bluuebunny/crossref_metadata_2025 huggingface dataset:
Strengthening the clinical laboratory workforce in Cambodia: a case study of a mixed-method in-service training program to improve laboratory quality management system oversight
Authors: Ong Siew Kim , Donovan Grant T. , Ndefru Nayah , Song Sophanna , Leang Chhayheng , Sek Sophat , Noble Michael , Perrone Lucy A.
Published: November 2020

Background

Laboratory diagnostic testing service delivery and compliance with international standards for laboratory quality are directly influenced by laboratory workforce competency. Many hospital laboratories in constrained resource settings such as Cambodia struggle to cope with the training needs of laboratory professionals in an environment of competing healthcare development priorities. Resource-limited countries need an adaptable and effective approach to provide laboratory professionals with job-specific quality oversight training to ensure the accuracy, timeliness, and reliability of diagnostic services.

Case presentation

Here, we describe the results of an in-service training and mentoring program conducted with the Cambodia Ministry of Health at 12 tertiary-level hospital laboratories to drive improvements in laboratory quality management systems toward ISO 15189 accreditation, which demonstrated significant progress between baseline and outcome audits in a concurrent study. This case study describes the program, and evaluates how the four primary activities, including actionable gap assessments and planning, centralized and in situ training curriculum, in-person mentoring, and remote tele-mentoring via video communication technologies, contributed towards quality improvement in the participating laboratories. We evaluated participant responses to Likert scale and free response questions from program and training evaluation surveys, and we used thematic analysis to develop a model of best practices within the program’s four primary activities to inform future training approaches. Of these activities, participants agreed most highly that in-person visits and planning based on gap assessments contributed to their learning and ability to improve laboratory operations. Tele-mentoring was rated lowest by participants, who were critical of excessive group dialogue and distraction during web-conferencing; however, feedback suggests both in-person and remote mentoring contribute to continuing education, accountability to action, and peer collaboration and problem solving to improve workforce efforts toward improved quality management systems.

Conclusions

We recommend here a package of in-service training activities for laboratory quality management system improvement initiatives in resource constrained settings that includes needs-based curricula and personalized action plans for participants; interactive and on-site training workshops; and in-person mentoring, complemented with well managed and regular tele-mentoring that focuses on knowledge retention, accountability to goals, and collaborative problem solving. Our model presents an adaptable approach to human resource development for quality improvement in medical laboratories.
Clathrin- and dynamin-dependent endocytosis limits canonical NF-κB signaling triggered by lymphotoxin β receptor
Authors: Maksymowicz Małgorzata , Miączyńska Marta , Banach-Orłowska Magdalena
Published: November 2020

Background

Lymphotoxin β receptor (LTβR) is a member of tumor necrosis factor receptor (TNFR) superfamily which regulates the immune response. At the cellular level, upon ligand binding, the receptor activates the pro-inflammatory NF-κB and AP-1 pathways. Yet, the intracellular distribution of LTβR, the routes of its endocytosis and their connection to the signaling activation are not characterized. Here, we investigated the contribution of LTβR internalization to its signaling potential.

Methods

Intracellular localization of LTβR in unstimulated and stimulated cells was analyzed by confocal microscopy. Endocytosis impairment was achieved through siRNA- or CRISPR/Cas9-mediated depletion, or chemical inhibition of proteins regulating endocytic routes. The activation of LTβR-induced signaling was examined. The levels of effector proteins of the canonical and non-canonical branches of the NF-κB pathway, and the phosphorylation of JNK, Akt, ERK1/2, STAT1 and STAT3 involved in diverse signaling cascades, were measured by Western blotting. A transcriptional response to LTβR stimulation was assessed by qRT-PCR analysis.

Results

We demonstrated that LTβR was predominantly present on endocytic vesicles and the Golgi apparatus. The ligand-bound pool of the receptor localized to endosomes and was trafficked towards lysosomes for degradation. Depletion of regulators of different endocytic routes (clathrin-mediated, dynamin-dependent or clathrin-independent) resulted in the impairment of LTβR internalization, indicating that this receptor uses multiple entry pathways. Cells deprived of clathrin and dynamins exhibited enhanced activation of canonical NF-κB signaling represented by increased degradation of IκBα inhibitor and elevated expression of LTβR target genes. We also demonstrated that clathrin and dynamin deficiency reduced to some extent LTβR-triggered activation of the non-canonical branch of the NF-κB pathway.

Conclusions

Our work shows that the impairment of clathrin- and dynamin-dependent internalization amplifies a cellular response to LTβR stimulation. We postulate that receptor internalization restricts responsiveness of the cell to subthreshold stimuli.

Graphical abstract
Proteomics identifies differences in fibrotic potential of extracellular vesicles from human tendon and muscle fibroblasts
Authors: Yeung Ching-Yan Chloé , Schoof Erwin M. , Tamáš Michal , Mackey Abigail L. , Kjaer Michael
Published: November 2020

Background

Fibroblasts are the powerhouses responsible for the production and assembly of extracellular matrix (ECM). Their activity needs to be tightly controlled especially within the musculoskeletal system, where changes to ECM composition affect force transmission and mechanical loading that are required for effective movement of the body. Extracellular vesicles (EVs) are a mode of cell-cell communication within and between tissues, which has been largely characterised in cancer. However, it is unclear what the role of healthy fibroblast-derived EVs is during tissue homeostasis.

