bluuebunny/crossref_metadata_2025 huggingface dataset:
Unpacking the dynamics of double stigma: how the HIV-TB co-epidemic alters TB stigma and its management among healthcare workers
Authors: Wouters Edwin , Sommerland Nina , Masquillier Caroline , Rau Asta , Engelbrecht Michelle , Van Rensburg André Janse , Kigozi Gladys , Ponnet Koen , Van Damme Wim
Published: February 2020

Background

HIV and tuberculosis (TB) are intricably interlinked in South Africa. The social aspects of this co-epidemic remain relatively unexplored. More specifically, no research has quantitatively explored the double stigma associated with HIV and TB in this context, and more specifically the impact of the co-epidemic on [1] the stigmatisation of TB and [2] the TB stigma mangement strategy of covering (i.e. the use of TB as a cover for having HIV). The current study aims to address this research gap by disentangling the complex mechanisms related to HIV-TB stigma.

Methods

Using Structural Equation Modelling (SEM), data of 882 health care workers (HCWs) in the Free State province, South Africa, are analysed to investigate the link between the stigmatization of HIV and TB and the stigma management by those affected. The current study focuses on health care workers (HCWs), as both TB and HIV have a severe impact on this professional group.

Results

The results demonstrate that the perceived link between the epidemics is significantly associated with double HIV-TB stigmatization. Furthermore, the link between the illnesses and the double stigma are driving the stigmatization of TB. Finally, the link between HIV and TB as well as the stigmatization of both diseases by colleagues are associated with an increased use of covering as a stigma management strategy.

Conclusions

This is the first quantitative study disentagling the mediating role of double stigma in the context of the co-epidemic as well as the impact of the co-epidemic on the social connotations of TB. The results stress the need for an integrated approach in the fight against HIV and TB recognizing the intertwined nature of the co-epidemic, not only in medical-clinical terms, but also in its social consequences.

Trial registration

South African National Clinical Trials Register, registration ID: DOH-27-1115-5204. Prospectively registered on 26 August 2015.
Tumour content ratio matters for detecting epidermal growth factor receptor mutation by cobas test in small biopsies; a retrospective study
Authors: Kogo Mariko , Fujimoto Daichi , Hosoya Kazutaka , Nagata Kazuma , Nakagawa Atsushi , Tachikawa Ryo , Yamashita Daisuke , Kitamura Yuka , Imai Yukihiro , Tomii Keisuke
Published: February 2020

Background

Recent studies indicate the benefit of treatment with osimertinib over that with conventional epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) for untreated EGFR-mutated non-small cell lung cancer (NSCLC). Cobas ver2 is the only companion diagnostic method for detecting EGFR mutations with osimertinib treatment. We clinically experience false negative cases with this test, but its actual sensitivity is unknown. Moreover, no study has suggested the importance of tumour dissection, and most facilities do not routinely perform them on small biopsies. The purpose of this study was to evaluate the sensitivity of cobas in clinical practice and clarify the role of dissection as a component of the cobas testing.

Methods

We examined 132 patients with EGFR-mutated NSCLC diagnosed by bronchoscopy and confirmed with PCR clamp. Patients were tested with cobas and the EGFR-positive rate was calculated. Samples with undetected EGFR mutations were retested after tumour dissection and the rate of samples whose EGFR mutation was corrected to positive was assessed. To evaluate tumour cellularity, the tumour content ratio was assessed by calculating tumour cell count over the total cell count on the slide.

Results

The positive rate of EGFR mutation identification was 76% with cobas, although EGFR mutation-negative patients retained responses to TKI therapy equivalent to positive patients did; however, the tumour content ratio of negative samples was significantly lower than that of positive samples. Twenty-nine negative samples underwent dissection and 24% were corrected to positive. Moreover, 53% of the samples with a tumour content ratio below 10% was negative for cobas, but 33% of these turned positive after dissection.

Conclusions

Cobas had a high false negative rate in clinical practice, and tumour content ratio might be associated with this rate. Dissection could improve the sensitivity of cobas, especially in samples with low tumour cellularity.
Rural-urban differences in the association between individual, facility, and clinical characteristics and travel time for cancer treatment
Authors: Segel Joel E. , Lengerich Eugene J.
Published: February 2020

Background

Greater travel time to cancer care has been identified as a potential barrier to care as well as associated with worse health outcomes. While rural cancer patients have been shown to travel farther for care, it is not known what patient, facility, and clinical characteristics may differentially be associated with greater roundtrip travel times for cancer patients by rurality of residence. Identifying these factors will help providers understand which patients may be most in need of resources to assist with travel.

Methods

Using 2010–2014 Pennsylvania Cancer Registry data, we examined the association between patient, facility, and clinical characteristics with roundtrip patient travel time using multivariate linear regression models. We then estimated separate models by rural residence based on the Rural-Urban Continuum Code (RUCC) of a patient’s county of residence at diagnosis to understand how the association of each factor with travel time may vary for patients separated into metro residents (RUCC 1–3); and two categories of non-metro residents (RUCC 4–6) and (RUCC 7–9).

Results

In our sample (n = 197,498), we document large differences in mean roundtrip travel time—mean 41.5 min for RUCC 1–3 patients vs. 128.9 min for RUCC 7–9 patients. We show cervical/uterine and ovarian cancer patients travel significantly farther; as do patients traveling to higher volume and higher-ranked hospitals.

