bluuebunny/crossref_metadata_2025 huggingface dataset:
PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies
Authors: Dworkin Emily R. , Jaffe Anna E. , Bedard-Gilligan Michele , Fitzpatrick Skye
Published: July 2021

Objective:

Sexual assault is associated with higher rates of posttraumatic stress disorder (PTSD) than other traumas, and the course of PTSD may differ by trauma type. However, the course of PTSD after sexual assault has not been summarized. The aim of this meta-analysis was to identify the prevalence and severity of PTSD and changes to the average rate of recovery in the 12 months following sexual assault.

Method:

Authors searched four databases for prospective studies published before April 2020 and sought relevant unpublished data. Eligible studies assessed PTSD in at least 10 survivors of sexual assault in at least two time points, starting within 3 months postassault. Random effects linear-linear piecewise models were used to identify changes in average recovery rate and produce model-implied estimates of monthly point prevalence and mean symptom severity.

Results:

Meta-analysis of 22 unique samples ( N = 2,106) indicated that 74.58% (95% confidence interval [CI]: [67.21, 81.29]) and 41.49% (95% CI: [32.36, 50.92]) of individuals met diagnostic criteria for PTSD at the first and 12th month following sexual assault, respectively. PTSD symptom severity was 47.94% (95% CI: [41.27, 54.61]) and 29.91% (95% CI: [23.10, 36.73]) of scales’ maximum severity at the first and 12th month following sexual assault, respectively. Most symptom recovery occurred within the first 3 months following sexual assault, after which point the average rate of recovery slowed.

Conclusions:

Findings indicate that PTSD is common and severe following sexual assault, and the first 3 months postassault may be a critical period for natural recovery.
A 10-Year Systematic Review of Photovoice Projects With Youth in the United States
Authors: Fountain Sarah , Hale Rachel , Spencer Nicola , Morgan Jinger , James Laura , Stewart M. Kathryn
Published: July 2021

Introduction

Photovoice is a method used in community-based participatory research that places cameras in the hands of people and invites them to record their lives, engage in critical dialogue, and advocate for changes needed in their communities. This article presents a review of the literature from 2010 to 2019 on photovoice projects implemented with U.S. youth informed by an emancipatory research conceptual framework.

Method

Information on 30 project elements was extracted from each of the 47 publications, representing 39 unique projects that met our inclusion criteria. Projects were also assessed for whether they met the goals of photovoice as originally conceptualized by Wang and Burris in 1997.

Results

Participants, policy makers, and community members were affected by photovoice projects. Outcomes ranged from researcher specific needs to community change and policy awareness and changes. Common outcomes included (1) gaining knowledge, (2) participant empowerment, (3) community change/action, (4) new partnerships, and (5) reaching policy makers. Of the 39 unique projects, 17 addressed all three photovoice goals, 12 addressed two, and 10 addressed only one. All the projects met the goal of enabling participants to record and reflect their community’s strengths and concerns. Twenty-four were aligned with all three principles of emancipatory research.

Discussion

Photovoice is a valuable, flexible tool that can enable participants to play an active, guiding role in assessing the needs and assets of their community. Through critical reflection and dialogue, youth can become change agents in their communities. No single set of strategies will work best for every project.
Co-Designing Evidence-Based Videos in Health Care: A Case Exemplar of Developing Creative Knowledge Translation “Evidence-Experience” Resources
Authors: Archibald Mandy , Ambagtsheer Rachel , Lawless Michael T. , Thompson Mark O. , Shultz Timothy , Chehade Mellick J. , Whiteway Lyn , Sheppard Anna , Plaza Maria Pinero-de , Kitson Alison L.
Published: July 2021

Objective:

Well-designed evidence-based resources that reflect participant experiences and priorities are imperative for informed consumer health decision-making and to combat the pervasive health misinformation existing today. Qualitative research data can inform the development of such resources, but the process of reconciling qualitative research data with other sources of evidence through co-design processes is not well described in the literature. In response to the need for such evidence-based materials and corresponding methodological guidance, we co-designed a series of video resources through transdisciplinary and community partnership. In this manuscript, we provide methodological insight into the process of collaborative co-design to improve the utilization of qualitative research evidence into evidence-based resources for the public.

Methods:

Following from a large qualitative research study, we engaged in a collaborative and creative co-design process involving a multi-stakeholder advisory group guided by Boyd’s co-design framework. We explicate this process, drawing from a case exemplar of transdisciplinary frailty research.

Results:

We utilized thematic qualitative data to co-produce: (i) an animation, (ii) a documentary-style video, (iii) a video vignette with key messages embedded in narratives of older adults, and (iv) a key-message video delivered by academic health researchers and clinicians.

