bluuebunny/crossref_metadata_2025 huggingface dataset:
Leipzig - Individual Placement and Support for people with mental illnesses (LIPSY): study protocol of a randomized controlled trial
Authors: Hussenoeder Felix S. , Koschig Maria , Conrad Ines , Gühne Uta , Pabst Alexander , Kühne Sophie-Elisabeth , Alberti Mathias , Stengler Katarina , Riedel-Heller Steffi G.
Published: August 2021

Background

Individuals receiving means-tested benefits are at a higher risk of being diagnosed with a psychiatric illness compared to those who are employed, and the rate of those working in the first labor market is low. The intervention (Individual Placement and Support, IPS) aims at maintaining or regaining working ability and at facilitating reintegration into the (first) labor market following a “first place, then train”-approach. The objective of the study is to conduct the first RCT in Germany that addresses a broad group of long-term unemployed individuals with severe mental illnesses that receive means-tested benefits, and to test the effectiveness of the IPS intervention.

Methods

In this randomized controlled trial, about 120 eligible participants aged between 18 years and local retirement age will be randomly allocated to an intervention group (IG) or to an active control group (CG) using a parallel arm design. The IG will receive IPS + high quality treatment as usual (TAU), the active CG will receive TAU + a booklet on integration measures. A block-randomization algorithm with a targeted assignment ratio of 1:1 for participants in IG and active CG will be used, stratified by sex and three age groups. Assessments will take place before the intervention at baseline (t0), and 6 (t1), 12 (t2), and 18 (t3) months later. Primary outcome will be the proportion of participants having worked at least 1 day in competitive employment since baseline, as assessed at t3. Secondary outcomes will be related to employment/ vocation and mental health. In addition, there will be a process evaluation. Treatment effects on outcomes will be tested using appropriate panel-data regression models, and acceptability, uptake and adherence will be evaluated using descriptive statistics and appropriate inference testing.

Discussion

The results of this trial are expected to generate a better understanding of the efficiency, feasibility, acceptance, and relevance of the IPS intervention in a German setting. They could be a first step towards the implementation of the method and towards improving the situation of long-term unemployed individuals with severe mental health problems.

Trial registration

German Clinical Trials Register (DRKS00023245), registered on 22.02.2021.
Comparing sagittal plane kinematics and kinetics of gait and stair climbing between hypermobile and non-hypermobile people; a cross-sectional study
Authors: Bates Alexander Vernon , McGregor Alison H. , Alexander Caroline M.
Published: August 2021

Background

Joint Hypermobility Syndrome (JHS) presents with a range of symptoms including widespread joint hypermobility and chronic arthralgia. The study objective was to investigate whether impairments in JHS are due to hypermobility or another factor of JHS by identifying impairments in gait and stair-climbing tasks; an activity that is demanding and so may better show differences between the cohorts.

Methods

Sixty-eight adults participated; 23 JHS, 23 Generalised Joint Hypermobility (GJH), and 22 Normal Flexibility (NF). Inclusion criteria for JHS participants were a positive classification using the Brighton Criteria, for GJH a Beighton Score ≥ 4, and for NF a Beighton Score < 4 with no hypermobile knees. Participants were recorded with a 10-camera Vicon system whilst they performed gait and stair-climbing. Temporal-spatial, and sagittal plane kinematic and kinetic outcome measures were calculated and input to statistical analyses by statistical parametric mapping (SPM).

Results

During the gait activity JHS had significantly greater stride time and significantly lower velocity than NF, and significantly greater stride time, lower velocity, and lower stride length than GJH. SPM analysis showed no significant differences between groups in gait kinematics. There were significant differences between groups for gait moments and powers; people with JHS tended to have lower moments and generate less power at the ankle, and favour power generation at the knee. A similar strategy was present in stair ascent. During stair descent people with JHS showed significantly more hip flexion than people with NF.

Conclusions

As there was only one significant difference between GJH and NF we conclude that impairments cannot be attributed to hypermobility alone, but rather other factor(s) of JHS. The results show that both gait and stair-climbing is impaired in JHS. Stair-climbing results indicate that JHS are using a knee-strategy and avoiding use of the ankle, which may be a factor for clinicians to consider during treatment.
Video mediastinoscopy-assisted superior mediastinal dissection in the treatment of thyroid carcinoma with mediastinal lymphadenopathy: preliminary results
Authors: Song Yuntao , Dai Liang , Xu Guohui , Wang Tianxiao , Yu Wenbin , Chen Keneng , Zhang Bin
Published: August 2021

Background

Mediastinal lymph node metastases (MLNM) are not rare in thyroid cancer, but their treatment has not been extensively studied. This study aimed to explore the preliminary application of video mediastinoscopy-assisted superior mediastinal dissection in the diagnosis and treatment of thyroid carcinoma with mediastinal lymphadenopathy.

Materials and methods

We retrospectively reviewed the clinical pathologic data and short-term outcomes of thyroid cancer patients with suspicious MLNM treated with video mediastinoscopy-assisted mediastinal dissection at our institution from 2017 to 2020.