Conclusions

To better understand patient travel burden, providers need to understand that factors predicting longer travel time may vary by rurality of patient residence and cancer type.
Root dentine thickness of danger zone in mesial roots of mandibular first molars
Authors: Zhou Guangchao , Leng Diya , Li Mingming , Zhou Yang , Zhang Cuifeng , Sun Chao , Wu Daming
Published: February 2020

Background

Better understanding of the danger zone anatomy in mesial roots (MRs) of mandibular first molars (MFMs) may serve to decrease the risk of mishaps. This study aimed to measure the minimal distal dentine thicknesses of danger zone in MRs of MFMs in a native Chinese population using cone-beam computed tomography (CBCT).

Methods

CBCT images of 1792 MFMs from 898 Chinese patients were analyzed. The minimal distal dentine thicknesses of the mesiobuccal (MB) and mesiolingual (ML) canals below the furcation 1, 2, 3, 4, 5 mm were measured. The association between the minimal distal dentine thicknesses and the root lengths, patient’s age and gender, side were assessed.

Results

The minimal distal dentine thicknesses of MB and ML canals are located 3 ∼ 4 mm below the furcation for both men and women. There are no differences between MB and ML canals, while the minimal distal dentine thicknesses of MB and ML canals were higher in men than women (P < 0.05), except at 1 and 3 mm of ML canals (P > 0.05). The minimal distal dentine thicknesses of MB and ML canals increased with age in both men and women at each location (P < 0.05). The minimum distal dentine thickness at every location were significantly different between long teeth and short teeth both in men and women (P < 0.05), with short teeth having the smallest mean values. There are no significant differences between two sides (P > 0.05).

Conclusions

The minimal distal dentine thicknesses of MRs in MSMs have close correlation with root length, patient’s age and gender.
Evaluation of the maxillary midline, curve of the upper lip, smile line and tooth shape: a prospective study of 140 Caucasian patients
Authors: Melo María , Ata-Ali Javier , Ata-Ali Fadi , Bulsei Marco , Grella Perluigi , Cobo Teresa , Martínez-González José María
Published: February 2020

Background

A number of reference patterns such as the interincisal line, curve of the upper lip, width of the smile or shape of the teeth have been studied in different populations. Determining the frequency of different smile aesthetic parameters in a European Caucasian population and exploring possible gender differences is important in order to obtain predictable treatment outcomes.

Methods

Photographs were obtained under resting and forced smiling conditions in 140 individuals (70 males and 70 females) with a mean age of 20.1 ± 4.3 years. Different variables were recorded, including the position of the maxillary interincisal midline in relation to the facial midline, the arc and width of the smile, and the shape of the teeth. The data were processed using the SPSS version 15.0 statistical package, with application of the chi-squared test and a confidence level of 95%. The statistical power was 80%, and the level of significance 5% (α = 0.05).

Results

A total of 94.3% of the sample presented a maxillary interincisal midline coinciding with the facial midline, and 80% had a consonant smile line. The curve of the upper lip was upwards in 47.1% of the cases, followed by a straight curve in 41.4%. Most of the subjects (84.3%) presented a medium smile line with tooth exposure to the second premolar (61.4%). There were no significant differences between males and females.

Conclusions

The integration of aesthetic criteria is needed in order to guarantee satisfactory and predictable dental treatment outcomes. There were no statistically significant differences between males and females. The maxillary interincisal midline coincided with the facial midline, with a consonant smile arc and a medium smile line, upward lip curve and oval tooth shape.
The tensions between micro-, meso- and macro-levels: physiotherapists’ views of their role towards fall prevention in the community – a qualitative study
Authors: Cerderbom Sara , Bjerk Maria , Bergland Astrid
Published: February 2020

Background

Falls are a global public health concern. Physiotherapists are a key resource in this context, but there is sparse knowledge about how they perceive their role in the primary care setting. Therefore, the purpose of the present study is to explore physical therapists’ (PTs) view of how they experience and perceive their role working with fall prevention in a community care setting.

Methods

Semi-structured interviews were conducted with 17 physiotherapists. Data were analysed using a qualitative thematic analysis.

Results

The analysis resulted in a core theme and three subthemes. The core theme was ‘capability to cope with the tensions between the micro-, meso- and macro-levels in fall, prevention’, which indicated the importance of an evolving multifaceted, evidence based and innovative physiotherapy role. A key factor for this role is to take an integrative biopsychosocial approach based on how biological and psychosocial factors are uniquely related in fall prevention. The three themes were as follows: 1) always moving and changing: the competent explorative knowledge-hungry clinician’s multifaceted role; 2) multiprofessional – but in the end alone; 3) reaching out–from the bottom to the top. Success in the role of physiotherapists in fall prevention depends on the empowering leadership and working culture, as well as on the time and multifaceted professional competence of the clinicians.

Conclusion

Our findings indicate that the PTs’ role reflects their abilities to change and improve their professional work in accordance with evidence based knowledge. To ensure good quality the PTs focused on the special needs of the patients, evidence-based fall prevention, interdisciplinary team work, good clinical competences, good skills in communication, and interpersonal relations. Attention should be placed on the importance of biopsychosocial perspective framing in the actual clinical and political context. The PTs saw the need for working at the micro-, meso- and macro-levels to succeed in the work of fall prevention.
Gender differences in pulmonary arterial hypertension patients with BMPR2 mutation: a meta-analysis
Authors: Ge Xiaoyue , Zhu Tiantian , Zhang Xinyi , Liu Ye , Wang Yonglong , Zhang Weifang
Published: February 2020

Objective

To investigate the differences in the proportions of BMPR2 mutations in familial hereditary pulmonary arterial hypertension (HPAH) and idiopathic pulmonary arterial hypertension (IPAH) between males and females and the relationship between BMPR2 mutation and PAH severity.

