bluuebunny/crossref_metadata_2025 huggingface dataset:
E-voting adoption in many countries: A literature review
Authors: Darmawan Ikhsan
Published: October 2021

Although the number of countries that have adopted e-voting has decreased lately, the number of academic publications on e-voting adoption has increased in the last two years. To date, there is no coherent narrative in the existing literature that explains the progress of the research on e-voting adoption. This article aims to answer the following research question: “How has research on the topic of e-voting adoption progressed over the last 15 years?” The article provides a semi-systematic review of 78 studies that were conducted from 2005 to 2020. In this article, I argue that although the studies on e-voting adoption are dominated by a single case study, by research in the United States, and by the positivist paradigm, scholars have employed the term “e-voting adoption” diversely and the research on e-voting adoption has evolved to address more specific research questions. Recommendations for the future agenda of research on e-voting adoption are also discussed.
Of Caste and Indian Politics: A Detour Through D. L. Sheth and Beyond
Authors: Hegde Sasheej
Published: October 2021

Stemming essentially from D. L. Sheth and the work embodied in his 1999 essay ‘Secularisation of Caste and Making of New Middle Class’, the article attempts to outline the pathways for an alternative engagement with caste and politics. In perspective is what is termed the ‘triumphalist’ mode of encountering caste identities; and, along this course, the extant possibilities of the constructivist understanding of caste are addressed. The stakes of the exercise are largely theoretical and conceptual, although a further thought is thrown in about the contemporary ground of caste politics in India as well.
Enabling Social Justice from Within: Reflections on the Student Voice, Pedagogy of Consciousness and the Idea of the University in Democracy
Authors: Maini Monika
Published: October 2021

The incidences of suicides by students from marginalized communities at Indian public universities indicate that the structural reforms have been insufficient in bringing social justice at universities and the situation demands a change in cognitive structures and processes that can mobilize shift towards just relations at the universities. This article aims to reflect upon pedagogy of consciousness developed by Paulo Freire and argue for its adoption by teachers to develop student voice that has the potential to bring social justice from within the universities. Following the interpretivist paradigm, the idea of the university given by Kant is explored to locate student voice and social justice within the framework of universities. The idea though places voice at core of university teaching learning process, limits its democratic potential by assuming apolitical role of the universities. Therefore, the author elaborates upon pedagogy of consciousness by Paulo Freire, to bring out its relevance in developing voice for social justice and rethinking the idea of the university. Through the analysis of in-depth interviews conducted with teachers and students at University of Delhi, the voices of students citing incidences of structural as well as epistemic injustice in the University are highlighted to develop the link between theory and practice. These voices point towards lack of spaces for expression of dissenting voices and understanding of these voices by teachers and students from privileged backgrounds. The article concludes with illustrating, how pedagogy of consciousness can develop this consciousness enabling praxis of transformation that brings political dissenting voices to the core of the idea of the university in democracy.
Preservice Elementary Teachers and Music in the Elementary Classroom
Authors: Potter Jennifer
Published: October 2021

The purpose of this pretest-posttest study was to investigate elementary preservice teachers’ perceptions of and level of comfort with music in the elementary classroom after enrolling in an online music integration course. Participants were preservice elementary teachers ( N = 93) enrolled in three sections of an online music integration course at a large university in Southern California. Results showed significant differences in participants’ agreement with aspects of music teaching, comfort with music, and music integration. Findings also indicated significant differences in participants’ rankings of musical outcomes in an elementary setting. There were no significant differences found among participants’ ranking of music and other subjects in the elementary classroom.
Quantitative proteomics reveals the effect of Yigu decoction (YGD) on protein expression in bone tissue
Authors: Zhang Ruikun , Yan Kun , Wu Yulun , Yao Xinmiao , Li Guijin , Ge Linpu , Chen Zhineng
Published: October 2021

Background

Osteoporosis (OP) is a systemic bone disease characterized by decreased bone mass, destruction of the bone tissue microstructure, increased bone brittleness and an increased risk of fracture. OP has a high incidence rate and long disease course and is associated with serious complications. Yigu decoction (YGD) is a compound prescription in traditional Chinese medicine that is used to treat OP. However, its mechanism in OP is not clear. This study used a tandem mass tag (TMT)quantitative proteomics method to explore the potential bone-protective mechanism of YGD in an osteoporotic rat model.

Materials and methods

A rat model of OP was established by ovariectomy. Eighteen 12-week-old specific-pathogen-free female Wistar rats weighing 220 ± 10 g were selected. The eighteen rats were randomly divided into 3 groups (n = 6 in each group): the normal, model and YGD groups. The right femurs from each group were subjected to quantitative biological analysis. TMT quantitative proteomics was used to analyze the proteins extracted from the bone tissue of rats in the model and YGD groups, and the differentially expressed proteins after intervention with YGD were identified as biologically relevant proteins of interest. Functional annotation correlation analysis was also performed to explore the biological function and mechanism of YGD.

Result

Compared with the model group, the YGD group showed significant upregulation of 26 proteins (FC > 1.2, P < 0.05) and significant downregulation of 39 proteins (FC < 0.833, P < 0.05). Four important targets involved in OP and 5 important signaling pathways involved in bone metabolism were identified.

