bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical Student Perception of Lifestyle Medicine and Willingness to Engage in Lifestyle Counseling: A Pilot Study of Allopathic and Osteopathic Medical Students
Authors: Lee Jenny Sunghyun , Xierali Imam M. , Jaini Paresh Atu , Jetpuri Zaiba , Papa Frank
Published: April 2021

Introduction. This study assessed medical students’ perception of lifestyle medicine and readiness to engage in lifestyle counseling. Methods. All medical students in one allopathic and one osteopathic medical school received a survey involving items designed to measure their awareness and interest in lifestyle medicine, perception of physicians serving as lifestyle role models for patients, and intent to practice lifestyle counseling. Results. Two hundred and eight-nine subjects (145 allopathic and 144 osteopathic students) responded to the survey. A total of 24.1% of responding allopathic students had heard about lifestyle medicine compared with 53.9% of responding osteopathic students ( P < .01). A total of 90.5% of allopathic students rated their current knowledge of lifestyle medicine as inadequate or poor compared with 78.7% of osteopathic students ( P < .01). Ninety-two percent of all respondents wanted to learn more about lifestyle medicine, while 95.2% believed they would provide more effective counseling if they were trained sufficiently to serve as a healthy lifestyle role model for their patients. Conclusions. Both cohorts favored learning more about lifestyle medicine and believed physicians should provide lifestyle counseling to patients with chronic diseases. Given these findings, and the demonstrated benefits of lifestyle medicine–based health care, the authors suggest that training in lifestyle medicine be increased in undergraduate medical education.
The functional vascular anatomy of the swine for research
Authors: Edwards Joseph , Abdou Hossam , Patel Neerav , Madurska Marta J , Poe Kelly , Bonin Janet E , Richmond Michael J , Rasmussen Todd E , Morrison Jonathan J
Published: April 2021

Objectives

Swine ( Sus Scrofa) are utilized broadly in research settings, given similarities to human vessel size and function; however, there are some important differences for clinicians to understand in order to interpret and perform translational research. This review article uses angiograms acquired in the course of a translational research program to present a description of the functional anatomy of the swine.

Methods

Digital subtraction angiography and computed tomography angiography were obtained throughout the course of multiple studies utilizing power injection with iodinated contrast. Subtracted two-dimensional images and three-dimensional multiplanar reformations were utilized post image acquisition to create maximal intensity projections and three-dimensional renderings of using open-source software (OsiriX). These imaging data are presented along with vessel measurements for reference.

Results

An atlas highlighting swine vascular anatomy, with an emphasis on inter-species differences that may influence how studies are conducted and interpreted, was compiled.

Conclusions

Swine are utilized in broad-reaching fields for preclinical research. While many similarities between human and swine vasculature exist, there are important differences to consider when conducting and interpreting research. This review article highlights these differences and presents accompanying images to inform clinicians gaining experience in swine research.
Two variations and one similarity in memory functions deployed by mice and humans to support foraging
Authors: Talbot Spencer , Gerdjikov Todor , De Lillo Carlo
Published: April 2021

Assessing variations in cognitive function between humans and animals is vital for understanding the idiosyncrasies of human cognition and for refining animal models of human brain function and disease. We determined memory functions deployed by mice and humans to support foraging with a search task acting as a test battery. Mice searched for food from the top of poles within an open arena. Poles were divided into groups based on visual cues and baited according to different schedules. White and black poles were baited in alternate trials. Striped poles were never baited. The requirement of the task was to find all baits in each trial. Mice’s foraging efficiency, defined as the number of poles visited before all baits were retrieved, improved with practice. Mice learnt to avoid visiting unbaited poles across trials (long-term memory) and revisits to poles within each trial (working memory). Humans tested with a virtual reality version of the task outperformed mice in foraging efficiency, working memory, and exploitation of the temporal pattern of rewards across trials. Moreover, humans, but not mice, reduced the number of possible movement sequences used to search the set of poles. For these measures, interspecies differences were maintained throughout the 3 weeks of testing. By contrast, long-term memory for never-rewarded poles was similar in mice and humans after the first week of testing. These results indicate that human cognitive functions relying on archaic brain structures may be adequately modelled in mice. Conversely, modelling in mice fluid skills likely to have developed specifically in primates requires caution.
Mediated phonological–semantic priming in spoken word production: Evidence for cascaded processing from picture–word interference
Authors: Mascelloni Matteo , McMahon Katie L , Piai Vitória , Kleinman Daniel , de Zubicaray Greig
Published: April 2021

