bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapid Palatal Expansion Should Not Be Trivialized: Two Case Reports of Unexpected Complications
Authors: Lopponi Gaia , Maino Bortolo Giuliano , Dalessandri Domenico
Published: June 2021

Rapid maxillary expansion is one of the most common orthodontic procedures performed in the pediatric population, easy to accomplish and compliance free, therefore really effective. Nevertheless, a careful diagnosis and frequent clinical follow-up appointments are necessary during the first weeks of active treatment. The purpose of this article was to report two cases of unexpected complications during orthopaedic maxillary expansion, involving two 7-year-old female patients, one presenting a saddle nose with suborbital hematoma and the other one an asymmetric palatal expansion. In both cases, the clinical situation progressively relapsed during the months following expansion appliance removal.
TaTME: Present and Future Perspectives?
Authors: Otero-Piñeiro A. M. , Bravo R. , Lacy A. M.
Published: June 2021

Transanal total mesorectal excision (TaTME) is a new procedure developed to overcome the specific difficulties posed by rectal surgery, especially in narrow pelvis, male, and obese patients, and can be used in benign and malignant pathologies. The advantages are especially important in rectal cancer, as they could potentially result in a more precise distal dissection, lower rate of positive circumferential resection margins, and increase the rate of sphincter-sparing procedures. The indications for TaTME are currently expanding, despite not yet being standardized. Training programs are increasing day by day, to improve the learning curve related to this difficult technique. The procedure is feasible and safe with similar intraoperative complications and readmission rates compared with open/laparoscopic approach. Oncological results have shown that TaTME is associated with better quality mesorectal excision and safer distal resection margin. In this work, we review the evolution of TaTME, surgical technique, development, applicability, current situation, and implementation, as well as future perspectives for colorectal cancer and other pathologies. While satisfactory short-term results have been reported, it is a new technique, and long-term results and definitive results from controlled trials are pending. As evidence of safety and feasibility accumulates, training programs structured to standardize teaching, training, and safe expansion will aid the safe spread of TaTME.
27.27 Product Class 27: 1,2-Diimines
Authors: Isovitsch R.
Published: June 2021

The utility of 1,2-diimines (α-diimines, 1,4-diazabutadienes) stems from the ease with which their steric and electronic properties can be tailored to a specific use. Current interest in this area involves using 1,2-diimines as precursors for novel bioactive compounds, as well as transition-metal ligands for the formation of novel polymerization catalysts and chemotherapeutic agents. In this review, the fundamental approaches for the synthesis of 1,2-diimines are described, as well as a current sampling of the unique ways that they are used to solve research problems. The chapter is organized based on the ways that 1,2-diimines are synthesized: condensation reactions and metal-promoted methods.
Multiplicity and simultaneity in ethnographic research: Exploring the use of drones in Ghana
Authors: Adotey Edem
Published: June 2021

This research note explores the ethical and methodological implications of using drones for ethnographic research at events that involve simultaneous activities and/or large crowds and large spaces. Based on the methodological challenges of collecting visual data using cameras in the case of royal funerals in Ghana, this note argues that the aerial viewpoint provided by drones could transform visual data collection by capturing sophisticated views of multiple events happening at the same time. However, it also identifies ethical and methodological challenges of using drones and argues that it could obscure the understanding of sociocultural complexities. This research note contributes to our understanding of visual methodologies by highlighting how drone technology extends and complicates current understandings and debates on the use of photographs and films in ethnography.
Destructive Arthropathy of the Femoral Head
Authors: Layfield Lester J , Crim Julia R
Published: June 2021

Objectives

Destructive arthropathy of the hip refers to noninfectious arthropathy causing extensive femoral head bone destruction. It has been described in the surgical literature using a variety of diagnostic criteria, but it remains a poorly defined entity.

Methods

Cases of destructive arthropathy diagnosed at our institution between July 1, 2015, and December 31, 2019, were identified by a free text search of the radiology database. The medical record of each case was reviewed for possible causes of femoral head destruction, clinical presentation, laboratory values, imaging studies, and pathologic diagnoses. Imaging studies and pathology specimens were retrospectively reviewed.

Results

Twenty femoral heads were identified in which there was 25% or greater destruction of the femoral head in the absence of infections, congenital disease, or inflammatory arthritis. Destructive arthropathy was characterized pathologically by fibromyxoid change of the marrow, aggregates of necrotic bone fragments, increased numbers of osteoclasts, increased trabecular destruction, and granuloma-like aggregates.

Conclusions

The histologic findings were distinctive. We postulate that a variety of preexisting conditions set in motion a cascade of tissue factors that led to bone destruction.
Nucleic acid requirement of plants from low phosphorus habitats. A Commentary on: Foliar nutrient-allocation patterns inBanksia attenuataandBanksia sessilisdiffering in growth rate and adaptation to low-phosphorus habitats
Authors: Raven John A
Published: June 2021

This article comments on:

Zhongming Han, Jianmin Shi, Jiayin Pang, Li Yan, Patrick M. Finnegan and Hans Lambers. Foliar nutrient allocation patterns in Banksia attenuata and Banksia sessilis differing in growth rate and adaptation to low-phosphorus habitats, Annals of Botany, Volume 128, Issue 4, 03 September 2021, Pages 419–430, https://doi.org/10.1093/aob/mcab013
Broad activation of the Parkin pathway induces synaptic mitochondrial deficits in early tauopathy
Authors: Jeong Yu Young , Han Sinsuk , Jia Nuo , Zhang Mingyang , Sheshadri Preethi , Tammineni Prasad , Cheung Jasmine , Nissenbaum Marialaina , Baskar Sindhuja S , Kwan Kelvin , Margolis David J , Jiang Peng , Kusnecov Alexander W. , Cai Qian
Published: June 2021

Mitochondrial defects are a hallmark of early pathophysiology in Alzheimer’s disease, with pathologically phosphorylated tau reported to induce mitochondrial toxicity. Mitophagy constitutes a key pathway in mitochondrial quality control by which damaged mitochondria are targeted for autophagy. However, few details are known regarding the intersection of mitophagy and pathologies in tauopathy.

Here, by applying biochemical and cell biological approaches including time-lapse confocal imaging in live tauopathy neurons, combined with gene rescue experiments via stereotactic injections of adeno-associated virus particles into tauopathy mouse brains, electrophysiological recordings and behavioural tests, we demonstrate for the first time that mitochondrial distribution deficits at presynaptic terminals are an early pathological feature in tauopathy brains. Furthermore, Parkin-mediated mitophagy is extensively activated in tauopathy neurons, which accelerates mitochondrial Rho GTPase 1 (Miro1) turnover and consequently halts Miro1-mediated mitochondrial anterograde movement towards synaptic terminals. As a result, mitochondrial supply at tauopathy synapses is disrupted, impairing synaptic function. Strikingly, increasing Miro1 levels restores the synaptic mitochondrial population by enhancing mitochondrial anterograde movement and thus reverses tauopathy-associated synaptic failure. In tauopathy mouse brains, overexpression of Miro1 markedly elevates synaptic distribution of mitochondria and protects against synaptic damage and neurodegeneration, thereby counteracting impairments in learning and memory as well as synaptic plasticity.

Taken together, our study reveals that activation of the Parkin pathway triggers an unexpected effect—depletion of mitochondria from synaptic terminals, a characteristic feature of early tauopathy. We further provide new mechanistic insights into how parkin activation-enhanced Miro1 degradation and impaired mitochondrial anterograde transport drive tauopathy-linked synaptic pathogenesis and establish a foundation for future investigations into new therapeutic strategies to prevent synaptic deterioration in Alzheimer’s disease and other tauopathies.
Transitioning health workers from PEPFAR contracts to the Uganda government payroll
Authors: Zakumumpa Henry , Rujumba Joseph , Amde Woldekidan , Damian Respicius Shumbusho , Maniple Everd , Ssengooba Freddie
Published: June 2021

Although increasing public spending on health worker (HW) recruitments could reduce workforce shortages in sub-Saharan Africa, effective strategies for achieving this are still unclear. We aimed to understand the process of transitioning HWs from President’s Emergency Plan for AIDS Relief (PEPFAR) to Government of Uganda (GoU) payrolls and to explore the facilitators and barriers encountered in increasing domestic financial responsibility for absorbing this expanded workforce. We conducted a multiple case study of 10 (out of 87) districts in Uganda which received PEPFAR support between 2013 and 2015 to expand their health workforce. We purposively selected eight districts with the highest absorption rates (‘high absorbers’) and two with the lowest absorption rates (‘low absorbers’). A total of 66 interviews were conducted with high-level officials in three Ministries of Finance, Health and Public Service (n = 14), representatives of PEPFAR-implementing organizations (n = 16), district health teams (n = 15) and facility managers (n = 22). Twelve focus groups were conducted with 87 HWs absorbed on GoU payrolls. We utilized the Consolidated Framework for Implementation Research to guide thematic analysis. At the sub-national level, facilitators of transition in ‘high absorber’ districts were identified as the presence of transition ‘champions’, prioritizing HWs in district wage bill commitments, host facilities providing ‘bridge financing’ to transition workforce during salary delays and receiving donor technical support in district wage bill analysis—attributes that were absent in ‘low absorber’ districts. At the national level, multi-sectoral engagements (incorporating the influential Ministry of Finance), developing a joint transition road map, aligning with GoU salary scales and recruitment processes emerged as facilitators of the transition process. Our case studies offer implementation research lessons on effective donor transition and insights into pragmatic strategies for increasing public spending on expanding the health workforce in a low-income setting.
Barriers and facilitators to the implementation of Health-Promoting School programmes targeting bullying and violence: a systematic review
Authors: Sadjadi Mahan , Blanchard Laurence , Brülle Rebecca , Bonell Chris
Published: June 2021

Health-Promoting School (HPS) interventions aim to reduce bullying and violence via curriculum, environmental and family/community-engagement components. Despite evidence of their effectiveness, factors influencing the implementation of such interventions are poorly understood. This systematic review aims to examine such factors by assessing qualitative process evaluations of HPS interventions aiming to reduce bullying, aggression or violence. A comprehensive systematic search of 12 databases was carried out, and 20 reports from 17 studies were included. Thematic synthesis was used to identify factors affecting implementation. Factors that enable implementation were related to programme characteristics and stakeholder buy-in, including support from leadership, teachers, students and parents. Good communication and staff climate were important. Interventions were better implemented when they framed health promotion as a core school business, were supported by a national policy, used local data to show need and effectiveness and provided high-quality, pragmatic and accessible staff training. The results of this review can serve to guide and facilitate the design and implementation of future bullying and violence prevention programmes. Since there is significant overlap in terms of the important pillars and guiding principles for all interventions guided by the HPS framework, the findings may apply to outcomes beyond bullying and violence.
Localized patterns in a generalized Swift–Hohenberg equation with a quartic marginal stability curve
Authors: Bentley David C , Rucklidge Alastair M
Published: June 2021

