bluuebunny/crossref_metadata_2025 huggingface dataset:
Horizontal and vertical movements of immature dusky sharks Carcharhinus obscurus in relation to commercial longline fisheries in the western North Atlantic Ocean
Authors: Kroetz Andrea M. , Gulak Simon J. B. , Carlson John K.
Published: August 2021

Background

Many species of sharks, including the dusky shark Carcharhinus obscurus, are often incidentally captured in commercial pelagic and bottom longline fisheries. Incidental capture can lead to at-vessel or post-release mortality and can be detrimental to populations of threatened, endangered, or prohibited species. The estimated at-vessel mortality for dusky sharks can be high in longline fisheries and, to minimize mortality, time–area closures have been designated in the western North Atlantic Ocean to mitigate interactions with longline fisheries, yet incidental capture of dusky sharks is still common. We compared the vertical and horizontal movements of dusky sharks to the overall fishing effort and depth fished of commercial pelagic and bottom longline fisheries to determine when and where overlap is present that could lead to incidental capture.

Results

Twenty-one (n = 21) dusky sharks were tagged with pop-up archival transmitting satellite tags and all were immature animals (123–200 cm FL) apart from two individuals (230 and 300 cm FL). Sharks were tagged off the coasts of North Carolina (71%) and Florida (29%). Twenty tags (95%) reported and provided tracks between 1 and 107 days (median 15 days) and 10 tags (50%) remained on sharks for > 4 days. Most individuals remained within the bottom longline closed area off the coast of North Carolina during their time at liberty. Dusky sharks primarily occupied the 20–40 m depth range 26% of the time, and overlapped with bottom and pelagic longline gears 41% and 59% of the time, respectively. Overlap was highest in the winter and spring for both commercial fisheries.

Conclusions

The use of archival satellite telemetry in this study has provided valuable preliminary information on vertical and horizontal movements of immature dusky sharks in western North Atlantic Ocean. Dusky sharks may be more vulnerable to incidental capture in the pelagic longline fishery due to the high fishing effort, larger areas of horizontal overlap, and greater percentage of vertical overlap. This information will inform mitigation measures of commercial longline fisheries, which can work toward population rebuilding of the species.
Challenging rigidity in Anorexia (treatment, training and supervision): questioning manual adherence in the face of complexity
Authors: Robertson Annaleise , Thornton Chris
Published: August 2021

Background

Anorexia Nervosa is a debilitating illness. While there have been many advancements to treatment protocols and outcomes for people with eating disorders, the field acknowledges there remains considerable room for improvement. This timely Special Edition of the Journal of Eating Disorders has invited those of us in the field to consider a range of topics in aid of this task, including potential modifications and implementation of evidence-based practice, specific and common psychotherapy factors, treatment manuals, adherence and individualising treatment approaches for individuals and families.

Body

In this paper, we briefly outline the key manualised treatments currently available to treat children, adolescents and adults with Anorexia Nervosa, considering the benefits, potential reasons for adaptations and limitations. We then review the current evidence for training strict adherence to treatment manuals which is often a key focus in training and supervision, questioning the association of increased treatment adherence with improved therapeutic outcome. We then summarise some key evidence behind other therapeutic factors which have been demonstrated to affect outcome regardless of which manual is implemented, such as readiness to change and therapeutic alliance.

Conclusion

The paper concludes with implications and considerations for future research, clinical guidelines, training and supervision, highlighting the need to consider the therapeutic relationship and processes alongside manual content to conduct best evidence-informed practice.
Emerging treatment modalities for systemic therapy in hepatocellular carcinoma
Authors: Qing Xin , Xu Wenjing , Zong Jingjing , Du Xuanlong , Peng Hao , Zhang Yewei
Published: August 2021

Hepatocellular carcinoma (HCC) has long been a major global clinical problem as one of the most common malignant tumours with a high rate of recurrence and mortality. Although potentially curative therapies are available for the early and intermediate stages, the treatment of patients with advanced HCC remains to be resolved. Fortunately, the past few years have shown the emergence of successful systemic therapies to treat HCC. At the molecular level, HCC is a heterogeneous disease, and current research on the molecular characteristics of HCC has revealed numerous therapeutic targets. Targeted agents based on signalling molecules have been successfully supported in clinical trials, and molecular targeted therapy has already become a milestone for disease management in patients with HCC. Immunotherapy, a viable approach for the treatment of HCC, recognizes the antigens expressed by the tumour and treats the tumour using the immune system of the host, making it both selective and specific. In addition, the pipeline for HCC is evolving towards combination therapies with promising clinical outcomes. More drugs designed to focus on specific pathways and immune checkpoints are being developed in the clinic. It has been demonstrated that some drugs can improve the prognosis of patients with HCC in first- or second-line settings, and these drugs have been approved by the Food and Drug Administration or are nearing approval. This review describes targeting pathways and systemic treatment strategies in HCC and summarizes effective targeted and immune-based drugs for patients with HCC and the problems encountered.
Advances in technology and applications of nanoimmunotherapy for cancer
Authors: Dou Lei , Meng Xiangdan , Yang Huiyuan , Dong Haifeng
Published: August 2021