Methods

A computer was used to search the electronic Cochrane Library, PubMed/MEDLINE, and EMBASE databases for clinical trials containing information on the relationship between PAH prognosis and BMPR2 mutations through March 2019. After obtaining the data, a meta-analysis was performed using Review Manager Version 5.3 and Stata.

Results

A meta-analysis was performed on 17 clinical trials (2198 total patients: 644 male, 1554 female). The results showed that among patients with HPAH and IPAH, the BMPR2 mutation rate is higher in male than in female patients [male group (224/644, 34.78%), female group (457/1554, 29.41%), OR = 1.30, 95% CI: 1.06~1.60,P = 0.01, I2 = 10%]. Furthermore, haemodynamic and functional parameters were more severe in IPAH and HPAH patients with BMPR2 mutations than in those without, and those with BMPR2 mutation were diagnosed at a younger age. The risk of death or transplantation was higher in PAH patients with BMPR2 mutations than in those without (OR = 2.51, 95% CI: 1.29~3.57,P = 0.003, I2 = 24%). Furthermore, the difference was significant only in male patients (OR = 5.58, 95% CI: 2.16~14.39,P = 0.0004, I2 = 0%) and not in female patients (OR = 1.41, 95% CI: 0.75~2.67,P = 0.29, I2 = 0%).

Conclusion

Among patients with HPAH and IPAH, men are more likely to have BMPR2 mutations, which may predict more severe PAH indications and prognosis.
Crosstalk between autophagy and metabolic regulation of cancer stem cells
Authors: El Hout Mouradi , Cosialls Emma , Mehrpour Maryam , Hamaï Ahmed
Published: February 2020

Cancer is now considered as a heterogeneous ecosystem in which tumor cells collaborate with each other and with host cells in their microenvironment. As circumstances change, the ecosystem evolves to ensure the survival and growth of the cancer cells. In this ecosystem, metabolism is not only a key player but also drives stemness. In this review, we first summarize our current understanding of how autophagy influences cancer stem cell phenotype. We emphasize metabolic pathways in cancer stem cells and discuss how autophagy-mediated regulation metabolism is involved in their maintenance and proliferation. We then provide an update on the role of metabolic reprogramming and plasticity in cancer stem cells. Finally, we discuss how metabolic pathways in cancer stem cells could be therapeutically targeted.
Correction to: Review of traditional uses, botany, chemistry, pharmacology, pharmacokinetics, and toxicology of Radix Cyathulae
Authors: Huang Yongliang , Wang Shanshan , Liu Li , Peng Wei , Wang Jiaolong , Song Ying , Yuan Qianghua , Yuan Xing , Wu Chunjie
Published: February 2020

In the original publication of this article [1], the English official name of the affiliation 1 has been changed to “Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, China”.
Correction to: Predicting the clinical trajectory in critically ill patients with sepsis: a cohort study
Authors:   on behalf of the MARS consortium, Klein Klouwenberg Peter M. C. , Spitoni Cristian , van der Poll Tom , Bonten Marc J. , Cremer Olaf L.
Published: February 2020

In the publication of this article [1], there are 4 collaborating authors missing from the ‘MARS consortium’. This has now been included in this correction article.
Thunder-fire moxibustion for cervical spondylotic radiculopathy: Study protocol for a randomized controlled trial
Authors: Huang Yunxuan , Zhang Jiabi , Xiong Buhui , Huang Ruina , Zhao Wenjing , Zhou Mengxue , Chen Qi , Xu Danghan , Chen Xinghua
Published: February 2020

Background

Thunder-fire moxibustion originated in China and contains traditional Chinese medicine. It can produce strong firepower, infrared thermal radiation, and medicinal effects when burning on the acupoints. Thunder-fire moxibustion is commonly used in patients with neck pain, but its efficacy has rarely been systematically demonstrated. We designed a randomized trial of thunder-fire moxibustion on cervical spondylotic radiculopathy (CSR) to investigate whether it is more effective than ibuprofen sustained-release capsules.

Methods

One hundred patients will be recruited and randomly divided into thunder-fire moxibustion and ibuprofen groups. The intervention consists of ten treatments and will last for 2 weeks. The Yasuhisa Tanaka 20 Score Scale is used as the primary outcome measure. It contains a combination of the self-conscious symptom in patients, objective clinical evaluation from doctors, and social evaluation (the ability to work and live). The objective and comprehensive evaluation of CSR patients before and after treatment is particularly needed. The Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2), Neck Disability Index score scale (NDI), and the Quality of Life Assessment (SF-36) are applied as secondary outcome measures. The assessment will take place at the baseline and the first and second weekends of treatment. If an adverse event (AEs) occurs, it will be reported.

Discussion

The aim of this trial is to determine whether thunder-fire moxibustion is more effective than ibuprofen in the treatment of patients with CSR.

