bluuebunny/crossref_metadata_2025 huggingface dataset:
Institutionalized Children and the Risk of Fetal Alcohol Spectrum Disorder (FASD); A Primer for Clinicians, Adoption Staff and Parents
Authors: Koren Gideon , Ornoy Asher
Published: February 2021

Objectives:

Our objective was to estimate the likelihood of abnormal development among institutionalized children, addressing either the risk in general, or the risk for fetal alcohol spectrum disorder (FASD).

Methods:

Narrative review of studies measuring developmental effects of these populations. We identified all systematic reviews and meta analyses dealing with the associations between institutionalization of children and their neurodevelopment in general, or between institunalization of children and their likelihood of suffering from FASD.

Results:

a) In a published meta-analysis the mean IQ/DQ was 84 among institutionalized children, as compared to 104 among children raised in families. Favorable caregiver-child ratios appeared to have a protective effect, whereas longer stays in institutions had a detrimental effect on IQ/DQ. b) A further meta- analysis has shown a positive impact of adoption on children’s cognitive development with adopted children’s displaying remarkably normal cognitive competence as compared to their non-adopted peers. c) The overall pooled prevalence was 6% (60 per 1,000, 95% CI 38-85) for full blown fetal alcohol syndrome (FAS), and 16.9% (95% CI 109-238 per 1,000) for the whole range of FASD. d) The estimated prevalence of FASD was 10-40 fold higher than the 7.7 per 1000 in the general population.

Conclusions:

A large proportion of adopted institutionalized children may not follow a normal developmental trajectory. If not afflicted by FASD, there is a positive impact of adoption on children’s cognitive development and in general they are comparable to their non- adopted peers.
Human Resource Management: For Humans
Authors: Soman Dilip
Published: February 2021

Marketing departments, governments and policymakers all around the world have increasingly started embracing the field of behavioural sciences in improving the design of products and services, enhancing communications, improving managerial decision-making, encouraging desired behaviour by stakeholders and, more generally, creating a human-centric marketplace. Within organisations, the human resources management (HRM) function is perhaps the one place that acknowledges that humans are central to the organisation’s success, so it is critical that HRM too actively embraces the insights and methods of behavioural sciences. In this article, I provide an overview of the behavioural sciences, discuss how HRM can benefit from an in-depth knowledge of the science and illustrate specific examples from recruitment processes, training and communications, incentive design, employee-oriented processes, and diversity and inclusion initiatives that could benefit from evidence from behavioural sciences.
Coevolution of group-living and aposematism in caterpillars: warning colouration may facilitate the evolution from group-living to solitary habits
Authors: Wang Lingzi , Cornell Stephen J. , Speed Michael P. , Arbuckle Kevin
Published: February 2021

Background

Animals use diverse antipredator mechanisms, including visual signalling of aversive chemical defence (aposematism). However, the initial evolution of aposematism poses the problem that the first aposematic individuals are conspicuous to predators who have not learned the significance of the warning colouration. In one scenario, aposematism evolves in group-living species and originally persisted due to kin selection or positive frequency-dependent selection in groups. Alternatively, group-living might evolve after aposematism because grouping can amplify the warning signal. However, our current understanding of the evolutionary dynamics of these traits is limited, leaving the relative merit of these scenarios unresolved.

Results

We used a phylogenetic comparative approach to estimate phenotypic evolutionary models to enable inferences regarding ancestral states and trait dynamics of grouping and aposematic colouration in a classic model system (caterpillars). We find strong support for aposematism at the root of the clade, and some (but weaker) support for ancestral solitary habits. Transition rates between aposematism and crypsis are generally higher than those between group-living and solitary-living, suggesting that colouration is more evolutionarily labile than aggregation. We also find that the transition from group-living to solitary-living states can only happen in aposematic lineage, suggesting that aposematism facilitates the evolution of solitary caterpillars, perhaps due to the additional protection offered when the benefits of grouping are lost. We also find that the high frequency of solitary, cryptic caterpillars is because this state is particularly stable, in that the transition rates moving towards this state are substantially higher than those moving away from it, favouring its accumulation in the clade over evolutionary time.

Conclusions

Our results provide new insights into the coevolution of colour and aggregation in caterpillars. We find support for an aposematic caterpillar at the root of this major clade, and for the signal augmentation hypothesis as an explanation of the evolution of aposematic, group-living caterpillars. We find that colouration is more labile than aggregation behaviour, but that the combination of solitary and cryptic habits is particularly stable. Finally, our results reveal that the transitions from group-living to solitary-living could be facilitated by aposematism, providing a new link between these well-studied traits.
Ensemble bootstrap methodology for forecasting dynamic growth processes using differential equations: application to epidemic outbreaks
Authors: Chowell Gerardo , Luo Ruiyan
Published: February 2021

Background

Ensemble modeling aims to boost the forecasting performance by systematically integrating the predictive accuracy across individual models. Here we introduce a simple-yet-powerful ensemble methodology for forecasting the trajectory of dynamic growth processes that are defined by a system of non-linear differential equations with applications to infectious disease spread.