Methods

Here, we performed proteomic analysis of small EVs derived from primary human muscle and tendon cells to identify the potential functions of healthy fibroblast-derived EVs.

Results

Mass spectrometry-based proteomics revealed comprehensive profiles for small EVs released from healthy human fibroblasts from different tissues. We found that fibroblast-derived EVs were more similar than EVs from differentiating myoblasts, but there were significant differences between tendon fibroblast and muscle fibroblast EVs. Small EVs from tendon fibroblasts contained higher levels of proteins that support ECM synthesis, including TGFβ1, and muscle fibroblast EVs contained proteins that support myofiber function and components of the skeletal muscle matrix.

Conclusions

Our data demonstrates a marked heterogeneity among healthy fibroblast-derived EVs, indicating shared tasks between EVs of skeletal muscle myoblasts and fibroblasts, whereas tendon fibroblast EVs could play a fibrotic role in human tendon tissue. These findings suggest an important role for EVs in tissue homeostasis of both tendon and skeletal muscle in humans.
Everything counts in sending the right message: science-based messaging implications from the 2020 WHO guidelines on physical activity and sedentary behaviour
Authors: Segar Michelle L. , Marques Marta M. , Palmeira Antonio L. , Okely Anthony D.
Published: November 2020

The World Health Organization (WHO) released the 2020 global guidelines on physical activity and sedentary behaviour. The new guidelines contain a significant change from the 2010 guidelines on physical activity for adults and older adults that has important implications for next-generation physical activity messaging: The removal of the need for aerobic activity to occur in bouts of at least 10 min duration. This change in the guidelines provides an opportunity to communicate in new ways that align with behavioural science, permitting physical activity communicators and promoters to better support people’s psychological needs, motivation, and ability to fit healthy levels of physical activity into their lives. The frames and messages we use to communicate about the guidelines matter because they influence whether activity is perceived as relevant, meaningful, and feasible – or not. When developing new physical activity communications there are some overarching principles, based on behavioural science, to keep in mind. Using established theory, this commentary aims to support the creation of more strategic frames and messages for increasing the value and integration of physical activity into daily living. Country-specific physical activity campaigns using these ideas will be discussed.
Glycemic variability: prognostic impact on acute ischemic stroke and the impact of corrective treatment for hyperglycemia. The GLIAS-III translational study
Authors: Fuentes Blanca , Pastor-Yborra Silvia , Gutiérrez-Zúñiga Raquel , González-Pérez de Villar Noemí , de Celis Elena , Rodríguez-Pardo Jorge , Gómez-de Frutos Mari Carmen , Laso-García Fernando , Gutiérrez-Fernández María , Ortega-Casarrubios MÁngeles , Soto Alfonso , López-Fernández María , Santamaría María , Díez-González Noemí , Freijo Mar M. , Zandio Beatriz , Delgado-Mederos Raquel , Calleja Ana , Portilla-Cuenca Juan Carlos , Lisbona Arturo , Otero-Ortega Laura , Díez-Tejedor Exuperio
Published: November 2020

Introduction

Glycemic variability (GV) represents the amplitude of oscillations in glucose levels over time and is associated with higher mortality in critically ill patients. Our aim is to evaluate the impact of GV on acute ischemic stroke (IS) outcomes in humans and explore the impact of two different insulin administration routes on GV in an animal model.

Methods

This translational study consists of two studies conducted in parallel: The first study is an observational, multicenter, prospective clinical study in which 340 patients with acute IS will be subcutaneously implanted a sensor to continuously monitor blood glucose levels for 96 h. The second study is a basic experimental study using an animal model (rats) with permanent occlusion of the middle cerebral artery and induced hyperglycemia (through an intraperitoneal injection of nicotinamide and streptozotocin). The animal study will include the following 6 groups (10 animals per group): sham; hyperglycemia without IS; IS without hyperglycemia; IS and hyperglycemia without treatment; IS and hyperglycemia and intravenous insulin; and IS and hyperglycemia and subcutaneous insulin. The endpoint for the first study is mortality at 3 months, while the endpoints for the animal model study are GV, functional recovery and biomarkers.

Discussion

The GLIAS-III study will be the first translational approach analyzing the prognostic influence of GV, evaluated by the use of subcutaneous glucose monitors, in acute stroke.

Trial registrationhttps://www.clinicaltrials.gov (NCT04001049)
Cost of goods sold analysis and recommendations to reduce costs of co-packaged mifepristone–misoprostol for medical abortion
Authors: Chinery Lester , Allaouidine Chadia , Tomazzini Alessandra , Larson Melanie , Gülmezoglu A. Metin
Published: November 2020

Objective

Understanding the price components of the mifepristone/misoprostol (combi-pack) for medical abortion to improve access is critical for identifying strategies to reduce product costs for quality-assured formulations and expanding its availability and use.

Methods

We constructed a cost of goods sold analysis using data collected from manufacturing companies in Bangladesh, China and India supported by publicly available information related to the product formulation, active pharmaceutical ingredients (API), manufacturing location, manufacturer profiles and other individual model components. Key model components were the active pharmaceutical ingredients (quality-assured or not), excipients, labour cost, operating cost and packaging.