Discussion:

The integration of experiential evidence of health care consumers with other sources of research evidence through co-design is an epistemological and procedural challenge with potential to improve public awareness, knowledge, and to support evidence-based decision making.
Characteristics and predictors of early hospital deaths in newly diagnosed APL: a 13-year population-wide study
Authors: Gill Harinder , Yung Yammy , Chu Hiu-Tung , Au Wing-Yan , Yip Pui-Kwan , Lee Emily , Yim Rita , Lee Paul , Cheuk Daniel , Ha Shau-Yin , Leung Rock Y. Y. , Ma Edmond S. K. , Kumana Cyrus R. , Kwong Yok-Lam
Published: July 2021

Despite therapeutic advances, early death (ED) remains a major factor curtailing survival of acute promyelocytic leukemia (APL). Studies examining factors that cause early death (ED; within 30 days of admission) and the correlation of survival with the timing of administration of all-trans retinoic acid (ATRA) and hemostatic parameters are scarce. We performed a cohort analysis of nonselect patients with newly diagnosed APL who presented to the health care system in Hong Kong, where oral arsenic trioxide was used. From 1 January 2007 to 30 April 2020, 358 patients (median age, 47 [1-97] years) with newly diagnosed APL were identified. ED occurred in 56 patients (16%): 11 (3%) died in the first 2 days after admission (intracranial hemorrhage [ICH], n = 6; APL-differentiation syndrome [APL-DS], n = 4; infection, n = 1); 22 (6%) died within 3 to 7 days (ICH, n = 12; APL-DS, n = 8; infections, n = 2), and 23 (6%) died within 8 to 30 days (ICH, n = 7; APL-DS, n = 11; infection, n = 5). Factors significantly associated with ED by multivariate analysis included male sex (P = .01); presenting leukocyte count ≥10 × 109/L (P = .03); fibrinogen <1.5 g/L (P = .02); and ATRA administration >24 hours after hospital admission (P < .001). After a median follow-up of 47 (0-166) months, the 5- and 10-year overall survival (OS) was 68.6% and 61.2%, respectively. Excluding EDs, the 5- and 10-year post–30-day OS improved to 81.3% and 72.5%. Early administration of ATRA (<24 hours) and vigorous correction of hemostatic abnormalities, including hypofibrinogenemia, are key to reducing ED.
Third-generation sequencing and metabolome analysis reveal candidate genes and metabolites with altered levels in albino jackfruit seedlings
Authors: Meng Xiangxu , Xu Jiahong , Zhang Maoning , Du Ruyue , Zhao Wenxiu , Zeng Qing , Tu Zhihua , Chen Jinhui , Chen Beibei
Published: July 2021

Background

Most plants rely on photosynthesis; therefore, albinism in plants with leaves that are white instead of green causes slow growth, dwarfing, and even death. Although albinism has been characterized in annual model plants, little is known about albino trees. Jackfruit (Artocarpus heterophyllus) is an important tropical fruit tree species. To gain insight into the mechanisms underlying the differential growth and development between albino jackfruit mutants and green seedlings, we analyzed root, stem, and leaf tissues by combining PacBio single-molecule real-time (SMRT) sequencing, high-throughput RNA-sequencing (RNA-seq), and metabolomic analysis.

Results

We identified 8,202 differentially expressed genes (DEGs), including 225 genes encoding transcription factors (TFs), from 82,572 full-length transcripts. We also identified 298 significantly changed metabolites (SCMs) in albinoA. heterophyllusseedlings from a set of 692 metabolites inA. heterophyllusseedlings. Pathway analysis revealed that these DEGs were highly enriched in metabolic pathways such as ‘photosynthesis’, ‘carbon fixation in photosynthetic organisms’, ‘glycolysis/gluconeogenesis’, and ‘TCA cycle’. Analysis of the metabolites revealed 76 SCMs associated with metabolic pathways in the albino mutants, including L-aspartic acid, citric acid, succinic acid, and fumaric acid. We selected 225 differentially expressed TF genes, 333 differentially expressed metabolic pathway genes, and 76 SCMs to construct two correlation networks. Analysis of the TF–DEG network suggested that basic helix-loop-helix (bHLH) and MYB-related TFs regulate the expression of genes involved in carbon fixation and energy metabolism to affect light responses or photomorphogenesis and normal growth. Further analysis of the DEG–SCM correlation network and the photosynthetic carbon fixation pathway suggested thatNAD-ME2(encoding a malic enzyme) and L-aspartic acid jointly inhibit carbon fixation in the albino mutants, resulting in reduced photosynthetic efficiency and inhibited plant growth.

Conclusions

Our preliminarily screening identified candidate genes and metabolites specifically affected in albinoA. heterophyllusseedlings, laying the foundation for further study of the regulatory mechanism of carbon fixation during photosynthesis and energy metabolism. In addition, our findings elucidate the way genes and metabolites respond in albino trees.
Identification of QTL related to anther color and hull color by RAD sequencing in a RIL population of Setaria italica
Authors: Xie Huifang , Hou Junliang , Fu Nan , Wei Menghan , Li Yunfei , Yu Kang , Song Hui , Li Shiming , Liu Jinrong
Published: July 2021

Background

Foxtail millet (Setaria italica) is one of the oldest domesticated crops and has been considered as an ideal model plant for C4 grasses. It has abundant type of anther and hull colors which is not only a most intuitive morphological marker for color selection in seed production, but also has very important biological significance for the study of molecular mechanism of regulating the synthesis and metabolism of flavonoids and lignin. However, only a few genetic studies have been reported for anther color and hull color in foxtail millet.

