bluuebunny/crossref_metadata_2025 huggingface dataset:
Otitis media outcomes of a combined 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine and 13-valent pneumococcal conjugate vaccine schedule at 1-2-4-6 months: PREVIX_COMBO, a 3-arm randomised controlled trial
Authors: Leach Amanda Jane , Mulholland Edward Kim , Santosham Mathuram , Torzillo Paul John , McIntyre Peter , Smith-Vaughan Heidi , Wilson Nicole , Arrowsmith Beth , Beissbarth Jemima , Chatfield Mark D. , Oguoma Victor M. , Morris Peter Stanley
Published: March 2021

Background

Aboriginal children living in Australian remote communities are at high risk of early and persistent otitis media, hearing loss, and social disadvantage. Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) are the primary pathogens. We compared otitis media outcomes in infants randomised to either a combination of Synflorix™ (PHiD-CV10, with protein D of NTHi) and Prevenar13™ (PCV13, with 3, 6A, and 19A), with recommended schedules for each vaccine alone. We previously reported superior broader overall immunogenicity of the combination schedule at 7 months, and early superiority of PHiD-CV10 compared to PCV13 at 4 months.

Methods

In an open-label superiority trial, we randomised (1:1:1) Aboriginal infants at 28 to 38 days of age, to either Prevenar13™ (P) at 2–4-6 months (_PPP), Synflorix™ (S) at 2–4-6 months (_SSS), or Synflorix™ at 1–2-4 months plus Prevenar13™ at 6 months (SSSP). Ears were assessed using tympanometry at 1 and 2 months, combined with otoscopy at 4, 6, and 7 months. A worst ear diagnosis was made for each child visit according to a severity hierarchy of normal, otitis media with effusion (OME), acute otitis media without perforation (AOMwoP), AOM with perforation (AOMwiP), and chronic suppurative otitis media (CSOM).

Results

Between September 2011 and September 2017, 425 infants were allocated to _PPP(143), _SSS(141) or SSSP(141). Ear assessments were successful in 96% scheduled visits. At 7 months prevalence of any OM was 91, 86, and 90% in the _PPP, _SSS, and SSSP groups, respectively. There were no significant differences in prevalence of any form of otitis media between vaccine groups at any age. Combined group prevalence of any OM was 43, 57, 82, 87, and 89% at 1, 2, 4, 6, and 7 months of age, respectively. Of 388 infants with ear assessments at 4, 6 and 7 months, 277 (71.4%) had OM that met criteria for specialist referral; rAOM, pOME, or CSOM.

Conclusions

Despite superior broader overall immunogenicity of the combination schedule at 7 months, and early superiority of PHiD-CV10 compared to PCV13 at 4 months, there were no significant differences in prevalence of otitis media nor healthy ears throughout the first months of life.

Trial registration

ACTRN12610000544077 registered 06/07/2010 and ClinicalTrials.govNCT01174849 registered 04/08/2010.
Mental health screening amongst police officers: factors associated with under-reporting of symptoms
Authors: Marshall Ruth E. , Milligan-Saville Josie , Petrie Katherine , Bryant Richard A. , Mitchell Philip B. , Harvey Samuel B.
Published: March 2021

Background

Mental health screening in the workplace aims to identify employees who are becoming symptomatic, in order to provide timely support and evidence-based interventions to those affected. Given the stigma associated with mental illness, accurate disclosure of mental health symptoms cannot be assumed. The present study sought to investigate factors associated with the accurate reporting of mental health symptoms amongst police officers.

Methods

A total of 90 serving police officers completed identical mental health screening surveys, one administered by the employer and the other anonymously by an independent organisation. Responses were then linked to compare differences in the number and severity of mental health symptoms reported on each questionnaire.

Results

Comparisons of matched self-report scores indicated that employees under-reported symptoms of mental health disorders when completing screening administered by their employer, with only 76.3% of symptoms declared. Under-reporting occurred regardless of gender and symptom type. Less senior staff (p = 0.05) and those with the most severe post-traumatic stress disorder and common mental disorder symptoms (p = 0.008) were significantly more likely to under-report symptoms.

Conclusions

Employer-administered mental health screening is not able to accurately capture all mental health symptoms amongst first responders. The fact that the severity of symptoms predicted the level of under-reporting means that simple changes to cut-off values cannot correct this problem.
Relationship between oral health-related knowledge, attitudes, practice, self-rated oral health and oral health-related quality of life among Chinese college students: a structural equation modeling approach
Authors: Zheng Suge , Zhao Lili , Ju Nianting , Hua Tiantian , Zhang Shunhua , Liao Shengkai
Published: March 2021

Background

This study aimed to evaluate the associations among oral health-related knowledge, attitudes, practice (KAP), self-rated oral health and oral health-related quality of life (OHRQoL) among Chinese college students.

Methods

Of the 2000 participants, 1751 (87.55%) students answered an online questionnaire between October 2019 and January 2020. The questionnaire included demographic characteristics, knowledge, attitudes, and practice related to oral health, self-rated oral health, and OHRQoL. Structural equation modelling was applied to assess the associations among study variables.