Methods

We propose and assess the performance of two ensemble modeling schemes with different parametric bootstrapping procedures for trajectory forecasting and uncertainty quantification. Specifically, we conduct sequential probabilistic forecasts to evaluate their forecasting performance using simple dynamical growth models with good track records including the Richards model, the generalized-logistic growth model, and the Gompertz model. We first test and verify the functionality of the method using simulated data from phenomenological models and a mechanistic transmission model. Next, the performance of the method is demonstrated using a diversity of epidemic datasets including scenario outbreak data of theEbola Forecasting Challengeand real-world epidemic data outbreaks of including influenza, plague, Zika, and COVID-19.

Results

We found that the ensemble method that randomly selects a model from the set of individual models for each time point of the trajectory of the epidemic frequently outcompeted the individual models as well as an alternative ensemble method based on the weighted combination of the individual models and yields broader and more realistic uncertainty bounds for the trajectory envelope, achieving not only better coverage rate of the 95% prediction interval but also improved mean interval scores across a diversity of epidemic datasets.

Conclusion

Our new methodology for ensemble forecasting outcompete component models and an alternative ensemble model that differ in how the variance is evaluated for the generation of the prediction intervals of the forecasts.
A pharmacist health coaching trial evaluating behavioural changes in participants with poorly controlled hypertension
Authors: Singh Harjit K. , Kennedy Gerard A. , Stupans Ieva
Published: February 2021

Background

To investigate whether pharmacist health coaching improves progression through the stages of change (SOC) for three modifiable health behaviours; diet, exercise, and medication management in participants with poorly controlled hypertension.

Methods

In this four-month controlled group study two community-based pharmacists provided three health coaching sessions to 20 participants with poorly controlled hypertension at monthly intervals. Changes in participants’ stages of change with respect to the modifiable health behaviours; diet, exercise, and medication management were assessed. To confirm the behaviour change outcomes, SOC were also assessed in a control group over the same period.

Results

Statistically significant changes in the modifiable health behaviours- medication management (d = 0.19; p = 0.03) and exercise (d = 0.85; p = 0.01) were apparent in participants who received health coaching and were evident through positive changes in the SOC charts. The participants in the control group did not experience significant changes with respect to the SOC. This was parallel to a decrease in mean systolic blood pressure from session one to session four by 7.53 mmHg (p < 0.05, d = − 0.42) in participants who received health coaching. Improvements to medication adherence was also apparent in these participants, evident from the mean scores for the Adherence to Refills and Medications Scale (ARMS), which decreased significantly from a mean of 15.60 to 13.05 (p < 0.05) from session one to four.

Conclusions

Pharmacist health coaching produced promising health outcomes in participants with poorly controlled hypertension. Pharmacists were able to facilitate a positive behaviour change in participants. However, larger participant cohorts are needed to explore these findings further.

Trial registration

Australia New Zealand Clinical Trials Registry ACTRN12618001839291. Date of registration 12/11/2018.
Retraction Note to: Long non-coding RNA SATB2-AS1 inhibits microRNA-155-3p to suppress breast cancer cell growth by promoting breast cancer metastasis suppressor 1-like
Authors: Cheng Shaoqiang , Xia Bingshu , Li Hongbin , Li Yuying , Lv Xinxin , Zhang Yue , Huang Yuanxi
Published: February 2021

This article has been retracted. Please see the Retraction Notice for more detail: 10.1186/s12935-021-01798-y
Metal biomarker mixtures and blood pressure in the United States: cross-sectional findings from the 1999-2006 National Health and Nutrition Examination Survey (NHANES)
Authors: Everson Todd M. , Niedzwiecki Megan M. , Toth Daniell , Tellez-Plaza Maria , Liu Haoran , Barr Dana B. , Gribble Matthew O.
Published: February 2021

Background

The objective of this study was to identify conditional relationships between multiple metal biomarkers that predict systolic and diastolic blood pressure in the non-institutionalized United States adult population below the age of 60.

Methods

We used inorganic exposure biomarker data and blood pressure data from three cycles (1999–2004) of the National Health and Nutrition Examination Survey (NHANES) to construct regression trees for blood pressure among adults ages 20–60 (adjusted for age, sex, body mass index, race, and smoking status) to identify predictors of systolic (SBP) and diastolic blood pressure (DBP). We also considered relationships among non-Hispanic black, Mexican-American, and white adults separately.

Results

The following metal exposure biomarkers were conditionally predictive of SBP and/or DBP in the full sample: antimony (Sb), barium (Ba), cadmium (Cd), cesium (Cs), lead (Pb), tungsten (W) and molybdenum (Mo). The highest average SBP (> 120 mmHg) was observed among those with low Sb (≤ 0.21 μg/dL) high Cd (> 0.22 μg/g creatinine) and high Pb (> 2.55 μg/dL) biomarkers. Those with the highest average DBP had high urinary W levels (> 0.10 μg/g creatinine) in combination with either urinary Sb > 0.17 μg/g creatinine or those with urinary Sb ≤ 0.17 μg/g creatinine, but with high blood Pb levels (> 1.35 μg/dL). Predictors differed by ethnicity, with Cd as the main predictor of SBP among non-Hispanic black adults, and Pb not selected by the algorithm as a predictor of SBP among non-Hispanic white adults.