Host-tumor immune interactions play critical roles in the natural history of tumors, including oncogenesis, progress and metastasis. On the one hand, neoantigens have the potential to drive a tumor-specific immune response. In tumors, immunogenic cell death (ICD) triggered by various inducers can initiate a strong host anti-immune response. On the other hand, the tolerogenic tumor immune microenvironment suppresses host immune responses that eradicate tumor cells and impair the effect of tumor therapy. Therefore, a deeper understanding and more effective manipulation of the intricate host-tumor immune interaction involving the host, tumor cells and the corresponding tumor immune microenvironment are required. Despite the encouraging breakthroughs resulting from tumor immunotherapy, no single strategy has elicited sufficient or sustained antitumor immune responses in most patients with specific malignancies due to limited activation of specific antitumor immune responses and inadequate remodeling of the tolerogenic tumor immune microenvironment. However, nanotechnology provides a unique paradigm to simultaneously tackle all these challenges, including effective “targeted” delivery of tumor antigens, sustained ICD mediation, and “cold” tumor microenvironment remodeling. In this review, we focus on several key concepts in host-tumor immune interactions and discuss the corresponding therapeutic strategy based on the application of nanoparticles.
Learning Factories 4.0 in technical vocational schools: can they foster competence development?
Authors: Roll Michael , Ifenthaler Dirk
Published: August 2021

Learning Factories 4.0 are thought to prepare vocational students for the challenges of Industry 4.0. The implementation of those interconnected Learning Factories 4.0 at technical vocational schools may promote the development of subject-related technical competencies as well as multidisciplinary digital competencies. Still, research is scarce with regard to the development of competencies supported through Learning Factories 4.0 in technical vocational schools. Hence this research focusses on subject-related technical and multidisciplinary digital competencies of technical vocational students change due to different levels of Learning Factory 4.0 interaction over time. Three subsequent competence tests with N = 63 technical vocational students were conducted. Findings indicate the benefits of integrating Learning Factories 4.0 for developing subject-related competencies in technical vocational schools. However, the study could not identify a positive development of multidisciplinary digital competencies. The findings of this study can help educators to further develop learning environments with support from Learning Factories 4.0 as well as preparing their learners for the demanding competencies of Industry 4.0.
Simultaneous GPS-tracking of parents reveals a similar parental investment within pairs, but no immediate co-adjustment on a trip-to-trip basis
Authors: Kavelaars Marwa M. , Baert Jan M. , Van Malderen Jolien , Stienen Eric W. M. , Shamoun-Baranes Judy , Lens Luc , Müller Wendt
Published: August 2021

Background

Parental care benefits the offspring, but comes at a cost for each parent, which in biparental species gives rise to a conflict between partners regarding the within-pair distribution of care. Pair members could avoid exploitation by efficiently keeping track of each other’s efforts and coordinating their efforts. Parents may, therefore, space their presence at the nest, which could also allow for permanent protection of the offspring. Additionally, they may respond to their partner’s previous investment by co-adjusting their efforts on a trip-to-trip basis, resulting in overall similar parental activities within pairs.

Methods

We investigated the coordination of parental care measured as nest attendance and foraging effort in the Lesser black-backed gull (Larus fuscus), a species with long nest bouts that performs extended foraging trips out of sight of their partner. This was achieved by GPS-tracking both pair members simultaneously during the entire chick rearing period.

Results

We found that the timing of foraging trips (and hence nest attendance) was coordinated within gull pairs, as individuals left the colony only after their partner had returned. Parents did not match their partner’s investment by actively co-adjusting their foraging efforts on a trip-by-trip basis. Yet, pair members were similar in their temporal and energetic investments during chick rearing.

Conclusion

Balanced investment levels over a longer time frame suggest that a coordination of effort may not require permanent co-adjustment of the levels of care on a trip-to-trip basis, but may instead rather take place at an earlier stage in the reproductive attempt, or over integrated longer time intervals. Identifying the drivers and underlying processes of coordination will be one of the next necessary steps to fully understand parental cooperation in long-lived species.
Deep learning assisted quantitative assessment of histopathological markers of Alzheimer’s disease and cerebral amyloid angiopathy
Authors: Perosa Valentina , Scherlek Ashley A. , Kozberg Mariel G. , Smith Lindsey , Westerling-Bui Thomas , Auger Corinne A. , Vasylechko Serge , Greenberg Steven M. , van Veluw Susanne J.
Published: August 2021

