bluuebunny/crossref_metadata_2025 huggingface dataset:
The importance of identifying the dimensionality of constructs employed in simulation and training for AI
Authors: Coovert Michael D , Bennett Winston
Published: August 2021

Advances at the intersection of artificial intelligence (AI) and education and training are occurring at an ever-increasing pace. On the education and training side, psychological and performance constructs play a central role in both theory and application. It is essential, therefore, to accurately determine the dimensionality of a construct, as it is often employed during both the assessment and development of theory, and its practical application. Traditionally, both exploratory and confirmatory factor analyses have been employed to establish the dimensionality of data. Due in part to inconsistent findings, methodologists recently resurrected the bifactor approach for establishing the dimensionality of data. The bifactor model is pitted against traditional data structures, and the one with the best overall fit (according to chi-square, root mean square error of approximation (RMSEA), comparative fit index (CFI), Tucker–Lewis index (TLI), and standardized root mean square residual (SRMR)) is preferred. If the bifactor structure is preferred by that test, it can be further examined via a suite of emerging coefficients (e.g., omega, omega hierarchical, omega subscale, H, explained common variance, and percent uncontaminated correlations), each of which is computed from standardized factor loadings. To examine the utility of these new statistical tools in an education and training context, we analyze data where the construct of interest is trust. We chose trust as it is central, among other things, to understanding human reliance upon and utilization of AI systems. We utilized the above statistical approach and determined the two-factor structure of widely employed trust scale is better represented by one general factor. Findings like this hold substantial implications for theory development and testing, prediction as in structural equation modeling (SEM) models, as well as the utilization of scales and their role in education, training, and AI systems. We encourage other researchers to employ the statistical measures described here to critically examine the construct measures used in their work if those measures are thought to be multidimensional. Only through the appropriate utilization of constructs, defined in part by their dimensionality, are we to advance the intersection of AI and simulation and training.
Circ_0006174 promotes colorectal cancer progression by sponging microRNA-142-3p and regulating X-linked inhibitor of apoptosis expression
Authors: Huang Bo , Cui Dejun , Ren Ying , Zhao Xun , Li Fei , Yuan Wenqiang
Published: August 2021

Background

Circular RNAs (circRNAs) are crucial in the regulation of gene expression and biological processes. However, in colorectal cancer, the expression characteristics and biological function of circRNA_0006174 (circ_0006174) is not fully understood. This work is aimed to investigate the biological function of circ_0006174 in colorectal cancer and its molecular mechanism.

Methods

Circ_0006174, microRNA-142-3p and X-linked inhibitor of apoptosis expression levels were detected in colorectal cancer tissues and cells using quantitative real-time polymerase chain reaction analysis or Western blot. The effects of circ_0006174 on colorectal cancer cell proliferation, apoptosis, migration and invasion were detected using the cell counting kit-8 method, bromodeoxyuridine experiments, flow cytometry analysis and Transwell experiments. The targeting relationship among circ_0006174, microRNA-142-3p and X-linked inhibitor of apoptosis was analysed by bioinformatics prediction, dual-luciferase reporter experiment and RNA immunoprecipitation experiment.

Results

Circ_0006174 was up-regulated in colorectal cancer tissues as well as in cell lines, and its high expression was remarkably associated with enlarged tumour volume and advanced tumour, node, metastasis stage of the patients. Circ_0006174 overexpression enhanced colorectal cancer cell proliferation, migration and invasion, and inhibited colorectal cancer cell apoptosis; while knocking down circ_0006174 caused the opposite effects. Circ_0006174 directly targeted and negatively regulated microRNA-142-3p expression, and X-linked inhibitor of apoptosis, a target gene of microRNA-142-3p, could be indirectly and positively modulated by circ_0006174.

Conclusion

Circ_0006174 facilitates colorectal cancer cell proliferation, migration and invasion, and represses colorectal cancer cell apoptosis by regulating microRNA-142-3p/X-linked inhibitor of apoptosis axis.
Netflix original series, global audiences and discourses of streaming success
Authors: Wayne Michael L , Uribe Sandoval Ana C
Published: August 2021

This article examines the discourses of streaming success within the television industry by focusing on Netflix and two of the service’s original series: Fauda and La Casa de Papel. Using publicly available secondary data through 2019, this analysis argues the transnational platform’s efforts to redefine successful television while maintaining a high level of data secrecy necessitate the discursive construction of a global and undifferentiated audience. Yet, rather than representing a break with the past, the discourses of streaming success reveal Netflix to be a television institution attempting to address traditional industry challenges.
Beyond stereotypes: Comparing Chinese and Australian parents’ perceptions of transition to school
Authors: Liu Liwei , O’Gorman Lyndal , Dillon-Wallace Julie , Petriwskyj Anne
Published: August 2021

Parents’ perceptions and expectations of transition to school influence their engagement in the transition process. In this study, eight Chinese and eight Australian parents were interviewed to explore their perceptions of transition to school. The results showed similarities in Chinese and Australian parents’ views of transition to school as a two-phase process involving preparation and school familiarisation. Cohort and intra-cohort differences were evident in the type of preparation, attention to diverse needs and the difficulty of the transition process. Moreover, Australian, but not Chinese, parents regarded transition to school as a change for themselves. The findings challenge stereotypes, indicating the need for more reciprocal communication to address parent expectations about transition to school in diverse communities.
Influence of Hospital Outdoor Space on Physiological Electroencephalography (EEG) Feedback of Staff
Authors: Cui Weiyi , Li Zao , Xuan Xiaodong , Lu Chao , Tang Qiqiang , Zhou Shaobo , Li Qingtao
Published: August 2021

Objectives:

To investigate the differences and relationships between different outdoor spaces of hospitals on the physiological electroencephalography (EEG) feedback (PEEGF) of staff.

