bluuebunny/crossref_metadata_2025 huggingface dataset:
A review: Antibody-dependent enhancement in COVID-19: The not so friendly side of antibodies
Authors: Sánchez-Zuno Gabriela Athziri , Matuz-Flores Mónica Guadalupe , González-Estevez Guillermo , Nicoletti Ferdinando , Turrubiates-Hernández Francisco Javier , Mangano Katia , Muñoz-Valle José Francisco
Published: October 2021

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), represents an unprecedented global public health emergency with economic and social consequences. One of the main concerns in the development of vaccines is the antibody-dependent enhancement phenomenon, better known as ADE. In this review, we provide an overview of SARS-CoV-2 infection as well as the immune response generated by the host. On the bases of this principle, we also describe what is known about the ADE phenomenon in various viral infections and its possible role as a limiting factor in the development of new vaccines and therapeutic strategies.
Learning Collaborative Events With Child Welfare and Health Care Providers Improve Systems Knowledge and Intent to Change
Authors: Scheid Jeanette M. , Sarinopoulos Issidoros , Cameron Sierra , Tanner Clare
Published: October 2021

Introduction:

Children in foster care are at higher risk of health problems. These risks present challenges to achieving permanency, safety, and well-being. Despite efforts to improve the systems serving children in foster care, gaps remain in achieving timely and quality health services. Based on stakeholder reports that health care provider knowledge about child welfare systems is a barrier to care, the Fostering Health Partnerships project conducted 2-session learning collaborative events across Michigan. The project team hypothesized that participants would increase knowledge of child welfare policy and that physician participants would identify and commit to practice change to improve health care services to children in foster care.

Methods:

Learning collaborative events included an in-person session followed by a live webinar session. Participants included child welfare professionals, physicians, and other health care representatives. Participants completed surveys assessing knowledge about child welfare health policy. Physician participants completed a post-event interview. The investigators used pre- and post-intervention survey design and qualitative evaluation of physician interview data to assess the impact of the learning collaborative events on knowledge and practice.

Results:

A total of 781 individuals attended the initial session and 383 attended the second session of 36 events for 80 counties in Michigan. 247 individuals completed pre- and post-event surveys and 7 physicians completed interviews after the events. Survey data showed that event participants demonstrated increased knowledge of child welfare policy related to health ( P < .001). Interviewed physicians reported making practice changes to improve health care services and indicated that the events were valuable though time intensive.

Conclusion:

An abbreviated learning collaborative process is an effective tool to improve knowledge and drive practice change. Future efforts will build on this project to improve access, coordination, and quality health services for children in foster care.
Characteristics of Rotavirus, ETEC, and Vibrio Cholerae Among Under 2-year Children Attending an Urban Diarrheal Disease Hospital in Bangladesh
Authors: Sarker Mohammad Habibur Rahman , Moriyama Michiko , Rahman Md Moshiur , Das Sumon Kumar , Uzzaman Md Nazim , Das Jui , Uddin Aftab , Banu Shakila , Khan Soroar Hossain , Shahid Abu SMSB , Shahunja K. M. , Chisti Mohammod Jobayer , Faruque Abu S. G. , Ahmed Tahmeed
Published: October 2021

Background

Information on comparative clinical and host characteristics of under-2 children with watery diarrhea caused by rotavirus, Enterotoxigenic Escherichia coli (ETEC), and Vibrio cholerae as single pathogens is lacking. We sought to investigate the sociodemographic, clinical, and host characteristics of under-2 children hospitalized due to these pathogens.

Methodology

We conducted a hospital-based case-control study using the icddr,b Diarrheal Diseases Surveillance System. Children of either sex, <2 years with diarrhea, who attended the hospital during 2014 to 2018, constituted the study population. Stool specimens having a single pathogen like rotavirus, ETEC, or Vibrio cholerae constituted the cases and stool specimens having no detectable common enteropathogens comprised the controls. Multinomial logistic regression analysis was done where control was the reference group.

Results

A total of 14 889 patients were enrolled, 6939 of whom were under-2 children, and 5245 (76%) constituted our study population. Among them 48% (n = 2532), 3% (n = 148) and 1% (n = 49) had rotavirus, ETEC, and Vibrio cholera, respectively. A control group (diarrhea without these 3 or Shigella, Salmonella, Aeromonas) accounted for 48% (n = 2516). In multinomial regression model, children with rotavirus (adjusted odds ratio [aOR], 1.36; 95% confidence interval [95% CI], 1.19-1.55) less often presented with dehydrating diarrhea compared to those with ETEC (aOR, 1.54; 95% CI, 1.05-2.26) and cholera (aOR, 2.25; 95% CI, 1.11-4.57). Rotavirus diarrhea was associated (aOR, 1.25; 95% CI, 1.07-1.46) with those who received antimicrobials prior to hospital admission and protectively associated with drinking tap water (aOR, 0.84; 95% CI, 0.73-0.95); however, ETEC diarrhea had protective association (aOR, 0.62; 95% CI, 0.43-0.92) with children who received antimicrobials prior to hospital admission and was associated with drinking tap water (aOR, 1.78; 95% CI, 1.19-2.66). Use of intravenous fluid was associated with cholera (aOR, 10.36; 95% CI, 4.85-22.16) and had protective association with rotavirus episodes (aOR, 0.64; 95% CI, 0.45-0.91).

