bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining variation in the quality of instructional interaction across teacher-directed activities in head start classrooms
Authors: Kook Janna Fuccillo , Greenfield Daryl B
Published: August 2020

High-quality instructional interaction, in which teachers engage children in conversations that support the development of higher order thinking skills, conceptual understanding, and advanced language skills, is associated with positive outcomes for preschool children. Classrooms serving low-income preschoolers tend to have lower levels of this kind of instruction and yet research suggests that it may be particularly important for these children. The aim of this study was to examine variation in the quality of instructional interactions in Head Start classrooms across different types of teacher-directed activities. Twenty-four Head Start classrooms were observed across four activity types (circle time, math activities, science activities, and storybook reading), and quality of instructional interaction was assessed using the Instructional Support domain of the Classroom Assessment Scoring System. Science activities and storybook reading were associated with higher quality instructional interaction compared with circle time, controlling for teacher characteristics and classroom contextual factors. Math activities were not associated with higher quality instructional interaction compared with circle time. Science and storybook reading may be natural entry points for supporting higher quality instructional interaction in Head Start classrooms.
Compact 3D-Printed Active Flexible Needle for Percutaneous Procedures
Authors: Varnamkhasti Zahra K. , Konh Bardia
Published: August 2020

Needle-based intervention has been a popular procedure for diagnosis and treatment of many types of cancer. However, poor needle placement and tumor visualization have been among the challenges resulting in poor clinical outcomes. There has been a lot of progress in medical imaging technology, but the structure of surgical needles has remained unchanged. This work presents a wire-driven 3D steerable, 3D-printed active needle for improved guidance inside the tissue toward the target. The needle is manipulated by 3 embedded tendons via a programmed motorized control unit. Feasibility tests in a tissue phantom showed an average 3D needle angular deflection of about 11°. This amount of angular deflection is expected to assist prostate brachytherapy via a curvilinear approach.
Prognostic Significance of the Modified Glasgow Prognostic Score in Patients With Pancreatic Cancer: A Meta-Analysis
Authors: Fu Wen , Wang Kun , Yan Shan , Wang Xie , Tang Bo , Chang Jiang , Wang Ran , Wu Tao
Published: August 2020

Background:

The prognostic value of the modified Glasgow prognostic score (mGPS) in patients with pancreatic cancer is controversial, based on previous studies. Therefore, this meta-analysis aimed to explore the relationship between mGPS and prognosis in pancreatic cancer.

Methods:

The databases PubMed, Web of Science, Embase, and the Cochrane Library were searched to identify eligible studies. Hazard ratios (HRs) and 95% confidence intervals (CIs) were used to estimate the associations between mGPS score and survival outcomes.

Results:

A total of 26 studies with 5198 patients were included in this meta-analysis. In a pooled analysis, elevated mGPS predicted poorer overall survival (OS; HR = 1.98, 95% CI, 1.65-2.37, P < .001). In addition, elevated mGPS was also significantly associated with worse progression-free survival (PFS), disease-free survival (DFS), and cancer-specific survival (CSS; HR = 1.95, 95% CI, 1.36-2.80, P < .001). Subgroup analyses confirmed a significant association between mGPS and survival outcomes.

Conclusions:

Our meta-analysis demonstrated that high mGPS was correlated to worse OS, PFS, DFS, and CSS in patients with pancreatic cancer. Therefore, mGPS could be employed as an effective prognostic factor for pancreatic cancer in clinical practice.
The Bias of Individuals (in Crowds): Why Implicit Bias Is Probably a Noisily Measured Individual-Level Construct
Authors: Connor Paul , Evers Ellen R. K.
Published: August 2020

Payne, Vuletich, and Lundberg’s bias-of-crowds model proposes that a number of empirical puzzles can be resolved by conceptualizing implicit bias as a feature of situations rather than a feature of individuals. In the present article we argue against this model and propose that, given the existing evidence, implicit bias is best understood as an individual-level construct measured with substantial error. First, using real and simulated data, we show how each of Payne and colleagues’ proposed puzzles can be explained as being the result of measurement error and its reduction via aggregation. Second, we discuss why the authors’ counterarguments against this explanation have been unconvincing. Finally, we test a hypothesis derived from the bias-of-crowds model about the effect of an individually targeted “implicit-bias-based expulsion program” within universities and show the model to lack empirical support. We conclude by considering the implications of conceptualizing implicit bias as a noisily measured individual-level construct for ongoing implicit-bias research. All data and code are available at https://osf.io/tj8u6/ .
What determines instant messaging communication? Examining the impact of person- and situation-level factors on IM responsiveness
Authors: Dogruel Leyla , Schnauber-Stockmann Anna
Published: August 2020

Acknowledging that the way mobile communication is used is shaped by socially negotiated social norms, this study examined the factors that impact instant messaging (IM) communication at the person and situation levels using the experience sampling method (ESM). We measured how the characteristics at the person level (i.e., availability and responsiveness preferences), contextual factors (i.e., location and copresence of others), and message-related attributes (i.e., sender and chat type) impact users’ responsiveness in IM communication. The study empirically investigated a sample of 90 smartphone users who completed 820 ESM protocols regarding their use of the messenger service WhatsApp. The results of the multilevel analyses revealed that users’ responsiveness in IM communication is affected by person- and situation-level factors, but the latter factors were found to have a much stronger impact. The effect of specific influential factors is discussed in detail.
Media Narratives About Concussions: Effects on Parents’ Intention to Inform Their Children About Concussions
Authors: Tallapragada Meghnaa , Cranmer Gregory A.
Published: August 2020

