bluuebunny/crossref_metadata_2025 huggingface dataset:
National variation in pulmonary metastasectomy for colorectal cancer
Authors: Fenton Hayley M. , Finan Paul J. , Milton Richard , Shackcloth Michael , Taylor John C. , Treasure Tom , Morris Eva J. A.
Published: December 2020

Aim

Evidence on patterns of use of pulmonary metastasectomy in colorectal cancer patients is limited. This population‐based study aims to investigate the use of pulmonary metastasectomy in the colorectal cancer population across the English National Health Service (NHS) and quantify the extent of any variations in practice and outcome.

Methods

All adults who underwent a major resection for colorectal cancer in an NHS hospital between 2005 and 2013 were identified in the COloRECTal cancer data Repository (CORECT‐R). All inpatient episodes corresponding to pulmonary metastasectomy, occurring within 3 years of the initial colorectal resection, were identified. Multi‐level logistic regression was used to determine patient and organizational factors associated with the use of pulmonary metastasectomy for colorectal cancer, and Kaplan–Meier and Cox models were used to assess survival following pulmonary metastasectomy.

Results

In all, 173 354 individuals had a major colorectal resection over the study period, with 3434 (2.0%) undergoing pulmonary resection within 3 years. The frequency of pulmonary metastasectomy increased from 1.2% of patients undergoing major colorectal resection in 2005 to 2.3% in 2013. Significant variation was observed across hospital providers in the risk‐adjusted rates of pulmonary metastasectomy (0.0%–6.8% of patients). Overall 5‐year survival following pulmonary resection was 50.8%, with 30‐day and 90‐day mortality of 0.6% and 1.2% respectively.

Conclusions

This study shows significant variation in the rates of pulmonary metastasectomy for colorectal cancer across the English NHS.
Deep learning for vision‐based fall detection system: Enhanced optical dynamic flow
Authors: Chhetri Sagar , Alsadoon Abeer , Al‐Dala'in Thair , Prasad P. W. C. , Rashid Tarik A. , Maag Angelika
Published: December 2020

Accurate fall detection for the assistance of older people is crucial to reduce incidents of deaths or injuries due to falls. Meanwhile, vision‐based fall detection system has shown some significant results to detect falls. Still, numerous challenges need to be resolved. The impact of deep learning has changed the landscape of the vision‐based system, such as action recognition. The deep learning technique has not been successfully implemented in vision‐based fall detection system due to the requirement of a large amount of computation power and requirement of a large amount of sample training data. This research aims to propose a vision‐based fall detection system that improves the accuracy of fall detection in some complex environments such as the change of light condition in the room. Also, this research aims to increase the performance of the pre‐processing of video images. The proposed system consists of Enhanced Dynamic Optical Flow technique that encodes the temporal data of optical flow videos by the method of rank pooling, which thereby improves the processing time of fall detection and improves the classification accuracy in dynamic lighting condition. The experimental results showed that the classification accuracy of the fall detection improved by around 3% and the processing time by 40–50 ms. The proposed system concentrates on decreasing the processing time of fall detection and improving the classification accuracy. Meanwhile, it provides a mechanism for summarizing a video into a single image by using dynamic optical flow technique, which helps to increase the performance of image preprocessing steps.
The impact of depression on heart transplant outcomes: A retrospective single‐center cohort study
Authors: de la Rosa Angelo , Singer‐Englar Tahli , Hamilton Michele A. , IsHak Waguih William , Kobashigawa Jon A. , Kittleson Michelle M.
Published: December 2020

Background

Depression is prevalent in patients with heart failure and after heart transplant. We identified the prevalence of pre‐ and post‐transplant depression and its association with clinical characteristics and post‐transplant outcomes.

Methods

We reviewed 114 adults transplanted 1/1/2015 to 12/31/2015 and identified patients with pre‐ and post‐transplant depression. Clinical characteristics and outcomes were compared.

Results

Of 114 patients, 35.1% had pre‐transplant depression and 26.3% had post‐transplant depression. Patients with post‐transplant depression within the first year were significantly more likely to have acute rejection (10% vs 0%), longer intensive care unit (11.7 days vs 7.8 days) and hospital stay (31.7 days vs 16.3 days), and discharge to inpatient rehabilitation (26.7% vs 8.3%). Patients with post‐transplant depression within the first year had significantly higher 5‐year mortality (30% vs 9.5%, p = .009). However, after adjustment for total artificial heart/biventricular assist device, acute rejection, intensive care unit, and hospital length of stay, this relationship was no longer significant (HR 2.11; 95% CI 0.18‐25.27; p = .556).

Conclusions

Depression is common among heart transplant candidates and recipients. While pre‐transplant depression did not impact outcomes, patients with post‐transplant depression were more likely to have had a complicated course, suggesting the need for increased vigilance regarding depression in such patients.
Effective procedure for endoscopic ultrasound‐guided prostate abscess aspiration drainage and saline irrigation
Authors: Soga Koichi , Mukai Hiroki , Akamatsu Naoaki
Published: December 2020

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Echocardiographic evaluation of ventricular septal defects
Authors: Nayak Srishti , Patel Akash , Haddad Lana , Kanakriyeh Mohammad , Varadarajan Padmini
Published: December 2020