Conclusions

Clinical presentations and host characteristics of rotavirus, ETEC, and Vibrio cholerae diarrhea differed from each other and the information may be helpful for clinicians for better understanding and proper management of these children.
Coupling Development of Manufacturing Promotion and Innovation in China
Authors: Li Bingqiang , Yu Jing , Huang Lei , Li Jinzhi , Luo Changhan
Published: October 2021

This study analyzed the manufacturing implemented different modes of innovation at different regions, and established a model to predict the likelihood that the enterprise would follow the innovation mode dominated by the local government. Governmental regulation of innovation and spurring enterprises to innovate were important tools for development of the manufacturing in China, but regional differences in economic development required different coupling strategies of innovation. The results revealed that the developed region in China was biased to undertake disruptive innovation, while the developing region drived incremental innovation mainly, and made a theoretical model to explore the probability respectively. We assigned corresponding values based on theoretical analysis and relevant assumptions, and discovered that in the developing region was more likely to follow the innovation mode proposed by the local government than that in the developed region, but the data demonstrated that the probability were comparatively small for both the developed region and the developing region.
Psychometric Properties and Structural Validity of the Serbian Version of the Copenhagen Burnout Inventory (CBIser)
Authors: Živanović Marko , Borjanić Bolić Emina , Vukčević Marković Maša
Published: October 2021

Copenhagen Burnout Inventory (CBI) is a tool assessing fatigue and exhaustion as the core features of burnout. Despite its wide use and evidence of good psychometric properties, little is known about its structural validity. Therefore, this study aimed to examine internal psychometric properties and the latent composition of the Serbian version of CBI. A sample of 382 child welfare workers engaged in the work with the domestic population and professionals working with refugees and migrants completed a 19-item version of CBIser. Results showed that full-scale CBI despite having good psychometric properties lacks structural validity. A short-form of the instrument was empirically derived and several concurrent confirmatory models found in previous studies were tested. A three-factor model of personal, work-, and client-related burnout showed to be the best fitting one, and the 13-item form of CBI proved to be a structurally valid and psychometrically sound measure of burnout.
Structured Supervision Propelling Job Performance in Universities: Achieving Goals without Chains
Authors: Nwosu Innocent A. , Ohuruogu Ben , Ekpechu Joseph O. A. , Okoronkwo Ethelbert , Chukwu Christiana O. , Obi Chinazor Franca , Ofoegbu Francis C.
Published: October 2021

The study is aimed at determining how structured supervision of influences work attitude and promotes job performance in universities. This is because the success of any academic institution depends on effective supervision of staff. To achieve the objectives, the study adopted survey research design using interviews and questionnaire. Respondents (107) were selected from different units/departments of a public university in Nigeria through stratified sampling technique. Data were analyzed using descriptive statistics. The study revealed that Junior Non-Academic Staff of the university were poorly supervised, leading to poor job performance. The cause of this is non-application of structured supervision. The study believes in structured supervision, which involves elimination of harsh supervision, enthronement of cordial relationship between workers and their supervisors, regular training of supervisors, promotion of exemplary supervision, and provision of institutional policy on supervision. Therefore, there is a strong relationship between structured supervision and high job performance. As a result, it is important that supervisors are regularly trained to imbibe spirit of structured supervision which will help them to lead their subordinates to achieve high job performance.
Analysis of Influence Factors on the Quality of International Collaboration Research in the Field of Social Sciences and Humanities: The Case of Chinese World Class Universities (2015–2019)
Authors: Zhe Cheng , Lu Xingfu , Xiong Xiong
Published: October 2021

This article aims to reveal the factors that affecting the impact of international collaboration papers in the field of social sciences and humanities. Based on resource-based theory and transaction cost theory, we analyzed the articles from a sample of 13,331 listed research papers come from the 42 world class universities in China using descriptive statistics, ordinary least square (OLS) regression, and came to the following conclusions: First, it is the quality rather than the quantity of international collaborator that affect the academic influence of the research outputs. Second, researchers from different backgrounds are conducive to improve the impact of research papers and the collaboration leading by Chinese university perform better. Yet, too much collaborators coming from different institutions would have an adverse impact, which may due to the increase cost of cooperation. Finally, collaborating researchers from developed countries or top universities will significantly improve the research performance because of the abundant resources behind them. Findings from this research suggest that setting up international collaboration should pay more attention to the level of the collaborator and consider the cost behind the whole process.
Current Applications of Machine Learning in Spine: From Clinical View
Authors: Ren GuanRui , Yu Kun , Xie ZhiYang , Wang PeiYang , Zhang Wei , Huang Yong , Wang YunTao , Wu XiaoTao
Published: October 2021

Study Design:

Narrative review.

Objectives:

This review aims to present current applications of machine learning (ML) in spine domain to clinicians.

Methods:

We conducted a comprehensive PubMed search of peer-reviewed articles that were published between 2006 and 2020 using terms (spine, spinal, lumbar, cervical, thoracic, machine learning) to examine ML in spine. Then exclude research of other domain, case report, review or meta-analysis, and which without available abstract or full text.

