bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatial-temporal variables for swimming coaches: A comparison study between video and TritonWear sensor
Authors: Pla Robin , Ledanois Thibaut , Simbana Escobar David , Aubry Anaël , Tranchard Benjamin , Toussaint Jean-François , Sedeaud Adrien , Seifert Ludovic
Published: July 2021

The main aim of this study was to evaluate the validity and the reliability of a swimming sensor to assess swimming performance and spatial-temporal variables. Six international male open-water swimmers completed a protocol which consisted of two training sets: a 6×100m individual medley and a continuous 800 m set in freestyle. Swimmers were equipped with a wearable sensor, the TritonWear to collect automatically spatial-temporal variables: speed, lap time, stroke count (SC), stroke length (SL), stroke rate (SR), and stroke index (SI). Video recordings were added as a “gold-standard” and used to assess the validity and the reliability of the TritonWear sensor. The results show that the sensor provides accurate results in comparison with video recording measurements. A very high accuracy was observed for lap time with a mean absolute percentage error (MAPE) under 5% for each stroke (2.2, 3.2, 3.4, 4.1% for butterfly, backstroke, breaststroke and freestyle respectively) but high error ranges indicate a dependence on swimming technique. Stroke count accuracy was higher for symmetric strokes than for alternate strokes (MAPE: 0, 2.4, 7.1 & 4.9% for butterfly, breaststroke, backstroke & freestyle respectively). The other variables (SL, SR & SI) derived from the SC and the lap time also show good accuracy in all strokes. The wearable sensor provides an accurate real time feedback of spatial-temporal variables in six international open-water swimmers during classical training sets (at low to moderate intensities), which could be a useful tool for coaches, allowing them to monitor training load with no effort.
Blood eosinophil count-guided corticosteroid therapy and as a prognostic biomarker of exacerbations of chronic obstructive pulmonary disease: a systematic review and meta-analysis
Authors: Liu Tao , Xiang Zi-Jian , Hou Xiao-Meng , Chai Jing-Jing , Yang Yan-Li , Zhang Xiao-Tong
Published: July 2021

Background:

Chronic obstructive pulmonary disease (COPD) is characterized by persistent respiratory symptoms and dyspnea, as well as an increase in the number of leukocytes in the airways, lungs, and pulmonary vessels. A ‘One size fits all’ approach to COPD patients with different clinical features may be considered outdated. The following are the two major objectives of this meta-analysis: the first is to determine if blood eosinophil counts (BEC) can serve as a prognostic biomarker of COPD outcomes, and the second is to determine which level of BEC is effective for inhaled corticosteroid (ICS) treatment.

Methods:

We searched articles published before 15 May 2021 in the following four electronic databases: Web of Science, Cochrane Library, EMBASE, and PubMed.

Results:

A total of 42 studies, comprising a sampling of 188,710 subjects, were summarized and compared in this meta-analysis. The rate ratio (RR) of exacerbations of COPD (ECOPD) between ICS and non-ICS treatment was statistically significant for the COPD patients with a baseline BEC ⩾ 2% or ⩾ 200 cells/μl, RR = 0.82 (0.73, 0.93) or 0.79 (0.70, 0.89) respectively, while the RR of ECOPD between ICS and non-ICS treatment was statistically insignificant for the COPD patients with baseline BEC < 2% or <200 cells/μl, RR = 0.97 (0.87, 1.08) or 0.97 (0.86, 1.08), suggested that ICS therapy was beneficial to the improvement of ECOPD in patients with a baseline BEC ⩾ 2% or BEC ⩾ 200 cells/μl.

Conclusion:

Our research shows that a BEC ⩾ 200 cells/μl or ⩾2% is likely to become the cutoff value of ICS treatment for ECOPD. Moreover, we believe that the baseline BEC can be used as a biomarker for predicting ECOPD. The stability of BEC requires special attention.
An unusual case of facial nerve palsy due to minor face trauma: A rare case report
Authors: Ghimire Rajan
Published: July 2021

There can be various causes of facial palsy, and sometimes the cause remains unidentified (Bell’s palsy). Among the various causes of facial palsy, trauma is a major one. Depending on the severity of paralysis, traumatic facial palsy can be medically managed using corticosteroid and eye care or with surgical decompression. In selective cases with incomplete facial palsy, radio-imaging studies may not always be required. We present the case of a 13-year-old boy who presented to the primary-level hospital with a complaint of facial palsy following minor trauma to the face (slapped over the face by a friend). His Sunnybrook Score was 63/100. We managed him with prednisolone (1 mg/kg/day) for 2 weeks and then tapered, and with eye care with artificial tears for 6 weeks. There was a complete resolution of symptoms in 6 weeks. Incomplete facial paralysis due to trauma to the face can be managed medically with corticosteroids and proper eye care with artificial tears.
Deficit Lay or Deficit Expert: How Do “Experts” in Environmental Projects Perceive Lay People and Lay Knowledge?
Authors: Koizumi Hatsue , Yamashita Hiromi
Published: July 2021

