bluuebunny/crossref_metadata_2025 huggingface dataset:
Does ovarian cystectomy pose a risk to ovarian reserve and fertility?
Authors: Balachandren Neerujah , Yasmin Ephia , Mavrelos Dimitrios , Saridogan Ertan
Published: October 2020

Key content

The impact of benign ovarian cysts on a woman’s fertility is dependent on the nature, size, number, bilaterality and risk of recurrence of the cyst(s).

Children and adolescents presenting with pathological ovarian cysts require a multidisciplinary team approach and, where possible, fertility sparing treatment should be offered.

Laparoscopic detorsion has the potential to preserve ovarian reserve and should remain the optimal treatment for ovarian torsion in girls and premenopausal women.

Surgery for bilateral endometriomas has been shown to increase the risk of developing premature ovarian insufficiency.

It is important to consider performing ovarian reserve assessments before any ovarian surgery in women who have not completed their family.

Learning objectives

To understand what factors need to be considered before making a decision to perform an ovarian cystectomy.

To be aware of different surgical techniques and their impact on fertility outcomes.

To take anatomical considerations into account to minimise damage to healthy ovarian tissue.

Ethical issues

The UK’s National Health Service does not routinely fund oocyte freezing for benign conditions.
Single‐parent expression drives dynamic gene expression complementation in maize hybrids
Authors: Li Zhi , Zhou Peng , Della Coletta Rafael , Zhang Tifu , Brohammer Alex B. , H. O’Connor Christine , Vaillancourt Brieanne , Lipzen Anna , Daum Chris , Barry Kerrie , de Leon Natalia , Hirsch Cory D. , Buell C. Robin , Kaeppler Shawn M. , Springer Nathan M. , Hirsch Candice N.
Published: October 2020

Single‐parent expression (SPE) is defined as gene expression in only one of the two parents. SPE can arise from differential expression between parental alleles, termed non‐presence/absence (non‐PAV) SPE, or from the physical absence of a gene in one parent, termed PAV SPE. We used transcriptome data of diverse Zea mays (maize) inbreds and hybrids, including 401 samples from five different tissues, to test for differences between these types of SPE genes. Although commonly observed, SPE is highly genotype and tissue specific. A positive correlation was observed between the genetic distance of the two inbred parents and the number of SPE genes identified. Regulatory analysis showed that PAV SPE and non‐PAV SPE genes are mainly regulated by cis effects, with a small fraction under trans regulation. Polymorphic transposable element insertions in promoter sequences contributed to the high level of cis regulation for PAV SPE and non‐PAV SPE genes. PAV SPE genes were more frequently expressed in hybrids than non‐PAV SPE genes. The expression of parentally silent alleles in hybrids of non‐PAV SPE genes was relatively rare but occurred in most hybrids. Non‐PAV SPE genes with expression of the silent allele in hybrids are more likely to exhibit above high parent expression level than hybrids that do not express the silent allele, leading to non‐additive expression. This study provides a comprehensive understanding of the nature of non‐PAV SPE and PAV SPE genes and their roles in gene expression complementation in maize hybrids.
A restorer‐of‐fertility‐like pentatricopeptide repeat protein promotes cytoplasmic male sterility in Arabidopsis thaliana
Authors: Durand Stéphanie , Ricou Anthony , Simon Matthieu , Dehaene Noémie , Budar Françoise , Camilleri Christine
Published: October 2020

Pentatricopeptide repeat (PPR) proteins form a large family of proteins targeted to organelles, where they post‐transcriptionally modulate gene expression through binding to specific RNA sequences. Among them, the mitochondria‐targeted restorer‐of‐fertility (Rf) PPRs inhibit peculiar mitochondrial genes that are detrimental to male gametes and cause cytoplasmic male sterility (CMS). Here, we revealed three nuclear loci involved in CMS in a cross between two distant Arabidopsis thaliana strains, Sha and Cvi‐0. We identified the causal gene at one of these loci as RFL24, a conserved gene encoding a PPR protein related to known Rf PPRs. By analysing fertile revertants obtained in a male sterile background, we demonstrate that RFL24 promotes pollen abortion, in contrast with the previously described Rf PPRs, which allow pollen to survive in the presence of a sterilizing cytoplasm. We show that the sterility caused by the RFL24 Cvi‐0 allele results from higher expression of the gene during early pollen development. Finally, we predict a binding site for RFL24 upstream of two mitochondrial genes, the CMS gene and the important gene cob. These results suggest that the conservation of RFL24 is linked to a primary role of ensuring a proper functioning of mitochondria, and that it was subsequently diverted by the CMS gene to its benefit.
Assembling the Healthopolis: Competitive city‐regionalism and policy boosterism pushing Greater Manchester further, faster
Authors: Lorne Colin , Coleman Anna , McDonald Ruth , Walshe Kieran
Published: October 2020

Health and care policy is increasingly promoted within competitive city‐region visions. Based on a two‐year study of health and social care devolution in Greater Manchester, England, we demonstrate how the “local problem” of governing health and care amid austerity politics was rearticulated as a “global opportunity” to forge new connections between place, health, and economy. The paper foregrounds the multiple tensions and contradictions accumulating through turning to health and care to push the city‐region further, faster.
Estimating the incidence of HIV infection in repeat blood donors with low average donation frequency
Authors: Brambilla Donald J. , Busch Michael P. , Glynn Simone A. , Kleinman Steven H. ,   for the NHLBI Recipient Epidemiology and Donor Evaluation Study‐III (REDS‐III)
Published: October 2020

Background

The standard approach to estimating HIV incidence in repeat blood donors includes only donors who made two or more donations in an estimation interval. In China and some other countries, large proportions of repeat donors donate only once in a 1‐ or 2‐year interval. The standard approach may not represent risk among all repeat donors in these areas. Two approaches to including all repeat donors in the incidence estimate were evaluated in a simulation study.