Ventricular septal defects (VSDs) are the most common forms of acyanotic congenital heart disease accounting for 37% of congenital heart disease in children. A VSD is defined by parts of the ventricular septum involved. There are four major types of VSDs: perimembranous, muscular, outlet, and inlet VSDs. Echocardiography is the most important clinical tool to help diagnose and characterize a VSD. Although most VSDs are clinically nonsignificant or close on their own, echocardiography with Doppler and color flow mapping can be used to provide accurate anatomic and hemodynamic evaluation of VSDs in order to determine if surgical or transcatheter‐based intervention is needed. Hence, understanding how to use echocardiography to characterize VSDs is of crucial importance when caring for patients with adult congenital heart disease.
Patent foramen ovale and atrial septal defect
Authors: Kheiwa Ahmed , Hari Pawan , Madabhushi Pranav , Varadarajan Padmini
Published: December 2020

Atrial septal defects (ASD) are among the most common congenital heart diseases encountered in adulthood. Patent foramen ovale (PFO) is present in up to 25% of the population. ASD could present as isolated lesion or in association with more complex congenital heart disease form as tetralogy of Fallot, or Ebstein's anomaly of tricuspid valve. There is a wide range of clinical presentation ranging from asymptomatic subjects surviving to adulthood undiagnosed to subjects presenting with right heart failure and severe pulmonary vascular disease (Eisenmenger syndrome). This manuscript is an in depth review of the complex atrial septation, the variable clinical presentation of ASD and PFO, and its clinical and therapeutic implications.
A practical guide to echocardiographic evaluation of adult Fontan patients
Authors: Kheiwa Ahmed , Harris Ian S. , Varadarajan Padmini
Published: December 2020

Recent advances in surgical techniques and perioperative care for patients with single ventricle physiology have led to a remarkable improvement in long‐term survival, such that now the majority of patients with single ventricle physiology are living to adulthood after Fontan palliation. The management of adult patients with Fontan physiology is one of the most challenging clinical dilemmas encountered in contemporary cardiology. The complex and heterogeneous anatomical and physiological abnormalities seen in Fontan patients mandate that any clinical evaluation, either for routine follow‐up or preoperative evaluation prior to any transcatheter or surgical intervention, incorporates detailed information from a careful and thorough echocardiographic examination, These examinations, however, can be complex and confusing, even for experienced echocardiographers. Ideally, the interpretation of these studies is informed by an understanding of the basic anatomical lesions and of the potential long‐term complications encountered in adult single ventricle patients. In this review, we present a practical and clinically oriented approach to the echocardiographic evaluation of adult patients with single ventricle physiology post‐Fontan.
Echocardiographic assessment of atrioventricular canal defects
Authors: Nayak Srishti , Kanakriyeh Mohammed , Varadarajan Padmini
Published: December 2020

AV canal defects (AVCD) are caused by maldevelopment of the endocardial cushions and typically include a primum atrial septal defect (ASD), an inlet ventricular septal defect (VSD), and a common atrioventricular valve. The variations in deformities provide the basis for the many terms used in the anatomical classifications: partial, transitional, intermediate, and complete common AVCD (balanced or unbalanced). The balanced complete common AVCDs are classified as Rastelli A, B, C depending on the anomaly of the anterior bridging leaflet division and attachments. Unbalanced complete AVCDs occur when the common AV valve leads primarily into the RV or LV. Echocardiographic apical, subcostal, and parasternal views are the best views to image AV canal defects. These views can help determine the type of repair required for the various AV canal defects.
Geomorphologic study of human tooth root surfaces following simulated avulsion by scanning electron microscopy
Authors: Ding Qian‐Wen , Lin Mei , Zhang Xin , Gong Yi
Published: December 2020

Background/Aims

Tooth avulsion is the most severe traumatic tooth injury. Immediate replantation after avulsion provides the highest success rate, whereas delayed replantation with dehydration for >1 h always results in ankylosis, replacement resorption, and eventual tooth loss. The aim of this study was to investigate the geomorphologic change of ultrastructure on tooth root surfaces due to dehydration.

Material and Methods

Twenty‐four sound human premolars and fully developed third molars without periodontitis were selected for the experiment. Roots were separated into 6–7 pieces with an intact root surface area (3 × 3 mm2) and then divided into the following groups: fresh group, prolonged dehydration groups (air drying for 1, 2, 4, 12, or 24 h), and dehydrated teeth (air drying for 2 h) treated with acid (Tris‐HCl buffer or citric acid buffer). More than six pieces of root from each group were subjected to scanning electron microscopy (SEM) observation. Captured images were exported to ImageJ software to quantitatively analyze the areas covered with fibers. Statistical significance was determined by comparing the means of the different groups using t‐testing or one‐way analysis of variance followed by post hoc testing.

Results

Fibrous “vegetation” covering the cementum was observed on the fresh root surface by SEM. This was destroyed by dehydration (>1 h), resulting in a root surface resembling the “Gobi Desert.” The difference was statistically significant (p < .001). Root surface deteriorated by dehydration could be recovered by the re‐use of the fibers embedded in the cementum as acid demineralization of the outer layer of cementum exposed the embedded fibers to simulate the geomorphology of fresh root surface.

Conclusions

Dehydrated teeth had deteriorated geomorphology of the root surface, which could be reversed by the re‐use of the fibers embedded in the cementum using citric acid. Direct evidence from SEM gives new insights into the replantation of dehydrated avulsed teeth.
Academics' and students' experiences in a chilean dental school during the COVID‐19 pandemic: A qualitative study
Authors: Prieto Diego , Tricio Jorge , Cáceres Felipe , Param Fernanda , Meléndez Catalina , Vásquez Pamela , Prada Pamela
Published: December 2020

Introduction

The quick spread of COVID‐19 has caused part of the world's population to adopt quarantine protocols that have limited professional activities, including dental training programmes. This study aimed to explore the experiences of students and personnel at a Chilean dental school during the COVID‐19 pandemic.