Trial registration

Chinese Clinical Trial Registry (http://www.chictr.org.cn), ChiCTR1800018820. Registered on 11 October 2018.
Description, molecular characteristics and Wolbachia endosymbionts of Onchocerca borneensis Uni, Mat Udin & Takaoka n. sp. (Nematoda: Filarioidea) from the Bornean bearded pig Sus barbatus Müller (Cetartiodactyla: Suidae) of Sarawak, Malaysia
Authors: Uni Shigehiko , Mat Udin Ahmad Syihan , Agatsuma Takeshi , Junker Kerstin , Saijuntha Weerachai , Bunchom Naruemon , Fukuda Masako , Martin Coralie , Lefoulon Emilie , Labat Amandine , Khan Faisal Ali Anwarali , Low Van Lun , Cheah Phaik Leng , Lim Yvonne Ai-Lian , Ramli Rosli , Belabut Daicus Martin , Zainuri Nur Afiqah , Matsubayashi Makoto , Omar Hasmahzaiti , Bhassu Subha , Uga Shoji , Hashim Rosli , Takaoka Hiroyuki , Azirun Mohd Sofian
Published: February 2020

Background

The genus Onchocerca Diesing, 1841 includes species of medical importance, such as O. volvulus (Leuckart, 1893), which causes river blindness in the tropics. Recently, zoonotic onchocercosis has been reported in humans worldwide. In Japan, O. dewittei japonica Uni, Bain & Takaoka, 2001 from wild boars is a causative agent for this zoonosis. Many filarioid nematodes are infected with Wolbachia endosymbionts which exhibit various evolutionary relationships with their hosts. While investigating the filarial fauna of Borneo, we discovered an undescribed Onchocerca species in the bearded pig Sus barbatus Müller (Cetartiodactyla: Suidae).

Methods

We isolated Onchocerca specimens from bearded pigs and examined their morphology. For comparative material, we collected fresh specimens of O. d. dewittei Bain, Ramachandran, Petter & Mak, 1977 from banded pigs (S. scrofa vittatus Boie) in Peninsular Malaysia. Partial sequences of three different genes (two mitochondrial genes, cox1 and 12S rRNA, and one nuclear ITS region) of these filarioids were analysed. By multi-locus sequence analyses based on six genes (16S rDNA, ftsZ, dnaA, coxA, fbpA and gatB) of Wolbachia, we determined the supergroups in the specimens from bearded pigs and those of O. d. dewittei.

Results

Onchocerca borneensis Uni, Mat Udin & Takaoka n. sp. is described on the basis of morphological characteristics and its genetic divergence from congeners. Molecular characteristics of the new species revealed its close evolutionary relationship with O. d. dewittei. Calculated p-distance for the cox1 gene sequences between O. borneensis n. sp. and O. d. dewittei was 5.9%, while that between O. d. dewittei and O. d. japonica was 7.6%. No intraspecific genetic variation was found for the new species. Wolbachia strains identified in the new species and O. d. dewittei belonged to supergroup C and are closely related.

Conclusions

Our molecular analyses of filarioids from Asian suids indicate that the new species is sister to O. d. dewittei. On the basis of its morphological and molecular characteristics, we propose to elevate O. d. japonica to species level as O. japonica Uni, Bain & Takaoka, 2001. Coevolutionary relationships exist between the Wolbachia strains and their filarial hosts in Borneo and Peninsular Malaysia.
Arginase promotes immune evasion of Echinococcus granulosus in mice
Authors: Cao Shengkui , Gong Wenci , Zhang Xiaofan , Xu Meng , Wang Ying , Xu Yuxin , Cao Jianping , Shen Yujuan , Chen Jiaxu
Published: February 2020

Background

Cystic echinococcosis is a chronic disease caused by infection with the larvae ofEchinococcus granulosus. The parasite’s ability to establish persistent infection is partly due to its evolving immune evasion strategies. One strategy may involve the protective effect of arginase, which impedes the control of pathogens or tumors, whereas it remains largely unknown duringE. granulosusinfection. Here, we analyzed whether arginase was produced in peritoneal cells and assessed its role in immunosuppression in mice infected with protoscoleces ofE. granulosus.

Methods

BALB/c mice injected with protoscoleces ofE. granulosuswere used to evaluate the expression of arginase (ARG) in mRNA and protein levels. The profiles of ARG-1 expression in peritoneal cells and CD3ζexpression in T cells from spleens were assessed at different time points (3, 6, 9 and 12 months post-infection) by flow cytometry.In vitro, peritoneal cells were co-cultured with purified T cells in a transwell system, and the levels of CD3ζre-expression were compared by flow cytometry. Meanwhile, the changes ofl-arginine and its related metabolites in serum were tested.

Results

Compared to the control group, the peritoneal cells from infected mice showed higher levels of ARG-1 mRNA and protein, unchanged ARG-2 and iNOS. Enhanced ARG-1 expression was present in SSClowCD11b+F4/80+, CD11b+CD11c+, CD11b+Gr-1+Ly-6C+Ly-6G−, CD11b+Gr-1+Ly-6C−Ly-6G+, CD11b+Gr-1+and CD11b+Ly-6G+cells. The proportion of cells and the proportion of ARG-1 expression in corresponding cells exhibited a rising trend along with the extension of infection time, except for fluctuations in SSClowCD11b+F4/80+and CD11b+CD11c+cells at 12 months post-infection, whereas the expression of CD3ζchain in CD4+and CD8+T cells showed a descending trend. Purified T cells showed declined re-expression of CD3ζwhen co-cultured with peritoneal cells from infected mice, and CD3ζwas regenerated by supplement ofl-arginine or arginase inhibitor BEC, rather than NOS inhibitorl-NMMA or catalase. Meanwhile, the concentrations ofl-arginine,l-citrulline and NO decreased, and those ofl-ornithine and urea increased in serum post-infection.