The cognitive architecture that allows humans to retrieve words from the mental lexicon has been investigated for decades. While there is consensus regarding a two-step architecture involving lexical-conceptual and phonological word-form levels of processing, accounts of how activation spreads between them (e.g., in a serial, cascaded, or interactive fashion) remain contentious. In addition, production models differ with respect to whether selection occurs at lexical or postlexical levels. The purpose of this study was to examine whether mediated phonological–semantic relations (e.g., drip is phonologically related to drill that is semantically related to hammer) influence production in adults as predicted by models implementing cascaded processing and feedback between levels. Two experiments using the picture–word interference (PWI) paradigm were conducted using auditory (Exp. 1) and written (Exp. 2) distractors. We hypothesised that a mediated semantic interference effect would be observable in the former with the involvement of both spoken word production and recognition, and in the latter if lexical representations are shared between written and spoken words in English, as assumed by some production accounts. Furthermore, we hypothesised a mediated semantic interference effect would be inconsistent with a postlexical selection account as the distractors do not constitute a relevant response for the target picture (e.g., drip-HAMMER). We observed mediated semantic interference only from auditory distractors, while observing the standard semantic interference effect from both auditory and written distractors. The current findings represent the first chronometric evidence involving spoken word production and recognition in support of cascaded processing during lexical retrieval in adults and present a significant challenge for the postlexical selection account.
From the Guest Editors: Canadian Perspectives on and Applications of Applied Sociology
Authors: Milne Emily , Cumming Sara J.
Published: April 2021

Public confidence and trust in higher education has declined (Johnson and Peifer 2017) and the future of the higher education sector has been questioned (AGB 2020). More specifically, the discipline of sociology is considered to be in “crisis” and applied sociological approaches are offered as a solution (Graizbord 2019; Weinstein 1997). The purpose of this introduction article as well as the broader special issue is to explore the nature and state of applied sociology in Canada. With a collection of seven articles authored by Canadian sociologists on topics including application research, reflections on process, and teaching practice, this special issue provides a platform to discuss and showcase the distinct nature and contributions of applied sociology in Canada as well as highlight the work of Canadian applied sociologists.
A retrospective comparative study on arthroscopic suture anchors repair and tendon debridement versus arthroscopic tendon debridement for treatment of recalcitrant lateral epicondylitis
Authors: Li Xu , Zheng Tong , Li Yue , Zhang Hailong , Lu Yi
Published: April 2021

Aim:

To compare the outcomes between the arthroscopic debridement of the extensor carpi radialis brevis (ECRB) tendon alone and repairs to the ECRB tendon with suture anchor for the treatment of refractory lateral epicondylitis (LE).

Methods:

We retrospectively reviewed our patients who underwent arthroscopic surgical treatment for refractory LE by a single surgeon from January 2008 to June 2018 with a minimum follow-up of 12 months. The visual analog scale (VAS), the Mayo Elbow Performance Score (MEPS), the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire, the Patient-Rated Tennis Elbow Evaluation (PRTEE) scale, the Verhaar scoring system and the time of back to work were compared between two groups.

Results:

Both groups showed a significant postoperative improvement regarding the VAS, MEPS, DASH, PRTEE and the Verhaar scoring system ( p < 0.05). The repair group showed better results regarding the MEPS, DASH, PRTEE and Verhaar scoring system comparing with the debridement group, which were statically significant ( p < 0.05). There were no significant differences between the two groups regarding the VAS both at rest and activity at the final follow-up. There were no significant differences for the average time for return to work ( p = 0.229). There were 11 patients in the debridement group and six patients in the repair group, who completed the MRI evaluation at 6 months postoperatively.

Conclusion:

Compared with arthroscopic release and debridement of the ECRB tendon, arthroscopic suture anchor repairing of the origin of the ECRB tendon provides better outcomes when addressing the refractory LE.

Level of Evidence:

Case Series: Level IV
Scaling an Internet of Things start-up: Can alliance strategy help?
Authors: Chakrabarti Dipankar , Sarkar Soumya , Mukherjee Arindam
Published: April 2021

Owners of start-ups in the high-tech field face multiple challenges while scaling-up. The major challenge is to form a proper strategy that guides them to move from building products for point solutions to more industry-focused solutions, retaining skilled resources, efficient workforce management, and improving market reach. This case study is on Distronix, a start-up in the Industrial Internet of Things that could see steady revenue within 3 years of its operations. Distronix wanted to reach the next orbit fast. Distronix wanted to change the organizational blueprint with a proper strategy to scale-up. The young entrepreneurs owning Distronix brainstormed with their employees and the industry experts to strategize the next phase of growth. Market reach and coping with the changing demand of customers on Industrial Internet of Things were the two most important aspects of their strategy. After discussing with stakeholders and the mentors, the owners focused on alliances to increase their delivery and market reach capabilities. They could establish strong alliances, even with larger companies, with proper planning and sustained quality delivery. From the inception of Distronix, owners established alliance, but those were ad hoc and not as per the holistic plan, which provided them a better focus and guidance on alliancing. The alliance strategy seems successful from its revenue growth but needs regular review as the technology stack is getting refreshed fast. Regular monitoring of performance is also critical. The case study shows the importance of a well-thought and well-rounded alliance strategy for a start-up to scale-up confidently.
Young Adults’ Physical Distancing Behaviors During the Initial Months of the COVID-19 Pandemic: Adherence to Guidelines and Associations With Alcohol Use Behavior
Authors: Einberger Clare , Graupensperger Scott , Lee Christine M.
Published: April 2021