Background:

Relieving the pressure of hospital staff is essential, and several studies have revealed that even short-term exposure to outdoor space has a decompression effect. Yet, the focus is scarcely centered on the differences and influential relationships between the PEEGF from different outdoor spaces where the staff spend time, particularly in large-scale hospitals in China.

Methods:

EEG measurement equipment was utilized to obtain the value of β wave (vβw) that represents the stress and anxiety of staff in three different outdoor spaces: open, traffic, and rest. On the basis of EEG data, correlation analysis was conducted in accordance with the proportion of space elements.

Results:

The proportion of natural elements, such as landscape ( r = −.800** p=.005) and waterscape ( r = −.782* p=.013), were negatively correlated with the vβw produced by staff, while the proportion of hard paving was positive ( r = .817** p=.004) with more vβw produced by staff. In other words, the percentage of landscape and waterscape can reduce stress, while hard paving has the opposite effect. Further, there was a difference in the amount of vβw generated between nurses and administrators in the open space at the entrance of the main building ( p = .043).

Conclusions:

The present study revealed the influence of different outdoor space elements of the hospital on the physiological feedback of staff, demonstrated the practical necessity of evidence-based design, and proposed relevant optimization suggestions.
Addition of chemotherapy to nivolumab after PD-1 inhibitor failure as bridge to allogeneic stem cell transplantation in classical Hodgkin’s lymphoma: report on three cases and literature review
Authors: Romero Samuel , Balaguer-Roselló Aitana , Montoro Juan , Beneit Paola , Martínez Amelia , Ruiz Cristina , Andreu Rafael , Guerreiro Manuel , Arnao Mario , Montava Alberto , Vicente Ana I. , Jarque Isidro , Sanz Jaime
Published: August 2021

The poor prognosis of refractory or relapsed (R/R) classical Hodgkin’s lymphoma (cHL) after autologous stem cell transplantation has improved greatly due to the introduction of brentuximab vedotin and PD-1 inhibitors. However, the duration of response achieved with these novel agents is too short. The information about the management of patients after anti-PD-1 therapy failure is very limited in cHL, although chemotherapy alone or combined with PD-1 inhibitors has shown encouraging results. We report three cases of heavily pretreated cHL, refractory to nivolumab monotherapy, successfully rescued with the addition of chemotherapy to nivolumab, as a bridge to allogeneic stem cell transplantation (allo-SCT). All three patients presented poor clinical features such as three to four previous lines including brentuximab vedotin and autologous stem cell transplantation, refractoriness to the last line of therapy previous to nivolumab, and rapid disease progression. Notwithstanding these characteristics and nivolumab failure, they achieved a complete response after the addition of chemotherapy, were consolidated with allo-SCT, and still remain in complete response. There are few studies concerning the combination of PD-1 inhibitors and chemotherapy after nivolumab failure, including one retrospective study and one phase II trial with nivolumab plus bendamustine. Therefore, only few patients are consolidated with allo-SCT. However, there are several ongoing trials investigating new combinations of chemotherapy and PD-1 inhibitors in R/R cHL, as well as in first line. All these data suggest that anti-PD-1 therapy may reprogram the immune system, activating and inhibiting effector and immunosuppressive cells, respectively, leading to overtake of chemorefractoriness. Allo-SCT can increase the immune-related events of patients treated with anti-PD-1 previously, consistent on acute graft- versus-host disease, sinusoidal obstruction syndrome, and noninfectious febrile syndrome. In conclusion, the combination of PD-1 inhibitor and chemotherapy may be a feasible therapy after anti-PD-1 treatment failure as a bridge to allo-SCT.
Behavioral Characteristics of Older Adults in Community Public Spaces: Gender and Aging in Dalian, China
Authors: Yu Wenting , Zhou Bo , Liu Jianjun
Published: August 2021

As people age, the community gradually becomes the main place for their daily activities. In old residential communities in China, variations in behaviors and venue choices of older adults reflect gender differences. This study focuses on the behavioral gender differences in old residential communities and the characteristics of venue use under the influence of the unique policies and culture of China. Semistructured interviews, behavioral mapping, and photo recording were utilized for data collection. The results showed that gender differences were reflected in the variability of behaviors and venue use of older adults. These differences are due to people’s living habits and gender characteristics as well as the top–down development of feminism in China. This study highlights the important role played by policies and culture in behavioral differences and stresses that systematically environmental construction could be used as a balanced means to address gender differences in old residential communities. This study also suggests minimizing activities with a strong gender orientation, balancing the gender allocation of service staff for older adults, and emphasizing space flexibility and versatility could help achieve a gender-balanced community environment.
Do Consumers Care About Aesthetics and Compatibility? The Intention to Use Wearable Devices in Health Care
Authors: Jeong Jeeyeon , Kim Yaeri , Roh Taewoo
Published: August 2021