Study Design and Methods

Under one approach, a donor infected at the first donation contributes a partial case to incidence that equals the proportion of time since the preceding donation that is in the estimation interval. Under the other, that donor contributes a full case if at least half the time since the previous donation is in the estimation interval and nothing otherwise. Infections identified at the second or subsequent donations in the interval contribute full cases as usual. The simulations involved proportions with single donations of 11% to 65% combined with a variety of patterns of rising, falling, or constant incidence.

Results

The partial‐case approach was unbiased under more test conditions than the whole‐case approach and exhibited smaller bias when both were biased. Under both approaches, bias >10% occurred only when rates of single donations >50% were combined with large changes in incidence over time.

Conclusion

The partial‐case approach performed better than the whole‐case approach. The conditions producing bias >10% are so extreme that they are unlikely to be encountered in the field.
Changes in Psychosocial Perspectives Among Physical Activity Leaders: Teacher Efficacy, Work Engagement, and Affective Commitment
Authors: Kuhn Ann Pulling , Carson Russell L. , Beighle Aaron , Castelli Darla M.
Published: October 2020

Purpose: This study examined changes in physical education teachers’ psychosocial perspectives after participating in a yearlong professional development about Comprehensive School Physical Activity Programming.Method: Twenty-three intervention teachers attended a workshop in Year 1 and received one academic year of technical assistance and mentorship, and 30 control teachers only attended a workshop in Year 2. Both groups completed pre- and post-self-reported measures on teacher efficacy, work engagement, and affective commitment.Results: At posttest, intervention teachers reported significantly higher levels of affective commitment, and a significant positive relationship was revealed between affective commitment and the degree to which before-school physical activity was implemented. More experienced teachers (>20 years) reported significantly higher levels of the work engagement subscale of vigor at posttest.Discussion/Conclusion: Participating in a Comprehensive School Physical Activity Program professional development may positively influence teachers’ job commitment levels and invigorate more experienced teachers, which may relate to Comprehensive School Physical Activity Program implementation.
The Highs and the Lows—Exploring the Nature of Optimally Impactful Development Experiences on the Talent Pathway
Authors: Taylor Jamie , Collins Dave
Published: October 2020

There appears to be general agreement that interaction with significant challenge should be a central feature of the development pathways for future high performers. There is, however, far less clarity about how such programs should be designed and delivered against core psychological principles. Accordingly, the purpose of this paper is to offer guidelines for talent development practitioners seeking to offer athletes the opportunity to maximize their growth and development. The authors propose that genuinely developmental experiences will likely offer a level of emotional disturbance and, as a result, more fully engage performers, prompting self and other facilitated reflection, and motivate future action. Furthermore, there is a necessity for these experiences and their follow-up, to be managed in a coherent manner and integrated with existing skills, experience, and future performance aims. In highlighting these issues, the authors offer recommendations for talent development coaches, managers, psychologists, and parents of athletes.
Ocular motility disturbances after glaucoma drainage device implantation for paediatric glaucoma: a cross-sectional study
Authors: Leahy Kate Elspeth , MacNeill Katelyn , Locke Jeff , Sobey Stephanie , Kraft Stephen P , Ali Asim
Published: October 2020

Aim

To grade extraocular motility in the field of action of each extraocular muscle following superotemporal glaucoma drainage device (GDD) implantation in a paediatric population and to investigate which drainage device (Ahmed vs Baerveldt) yields less extraocular motility disturbance.

Methods

Cross-sectional study of children with a GDD implanted consecutively by a single surgeon who underwent ocular motility examination by two masked orthoptists. Ductions in the cardinal positions were graded. Ocular alignment, visual acuity, binocularity, stereopsis and intraocular pressure were also measured, and patient charts were reviewed.

Results

Thirty children each had one eye included. Twenty-one eyes had an Ahmed GDD and 9 had a Baerveldt GDD. Mean time between GDD insertion and ocular motility exam was 68 months in the Ahmed group and 19 months in the Baerveldt group. Exotropia was present in 46% and vertical heterotropia in 46% of children post-GDD insertion. Thirty-three percent of eyes had a moderate or severe limitation of elevation in abduction, 30% of elevation in adduction, 10% of abduction and 10% of adduction. There was a trend towards more eyes in the Ahmed group (62%) having at least a moderate limitation in ocular motility (−2 or worse; scale −1 to −4) compared with the Baerveldt group (22%).