This research reveals expert perceptions of lay people and lay knowledge in environmental projects, such as information giving activities, research projects, and environmental planning projects. A semistructured interview method was employed with six researchers from a university in Sweden. Although the expert–lay relationship has traditionally been discussed within a “deficit model,” many experts in this research expressed a more positive view of lay people and lay knowledge; however, situations where lay knowledge was considered useful varied. The experts’ motivation for communication was analyzed within the four communication modes of education, responding, supplementing, and dialogue. Their recognition of the “deficit expert” was one of the remarkable findings: the experts acknowledged their knowledge and competence in understanding “reality” had its limitations and questioned the objectivity and universality of science in relation to environmental science.
Secondary School Teachers’ Professional Development in Australia and Shanghai: Needs, Support, and Barriers
Authors: Fang Guangbao , Chan Philip Wing Keung , Kalogeropoulos Penelope
Published: July 2021

Using data from the Teaching and Learning International Survey (TALIS; 2013), this article explores teachers’ needs, support, and barriers in their professional development. The research finds that Australian teachers expressed greater needs in information and communication technology (ICT) use and new technology training for teaching, while Shanghai teachers required more assistance to satisfy students’ individual learning and pedagogical competencies. More than 80% of Australian and Shanghai teachers received scheduled time to support their participation in professional development, whereas less than 20% of Australian and Shanghai teachers received monetary or nonmonetary support. In terms of barriers, Australian and Shanghai teachers reported two significant barriers that conflicted with their participation in professional development: “working schedule” and “a lack of incentives to take part.” This article reveals implications of the study in the design of an effective professional development program for Australian and Shanghai teachers and ends with discussing the limitations of the research and future research directions.
Factors Affecting Sustainable Intention to Use Mobile Banking Services
Authors: Naruetharadhol Phaninee , Ketkaew Chavis , Hongkanchanapong Niracha , Thaniswannasri Piranat , Uengkusolmongkol Techin , Prasomthong Sirapassorn , Gebsombut Nathatenee
Published: July 2021

This study aims to (a) identify perception factors that affect current mobile banking (M-banking) consumers’ continuous use of the technology, (b) explain the self-service technology (STT) dimensions that affect customers’ behavioral intention, and (c) be able to offer recommendations to the banking industry or other organizations related to M-banking in terms of developing M-banking services in the future. Analyzed data were collected from 688 existing Thai M-banking users through online questionnaires. This study used the SPSS and AMOS statistical programs to analyze the data by applying structural equation modeling based on SSTs’ service qualities and the technology acceptance model (TAM). From the results, this analysis shows positive and significant relationships among SSTs’ service qualities, perception, and sustainable intention to use M-banking services. This study provides vital knowledge related to essential characteristics of M-banking as an STT that could assist banking institutions and application providers in enhancing their M-banking products. Moreover, this study adds to the knowledge area of SSTs’ service qualities in financial mobile application dimensions.
Bridging Cultural Identities: Examining Newcomer’s Post-Secondary School Integration Experiences Through an Arts-Based Ethnographic Approach
Authors: Saunders Jessica F. , Zak Michelle , Matejko Emily , Kassan Anusha , Mukred Rabab , Priolo Alissa
Published: July 2021

Many modern emerging adults undertake the task of identity development while navigating life on a post-secondary campus, where they assimilate to new social and learning environments. Emerging adult newcomers (i.e. immigrants) must navigate additional developmental challenges as they reconcile their cultural, ethnic, and personal identity development simultaneously while facing systemic barriers to post-secondary integration. We employed an arts-based engagement ethnography to investigate the post-secondary integration experiences of 10 emerging adults from a person-first perspective. Through cultural probes, individual semi-structured interviews, and focus groups, we identified four key structures to participants’ integration experience: fitting in (through assimilation and accommodation), biculturalism, managing familial expectations, and being a newcomer in the classroom. This research clarifies the key experiences shaping young newcomer identity development and highlights the profound ways in which young newcomers negotiate and reconcile their intersecting identities while integrating into new education contexts following migration.
A Rare Case Report of a Corpus Callosal Splenial Lesion in the Context of Atypical Neuroleptic Malignant Syndrome
Authors: Serdenes Ryan , Orr Samuel , Trio Pamela , Chandrasekhara Seetha , Musselman Meghan
Published: July 2021

In this report, we describe a case of atypical neuroleptic malignant syndrome (NMS) presenting with an isolated lesion in the splenium of the corpus callosum (ILSCC). There is a paucity of information regarding this topic within the literature and only 7 previous case reports have been published at the time of writing. To our knowledge, this case report is also the first to describe an atypical NMS variant in the context of an ILSCC. In this report, we describe the important considerations in formulating differential diagnosis for ILSCC and are the first report to propose a possible pathophysiological mechanism relating ILSCC with NMS.
Rhabdoid Meningioma Metastases Cervical Lymph Nodes: A Rare Clinical Case Report and Treatment Outcome
Authors: Nguyen Dang Van , Duong Nghĩa Van , Tran Toan Trung
Published: July 2021

