bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of maternal singing on well-being, postpartum depression and bonding – a randomised, controlled trial
Authors: Wulff Verena , Hepp Philip , Wolf Oliver T. , Fehm Tanja , Schaal Nora K.
Published: July 2021

Background

Postpartum depression is fairly common in new mothers and moreover associated with impaired bonding and poor maternal well-being. The aim of the present study was to investigate the impact of a mother-infant singing intervention within the first three months after birth on maternal well-being, depressive symptoms and bonding.

Methods

120 women who were recruited at the maternity ward at the University Clinic in Düsseldorf took part in this prospective, randomised-controlled study. Beside the baseline measurement 1–3 days after childbirth, depressive symptoms, maternal well-being and mother-infant bonding were evaluated with questionnaires before (two weeks after birth) and after (twelve weeks after birth) the intervention took place. The experimental group (n = 59) participated in several singing intervention sessions while the control group (n = 61) did not. In the intervention group, salivary cortisol as well as attachment and mood were assessed immediately before and after the singing sessions.

Results

The participants of the intervention group showed a significant reduction of cortisol (p = .023) and an improvement of attachment and mood from start to end of the intervention session (allp ≤ .008). However, no prolonged effects were revealed beyond the intervention sessions as the two groups did not differ regarding the alterations of the primary outcomes postpartum depression (interaction effectp = .187) and postpartum bonding (interaction effectp = .188) in the 10-week period from two up to twelve weeks after childbirth (allp > .05). Additional analyses of singing habits at home in both groups, revealed that only in the singing group more frequent singing was associated with less anxiety and more well-being of the mother.

Conclusion

Singing towards the infant seems to have positive immediate effects on the well-being of new mothers (on subjective variables as well as physiological measurements). However, the intervention did not lead to more long lasting positive effects although several limitations should be considered.

Trial registration

DRKS00015178(registered at the German Clinical Trial Registry), date of registration: 09.11.2018.
The pathways between natural disasters and violence against children: a systematic review
Authors: Cerna-Turoff Ilan , Fischer Hanna-Tina , Mansourian Hani , Mayhew Susannah
Published: July 2021

Background

Natural disasters are increasingly affecting a larger segment of the world’s population. These highly disruptive events have the potential to produce negative changes in social dynamics and the environment which increase violence against children. We do not currently have a comprehensive understanding of how natural disasters lead to violence against children despite the growing threat to human populations and the importance of violence as a public health issue. The mapping of pathways to violence is critical in designing targeted and evidence-based prevention services for children. We systematically reviewed peer-reviewed articles and grey literature to document the pathways between natural disasters and violence against children and to suggest how this information could be used in the design of future programming.

Methods

We searched 15 bibliographic databases and six grey literature repositories from the earliest date of publication to May 16, 2018. In addition, we solicited grey literature from humanitarian agencies globally that implement child-focused programming after natural disasters. Peer-reviewed articles and grey literature that presented original quantitative or qualitative evidence on how natural disasters led to violence against children were included. The authors synthesized the evidence narratively and used thematic analysis with a constant comparative method to articulate pathways to violence.

Results

We identified 6276 unduplicated publications. Nine peer-reviewed articles and 17 grey literature publications met the inclusion criteria. The literature outlined five pathways between natural disasters and violence, including: (i) environmentally induced changes in supervision, accompaniment, and child separation; (ii) transgression of social norms in post-disaster behavior; (iii) economic stress; (iv) negative coping with stress; and (v) insecure shelter and living conditions.

Conclusions

Service providers would benefit from systematic documentation to a high-quality standard of all possible pathways to violence in tailoring programming after natural disasters. The identified pathways in this review provide a foundation for designing targeted prevention services. In addition, the positive coping strategies within certain affected families and communities can be leveraged in implementing strength-based approaches to violence prevention.
Internet search results correlate with seasonal variation of sarcoidosis
Authors: Stanton Amanda , Katz Steven J.
Published: July 2021

Background

The etiology and pathophysiology of sarcoidosis remains unclear, with epidemiologic studies limited by its relatively low prevalence. The internet has prompted patients to seek information about medical diagnoses online; Google Trends provides access to an anonymized version of this data, which has a new role in epidemiology. We hypothesize that there is seasonal variation in the relative search interest of sarcoidosis, which would suggest seasonal variation in the incidence of sarcoidosis.

Methods

Google Trends was used to assess the relative search volume from 2010 to 2020 for “sarcoidosis” and “sarcoid” in 7 countries. ANOVA with multiple comparisons was performed to compare the mean relative search volume by month and by season for each country, with a p-value less than 0.05 indicating statistical significance.

Results

Our analysis revealed a significant seasonal variation in search popularity in 4 of the 7 countries and in the Northern Hemispheric countries combined. Direct comparison showed search terms to be more popular in spring, specifically March & April, than in the winter. Southern Hemisphere data was not statistically significant but showed a trend towards a nadir in December and a peak in September and October.

