bluuebunny/crossref_metadata_2025 huggingface dataset:
Local traditional ecological knowledge about hay management practices in wetlands of the Biebrza Valley, Poland
Authors: Sucholas Joanna , Molnár Zsolt , Łuczaj Łukasz , Poschlod Peter
Published: February 2022

Background

The Biebrza Valley is one of the largest complexes of wetlands (floodplain and percolation mire) and conservation sites in Central Europe. Local communities have managed the area extensively for subsistence and farming purposes for centuries; nonetheless, since the 1960s, hand mowing and livestock grazing have been gradually ceasing due to the intensification of farming, and wetlands have undergone natural succession. Currently, the protection of this vast ecosystem is challenging. Despite its remarkable cultural origin, the complexity of the traditional practices and knowledge of local people have never been studied comprehensively. Therefore, we found it urgent to explore if traditional ecological knowledge that could be used in conservation management of the area still exists among the local community.

Methods

We interviewed 42 inhabitants of seven villages located in the Lower Basin of the Biebrza Valley (NE-Poland) in the consecutive years 2018–2020. We applied semi-structured, repeated interviews with farmers (aged 29–89), each lasting several hours. By using different ethnoecological methods (visual stimuli, walks in wetlands, co-mapping of the area), we explored traditional knowledge on the plants, landscape and traditional management of wetlands.

Results

Farmers from the oldest generation, who used to manage wetlands with scythes, shared the deepest ecological knowledge. Local people divided wetlands into zones differentiated by vegetation type and hay quality. Depending on plant composition, people managed wetlands under a mixed regime: mowing once or twice a year during periods that ensured good hay quality and pasturing various livestock: cattle, horses, sheep, pigs and fowl. We identified at least 50 plant ethnospecies, which were described exhaustively by their habitat, morphological features, and mowing and grazing value.

Conclusions

The local community in the Biebrza Valley shared a deep traditional ecological knowledge and had a good memory of traditional farming practices. Research confirmed the unquestionable cultural origin of the local ecosystem, therefore in conservation endeavours the area should be treated first and foremost as a cultural landscape. The documented exceptional local perception of the wetland landscape, elements of traditional knowledge and complex farming practices should be considered for inclusion into conservation management, and cooperation with the local community should also be taken into account.
The use of Kumpfer’s resilience framework in understanding the breastfeeding experience of employed mothers after returning to work: a qualitative study in China
Authors: Guo Honghua , Zhou Rong , Li Minxiang , Zhang Siqi , Yi Huanying , Wang Linjie , Li Tong , Zhang Caihong , Lu Hong
Published: February 2022

Background

The increasing numbers of women in the workforce is an inevitable trend in China. More and more employed women stop breastfeeding because of working stressors. Many mothers, however, overcome the challenges and insist on breastfeeding after returning to work. Their individual experience of breastfeeding may provide a new insight to promote and support breastfeeding on employed mothers. This study sought to understand mothers’ experience with insisting on breastfeeding after returning to work based on Kumpfer’s Resilience Framework in Chinese context.

Methods

This qualitative study was designed with semi-structured interviews. Purposive sampling and snowball sampling were employed to recruit 13 full-time working mothers with a stable job in the public sector who continued to breastfeed for 1 month or longer after returning to work in Haikou, Hainan Province, China. Interviews were conducted from January to March 2020 to capture participants’ experiences of breastfeed after returning to work. Grounded theory and Kumpfer’s Resilience Framework were used to analyze data via a systematic and iterative process.

Results

Employed mothers built resilience while continuing to breastfeed after returning to work. The core concept was "dynamic interaction". Other categories were the background and explanation of this phenomenon. For working mothers who continued to breastfeed, resilience involved "dynamic interaction", which started from "experiencing stressors" and "obtaining support", two environmental factors interacted with the individual to "build resilience qualities", which interact with environment led to “behavioral resilience”. And then the ongoing dynamic interaction between behavioral resilience and environment ultimately led to three different "weaning processes", including natural weaning, active weaning, and forced weaning.

Conclusions

This study identified the framework of resilience in mothers who were in the adversity of breastfeeding after returning to work based on Kumpfer’s Resilience Framework. It provided a new insight into the resilience of employed mothers around the world to continue breastfeeding and showed the different culture of breastfeeding on employed mothers.
Stability investigation of air-dried olive ribo nucleic acids for metavirome studies
Authors: Mirzaei Leila , Yadollahi Abbas , Kermani Maryam Jafarkhani , Naderpour Masoud , Zeinanloo Ali Asghar
Published: February 2022

Background

The application of ribo nucleic acids for molecular studies requires high integrity and quality of extracted total RNA samples. In addition, the need to transfer RNA samples at room temperature without special treatments such as ice and liquid nitrogen storage according to international transport laws highlights the importance of low cost alternative methods such as RNA air-drying, lyophilisation and transportable agents. In this study, the quality and quantity of air-dried RNA samples from leaf, petiole and bark tissues of different olive genotypes using several RNA extraction methods were compared with lyophilized ground leaves and RNAlater-stored tissue samples before precipitation. The quality of RNA and prepared libraries were checked by several techniques including agarose and polyacrylamide gel electrophoresis, Agilent quality control, RT-PCR amplification of housekeeping and viral genes and high throughput sequencing.