Conclusion

Strabismus is common in children with GDDs. Our motility and alignment findings are consistent with either a mass effect of the device and bleb and/or scarring beneath the plate in the quadrant of the GDD causing dysmotility, most commonly limitation towards the GDD.
Effect of periodontal treatment on diabetes-related healthcare costs: a retrospective study
Authors: Smits Kirsten P J , Listl Stefan , Plachokova Adelina S , Van der Galien Onno , Kalmus Olivier
Published: October 2020

Introduction

Periodontitis has been considered a sixth complication of diabetes. The aim of this study was to assess the impact of periodontal treatment on diabetes-related healthcare costs in patients with diabetes.

Research design and methods

A retrospective analysis was done, exploiting unique and large-scale claims data of a Dutch health insurance company. Data were extracted for a cohort of adults who had been continuously insured with additional dental coverage for the years 2012–2018. Individuals with at least one diabetes-related treatment claim in 2012 were included for analysis. A series of panel data regression models with patient-level fixed effects were estimated to assess the impact of periodontal treatment on diabetes-related healthcare costs.

Results

A total of 41 598 individuals with diabetes (age range 18–100 years; 45.7% female) were included in the final analyses. The median diabetes-related healthcare costs per patient in 2012 were €38.45 per quarter (IQR €11.52–€263.14), including diagnoses, treatment, medication and hospitalization costs. The fixed effect models showed €12.03 (95% CI −€15.77 to −€8.29) lower diabetes-related healthcare costs per quarter of a year following periodontal treatment compared with no periodontal treatment.

Conclusions

Periodontitis, a possible complication of diabetes, should receive appropriate attention in diabetes management. The findings of this study provide corroborative evidence for reduced economic burdens due to periodontal treatment in patients with diabetes.
Dietary intake of adults with and without diabetes: results from NHANES 2013–2016
Authors: McClure Scott T , Schlechter Haley , Oh Susan , White Karen , Wu Beiwen , Pilla Scott Jordan , Maruthur Nisa M , Yeh Hsin-Chieh , Miller Edgar R , Appel Lawrence J
Published: October 2020

Introduction

Diet is a critical aspect of the management of adults with diabetes. This paper aims to compare dietary intakes of key macronutrients and micronutrients of US adults with and without diabetes and across the spectrum of diabetes.

Research design and methods

We compared absolute and energy-adjusted dietary intake of major macronutrients and micronutrients among those with and without diabetes and across the spectrum of glycemic control using a 24-hour dietary recall from a cross-sectional, nationally representative sample of 9939 US adults, 20+ years old (National Health and Nutrition Examination Survey 2013–2016). Diabetes was defined as an glycohemoglobin A1c (HbA1c)≥6.5%, fasting glucose ≥126 mg/dL, serum glucose at 2 hours following a 75 g glucose load (oral glucose tolerance test) ≥200 mg/dL, any diagnosis of diabetes or use of diabetes medication (self-reported).

Results

Percent of calories from macronutrients was similar for those with and without diabetes (p>0.05, energy adjusted and adjusted for age, race, and sex). In both groups, sugar accounted for about 20% of calories. Those with diabetes consumed about 7% more calcium (p=0.033), about 5% more sodium (p=0.026), and had lower diet quality (Healthy Eating Index-2015, p=0.021) than those without diabetes. Among those with diabetes, those with an HbA1c>9.0% consumed about 4% less magnesium (p-analysis of variance=0.007) than those with an HbA1c<6.5%. Results were similar within strata of age, race, and sex. Macronutrient intake did not vary consistently by HbA1c level.

Conclusions

In this nationally representative sample, there were no substantial or consistent differences in the dietary intake of macronutrients or micronutrients between US adults with and without diabetes. Improving the diets of those with diabetes will likely require enhanced targeted efforts to improve the dietary intake of persons with diabetes, as well as broad efforts to improve the dietary intake of the general population.
Implementation of national antenatal hypertension guidelines: a multicentre multiple methods study
Authors: Whybrow Rebecca , Webster Louise , Girling Joanna , Brown Heather , Wilson Hannah , Sandall Jane , Chappell Lucy
Published: October 2020

Objective

To evaluate the implementation of National Institute for Health and Care Excellence antenatal hypertension guidelines, to identify strategies to reduce incidences of severe hypertension and associated maternal and perinatal morbidity and mortality in pregnant women with chronic hypertension.

Methods

We used a multiple method multisite approach to establish implementation of guidelines and the associated barriers and facilitators. We used a national survey of healthcare professionals (n=97), case notes review (n=55) and structured observations (n=42) to assess implementation. The barriers and facilitators to implementation were identified from semistructured qualitative interviews with healthcare professionals (n=13) and pregnant women (n=18) using inductive thematic analysis. The findings were integrated and evaluated using the Consolidated Framework for Implementation Research.

Setting and participants

Pregnant women with chronic hypertension and their principal carers (obstetricians, midwives and physicians), at three National Health Service hospital trusts with different models of care.

Results

We found severe hypertension to be prevalent (46% of case notes reviewed) and target blood pressure practices to be suboptimal (56% of women had an antenatal blood pressure target documented). Women were infrequently given information (52%) or offered choice (19%) regarding antihypertensives. Women (14/18) reported internal conflict in taking antihypertensives and non-adherence was prevalent (8/18). Women who were concordant with treatment recommendations described having mutual trust with professionals mediated through appropriate information, side effect management and involvement in decision making. Professionals reported needing updates and tools for target blood pressure setting and shared decision making underpinned by antihypertensive safety and effectiveness research.