Results:

Total 1738 articles were retrieved from database, and 292 studies were finally included. Key findings of current applications were compiled and summarized in this review. Main clinical applications of those techniques including image processing, diagnosis, decision supporting, operative assistance, rehabilitation, surgery outcomes, complications, hospitalization and cost.

Conclusions:

ML had achieved excellent performance and hold immense potential in spine. ML could help clinical staff to improve medical level, enhance work efficiency, and reduce adverse events. However more randomized controlled trials and improvement of interpretability are essential to clinicians accepting models’ assistance in real work.
What Do Preambles Do? A Study of Constitutional Intent and Reality
Authors: Ummareddy Neha , Alam Aniket
Published: October 2021

‘We, the people’ is the most popular phrase from the constitutions. In spite of the fact that the number of countries including preamble as part of their constitution has been on the rise, preambles have received scant attention in academia. The importance of preambles has been established in multiple studies yet preambles have been looked at in isolation from socio-economic-environmental contexts. Our article attempts to present a unique insight by correlating preambles with the socio-economic-environmental and infrastructural context within which they exist. It explores whether these correlations exist and if they do with which features and to what extent and the possibility of a causal link.

We pursue a statistical study between various indicators that reflect the growth of a country and the presence or absence of various elements in preambles across the world. Our study finds that correlations exist between the economic-social-environmental and infrastructural context of a nation-state and different elements in their preambles. Our study rigorously engages with patterns in development indicators across years to provide correlational insights into the role of preambles not just as a dormant reference but as active fragments of the socio-political-economic reality of a nation-state. We hope our article establishes grounds for a further study of the manner in which preambles and the non-political aspects of a nation-state can engage with each other.
Diagnostic Accuracy of Ultrasonography for Rotator Cuff Tears: A Systematic Review and Meta-analysis
Authors: Farooqi Ali S. , Lee Alexander , Novikov David , Kelly Ann Marie , Li Xinning , Kelly John D. , Parisien Robert L.
Published: October 2021

Background:

With recent improvements in transducer strength, image resolution, and operator training, ultrasound (US) provides an excellent alternative imaging modality for the diagnosis of rotator cuff tears.

Purpose:

To evaluate the diagnostic accuracy of US for partial- and full-thickness rotator cuff tears and biceps tendon tears, compare diagnostic values with those of magnetic resonance imaging (MRI) using arthroscopy as the reference standard, assess longitudinal improvements in accuracy, and compare diagnostic values from operators with different training backgrounds.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

The PubMed and Cochrane Library databases were systematically searched for full-text journal articles published between January 1, 2010, and April 1, 2020. The inclusion criteria were studies that evaluated the diagnostic accuracy of US for rotator cuff tears or biceps tendon tears utilizing arthroscopy as the reference standard. The exclusion criteria were studies with <10 patients, studies including massive tears without reporting diagnostic data for specific tendons, and studies lacking diagnostic outcome data. Extracted outcomes included diagnostic accuracy, sensitivity, specificity, negative predictive value, and positive predictive value. The mean difference and 95% confidence interval were calculated for both US and MRI diagnostic values, and meta-analysis was conducted using the Mantel-Haenszel random-effects model.

Results:

In total, 23 eligible studies involving 2054 shoulders were included. US demonstrated a higher median diagnostic accuracy for supraspinatus tendon tears (0.83) and biceps tendon tears (0.93) as compared with subscapularis tendon tears (0.76). US was found to have a higher median accuracy (0.93) for full-thickness supraspinatus tears than partial-thickness tears (0.81). US had superior median sensitivity for partial-thickness supraspinatus tears when performed by radiologists as opposed to surgeons (0.86 vs 0.57). Meta-analysis of the 5 studies comparing US and MRI demonstrated no statistically significant difference in diagnostic sensitivity, specificity, or accuracy for any thickness supraspinatus tears (P = .31-.55), full-thickness tears (P = .63-.97), or partial-thickness tears ( P = .13-.81).

Conclusion:

For experienced operators, US is a highly sensitive and specific diagnostic modality for the diagnosis of supraspinatus tears and demonstrates statistically equivalent capability to MRI in the diagnosis of both full- and partial-thickness rotator cuff tears.
Novel HSD17B4 Variants Cause Progressive Leukodystrophy in Childhood: Case Report and Literature Review
Authors: Yamamoto Akiyo , Fukumura Shinobu , Habata Yumi , Miyamoto Sachiko , Nakashima Mitsuko , Takashima Shigeo , Kawasaki Yukihiko , Shimozawa Nobuyuki , Saitsu Hirotomo
Published: October 2021