Results

Although RNA value varied amongst cultivars, RNA extraction with TRIzol™ Reagent in fresh extractions and samples stored in RNAlater before RNA extraction resulted in 455.26 ng/µL and 63.46 ng/µL (mean value of cultivars) as the highest RNA concentration averages, respectively. RNA samples extracted by TRIzol™ Reagents and stored for a short term at – 80 °C before air-drying showed the third highest concentration (44.87 ng/µL). The synthesized cDNAs quality for PCR amplification of housekeeping genes (Rbc 1 and Nad 5) and partial genomes of Arabis mosaic virus and Cucumber mosaic virus showed satisfactory results in RNA samples extracted by TRIzol™ Reagents despite its variation amongst cultivars.

Conclusions

Considering the difficulties in the extraction of high quality and quantity RNA in olive for molecular analyses, this study demonstrated that RNA extraction method based on TRIzol™ Reagent can be considered for virobiome studies of both fresh and air-dried samples.
Fast estimation of plant growth dynamics using deep neural networks
Authors: Gall Gabriella E. C. , Pereira Talmo D. , Jordan Alex , Meroz Yasmine
Published: February 2022

Background

In recent years, there has been an increase of interest in plant behaviour as represented by growth-driven responses. These are generally classified into nastic (internally driven) and tropic (environmentally driven) movements. Nastic movements include circumnutations, a circular movement of plant organs commonly associated with search and exploration, while tropisms refer to the directed growth of plant organs toward or away from environmental stimuli, such as light and gravity. Tracking these movements is therefore fundamental for the study of plant behaviour. Convolutional neural networks, as used for human and animal pose estimation, offer an interesting avenue for plant tracking. Here we adopted the Social LEAP Estimates Animal Poses (SLEAP) framework for plant tracking. We evaluated it on time-lapse videos of cases spanning a variety of parameters, such as: (i) organ types and imaging angles (e.g., top-view crown leaves vs. side-view shoots and roots), (ii) lighting conditions (full spectrum vs. IR), (iii) plant morphologies and scales (100 μm-scale Arabidopsis seedlings vs. cm-scale sunflowers and beans), and (iv) movement types (circumnutations, tropisms and twining).

Results

Overall, we found SLEAP to be accurate in tracking side views of shoots and roots, requiring only a low number of user-labelled frames for training. Top views of plant crowns made up of multiple leaves were found to be more challenging, due to the changing 2D morphology of leaves, and the occlusions of overlapping leaves. This required a larger number of labelled frames, and the choice of labelling “skeleton” had great impact on prediction accuracy, i.e., a more complex skeleton with fewer individuals (tracking individual plants) provided better results than a simpler skeleton with more individuals (tracking individual leaves).

Conclusions

In all, these results suggest SLEAP is a robust and versatile tool for high-throughput automated tracking of plants, presenting a new avenue for research focusing on plant dynamics.
Simultaneous integrated boost (SIB) to dominant intra-prostatic lesions during extreme hypofractionation for prostate cancer: the impact of rectal spacers
Authors: Osman Sarah O. S. , Fairmichael Ciaran , Whitten Glenn , Lundy Gavin S. , Wesselman Rachel , Wilson Melissa LaBonte , Hounsell Alan R. , Prise Kevin M. , Irvine Denise , McGarry Conor K. , Jain Suneil
Published: February 2022

Purpose

Boosting dominant intra-prostatic lesions (DILs) has the potential to increase the therapeutic ratio in prostate cancer radiotherapy. In this study, employing 5-fraction stereotactic ablative radiotherapy (SABR) volumetric modulated arc therapy (VMAT) to deliver 40 Gy to the prostate clinical target volume (CTV) while boosting the DIL up to 50 Gy was evaluated for patients before and after rectal spacer insertion.

Materials and methods

24 Computed Tomography (CT) scans of 12 prostate cancer patients with unfavourable intermediate or high risk prostate cancer were employed in this study. At least two treatment plans were generated for each patient to compare pre- and post-spacer insertion plans. Plans were evaluated for target coverage, organs-at-risk doses, and the achievable boost dose level.

Results

The CTV coverage was significantly better in plans with a spacer, V40Gy 98.4% versus 97.0% (p = 0.012). Using spacers significantly reduced rectal dose in all 12 patients in this study. It was possible to boost DIL to 50 Gy to without violating dose constraints in 6 of 12 patients and to 47.5 Gy in 3 patients post-spacer insertion. For 3 patients (25%) it was not possible to boost DIL above 45 Gy even with a spacer in situ. Without a spacer, for 6 patient (50%) clinically acceptable plan were only achieved when the DIL dose was lowered to 45 Gy. In five of these 6 patients the dose limiting structure was the urethra (urethra planning risk volume V45Gy [cc] ≤ 0.1 cc constraint).