Traditionally, analysis of neuropathological markers in neurodegenerative diseases has relied on visual assessments of stained sections. Resulting semiquantitative scores often vary between individual raters and research centers, limiting statistical approaches. To overcome these issues, we have developed six deep learning-based models, that identify some of the most characteristic markers of Alzheimer’s disease (AD) and cerebral amyloid angiopathy (CAA). The deep learning-based models are trained to differentially detect parenchymal amyloid β (Aβ)-plaques, vascular Aβ-deposition, iron and calcium deposition, reactive astrocytes, microglia, as well as fibrin extravasation. The models were trained on digitized histopathological slides from brains of patients with AD and CAA, using a workflow that allows neuropathology experts to train convolutional neural networks (CNNs) on a cloud-based graphical interface. Validation of all models indicated a very good to excellent performance compared to three independent expert human raters. Furthermore, the Aβ and iron models were consistent with previously acquired semiquantitative scores in the same dataset and allowed the use of more complex statistical approaches. For example, linear mixed effects models could be used to confirm the previously described relationship between leptomeningeal CAA severity and cortical iron accumulation. A similar approach enabled us to explore the association between neuroinflammation and disparate Aβ pathologies. The presented workflow is easy for researchers with pathological expertise to implement and is customizable for additional histopathological markers. The implementation of deep learning-assisted analyses of histopathological slides is likely to promote standardization of the assessment of neuropathological markers across research centers, which will allow specific pathophysiological questions in neurodegenerative disease to be addressed in a harmonized way and on a larger scale.
Assessment of job satisfaction among pharmacy professionals
Authors: Berassa Muluwork Sahile , Chiro Tebeje Ashegu , Fanta Selamawit
Published: August 2021

Background

Job satisfaction of pharmacy professionals is appreciably related to quality of pharmaceutical care. Poor Job satisfaction is associated with low productivity, absenteeism, high turnover and reduced working hours. Little is known about job satisfaction and its related factors among pharmacy professionals in Tikur Anbessa Specialized Hospital. Therefore, the current study is aimed to assess the level of job satisfaction among pharmacy professionals working in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

Methods

Institutional based cross sectional study was conducted among 80 pharmacy professionals working in Tikur Anbessa specialized hospital in Addis Ababa, Ethiopia from January to April 2019. The census sampling technique was used and data were collected using semi-structured self-administered questionnaire. Statistical analysis was carried out using the Statistical Package for the Social Sciences version 21.0.

Result

Among 85 participants, 80 responded to the questionnaires completely that makes the response rate of 94%. A majority of the respondents were female (63.8%), with age group 30–39 years (57.5%), own bachelor degree (89.0%), had 1–5 years of work experience (65.0%) and provide outpatient pharmacy service (22.5%). Near to half (47.0%) of the respondents were not satisfied with their job. Only one among five of the participants feel that they are doing professional job which they enjoy and want to stay on their current working place. The least satisfaction score was obtained for staff adequacy (15.0%) and the highest satisfaction score was obtained for job relation of pharmacists with other health care professionals (74.0%).

Conclusion

In the current study near to half of the hospital pharmacists were poorly satisfied on their job. High workload, inadequate salary, low respect and treat from hospital management teams, uncomfortable working environment and insufficient promotion opportunities within the hospital were mentioned as the major reasons for their poor job satisfaction. Thus, policy makers, pharmacy directors and hospital administrators, should work to reduce workload, to increase incentives and to create good working environment to improve job satisfaction and the quality of pharmaceutical care in the hospital.
Use of DNA metabarcoding of bird pellets in understanding raptor diet on the Qinghai-Tibetan Plateau of China
Authors: Hacker Charlotte E. , Hoenig Brandon D. , Wu Liji , Cong Wei , Yu Jingjing , Dai Yunchuan , Li Ye , Li Jia , Xue Yadong , Zhang Yu , Ji Yunrui , Cao Hanning , Li Diqiang , Zhang Yuguang , Janecka Jan E.
Published: August 2021

Background

Diet analysis is essential to understanding the functional role of large bird species in food webs. Morphological analysis of regurgitated bird pellet contents is time intensive and may underestimate biodiversity. DNA metabarcoding has the ability to circumvent these issues, but has yet to be done.

Methods

We present a pilot study using DNA metabarcoding of MT-RNR1 and MT-CO1 markers to determine the species of origin and prey of 45 pellets collected in Qinghai and Gansu Provinces, China.

Results

We detected four raptor species [Eurasian Eagle Owl (Bubo bubo), Saker Falcon (Falco cherrug), Steppe Eagle (Aquila nipalensis), and Upland Buzzard (Buteo hemilasius)] and 11 unique prey species across 10 families and 4 classes. Mammals were the greatest detected prey class with Plateau Pika (Ochotona curzoniae) being the most frequent. Observed Shannon’s and Simpson’s diversity for Upland Buzzard were 1.089 and 0.479, respectively, while expected values were 1.312 ± 0.266 and 0.485 ± 0.086. For Eurasian Eagle Owl, observed values were 1.202 and 0.565, while expected values were 1.502 ± 0.340 and 0.580 ± 0.114. Interspecific dietary niche partitioning between the two species was not detected.