In some pattern-forming systems, for some parameter values, patterns form with two wavelengths, while for other parameter values, there is only one wavelength. The transition between these can be organized by a codimension-three point at which the marginal stability curve has a quartic minimum. We develop a model equation to explore this situation, based on the Swift–Hohenberg equation; the model contains, amongst other things, snaking branches of patterns of one wavelength localized in a background of patterns of another wavelength. In the small-amplitude limit, the amplitude equation for the model is a generalized Ginzburg–Landau equation with fourth-order spatial derivatives, which can take the form of a complex Swift–Hohenberg equation with real coefficients. Localized solutions in this amplitude equation help interpret the localized patterns in the model. This work extends recent efforts to investigate snaking behaviour in pattern-forming systems where two different stable non-trivial patterns exist at the same parameter values.
Characteristics of quality activities in a tertiary teaching hospital in Western Australia
Authors: Li Qun Catherine , Karnon Jonathan , Towler Simon , Codde Jim
Published: June 2021

Background

Despite all the resourcefulness and efforts in the last 30 years for quality in healthcare, safety and quality considerations are recognized with up to 17% of total hospital activity and expenditure related to adverse events. A knowledge gap is identified in the literature that few studies have reported from a whole hospital perspective on what and how quality activities are being performed, particularly in the Australian context.

Objective

This study aims to describe the characteristics of quality activities in a tertiary quaternary hospital in Western Australia.

Methods

Data from the study hospital’s electronic quality management system Governance, Evidence, Knowledge and Outcome between 1 January 2015 and 31 December 2019 was analysed by using descriptive and thematic methods.

Results

Quality assurance (QA) accounted for 68.3% of all quality activities in the study hospital. Principal investigators of activities were mostly in clinical roles and relatively senior in their profession. Collaboration within the same profession and same team was common, but much less so across departments. The median quality cycle length measured by proposal submission to completion was 202 days, but 190 days when measured by proposal approval to completion. A majority (93.2%) of quality activities were undertaken as part of everyday business. Common issues outlined in activity reports were documentation and compliance 44.8% (n = 100), data and tool limitations 10.8% (n = 24), variation in care 9.9% (n = 22), process 9.4% (n = 21), and knowledge and awareness 9.0% (n = 20). Common recommendations to address the issues were communicating findings to relevant teams and governance committees 26.8% (n = 104), further data collection including re-audit 26.0% (n = 101), education and training 20.4% (n = 79), process review and/or development 13.9% (n = 54), and policy/guidelines review and/or development 4.4% (n = 17).

Conclusion

Understanding the characteristics of quality activities from a whole hospital perspective provides insights and informs discussions relating to the efficiency and effectiveness of quality activities in hospitals. Embedding quality activities into everyday business is achievable for hospitals but considerations need to occur on how to sustain staff motivation and enthusiasm by helping individuals and teams reach the ultimate goals for improvement and keeping performance monitoring as close to the real time of care as possible. There is a need to transform QA into quality improvement, with the 90-day cycle being a feasible target for QA in hospitals.
We Are a Community of Practice, Not a Paradigm! How to Meaningfully Integrate Gender and Feminist Approaches in IR Syllabi
Authors: Sondarjee Maïka
Published: June 2021

The most frequent practice in teaching western undergraduate students about international relations (IR) is either to avoid gender studies altogether or at best to compartmentalize them to a single week. This practice marginalizes feminist research by amalgamating highly heterogeneous publications under the pretense that “they look at gender.” Rather than treating gender studies as a unified research program, they should be linked to the full range of theories, approaches, or topics they are relevant to, based on their normative and ontological assumptions. In the end, gender-oriented scholars do not form a would-be paradigm, but a community of practice. This community, however, can itself perpetuate colonial exclusions and silencing. This study is based on a content analysis of fifty western undergraduate “Introduction to IR” syllabi from 2015 to 2020, as well as a reflection on my own experience since 2011 as a student, teaching assistant, guest lecturer, and professor in ten IR courses at three western universities.
A Novel Thyroglobulin Immunoassay Using the Specimen-Pretreatment Process Improves the Accuracy of Thyroglobulin Measurements in Anti-Thyroglobulin Positive Specimens
Authors: Kitamura Yoshiyuki , Narita Sho , Kuroda Yu , Yagi Shintaro , Aoyagi Katsumi
Published: June 2021

Background

Recently, second-generation thyroglobulin (Tg) sandwich immunoassays have been used in clinical laboratories to measure the serum Tg levels, which is a tumor marker used to monitor postoperative patients with differentiated thyroid cancers. However, these immunoassays are often subject to Tg autoantibody (TgAb) interference. TgAb interference is inevitable for almost all Tg immunoassays, resulting in unreliable Tg measurement values of TgAb-positive samples.