Meningioma is the most common central nervous system tumor that usually behaves benignly and has a good prognosis after treatment with tumor gross resection and with or without adjuvant therapy. Malignancy in meningioma is very rare and extracranial metastasis to cervical lymph nodes is even rarer. We report a case of a 40-year-old woman diagnosed with metastatic rhabdoid meningioma. She had recurrent primary disease and metastasis to bilateral cervical lymph nodes. She previously had intracranial tumor twice resected. We also review relevant, previously published cases in the literature. I hope you find these suggestions helpful.
Discursive politics and policy (im)mobility: Metro-TOD policies in India
Authors: Mittal Harsh , Shah Arpit
Published: July 2021

Large investments in metro systems, supported through a Transit-Oriented Development (TOD) regime, have become the preferred policy option to achieve sustainable and inclusive urban mobility in India. In this paper, we examine the particular practices and power relations through which metro-TOD policies have emerged and gained discursive dominance in India’s urban transport policies. We do so by bringing together urban policy mobilities (UPM) and argumentative discourse analysis (ADA) to conceptualize (im)mobility as the intense movement of specific discursive framings to the exclusion of others. Our analysis brings out the crucial role played by Urban Mobility India (UMI), an annual conference organized by the Indian federal government, in the (im)mobility of metro-TOD policies across Indian cities. We contribute to the growing literature on the power-laden nature of policy circulation in the Global South and address concerns regarding lack of analytical attention to marginalized policy pathways and immobile elements of mobile policies in UPM literature. We argue that policy mobility scholars can move beyond the analytical binaries of mobile/immobile policies by drawing upon the concepts of ADA which allow close examination of the discursive politics at play in policy related conferences. By studying the intra-national (im)mobility of metro-TOD policies in India, we expand the bounds of UPM literature towards a geography that has received limited attention thus far.
Chronic Pain is Associated With Reduced Sympathetic Nervous System Reactivity During Simple and Complex Walking Tasks: Potential Cerebral Mechanisms
Authors: Yeater Taylor D. , Clark David J. , Hoyos Lorraine , Valdes-Hernandez Pedro A. , Peraza Julio A. , Allen Kyle D. , Cruz-Almeida Yenisel
Published: July 2021

Background

Autonomic dysregulation may lead to blunted sympathetic reactivity in chronic pain states. Autonomic responses are controlled by the central autonomic network (CAN). Little research has examined sympathetic reactivity and associations with brain CAN structures in the presence of chronic pain; thus, the present study aims to investigate how chronic pain influences sympathetic reactivity and associations with CAN brain region volumes.

Methods

Sympathetic reactivity was measured as change in skin conductance level (ΔSCL) between a resting reference period and walking periods for typical and complex walking tasks (obstacle and dual-task). Participants included 31 people with (n = 19) and without (n = 12) chronic musculoskeletal pain. Structural 3 T MRI was used to determine gray matter volume associations with ΔSCL in regions of the CAN (i.e., brainstem, amygdala, insula, and anterior cingulate cortex).

Results

ΔSCL varied across walking tasks (main effect p = 0.036), with lower ΔSCL in chronic pain participants compared to controls across trials 2 and 3 under the obstacle walking condition. ΔSCL during typical walking was associated with multiple CAN gray matter volumes, including brainstem, bilateral insula, amygdala, and right caudal anterior cingulate cortex (p’s < 0.05). The difference in ΔSCL from typical-to-obstacle walking were associated with volumes of the midbrain segment of the brainstem and anterior segment of the circular sulcus of the insula (p’s < 0.05), with no other significant associations. The difference in ΔSCL from typical-to-dual task walking was associated with the bilateral caudal anterior cingulate cortex, and left rostral cingulate cortex (p’s < 0.05).

Conclusions

Sympathetic reactivity is blunted during typical and complex walking tasks in persons with chronic pain. Additionally, blunted sympathetic reactivity is associated with CAN brain structure, with direction of association dependent on brain region. These results support the idea that chronic pain may negatively impact typical autonomic responses needed for walking performance via its potential impact on the brain.
Management of Basal Cell Adenoma of Accessory Parotid Gland Through Transoral Approach: Report of a Rare Case With Review
Authors: Naik Charudatta , Joshi Sanjay , Mhatre Bhupendra , Punamiya Sneha
Published: July 2021

Diagnosis of mid-cheek mass has always been a diagnostic dilemma for clinicians. The incidence of the accessory parotid gland (APG) has been well documented in the literature. However, a diverse spectrum of pathologies can arise from this accessory parotid tissue. Basal cell adenoma is a rare benign tumor that predominantly affects the parotid gland. Its occurrence in the accessory parotid gland has been documented in 9 cases till date. Surgical approaches for the management of such APG lesions have been in debate. This report documents a case of Basal Cell Adenoma arising in accessory parotid tissue in a 55-year-old woman who was treated by transoral excision. This paper also reviews previously documented cases of all APG lesions and attempts to elucidate the rationale for selecting an appropriate surgical approach.
Increasing Social Communication of Students With Intellectual Disability in Rural College Classrooms
Authors: Douglas Karen H. , Idol Whitney A. , Chung Yun-Ching
Published: July 2021