Conclusions

Our results demonstrate successful use of DNA metabarcoding for understanding diet via a novel noninvasive sample type to identify common and uncommon species. More work is needed to understand how raptor diets vary locally, and the mechanisms that enable exploitation of similar dietary resources. This approach has wide ranging applicability to other birds of prey, and demonstrates the power of using DNA metabarcoding to study species noninvasively.
Avian-power line interactions in the Gobi Desert of Mongolia: are mitigation actions effective?
Authors: Orihuela-Torres Adrian , Pérez-García Juan M. , Morales-Reyes Zebensui , Naves-Alegre Lara , Sánchez-Zapata José A. , Sebastián-González Esther
Published: August 2021

Background

Electrocution and collisions on power lines are among the leading causes of non-natural mortality for birds. Power lines are exponentially increasing, particularly in developing countries, but mitigation strategies to prevent bird mortality are questionable. Mongolia combines a recently increased power line network, an abundant raptor population, a dangerous crossarm configuration and a habitat with no natural perches, producing many bird-power line interactions. Our aim is to assess the bird mortality caused by power lines in the Gobi Desert of Mongolia, to determine the factors increasing the risk of bird electrocution, and to evaluate the effectiveness of used retrofitting measures.

Methods

In July 2019 we covered 132.9 km of 15 kV power lines checking 1092 poles. We also conducted bird transects to record raptor and corvid richness and abundance, to assess species vulnerability to electrocution.

Results

We recorded 76 electrocuted birds of 7 species. Electrocution rate was 6.96 birds/100 poles. The most affected species were Common Raven (Corvus corax) and Upland Buzzard (Buteo hemilasius), highlighting the electrocution of 5 endangered Saker Falcons (Falco cherrug). By contrast, we only recorded 8 individuals of 5 species colliding with wires, the most affected being Pallas’s Sandgrouse (Syrrhaptes paradoxus). About 76.1% of sampled poles had some mitigation measure. Of these, 96.6% were brush perch deflectors and 3.4% rotating-mirrors perch deterrents. We found differences in electrocution rates among crossarm configurations, with the strain insulator with one jumper being the most lethal. Additionally, we found no correlation between bird abundance and electrocution rates, suggesting that some species are more sensitive to electrocution. Although no differences in total bird electrocution rates were detected between poles with and without perch deterrents, when bird size is considered, deterrents reduced the mortality rate of small birds, while they were ineffective for medium-sized birds.

Conclusions

Despite the widespread use of perch deterrents in the Mongolian power line network, there is still an alarming electrocution rate. This strategy is ineffective and some mechanisms, such as brush perch deflectors, may increase the electrocution rate for some medium-sized birds. Finally, we propose strategies to minimize the avian electrocution rate in the Gobi Desert.
Congenital hemophilia A diagnosed with postoperative hemorrhage after thyroidectomy for papillary thyroid carcinoma: a case report
Authors: Saitou Marie , Okamoto Muneo , Nagaoka Ryuta , Jikuzono Tomoo , Sen Masaomi , Kazusaka Hiroko , Matsui Mami , Sugitani Iwao
Published: August 2021

Background

Postoperative bleeding in thyroid surgery is a serious complication with fatal outcomes. Risk factors for postoperative hemorrhage have been reported as old age, male sex, Graves' disease, use of anticoagulants, and hematological disorders. Among the hematological diseases, congenital hemophilia is an inherited bleeding disorder characterized by absence or reduced levels of clotting factors VIII or IX. Most patients with hemophilia display bleeding symptoms during infancy or childhood, but diagnosis could be delayed in mild cases. We report a case of congenital hemophilia A that was diagnosed after three episodes of postoperative bleeding after thyroid surgery.

Case presentation

A 46-year-old man developed repeated postoperative hemorrhage after thyroid surgery for thyroid cancer. In this case, several irregularities were seen in the postoperative course, such as a relatively long interval between surgery and bleeding, the lack of an obvious bleeding point, fresh red blood dripping from the drain insertion site on the second postoperative day, and repeated bleeding three times. We therefore considered that the cause of postoperative hemorrhage might be other than the surgical operations. After a thorough examination, hemophilia A was diagnosed.

Conclusions

Hemophilia is a risk factor for postoperative bleeding in thyroid surgery. However, mild hemophilia shows normal prothrombin time and activated partial thromboplastin time. We encountered a case of papillary thyroid carcinoma associated with congenital hemophilia A, which was diagnosed after repeated bleeding.
A rare case of sigmoid colon cancer in which the lower limbs received collateral blood flow from the inferior mesenteric artery owing to peripheral artery disease
Authors: Kihara Kyoichi , Horie Hiromu , Miyatani Kozo , Endo Masayuki , Matsunaga Tomoyuki , Yamamoto Manabu , Yata Shinsaku , Tokuyasu Naruo , Sakamoto Teruhisa , Fujiwara Yoshiyuki
Published: August 2021

Background

Colorectal cancer and peripheral artery disease are common conditions in older adults and may coexist in this population. Lymph node dissection along the inferior mesenteric artery is a vital procedure in cases of left-sided colorectal cancer. However, the inferior mesenteric artery may show a collateral blood pathway in rare cases of peripheral artery disease. We report a case of advanced sigmoid colon cancer in which the lower limbs received inferior mesenteric artery flow owing to asymptomatic peripheral artery disease. The possibility of catastrophic lower-limb ischemia because of complete mesenteric excision with ligation of the inferior mesenteric artery was a matter of concern in this case.

