bluuebunny/crossref_metadata_2025 huggingface dataset:
‘I can no longer do my work like how I used to’: a mixed methods longitudinal cohort study exploring how informal working mothers balance the requirements of livelihood and safe childcare in South Africa
Authors: Horwood Christiane , Hinton Rachael , Haskins Lyn , Luthuli Silondile , Mapumulo Sphindile , Rollins Nigel
Published: August 2021

Background

Returning to work after childbirth is challenging for working mothers. Childcare quality may have lifelong effects on children’s health, development and cognitive function. Over 60% of working women globally are informal workers without employment or maternity protection, but little is known about how these women care for their children.

Methods

We conducted a mixed-methods longitudinal cohort study among informal women workers in Kwazulu-Natal, South Africa between July 2018 and August 2019. Participants were followed up from late pregnancy until they had returned to work. We conducted structured quantitative interviews and in-depth qualitative interviews at different time points: before and after the baby was born, and after returning to work. Subsequently, a photovoice activity was conducted with groups of participants to explore the childcare environment. We employed narrative thematic analysis for qualitative data and descriptive analysis for quantitative data.

Results

24 women were recruited to participate. Women returned to work soon after the baby was born, often earlier than planned, because of financial responsibilities to provide for the household and new baby. Women had limited childcare choices and most preferred to leave their babies with family members at home, as the most convenient, low cost option. Otherwise, mothers chose paid carers or formal childcare. However, formal childcare was reported to be poor quality, unaffordable and not suited to needs of informal workers. Mothers expressed concern about carers’ reliability and the safety of the childcare environment. Flexibility of informal work allowed some mothers to adapt their work to care for their child themselves, but others were unable to arrange consistent childcare, sometimes leaving the child with unsuitable carers to avoid losing paid work. Mothers were frequently anxious about leaving the child but felt they had no choice as they needed to work.

Conclusion

Mothers in informal work had limited childcare options and children were exposed to unsafe, poor-quality care. Maternity protection for informal workers would support these mothers to stay home longer to care for themselves, their family and their baby. Provision of good quality, affordable childcare would provide stability for mothers and give these vulnerable children the opportunity to thrive.
Naturopaths’ mobilisation of knowledge and information in clinical practice: an international cross-sectional survey
Authors: Steel Amie , Leach Matthew , Brosnan Caragh , Ward Vicky , Lloyd Iva
Published: August 2021

Background

The contemporary evidence-based practice model acknowledges the importance of patient preferences and clinician experience when applying evidence within a clinical setting. Knowledge mobilisation (KM) acknowledges the complexities of knowledge translation by recognising and respecting diversity in types of knowledge and how such diversity can influence health care and health care choices. While there has been considerable discussion on KM in health care, it has received little attention in the field of naturopathy. Despite naturopathy’s widespread international use, it is unclear how naturopathic practitioners (NPs) use and share knowledge and information in clinical practice. This study examines the mobilisation of knowledge amongst NPs internationally.

Methods

Online, international, cross-sectional survey of a self-selected sample of NPs from any country, that were either currently in clinical practice or had been in practice within the previous 12 months. The survey was administered in five languages (English, French, Portuguese, Spanish, German). Descriptive statistics were prepared for all survey items.

Results

The survey was completed by 478 NPs who reported using an average of seven (median = 7, SD = 2.6) information sources to inform patient care. NPs also drew on knowledge gained through patients sharing their perspectives of living with their health condition (Always/Most of the time: 89.3%). They mostly sought knowledge about how a treatment might benefit a patient, as well as knowledge about treatment safety and a better understanding of a patient’s health condition. NPs frequently reported sharing knowledge developed through consideration of the patient’s unique needs (83.3%), and primarily shared knowledge by producing information for the public (72.6%) and for patients (72.2%).

Conclusions

Based on these findings, it may be argued that NPs practice knowledge mobilisation; employing multiple forms and sources of knowledge, and mobilising knowledge to - as well as from - others. Due to their active engagement in patient and community education, NPs also may be considered knowledge brokers. In the context of the growing understanding of the complexities of knowledge translation and mobilisation in contemporary health care – and particularly within the context of implementation science – this study provides novel insights into an under-researched element of health services accessed by the community.
I’m No Superman: fostering physician resilience through guided group discussion of Scrubs
Authors: Holtzclaw Arthur , Ellis Jack , Colombo Christopher
Published: August 2021

Background

Almost half of trainees experience burnout during their career. Despite the Accreditation Council on Graduate Medical Education (ACGME) recommendation that training programs enact well-being curricula, there is no proven method of addressing this difficult topic.

Methods

We created a curriculum addressing physician resiliency and well-being, designed for an Internal Medicine Residency Program. This curriculum utilized episodes from a medical television series, Scrubs, to facilitate a monthly, 1-h faculty guided discussion group. We collected informal feedback and abbreviated Maslach Burnout Inventories (aMBI) monthly and conducted a formal focus group after 6 months to gauge its effectiveness.

Results

The curriculum was successfully conducted for 12 months with each session averaging 18–20 residents. Residents reported high satisfaction, stating it was more enjoyable and helpful than traditional resiliency training. 19 of 24 residents (79 %) completed a baseline aMBI, and 17 of 20 residents (85 %) who attended the most recent session completed the 6-month follow-up, showing a non-significant 1-point improvement in all subsets of the aMBI.