As more students with an intellectual disability are attending postsecondary programs at colleges and universities, these students are presented with new opportunities for socialization (e.g., conversing with peers and faculty across campus environments, joining organizations of interest, and participating in campus events). The generalization of social skills to new settings and classrooms with unfamiliar people may be challenging for some individuals with an intellectual disability. We conducted a single-case study using a multiple baseline design across student and peer pairs to evaluate the effects of peer training on the social communication of students in rural college classrooms. Specifically, we collected data on students taking three or more turns during conversations, initiating or responding to their peer partners, and discussing academic or social topics (communication function) using partial interval recordings. After a brief training session with peers, all students increased the percentage of intervals taking three or more turns, with the majority of student responses focusing on academic content. We conclude the article by discussing key findings, limitations, future research directions, and implications for practice.
Multimodal single-cell analysis of cutaneous T-cell lymphoma reveals distinct subclonal tissue-dependent signatures
Authors: Herrera Alberto , Cheng Anthony , Mimitou Eleni P. , Seffens Angelina , George Dean , Bar-Natan Michal , Heguy Adriana , Ruggles Kelly V. , Scher Jose U. , Hymes Kenneth , Latkowski Jo-Ann , Ødum Niels , Kadin Marshall E. , Ouyang Zhengqing , Geskin Larisa J. , Smibert Peter , Buus Terkild B. , Koralov Sergei B.
Published: July 2021

Cutaneous T-cell lymphoma (CTCL) is a heterogeneous group of mature T-cell neoplasms characterized by the accumulation of clonal malignant CD4+ T cells in the skin. The most common variant of CTCL, mycosis fungoides (MF ), is confined to the skin in early stages but can be accompanied by extracutaneous dissemination of malignant T cells to the blood and lymph nodes in advanced stages of disease. Sézary syndrome (SS), a leukemic form of disease, is characterized by significant blood involvement. Little is known about the transcriptional and genomic relationship between skin- and blood-residing malignant T cells in CTCL. To identify and interrogate malignant clones in matched skin and blood from patients with leukemic MF and SS, we combine T-cell receptor clonotyping with quantification of gene expression and cell surface markers at the single cell level. Our data reveal clonal evolution at a transcriptional and genetic level within the malignant populations of individual patients. We highlight highly consistent transcriptional signatures delineating skin- and blood-derived malignant T cells. Analysis of these 2 populations suggests that environmental cues, along with genetic aberrations, contribute to transcriptional profiles of malignant T cells. Our findings indicate that the skin microenvironment in CTCL promotes a transcriptional response supporting rapid malignant expansion, as opposed to the quiescent state observed in the blood, potentially influencing efficacy of therapies. These results provide insight into tissue-specific characteristics of cancerous cells and underscore the need to address the patients’ individual malignant profiles at the time of therapy to eliminate all subclones.
Leukocyte count and the risk of adverse outcomes in patients with HFpEF
Authors: Zhu Zhaowei , Zhou Shenghua
Published: July 2021

Background

Inflammation is a key feature of heart failure including HFpEF. The leukocyte count is a marker of inflammation that is widely used in clinical practice. However, there is little available evidence for the relationship between leukocyte count and the outcomes of HFpEF.

Methods

We analyzed data from the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial. The primary outcome was all-cause mortality, the secondary outcome was composite cardiovascular events and hospitalization for heart failure. Multivariable Cox proportional hazard models were used to compare the risk profiles of patients with leukocyte quartiles, subgroup study divided by sex was also analyzed.

Results

The present study included 2898 patients with HFpEF.429 deaths, 671 composite cardiovascular events and 386 hospitalization for heart failure occurred during a mean 3.4 years follow-up. The association between leukocyte count and adverse outcomes followed a U-shaped curve. After multivariable adjustment, the patients with the lowest leukocyte count (Q1) and the highest leukocyte count (Q4) faced higher risk of all-cause death(Q1 vs. Q2, adjusted HR: 1.439; 95% CI: 1.060–1.953, p = 0.020; Q4 vs. Q2, adjusted HR, 1.901; 95%CI: 1.424–2.539, p < 0.001). The subgroup analysis showed a consistent result in female but not male patients.

Conclusions

The association between leukocyte count and risk of adverse outcomes followed a U-shaped curve. Both higher and lower leukocyte count are associated with worse outcomes in patients with HFpEF, which may be attributed to the two sides of inflammation in cardiac remodeling.
Managing overlap of primary study results across systematic reviews: practical considerations for authors of overviews of reviews
Authors: Lunny Carole , Pieper Dawid , Thabet Pierre , Kanji Salmaan
Published: July 2021

Background

Overviews often identify and synthesise a large number of systematic reviews on the same topic, which is likely to lead to overlap (i.e. duplication) in primary studies across the reviews. Using a primary study result multiple times in the same analysis overstates its sample size and number of events, falsely leading to greater precision in the analysis. This paper aims to: (a) describe types of overlapping data that arise from the same primary studies reported across multiple reviews, (b) describe methods to identify and explain overlap of primary study data, and (c) present six case studies illustrating different approaches to manage overlap.