Conclusions

Overall, these findings suggest seasonal variation with a possible peak in spring and nadir in winter. This supports the hypothesis that sarcoidosis has seasonal variation and is more commonly diagnosed in spring, but more evidence is needed to support this, as well as investigation into the pathophysiology of sarcoidosis to explain this phenomenon.
Prediction model for thyrotoxic atrial fibrillation: a retrospective study
Authors: Ponomartseva Daria Aleksandrovna , Derevitskii Ilia Vladislavovich , Kovalchuk Sergey Valerevich , Babenko Alina Yurevna
Published: July 2021

Background

Thyrotoxic atrial fibrillation (TAF) is a recognized significant complication of hyperthyroidism. Early identification of the individuals predisposed to TAF would improve thyrotoxic patients’ management. However, to our knowledge, an instrument that establishes an individual risk of the condition is unavailable. Therefore, the aim of this study is to build a TAF prediction model and rank TAF predictors in order of importance using machine learning techniques.

Methods

In this retrospective study, we have investigated 36 demographic and clinical features for 420 patients with overt hyperthyroidism, 30% of which had TAF. At first, the association of these features with TAF was evaluated by classical statistical methods. Then, we developed several TAF prediction models with eight different machine learning classifiers and compared them by performance metrics. The models included ten features that were selected based on their clinical effectuality and importance for model output. Finally, we ranked TAF predictors, elicited from the optimal final model, by the machine learning tehniques.

Results

The best performance metrics prediction model was built with the extreme gradient boosting classifier. It had the reasonable accuracy of 84% and AUROC of 0.89 on the test set. The model confirmed such well-known TAF risk factors as age, sex, hyperthyroidism duration, heart rate and some concomitant cardiovascular diseases (arterial hypertension and conjestive heart rate). We also identified premature atrial contraction and premature ventricular contraction as new TAF predictors. The top five TAF predictors, elicited from the model, included (in order of importance) PAC, PVC, hyperthyroidism duration, heart rate during hyperthyroidism and age.

Conclusions

We developed a machine learning model for TAF prediction. It seems to be the first available analytical tool for TAF risk assessment. In addition, we defined five most important TAF predictors, including premature atrial contraction and premature ventricular contraction as the new ones. These results have contributed to TAF prediction investigation and may serve as a basis for further research focused on TAF prediction improvement and facilitation of thyrotoxic patients’ management.
Age estimation based on Willems method versus country specific model in Saudi Arabia children and adolescents
Authors: Alqerban Ali , Alrashed Muath , Alaskar Ziyad , Alqahtani Khalid
Published: July 2021

Background

The aims of this study were to create a method for estimation of dental age in Saudi children and adolescents based on the Willems model developed using the Belgian Caucasian (BC) reference data and to compare the ability of the two models to predict age in Saudi children.

Methods

Development of the seven lower left permanent mandibular teeth was staged in 1146 panoramic radiographs from healthy Saudi children (605 male, 541 female) without missing permanent teeth and without all permanent teeth fully developed (except third molars). The data were used to validate the Willems BC model and to construct a Saudi Arabian-specific (Willems SA) model. The mean error, mean absolute error, and root mean square error obtained from both validations were compared to quantify the variance in errors in the sample.

Results

The overall mean error for the Willems SA method was 0.023 years (standard deviation, ± 0.55), indicating no systematic underestimation or overestimation of age. For girls, the error using the Willems SA method was significantly lower but still negligible at 0.06 years. A small but statistically significant difference in total mean absolute error (11 days) was found between the Willems BC and Willems SA models when the data were compared independent of sex. The overall mean absolute error for girls was slightly lower for the Willems BC method than for the Willems SA method (1.33 years vs. 1.37 years).

Conclusions

The difference in ability to predict dental age between the Willems BC and Willems SA methods is very small, indicating that the data from the BC population can be used as a reference in the Saudi population.
Variations in hip fracture inpatient care in Japan, Korea, and Taiwan: an analysis of health administrative data
Authors: Kim Hongsoo , Cheng Shou-Hsia , Yamana Hayato , Lee Seyune , Yoon Nan-He , Lin Yi-Chieh , Fushimi Kiyohide , Yasunaga Hideo
Published: July 2021

Background

Little is known about hip fracture inpatient care in East Asia. This study examined the characteristics of patients, hospitals, and regions associated with delivery of hip fracture surgeries across Japan, Korea, and Taiwan. We also analyzed and compared how the resource use and a short-term outcome of the care in index hospitals varied according to factors in the respective health systems.

Methods

We developed comparable, nationwide, individual-level health insurance claims datasets linked with hospital- and regional-level statistics across the health systems using common protocols. Generalized linear multi-level analyses were conducted on length of stay (LOS) and total cost of index hospitalization as well as inpatient death.

Results

The majority of patients were female and aged 75 or older. The standardized LOS of the hospitalization for hip fracture surgery was 32.5 (S.D. = 18.7) days in Japan, 24.7 (S.D. = 12.4) days in Korea, and 7.1 (S.D. = 2.9) days in Taiwan. The total cost per admission also widely varied across the systems. Hospitals with a high volume of hip fracture surgeries had a lower LOS across all three systems, while other factors associated with LOS and total cost varied across countries.