Materials and Methods

This phenomenological descriptive qualitative study reported staff and students’ experiences during the pandemic through in‐depth, semi‐structured interviews. These were recorded on audio and video with a digital platform. Three researchers then transcribed and analyzed the recordings and codified the answers into categories to determine the emerging topics until a saturation point was reached.

Results

The core emerging themes among the staff group were (1) change in the personal/professional life balance, (2) online learning through digital platforms, (3) staff perceptions of students’ learning experiences, and (4) concerns about the future. For students, the themes were (1) changes in the learning process, (2) online learning through digital platforms, (3) interpersonal relationships, and (4) concerns about the future.

Conclusion

The COVID‐19 pandemic has been a period of learning for our dental school staff and students. Even though online learning has been a useful tool for delivering didactic (theoretical) concepts, it has been unable to replace conventional education, including skills training. Students and teachers reported being overwhelmed at the beginning of the pandemic, but they have shown remarkable adaptability and resilience during this period.
Effectiveness of enhanced video‐based learning on removable partial denture module
Authors: Abd‐Shukor Siti N. , Yahaya Norziha , Tamil Azmi M. , Botelho Micheal G. , Ho Ting K.
Published: December 2020

Introduction

The application of video‐based learning in dentistry has been widely investigated; however, the nature of on‐screen video enhancements of the video has been minimally explored in the literature. This study investigated the effectiveness of an in‐class and on‐demand enhanced video to support learning on removable partial dentures in terms of knowledge acquisition, perception and clinical skill performance.

Methods

Fifty‐four dental students enrolled in 2018 were recruited as participants and assigned to two groups. Both groups were given the same lecture and asked to watch the same video in either the enhanced or non‐enhanced version. The enhanced video was modified with the contemporaneous subtitle of the presenters’ dialogue, text bullet points and summary text pages. The knowledge acquisition from the two types of video was subjected to pre‐ and post‐tests one month after the students watched the video. A questionnaire was used to evaluate the students’ perceptions of the learning experience and a performance test on practical skills was performed after six weeks. All the students responded to the test (100%).

Results

The enhanced video demonstration improved the students’ short‐term knowledge acquisition after they watched the video, with an average score of 1.59 points higher in the enhanced group than in the non‐enhanced group (p < .05). The practical performance did not differ between the two groups. The students were more likely accepted the enhanced video as a replacement of the existing teaching method rather than a teaching supplement (70.3%).

Conclusion

The application of the enhanced video demonstration resulted in a better theoretical knowledge retention but not practical performance. Students also preferred watching video to using conventional learning methods.
Immaterial Alliances: Constructions of Self‐Other Relations and Conceptions of Belonging in the Therapeutic Narratives of Muslim and Buddhist Cambodians
Authors: Lesley Elena
Published: December 2020

Although religious worship was banned during the Khmer Rouge regime (1975–79), spiritual practices are once again flourishing in Cambodia. These include both the practices of the majority Buddhist population and a small but visible Cham Muslim minority. While popular Buddhism in Cambodia today incorporates the legacies of Hinduism and animism in the country, the majority of Cham Muslims have adopted a more orthodox version of Islam due to the influence of global proselytization. This article argues that these dominant strains of religious practice divergently train conscious attention in habitual patterns, cultivating different orientations of intentionality among Khmer Buddhist and Cham Muslim Khmer Rouge survivors. The patterns of attention encouraged by current religious practices shape the narrative organization of memory as survivors engage in an NGO‐sponsored form of psychotherapeutic “testimonial therapy.” As my ethnographic findings demonstrate, these divergent narrative constructions and their public performance reinforce different relational experiences of selfhood and engagement with supernatural others among Cambodian Buddhists and Muslims, with significant implications for perceived social belonging in contemporary society.
Practical protocols for timed artificial insemination of jennies using cooled or frozen donkey semen
Authors: Yang Feng , Li Nan , Liu Bing , Yu Jie , Wu Shuaishuai , Zhang Ruitao , Yang Weigang , Ji Chuanliang , Sun Qianqian , Ma Jinliang , Li Min , Zhou Jingqian , Zhou Xiangshan , Pietrani Melina , Losinno Luis , Zeng Shenming
Published: December 2020

Background

With the expansion of the donkey industry, timed artificial insemination (TAI) is becoming increasingly important in the reproductive management of jennies, however, TAI has not been widely investigated in donkeys.

Objectives

To develop efficient TAI protocols for cooled or frozen semen in jennies, based around ovulation induction with a GnRH analogue.

Study design

Experimental exploratory study.