Results

Nineteen patients were included: 14 with medullary thyroid carcinoma and five with papillary thyroid carcinoma. Superior mediastinal nodes were positive in nine (64.3%) patients with medullary thyroid carcinoma and in four (80.0%) patients with papillary carcinoma. No fatal bleeding occurred. There were three cases of temporary recurrent laryngeal nerve (RLN) palsy postoperatively, one of which was bilateral. Four patients had temporary hypocalcemia requiring supplementation, one had a chyle fistula, and one developed wound infection after the procedure. Postoperative serum molecular markers decreased in all patients. One patient died of cancer while the other 18 patients remained disease-free, with a median follow-up of 33 months.

Conclusion

Video mediastinoscopy-assisted superior mediastinal dissection can be performed relatively safely in patients with suspicious MLNM. This diagnostic and therapeutic approach may help control locoregional recurrences.
An exploratory analysis of work engagement among women with and without disordered eating
Authors: Willmer Mikaela , Westerberg Jacobson Josefin , Lindberg Magnus
Published: August 2021

Background

Around 10% of the female population is estimated to have a subclinical eating disorder. Many of these women are of working age. Previous research has shown associations between unhealthy eating behaviors and occupational stress or burnout. However, no previous study has explored the association between disordered eating and work engagement, a positive, fulfilling, affective-cognitive state of mind which has been positioned as the conceptual opposite of burnout. Thus, that was the aim of the present study.

Methods

In this cross-sectional study, a sample of 701 Swedish women completed the 9-item Utrecht Work Engagement Scale (UWES-9) and the Eating Disorder Examination Questionnaire (EDE-Q). They were divided into a Healthy Eating (HE) and a Disordered Eating (DE) group based on their EDE-Q scores. The Mann–Whitney U test was used to test the association between disordered eating and work engagement. The Kruskal Wallis test was used to assess the associations between educational level, marital status and age group, and work engagement.

Results

Neither the UWES scores nor the EDE-Q scores were found to have a normal distribution. Non-parametric testing showed that the DE group reported significantly lower work engagement than the HE group (p = 0.016). There were no significant associations between education, marital status or age (independent variables) and work engagement (dependent variable) (p = 0.826, 0.309, and 0.349, respectively).

Conclusion

These findings indicate that work engagement may play a role in disordered eating, and that there is a need for future research to consider the workplace environment as a potential source for altering disordered eating behaviors.
Use of community-based interventions to promote family planning use among pastoralist women in Ethiopia: cluster randomized controlled trial
Authors: Alemayehu Mussie , Medhanyie Araya Abrha , Reed Elizabeth , Bezabih Afework Mulugeta
Published: August 2021

Background

Afar region is one of the pastoralist dominated regions in Ethiopia. The region is characterized by a low contraceptive prevalence rate (CPR) of 5.4%. Lack of awareness of contraceptive use, husband objection and religious barriers are attributed to low CPR in the region. This study assessed the effect of community-based interventions for promoting family planning (FP) use among pastoralist communities in Ethiopia.

Methods

The study design was a three-arm, parallel, clustered randomized controlled trial (CRT). The three study arms were: (1) male involvement in family planning (FP) education; (2) women’s education on FP; and (3) control. A total of 33 clusters were randomized and allocated with a one-to-one ratio. Intervention components included (1) health education on FP to married women and men by faema leaders (a traditional community-based structure that serves as a social support group); (2) video-assisted message on FP; and (3) assisting the faema leader using health workers and health extension workers (HEWs). The intervention was given for a total of nine months. FP use and intentions were measured as outcome variables. In addition, a cluster-level summary considering a cluster effect analysis was performed. The result was presented with t.test, adjusted risks and its 95% confidence interval (CI).

Results

The proportion of FP use among the arms was 34% in the male involvement in FP education, 17.5% in women’s education on FP and 4.3% in the control. There was a positive change in the proportion of FP use in the male involvement in FP education and women’s education on FP arms with absolute risk (AR) of 0.29 (95% CI, 0.23,0.34) and 0.13 (95% CI,0.08,0.17), respectively, as compared to the control arm. Similarly, married women in the male involvement in FP education and women’s education on FP arms had 3.4 (2.48, 4.91) and 2.1 (1.50, 2.95) higher intention to use FP, respectively, as compared with the control arm.

Conclusion

The present study suggests that in such male-dominated pastoralist communities with more considerable religious barriers, the community-based health education mainly targeting males appears to be a promising strategy for improving FP use and intention to use FP.

Trial registration

ClinicalTrials.gov, NCT03450564, March, 2018.
Individual and context correlates of the oral pill and condom use among Brazilian female adolescents
Authors: Borges Ana Luiza Vilela , Duarte Luciane Simões , Lay Alejandra Andrea Roman , Fujimori Elizabeth
Published: August 2021

Background

Studies have examined the impact of contextual factors on the use of contraceptives among adolescents and found that many measures of income and social inequality are associated with contraceptive use. However, few have focused on maternal and primary health indicators and its influence on adolescent contraceptive use. This paper assesses whether maternal mortality rates, antenatal care visits, and primary healthcare coverage are associated with pill and condom use among female adolescents in Brazil.

Methods

We used data from the Study of Cardiovascular Risks in Adolescents (ERICA), a national, school-based cross-sectional study conducted in Brazil. A subsample of all female adolescents who had ever had sexual intercourse and were living in one of the 26 State capitals and the Federal District was selected (n = 7415). Multilevel mixed effects logistic regression models were estimated to examine the effect of contextual variables on pill and condom use.