Results

Combi-pack direct production cost ranges from US$1.08 for finished products which are not quality assured to US$3.05 for products containing quality assured active pharmaceutical ingredients, which means that with a 30% administrative fee applied to those prices, it could be made available between US$1.40 and US$3.97 depending on location, manufacturer’s profile, optimal market situation and the quality of the active pharmaceutical ingredients. The main model component impacting on the cost range is the purchase price of mifepristone active pharmaceutical ingredient and the current differential between quality-assured material supported by adequate documentation and API for which quality assurance cannot be demonstrated. Compared to India cost of goods sold is lower in Bangladesh primarily due to lower operating costs, including the cost of labour.

Conclusions

It is feasible to lower the cost of quality-assured combi-packs, through reducing mifepristone API cost and selection of the manufacturing location. However, manufacturers need to be incentivised to achieve WHO pre-qualification with a carefully built business case and require support in identifying and sourcing competitively priced material and manufacturing products to the necessary standard.
Evaluation of maize lodging resistance based on the critical wind speed of stalk breaking during the late growth stage
Authors: Xue Jun , Ming Bo , Xie Ruizhi , Wang Keru , Hou Peng , Li Shaokun
Published: November 2020

Background

The accurate evaluation of the stalk-lodging resistance during the late stage of maize growth can provide a basis for the selection of cultivars, the evaluation of cultivation techniques, and timely mechanical grain harvesting. In this study, the critical wind speed of stalk breaking, plant morphology, stalk mechanical strength, and lodging rate were investigated in 10 maize cultivars to identify the parameters evaluate lodging resistance during the later growth stage of maize. Clarify the relationship with the stalk mechanical strength, critical wind speed of stalk breaking, and natural lodging rate in the field.

Results

The results showed that, in the late growth stage, with increasing number of days after physiological maturity, (1) the stalk lodging rate gradually increased, (2) the stalk breaking force and rind penetration strength (RPS) of the third internode above the soil gradually decreased, and (3) the critical wind speed of stalk breaking increased first and then decreased, and was highest at about 16–24 days after physiological maturity. The position of stalk lodging mostly occurred between second and fifth internodes. The torque at the base of maize plant increased as wind speed increased, and the different of torque was excited among different maize cultivars under same wind speed. Furthermore, the stalk lodging rate was significantly negatively correlated with the critical wind speed of stalk breaking. Additionally, the critical wind speed of stalk breaking was significantly positively correlated with the stalk breaking force and the RPS.

Conclusion

This indicates that the critical wind speed of stalk breaking is a superior way to determine the stalk lodging resistance. These results suggest that, in the late growth stage, the decrease in the stalk mechanical strength is an important reason for the decrease in the critical wind speed of stalk breaking and the increase in the lodging rate.
Hypofractionated proton beam radiotherapy in patients with unresectable liver tumors: multi-institutional prospective results from the Proton Collaborative Group
Authors: Parzen Jacob S. , Hartsell William , Chang John , Apisarnthanarax Smith , Molitoris Jason , Durci Michael , Tsai Henry , Urbanic James , Ashman Jonathan , Vargas Carlos , Stevens Craig , Kabolizadeh Peyman
Published: November 2020

Background

Recent advances in radiotherapy techniques have allowed ablative doses to be safely delivered to inoperable liver tumors. In this setting, proton beam radiotherapy (PBT) provides the means to escalate radiation dose to the target volume while sparing the uninvolved liver. This study evaluated the safety and efficacy of hypofractionated PBT for liver tumors, predominantly hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC).

Methods

We evaluated the prospective registry of the Proton Collaborative Group for patients undergoing definitive PBT for liver tumors. Demographic, clinicopathologic, toxicity, and dosimetry information were compiled.

Results

To date, 63 patients have been treated at 9 institutions between 2013 and 2019. Thirty (48%) had HCC and 25 (40%) had ICC. The median dose and biological equivalent dose (BED) delivered was 58.05 GyE (range 32.5–75) and 80.5 GyE (range 53.6–100), respectively. The median mean liver BED was 13.9 GyE. Three (4.8%) patients experienced at least one grade ≥ 3 toxicity. With median follow-up of 5.1 months (range 0.1–40.8), the local control (LC) rate at 1 year was 91.2% for HCC and 90.9% for ICC. The 1-year LC was significantly higher (95.7%) for patients receiving BED greater than 75.2 GyE than for patients receiving BED of 75.2 GyE or lower (84.6%, p = 0.029). The overall survival rate at 1 year was 65.6% for HCC and 81.8% for ICC.

Conclusions

Hypofractionated PBT results in excellent LC, sparing of the uninvolved liver, and low toxicity, even in the setting of dose-escalation. Higher dose correlates with improved LC, highlighting the importance of PBT especially in patients with recurrent or bulky disease.
Conformation-selective tau monoclonal antibodies inhibit tau pathology in primary neurons and a mouse model of Alzheimer’s disease
Authors: Gibbons Garrett S. , Kim Soo-Jung , Wu Qihui , Riddle Dawn M. , Leight Susan N. , Changolkar Lakshmi , Xu Hong , Meymand Emily S. , O’Reilly Mia , Zhang Bin , Brunden Kurt R. , Trojanowski John Q. , Lee Virginia M. Y.
Published: November 2020

Background

The spread of tau pathology in Alzheimer’s disease (AD) is mediated by cell-to-cell transmission of pathological tau seeds released from neurons that, upon internalization by recipient neurons, template the misfolding of naïve cellular tau, thereby propagating fibrillization. We hypothesize that anti-tau monoclonal antibodies (mAbs) that selectively bind to pathological tau seeds will inhibit propagation of tau aggregates and reduce the spread of tau pathology in vivo.