This study examined the influencing factors on consumers’ intention to use wearable devices in health care (WDH). Although the importance of the WDH market is increasing, existing empirical study results on WDH have been selectively investigated based on the technology acceptance model (TAM). To address this issue, we endeavored to contribute by integrating the theory of planned behavior (TPB) and innovation diffusion theory (IDT) on top of TAM to explain the psychological mechanism underlying consumer behaviors, especially when adopting advanced wearable devices in the health care domain. We surveyed 303 people in Pangyo IT Valley, South Korea, and attempted a path analysis using PLS-SEM estimation. The findings suggest that individual innovativeness (IIN) directly affects consumers’ intention to use (IU) WDH, while self-efficacy (SE), aesthetics (AES), and compatibility (COM) have indirectly influenced their usage intentions. Detailed results are described in the article.
Myelopathic Patients Undergoing Severe Pediatric Spinal Deformity Surgery Can Improve Neurologic Function to That of Non-Myelopathic Patients by 1-Year Postoperative
Authors: Cerpa Meghan , Zuckerman Scott L. , Lenke Lawrence G. , Kelly Michael P. , Yaszay Burt , Newton Peter , Sponseller Paul , Erickson Mark , Garg Sumeet , Pahys Joshua , Samdani Amer , Cahill Patrick , McCarthy Richard , Bumpass David , Sucato Daniel , Boachie-Adjei Oheneba , Shah Suken , Gupta Munish
Published: August 2021

Study Design:

Multi-center, prospective, observational cohort.

Objective:

To compare myelopathic vs. non-myelopathic ambulatory patients in short- and long-term neurologic function, operative treatment, and patient-reported outcomes.

Methods:

Pediatric deformity patients from 16 centers were enrolled with the following inclusion criteria: aged 10-21 years-old, a Cobb angle ≥100° in either the coronal or sagittal plane or any sized deformity with a planned 3-column osteotomy, and community ambulators. Patients were dichotomized into 2 groups: myelopathic (abnormal preoperative neurologic exam with signs/symptoms of myelopathy) and non-myelopathic (no clinical signs/symptoms of myelopathy).

Results:

Of 311 patients with an average age of 14.7 ± 2.8 years, 29 (9.3%) were myelopathic and 282 (90.7%) were non-myelopathic. There was no difference in age ( P = 0.18), gender ( P = 0.09), and Risser Stage ( P = 0.06), while more patients in the non-myelopathic group had previous surgery (16.1% vs. 3.9%; P = 0.03). Mean lower extremity motor score (LEMS) in myelopathic patients increased significantly compared to baseline at every postoperative visit: Baseline: 40.7 ± 9.9; Immediate postop: 46.0 ± 7.1, P = 0.02; 1-year: 48.2 ± 3.7, P < 0.001; 2-year: 48.2 ± 7.7, P < 0.001). The non-myelopathic group had significantly higher LEMS immediately postoperative ( P = 0.0007), but by 1-year postoperative, there was no difference in LEMS between groups (non-myelopathic: 49.3 ± 3.6, myelopathic: 48.2 ± 3.7, P = 0.10) and was maintained at 2-years postoperative (non-myelopathic: 49.2 ± 3.3, myelopathic: 48.2 ± 5.7, P = 0.09). Both groups improved significantly in all SRS domains compared to preoperative, with no difference in scores in the domains for pain ( P = 0.12), self-image ( P = 0.08), and satisfaction ( P = 0.83) at latest follow-up.

Conclusion:

In severe spinal deformity pediatric patients presenting with preoperative myelopathy undergoing spinal reconstructive surgery, myelopathic patients can expect significant improvement in neurologic function postoperatively. At 1-year and 2-year postoperative, neurologic function was no different between groups. While non-myelopathic patients had significantly higher postoperative outcomes in SRS mental-health, function, and total-score, both groups had significantly improved outcomes in every SRS domain compared to preoperative.
A Rare Case of Extramedullary Plasmacytosis
Authors: Farraj Kristen L. , Kaliounji Aboud , Kagolanu Deepthi , Khan Nausheer
Published: August 2021

Plasmacytosis is the abnormal proliferation of plasma cells in tissue, bone, blood, or exudates. Mucous membrane plasmacytosis is a rare form of plasmacytosis that is usually idiopathic in nature. A 68-year-old female underwent a diagnostic and therapeutic esophagogastroduodenoscopy, which revealed a friable antral erythematous gastric fold and a gastric polyp. Subsequent pathological testing was positive for diffuse polyclonal plasma cell proliferation, which was suggestive of a gastric plasmacytosis. In this article, we report a rare presentation of mucous membrane plasmacytosis.
Patient Experiences With Telemedicine in a National Health Service Rheumatology Outpatient Department During Coronavirus Disease-19
Authors: Jones Matthew T , Arif Rameez , Rai Ashok
Published: August 2021