Results

Among the total students, oral health-related knowledge and attitudes were satisfactory, while the oral health practice was not optimistic. The final model showed satisfactory fitness to the data. Oral health knowledge was associated with attitudes directly and positively. Attitudes toward oral health had a direct and positive effect on practice. Oral health knowledge had an indirect effect on practice through attitudes. Oral health practice was directly associated with self-rated oral health. Oral health knowledge, practice, and self-rated oral health all affected OHRQoL directly and positively, while attitudes had a direct negative impact on OHRQoL.

Conclusions

OHRQoL was influenced by oral health knowledge, attitudes, practice, and self-rated oral health. Our findings support the KAP theory. Limitations of the KAP model were also found.
The necessity of examining patients’ social behavior and teaching behavior change theories: curricular innovations induced by the COVID-19 pandemic
Authors: McKinley Danette Waller , Ghaffarifar Saeideh
Published: March 2021

During the COVID-19 pandemic, despite many widespread calls for social distancing, recommendations have not been followed by some people and the high rate of non-compliance has significantly affected lives all around the world. It seems that the rate of non-compliance with the recommendations among medical students has been as high as the rest of the other youth. In the time that students are removed from clinical environments and most physician teachers are strained in providing services to patients, medical students can be trained in interdisciplinary behavior change counseling programs and they can be employed in delivering virtual consultations to the patients referred to medical centers.

In this quick review, we provide an argument regarding the importance of integrating the topic of patients’ social history into the undergraduate medical curriculum and the necessity of teaching theories of behavior change to medical students. Hypotheses are proposed that focus on the importance of integrating behavioral and social sciences into the medical curriculum and to teach theories or models of behavior change to students. Health professions educators can design and implement interventions to teach hypothesized models of behavioral change to medical students and evaluate the effectiveness of those interventions. The impacts of such educational interventions on increasing people’s compliance with recommendations to improve public health can be evaluated as well.
Impact of COVID-19 pandemic on dental education: online experience and practice expectations among dental students at the University of Jordan
Authors: Hattar Susan , AlHadidi Abeer , Sawair Faleh A. , Alraheam Islam Abd , El-Ma’aita Ahmad , Wahab Fouad Kadim
Published: March 2021

Background

The quarantine associated with the COVID-19 pandemic forced dental schools to suspend their clinical training and to shift to distant learning methods. The aim of this study is to investigate the impact of quarantine on the self-perceived preparedness of dental graduates and to explore the efficacy of online education from students’ perspectives.

Methods

The questionnaire distributed to dental students comprised of two main sections. The first part covered the online education experience, and the second part measured the level of self-perceived preparedness for a range of cognitive, communication and professional skills.

Results

The survey yielded a response rate of 72%. The majority of students (77%) agreed that they missed educational experiences as a result of the lockdown. More than half of them felt less motivated to follow-up with distant e-learning and believed that online assessment is not a good method for evaluation. A high percentage of the students (66%) thought that online group discussions had a positive value while 67% preferred online lectures compared to theatre lectures. Majority of students particularly 5th year (78.7%) (p < 0.001) stated that the quarantine increased their collaboration with their colleagues. According to 87% of students, the experience most negatively affected was their clinical training. In general, students showed satisfactory self-perceived preparedness related to a range of attributes and professional skills.

Conclusions

The data showed that students partially appreciated the online system, whereas they did not consider it a substitute for face to face clinical practice. The overall self-perceived preparedness level was promising; however students had reservations regarding independent practice following graduation.
‘We always find things to learn from.’ Lessons from the implementation of the global maternal sepsis study on research capacity: a qualitative study
Authors: Compaoré Rachidatou , Brizuela Vanessa , Khisa Anne M. , Gómez Alejandra López , Baguiya Adama , Bonet Mercedes , Thorson Anna , Gitau Evelyn , Kouanda Seni
Published: March 2021

Background

Research capacity strengthening could be an indirect outcome of implementing a research project. The objective of this study was to explore the ability of the global maternal sepsis study (GLOSS), implemented in 52 countries, to develop and strengthen sexual and reproductive health research capacity of local participants in low- and middle- income participating countries.

Methods

We carried out a qualitative study employing grounded theory in sixteen countries in Africa and Latin America. We used inductive and deductive methods through a focus group discussion and semi-structured interviews for the emergence of themes. Participants of the focus group discussion (n = 8) were GLOSS principal investigators (PIs) in Latin America. Interviewees (n = 63) were selected by the country GLOSS PIs in both Africa and Latin America, and included a diverse sample of participants involved in different aspects of study implementation. Eighty-two percent of the participants were health workers. We developed a conceptual framework that took into consideration data obtained from the focus group and refined it based on data from the interviews.

Results

Six themes emerged from the data analysis: recognized need for research capacity, unintended effects of participating in research, perceived ownership and linkage with the research study, being just data collectors, belonging to an institution that supports and fosters research, and presenting study results back to study implementers. Research capacity strengthening needs were consistently highlighted including involvement in protocol development, training and technical support, data analysis, and project management. The need for institutional support for researchers to conduct research was also emphasised.