Methods

To address TgAb interference, we have developed a novel immunoassay based on a fully automated chemiluminescent enzyme immunoassay system using the effective specimen-pretreatment process to inactivate TgAb in blood and evaluated its assay performance.

Results

The developed assay was traceable to BCR457 IRMM reference material with a limit of quantification of 0.03 ng/mL. The pretreatment process inactivated almost all TgAb in specimens and allowed accurate Tg measurements in TgAb-positive samples in which TgAb interference was observed using the immunoassays. Size-exclusion chromatography analysis of immunoreactive Tg molecule in a TgAb-positive serum verified disruption of the Tg–TgAb immune complex by the pretreatment process. Good correlation of Tg values in TgAb-negative specimens was observed between the new Tg immunoassay and the second-generation sandwich immunoassays. However, there were numerous discrepant samples on bias plots between the new Tg immunoassay and the second-generation sandwich immunoassays for TgAb-positive specimens.

Conclusions

This study indicates the new Tg immunoassay with the specimen-pretreatment process is both robust and free from interference by TgAb. Thus, this novel assay is superior to second-generation sandwich immunoassays and gives accurate Tg concentrations even for TgAb-positive cases.
Xanthomicrol suppresses human hepatocellular carcinoma cells migration and invasion ability via Μu-opioid receptor
Authors: Lin Zi-Zhong , Bo Nie , Fan Yu-Chun , Wu Yan-Ting , Yao Hong-Liang , Chen Su , Yu Hui-Fan , Jiang Li-He
Published: June 2021

Background

Xanthomicrol is one of the methoxylated flavones and a promising cancer chemopreventive agent, but its anti-migration and anti-invasion ability on human hepatocellular carcinoma (HCC) remains unknown.

Objectives

This study aims to explore Xanthomicrol’s effects on migration and invasion ability of the human HCC Huh7 cell line.

Methods

Viability of Huh7 cells was measured by cell counting kit-8 (CCK8) assay. Cell apoptosis was assayed with flow cytometry analysis. The ability of migration and invasion of Huh7 cells was then detected through Transwell assays. Epithelial–mesenchymal transition (EMT)-related proteins were also detected through Western blot.

Key findings

Xanthomicrol inhibits the migration and invasion of Huh7 cells. The overexpression of Μu-opioid receptor (MOR) increases Huh7 cells’ proliferation and enhances migration and invasion ability, while xanthomicrol treatment decreases the expression of MOR. Moreover, xanthomicrol can reverse migration, invasion and EMT-related protein expression by overexpressed MOR.

Conclusions

These results suggest that xanthomicrol is a potential MOR antagonist, and it possesses potent anti-migration and anti-invasion ability on Huh7 cells.
Ulnar nerve compression secondary to migration of pyrocarbon implant following right wrist arthroplasty
Authors: Cheung Lok Ka , Smock Elliott , Pickford Mark
Published: June 2021

A 50-year-old, right-hand dominant woman presented with a seven-month history of stiffness, pain and swelling on the ulnar side of her right wrist. She had undergone right wrist arthroplasty with a Pyrocarbon Amandys implant seven months previously for post-traumatic degenerative arthritis. She had an uneventful initial recovery until developing carpal tunnel syndrome, for which she underwent carpal tunnel release 5 months after her arthroplasty.

Examination revealed a painful and limited range of movement in the affected wrist, with weakness of the first dorsal interosseous muscle and altered sensation in the ring finger. A hard swelling was visible and palpable on the palmar-ulnar aspect of the wrist. X-rays showed that the swelling was due to the dislocated Amandys implant (which was thought to be causing compression neuropathy of the ulnar nerve). The patient underwent removal of the pyrocarbon implant (through a palmar approach) and total wrist fusion one month later, following which the wrist successfully united and all symptoms of ulnar nerve compression resolved.

Although some studies have reported migration of pyrocarbon implant following total wrist arthroplasty, to our knowledge, this is the first reported case of ulnar compression neuropathy from a migrated pyrocarbon wrist implant.
A Pediatric Hospital Physical Therapy and Occupational Therapy Department’s Response to COVID-19: An Administrative Case Report
Authors: Greenwood Jonathan , Fragala-Pinkham Maria , Dakhlian Megan Geno , Brennan Ellen , Ploski Christine , Correia Annette
Published: June 2021

Objective

The purpose of this case report is to describe the challenges that COVID-19 presented for therapists in a pediatric hospital and the response to these challenges.

Methods

The case report setting is a physical therapy and occupational therapy department (department) of an academic pediatric medical center that provides a range of health care services for children and youth. Challenges that COVID-19 presented to the department included (1) managing safety concerns for patients, their families, and staff; (2) continuing to provide high-quality therapy services within state-mandated restrictions; (3) triaging patients; and (4) keeping clinicians employed and working productively.

Results

The department therapists responded to these challenges by (1) increasing communication huddles; (2) developing procedures for staffing and triaging of patients; (3) developing procedures for telehealth therapy services; and (4) designing a remote work program for all department employees. The number of patients and staff on site were reduced by initiating telehealth services, triaging patients, and developing a remote work plan. Communication huddles, department meetings, and supervision meetings were converted to virtual meetings. Staffing rates, patient-care productivity, and department project work were maintained.