Methods

We inoculated mice with human AD brain-derived extracts containing tau paired helical filaments (AD-tau) and identified two novel mAbs, DMR7 and SKT82, that selectively bind to a misfolded pathological conformation of tau relative to recombinant tau monomer. To evaluate the effects of these mAbs on the spread of pathological tau in vivo,5xFAD mice harboring significant brain Aβ plaque burden were unilaterally injected with AD-tau in the hippocampus, to initiate the formation of neuritic plaque (NP) tau pathology, and were treated weekly with intraperitoneal (i.p.) injections of DMR7, SKT82, or IgG isotype control mAbs.

Results

DMR7 and SKT82 bind epitopes comprised of the proline-rich domain and c-terminal region of tau and binding is reduced upon disruption of the pathological conformation of AD-tau by chemical and thermal denaturation. We found that both DMR7 and SKT82 immunoprecipitate pathological tau and significantly reduce the seeding of cellular tau aggregates induced by AD-tau in primary neurons by 60.5 + 13.8% and 82.2 + 8.3%, respectively, compared to IgG control. To investigate the mechanism of mAb inhibition, we generated pH-sensitive fluorophore-labeled recombinant tau fibrils seeded by AD-tau to track internalization of tau seeds and demonstrate that the conformation-selective tau mAbs inhibit the internalization of tau seeds. DMR7 and SKT82 treatment reduced hyperphosphorylated NP tau as measured with AT8 immunohistochemistry (IHC) staining, but did not achieve statistical significance in the contralateral cortex and SKT82 significantly reduced tau pathology in the ipsilateral hippocampus by 24.2%;p = 0.044.

Conclusions

These findings demonstrate that conformation-selective tau mAbs, DMR7 and SKT82, inhibit tau pathology in primary neurons by preventing the uptake of tau seeds and reduce tau pathology in vivo,providing potential novel therapeutic candidates for the treatment of AD.
Detection and prevalence of depression among adult type 2 diabetes mellitus patients attending non-communicable diseases clinics in Lilongwe, Malawi
Authors: Udedi Michael , Pence Brian W. , Stewart Robert C. , Muula Adamson S.
Published: November 2020

Background

Depression is associated with chronic physical illnesses and negatively affects health outcomes. However, it often goes undiagnosed and untreated. We investigated the prevalence of depression among adult type 2 diabetes mellitus (T2DM) patients attending non-communicable diseases (NCD) clinics in Lilongwe, Malawi, and estimated the level of routine detection by NCD clinicians. This study set out to determine the prevalence of major depression and its detection among adult type 2 diabetes mellitus (T2DM) patients attending NCD clinics in Lilongwe, Malawi.

Methods

In a cross-sectional study design, 323 T2DM patients aged ≥ 18 years were screened for depression with the Patient Health Questionnare-9 (PHQ-9) followed by diagnostic assessment with the Structured Clinical Interview for DSM-IV (SCID). We analysed the association between presence of major depression and sociodemographic factors using logistic regression.

Results

Three quarters of the participants (76%) were females. The participants’ ages ranged from 21–79 years. Of the 323 participants, 58 (18%) met criteria for DSM-IV major depression. None of the cases of major depression had been identified by the NCD clinicians. Major depression was found not to be significantly associated with any of the sociodemographic factors.

Conclusions

We found that depression is common among NCD clinic attendees with T2DM in Malawi, and poorly detected by NCD clinicians. Given the high prevalence and challenges in clinical identification, integration of depression screening with a standardized validated tool should be a high priority so as to link patients to appropriate services.
High-throughput screening reveals novel mutations in spinal muscular atrophy patients
Authors: Zhang Ruiping , Gu Chunyu , Pu Linjie , Meng Yingtao , Shu Jianbo , Cai Chunquan
Published: November 2020

Background

Spinal muscular atrophy (SMA) is an autosomal recessive hereditary disease associated with severe muscle atrophy and weakness in the limbs and trunk. The discovery of mutated genes is helpful in diagnosis and treatment for SMA.

Methods

Eighty-three whole blood samples were collected from 28 core families of clinically suspected SMA, and multiplex ligation probe amplification (MLPA) was performed. Afterwards, the complete gene sequence ofSMN1gene was detected. Furthermore, 20 SMA patients were selected from the 28 probands, and 5 non SMA children as controls. The Life Technologies SOLiD™ technology with mate-pair chemistry was utilized to conduct the whole exome high-throughput sequencing.

Results

Twenty-two probands were SMA patients, 3 probands carriers, and 3 probands normal individuals. Moreover, 2 parents from 2 SMA families were with 3SMN1exon7 copies. SixSMN1single nucleotide variants (SNVs) were identified in the 83 samples, and c.[84C > T], c.[271C > T], c.[−39A > G] and g.[70240639G > C] were novel. Compared with control group, 9102 mutation were selected out in SMA patients.SPTA1mutation c.[−41_-40insCTCT],FUT5SNV c.[1001A > G], andMCCC2SNV c.[−117A > G] were the 3 most frequent mutations in SMA group (95, 85 and 75%, respectively).