Conclusion

This study suggests that research capacity strengthening of local researchers was an unintentional outcome of the large multi-country study on maternal sepsis. However, for sustainable research capacity to be built, study coordinators and funders need to deliberately plan for it, addressing needs at both the individual and institutional level.
Towards an integrated animal health surveillance system in Tanzania: making better use of existing and potential data sources for early warning surveillance
Authors: George Janeth , Häsler Barbara , Komba Erick , Sindato Calvin , Rweyemamu Mark , Mlangwa James
Published: March 2021

Background

Effective animal health surveillance systems require reliable, high-quality, and timely data for decision making. In Tanzania, the animal health surveillance system has been relying on a few data sources, which suffer from delays in reporting, underreporting, and high cost of data collection and transmission. The integration of data from multiple sources can enhance early detection and response to animal diseases and facilitate the early control of outbreaks. This study aimed to identify and assess existing and potential data sources for the animal health surveillance system in Tanzania and how they can be better used for early warning surveillance. The study used a mixed-method design to identify and assess data sources. Data were collected through document reviews, internet search, cross-sectional survey, key informant interviews, site visits, and non-participant observation. The assessment was done using pre-defined criteria.

Results

A total of 13 data sources were identified and assessed. Most surveillance data came from livestock farmers, slaughter facilities, and livestock markets; while animal dip sites were the least used sources. Commercial farms and veterinary shops, electronic surveillance tools like AfyaData and Event Mobile Application (EMA-i) and information systems such as the Tanzania National Livestock Identification and Traceability System (TANLITS) and Agricultural Routine Data System (ARDS) show potential to generate relevant data for the national animal health surveillance system. The common variables found across most sources were: the name of the place (12/13), animal type/species (12/13), syndromes (10/13) and number of affected animals (8/13). The majority of the sources had good surveillance data contents and were accessible with medium to maximum spatial coverage. However, there was significant variation in terms of data frequency, accuracy and cost. There were limited integration and coordination of data flow from the identified sources with minimum to non-existing automated data entry and transmission.

Conclusion

The study demonstrated how the available data sources have great potential for early warning surveillance in Tanzania. Both existing and potential data sources had complementary strengths and weaknesses; a multi-source surveillance system would be best placed to harness these different strengths.
Quantification of IgY to Erysipelothrix rhusiopathiae in serum from Swedish laying hens
Authors: Wattrang Eva , Eriksson Helena , Albihn Ann , Dalgaard Tina Sørensen
Published: March 2021

Background

Erysipelas, caused by Erysipelothrix rhusiopathiae (ER), is an important emerging disease in free-range and organic egg-production. The aim of the present study was to assess if quantification of ER specific IgY titers may aid the understanding of erysipelas in commercial laying hens. The methodology was validated with sequentially collected sera from experimentally ER infected SPF-chickens and subsequently applied on sera from Swedish commercial laying hens collected during and after outbreaks of erysipelas or collected at slaughter from healthy hens housed in furnished cages, barn production or in organic production (with outdoor access).

Results

In experimentally infected SPF-chickens, titers to ER were significantly increased approximately one week after infection while IgY to ER in uninfected age-matched controls remained low. Also chickens infected with low doses of ER, not displaying clinical signs of disease and with low recovery of ER in blood samples showed high titers of IgY to ER. For laying hens during and after erysipelas outbreaks the majority of samples were considered positive for antibodies to ER with a large variation in levels of IgY titers to ER between individuals. For healthy laying hens at slaughter all samples were deemed positive for antibodies to ER. An influence of flock on levels of IgY titers to ER was observed for both healthy hens and hens during erysipelas outbreaks. For healthy laying hens at slaughter no influence of the housing systems included in the study, history of erysipelas outbreaks at the farm or vaccination on levels of IgY titers to ER was noticed.

Conclusions

Taken together, these results show that high numbers of commercial laying hens showed high IgY titers to ER, comparable to those elicited by experimental ER infection, indicating that ER or bacteria that raises antibodies that cross-react with ER are common in this environment.
Correction to: PGC-1α regulates airway epithelial barrier dysfunction induced by house dust mite
Authors: Saito Tsutomu , Ichikawa Tomohiro , Numakura Tadahisa , Yamada Mitsuhiro , Koarai Akira , Fujino Naoya , Murakami Koji , Yamanaka Shun , Sasaki Yusaku , Kyogoku Yorihiko , Itakura Koji , Sano Hirohito , Takita Katsuya , Tanaka Rie , Tamada Tsutomu , Ichinose Masakazu , Sugiura Hisatoshi
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.
CDCA8 as an independent predictor for a poor prognosis in liver cancer
Authors: Shuai Yu , Fan Erxi , Zhong Qiuyue , Chen Qiying , Feng Guangyong , Gou Xiaoxia , Zhang Guihai
Published: March 2021

Background

Human cell division cycle associated 8 (CDCA8) a key regulator of mitosis, has been described as a potential prognostic biomarker for a variety of cancers, such as breast, colon and lung cancers. We aimed to evaluate the potential role of CDCA8 expression in the prognosis of liver cancer by analysing data from The Cancer Genome Atlas (TCGA).