Conclusions

Our findings demonstrated that ARG-1 expression is enhanced in multiple myeloid cells from peritoneum and promotes immune evasion ofE. granulosusin mice by inhibiting the expression of T cell receptor CD3ζchain and antagonism against iNOS.
Spatial pattern and driving factors of biomass carbon density for natural and planted coniferous forests in mountainous terrain, eastern Loess Plateau of China
Authors: Sun Lina , Wang Mengben , Fan Xiaohui
Published: February 2020

Background

Understanding the spatial pattern and driving factors of forest carbon density in mountainous terrain is of great importance for monitoring forest carbon in support of sustainable forest management for mitigating climate change.

Methods

We collected the forest inventory data in 2015 in Shanxi Province, eastern Loess Plateau of China, to explore the spatial pattern and driving factors of biomass carbon density (BCD) for natural and planted coniferous forests using Anselin Local Moran’s I, Local Getis-Ord G* and semivariogram analyses, and multi-group structural equation modeling, respectively.

Results

The result of spatial pattern of BCDs for natural forests showed that the BCD was generally higher in the north but lower in the south of Shanxi. The spatial pattern for planted forests was substantially different from that for natural forests. The results of multi-group SEM suggested that elevation (or temperature as the alternative factor of elevation) and stand age were important driving factors of BCD for these two forest types. Compared with other factors, the effects of latitude and elevation on BCD showed much greater difference between these two forest types. The difference in indirect effect of latitude (mainly through affecting elevation and stand age) between natural and planted forests was to some extent a reflection of the difference between the spatial patterns of BCDs for natural and planted forests in Shanxi.

Conclusions

The natural coniferous forests had a higher biomass carbon density, a stronger spatial dependency of biomass carbon density relative to planted coniferous forests in Shanxi. Elevation was the most important driving factor, and the effect on biomass carbon density was stronger for natural than planted coniferous forests. Besides, latitude presented only indirect effect on it for the two forest types.
High Resolution MR Imaging guidelines in retinoblastoma: prospective study correlated with histopathological results
Authors: Habib Yomna S. , Youssef Ayda A. , AlKiki Hasan A. , Ghareeb Hala T. , ElZomor Hossam El Dein A.
Published: February 2020

Background

Retinoblastoma is the commonest intraocular pediatric neoplasm. With the recent scope of shifting to eye preserving therapies, preoperative MRI is becoming the primary noninvasive diagnostic method to confirm the diagnosis, assess the ocular coats and optic nerve, and detect extraocular tumor extension and intracranial primitive neuroectodermal tumor associated with retinoblastoma as funduscopy and ultrasound have limitations. Diffusion-weighted images (DWIs) detect abnormalities based on differences in tissue cellularity. Echoplanar-based (EP) DWI results in susceptibility artifacts and geometric distortions, which make DWI of the orbit a challenging technique. The purpose of our study is to evaluate preoperative magnetic resonance (MR) imaging diagnostic merits and indices in patients with retinoblastoma.

Results

Fifty-eight eyes were prospectively reviewed in 30 girls and 27 boys (mean age at diagnosis was 23 months ± 18.9) with retinoblastoma by two radiologists on T1-weighted images, fat saturated T2-weighted images, DWIs, ADC, and postcontrast T1-weighted MR images with and without fat suppression. All patients included were primarily treated by surgical enucleation; one girl had bilateral enucleation. MRI shows accuracy, sensitivity, specificity, NPV, and PPV; 86.2%, 95.3%, 60%, 81.8%, and 87.2% respectively for choroidal invasion; 75.8%, 58.8%, 82.9%, 83%, and 58.8% in prelaminar optic nerve invasion; and 86.2%, 85.2%, 87%, 87%, and 85% in postlaminar optic nerve invasion (PLONI) respectively. For sclera and extrascleral tumor invasion, MRI show accuracy, sensitivity, specificity, NPV, and PPV of 93%, 55.6%, 100%, 92.5%, 100%, and 98.3%, 100%, 98%,100%, 80% respectively. On DWIs, the vital solid tumor shows hyperintense signal compared to the vitreous. The difference between the mean ADC value of the solid enhancing tumor (0.3[0.12–0.8] × 10−3 s/mm2) and nonenhancing necrotic parts (1.4[1.0–1.8] × 10−3 s/mm2) was statistically significant (p < 0.001). No correlation was found between the ADC values and high risk features for metastasis. Abnormal anterior chamber enhancement shows no statistically significant correlation with main MRI and histopathology findings. Maximum tumor diameter in mm show statistically significant correlation with postlaminar optic nerve invasion (ρ = .002) and choroidal invasion (ρ = .007). Sensitivity and specificity of different tumor size cutoff values are calculated using the ROC analysis.