Conclusions

Clinically acceptable plans for 5 fraction SABR, 40 Gy to the prostate CTV, with a SIB to DIL (45–50 Gy) were achieved. The boost dose achieved was DIL location dependent and primarily affected by DIL’s proximity to the urethra. Compared to plans before spacer insertion, higher DIL dose were achieved with spacer in situ for 25% of the patients. Moreover, significant reduction in rectal dose and better target coverage were also achieved for all patients with spacers in situ.
Generation of ozone during irradiation using medical linear accelerators: an experimental study
Authors: Hara N. , Oobuchi J. , Isobe A. , Sugimoto S. , Takatsu J. , Sasai K.
Published: February 2022

Background

Some patients have noted a foul odor during radiation therapy sessions, but the cause of the odor remains unknown. Since we suspected that this phenomenon is due to ozone generated by ionizing radiation, this experimental study measured ozone concentrations in the treatment room and in a coiled polyvinyl chloride (PVC) tube placed within the radiation field.

Methods

We measured ozone concentrations using an ultraviolet absorption method and an ozone monitor. A PVC tube (inner diameter 7 mm, outer diameter 10 mm) was used to mimic the environment of the nasal cavity. The tube (790 cm) was coiled and set between two 4-cm-thick (for X-rays) or 2-cm-thick (for electron beams) water-equivalent solid phantoms. The sampling tube of the ozone monitor was inserted into the PVC tube, and the joint was sealed to prevent environmental air contamination. To measure ozone concentrations in the atmosphere, the sampling tube supplied with the unit was used. A linac was used on a full-sized treatment field (40 cm × 40 cm at a source-to-axis distance of 100 cm). The effect of an electron beam on ozone concentrations was also evaluated with a full-sized treatment field (40 cm × 40 cm at a source-to-surface distance of 100 cm).

Results

Ozone levels in the treatment room were undetectable before the start of daily treatment but reached 0.008 parts per million (ppm) or more at 1 h after the start of treatment. Concentrations then remained nearly constant at 0.010–0.015 ppm throughout the day. The maximum ozone concentration in the PVC tube was only 0.006 ppm, even when it was irradiated at 2400 monitor units/min. Depending on the X-ray dose rate, the concentration increased to a maximum of 0.010 ppm with oxygen flowing into the other end of the tube at 1.5 L/min. Ozone concentrations in the PVC tube did not differ significantly between X-ray and electron-beam irradiation.

Conclusions

Only traces of ozone were found in the PVC tube that was used to mimic the nasal passages during radiation, these concentrations were too low for human perception. However, ozone concentrations did reach potentially detectable levels in the treatment room.
SMOC approach for total knee arthroplasty in valgus knees
Authors: Li Tao , Liu Yikai , Li Chenkai , Zhang Haining
Published: February 2022

Objective

This study was performed to compare clinical outcomes among patients with valgus knees undergoing total knee arthroplasty via the medial parapatellar approach and the subvastus with minimal oblique cut approach.

Methods

A total of 232 patients (246 knees) undergoing total knee arthroplasty between December 2014 and December 2016 were retrospectively included in the investigation. The study population consisted of 120 patients (128 knees; 32 men and 88 women) with a mean age of 62.43 ± 8.12 years treated via the medial parapatellar approach, and 112 patients (118 knees; 30 men and 82 women with a mean age of 63.15 ± 7.83 years) treated via the subvastus with minimal oblique cut approach. Nine preoperative parameters (number of patients, sex, age, body mass index, number of knees, valgus angle, visual analogue scale score, range of motion, Hospital for Special Surgery score), five perioperative parameters (operative time, amount of drainage, Visual analogue scale score at 24 h after the operation, time to straight leg raising, radiological alignment), and two postoperative parameters (range of motion, Hospital for Special Surgery score) were assessed at 1 day, 1 week, 6 weeks, 8 weeks and 1 year after the operation, along with postoperative complications.

Results

There were no significant differences in the nine preoperative parameters between the two groups. The subvastus with minimal oblique cut group had a longer operative time, while the parapatellar approach group showed more drainage and a higher mean Visual analogue scale score. Compared to the medial parapatellar group, the subvastus with minimal oblique cut group had a shorter time to straight leg raising. There were no differences in radiological alignment between the two groups. The groups showed similar range of motion and Hospital for Special Surgery scores at 8 weeks and 1 year, but both were higher in the subvastus with minimal oblique cut group at 1 day, 1 week and 6 weeks. During postoperative follow-up, postoperative subluxation of the patella occurred in five cases in the medial parapatellar group. Neither group showed any instability, recurrent valgus deformity or radiographic loosening.

Conclusion

The subvastus with minimal oblique cut approach provides excellent early recovery for total knee arthroplasty of valgus knees with no increase in complications.
Hardware-free MPFL reconstruction in patients with recurrent patellofemoral instability is safe and effective
Authors: Marín Fermín Theodorakys , Migliorini Filippo , Kalifis Giorgos , Zikria Bashir Ahmed , D’Hooghe Pieter , Al-Khelaifi Khalid , Papakostas Emmanouil T. , Maffulli Nicola
Published: February 2022

Purpose

This systematic review evaluated the clinical outcomes of hardware-free MPFL reconstruction techniques in patients with recurrent patellofemoral instability, focusing on patient-reported outcome measures (PROMs), redislocation rate, and complications. The hypothesis was that hardware-free MPFL reconstruction in patients with recurrent patellofemoral instability is safe and effective.