Conclusions

We identified some mutations in bothSMN1and other genes, and c.[271C > T], c.[−41_-40insCTCT], c.[1001A > G] and c.[−117A > G] might be associated with the onset of SMA.
Carriage of ESBL-producing Gram-negative bacteria by flies captured in a hospital and its suburban surroundings in Ethiopia
Authors: Tufa Tafese Beyene , Fuchs Andre , Wienemann Tobias , Eggers Yannik , Abdissa Sileshi , Schneider Marlen , Jensen Björn-Erik Ole , Bode Johannes G. , Pfeffer Klaus , Häussinger Dieter , Mackenzie Colin R. , Orth Hans Martin , Feldt Torsten
Published: November 2020

Background

Local data from the Asella Teaching and Referral Hospital in the town of Asella, Ethiopia reveal a high prevalence of extended-spectrum β-lactamase- (ESBL) producing Gram-negative bacteria (GNB) in clinical isolates. To investigate a possible route of transmission, we determined the proportions ESBL-producing GNB in isolates from flies caught in the hospital and in the town of Asella.

Methods

Flies were collected in August 2019 from the neonatal intensive care unit (NICU), the orthopedic ward, the hospital’s waste disposal area, and from a butchery situated 1.5 km from the hospital. After trapping, the flies were macerated and suspended in sterile normal saline. The suspensions were inoculated on MacConkey agar and incubated overnight. Species identification and antimicrobial susceptibility testing were performed using Vitek®-MS and VITEK® 2.

Results

In total, 103 bacterial isolates were obtained from 85 flies (NICU: 11 isolates from 20 flies, orthopedic ward: 10 isolates from 12 flies, waste disposal area: 37 isolates from 26 flies, butchery: 45 isolates from 27 flies). The proportions of ESBL-producing bacteria among isolates obtained from flies collected in the hospital compound were significantly higher (82%, 90%, and 57% in NICU, orthopedic ward and waste disposal area, respectively) compared to flies collected outside of the hospital compound (2% (@1/45) in the butchery) (p ≤ 0.001). The proportion of ESBL was 67% (6/9) among Raoultella spp. 67% (4/6) among Kluyvera spp., 56% (5/9) among Enterobacter spp., 50% (5/10) among E. coli, and 44% (8/18) among Klebsiella spp.. Of the 40 ESBL-genes detected, 85% were CTX-M-like, 83% TEM-like, 23% SHV-like, and 2% CTX-M-2-like. ESBL-producing bacteria showed higher rates of resistance against ciprofloxacin (66% vs. 5%), gentamicin (68% vs. 3%), piperacillin-tazobactam (78% vs. 5%), and trimethoprim-sulfamethoxazole (88% vs. 16%), compared to non-ESBL-producing bacteria.

Conclusion

A high proportion of ESBL was identified in isolates from flies caught in the hospital compound compared with isolates of flies collected at a distance of 1.5 km from the hospital. Flies can be potential vectors for transmission of multidrug-resistant (MDR) bacteria within hospitals. Further studies are needed to determine the source of MDR colonization in flies and possible impact of MDR for nosocomial infections.
Sorption and leaching characteristics of pesticides in volcanic ash soils of Jeju Island, Korea
Authors: Park Won-Pyo , Chang Kong-Man , Hyun Hae-Nam , Boo Kyung-Hwan , Koo Bon-Jun
Published: November 2020

It is important to evaluate leaching behavior in agricultural soils to prevent the pollution of groundwater by pesticides. We identified the distribution coefficients (Kd) of ten pesticides with different physicochemical properties and compared their leaching characteristics using wick lysimeters from three distinct soil types on Jeju Island. The Kdvalues varied by pesticide and soil, but were within the range of 1.2 to 4231 L kg−1. Based on the European standard (Kd < 10 L kg−1), six pesticides (alachlor, ethoprophos, carbofuran, napropamide, tebuconazole, and etridiazole) were mobile in at least one tested soil, and their soil organic carbon affinity was ≤ 5.811. This value differed greatly from the other pesticides (16.533 and higher). The solubility of the six mobile pesticides was ≥ 32 mg L−1, which substantially differed from the other pesticides (≤ 0.71 mg L−1). Thus, we conclude that our mobility assessment, which is based on Kdvalues, can be used to predict the leaching of pesticides in the volcanic ash soils of Jeju Island. The use of pesticides should be strictly controlled to reduce the possibility of groundwater contamination.
Particle size of ginseng (Panax ginseng Meyer) insoluble dietary fiber and its effect on physicochemical properties and antioxidant activities
Authors: Jiang Guihun , Wu Zhaogen , Ameer Kashif , Li Shanji , Ramachandraiah Karna
Published: November 2020