Results

Sixty-five percent of female adolescents reported using pill while 21.9% reported using condom during the last sexual intercourse. Adolescents living in municipalities with low maternal mortality and high antenatal care coverage were significantly more likely to use pill during the last sexual intercourse compared to those from municipalities with high maternal mortality and low antenatal care coverage. Primary healthcare coverage (proportion of the population covered by primary healthcare teams) was not significantly associated with either condom or pill use during the last sexual intercourse.

Conclusion

Our findings suggest that promoting the use of pill among female adolescents may require approaches to strengthen healthcare systems rather than those focused solely on individual attributes.
Medical student exposure to women’s health concepts and practices: a content analysis of curriculum at Canadian medical schools
Authors: Anderson Natalie N. , Gagliardi Anna R.
Published: August 2021

Background

Women’s health (WH) includes a broad array of concerns and challenges that affect health across the lifespan. Considerable research shows that women continue to experience disparities in access to and quality of care. Apart from surveys of medical trainees and faculty, little research and none in Canada examined medical curriculum for WH. This study assessed how Canadian medical schools integrate WH in their curriculum.

Methods

We used deductive and summative content analysis to describe instances and the nature of WH topics in program and course descriptions that were publicly-available on web sites of Canadian medical schools. We reported results using summary statistics and text examples. We employed a framework, tested in our prior research, that included mention of women’s health principles and practices relevant to any health concern or condition including factors (e.g. sex, gender, social determinants) that influence health, and access to or quality of care.

Results

We retrieved 1459 documents from 16 medical schools (median 49.5, range 16 to 301). Few mentioned WH (125, 8.6 %), and the quantity of mentions varied by school (range 0.0–37.5 %). Pre-clerkship course documents more frequently mentioned WH (61/374, 17.3 %, chi square 43.2, p < 0.00001) compared with clerkship course documents (58/1067, 5.4 %). Core course documents more frequently mentioned WH (72/542, 13.3 %, chi square 29.0, p < 0.00001) compared with elective course documents WH (47/899, 5.2 %). Overall, documents more frequently referred to the WH domain of social determinants of health (88, 70.4 %). Few documents addressed women’s health (21, 16.8 %), sex or gender (19, 15.2 %), other considerations (15.2 %) or principles/components of women’s health (2, 1.6 %). Most documents that mentioned WH provided little detail about what those concepts referred to or how to optimize WH.

Conclusions

Based on program and course descriptions, WH may not be well-integrated at Canadian medical schools, and future physicians may not be consistently exposed to the full breadth of WH. This reveals opportunities for enhancing WH in the medical curriculum. Future research is needed to engage stakeholders including women in developing, implementing and evaluating competencies and corresponding curriculum that reflect the full range of WH concepts and practices.
From centralized DRG costing to decentralized TDABC-assessing the feasibility of hospital cost accounting for decision-making in Denmark
Authors: Malmmose Margit , Lydersen Jogvan Pauli
Published: August 2021

Background

The objective is to examine hospital cost accounts to understand the foundation upon which healthcare decisions are based. More specifically, the aim is to add insights to accounting practices and their applicability towards a newly establish value-based agenda with a focus on patient-level cost data.

Methods

We apply a cost accounting framework developed to position and understand hospital cost practices in relation to government requirements. Allocated cost account data from 2015 from all Danish hospitals were collected and analyzed. These cost accounts lay the foundation for diagnosis related group (DRG) rate setting. We further compare the data’s limitations and potential in a value-based healthcare (VBHC) agenda with the aim of implementing time-driven activity based costing (TDABC).

Results

We find exceedingly aggregated department-level data that are not tied to patient information. We investigate these data and find large data skewness in the current system, mainly due to structural variances within hospitals. We further demonstrate the current costs data’s lack of suitability for VBHC but with suggestions of how cost data can become applicable for such an approach, which will increase cost data transparency and, thus, provide a better foundation for both local and national decision-making.

Conclusions

The findings raise concerns about the cost accounts’ ability to provide valid information in healthcare decision-making due to a lack of transparency and obvious variances that distort budgets and production-value estimates. The standardization of costs stemming from hospitals with large organizational differences has significant implications on the fairness of resource allocation and decision-making at large. Thus, for hospitals to become more cost efficient, a substantially more detailed clinically bottom-led cost account system is essential to provide better information for prioritization in health.
Antibiotic use and irrational antibiotic prescriptions in 66 primary healthcare institutions in Beijing City, China, 2015–2018
Authors: Taxifulati Yumiti , Wushouer Haishaerjiang , Fu Mengyuan , Zhou Yue , Du Kexin , Zhang Xi , Yang Yaoyao , Zheng Bo , Guan Xiaodong , Shi Luwen
Published: August 2021

Objectives

To identify the patterns of antibiotic use and irrational antibiotic prescriptions in primary healthcare institutions (PHIs) in Dongcheng District of Beijing, China.

Materials and methods

All primary healthcare institutions (7 community healthcare centres and 59 community healthcare stations in total) in Dongcheng District were included in the study. Prescription data from January 2015 to December 2018 was derived from the Beijing Prescription Reviewing System of Primary healthcare institutions and analysed retrospectively. The antibiotic prescription rate was calculated and cases of irrational antibiotic prescriptions were identified.