Results

Quantitative trait loci (QTL) analysis for anther color and hull color was conducted using 400 F6 and F7 recombinant inbreed lines (RILs) derived from a cross between parents Yugu18 and Jigu19. Using restriction-site associated DNA sequencing, 43,001 single-nucleotide polymorphisms (SNPs) and 3,022 indels were identified between both the parents and the RILs. A total of 1,304 bin markers developed from the SNPs and indels were used to construct a genetic map that spanned 2196 cM of the foxtail millet genome with an average of 1.68 cM/bin. Combined with this genetic map and the phenotypic data observed in two locations for two years, two QTL located on chromosome 6 (Chr6) in a 1.215-Mb interval (33,627,819–34,877,940 bp) for anther color (yellow - white) and three QTL located on Chr1 in a 6.23-Mb interval (1–6,229,734 bp) for hull color (gold-reddish brown) were detected. To narrow the QTL regions identified from the genetic map and QTL analysis, we developed a new method named “inconsistent rate analysis” and efficiently narrowed the QTL regions of anther color into a 60-kb interval (34.13–34.19 Mb) in Chr6, and narrowed the QTL regions of hull color into 70-kb (5.43–5.50 Mb) and 30-kb (5.69–5.72 Mb) intervals in Chr1. Two genes (Seita.6G228600.v2.2 and Seita.6G228700.v2.2) and a cinnamyl alcohol dehydrogenase (CAD) gene (Seita.1G057300.v2.2) with amino acid changes between the parents detected by whole-genome resequencing were identified as candidate genes for anther and hull color, respectively.

Conclusions

This work presents the related QTL and candidate genes of anther and hull color in foxtail millet and developed a new method named inconsistent rate analysis to detect the chromosome fragments linked with the quality trait in RILs. This is the first study of the QTL related to hull color in foxtail millet and clarifying that the CAD gene (Seita.1G057300.v2.2) is the key gene responsible for this trait. It lays the foundation for further cloning of the functional genes and provides a powerful tool to detect the chromosome fragments linked with quality traits in RILs.
Genomic analysis of group B Streptococcus from milk demonstrates the need for improved biosecurity: a cross-sectional study of pastoralist camels in Kenya
Authors: Seligsohn Dinah , Crestani Chiara , Forde Taya L. , Chenais Erika , Zadoks Ruth N.
Published: July 2021

Background

Streptococcus agalactiae(Group BStreptococcus, (GBS)) is the leading cause of mastitis (inflammation of the mammary gland) among dairy camels in Sub-Saharan Africa, with negative implications for milk production and quality and animal welfare. Camel milk is often consumed raw and presence of GBS in milk may pose a public health threat. Little is known about the population structure or virulence factors of camel GBS. We investigated the molecular epidemiology of camel GBS and its implications for mastitis control and public health.

Results

Using whole genome sequencing, we analysed 65 camel milk GBS isolates from 19 herds in Isiolo, Kenya. Six sequence types (STs) were identified, mostly belonging to previously described camel-specific STs. One isolate belonged to ST1, a predominantly human-associated lineage, possibly as a result of interspecies transmission. Most (54/65) isolates belonged to ST616, indicative of contagious transmission. Phylogenetic analysis of GBS core genomes showed similar levels of heterogeneity within- and between herds, suggesting ongoing between-herd transmission. The lactose operon, a marker of GBS adaptation to the mammary niche, was found in 75 % of the isolates, and tetracycline resistance genetet(M) in all but two isolates. Only the ST1 isolate harboured virulence genesscpBandlmb, which are associated with human host adaptation.

Conclusions

GBS in milk from Kenyan camel herds largely belongs to ST616 and shows signatures of adaptation to the udder. The finding of similar levels of within- and between herd heterogeneity of GBS in camel herds, as well as potential human-camel transmission highlights the need for improved internal as well as external biosecurity to curb disease transmission and increase milk production.
Multi-omics analyses on Kandelia obovata reveal its response to transplanting and genetic differentiation among populations
Authors: Zhao Yuze , Zhong Yifan , Ye Congting , Liang Pingping , Pan Xiaobao , Zhang Yuan-Ye , Zhang Yihui , Shen Yingjia
Published: July 2021

Background

Restoration through planting is the dominant strategy to conserve mangrove ecosystems. However, many of the plantations fail to survive. Site and seeding selection matters for planting.

The process of afforestation, where individuals were planted in a novel environment, is essentially human-controlled transplanting events. Trying to deepen and expand the understanding of the effects of transplanting on plants, we have performed a seven-year-long reciprocal transplant experiment on Kandelia obovata along a latitudinal gradient.

Results

Combined phenotypic analyses and next-generation sequencing, we found phenotypic discrepancies among individuals from different populations in the common garden and genetic differentiation among populations. The central population with abundant genetic diversity and high phenotypic plasticity had a wide plantable range. But its biomass was reduced after being transferred to other latitudes. The suppressed expression of lignin biosynthesis genes revealed by RNA-seq was responsible for the biomass reduction. Moreover, using whole-genome bisulfite sequencing, we observed modification of DNA methylation in MADS-box genes that involved in the regulation of flowering time, which might contribute to the adaptation to new environments.