Conclusions

Women’s non-adherence to antihypertensives is higher than anticipated. Suboptimal information provision around treatment, choice of antihypertensives and target setting practices by healthcare professionals may be contributory. Understanding the reasons for non-adherence will inform education and decision-making strategies needed to address both clinician and women’s behaviour. Further research into the effectiveness and long-term safety of common antihypertensives is also required.
Cross-classified Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) to evaluate hospital performance: the case of hospital differences in patient survival after acute myocardial infarction
Authors: Rodriguez-Lopez Merida , Merlo Juan , Perez-Vicente Raquel , Austin Peter , Leckie George
Published: October 2020

Objective

To describe a novel strategy, Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) to evaluate hospital performance, by analysing differences in 30-day mortality after a first-ever acute myocardial infarction (AMI) in Sweden.

Design

Cross-classified study.

Setting

68 Swedish hospitals.

Participants

43 247 patients admitted between 2007 and 2009, with a first-ever AMI.

Primary and secondary outcome measures

We evaluate hospital performance by analysing differences in 30-day mortality after a first-ever AMI using a cross-classified multilevel analysis. We classified the patients into 10 categories according to a risk score (RS) for 30-day mortality and created 680 strata defined by combining hospital and RS categories.

Results

In the cross-classified multilevel analysis the overall RS adjusted hospital 30-day mortality in Sweden was 4.78% and the between-hospital variation was very small (variance partition coefficient (VPC)=0.70%, area under the curve (AUC)=0.54). The benchmark value was therefore achieved by all hospitals. However, as expected, there were large differences between the RS categories (VPC=34.13%, AUC=0.77)

Conclusions

MAIHDA is a useful tool to evaluate hospital performance. The benefit of this novel approach to adjusting for patient RS is that it allowed one to estimate separate VPCs and AUC statistics to simultaneously evaluate the influence of RS categories and hospital differences on mortality. At the time of our analysis, all hospitals in Sweden were performing homogeneously well. That is, the benchmark target for 30-day mortality was fully achieved and there were not relevant hospital differences. Therefore, possible quality interventions should be universal and oriented to maintain the high hospital quality of care.
National survey to estimate sodium and potassium intake and knowledge attitudes and behaviours towards salt consumption of adults in the Sultanate of Oman
Authors: Al-Mawali Adhra , D'Elia Lanfranco , Jayapal Sathish Kumar , Morsi Magdi , Al-Shekaili Waleed Nasser , Pinto Avinash D , Al-Kharusi Hilal , Al-Balushi Zainab , Idikula John , Al-Harrasi Ayaman , Cappuccio Francesco P
Published: October 2020

Objectives

To estimate population sodium and potassium intakes and explore knowledge, attitudes and behaviour (KAB) towards the use of salt in adults in the Sultanate of Oman.

Design

National cross-sectional population-based survey.

Setting

Proportional random samples, representative of Omani adults (18 years or older), were obtained from all governorates of the Sultanate of Oman.

Participants

Five hundred and sixty-nine (193 men, 376 women; 18 years or older) were included in the analysis (response rate 57%). Mean age was 39.4 years (SD 13.1). Participants attended a screening including demographic, anthropometric and physical measurements.

Primary and secondary outcome measures

We assessed dietary sodium, potassium and creatinine by 24-hour urinary sodium (UNa), potassium (UK) and creatinine (UCr) excretions. We collected KAB by a questionnaire on an electronic tablet.

Results

Mean UNa was 144.3 (78.8) mmol/day, equivalent to 9.0 g of salt/day and potassium excretion 52.6 (32.6) mmol/day, equivalent to 2.36 g/day, after adjusting for non-urinary losses. Men ate significantly more sodium and potassium than women. Only 22% of the sample had a salt intake below the WHO recommended target of 5 g/day and less than 10% met WHO targets for potassium excretion (>90 mmol/day). While 89.1% of those interviewed knew that consuming too much salt could cause serious health problems and only 6.9% felt they were using too much added salt, one in two participants used always or often salt, salty seasonings or salty sauces in cooking or when preparing food at home.

Conclusions

In the Sultanate of Oman, salt consumption is higher and potassium consumption lower than recommended by WHO, both in men and in women. The present data provide, for the first time, evidence to support a national programme of population salt reduction to prevent the increasing burden of cardiovascular disease in the area.
Provision of essential evidence-based interventions during facility-based childbirth: cross-sectional observations of births in northeast Nigeria
Authors: Exley Josephine , Hanson Claudia , Umar Nasir , Willey Barbara , Shuaibu Abdulrahman , Marchant Tanya
Published: October 2020

Objectives

To measure the provision of evidence-based preventive and promotive interventions to women, and subsequently their newborns, during childbirth in a high-mortality setting.

Design and participants

Cross-sectional observations of care provided to women, and their newborns during the intrapartum and immediate postpartum period using a standardised checklist capturing healthcare worker behaviours regarding lifesaving and respectful care.

Setting

Ten primary healthcare facilities in Gombe state, northeast Nigeria. The northeast region of Nigeria has some of the highest maternal and newborn death rates globally.