Methods

The Wilcoxon rank-sum test was used to compare the difference in CDCA8 expression between liver cancer tissues and matched normal tissues. Then, we applied logistic regression and the Wilcoxon rank-sum test to identify the association between CDCA8 expression and clinicopathologic characteristics. Cox regression and the Kaplan–Meier method were used to examine the clinicopathologic features correlated with overall survival (OS) in patients from the TCGA. Gene set enrichment analysis (GSEA) was performed to explore possible mechanisms of CDCA8 according to the TCGA dataset.

Results

CDCA8 expression was higher in liver cancer tissues than in matched normal tissues. Logistic regression and the Wilcoxon rank-sum test revealed that the increased level of CDCA8 expression in liver cancer tissues was notably related to T stage (OR = 1.64 for T1/2 vs. T3/4), clinical stage (OR = 1.66 for I/II vs. III/IV), histologic grade (OR = 6.71 for G1 vs. G4) and histological type (OR = 0.24 for cholangiocarcinoma [CHOL] vs. hepatocellular carcinoma [LIHC]) (all P-values < 0.05). Kaplan–Meier survival analysis indicated that high CDCA8 expression was related to a poor prognosis in liver cancer (P = 2.456 × 10−6). Univariate analysis showed that high CDCA8 expression was associated with poor OS in liver cancer patients, with a hazard ratio (HR) of 1.85 (95% confidence interval [CI]: 1.47–2.32; P = 1.16 × 10–7). Multivariate analysis showed that CDCA8 expression was independently correlated with OS (HR = 1.74; CI: 1.25–12.64; P = 1.27 × 10–5). GSEA revealed that the apoptosis, cell cycle, ErbB, MAPK, mTOR, Notch, p53 and TGF-β signaling pathways were differentially enriched in the CDCA8 high expression phenotype.

Conclusions

High CDCA8 expression is a potential molecular predictor of a poor prognosis in liver cancer.
Validation of preimplantation genetic tests for aneuploidy (PGT-A) with DNA from spent culture media (SCM): concordance assessment and implication
Authors: Yin Baoli , Zhang Huijuan , Xie Juanke , Wei Yubao , Zhang Cuilian , Meng Li
Published: March 2021

Background

Spent culture medium (SCM) as a source of DNA for preimplantation genetic tests aneuploidy (PGT-A) has been widely discussed.

Methods

Seventy-five blastocysts that were donated for research provided a unique possibility in which multiple specimens, including trophectoderm (TE) biopsy, SCM, and paired corresponding whole blastocyst (WB) specimens from the same blastocyst source, could be utilized for the purpose of this preclinical validation.

Results

To conduct a validation ploidy concordance assessment, we evaluated the full chromosomal concordance rates between SCM and WB (SCM-to-WB), and between TE and WB (TE-to-WB) as well as sensitivity, specificity and overall diagnostic accuracy. 78.67% (59/75) of NGS results in the SCM group were interpretable, a significantly lower percentage than their corresponding TE and WB groups. This discrepancy manifests itself in intrinsically low quantity and poor integrity DNA from SCM. Subsequently, remarkable differences in full concordance rates (including mosaicism, and segmental aneuploidies) are seen as follows: 32.2% (SCM-to-WB, 19/59) and 69.33% (TE-to-WB, 52/75), (p < 0.001). In such cases, full concordance rates were 27.27% (15/55) in SCM-to-WB, and, 76% (57/75) in TE-to-WB (p < 0.001). Collectively, the NGS data from SCM also translated into lower sensitivities, Positive Predictive Value (PPV), Negative Predictive Value (NPV), overall diagnostic accuracies, and higher Negative Likelihood Ratio (NLR).

Conclusions

Our study reveals that DNA is detectable in the majority of SCM samples. Individual chromosomal aberration, such as segmental aneuploidy and mosaicism, can be quantitatively and qualitatively measured. However, TE still provides a more accurate and reliable high-throughput methodology for PGT-A. Meanwhile, cell-free DNA in SCM reporting lacks uniform diagnostic interpretations. Considering that this test is meant to determine which embryos are relegated to be discarded, PGT-A with cell-free DNA in SCM should not be permitted to be applied in routine clinical settings for diagnosis purpose.
Online art therapy in elementary schools during COVID-19: results from a randomized cluster pilot and feasibility study and impact on mental health
Authors: Malboeuf-Hurtubise Catherine , Léger-Goodes Terra , Mageau Geneviève A. , Taylor Geneviève , Herba Catherine M. , Chadi Nicholas , Lefrançois David
Published: March 2021

Background

Emerging literature on the current COVID-19 crisis suggests that children may experience increased anxiety and depression as a result of the pandemic. To prevent such school and mental health-related problems, there is a timely need to develop preventive strategies and interventions to address potential negative impacts of COVID-19 on children’s mental health, especially in school settings. Results from previous child clinical research indicate that art-based therapies, including mindfulness-based art therapy, have shown promise to increase children’s well-being and reduce psychological distress.

Objective

The goal of the present pilot and feasibility study was to compare the impact of an emotion-based directed drawing intervention and a mandala drawing intervention, on mental health in elementary school children (N = 22), in the context of the COVID-19 pandemic. Both interventions were group-based and delivered online and remotely. A pilot study using a randomized cluster design was implemented to evaluate and compare both interventions in relation to child anxiety, depression, inattention and hyperactivity symptoms.