This study examined the effects of media narratives about concussions on parent’s intentions to inform their children about concussions. A randomized experiment of 600 parents whose children play football in middle school or high school were presented with one of the five narrative conditions or the control condition (where parents read a brochure). Results indicate that parents who read the narrative shared from the perspective of a high school football player, a parent, a coach, and a Center for Disease Control and Prevention researcher induced negative emotions, and those exposed to the narratives from the perspective of a high school football player and a parent also experienced a sense of identification and thereby reduced counterargument. Negative emotions and a reduced counterargument influenced intentions of these parents to inform their children of the dangers and risks of playing football and prompted them to read information on sports-related concussions. The results of this study have implications for communities and organizations seeking to motivate parents to engage in informative conversations with their children about the dangers and risks associated with playing football including concussions.
Lag-Screw Osteosynthesis in Thoracolumbar Pincer Fractures
Authors: Auerswald Marc , Messer-Hannemann Philipp , Sellenschloh Kay , Wahlefeld Jan , Püschel Klaus , Araujo Sven Hirschfeld , Morlock Michael M. , Schulz Arndt P. , Huber Gerd
Published: August 2020

Study Design:

Biomechanical.

Objective:

This study evaluates the biomechanical properties of lag-screws used in vertebral pincer fractures at the thoracolumbar junction.

Methods:

Pincer fractures were created in 18 bisegmental human specimens. The specimens were assigned to three groups depending on their treatment perspective, either bolted, with the thread positioned in the cortical or cancellous bone, or control. The specimens were mounted in a servo-hydraulic testing machine and loaded with a 500 N follower load. They were consecutively tested in 3 different conditions: intact, fractured, and bolted/control. For each condition 10 cycles in extension/flexion, torsion, and lateral bending were applied. After each tested condition, a computed tomography (CT) scan was performed. Finally, an extension/flexion fatigue loading was applied to all specimens.

Results:

Biomechanical results revealed a nonsignificant increase in stiffness in extension/flexion of the fractured specimens compared with the intact ones. For lateral bending and torsion, the stiffness was significantly lower. Compared with the fractured specimens, no changes in stiffness due to bolting were discovered. CT scans showed an increasing fracture gap during axial loading both in extension/flexion, torsion, and lateral bending in the control specimens. In bolted specimens, the anterior fragment was approximated, and the fracture gap nullified. This refers to both the cortical and the cancellous thread positions.

Conclusion:

The results of this study concerning the effect of lag-screws on pincer fractures appear promising. Though there was little effect on stiffness, CT scans reveal a bony contact in the bolted specimens, which is a requirement for bony healing.
The Impact of Vertebral End Plate Lesions on the Radiological Outcome in Oblique Lateral Interbody Fusion
Authors: Chung Nam-Su , Lee Han-Dong , Jeon Chang-Hoon
Published: August 2020

Study Design:

Retrospective case-control study.

Objectives:

Vertebral end plate (EP) lesions include Modic changes, Schmorl’s nodes, EP erosion, EP sclerosis, and so on. While previous studies have mostly focused on the association between vertebral EP lesions and low back pain, few studies evaluated the influence of vertebral EP lesions on the radiological outcomes in lumbar interbody fusion.

Methods:

This study included a total of 125 operated disc levels from 86 consecutive patients who underwent a 1- or 2-level oblique lateral interbody fusion (OLIF) and had more than 1-year regular follow-up. The presence of vertebral EP lesions, changes in disc heights/angle, cage subsidence, and fusion grade were examined. The associations between vertebral EP lesions and radiological parameters were analyzed.

Result:

The presence of Modic changes, Schmorl’s node, EP cartilage erosion, and EP sclerosis were found in 72 (57.6%), 26 (20.8%), 31 (24.8%), and 44 (35.2%) disc levels, respectively. The mean anterior disc height increased from 6.9 ± 3.8 mm to 13.1 ± 2.7 mm ( P < .001) and the mean segmental angle increased from 2.9° ± 5.8° to 9.2° ± 4.8° ( P < .001) at the last follow-up. The overall fusion rate was 98.4% (123/125) and cage subsidence rate was 7.2% (9/125). All radiological parameters and cage subsidence rate were not different regardless of vertebral EP lesions.

Conclusions:

Vertebral EP lesions did not affect the overall radiological outcome in 1- or 2-level OLIF. These results come from the stable contact between lateral cage and peripheral rim of vertebral EP.
Sleep-related breathing disorders and pulmonary hypertension
Authors: Adir Yochai , Humbert Marc , Chaouat Ari
Published: August 2020

Sleep-related breathing disorders (SBDs) include obstructive apnoea, central apnoea and sleep-related hypoventilation. These nocturnal events have the potential to increase pulmonary arterial pressure (PAP) during sleep but also in the waking state. “Pure” obstructive sleep apnoea syndrome (OSAS) is responsible for a small increase in PAP whose clinical impact has not been demonstrated. By contrast, in obesity hypoventilation syndrome (OHS) or overlap syndrome (the association of chronic obstructive pulmonary disease (COPD) with obstructive sleep apnoea (OSA)), nocturnal respiratory events contribute to the development of pulmonary hypertension (PH), which is often severe. In the latter circumstances, treatment of SBDs is essential in order to improve pulmonary haemodynamics.

Patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) are at risk of developing SBDs. Obstructive and central apnoea, as well as a worsening of ventilation–perfusion mismatch, can be observed during sleep. There should be a strong suspicion of SBDs in such a patient population; however, the precise indications for sleep studies and the type of recording remain to be specified. The diagnosis of OSAS in patients with PAH or CTEPH should encourage treatment with continuous positive airway pressure (CPAP). The presence of isolated nocturnal hypoxaemia should also prompt the initiation of long-term oxygen therapy. These treatments are likely to avoid worsening of PH; however, it is prudent not to treat central apnoea and Cheyne–Stokes respiration (CSR) with adaptive servo-ventilation in patients with chronic right-heart failure because of a potential risk of serious adverse effects from such treatment.

In this review we will consider the current knowledge of the consequences of SBDs on pulmonary haemodynamics in patients with and without chronic respiratory disease (group 3 of the clinical classification of PH) and the effect of treatments of respiratory events during sleep on PH. The prevalence and consequences of SBDs in PAH and CTEPH (groups 1 and 4 of the clinical classification of PH, respectively), as well as therapeutic options, will also be discussed.
Characteristics and reference ranges of CD4+T cell subpopulations among healthy adult Han Chinese in Shanxi Province, North China
Authors: Niu Hong-Qing , Zhao Xiang-Cong , Li Wei , Xie Jian-Fang , Liu Xiao-Qing , Luo Jing , Zhao Wen-Peng , Li Xiao-Feng
Published: August 2020

Background

Immunophenotyping of blood lymphocytes is an essential tool to evaluate the immune function of patients with immunodeficiency or autoimmunity. Predominately identified CD4+T cell subsets, Th1, Th2, Th17, as well as regulatory T (Treg) cells, play crucial roles in several immunological and pathological conditions. Considering the variations in cell counts among populations and ethnicities, specific CD4+T cell subset reference values need to be locally established to enable meaningful comparisons and accurate data interpretation in clinical and research settings. Therefore, the aim of this study was to establish distributions and reference ranges for blood CD4+T cell subpopulations in age- and sex-balanced healthy adults of a Han Chinese population in Shanxi Province, North China.

Methods

Peripheral blood CD4+T cell subsets were examined in 150 healthy volunteers (75 males, 75 females) aged 20–70 years with a four-color FACSCalibur flow cytometer.

Results

Reference value percentages (absolute counts, cells/μl) were defined as 95% of the population for cell types as follows: CD4+T, 23.78–51.07 (360–1127); Th1, 0.43–39.62 (2.64–276.21); Th2, 0.27–3.57 (1.80–27.14); Th17, 0.22–2.62 (1.10–19.54); and Treg, 2.17–7.94 (13.47–64.58). The ranges for the Th1:Th2 and Th17:Treg ratios were 0.59–52.37 and 0.04–0.76, respectively. Notably, a significant increase was observed in the values of Treg cells in older individuals, and the numbers of Treg cells in females also tended to decrease when compared to those in males. Therefore, we established the distribution and reference range of CD4+T cell subsets based on age and sex, demonstrating the lowest values of Treg cells in younger females.

Conclusions

Collectively, our data provide population-, age-, and sex-specific distributions and reference ranges of circulating CD4+T cell subpopulations, which can be adopted to guide clinical decisions and interpretation of immunophenotyping data in the Han Chinese population in Taiyuan, Shanxi Province, China. In addition, the low expression of peripheral Treg cells in younger females may be associated with the predisposition of females to autoimmune diseases.
Pseudonajide peptide derived from snake venom alters cell envelope integrity interfering on biofilm formation in Staphylococcus epidermidis
Authors: Schneider Rafael , Primon-Barros Muriel , Von Borowski Rafael Gomes , Chat Sophie , Nonin-Lecomte Sylvie , Gillet Reynald , Macedo Alexandre José
Published: August 2020

Background

The increase in bacterial resistance phenotype cases is a global health problem. New strategies must be explored by the scientific community in order to create new treatment alternatives. Animal venoms are a good source for antimicrobial peptides (AMPs), which are excellent candidates for new antimicrobial drug development. Cathelicidin-related antimicrobial peptides (CRAMPs) from snake venoms have been studied as a model for the design of new antimicrobial pharmaceuticals against bacterial infections.

Results

In this study we present an 11 amino acid-long peptide, named pseudonajide, which is derived from a Pseudonaja textilis venom peptide and has antimicrobial and antibiofilm activity against Staphylococcus epidermidis. Pseudonajide was selected based on the sequence alignments of various snake venom peptides that displayed activity against bacteria. Antibiofilm activity assays with pseudonajide concentrations ranging from 3.12 to 100 μM showed that the lowest concentration to inhibit biofilm formation was 25 μM. Microscopy analysis demonstrated that pseudonajide interacts with the bacterial cell envelope, disrupting the cell walls and membranes, leading to morphological defects in prokaryotes.