Methods and Results

In experiment 1, the effects of different GnRH analogue (deslorelin) doses, follicle diameter (FD) at induction, repeated use of a GnRH analogue, and the influence of season on induction efficiency, as well as distribution of ovulations over time after induction were investigated. Induction efficiency was sufficient with 2.2 mg deslorelin (≥90% ovulation within 48 hours of treatment). Ovulation rate between 24 and 48 hours was highest when the FD at treatment was 31‐35 mm, as compared to 25‐30 mm or 36‐40 mm. Repeated use of deslorelin or treatment during different seasons had no effect on induction efficiency. About 70% of ovulations occurred between 32 and 48 hours, and highest incidence of ovulation was at 36‐38 hours after induction. In experiment 2, TAI using cooled semen (1 × 109 motile sperm in a 10 mL volume) was performed once at 8 hours after induction (n = 59). Pregnancy rate after TAI with cooled semen was 49.2% (29/59). In experiment 3, jennies were inseminated twice with 10 (n = 23), 5 (n = 31), 3 (n = 32), 2 (n = 82) and 1 (n = 66) straws (more than 50 × 106 motile spermatozoa in each 0.5 mL straw) of frozen semen at 34 and 42 hours after induction. The pregnancy rates were 30.4%, 35.5%, 34.4%, 29.3% and 28.8%, respectively (P > 0.05).

Main limitations

In the frozen semen trial, 22.5% (68/302) jennies were excluded after failure to ovulate during the appropriate time interval. In addition, there were no control groups for the AI trials.

Conclusion

When FD reaches 31‐35 mm, a donkey jenny can be inseminated once using cooled semen at 8 hours or twice using frozen semen at 34 and 42 hours after deslorelin treatment. The frozen semen TAI protocol resulted in acceptable pregnancy rates using 1 × 108 motile spermatozoa per cycle.
Disentangling effects of predators and landscape factors as drivers of stream fish community structure
Authors: Bruckerhoff Lindsey A. , Gido Keith B. , Estey Michael , Moore Pamela J.
Published: December 2020

Experimental and fine‐scale studies indicate predators can have strong effects on stream fishes. It is unclear, however, how predators interact with landscape factors to influence stream fish communities at scales relevant to management and conservation. Because predators and prey respond to environmental variability, measuring community responses to predators requires resolving the effects of abiotic factors on both predators and prey.

We collected stream fish community data in the summers of 2017 and 2018 and paired structural equation modelling with multivariate methods to identify abiotic factors that influenced the distribution of a predatory fish, largemouth bass (Micropterus salmoides) and community structure of stream fish. We then compared how fish species richness and community composition responded to the presence of bass mediated by environmental factors.

Probability of occurrence of bass increased with catchment area, while richness responded to both natural and anthropogenic characteristics of streams and their catchments. Contrary to our prediction, richness was higher at sites with bass and several species exhibited positive co‐occurrence and abundance patterns with bass, while only one species had a negative relationship.

Higher diversity of stream fishes in the presence of bass highlights the difficulties in understanding the combined effects of predators and environmental variation, both natural and human induced, as drivers of community structure. We discuss several challenges to understanding the effects of predators in natural systems, including unmeasured environmental variability, mismatch of spatial and temporal scales, and context dependency of ecological responses.
The clock is ticking: Temporally prioritizing eradications on islands
Authors: Carter Zachary T. , Lumley Thomas , Bodey Thomas W. , Russell James C.
Published: December 2020

Achieving conservation objectives is time critical, but the vast number of threats and potential actions means some form of ranking is necessary to aid prioritization. Objective methods for ranking conservation actions based on when they are differentially likely to become feasible, or to succeed, are currently unavailable within existing decision‐making frameworks but are critical for making informed management decisions. We demonstrate how statistical tools developed for survival (or time‐to‐event) analysis can be used to rank conservation actions over time, through the lens of invasive mammal eradications on islands. Here we forecast the probability of eradicating commensal rat species (Rattus rattus, R. norvegicus, R. exulans) from the New Zealand archipelago by the government's stated target of year 2050. Our methods provide temporally ranked eradication trajectories for the entire country, thus facilitating meeting nationwide policy goals. This demonstration highlights the relevance and applicability of such an approach and its utility for prioritizing globally effective conservation actions.
Shared functional traits explain synchronous changes in long‐term count trends of migratory raptors
Authors: Dumandan Patricia Kaye T. , Bildstein Keith L. , Goodrich Laurie J. , Zaiats Andrii , Caughlin T. Trevor , Katzner Todd E.
Published: December 2020

Aim

Assessing long‐term shifts in faunal assemblages is important to understand the consequences of ongoing global environmental change. One approach to assess drivers of assemblage changes is to identify the traits associated with synchronous shifts in count trends among species. Our research identified traits influencing trends in 73 years of count data on migrating raptors recorded in the north‐eastern USA.

Location

Pennsylvania, USA.

Time period

1946–2018.

Major taxa studied

Birds of prey/raptors.

Methods

Migrating raptors were counted during autumn, following a standardized protocol. We used a hierarchical breakpoint model to identify when count trends shifted and to assess the role of traits in driving these trends before and after the breakpoint. Specifically, we quantified the probability of the direction (PD) of an effect of body mass, habitat or dietary specialization, migratory behaviour and susceptibility to dichlorodiphenyltrichloroethane (DDT) on count trends.

Results

We documented an assemblage‐wide mean shift in count trends of migrating raptors in 1974. In general, species that exhibited negative count trends before the breakpoint exhibited positive count trends afterwards. We found that traits associated with resource use (diet and habitat specialization) had high probabilities of affecting count trends, pre‐ and post‐breakpoint (> 90%). Moreover, the direction of their effects differed during both periods. Unexpectedly, other traits we evaluated, including DDT susceptibility, had relatively weaker associations with count trends.