Throughout the COVID-19 pandemic, the scientific and public health communities have become increasingly focused on understanding young adults’ physical distancing behaviors and the role that young adults have on viral potentiation and community spread. In the present study, we surveyed a group of 560 young adults (ages 22-28) from the greater Seattle area in April 2020, during statewide “shelter-in-place” recommendations, to examine young adults’ self-reported adherence to physical distancing guidelines. Self-report measures were used to identify strong adherers and poor adherers, which we then compared in terms of engagement in specific physical distancing behaviors and alcohol use behaviors pertaining to physical distancing adherence. We found that most young adults are classified as strong adherers, and that poor adherers reported more frequent violations of physical distancing guidelines including having friends over to their residence or going over to other residences. Poor adherers were also significantly more likely to engage in high-risk alcohol use behavior, such as heavy episodic drinking, compared to those young adults who were classified as strong adherers. Our results provide initial evidence that young adults who engage in high-risk drinking may be at greater risk for non-adherence to government recommended physical distancing guidelines. This deeper understanding of young adult behavior during the COVID-19 pandemic can better inform public health outreach to increase physical distancing adherence currently, as well as in preparation for future contagious health crises that may require societal-level adherence to behavioral guidelines.
The Wretched of COVID-19 in Brazil: Colonial Spectres of an Announced Crisis
Authors: Faustino Deivison M.
Published: April 2021

This article discusses the epidemiological indices of COVID-19 infection and mortality in Brazil, as well as the responses of the public health authorities, based on an analysis of the structural relationship between capitalism, colonialism, and racism. The economic, social, and political reflexes manifested in the pandemic crisis must be situated in Brazil’s ‘colonial path of capitalist concretization’. Racism was and remains the element without which the peculiarities of capitalism in Brazil cannot be understood. It is argued that colonial path of Brazilian capitalism and the current dismantling of the social and political rights that were previously obtained by the subordinate classes—the wretched of Brazil—created a social and political environment favorable to the accelerated dissemination of COVID-19 and a very high mortality in the country.
Determinism and Non-linear Behaviour of Log-return and Conditional Volatility: Empirical Analysis for 26 Stock Markets
Authors: Dhifaoui Zouhaier
Published: April 2021

Determinism and non-linear behaviour in log-return and conditional volatility time series of the stock market index is examined for twenty-six countries. For this goal, the principal statistical techniques used in this study are a robust estimator of correlation dimension, a normalized non-linear prediction error, and pseudo-periodic surrogate data method. The proposed approach indicates, first, the stochastic behaviour of all log-return time series. Second, the inability of local linear, ARMA, or state- dependent noise models (such as ARCH, GARCH, and EGARCH) to describe its structure for the frontier, emerging, and developed markets. The same stochastic behaviour of conditional volatility time series, estimated by the stochastic volatility model with moving average innovations, is detected. This finding proves the efficiency of the stochastic volatility model compared with some analysed types of GARCH models for all studied markets.

JEL Classification: C12, C52, D53, E44
Marketing Strategy for Financial Services in Indian Financial Service Institutions
Authors: Sharma Preeti , Shrivastava Avinash K.
Published: April 2021

Indian financial sector passed through various stages of development including pre-nationalization, post-nationalization and the recent one post-liberalization. In these stages, marketing was at hibernation mode, as the relationship between banking and marketing was not considered important. However, the recent developments in the Indian financial sector as well as changes in customer preferences towards financial services have aggravated a need for a stronger relationship between marketing and financial service institutions. This thought grew up after there was a realization of the sustainable structure. In light of the above development, authors have attempted to study and explore the marketing strategy of financial service institutions specifically for financial products and services to target retail customers. This exploratory research is carried out by interviewing around 285 employees (in sales and marketing in banks and NBFCs) in Delhi-NCR region through a structured questionnaire. A total of 24 factors were identified through the literature available on the topic (factors that affect the marketing strategy of financial services offered). Exploratory factor analysis was applied, and it was found that five most influential factors are devising a differential marketing strategy. This marketing strategy has been named as ‘PRISM’ (acronym of the strategies developed).
Hyperlipidemia Is a Risk Factor of Adhesive Capsulitis: Real-World Evidence Using the Taiwanese National Health Insurance Research Database
Authors: Wang Jr-Yi , Liaw Chen-Kun , Huang Chi-Chang , Liou Tsan-Hon , Lin Hui-Wen , Huang Shih-Wei
Published: April 2021

Background:

Patients with adhesive capsulitis are evaluated for pain and progressive contracture of the glenohumeral joint. Whether endocrine, immune, or inflammatory processes are involved in its definite pathogenesis is still under debate. Some cross-sectional studies with a small sample size have noted that hyperlipidemia is a possible risk factor for frozen shoulders.