Main outcome measures

Data on 50 measures of internationally recommended evidence-based interventions and good practice.

Results

1875 women were admitted to a health facility during the observation period; of these, 1804 gave birth in the facility and did not experience an adverse event or death. Many clinical interventions around the time of birth were routinely implemented, including provision of uterotonic (96% (95% CI 93% to 98%)), whereas risk-assessment measures, such as history-taking or checking vital signs were rarely completed: just 2% (95% CI 2% to 7%) of women had their temperature taken and 12% (95% CI 9% to 16%) were asked about complications during the pregnancy.

Conclusions

The majority of women did not receive the recommended routine processes of childbirth care they and their newborns needed to benefit from their choice to deliver in a health facility. In particular, few benefited from even basic risk assessments, leading to missed opportunities to identify risks. To continue with the recommendation of childbirth care in primary healthcare facilities in high mortality settings like Gombe, it is crucial that birth attendant capacity, capability and prioritisation processes are addressed.
Using patient feedback to drive quality improvement in hospitals: a qualitative study
Authors: Berger Simone , Saut Ana Maria , Berssaneti Fernando Tobal
Published: October 2020

Objectives

Although different forms of patient feedback are available, their use in hospital management is still limited. The objective of this study is to explore how patient feedback is currently used in hospitals to improve quality.

Design

This is a qualitative exploratory multiple case study. Data collection included nine interviews, of an average duration of 50 min, conducted between March and June 2019. Additionally, a document and secondary data analysis were performed.

Setting

This study was conducted in three Brazilian hospitals selected for their solid patient feedback practises.

Participants

Managers from the customer service, quality, nursing, operations, projects and patient experience departments of the three hospitals.

Results

Despite literature suggesting that organisational objectives regarding patient feedback are not clear, data show that there is managerial concern regarding the promotion of an environment capable of changing according to patient feedback. In these instances, organisational processes were structured to focus on patients’ feedback and its receipt by the staff, including a non-punitive culture. Several patient feedback forms are available: voluntary events, patient surveys and informal feedback. Instruments to measure patient feedback focused on specific aspects of healthcare, to identify and clarify the problems for addressal by the management. The net promoter score was the main strategic indicator of patient feedback, used to assess the impact of improvement action.

Conclusions

The hospitals had established objectives that valued the patient’s perspective. Involvement of the health team, availability of different channels for feedback and the use of quality tools are considered a good basis for using patient feedback to drive quality improvement.
Prediction of type 2 diabetes risk in people with non-diabetic hyperglycaemia: model derivation and validation using UK primary care data
Authors: Coles Briana , Khunti Kamlesh , Booth Sarah , Zaccardi Francesco , Davies Melanie J , Gray Laura J
Published: October 2020

Objective

Using primary care data, develop and validate sex-specific prognostic models that estimate the 10-year risk of people with non-diabetic hyperglycaemia developing type 2 diabetes.

Design

Retrospective cohort study.

Setting

Primary care.

Participants

154 705 adult patients with non-diabetic hyperglycaemia.

Primary outcome

Development of type 2 diabetes.

Methods

This study used data routinely collected in UK primary care from general practices contributing to the Clinical Practice Research Datalink. Patients were split into development (n=109 077) and validation datasets (n=45 628). Potential predictor variables, including demographic and lifestyle factors, medical and family history, prescribed medications and clinical measures, were included in survival models following the imputation of missing data. Measures of calibration at 10 years and discrimination were determined using the validation dataset.

Results

In the development dataset, 9332 patients developed type 2 diabetes during 293 238 person-years of follow-up (31.8 (95% CI 31.2 to 32.5) per 1000 person-years). In the validation dataset, 3783 patients developed type 2 diabetes during 115 113 person-years of follow-up (32.9 (95% CI 31.8 to 33.9) per 1000 person-years). The final prognostic models comprised 14 and 16 predictor variables for males and females, respectively. Both models had good calibration and high levels of discrimination. The performance statistics for the male model were: Harrell’s C statistic of 0.700 in the development and 0.701 in the validation dataset, with a calibration slope of 0.974 (95% CI 0.905 to 1.042) in the validation dataset. For the female model, Harrell’s C statistics were 0.720 and 0.718, respectively, while the calibration slope was 0.994 (95% CI 0.931 to 1.057) in the validation dataset.

Conclusion

These models could be used in primary care to identify those with non-diabetic hyperglycaemia most at risk of developing type 2 diabetes for targeted referral to the National Health Service Diabetes Prevention Programme.
Regional differences in tobacco smoking and lung cancer in Portugal in 2018: a population-based analysis using nationwide incidence and mortality data
Authors: Forjaz Gonçalo , Bastos Joana , Castro Clara , Mayer Alexandra , Noone Anne-Michelle , Chen Huann-Sheng , Mariotto Angela B
Published: October 2020

Objectives

This study aims to estimate the proportion of lung cancer cases and deaths attributable to tobacco smoking in Portugal in 2018, complemented by trends in incidence and mortality, by sex and region.