Main conclusions

Trait‐based frameworks have promise for testing generalized assumptions about drivers of population trajectories. Historically, DDT was considered a key driver of changes in raptor population trends. However, our analysis suggests that other factors were also relevant. Moreover, the positive association between count trends and generalist behaviour depended on the temporal context. This result has implications for other settings where demographic trends can be linked to traits and help to identify drivers of biodiversity change.
University‐industry‐government triple helix relationship and regional innovation efficiency in China
Authors: Zhuang Tao , Zhou Zhixia , Li Qingjun
Published: December 2020

By utilizing panel data of provinces in China from 2012 to 2018, this paper measured innovation efficiency of each regional innovation system and the triple helix relationship of the university‐industry‐government system, then, empirically investigated the influence of the triple helix relationship on regional innovation efficiency. It has been found that: (1) the regional innovation efficiency in China increases slightly year by year, the regional differences are obvious, and university–industry bilateral cooperation is the tightest; (2) cooperation between universities and industries is most beneficial to improve regional innovation efficiency, cooperation between universities and governments significantly promotes scale efficiency in the long run, cooperation between industries and governments significantly promotes regional innovation comprehensive efficiency and pure technical efficiency, meanwhile inhibits scale efficiency, coordinated relation among universities, industries, and governments is beneficial to improve regional innovation comprehensive efficiency and scale efficiency. The research results provide useful theoretical support and policy enlightenment for improving regional innovation efficiency.
Usefulness of virtual parenchymal perfusion software visualizing embolized areas to determine optimal catheter position in superselective conventional transarterial chemoembolization for hepatocellular carcinoma
Authors: Miyayama Shiro , Yamashiro Masashi , Ikeda Rie , Matsumoto Junichi , Ogawa Nobuhiko , Sakuragawa Naoko
Published: December 2020

Aim

To determine the optimal catheter position during superselective conventional transarterial chemoembolization (cTACE) for hepatocellular carcinoma (HCC) using virtual parenchymal perfusion software.

Methods

Patients who had newly developed HCC nodules ≤6 cm and five or fewer lesions were eligible. The virtual catheter tip was placed on a tumor‐feeder identified by TACE guidance software using cone‐beam computed tomography during hepatic arteriography to minimize the virtual embolized area (VEA), including the tumor with a safety margin. Conventional transarterial chemoembolization was then carried out at the same position. The VEA and real embolized area where iodized oil was retained on cone‐beam computed tomography after cTACE were compared using the dice similarity coefficient, linear regression analysis, and mean surface distance. Technical success of cTACE and therapeutic effects by the modified Response Evaluation Criteria in Solid Tumors were also evaluated.

Results

Ninety‐one tumors in 56 patients were embolized. The mean dice similarity coefficient values in 80 VEAs and real embolized areas were 0.78 ± 0.01. Both volumes were well correlated (r = 0.957, p < 0.001) with a mean surface distance of 2.78 ± 2.11 mm. Eighty‐four (92.3%) tumors were embolized with a safety margin. Regarding the early response of 82 tumors, complete response was achieved in 72 (87.8%), partial response in six (7.3%), and stable disease in four (4.9%). Regarding responses of 81 tumors during the follow‐up (mean, 20 ± 4.9 months), complete response was maintained in 62 (76.5%), whereas 19 (23.5%), including six that were incompletely embolized, locally progressed.

Conclusion

Virtual parenchymal perfusion software can determine the optimal catheter position in superselective cTACE.
Transmitted HIV‐1 drug resistance in a large international cohort using next‐generation sequencing: results from the Strategic Timing of Antiretroviral Treatment (START) study
Authors: Baxter JD , Dunn D , Tostevin A , Marvig RL , Bennedbæk M , Cozzi‐Lepri A , Sharma S , Kozal MJ , Gompels M , Pinto AN , Lundgren J ,   for the INSIGHT START Study Group
Published: December 2020

Objectives

The aim of this analysis was to characterize transmitted drug resistance (TDR) in Strategic Timing of Antiretroviral Treatment (START) study participants by next‐generation sequencing (NGS), a sensitive assay capable of detecting low‐frequency variants.

Methods

Stored plasma from participants with entry HIV RNA > 1000 copies/mL were analysed by NGS (Illumina MiSeq). TDR was based on the WHO 2009 surveillance definition with the addition of reverse transcriptase (RT) mutations T215N and E138K, and integrase strand transfer inhibitor (INSTI) surveillance mutations (Stanford HIVdb). Drug resistance mutations (DRMs) detected at three thresholds are reported: > 2%, 5% and 20% of the viral population.

Results

Between 2009 and 2013, START enrolled 4684 antiretroviral therapy (ART)‐naïve individuals in 35 countries. Baseline NGS data at study entry were available for 2902 participants. Overall prevalence rates of TDR using a detection threshold of 2%/5%/20% were 9.2%/5.6%/3.2% for nucleoside reverse transcriptase inhibitors (NRTIs), 9.2%/6.6%/4.9% for non‐NRTIs, 11.4%/5.5%/2.4% for protease inhibitors (PIs) and 3.5%/1.6%/0.1% for INSTI DRMs and varied by geographic region. Using the 2% detection threshold, individual DRMs with the highest prevalence were: PI M46IL (5.5%), RT K103NS (3.5%), RT G190ASE (3.1%), T215ISCDVEN (2.5%), RT M41L (2.2%), RT K219QENR (1.7%) and PI D30N (1.6%). INSTI DRMs were detected almost exclusively below the 20% detection threshold, most commonly Y143H (0.4%), Q148R (0.4%) and T66I (0.4%).