Results

Analyses of covariance revealed a significant effect of the type of drawing intervention on levels of inattention, after controlling for baseline levels. Participants in the emotion-based directed drawing group showed lower inattention scores at post-test, when compared to participants in the mandala group. Post-hoc sensitivity analyses showed significant decreases in pre-to-post scores for levels of hyperactivity for the complete sample.

Conclusion

Overall, results from this pilot and feasibility study showed that both an emotion-based directed drawing intervention and a mandala drawing intervention may be beneficial to improve mental health in elementary school children, in the context of the current COVID-19 pandemic. From a feasibility standpoint, results indicate that the implementation of both interventions online and remotely, through a videoconference platform, is feasible and adequate in school-based settings. Further work incorporating larger sample sizes, longitudinal data and ensuring sufficient statistical power is warranted to evaluate the long-term impact of both interventions on children’s mental health.
An efficient system for intestinal on-site butyrate production using novel microbiome-derived esterases
Authors: Jung Dah Hyun , Yong Ji Hyun , Hwang Wontae , Yoon Mi Young , Yoon Sang Sun
Published: March 2021

Short-chain fatty acids, especially butyrate, play beneficial roles in sustaining gastrointestinal health. However, due to limitations associated with direct consumption of butyrate, there has been interest in using prodrugs of butyrate. Tributyrin (TB), a triglyceride composed of three butyrate molecules and a glycerol, is a well-studied precursor of butyrate. We screened a metagenome library consisting of 5760 bacterial artificial chromosome clones, with DNA inserts originating from mouse microbiomes, and identified two clones that efficiently hydrolyse TB into butyrate. Nucleotide sequence analysis indicated that inserts in these two clones are derived from unknown microbes. BLASTp analysis, however, revealed that each insert contains a gene homologous to acetylesterase or esterase genes, from Clostridium spp. and Bacteroides spp., respectively. Predicted structures of these two proteins both contain serine-histidine-aspartate catalytic triad, highly conserved in the family of esterases. Escherichia coli host expressing each of the two candidate genes invariably produced greater amounts of butyrate in the presence of TB. Importantly, administration of TB together with cloned E. coli cells alleviated inflammatory symptoms in a mouse model of acute colitis. Based on these results, we established an efficient on-site and real-time butyrate production system that releases butyrate in a controlled manner inside the intestine.
Giotto: a toolbox for integrative analysis and visualization of spatial expression data
Authors: Dries Ruben , Zhu Qian , Dong Rui , Eng Chee-Huat Linus , Li Huipeng , Liu Kan , Fu Yuntian , Zhao Tianxiao , Sarkar Arpan , Bao Feng , George Rani E. , Pierson Nico , Cai Long , Yuan Guo-Cheng
Published: March 2021

Spatial transcriptomic and proteomic technologies have provided new opportunities to investigate cells in their native microenvironment. Here we present Giotto, a comprehensive and open-source toolbox for spatial data analysis and visualization. The analysis module provides end-to-end analysis by implementing a wide range of algorithms for characterizing tissue composition, spatial expression patterns, and cellular interactions. Furthermore, single-cell RNAseq data can be integrated for spatial cell-type enrichment analysis. The visualization module allows users to interactively visualize analysis outputs and imaging features. To demonstrate its general applicability, we apply Giotto to a wide range of datasets encompassing diverse technologies and platforms.
Concept and development of an interactive tool for trial recruitment planning and management
Authors: Spies Ruan , Siegfried Nandi , Myers Bronwyn , Grobbelaar Sara S.
Published: March 2021

Background

Predicting and monitoring recruitment in large, complex trials is essential to ensure appropriate resource management and budgeting. In a novel partnership between clinical trial investigators of the South African Medical Research Council and industrial engineers from the Stellenbosch University Health Systems Engineering and Innovation Hub, we developed a trial recruitment tool (TRT). The objective of the tool is to serve as a computerised decisions-support system to aid the planning and management phases of the trial recruitment process.

Method

The specific requirements of the TRT were determined in several workshops between the partners. A Poisson process simulation model was formulated and incorporated in the TRT to predict the recruitment duration. The assumptions underlying the model were made in consultation with the trial team at the start of the project and were deemed reasonable. Real-world data extracted from a current cluster trial, Project MIND, based in 24 sites in South Africa was used to verify the simulation model and to develop the monitoring component of the TRT.

Results

The TRT comprises a planning and monitoring component. The planning component generates different trial scenarios for predicted trial recruitment duration based on user inputs, e.g. number of sites, initiation delays. The monitoring component uses and analyses the data retrieved from the trial management information system to generate different levels of information, displayed visually on an interactive, user-friendly dashboard. Users can analyse the results at trial or site level, changing input parameters to see the resultant effect on the duration of trial recruitment.