Conclusion

In response to COVID-19, the department developed new protocols and provided information about the protocols, which might be helpful for other pediatric hospitals or outpatient settings when planning for future pandemics or other issues that challenge the ability to provide usual care. Increasing the frequency of verbal and written communication on operational topics is recommended. Primary sources of information from national organizations (eg, the American Physical Therapy Association and the American Occupational Therapy Association) can assist with determining the scope of practice and code of conduct during a pandemic.

Impact

COVID-19 posed challenges to operations and delivery of patient care. Although this case report is specific to COVID-19, principles applied and lessons learned from this experience can be applied to other emergency situations.
Challenges to Democratic Practices and Discourses in the European Parliament: Feminist Perspectives on the Politics of Political Groups
Authors: Kantola Johanna , Lombardo Emanuela
Published: June 2021

The European Parliament is now host to a significant number of politicians from radical right populist parties, leaving the Parliament to deal with illiberal elements within its structures. At the heart of the European Union's democratic values is a commitment to gender equality, a commitment hotly contested by illiberal actors and radical right populists. The research objective of this article is to use feminist political theories of democracy to understand the challenges and possibilities for democracy in the European Parliament. This overarching research objective is approached through studying political groups’ discourses and practices of democracy and equality. A qualitative analysis of parliamentary debates and interviews with European Parliament Members and staff in the 2014–2019 and 2019–2024 legislatures makes it possible to identify both antagonistic dynamics targeting gender and human rights and agonistic deliberation which creates opportunities for improving democratic practices.
Deciphering Adverse Drug Reactions:In VitroPriming and Characterization of Vancomycin-Specific T Cells From Healthy Donors Expressing HLA-A*32:01
Authors: Ogese Monday O , Lister Adam , Gardner Joshua , Meng Xiaoli , Alfirevic Ana , Pirmohamed Munir , Park B Kevin , Naisbitt Dean J
Published: June 2021

Drug rash with eosinophilia with systemic symptoms (DRESS) is a serious adverse event associated with use of the glycopeptide antibiotic vancomycin. Vancomycin-induced drug rash with eosinophilia with systemic symptoms is associated with the expression of human leukocyte antigen (HLA)-A*32:01, suggesting that the drug interacts with this HLA to activate CD8+ T cells. The purpose of this study was to utilize peripheral blood mononuclear cell from healthy donors to: (1) investigate whether expression of HLA-A*32:01 is critical for the priming naïve of T cells with vancomycin and (2) generate T-cell clones (TCC) to determine whether vancomycin exclusively activates CD8+ T cells and to define cellular phenotype, pathways of drug presentation and cross-reactivity. Dendritic cells were cultured with naïve T cells and vancomycin for 2 weeks. On day 14, cells were restimulated with vancomycin and T-cell proliferation was assessed by [3H]-thymidine incorporation. Vancomycin-specific TCC were generated by serial dilution and repetitive mitogen stimulation. Naïve T cells from HLA-A*02:01 positive and negative donors were activated with vancomycin; however the strength of the induced response was significantly stronger in donors expressing HLA-A*32:01. Vancomycin-responsive CD4+ and CD8+ TCC from HLA-A*32:01+ donors expressed high levels of CXCR3 and CCR4, and secreted IFN-γ, IL-13, and cytolytic molecules. Activation of CD8+ TCC was HLA class I-restricted and dependent on a direct vancomycin HLA binding interaction with no requirement for processing. Several TCC displayed cross-reactivity with teicoplanin and daptomycin. To conclude, this study provides evidence that vancomycin primes naïve T cells from healthy donors expressing HLA-A*32:01 through a direct pharmacological binding interaction. Cross-reactivity of CD8+ TCC with teicoplanin provides an explanation for the teicoplanin reactions observed in vancomycin hypersensitive patients.
Mono-n-Butyl Phthalate Distributes to the Mouse Ovary and Liver and Alters the Expression of Phthalate-Metabolizing Enzymes in Both Tissues
Authors: Jauregui Estela J , Lock Jasmine , Rasmussen Lindsay , Craig Zelieann R
Published: June 2021

Humans are exposed to phthalates daily via items such as personal care products and medications. Reproductive toxicity has been documented in mice exposed to di-n-butyl phthalate (DBP); however, quantitative evidence of its metabolite, mono-n-butyl phthalate (MBP), reaching the mouse ovary and its effects on hepatic and ovarian biotransformation enzymes in treated mice is still lacking. Liquid chromatography/tandem mass spectrometry (LC-MS/MS) was employed to quantify MBP levels in liver, serum, and ovary from mice treated with a single or repeated exposure to the parent compound, DBP. Adult CD-1 females were pipet fed once or for 10 days with vehicle (tocopherol-stripped corn oil) or DBP at 1, 10, and 1000 mg/kg/day. Tissues and serum were collected at 2, 6, 12, and 24 h after the single or final dose and subjected to LC-MS/MS. Ovaries and livers were processed for qPCR analysis of selected phthalate-associated biotransformation enzymes. Regardless of duration of exposure (single vs repeated), MBP was detected in the tissues of DBP-treated mice. In single dose mice, MBP levels peaked at ≤6 h and fell close to background levels by 24 h post-exposure. Following the last repeated dose, MBP levels peaked at ≤2 h and fell to background levels by 12 h. Hepatic and ovarian expression of Lpl, Aldh1a1, Adh1, Ugt1a6a, and Cyp1b1 were altered in DBP-treated mice in a time- and dose-specific manner. These findings confirm that MBP reaches the mouse liver and ovary after oral exposure to DBP and influences the expression of hepatic and ovarian phthalate-associated biotransformation enzymes.
Using 3D geometric morphometrics to aid taxonomic and ecological understanding of a recent speciation event within a small Australian marsupial (Antechinus: Dasyuridae)
Authors: Viacava Pietro , Baker Andrew M , Blomberg Simone P , Phillips Matthew J , Weisbecker Vera
Published: June 2021