Conclusions

Use of NGS in this study population resulted in the detection of a large proportion of low‐level variants which would not have been detected by traditional Sanger sequencing. Global surveillance studies utilizing NGS should provide a more comprehensive assessment of TDR prevalence in different regions of the world.
Streptococcus mutans and Streptococcus sobrinus distribution in the saliva and plaque of Iranian population: Higher prevalence of S. mutans serotypes f and k
Authors: Babaeekhou Laleh , Ghane Maryam , Ezatzade Farshad , Eftekhari Toroghi Sadegh
Published: December 2020

Objective

This study aimed to find the relation of the MS co‐existence with the decayed, missing (Extracted) and filled teeth (DMFT) score and the prevalence of Streptococcus mutans serotypes in the Iranian population.

Methods

In this cross‐sectional research conducted in 2018, volunteers aged 10–60< years were measured by population selection criteria. PCR technique was used to screen MS serotypes in the homogenized saliva and plaque samples.

Results

499 subjects met the selection criteria of the study population. Out of 499 samples, 448 samples were finalized for serotype determination and DMFT relation evaluation. From 448, 348 (77.6%) samples harboured only S. mutans, 44 (9.8%) had both S. mutans and S. sobrinus, 6 (1.3%) were positive for S. sobrinus alone, and 94 (20.9%) were free of both specious. The mean DMFT score in people with S. mutans (6.7) was higher than S. mutans negative (4.6) participants (p < 0.05). In people with both S. mutans and S. sobrinus, the mean DMFT did not change significantly. The frequency of c, e, f and k serotypes was 47.7, 22.7, 27.5 and 22.1%, respectively. The mean DMFT score in participants with serotype e was significantly higher than others (p < .05).

Conclusions

People can acquire different S. mutans serotypes over a lifetime. The high prevalence rate of serotype k, a systemic S. mutans serotype, calls worldwide studies on the prevalence of serotype k strains.
Accuracy and efficiency of guided root‐end resection using a dynamic navigation system: a human cadaver study
Authors: Dianat O. , Nosrat A. , Mostoufi B. , Price J.B. , Gupta S. , Martinho F. C.
Published: December 2020

Aim

To determine and compare the accuracy and efficiency of a dynamic navigation system (DNS) with a freehand (FH) technique when conducting root‐end resection in a human cadaver model.

Methodology

Forty roots in cadaver heads were included and divided into two groups: DNS (n = 20) and FH (n = 20). Cone beam computed tomography (CBCT) scans of all teeth were taken. The drilling path and depth were planned virtually to using the X‐guide software (X‐Nav Technologies, Lansdale, PA, USA). Osteotomy and root‐end resection were done under navigation in the DNS group, and freehand under the dental operating microscope in the FH group. Post‐operative CBCTs were taken. Linear deviations, angular deflection, time of operation and number of mishaps were compared with determine the accuracy and efficiency. Shapiro–Wilk, one‐way ANOVA and Fisher exact tests were used (P < 0.05).

Results

Linear deviations, angular deflection and operation time were significantly less in the DNS group (P < 0.05). The number of mishaps was not different between the two groups (P > 0.05). Subgroup analyses revealed that the distance of >5 mm from buccal cortical plate was significantly associated with lower accuracy, increased operation time and greater incidence of mishaps in the FH group (P < 0.05), but not in the DNS group.

Conclusions

The dynamic navigation system was more accurate and more efficient in root‐end resection in a cadaver model than the freehand technique. The distance of the roots from the buccal cortical plate had a significant negative impact on the accuracy and efficacy of the root‐end resection procedure when using the freehand technique. The dynamic navigation system has the potential to be a safe and reliable technological addition to endodontic microsurgery.
Emulsion‐forming properties of heat‐induced pork myofibrillar protein affected by NaCl
Authors: Zhu Chao‐Zhi , Jin Hao‐Quan , Yin Feng , Cui Wen‐Ming , Zhang Qiu‐Hui , Zhao Gai‐Ming
Published: December 2020

The emulsification characteristics of myofibrillar proteins (MPs) with different NaCl concentrations also affect the quality of meat products after cooking. We investigated the effects of heating (100 °C) on the solubility, emulsifying activity, and conformational and environmental changes of MPs prepared with different NaCl concentrations. Emulsifying activity increased with increasing NaCl prior to heating, but there was no significant effect after heating. The viscosity increased and particle size decreased with increasing NaCl before heating, but these properties did not change after heating. NaCl did not affect the amount of α‐helix and β‐sheet. We deduced that the different emulsifying activity of myofibrillar proteins with different NaCl concentrations after heating may have been due to changes in the local environment of MPs. An understanding of the physicochemical and functional properties of MPs would unlock an area for development of meat products at different NaCl and temperature in the food industry.
Cooking does not impair the impact of pulsed electric field on the protein digestion of venison (Cervus elaphus) during in vitro gastrointestinal digestion
Authors: Bhat Zuhaib F. , Morton James D. , Mason Susan L. , Jayawardena Sasika Reshan , Mungure Tanyaradzwa , Bekhit Alaa El‐Din A.
Published: December 2020