D-bifunctional protein (DBP) deficiency is a peroxisomal disorder with a high degree of phenotypic heterogeneity. Some patients with DBP deficiency develop progressive leukodystrophy in childhood. We report a 6-year-old boy with moderate hearing loss who presented with developmental regression. Brain magnetic resonance imaging demonstrated progressive leukodystrophy. However, very long chain fatty acids (VLCFAs) in the plasma were at normal levels. Whole-exome sequencing revealed compound heterozygous variants in HSD17B4 (NM_000414.3:c.[350A > T];[394C > T], p.[[Asp117Val]];[[Arg132Trp]]). The c.394C > T variant has been identified in patients with DBP deficiency and is classified as likely pathogenic, while the c.350A > T variant was novel and classified as uncertain significance. Although one of the two variants was classified as uncertain significance, an accumulation of phytanic and pristanic acids was identified in the patient, confirming type III DBP deficiency. DBP deficiency should be considered as a diagnosis in children with progressive leukodystrophy and hearing loss even if VLCFAs are within normal levels.
Dependence of COVID-19 Policies on End-of-Year Holiday Contacts in Mexico City Metropolitan Area: A Modeling Study
Authors: Alarid-Escudero Fernando , Gracia Valeria , Luviano Andrea , Roa Jorge , Peralta Yadira , Reitsma Marissa B. , Claypool Anneke L. , Salomon Joshua A. , Studdert David M. , Andrews Jason R. , Goldhaber-Fiebert Jeremy D. ,   Stanford-CIDE Coronavirus Simulation Model (SC-COSMO) Modeling Consortium
Published: October 2021

Background. Mexico City Metropolitan Area (MCMA) has the largest number of COVID-19 (coronavirus disease 2019) cases in Mexico and is at risk of exceeding its hospital capacity in early 2021. Methods. We used the Stanford-CIDE Coronavirus Simulation Model (SC-COSMO), a dynamic transmission model of COVID-19, to evaluate the effect of policies considering increased contacts during the end-of-year holidays, intensification of physical distancing, and school reopening on projected confirmed cases and deaths, hospital demand, and hospital capacity exceedance. Model parameters were derived from primary data, literature, and calibrated. Results. Following high levels of holiday contacts even with no in-person schooling, MCMA will have 0.9 million (95% prediction interval 0.3–1.6) additional COVID-19 cases between December 7, 2020, and March 7, 2021, and hospitalizations will peak at 26,000 (8,300–54,500) on January 25, 2021, with a 97% chance of exceeding COVID-19-specific capacity (9,667 beds). If MCMA were to control holiday contacts, the city could reopen in-person schools, provided they increase physical distancing with 0.5 million (0.2–0.9) additional cases and hospitalizations peaking at 12,000 (3,700–27,000) on January 19, 2021 (60% chance of exceedance). Conclusion. MCMA must increase COVID-19 hospital capacity under all scenarios considered. MCMA’s ability to reopen schools in early 2021 depends on sustaining physical distancing and on controlling contacts during the end-of-year holiday.
Integrating physical and mental healthcare: Facilitators and barriers to success
Authors: Monaghan Karen , Cos Travis
Published: October 2021

Introduction:

Effective and appropriate provision of mental healthcare has long been a struggle globally, resulting in significant disparity between prevalence of mental illness and access to care. One attempt to address such disparity was the Patient Protection and Affordable Care Act (PPACA), 2010, mandate in the United States to integrate physical and mental healthcare in Federally Qualified Health Centers (FQHCs). The notion of integration is attractive, as it has demonstrated the potential to improve both access to mental healthcare and healthcare outcomes. However, while the PPACA mandate set this requirement for FQHCs, no clear process as to how these centers should achieve successful integration was identified.

Methods:

This research employed case study methods to examine the implementation of this policy in two FQHCs in New England. Data were obtained from in-depth interviews with leadership, management, and frontline staff at two case study sites.

Results:

Study findings include multiple definitions of and approaches for integrating physical and mental healthcare, mental healthcare being subsumed into, rather than integrated with, the medical model and multiple facilitators of and barriers to integration.

Conclusion:

This study asked questions about what integration means, how it occurs, and what factors facilitate or pose barriers to integration. Integration is facilitated by co-location of providers within the same department, a warm hand-off, collaborative collegial relationships, strong leadership support, and a shared electronic health record. However, interdisciplinary conflict, power differentials, job insecurity, communication challenges, and the subsumption of mental health into the medical model pose barriers to successful integration.
Assessing Materials Management Practices Effect on Firm’s Performance in Ghana Using Dominance Analysis: Evidence from a Listed Company
Authors: Essel Ronald Ebenezer
Published: October 2021

The objective of this study is to empirically examine the effect of materials management on a firm’s performance by exploring employee views and utilizing a firm’s financial statement data within the Ghanaian context, focusing on Fan Milk Limited, a listed manufacturing firm in Ghana. A cross-sectional research design was espoused for the study, utilizing questionnaires completed by 240 respondents selected via simple random sampling. SPSS version 25.0 was utilized for data analysis, which included descriptive statistics, principal component analysis, exploratory factor analysis with varimax rotation, reliability/validity analysis, and multivariate regression aided with relative importance analysis via dominance analysis. The study found significant positive relationships between all eight materials management practices and a firm’s performance. Dominance analysis further revealed that materials requirement planning and control was the most important predictor of a firm’s performance, while ergonomics was the least important predictor of performance. Managerial recommendations established should be viewed critically while managing manufacturing firms.
Accelerating Employability through Social Safety Net in Rural Bangladesh: Employment Generation Programme for the Poorest
Authors: Uddin Nasir , Kaiser Z. R. M. Abdullah
Published: October 2021