Taxonomic distinction of species forms the foundation of biodiversity assessments and conservation priorities. However, traditional morphological and/or genetics-based taxonomic assessments frequently miss the opportunity of elaborating on the ecological and functional context of species diversification. Here, we used 3D geometric morphometrics of the cranium to improve taxonomic differentiation and add ecomorphological characterization of a young cryptic divergence within the carnivorous marsupial genus Antechinus. Specifically, we used 168 museum specimens to characterize the recently proposed clades A. stuartii ‘south’, A. stuartii ‘north’ and A. subtropicus. Beyond slight differences attributable to overall size (and, therefore, not necessarily diagnostic), we also found clear allometry-independent shape variation. This allowed us to define new, easily measured diagnostic traits in the palate, which differentiate the three clades. Contrary to previous suggestions, we found no support for a latitudinal gradient as causing the differentiation between the clades. However, skull shape co-varied with temperature and precipitation seasonality, suggesting that the clades may be adapted to environmental variables that are likely to be impacted by climate change. Our study demonstrates the use of 3D geometric morphometrics to improve taxonomic diagnosis of cryptic mammalian species, while providing perspectives on the adaptive origins and potential future threats of mammalian diversity.
Survey of the Impact of COVID-19 on Pediatric Orthopaedic Surgeons Globally
Authors: Gibbard Marissa , Ponton Ethan , Sidhu Bernita V. , Farrell Sarah , Bone Jeffrey N. , Wu Luke A. , Schaeffer Emily , Cooper Anthony , Aroojis Alaric , Mulpuri Kishore
Published: June 2021

Background:

The coronavirus disease 2019 (COVID-19) pandemic required rapid, global health care shifts to prioritize urgent or pandemic-related care and minimize transmission. Little is known about impacts on pediatric orthopaedic surgeons during this time. We aimed to investigate COVID-19-related changes in practice, training, and research among pediatric orthopaedic surgeons globally.

Methods:

An online survey was administered to orthopaedic surgeons with interest in pediatrics in April 2020 and a follow-up was administered in February 2021. The surveys captured demographics and surgeons’ self-reported experiences during the pandemic. Participants were recruited from web media and available email lists of orthopaedic societies over a 2-month period. Descriptive statistics were used to analyze results, stratified by the severity of local COVID-19-related measures.

Results:

A total of 460 responses from 45 countries were collected for initial survey. Of these, 358 (78.5%) respondents reported lockdown measures in their region at time of survey. Most (n=337, 94.4%) reported pausing all elective procedures. Surgeons reported a reduction in the average number of surgeries per week, from 6.89 (SD=4.61) prepandemic to 1.25 (SD=2.26) at time of survey (mean difference=5.64; 95% confidence interval=5.19, 6.10). Average number of elective outpatient appointments per week decreased from 67.89 (SD=45.78) prepandemic to 11.79 (SD=15.83) at time of survey (mean difference=56.10, 95% confidence interval=5.61, 60.58). In total, 177 (39.4%) surgeons reported using virtual modes of outpatient appointments for the first time. Of 290 surgeons with trainees, 223 (84.5%) reported implementation of systems to continue training such as webinars or virtual rounds. Of 192 respondents with research, 149 (82.8%) reported continuing research activities during the pandemic with most reporting either cessation (n=75, 64.15%), or reduction (n=25, 29.9%) in participant recruitment. A total of 111 responses from 28 countries were collected during follow-up. Surgeons described policy and circumstantial changes that facilitated resumption of clinical work.

Conclusions:

The COVID-19 pandemic and its related counter measures have had significant impacts on pediatric orthopaedic practice and increased uptake of technology to provide care continuity. Rigorous epidemiological studies are needed to assess impacts of delayed and virtual care on patient outcomes.
Distal Bile Duct Cancer: Radical (R0 > 1 mm) Resection Achieves Favorable Survival
Authors: Tjaden Christine , Hinz Ulf , Klaiber Ulla , Heger Ulrike , Springfeld Christoph , Goeppert Benjamin , Schmidt Thomas , Mehrabi Arianeb , Strobel Oliver , Berchtold Christoph , Schneider Martin , Diener Markus , Neoptolemos John P. , Hackert Thilo , Büchler Markus W.
Published: June 2021

Objective:

Evaluation of the outcome after resection for distal bile duct cancer (DBC) with focus on the impact of microscopic histopathological resection status R0 (>1 mm) versus R1 (≤1 mm) vs R1 (direct).

Summary Background Data:

DBC is a rare disease for which oncologic resection offers the only chance of cure.

Methods:

Prospectively collected data of consecutive patients undergoing pancreaticoduodenectomy for DBC were analyzed. Histopathological resection status was classified according to the Leeds protocol for pancreatic ductal adeno carcinoma (PDAC) (PDAC; R0 >1 mm margin clearance vs R1 ≤1 mm vs R1 direct margin involvement).