Conclusions

Taking advantage of classical ecological experiments as well as multi-omics analyses, our work observed morphology differences and genetic differentiation among different populations of K. obovata, offering scientific advice for the development of restoration strategy with long-term efficacy, also explored phenotypic, transcript, and epigenetic responses of plants to transplanting events between latitudes.
Factors associated with death in confirmed cases of COVID-19 in the state of Rio de Janeiro
Authors: Cini Oliveira Marcella , de Araujo Eleuterio Tatiana , de Andrade Corrêa Allan Bruno , da Silva Lucas Dalsenter Romano , Rodrigues Renata Coelho , de Oliveira Bruna Andrade , Martins Marlos Melo , Raymundo Carlos Eduardo , de Andrade Medronho Roberto
Published: July 2021

Background

COVID-19 can occur asymptomatically, as influenza-like illness, or as more severe forms, which characterize severe acute respiratory syndrome (SARS). Its mortality rate is higher in individuals over 80 years of age and in people with comorbidities, so these constitute the risk group for severe forms of the disease. We analyzed the factors associated with death in confirmed cases of COVID-19 in the state of Rio de Janeiro. This cross-sectional study evaluated the association between individual demographic, clinical, and epidemiological variables and the outcome (death) using data from the Unified Health System information systems.

Methods

We used the extreme boosting gradient (XGBoost) model to analyze the data, which uses decision trees weighted by the estimation difficulty. To evaluate the relevance of each independent variable, we used the SHapley Additive exPlanations (SHAP) metric. From the probabilities generated by the XGBoost model, we transformed the data to the logarithm of odds to estimate the odds ratio for each independent variable.

Results

This study showed that older individuals of black race/skin color with heart disease or diabetes who had dyspnea or fever were more likely to die.

Conclusions

The early identification of patients who may progress to a more severe form of the disease can help improve the clinical management of patients with COVID-19 and is thus essential to reduce the lethality of the disease.
Mapping causal circuit dynamics in stroke using simultaneous electroencephalography and transcranial magnetic stimulation
Authors: Rolle Camarin E. , Baumer Fiona M. , Jordan Joshua T. , Berry Ketura , Garcia Madelleine , Monusko Karen , Trivedi Hersh , Wu Wei , Toll Russell , Buckwalter Marion S. , Lansberg Maarten , Etkin Amit
Published: July 2021

Background

Motor impairment after stroke is due not only to direct tissue loss but also to disrupted connectivity within the motor network. Mixed results from studies attempting to enhance motor recovery with Transcranial Magnetic Stimulation (TMS) highlight the need for a better understanding of both connectivity after stroke and the impact of TMS on this connectivity. This study used TMS-EEG to map the causal information flow in the motor network of healthy adult subjects and define how stroke alters these circuits.

Methods

Fourteen stroke patients and 12 controls received TMS to two sites (bilateral primary motor cortices) during two motor tasks (paretic/dominant hand movement vs. rest) while EEG measured the cortical response to TMS pulses. TMS-EEG based connectivity measurements were derived for each hemisphere and the change in connectivity (ΔC) between the two motor tasks was calculated. We analyzed if ΔC for each hemisphere differed between the stroke and control groups or across TMS sites, and whether ΔC correlated with arm function in stroke patients.

Results

Right hand movement increased connectivity in the left compared to the right hemisphere in controls, while hand movement did not significantly change connectivity in either hemisphere in stroke. Stroke patients with the largest increase in healthy hemisphere connectivity during paretic hand movement had the best arm function.

Conclusions

TMS-EEG measurements are sensitive to movement-induced changes in brain connectivity. These measurements may characterize clinically meaningful changes in circuit dynamics after stroke, thus providing specific targets for trials of TMS in post-stroke rehabilitation.
mHealth intervention for multiple lifestyle behaviour change among high school students in Sweden (LIFE4YOUth): protocol for a randomised controlled trial
Authors: Bendtsen Marcus , Seiterö Anna , Bendtsen Preben , Henriksson Hanna , Henriksson Pontus , Thomas Kristin , Löf Marie , Müssener Ulrika
Published: July 2021

Background

National surveys in Sweden demonstrate that the majority of young people do not engage in health promoting behaviours at levels recommended by the Public Health Agency of Sweden. The objective of this study is to estimate the effectiveness of a novel mHealth intervention named LIFE4YOUth, which targets multiple lifestyle behaviours (alcohol, diet, physical activity, and smoking) among high school students in Sweden.

Methods

A 2-arm parallel groups single blind randomised controlled trial (1:1) will be employed to estimate the effectiveness of the novel mHealth intervention. Students will be recruited at high schools throughout Sweden, and will be included if they fulfil one of six criteria relating to unhealthy behaviours with respect to alcohol, diet, physical activity and smoking. Eligible participants will be randomised to either receive the novel intervention immediately, or to be placed on a waiting list for 4 months. The intervention consists of a combination of recurring screening, text messages, and an interactive platform which is adaptable to individual preferences. Outcome measures with respect to alcohol, diet, physical activity and smoking will be assessed through questionnaires at 2 and 4 months post randomisation.

Discussion

The findings of this trial could be generalised to a diverse high-school student population as our recruitment encompass a large proportion of schools throughout Sweden with various educational profiles. Furthermore, if effective, the mHealth intervention has good potential to be able to be scaled up and disseminated at high schools nationally.