This article assesses the effectiveness of the employment generation programme for the poorest (EGPP) and its impact on ensuring employment opportunities and employability of targeted beneficiaries in rural areas in Bangladesh. In particular, it examines the appropriateness of targeted beneficiaries, selection, and the impact of the programme on changing their livelihood and economic indicators. Respondents were selected from 12 unions of four districts of the Chattogram division, and data were collected using the interview method and key informant interview. First, the findings suggest that accurately selecting beneficiaries and households was a challenging task owing to inappropriate wage rates, social context and political influences. Besides, misappropriation of the selection process of beneficiaries is one of the main concerns of this programme. Second, the EGPP has improved the income levels of a significant number of beneficiaries and made a positive impact on their certain basic needs and livelihood indicators. Despite drawbacks in the implementation, the study concludes that the provision of adequate measures of employment generation programmes based on equity and geographical demands will notably contribute to ensuring the employability of the unemployed and marginalised sections of the country.
Dwindling Fish Catch in Kwale, Kenya: Vulnerable Southern Coast Marine Fisher Communities and Alternative Sustainable Livelihoods
Authors: Nyawade Okinyi B. , Were-Kogogo Pamela , Adero Daniel O. , Owiti Phanuel , Osimbo Harriet , Chege Mercy
Published: October 2021

Marine fisher communities of Kwale in the South Coast of Kenya have, for generations, depended nearly exclusively on fisheries and fish-based livelihoods. In recent times, dwindling fish catch has threatened their livelihoods. Diversification of livelihood sources is touted as a potential remedy, but much less is understood about the available alternative sustainable options and their viability. This study examined the potency and viability of the alternative livelihood options for the fishermen communities. It used a cross-sectional descriptive survey design premised on mixed qualitative and quantitative methods to collect and analyse the data from 346 randomly selected households. Emerging livelihood options with potency for adoption include apiculture, seaweed farming, agriculture, small business enterprises and mangrove conservation, among others. Preference is given to supplemental livelihood sources as opposed to alternative livelihoods. Implications for policy include the need for public extension services and training to invigorate households’ income.
DRIVEN to Change Attitudes Toward Dating Violence: Outcomes From a 6-Month Follow-Up Study
Authors: Terrazas-Carrillo Elizabeth , Garcia Ediza , Vasquez Desi A. , Sabina Chiara , Rodriguez Amanda S.
Published: October 2021

While dating violence (DV) is a significant issue present on college campuses among students of all ethnic groups, research suggests that DV is preventable. As Latino representation at colleges increases, it is important to find DV prevention programs addressing specific sociocultural characteristics of this ethnic group. We created the DRIVEN (Dating Relationships Involving Violence End Now) program to fill a significant need for DV programming tailored to Latino college students. This study examines the durability of initial positive outcomes over a 6-month period. To do so, we conducted a 6-month follow-up with a total of 49 Latino college students attending a Hispanic Serving Institution (HSI) located on the U.S.-Mexico border. Results suggest DRIVEN outcomes were maintained on the following variables: dating violence attitudes, dating violence victimization and perpetration, and marianismo. Implications for these findings are discussed in the context of implementing group-based programs with college students.
Circadian effects of ionizing radiation on reproductive function and clock genes expression in male mouse
Authors: Qin Fenju , Liu Ningang , Nie Jing , Shen Tao , Xu Yingjie , Pan Shuxian , Pei Hailong , Zhou Guangming
Published: October 2021

Background

Exposure to the ionizing radiation (IR) encountered outside the magnetic field of the Earth poses a persistent threat to the reproductive functions of astronauts. The potential effects of space IR on the circadian rhythms of male reproductive functions have not been well characterized so far.

Methods

Here, we investigated the circadian effects of IR exposure (3 Gy X-rays) on reproductive functional markers in mouse testicular tissue and epididymis at regular intervals over a 24-h day. For each animal, epididymis was tested for sperm motility, and the testis tissue was used for daily sperm production (DSP), testosterone levels, and activities of testicular enzymes (glucose-6-phosphate dehydrogenase (G6PDH), sorbitol dehydrogenase (SDH), lactic dehydrogenase (LDH), and acid phosphatase (ACP)), and the clock genes mRNA expression such asClock,Bmal1,Ror-α,Ror-β, orRor-γ.

Results

Mice exposed to IR exhibited a disruption in circadian rhythms of reproductive markers, as indicated by decreased sperm motility, increased daily sperm production (DSP), and reduced activities of testis enzymes such as G6PDH, SDH, LDH, and ACP. Moreover, IR exposure also decreased mRNA expression of five clock genes (Clock,Bmal1,Ror-α,Ror-β, orRor-γ) in testis, with alteration in the rhythm parameters.

Conclusion

These findings suggested potential health effects of IR exposure on reproductive functions of male astronauts, in terms of both the daily overall level as well as the circadian rhythmicity.
A new model of inexpensive portable homemade PERC Mentor (IPHOM) and its validation
Authors: Shukla Abhishek , Sethi Gurwinder , Dutta Ananya , Aggarwal Puneet , Gupta Ayon
Published: October 2021

Background

Percutaneous nephrolithotomy (PCNL) is a complex surgery and has a flat learning curve. Due to this and the ethical issues, trainees do not get enough hands on exposure. Virtual simulator is very expensive and bulky. Animal model requires legal clearance. This inexpensive portable homemade PERC Mentor (IPHOM) teaches all the major aspects of PCNL surgery. This article has shown the way to make this model and its validation study.