Dietary fibers (DFs) and associated phytochemicals in ginseng species are known to provide various functional and health benefits. The incorporation of ginseng insoluble dietary fiber (IDF) in food products often result in undesirable physicochemical properties. Thus, to overcome such demerits, micronization of IDF has been considered. This study investigated the effect of particle size on the physicochemical properties, antioxidant activities, structure and thermal analysis of ginseng IDF. Micronized IDF powder with median particle diameter of 15.83 μm was produced through fine grinding. Reduction of ginseng IDF resulted in increased brightness, water holding capacity and solubility. Decreasing particle sizes also lowered bulk, tapped density, Carr index and Hausner ratio. Reduction of particle size caused greater extractability of mineral and phenolic content and thereby increasing the DPPH radical scavenging activity and ferric reducing antioxidant power. Increased polyphenol extraction with smaller particle size also lowered the mice erythrocytes hemolysis percentage while the hemolysis inhibition rate was increased. Particle size also influenced the thermal stability of ginseng IDF powders. FTIR spectra revealed lack of impact on the major phenolic structures due to superfine grinding. Hence,micronized ginseng IDF powders with improved physicochemical properties and antioxidant activities possess the potential to be used in food and pharmaceutical industries.
The epidemiology, molecular pathogenesis, diagnosis, and treatment of maturity-onset diabetes of the young (MODY)
Authors: Nkonge Ken Munene , Nkonge Dennis Karani , Nkonge Teresa Njeri
Published: November 2020

Background

The most common type of monogenic diabetes is maturity-onset diabetes of the young (MODY), a clinically and genetically heterogeneous group of endocrine disorders that affect 1–5% of all patients with diabetes mellitus. MODY is characterized by autosomal dominant inheritance but de novo mutations have been reported. Clinical features of MODY include young-onset hyperglycemia, evidence of residual pancreatic function, and lack of beta cell autoimmunity or insulin resistance. Glucose-lowering medications are the main treatment options for MODY. The growing recognition of the clinical and public health significance of MODY by clinicians, researchers, and governments may lead to improved screening and diagnostic practices. Consequently, this review article aims to discuss the epidemiology, pathogenesis, diagnosis, and treatment of MODY based on relevant literature published from 1975 to 2020.

Main body

The estimated prevalence of MODY from European cohorts is 1 per 10,000 in adults and 1 per 23,000 in children. Since little is known about the prevalence of MODY in African, Asian, South American, and Middle Eastern populations, further research in non-European cohorts is needed to help elucidate MODY’s exact prevalence. Currently, 14 distinct subtypes of MODY can be diagnosed through clinical assessment and genetic analysis. Various genetic mutations and disease mechanisms contribute to the pathogenesis of MODY. Management of MODY is subtype-specific and includes diet, oral antidiabetic drugs, or insulin.

Conclusions

Incidence and prevalence estimates for MODY are derived from epidemiologic studies of young people with diabetes who live in Europe, Australia, and North America. Mechanisms involved in the pathogenesis of MODY include defective transcriptional regulation, abnormal metabolic enzymes, protein misfolding, dysfunctional ion channels, or impaired signal transduction. Clinicians should understand the epidemiology and pathogenesis of MODY because such knowledge is crucial for accurate diagnosis, individualized patient management, and screening of family members.
Optical coherence tomography angiography measured area of retinal neovascularization is predictive of treatment response and progression of disease in patients with proliferative diabetic retinopathy
Authors: Vergmann Anna Stage , Sørensen Kristian Tølbøl , Torp Thomas Lee , Kawasaki Ryo , Wong Tien , Peto Tunde , Grauslund Jakob
Published: November 2020

Background

The purpose of this study was to evaluate the area of retinal neovascularization in patients with treatment-naïve proliferative diabetic retinopathy (PDR) as measured by optical coherence tomography angiography (OCT-A) as a marker of subsequent treatment response after panretinal photocoagulation (PRP), and to examine if this area correlated with area of retinal neovascularization as measured by fluorescein angiography (FA).

Methods

En face OCT-A scans (4.5 × 4.5 mm) of neovascularizations were obtained at baseline (BL) before PRP and at month (M) 3 and M6 after treatment. Progression of PDR were defined as lesion growth (assessed by ophthalmoscopy and wide-field fundus photo) or increasing leakage by Optos ultra-widefield FA, and patients were divided into two groups; progression or non-progression. Mann–Whitney U test and Wilcoxon signed-rank test were used to analyse differences between groups and between time points. Areas of retinal neovascularizations (OCT-A and FA) were calculated by algorithms developed in Python (version 3.6.8, The Python Software Foundation, USA).

Results

Of 21 eyes included, 14 had progression of disease. Median OCT-A area did not differ between the two groups (progression vs. non-progression) at BL (76.40 ± 162.03 vs. 72.62 ± 94.15, p = 0.43) but were statistically significantly larger in the progression group at M6 (276.69 ± 168.78 vs. 61.30 ± 70.90, p = 0.025). Median FA area did not differ in the progression vs. the non-progression group at BL (111.42 ± 143.08 vs. 60.80 ± 54.83, p = 0.05) or at M6 (200.12 ± 91.81 vs. 123.86 ± 162.16, p = 0.62). Intraclass correlation between area by OCT-A and FA was −5.99 (95% CI: −35.28–0.993), p = 0.71.

Conclusions

In this study of patients with treatment-naïve PDR, we showed that increasing area of retinal neovascularizations measured by OCT-A at M6 indicated progression of disease after PRP treatment. Our results suggest that area by OCT-A reflects disease activity and that it can be used as an indicator to monitor the progression of PDR over time, and to evaluate treatment response six months after PRP.

Trial registrationhttps://clinicaltrials.gov (identifier: NCT03113006). Registered April 13, 2017.
Combined effects of MSU crystals injection and high fat-diet feeding on the establishment of a gout model in C57BL/6 mice
Authors: Lin Xiaoying , Shao Tiejuan , Wen Xianghui , Wang Mingzhu , Wen Chengping , He Zhixing
Published: November 2020

Objective

Gout is characterized by inflammatory arthritis with hyperuricaemia and deposition of monosodium urate (MSU) crystals in the joints. Several animal models have been proposed based on MSU crystals injection or high-fat diet feeding; however, neither hyperuricaemia model nor acute gout model can effectively reflect clinical features of gout. This study aimed to assess the effectiveness of a compound gout model induced by the combination of MSU crystals injection and high-fat diet feeding.