Conclusions

This novel, low-cost, easily implemented curriculum addressed resiliency and burn-out in an Internal Medicine Residency. It was extremely well received and can easily be expanded to other training programs or to providers outside of training.
Donkey-derived anti-CDV IgG, as a passive immunotherapy agent, can effectively increase survival rates of the experimental CDV-infected dogs
Authors: Zhang Jianlou , Cui Dan , Zuo Yuzhu , Zheng Zhiqiang , Wu Fengyang , Li Wenyan , Zhang Yonghong , Huo Shanshan , Li Nan , Li Lanhui , Guan Yueqiang , Zhong Fei
Published: August 2021

Background

Humoral immunity plays an important role in the prevention of canine distemper. Anti-CD virus (CDV) antibody has strong antiviral activity and is widely used in the treatment of CD. However, with the increase of CD cases, the availability of therapeutic CD antibody fell short of the clinical needs.

Results

The high-titer antiserum with the high-titer neutralizing activity against CDV was obtained from the donkeys (Dezhou Donkey) immunized with the inactivated CDV vaccine. The donkey anti-CDV IgG was purified from the donkey serum, which was identified to significantly inhibit the CDV replication in the cultured Vero cells and effectively reduce the clinical symptoms and increase the survival rates (75%) of CDV-infected dogs (Shih-tzu Dog), similar to that treated with the dog-derived anti-CDV IgG. These results indicate that donkey-derived IgG is a potential substitute for dog-derived IgG to treat the CD in clinic.

Conclusions

Administration of donkey-derived anti-CDV IgG can ameliorate clinical symptoms and inhibit virus replication, thereby increasing the survival of CDV-infected dogs. This study opens up a new source of therapeutic antibody for CD treatment.
Global and regional right ventricular mechanics in repaired tetralogy of Fallot with chronic severe pulmonary regurgitation: a three-dimensional echocardiography study
Authors: Bidviene Jurate , Muraru Denisa , Kovacs Attila , Lakatos Bálint , Ereminiene Egle , Liptai Csilla , Vaskelyte Jolanta-Justina , Zaliunas Remigijus , Surkova Elena , Badano Luigi P.
Published: August 2021

Background

Data about the right ventricular (RV) mechanics adaptation to volume overload in patients with repaired tetralogy of Fallot (rToF) are limited. Accordingly, we sought to assess the mechanics of the functional remodeling occurring in the RV of rToF with severe pulmonary regurgitation.

Methods

We used three-dimensional transthoracic echocardiography (3DTE) to obtain RV data sets from 33 rToF patients and 30 age- and sex- matched controls. A 3D mesh model of the RV was generated, and RV global and regional longitudinal (LS) and circumferential (CS) strain components, and the relative contribution of longitudinal (LEF), radial (REF) and anteroposterior (AEF) wall motion to global RV ejection fraction (RVEF) were computed using the ReVISION method.

Results

Corresponding to decreased global RVEF (45 ± 6% vs 55 ± 5%, p < 0.0001), rToF patients demonstrated lower absolute values of LEF (17 ± 4 vs 28 ± 4), REF (20 ± 5 vs 25 ± 4) and AEF (17 ± 5 vs 21 ± 4) than controls (p < 0.01). However, only the relative contribution of LEF to global RVEF (0.39 ± 0.09 vs 0.52 ± 0.05, p < 0.0001) was significantly decreased in rToF, whereas the contribution of REF (0.45 ± 0.08 vs 0.46 ± 0.04, p > 0.05) and AEF (0.38 ± 0.09 vs 0.39 ± 0.04, p > 0.05) to global RVEF was similar to controls. Accordingly, rToF patients showed lower 3D RV global LS (-16.94 ± 2.9 vs -23.22 ± 2.9, p < 0.0001) and CS (-19.79 ± 3.3 vs -22.81 ± 3.5, p < 0.01) than controls. However, looking at the regional RV deformation, the 3D CS was lower in rToF than in controls only in the basal RV free-wall segment (p < 0.01). 3D RV LS was reduced in all RV free-wall segments in rToF (p < 0.0001), but similar to controls in the septum (p > 0.05).

Conclusions

3DTE allows a quantitative evaluation of the mechanics of global RVEF. In rToF with chronic volume overload, the relative contribution of the longitudinal shortening to global RVEF is affected more than either the radial or the anteroposterior components.
Clinical efficacy and safety of maintenance therapy for advanced non-small cell lung cancer: a retrospective real-world study
Authors: Xu Xiangwei , Li Ruya , Zhu Peizhen , Zhang Penghai , Chen Jun , Lin Yongsheng , Chen Yinqiao
Published: August 2021

Background

The clinical efficacy and safety of maintenance therapy (MT) for patients with advanced non-small cell lung cancer (NSCLC) have not been determined in the real word. This retrospective study of real-world data analyzed these issues in patients with advanced NSCLC and stable or responsive tumors after 4–6 cycles of first-line chemotherapy.

Methods

We classified 158 patients into MT (34 IIIB and 37 IV stage) and non-MT (47 IIIB and 40 IV stage) groups and then compared the clinical outcomes of progression-free survival (PFS) and overall survival (OS). The influences of maintaining chemotherapy or targeted drugs, regimens, and duration on PFS were also investigated. Prognostic factors for OS were identified by univariate and multivariate analyses.