Conclusion

There were wide variations in resource use for hip fracture surgery in the index hospital within and across the three health systems with similar social health insurance schemes in East Asia. Further investigations into the large variations are necessary, along with efforts to overcome the methodological challenges of international comparisons of health system performance.
Indirect costs associated with out-of-country referral for proton therapy: a survey of adult and pediatric patients in Alberta, Canada
Authors: Middleton Jacqueline , Black Karina , Ghosh Sunita , Eisenstat David D. , Patel Samir
Published: July 2021

Background

Patients in Alberta, Canada are referred to the United States (US) for proton treatment. The Alberta Ministry of Health pays for the proton treatment and the cost of flights to and from the United States. This study aimed to determine the out-of-pocket expenses incurred by patients or patients’ families.

Methods

An electronic survey was sent to 59 patients treated with proton therapy between January 2008 and September 2019. Survey questions asked about expenses related to travel to the US and those incurred while staying in the US, reimbursement of expenses, and whether any time away from work was paid or unpaid leave.

Results

Seventeen respondents (response rate, 29%) reported expenses of flights for family members (mean, CAD 1886; range CAD 0–5627), passports/visas and other travel costs (mean, CAD 124; range CAD 0–546), accommodation during travel to the US (mean, CAD 50; range CAD 0–563), food during travel to the US (mean, CAD 89; range CAD 0–338), accommodation in the US (rented home/apartment mean, CAD 7394; range CAD 3075-13,305; hotel mean, CAD 4730; range CAD 3564-5895; other accommodation mean CAD 2660; range CAD 0–13,842), transportation in the US (car mean, CAD 2760; range CAD 0–7649; bus/subway mean, CAD 413; range CAD 246–580), and food in the US (mean, CAD 2443; range 0–6921). Expenses were partially reimbursed or covered by not-for-profit organizations or government agencies for some patients (35%). Patients missed a mean of 59 days of work; accompanying family members missed an average of 34 days. For 29% this time away from work was paid, but unpaid for 71% of respondents.

Conclusions

Multiple factors contributed to the expenses incurred including age of the patient, number of accompanying individuals, available accommodation, mode of transportation within the US, and whether the patient qualified for financial support. Added to this burden is the potential loss of wages for time away from work. The study showed a large variation in indirect costs for each family and supports actively seeking more opportunities for financial support for families with children with cancer.
Relatives’ experiences with abuse and neglect in Norwegian nursing homes. A qualitative study
Authors: Saga Susan , Blekken Lene Elisabeth , Nakrem Sigrid , Sandmoe Astrid
Published: July 2021

Background

Elder abuse in nursing homes (NH) is a widespread and complex problem. Residents’ ability to share their experiences are impeded, due to a high degree of cognitive problems and frailty, and previous studies are thus mainly based on reports from staff. Therefore, we aimed to give voice to the residents by investigating their relatives’ experiences with elder abuse in NH.

Methods

Qualitative individual interviews were conducted with 16 relatives of residents with experience of abuse and/or neglect in NH. Content analysis was used to analyse the data.

Results

Relatives perceived neglect as most pervasive and staff-to-resident psychological abuse as a key problem. Physical abuse was mostly related to resident-to-resident aggression. Relatives perceived elder abuse in NH to be related to low competence among staff, low staffing, poor NH leadership, working cultures characterized by fear and loyalty to employer or co-workers, and a lack of individualized care for the residents. Furthermore, relatives themselves experienced maltreatment from NH, which caused them to suffer stress, anxiety and distrust. Relatives also expressed a need to compensate for lack of care.

Conclusions

Relatives of NH residents who had experienced abuse reported that neglect of basic care and individual rights was predominant and viewed organizational explanations as most important. Relatives perceive themselves as collaborators in care and are emotionally attached to their family member. Therefore, if relatives experience resident abuse or neglect, it inflicts a feeling of being mistreated themselves, particularly if they are not listened to or their notice of abuse on the part of the resident is ignored or trivialized. Including relatives in a committed partnership with NH in care practices is not only a valuable path to reduce the risk of abuse, but it also leads to a more sustainable healthcare with high standards of quality and safety.
tRNA derived fragment (tRF)-3009 participates in modulation of IFN-α-induced CD4+ T cell oxidative phosphorylation in lupus patients
Authors: Geng Guannan , Wang Huijing , Xin Weiwei , Liu Zhe , Chen Jie , Danting Zhang , Han Fei , Ye Shuang
Published: July 2021

Background

Accumulating evidence suggests tRNA-derived fragments (tRFs) play important roles in cellular homeostasis. Here we aimed to explore aberrant expression of tRFs in CD4+ T cells from patients with systemic lupus erythematosus (SLE) and their potential function in the SLE pathogenesis.

Methods

First, small RNA sequencing was performed on CD4+ T cells from four SLE patients and three healthy controls (HCs). Candidate tRFs were then validated in CD4+ T cells from 97 SLE patients and their relevant disease controls using qRT-PCR. Then sequencing was used to investigate the profiles of HC-derived CD4+ T cells transfected with tRF-3009. Lastly, tRF-3009 siRNA or tRF-3009 mimics were transfected into CD4+ T cells with/without IFN-α. Changes in oxygen consumption rate (OCR), ATP, and ROS production were analyzed.