Purpose/Hypothesis:

The purpose was to conduct a longitudinal population-based study to investigate the risk of adhesive capsulitis among patients with hyperlipidemia. It was hypothesized that patients with hyperlipidemia would have a higher risk of adhesive capsulitis and that the use of statin drugs could reduce the rate.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Using data from the National Health Insurance Research Database (NHIRD) of Taiwan, the authors obtained the records of patients with hyperlipidemia who received a diagnosis between 2004 and 2005 and were followed up until the end of 2010. The control cohort comprised age- and sex-matched patients without hyperlipidemia. Propensity score matching was performed for the other comorbidities. A Cox multivariate proportional hazards model was applied to analyze the risk factors of adhesive capsulitis. The hazard ratio (HR) and adjusted HR were estimated between the study and control cohorts after adjustment for confounders. The effects of statin use on adhesive capsulitis risk were also analyzed.

Results:

The NHIRD records of 28,748 patients and 114,992 propensity score–matched controls were evaluated. A higher incidence rate of adhesive capsulitis was revealed in the hyperlipidemia cohort, with a crude HR of 1.70 (95% CI, 1.61-1.79; P < .001) and adjusted HR of 1.50 (95% CI, 1.41-1.59; P < .001). Patients with hyperlipidemia who used a statin still had higher crude and adjusted HRs compared with controls. Statin use did not exert protective effects on patients with hyperlipidemia.

Conclusion:

Patients with hyperlipidemia had a 1.5-fold higher risk of adhesive capsulitis than did healthy controls. Statin use did not provide protection against adhesive capsulitis in patients with hyperlipidemia.
A Pragmatist Approach to Complexity Theorizing in Project Studies: Orders and Levels
Authors: Tywoniak Stephane , Ika Lavagnon , Bredillet Christophe
Published: April 2021

The limitations of complexity theorizing in project studies are traced back to simplistic and reductionist theorizing strategies. This article offers pragmatist recommendations to develop strong theorizing strategies organized in a triad: orders of theorizing (degree of recursiveness of the theorizing process), levels of theorizing (interactions between micro, meso, and macro loci of analysis), and the integration between orders and levels brought together in a recursive relationship of co-construction. We offer four main contributions to complexity theorizing in project studies: pragmatism is useful, deeper attention should be paid to theorizing across levels, third-order theorizing is needed, and complexifying terminology is required.
Linkage disequilibrium patterns, population structure and diversity analysis in a worldwide durum wheat collection including Argentinian genotypes
Authors: Roncallo Pablo Federico , Larsen Adelina Olga , Achilli Ana Laura , Pierre Carolina Saint , Gallo Cristian Andrés , Dreisigacker Susanne , Echenique Viviana
Published: April 2021

Background

Durum wheat (Triticum turgidumL. ssp.durumDesf. Husn) is the main staple crop used to make pasta products worldwide. Under the current climate change scenarios, genetic variability within a crop plays a crucial role in the successful release of new varieties with high yields and wide crop adaptation. In this study we evaluated a durum wheat collection consisting of 197 genotypes that mainly comprised a historical set of Argentinian germplasm but also included worldwide accessions.

Results

We assessed the genetic diversity, population structure and linkage disequilibrium (LD) patterns in this collection using a 35 K SNP array. The level of polymorphism was considered, taking account of the frequent and rare allelic variants. A total of 1547 polymorphic SNPs was located within annotated genes. Genetic diversity in the germplasm collection increased slightly from 1915 to 2010. However, a reduction in genetic diversity using SNPs with rare allelic variants was observed after 1979. However, larger numbers of rare private alleles were observed in the 2000–2009 period, indicating that a high reservoir of rare alleles is still present among the recent germplasm in a very low frequency. The percentage of pairwise loci in LD in the durum genome was low (13.4%) in our collection. Overall LD and the high (r2 > 0.7) or complete (r2 = 1) LD presented different patterns in the chromosomes. The LD increased over three main breeding periods (1915–1979, 1980–1999 and 2000–2020).

Conclusions

Our results suggest that breeding and selection have impacted differently on the A and B genomes, particularly on chromosome 6A and 2A. The collection was structured in five sub-populations and modern Argentinian accessions (cluster Q4) which were clearly differentiated. Our study contributes to the understanding of the complexity of Argentinian durum wheat germplasm and to derive future breeding strategies enhancing the use of genetic diversity in a more efficient and targeted way.
Listening to student voice-understanding student and faculty experience at two UK graduate entry programmes
Authors: Alagha M. Abdulhadi , Jones Linda
Published: April 2021

Context

Shortage of physicians in the UK has been a long-standing issue. Graduate entry medicine (GEM) may offer a second point of entry for potential doctors. However, the challenges of developing and implementing these programmes are still unrecognised. This small-scale study aimed to briefly explore the opportunities and challenges facing students at two UK GEM programmes.

Methods

Two case studies were conducted at Imperial College and Scotland’s GEM (ScotGEM) and used a triangulated qualitative approach via semi-structured and elite interviews. Data analysis, informed by grounded theory, applied thematic and force-field analysis in an empirical approach to generate evidence and instrumental interpretations for Higher Education Institutions.