Results

Among the patients, 71 received MT and 87 did not. The median PFS and OS were significantly prolonged in the MT group than non-MT group (5.6 and 14.2 vs. 2.8 and 9.8 months, respectively; both p < 0.0001). The PFS was extended when patients were maintained with targeted drugs compared with chemotherapy, > 4 cycles of chemotherapy, and targeted drugs for > 3 months (all P < 0.0001). Patients with adenocarcinoma and without distant metastasis derived a better OS benefit from MT (P = 0.041 and P = 0.037, respectively). Multivariate analysis revealed that female sex and MT were independent prognostic factors for extended OS (P = 0.039 and P < 0.0001, respectively). The major adverse events of MT comprised tolerable hematological toxicity and gastrointestinal reactions.

Conclusions

MT was advantageous and tolerable for patients with advanced NSCLC, especially those with adenocarcinomas without distant metastasis who were treated with targeted drugs, which was an independent prognostic factor for OS.
Research progress of endometrial receptivity in patients with polycystic ovary syndrome: a systematic review
Authors: Bai Xuechun , Zheng Lianwen , Li Dandan , Xu Ying
Published: August 2021

Polycystic ovary syndrome (PCOS) is a neuroendocrine heterogeneous disease that frequently occurs in women of reproductive age, causing serious damage to the fertility, quality of life, and physical and mental health of patients. The current studies have proved that satisfactory endometrial receptivity is one of the conditions that must be met during the process of spermatovum position, adhesion and invasion, as well as the subsequent blastocyst division and embryo development. Women with PCOS may suffer a series of pathological processes such as changes in the expression levels of hormones and related receptors, imbalances in the proportion of miscellaneous cytokines, insulin resistance, low-grade chronic inflammation and endometrial morphological changes, which will damage endometrial receptivity from various aspects and obstruct fertilized egg nidation and embryonic development, thus causing adverse reproductive health events including infertility and abortion. This article reviews the research progress about characteristics and related influencing factors of endometrial receptivity in PCOS patients.
Inhibition of heat shock protein family A member 8 attenuates spinal cord ischemia–reperfusion injury via astrocyte NF-κB/NLRP3 inflammasome pathway
Authors: Mi Jingyi , Yang Yang , Yao Hao , Huan Zhirong , Xu Ce , Ren Zhiheng , Li Wenfu , Tang Ying , Fu Rao , Ge Xin
Published: August 2021

Background

Astrocyte over-activation and extensive neuron loss are the main characteristic pathological features of spinal cord ischemia–reperfusion injury (SCII). Prior studies have placed substantial emphasis on the role of heat shock protein family A member 8 (HSPA8) on postischemic myocardial inflammation and cardiac dysfunction. However, it has never been determined whether HSPA8 participates in astrocyte activation and thus mediated neuroinflammation associated with SCII.

Methods

The left renal artery ligation-induced SCII rat models and oxygen–glucose deprivation and reoxygenation (OGD/R)-induced rat primary cultured astrocytes were established. The lentiviral vector encoding short hairpin RNA targeting HSPA8 was delivered to the spinal cord by intrathecal administration or to culture astrocytes. Then, the spinal neuron survival, gliosis, and nod-like receptor pyrin domain-containing 3 (NLRP3) inflammasome and its related pro-inflammatory cytokines were analyzed.

Results

SCII significantly enhanced the GFAP and HSPA8 expression in the spinal cord, resulting in blood–brain barrier breakdown and the dramatical loss of spinal neuron and motor function. Moreover, injury also increased spinal nuclear factor-kappa B (NF-κB) p65 phosphorylation, NLRP3 inflammasome-mediated caspase-1 activation, and subsequent interleukin (IL)-1β as well as IL-18 secretion. Silencing the HSPA8 expression efficiently ameliorated the spinal cord tissue damage and promoted motor function recovery after SCII, through blockade of the astrocyte activation and levels of phosphorylated NF-κB, NLRP3, caspase-1, IL-1β, and IL-18. Further in vitro studies confirmed that HSPA8 knockdown protected astrocytes from OGD/R-induced injury via the blockade of NF-κB and NLRP3 inflammasome activation.

Conclusion

Our findings indicate that knockdown of HSPA8 inhibits spinal astrocytic damage after SCII, which may provide a promising therapeutic strategy for SCII treatment.
Quinic acid: a potential antibiofilm agent against clinical resistant Pseudomonas aeruginosa
Authors: Lu Lan , Zhao Yuting , Yi Guojuan , Li Mingxing , Liao Li , Yang Chen , Cho Chihin , Zhang Bin , Zhu Jie , Zou Kun , Cheng Qiang
Published: August 2021

Background

The biofilm state of pathogens facilitates antimicrobial resistance which makes difficult-to-treat infections. In this regard, it has been found that the compounds screened from plant extracts represent one category of the most promising antibiofilm agents. However, the antibiofilm activities and the active ingredients of plant extracts remain largely unexplored. In this background, the study is (1) to screen out the plant extracts with antibiofilm ability against Pseudomonas aeruginosa, and (2) to identify the active ingredients in the plant extracts and elucidate the underlying mechanism of the antibiofilm activities.

Methods

Micro-broth dilution method, in vitro biofilm model, LC–MS/MS analysis and P. aeruginosa-mouse infection model were adopted to assess the antibiofilm activity. GC–MS analysis was performed to detect the active ingredients in plasma. RNA-Seq, GO analysis, KEGG analysis and RT-qPCR were adopted to elucidate the underlying mechanism of antibiofilm activities against P. aeruginosa.