Results

We identified 482 differentially expressed tRFs from SLE CD4+ T cells and chose tRF-3009 for further analysis due to its upregulation and the positive correlations between its expression and SLEDAI, active lupus nephritis and serum IFN-α levels. In vitro, tRF-3009 over-expressing CD4+ T cell profiling and putative analysis linked this product to the type I IFN and oxidative phosphorylation (OXPHOS) pathways. Interestingly, IFN-α is capable of inducing ROS and ATP production in CD4+ T cells, while knockdown of tRF-3009 reversed this process. Overexpression of tRF-3009 in CD4+ T cells alone was sufficient to upregulate OCR, ROS, and ATP production.

Conclusions

Our study is the first to link aberrant tRF expression and SLE. tRF-3009 may participate in metabolic modulation of IFN-α-induced CD4+ T cell OXPHOS in lupus.
Asiatic acid alleviates Ang-II induced cardiac hypertrophy and fibrosis via miR-126/PIK3R2 signaling
Authors: Li Haiyu , Tian Xiaoxu , Ruan Yongjuan , Xing Junhui , Meng Zhe
Published: July 2021

Background

Cardiac hypertrophy is an independent risk factor of many cardiovascular diseases. Studies have demonstrated that microRNA-126 (miR-126) was involved in angiogenesis during physiological and pathological process. However, its role in cardiac hypertrophy has not been known clearly. Our previous study demonstrated that asiatic acid (AA) has obvious protective effect on cardiac hypertrophy. Here, this study aimed to discover the regulatory role of miR-126 and its mechanism in cardiac hypertrophy, and to determine whether AA’s anti-hypertrophy effect is partially miR-126 dependent.

Methods

Male Sprague Dawley rats were AngII infused via osmotic minipumps for 4 weeks and were treated with AA (20 mg/kg/day) by oral gavage. Cardiac hypertrophy was assessed using the echocardiography and histological analysis. In vitro studies,cardiomyocyte and cardiac fibroblasts (CF) were treted with AngII and AngII plus AA. And, the effect of AA on miR-126 and PI3K/AKT signaling pathway was investigated.

Results

Treatment of rats with AA decreased the ratio of heart weight to tibia length and hypertrophy markers. In vitro exprements demonstrated that AA significantly attenuated AngII-induced cardiac growth and cardiac fibroblast collagen expression. Moreover, our results found downregulation of miR-126 and activation of PI3K/AKT signaling pathway in AngII infusion induced cardiac hypertrophy model. It was also determined that miR-126 targets PIK3R2 directly.

Conclusions

AA supplementation upregulated the expression of miR-126 and conferred cardio-protection effect against AngII induced cardiac hypertrophy.
Gastric mucin phenotype indicates aggressive biological behaviour in early differentiated gastric adenocarcinomas following endoscopic treatment
Authors: Song Kai , Yang Qi , Yan Yu , Yu Xiaoyan , Xu Kanlun , Xu Jinghong
Published: July 2021

Background

The distribution of mucin phenotypes and their relationship with clinicopathological features in early differentiated gastric adenocarcinomas in a Chinese cohort are unknown. We aimed to investigate mucin phenotypes and analyse the relationship between mucin phenotypes and clinicopathological features, especially biological behaviours, in early differentiated gastric adenocarcinomas from endoscopic specimens in a Chinese cohort.

Methods

Immunohistochemical staining of CD10, MUC2, MUC5AC, and MUC6 was performed in 257 tissue samples from patients with early differentiated gastric adenocarcinomas. The tumour location, gross type, tumour size, histological type, depth of invasion, lymphovascular invasion, mucosal background and other clinicopathological parameters were evaluated. The relationship between mucin phenotypes and clinicopathological features was analysed with the chi-square test.

Results

The incidences of gastric, gastrointestinal, intestinal and null phenotypes were 21 %, 56 %, 20 and 3 %, respectively. The mucin phenotypes were related to histology classification (P < 0.05). The proportion of the gastric phenotype became greater during the transition from differentiated to undifferentiated (P < 0.05). Complete intestinal metaplasia was higher in the gastric and intestinal phenotypes than in the gastrointestinal phenotype (P < 0.05). Tumours with poorly differentiated adenocarcinoma were mainly of the gastric phenotype, which was significantly higher than that of purely differentiated tubular adenocarcinoma (P < 0.05), and the depth of invasion in the mixed type was deeper (P < 0.05). Neither recurrence nor metastasis was detected.

Conclusions

The mucin phenotype of early-differentiated gastric adenocarcinoma has clinical implications, and the gastric phenotype has aggressive biological behaviour in early differentiated gastric cancers, especially in those with poorly differentiated adenocarcinoma or papillary adenocarcinoma components.
The survival outcome and complication of secondary cytoreductive surgery plus chemotherapy in recurrent ovarian cancer: a systematic review and meta-analysis
Authors: Ding Ting , Tang Dan , Xi Mingrong
Published: July 2021

Objective

The aim of this meta-analysis was to assess the effectiveness and safety of secondary cytoreductive surgery plus chemotherapy (SCS + CT) in recurrent ovarian cancer (ROC). Our secondary purpose was to analyze whether patients could benefit from complete resection.