Conclusion

High-resolution ocular MR imaging can reliably detect postlaminar optic nerve invasion, choroid, and extrascleral invasion; meanwhile, it shows low sensitivity in prelaminar optic nerve, ciliary body, and sclera invasion. Significantly lower ADC values in viable tumor than necrotic parts are recorded.
An efficient wavefield inversion for transversely isotropic media with a vertical axis of symmetry
Authors: Song Chao , Alkhalifah Tariq
Published: February 2020

Conventional full-waveform inversion (FWI) aims at retrieving a high-resolution velocity model directly from the wavefields measured at the sensor locations resulting in a highly nonlinear optimization problem. Due to the high nonlinearity of FWI (manifested in one form in the cycle-skipping problem), it is easy to fall into local minima. Considering that the earth is truly anisotropic, a multiparameter inversion imposes additional challenges in exacerbating the null-space problem and the parameter trade-off issue. We have formulated an optimization problem to reconstruct the wavefield in an efficient matter with background models by using an enhanced source function (which includes secondary sources) in combination with fitting the data. In this two-term optimization problem to fit the wavefield to the data and to the background wave equation, the inversion for the wavefield is linear. Because we keep the modeling operator stationary within each frequency, we only need one matrix inversion per frequency. The inversion for the anisotropic parameters is handled in a separate optimization using the wavefield and the enhanced source function. Because the velocity is the dominant parameter controlling the wave propagation, it is updated first. Thus, this reduces undesired updates for anisotropic parameters due to the velocity update leakage. We find the effectiveness of this approach in reducing parameter trade-off with a distinct Gaussian anomaly model. We find that in using the parameterization [Formula: see text], and [Formula: see text] to describe the transversely isotropic media with a vertical axis of symmetry model in the inversion, we end up with high resolution and minimal trade-off compared to conventional parameterizations for the anisotropic Marmousi model. Application on 2D real data also indicates the validity of our method.
Imaging below a complex overburden with borehole-seismic data
Authors: Haldorsen Jakob B. U. , Jahren Leif
Published: February 2020

We have determined how the measured polarization and traveltime for P- and S-waves can be used directly with vertical seismic profile data for estimating the salt exit points in a salt-proximity survey. As with interferometry, the processes described use only local velocities. For the data analyzed in this paper, our procedures have confirmed the location, inferred from surface-seismic data, of the flank of a steeply dipping salt body near the well. This has provided us more confidence in the estimated reservoir extent moving toward the salt face, which in turn has added critical information for the economic evaluation of a possible new well into the reservoir. We also have found that ray-based vector migration, based on the assumptions of locally plane wavefronts and locally plane formation interfaces, can be used to create 3D reflection images of steeply dipping sediments near the well, again using only local velocities. Our local reflection images have helped confirm the dips of the sediments between the well and the salt flank. Because all parameters used in these processes are local and can be extracted from the data themselves, the processes can be considered to be self-sufficient.
Multidisciplinary Tool Kit for Febrile Neutropenia: Stewardship Guidelines,Staphylococcus aureusEpidemiology, and Antibiotic Use Ratios
Authors: Bartash Rachel , Cowman Kelsie , Szymczak Wendy , Guo Yi , Ostrowsky Belinda , Binder Adam , Sheridan Carol , Levi Michael , Gialanella Philip , Nori Priya
Published: February 2020

PURPOSE:

Inappropriate vancomycin for febrile neutropenia (FN) is an ideal antimicrobial stewardship target. To improve vancomycin prescribing, we instituted a multifaceted intervention, including an educational guideline with audit for compliance; an antibiotic use audit; and an assessment of local burden of methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection.

MATERIALS AND METHODS:

We conducted a quasi-experimental pre-post intervention review of vancomycin initiation for FN on a 32-bed hematology/oncology unit. A retrospective chart review was conducted from November 2015 to May 2016 (preintervention period). In January 2017, we implemented an institutional FN guideline emphasizing criteria for appropriate use. Vancomycin audit was conducted from February 2017 to October 2017 (postintervention period). The primary outcome was appropriateness of vancomycin initiation. We then compared average antibiotic use (days of therapy per 1,000 patient days) for vancomycin and cefepime before and after intervention. Finally, unit-wide MRSA screening cultures were obtained upon admission and bimonthly for 6 weeks (October 2, 2017, to November 9, 2017). Screened patients were followed for 12 months for clinical MRSA infection.

RESULTS:

Forty-three (49%) of 88 preintervention patients were started on empiric vancomycin appropriately, compared with 59 (66%) of 90 postintervention patients ( P = .02). There was a significant decrease in vancomycin use after intervention. Six (7.1%) of 85 patients screened positive for MRSA colonization. During the 12-month follow-up, no colonized patients developed clinical MRSA infections (positive predictive value, 0.0%). Of the 79 noncolonized patients, 2 developed a clinically significant infection (negative predictive value, 97.5%).

CONCLUSION:

Guideline-focused education can improve vancomycin appropriateness in FN and should be bundled with education and feedback about local MRSA epidemiology and antibiotic use rates for maximal stewardship impact.
From Orientation to Onboarding: A Survey-Based Departmental Improvement Program for New Radiation Oncology Faculty Physicians
Authors: Cuaron John J. , Gillespie Erin F. , Gomez Daniel R. , Khan Atif J. , Mychalczak Borys , Cahlon Oren
Published: February 2020

PURPOSE:

To evaluate physician-reported assessments of an established faculty orientation program for new radiation oncology physicians at a large academic center and to prospectively analyze the effects of an onboarding improvement program based on those assessments.