Methods

IPHOM can be made at home with carton box, ball bearings, LED torch and some hospital wastes. After a short demonstration of IPHOM, 14 residents and 4 urologists were given 8 tasks to perform on it followed by 15-min supervised practice exercise on day 0 and day 1. Their performance was reassessed on day 2 and 3. Response to 17 feedback points was recorded on a seven-point Likert scale.

Results

There was significant difference between the performance of expert and novice on day 0. Expert completed all the tasks in less time and no. of attempts. The time for tract dilatation and duration of radiation exposure were significantly less in the expert group. The performance of both expert and novice improved on day 2 and 3, but the improvement was significantly more in novice. Response to the feedback points showed no difference between expert and novice (p > .05).

Conclusions

We have found that training on IPHOM has improved the concept and skills of PCNL in residents. The simplicity and low cost of the model make it constructible at home.
Quantitative effect of subretinal fluid and intraretinal edema on visual acuity in uveitic cystoid macular edema
Authors: Weldy Eric W. , Patnaik Jennifer L. , Pecen Paula E. , Palestine Alan G.
Published: October 2021

Background

The effect of subretinal fluid (SRF) in uveitic cystoid macular edema (CME) is not fully understood. This study evaluates the quantitative effect of SRF and intraretinal thickness on visual acuity in eyes with uveitic CME. We separately measured SRF and intraretinal area on Optical Coherence Tomography (OCT) to determine the associations of each component with visual acuity and response to treatment.

Main text

Medical records were reviewed of patients with CME presenting to the University of Colorado uveitis clinic from January 2012 to May 2019. All available OCTs were reviewed to classify eyes as either having only CME or CME with SRF. Intraretinal area was manually measured using Image J along the central 1-mm section of B-scan OCT spanning from the internal limiting membrane to the outer most portion of the outer retina including both cysts and retinal tissue. SRF cross-sectional area was measured spanning from the outermost portion of the outer retina to retinal pigment epithelium. Response to treatment was assessed one to four months after presentation. Eyes with CME secondary to structural or non-inflammatory causes were excluded.

Forty-seven (50.5%) eyes had CME alone and 46 (49.5%) eyes had SRF with CME. Measured SRF cross-sectional area was not associated (p = 0.21) with LogMAR at presentation. Conversely, intraretinal area was strongly correlated with visual acuity in eyes with SRF (p < 0.001) and without SRF (p < 0.001). Following treatment, there was a significant decrease in intraretinal area for both groups (p < 0.001), with a larger decrease in the SRF group compared to the non-SRF group (p = 0.001). Similarly, logMAR improved in both groups (p = 0.008 for SRF eyes and p = 0.005 for non-SRF eyes), but the change was more prominent in the SRF group (p = 0.06).

Conclusions

There was no direct association observed between the amount of SRF and visual acuity. In contrast, increased intraretinal area was significantly associated with decreased visual acuity. This relationship between intraretinal thickening and visual acuity may explain differences observed in response to treatment between SRF and non-SRF eyes, with a larger decrease in the intraretinal cross-sectional area in SRF eyes associated with a greater improvement in logMAR visual acuity.
The genetic impact of an Ebola outbreak on a wild gorilla population
Authors: Fontsere Claudia , Frandsen Peter , Hernandez-Rodriguez Jessica , Niemann Jonas , Scharff-Olsen Camilla Hjorth , Vallet Dominique , Le Gouar Pascaline , Ménard Nelly , Navarro Arcadi , Siegismund Hans R. , Hvilsom Christina , Gilbert M. Thomas P. , Kuhlwilm Martin , Hughes David , Marques-Bonet Tomas
Published: October 2021

Background

Numerous Ebola virus outbreaks have occurred in Equatorial Africa over the past decades. Besides human fatalities, gorillas and chimpanzees have also succumbed to the fatal virus. The 2004 outbreak at the Odzala-Kokoua National Park (Republic of Congo) alone caused a severe decline in the resident western lowland gorilla (Gorilla gorilla gorilla) population, with a 95% mortality rate. Here, we explore the immediate genetic impact of the Ebola outbreak in the western lowland gorilla population.

Results

Associations with survivorship were evaluated by utilizing DNA obtained from fecal samples from 16 gorilla individuals declared missing after the outbreak (non-survivors) and 15 individuals observed before and after the epidemic (survivors). We used a target enrichment approach to capture the sequences of 123 genes previously associated with immunology and Ebola virus resistance and additionally analyzed the gut microbiome which could influence the survival after an infection. Our results indicate no changes in the population genetic diversity before and after the Ebola outbreak, and no significant differences in microbial community composition between survivors and non-survivors. However, and despite the low power for an association analysis, we do detect six nominally significant missense mutations in four genes that might be candidate variants associated with an increased chance of survival.

Conclusion

This study offers the first insight to the genetics of a wild great ape population before and after an Ebola outbreak using target capture experiments from fecal samples, and presents a list of candidate loci that may have facilitated their survival.
Plasma chemokines as immune biomarkers for diagnosis of pediatric tuberculosis
Authors: Kumar Nathella Pavan , Hissar Syed , Thiruvengadam Kannan , Banurekha Velayuthum V. , Balaji Sarath , Elilarasi S. , Gomathi N. S. , Ganesh J. , Aravind M. A. , Baskaran Dhanaraj , Tripathy Srikanth , Swaminathan Soumya , Babu Subash
Published: October 2021

Background

Diagnosing tuberculosis (TB) in children is challenging due to paucibacillary disease, and lack of ability for microbiologic confirmation. Hence, we measured the plasma chemokines as biomarkers for diagnosis of pediatric tuberculosis.