Trial registration

Registered prospectively on 2020-05-20 in ISRCTN (ISRCTN34468623).
The prevalence of dental caries and associated factors among secondary school children in rural highland Vietnam
Authors: Van Chuyen Nguyen , Van Du Vu , Van Ba Nguyen , Long Dao Duc , Son Ho Anh
Published: July 2021

Background

To determine the prevalence of dental caries in primary and permanent teeth and identify factors associated with dental caries among secondary school children in rural highland Vietnam.

Methods

This was a cross-sectional study that included 1985 secondary schoolchildren. Dental examination was performed at school using World Health Organization criteria. Data collection on demographic characteristics and knowledge, attitude, and practices related to dental caries was conducted by interviewing children. Descriptive and inferential statistics using a multivariate logistic regression model were applied.

Results

Prevalence of caries in primary and permanent teeth was 41.1 and 68.9 %, respectively. Prevalence of caries in primary teeth in the age group 11–12 years old (59.4 %) was significantly higher than in children in the age group of 13–14 years (27.8 %; p < 0.01). Factors associated with dental caries in primary teeth were age group of 11–12 years, belonging to the Jarai ethnic group, and having inadequate knowledge or attitude related to dental caries. Factors associated with dental caries in permanent teeth were having insufficient knowledge, attitude, and practices related to dental caries.

Conclusions

The prevalence of dental caries in primary and permanent teeth was high among secondary school children in Vietnam’s rural highlands. It is recommended that interventions focus on younger secondary school children and the Jarai minority ethnic group, and that interventions should emphasize improving knowledge, attitudes, and practices related to dental caries.
Effects of different antibacterial disinfectants on microleakage of bulk-fill composite bonded to different tooth structures
Authors: Bin-Shuwaish Mohammed , AlHussaini Alhanouf , AlHudaithy Lina , AlDukhiel Shamma , AlJamhan Abdullah , Alrahlah Ali
Published: July 2021

Background

This in-vitro study aimed to investigate the effect of two different antibacterial disinfectants on the microleakage performance of newly developed bulk-fill composite, bonded to different tooth structures.

Methods

Class V cavities were prepared in 30 sound premolar teeth, with enamel occlusal margins (OM) and dentin cervical margins (CM). Two disinfectants, 2% chlorhexidine gluconate (CHX) and Listerine Miswak (ListM), were used. Teeth were divided into three groups (n = 10): G1, Control; G2, CHX; and G3, ListM. Disinfectants were applied to the cavity preparation walls after they were etched with 35% phosphoric acid. The Single Bond Universal adhesive system was then used, and teeth were restored with Filtek One Bulk Fill composite. Samples were examined, after thermocycling aging, by stereomicroscopy for the evaluation of marginal dye penetration.

Results

The highest mean microleakage score was reported in the CM of G1 (2.60 ± 1.174), which was significant compared with that of G2 only (p = 0.02). OM in G1 showed no microleakage, with no significant differences found among groups (χ2 = 1.39, p = 0.50). No significant differences were reported between G2 and G3 (p = 0.45 OM; p = 0.17 CM).

Conclusions

Cavity pretreatment with CHX is not significantly different to pretreatment with CHX. In contrast, CHX improved the cervical marginal seal as compare to the control group (G1).
An underestimated pitfall of oral candidiasis in head and neck cancer patients undergoing radiotherapy: an observation study
Authors: Chitapanarux Imjai , Wongsrita Somying , Sripan Patumrat , Kongsupapsiri Panithan , Phakoetsuk Panchalee , Chachvarat Siriarrayapa , Kittidachanan Kittikun
Published: July 2021

Background

Oral candidiasis is a common problem associated with head and neck radiation therapy (RT) consequences being pain, burning sensation, taste change, and systemic infection. There are difficulties in differentiating between oral candidiasis and radiation induced oral mucositis. We conducted a prospective study to explore the incidence of clinical oral candidiasis and evaluate the accuracy of diagnosis among head and neck cancer (HNC) patients receiving RT or concurrent chemoradiotherapy (CCRT).

Methods

This study included 86 HNC patients who had no clinical signs or symptoms of oral candidiasis. Oral mucosa and tongue swabs were carried out and analyzed three times by fungal cultures at the following time points: (1) before RT, (2) at the time of clinically diagnosed candidiasis or during RT at between the 15th–17th fraction (whichever occurred first), and (3) at the end of RT. The accuracy of clinical oral candidiasis was explored and confirmed by fungal colonization techniques. The incidence and risk factors associated with fungal colonization before and throughout the treatment were analyzed.

Results

The overall incidence of clinical oral candidiasis was 53.5% throughout the course of RT. Confirmation of fungal colonization was found in 39.5%, 65.9%, and 57.7% of cases before RT, during RT, and end of RT, respectively. The accuracy of the diagnosis using only clinical presentation was demonstrated in 60%, 50%, and 52% before RT, during RT, and end of RT, respectively. Logistic regression analysis showed that age, CCRT, and using 2% viscous lidocaine solution were independent risk factors for fungal colonization.