Results

Although GEM forms an opportunity for graduates to enter medicine, the different drivers of each programme were key in determining entry requirements and challenges experienced by postgraduates. Three key dilemmas seem to influence the experiences of learners in GEM programmes: (a) postgraduate identity and the everchanging sense-of-self; (b)self-directed and self-regulated learning skills, and (c) servicescape, management and marketing concepts.

Conclusions

Graduate entry programmes may support policy makers and faculty to fill the workforce gap of healthcare professionals. However, their successful implementation requires careful considerations to the needs of graduates to harness their creativity, resilience and professional development as future healthcare workers.
Prevalence of advance care planning practices among people with chronic diseases in hospital and community settings: a retrospective medical record audit
Authors: Jeong Sarah , Barrett Tomiko , Ohr Se Ok , Cleasby Peter , Davey Ryan , David Michael
Published: April 2021

Background

Advance Care Planning (ACP) enables healthcare professionals to embrace the important process where patients think about their values in life and goals for health care, and discuss their future health care preferences with family members for a time when they are not able to make health care decisions. Despite the promotion of ACP last two decades, and well-known benefits of ACP and a written Advance Care Directive (ACD), they are still underutilised in Australia and across the world. Previous studies have provided some insights, however, an uptake of ACP and prevalence of ACDs in community settings is rarely reported.

Methods

The aim of this study was to determine the uptake of ACP and prevalence of ACDs among people with chronic diseases in hospital and community settings. A retrospective medical record audit of eligible patients looking for evidence of ACP was conducted in 16 research sites in eight hospital and eight community care settings. Participants included those who were admitted to one of the research sites, and who were aged 18 years and over with at least one of nine nominated chronic diseases. The primary outcome measures included the number of patients with evidence of ACP through the following practices: completion of an ACD, appointment of an Enduring Guardian (EG), or completion of a resuscitation plan.

Results

The overall prevalence of ACD was 2.8% (n = 28) out of 1006 audited records, and only 10 (1%) of them were legally binding. The number of EGs appointed was 39 (3.9%) across the sites. A total of 151 (15.4%) resuscitation plans were found across the eight hospital sites. 95% (n = 144) of the resuscitation plans indicated ‘Not-for-resuscitation’.

Conclusions

The uptake of ACP is very low. Current medical recording system reveals the challenges in ACP lie in the process of storage, access and execution of the ACDs. Given that having an ACD or Enduring Guardian in place is only useful if the treating physician knows how and where to access the information, it has implications for policy, information system, and healthcare professionals’ education.

Trial registration

The study was retrospectively registered with the Australian New Zealand Clinical Trials Registry (Trial ID: ACTRN12618001627246). The URL of the trial registry record http://www.anzctr.org.au/trial/MyTrial.aspx
The role of CD38 in HIV infection
Authors: Lu Liqi , Wang Jie , Yang Qian , Xie Xiuqiao , Huang Yuanshuai
Published: April 2021

The widely-expressed molecule CD38 is a single-stranded type II transmembrane glycoprotein that is mainly involved in regulating the differentiation and activation state of the cell. CD38 has broad and complex functions, including enzymatic activity, intercellular signal transduction, cell activation, cytokine production, receptor function and adhesion activity, and it plays an important role in the physiological and pathological processes of many diseases. Many studies have shown that CD38 is related to the occurrence and development of HIV infection, and CD38 may regulate its progression through different mechanisms. Therefore, investigating the role of CD38 in HIV infection and the potential signaling pathways that are involved may provide a new perspective on potential treatments for HIV infection. In the present review, the current understanding of the roles CD38 plays in HIV infection are summarized. In addition, the specific role of CD38 in the process of HIV infection of human CD4+T lymphocytes is also discussed.
Pseudo-Wellens syndrome from sepsis-induced cardiomyopathy: a case report and review of the literature
Authors: Ju Teressa Reanne , Yeo Ilhwan , Pontone Gregory , Bhatt Reema
Published: April 2021

Background

Pseudo-Wellens syndrome is a rare entity characterized by the presence of electrocardiogram (ECG) changes of Wellens syndrome but without the stenosis of the left anterior descending (LAD) coronary artery. In previous reports, pseudo-Wellens syndrome most commonly resulted from recreational drug use or unidentified etiologies. We present a unique case of pseudo-Wellens syndrome due to sepsis-induced cardiomyopathy and a review of the literature.

Case presentation

A 62-year-old Caucasian woman was admitted for sepsis from left foot cellulitis. Laboratory data were notable for elevated lactate of 2.5 mmol/L and evidence of acute kidney injury. She developed chest pain on the third day of hospitalization. ECG showed symmetric T-wave inversion in leads V1–V4. Serial troponin I levels were within normal limits. Chest imaging showed no pulmonary embolism. Echocardiogram showed ejection fraction of 25%, left ventricular diastolic diameter of 4.6 cm, and multiple segmental wall motion abnormalities. Cardiac catheterization showed patent coronary arteries. The hospital course was complicated by transient sinus bradycardia and hypotension. She was hospitalized for a total of 17 days. ECG prior to discharge showed resolution of T-wave changes.