Results:

A total of 196 patients underwent pancreaticoduodenectomy for DBC. Microscopic complete tumor clearance (R0>1 mm) was achieved in 113 patients (58%). Median overall survival (OS) of the entire cohort was 37 months (5- and 10-year OS rate: 40% and 31%, respectively). After R0 resection, median OS increased to 78 months with a 5-year OS rate of 52%. Negative prognostic factors were age >70 years (P < 0.0001, hazard ratio (HR) 2.48), intraoperative blood loss >1000 mL (P = 0.0009, HR 1.99), pN1 and pN2 status (P = 0.0052 and P = 0.0006, HR 2.14 and 2.62, respectively) and American Society of Anesthesiologists score >II (P = 0.0259, HR 1.61).

Conclusions:

This is the largest European single-center study of surgical treatment for DBC and the first to investigate the prognostic impact of the revised PDAC resection status definition in DBC. The results show that this definition is valid in DBC and that “true” R0 resection (>1 mm) is a key factor for excellent survival. In contrast to PDAC, there was no survival difference between R1 (≤1 mm) and R1 (direct).
Measuring and Improving Emotional Intelligence in Surgery
Authors: Abi-Jaoudé Joanne G. , Kennedy-Metz Lauren R. , Dias Roger D. , Yule Steven J. , Zenati Marco A.
Published: June 2021

Objective:

Evaluate how emotional intelligence (EI) has been measured among surgeons and to investigate interventions implemented for improving EI.

Summary Background:

EI has relevant applications in surgery given its alignment with nontechnical skills. In recent years, EI has been measured in a surgical context to evaluate its relationship with measures such as surgeon burnout and the surgeon-patient relationship.

Methods:

A systematic review was conducted by searching MEDLINE, EMBASE, CINAHL, and PSYCINFO databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MeSH terms and keywords included “emotional intelligence,” “surgery,” and “surgeon.” Eligible studies included an EI assessment of surgeons, surgical residents, and/or medical students within a surgical context.

Results:

The initial search yielded 4627 articles. After duplicate removal, 4435 articles were screened by title and abstract and 49 articles proceeded to a full-text read. Three additional articles were found via hand search. A total of 37 articles were included. Studies varied in surgical specialties, settings, and outcome measurements. Most occurred in general surgery, residency programs, and utilized self-report surveys to estimate EI. Notably, EI improved in all studies utilizing an intervention.

Conclusions:

The literature entailing the intersection between EI and surgery is diverse but still limited. Generally, EI has been demonstrated to be beneficial in terms of overall well-being and job satisfaction while also protecting against burnout. EI skills may provide a promising modifiable target to achieve desirable outcomes for both the surgeon and the patient. Future studies may emphasize the relevance of EI in the context of surgical teamwork.
Identification of social engagement indicators associated with autism spectrum disorder using a game-based mobile application
Authors: Varma Maya , Washington Peter , Chrisman Brianna , Kline Aaron , Leblanc Emilie , Paskov Kelley , Stockham Nate , Jung Jae-Yoon , Sun Min Woo , Wall Dennis P.
Published: June 2021

Objective

Autism spectrum disorder (ASD) is a widespread neurodevelopmental condition with a range of potential causes and symptoms. Children with ASD exhibit behavioral and social impairments, giving rise to the possibility of utilizing computational techniques to evaluate a child’s social phenotype from home videos.

Methods

Here, we use a mobile health application to collect over 11 hours of video footage depicting 95 children engaged in gameplay in a natural home environment. We utilize automated dataset annotations to analyze two social indicators that have previously been shown to differ between children with ASD and their neurotypical (NT) peers: (1) gaze fixation patterns and (2) visual scanning methods. We compare the gaze fixation and visual scanning methods utilized by children during a 90-second gameplay video in order to identify statistically-significant differences between the two cohorts; we then train an LSTM neural network in order to determine if gaze indicators could be predictive of ASD.

Results

Our work identifies one statistically significant region of fixation and one significant gaze transition pattern that differ between our two cohorts during gameplay. In addition, our deep learning model demonstrates mild predictive power in identifying ASD based on coarse annotations of gaze fixations.

Discussion

Ultimately, our results demonstrate the utility of game-based mobile health platforms in quantifying visual patterns and providing insights into ASD. We also show the importance of automated labeling techniques in generating large-scale datasets while simultaneously preserving the privacy of participants. Our approaches can generalize to other healthcare needs.
The Effectiveness of Telephone Intervention for Improving Patient Adherence to Medication among Diabetic Patients: A Systematic Review and Meta-analysis of Randomized Trials
Authors: Monterona Debbie P. , Matinong Rhoda Alfonsa , De Silos Jeriel
Published: June 2021

Introduction

Diabetes is one of the chronic diseases that requires adherence to prescribed medications. With the current pandemic, mobile technology plays a role in caring for patients remotely.

Objective

To determine the effectiveness of telephone intervention (phone call and text message) on medication adherence among diabetic patients.

Methodology

Randomized controlled trials were searched in Cochrane Library, PubMed, Herdin, BMC Health Services Research using combination of terms through boolean operators (“phone message” OR “phone call” AND (“medication adherence” AND “diabetes”) which compared telephone intervention vs usual care. mean, sample size and standard deviation of Medication Adherence in each study were extracted. Review Manager 5.4 software was used for statistical analysis.