Conclusions

Combinations of metal biomarkers have different apparent relationships with blood pressure. Additional research in toxicological experimental models and in epidemiological studies is warranted to evaluate the suggested possible toxicological interactions between Sb, Cd, and Pb; and between W, Sb, and Pb; for cardiovascular (e.g., blood pressure) health. We also think future epidemiological research on inorganic exposure sets in relation to health outcomes like blood pressure might benefit from stratification by race and ethnicity.
Biopsy sampling during self-expandable metallic stent placement in acute malignant colorectal obstruction: a narrative review
Authors: Bennedsgaard Sigrid Skov , Iversen Lene Hjerrild
Published: February 2021

Background

Histopathology is a crucial part of diagnosis and treatment guidance of colorectal cancer. In Denmark, it is not routine to biopsy during self-expandable metallic stent (SEMS) placement as a treatment option for acute colorectal obstruction of unknown etiology. This is due to lack of knowledge about the risks of hemorrhage, and thus the risk to aggravate the deteriorating overview conditions. Therefore, the aim of this study is to investigate whether there is evidence to avoid biopsy sampling during acute SEMS placement.

Methods

The PubMed, Embase, and Cochrane Library databases were searched for relevant studies. Studies were included if they described biopsy sampling in relation to SEMS placement. Additionally, national and international guidelines were scrutinized on Google and by visiting the websites of national and international gastrointestinal societies.

Results

In total, 43 studies were included in the review. Among these, one recommended biopsy during SEMS placement, three advised against biopsy, 23 just reported biopsy was performed during the procedure, and 16 reported biopsy before or after the procedure, or the timing was not specified. Among the 12 included guidelines, only two described biopsy during SEMS placement.

Conclusion

The literature on the subject is limited. In 24 of the 43 included studies, biopsy sampling was done during SEMS placement without reporting a decrease in the technical success rate. The included guidelines were characterized by a general lack of description of whether biopsy during SEMS placement should be performed or not. Prospective studies are needed in order to establish the real risk of hemorrhage, if any, when a biopsy is obtained.
Application of 3D printing and framework internal fixation technology for high complex rib fractures
Authors: Zhou Xuetao , Zhang Dongsheng , Xie Zexin , Yang Yang , Chen Menghui , Liang Zheng , Zhang Guoliang , Li Shujun
Published: February 2021

Objective

To explore the clinical effect of 3D printing combined with framework internal fixation technology on the minimally invasive internal fixation of high complex rib fractures.

Methods

Total 16 patients with high complex rib fractures were included in the study. Before the procedure, the 3D rib model was reconstructed based on the thin-layer chest CT scan. According to the 3D model, the rib locking plate was pre-shaped, and the preoperative planning were made including the direction of the locking plate, the location of each nail hole and the length of the screw. During the operation, the locking plate was inserted from the sternum to the outermost fracture lines of ribs with screws at both ends. In addition, the locking plate was used as the frame to sequentially reduce the middle fracture segment and fix with screws or steel wires. Chest x-rays or chest CT scans after surgery were used to assess the ribs recovery. All patients were routinely given non-steroidal anti-inflammatory drugs (NSAIDS) for analgesia, and the pain level was evaluated using numerical rating scale (NRS).

Results

The preoperative planning according to the 3D printed rib model was accurate. The reduction and fixation of each fracture segment were successfully completed through the framework internal fixation technology. No cases of surgical death, and postoperative chest pain was significantly alleviated. Five to 10 months follow up demonstrated neither loosening of screws, nor displacement of fixtures among patients. The lungs of each patients were clear and in good shape.

Conclusion

The application of 3D printing combined with framework internal fixation technology to the high complex rib fractures is beneficial for restoring the inherent shape of the thoracic cage, which can realize the accurate and individualized treatment as well as reduces the operation difficulty.
Comparison of the efficacy of different androgens measured by LC-MS/MS in representing hyperandrogenemia and an evaluation of adrenal-origin androgens with a dexamethasone suppression test in patients with PCOS
Authors: Chen Fu , Chen Minjie , Zhang Weichun , Yin Huihuang , Chen Guishan , Huang Qingxia , Yang Xiaoping , Chen Lan , Lin Chujia , Yin Guoshu
Published: February 2021

Background

The aims of this study were to compare the efficacy of different androgens measured by liquid chromatography-mass spectrometry (LC-MS/MS) in representing hyperandrogenemia and to evaluate adrenal-origin androgens with a dexamethasone suppression test in patients with polycystic ovary syndrome (PCOS).

Methods

One hundred and two patients with PCOS and 41 healthy volunteers were recruited and total serum testosterone (TT), androstenedione (AD), dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) were measured by LC-MS/MS. ROC analysis was performed to compare the efficacy of different androgens in representing hyperandrogenemia. Dexamethasone suppression test was performed in 51 patients with PCOS and above indicators were measured after dexamethasone administration. The prediction efficacy of DHEA and DHEA-S at baseline in the dexamethasone suppression test was evaluated with ROC analysis.