Methods

We searched EMBASE, MEDLINE, the Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials, from inception to April 2021. We used appropriate scales to assess the risk of bias. Data from included studies that reported median PFS or OS were weighted by individual study sample size, and aggregated for meta-analysis. We calculated the pooled proportion of complications within 30 days after surgery.

Results

We identified 13 articles, including three RCTs and ten retrospective cohort studies. A total of 4572 patients were included, of which 916 patients achieved complete resection, and all patients were comparable at baseline. Compared with chemotherapy alone, SCS + CT significantly improved the PFS (HR = 0.54, 95% CI: 0.43–0.67) and OS (HR = 0.60, 95% CI: 0.44–0.81). Contrary to the results of cohort studies, the meta-analysis of RCTs showed that SCS + CT could not bring OS benefits (HR = 0.93, 95% CI: 0.66–1.3). The subgroup analysis showed the prognostic importance of complete resection. Compared with chemotherapy alone, complete resection was associated with longer PFS (HR = 0.53, 95% CI: 0.45–0.61) and OS (HR = 0.56, 95% CI: 0.39–0.81), while incomplete resection had no survival benefit. Additionally, complete resection could maximize survival benefit compared with incomplete resection (HR = 0.56, 95% CI: 0.46–0.69; HR = 0.61, 95% CI: 0.50–0.75). The pooled proportion for complications at 30 days was 21% (95% CI: 0.12–0.30), and there was no statistical difference in chemotherapy toxicity between the two groups.

Conclusion

The review indicated that SCS + CT based regimens was correlated with better clinical prognosis for patients with recurrent ovarian cancer, but the interpretation of OS should be cautious. The meta-analysis emphasizes the importance of complete resection, suggesting that the potential benefits of prolonging survival may outweigh the disadvantages of any short-term complications associated with surgery.
The Investigational Clinical Center: a clinical-supportive and patient-centered trial unit model. Ten years of experience through normal and pandemic times of a large pediatric trial center in Italy
Authors: Pontrelli Giuseppe , Ciabattini Marco , De Crescenzo Franco , Biondi Isabella , Cocchiola Rossana , Copponi Giorgia , Frillici Claudia , Molinari Francesca , Rocchi Francesca , Simonetti Alessandra , Rossi Paolo , Livadiotti Susanna
Published: July 2021

Evidence-based medicine relies on appropriately designed, conducted and reported clinical trials (CTs) to provide the best proofs of efficacy and safety for pharmacological and non-pharmacological treatments. Modern clinical research features high complexity and requires a high workload for the management of trials-related activities, often hampering physicians’ participation to clinical trials. Dealing with children in clinical research adds complexity: rare diseases, parents or legal guardian reluctance to engage and recruitment difficulties are major reasons of pediatric trials failure.

However, because in pediatrics many treatments are prescribed off-label or are lacking, well-designed clinical trials are particularly needed. Clinical Trial Units (CTUs) are indeed an important asset in the implementation of clinical trials, but their support to investigators is limited to administrative and non-clinical tasks. In this paper we present the model of the Investigational Clinical Center (ICC) of the Bambino Gesù Children’s Hospital in Rome. The ICC includes clinicians supporting the Principal Investigators for clinical management of enrolled patients in compliance of Good Clinical Practice, the legal framework of Clinical Trials. Furthermore, we present 10 years’ experience in pediatric clinical trials and how it has been affected in 2020 by the COVID-19 pandemic. The activity of the ICC has been evaluated according to specific metrics of performance. The ICC model offers a complete support, helping investigators, patients and their families to overcome majority of barriers linked to clinical research, even in time of pandemic. We propose this organization as an innovative model for total-supportive and patient-centered clinical trial implementation.
Genome-wide transcriptomic analysis of the forebrain of postnatal Slc13a4+/− mice
Authors: Harvey Tracey J. , Davila Raul Ayala , Vidovic Diana , Sharmin Sazia , Piper Michael , Simmons David G.
Published: July 2021

Objective

Sulfation is an essential physiological process that regulates the function of a wide array of molecules involved in brain development. We have previously shown expression levels for the sulfate transporter Slc13a4 to be elevated during postnatal development, and that sulfate accumulation in the brains of Slc13a4+/− mice is reduced, suggesting a role for this transporter during this critical window of brain development. In order to understand the pathways regulated by cellular sulfation within the brain, we performed a bulk RNA-sequencing analysis of the forebrain of postnatal day 20 (P20) Slc13a4 heterozygous mice and wild-type litter mate controls.