The coronavirus disease-19 pandemic changed rheumatology practice with remote consultations being increasingly utilized where appropriate. We evaluated patient experiences with telephone consultations and report on patient attitudes toward current health care delivery and perspectives of telemedicine in a UK National Health Service rheumatology outpatient department. We analyzed 297 questionnaires from a postal survey conducted during the summer of 2020 after a telephone follow-up consultation. The mean age of respondents was 67 years and 68% were female. The 161 respondents (54%) reported it was their first telephone consultation and overall, 239 (84%) were satisfied with their health assessment. 60% would be happy to have future routine follow-up telephone consultations. Patients advised to shield shared similar satisfaction to the whole sample. However, with increasing age we identified a higher proportion were dissatisfied with telephone consultations and unlikely to have accessibility to video consultation or preferentially opt for this modality.
Understanding Reproductive Health Services in Eastern Uttar Pradesh, India: A Dalit Feminist Approach
Authors: Chandra Priti
Published: August 2021

The identity of women cannot be seen in isolation but as one that exists along with other constituents that intersect with class, race, sexuality and caste. Being a woman, a person is already at periphery and adding caste to it makes her more vulnerable. Thus, Dalit women are more subjugated in Indian society whether it is about leading a normal life or availing reproductive health services. This study primarily draws from a Dalit feminist perspective to understand the subjectivity and nuisances of the Dalit women who avail reproductive health services. While availing reproductive health services, the sort of discrimination the Dalit women face are denial in providing reproductive health services, creation and observation of distance from the Dalit women by the health practitioners and promotion of privatization of healthcare services. The study is based on qualitative research design which includes participant observation, in which a total of 27 married women were selected for the in-depth interview; among them, 16 women were from the Dalit community and 9 women were from the so-called upper caste community. This study was conducted in 2015 between February and April in Mau district of Eastern Uttar Pradesh, India.
Loss of erythroblasts in acute myeloid leukemia causes iron redistribution with clinical implications
Authors: Lopes Marta , Duarte Tiago L. , Teles Maria J. , Mosteo Laura , Chacim Sérgio , Aguiar Eliana , Pereira-Reis Joana , Oliveira Mónica , Silva André M. N. , Gonçalves Nuno , Martins Gabriela , Kong Isabella Y. , Zethoven Magnus , Vervoort Stephin , Martins Sandra , Quintela Miguel , Hawkins Edwin D , Trigo Fernanda , Guimarães João T. , Mariz José M. , Porto Graça , Duarte Delfim
Published: August 2021

Acute myeloid leukemia (AML) is a heterogeneous disease with poor prognosis and limited treatment strategies. Determining the role of cell-extrinsic regulators of leukemic cells is vital to gain clinical insights into the biology of AML. Iron is a key extrinsic regulator of cancer, but its systemic regulation remains poorly explored in AML. To address this question, we studied iron metabolism in patients with AML at diagnosis and explored the mechanisms involved using the syngeneic MLL-AF9–induced AML mouse model. We found that AML is a disorder with a unique iron profile, not associated with inflammation or transfusion, characterized by high ferritin, low transferrin, high transferrin saturation (TSAT), and high hepcidin. The increased TSAT in particular, contrasts with observations in other cancer types and in anemia of inflammation. Using the MLL-AF9 mouse model of AML, we demonstrated that the AML-induced loss of erythroblasts is responsible for iron redistribution and increased TSAT. We also show that AML progression is delayed in mouse models of systemic iron overload and that elevated TSAT at diagnosis is independently associated with increased overall survival in AML. We suggest that TSAT may be a relevant prognostic marker in AML.
Intermittent hypoxia-related alterations in vascular structure and function: a systematic review and meta-analysis of rodent data
Authors: Harki Olfa , Boete Quentin , Pépin Jean-Louis , Arnaud Claire , Belaidi Elise , Faury Gilles , Khouri Charles , Briançon-Marjollet Anne
Published: August 2021

Background

Obstructive sleep apnoea and the related intermittent hypoxia (IH) are widely recognised as risk factors for incident cardiovascular diseases. Numerous studies support the deleterious vascular impact of IH in rodents but an overall interpretation is challenging owing to heterogeneity in rodent species investigated and the severity and duration of IH exposure. To clarify this major issue, we conducted a systematic review and meta-analysis to quantify the impact of IH on systemic artery structure and function depending on the different IH exposure designs.

Methods

We searched PubMed, Embase and Web of Science, and included 125 articles in a meta-analysis, among them 112 using wild-type rodents and 13 using apolipoprotein E knockout (ApoE−/−) mice. We used the standardised mean difference (SMD) to compare results between studies.

Results

IH significantly increased mean arterial pressure (+13.90 (95% CI 11.88–15.92) mmHg), and systolic and diastolic blood pressure. Meta-regressions showed that mean arterial pressure change was associated with strain and year of publication. IH altered vasodilation in males but not in females and increased endothelin-1-induced but not phenylephrine-induced vasoconstriction. Intima–media thickness significantly increased upon IH exposure (SMD 1.10 (95% CI 0.58–1.62); absolute values +5.23 (2.81–7.84) µm). This increase was observed in mice but not in rats and was negatively associated with age. Finally, IH increased atherosclerotic plaque size in ApoE−/−mice (SMD 1.08 (95% CI 0.80–1.37)).