Design

Cancer cases for 1998–2011 and cancer deaths for 1991–2018 were obtained from population-based registries and Statistics Portugal, respectively. We projected cases for 2018 and used reported deaths for the same year to estimate, using Peto’s method, the number and proportion of lung cancer cases and deaths caused by tobacco smoking in 2018. We calculated the age-adjusted incidence and mortality rates in each year of diagnosis and death. We fitted a joinpoint regression to the observed data to estimate the annual percentage change (APC) in the rates.

Setting

Portugal.

Results

In 2018, an estimated 3859 cases and 3192 deaths from lung cancer were attributable to tobacco smoking in Portugal, with men presenting a population attributable fraction (PAF) of 82.6% (n=3064) for incidence and 84.1% (n=2749) for mortality, while in women those values were 51.0% (n=795) and 42.7% (n=443), respectively. In both sexes and metrics, the Azores were the region with the highest PAF and the Centre with the lowest. During 1998–2011, the APC for incidence ranged from 0.6% to 3.0% in men and 3.6% to 7.9% in women, depending on region, with mortality presenting a similar pattern between sexes.

Conclusion

Exposure to tobacco smoking has accounted for most of the lung cancer cases and deaths estimated in Portugal in 2018. Differential patterns of tobacco consumption across the country, varying implementation of primary prevention programmes and differences in personal cancer awareness may have contributed to the disparities observed. Primary prevention of lung cancer remains a public health priority, particularly among women.
Study of Mothers’ and Infants’ Life Events Affecting Oral Health (SMILE) birth cohort study: cohort profile
Authors: Do Loc G , Ha Diep H , Bell Lucinda K , Devenish Gemma , Golley Rebecca K , Leary Sam D. , Manton David J. , Thomson W. Murray , Scott Jane A , Spencer A. John
Published: October 2020

Purpose

The long-term goal of the Study of Mothers’ and Infants’ Life Events Affecting Oral Health (SMILE) birth cohort study is to identify and evaluate the relative importance and timing of critical factors that shape the oral health of young children. It will then evaluate those factors in their inter-relationship with socioeconomic influences.

Participants

SMILE is a single-centre study conducted in Adelaide, Australia. All newborns at the main three public hospitals between July 2013 and August 2014 were eligible for inclusion. The final recruited sample at birth was 2181 mother/infant dyads. Participants were followed up with questionnaires when the child was 3 and 6 months of age, and 1, 2 and 5 years of age. Oral epidemiological examinations and anthropometric assessments were conducted at age 2 and 5 years.

Findings to date

SMILE has contributed comprehensive data on dietary patterns of young children. Intakes of free sugars, core and discretionary foods and drinks have been detailed. There was a sharp increase in free sugars intake with age. Determinants of dietary patterns, oral health status and body weight during the first 5 years of life have been evaluated. Socioeconomic characteristics such as maternal education and household income and area-level socioeconomic profile influenced dietary patterns and oral health behaviours and status.

Future plan

Funding has been obtained to conduct oral epidemiological examinations and anthropometric assessments at age 7–8 years. Plans are being developed to follow the cohort into adolescent years.
Decreasing referrals to transient ischaemic attack clinics during the COVID-19 outbreak: results from a multicentre cross-sectional survey
Authors: D'Anna Lucio , Sheikh Ambreen , Bathula Raj , Elmamoun Salwa , Oppong Adelaide , Singh Ravneeta , Redwood Rebecca , Janssen John , Banerjee Soma , Vasileiadis Evangelos
Published: October 2020

Objective

The COVID-19 pandemic is having major implications for stroke care with a documented significant fall in hospital acute stroke admissions. We investigated whether COVID-19 has resulted in a decreased number of referrals to the transient ischaemic attack (TIA) clinics across the North West London region.

Setting and design

All the TIA clinical leads of the North West London region received an invitation by email to participate in an online survey in May 2020. The survey questionnaire aimed to assess the number of patients with suspected TIA consecutively referred to each of the TIA clinics of the North West London region between 1 March and 30 April 2020, the COVID-19 period, and between 1 March and 30 April 2019.

Results

We had a response rate of 100%. During the COVID-19 period, the TIA clinics of the North West London region received 440 referrals compared with 616 referrals received between 1 March and 30 April 2019 with a fall in the number of the referrals by 28.6%. In April 2020 compared with April 2019, the number of the referrals declined by 40.1%.

Conclusions

This multicentre analysis documented a significant reduction in the number of patients referred with suspected TIA to the specialised rapid access outpatient clinics in the North West London region during the COVID-19 pandemic. Future studies are needed to confirm our findings and to better characterise the incidence of cerebrovascular disease during the COVID-19 pandemic.
Managing the return to sport of the elite footballer following semimembranosus reconstruction
Authors: Taberner Matt , Haddad Fares S , Dunn Andy , Newall Adam , Parker Lloyd , Betancur Esteban , Cohen Daniel D
Published: October 2020