Conclusions

YGD can significantly increase the bone mineral density (BMD) of osteoporotic rats and may play a therapeutic role by regulating target proteins involved in multiple signaling pathways. Therefore, these results improve the understanding of the OP mechanism and provide an experimental basis for the clinical application of YGD in OP treatment.
SWATH-MS based quantitive proteomics reveal regulatory metabolism and networks of androdioecy breeding system in Osmanthus fragrans
Authors: Duan Yi-Fan , Zhang Cheng , Zhang Min , Ye Yu , Zhang Kai-Lu , Chen Mo-Xian , Chen Lin , Wang Xian-Rong , Zhu Fu-Yuan
Published: October 2021

Background

The fragrant flower plant Osmanthus fragrans has an extremely rare androdioecious breeding system displaying the occurrence of males and hermaphrodites in a single population, which occupies a crucial intermediate stage in the evolutionary transition between hermaphroditism and dioecy. However, the molecular mechanism of androdioecy plant is very limited and still largely unknown.

Results

Here, we used SWATH-MS-based quantitative approach to study the proteome changes between male and hermaphroditic O. fragrans pistils. A total of 428 proteins of diverse functions were determined to show significant abundance changes including 210 up-regulated and 218 down-regulated proteins in male compared to hermaphroditic pistils. Functional categorization revealed that the differentially expressed proteins (DEPs) primarily distributed in the carbohydrate metabolism, secondary metabolism as well as signaling cascades. Further experimental analysis showed the substantial carbohydrates accumulation associated with promoted net photosynthetic rate and water use efficiency were observed in purplish red pedicel of hermaphroditic flower compared with green pedicel of male flower, implicating glucose metabolism serves as nutritional modulator for the differentiation of male and hermaphroditic flower. Meanwhile, the entire upregulation of secondary metabolism including flavonoids, isoprenoids and lignins seem to protect and maintain the male function in male flowers, well explaining important feature of androdioecy that aborted pistil of a male flower still has a male function. Furthermore, nine selected DEPs were validated via gene expression analysis, suggesting an extra layer of post-transcriptional regulation occurs during O. fragrans floral development.

Conclusion

Taken together, our findings represent the first SWATH-MS-based proteomic report in androdioecy plant O. fragrans, which reveal carbohydrate metabolism, secondary metabolism and post-transcriptional regulation contributing to the androdioecy breeding system and ultimately extend our understanding on genetic basis as well as the industrialization development of O. fragrans.
Hemophagocytic lymphohistiocytosis and thrombotic microangiopathy after parvovirus B19 infection and renal transplantation: a case report
Authors: Steffen C. J. , Koch N. , Eckardt K. U. , Amann K. , Seelow E. , Schreiber A.
Published: October 2021

Background

Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening disease characterized by hyperactivation of the immune system that causes hypercytokinemia and potentially multi organ failure. HLH can occur in patients with underlying rheumatic or autoinflammatory disorders. Additionally, HLH can develop in patients during infections or malignancies without a known genetic predisposition.

Case presentation

We herein report a patient, who presented with fever, both acute kidney and liver injury, anemia, thrombocytopenia and HSV stomatitis. HLH was diagnosed based on clinical criteria and qPCR revealed an acute parvovirus B19 infection as potential underlying infectious trigger. Treatment was started with both IVIG and dexamethasone. Subsequently, kidney biopsy demonstrated TMA.

Conclusions

In rare cases both HLH and aHUS can occur simultaneously in a patient as a consequence of viral infections. Insights from this unusual case might help physicians understand this complex symptom constellation.
Histologic differences between in situ and embolized carotid web thrombi: a case report
Authors: Gao Qun , Hu Shen , Yang Ximeng , Wang Junjie , Lu Jun , Wang Daming
Published: October 2021

Background

The significance of carotid webs (CaWs) in ischemic stroke is becoming acknowledged. Histological features of clot composition in situ and secondary cerebrovascular embolized thrombi caused by CaW have not been described concurrently. Understanding clots’ histological composition is essential for understanding the pathophysiology of clot formation in CaW.

Case presentation

A 50-year-old male patient with acute ischemic stroke, which was believed to be caused by ipsilateral CaW, was admitted to the hospital. Mechanical thrombectomy was used to retrieve thromboemboli from the middle cerebral artery. One month thereafter, the patient underwent carotid endarterectomy, and in situ CaW thrombi were retrieved. Histological analysis by hematoxylin and eosin staining revealed that histopathologic embolized thrombi appeared as typical mixed thrombi, 46.03% fibrin/platelet ratio, 48.12% RBCs, and 5.85% white blood cells. In situ thrombi had a higher fibrin/platelet ratio (68.0%), fewer RBCs (17.2%), and 14.8% white blood cells.

Conclusion

The histopathology of large vessel occlusion stroke embolized thrombi by CaW is similar to that of other stroke etiologies. However, the clot composition of embolized thrombi significantly differs from that of in situ thrombi. CaW’s in situ thrombi showed predominantly fibrin, and embolized thrombi had equivalent contents of red blood cells and fibrin/platelets. Histopathological differences between in situ and embolized thrombi suggest new research directions for the etiology of embolization. Further studies are required to confirm these results.
When a vesicular placenta meets a live fetus: case report of twin pregnancy with a partial hydatidiform mole
Authors: Lin Minhuan , Chen Jinzhu , Liao Bing , He Zhiming , Lin Shaobin , Luo Yanmin
Published: October 2021

Background

Hydatidiform moles exhibit a distinctive gross appearance of multiple vesicles in the placenta. The advances in cytogenetic technologies have helped uncover novel entities of hydatidiform moles and enabled elaborate diagnoses. However, management of a vesicular placenta with a coexistent live fetus poses a bigger challenge beyond hydatidiform moles.