Conclusions

Our meta-analysis established that IH, independently of other confounders, has a strong effect on vascular structure and physiology. Our findings support the interest of identifying and treating sleep apnoea in routine cardiology practice.
Theratyping cystic fibrosisin vitroin ALI culture and organoid models generated from patient-derived nasal epithelial conditionally reprogrammed stem cells
Authors: Sette Giovanni , Lo Cicero Stefania , Blaconà Giovanna , Pierandrei Silvia , Bruno Sabina Maria , Salvati Valentina , Castelli Germana , Falchi Mario , Fabrizzi Benedetta , Cimino Giuseppe , De Maria Ruggero , Biffoni Mauro , Eramo Adriana , Lucarelli Marco
Published: August 2021

Question

Cystic fibrosis (CF) is due to pathogenic variants in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Recent improvements have enabled pharmacological therapy aiming at restoring mutated CFTR expression and function. CFTR “modulators” have revolutionised the CF therapeutic landscape, particularly the last approved, Trikafta. This drug combination is indicated by the United States Food and Drug Administration and very recently by the European Medicines Agency for genotypes carrying at least one copy of CFTR with the F508del pathogenic variant. However, several genotypes are not yet eligible for Trikafta treatment.

Materials/patients and methods

We exploited an innovative cellular approach allowing highly efficientin vitroexpansion of airway epithelial stem cells (AESCs) through conditional reprogramming from nasal brushing of CF patients. This approach, coupled to the development of AESC-derived personalised disease models, as organoids and air–liquid interface (ALI) cultures, revealed highly suitable for CFTR pharmacological testing.

Results and answer to the question

We fully validated the experimental models and implemented the CFTR functional assays and biochemical CFTR protein characterisation, which allowed the evaluation of the efficacy of clinically available modulators in restoring CFTR maturation and function of each patient-derived “avatar” (theratyping). F508del homozygous genotypes, used as controls, confirmed the higher clinical activity of Trikafta in comparison with older modulators. In addition, Trikafta showed its efficacy on three rare genotypes previously not eligible for treatment with modulators, opening the way to clinical translation. Finally, encouraging results for innovative drug combinations were obtained.
Metastatic prostate cancer: clinical aspects and treatment limitations in a university hospital center in Senegal
Authors: Ondo Cyrille Ze , Ndiath Abdoulaye , Sarr Alioune , Thiam Amath , Sine Babacar , Sow Ousmane , Ndour Ndiaga Seck , Diao Babacar , Fall Papa Ahmed , Ndoye Alain Khassim
Published: August 2021

Background

Prostate cancer is most often diagnosed at the metastatic stage in many sub-Saharan African countries. The objective of our study is to analyze the management of metastatic prostatic adenocarcinoma based on epidemiological, clinical, therapeutic and evolutionary aspects in developing country context.

Methods

Retrospective study collecting 276 patients from January 1st, 2012 to December 31st, 2019 in Aristide Le Dantec University Hospital in Dakar, Senegal. Parameters studied: age, family history of prostate cancer, reasons for consultation, total Prostate Specific Antigen (PSA), anatomic pathology examination, extension assessment, treatment, nadir PSA, castration resistance, and overall survival.

Results

The average age was 71.4 years. A family history of prostate cancer was noted in 21 patients. Spinal pain was the most noted reason for consultation. The average total PSA level was 1967.1 ng/ml. The majority of patients had moderately differentiated prostate cancer. Bone metastases were the most common. All patients had androgen suppression. A tumor cytoreduction was performed in 89 patients. The average nadir PSA was 193 ng/ml as early as the sixth month. The time to onset of castration resistance ranged from 6 to 30 months. Abiraterone acetate was used in seven patients and docetaxel in 43 patients. The overall survival of the patients was 19.8 ± 1.2 months.

Conclusion

Metastatic prostate cancer was most often symptomatic at the time of diagnosis. Second-line treatments were rarely used during castration resistance. Overall survival was low.
Bordetella avium-associated endophthalmitis: case report
Authors: Zhang Rui , Hu Liping , Xu Chong , Wu Jianhua , Xu Changzhong , Feng Chao
Published: August 2021

Background

Bordetella avium, an aerobic bacterium that rarely causes infection in humans, is a species of Bordetella that generally inhabits the respiratory tracts of turkeys and other birds. It causes a highly contagious bordetellosis. Few reports describe B. avium as a causative agent of eye-related infections.

Case presentation

We report a case of acute infectious endophthalmitis associated with infection by B. avium after open trauma. After emergency vitrectomy and subsequent broad-spectrum antibiotic treatment, the infection was controlled successfully, and the patient’s vision improved.