Methods

The compound gout model was induced by high-fat diet feeding per day and the intraplantar injection of MSU crystals (1 mg) into the footpad of each mouse every 10 days. Serum uric acid, foot swelling and pain analyses were performed at days 22, 32 and 42. Gout inflammation, serum proinflammatory cytokines and gut microbiota analyses were performed only at day 42.

Results

Compared to hyperuricaemia model or acute gout model, the compound gout model showed little advantages of elevating serum uric acid, causing foot swelling and gout inflammation, while it caused more severe serum inflammation and gut microbiota dysbiosis. Severe serum inflammation in the compound gout model could be reflected by the increased levels of IL-1α, IL-4, IL-6, IL-10, IL-12p40, IL-12p70, IFN-γ, KC, MCP-1 and MIP-1β. In addition, the compound gout model induced more alterations in the gut microbiota, including increasing levels of Desulfovibrio and Parasutterella.

Conclusion

The injection of MSU and feed of high-fat diet have a combined effect on elevating serum inflammation and causing gut microbiota disorders in the process of establishing a gout model.
An asymptotic model for solving mixed integral equation in some domains
Authors: Abdou Mohamed Abdella , Awad Hamed Kamal
Published: November 2020

In this paper, we discuss the solution of mixed integral equation with generalized potential function in position and the kernel of Volterra integral term in time. The solution will be discussed in the space$$L_{2} (\Omega ) \times C[0,T],$$L2(Ω)×C[0,T],$$0 \le t \le T < 1$$0≤t≤T<1, where$$\Omega$$Ωis the domain of position and$$t$$tis the time. The mixed integral equation is established from the axisymmetric problems in the theory of elasticity. Many special cases when kernel takes the potential function, Carleman function, the elliptic function and logarithmic function will be established.
Incidentally recognized COVID-19 pneumonia in routine oncologic 18F-FDG PET/CT examinations: a local experience during pandemic era
Authors: Ali Susan Adil , Abdelkawi Moustafa Mahmoud
Published: November 2020

Background

CT chest findings of COVID-19 pneumonia can be detected before the clinical symptoms become evident in many cases. In this work, we presented our experience in incidental detection of COVID-19-associated pneumonia in asymptomatic patients coming for routine oncologic 18F-FDG PET/CT examinations during the COVID-19 pandemic, which contribute in the detection of the affected patients early to be isolated and properly managed. We reported the cases with incidental finding of COVID-19 pneumonia among 764 asymptomatic patients who were referred for whole-body 18F-FDG PET/CT examinations for routine oncologic indications in the period between 15 March and 15 June 2020, and RT-PCR testing for them was requested for confirmation.

Results

Among the 764 scanned patients, we had recognized 87 patients (11.3%) having features of COVID-19 pneumonia. RT-PCR testing of them confirmed COVID-19 infection in 78 cases, yet 3 were negative and no RT-PCR testing was performed in 6 cases (only isolated and carefully monitored).

Conclusion

18F-FDG PET/CT is sensitive for early COVID-19 detection, even in asymptomatic patients that guide proper management and also highlight the key role of a radiologist and the importance of applying safety measures in clinical services during the pandemic to minimize the spread of infection.
Ultrasonography diagnostic validity in structural and functional laryngeal disorders
Authors: Nasser Haytham Mohamed , Askoura Anas , Hussein Ahmed
Published: November 2020

Background

The diagnostic approach for patients with laryngeal lesions differs among otolaryngologists. Indirect laryngoscopy, flexible fibrooptic laryngoscopy, CT, and MRI are all modalities used for diagnosis. Ultrasonography is noninvasive, non-irradiating, and safe. The availability, affordability, and usability of portable ultrasound units have undergone dramatic improvements. It is well tolerated by patients, dynamic technique that can be performed easily in phonation, quickly performed, and allows for photo-documentation. Our objective is to evaluate the laryngeal ultrasound as a diagnostic tool to evaluate different laryngeal structure as regard laryngeal dynamics (range and abnormality), and anatomic structures. This prospective study was carried out on individuals in “blinded for peer review” hospitals. They were divided into group I (healthy volunteers), group II (unilateral vocal fold paralysis), and group III (patients underwent vertical hemilaryngectomies). All patients were subjected to full history taking, detailed head and neck examination, and fibrooptic nasopharyngolaryngoscopy then all patients underwent laryngeal sonographic examination. The photos were analyzed to identify various laryngeal structures and to measure glottic areas and inter-arytenoid distances.

Results

After recognition of laryngeal anatomic details and different measurements, we found that the percent of change in length and area were much less in group III than group I or II. Another important finding is that glottic area during respiration is related significantly to interarytenoid length during respiration with a statistically significant regression coefficient.