Results

The AUCs of TT, AD, free androgen index (FAI) and DHEA-S in ROC analysis for representing hyperandrogenemia were 0.816, 0.842, 0.937 and 0.678, respectively. The optimal cutoff value of TT was 0.337 ng/ml, with a sensitivity of 72.0% and specificity of 82.93%. The optimal cutoff value for AD was 1.309 ng/ml, with a sensitivity of 81.0% and specificity of 73.17%. The optimal cutoff value of the FAI was 2.50, with a sensitivity of 87.0% and specificity of 92.68%. Alternatively, AD or FAI more than the optimal cutoff values as evidence of hyperandrogenemia had the highest sensitivity of 91.18%. The levels of cortisol, DHEA and DHEA-S were all suppressed to narrow ranges after dexamethasone administration. Nine and 8 of 51 patients with PCOS had significant decreases in TT and AD, respectively. DHEA can be used as a indicator for predicting significant decrease of TT in dexamethasone suppression test with cutoff value of 13.28 ng/ml. A total of 27.5% (14/51) of patients had DHEA-S excess, but only 1 of 9 patients who had a significant decrease in TT had elevated level of DHEA-S at baseline.

Conclusions

AD measured by LC-MS/MS can represent hyperandrogenemia in PCOS patients and, combined with TT or FAI, can improve the screening efficiency of hyperandrogenemia. Seventeen percent of PCOS patients had adrenal-origin androgen dominance, with TT significantly decreasing after 2 days of dexamethasone administration. Adrenal-origin androgen dominance was not parallel with DHEA-S excess in patients with PCOS.
Survival and biomarker analysis for ovarian mucinous carcinoma according to invasive patterns: retrospective analysis and review literature
Authors: Hada Taira , Miyamoto Morikazu , Ishibashi Hiroki , Matsuura Hiroko , Sakamoto Takahiro , Kakimoto Soichiro , Iwahashi Hideki , Tsuda Hitoshi , Takano Masashi
Published: February 2021

Background

In ovarian mucinous carcinoma, invasive pattern is the important factor but there were less reposts to investigate it. The aim of this study was to examine the association between prognosis and invasive patterns of ovarian mucinous carcinoma and to investigate the biomarkers of the diagnosis and prognosis immunochemically. Patients with ovarian mucinous carcinoma at our institution between 1984 and 2018 were identified. A pathological review was conducted using the 2020 World Health Organization criteria. The prognosis of infiltrative invasion and expansile invasion of ovarian mucinous carcinoma were retrospectively compared. In addition, immunohistochemical staining was conducted for all cases, and the immunohistochemical differences between the two invasive patterns were compared.

Results

After the pathological review, 25 cases with infiltrative invasion and 24 cases with expansile invasion were included. Ovarian mucinous carcinoma with infiltrative invasion showed significantly worse progression-free survival (PFS, p < 0.01) and overall survival (OS, p < 0.01) than those with expansile invasion. Multivariate analysis demonstrated that the pattern of infiltrative invasion was a worse prognostic factor for PFS (hazard ratio 9.01, p < 0.01) and OS (hazard ratio 17.56, p < 0.01). Immunohistochemically, cytokeratin (CK) 5/6 (p = 0.01), cluster of differentiation (CD) 24 (p = 0.02), and epithelial growth factor receptor (EGFR) (p < 0.01) were statistically related to infiltrative invasion. The PFS (p = 0.04) and OS (p = 0.02) of cases with EGFR-positive OMC were worse than those with negative OMC.

Conclusions

Infiltrative invasion was observed to be a prognostic factor showing worse outcomes for ovarian mucinous carcinoma compared to expansile infiltration. CK5/6, CD24, and EGFR might be biomarkers of the diagnosis.
Innovations with tele-ultrasound in education sonography: the use of tele-ultrasound to train novice scanners
Authors: Drake Anne E. , Hy Jonathan , MacDougall Gordon A. , Holmes Brendan , Icken Lauren , Schrock Jon W. , Jones Robert A.
Published: February 2021

Objectives

Point-of-care ultrasound (POCUS) has become increasingly integrated into medical education given the growing role of evaluative and procedural techniques in practice today. Tele-ultrasound is a new and promising venture that aims to expand medical knowledge and education to previously unreached or underserved areas. This study aimed to determine the non-inferiority of teaching ultrasound remotely using tele-ultrasound via the Philips Lumify (Philips Medical Systems, Bothell, WA) system, which utilizes video conferencing technology and real-time imaging that can be viewed by the operator and educator simultaneously.

Methods

Three commonly used ultrasound exams were taught and evaluated in 56 ultrasound-naive medical participants: Focused Assessment with Sonography in Trauma (FAST), Lower Extremity Deep Venous Thrombosis (LEDVT) screening, and ultrasound-guided vascular access. The participants were randomized into either in-person traditional learning or tele-ultrasound learning with the Philips Lumify (Philips Medical Systems, Bothell, WA) units. The primary outcome of interest was the ability to perform certain tasks for each exam

Results

Competency on each exam was tested across all exams and no inferiority was found between in-person and remote learning (p < 0.05).

Conclusions

Our findings support the use of tele-ultrasound in beginner ultrasound education.
Pesticide traces in local crops of Sancti Spíritus, Cuba: risk assessment study
Authors: López-Dávila Edelbis , Houbraken Michael , De Rop Jasmine , Claus Gregor , Wumbei Abukari , Romero Romero Osvaldo , Spanoghe Pieter
Published: February 2021

Background

Vegetables and rice produced in Cuba may contain residue of pesticides that exceed the maximum residue limits (MRLs). Pesticide residues on crop samples from Sancti Spíritus province were analyzed. Based on these residue data, a risk assessment of consumer exposure was conducted.