The present study was conducted to elucidate whether cooking impairs the positive effect of pulsed electric field (PEF) on the digestibility of venison during in vitro gastrointestinal protein digestion. Previous studies have used fresh uncooked meat to demonstrate the effect of PEF on protein digestibility during gastrointestinal digestion neglecting the effect that cooking could induce during meat preparation process. PEF‐treated samples (T1, 10 kV, 90 Hz, 20 µs) were cooked (core temperature of 75 °C) and subjected to in vitro simulated gastrointestinal protein digestion along with non‐treated controls. A 3% increase of in vitro protein digestibility was found in cooked PEF‐treated venison (P < 0.05). A positive (P < 0.05) impact of PEF processing was observed on overall protein digestion as measured by soluble protein (%) and SDS‐PAGE. PEF did not change (P > 0.05) the release of minerals from cooked venison during digestion. Cooking had no negative influence on the mechanism through which PEF operates in improving the protein digestibility of venison.
Qualitative process evaluation of a problem‐solving and Story‐bridge based mental health literacy program with community leaders in Ghana
Authors: Arthur Yaw Amankwa , Boardman Gayelene H. , McCann Terence V.
Published: December 2020

Improved knowledge about, and positive attitudes towards, people with mental illness could lead to improved support and decreased stigma for people with mental illness, including their families and carers. The aims of our study were to evaluate the perspectives of community leaders about the usefulness of a cluster randomized trial of a problem‐solving and Story‐bridge based mental health literacy (MHL) programme and to understand whether they utilized the knowledge acquired from the programme in their usual interactions with people with mental illness and their families. Twenty‐five participants were sampled randomly from the intervention cluster of the trial to participate in a qualitative process evaluation, and individual interviews were used to collect data. A thematic analysis of the data was undertaken. Three themes were abstracted from the data, reflecting participants’ perspectives about the usefulness of the programme: overcoming fear of perceived dangerousness, increasing willingness to engage, and becoming empathetic and non‐judgemental. This qualitative process evaluation offers insights into how a problem‐solving and Story‐bridge based MHL programme to a targeted group could lead to real and supportive actions/attitudes to people with mental illness. The findings have clinical relevance for a collaboration among family members and caregivers, community leaders and community psychiatric nurses, and other primary healthcare workers to develop community MHL strategies to improve the quality of care, support and life of people with mental disorders.
The factors related to a sedentary lifestyle: A meta‐analysis review
Authors: Martins Larissa Castelo Guedes , Lopes Marcos Venícios de Oliveira , Diniz Camila Maciel , Guedes Nirla Gomes
Published: December 2020

Aims

To compare factors associated with the sedentary lifestyle described in the literature with the factors listed in NANDA International.

Design

Systematic review with meta‐analysis of factors associated with a sedentary lifestyle in adolescents, adults and older people.

Data sources

An electronic search of PubMed, Scopus, CINAHL and Latin America and the Caribbean Literature on Health and Science databases conducted in May 2016.

Review methods

Descriptive data were extracted according to a standardized form. The odds ratios for each etiological factor associated with a sedentary lifestyle were extracted directly from the articles or calculated from the data described therein. The meta‐analysis was conducted for factors that were investigated in more than one study.

Results

Thirty‐five articles were included. The statistically significant factors were: lack of social support, of physical space, of time, of motivation, of sports skills and of interest in physical activity, intolerance to activity, being retired, living in a low‐income country, laziness, not having a job/studying, low socioeconomic status and level of knowledge about physical activity, female gender, living in an urban area, negative self‐perception of health, using public transportation, being in the oldest age group in the study and perceived physical disability.

Conclusion

The new factors associated with a sedentary lifestyle and those already included in the NANDA International classification will lead to better clinical guidance for nurses.

Impact

Knowledge about these factors can contribute directly to public health policies.
Validation of novel identification algorithms for major adverse cardiovascular events in a Japanese claims database
Authors: Shima Daisuke , Ii Yoichi , Higa Shingo , Kohro Takahide , Hoshide Satoshi , Kono Ken , Fujimoto Shigeru , Niijima Satoshi , Tomitani Naoko , Kario Kazuomi
Published: December 2020

Predicting clinical outcomes can be difficult, particularly for life‐threatening events with a low incidence that require numerous clinical cases. Our aim was to develop and validate novel algorithms to identify major adverse cardiovascular events (MACEs) from claims databases. We developed algorithms based on the data available in the claims database International Classification of Diseases, Tenth Revision (ICD‐10), drug prescriptions, and medical procedures. We also employed data from the claims database of Jichi Medical University Hospital, Japan, for the period between October 2012 and September 2014. In total, we randomly extracted 100 potential acute myocardial infarction cases and 200 potential stroke cases (ischemic and hemorrhagic stroke were analyzed separately) based on ICD‐10 diagnosis. An independent committee reviewed the corresponding clinical data to provide definitive diagnoses for the extracted cases. We then assessed the algorithms’ accuracy using positive predictive values (PPVs) and apparent sensitivities. The PPVs of acute myocardial infarction, ischemic stroke, and hemorrhagic stroke were low only by diagnosis (81.6% [95% CI 72.5–88.7]; 31.0% [95% CI 22.8–40.3]; and 45.5% [95% CI 34.1–57.2], respectively); however, the PPVs were elevated after adding the prescription and procedure data (87.0% [95% CI 78.3–93.1]; 44.4% [95% CI 32.7–56.6]; and 46.1% [95% CI 34.5–57.9], respectively). When we added event‐specific prescription and procedure data to the algorithms, the PPVs for each event increased to 70%–98%, with apparent sensitivities exceeding 50%. Algorithms that rely on ICD‐10 diagnosis in combination with data on specific drugs and medical procedures appear to be valid for identifying MACEs in Japanese claims databases.
Combination of hyperglycaemia and hyperlipidaemia induces endothelial dysfunction: Role of the endothelin and nitric oxide systems
Authors: Abu‐Saleh Niroz , Yaseen Hiba , Kinaneh Safa , Khamaisi Mogher , Abassi Zaid
Published: December 2020