Data description

We performed an RNA transcriptomic based sequencing screen on the whole forebrain from Slc13a4+/− and Slc13a4+/+mice at P20. Differential expression analysis revealed 90 differentially regulated genes in the forebrain of Slc13a4+/− mice (a p-value of 0.1 was considered as significant). Of these, 55 were upregulated, and 35 were downregulated in the forebrain of heterozygous mice. Moreover, when we stratified further with a ± 1.2 fold-change, we observed 38 upregulated, and 16 downregulated genes in the forebrain of heterozygous mice. This resource provides a useful tool to interrogate which pathways may require elevated sulfate levels to drive normal postnatal development of the brain.
White matter hyperintensities in autopsy-confirmed frontotemporal lobar degeneration and Alzheimer’s disease
Authors: Desmarais Philippe , Gao Andrew F. , Lanctôt Krista , Rogaeva Ekaterina , Ramirez Joel , Herrmann Nathan , Stuss Donald T. , Black Sandra E. , Keith Julia , Masellis Mario
Published: July 2021

Background

We aimed to systematically describe the burden and distribution of white matter hyperintensities (WMH) and investigate correlations with neuropsychiatric symptoms in pathologically proven Alzheimer’s disease (AD) and frontotemporal lobar degeneration (FTLD).

Methods

Autopsy-confirmed cases were identified from the Sunnybrook Dementia Study, including 15 cases of AD and 58 cases of FTLD (22 FTLD-TDP cases; 10 FTLD-Tau [Pick’s] cases; 11 FTLD-Tau Corticobasal Degeneration cases; and 15 FTLD-Tau Progressive Supranuclear Palsy cases). Healthy matched controls (n = 35) were included for comparison purposes. Data analyses included ANCOVA to compare the burden of WMH on antemortem brain MRI between groups, adjusted linear regression models to identify associations between WMH burden and neuropsychiatric symptoms, and image-guided pathology review of selected areas of WMH from each pathologic group.

Results

Burden and regional distribution of WMH differed significantly between neuropathological groups (F5,77 = 2.67, P’ = 0.029), with the FTLD-TDP group having the highest mean volume globally (8032 ± 8889 mm3) and in frontal regions (4897 ± 6163 mm3). The AD group had the highest mean volume in occipital regions (468 ± 420 mm3). Total score on the Neuropsychiatric Inventory correlated with bilateral frontal WMH volume (β = 0.330, P = 0.006), depression correlated with bilateral occipital WMH volume (β = 0.401, P < 0.001), and apathy correlated with bilateral frontal WMH volume (β = 0.311, P = 0.009), all corrected for the false discovery rate. Image-guided neuropathological assessment of selected cases with the highest burden of WMH in each pathologic group revealed presence of severe gliosis, myelin pallor, and axonal loss, but with no distinguishing features indicative of the underlying proteinopathy.

Conclusions

These findings suggest that WMH are associated with neuropsychiatric manifestations in AD and FTLD and that WMH burden and regional distribution in neurodegenerative disorders differ according to the underlying neuropathological processes.
Surgical treatment of esophageal atresia with lower tracheoesophageal fistula in an extremely preterm infant (510 g, 25 + 5 weeks): a case report
Authors: Feng Xiaoyan , Thomé Ulrich , Stepan Holger , Lacher Martin , Wagner Richard
Published: July 2021

Background

The surgical management of esophageal atresia in extreme-low-birth-weight infants (< 1000 g) is challenging. We report on an extreme-low-birth-weight infant who was extremely preterm (510 g, 25 + 5 weeks) and of prenatally unknown Gross type C esophageal atresia.

Case presentation

After resuscitation and intubation, the tracheoesophageal fistula was closed on the first day of life in the neonatal intensive care unit via an extrapleural approach using a titanium clip. On the sixth day of life, the Caucasian child was extubated. To minimize the operative trauma in the initial neonatal period, we prolonged gastrostomy placement until the 22nd day of life (weight 725 g). At the age of 3 months (weight 2510 g), thoracoscopic esophageal anastomosis was performed. The postoperative course was unremarkable. During the further clinical course, eight esophageal dilations were necessary. Currently, the patient swallows without difficulties at the age of 4 years and thrives well [15 kg (Percentile 28); 100 cm (Percentile 24)].

Conclusions

Our case shows that minimized postnatal surgical trauma with primary tracheoesophageal fistula closure at the bedside, delayed gastrostomy, and minimally invasive esophageal repair after substantial weight gain (> 2.5 kg) is a good strategy for esophageal atresia/tracheoesophageal fistula in extreme-low-birth-weight infants.
On the effects of spatial resolution on effective distance measurement in digital landscapes
Authors: Murekatete Rachel Mundeli , Shirabe Takeshi
Published: July 2021

Background

Connectivity is an important landscape attribute in ecological studies and conservation practices and is often expressed in terms of effective distance. If the cost of movement of an organism over a landscape is effectively represented by a raster surface, effective distances can be equated with the cost-weighted distance of least-cost paths. It is generally recognized that this measure is sensitive to the grid’s cell size, but little is known if it is always sensitive in the same way and to the same degree and if not, what makes it more (or less) sensitive. We conducted computational experiments with both synthetic and real landscape data, in which we generated and analyzed large samples of effective distances measured on cost surfaces of varying cell sizes derived from those data. The particular focus was on the statistical behavior of the ratio—referred to as ‘accuracy indicator’—of the effective distance measured on a lower-resolution cost surface to that measured on a higher-resolution cost surface.