MATERIALS AND METHODS:

An anonymous survey was designed and distributed to physicians new to the department who received onboarding orientation between 2013 and 2017. Survey questions addressed the comprehensiveness, effectiveness, and utility of various orientation activities. On the basis of the survey results, an improved onboarding program was designed and implemented for nine new faculty members between May 2018 and November 2018. A post-intervention survey querying topics similar to those in the pre-intervention survey was distributed to the new faculty members. Descriptive statistics were generated to compare the pre-intervention and post-intervention groups.

RESULTS:

The overall rate of survey completion was 85% (17 of 20). The intervention program markedly improved physician assessment of comprehensiveness and effectiveness of the onboarding process. Physicians strongly and consistently identified mentor shadowing, on-the-job training, and other faculty mentorship activities as the most important components of an effective onboarding experience.

CONCLUSION:

An enhanced, tailored, person-oriented, formal onboarding improvement program significantly increased physician assessment scores of comprehensiveness and effectiveness of the faculty onboarding process. This model can serve as a framework for increasing physician preparedness, encouraging early physician mentorship, and ensuring a universal standard of quality across large practices.
Skeletal muscle in health and disease
Authors: Morgan Jennifer , Partridge Terence
Published: February 2020

Skeletal muscle fibres are multinucleated cells that contain postmitotic nuclei (i.e. they are no longer able to divide) and perform muscle contraction. They are formed by fusion of muscle precursor cells, and grow into elongating myofibres by the addition of further precursor cells, called satellite cells, which are also responsible for regeneration following injury. Skeletal muscle regeneration occurs in most muscular dystrophies in response to necrosis of muscle fibres. However, the complex environment within dystrophic skeletal muscle, which includes inflammatory cells, fibroblasts and fibro-adipogenic cells, together with the genetic background of the in vivo model and the muscle being studied, complicates the interpretation of laboratory studies on muscular dystrophies. Many genes are expressed in satellite cells and in other tissues, which makes it difficult to determine the molecular cause of various types of muscular dystrophies. Here, and in the accompanying poster, we discuss our current knowledge of the cellular mechanisms that govern the growth and regeneration of skeletal muscle, and highlight the defects in satellite cell function that give rise to muscular dystrophies.
Occupational Activities: Factors That Tip the Balance From Bone Accrual to Bone Loss
Authors: Barbe Mary F. , Popoff Steven N.
Published: February 2020

It is commonly assumed that beneficial adaptations in bone occur with vigorous exercise, yet any adaptive re/modeling in bone undergoing persistent overloading can be counteracted by superimposed inflammatory, compressive, and tensile loading–induced damage responses above thresholds of tissue fatigue failure and repair. This leads to a tenuous balance between achieving bone accrual and loss.
Thyroid Function and Nutrient Status in the Athlete
Authors: Larson-Meyer D. Enette , Gostas Demetre E.
Published: February 2020

Thyroid disease is common in the general population, especially in women, and also may be prevalent among athletes. Autoimmune disorders are the most common cause of thyroid disorders in countries with iodine-fortification programs; however, thyroid dysfunction can be brought on by nutritional factors, including insufficient energy intake and iodine, selenium, iron, and vitamin D deficiency. Additionally, strenuous exercise may be associated with transient alterations in thyroid hormones. While the development of thyroid related disorders has the potential to impact health and peak performance, typical clinical manifestations are highly variable, lack specificity, and are frequently confused with other health problems. The assessment process should focus on anthropometric changes, biochemical tests (thyroid panel), personal and family history, examination for appropriate signs and symptoms, and diet and environmental assessment that includes adequacy of energy, iodine, iron, selenium, and vitamin D intake/status along with excess stress and exposure to environmental contaminants and dietary goitrogens.
Footwear and Cadence Affect Gait Variability in Runners with Patellofemoral Pain
Authors: BONACCI JASON , FOX AARON , HALL MICHELLE , FULLER JOEL T. , VICENZINO BILL
Published: February 2020

Purpose

To examine the effects of increased cadence and minimalist footwear on lower-limb variability in runners with patellofemoral pain (PFP).

Methods

Fifteen (12 female, 3 male) runners with PFP ran on an instrumented treadmill with three-dimensional motion capture in three randomly ordered conditions: (i) standard shoe at preferred cadence, (ii) standard shoe +10% cadence, and (iii) minimalist shoe at preferred cadence. Vector coding was used to calculate coordination variability between strides for select lower-limb joint couplings. Approximate entropy was calculated to assess continuous variability for segment kinematic and kinetic data and compared between conditions using repeated-measures ANOVA. One-dimensional statistical parametric mapping repeated-measures ANOVA was performed on the coordination variability data. Cohen’s d effect size was calculated for all comparisons.

Results

Larger approximate entropy values (i.e., greater variability) were observed for the standard shoe +10% cadence versus the standard shoe at preferred cadence for hip flexion/extension (P < 0.001; d = 1.12), hip adduction/abduction (P < 0.001; d = 0.99) and ankle dorsiflexion/plantarflexion (P < 0.001; d = 1.37) kinematics, and knee flexion/extension moments (P < 0.001; d = 0.93). Greater variability was also observed in the minimalist shoe versus the standard shoe at preferred cadence for hip internal/external rotation moments (P < 0.001; d = 0.76), knee adduction/abduction moments (P < 0.001; d = 0.51), and knee internal/external rotation moments (P < 0.001; d = 1.02). One-dimensional statistical parametric mapping repeated-measures ANOVA revealed no significant differences in coordination variability between running conditions.