Conclusions

The results of this study demonstrated an underestimation of clinical oral candidiasis before and throughout the course of radiotherapy from using only clinical sign and symptoms. Crucial attention to detail and testing in the oral examination could improve decision making for detection of oral candidiasis in HNC patients receiving RT or CCRT.
Development of consensus-based aims, contents, intended learning outcomes, teaching, and evaluation methods for a history of medicine and pharmacy course for medical and pharmacy students in the Arab world: a Delphi study
Authors: Shawahna Ramzi
Published: July 2021

Background

History courses are “required” elements among the didactic elements of the medical and pharmacy curricula in many schools around the world. The aim of this study was to develop consensus-based aims, contents, intended learning outcomes, teaching, and evaluation methods of a history of medicine and pharmacy course for medical and pharmacy students in the Arab World.

Methods

A systematic search of PubMed, ScienceDirect, SpringerLink, Scopus, and Google Scholar was conducted to identify course aims, contents, intended learning outcomes from the literature. The search was supplemented by semi-structured in-depth interviews with 5 educators/academicians, 3 pharmacists, and 3 physicians. The Delphi technique was used among panelists (10 educators/academicians, 4 physicians, and 4 pharmacists) to develop consensus-based course aims, contents, intended learning outcomes, teaching, and evaluation methods.

Results

The vast majority of the panelists agreed on the 10 items (agreement ≥88.9%) on the importance of teaching history to medical and pharmacy students. Consensus-based aims (n = 4) and intended learning outcomes (n = 13) were developed in the 1st and 2nd iterative Delphi rounds. The panelists suggested that 16 dedicated meeting hours (1 credit hour) would be required to cover the course. Bloom’s verbs were used to target the lower and higher orders of the cognitive domain. The course could be taught through face-to-face lectures, provision of reading materials, video documentaries, case studies, group discussions and debates. Multiple-choice questions, written reflections, portfolios, group projects, and engagement in discussions and debates might be used to evaluate performance of students.

Conclusion

Consensus-based course of history of medicine and pharmacy course was developed for medical and pharmacy students in the Arab World. Well-designed course aims, contents, intended learning outcomes, teaching, and evaluation methods are more likely to meet the accreditation requirements and might improve performance of medical and pharmacy students. Future studies are still needed to investigate if such consensus-based courses can improve performance of the students.
Consent to research participation: understanding and motivation among German pupils
Authors: Reetz Jana , Richter Gesine , Borzikowsky Christoph , Glinicke Christine , Darabaneanu Stephanie , Buyx Alena
Published: July 2021

Background

The EU’s 2006 Paediatric Regulation aims to support authorisation of medicine for children, thus effectively increasing paediatric research. It is ethically imperative to simultaneously establish procedures that protect children’s rights.

Method

This study endeavours (a) to evaluate whether a template consent form designed by the Standing Working Group of the German-Research-Ethics-Committees (AKEK) adequately informs adolescents about research participation, and (b) to investigate associated phenomena like therapeutic misconception and motives for research participation. In March 2016 a questionnaire study was conducted among 279 pupils (mean age 13.1 years) of a secondary school in northern Germany.

Results

A majority of participants showed a general good understanding of foundational research ethics concepts as understood from the AKEK consent form. Nevertheless, our data also suggests possible susceptibility to therapeutic misconception. Own health concerns and pro-social considerations were found to be significant motivational factors for participating in research, while anticipation of pain lessens likelihood of participation. Advice from trusted others is an important decisional influence, too. Furthermore, data security was found to be a relevant aspect of adolescents’ decision-making process.

Conclusion

Bearing in mind adolescents’ generally good understanding, we infer the lack of knowledge about medical research in general to be one source of therapeutic misconception. To further improve the quality of consent we propose a multi-staged approach whereby general research education is completed before an individual becomes a patient or potential participant. To the best of our knowledge this is the first German questionnaire-study addressing issues of informed consent in a large under-age sample.
Using Theoretical Domains Framework (TDF) to understand implementation of a pragmatic clinical trial in Public Dental Service in Norway
Authors: Hovden E. A.S. , Skudutyte-Rysstad Rasa
Published: July 2021

Background

Most dental research in Norway has traditionally been conducted by universities, and the involvement of clinicians in research projects has not been a common practice.

The aim of the present study was to identify behavioral factors that influence effective implementation of a pragmatic clinical trial in the Public Dental Service (PDS) in Norway and to understand which of these factors result in higher patient recruitment.

Methods

Dentists, dental hygienists, and dental assistants at nine Public Dental Service clinics in three counties in Norway involved in an ongoing pragmatic clinical trial were asked to complete an electronically distributed questionnaire based on the Theoretical Domains Framework (TDF).

Results

Thirty-seven out of 69 dentists and dental hygienists (54 %) and seventeen out of 57 dental assistants (30 %) answered the questionnaire. “Knowledge” was the domain with the highest mean response, suggesting strong confidence in personal knowledge and practical skills among the clinicians. Together with “beliefs about consequences,” “organizational resources,” and “environmental context,” “knowledge” was the one of five domains identified as important behavioral determinants in patient recruitment to clinical trials by dental professionals.