Conclusions

Our results suggest that pseudonajide’s positives charges interact with negatively charged cell wall components of S. epidermidis, leading to cell damage and inhibiting biofilm formation.
Two cases of idiopathic steroid-resistant nephrotic syndrome complicated with thrombotic microangiopathy
Authors: Nishi Kentaro , Sato Mai , Ogura Masao , Okutsu Mika , Ishikura Kenji , Kamei Koichi
Published: August 2020

Background

Thrombotic microangiopathy (TMA) is a histopathological entity associated with microangiopathic hemolytic anemia, thrombocytopenia, and end-organ ischemic damage. Although TMA is caused by various diseases, there have been few reports regarding children with idiopathic nephrotic syndrome (NS) and TMA. Here we report two 1-year-old infants with steroid-resistant NS (SRNS) who presented with severe hypertension, acute kidney injury (AKI), and TMA.

Case presentation

The diagnosis of NS was complicated with anemia, AKI, and hypertension. Maximum blood pressure was 150/70 mmHg in Case 1 and 136/86 mmHg in Case 2. There was no thrombocytopenia during their clinical course in both cases. Renal biopsy showed the features of TMA, including endothelial cell swelling, capillarectasia or marked mesangiolysis, along with mesangial proliferation in Case 1 and TMA with minor glomerular abnormalities in Case 2. Hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, and secondary TMA other than that caused by hypertension were excluded. Oral prednisolone therapy, frequent infusion of albumin and diuretics, and multiple anti-hypertensive drugs were initiated. Blood pressure was controlled after 6 and 7 days from initiation of multiple anti-hypertensive drugs and lisinopril was added due to persistent mild proteinuria and mild hypertension after improvement of renal function in both cases. Proteinuria resolved completely 4 months after admission with daily oral prednisolone for 4 weeks followed by alternative daily oral prednisolone for 4 weeks in Case 1. Proteinuria resolved completely 10 months after admission with initial prednisolone treatment for 4 weeks followed by cyclosporine A and intravenous methylprednisolone pulse therapy in Case 2. The follow-up biopsy showed no TMA findings in both patients. Because the patient in Case 1 subsequently developed frequent relapsing NS, cyclosporine A was commenced after the second biopsy and he did not have any flares for 2 years. Renal function was normal in Case 1 and mildly decreased in Case 2 at last follow-up (creatinine-eGFR of 136.2 mL/min/cm2 in Case 1 and 79.5 mL/min/cm2 in Case 2).

Conclusion

Severe hypertension and AKI can be signs of TMA in patients with SRNS. Strict anti-hypertensive therapy might improve renal outcomes.
The value of a vaginal sample for detecting PAMG-1 (Partosure®) in women with a threatened preterm delivery (the MAPOSURE Study): protocol for a multicenter prospective study
Authors: Marie Emilie , Ducarme Guillaume , Boivin Marion , Badon Virginie , Pelerin Hélène , Le Thuaut Aurélie , Lamoureux Zeineb , Riche Valéry-Pierre , Winer Norbert , Thubert Thibault , Dochez Vincent
Published: August 2020

Background

Threatened preterm delivery (TPD) is the leading cause of inpatient admissions during pregnancy. The ability to predict the risk of imminent preterm delivery is thus a major priority in obstetrics. The aim of our study is to assess the diagnostic performance of the test to detect the placental alpha microglobulin 1 (PAMG-1) for the prediction of delivery within 7 days in women with TPD.

Methods

This is a prospective multicenter diagnostic study. Inclusion criteria are singleton pregnancy, gestational age between 24 + 0 and 33 + 6 weeks inclusive, cervical measurement 25 mm or less assessed by transvaginal ultrasound (with or without uterine contractions), clinically intact membranes and cervical dilatation < 3 cm assessed by digital examination.

According to the current protocol, when a women presents with TPD and the diagnosis is confirmed by transvaginal ultrasound, a vaginal sample to test for genital infection is performed. At the same time, the midwife will perform the PartoSure® test. To perform this analysis, a sample of cervicovaginal secretions is taken with the vaginal swab furnished in the test kit.

The primary outcome is the specificity of the PartoSure® test of women who gave birth more than 7 days after their hospitalization for TPD. The secondary outcomes are the sensitivity, PPV, and NPV of the Partosure® test and the factors associated with false positives (with a univariate logistic regression model).

Starting with the hypothesis of an anticipated specificity of 89%, if we want to estimate this specificity with a confidence interval of ± 5%, we will require 151 women who do not give birth within 7 days. We therefore decided to include 400 women over a period of two years to have a larger number of events (deliveries within 7 days).

Discussion

The different tests already used such as fetal fibronectin and phIGFBP-1, are not sufficiently relevant to recommend their use in daily practice. The different studies of PAMG-1 described above thus provide support for the use of this substance, tested by PartoSure®. Nonetheless, other larger studies are necessary to validate its use in daily practice and our study could answer this question.

Trial registration

NCT03401255 (January 15, 2018)
Prevalence and associated factors of visual impairment among adults at Debre Berhan town, North Shewa, Ethiopia
Authors: Assefa Natnael Lakachew , Admas Addisu Wondifraw , Adimasu Nebiyat Feleke
Published: August 2020

Background

Visual impairment refers to presenting distance visual acuity worse than 6/18 in the worst eye. It remains a global challenge that greatly affects the mobility, social participation and the quality of life of the people. This study was aimed to determine the prevalence and associated factors of visual impairment among adults aged ≥ 18 years.