Methods

We conducted a prospective case control study using children with confirmed, unconfirmed and unlikely TB. Multiplex assay was performed to examine the plasma CC and CXC levels of chemokines.

Results

Baseline levels of CCL1, CCL3, CXCL1, CXCL2 and CXCL10 were significantly higher in active TB (confirmed TB and unconfirmed TB) in comparison to unlikely TB children. Receiver operating characteristics curve analysis revealed that CCL1, CXCL1 and CXCL10 could act as biomarkers distinguishing confirmed or unconfirmed TB from unlikely TB with the sensitivity and specificity of more than 80%. In addition, combiROC exhibited more than 90% sensitivity and specificity in distinguishing confirmed and unconfirmed TB from unlikely TB. Finally, classification and regression tree models also offered more than 90% sensitivity and specificity for CCL1 with a cutoff value of 28 pg/ml, which clearly classify active TB from unlikely TB. The levels of CCL1, CXCL1, CXCL2 and CXCL10 exhibited a significant reduction following anti-TB treatment.

Conclusion

Thus, a baseline chemokine signature of CCL1/CXCL1/CXCL10 could serve as an accurate biomarker for the diagnosis of pediatric tuberculosis.
Renal angina index predicts fluid overload in critically ill children: an observational cohort study
Authors: Gorga Stephen M. , Carlton Erin F. , Kohne Joseph G. , Barbaro Ryan P. , Basu Rajit K.
Published: October 2021

Background

Fluid overload and acute kidney injury are common and associated with poor outcomes among critically ill children. The prodrome of renal angina stratifies patients by risk for severe acute kidney injury, but the predictive discrimination for fluid overload is unknown.

Methods

Post-hoc analysis of patients admitted to a tertiary care pediatric intensive care unit (PICU). The primary outcome was the performance of renal angina fulfillment on day of ICU admission to predict fluid overload ≥15% on Day 3.

Results

77/139 children (55%) fulfilled renal angina (RA+). After adjusting for covariates, RA+ was associated with increased odds of fluid overload on Day 3 (adjusted odds ratio (aOR) 5.1, 95% CI 1.23–21.2, p = 0.025, versus RA-). RA- resulted in a 90% negative predictive value for fluid overload on Day 3. Median fluid overload was significantly higher in RA+ patients with severe acute kidney injury compared to RA+ patients without severe acute kidney injury (% fluid overload on Day 3: 8.8% vs. 0.73%, p = 0.002).

Conclusion

Among critically ill children, fulfillment of renal angina was associated with increased odds of fluid overload versus the absence of renal angina and a higher fluid overload among patients who developed acute kidney injury. Renal angina directed risk classification may identify patients at highest risk for fluid accumulation. Expanded study in larger populations is warranted.
Butyrophilin-like 9 expression is associated with outcome in lung adenocarcinoma
Authors: Ma Weishuang , Liang Jiaming , Mo Junjian , Zhang Siyuan , Hu Ningdong , Tian Dongbo , Chen Zisheng
Published: October 2021

Background

Lung adenocarcinoma (LUAD) is the most prevalent non-small cell lung cancer (NSCLC). Patients with LUAD have a poor 5-year survival rate. The use of immune checkpoint inhibitors (ICIs) for the treatment of LUAD has been on the rise in the past decade. This study explored the prognostic role of butyrophilin-like 9 (BTNL9) in LUAD.

Methods

Gene expression profile of buytrophilins (BTNs) was determined using the GEPIA database. The effect of BTNL9 on the survival of LUAD patients was assessed using Kaplan-Meier plotter and OncoLnc. Correlation between BTNL9 expression and tumor-infiltrating immune cells (TILs) was explored using TIMER and GEPIA databases. Further, the relationship between BTNL9 expression and drug response was evaluated using CARE. Besides, construction and evaluation of nomogram based on BTNL9 expression and TNM stage.

Results

BTNL9 expression was downregulated in LUAD and was associated with a poor probability of 1, 3, 5-years overall survival (OS). In addition, BTNL9 expression was regulated at epigenetic and post-transcriptional modification levels. Moreover, BTNL9 expression was significantly positively correlated with ImmuneScore and ESTIMATEScore. Furthermore, BTNL9 expression was positively associated with infiltration levels of B cells, CD4+ T cells, and macrophages. Kaplan-Meier analysis showed that BTNL9 expression in B cells and dendritic cells (DCs) was significantly associated with OS. BTNL9 expression was significantly positively correlated with CARE scores.

Conclusions

These findings show that BTNL9 is a potential prognostic biomarker for LUAD. Low BTNL9 expression levels associated with low infiltration levels of naïve B cells, and DCs in the tumor microenvironment are unfavorable for OS in LUAD patients.
Absent Bell’s phenomenon in patients with thyroid eye disease
Authors: Chung Hyun Woo , Lee Hwa , Baek Sehyun
Published: October 2021

Background

To investigate the incidence of absent Bell’s phenomenon (BP) and the relationship between absent BP and inferior rectus muscle hypertrophy and other clinical features in patients with thyroid eye disease (TED).