Conclusion

This TRT is an easy-to-use tool that assists in the management of the trial recruitment process. The TRT has potential to expedite improved management of clinical trials by providing the appropriate information needed for the planning and monitoring of the trial recruitment phase. This TRT extends prior tools describing historic recruitment only to using historic data to predict future recruitment. The broader project demonstrates the value of collaboration between clinicians and engineers to optimise their respective skillsets.
A Community-enabled Readiness for first 1000 Days Learning Ecosystem (CRADLE) for first-time families: study protocol of a three-arm randomised controlled trial
Authors: Loy See Ling , Thilagamangai  , Teo Joyce , Chan Sze Wern , Razak Nurul Khairani Abdul , Chay Oh. Moh , Ng Kee Chong
Published: March 2021

Background

Enhanced parenting self-efficacy (PSE) contributes to positive parenting and future parental-child health. First-time parents, in particular, are in need of support since the pregnancy until post-delivery to strengthen their early PSE. However, there is a lack of effective and sustainable relevant programmes in the community. The Community-enabled Readiness for first 1000 Days Learning Ecosystem (CRADLE) aims to develop a self-learning eco-community throughout the pregnancy and early childhood to promote PSE among first-time parents. We apply choice architecture strategy using behavioural nudges and midwife-led continuity care during the first 1000 days, and test their effects on PSE and mother-child health for first-time families in Singapore.

Methods

This three-arm randomised controlled trial will recruit up to 750 pregnant women from the KK Women’s and Children’s Hospital, Singapore. Participants will be randomly assigned to receive: (1) standard routine care; (2) behavioural nudges (text messages) along with the use of a social media platform; or (3) midwife-led continuity care involving individualised teleconferencing sessions, during pregnancy and post-delivery. Using web-based questionnaires, participants will be assessed for baseline socio-demography and health status in the first visit, with follow-up assessments in the third trimester, at birth, 6-week (primary end-point), 6-, 12-, 18- and 24-month post-delivery. The primary outcome is PSE. Secondary outcomes include health and birth experience, mental wellness, feeding practice, maternal and child nutritional status. Intention-to-treat and per-protocol analyses will be performed using general linear models to test the effects of interventions across three arms. Recruitment has begun in June 2020 and is estimated to complete in September 2022.

Discussion

This study may identify a sustainable effective strategy in the community by helping first-time parents to have a positive experience during the pregnancy, childbirth and parenthood, leading to an enhanced PSE and health outcomes for both mother and child. Findings from this study will provide insight into the implementation of early parenting and mother-child care programmes.

Trial registration

ClinicalTrials.gov NCT04275765. Registered on 19 February 2020.
Physiological and transcriptional response to drought stress among bioenergy grass Miscanthus species
Authors: De Vega Jose J. , Teshome Abel , Klaas Manfred , Grant Jim , Finnan John , Barth Susanne
Published: March 2021

Background

Miscanthusis a commercial lignocellulosic biomass crop owing to its high biomass productivity, resilience and photosynthetic capacity at low temperature. These qualities makeMiscanthusa particularly good candidate for temperate marginal land, where yields can be limited by insufficient or excessive water supply. Differences in response to water stress have been observed amongMiscanthusspecies, which correlated to origin. In this study, we compared the physiological and molecular responses amongMiscanthusspecies under excessive (flooded) and insufficient (drought) water supply in glasshouse conditions.

Results

A significant biomass loss was observed under drought conditions in all genotypes.M. x giganteusshowed a lower reduction in biomass yield under drought conditions compared to the control than the other species. Under flooded conditions, biomass yield was as good as or better than control conditions in all species. 4389 of the 67,789 genes (6.4%) in the reference genome were differentially expressed during drought among fourMiscanthusgenotypes from different species. We observed the same biological processes were regulated acrossMiscanthusspecies during drought stress despite the DEGs being not similar. Upregulated differentially expressed genes were significantly involved in sucrose and starch metabolism, redox, and water and glycerol homeostasis and channel activity. Multiple copies of the starch metabolic enzymes BAM and waxy GBSS-I were strongly up-regulated in drought stress in allMiscanthusgenotypes, and 12 aquaporins (PIP1, PIP2 and NIP2) were also up-regulated in drought stress across genotypes.

Conclusions

Different phenotypic responses were observed during drought stress amongMiscanthusgenotypes from different species, supporting differences in genetic adaption. The low number of DEGs and higher biomass yield in flooded conditions supportedMiscanthususe in flooded land. The molecular processes regulated during drought were shared amongMiscanthusspecies and consistent with functional categories known to be critical during drought stress in model organisms. However, differences in the regulated genes, likely associated with ploidy and heterosis, highlighted the value of exploring its diversity for breeding.
RETRACTED ARTICLE: MicroRNA-29 mediates anti-inflammatory effects and alleviation of allergic responses and symptoms in mice with allergic rhinitis
Authors: Wang Jia , Yin Jinshu , Peng Hong , Liu Aizhu
Published: March 2021

Background

To investigate the role of microRNA-29 (miR-29) in mice with allergic rhinitis (AR) and its underlying mechanism.

Methods

AR model was established in BALB/c mice by intraperitoneal sensitization and intranasal challenge with ovalbumin (OVA). miRNA expression was examined in the nasal mucosa tissues of mice and patients with AR, and miRNA-29 was found to be downregulated. To unveil the role of miRNA-29 in AR, it was overexpressed in the nasal mucosa of AR mice by intranasal administration of miRNA-29 agomir. The symptoms of nasal rubbing and sneezing were recorded and evaluated. miR-29 expression, OVA-specific immunoglobulin E (IgE) concentration, pro-inflammatory cytokines levels, eosinophils number, and cleaved caspase-3 and CD276 expression were examined in nasal mucosa tissues and nasal lavage fluid (NALF) by qRT-PCR, ELISA, hematoxylin and eosin staining, western blotting, or immunohistochemistry, respectively. TUNEL assay was used to analyze nasal mucosa cells apoptosis.