Methods

A community-based cross-sectional study was conducted at Debre Berhan town. Systematic random sampling method was employed to select the study participants from adult’s aged ≥18 years. Data was collected by interview with a pre-tested semi structured questionnaire. Both anterior and posterior segment ocular examinations were done by Optometrists and Ophthalmologist. After all ocular examinations adult’s aged ≥18 years with presenting Visual acuity of < 6/18 in the worst eye were considered as visually impaired. Multivariate logistic regression was used to identify the determinant factors and p value less than 0.05 was considered as statistically significant.

Results

A total of 416 participants were enrolled in the study with a 98.6% response rate. The prevalence of visual impairment among adults aged ≥ 18 years was 16.8% (95% CI, 13.5–20.2%). Among the overall prevalence of visually impaired adults 27 (6.49%) had bilateral VI and 43 (10.34%) had monocular VI. Aged > 64 years (AOR = 12.18, 95%CI: 4.47–33.20), illiterates AOR = 3.02, 95% CI: 1.36–6.72), previous eye trauma (AOR = 4.44, 95% CI: 1.64–12.04), family size > 5 (AOR: 4.44, 95% CI: 1.43–13.75) and family history of eye problem (AOR = 7.02, 95% CI: 1.95–25.22) had statistically significant association with visual impairment.

Conclusions

Prevalence of visual impairment among adults was found to be a significant public health problem. Older age, illiterates, previous eye trauma, large family size and family history eye problem were positively associated with visual impairment.
Correction to: Implementation of nationwide screening of pregnant women for HTLV-1 infection in Japan: analysis of a repeated cross-sectional study
Authors: Yonemoto Naohiro , Suzuki Shunji , Sekizawa Akihiko , Hoshi Shinichi , Sagara Yoko , Itabashi Kazuo
Published: August 2020

An amendment to this paper has been published and can be accessed via the original article.
Validity of the self-reported five-part questionnaire as an assessment of generalized joint hypermobility in early pregnancy
Authors: Schlager Angela , Ahlqvist Kerstin , Pingel Ronnie , Nilsson-Wikmar Lena , Olsson Christina B. , Kristiansson Per
Published: August 2020

Background

The assessment of generalized joint hypermobility is difficult due to differences in classification methods and in the performance of joint mobility assessment. The primary aim was to evaluate the validity of the self-reported five-part questionnaire, 5PQ, for identifying generalized joint hypermobility using the Beighton score as reference test. The secondary aim was to describe how joint angles measured in degrees included in the Beighton score varied in different cut-off levels in the self-reported 5PQ and the Beighton score.

Methods

A cross-sectional validity study with a total of 301 women in early pregnancy, mean age of 31 years, were included in the study. The participants answered the self-reported 5PQ before the joint angles were measured. To standardize the joint mobility measurement, a structural protocol was used. The sensitivity, specificity, receiver operating characteristic curve, area under curve, positive- and negative predictive value, positive likelihood ratio and Spearman’s rank correlation between the self-reported 5PQ ≥ 2 and the Beighton score ≥ 5 were used as main outcome measures in the validity analyses. Joint angles, measured in degrees, were calculated with means in relation to different cut-off levels.

Results

There was moderate correlation between the self-reported 5PQ and the Beighton score. The highest combined sensitivity, 84.1%, as well as specificity, 61.9%, was on 5PQ cut-off level ≥ 2, with a 38% false-positive rate, a moderate area under curve, a low positive predictive value and likelihood ratio, and a high negative predictive value. The odds of a self-reported 5PQ, cut-off level ≥ 2, among women with generalized joint hypermobility, Beighton ≥5, was low indicating a low post-test probability. The mean for all joint angles measured in degrees increased with increased cut-off levels, both in the Beighton score and in the self-reported 5PQ. However, there was a significant variation for each cut-off level.

Conclusions

There is uncertainty in identifying generalized joint hypermobility in young women using the self-reported 5PQ with a cut-off level of ≥2 when the Beighton score ≥ 5 is used as the reference test. The strength of the self-reported 5PQ is to rule-out women without generalized joint hypermobility.
How to predict early clinical outcomes and evaluate the quality of primary total knee arthroplasty: a new scoring system based on lower-extremity angles of alignment
Authors: Chen Ziming , Deng Zhantao , Li Qingtian , Chen Junfeng , Ma Yuanchen , Zheng Qiujian
Published: August 2020

Background

A method that can accurately predict the outcome of surgery can give patients timely feedback. In addition, to some extent, an objective evaluation method can help the surgeon quickly summarize the patient’s surgical experience and lessen dependence on the long wait for follow-up results. However, there was still no precise tool to predict clinical outcomes of total knee arthroplasty (TKA). This study aimed to develop a scoring system to predict clinical results of TKA and then grade the quality of TKA.

Methods

We retrospectively reviewed 98 primary TKAs performed between April 2013 and March 2017 to determine predictors of clinical outcomes among lower-extremity angles of alignment. Applying multivariable linear-regression analysis, we built Models (i) and (ii) to predict detailed clinical outcomes which were evaluated using the Knee Society Score (KSS). Multivariable logistic-regression analysis was used to establish Model (iii) to predict probability of getting a good clinical outcome (PGGCO) which was evaluated by Knee Injury and Osteoarthritis Outcome Score (KOOS) score. Finally, we designed a new scoring system consisting of 3 prediction models and presented a method of grading TKA quality. Thirty primary TKAs between April and December 2017 were enrolled for external validation.