Results

Lonicerae Japonicae Flos (LJF) among 13 plants could exert significant inhibitory effects on bacterial biofilm formation, mobility and toxin release in vitro, and it could exert antibiofilm effect in vivo too. Moreover, quinic acid, as one metabolite of chlorogenic acid, was found as an active ingredient in LJF against the biofilm of P. aeruginosa. The active ingredient significantly inhibited EPS secretion in biofilm formation and maturity and could achieve synergistic antibiofilm effect with levofloxacin. It reduced the biofilm formation by regulating core targets in quorum sensing system. In GO process, it was found that the core targets were significantly enriched in multiple biological processes involving locomotion, chemotaxis and motility mediated by flagellum/cilium, which was related to KEGG pathways such as bacterial chemotaxis, oxidative phosphorylation, ribosome, biofilm formation, cyanoamino acid metabolism and quorum sensing. Finally, the binding of quinic acid with core targets rhlA, rhlR and rhlB were validated by molecular docking and RT-qPCR.

Conclusions

In summary, the study verified the in vitro and in vivo antibiofilm effects of LJF against P. aeruginosa and elucidated the active ingredients in LJF and its conceivable pharmacological mechanism, indicating that quinic acid could have the potential of an antibiofilm agent against P. aeruginosa and related infections.

Graphic abstract
Genetic determination of the ovarian reserve: a literature review
Authors: Moiseeva Aleksandra V. , Kudryavtseva Varvara A. , Nikolenko Vladimir N. , Gevorgyan Marine M. , Unanyan Ara L. , Bakhmet Anastassia A. , Sinelnikov Mikhail Y.
Published: August 2021

The ovarian reserve is one of the most important indicators of female fertility. It allows for the evaluation of the number of viable oocytes. This parameter is actively used in pregnancy planning and in assisted reproductive technology application, as it determines chances of successful fertilization and healthy pregnancy. Due to increased attention towards diagnostic tests evaluating the ovarian reserve, there has been a growing interest in factors that influence the state of the ovarian reserve. True reasons for pathological changes in the ovarian reserve and volume have not yet been explored in depth, and current diagnostic screening methods often fall short in efficacy. In the following review we analyze existing data relating to the study of the ovarian reserve through genetic testing, determining specific characteristics of the ovarian reserve through genetic profiling. We explore existing studies dedicated to finding specific genetic targets influencing the state of the ovarian reserve.
Hypertonic saline in people with cystic fibrosis: review of comparative studies and clinical practice
Authors: Terlizzi Vito , Masi Eleonora , Francalanci Michela , Taccetti Giovanni , Innocenti Diletta
Published: August 2021

Cystic fibrosis (CF) is a multisystem disorder, caused by mutations in the CF transmembrane conductance regulator (CFTR) gene. These cause a reduced secretion of chloride, a marked absorption of sodium and, therefore, of water, through the epithelium, resulting in the formation of thickened secretions in organs such as lung or pancreas. These viscous secretions lead to airway obstruction, chronic infection and inflammation resulting in progressive lung damage, bronchiectasis and eventual respiratory failure. Although the average life expectancy has increased over the last 30 years, lung disease is the most common cause of death in people with CF. For these reasons, the improvement of sputum clearance is a major therapeutic aim in CF and early initiation of airway clearance is widely recommended and implemented. Symptomatic mucolytic therapy today is mainly based on inhalation of DNase, hypertonic saline or mannitol, in combination with physiotherapy. Mucolytic agents break down the gel structure of mucus and therefore decrease its elasticity and viscosity, reducing the pulmonary exacerbation frequency and to improve and stabilize lung function. Nevertheless, high quality studies comparing these mucolytic drugs are still few, and the individual experiences of patients and caregivers explain the high variability of their use globally. This review will summarize the current knowledge on hypertonic saline in the treatment of CF lung disease. Furthermore, we report the real-world prescription of inhaled mucolytic agents in CF.
Long non-coding RNA SNHG8 enhances triple-negative breast cancer cell proliferation and migration by regulating the miR-335-5p/PYGO2 axis
Authors: Qian Jintao , Lei Xinhan , Sun Yue , Zheng Lu , Li Jia , Zhang Shuai , Zhang Lei , Li Wanwan , Shi Jianing , Jia Wenjun , Tang Tong
Published: August 2021

Background

Growing evidence has demonstrated that long non-coding RNAs (lncRNAs) can function as modulators in the development of triple-negative breast cancer (TNBC). However, the function of lncRNA small nucleolar RNA host gene 8 (SNHG8) in TNBC remains unclear. Therefore, our study aimed at investigating the role of SNHG8 in the proliferation and migration of TNBC cells.

Methods

SNHG8 expression was evaluated using RT-qPCR assay. Cell proliferation and migration were assessed by EdU, colony formation and Transwell assays. The levels of proteins related to EMT process were examined by western blot assay. The interaction among SNHG8, miR-335-5p and pygopus family PHD finger 2 (PYGO2) was detected by RIP assay, RNA pull down assay and luciferase reporter assay.

Results

SNHG8 expression was significantly up-regulated in TNBC cells. SNHG8 silencing obviously inhibited TNBC cell proliferation, migration and EMT process. Moreover, SNHG8 acted as a sponge to sequester miR-335-5p in TNBC cells. Besides, PYGO2 was proven as a target gene of miR-335-5p, and SNHG8 promoted TNBC cell proliferation, migration and EMT process through regulating miR-335-5p and PYGO2.