Case presentation

A 73-year-old man with asymptomatic peripheral artery disease was diagnosed with stage IIIB advanced sigmoid colon cancer. Angiography using a balloon-occlusion catheter revealed that his lower limbs received prominent inferior mesenteric artery blood flow through a collateral pathway. Therefore, interventional radiologists and cardiovascular surgeons evaluated the indications for endovascular stents or bypass grafts. The patient also had dilated cardiomyopathy, so the cardiovascular physicians evaluated his tolerance in the worst-case scenario of a colorectal anastomotic leak. The patient underwent axillofemoral artery bypass and two-stage laparoscopic sigmoid colectomy without anastomosis. The postoperative course was uneventful, and he resumed his job within a month after the resection.

Conclusions

Although collateral flow from the inferior mesenteric artery is rare in patients with peripheral artery disease, a few case reports have described fatal lower-limb ischemia following anterior resection. The perioperative multidisciplinary evaluation enabled us to understand the patient’s condition and risks, and allowed successful cancer treatment without ischemia of the lower limbs.
Serum Cardiac and Skeletal Muscle Marker Changes in Repetitive Breath-hold Diving
Authors: Cialoni Danilo , Brizzolari Andrea , Sponsiello Nicola , Lancellotti Valentina , Lori Cesare , Bosco Gerardo , Marroni Alessandro , Barassi Alessandra
Published: August 2021

Background

Breath-hold diving (BH-diving) is associated to extreme environmental conditions, prolonged physical activity, and complex adaptation mechanisms to supply enough O2 to vital organs. Consequently, one of the biggest effects could be an increased exercise-induced muscle fatigue, in both skeletal and cardiac muscles that can induce an increase of muscles injury markers including creatine kinase (CK), aspartate transferase (AST), and alanine transferase (ALT) when concerning the skeletal muscle, cardiac creatine kinase isoenzyme (CK-MBm) and cardiac troponin I (cTnI) when concerning the cardiac muscle, and lactate dehydrogenase (LDH) as index of muscle stress. The aim of this study is to investigate serum cardiac and skeletal muscle markers before and after a BH-diving training session.

Results

We found statistically significant increases of CK (T0: 136.1% p < 0.0001; T1: 138.5%, p < 0.0001), CK-MBm (T0: 145.1%, p < 0.0001; T1: 153.2%, p < 0.0001) LDH (T0: 110.4%, p < 0.0003; T1: 110.1%, p < 0.0013) in both T0 and T1 blood samples, as compared to basal value. AST showed a statistically significant increase only at T0 (106.8%, p < 0.0007) while ALT did not exhibit statistically significant changes. We did not find any changes in cTnI levels between pre-dive and post-dive samples.

Conclusions

Our data seem to indicate that during a BH-diving training session, skeletal and cardiac muscles react to physical effort releasing stress-related substances. Although the peculiar nature of BH-diving makes it difficult to understand if our results are related only to exercise induced muscle adaptation or whether acute hypoxia or a response to environmental changes (pressure) play a role to explain the observed changes, further studies are needed to better understand if these biomarker changes are linked to physical exercise or to acute hypoxia, or if both conditions play a role.
Vital and Clinical Signs Gathered Within the First Minutes After a Motorcycle Accident on a Racetrack: an Observational Study
Authors: Hugelius Karin , Lidberg Jerry , Ekh Linda , Örtenwall Per
Published: August 2021

Background

Little is known about vital signs during the very first minutes after an accident. This study aimed to describe the vital signs of motorcycle riders shortly after racetrack crashes and examine the clinical value of these data for the prehospital clinical assessments.

Methods

A retrospective observational cohort based on data from medical records on 104 motorcycle accidents at a racetrack in Sweden, covering the season of 2019 (May 01 until September 17), was conducted. Both race and practice runs were included. In addition, data from the Swedish Trauma Registry were used for patients referred to the hospital. Kruskal-Wallis test and linear regression were calculated in addition to descriptive statistics.

Results

In all, 30 riders (29%) were considered injured. Sixteen riders (15%) were referred to the hospital, and of these, five patients (5% of all riders) had suffered serious injuries. Aside from a decreased level of consciousness, no single vital sign or kinematic component observed within the early minutes after a crash was a strong clinical indicator of the occurrence of injuries. However, weak links were found between highsider or collision crashes and the occurrence of injuries.

Conclusion

Except for a decreased level of consciousness, this study indicates that the clinical value of early measured vital signs might be limited for the pre-hospital clinical assessment in the motorsport environment. Also, an adjustment of general trauma triage protocols might be considered for settings such as racetracks. Using the context with medical professionals at the victim’s side within a few minutes after an accident, that is common in motorsport, offers unique possibilities to increase our understanding of clinical signs and trauma in the early state after an accident.
Dynamic co-expression modular network analysis in nonalcoholic fatty liver disease
Authors: Zheng Jing , Wu Huizhong , Zhang Zhiying , Yao Songqiang
Published: August 2021

Background

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease affecting people’s health worldwide. Exploring the potential biomarkers and dynamic networks during NAFLD progression is urgently important.