Conclusions

The findings suggest that TDF was useful to understand factors affecting implementation of clinical trials in PDS and that several factors such as clinical relevance of trial to be implemented, organizational resources, and communication with the research team require more attention when planning and implementing clinical trials in PDS.
Factors associated with response and remission from depression at 6-months of treatment in a retrospective cohort treated within an integrated care program
Authors: Jeffrey Jessica , Klomhaus Alex , Aralis Hilary , Barrera Wendy , Rosenberg Shanna , Grossman Mark , Lester Patricia
Published: July 2021

Background

Depression causes significant morbidity, which impacts mental health, overall general health outcomes, everyday functioning and quality of life. This study aims to contribute to knowledge in the field through enhanced understanding of factors that influence depression response and remission, with consideration for design of treatment services to optimize depression outcomes within integrated care programs.

Methods

Using routine behavioral health screening and electronic health record data, we identified a retrospective cohort consisting of 615 adult patients receiving depression treatment within an integrated care program. Cohort member Patient Health Questionnaire (PHQ-9) data was analyzed for the 6 months following initiation of treatment. Multinomial regression models were estimated to identify factors associated with depression treatment response (PHQ-9 < 10) and remission (PHQ-9 < 5).

Results

At 6 months, 47% of patients demonstrated treatment response and 16% demonstrated remission. Baseline trauma symptoms and suicidal ideation were significantly associated with decreased odds of achieving remission (Odds Ratio (95% CI) [OR] = 0.45 (0.23, 0.88) and OR = 0.49 (0.29, 0.82), respectively). In fully adjusted models, baseline suicidal ideation remained significant (OR = 0.53 (0.31, 0.89)) and some evidence of an association persisted for baseline trauma symptoms (OR = 0.51 (0.25, 1.01)).

Conclusions

After controlling for baseline depression symptoms, the presence of suicidal ideation is associated with reduced likelihood of remission. Increased understanding of factors associated with depression treatment outcomes may be employed to help guide the delivery and design of clinical services. Alongside routine screening for co-morbid anxiety, suicidal ideation and traumatic stress should be assessed and considered when designing depression treatment services.
Radiopharmaceutical and Eu3+ doped gadolinium oxide nanoparticles mediated triple-excited fluorescence imaging and image-guided surgery
Authors: Shi Xiaojing , Cao Caiguang , Zhang Zeyu , Tian Jie , Hu Zhenhua
Published: July 2021

Cerenkov luminescence imaging (CLI) is a novel optical imaging technique that has been applied in clinic using various radionuclides and radiopharmaceuticals. However, clinical application of CLI has been limited by weak optical signal and restricted tissue penetration depth. Various fluorescent probes have been combined with radiopharmaceuticals for improved imaging performances. However, as most of these probes only interact with Cerenkov luminescence (CL), the low photon fluence of CL greatly restricted it’s interaction with fluorescent probes for in vivo imaging. Therefore, it is important to develop probes that can effectively convert energy beyond CL such as β and γ to the low energy optical signals. In this study, a Eu3+doped gadolinium oxide (Gd2O3:Eu) was synthesized and combined with radiopharmaceuticals to achieve a red-shifted optical spectrum with less tissue scattering and enhanced optical signal intensity in this study. The interaction between Gd2O3:Eu and radiopharmaceutical were investigated using18F-fluorodeoxyglucose (18F-FDG). The ex vivo optical signal intensity of the mixture of Gd2O3:Eu and18F-FDG reached 369 times as high as that of CLI using18F-FDG alone. To achieve improved biocompatibility, the Gd2O3:Eu nanoparticles were then modified with polyvinyl alcohol (PVA), and the resulted nanoprobe PVA modified Gd2O3:Eu (Gd2O3:Eu@PVA) was applied in intraoperative tumor imaging. Compared with18F-FDG alone, intraoperative administration of Gd2O3:Eu@PVA and18F-FDG combination achieved a much higher tumor-to-normal tissue ratio (TNR, 10.24 ± 2.24vs.1.87 ± 0.73,P = 0.0030). The use of Gd2O3:Eu@PVA and18F-FDG also assisted intraoperative detection of tumors that were omitted by preoperative positron emission tomography (PET) imaging. Further experiment of image-guided surgery demonstrated feasibility of image-guided tumor resection using Gd2O3:Eu@PVA and18F-FDG. In summary, Gd2O3:Eu can achieve significantly optimized imaging property when combined with18F-FDG in intraoperative tumor imaging and image-guided tumor resection surgery. It is expected that the development of the Gd2O3:Eu nanoparticle will promote investigation and application of novel nanoparticles that can interact with radiopharmaceuticals for improved imaging properties. This work highlighted the impact of the nanoprobe that can be excited by radiopharmaceuticals emitting CL, β, and γ radiation for precisely imaging of tumor and intraoperatively guide tumor resection.
Growth rate-dependent flexural rigidity of microtubules influences pattern formation in collective motion
Authors: Zhou Hang , Isozaki Naoto , Fujimoto Kazuya , Yokokawa Ryuji
Published: July 2021

Background

Microtubules (MTs) are highly dynamic tubular cytoskeleton filaments that are essential for cellular morphology and intracellular transport. In vivo, the flexural rigidity of MTs can be dynamically regulated depending on their intracellular function. In the in vitro reconstructed MT-motor system, flexural rigidity affects MT gliding behaviors and trajectories. Despite the importance of flexural rigidity for both biological functions and in vitro applications, there is no clear interpretation of the regulation of MT flexural rigidity, and the results of many studies are contradictory. These discrepancies impede our understanding of the regulation of MT flexural rigidity, thereby challenging its precise manipulation.