Conclusions

Totally, our study indicated that SNHG8 promoted TNBC cell proliferation and migration by regulating the miR-335-5p/PYGO2 axis.
Human Leukocyte Antigens class II (HLA II) gene profile from an admixed population of patients with type 1 diabetes with severe diabetic retinopathy: a nested case-control study in Brazil
Authors: Santos Deborah Conte , Porto Luís Cristóvão , Pizarro Marcela Haas , de Melo Laura Gomes Nunes , Silva Dayse A. , Oliveira Romulo Vianna , Villela Anna Paula , Muniz Luiza Harcar , Soares Camila , Tannus Lucianne Righeti Monteiro , Drummond Karla Rezende Guerra , Pinheiro André Araújo , Mallmann Felipe , Leal Franz Schubert Lopes , Malerbi Fernando Korn , Morales Paulo Henrique , Gomes Marília Brito
Published: August 2021

Background

Although the well-established role of the HLA genes on the predisposition of type 1 diabetes (T1D), its contribution to the development and progression of diabetic retinopathy is still unclear, especially in admixed populations. We aimed to study the relationship between HLA alleles and severe diabetic retinopathy in a highly admixed population of T1D patients.

Methods

This was a nested case-control study based on a cross-sectional, nationwide survey conducted in Brazil. We included 117 patients with severe diabetic retinopathy and 117 random controls composed of T1D patients without retinopathy, matched for diabetes duration.HLA-class II genes (HLA-DRB1, -DQA1, and -DQB1) were genotyped using the SSO and NGS methods.

Results

HaplotypesHLA-DRB1*04:05 ~ DQA1*03:01 g ~ DQB1*03:02(OR 1.75, CI 0.97–3.16, p value 0.058) andHLA-DRB1*13:02 ~ DQA1*01:02 ~ DQB1*06:04(OR 5.18, CI 1.12–23.09, p value 0.019) were more prevalent on the severe DR group but they did not present statistically difference after Bonferroni correction. The most frequent haplotype on both groups wasHLA-DRB1*03:01 ~ DQA1*05:01 g ~ DQB1*02:01(29.6% on severe DR and 33.33% on the control group).

Conclusions

Our study showed no influence of HLA genes on the development of DR. Further longitudinal data is needed to better understand the role of genetic factors on this multifactorial significant microvascular complication.
Estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation study
Authors: Schüttler Dominik , Krammer Simone , von Stülpnagel Lukas , Sams Lauren , Bauer Axel , Hamm Wolfgang , Brunner Stefan
Published: August 2021

Background

Assessing lactate (LT) or anaerobic thresholds (AT) in athletes is an important tool to control training intensities and to estimate individual performance levels. Previously we demonstrated that ECG-based assessment of cardiac repolarization instability during exercise testing allows non-invasive estimation of AT in recreational athletes. Here, we validate this method in professional and amateur team sports athletes.

Methods

We included 65 team sports athletes (32 professionals and 33 amateur athletes; 51 men, 14 women, mean age 22.3 ± 5.2 years) undergoing a standardized incremental cycle exercise test. During exercise testing a high-resolution ECG (1000 Hz) was recorded in Frank-leads configuration and beat-to-beat vector changes of cardiac repolarization (dT°) were assessed by previously established technologies. Repolarization-based AT (ATdT°) was estimated by its typical dT°-signal pattern. Additionally, LT was detected in accordance to methods established by Mader (LTMader) and Dickhuth (LTDickhuth).

Results

All athletes performed exercise testing until exhaustion with a mean maximum workload of 262.3 ± 60.8 W (241.8 ± 64.4 W for amateur athletes and 283.4 ± 49.5 W for professional athletes). Athletes showed ATdT°at 187.6 ± 44.4 W, LTDickhuthat 181.1 ± 45.6 W and LTMaderat 184.3 ± 52.4 W. ATdT°correlated highly significantly with LTDickhuth(r = 0.96,p < 0.001) and LTMader(r = 0.98,p < 0.001) in the entire cohort of athletes as well as in the subgroups of professional and amateur athletes (p < 0.001 for all).

Conclusions

ATdT°, defined by the maximal discordance between dT° and heart rate, can be assessed reliably and non-invasively via the use of a high-resolution ECG in professional and amateur athletes.
Impact of human adipose tissue-derived stem cells on dermatofibrosarcoma protuberans cells in an indirect co-culture: an in vitro study
Authors: Yuan Zhaoqi , Zhu Zhu , Zhu Fangxing , Ding Feixue , Wang Yinmin , Wang Xiuxia , Luo Xusong , Yang Jun , Liu Fei , Sun Di
Published: August 2021

Background

Autologous adipose tissue transfer may be performed for aesthetic needs following the resection of dermatofibrosarcoma protuberans (DFSP), the most common cutaneous soft tissue sarcoma, excluding Kaposi sarcoma. The regenerative effectiveness of cell-assisted lipotransfer is dependent on the presence of adipose tissue-derived stem cells (ADSCs). This is the first study to evaluate the potential oncological risks as ADSCs could unintentionally be sited within the proximity of the tumor microenvironment of DFSP cells.

Methods

Primary DFSP cells were indirectly co-cultured with ADSCs in a conditioned medium or in a Transwell system. The impact was analyzed by assessing proliferation, migration, invasion, angiogenesis, and tumor-associated genes and proteins. Results of these assays were compared between co-culture and mono-culture conditions.

Results

Our experimental results showed that ADSCs were able to promote proliferation, migration, invasion, and angiogenesis of DFSP cells; this was accompanied by a significant increase in the expression levels of beta-type platelet-derived growth factor receptor, collagen type I alpha 1 chain, vascular endothelial growth factor, hepatocyte growth factor, and basic fibroblast growth factor.