Conclusion

Laryngeal ultrasound is a valid diagnostic tool for imaging laryngeal structures and measuring various distances and areas inside the larynx. It is recommended to consider ultrasonography as a reliable imaging modality, and at least a useful adjunct to endoscopy when identification of airway patency, vocal fold mobility, or structural alterations is suspected. To our best knowledge, this study may contain a hitherto undescribed correlation between inter-arytenoid length and glottic area.
Unintended consequences: a qualitative study exploring the impact of collecting implementation process data with phone interviews on implementation activities
Authors: Gruß Inga , Bunce Arwen , Davis James , Gold Rachel
Published: November 2020

Background

Qualitative data are crucial for capturing implementation processes, and thus necessary for understanding implementation trial outcomes. Typical methods for capturing such data include observations, focus groups, and interviews. Yet little consideration has been given to how such methods create interactions between researchers and study participants, which may affect participants’ engagement, and thus implementation activities and study outcomes. In the context of a clinical trial, we assessed whether and how ongoing telephone check-ins to collect data about implementation activities impacted the quality of collected data, and participants’ engagement in study activities.

Methods

Researchers conducted regular phone check-ins with clinic staff serving as implementers in an implementation study. Approximately 1 year into this trial, 19 of these study implementers were queried about the impact of these calls on study engagement and implementation activities. The two researchers who collected implementation process data through phone check-ins with the study implementers were also interviewed about their perceptions of the impact of the check-ins.

Results

Study implementers’ assessment of the check-ins’ impact fell into three categories: (1) the check-ins had no effect on implementation activities, (2) the check-ins served as a reminder about study participation (without relating a clear impact on implementation activities), and (3) the check-ins caused changes in implementation activities. The researchers similarly perceived that the phone check-ins served as reminders and encouraged some implementers’ engagement in implementation activities; their ongoing nature also created personal connections with study implementers that may have impacted implementation activities. Among some study implementers, anticipation of the check-in calls also improved their ability to recount implementation activities and positively affected quality of the data collected.

Conclusion

These results illustrate the potential impact of qualitative data collection on implementation activities during implementation science trials. Mitigating such effects may prove challenging, but acknowledging these consequences—or even embracing them, perhaps by designing data collection methods as implementation strategies—could enhance scientific rigor. This work is presented to stimulate debate about the complexities involved in capturing data on implementation processes using common qualitative data collection methods.

Trial registration

ClinicalTrials.gov,NCT02325531. Registered 15 December 2014.
The role of serum bile acid profile in differentiation between nonalcoholic fatty liver disease and chronic viral hepatitis
Authors: Elsheashaey Azza , Obada Manar , Abdelsameea Eman , Bayomy Mohamed F. F. , El-Said Hala
Published: November 2020

Background

Bile acids are essential organic molecules synthesized from cholesterol in the liver. They have been utilized as indicators of hepatobiliary impairment because synthesis of BAs and their metabolism are influenced by liver diseases. We aimed to investigate the role of serum bile acid level and composition in differentiation between nonalcoholic fatty liver disease (NAFLD) and chronic viral hepatitis. An ultra-performance liquid chromatography coupled with mass spectrometry assay was used to measure the serum level of 14 bile acids in chronic viral hepatitis and NAFLD patients beside normal healthy control subjects.

Results

The mean serum levels of 11 out of the 14 bile acids (two primary, six conjugated, and three secondary) were significantly higher in viral hepatitis compared to control. Only 4 bile acids [2 primary, one glycine conjugated (GCDCA), and one secondary (LCA)] had statistically significant increase in their mean serum bile acid level in NAFLD compared to control. Comparing viral hepatitis group against NAFLD group revealed that the mean serum levels of five conjugated and one secondary bile acid (DCA) were significantly higher in viral hepatitis group. Receiver operating characteristic (ROC) curve analysis revealed that LCA had the best diagnostic performance for viral hepatitis followed by TCA and GCDCA. ROC curve for the combined three parameters had better sensitivity and specificity (70.55% and 94.87% respectively).

Conclusion

BA compositions including primary, secondary, and conjugated ones could differentiate between chronic viral hepatitis and NAFLD patients, and they might be potential distinguishing biomarkers for this purpose.
Effect of ice massage with integrated neuromuscular inhibition technique on pain and function in subjects with mechanical neck pain: randomized controlled trial
Authors: Al-Najjar Heba Mohammed Moselhy , Mohammed Amal Hassan , Mosaad Dalia Mohammed
Published: November 2020

Background

Myofascial trigger point (MTrP) plays a major role in the genesis of mechanical neck pain, which may lead to chronic disorders. The purpose of the study is to investigate and compare the effect of ice massage plus integrated neuromuscular inhibition technique (INIT) versus INIT alone on active trigger points in the upper trapezius of persons having mechanical neck pain. Forty participants diagnosed as mechanical neck pain with upper trapezius active myofascial trigger points. They were randomized into two equal groups. Group A (experimental) received ice massage for 10 min plus INIT, while group B (control) received INIT alone. The treatment program continued for 2 weeks (3 sessions/week). The outcome measures are the pain intensity, pain pressure threshold, cervical lateral side bending and neck daily functions.

Results

The results showed that there were significant improvements in VAS at p = .899 and F = .78, PPT at p = .288 and F = .553, cervical side bending at p = .094 and F < 0.00001, and NDI at p = .164 and F = 0.00001 in both groups, while there were no statistically significant differences between both groups as p > 0.05.

Conclusion

Ice massage and INIT are effective methods in managing active trigger points in the upper trapezius of persons having mechanical neck pain without statistically significant difference.