Case presentation

A 33-year-old woman was referred to our department for suspected hydatidiform mole coexistent with a live fetus at 24 weeks’ gestation. The patient had conceived through double embryo transplantation, and first-trimester ultrasonography displayed a single sac. Mid-trimester imaging findings of normal placenta parenchyma admixed with multiple vesicles and a single amniotic cavity with a fetus led to suspicion of a singleton partial molar pregnancy. After confirmation of a normal diploid by amniocentesis and close surveillance, the patient delivered a healthy neonate. Preliminary microscopic examination of the placenta failed to clarify the diagnosis until fluorescence in situ hybridization showed a majority of XXY sex chromosomes. The patient developed suspected choriocarcinoma and achieved remission for 5 months after chemotherapy, but relapsed with suspected intermediate trophoblastic tumor.

Conclusion

We report a rare case of twin pregnancy comprising a partial mole and a normal fetus that resembled a singleton partial molar pregnancy. Individualized care is important in conditions where a vesicular placenta coexists with a fetus. We strongly recommend ancillary examinations in addition to traditional morphologic assessment in such cases.
Sociodemographic characteristics and disability pensions of frequent attenders in occupational health primary care – a follow-up study in Finland
Authors: Reho Tiia , Atkins Salla , Korhonen Mikko , Siukola Anna , Sumanen Markku , Viljamaa Mervi , Uitti Jukka , Sauni Riitta
Published: October 2021

Background

Work disability is a complex issue that requires preventive efforts from healthcare systems and individuals, and that too often results in disability pensions (DP). While many studies have attempted to characterize risk factors of work disability, many showing for example a link between socioeconomic positions, working conditions and frequent attendance to OH primary care it is not known if frequent attendance is associated with DP despite the sociodemographic factors. This study aims to address this gap and examine the association between frequent attendance to OH primary care and DP, when adjusted by sociodemographic factors.

Methods

This study combines routine medical record data of an occupational health service provider with comprehensive national registers. Medical record data were used to define groups of frequent attenders to OH primary care (FA) (1-year-FA, 2-year-FA, persistent-FA and non-FA) from 2014 to 2016. The sociodemographic factors (including i.e. educational level, occupational class, unemployment periods) were derived from Statistic Finland and DP decisions were derived from Finnish Centre for Pensions. Association of frequent attendance to OH primary care with DP decisions were analyzed and adjusted by sociodemographic factors.

Results

In total, 66,381 patients were included. Basic and intermediate education along with manual and lower non-manual work predicted frequent attendance to OH primary care. Unemployment in 2013 did not predict frequent attendance to OH primary care. Frequent attendance to OH primary care was associated with DP within next two years, even when adjusted for sociodemographic factors. The association of frequent attendance to OH primary care with DP grew stronger as high service use persisted over time.

Conclusions

Frequent attendance to OH primary care is associated with DP risk in the near future despite the underlying sociodemographic differences. Patients using OH primary care services extensively should be identified and rehabilitative needs and measures necessary to continue in the work force should be explored. Sociodemographic issues that co-exist should be explored and considered when planning interventions.
The impact of teenage pregnancy on school dropout in Brazil: a Bayesian network approach
Authors: Cruz Emerson , Cozman Fabio Gagliardi , Souza Wilson , Takiuti Albertina
Published: October 2021

Background

As reported by the World Health Organization, adolescent pregnancy is a major public health concern given its impact on the life of mothers and their family members. In this study we investigated possible cause-effect relations between teenage pregnancy and school dropout, and other attributes that gravitate around them, using the Bayesian network approach.

Methods

We used a database prepared by the Adolescent House Project and invited experts in the areas of Health, Education and Social Assistance to answer a survey containing questions aimed at detecting possible causal relationships. To perform the statistical analysis and the numerical simulations we employed the language and formalism of Bayesian networks.

Results

The analysis indicated a strong cause-effect relation between teenage pregnancy and school dropout, bolstered by economic vulnerability. We were able to identify the profile of the female teenager who drops out from school: white girls older than 15 years who got pregnant at least once, are not working to generate an income, and who belong to the group where the family income is less than or equal to US$780 per month. Also we detected the “maternal impact factor", i.e., the effect caused by whether or not the mothers of the teenagers have experienced teenage pregnancy.

Conclusion

There are many factors that lead teenagers to drop out of school; we confirmed not only the commonsense notion that pregnancy of the teenager is a major factor but found that a history of teenage pregnancy on the part of the mother is a major factor. Moreover, Bayesian networks emerged as an interesting mathematical framework to perform the statistical analysis.
Innate lymphoid cells exhibited IL-17-expressing phenotype in active tuberculosis disease
Authors: Pan Linyue , Chen Xiaoli , Liu Xuanqi , Qiu Wenjia , Liu Yunhuan , Jiang Weiping , Zheng Yang , Mou Yan , Xu Wei , Li Xiangyang , Ge Haiyan , Zhu Huili
Published: October 2021

Background

Innate lymphoid cells (ILCs), as an important group of innate immunity, could respond rapidly to Mycobacterium tuberculosis (Mtb) infection. In this research, we studied the phenotypic changes of circulatory ILCs in active tuberculosis (TB) disease.