Methods

We first updated the search in PubMed for methods from the MOoR framework relating to overlap of primary studies. One author screened the studies titles and abstracts, and any full-text articles retrieved, extracted methods data relating to overlap of primary studies and mapped it to the overlap methods from the MOoR framework. We also describe six case studies as examples of overviews that use specific overlap methods across the steps in the conduct of an overview. For each case study, we discuss potential methodological implications in terms of limitations, efficiency, usability, and resource use.

Results

Nine methods studies were found and mapped to the methods identified by the MOoR framework to address overlap. Overlap methods were mapped across four steps in the conduct of an overview – the eligibility criteria step, the data extraction step, the assessment of risk of bias step, and the synthesis step. Our overview case studies used multiple methods to reduce overlap at different steps in the conduct of an overview.

Conclusions

Our study underlines that there is currently no standard methodological approach to deal with overlap in primary studies across reviews. The level of complexity when dealing with overlap can vary depending on the yield, trends and patterns of the included literature and the scope of the overview question. Choosing a method might be dependent on the number of included reviews and their primary studies. Gaps in evaluation of methods to address overlap were found and further investigation in this area is needed.
Comparing neoadjuvant long-course chemoradiotherapy with short-course radiotherapy in rectal cancer
Authors: Wang Jian , Long Yiwen , Liu Kun , Pei Qian , Zhu Hong
Published: July 2021

Background

The purpose of this study was to compare short-course radiotherapy (SC) or neoadjuvant long-course chemoradiotherapy (LC) treatment for locally advanced rectal cancer patients.

Methods

Patients with a diagnosis of locally advanced rectal cancer (LARC) who had undergone neoadjuvant radiotherapy before surgery between 2013 and 2018 at the medical center in China were included in this study. All patients’ MRI confirmed T2N+M0 or T3-4N0-3M0 clinical stages. Patients in the SC group received pelvic radiotherapy with a dose of 5 × 5 Gy (with or without chemotherapy at any time), followed by immediate or delayed surgery. Patients in the LC group received a dose of 50–50.4 Gy in 25–28 fractions, concomitantly with FOLFOX or capecitabine-based chemotherapy, followed by surgery 4–6 weeks later. All clinical data were retrospectively collected, and long-term follow-up was completed and recorded at the same time.

Results

A total of 170 were eligible to participate in this study, 32 patients in the SC group, and 138 in the LC group. The median follow-up time of living patients was 39 months. The disease-free survival (DFS) and overall survival (OS) rates in the SC group and LC group at 3 years, were, 84.9% versus 72.4% (P = 0.273) and 96.2% versus 87.2% (P = 0.510), respectively. The complete pathological response (pCR) rates in the SC group and LC group were, 25% versus 18.1% (the difference was not statistically significant, P = 0.375), respectively. However, the SC group had better node(N) downstaging compared to the LC group (P = 0.011).

Conclusions

There were no differences observed in DFS and OS between short-course radiotherapy and long-course chemoradiation, and both can be used as treatment options for patients with locally advanced rectal cancer.
Epidemiological and clinical characteristics of immunocompromised patients infected with Pneumocystis jirovecii in a twelve-year retrospective study from Norway
Authors: Grønseth Stine , Rogne Tormod , Hannula Raisa , Åsvold Bjørn Olav , Afset Jan Egil , Damås Jan Kristian
Published: July 2021

Background

Pneumocystis pneumonia (PCP) severely menaces modern chemotherapy and immunosuppression. Detailed description of the epidemiology of Pneumocystis jirovecii today is needed to identify candidates for PCP-prophylaxis.

Methods

We performed a 12-year retrospective study of patients with P. jirovecii detected by polymerase chain reaction in Central Norway. In total, 297 patients were included. Comprehensive biological, clinical and epidemiological data were abstracted from patients’ medical records. Regional incidence rates and testing trends were also assessed.

Results

From 2007 to 2017 we found a 3.3-fold increase in testing for P. jirovecii accompanied by a 1.8-fold increase in positive results. Simultaneously, regional incidence rates doubled from 5.0 cases per 100,000 person years to 10.8. A majority of the study population had predisposing conditions other than human immunodeficiency virus (HIV). Hematological (36.0%) and solid cancers (25.3%) dominated. Preceding corticosteroids were a common denominator for 72.1%. Most patients (74.4%) presented with at least two cardinal symptoms; cough, dyspnea or fever. Main clinical findings were hypoxia, cytopenias and radiological features consistent with PCP. A total of 88 (29.6%) patients required intensive care and 121 (40.7%) suffered at least one complication. In-hospital mortality was 21.5%. Three patients (1.0%) had received prophylaxis.

Conclusions

P. jirovecii is re-emerging; likely due to increasing immunosuppressants use. This opportunistic pathogen threatens the life of heterogenous non-HIV immunosuppressed populations currently at growth. Corticosteroids seem to be a major risk factor. A strategy to increase prophylaxis is called for.
Restorative reproductive medicine for infertility in two family medicine clinics in New England, an observational study
Authors: Stanford Joseph B. , Carpentier Paul A. , Meier Barbara L. , Rollo Mark , Tingey Benjamin
Published: July 2021

Background

Restorative reproductive medicine (RRM) seeks to identify and correct underlying causes and factors contributing to infertility and reproductive dysfunction. Many components of RRM are highly suitable for primary care practice. We studied the outcomes amongst couples who received restorative reproductive medicine treatment for infertility in a primary care setting.

