaluate (1) whether incentives based on behaviorally enhanced gamification can improve physical activity in this patient population and (2) whether corticosteroids injections reduce pain and disability in patients with KOA. Results of this trial will help to direct clinical practice and inform management guidelines.

Trial registration

ClinicalTrials.gov NCT05035810. Registered on 5 September 2021.
Deep learning based on ultrasound images assists breast lesion diagnosis in China: a multicenter diagnostic study
Authors: Gu Yang , Xu Wen , Lin Bin , An Xing , Tian Jiawei , Ran Haitao , Ren Weidong , Chang Cai , Yuan Jianjun , Kang Chunsong , Deng Youbin , Wang Hui , Luo Baoming , Guo Shenglan , Zhou Qi , Xue Ensheng , Zhan Weiwei , Zhou Qing , Li Jie , Zhou Ping , Chen Man , Gu Ying , Chen Wu , Zhang Yuhong , Li Jianchu , Cong Longfei , Zhu Lei , Wang Hongyan , Jiang Yuxin
Published: July 2022

Background

Studies on deep learning (DL)-based models in breast ultrasound (US) remain at the early stage due to a lack of large datasets for training and independent test sets for verification. We aimed to develop a DL model for differentiating benign from malignant breast lesions on US using a large multicenter dataset and explore the model’s ability to assist the radiologists.

Methods

A total of 14,043 US images from 5012 women were prospectively collected from 32 hospitals. To develop the DL model, the patients from 30 hospitals were randomly divided into a training cohort (n = 4149) and an internal test cohort (n = 466). The remaining 2 hospitals (n = 397) were used as the external test cohorts (ETC). We compared the model with the prospective Breast Imaging Reporting and Data System assessment and five radiologists. We also explored the model’s ability to assist the radiologists using two different methods.

Results

The model demonstrated excellent diagnostic performance with the ETC, with a high area under the receiver operating characteristic curve (AUC, 0.913), sensitivity (88.84%), specificity (83.77%), and accuracy (86.40%). In the comparison set, the AUC was similar to that of the expert (p = 0.5629) and one experienced radiologist (p = 0.2112) and significantly higher than that of three inexperienced radiologists (p < 0.01). After model assistance, the accuracies and specificities of the radiologists were substantially improved without loss in sensitivities.

Conclusions

The DL model yielded satisfactory predictions in distinguishing benign from malignant breast lesions. The model showed the potential value in improving the diagnosis of breast lesions by radiologists.
Acute coronary syndrome in an 8-year-old child with familial hypercholesterolemia: a case report
Authors: Wang Nan , Wei Ying , Zhou Gang , Zhang Yue , Song Jiyang
Published: July 2022

Background

Familial hypercholesterolemia (FH) is the most commonly inherited metabolic disease and has an autosomal dominant mode of inheritance. Patients with FH usually present with high levels of low-density lipoprotein-cholesterol, xanthomas and early coronary artery disease. Children with FH are subject to developing early and enhanced atherosclerosis, leading to an increased risk of coronary events. We report here an 8-year-old patient with acute coronary syndrome (ACS) who was diagnosed with homozygous FH (HoFH) due to mutations in the low-density lipoprotein receptor (LDLR) gene and subsequently treated with percutaneous transluminal coronary angioplasty (PTCA) after filtration plasma. To the best of our knowledge, this patient is the youngest case of HoFH treated with filtration plasma followed by PTCA reported to date.

Case presentation

An 8-year-old Asian patient was admitted to Gansu Provincial Hospital presenting symptoms of ACS. Laboratory tests showed that the patient’s cholesterol and low-density lipid levels were extremely high. An electrocardiogram (ECG) revealed sinus arrhythmia and electric axis deviation to the right, but the ECG was roughly normal. Multiple cardiac function abnormalities were diagnosed on the ECG. Multiple sites of coronary artery stenosis were determined by computed tomography angiography. DNA sequencing of exons showed a C-to-A substitution at nucleotide 126 in exon 2, resulting in a LDLR mutation in the patient and seven other family members. Following combination treatment with lipid-lowering drugs, anti-thrombosis drugs, filtration plasma and PTCA, the patient’s symptoms were significantly improved and the patient discharged.