Endothelial dysfunction (ED) is a key feature of diabetes and is a major cause of diabetic vasculopathy. Diabetic patients who also exhibit hyperlipidaemia suffer from accelerated vascular complications. While the deleterious effects of high glucose levels (HG) and hyperlipidaemia alone on ED are well established, the effects of combined hyperlipidaemia and HG have not been thoroughly studied. Therefore, the current study examines whether HG and hyperlipidaemia exert synergistic ED, and explores the mechanisms underlying this phenomenon. We applied multi‐disciplinary approaches including cultured HUVECs and HMEC‐1 as well as knockout mice CByJ.129S7(B6)‐Ldlrtm1Her/J (LDLR−/−) to investigate the mechanisms underlying combined HG and hyperlipidaemia‐induced ED. Incremental doses of glucose in the presence or absence of OxLDL were added to HUVECs and HMEC‐1. After 5 days, the status of nitric oxide (NO) and endothelin (ET)‐1 systems as well as their signal transduction were assessed using Western blot, ELISA and immunoreactive staining. The effects of chronic combination of HG and hyperlipidaemia on endothelial integrity and function as well as alterations in circulatory NO and ET‐1 systems were examined in knockout mice LDLR−/− and their wild‐type. HUVEC cells exposed to HG and OxLDL displayed enhanced ET‐1 production, more than HG or OxLDL when added alone. Overproduction of ET‐1 stems from up‐regulation of endothelin converting enzyme (ECE)‐1 as observed under these conditions. In contrast, combination of HG and OxLDL dramatically decreased both total endothelial NO synthase (eNOS) by 60%, and activated eNOS (peNOS) by 80%. Moreover, NRF2 decreased by 42% and its active form (pNRF2) by 56%, as compared to baseline. Likewise, ETB levels decreased by 64% from baseline on endothelial cells. Furthermore, diabetic LDLR−/− mice displayed a higher blood pressure, plasma triglycerides, cholesterol, ET‐1 and NO2/NO3 levels, when compared with normoglycemic LDLR−/− and BALB mice. Combined hyperglycaemia and hyperlipidaemia activates the ET system and attenuates the nitric oxide system with the Nrf2 signalling pathway. These findings suggest that perturbations in these paracrine systems may contribute to ED.
Rea regulates microglial polarization and attenuates neuronal apoptosis via inhibition of the NF‐κB and MAPK signalings for spinal cord injury repair
Authors: Xiao Shining , Wang Chenggui , Yang Quanming , Xu Haibin , Lu Jinwei , Xu Kan
Published: December 2020

Inflammation and neuronal apoptosis aggravate the secondary damage after spinal cord injury (SCI). Rehmannioside A (Rea) is a bioactive herbal extract isolated from Rehmanniae radix with low toxicity and neuroprotection effects. Rea treatment inhibited the release of pro‐inflammatory mediators from microglial cells, and promoted M2 polarization in vitro, which in turn protected the co‐cultured neurons from apoptosis via suppression of the NF‐κB and MAPK signalling pathways. Furthermore, daily intraperitoneal injections of 80 mg/kg Rea into a rat model of SCI significantly improved the behavioural and histological indices, promoted M2 microglial polarization, alleviated neuronal apoptosis, and increased motor function recovery. Therefore, Rea is a promising therapeutic option for SCI and should be clinically explored.
The regulation of NONO by USP11 via deubiquitination is linked to the proliferation of melanoma cells
Authors: Feng Peifu , Li Ling , Dai Jing , Zhou Lingli , Liu Jing , Zhao Jinfeng , Li Xiaodong , Ling Neng , Qiu Siyuan , Zhang Lin , Xie Tiantian , Chen Yinglei , Donovan Michael J. , Peng Tianhuan , Song Jianhui , Ye Mao
Published: December 2020

Ubiquitin‐specific protease 11 (USP11) has been implicated in the regulation of DNA repair, apoptosis, signal transduction and cell cycle. It belongs to a USP subfamily of deubiquitinases. Although previous research has shown that USP11 overexpression is frequently found in melanoma and is correlated with a poor prognosis, the potential molecular mechanism of USP11 in melanoma remains indefinitive. Here, we report that USP11 and NONO colocalize and interact with each other in the nucleus of melanoma cells. As a result, the knockdown of USP11 decreases NONO levels. Whereas, overexpression of USP11 increases NONO levels in a dose‐dependent manner. Furthermore, we reveal that USP11 protects NONO protein from proteasome‐mediated degradation by removing poly‐ubiquitin chains conjugated onto NONO. Functionally, USP11 mediated melanoma cell proliferation via the regulation of NONO levels because ablation of USP11 inhibits the proliferation which could be rescued by ectopic expression of NONO protein. Moreover, a significant positive correlation between USP11 and NONO concentrations was found in clinical melanoma samples. Collectively, these results demonstrate that USP11 is a new deubiquitinase of NONO and that the signalling axis of USP11‐NONO is significantly involved in melanoma proliferation.