Material and methods

Differentially expressed genes (DEGs) in obesity, NAFL and NASH were screened from GSE126848 and GSE130970, respectively. Gene set enrichment analysis of DEGs was conducted to reveal the Gene Ontology (GO) biological process in each period. Dynamic molecular networks were constructed by DyNet to illustrate the common and distinct progression of health- or obesity-derived NAFLD. The dynamic co-expression modular analysis was carried out by CEMiTool to elucidate the key modulators, networks, and enriched pathways during NAFLD.

Results

A total of 453 DEGs were filtered from obesity, NAFL and NASH periods. Function annotation showed that health-NAFLD sequence was mainly associated with dysfunction of metabolic syndrome pathways, while obesity-NAFLD sequence exhibited dysregulation of Cell cycle and Cellular senescence pathways. Nine nodes including COL3A1, CXCL9, CYCS, CXCL10, THY1, COL1A2, SAA1, CDKN1A, and JUN in the dynamic networks were commonly identified in health- and obesity-derived NAFLD. Moreover, CYCS, whose role is unknown in NAFLD, possessed the highest correlation with NAFLD activity score, lobular inflammation grade, and the cytological ballooning grade. Dynamic co-expression modular analysis showed that module 4 was activated in NAFL and NASH, while module 3 was inhibited at NAFLD stages. Module 3 was negatively correlated with CXCL10, and module 4 was positively correlated with COL1A2 and THY1.

Conclusion

Dynamic network analysis and dynamic gene co-expression modular analysis identified a nine-gene signature as the potential key regulator in NAFLD progression, which provided comprehensive regulatory mechanisms underlying NAFLD progression.
‘Why didn’t they see my scars?’ Critical thematic analysis of simulated participants’ perceived tensions surrounding objective structured clinical examinations
Authors: Corrigan Mairead , Reid Helen J. , McKeown Pascal P.
Published: August 2021

Background

Simulated participants (SPs) play an important role in simulated assessments of clinical encounters between medical students and patients, most notably in objective structured clinical examinations (OSCEs). SP contributions to OSCEs are invaluable, taking the role of a patient or carer. While SPs in some settings/contexts may rate students, their role has been problematized in the literature for their lack of agency within a standardised format of OSCEs that promotes reliability, objectivity and accountability. In this study, we explored SP experiences for tensions that result from simulated assessments and their potential implications for education.

Methods

Semi-structured interviews were conducted with seven SPs who were also tasked with providing a global mark for students. They were purposively selected to include women and men of different ages, occupation, education and experience as an SP. The interviews were analysed using a critical thematic analysis using a phenomenological approach.

Results

SP experiences directly addressed tensions and contradictions around OSCEs. SP participants described their experiences under four themes: industrialising, reducing, performativity and patient safety. OSCEs were compared to an industrial process that promoted efficiency but which bore no resemblance to real-life doctor-patient encounters. They were perceived to have a power and agency that reduced SPs to verbalising scripts to ensure that students were exposed to a standardised simulated experience that also underlined the performative role of SPs as props. These performative and reductionist experiences extended to students, for whom the mark sheet acted as a checklist, promoting standardised responses that lacked genuineness. All of this created a tension for SPs in promoting patient safety by ensuring that those medical students who passed were clinically competent.

Conclusions

OSCEs often form part of high-stakes exams. As such, they are governed by processes of industrialisation, accountability and standardisation. OSCEs possess a power and agency that can have unintended negative consequences. These include ‘conditioning’ students to adopt behaviours that are not suited to real-life clinical encounters and are not person-centred.
Safe use of radiopharmaceuticals in patients with chronic kidney disease: a systematic review
Authors: Schreuder Nanno , de Romijn Iris , Jager Pieter L. , Kosterink Jos G. W. , van Puijenbroek Eugène P.
Published: August 2021

Background

Patients with chronic kidney disease (CKD) may need to have their radiopharmaceutical dosage adjusted to prevent adverse effects and poor outcomes, but there are few recommendations on radiopharmaceutical dosing for this group of patients. The aim of this study is to provide an overview of the available information on radiopharmaceutical dose recommendations for patients with CKD.

Methods

We performed a systematic literature review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We conducted a literature search in the MEDLINE (PubMed) and Embase databases and screened potentially relevant studies using inclusion and exclusion criteria. We independently assessed the included observational studies’ methodologies and extracted relevant data.

Results

Of the 5795 studies first identified, 34 were included in this systematic review. These studies described three radiopharmaceuticals: [131I]sodium iodine, [18F]fludeoxyglucose, and [131I]iobenguane. Twenty-nine studies (85.3%) reported data on patients with CKD stage 5, while only three studies mentioned CKD patients in other stages (8.8%).