Conclusions

B. avium can cause infection in the human eye, which can manifest as acute purulent endophthalmitis. Nanopore targeted sequencing technology can quickly identify this organism. Emergency vitrectomy combined with lens removal and silicone oil tamponade and the early application of broad-spectrum antibiotics are key for successful treatment.
Omouma: a prospective mother and child cohort aiming to identify early biomarkers of pregnancy complications in women living in Qatar
Authors: Kumar Manoj , Saadaoui Marwa , Elhag Duaa Ahmed , Murugesan Selvasankar , Al Abduljabbar Shaikha , Fagier Yassin , Ortashi Osman , Abdullahi Hala , Ibrahim Ibrahim , Alberry Medhat , Abbas Anthony , Ahmed Sawssan R. , Hendaus Mohamed A. , Kalache Karim , Terranegra Annalisa , Al Khodor Souhaila
Published: August 2021

Background

Pregnancy is governed by multiple molecular and cellular processes, which might influence pregnancy health and outcomes. Failure to predict and understand the cause of pregnancy complications, adverse pregnancy outcomes, infant’s morbidity and mortality, have limited effective interventions. Integrative multi-omics technologies provide an unbiased platform to explore the complex molecular interactions with an unprecedented depth. The objective of the present protocol is to build a longitudinal mother-baby cohort and use multi-omics technologies to help identify predictive biomarkers of adverse pregnancy outcomes, early life determinants and their effect on child health.

Methods/design

: One thousand pregnant women with a viable pregnancy in the first trimester (6–14 weeks of gestation) will be recruited from Sidra Medicine hospital. All the study participants will be monitored every trimester, at delivery, and one-year post-partum. Serial high-frequency sampling, including blood, stool, urine, saliva, skin, and vaginal swabs (mother only) from the pregnant women and their babies, will be collected. Maternal and neonatal health, including mental health and perinatal growth, will be recorded using a combination of questionnaires, interviews, and medical records. Downstream sample processing including microbial profiling, vaginal immune response, blood transcriptomics, epigenomics, and metabolomics will be performed.

Discussion

It is expected that the present study will provide valuable insights into predicting pregnancy complications and neonatal health outcomes. Those include whether specific microbial and/or epigenomics signatures, immune profiles are associated with a healthy pregnancy and/or complicated pregnancy and poor neonatal health outcome. Moreover, this non-interventional cohort will also serve as a baseline dataset to understand how familial, socioeconomic, environmental and lifestyle factors interact with genetic determinants to influence health outcomes later in life. These findings will hold promise for the diagnosis and precision-medicine interventions.
Formal evidence-based medicine instruction in Turkish undergraduate medical education: an initial evaluation
Authors: Çakmakkaya Özlem Serpil
Published: August 2021

Background

Global and national undergraduate medical education accreditation organizations recommend the inclusion of Evidence-Based Medicine (EBM) instructions into the medical schools’ curricula. Accordingly, some Turkish medical schools have individually developed and implemented EBM training programs, but there is no data of current programs’ effectiveness and students’ learning achievements due to the lack of a validated Turkish language EBM assessment tool.

This study evaluates the effect of a newly introduced formal EBM instruction to the curriculum on students’ knowledge and skills by using the recently published Turkish adaptation of the Fresno Test.

Methods

The study is an experimental investigation using pre- and post-test evaluations. A five-week EBM course was developed according to Kern’s six-step curriculum development approach. A total of 78 students from the third (n = 30), fourth (n = 19) and fifth (n = 29) year of medical school voluntarily consented and were enrolled into the course. Overall, the Cerrahpaşa Medical Faculty had a total of 555, 461, and 400 students enrolled in the third, fourth, and fifth year, respectively.

The program has been evaluated based on students’ learning achievements and survey responses.

Results

The students’ mean pre-test Fresno Test score improved from 49.9 ± 18.2 to 118.9 ± 26.3 post-training. The Cohen’s effect size was 3.04 (95% CI, 2.6–3.5). The overall students’ satisfaction score was 8.66 ± 1.09 on a 1 to 10 scale.

Conclusions

The program was effective in improving students’ knowledge and skills on EBM. We propose to offer the program as an elective course during the third year of the medical school curriculum based on all data obtained during the program evaluation.
The internationalization of TCM towards Portuguese-speaking countries
Authors: Zheng Xiaoting , Lyu Liyang , Lu Hong , Hu Yuanjia , Chan Ging
Published: August 2021

With the increasing demand for traditional Chinese medicine (TCM) in Portuguese-speaking countries (PSC), local regulatory systems and relevant legislation are still insufficient and lagging, even blank in some of them. This kind of unbalanced pace either makes users of TCM exposed in potential risk or eventually obstructs the long-term development of TCM in PSC. Despite existing tremendous studies on the internationalization of TCM, there are few studies specific to PSC. Thus, by a comprehensive desk review and typical case study, this article aims to summarize current situation of TCM in PSC by a cross-regional comparison, to identify various critical challenges, and further to provide an insightful reference to impel the development of TCM in PSC.
Collision with opponents—but not foul play—dominates injury mechanism in professional men’s basketball
Authors: Achenbach Leonard , Klein Christian , Luig Patrick , Bloch Hendrik , Schneider Dominik , Fehske Kai
Published: August 2021

Background

To identify injury patterns and mechanisms in professional men’s basketball by means of video match analysis.

Methods

In Germany, injuries are registered with the statutory accident insurance for professional athletes (VBG) by clubs or club physicians as part of occupational accident reporting. Moderate and severe injuries (absence of > 7 days) sustained during basketball competition in one of four seasons (2014–2017 and 2018–2019) in the first or second national men’s league in Germany were prospectively analyzed using a newly developed standardized observation form. Season 2017–2018 was excluded because of missing video material.