Methods

We recruited 40 patients with active Mtb infection (TB group) and 41 healthy subjects (NC group), and collected their clinical information and peripheral blood. Circulating ILCs, ILC subsets, dendritic cells (DCs), macrophages, and the production of cytokines in ILCs were tested by flow cytometry (FCM). Enzyme-linked immunosorbent assay (ELISA) was used to detect plasma IL-23.

Results

Compared with healthy control, total ILCs (0.73% vs. 0.42%, P = 0.0019), ILC1 (0.55% vs. 0.31%, P = 0.0024) and CD117+ ILC2 (0.02% vs. 0.01%, P = 0.0267) were upregulated in TB group. The total IL-17+ lymphocytes were elevated (3.83% vs. 1.76%, P = 0.0006) while the IL-22+ lymphocytes remained unchanged. Within ILC subsets, ILC3, CD117+ ILC2 and ILC1 in TB group all expressed increased IL-17 (15.15% vs. 4.55%, 19.01% vs. 4.57%, 8.79% vs. 3.87%, P < 0.0001) but similar IL-22 comparing with healthy control. TB group had more plasma IL-23 than NC group (7.551 vs. 5.564 pg/mL, P = 0.0557). Plasma IL-23 in TB group was positively correlated to IL-17+ ILC3 (r = 0.4435, P = 0.0141), IL-17+CD117+ ILC2 (r = 0.5385, P = 0.0021) and IL-17+ ILC1(r = 0.3719, P = 0.0430). TB group also had elevated DCs (9.35% vs. 6.49%, P < 0.0001) while macrophages remained unchanged. Within TB group, higher proportion of IL-17+ ILCs was related to severer inflammatory status and poorer clinical condition.

Conclusions

In active TB disease, circulatory ILCs were upregulated and exhibited IL-17-expressing phenotype. This may expand the understanding of immune reaction to Mtb infection.
What is the impact of scoliotic correction on postoperative shoulder imbalance in severe and rigid scoliosis
Authors: Yuan Shuo , Fan Ning , Hai Yong , Wu Qichao , Du Peng , Zang Lei
Published: October 2021

Background

Although recent studies have investigated the risk factors for PSI, few studies have focused on the impact of scoliotic correction on postoperative shoulder imbalance (PSI), especially in severe and rigid scoliosis (SRS). The purpose of the study was to study the effect of scoliotic correction on PSI in SRS.

Methods

The preoperative, postoperative, and minimum 2-year follow-up radiographs of 48 consecutive patients with SRS who underwent posterior spinal fusion surgery were evaluated. We regarded radiographic shoulder height (RSH) as a shoulder balance parameter and divided the patients into improved and aggravated groups of PSI from pre- to post-operation and from post-operation to last follow-up, respectively. In addition, patients were divided into nine groups based on the observed changes in PSI after surgery and at follow-up, and the correction rate ratios were calculated among the groups. Independent samples T test and Chi-squared test were performed between the improved and aggravated groups of PSI.

Results

After surgery, the proximal thoracic curve (PTC) flexibility (P = 0.040), correction rate of the main thoracic curve (MTC) (P = 0.010), and Cobb angle of the lumbar curve (LC) (P = 0.037) were significantly higher, while the ratio of the correction rate of the PTC to the MTC (P = 0.042) was smaller in the aggravated group. At follow-up, the improved group had significantly larger PTC flexibility (P = 0.006), larger ratio of the correction rate of PTC to MTC (P = 0.046), a larger ratio correction rate of PTC to LC (P = 0.027), and a smaller correction rate of LC (P = 0.030). The correction rate ratios of the groups after surgery were as follows: negative to negative (N-N) (1.08) > negative to balance (N-B) (0.96) > negative to positive (N-P) (0.67), B-N (1.26) > B-B (0.94) > B-P (0.89), and P-N (0.34) > P-P (0.83). The order of the correction rate ratio at follow-up was as follows: N-N (0.96) > N-B (0.51), B-B (0.97) > B-P (0.90), and P-B (0.87) > P-P (0.84).

Conclusion

Harmonizing the correction rate ratio of the PTC, MTC, and LC should be recommended for intraoperative correction and postoperative compensation of PSI. In addition, greater PTC flexibility plays an important role in the spontaneous correction and compensation of PSI in SRS.
Presepsin as a predictor of septic shock in patients with urinary tract infection
Authors: Sekine Yoshitaka , Kotani Kazuhiko , Oka Daisuke , Nakayama Hiroshi , Miyazawa Yoshiyuki , Syuto Takahiro , Arai Seiji , Nomura Masashi , Koike Hidekazu , Matsui Hiroshi , Shibata Yasuhiro , Murakami Masami , Suzuki Kazuhiro
Published: October 2021

Background

Recently, presepsin has been reported to be a useful biomarker for early diagnosis of sepsis and evaluation of prognosis in septic patients. However, few reports have evaluated its usefulness in patients with urinary tract infections (UTI). This study aimed to evaluate whether presepsin could be a valuable marker for detecting severe sepsis, and whether it could predict the therapeutic course in patients with UTI compared with markers already used: procalcitonin (PCT) and C-reactive protein (CRP).