Conclusion

We found no consistent recommendations for radiopharmaceutical dosing in patients with CKD. Although some studies do mention dosing difficulties in patients with CKD, information is available for only a few radiopharmaceuticals, and recommendations are sometimes contradictory. Further research on radiopharmaceutical dosing in patients with CKD is needed to determine whether these patients require specific dosing, especially for therapeutic radiopharmaceuticals where a non-optimised dose may lead to an increased risk of toxicity for non-targeted organs. Including patients with CKD in studies and providing specific information about dosing in these patients should be a priority for the radiopharmaceutical community.
Symptoms and impacts of ambulatory nonsense mutation Duchenne muscular dystrophy: a qualitative study and the development of a patient-centred conceptual model
Authors: Williams Kate , Davidson Ian , Rance Mark , Boehnke Axel , Buesch Katharina , Acaster Sarah
Published: August 2021

Background

Duchenne muscular dystrophy is a rare genetic neuromuscular disorder, which can result in early death due to disease progression. Ataluren is indicated for the treatment of nonsense mutation Duchenne muscular dystrophy, in ambulatory individuals aged two years and older. This study explored the symptoms and impacts of nonsense mutation Duchenne muscular dystrophy and experience with ataluren.

Methods

Qualitative interviews were conducted with caregivers in the UK. Interviews were conducted by telephone, were recorded and transcribed. Data were analysed using thematic analysis and saturation was recorded.

Results

Ten interviews were conducted with parents of individuals aged 4–19 years. Key symptoms included muscle weakness and muscle breakdown, which were associated with limitations in physical function and pain. These impacted individuals’ daily activities, social activities and emotional wellbeing. These concepts and relationships were illustrated in a conceptual model, along with positive and negative moderating factors. Experience with ataluren and changes since initiation with treatment were discussed.

Conclusion

Individuals with nonsense mutation Duchenne muscular dystrophy experience a range of interrelated symptoms and functional issues which impact their broader health-related quality of life. Treatments which address this high unmet need have the potential to improve the health-related quality of life of these individuals.
Paradoxical role of hepatocyte growth factor in ischemic stroke: stroke risk/stroke recovery
Authors: Al-Ahmar Ibraheim , Mohamed Noha , Elshony Hosna
Published: August 2021

Background

Hepatocyte growth factor (HGF) has an obvious pathological role in atherosclerosis and plaque instability leading to an acute ischemic stroke; however, its beneficial role in stroke recovery is still restricted to experimental studies. The aim of the current study was to investigate the association between HGF and carotid atherosclerosis and evaluate its value as a prognostic marker of ischemic stroke and its role in stroke recovery.

Results

This case–control study was done on 100 patients with first time anterior circulation ischemic stroke, subjected to clinical and laboratory evaluation of atherosclerosis risk factors. Brain imaging, cardiac work-up and ultrasonographic assessment of carotid atherosclerosis (using intimal medial thickness and plaque score) were all done. Clinical evaluation of initial stroke severity, using National Institutes of Health Stroke Scale (NIHSS), and stroke outcome after 3 m, using Modified Rankin Scale (MRS), was performed. Measurement of HGF serum concentration was done to all stroke patients within 24 h of stroke onset and compared to results of 100 matched healthy subjects aged more than 50 years. HGF was significantly higher in stroke patients than healthy controls and in atherothrombotic than cardioembolic stroke group and its level was significantly correlated with atherosclerosis risk factors, degree of carotid atherosclerosis and better stroke outcome; however, it was not significantly correlated with initial stroke severity.

Conclusion

HGF is strongly associated with carotid atherosclerosis and other atherosclerosis risk factors and subsequent atherothrombotic stroke. Also, it can be used as a good prognostic marker in atherothrombotic stroke suggesting its role in stroke recovery but more studies are needed to explore this beneficial role as well as its therapeutic potentials in ischemic stroke patients.
Management of mucoid degeneration of the anterior cruciate ligament: a systematic review
Authors: Sweed Tamer , Mussa Mohamed , El-Bakoury Ahmed , Geutjens Guido , Metcalfe Andrew
Published: August 2021

Purpose

The purpose of this study was to investigate the outcomes of management of mucoid degeneration of the anterior cruciate ligament (MDACL) by performing a systematic review of methods of treatment that have been reported.

Methods

A systematic literature search in the databases MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus was performed through July 2020 by three independent reviewers. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and registered in the PROSPERO database (CRD42018087782). Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria.

Results

A total of nine studies were eligible for review. All nine studies assessed the outcome of arthroscopic debridement of MDACL. A total of 313 knees in 292 patients were included. The mean follow up ranged from 13 to 72 months. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). The rate of simultaneous meniscectomy ranged from 13 to 44%. Postoperative pain relief ranged from 53.8 to 95%. There was an improvement in postoperative range of motion and outcome scores (Lysholm and International Knee Documentation Committee scores and the Knee Injury and Osteoarthritis Outcome Score). Postoperative Lachman test was positive in 40% of patients, and 6% of patients had symptomatic instability. The mean MINORS score was 9.5 out of 16 (4–12).

Conclusions

Arthroscopic debridement of the anterior cruciate ligament (ACL) results in satisfactory pain relief and improvement in knee outcome scores. Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed.