Methods

Samples collected during the 2017, 2018, and 2019 periods were analyzed using UPLC-MS/MS and GC/ECD chromatography techniques. A deterministic risk assessment was performed, using consumption data collected by the authors. Also, a probabilistic risk assessment was worked out with @RISK for the Monte Carlo simulation.

Results

A broad range of pesticides were detected in the samples. Most of the detected active ingredients were insecticides and fungicides. A considerable part of the detected pesticide residues exceeded the EU and Cuban MRLs. However, the deterministic risk assessment revealed that the consumer risk of pesticide exposure is low. Only in the maximum exposure scenario children and adults were exposed to methamidophos residues in tomatoes higher than the acceptable daily intake.

Conclusions

When a more realistic consumption (50th percentile) and higher (95th percentile) consumption pattern for tomatoes was assumed, the deterministic risk assessment found no chronic risk for children and adults being exposed to methamidophos present in the tomato samples. Furthermore, the probabilistic risk assessment concerning methamidophos exposure in tomato for children and adult strata showed no risk. To perform in the future a more accurate risk assessment for Cuban consumers it is important to have more detailed consumption data and an expanded dataset of the residues in different crops.
Using hospitalization data for injury surveillance in agriculture, forestry and fishing: a crosswalk between ICD10CM external cause of injury coding and The Occupational Injury and Illness Classification System
Authors: Scott Erika , Hirabayashi Liane , Graham Judy , Krupa Nicole , Jenkins Paul
Published: February 2021

Background

While statistics related to occupational injuries exist at state and national levels, there are notable difficulties with using these to understand non-fatal injuries trends in agriculture, forestry, and commercial fishing. This paper describes the development and testing of a crosswalk between ICD-10-CM external cause of injury codes (E-codes) for agriculture, forestry, and fishing (AFF) and the Occupational Injury and Illness Classification System (OIICS). By using this crosswalk, researchers can efficiently process hospitalization data and quickly assemble relevant cases of AFF injuries useful for epidemiological tracking.

Methods

All 6810 ICD-10-CM E- codes were double-reviewed and tagged for AFF- relatedness. Those related to AFF were then coded into a crosswalk to OIICS. The crosswalk was tested on hospital data (inpatient, outpatient, and emergency department) from New York, Massachusetts, and Vermont using SAS9.3. Injury records were characterized by type of event, source of injury, and by general demographics using descriptive epidemiology.

Results

Of the 6810 E-codes available in the ICD-10-CM scheme, 263 different E-codes were ultimately classified as 1 = true case, 2 = traumatic/acute and suspected AFF, or 3 = AFF and suspected traumatic/acute. The crosswalk mapping identified 9969 patient records either confirmed to be or suspected to be an AFF injury out of a total of 38,412,241 records in the datasets, combined. Of these, 963 were true cases of agricultural injury. The remaining 9006 were suspected AFF cases, where the E-code was not specific enough to assign certainty to the record’s work-relatedness. For the true agricultural cases, the most frequent combinations presented were contact with agricultural/garden equipment (301), non-roadway incident involving off-road vehicle (222), and struck by cow or other bovine (150). For suspected agricultural cases, the majority (68.2%) represent animal-related injuries.

Conclusions

The crosswalk provides a reproducible, low-cost, rapid means to identify and code AFF injuries from hospital data. The use of this crosswalk is best suited to identifying true agricultural cases; however, capturing suspected cases of agriculture, forestry, and fishing injury also provides valuable data.
Development of a conformal woven fabric antenna for wearable breast hyperthermia
Authors: Mukai Yusuke , Suh Minyoung
Published: February 2021

Breast hyperthermia is a non-invasive cancer treatment, where breast temperature is mildly elevated by a localized electromagnetic (EM) irradiation to deactivate and damage cancer cells. The emerging needs associated with this medical modality include the development of a highly wearable microwave applicator with a low power requirement to enable a more patient-friendly and continuous hyperthermia therapy. As a potential solution, we propose a textile antenna that consists of a copper-plated woven polyester fabric as a radiating patch and a ground plane and a woven polyester fabric as a dielectric substrate and a padding layer. The porous nature of these textile materials enables construction of a lightweight and flexible antenna with a low dielectric loss for a more comfortable hyperthermia treatment. By incorporating a synthetic breast tissue for a model study, the temperature rises were measured to be 3.3 °C and 1.9 °C at 5 mm and 15 mm depths, respectively, after 15 min of heating (input power of 1 W). This suggests that the textile-based approach could be an effective solution for comfortable and long-term applications of breast hyperthermia therapy.
In vitro validation of Digital Image Analysis Sequence (DIAS) for the assessment of the marginal fit of cement-retained implant-supported experimental crowns
Authors: Villias Aristeidis A. , Kourtis Stefanos G. , Karkazis Hercules C. , Polyzois Gregory L.
Published: February 2021

Background

The replica technique with its modifications (negative replica) has been used for the assessment of marginal fit (MF). However, identification of the boundaries between prosthesis, cement, and abutment is challenging. The recently developed Digital Image Analysis Sequence (DIAS) addresses this limitation. Although DIAS is applicable, its reliability has not yet been proven.