Results

We extracted 11,166,905 prescriptions from the database. Only 189,962 prescriptions were included in the study, among which 9167 (4.8%) contained antibiotics. The antibiotic prescription rate fell from 5.2% in 2015 to 4.1% in 2018 while irrational antibiotic prescription rate increased from 10.4 to 11.8%. Acute Bronchitis was the most prevalent diagnosis (17.6%) for antibiotic prescriptions, followed by Unspecified Acute Respiratory Tract Infection (14.4%), Acute Tonsillitis (9.9%), and Urinary Tract Infection (6.4%). Around 10% of the prescriptions for the top 7 diagnoses identified were rated as irrational. Cephalosporins, fluoroquinolones, and macrolides were the most prescribed antibiotics, which accounted for 89.3% of all antibiotic prescriptions. Of all the antibiotic prescriptions, 7531 were reviewed, among which 939 (12.5%) were rated as irrational because of antibiotic use. Among all the irrational prescriptions, prescriptions with inappropriate antibiotic use and dosage accounted for the majority (54.4%).

Conclusion

Although a relatively low level of antibiotic utilization was found in PHIs in Dongcheng District of Beijing, the utilization patterns differed considerably from developed countries and irrational prescriptions remained. Considering the imbalanced allocation of medical resources between primary healthcare setting and secondary and tertiary hospitals, there need to be more efforts invested in regions with different levels of economic development.
Health facilities’ readiness for safe surgical care provision in Uganda and the Eastern Democratic Republic of Congo during Ebola and COVID-19 era
Authors: Sikakulya Franck Katembo , Ssebuufu Robinson , Longombe Albert Ahuka Ona , Okedi Xaviour Francis , Ilumbulumbu Michel Kalongo , Valimungighe Moise Muhindo , Pascal Furaha Nzanzu Blaise , Vahwere Bienfait Mumbere , Mambo Simon Binezero , Mulumba Yusuf , Muyisa Anderson Muhindo Muhasa , Sonia Fatuma Djuma , Sekabira John , Fualal Jane O. , Kyamanywa Patrick
Published: August 2021

Objective

This study aimed to assess health facilities’ readiness to provide safe surgical care during Ebola and COVID-19 era in Uganda and in the Eastern DR Congo.

Methods

A cross-sectional study was conducted in selected national, regional referral and general hospital facilities in Uganda and in the eastern part of DR Congo from 1st August 2020 to 30th October 2020. Data was analysed using Stata version 15.

Results

The participation rate was of 37.5 % (72/192) for both countries. None of the hospitals fulfilled the readiness criteria for safe surgical care provision in both countries. The mean bed capacity of participating health facilities (HF) was 184 in Eastern DR Congo and 274 in Uganda with an average surgical ward bed capacity of 22.3 % (41/184) and 20.4 % (56/274) respectively. The mean number of operating rooms was 2 and 3 in Eastern DR Congo and Uganda respectively. Nine hospitals (12.5 %) reported being able to test for Ebola and 25 (34.7 %) being able to test for COVID-19. Postponing of elective surgeries was reported by 10 (13.9) participating hospitals. Only 7 (9.7 %) hospitals reported having a specific operating room for suspect or confirmed cases of Ebola or COVID-19. Appropriate Personal Protection Equipment (PPE) was reported to be available in 60 (83.3 %) hospitals. Most of the staff had appropriate training on donning and doffing of PPE 40 (55.6 %). Specific teams and protocols for safe surgical care provision were reported to be present in 61 (84.7 %) and 56 (77.8 %) respectively in Uganda and Eastern DR Congo participating hospitals.

Conclusions

The lack of readiness to provide safe surgical care during Ebola and COVID-19 era across the participating hospitals in both countries indicate a need for strategies to enhance health facility supplies and readiness for safe surgical provision in resource-limited settings.
The relationship between sternum variation and mode of locomotion in birds
Authors: Lowi-Merri Talia M. , Benson Roger B. J. , Claramunt Santiago , Evans David C.
Published: August 2021

Background

The origin of powered avian flight was a locomotor innovation that expanded the ecological potential of maniraptoran dinosaurs, leading to remarkable variation in modern birds (Neornithes). The avian sternum is the anchor for the major flight muscles and, despite varying widely in morphology, has not been extensively studied from evolutionary or functional perspectives. We quantify sternal variation across a broad phylogenetic scope of birds using 3D geometric morphometrics methods. Using this comprehensive dataset, we apply phylogenetically informed regression approaches to test hypotheses of sternum size allometry and the correlation of sternal shape with both size and locomotory capabilities, including flightlessness and the highly varying flight and swimming styles of Neornithes.

Results

We find evidence for isometry of sternal size relative to body mass and document significant allometry of sternal shape alongside important correlations with locomotory capability, reflecting the effects of both body shape and musculoskeletal variation. Among these, we show that a large sternum with a deep or cranially projected sternal keel is necessary for powered flight in modern birds, that deeper sternal keels are correlated with slower but stronger flight, robust caudal sternal borders are associated with faster flapping styles, and that narrower sterna are associated with running abilities. Correlations between shape and locomotion are significant but show weak explanatory power, indicating that although sternal shape is broadly associated with locomotory ecology, other unexplored factors are also important.