Results

Decreased expression of miR-29 was observed in AR, the symptoms of which were alleviated by overexpressing miR-29. In addition, overexpression of miR-29 markedly reduced the concentration of OVA-specific IgE, the levels of IL-4, IL-6, IL-10, and IFN-γ, the pathological alterations and eosinophils infiltration in the nasal mucosa. Furthermore, restoration of miR-29 expression reduced nasal mucosa cell apoptosis. Moreover, overexpression of miR-29 significantly attenuated CD276 mRNA and protein levels in nasal mucosa cells.

Conclusion

MiR-29 mediated antiallergic effects in OVA-induced AR mice by decreasing inflammatory response, probably through targeting CD276. MiRNA-29 may serve as a potential novel therapeutic target for the treatment of AR.
On a reverse Mulholland-type inequality in the whole plane with general homogeneous kernel
Authors: Luo Ricai , Yang Bicheng , Huang Xingshou
Published: March 2021

By using the idea of introducing parameters and weight coefficients, a new reverse discrete Mulholland-type inequality in the whole plane with general homogeneous kernel is given, which is an extension of the reverse Mulholland inequality. The equivalent forms are obtained. The equivalent statements of the best possible constant factor related to several parameters and a few applied examples are presented.
Convergence and stability of modified multi-step Noor iterative procedure with errors for strictly hemicontractive-type mappings in Banach spaces
Authors: Asaduzzaman Md.
Published: March 2021

In this paper, we introduce and study a modified multi-step Noor iterative procedure with errors for two Lipschitz strictly hemicontractive-type mappings in arbitrary Banach spaces and constitute its convergence and stability. The obtained results in this paper generalize and extend the corresponding result of Hussainet al.(Fixed Point Theory Appl. 2012:160, 2012) and some analogous results of several authors in the literature. Finally, a numerical example is included to illustrate our analytical results and to display the efficiency of our proposed novel iterative procedure with errors.
The value of myocardial MIBI washout rate in risk stratification of coronary artery disease
Authors: Othman Mohammed Omar Mohammed , Moustafa Hosna Mohammed , El-Ghany Mohammed Mahmoud Abd , El-Mon’em El-Rasad Shaimaa Ahmed Abd
Published: March 2021

Background

Although it is well established that MIBI does not redistribute as thallium within the myocardium, it showed a reverse redistribution phenomenon that can be expressed by the rate of myocardial MIBI washout. The aim in this study was calculating the global myocardial washout of the MIBI (GWR) in patients diagnosed with coronary artery disease (CAD) of different risk stratifications.

Results

This prospective study included 100 patients. All patients were stratified into low-, intermediate-, and high-risk groups according to clinical evaluation using Framingham score, stress ECG results using Duke’s score and finally myocardial perfusion imaging prognostic findings. GWR was estimated in each of these groups. GWR mean was 9.5%, 13%, and 18% within clinically stratified patients into low-, intermediate-, and high-risk patients respectively with correlation coefficient 0.4. In addition, GWR mean was 9.7%, 15.4%, and 18.7% within patients stratified according to exercise ECG findings into low-, intermediate-, and high-risk patients respectively with correlation coefficient 0.6. Combining all myocardial perfusion findings, GWR mean was 7.9%, 15.1%, and 19.3% in patient with low-, intermediate-, and high-risk imaging findings respectively with correlation coefficient 0.71.

Conclusion

GWR is positively correlated with the risk stratifications of the CAD patients. GWR can be used as an additional parameter to assess the risk of CAD patients.
Patient educational level and management of bipolar disorder
Authors: Karanti Alina , Bublik Lana , Kardell Mathias , Annerbrink Kristina , Lichtenstein Paul , Runeson Bo , Pålsson Erik , Landén Mikael
Published: March 2021

Background

Socioeconomic factors can affect healthcare management.

Aims

The aim was to investigate if patient educational attainment is associated with management of bipolar disorder.

Method

We included patients with bipolar disorder type 1 (n = 4289), type 2 (n = 4020) and not otherwise specified (n = 1756), from the Swedish National Quality Register for Bipolar Disorder (BipoläR). The association between patients’ educational level and pharmacological and psychological interventions was analysed by binary logistic regression. We calculated odds ratios after adjusting for demographic and clinical variables.

Results

Higher education was associated with increased likelihood of receiving psychotherapy (adjusted odds ratio 1.34, 95% CI 91.22–1.46) and psychoeducation (adjusted odds ratio 1.18, 95% CI 1.07–1.46), but with lower likelihood of receiving first-generation antipsychotics (adjusted odds ratio 0.76, 95% CI 0.62–0.94) and tricyclic antidepressants (adjusted odds ratio 0.76, 95% CI 0.59–0.97). Higher education was also associated with lower risk for compulsory in-patient care (adjusted odds ratio 0.79, 95% CI 0.67–0.93).