Results

In the experiment with synthetic cost surfaces, the sample values of the accuracy indicator were generally clustered around 1, but slightly greater with the absence of linear sequences (or barriers) of high-cost or inadmissible cells and smaller with the presence of such sequences. The latter tendency was more dominant, and both tendencies became more pronounced as the difference between the spatial resolutions of the associated cost surfaces increased. When two real satellite images (of different resolutions with fairly large discrepancies) were used as the basis of cost estimation, the variation of the accuracy indicator was found to be substantially large in the vicinity (1500 m) of the source but decreases quickly with an increase in distance from it.

Conclusions

Effective distances measured on lower-resolution cost surfaces are generally highly correlated with—and useful predictors of—effective distances measured on higher-resolution cost surfaces. This relationship tends to be weakened when linear barriers to dispersal (e.g., roads and rivers) exist, but strengthened when moving away from sources of dispersal and/or when linear barriers (if any) are detected by other presumably more accessible and affordable sources such as vector line data. Thus, if benefits of high-resolution data are not likely to substantially outweigh their costs, the use of lower resolution data is worth considering as a cost-effective alternative in the application of least-cost path modeling to landscape connectivity analysis.
Vitamin K alleviates bone calcium loss caused by Salmonella Enteritidis through carboxylation of osteocalcin
Authors: Liu Yaojun , Mosenthin Rainer , Zhao Lihong , Zhang Jianyun , Ji Cheng , Ma Qiugang
Published: July 2021

Background

The present study aimed at evaluating the effect of vitamin K (VK) supplementation on bone health of laying hens challenged by Salmonella Enteritidis.

Methods

A total of 80 32-week-old double negative salmonella-free brown-egg laying hens were randomly assigned to 4 treatments with 20 replicates each (1 bird per replicate) according to a 2 × 2 factorial design with 2 dietary VK supplementation levels [0 mg/kg (VK0) vs 2 mg/kg VK (VK2) and 2 challenge treatments [Salmonella Enteritidis (SE) vs physiological saline solution (PS)]. During the last 3 days of week 43 of age, birds of both VK treatments were either orally challenged with 1.0 mL suspension of 109 cfu/mL S. Enteritidis daily or received the same volume of PS.

Results

The laying rate, daily egg mass, tibia strength, CT, cOC and cOC/(cOC + ucOC) of VK2 treatment increased (P < 0.05) in contrast to VK0, however, the medullary area and ucOC of VK2 treatment decreased (P < 0.05) in contrast to VK0. Mortality, medullary area, serum Ca content of SE treatments increased (P < 0.05) in contrast to PS treatments. In both SE treatments, the decrease (P < 0.05) in birds’ tibia strength was associated with higher (P < 0.05) Ca levels in serum. There is an interaction (P < 0.05) between SE challenge and VK levels with regard to tibia strength and serum Ca levels. At week 42, serum CT was positively correlated with cOC (R = 0.99, P = 0.009); at week 44, tibia strength was positively correlated with BMD (R = 0.95, P = 0.045), but negatively correlated with medullary area (R = − 0.98, P = 0.018).

Conclusions

VK (2 mg/kg) supplementation to diets of laying hens can enhance bone strength under challenge situations with Salmonella Enteritidis. Medullary area has proven to be a sensitive biomarker for bone calcium loss caused by SE infection.
Anticipatory governance for newcomers: lessons learned from the UK, the Netherlands, Finland, and Korea
Authors: Heo Kyungmoo , Seo Yongseok
Published: July 2021

Anticipatory governance (AG) is defined as a “system of systems” that employs foresight to create future plans and execute relevant actions. Recently, various frameworks of AG have been introduced, but there is little practical information available for newcomers on how to do this. This research conducted a framework-based comparative country analysis to provide lessons learned for newcomers in the sphere of foresight-linked AG. By evaluating the AG levels of Finland, the UK, the Netherlands, and Korea, we found that the consequences of foresight-linked AGs were different in each country. At the same time, we also identified a common denominator, namely, future receptivity, a “human or people” capacity to accept and understand the value of foresight. Instead of temporary system changes or organizational modifications, future receptivity is an underlying element for newcomers to overcome lingering short-termism and facilitate the coordination of stakeholders concerning foresight. In conclusion, we suggest ways to promote future receptivity for newcomers. First, the government should educate and train the public and government officials to promote future literacy and future proficiency. Second, the government should provide a process for public participation such as nationwide networking that enables the public to influence their diverse future images over foresight outcomes.
Three dimensional printed models of the airway for preoperative planning of open Laryngotracheal surgery in children: Surgeon's perception of utility
Authors: Wasserzug Oshri , Fishman Gadi , Carmel-Neiderman Narin , Oestreicher-Kedem Yael , Saada Maher , Dadia Solomon , Golden Eran , Berman Philip , Handzel Ophir , DeRowe Ari
Published: July 2021

Background

Preoperative planning of open laryngotracheal surgery is important for achieving good results. This study examines the surgeon's perception of the importance of using life size 3D printed models of the pediatric airway on surgical decision making.

Methods

Life-size three-dimensional models of the upper airway were created based on CT images of children scheduled for laryngotracheal-reconstruction and cricotracheal resection with anastomosis. Five pediatric airway surgeons evaluated the three-dimensional models for determining the surgical approach, incision location and length, graft length, and need for single or double-stage surgery of seven children (median age 4.4 years, M:F ratio 4:3). They rated the importance of the three-dimensional model findings compared to the direct laryngoscopy videos and CT findings for each domain on a validated Likert scale of 1–5.