Conclusion

Pseudo-Wellens syndrome may result from myocardial ischemia due to vasospasm or myocardial edema from external insults. In our case, we suspect sepsis-related cytokine production resulting in cardiomyopathy and pseudo-Wellens syndrome. The clinical manifestations were indistinguishable between Wellens and pseudo-Wellens syndrome. Physicians should include the diagnosis of pseudo-Wellens syndrome when considering the presence of LAD coronary artery occlusion given risk stratifications.
Exosomes derived from miR-26a-modified MSCs promote axonal regeneration via the PTEN/AKT/mTOR pathway following spinal cord injury
Authors: Chen Yuyong , Tian Zhenming , He Lei , Liu Can , Wang Nangxiang , Rong Limin , Liu Bin
Published: April 2021

Background

Exosomes derived from the bone marrow mesenchymal stem cell (MSC) have shown great potential in spinal cord injury (SCI) treatment. This research was designed to investigate the therapeutic effects of miR-26a-modified MSC-derived exosomes (Exos-26a) following SCI.

Methods

Bioinformatics and data mining were performed to explore the role of miR-26a in SCI. Exosomes were isolated from miR-26a-modified MSC culture medium by ultracentrifugation. A series of experiments, including assessment of Basso, Beattie and Bresnahan scale, histological evaluation, motor-evoked potential recording, diffusion tensor imaging, and western blotting, were performed to determine the therapeutic influence and the underlying molecular mechanisms of Exos-26a in SCI rats.

Results

Exos-26a was shown to promote axonal regeneration. Furthermore, we found that exosomes derived from miR-26a-modified MSC could improve neurogenesis and attenuate glial scarring through PTEN/AKT/mTOR signaling cascades.

Conclusions

Exosomes derived from miR-26a-modified MSC could activate the PTEN-AKT-mTOR pathway to promote axonal regeneration and neurogenesis and attenuate glia scarring in SCI and thus present great potential for SCI treatment.

Graphical abstract
Can a deep learning model based on intraoperative time-series monitoring data predict post-hysterectomy quality of recovery?
Authors: Zhao Xu , Liao Ke , Wang Wei , Xu Junmei , Meng Lingzhong
Published: April 2021

Background

Intraoperative physiological monitoring generates a large quantity of time-series data that might be associated with postoperative outcomes. Using a deep learning model based on intraoperative time-series monitoring data to predict postoperative quality of recovery has not been previously reported.

Methods

Perioperative data from female patients having laparoscopic hysterectomy were prospectively collected. Deep learning, logistic regression, support vector machine, and random forest models were trained using different datasets and evaluated by 5-fold cross-validation. The quality of recovery on postoperative day 1 was assessed using the Quality of Recovery-15 scale. The quality of recovery was dichotomized into satisfactory if the score ≥122 and unsatisfactory if <122. Models’ discrimination was estimated using the area under the receiver operating characteristics curve (AUROC). Models’ calibration was visualized using the calibration plot and appraised by the Brier score. The SHapley Additive exPlanation (SHAP) approach was used to characterize different input features’ contributions.

Results

Data from 699 patients were used for modeling. When using preoperative data only, all four models exhibited poor performance (AUROC ranging from 0.65 to 0.68). The inclusion of the intraoperative intervention and/or monitoring data improved the performance of the deep leaning, logistic regression, and random forest models but not the support vector machine model. The AUROC of the deep learning model based on the intraoperative monitoring data only was 0.77 (95% CI, 0.72–0.81), which was indistinct from that based on the intraoperative intervention data only (AUROC, 0.79; 95% CI, 0.75–0.82) and from that based on the preoperative, intraoperative intervention, and monitoring data combined (AUROC, 0.81; 95% CI, 0.78–0.83). In contrast, when using the intraoperative monitoring data only, the logistic regression model had an AUROC of 0.72 (95% CI, 0.68–0.77), and the random forest model had an AUROC of 0.74 (95% CI, 0.73–0.76). The Brier score of the deep learning model based on the intraoperative monitoring data was 0.177, which was lower than that of other models.

Conclusions

Deep learning based on intraoperative time-series monitoring data can predict post-hysterectomy quality of recovery. The use of intraoperative monitoring data for outcome prediction warrants further investigation.

Trial registration

This trial (Identifier: NCT03641625) was registered at ClinicalTrials.gov by the principal investigator, Lingzhong Meng, on August 22, 2018.
Anesthetic management of a morbidly obese patient with endometrial cancer during robot-assisted laparoscopic surgery
Authors: Ishida Yusuke , Nakazawa Koichi , Okada Toshio , Tsuzuki Yumi , Kobayashi Takayuki , Yamada Rikako , Uchino Hiroyuki
Published: April 2021

Background

The number of robot-assisted surgeries being performed has increased in recent years, even in patients with risk factors, such as obesity, owing to advancements in medical technologies. We here report the anesthetic management of a morbidly obese woman who underwent robot-assisted surgery.