Conclusion

We report the rare case of a patient with ACS attributable to HoFH who was treated with PTCA following filtration plasma. The patient was shown to have clinically diagnosed and molecularly confirmed HoFH that resulted from a mutation in the LDLR gene. Children with HoFH have higher risk of early coronary events and death from myocardial infarction due to premature atherosclerosis than adults. Earlier intervention and treatment will bring great benefits to the long-term survival of pediatric patients.
Recurrent squamous cell carcinoma and a novel mutation in a patient with xeroderma pigmentosum: a case report
Authors: Şahin Ezgi Aysu , Taşkıran Ekim Zihni , Kiper Pelin Özlem Şimşek , Aydın Burça , Utine Eda
Published: July 2022

Background

Xeroderma pigmentosum is an extremely serious genetic disorder defined by sensitivity to sunlight, resulting in sunburn and pigment changes. If patients are not completely protected from ultraviolet radiation, xeroderma pigmentosum is characterized by a greatly increased risk of sunlight-induced cutaneous neoplasms. There is no standard therapy for skin cancer of xeroderma pigmentosum. However, immune checkpoint inhibitors were reported to increase response rates and improve outcomes and life expectancy in patients with various cancers, including squamous cell carcinoma in xeroderma pigmentosum. In this paper, we report on a patient with xeroderma pigmentosum from a consanguineous family with recurrent facial chemotherapy-resistant squamous cell carcinoma lesions treated successfully with an anti-programmed cell death protein 1 monoclonal antibody in both relapses.

Case presentation

A 7-year-old Turkish male was referred to our oncology department for recurring squamous cell carcinoma after local excision of the tumor over his nose. The lesion was a rapidly growing lesion, measuring 8 × 4 cm in size. Physical examination revealed that he also had hemorrhagic crusted plaques and nodules over both eyelids and upper lip, with multiple hypo- and hyperpigmented punctate lesions all over his body. After two more cycles of chemotherapy, progressive disease was noted, and a new lesion on the right eyelid caused blurred vision. Anti-programmed cell death protein 1 antibody treatment was planned with concomitant radiotherapy. He received nivolumab every 3 weeks for 4 months, improving his vision. No new lesions or active complaints have been observed in the current situation, and complete remission has been achieved. On the last admission, the patient was clinically diagnosed with xeroderma pigmentosum. Owing to the condition’s genetic heterogeneity, whole-exome sequencing was performed with Ion Proton next-generation sequencing platform, and the c.2250 + 1G>A splice site mutation of theXPCgene was detected in the homozygous state.

Conclusions

The clinical report emphasizes the importance of clinical awareness and crucial early diagnosis of xeroderma pigmentosum and presents a novel causative homozygous c.2250 + 1G>A splice site mutation. Our case proves that next-generation sequencing is an effective method for the rapid diagnosis and determination of xeroderma pigmentosum genetic etiology.
Retinoic acid and FGF10 promote the differentiation of pluripotent stem cells into salivary gland placodes
Authors: Zhang Siqi , Sui Yi , Yan Shuang , Zhang Yifei , Ding Chong , Su Xiaodong , Xiong Jingwei , Wei Shicheng
Published: July 2022

Background

Salivary glands produce saliva that play essential roles in digestion and oral health. Derivation of salivary gland organoids from pluripotent stem cells (PSCs) provides a powerful platform to model the organogenesis processes during development. A few studies attempted to differentiate PSCs into salivary gland organoids. However, none of them could recapitulate the morphogenesis of the embryonic salivary glands, and most of the protocols involved complicated manufacturing processes.

Methods

To generate PSC-derived salivary gland placodes, the mouse embryonic stem cells were first differentiated into oral ectoderm by treatment with BMP4 on day 3. Retinoic acid and bFGF were then applied to the cultures from day 4 to day 6, followed by a 4-day treatment of FGF10. The PSC-derived salivary gland placodes on day 10 were transplanted to kidney capsules to determine the regenerative potential. Quantitative reverse transcriptase–polymerase chain reaction, immunofluorescence, and RNA-sequencing were performed to identify the PSC-derived SG placodes.

Results

We showed that step-wise treatment of retinoic acid and FGF10 promoted the differentiation of PSCs into salivary gland placodes, which can recapitulate the early morphogenetic events of their fetal counterparts, including the thickening, invagination, and then formed initial buds. The PSC-derived salivary gland placodes also differentiated into developing duct structures and could develop to striated and excretory ducts when transplanted in vivo.

Conclusions

The present study provided an easy and safe method to generate salivary gland placodes from PSCs, which offered possibilities for studying salivary gland development in vitro and developing new cell therapies.