Methods

From April 2014 to December 2016, a total of 50 patients with urinary tract infections admitted to Gunma university hospital were enrolled in this study. Vital signs, presepsin, PCT, CRP, white blood cell (WBC) count, causative agents of urinary-tract infections, and other data were evaluated on the enrollment, third, and fifth days. The patients were divided into two groups: with (n = 11) or without (n = 39) septic shock on the enrollment day, and with (n = 7) or without (n = 43) sepsis on the fifth day, respectively. Presepsin was evaluated as a biomarker for systemic inflammatory response syndrome (SIRS) or septic shock.

Results

Regarding the enrollment day, there was no significant difference of presepsin between the SIRS and non-SIRS groups (p = 0.276). The median value of presepsin (pg/mL) was significantly higher in the septic shock group (p < 0.001). Multivariate logistic regression analysis showed that presepsin (≥ 500 pg/ml) was an independent risk factor for septic shock (p = 0.007). ROC curve for diagnosing septic shock indicated an area under the curve (AUC) of 0.881 for presepsin (vs. 0.690, 0.583, and 0.527 for PCT, CRP and WBC, respectively). Regarding the 5th day after admission, the median presepsin value on the enrollment day was significantly higher in the SIRS groups than in the non-SIRS groups (p = 0.006). On the other hand, PCT (≥ 2 ng/ml) on the enrollment day was an independent risk factor for SIRS. ROC curve for diagnosing sepsis on the fifth day indicated an AUC of 0.837 for PCT (vs. 0.817, 0.811, and 0.802 for presepsin, CRP, and WBC, respectively).

Conclusions

This study showed that presepsin may be a good marker for diagnosing septic shock based on admission data in patients with UTI.
Effects of early geometric confinement on the transcriptomic profile of human cerebral organoids
Authors: Sen Dilara , Voulgaropoulos Alexis , Keung Albert J.
Published: October 2021

Background

Human cerebral organoids (hCO) are attractive systems due to their ability to model important brain regions and transcriptomics of early in vivo brain development. To date, they have been used to understand the effects of genetics and soluble factors on neurodevelopment. Interestingly, one of the main advantages of hCOs are that they provide three dimensionality that better mimics the in vivo environment; yet, despite this central feature it remains unclear how spatial and mechanical properties regulate hCO and neurodevelopment. While biophysical factors such as shape and mechanical forces are known to play crucial roles in stem cell differentiation, embryogenesis and neurodevelopment, much of this work investigated two dimensional systems or relied on correlative observations of native developing tissues in three dimensions. Using hCOs to establish links between spatial factors and neurodevelopment will require the use of new approaches and could reveal fundamental principles of brain organogenesis as well as improve hCOs as an experimental model.

Results

Here, we investigated the effects of early geometric confinements on transcriptomic changes during hCO differentiation. Using a custom and tunable agarose microwell platform we generated embryoid bodies (EB) of diverse shapes mimicking several structures from embryogenesis and neurodevelopment and then further differentiated those EBs to whole brain hCOs. Our results showed that the microwells did not have negative gross impacts on the ability of the hCOs to differentiate towards neural fates, and there were clear shape dependent effects on neural lineage specification. In particular we observed that non-spherical shapes showed signs of altered neurodevelopmental kinetics and favored the development of medial ganglionic eminence-associated brain regions and cell types over cortical regions. Transcriptomic analysis suggests these mechanotransducive effects may be mediated by integrin and Wnt signaling.

Conclusions

The findings presented here suggest a role for spatial factors in brain region specification during hCO development. Understanding these spatial patterning factors will not only improve understanding of in vivo development and differentiation, but also provide important handles with which to advance and improve control over human model systems for in vitro applications.
Early childhood caries, primary caregiver oral health knowledge and behaviours and associated sociological factors in Australia: a systematic scoping review
Authors: Andrew Lesley , Wallace Ruth , Wickens Nicole , Patel Jilen
Published: October 2021

Background

Early childhood caries disproportionately affects vulnerable groups and remains a leading cause of preventable hospital admissions for Western Australian children. The Western Australia State Oral Health Plan seeks to improve child oral health through universal and targeted health promotion initiatives with primary caregivers. These initiatives require evidence of primary caregiver oral health knowledge and behaviours and baseline data on early childhood caries. The objective of this systematic scoping review was to understand current oral health knowledge and practices of primary caregivers of children aged 0–4 years, identify influential socioecological determinants, and identify data on early childhood caries in the Western Australian context.

Methods

A systematic scoping review framework identified articles published between 2010 and 2021, using Scopus, PubMed, Medline, CINAHL, PsycINFO, selected article reference lists, and oral health websites. The lack of Western Australian specific literature prompted the inclusion of Australia-wide articles. Articles were screened via author consensus, with eight selected.

Results

Western Australia and nation-wide data on early childhood caries are limited and mostly dated. WA data from children aged 2–3 years, collected in 2006, suggests the prevalence is 2.9% in this state, with national data of children from 0 to 3 years, collected from 2006 and 2008, suggesting an early childhood caries prevalence of 3.4–8% of children aged 18 months, rising sharply by 36 months of age. Nationally, fewer than half the primary caregivers reported following evidence-based oral health recommendations for their young children. Perceptions of the role of dental services for young children tends to be focussed on treatment, rather than surveillance and prevention. Knowledge of dietary and oral hygiene practices is inconsistent and awareness of the Child Dental Benefit Schedule low. Young children’s oral health status is clearly associated with socioecological factors, including socioeconomic status.