Methods

A total of 104 patients who were first diagnosed with TED between January and December 2014 were included. Inferior rectus muscle area and associations with clinical features of TED and thyroid function test including thyroid specific antibodies were compared between patients with TED with and without BP. The volume of the inferior rectus muscle was calculated by adding up all the cross-sectional areas measured on sagittal CT images.

Results

Among the 104 patients, 14 had absent BP (13.5%), 12 with bilateral and two with unilateral. There was no significant difference in thyroid function test, presence of TSIs, exophthalmos, or volume of inferior rectus muscle measured in CT scans (P > 0.05). Incidence of diplopia, elevation limitation, and upper eyelid retraction were risk factors of absent BP in TED patients (by logistic regression analysis, P < 0.05).

Conclusions

Inferior rectus muscle hypertrophy was not the cause of absent BP in TED patients. Fibrosis and tightening of the inferior rectus muscle, lower eyelid, and surrounding orbital tissues, rather than inferior rectus muscle hypertrophy, might be related to absent BP in TED patients.
Characteristics of retinal detachment associated with atopic dermatitis
Authors: Lee Youlim , Park Woo Kyung , Kim Rae-Young , Kim Mirinae , Park Young-Gun , Park Young-Hoon
Published: October 2021

Background

To examine the characteristics of rhegmatous retinal detachment (RRD) associated with atopic dermatitis.

Method

Medical records of 2257 patients who underwent RD surgery at this clinic between 2008 and 2018 were retrospectively reviewed. Among them, 61 patients who were diagnosed as AD were assigned into the experimental group and 100 patients who did not have AD were randomly selected and assigned into the control group.

Demographics, characteristics of detachment, initial operative method, and prognosis after surgery were investigated as main outcomes. Additionally, in pseudophakic RD patients, the period between the cataract surgery and onset of RD was measured.

Result

Postoperative VA and prognosis were significantly worse and bilateral involvement of RD was more common in the atopy group than in the control group. (P value = 0.005, 0.001 each) Characteristics of retinal breaks were different between the two groups. Additionally, the risk of developing RD within 1 year after cataract surgery was significantly higher in pseudophakic patients of the atopic group than in the control group. (P value = 0.013) However, there was no significant difference in mean preoperative VA or refractive index between the two groups.

Conclusion

Our results show that in atopic patients, RD occurs at a young age with different characteristics compared to non-atopic patients. Atopic RD has a poor visual prognosis. Thus, it requires careful management. Furthermore, the risk of developing RD within 1 year after cataract surgery is higher in atopic patients. Therefore, it is important to perform regular and extensive check-up after cataract surgery for atopic patients.
Study protocol: childhood outcomes of fetal genomic variants: the PrenatAL Microarray (PALM) cohort study
Authors: Hui Lisa , Pynaker Cecilia , Kennedy Joanne , Lewis Sharon , Amor David J. , Walker Susan P. , Halliday Jane ,   On behalf of the PALM cohort study group, Norris Fiona , Gugasyan Lucy , Regan Matt , Vasudevan Anand , Fawcett Susan , McGillivray George , Graetz Melissa , Said Joanne , Begg Lisa , Wapner Ron , Levy Brynn
Published: October 2021

Background

The implementation of genomic testing in pregnancy means that couples have access to more information about their child’s genetic make-up before birth than ever before. One of the resulting challenges is the management of genetic variations with unclear clinical significance. This population-based study will help to close this critical knowledge gap through a multidisciplinary cohort study of children with and without genomic copy number variants (CNVs) diagnosed before birth. By comparing children with prenatally-ascertained CNVs to children without a CNV, we aim to (1) examine their developmental, social-emotional and health status; (2) measure the impact of prenatal diagnosis of a CNV on maternal perceptions of child health, behavior and development; and (3) determine the proportion of prenatally-ascertained CNVs of unknown or uncertain significance that are reclassified as benign or pathogenic after 2 or more years.

Methods

This study will establish and follow up a cohort of mother-child pairs who have had a prenatal diagnosis with a chromosomal microarray from 2013-2019 in the Australian state of Victoria. Children aged 12 months to 7 years will be assessed using validated, age-appropriate measures. The primary outcome measures will be the Wechsler Preschool and Primary Scale of Intelligence IV (WPSSI-IV) IQ score (2.5 to 7 year old’s), the Ages and Stages Questionnaire (12-30 months old), and the Brief Infant- Toddler Social and Emotional Assessment (BITSEA) score. Clinical assessment by a pediatrician will also be performed. Secondary outcomes will be scores obtained from the: Vineland Adaptive Behavior Scale, Maternal Postnatal Attachment Questionnaire, the Vulnerable Child Scale, Profile of Mood States, Parent Sense of Competence Scale. A descriptive analysis of the reclassification rates of CNVs after ≥2 years will be performed.

Discussion

This study protocol describes the first Australian cohort study following children after prenatal diagnostic testing with chromosomal microarray. It will provide long-term outcomes of fetal genomic variants to guide evidence-based pre-and postnatal care. This, in turn, will inform future efforts to mitigate the negative consequences of conveying genomic uncertainty during pregnancy.

Trial registration

ACTRN12620000446965p; Registered on April 6, 2020.