Level of evidence

IV
The role of NKX2-5 gene polymorphisms in congenital heart disease (CHD): a systematic review and meta-analysis
Authors: Ashiq Sana , Ashiq Kanwal , Sabar Muhammad Farooq
Published: August 2021

Background

The gene NKX2-5 is a key transcription factor that plays an essential role in normal cardiac development. Although some recent studies have studied the role of polymorphisms in the NKX2-5 gene in congenital heart diseases (CHDs), the results were not consistent and remained uncertain. Therefore, we conduct a review of literature and investigate the association of genetic polymorphisms with CHDs.

Results

We selected seventeen studies regarding the association of NKX2-5 gene rs2277923 polymorphism with CHDs. Overall, in all the tested genetic models, the 63A > G polymorphism was not significantly associated with increased congenital heart defects risk. We used pooled odds ratios (OR) to calculate the association of CHDs with rs2277923 including allelic model: OR 1.00, 95% CI 0.82–1.21; homozygote model: OR 0.95, 95%CI 0.68–1.33, recessive model: OR 0.89 CI 0.70–1.13, heterozygote model: OR: 1.09, 95%CI 0.87–1.37, dominant model: OR 1.08 CI 0.82–1.42 and overdominant model: OR 1.17 CI 1.01–1.35. In addition, our analysis suggests that no publication bias exists in this meta-analysis.

Conclusions

Our findings suggested that 63A > G polymorphism in the NKX2-5 gene was not significantly associated with congenital heart defects. However, in the future, more studies with increased sample size are required that may provide us more definite conclusions.
Assessment of postural instability in Parkinson’s disease patients
Authors: Talaat Mohamed Aziz Mohamed , Elfatatry Amr , Noor Nibras Mohamed Ibrahim Mohamed , Eldeeb Mirhan
Published: August 2021

Background

Parkinson’s disease (PD) is a degenerative, progressive, neurological condition that influences the control of a person’s body movements. Computerized dynamic posturography (CDP) is a clinical tool intended to evaluate the integration of visual, vestibular, and somatosensory inputs to maintain postural gait. Posturography can be used to measure postural instability in PD patients. So, the aim of this study was to evaluate the postural control and elaborate on the pathophysiology of the balance impairment in PD patients in the “on” state.

Results

All antero-posterior (AP) and medio-lateral (ML) sensory balance scores, except vestibular ones, were significantly lower in the study group compared to the control group. AP and ML sway were generally higher in the study group at all frequencies, with AP being mostly greater compared to ML sway in PD subjects. Global sensory scores were shown to deteriorate with increased durations of the disease and treatment.

Conclusions

PD patients have higher postural instability in comparison to controls with AP sway being higher compared to ML.
Performance evaluation and stability analysis of malt barley (Hordeum vulgare L.) varieties for yield and quality traits in Eastern Amhara, Ethiopia
Authors: Assefa Abebe , Girmay Getawey , Alemayehu Tesfaye , Lakew Alemu
Published: August 2021

Background

Barley (Hordeum vulgare L.) is an annual cereal crop that belongs to the grass family Poaceae of the tribe Triticeae. It is the fifth most important cereal crop after teff, wheat, maize and sorghum in area coverage in Ethiopia. Important malting barley characteristics include kernel size, kernel protein content, extractable malt and diastatic power. Malt barely is an important crop in the study area; however, the productivity is low in the area varying from 15 kg ha−1 to 21 kg ha−1. The aim of the study was to identify high yielding, standard quality and stable malting barley variety to the study areas and similar agro-ecologies. Field experiments were conducted using eight improved malt barely varieties during the main cropping seasons (from the first week of July to end of October) in 2016 and 2017 at two selected sites Dehana (Amede work) and Lalibela (Medagai)) in north east Ethiopia. Data on grain yield and yield related traits, and quality attributes were recorded. Days to 50% heading (DH), and days to 90% maturity (DM) were recorded on plots basis. Plant height (PH, in cm), spike length (SPL, in cm), and number of seeds per spike (SPS) were measured on five randomly selected plants per plot of the central four rows. Mean grain yield (GY; grams of grain produced per plot, converted in kg ha−1), above ground dry biomass or biological yield (BY; dry weight of the above ground harvested biomass grams per plot, in kg ha−1) and thousand grain weight (TGW; weight of 1000 kernels, in grams) were measured on whole plots. Data were analyzed using SAS software program and significance of the mean difference was tested in least significant difference Test (LSD).

Result

The analysis of variance for grain yield and quality traits showed that the main effects of both genotypes and environments, and their interaction effect, were highly significant (P ≤ 0.01). The environment main effect accounted for 42%, 38% and 50% of the total grain yield, thousand kernel weight and kernel protein content variation, respectively. The average grain yield across varieties varied from 1652 kg ha−1 to 3377 kg ha−1.

Conclusions

Three malting barley varieties (IBON174/03, EH1847 and Bahati) were found to be relatively high yielding, stable for grain yield and full fill the quality parameters. Therefore, these varieties are recommended for production. A further study is required on agronomic practices and brewing quality attributes in malt barley.