Conclusions

Recent early childhood caries data and evidence of primary care-givers’ oral health knowledge and behaviours are unavailable in Western Australia, a similar situation exists nationwide. To realise the Western Australian and National Oral Health Plans, research is required to address this knowledge gap.
Challenges of peer assisted learning in online clinical skills training of ophthalmology module
Authors: Nisar Sumera , Mahboob Usman , Khan Rehan Ahmed , Rehman Durraiz
Published: October 2021

Background

Online communication has taken over in the last 2 years due to the frequent lockdowns because of the COVID-19 pandemic. Overburdened physicians in this pandemic are struggling to get enough time to teach clinical skills online to the students. Also, due to student’s safety issues, the students cannot fully attend the clinics. Therefore, in this scenario, online PAL (Peer Assisted Learning) sessions for clinical skill teaching and learning can be an effective alternative for undergraduate medical students. The academic limitations caused by the COVID-19 related lockdown however can have a pleasurable outcome if certain challenges, related to online PAL, are overcome. Therefore, the present study aims to identify the challenges of Peer Assisted Learning (PAL) sessions during online clinical skills training in the Ophthalmology module of undergraduate medical students.

Methods

This qualitative exploratory study, utilizing online focus group discussions to explore the challenges of online PAL in training and learning of clinical skills were carried at the Ophthalmology department of Batterjee Medical College, Jeddah; Saudi Arabia. A purposive convenient sampling technique was used to collect data. Data were transcribed and analyzed using thematic analysis.

Results

The study identified six themes that were further divided into smaller subthemes. The subthemes derived from the collected data were organized under the following major themes; infrastructure, learning environment, psychological problems, interaction deficit, learning desires, and desire for feedback on performance. The major challenge reported by the medical student during online PAL sessions was infrastructure in terms of network connection, scheduling, and timing of the session. The unprofessional learning environment, psychological problems in terms of behavioral issues and personality changes, interaction deficit with peers, tutor, and patient, learning desires, and desire for feedback on performance were the other important challenges faced by the students.

Conclusion

The challenges explored by our study can be used by the medical educators to incorporate online PAL as an effective, efficient, and alternative teaching and learning modality in the curriculum especially in compromised circumstances like the current COVID-19 pandemic.
Impact of universal home visits on child health in Bauchi State, Nigeria: a stepped wedge cluster randomised controlled trial
Authors: Omer Khalid , Joga Altine , Dutse Umar , Hasan Khalid , Aziz Amar , Ansari Umaira , Gidado Yagana , Baba Muhd Chadi , Gamawa Adamu Ibrahim , Mohammad Rilwanu , Andersson Neil , Cockcroft Anne
Published: October 2021

Background

Nigeria is the second biggest contributor to global child mortality. Infectious diseases continue to be major killers. In Bauchi State, Nigeria, a stepped wedge cluster randomised controlled trial tested the health impacts of universal home visits to pregnant women and their spouses. We present here the findings related to early child health.

Methods

The home visits took place in eight wards in Toro Local Government Authority, randomly allocated into four waves with a delay of 1 year between waves. Female and male home visitors visited all pregnant women and their spouses every 2 months during pregnancy, with a follow up visit 12–18 months after the birth. They presented and discussed evidence about household prevention and management of diarrhoea and immunisation. We compared outcomes among children 12–18 months old born to mothers visited during the first year of intervention in each wave (intervention group) with those among children 12–18 months old pre-intervention in subsequent waves (control group). Primary outcomes included prevalence and management of childhood diarrhoea and immunisation status, with intermediate outcomes of household knowledge and actions. Generalised Estimating Equations (GEE), with an exchangeable correlation matrix and ward as cluster, tested the significance of differences in outcomes.

Results

The analysis included 1796 intervention and 5109 control children. In GEE models including other characteristics of the children, intervention children were less likely to have suffered diarrhoea in the last 15 days (Odds Ratio (OR) 0.40, 95% confidence interval (CI) 0.30–0.53) and more likely to have received increased fluids and continued feeding in their last episode of diarrhoea (OR 6.06, 95% CI 2.58–14.20). Mothers of intervention children were more likely to identify lack of hygiene as a cause of diarrhoea (OR 2.24, 95% CI 1.27–3.95) and their households had better observed hygiene (OR 3.29, 95% CI 1.45–7.45). Intervention children were only slightly more likely to be fully immunised (OR 1.67, 95% CI 0.78–3.57).

Conclusions

Evidence-based home visits to both parents stimulated household actions that improved prevention and management of childhood diarrhoea. Such visits could help to improve child health even in settings with poor access to quality health services.