Results

We set up a scoring system consisting of 3 models. The interpretations of Model (i) and (ii) were good (R2 = 0.756 and 0.764, respectively). Model (iii) displayed good discrimination, with an area under the curve (AUC) of 0.936, and good calibration according to the calibration curve. Quality of surgery was stratified as follows: “A” = PGGCO ≥0.8, “B” = PGGCO ≤0.6 but < 0.8, and “C” = PGGCO < 0.6. The scoring system performed well in external validation.

Conclusions

This study first developed a validated, evidence-based scoring system based on lower-extremity angles of alignment to predict early clinical outcomes and to objectively evaluate the quality of TKA.
Comparison of Retzius-sparing robot-assisted laparoscopic radical prostatectomy vs standard robot-assisted radical prostatectomy: a meta-analysis
Authors: Jiang Yu-Li , Zheng Gao-Feng , Jiang Ze-Peng , Zhen-Li  , Zhou Xie-Lai , Zhou Jin , Ye Chun-Hua , Wang Kang-Er
Published: August 2020

Background

To compare the postoperative continence and clinical outcomes of Retzius-sparing robot-assisted laparoscopic radical prostatectomy (RS-RALP) with non-RS RALP for patients with prostate cancer.

Methods

We searched PUBMED, EMBASE and the Cochrane Central Register from 1999 to 2019 for studies comparing RS-RALP to non-RS RALP for the treatment of prostate cancer. We used RevMan 5.2 to pool the data.

Results

A total of eight studies involving 1620 patients were included in our meta-analysis. No significant difference was found in positive surgical margins (PSM), bilateral nerve-sparing, postoperative hernia, complications, blood loss, or operative time. Postoperative continence was better with RS-RALP compared with non-RS RALP (OR = 1.02, OR: 2.86, 95% CI 1.94–4.20, p < 0.05).

Conclusions

RS-RALP had a better recovery of postoperative continence than non-RS RALP. The perioperative outcomes were comparable for the two methods.
The allelopathic, adhesive, hydrophobic and toxic latex of Euphorbia species is the cause of fairy circles investigated at several locations in Namibia
Authors: Meyer J. J. Marion , Schutte Christiaan E. , Hurter Jan W. , Galt Nicole S. , Degashu Petunia , Breetzke Greg , Baranenko Denis , Meyer Nicole L.
Published: August 2020

Background

In this multidisciplinary study we present soil chemical, phytochemical and GIS spatial patterning evidence that fairy circles studied in three separate locations of Namibia may be caused by Euphorbia species.

Results

We show that matrix sand coated with E. damarana latex resulted in faster water-infiltration rates. GC-MS analyses revealed that soil from fairy circles and from under decomposing E. damarana plants are very similar in phytochemistry. E. damarana and E. gummifera extracts have a detrimental effect on bacteria isolated from the rhizosphere of Stipagrostis uniplumis and inhibit grass seed germination. Several compounds previously identified with antimicrobial and phytotoxic activity were also identified in E. gummifera. GIS analyses showed that perimeter sizes and spatial characteristics (Voronoi tessellations, distance to nearest neighbour ratio, pair correlation function and L-function) of fairy circles are similar to those of fairy circles co-occurring with E. damarana (northern Namibia), and with E. gummifera (southern Namibia). Historical aerial imagery showed that in a population of 406 E. gummifera plants, 134 were replaced by fairy circles over a 50-year period. And finally, by integrating rainfall, altitude and landcover in a GIS-based site suitability model, we predict where fairy circles should occur. The model largely agreed with the distribution of three Euphorbia species and resulted in the discovery of new locations of fairy circles, in the far southeast of Namibia and part of the Kalahari Desert of South Africa.

Conclusions

It is proposed that the allelopathic, adhesive, hydrophobic and toxic latex of E. damarana, E. gummifera, and possibly other species like E. gregaria, is the cause of the fairy circles of Namibia in the areas investigated and possibly in all other areas as well.
Relationship between hemoglobin and insulin-like growth factor-1 in children and adolescents with idiopathic short stature
Authors: Zhao Qianqian , Zhang Mei , Ji Baolan , Chu Yuntian , Pan Hui , Yan Wenhua , Ban Bo
Published: August 2020

Background

The growth hormone/insulin-like growth factor-1 (GH/IGF-1) axis is critical for the regulation of children’s growth and development. Serum IGF-1 concentrations are usually low in individuals with idiopathic short stature (ISS) despite normal endogenous GH levels, and the associated underlying factors are unknown. This study aimed to explore the relationship between IGF-1 and hemoglobin (Hb) in children with ISS.

Methods

A cross-sectional analysis was performed including 178 children and adolescents with ISS who were enrolled from March 2013 to February 2019. The related clinical and biochemical parameters were evaluated for each patient. Univariate analysis, smooth curve fitting and multivariate piecewise linear regression were performed.

Result

The mean levels of IGF-1 standard deviation scores (SDS) and Hb were − 0.99 (− 1.60 - -0.09) and 131.81 ± 9.36 g/L, respectively. Univariate analysis displayed a significant positive association between Hb and IGF-1 SDS (P < 0.001). After adjusting for potential confounding factors, the positive relationship between Hb and IGF-1 SDS remained (P = 0.001). Furthermore, there was an inflection point for Hb in the curve. In a multivariate piecewise linear regression model, IGF-1 SDS was significantly positively associated with Hb when Hb concentrations were lower than 145 g/L (B 0.05; 95% CI 0.02, 0.07;P < 0.001). However, IGF-1 SDS decreased with increasing Hb levels when Hb concentrations were greater than 145 g/L (B -0.15; 95% CI -0.23, − 0.06;P = 0.001).