Conclusions

The current report clearly demonstrates that ADSCs can enhance different malignant properties of DFSP cells in vitro, which should not be neglected when considering the clinical use of human ADSCs and its related derivatives in skin regenerative therapies.
Clinical and imaging outcomes after intrathecal injection of umbilical cord tissue mesenchymal stem cells in cerebral palsy: a randomized double-blind sham-controlled clinical trial
Authors: Amanat Man , Majmaa Anahita , Zarrabi Morteza , Nouri Masoumeh , Akbari Masood Ghahvechi , Moaiedi Ali Reza , Ghaemi Omid , Zamani Fatemeh , Najafi Sharif , Badv Reza Shervin , Vosough Massoud , Hamidieh Amir Ali , Salehi Mona , Montazerlotfelahi Hadi , Tavasoli Ali Reza , Heidari Morteza , Mohebi Hossein , Fatemi Ali , Garakani Amir , Ashrafi Mahmoud Reza
Published: August 2021

Background

This study assessed the safety and efficacy of intrathecal injection of umbilical cord tissue mesenchymal stem cells (UCT-MSC) in individuals with cerebral palsy (CP). The diffusion tensor imaging (DTI) was performed to evaluate the alterations in white-matter integrity.

Methods

Participants (4–14 years old) with spastic CP were assigned in 1:1 ratio to receive either UCT-MSC or sham procedure. Single-dose (2 × 107) cells were administered in the experimental group. Small needle pricks to the lower back were performed in the sham-control arm. All individuals were sedated to prevent awareness. The primary endpoints were the mean changes in gross motor function measure (GMFM)-66 from baseline to 12 months after procedures. The mean changes in the modified Ashworth scale (MAS), pediatric evaluation of disability inventory (PEDI), and CP quality of life (CP-QoL) were also assessed. Secondary endpoints were the mean changes in fractional anisotropy (FA) and mean diffusivity (MD) of corticospinal tract (CST) and posterior thalamic radiation (PTR).

Results

There were 36 participants in each group. The mean GMFM-66 scores after 12 months of intervention were significantly higher in the UCT-MSC group compared to baseline (10.65; 95%CI 5.39, 15.91) and control (β 8.07; 95%CI 1.62, 14.52; Cohen’s d 0.92). The increase was also seen in total PEDI scores (vs baseline 8.53; 95%CI 4.98, 12.08; vs control: β 6.87; 95%CI 1.52, 12.21; Cohen’s d 0.70). The mean change in MAS scores after 12 months of cell injection reduced compared to baseline (−1.0; 95%CI −1.31, −0.69) and control (β −0.72; 95%CI −1.18, −0.26; Cohen’s d 0.76). Regarding CP-QoL, mean changes in domains including friends and family, participation in activities, and communication were higher than the control group with a large effect size. The DTI analysis in the experimental group showed that mean FA increased (CST 0.032; 95%CI 0.02, 0.03. PTR 0.024; 95%CI 0.020, 0.028) and MD decreased (CST −0.035 × 10-3; 95%CI −0.04 × 10-3, −0.02 × 10-3. PTR −0.045 × 10-3; 95%CI −0.05 × 10-3, −0.03 × 10-3); compared to baseline. The mean changes were significantly higher than the control group.

Conclusions

The UCT-MSC transplantation was safe and may improve the clinical and imaging outcomes.

Trial registration

The study was registered with ClinicalTrials.gov (NCT03795974).
Biomimetic nerve guidance conduit containing engineered exosomes of adipose-derived stem cells promotes peripheral nerve regeneration
Authors: Yang Zheng , Yang Yang , Xu Yichi , Jiang Weiqian , Shao Yan , Xing Jiahua , Chen Youbai , Han Yan
Published: August 2021

Background

Efficient and stable delivery of neurotrophic factors (NTFs) is crucial to provide suitable microenvironment for peripheral nerve regeneration. Neurotrophin-3 (NT-3) is an important NTF during peripheral nerve regeneration which is scarce in the first few weeks of nerve defect. Exosomes are nanovesicles and have been served as promising candidate for biocarrier. In this work, NT-3 mRNA was encapsulated in adipose-derived stem cell (ADSC)-derived exosomes (ExoNT-3). These engineered exosomes were applied as NT-3 mRNA carrier and then were loaded in nerve guidance conduit (ExoNT-3-NGC) to bridge rat sciatic nerve defect.

Method

NT-3 mRNA was encapsulated in exosomes by forcedly expression of NT-3 mRNA in the donor ADSCs. ExoNT-3 were co-cultured with SCs in vitro; after 24 h of culture, the efficiency of NT-3 mRNA delivery was evaluated by qPCR, western blotting and ELISA. Then, ExoNT-3 were loaded in alginate hydrogel to construct the nerve guidance conduits (ExoNT-3-NGC). ExoNT-3-NGC were implanted in vivo to reconstruct 10 mm rat sciatic nerve defect. The expression of NT-3 was measured 2 weeks after the implantation operation. The sciatic nerve functional index (SFI) was examined at 2 and 8 weeks after the operation. Moreover, the therapeutic effect of ExoNT-3-NGC was also evaluated by morphology assay, immunofluorescence staining of regenerated nerves, function evaluation of gastrocnemius muscles after 8 weeks of implantation.