Trial registration

ISRCTN82954580. Date: 11/08/2017. Retrospectively registered.
Association of MTHFR C677T variant genotype with serum folate and Vit B12 in Iranian patients with colorectal cancer or adenomatous polyps
Authors: Ghorbani Mahla , Azghandi Marjan , Khayami Reza , Baharara Javad , Kerachian Mohammad Amin
Published: October 2021

Background

The incidence of colorectal cancer (CRC) has increased during recent years in Iran and other developing countries. Clinical studies suggest that essential folate dietary intake and moderate deficiency of methylenetetrahydrofolate reductase (MTHFR) may protect and reduce the risk of CRC. The present study aimed to investigate the clinical significance of C677T polymorphism within the MTHFR gene and its correlation with the serum folate and Vit B12 in the Iranian population suffering from CRC.

Methods

Blood samples were taken from 1017 Iranian individuals (517 cases and 500 controls) who were referred for colonoscopy. TaqMan probe assay was performed for C677T MTHFR polymorphism. Sera were fractionated from the blood samples of 43 patients and controls and folate and Vit B12 concentrations were measured by a monobind kit. The correlation of MTHFR polymorphisms and folate/vitamin-B12 with CRC risk was analyzed.

Results

In the current study, we found the frequency of three different genotypes of MTHFR polymorphism in the Iranian population i.e., CC, CT, and TT, to be 51.31, 26.73, 21.96 and 61, 32.2, 6.8 in case and control groups, respectively. The homozygote genotype of MTHFR rs1801133 polymorphism is associated with an increased risk of CRC by 3.68, 1.42, and 3.74-fold in codominant, dominant, and recessive models respectively (p value < 0.01). Our study revealed that there was no significant difference between the amount of folate and Vit B12 in the case and control groups (p value > 0.05).

Conclusions

This study revealed that there was no significant difference between the amount of folate and Vit B12 in the case and control groups. Furthermore, our results demonstrated a higher risk association for 677TT and 677TT + C677T genotypes of MTHFR compared with 677CC carriers among CRC patients.
Analyzing the whole-transcriptome profiles of ncRNAs and predicting the competing endogenous RNA networks in cervical cancer cell lines with cisplatin resistance
Authors: Lv Huimin , Jin Shanshan , Zou Binbin , Liang Yuxiang , Xie Jun , Wu Suhui
Published: October 2021

Background

Cervical cancer (CC) is one of the most common malignant tumors in women. In order to identify the functional roles and the interaction between mRNA and non-coding RNA (ncRNA, including lncRNA, circRNA and miRNA) in CC cisplatin (DDP) resistance, the transcription profile analysis was performed and a RNA regulatory model of CC DDP resistance was proposed.

Methods

In this study, whole-transcriptome sequencing analysis was conducted to study the ncRNA and mRNA profiles of parental SiHa cells and DDP resistant SiHa/DDP cells. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were performed for pathway analysis based on the selected genes with significant differences in expression. Subsequently, ceRNA network analyses were conducted using the drug resistance-related genes and signal-transduction pathways by Cytoscape software. Furthermore, a ceRNA regulatory pathway, namely lncRNA-AC010198.2/hsa-miR-34b-3p/STC2, was selected by RT-qPCR validation and literature searching. Further validation was done by both dual-luciferase reporter gene assays and RNA pull-down assays. Besides that, the changes in gene expression and biological function were further studied by performing si-AC010198.2 transfection and DDP resistance analyses in the SiHa and SiHa/DDP cells, respectively.

Results

Using bioinformatics and dual-luciferase reporter gene analyses, we found that AC010198.2/miR-34b-3p/STC2 may be a key pathway for DDP resistance in CC cells. Significant differences in both downstream gene expression and the biological function assays including colony formation, migration efficiency and cell apoptosis were identified in AC010198.2 knockdown cells.

Conclusions

Our study will not only provide new markers and potential mechanism models for CC DDP resistance, but also discover novel targets for attenuating it.
EF24 exerts cytotoxicity against NSCLC via inducing ROS accumulation
Authors: Chang Minghui , Shang Ming , Yuan Fang , Guo Wei , Wang Cuijuan
Published: October 2021

Background

The role of Diphenyldifluoroketone (EF24), a synthetic analogue of curcumin with noteworthy antitumor potential, remains unclear in non-small cell lung cancer (NSCLC). Herein, the inhibitory effect of EF24 on NSCLC and its mechanism were studied.

Methods

Cytotoxicity was measured by MTT assay, colony formation assay and xenograft model. Cell apoptosis and reactive oxygen species (ROS) level were quantified by flow cytometer. Protein level was detected by western blot assay. Mitochondria and autophagosomes were observed using transmission electron microscope and confocal microscopy.

Results

In-vitro, EF24 significantly induced proliferation inhibition, apoptosis, mitochondrial fission and autophagy of NSCLC cell lines. These cytotoxic effects were significantly attenuated by two reactive oxygen species (ROS) scavengers, indicating its anti-cancer effects largely depend on ROS accumulation. In-vivo, EF24 inhibited tumor growth in a dose-dependent manner. Moreover, no pathological changes of heart, lung, spleen, kidney and liver of mice were observed. Collectively, EF24 induced ROS accumulation, in turn activates cell apoptosis, and then exerts its cytotoxicity on NSCLC cells.