Methods

Two family physicians in Massachusetts trained in a systematic approach to RRM (natural procreative technology, or NaProTechnology) treated couples with infertility. We retrospectively reviewed the characteristics, diagnoses, treatments, and outcomes for all couples treated during the years 1989 to 2014. We compared pregnancy and live birth by clinical characteristics using Kaplan-Meier analysis. We employed the Fleming-Harrington weighted Renyi test or the logrank test to compare the cumulative proportion with pregnancy or with live birth.

Results

Among 370 couples beginning treatment for infertility, the mean age was 34.8 years, the mean prior time trying to conceive was 2.7 years, and 27% had a prior live birth. The mean number of diagnoses per couple was 4.9. Treatment components included fertility tracking with the Creighton Model FertilityCare System (80%); medications to enhance cervical mucus production (81%), to stimulate ovulation (62%), or to support the luteal phase (75%); and referral to female laparoscopy by a surgeon specializing in endometriosis (46%). The cumulative live birth rate at 2 years was 29% overall; this was significantly higher for women under age 35 (34%), and for women with body mass index < 25 (40%). There were 2 sets of twins and no higher-order multiple gestations. Of the 63 births with data available, 58 (92%) occurred at term.

Conclusions

Family physicians can provide a RRM approach for infertility to identify underlying causes and promote healthy term live births. Younger women and women with body mass index < 25 are more likely to have a live birth.
Differences in expression of genes related to steroidgenesis in abdominal subcutaneous adipose tissue of pregnant women with and without PCOS; a case control study
Authors: Emami Neda , Moini Ashraf , Yaghmaei Parichehreh , Akbarinejad Vahid , Shahhoseini Maryam , Alizadeh AliReza
Published: July 2021

Background

It was reported that steroid-related gene expressions in the adipose tissue (AT) of women differ between women affected with polycystic ovary syndrome (PCOS) and non-PCOS. Although association between PCOS in mother and offspring’s health is a crucial issue, there are few studies focusing on AT of pregnant women suffering from PCOS. Our objectives were to determine the differences between mRNA expression levels of key steroid-converting enzymes in abdominal subcutaneous AT of pregnant women afflicted with PCOS and non-PCOS.

Methods

Twelve pregnant women with PCOS (case) and thirty six non-PCOS pregnant women (control) (1:3 ratio; age- and BMI-matched) undergoing cesarean section were enrolled for the present study. Expressions of fifteen genes related to steriodogenesis in abdominal subcutaneous AT were investigated using quantitative real-time PCR.

Results

No significant differences were detected with respect to age, BMI (prior pregnancy and at delivery day), gestational period and parity among pregnant women with PCOS and non-PCOS. Most of the sex steroid-converting genes except 17β-Hydroxysteroid dehydrogenases2 (17BHSD2), were highly expressed on the day of delivery in subcutaneous AT. Women with PCOS showed significantly higher mRNA levels of steroidgenic acute regulator (STAR; P < 0.001), cytochrome P450 monooxygenase (CYP11A1; P < 0.05), 17α-hydroxylase (CYP17A1; P < 0.05), and 11β-Hydroxysteroid dehydrogenase (11BHSD1 and 11BHSD2; P < 0.05). The expression of steroid 21-hydroxylase (CYP21) in non-PCOS was fourfold higher than those of women with PCOS (P < 0.001). There were no significant differences between relative expression of aromatase cytochrome P450 (CYP19A1), 3β-hydroxysteroid dehydrogenase (3BHSD1 and 3BHSD2), and 17BHSD family (1, 3, 5, 7, and 12) between the two groups.

Conclusion

The expression levels of genes related to sex steroids metabolism were similar to age-matched and BMI- matched pregnant non-PCOS and pregnant women with PCOS at delivery day. However, the alterations in gene expressions involved in glucocorticoids and mineralocorticoids metabolism were shown. It is necessary to point out that further studies regarding functional activity are required. More attention should be given to AT of pregnant women with PCOS that was previously ignored.
Multicenter randomized controlled trial and registry study to assess the safety and efficacy of the NanoKnife® system for the ablation of stage 3 pancreatic adenocarcinoma: overview of study protocols
Authors: Narayanan Govindarajan , Bilimoria Malcolm M. , Hosein Peter J. , Su Zhaohui , Mortimer Kathleen M. , Martin Robert C. G.
Published: July 2021

Background

Irreversible electroporation (IRE) is a local ablation technique utilizing high voltage, low energy direct current to create nanopores in cell membrane which disrupt homeostasis and leads to cell death. Previous reports have suggested IRE may have a role in treating borderline resectable and unresectable Stage 3 pancreatic tumors.