Results

The engineered exosomes could deliver NT-3 mRNA to the recipient cells efficiently and translated into functional protein. The constructed NGC could realize stable release of exosomes at least for 2 weeks. After NGC implantation in vivo, ExoNT-3-NGC group significantly promote nerve regeneration and improve the function recovery of gastrocnemius muscles compared with control exosomes (Exoempty-NGC) group.

Conclusion

In this work, NGC was constructed to allow exosome-mediated NT-3 mRNA delivery. After ExoNT-3-NGC implantation in vivo, the level of NT-3 could restore which enhance the nerve regeneration. Our study provide a potential approach to improve nerve regeneration.
Influence mechanism of running sportswear fatigue based on BP neural network
Authors: Liu Xiaoli , Li Zhibin
Published: August 2021

The fatigue of running sportswear is reflected in the fatigue caused by the tightness of the tights on the skin surface of the limbs, trunk, and other parts during long-term running sports. However, the current research on the fatigue of running sportswear is not deep enough. Therefore, the purpose of this study is to study the mechanism of the fatigue of running sportswear based on BP neural network. This article first takes sportswear as the starting point and uses the surface myoelectricity index as a physiological quantity as a means to combine clothing with sports medicine and sports physiology, breaking the traditional shackles of subjective assessment of fatigue, and giving play to the advantages of interdisciplinary to expand the new direction of the apparel industry and, secondly, use muscle fatigue evaluation method to analyze the muscles of the lower leg under the pressure of sportswear to analyze the strength of the EMG signal and the number of participating sports units and the frequency of discharge synchronization. Experimental data shows that the AUC is 0.756 when wearing sports tights, the sensitivity and specificity are 72% and 19%, and the accuracy is 65%. The experimental results show that clothing pressure affects the fatigue of running sportswear based on BP neural network.
Retention in opioid agonist treatment: a rapid review and meta-analysis comparing observational studies and randomized controlled trials
Authors: Klimas Jan , Hamilton Michee-Ana , Gorfinkel Lauren , Adam Ahmed , Cullen Walter , Wood Evan
Published: August 2021

Background

Although oral opioid agonist therapies (OATs), buprenorphine and methadone, are effective first-line treatments, OAT remains largely underutilized due to low retention rates and wide variation across programs. This rapid review therefore sought to summarize the retention rates reported by randomized controlled trials (RCTs) and controlled observational study designs that compared methadone to buprenorphine (or buprenorphine-naloxone).

Methods

We searched four electronic databases (EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, up to April 2018) for RCTs and controlled observational studies that compared oral fixed-dose methadone to buprenorphine versus methadone (or buprenorphine-naloxone). Data were extracted separately for two different definitions of retention in treatment: (1) length of time retained in the study and (2) presence on the final day of a study. Separate random effects meta-analyses were performed for RCTs and controlled observational studies. Data from controlled observational studies where retention was measured as the length of time retained in the study were not amenable to meta-analysis.

Results

Among 7603 studies reviewed, 10 RCTs and 3 observational studies met inclusion criteria (n = 5065) and compared fixed-dose oral buprenorphine with methadone. Across studies, the average retention rate was highly variable (RCTs: buprenorphine 20.0–82.5% and methadone 30.7–83.8%; observational studies: buprenorphine 20.2–78.3% and methadone 48.3–74.8%). For time period retained in the study, we observed no significant difference in treatment retention for buprenorphine versus methadone in RCTs (standardized mean difference [SMD] =  − 0.07; 95% CI − 0.35–0.21, p = 0.63; quality of evidence: low). For presence on the final study day, we observed no significant difference between buprenorphine and methadone treatment retention in RCTs (risk ratio [RR] = 0.89; 95% CI 0.73–1.08, p = 0.24; quality of evidence: low) and controlled observational studies (RR = 0.75; 95% CI 0.36–1.58, p = 0.45).

Conclusion

Meta-analysis of existing RCTs suggests retention in oral fixed-dose opioid agonist therapy with methadone appears to be generally equal to buprenorphine (or buprenorphine-naloxone), with wide variation across studies. Similarly, a meta-analysis of three controlled observational studies indicated no difference in treatment retention although there was significant heterogeneity among the included studies. The length of follow-up did not appear to affect the retention rate.

Systematic review registration

PROSPERO CRD42018104452.
Correlation between antibiotic consumption and the incidence of healthcare facility-onset Clostridioides difficile infection: a retrospective chart review and analysis
Authors: Yun Ji Hyun , Park Ga Eun , Ki Hyun Kyun
Published: August 2021

Background

Healthcare facility-onset Clostridioides difficile infection is the leading cause of antibiotic-associated diarrhea, and is associated with morbidity and mortality. The use of antibiotics is an important risk factor for healthcare facility-onset C. difficile infection. We evaluated the correlation between the incidence of healthcare facility-onset C. difficile infection and antibiotic consumption, according to antibiotic class.

Methods

Patients with healthcare facility-onset C. difficile infection from January 2017 to December 2018 at Konkuk University Medical Center (a tertiary medical center) were included. We evaluated changes in the incidence of healthcare facility-onset C. difficile infection and antibiotic consumption. The correlation between the incidence of healthcare facility-onset C. difficile infection and antibiotic consumption was evaluated two ways: without a time interval and with 1-month interval matching.