Conclusions

These results display the ecological importance of the avian sternum for flight and locomotion by providing a novel understanding of sternum form and function in Neornithes. Our study lays the groundwork for estimating the locomotory abilities of paravian dinosaurs, the ancestors to Neornithes, by highlighting the importance of this critical element for avian flight, and will be useful for future work on the origin of flight along the dinosaur-bird lineage.
The impact of colonial-era policies on health workforce regulation in India: lessons for contemporary reform
Authors: Sriram Veena , Keshri Vikash R. , Kumbhar Kiran
Published: August 2021

Background

Regulation is a critical function in the governance of health workforces. In many countries, regulatory councils for health professionals guide the development and implementation of health workforce policy, but struggle to perform their responsibilities, particularly in low- and middle-income countries (LMICs). Few studies have analyzed the influence of colonialism on modern-day regulatory policy for health workforces in LMICs. Drawing on the example of regulatory policy from India, the goals of this paper is to uncover and highlight the colonial legacies of persistent challenges in medical education and practice within the country, and provide lessons for regulatory policy in India and other LMICs.

Main body

Drawing on peer-reviewed and gray literature, this paper explores the colonial origins of the regulation of medical education and practice in India. We describe three major aspects: (1) Evolution of the structure of the apex regulatory council for doctors—the Medical Council of India (MCI); (2) Reciprocity of medical qualifications between the MCI and the General Medical Council (GMC) in the UK following independence from Britain; (3) Regulatory imbalances between doctors and other cadres, and between biomedicine and Indian systems of medicine.

Conclusions

Challenges in medical education and professional regulation remain a major obstacle to improve the availability, retention and quality of health workers in India and many other LMICs. We conclude that the colonial origins of regulatory policy in India provide critical insight into contemporary debates regarding reform. From a policy perspective, we need to carefully interrogate why our existing policies are framed in particular ways, and consider whether that framing continues to suit our needs in the twenty-first century.
Demographic characteristics associated with circadian rest-activity rhythm patterns: a cross-sectional study
Authors: Li Jingen , Somers Virend K. , Lopez-Jimenez Francisco , Di Junrui , Covassin Naima
Published: August 2021

Background

Rest-activity rhythm (RAR), a manifestation of circadian rhythms, has been associated with morbidity and mortality risk. However, RAR patterns in the general population and specifically the role of demographic characteristics in RAR pattern have not been comprehensively assessed. Therefore, we aimed to describe RAR patterns among non-institutionalized US adults and age, sex, and race/ethnicity variation using accelerometry data from a nationally representative population.

Methods

This cross-sectional study was conducted using the US National Health and Nutrition Examination Survey (NHANES) 2011–2014. Participants aged ≥20 years who were enrolled in the physical activity monitoring examination and had at least four 24-h periods of valid wrist accelerometer data were included in the present analysis. 24-h RAR metrics were generated using both extended cosinor model (amplitude, mesor, acrophase and pseudo-F statistic) and nonparametric methods (interdaily stability [IS] and intradaily variability [IV]). Multivariable linear regression was used to assess the association between RAR and age, sex, and race/ethnicity.

Results

Eight thousand two hundred participants (mean [SE] age, 49.1 [0.5] years) were included, of whom 52.2% were women and 67.3% Whites. Women had higher RAR amplitude and mesor, and also more robust (pseudo-F statistic), more stable (higher IS) and less fragmented (lower IV) RAR (all Ptrend < 0.001) than men. Compared with younger adults (20–39 years), older adults (≥ 60 years) exhibited reduced RAR amplitude and mesor, but more stable and less fragmented RAR, and also reached their peak activity earlier (advanced acrophase) (all Ptrend < 0.001). Relative to other racial/ethnic groups, Hispanics had the highest amplitude and mesor level, and most stable (highest IS) and least fragmented (lowest IV) RAR pattern (Ptrend < 0.001). Conversely, non-Hispanic blacks had the lowest peak activity level (lowest amplitude) and least stable (lowest IS) RAR pattern (all Ptrend < 0.001).

Conclusions

In the general adult population, RAR patterns vary significantly according to sex, age and race/ethnicity. These results may reflect demographic-dependent differences in intrinsic circadian rhythms and may have important implications for understanding racial, ethnic, sex and other disparities in morbidity and mortality risk.
Mechanism of interaction between virus and host is inferred from the changes of gene expression in macrophages infected with African swine fever virus CN/GS/2018 strain
Authors: Yang Bo , Shen Chaochao , Zhang Dajun , Zhang Ting , Shi Xijuan , Yang Jinke , Hao Yu , Zhao Dengshuai , Cui Huimei , Yuan Xingguo , Chen Xuehui , Zhang Keshan , Zheng Haixue , Liu Xiangtao
Published: August 2021

Background

African swine fever virus (ASFV) is a highly lethal virus that can infect porcine alveolar macrophages (PAMs). Since ASFV, China has dealt with a heavy blow to the pig industry. However, the effect of infection of ASFV strains isolated from China on PAM transcription level is not yet clarified.

Methods

In this study, RNA sequencing (RNA-seq) was used to detect the differential expression of genes in PAMs at different time points after ASFV-CN/GS/2018 infection. The fluorescent quantitative polymerase chain reaction (qPCR) method was used to confirm the altered expression of related genes in PAMs infected with ASFV.