Conclusions

Pharmacological and psychological treatment of bipolar disorder differ depending on patients’ educational attainment. The reasons for these disparities remain to be explained.
Changing practice: assessing attitudes toward a NICE-informed collaborative treatment pathway for bipolar disorder
Authors: Elliott Adele Louise , Watson Stuart , Dodgson Guy , Cohen-Tovée Esther , Ling Jonathan
Published: March 2021

Background

Bipolar disorder is a chronic mental health condition, which can result in functional impairment despite medication. A large evidence base supports use of psychological therapies and structured care in the treatment of mood disorders, but these are rarely implemented. e-Pathways are digital structures that inform and record patient progress through a healthcare system, although these have not yet been used for bipolar disorder.

Aims

To assess the perceived benefits and costs associated with implementing a collaborative NICE-informed e-pathway for bipolar disorder.

Method

Healthcare professionals and people with bipolar disorder attended a workshop to share feedback on e-pathways. Data were collected through questionnaires (n= 26) and transcription of a focus group, analysed qualitatively by a framework analysis.

Results

Patients and healthcare professionals welcomed the development of an e-pathway for bipolar disorder. There were five elements to the framework: quality and delivery of care, patient–clinician collaboration, flexibility and adaptability, impact on staff and impact on healthcare services.

Conclusions

Identification of benefits and costs ensures that future development of e-pathways addresses concerns of healthcare professionals and people with bipolar disorder, which would be essential for successful implementation. Recommendations for this development include making e-pathways less complicated for patients, ensuring sufficient training and ensuring clinicians do not feel their skills become invalidated. Limitations of the study, and directions for future research, are discussed.
Spenser’s Youth
Authors: Wilson-Okamura David
Published: March 2021

Epics modeled on the Odyssey typically include a version of Homer’s Circe episode. Edmund Spenser’s variant, the Bower of Bliss, is unusual for ending in physical violence so pronounced that many readers have taken against its putative hero, Sir Guyon. This essay reviews the role of magic in similar episodes to show the enormity of Spenser’s seemingly conservative storytelling. It also defends Spenser’s hero from charges of intemperance and immaturity. The question of intemperance stems from misunderstanding Aristotle. That of immaturity is more complicated. In the economy of justice, youth counteracts complacency. One of Guyon’s prototypes, the biblical king Josiah, is an example. Spenser pictures all his heroes as young, and growing up is part of his design for the epic as a whole. His attitude, though, is not condescending. The danger of sexual indulgence, which Guyon’s critics sometimes dismiss, is one that the epic tradition took seriously and that Spenser himself connected with the recent downfall of public figures.
Construction of Boronate-Affinity Magnetic Immunity SERS Sensor and Detection of Alpha-Fetoprotein (AFP) in Human Serum
Authors: He Yuhan , Li Lijun , Li Xiaoxuan , Lin Chubing , Zhang Yan
Published: March 2021

According to its characteristics, borate can recognize and adsorb target glycoproteins and specific binding properties of antigens and antibodies. This article introduces a preparation method for a magnetic immune SERS sensor, and it is used for the specific identification and detection of trace AFP in human serum. The test used AFP as the target protein and 4-mercaptophenylboronic acid (4-MPBA) modified gold-coated silver nanoparticles (Ag@AuNPs) as the signal factor. After the AFP antibody was grafted on the boric acid group, the SERS detection probe (Ag@Au@4-MPBA@Anti-AFP) was obtained. On the surface of boric acid-functionalized (-P) magnetic silica particles, AFP antibody was modified, and the particles were used as magnetic immunocapture probes (Fe3O4@SiO2-P@Anti-AFP). Finally, the sandwich structure complex of “detection probe-target protein-capture probe” was successfully constructed. The prepared magnetic immune SERS sensor exhibits excellent selectivity and high sensitivity for AFP detection; based on the signal-to-noise ratio S/N = 3, the detection limit can reach 1.0 ng/mL; by performing a spike test on AFP in human serum, the sensor can be used to detect AFP in actual samples. The recovery rate was between 85.8% and 105.7%, and the RSD distribution was ≤3.52%. The sensor was easy to prepare, required no complex processing of samples and can achieve rapid detection, so that it is expected to become a new strategy for clinical detection of AFP.
Back To The Good—or Were They the Bad—Old Days of Antitrust? A Review Essay of Jonathan B. Baker’s The Antitrust Paradigm: Restoring a Competitive Economy
Authors: Winston Clifford
Published: March 2021

This essay reviews Jonathan Baker’s important book, The Antitrust Paradigm: Restoring a Competitive Economy, to frame the debate over appropriate antitrust policy and enforcement. Baker argues that competition is inadequate in many US markets and that antitrust could and should be strengthened to restore competition and benefit consumers. Baker presents an unrelenting critique of what he believes is the University of Chicago’s harmful influence on what was once an effective antitrust policy. I compress Baker’s book into four issues that economists can debate and I offer an alternative view that is more supportive of the current state of industry competition, the efficacy of market forces, and the case for limited antitrust intervention. (JEL D22, K21, L11, L13, L40)