Case presentation

A 44-year-old woman (height, 165 cm; weight, 147 kg; body mass index, 54 kg/m2) was scheduled to undergo robot-assisted laparoscopic hysterectomy for endometrial cancer. Preoperative weight loss and rehearsal of positioning during induction of anesthesia and surgical procedures greatly contributed to the surgical success. Monitoring of oxygen reserve index in combination with SpO2 was useful for appropriate airway and respiratory management. During anesthesia induction, the ramp position using a special commercially available cushion facilitated manual mask ventilation and tracheal intubation. Lung-protective ventilation using a limited tidal volume with moderate PEEP was applied during the robot-assisted surgical procedure.

Conclusion

We successfully managed anesthesia without any complications.
Coating Lacticaseibacillus rhamnosus GG in Alginate Systems: an Emerging Strategy Towards Improved Viability in Orange Juice
Authors: Bonaccorso Angela , Russo Nunziatina , Romeo Alessia , Carbone Claudia , Grimaudo Maria Aurora , Alvarez-Lorenzo Carmen , Randazzo Cinzia , Musumeci Teresa , Caggia Cinzia
Published: April 2021

Fruit juices are successfully proposed as suitable probiotic vehicles, but researchers’ efforts should be developed to avoid effects of bacteria overgrowing on sensory and nutritional cues of final products and to preserve viability of probiotic bacteria during storage. In the present study, encapsulation of Lacticaseibacillus rhamnosus GG strain in alginate systems was performed through ionotropic gelation technology. The alginate systems were optimized by using Box-Behnken Design to investigate the influence of three independent variables at three different levels: particle mean size and polydispersity index. The optimized probiotic-loaded alginate particles were added to orange juice samples. The viability of the probiotic strain, both as free and microencapsulated, was evaluated in orange juice stored at 5°C for 35 days. Morphology and size of probiotic-loaded alginate particles were found suitable for incorporation into juice. TEM analysis revealed that unloaded systems were clustered as nanoparticles (CL_NP), while the loaded sample appeared as a coated system (Coated_LGG). Microbiological evaluation revealed that the encapsulation assured the survival of Coated_LGG, with a reduction of less than 1-unit log in cellular density after 35 days of refrigerated storage in orange juice. Results indicated that the encapsulated bacteria did not affect the macroscopic properties neither the microbiological characteristic of orange juice; thus, it can be proposed as functional food.
The Clinical Utility of DCISionRT® on Radiation Therapy Decision Making in Patients with Ductal Carcinoma In Situ Following Breast-Conserving Surgery
Authors: Shah Chirag , Bremer Troy , Cox Charles , Whitworth Pat , Patel Rakesh , Patel Anushka , Brown Eric , Gold Linsey , Rock David , Riley Lee , Kesslering Christy , Brown Sheree , Gabordi Robert , Pellicane James , Rabinovich Rachel , Khan Sadia , Templeton Sandra , Majithia Lonika , Willey Shawna C. , Wärnberg Fredrik , Gerber Naamit K. , Shivers Steve , Vicini Frank A.
Published: April 2021

Background

The role of radiation therapy (RT) following breast-conserving surgery (BCS) in ductal carcinoma in situ (DCIS) remains controversial. Trials have not identified a low-risk cohort, based on clinicopathologic features, who do not benefit from RT. A biosignature (DCISionRT®) that evaluates recurrence risk has been developed and validated. We evaluated the impact of DCISionRT on clinicians’ recommendations for adjuvant RT.

Methods

The PREDICT study is a prospective, multi-institutional, observational registry in which patients underwent DCISionRT testing. The primary endpoint was to identify the percentage of patients where testing led to a change in RT recommendations.

Results

Overall, 539 women were included in this study. Pre DCISionRT testing, RT was recommended to 69% of patients; however, post-testing, a change in the RT recommendation was made for 42% of patients compared with the pre-testing recommendation; the percentage of women who were recommended RT decreased by 20%. For women initially recommended not to receive an RT pre-test, 35% had their recommendation changed to add RT following testing, while post-test, 46% of patients had their recommendation changed to omit RT after an initial recommendation for RT. When considered in conjunction with other clinicopathologic factors, the elevated DCISionRT score risk group (DS > 3) had the strongest association with an RT recommendation (odds ratio 43.4) compared with age, grade, size, margin status, and other factors.