Hamstring strains are the most common injury in elite football and typically occur during high-speed running. Despite its important contribution to power production in the late swing phase, injury to the semimembranosus (SM) is less common than to the biceps femoris, but may involve the free tendon and depending on the degree of retraction, warrant surgical repair. Few case reports detail clinical reasoning, supported by objective data during rehabilitation in elite footballers, and none have described the return to sport (RTS) process following this type of hamstring injury. In this article, we outline the management and RTS of an English Premier League (EPL) footballer who suffered a high-grade SM proximal tendon tear during training. Due to the degree of retraction of the free tendon, the player underwent surgical reconstruction at the recommendation of an orthopaedic surgeon. Early physiotherapy care, nutritional support, on- and off-pitch injury-specific reconditioning and global athletic development are outlined, alongside strength and power diagnostic and global positioning systems data, assessment of pain, player feedback and MRI informed clinical reasoning and shared decision-making during the RTS process. 18 weeks post-surgery the player returned to team training, transferring to a new club 3 weeks later. 2.5 years post RTS, the player remains free of re-injury playing regularly in the EPL.
An interface between the Powheg Box and MadGraph5_aMC@NLO
Authors: Nason Paolo , Oleari Carlo , Rocco Marco , Zaro Marco
Published: October 2020

In this paper we present a framework for developingPowheg Boxgenerators usingMadGraph5_aMC@NLOfor the computation of the matrix elements. Within this framework, all the flexibility ofMadGraph5_aMC@NLOfor the generation of matrix elements for Standard Model processes and for several of its extensions can be exploited, as well as all features of thePowheg Boxframework, including the possibility of multijet merging without a merging scale (using the so called MiNLO approach). As a proof of concept, we develop a generator for the production of a spin-0 Higgs-like boson in association with up to two jets, with CP-violating couplings.
Variation of Calderón–Zygmund operators with matrix weight
Authors: Duong Xuan Thinh , Li Ji , Yang Dongyong
Published: October 2020

Let [Formula: see text], [Formula: see text] and [Formula: see text] be a matrix [Formula: see text] weight. In this paper, we introduce a version of variation [Formula: see text] for matrix Calderón–Zygmund operators with modulus of continuity satisfying the Dini condition. We then obtain the [Formula: see text]-boundedness of [Formula: see text] with norm [Formula: see text] by first proving a sparse domination of the variation of the scalar Calderón–Zygmund operator, and then providing a convex body sparse domination of the variation of the matrix Calderón–Zygmund operator. The key step here is a weak type estimate of a local grand maximal truncated operator with respect to the scalar Calderón–Zygmund operator.
Algebraic links in lens spaces
Authors: Horvat Eva
Published: October 2020

The lens space [Formula: see text] is the orbit space of a [Formula: see text]-action on the 3-sphere. We investigate polynomials of two complex variables that are invariant under this action, and thus define links in [Formula: see text]. We study properties of these links, and their relationship with the classical algebraic links. We prove that all algebraic links in lens spaces are fibered, and obtain results about their Seifert genus. We find some examples of algebraic knots in [Formula: see text], whose lift in the [Formula: see text]-sphere is a torus link.
Machine Learning Based on a Multiparametric and Multiregional Radiomics Signature Predicts Radiotherapeutic Response in Patients with Glioblastoma
Authors: Pan Zi-Qi , Zhang Shu-Jun , Wang Xiang-Lian , Jiao Yu-Xin , Qiu Jian-Jian
Published: October 2020

Background and Objective. Although radiotherapy has become one of the main treatment methods for cancer, there is no noninvasive method to predict the radiotherapeutic response of individual glioblastoma (GBM) patients before surgery. The purpose of this study is to develop and validate a machine learning-based radiomics signature to predict the radiotherapeutic response of GBM patients. Methods. The MRI images, genetic data, and clinical data of 152 patients with GBM were analyzed. 122 patients from the TCIA dataset (training set:

n
=
82

; validation set:

n
=
40

) and 30 patients from local hospitals were used as an independent test dataset. Radiomics features were extracted from multiple regions of multiparameter MRI. Kaplan-Meier survival analysis was used to verify the ability of the imaging signature to predict the response of GBM patients to radiotherapy before an operation. Multivariate Cox regression including radiomics signature and preoperative clinical risk factors was used to further improve the ability to predict the overall survival (OS) of individual GBM patients, which was presented in the form of a nomogram. Results. The radiomics signature was built by eight selected features. The

C

-index of the radiomics signature in the TCIA and independent test cohorts was 0.703 (

P
<
0.001

) and 0.757 (

P
=
0.001

), respectively. Multivariate Cox regression analysis confirmed that the radiomics signature (HR: 0.290,

P
<
0.001

), age (HR: 1.023,

P
=
0.01

), and KPS (HR: 0.968,

P
<
0.001

) were independent risk factors for OS in GBM patients before surgery. When the radiomics signature and preoperative clinical risk factors were combined, the radiomics nomogram further improved the performance of OS prediction in individual patients (

C
‐
index
=
0.764

and 0.758 in the TCIA and test cohorts, respectively). Conclusion. This study developed a radiomics signature that can predict the response of individual GBM patients to radiotherapy and may be a new supplement for precise GBM radiotherapy.
Muscle Injury in Bodybuilding Based on Mesoporous Multifunctional Nanomaterials for Sports Rehabilitation Training
Authors: Zhao Changjun
Published: October 2020