Results

A total of 1154 differentially expressed genes were identified after ASFV-CN/GS/2018 infection, of which 816 were upregulated, and 338 were downregulated. GO and KEGG analysis showed that these genes were dynamically enriched in various biological processes, including innate immune response, inflammatory response, chemokines, and apoptosis. Furthermore, qPCR verified that the DEAD box polypeptide 58 (DDX58), Interferon-induced helicase C domain-containing protein 1 (IFIH1), Toll-like receptor 3 (TLR3), and TLR7 of PAMs were upregulated after ASFV infection, while TLR4 and TLR6 had a significant downward trend during ASFV infection. The expression of some factors related to antiviral and inflammation was altered significantly after ASFV infection, among which interferon-induced protein with tetratricopeptide repeats 1 (IFIT1), IFIT2, Interleukin-6 (IL-6) were upregulated, and Ewing’s tumor-associated antigen 1 homolog (ETAA1) and Prosaposin receptor GPR37 (GPR37) were downregulated. In addition, we discovered that ASFV infection is involved in the regulation of chemokine expression in PAMs, and the chemokines, such as C-X-C motif chemokine 8 (CXCL8) and CXCL10, were upregulated after infection. However, the expression of chemokine receptor C-X-C chemokine receptor type 2 (CXCR2) is downregulated. Also, that the transcriptional levels of pro-apoptotic and anti-apoptotic factors changed after infection.

Conclusions

After ASFV-CN/GS/2018 infection, the expression of some antiviral and inflammatory factors in PAMs changed significantly. The ASFV infection may activates the RLR and TLR signaling pathways. In addition, ASFV infection is involved in regulating of chemokine expression in PAMs and host cell apoptosis.
A retrospective study on disease management in children and adolescents with phenylketonuria during the Covid-19 pandemic lockdown in Austria
Authors: Herle Marion , Brunner-Krainz Michaela , Karall Daniela , Goeschl Bernadette , Möslinger Dorothea , Zobel Joachim , Plecko Barbara , Scholl-Bürgi Sabine , Spenger Johannes , Wortmann Saskia B. , Huemer Martina
Published: August 2021

Background

In classical phenylketonuria (PKU) phenylalanine (Phe) accumulates due to functional impairment of the enzyme phenylalanine hydroxylase caused by pathogenic variants in the PAH gene. PKU treatment prevents severe cognitive impairment. Blood Phe concentration is the main biochemical monitoring parameter. Between appointments and venous blood sampling, Austrian PKU patients send dried blood spots (DBS) for Phe measurements to their centre. Coronavirus disease-19 (COVID-19), caused by the SARS CoV-2 virus, was classified as a pandemic by the World Health Organization in March 2020. In Austria, two nationwide lockdowns were installed during the first and second pandemic wave with variable regional and national restrictions in between. This retrospective questionnaire study compared the frequency of Phe measurements and Phe concentrations during lockdown with the respective period of the previous year in children and adolescents with PKU and explored potential influencing factors.

Results

77 patients (30 female, 47 male; mean age 12.4 [8–19] years in 2020) from five centres were included. The decline of venous samples taken on appointments in 2020 did not reach significance but the number of patients with none or only one DBS tripled from 4 (5.2%) in 2019 to 12 (15.6%) in 2020. Significantly more patients had a decline than a rise in the number of DBS sent in between 2019 and 2020 (p < 0.001; Chi2 = 14.79). Especially patients ≥ 16 years sent significantly less DBS in 2020 (T = 156, p = 0.02, r = 0.49). In patients who adhered to DBS measurements, Phe concentrations remained stable. Male or female sex and dietary only versus dietary plus sapropterin treatment did not influence frequency of measurements and median Phe.

Conclusion

During the COVID pandemic, the number of PKU patients who stopped sending DBS to their metabolic centre increased significantly, especially among those older than 16 years. Those who kept up sending DBS maintained stable Phe concentrations. Our follow-up system, which is based on DBS sent in by patients to trigger communication with the metabolic team served adherent patients well. It failed, however, to actively retrieve patients who stopped or reduced Phe measurements.
Continuous renal replacement therapy in COVID-19—associated AKI: adding heparin to citrate to extend filter life—a retrospective cohort study
Authors: Valle Eduardo de Oliveira , Cabrera Carla Paulina Sandoval , Albuquerque Claudia Coimbra César de , Silva Giovanio Vieira da , Oliveira Márcia Fernanda Arantes de , Sales Gabriel Teixeira Montezuma , Smolentzov Igor , Reichert Bernardo Vergara , Andrade Lucia , Seabra Victor Faria , Lins Paulo Ricardo Gessolo , Rodrigues Camila Eleuterio
Published: August 2021

Background

Coronavirus disease 2019 (COVID-19) may predispose patients to thrombotic events. The best anticoagulation strategy for continuous renal replacement therapy (CRRT) in such patients is still under debate. The purpose of this study was to evaluate the impact that different anticoagulation protocols have on filter clotting risk.

Methods

This was a retrospective observational study comparing two different anticoagulation strategies (citrate only and citrate plus intravenous infusion of unfractionated heparin) in patients with acute kidney injury (AKI), associated or not with COVID-19 (COV + AKI and COV − AKI, respectively), who were submitted to CRRT. Filter clotting risks were compared among groups.