Conclusion

This study demonstrated that Hb is associated with IGF-1 in Chinese children and adolescents with ISS. The levels of IGF-1 increased with the elevation of Hb, but when the concentration of Hb exceeded a certain range, with the increase of Hb, IGF-1 decreased instead.
Impact of gastroesophageal reflux on longitudinal lung function and quantitative computed tomography in the COPDGene cohort
Authors: Baldomero Arianne K. , Wendt Chris H. , Petersen Ashley , Gaeckle Nathaniel T. , Han MeiLan K. , Kunisaki Ken M. ,   for the COPDGene Investigators
Published: August 2020

Rationale

Gastroesophageal reflux disease (GERD) is a common comorbidity in chronic obstructive pulmonary disease (COPD) and has been associated with increased risk of acute exacerbations, hospitalization, emergency room visits, costs, and quality-of-life impairment. However, it remains unclear whether GERD contributes to the progression of COPD as measured by lung function or computed tomography.

Objective

To determine the impact of GERD on longitudinal changes in lung function and radiographic lung disease in the COPDGene cohort.

Methods

We evaluated 5728 participants in the COPDGene cohort who completed Phase I (baseline) and Phase II (5-year follow-up) visits. GERD status was based on participant-reported physician diagnoses. We evaluated associations between GERD and annualized changes in lung function [forced expired volume in 1 s (FEV1) and forced vital capacity (FVC)] and quantitative computed tomography (QCT) metrics of airway disease and emphysema using multivariable regression models. These associations were further evaluated in the setting of GERD treatment with proton-pump inhibitors (PPI) and/or histamine-receptor 2 blockers (H2blockers).

Results

GERD was reported by 2101 (36.7%) participants at either Phase I and/or Phase II. GERD was not associated with significant differences in slopes of FEV1(difference of − 2.53 mL/year; 95% confidence interval (CI), − 5.43 to 0.37) or FVC (difference of − 3.05 mL/year; 95% CI, − 7.29 to 1.19), but the odds of rapid FEV1decline of ≥40 mL/year was higher in those with GERD (adjusted odds ratio (OR) 1.20; 95%CI, 1.07 to 1.35). Participants with GERD had increased progression of QCT-measured air trapping (0.159%/year; 95% CI, 0.054 to 0.264), but not other QCT metrics such as airway wall area/thickness or emphysema. Among those with GERD, use of PPI and/or H2blockers was associated with faster decline in FEV1(difference of − 6.61 mL/year; 95% CI, − 11.9 to − 1.36) and FVC (difference of − 9.26 mL/year; 95% CI, − 17.2 to − 1.28).

Conclusions

GERD was associated with faster COPD disease progression as measured by rapid FEV1decline and QCT-measured air trapping, but not by slopes of lung function. The magnitude of the differences was clinically small, but given the high prevalence of GERD, further investigation is warranted to understand the potential disease-modifying role of GERD in COPD pathogenesis and progression.

Clinical trials registration

NCT00608764.
Establishment and characterization of breast cancer organoids from a patient with mammary Paget’s disease
Authors: Pan Bo , Zhao Dongyi , Liu Yaqian , Li Na , Song Chen , Li Ning , Li Xuelu , Li Man , Zhao Zuowei
Published: August 2020

Background

Mammary Paget’s disease (MPD) is an uncommon cutaneous intraepithelial malignancy with ulceration of the nipple or areola. Its pathogenesis and genomic mutation remain largely unknown and no cell lines are established from primary tumors.

Methods

We collected surgical tumor specimens from a 65-year-old Chinese woman diagnosed with MPD and established patient-derived breast cancer (BC) organoids from MPD using organoid culture technology.

Results

We successfully propagated BC organoids from a patient with MPD for more than 6 months. The organoids were cultured for long-term expansion without any change in spherical organoid morphology. Besides, the spherical organoid morphology did not change when they underwent cryopreservation after resuscitation. The H&E staining and immunohistochemistry analyses showed the similar morphological and histological features of the organoids compared with their paired original BC tissues. The organoids retained positive expression of breast cancer biomarkers: estrogen receptor, progesterone receptor, antigen Ki-67 and negative expression of human epidermal growth factor receptor 2. We also showed that MPD organoids recapitulated the unique genomic landscape including copy number alterations, mutational load, mutational signatures and cancer gene mutations by whole genome sequencing. In situ senescence-associated acid beta galactosidase assay confirmed senescence phenomenon existed in the process of organoids culture and there was no significant difference in the proportion of senescent organoids after organoid passage and resuscitation.

Conclusions

Our results suggested that an effective platform for ex vivo BC organoids from MPD patients could be used to explore clinicopathological and genomic characteristics of these patients.
Stocking pattern for anti-malarial medications among proprietary patent medicine vendors in Akinyele Local Government Area, Ibadan, Nigeria
Authors: Kodaolu Mary Y. , Fagbamigbe Adeniyi F. , Ajayi IkeOluwapo O.
Published: August 2020

Background

Policymakers have recognized that proprietary patent medicine vendors (PPMVs) can provide an opportunity for effective scaling up of artemisinin-based combination therapy (ACT) since they constitute a major source of malaria treatment in Nigeria. This study was designed to determine the stocking pattern for anti-malarial medications, knowledge of the recommended anti-malarial medicine among PPMVs in Akinyele Local Government Area (LGA) of Oyo State, Nigeria and their perception on ways to improve PPMV adherence to stocking ACT medicines.