Methods

Patients with Stage 3 pancreatic ductal adenocarcinoma (PDAC) will be enrolled in either a randomized, controlled, multicenter trial (RCT) or a multicenter registry study. Subjects enrolled in the RCT must have no evidence of disease progression after 3 months of modified FOLFIRINOX (mFOLFIRINOX) treatment prior to being randomization to either a control or IRE arm. Post-induction and post-IRE treatment for the control and IRE arms, respectively, will be left to the discretion of the treating physician. The RCT will enroll 528 subjects with 264 per arm and include up to 15 sites. All subjects will be followed for at least 24 months or until death. The registry study will include two cohorts of patients with Stage 3 PDAC, patients who received institutional standard of care (SOC) alone and those treated with IRE in addition to SOC. Both cohorts will be required to have undergone at least 3 months of SOC without progression prior to enrollment. The registry study will enroll 532 patients with 266 patients in each arm. All patients will be followed for at least 24 months or until death. The primary efficacy endpoint for both studies will be overall survival (OS). Co-primary safety endpoints will be 1) time from randomization or enrollment in the registry to death or new onset of Grade 4 adverse event (AE), and (2 high-grade complications defined as any AE or serious AE (SAE) with a CTCAE v5.0 grade of 3 or higher. Secondary endpoints will include progression-free survival, cancer-related pain, quality of life, and procedure-related pain for the IRE arm only.

Discussion

These studies are intended to provide Level 1 clinical evidence and real-world data demonstrating the clinical utility and safety of the use of IRE in combination with chemotherapy in patients with Stage 3 PDAC.

Trial registration

Clinicaltrials.gov NCT03899636 and NCT03899649. Registered April 2, 2019. Food and Drug Administration (FDA) Investigational Device Exemption (IDE) trial G180278 approved on May 3, 2019.
The experiences and strategies of parents’ of adults with anorexia nervosa or bulimia nervosa: a qualitative study
Authors: Karlstad Jannike , Moe Cathrine Fredriksen , Wattum Mari , Brinchmann Berit Støre
Published: July 2021

Background

Caring for an individual with an eating disorder involves guilt, distress and many extra burdens and unmet needs. This qualitative study explored the experiences of parents with adult daughters suffering from anorexia nervosa or bulimia nervosa and the strategies they adopted. A subsidiary aim of the study was to explore the relationship between the caregivers’ perceived need for professional support and the support they reported receiving in practice from the health services.

Methods

Semi-structured interviews were conducted with 11 mothers and fathers from across Norway. Data collection, coding and analysis was conducted using the principles of constructivist grounded theory in an iterative process. The main concern shared by participants was identified by this process and their “solution” to the main concern then formed the content of the core category.

Results

″Wearing all the hats″ emerged as the core category, indicating that the parents have to fulfil several roles to compensate the lack of help from health services. The three subcategories: “adapting to the illness”, “struggling for understanding and help” and “continuing to stay strong” described how the participants handled their situation as parents of adult daughters with eating disorders.

Conclusions

In daily life, the parents of adults with eating disorders have to attend to a wide range of caregiver tasks to help their ill daughters. This study suggests that the health services that treat adults with eating disorders should be coordinated, with a professional carer in charge. The parents need easy access to information about the illness and its treatment. They also need professional support for themselves in a demanding situation.
Impact of long working hours on health based on observations in China
Authors: Chu Liming
Published: July 2021

Background

Health should be a key focus in considerations of long working hours. Little is known about for which groups of people working longer hours is more harmful to their health. Additionally, the definition of long working hours varies slightly due to country differences in working hours systems. Therefore, this study aims to explore the association between long working hours and the self-rated health (SRH) level, taking into account gender and educational differences.

Method

Data were collected from two waves (2016 and 2018) of the China Family Panel Studies (CFPS). A total of 6972 workers were available for analysis. Descriptive statistical analysis, an ordered probit (oprobit) model and conditional mixed process (CMP) regression analyses were used to analyze the data. Furthermore, I conducted a stratified analysis by gender and education groups.

Result

This study observed a negative association between long working hours and SRH. Compared to other education groups, labor with long working hours had a more negative impact on the SRH of those with higher education. Long working hours had a more negative influence on the SRH of male workers. In contrast, no clear association was found among female workers.

Conclusion

This study estimates SRH of those with long working hours in China. Among workers, long working hours have a negative impact on the health of workers with college degrees or beyond. One possible explanation is that they do not exercise, their diet is unreasonable, and their working conditions involve chronic exposure to computer radiation. The negative health effects of long working hours on males are four times greater than those on females. This study provides valuable insights into the health of the workforce, working time regulations and overtime rules.
Knowledge, health beliefs and attitudes towards dementia and dementia risk reduction among descendants of people with dementia: a qualitative study using focus group discussions
Authors: Vrijsen J. , Maeckelberghe E. L. M. , Broekstra R. , de Vries J. J. , Abu-Hanna A. , De Deyn P. P. , Voshaar R. C. Oude , Reesink F. E. , Buskens E. , de Rooij S. E. , Smidt N.
Published: July 2021

Background

Individuals with a parental family history of dementia have an increased risk of developing dementia because they share their genes as well as their psychosocial behaviour. Due to this increased risk and their experience with dementia, they may be particularly eager to receive information regarding dementia risk reduction (DRR). This study evaluated the knowledge, beliefs and attitudes towards dementia and DRR among descendants of people with dementia.