Results

Three trials met the inclusion criteria and were included in this study. The telephone intervention did not result in statistically significant improvement in medication adherence among diabetics (pooled mean difference: 0.05 95%CI -.08 to 0.17) Conclusion: The intervention was no more effective than the usual care. However, mobile use has potential application for remote care during this pandemic.
COVID-19 Susceptibility, Mortality, and Length of hospitalization based on age-sex composition: Evidence from Davao Region Philippines
Authors: Ceballos Roel F.
Published: June 2021

The coronavirus disease is spreading continuously worldwide with an unprecedented amount of impact on every human society. In order to reduce the risks of infections and mortality, several interventions such as mobility restrictions for different age groups and vaccination prioritization programs are implemented in the Philippines. Identifying age-sex composition with greater susceptibility, longer hospitalization, and higher fatality is useful to guide the targeted intervention and establish risk stratification for patients infected with COVID-19 within communities and localities. Furthermore, it is also helpful in the allocation of medical resources and assessment of vaccination priority. We analyzed the COVID-19 data provided by the Davao Center for Health Development of the Department of Health Davao Region in the Philippines. The dataset contains records of COVID-19 cases reported from March 2020 to April 2021. Methods that were used include descriptive statistics, graphical presentations, and nonparametric statistical methods. The study reveals that male children and female senior citizens are the most susceptible age-sex composition while male senior citizen is the subgroup with the highest case fatality and mortality. Furthermore, regardless of sex groups, the senior citizen is the subgroup with the longest hospitalization. Susceptibility due to exposure should be included as a criterion in determining the age-sex compositions for vaccination priority against COVID-19 and other potentially deadly viruses. Further, Proper planning and allocation of medical resources for the elderly should be prioritized in the provincial levels.
Entitled to Property: Inheritance Laws, Female Bargaining Power, and Child Health in India
Authors: Hossain Shahadath , Nikolov Plamen
Published: June 2021

Child height is a significant predictor of human capital and economic status throughout adulthood. Moreover, non-unitary household models of family behavior posit that an increase in women’s bargaining power can influence child health. We study the effects of an inheritance policy change, the Hindu Succession Act (HSA), which conferred enhanced inheritance rights to unmarried women in rural India, on child height. We find robust evidence that the HSA improved the height and weight of children. In addition, we find evidence consistent with a channel that the policy improved the women’s intrahousehold bargaining power within the household, leading to improved parental investments for children. These study findings are also compatible with the notion that children do better when their mothers control a more significant fraction of the family. Therefore, policies that empower women can have additional positive spillovers for children’s human capital. (JELD13, I12, I13, J13, J16, J18, K13, O12, O15, Z12, Z13)
Acceptability, usability and performance of lateral flow immunoassay tests for SARS-CoV-2 antibodies: REACT-2 study of self-testing in non-healthcare key workers
Authors: Davies Bethan , Araghi Marzieh , Moshe Maya , Gao He , Bennet Kimberly , Jenkins Jordan , Atchison Christina , Darzi Ara , Ashby Deborah , Riley Steven , Barclay Wendy , Elliott Paul , Ward Helen , Cooke Graham
Published: June 2021

Background

Seroprevalence studies in key worker populations are essential to understand the epidemiology of SARS-CoV-2. Various technologies, including laboratory assays and point-of-care self-tests, are available for antibody testing. The interpretation of seroprevalence studies requires comparative data on the performance of antibody tests.

Methods

In June 2020, current and former members of the UK Police forces and Fire service performed a self-test lateral flow immunoassay (LFIA) and provided a saliva sample, nasopharyngeal swab, venous blood samples for Abbott ELISA and had a nurse performed LFIA. We present the prevalence of PCR positivity and antibodies to SARS-CoV-2 in this cohort following the first wave of infection in England; the acceptability and usability of self-test LFIAs (defined as use of the LFIA kit and provision of a valid result, respectively); and determine the sensitivity and specificity of LFIAs compared to laboratory ELISAs.

Results

In this cohort of non-healthcare key workers, 7.4% (396/5,348; 95% CI, 6.7-8.1) were antibody positive. Seroprevalence was 8.9% (6.9-11.4) in those under 40 years, 11.5% (8.8-15.0) in those of non-white British ethnicity and 7.8% (7.1-8.7) in those currently working. The self-test LFIA had an acceptability of 97.7% and a usability of 90.0%. There was substantial agreement between within-participant LFIA results (kappa 0.80; 0.77-0.83). The LFIAs (self-test and nurse-performed) had a similar performance: compared to ELISA, sensitivity was 82.1% (77.7-86.0) self-test and 76.4% (71.9-80.5) nurse-performed with specificity of 97.8% (97.3-98.2) and 98.5% (98.1-98.8) respectively.

Conclusion

A greater proportion of the non-healthcare key worker cohort showed evidence of previous infection with SARS-CoV-2 than the general population at 6.0% (5.8-6.1) following the first wave in England. The high acceptability and usability reported by participants and the similar performance of self-test and nurse-performed LFIAs indicate that the self-test LFIA is fit for purpose for home-testing in occupational and community prevalence studies.