Methods

A cross-sectional survey was conducted among 320 PPMVs using a mixed method of data collection. Survey respondents were consecutively selected as a complete listing of all the PPMVs was not available. A pretested interviewer-administered questionnaire was used to collect quantitative data and two focus group discussions (FGD) were conducted among PPMVs using a pretested FGD guide.

Results

Most PPMVs stocked artemether-lumefantrine (90.9%), dihydroartemisinin-piperaquine (5.3%) and artesunate-amodiaquine (2.8%). Drugs contrary to the policy, which included sulfadoxine-pyrimethamine, chloroquine, quinine, halofantrine, artesunate, and artemether were stocked by 93.8, 22.8, 0.6, 1.3, 6.6, and 7.8% of the PPMVs, respectively. Most PPMVs (96.3%) had good knowledge of artemether-lumefantrine as the first-line treatment for malaria and 2.8% had good knowledge of artesunate-amodiaquine as the alternate treatment for malaria. The major factors influencing stocking decision were government recommendations (41.3%) and consumer demand (40.30%).

Conclusion

Stocking of artemisinin-based combinations was high among PPMVs, although they also stocked and dispensed other anti-malarial drugs and this has serious implications for drug resistance development. The PPMVs had considerable knowledge of the recommended treatment for uncomplicated malaria and stocking decisions were overwhelmingly driven by consumer demand. However, there is a need for more enlightenment on discontinuation of government-banned anti-malarial drugs.
Quality of life in people with transsexuality after surgery: a systematic review and meta-analysis
Authors: Eftekhar Ardebili Mehrdad , Janani Leila , Khazaei Zaher , Moradi Yousef , Baradaran Hamid Reza
Published: August 2020

Background

Several reports have demonstrated varying results on the quality of life (QoL) of the transgender population. Therefore, the aim of this study was to conduct a systematic review and meta-analysis about the quality of life (QoL) of individuals during the post transsexual surgery period.

Methods

We searched major biomedical electronic databases, including Scopus, Google Scholar, Psychological Information Database (PsycInfo), Web of Science, PubMed, Excerpta Medica dataBASE (EMBASE), and ProQuest, for all relevant literature published in English up to December 2019. The included papers required to be cross sectional studies that reported quality of life in people with transsexuality post surgery. After selecting eligible studies, 2 authors extracted data of each study independently and resolved any inconsistency by consensus with the third reviewer. The risk of bias was assessed by 2 independent research experts by the Newcastle-Ottawa Scale (NOS).

Results

In this study, out of 497 articles extracted from the initial investigation, 8 articles with 1099 patients were ultimately selected for meta-analysis. The pooled mean of quality of life in transsexual individuals was obtained to be 70.45 (95%CI 55.87–85.03) and 59.17 (95%CI 48.59–69.74), based on World Health Organization Quality of Life (WHOQoL-BREF) and The 36-item short form of the Medical Outcomes Study questionnaire (SF36), respectively. Also, the results of the subgroup analysis for the weighted mean quality of life in male to female and female to male showed that the mean quality of life in female to male was 57.54 (95%CI 42.24–72.84) and it was 62.47 (95%CI 45.94–79.00) in male to female, based on SF36 questionnaire. Moreover, the weighted mean quality of life in female to male was 69.99 (95%CI 43.76, 96.23) and it was 70.65 (95%CI 53.11, 88.19) in male to female, based on WHOQoL-BREF questionnaire.

Conclusion

The results of this systematic review may support the approaches to transsexuality that facilitates sex reassignment. In this review, the means of quality of life after surgery were not compared to the means of quality of life before surgery or even before hormonal therapy which was due to inadequate number of primary studies.
Measuring quality of life in Duchenne muscular dystrophy: a systematic review of the content and structural validity of commonly used instruments
Authors: Powell Philip A. , Carlton Jill , Woods Helen Buckley , Mazzone Paolo
Published: August 2020

Duchenne muscular dystrophy (DMD) is an inherited X-linked neuromuscular disorder. A number of questionnaires are available to assess quality of life in DMD, but there are concerns about their validity. This systematic review aimed to appraise critically the content and structural validity of quality of life instruments for DMD. Five databases (EMBASE, MEDLINE, CINAHL, PsycINFO, and Cochrane Library) were searched, with supplementary searches in Google Scholar. We included articles with evidence on the content and/or structural validity of quality of life instruments in DMD, and/or instrument development. Evidence was evaluated against the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. Fifty five articles featured a questionnaire assessing quality of life in DMD. Forty instruments were extracted and 26 underwent assessment. Forty-one articles contained evidence on content or structural validity (including 37 development papers). Most instruments demonstrated low quality evidence and unsatisfactory or inconsistent validity in DMD, with the majority not featuring direct validation studies in this population. Only KIDSCREEN received an adequate rating for instrument design and a satisfactory result for content validity based on its development, yet, like the majority of PROMs, the measure has not been directly validated for use in DMD. Further research is needed on the validity of quality of life instruments in DMD, including content and structural validity studies in this population.