Results

Video analysis included 175 (53%) of 329 moderate and severe match injuries. Contact patterns categorized according to the different body sites yielded eight groups of typical injury patterns: one each for the head, shoulders, and ankles, two for the thighs, and three for the knees. Injuries to the head (92%), ankles (76%), shoulders (70%), knees (47%), and thighs (32%) were mainly caused by direct contact. The injury proportion of foul play was 19%. Most injuries (61%) occurred in the central zone below the basket. More injuries occurred during the second (OR 1.8,p = 0.018) and fourth quarter (OR 1.8,p = 0.022) than during the first and third quarter of the match.

Conclusion

The eight identified injury patterns differed substantially in their mechanisms. Moderate and severe match injuries to the head, shoulders, knees, and ankles were mainly caused by collision with opponents and teammates. Thus, stricter rule enforcement is unlikely to facilitate safer match play.
Case fatality inequalities of critically ill COVID-19 patients according to patient-, hospital- and region-related factors: a French nationwide study
Authors: Guillon Antoine , Laurent Emeline , Duclos Antoine , Godillon Lucile , Dequin Pierre-François , Agrinier Nelly , Kimmoun Antoine , Grammatico-Guillon Leslie
Published: August 2021

Background

The COVID-19 sanitary crisis inflicted different challenges regarding the reorganization of the human and logistic resources, particularly in intensive care unit (ICU). Interdependence between regional pandemic burden and individual outcome remains unknown. The study aimed to assess the association between ICU bed occupancy and case fatality rate of critically ill COVID-19 patients.

Methods

A cross-sectional study was performed in France, using the national hospital discharge database from March to May, 2020. All patients admitted to ICU for COVID-19 were included. Case fatality was described according to: (i) patient’s characteristics (age, sex, comorbid conditions, ICU interventions); (ii) hospital’s characteristics (baseline ICU experience assessed by the number of ICU stays in 2019, number of ICU physicians per bed), and (iii) the regional outbreak-related profiles (workload indicator based on ICU bed occupancy). The determinants of lethal outcome were identified using a logistic regression model.

Results

14,513 COVID-19 patients were admitted to ICU; 4256 died (29.3%), with important regional inequalities in case fatality (from 17.6 to 33.5%). Older age, multimorbidity and clinical severity were associated with higher mortality, as well as a lower baseline ICU experience of the health structure. Regions with more than 10 days with ≥ 75% of ICU occupancy by COVID-19 patients experienced an excess of mortality (up to adjusted OR = 2.2 [1.9–2.6] for region with the highest occupancy rate of ICU beds).

Conclusions

The regions with the highest burden of care in ICU were associated with up to 2.2-fold increase of death rate.
A five-component infection control bundle to permanently eliminate a carbapenem-resistant Acinetobacter baumannii spreading in an intensive care unit
Authors: Meschiari Marianna , Lòpez-Lozano José-María , Di Pilato Vincenzo , Gimenez-Esparza Carola , Vecchi Elena , Bacca Erica , Orlando Gabriella , Franceschini Erica , Sarti Mario , Pecorari Monica , Grottola Antonella , Venturelli Claudia , Busani Stefano , Serio Lucia , Girardis Massimo , Rossolini Gian Maria , Gyssens Inge C. , Monnet Dominique L. , Mussini Cristina
Published: August 2021

Background

Carbapenem-resistant Acinetobacter baumannii (CRAB) infection outbreaks are difficult to control and sometimes require cohorting of CRAB-positive patients or temporary ward closure for environmental cleaning. We aimed at controlling the deadly 2018 CRAB outbreak in a 12 bed- intensive care unit (ICU) including 9 beds in a 220 m2 open space. We implemented a new multimodal approach without ward closure, cohorting or temporarily limiting admissions.

Methods

A five-component bundle was introduced in 2018 including reinforcement of hand hygiene and sample extension of screening, application of contact precautions to all patients, enhanced environmental sampling and the one-time application of a cycling radical environmental cleaning and disinfection procedure of the entire ICU.

The ICU-CRAB incidence density (ID), ICU alcohol-based hand rub consumption and antibiotic use were calculated over a period of 6 years and intervention time series analysis was performed. Whole genome sequencing analysis (WGS) was done on clinical and environmental isolates in the study period.

Results

From January 2013, nosocomial ICU-CRAB ID decreased from 30.4 CRAB cases per 1000 patients-days to zero cases per 1000 patients-days. Our intervention showed a significant impact (-2.9 nosocomial ICU-CRAB cases per 1000 bed-days), while no influence was observed for antibiotic and alcohol-based hand rub (AHR) consumption.

WGS demonstrated that CRAB strains were clonally related to an environmental reservoir which confirms the primary role of the environment in CRAB ICU spreading.

Conclusion

A five-component bundle of continuous hand hygiene improvement, extended sampling at screening including the environment, universal contact precautions and a novel cycling radical environmental cleaning and disinfection procedure proved to be effective for permanently eliminating CRAB spreading within the ICU. Cohorting, admission restriction or ICU closure were avoided.
The metabolic footprint of Clostridia and Erysipelotrichia reveals their role in depleting sugar alcohols in the cecum
Authors: Tiffany Connor R. , Lee Jee-Yon , Rogers Andrew W. L. , Olsan Erin E. , Morales Pavel , Faber Franziska , Bäumler Andreas J.
Published: August 2021

Background

The catabolic activity of the microbiota contributes to health by aiding in nutrition, immune education, and niche protection against pathogens. However, the nutrients consumed by common taxa within the gut microbiota remain incompletely understood.