Methods

This systematic review was conducted following the PRISMA guidelines. PubMed, Scopus, and Virtual Health Library databases were accessed in October 2021. All the clinical studies investigating the efficacy and feasibility of hardware-free MPFL reconstruction were screened for inclusion. Only studies with a minimum 24-month follow-up were considered eligible. Kujala Anterior Knee Pain Scale improvement and redislocation rate after surgical treatment were evaluated as primary outcomes. The rate of postoperative complications was evaluated as a secondary outcome. The quality of the methodological assessment was assessed using the Modified Coleman Methodology Score.

Results

Eight studies were included in the present systematic review. The quality of the methodological assessment was moderate. Short- to long-term improvement of Kujala score was observed in all included studies. Mean score improvement ranged from + 13.2/100 to + 54/100, with mean postoperative scores ranging from 82/100 to 94/100. Patellar redislocation was observed in 8.33% (8 of 96) patients.

Conclusion

Hardware-free MPFL reconstruction with or without associated soft-tissue or bony realignment procedures provided reliable clinical improvements and was associated with a low rate of redislocation in patients with recurrent patellofemoral instability. Advantages such as safety, femoral physis preservation, and comparable complication profiles with implant-based techniques endorse its implementation. Orthopedic surgeons in cost-sensitive environments may also benefit their patients with lower costs, no need for implants, lack of implant-related complications, or surgery for implant removal.

Level of evidence: Level IV.
Key quality factors for Chinese herbal medicines entering the EU market
Authors: Wang Mei , Yao Pei-Fen , Sun Peng-Yue , Liang Wen , Chen Xiao-Jia
Published: February 2022

Chinese herbal medicines (CHMs) have unique advantages in the prevention and treatment of diseases, which are widely recognized in the world. More and more CHMs are becoming increasingly popular in the international markets. However, the quality control of CHMs is a significant issue for their acceptance and recognition in the international market. This review mainly focuses on the quality requirements for CHMs to enter the European Union (EU) market. Both Chinese and European regulations and quality controls are compared. Firstly, the EU medicinal regulatory system and relevant regulations were reviewed. Secondly, the key factors of the quality control of CHMs, including Chinese herbal drugs, extracts and products were compared with those of European herbal medicines in the EU market. Subsequently, three main registration routes for herbal medicinal products including Chinese herbal medicinal products entering the EU were introduced. Furthermore, the legal status of traditional Chinese medicine granules in the EU was also discussed. Through the comparison of the key quality factors for CHMs in China and the EU, the similarities and differences in terms of quality requirements and regulations are addressed, which provides a reference for the development of CHMs into the EU market.
Secondary peripheral chondrosarcoma arising in solitary osteochondroma: variables influencing prognosis and survival
Authors: Righi Alberto , Pacheco Marina , Cocchi Stefania , Asioli Sofia , Gambarotti Marco , Donati Davide Maria , Evangelista Andrea , Gnoli Maria , Locatelli Manuela , Mordenti Marina , Boarini Manila , Brizola Evelise , Pedrini Elena , Sangiorgi Luca
Published: February 2022

Background

Secondary peripheral chondrosarcomas arising in solitary osteochondromas is an unusual complication, reported in small series. In this study, we aimed to present our experience with this rare variant of chondrosarcoma and compare results with already published data in order to determine prognostic factors for overall and disease-free survival.

Methods

The case study includes retrospective data from patients diagnosed at a single institution from 1943 to 2019. Clinical data were collected reviewing all available medical records from first to last follow-up visits. To exclude the presence of the Multiple Osteochondroma Hereditary Syndrome, few patients, with a suspect of a familial form of the disease, were evaluated for the presence of germline heterozygous variants in EXT1 and EXT2 genes. Results were summarized using descriptive statistics and statistical analysis were performed to reveal associations between variables.

Results

Two hundred and fourteen secondary peripheral chondrosarcomas that arose exclusively from solitary osteochondromas diagnosed in a multidisciplinary setting at the IRCCS Istituto Ortopedico Rizzoli were retrospectively identified, 66.4% males and 33.6% females with a median age at diagnosis of 38 years. The local recurrence rate was 17.3%, while the metastases one was 5.1%. Besides age, a high histologic grade is the only factor associated with worse 5-year and 10-year overall survival (log-rank p = 0.0005, HR = 3.74; 95% CI 1.69–8.26). Moreover, high histological grade (HR = 3.75; 95% CI = 1.69–8.34; p = 0.001) and surgical debulking (HR = 3.71; 95% CI = 1.57–8.79; p = 0.003) were associated with a significantly worse disease-free survival.

Conclusions

Our study confirm the low-grade behavior of secondary peripheral chondrosarcomas and demonstrate that the best choice of treatment for those arising in solitary osteochondromas is the wide surgical excision, when possible. Location per se is not a factor that affects prognosis, while the accurate histological grade assessment is correlated with the tumor aggressiveness and a long term follow up is necessary for this rare variant of chondrosarcoma.
Rare disorders have many faces: in silico characterization of rare disorder spectrum
Authors: Frederiksen Simona D. , Avramović Vladimir , Maroilley Tatiana , Lehman Anna , Arbour Laura , Tarailo-Graovac Maja
Published: February 2022

Background

The diagnostic journey for many rare disease patients remains challenging despite use of latest genetic technological advancements. We hypothesize that some patients remain undiagnosed due to more complex diagnostic scenarios that are currently not considered in genome analysis pipelines. To better understand this, we characterized the rare disorder (RD) spectrum using various bioinformatics resources (e.g., Orphanet/Orphadata, Human Phenotype Ontology, Reactome pathways) combined with custom-made R scripts.