Results

Here, plausible explanations for these discrepancies are provided and a new method to evaluate the MT rigidity is developed. Moreover, a new relationship of the dynamic and mechanic of MTs is revealed that MT flexural rigidity decreases through three phases with the growth rate increases, which offers a method of designing MT flexural rigidity by regulating its growth rate. To test the validity of this method, the gliding performances of MTs with different flexural rigidities polymerized at different growth rates are examined. The growth rate-dependent flexural rigidity of MTs is experimentally found to influence the pattern formation in collective motion using gliding motility assay, which is further validated using machine learning.

Conclusion

Our study establishes a robust quantitative method for measurement and design of MT flexural rigidity to study its influences on MT gliding assays, collective motion, and other biological activities in vitro. The new relationship about the growth rate and rigidity of MTs updates current concepts on the dynamics and mechanics of MTs and provides comparable data for investigating the regulation mechanism of MT rigidity in vivo in the future.

Graphic Abstract
Tumor susceptibility gene 101 is required for the maintenance of uterine epithelial cells during embryo implantation
Authors: Byun Hyunji , Kwon Sojung , Wagner Kay-Uwe , Shin Hyejin , Lim Hyunjung Jade
Published: July 2021

Background

The tumor susceptibility gene 101 (Tsg101), a component of the endosomal sorting complex required for transport (ESCRT) complex I, is involved in multiple biological processes involving endomembranous structures and the plasma membrane. The role of Tsg101 in the uterine epithelium was investigated in Tsg101 floxed mice crossed with Lactoferrin-iCre mice (Tsg101d/d).

Methods

Tsg101d/d mice were bred with stud male mice and the status of pregnancy was examined on days 4 and 6. Histological analyses were performed to examine the uterine architecture. Immunofluorescence staining of several markers was examined by confocal microscopy. Uterine epithelial cells (UECs) were isolated from Tsg101f/f and Tsg101d/d mice, and the expression of necroptosis effectors was examined by RT-PCR, western blotting, and immunofluorescence staining. UECs were also subjected to RNA expression profiling.

Results

Tsg101d/d female mice were subfertile with implantation failure, showing unattached blastocysts on day 6 of pregnancy. Histological and marker analyses revealed that some Tsg101d/d day 4 pregnant uteri showed a disintegrated uterine epithelial structure. Tsg101d/d UECs began to degenerate within 18 h of culture. In UECs, expression of necroptosis effectors, such as RIPK1, RIPK3, and MLKL were first confirmed. UECs responded to a stimulus to activate necroptosis and showed increased cell death.

Conclusions

Tsg101 deficiency in the uterine epithelium causes implantation failure, which may be caused by epithelial defects. This study provides evidence that UECs harbor a necroptotic machinery that responds to death-inducing signals. Thus, Tsg101 expression in the uterine epithelium is required for normal pregnancy in mice.
Predictive models for chronic kidney disease after radical or partial nephrectomy in renal cell cancer using early postoperative serum creatinine levels
Authors: Chae Dongwoo , Kim Na Young , Kim Ki Jun , Park Kyemyung , Oh Chaerim , Kim So Yeon
Published: July 2021

Background

Several predictive factors for chronic kidney disease (CKD) following radical nephrectomy (RN) or partial nephrectomy (PN) have been identified. However, early postoperative laboratory values were infrequently considered as potential predictors. Therefore, this study aimed to develop predictive models for CKD 1 year after RN or PN using early postoperative laboratory values, including serum creatinine (SCr) levels, in addition to preoperative and intraoperative factors. Moreover, the optimal SCr sampling time point for the best prediction of CKD was determined.

Methods

Data were retrospectively collected from patients with renal cell cancer who underwent laparoscopic or robotic RN (n = 557) or PN (n = 999). Preoperative, intraoperative, and postoperative factors, including laboratory values, were incorporated during model development. We developed 8 final models using information collected at different time points (preoperative, postoperative day [POD] 0 to 5, and postoperative 1 month). Lastly, we combined all possible subsets of the developed models to generate 120 meta-models. Furthermore, we built a web application to facilitate the implementation of the model.

Results

The magnitude of postoperative elevation of SCr and history of CKD were the most important predictors for CKD at 1 year, followed by RN (compared to PN) and older age. Among the final models, the model using features of POD 4 showed the best performance for correctly predicting the stages of CKD at 1 year compared to other models (accuracy: 79% of POD 4 model versus 75% of POD 0 model, 76% of POD 1 model, 77% of POD 2 model, 78% of POD 3 model, 76% of POD 5 model, and 73% in postoperative 1 month model). Therefore, POD 4 may be the optimal sampling time point for postoperative SCr. A web application is hosted at https://dongy.shinyapps.io/aki_ckd.

Conclusions

Our predictive model, which incorporated postoperative laboratory values, especially SCr levels, in addition to preoperative and intraoperative factors, effectively predicted the occurrence of CKD 1 year after RN or PN and may be helpful for comprehensive management planning.