Results

A total of 446 episodes of healthcare facility-onset C. difficile infection occurred during the study period. The incidence of healthcare facility-onset C. difficile infection was 9.3 episodes per 10,000 patient-days, and increased significantly. We observed an increase in the consumption of β-lactam/β-lactamase inhibitors, and a decrease in the consumption of other classes of antibiotics, with a significant decrease in the consumption of fluoroquinolones, glycopeptides, and clindamycin (P = 0.01, P < 0.001, and P = 0.001, respectively). The consumption of β-lactam/β-lactamase inhibitors was independently correlated with the incidence of healthcare facility-onset C. difficile infection in the analysis without a time interval. When the analysis was conducted with 1-month interval matching, glycopeptide consumption was independently associated with the incidence of healthcare facility-onset C. difficile infection.

Conclusions

Despite the reduction in fluoroquinolone and clindamycin consumption, the incidence of healthcare facility-onset C. difficile infection increased during the study period, and was correlated with increased consumption of β-lactam/β-lactamase inhibitors. Reduced consumption of specific antibiotics may be insufficient to reduce the incidence of healthcare facility-onset C. difficile infection.
Arterial spin labeling for presurgical localization of refractory frontal lobe epilepsy in children
Authors: Zhang Jia , Zhang Heng , Li Yang , Yuan Meng , Zhang Jinxiu , Luo Huan , Yao Zeshan , Gan Jing
Published: August 2021

Background

Epilepsy is one of the most common chronic neurological diseases. Despite the great variety and prevalence of antiepileptic drug treatments, one-third of epilepsies remain drug resistant. The frontal lobe is extensive, and frontal lobe seizures are difficult to locate, which increases the difficulty of the preoperative localization of the epileptogenic zone.

Case presentation

Two previously healthy girls with refractory frontal lobe epilepsy showed significant perfusion abnormalities in the right frontal lobe using the cerebral blood perfusion (CBF) quantitative analysis system. They became seizure-free after lesionectomy of the frontal lobe by ASL combined with electroencephalography (EEG) rapid localization. The histopathological diagnosis was focal cortical dysplasia (FCD) type IIa and IIb.

Conclusions

The positive outcome suggests that the combined use of ASL with EEG could be a beneficial option for the presurgical evaluation of pediatric epilepsy.
A note on the multiplicative fairness score in the NIJ recidivism forecasting challenge
Authors: Mohler George , Porter Michael D.
Published: August 2021

Background

The 2021 NIJ recidivism forecasting challenge asks participants to construct predictive models of recidivism while balancing false positive rates across groups of Black and white individuals through a multiplicative fairness score. We investigate the performance of several models for forecasting 1-year recidivism and optimizing the NIJ multiplicative fairness metric.

Methods

We consider standard linear and logistic regression, a penalized regression that optimizes a convex surrogate loss (that we show has an analytical solution), two post-processing techniques, linear regression with re-balanced data, a black-box general purpose optimizer applied directly to the NIJ metric and a gradient boosting machine learning approach.

Results

For the set of models investigated, we find that a simple heuristic of truncating scores at the decision threshold (thus predicting no recidivism across the data) yields as good or better NIJ fairness scores on held out data compared to other, more sophisticated approaches. We also find that when the cutoff is further away from the base rate of recidivism, as is the case in the competition where the base rate is 0.29 and the cutoff is 0.5, then simply optimizing the mean square error gives nearly optimal NIJ fairness metric solutions.

Conclusions

The multiplicative metric in the 2021 NIJ recidivism forecasting competition encourages solutions that simply optimize MSE and/or use truncation, therefore yielding trivial solutions that forecast no one will recidivate.
DSM-5 personality trait facets amongst child molesters: an exploratory comparison with other types of offenders
Authors: Ferretti Fabio , Carabellese Felice , Catanesi Roberto , Coluccia Anna , Ferracuti Stefano , Schimmenti Adriano , Caretti Vincenzo , Lorenzi Lore , Gualtieri Giacomo , Carabellese Fulvio , Pozza Andrea
Published: August 2021

Background

DSM-5 provided a dimensional model of personality disorders which may be more clinically informative for the assessment and management of prisoners than a categorical one, as diagnoses of personality disorders alone cannot explain the type of violence. The role of DSM-5 personality facets is however understudied in child molesters, and no study compared these clinical features between individuals who have committed sex crime against children and those who have committed other types of crime. The present study compared DSM-5 personality trait facets between prisoners who had committed sex crime against children, prisoners who had committed property crime (i.e., robbery, fraud) and those who had committed crime against the person (i.e., homicide, assault or violence not implying a sexual element). A further aim was to explore which facets were associated with sex crime against children as compared with the other types of crime, controlling for socio-demographics (age, gender), psychiatric comorbidity (presence of any psychiatric diagnoses) and general psychopathy traits.

Methods

One hundred sixty-seven prisoners participated (91 had committed sex crime against children, 25 property crime, and 51 committed a crime against the person) and completed the Personality Inventory for the DSM-5 and the Psychopathy Checklist-Revised.

Results

Prisoners who had committed sex crime against children reported higher Restricted Affectivity traits than those who had committed property crime and crime against the person and higher Irresponsibility traits than those who had committed property crime. The results of a multinomial logistic regression analysis showed that on the one hand being a man, having a higher age, and the presence of a psychiatric comorbidity were more likely to be related to sex crime than property crime, on the other hand higher Irresponsibility personality traits, being a man, and the presence of a psychiatric comorbidity were more likely to be related to sex crime against children than crime against the person.

Conclusions

The Irresponsibility facet might be specific to child molesters and can differentiate this group from offenders who have committed other crime types. This facet might be considered a key target of a tailored assessment and treatment planning during clinical practice with child molesters.