Results

Our in silico characterization led to identification of 145 borderline-common, 412 rare and 2967 ultra-rare disorders. Based on these findings and point prevalence, we would expect that approximately 6.53%, 0.34%, and 0.30% of individuals in a randomly selected population have a borderline-common, rare, and ultra-rare disorder, respectively (equaling to 1 RD patient in 14 people). Importantly, our analyses revealed that (1) a higher proportion of borderline-common disorders were caused by multiple gene defects and/or other factors compared with the rare and ultra-rare disorders, (2) the phenotypic expressivity was more variable for the borderline-common disorders than for the rarer disorders, and (3) unique clinical characteristics were observed across the disorder categories forming the spectrum.

Conclusions

Recognizing that RD patients who remain unsolved even after genome sequencing might belong to the more common end of the RD spectrum support the usage of computational pipelines that account for more complex genetic and phenotypic scenarios.
Artificial intelligence in mammographic phenotyping of breast cancer risk: a narrative review
Authors: Gastounioti Aimilia , Desai Shyam , Ahluwalia Vinayak S. , Conant Emily F. , Kontos Despina
Published: February 2022

Background

Improved breast cancer risk assessment models are needed to enable personalized screening strategies that achieve better harm-to-benefit ratio based on earlier detection and better breast cancer outcomes than existing screening guidelines. Computational mammographic phenotypes have demonstrated a promising role in breast cancer risk prediction. With the recent exponential growth of computational efficiency, the artificial intelligence (AI) revolution, driven by the introduction of deep learning, has expanded the utility of imaging in predictive models. Consequently, AI-based imaging-derived data has led to some of the most promising tools for precision breast cancer screening.

Main body

This review aims to synthesize the current state-of-the-art applications of AI in mammographic phenotyping of breast cancer risk. We discuss the fundamentals of AI and explore the computing advancements that have made AI-based image analysis essential in refining breast cancer risk assessment. Specifically, we discuss the use of data derived from digital mammography as well as digital breast tomosynthesis. Different aspects of breast cancer risk assessment are targeted including (a) robust and reproducible evaluations of breast density, a well-established breast cancer risk factor, (b) assessment of a woman’s inherent breast cancer risk, and (c) identification of women who are likely to be diagnosed with breast cancers after a negative or routine screen due to masking or the rapid and aggressive growth of a tumor. Lastly, we discuss AI challenges unique to the computational analysis of mammographic imaging as well as future directions for this promising research field.

Conclusions

We provide a useful reference for AI researchers investigating image-based breast cancer risk assessment while indicating key priorities and challenges that, if properly addressed, could accelerate the implementation of AI-assisted risk stratification to future refine and individualize breast cancer screening strategies.
Efficacy and safety of Tengfu Jiangya tablet combined with valsartan/amlodipine in the treatment of stage 2 hypertension: study protocol for a randomized controlled trial
Authors: Wang Yu , Hua Zhen , Chen Wenjing , Zhu Yushuo , Li Yunlun
Published: February 2022

Background

The prevalence rate of hypertension in the Chinese population is on the rise, and the control rate of hypertension is low. International guidelines, including the 2018 Chinese Guidelines for the Management of Hypertension, recommend optimized drug selection and combination therapy for patients with stage 2 hypertension and blood pressure ≥ 160/100 mmHg, including valsartan/amlodipine (Val/Aml). The traditional Chinese medicine (TCM) compound Tengfu Jiangya tablet (TJT; No. Z20110021, Shandong Provincial Food and Drug Administration) is prepared in the medical institution of Affiliated Hospital of Shandong University of Traditional Chinese Medicine. It is an effective compound preparation of TCM for the treatment of hypertension in the national clinical research base of TCM. The aim of this study was to evaluate the efficacy and safety of TJT combined with Val/Aml in the treatment of stage 2 hypertension with hyperactivity of liver yang.

Methods

This randomized double-blind, placebo-controlled, multicenter trial will be conducted with a total of 288 participants with stage 2 hypertension at seven clinical trial centers. The stratified random method will be used, and the subcenter will be taken as the stratification factor. Eligible patients will be randomly assigned (1:1) into groups receiving either TJT or placebo three times daily for 28 days, both combined with Val/Aml 80/5 mg. The primary efficacy endpoint is the reduction in the mean sitting systolic blood pressure (msSBP) and the mean sitting diastolic blood pressure (msDBP) from baseline to week 4. Adverse events and laboratory test results will be monitored throughout the trial.

Discussion

This is the first placebo-controlled randomized trial conducted to evaluate the efficacy and safety of a Chinese herbal extract combined with Val/Aml in patients with stage 2 hypertension. Our study may help to provide evidence-based recommendations of a complementary preventive measure for stage 2 hypertension.