Method

Using a semi-structured topic guide, three focus group discussions were conducted consisting of 12 female (80%) and 3 male (20%) descendants of people with dementia with a mean (± SD) age of 48.8 (± 12) years. Focus group discussions were audio recorded and transcribed. Each transcript was analysed thoroughly, and where appropriate, a code was generated and assigned by two researchers independently. Then, similar codes were grouped together and categorized into themes.

Results

The items in the topic guide could only be addressed after participants had been given the opportunity to share their experiences of having a parent with dementia. Participants were unaware or uncertain about the possibility of reducing the risk of developing dementia and therefore hesitant to assess their dementia risk without treatment options in sight. Moreover, participants indicated that their general practitioner only gave some information on heritability, not on DRR. Although participants identified a large number of modifiable risk factors as a group during the group discussions, they were eager to receive more information on dementia and DRR. In the end, participants adopted a more positive attitude towards a DRR programme and provided suggestions for the development of future DRR programmes.

Conclusions

Although the research aim was to evaluate the knowledge, beliefs and attitudes towards dementia and DRR, sharing experiences of having a parent with dementia seemed a prerequisite for considering participants’ own risk of developing dementia and participating in a DRR programme. Knowledge of dementia and DRR was limited. Due to unawareness of the possibility of reducing dementia risk, participants were hesitant about assessing their dementia risk. Group discussions positively changed the perception of dementia risk assessment and participants’ willingness to participate in a DRR programme.
LINC01414/LINC00824 genetic polymorphisms in association with the susceptibility of chronic obstructive pulmonary disease
Authors: Zhou Xiaoman , Zhang Yunjun , Zhang Yutian , Li Quanni , Lin Mei , Yang Yixiu , Xie Yufei , Ding Yipeng
Published: July 2021

Objective

Chronic obstructive pulmonary disease (COPD) is a complicated multi-factor, multi-gene disease. Here, we aimed to assess the association of genetic polymorphisms in LINC01414/ LINC00824 and interactions with COPD susceptibility.

Methods

Three single nucleotide polymorphisms (SNPs) in LINC01414/LINC00824 was genotyped by Agena MassARRAY platform among 315 COPD patients and 314 controls. Logistic analysis adjusted by age and gender were applied to estimate the genetic contribution of selected SNPs to COPD susceptibility.

Results

LINC01414 rs699467 (OR = 0.73, 95% CI 0.56–0.94, p = 0.015) and LINC00824 rs7815944 (OR = 0.56, 95% CI 0.31–0.99, p = 0.046) might be protective factors for COPD occurrence, while LINC01414 rs298207 (OR = 2.88, 95% CI 1.31–6.31, p = 0.008) risk-allele was related to the increased risk of COPD in the whole population. Rs7815944 was associated with the reduced risk of COPD in the subjects aged > 70 years (OR = 0.29, p = 0.005). Rs6994670 (OR = 0.57, p = 0.007) contribute to a reduced COPD risk, while rs298207 (OR = 7.94, p = 0.009) was related to a higher susceptibility to COPD at age ≤ 70 years. Rs298207 (OR = 2.54, p = 0.043) and rs7815944 (OR = 0.43, p = 0.028) variants was associated COPD risk among males. Rs7815944 (OR = 0.16, p = 0.031) was related to the reduced susceptibility of COPD in former smokers. Moreover, the association between rs298207 genotype and COPD patients with dyspnea was found (OR = 0.50, p = 0.016), and rs7815944 was related to COPD patients with wheezing (OR = 0.22, p = 0.008).

Conclusion

Our finding provided further insights into LINC01414/LINC00824 polymorphisms at risk of COPD occurrence and accumulated evidence for the genetic susceptibility of COPD.
Case report: Fabrication of a dental implant guide based on tetrahedron positioning technology
Authors: Lin Jie , Lin Zhenxiang , Zheng Zhiqiang
Published: July 2021

Background

Conventional static computer-assisted implant surgery (s-CAIS) requires special equipment, such as 3D printers or computer numerical control (CNC) lathes. We present a low-cost workflow for manufacturing dental implant guides based on tetrahedron positioning technology (TPT). The aim of this case report was to use a surgical guide technique for dental implant placement using tetrahedron positioning technology.

Case presentation

A 28-year-old man consulted for the treatment of a missing right first mandibular molar by implant placement. The cone-beam computed tomography (CBCT) data were imported into medical image processing software for analysis, and the implant design was simulated. The implant design on CBCT was transferred to the mandibular model using TPT, and the implant surgical guide was made to guide the dental implant operation. CBCT was performed postoperatively and compared with the preoperative design to check the accuracy. The central deviation of the implant head was 0.31 mm, the central deviation of the implant apex was 0.93 mm, and the implant angular deviation was 2.45°.

Conclusion

The use of tetrahedral positioning technology based on CBCT data is a new method for making implant guides. It is a promising technique offering a highly predictable outcome and lower risk of iatrogenic damage. However, these results should be interpreted with care since they are based on limited evidence from a case report. Larger population studies with longer follow-up periods and standardized experimental studies are required.