The purpose of this study was to verify the DIAS as an acceptable method for the quantitative assessment of MF at cemented crowns, by conducting statistical tests of agreement between different examiners.

Methods

One hundred fifty-one implant-supported experimental crowns were cemented. Equal negative replicas were produced from the assemblies. Each replica was sectioned in six parts, which were photographed under an optical microscope. From the 906 standardized digital photomicrographs (0.65 μm/pixel), 130 were randomly selected for analysis. DIAS included tracing the profile of the crown and the abutment and marking the margin definition points before cementation. Next, the traced and marked outlines were superimposed on each digital image, highlighting the components’ boundaries and enabling MF measurements.

One researcher ran the analysis twice and three others once, independently. Five groups of 130 measurements were formed. Intra- and interobserver reliability was evaluated with intraclass correlation coefficient (ICC). Agreement was estimated with the standard error of measurement (SEM), the smallest detectable change at the 95% confidence level (SDC95%), and the Bland and Altman method of limits of agreement (LoA).

Results

Measured MF ranged between 22.83 and 286.58 pixels. Both the intra- and interobserver reliability were excellent, ICC = 1 at 95% confidence level. The intra- and interobserver SEM and SDC95% were less than 1 and 3 pixels, respectively. The Bland–Altman analysis presented graphically high level of agreement between the mean measurement of the first observer and each of the three other observers’ measurements. Differences between observers were normally distributed. In all three cases, the mean difference was less than 1 pixel and within ± 3 pixels LoA laid at least 95% of differences. T tests of the differences did not reveal any fixed bias (P > .05, not significant).

Conclusion

The DIAS is an objective and reliable method able to detect and quantify MF at ranges observed in clinical practice.
An unusual presentation of acute myocardial infarction in physiotherapy direct access: findings from a case report
Authors: Storari Lorenzo , Barbari Valerio , Brindisino Fabrizio , Testa Marco , Filippo Maselli
Published: February 2021

Background

Shoulder pain (SP) may originate from both musculoskeletal and visceral conditions. Physiotherapists (PT) may encounter patients with life-threatening pathologies that mimic musculoskeletal pain such as Acute Myocardial Infarction (AMI). A trained PT should be able to distinguish between signs and symptoms of musculoskeletal or visceral origin aimed at performing proper medical referral.

Case presentation

A 46-y-old male with acute SP lasting from a week was diagnosed with right painful musculoskeletal shoulder syndrome, in two successive examinations by the emergency department physicians. However, after having experienced a shift of the pain on the left side, the patient presented to a PT. The PT recognized the signs and symptoms of visceral pain and referred him to the general practitioner, which identified a cardiac disease. The final diagnosis was acute myocardial infarction.

Conclusion

This case report highlights the importance of a thorough patient screening examination, especially for patients treated in an outpatient setting, which allow distinguishing between signs and symptoms of musculoskeletal from visceral diseases.
Making the case for the family model in in-patient child and adolescent mental healthcare
Authors: Cousins Lesley , Holmes Joanne
Published: February 2021

Within paediatrics, young children experiencing physical and emotional distress are admitted to hospital with their parents as a matter of course, recognising the trauma associated with parting children from their carers. Much of this practice is underpinned by our understanding of attachment theory, which also sits as a fundamental tenet of child psychiatry. Yet the culture in psychiatric in-patient hospitals remains to admit young children without their parents, often to units that are geographically distant from the family home. We argue that the practice of admitting lone children to psychiatric in-patient units is likely to be traumatising as well as less effective. We believe this culture requires challenge and change.
Development of severe psychological distress among low-income individuals during the COVID-19 pandemic: longitudinal study
Authors: Kikuchi Hiroyuki , Machida Masaki , Nakamura Itaru , Saito Reiko , Odagiri Yuko , Kojima Takako , Watanabe Hidehiro , Inoue Shigeru
Published: February 2021

Background

It has been indicated that the health impact of COVID-19 is potentially greater in individuals from lower socioeconomic status than in the overall population.

Aims

To examine how the spread of COVID-19 has altered the general public's mental health, and whether such changes differ in relation to individual income.

Method

An online longitudinal survey was conducted at three different time periods during the pandemic. We recruited 1993 people aged 20–70 years, living in the Tokyo metropolitan area in Japan. Participants’ mental health was measured with the six-item version of the Kessler Psychological Distress Scale; the existence of severe psychological distress was ascertained through the cut-off data. Multiple logistic and mixed-model ordinal logistic regression analyses were performed, with income as the independent variable.

Results

Of the participants, 985 were male, with a mean age of 50.5 (±15.8) years. Severe psychological distress percentages for each tested period were 9.3%, 11.2% and 10.7% for phases 1, 2 and 3, respectively. Between phases 1 and 2 or phases 2 and 3, the group that earned <£15 000 had significantly higher propensity to develop severe psychological distress than the group that earned ≥£45 000 (odds ratio 2.09, 95% CI 0.95–4.56 between phases 1 and 2; odds ratio 3.00, 95% CI 1.01–9.58 between phases 2 and 3).