Trial registration

Chinese Clinical Trial RegistryChiCTR2000030611. Registered on 8 March 2020
Comparing the efficacy and safety of minimally invasive biportal endoscopic spine surgery versus conventional microscopic discectomy in single-level lumbar herniated intervertebral disc (ENDO-BH Trial): a multicenter, prospective, randomized controlled equivalence trial study protocol
Authors: Park Sang-Min , Song Kwang-Sup , Kim Ho-Joong , Park Si-Young , Kang Taewook , Kang Min-Seok , Heo Dong Hwa , Park Choon Keun , Lee Dong-Geun , Hwang Jin Sub , Jang Jae-Won , Kim Jun Young , Kim Jin-Sung , Lee Hong-Jae , You Ki-Han , Park Hyun-Jin
Published: February 2022

Background

Biportal endoscopic surgery has recently been performed in lumbar discectomy, with advantages over conventional surgery, such as less skin scarring and muscle damage. However, the clinical results have not been established. Although previous studies reported no difference between the biportal endoscopic and microscopic discectomy clinical results, the evidence was weak. Therefore, this study aims to evaluate the efficacy and safety of the biportal endoscopic discectomy versus the microscopic discectomy.

Methods

This prospective multicenter randomized controlled equivalence trial is designed to compare the efficacy and safety outcomes of patients who underwent lumbar discectomy using biportal endoscopy or microscopy. We will include 100 participants (50 per group) with a lumbar herniated disc. The primary outcome will be the Oswestry Disability Index (ODI) score 12 months after surgery based on a modified intention-to-treat strategy. The secondary outcomes will include the visual analog scale score for low back and lower extremity radiating pain, the ODI score, the Euro-Qol-5-Dimensions score, surgery satisfaction, walking time, postoperative return to daily life period, postoperative surgical scar, and surgery-related variables, such as postoperative drainage, operation time, admission duration, postoperative creatine kinase, and implementation status of conversion to open surgery. Radiographic outcomes will also be analyzed using magnetic resonance imaging (MRI) or computed tomography (CT) and simple radiographs. Safety will be assessed by evaluating all adverse and severe adverse events and surgery-related effects. The participants will be assessed by a blinded assessor before surgery (baseline) and 2 weeks and 3, 6, and 12 months after surgery.

Discussion

This trial will be the first prospective, multicenter, randomized controlled trial to analyze the efficacy and safety of biportal endoscopic discectomy in lumbar herniated disc.

This trial is designed for evaluating the equivalence of the results between biportal endoscopic and microscopic discectomy including adequate sample size, blinded analyses, and prospective registration to reduce bias. This trial will provide enough data on the effectiveness and safety of biportal endoscopic surgery and will be an important study that allows clear conclusions.

Trial registration

Clinical Research Information Service (cris.nih.go.kr.) (KCT0006191). Registered on 27 March 2021
Sympatric occurrence of Ixodes ricinus with Dermacentor reticulatus and Haemaphysalis concinna and the associated tick-borne pathogens near the German Baltic coast
Authors: Răileanu Cristian , Tauchmann Oliver , Silaghi Cornelia
Published: February 2022

Background

Ixodid ticks from the Northern Hemisphere have registered a northward expansion in recent years, and Dermacentor reticulatus is such an example in Europe, its expansion being considered a result of climate change alongside other factors. The aim of this study was to identify the composition of questing tick species and the associated pathogens at different sites near the German Baltic coast.

Methods

Questing ticks were collected monthly at four sites (May–November, 2020), mainly grasslands, and in October and November 2020 at a fifth site. Molecular screening of ticks for pathogens included RT-qPCR for the tick-borne encephalitis virus (TBEV), qPCR for Anaplasma phagocytophilum, PCR for Babesia species and Rickettsia species, and nested PCR for Borrelia species.

Results

Altogether 1174 questing ticks were collected: 760 Ixodes ricinus, 326 D. reticulatus and 88 Haemaphysalis concinna. The highest activity peak of I. ricinus and D. reticulatus was in May, in June for H. concinna while a second peak was observed only for I. ricinus and D. reticulatus in September and October, respectively. All samples tested negative for TBEV. For A. phagocytophilum, 1.5% of I. ricinus adults tested positive while the minimum infection rate (MIR) in nymphs was 1.3%. This pathogen was found in 0.6% of D. reticulatus. Babesia spp. were detected in I. ricinus (18.2% adults, 2.1% MIR in nymphs) and H. concinna (13.3% adults, 9.7% MIR in nymphs). Borrelia spp. were present only in I. ricinus (49.1% adults, 11.9% MIR in nymphs), while Rickettsia spp. were detected in I. ricinus (14% adults, 8.9% MIR in nymphs) and D. reticulatus (82%). Co-detection of pathogens was observed in 26.6% and 54.8% of positive I. ricinus adults and nymph pools, respectively, while one D. reticulatus tested positive for A. phagocytophilum and Rickettsia spp. The most common co-infection in I. ricinus adults was Babesia microti and Borrelia afzelii (12.3% of positive ticks).

Conclusions

The results of this study confirm the northern expansion of D. reticulatus and H. concinna in Germany. The detailed data of the infection levels at each location could be useful in assessing the risk of pathogen acquisition following a tick bite.