Conclusions

The results showed that EF24 exerted cytotoxicity against NSCLC via ROS accumulation. Thus, EF24 might serve as a potential anti-cancer agent for the treatment of NSCLC.
FAM49B promotes breast cancer proliferation, metastasis, and chemoresistance by stabilizing ELAVL1 protein and regulating downstream Rab10/TLR4 pathway
Authors: Li Yanhui , Xiong Yue , Wang Zhen , Han Jianjun , Shi Sufang , He Jinglan , Shen Na , Wu Wenjuan , Wang Rui , Lv Weiwei , Deng Yajun , Liu Weiguang
Published: October 2021

Background

Breast cancer (BC) is one of the most common cancers and the leading cause of death in women. Previous studies have demonstrated that FAM49B is implicated in several tumor progression, however, the role and mechanism of FAM49B in BC remain to be explored. Therefore, in this study, we aimed to systematically study the role of FAM49B in the proliferation, metastasis, apoptosis, and chemoresistance of BC, as well as the corresponding molecular mechanisms and downstream target.

Methods

The ONCOMINE databases and Kaplan–Meier plotter databases were analyzed to find FAM49B and its prognostic values in BC. FAM49B expression in BC and adjacent non-tumor tissues was detected by western blot and IHC. Kaplan–Meier analysis was used to identify the prognosis of BC patients. After FAM49B knockdown in MCF-7 and MDA-MB-231 cells, a combination of co-immunoprecipitation, MTT, migration, and apoptosis assays, nude mouse xenograft tumor model, in addition to microarray detection and data analysis was used for further mechanistic studies.

Results

In BC, the results showed that the expression level of FAM49B was significantly higher than that in normal breast tissue, and highly expression of FAM49B was significantly positively correlated with tumor volume, histological grade, lymph node metastasis rate, and poor prognosis. Knockdown of FAM49B inhibited the proliferation and migration of BC cells in vitro and in vivo. Microarray analysis revealed that the Toll-like receptor signaling pathway was inhibited upon FAM49B knockdown. In addition, the gene interaction network and downstream protein validation of FAM49B revealed that FAM49B positively regulates BC cell proliferation and migration by promoting the Rab10/TLR4 pathway. Furthermore, endogenous FAM49B interacted with ELAVL1 and positively regulated Rab10 and TLR4 expression by stabilizing ELAVL1. Moreover, mechanistic studies indicated that the lack of FAM49B expression in BC cells conferred more sensitivity to anthracycline and increased cell apoptosis by downregulating the ELAVL1/Rab10/TLR4/NF-κB signaling pathway.

Conclusion

These results demonstrate that FAM49B functions as an oncogene in BC progression, and may provide a promising target for clinical diagnosis and therapy of BC.
Time to scale up molecular surveillance for anti-malarial drug resistance in sub-saharan Africa
Authors: Nsanzabana Christian
Published: October 2021

Artemisinin resistance has emerged and spread in the Greater Mekong Sub-region (GMS), followed by artemisinin-based combination therapy failure, due to both artemisinin and partner drug resistance. More worrying, artemisinin resistance has been recently reported and confirmed in Rwanda. Therefore, there is an urgent need to strengthen surveillance systems beyond the GMS to track the emergence or spread of artemisinin and partner drug resistance in other endemic settings. Currently, anti-malarial drug efficacy is monitored primarily through therapeutic efficacy studies (TES). Even though essential for anti-malarial drug policy change, these studies are difficult to conduct, expensive, and may not detect the early emergence of resistance. Additionally, results from TES may take years to be available to the stakeholders, jeopardizing their usefulness. Molecular markers are additional and useful tools to monitor anti-malarial drug resistance, as samples collected on dried blood spots are sufficient to monitor known and validated molecular markers of resistance, and could help detecting and monitoring the early emergence of resistance. However, molecular markers are not monitored systematically by national malaria control programmes, and are often assessed in research studies, but not in routine surveillance. The implementation of molecular markers as a routine tool for anti-malarial drug resistance surveillance could greatly improve surveillance of anti-malarial drug efficacy, making it possible to detect resistance before it translates to treatment failures. When possible, ex vivo assays should be included as their data could be useful complementary, especially when no molecular markers are validated.
The relative importance of households as a source of variation in child malnutrition: a multilevel analysis in India
Authors: Jain Anoop , Rodgers Justin , Kim Rockli , Subramanian S. V.
Published: October 2021

Background

Child malnutrition remains a major public health issue in India. Along with myriad upstream and social determinants of these adverse outcomes, recent studies have highlighted regional differences in mean child malnutrition rates. This research helps policy makers look between urban and rural communities and states to take a population-level approach to addressing the root causes of child malnutrition. However, one gap in this between-population approach has been the omission of households as a unit of analysis. Households could represent important sources of variation in child malnutrition within communities, districts, and states.

Methods

Using the fourth round of India’s National Family Health Survey from 2015 to 2016, we analyzed four and five-level multilevel models to estimate the proportion of variation in child malnutrition attributable to states, districts, communities, households, and children.

Results

Overall, we found that of the four levels that children were nested in (households, communities, districts, and states), the greatest proportion of variation in child height-for-age Z score, weight-for-age Z score, weight-for-height Z score, hemoglobin, birthweight, stunting, underweight, wasting, anemia, and low birthweight was attributable to households. Furthermore, we found that when the household level is omitted from models, the variance estimates for communities and children are overestimated.

Conclusions

These findings highlight the importance of households as an important source of clustering and variation in child malnutrition outcomes. As such, policies and interventions should address household-level social determinants, such as asset and social deprivations, in order to prevent poor child growth outcomes among the most vulnerable households in India.