Conclusions

DCISionRT provided information that significantly changed the recommendations to add or omit RT. Compared with traditional clinicopathologic features used to determine recommendations for or against RT, the factor most strongly associated with RT recommendations was the DCISionRT result, with other factors of importance being patient preference, tumor size, and grade.
Pricing and Budgeting in the Production of Commodity Output. Added Value Accounting
Authors: Grachev A.
Published: April 2021

This article discusses the organization of cost accounting in the context of items and elements of a manufacturing enterprise. For this, a general cost matrix is analyzed and a price formula for cost items and cost elements is developed. Particular attention is paid to the pricing and budgeting procedures, as well as the justification of the produced value added of the commodity output.
Development of Emotional Intelligence in Readers of Primary School Age in Literary Reading Lessons
Authors: Sil'chenkova L.
Published: April 2021

The article is devoted to the development by readers of primary school age of the emotional sphere of a work of art, through which one of the key modern competencies is formed - emotional intelligence. The author describes the possibilities of developing emotional intelligence in junior schoolchildren in the course of studying the subject "Literary reading", which is carried out on the basis of their acquaintance with the psychology of children's fiction. Psychologism is considered as an element of the artistic form of a work, with the help of which its meaning and ideological and emotional content are expressed. The methods of using psychologism in the literary and artistic text are characterized and, taking this into account, the methodological approaches to the development of full-fledged textual activity of primary schoolchildren are considered.
Pedagogical Support As a Condition for the Successful Development of Textual Activity Among Schoolchildren of the Fourth-Fifth Grades
Authors: Vasil'evyh I.
Published: April 2021

The article discusses the problem of the necessary pedagogical support of fourth-fifth-grade students in the course of the formation of their analytical and productive-creative activities. The ways of using the heuristic educational dialogue in organizing the textual activity of schoolchildren are characterized. The educational dialogue is considered as an effective method that stimulates the student to independent analytical work with the text, its interpretation, expanding the experience of the student's communicative interaction with classmates and the teacher, allowing the latter to carry out a differentiated approach to teaching each child, taking into account the level of his speech development. Using a specific example, the teaching capabilities of the educational dialogue method are revealed when working in the lesson with a text-description and the guiding role of the teacher in this process.
Diagnostics of the Level of Development of Metasubject Skills of Primary School Graduates (Based on the Subjects "Literary Reading" and "Literature")
Authors: Aristova M. , Belyaeva N.
Published: April 2021

The article describes a system of diagnostic techniques for identifying the level of development of metasubject skills of students during the transition from primary school to the general school (based on the subjects "Literary reading" and "Literature"). An analysis of the diagnostic results shows that the proposed diagnostic tasks and methodological approaches to their assessment help to determine the grounds for differentiating education in both primary and secondary schools, to identify the relationship between meta-subject and subject results in the process of teaching literary reading and literature.
Modern Elementary School: Learning Differentiation
Authors: Vinogradova Natalya
Published: April 2021

The article discusses the problem of differentiation of education at the present stage of development of the first school link in education. The article reveals the features of ensuring a differentiated approach, taking into account groups of students that differ in the level of success in learning and development. The characteristics of children belonging to different groups and in need of teacher's pedagogical support are given. The author proves the need for a teacher to use a differentiated approach to teaching younger schoolchildren, who usually fall out of the zone of the teacher's everyday attention - the so-called good and satisfactory students.
Pedagogical Interaction of a Preschool Organization, Family and School in Preparing Children for Schooling
Authors: Shakhmanova A. , Ponomareva E.
Published: April 2021

The article examines an important and complex stage in the development of a child's personality during his transition from preschool childhood to school. The concept of "a child's readiness to learn at school" is characterized, the types of readiness and their content are highlighted, correlated with the new tasks of modern primary education. Particular attention is paid to the issues of well-functioning interaction of the preschool educational organization, family and school as a condition for improving the quality of preparing children for schooling. The essence of the concepts "interaction", "pedagogical interaction" is revealed, and the functions of all participants in the studied period of the educational process are determined.
The Influence of Didactic Play on Reducing the Level of Anxiety in the Classroom
Authors: Volobueva E.
Published: April 2021

The article highlights the issues of the teacher's use of didactic games as a form of teaching organization and an effective means of preventing and reducing anxiety among younger students in the process of educational activities in the classroom. The concept of "school anxiety" is characterized. The importance of didactic games for the development of children’s ability and desire to learn, increasing their intellectual activity, enriching the experience of communicative interaction with classmates, forming a sense of camaraderie and responsibility for the team result is considered.

The possibility of conducting educational games in the development of any subject content has been substantiated. Examples of didactic games for working in mathematics lessons with first-graders showing anxiety are given.
Linear Program-Based Approximation for Personalized Reserve Prices
Authors: Derakhshan Mahsa , Golrezaei Negin , Paes Leme Renato
Published: April 2021

We study the problem of computing data-driven personalized reserve prices in eager second price auctions without having any assumption on valuation distributions. Here, the input is a data set that contains the submitted bids of n buyers in a set of auctions, and the problem is to return personalized reserve prices r that maximize the revenue earned on these auctions by running eager second price auctions with reserve r. For this problem, which is known to be NP complete, we present a novel linear program (LP) formulation and a rounding procedure, which achieves a 0.684 approximation. This improves over the [Formula: see text]-approximation algorithm from Roughgarden and Wang. We show that our analysis is tight for this rounding procedure. We also bound the integrality gap of the LP, which shows that it is impossible to design an algorithm that yields an approximation factor larger than 0.828 with respect to this LP.

This paper was accepted by Chung Piaw Teo, Management Science Special Section on Data-Driven Prescriptive Analytics.