Graphical Abstract
DevKidCC allows for robust classification and direct comparisons of kidney organoid datasets
Authors: Wilson Sean B. , Howden Sara E. , Vanslambrouck Jessica M. , Dorison Aude , Alquicira-Hernandez Jose , Powell Joseph E. , Little Melissa H.
Published: February 2022

Background

While single-cell transcriptional profiling has greatly increased our capacity to interrogate biology, accurate cell classification within and between datasets is a key challenge. This is particularly so in pluripotent stem cell-derived organoids which represent a model of a developmental system. Here, clustering algorithms and selected marker genes can fail to accurately classify cellular identity while variation in analyses makes it difficult to meaningfully compare datasets. Kidney organoids provide a valuable resource to understand kidney development and disease. However, direct comparison of relative cellular composition between protocols has proved challenging. Hence, an unbiased approach for classifying cell identity is required.

Methods

The R package, scPred, was trained on multiple single cell RNA-seq datasets of human fetal kidney. A hierarchical model classified cellular subtypes into nephron, stroma and ureteric epithelial elements. This model, provided in the R package DevKidCC (github.com/KidneyRegeneration/DevKidCC), was then used to predict relative cell identity within published kidney organoid datasets generated using distinct cell lines and differentiation protocols, interrogating the impact of such variations. The package contains custom functions for the display of differential gene expression within cellular subtypes.

Results

DevKidCC was used to directly compare between distinct kidney organoid protocols, identifying differences in relative proportions of cell types at all hierarchical levels of the model and highlighting variations in stromal and unassigned cell types, nephron progenitor prevalence and relative maturation of individual epithelial segments. Of note, DevKidCC was able to distinguish distal nephron from ureteric epithelium, cell types with overlapping profiles that have previously confounded analyses. When applied to a variation in protocol via the addition of retinoic acid, DevKidCC identified a consequential depletion of nephron progenitors.

Conclusions

The application of DevKidCC to kidney organoids reproducibly classifies component cellular identity within distinct single-cell datasets. The application of the tool is summarised in an interactive Shiny application, as are examples of the utility of in-built functions for data presentation. This tool will enable the consistent and rapid comparison of kidney organoid protocols, driving improvements in patterning to kidney endpoints and validating new approaches.
Mobile applications for the sport and exercise nutritionist: a narrative review
Authors: Peart Daniel J. , Briggs Marc A. , Shaw Matthew P.
Published: February 2022

Mobile technology is widespread in modern society, and the applications (apps) that they run can serve various purposes. Features such as portability, ease of communication, storage, and relative low cost may make such technology attractive to practitioners in several fields. This review provides a critical narrative on the existing literature for apps relevant to the field of sport and exercise nutrition. Three main areas are discussed: (1) dietary analysis of athletes, (2) nutrition education for athletes, (3) estimating body composition. The key purpose of the review was to identify what literature is available, in what areas apps may have a benefit over traditional methods, and considerations that practitioners should make before they implement apps into their practice or recommend their use to coaches and athletes.
Relationship of sex differences in cortical thickness and memory among cognitively healthy subjects and individuals with mild cognitive impairment and Alzheimer disease
Authors: Cieri Filippo , Zhuang Xiaowei , Cordes Dietmar , Kaplan Nikki , Cummings Jeffery , Caldwell Jessica ,   for the Alzheimer’s Disease Neuroimaging Initiative (ADNI)
Published: February 2022

Background

An aging society has increased rates of late onset Alzheimer disease dementia (ADD), the most common form of age-related dementia. This neurodegenerative disease disproportionately affects women.

Methods

We use data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) to examine sex differences in cortical thickness (CT) and memory performance. Analyses of covariance (ANCOVA) models were used to examine effects of sex and diagnosis (DX) on CT and verbal memory. For regions demonstrating significant interaction effects of sex and DX, we tested whether sex moderated cognition-thickness relationships. We used machine learning as a complementary method to explore multivariate CT differences between women and men.

Results

Women demonstrated greater CT in many brain regions. More specifically, men showed relatively consistent CT declines in all stages, from normal control (NC) to ADD in the bilateral cingulate cortex, bilateral temporal regions, and left precuneus; women had more stable CT in these regions between NC and mild cognitive impairment (MCI) stages, but sharper declines from MCI to ADD. Similarly, for the Rey Auditory Verbal Learning Test (RAVLT), ANCOVA analyses showed that women had significantly better immediate and delayed recall scores than men, at NC and MCI stages, but greater differences, cross-sectionally, from MCI to ADD than men. We found significant sex moderation effects between RAVLT-immediate scores and CT of right isthmus-cingulate for all subjects across DX. Partial correlation analyses revealed that increased CT of right isthmus-cingulate was associated with better verbal learning in women, driven by positron emission tomography defined amyloid positive (Aβ+) subjects. Significant sex-moderation effects in cognition-thickness relationships were further found in the right middle-temporal, left precuneus, and left superior temporal regions in Aβ+ subjects. Using a machine learning approach, we investigated multivariate CT differences between women and men, showing an accuracy in classification of 75% for Aβ+ cognitively NC participants.