Conclusions

Greater hip and knee kinematic and kinetic variability observed with either increased cadence or minimalist footwear may be beneficial for those with PFP.
O BALANCED SCORECARD APLICADO À ADMINISTRAÇÃO PÚBLICA MUNICIPAL: UM ESTUDO NA PREFEITURA DE IBIÚNA, ESTADO DE SÃO PAULO
Authors: Andrade Alequexandre Galvez , Moraes Yohanna Godinho da Silva , Mangini Eduardo Roque
Published: February 2020

O planejamento estratégico produz um resultado articulado, na forma de um sistema integrado de decisões. O Balanced Scorecard permite que haja um alinhamento entre missão, visão e valores, por meio de indicadores que são agrupados em quatro perspectivas que, segundo Niven (2002), na administração pública, são cidadãos, processos internos, aprendizagem e crescimento e orçamento/financeiro. O objetivo deste trabalho foi elaborar o Balanced Scorecard na administração pública no município de Ibiúna, estado de São Paulo, Brasil. A pesquisa tem natureza qualitativa com aplicação do método do estudo de caso, por tratar de situações complexas, contemporâneas e contextualizadas (YIN, 2015). Os resultados indicam que a elaboração do Balanced Scorecard é aplicável ao setor público e permite a consolidação das metas estabelecidas no Plano Diretor, Plano Plurianual, na lei de diretrizes orçamentárias e lei orçamentária anual, aumentando o controle e a transparência das informações, melhorando o alinhamento com a visão e a missão do município, correspondendo aos preceitos modernos da transparência.
QUALIDADE DA INFORMAÇÃO DOS DADOS GOVERNAMENTAIS ABERTOS: ANÁLISE DO PORTAL DE DADOS ABERTOS BRASILEIRO
Authors: Silva Ambrozina De Abreu Pereira , Monteiro Doraliza Auxiliadora Abranches , Reis Anderson De Oliveira
Published: February 2020

Este estudo tem como objetivo analisar o Portal Brasileiro de Dados Abertos, sob a perspectiva da qualidade dos dados e dos princípios de DGA’s. Foram analisadas informações disponíveis no ano de 2018 no Website do Portal. As categorias de análise que compuseram a pesquisa foram os princípios de DGA’s, apontados pelo Open Government Working Group e as dimensões para a análise da qualidade dos dados, propostos por Parker et al. (2006). O portal, enquanto catalogador dos dados, atende, praticamente, a todos os princípios de DGA´s. Quanto à qualidade das informações, dimensões como adequação, relevância, atualização, facilidade de manipulação e entendimento merecem atenção por parte da Administração Pública. Espera-se que os fatores apontados sejam considerados pela Administração Pública, possibilitando a disponibilização de dados qualificados que contribuam com o aperfeiçoamento das ações governamentais, promovendo possibilidades efetivas de consulta às informações fornecidas pela Administração Pública brasileira, favorecendo o processo de participação da sociedade civil.
INFLUÊNCIA DAS REDES SOCIAIS NO PROCESSO DE DECISÃO DE COMPRA DO CONSUMIDOR
Authors: Viana Mercia Cristiley Barreto , Silva Maria Eleneide da Paiva da
Published: February 2020

As redes sociais vêm desenvolvendo um importante papel no marketing e têm provocado mudanças no comportamento do consumidor ao exercer influências no processo de compra de um bem ou serviços. A pesquisa se propôs a investigar as influências das redes sociais no processo de decisão dos consumidores das óticas. Para a realização do estudo, foi utilizada uma metodologia de caráter descritivo com abordagem quantitativa e coleta dos dados, por meio de aplicação de 210 questionários com os consumidores das óticas de Pau dos Ferros/RN. A análise dos resultados deu-se por meio de testes e métodos de análises estatísticos, qual seja, Teste de Bartlett e KMO, Cronbach Alpha, teste t de Student e a análise fatorial. Nos resultados, constatou-se que os consumidores de óticas são influenciados pelo conteúdo que eles visualizam nas principais redes sociais (facebook e whatsapp) e, principalmente, quando alguma variável acerca da qualidade do produto, preço, marca, propaganda e indicação de familiares e amigos está presente nas postagens.
Development of a cell-free split-luciferase biochemical assay as a tool for screening for inhibitors of challenging protein-protein interaction targets
Authors: Cooley Rachel , Kara Neesha , Hui Ning Sze , Tart Jonathan , Roustan Chloë , George Roger , Hancock David C. , Binkowski Brock F. , Wood Keith V. , Ismail Mohamed , Downward Julian
Published: February 2020

Targeting the interaction of proteins with weak binding affinities or low solubility represents a particular challenge for drug screening. The NanoLucâ ® Binary Technology (NanoBiTâ ®) was originally developed to detect protein-protein interactions in live mammalian cells. Here we report the successful translation of the NanoBit cellular assay into a biochemical, cell-free format using mammalian cell lysates. We show that the assay is suitable for the detection of both strong and weak protein interactions such as those involving the binding of RAS oncoproteins to either RAF or phosphoinositide 3-kinase (PI3K) effectors respectively, and that it is also effective for the study of poorly soluble protein domains such as the RAS binding domain of PI3K. Furthermore, the RAS interaction assay is sensitive and responds to both strong and weak RAS inhibitors. Our data show that the assay is robust, reproducible, cost-effective, and can be adapted for small and large-scale screening approaches. The NanoBit Biochemical Assay offers an attractive tool for drug screening against challenging protein-protein interaction targets, including the interaction of RAS with PI3K.