Conclusions

Although there has been significant deterioration in mental health among citizens during the COVID-19 pandemic, this was more significant among those with lower income. Therefore, mental health measures that focus on low socioeconomic groups may be necessary.
Protocol for process evaluation of integration of mental health into primary healthcare in two states in Nigeria: the mhSUN programme
Authors: Eaton Julian , Akande Yusuf , Onukogu Uchechi , Nwefoh Emeka , Sheikh Taiwo Lateef , Ekpe Ekpe Essien , Gureje Oye
Published: February 2021

Background

Current international recommendations to address the large treatment gap for mental healthcare in low- and middle-income countries are to scale up integration of mental health into primary care. There are good outcome studies to support this, but less robust evidence for effectively carrying out integration and scale-up of such services, or for understanding how to address contextual issues that routinely arise.

Aims

This protocol is for a process evaluation of a programme called Mental Health Scale Up Nigeria. The study aims are to determine the extent to which the intervention was carried out according to the plans developed (fidelity), to examine the effect of postulated moderating factors and local context, and the perception of the programme by primary care staff and implementers.

Method

We use a theoretical framework for process evaluation based on the Medical Research Council's Guidelines on Process Evaluation. A Theory of Change workshop was carried out in programme development, to highlight relevant factors influencing the process, ensure good adaptation of global normative guidelines and gain buy-in from local stakeholders. We will use mixed methods to examine programme implementation and outcomes, and influence of moderating factors.

Results

Data sources will include the routine health information system, facility records (for staff, medication and infrastructure), log books of intervention activities, supervision records, patient questionnaires and qualitative interviews.

Conclusions

Evidence from this process evaluation will help guide implementers aiming to scale up mental health services in primary care in low- and middle-income countries.
Social functioning and emotion recognition in adults with triple X syndrome
Authors: Otter Maarten , Crins Peter M. L. , Campforts Bea C. M. , Stumpel Constance T. R. M. , van Amelsvoort Thérèse A. M. J. , Vingerhoets Claudia
Published: February 2021

Background

Triple X syndrome (TXS) is caused by aneuploidy of the X chromosome and is associated with impaired social functioning in children; however, its effect on social functioning and emotion recognition in adults is poorly understood.

Aims

The aim of this study was to investigate social functioning and emotion recognition in adults with TXS.

Method

This cross-sectional cohort study was designed to compare social functioning and emotion recognition between adults with TXS (n= 34) and an age-matched control group (n= 31). Social functioning was assessed with the Adult Behavior Checklist and Social Responsiveness Scale for Adults. Emotion recognition was assessed with the Emotion Recognition Task in the Cambridge Neuropsychological Test Automated Battery. Differences were analysed by Mann-WhitneyU-test.

Results

Compared with controls, women with TXS scored higher on the Adult Behavior Checklist, including the Withdrawn scale (P< 0.001, effect size 0.4) and Thought Problems scale (P< 0.001, effect size 0.4); and higher on the Social Responsiveness Scale for Adults, indicating impaired social functioning (P< 0.001, effect size 0.5). In addition, women with TXS performed worse on the Emotion Recognition Task, particularly with respect to recognising sadness (P< 0.005, effect size 0.4), fear (P< 0.01, effect size 0.4) and disgust (P< 0.02, effect size 0.3).

Conclusions

Our findings indicate that adults with TXS have a higher prevalence of impaired social functioning and emotion recognition. These results highlight the relevance of sex chromosome aneuploidy as a potential model for studying disorders characterised by social impairments such as autism spectrum disorder, particularly among women.
Association of Parental Consanguinity With Papillary Thyroid Carcinoma: A Case-Control Study
Authors: Zayed Ayman A , Amarin Justin Z , Al-Ani Abdallah T , Altell Tareq L , Abdelhamid Sultan S , Qirem Murad M , Fahmawi Suhib M , Elshebli Sanad M , Hamo Khair M , Zaghlol Louay Y , Tierney Michael E , Zayed Jana A , Haghighi Alireza
Published: February 2021

Context

Papillary thyroid carcinoma (PTC) is the most common type of nonmedullary thyroid carcinoma. Uncommonly, PTC is associated with multiple genetic alterations and chromosomal abnormalities and displays familial patterns of inheritance. Parental consanguinity increases susceptibility to many genetic disorders.

Objective

This work aimed to investigate the association of parental consanguinity with PTC.

Methods

This case-control study of PTC patients compared with healthy controls took place in a tertiary referral hospital. We recruited 200 PTC patients who were managed at the endocrinology outpatient clinics of the Jordan University Hospital, and we recruited 515 healthy controls from a nonclinical setting. We interviewed all participants and collected sociodemographic data. We reviewed the family pedigrees of each participant four generations back and excluded any participant who was related. We established whether the parents of each participant were first cousins, first cousins once removed, second cousins, or unrelated. We then used binary logistic regression to assess the association of parental consanguinity with PTC adjusted for age, sex, smoking status, body mass index, and parental education.

Results

We recruited 715 participants. The numbers of PTC patients and healthy controls were 200 (28.0%) and 515 (72.0%), respectively. The rate of parental consanguinity was 25.5% in PTC patients and 12.2% in healthy controls. Parental consanguinity was significantly associated with PTC (adjusted odds ratio, 2.60; 95% CI, 1.63-4.17; P < .001).