Conclusions

Sex differences in memory and CT can play a key role in the different vulnerability and progression of ADD in women compared to men. Machine learning indicates sex differences in CT are most relevant early in the ADD neurodegeneration.
A multipurpose TNM stage ontology for cancer registries
Authors: Nicholson Nicholas Charles , Giusti Francesco , Bettio Manola , Carvalho Raquel Negrao , Dimitrova Nadya , Dyba Tadeusz , Flego Manuela , Neamtiu Luciana , Randi Giorgia , Martos Carmen
Published: February 2022

Background

Population-based cancer registries are a critical reference source for the surveillance and control of cancer. Cancer registries work extensively with the internationally recognised TNM classification system used to stage solid tumours, but the system is complex and compounded by the different TNM editions in concurrent use. TNM ontologies exist but the design requirements are different for the needs of the clinical and cancer-registry domains. Two TNM ontologies developed specifically for cancer registries were designed for different purposes and have limitations for serving wider application. A unified ontology is proposed to serve the various cancer registry TNM-related tasks and reduce the multiplication effects of different ontologies serving specific tasks. The ontology is comprehensive of the rules for TNM edition 7 as required by cancer registries and designed on a modular basis to allow extension to other TNM editions.

Results

A unified ontology was developed building on the experience and design of the existing ontologies. It follows a modular approach allowing plug in of components dependent upon any particular TNM edition. A Java front-end was developed to interface with the ontology via the Web Ontology Language application programme interface and enables batch validation or classification of cancer registry records. The programme also allows the means of automated error correction in some instances. Initial tests verified the design concept by correctly inferring TNM stage and successfully handling the TNM-related validation checks on a number of cancer case records, with a performance similar to that of an existing ontology dedicated to the task.

Conclusions

The unified ontology provides a multi-purpose tool for TNM-related tasks in a cancer registry and is scalable for different editions of TNM. It offers a convenient way of quickly checking validity of cancer case stage information and for batch processing of multi-record data via a dedicated front-end programme. The ontology is adaptable to many uses, either as a standalone TNM module or as a component in applications of wider focus. It provides a first step towards a single, unified TNM ontology for cancer registries.
Multiple species animal movements: network properties, disease dynamics and the impact of targeted control actions
Authors: Cardenas Nicolas C. , Sykes Abagael L. , Lopes Francisco P. N. , Machado Gustavo
Published: February 2022

Infectious diseases in livestock are well-known to infect multiple hosts and persist through a combination of within- and between-host transmission pathways. Uncertainty remains about the epidemic dynamics of diseases being introduced on farms with more than one susceptible host species. Here, we describe multi-host contact networks and elucidate the potential of disease spread through farms with multiple hosts. Four years of between-farm animal movement among all farms of a Brazilian state were described through a static and monthly snapshot of network representations. We developed a stochastic multilevel model to simulate scenarios in which infection was seeded into single host and multi-host farms to quantify disease spread potential, and simulate network-based control actions used to evaluate the reduction of secondarily infected farms. We showed that the swine network was more connected than cattle and small ruminants in both the static and monthly snapshots. The small ruminant network was highly fragmented, however, contributed to interconnecting farms, with other hosts acting as intermediaries throughout the networks. When a single host was initially infected, secondary infections were observed across farms with all other species. Our stochastic multi-host model demonstrated that targeting the top 3.25% of the farms ranked by degree reduced the number of secondarily infected farms. The results of the simulation highlight the importance of considering multi-host dynamics and contact networks while designing surveillance and preparedness control strategies against pathogens known to infect multiple species.
Innovative financing of the sustainable development goals in the countries of the Western Balkans
Authors: Lukšić Igor , Bošković Bojana , Novikova Aleksandra , Vrbensky Rastislav
Published: February 2022

Background

This paper is related to the current stage of development in the Western Balkans. Despite becoming growing instruments to finance sustainable green development, debt swaps and social or sustainability bonds are relative novelties in this region. At the same time, the development needs are huge, especially in the light of the COVID-19 aftermath.

Results

The review of both historic financial instruments, such as the debt for nature swaps, and more recent ones, such as sustainability bonds in its variations, highlight the potential for use in developing countries. The relatively recent case from Montenegro and the recent issuance of the green bond in Serbia showcase the possibilities. The focus of this paper is an analysis of the public debt position of Western Balkan countries. The growing level of public debt over the past decade points to a lack of adequate interventions and a relatively imminent need for fiscal consolidation. The research suggests that environmental, social, governance/sustainability-linked bonds and debt-for-climate swap investments as innovative financial instruments that hold promise in leveraging additional finance to support the sustainability goals of the six countries of the Western Balkans. This influx of capital would be particularly advantageous, given their needs relative to EU accession and their economic and structural challenges. The recommendations for policymakers are derived based on the history and features of green bonds as well as debt-for-nature swaps and their diverse underlying mechanisms which are adaptable to the respective countries.

Conclusions

The related countries would benefit from exploring more innovative approaches to finance sustainable societies. In close cooperation with the EU and taking the European Green Deal into consideration, it is recommended that the six countries of the Western Balkans design financing mechanisms that will bring increased transparency to the different policies and more accountability for their implementation. Applying the recommended modality may help keep the problem of the public debt at bay, while additional funds may support implementation of structural reforms.