Methods

Here we combined microbiota profiling with an un-targeted metabolomics approach to determine whether depletion of small metabolites in the cecum of mice correlated with the presence of specific bacterial taxa. Causality was investigated by engrafting germ-free or antibiotic-treated mice with complex or defined microbial communities.

Results

We noted that a depletion of Clostridia and Erysipelotrichia from the gut microbiota triggered by antibiotic treatment was associated with an increase in the cecal concentration of sugar acids and sugar alcohols (polyols). Notably, when we inoculated germ-free mice with a defined microbial community of 14 Clostridia and 3 Erysipelotrichia isolates, we observed the inverse, with a marked decrease in the concentrations of sugar acids and polyols in cecal contents. The carbohydrate footprint produced by the defined microbial community was similar to that observed in gnotobiotic mice receiving a cecal microbiota transplant from conventional mice. Supplementation with sorbitol, a polyol used as artificial sweetener, increased cecal sorbitol concentrations in antibiotic-treated mice, which was abrogated after inoculation with a Clostridia isolate able to grow on sorbitol in vitro.

Conclusions

We conclude that consumption of sugar alcohols by Clostridia and Erysipelotrichia species depletes these metabolites from the intestinal lumen during homeostasis.
Microglial transcriptome analysis in the rNLS8 mouse model of TDP-43 proteinopathy reveals discrete expression profiles associated with neurodegenerative progression and recovery
Authors: Hunter Mandana , Spiller Krista J. , Dominique Myrna A. , Xu Hong , Hunter Francis W. , Fang Terry C. , Canter Rebecca G. , Roberts Christopher J. , Ransohoff Richard M. , Trojanowski John Q. , Lee Virginia M.-Y.
Published: August 2021

The microglial reaction is a hallmark of neurodegenerative conditions, and elements thereof may exert differential effects on disease progression, either worsening or ameliorating severity. In amyotrophic lateral sclerosis (ALS), a syndrome characterized by cytoplasmic aggregation of TDP-43 protein and atrophy of motor neurons in the cortex and spinal cord, the transcriptomic signatures of microglia during disease progression are incompletely understood. Here, we performed longitudinal RNAseq analysis of cortical and spinal cord microglia from rNLS8 mice, in which doxycycline-regulatable expression of human TDP-43 (hTDP-43) in the cytoplasm of neurons recapitulates many features of ALS. Transgene suppression in rNLS8 mice leads to functional, anatomical and electrophysiological resolution that is dependent on a microglial reaction that is concurrent with recovery rather than disease onset. We identified basal differences between the gene expression profiles of microglia dependent on localization in spinal cord or cortex. Microglia subjected to chronic hTDP-43 overexpression demonstrated transcriptomic changes in both locations. We noted strong upregulation of Apoe, Axl, Cd63, Clec7a, Csf1, Cst7, Igf1, Itgax, Lgals3, Lilrb4, Lpl and Spp1 during late disease and recovery. Importantly, we identified a distinct suite of differentially expressed genes associated with each phase of disease progression and recovery. Differentially expressed genes were associated with chemotaxis, phagocytosis, inflammation, and production of neuroprotective factors. These data provide new insights into the microglial reaction in TDP-43 proteinopathy. Genes differentially expressed during progression and recovery may provide insight into a unique instance in which the microglial reaction promotes functional recovery after neuronal insult.
A novel strategy for D-psicose and lipase co-production using a co-culture system of engineered Bacillus subtilis and Escherichia coli and bioprocess analysis using metabolomics
Authors: Zhang Jun , Luo Wen , Wang Zhiyuan , Chen Xiaoyan , Lv Pengmei , Xu Jingliang
Published: August 2021

To develop an economically feasible fermentation process, this study designed a novel bioprocess based on the co-culture of engineered Bacillus subtilis and Escherichia coli for the co-production of extracellular D-psicose and intracellular lipase. After optimizing the co-culture bioprocess, 11.70 g/L of D-psicose along with 16.03 U/mg of lipase was obtained; the glucose and fructose were completely utilized. Hence, the conversion rate of D-psicose reached 69.54%. Compared with mono-culture, lipase activity increased by 58.24%, and D-psicose production increased by 7.08%. In addition, the co-culture bioprocess was explored through metabolomics analysis, which included 168 carboxylic acids and derivatives, 70 organooxygen compounds, 34 diazines, 32 pyridines and derivatives, 30 benzene and substituted derivatives, and other compounds. It also could be found that the relative abundance of differential metabolites in the co-culture system was significantly higher than that in the mono-culture system. Pathway analysis revealed that, tryptophan metabolism and β-alanine metabolism had the highest correlation and played an important role in the co-culture system; among them, tryptophan metabolism regulates protein synthesis and β-alanine metabolism, which is related to the formation of metabolic by-products. These results confirm that the co-cultivation of B. subtilis and E. coli can provide a novel idea for D-psicose and lipase biorefinery, and are beneficial for the discovery of valuable secondary metabolites such as turanose and morusin.