Results

The mean rating for all domains was 3.6 ± 0.63 (“moderately important” to “very important”), and the median rating was 4 (“very important”). There was full agreement between raters for length of incision and length of graft. The between-rater agreement was 0.608 (“good”) for surgical approach, 0.585 (“moderate”) for incision location, and 0.429 (“moderate”) for need for single- or two-stage surgery.

Conclusion

Patient-specific three-dimensional printed models of children's upper airways were scored by pediatric airway surgeons as being moderately to very important for preoperative planning of open laryngotracheal surgery. Large–scale, objective outcome studies are warranted to establish the reliability and efficiency of these models.

Graphical Abstract
Eliciting the public preferences for pharmaceutical subsidy in Iran: a discrete choice experiment study
Authors: Delpasand Mansoor , Olyaaeemanesh Alireza , Jaafaripooyan Ebrahim , Abdollahiasl Akbar , Davari Majid , Kazemi Karyani Ali
Published: July 2021

Background

Deciding on pharmaceutical subsidy is regarded as a challenging issue for healthcare policymakers in Iran in most times. Public preferences, rarely attended in Iran, could be invaluable for including a particular drug in the list of subsidized medications.

Objectives

The current study aims to elicit the public preferences to develop an evidence-based decision-making framework for entering a drug into the list of subsidies in Iran.

Methods

Discrete Choice Experiment (DCE) was employed to elicit the public preferences. Around 34 attributes were identified based on the systematic review and interview with 51 experts. By holding an expert panel, 7 attributes were finalized, namely: the survival after treatment, quality of life after treatment (QoL), alternative treatment, age group of the target population, cost burden for the government, disease severity, and drug manufacturer country. Next, 1224 households were selected for the survey in the city of Tehran, using random cluster sampling. Data were analyzed using conditional logit model.

Results

The survival after treatment (β = 1.245; SE = 0.053) and cost burden for the government (β = − 0.140; SE = 0.050) had the highest and lowest priority, respectively, in the preferences for allocating subsidy to a drug. In developed region, unlike the other two regions, the level of domestic drug production (β =− 0.302; SE = 0.073) was inversely associated with preferences toward allocating subsidy to a drug. In contrast to other districts, those living in district number one (β = 2.053; SE = 0.138) gave the highest value to promoting the QoL after treatment.

Conclusions

It is suggested that policymakers pay more attention to attributes such as effectiveness and alternative treatment when developing an evidence-based framework for entering a drug into the list of subsidies. This study highlighted the public belief in the government’s subsidy for medicines, provided that, this results in an increased survival and QoL.
Epidemiology of sudden death in organized school sports in Japan
Authors: Hosokawa Yuri , Murata Yuki , Stearns Rebecca L. , Suzuki-Yamanaka Miwako , Kucera Kristen L. , Casa Douglas J.
Published: July 2021

Background

Nearly half of the sudden deaths documented in Japanese middle and high school occurred during school organized sport activities. However, no study to date has calculated the incidence rates of these deaths by sport. Therefore, this study aimed to describe the epidemiology of sudden death in organized school sports in Japan.

Methods

Data submitted to Japan Sport Council (JSC) Injury and Accident Mutual Aid Benefit System between 2005 and 2016 were retrieved from JSC website for analysis (n = 1137). Case information on fatal incidents that occurred during organized school sports in middle and high school students were extracted for analysis (n = 198). Descriptive statistics about activity type, sex, sport, cause of death, and presence of on-site trained medical personnel were calculated using frequencies and proportions. Sudden death incidence rates were expressed per 100,000 athlete-years with 95% confidence intervals (CI).

Results

The overall incidence rate of sports-related death was 0.38 deaths per 100,000 athlete-years (95%CI = 0.30, 0.45). Only three cases (2%) reported having trained medical personnel on-site at the time of death. Most deaths were in male student athletes (n = 149/162, 92%), with 7.5 times greater fatality rate in male compared to female student athletes (incidence rate ratio, 7.5; 95%CI = 4.43, 13.22). Baseball (n = 25/162, 15.4%), judo (n = 24/162, 14.8%), soccer/futsal (n = 20/162, 12.3%), and basketball (n = 18/162, 11.1%) accounted for 53.7% of deaths. Accounting for the number of participants in the respective sport, the three highest average incident rates of death were reported in rugby (4.59 deaths per 100,000 athlete-years, 95%CI = 2.43, 6.75), judo (3.76 deaths per 100,000 athlete-years, 95%CI = 1.58, 5.93), and baseball (0.59 deaths per 100,000 athlete-years, 95%CI = 0.38, 0.79). The top three causes of death were sudden cardiac arrest (n = 68/162, 42.0%), head trauma (n = 32/162, 19.8%), and heat related injury (n = 25/162, 15.4%).

Conclusions

In conclusion, the highest rates of sports-related death among Japanese student athletes were observed in the following: rugby, male athletes, and during practices. The leading cause of death was sudden cardiac arrest.