Conclusion

Parental consanguinity is a risk factor for PTC. Our findings should be considered during familial risk assessment and genetic counseling, especially in populations with high rates of consanguinity.
Mendelian Randomization Highlights the Causal Role of Normal Thyroid Function on Blood Lipid Profiles
Authors: Wang Yanjun , Guo Ping , Liu Lu , Zhang Yanan , Zeng Ping , Yuan Zhongshang
Published: February 2021

The association between thyroid function and dyslipidemia has been well documented in observational studies. However, observational studies are prone to confounding, making it difficult to conduct causal inference. We performed a 2-sample bidirectional Mendelian randomization (MR) using summary statistics from large-scale genome-wide association studies of thyroid stimulating hormone (TSH), free T4 (FT4), and blood lipids. We chose the inverse variance–weighted (IVW) method for the main analysis, and consolidated results through various sensitivity analyses involving 6 different MR methods under different model specifications. We further conducted genetic correlation analysis and colocalization analysis to deeply reflect the causality. The IVW method showed per 1 SD increase in normal TSH was significantly associated with a 0.048 SD increase in total cholesterol (TC; P < 0.001) and a 0.032 SD increase in low-density lipoprotein cholesterol (LDL; P = 0.021). A 1 SD increase in normal FT4 was significantly associated with a 0.056 SD decrease in TC (P = 0.014) and a 0.072 SD decrease in LDL (P = 0.009). Neither TSH nor FT4 showed causal associations with high-density lipoprotein cholesterol and triglycerides. No significant causal effect of blood lipids on normal TSH or FT4 can be detected. All results were largely consistent when using several alternative MR methods, and were reconfirmed by both genetic correlation analysis and colocalization analysis. Our study suggested that, even within reference range, higher TSH or lower FT4 are causally associated with increased TC and LDL, whereas no reverse causal association can be found.
Craniofacial transitions: the role of EMT and MET during head development
Authors: Milmoe Natalie J. , Tucker Abigail S.
Published: February 2021

Within the developing head, tissues undergo cell-fate transitions to shape the forming structures. This starts with the neural crest, which undergoes epithelial-to-mesenchymal transition (EMT) to form, amongst other tissues, many of the skeletal tissues of the head. In the eye and ear, these neural crest cells then transform back into an epithelium, via mesenchymal-to-epithelial transition (MET), highlighting the flexibility of this population. Elsewhere in the head, the epithelium loses its integrity and transforms into mesenchyme. Here, we review these craniofacial transitions, looking at why they happen, the factors that trigger them, and the cell and molecular changes they involve. We also discuss the consequences of aberrant EMT and MET in the head.
THOC4 regulates energy homeostasis by stabilizing TFEB mRNA during prolonged starvation
Authors: Fujita Toshiharu , Kubo Sayaka , Shioda Tatsuya , Tokumura Ayaka , Minami Satoshi , Tsuchiya Megumi , Isaka Yoshitaka , Ogawa Hidesato , Hamasaki Maho , Yu Li , Yoshimori Tamotsu , Nakamura Shuhei
Published: February 2021

TFEB, a basic helix-loop-helix transcription factor, is a master regulator of autophagy, lysosome biogenesis and lipid catabolism. Compared to posttranslational regulation of TFEB, the regulation of TFEB mRNA stability remains relatively uncharacterized. In this study, we identified the mRNA-binding protein THOC4 as a novel regulator of TFEB. In mammalian cells, siRNA-mediated knockdown of THOC4 decreased the level of TFEB protein to a greater extent than other bHLH transcription factors. THOC4 bound to TFEB mRNA and stabilized it after transcription by maintaining poly(A) tail length. We further found that this mode of regulation was conserved in Caenorhabditiselegans and was essential for TFEB-mediated lipid breakdown, which becomes over-represented during prolonged starvation. Taken together, our findings reveal the presence of an additional layer of TFEB regulation by THOC4 and provide novel insights into the function of TFEB in mediating autophagy and lipid metabolism.
Neonatal low-density granulocytes internalize and kill bacteria but suppress monocyte function using extracellular DNA
Authors: Seman Brittany G. , Vance Jordan K. , Akers Stephen M. , Robinson Cory M.
Published: February 2021

Low-density granulocytes (LDGs) are found abundantly in neonatal blood; however, there is limited mechanistic understanding of LDG interactions with bacteria and innate immune cells during acute infection. We aimed to determine how human neonatal LDGs may influence control of the bacterial burden at sites of infection, both individually and in the presence of mononuclear phagocytes. LDGs from human umbilical cord blood do phagocytose Escherichia coli O1:K1:H7 and traffic bacteria into acidic compartments. However, LDGs were significantly less efficient at bacterial uptake and killing compared to monocytes, and this activity was associated with a reduced inflammatory cytokine response. The presence of bacteria triggered the release of DNA (eDNA) from LDGs into the extracellular space that resembled neutrophil extracellular traps, but had limited anti-bacterial activity. Instead, eDNA significantly impaired monocyte control of bacteria during co-culture. These results suggest that LDG recruitment to sites of bacterial infection may compromise host protection in the neonate. Furthermore, our findings reveal novel insights into LDG activity during infection, clarify their inflammatory contributions relative to monocytes, and identify a novel LDG mechanism of immunosuppression.

This article has an associated First Person interview with the first author of the paper.