As an important means of treating diseases, chemical-based drugs have always guaranteed people’s health and longevity. However, due to the nature of some drugs, their use in the medical field is limited. This study mainly discusses the treatment of muscle damage based on sports rehabilitation training mesoporous multifunctional nanomaterials in bodybuilding. The biological characteristics of the targeted control of mesoporous multifunctional nanomaterials for target drugs were studied by analyzing the regeneration of skeletal muscles of mice after gastrocnemius strain under computer control. The electrostatic interactions modified by the consensus binding between AS1411 and Dimer-PPTcDA on the surface of mesoporous silicon are used to block the pores, and the release of objective molecules depends on the concentration of the drug in the tendon cells and the time of action. In this system, AS1411 has both the characteristics of the target substance and the active site of the targeted stimulus response in the cell. After FAM is labeled AS1411, the fluorescence of FAM can be used to monitor the release of the drug in real time, so as to directly release the drug to the lesion, maintain local effectiveness, and greatly improve the biological activity of the drug. In addition, in the safety analysis of mesoporous multifunctional nanomaterials on cells, if the concentration of nanoparticles is 90 μg/mL, the cell survival rate is almost 100%. The results show that the mesoporous multifunctional nanomaterials have low cytotoxicity and cell activity is not affected. The smaller the particle size of mesoporous silicon, the easier it is to invade the focus cells. In addition, confocal microscopy imaging has also effectively demonstrated the targeting effect of mesoporous multifunctional nanomaterials on cells.
Evaluation of Anti‐Inflammatory Components of Guizhi Fuling Capsule, an Ancient Chinese Herbal Formula, in Human Umbilical Vein Endothelial Cells
Authors: Zheng Yuzhong , Xin Guizhong , Gong Guowei , Dong Tina TX , Li Ping , Tsim Karl W. K.
Published: October 2020

Background. Guizhi Fuling capsule (GFC), a well‐known formula composed of five medicinal herbs, is commonly prescribed to treat primary dysmenorrhea, as well as to achieve good clinical efficacy in China. However, the active components of GFC have not been identified. Here, the anti‐inflammatory functions of GFC, as well as its major ingredients, were evaluated in human umbilical vein endothelial cells (HUVECs). Methods. Lipopolysaccharide (LPS) was used in HUVECs to imitate the cellular inflammation. Then, GFC‐triggered mRNA expressions of cyclooxygenase‐1 (COX‐1) and COX‐2 were determined by real‐time PCR, while the expression of COX‐2 protein was revealed by western blotting. Besides, nine components of GFC were evaluated for their contribution value in the anti‐dysmenorrhea effects Results. The application of GFC downregulated the mRNA expressions of COX‐1 and COX‐2 mRNAs. Nine major components of GFC were tested in the inflammatory system, and three compounds, including paeoniflorin, benzoylpaeoniflorin, and amygdalin, exhibited robust activation in HUVECs. The combination of paeoniflorin, benzoylpaeoniflorin, and amygdalin showed over 80% of the anti‐inflammatory activation. Conclusion. Our study supports that GFC plays a promising role in anti‐dysmenorrhea function by decreasing COXs’ expression. Besides, paeoniflorin, benzoylpaeoniflorin, and amygdalin could be considered as major regulators for the anti‐dysmenorrhea effects of GFC.
SMARCB1 Promotes Ubiquitination and Degradation of NR4A3 via Direct Interaction Driven by ROS in Vascular Endothelial Cell Injury
Authors: Lu Bingzheng , Zhu Zhu , Sheng Longxiang , Li Yuan , Yang Yang , Chen Yupin , Xue Dongdong , Zhou Yuwei , Cai Wei , Chen Chen , Wei Cailv , Xu Dong , Yan Min , Lin Suizhen , Yan Guangmei , Yin Wei
Published: October 2020

Nuclear receptor subfamily 4 group A member 3 (NR4A3) protects the vascular endothelial cell (VEC) against hypoxia stress, whose expression is primarily reported to be governed at a transcriptional level. However, the regulation of NR4A3 in the protein level is largely unknown. Here, we report that NR4A3 protein abundance is decreased immensely in VEC injury induced by reoxygenation after oxygen-glucose deprivation (OGD-R), which is significantly blocked by the administration of the antioxidative steroid TRIOL. Moreover, the notable improvement of NR4A3 and the alleviation of pulmonary endothelial barrier hyperpermeability induced by acute hypobaric hypoxia in cynomolgus monkeys are also observed after TRIOL administration. The overproduction of reactive oxygen species (ROS) decreases NR4A3 protein abundance in VEC under OGD-R condition, which is reversed by TRIOL and N-acetylcysteine (NAC). TRIOL dose-dependently increases the NR4A3 protein level by inhibiting ubiquitination and ubiquitin proteasome system- (UPS-) mediated degradation rather than promoting its transcription. Using yeast two-hybrid screening, we further identify the interaction between NR4A3 and SWI/SNF-related matrix-associated actin-dependent regulator of chromatin subfamily B member 1 (SMARCB1), and the DNA-binding domain of NR4A3 is required for this interaction. Knockdown of SMARCB1 reduces ubiquitination and degradation of NR4A3, suggesting the proubiquitylation effect of this interaction which is enhanced by ROS in VEC injury induced by OGD-R. In summary, our study here for the first time reveals a posttranslational regulation in SMARCB1-mediated NR4A3 protein degradation which is driven by ROS, providing further understanding of the impaired regulation of NR4A3-mediated prosurvival pathways under pathological condition in VEC.