Results

Between January 2019 and July 2020, 238 patients were evaluated: 188 in the COV + AKI group and 50 in the COV − AKI group. Filter clotting during the first filter use occurred in 111 patients (46.6%). Heparin use conferred protection against filter clotting (HR = 0.37, 95% CI 0.25–0.55), resulting in longer filter survival. Bleeding events and the need for blood transfusion were similar between the citrate only and citrate plus unfractionated heparin strategies. In-hospital mortality was higher among the COV + AKI patients than among the COV − AKI patients, although it was similar between the COV + AKI patients who received heparin and those who did not. Filter clotting was more common in patients with D-dimer levels above the median (5990 ng/ml). In the multivariate analysis, heparin was associated with a lower risk of filter clotting (HR = 0.28, 95% CI 0.18–0.43), whereas an elevated D-dimer level and high hemoglobin were found to be risk factors for circuit clotting. A diagnosis of COVID-19 was marginally associated with an increased risk of circuit clotting (HR = 2.15, 95% CI 0.99–4.68).

Conclusions

In COV + AKI patients, adding systemic heparin to standard regional citrate anticoagulation may prolong CRRT filter patency by reducing clotting risk with a low risk of complications.
X-CNV: genome-wide prediction of the pathogenicity of copy number variations
Authors: Zhang Li , Shi Jingru , Ouyang Jian , Zhang Riquan , Tao Yiran , Yuan Dongsheng , Lv Chengkai , Wang Ruiyuan , Ning Baitang , Roberts Ruth , Tong Weida , Liu Zhichao , Shi Tieliu
Published: August 2021

Background

Gene copy number variations (CNVs) contribute to genetic diversity and disease prevalence across populations. Substantial efforts have been made to decipher the relationship between CNVs and pathogenesis but with limited success.

Results

We have developed a novel computational framework X-CNV (www.unimd.org/XCNV), to predict the pathogenicity of CNVs by integrating more than 30 informative features such as allele frequency (AF), CNV length, CNV type, and some deleterious scores. Notably, over 14 million CNVs across various ethnic groups, covering nearly 93% of the human genome, were unified to calculate the AF. X-CNV, which yielded area under curve (AUC) values of 0.96 and 0.94 in training and validation sets, was demonstrated to outperform other available tools in terms of CNV pathogenicity prediction. A meta-voting prediction (MVP) score was developed to quantitively measure the pathogenic effect, which is based on the probabilistic value generated from the XGBoost algorithm. The proposed MVP score demonstrated a high discriminative power in determining pathogenetic CNVs for inherited traits/diseases in different ethnic groups.

Conclusions

The ability of the X-CNV framework to quantitatively prioritize functional, deleterious, and disease-causing CNV on a genome-wide basis outperformed current CNV-annotation tools and will have broad utility in population genetics, disease-association studies, and diagnostic screening.
A 192 bp ERV fragment insertion in the first intron of porcine TLR6 may act as an enhancer associated with the increased expressions of TLR6 and TLR1
Authors: Wang XiaoYan , Chen Zixuan , Murani Eduard , D’Alessandro Enrico , An Yalong , Chen Cai , Li Kui , Galeano Grazia , Wimmers Klaus , Song Chengyi
Published: August 2021

Background

Toll-like receptors (TLRs) play important roles in building innate immune and inducing adaptive immune responses. Associations of the TLR genes polymorphisms with disease susceptibility, which are the basis of molecular breeding for disease resistant animals, have been reported extensively. Retrotransposon insertion polymorphisms (RIPs), as a new type of molecular markers developed recently, have great potential in population genetics and quantitative trait locus mapping. In this study, bioinformatic prediction combined with PCR-based amplification was employed to screen for RIPs in porcine TLR genes. Their population distribution was examined, and for one RIP the impact on gene activity and phenotype was further evaluated.

Results

Five RIPs, located at the 3' flank of TLR3, 5' flank of TLR5, intron 1 of TLR6, intron 1 of TLR7, and 3' flank of TLR8 respectively, were identified. These RIPs were detected in different breeds with an uneven distribution among them. By using the dual luciferase activity assay a 192 bp endogenous retrovirus (ERV) in the intron 1 of TLR6 was shown to act as an enhancer increasing the activities of TLR6 putative promoter and two mini-promoters. Furthermore, real-time quantitative polymerase chain reaction (qPCR) analysis revealed significant association (p < 0.05) of the ERV insertion with increased mRNA expression of TLR6, the neighboring gene TLR1, and genes downstream in the TLR signaling pathway such as MyD88 (Myeloid differentiation factor 88), Rac1 (Rac family small GTPase 1), TIRAP (TIR domain containing adaptor protein), Tollip (Toll interacting protein) as well as the inflammatory factors IL6 (Interleukin 6), IL8 (Interleukin 8), and TNFα (Tumor necrosis factor alpha) in tissues of 30 day-old piglet. In addition, serum IL6 and TNFα concentrations were also significantly upregulated by the ERV insertion (p < 0.05).

Conclusions

A total of five RIPs were identified in five different TLR loci. The 192 bp ERV insertion in the first intron of TLR6 was associated with higher expression of TLR6, TLR1, and several genes downstream in the signaling cascade. Thus, the ERV insertion may act as an enhancer affecting regulation of the TLR signaling pathways, and can be potentially applied in breeding of disease resistant animals.
2-D DOA estimation method based on coprime array MIMO radar
Authors: Zhang Fei , Zhang Zijing , Jin Aisuo , Ji Chuantang , Wang Yi
Published: August 2021

Aiming at the problem that traditional direction of arrival (DOA) estimation methods cannot handle multiple sources with high accuracy while increasing the degrees of freedom (DOF), a new method for 2-D DOA estimation based on coprime array MIMO radar (SA-MIMO-CA) is proposed. First of all, in order to ensure the accuracy of multi-source estimation when the number of elements is finite, a new coprime array model based on MIMO (MIMO-CA) is proposed. This method is based on a new MIMO array-based co-prime array model (MIMO-CA), which improves the accuracy of multi-source estimation when the number of array elements is limited, and obtains a larger array aperture with a smaller number of array elements, and improves the estimation accuracy of 2-D DOA. Finally, the effectiveness and reliability of the proposed SM-MIMO-CA method in improving the DOF of array and DOA accuracy are verified by experiments.
Generalized modular fractal spaces and fixed point theorems
Authors: Alihajimohammad Alireza , Saadati Reza
Published: August 2021

In this article, we introduce a new concept of Hausdorff distance through generalized modular metric on nonempty compact subsets and study some topological properties of it. This concept with contraction theory and the iterated function system (IFS) helps us to define a generalized modular fractal space.
Effects of supplemental irrigation on yield, water use efficiency and nitrogen use efficiency of potato grown in mollic Andosols
Authors: Satognon Felix , Owido Seth F. O. , Lelei Joyce J.
Published: August 2021

Background

Low soil fertility and reduced seasonal rainfall contribute to low potato (Solanum tuberosum L.) yield in Kenya. Nitrogen (N) deficiency is the major problem facing by the smallholder farmers of Kenya due to lack of fallow. Hence an introduction of supplemental irrigation with an adequate application of this nutrient could increase potato yield. The objective of this study was to determine the effects of supplemental irrigation and N-fertilisation on potato tuber yield, water use efficiency (WUE) and nitrogen use efficiency (NUE). The experiment was conducted in Nakuru County, Kenya for two seasons. The experimental soils are classified as mollic Andosols. The treatments comprised two irrigation treatments of full supplemental irrigation (FI) and rainfed production (RF) and four N levels of four N levels of 0 (N0), 60 (N1), 90 (N2) and 130 kg N/ha (N3).

Results

The results showed that total tuber yield, marketable tuber yield and NUE were significantly (P < 0.001) affected by irrigation × N-fertilisation while WUE was only affected (P < 0.001) by N-fertilisation. The highest total tuber yield, 58.28 tonnes/hectare (t/ha), was recorded under FI combined with N3. Treatment FI significantly increased marketable tuber yield by approximately 125.58% in all N treatments compared to RF. The highest NUE of potato (236.44 kg/kg of N) was obtained under FI combined with N3 but not significantly different from the NUE of potato obtained under FI with N2. N-fertilisation N3 produced the highest WUE of 14.24 kg/m3. Significant correlation was obtained between tuber yield and number of tubers/plant (r = 0.75, P < 0.001), NUE (r = 0.95, P < 0.001) and WUE (r = 0.72, P < 0.001).

Conclusion

High potato yield and marketable tuber yield can be achieved in mollic Andosols when water deficits of the growing season are eliminated with supplemental irrigation and an application of 130 kg N/ha.
Application of the analytic hierarchy process in the selection of traditional food criteria in Vojvodina (Serbia)
Authors: Blešić Ivana , Petrović Marko D. , Gajić Tamara , Tretiakova Tatiana , Vujičić Miroslav , Syromiatnikova Julia
Published: August 2021

Vojvodina Province (Northern Serbia) represents a multicultural area inhabited by around thirty nations and national or ethnic groups with their authentic tradition and culture. The gastronomy of Vojvodina has been forming as a reflection of geographic characteristics—natural conditions and social events in this area. The life numerous nations share on this fertile soil of Vojvodina has initiated mutual impact of various customs, which contributed to the creation of a unique and specific Vojvodina cuisine. In this paper, mixed-method research approach was applied. The application of the analytic hierarchy process (AHP) method was preceded by a survey research on the sample of 289 guests in the restaurants on the territory of Vojvodina. The aim of the research was to define the key motives when choosing a traditional Vojvodina dish. In the second stage, AHP model was used for ranking factors significant for choosing traditional food by 29 experts in the field of hospitality and gastronomy. The result shows that Sensory appeal is the most important criterion for choosing traditional food in restaurants by the experts, followed by Health concern, and Familiarity.
Recurrent acute pancreatitis in a Wilson disease patient: an unusual association
Authors: Kumar Sanjay , Sundaram Sridhar , Darak Harish , Giri Suprabhat , Bhatia Shobna
Published: August 2021

Background

Wilson’s disease is a multisystem disorder with predominant clinical symptoms depending on the site of copper deposition in the body. Hepatic presentation is usually seen in the younger age group. And pancreatitis is rarely associated with Wilson’s disease. To the best of our knowledge, recurrent acute pancreatitis as a presenting manifestation in a WD patient has not been mentioned before in the literature.

Case presentation

We report a 17-year-old boy who presented with recurrent acute pancreatitis and subsequently developed deranged liver enzymes and ascites. Work up for the cause of recurrent acute pancreatitis was normal. Low ceruloplasmin (0.07 mg/dL), high 24-h urinary copper excretion (576 μg/day), and dry copper content in the liver (270 μg/g) clinched the diagnosis of Wilson’s disease. The patient was started on a low-copper diet and D-penicillamine therapy resulting in an improvement in symptoms and no further recurrence of pancreatitis.

Conclusion

The possibility of Wilson’s disease should be considered in young patients with recurrent acute pancreatitis, who have a protracted and obscure disease course.